Yuav siv li cas Amoxiclav 312?

Hmoov rau kev tshem tawm ntawm qhov ncauj, 156.25 mg / 5 ml thiab 312,5 mg / 5 ml

5 ml ntawm kev ncua (1 tshuaj pipette) ntim

yam tshuaj: amoxicillin li amoxicillin trihydrate 125 mg, clavulanic acid li potassium clavulanate 31.25 mg (rau noj 156.25 mg / 5 ml) lossis amoxicillin li amoxicillin trihydrate 250 mg, clavulanic acid li potassium clavulanate 62.5 mg (rau kev noj tshuaj 312,5 mg / 5 ml)

zam txim: anhydrous citric acid, anhydrous sodium citrate, microcrystalline cellulose, sodium carboxymethyl cellulose, xanthan ntawm cov pos hniav, anhydrous colloidal silicon dioxide, silicon dioxide, Strawberry flavouring (rau ntau npaum ntawm 156.25 mg / 5 ml), Wild Cherry flaving (rau ntau npaum ntawm 312,5 mg / 5 ml), sodium benzoate, sodium saccharin, mannitol.

Crystalline hmoov los ntawm dawb mus rau lub teeb daj.

Qhov npaj ncua kev kawm yog qhov homogeneous kev ncua los ntawm yuav luag dawb rau daj.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Amoxicillin thiab clavulanic acid yog ua kom yaj tag hauv kev daws teeb meem ntawm pH ntawm lub cev. Ob qho khoom siv tau zoo nqus tom qab kev tswj hwm ntawm qhov ncauj. Nws yog qhov zoo dua rau noj amoxicillin / clavulanic acid lub sijhawm lossis thaum pib noj mov. Tom qab kev tswj hwm ntawm qhov ncauj, lub bioavailability ntawm amoxicillin thiab clavulanic acid yog kwv yees li 70%. Lub zog puab ntawm kev saib xyuas ntawm cov tshuaj nyob rau hauv lub plasma ntawm ob feem sib xyaw zoo ib yam nkaus. Qhov siab tshaj tawm cov dej siab tau mus txog 1 teev tom qab kev tswj hwm.

Qhov ntau ntawm amoxicillin thiab clavulanic acid nyob rau hauv cov ntshav ntshav thaum noj cov tshuaj amoxicillin / clavulanic acid ua ke yog zoo li cov tau pom nrog lub qhov ncauj cais cov tshuaj ntawm qhov sib npaug ntawm amoxicillin thiab clavulanic acid.

Txog 25% ntawm tag nrho cov nyiaj ntawm clavulanic acid thiab 18% ntawm amoxicillin khi rau cov ntshav protein. Qhov ntim ntawm kev faib tawm rau kev tswj hwm qhov ncauj ntawm cov tshuaj yog kwv yees 0.3-0.4 l / kg ntawm amoxicillin thiab 0.2 l / kg ntawm clavulanic acid.

Tom qab kev tswj hwm kev siv tshuaj, ob qho tib si amoxicillin thiab clavulanic acid tau pom nyob hauv lub zais zis, cov tawv nqaij ntawm lub plab hauv plab, tawv nqaij, rog, cov leeg nqaij, synovial thiab peritoneal kua, kua tsib thiab kua paug. Amoxicillin nkag mus rau hauv lub cev tsis zoo ua kua dej.

Amoxicillin thiab clavulanic acid hla qhov chaw tiv thaiv hniav. Ob seem puav leej sib kis mus rau niam mis.

Amoxicillin yog qee cov tso tawm hauv cov zis hauv daim ntawv ntawm tsis muaj zog penicillic acid nyob rau hauv ntau npaum li 10 - 25% ntawm thawj koob tshuaj. Clavulanic acid yog metabolized nyob rau hauv lub cev thiab nthuav tawm hauv cov zis thiab quav, ntxiv rau hauv cov qauv ntawm cov pa roj carbon dioxide nrog cov pa tawm ntawm huab cua.

Qhov nruab nrab kev tshem tawm ib nrab-lub neej ntawm amoxicillin / clavulanic acid yog li 1 teev, thiab qhov nruab nrab tag nrho kev sib tw yog kwv yees li 25 l / teev. Li ntawm 60-70% ntawm amoxicillin thiab 40-65% ntawm clavulanic acid raug tso tawm tsis hloov pauv hauv cov zis hauv thawj 6 teev tom qab noj ib qho tshuaj amoxicillin / clavulanic acid ntsiav tshuaj. Thaum lub sij hawm ntau cov kev tshawb fawb, nws tau pom tias 50-85% ntawm amoxicillin thiab 27-60% ntawm clavulanic acid tau tawm hauv cov zis hauv 24 teev. Qhov loj tshaj plaws ntawm clavulanic acid tau tawm hauv thawj 2 teev tom qab daim ntawv thov.

Kev siv ib txhij ntawm probenecid qeeb ua rau kev tso tawm ntawm amoxicillin, tab sis cov tshuaj no tsis cuam tshuam qhov cuam tshuam ntawm clavulanic acid los ntawm ob lub raum.

