Aznam Dzh

General characteristics. Structure:

Active ingredient: 0,5 g or 1 g of an azetreonam in terms of anhydrous to aztreona.

Excipients: L-arginine.

Pharmacological properties:

Pharmacodynamics. Monocyclic beta лактамный antibiotic. A kernel of a molecule is alpha methyl-3-amino-mono-baktamnaya acid. Suppresses synthesis of a cell wall, works bakteritsidno, it is steady against beta lactamelements of gram-negative bacteria.

It is active concerning gram-negative aerobic activators (Salmonella spp., Shigella spp., Proteus spp., Escherichia coli, Klebsiella spp., Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, Pseudomonas aeruginosa, Entero-Citrobacter spp.), does not affect gram-positive microorganisms and anaerobe bacterias.

Appointment at an allergy to penicillin, cephalosporins and karbapenema is possible. Between aztreonamy and aminoglycosides there is a cross resistance. Seldom causes dysbacteriosis.

Pharmacokinetics. At intramuscular introduction absorption - bystry. Time of achievement of the maximum concentration (Tstakh) is 1 h. The maximum concentration (Stakh) - later in/in introductions of 0.5, 1 and 2 g - 54, 90 and 204 mkg/ml respectively. Passes gistogematichesky barriers and well gets into fabrics. The elimination half-life (T1/2) - 1.7 h (at normal function of kidneys), at disturbance of secretory function and at advanced age - is extended.

Gets through a blood-brain barrier (GEB) at an inflammation of a meninx, gets through a placenta, it is allocated with breast milk. It is slightly metabolized in a liver. 60-75% are removed by kidneys in not changed look, 12% - through intestines.
At a hemodialysis concentration in blood decreases by 30-60%.

Indications to use:

Sepsis, endocarditis, meningitis, peritonitis, lower respiratory tract infections (pneumonia, abscess of lungs, a pleura empyema, bronchitis), infections of bodies of the digestive tract (DT), an infection of biliary tract (a cholangitis, cholecystitis, a coloenteritis), infections of kidneys and urinary tract, the urogenital sphere (gonorrhea, pyelonephritis, an urethritis, cystitis, an endometritis), infections of bones, skin and soft tissues, the localized parenchymatous abscesses infected burns and wounds, infections or threat of infections at patients with reduced immunity, postoperative infections (including prevention).

Route of administration and doses:

Intramusculary, intravenously struyno and kapelno. At pyelonephritis and infections of urinary tract appoint 2-3 times, in oil on 0,5-1 g, a day. At system infections of a medium-weight current - on 1-2 g 2-3 times a day; at system infections of a heavy current - on 2 g 2-4 times a day. The maximum daily dose - 8 g.

At treatment of acute uncomplicated gonorrhea and acute uncomplicated cystitis - 1 g once in oil.

At sepsis, peritonitis enter in/in; for jet in/in introductions drug is dissolved in 6-10 ml of water for injections; enter within 3-5 min.; for in drop infusion of 1 g of drug dissolve in 3 ml of water for injections and dissolve 0,9% of NaCl solution in 50-100 ml.

To children 9 months are aged more senior appoint 30 mg/kg 3-4 times a day; to children 2 years at the heavy course of infections are more senior - 50 mg/kg 3-4 times a day. At HPN (KK of 10-30 ml/min.) appoint a half of an average single dose.

Side effects:

Allergic reactions: skin rash, skin itch, multiformny exudative erythema, petechias, small tortoiseshell.

From the alimentary system: diarrhea, nausea, vomiting, stomatitis, taste change, candidiasis.

From a nervous system: spasms, diplopia, sleeplessness, dizziness, headaches, confusion of consciousness. From a musculoskeletal system: mialgiya, arthralgia.

Laboratory indicators: eosinophilia, thrombocytopenia, increase in a prothrombin time, anemia, neutropenia, increase in activity of "hepatic" transaminases (ALT and ACT) and alkaline phosphatase (AP).

Local reactions: at in introduction - phlebitis, thrombophlebitis, unpleasant feelings in the place in oil of introduction.

Others: swelling of mammary glands, the increased sweating.

Interaction with other medicines:

Pharmaceutical it is incompatible with heparin and metronidazole.

Synergism – with Vancomycinum, clindamycin, aminoglycosides, penicillin, cephalosporins, karbapenema, metronidazole.

Contraindications:

Hypersensitivity, the chronic renal failure (CRF) (the clearance of creatinine (CC) less than 10 ml/min.), a liver failure, pregnancy, the lactation period, children's age (up to 9 months).

With care. Allergic reactions to others beta лактамные antibiotics.

Overdose:

Symptoms: polymorphic nonspecific manifestations.

Treatment: symptomatic, haemo - or peritoneal dialysis.

Storage conditions:

To store in the dry, protected from light place at a temperature not above 25 °C. To store in the place, unavailable to children. A period of validity - 3 years. Not to use after expiry date.

Issue conditions:

According to the recipe

Packaging:

On 0,5 or 1,0 g of active ingredient in the bottle of colourless glass corked by a stopper from the chlorbutyl rubber rolled by an aluminum cap, and a plastic cap. On 1 bottle together with the application instruction in a pack cardboard.