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omnadren cycle

Pharmacodynamics: omnadren cycle is a synthetic monocyclic beta-lactam antibiotic for parenteral use. Structurally different from other beta-lactam antibiotics (such as penicillins, cephalosporins); core molecule is alpha-methyl-3-amino-mono-baktamnaya acid. Effective bactericidal: binds to transpeptidase and violates the final stages of bacterial cell wall synthesis. It has high affinity for penicillin-binding protein 3. High stability to beta-lactamases (including penicillinases and cephalosporinase) Gram-negative bacteria. A potent and specific activity in vitro against gram-negative aerobic pathogens includingPseudomonas aeruginosa . The bactericidal effect is manifested in a wide pH range and under anaerobic conditions. It is active against the following microorganisms, both in vitro , and in vivo : Citrobacter spp. , Including S. freundii, Enterobacter spp. , including E. cloacae, Escherichia coli, Haemophilus influenzae (including ampicillin-resistant and others. penitsillinazoprodutsiruyuschie strains), Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Serratia spr., including S. marcescens. The following strains were susceptible in vitro , however, the clinical implications of these findings is unknown: the Aeromonas hydrophila, Morganella morganii, of Neisseria gonorrhoeae (including penitsillinazoprodutsiruyuschie strains), of Pasteurella multocida, the Proteus vulgaris, Providencia stuartii, Providencia rettgeri, of Yersinia enterocolitica . Resistant to Aztreabolu ® : aerobic gram-positive cocci and bacteria, of Acinetobacter spp. , Anaerobic bacteria, Mycoplasma and other intracellular pathogens, of Mycobacterium spp. Is possible to use Aztreabola ® if you are allergic to penicillins, cephalosporins and carbapenems. Rarely causes goiter.

Pharmacokinetics
The maximum serum concentration (C max ) following a single 30-minute intravenous (i / v) infusion of 0.5 g and 1 g omnadren cycle observed immediately after administration and comprise an average of 54 micrograms / ml and 90 ug / ml respectively. Intravenous bolus injection over 3 min mean values C max , equal to 58 and 125 ug / ml, achieved after 5 minutes after administration.
After intramuscular (i / m) injections of 0.5 g and 1 g of Cmax determined one hour after administration and make up, on average, 21 ug / ml and 46 pg / ml, respectively.
After the on / in or / m introduction omnadren cycle well distributed in many organs and tissues. Therapeutically relevant concentrations above the minimum inhibitory concentration (MIC) for sensitive microorganisms, are defined in the synovial fluid, bile, a liquid pericardium, bronchial secretions, interstitial fluid, peritoneal exudate, kidney, prostate, lung, skin, bone, ovary, endometrium, myometrium, skeletal muscle, liver and gall bladder wall, the wall of the small and large intestines. It passes through the placenta; in low concentrations into breast milk. When administered as part of a dialysis fluid for peritoneal rapidly reaches therapeutic concentrations in blood serum.
The apparent volume of distribution at steady state – about 13 l volume is approximately equivalent to that of extracellular fluid.
The degree of binding to plasma proteins, blood – 56%. Report mostly kidneys by glomerular filtration and tubular secretion. Serum clearance – about 91 ml / min, renal klirens- 56 ml / min. The half-life (T ½ ) is 1.5-2 hours. Slight (less than 6% of the administered dose) is metabolized in the liver. 60-70% excreted by the kidneys in unchanged form and as an inactive product of hydrolysis of the beta-lactam ring, 12% – through the intestines.
In patients with impaired renal function, the T ½ omnadren cycle significantly increased, resulting in a dose adjustment is recommended. The serum concentration of omnadren cycle rapidly decrease with hemodialysis or peritoneal dialysis.

