Antiviral Antibiotic API Material Azithromycin For Urinary Tract Infection 83905-01-5

CAS:83905-01-5 Azithromycin Antiviral antibiotic Antifungal material

Chinese name Azithromycin foreign name Azithromycin alias Azithromycin, Azithromycin molecular formula C38H72N2O12 molecular weight 748.984CAS login number 83905-1-5 density 1.18 g/cm³EINECS login number 617-500-5 melting point 113 To 115 ° C Hazard Description XI, XN Safety Description S22,S36/37,S45 Hazard symbol R42/43

directory

1 indications

2 Clinical application

3 Adverse Reactions

4 Precautions

5 taboo

6 Drug interactions

indications

Applicable to the following infections caused by sensitive bacteria: bronchitis, pneumonia and other lower respiratory tract infections; Skin and soft tissue infections; Acute otitis media; Sinusitis, pharyngitis, tonsillitis and other upper respiratory tract infections (penicillin is the treatment of suppurative streptococcal pharyngitis, is also the commonly used drugs to prevent rheumatic fever. Azithromycin can effectively remove oropharyngeal streptococcus, but there is no data on the efficacy of azithromycin in the treatment and prevention of rheumatic fever. Azithromycin can be used for simple genital infections caused by chlamydia trachomatis in male-female transmitted diseases. Azithromycin can also be used for simple genital infections caused by non-multidrug-resistant gonorrhoeae and chancroid caused by Haemophilus dukei (to exclude the co-infection of Treponema pallidum).

Clinical application of

Take orally once daily, as a whole tablet, with food. Azithromycin tablets are used to treat various infectious diseases. The course of treatment and the method of use are as follows: For sexually transmitted diseases caused by Chlamydia trachomatis, Haemophilus dukei or Neisseria gonorrhoeae, only 1000mg of this product is taken orally once. Treatment for other infections: Total dose 1500mg, 500mg of this product once daily for 3 days. Or the total dose is the same, 500mg on the first day, and 250mg orally once a day from the second to the fifth days.

Adverse reactions

(1) Abnormal blood and lymphatic system: transient neutropenia was occasionally observed in clinical trials, but there was no evidence that azithromycin was associated with it. Ear and labyrinthine abnormalities: some patients with azithromycin have experienced hearing impairment including hearing loss, tinnitus, and/or deafness. According to the investigation and study, this phenomenon is related to the continuous high dose of this product in the patients. Through the follow-up of these patients, it was found that most of the patients' hearing could be restored. (2) Gastrointestinal abnormalities: nausea, vomiting, diarrhea, loose stools, abdominal discomfort (pain or cramps), flatulence. (3) Abnormal hepatobiliary system: abnormal liver function. 2. Skin and subcutaneous soft tissue abnormalities: allergic reactions including rash and angioneurotic edema. Other adverse events reported during use of this product after marketing include: (1) Infection and implantation: candidiasis and vaginitis. (2) Blood and lymphatic system abnormalities: thrombocytopenia. (3) Abnormal immune system: allergic reaction (rarely fatal). (4) Abnormal metabolism and nutrition: anorexia. (5) mental disorders: aggressive reaction, nervousness, anxiety, anxiety. (6) Nervous system abnormalities: dizziness, convulsion (similar to other macrolide types), headache, increased activity, somatosensory, paresthesia, lethargy, fainting. There are rare reports of taste/smell inversions and/or omissions. But whether it is related to medication is not clear. (7) Abnormal ears and labyrinth: vertigo. (8) Cardiac abnormalities: Palpitations and arrhythmias, including ventricular tachycardia (as with other macrolides), have been reported; Prolonged QT interval and apex torsion ventricular tachycardia have rarely been reported. However, azithromycin has not been associated with these adverse events. (9) Vascular abnormalities: hypotension. (10) Gastrointestinal abnormalities: vomiting/diarrhea (rare dehydration), dyspepsia, constipation, pseudomembolic enteritis, pancreatitis, and tongue discoloration (rare).

Matters needing attention

1. As with erythromycin and other macrolides, severe allergic reactions such as angioedema and anaphylaxis (rarely fatal) are rarely reported. Some reactions caused by azithromycin may be recurrent and require longer observation and treatment. 2. Because the liver is the main pathway of azithromycin clearance, the use of azithromycin in patients with obvious liver disease should be cautious. 3. Ergotoxicosis has been reported in patients treated with ergot derivatives while taking some macrolide antibiotics. Although there is no evidence of interaction between ergomycin and azithromycin, it is not advisable to administer azithromycin and ergomycin derivatives at the same time due to the theoretical possibility of ergotoxicosis. 4. As with other antibiotic preparations, attention should be paid to the symptoms of double infection caused by non-sensitive bacteria, including fungi. 5. Clostridium difficile associated diarrhea (CDAD), including azithromycin, has been reported with almost all antimicrobial agents, which can range in severity from mild diarrhea to fatal enteritis. Antimicrobial therapy can cause changes in the normal bacterial flora of the colon, leading to overgrowth of C. difficile. Toxins A and B produced by Clostridium difficile are associated with the pathogenesis of CDAD. Highly virulent Clostridium difficile causes increased morbidity and mortality. These infections may not respond to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who develop diarrhea following antibiotic treatment. Since CDAD has been reported after more than 2 months of antimicrobial therapy, careful medical history should be taken. 6. In patients with severe renal insufficiency (glomerular filtration rate < 10 mL /min), the systemic exposure to azithromycin was increased by 33%. 7. The use of other macrolides has been reported to cause cardiac repolarization and prolonged QT interval, leading to the risk of arrhythmias and tip torsion ventricular tachycardia. Azithromycin cannot be ruled out as having similar effects in patients at increased risk of prolonged cardiac repolarization. 8. There was no evidence that azithromycin affected the patient's ability to drive or operate the machine.

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taboo

It is contraband for those allergic to azithromycin, erythromycin or any other macrolides.

Drug interaction

Aluminum and magnesium antacid agents can decrease the peak plasma concentration of oral azithromycin, but do not decrease the AUC value.

Oral administration of azithromycin did not affect plasma theophylline level or pharmacokinetics after intravenous administration of a single dose of theophylline. Since macrolides are currently available to increase plasma theophylline concentrations, caution should be taken when administered with azithromycin and theophylline together, and plasma theophylline levels should be monitored.

Oral administration of azithromycin did not affect the prothrombin time with single dose of benzylacetone. However, caution should be exercised when administering azithromycin and benzylacetone together, and careful monitoring of prothrombin time should be taken. Clinically, the use of macrolides and benzyl acetone at the same time increases the effectiveness of anticoagulants.

Close observation of patients is recommended when azithromycin is used together with the following drugs:

Digoxin - Increases digoxin levels.

Ergotamine or dihydroergotamine -- Symptoms of acute ergotamine toxicity are severe peripheral vasospasm and hyperesthesia (tactile pain).

Triazolam - The pharmacological effects of triazolam are enhanced by reducing the degradation of triazolam.

Cytochrome P450 system metabolic drug - increases serum levels of carbamazepine, terfinadine, cyclosporine, cyclohexobarbital, phenytoin, etc