The drug has a bactericidal effect (able to kill) for many species of pathogenic or conditionally pathogenic bacteria (causative agents of infectious diseases), that is, it is an antibiotic for choosing a wide range of activity.
Many species are sensitive to benzylpenicillin staphylococci and streptococci, pathogens of diphtheria, gonorrhea, Siberian ulcers, meningococcal infection, syphilis, actinomycosis, gas gogrene causative agents and some other bacterial infections.
The drug does not act on bacteria that produce a penicillinase enzyme that destroys penicillin.
The antibacterial effect of benzylpenicillin is achieved due to its depressing effect on the formation of the outer shell of the bacterial cell. Thus, the destruction of dividing (breeding) bacteria occurs.
Due to poor absorption in the intestine, the drug is applied only for parenteral administration (By passing the digestive tract), that is, for intramuscular or intravenous injections, benzylpenicillin is less likely to be introduced into the spinal channel (endolumboral), on the wound or organ during operation or endoscopy.
Interesting! The discovery of antibiotics of the penicillin row has become a significant progress in the treatment of infectious diseases, which raised the level of medicine to a new stage. Before the appearance of antibacterial drugs, there was a very high mortality from various infections, a pandemic was often arose (mass incidence of city, country or several states with infectious diseases). Until now, the determination of the living standards includes mortality rates from infectious pathology.
Penicillin was the very first antibiotic, which later became the basis for the opening of new types of antimicrobial funds, and made it possible to save a huge number of people for many years.
Mold efficiency was known in the XI century of our era, during Avicenna. But in 1929, the English microbiologist Alexander Fleming was made public the results of the study of the substance allocated from mold, active against various bacteria. This substance was named Penicillin in honor of the kind of mold mushrooms, from which was allocated (mushrooms genus Penicillium).
Forms of release benzylpenicillin, trade names
Benzylpenicillin is produced in the form of a dry powder - compounds of benzylpenicillin salt (sodium, potassium, novocaine salts, benzatin). Dry powder is designed to prepare a solution for intramuscular and intravenous injections.The choice of the type of benzylпenicillin is determined by the course of the infectious disease. Thus, the sodium and potassium salt of benzylpeniciline for half an hour provide the maximum concentration of the antibiotic in the blood, and the benzylpenicillin novocaine and benzatin salt are absorbed slowly and valid long. Accordingly, sodium and potassium salts are used in acute inflammatory processes that require immediate action of antibiotics. Benzylpenicillin Benzatin and Novocaine Salt are used in the treatment of "slow", chronic diseases that require long-term use of the antibiotic, preventing relapses of certain infections.
| Tradename | Dosage of dry powder for the preparation of injection mortar, in 1 vial | Manufacturers | Application area |
| 1 million units 5 million | "Synthesis", Russia, Biosynthesis, Russia, "Kraspharma", Russia, Sandoz, Austria, "Avant", Ukraine, "Bayer", Germany, "Kyivmedpreparat", Ukraine | Treatment of infections of respiration organs, nose, ear, throat, urogenital system, purulent infections of eyes, skin and bones, nervous system and other organs, as well as sepsis, scarletins, diphtheria, Siberian ulcers, syphilis and other diseases, the causative agent of which are bacteria sensitive to benzylpenicillin. |
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| Novocin (sodium salt) | |||
| Procaine PenicillinG. 3 mega (Plot of benzylpenicillin) | |||
| PenicillinG.sodium salt | |||
| Benzylpenicillin sodium salt | 500 thousand | "Kraspharma", Russia | |
| Benzylpenicillin potassium salt | |||
| Benzylpenicillin Novocaine Sol | |||
| Novocin (sodium salt) | |||
| Procaine PenicillinG. 3 mega (Plot of benzylpenicillin) | |||
| PenicillinG.sodium salt | |||
| Benzatin benzylpenicillin: Extensively Retaren "Moldamine" | 2.4 million | Sandoz, Austria, SC "Antibiotics S. A.", Romania. | The drug is recommended in the treatment of syphilis, inflammatory diseases associated with streptococcus, prophylactic treatment of rheumatic diseases and postoperative complications. |
| Bicyllin-1. (Benzatin benzylpenicillin) | 300 thousand 600 thousand 1.2 million | "Synthesis", Russia, "TM", Republic of Belarus, "Arterium", Ukraine, Kyivmedpreparat, Ukraine. | It is used in infectious diseases caused by the pathogen sensitive to benzylpenicillin: syphilis, diphtheria, sophilic inflammation, chronic infections caused by staphylococcal and streptococcus and so on. Most often used for the treatment and prevention of rheumatic diseases. Benzatin salt is relevant to use for long-term therapy. |
| Bicyllin-3. (Benzylпenicillin benzitin mixtures, sodium and novocaine salts of 200,000 units) | 600,000 | Treatment of syphilis, exacerbations of rheumatism, grinding inflammation, chronic infections of the upper respiratory tract caused by streptococcus. The drug is intended for long-term use. | |
| Bicyllin-5. (Benzitin benzylpenicillin mixtures at a dose of 1.2 million units and novocaine benzylпenicillin salt 300 thousand units) | 1.5 million | Prevention of rheumatism, treatment of syphilis, chronic streptococcal infection. Bicyllin-5 is recommended if necessary for long-term antibacterial therapy. |
The mechanism of therapeutic action of benzylpenicillin
Benzyplicillin after parenteral administration (in the form of injections) is quickly distributed through all organs and tissues. Maximum concentration In the blood of the sodium and potassium compound benzylpenicillin is achieved after 20-30 minutes, and benzylpenicilline benzatin and its mixture - after 12-24 hours.The half-life of the sodium and potassium salt benzylpenicillin from the body is 40-60 minutes, and benzylpenicilline benzatin and its mixtures - on average 2 weeks. Benzylpenicillin is derived mainly by the kidneys, in a small amount is excreted with other biological fluids (saliva, then, tears, bile, breast milk).
Bezylpenicillin does not penetrate the fabric of prostate and non-converted brain shells But in the presence of meningitis - benzylpenicillin through the hematorecephalic barrier penetrates well, so it can be used in the treatment of bacterial infections of the nervous system.
Bezylpenicillin manifests bactericidal action That is, it contributes to the death of the bacteria sensitive to it. Benzylpenicillin inhibits transpeptidase (blocks the generation of the enzyme), participating in the synthesis of the cell wall of the outer shell of bacteria.
The cell wall of the bacteria consists of peptideoglycans (connected amino acids), adjacent to the cytoplasmic membrane of the bacterial cell.
Functions of the cell membrane bacteria:
- forms the structural integrity of the microorganism;
- protects the bacterium from the impact on it of immune cells of the body and various factors;
- provides power cells and extinguishing from it products of vital activity.
- determines the division on gram-positive and gram-negative microorganisms: Transpeptidase is found to be revealed in gram-positive bacteria, and only in some gram-negative bacteria, the construction of the cell wall of mixed genes involving transpeptidase.
- is a catalyst (stimulant) of the reaction of binding amino acids peptidoglycan among themselves.
