Niflad ES 600mg/42.9mg Imexpharm Perawatan infeksi kulit, dermatitis purulen kronis (4 blister x 7 tablet)

Bentuk sediaan 4 tas blister x 7 tablet
Spesifikasi Asam clavulanic, amoxicilin

Komposisi

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Informasi komposisi	Isi
Asam clavulanic	42,9 mg
Amoxicilin	600 mg

Migunakake

Indications Niflad ES 600mg/42.9mg is used to treat cases of bacterial infections caused by sensitive bacteria such as: Skin infection and subcutaneous organization, chronic pus dermatitis. Beta-lactamase. ATC code: J01CR02 Amoxicilin is a semi -synthetic antibiotic in the penicillin group, which has a bactericidal effect due to the drug attached to one or more penicillin -mounted proteins of bacteria (PBPS) to inhibit peptidoglycan biosynthesis, an important component of bacterial cell walls. This inhibitor weakens the cell wall leading to bacteria decomposed and die. Amoxicillin is easily destroyed by beta-lactamase enzymes and therefore the antibacterial spectrum of the monoclonal amoxicillin does not include bacteria that produce these enzymes. Clavulanic acid is a beta-lactam, structurally related to penicillin. Clavulanic acid has the ability to inhibit beta-lactamase enzymes and thus prevent inactivity to amoxicillin. Clavulanic acid monomers do not have clinical antibacterial effects. Mobile pharmacokinetics/ pharmacokinetic association: The time of antibiotic concentration is higher than the minimum inhibitory concentration (T> MIC) is the main parameter that shows the effect of amoxicillin. Resistance mechanism: Two resistance mechanisms with amoxicillin combination and clavulanic acid: Inactivated drugs by beta-lactamase not inhibited by clavulanic acid including beta-lactamase B, C, D. Part of the bacterial resistance, especially in Gram -negative bacteria. Antibacterial spectrum of drugs: often sensitive bacteria: Aerobic Gram -positive bacteria: Staphylococcus aureus, Streptococcus spp. Prevotella (except Prevotella Bivia). Amoxicillin and clavulanic acid are completely dissociated in water solution in physiological pH. Both ingredients are well absorbed and quickly after drinking. The absorption of amoxicillin/ clavulanic acid is improved when taken at the beginning of the meal. Oral bioavailability of amoxicillin and clavulanic acid is about 70%. The characteristics of two plasma components are the same and the time to reach the peak concentration (TMAX) of each component is about 1 hour. The following pharmacokinetic parameters are recorded when using amoxicillin/clavulanic acid is 45 mg/3.2 mg/kg every 12 hours for children. content cmax (µg/ml) max (hour) auc (0-t) (µg. t1/2 (hours) Amoxicilin 15,7 ± 7.7 2.0 (1,0 - 4.0) 59,8 ± 20.0 1.4 ± 0.35 Clavulanic 1.7 ± 0.9 1.1 (1,0 - 4.0) 4.0 ± 1.9 1.1 ± 0.29 * Middle (interval) distribution About 25% of total clavulanic acid in plasma and 18% of total amoxicillin in plasma is linked to protein. Expression distribution volume is about 0.3 to 0.4 l/kg for amoxicillin and about 0.2 l/kg for clavulanic acid. After intravenous injection, both amoxicillin and clavulanic acid have been found in gallbladder, abdominal tissue, skin, fat, muscle tissue, fluid and abdominal fluid, bile and pus of the wound. Amoxicillin is not much distributed in cerebrospinal fluid. Animal studies show that there is no storage of drug metabolites in the body. Like other antibiotics penicillin, amoxicillin can be distributed into breast milk. A very small amount of Clavulanic acid has also been discovered in breast milk. both amoxicillin and clavulanic acid have passed the placenta fence. transformation about 10 - 25% amoxicillin in the starting dose is excreted in urine in the form of peniciloic acid that does not work. Clavulanic acid metabolizes a lot in the human body, excreted into urine, feces and in the form of carbon dioxid in exhaled gas. Elimination Amoxicillin is excreted mainly through the kidneys, while clavulanic acid is eliminated by the mechanism through both the kidneys and external kidneys. Combining amoxicillin/ clavulanic acid has an average selling time for about 1 hour and total clearance of about 25 l/ hour in healthy people. Nearly 60 - 70% amoxicillin and 40 - 65% of Clavulanic acid are eliminated in urine in the form of unchanged in the first 6 hours after taking a single tablet with amoxicillin/ clavulanic acid with a content of 250 mg/ 125 mg or 500 mg/ 125 mg. Different studies show that about 50 - 85% amoxicillin and 27 - 60% of Clavulanic acid are eliminated through urine after 24 hours. Clavulanic acid is most eliminated in the first 2 hours after taking the drug. Concentrated with probenecid may slow down amoxicillin, but does not affect the elimination of clavulanic acid through the kidney. Age Amoxicillin's sale time in children from 3 months to 2 years old is equivalent to older children and adults. In newborns (including premature babies), in the first week after birth, do not use more than 2 times/day because the emissions through the kidneys have not been fully developed. Because the elderly people have a higher impairment of renal function, it is necessary to be cautious when choosing the dose and monitoring the kidney function throughout the treatment process. Sex After drinking amoxicilin/ clavulanic acid in healthy women and men shows that gender does not significantly affect the pharmacokinetics of both amoxicillin and clavulanic acid. kidney failure The total serum clearance coefficient of amoxicillin/ clavulanic acid decreases corresponding to the impaired renal function. The decrease in amoxicillin clearance is more pronounced than clavulanic acid, as the ratio of amoxicillin eliminates through the kidneys is higher. Therefore, the dose for patients with renal impairment must prevent excessive accumulation of amoxicillin while maintaining the appropriate clavulanic acid level. liver failure Patients with liver failure should be carefully indicated and monitored liver function periodically.

