Antibiotic intravenously

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Can an intramuscular antibiotic be administered intravenously?

A friend told me how she used the antibiotic cefazolin . Since intramuscular administration of cefazolin, even together with lidocaine , is quite painful, the girl decided to inject herself with this antibiotic intravenously.

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And also together with lidocaine, the instructions for which she did not read. A friend diluted 1 g of cefazolin in 5 ml of 1% lidocaine and injected it intravenously in 5-10 seconds. The subsequent sensations caused by the side effects of the rapid administration of 2 drugs discouraged her from continuing any further IV treatment. I will tell you about the adverse reactions that arose a little later. The friend returned to intramuscular injection.

We will analyze whether antibiotics that were prescribed intramuscularly can be administered intravenously, and how to dilute the antibiotic powder from the bottle.

Back in 1976, it was proposed to divide all antibiotics into 2 groups. The effect of antibiotics of the first group depends on the duration of their presence in the lesion, the second group - on the maximum achieved concentration in the lesion.

Antibiotics have 2 effects on sensitive bacteria:

  • bacteriostatic (Greek statike - motionless ) - cessation of growth and reproduction of bacteria;
  • bactericidal (lat. cidere - kill ) - killing bacteria with subsequent decay.

There are antibiotics that provide only a bacteriostatic effect. Other antibiotics have a bacteriostatic effect in low doses, and a bactericidal effect in higher doses.

Now consider a figure showing the dependence of the concentration of a drug in the blood on the method of its administration.

Intraperitoneal administration is used mainly in animals

  • When administered intravenously, a very high concentration of the drug is immediately created in the blood, which quickly drops because the drug goes into the tissues, is destroyed and excreted by the liver and/or kidneys.
  • When administered intramuscularly, the antibiotic is absorbed more slowly into the blood from muscle tissue and acts longer, while the peak concentration is lower than when administered intravenously.
  • When the drug is taken orally, the active substance is slowly absorbed and excreted slowly, and the peak concentration is low.

Antibiotics whose effect depends on time

The method (where) and frequency (how many times per day) of administration of antibiotics of this group are aimed at maintaining the antibiotic content in the blood and at the site of infection for as long as possible in concentrations above the minimum (above the MIC). The main parameter is the time during which the concentration of the antibiotic in the blood is above the MIC.

So, the first group includes antibiotics for which time ( duration of action ) is important. Antibiotics in this group are often prescribed intramuscularly, since intravenous administration leads to large fluctuations in blood levels and insufficient effect. In intensive care units, in order to maintain a stable concentration of the drug in the blood when administered through an intravenous catheter, special dispensers are used ( infusion pumps, infusion pumps, infusers, syringe pumps ), which allow the medication to be administered for several hours.

Antibiotics for which time is more important (the first 4 groups belong to beta-lactam antibiotics):

  1. PENICILLINS: benzylpenicillin, ampicillin, amoxicillin, oxacillin, carbenicillin, ticarcillin, azlocillin , etc.

The sodium salt of benzylpenicillin in the bottle is diluted with saline solution (0.9% sodium chloride solution), water for injection or 0.25-0.5% novocaine solution. It is administered intramuscularly 4-6 times a day, intravenous administration is allowed (only when diluted in water for injection or saline).

Novocaine salt of benzylpenicillin ( procaine benzylpenicillin ) is diluted with water for injection or saline solution. It cannot be administered intravenously; it is administered intramuscularly.

Extended forms of penicillin, or bicillins ( benzathine benzylpenicillin ), are administered only intramuscularly, since they are sparingly soluble, are slowly absorbed and maintain the desired concentration of penicillin in the blood for a long time.

  • CEPHALOSPORINS: cefazolin, cephalexin, cefepime, cefixime, cefoperazone, cefotaxime, cefpirome, ceftazidime, ceftriaxone, cefuroxime , etc.
  • CARBAPENEMS: meropenem, ertapenem, doripenem .
  • MONOBACTAMS: aztreonam .
  • MACROLIDES: erythromycin, roxithromycin, clarithromycin, oleandomycin, spiramycin, midecamycin.

    Please note: azithromycin (trade name - sumamed ), belonging to the macrolide group, belongs to the second group of antibiotics. Its effect depends on the maximum concentration achieved. The reason is that azithromycin accumulates inside cells and is very effective against intracellular pathogens. The concentration of azithromycin in tissues and cells is several times higher than in blood plasma, and at the site of infection it is 24-34% higher than in healthy tissues. Azithromycin is taken once a day. It cannot be administered intramuscularly or intravenously in a stream; it can only be administered orally or intravenously slowly.

  • LINCOSAMIDES: lincomycin, clindamycin.

    • Antibiotics whose effect depends on concentration

    The second group of antibiotics gives maximum effect when the maximum concentration is reached. Typically, they can be administered intravenously.

    Antibiotics of the second group:

    1. AMINOGLICOSIDES: gentamicin, amikacin, kanamycin, netilmicin, streptomycin, tobramycin, framycetin, neomycin .

    Aminoglycosides are not absorbed in the intestine, so they are taken orally only for intestinal sanitation (due to high toxicity, neomycin is prescribed only orally). Traditionally, aminoglycosides are prescribed intramuscularly 2-3 times a day, but studies have shown that intravenous administration of the entire daily dose once a day is not only as effective, but also cheaper and has fewer side effects (aminoglycosides can impair the function of the kidneys and inner ear ). The only exception to intravenous administration once a day is bacterial endocarditis ( inflammation of the inner lining of the heart with predominant damage to the valves ), in which the traditional intramuscular administration regimen is recommended. In elderly patients and in cases of impaired renal function, caution is also required; in such cases, it is recommended to administer the daily dose of aminoglycoside intramuscularly in parts, and also determine the level of the drug in the blood before administration.

  • FLUOROQUINOLONES: ofloxacin, ciprofloxacin, norfloxacin, lomefloxacin, levofloxacin, sparfloxacin, grepafloxacin, moxifloxacin, gemifloxacin, gatifloxacin.

    Experiments on animals have proven the high antibacterial effectiveness of daily doses administered intravenously, however, high concentrations of fluoroquinolones can cause adverse reactions from the nervous system, so the daily dose of fluoroquinolone is administered intravenously, usually within minutes.

  • TETRACYCLINES: tetracycline, oxytetracycline, doxycycline, minocycline, tigecycline.

    AZITHROMYCIN (exclusion from the group of macrolides ).

    Solvents for antibiotic injections

    The most well-known 5 solvents for the preparation of injection dosage forms (dissolving the dry contents of bottles):

    • water for injections,
    • isotonic (0.9%) sodium chloride solution,
    • glucose solution (usually 5%),
    • novocaine solution,
    • lidocaine solution.

    All injection solvents must be purchased at a pharmacy, be sterile and opened immediately before use (ampoules, vials).

