Some infectious diseases are not so easy to defeat. They can not only seriously disrupt the state of health, but even create a real threat to the life of the patient. In such cases, truly high-quality and effective medicines should be used that can successfully defeat a dangerous infection and restore health. To combat various infectious diseases, they often use Imipenem + Cilastatin. According to the reviews of patients and doctors, it is incredibly effective. Before deciding whether to start treatment with the drug in question, it is necessary to find out as much information as possible about the drug "Imipenem + Cilastatin": the trade name of the drug, the characteristics of the action and the method of its use. Who needs to use the medication in question? What are the contraindications? What adverse reactions can be expected? You can find out all this information by reading this article.
Structure
The composition of the drug "Imipenem + Cilastatin" includes an equal combination of cilastatin (which is an inhibitor of the enzyme dihydropeptidase of the kidneys) and imipenem sodium salts (antibiotic). One bottle of the drug, as a rule, contains five hundred milligrams of both substances.
Release form
The drug in question "Imipenem + Cilastatin" is available in the form of a powder for injection (for intravenous administration) in bottles of various volumes, namely sixty and one hundred and twenty milliliters. This powder must be dissolved in a solution (buffer) of sodium bicarbonate.
In the case when the drug is prescribed for intramuscular administration, vials containing 0.5 or 0.75 grams of imipenem and cilastatin should be purchased (depending on the dosage that was prescribed to the patient by the attending physician).
Indications for use
The drug "Imipenem + Cilastatin" is prescribed for use by patients in the presence of infectious and inflammatory diseases that were caused by any microorganisms sensitive to the action of the main active substances of the drug, which include both polymicrobial and mixed aerobic-anaerobic infections (these include infectious diseases of the urinary tract and lower respiratory tract; sepsis; infectious diseases of the joints and bones; peritonitis; intraabdominal infections; inflammatory processes that occur in the pelvic organs,. various infectious diseases of the skin and soft tissues, as well as endocarditis Also, the drug is effectively used as a prevention of complications after surgery.
pharmachologic effect
The effectiveness of the drug "Imipenem + Cilastatin" is due to the successful combination of two active components. The first, imipenem, is a special beta-lactam antibiotic that actively destroys pathogenic bacteria (thus having a bactericidal effect). This substance has a fairly wide spectrum of action. This means that many pathogenic microorganisms are sensitive to its effects. The second component, cilastatin sodium, actively acting on the enzyme that decomposes imipenem in the kidneys of the patient's body, suppresses its effect, which contributes to a sufficient increase in the concentration of the above antibiotic unchanged in the patient's body. Therefore, the overall effectiveness of the drug "Imipenem + Cilastatin" increases many times.
Application
To achieve the greatest effect and to avoid the occurrence of any negative effects of therapy, it is important to carefully adhere to the recommendations regarding the use of the drug. The drug "Imipenem and Cilastatin Jodas" is administered intravenously (drip) into the patient's body.
Despite the fact that the instruction offers average doses for the use of the drug, before starting treatment, it is important to adjust the treatment regimen directly with the attending physician, who will be able to correctly set the appropriate dosage taking into account all the individual characteristics of the patient and his medical history.
The doses that the instruction for the use of the substance in question contains for the medicine "Imipenem + Cilastatin" are intended for those patients whose body weight exceeds seventy kilograms. Those patients whose body weight is less should proportionally reduce the working dose of the drug (it is important that a competent specialist direct this process).
For an adult patient, the average daily dose of the drug "Imipenem and Cilastatin Jodas" is one to two grams, provided it is divided into three to four injections. At the same time, the maximum dose that is acceptable for administration within one day is four grams or fifty milligrams per kilogram of body weight (the choice should fall on the smaller of the two permissible doses).
Also, doses vary depending on the severity of the disease. So, if we are talking about a patient with a mild severity of the course of the infection, then the working dose of the drug for him will be two hundred and fifty milligrams (injections should be repeated four times a day). If the severity is moderate, then the amount of the drug for a single injection should be five hundred milligrams. The drug should be administered three times a day. If the infection is severe, then this dose should be used four times a day. When the patient’s condition is so serious that there is a serious threat to his life, one gram should be administered three to four times a day. The drug should be administered slowly (grams over an hour, two hundred and fifty - five hundred milligrams - over twenty - thirty minutes).
If the drug is used to prevent postoperative infections, it is important to introduce one gram during anesthesia and the same dose three hours later.
If during the operation there is a risk of developing any kind of infection (especially with regard to operations on the rectum and colon), "Imipenem + Cilastatin" instructions for use recommends the administration of five hundred milligrams eight and sixteen hours after anesthesia.
In order to prepare a working solution, it is necessary to add one hundred milliliters of a specialized solvent to the vial with the powder of the substance, which includes a five percent or ten percent aqueous dextrose solution, 0.9% sodium chloride solution. In such a solution, the concentration of the antibiotic imipenem should be no more than five milligrams per milliliter.
Do not use the drug in question simultaneously with other antibacterial drugs, as well as with the salt of lactic acid.
The substance is incompatible with other beta-lactam antibiotics (these include cephalosporin, monobactam and penicillin). Their simultaneous use can lead to cross-allergic reactions.
Interaction with ganciclovir sometimes provokes the development of generalized seizures.
Various substances that block tubular secretion increase the concentration of imipenem in blood plasma, as well as its half-life. Thus, if the administration of this substance in high doses is required for effective treatment, then these groups of substances should not be used simultaneously.
It is forbidden to use the drug in question during the period of bearing a child, as well as during breastfeeding.
This medicine should not be used to combat meningitis.
Urine during therapy may be slightly colored in a reddish tint.
