Цефтазидим Порошок, флакон, 1 шт, 0.1 гр, для раствора для внутривенного и внутримышечного введения

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Концентрации цефтазидима превышающие минимальные ингибирующие концентрации для большинства распространенных патогенных микроорганизмов могут быть достигнуты в костной ткани тканях сердца желчи мокроте синовиальной жидкости внутриглазной плевральной и перитонеальной жидкостях. Легко проникает через плаценту и выделяется с трудным молоком. При отсутствии воспалительного процесса плохо проникает через гематоэнцефалический барьер. При менингите концентрация в спинномозговой жидкости достигает терапевтического значения (4-20 мг/л и выше). Период полувыведения - 19 ч у новорожденных - в 3-4 раза продолжительнее; при гемодиализе - 3-5 ч. Не метаболизируется в печени. Выводится почками (80-90 % в неизмененном виде путем клубочковой фильтрации) в течение 24 ч; с желчью - менее 1 %."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Инфекции нижних дыхательных путей (бронхит инфицированные бронхоэктазы пневмония абсцесс легкого эмпиема плевры инфекции легких у больных муковисцидозом);"}},{"type":"paragraph","data":{"text":"ЛОР-инфекции (средний отит мастоидит синусит);"}},{"type":"paragraph","data":{"text":"инфекции мочевыводящих путей (пиелонефрит пиелит цистит уретрит абсцесс почки);"}},{"type":"paragraph","data":{"text":"инфекции мягких тканей (флегмона рожа раневые инфекции мастит язва кожи);"}},{"type":"paragraph","data":{"text":"инфекции костей и суставов (остеомиелит септический артрит);"}},{"type":"paragraph","data":{"text":"инфекции желудочно-кишечного тракта желчевыводящих путей и брюшной полости (холангит холецистит эмпиема желчного пузыря забрюшинные абсцессы перитонит диверкулит энтероколит); инфекции органов малого таза;"}},{"type":"paragraph","data":{"text":"сепсис;"}},{"type":"paragraph","data":{"text":"гонорея;"}},{"type":"paragraph","data":{"text":"менингит."}},{"type":"paragraph","data":{"text":"Профилактика инфекционных осложнений при операциях на предстательной железе."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к цефтазидиму и к препаратам группы цефалоспоринов и пенициллинов."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Почечная недостаточность период новорожденности колит в анамнезе пациенты с синдромом мальабсорбции (повышен риск снижения протромбиновой активности особенно у лиц с выраженной почечной и/или печеночной недостаточностью) кровотечения в анамнезе."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В период беременности цефтазидим назначают только в том случае когда предполагаемая польза для матери превышает потенциальный риск для плода. При необходимости назначения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутривенно или внутримышечно. Доза препарата устанавливается индивидуально в зависимости от локализации инфекции и тяжести течения заболевания чувствительности возбудителя возраста массы тела и функции почек пациента.Взрослым и детям старше 12 лет назначают по 1 г каждые 8-12 ч или по 2 г с интервалом 12 ч.При тяжелых инфекциях особенно у пациентов со сниженным ммунитетом (включая пациентов с нейтропенией) - по 2 г каждые 8 ч. При инфекциях мочевыводящих путей - 025 г 2 раза в сутки. При инфекциях костей и суставов - по 20 г каждые 12 ч. При муковисцидозе инфекциях легких вызванных Pseudomonas spp. - по 0-50 мг/кг каждые 8 ч.При операциях на предстательной железе в профилактических целях вводят перед индукцией анестезии 1 г повторяют введение после удаления катетера. Пожилым пациентам максимальная суточная доза должна составлять не более 3 г.Новорожденным и младенцам в возрасте до 2 мес назначают 25-60 мг/кг/сут (кратность 2 введения).Детям старше 2 мес назначают по 30-100 мг/кг/сут (кратность 2-3 введения) детям со сниженным иммунитетом муковисцидозом и менингитом -L50 мг/кг/сут (кратность 3 введения).