Zaxter

Antimicrobial agent of a wide range of consumption, manufactured by Alkem Laboratories Ltd (India) - Zaxter (international name and active element of the drug - Meropenem). The accompanying component is anhydrous sodium carbonate.

Indications Zaxter

The drug under consideration, in its focus, can be attributed to antibiotics (beta-lactam group). Indications for use Zackter is the necessity of arresting diseases caused by pathogenic bacteria that react positively to meropenem (a broad-spectrum bactericidal antibiotic).

• Pneumonia.
• Inflammation of the pleura ( pleurisy ).
• Septicemia (blood infection is a form of sepsis).
• Urinary tract infection.
• Endometritis (inflammation of the mucous membrane of the uterus) and other infectious diseases of the gynecological nature.
• An infection that is caused by microorganisms colonizing the gastrointestinal tract and penetrating into other, usually sterile, areas of the abdominal cavity.
• Infection of the skin and muscle tissue.
• Meningitis (inflammation of soft membranes around the brain and spinal cord).
• Febrile neutropenia, if there is a suspicion that the causative agent of the disease in adults is a pathogenic flora. The protocol of therapeutic measures considers the drug Zaxter in two forms: either as a monotherapy or it is taken in conjunction with other medicinal antiviral or antifungal agents.
• Other polymicrobial infections. Drug therapy is prescribed, as in the previous case: either Zakster is the only course drug, or as a component of a whole complex of antimicrobial medicines.

Release form

The powder, which is subsequently diluted and used as a solution for injections (1000 mg in vials) is the only form of release of the drug, Zaxter, which does not distinguish its diversity.

Pharmacodynamics

The proposed by the pharmaceutical company Alkem Laboratories Ltd. Zaxter refers to carbapenem antibiotic. It is used parenterally, that is, bypassing the gastrointestinal tract (injections, inhalations). This drug is sufficiently stable to the influence of human dihydropeptidase, for this reason there is no need for additional administration of drugs that reduce the rate of the patient's reactions in the body. The active substance of the drug Zaxter has an antimicrobial effect on the functional systems of the patient due to the active effect on the educational processes of the pathogenic cell.

Pharmacodynamics Zakster with its high level of bactericidal action, encompassing a large range of anaerobic and aerobic microorganisms, is due to the fact that the active component of the drug is close in parameters to the protein of human blood. Meropenem perfectly binds penicillin (PBP), and also has a stable neutrality to many representatives of serine beta-lactamases.

Meropenem does not reveal any signs of an allergic nature as a result of the sampling. Other observations and studies show that Zaxter acts not as a counterbalance, but in tandem with various antibiotics. The use of meropenem gives a wonderful postantibiotic result. Based on the results of numerous monitoring, pharmacists, together with practicing doctors, established an effective dosage of the drug and offered general recommendations on the necessary sensitivity of the pathogenic flora to meropenem.

The antimicrobial spectrum of the drug Zaxter, with its active substance meropenem, includes most known medicines and clinically frequently activated aerobic and anaerobic, gram-positive and gram-negative strains of bacteria.

Pharmacokinetics

The suction process. Depending on the dosage of the drug and on the rate of intravenous administration, the maximum content of the drug in the blood can vary from 23 μg / ml to 112 μg / ml. The pharmacokinetics of Zaxter is also manifested in the fact that it works as a link with the serum protein of plasma only by 2%. The medication in question has an excellent property of a high level of penetration into the liquid constituents and various tissue layers of the human body. Already within half an hour - one and a half hours (depending on the characteristics of the patient's body) after the administration of the drug, the blood receives a therapeutic dosage. During this time, only a small part of the drug penetrates the patient's liver, degenerating into a certain inactive metabolite.

Metabolism and excretion of Zaxter. The half-life is not long and is only one hour from the moment of its introduction. Approximately 70% of the drug is excreted (excreted) in the urine through the kidneys, moreover, this part of it is excreted by the body, without any changes. If the patient has a history of pathological changes in the kidneys, the process of excretion slows down. The loss of meropenem directly depends on the severity of the disease, the depth of pathological changes, the level of decrease in creatinine.