Sadurunge njupuk Niflad ES 600mg/42.9mg Imexpharm Perawatan infeksi kulit, dermatitis purulen kronis (4 blister x 7 tablet)

How to use Niflad ES dispersed tablets are used by oral: mixing pills in a little water, stirring and drinking immediately. You can put the pill in the mouth to disintegrate, then swallow and drink immediately with plenty of water. Should take medicine before meals to minimize the possibility of intolerance in the gastrointestinal tract. Instructions on how to open the packaging: Use your hands or sharp tools to open in the border on the blister to get the tablet. Do not press, press to remove the pill from the blister to avoid the broken or break. If the pills are not intact, still make the drug into the water and use it according to the instructions. Use the tablet immediately after removing the blister. Dosage Take the drug as directed by the doctor and the right dose in the prescription. recommended dose 90 mg amoxicillin/6.4 mg Clavulanic acid/kg/day, divided into 2 times/day. For children weighing

Efek sisih

The unwanted effects of the drug (ADRS) is the most common ADRS) is diarrhea, nausea and vomiting. The frequency is determined as follows: Very common (ADR ≥ 1/10), common (1/100 ≤ ADR

Pènget

Sadurunge nggunakake obat kasebut, sampeyan kudu maca instruksi kasebut kanthi teliti lan deleng informasi ing ngisor iki.

kontraindikasi

Niflad ES 600mg/42.9mg kontraindikasi ing kasus ing ngisor iki:

Pasien karo amoxicillin, asam clavulanic, antibiotik liyane kalebu klompok penisilin utawa komponen obat apa wae (deleng bagean bahan ing rumus).

Ati-ati nalika nggunakake

Pancegahan nalika nggunakake amoxicillin / asam clavulanic kanggo obyek ing ngisor iki:

Pasien sing duwe riwayat alergi antibiotik cephem.

Pasien sing duwe riwayat kulawarga rentan ngalami gejala alergi kayata asma bronkial, ruam, urtikaria ...

Pasien sing kurang penyerapan, nutrisi ing saluran pencernaan lan kurang.

Sadurunge miwiti perawatan karo asam amoxicillin/clavulanic, riwayat alergi pasien kudu diteliti kanthi ati-ati karo penisilin, cephalosporin utawa obat beta-laktam liyane.

