Doriprex

Doriprex (also known as doripenem) is an antibiotic from the carbapenem class. It is used to treat serious infections caused by various types of bacteria. Doriprex is commonly used in hospitals to treat infections of the gastrointestinal tract, urinary tract, skin, lungs and other organs. This drug is often used in cases where other antibiotics do not work due to bacterial resistance to them. Like other antibiotics, the use of Doriprex should be prescribed and supervised by a physician.

Indications Doriprexa

1. Complicated gastrointestinal infections such as peritonitis (inflammation of the abdominal cavity).
2. Urinary tract infections, including pyelonephritis (inflammation of the kidneys), acute cystitis (inflammation of the bladder) and others.
3. Infections of the skin and soft tissues, such as cellulitis (inflammation of the subcutaneous tissue) and infected wounds.
4. Severe lung infections such as pneumonia.
5. Other serious infections caused by microorganisms sensitive to Doriprex.

Release form

Doripenem, whose commercial name is Doriprex, is usually available in powder form for the preparation of a solution for injection. This powder is usually dissolved in a special solvent provided in the kit to create a solution, which is then injected into the patient's body intravenously.

Pharmacodynamics

1. Mechanism of action: Doripenem is a beta-lactam antibiotic, like penicillins and cephalosporins. It acts by inhibiting bacterial cell wall synthesis, leading to their death. It has a broad spectrum of action against gram-positive, gram-negative and anaerobic bacteria.
2. Interaction with bacterial enzymes: Doripenem is resistant to beta-lactamases, which makes it more effective against many bacteria that exhibit resistance to other antibiotics due to the production of this enzyme.
3. Pharmacokinetics: After intravenous administration, doripenem is rapidly and completely absorbed. Its maximum concentration in the blood is reached 0.5-1 hour after administration. It has good distribution in tissues and body fluids.
4. Mechanisms of resistance: Although doripenem has a broad spectrum of action, some bacteria can develop resistance to it. This may be due to the production of beta-lactamases, changes in the structure of penicillin-binding proteins, etc.
5. Effect on microorganisms: Doripenem effectively destroys many bacteria, helping to eliminate infections caused by strains sensitive to it.

Doripenem has activity against a wide range of bacteria, including many gram-positive, gram-negative and anaerobic organisms. Some of them include:

Gram-positive bacteria:

1. Streptococcus pneumoniae
2. Streptococcus pyogenes
3. Streptococcus agalactiae
4. Enterococcus faecalis (including penicillinase-producing strains)
5. Staphylococcus aureus (including methicillin-sensitive strains)

Gram-negative bacteria:

1. Escherichia coli
2. Klebsiella pneumoniae
3. Enterobacter species
4. Proteus mirabilis
5. Serratia marcescens
6. Haemophilus influenzae
7. Neisseria meningitidis
8. Pseudomonas aeruginosa

Anaerobic bacteria:

1. Bacteroides fragilis
2. Clostridium perfringens
3. Peptostreptococcus species

Pharmacokinetics

1. Absorption: Doripenem is usually administered intravenously because it is poorly absorbed from the gastrointestinal tract after oral administration.
2. Distribution: After intravenous administration, doripenem is rapidly and evenly distributed throughout the tissues and body fluids. It has a high penetration rate into many organs and tissues, including the lungs, skin, soft tissue, bile, bone, and synovial fluid.
3. Metabolism: Doripenem is metabolized in the body primarily by dehydrogenases, forming inactive metabolites. The metabolism of doripenem does not play a significant role in its clinical activity.
4. Elimination: Doripenem is primarily eliminated from the body via the kidneys, both unchanged and as inactive metabolites. Its half-life in the body is approximately 1 hour.
5. Half-life: The half-life of doripenem in the body is usually about 1 hour.
6. Dialysis: Doripenem can be removed from the blood by hemodialysis. Therefore, dosage adjustment may be necessary in case of long-term treatment of patients on hemodialysis.

Dosing and administration

Doriprex (Doripenem) is usually given as an intravenous injection. Dosage may depend on the patient's specific medical condition, the severity of the infection, as well as individual factors. Typically the recommended dose is 500 mg to 1 g per day, divided into two or three injections.

