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Данная комбинация обеспечивает высокую"}},{"type":"paragraph","data":{"text":"бактерицидную активность."}},{"type":"paragraph","data":{"text":"Панклав обладает широким спектром антибактериального действия. Активен в отношении"}},{"type":"paragraph","data":{"text":"как чувствительных к амоксициллину штаммов, так и в отношении штаммов,"}},{"type":"paragraph","data":{"text":"продуцирующих β-лактамазы:"}},{"type":"paragraph","data":{"text":"Грамположительные аэробы: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus"}},{"type":"paragraph","data":{"text":"viridans, Streptococcus bovis, Staphylococcus aureus (кроме метициллин-резистентных"}},{"type":"paragraph","data":{"text":"штаммов), Staphylococcus epidermidis (кроме метициллин-резистентных штаммов), Listeria"}},{"type":"paragraph","data":{"text":"spp., Enteroccocus spp."}},{"type":"paragraph","data":{"text":"Грамотрицательные аэробы: Bordetella pertussis, Brucella spp., Campylobacter jejuni,"}},{"type":"paragraph","data":{"text":"Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella"}},{"type":"paragraph","data":{"text":"spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida,"}},{"type":"paragraph","data":{"text":"Proteus spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersenia enterocolitica."}},{"type":"paragraph","data":{"text":"Анаэробы: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Bacteroides spp.,"}},{"type":"paragraph","data":{"text":"Actinomyces israelii."}},{"type":"paragraph","data":{"text":"Фармакокинетика:"}},{"type":"paragraph","data":{"text":"Основные фармакокинетические параметры амоксициллина и клавулановой кислоты"}},{"type":"paragraph","data":{"text":"сходны. Оба компонента хорошо всасываются после приема внутрь, прием пищи не влияет"}},{"type":"paragraph","data":{"text":"на степень всасывания. Пик плазменных концентраций достигается приблизительно через 1"}},{"type":"paragraph","data":{"text":"час после приема."}},{"type":"paragraph","data":{"text":"Оба компонента характеризуются хорошим объемом распределения в жидкостях и тканях"}},{"type":"paragraph","data":{"text":"организма (легкие, среднее ухо, плевральная и перитониальная жидкости, матка, яичники и"}},{"type":"paragraph","data":{"text":"т.д.). Амоксициллин также проникает в синовиальную жидкость, печень, предстательную"}},{"type":"paragraph","data":{"text":"железу, небные миндалины, мышечную ткань, желчный пузырь, секрет придаточных пазух"}},{"type":"paragraph","data":{"text":"носа, слюну и бронхиальный секрет."}},{"type":"paragraph","data":{"text":"Амоксициллин и клавулановая кислота не проникают через гемато-энцефалический барьер"}},{"type":"paragraph","data":{"text":"при невоспаленных мозговых оболочках."}},{"type":"paragraph","data":{"text":"Амоксициллин и клавулановая кислота проникают через плацентарный барьер и в следовых"}},{"type":"paragraph","data":{"text":"концентрациях выводятся с грудным молоком."}},{"type":"paragraph","data":{"text":"Амоксициллин и клавулановая кислота характеризуются низким связыванием с белками"}},{"type":"paragraph","data":{"text":"плазмы."}},{"type":"paragraph","data":{"text":"Амоксициллин частично метаболизируется, клавулановая кислота подвергается,"}},{"type":"paragraph","data":{"text":"по - видимому, интенсивному метаболизму."}},{"type":"paragraph","data":{"text":"Амоксициллин выводится почками практически в неизменном виде путем тубулярной"}},{"type":"paragraph","data":{"text":"секреции и клубочковой фильтрации. Клавулановая кислота выводится путем клубочковой"}},{"type":"paragraph","data":{"text":"фильтрации, частично в виде метаболитов. Небольшие количества могут выводиться через"}},{"type":"paragraph","data":{"text":"кишечник и легкими. Период полувыведения амоксициллина и клавулановой кислоты"}},{"type":"paragraph","data":{"text":"составляет 1 - 1.5 часа. У пациентов с тяжелой почечной недостаточностью период"}},{"type":"paragraph","data":{"text":"полувыведения увеличивается до 7.5 часов для амоксициллина и до 4.5 часов для"}},{"type":"paragraph","data":{"text":"клавулановой кислоты."}},{"type":"paragraph","data":{"text":"Оба компонента удаляются гемодиализом и незначительные количества - перитонеальным"}},{"type":"paragraph","data":{"text":"диализом.