Максимальная суточная доза для детей не должна превышать 6 г. У больных с нарушением функции почек (включая пациентов которым проводят диализ) режим дозирования цефтазидима устанавливают в зависимости от клиренса креатинина."}},{"type":"paragraph","data":{"text":"Клиренс креатинина (мл/мин)"}},{"type":"paragraph","data":{"text":"Режим дозирования"}},{"type":"paragraph","data":{"text":"31-50"}},{"type":"paragraph","data":{"text":"16-30"}},{"type":"paragraph","data":{"text":"6-15"}},{"type":"paragraph","data":{"text":"Менее 5"}},{"type":"paragraph","data":{"text":"по 10 г каждые 12 ч"}},{"type":"paragraph","data":{"text":"по 10 г каждые 24 ч"}},{"type":"paragraph","data":{"text":"по 05 г каждые 24 ч"}},{"type":"paragraph","data":{"text":"по 05 г каждые 48 ч"}},{"type":"paragraph","data":{"text":"На фоне гемодиализа поддерживающие дозы рассчитывают с учетом клиренса креатинина введение проводят после каждого сеанса гемодиализа. На фоне перитонеального диализа помимо внутривенного введения цефтазидим можно включать в диализный раствор (125-250 мг на 2 л диализного раствора). У пациентов с почечной недостаточностью находящихся на непрерывном гемодиализе с использованием артериовенозного шунта и у пациентов находящихся на гемофильтрации высокой скорости в отделении интенсивной терапии рекомендуемые дозы - 10 г/сут ежедневно (за одно или несколько введений)."}},{"type":"paragraph","data":{"text":"У пациентов находящихся на гемофильтрации низкой скорости назначают дозы рекомендуемые при нарушении функции почек."}},{"type":"paragraph","data":{"text":"Длительность курса терапии составляет 7-14 дней. При инфекциях вызванных Pseudomonas aeruginosa (пневмония осложнения обусловленные инфекцией легких при муковисцидозе менингит) курс лечения может быть увеличен до 21 дня."}},{"type":"paragraph","data":{"text":"Приготовления растворов для инъекций:"}},{"type":"paragraph","data":{"text":"Дозировка"}},{"type":"paragraph","data":{"text":"Способ введения"}},{"type":"paragraph","data":{"text":"Объем растворителя (мл)"}},{"type":"paragraph","data":{"text":"05 г"}},{"type":"paragraph","data":{"text":"внутримышечно"}},{"type":"paragraph","data":{"text":"15"}},{"type":"paragraph","data":{"text":"внутривенно болюсно"}},{"type":"paragraph","data":{"text":"50"}},{"type":"paragraph","data":{"text":"1 г"}},{"type":"paragraph","data":{"text":"внутримышечно"}},{"type":"paragraph","data":{"text":"30"}},{"type":"paragraph","data":{"text":"внутривенно болюсно"}},{"type":"paragraph","data":{"text":"10"}},{"type":"paragraph","data":{"text":"внутривенно инфузионно"}},{"type":"paragraph","data":{"text":"50"}},{"type":"paragraph","data":{"text":"В полученном готовом растворе могут присутствовать небольшие пузырьки диоксида углерода что не влияет на эффективность препарата. Использовать только свежеприготовленный раствор. Легкое пожелтение раствора не влияет на эффективность."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Аллергические реакции: крапивница лихорадка эозинофилия кожный зуд токсический эпидермальный некролиз (синдром Лайелла) мультиформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона) ангионевротический отек бронхоспазм анафилактический шок."}},{"type":"paragraph","data":{"text":"Местные реакции: при внутривенном введении - флебит; при внутримышечном введении - болезненность жжение уплотнение в месте инъекции."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: головная боль головокружение парестезии судорожные припадки энцефалопатия \"порхающий\" тремор."}},{"type":"paragraph","data":{"text":"Со стороны мочеполовой системы: нарушение функции почек токсическая нефропатия кандидозный вагинит."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: тошнота рвота диарея запор боль в животе колит холестаз орофарингеальный кандидоз."}},{"type":"paragraph","data":{"text":"Со стороны органов кроветворения: лейкопения нейтропения тромбоцитопения лимфоцитоз гемолитическая анемия геморрагии."