The pharmacokinetics of Zaxter, when used in the case of children, is similar to that seen in adults, with the only difference being that a different dosage is prescribed and the half-life of the drug in children under the age of two, with a healthy history, is approximately one and a half - three hours. In patients with advanced age, there is a decrease in the level and rate of excretion of this drug.

In connection with the foregoing, it is necessary to understand that any changes with creatinine clearance (increase or decrease in its level) require an immediate change in the dosage of Zaxter. Dynamic changes in patients with liver diseases are not observed.

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Dosing and administration

The use of any medical device is due to the nature of the pathogen and the severity of the manifestation of the disease, as well as the condition of the patient himself. In this regard, the method of administration and dose of Zaxter medicinal products is also prescribed based on the patient's age limit and the diagnosed disease.

For adults, the manufacturer recommends taking:

The daily dosage for most infections is 500 mg. The medication is administered eight hours after the previous entry. In case of medical necessity (severe infectious forms), the dose can be increased to 1000 mg of Zaxter, the reception is carried out at the same interval.

In some cases (for example, meningitis, cystic fibrosis and others), the dosage is significantly increased and goes to the figure of 2 g of the drug, which is taken by the patient every eight hours.

Very accurately, it is necessary to attribute Zaxter (with its active substance meropenem), if according to the protocol of treatment it goes as the only remedy, especially in severe cases of an infectious disease of the lower respiratory tract. In this regard, it is necessary to regularly take samples for individual drug tolerance.

If the use of Zaxter is justified by medical necessity, while the patient suffers from a kidney pathology (creatinine clearance less than 51 ml / min), the dosage of the drug is reduced:

• if the rate of creatinine is 26 - 50 ml / min, then take one dose of the drug (500 mg, 1 g, 2 g - according to the disease and its severity), with an interval of 12 hours;
• at a rate of 10 - 25 ml / min - half the dosage of Zaxter, every 12 hours;
• if the rate is below 10 ml / min, take a half dose of the drug at intervals of 24 hours.

This drug is excreted out of the body with hemodialysis. Therefore, if there was a need to take Zaxter (especially with a long course of treatment), the manufacturer recommends that he be administered to the patient before the end of this procedure (hemodialysis). This will return to normal the composition and concentration ratios in the plasma.

If the patient suffers from diseases that are associated with a malfunction in the liver, then there is no need to adjust the dosage of Zaxter. Older patients who have no problems in kidney function and at a healthy level of creatinine clearance are not required to adjust the amount of the drug.

Dosage and administration of Zaxter for children:

• babies from three months to 12 years, depending on the type and severity of the infection, take the drug every eight hours, and the recommended dosage is 10 to 20 mg per kilogram of the baby's weight.
• If a child weighs more than 50 kg, then he is given a dose as an adult patient.
• in the case of a baby (aged 4 to 18 years) cystic fibrosis, as well as during an exacerbation with chronic diseases of the lower respiratory tract (infectious nature), the dose can be 25-40 mg per kilogram of the child's weight. Enter Zaxter every eight hours.
• in the case of meningitis - every eight hours, 40 mg per kilogram of the baby is administered.

Zakster solution prepared immediately before the drug. Before use, the suspension is shaken well. If the drug is administered intravenously bolus (the whole procedure takes about 5 minutes), meropenem powder (250 mg) is dissolved in special water suitable for injection (5 ml). As a result, the concentration is 50 mg / ml. The suspension is clear, colorless or slightly yellow in color.

If the drug is administered intravenously infusion (the procedure is stretched for 15 - 30 minutes). Instead of water, you can use compatible fluids for infusions (50 - 200 ml).

Use Zaxter during pregnancy

Waiting for the baby is always a joy. But none of the future mothers is immune from the likelihood of illness, including infectious diseases. If the disease does occur, use of Zaxter during pregnancy or lactation is not desirable. It is justified only when the attending physician understands that the positive effect on which it is calculated is much higher for the patient than the negative impact to which the fetus or newborn child is exposed. In any case, Zaxter should be taken only under the prescription of the doctor, and under its constant control, so that at the moment of unforeseen reactions it is possible to cancel the drug completely, or to correct its dosage. In the process of taking this medication, breastfeeding should be discontinued, as it is proved that the drug Zakster easily penetrates into human fluid substances, including breast milk.

