Litaelo bakeng sa ts'ebeliso ea lithethefatsi, li-analogues, litekolo

Nomoro ea ngoliso: P N015030 / 04-131213
Lebitso la Brand: Augmentin®
Lebitso la machabeng leo e seng la thekiso kapa sehlopha: amoxicillin + clavulanic acid.
Foromo ea boholo ba phofo: Phofo ea ho emisoa bakeng sa tsamaiso ea molomo.

Sebopeho sa moriana
Lintho tse sebetsang:
Amoxicillin trihydrate ho latela amoxicillin 125.0 mg, 200.0 mg kapa 400.0 mg ka 5 ml ea ho emisoa.
Potasiamo clavulanate ho latela clavulanic acid 31.25 mg, 28,5 mg kapa 57.0 mg ka 5 ml ea ho emisoa.
Baeti:
Xanthan gum, aspartame, acid ea presinicon, colloidal silicon diode, hypromellose, flavors ea lamunu 1, tatso ea lamunu 2, tatso ea raspberry, flavored molasses, silicon dioxide.
Tekanyo ea likarolo tse sebetsang ho emisoa

Foromo ea boholo ba karo-karolelano ea likarolo tse sebetsang Amoxicillin, mg (ka sebopeho sa amoxicillin trihydrate) Clavulanic acid, mg (ka sebopeho sa potasiamo clavulanate)
Phofo ea ho emisoa 125 mg / 31.25 mg ho 5 ml 4: 1 125 31.25
Phofo ea ho emisoa 200 mg / 28,5 mg ho 5 ml 7: 1,200 28,5
Phofo bakeng sa ho hlophisoa ha ho emisoa ha 400 mg / 57 mg ho 5 ml 7: 1 400 57

Tlhaloso
Bakeng sa litekanyetso tsa 125 mg / 31.25 mg ho 5 ml: phofo ea mmala o mosoeu kapa o batlang o le tšoeu, o nang le monko o ikhethang. Ha e kenngoa, ho emisoa ka bosoeu kapa hoo e ka bang bosoeu. Ha e eme, e bosoeu kapa e batlang e tšoeu e bopa butle butle.
Bakeng sa litekanyetso tsa 200 mg / 28,5 mg ka 5 ml kapa 400 mg / 57 mg ka 5 ml: phofo e tšoeu kapa e batlang e tšoeu, e nang le monko oa semelo. Ha e kenngoa, ho emisoa ka bosoeu kapa hoo e ka bang bosoeu. Ha e eme, e bosoeu kapa e batlang e tšoeu e bopa butle butle.

Sehlopha sa setso: Antibiotic, nusu-synthetic penicillin + beta-lactamase inhibitor.

Khoutu ea ATX: J01CR02

TLHALOSO YA PHARMACOLOGICAL

Mofumahali
Mokhoa oa ketso
Amoxicillin ke motsoako o mongata oa tlhaho o pharalletseng o nang le lintho tse khahlanong le likokoana-hloko tse ngata tse ntle tsa gram le gram-negative. Ka nako e ts'oanang, amoxicillin e kotsing ea ho felisoa ke beta-lactamases, ka hona bongata ba ts'ebetso ea amoxicillin ha bo fetele ho likokoana-hloko tse hlahisang enzyme ena.
Clavulanic acid, beta-lactamase inhibitor e amanang le penicillin, e khona ho inactivate ea mefuta e mengata ea beta-lactam e fumanoang penicillin le cephalosporin e loants'ang likokoana-hloko. Clavulanic acid e na le katleho e lekaneng khahlanong le plasmid beta-lactamases, eo hangata e khethollang ho hanyetsa ha libaktheria, mme e sa sebetseng khahlano le mofuta oa 1 oa chromosomal beta-lactamases, o sa thibeloang ke clavulanic acid.
Ho ba teng ha clavulanic acid ha ho hlophisoa Augmentin® ho sireletsa amoxicillin hore e se ke ea senngoa ke li-enzyme - beta-lactamases, tse lumellang ho holisa bongata ba antibacterial ea amoxicillin.
Se latelang ke mosebetsi oa ho kopanya oa in vitro oa amoxicillin le clavulanic acid.
Bacteria e atisang ho ba teng ha e kopana le amoxicillin le clavulanic acid
Li-aerobes tse ntle tsa gram
Bacillus anthracis
Enterococcus faecalis
Listeria monocytogene
Nocardia asteroides
Streptococcus pyogene1,2
Streptococcus agalactiae 1.2
Streptococcus spp. (tse ling beta hemolytic streptococci) 1,2
Staphylococcus aureus (methicillin e hlokolosi) 1
Staphylococcus saprophyticus (methicillin sensative)
Coagulase-negative staphylococci (e amehang ka methicillin)
Li-anaerobes tse ntle le tse ntle
Clostridium spp.
Peptococcus niger
Pusostreptococcus magnus
Peptostreptococcus micros
Peptostreptococcus spp.
Li-aerobes tse senang maikutlo
Bordetella pertussis
Haemophilus influenzae1
Helicobacter pylori
Moraxella catarrhalis1
Neissevia gonorrhoeae
Pasteurella multocida
Vibrio k'holera
Li-anaerobes tse senang maikutlo
Bacteroides fragilis
Bacteroides spp.
Capnocytophaga spp.
Eikenella corrodens
Fusobacterium nucleatum
Fusobacterium spp.
Porphyromonas spp.
Prevotella spp.
Tse ling
Borrelia burgdorferi
Leptospira icterohaemorrhagiae
Treponema pallidum
Bacteria eo ka eona e ileng ea hanyetsa motsoako oa amoxicillin le clavulanic acid e kanna ea ba teng
Li-aerobes tse senang maikutlo
Escherichia coli1
Klebsiella oxetoca
Klebsiella pneumoniae1
Klebsiella spp.
Proteus mirabilis
Proteus vulgaris
Proteus spp
Salmonella spp
Shigella spp.
Li-aerobes tse ntle tsa gram
Corynebacterium spp.
Enterococcus faecium
Streptococcus pneumoniae 1.2
Li-squid tsa sehlopha sa Streptococcus
Bacteria e hanyetsanang ka tlhaho le motsoako oa amoxicillin le clavulanic acid
Li-aerobes tse senang maikutlo
Spinetobacter spp.
Citrobacter freundii
Enterobacter spp.
Hafnia alvei
Legionella pneumophila
Morganella morganii
Providencia spp.
Pseudomonas spp.
Serratia spp
Stenotrophomonas maltophilia
Yersinia enterocolitica
Tse ling
Chlamydia pneumoniae
Chlamydia psittaci
Chlamydia spp.
Coxiella burnetii
Mycoplasma spp.
1 - bakeng sa libaktheria tsena, ts'ebetso ea bongaka ea motsoako oa amoxicillin le clavulanic acid e bontšitsoe lithutong tsa bongaka.
2 - mefuta ea mefuta ena ea libaktheria ha e hlahise beta-lactamase.
Sensitivity le amoxicillin monotherapy e fana ka maikutlo a tšoanang le a kopantsoeng ea amoxicillin le clavulanic acid.
Mofumahali
Suction
Lithako ka bobeli tse sebetsang tsa lithethefatsi Augmentin®, amoxicillin le clavulanic acid, li kenella ka potlako le ka botlalo ho tsoa pampiring ea gastrointestinal (GIT) kamora ho tsamaisoa ka molomo. Ho kenngoa ha lintho tse sebetsang tsa tokiso ea Augmentin® ho nepahetse ha ho nooa moriana qalong ea lijo.
Litekanyetso tsa pharmacokinetic tsa amoxicillin le clavulanic acid tse fumanoeng ka teko ea bongaka li bontšoa ka tlase, ha baithaopi ba phetseng hantle ba lilemo tse 2-12 ba le ka mpeng e se nang letho ba nkile Augmentin® phofo bakeng sa ho emisoa ka molomo, 200 mg / 28,5 mg ka 5 ml (228 , 5 mg) ka tekanyetso ea 45 mg / 6.4 mg / kg ka letsatsi, e arotsoe ka litekanyetso tse peli.
Litekanyetso tsa mantlha tsa pharmacokinetic