Inhibition of transpeptidase Actual with the growth of microorganisms and their reproduction , The "sleeping" bacteria benzylpenicillin does not work.
Some bacteria from nature or in the process of producing resistance (sustainability) to antibacterial drugs are distinguished by an enzyme penicillinase which binds to the preparations of the penicillin row and blocks their action. In this case, benzylpenicillin will not act. For this, you can use penicillin-row antibiotics, protected clawulanic acid (for example, Augmentin, Amoxiclav).
Bacteria for which benzylpenicillin is active
1. Gram-positive bacteria:- Streptococcus SPP. - Streptococci: Pneumoniae (Streptococcus Pneumoniae), Piogen Streptococcus (Streptococcus Pyogenes).
- Staphylococcus SPP. - Staphylococci not containing penicillinase.
- Corynebacterium Diphtheriae. - Difteria causative agent.
- Bacillus Anthracis - The causative agent of Siberian ulcers.
Clostridium. sPP. - Gas goggle pathogens.
3. Gram-negative bacteria:
- NEISSERIA MENINGITIDIS. - Meningokok;
- Neisseria Gonorrhoeae. - The causative agent of gonorrhea.
5. Spirocaetaceae. - spirochetes, pathogens of syphilis, returning typhoid, firmbezia, Lyme disease and so on.
What pathologies are assigned?
Benzylpenicillin is prescribed for etiological therapy (treatment aimed at the death of the causative agent of the disease) by one drug or in a complex with other groups of antibacterial drugs. In recent decades, due to frequent use of penicillin-row preparations, the benzylpenicillin is often detected resistant microorganismsThat is, the antibiotic ceases to act on bacteria. Because of this, in recent years, they give the advantage to other more modern drugs. During this time, the bacteria lost their properties of resistance to penicillins. Therefore, many pathogens have become more sensitive to benzylpenicillin, and it is possible to use it in the treatment of many infectious pathologies. But for the successful treatment of antibiotics, it is recommended to select on the basis of the data of the drug sensitivity of pathogens to antibiotics (that is, antibioticogram).Benzylpenicillin (namely, benzatin) is most often and effectively used in the treatment of syphilis and other pathologies caused by spirochetes. Also benzylpenicillin benzatin, and its mixtures (Bicyllin-3, -5) are a classic in the treatment and prevention of rheumatic diseases.
| Pathology | Mechanism of action | Dosage |
ENT infections:
| Benzylpenicillin operates at the most common pathogens of these diseases:
| Benzylpenicillin sodium and potassium salts:
The daily dose for the diseases of the average severity is 50,000 – 100,000 units per 1 kg of body weight per day for 4-6 administrations, and with severe flow - up to 200,000 - 300,000 units / kg / day. For 6 receptions. It is possible intravenous drip or intramuscular administration of the drug, as well as their alternation. For intrapharmal administration of the drug - 500,000 units are bred in 10 ml, and 1 ml is introduced. For the prevention of scarletins in children in contact with patients, |
Respiratory infections
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Bacterial diseases of the genitourinary system:
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Bacterial eye diseases:
| In purulent diseases, benzylpenicillin eyes can be administered subconnectivo (Injection in the conjunction) or intravitreal (The introduction of the drug with the help of special equipment into the vitreal cavity of the eyeball). This procedure is carried out only in hospital conditions specially trained ophthalmologists. | |
| Sepsis (Common bacterial infection with bacteria in the blood - bacteremia). Septic Endocarditis - The defeat of the heart during sepsis, is the most dangerous complication of sepsis, often causes fatal outcome. | The drug is beginning to be administered neatly, gradually increasing the dose, in order to avoid infectious-toxic shock (ITH). The daily dose of benzylpenicillin (sodium or potassium salt) during sepsis and septic endocarbage ranges from 18,000,000 to 24,000,000 units for 6 intravenous slow drip injections before improving the overall state, then go to intramuscular injections. In the treatment of childrenAccording to life indications, it is possible to use the dose of the drug to 500,000 units / kg / day for 4-6 administrations (intravenously drip, slowly). The duration of treatment from 2 weeks to 2 months. |
|
| Diseases that are transmitted by half: gonorrhea | Benzylpenicillin acts on the gonococci and pale treponus (the causative agent of syphilis), inhibits the transpeptide, disrupting the synthesis of the outer shell of microorganisms (lysis bacteria) | When first infected with gonorads Conduct a shock course benzylpenicillin (sodium or potassium salt): The first introduction of the drug is 600 thousand units, then 400 thousand units every 3-4 hours (without interruptions), all are administered an average of 3 million units for the entire course. Sometimes the introduction of 600 thousand units of benzylpenicillin with 3 ml of fis. The solution and 5 ml of the patient's blood, the mixture is injected intramuscularly in front of the night sleep, then after 6-8 hours continues the shock diagram of the drug. With repeated cases of gonorrhea or its chronic flow Benzylpenicillin (sodium or potassium salt) is 400 thousand eroys every 3-4 hours, in just a course it is necessary to introduce up to 6 million units. Preparations of benzylpenicillin benzatin with acute gonor:600,000 units 1 time per day, 6 intramuscular administrations or 1.2 million foods 1 time after a day, 3 injections. With repeated and chronic forms of gonorrhea:600 000 ° C 10 injections are intramuscularly 1 time per day. |
| syphilis . | In the treatment of syphilis use benzylпenicillina benzatin. For fresh syphilis process - Enter 1-2 intramuscular injections of 2.4 million units with a difference of 7 days. With a late syphilis - 2,400,000 cells 1 time per week from 3 to 5 injections. With congenital syphilis in children: Benzylpenicillin Benzatin 1 200,000 U intramuscularly (dose to divide 2 buttons) once. |
|
Inflammatory diseases of the skin and subcutaneous fiber:
| The effect of the drug at the most common pathogens of skin diseases and soft tissues:
| Bacterial infections of the skin and soft tissues are treated with benzylpenicillin in a daily dose of 10 - 12 million units for adults and up to 300 thousand units / kg for children for 6 intramuscular or intravenous injections. Course of treatment from 10 days to 1 month. Also used subcutaneous slipping Affected areas with antibiotics. For this, the novocaine salt of benzylpenicillin is used, 1-2 million units are bred in 10 ml of water for injections, 1 ml of the solution is added with 1 ml of 0.25% of the novel solution. For gas gangrene The sodium or potassium salt of benzylpenicillin in a high dose of 10 million foods is 4-6 times a day at least 2 weeks. Next, with the aim of prevention, benzylpenicillin Benzatin 2.4 million union is administered. In the face of inflammation The sodium and potassium salt of benzylpenicillin in a large dose - 1-2 million cells 6 times a day, a course of treatment from 7 to 10 days. For the prevention of exacerbations of corrosion inflammation Using injections 2,400,000 units of benzylpenicillin benzatin 1 time per month over several years, or seasonally in spring-autumn periods of 3 months. For the prevention of infection of wounds and postoperative complications Benzylpenicillin Benzatin 2.4 million adults and 1.2 million units for children are used once, if necessary, they repeat the injection no earlier than after 1 week. |
Purulent bone diseases:
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Infections of meningeal shells:
