ERITROMISIN tabletkalari 250mg N20
ERITROMISIN tabletkalari 250mg N20 qo'llanmasi
Farmakokinetikasi
Biokiraolishligi 30-65% ni tashkil qiladi. Organizmning ko'pchilik to'qimalari va suyuqliklarida taqsimlanadi. Plazma oqsillari bilan bog'lanishi 70-90% ni tashkil qiladi. Jigarda, qisman faol bo'lmagan metabolitlar hosil qilib metabolizmga uchraydi. T - 1,4-2 soat. Safro va siydik bilan chiqariladi.
Farmakologik ta'siri
Makrolidlar guruhiga mansub antibiotik. Bakteriostatik ta'sir ko'rsatadi. Biroq, yuqori dozalarda sezgir mikroorganizmlarga nisbatan bakteritsid ta'sir ko'rsatadi. Eritromitsin bakteriyalar ribosomalari bilan qaytar tarzda bog'lanadi, shu bilan oqsil sintezini bostiradi.
Grammusbat bakteriyalar: Staphylococcus spp. (penitsillinaza ishlab chiqaradigan va ishlab chiqarmaydigan shtammlar), Streptococcus spp. (shu jumladan Streptococcus pneumoniae); grammanfiy bakteriyalar: Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Brucella spp., Legionella spp., Bacillus anthracis, Corynebacterium diphtheriae; anaerob bakteriyalar: Clostridium spp. ga nisbatan faol.
Eritromitsin shuningdek Mycoplasma spp., Chlamydia spp., Spirochaetaceae, Rickettsia spp. ga nisbatan faol.
Eritromitsinga grammanfiy tayoqchalar, shu jumladan Escherichia coli, Pseudomonas aeruginosa, Shigella spp., Salmonella spp. chidamli.
Nojo'ya samaralari
Ovqat hazm qilish tizimi tomonidan: ko'ngil aynishi, qusish, epigastriyda og'riq, xolestatik sariqlik, tenezmlar, diareya, disbakterioz; kamdan-kam hollarda - soxtamembranoz enterokolit, jigar faoliyatining buzilishi, jigar transaminazalari faolligining oshishi, pankreatit.
Allergik reaksiyalar: teri toshmasi, eshakemi, eozinofiliya; kamdan-kam hollarda - anafilaktik shok.
Kimyoterapevtik ta'sir bilan bog'liq effektlar: og'iz bo'shlig'i kandidozi, qin kandidozi.
Sezgi organlari tomonidan: qaytuvchan ototoksiklik - eshitishning pasayishi va/yoki quloqlarda shovqin (yuqori dozalarda qo'llanilganda - 4 g/sut dan ortiq).
Yurak-qon tomir tizimi tomonidan: kamdan-kam hollarda - taxikardiya, EKG da QT intervalining uzayishi, bo'lmachalar hilpillashi va/yoki titrashi (EKG da QT intervali uzaygan bemorlarda).
Mahalliy reaksiyalar: v/i yuborish joyida flebit.
Maxsus saqlash sharoitlari
Jigar va/yoki buyrak funksiyasi buzilishlarida ehtiyotkorlik bilan qo'llaniladi.
Oshqozon shirasi kislotaliligini oshiruvchi preparatlar va kislotali ichimliklar eritromitsinni faolsizlantiradi. Eritromitsinni sut va sut mahsulotlari bilan ichish mumkin emas.
Qo'llanilishi mumkin bo'lmagan holatlar
Anamnezda sariqlik, jigar funksiyasining yaqqol buzilishlari, makrolidlarga yuqori sezuvchanlik.
Dori vositalarining o'zaro ta'siri
Eritromitsin teofillin, aminofillin, kofein bilan bir vaqtda qo'llanilganda ularning qon plazmasidagi kontsentratsiyasining oshishi qayd etiladi va shu bilan toksik ta'sir rivojlanish xavfi ortadi.
Eritromitsin qon plazmasida siklosporin kontsentratsiyasini oshiradi va nefrotoksik ta'sir rivojlanish xavfini oshirishi mumkin.
Kanalchalar sekretsiyasini bloklovchi preparatlar eritromitsin T davrini uzaytiradi.
Linkomitsin, klindamitsin va xloramfenikol bilan nomutanosib (antagonizm).
Eritromitsin beta-laktam antibiotiklar (penitsillinlar, sefalosporinlar, karbapenemlar) ning bakteritsid ta'sirini pasaytiradi.
Bir vaqtda qo'llanilganda eritromitsin teofillin miqdorini oshiradi.
Metabolizmi jigarda amalga oshiriladigan preparatlar (karbamazepin, valproat kislotasi, geksobarbital, fenitoin, alfentanil, dizopiramid, lovastatin, bromokriptin) bilan bir vaqtda qabul qilinganda ushbu preparatlarning plazmadagi kontsentratsiyasi oshishi mumkin (jigar mikrosomal fermentlari ingibitori hisoblanadi).
Eritromitsin v/i yuborilganda etanol ta'sirini kuchaytiradi (oshqozon bo'shashining tezlashishi va oshqozon shilliq qavatida alkogoldegidrogenaza ta'sir davomiyligining pasayishi).
Eritromitsin triazolam va midazolam klirensini pasaytiradi va shuning uchun benzodiazepinlarning farmakologik samaralarini kuchaytirishi mumkin.
Terfenadin yoki astemizol bilan bir vaqtda qabul qilinganda aritmiya (qorinchalar hilpillashi va titrashi, qorinchalar taxikardiyasi, o'limga olib kelguncha) rivojlanishi mumkin; digidroergotamin yoki gidrirlanmagan shoxkuya alkaloidlari bilan - tomirlarning spazmgacha torayishi, dizesteziya bo'lishi mumkin.
Bir vaqtda qo'llanilganda metilprednizolon, felodipin va kumarin qatori antikoagulyantlarining eliminatsiyasini sekinlashtiradi (samarasini kuchaytiradi).
Lovastatin bilan birga tayinlanganda rabdomioliz kuchayadi.
Eritromitsin digoksinning biologik kira olishini oshiradi.
Eritromitsin gormonal kontratseptsiya samaradorligini pasaytiradi.
Dozirovkasi
Aniq preparatni qo‘llash usuli va dozalash tartibi uning chiqarilish shakli va boshqa omillarga bog‘liq. Optimal dozalash tartibini shifokor belgilaydi. Aniq preparatning qo‘llaniladigan dori shaklining qo‘llash ko‘rsatmalari va dozalash tartibiga qat’iy rioya qilish kerak.
Hajm/og'irlik
ERITROMISIN tabletkalari 250mg N20 o'xshash dorilari
Eritromitsin boshqa chiqarish shakllari
ERITROMISIN tabletkalari 250mg N20 analoglari
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