Motsoako o sebetsang oa Cmax (mg / l) Tmax (lihora) AUC (mg × h / l) T1 / 2 (lihora)
Amoxicillin 11.99 ± 3.28 1.0 (1.0-2.0) 35.2 ± 5.01.22 ± 0.28
Clavulanic acid 5.49 ± 2.71 1.0 (1.0-2.0) 13.26 ± 5.88 0.99 ± 0.14

Litekanyetso tsa pharmacokinetic tsa amoxicillin le clavulanic acid tse fumanoeng tekong ea bongaka li bontšoa ka tlase ha baithaopi ba phetseng hantle ba nkile tekanyetso e le 'ngoe ea Augmentin®, phofo bakeng sa ho emisoa ka molomo, 400 mg / 57 mg ka 5 ml (457 mg).
Litekanyetso tsa mantlha tsa pharmacokinetic

Motsoako o sebetsang oa Cmax (mg / l) Tmax (lihora) AUC (mg × h / l)
Amoxicillin 6.94 ± 1.24 1.13 (0.75-1.75) 17.29 ± 2.28
Clavulanic acid 1.10 ± 0.42 1.0 (0.5-1.25) 2.34 ± 0.94

Cmax - boholo ba mahloriso a plasma.
Tmax - nako ea ho fihlela mahloriso a mangata a plasma.
AUC ke sebaka se tlas'a mohokelo oa nako ea mahloriso.
T1 / 2 - halofo ea bophelo.
Tsamaiso
Joalo ka kopants'o e kenelletseng ea amoxicillin le clavulanic acid, kalafo ea methapo ea amoxicillin le clavulanic acid e fumanoa linthong tse fapaneng le mokelikeli oa methapo (ka mokokotlong, mathoasong a mpa ea mpa, letlalo, adipose le mesifa ea mesifa, mokelikeli oa methapo ea kutlo le lefutso). .
Amoxicillin le clavulanic acid li na le tekanyo e fokolang ea ho tlama liprotheine tsa plasma. Boithuto bo bontšitse hore 25% ea kakaretso eohle ea clavulanic acid le 18% ea amoxicillin e plasma ea mali e lumellana le liprotheine tsa plasma.
Lithutong tsa liphoofolo, ha ho litumelo tsa likarolo tsa tokiso ea Augmentin® ho setho leha e le sefe se fumanoeng.
Amoxicillin, joalo ka penicillin e ngata, e fetela lebese la matsoele. Khoele ea clavulanic acid le eona e ka fumanoa lebeseng. Ntle le monyetla oa ho susumetsa maikutlo, letšollo le li-candidiasis tsa mucous membrous ea molomo, ha ho na litlamorao tse mpe tsa amoxicillin le clavulanic acid tse mabapi le bophelo bo botle ba bana ba anyesitsoeng.
Boithuto ba ho tsoala liphoofolo bo bontšitse hore amoxicillin le clavulanic acid li tšela mokoallo oa placental. Leha ho le joalo, ha ho na litla-morao tse bohloko tse fumanoeng ho lesea.
Metabolism
10-25% ea tekanyetso ea pele ea amoxicillin e hlahisoa ke liphio ka mokhoa oa metabolite o sa sebetseng (penicilloic acid). Clavulanic acid e na le metabolism haholo ho 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid le 1-amino-4-hydroxybutan-2-e 'ngoe' me e bontšitsoe ke liphio. mmoho le moya o felletseng ka sebopeho sa khabone.
Ho tsala
Joalo ka penicillin e ngoe, amoxicillin e hlahisoa haholo ke liphio, athe clavulanic acid e etsoa ka methapo ea kutlo le e feteletseng. Hoo e ka bang 60-70% ea amoxicillin le 40-65% ea clavulanic acid e epolloa ke menoana e sa fetoloang lihoreng tse 6 tsa pele kamora ho nka letlapa le le leng la 250 mg / 125 mg kapa Letlapa le le leng la 500 mg / 125 mg. Ts'ebetso e ts'oanang ea probenecid e liehisa tlhahiso ea amoxicillin, empa eseng clavulanic acid (bona karolo "Tšebelisano le lithethefatsi tse ling").

LIPUO TSA SEBELISO

Ts'oaetso ea baktheria e bakoang ke likokoana-hloko tse ikhethileng ho amoxicillin / clavulanic acid:
• Ts'oaetso ea ENT, joalo ka tenillillitis ea morao-rao, sinusitis, otitis media, e atisang ho bakoa ke Streptococcus pneumoniae, Haemophilus influenzae, moraxella catarrhalis, le Streptococcus pyogene.
• Tšoaetso e tlase ea phepelo ea methapo, joalo ka ho ata ha bronchitis e sa foleng, lobar pneumonia le bronchopneumonia, e atisang ho bakoa ke Streptococcus pneumoniae, Haemophilus influenzae, le Moraxella catarrhalis.
• Tšoaetso ea pampitšana ea Urogenital, joalo ka cystitis, urethritis, pyelonephritis, ts'oaetso ea basali, hangata e bakoang ke mefuta ea lelapa la Enterobacteriaceae (haholo-holo mofuta oa Escherichia), Staphylococcus saprophyticus le Enterococcus, le gonorrhea e bakoang ke Neisseria gonorrhoeae.
• Tšoaetso ea letlalo le lisele tse bonolo, tse atisang ho bakoa ke Staphylococcus aureus, Streptococcus pyogene, le mefuta ea mofuta oa Bacteroides.
• Ts'oaetso ea masapo le manonyeletso, joalo ka osteomyelitis, hangata e bakoa ke Staphylococcus aureus, haeba kalafo ea nako e telele e hlokahala.

Ts'oaetso e bakoang ke likokoana-hloko tse anngoeng ke amoxicillin e ka alafshoa ka Augmentin®, hobane amoxicillin ke e 'ngoe ea metsoako ea eona e sebetsang.

TLHOKOMELISO E SEBELISANG

• Hypersensitivity ho amoxicillin, clavulanic acid, likarolo tse ling tsa lithethefatsi, lithibela-mafu tsa beta-lactam (mohlala, penicillin, cephalosporins) ho anamnesis,
• likarolo tse fetileng tsa jaundice kapa ts'ebetso ea sebete e sa sebetseng ha u sebelisa motsoako oa amoxicillin le clavulanic acid ho anamnesis,
• lilemo tsa bana ho isa ho likhoeli tse 3,
• ts'ebetso e sa sebetseng hantle ea renal (tumello ea creatinine ka tlase ho 30 ml / min),
• phenylketonuria.

HO SEBELISA HO ETSA LINTHO TSOHLE LE HO FIHLELA FEELA

Boimana
Thutong ea mosebetsi oa ho ba le liphoofolo ho liphoofolo, tsamaiso ea molomo le ea botsoali ea Augmentin® ha ea ka ea baka litlamorao tsa teratogenic.
Phuputsong e le 'ngoe ho basali ba nang le ho phatloha kapele ho litho tsa' mele, ho fumanoe hore kalafo ea lithethefatsi tsa prophylactic e ka amahanngoa le kotsi e eketsehang ea necrotizing enterocolitis ho masea a sa tsoa hlaha. Joalo ka meriana eohle, Augmentin® ha e khothalletsoe hore e sebelisoe nakong ea kemolo, ntle leha phaello e lebelletsoeng ho mme e feta kotsi e ka ba teng ho lesea.
Nako ea ho anyesa
Sesebelisoa sa Augmentin® se ka sebelisoa nakong ea ho anyesa. Ntle le monyetla oa ho susumetsa maikutlo, lets'ollo, kapa licidiasis ea mucous membrous ea molomo e amanang le ho kenella ha lipalo tse fumanehang tsa metsoako e sebetsang ea sehlahisoa sena ka lebeseng la matsoele, ha ho litla-morao tse ling tse ileng tsa bonoa ho masea a anyesitsoeng. Ha ho e-ba le litlamorao tse mpe ho masea a anyesitsoeng, ho anyesa ho lokela ho emisoe.