| Antibacterial effect on meningococci, staphylococci, streptococci. The action mechanism is the same. | With purulent diseases of the central nervous system, benzylpenicillin are prescribed in a daily dose of 10-12 million units for adults and up to 300-500 thousand units / kg for children for 6 administrations. Course treatment from 14 days to 1 month. In meningitis, the sodium salt of benzylpenicillin is also injected into the spinal channel ( endoomumbo) In a dose of 5-10 thousand units in 5-10 ml of water for adults for adults and 2,500 - 5,000 units for children older than 1 year in 2.5-5 ml of water for injection. Repeat the procedure 1 times a day for several days, then transferred to a standard injecting input scheme. In severe cases, in 2 weeks of treatment, you can enter the injection of Bicillin-5. |
| anthrax | Bactericidal action against the causative agent of Siberian ulcers is Bacillus Anthracis. | The daily dose of benzylpenicillin in the treatment of Siberian ulcers is from 18 to 20 million units for adults and 200 - 300 thousand units / kg for children, the drug is introduced intravenously drip slowly and intramuscularly every 3 hours. Course of treatment on average 10 days. |
Surriers caused by spirochetes:
| The mechanism of action of benzylpenicillin on spirochetes is similar. | With a returning typhoid daily dosebenzylpenicillin sodium salt - 3 million units for 6 administrations intramuscularly. At Frambeziaadults are recommended for 1.2 or 2.4 million units, children 0.6-1.2 million jacket benzylpenicillin 1-2 injections intramuscularly. In Lyme disease The maximum doses of benzylpenicillin (sodium or potassium salt) are recommended in the presence of complications: adults from 18 to 20 million units, for children 200-300,000 units / kg per day, the drug is introduced every 3-4 hours. Course of treatment from 2 weeks. |
| Treatment and prevention of rheumatic diseases | All rheumatic diseases (rheumatism, rheumatoid arthritis, vasculitis, systemic red lupus and many others) are characterized by chronic damage to the connective tissue. In the pathogenesis of the development of rheumatism, the main role is played by the circulation of a large number of immune complexes (antigen B-hemolytic streptococcus + antibody). Therefore, the etiotropic treatment of rheumatism is directed to the bacteria streptococci: the less pathogens, the less immune complexes. Given the prevalence of the process and chronic flow, in the treatment of rheumatism, a high dose of the drug with a long (prolonged) effect is important, therefore it is advisable to use benzylpenicillin benzatin (Bicyllin-1, -3, -5 and analogs). | In the period of exacerbation of rheumatism, sodium or novocaine benzylpenicillin salts in a dose of 600,000 cells are used 1 time per day, for children 50-100,000 units / kg 1 time per day. The course of such a scheme is 10 days. Next start prevention of rheumatism Bicyllin:
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How to apply medication
Sodium and potassium salt benzylпenicillin
Introduction methods:- intramuscularly;
- inkjet or drip intravenous injections;
- subcutaneously;
- intraphalically;
- endoomumboral (in the spinal channel);
- subconnectivally and intravitreally (in the conjunction and in the vitreal cavity of the eye);
- in the ear;
- in nasal moves;
- intorgano (during surgical manipulations).
All solutions must be prepared immediately before administration in sterile conditions.
- sterile water for injection (for all methods for administering the drug);
- saline solution of sodium chloride 0.9% (for any methods of parenteral administration);
- novocaine 2.5% and 5% (only for intramuscular injections);
- glucose solution is 5% (only for intravenous drip injections).
Benzylpenicillin benzatin and its mixture
The drug is intended only for intramuscular administration, and it is introduced deep into the outer upper quadrant of the jagged muscle. It is not allowed to introduce the drug if blood got into the syringe during the injection.Bicyllin-3, Bicyllin-5 and the dilution of the drug in Novocaine is not allowed in the case of a positive test for novocaine or the presence of allergic and anaphylactic reactions to it.
Bicyllin-3 is not used in pediatric practice.
Benzatin benzylpenicillin can be used for a long, years, for example, with rheumatism.
Solvents for the preparation of an injection solution:
- sterile water for injection;
- sodium solution chloride 0.9%;
- nOWOCAIN solution 2.5% or 5%.
Bezylpenicillin can not be poured simultaneously with hypertensive solutions of salts, sodium bicarbonate (soda), neogenesis, reosorbilakt and other infusion solutions.
Special guidelines for receiving benzylпenicillin
- Not allowed The introduction of the drug simultaneously with other drugs in one syringe.
- Before the introduction of the drug must be carried out allergological sample to antibiotic (If there is no data on previous facts of the use and tolerance of the drug), especially in persons suffering from bronchial asthma and other types of allergies. It should also be carefully used to use the drug to people who had an allergic reaction to cephalosporine antibiotics (ceftriaxone, ceftazidim, cefatasoline, and so on).
- When a novocaine salt is used or bred it in Novocaine, it is necessary to hold allergotch and Novocaine. Novocaine benzylpenicillin salt is introduced only intramuscularly!
- In the absence of a therapeutic effect Against the background of treatment with this tool through the 3rd day, it is necessary to revise etiotropic therapy and choose the drug from another group of antibiotics.
- Additional cancellation of the drugor obtaining low doses of its doses will not only not give a positive therapeutic result, but also may cause the development of resistance (stability) of the pathogen to the antibiotic.
- In case of receipt antibioticograms with the resistance of the pathogen to benzylпenicillinIt is necessary to urgently replace it with the drug to which sensitivity is stored.
- The use of benzylpenicillin during pregnancy and lactation Perhaps only in cases where the risk of developing side effects of the drug to mom and child is smaller than from the failure of an antibiotic or by life indications.
- For people, older than 60 years and persons suffering from kidney disease, The dose of the antibiotic is reduced, since, with a disruption of renal filtration, a large concentration of the active substance in the blood and tissues is observed.
- The drug does not affect attentiveness and reaction.driving a car or during the fulfillment of responsible work requiring increased concentration of attention.
| Form benzylpenicillin | Adults | Children | ||
| Minimum daily dose | Maximum daily dose | Minimum daily dose | Maximum daily dose | |
| Benzylpenicillin sodium and potassium salt | 1 million units for 4-6 receptions. | 60 million units for 6-8 receptions. | 50 thousand units per 1 kg of body weight for 4-6 receptions. | 300 thousand units per 1 kg of body weight, according to life indications, it is possible to use 500 thousand units / kg for 6-8 receptions. |
| BenzylPenicillina Benzatin | 300 thousand four days every 3-4 days. | 2.4 million 1 time per week. | 600 thousand one-time (for newborns). | 1.2 million food once a week. |
| Bicyllin-3. | 600 thousand food once a week. | 1.8 million 2 times a week. | Contraindicated | Contraindicated |
| Bicyllin-5. | 1.2 million food 1 time in 3 weeks. | 2.4 million 1 time per month. | Children up to 8 years old 600 thousand units 1 time in 3 weeks, from 8 to 12 years old - 1.2 million food once a month. | |
* For intramuscular, inkjet or drip intravenous administration of benzylpenicillin dosage, do not differ. But they differ depending on the type of combination of the drug (sodium salt, benzatin, and so on).
