clen

Imentin is combined preparation ticarcillin sodium -polusinteticheskogo karboksipenitsillina broad spectrum antibacterial activity and potassium clavulanate produced by many clen bacteria. The action of  can lead to destruction of some antibacterial agents even before their exposure to pathogens. Potassium clavulanate destroy this protective mechanism by blocking the action of enzymes, making the bacteria susceptible to ticarcillin. Potassium clavulanate has no antibacterial activity, but its combination with ticarcillin in a preparation Timentin provides a broad-spectrum antibiotic that is insensitive .

Timentin bactericidal effect in vitro against a broad spectrum of microorganisms.

Gram-negative bacteria:

 

  • Acinetobacter species
  • Moraxella catarrhalis
  • Citrobacter species, including C. freundii, C. and S. diversus amalonaticus
  • Enterobacter species (despite the fact that many strains of Enterobacter species are resistant in vitro, clinical efficacy ticarcillin with clavulanic acid in urinary tract infections has been demonstrated)
  • Escherichia coli
  • Haemophilus influenzae
  • Klebsiella species, including K. pneumoniae
  • Morganella morganii
  • Neisseria gonorrhoeae
  • Neisseria meningitidis #
  • Proteus mirabilis
  • Proteus vulgaris clen
  • Providencia rettgeri
  • Providencia stuartii
  • Pseudomonas aeruginosa
  • Pseudomonas including P. maltophilia
  • Salmonella species
  • Serratia species, including S, marcescens

 

Gram-positive bacteria:

 

  • Staphylococcus aureus
  • Staphylococcus epidermidis (coagulase-negative)
  • Staphylococcus saprophyticus
  • Streptococcus agalactiae # (group B)
  • Streptococcus bovis #
  • Enterococcus faecalis #
  • Streptococcus pneumoniae # (Dipplococcus pneumoniae)
  • Streptococcus pyogenes # (group A beta-hemolytic)
  • Viridans group streptococci

 

Anaerobic bacteria:

 

  • Bacteroides species, including the B. fragilis group (B. fragilis, B. vulgatus, B. thetaiotaomicron, B. ovatus, B. distasonis), and non-B. fragilis (beta melanogennye)
  • Clostridium species including C. perfringens, C. difficile, C. sporogenes, C. and S. ramosum bifermentans #
  • Eubacterium species clen
  • Fusobacterium species including F. nucleatum and F. necrophorum #
  • Peptococcus species #
  • Peptostreptococcus species #
  • Veillonella species

 

# Sign marked sensitive to ticarcillin strains not producing beta-lactamase.

Pharmacokinetics
The mean value of the area under the curve, “concentration-time” for ticarcillin is 485 ug / ml / 3.1 hours after administration, and 3.2 g of respective values of clavulanic acid up to 8.2 mcg / mL / hr and 15.6 g / ml / h. Following intravenous infusion at a dose of ticarcillin 3.1 g and 3.2 g for 30 minutes, the maximal plasma concentration achieved immediately after infusion, and 330 constitute ug / ml for both doses. Thus pharmacokinetic parameters of clavulanic acid is 8 ug / ml (3.1 grams of ticarcillin) and 16 ug / ml (3.2 grams of ticarcillin).

Distribution
ticarcillin distributed in organs and tissues when administered parenterally. It has been shown ticarcillin penetration into the bile, pleural fluid, cerebrospinal fluid. Half-life is inversely proportional to the blood plasma creatinine clearance. Plasma protein binding is 50% for ticarcillin and 25% for clavulanic acid.

Excretion
average half-life of blood serum determined in healthy volunteers for ticarcillin and clavulanic acid is 68 minutes and 64 minutes respectively. Approximately 60-70% of ticarcillin and 35-45% of clavulanic acid is excreted unchanged by the kidneys during the first hours after administration of a single dose of the drug (in healthy volunteers with normal renal function). Two hours after the intravenous infusion of 3.2 g ticarcillin drug concentration in urine is greater than 1500 micrograms / ml and clavulanic acid concentration exceeds 70 g / ml. After 4-6 hours after administration at a dose of 3.2 g of the urinary concentration of 2 ug / ml.

Patients with impaired renal function
ticarcillin can be displayed by dialysis, and the elimination rate is dependent on the type of dialysis.