TLHALOSO LE PUSO

Bakeng sa tsamaiso ea molomo.
Mokhoa oa ho fokotsa litekanyetso o beoa ka bonngoe ho latela lilemo, boima ba 'mele, ts'ebetso ea liphio tsa mokuli, le botebo ba ts'oaetso.
Ho fokotsa litšitiso tse ka bang teng ka mpeng le ho ntlafatsa ho monya, moriana o lokela ho nooa qalong ea lijo.
Tlhahlobo e fokolang ea phekolo ea baktheria ke matsatsi a 5.
Phekolo ha ea lokela ho tsoela pele matsatsi a fetang 14 ntle le ho hlahloba maemo a kliniki.
Haeba ho hlokahala, ho ka etsahala ho etsa kalafo ea mohato ka mohato (oa pele, tsamaiso ea botsoali ea tokiso ea Augmentin® ka foromo ea litekanyetso ke phofo bakeng sa ho hlophisoa ha tharollo bakeng sa tsamaiso ea methapo ka phetoho e latelang tokisetsong ea Augmentin® ka mefuta ea litekanyetso tsa molomo.
Batho ba baholo le bana ba lilemo tse 12 le ho feta kapa ba boima ba 40 kg kapa ho feta
Ho khothalletsoa ho sebelisa mefuta e meng ea litekanyetso tsa Augmentin® kapa 11 ml ea ho emisoa ka tekanyetso ea 400 mg / 57 mg ka 5 ml, e lekanang le Letlapa le le leng la Augmentin®, 875 mg / 125 mg.
Bana ba lilemo li 3 ho isa ho lilemo tse 12 ba nang le boima ba 'mele bo ka tlase ho 40 kg
Palo ea tekanyetso e etsoa ho latela lilemo le boima ba 'mele, bo bontšitsoeng ka boima ba' mele a mg / kg ka letsatsi kapa ho milliliters ea ho emisoa. Tekanyetso ea letsatsi le letsatsi e arotsoe ka litekanyetso tse peli kamora lihora tse 12. Mokhoa o khothalelitsoeng oa litekanyetso le boholo ba tsamaiso li hlahisoa tafoleng e ka tlase.
Tafole ea regimen ea Augmentin ® (lipalo tsa lethal dose bakeng sa amoxicillin)

Ho emisoa 7: 1 (200 mg / 28,5 mg ka 5 ml kapa 400 mg / 57 mg ka 5 ml) ho litekanyetso tse 2 ka mor'a lihora tse 12
Litekanyetso tse tlase 25 mg / kg / ka letsatsi
Litekanyetso tse phahameng 45 mg / kg / ka letsatsi

Methapo e tlase ea Augmentin® e khothaletsoa bakeng sa kalafo ea tšoaetso ea letlalo le lisele tse bonolo, hammoho le li-millillitis tse ipheta-phetang.
Methapo e phahameng ea Augmentin® e khothalletsoa bakeng sa kalafo ea maloetse a kang otitis media, sinusitis, ts'oaetso ea phepelo e tlase ea phefumoloho le ts'ebetso ea moroto, ts'oaetso ea masapo le manonyeletso.
Bakeng sa Augmentin ® e na le karolelano ea amoxicillin ho clavulanic acid 7: 1, ha ho na lintlha tse lekaneng tsa kliniki ho khothaletsa tšebeliso ea litekanyetso tse fetang 45 mg / kg / letsatsi ho litekanyetso tse 2 tse arohaneng ho bana ba ka tlase ho lilemo tse peli.
Bana ho tloha ho tsoalo ho isa ho likhoeli tse 3
Ts'ebeliso ea ho emisoa ka karolelano ea amoxicillin ho clavulanic acid 7: 1 (200 mg / 28,5 mg ka 5 ml le 400 mg / 57 mg ka 5 ml) e hlakotsoe ho baahi bana.
Masea pele ho nako
Ha ho na likhothaletso mabapi le mofuta oa moriana.
Lihlopheng tse ikhethang tsa bakuli
Bakuli ba baholo
Ha ho hlokahale hore ho sebelisoe mofuta oa mofuta oa litekanyetso, 'me ho sebelisoe mofuta o tšoanang oa kalafo joaloka ho bakuli ba baholo. Ho bakuli ba tsofetseng ba nang le bothata ba ho sebetsa ha renal, ho fuoe tekanyetso e nepahetseng bakeng sa bakuli ba baholo ba nang le ts'ebetso ea renal.
Bakuli ba nang le ts'oaetso ea renal
Ho emisoa ka 7: 1 (200 mg / 28,5 mg ka 5 ml kapa 400 mg / 57 mg ka 5 ml) e lokela ho sebelisoa feela ho bakuli ba nang le tumello ea creatinine e kholo ho feta 30 ml / min, ntle le phetoho ea litekanyetso e hlokahalang.
Maemong a mangata, haeba ho khonahala, phekolo ea batsoali e lokela ho khethoa.
Bakuli ba nang le ts'ebetso ea sebete e sa sebetseng
Phekolo e etsoa ka tlhokomeliso; ts'ebetso ea sebete e hlahlojoa khafetsa.
Ha ho na data e lekaneng ho fetola litlhahiso tsa lethal dose ho bakuli ba joalo.
Mokhoa oa ho lokisa ho emisoa
Ho emisoa ho lokisoa hang-hang pele ho tšebeliso ea pele.
Hoo e ka bang 40 ml ea metsi a phehiloeng a kentsoeng mocheso oa kamore o lokela ho eketsoa ka botlolong ea phofo, ebe o koala botlolo ka sekwahelo ebe o sisinyeha ho fihlela phofo e hlapollotsoe ka botlalo, lumella botlolo hore e eme metsotso e 5 ho netefatsa hore e belisoa ka botlalo. Ka nako eo eketsa metsi ho letšoao le ka botlolong ebe o sisinya botlolo hape. Ka kakaretso, metsi a ka bang 64 di ml a hlokahala ho lokisa ho emisoa.
Botoro e lokela ho tsukutloa hantle pele ho ts'ebeliso e 'ngoe le e' ngoe. Bakeng sa dosing e nepahetseng ea lithethefatsi, sebelisa sekepe se lekanyang kapa seratsoana sa dosing, se lokelang ho hlatsuoa hantle ka metsi kamora tšebeliso e ngoe le e ngoe.Kamora ho hlapisoa, ho emisoa ha hoa lokela ho bolokoa matsatsi a sa feteng a 7 sehatsetsing, empa se sa hoama.
Bakeng sa bana ba ka tlase ho lilemo tse peli, tekanyo e le 'ngoe ea tekanyo ea ho emisoa ha lithethefatsi Augmentin® e ka hlapolloa ka metsi ka karolelano ea 1: 1.

Sokolla foromo le sebopeho

Motsoako oa lithibela-mafu o fumaneha ka mefuta e latelang:

matlapa a koahetsoeng ka filimi: oval, e tšoeu kapa e batla e tšoeu, ho robeha - ho tloha bosoeu-bosehla ho isa ho bosoeu ho litekanyetso tse 250 mg (250 + 125): ka mongolo o tšekaletseng lehlakoreng le leng la letlapa la AUGMENTIN (ka lilakane tsa li-pcs tse 10, ho Carton pack 2 blisters), 500 mg e ngoe le e ngoe (500 + 125): e nang le mongolo o kentsoeng "А А" le kotsi ka lehlakoreng le leng (ka lithutsoana tsa li-pcs tse 7 kapa tse 10, ka har'a lebokose la marang-rang a mabeli, 875 mg (875 + 125) ): ka litlhaku "A" le "C" ka mahlakoreng a mabeli a letlapa le kotsi ea ho robeha ka lehlakoreng le le leng (ka marang-rang a li-pcs tse 7, ka lebokoseng la karete ea lilakane tse peli),
phofo bakeng sa ho emisoa bakeng sa tsamaiso ea molomo: e tšoeu kapa e batla e le tšoeu, e nang le monko o ts'oanang, ha e hlapollotsoe, ho emisoa (e tšoeu kapa e batla e le tšoeu), eo ho eona ho thehoang liforomo tsa phomolo (ka libotlolong tsa khalase, botlolo e le 'ngoe e nang le cap e lekantsoeng lebokoseng la karete ea karete) ,
phofo bakeng sa tharollo bakeng sa tsamaiso ea methapo: ho tloha ho o mosoeu ho isa ho o mosoeu (ka pakete ea libotlolo tsa karete tse 10).

Augmentin e sebelisa motsoako oa clavulanic acid (ka mofuta oa letsoai la potasiamo) le amoxicillin (ka sebopeho sa letsoai la sodium) e le lintho tse sebetsang.