}},{"type":"paragraph","data":{"text":"Лабораторные показатели: гиперкреатининемия повышение концентрации мочевины ложноположительная реакция мочи на глюкозу повышение активности \"печеночных\" трансаминаз и щелочной фосфатазы гипербилирубинемия ложноположительная прямая реакция Кумбса увеличение протромбинового времени."}},{"type":"paragraph","data":{"text":"Прочие: носовое кровотечение суперинфекция."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: боль воспаление флебит в месте инъекции головокружение парестезии головная боль судороги у пациентов с почечной недостаточностью гиперкреатининемия гипербилирубинемия тромбоцитоз тромбоцитопения эозинофилия лейкопения удлинение протромбинового времени."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое в случае почечной недостаточности -перитонеальный диализ или гемодиализ."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Фармацевтически несовместим с аминогликозидами ванкомицином. Нельзя использовать раствор натрия гидрокарбоната в качестве растворителя."}},{"type":"paragraph","data":{"text":"\"Петлевые\" диуретики аминогликозиды ванкомицин клиндамицин снижают клиренс в результате чего возрастает риск нефротоксического действия."}},{"type":"paragraph","data":{"text":"Бактериостатические антибиотики (в т.ч. хлорамфеникол) снижают действие препарата."}},{"type":"paragraph","data":{"text":"Фармацевтически совместим со следующими растворами: при концентрации от 1 до 40 мг/мл - натрия хлорид 09 %; натрия лактат; раствор Хартмана; декстроза 5 %; натрия хлорид 0225 % и декстроза 5 %; натрия хлорид 045 % и декстроза 5 %; натрия хлорид 09 % и декстроза 5 %; натрия хлорид )18 % и декстроза 4 %; декстроза 10 %; декстран с молекулярной массой около 40 кДА 10 % в растворе натрия хлорида 09 % или в растворе декстрозы 5 %; декстран с молекулярной массой около 70 кДА 6 % в растворе натрия хлорида 09 % или в растворе декстрозы 5%."}},{"type":"paragraph","data":{"text":"В концентрациях от 005 до 025 мг/мл цефтазидим совместим с раствором для перитонеального диализа (лактат)."}},{"type":"paragraph","data":{"text":"Для внутримышечного введения цефтазидим может быть разведен раствором лидокаина гидрохлорида 05-1 %. Оба компонента сохраняют активность если цефтазидим в концентрации 4 мг/мл добавляют к следующим растворам: гидрокортизон (гидрокортизона натрия фосфат) 1 мг/мл в растворе натрия хлорид 09 % или растворе декстрозы 5 %; цефуроксим (цефуроксим натрия) 3 мг/мл в растворе натрия хлорид 09 %; клоксациллин (клоксациллин натрия) 4 мг/мл в растворе натрия хлорид 09 %; гепарин 10 МЕ/мл или 50 МЕ/мл в растворе натрия хлорид 09 %; калия хлорид1 10 мЭк/л или 40 мЭк/л в растворе натрия хлорид 09 %. При смешивании раствора цефтазидима (500 мг в 15 мл воды для инъекций) и метронидазола (500 мг/100 мл) оба компонента сохраняют свою активность."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Пациенты имевшие в анамнезе аллергические реакции на пенициллины могут иметь повышенную чувствительность к цефалоспориновым антибиотикам."}},{"type":"paragraph","data":{"text":"Цефтазидим может препятствовать синтезу витамина К вследствие подавления кишечной флоры что может вызвать снижение уровня зависимых от витамина К факторов свертывания крови и в редких случаях привести к гипопротромбинемии и кровотечению. Назначение витамина К устраняет гипопротромбинемию. У тяжелых пожилых и ослабленных больных у пациентов с нарушением функции печени и у лиц с неполноценным питанием риск развития кровотечений наиболее высок."}},{"type":"paragraph","data":{"text":"У некоторых пациентов во время или после применения цефтазидима может виться псевдомембранозный колит вызываемый токсином Clostridium difficile. В легких случаях достаточно отмены препарата при более тяжелых -рекомендуется восстановление водно-солевого и белкового баланса при необходимости следует назначать метронидазол ванкомицин внутрь."}},{"type":"paragraph","data":{"text":"Во время лечения нельзя употреблять этанол - возможны дисульфирамоподобные эффекты."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"При применении цефтазидима необходимо соблюдать осторожность при управлении автомобилем и другой техникой."