    WATER FOR INJECTION - sterile specially prepared water with low salt content. However, the introduction of large volumes of water for injection can disrupt the ion-salt balance in the body, so for volumetric infusions (infusions) saline or Ringer's solution (contains sodium, potassium and calcium chlorides) is used.

    Standards for the content of microbes in water for injection in the USA and Europe are a thousand times stricter than in Russia

    How to obtain water for injections

    Source: same

    ISOTONIC (0.9%) SODIUM CHLORIDE SOLUTION ( saline, saline ) has an osmotic salt pressure equal to the osmotic pressure of blood plasma. The introduction of saline does not cause additional movement of fluid in or out of the blood vessels. However, saline solution contains sodium chloride (table salt), which may be undesirable for dissolving single antibiotics.

    It is safest to dilute any antibiotic in water for injection. It is also usually possible to use an isotonic sodium chloride solution (read the instructions for the antibiotic). For intravenous administration, antibiotics must be diluted in water for injection or saline (no anesthetics for intravenous administration).

    Sometimes a 5% GLUCOSE SOLUTION is used to dissolve drugs. Is it possible to dilute an antibiotic with a solution of 5% glucose? In many cases it is possible, but not in all, so always refer to the instructions for the drug. Glucose solution is destroyed when stored in a glass container with residual alkali, so hydrochloric acid (HCl) is added to it for stability. Glucose itself, being a strong oxidizing agent, can also enter into chemical reactions. Therefore, a number of drugs are prohibited from being dissolved in glucose, starting with ascorbic acid and cardiac glycosides and ending with the antibiotics benzylpenicillin, lincomycin, streptomycin .

    Intramuscular administration of cefazolin is very painful, so it is usually diluted with a local anesthetic (an anesthetic that blocks pain receptors). Previously, a solution of NOVOCAINE (procaine) was widely used in medicine. Is it possible to dilute antibiotics in a solution of novocaine? Not all. Novocaine injection solutions are also stabilized with hydrochloric acid, so some antibiotics can be destroyed in an acidic environment: ampicillin (can only be diluted in water for injection), amphotericin B (only in water for injection). A solution of streptomycin in novocaine can be stored for no more than 6 hours. As for benzylpenicillin , its decomposition in an acidic environment does not occur immediately, but gradually: after 30 minutes - 1.5%, after 24 hours - 40%. Hence the conclusion: benzylpenicillin can be dissolved in novocaine, but only before use. Unused benzylpenicillin solution cannot be stored. You may ask: how is the novocaine salt of benzylpenicillin (procaine benzylpenicillin) made? In this case, novocaine is not stabilized by hydrochloric acid, and before administration the drug is diluted with water for injection.

    Novocaine has now lost its former role and has been replaced by LIDOCAINE since the mid-1990s. Lidocaine is 2 times better than novocaine in terms of strength and duration of pain relief, and also works well in inflamed tissues. Lidocaine is less likely to cause allergies and is considered less toxic.

    According to the instructions for cefazolin , for intramuscular administration it can be diluted with lidocaine . Lidocaine is not only a local anesthetic, but also an antiarrhythmic drug (treatment of ventricular arrhythmias). Lidocaine causes many unwanted reactions, especially when administered quickly or in high doses.

    From the nervous system and sensory organs: depression or stimulation of the central nervous system, nervousness, euphoria, flashing “floaters” before the eyes, photophobia, drowsiness, headache, dizziness, tinnitus, diplopia, impaired consciousness, depression or cessation of breathing, muscle twitching, tremor, disorientation, convulsions (the risk of their development increases against the background of hypercapnia and acidosis).

    From the cardiovascular system and blood (hematopoiesis, hemostasis): sinus bradycardia, cardiac conduction disturbances, transverse heart block, decreased or increased blood pressure, collapse.

    From the gastrointestinal tract: nausea, vomiting.

    Allergic reactions: generalized exfoliative dermatitis, anaphylactic shock, angioedema, contact dermatitis (hyperemia at the site of application, skin rash, urticaria, itching), short-term burning sensation in the area of ​​action of the aerosol or at the site of application of the plate.

    Other: sensation of heat, cold or numbness of the extremities, malignant hyperthermia, suppression of the immune system.

    A friend told me that she diluted 1 g of cefazolin in 5 ml of 1% lidocaine and injected it intravenously in 5-10 seconds. Not even half a minute had passed before she “ turned inside out ” (severe vomiting occurred). Fortunately, after a few minutes the condition returned to normal, but the vomiting greatly frightened the friend. Nausea and vomiting can be side effects not only of lidocaine, but also of cefazolin, and in our case, the side effects of the 2 drugs and their rapid administration probably overlapped. This dose of lidocaine should not be administered intravenously in less than 1 minute. Although it could have been worse - for example, convulsions.

    When administered intravenously, the instructions for cefazolin recommend administration within 3-5 minutes. If you ignore the instructions, you can seriously harm yourself.

    • ex tempore (Latin “ from time ”) - as needed, immediately, without storage;
    • parenteral (from the Greek para - about , enteron - intestines ) - the introduction of medicine into the body, bypassing the gastrointestinal tract. Parenteral administration includes injections (intravenously, intramuscularly, subcutaneously, etc.), as well as inhalations, intranasal, intraosseous, subconjunctival administration, etc.;
    • bolus administration (lat. bolus - lump, piece ) - parenteral administration of the drug in a short time (usually no more than 3-5 minutes) in contrast to a longer infusion (dropper). The concepts of “ intravenous bolus ” and “ intravenous bolus ” are practically the same.

    The main thing from the article

    1. Antibiotics are divided into 2 groups. For the first group, time is important (long-term maintenance of the desired concentration in the blood), this includes all beta-dactam antibiotics ( penicillins, cephalosporins, carbapenems, monobactams ), macrolides (with the exception of azithromycin) and lincosamides .

    For the second group, the peak concentration of the antibiotic in the lesion is more important; these include aminoglycosides, fluoroquinolones, tetracyclines, azithromycin and vancomycin .

