peniciline antistafilococice
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PENICILINE PENICILINE ANTISTAFILOCOCICEANTISTAFILOCOCICE
Meticilina, Nafcilina, Oxacilina, Meticilina, Nafcilina, Oxacilina, Dicloxacilina, FlucloxacilinaDicloxacilina, Flucloxacilina
Sunt active pe stafilococi secretori Sunt active pe stafilococi secretori de betalactamaza-exceptie Staf. de betalactamaza-exceptie Staf. MRSAMRSA
Reactii adverse : tulburari digestive, Reactii adverse : tulburari digestive, hepatice,leucopenie, nefrite toxice, hepatice,leucopenie, nefrite toxice, reactii alergicereactii alergice
OxacilinaOxacilina
AdministrareAdministrare Per os, i.m., i.v.Per os, i.m., i.v.
T1/2T1/2 30-60 min30-60 min
Biodisponibilitate 33%Biodisponibilitate 33%
Legare de prot. Legare de prot. plasmaticeplasmatice
90%90%
Distributie in Distributie in tes.tes.
In majoritatea tes. Nu trece In majoritatea tes. Nu trece in LCRin LCR
Traverseaza placenta, Traverseaza placenta, partial in laptele maternpartial in laptele matern
EliminareaEliminarea Renala 45% forma activa, Renala 45% forma activa, restul sub forma de restul sub forma de metabolitimetaboliti
OXACILINAOXACILINA
POSOLOGIA:POSOLOGIA:Adulti: 2-3g/zi la 6oreAdulti: 2-3g/zi la 6ore Nou-nascuti 20-30mg/kg/zi - 4 prizeNou-nascuti 20-30mg/kg/zi - 4 prizeSugar, copil mic :Sugar, copil mic : - 50-80mg/kg/zi - 4 prize- 50-80mg/kg/zi - 4 prizeInfectii grave: Adulti 2-12g/zi i.m. sau i.v.Infectii grave: Adulti 2-12g/zi i.m. sau i.v. Copii 100-200mg/kg/zi i.m. Copii 100-200mg/kg/zi i.m.
sau i.v.sau i.v.
NafcilinaNafcilina
AdministrareAdministrare i.m., i.v.i.m., i.v.
T1/2T1/2 60 min60 min
Legare de prot. Legare de prot. plasmaticeplasmatice
90%90%
Distributie in Distributie in tes.tes.
In majoritatea tes. Nu trece In majoritatea tes. Nu trece in LCRin LCR
Traverseaza placenta, Traverseaza placenta, partial in laptele maternpartial in laptele matern
EliminareaEliminarea Renala 33% forma activa, Renala 33% forma activa, restul prin metabolizare restul prin metabolizare hepaticahepaticaAdulti 500mg la 6 ore, copii 25mg/kg/ziAdulti 500mg la 6 ore, copii 25mg/kg/zi
PENICILINE CU SPECTRU PENICILINE CU SPECTRU LARGLARG
AMOXICILINA, AMPICILINAAMOXICILINA, AMPICILINA PIVAMPICILINA, BACAMPICILINA, PIVAMPICILINA, BACAMPICILINA,
TALAMPICILINATALAMPICILINA
Gram-pozitivi Gram-pozitivi Gram-negativiGram-negativi
pen-susc pen-susc S. aureusS. aureus Proteus mirabilis Proteus mirabilisGroup streptococciGroup streptococci SSalmonella, Shigellaalmonella, Shigella E. coliE. coliEnterococcus sp.Enterococcus sp. L- L- H. influenzaeH. influenzae Listeria monocytogenesListeria monocytogenes
AMPICILINAAMPICILINA
AdministrareAdministrare Per os, i.m., i.v.Per os, i.m., i.v.
T1/2T1/2 90 min90 min
Biodisponibilitate 60%Biodisponibilitate 60%
Legare de prot. Legare de prot. plasmaticeplasmatice
18%18%
Distributie in Distributie in tes.tes.