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Порошок для приготовления раствора для внутривенного и внутримышечного введения 05 г и 10 г."}},{"type":"header","data":{"text":"Упаковка:","level":3}},{"type":"paragraph","data":{"text":"По 05 г и 10 г цефтазидима в стеклянные флаконы вместимостью 10 мл.1 флакон с инструкцией по применению в картонной пачке. 50 флаконов с инструкциями по применению в количестве 10 штук в картонной коробке (для стационаров)."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Список Б. В сухом защищенном от света месте при температуре не выше 25 °С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не использовать после истечения срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Общество с ограниченной ответственностью \"КОМПАНИЯ \"ДЕКО\" (ООО \"КОМПАНИЯ \"ДЕКО\"), 171130, Тверская обл., Вышневолоцкий район, пос. Зеленогорский, ул. Советская, д. 6а, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ООО \"КОМПАНИЯ \"ДЕКО\""}}]}],"source":null},"description_toggle":false,"short_description":"Цефалоспориновый антибиотик III поколения для парентерального применения. Действует бактерицидно (нарушает синтез клеточной стенки микроорганизмов). Обладает широким спектром действия. Устойчив к действию большинства бета-лактамаз.Активен в отношении грамотрицательных микроорганизмов: Pseudomonas spp. в т.ч. Pseudomonas aeruginosa; Klebsiella spp. в т.ч. Klebsiella pneumoniae; Proteus mirabilis Proteus vulgaris; Escherichia coli; Enterobacter spp. включая Enterobacter aerogenes Enterobacter cloacae; Citrobacter spp.; включая Citrobacter diversus Citrobacter freundii; Neisseria meningitidis; Haemophilus influenzae (включая штаммы устойчивые к ампициллину);грамположительных микроорганизмов: Staphylococcus aureus (продуцирующие и не продуцирующие пенициллиназу штаммы чувствительные к метициллину) Streptococcus pyogenes (бета-гемолитический стрептококк группы A) Streptococcus agalactiae (бета-гемолитический стрептококк группы В) Streptococcus pneumoniae; анаэробных микроорганизмов: Bacteroides spp. (многие штаммы Bacteroides fragilis резистентны).Неактивен в отношении устойчивых в метициллину Staphylococcus spp. Streptococcus faecalis Enterococcus spp. Listeria monocytogenes Campylobacter spp. и Clostridium difficile.Активен in vitro против большинства штаммов следующих микроорганизмов (клиническое значение этой активности неизвестно): Clostridium perfringens Aсinetobacter spp. Haemophilus parainfluenzae Morganella morganii. Neisseria gonorrhoeae Peptococcus spp. Peptostreptococcus spp. Providencia spp. в том числе Providencia rettgeri Salmonella spp. Shigella spp. Staphylococcus еpidermidis Yersinia enterocolitica. Максимальная концентрация в плазме крови после внутримышечного введения в дозах 05 и 10 г - 17 и 39 мг/л соответственно. Время необходимое для достижения максимальной концентрации - 1 ч. Максимальная концентрация в плазме крови после внутривенного болюсного зведения в дозах 05 1 и 2 г - 42 69 и 170 мг/мл соответственно. Терапевтически эффективные сывороточные концентрации сохраняются через 8-12 ч после внутривенного и внутримышечного введения. Связь с белками плазмы - менее 10 %. Концентрации цефтазидима превышающие минимальные ингибирующие концентрации для большинства распространенных патогенных микроорганизмов могут быть достигнуты в костной ткани тканях сердца желчи мокроте синовиальной жидкости внутриглазной плевральной и перитонеальной жидкостях. Легко проникает через плаценту и выделяется с трудным молоком. При отсутствии воспалительного процесса плохо проникает через гематоэнцефалический барьер. При менингите концентрация в спинномозговой жидкости достигает терапевтического значения (4-20 мг/л и выше). Период полувыведения - 19 ч у новорожденных - в 3-4 раза продолжительнее; при гемодиализе - 3-5 ч. Не метаболизируется в печени. 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