Letlapa le le leng le na le:

dintho tse sebetsang: clavulanic acid - 125 mg, amoxicillin (joalo ka ha e le Trihydrate) - 250, 500 kapa 875 mg,
excipients: sodium carboxymethyl starch, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

Karolo ea ho kopanya filimi ea matlapa e kenyelletsa: hypromellose, hypromellose (5cP), macrogol 6000, macrogol 4000, dimethicone, titanium dioxide.

5 ml ea ho emisoa ho hlophisitsoeng bakeng sa tsamaiso ea molomo e na le:

dintho tse sebetsang, karolelano ea amoxicillin (ka sebopeho sa 'mele) ho clavulanic acid (ka mofuta oa letsoai la potasiamo): 125 mg / 31.25 mg, 200 mg / 28,5 mg, 400 mg / 57 mg,
li-excipient: hypromellose, xanthan gum, acid e tsoakiloeng, aspartame, colloidal silicon dioxide, litatso (lamunu 1, lamunu 2, raspberry, "Bright molasses"), silicon dioxide.

Vial e le 'ngoe (1200 mg) ea tharollo ea methapo e na le lintho tse sebetsang:

amooticillin (ka mokhoa oa letsoai la sodium) - 1000 mg,
clavulanic acid (ka mofuta oa letsoai la potasiamo) - 200 mg.

Mofumahali

Amoxicillin ke lithibela-mafu tsa semisynthetic wide-spectrum tse sebetsang khahlanong le likokoana-hloko tse ngata tse seng ntle tsa grame le gram. Leha ho le joalo, amoxicillin e kotsing ea ho felisoa ke β-lactamases, ka lebaka leo, ts'ebetso ea eona ea ts'ebetso ha e fetele ho libaktheria tse hlahisang enzyme ena.

Clavulanic acid e na le sebopeho se ts'oanang le penicillin ebile ke inhibitor ea β-lactamases, e hlalosang bokhoni ba eona ba ho inactivate tse ngata tse fapaneng tsa β-lactamases, tse teng ka har'a likokoana-hloko tse bonts'ang ho hanyetsa li-cephalosporins le penicillin. Karolo ena e sebetsang e sebetsa hantle ho li-plasmid β-lactamases, tseo hangata li fanang ka khanyetso ea baktheria, mme e sa sebetse hantle khahlanong le mofuta oa 1 chromosome β-lactamases e sa thibeloang ke clavulanic acid.

Ho kenyelletsoa ha clavulanic acid ho sebopeho sa Augmentin ho u lumella ho sireletsa amoxicillin ho tloha timetsong ke li-enzyme - β-lactamases, e netefatsang kholo ea sekhahla sa antibacterial ea ntho ena.

In vitro, likokoana-hloko tse latelang li amehile ka ho kopana ha amoxicillin le clavulanic acid:

gram-negative aerobes: Vibrio cholerae, Bordetella pertussis, Pasteurella multocida, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Helicobacter pylori,
Li-aerobes tse nang le sebopeho se hlakileng: coagulase-negative staphylococci (li-sensins tse amehang methicillin), Staphylococcus saprophyticus (e bonts'a kutloisiso ea methicillin), Staphylococcus aureus (e bonts'ang kutloisiso ea methicillin), Bacillus anthracis, Streptococcus agal. (tse ling tsa β-hemolytic streptococci), Streptococcus pyogene, Enterococcus faecalis, Nocardia asteroides, Listeria monocytogene,
gram-negative anaerobes: Prevotella spp., bactericides fragilis, Bacteroides spp., Porphyromonas spp., Fusobacterium spp., Fusobacterium nucleatum, Eikenella corrodens, Capnocytophaga spp.,
gram-positive anaerobes: Peptostreptococcus spp., peptostreptococcus magnus, Peptostreptococcus micros, Peptostreptococcus niger, Clostridium spp.,
Ba bang: Treponema pallidum, Leptospira icterohaemorrhagiae, Borrelia burgdorferi.

Likokoana-hloko tse latelang li tšoauoa ka ho hanyetsa molemong oa motsoako oa amoxicillin le clavulanic acid:

gram-positive aerobes: streptococci of the Viridans group, Corynebacterium spp., Streptococcus pneumoniae (lits'oants'o tsa mofuta ona oa libaktheria ha li hlahise act-lactamases, mme ts'ebetso ea phekolo ea meriana e netefalitsoe ke litholoana tsa lithuto tsa kliniki), Enterococcus faecium,
gram-negative aerobes: Shigella spp., Escherichia coli, Salmonella spp., Klebsiella spp., Klebsiella pneumoniae, Klebsiella oxytoca, Proteus spp., Proteus vulgaris, Proteus mirabilis.

Libaktheria tse latelang ha li lumellane le lithethefatsi ka tlhaho, tse kenyeletsang amoxicillin le clavulanic acid:

gram-negative aerobes: Yersinia enterocolitica, Acinetobacter spp., Stenotrophomonas maltophilia, Citrobacter freundii, Serratia spp. Enterobacter spp, Pseudomonas spp., Hafnia alvei, Providencia spp., Morganella morganii, Legionella pneum
tse ling: Coxiella burnetii, Chlamydia psittaci, Chlamydia pneumoniae, Chlamydia spp., Mycoplasma spp.

Boikutlo ba pathogen ho amootherillin monotherapy bo fana ka maikutlo a tšoanang le a kopantsoeng ea amoxicillin le clavulanic acid.

Mofumahali

Clavulanic acid le amoxicillin li potlakisa ka bongata hoo e ka bang 100% ho tsoa liphatseng tsa gastrointestinal (GIT) ha li nooa ka molomo. Ho kenngoa ha likarolo tse sebetsang tsa Augmentin ho nkoa e le ntho e nepahetseng ha sethethefatsi se kena 'meleng qalong ea lijo.

Ts'ebeliso ea ho emisoa bakeng sa tsamaiso ea molomo e ithutile litekong tsa bongaka moo baithaopi ba phetseng hantle ba lilemo li 2 ho isa ho 12 ba nkile karolo. Ba nkile Augmentin ka litekanyetso tsa 125 mg / 31.25 mg 5 ml ka mpeng e se nang letho ho litekanyetso tse 3 tse arohaneng, ka litekanyetso tsa letsatsi le letsatsi tsa amoxicillin le clavulanic acid ea 40 le 10 mg / kg, ka ho latellana. Ka lebaka la teko ena, ho fumanoe likarolo tse latelang tsa pharmacokinetic:

clavulanic acid: boholo bo boholo ba 2.7 ± 1.6 mg / ml, nako ea ho fihlela litaba tsa plasma tse kaholimo ho lihora tse 1,6 (bolelele ba lihora tse 1-2), AUC 5.5 ± 3.1 mg × h / ml, feliso ea halofo ea bophelo ea 0,94 ± 0,05 lihora,
amooticillin: boholo ba mahloriso 7.3 ± 1.7 mg / ml, nako ea ho fihlela litaba tsa plasma tse ngata ka lihora tse 2.1 (lihora tse 1,3,3), AUC 18.6 ± 2.6 mg × h / ml Ho felisoa ha halofo ea bophelo ba lihora tse 1,0 ± 0,3.

Lithuto tse bapisang tsa litšobotsi tsa pharmacokinetics tsa Augmentin le tsona li ile tsa etsoa ha li e nka ka mokhoa oa matlapa, matlapa a koahetsoeng ka filimi (ka mpeng e se nang letho). Liphetho tsa ho khetholla litekanyetso tsa pharmacokinetic ho latela ho kenella ha Augmentin, clavulanic acid le amoxicillin ka litekanyetso tse fapaneng e bile tse latelang:

