Medomycin

Medomycin is a tetracycline of a semi-synthetic type; is a bacteriostatic antibiotic and has a large range of therapeutic activity.

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Indications Medomicina

It is used for the therapy of certain infectious-inflammatory diseases that occur under the action of sensitive bacteria:

• respiratory system (tracheitis with pharyngitis, pulmonary abscess, bronchitis, having acute or chronic degree, joint pneumonia, bronchopneumonia and pyotorax);
• ENT organs (for example, sinusitis with otitis media, and in addition tonsillitis and so on);
• urogenital system (pyelonephritis or urethritis, endometritis with cystitis, gonorrhea, prostatitis, endocervicitis and urethrocystitis, and in addition the urogenital form of mycoplasmosis and orcoepididimitis in the acute stage);
• GIT and ZHVP (cholangitis with cholecystitis, as well as gastroenterocolitis, shigellosis and diarrhea of "travelers");
• soft tissues and epidermis (abscesses and panaritsia with phlegmon and furunculosis, and in addition, wounds and burns that are of an infected nature, etc.);
• eye infections;
• pian, syphilis, rickettsiosis with iersiniosis, as well as legionellosis and chlamydia, with different localization (proctitis with prostatitis included here);
• koksiellosis, Bull fever and typhus (this includes its tick, rash and recurrent forms), Lyme borreliosis of the 1st stage, as well as malaria, shigellosis, amoebiasis, tularemia, radicular fungal disease and cholera;
• for complex treatment is used for water fever, trachoma, ornithosis and granulocyte form of erlichiosis;
• osteomyelitis and brucellosis with whooping cough;
• peritonitis, sepsis, as well as septic form of endocarditis in subacute stage.

It is also used to prevent the appearance of:

• suppurative complications after surgical procedures;
• malaria, induced by plasmodium activity falciparum;
• diseases during short travels (less than 4 months) in areas where strains resistant to pyrimethamine sulfadoxine or chloroquine are prevalent.

Release form

The preparation is sold in capsules with a volume of 0.1 g, in the amount of 10 pieces packed in a blister plate. Inside the box there is one such plate.

Pharmacodynamics

After passing the drug into the cell, it affects the activity of the pathogens located there. Inhibits the binding of proteins within bacterial cells and destroys the chains of transport RNA-aminoacyl to the membrane of the 30S subunit of the ribosome.

High sensitivity with respect to medicament is possessed by:

• Gram-positive bacteria: staphylococcus (here epidermal and golden are included), streptococci (pneumococcus enter here), as well as listeria and clostridia;
• Gram-negative bacteria: hemophilic rod, meningococcus, gonococcus, E. Coli, Klebsiella, Shigella, salmonella with enterobacter, yersinia, dysenteric amoeba, bacteroides and treponema (among them strains with resistance to other antibiotics (such as modern cephalosporins with penicillins)) . The most sensitive are haemophilic rods (91-96%), as well as intracellular pathogens.

Doxycycline demonstrates the therapeutic activity of a relatively large proportion of bacteria that cause the development of dangerous diseases of infectious origin: legionella with rickettsia, anthrax, plague and tularemia, a cholera vibrio with brucella, and in addition bacteria causing sapa and chlamydia (microbes that cause trachoma, ornithosis or granuloma venereal nature). At the same time, it does not affect most of the proteic strains, fungi and Pseudomonas aeruginosa.

The drug suppresses the flora of the intestines more weakly than other tetracycline antibiotics, and also has a more complete absorption and a longer duration of exposure. The expression of antibacterial activity of doxycycline is higher than that of natural tetracyclines. Compared with oxytetracycline and tetracycline, the drug has a more pronounced drug effect and a prolonged effect, which develops even with therapy with dosages ten times lower in size. The drug has cross-resistance to penicillins and other tetracyclines.

Pharmacokinetics

When administered orally, the drug is almost completely absorbed inside the digestive tract. The consumption of food does not significantly affect the absorption of doxycycline.

It is widely distributed within liquids with tissues. Protein synthesis inside the plasma is 80-95%. The half-life is approximately 12-22 hours.

Excretion of the substance in the unmodified state is 40% performed with urine; but most of the portion through excretion of bile is excreted with feces.

Dosing and administration

Intravenously, the drug is administered in severe stages of diseases that are purulent-septic in nature, when it is required to quickly achieve high values of drugs inside the blood, as well as in situations where it is difficult to administer the drug orally. Transfer the patient to the use of drugs inside should be immediately, as it becomes possible.

