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Chemical nameErythromycin 9-[0-[(2-метоксиэтокси)ме тил]-оксим]
Of drugsThe drugs of anti - (бактериостатическое) . Associated with the 50S subjedinica ribosom, ingibiruet translocation reaction and transpeptidace suspends education peptide linkages between amino acids and peptide chain down protein biosynthesis ribosomami, depressing growth and reproduction of bacteria. And postantibioticski Effectom.bystro absorbed in the intestine (stable in the acidic environment of stomach), is found in the blood after 15 minutes (of food intake back, but have little impact on the bioavailability). C_max achieved through 1.5-2 h at the dose of 150 mg of 6.6 mg / O Appointment every 12h maintain effective concentrations over the course. With long-term use of 150 mg twice a day or 300 mg once a day equilibrium concentration in the blood is between 2 and 4 days cumulation is not observed. So 96% is associated with plasma proteins (mainly from acid glikoproteinom, to a lesser extent, from albuminom and lipoproteinami), and increased concentration in the blood above 4 mg / l fixation on proteins declined. There is a high volume of distribution (31.2 litres), well penetrates the tissues and fluids (lungs, bronhialny secret nebnye pyelonephritis, adenoids, and quite sinus surgery, bone, skin, genitals, drinking, liquid secondary ear and skin blister, sleznuu, plevralnuu, sinovialnuu); Little place in the liquor. Creates high (sufficient to suppress growth intracellular pathogens infections) concentration macrofagah, polimorfnoyadernah neitrofilah, monocitah, stimulates their faguoqitarnuyu activity. Metabolised, although more than half of the active substance presented as unaltered, mainly through blood, in part urine (up to 10%), through the lungs (15%) in breast milk (less than 0.05%). Kidney Cl increases with the dose. Excreted slowly T_1/2 little depends on the dose and the 10,5-14 pm Children between the ages of 1 month to 13 years T_1/2 to 20 hours When a single 300 mg in older patients (60-79 years) increased the AUC and T_1/2 declining kidney Cl because of declining kidney function, but the number of available with urine drug is not changing. In patients with alcoholic cirrhosis is increasing significantly and T_1/2 C_max with heavy kidney failure increased the AUC and T_1/2 declines S_1 renal excretion with Mochoi.k roksitromitino sensitive Bordetella pertussis, Borrelia burgdorferi, Moraxella (Branhamella) catarrhalis, Campylobacter coli, Campylobacter jejuni, Chlamydia trachomatis, Chlamydia psittaci, Chlamydia pneumoniae, Clostridium spp. , Corynebacterium diphtheriae, Enterococcus, Gardnerella vaginalis, Methi-S-Staphylococcus, Neisseria meningitidis, Helicobacter pylori, Legionella pneumophilia, Listeria monocytogenes, Mycoplasma pneumoniae, Pasteurella multocida, Peptostreptococcus, Porphyromonas, Propionibacterium acnes, Rhodococcus egui, Streptococcus pneumoniae, Streptococcus spp. , Haemophilus influenzae, Ureaplasma urealyticum, Vibrio cholerae, Staphylococcus aureus, Staphylococcus Epidermidis.obladaet �ротивовоспалительно�� activity from antioxidant properties and inhibition of Cytokines.
IndicationsSexually respiratory and Lor-organov (tonzillit, pharyngitis, sinusit, diphtheria, whooping cough, otitis medium SARS bacterial infection in chronic obstructive lung diseases, bronchitis, and acute exacerbation of chronic, panbronhiolit, bronhoektaza), the genitourinary system (Hospital but gonoreynogo, Dysmenorrhea, zerviko-waginit, including caused father and mikoplazma), the skin and soft tissues (face, wrapping, furunkula, folliculitis, impetigo, piodermia) of the oral cavity (periodontit, periostit, chronic osteomielit), NIMBY erythema, prevention of meningococcal meningitis among people who have been in contact with infected, in patients with bakteriemiei endocarditis, and the dental operations.
ContraindicationsГиперчувствительност ь (incl. to antibiotikam-makrolidam etc.), expressed human liver, pregnancy, breast-feeding (at the end of treatment), breast age (up to 2 months), a simultaneous intake of ergotamine.
Side-EffectsNausea, vomiting, anorexia, neuralgia, constipation / diarrhea, stomachache, flatulence, melena, changing taste, tranzithornoe increasing transaminaz and alkaline phosphatase, holetsaticeski hepatitis, pancreatitis symptoms; Dizziness, weakness, malaise, impaired vision and smell, noise in the ears, headache, parestesia; Itching, rash, hyperemia, urticaria, eczema, swelling angioneuroticeski, bronhospazm, anaphylactic shock; Superinfection, oral and vaginal candidiasis.
Patient interactionIncreases the absorption of digoxin. Increases C_max, AUC, T_1/2 and general Cl theofillina, midazolama, triazolama and might increase their toxicity. Do toxicity ergotamine and ergotaminopodobnykh sossoudossoujiwath funds (increases risk of ergotizma and necrotic tissue limbs). Push from the blood plasma proteins dizopiramid (in the blood increases the free fraction). Increases savorotocnuu concentration astemizola, cizaprida, pimozida, resulting in a longer QT interval and / or a heavy heart arrhythmias. When combined with omeprazolom increases bioavailability of both drugs.
PrecautionsIn appointing patients with liver failure should proceed with caution, a correction dose monitor liver function. The joint appointment terfenadina, astemizola, cizaprida pimozida and there is a need to control the ECG.
Dosing and AdministrationInside, and food, adults-150 mg twice or 300 mg once a day, with severe renal failure is 150 mg once a day. For children from 5 to 8 mg / kg / day in 2 admission (not exceeding 10 days). Length rate depends on the severity of infection and the causal agent activity (from 5-12 days with acute respiratory diseases and Lor-organov to 2-2.5 months after chronic osteomielite).
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