Interaction with other drugs
Bezylpenicillin is not recommended to apply with drugs affecting the excretion of the kidneys. Samples (medication for the treatment of gout) increases the level of benzylpenicillin in the blood, and diuretic products (Diuretics - Furosemide, Laziks and others), on the contrary, reduce the concentration of the drug in the blood.Also not recommended simultaneous use of benzylпenicillin with antibacterial drugs that slow down the growth of bacteria and prevent their reproduction (have a bacteriostatic mechanism of action), as benzylpenicillin acts precisely on growing and breeding pathogens. These drugs include tetracycline, doxycycline and some others.
Possible side effects
| By-effect | Why and when does it occur? | How does it manifest? | How to eliminate? | |
| Allergic reactions of instant type: Hives | On the introduction of all antibacterial drugs, allergic reactions occur quite often, anaphylactic shock, fortunately, rarely. Usually, severe allergies occur after re-administering drugs into the body. After the primary contact of the immune system with an allergen, there is a mass formation of immunoglobulins E, which is responsible for allergic to the immediate type of hypersensitivity. With a re-contact with an allergen in the human body, a large number of immune compounds begins to form (immunoglobulin E + allergen), which may have a damaging property on their own body tissues. As a result, inflammation, accompanied by expressed edema, damage to the skin and mucous membranes, less often - damage to the internal organs. Who has an allergic reaction to medicines?
| The appearance on the skin of red blisters, externally replacing the reaction to nettle, rash first appears in the field of administration of the drug, and then can spread throughout the body. After stopping allergies, the rash quickly disappear, there are unchanged skin. In general blood test, there is a significant increase in eosinophil levels (more than 6%)  | With any allergic reaction to the introduction of benzylpenicillin, immediately stop its introduction, cancel it. The reaction and other representatives of the antibiotics of the penicillin row, as well as on cephalosporins (ceftriaxone, cefasoline, cefepim, and so on). With an allergic reaction of moderate severity, antihistamines (suprastine, diphroll, tavergil and others) are administered, it is desirable to introduce them to paranhely. With severe reactions, large doses of prednisolone or other glucocorticosteroids are used. It is then prescribed infusion therapy (drip administration of solutions) with diuretic drugs (furosemide, and so on) in order to quickly remove the drug from the body. Breathing disorder is an indication for intubation (with a larynx tracheotomy edema) and / or connecting to the IVL apparatus (artificial ventilation of the lungs). With the development of anaphylactic shock, in addition to prednisone, adrenaline is introduced. After stopping the acute period of anaphylaxis, it is recommended to introduce 1 million pieces of penicillinase drug, which acts as antidote (antidote) to preparations of penicillin row. The patient and / or his relatives are necessarily reported on the presence of the intolerance of this drug, this fact is noted in the patient's medical card in order to prevent such reactions in the future. |
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| sweet Qincke (or angioedema edema) | Against the background of the drug, there is a sharp local edema of individual parts of the person, as well as mucous languages, larynx, trachea, bronchi and esophagus. Elevation is accompanied by a feeling of burning and discomfort in these areas. Hazardous complications - sandwich edema or lungs, which can lead to patient suffocation.  |
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| Anaphylactic shock | The hardest side effect that may be requiring immediate resuscitation preparations. The main manifestations of the shock are a sharp decrease in blood pressure (less than 60/40 mm of Hg. Art.), The difficulty of breathing, up to its termination, arrhythmia and stop of the heart, it is possible to loss of consciousness, comatose state, convulsive syndrome. | |||
| Bronchial asthma attack | Dyspnea, noisy breathing with an elongated exhalation, may appear the appearance of the face of the face, the panic state of the patient. | |||
| Serum-like reaction syndrome: | In the pathogenesis of the development of serum-like reactions lies the reaction of the hypersensitivity of the slow-type. It is based on the formation of immunological complexes of antigen + antibody (immunoglobulins of class M and G) and a gradual increase in their quantity. These complexes are settled on the walls of vessels, surfaces of joints, renal glomers and other organs, where another immunological reaction occurs (complement binding reaction) and tissue damage and organs, as a result of the occurrence of serum-like reactions. | Serum-like reactions may occur in a week of benzylpenicillin treatment. Symphomes of serum-like reactions:
| It is necessary to change benzylpenicillin on the antibiotic of another group. Also recommended disintellation therapy. | |
| Defeat of the cardiovascular system: hypercalemia | Hypercalemia can develop when using a benzylpenicillin potassium salt. In the presence of heart disease, violation of the removal of the drug with kidneys or the introduction of large doses of the drug, the level of potassium in the blood may increase, which leads to a violation of myocardial work. |
| In the manifestation of symptoms of hypercalemia, it is necessary to replace the potassium salt on sodium or novocaina. Therapeutic correction of the drug is carried out by calcium preparations (calcium chloride). |
|
| allergic myocarditis | The development of this state also contributes to the allergies (slow-type hypersensitivity). Immune complexes affect myocardium, causing an inflammatory process in it and violate its function. |
| Immediate cancellation of the drug. Next, they are prescribed glucocortic brides (prednisone), antihistamines (Tueva, Supratin and Other), calcium preparations, vitamins P, C. In severe cases, hemodialysis or hemosorption is carried out. |
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| Defeat kidney | Benzylpenicillin can lead to development interstitial nephritis. The pathogenesis of the development of this disease is also a manifestation of allergies (slow-type hypersensitivity). In this case, the immune complexes are settled in the lumen of the renal tubules, destroying their membranes, the following immunological reactions (complement binding reaction with the participation of immunoglobulins of class M and G) occur here. Damaged kidney structures are replaced by a connective tissue, thereby reducing the functionality of the organ. | Rarely benzylpenicillin may coal bone marrow sprouts and stem cells (precursor cells) of granulocytes (leukocyte type). This leads to development leukopenia and agranulocytosis. |
| This condition is very heavy, can lead to a fatal outcome. When the first manifestations of this side effect are discovered, it is urgent to replace the drug, not allowing aggravation of the state of the bone marrow. In some cases, drugs that stimulate the formation of leukocytes (pentoxyl, sodium nucleic acid, leucogen) are used. Urthius) and dysbiosis. |
Pharmacotherapeutic Group:
- Antimicrobial, antiparasitic and antihafts
Pharmacological properties:
Pharmacodynamics
Antibiotic group of biosynthetic penicillins. It has a bactericidal effect by inhibiting the synthesis of the cell wall of microorganisms.
Active in relation to gram-positive bacteria: Staphylococcus SPP., Streptococcus SPP. (including Streptococcus Pneumoniae), Corynebacterium Diphtheriae, Bacillus Anthracis; Gram-negative bacteria: NEISSERIA GONORRHOEAE, NEISSERIA MENINGITIDIS; anaerobic spore-forming sticks; as well as Actinomyces SPP., SpirocaetaEae.
The action of benzylpenicillin is stable Staphylococcus SPP strains., Producing penicillinase. Credited in an acidic environment.