Indications
Timentin indicated for the treatment of infections caused by pathogens with established or suspected sensitivity, such as:

 

  • Infections of bone and connective tissue caused by beta-lactamase producing strains of Staphylococcus aureus
  • Gynecological infections, including endometritis induced beta-lactamase producing strains of Bacteroides melaninogenicus #, species Enterobacter (including E. cloacae #), Escherichia coli, Klebsiella pneumoniae #, Staphylococcus aureus and Staphylococcus epidermidis
  • Intraabdominal infections, including peritonitis caused by beta-lactamase producing strains of Escherichia coli, Klebsiella pneumoniae and Bacteroides fragilis #
  • Lower respiratory tract infections caused by beta-lactamase producing strains of Staphylococcus aureus, Haemophilus influenzae # and Klebsiella species #
  • Septicemia including bacteremia caused by beta-lactamase producing strains of Klebsiella species #, E. coli #, Staphylococcus aureus #, Pseudomonas aeruginosa # (and other Pseudomonas species #)
  • Infections of the skin and subcutaneous tissue caused by beta-lactamase producing strains of Staphylococcus aureus, Klebsiella species # and E. coli #
  • Urinary tract infections (complicated and uncomplicated) caused by beta-lactamase-producing strains of E. coli, Klebsiella species, Pseudomonas aeruginosa # (and other Pseudomonas species #), Citrobacter species #, Enterobacter cloacae #, Serratia marcescens # and Staphylococcus aureus #

 

The efficacy against microorganisms clen marked with #, was shown for less than 10 infections in each nosological group.

Contraindications
: Hypersensitivity to beta-lactam antibiotics (including penicillins and cephalosporins) .Preparat contraindicated in premature babies with impaired renal function.

Precautions
Very rarely reported of hypokalemia during treatment with the drug. Therefore, caution should be exercised when administered to patients with an imbalance of electrolytes and fluids. It recommended periodic monitoring of potassium serum levels in patients receiving long-term medication. In some patients, the treatment timentin observed a moderate increase in alanine aminotransferase and aspartate. In this regard, patients with severe hepatic impairment Timentin function should be used with caution.

pregnancy and lactation Pregnancy Studies in animals have teratogenic effects of the drug were found. There are limited data on its use during pregnancy. The decision on the appointment of the drug during pregnancy should be taken with extreme caution. In this regard, the appointment of timentin pregnant women physician should carefully weigh the potential benefits and potential risks associated with the use of this drug.

Lactation
Timentin can be given during lactation, but taking into account that trace amounts of the drug passes into breast milk, it is necessary to take into account the risk of sensitization in the newborn.

Dosing and Administration
Timentin administered intravenously:. Jet slowly (over 3-4 minutes) or drip (for 20-30 minutes)
intervals between infusions should be at least 4 hours.
Treatment should continue for 48-72 hours after the disappearance clinical symptoms.

SIDE EFFECTS Reactions giperchuvstvitelyyusti Skin rash, itching, hives, anaphylactic reactions. Very rare – bullous reactions (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis). When clen all reactions giperchuvstvitelyyusti timentin use should be discontinued.

clembuterol

should not use clembuterol in combination treatment regimens Nikavir together with stavudine and, since these drugs are direct competitive mechanism of action, which may lead to a reduction activity.

In some patients treated with zidovudine together with phenytoin, there was a decrease in the blood concentration of the latter.

Some drugs, such as aspirin, codeine, morphine, indomethacin, ketoprofen, naproxen, oxazepam, lorazepam, cimetidine, clofibrate, dapsone, inosine pranobex, may affect metabolism by competitive inhibition of zidovudine and glyukuronirovaniya direct inhibition of microsomal liver enzymes. In appointing these drugs together with zidovudine should be considered the possibility of interaction.

Adriamycin, alpha-interferon, amphotericin-B, cotrimoxazole, vinblastine, vincristine, ganciclovir, dapsone, sulfadiazine and other sulfonamides used in conjunction with clembuterol, reinforce myelotoxicity.

Paracetamol – increases the incidence of neutropenia due to inhibition of metabolism of (both drugs glyukuroniruyutsya).

Radiation therapy – increases the risk of toxicity of zidovudine.

Clembuterol increases the concentration of fluconazole.

There synergistic effect with other drugs (drug) used against HIV (particularly lamivudine), on the replication of HIV in cell culture.

Nucleoside analogue ribavirin antagonizes the antiviral activity of zidovudine in vitro, so you should avoid the simultaneous use of these two drugs. Under the influence of probenecid reduces renal excretion of the glucuronide (and possibly zidovudine itself).

Cautions To avoid complications Zidovudine is used under medical supervision.

Patients should be warned that they should not be alone at a time to use other drugs. Irregular the drug best place to buy clenbuterol can lead to development of resistance of the virus and reduce treatment efficiency.

