Is it possible to store diluted penicillin? Benzylpenicillin - drugs (sodium salt, potassium salt, novocaine salt, benzathine benzylpenicillin, etc.), action, instructions for use (how to dilute, dosage, methods of administration), analogues, reviews, prices

Instructions

Inject benzylpenicillin potassium salt and benzylpenicillin sodium salt into a vein, under the skin or into the abdominal or pleural cavity. These same substances can be produced in the form eye drops or aerosols. Inject sodium salt only endolumbarally. For injection under the skin or into muscles, make the solution with 1%.

Use benzylpenicillin novocaine salt in the form of a suspension, prepare it with an isotonic solution of sodium chloride or sterile water for injection. Administer the drug once a day, only intramuscularly.

A suspension of novocaine salt of benzylpenicillin with aqueous soluble ecmoline is also administered intramuscularly once a day. It comes in 2 bottles, which must be mixed according to the instructions and stored at room temperature.

The drug long acting is bicillin 1, it is used for diseases caused by pathogens sensitive to penicillin. Prepare the suspension with isotonic sodium chloride solution or with sterile water for injection. Drive only intramuscularly, making sure that you do not hit a vein. The drug is used no more than once a week.

Bicillin 3 is a mixture of equal parts of sodium or potassium salt of benzylpennicillin, as well as novocaine salt and bicillin 1. Inject it once every 3 days or once a week. Bicillin 5 is a mixture consisting of bicillin 1 and novocaine salt; inject it intramuscularly.

Phenoxymethylpenicillin stands out from the general series in that it is not destroyed by an acidic environment gastric juice, and this makes it possible to take it orally.

Semi-synthetic penicillins, such as oxacillin and methicillin, are also administered intramuscularly; prepare the solution with sterile water for injection. Oxacillin can also be taken. Ampicillin is also semi-synthetic, has a wide spectrum of action and.

Please note

In some cases, penicillin drugs can cause anaphylactic shock, so they should be taken with caution.

Useful advice

Bicillin 5 is very effective as a means of preventing rheumatic attacks.

Lip piercing has been widely used since ancient times. But if on early stages history he was a kind of symbol, then for modern man became a decoration. Many people believe that it is safe and inject lip you can do it yourself. But this is far from true; great care and attentiveness are required.

Instructions

Wash your hands thoroughly, prepare workplace and put on new gloves.

Piercings can be done around the entire perimeter of the lips. Once you have decided on the location, carefully inspect inner side lips. To do this, pull it back slightly and find an area where you can see less blood vessels. Damage to them should be avoided during piercing surgery.

Make a puncture with a quick movement. Then remove the needle and immediately put on the previously disinfected pierce. It should not be removed at a minimum. Don't forget to treat your piercing with hydrogen peroxide daily.

Useful advice

Injecting your lip yourself is very dangerous. Therefore, it is best for you to contact a professional. And even in this case, carefully study the salon you plan to visit. It must be absolutely clean, because any contamination can subsequently lead to infection and suppuration.
Talk to the master and ask him how and with what needles he works. Ask for a portfolio good specialist I'm always happy to show it to clients. If the explanations are too vague or the master offers to do the piercing with a special gun, it is better to refuse his services and continue the search.

Even at the beginning of the 20th century, despite a huge leap in the field of medicine, large number diseases were difficult to treat or could not be treated at all. But when the antibiotic penicillin was discovered, everything changed in better side. Over decades, millions of human lives have been saved.

Alexander Fleming

It was this Scottish scientist who used penicillin. Born August 6, 1881. After leaving school he graduated from the Royal College of Surgeons, after which he remained to work there. After England joined the First, he became captain of a military hospital in the Royal Army. After the war he worked on isolating pathogens infectious diseases, as well as methods to combat them.

History of the discovery of penicillin

Fleming's worst enemy in his laboratory was mold. Common gray mold that affects walls and corners of poorly ventilated and damp rooms. More than once, Fleming lifted the lid of a Petri dish and then noticed with annoyance that the streptococcal cultures he was growing were covered with a layer of mold. As soon as the bowl with the biomaterial was left in the laboratory for a few hours, the nutrient layer on which the bacteria immediately became covered with mold. As soon as the scientist did not fight with her, everything was in vain. But one day, on one of the moldy bowls, he noticed strange phenomenon. A small bald patch has formed around the colony of bacteria. He is under the impression that bacteria simply could not multiply in moldy areas.

About antibacterial effect mold has been known since ancient times. The first mention of the use of mold for treatment purulent diseases were mentioned in the works of Avicenna.

