Zinacef powder for injection vial 1,5g N1
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Description
Powder for solution for injection Zinacef contains in the composition of cefuroxime (in the form of sodium salt). Cefuroxime is active against a wide range of pathogens, including strains that produce beta-lactamase. The bactericidal effect of cefuroxime is associated with the suppression of the synthesis of the bacterial cell wall as a result of binding to the main target proteins.
Active ingredients
Cefuroxime
Release form
Powder
Composition
Cefuroxime (in the form of sodium salt) 1.5 g
Indications
Treatment of diseases caused by bacteria susceptible to cefuroxime: -infection of the upper and lower respiratory tract (pneumonia, bronchitis, infected bronchiectasis, lung abscess, postoperative infectious diseases of the chest organs), otolaryngitis infections (otitis media, sinusitis, tonsillitis, pharyngitis) ), - infections of the urinary tract (pyelonephritis, cystitis, asymptomatic bacteriuria, gonorrhea), - infections of the skin and soft tissues (furunculosis, erysipelas and wound infections), - infections of bones and joints (osteomyelitis and septic arthritis t), - infection of the pelvic organs, -septitsemiya, -meningit, -peritonit.Profilaktika infectious complications during operations on the abdominal, pelvic, orthopedic surgery, heart surgery, lung, esophagus and blood vessels.
Precautionary measures
Precautions should be prescribed to patients with an anaphylactic reaction to penicillins and other beta-lactam antibiotics in history. When used simultaneously with aminoglycosides and diuretics, the risk of nephrotoxic effects increases, therefore, kidney function must be monitored when using this combination of drugs, especially in elderly patients, with kidney disease and in those receiving the drug in a high dose. When treating meningitis with Zinaceph, some children have had a hearing loss moderate, while in the CSF were determined positive culture Haemophilus influenzae after 18-36 hours of therapy. Similar phenomena were also observed when using other antibiotics, their clinical significance is not known. Pseudomembranous colitis is observed when using a wide range of antibiotics, the possibility of its occurrence must be kept in mind in patients with severe diarrhea,arose during or after the course of treatment with antibiotics. Cefuroxime is also available in the form of axetil (Zinnat) in pills, which allows you to prescribe the same antibiotic successively when switching from parenteral to oral therapy is needed. the course of treatment with Zinacef, an antibiotic for parenteral administration, before using Zinnat inside (step therapy method). In case of step therapy, the time for switching to oral therapy It determined by the severity of infection, clinical status and susceptibility. If there is no clinical effect within 72 hours from the start of treatment, the parenteral course of therapy should be continued. Before starting the step therapy, contact the available reference books for cefuroxime axetil for information. Zinc does not affect the results of the determination of glucose in the urine using enzymatic methods. However, when using other methods (Benedict, Fehling, Klinitest), there may be an interaction that does not lead to false positive results. In patients receiving Zinacef, it is recommended to use the method with glucose oxidase or hexokinase to determine the glucose level in the blood / plasma. quantitative determination of creatinine by the alkali-picrate method.
Use during pregnancy and lactation
The drug belongs to category B. Precautions should be prescribed during pregnancy. Cefuroxime is excreted in breast milk, so caution should be exercised in prescribing the drug to nursing mothers. There are no data on the development of embryotoxic or teratogenic effects of cefuroxime.
Dosage and administration
Adults appoint i / m or / 750 mg 3 times / day. In more severe cases, the drug is introduced into / in a dose of 1.5 g 3 times / day. If necessary, Zinacef can be administered every 6 hours, and the daily dose can be from 3 to 6 g. In some infections, it is effective to prescribe Zinacef at a dose of 750 mg or 1.5 g 2 times / day (i / m or v / v) followed by taking Zinnat inside. For children, the drug is prescribed in a dose of 30-100 mg / kg / day in 3-4 doses. For most infections, the optimal dose is 60 mg / kg / day. Newborns are prescribed 30-100 mg / kg / day in 2-3 doses. For the treatment of gonorrhea, 1.5 g are administered once (two doses of 750 mg i / m to different places , eg,in both gluteal muscles). In meningitis, adults are prescribed 3 g i.v. every 8 h, children 150-250 mg / kg / day i.v. in 3-4 doses, newborn 100 mg / kg / day i.v. For the prevention of infectious complications during operations on the abdominal organs, pelvis and orthopedic interventions, Zinacef in a dose of 1.5 g is introduced into / in during induction anesthesia. After 8 hours and 16 hours after the operation, 750 mg of Zinatseff may be additionally introduced. For the prevention of infectious complications during operations on the heart, lungs, esophagus and vessels during induction anesthesia, Zinatse is administered IV at a dose of 1.5 g, and then within 24-48 hours, 750 mg 3 times / day intramuscularly. With a complete joint replacement, 1.5 g of cefuroxime powder can be mixed with a polymer package with methyl methacrylate cement before adding the liquid polymer.