Patients should be informed that zidovudine therapy does not reduce the risk of transmitting HIV to others through sexual contact or blood transfusion.

During treatment, carried out monitoring of peripheral blood: 1 every 2 weeks. during the first 3 months. therapy, then – 1 time per month.

Hematologic changes appear after 4-6 weeks. from the start of therapy (anemia and neutropenia often develops when used in high doses – 1500 mg / day in patients with reduced content of clembuterol, with untreated HIV infection anabolic z store (with reduced bone marrow reserve prior to treatment), neutropenia. anemia, vitamin B12 deficiency). By reducing Hb more than 25% reduction in the number of neutrophils or more than 50% compared to baseline – blood tests carried out more often. Patients receiving the drug may develop opportunistic infections and other. Complications of HIV infection, so they should remain under medical supervision.

clenbuterol

If necessary, the appointment of the drug during pregnancy should be carefully correlate the expected benefit to the mother and the potential risk to the fetus. Clenbuterol is not recommended for women up to 14 weeks of pregnancy.
Women applying zidovudine is not recommended to breast-feed.

Dosing and Administration
Inside adults by 0.6-0.8 g per day in 3-4 divided doses. When lesions of the CNS HIV daily dose is doubled. Children older than 2 years of drug prescribed at the rate of 0.01-0.02 g / kg per day.

When expressed dose side effects may be reduced to 0.3 grams per day in adults and in children of calculation to 0.005 g / kg.

The course of treatment – a long, almost indefinitely. There are breaks in the course of treatment up to 1 month.

The antenatal women, the pregnancy, we recommend taking Zidovudine to 0.1 g 5 times a day starting at 14 weeks of pregnancy until delivery.

Special dosage of changing the data is not in the elderly.

Patients with renal impairment should be given clenbuterol at lower doses. Further changes in the dosage should correlate with hematological parameters and clinical response to the drug.

When liver failure may require dose adjustment: physicians should pay attention to the signs of intolerance to the drug and, if necessary, increase the intervals between doses.

For the prevention of occupational exposure to HIV (with infected biological material) and in other cases, parenteral risk  infection, it is recommended to take as soon as possible Zidovudine 0.2 grams 3 times per day (not later than 72 hours after a possible infection ) for 4 weeks.

By reducing  is 25% of the original, the number of neutrophils by 50% from baseline – daily dose reduced by 2 times or temporarily canceled. After restoring parameters the dose may be further increased to the initial daily values. Treatment is terminated if less than 7.5 g Hb / dL or neutrophil count below 750 / ml. With the development of anemia (Hb reduction at 2 g / dl) or neutropenia, which are determined by two assays at intervals of 24 hours or reducing the number of platelets to 50,000 / L, the dose is reduced by 30%. Discontinuation of treatment in children is required: at lower hemoglobin less than 8 g / dL; reducing the number of neutrophils to 500 / ml in two consecutive measurements at intervals of 24 hours; a decrease in platelet count to 25,000 / microliter or progressive renal failure. After stabilization of hematological parameters resume treatment at lower doses.

Side effects
In the early days of zidovudine – dizziness, weakness, loss of appetite, diarrhea. Usually these effects disappear later. With long-term use of the drug may cause pruritus, paresthesia, myalgia. Allergic reactions such as urticaria are rare. Serious complications are anemia, which can develop within 4-6 weeks clenbuterol of starting treatment and granulocytopenia (6-8 weeks). Reduced hemoglobin can be observed early (within 2-4 weeks after treatment). Therefore requires constant monitoring of formula laboratory blood and hemoglobin.

The frequency of complications related to the dose of the drug, so the complications are more common in the later stages of the disease. If adverse reactions it is advisable to try to continue treatment zidovudine and prescribe other drugs to correct complications. With a pronounced toxic effect of  canceled up to restore the affected systems. Other side effects: neutropenia, leukopenia, thrombocytopenia; asthenic syndrome, somnolence, taste perversion, false angina, gastralgia, nausea, vomiting, flatulence, pancreatitis; increased activity of “liver” transaminases, hypercreatininemia, elevated serum amylase; fever, the development of secondary infection; insomnia, depression, increased urination, vomiting, cough.

Assessing the tolerability of the drug, it should be borne in mind that the skin rashes, dizziness, weakness, headache, anorexia, diarrhea, myalgia, anemia, thrombocytopenia, may be a manifestation of the most HIV infections and secondary diseases associated with it, rather than a toxic effect of zidovudine.

