Cefuroxim 500mg vidipha medicine for infections (2 blisters x 5 tablets)

Dosage form Box of 2 blisters x 5 tablets
Specifications Cefuroxim
Ingredient Tonsillitis, otitis media, urinary tract infections, skin infections and soft tissue, acute bronchitis, chronic bronchitis, pneumonia, Lyme disease

Ingredient

Composition information	Content
Cefuroxim	500mg

Uses

indications

Cefuroxim 500mg drug is indicated in the following cases:

Treatment of mild infections to fit the respiratory tract caused by sensitive bacteria: otitis media (caused by S. Pneumoniae, H. Influenzae, M. Catrhalis including Beta-lactamase or S. Pyogenes), tonsillitis (caused by S. Pneumoniae, H. Influenzae). The outbreak of chronic bronchitis or acute bronchitis (caused by S. Pneumoniae, H. Influenzae).

Pneumonia is suffering from the community.

Uncontrolled urinary infections.

Skin infections and soft tissue.

The first lymphoma treatment is manifested by the erythema symptoms caused by Borrelia Burgdoteri.

Note: Bacterial culture, antibiotics before and during treatment.

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 attaches 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. The affinity of Cefuroxime with PvP of different types will determine 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 to the drug. The time of blood concentration in blood is greater than the minimum inhibitory concentration of antibiotics with isolated bacteria (> mic) is a dynamic parameter/pharmacokinetics that are closely related to Cefuroxime's treatment efficiency. T> Mic need to reach at least 40-50% of the distance between the two giving drugs.

antibacterial spectrum:

Like other 2nd generation cephalosporin antibiotics (Cefaclor, Ceramandol), 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 Cephalosporin antibiotics of generation 3. of the beta lactamase enzyme compared to Ceramandol, due to the better effect on the bacterial strains that produce beta lactamase such as Haemophilus Infuenzae, Neisseria, Escherichia Coli, Entobacter, Klebsiella. Unlike cefoxitin as an antibiotic and 2nd generation cephalosporin group, cefuroxime does not work on some anaerobic bacteria like bacteroides fragilis.

In Gram -positive aerobic bacteria: Cefuroxime works on staphylococcus aureus (including penicillinase sentient beings and non -penicillinase), on staphylococcus epidermidis. Staphylococcus strains resist the groupicillin 8 1 antibiotic group (methicillin, oxacilin) have all resisted cefuroxime. Listeria Monocytogenes also resisted Cefuroxime.

In Gram -negative aerobic bacteria: Cefuroxime works on most Gram -negative and many gram -negative bacteria, including the Enterobacteriaceae bacteria. Cefuroxime works on the following bacteria belonging to the Enterobacteriaceae family: Citrobacter Diversus, C. Freundii, Enterobacter Aerogenes, Escherichia Coli, Klebsiella Pneumonia, Proteus Mirabilis, Providencia Stuartii, Salmonella and Shigella. Most of the strains of Morganella Morgani, Provindencia Rettgeri, Proteus Vulgaris, Entobacter Clacae, Legionella, Pseudomonas, Campylobacter, Serretia have been resistant to 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. Ditficile. Most of the bacteroides Fragilis strains have resisted Cefuroxime.

Anti-drug: Cefuroxime resistance bacteria are mainly according to the targeted PBP processing mechanism, biopsory beta-lactamase or reduce Cefuroxime's bustle through bacterial cell membranes.

pharmacokinetics

absorption:

After taking Cefuroxime acetyl pharmaceutical absorption through the gastrointestinal tract and quickly hydrolyzed in the intestinal and blood mucosa to form Cefuroxime into the circulatory system, optimal absorption occurs when drinking immediately after meals.