  • It is strictly forbidden to administer intravenously long-acting antibiotics, which are allowed to be administered only intramuscularly (for example, bicillin-1, bicillin-3, bicillin-5 ). If bicillin is administered intravenously, a serious complication is likely - embolism ( blockage with insoluble particles ) of the vessels of the lungs and brain, which can lead to organ infarction and death. Intra-arterial administration of bicillin will clog small arteries and lead to gangrene (death) of a limb or other part of the body. It is recommended that immediately before administering bicillin intramuscularly, pull the syringe plunger towards you to make sure that no blood enters the syringe (that the needle does not accidentally enter the vessel).
  • For intravenous administration, the antibiotic is diluted in water for injection. You can use saline solution or 5% glucose solution for dissolution only if this is allowed by the instructions for the antibiotic. lidocaine can be used to dilute the antibiotic for intramuscular administration , if this is permitted in the instructions for the drug.
  • You cannot administer an antibiotic in the same syringe with any other drugs, unless specifically permitted by the instructions. For example, mutual inactivation of drugs is possible—loss of activity (for example, penicillins and cephalosporins inactivate aminoglycosides when mixed, but when administered separately into the body they enhance each other’s effects). It is not advisable to self-administer antibiotics and other drugs.
  • Only freshly prepared antibiotic solutions should be administered. Soluble antibiotics may degrade or react with the solvent and therefore should not usually be stored.
  • The final decision regarding the antibiotic regimen is made by the attending physician, taking into account the diagnosis, concomitant diseases and risk factors.
  • Be sure to read the instructions for your medications. If it is written that the drug must be administered intravenously over 3-5 minutes or the rate of administration is indicated, it must be understood that faster administration may be fraught with complications.

    • My comments regarding the treatment of a friend

    • She was prescribed cefazolin to treat a cough with purulent sputum. Antibiotics must be prescribed in case of pneumonia (pneumonia), and bronchitis is not an indication for the mandatory prescription of an antibiotic.
    • Antibiotics are often prescribed irrationally: without indications, inappropriately, or with the wrong dosage regimen. In this case, cefazolin intramuscularly 2 times a day can be replaced with cephalexin orally 3 times a day. Cefazolin and cephalexin are 1st generation cephalosporins, have an almost identical spectrum of action and cost approximately the same.
    • It was possible to add to the treatment the anti-inflammatory immunomodulator Galavit, which is effective against purulent infections, enhances the effect of antibiotics (but can be used without them) and does not produce side effects. And to kindle mucus and reduce inflammation, I usually recommend the complex herbal preparation Bronchipret .

    Regarding cough prevention

    • Do not smoke - smoking disrupts the protective function of the ciliated epithelium of the respiratory tract. Over the years, the cough becomes chronic (“ smoker’s cough ”).
    • To prevent purulent complications of respiratory infections (including in smokers), I recommend using bacterial lysates: Ismigen (Respibron), Bronchomunal and others. I wrote a detailed article on this topic earlier. Bacterial lysates will not be able to protect against the occurrence of acute respiratory infections/ARVI, but will significantly reduce the severity of the disease and the risk of complications.

    When writing this article, the material was used: The influence of the pharmacodynamics of various classes of antibacterial drugs on their dosage regimens (Strachunsky L. S., Mukonin A. A. Smolensk State Medical Academy. ANTIBIOTICS AND CHEMOTHERAPY, 2000 - N4, pp. 40-44).

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    Source: http://www.happydoctor.ru/info/1955

    Benefits of broad-spectrum injectable antibiotics

    Antibiotics are a large group of medicines whose action is aimed at combating infectious and inflammatory diseases.

    At the moment, the list of drugs has changed significantly; they are prescribed more and more often due to their wide spectrum of action. In more severe conditions, injections of the drug are required, since their use has a number of advantages.

    We will look at which ones exactly in this article.

    Features of the main groups of antibiotics

    The following groups of antibiotic drugs are most often used by injection:

    1. Cephalosporins are broad-spectrum antibiotics that are effective in pneumonia, gynecology, and urology. It is administered both intravenously and intramuscularly. This group rarely causes allergies and is better tolerated than penicillins. Approved for use by infants and pregnant women. Representatives include Tseporin.

    Penicillins are widely used for sore throat, otitis, pneumonia, skin diseases, and cystitis. These drugs often develop allergies, expressed by urticaria, rash, and shortness of breath.

    Parasitologist Rykov S.V.: statistics show that more than 78% of the country's population is infected with PARASITES.

    Often, prolonged diseases of the nasopharynx are caused by helminths, which can move freely throughout the body. Many people find out about the presence of parasites in the nose or throat by chance when they consult a doctor.

    Read the interview with the head of parasitology —>

    Penicillins are approved for use by pregnant women and infants. When treated with this group, birth control pills become less effective. Representatives include: Ampicillin, Biomycin, Amoxicillin.

    Macrolides are prescribed for bronchitis, sore throat, and whooping cough. This group is less effective than the previous two, as it acts to stop reproduction.

    Medicines of this type rarely lead to the development of allergies. A course of treatment with macrolides cannot be repeated within 3 months, because bacteria quickly develop resistance to this group. The representative is Azithromycin.

  • Fluoroquinols treat otitis media, bronchitis, cystitis, and chlamydia. These rather strong broad-spectrum antibiotics are contraindicated for pregnant women and infants because they disrupt the formation of the skeleton. The drugs include: Levofloxacin, Gatifloxacin.

    • Broad-spectrum antibiotics of other groups are also used:

    1. Tetracycline series (Tetracycline).
    2. Carbapenem series (Ertapenem, Meropenem).
    3. Amphenicol series (Chloramphenicol).
    4. Aminoglycoside series (Streptomycin).

    Important! The prescription of drugs occurs when the causative agent of the infection is identified, since a specific drug has an effect on certain pathogenic microorganisms.

    Doctors prescribe antibiotic injections in extreme cases. Almost all broad-spectrum antibiotics are available in the form of tablets, capsules and suspensions.

    Only a specialist decides whether to prescribe the drug in injections. Most often, injections are used for the following diseases:

    Benefits of injections

    Injectable broad-spectrum antibiotics are better than tablets for a number of reasons. Among the advantages of injections are the following:

    • tablets harm the stomach and entire digestive tract. This is especially true for people suffering from diseases of the gastrointestinal tract;
    • pills harm your kidneys. It is especially difficult for people with kidney failure, because up to 80% of the tablets are excreted through the kidneys;
    • treatment with injections is much faster than with pills;
    • an injection is the only remedy that is suitable for seriously ill patients who are in an unconscious or inadequate state;
    • Injectable antibiotics have few side effects.

    Areas of application of injectable antibiotic drugs

    The presence of some serious diseases often requires the use of injections. The choice of medication is based on the infection that caused the illness.

    Pneumonia

    Most often, pneumonia is treated with a group of macrolides, because fluoroquinols are ineffective, and pathogens are not sensitive to tetracyclines. Typically, treatment for pneumonia takes about 10 days.

    If the condition improves, it is dangerous to stop taking it yourself, because this leads to bacterial resistance.

    An untreated disease is more complicated and less treatable. Most often, injections are given with the following drugs:

    • Ceftriaxone is administered 2 times a day;
    • Sulbactam in combination with Amoxicillin is given 3 times a day.
    • Azithromycin is administered only by drip.

    to contents ↑

    Situations arise when treatment of ARVI involves the administration of a broad-spectrum antibiotic.