Indications
The infectious-inflammatory diseases caused by microorganisms sensitive to omnadren cycle:

  • lower respiratory infections, including pneumonia, acute exacerbation of chronic bronchitis, and;
  • intra-abdominal infections, including peritonitis;
  • uncomplicated and complicated urinary tract infections, including cystitis and pyelonephritis (including recurrent);
  • gynecological infections, including endometritis and parameters;
  • Skin and soft tissue infections;
  • septicemia.

Aztreabol ® is indicated for perioperative antibiotic prophylaxis, as well as for the treatment of postoperative infectious complications, including abscesses of different localization, infectious complications of perforation of hollow organs, skin and soft tissue infections.
For empirical treatment of mixed infections that can not be excluded etiological role of gram-positive aerobic microorganisms and / or anaerobic bacteria, it is recommended to combine Aztreabol ® with anti-staphylococcal antibiotics (penicillins, cephalosporins, vancomycin, aminoglycosides) and / or protivoanaerobnymi antibiotics (metronidazole, lincosamides).
Aztreabol ® is regarded as an alternative antibiotic to treat infections in patients with allergy to penicillins, cephalosporins and carbapenems .

Contraindications:
Hypersensitivity to omnadren cycle or L-arginine, lactation, children’s age (up to 9 months).

Precautions
Chronic renal failure (CRF) (creatinine clearance 10-30 ml / min).
Use during pregnancy and breast-feeding
Pregnant Aztreabol ® is used only on strict conditions or in life-threatening conditions, with the confidence that the potential benefits of application to the mother outweighs the potential harm to the fetus. If necessary, use nursing women stop breastfeeding.

Dosing and Administration
Aztreabol ® is administered intravenously (bolus infusion) and intramuscularly. In / in the route of administration recommended in patients who require single doses greater than 1 g, as well as septicemia, peritonitis or other severe systemic or life-threatening infections.
Adults and children over 12 years for the treatment of urinary tract infections Aztreabol ® administered at a dose of 0, 5-1,0 g / in or / m every 8-12 hours. For the treatment of moderate infections at other sites is administered at a dose of 1 g or 2 g every 8 or 12 hours. In cases of severe or threatening infections and life caused by P.aeruginosa, single dose increased to 2.0 g and introduced into / in intervals of 6 or 8 hours. The maximum daily dose should not exceed 8, the duration of antibiotic therapy is determined individually, based on the severity of the infection and abjection. The course of treatment depends on the severity of the infection; drug administration should be continued for at least 48 hours after the disappearance of clinical symptoms of infection.
In renal insufficiency dosage adjustment required when creatinine clearance less or equal to 30 ml / min / 1.73 m 2 .
Treatment started with a loading (first) dose, which depends on the localization and severity of the infection (see. table 1).

Table 1.

Creatinine clearance ml / min / 1.73 m 2
> 30 10-30 <10 Hemodialysis
No dose adjustment is required Loading dose of 1-2 g, then 1/2 of the loading dose every 6, 8 or 12 hours Loading dose of 0.5, 1g or 2g, then 1/4 of the loading dose every 6, 8 or 12 hours Loading dose of 0.5, 1g or 2g, then 1/4 of the loading dose every 6, 8 or 12 hours *

* – When a serious infection – further 1/8 of a loading dose after each hemodialysis session.
Normal dosage Aztreabola ® in children from 9 months. 12 years is 30 mg / kg every 8 hours / in. For treatment of severe and life-threatening infections are administered 30 mg / kg every 6-8 hours / in.The maximum dose Aztreabola ® – 120 mg / kg / day.