\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания, вызванные чувствительными к комбинации"}},{"type":"paragraph","data":{"text":"амоксициллин/клавулановая кислота штаммами:"}},{"type":"paragraph","data":{"text":"Инфекции верхних отделов дыхательных путей и ЛОР-органов (острый и хронический"}},{"type":"paragraph","data":{"text":"синусит, острый и хронический отит, тонзиллит, фарингит)"}},{"type":"paragraph","data":{"text":"Инфекции нижних отделов дыхательных путей (острые и хронические бронхиты и"}},{"type":"paragraph","data":{"text":"пневмонии, эмпиема плевры)"}},{"type":"paragraph","data":{"text":"Инфекции мочевыводящих путей (в том числе циститы, уретриты, пиелонефриты)"}},{"type":"paragraph","data":{"text":"Инфекции в гинекологии (в том числе сальпингит, сальпингоофорит, эндометрит,"}},{"type":"paragraph","data":{"text":"септический аборт)."}},{"type":"paragraph","data":{"text":"Инфекции костей и суставов (в том числе хронический остеомиелит)."}},{"type":"paragraph","data":{"text":"Инфекции кожи и мягких тканей (в том числе флегмона, раневая инфекция)."}},{"type":"paragraph","data":{"text":"Инфекции желчных путей (холецистит, холангит)."}},{"type":"paragraph","data":{"text":"Заболевания, передаваемые половым путем (гонорея, шанкроид)."}},{"type":"paragraph","data":{"text":"Одонтогенные инфекции."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к компонентам препарата, цефалоспоринам и др. бета-лактамным"}},{"type":"paragraph","data":{"text":"антибиотикам, инфекционный мононуклеоз (в т.ч. при появлении кореподобной сыпи),"}},{"type":"paragraph","data":{"text":"детский возраст до 12 лет (для данной лекарственной формы)."}},{"type":"paragraph","data":{"text":"С осторожностью - беременность, период лактации, тяжелая печеночная недостаточность,"}},{"type":"paragraph","data":{"text":"заболевания желудочно-кишечного тракта (в т.ч. колит в анамнезе, связанный с"}},{"type":"paragraph","data":{"text":"применением пенициллинов), хроническая почечная недостаточность."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"При беременности может применяться, когда польза от его применения значительно"}},{"type":"paragraph","data":{"text":"превышает риск, существующий всегда при использовании любого препарата в течение"}},{"type":"paragraph","data":{"text":"беременности. При необходимости применения препарата в период лактации грудное"}},{"type":"paragraph","data":{"text":"вскармливание приостанавливают."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Таблетки следует принимать внутрь во время еды, не разжевывая, запивая небольшим"}},{"type":"paragraph","data":{"text":"количеством воды."}},{"type":"paragraph","data":{"text":"Взрослым и детям старше 12 лет (с массой тела более 40 кг) обычная доза в случае легкого и"}},{"type":"paragraph","data":{"text":"среднетяжелого течения инфекций составляет одна таблетка 250 мг/125 мг 3 раза в сутки."}},{"type":"paragraph","data":{"text":"При тяжелом течении инфекций назначают по 1 таблетке 500/125 мг 3 раза в сутки."}},{"type":"paragraph","data":{"text":"Максимальная суточная доза клавулановой кислоты (в форме калиевой соли) составляет для"}},{"type":"paragraph","data":{"text":"взрослых - 600 мг и 10 мг/кг массы тела для детей."}},{"type":"paragraph","data":{"text":"Максимальная суточная доза амоксициллина составляет 6 г для взрослых и 45 мг/кг массы"}},{"type":"paragraph","data":{"text":"тела для детей."}},{"type":"paragraph","data":{"text":"Курс лечения составляет 5-14 дней. Продолжительность курса лечения определяется"}},{"type":"paragraph","data":{"text":"лечащим врачом. Лечение не должно продолжаться более 14 дней без повторного"}},{"type":"paragraph","data":{"text":"медицинского осмотра."}},{"type":"paragraph","data":{"text":"Дозировка при одонтогенных инфекциях: 1 таблетка 500 мг/125 мг каждые 12 часов в"}},{"type":"paragraph","data":{"text":"течение 5 дней."}},{"type":"paragraph","data":{"text":"Дозировка при почечной недостаточности умеренной степени (клиренс креатинина 10-30"}},{"type":"paragraph","data":{"text":"мл/мин) составляет 1 таблетка 500 мг/125 мг каждые 12 часов или 1 таблетка 250 мг/125 мг"}},{"type":"paragraph","data":{"text":"(при легком и среднетяжелом течении) 2 раза в сутки, при тяжелой почечной"}},{"type":"paragraph","data":{"text":"недостаточности (клиренс креатинина менее 10 мл/мин) - 1 таблетка 500/125 мг каждые 24 ч"}},{"type":"paragraph","data":{"text":"или 1 таблетка 250 мг/125 мг (при легком и среднетяжелом течении) 1 раз в сутки."