Cefuroxim 500mg Vidipha medicine for infection treatment (10 blisters x 10 tablets)
Dosage form Box of 10 blisters x 10 tablets
Specifications Cefuroxim
Ingredient Tonsillitis, otitis media, urinary tract infections, skin infections and soft tissue, acute bronchitis, chronic bronchitis, pneumonia
Ingredient
| Composition information | Content |
| Cefuroxim | 500mg |
Uses
indications
Cefuroxim 500 mg drug is indicated in the following cases:
Need to test kidney function when indicated.
Pharmacokology
cefuroxime is Cephalosporin antibiotic, semi -synthetic, 2nd generation. Cefuroxime acetyl is precursor, itself does not have antibacterial effect, in the body hydrolyzed under the effect of enzyme esterase into cefuroxime to work.
Cefuroxime has the effect of killing bacteria in the stage of growth and division by inhibiting the synthesis of bacterial cell walls.
The drug is attached to proteins attached to penicillin (penicillin binding protein, PBP), which are proteins involved in the composition of bacterial cell membrane structure, acting as a catalytic enzyme for the final stage of the synthesis of cell walls. As a result, the synthetic cell wall will be weakened and unstable under the impact of osmotic pressure.
Cefuroxime's mounting affinity with PBP of different types will decide the effect of the drug.
As well as other beta-lactam antibiotics, the bactericidal effect of cefuroxime depends on time. Therefore, the goal of the dose regime is to optimize the exposure period of bacteria with the drug.
The time of blood concentration in blood is greater than the minimum inhibitory concentration of antibiotics with isolated bacteria (T> MIC) is a pharmacokinetic/pharmacokinetic parameters that are closely related to the effectiveness of Cefuroxime treatment.
t> mic needs to reach at least 40-50% of the distance between the two giving.
antibacterial spectrum:
Like other 2nd generation cephalosporin antibiotics (Cefaclor, Cefamandol), Cefuroxime has in vitro activity in Gram -negative bacteria better than the first -generation Cephalosporin antibiotics, but the spectrum on gram -negative bacteria is narrower than the 3rd generation Cephalosporin antibiotics.
Cefuroxime is more sustainable under the hydrolysis of the beta lactamase enzyme compared to Cefamandol, due to the better effect on bacterial strains that produce beta lactamase such as Haemophilus Infuenzae, Neisseria, Escherichia Coli, Entobacter, Klebsiella.
Unlike Cefoxitin is an antibiotic and 2nd generation cephalosporin group, Cefuroxime does not work on some anaerobic bacteria such as Bacteroides Fragilis.
In Gram -positive aerobic bacteria: Cefuroxime works on Staphylococcus aureus (including penicillinase and non -birth penicillinase), on staphylococcus epidermidis. Staphylococcus strains of antibiotic group penicillin resistant penicillinase (methicillin, oxacilin) have all resisted cefuroxime. Listeria monocytogenes also resist cefuroxime.
In Gram -negative aerobic bacteria: Cefuroxime works on most Gram -negative and multiple gram -negative bacteria, including the Enterobacteriaceae.
Cefuroxime works on the following bacteria of the family of Enterobacteriaceae: Citrobacter Diversus, C. Freundii, Entobacter Aerogenes, Escherichia Coli, Klebsiella Pneumonia, Proteus Mirabilis, Providencia Stuartii, Salmonella and Shigella. Most of the strains of Morganella Morganiiiiiiiii, Provindencia Rettgeri, Proteus Vulgaris, Entobacter Clacae, Legionella, Pseudomonas, Campylobacter, Serretia have resisted Cefuroxime.
Cefuroxime is highly active on Haemophilus Infuenzae (including strains that are resistant to ampicilin), H. Parainfluenzae and Moraxella Catatrhalis. Cefuroxime also works well on Neisseria Gonorrhoeae and N. Meningitidis.
In anaerobic bacteria: Cefuroxime is active on Actinomyces, Eubacterium, Fusobacterium, Lactobacillus, Peptococcus, Peptostreptoccus, Propionibacterium. Cefuroxime is active on some Clostridium strains but does not work on C. difficile.
Most of the bacterioides Fragilis strains have resisted Cefuroxime. Drug resistance: Cefuroxime resistance bacteria are mainly according to the target PBP processing mechanism, beta-lactamase or reduce the permeability of cefuroxime through bacterial cell membranes.
pharmacokinetics
absorption:
After taking Cefuroxime Acetyl, it is absorbed through the gastrointestinal tract and is quickly hydrolyzed in the intestinal mucosa and in the blood to form a cefuroxime into the circulatory system. Optimal absorption occurs when drinking immediately after meals.