Discovery of penicillin

Having preserved the “strange” mold, Fleming grew an entire colony from it. His research showed that streptococci and staphylococci were unable to develop in the presence of this mold. Having previously carried out various experiments, Fleming concluded that under the influence of some bacteria others die. He called this phenomenon antibiosis. It is not that in the case of mold, he encountered the phenomenon of antibiosis with his own eyes. After careful research, he finally managed to isolate from the mold antimicrobial drug. Fleming named the substance penicillin in honor of Latin name the type of mold from which he isolated it. Thus, in 1929, in the dark laboratory of St. Mary's Hospital, the well-known penicillin.

In 1945, Alexander Fleming, as well as scientists who established industrial production penicillin, Howard Frey and Ernest Chain were awarded the Nobel Prize.

Industrial production of the drug

Fleming's attempts to establish industrial production of penicillin were in vain. Only in 1939, two Oxford scientists, Howard Frey and Ernest Chain, after several years of work, were able to achieve noticeable success. They obtained some crystalline penicillin, after which they began the first tests. The first person to be brought to life through the administration of penicillin was a 15-year-old boy suffering from blood poisoning.

Video on the topic

Sources:

• How penicillin was discovered in 2019

Most often it stings under the chest during sports. This is one of the types of abdominal pain. Pain underneath right breast may be associated with problems such as gallstones, appendicitis, fracture chest and for other reasons.

Appendicitis

Inflammation of the appendix, vermiform appendix attached to the intestines is appendicitis. Main symptom of this disease - abdominal pain. Mild fever, nausea and vomiting are other symptoms of this problem. The pain that is felt in the right side comes from. At first she may not be strong, but deaf.

Gallstones

Digestive juice, thickening, enters. These clots are called gallstones. In this case, you should stop eating until the problem is resolved with help. proper treatment. Pain in the lower chest is the main symptom of this disease. This pain may involve the upper back on the right side and the entire right side chest. Nausea, vomiting and gas in the stomach are other symptoms of this disease.

Colic in the side

In this case, the patient feels sharp pain in the side just below the rib cage. As a rule, people feel such pain while performing physical exercise and after jogging or walking.

Colic may occur due to contraction of the liver or spleen.

Diaphragmatic ischemia, parietal peritoneal irritation and imbalance thoracic spine These are other causes of colic.

Chest fracture

Acute pain may be felt as a result of the chest. A common reason for this is physical injury. Most often, injury occurs directly. But sometimes a person can get seriously injured.

People with osteoporosis are especially susceptible to these types of fractures. If you experience severe pain, you should immediately consult a doctor, as it is often accompanied by damage to the spleen, lungs, or blood vessels.

Since there can be many causes of pain in the lower chest, treatment should be carried out only after a correct diagnosis. Chest pain in itself is not a disease, but a symptom of one of many disorders.

Pleurisy

With this disease, the mucous membranes of the lungs and other parts of the chest become inflamed. Becomes. Acute pain is caused by friction of the pleural layers. Pleurisy occurs as a result of pneumonia or tuberculosis and an infection. Others – chest injury, rheumatoid arthritis, skin tuberculosis.

Intestinal obstruction

The disease occurs as a result of intestinal volvulus or a blocking object entering the intestine. At the same time, convulsions are felt, which either intensify or weaken. The pain may become acute after eating. Another symptom of intestinal obstruction is loose stool.

Sources:

• Pain under breasts in rib cage area? Help?

Stitching pain under the ribs may indicate the most various diseases. It is important to consult a doctor promptly unpleasant symptoms to determine the cause of pain and prevent serious problems with health.

With the help of pain, the body always signals that some important systems fail. If you have stabbing pain in the left hypochondrium, you should not ignore suspicious symptoms. Be sure to study the location of the pain and consult a doctor: depending on how exactly the pain manifests itself, the doctor will be able to determine its cause. Pain in the left hypochondrium often occurs even in healthy people, signaling various problems, ranging from heart failure to disorders of the nervous system.

What can cause pain?

Chest pain is a common phenomenon that is most often regarded as a sign of problems with. However, discomfort may also indicate other diseases:

Inflammation of the spleen;
- stomach diseases;
- peptic ulcer;
- malignant tumors V gastrointestinal tract;
- pancreatitis (glands);
- ;
- kidney diseases;
- various pathologies nervous system;
- endocrine diseases;
- or fractures;
- osteochondrosis thoracic spine.

How to determine the cause of pain?

If acute stabbing pain occurs, radiating to left hand and shoulder blade, you should visit a cardiologist as soon as possible. These symptoms may indicate serious heart failure. The stronger painful sensations, the sooner the patient should be shown to the doctor: sudden burning pain in the left hypochondrium may indicate myocardium.

If the pain radiates to the front abdominal wall, and is also sometimes localized in the right hypochondrium, it is worth contacting a gastroenterologist. It is possible that the cause of the discomfort is a stomach ulcer or duodenum. Cutting pain of a girdle nature can be caused by acute pancreatitis.