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    You cannot use them on your own, but there are quite good reasons for prescribing them, these are:

    • weakened immune system;
    • chronic otitis;
    • gastrointestinal disorders;
    • purulent infections;
    • accession of sore throat.

    In the case of ARVI, it is possible to determine which drug will be effective based on the localization of the process and the patient’s condition. The most effective groups of drugs:

    1. Cephalosporins. Used when complications from the respiratory system occur.
    2. Fluoroquinolones. They have excellent bactericidal effects. Not suitable for children.
    3. Macrolides. Used for sore throat, otitis, sinusitis.
    4. Penicillins. widely used to treat children.

    to contents ↑

    Gynecology

    In gynecology, treatment is often carried out using injectable drugs.

    If the patient has an acute course of the disease, then first treatment with broad-spectrum antibiotics is started, which help fight a large number of pathogens of the inflammatory process.

    Then, after diagnosis and identification of the pathogen, medications are prescribed to help cope with the established infection.

    In gynecology, local injections are often used; most often the injection is placed in:

    The following diseases are treated using a similar method:

    It is better to do the procedures in the department; the finest needles are used to reduce pain. For a complete cure, it is necessary to complete a full course of antibiotic therapy.

    Injection therapy helps better than tablets, since there is a direct effect on the inflammatory focus. In gynecology, the following groups of antibiotics are most often used:

    1. Penicillins. They are widely used for female diseases, and the injection can be given either intramuscularly or at the site of the inflammatory process.
    2. Often, for inflammation of the uterus and appendages, broad-spectrum macrolide antibiotics are prescribed.
    3. If there is a suspicion of an aerobic infection, then along with the tetracycline series, Metronidazole is used, which suppresses the activity of bacteria developing in the air.

    There are times when injectable medications are preferable to tablets. However, you need to remember that self-medication can cause more harm, so drugs should be used only as prescribed by a specialist.

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    Source: http://oantibiotikah.ru/preparaty/primenenie-antibiotikov-v-ukolax.html

    Names of antibiotics in injections

    Antibiotics are a group of drugs, natural or semi-synthetic origin, that suppress the growth or cause complete death of living cells (prokaryotes and protozoa).

    There are two subgroups of antibiotics:

    • bacteriostatic (bacteria lose the ability to reproduce, but remain alive)
    • bactericidal (bacteria die and then are naturally removed from the body).

    The classification is based on the general composition of the product. There are beta-lactam antibiotics (penicillins and cephalosporins), macrolides, tetracyclines, aminoglycosides, chloramphenicol, glycopeptide and anti-tuberculosis.

    Broad-spectrum antibiotics are combination drugs, due to their effect on various types of bacteria, they are highly effective in treating a large number of diseases. Narrow spectrum – these are those that have an effect on one specific type of bacteria.

    When to be treated with antibiotics, indications

    According to the instructions for use, each antibiotic has a minimum required period of use, frequency and dosage. Due to the direct connection between the negative effects of these drugs on the gastrointestinal tract, and as a result on the general state of the body’s protective functions, the question arises of the relevance of taking it in a particular case.

    It is useless to take this type of means of influencing viral infections, which include:

    • Colds, flu, runny nose, acute bronchitis, as well as sore throat not caused by streptococci.
    • Ear viral infections

    The main indications for antibiotic treatment should be highlighted:

    • Purulent processes (swelling of the face or orbit with sinusitis)
    • Tonsillitis with culture of group A streptococcus
    • Sore throat anaerobic, inherent putrid odor, ulcers
    • Acute moderate otitis, which is confirmed by otoscopy
    • Atypical pneumonia
    • Pneumonia
    • Sinusitis, if changes in the sinuses persist, with ARVI, if at least a day has passed since the illness.

    The causative agents of bacterial infections are very often considered to be those bacteria that constantly live in the nasopharynx and oral cavity.

    They do not harm the body, since their increase is strictly controlled by the cells of the immune system.

    If this interaction is imbalanced, viral-bacterial diseases manifest themselves.

    Intravenous antibiotics are drugs that are specifically administered directly into the blood. Intravenous administration is an alternative to topical and oral antibiotics.

    For intravenous administration, catheters, infusion pumps, and ordinary syringes are used. In fact, antibiotics are added to the catheter or bag of sterile saline solution to ensure even infusion. Which method to choose depends on the general health of the patient and the characteristics of the drug.

    For treatment with intravenous antibiotics, mandatory additional examinations are inevitable, and testing to identify the type of infection is possible. For dosage, the guideline is the weight of the patient, in order to avoid oversaturation, so-called overdose, or insufficient amount in the fight against microorganisms.

    Intravenous antibiotics provide immediate effect. They are mainly used against advanced conditions, infections with complications, because they guarantee the rapid effect of these drugs, which is very important in certain unforeseen situations.

    Ensuring immediate action, in which the medicine reaches the site of infection by entering it directly into the blood.

    Intramuscular antibiotics

    To administer antibiotics intramuscularly, it should be taken into account that muscle tissue has a huge number of lymphatic and blood vessels, which ensures that the drug is administered quickly, ensuring maximum absorption.

    To answer the question whether all antibiotics can be administered intramuscularly and intravenously, or perhaps there are drugs that can only be administered using one of the above methods.

    There are antibiotics that have an exclusively bacteriostatic effect. Other antibiotics, depending on the dosage, at higher doses they are bactericidal, and at minimum doses they are bacteriostatic.

    As a result, the following patterns of drug concentration and exposure time to bacteria are identified:

    • The maximum concentration in the blood occurs when the drug is administered intravenously, followed by an immediate decrease in concentration due to its distribution throughout the tissues, followed by natural excretion through the kidneys or liver.
    • Longer exposure to the antibiotic due to relatively slow absorption into the blood from muscle tissue, which necessarily affects the maximum concentration; it is significantly lower than when the drug is infused intravenously.
    • The lowest concentration when taking the drug orally, slow absorption by the body, and also slow elimination.

    In fact, for intramuscular antibiotics, the effect time is characteristic, because with intravenous administration the effect is insufficient due to huge fluctuations in saturation in the blood. An example of these drugs: penicillins, cephalosporins, carbapenems, monobactams, macrolides, lincosamides.

    The mechanism of action of antibiotics in injections in adults

    An antibiotic, no matter how it was administered, ends up in the blood. Intramuscular administration and intravenous injections do not contradict, but rather contribute to the distribution of the drug throughout the body.

    Penicillin and ampicillin are excellent in the treatment of otitis, although ampicillin has a better ability to accumulate in the middle ear, which in this situation will be more effective.

    Lincomycin has excellent ability to penetrate bones, this ability is used in the treatment of osteomyelitis, a purulent inflammation of the bone. This drug will be effective only in the form of injections, since when administered orally it does not have the ability to be absorbed into the blood.