In majoritatea tes. trece in In majoritatea tes. trece in LCR LCR
Traverseaza placenta, Traverseaza placenta, partial in laptele maternpartial in laptele matern
EliminareaEliminarea Renala 82% forma activa, Renala 82% forma activa, restul prin bila si scaunrestul prin bila si scaun
AMPICILINAAMPICILINA
POSOLOGIA:POSOLOGIA: Adulti: 2-4g/zi la 6oreAdulti: 2-4g/zi la 6ore Nou-nascuti 50-100mg/kg/zi - 4 prizeNou-nascuti 50-100mg/kg/zi - 4 prize Sugar, copil mic :Sugar, copil mic : - 100-200mg/kg/zi - 4 prize- 100-200mg/kg/zi - 4 prize Infectii grave: Adulti 4-12g/zi i.m. sau i.v.Infectii grave: Adulti 4-12g/zi i.m. sau i.v. Copii 200-400mg/kg/zi i.m. Copii 200-400mg/kg/zi i.m.
sau i.v.sau i.v.
AMPICILINAAMPICILINA
INDICATII TERAPEUTICE:INDICATII TERAPEUTICE:
- meningite bacteriene- meningite bacteriene
- sinuzite, otite medii, bronsite - sinuzite, otite medii, bronsite cronice acutizatecronice acutizate
- infectii urinare- infectii urinare
- infectii biliare, inf. Intestinale- infectii biliare, inf. Intestinale
Reactii adverse: reactii alergice si Reactii adverse: reactii alergice si tulburari gastrointestinaletulburari gastrointestinale
AMOXICILINAAMOXICILINA
AdministrareAdministrare Per os, i.m., i.v.Per os, i.m., i.v.
T1/2T1/2 110 min110 min
Biodisponibilitate 98%Biodisponibilitate 98%
Legare de prot. Legare de prot. plasmaticeplasmatice
Distributie in Distributie in tes.tes.
In majoritatea tes. trece in In majoritatea tes. trece in LCR LCR
Traverseaza placenta, Traverseaza placenta, partial in laptele maternpartial in laptele matern
EliminareaEliminarea Renala 86% forma activa, Renala 86% forma activa, restul prin bila si scaunrestul prin bila si scaun
AMOXICILINAAMOXICILINA POSOLOGIA:POSOLOGIA: Adulti: inf. Medii-grave 2-4g/zi la 8oreAdulti: inf. Medii-grave 2-4g/zi la 8ore inf usoare- 250mg la 8 oreinf usoare- 250mg la 8 ore copil >2ani 62,5 mg la 8 orecopil >2ani 62,5 mg la 8 ore copil >2ani 125 mg la 8 orecopil >2ani 125 mg la 8 ore Infectii grave: Adulti 500mg/8ore i.m. sau i.v.Infectii grave: Adulti 500mg/8ore i.m. sau i.v. Copii 50-100mg/kg/zi i.m. sau i.v. Copii 50-100mg/kg/zi i.m. sau i.v.
3prize3prize
COMBINATIICOMBINATII
AMPICILINA + SULFBACTAM 2:1AMPICILINA + SULFBACTAM 2:1 AMOXICILINA + ACID AMOXICILINA + ACID
CLAVULANIC 4:1CLAVULANIC 4:1
PENICILINE ACTIVE PE PENICILINE ACTIVE PE PSEUDOMONAS PSEUDOMONAS AERUGINOSAAERUGINOSA
CARBOXIPENICILINE: CARBOXIPENICILINE: carbenicilina, carbenicilina, ticarcilinaticarcilina
Gram-negativiGram-negativi
Proteus mirabilisProteus mirabilis
SSalmonella, Shigellaalmonella, Shigella E. coliE. coliH. influenzaeH. influenzaeEnterobacter sp.Enterobacter sp.Pseudomonas aeruginosaPseudomonas aeruginosa
PENICILINE ACTIVE PE PENICILINE ACTIVE PE PSEUDOMONAS PSEUDOMONAS AERUGINOSAAERUGINOSA
UREIDOPENICILINE : piperacilina, UREIDOPENICILINE : piperacilina, azlocilinaazlocilinaGram-pozitivi Gram-pozitivi Gram-negativi Gram-negativi viridans strepviridans strep Proteus mirabilisProteus mirabilis SSalmonella, Shigellaalmonella, Shigella EnterococcusEnterococcus E. coliE. coli
L- L- H. influenzaeH. influenzae AnaerobiAnaerobi Enterobacter sp.Enterobacter sp. Pseudomonas Pseudomonas aeruginosaaeruginosa
Serratia marcescensSerratia marcescens
CARBENICILINACARBENICILINA
AdministrareAdministrare Per i.m., i.v.Per i.m., i.v.
T1/2T1/2 60 min60 min
Legare de prot. Legare de prot. plasmaticeplasmatice
50%50%
Distributie in Distributie in tes.tes.