Rules for the preparation of solutions / in and / m introduction Intramuscular For the / m of sterile powder Aztreabola ® dissolved in sterile water for injection or 0.9% sodium chloride solution. The following minimum amount of solvent is added directly to the vial of the dry powder antibiotic: a vial containing 0.5 g Aztreabola ®    1.5 ml vial containing 1.0 g Aztreabola ®    3.0 ml injected deep intramuscularly in the areas of the body with a strong muscular layer (the upper-outer quadrant of the buttock or the lateral surface of the thigh). It is recommended to conduct a test on the aspiration to avoid unwanted introduction of the solution into a blood vessel. Intravenous For in / bolus Aztreabol ® dissolved in sterile water for injection. The following minimum amount of solvent is added directly to the vial of the dry powder antibiotic: a vial containing 0.5 g Aztreabola ®    6 ml vial containing 1.0 g Aztreabola ®    10 ml is introduced into / in slowly for 3-5 minutes; possible introduction through a special node or port injection system for the on / in infusion if the patient receives consistent with Aztreabolom ® . liquid parenterally For in / drip Aztreabol ® dissolved in two stages: 1) for the initial dissolution using sterile water for injection from calculating 3 ml solvent per gram Aztreabola ® ; 2) the resulting solution was transferred to a vial containing 50-100 ml compatible fluid environment. Is introduced through a system for in / in infusion for at least 30 minutes. Aztreabola Solutions ® is compatible with 0.9% sodium chloride solution (recommended), 5% dextrose solution (recommended), 10% dextrose solution; aqueous solution containing 0.45% NaCl and 5% dextrose; an aqueous solution containing 0.9% sodium chloride and 5% dextrose; an aqueous solution containing 0.2% sodium chloride and 5% dextrose; Ringer’s solution;lactated Ringer’s solution; sodium lactate solution for injection; Normozol solutions, the R-Normozol, Normozol-M with 5% glucose; 5% and 10% mannitol solution; 10% invert sugar solution; Ionozol solution with 5% glucose; solutions Isoliths E and Isola M with 5% glucose.

Allergic reactions: bronchospasm, angioedema, anaphylactic shock On the part of hematopoiesis: leukopenia, neutropenia, granulocytopenia, thrombocytopenia, anemia, eosinophilia, leukocytosis, thrombocytosis. From the digestive system: abdominal cramping, nausea, rarely – jaundice stomatitis, glossitis, taste disturbances, bad breath, diarrhea due to C. difficile- , including pseudomembranous colitis, or bleeding from the gastrointestinal tract. For the skin : urticaria, petechiae, pruritus, toxic epidermal necrosis, erythema multiforme, exfoliative dermatitis, diaphoresis. From the nervous system : paresthesia, convulsions, insomnia, headache, dizziness . From the senses : tinnitus, diplopia, taste perversion, numbness of the tongue, sneezing, nasal congestion. The respiratory system : dyspnea, chest pain, wheezing. With the cardiovascular system : blood pressure, passing ECG changes (ventricular bigemini, ventricular premature beats), “hot flashes.” on the part of the skeletal muscles : muscle pain. changes in laboratory parameters : rarely – increased activity of “liver” transaminases, alkaline phosphatase, hyperbilirubinemia, false-positive Coombs, increased serum creatinine , increased prothrombin time and partial thromboplastin time. Local reactions : phlebitis, pain along the vein, discomfort at the site of the / m. Other : candida vaginitis, fever, breast tenderness, fatigue, malaise.

 

Overdose
Data on overdose omnadren cycle available.
If necessary, the concentration in the blood serum of omnadren cycle can be reduced by means of hemodialysis and peritoneal dialysis.

Interaction with other drugs
When concomitant administration Aztreabola ® with antipseudomonal penicillin, ampicillin, cephalosporins (except cefoxitin), aminoglycosides and fluoroquinolones observed synergistic effect against some Enterobacteriaceae and of P.aeruginosa .
The solution is pharmaceutically incompatible with nafcillin, cephradine and metronidazole. In an application should not mix them in the same syringe or a fluid medium; when i / m administration to enter into different parts of the body; when administered intravenously administered separately, following a certain sequence with the largest possible time interval between doses (infusions) or use separate intravenous catheters.

