Nacef

Nacef is an antiparasitic, antimicrobial drug.

Indications Natsefa

It is used in the treatment of infectious diseases affecting the urogenital system, joints, respiratory tract, epidermis and soft tissues, as well as organs in the pelvic area (these diseases are caused by the activity of sensitive microorganisms).

The drug also demonstrates its effectiveness in endocarditis with sepsis, cholecystitis with mastitis and osteomyelitis, as well as in peritonitis, otitis media and venereal diseases, as well as in infections that appear as a result of wounds, surgical procedures or burns.

For prevention purposes, it is prescribed before performing surgical operations.

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Release form

The drug is released as a lyophilisate for injections, in vials of 0.5 or 1 g. The solvent for the lyophilisate is the injection liquid contained in 5 ml ampoules. Inside the box there are 1 or 5 vials with the lyophilisate, as well as 1 ampoule with the solvent for each vial.

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Pharmacodynamics

The first generation cephalosporin antibiotic, the substance cefazolin, destroys the binding processes and cell membranes of pathogenic microbes, due to which its antibacterial effect develops.

The drug demonstrates effectiveness in bacterial pathologies caused by the activity of diphtheria corynebacteria, streptococci, neisseria, shigella, golden staphylococci and klebsiella. In addition, it affects intestinal coli, leptospira, enterobacter, hemophilic rods, spirochetes, enterococci and salmonella.

Serratia, tuberculosis mycobacteria, indole-positive strains of Proteus, Pseudomonas aeruginosa with anaerobes, and also methicillin-resistant staphylococci are resistant to drug action.

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Pharmacokinetics

The drug is destroyed in the gastrointestinal tract. When the drug was administered intramuscularly to a healthy volunteer (in a 0.5 or 1 g dose), peak values were noted after 60 minutes and were equal to 37 and 64 mcg/ml, respectively. After 8 hours, the serum values were 3 and 7 mcg/ml, respectively.

Following intravenous injection of a 1000 mg dose, peak plasma concentrations are 185 μg/mL, with serum levels of 4 μg/mL after 8 hours. Half-life in blood is approximately 1.8 hours (intravenous injection) and 2 hours (intramuscular injection). Tests in hospitalized patients with infections have shown Cmax levels to be approximately equivalent to those seen in volunteers.

The substance penetrates into the tissues of the cardiovascular system, joints, kidneys, peritoneum, and also the urinary tract, middle ear, placenta, soft tissues, respiratory tract and epidermis. The drug indicators in bile and gallbladder tissues are much higher than its indicators in blood serum. In synovium, cefazolin values become similar to the serum indicator approximately 4 hours after injection.

The drug does not penetrate the BBB well, but can penetrate the placenta and is found in the amniotic fluid. A small amount of the drug is excreted in breast milk. The distribution volume is 0.12 l/kg. Synthesis with plasma protein is 85%. The drug is not subject to biotransformation.

Excretion of the unchanged component occurs mainly through the kidneys: during the first 6 hours - about 60% of the drug, and after 24 hours - approximately 70-80%. With intramuscular administration in portions of 0.5 and 1 g, the peak values of the drug in the urine are equal to 2400 and 4000 mcg/ml, respectively.

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Dosing and administration

The drug is administered by intravenous jet injections (or intravenous infusions), as well as intramuscular injections.

The average daily dosage for an adult is 1000 mg, administered twice a day (500 mg each). The maximum permissible daily dose is 6 g (rarely 12 g). If larger doses of the drug are used, the number of injections per day can be increased to 3-4 times.

The average daily dose for children is 20-50 mg/kg (or occasionally 100 mg/kg). This dosage should be administered over 3-4 injections.

This course lasts for 7-10 days.

If a person has kidney disease, the daily dose is calculated taking into account the CC values. If they are more than 55 ml/minute, a standard dosage scheme can be prescribed for adults. If the CC indicator is within 35-54 ml/minute, the portion size remains standard, but the number of administrations should be changed. If the CC level is below 34 ml/minute, the dosage of the drug is reduced by 50%, with procedures carried out at intervals of 18-24 hours.

Dosages for children with renal pathologies are also selected based on CC indicators:

• if the CC level is below 70 ml/minute, 60% of the average portion is prescribed;
• at values below 40 ml/minute – 25% of the average dose;
• if the readings are less than 20 ml/minute – 10% of the standard dosage.

For intramuscular injections, the lyophilisate Nacef is diluted in a novocaine solution, a 0.9% sodium chloride solution, or the solvent supplied with the medication (4-5 ml of the substance is used).

For intravenous infusions, the drug should be dissolved using a 5% glucose solution or saline (0.1-0.25 l). The duration of the infusion is 20-30 minutes.

For jet intravenous injections, the drug is diluted in saline (10 ml). The duration of such injections is 3-5 minutes.

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Use Natsefa during pregnancy

Nacef should not be used during lactation or pregnancy.

Contraindications

It is contraindicated to prescribe the drug to people with hypersensitivity to cefazolin, as well as other cephalosporins and β-lactam antibiotics.

Caution is required when used in individuals with renal or hepatic insufficiency, as well as pseudomembranous enterocolitis.

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Side effects Natsefa

Sometimes, when administering the drug, nausea, prolongation of PT values, stool disorders, thrombocyto- or neutropenia, as well as a positive Coombs test result, thrombocytosis, abdominal pain and leukopenia are observed.

Rarely, treatment causes kidney dysfunction, seizures, hepatitis, hemolytic anemia, phlebitis, pseudomembranous colitis, intrahepatic cholestasis, and pain at the injection site.

Injections of drugs may cause allergy symptoms – bronchial spasms, itching, anaphylaxis, hyperthermia and angioedema.

A long course of treatment can lead to the development of candidiasis, dysbacteriosis, and superinfection.

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Overdose

In case of intoxication with Nacef, thrombocytosis, dizziness, hyperbilirubinemia, and also convulsions and paresthesia are observed.

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Interactions with other drugs

The drug cannot be combined with diuretics or anticoagulants.

The combination of the drug with aminoglycosides contributes to the increased incidence of renal dysfunction. It is prohibited to use 2 drugs simultaneously, as this inactivates their medicinal effect.

Medicines that block tubular secretion inhibit the excretion of Nacef.

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Storage conditions

Nacef must be kept in a dark place at temperatures no higher than +25°C.

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Shelf life

Nacef can be used for 3 years from the date of manufacture of the drug. The ready solution has a shelf life of 24 hours (at a temperature of 5-25 ° C) or 5 days (at a temperature of 2-5 ° C).

Application for children

It is prohibited to prescribe the medication to newborns.

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Analogues

Analogues of the drug are Dexamethasone, Ampicillin trihydrate (and also sodium salt) and Ampicillin, as well as Cloxacillin, Ampiox, Meronem with Levomycetin, and also sodium salt of benzylpenicillin, Vancomycin, gentamicin sulfate, Sulfazin with oleandomycin phosphate, Oflobac and Sulfapyridazine, as well as Cefotaxime, Ciprolet and Ceftriaxone with Tsifran and Cefazolin.

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