In majoritatea tes. Trece in In majoritatea tes. Trece in LCR 30-50%, nu LCR 30-50%, nu traverseaza meningele traverseaza meningele inflamatinflamat
EliminareaEliminarea Renala 80% forma activa, Renala 80% forma activa, restul prin bila si scaunrestul prin bila si scaun
CARBENICILINACARBENICILINA
INDICATII TERAPEUTICE:INDICATII TERAPEUTICE:
- Infectii cu PSEUDOMONAS- Infectii cu PSEUDOMONAS
- inf respiratorii pneumonii, - inf respiratorii pneumonii,
- arsuri infectate,infectii cutanate- arsuri infectate,infectii cutanate
- infectii urinare- infectii urinare
- Se asociaza cu aminoglicozide- Se asociaza cu aminoglicozide
Reactii adverse: accidente hemoragice, Reactii adverse: accidente hemoragice, hipokaliemie hepatice,leucopenie, nefrite hipokaliemie hepatice,leucopenie, nefrite toxice, reactii alergicetoxice, reactii alergice
CARBENICILINACARBENICILINA
POSOLOGIA: POSOLOGIA: In inf urinare: 50-100mg/kg/ziIn inf urinare: 50-100mg/kg/zi In inf sistemice cu Enterobacte, Proteus In inf sistemice cu Enterobacte, Proteus 200 mg/kg/zi200 mg/kg/zi
Infectii grave: Adulti 20-40g/zi i.m. sau Infectii grave: Adulti 20-40g/zi i.m. sau i.v la 8ore.i.v la 8ore.
Copii 100-600mg/kg/zi i.m. Copii 100-600mg/kg/zi i.m. sau i.v.sau i.v.
PIPERACILINAPIPERACILINA
AdministrareAdministrare i.m., i.v.i.m., i.v.
T1/2T1/2 90 min90 min
Legare de prot. Legare de prot. plasmaticeplasmatice
50%50%
Distributie in Distributie in tes.tes.
In majoritatea tes. Trece in In majoritatea tes. Trece in LCRLCR
EliminareaEliminarea Renala 80% forma activa, Renala 80% forma activa, restul prin bila si scaunrestul prin bila si scaun
PIPERACILINAPIPERACILINA
Indicatii terapeutice: inf. Indicatii terapeutice: inf. Abdominale, pulmonare, urinare, Abdominale, pulmonare, urinare, ginecologice si ale pielii oaselor si ginecologice si ale pielii oaselor si articulatiilor cu germeni sensibiliarticulatiilor cu germeni sensibili
125-300mg/kg/zi la 6 ore <2g/doza125-300mg/kg/zi la 6 ore <2g/doza Piperacilina+Tazobactam- 4,5 g Piperacilina+Tazobactam- 4,5 g
(8:1) la 8 ore(8:1) la 8 ore R. adverse:R. adverse:
CEFALOSPORINECEFALOSPORINE
Cephalosporium acremonium Inel dihidrotiazinic + inel
betalactamic 4 generatii
Cefalosporinele de Cefalosporinele de generatia Igeneratia I
CEFAZOLINA,CEFALOTINA,CEFAPIRINCEFAZOLINA,CEFALOTINA,CEFAPIRINA,CEFATRIZINA,CEFATRIZIN, CEFALEXINA, , CEFALEXINA, CEFADROXIL, CEFRADINACEFADROXIL, CEFRADINA
Actiune foarte buna impotriva germenilor Actiune foarte buna impotriva germenilor aerobi gram pozitivi si actiune limitata aerobi gram pozitivi si actiune limitata impotriva catorva germeni aerobi gram-impotriva catorva germeni aerobi gram-negativi.negativi.
Gram-pozitivi Gram-pozitivi Gram-negativiGram-negativimeth-susc meth-susc S. aureusS. aureus E. coliE. colipen-susc pen-susc S. pneumoniaeS. pneumoniae K. pneumoniaeK. pneumoniae streptococcistreptococci P. mirabilisP. mirabilisviridans streptococci viridans streptococci
Cefalosporinele de Cefalosporinele de generatia IIgeneratia II
CEFAMANDOL,CEFUROXIM, CEFAMANDOL,CEFUROXIM, CEFOXITINA, CEFOTETAN, CEFONICID, CEFOXITINA, CEFOTETAN, CEFONICID, CEFORANIDCEFORANID, CEFACLOR, CEFACLOR
Gram-pozitiviGram-pozitivi Gram-Gram-negativinegativi
meth-susc meth-susc S. aureusS. aureus E. coliE. colipen-susc pen-susc S. pneumoniaeS. pneumoniae K. pneumoniaeK. pneumoniaeGroup streptococciGroup streptococci P. mirabilisP. mirabilisviridans streptococciviridans streptococci H. influenzaeH. influenzae
