Benzylpenicillin sodium salt (Benzylpenicillinum-natrium).

     Synonym : Benzylpenicillinum Natricum.

     White powder melkokristallichesky bitter taste, slightly gigroskopichen. Easily destroyed when the effects of acids, alkalis and oxidizers, when heated in water solutions, as well as actions penitsillinazy. Slowly destroyed in the storage solutions at ambient temperatures.

     Very easily soluble in water, soluble in alcohol.

     Theoretically activity sodium salt benzylpenicillin 1670 ED is 1 mg, the drug produced little activity at least 1600 ED 1 mg.

     Penicillin is active against gram microorganisms (staphylococcus, streptococcal pneumococcal, cause diphtheria, anaerobic spore sticks, anthrax bacilli), gram kokkov (gonokokkov, meningokokkov), as well as spirohet, some aktinomitsetov and other microorganisms. The drug was not effective against most gram bacteria rikketsy, viruses, simplest, mushrooms.

     By benzylpenicillin resistant strains of staphylococcus, forming enzyme penitsillinazu, destroying benzylpenicillin. Low benzylpenicillin for coliform bacteria, Escherichia wand and other microorganisms is also linked to some of their teeth with penitsillinazy.

     Penicillin with intramuscular a rapidly absorbed in the blood and is found in body fluids and tissues; In spinal fluid penetrates to a small extent. The maximum concentration in the blood after intramuscular imposing a 30-60 min. In subcutaneous introduction intake less constant speed, usually the maximum concentration in the blood was after 60 minutes. After 3 to 4 h after a single intramuscular or subcutaneous injections of blood found only traces of the antibiotic. Afterwards support at a high enough concentration for the necessary therapeutic effect level, we must make injections every 3 to 4 hours When intravenously, the concentration of penicillin in the blood rapidly declining. When administered medication poorly absorbed and razrushaetaya gastric juice and penitsillinazoy, produtsiruemoy intestinal microflora. Provided mainly kidneys.

     The concentration and duration of benzylpenicillin circulating in the blood depend on the size of the input dose. Antibiotics well penetrates the tissues and body fluids. In spinal fluid he found in a small number of rules, but when brain nerve coats his concentration.

     Benzylpenicillin applied to diseases caused by microorganisms sensitive to it : focal pneumonia and pneumonia, acute and subacute septic endocarditis, infection, trauma, infection prophylaxis skin, soft tissues and mucous membranes, eight pleurisy, peritonitis, cystitis, and piemii septicemia, acute and chronic osteomyelitis , various forms of flu, diphtheria, rozhistom bronchitis, chronic inflammatory diseases in obstetric and otorinolaringologicheskoy practice; with inflammatory eye disease, meningitis (brain nerve when shells drug crosses the blood-brain barrier, but for a therapeutic effect in intramuscular application to be introduced in high doses. In the most severe cases, the introduction of intramuscular combine with endolyumbalnym.) , scarlet fever, gonorrhea, Infections, syphilis, anthrax, actinomycetes and other infectious diseases.

     When infections caused by susceptible to penicillin microorganisms, benzylpenicillin is an effective medicine.

     Penicillin and other drugs in this group to effectively operate on all forms of syphilis. They are the primary tools for treating the disease. Active syphilis better shape curable penitsillinami.

     When infection caused by microorganisms, is not sensitive to penicillin (including influenza without complications bacterial infection), the use of benzylpenicillin irrational and not very safe because of the potential side effects caused by antibiotic.

     Sodium salt of benzylpenicillin impose a solution subcutaneously or intramuscularly, as appropriate, in the veins and cavities (abdominal, chest, etc.). When lung diseases also used as a spray, eye diseases, in the form of eye drops and subkonyunktivalno.

     Of all the drugs benzylpenicillin, only sodium salt impose endolyumbalno. Other drugs penicillin for this purpose does not apply.