After taking Cefuroxime acetyl tablets, reaching the peak concentration (2.1mcg/ml for a dose of 125mg, 4.1mcg/ml for a dose of 250mg, 7.0mcg/ml for a dose of 500mg and 13.6mcg/ml for a dose of Loomg) about 2-3 hours after taking the drug with food.
Cefuroxime's absorption rate from the chaos dropped sharply compared to the tablet, resulting in a lower peak concentration and a decrease in the body (less than 4-17%).
Cefuroxime acetyl oral oral discharge is not equivalent to biological equivalent to Cefuroxime acetyl tablets when testing in healthy adults and therefore cannot be replaced according to Miligam/Miligam correlation. The pharmacokinetics of the linear cefuroxime in the oral dose of 125-1000mg. There is no cefuroxime accumulation after repeating the oral dose 250-500mg.
Distribution:
Mounting with protein has been published is 33-50% depending on the method of use. After a single dose of Cefuroxime 500mg on 12 healthy volunteers, the distribution volume is 50 l (CV% = 28%).
Cefuroxime concentration exceeds the minimum inhibitory level of pathogens that can be achieved in lymphadenopathy, sinus tissue, bronchial mucosa, bone, pleural fluid, joint fluid, inflammatory fluid, interstitial fluid, bile, phlegm and aquarium. Cefuroxime passes through the bloody barrier when the meninges are inflamed.
Metabolism:
cefuroxime is not metabolized.
Era:
Semi -selling time in plasma from 1 to 1.5 hours. Cefuroxime is excreted through glomerular filtration and excreted in the renal tubules. The clearance factor of the kidney is at 125-148 ml/min/1.73m2.
Before taking Cefuroxim 500mg Vidipha medicine for infection treatment (10 blisters x 10 tablets)
How to use
Cefuroxim 500 mg should be taken for meals.
Children under 13 years of age: Using other forms of preparation, with appropriate content.
Dosage
Adults and children over 13 years old:
Ear tinema infection (sore throat, otitis media, sinusitis): Take 500mg, 12 hours. 10 -day treatment time.
Lower respiratory infections: Take 500mg, 12 hours. The 10 -day treatment time with the outbreak of chronic bronchitis, and from 5 to 10 days with acute bronchitis is accompanied by superinfection.
Pneumonia is suffering from the community for outpatient patients: Take 500mg, 12 hours. Treatment period of 10 -14 days.
Uncontrolled urinary infections, skin infections and soft tissue infections: Take 500mg, 12 hours, for 10 days.
New lymphoma: Take 500mg, 12 hours, in 20 days.
Case of renal failure:
Need to adjust the time between the doses for patients with creatinine clearance
Note: There is no equivalent of the bioavailability between the tablet form and the oral mixing form, so they cannot replace these two forms based on Mg/Mg conversion. Creatinine clearance (ml/minute) ≥ 30 No need to adjust the dose 10 to 30 Standard dose every 24 hours Standard dose every 48 hours Overdose: Need to care about the overdose of many drugs, abnormal drug interaction and pharmacokinetics in patients. Protects the respiratory tract of the patient, supports ventilation and infusion. If the seizure is developed, stop using the drug immediately, the anti -convulsed therapy may be used if clinically indicated. Hemorrhage can eliminate blood from the blood, but most of the treatment is supporting or resolving symptoms. do when using overdose? However, it can cause an increase in nervous stimulation and seizures, especially in people with kidney failure.
What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.
Side Effects
When using Cefuroxim 500 mg, you may experience unwanted effects (ADR).
Common, ADR> 1/100
Nervous system disorders: headache, dizziness.
Liver disorders, bile: Increase liver enzymes.
Uncommon, 1/1000
Gastrointestinal disorders: Vomiting. Skin and subcutaneous tissues: skin. Not yet evaluated from available figures: Immune system disorders: Drug fever, serum, anaphylaxis, Jarisch-Herxheimer reaction. Gastrointestinal disorders: fake colitis. Liver disorders, bile: jaundice, hepatitis. Skin and subcutaneous tissue: urticaria, itching, diverse roses, Stevens-Johnson syndrome, poisoned epidermal necrosis (exanthematic necrosis), angioedema. Instructions on how to handle ADR Notify the doctor with unwanted effects when using the drug. Stop using Cefuroxime, in case of allergies or serious hypersensitivity reactions, it is necessary to conduct supportive treatment (maintain ventilation, use adrenalin, oxygen, corticosteroid intravenous injection). When a mild mild fake colitis, usually just stop the drug. In medium and severe cases, it is necessary to infusion and electrolytes, protein supplements and antibiotic treatment with anti -Clostridium difficile effect (metronidazol or oral vancomycin). Caution should be careful to check the history of drug use in the case of suspected fake colitis due to disease may appear late after two months, even later after stopping antibiotic treatment regimen.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
contraindicated
Cefuroxim 500 mg is contraindicated in the following cases:
Caution when using
Hypersensitivity reaction:
For patients with a history of hypersensitivity to penicillin, or other beta-lactam drugs because of the risk of cross-sensitivity. Like all beta-lactam drugs, serious hypersensitivity reactions and sometimes deaths have been reported. In case of serious hypersensitivity reactions, cefuroxime must be discontinued immediately and must take appropriate emergency measures.
