Uses of Gramsyrop

Gramsyrop drug is prepared in the form of powder for oral suspension, with the main ingredient being Cephalexin. The drug is used in the treatment of infections caused by strains of bacteria that are sensitive to the active substance of the drug.

Each package of 1.5g of Gramsyrop drug contains Cephalexin monohydrate equivalent to 125mg of Cephalexin and other excipients. Cephalexin is a first-generation cephalosporin antibiotic, with bactericidal effect due to its ability to inhibit bacterial cell envelope synthesis. Cephalexin is an oral antibiotic and has an antibacterial spectrum similar to that of 1st generation cephalosporins.
Cephalexin has a medium spectrum of activity such as:
On gram-positive bacteria: Streptococcus, pneumococcus, staphylococcus (except methicillin-resistant streptococcus). ); On gram-negative bacteria: E.coli, Proteus mirabilis, Klebsiella pneumoniae and Shigella; Resistant strains: methicillin-resistant Staphylococcus, Enterococcus, Enterobacter, Proteus with positive indole reaction, Pseudomonas aeruginosa, Bacteroides. Indications for use of Gramsyrop: Treatment of infections caused by susceptible bacteria (but not indicated for the treatment of severe infections):
Respiratory tract infections: Acute and chronic bronchitis, bronchiectasis infection; Ear - nose - throat infections: otitis media, sinusitis, mastoiditis, tonsillitis and pharyngitis; Urinary tract infections: Prostatitis, cystitis, prophylaxis of recurrent urinary tract infections; Obstetric and gynecological infections; Bone, skin and soft tissue infections; Gonorrhea (when penicillin is not suitable); Oral infections; Alternative prophylaxis to penicillin for patients with heart disease requiring severe treatment. Note: Bacterial cultures and susceptibility testing should be performed before and during administration of Gramsyrop. The patient's renal function should be assessed when indicated.
Contraindications to the use of Gramsyrop:
Patients with a history of allergy to cephalosporin antibiotics; Patients with a history of penicillin-induced anaphylaxis or other severe IgE immune globulin-mediated reactions.

Usage: Orally.
Dosage:
Adults: The usual dose is 250 - 500mg every 6 hours depending on the severity of the infection. The maximum dose of Gramsyrop drug can be up to 4g/day. When higher doses are needed, a single dose of injectable cephalosporin should be considered; Children: The usual dose is 25-50mg/kg body weight in 24 hours, divided into 2-3 oral doses. For severe infections, the dose is 100mg/kg body weight for 24 hours. Note: The duration of taking Gramsyrop should last for at least 7-10 days, but in complicated, chronic and recurrent urinary tract infections, it is recommended to treat it for 2 weeks (with a dose of 1g/time x 2 times/day). ). For gonorrhea, a single dose is usually 3g with 1g probenecid for men or 2g with 0.5g probenecid for women. The combined use of Gramsyrop with probenecid will prolong the elimination time of Cephalexin, increasing the drug's serum concentration by 50 - 100%.
To date, Cephalexin has not shown any nephrotoxicity. However, as with all antibiotics that are eliminated mainly by the kidneys, there is a risk of drug accumulation in the body when renal function is reduced to less than 1⁄2 of the normal range. Therefore, the maximum recommended dose should be reduced (6g/day for adults, 4g/day for children) to ensure appropriateness for these patients. In the elderly, the degree of renal impairment should be assessed before taking the drug.
Adjust dose of Gramsyrop drug in case of renal failure:
Creatinine clearance ≥ 50ml/min, serum creatinine ≤ 132 micromol/l: Maximum maintenance dose is 1g, 4 times in 24 hours; Creatinine clearance 20 - 49ml/min, serum creatinine 133 - 295 micromol/l: Maximum maintenance dose is 1g, 3 times in 24 hours; Creatinine clearance 10 - 19ml/min, serum creatinine 296 - 470 micromol/l: Maximum maintenance dose is 500mg, 3 times in 24 hours; Creatinine clearance ≤ 10ml/min, serum creatinine ≥ 471 micromol/l: Maximum maintenance dose is 250mg, twice in 24 hours; Overdose: Following an acute overdose of Gramsyrop, most patients experience nausea, vomiting, and diarrhea. However, this drug may cause neuromuscular hypersensitivity and seizures, especially in patients with renal impairment. The management of overdose should consider the possibility of multiple drug overdose, drug interactions, and unusual pharmacokinetics of the patient.
Usually, gastric lavage is not necessary for the patient, unless the cephalexin dose is 5-10 times the normal dose. Dialysis can also help remove drugs from the blood, but is usually not necessary. In addition, it is necessary to pay attention to protect the patient's respiratory tract, support ventilation and infusion. The patient can be given activated charcoal to drink several times instead of or in addition to the indication for gastric lavage. The patient's respiratory tract should be protected while gastric lavage or activated charcoal is being used.

