Composition, structure and packing
Tablets are white, ploskotsilindricheskoy shape with beveled and risks.
1 tab. ampicillin (in the form of trihydrate) 250 mg.
Excipients: potato starch, magnesium stearate, talc, polyvinylpyrrolidone, Tween-80.
Powder for Oral suspension white with a yellowish tinge, with a specific smell, preparation of suspensions of white with a yellowish tinge.
1 vial. 5 ml of a suspension prepared. ampicillin (in the form of trihydrate) 5 g/250 mg.
Excipients: polyvinylpyrrolidone, sodium glutamate 1-acid water, sodium phosphate, disodium phosphate, or disodium anhydrous, Trilon B, dextrose, vanilla, essence of aromatic edible (raspberry), refined sugar or powdered sugar refinery.
Powder for solution for injection in white, hygroscopic.
1 vial. ampicillin (in the form of sodium salt) 1 PM
Powder for solution for injection in white, hygroscopic.
1 vial. ampicillin (in the form of sodium salt) 2
Clinico-pharmacological group: Antibiotic penicillin group of broad-spectrum, collapsing penicillinase.
Pharmacological action
Antibiotic group semisynthetic penicillins a broad spectrum of action. Bactericidal action by suppressing the synthesis of bacterial cell wall. It is active against Gram-positive aerobic bacteria: Staphylococcus spp. (With the exception of strains producing penicillinase), Streptococcus spp. (Including Enterococcus spp.), Listeria monocytogenes; Gram-negative aerobic bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Bordetella pertussis, some strains of Haemophilus influenzae. Destroyed by penicillinase. Acid-resistant.
Pharmacokinetics
Absorption
After oral administration is well absorbed from the gastrointestinal tract, or failure in the acidic environment of the stomach. After parenteral administration (in / m / v) is found in plasma in high concentrations.
Distribution
Well into the tissue and biological fluids, is found in therapeutic concentrations in pleural, peritoneal and synovial fluids. Penetrates through the placental barrier. Poorly crosses the blood-brain barrier, but the inflammation of the meninges of BBB permeability increases dramatically. Metabolism 30% of ampicillin is metabolized in the liver.
Withdrawal
T1 / 2 - 1-1.5 hours is derived mainly from urine, and urine are very high concentrations of unchanged drug. Partly derived from bile. With repeated administration not cumulative.
Statement
Infectious-inflammatory diseases caused by microorganisms susceptible to ampicillin, including:
respiratory tract infections (including bronchitis, pneumonia, lung abscess);
infection ENT organs (including tonsillitis);
biliary tract infections (including cholecystitis, cholangitis);
urinary tract infections (including pyelitis, pyelonephritis, cystitis);
gastrointestinal infections (including salmonellonositelstvo);
gynecological infections;
infections of skin and soft tissues;
peritonitis;
sepsis, bacterial endocarditis;
serologies
rheumatism
mug;
scarlet fever;
gonorrhea.
Dosage regimen
Install individually depending on the severity, localization of infection and sensitivity of the parasite. When administered a single dose for adults is 250-500 mg daily dose - 1-3, the maximum daily dose is - 4 PM
Children of drug administered in a daily dose of 50-100 mg / kg for children weighing up to 20 kg - 12.5-25 mg / kg. The daily dose is divided into 4 admission. Duration of treatment depends on the severity of infection and the effectiveness of treatment.
The tablets are inside, regardless of the meal. To prepare the suspension in a vial with a powder added to 62 ml of distilled water. Dosing prepared suspension of the special spoon, which has two tags: the lower corresponds to 2.5 ml (125 mg), upper - 5 ml (250 mg). The suspension should be washed down with water.
For parenteral administration (in / m / v jet, or in / drip) single dose for adults is 250-500 mg daily dose - 3.1 g; in severe infections the daily dose may be increased to 10 grams or more.
Newborn drug administered in a daily dose of 100 mg / kg, children other age groups - 50 mg / kg. In severe infections these doses may be doubled. The daily dose is divided into 4-6 injections at intervals of 4-6 hours in length / m introduction - 7-14 days. Running in / application 5-7 days before proceeding (if necessary) to the / m injection.
