Indications:

• acute or chronic bronchitis

• acute or chronic pneumonia

• cystic fibrosis

• bronchiectasis

• bronchial asthma in the presence of thickened sputum

• operations on the airways and after intratracheal anesthesia in order to prevent complications

• bronchoscopy, bronchography

Side effects: allergic reactions such as rash, Quincke's edema; vomiting, nausea, diarrhea, dyspeptic disorders; pulmonary hemorrhage (proteolytic enzymes); bronchospasm; weakness, headache, tinnitus; drowsiness

Contraindications: individual intolerance, gastric ulcer and dpk, kidney and liver diseases, bronchial asthma, organic heart damage, the first trimester of pregnancy, breastfeeding.

Bromhexine - the action begins in 30 minutes within 10-12 hours.

110. Antibiotics of the group of carbapenems and monobactams. Classification. Mechanism of action. The nature of the action. Spectrum of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Classification: belong to beta-lactam antibiotics:

1. Carbapenems - imipenem, meropenem, ethapenem.

2. Monobactams - aztreones.

Mechanism: inhibit the synthesis of the cell wall.

The nature of the action: bactericidal.

Spectrum of action: Carbapenems - G + and G-, anaerobes. Monobactams: G-

IndicationsI:

CARBAPENEM	MONOBACTAMS
hospital pneumonia	with exacerbation of chronic bronchitis, community-acquired and hospital-acquired pneumonia
pulmonary sepsis with cystic fibrosis	intra-abdominal and gynecological infections
complicated urinary tract infections	urinary tract infections
community-acquired and hospital intra-abdominal infections	infections of the skin, soft tissues, bones and joints
gynecological and obstetric infections	sepsis
infections of the skin, soft tissues, bones and joints
diabetic foot
neutropenic fever
endocarditis, sepsis
meningitis and brain abscess
prevention of infectious complications of anesthesia and perioperative infections

Side effects:

• nausea, vomiting, diarrhea, allergic reactions, tremors, convulsions (carbapenems)

• abdominal pain, nausea, vomiting, diarrhea, phlebitis, pain and swelling at the site of intramuscular injection, allergic reactions are rare (monobactams)

Contraindications:

• hypersensitivity to β-lactam antibiotics, pregnancy, infants under 3 months, breastfeeding (carbapenems)

• hypersensitivity, pregnancy, infants, breastfeeding, with renal failure and cirrhosis, reduce the dose of antibiotic (monobactams)

Imipenem, tienam - resistant to beta-lactamases, is destroyed in the renal tubules.

Meropenem- resistant to beta-lactamases, does not break down in the renal tubules, lasts 8 hours. Aztreonam - resistant to beta-lactamases, does not work on gram (+), in case of urinary tract infections.