    Rules for treatment with antibacterial drugs:

    • Prescription of antibacterial drugs is possible only by a medical specialist
    • Antibiotics are not used in the treatment of viral infections; you can get the exact opposite result.
    • Strictly adhere to the medication regimen, dosage, frequency
    • It is forbidden to independently adjust the dosage or stop taking it.
    • It is forbidden to combine antibacterial drugs with physical activity until complete recovery.
    • Consumption of alcoholic beverages is prohibited
    • A proper diet will help to avoid dysbacteriosis as much as possible.

    The technique of performing an antibiotic sensitivity test is a mandatory procedure for early diagnosis of the disease and in deciding the treatment mechanism for the patient.

    The main stages of the procedure should be highlighted:

    • Prepare the medicine, solvent (water for injection or sodium chloride of appropriate concentration is suitable), sterile cotton wool, ethyl alcohol 70%. Sterile instruments are required: needles, syringes, gloves
    • Psychological preparation of the patient for manipulation is mandatory

    When performing a skin test, you should:

    1. Hands are treated hygienically, sterile gloves are put on;
    2. The antibiotic is diluted with isotonic sodium chloride solution at the rate of 1 ml of solvent per unit.
    3. A syringe is filled with 0.1 ml of drug solution
    4. 0.9 ml of solvent gets into the syringe
    5. Prepare a syringe in a tray on a sterile napkin, 2 cotton balls soaked in alcohol, covered with a sterile napkin;
    6. Wipe the middle third of the palmar surface of the forearm with an alcohol-soaked cotton ball;
    7. After noting the time, apply one drop

    The result is read as follows:

    • in case of any reaction within 30 minutes, the medicine is not suitable for the patient
    • if no reaction is detected after 30 minutes, you can do a scratch test, which is similar in the preparation mechanism to the 6th point of the skin test mechanism, then there are the following additions:
    • Two parallel non-bloody scratches are made with a needle
    • Time is fixed
    • Disinfection of used instruments.
    1. 0.1 ml of the drug solution is injected under the skin
    2. The time is recorded;
    3. Used instruments are disinfected

    When reading the result, you must follow the principles:

    • Time intervals of 20 minutes, 1 hour, 2 hours and every next 2 hours up to 24 hours from the onset of action are taken into account
    • A positive result is considered in case of any reaction (swelling, redness);
    • If the result is negative, this drug is suitable for the patient for treatment;
    • The result must be recorded in the medical history.

    Source: http://stopzaraza.com/lechenie/antibiotiki-v-ukolax.html

    Ceftriaxone

    Description current as of 07/21/2015
    • Latin name: Ceftriaxone
    • ATX code: J01DD04
    • Active ingredient: Ceftriaxone
    • Manufacturer: JSC Pharmaceutical Company Darnitsa (Ukraine), Shreya Life Sciences Pvt. Ltd. (India), JSC LECCO (Russia)

    Compound

    The drug contains ceftriaxone, an antibiotic from the class of cephalosporins (β-lactam antibiotics whose chemical structure is based on 7-ACA).

    What is Ceftriaxone?

    According to Wikipedia, ceftriaxone is an antibiotic whose bactericidal effect is due to its ability to disrupt the synthesis of peptidoglycan in bacterial cell walls.

    The substance is a slightly hygroscopic, finely crystalline powder of yellowish or white color. One bottle of the drug contains 0.25, 0.5, 1 or 2 grams of sterile sodium salt of ceftriaxone.

    Release form

    Powder 0.25/0.5/1/2 g for preparation:

    Ceftriaxone is not available in tablets or syrup.

    pharmachologic effect

    Bactericidal. A third-generation drug from the “Cephalosporins” group of antibiotics.

    Pharmacodynamics and pharmacokinetics

    A universal antibacterial agent, the mechanism of action of which is determined by the ability to suppress the synthesis of the bacterial cell wall. The drug exhibits greater resistance to most β-lactamases of Gram (+) and Gram (-) microorganisms.

    Active regarding:

    • Gram (+) aerobes - St. aureus (including penicillinase-producing strains) and Epidermidis, Streptococcus (pneumoniae, pyogenes, viridans group);
    • Gram (-) aerobes - Enterobacter aerogenes and cloacae, Acinetobacter calcoaceticus, Haemophilus influenzae (including penicillinase-producing strains) and parainfluenzae, Borrelia burgdorferi, Klebsiella spp. (including pneumoniae), Escherichia coli, Moraxella catarrhalis and diplococci of the genus Neisseria (including penicillinase-producing strains), Morganella morganii, Proteus vulgaris and Proteus mirabilis, Neisseria meningitidis, Serratia spp., some strains of Pseudomonas aeruginosa;
    • anaerobes - Clostridium spp. (exception: Clostridium difficile), Bacteroides fragilis, Peptostreptococcus spp..

    In vitro (clinical significance remains unknown) activity is observed against strains of the following bacteria: Citrobacter diversus and freundii, Salmonella spp. (including against Salmonella typhi), Providencia spp. (including in relation to Providencia rettgeri), Shigella spp.; Bacteroides bivius, Streptococcus agalactiae, Bacteroides melaninogenicus.

    Methicillin-resistant Staphylococcus, many strains of Enterococcus (including Str. faecalis) and group D Streptococcus are resistant to cephalosporin antibiotics (including ceftriaxone).

    • bioavailability - 100%;
    • T Cmax when Ceftriaxone is administered intravenously - at the end of the infusion, when administered intramuscularly;
    • connection with plasma proteins - from 83 to 96%;
    • T1/2 with intramuscular administration - from 5.8 to 8.7 hours, with intravenous administration - from 4.3 to 15.7 hours (depending on the disease, the patient’s age and the condition of his kidneys).

    In adults, the concentration of ceftriaxone in the cerebrospinal fluid when administered 50 mg/kg after 2-24 hours is many times higher than the MIC (minimum inhibitory concentration) for the most common pathogens of meningococcal infection. The drug penetrates well into the cerebrospinal fluid during inflammation of the meninges.

    Ceftriaxone is excreted unchanged:

    • kidneys - by 33-67% (in newborn babies this figure is 70%);
    • with bile into the intestines (where the drug is inactivated) - by 40-50%.

    Indications for use of Ceftriaxone

    The annotation states that the indications for the use of Ceftriaxone are infections caused by bacteria sensitive to the drug. Intravenous infusions and injections of medications are prescribed to treat:

    The drug is also used for perioperative prophylaxis and for the treatment of immunocompromised patients.

    What is Ceftriaxone used for for syphilis?

    Although penicillin is the drug of choice for various forms of syphilis, its effectiveness may be limited in some cases.

    The use of cephalosporin antibiotics is resorted to as a backup option in case of intolerance to drugs of the penicillin group.