Solution for i / m administration is prepared by adding to the contents of the vial 2 ml water for injection. For iv administration a single dose of jet preparation (no more than 2 g) dissolved in 5-10 ml of water for injection or isotonic sodium chloride solution and injected slowly over 3-5 minutes (1-2 g over 10-15 min) .
When a single dose greater than 2 g, a drug is introduced into / in the drip. For this one-time dose (2-4 g) is dissolved in 7.5-15 ml of water for injection, then the resulting solution added to 125-250 ml isotonic sodium chloride or 5.10% glucose solution and injected at a speed of 60-80 Cap. min.
When i / v drip children as a solvent used 5-10% glucose solution (30-50 ml depending on age). The solutions are used immediately after preparation.
Side effect
Allergic reactions: skin rash, urticaria, Quincke's edema, pruritus, exfoliative dermatitis, erythema multiforme, and in rare cases - anaphylactic shock.
On the part of the digestive system: nausea, vomiting, diarrhea, glossitis, stomatitis, pseudomembranous colitis, bowel bacteria overgrowth, increase in liver transaminases.
The part of the hemopoietic system: anemia, leukopenia, thrombocytopenia, agranulocytosis. Effects due to chemotherapeutic action: oral candidiasis, vaginal candidiasis.
Contraindications
increased sensitivity to antibiotics of the penicillin group and other beta-lactam antibiotics;
marked disturbances of liver function (for parenteral use).
Pregnancy and lactation
It is possible to use the drug during pregnancy on the evidence in those cases where the benefits to the mother outweighs the potential risk to the fetus. Ampicillin is excreted in breast milk in low concentrations. If necessary, use during lactation should decide on the termination of breastfeeding.
Application for violations of liver function
Parenteral use is contraindicated when disturbancies liver function.
Application for violations of renal function
Patients with impaired renal function require correction dosing regimen, depending on the spacecraft. In applying the drug in high doses in patients with renal insufficiency may be toxic to the CNS.
Cautions
Precautions against the background of the simultaneous application of desensitizing should appoint a drug in bronchial asthma, hay fever and other allergic diseases. In the process of Ampicillin-Akos requires systematic monitoring of kidney function, liver and peripheral blood picture.
When liver failure medication should be used only under the control of liver function. Patients with impaired renal function require correction dosing regimen, depending on the spacecraft.
In applying the drug in high doses in patients with renal insufficiency may be toxic to the CNS.
In applying the drug for the treatment of sepsis can bacteriolysis reaction (reaction Jarisch-Herxheimer).
If you have allergic reactions during treatment with ampicillin-Akos drug should be removed and appoint desensitizing therapy. In weakened patients with prolonged use of the drug may develop a superinfection due to ampicillin-resistant microorganisms. For prevention of candidiasis in conjunction with ampicillin-Akos should appoint nystatin or levorin, as well as vitamins B and C.
Overdose
Currently, cases of drug overdose Ampicillin-Akos not reported.
Drug Interactions
Probenecid, while the use of ampicillin-Akos reduces tubular secretion of ampicillin, resulting in increased concentration in blood plasma and increases the risk of toxic action.
With simultaneous application of ampicillin-Akos with allopurinol increases the probability of occurrence of skin rash.
When applied simultaneously with the ampicillin-Akos reduced efficiency estrogenosoderzhaschih oral contraceptives.
When applied simultaneously with the ampicillin-Akos increases the effectiveness of anticoagulants and antibiotics-aminoglycosides.
Terms and Conditions of storage
List B. The drug should be stored in a cool, dark place, tablets and powder for suspension - at a temperature of 15 ° to 25 ° C, powder for solution for injection - at or above 20 ° C.
Expiration of tablets, powder for suspension and powder for solution for injection - 2 years. Preparation of suspensions should be stored in the refrigerator or at room temperature for no more than 8 days. Prepared solutions for the / m and / in the introduction of storage can not be.
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