Ib nrab-lub neej ntawm amoxicillin zoo ib yam li cov menyuam yaus hnub nyoog 3 hlis txog 2 xyoos, tseem yog menyuam yaus thiab neeg laus. Thaum muab tshuaj rau cov menyuam yaus me (nrog rau cov menyuam mos thaum yug los) hauv thawj lub limtiam ntawm lub neej, cov tshuaj yuav tsum tsis txhob siv ntau dua ob zaug hauv ib hnub, uas cuam tshuam nrog kev hloov lub plawv tsis ua haujlwm ntawm cov menyuam yaus. Vim tias qhov tseeb tias cov neeg laus laus feem ntau yuav mob lub raum, lub tshuaj yuav tsum tau txiav txim nrog kev ceev faj rau pawg neeg mob no, tab sis yog tias tsim nyog, kev tshuaj xyuas lub raum kev ua haujlwm yuav tsum tau ua.

Tag nrho kev tshem tawm ntawm amoxicillin / clavulanic acid nyob rau hauv cov ntshav txo qis hauv cov xaim ncaj qha rau ib qho kev txo qis hauv kev ua haujlwm. Qhov txo qis ntawm amoxicillin tshem tawm yog qhov tshaj tawm piv rau clavulanic acid, txij li ntau dua ntawm amoxicillin yog tawm dhau los ntawm lub raum. Yog li, thaum muab tshuaj rau cov neeg mob uas lub raum tsis ua haujlwm, yuav tsum tau txhaj tshuaj kho kom tsis txhob muaj cov tshuaj amoxicillin ntau ntau thiab tswj cov qib clavulanic acid yuav tsum tau ua.

Thaum muab tshuaj rau cov neeg mob uas lub siab tsis ua hauj lwm zoo, yuav tsum ceev faj thaum xaiv ib koob thiab soj ntsuam daim siab ua haujlwm tas li.

Cov Tshuaj Hauv Tshuaj

Amoxicillin yog tshuaj tua kab mob ib nrab los ntawm pawg neeg penicillin (beta-lactam tshuaj tua kab mob) uas tiv thaiv ib lossis ntau tshaj li cov enzymes (feem ntau hu ua penicillin-khi cov protein) koom nrog biosynthesis ntawm peptidoglycan, uas yog ib qho tseem ceeb qauv ntawm cov kab mob ntawm tes ua phab ntsa. Kev txwv tsis pub peptidoglycan hluavtaws ua rau kev ua haujlwm tsis zoo ntawm lub xovtooj ntawm phab ntsa, feem ntau ua raws li cov cell lysis thiab cell tuag.

Amoxicillin raug pov tseg los ntawm beta-lactamases uas ua los ntawm cov kab mob tiv taus, thiab yog li ntawd, kev ua si spectrum ntawm amoxicillin ib leeg tsis suav nrog cov kab mob me me uas tsim cov enzymes no.

Clavulanic acid yog beta-lactam kev txuam nrog penicillins. Nws inhibits qee qhov beta-lactamases, yog li tiv thaiv qhov ua tsis tiav ntawm amoxicillin thiab nthuav nws cov kev ua haujlwm spectrum. Clavulanic acid nws tus kheej tsis muaj qhov chaw mos ua rau muaj kev cuam tshuam loj heev rau kev kho mob.

Tshaj lub sijhawm dhau los ntawm qhov kev txwv qis tshaj plaws (T> IPC) yog suav tias yog qhov kev txiav txim siab tseem ceeb ntawm cov hauj lwm zoo ntawm amoxicillin.

Ob txoj haujlwm tseem ceeb ntawm kev ua rau amoxicillin thiab clavulanic acid yog:

inactivation los ntawm cov kab mob beta-lactamases uas tsis tau txhawm los ntawm clavulanic acid, suav nrog cov chav kawm B, C thiab D.

ib qho kev hloov pauv ntawm kev sib txuas ua ke ntawm penicillin, uas txo qis kev sib raug zoo ntawm cov tshuaj tua kab mob mus rau lub hom phiaj.

Lub zog tsis haum ntawm cov kab mob lossis cov txheej txheem ntawm lub efflux twj tso kua mis (thauj cov tshuab) tuaj yeem ua rau lossis tswj qhov tsis kam ntawm cov kab mob, tshwj xeeb tshaj yog cov kab mob gram-tsis zoo.

Ciaj ciam qhov tseem ceeb ntawm MIC rau amoxicillin / clavulanic acid yog cov tau txiav txim siab los ntawm European Pawg Neeg Saib Xyuas Kev Tiv Thaiv Antimicrobial Rhiab (EUCAST).