However, the exact dosage and regimen of Doriprex should always be determined by a doctor, who takes into account all the features of a particular case and protocols for the treatment of infections.

Use Doriprexa during pregnancy

The use of doripenem (Doriprex) during pregnancy is not recommended, as there is limited information on its safety during this period. Here are some data from studies:

1. Study of the safety and efficacy of doripenem in gynecological infections: The study included women with gynecological infections, including pregnant women. Doripenem was used as intravenous drops of 0.25 g twice a day for 3-8 days. The observed clinical efficacy was 91.7% and the drug was well tolerated. However, the study was limited by the small number of pregnant patients, and therefore the data on the safety of its use during pregnancy are insufficient to draw definitive conclusions (Chimura et al., 2008).

Due to the limited data on the safety of doripenem during pregnancy, it is important to use this drug only under strict indications and under the supervision of a physician. Always consult a physician before using any medication during pregnancy.

Contraindications

1. Allergy to carbapenem antibiotics: People with a known allergy to carbapenem antibiotics such as imipenem, meropenem or others should avoid using Doriprex due to the risk of allergic reactions.
2. Allergy to components of the drug: Patients with a known allergy to any component of Doriprex, including Doripenem itself or any additives, should also avoid its use.
3. Kidney problems: Patients with severe renal impairment, especially those undergoing hemodialysis, may require doriprex dosage adjustments or additional medical monitoring.
4. Pregnancy and breastfeeding: The safety of Doriprex during pregnancy or breastfeeding has not been established, and its use in these cases should only be done when clearly necessary and under the supervision of a physician.
5. Gastrointestinal problems: Some patients may have gastrointestinal problems, such as colitis or diarrhea, which may contraindicate the use of Doriprex.
6. Epilepsy: Doripenem may cause seizures in some patients, so its use may require caution in people with a history of seizures.

Side effects Doriprexa

1. Elevated Liver Enzymes: Transient increases in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase may occur. This may indicate liver toxicity.
2. Diarrhea: One of the most common side effects of antibiotics. Diarrhea can be mild or severe.
3. Candidiasis (fissure dermatitis): The growth of Candida fungi, especially in the mouth, skin or vagina.
4. Stomach and intestinal disorders: Including nausea, vomiting, abdominal pain.
5. Allergic reactions: Shortness of breath, skin rash, itching, angioedema (swelling of the skin and mucous membranes).
6. Systemic reactions: Angioedema reactions, anaplaxia (severe allergic reaction), as well as anemia and other hematopoietic disorders are possible.
7. Possible kidney damage: Including worsening kidney function or crystalluria (formation of crystals in the urine).
8. Neurological side effects: Including headache, dizziness, insomnia and others.

Overdose

Information about overdose with doripenem (trade name Doriprex) is usually limited, as cases of overdose are rare due to the fact that the drug is usually administered under medical supervision. However, in case of overdose, unwanted side effects may occur.

If you suspect an overdose of doripenem, you should immediately seek medical help. Treatment of overdose usually consists of supportive care, including monitoring of the functions of organs and body systems, as well as symptomatic treatment.

Interactions with other drugs

1. Probenecid and other drugs that increase blood levels: Probenecid and other drugs that increase blood levels of antibiotics by decreasing their elimination through the kidneys may increase the concentration of doripenem in the body, which may increase its toxicity.
2. Antiepileptic drugs: Some antiepileptic drugs, such as carbamazepine and phenytoin, may accelerate the metabolism of doripenem and decrease its blood levels, which may reduce its effectiveness.
3. Drugs that cause neutropenia: Drugs that can cause neutropenia (decreased levels of neutrophils in the blood), such as cytotoxic drugs and some antibiotics, may increase the risk of neutropenia when co-administered with doripenem.
4. Drugs that adversely affect the kidney: Drugs that may adversely affect kidney function may increase the risk of doripenem toxicity, since doripenem is eliminated from the body primarily through the kidneys.
5. Drugs that decrease intestinal absorption: Drugs that may decrease the intestinal absorption of other drugs may decrease the effectiveness of doripenem when taken orally.
6. Drugs that adversely affect the central nervous system: Some drugs that adversely affect the central nervous system may increase some of the side effects of doripenem, such as dizziness or drowsiness.