Auclatyl medicine 500mg/125mg Tipharco treatment of infection (2 blisters x 10 tablets)

Pharmacy

amoxicillin and clavulanic acid are a combination of bactericidal effects. This combination does not change the mechanism of the effect of amoxicillin (inhibiting the synthesis of peptidoglycan bacterial cell membrane) but also has the effect of anti-bactericidal, expanding the effects of amoxicillin against many bacteria that produce beta-lactamase previously resistant to Amoxicilin alone, due to clavulanic acid with high affinity and attachment to beta-lactamase of bacteria to inhibit.

Clavulanic acid obtained from the fermentation of Streptomyces Clavuligerus, has a beta - lactamase structure similar to penicillin nucleus, itself has a very weak antibacterial effect and has the ability to inhibit beta - lactamase due to the majority of Gram -negative and Staphylococcus bacteria born, but Staphylococcus Methicilin/OxiCilin/Oxacilin It must be considered as resistant to amoxicillin and clavulanic acid. In vitro acid clavulanic often inhibits staphylococcus penicilinase, beta - lactamase created by Bacteroides Fragilis, Moraxella Catatrhalis (formerly Branhamella Catatrhalis), and beta - lactamase classified according to Richmond and Sykes Ty II, III, IV and V. Clavulanic Acid. Cephalosporinase type produced by Proteus Vulgaris, Bacteroides Fragilis and Burkholderia Cepacia (formerly known as Pseudomonas Cepacia) but often does not inhibit Cephalosporinase transmitted via chromosomes Richmond - Sykes Typ I; Therefore, many strains of Citrobacter, Enterobacter, Morganella, Serratia spp., and Pseudomonas Aeruginosa are still resistant. Some beta - Lactamase broad spectrum transmitted via plasmid of Klebsiella Pneumoniae, some other Enterobacteriaceae and pseudomonas aeruginosa are also not inhibited by clavulanic acid.

Clavulanic acid can be absorbed through the bacterial cell wall, so it can inhibit the enzyme outside the cell and enzyme attached to the cell. The effects that vary depending on the inhibitory enzyme, but clavulanic acid often acts as a disputed and unfavorable inhibitor.

The bactericidal spectrum of the drug includes:

Gram -positive bacteria

Aerodic type: Streptococcus Faecalis, Streptococcus Pneumoniae, Streptococcus Pyogenes, Streptococcus Viridans, Staphylococcus aureus, Corynebacterium, Bacillus anthracis, Listeria monocytogenes.

Anaerobic type: Clostridium, peptococcus, peptostreptococcus.

Gram -negative bacteria

Air -favorite type: Haemophilus Influenzae, Moraxella Catnrhalis, Escherichia Coli, Proteus Mirabilis, Proteus vulgaris, Klebsiella, Salmonella, Shigella, Bordetella, Neisseria Gonorrhoeea, Neisseria Meningitidis, Vibrio Cholerae, Pasteurella Multocida.

Anaerobic type: Baceroides including B. Fragilis.

pharmacokinetics

amoxicillin and clavulanic acid are easily absorbed by oral and sustainable with the acid fluid of the stomach. The concentration of amoxicillin and clavulanic acid in the serum reaches maximum after 1 - 2.5 GL to take single dose of regular tablets.

Clavulanic acid does not affect the pharmacokinetics of amoxicilin, but amoxicillin can increase the absorption through the gastrointestinal tract and excretion through the urinary tract for clavulanic acid compared to when using lonely clavulanic acid.

The absorption of the drug is not affected by food and it is best to take it right before meals. At the same time, do not take medicine with a high -fat meal due to Clavulanic acid absorption is reduced and should not be taken while hunger due to amoxicillin absorption is reduced.