When using Gramsyrop, patients may experience some side effects (the rate is about 3-6% of patients) such as:
Common: Diarrhea, nausea; Uncommon: Eosinophilia, skin pruritus, urticaria, rash, reversible increase in transaminases; Rare: Headache, dizziness, fatigue, anaphylactoid reactions, thrombocytopenia, neutropenia, pseudomembranous colitis, abdominal pain, gastrointestinal disturbances, toxic epidermal necrolysis (syndrome) Lyell), erythema multiforme, Stevens - Johnson syndrome, Quincke's edema, hepatitis, cholestatic jaundice, vaginitis, genital pruritus, interstitial nephritis (reversible),... Side effects of the drug Gramsyrop, patients should immediately report to the doctor. With severe allergy or hypersensitivity, supportive therapy should be instituted (ventilation, administration of oxygen, epinephrine, intravenous steroid injections). If the pseudomembranous colitis is mild, the patient usually just needs to stop taking the drug. For moderate and severe cases, the patient should be given fluids and electrolytes, protein supplements, and treated with antibiotics effective in treating Clostridium difficile colitis.

Before and while taking Gramsyrop, patients should be aware:
Cephalexin is generally well tolerated even in patients allergic to penicillin. However, there are also a few cases of cross-allergic reactions; Like other broad-spectrum antibiotics, long-term use of Cephalexin can lead to overgrowth of non-susceptible bacteria such as Clostridium difficile, Enterococcus, Candida,... In this case, The patient should stop taking the drug. There have been cases of pseudomembranous colitis with the use of broad-spectrum antibiotics. Therefore, attention should be paid to the diagnosis of the disease in people with severe diarrhea during and after antibiotic use; Like antibiotics that are eliminated mainly by the kidneys, in renal failure, the dose of Cephalexin should be reduced appropriately; Patients taking Cephalexin may have a false-positive reaction when testing glucose with Clinitest tablets, Fehling's solution, or Benedict's solution. However, enzyme tests should not affect the results; Cephalexin causes a false positive with the Coombs test; Cephalexin can interfere with the alkaline picrate creatinine quantification, giving false results, but the increase is unlikely to be clinically significant; Clinical trials have shown that Gramsyrop is not teratogenic, but caution should still be exercised in its use in the first months of pregnancy. Take medication only when absolutely necessary, with the permission of the doctor; Concentrations of Cephalexin in breast milk are very low. However, consideration should still be given to temporarily stopping breastfeeding if the mother is taking Gramsyrop.

Some drug interactions of Gramsyrop include:
Using high doses of cephalosporins (including Gramsyrop) concurrently with other drugs that are also nephrotoxic such as aminoglycosides or potent diuretics (ethacrynic acid, piretanide, furosemide) can be adversely affect renal function. Clinical experience shows that if Cephalexin is taken at the recommended dose, there are no problems; There have been reports of Cephalexin reducing the effect of estrogen in oral contraceptives; Cholestyramine binds to Cephalexin in the intestine, leading to a delay in its absorption. This interaction is of little clinical significance; When used concurrently, Probenecid increases serum concentrations and increases the half-life of Cephalexin. However, this drug interaction is not a serious problem. Doctors even exploit this interaction to treat gonorrhea. During the use of Gramsyrop, the patient should strictly follow the instructions of the doctor. This ensures effective treatment for infections and limits dangerous complications.