    The valuable properties of the drug are:

    • the presence in its composition of chemical substances that have the ability to suppress the formation of cell membranes and mucopeptide synthesis in the walls of bacterial cells;
    • the ability to quickly penetrate organs, fluids and tissues of the body and, in particular, into the cerebrospinal fluid, which in patients with syphilis undergoes many specific changes;
    • Possibility of use for the treatment of pregnant women.

    The medicine is most effective in cases where the causative agent of the disease is Treponema pallidum, since the distinctive feature of Ceftriaxone is its high treponemocidal activity. The positive effect is especially pronounced with intramuscular administration of the drug.

    Treatment of syphilis with the use of the drug gives good results not only in the early stages of the disease, but also in advanced cases: with neurosyphilis, as well as with secondary and latent syphilis.

    Since T1/2 of Ceftriaxone is approximately 8 hours, the drug can be used equally successfully in both inpatient and outpatient treatment regimens. It is enough to administer the drug to the patient once a day.

    For preventive treatment, the drug is administered over 5 days, for primary syphilis - a 10-day course, early latent and secondary syphilis are treated within 3 weeks.

    For non-advanced forms of neurosyphilis, the patient is administered a single dose of 1-2 g of Ceftriaxone for 20 days; in the later stages of the disease, the drug is administered at a dose of 1 g/day. for 3 weeks, after which an interval of 14 days is maintained and treatment with a similar dosage is carried out for 10 days.

    For acute generalized meningitis and syphilitic meningoencephalitis, the dose is increased to 5 g/day.

    Ceftriaxone injections: why is the drug prescribed for angina in adults and children?

    Despite the fact that the antibiotic is effective for various lesions of the nasopharynx (including sore throat and sinusitis), it is, as a rule, rarely used as a drug of choice, especially in pediatrics.

    For angina, the medicine can be administered through a dropper into a vein or in the form of regular injections into the muscle. However, in the vast majority of cases, the patient is prescribed intramuscular injections. The solution is prepared immediately before use. The finished mixture remains stable at room temperature for 6 hours after preparation.

    For children with angina, Ceftriaxone is prescribed in exceptional cases when acute angina is complicated by severe suppuration and inflammation.

    The appropriate dosage is determined by the attending physician.

    During pregnancy, the drug is prescribed in cases where penicillin antibiotics are not effective. Although the medicine crosses the placental barrier, it does not have a significant effect on the health and development of the fetus.

    Treatment of sinusitis with Ceftriaxone

    For sinusitis, antibacterial agents are first-line drugs. Completely penetrating the blood, Ceftriaxone is retained at the site of inflammation in the required concentrations.

    As a rule, the medicine is prescribed in combination with mucolytics, vasoconstrictors, etc.

    How to inject the drug for sinusitis? Typically, the patient is prescribed Ceftriaxone to be injected into the muscle twice a day, 0.5-1 g. Before injection, the powder is mixed with Lidocaine (it is preferable to use a one percent solution) or d/i water.

    Treatment lasts at least 1 week.

    Contraindications

    Ceftriaxone is not prescribed in case of known hypersensitivity to cephalosporin antibiotics or auxiliary components of the drug.

    Side effects of Ceftriaxone

    Side effects of the drug appear as:

    If the medicine is administered intravenously, inflammation of the venous wall, as well as pain along the vein, is possible. The injection of the drug into the muscle is accompanied by pain at the injection site.

    Ceftriaxone (injections and IV infusion) may also affect laboratory parameters. The patient's prothrombin time decreases (or increases), the activity of alkaline phosphatase and liver transaminases increases, as well as the concentration of urea, hypercreatininemia, hyperbilirubinemia, and glycosuria develop.

    Reviews of the side effects of Ceftriaxone allow us to conclude that with intramuscular administration of the drug, almost 100% of patients complain of severe pain from the injection, some report muscle pain, dizziness, chills, weakness, itching and rash.

    The injections are easiest to tolerate if you dilute the powder with an anesthetic. In this case, it is necessary to do a test both for the drug itself and for the painkiller.

    Instructions for use of Ceftriaxone. How to dilute Ceftriaxone for injection?

    The manufacturer's instructions and the Vidal reference book indicate that the drug can be injected into a vein or into a muscle.

    Dosage for adults and children over 12 years of age/day. The antibiotic is administered once or once every 12 hours at half the dose.

    In particularly serious cases, as well as if the infection is caused by a pathogen moderately sensitive to Ceftriaxone, the dose is increased to 4 g/day.

    For gonorrhea, a single injection of 250 mg of the drug into the muscle is recommended.

    For preventive purposes, before an infected or suspected infected operation, depending on the degree of danger of infectious complications, the patient should be administered a single dose of 1-2 g of Ceftriaxone 0.5-1.5 hours before surgery.

    For children in the first 2 weeks of life, the medicine is administered 1 time per day. The dose is calculated using the formula mg/kg/day. The highest dose is 50 mg/kg (which is due to the underdevelopment of the enzyme system).

    The optimal dosage for children under 12 years of age (including infants) is also selected depending on weight. The daily dose varies from 20 to 75 mg/kg. For children weighing more than 50 kg, Ceftriaxone is prescribed in the same dose as for adults.

    Doses greater than 50 mg/kg should be administered as an intravenous infusion over at least 30 minutes.

    For bacterial meningitis, treatment begins with a single dose of 100 mg/kg/day. The highest dose is 4 g. As soon as the pathogen is isolated and its sensitivity to the drug is determined, the dose is reduced.

    Reviews about the drug (in particular, about its use in children) allow us to conclude that the drug is very effective and affordable, but its significant drawback is severe pain at the injection site. As for side effects, according to the patients themselves, there are no more of them than with any other antibiotic.

    How many days to inject the drug?

    The duration of treatment depends on what pathogenic microflora causes the disease, as well as on the characteristics of the clinical picture. If the causative agent is Gram (-) diplococci of the genus Neisseria, the best results can be achieved in 4 days, if enterobacteria are sensitive to the drug - posterior.

    Ceftriaxone injections: instructions for use. How to dilute the drug?

    To dilute the antibiotic, use Lidocaine solution (1 or 2%) or water for injection (d/i).

    When using water d/i, it should be taken into account that intramuscular injections of the drug are very painful, so if the solvent is water, there will be discomfort both during the injection and for some time after it.

    Water for diluting the powder is usually taken in cases where the use of Lidocaine is impossible due to the patient being allergic to it.

    The best option is a one percent solution of Lidocaine. It is better to use water as an adjuvant when diluting the drug with Lidocaine 2%.

    Is it possible to dilute Novocaine with Ceftriaxone?

    Novocaine, when used to dilute the drug, reduces the activity of the antibiotic, while at the same time increasing the likelihood of the patient developing anaphylactic shock.

    Based on the reviews of the patients themselves, they note that Lidocaine is better than Novocaine in relieving pain when Ceftriaxone is administered.

