Chloramphenicol (When ATH D06AX02)

When ATH:
D06AX02

Characteristic.

Synthetic antibiotics, identical to natural - the waste products of the microorganism Streptomyces venezuelae.

White or white with a faint yellowish-green white crystalline powder, bitter taste. It is soluble in water, easy - in ethanol, The ethyl acetate solution, practically insoluble in chloroform.

Pharmacological action.
Antibacterial, bacteriostatic.

Application.

For systemic use (parenterally and inwardly): typhoid fever, paratif, salmonellosis (generalized forms), Brucellosis, rickettsioses (incl. sypnoj fever, Rocky Mountain spotted fever, Q fever), tulyaremiya, dysentery, brain abscess, meningococcal infection, trachoma, inguinal lymphogranuloma, Chlamydia, iersinioz, erlikhioz, urinary tract infection, purulent wound infection, gnoynыy peritonitis, biliary tract infections.

For outdoor use: bacterial skin infections, incl. boils, wounds, infected burns, bedsores, sores, cracked nipples in nursing mothers.

Eye drops, liniment eye: bacterial eye infections, incl. conjunctivitis, keratit, keratokonъyunktyvyt, .Aloe, episcleritis, scleritis.

Contraindications.

Hypersensitivity, diseases of the blood, acute intermittent porphyria, expressed by the human kidney and liver, deficiency of glucose-6-fosfatdegidrogenazы, psoriasis, eczema, fungal skin disease, the neonatal period (to 4 Sun) and early childhood.

Restrictions apply.

Diseases of the cardiovascular system, a tendency to allergic diseases.

Pregnancy and breast-feeding.

When pregnancy is possible, if the effect of therapy outweighs the potential risk to the fetus (adequate and well-controlled studies on the use during pregnancy has not been, It should take into account the ability to cross the placenta chloramphenicol).

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

When administered enters breast milk of nursing women and may cause serious side effects in children, breastfed. When applied topically, systemic absorption is possible. Therefore, nursing mothers should stop breast-feeding or, or use of the drug.

Side effects.

Systemic effects

From the digestive tract: dyspepsia, nausea, vomiting, diarrhea, irritation of the mucous membranes of the mouth and throat, dysbiosis.

Cardio-vascular system and blood (hematopoiesis, hemostasis): leukopenia, thrombocytopenia, reticulocytopenia, gipogemoglobinemiâ, agranulocytosis, aplasticheskaya anemia.

From the nervous system and sensory organs: psychomotor disturbances, depression, disturbance of consciousness, delirium, optic neuritis, visual and auditory hallucinations, taste disturbance, hearing loss and vision, headache.

Allergic reactions: skin rash, hives, angioedema.

Other: dermatitis, secondary fungal infection, cardiovascular collapse (in children under 1 year).

If application to the skin and conjunctival application: Local allergic reactions.

Cooperation.

Cycloserine enhances neuronal, ristomycin - haematotoxicity. Phenobarbital uskoryaet biotransformatsiyu, reduces the concentration and duration of effect. It inhibits metabolism of tolbutamide, hlorpropamyda, Derivatives oksikumarina (increases hypoglycemic and anticoagulation properties). Erythromycin, oleandomiцin, Nystatin, levorin increase the antibacterial activity, salt benzylpenicillin - reduce. Incompatible with cytostatics, sulьfanilamidami, pyrazolone derivatives, difeninom, ʙarʙituratami, alcohol.

Overdose.

Symptoms: "Gray syndrome" (cardiovascular syndrome) and preterm neonates treated with high doses of (the cause is the accumulation of chloramphenicol, due to immaturity of liver enzymes and a direct toxic effect on the myocardium) - Blue-gray skin color, low body temperature, spasmodic breathing, no reaction, cardiovascular failure (mortality reaches 40%).

Treatment: hemosorption, simptomaticheskaya therapy.

Dosing and Administration.

/ M, I /, inside. Dosage regimen individual. Inside: for 30 minutes before eating (in the case of nausea and vomiting - via 1 hours after meals) and local. The single dose for adults - 0.25-0.5 g; daily - 2,0 g (in severe cases - up 4 g, under strict medical supervision and monitoring of the state of the blood and kidney function). The daily dose divided into 3-4 receptions. Single dose for children under 3 s - 10-15 mg / kg body weight, 3-8 Years - 0.15-0.2 g, senior 8 years - 0.2-0.3 g; take 3-4 times a day. The course of treatment - 7-10 days (on indications, provided a good portability - up 2 Sun).

Locally, fur gloves: alcoholic solvents and 5-10% liniment is applied to the damaged skin several times per day (directly or impregnated with sterile gauze). Can be used with occlusive dressing. Dressing spend 1-3 days (rare - in 4-5 days) until complete wound cleansing.

Konъyunktyvalno: in the treatment of inflammatory diseases of the eye is used 1% liniment or 0,25% water solution.

Precautions.

The treatment must regularly monitor patterns of peripheral blood.

In the treatment of cracked nipples in nursing mothers is not required discontinuation of breastfeeding newborns.

Cooperation