M. catarrhalisM. catarrhalisNeisseria sp.Neisseria sp.
Cefalosporinele de Cefalosporinele de generatia IIIgeneratia III
CEFTRIAXON, CEFOTAXIM, CEFOPERAZONA, CEFTRIAXON, CEFOTAXIM, CEFOPERAZONA, CEFTAZIDIM, CEFPIRON, MOXALACTAMCEFTAZIDIM, CEFPIRON, MOXALACTAM
Gram-negativi aerobiGram-negativi aerobiE. coliE. coli, , K. pneumoniaeK. pneumoniae, , P. mirabilisP. mirabilisH. influenzaeH. influenzae, , M. catarrhalisM. catarrhalis, , N. gonorrhoeaeN. gonorrhoeae ; ; N. N. meningitidismeningitidis
CitrobacterCitrobacter sp., sp., EnterobacterEnterobacter sp., sp., AcinetobacterAcinetobacter sp. sp.Morganella morganiiMorganella morganii, , Serratia marcescensSerratia marcescens, , ProvidenciaProvidenciaPseudomonas aeruginosaPseudomonas aeruginosa (ceftazidim si (ceftazidim si cefoperazona)cefoperazona)
Gram-pozitivi aerobiGram-pozitivi aerobiS. Pneumonie pen. rez. S. Pneumonie pen. rez. (ceftriaxon si cefotaxim)(ceftriaxon si cefotaxim)
Cefalosporinele de Cefalosporinele de generatia IVgeneratia IV
Extinderea spectrului de activitateExtinderea spectrului de activitate gram-positivi: similar cu ceftriaxongram-positivi: similar cu ceftriaxon gram-negatives: similar cu ceftazidim, gram-negatives: similar cu ceftazidim,
incluzand incluzand Pseudomonas aeruginosaPseudomonas aeruginosa; ; EnterobacterEnterobacter sp producator de betalactamaza. sp producator de betalactamaza.
Sunt stabile la Sunt stabile la -lactamases; spectrul -lactamases; spectrul acopera toti germenii producatori de acopera toti germenii producatori de betalactamaza betalactamaza
• CEFEPIMACEFEPIMA
REACTII ADVERSEREACTII ADVERSE
Reactii de hipersensibilizare : urticarie, Reactii de hipersensibilizare : urticarie, bronhospasm, soc anafilacticbronhospasm, soc anafilactic
Reactii hematologice: tulburari de Reactii hematologice: tulburari de coagulare, neutropenie, trombocitopenie.coagulare, neutropenie, trombocitopenie.
Nefrotoxicitate la asocierea cu Nefrotoxicitate la asocierea cu aminoglicozideaminoglicozide
HepatotoxicitateHepatotoxicitate Tulburari gastrointestinaleTulburari gastrointestinale Flebita, durere la locul administrariiFlebita, durere la locul administrarii
CEFALOTINACEFALOTINA
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 05-1g la 6 oreAdult: 05-1g la 6 ore
Copil: 100mg/kg/zi la 6 oreCopil: 100mg/kg/zi la 6 ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
90 min90 min
50%50%
Distributie in tes.Distributie in tes. In majoritatea tes. Nu trece In majoritatea tes. Nu trece in LCR.in LCR.
EliminareaEliminarea Renala 50% forma activa,Renala 50% forma activa,
CefazolinaCefazolina
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 0.5-2g la 12 oreAdult: 0.5-2g la 12 ore
Copil: 100mg/kg/zi la 6 oreCopil: 100mg/kg/zi la 6 ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
180 min180 min
80%80%
Distributie in tes.Distributie in tes. In majoritatea tes. Nu trece In majoritatea tes. Nu trece in LCR.in LCR.
EliminareaEliminarea Renala 100% forma Renala 100% forma activa,filtrare glomerularaactiva,filtrare glomerulara
CEFALEXINACEFALEXINA
AdministrareAdministrare Per osPer os
DozeDoze Adult: 0.5-1g la 8 oreAdult: 0.5-1g la 8 ore
Copil: 50-100mg/kg/zi la 8 Copil: 50-100mg/kg/zi la 8 oreore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
120 min120 min
80%80%
Distributie in tes.Distributie in tes. In majoritatea tes. In majoritatea tes.
