Zaxter

Antimicrobial agent of wide application, produced by Alchem Laboratories Ltd (India) - Zakster (international name and active element of the drug - Meropenem). The accompanying component is anhydrous sodium carbonate.

Indications Zaxter

The drug in question, by its purpose, can be classified as an antibiotic (beta-lactam group). Indications for the use of Zakster are the need to stop diseases caused by pathogenic bacteria that respond positively to meropenem (a broad-spectrum bactericidal antibiotic).

• Pneumonia.
• Inflammation of the pleura ( pleurisy ).
• Septicemia (blood infection - a form of sepsis).
• Urinary tract infection.
• Endometritis (inflammation of the uterine mucosa) and other infectious diseases of a gynecological nature.
• An infection caused by microorganisms that colonize the gastrointestinal tract and spread to other, usually sterile, areas of the abdominal cavity.
• Infection of the skin and muscle tissue.
• Meningitis (inflammation of the soft membranes around the brain and spinal cord).
• Febrile neutropenia, if there is a suspicion that the causative agent of the disease in adults is pathogenic flora. The protocol of therapeutic measures considers the drug Zakster in two forms: either as a monodrug, or it is taken in combination with other drugs of antiviral or antifungal action.
• Other polymicrobial infections. Drug therapy is prescribed as in the previous case: either Zakster is used as the only drug in the course, or as a component of a whole complex of antimicrobial medications.

Release form

The powder, which is subsequently diluted and used as a solution for injections (1000 mg in vials) is the only form of release of the drug Zakster, which does not distinguish it from other drugs.

Pharmacodynamics

Suggested by the pharmaceutical company Alchem Laboratories Ltd. Zakster is a carbapenem antibiotic. It is used parenterally, that is, bypassing the gastrointestinal tract (injections, inhalations). This drug is quite stable to the influence of human dihydropeptidase, for this reason there is no need for additional administration of drugs that reduce the rate of reactions occurring in the patient's body. The active substance of the drug Zakster has an antimicrobial effect on the functional systems of the patient due to the active effect on the educational processes of the pathogenic cell.

Pharmacodynamics of Zakster with its high level of bactericidal action, covering a wide range of anaerobic and aerobic microorganisms, is due to the fact that the active component of the drug is close in parameters to the protein of human blood. Meropenem perfectly binds penicillin (PBP), and also has a stable neutrality to many representatives of serine beta-lactamases.

Meropenem does not reveal any signs of allergic nature as a result of testing. Other observations and studies show that Zakster acts not in opposition to, but in tandem with various antibiotics. The use of meropenem gives an excellent post-antibiotic result. Based on the results of numerous monitoring, pharmacists, together with practicing doctors, established an effective dosage of the drug and proposed general recommendations on the necessary sensitivity of pathogenic flora to meropenem.

The antimicrobial spectrum of the drug Zaxtera, with its active substance meropenem, includes most of the known medical and clinically frequently activated aerobic and anaerobic, gram-positive and gram-negative strains of bacteria.

Pharmacokinetics

The absorption process. Depending on the dosage of the drug and the rate of intravenous administration, the maximum content of the drug in the blood can vary from 23 mcg / ml to 112 mcg / ml. The pharmacokinetics of Zakster is also manifested in the fact that it works as a link with the protein of the serum plasma by only 2%. The drug in question has an excellent property of high penetration into the liquid components and various tissue layers of the human body. Already within half an hour - an hour and a half (depending on the characteristics of the patient's body) after the administration of the drug, the blood receives a therapeutic dosage. During this time, only an insignificant part of the drug penetrates the patient's liver, degenerating into a certain inactive metabolite.

Metabolism and excretion of Zaxter. The half-life of the drug is short and is only one hour from the moment of its administration. Approximately 70% of the drug is excreted in the urine through the kidneys, and this part is excreted by the body without any changes. If the patient has a history of pathological changes in the kidneys, the excretion process slows down. Losses of meropenem directly depend on the severity of the disease, the depth of pathological changes, the level of creatinine reduction.