Intravenously, the drug is administered through a dropper - an ex tempore solution is used. In such a case, 0.1 or 0.2 g of the substance is diluted in injectable water (5-10 ml), and then this liquid is added to a 0.9% NaCl solution or a 5% dextrose solution (0.25 or 0 , 5 L). The indices of the substance inside the infusion fluid should not be more than 1 mg / ml or less than 0.1 mg / ml. The duration of the infusion depends on the size of the portion (0.1 or 0.2 g) and is within 1-2 hours (speed - 60-80 drops / minute). During the infusion, the solution must be protected from any light (both electric and solar). Last such therapy with intravenous administration should be 3-5 days, and in case of good tolerability it lasts up to 7 days, after which the patient is transferred (if necessary) to oral use.

To treat inflammations developing in women in the pelvic region (acute form), 0.1 g of drugs are administered at intervals of 12 hours (often with medomycin combined with third generation cephalosporins). Further treatment continues with oral use of doxycycline - in a dose of 0.1 g 2 times a day, for 14 days.

Orally, children weighing more than 45 kg and adults need on average to take 0.2 g for the first day (with a division into 2 uses - 0.1 g 2 times a day), then go on to receive 0, 1 g per day (in 1-2 consumption). In the case of infections affecting the urethra, and having a chronic form, during the entire course of the course, use 0.2 g of drugs per day.

During the treatment of gonorrhea, one of the following methods is used:

• with urethritis in an acute form, without complications, 500 mg of substance are consumed per course (300 mg for the first dose, and 100 mg for the first and third and 6 hours for the 2 nd and 3 rd ones). A method can be used with the use of a medicine for 0.1 g per day until a complete cure (for women), or 0.1 g 2 times a day for 7 days (for men);
• In case of gonorrhea occurring with complications, 800-900 mg are taken for the whole cycle, divided into 6-7 uses (300 mg for the first dose, and then 6 others, with intervals equal to 6 hours).

During therapy with syphilis, 300 mg of the drug are used per day for a period of at least 10 days (either orally or intravenously).

In case of infections (provoked by Chlamydia trachomatis activity), affecting the rectum, urethra and uterine neck, and proceeding without complications, it is necessary to apply 0.1 g of LS 2 times per day for a minimum of 1 week.

In infections affecting the male genitalia, you need to use 100 mg of medication (2 times a day) for 4 weeks.

In the treatment of chloroquine-resistant malaria, 200 mg of medication per day (in combination with shizontocidal drugs (quinine)) are consumed for 7 days. To prevent the development of malaria, take 1-fold a day to take 100 mg of the drug for 1-2 days before the trip, and then every day during it and for 4 weeks after its end. For a child of 8 years, the daily dose is 2 mg / kg.

To prevent the diarrhea of "travelers" on the first day of the trip, 200 mg of Medomycin (1x or 2-fold (in a dose of 100 mg) per day), and later 100 mg 1-fold per day during the entire stay in the a dangerous region (maximum 21 days).

When treating water fever, the drug is used orally in a dose of 100 mg, 2 times a day for the first week. To prevent the development of this pathology, 200 mg of medicament is applied 1-fold for a week during the entire time of being present in a hazardous area, and then 200 mg at the end of the journey.

To prevent the emergence of infections after medical abortion, you need to take 100 mg of substance 60 minutes before the abortion, and then another 200 mg after half an hour after the end of the procedure.

To treat acne throughout the cycle lasting 6-12 weeks, take 100 mg of medication per day.

During the day, adults are allowed to take no more than 300 mg of the substance. For severe infections caused by gonococci, you can consume up to 600 mg of LS per day.

Children weighing less than 45 kg (9-12 years of age) can take an average of 4 mg / kg for the first day, and 2 mg / kg per day for 1-2 days (1-2 tablets). If the infections are severe, you should prescribe the drug in a dose of 4 mg / kg at intervals of 12 hours.

If the patient has a failure of liver function in the severe stage, it is necessary to reduce the daily dosage of the medication, because with such violations doxycycline gradually cumulates inside the body, which causes the risk of hepatotoxicity.

Use Medomicina during pregnancy

You can not use Medomycin for lactation, and pregnancy, because doxycycline inhibits the process of osteogenesis, weakens the strength of the bones in the fetus and destroys the processes of healthy development of the teeth (hypoplasia affecting the enamel, and an incurable change in the shade of the teeth).

