anabella,конечно,врач не виноват в том,что животное заболело.А в том,что при лечении хромоты был назначен атибиотик,применять который лошадям не рекомендуется,хозяева не были поставлены в известность о возможных осложнениях и в результате животное пало от тяжелейшего колита,кто виноват? Хозяева,в том что не заканчивали ветфак,или в том,что доверяя одному врачу тут же параллельно не обратились к другому,третьему..?
Фараону был назначен Цефтриаксон относящийся к группе цефалоспоринов.
*такой "пушкой" как цефалоспорины "по воробьям не стреляют" - это антибиотик который можно и нужно применять лишь твердо зная о том, что ничего кроме него животному помочь не способно.*( с http://www.zoo-dom.com.ua/forum/)
Это ж какое у Фараона было заболевание? Хромота,не совместимая с жизнью?
Ceftriaxone Sodium
Prescriber Highlights
3rd generation cephalosporin; achieves high levels in CNS; long half life
Potentially could cause hypersensitivity reactions, granulocytopenia/thrombocytopenia, diarrhea, mild azotemia, biliary "sludging"
Causes pain on IM injection; Give IV over 30 minutes (or more)
May need to reduce dose in renal failure, avoid with icterus
Check drug-drug and drug-lab interactions
Chemistry
A third generation cephalosporin, ceftriaxone sodium occurs as white to yellowish-orange crystalline powder. It is soluble in water (400 mg/ml at 25°C). Potencies of commercial products are expressed in terms of ceftriaxone. One gram of ceftriaxone sodium contains 3.6 mEq of sodium.
Storage/Stability/Compatibility
The sterile powder for reconstitution should be stored at, or below 25°C and protected from light.
After reconstituting with either 0.9% sodium chloride or D5W, ceftriaxone solutions (at concentrations of approximately 100 mg/ml) are stable for 3 days at room temperature and for 10 days when refrigerated. Solutions of concentrations of 250 mg/ml are stable for 24 hours at room temperature and 3 days when refrigerated. At concentrations of 10-40 mg/ml solutions frozen at -20°C are stable for 26 weeks. The manufacturer does not recommend admixing any other anti-infective drugs with ceftriaxone sodium.
Pharmacology
Ceftriaxone is a third generation injectable cephalosporin agent. The third generation cephalosporins retain the gram-positive activity of the first and second-generation agents, but in comparison, have much expanded gram-negative activity. Included in this group are: cefotaxime (IM/IV), moxalactam (actually a 1-oxa-beta-lacatam; IM/IV), cefoperazone (IM/IV), ceftizoxime (IM/IV), ceftazidime (IM/IV), ceftriaxone (IM/IV), ceftiofur (IM) and cefixime (PO). As with the 2nd generation agents, enough variability exists with individual bacterial sensitivities that susceptibility testing is necessary for most bacteria. Usually only ceftazidime and cefoperazone are active against most strains of Pseudomonas aeruginosa. Because of the excellent gram-negative coverage of these agents and when compared to the aminoglycosides, their significantly less toxic potential, they have been used on an increasing basis in veterinary medicine.
Uses/Indications
Ceftriaxone is used to treat serious infections, particularly against susceptible Enterobacteriaceae that are not susceptible to other less expensive agents or when aminoglycosides are not indicated (due to their potential toxicity). Its long half life, good CNS penetration, and activity against Borrelia burgdorferi also has made it a potential choice for treating Lyme's disease.
Pharmacokinetics
Ceftriaxone is not absorbed after oral administration and must be given parenterally. It is widely distributed throughout the body; CSF levels are higher when meninges are inflamed. Ceftriaxone crosses the placenta and enters maternal milk in low concentrations; no documented adverse effects to offspring have been noted. Ceftriaxone is excreted by both renal and non-renal mechanisms and in humans, elimination half-lives are approximately 6-11 hours. Dosage adjustments generally are not required for patients with renal insufficiency (unless severely uremic) or with hepatic impairment.
In dogs, ceftriaxone bioavailability after IM or SC administration equal that of IV, but peak levels occur much faster after IM (approximately 30 minutes) than SC (80 minutes). Peak levels are higher with IM administration than SC, but total area under the curve is similar for both routes. Elimination half-life is longer after SC administration (1.73 hrs) than either IM (1.17 hrs) or IV administration (0.88 hrs). The authors of the study (Rebuelto, Albarellos et al. 2002) concluded that once or twice daily IM or SC injections of 50 mg/kg should be adequate to treat most susceptible infections in dogs.
Contraindications/Precautions
Only prior allergic reaction to cephalosporins contraindicates ceftriaxone's use. In humans documented hypersensitive to penicillin, up to 16% may also be allergic to cephalosporins. The veterinary significance of this is unclear.
Although bleeding times have only been reported rarely in humans, ceftriaxone should be used with caution in patients with vitamin K utilization or synthesis abnormalities (e.g., severe hepatic disease).
