Ciprofloxacin of 0,2%

General characteristics. Structure:

Active ingredients: 2 g of ciprofloxacin, 1,34 g of sodium of a lactate, 9 g of sodium of chloride in 1 l of infusion solution.

Antimicrobic drug of a broad spectrum of activity from group of ftorkhinolon.

Pharmacological properties:

Pharmacodynamics. Ciprofloxacin is active concerning the majority of gram-negative microorganisms: pyocyanic, hemophilic and intestinal sticks, shigellas, salmonellas, meningokokk, gonokokk, some kinds of enterococci; many strains of the stafilokokk (which are producing and not producing a penicillinase), a kampilobakter, легионелл, mycoplasmas, chlamydias, mycobacteria; and also the microorganisms producing beta lactamelements. Kpreparaturezistentna: Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Action concerning Treponemapallidumizucheno is not enough.

Bystry bactericidal effect of ciprofloxacin is connected with its unique nature of action. Ciprofloxacin, as well as other ftorkhinolona, blocks bacterial DNK-girazu and breaks the DNA function that causes death of bacteria. Ciprofloxacin damages a membrane of a bacterial cell that leads to an exit of cellular contents. It is effective both in a phase of reproduction of bacteria, and in a resting phase, it is also active concerning intracellular bacteria. Drug has considerable post-antibiotic effect — till six o'clock — and thus prevents growth of bacteria.

Pharmacokinetics. The maximum concentration in serum after intravenous administration of doses of 100 and 200 mg reach 2,0 and 3,8 mkg / млсоответственнои repeatedly exceed Mpkdl of the majority of microorganisms. Bioavailability makes about 70%.

Ciprofloxacin is very well distributed in an organism and reaches therapeutic concentration in the majority of fabrics and biological liquids of an organism, including a phlegm, bones, peritoneal liquid, a prostate and pelvic fabrics. Linkng with proteins of 19-40%.

It is removed preferential by kidneys (45% in not changed look, 11% - in the form of metabolites). Other part of a dose is allocated through intestines (20% - in not changed look, 5-6% - in the form of metabolites). The elimination half-life makes 3-5 h.

Indications to use:

Ciprofloxacin is shown for treatment of the following infections caused by microorganisms, sensitive to it:

Respiratory infections: pneumonia, bronchial pneumonia, the infected pleurisy, an empyema, the lung abscess infected bronchiectasias, an exacerbation of chronic bronchitis and pulmonary infections at the patients suffering from a mucoviscidosis.

Infections of urinary tract: acute and chronic pyelonephritis, prostatitis, cystitis, epididymite and chronic uncomplicated recurrence of infections of an uric path; gonorrhea.

Infections of an ear, throat, nose: average otitis, sinusitis, mastoiditis.

Infections of skin and soft tissues: the infected ulcers, abscesses, cellulitis, outside otitis infected burns.

Digestive tract infections: typhoid, bacterial diarrheas.

Intraperitoneal infections: peritonitis, intraperitoneal abscesses, cholangitis, cholecystitis, empyema of a gall bladder.

Gynecologic infections: salpingitis, endometritis, inflammatory diseases of pelvic bodies.

Infections of bones and joints: acute and chronic osteomyelitis, septic arthritis.

Heavy system infections: a septicaemia, bacteremia, infections at patients with disturbances of immune system.

Route of administration and doses:

Doses of intravenous administration of ciprofloxacin are established individually depending on localization and weight of a course of an infection, a species of microorganism, age, body weight and a condition of function of kidneys of the patient.

At infections of urinary tract appoint 100 mg twice a day. At lower respiratory tract infections – to 200 mg there are each 12 hours. At acute gonorrhea drug is appointed once in a dose of 100 mg. At very heavy infections and weak sensitivity of the activator it is possible to raise a dose to 400 mg three times a day. For prevention of infections at surgical interventions appoint 200 – 400 mg in 30 min. or 1 h before operation. Lasting operation over 4 watch the drug is administered repeatedly in the same dose.

Duration of infusion has to make 30 min. at a dose of 100 mg and 60 min. at a dose of 200 mg.

The general daily dose at patients with heavy renal disturbances (clearance of creatinine – 20 ml/min.) has to be cut by half.

To children. Usually are not recommended to appoint ciprofloxacin children and teenagers (up to 15 years). However if the advantage of drug exceeds potential risk, it is necessary to appoint 5-10 mg/kg a day in two divided doses depending on weight of an infection.

Infusion solution of ciprofloxacin contains 0,9% solution of chloride sodium therefore does not demand additional cultivation.

The course of treatment depends on weight of an infection, clinical improvement and data of the bacteriological analysis. Usually a course of treatment at acute infections of 5-7 days. Treatment has to continue, at least, within three days after disappearance of signs and symptoms of an infection.

Features of use:

As ciprofloxacin can stimulate TsNS, it is necessary to appoint it with care the patient with disturbances of TsNS, such as arteriosclerosis of vessels of a brain or epilepsy.

The patients using this drug have to be well hydrated to prevent a crystalluria.

It is necessary to avoid excessive shift of reaction of urine in the alkaline party.

Side effects:

From digestive sistemy:toshnota, vomiting, diarrhea, abdominal pain, increase in activity of hepatic transaminases, ShchF, LDG, bilirubin, pseudomembranous colitis.

From TsNS: headache, dizziness, feeling of fatigue, frustration of a dream, dreadful dreams, hallucinations, faints, visual disturbances.

From an urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminouriya, hamaturia, tranzitorny increase in content in creatinine blood serum.

From system of a hemopoiesis: eosinophilia, leukopenia, neutropenia, change of quantity of thrombocytes.

From cardiovascular system: tachycardia, disturbances of a cordial rhythm, arterial hypotension.

Allergic reactions: skin itch, small tortoiseshell, Quincke's edema, Stephens-Johnson's syndrome, arthralgias.

The side reactions connected with chemotherapeutic action: candidiasis.

Local reactions: morbidity, phlebitis. At use of eye drops easy morbidity and a hyperemia of a conjunctiva are in certain cases possible.

Interaction with other medicines:

Concentration of theophylline in blood serum and the period of its semi-removal can increase at its co-administration with ciprofloxacin therefore it is recommended to monitor carefully emergence of symptoms of teofillinovy intoxication and, in case of need, to regulate a dose.

Probenetsid detains release of ciprofloxacin.

Contraindications:

Ciprofloxacin is contraindicated to patients with hypersensitivity to ciprofloxacin and other hinolonovy derivatives, and also women during pregnancy and feeding with a breast.

Overdose:

The specific antidote is unknown. It is necessary to control carefully a condition of the patient, to make a gastric lavage, to carry out usual measures of acute management, to provide sufficient intake of liquid. By means of haemo - and peritoneal dialysis it can be removed only insignificant (less than 10%) amounts of drug.

Storage conditions:

List B. In the dry, protected from light place at a temperature not above + 25 °C. Period of validity 2 years.

Issue conditions:

According to the recipe

Packaging:

On 100, 250 and 500 ml in polymeric containers for infusion solutions.