Ticarcillin


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intravenous
Severe Gram-negative infections, Skin infections, Septicaemia, Peritonitis, Bone and joint infections
Adult: 200-300 mg/kg daily by infusion in divided doses every 4 or 6 hr.
Child: 200-300 mg/kg by infusion in divided doses every 4 or 6 hr.

Parenteral
Complicated urinary tract infections
Adult: 150-200 mg/kg daily by IV infusion in divided doses every 4 or 6 hr.
Child: 150-200 mg/kg daily by IV infusion in divided doses every 4 or 6 hr.

Parenteral
Uncomplicated urinary tract infections
Adult: 1 g IM/slow IV Inj every 6 hr.
Child: 50-100 mg/kg in divided doses every 6-8 hr. Do not inject >2 g into each IM site.
Renal Impairment
Intravenous:
Peritoneal dialysis patients: 3 g every 12 hr; haemodialysis patients: 2 g every 12 hr plus an additional dose of 3 g after each dialysis session.
CrClDosage
<10Initial IV loading dose of 3 g, followed by 2 g every 12 hr (or 1 g IM every 6 hr).
<10> with hepatic impairmentInitial IV loading dose of 3 g, followed by 2 g IV every 24 hr or 1 g IM every 12 hr.
10-30Initial IV loading dose of 3 g, followed by 2 g every 8 hr.
30-60Initial IV loading dose of 3 g, followed by 2 g every 4 hr.
Parenteral:
Complicated urinary tract infections: Peritoneal dialysis patients: 3 g every 12 hr; haemodialysis patients: 2 g every 12 hr plus an additional dose of 3 g after each dialysis session.
CrClDosage
<10Initial IV loading dose of 3 g, followed by 2 g every 12 hr (or 1 g IM every 6 hr).
<10 with hepatic impairmentInitial IV loading dose of 3 g, followed by 2 g IV every 24 hr or 1 g IM every 12 hr.
10-30Initial IV loading dose of 3 g, followed by 2 g every 8 hr.
30-60Initial IV loading dose of 3 g, followed by 2 g every 4 hr.
Tương kỵ
Incompatible with aminoglycosides.
Chống chỉ định
Hypersensitivity to penicillins.
Thận trọng
Restricted sodium diet. Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Avoid contact, skin sensitisation may occur. Monitor electrolyte concentrations, renal, hepatic and haematological status during prolonged and high dose therapy. Jarisch-Herxheimer reaction may be seen in spirochete infections particularly syphilis; avoid intrathecal route.
Phản ứng phụ
Pain at the inj site and phlebitis; electrolyte disturbances (hypokalaemia or hypernatraemia); dose-dependent coagulation defect; purpura and haemorrhage; hypersensitivity reactions; haemolytic anaemia; interstitial nephritis; neutropenia; CNS toxicity including convulsions; diarrhoea; pseudomembranous colitis. Haemorrhagic cystitis especially in cystic fibrosis patients.
Potentially Fatal: Anaphylaxis.
IM/IV/Parenteral: B
Tương tác
Probenecid decreases clearance of ticarcillin. Increased bleeding risk with warfarin, acenocoumarol. Possible increase in ciclosporin, methotrexate levels with concurrent use. Possible contraceptive failure with combined oral contraceptives.
Lab Interference
May interfere with diagnostic tests for urinary glucose using copper sulfate, direct Coombs' test, and test for urinary or serum proteins. May interfere with diagnostic tests that use bacteria.
Tác dụng
Description: Ticarcillin is bactericidal through inhibition of the final cross-linking stage of peptidoglycan production by binding and inactivating transpeptidases thus inhibiting bacterial cell wall synthesis. It is active against gram-positive bacteria, gram-negative cocci, Pseudomonas aeruginosa, spirochetes, actinomycetes and has an extended spectrum of gram-negative bacteria compared to benzylpenicillin.
Pharmacokinetics:
Absorption: Not absorbed from GI tract. Peak plasma concentrations: 0.5-1 hr (IM).
Distribution: Widely distibuted. Protein-binding: 50%. Plasma half-life: 70 min; 50 min (patients with cystic fibrosis).
Metabolism: Limited metabolism.
Excretion: 90% excreted unchanged in urine.
Phân loại MIMS
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