Reaksi hipersensitivitas sing abot lan kadhangkala fatal (kayata anafilaksis) wis dicathet ing pasien sing diobati karo kelompok penisilin. Reaksi kasebut asring kedadeyan ing pasien sing duwe riwayat alergi penisilin lan alergen liyane. Yen ana reaksi alergi, sampeyan kudu mandheg nggunakake amoxicillin / asam clavulanic lan perawatan liyane kanggo perawatan liyane sing cocog.

Kejang bisa kedadeyan ing pasien kanthi fungsi ginjel cacat utawa obat-obatan dosis dhuwur. Mula, ati-ati nalika njupuk obat kanggo pasien sing duwe gangguan ginjel lan nyetel dosis miturut reresik bun.

Nggunakake allopurinol nalika diobati karo amoxicillin bisa nambah risiko alergi kulit.

Ngombe obat sing tahan kadhang-kadhang njalari tuwuhe bakteri sing ora sensitif.

Munculé eritema kabeh awak kanthi pustula ing wiwitan perawatan bisa uga minangka manifestasi saka pustulosis exanthematous generalisata akut (AGEP). Yen manifestasi kasebut katon, pasien kudu mandhegake obat kasebut lan kontraindikasi karo obat sing ngemot amoxicillin.

Ati-ati nalika digunakake kanthi kombinasi karo amoxicillin/asam klavulanat kanggo pasien sing duwe fungsi ati sing cacat.

Efek samping obat ing ati utamane dumadi ing pasien lanang, wong tuwa lan pasien kudu diobati kanthi suwe, jarang kedadeyan ing bocah-bocah. Biasane, pratandha lan gejala biasane kedadeyan sajrone proses kasebut utawa sawise perawatan sing cendhak, nanging ing sawetara kasus, bisa uga ora jelas nganti sawetara minggu sawise mandheg perawatan. Gejala kasebut asring bisa pulih dhewe. Nanging, isih ana kasus serius, malah pati, nanging arang banget, utamané ing patients karo penyakit serius utawa nggunakake ing kombinasi karo obat-obatan sing beresiko mengaruhi ati.

Colitis gadhah antibiotik wis kacarita karo meh kabeh agen antibakteri kalebu amoxicillin lan bisa fluktuasi ing tingkat saka entheng kanggo ngancam nyawa. Mulane, perlu kanggo diagnosa penyakit iki ing pasien sing diare sajrone utawa sawise ngobati. Yen kolitis ana gandhengane karo antibiotik, mula kudu mandheg nggunakake asam amoxicillin / clavulanic langsung lan nindakake perawatan sing cocog. Kontraindikasi nggunakake inhibitor wesi usus ing kasus kasebut.

Priksa sacara periodik fungsi organ kayata fungsi ginjel lan ati, indeks hematologi sajrone perawatan jangka panjang.

Wektu prothrombin wis dilaporake ing pasien sing diobati karo amoxicillin / asam clavulanic, nanging jarang kedadeyan. Kondisi pasien kudu dipantau nalika digunakake bebarengan karo antikoagulan. Sampeyan bisa nyetel dosis antikoagulan oral yen perlu kanggo njaga konsentrasi antikoagulan kaya sing dikarepake.

Kasus langka banget fenomena kristal urin ing pasien sing nyuda ekskresi urin, utamane ing pasien sing njupuk obat ing bentuk injeksi. Pasien kudu njaga cairan oral sing cukup lan jumlah output urin kanggo nyuda kemampuan nyebabake kristal amoxicillin urin, utamane nalika njupuk obat kasebut ing dosis dhuwur. Ing pasien sing duwe saluran kemih, papan pamriksaan biasa mbutuhake kateter.

Sajrone perawatan amoxicillin, enzim glukosa oksidase kudu digunakake nalika tes glukosa dibutuhake ing urin amarga metode non-enzim sing bisa menehi asil positif palsu.

Asam klavulanat ing obat kasebut bisa nyebabake kohesi IgG lan albumin ing membran sel getih abang, sing nyebabake asil positif palsu saka solusi Coombs.

Obat kasebut bisa nyebabake tes positif palsu Bio-Rad Laboratories Platelia Aspergillus EIA amarga reaksi silang karo polisakarida lan polyfuranose dudu Aspergillus. Mula, kanggo pasien sing njupuk amoxicilin lan asam clavulanic, ati-ati yen ana asil positif nalika dites nganggo metode iki lan kudu ditemtokake kanthi cara diagnostik liyane.

