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The maximum concentration winstrol reviews pocle single infusion of 400 mg pefloxacin observed after 60 min at 4 ug / ml; therapeutic concentrations are maintained for 12-15 hours. After repeated infusions  serum reach 10 mcg / ml. 25-30% of the administered dose is bound to plasma proteins. Quickly it penetrates and is well distributed in many organs, tissues and body fluids. Therapeutically relevant concentrations exceeding serum concentration observed in clyune, sputum, aortic valve, mitral valve, myocardium, bone, mucosa and intestinal wall, the peritoneal fluid, pancreatic juice and pancreatic tissue (including necrotic) wall cholic bladder, bile, prostate, seminal fluid. The volume of distribution.Upon repeated administration. Part of the dose is metabolized in the liver to form these metabolites: N-dimetilpefloksatsina (norfloxacin, which has significant anti-bacterial activity), pefloxacin-N-oxide-glucuronide and pefloxacin. 50-60% of the administered dose excreted by the kidneys as the unchanged form and in the form of metabolites; 30% is excreted in the bile into the intestinal lumen (also partly unchanged, partly – in the form of active metabolites (norfloxacin)). The content of unchanged drug in urine within 1-2 h after administration -. 25 .mu.g / ml, after 12-24 h -. 15 ug / ml. Unmodified pefloxacin and its metabolites are detected in the urine within 84 hours. After the last injection. Not readily dialysis: pefloxacin extraction rate in hemodialysis – less than 23%.

Indications
Antibiotic treatment of the following infections caused by susceptible microorganisms: infections of the central nervous system (bacterial meningitis caused by meningococcal bacteria and gram-negative, including post-traumatic or post-operative); upper respiratory tract infections and upper respiratory tract (acute and chronic sinusitis, mastoiditis); lower respiratory tract infections (acute and exacerbation of chronic bronchitis, bronchiectasis, hospital and community-acquired pneumonia caused by Gram-negative bacteria and intracellular pathogens); abdominal infections (cholecystitis, cholangitis, treatment and prevention of infectious complications of acute destructive pancreatitis, local and widespread peritonitis, including post-operative); complicated and uncomplicated infections of the kidneys and urinary tract infections (acute exacerbation of chronic pyelonephritis, infectious complications after surgery of the urinary tract); pelvic infections in women (pelvioperitonit, oophoritis, tubo-ovarian abscess, endometritis, Bartolini); infections of the reproductive system in men (orchitis, orchiepididymitis, prostatitis); soft tissue infections; infections of bones and joints; sepsis; infections, sexually transmitted infections (gonorrhea, urogenital chlamydiosis); Bacterial infections of the gastrointestinal tract, including ehsherihioza, shigellosis, cholera, salmonellosis, typhoid fever, paratyphoid A, B, C, yersiniosis.
It is used for antibiotic prophylaxis of postoperative septic complications in urology, abdominal surgery and gynecology.

Contraindications:
Hypersensitivity to fluoroquinolones, children up to 18 years, during pregnancy and lactation, in patients with a deficiency of glucose-6-phosphate dehydrogenase.

Precautions
Patients with neurological disorders (epilepsy, convulsive disorder of unknown etiology, severe organic damage to the central nervous system, cerebrovascular accident); severe renal and / or hepatic insufficiency.

Dosing and Administration
Winstrol reviews is administered by i / v drip infusion lasting at least 60 minutes.
The first dose – 800 mg. Then, 400 mg every 12 hours.
In patients with impaired liver function 400 mg every 24 hours. In more severe violations administered 400 mg every 36 hours. In severe liver disease (jaundice and ascites), the interval between injections is extended to 2 days.
In patients with severe renal impairment (creatinine clearance less than 10 ml / min) and hemodialysis 400 mg every 24 hours.
The duration of treatment is determined by the location and severity of infection. On can be applied parenterally Pefloksabol initial stages of treatment; after the positive dynamics in the presence of the indications for continuing therapy go on receiving the oral form of the drug.
For the prevention of infectious complications in surgical practice recommends the introduction of 400 – 800 mg one hour prior to surgery.

Preparation of the infusion solution
contents of the ampule (5 ml) was diluted with 250 mL of 5% dextrose solution. The resulting solution was injected intravenously during 60 min.

Side-Effects From the nervous system and sensory organs : depression, headache, dizziness, fatigue, insomnia, seizure, anxiety, agitation, tremor, rarely – seizures. On the part of the gastrointestinal tract : nausea, vomiting, diarrhea, transient increase in activity of “liver” transaminases, cholestatic jaundice, hepatitis. With the genitourinary system: crystalluria, rarely – glomerulonephritis, dysuria. Allergicreactions: skin rash, pruritus, urticaria, flushing of the skin, rarely – phototoxic reactions, angioedema, bronchospasm, arthralgia. From the blood system and organs of hematopoiesis : leukopenia, neutropenia, thrombocytopenia, agranulocytosis, eosinophilia. Other : tachycardia, myalgia, tendonitis, candidiasis, lengthening the QT interval. Local reactions : phlebitis.

 

Overdose
symptoms: confusion, convulsions, discoordination movements. Treatment: the specific antidote is not known. Recommended symptomatic treatment, if necessary – hemodialysis and peritoneal dialysis.

Interaction with other drugs Antibiotics : pefloxacin combination with aminoglycosides have synergistic activity against gram-negative aerobic bacteria, including those of P.aeruginosa , allowing you to reduce the dose of aminoglycosides and reduce the likelihood of general relativity – and nephrotoxicity. Additive and synergistic effects achieved by combining pefloxacin with beta-lactam antibiotics, rifampin and fosfomycin. Pefloxacin reduces theophylline metabolism in the liver, resulting in increased concentrations of theophylline in the plasma and the central nervous system. To prevent the development of toxic dose of theophylline should be reduced. Reduces prothrombin index. During treatment with pefloxacin in patients receiving indirect anticoagulants, requires constant monitoring of blood picture.Cimetidine and other inhibitors of microsomal oxidation increase the half-life of pefloxacin, reduced total body clearance, but do not affect the volume of distribution and renal clearance. Due to the physical and chemical incompatibility, pefloxacin, concentrate for solution for infusion should not be diluted with solutions containing chloride ions!

 

Cautions
When mixed winstrol reviews infections, perforated processes in the abdominal cavity, pelvic infections combined with drugs active against anaerobes (metronidazole, clindamycin).
During treatment patients should receive plenty of fluids (to prevent crystalluria).
As in the treatment of other quinolones, due to possible photosensitivity it is recommended to avoid prolonged exposure to direct sunlight or ultraviolet radiation.
For patients with severe liver and kidney disease need dose adjustment in proportion to the degree of damage.
if you experience during or after treatment with pefloxacin severe and prolonged diarrhea is necessary to exclude the development of pseudomembranous colitis (requires immediate withdrawal of the drug and the appointment of appropriate treatment).

Effects on ability to drive vehicles and management mechanisms
In the period of treatment must be careful when driving and other lesson. Potentially hazardous activities that require high concentration and psychomotor speed reactions. how much to inject for weight loss

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