An examination of the gastrointestinal tract is also required if pain in the left side of the chest is accompanied by nausea and vomiting, since it is necessary to exclude the presence of malignant neoplasms.

Extreme pain in the left hypochondrium caused by an enlarged spleen. If you feel a strong attack cutting pain in the left hypochondrium, accompanied by darkening of the skin around the navel, it is necessary to urgently call emergency assistance. There may be a rupture of the spleen, and the lack of timely medical care can lead to death.

If attacks acute pain after a few days they begin to be accompanied skin rashes, the patient may be diagnosed with herpes zoster.

Sometimes the cause of attacks of acute causeless pain in the left side of the chest is a pathology of the nervous system. Typically, such pain occurs suddenly without painkillers, accompanied by cramps or migraines.

How to treat pain syndrome?

First of all, you should consult your doctor. Only experienced specialist will be able to appoint necessary examinations and put accurate diagnosis. For primary diagnosis You should visit your local physician, who, if necessary, will refer you for further consultation with to a specialized specialist.

Modern society wary of antibiotics. There is a strong belief that they bring more harm than good. But, however, back in the mid-twentieth century, penicillin was the only antibiotic of its kind that could cure most of the diseases from which people simply died.

Discovery of penicillin

The discovery of penicillin was truly a happy accident. Scientist, professor, and later Nobel laureate Alexander Fleming, lived and worked in Scotland at the beginning of the last century. During the Second World War, he worked as a doctor in. At that time, people died from blood poisoning and gangrene, despite the fact that the operations were carried out successfully. Fleming really wanted to find one that would be able to prevent sepsis.

The scientist was somewhat sloppy, and having left home, where he was conducting experiments in search of , for a long time, he left the Petri dishes dirty. In them he conducted bacteriological experiments. When the doctor returned, he discovered that mold had bloomed everywhere, and in one of the cups it had killed staphylococcus. The scientist brought this mold by accident from a neighboring laboratory where experiments were carried out with molds.

These events took place in 1928 and, until the 40s, Fleming struggled to develop a cure. Because it was necessary not only to understand how it works, but also to conduct experiments, derive the required form medicines and establish production. Only in 1941 was it possible to save the first person from death with the help of penicillin. And mass production of this was established by 1952. From this point on, penicillin was available in most pharmacies.

How does penicillin work?

Penicillin is safe for humans and animals, unlike antiseptic drugs. Its action is based on the inhibition of the vital activity of bacteria that produce peptidoglycan, which is involved in the construction cell membranes. Penicillin blocks the production of this substance, thereby preventing the construction of new bacterial cells and destroying existing ones. Human cells are not exposed to penicillin because they have a different structure.

Penicillin today

It is generally accepted that penicillin is becoming obsolete. That he is no longer able to cope with the huge number of pathogenic bacteria that, having adapted to him, have mutated, forming new species. This is partially true, but today new semi-synthetic drugs have been created to which bacteria have not yet had time to adapt, unlike natural penicillin.

Possible causes of pain

It can stab quite well natural cause– this pain is often observed during intense physical activity. To ensure that working muscles need nutrition and oxygen, blood enters the bloodstream from a “reserve reserve” that did not circulate through the vessels before the load. The spleen becomes filled with blood, increases in size and puts pressure on the nerve cells of its own membrane. This is what causes pain.

If the pain occurs suddenly in an area that has not previously given you trouble, it is most often a symptom of a disease. How more pain, the sooner you need to see a doctor, especially if the onset of discomfort was preceded by an injury.

– usually such pain intensifies sharply or with a change in body position.

Stitching pain accompanied by high temperature- one of the symptoms of left-sided pneumonia.

Pain in the left side, if accompanied by shortness of breath, darkening of the eyes, severe weakness, may be a symptom of diseases of the cardiovascular system, in particular, coronary disease heart disease, cardiomyopathy or even heart attack. It is also impossible to exclude pathologies of the spleen, acute appendicitis, kidney disease (the pain may radiate to the back) or diaphragmatic hernia.

What to do?

Considering the diversity possible diseases, the symptom of which is stabbing pain in the right side, you should not engage in self-diagnosis. Depending on the intensity of the pain, you need to consult a doctor urgently, call a local therapist at home, or come to his appointment yourself.

If you have any chronic diseases, which can cause repeated stabbing pains in the left hypochondrium, you can take medications prescribed by your doctor in case of exacerbation, and then seek treatment medical care. Pain that occurs for the first time will most likely require examination and testing to determine its origin.