After taking Cefuroxime acetyl pills, reaching the peak concentration (2.1mcg/ml for a dose of 125mg, 4.1mg/ml for a dose of 250mg, 7.0mcg/ml for a dose of 500mg and 13.6mcg/ml for a dose of 1000mg) about 2-3 hours after taking the same medicine with food. The absorption rate of Cefuroxime from the mixture decreases sharply compared to the tablet, resulting in lower concentration and the bioavailability of the whole body decreases (less than 4-17%). Cefuroxime acetyl oral oral discharge is not biological equivalent to Cefuroxime Acetil tablets when testing in healthy adults and therefore cannot be replaced according to the Miligam/Miligam correlation (see the dose and usage). The pharmacokinetics of the linear cefuroxime in the oral dose of 125-1000mg. No cefuroxime accumulation after restoring the dose of 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 inhibition of pathogens that can be achieved in lymphadenopathy, sinus surgery, bronchial mucosa, bone, pleural fluid, joint fluid, inflammation, interstitial fluid, bile, sputum and aquatic fluid. Cefuroxime passes through the bloody barrier when the meninges are inflamed.

Note: Notify the doctor unwanted effects when using the drug.

Biological change: Cefuroxime is not metabolized.

Elimination: Semi -selling time in plasma is from 1 to 1.5 hours. Cefuroxime is excreted through glomerular filtration and excreted in the renal tubules. The clearance coefficient of the kidney is at 125-148 m/min 1,73m2.

Special patient target group:

Sex: Observed that there is no difference in pharmacokinetics of Cefuroxime between men and women. Elderly patients are more likely to have a decrease in renal function, so the dose should be adjusted in accordance with the kidney function in the elderly (see the dose and usage).

There is no clinical test data on the use of Cefuroxime Acetyl in children at the age of 3 months.

Renal failure: The safety and effectiveness of cefuroxime acetyl in patients with renal failure have not been established. Cefuroxime is excreted mainly through the kidneys. Therefore, as for all other antibiotics, in patients with a significant impaired renal function (for example, CLCR

Having been dynamic/pharmacological association:

For cephalosporin, the most important pharmacological - pharmaceutical index corresponds to the efficiency in in vivo has been shown to be the percentage of the drug dosage (T%) is the Cefuroxime concentration that is not attached above the minimum inhibitory concentration (MIC) in different individuals (ie T%> MIC).

Probenecid inhibits cefuroxime elimination through the renal tubules, causing the cefuroxime concentration in plasma to rise and last longer. Cefuroxime only excreted in bile with very small amounts.

Before taking Cefuroxim 500mg vidipha medicine for infections (2 blisters x 5 tablets)

How to use

should drink at meals.

Dosage

Children under 13 years of age: Use other forms of preparation. Have the appropriate content.

Adults and children over 13 years old:

Ear tinet 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 10 - 14 days.

Urinary tract infections without complications of skin and soft tissue infections: Take 500mg, 12 hours, for 10 days.

New Lyme disease: Take 500mg, 12 hours, in 20 days.

In case of renal failure: Need to adjust the time between the patients for patients with creatinine clearance

Creatinine clearance (ml/minute)

≥30

No need to adjust the dose

10 to 30

Standard dose every 24 hours

Standard dose every 48 hours

Add 1 more standard at the end of the time of the separation

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? However, it can cause an increase in nervous stimulation and seizures, especially in people with kidney failure.

Overdose:

Need to care about the overdose of many drugs, abnormal drug interaction and pharmacokinetics in patients.

Protect the respiratory tract of the patient, support ventilation and infusion. If the seizure is developed, the patient stops, immediately using the drug, the anti -seizure therapy may be used if there is a clinical indication. Hemorrhage can eliminate blood from the blood, but most of the treatment is supporting or resolving symptoms.

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. Note that it should not be used double the prescribed dose.

Side Effects

When using Cefuroxim, you may experience unwanted effects (ADR).

Common, 1/100

Infections and parasites of overworked development of Candida.

Color disorders and lymphatic systems: Eosin leukemia.

Nervous system disorders: headache, dizziness.

Digestive disorders: diarrhea, nausea, abdominal pain.

Liver disorders, bile: Increase liver enzymes.