The pharmacokinetics of Zakster, when used in children, is similar to that seen in adults, with the only difference being that a different dosage is prescribed and the half-life of the drug in children under two years of age, with a healthy anamnesis, is approximately one and a half to three hours. In elderly patients, a decrease in the level and rate of excretion of this drug is noted.

In connection with the above, it is necessary to understand that any changes in creatinine clearance (increase or decrease in its level) require immediate changes in the dosage of Zaxter. Dynamic changes in patients suffering from liver diseases are not observed.

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Dosing and administration

The use of any medical product is determined by the type of pathogen and the severity of the disease, as well as the condition of the patient. In this regard, the method of administration and doses of the drug Zakster are also prescribed based on the patient's age and diagnosed disease.

For adults, the manufacturer recommends taking:

The daily dosage for most infections is 500 mg. The drug is taken eight hours after the previous administration. If medically necessary (severe infectious forms), the dose can be increased to 1000 mg of Zaxter, the administration is carried out at the same interval.

In some cases (for example, meningitis, cystic fibrosis and others) the dosage is significantly increased and reaches 2 g of the drug, which is taken by the patient every eight hours.

It is necessary to prescribe Zakster (with its active substance meropenem) very carefully if according to the treatment protocol it is the only therapeutic agent, especially in severe cases of lower respiratory tract infections. In this regard, it is necessary to regularly take tests for individual tolerance of the drug.

If the use of Zaxter is justified by medical necessity, and the patient suffers from kidney dysfunction (creatinine clearance is less than 51 ml/min), the dosage of the drug is reduced:

• if the creatinine level is 26 - 50 ml/min, then one dose of the drug is taken (500 mg, 1 g, 2 g - according to the disease and its severity), at intervals of 12 hours;
• at a rate of 10 - 25 ml/min - half the dosage of Zaxter, every 12 hours;
• If the flow rate is below 10 ml/min, take half the dose of the drug at intervals of 24 hours.

The drug in question is perfectly excreted from the body by hemodialysis. Therefore, if it is necessary to take Zaksterom (especially during a long course of treatment), the manufacturer recommends administering it to the patient just before the end of this procedure (hemodialysis). This will return the composition and concentration ratios in the plasma to normal.

If the patient suffers from diseases associated with liver dysfunction, then there is no need to adjust the dosage of Zaxter. Elderly patients who do not have problems with kidney function and with a healthy creatinine clearance level do not need to adjust the amount of the drug.

Method of administration and dosage of the drug Zakster for children:

• Children from three months to 12 years old, depending on the type and severity of the infection, take the medicine every eight hours, and the recommended dosage is 10 - 20 mg per kilogram of the child's weight.
• If a child weighs more than 50 kg, he is prescribed the same dose as an adult patient.
• in case of a child (aged 4-18 years) suffering from cystic fibrosis, as well as during an exacerbation of chronic diseases of the lower respiratory tract (of an infectious nature), the dose may be 25-40 mg per kilogram of the child's weight. Zakster is administered every eight hours.
• in case of meningitis, 40 mg per kilogram of the baby is administered every eight hours.

Zakster solution is prepared immediately before administration. Before use, the suspension is shaken well. If the drug is administered intravenously by bolus (the entire procedure takes about 5 minutes), meropenem powder (250 mg) is dissolved in special water suitable for injection (5 ml). As a result, the concentration is 50 mg/ml. The suspension is transparent, colorless or slightly yellow.

If the drug is administered intravenously by infusion (the procedure takes 15-30 minutes), compatible infusion fluids (50-200 ml) can be used instead of water.

Use Zaxter during pregnancy

Waiting for a baby is always a joy. But none of the expectant mothers is immune from the possibility of illness, including infectious diseases. If the disease has already occurred, the use of Zakster during pregnancy or lactation is not advisable. Its use is justified only in cases where the attending physician understands that the positive effect expected for the patient is significantly higher than the negative impact to which the fetus or newborn child is exposed. In any case, Zakster should be taken only as prescribed by a doctor, and under his constant supervision, so that at the time of unexpected reactions it is possible to cancel the drug completely, or adjust its dosage. During the process of taking this drug, breastfeeding should be stopped, since it has been proven that Zakster easily penetrates into human liquid substances, including breast milk.