Frequently disturbing pain in the side during physical activity can be eliminated if you don't start at full stomach or without warming up. Watch your breathing during exercise - it should be deep enough so that diaphragm spasms do not occur.

Target: parenteral administration of drugs.

Indications: doctor's prescription.

Contraindications: expired medicine, violation of the sterility of the bottle.

Equipment: a bottle of medicine, a syringe with a needle; 70% alcohol, cotton balls, scissors.

Rules for diluting antibiotics:

Solvents: 0.25% or 0.5% novocaine solution, 0.9% sodium chloride solution, sterile water for injection.

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles of 250,000, 500,000, 1,000,000 units. Dosed in action units.

There is a rule:

1 ml of solution should contain 100,000 units of penicillin

Thus, if the bottle contains 500,000 units, then you need to take 5 ml of novocaine.

Algorithm of actions of the nurse:

1. Read the name of the medicine, its dosage, and expiration date on the bottle.

2. Bend the metal cap with tweezers and treat the rubber stopper with alcohol.

3. Draw into the syringe required quantity solvent, pierce the stopper with a large-diameter needle and inject the solvent into the bottle.

4. Remove the bottle along with the needle from the needle cone and, shaking the bottle, ensure that the powder is completely dissolved.

5. Place the needle on the needle cone.

4. Turn the bottle upside down, pull the plunger towards you - the medicine flows into the syringe.

5. Having collected the required amount of the drug, remove the needle from the bottle.

Note. Opened bottles must be used within 24 hours.

Intramuscular injection technique

Target: administration of a drug bypassing the gastrointestinal tract .

Equipment: sterile tray, tray for used syringes, sterile syringe with sterile needles, sterile cotton balls, ethyl alcohol 70°, container with disinfectant.

Algorithm of actions of the nurse:

Explain to the patient the procedure for the upcoming procedure.

Help the patient take the required position and clear the injection site.

Wash your hands, put on gloves and use an alcohol roller.

Apply the alcohol ball to the injection site twice in the same direction.

Take the syringe into right hand, position it perpendicular to the surface of the patient’s body, place the 5th finger on the needle cannula, the remaining fingers on the cylinder.

Use your left hand to stretch the skin at the injection site.

Insert the needle into the muscle at an angle of 90 degrees, 2/3 the length of the needle.

Pull the plunger towards you, make sure there is no blood in the syringe (mandatory when injecting oil solutions).

Administer the drug.

Apply a sterile ball moistened with ethyl alcohol 70° to the injection site, quickly remove the needle and syringe.

Help the patient find a comfortable position.

Treat the syringe, needles, balls.

Remove gloves, wash your hands.

Notes:

An intramuscular injection is performed in the upper outer quadrant of the buttock and middle third outer thigh (vastus lateralis muscle).

Before administration, oil solutions must be heated in a water bath to a temperature of 38° C.

Bicillin (long-acting antibiotic) dilute saline solution(less foaming), administer immediately, as the suspension quickly crystallizes.

After administering oil solutions and bicillin, apply a heating pad to the injection site.

Description

Amorphous or fine crystalline powder white, soluble in water, alcohol, ether and acetone.

Compound

1 bottle of the drug contains the active ingredient: benzylpenicillin sodium salt- 1,000,000 units.

Pharmacological action

Benzylpenicillin is active against gram-positive microorganisms (staphylococci, streptococci, pneumococci, anaerobic bacilli, anthrax bacilli), gram-negative cocci (gonococci, meningococci), as well as against spirochetes, some actinomycetes and other microorganisms.

Benzylpenicillin, when administered intramuscularly, is quickly absorbed into the blood and detected in body fluids and tissues; penetrates into the cerebrospinal fluid in small quantities. The maximum concentration in the blood is observed after intramuscular administration after 30-60 minutes. 3-4 hours after a single intramuscular or subcutaneous injection Only traces of the antibiotic appear in the blood. To maintain concentration at a level quite high for a therapeutic effect, injections must be given every 3-4 hours. When administered intravenously, the concentration of penicillin in the blood decreases rapidly. Bacteria of the enteric typhoid group, Brucella, mycobacteria, protozoa, viruses, fungi and rickettsia do not respond to the action of penicillin. This is due to the fact that these microorganisms are capable of producing a specific enzyme - penicillinase, which destroys the lactam ring in the penicillin molecule, as a result of which they lose their antimicrobial effect.

Application

Treatment for large cattle, sheep, goats, pigs, horses, rabbits, fur-bearing animals and dogs, chickens, ducks, turkeys necrobacteriosis, pasteurellosis, pneumonia, mastitis, wound infections and infections urinary tract, septicemia, phlegmon, as well as actinomycosis, emphysematous carbuncle, streptococcal infection; wash, catarrhal and lobar pneumonia, influenza, stachybotriotoxicosis of horses; streptococcosis, staphylococcosis, infectious stomatitis and rhinitis, plague of fur-bearing animals and dogs; erysipelas of pigs and spirochetosis of poultry.

