Tiamphenicol glycinate acetylcysteineate
Latin name of the substance Tiamphenicola glycinate acetylcysteinate
Thiamphenicoli glycinas acetylcysteinas (born Thiamphenicoli glycinatis acetylcysteinatis)
[(2R,3R)-2-[(2,2-Dichloroacetyl)amino]-3-hydroxy-3-(4-methyl sulfonylphenyl)propyl] 2-amino-3-[[[(2R)-1-methyl sulfony-3-oxopropanol-2-il]amino]-3-oxopropanoate
Pharmacological group of the substance Tiamphenicol glycinate acetylcysteinate
Model clinical and pharmacological article 1
Pharmacy. Combined drug, the action of which is due to the components that make up it, has an antibacterial and expectorant effect. Tiamphenicol - broad-spectrum antibiotic (disrupts intracellular protein synthesis). Active against Streptococcus pneumoniae, Staphylococcus spp., Haemophilus influenzae, Klebsiella spp. The association with N-acetylcysteine prevents its destruction and provides bactericidal concentration in the inflammation area. Acetylcysteine is an expectorant, the effect of which is associated with the ability of its free sulfhydrilic groups to break the intra- and intermolecular disulphide bonds of mucopolysaccharides sputum, which leads to a decrease in its viscosity. Increases the secretion of less viscous sialomucines by glass-shaped cells, reduces the adhesion of bacteria on the epithelial cells of the bronchial mucous membrane. A similar effect has on the secret formed in inflammatory diseases of the nasopharynx and ear. It has an antioxidant effect due to the presence of an SH-group capable of neutralizing electrophilic oxidative toxins. Protects alpha1-antitrypsin (elastase inhibitor) from the inactivating effects of HOCl - a powerful oxidizer produced by myeloperoxidase of active phagocytes. Penetrating into the cell, acetylcysteine is deacetylated, releasing L-cysteine - an amino acid necessary for the synthesis of glutathione, which is an important antioxidant factor in intracellular protection.
Indications. Bronchitis, pneumonia, bronchoectatic disease, cystic fibrosis, lung abscess, lung emphysema, bronchiolitis, catarrhal and purulent otitis, maxillary sinusitis, pharyngitis, laryngotracheitis. Postoperative respiratory complications (prevention and treatment). Preparing for bronchoscopy, bronchography, aspiration drainage. For washing abscesses, nasal passages, sinuses, eardrum; fistula treatment, surgical field for operations on the nasal cavity and mastoid process.
Contraindications. Hypersensitivity; anemia, leukopenia, thrombocytopenia, lactation period.
With caution. Liver failure, CVD, children under 2 years of age (due to underdevelopment of kidney function), pregnancy.
Dosage. I/m, for adults - 500 mg 2-3 times a day; for children under 2 years - 125 mg 2 times a day; 3-6 years - 250 mg 2 times a day; 7-12 years - 250 mg 3 times a day. If necessary, the doses can be increased by 2 times. Course of treatment - no more than 10 days.
For premature and newborn children up to 2 weeks average dose - 25 mg/kg.
Patients over 65 years of age use minimum effective doses. Inhalation: for adults - 250 mg 1-2 times a day; for children - 125 mg 1-2 times a day.
Endotracheally, through bronchoscope, intubation tube, tracheostomu - 1-2 ml of solution (for adults dissolve 500 mg of dry matter, for children - 250 mg).
Local: 1-2 ml of the solution (500 mg of dry matter is dissolved for adults and 250 mg for children).
In case of nasopharynx and ear diseases, bury 2-4 caps in each nasal passage or external ear canal.
Side effect. Allergic reactions; reticulocytopenia, anemia; leukopenia, neutropenia, thrombocytopenia. When taken as an aerosol - stomatitis, rhinitis, nausea.
Special instructions. During treatment it is necessary to control the picture of peripheral blood. If the number of leukocytes (less than 4 thousand µl) and granulocytes (more than 40%) decreases, the drug is canceled.
Use during pregnancy and lactation is possible only when the potential benefit to the mother exceeds the potential risk to the fetus or newborn.
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