Противомикробное средство широкого спектра действия, относит... Инструкция
Показания к применению
Для приема внутрь: урогенитальные инфекции (острый цистит, уретрит, пиелонефрит); гинекологические инфекции; инфекции кожи и мягких тканей; тяжелые инфицированные ожоги; с профилактической целью при урологических операциях (в т.ч. цистоскопии, катетеризации).
Для наружного и местного применения: инфекционно-воспалительные заболевания полости рта и глотки, ...
Хроническая почечная недостаточность тяжелой степени; беременность; период лактации (грудного вскармливания); детский возраст до 4 лет; повышенная чувствительность к фуразидину и другим нитрофуранам.
Противомикробное средство широкого спектра действия, относится к группе нитрофуранов. Механизм действия связан с ингибированием синтеза нуклеиновых кислот. Под влиянием нитрофуранов происходит подавление активности дыхательной цепочки и цикла трикарбоновых кислот (цикла Кребса), а также угнетение других биохимических процессов микроорганизмов, что приводит к разрушению их оболочки или цитоплазматической мембраны.
Активен в отношении грамположительных кокков: Staphylococcus spp., Streptococcus spp.; грамотрицательных палочек: Escherichia coli, Salmonella spp., Shigella spp., Klebsiella spp.
К фуразидину устойчивы: Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp., большинство штаммов Proteus spp., Serratia spp.
В зависимости от концентрации оказывает бактерицидное или бактериостатическое действие. Против большей части бактерий бактериостатическая концентрация составляет от 10 до 20 мкг/мл. Бактерицидная концентрация примерно в 2 раза выше.
Фармакокинетика
После приема внутрь фуразидин абсорбируется из тонком отделе кишечника путем пассивной диффузии. Всасывание нитрофуранов из дистального сегмента тонкого кишечника превышает всасывание из проксимального и медиального сегментов соответственно в 2 и 4 раза (следует учитывать при одновременном лечении урогенитальных инфекций и заболеваний ЖКТ, в частности хронических энтеритов). Нитрофураны плохо всасываются из толстой кишки.
Cmax в плазме крови сохраняется от 3 до 7 или 8 ч, в моче фуразидин обнаруживается через 3-4 ч.
В организме фуразидин распределяется равномерно. Клинически важно высокое содержание препарата в лимфе (задерживает распространение инфекции по лимфатическим путям). В желчи концентрация его в несколько раз выше, чем в сыворотке, а в ликворе - в несколько раз ниже, чем в сыворотке. В слюне содержание фуразидина составляет 30% от его концентрации в сыворотке. Концентрация фуразидина в крови и тканях сравнительно небольшая, что связано с быстрым его выделением, при этом концентрация в моче значительно выше, чем в крови.
Метаболизируется в незначительной степени (<10%).
Выводится почками путем клубочковой фильтрации и канальцевой секреции (85%), частично подвергается обратной реабсорбции в канальцах. При низких концентрациях фуразидина в моче преобладает процесс фильтрации и секреции, при высоких концентрациях уменьшается секреция и увеличивается реабсорбция. Фуразидин, являясь слабой кислотой в кислой моче не диссоциирует, подвергается интенсивной реабсорбции, что может усилить развитие системных побочных эффектов. При щелочной реакции мочи выведение фуразидина усиливается.
При снижении выделительной функции почек интенсивность метаболизма возрастает.
Показания к применению
Для приема внутрь: урогенитальные инфекции (острый цистит, уретрит, пиелонефрит); гинекологические инфекции; инфекции кожи и мягких тканей; тяжелые инфицированные ожоги; с профилактической целью при урологических операциях (в т.ч. цистоскопии, катетеризации).
Для наружного и местного применения: инфекционно-воспалительные заболевания полости рта и глотки, инфицированные раны.
Противопоказания
Хроническая почечная недостаточность тяжелой степени; беременность; период лактации (грудного вскармливания); детский возраст до 4 лет; повышенная чувствительность к фуразидину и другим нитрофуранам.
С осторожностью
С осторожностью применять при дефиците глюкозо-6-фосфатдегидрогеназы.
Применение при беременности и в период грудного вскармливания
Противопоказано применение препарата при беременности и в период лактации (грудного вскармливания).
Способ применения и дозы
Принимают внутрь после еды. Взрослым - по 50-100 мг 3 раза/сут, детям старше 3 лет - по 25-50 мг (не более 5 мг/кг массы тела) 3 раза/сут. Курс лечения 7-10 дней. При необходимости повторения курса лечения следует сделать перерыв в течение 10-15 дней. Для профилактики инфекции (в т.ч. при урологических операциях, цистоскопии, катетеризации) - 50 мг однократно за 30 мин до процедуры.
Применяют наружно 2-3 раза/сут для промывания ран или смачивания перевязочного материала.
Применяют местно 2-3 раза/сут в виде полосканий полости рта и глотки.