Dosage

Solutions of the sodium salt of benzylpenicillin are prepared in sterile distilled water or in a 0.5% solution of novocaine, which prolongs the action of benzylpenicillin, or in an isotonic solution of sodium chloride and administered intramuscularly. To support the necessary constant high concentration in the blood, penicillin is administered 4-6 times a day in the following doses:

Kind of animals and birds	One-time intramuscular dose, units/kg body weight
	Adults	Young animals
cattle
sheep, goats
fur animals and dogs
chickens, ducks, turkeys

The course of treatment is at least 4-7 days, in severe forms of the disease 7-10 days or more. A solution of benzylpenicillin sodium salt can be administered intravenously (in severe septic conditions). With this method, the dose of antibiotic is 2 times less than recommended for intramuscular injection. It is also used subcutaneously and as a powder on wound surfaces. If necessary, you can use an aerosol.

Contraindications

Use in animals with hypersensitivity to the drug is prohibited.

Warning

Slaughter of animals for meat is allowed on the 3rd day, consumption of milk for food on the 2nd day after the last administration of the drug. By the specified date, meat and milk are fed to unproductive animals or disposed of (depending on the veterinarian’s conclusion).

Release form

Glass bottles of 500, 1000, 1500 thousand units.

Storage

List B. Dry, dark place at a temperature from +5°C to +20°C.

Penicillin is one of the most commonly used bactericidal drugs, available in tablet form and as a powder for injection. The medication has a wide range of applications and is actively used to eliminate many pathologies. bacterial nature. Most effective form use of the drug - injections.

Description and composition of the drug

Penicillin is the first bactericidal agent, obtained from the waste products of microorganisms. Its inventor is called Alexander Fleming, who discovered the antibiotic by accident, discovering its antimicrobial effect.

The first samples of the drug were obtained in the USSR by scientists Balezina and Ermolyeva in the mid-twentieth century. After this, the medicine began to be produced on an industrial scale. At the end of the fifties of the twentieth century, synthetic penicillins were also obtained.

Currently, four groups of penicillins are used in medicine:

• natural origin;
• semi-synthetic compounds;
• aminopenicillins wide range applications;
• broad-spectrum bactericidal penicillins.

For injection use penicillin G sodium salt 500 thousand units or 1 million units. IN pharmacy chains Such powder can be purchased in glass bottles, sealed with a rubber stopper. Before direct administration, the powder is diluted with water. The drug can be obtained from a pharmacy with a doctor's prescription.

Pharmacological characteristics

In my own way chemical composition Penicillin is an acid used to produce salts. Its biosynthetic products act on anaerobic spore-forming rods, gram-positive and gram-negative bacteria, inhibiting the synthesis of their walls. Benzylpenicillin is considered the most active and relevant drug today.

The penicillin drug is administered intramuscularly and immediately after direct use it enters the bloodstream and quickly concentrates in muscles and joints, and tissue lesions. The highest degree of concentration of the composition is observed half an hour to an hour after the procedure.

Drug concentration in cerebrospinal fluid And abdominal cavity minimal. The composition is excreted through the kidneys and bile. The half-life is up to one and a half hours.

Indications for use

Penicillin treatment with injections is carried out with the development bacterial infections, among which:

• focal and lobar pneumonia;
• chronic and acute osteomyelitis;
• pleural empyema;
• blood poisoning;
• acute and subacute types of endocarditis;
• tonsillitis;
• scarlet fever;
• infectious inflammatory processes of the brain;
• erysipelas;
• anthrax;
• furunculosis and its complications;
• acute cholecystitis;
• gonorrhea;
• rheumatism;
• inflammatory bacterial pathologies urinary route and reproductive organs;
• diphtheria;
• ENT pathologies;
• purulent dermatological lesions;
• pyemia;
• actinomycosis.

Important: Penicillin is used not only to treat human diseases, but also to eliminate pathologies in animals and is one of the most inexpensive drugs of its kind.

Methods of treatment using Penicillin

According to the instructions for use, the drug is allowed to be administered in four main ways, depending on the type and extent of the lesion:

• into the spinal canal;
• intravenously;
• intramuscularly;
• subcutaneously

Injections are given every three to four hours, maintaining the content of the composition so that for each milliliter of the patient’s blood there is a concentration of 0.1-0.3 units. In most cases, the treatment regimen is selected individually for each patient. The same applies to the course of treatment.