Dosage forms of the drug (for intravenous administration and for intramuscular administration) should be used strictly for its intended purpose. They are not interchangeable. Before you begin treatment with the medication in question, it is important to conduct a thorough study for allergic reactions or increased individual sensitivity to beta-lactam antibiotics.
If the patient already had other diseases of the gastrointestinal tract, for example, colitis, then when using the drug in question, there is a possibility of developing pseudomembranous enterocolitis.
In order to successfully avoid the occurrence of any unpleasant reactions from the central nervous system in those patients who had any brain injuries or suffered convulsions, it is recommended that accompanying therapy with high-quality antiepileptic drugs.
It should be borne in mind that elderly patients are likely to have age-related renal impairment, which may require a dose reduction.
It is important to remember that elderly patients should be used with caution. As a rule, they manifest symptoms of a variety of age-related disorders in the functioning of the kidneys. In this case, if it is necessary to use the drug "Imipenem + Cilastatin", the instructions for use recommend that you consult with your doctor to reduce the dose used.
There are some special conditions for the use of the medication in question for children. If their body weight exceeds forty kilograms, then the same recommendations may be applicable to them as for adult patients. If the child is older than three months, and his weight is less than forty kilograms, then the maximum daily dose of such a patient will be two grams. They should inject fifteen milligrams per kilogram four times a day.
In no case should you use the medicine "Imipenem + Cilastatin" for children who have not yet reached the age of three months, as well as for those babies who have impaired normal functioning of the kidneys, which can be expressed in a concentration of serum creatinine above two milligrams per deciliter.
Contraindications
There are some nuances that must be considered when using "Havepenem + Cilastatin". The instruction recommends that you carefully study the contraindications to this drug. And among them the following are distinguished:
- the period of bearing a child;
- period of breastfeeding;
- children's age up to three months;
- children who suffer from impaired renal function associated with a high concentration of serum creatinine;
- individual sensitivity to individual components of the drug in question, as well as to other beta-lactam antibiotics and to carbapenems.
It is important to consider that for elderly patients, as well as those who suffer or have ever suffered from diseases of the central nervous system or diseases of the gastrointestinal tract, the drug should be taken with caution under the constant supervision of the attending physician. It is he who will be able to competently prescribe the correct dosage of the drug "Imipenem + Cilastatin." Contraindications are important to study before starting treatment.
Side effects
It is important to know one more nuance about the tool "Imipenem + Cilastatin". The formula of the drug is such that some patients may experience some adverse reactions from various body systems. Among them there are: thrombophlebitis, taste disorder, candidiasis, oliguria, myoclonus, hallucinations, paresthesias, confusion, acute renal failure, mental disorders, epileptic seizures, polyuria, anuria, indigestion, hepatitis, nausea and vomiting, leukopenia, pseudocolumbra lymphocytosis, hyperbilirubinemia, eosinophilia, pruritus, leukopenia, skin rash, thrombocytosis, hypercreatininemia, monocytosis, urticaria, basophilia, direct positive Coombs test.
There is no exact information on how to cope with an overdose of the drug in question. However, it is known that these active substances successfully undergo hemodialysis. Nevertheless, it is still unknown how effective this procedure is in case of an overdose. Therefore, it is important to follow all the recommendations that the description of this drug contains for the use of Imipenem + Cilastatin.
Storage conditions
In order for the use of the drug to be effective, it is important to consider another important point. Namely, how the drug "Imipenem + Cilastatin" should be stored. The description of the substance contains the following tips.
The powder should be kept in a room in which room temperature is maintained. The finished working solution should be used no later than an hour after manufacture. Sodium chloride solutions at room temperature can be stored for no more than ten hours, and no more than forty-eight in the refrigerator. Glucose solutions can be stored for no more than four and twenty-four hours, respectively.
Analogs
There are a number of drugs that are part of the group of analogues of Imipenem + Cilastatin. Substitutes of the medication in question are Inemplus, Miksatsil, Lastinem, Sinerpen, Thiaktam, Pimin, Supranem and Tienam. As a rule, all these drugs have the same active substance as the drug in question. The main active substances of these drugs are imipenem, cilastatin (whose trade name is reflected in the above medicines). Thus, for these medicines, on the whole, contraindications, side effects, and pharmacological effects coincide. However, it should be remembered that the dosage should be prescribed by the attending physician, who can take into account all the necessary nuances. The drug "Imipenem + Cilastatin", analogues of the drug should not be used by patients without permission, without the appointment of a physician and his constant monitoring. Including his consultation is necessary when selecting the appropriate analogue.
Generalization
Practice confirms the effectiveness of the drug "Imipenem + Cilastatin." Testimonials report successful treatment results. However, both doctors and patients emphasize the fact that it is important to adhere precisely to the recommendations contained in the instructions and which are provided by the attending physician. Only this method of therapy can benefit the patient.
Contraindications should not be ignored, the presence of which does not allow starting the treatment with the drug in question. Otherwise, its use can not only not give a positive result, but also cause serious harm to the physical condition of the patient. Also, improper use of the drug in question can lead to side effects, some of which can significantly aggravate the patient's condition. It is important that the treatment is carried out under the guidance of a competent attending physician, who would not only be well acquainted with the features of the use of this medicine, but also possess the necessary skills and knowledge in order to cope with unexpectedly arising difficult situations. Your health should be in the hands of true professionals.
Before deciding to start treatment with the drug in question, it is important to carefully read all the information about it that reflects the characteristics of its effect on the body. You need to know everything about the potential possible adverse reactions, the occurrence of which can cause a lot of inconvenience to the patient and the difficulties of his attending physician.
It is important to treat the choice of treatment method as responsibly as possible. Choose the best quality products!