|Drug Name||cloxacillin sodium for injection|
|chemical name||(2S,5R,6R)-3,3-dimethyl-6-[5-methyl-3-(2-chlorophenyl)-4-isoxylcarbonylamino]-7-oxo-4- Sodium oxa-1-azabicyclo[3.2.0]heptane-2-carboxate.|
This product is a white powder or a crystalline powder.Pharmacology and Toxicology
This product is semi-synthetic penicillin, which has the characteristics of acid and penicillin resistance, antibacterial activity against Gram-positive cocci and Neisseria, and enzyme-producing strains against Staphylococcus (including Staphylococcus aureus and Coagulase-negative Staphylococcus). The antibacterial activity is stronger than that of oxacillin, but the antibacterial effect against penicillin-sensitive staphylococci and various streptococci is weaker than that of penicillin, and it is ineffective against methicillin-resistant staphylococci.Pharmacokinetics
Intramuscular injection of cloxacillin 0.5g, peak plasma concentration (Cmax) reached 0.5 hours, 15mg / L. 0.75 g of cloxacillin was intravenously instilled for 3 hours, and the blood concentration was 15 mg/L and 0.6 mg/L immediately after the end of the instillation and 3 hours later. The serum protein binding rate of this product is 94%, which can penetrate into the bone tissue, pus and joint effusion of patients with acute osteomyelitis, and also has a higher concentration in pleural effusion. It can also enter the fetus through the placenta, but it is difficult to pass the normal blood-cerebrospinal fluid barrier. The half-life (t1/2b) of cloxacillin blood elimination is 0.5-1.1 hours, mainly through glomerular filtration and tubular secretion, and is excreted from the urine. After intravenous infusion of this product, about 62% is excreted from the urine, about 6 % is excreted from bile and a small amount is metabolized in the liver.[indications]
This product is only suitable for the treatment of penicillin-producing staphylococcal infections, including sepsis, endocarditis, pneumonia and skin and soft tissue infections. It can also be used for mixed infections caused by Streptococcus pyogenes or pneumococci and penicillin-resistant Staphylococcus.Dosage
1. Intramuscular injection of adult 2g daily, divided into 4 times, children daily weight of 25 ~ 50mg / kg, divided into 4 times. 0.5% lidocaine can be added to reduce local pain during intramuscular injection.
2. Intravenous infusion of 4 to 6 g per day for adults, divided into 2 to 4 times; children with a weight of 50 to 10 mg / kg a day, divided into 2 to 4 times.
3. If the weight of newborns is less than 2kg, the body weight will be 25mg/kg every 12 hours, and the body weight will be 25mg/kg every 8 hours when the age is 15~30 days. If the body weight exceeds 2kg, the age is 1~14. The body weight is given to 25 mg/kg every 8 hours, and the body weight is 25 mg/kg every 6 hours for 15 to 30 days.
Patients with mild or moderate renal dysfunction do not need to adjust the dose. Patients with severe renal dysfunction should avoid using large doses to prevent central nervous system toxicity.Adverse reactions
1. Allergic reactions: various types of rash such as urticaria are common, leukopenia, interstitial nephritis, asthma attacks and other serum-type reactions can also occur, severe cases such as anaphylactic shock occasionally; once anaphylactic shock occurs, must Rescue on the spot, keep the airway open, oxygen and give adrenaline, glucocorticoid and other treatments.
2. Intravenous injection of this product can produce nausea, vomiting and elevated serum aminotransferase.
3. High-dose injection of this product can cause central nervous system toxicity such as convulsions.
4. It has been reported that infants have hematuria, proteinuria and uremia after using large doses of this product.
5. Individual cases have agranulocytosis or cholestatic jaundice.
Those with a history of allergic reactions to penicillins or those with positive penicillin skin tests are banned.Precautions
1. Before applying this product, you should inquire about the history of drug allergy and conduct a penicillin skin test.
2. Patients who are allergic to a penicillin may be allergic to other penicillins or penicillamine.
3. Patients with allergic diseases such as asthma, eczema, hay fever, urticaria should use this product with caution.
4. This product reduces the ability of patients to bind bilirubin and serum proteins. This product is used with caution in neonates, especially those with jaundice.
[Pregnant women and lactating women]
There is currently a lack of adequate research on the effects of this product on pregnant women, so pregnant women should use this product only when it is really necessary. A small amount of this product is secreted in the milk, so breastfeeding women should stop breastfeeding when applying this product.
Newborns, especially premature babies, should be used with caution.medicine interactions
1. This product is incompatible with aminoglycosides, norepinephrine, m-hydroxylamine, phenobarbital, vitamin B, vitamin C and other drugs. It should not be infused with the same bottle.
2. Probenecid can reduce the secretion of tubulin from cloxacillin and prolong the serum half-life of this product.
3. Aspirin and sulfa drugs inhibit the binding of this product to serum proteins and increase the free blood concentration of this product.
0.5g (calculated according to C19H18ClN3O5S)[Storage]
Sealed and kept in a dry place.
S22Do not breathe dust.
Do not inhale dustFor export only