The novocaine benzylpenicillin salt compared with the potassium and sodium salts is characterized by a greater duration of action.
Pharmacokinetics
After the introduction, the introduction is quickly absorbed from the injection site. Widely distributed in the tissues and body fluids. Benzylpenicillin penetrates well through a placental barrier, a BEB with inflammation of brain shells.
T 1/2 - 30 min. Displays with urine.
Indications for use:
Treatment of diseases caused by benzylpenicilline microorganisms: Brewing and focal pneumonia, Empiama pleura, sepsis, septicemia, peymain, acute and subacute septic endocarditis, meningitis, acute and chronic osteomyelitis, urinary and biliary tract infections, angina, purulent skin infections, soft tissues and mucous membranes, face, difftheria, scarletin, Siberian ulcer, actinomycosis, treatment of purulent-inflammatory diseases in obstetric and gynecological practice, ENT diseases, eye diseases, gonorrhea, Blennorya, Syphilis.
Refers to diseases:
- Angina
- Gonorrhea
- Diphtheria
- Infection
- Meningitis
- Osteomyelitis
- Pleurisy
- Pneumonia
- Rygin
- Sepsis
- Syphilis
- Scarlet fever
- Empiama
- Empiama pleura
- Endocarditis
- Ulcer
Contraindications:
Increased sensitivity to benzylpenicillin and other preparations from the penicillin group and cephalosporins. Endoomumbal administration is contraindicated with patients suffering from epilepsy.
Method of use and dose:
Individual. Enter in / m, in / in, p / k, endoomolumboral.
With the / m and in / in the introduction of adults, the daily dose varies from 250,000 to 60 million units. The daily dose for children under the age of 1 is 50,000-100,000 units / kg, older than 1 year - 50,000 units / kg; If necessary, the daily dose can be increased to 200,000-300,000 units / kg, according to life indications - up to 500,000 units / kg. Multiplicity of introduction 4-6 times / day.
Endolumboly administered depending on the disease and severity of the flow of adults - 5000-10,000 units, children - 2000-5000 units. The drug is bred in sterile water for injections or at a 0.9% solution of sodium chloride at the rate of 1 thousand s / ml. Before injection (depending on the level of intracranial pressure), 5-10 ml of SMF are removed and it is added to an antibiotic solution in an equal ratio.
P / K benzylpenicillin is used to slip infiltrates (100,000-200,000 units per 1 ml of 0.25% -0.5% of the novel solution).
Benzylpenicillin potassium salt is used only in / m and p / k, in the same doses as benzylpenicillin sodium salt.
Benzylpenicilline Novocaine salt apply only in / m. Average therapeutic dose for adults: one-time - 300,000 units, daily - 600,000 units. Children under the age of 1 year - 50,000-100,000 units / kg / day, older than 1 year - 50,000 units / kg / day. The multiplicity of introduction is 3-4 times / day.
The duration of the treatment with benzylpenicillin, depending on the shape and severity of the course of the disease, can be from 7-10 days to 2 months or more.
Side effect:
From the digestive system: Diarrhea, nausea, vomiting.
Effects due to chemotherapeutic effects: Candidiasis of the vagina, cavity candidiasis.
From the CNS: With the use of benzylpenicillin in high doses, especially in the endolumbal administration, the development of neurotoxic reactions is possible: nausea, vomiting, increasing reflex excitability, symptoms of meningism, convulsions, coma.
Allergic reactions: Increase body temperature, urticaria, skin rash, rash on mucous membranes, joint pain, eosinophilia, angioedema edema. Cases of anaphylactic shock with fatal outcome are described.
Application in pregnancy and breastfeeding:
Application during pregnancy is possible only when the intended benefit of therapy for the mother exceeds the potential risk to the fetus.
If you need to use during the lactation period, it is necessary to resolve the issue of cessation of breastfeeding.
Interaction with other drugs:
The probilecid reduces the tubular secretion of benzylpenicillin, as a result, the concentration of the latter in the blood plasma increases, the half-life increases.
With simultaneous use with antibiotics that have a bacteriostatic effect (tetracycline), the bactericidal effect of benzylpenicillin decreases.
Special instructions and precautions:
Caution is used in patients with impaired kidney function, with heart failure, predisposition to allergic reactions (especially during drug allergies), with increased sensitivity to cephalosporins (due to the possibility of developing cross-allergies).
If after 3-5 days after the start of the use of the effect, it is not noted, it is necessary to proceed to the use of other antibiotics or combined therapy.
In connection with the possibility of the development of fungal superinfection, it is advisable in the treatment of benzylpenicillin to prescribe antifungal drugs.
It is necessary to take into account that the use of benzylpenicillin in subterapeutic doses or early cessation of treatment often leads to the emergence of resistant strains of pathogens.
With violations of the kidney function
Caution is used in patients with impaired kidney function.
Natural antibiotic group of penicillins. Acid-resistant, collapsed beta-lactamase (penicillinase).
In medical practice, benzylpenicillin sodium, potassium and novocaine salt are used.
White small crystalline powder of bitter taste. Slightly hygroscopic. Very easily soluble in water, soluble in ethanol and methanol. Easily collapsed under the influence of acids, alkalis and oxidizing agents. Introduced in / m, in / in, p / k, endoomumboral, intraterally.
Benzylpenicillin potassium salt is a white fine-crystalline powder of bitter taste. Gigroscopic. Very easily soluble in water, soluble in ethanol and methanol. Easily collapsed under the influence of acids, alkalis, oxidizing agents. Introduced in / m, p / k.
Benzylpenicillin Novocaine Salt is a white fine-crystalline powder without smell, bitter taste. Gigroscopic. Little soluble in water, ethanol and methanol. It is difficult to soluble in chloroform. With water forms a subtle suspension. Resistant to light action. Easily collapsed in the action of acids and alkalis. Enter only in / m.
Indications for use
Treatment of diseases caused by benzylpenicilline microorganisms: Brewing and focal pneumonia, Empiama pleura, sepsis, septicemia, peymain, acute and subacute septic endocarditis, meningitis, acute and chronic osteomyelitis, urinary and biliary tract infections, angina, purulent skin infections, soft tissues and mucous membranes, face, difftheria, scarletin, Siberian ulcer, actinomycosis, treatment of purulent-inflammatory diseases in obstetric and gynecological practice, ENT diseases, eye diseases, gonorrhea, Blennorya, Syphilis.