After drinking, both amoxicillin and clavulanic acid are distributed into the lungs, pleural fluid and peritoneal fluid, passing through the placenta. A small amount of pills found in sputum, saliva as well as in breast milk. When the meninges are not inflamed, the concentration of the medication in the cerebrospinal fluid is very low, but the larger amount of the drug is achieved when the meninges are inflamed. Amoxicillin binds with serum protein about 17-20% and Clavulanic acid is notified to the protein about 22 - 30%.

After taking single dose of amoxicillin and clavulanic acid in adults with normal kidney function, 50 - 73% amoxicillin and 25 - 45% Clavulanic acid are discharged in urine in the form of unchanged within 6 to 8 hours. In people with kidney failure, the serum concentration of both amoxicillin and clavulanic acid is higher as well as half -life excreted longer. In patients with 9 ml/minute creatinine clearance, half -life of amoxicillin and clavulanic acid are 7.5 and 4.3 hours respectively. Both amoxicillin and clavulanic acid are removed when hemolysis. When the abdominal dung, clavulanic acid is also removed while only a very small amount of amoxicillin is removed.

Probenecid extends the excretion time of amoxicillin but does not affect the elimination of clavulanic acid.

If allergic reactions occur such as erythema, iron, anaphylaxis, Stevens - Johnson syndrome, amoxicillin must be stopped and immediately treated emergency treatment with Adrenalin, oxygen breathing, intravenous corticosteroids and ventilation, including internal trachea and never being treated with penicilin or catphalosporin.

Fake colitis: If mild: stop the drug; If heavy (the possibility is due to Clostridium difficile). Water and electrolytes, anti -Clostridium antibiotics (Metronidazol, Vancomycin).

Caution when using

Attention to the elderly, patients with a history of jaundice/liver dysfunction due to amoxicilin and clavulanic acid because clavulanic acid causes increased cholestatic risk in the liver.

Signs and symptoms of cholestasis jaundice occur rarely when taking the drug but may be severe. However, these symptoms are often recovered and will end after 6 weeks of stopping treatment.

There may be severe hypersensitivity reactions in patients with a history of allergies to penicillin or other allergens, so before starting amoxicillin treatment, it is necessary to carefully investigate a history of allergies to penicillin, cephalosporin and other allergens.

Average or severe renal failure should pay attention to adjusting the dose.

Amoxicillin users are reddened with lymphadenous fever.

Taking drugs for prolonged drugs sometimes develops resistant bacteria.

Periodically check the hematology, liver and kidney function during treatment. Distinguished diagnosis is needed to detect cases of diarrhea caused by C. different and colitis with fake membranes. There is a high risk of a rash in patients with monon cells.

The ability to drive and operate machinery

The drug can cause headaches, fatigue, dizziness, convulsions, insomnia, so cautious when used for people who are driving and operating machinery.

Pregnancy

Avoid the use of drugs for pregnant women, especially in the first 3 months, except for the necessary cases prescribed by a physician.

Breastfeeding period

During breastfeeding can use preparations. The drug is not harmful to breastfed children unless there is a risk of sensitivity due to a very small amount of medicine in milk.

Medicinal interaction

The drug can cause prolonged bleeding time and blood clotting. Therefore, it is necessary to be careful for patients who are being treated with anticoagulants (Warfarin).

The drug can reduce the effectiveness of oral contraceptives, so it is necessary to notify the patient in advance.

Nifedipine increases amoxicillin absorption.

Patients with hyperuricemia when using allopurinol along with amoxicillin will increase the ability of amoxicillin.

There may be antagonists between amoxicilin and alkaline bacteria such as fusidic acid, chloramphenicoi, tetracyclin.

Amoxicillin reduces methotrexate secretion, increases toxicity on the gastrointestinal tract and hematopoietic system. Probenecid when taken right before or simultaneously with amoxcilin reduces amoxicillin elimination, thereby increasing the concentration of amoxicillin in the blood. However, Probenecid does not affect the sale time, the maximum concentration of the drug in the blood (CMAX and the area under the curve of the drug concentration over time in the blood (AUC) of Clavulanic Acid.