Special instructions for use

In order for treatment to be as effective and safe as possible, it is necessary to take into account following problems therapy:

1. Before starting to use the medicine, it is necessary to test for possible intolerance to antibiotics.
2. The medication must be replaced if three to five days later, if the therapy shows insufficient effectiveness.
3. To prevent the occurrence of mycotic superinfection, it is necessary to take antifungal medications during treatment. It is also important to pay attention to the likelihood of colonization of the body with resistant strains of bacteria.
4. It is possible to dilute the medicine for injection only with water for injection, strictly following the proposed proportions.
5. It is not recommended to skip injections. If missed, it is necessary to administer the drug as soon as possible and restore the regimen.
6. After the expiration date, the medicine becomes toxic and dangerous to use.

Limitations and main contraindications

Penicillin has relatively few contraindications. The main one is hypersensitivity to the antibiotic itself and other drugs in its group. In addition, the medication is not recommended for use if:

• manifestations of allergies in the form of urticaria, asthma and hay fever;
• manifestations of intolerance to antibiotics and sulfonamides.

It is necessary to use the medicine under the supervision of a doctor for pathologies of the kidneys and cardiovascular system.

Side effects and complications

An overdose of medication does not pose a threat to the patient's life. In this case, nausea and vomiting and a general deterioration in health may occur. In addition, the development of hyperkalemia is likely with the simultaneous use of potassium supplements. IN in rare cases possible epileptic seizures. Exceeding the prescribed dosage is treated symptomatically.

At long-term use antibiotic is likely a manifestation allergic reactions(urticaria, swelling, rash formation, anaphylactic manifestations, extremely rarely - death). Treatment in this situation is symptomatic. Typically, adrenaline is administered intravenously. In other situations the following are also possible:

• disturbance of digestive processes and stool;
• dysbacteriosis;
• fungal diseases of the oral cavity and vagina;
• neurotoxic manifestations, seizures, coma.

Important: In order to reduce the likelihood of negative reactions for therapy, it is recommended not to exceed the established dosages and not to extend the course of treatment without the consent of the doctor.

Interaction of Penicillin with other drugs

Concomitant treatment with Probenecid increases the half-life of the antibiotic components. The use of Tetracycline and sulfonamides significantly reduces the effectiveness of Penicillin. Cholistyramine seriously reduces the bioavailability of the antibiotic.

Due to incompatibility, you cannot give an injection of Penicillin and any aminoglycoside at the same time. Also prohibited joint use thrombolytics.

The risk of bleeding increases with simultaneous use anticoagulants and Penicillins against Pseudomonas aeruginosa. Therefore, treatment in this case should be supervised by a specialist.

Antibiotic therapy slows down the elimination of methotrexate and also reduces the effectiveness of oral contraceptives.

Penicillin analogues

1. Cefazolin. A drug from the group of cephalosporins, which can be used in case of intolerance to penicillin medications. Used for intramuscular and intravenous administration and saves therapeutic properties after the procedure for ten hours.
2. Ceftriaxone. The cephalosporin medication is most often used in a hospital setting. Intended for the treatment of inflammatory processes caused by bacterial pathogens, it is active against gram-negative bacteria and anaerobic infections.
3. Extensillin. Refers to the number beta-lactam antibiotics long-term exposure. The medication is available in powders and is not recommended for use simultaneously with non-steroidal drugs against inflammatory processes.

Among drugs for oral administration containing a similar active ingredient, highlight:

• Ampicillin trihydrate;
• Amoxicillin;
• Flemoxin Solutab;
• Amosin;
• Amoxicar;
• Ecobol.

Important: Replacement is made if it is impossible to give injections, intolerance to penicillins, as well as if the latter are insufficiently effective.

Conclusion

Penicillin is a first-generation antibiotic that has been tested over the years and through long-term trials. Currently, the drug is used to treat many bacterial infections in a modernized form and is relatively safe for humans. Penicillins are actively used in veterinary medicine and have several varieties, which are selected for therapy depending on the type of disease and individual characteristics patient.

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The popularity of penicillins is due to their pronounced bactericidal effect, low toxicity and wide range dosages. The disadvantages of this class of antibiotics include frequent allergies for penicillin and high risk cross allergic reactions with others.

All representatives of this group can be divided into biosynthetic and semi-synthetic penicillins.

The first representative of natural antimicrobial drugs and the ancestor of the penicillin class is benzylpenicillin (penicillin).

The drug is completely unstable when orally and is completely destroyed in the gastrointestinal tract. Penicillin is for injection only. When administered intramuscularly, the drug is well absorbed and is capable of creating a significant therapeutic concentration within half an hour.

Other biosynthetic penicillins can be used for oral administration. Preparations of phenoxymethylpenicillin (Megacillin Oral ®, Penicillin v ®) and benzathine phenoxymethylpenicillin (Ospen) have good stability when taken orally, their bioavailability depends little on food intake.