Letlapa le le leng la Augmentin le noang litekanyetso tsa 250 mg / 125 mg: bakeng sa amoxicillin - palo e phahameng ea 3.7 mg / l, nako ea ho fihla sehlohlolong sa plasma e kholo ea lihora tse 1,1, AUC (sebaka se ka tlas'a "" mahloriso - nako ") h / ml halofo ea bophelo (T_1/2) 1 hora. Bakeng sa clavulanic acid, khatello e phahameng ke 2.2 mg / l, nako ea ho fihlela khatello e kholo ea plasma ea mali ke lihora tse 1,2, AUC 6.2 mg × h / ml, T_1/2 - Lihora tse 1,2
matlapa a mabeli a Augmentin a na le litekanyetso tsa 250 mg / 125 mg: bakeng sa amoxicillin - boholo bo phahameng ba 5.8 mg / l, nako ea ho fihla sehlohlolong sa plasma e kholo ea lihora tse 1.5, AUC 20,9 mg × h / ml, T_1/2 - Lihora tse 1,3. Bakeng sa clavulanic acid, khatello e phahameng ke 4.1 mg / L, nako ea ho fihlela khatello ea plasma e kholo ke lihora tse 1,3, AUC 11.8 mg × h / ml, T_1/2 - 1 hora
Letlapa le le leng la Augmentin le na le litekanyetso tsa 500 mg / 125 mg: bakeng sa amoxicillin - boholo bo phahameng ba 6.5 mg / l, nako ea ho fihla sehlohlolong sa plasma e kholo ea lihora tse 1.5, AUC 23.2 mg × h / ml, T_1/2 - Lihora tse 1,3. Bakeng sa clavulanic acid, khatello e phahameng ke 2,8 mg / l, nako ea ho fihlela khatello e kholo ea plasma ea mali ke lihora tse 1,3, AUC 7.3 mg × h / ml, T_1/2 - lihora tse 0,8
amooticillin ka thoko ka tekanyo ea 500 mg: boholo bo phahameng ba 6.5 mg / l, nako ea ho fihla maemong a phahameng a plasma 1.3, AUC 19.5 mg × h / ml, T_1/2 - lihora tse 1,1
clavulanic acid e le ngoe ka tekanyo ea 125 mg: boholo bo phahameng ba 3.4 mg / l, nako ea ho fihlella boholo ba mahloriso a plasma 0,9, AUC 7.8 mg × h / ml, T_1/2 - lihora tse 0,7.

Pharmacokinetics ea lithethefatsi le eona e ile ea hlahlojoa le tsamaiso e kenang ea botsing ea Augmentin ho baithaopi ba phetseng hantle. Ka lebaka leo, likarolo tse latelang tsa pharmacokinetic li ile tsa fumanoa ho latela tekanyetso:

Tekanyetso ea 1000 mg / 200 mg: bakeng sa amoxicillin - boholo ba mahloriso a 105.4 μg / ml, T_1/2 - lihora tse 0,9, AUC 76.3 mg × h / ml, e pepesitsoe ka har'a moroto nakong ea lihora tse 6 tsa pele kamora ts'ebetso ea 77.4% ea ntho e sebetsang. Bakeng sa clavulanic acid, khatello e phahameng ke 28,5 μg / ml, T_{1/2 –} Lihora tse 0,9, AUC 27.9 mg × h / ml, e pepesitsoe ka har'a moroto nakong ea lihora tse 6 tsa pele kamora ts'ebetso ea 63.8% ea ntho e sebetsang.
litekanyetso tsa 500 mg / 100 mg: bakeng sa amoxicillin - khatello e phahameng ea 32.2 μg / ml, T_1/2 - Lihora tse 1,07, AUC 25,5 mg × h / ml, e pepesitsoe ka har'a moroto nakong ea lihora tse 6 tsa pele kamora ho tsamaisoa ha 66,5% ea ntho e sebetsang. Bakeng sa clavulanic acid, khatello e phahameng ke 10,5 μg / ml, T_1/2 - lihora tse 1,12, AUC 9.2 mg × h / ml, e pepesitsoeng ka har'a moroto nakong ea lihora tse 6 tsa pele kamora ts'ebetso ea 46% ea ntho e sebetsang.

Ka bobeli ha e nkuoa ka molomo le kahare, clavulanic acid le amoxicillin tse ling tsa methapo ea kutlo li ikemiselitsoe mokelikeling oa methapo le li-tishu tse fapaneng (bokong ba mpa ea mpa ea mpa, lesapo la mokokotlo, lesapo la mokokotlo, lesapo la mokokotlo oa mokokotlo, bile, peritoneal le synovial mokelikeli).

Likarolo ka bobeli tse sebetsang tsa Augmentin li tlama ka thata liprotheine tsa plasma. Liphetho tsa lipatlisiso li bonts'a hore tekanyo ea ho tlama hoa li-protein tse nang le liprotheine tsa plasma e batla e le 18%, le clavulanic acid - 25%. Liteko tsa liphoofolo ha li netefatse ho bokellana ha lintho tse sebetsang lithong life kapa life.

Amoxicillin e fetela ka lebeseng, le eona e khethollang acid ea clavulanic ho latela mohlala. Litlamorao tse mpe tsa lintho tsena bophelong ba bana ba anyesitsoeng, hammoho le nts'etsopele ea li-membrane tsa mucous tsa mokokotlo oa molomo, lets'ollo le kotsi ea ho ts'oaroa ha li so tsejoe.

Boithuto ba ts'ebetso ea ho ikatisa ho liphoofolo ha u sebelisa amoxicillin hammoho le clavulanic acid e bonts'itse hore likarolo tse sebetsang tsa Augmentin li kenella kahara "placental bar", empa li se na phello e mpe ho "fetus".

Ho tloha ho 10 ho isa ho 25% ea lethal dose le amoheloang amoxicillin e pepesitsoe ka har'a moroto ka mokhoa oa penicilloic acid, metabolite e sa bontsheng ts'ebetso ea pharmacological. Clavulanic acid e na le metabolism e ngata, e etsa 1-amino-4 hydroxy-butan-2-e 'ngoe le 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid, mme e epolloa ka ts'ebetso ea mala. , ka moroto, hape le moea o fepileng ka sebopeho sa khabone.

Amoxicillin e pepesoa haholo-holo ka liphio, athe clavulanic acid e tšoauoa ka moelelo oa morao-rao le mochine o mongata haholo. Hoo e ka bang 45-65% ea clavulanic acid le 60-70% ea amoxicillin ha e qhaloe ntle ho moroto nakong ea lihora tse 6 tse qalang ka mor'a ho nka Letlapa le le leng la 500 mg / 125 mg kapa 250 mg / 125 mg kapa kamora ho kenngoa ka lehare le le leng la bolment la Augmentin ka litekanyetso tsa 500 mg / 100 mg kapa 1000 mg / 200 mg. Ts'ebetso e ts'oanang ea probenecid e thibela tlhahiso ea amoxicillin, empa ha e ame tlhahiso ea tlhahiso ea clavulanic acid.

Matšoao a ho sebelisoa

Ho latela litaelo, Augmentin e fuoe ts'oaetso ea baktheria e bakoang ke likokoana-hloko tse amehang ka lithibela-mafu.

tšoaetso ea letlalo, lisele tse bonolo,
ts'oaetso ea pampitšana ea phefumoloho: bronchitis, lobar bronchopneumonia, empyema, abscess ea lung,
ts'oaetso ea genitourinary system: cystitis, urethritis, pyelonephritis, sepsis ea ho ntša mpa, syphilis, gonorrhea, tšoaetso ea litho tse sebakeng sa pelvic,
ts'oaetso ea masapo le manonyeletso: osteomyelitis,
tšoaetso ea odontogenic: periodontitis, odontogenic maxillary sinusitis, lekhopho le matla la meno,
tšoaetso e hlahisoang e le phephetso kamora ho buuoa: peritonitis.

Contraindication

hypersensitivity ho clavulanic acid, amoxicillin, likarolo tse ling tsa lithethefatsi le lithibela-mafu tsa beta (cephalosporins, penicillin) ho anamnesis,
linyeoe tsa pele tsa jaundice kapa ho se sebetse ha sebete ha o sebelisa motsoako oa clavulanic acid e nang le amoxicillin historing
mosebetsi o sa sebetseng oa renal (phofo bakeng sa ho hlophisoa ha ho emisoa bakeng sa tsamaiso ea molomo ea 200 mg / 28,5 mg le 400 mg / 57 mg, matlapa a 875 mg / 125 mg),
phenylketonuria (phofo bakeng sa ho emisoa ka molomo).

Contraindication ho Augmentin bakeng sa bana: matlapa - ho fihlela ho lilemo tse 12 le boima ba 'mele bo ka tlase ho 40 kg, phofo bakeng sa ho emisoa ka molomo 400 mg / 57 mg le 200 mg / 28,5 mg - ho fihlela likhoeli tse 3.

Ha ts'ebetso ea ho senyeha ha sebete e sa sebetse, Augmentin e lokela ho nkuoa ka hloko.

Nakong ea kemolo le kanyeso, qeto mabapi le tlhoko ea tšebeliso ea lithethefatsi e etsoa ke ngaka e eang.