Side effects
On the part of the digestive system: nausea, vomiting, diarrhea, spasms and abdominal pain, pseudomembranous colitis, oral candidiasis, increased liver enzymes (ALT, AST, LDH, ALP), hyperbilirubinemia. From the hematopoietic system: eosinophilia, leukopenia neutropenia, thrombocytopenia, agranulocytosis, hemolytic anemia. For the central nervous system and sensory organs: convulsions, hearing loss. For the urogenital system: impaired kidney function with increased creatinine and / or urea nitrogen and reduced CC, itching STI, vaginitis (with the development of candidiasis). Allergic reactions: exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), skin rash (including urticarial), pruritus, drug fever, bronchospasm, serum sickness, very rarely - anaphylactic shock. Laboratory indicators: Coombs' false positive test. Local reactions: with i / m administration - pain, irritation and infiltration at the injection site, with a / in the introduction - phlebitis, thrombophlebitis. Long-term use Zinatsepha can resist Enjoy excessive growth of insensitive microorganisms, incl. Candida fungi with the development of oral candidiasis and vagina (itching, discharge).
Overdose
Symptoms: increased excitability of the cerebral cortex with the development of convulsions. Treatment: symptomatic therapy, hemodialysis, peritoneal dialysis.
Interaction with other drugs
Simultaneous intake with "loopback" diuretics (furosemide) and aminoglycosides slows down tubular secretion, reduces renal clearance, increases plasma concentration and increases T1 / 2 cefuroxime, which increases the risk of nephrotoxic effects. Zinacef in combination with aminoglycosides act additively, but synergism of action can sometimes be observed. When mixing a solution of cefuroxime (1.5 g in 15 ml of water for injection) and metronidazole (500 mg / 100 ml), both components retain their activity up to 24 hours at a temperature not higher than 25 ° C. Zinacef in a dose of 1.5 g is compatible with a solution of azlocillin (1 g in 15 ml or 5 g in 50 ml), both components retain their activity up to 24 hours at 4 ° C or up to 6 hours at a temperature not exceeding 25 ° C. The solution of Zinacef (5 mg / ml) in a 5% or 10% solution of xylitol can be stored for up to 24 hours at a temperature not exceeding 25 ° C. Zinacef is compatible with aqueous solutions containing up to 1% lidocaine hydrochloride. Zinacef is compatible with the most widely used infusion solutions When mixed with the following solutions, the drug is stable up to 24 hours at room temperature: 0.9% sodium chloride solution, 5% dextrose solution for injection, 0.18% sodium chloride solution and 4% dextrose solution for injection, 5% dextrose solution and 0.9% sodium chloride solution, 5% dextrose solution 0.45% sodium chloride solution, 5% dextrose solution and 0.225% sodium chloride solution, 10% dextrose solution for injection, Ringer's solution, Ringer's lactate solution, Hartman solution. Cefuroxime stability in 0.9% sodium chloride solution and 5% dextrose solution is not disturbed in the presence of sodium phosphate hydrocortisone. With the following solutions, Zinacef is compatible and stable for 24 hours at room temperature: heparin (10 U / ml and 50 U / ml) in 0.9% sodium chloride, potassium chloride (10 meq / l and 40 meq / l) in 0.9% sodium chloride solution. Zinatse should not be mixed In a single syringe with aminoglycoside antibiotics. The sodium bicarbonate solution has a 2.74% pH value that significantly affects the color of the cefuroxime solution, so it is not recommended to be used to dilute Zinatseff. However, if the patient is injected with sodium bicarbonate solution by infusion, then Zinacef can, if necessary, be introduced directly into the tube of the infusion system.