Nacef

Nacef is an antiparasitic, antimicrobial drug.

Indications of the nacef

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

Efficacy of the drug also demonstrates with endocarditis with sepsis, cholecystitis with mastitis and osteomyelitis, and in addition with peritonitis, otitis media and venereal diseases, as well as infections resulting from wounds, surgical procedures or burns.

For prevention, he is appointed before performing surgical operations.

[1], [2], [3]

Release form

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

[4], [5]

Pharmacodynamics

Cephalosporin antibiotic of the 1st generation, the substance cefazolin, destroys the binding processes, as well as the cell membranes of pathogenic microbes, due to which its antibacterial effect develops.

The drug demonstrates effectiveness in bacterial pathologies, which are provoked by the activity of diphtheria corynebacteria, streptococci, Neisseria, Shigella, Staphylococcus aureus and Klebsiella. In addition, it affects the intestinal rods, leptospira, enterobacter, hemophilic rods, spirochetes, enterococci and salmonella.

Resistance to medicinal action is possessed by serrations, tubercular mycobacteria, indole-positive strains of the protein, Pseudomonas aerobes with anaerobes, and also staphylococci resistant to methicillin.

[6]

Pharmacokinetics

The medication is destroyed inside the digestive tract. When intramuscular injection of drugs to a healthy volunteer (in a dose of 0.5 or 1 g), peak values were observed after 60 minutes and were equal to 37, respectively, and 64 μg / ml, respectively. After 8 hours, the serum indices inside the serum were 3, as well as 7 μg / ml, respectively.

After an intravenous injection of 1000 mg, the peak LS is 185 μg / ml, and the serum values after 8 hours are 4 μg / ml. The half-life from the blood is about 1.8 hours (intravenous injection), and also 2 hours (intramuscular injection). Tests performed in hospitalized patients with infections demonstrated that the Cmax level in them is approximately equivalent to the values noted in volunteers.

The substance penetrates the tissues of the CCC, joints, kidneys, peritoneum, and in addition urinary ducts, middle ear, placenta, soft tissues, respiratory tracts and epidermis. Indicators of drugs inside the bile and gall bladder tissues are much higher than its values inside the blood serum. In synovia, cefazolin values become similar to serum levels approximately 4 hours after injection.

The medication passes badly through the BBB, but is able to penetrate the placenta and is noted inside the amniotic fluid. A small amount of the drug is excreted with human milk. The indicator of the distribution volume is 0.12 l / kg. The synthesis with plasma protein is 85%. The drug is not biotransformation.

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

[7], [8],

Dosing and administration

The drug is injected with jet intravenous injection (or IV infusion), as well as intramuscular injections.

The average daily dosage for an adult is 1000 mg, which is administered twice a day (500 mg each). The maximum allowable size of a daily dose is 6 g (occasionally it can be 12 g). If you use increased portions of drugs, the number of injections per day can be increased to 3-4 times.

The size of the average child's dose per day is 20-50 mg / kg (or, occasionally, 100 mg / kg). This dosage should be administered for 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 QC values. If they are more than 55 ml / minute, a standard dosage regimen can be prescribed for adults. If the QC value is between 35-54 ml / minute, the serving size remains standard, but the number of administrations needs to be changed. At a QC level below 34 ml / minute, the dosage of drugs is reduced by 50%, with procedures at intervals of 18-24 hours.

Also on the parameters of QA, doses are selected for children with kidney pathologies:

• at a QC level below 70 ml / minute, 60% of the median portion is prescribed;
• at values below 40-ml / minute - 25% of the average dose;
• at rates less than 20 ml / minute - 10% of the standard dosage.

For intramuscular injections lyophilizate Nacef diluted in novocaine solution, 0.9% solution of sodium chloride or the drug applied to the drug (using 4-5 ml of the substance).

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

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

[15], [16], [17], [18]

Use of the nacef during pregnancy

The nacef can not be used for lactation or pregnancy.

Contraindications

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

Caution is required when used in individuals with kidney failure or liver, as well as pseudomembranous form of enterocolitis.

[9], [10], [11]

Side effects of the nacef

Sometimes with the introduction of the drug, nausea, prolongation of PTV, stool, thrombocytopenia or neutropenia, as well as a positive response from Coombs test, thrombocytosis, abdominal pain and leukopenia are noted.

Occasionally, treatment causes the appearance of disorders in the work of the kidneys, seizures, hepatitis, hemolytic form of anemia, phlebitis, pseudomembranous form of colitis, intrahepatic cholestasis and pain at the site of the injection.

Because of drug injections, allergy symptoms may appear - bronchial spasms, itching, anaphylaxis, hyperthermia and angioedema.

A prolonged course of treatment can lead to the development of candidamycosis, dysbiosis, as well as superinfection.

[12], [13], [14]

Overdose

In intoxication, Natsef noted thrombocytosis, dizziness, hyperbilirubinemia, and in addition cramps and paresthesia.

[19]

Interactions with other drugs

You can not combine the drug with diuretics, as well as anticoagulants.

Combination of the drug with aminoglycosides contributes to the increase in the development of disorders of renal function. Do not use 2 drugs at the same time, as this inactivates their medicinal effect.

Medications that block the secretion of the tubules inhibit the excretion of the natsef.

[20], [21], [22], [23]

Storage conditions

The nacef should be kept in a dark place, with temperature values not exceeding + 25 ° C.

[24], [25]

Shelf life

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

Application for children

It is forbidden to prescribe medication to newborns.

[26], [27], [28], [29]

Analogues

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

[30], [31], [32], [33]