Uncommon, 1/1000

Blood disorders and lymphatic systems: Coombs test chapter, thrombocytopenia, leukemia (sometimes deeply decreased).

Gastrointestinal disorders: Vomiting.

Skin and subcutaneous tissues: skin.

Not yet evaluated from available figures:

Infections and parasites of excessive growth of Clostridium difficile.

Color disorders and lymphatic systems: Hemorrhage anemia.

Immune system disorders: Drug fever, serum, anaphylaxis, Jarisch-Herxheimer reaction.

Gastrointestinal disorders: fake colitis (see the cautious part).

Liver disorders, bile: jaundice, hepatitis.

Skin and subcutaneous tissue: urticaria, itching, diverse roses, Stevens-Johnson syndrome, poisoned epidermal necrosis (exanthematic necrosis) (see immune system disorders), angioedema.

Instructions on how to handle ADR:

CEFUROXIME Use, in case of allergies or serious hypersensitivity reactions, need to conduct supportive treatment (maintain ventilation, use Adrenalin, Oxygen, Conticosteroid 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 supplementation and antibiotic treatment with antibiotic effect Clostridium difficile (Metronidazol or oral vancomycin). Carefully check the history of drug use in case of suspected fake colitis because the disease may appear late after two months, even later after stopping the antibiotic treatment regimen.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindications:

Cefuroxim drugs are contraindicated in the following cases:

Hypersensitivity to cefuroxime or any ingredients of the drug.

Patients with a history of hypersensitivity to antibiotics of cephalosporin.

Patients with severe hypersensitivity (e.g. anaphylactic reaction) with any other betalactam antibacterial drugs (penicillin, monobactam and carbapenem).

Caution when using

Hypersensitive 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. Be cautious when used if used Cefuroxime for patients with a serious hypersensitivity with other beta-lactam. This is the direct result from the bactericidal effect of Cefuroxime Acetyl for Lyme -causing bacteria, Borrelia Bursdorferi. It is necessary to reassure the patient that this is a common consequence and often restricted itself when using antibiotics to treat Lyme disease.

Excessive development of non -sensitive microorganisms:

As well as other antibiotics, the use of cefuroxime acetyl can lead to over -development of Candida. Prolonged use can also lead to overworked development of other unsure microorganisms (such as Enterococci and Clostridium difficile), may need treatment.

Clostridium difficile: diarrhea caused by Clostridium difficile (CDAD) has been reported related to the use of almost all antibacterial drugs, including cefuroxime acetyl, and severity may fluctuate from mild diarrhea to fatal 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 of 3 incidence and deaths when these infections do not respond to antibiotic therapy, they may require colon cutting procedure. 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 water and electrical explanation, supplementing protein, using antibiotics C. Difficile, and surgical evaluation should be conducted as clinical indications.

affect diagnostic tests: The development of positive results of Coornb associated with the use of cefuroxime may interfere with blood combination with blood.

affect glucose tests: The results of false positive glucose in the urine can occur with dynamic cutting tests, and the fake negative results in the blood glucose can occur with Ferricyanide tests in subjects using Cefuroxime Acetil.

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

Researching the impact of the drug on the ability to drive and using machines has not been done. However, this drug can cause dizziness and dizziness, so the patient must be cautious when driving or operating machinery.

Pregnancy

studies on rats 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, leading to a decrease in estrogen absorption load and reduce the effectiveness of oral oral contraceptive contraceptives. Patient advice is required to consider transferring to additional contraception (no hormonal) during treatment.

Experimental testing in the laboratory: The fake positive reaction of glucose in the urine may occur with copper reduction tests (for example, Benedict or Fehling solution), but does not occur with enzyme -based glucose tests, when false negative results occur in Ferricyanide tests, to use one of two methods Determine the plasma glucose concentration in patients taking cefuroxime acetyl. The presence of cefuroxime does not interfere with serum creatinine testing and alkaline picrat water.

Storage

In a dry place, the temperature does not exceed 300C, avoiding light.

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