    In addition, the use of a non-freshly prepared solution of Ceftriaxone with Novocaine increases pain during injection (the solution remains stable for 6 hours after preparation).

    How to dilute Ceftriaxone with Novocaine?

    If Novocain is used as a solvent, it is taken in a volume of 5 ml per 1 g of the drug. If you take a smaller amount of Novocaine, the powder may not completely dissolve, and the syringe needle will become clogged with lumps of medicine.

    Dilution with Lidocaine 1%

    For injection into the muscle, 0.5 g of the drug is dissolved in 2 ml of a one percent solution of Lidocaine (the contents of one ampoule); For 1 g of the drug take 3.6 ml of solvent.

    The dosage of 0.25 g is diluted in the same way as 0.5 g, that is, with the contents of 1 ampoule of 1% Lidocaine. After this, the finished solution is drawn into different syringes, half the volume in each.

    The medicine is injected deep into the gluteal muscle (no more than 1 g in each buttock).

    The drug diluted with Lidocaine is not intended for intravenous administration. It is allowed to be injected strictly into the muscle.

    How to dilute Ceftriaxone injections with Lidocaine 2%?

    To dilute 1 g of the drug, take 1.8 ml of water and two percent Lidocaine. To dilute 0.5 g of the drug, also mix 1.8 ml of Lidocaine with 1.8 ml of water, but only half of the resulting solution (1.8 ml) is used for dissolution. To dilute 0.25 g of the drug, take 0.9 ml of a solvent prepared in a similar way.

    Ceftriaxone: how to dilute children for intramuscular administration?

    This method of intramuscular injection is practically not used in pediatric practice, since Ceftriaxone with novocaine can cause severe anaphylactic shock in a child, and in combination with lidocaine, it can contribute to the occurrence of convulsions and disruption of the heart.

    For this reason, the optimal solvent when using the drug in children is ordinary water. The impossibility of using painkillers in childhood requires an even slower and more careful administration of the medicine in order to reduce pain during the injection.

    Dilution for intravenous administration

    For intravenous administration, 1 g of the drug is dissolved in 10 ml of distilled water (sterile). The drug is administered slowly over 2-4 minutes.

    Dilution for intravenous infusion

    When carrying out infusion therapy, the drug is administered for at least half an hour. To prepare a solution, 2 g of powder is diluted in 40 ml of a Ca-free solution: dextrose (5 or 10%), NaCl (0.9%), fructose (5%).

    Additionally

    Ceftriaxone is intended exclusively for parenteral administration: manufacturers do not produce tablets and suspensions due to the fact that the antibiotic, when in contact with body tissues, is highly active and severely irritates them.

    Doses for animals

    The dosage for cats and dogs is selected taking into account the body weight of the animal. As a rule, it is mg/kg.

    If a 0.5 g bottle is used, 1 ml of two percent Lidocaine and 1 ml of water d/i (or 2 ml of Lidocaine 1%) should be added to it. After vigorously shaking the medicine until the lumps are completely dissolved, it is drawn into a syringe and injected into the muscle or under the skin of the sick animal.

    The dosage for a cat (Ceftriaxone 0.5 g is usually used for small animals - cats, kittens, etc.), if the doctor prescribed 40 mg of Ceftriaxone per 1 kg of weight, is 0.16 ml/kg.

    For dogs (and other large animals), take bottles of 1 g. The solvent is taken in a volume of 4 ml (2 ml Lidocaine 2% + 2 ml water for injection). For a dog weighing 10 kg, if the dose is 40 mg/kg, you need to administer 1.6 ml of the prepared solution.

    If it is necessary to administer Ceftriaxone intravenously through a catheter, sterile distilled water is used for dilution.

    Overdose

    Signs of a drug overdose are convulsions and central nervous system stimulation. Peritoneal dialysis and hemodialysis are ineffective in reducing ceftriaxone concentrations. The medicine does not have an antidote.

    Interaction

    In one volume, it is pharmaceutically incompatible with other antimicrobial agents.

    By suppressing intestinal microflora, it prevents the formation of vitamin K in the body. For this reason, using the drug in combination with agents that reduce platelet aggregation (sulfinpyrazone, NSAIDs) can provoke bleeding.

    The same feature of Ceftriaxone enhances the effect of anticoagulants when used together.

    In combination with loop diuretics, the risk of nephrotoxicity increases.

    Terms of sale

    A recipe in Latin is required to purchase.

    Recipe in Latin (sample):

    S. In the supplied solvent. V/m, 1 rub./day.

    Storage conditions

    Keep away from light. The optimal storage temperature is up to 25°C.

    When used without medical supervision, the drug can cause complications, so bottles with powder should be kept out of the reach of children.

    Best before date

    special instructions

    The drug is used in a hospital setting. In patients who are on hemodialysis, as well as with simultaneous severe hepatic and renal failure, plasma concentrations of Ceftriaxone should be kept under control.

    With long-term treatment, regular monitoring of the peripheral blood picture and indicators characterizing the function of the kidneys and liver is required.

    Sometimes (rarely) an ultrasound of the gallbladder may show shadows that indicate the presence of sediment. The darkening disappears after stopping the course of treatment.

    In some cases, it is advisable for weakened sick and elderly patients to prescribe vitamin K in addition to Ceftriaxone.

    If there is an imbalance of water and electrolytes, as well as arterial hypertension, the level of sodium in the blood plasma should be monitored. If the treatment is long-term, the patient is advised to undergo a general blood test.

    Like other cephalosporins, the drug has the ability to displace bilirubin bound to serum albumin, and therefore it is used with caution in newborns with hyperbilirubinemia (and, in particular, in premature infants).

    The drug does not affect the speed of neuromuscular conduction.

    Ceftriaxone analogues: what can replace the drug?

    Ceftriaxone or Cefazolin - which is better?

    Both drugs belong to the “Cephalosporins” group, but Ceftriaxone is a third generation antibiotic, and Cefazolin is a first generation drug.

    An important feature of first generation cephalosporin antibiotics is that they are not effective against listeria and enterococci, have a narrow spectrum of action and a low level of activity against Gram (-) bacteria.

    Cefazolin is used mainly in surgery for perioperative prophylaxis, as well as for the treatment of soft tissue and skin infections.

    Its prescription for the treatment of infections of the genitourinary system and respiratory tract cannot be considered as justified, which is associated with a narrow spectrum of antimicrobial activity and high resistance to it among potential pathogens.

    Which is better: Ceftriaxone or Cefotaxime?

    Cefotaxime and Ceftriaxone are the basic antimicrobial agents of the third generation cephalosporin group. The drugs are almost identical in their bactericidal properties.

    Alcohol compatibility

    You should not drink alcohol during treatment with the drug. The combination of “Ceftriaxone + ethanol” can provoke symptoms similar to those of severe poisoning, and in some cases lead to the death of the patient.