Experience in the use of the drug in the treatment of children with the pathology of the functioning of the liver and kidneys is not available. Do not assign it to babies who are not yet three months old.

Contraindications

Due to its excellent pharmacokinetic and pharmacodynamic characteristics, the drug in question is widely used by doctors to stop and completely cure diseases caused by viral and bacterial infections. But, nevertheless, there are also contraindications to the application of Zaxter.

• It is not necessary to ascribe and apply to babies who have not yet reached the age of three months.
• Do not use this drug and when the kid has a history of disorders related to the functioning of the kidney and liver (kidney and liver failure).
• For all categories of patients in case of individual intolerance to one or more components of the drug Zaxter.

Side effects Zaxter

Due to its high efficiency "in struggle" with the pathogenic flora in the face of fungal and viral infections, the drug Zaxter is actively used in treatment protocols. As a rule, this drug is well tolerated by the human body, but there are exceptions. It is rare enough, but there are cases when Zakster's side-effects demand an immediate cessation of his admission. The unpleasant consequences of using the drug include:

• Thrombocytopenia (a decrease in the number of platelets in the peripheral blood (by 1 mm ³ less than 200 thousand enzymes)).
• Increased headache.
• Disturbance in the functioning of the digestive tract:
  • Nausea, in more acute manifestations shifting into vomiting.
  • Diarrhea (frequent loose stools - diarrhea).
  • Pain in the stomach.
  • Increase in the concentration of protein involved in metabolic processes.
  • Rashes and itching.
• Eosinophilia (an increase in the number of eosinophils in the blood plasma, mainly with allergies or after stopping the infectious disease).
• Hepatobiliary pathology (increase in bilirubin concentration).
• Thrombocytopenia (a decrease in the number of platelets in the peripheral blood below 150 · 109 / L, entails extensive bleeding and problems of stopping it).

Less common manifestations when using Zaxter:

• Convulsions.
• Hemolytic anemia is an anemia that occurs due to an increased rate of erythrocyte destruction.
• Thrombophlebitis (inflammation of the venous walls, thrombus formation).
• Leukopenia - a drop in the number of leukocytes per unit volume of blood.
• Paresthesia - a kind of sensitivity disorder, characterized by sensations of tingling, numbness (there is a feeling of crawling crawling).
• Hives.
• Angioedema (or Quincke's edema) is a reaction to stimuli of various kinds (biological or chemical nature).
• Pseudomembranous colitis.
• Oral and vaginal candidiasis.
• And others

Overdose

If you use a more significant amount of the drug, an overdose is unlikely because of the rapid release of meropenem from the patient's body through the kidneys with urine. But if, however, an overdose of Zaxter happened, it manifests itself with the same symptoms that were previously voiced in the section "Side effects of Zakster". Therapeutic therapy is performed as symptomatic, that is, it is aimed at eliminating the symptom.

Interactions with other drugs

With the joint use of any medications, you need to be extra careful, since the interaction of Zaxter with other drugs is not always sufficiently thoroughly studied.

It is not necessary to ascribe a joint intake of such drugs as probenecid and Zaxter, since both of them, when administered, are prone to increased turbulence, which negatively affects renal secretion, leading to renal renal insufficiency. This leads to an increase in the level of meropenem in the peripheral blood, extending the period of its half-life. In this case, Zaxter should be administered separately from probenecid.

If necessary, do not prescribe together Zaxter with drugs that are known to be toxic to the kidneys, especially if the patient suffers from kidney failure.

The effect of the drug under consideration on the process of protein binding by medicaments used in combination with meropenem is not known.

With the joint use of drugs, the active ingredient of which is valproic acid, its percentage in blood serum, due to the effects of Zaxter may decrease.

With the joint use of Zaxter with other drugs (except for probenecid), no other negative manifestations are detected.

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Storage conditions

Do not keep this medicine in a room where the temperature exceeds 30 ^о С, but it should not be brought to freezing. Use a fresh, freshly prepared solution. One bottle of the drug is only suitable for single use. Keep it in a place that will not be accessible to children. As can be seen from the above, the storage conditions of Zakster are simple.

Shelf life

Shelf life of the drug in question is 24 months (two years). In the event that the expiration date of the medicinal product has expired, it is not recommended to use it in the future.