There is no experience of using the drug to treat children with liver and kidney dysfunction. It should not be prescribed to children under three months of age.

Contraindications

Due to its excellent pharmacokinetic and pharmacodynamic characteristics, the drug in question is widely used by doctors to stop and completely cure diseases caused by viral and bacterial infections. However, there are contraindications to the use of Zakster.

• It should not be prescribed or used for children under three months of age.
• This medicine should not be used when the baby has a history of problems with the functioning of the kidneys and liver (renal and hepatic insufficiency).
• For all categories of patients in case of individual intolerance to one or more components of the drug Zakster.

Side effects Zaxter

Due to its high efficiency "in the fight" against pathogenic flora in the form of fungal and viral infections, the drug Zakster is actively used in treatment protocols. As a rule, this drug is well tolerated by the human body, but there are exceptions. Quite rarely, but there are cases when the side effects of Zakster would require immediate cessation of its use. The unpleasant consequences of using the drug include:

• Thrombocytopenia (a decrease in the number of platelets in the peripheral blood (there are less than 200 thousand of the enzyme per 1 mm³)).
• Increased headache.
• Disruption of the digestive tract:
  • Nausea, which in more acute cases turns into vomiting.
  • Diarrhea (frequent loose stools – diarrhea).
  • Stomach pain.
  • Increased concentration of protein involved in metabolic processes.
  • Rash and itching.
• Eosinophilia (an increase in the number of eosinophils in the blood plasma, mainly in case of allergies or after the relief of an infectious disease).
• Hepatobiliary pathology (increased bilirubin concentration).
• Thrombocytopenia (a decrease in the number of platelets in the peripheral blood below 150 x 109/l, which leads to extensive bleeding and problems stopping it).

Less common manifestations when using the drug Zakster:

• Cramps.
• Hemolytic anemia is anemia that occurs due to an increased rate of red blood cell destruction.
• Thrombophlebitis (inflammation of the venous walls, thrombus formation).
• Leukopenia is a decrease in the number of leukocytes per unit volume of blood.
• Paresthesia is a type of sensory disorder characterized by sensations of tingling and numbness (a crawling sensation).
• Hives.
• Angioedema (or Quincke's edema) is a reaction to various types of irritants (biological or chemical in nature).
• Pseudomembranous colitis.
• Oral and vaginal candidiasis.
• And others

Overdose

When using a more significant amount of the drug, an overdose is unlikely due to the fairly rapid elimination of meropenem from the patient's body through the kidneys with urine. But if an overdose of Zaxter does occur, it manifests itself with the same symptoms that were voiced earlier in the section "Side effects of Zaxter". Therapy is symptomatic, that is, aimed at eliminating the symptoms.

Interactions with other drugs

When using any medications together, special care must be taken, since the interaction of Zakster with other drugs has not always been sufficiently studied.

It is not advisable to prescribe the combined use of such drugs as probenecid and Zakster, since both of them are subject to increased turbulence during administration, which negatively affects renal secretion, leading to renal renal failure. This leads to an increase in the level of meropenem in the peripheral blood, prolonging its half-life. In this case, Zakster is better administered separately from probenecid.

If necessary, Zakster should not be administered together with drugs that are known to be toxic to the kidneys, especially if the patient suffers from renal failure.

The effect of the drug in question on the process of protein binding by drugs used in combination with meropenem is unknown.

When used together with drugs whose active ingredient is valproic acid, its percentage content in the blood serum may decrease due to the effect of Zaxter.

When Zaxter was used in combination with other drugs (except probenecid), no other negative effects were observed.

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Storage conditions

This medicine should not be kept in a room where the temperature exceeds 30 ^° C, but it should not be allowed to freeze either. It is better to use a fresh, just prepared solution. One bottle of the drug is suitable for single use only. It should be stored in a place that is inaccessible to children. As can be seen from the above, the storage conditions for Zakster are simple.

Shelf life

The shelf life of the drug in question, Zakster, is 24 months (two years). If the shelf life of the drug has expired, it is not recommended to use it further.