    Ceftriaxone during pregnancy and breastfeeding

    The drug is contraindicated in the first trimester of pregnancy. If it is necessary to prescribe to a nursing woman, the child should be switched to formula.

    Reviews of Ceftriaxone during pregnancy confirm that the drug is indeed a very powerful and very effective antibacterial agent that can not only cure the underlying disease, but also prevent the development of its complications.

    Considering that the drug (like other antibiotics) has side effects, it is prescribed only in cases where potential complications of the disease could be more harmful than the use of the drug (in particular, for infections of the urogenital tract, to which pregnant women are very susceptible).

    Reviews of Ceftriaxone

    Ceftriaxone - reviews from doctors confirm this fact - is a potent antibiotic that helps cure the disease in a short time and with a minimum number of side effects. It is allowed to be used for children and during pregnancy (exception - 1st trimester).

    According to the patients themselves, the main disadvantage of the drug is that the injections are very painful.

    In reviews of Ceftriaxone injections for children, to facilitate the procedure, mothers (on the advice of the attending physician) are recommended to use Emla cream, which is a local anesthetic. It is applied in about half an hour to the intended injection site.

    How much does an antibiotic cost in Russian pharmacies?

    The price of Ceftriaxone injections varies depending on which company produces it, as well as the number of ampoules in each package and the concentration of the active substance in the vial.

    The price of Ceftriaxone in Ukraine is from 6.6 UAH per 0.5 g bottle. However, there is no significant difference between prices in the capital’s pharmacies and pharmacies in other cities (Kharkov, Dnepropetrovsk, Lvov).

    The price of Ceftriaxone in Russian pharmacies is from 17 rubles per bottle.

    It is impossible to buy Ceftriaxone tablets. The drug is intended exclusively for parenteral administration.

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    BIOSPHERE

    Cetrin 1 tablet per day and Comfoderm cream. I gave injections to my mother, she also had hives all over her body. But thank God everything went away thanks to these drugs.

    I have the same thing: eleven injections with lidocoine and intravenous injection. no pain but with a very swollen face))

    I gave myself ceftriaxone once, then vomited worms all night. I highly recommend this miracle.

    This is a very scary antibiotic. The EGR should be prescribed and installed with great caution. Correctly written, only in a hospital setting. A woman we know died after one injection. Anaphylactic shock! And the ambulance didn't help. And he was prescribed by an ENT specialist for sinusitis, treatment at home. Horror! The child remained 13 years old. Everything happened in front of my husband and daughter

    Can ceftriaxone be used to treat swollen lymph nodes?

    Karina, Lidocaine is safer than novocaine due to its chemical structure. The drug belongs to the second generation of analgesics, according to its chemical structure to the group of amides, which provides greater pain relief effectiveness than when using predecessor analgesics (Novocaine). Novocaine belongs to the first generation essential analgesics, so there is a high probability of allergic reactions. Since the breakdown of Novocaine produces para-aminobenzoic acid and its esters in the body, which often cause allergies. Lidocaine has been widely used in clinical practice by doctors for a long time, so there is no doubt about its effectiveness and good tolerability. To avoid side effects of the drug, consult your doctor before use. All the best!

    What is the effect of lidocaine? Why is it safer than Novocaine?

    Since intramuscular injections cause discomfort at the injection site and unpleasant pain, the optimal choice for dissolving cephalosporin antibiotics is Lidocaine in a 1% concentration of 3.5 ml. This concentration ensures effective dissolution of the antibiotic and a powerful analgesic effect when administered intramuscularly. For comparison, Novocaine has a less pronounced analgesic effect (4 times weaker than Lidocaine), and the frequency of adverse allergic reactions with its use occurs 3 times more often. Lidocaine belongs to the second generation of drugs, so it is more effective and well tolerated. Consult your healthcare practitioner before use. Good health to you!

    Not a bad drug, I injected my husband, although he complained very much that the injections were quite painful with it. At first I did it with water for injection, but later I read that this was wrong. To dissolve cephalosporins, including Ceftriaxone, Lidocaine must be used. The optimal dosage is 1% 3.5 ml. The use of Lidocaine is rarely complicated by allergic reactions (3 times less likely than Novocaine), and Lidocaine also has a powerful analgesic effect (4 times more effective than Novocaine). Lidocaine belongs to the second generation of analgesic drugs, therefore it is safer than its predecessors - representatives of the first generation of ether analgesics, such as Novocaine. The drug has long proven itself in the clinical practice of many doctors, so its effectiveness and good tolerability are confirmed by time. Consult your healthcare practitioner before use. All the best!

    I liked Ceftriaxone, it quickly got me back on my feet, although the injections were very painful. Since these intramuscular injections cause discomfort at the injection site and unpleasant pain, the optimal choice for dissolving cephalosporin antibiotics is Lidocaine at a 1% concentration of 3.5 ml. This concentration ensures effective dissolution of the antibiotic and a powerful analgesic effect when administered intramuscularly. For comparison, Novocaine has a less pronounced analgesic effect (4 times weaker than Lidocaine), and the frequency of adverse allergic reactions with its use occurs 3 times more often. Lidocaine belongs to the second generation of drugs, so it is more effective and well tolerated. Consult your healthcare practitioner before use. Good health to you!

    Regarding Konstantin’s comment, I do not agree with the statement that WHO recommends lidocaine as a solvent for antibiotics. WHO recommends lidocaine as an anesthetic, but nevertheless, lidocaine is also excellent for dissolving cephalosporins, this tactic is time-tested.

    Very informative article. thank you. But I have information regarding Lidocaine. The article states that a 2% lidocaine solution can be diluted with water for injection. This is not recommended, since according to the standards of the World Health Organization, the solvent for cephalosporin antibiotics is a 1% solution of lidocaine; it is in this concentration that the optimal result of dissolving the drug is achieved. The WHO has no recommendations regarding Novocaine, and its instructions do not indicate its properties as a solvent for cephalosporin antibiotics. Also, before using Lidocaine, it is necessary to perform an allergy test if the patient is using this drug for the first time. During pregnancy at any stage of gestation and nursing mothers, Lidocaine is also contraindicated, so consult a specialist when using and dissolving antibiotics. Good health to you!

    After the next injection, my wife developed spots all over, like hives, severe itching all over her body, after which the skin on her legs turned blue, we are in a panic, what should we do? ? ?

    Konstantin: What I liked about the drug Prostanorm: reasonable price, pronounced effect of taking it.

    Valentina: I, too, am all about diet and exercise. I hoped for loads, I thought that my healthy lifestyle.

    Nina: I was on pills for a year and a half, then somehow everything calmed down. Mostly climatefit.

    Elena: With the onset of menopause, the skin completely deteriorated and became dry. I saw a cream for .

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    Source: http://medside.ru/tseftriakson