Form release
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 500 thousand units; Flacon (bottle)
BenzylPenicillin sodium salt
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 250 thousand units; Block (Block) Box (Box) 50
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 500 thousand units; bottle (bottle) pack cardboard 1
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 500 thousand units; Blocker (bottle) pack cardboard 5
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 500 thousand units; Block (bottle) pack cardboard 10
BenzylPenicillin sodium salt
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; bottle (bottle) pack cardboard 1
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Blocker (bottle) pack cardboard 5
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Block (bottle) pack cardboard 10
BenzylPenicillin sodium salt
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Block (Block) Box (box) Cardboard 50
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 500 thousand units; Block (Block) Box (box) Cardboard 50
BenzylPenicillin sodium salt
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Block (Block) Box (box) Cardboard 50
BenzylPenicillin sodium salt
0
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Block (Block) Box (box) Cardboard 50
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Boton (Block) Box (box) Cardboard 1
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Block (Block) Box (box) Cardboard 50
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Boton (Block) Box (box) Cardboard 1
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 1 million units; Flacon (bottle)
BenzylPenicillin sodium salt
Powder for the preparation of an injection solution for intramuscular administration of 250 thousand units; Flacon (bottle)
Pharmacodynamics
Antibiotic group of biosynthetic penicillins. It has a bactericidal effect by inhibiting the synthesis of the cell wall of microorganisms.
Active in relation to gram-positive bacteria: Staphylococcus SPP., Streptococcus SPP. (including Streptococcus Pneumoniae), Corynebacterium Diphtheriae, Bacillus Anthracis; Gram-negative bacteria: NEISSERIA GONORRHOEAE, NEISSERIA MENINGITIDIS; anaerobic spore-forming sticks; as well as Actinomyces SPP., SpirocaetaEae.
The action of benzylpenicillin is stable Staphylococcus SPP strains., Producing penicillinase. Credited in an acidic environment.
The novocaine benzylpenicillin salt compared with the potassium and sodium salts is characterized by a greater duration of action.
Pharmacokinetics
After the introduction, the introduction is quickly absorbed from the injection site. Widely distributed in the tissues and body fluids. Benzylpenicillin penetrates well through a placental barrier, a BEB with inflammation of brain shells.
T1 / 2 - 30 min. Displays with urine.
Use during pregnancy
Application during pregnancy is possible only when the intended benefit of therapy for the mother exceeds the potential risk to the fetus.
If you need to use during the lactation period, it is necessary to resolve the issue of cessation of breastfeeding.
Other special occasions when taking
Bronchial asthma, pollinosis, renal failure.
Contraindications for use
Increased sensitivity to benzylpenicillin and other preparations from the penicillin group and cephalosporins. Endoomumbal administration is contraindicated with patients suffering from epilepsy.
Side effects
From the digestive system: diarrhea, nausea, vomiting.
Effects caused by chemotherapeutic effects: Candidia of the vagina, Candidiasis of the oral cavity.
From the CNS side: when using benzylpenicillin in high doses, especially with endolumbal administration, neurotoxic reactions are possible: nausea, vomiting, increasing reflex excitability, symptoms of meningism, convulsions, coma.
Allergic reactions: an increase in body temperature, urticaria, skin rash, rash on mucous membranes, joint pain, eosinophilia, angioedema swelling. Cases of anaphylactic shock with fatal outcome are described.
Method of application and dose
In / m, in / in (except for the novocaine salt of benzylpenicillin), p / k, endoomolumbo (only sodium salt benzylpenicillin), in cavity, intrachealy; In ophthalmology - instillation in the conjunctival bag, subconjunctivally, inttyravitreally.
At a / m and in / in the introduction: for adults - 2-12 million units / day in 4-6 administrations; under community-hospital pneumonia - 8-12 million units / day in 4-6 injections; With meningitis, endocarditis, gas gangrene - V / in 18-24 million units / day in 6 administrations.
The duration of the treatment with benzylpenicillin, depending on the shape and severity of the disease ranges from 7-10 days to 2 months and more (for example, during sepsis, septic endocarditis).
Overdose
Symptoms: cramps, violation of consciousness.
Treatment: cancellation of the drug, symptomatic therapy.
Interactions with other drugs
The probilecid reduces the tubular secretion of benzylpenicillin, as a result, the concentration of the latter in the blood plasma increases, the half-life increases.
With simultaneous use with antibiotics that have a bacteriostatic effect (tetracycline), the bactericidal effect of benzylpenicillin decreases.
Precautions when receiving
V / B, endoomumboral and in the cavity is administered only in the hospital.
Use the preparations of benzylpenicillin is only necessary for its intended purpose and under the supervision of the doctor. It must be remembered that the use of insufficient doses of benzylpenicillin (as well as other antibiotics) or too early cessation of treatment often leads to the development of sustainable strains of microorganisms. When resistance appears, the treatment of another antibiotic should be continued.
Benzylpenicillin Novocaine salt is administered only in / m. V / B and endoommumbal administration is not allowed. Of all the preparations of benzylpenicillin, only sodium salt is introduced endoomumboral.
With bronchial asthma, polynosis and other allergic diseases, benzylpenicillin are used with caution while simultaneously assigning antihistamine.
When developing in patients, allergic reactions, the drug should be discontinued. In weakened patients, newborns, elderly people with long-term treatment, it is possible to develop superinfection caused by microflora-resistant drug (yeast-like mushrooms, gram-negative microorganisms). Due to the fact that with prolonged oral administration of antibiotics, an intestinal microflora can be suppressed, producing vitamins B1, B6, B12, PP, patients for the prevention of hypovitaminosis, it is advisable to assign vitamins of group B.
In the event that 2-3 days after the start of receiving the drug (maximum 5 days), the effect is not noted, it is necessary to proceed to the treatment with another antibiotic or to combined therapy.
Special guidelines when taking
Caution is used in patients with impaired kidney function, with heart failure, predisposition to allergic reactions (especially during drug allergies), with increased sensitivity to cephalosporins (due to the possibility of developing cross-allergies).
If after 3-5 days after the start of the use of the effect, it is not noted, it is necessary to proceed to the use of other antibiotics or combined therapy.
In connection with the possibility of the development of fungal superinfection, it is advisable in the treatment of benzylpenicillin to prescribe antifungal drugs.
It is necessary to take into account that the use of benzylpenicillin in subterapeutic doses or early cessation of treatment often leads to the emergence of resistant strains of pathogens.
Storage conditions
List B.: In a dry place, at a temperature not higher than 20 ° C.
Shelf life
Belonging to ATX classification:
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In this article we will talk about this drug as "benzylpenicillin sodium salt". Instructions for use, readings, dosage and use recommendations will be covered in the article. In addition, we will consider the pharmacological properties of the drug, possible side effects and the interaction of the drug with other medicines.
common data
The drug is an antimicrobial agent and an antibiotic belonging to the penicillin group. The benzylpenicillin itself sodium salt, the instruction on the use of which will be presented below, is produced by various mold mushrooms.
The drugs of this group are used for intramuscular administration, exposure to various tissues and organs in which blood delivers a small amount of penicillin. In order for the drug to begin to apply on the head and spinal cord, as well as the brain shell, it is introduced subarachnoid.
Benzylpenicillin sodium salt, instructions for use: pharmocheological action
The drug is effective against gram-positive microorganisms, which include:
- staphylococci;
- streptococci;
- pneumococci;
- chopsticks of Siberian ulcers;
- aerobic (surviving and oxygen) spore-forming sticks.
In addition, the drug is active against gram-negative kokks (meningococcus, gonococcus), spirochete, actinomycetes and a number of other microorganisms. Ineffective benzylpenicillin sodium salt against viruses, rickettsies, mushrooms, simplest.