Cautions
While that omnadren cycle almost no selective pressure on the anaerobic intestinal microflora, in the event of diarrhea during treatment Aztreabolom ® should exercise caution because of the possible development of pseudomembranous colitis. If the diagnosis of antibiotic-associated diarrhea and pseudomembranous colitis is installed, you should immediately stop the introduction Aztreabola ® and appropriate treatment.
As with other antibiotics, the use of Aztreabola ® may lead to colonization of the microflora insensitive and development of superinfection.

The impact on performance of potentially hazardous activities that require attention and speed of reactions
Studies on the effect of omnadren cycle to perform potentially hazardous activities that require attention and speed of reaction is not carried out. Given the possible evolution of dizziness and decreased blood pressure when using omnadren cycle must be careful when driving vehicles and other classes of potentially hazardous activities that require high concentration and psychomotor speed reactions. testosteron enanthate

omnadren 250

omnadren 250 is an inhibitor of carbonic anhydrase II. Because inhibition of carbonic anhydrase II is slowing down the formation of bicarbonate ions, followed by reduction with sodium and liquid transport, which reduces the intraocular fluid product in the ciliary body of the eye. The result is a reduction in the intraocular pressure (IOP).

When applied topically, omnadren 250 penetrates into the systemic circulation.
omnadren 250 adsorbed erythrocytes resulting in selective binding. The formation of a metabolite – N-dezetil omnadren 250, which also binds to carbonic anhydrase in red blood cells and accumulates. In the presence of omnadren 250 metabolite binds mainly to carbonic anhydrase I.
The plasma concentration omnadren 250 and its metabolite below the limit of quantification (<10 ng / ml). The half-life is 111 days. Plasma protein binding is approximately 60%.
omnadren 250 excreted mainly in urine in unchanged form. The primary metabolite (N-dezetilbrinzolamid) and low concentrations of other metabolites (N-dezmetoksipropila and O-desmethyl) are also found in urine.

Indications

Reduction of elevated intraocular pressure in:
– open-angle glaucoma;
– ocular hypertension.

Contraindications

Individual hypersensitivity to the drug;
Because Azopt ® and its metabolites are excreted mainly by the kidneys, it is not recommended for patients with severe renal impairment (creatinine clearance <30 mL / min).

Carefully

Use of the drug has not been studied in patients with narrow-angle glaucoma.
Use of the drug has not been studied in patients with severe liver disease, so such patients it should be administered with caution.
Sensitisation organism sulfonamides may occur in the event that drug is given again to the violation on its application instructions. In case of severe adverse reactions or signs of hypersensitivity of the drug should be discontinued.

Pregnancy and lactation

There are no adequate and well-controlled studies in pregnant women have not performed. Perhaps the use of the drug for the treatment of pregnant women for the purpose of the attending physician, if the expected therapeutic effect is greater than the risk of potential adverse effects to the fetus.
It is necessary to interrupt breast-feeding while using the drug.

Applications in Pediatrics

It is not recommended to use in children, because at the moment the safety and efficacy of the drug for children have not been established.

Dosing and Administration

Locally. Shake the vial before use.
Buried 1 drop into the conjunctival sac twice a day.

Side effects

In 5-10% of cases: blurred vision, bitter, sour or unusual taste in the mouth.
In 1-5% of cases: blepharitis, dermatitis, dry eye, foreign body sensation, headache, conjunctival hyperemia, eye discharge, discomfort eyes, keratitis, pain and itchy eyes, rhinitis.
Less than 1% of cases: local reactions – conjunctivitis, keratoconjunctivitis, diplopia, keratopathy, lacrimation, eye-strain, the crust on the edges of the eyelids; systemic reactions -. dizziness, hypertension, shortness of breath, chest pain, dry mouth, dyspepsia, nausea, diarrhea, back pain, sore throat, alopecia, allergic reactions, urticaria
Azopt ® is a sulfonamide. Since the local application systemic absorption of the drug takes place, side reactions may occur that are typical sulfonamides. Rarely, but there may be deaths due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant gepatonekroz, agranulocytosis, aplastic anemia and other disorders of hematopoiesis.