Tso cov ntaub ntawv thiab cov nyob ua ke

Daim ntawv ntau ntau ntawm cov tshuaj visually yog cov hmoov dawb npaj rau kev npaj ncua kev kawm. Kev sib xyaw ntawm 250 mg ntawm amoxicillin trihydrate (lossis 500 mg) thiab 62 mg ntawm clavulanic acid nyob rau hauv daim ntawv ntawm cov ntsev potassium (125 mg) yog siv los ua cov sib xyaw nquag. Txhawm rau txhawm rau txhim kho palatability thiab txhim kho kev nyab xeeb, cov tshuaj nquag tau ntxiv nrog cov khoom hauv qab no:

• colloidal lub cev qhuav dej silica,
• Tsiaj qus Cherry Flavor
• benzoate, carboxycellulose thiab sodium saccharin,
• microcrystalline cellulose,
• xanthan ntawm cov pos hniav,
• mannitol.

Cov tshuaj tua kab mob yog siv hauv cov kis mob.

Cov tshuaj yog muaj nyob hauv khob iav. Thaum diluting hmoov nrog dej rwg, ib qho kev ua tiav tiav tau, uas yog homogeneous sib xyaw nrog ib qho dawb lossis daj zas.

Pharmacological kev txiav txim

Cov tshuaj yog cov tshuaj tua kabmob, tua cov kab mob ntawm cov kab mob me me. Cov txheej txheem ntawm kev ua yog raws li ua haujlwm ntawm antoxicillial ntawm amoxicillin, ib qho kev sib tshooj semisynthetic los ntawm pawg neeg penicillin. Tus neeg sawv cev Beta-lactam inhibits qhov kev ua si enzymatic ntawm cov tshuaj uas lub luag haujlwm rau cov synthesis ntawm peptidoglycan. Qhov kev sib xyaw no yog qhov tsim nyog rau kev sib txuas lus ib leeg thiab ntxiv dag zog rau daim nyias nyias ntawm lub cev kis tau. Thaum nws raug rhuav tshem, lub plhaub sab nraud pov tseg lawm, thiab cov kab mob hauv lub cev tuag hauv qab ntawm osmotic siab.

Tib lub sijhawm, amoxicillin tsis ua haujlwm tawm tsam cov kab mob me me uas tsim cov beta-lactamases. Cov Enzymes rhuav tshem cov tshuaj tua kab mob ib nrab, yog li cov ntsev ntsev ntawm clavulanic acid tau ntxiv rau cov tshuaj los tiv thaiv nws. Nws inhibits kev ua haujlwm ntawm beta-lactamases, thaum amoxicillin ua rau kev tuag ntawm cov kab mob. Ua tsaug rau qhov kev sib xyaw ua ke no, tus neeg sawv cev tiv thaiv kab mob tau txuas ntxiv ntawm kev ua.

Cov Tshuaj Pharmacokinetics

Thaum siv txoj kev tshem tawm kev hais lus, ob qho kev sib xyaw ua ke raug tso tawm nyob rau hauv qhov kev txiav txim ntawm esterases nyob rau hauv txoj hnyuv thiab tau nqus rau hauv phab ntsa ntawm cov hnyuv me. Thaum lawv nkag rau hauv cov hlab ntshav, semisynthetic penicillin thiab beta-lactam ncav cuag cov ntshav siab tshaj plaws nyob rau hauv ib teev. Ob qho sib txuas ua ke tsis khi rau cov protein plasma. Nrog albumin, cov ntaub ntawv nyuaj tsuas yog 18-20% ntawm cov tshuaj nquag.

Thaum lawv nkag rau hauv cov hlab ntshav, semisynthetic penicillin thiab beta-lactam ncav cuag cov ntshav siab tshaj plaws nyob rau hauv ib teev.

Amoxicillin yauv raug mob biotransformation hauv hepatocytes rau tsawg dua li clavulanic acid. Cov tshuaj yeeb dej caw tawm sab nraud los ntawm lub raum los ntawm kev pom kev txhaws hauv nws daim ntawv qub. Ib qhov nqi ntawm clavulanate tawm hauv lub cev hauv daim ntawv ntawm cov khoom lag luam metabolic nrog quav. Qhov kev tshem tawm ib nrab-lub neej ua rau txog 60-90 feeb.

Kev ntsuas rau siv

Cov tshuaj yog siv rau cov kab mob ntawm cov kab mob tshwm sim los ntawm kev tsis tuaj yeem loj hlob ntawm cov kab mob pathogenic:

• kis kab mob ntawm cov pa hauv siab thiab cov kabmob ENT: pharyngeal abscess, mob ntawm tus hlab ntsha o thiab hlab ntsha txhaws, mob otitis media, tonsillitis, sinusitis,
• inflammatory kab mob ntawm lub ntsws thiab bronchi (mob ntsws, mob ntsws),
• kev sib kis ntawm kev txhab ntawm kev txhab, kev puas tsuaj rau cov pob txha mos (osteomyelitis), kis mob ntawm cov nqaij mos mos,
• mob hniav (alveolitis),
• kev puas tsuaj rau cov khoom sib tsoo thiab lub zais zis,
• cov kab mob gynecological thiab cov kab mob sib kis (sib deev gonorrhea thiab mob chlamydia).

Cov tshuaj muaj cai rau kev siv los tiv thaiv postoperative teeb meem tshwm sim los ntawm qhov muaj tus kab mob, los yog siv rau kev kho pob txuv provoked los ntawm kev loj hlob ntawm staphylococcus.