Resistant to the preparation of Staphylococci strains, which are able to produce a penicillinase enzyme, decomposing benzylpenicillin. The drug shows low activity in intestinal bacteria and other microorganisms that are capable of using penicillinase in different amounts.
Pharmacokinetics
With intramuscular administration, the drug quickly falls into the blood, from where it is delivered to other liquids of the body and tissue. As for the spinal fluid, a small amount of benzylпenicillin penetrates there. The highest concentration of substance in the blood after administration is intramuscularly marked after 30-50 minutes. If the drug was introduced subcutaneously, then the absorption rate will decrease and the greatest amount of substance in the blood will be observed in an hour.
Three hours after injection (subcutaneous or intramuscular), only benzylпenicillin traces will remain in the blood. Therefore, in order to maintain a high concentration of the drug in the body for a long time, it is necessary to make injections every four hours.
When the drug is administered intravenously, its concentration is quickly reduced. And when taking orally, benzylpenicillin is destroyed under the action of penicillinase (enzyme) and gastric juice.
From the body, the drug is displayed with urine.
Indications
Must be carefully studied before appointing such a drug as benzylpenicillin sodium salt, instructions for use, dose and testimony. Let's start with the latter. So, the drug is prescribed:
- for diseases of the lungs and respiratory tract;
- severe septic diseases;
- septic endocarditis;
- sepsis;
- infections and infected wounds of soft tissues, skin and mucous membranes;
- burns;
- inflammations of the dorsal and brain, the Mazgov's shells;
- purulent pleurisy;
- peritonitis;
- cystitis;
- peymia and septicemia;
- osteomyelitis;
- diphtheria;
- scarlay;
- gonor;
- face inflammation;
- blennorea in newborns;
- siberian ulcer;
- syphilis;
- actinomycosis;
- various gynecological inflammation;
- inflammatory diseases of the throat, ear and nose.
Use and dosage rules
Depending on the diagnosis, various therapy can be assigned using a benzylпenicilline sodium salt. Instructions for use, the method of administration and possible dosages will be considered in this section.
The course of treatment with a drug can last, depending on the disease, from 4 weeks to 2 months and even more. The drug can be entered in the following ways:
- Intramuscularly in the outer upper berry quadrant. The drug is bred before administration in distilled water, a solution of novocaine or sodium chloride.
- Intravenously - only with such severe diseases as meningitis, septic endocarditis, sepsis, etc. The drug is introduced every 4 hours or a continuous drip method - 30 drops per minute for 6-12 hours.
- The endoomumbo benzylpenicillin sodium salt can also be introduced. Instructions for use (use method) provides for such a method with inflammation of the spinal and brain, including brain shells. The drug is introduced very slowly - 1-2 minutes.
- There are cases when benzylpenicillin is used to slip inflammatory foci. For example, with actinomycosis, leismaniasis of skin, chronic pyodermia and other infectious skin diseases.
- With the help of inhalations - for the treatment and prevention of lung diseases and respiratory tract. For this, benzylpenicillin is mixed with sodium chloride solution or distilled water. There are inhalations no more than 2 times a day. For a long time, one procedure is from 10 to 30 minutes.
- The drug is also introduced into a pleural or abdominal cavity with purulent pleuritic or peritonitis.
- In the form of washes, ointments, wet dressings, rims and powders - in burns, wounds of soft tissues, osteomyelitis, etc.
- Also used a solution of the drug in the treatment of ENT diseases and in ophthalmology.
Benzylpenicillin can be used in therapy with other antibiotics and sulfanilaminamide drugs. In this case, the tool will increase the therapeutic effect of the drugs used.
Side effects
It can also have a negative impact of benzylpenicillin sodium salt. Instructions for use notes that they are most often manifested with intravenous administration of the drug.
Basically, side effects are associated with the drug. Among adverse symptoms are marked:
- candidiasis;
- hives;
- temperature increase;
- headaches;
- chills;
- pain in the joints;
- swelling quinque;
- eosinophilia;
- various types of dermatitis;
- fever;
- lymphadenopathy;
- anaphylactic shock - in very rare cases.
Contraindications
Not to all patients can approach therapy using the benzylpenicillin drug sodium salt. Instructions for use and the rule of administration of the drug provide a number of contraindications. Among them:
- such allergic diseases like urticaria, hay fever, bronchial asthma, etc.;
- increased sensitivity to Penicillin derivative;
- unusual reaction to drugs;
- stability of the causative agent of the disease to the standard dose of benzylpenicillin.
The introduction of the drug with endolumbar can be prohibited during epilepsy.
Pregnancy and lactation
It is prescribed during pregnancy only if the benefits of treatment for a woman will exceed the potential risk to her future child. Otherwise, the drug is not prescribed. Risk and efficiency ratio is determined by the attending physician.
In case of the need to receive the drug during breastfeeding period, feeding is recommended to stop.
Properties
The drug substance benzylpenicillin The sodium salt has the appearance of a white small-crystalline powder with a bitter flavor, which is easily dissolved in the liquid.
The drug is easily collapsed under the influence of acids, alkalis, oxidizing agents, penicillinase enzyme, as well as when heated. Prepare the medicinal substance is necessary immediately before administration.
Precautions
The drug is administered only in stationary conditions for the appointment of a doctor and under its supervision. When passing therapy, it must be remembered that the insufficient dose of benzylpenicillin or early completion of treatment can lead to the formation of sustainable strains of microorganisms. In the event of resistance to the drug, the treatment continues with other antibiotics.
At a tendency to allergic reactions, the preparation of benzylпenicillin sodium salt is administered together with antihistamine. Instructions for use (the effect of the drug in it is prescribed especially in detail) informs that when a patient has allergic manifestations, therapy is immediately stopped.
In certain groups of patients (older people, newborns, weakened diseases), immunity can occur to benzylпenicillin, which causes the development of superinfection.
With prolonged use of the antibiotic, the intestinal microflora may be suppressed or partially destroyed, which leads to a decrease in the production of vitamins of group. Therefore, in preventive purposes, patients are often prescribed vitamins B1, B12, etc.
If, after the start of therapy, no effect was noticed for 3 days, then it is necessary to go to the combined treatment or assign a new antibiotic.
special instructions
With caution, it is prescribed to people with heart failure and a violation of the work of the renal benzylpenicillin sodium salt. Instructions for use also recommends special attention to pay for the patients who have noted hypersensitivity to cephalosporins.
Due to the possibility of fungal superinfection, antifungal agents are recommended.
Interaction with other drugs
When appropriate with those antibiotics, which have a bacteriostatic effect, the bactericidal effect of the benzylпenicillin itself is reduced.
The probe drug has a property to reduce the channel secretion of the antibiotic, which leads to an increase in the level of the latter in the blood and, as a result, an increase in the time of removal from the body.
Registration number: P N003271 / 02-060810
Trade name of the drug: Benzylpenicillin
International UnPatented Name (MNN): benzylpenicillin
Dosage form: Powder for preparing a solution for intramuscular and subcutaneous administration.
