Sodium Injection Instructions cefpiramide [Drug Name] Common name: Injection cefpiramide English name: cefpiramide sodium for injection Pinyin: zhusheyong toubaopi'anna The main ingredients cefpiramide, its chemical name: (6r, 7r) -7 - [(r) -2 - (4 - hydroxy-6 - methyl-3 - pyridinylcarbonylamino) -2 - ( p-hydroxyphenyl) acetamido] -3 - [[(1 - methyl-1h-tetrazol-5 - yl) thio] methyl] -8 - oxo-5 - thia - 1 - azabicyclo [ 4.2.0] oct-2 - ene-2 - carboxylic acid sodium salt. Its structural formula is: Formula: c25h23n8nao7s2 Molecular Weight: 634.62 【Properties】 white to off-white lumps or powder. Pharmacology and Toxicology An antibacterial effect (1) Gram-positive bacteria have strong antibacterial activity against Gram-negative bacteria, including bacteria, including also a broad-spectrum antimicrobial activity. Meanwhile, Pseudomonas aeruginosa and other non-glucose-fermenting Gram-negative bacteria have strong antibacterial activity. Sterilizing effect of the drug, and the β-lactamase stability of various bacteria. (2) used for experimental infection (mice), the exhibit excellent therapeutic effect. (3) to penicillins, cephalosporins or other aminoglycoside antibiotic-resistant bacteria, especially Pseudomonas aeruginosa sensitive. 2, the mechanism Penicillin-binding protein (pbp) of 1a, 1b, and 3 have a strong affinity for the inhibition of bacterial cell wall synthesis, and thus play a bactericidal effect. Pharmacokinetics] 1, the blood concentration When healthy adults and intravenous 0.5g 1g, the concentration in the blood after 5 minutes, respectively 163μg/ml and 264μg/ml, respectively, after 12 hours at reduced 10.7μg/ml and 17.7μg/ml, half-life in blood concentrations are 4.5 hours. After one hour infusion 1g and when 2g, ending drip blood concentrations peaked when, respectively, 215μg/ml and 306μg/ml, respectively, down 14.7μg/ml and 30.6μg/ml started 12 hours after infusion . High blood levels and was sustained. Continuous administration no accumulation. 2, excretion Healthy adults within 24 hours after intravenous injection of urinary excretion rate of about 23 percent, 12 to 24 hours after administration of the urine remains high concentrations of approximately 50μg/ml. Most of the goods by the biliary excretion of bile cefpiramide concentrations greater than 10 times the plasma, probenecid does not affect cefpiramide eliminated. 3, in the distribution of body fluids and tissues This product is distributed in high concentrations in the liver and gallbladder tissue in the female reproductive system, the peritoneal exudate, oral tissue, tonsil tissue, skin and burns tissue and sputum well distributed. 4, the concentration of the blood when the liver and kidney dysfunction After intravenous injection to patients with liver dysfunction 1g, its concentration in the blood compared with healthy adults is slightly persistent trend, liver cirrhosis patient's blood half-life is approximately 2-fold concentration of healthy adults, the patient's blood levels of hepatitis half-life of about 1.2 in healthy adults to 1.9 times. After intravenous injection to patients with renal dysfunction 0.5g, its concentration in the blood compared with healthy adults is slightly persistent trend, however, even the ccr less than 10ml/min cases, its half-life in blood concentrations of only about 1.3 times longer, not confirmed with ccr closely related. This extension of degree less than other cephalosporin antibiotics. ccr (ml / min) ≥ 90 90 ~ 60 60 ~ 30 30 ~ 10 <10 t1 / 2 (hr) 4.06 6.22 4.44 7.5 5.18 The drug is used to severe liver and kidney function disorder patients need appropriate dose and dosing interval adjustment. 5. Metabolize Almost no in vivo metabolism, urinary and fecal metabolites found no antibacterial activity. 6 children's blood levels and excretion Pharmacokinetics for children and adults the same time, the concentration of serum half-life of 3.6 to 4 hours, 8 hours in the urinary excretion rate of 21 to 25%. Indications applicable to the case by Staphylococcus aureus, Streptococcus (except enterococci outside), anaerobic bacteria are anaerobic Streptococcus, E. coli, Citrobacter, Klebsiella spp, intestinal spp, Proteus, Morganella Proteus, Pseudomonas, Haemophilus influenzae, Acinetobacter, Bacteroides genus of the drug-sensitive bacteria caused by various infections following: 1) sepsis; 2) burns, surgical incisions and other secondary infections; 3) pharyngitis (throat abscess), acute bronchitis, tonsillitis (inflammation around the tonsils, peritonsillar abscess), chronic bronchitis, bronchiectasis (infection ), secondary infections of chronic