Overdosing
maximum registered clenbuterol concentration in the blood was 49.4 micrograms / ml (after intravenous injection at a dose of 7.5 mg / kg every 4 hours for two weeks). After such overdose any specific symptoms were not observed. In the case of intoxication hemodialysis and peritoneal dialysis substantially increase the excretion of glucuronic metabolite of zidovudine.

clenbuterol dosage

Zidovudine is a thymidine analogue and belongs to the group of nucleoside antiviral drugs. It has strong inhibitory activity against retroviruses, including human immunodeficiency virus .

The infected human cells is phosphorylated by the action of thymidine kinase to azidothymidine triphosphate, which is a substrate inhibitor of reverse transcriptase of retroviruses: the introduction of azidothymidine triphosphate in the synthesized circuit virus , its further formation blocked virus reproduction stops, on which is based the therapeutic effect to reduce concentrations the patient’s blood. Azidothymidine triphosphate Competitive inhibitory activity against reverse transcriptase is approximately 100 times greater than that observed for the polymerase alpha of human cells, thus clenbuterol dosage has no effect on the normal metabolism of the human body.

It was found that low concentrations of zidovudine inhibit many strains of Enterobacteriaceae in vitro, including strains of various species coli (bacteria with resistance develops quickly). Activity against Pseudomonas aeruginosa masteron side effects in vitro has not been established. In very high concentrations (1.9 mcg / ml (7 mmol / L)) suppresses Giardia lamblia, although activity against other protozoa absent.

Clenbuterol dosage is well absorbed from the gastrointestinal tract, maximum concentration (Cmax) in blood is achieved in 30-90 minutes, the bioavailability is 63%. It penetrates the blood-brain barrier (BBB) and is found in the cerebrospinal fluid ( in a concentration of 15-64% of the initial dose.

It penetrates through the placenta, so that its concentration in cord blood is comparable to that in maternal blood. It is found in breast milk. Metabolism occurs in the liver to form a glucuronide which is excreted from the body by the kidneys in the urine.

In patients with impaired hepatic function possible cumulation of zidovudine by decreasing glyukuronirovaniya in the liver.

Data on the pharmacokinetics of zidovudine in pregnant women is limited, as well as in older patients. Children over the age of 5-6 months. Zidovudine pharmacokinetic data are similar to those in adults.

Reception with fatty food reduces the rate and extent of absorption.

When inside designation 200 mg six times daily plasma, the minimum concentration (Cmin) – 0,1 mcg / ml of plasma. It penetrates through the BBB, the concentration in CSF – 24% of the plasma concentration in children. It passes through the placenta (concentration in the tissues of the central nervous system in 13-week fetal – 0.01 mmol / l, which is below the effective antiviral concentration). The volume of distribution in adults and children – 1.4-1.7 l / kg (42-52 l / m). It accumulates in the seminal fluid, wherein the concentration exceed those femara side effects in serum 1,3-20,4 times, but does not affect the elimination of HIV from semen and therefore can not prevent the sexual transmission.

The average half-life (T?) Of cells – 3.3 hours; serum from adults – about 1 h (0.8-1.2 h), renal failure (creatinine clearance (CC) of less than 30 ml / min) – 1.4-2.9 hours at cirrhosis – varies depending on the severity of liver disease, on average, 2.4 hours; in children aged 2 weeks-13 years – 1-1.8 hours in neonates (whose mothers received zidovudine) -13 hours Renal clearance -. 27.1 mL / min / kg in children – 30.9 ml / min / kg, exceeds KK. In the liver occurs conjugation with glucuronic acid; primary inactive metabolite – 3′-azido-3′-deoxy-5′-O-beta-D-glyukopiranurono-ziltimidin, T? normal kidney function h -1, renal insufficiency – 8 hours at anuria – 29-94 h at cirrhosis – varies depending on the extent of liver failure, on average, about 2.4 hours; excreted by the kidneys and does not exhibit antiviral activity.

In unchanged form excreted by the kidneys by 14-18% in children – 30%; in the form of glucuronides – 60-74% in children – 45%. Not accumulates; in patients with chronic liver failure may be the accumulation of metabolites (conjugates with glucuronic acid), which increases the risk of symptoms of toxic action.

Indications for use in adults and children over 2 years of HIV infection at the stage of secondary diseases in the stage of acute infection and the primary clinical manifestations at lower less , as well as in the incubation stage.

Pregnant women may be administered with the progression of secondary diseases in HIV infection or when the number of clenbuterol dosage lymphocytes is less than 0.2 x 109%. In other cases, treatment zidovudine can be interrupted before cytomel uk the expiry of the first trimester of pregnancy.