If the need for therapy with lactation should be abandoned breastfeeding for a period of treatment.

Contraindications

The main contraindications:

• the presence of intolerance against tetracyclines;
• disorders of renal or hepatic activity in severe degree;
• leukopenia or porphyria;
• myasthenia gravis (with intravenous injection).

Side effects Medomicina

The use of medication can trigger the development of side effects:

• signs of the digestive function: nausea, glossitis, anorexia, diarrhea, enterocolitis, vomiting, and in addition dysphagia or pseudomembranous form of colitis;
• Symptoms of an allergic or dermatological nature: Quincke edema, SLE exacerbation, urticaria, anaphylactic manifestations, photosensitivity, exfoliative form of dermatitis, rashes of maculopapular or erythematous type and pericarditis;
• violations of hepatic activity: disorders in the work of the liver (after prolonged use of drugs or in people with deficiency of liver or kidney function);
• disorders affecting the functioning of the kidney: an increase in the level of residual urea nitrogen, caused by the anti-anabolic effect of drugs;
• lesions affecting the hematopoietic system: neutro- or thrombocytopenia, eosinophilia and hemolytic form of anemia, and a decrease in prothrombin;
• dysfunction of the NS: benign increase in ICP (vomiting, anorexia, swelling in the optic nerve and headaches) and vestibular disorders (feeling unstable or dizzy);
• problems associated with the work of thyroid: in people who have long used doxycycline, there can be a curable staining of thyroid tissue in a dark brown hue;
• damage to the epidermis and teeth: inhibition of osteogenesis and violation of healthy development of teeth in the child (irreversible change in the shade of the teeth and the appearance of hypoplasia in the enamel area);
• Other: development of candidiasis (glossitis, vaginitis, stomatitis or proctitis) as a sign of superinfection.

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Overdose

Manifestations of intoxication: potentiation of negative symptoms provoked by liver damage - fever, azotemia, vomiting, increased activity of transaminases, jaundice and increased values of PTV.

To eliminate the disorders, gastric lavage is performed; also the patient needs to drink a lot of fluids. If required - cause vomiting, give to take activated charcoal and osmotic laxatives. Symptomatic measures are also taken. The sessions of peritoneal dialysis or hemodialysis will be ineffective.

Interactions with other drugs

Magnesium-, aluminum- and calcium-containing antacids, drinking soda, iron drugs and magnesium-type laxatives weaken the absorption of doxycycline, which is why it is necessary to apply these drugs at an interval equal to 3 hours.

When combined with anticoagulants, their dosage sometimes needs to be lowered, because tetracyclines depress the activity of prothrombin inside the plasma.

Combined use of Medomycin with destructive binding of cell membranes with antibiotics from the group of bactericidal (cephalosporin or penicillin), leads to a weakening of drug efficacy of the latter.

When used together with doxycycline, the reliability of hormonal contraception for oral administration is weakened. In addition, the incidence of acyclical bleeding increases (if OC containing estrogen is used).

When a drug is combined with barbiturates, phenytoin, ethyl alcohol, carbamazepine, rifampicin, primidone and other drugs that stimulate the oxidation of microsomes, its metabolism is accelerated, while the values inside the blood plasma are reduced.

The combination with bismuth drugs can cause a decrease in drug absorption.

The combination of the drug with cyclosporine increases the plasma values of the latter.

Taking methoxyfluorane together with tetracyclines can lead to fatal renal toxicity.

Zinc reduces the absorption of the drug.

Combination with retinol leads to an increase in ICP.

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Storage conditions

Medomycin should be kept in a dark and dry place at temperature values of a maximum of 25 ° C.

Shelf life

Medomycin can be used within 4 years of the release of the medication.

Application for children

It is forbidden to prescribe doxycycline in pediatrics (children under 8 years of age), because tetracyclines (including doxycycline) lead to a prolonged change in the shade of the teeth, inhibition of the longitudinal growth of skeletal bones, and hypoplasia of the enamel in this group of patients.

Analogues

The analogues of the drug are Vibramycin, Oletetrin, Unidox with Doxycycline, Tetracyclin and Doxie, and in addition Doxibene, Tetracycline Hydrochloride, Doxycycline Hydrochloride and Metacycline Hydrochloride.