Hydroxymethylquinoxaline dioxide + Isoniazid - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Antibiotics

Included in the formulation

Hicksozid

lyophilizate d / inhal. c / cavity

MIR-FARM, LLC Russia

АТХ:

J.04.A.C.51 Isoniazid in combination with other drugs

Pharmacodynamics:

Combined anti-tuberculosis drug.

Hydroxymethyl-quinoxylindioxide

Synthetic antibacterial agent, a derivative of quinoxaline. Activates the processes of peroxidation, which lead to a disruption of DNA biosynthesis and deep structural changes in the cytoplasm of microbial cells.

Has a bactericidal effect in relation to the rod of Rod Friedlander, Proteus vulgaris, Pseudomonas aeruginosa, Escherichia coli, Salmonella spp., Shigella dysenteria, Shigella boydii, Shigella flexneri, Shigella sonnei, Staphylococcus spp., Streptococcus spp., anaerobes Clostridium perfringens.

Isoniazid

Inhibits the enzymes necessary for the synthesis of mycolic acids, which are the main structural fragments of the cell walls of mycobacterium tuberculosis.

The most intensive synthesis of mycolic acids is carried out in growing cells, so isoniazid has a bactericidal action on them, and bacteriostatic action on mature cells. The high selectivity of the chemotherapeutic effect of isoniazid is due to the fact that there are no mycolic acids in the tissues of the macroorganism, as well as in other microorganisms.

In combination with hydroxymethylquinoxaline dioxide, 5 times more active against mycobacteria tuberculosis.

Pharmacokinetics:

After inhalation or pleural administration quickly leaves the general blood flow, being distributed along the body fluids: pleural, cerebrospinal, ascitic. It accumulates in sputum, saliva, lung tissue, muscles, liver and kidneys. Penetrates through the blood-brain and placental barrier, is found in breast milk.

Metabolism in the liver.

The half-life of hydroxymethylquinoxaline dioxide is 6-8 hours; isoniazid - for "fast acetylators" is 1 hour, for "slow acetylators" - 3 hours. The rate of acetylation of the drug is genetically determined, so the half-life of isoniazid varies.

Elimination by the kidneys.

Indications:

It is used for the treatment of fibro-cavernous tuberculosis, bronchial tuberculosis, bronchial fistula, tuberculosis empyema.

ICD-10

I.A15-A19.A15 Tuberculosis of respiratory organs, confirmed bacteriologically and histologically

Contraindications:

Epilepsy, organic diseases of the central nervous system, insufficiency of adrenal cortex function, acute heart failure, individual intolerance, children under 18 years of age.

Carefully:

Atherosclerosis, psoriasis, bronchial asthma, renal insufficiency, myxedema, hypersensitivity.

Pregnancy and lactation:

Recommendations for FDA - category D. Contraindicated in pregnancy and lactation.

Dosing and Administration:

Inhalation, once a day after meals, depending on the patient's body weight:

30-40 kg: 5 ml;

40-50 kg: 8 ml;

60 kg or more: 10 ml.

Intrapleural, once a day after ingestion, depending on the patient's body weight:

30-40 kg: 2 ml;

40-50 kg: 8 ml;

60 kg or more: 10 ml.

The highest daily dose: 10 ml.

The highest single dose: 10 ml.

Side effects:

Central and peripheral nervous system: memory disorders, insomnia, mental disorders disorders, euphoria, peripheral neuritis, muscle twitching, hallucinations.

The cardiovascular system: pain in the heart.

Digestive system: gastralgia, vomiting, diarrhea, drug-induced hepatitis.

Musculoskeletal system: tetany (convulsions gastrocnemius muscles).

Dermatological reactions: itching, rash, candidiasis.

Sense organs: optic neuritis - blurred vision or loss of vision.

Reproductive system: gynecomastia, menorrhagia.

Chills, fever, allergic reactions.

Overdose:

Cases of overdose are not described.

Treatment is symptomatic.

Interaction:

Strengthens the action indirect hemocoagulants.

Inhibits the metabolism of benzodiazepines, phenytoin and theophylline.

Simultaneous use with paracetamol and other hepatotoxic substances increases the risk of toxic hepatonecrosis.

Antatsidnye means slow down and reduce the absorption of isoniazid in the intestine, it is recommended to take them with an interval of 1 hour.

With the simultaneous use of certain fish species (tuna, sardinella) and cheeses (Swiss), there may be a hyperemia of the skin, itching, headache due to the isoniazid suppression of monoamine oxidase and diaminoxidase activity in the blood plasma and a violation of the metabolism of histamine and tyramine.

Special instructions:

In the treatment it is not recommended to drive vehicles and work with moving mechanisms.

To prevent and reduce the side effects of isoniazid, the intake of vitamins B₁ and B₆, as well as glutamic acid.

Instructions

Hydroxymethylquinoxaline dioxide + isoniazid (Hydroxymethylchinoxalindioxydum + Isoniazidum)