Description overdue on 03/09/2013

Beta-lactam antibiotic. Active kompnenty - cilastatin and imipenem . The drug has a broad spectrum of antimicrobial action. Tienam bactericidal effect on gram-negative flora, anaerobic, aerobic and Gram-positive bacteria . The mechanism of action is based on inhibition of the cell wall of the microorganism to synthesize. One component of the medicament - refers to the group imipenem of the carbapenems is thienamycin derivative.

The second component - cilastatin sodium   It inhibits the action of an enzyme which metabolizes imipenem in the kidney by increasing its concentration in the urinary system unchanged. Cilastatin no effect on beta-lactamase microorganism does not possess its own antibacterial activity. Tienam active against streptococci , Staphylococci, enterococci, Campylobacter, enterobacteria, gardnerellas, Neisseria, Klebsiella, yersiny, Listeria, Mycobacterium. The drug affects the flora, resistant to penicillins, aminoglycosides, cephalosporins. A synergistic effect is observed with aminoglycosides against Pseudomonas aeruginosa in vitro. Tienam produced in powder form for preparation of the solution administered intramuscularly, intravenously.

Indications:

Drug Usage Tienam recommends prescribers in infectious diseases of the skin, the lower respiratory tract, soft tissues, joints, pelvic organs, with sepsis , Intra-abdominal infections, nosocomial infections, bacterial endocarditis When mixed infections, for the prevention of inflammatory processes in the postoperative period.

Contraindications:

Antibiotic Tienam not indicated during pregnancy intolerance to beta-lactam antibiotics, the carbapenems, children up to the age of three months, with severe renal pathology system. The solution was prepared on the basis of lidocaine, for intramuscular injection is contraindicated in case of intolerance to local anesthetics of the amide group (developing shock, broken intracardiac conduction ). When breastfeeding, the elderly and the pathology of the central nervous system Tienam used with caution, after prior consultation of narrow specialists.

Side effect:

Urogenital:   rare in the development of acute renal failure, polyuria, anurii . oliguria . Nervous system:   paresthesia, myoclonus, hallucinations, mental disorders, seizures, confusion. The digestive tract:   rarely develops drug-induced hepatitis, pseudomembranous enterocolitis , Vomiting, nausea and diarrhea syndrome. Hemostatic system and organs of blood:   decrease in hemoglobin levels, eosinophilia, registering a positive Coombs reaction, elongation prothrombin time , Basophilia, monocytosis, thrombocytopenia, neutropenia, lymphocytosis, agranulocytosis, leukopenia. Changes in laboratory parameters:   increased BUN, bilirubin , Creatinine, liver enzymes ALT and AST, the registration of a positive Coombs test. Allergic response:   toxic epidermal necrolysis, angioedema, exudative erythema multiforme, urticaria, skin rashes, fever, pruritus, exfoliative dermatitis, anaphylactic reactions. Perhaps the development of candidiasis, change in taste perception, flushing of the skin, pain, caused by the formation of infiltration in the area of ​​the injection; thrombophlebitis.

Mode of application:

Tienam administered intravenously, intramuscularly. The maximum daily amount of the antibiotic is 4000 mg (calculation scheme 50 mg per 1 kg of body weight). Dose adjustment is carried out based on the renal system operation, weight of the patient and the severity of the condition. Prevention of postoperative complications: 1000 mg intravenously (mandatory induction of anesthesia), followed by 3 hours administered repeatedly. Tienam intramuscularly administered at 500-750 mg 2 times per day (the maximum number of antibiotic - 1500 mg).

Special instructions:

Tienam not used to treat meningitis. Medications can cause staining of urine red. The solution for intramuscular injection is not used for intravenous infusions (vzaimonezamenyaemy). Before the introduction of antibiotic required medical history to identify evidence of allergic responses to beta-lactams. The risk of developing   pseudomembranous enterocolitis significantly increased in patients with disorders of the digestive tract (colitis in history). For prevention   seizures   in predisposed individuals (brain injury history) receiving antiepileptic medications continues throughout the course of treatment. Buy Tienam can be a pharmacy on presentation of a medical prescription form. In the elderly should take into account age-related changes in the renal system, and if necessary, the dose adjustment. The price of the drug Tienam varies depending on the pharmacy network.

Drug Interactions:

Tienam incompatible with other antibiotics lactic acid salt . Perhaps the development of cross-allergy with simultaneous treatment with cephalosporins and penicillins. With regard to other beta-lactams (cephalosporins, penicillins, monobactams) observed antagonism . Generalized seizures develop during treatment with ganciclovir. Drugs that block tubular secretion, may increase the antibiotic in blood and increase the half-life of imipenem.