     The most widely intramuscular way of benzylpenicillin. For intramuscular a drug producing ex tempore, adding to the contents of a bottle 1 - 3 ml of sterile water for injections, isotonic sodium chloride solution, or 0.5% solution of novocaine. Solution of novocaine provides slightly more prolonged drug in the body (see Benzilpenitsillina novokainovaya salt). Prepare solutions complying with the rules upgrades. The solvent introduce sterile syringe directly into a bottle, prokalyvaya of rubber cork bottle, tentatively shabby alcohol. Solutions benzylpenicillin in solution novocaine sometimes troubled by the education novokainovoy salt benzylpenicillin. This is not an obstacle for intramuscular injection.

     Enter benzylpenicillin intramuscularly usually deep in the muscles. Intravenous (struyno drip) enter the sodium salt of benzylpenicillin with severe illness (sepsis, meningitis, etc.).

     In intramuscular and intravenous benzylpenicillin single dose of sodium salt in a medium during infections (urinary diseases and psoriasis ways, soft tissue infection, etc.) are usually 250000 - 500000 ED; Daily 1000000 2000000 - ED. In heavy infections (sepsis, septic endocarditis, meningitis, etc.) to enter 1000000020 000000 ED day; When gas gangrene-to 40 million-60 million ED.

     For a single intravenous dose of inkjet benzylpenicillin sodium salt (1000000, 2000000 ED) dissolve in 5 to 10 ml of sterile water for injection or isotonic sodium chloride solution and impose slowly for 3 to 5 minutes.

     For intravenous drip introduction to throw 2000000 5000000 ED-100-200 ml isotonic sodium chloride solution, or 5 - 10% glucose solution and impose a speed of 60 to 80 drops per minute. In drip administered to children as a solvent used 5 - 10% glucose solution (30, 100 ml, depending on the dose and age).

     Solutions used immediately after cooking, while avoiding the addition of other drugs.

     Children benzylpenicillin appointed in different daily doses : in the age of 1-to 50000 - 100000 ED 1 kg of body weight over one year to 50,000 ED / kg. In heavy infections (meningitis, sepsis, severe acute pneumonia), the daily dose can be increased to 200000 - 300000 ED / kg, and in exceptional cases (for health) to 500,000 ED / kg.

     The daily dose distribute 4-6 introductions.

     Intravenous sodium salt of benzylpenicillin introduce 1 - 2 times a day, coupled with intramuscular injections.

     Dental Treatment (and other drugs in this group) patients with syphilis and gonorrhea to produce specially designed schemes.

     Endolyumbalno sodium salt of benzylpenicillin in introducing diseases entering the brain and spinal cord and brain coats. Depending on the nature of the disease designate adult ED 10000-5000, children from 2000 to 5000 ED. Let's preparation of sterile water for injection or isotonic sodium chloride solution at the rate of 1000 ml ED 1. Before injection (depending on the level vnutricherepnogo pressure) are removed from the spinal canal 5 to 10 ml spinal fluid and add it to the antibiotic solution very similar. Enter slowly (1 ml / min), usually once a day for 2 to 3 days, then transferred to the intramuscular injections.

     Subcutaneously using sodium salt of benzylpenicillin to obkalyvaniya infiltrates (100000 - 200000 ED in 1 ml of 0.25 - 0.5% solution of novocaine).

     In cavity (abdominal, chest, etc.) imposed solution benzylpenicillin sodium salt concentration in the 10000-20000 ED in 1 ml for adults and 2000-5000 ED in 1 ml for children. Dissolve in sterile water for injection or isotonic sodium chloride solution. The duration of 5 to 7 days, then transferred to a local analgesic.

     When lung disease (chronic bronchitis, pneumonia, gangrene light, etc.) often use aerosol penicillin : single dose of adult 100000 - 300000 ED. Let's 3 to 5 mL of distilled water; Apply 1 to 2 times daily; Duration inhalation 10-30 minutes. In nagnoitelnyh processes in the lungs are also introducing products intratrahealno solution (after careful anaesthesia Wrench, larynx and trachea). 100000 ED usually applied in 10 ml isotonic sodium chloride solution.