Biodisponibilitate 50%Biodisponibilitate 50%
EliminareaEliminarea Renala 80% forma Renala 80% forma activa,secretie activaactiva,secretie activa
CEFUROXIMCEFUROXIMAdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 750-1500mg la 12 Adult: 750-1500mg la 12 oreore
Copil: 100mg/kg/zi la 12oreCopil: 100mg/kg/zi la 12ore
500mg la 12 ore in inf. 500mg la 12 ore in inf. Pulm.Pulm.
250 mg la 12 ore in inf. 250 mg la 12 ore in inf. urinareurinare
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
Distributie in tes.Distributie in tes. In majoritatea tes. Trece in In majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 90% forma activa,Renala 90% forma activa,
CEFACLORCEFACLOR
AdministrareAdministrare Per osPer os
DozeDoze Adult: 750mg la 8 oreAdult: 750mg la 8 ore
Copil: 20mg/kg/zi la 8 oreCopil: 20mg/kg/zi la 8 ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
120 min120 min
80%80%
Distributie in tes.Distributie in tes. In majoritatea tes. Nu trece In majoritatea tes. Nu trece in LCRin LCR
Biodisponibilitate 80%Biodisponibilitate 80%
EliminareaEliminarea Renala 60% forma Renala 60% forma activa,secretie activa, 40% activa,secretie activa, 40% biliarabiliara
CEFOTAXIMCEFOTAXIM
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 1-2g la 12 oreAdult: 1-2g la 12 ore
Copil: 50-100mg/kg/zi la Copil: 50-100mg/kg/zi la 12ore12ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
180 min180 min
80-90%80-90%
Distributie in tes.Distributie in tes. In majoritatea tes. Trece in In majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 40% forma activa, Renala 40% forma activa, 15% metaboliti activi, 45% 15% metaboliti activi, 45% metaboliti inactivimetaboliti inactivi
CEFTRIAXONCEFTRIAXON
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 1-2g la 12 oreAdult: 1-2g la 12 ore
Copil: 50-100mg/kg/zi la Copil: 50-100mg/kg/zi la 12ore12ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
180 min180 min
90-95%90-95%
Distributie in tes.Distributie in tes. In majoritatea tes. Trece in In majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 60% forma activa, Renala 60% forma activa, 40% prin bila40% prin bila
CEFOPERAZONACEFOPERAZONA
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 1-2g la 12 oreAdult: 1-2g la 12 ore
Copil: 50-100mg/kg/zi la Copil: 50-100mg/kg/zi la 12ore12ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
180 min180 min
90%90%
Distributie in tes.Distributie in tes. In majoritatea tes. Trece in In majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 30% forma activa, Renala 30% forma activa, 70% prin bila70% prin bila
CEFTAZIDIMCEFTAZIDIM
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 1-2g la 12 oreAdult: 1-2g la 12 ore
Copil: 50-100mg/kg/zi la Copil: 50-100mg/kg/zi la 12ore12ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
180 min180 min
Distributie in tes.Distributie in tes. In majoritatea tes. Trece in In majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 85% forma activa,Renala 85% forma activa,
CEFEPIMACEFEPIMA
AdministrareAdministrare i.m., i.v.i.m., i.v.
DozeDoze Adult: 0.5-2g la 12 oreAdult: 0.5-2g la 12 ore
Copil: 50-100mg/kg/zi la Copil: 50-100mg/kg/zi la 12ore12ore
T1/2T1/2
Legare de prot. Legare de prot. plasmaticeplasmatice
120 min120 min
85%85%
Distributie in tes.Distributie in tes. Vol de distrib: 14-20 l.In Vol de distrib: 14-20 l.In majoritatea tes. Trece in majoritatea tes. Trece in LCR.-concentratii activeLCR.-concentratii active
EliminareaEliminarea Renala 85% forma activa,Renala 85% forma activa,
CEFEPIMACEFEPIMA
Rezistenta germenilor la cefepima se Rezistenta germenilor la cefepima se realizeaza mai greurealizeaza mai greu
Are molecula cu sarcina pozitiva si Are molecula cu sarcina pozitiva si patrunde mai usor prin porii patrunde mai usor prin porii membranei bacterienemembranei bacteriene
Are afinitate mai mare pentru Are afinitate mai mare pentru proteinele receptoare PBP proteinele receptoare PBP
Este stabila la actiunea Este stabila la actiunea betalactamazelorbetalactamazelor