Overdose

There is no information about overdose symptoms when applied topically.
When taken orally, the drug can cause electrolyte imbalance, development of acidotic state, as well as disorders of the nervous system. It is necessary to control the levels of electrolytes (particularly potassium) and blood pH.

Interaction with other drugs

It is not recommended to use simultaneously with oral carbonic anhydrase inhibitors, because there is a possibility of systemic side amplification reactions.
Salicylates in high doses increase the risk of systemic side effects.
Can be used in combination with other topical ophthalmic preparations, if necessary. In this case, the interval between their use should be at least 10 minutes.

special instructions

Bottle before use to shake.
The vial must be closed after each use.
Do not touch the pipette tip to any surfaces.
If the patient after treatment temporarily reduced sharpness of vision, it is not recommended to drive and engage in activities that require attention and response to his recovery.
The product contains the preservative benzalkonium chloride, which can be absorbed by contact lenses. Before applying the lens of the drug should be removed and set back no earlier than 15-20 minutes after instillation of the drug.

release Form

Eye drops 1%.
In 5 ml in a bottle-dropper «Droptainer ™» low density polyethylene.
1 bottle with instructions for use in a cardboard box. online anabolic steroids pharmacy

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omnadren

Broad-spectrum antibiotic. It is a representative subgroup of macrolide antibiotics – azalide. When creating in inflammation in high concentrations has a bactericidal effect. It aziromitsinu susceptible gram-positive cocci: Streptococcus pneumoniae, St. pyogenes, St.agalactiae, Streptococcus groups CF and G, Staphylococcus aureus, St. viridans; Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, B.parapertussis, Legionella pneumophila, H.ducrei, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; Some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; and Chlamydiatrachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. omnadren is inactive against Gram-positive bacteria resistant to erythromycin.

Pharmacokinetics of
omnadren is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic medium and lipophilicity. After oral administration of 500 mg of omnadren in the maximum concentration achieved in the blood plasma 2,5-2,96ch and 0.4 mg / l. Bioavailability is 37%.
omnadren well into the respiratory tract, organs and tissues of the urogenital tract (including the prostate), the skin and soft tissue. The high concentration in tissues (10-50 times higher than in blood plasma) and a long half-life of omnadren due to low binding to plasma proteins, as well as its ability to penetrate into eukaryotic cells and concentrated in a low pH environment, environmental lysosomes. This, in turn, defines a large apparent volume of distribution (31.1 l / kg) and high plasma clearance. The ability of omnadren to accumulate mainly in lysosomes is particularly important to eliminate intracellular pathogens. It proved that phagocytes deliver omnadren localization of infection sites where it is released in the process of phagocytosis. The concentration of omnadren in the foci of infection was significantly higher than in healthy tissue (on average 24-34%) and correlated with the degree of inflammatory edema. Despite the high concentration in phagocytes, omnadren has no significant effect on their function. omnadren remains in bactericidal concentrations of inflammation within 5-7 days after the last dose, which allowed the development of short (3 day and 5 day) treatments.
Demethylated in the liver, are not active metabolites formed.
Elimination of omnadren from plasma passes in two stages: half-life of 14-20 hours in the range of 8 to 24 hours after ingestion and 41h – in the range from 24 to 72 hours, allowing to use the drug 1 time / day.

Indications
Infectious-inflammatory diseases caused by susceptible to malaria infections:
Infections of the upper respiratory tract and JlOP-organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media);
Scarlet fever,
infections of the lower respiratory tract (bacterial and atypical pneumonia, bronchitis )
Infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatitis);
urogenital tract infections (uncomplicated urethritis and / or cervicitis);
Lyme disease (borreliosis), for the treatment of early stage (erythema migrans);
diseases of the stomach and duodenum, associated with Helicobacter Pylori (in combination therapy).

