Антибактериальный препарат из группы хинолонов. Действует ба... Инструкция
Показания к применению
Острые и хронические инфекционно-воспалительные заболевания мочевыводящих путей, вызванные чувствительными к Палину микроорганизмами, в том числе: пиелонефрит; уретрит; цистит; простатит; профилактика инфекций при инструментальных вмешательствах в урологической и гинекологической практике.
Противопоказания
повышенная чувствительность к любому из компонентов препарата, выраженные нарушения функции почек (клиренс креатинина < 10 мл/мин), выраженные нарушения функции печени (в т.ч. цирроз), порфирия, заболевания центральной нервной системы (неврологические состояния с пониженным судорожным порогом), беременность и период лактации, детский возраст до 14 лет. ...
Действующее вещество: Пипемидовая кислота (Pipemidic acid)Концентрация действующего вещества (мг): 200
Фармакологические свойства
Антибактериальный препарат из группы хинолонов. Действует бактерицидно. Препарат активен в отношении грамотрицательных бактерий: Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Neisseria spp., Pseudomonas aeruginosa; грамположительных бактерий: Staphylococcus aureus. Препарат не активен в отношении анаэробных микроорганизмов.
Показания к применению
Острые и хронические инфекционно-воспалительные заболевания мочевыводящих путей, вызванные чувствительными к Палину микроорганизмами, в том числе: пиелонефрит; уретрит; цистит; простатит; профилактика инфекций при инструментальных вмешательствах в урологической и гинекологической практике.
Противопоказания
повышенная чувствительность к любому из компонентов препарата, выраженные нарушения функции почек (клиренс креатинина < 10 мл/мин), выраженные нарушения функции печени (в т.ч. цирроз), порфирия, заболевания центральной нервной системы (неврологические состояния с пониженным судорожным порогом), беременность и период лактации, детский возраст до 14 лет. С осторожностью: аллергические реакции на хинолоны в анамнезе
Применение при беременности и в период грудного вскармливания
Безопасность применения Палина при беременности и в период лактации не изучена, поэтому препарат противопоказан к применению при беременности. При необходимости применения препарата Палин в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Внутрь. Средняя суточная доза составляет 800 мг, разделенные на два приема, т.е. 400 мг (2 капсулы) каждые 12 часов, утром и вечером перед едой. При стафилококковых инфекциях интервал между приемами не должен составлять более 8 часов (т.е. доза может быть увеличена до 2 капсул 3 раза в день). При заболеваниях почек продолжительность терапии составляет от 3 до 6 недель, при простатите 6-8 недель. Во время терапии больному рекомендуется обильное питье. При рецидивах острых инфекций мочевыводящих путей у женщин одновременно с пероральным лечением рекомендуется назначение по 1 вагинальной свече на ночь в течение 7-10 дней. Курс лечения составляет в среднем 10 дней. При необходимости курс лечения может быть продлен в зависимости от течения заболевания. Продолжительность курса лечения определяется лечащим врачом.
Побочное действие
Побочные эффекты в большинстве случаев слабые и преходящие, как правило, не требующие отмены препарата. Чаще других отмечаются тошнота, рвота, диарея, гастралгия. Как и при приеме других антимикробных средств, во время лечения возможно возникновение резистентности или суперинфекции. В редких случаях может развиваться псевдомембранозный колит с тяжелой диареей. Крайне редко фиксировались нежелательные эффекты препарата со стороны нервной системы. Отмечались расстройства зрения, головная боль, возбуждение, депрессия, спутанность сознания, галлюцинации, тремор, судороги. Очень редко могут возникать большие судорожные припадки. Возможны расстройства сна и сенсорные нарушения. Не рекомендуется использовать этот препарат у детей. Как и другие хинолоны, пипемидовая кислота накапливается в хрящах. Особо упоминается явление мышечного гипертонуса у новорожденных и детей. Могут возникать аллергические реакции - слабый зуд кожи, кожные высыпания, синдром Стивенса-Джонсона, фотосенсибилизация. Кожные реакции обратимы. Имеются единичные сообщения о развитии анафилактических реакций. У пациентов с недостаточностью глюкозо-6-фосфатдегидрогеназы может развиваться гемолитическая анемия. Имеются отдельные сообщения о развитии эозинофилии. У пожилых пациентов и пациентов с нарушениями функции почек может развиваться тромбоцитопения.
Передозировка
Не имеется сообщений о развитии угрожающих побочных эффектов или летальном исходе при передозировке препарата. Симптомы: тошнота, рвота, головокружение, головная боль, спутанность сознания, тремор, судороги. Лечение: специфического антидота нет. Если с момента приема препарата прошло менее 4 ч, для уменьшения всасывания необходимо промыть желудок с последующим назначением активированного угля. При развитии побочных эффектов со стороны ЦНС (включая эпилептиформные судороги) назначают симптоматическое лечение (диазепам). Выведение препарата можно ускорить с помощью форсированного диуреза.
Особые указания
С осторожностью назначают препарат пациентам, имеющим в анамнезе нарушения мозгового кровообращения (в т.ч. кровоизлияние в головной мозг, спазмы сосудов головного мозга), судороги; при эпилепсии; пациентам в возрасте старше 70 лет (из-за повышенного риска развития побочных эффектов у данной категории пациентов). В период приема препарата пациенты должны получать обильное питье (под контролем диуреза). Вследствие возможной фотосенсибилизации в период приема Палина следует избегать УФ-облучения. В связи с возможностью развития перекрестной чувствительности следует соблюдать осторожность при назначении Палина пациентам, имеющим в анамнезе аллергические реакции на хинолоны. При длительном применении препарата следует контролировать общие показатели крови, определять функции печени и почек и периодически определять чувствительность микрофлоры к пипемидовой кислоте. При применении препарата может отмечаться ложноположительная реакция мочи на глюкозу при использовании реактива Бенедикта или раствора Феллинга. Рекомендуется использовать ферментативные реакции с глюкозооксидазой. Использование в педиатрииНе рекомендуется применять Палин у детей. Пипемидовая кислота накапливается в хрящах. Также имеются сообщения о развитии мышечного гипертонуса у новорожденных и детей. Влияние на способность к вождению автотранспорта и управлению механизмамиПри применении препарата следует воздерживаться от занятий потенциально опасными видами деятельности, требующих повышенной концентрации внимания и быстроты психомоторных реакций.
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