respiratory disease, pneumonia, lung abscess, empyema; 4) pyelonephritis, cholangitis; 5) peritonitis (including pelvic peritonitis, bladder rectum abscess); 6) adnexitis, uterus infections, pelvic inflammatory disease, uterine inflammation of connective tissue next, bartholinitis; 7) meningitis; 8) jaw arthritis, cellulitis around the jaw. Dosage Usual dose for adults is cefpiramide daily 1 ~ 2g, 2 intravenous injection or intravenous drip. When refractory or severe infections, the symptoms may be increased depending on 4g a day, 2 to 3 times intravenously. Children usual dose by 30 ~ 80mg per kg of body weight per day, 2 to 3 times intravenously. When refractory or severe infections, the symptoms may be increased depending on the daily per kilogram 150mg, 2 to 3 times intravenously. Method of administration and precautions: (1) intravenous infusion of this product, adding glucose, electrolyte solution, such as an amino acid infusion liquid, 30 to 60 minutes after infusion is completed; (2) The drug can only be used for intravenous administration. Dissolved in water for injection must not use intravenous drugs, because the solution is not isotonic; (3) high-dose intravenous administration, sometimes causing vascular pain and thrombophlebitis, in order to prevent the emergence of such symptoms, they should pay attention to dissolving injection, injection site _select_ion, injection methods, injection speed should be slow; (4) shall be dissolved quickly, when you need to save, be sure to use within 24 hours; (5) should not be mixed cefpiramide bit with other drugs in the same container. Clinical research statistics adverse reactions reported in the literature, the goods in the pre-listing and post-listing analysis conducted 15,442 cases, the adverse reactions and laboratory abnormalities were 617 cases (4%). Mainly for rare diarrhea, nausea and other gastrointestinal symptoms, and skin rashes and other symptoms, leukopenia, increased eosinophils and other blood abnormalities, bun, creatine, creatinine renal dysfunction such as elevated, got, gpt elevated liver function abnormalities person. 1. Serious adverse reactions (1) anaphylactic shock (<0.1%) Close observation, the symptoms should be discontinued and appropriate disposal. (2) acute renal failure and other serious renal dysfunction (<0.1%) When regularly check kidney function, close observation, abnormal, should be discontinued and appropriate disposal. (3) pseudomembranous colitis, with the bloody severe colitis (<0.1%) Abdominal pain, diarrhea and other symptoms when frequent, should be discontinued immediately and appropriate disposal. (4) interstitial pneumonia, pulmonary eosinophil infiltration syndrome (<0.1%) When fever, cough, dyspnea, chest x-ray abnormalities, increased eosinophils and other symptoms, should be discontinued, and given corticosteroids, proper disposal. 2. Serious adverse reactions appear similar drugs (1) malignant bullous erythema multiforme (stevens-johnson syndrome), toxic epidermal necrolysis syndrome (lyell syndrome) It is reported when using other cephalosporin antibiotics, occasionally vicious bullous erythema multiforme (stevens-johnson syndrome), toxic epidermal necrolysis syndrome (lyell syndrome) should be closely observed, abnormal, should discontinued and appropriate disposal. (2) hemolytic anemia It was reported that the use of other cephalosporins (cet, cer, etc.), hemolytic anemia, abnormal, should be discontinued and appropriate disposal. (3) Other adverse reactions The following adverse reactions occur, they should take appropriate measures as necessary to reduce the dose, withdrawal and so on. 0.1 ~ 5% <0.1% ※ allergic rash, itching, fever, urticaria, thin spots, redness of the skin, joint pain, etc. Hematologic neutropenia, anemia, increased eosinophils, thrombocytopenia Liver got, gpt, al-p, ldh elevated bilirubin, γ-gpt rise Digestive diarrhea, nausea, vomiting, loss of appetite, etc. Dual infection stomatitis, candidiasis Vitamin deficiency of vitamin k deficiency symptoms (hypoprothrombinaemia Bleeding tendency, etc.), vitamin b deficiency symptoms (glossitis, Stomatitis, anorexia, neuritis, etc.) Other headaches, hot feeling, a sense of general malaise ※ occurrence of such symptoms, and so should be discontinued and appropriate treatment. Taboo has caused the drug ingredient patient's past history of anaphylactic shock disabled; against the drug ingredients or cephalosporins patients with a history of allergy disabled. [Note] (1) in patients with severe liver and kidney dysfunction, should be properly adjusted and medication dosage interval, carefully