Perenatalnoy Prevention of HIV transmission from an infected mother to child, as zidovudine reduces the risk of intrauterine infection.

Preventing contamination of persons who have received injections and cuts while work with HIV-contaminated material.

Contraindications – Hypersensitivity to the drug; – leukopenia (neutrophil count less than 500 l) – anemia (hemoglobin (Hb) less than 50 g / l); – thrombocytopenia (platelets less than 25 thousand in l.); – Improving aminotransferases and creatinine than 3 times the upper limit of normal; – children under 2 years old.

Precautions: inhibition of bone marrow hematopoiesis, deficiency of cyanocobalamin (vitamin B12) and folic acid, liver failure, older age, obesity, with hepatomegaly, hepatitis or any known risk factors for liver disease. In the treatment of zidovudine such patients should be carefully monitored.

clenbuterol before and after

Is not recommended the simultaneous use of drugs that affect blood clotting (anticoagulants for oral administration of heparin, acetylsalicylic acid). If the concomitant use of these drugs is absolutely necessary, should regularly monitor coagulation parameters. Simultaneous use of antacid preparations group leads to decrease in the blood concentration of ticlopidine 18%. The simultaneous use of cimetidine leads to a significant increase in the concentration of ticlopidine in blood. Ticlopidine may cause a slight clenbuterol before and after (approximately 15%) reduction in the concentration of digoxin in the bloodstream. Drugs metabolism involving microsomal liver enzymes (e.g., some hypnotic and sedative drugs), are metabolized slowly under ticlopidine treatment. Violation of the liver may also reduce the rate of metabolism of other drugs. Ticlopidine cephalosporins slows down and causes a rise of their blood concentrations. Patients taking ticlopidine, cephalosporins dose should be adjusted accordingly. Ticlopidine slows excretion of theophylline. Simultaneous use of theophylline and ticlopidine may cause an increase in the concentration of theophylline, and lead to overdose. Concomitant use of phenytoin and ticlopidine requires special care as ticlopidine increases the concentration of phenytoin in plasma. It is necessary to determine the level of serum phenytoin and adjust the dose.

Cautions The most common violations of blood and bleeding tendency associated with insufficiently frequent monitoring of coagulation parameters or late diagnosis of these disorders. Excessive coagulation inhibition occurs primarily in patients treated concurrently with antikoagulyaty ticlopidine, acetylsalicylic acid or other non-steroidal anti-inflammatory drugs. Faults in the system of coagulation or signs of an inflammatory disease (eg, sore throat, fever, attacks on the mucous membrane of the tonsils) it is necessary to consult a doctor. Physicians also need to be informed about the reception of other drugs, especially the above. In the treatment of ticlopidine without consulting clenbuterol before and after a doctor can not be used painkillers and drugs to lower the temperature. When the need for surgical intervention (even a small, such as, for example, tooth extraction), the doctor should say that the patient is taking ticlopidine, as it must take into account when planning manipulation or surgery. If possible, ticlopidine reception should be discontinued at least 10 days before the procedure. In the case of urgent surgical intervention is necessary to introduce a dose of methylprednisolone 0.5-1.0 mg / kg body masy or spend transfusion of platelets. Ticlopidine is metabolized primarily by the liver. In patients with impaired liver function the drug should be used with extreme caution. You must inform the doctor about the presence of acute liver disease or an illness in the history. There are reports of rare cases of hepatitis and cholestatic jaundice. In the case of jaundice, icteric sclera, colorless stool or unusually dark urine should immediately consult a doctor. Chronic use tren ace of ticlopidine may cause changes in the biochemical analysis of blood: an increase in alkaline phosphatase activity or enzymes, increased cholesterol and triglyceride levels. Blood must be monitored over time during the first three months of treatment. Prior to treatment ticlopidine and then every 2 weeks for the first 3 months of treatment necessary to control the number of platelets and the composition of the leukocyte formula. Since the use of the drug due to the risk of severe neutropenia and / or agranulocytosis, ticlopidine should only be used in patients with hypersensitivity to aspirin patients or in patients in which the use acetylsalicylic acid inefficiently.

Use in pregnancy and lactation The drug can be used during clenbuterol before and after pregnancy unless absolutely necessary. There has been no adequate studies on the excretion of ticlopidine with mother’s milk. If the use of ticlopidine is necessary during lactation, the drug should be used with extreme caution. stretch marks bodybuilding kalpa pharmaceuticals easy to follow bodybuilding diet