Побочное действие
Со стороны пищеварительной системы: редко - тошнота, рвота, потеря аппетита, нарушения функции печени.
Со стороны ЦНС и периферической нервной системы: редко - головная боль, головокружение, полиневрит.
Аллергические реакции: редко - кожная сыпь (в т.ч. папулезные высыпания).
Взаимодействие с другими лекарственными средствами
При комбинации фуразидина с ристомицином, хлорамфениколом, сульфаниламидами повышается риск угнетения кроветворения (не следует применять одновременно).
Не рекомендуется одновременно с нитрофуранами применять препараты, способные подкислять мочу (в т.ч. аскорбиновую кислоту, кальция хлорид).
Особые указания
Для уменьшения вероятности развития побочных эффектов фуразидин запивают большим количеством жидкости.
При появлении побочных эффектов применение следует прекратить (токсические явления чаще проявляются у пациентов со сниженной выделительной функцией почек).
В период лечения пациенту рекомендуется воздержаться от употребления алкоголя, поскольку возможно усиление побочных эффектов.
Не принимать удвоенную дозу для компенсации пропущенной дозы.
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Механизм действия связан с ингибированием синтеза нуклеиновых кислот. Под влиянием нитрофуранов происходит подавление активности дыхательной цепочки и цикла трикарбоновых кислот (цикла Кребса), а также угнетение других биохимических процессов микроорганизмов, что приводит к разрушению их оболочки или цитоплазматической мембраны."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАктивен в отношении грамположительных кокков:\u003c/i\u003e Staphylococcus spp., Streptococcus spp.; \u003ci\u003eграмотрицательных палочек:\u003c/i\u003e Escherichia coli, Salmonella spp., Shigella spp., Klebsiella spp."}},{"type":"paragraph","data":{"text":"К фуразидину \u003ci\u003eустойчивы:\u003c/i\u003e Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp., большинство штаммов Proteus spp., Serratia spp."}},{"type":"paragraph","data":{"text":"В зависимости от концентрации оказывает бактерицидное или бактериостатическое действие. Против большей части бактерий бактериостатическая концентрация составляет от 10 до 20 мкг/мл. Бактерицидная концентрация примерно в 2 раза выше."}},{"type":"header","data":{"text":"Фармакокинетика","level":4}},{"type":"paragraph","data":{"text":"После приема внутрь фуразидин абсорбируется из тонком отделе кишечника путем пассивной диффузии. Всасывание нитрофуранов из дистального сегмента тонкого кишечника превышает всасывание из проксимального и медиального сегментов соответственно в 2 и 4 раза (следует учитывать при одновременном лечении урогенитальных инфекций и заболеваний ЖКТ, в частности хронических энтеритов). Нитрофураны плохо всасываются из толстой кишки."}},{"type":"paragraph","data":{"text":"C\u003csub\u003emax \u003c/sub\u003eв плазме крови сохраняется от 3 до 7 или 8 ч, в моче фуразидин обнаруживается через 3-4 ч."}},{"type":"paragraph","data":{"text":"В организме фуразидин распределяется равномерно. Клинически важно высокое содержание препарата в лимфе (задерживает распространение инфекции по лимфатическим путям). В желчи концентрация его в несколько раз выше, чем в сыворотке, а в ликворе - в несколько раз ниже, чем в сыворотке. В слюне содержание фуразидина составляет 30% от его концентрации в сыворотке. Концентрация фуразидина в крови и тканях сравнительно небольшая, что связано с быстрым его выделением, при этом концентрация в моче значительно выше, чем в крови."}},{"type":"paragraph","data":{"text":"Метаболизируется в незначительной степени (<10%)."}},{"type":"paragraph","data":{"text":"Выводится почками путем клубочковой фильтрации и канальцевой секреции (85%), частично подвергается обратной реабсорбции в канальцах. При низких концентрациях фуразидина в моче преобладает процесс фильтрации и секреции, при высоких концентрациях уменьшается секреция и увеличивается реабсорбция. 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При щелочной реакции мочи выведение фуразидина усиливается."}},{"type":"paragraph","data":{"text":"При снижении выделительной функции почек интенсивность метаболизма возрастает."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Для приема внутрь: урогенитальные инфекции (острый цистит, уретрит, пиелонефрит); гинекологические инфекции; инфекции кожи и мягких тканей; тяжелые инфицированные ожоги; с профилактической целью при урологических операциях (в т.ч. цистоскопии, катетеризации)."}},{"type":"paragraph","data":{"text":"Для наружного и местного применения: инфекционно-воспалительные заболевания полости рта и глотки, инфицированные раны."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Хроническая почечная недостаточность тяжелой степени; беременность; период лактации (грудного вскармливания); детский возраст до 4 лет; повышенная чувствительность к фуразидину и другим нитрофуранам."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"С осторожностью применять при дефиците глюкозо-6-фосфатдегидрогеназы."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Противопоказано применение препарата при беременности и в период лактации (грудного вскармливания)."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Принимают внутрь после еды. 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