Litaelo tsa Augmentin: mokhoa le litekanyetso

Pele ho khethoa ha Augmentin, ho khothalletsoa ho etsa tlhahlobo ho bona maikutlo a microflora e bakileng lefu lena lithibela-mafu. Ka mor'a moo, ngaka e beha mofuta oa moriana o nahanang ka lilemo tsa mokuli, boima ba hae, tšebetso ea liphio le ho teba ha lefu lena.

Tsela e nepahetseng ea kalafo e sebetsang ke matsatsi a 5, nako e telele ea kalafo ntle le ho lokisa maemo a bongaka ke libeke tse peli. Nka sethethefatsi qalong ea lijo.

Haeba ho hlokahala, lekhetlo la pele moriana o fanoa ka mokhoa oa botsoali, joale ho ka fanoa ka tsamaiso ea molomo.

Litekanyetso tse khothalelitsoeng ha u nka litafole tsa Augmentin bakeng sa bana ba lilemo tse fetang 12 le ba baholo:

bakeng sa ts'oaetso ea tšoaetso e bonolo ho isa ho tekano: Letlapa le le leng (250 mg + 125 mg) makhetlo a 3 ka letsatsi,
bakeng sa ts'oaetso e matla kapa e sa foleng: Letlapa le le leng (500 mg + 125 mg) makhetlo a 3 ka letsatsi kapa Letlapa le le leng (875 mg + 125 mg) makhetlo a 2 ka letsatsi.

Bohlokoa: Matlapa a 2 a 250 mg / 125 mg ha a lekane le Letlapa le le leng la 500 mg / 125 mg.

Meteo e khothalelitsoeng ha o nka ho emisoa ha Augmentin:

bana ba kaholimo ho lilemo tse 12 le batho ba baholo: 11 ml ea ho emisoa ha 400 mg / 57 mg / 5 ml makhetlo a 2 ka letsatsi (e tsamaellanang le letlapa le le leng la 875 mg + 125 mg),
bana ho tloha ho likhoeli tse 3 ho isa ho lilemo tse 12 (boima ba ho fihlela ho 40 kg): lethaliti la letsatsi le letsatsi le khethoa ho latela boima ba 'mele le lilemo (ml bakeng sa ho emisoa, kapa mg / kg / letsatsi). Boleng bo lekantsoeng bo lokela ho aroloa ka tekanyetso e 3 le karohanyo ea lihora tse 8 (bakeng sa ho emisoa ha 125 mg / 31.25 mg / 5 ml), kapa tekanyetso ea 2 (bakeng sa ho emisoa ha 400 mg / 57 mg / 5 ml kapa 200 mg / 28,5 mg / 5 ml) nako le nako ea lihora tse 12. Bakeng sa ho emisoa ha 125 mg / 31.25 mg / 5 ml, litekanyetso tse tlase * - 20 mg / kg / letsatsi, litekanyetso tse phahameng tsa ** - 40 mg / kg / letsatsi. Bakeng sa ho emisoa ha 400 mg / 57 mg / 5 ml le 200 mg / 28,5 mg / 5 ml, litekanyetso tse tlase ke 25 mg / kg / letsatsi, litekanyetso tse phahameng ke 45 mg / kg / letsatsi.

* Ho sebelisoa litlhare tse tlase kalafong ea li-tonsillitis tse tloaelehileng le tšoaetso ea lisele tse bonolo le letlalo.

** Ho hlokahala tekanyetso e phahameng kalafong ea sinusitis, mecha ea litaba ea otitis, ts'oaetso ea manonyeletso le masapo, pampitšana ea ho ntša metsi le ho hema.

Litekanyetso tse khothalelitsoeng tsa Augmentin ka mokhoa oa tharollo ea tsamaiso ea methapo (iv):

bana ba ka holimo ho lilemo tse 12 le batho ba baholo: 1000 mg / 200 mg makhetlo a 3 ka letsatsi (lihora tse ling le tse ling tse 8), le ts'oaetso e matla, nako e pakeng tsa liente e ka fokotsoa ho isa ho lihora tse 4-6,
bana ho tloha ho likhoeli tse 3 ho isa ho lilemo tse 12: makhetlo a 3 ka letsatsi ka tekanyo ea 50 mg / 5 mg / kg kapa 25 mg / 5 mg / kg ho latela botebo ba ts'oaetso, nako e pakeng tsa liente ke lihora tse 8,
bana ba ka tlase ho likhoeli tse 3: ba na le boima ba 'mele bo fetang likilo tse 4 - 25 mg / 5 mg / kg kapa 50 mg / 5 mg / kg nako le nako ka lihora tse 8, ka boima ba' mele bo ka tlase ho 4 kg - 25 mg / 5 mg / kg lihora tse ling le tse ling tse 12.

Augmentin e lokela ho nkuoa ka tieo ho litekanyetso tse behiloeng ke ngaka, e shebelletse moralo oa litekanyetso o behiloeng.

Litlamorao

Ts'ebeliso ea Augmentin maemong a sa tloaelehang e ka baka litlamorao tse latelang (haholo-holo tse bonolo le tse liehang):

hematopoietic system: thrombocytopenia, leukopenia (ho kenyeletsa neutropenia), hemolytic anemia le agranulocytosis (e fetohang), keketseho ea index ea prothrombin le nako ea ho tsoa mali,
sesole sa mmele: mokokotlo oa mmele o ka bakoang ke anaphylaxis, angioedema, lefu le ts'oanang le lefu la serum, lefu la Stevens-Johnson, vasculitis, chefo e thibelang lefu la ho hlohlona, dermatitis e matla le e matla. Augmentin e lokela ho emisoa haeba mofuta ofe kapa ofe oa lefu la ho nyekeloa ke dermatitis o ka hlaha.
matšoao a letlalo: rash, urticaria, erythema multiforme,
tsamaiso ea methapo e bohareng: hyperactivity le tetemous (e feto-fetoheng), hlooho e bohloko, ho tsekela,
sebete: cholestatic jaundice, hepatitis, keketseho e tloaelehileng ea maemo a ACT le / kapa ALT (litla-morao tsena li hlaha nakong ea kalafo kapa hang ka mor'a eona, hangata ho bakuli ba baholo le ho banna (ba nang le kalafo ea nako e telele), ho bana - hangata haholo, mme ba e fetoloe)
Sistimi ea urine: "crystalluria", "interstitial nephritis"

Khafetsa, ts'ebeliso ea Augmentin e ka baka lets'ollo ho batho ba baholo le bana, ho nyekeloa le pelo, ho hlatsa, dyspepsia (mathata ana a ho ja a ka fokotsoa haeba o ka noella moriana ka lijo).

Nako le nako, ho bana ba nkileng ho emisoa ha Augmentin, 'mala oa seaparo se holimo sa enamel ea meno o ka fetoha.

Phello ea kokoana-hloko ea lithethefatsi hangata e baka li-candidiasis tsa membrane ea mucous, maemong a sa tloaelehang e ka baka hemorrhagic le pseudomembranous colitis.