administered. (2) applying the drug to prevent the emergence of resistant, the sensitivity should be determined after administration, treatment should be administered in the treatment of disease control in the shortest time necessary for the principle. (3) to penicillin antibiotics in patients with a history of allergies; patients themselves or their parents, brothers and sisters, bronchial asthma, skin rashes, urticaria and other allergies; patients with severe kidney dysfunction [the drug concentration in the blood to maintain a sustainable, Therefore, the need to reduce the dose or longer dosing interval]; patient or non-patient eating bad oral intake of nutrition, poor general condition of patients [vitamin k deficiency symptoms can occur, should be closely observed], should be used with caution. (4) it is possible to anaphylactic shock, the need for full inquiry. (5) must do the rescue anaphylaxis medication preparation, so that after treatment the patient must be kept quiet state, close observation. (6) After a week during treatment and medication should not be drinking, otherwise there may be facial flushing, nausea, tachycardia, sweating, headache and other symptoms. (7) Long-term use of the product can lead to resistant bacteria, Clostridium colon drug may lead to the proliferation of pseudomembranous colitis, caused by severe diarrhea. (8) reaction using paper other than the class's reagent, when Fehling reagent urine test urine examination conducted pills, sometimes false positive reactions, should be noted. Sometimes positive reaction (9) direct anti-globulin serum test, should be noted. (10) It is reported that in young rats by subcutaneous injection, and found promoting testicular atrophy, inhibition of sperm formation. [Pregnant and lactating women use the drug has not been established perinatal administration of security, so that when judging the treatment of perinatal women or pregnant women who may benefit exceeds the risk of sex, be used. Pediatric Use of the drug has not been established premature or newborn child safety. [Elderly patients] for the elderly, should be aware of the following issues, control the dose and dosing interval, closely observe the patient condition, carefully administered (1) older and more physiological function decline, prone to adverse reactions. (2) the elderly sometimes bleeding tendency caused by lack of vitamin k. [Interaction] (1) the prohibition of alcohol or alcoholic beverages. May occur while taking facial flushing, nausea, tachycardia, sweating, headache and other symptoms. The mechanism is not clear, it may be disulfiram-like symptoms on cephalosporin structure 3 n-methyl mercaptotetrazoles thiomethyl connection caused. (2) the same clothes anticoagulants may produce a synergistic effect, leading to bleeding. (3) When using the same precautions Drug Name: diuretics (furan-phenylalanine, azosemide, piretanide, bumetanide, etc.) Clinical symptoms and measures: According to the report of cephalosporin antibiotics in combination with other applications, increased renal dysfunction. Mechanisms, risk factors mechanisms: not yet clear solution, consider the blood of drug-induced dehydration diuretic concentration increased. Overdosage or frequent medication overdose can cause nausea, vomiting, diarrhea, seizures, require symptomatic treatment. [Specification] 1.0g (in c25h24n8o7s2 dollars) [Storage] sealed and kept cool dark dry place. [Package] control antibiotic bottle, 1 bottle / box [Validity] 24 months
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Drug Encyclopedia
Drug Name (Including trade name, generic name) cefpiramide Dosage intramuscular, intravenous injection or infusion, adult, 1 ~ 2g / d, 2 times a day. Children, the daily per kilogram of body weight 30 ~ 80mg, 2 to 3 times given. Pharmacological effects of a broad spectrum antibiotic, against Gram-positive bacteria, Gram-negative bacteria and anaerobic bacteria are effective within a variety of β-lactamase stability, Acute and chronic bronchitis, the main indications for the treatment of sensitive bacteria caused pneumonia, suppurative lung disease, tonsillitis, urinary tract infections, gynecological infections. If necessary, in combination with aminoglycosides. Adverse reactions This product has methylthiotetrazole side chains (such as chronic liver disease, malnutrition) and other patients for the synthesis of vitamin K deficiency disorders and vitamin reserves, subject to monitoring prothrombin time, and adequate vitamin K. The same as the rest of adverse reactions with other third-generation cephalosporins. Precautions preparations