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Chỉ định và Liều dùng
Oral
Lower respiratory tract infections, Upper respiratory tract infections Adult: Each capsule contains amoxicillin 250 mg and bromhexine 8 mg: 1-2 capsules 8 hrly.
Child: 40mg/kg/day given in 3 divided doses. |
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Chống chỉ định
Penicillin allergy, lactation.
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Thận trọng
Pregnancy, renal and hepatic disease and history of peptic ulcer . Infectious mononucleosis.
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Tác dụng không mong muốn
Headache, nausea, dizziness, vomiting, diarrhoea, black hairy tongue, maculopapular rash, urticaria, eosinophilia, hemolytic anemia, thrombocytopenia.
Potentially Fatal: Anaphylaxis, pseudomembranous colitis, acute cytoloytic hepatitis and Stevens-Johnson syndrome. |
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Tương tác
Live oral typhoid vaccine should not be given 3 days before or 3 days after amoxicillin admin as immune response may be attenuated. Amoxicillin increases the anticoagulant response of coumarins. Amoxicillin may reduce OC pill absorption leading to breakthrough bleeding or pregnancy. Amoxicillin reduces the renal clearance of methotrexate and pemetrexate. Amoxicillin level significantly reduced when given with or 2 hr after acacia admin. Bromhexine enhances the penetration of amoxicillin into bronchial secretions.
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Tương tác với thức ăn
Tannins in catha reduced amoxicillin absorption if amoxicillin is admin <2 hr after chewing catha.
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Ảnh hưởng đến kết quả xét nghiệm
Possible interference with urinary glucose tests using cupric sulfate. May increase degradation of aminoglycosides in vitro. Increase in ALT and AST.
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Tác dụng
Description:
Mechanism of Action: Amoxicillin inhibits the final transpeptidation of peptidoglycan synthesis in bacterial cell walls. Hence, cell wall synthesis is inhibited and results in bacterial lysis. Bromhexine is a mucolytic. It thins and liquifies the mucus and helps increased penetration of the antibiotic. The less viscous mucus is easily removed by ciliary movement and expectoration. Pharmacokinetics: Absorption: Amoxicillin: Rapidly and almost completely absorbed from the GI tract; peak plasma concentration (oral): 1-2 hr. Bromhexine: Bioavailability: 20% (oral); peak plasma concentration: 1 hr. Distribution: Amoxicillin: Protein binding: 17-20 %; Widely distributed to body fluid and bone, CSF (small concentrations except when meninges are inflamed). Bromhexine: Highly protein-bound; Widely distributed. Metabolism: Amoxicillin: Partially metabolised to penicilloic acid. Bromhexine: Extensively hepatically metabolized to ambroxol. Excretion: Amoxicillin: Via urine: 60% as unchanged drug. Elimination half-life: Adults: 0.7-1.4hr, CrCl:<10 ml/min: 7-21 hr; infants & children: 1-2 hr.Bromhexine: Via urine: As mainly metabolites; elimination half-life (terminal): 13-40 hr. |
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Phân loại MIMS
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