}},{"type":"paragraph","data":{"text":"При анурии интервал между дозированием следует увеличить до 48 часов и более."}},{"type":"paragraph","data":{"text":"Две таблетки Панклава по 250 мг/125 мг неэквивалентны одной таблетке Панклава по 500"}},{"type":"paragraph","data":{"text":"мг/125 мг, поскольку они содержат разное количество клавулановой кислоты."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: тошнота, рвота, диарея, нарушение функции"}},{"type":"paragraph","data":{"text":"печени, повышение активности \"печеночных\" трансаминаз, стоматит, в единичных случаях -"}},{"type":"paragraph","data":{"text":"умеренное бессимптомное повышение уровня «печеночных» ферментов и щелочной"}},{"type":"paragraph","data":{"text":"фосфатазы, холестатическая желтуха, гепатит, псевдомембранозный колит."}},{"type":"paragraph","data":{"text":"Аллергические реакции: крапивница, кожный зуд, эритематозные высыпания, редко -"}},{"type":"paragraph","data":{"text":"мультиформная эритема, анафилактический шок, токсический эпидермальный некролиз,"}},{"type":"paragraph","data":{"text":"острый генерализованный экзантематозный пустулез, сывороточная болезнь, отек Квинке,"}},{"type":"paragraph","data":{"text":"крайне редко - эксфолиативный дерматит, синдром Стивенса-Джонсона, и"}},{"type":"paragraph","data":{"text":"анафилаксический шок."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы: головокружение, головная боль, судороги"}},{"type":"paragraph","data":{"text":"(судороги могут возникнуть при нарушении функции почек или у пациентов, получающих"}},{"type":"paragraph","data":{"text":"высокие дозы Панклава)."}},{"type":"paragraph","data":{"text":"Прочие: кандидоз кожи и слизистых оболочек, развитие суперинфекции, обратимое"}},{"type":"paragraph","data":{"text":"увеличение протромбинового времени, вагинит, интерстициальный нефрит. "}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: нарушение функции желудочно-кишечного тракта: тошнота, рвота; возможны:"}},{"type":"paragraph","data":{"text":"возбуждение, бессонница, в редких случаях – судорожные припадки, а также нарушение"}},{"type":"paragraph","data":{"text":"водно-электролитного баланса."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое, при недавнем приеме препарата (менее 4 часов) - промывание"}},{"type":"paragraph","data":{"text":"желудка, прием абсорбента. Гемодиализ эффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Антациды, глюкозамин, слабительные средства, аминогликозиды - замедляют и снижают"}},{"type":"paragraph","data":{"text":"абсорбцию; аскорбиновая кислота повышает абсорбцию."}},{"type":"paragraph","data":{"text":"Бактерицидные антибиотики (в т.ч. аминогликозиды, цефалоспорины, циклосерин,"}},{"type":"paragraph","data":{"text":"ванкомицин, рифампицин) оказывают синергидное действие; бактериостатические"}},{"type":"paragraph","data":{"text":"препараты (макролиды, хлорамфеникол, линкозамиды, тетрациклины, сульфаниламиды) -"}},{"type":"paragraph","data":{"text":"антагонистическое."}},{"type":"paragraph","data":{"text":"Повышает эффективность непрямых антикоагулянтов (подавляя кишечную микрофлору,"}},{"type":"paragraph","data":{"text":"снижает синтез витамина К и протромбиновый индекс). При одновременном приеме"}},{"type":"paragraph","data":{"text":"антикоагулянтов, необходимо следить за показателями свертываемости крови."}},{"type":"paragraph","data":{"text":"Уменьшает эффективность пероральных контрацептивов, лекарственных средств, в процессе"}},{"type":"paragraph","data":{"text":"метаболизма которых образуется парааминобензойная кислота, этинилэстрадиола - риск"}},{"type":"paragraph","data":{"text":"развития кровотечений \"прорыва\"."}},{"type":"paragraph","data":{"text":"Диуретики, аллопуринол, фенилбутазон, нестероидные противовоспалительные препараты и"}},{"type":"paragraph","data":{"text":"др. препараты, блокирующие канальцевую секрецию, повышают концентрацию"}},{"type":"paragraph","data":{"text":"амоксициллина (клавулановая кислота выводится в основном путем клубочковой"}},{"type":"paragraph","data":{"text":"фильтрации)."}},{"type":"paragraph","data":{"text":"Аллопуринол повышает риск развития кожной сыпи."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При курсовом лечении необходимо проводить контроль за состоянием функции органов"}},{"type":"paragraph","data":{"text":"кроветворения, печени и почек."