Other long-acting natural penicillins (benzylpenicillin procaine and benzathine benzylpenicillin) are administered intramuscularly.

Semi-synthetic penicillins are also used orally (as a substitute for injectable penicillin):

• extended spectrum (and Amoxicillin ®);
• protected penicillins (/Clavulanate ®);
• combination of two antibiotics (Ampicillin ® /).

Antistaphylococcal Oxacillin is also available in tablet form.

Inhibitor-protected antipseudomonas protected penicillins (Ticarcillin/clavulanate ®, Piperacillin/tazobactam ®) and antipseudomonas unprotected penicillins are used only intravenously.

Penicillin ® - what is it?

Benzylpenicillin ® is a biosynthetic antibiotic, the first natural antimicrobial drug.

Penicillin suppresses the synthesis of cell wall components in bacteria, disrupting the resistance of the membrane, provoking the death of the pathogen. The mechanism of action of penicillins is bactericidal.

The drug has low toxicity and low cost, but at the moment the level of acquired resistance in staphylo-, gono-, pneumococci and bacteroides is quite high, which limits its use in the treatment of diseases caused by these pathogens.

An allergy to penicillin is the most common side effect of its use. Therefore, before use, be sure to test for tolerance.

The antibiotic is active against non-penicillinase-forming strains of staphylococci, streptococci, treponemas, the causative agent of anthrax and diphtheria, some gram-negative pathogens (meningococci), etc. Rickettsia and most gram pathogens, as well as penicillinase-producing strains, are resistant to penicillin.

Therapeutic concentration is achieved half an hour after intramuscular administration. The medicine is excreted from the body through urine and kidneys. It accumulates well in organs and tissues. However, it is not able to penetrate the prostate gland and does not overcome the blood-ophthalmic and unchanged blood-brain barriers.

Pharmacological group of penicillin ®

Beta-lactam antibiotics - penicillins.

Penicillin ® dosage forms

Benzylpenicillin is completely destroyed when exposed to an acidic environment, therefore it is not used orally and does not have a tablet form.

For injection produced as benzylpenicillin:

• sodium salt (penicillin g);
• potassium salt;
• procaine salt.

Procaine salt is characterized by the longest duration therapeutic action. Sodium is the least toxic and rarely leads to local tissue irritation when administered; it is used in pediatric practice.

Penicillin G is produced in the form of vials containing powder for making injection solution 500 thousand units and 1 million units each.

Procaine salt is available in three hundred thousand, six hundred thousand and 1.2 million units.

Penicillin ® recipe in Latin

Example of a prescription for penicillin in Latin:

Rp.: Benzylpenicillini-natrii 1000000ED
D.t.d. №10 in flac.
S. IM 1,000,000 units 4 times a day in 2 ml of water for injection

Indications and contraindications for the use of penicillin ®

Prescribed for the treatment of bacterial infections associated with sensitive flora.

Local penicillin ® can be used to gargle and drop into the nose (for purulent, bacterial runny nose).

One of the methods of treating conjunctivitis in children is instillation weak solution penicillin, but if you use this drug, you should consult your pediatrician, self-appointment not recommended. This is due to the fact that an allergy to penicillin occurs even when prescribed locally and can manifest itself not only as burning of the mucous membrane, redness of the eye, but also angioedema or anaphylactic shock.

Systemic penicillin ® can be prescribed to eliminate infections: wound, urinary tract, skin and gastrointestinal tract. For therapy, osteomyelitis, septic endocarditis, . And also for pyemia, diphtheria (in combination with toxoid), actinomycosis, anthrax. Used for ENT pathologies and in ophthalmological practice.

The drug is contraindicated in patients who are allergic to penicillin or other beta-lactam agents, as there is a high risk of cross-hypersensitivity. It is also not prescribed to newborns from mothers with penicillin intolerance.

Intralumbar administration is not used to treat patients with epilepsy.

Wed can be prescribed from birth, but for children under two years of age it is prescribed only for health reasons, strictly as prescribed by a doctor.

Potassium salt is contraindicated in patients with arrhythmias and hyperkalemia.

Use with caution for women carrying a child or breastfeeding.

Dosage and instructions for use of penicillin ® sodium salt in ampoules (injections)

Penicillin G can be used intramuscularly, intravenously (boost or drip administration) and subcutaneously, endolumbar and intratracheal administration are also sometimes used.

Since allergies to penicillin are quite common, a sensitivity test to the drug must be performed before administration.

Standard daily dosage for adults Penicillin g (intravenous administration) for moderate diseases is from one to two million units, with severe course infectious process– up to 20 million units.

The dosage administered at a time is from 250 thousand to five hundred thousand units. Penicillin is administered four times a day.

