Directory → Antimicrobials, and protivoparazitarnae protivoglistnae funds → Antibiotics → Macrolides and azalida → Clarithromycin
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CharacteristicsAntibiotics second generation of a group of macrolides. White or no white crystalline powder, soluble in acetone, sparingly soluble in methanol, ethanol, acetonitrile and nerastvorim almost in the water.
Of drugsDrugs, the Sun (bacteriostatic), protivoyazvennoe. Associated with the 50S subjedinica membranes ribosom microbial cells and suppresses the synthesis of protein. The ingestion quickly and adequately absorbed. Food slows induction are not significantly influencing bioavailability. After receiving a single recorded two savorotocna peak concentration. The second peak is the ability to concentrate in the gall bladder and then gradual or quick release. The plasma is associated with savorotocnami protein (more than 90%). About 20% of the dose immediately oxidized in the liver with the formation of a metabolita 14-гидроксикларитроми��ина (has expressed antimicrobial activity against Haemophilus influenzae). Biotransformation kataliziruetsa enzymes zitohromnogo of P450. It enters the fluid and tissues, a concentration 10 times higher than the level in the serum. T_1/2 admission to 250 mg, 3-4 p, 500 mg-at 5-7 Return with urine in unchanged form 20-30%, the rest in the form of metabolites. Active against intracellular pathogens (Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia trachomatis and Chlamydia pneumoniae, Ureaplasma urealyticum), grampolaugitionah (Streptosoccus spp. And Staphylococcus spp. , Listeria monocytogenes, Corynebacterium spp.) Gramotricationah and bacteria (Haemophilus influenzae and Haemophilus ducreyi, Moraxella catarrhalis, Bordetella pertussis, Neisseria meningitidis, Borrelia burgdorferi, Pasteurella multocida, Campylobacter spp. , Helicobacter pylori) Some anaerobov (Eubacterium spp. , Peptococcus spp. , Propionibacterium spp. , Clostridium perfringens, Bacteroides melaninogenicus), Toxoplasma gondii and all mycobacteria other than V.tuberculosis.
IndicationsSexually upper respiratory tract and Lor-organov (tonzillofaringit average otitis, acute sinusit), lower respiratory tract infections (acute bronchitis, exacerbation of chronic bronchitis, bacterial and SARS), the skin and soft tissues, mikobacterialnaya infection (M.avium complex, M.cansasii, M.marinom, M.leprae), saying the disease duodenal ulcers and stomach problems caused by the Helicobacter pylori (combined therapy).
ContraindicationsHypersensitivity, severe liver disease, porphyria, pregnancy and breast-feeding.
Side-EffectsNausea, vomiting, changes in taste, abdominal pain, diarrhoea, psevdomembranosny Colitis, disease, glossit, dizziness, headache, anxiety, fear, insomnia, nightmares, the increase in activity of liver enzymes, holetsatical jaundice, allergic (urticaria, syndrome Stevens-Johnson, etc.) and anaphylactoidnye reaction.
Patient interactionIncreases concentration in the blood products metaboliziruthan in the liver, with the participation of enzymes zitohromnogo of P450 : racumin etc. anti proximity, carbamazepina, theofillina, astemizola, cizaprida, triazolama, midazolama, cyclosporine, digoxin, LPV alkaloids, etc., reduces the absorption of pills.
PrecautionsBe wary appoint amidst preparations metaboliziruthan sauce (to measure their concentration in the blood). When combined with varfarinom or other indirect antikoagulyantami there is a need to control protrombinovoe time. In heart disease in history is not recommended simultaneous with terfenadine, cizapridom, astemizolom.
Dosing and AdministrationThe inside is not liquid, squeezed small amounts of liquid. Adults and children over the age of 12 years, 250 mg every 12 hours; With sinusitis, severe infections, including by H.influenzae, 500 mg in 12 hours; maximum daily intake and two children up to 12 years in the 7.5 mg / kg body weight every 12 hours; maximum daily dose of 500 mg. The course of treatment is 14 days. In patients with renal insufficiency (as Cl creatinine less than 30 ml / min or concentration of whey creatinine more than 3.3 ml diet) that the admission of one-time 250 mg / day (with heavy infections on the 250 mg twice a day).
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