Melemo ea pharmacological

Mofumahali
Mokhoa oa ketso
Amoxicillin ke penicillin e 'ngoe ea synthetic (beta-lacgam antibacteric) e thibelang enzyme e le' ngoe kapa ho feta (e tsejoang e le liprotheine tse tlamisang penicillin) nakong ea biosynthesis ea bacterium peptidoglycan, e leng karolo e kopanyang ea sebopeho sa lisele tsa baktheria. Thibelo ea peptidoglycan synthesis e lebisa ho ho fokotsoa ha lebota la sele, 'me ka mor'a moo e lebise ho lizing le lefu la sele.
Amoxicillin e senngoa ke beta-lactamases e hlahisoang ke libaktheria tse sa sebetseng, ka hona karolo ea ts'ebetso ea amoxicillin ka boeona ha e kenyelle likokoana-hloko tse hlahisang li-enzyme tsena.
Clavulanic acid ke beta-lactamase inhibitor e amanang le penicillin. Clavulanic acid e thibela ts'ebetso ea li-enzyme tse ling tsa beta-lactamase, ka tsela eo e thibela ho qaptjoa ha amoxicillin. Clavulanic acid feela ha e bontše phello ea bohlokoa ea antibacterial.
Kamano ea li-pharmacokinetics / pharmacodynamics
Selo sa mantlha se khethollang katleho ea amoxicillin ke nako ea ho fetisa bonyane ba inhibitory mahloriso (T> IPC).
Mokhoa oa ho hanyetsa mokhoa
Ho na le mekhoa e 'meli e ka sehloohong ea ho theha ho hanyetsa amioillillin / clavulanic acid:
• Ho se sebetse ke li-beta-lactamase tse sa thibeloang ke clavulanic acid, ho kenyelletsa le beta-lactamase ea litlelase B, C le D.
• Liphetoho liprotheine tse tlamang penicillin, tse lebisang ho fokotseheng ha tumellano ea moemeli oa antibacterial bakeng sa sepheo sena sa ketso.
Ntle le moo, liphetoho phetohong ea khetla ea microorganism, hammoho le polelo ea lipompo tsa efflux, li ka baka kapa tsa kenya letsoho kholong ea ho hanyetsa baktheria, haholoholo ka hara libaktheria tse seng ntle le gram.
Boikutlo ba bacteriological ho lithibela-mafu bo fapana ka sebaka le nako. Ho bohlokoa ho ela hloko data ea sensitivity ea lehae, haholo ha ho tluoa kalafo ea ts'oaetso e matla. Litsebi li lokela ho botsoa haeba data ea hanyetsano ea lehae e belaella katleho ea moriana ho phekola mafu a itseng.
Likokoana-hloko tse sa bonahaleng
Likokoana-hloko tsa Aerobic tsa gram tse ntle:
Enterococcus faecalis, Gardnerella vaginalis, Staphylococcus aureus, methicillin-sens *, cagyase-negative staphylococci (methicillin-sens) Streptococcus agalactiae, Streptococcus pneumoniae1,Streptococcus pyogene le tse ling tsa beta hemolytic streptococci, sehlopha Li-viridans tsa Streptococcus.
Likokoana-hloko tse mpe tsa aerobic gram-negative:
Capnocytophaga spp., Eikenella corrodens, Haemophilus influenzae 2, Moraxella catarrhalis, Pasteurella multocida
Likokoana-hloko tsa Anaerobic:
Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp.
Likokoana-hloko tse ileng tsa hanyetsoa li ka khoneha
Likokoana-hloko tsa Aerobic tsa gram tse ntle:
Enterococcus faecium **
Likokoana-hloko tse mpe tsa aerobic gram-negative:
Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris
Likokoana-hloko tse loantšang tlhaho
Likokoana-hloko tse mpe tsa aerobic gram-negative
Acinetobacter sp., Citrobacter freundii, Enterobacter sp., Legionella pneumophila, Morganella morganii, Providencia spp., Pseudomonas sp., Serratia sp., Stenotrophomonas maltophIlia
Likokoana-hloko tse ling
Chlamydophilia pneumoniae, Chlamodophila psittaci, Coxiella burnetti, Mycoplasma pneumoniae.
* Li-staphylococci tsohle tse hananang le methicillin li loantšoa le amoxicillin / clavulanic acid. "Boikutlo bo bonolo ba tlhaho ha ho se na mochini o hanyetsanang oa ho hanyetsa.
1 Drug Augmentin, phofo bakeng sa ho emisoa ka molomo, 200 mg / 28,5 mg ka 5 ml le 400 mg / 57 mg ka 5 ml, e sa loketseng kalafo ea ts'oaetso ea tšoaetso ea penicillin e amanang le pneumoniae ea Streptococcus (bona. likarolo "Tekanyetso le Tsamaiso" le "Litšireletso").
2 Linaheng tse ling tsa EU, mathata a nang le maikutlo a fokotsehileng a tlalehiloe ka makhetlo a fetang 10%.
Mofumahali
Suction
Amoxicillin le clavulanic acid li qhibilihang ka ho felletseng ka tharollo ea metsi le pH ea 'mele. Likarolo tsena ka bobeli li kenngoa ka potlako le hantle 'meleng ho tloha pampiring ea gastrointestinal (GIT) kamora tsamaiso ea molomo. Ho fufuleloa hoa lintho tse mafolofolo ho nepahetse haeba u ka sebelisa moriana qalong ea lijo. Kamora ho tsamaisoa ka molomo, bioavailability ea amoxicillin le clavulanic acid ke 70%. Litekanyetso tsa pharmacokinetic tsa likarolo tsena ka bobeli lia tšoana, nako ea ho fihlela mahloriso a mangata a plasma (Tmax) e ka ba hora e le 'ngoe.
Ka tlase ho na le liphetho tsa pharmacokinetic tsa lipatlisiso moo litafole tsa amoxicillin / clavulanic acid (dosage 875 mg / 125 mg) li neng li nkuoa ke baithaopi ba phetseng hantle makhetlo a 2 ka letsatsi ka mpeng e se nang letho.

Boleng bo mahareng ba paramo ea pharmacokinetic (± ho kheloha ho tloaelehileng)

AUC (0-244) (μg x h / ml)

Amoxicillin / clavulanic acid 875 mg / 125 mg

Bongata

Haeba ho na le ts'oaetso e fetelletseng ea Augmentin, ho na le litšitiso tse bang teng maemong a lekanang le motlakase oa metsi le matšoao a mabe a tsoang mokhoeng oa ka mpeng. Ho na le litlaleho tsa nts'etsopele ea amoxicillin crystalluria, eo maemong a mang e ileng ea tsosa nts'etsopele ea ho se sebetse hantle ha methapo. Bakuli ba nang le mathata a liphio, hammoho le ba noang moriana o tekanyetso e phahameng, ba ka ts'oaroa.

Ho emisa ntho e mpe e amanang le ts'ebetso ea ts'ebetso ea mokokotlo, ho fanoa ka phekolo ea matšoao, ha ho khethoa ho tla lebisoa tlhokomelo e khethehileng ho fetoleng botsitso ba motlakase oa metsi. Clavulanic acid le amoxicillin e ka tlosoa tsamaisong ea kemiso ka ts'ebetso ea hemodialysis.

Phuputso e ka lebelloang setsing sa toxicology eo ho eona bana ba 51 ba ileng ba nka karolo ba netefalitse hore tsamaiso ea amoxicillin ka lethal dose e sa feteng 250 mg / kg ha ea ka ea lebisa ho nts'etsopele ea matšoao a bohlokoa a bongaka a bongoana bo bongata mme ha e hloke ho hlaseloa ka mpeng.

Kamora ho kenella ka hare ho enzodillin ka tekanyetso ea bohlokoa, e ka ba sethala ho catheters tsa moroto, ka hona, boiphihlelo ba bona bo lokela ho hlahlojoa khafetsa.

Litaelo tse khethehileng

Nakong ea kalafo ea Augmentin, ho hlokahala hore pele ho bokelloe nalane e qaqileng ea bongaka ho tseba hore na ho kile ha ba le litla-morao tsa hypersensitivity tsa cephalosporins, penicillin kapa allergen tse ling.

Liphetoho tse tebileng tsa anaphylactoid, ka linako tse ling tse bolaeang, li tlalehiloe maemong a mang. Ka ho khetheha kotsi e kholo ea maemo a joalo ho bakuli ba nang le nalane ea hypersensitivity ho penicillin. Haeba ho kula ho hlaha, phekolo ea Augmentin e lokela ho emisoa hanghang; maemong a boima, adrenaline e lokela ho tsamaisoa hanghang. Ho ka ba le tlhoko ea kalafo ea oksijene, tsamaiso e kenang ea li-glucocorticosteroids, ho netefatsa patency ea moea, ho kenyelletsa ho kenella kahare.

Ka tšebeliso ea nako e telele ea Augmentin, menyetla ea ho hlahisa haholo likokoana-hloko tse sa tsotelleng e eketseha.

Bokhachane le pelehi

Liphetho tsa boithuto ba tšebetso ea ho ba le liphoofolo ho liphoofolo tse nang le tsamaiso ea batsoali le ea molomo ea Augmentin li tiisa ho se be teng hoa litlamorao tsa lithethefatsi. Phuputso e le 'ngoe, e neng e etsoa ho bakuli ba nang le ho phatloha ho sa sebetseng ha litho tsa ka pele ho nako, e fana ka maikutlo a hore phekolo ea prophylactic e nang le moriana o thibelang likokoana-hloko e ka eketsa kotsi ea ho beha li-enterocolitis ho masea a sa tsoa hlaha. Ka hona, Augmentin e lokela ho sebelisoa feela maemong ao phaello e ka bang teng ea kalafo ho mme e feta haholo litlamorao tse mpe tse ka bang teng ho lesea.