Structure:
Benzylpenicillin sodium in terms of active substance - 500000 units, 1000000
Description: White powder with a weak characteristic odor.
Pharmacotherapeutic group: Antibiotic Penicillin Biosynthetic
ATX code J01ce01
Pharmacological properties
Pharmacodynamics
Bactericidal antibiotic from a group of biosynthetic "natural" penicillins. Suppresses the synthesis of the cell wall of microorganisms. Active in relation to gram-positive pathogens: Staphylococcus SPP. (Introduced penicillinase), Streptococcus SPP. (including Streptococcus Pneumoniae), Corynebacterium Diphtheriae, Bacillus Anthracis, Actinomyces SPP.; Gram-negative microorganisms: Neisseria Gonorrhoeae, Neisseria Meningitidis, as well as SPIROCHAETES class families, including Treponema SPP. Not effective in relation to most gram-negative bacteria, Rickettsia SPP., Simplest. The action of the drug is resistant penicillin-forming strains of microorganisms.
Pharmacokinetics
The time to achieve maximum concentration (TSMAs) with intramuscular administration - 20-30 minutes. Communication with plasma proteins is 60%. It penetrates into organs, fabrics and biological fluids, except for the liquor, eye tissues and the prostate gland, with inflammation of meningeal shells penetrates through the hematorethelical barrier (GEB). Excreted by kidneys unchanged. The half-life (T½) period is 30-60 minutes, with renal failure - 4-10 hours or more.
Indications for use
Infectious and inflammatory diseases caused by sensitive pathogens:
- breath organs: Complete Pneumonia, Empiama Plevra, Bronchitis;
- ENT organs;
- greeting system: pyelonephritis, pyelitis, cystitis, urethritis, cervicitis;
- biliary tract: cholegitis, cholecystitis;
- skin and soft tissue: face, impetigo, secondary infected dermatoses, wound infection;
- eye disease: Gaoblennorya, corneal ulcers;
- sepsis, septic endocarditis (acute and subacute),
- peritonitis;
- gonorrhea, Syphilis;
- meningitis;
- osteomyelitis;
- diphtheria; scarlet fever; actinomycosis; anthrax.
Hypersensitivity, including other penicillins, cephalosporins.
Carefully
Allergic diseases (bronchial asthma, polynosis), renal failure.
Application in pregnancy and breastfeeding
Application during pregnancy is possible if the estimated benefit for the mother exceeds the potential risk to the fetus. If necessary, the use of the drug during the lactation should stop breastfeeding.
Method of application and dose
Intramuscularly, subcutaneously.
Intramuscularly with a medium-sized flow of infections of the upper and lower respiratory tract, urinary and biliary paths, infections of soft tissues, etc.
- 2.5-5 million units for 4 administration per day.
Daily dose for children under the age of 1 year - 500,000-100000 U / kg, older than 1 year - 50,000 units / kg; if necessary - 200,000-300000 U / kg; According to the "life" testimony - an increase of up to 500,000 units / kg. The multiplicity of administration is 4-6 times a day.
Subcutaneously for glutanking infiltrates at a concentration of 100,000-200000 units in 1 ml of 0.25-0.5% of the removal solution.
For diseases of the eye: Eye drops at a concentration of 20000-100000 units in 1 ml of a 0.9% sodium solution of chloride or distilled water, 1 -2 drops 6-8 times a day.
The duration of treatment with the drug depending on the shape and severity of the course of the disease-7-10 days.
Method of preparation of solutions
The solution of the drug for intramuscular administration is prepared immediately before administration by adding 1-3 ml of water for injection or 0.9% solution of sodium chloride to the content of the volatility, or 0.5% solution of the procaine.
When breeding benzylpenicillin in a solution, the solution may be observed in the solution of the solution due to the formation of benzylpenicillin crystals Prinos, which is not an obstacle to intramuscular and subcutaneous administration of the drug. Solutions are used immediately after preparation, not allowing other medicines to them.
A solution for local applications in ophthalmology should be prepared by EX Tempore: the contents of the vial of diversify a 0.9% solution of sodium chloride or distilled water - 500,000 units in 5 -25 ml, 100,000,000 units of 10-50 ml, respectively.
Side effect
Allergic reactions: Hyperthermia, urticaria, skin rash, rash on mucous membranes, arthralgia, eosinophilia, angioedema edema, interstitial nephritis, bronchospasm; Rarely anaphylactic shock. At the beginning of the course of treatment (especially in the treatment of congenital syphilis) rarely - fever, chills, increased sweating, aggravation of the disease, the reaction of Yarisha-Gersheimer.
From the cardiovascular system: Reducing the ejection ejection fraction of arrhythmia, stopping heart, chronic heart failure (because when introducing large doses, hypernatremia may occur).
Local reactions: soreness and sealing at the site of intramuscular administration
Other: With prolonged use of dysbacteriosis, the development of superinfection.
Overdose
Symptoms: cramps, violation of consciousness.
Treatment: Cancellation of the drug, symptomatic therapy.
Interaction with other drugs
Bactericidal antibiotics (including cephalosporins, vancomycin, aminoglycosides rifampicin) have a synergide effect; bacteriostatic (including macrolides, chloracycles, lincoosamides, tetracyclines) - antagonistic increases the efficiency of indirect anticoagulants (suppressing the intestinal microflora reduces the prothrombin index); Reduces the effectiveness of oral contraceptives of drugs, in the process of metabolism of which a para-aminobenzoic acid is formed - the risk of developing the "breakthrough" bleeding.
Diuretics, Allopurinol, Channel Secrets, Phenylbutazone blockers, Nonteroidal anti-inflammatory drugs, reducing the tubular secretion, increase the concentration of benzylpenicillin.
Allopurinol increases the risk of developing allergic reactions (skin rash).
special instructions
If after 2-3 days (maximum 5 days) after the start of use of the effect of the effect, it is not noted, it is necessary to proceed to the use of other antibiotics or combination therapy. Due to the possibility of the development of fungal lesions, it is advisable for long-term treatment with benzylpenicillin to assign vitamins of group B, if necessary, antifungal drugs. It must be borne in mind that the use of insufficient doses of the drug or too early cessation of treatment often leads to the emergence of resistant strains of pathogens.
Information about the effect of the drug on the ability to control vehicles and other mechanisms is absent. However, given the possible side effect on the side of the cardiovascular system, care should be taken in case of this kind of activity.
Form release
Powder for the preparation of a solution for intramuscular and subcutaneous administration of 500,000 units, 10,000,000 units in the vial with a capacity of 10 ml.
1 bottle, along with instructions for use, placed in a pack.
10 bottles together with the instructions for use are placed in a box of cardboard box.
For the hospital: 50 bottles and 5 instructions for use are placed in a box of cardboard boxes.
Storage conditions
List B. in light-protected place at a temperature not higher than 25 ° C.
Keep out of the reach of children.
Shelf life
Z year. Do not use after the expiration date.
Conditions of vacation from pharmacies
On prescription.
Claims from buyers accept company-producer
OJSC "Kraspharma"
Russia 660042 Krasnoyarsk, ul. 60 years of October, d. 2.
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