Before starting treatment, pay attention to patients with a history of serious hypersensitivity reactions caused by cefuroxime, other cephalosporins or any other beta-lactam. Be cautious when used if used Cefuroxime for patients with a history of sensitivity is not serious with other beta-lactam.
Jarisch-HERXHEIMER reaction:
Jarisch-HERXHEIMER reaction was seen after taking Cefuroxime Acetyl to treat Lyme disease. This is a direct result from the bactericidal effect of Cefuroxime Acetyl for Lyme pathogenic bacteria, Borrelia Burgdorferi bacteria, it is necessary to reassure the patient that this is a common consequence and often restricted when using antibiotics to treat Lyme disease.
Excessive development of non -sensitive microorganisms:
As well as other antibiotics, the use ofCuroxime acetyl can lead to over -development of Candida. Prolonged use can also lead to overworked development of other non -sensitive microorganisms (such as Enterococci and Clostridium difficile), may need treatment.
diarrhea related to Clostridium difficile:
diarrhea caused by Clostridium Difficile (CDAD) has been reported related to the use of almost all antibacterial drugs, including Cefuroxime acetyl, and the severity may range from mild diarrhea to deadly colitis. Treatment with antibacterial drugs will alter the normal microbiological system of the intestine leading to the excessive growth of C. different.
c. Difficile produces toxins A and B, contributing to CDAD development. The toxin increased by C. Difficile, causing an increase in the incidence of disease and death, when these infections do not respond to antibiotic therapy, the tip of colon can be required. CDAD must be considered in all patients with diarrhea after antibacterial use.
Caution in people with a history of disease is necessary because CDAD has been reported more than 2 months after using antibacterial drugs. If suspected or identified CDAD, antibacterial drugs that are not against C. Difficile may need to stop using.
Adjusting the water and electrical explanation, supplementing protein, using antibiotic treatment C. Difficile, and surgical evaluation should be conducted as clinical indications.
affect diagnostic tests:
The development of positive gifts of the COAMB test related to the use of Cefuroxime can interfere with blood combination with blood.
affects the glucose test:
Palf -positive results in the urine can occur with copper reduction tests, and the negative results of the blood/ serum can occur with ferricyanide tests in subjects using cefuroxime acetyl.
Check the kidney function in serious patients who are taking the maximum dose.
When used simultaneously with strong diuretics.
The ability to drive and operate machinery
Research on the impact of the drug on the ability to drive and use machines has not been done. However, this drug can be dizzy, dizziness should warn the patient to be cautious when driving or operating machinery.
Pregnancy
studies on mice and rats do not see signs of fertility or fetus damage due to cefuroxime drugs.
Using this antibiotic to treat nephritis - pyelonephritis in pregnant people does not see unwanted effects in newborn babies after exposure to the mother's uterus, cephalosporin is often considered safe to use during pregnancy.
However, strict research on pregnant women is incomplete. Because studies on animals are not always predictable to be responded by people, they only use this drug on pregnant people if needed.
breastfeeding period
cefuroxime excreted in breast milk at low concentrations. It seems that this concentration does not work on breastfed babies, but should be concerned when children see diarrhea, wasting and rash.
Drug interaction
Reducing effect: Ranitidin with sodium bicarbonate reduces the bioavailability of cefuroxime acetyl. The drug should be used at least 2 hours apart after antacids or H2 blockers, as these drugs can increase the stomach pH.
Increased effect: High doses Probenecid reduces Cefuroxime clearance in the kidneys, making Cefuroxime concentration in plasma higher and longer.
Increased toxicity: Aminoglycosides increase the likelihood of kidney poisoning.
Oral contraceptive pills: Cefuroxime acetyl can affect the intestinal bacteria system, leading to reducing estrogen reabsorption and reducing the effectiveness of Estrogen/Progesterone contraceptive contraceptive pills, patients need to consider transferring to additional methods of contraception (no hormonal) during treatment.
Testing interaction in the laboratory:
The false positive glucose reaction in the urine can occur with copper reduction tests (for example: Benedict or Fehling solution), but does not occur with enzyme -based glucose tests.
When a false negative result occurs in Ferricyanide tests, it is recommended to use one of two methods of oxidase or hexokinase to determine blood/ plasma glucose concentration in patients using cefuroxime acetyl.
The presence of cefuroxime does not interfere with serum creatinine testing and urine by alkaline picrat method.
Storage
In a dry place, the temperature does not exceed 30 ° C, avoiding light.
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