Informasi sing gegandhengan karo eksipien obat:

Obat kasebut ngandhut bahan bantu pewarna fd & c kuning 6 telaga alum mula kudu ati-ati nalika njupuk obat kanggo pasien alergi atopik.

Efek obat ing nyopir lan mesin operasi

Ora ana panaliten babagan efek obat kasebut ing kemampuan nyopir lan ngoperasikake mesin. Nanging, amarga obat kasebut bisa nyebabake sawetara efek sing ora dikarepake kayata reaksi alergi, pusing, konvulsi ... Mulane, pasien ora kudu nyopir utawa ngoperasikake mesin nalika njupuk obat kasebut.

Gunakake obat kanggo wanita nalika meteng lan laktasi

Amarga keamanan perawatan karo amoxicillin / asam Asam Clavulanic kanggo wanita ngandhut lan nyusoni, mula obat kasebut mung ora ditliti sawise sinau lan nyusoni. keuntungan kanggo ibu ngluwihi risiko bayi disusui/ nyusoni.

Interaksi obat

Interaksi obat:

Probenesid:

Aja bebarengan karo Probenecid. Probenecid nyuda sekresi amoxicillin ing tubulus ginjel, saéngga nambah lan nambah konsentrasi amoxicillin ing getih nanging ora mengaruhi asam clavulanic.

Obat antikoagulan oral:

Antikoagulan oral lan antibiotik penisilin wis akeh digunakake ing kasunyatan tanpa nyathet interaksi. Nanging, ing literatur, nuduhake extension wektu prothrombin, nambah indeks normalisasi internasional (INR) ing pasien nggunakake acenocoumarol utawa warfarin bebarengan karo amoxicillin. Yen perlu kanggo nggunakake bebarengan, kudu kasebut kanthi teliti, ngawasi wektu Prothrombin utawa INR nalika miwiti utawa mungkasi Niflad ES. Bisa nyetel dosis antikoagulan yen perlu.

Pil kontrasepsi oral:

Obat kasebut bisa nyuda efektifitas kontrasepsi oral amarga obat-obatan sing ngganti bakteri usus lan nyegah reabsorpsi usus saka pil kontrasepsi oral.

mycophenolat mofetil:

Ing pasien sing njupuk Mycophenolat Mofetil, ana laporan babagan nyuda konsentrasi 50% sadurunge dosis metabolit kanthi aktivitas asam mycophenolic (MPA) sawise perawatan karo asam amoxicilin / clavulanic. Owah-owahan konsentrasi sadurunge dosis iki bisa uga ora nuduhake owah-owahan ing tingkat paparan MPa sakabèhé. Mulane, ora perlu nyetel dosis mycophenolat mofetil tanpa bukti klinis komplikasi grafted. Nanging, ngawasi klinis kudu dipantau kanthi rapet sajrone nggunakake obat kasebut lan sawetara wektu sawise mungkasi perawatan karo antibiotik.

Tes diagnostik:

Tes glukosa ing urin: Sajrone perawatan karo amoxicillin, enzim glukosa glukosa kudu digunakake nalika tes glukosa dibutuhake ing urin amarga metode non-enzim sing bisa menehi asil positif palsu.

Coombs: Asam klavulanat nyebabake kohesi naratif IgG lan albumin ing membran sel getih abang, nyebabake asil positif palsu saka solusi Coombs.

Bio-Rad Laboratories Platelia Aspergillus Eia: Obat kasebut bisa nyebabake tes positif palsu Bio-Rad Laboratories Platelia Aspergillus EIA amarga reaksi silang karo polisakarida lan polyfuranose dudu Aspergillus. Mula, kanggo pasien sing njupuk amoxicilin lan asam clavulanic, ati-ati yen ana asil positif nalika dites nganggo metode iki lan kudu ditemtokake kanthi cara diagnostik liyane.

Kavaleri obat:

Amarga ora ana studi babagan korespondensi obat kasebut, ora nyampur obat iki karo obat liya.

Panyimpenan

ora luwih saka 30 derajat C, aja nganti lembab lan aja nganti cahya.

Obat liyane

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