Reproductive/Nursing Safety
No teratogenic effects were demonstrated in studies in pregnant mice and rats given up to 20 times labeled doses of ceftriaxone. In humans, the FDA categorizes this drug as category B for use during pregnancy (Animal studies have not yet demonstrated risk to the fetus, but there are no adequate studies in pregnant women; or animal studies have shown an adverse effect, but adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester of pregnancy, and there is no evidence of risk in later trimesters.)
Adverse Effects/Warnings
Because veterinary usage of ceftriaxone is very limited, an accurate adverse effect profile has not been determined. The following adverse effects have been reported in humans and may or may not apply to veterinary patients: hematologic effects, including eosinophilia (6%), thrombocytosis (5%), leukopenia (2%) and more rarely, anemia, neutropenia, lymphopenia and thrombocytopenia. Approximately 2-4% of humans get diarrhea. Very high dosages (100 mg/kg/day) in dogs have caused a "sludge" in bile. Hypersensitivity reactions (usually a rash) have been noted. Increased serum concentrations of liver enzymes, BUN, creatinine, and urine casts have been described in about 1-3% of patients. When given IM, pain may be noted at the injection site.
Overdosage/Acute Toxicity
Limited information available; overdoses should be monitored and treated symptomatically and supportively if required.
Drug Interactions
Synergism against some Enterobacteriaceae (e.g., Pseudomonas aeruginosa) may be attained if using cefoperazone with an aminoglycoside (e.g., gentamicin, amikacin). Organisms with a high degree of resistance to both ceftriaxone and the aminoglycoside are unlikely to be affected when the two drugs are used together.
Probenecid does not have an effect on ceftriaxone elimination.
Laboratory Considerations
When using Kirby-Bauer disk diffusion procedures for testing susceptibility, a specific 30 micrograms ceftriaxone disk should be used. A cephalosporin-class disk containing cephalothin should not be used to test for ceftriaxone susceptibility. An inhibition zone of 18 mm or more indicates susceptibility; 14-17 mm, intermediate; and 13 mm or less, resistant.
When using a dilution susceptibility procedure, an organism with a MIC of 16 micrograms/ml or less is considered susceptible and 64 micrograms/ml or greater is considered resistant. With either method, infections caused by organisms with intermediate susceptibility may be effectively treated if the infection is limited to tissues where the drug is concentrated or if a higher than normal dose is used.
Ceftriaxone, like most other cephalosporins, may cause a false-positive urine glucose determination when using the cupric sulfate solution test (e.g., Clinitest®).
Ceftriaxone in very high concentrations (50 micrograms/ml or greater) may cause falsely elevated serum creatinine levels when manual methods of testing are used. Automated methods do not appear to be affected.
Doses
Dogs
1. For meningitis/borreliosis: 15-50 mg/kg (maximum single dose in humans is 1 gram) IV or IM q12h for 4-14 days
For preoperative/intraoperative use: 25 mg/kg (maximum single dose in humans is 1 gram) IM or IV one time
For skin, genitourinary infections: 25 mg/kg IM once daily (q24h) for 7-14 days (Greene and Watson 1998)
2. For infectious endocarditis and documented resistance against or other contraindications for fluroquinolones and aminoglycosides in dogs: 20 mg/kg IV q12h (DeFrancesco 2000)
3. 15-50 mg/kg (route not specified) once daily (Trepanier 1999)
Cats
1. For systemic infections: 25-50 mg/kg IV, IM or Intraosseous q12h as long as necessary (Greene and Watson 1998)
Horses
For susceptible infections:
1. 25-50 mg/kg q12h IV or IM (Note: This is a human dose and should be used as a general guideline only) (Walker 1992)
2. 20 mg/kg IV q12h (Brumbaugh 1999)
Monitoring Parameters
1) Efficacy; 2) If long-term therapy, occasional CBC, renal function (BUN, Serum Creatinine, urinalysis) and liver enzymes (AST, ALT) may be considered.
Dosage Forms/Approval Status/Withholding Times
Veterinary-Approved Products: None. Y NAS ETO LEKARSTVO LEGALNO ISPOLSOVAT NERAZRESHENO. TOLKO V SAMOMTYJELOM SLYCHAE. NIKAKIX ISSLEDOVANII NA LOHADYAX NE PROVEDENO.
Human-Approved Products:
Ceftriaxone Powder for Injection: 250 mg, 500 mg (as sodium), 1 g, 2g, 10 g in vials, piggyback vials, ADD-Vantage vials and in bulk. Rocephin® (Roche); (Rx)
Ceftriaxone Injection in 5% dextrose in Water 1 g (as sodium) and 2 g frozen, premixed 50 ml containers; Rocephin® (Roche); (Rx)
Ceftriaxone Sodium may also be known by the following synonyms: ceftriaxonum natricum, Ro-13-9904, or Ro-13-9904/000; many trade names are available.
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