Benzilpenicillin
When ATH:
J01CE01
Characteristic.
Natural antibiotic penicillin group. Kislotoneustoychiv, destroyed beta-lactamase (penitsillinazoy).
In medical practice using penicillin sodium, potassium salt and procaine.
Benzylpenicillin sodium salt - white crystalline powder bitter taste. Slightly hygroscopic. Very easily soluble in water, soluble in methanol and ethanol. Easily destroyed by acids, alkalis and oxidants. Enter / m, I /, n / a, endolyumbalno, intratracheal.
Benzylpenicillin potassium salt - white crystalline powder bitter taste. Hygroscopic. Very easily soluble in water, soluble in methanol and ethanol. Easily destroyed by acids, alkalis, oxidants. Enter / m, n / a.
Benzylpenicillin novocaine salt - white crystalline powder, odorless, bitter taste. Hygroscopic. It is soluble in water, ethanol and methanol. It is soluble in chloroform. Since water forms a thin slurry. Resistant to light. Easily destroyed by the action of acids and alkalis. Enter only the / m.
Pharmacological action.
Antibacterial, bactericide.
Application.
Bacterial infections, caused by susceptible pathogens: lobar and lobular pneumonia, empyema, bronchitis; bacterial endocarditis (acute and subacute), wound infection, purulent skin infections, soft tissue and mucous membranes (incl. mug, impetigo, secondarily infected dermatitis), purulent pleurisy, peritonitis, sepsis, osteomyelitis, infection of upper respiratory tract (sore throat), meningitis, Diphtheria, gazovaя gangrene, scarlet fever, gonorrhea, leptospirosis, syphilis, anthrax, pulmonary actinomycosis, urinary infection- and biliary tract, treatment of inflammatory diseases in obstetric practice, eye diseases (incl. Acute gonococcal conjunctivitis, helcoma, blennophthalmia).
Contraindications.
Hypersensitivity, incl. other penicillins; epilepsy (endolyumbalno for administration), hyperkalemia, arrhythmia (for potassium salt).
Restrictions apply.
Bronchial asthma, pollen disease, renal failure.
Pregnancy and breast-feeding.
When pregnancy is possible, if the expected benefit to the mother outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.
Side effects.
Allergic reactions: anaphylactic shock, hives, angioedema, fever / chills, headache, arthralgia, eozinofilija, interstitial nephritis, bronchospasm, skin rashes.
Other: for sodium salt - a violation of myocardial contractility; for the potassium salt - arrhythmia, cardiac arrest, hyperkalemia.
When administered endolyumbalno - neurotoxic reaction: nausea, vomiting; increasing the reflex excitability, meningeal symptoms, convulsions, coma.
Cooperation.
Bactericidal antibiotics (incl. cephalosporins, vancomycin, rifampicin, aminoglikozidy) - Synergism, bacteriostatic (incl. makrolidы, chloramphenicol, lincosamides, tetracikliny) - Antagonizm. Diuretic, allopurinol, blockers tubular secretion, NSAIDs reduce tubular secretion, increase the concentration of penicillin. Improves the effectiveness of indirect anticoagulants (by suppressing the intestinal microflora and reducing prothrombin index). Reduces the effect of oral contraceptives. Allopurinol increases the risk of allergic reactions (skin rash).
Overdose.
Symptoms: convulsions, disturbance of consciousness.
Treatment: removal of the drug, simptomaticheskaya therapy.
Dosing and Administration.
/ M, I / (except procaine penicillin salt), n / a, endolyumbalno (Only sodium benzylpenicillin), in cavity, intratracheal; in ophthalmology - instillation in the conjunctival sac, subkonъyunktyvalno, intravitreal.
When the / m and / in the introduction: for adults - 2-12 million units / day for 4-6 injections; community-acquired pneumonia - 8-12 million units / day for 4-6 injections; meningitis, endokardite, gas gangrene - in / 18-24 million U / day 6 introduced.
Duration of treatment benzylpenicillin depending on the form and severity of the disease ranges from 7-10 days until 2 months and more (such as sepsis, bacterial endocarditis).
Precautions.
B /, endolyumbalno and oral administered only in hospitals.
Use the drug penicillin is necessary only for its intended purpose and under the supervision of a physician. It must be remembered, that the use of insufficient doses of penicillin (as well as other antibiotics) or too early termination of treatment often leads to the development of resistant strains of micro-organisms. When the resistance should continue treatment with another antibiotic.
Procaine penicillin G is administered only in / m. In / in the introduction and endolyumbalnoe not allowed. Of all the drugs benzylpenicillin only sodium administered endolyumbalno.
In bronchial asthma, hay fever and other allergic diseases benzylpenicillin used with caution with concomitant administration of antihistamines.
With the development of allergic reactions in patients receiving the drug should be discontinued. In debilitated patients, Newborn, elderly long-term care may develop superinfection, caused by drug-resistant microflora (yeast-like fungi, Gram-negative bacteria). Because, that prolonged oral antibiotics can be inhibited intestinal microflora, produce vitamin B1, IN6, IN12, RR, patients for the prevention of vitamin deficiencies advisable to appoint B vitamins.
When, if after 2-3 days after receiving the drug (max. 5 days) the effect is not observed, must go to another antibiotic treatment or combination therapy.
