Брамитоб Раствор, ампулы, 56 шт, 4 мл, 75 мг/мл, для ингаляций

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Носовой зажим может помочь пациенту дышать ртом."}},{"type":"paragraph","data":{"text":"Указания по очистке и дезинфекции небулайзера."}},{"type":"paragraph","data":{"text":"После окончания процедуры ингаляции небулайзер следует разобрать, отдельные его части (за исключением трубки) тщательно промыть горячей водой и жидким моющим средством, прополоскать и насухо вытереть чис­той сухой тряпочкой, не оставляющей волокон. Для регулярной дезинфекции небулайзера рекомендуется опустить его отдельные части (кроме трубки), очищенные в соответствии с данными выше указаниями, в рас­твор, состоящий из одной части 9% уксусной кислоты и трех частей горя­чей воды, на один час, затем промыть горячей водой и насухо вытереть чистой тряпочкой."}},{"type":"paragraph","data":{"text":"После  завершения дезинфекции использованный раствор следует сразу же вылить."}},{"type":"paragraph","data":{"text":"В качестве альтернативы дезинфекцию можно проводить путем кипячения в течение 10 минут."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Тошнота, рвота. сонливость. нарушение слуха. нарушение функции почек. нарушения картины крови. аллергические реакции."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\n\nСимптомом передозировки может быть выраженная осиплость голоса."}},{"type":"paragraph","data":{"text":"При случайном попадании БРАМИТОБА внутрь токсическое действие маловероятно, поскольку тобрамицин плохо всасывается из желудочно-кишечного тракта."}},{"type":"paragraph","data":{"text":"При случайном внутривенном введении БРАМИТОБА могут развить­ся симптомы и признаки передозировки тобрамицина, такие как голово­кружение, потеря слуха, звон в ушах, вертиго, респираторный дистресс-синдром, блокада нейромышечной проводимости и нарушение функции почек."}},{"type":"paragraph","data":{"text":"В случае проявления признаков передозировки БРАМИТОБ следует немедленно отменить и провести исследование показателей функции почек. Для контроля передозировки может быть полезным определение концентраций тобрамицина в сыворотке крови.\n\n"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nНе выявлено значимого лекарственного взаимодействия БРАМИТОБА при совместном применении с муколитиками, β 2- адреномиметиками, инга­ляционными кортикостероидами и другими пероральными и парентераль­ными антибиотиками с антипсевдомонадной активностью."}},{"type":"paragraph","data":{"text":"Следует избегать одновременного или последовательного применения ингаляционного тобрамицина и других потенциально нефро- или ототоксичных лекарственных препаратов. Некоторые диуретики могут усиливать токсичность аминогликозидов, изменяя концентрации антибиотика в сыво­ротке и тканях. Ингаляционный тобрамицин не следует назначать одно­временно с этакриновой кислотой, фуросемидом, мочевиной или маннитолом."}},{"type":"paragraph","data":{"text":"Токсичность аминогликозидов может увеличиваться при парентераль­ном введении следующих препаратов: амфотерицина В, цефалотина, цик­лоспорина, такролимуса, полимиксинов (риск усиления нефротоксичности), препаратов платины (риск усиления нефротоксичности и ототоксичности) а так же ингибиторов холинэстеразы и ботулотоксина (нейромышечные эффекты).\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Лечение БРАМИТОБОМ должен назначать врач, имеющий опыт ве­дения больных муковисцидозом. Длительность курсового лечения опреде­ляется врачом, исходя из клинической картины заболевания. В случае под­твержденного ухудшения легочных функций следует назначить дополни­тельную антибактериальную терапию."}},{"type":"paragraph","data":{"text":"Во время лечения БРАМИТОБОМ пациенту следует продолжать стандартную физиотерапию грудной клетки. Применение бронходилататоров должно продолжаться по клиническим показаниям. При использовании нескольких методов лечения дыхательных нарушений рекомендуется сле­дующий порядок: бронходилататор, дыхательная физиотерапия, другие ин­галяционные лекарственные средства и в конце - Брамитоб."}},{"type":"paragraph","data":{"text":"Брамитоб не следует смешивать с другими ингаляционными лекарст­венными средствами."}},{"type":"paragraph","data":{"text":"БРАМИТОБ следует применять с большой осторожностью у больных с паркинсонизмом или другими состояниями, характеризующимися мышечной слабостью, включая myasthenia gravis, поскольку аминогликозиды могут усиливать мышечную слабость из-за возможного курареподобного действия на нейромышечную проводимость."}},{"type":"paragraph","data":{"text":"Препарат следует применять с осторожностью у больных с доказанной или подозреваемой почечной недостаточностью, при условии мониторинга концентраций тобрамицина в сыворотке крови."}},{"type":"paragraph","data":{"text":"Необходимо периодически оценивать показатели функции почек (уро­вень мочевины и креатинина не менее одного раза в течение 6 курсов тера­пии БРАМИТОБОМ). При появлении признаков нефротоксичности, лече­ние тобрамицином следует прервать до снижения минимальных концен­траций препарата в сыворотке менее 2 мкг/мл. Затем лечение БРАМИТО­БОМ можно возобновить по медицинским показаниям. Пациентов, одно­временно получающих парентеральную терапию другими аминогликозидами, следует тщательно наблюдать из-за возможности развития кумуля­тивной токсичности."}},{"type":"paragraph","data":{"text":"При использовании аминогликозидов возможно развитие ототоксичности (гипоакузия, системное и несистемное головокружение, атаксия)."}},{"type":"paragraph","data":{"text":"При ингаляции возможно появление кашлевого рефлекса. Применение ингаляционного тобрамицина у больных с острым кровохарканьем должно проводиться только в том случае, если польза от лечения превышает риск провокации дальнейшего кровотечения."}},{"type":"paragraph","data":{"text":"У некоторых больных, получавших тобрамицин, отмечается повыше­ние МПК аминогликозидов в отношении изученных выделенных штаммов P. aeruginosa. Возможно развитие резистентности штаммов P. aeruginosa, к внутривенно вводимому тобрамицину."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре + 2-8°С, в оригинальной упаковке для защиты от света, вдали от нагревательных приборов. Не замораживать. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]}],"source":null},"description_toggle":false,"short_description":"Тобрамицин - аминогликозидный антибиотик, продуцируемый микроорга­низмами рода Streptomyces tenebrarius . Основной механизм его действия - нарушение синтеза белка, что ведет к изменению проницаемости клеточ­ной мембраны, нарастающему повреждению клеточной оболочки и после­дующей гибели клетки. Тобрамицин обладает бактерицидным действием в концентрациях, равных или несколько превышающих подавляющие концентрации. Тобрамицин более активен, чем гентамицин, в отношении Pseudomonas aeruginosa и некоторых штаммов протея; около 50% штаммов Pseudomonas aeruginosa, устойчивой к гентамицину, являются чувствительными к тобрамицину. При ингаляционном введении минимальная подавляющая концентрация (МПК) тобрамицина в мокроте больных муковисцидозом существенно выше, чем при парентеральном введении.","substance":[{"id":172,"title":"Тобрамицин","title_latin":"Tobramycinum","slug":"tobramitsin_172"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Брамитоб - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72107/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72107/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[],"related_products":{"title":"Аналоги","type":"analogs","products":[{"id":97896,"title":"Тобропт гл.","subtitle":{"full":"Капли, 5 мл, 0,3 %","short":"Капли, 5 мл, 0,3 %","package":"5 мл, 0,3 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