In patients with gas gangrene the daily dose ranges from 40 to 60 million units.

For babies up to one year old, from 50 to 100 thousand units/kg are administered per day. From a year – 50 thousand units/kg. At serious illness the dosage can be raised to two hundred to three hundred thousand units/kg. Daily dose should be divided into four to six administrations.

To comply with the penicillin dilution technique, the solution is prepared immediately before administration. When used intravenously, water for injection or 0.9% saline solution is used to dilute the powder. It is administered slowly over 5 to 10 minutes.

When administered by drip, dilute with 0.9% saline and administer within an hour and a half.

Intravenous use can be alternated with IM (one or two times IV per day, the rest intramuscularly).

For intramuscular administration, water for injection, procaine solution, and 0.9% saline solution are used to dilute the powder.

Standard dose (per day) for moderate infections:

• UAP (upper respiratory tract);
• LDP (lower respiratory tract);
• UVP (urinary);
• Bile ducts (bile ducts);
• Skin and fatty acids,

It ranges from 2.5 to 5 million units (for adults). The dose is administered 4 times.

The drug can also be used subcutaneously for injection purposes. inflammatory infiltrates. Penicillin in a dose of 100 to 200 thousand is diluted with a 0.25-0.5% solution of procaine (1 milliliter).

In ophthalmology it is used in a dose of 20 to 100 thousand, diluted with saline or distilled water. Prescribe 1-2 drops four to six times a day. Before using the drug, you must consult your doctor.

Features of the use of penicillin ®

It is important to remember that all parenteral penicillin solutions must be used immediately. Since during storage the solution breaks down into metabolites.

With prolonged use of an antibiotic, the risk of fungal diseases of the skin and mucous membranes increases, therefore, for the purpose of prevention, B vitamins are prescribed, ascorbic acid, antifungal agents (Nystatin ®, less commonly Levorin ®).

It must be remembered that courses of treatment that are insufficient in duration, as well as low dosages, can cause the formation of antibiotic-resistant strains of bacteria.

During penicillin therapy, it is forbidden to drink alcohol, as they are strictly incompatible, juices, sweets, yoghurts and milk. It is also recommended to exclude baked goods and carbonated drinks.

Symptoms of a drug overdose include convulsions, meningeal symptoms, loss of consciousness, electrolyte disturbances, arrhythmias.

Treatment of overdose is symptomatic. In severe cases, hemodialysis may be performed.

Penicillin can be used to treat women carrying a child, however, when prescribing the drug during lactation, it is recommended to stop breastfeeding. This is due to the ability of the antibiotic to penetrate milk and cause sensitization, dyspeptic disorders And fungal infections at the baby's.

If there is no effect from monotherapy with penicillin for three to five days, it is necessary to switch to combination antibacterial therapy or change the drug.
Penicillin cannot be combined with Allopurinol ® and may result in a non-allergic rash.

Also, it is not prescribed with tetracycline, due to the antagonistic interaction of benzylpenicillin with bacteriostatic antimicrobial agents.

WITH bactericidal antibiotics penicillin interacts synergistically.

Eliminates effectiveness hormonal contraceptives, increasing the risk unwanted pregnancy or bleeding (if they were used for therapeutic purposes).

It cannot be combined with anticoagulant drugs; this combination may cause bleeding. When prescribing an antibiotic to this category of patients, it is necessary to carefully and regularly monitor the prothrombin time.

The antibiotic does not affect the speed of mental and motor reactions, and also does not affect the ability to drive a car. However, it is important to consider the risk side effect drug to the central nervous system And cardiovascular system, because side effects may affect the ability to operate complex machinery.

Allergy to penicillin ® and other side effects from use

Undesirable effects from use may include an allergy to penicillin varying degrees gravity. Intolerance can manifest itself as urticaria, common and exfoliative dermatitis, arthralgia, bronchospachm, eosinophilia, angioedema, fever, erythema multiforme. Anaphylactic shock, thrombocytopenic purpura.

When using sodium salt (penicillin g), the pumping function of the heart may decrease.

Potassium is characterized by cardiac arrhythmias and hyperkalemia; in rare cases, cardiac arrest is possible.

Also possible: jades, meningeal symptoms, development of seizures.

A blood test may show a decrease in the number of leukocytes and neutrophils. Hemolytic anemia rarely develops.

Disorders from the gastrointestinal tract, phlebitis at the injection site may be observed (to prevent this, change the injection site every two days), etc.

During treatment of syphilis, Jarisch-Herxheimer syndrome may develop, characterized by chills, fever, muscle and joint pain, serum sickness, tachycardia, sharp decline Blood pressure (up to collapse), abdominal pain and rarely, heart failure.