}},{"type":"paragraph","data":{"text":"С целью снижения риска развития побочных эффектов со стороны желудочно-кишечного"}},{"type":"paragraph","data":{"text":"тракта, следует принимать препарат во время еды."}},{"type":"paragraph","data":{"text":"Возможно развитие суперинфекции за счет роста нечувствительной к препарату"}},{"type":"paragraph","data":{"text":"микрофлоры, что требует соответствующего изменения антибактериальной терапии."}},{"type":"paragraph","data":{"text":"У пациентов, имеющих повышенную чувствительность к пенициллинам, возможны"}},{"type":"paragraph","data":{"text":"перекрестные аллергические реакции с цефалоспориновыми антибиотиками."}},{"type":"paragraph","data":{"text":"Прием Панклава приводит к появлению амоксициллина в моче. Высокие концентрации"}},{"type":"paragraph","data":{"text":"амоксициллина дают ложно-положительную реакцию на глюкозу мочи при использовании"}},{"type":"paragraph","data":{"text":"реактива Бенедикта или раствора Феллинга. Рекомендуется использовать ферментативные"}},{"type":"paragraph","data":{"text":"реакции с глюкозооксидазой."}},{"type":"paragraph","data":{"text":"На способность к концентрации внимания препарат не влияет."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые пленочной оболочкой, 250 мг/125 мг и 500 мг/125 мг."}},{"type":"paragraph","data":{"text":"По 15 или 20 таблеток в банку из темного стекла, укупоренную пластиковой крышкой с"}},{"type":"paragraph","data":{"text":"силикагелем и контролем первого вскрытия. 1 банку с инструкцией по применению"}},{"type":"paragraph","data":{"text":"помещают в пачку картонную."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом, защищенном от света месте, при температуре от 15 до 25оС."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении 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":"Хемофарм А.Д., Сербия"}},{"type":"paragraph","data":{"text":"26300 г. Вршац, Београдский путь бб, Сербия"}},{"type":"paragraph","data":{"text":"Тел.: 13/803100, факс: 13/803424"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Россия, 603950, г. Нижний Новгород, ГСП-458, ул. Салганская, 7 и по"}},{"type":"paragraph","data":{"text":"тел.: (495) 221-70-40, факс: (495) 221-70-46."}}]}],"source":null},"description_toggle":false,"short_description":"Фармакодинамика: Панклав представляет собой комбинацию амоксициллина – полусинтетического пенициллина с широким спектром антибактериальной активности и клавулановой кислоты - необратимого ингибитора бета-лактамаз (II, III, IV, V типа; неактивен в отношении I типа). Клавулановая кислота образует стойкий инактивированный комплекс с указанными ферментами и защищает амоксициллин от потери антибактериальной активности, вызванной продукцией β-лактамаз, как основными возбудителями и ко-патогенами, так и условнопатогенными микроорганизмами. Данная комбинация обеспечивает высокую бактерицидную активность. Панклав обладает широким спектром антибактериального действия. Активен в отношении как чувствительных к амоксициллину штаммов, так и в отношении штаммов, продуцирующих β-лактамазы: Грамположительные аэробы: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus bovis, Staphylococcus aureus (кроме метициллин-резистентных штаммов), Staphylococcus epidermidis (кроме метициллин-резистентных штаммов), Listeria spp., Enteroccocus spp. Грамотрицательные аэробы: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersenia enterocolitica. Анаэробы: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Bacteroides spp., Actinomyces israelii. Фармакокинетика: Основные фармакокинетические параметры амоксициллина и клавулановой кислоты сходны. Оба компонента хорошо всасываются после приема внутрь, прием пищи не влияет на степень всасывания. Пик плазменных концентраций достигается приблизительно через 1 час после приема. Оба компонента характеризуются хорошим объемом распределения в жидкостях и тканях организма (легкие, среднее ухо, плевральная и перитониальная жидкости, матка, яичники и т.д.). Амоксициллин также проникает в синовиальную жидкость, печень, предстательную железу, небные миндалины, мышечную ткань, желчный пузырь, секрет придаточных пазух носа, слюну и бронхиальный секрет. Амоксициллин и клавулановая кислота не проникают через гемато-энцефалический барьер при невоспаленных мозговых оболочках. 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