Ho khethoa ha Augmentin nakong ea lebone ho lumelloa. Leha ho le joalo, haeba bana ba e-ba le karabelo e mpe (candidiasis ea mucous membrous ea cavity ea molomo, lets'ollo, sensitization e eketsehileng), ho khothalletsoa ho emisa ho anyesa.

Sebelisa bongoaneng

Ho khethoa ha Augmentin bakeng sa bana ho lumelloa ho latela lipontšo tse lumellanang le lengolo la litekanyetso:

phofo bakeng sa ho hlophisoa ha ho emisoa bakeng sa tsamaiso ea molomo le phofo bakeng sa ho hlophisoa ha tharollo bakeng sa tsamaiso ea iv - ho tloha tsoalong,
matlapa a koahetsoeng ka filimi - ho tloha lilemong tse 12.

Ka mosebetsi o sa sebetseng oa renal

Bakeng sa bakuli ba nang le bothata ba ho hlaphoheloa kelellong, ho fetoloa ha lethal dose ho ipapisitse le lethal dose le phahameng la kalafo ea amoxicillin mme ho ipapisitsoe le tlhahiso ea clearinine clearance (CC).

Ha ho nkuoa ke bakuli ba baholo ba nang le CC e kholo ho feta 30 ml / min, matlapa a Augmentin a na le litekanyetso tsa 500 mg / 125 mg kapa 250 mg / 125 mg, hammoho le ho emisoa ka litekanyetso tsa 125 mg / 31.25 mg ka 5 ml, ha ho na tlhoko ea tokiso ea tekanyetso. Haeba boleng ba QC bo tsoa ho 10 ho isa ho 30 ml / min, bakuli ba khothalletsoa ho nka Letlapa le le leng la 500 mg / 125 mg kapa 1 letlapa la 250 mg / 125 mg (bakeng sa tšoaetso e bonolo ho isa tekano) makhetlo a 2 ka letsatsi kapa 20 ml ea ho emisoa ha 125 mg / 31.25 mg ka makhetlo a 5 ml makhetlo a 2 ka letsatsi.

Ka boleng ba CC ba ka tlase ho 10 ml / min, Augmentin e sebelisoa ho litekanyetso tsa 1 Letlapa 500 mg / 125 mg kapa 1 letlapa 250 mg / 125 mg (bakeng sa tšoaetso e bonolo ho isa tekanyong) nako e le 1 ka letsatsi kapa 20 ml ea ho emisoa ha 125 mg / 31.25 mg ka 5 di ml hang ka letsatsi.

Matlapa a 875 mg / 125 mg a ngoletsoe feela bakuli bao CC ea bona e fetang 30 ml / min; ka hona, tokiso ea litekanyetso ha e hlokehe. Maemong a mangata, ho khothalletsoa tsamaiso ea batsoali ea Augmentin.

Ha e sebelisoa ho batho ba baholo le ho bana ba ka holimo ho lilemo tse 12 kapa ba boima ho feta 40 kg ba nang le hemodialysis, lethal dose le khothalletsoang la Augmentin ke Letlapa le le leng 500 mg / 125 mg (matlapa a 2 250 mg / 125 mg) hang ka lihora tse 24 kapa 20 ml Ho emisoa 125 mg / 31.25 mg nako e le ngoe ka letsatsi.

Nakong ea ts'ebetso ea ho kopanya lijo hammoho le qetellong ea eona, mokuli o fumana letlapa le le leng (1), le u lumellang ho fokotseha ha phokotseho ea khohlopo ea clavulanic acid le amoxicillin serum ea mali.

Ho sebelisana le lithethefatsi

Lithethefatsi tsa probenecid le tse tšoanang (phenylbutazone, diuretics, NSAIDs) li fokotsa secretion ea tubular ea amoxicillin. Tsamaiso e ts'oanang ha e khothalletsoe, hobane e ka tsamaisana le ho phehella le ho eketseha ha khatello ea amoxicillin maling (ha kutloelo-bohloko ea kutlo ea clavulanic acid e sa theohe).

Ho ja ka Augmentin ho ka ama phello ea lithibela-pelehi tsa molomo, ho fokotsa katleho ea tsona (mokuli o lokela ho tsebisoa ka sena).

Augmentin ka mokhoa oa tharollo ea ente e ke ke ea tsoakoa le lithibela-mafu tsa aminoglycoside ka seratsoaneng se le seng, hobane maemong ana ba felloa ke tšebetso. Hape ha ho amohelehe ho kopanya le litharollo tsa infusion tse nang le dextran, dextrose le sodium bicarbonate. Se ke oa kopanya le lihlahisoa tsa mali, le tharollo ea liprotheine tse ling (liprotheine tsa hydrolysates), le lipid emulsions bakeng sa tsamaiso ea methapo (iv).

Li-antibiotic tse nang le metsoako e tšoanang e sebetsang: Amoxiclav, Arlet, Clamosar, Bactoclav, Verklav, Liklav, Panclav, Rapiklav, Ranklav, Medoklav, Flemoklav Solutab, Ekoklav, Fibell.

Litlhahiso tsa Augmentin ka mochine oa ts'ebetso, lithethefatsi tsa sehlahisoa se le seng sa litlhare: Ampioks, Ampisid, Libakcil, Oxamp, Oxampicin, Oxamsar, Sulbacin, Sultasin, Santaz, jj.

Lipehelo le maemo a polokelo

Boloka ka lithemparetjha ho fihla ho 25 ° C sebakeng se ommeng moo bana ba sa se fihlelang.

matlapa a nang le amoxicillin ea 875 mg le 250 mg - lilemo tse 2,
matlapa a nang le amioillillin 500 mg - lilemo tse 3,
phofo bakeng sa tharollo bakeng sa tsamaiso e kenelletseng - lilemo tse 2,
phofo bakeng sa ho emisoa ka sebopeho se sa patoang - lilemo tse 2,
ho emisoa ho lokisitsoeng (ka mocheso kahare ho 2-8 ° C) - matsatsi a 7.

Litlhahlobo mabapi le Augmentin

Bakuli ba siea litlhahlobo tse ntle ka Augmentin ka mokhoa oa litafole le lipelaelo bakeng sa bana, ba ba khethollang e le ba sebetsang le ba tšepahalang. Tekanyetso e tloaelehileng ea lithethefatsi liforong tse ikhethileng ke lintlha tse 4,3,5,5 ho tsoa ho 5. Bo-'mè ba bangata ba na le tjantjello mabapi le ho emisoa, hobane ho u lumella ho sebetsana ka katleho le mafu a khafetsa a bongoana a joalo ka tonsillitis kapa bronchitis. Ntle le moo, ho emisoa ho na le tatso e monate, ka lebaka leo bana ba e ratang haholo.

Hape, monyetla oa Augmentin o nkuoa e le monyetla oa tšebeliso ea ona ho basali baimana, haholoholo ho li-trimesters tsa II le III. Lingaka li re nakong ena bakeng sa kalafo e atlehileng ho bohlokoa haholo ho hlokomela ho nepahala ha litekanyetso le ho latela litlhahiso tsohle.

Theko ea Augmentin libakeng tsa meriana

Theko e tloaelehileng ea Augmentin ka sebopeho sa letlapa: litekanyetso 875 mg / 125 mg - 355-388 li-ruble. sephutheloana se le seng sa li-pcs tse 14., litekanyetso tsa 500 mg / 125 mg - li-ruble tse 305-421. sephutheloana se le seng sa li-pcs tse 14., litekanyetso li-250 mg / 125 mg - li-ruble tse 250-266. ka pakete e le 20 likhomphutha.

O ka reka phofo bakeng sa ho hlophisoa ha ho emisoa ka molomo ka litekanyetso tsa 125 mg / 31.25 mg ka 5 ml bakeng sa li-ruble tse 134-158, litekanyetso tsa 200 mg / 28,5 mg ka 5 ml bakeng sa li-ruble tse 147-162, le litekanyetso tsa 400 mg / 57 mg ka 5 di ml - bakeng sa li-ruble tse 250-2776.

Phofo bakeng sa ho hlophisoa ha tharollo bakeng sa tsamaiso ea methapo ha e sa fumanehe.