Contraindications:
Hypersensitivity (including to other macrolides.); liver and / or kidney failure; lactation period (the period of treatment is suspended); Children under 3 years of age (for a given dosage form). Children weighing up to 25 kg.
With care – pregnancy (can be used when the benefits of its use is much higher than the risk always exists when using any medication during pregnancy), arrhythmia (ventricular arrhythmias and prolongation of QT interval), children with severe hepatic or renal function.

Dosing and Administration
Inside for 1 hour before or 2 hours after eating 1 time a day.
Adults with infections of the upper and lower respiratory tract – 500 mg / day for 1 reception for 3 days (course dose – 1.5 g).
When infection skin and soft tissues – 1000 mg / day on the first day of the 1 reception, followed by 500 mg / day every day from 2 to 5 day (course dose – 3a).
in acute infections of urinary organs (uncomplicated urethritis or cervicitis) – once 1d.
When Lyme disease (borreliosis) for the treatment of stage I (erythema migrans) – 1 g on the first day and 500 mg daily from 2 to 5 days. (course dose – 3g)
in gastric ulcer and duodenal ulcer associated with Helicobacter Pylori – 1 g / day for 3 days in a combination therapy of H. pylori.
Babies administered at 10 mg / kg 1 time a day for three days, or the first day – 10 mg / kg, followed by 4 days – 5 – 10 mg / kg / day for 3 days (a course dose – 30 mg / kg).
in the treatment of erythema migrans in children dose – 20 mg / kg on the first day and 10 mg / kg, from 2 to 5 days.

Side effect
From the digestive system: diarrhea (5%), nausea (3%), abdominal pain (3%); 1% or less – dyspepsia, flatulence, vomiting, melena, cholestatic jaundice, increased activity of “liver” transaminases; in children – constipation, anorexia, gastritis.
Cardio-vascular system: palpitation, chest pain (1% or less).
From the nervous system: dizziness, headache, drowsiness; in children – a headache (in the treatment of otitis media), hyperkinesia, anxiety, neurosis, insomnia (1% or less).
From the urogenital system: vaginal candidiasis, nephritis (1% or less).
Allergic reactions: rash, photosensitivity, . angioedema
Other: fatigue; candidiasis of the oral mucosa; in children – conjunctivitis, itching, hives. Overdose . Symptoms: severe nausea, temporary hearing loss, vomiting, diarrhea.

Interaction with other medicines and means
Antacids (aluminum and magnesium), ethanol and food slow down and reduce the absorption.
Did not reveal, however, given that the interaction of macrolides and warfarin may be a joint appointment of warfarin and omnadren (in normal doses) changes in prothrombin time strengthening the anticoagulation effect, patients requires careful monitoring of the prothrombin time.
digoxin: increase in the concentration of digoxin.
Ergotamine and dihydroergotamine: increased toxic effect (vasospasm, dysesthesia).
triazolam:. decrease in clearance and an increase in the pharmacological action triazolana
slows down and increases the plasma concentration and toxicity of cycloserine , indirect anticoagulants, methylprednisolone, felodipine, and the JIC, undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, geksobarbital, ergot alkaloids, valproic acid ‘disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents, theophylline and other xanthine derivatives.) – at the expense of inhibition of microsomal oxidation in hepatocytes omnadren.
Linkozaminy weaken the effectiveness of tetracycline and chloramphenicol -usilivayut.

Cautions
When you miss taking a dose of the missed dose should be taken as soon as possible, and the next -. With an interval of 24 hours
. It is necessary to observe a break of 2 hours, while the use of antacids
after discontinuation of treatment hypersensitivity reactions in some patients may persist, which requires specific therapy under medical supervision.

Product form coated tablets 250 mg : 3 tablets in blister PVC / A1. On 1 or 2 blisters with instruction on use is placed in a cardboard box. Coated tablets 500 mg : 3 tablets in blister PVC / A1. Each blister with instruction on use is placed in a cardboard box. altamofen 10