     With eye diseases (acute conjunctivitis, corneal ulcers, gonoblennoreya etc.) sometimes designate eye drops containing 20000 - 100000 ED sodium salt of benzylpenicillin 1 ml isotonic sodium chloride solution or distilled water.

     Enter 1 - 2 drops of 6 - 8 times a day.

     To Ear drops, or drops in the nose using solutions containing 10000100000 ED in 1 ml.

     Dental treatment depending on the form and severity of the disease can last from 7 to 10 days to two months or more (with sepsis, septic endocarditis, etc.). If after 3 to 5 days after the start of treatment effect is not there, it should move to other antibiotics, or impose benzylpenicillin with other synthetic antibiotics or chemotherapy drugs.

     Combination therapy may enhance the effectiveness of drugs and to prevent the development of resistant forms of bacteria; Should, however, consider increasing side effects.

     Apply benzylpenicillin, and containing his preparations necessary for the purpose and only under medical supervision. Penicillin appointed only in cases where disease is caused by susceptible to the antibiotic microorganisms.

     It should be borne in mind the possibility of resistance of pathogens (especially penitsillinazoobrazuyuschih staphylococcus) to benzylpenicillin.

     Be aware that the use of low doses of benzylpenicillin (and other antibiotics), or too early termination of treatment often leads to the emergence of resistant strains of pathogens.

     If we find resistance to pathogens benzylpenicillin should replace it with another antibiotic.

     Benzylpenicillin sodium salt of penicillin and other drugs can cause various side effects. Some patients, especially with heightened sensitivity, are headache, increased body temperature, urticaria, skin rashes and skin irritation, pain in joints, eosinophilia, angionevrotichesky swelling and other allergic reactions; Describe anaphylactic shock fatal.

     In inhalation penicillin can develop pharyngitis and laringity allergic nature of asthma attacks.

     In the case of allergic reactions expressed designate adrenaline, glucocorticoids, protivogistaminnye drugs (dimedrol or other), calcium chloride. Applied also penitsillinazu enzyme preparation (see). In severe allergic reactions designate prednisolone or other Glucocorticosteroids.

     When the first signs of anaphylactic shock must be taken to remove the patient from the state (via the introduction, dimedrol, calcium chloride, use heart of inhaling oxygen warming, etc.; Immediately after removing the patient from asphyxia and shock entering 1000000 ED penitsillinazy).

     The use of very high doses of benzylpenicillin, and especially with the introduction endolyumbalnom can cause neurotoxic events (nausea, vomiting, increased excitability reflexive, meningizma symptoms, convulsions, coma). Endolyumbalnye injections must be carried out with great care.

     In appointing benzylpenicillin and preparations containing penicillin, it is necessary to find out whether the patient has complications (MEPhI allergic reactions) in the previous application of penicillin.

     In connection with the possibility of a fungal disease mucous membranes and skin, especially among infants, the elderly and patients weakened useful in the treatment of penicillin appoint B vitamins and vitamin C, as appropriate, nystatin or levorin.

     Benzilpenitsllin and all other drugs penicillin not receive patients with increased sensitivity to penicillin, suffering from bronchial asthma, krapivnitsey, hay fever and other allergic diseases, and those with high sensitivity and unusual reaction to the reception of other antibiotics and other medicines.

     Contraindications to endolyumbalnomu introduction is also epilepsy.

     We recommend that there be no more than 20 million ED daily persons aged 60 years and not to impose massive doses pregnant.

     Product : in vials, sealed rubber congestion, obzhatymi aluminum caps (the same applies to all cans of antibiotics), on 250000; 500,000 and one million ED.

     Storage : List B. In dry place at room temperature.

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