23.06.2020

Medicinal reference book geotar. Medicinal reference book geotar Bicillin 5 pharmacological group

Contents [Show]

"Bicillin" is a penicillin antibiotic with a prolonged action. Its difference from other drugs in the group is that daily injections are not required, since the concentration of the antibiotic in the body remains quite high for a week. Typically, injections are given once a week in the treatment room. In the absence of allergic reactions, injections can be given at home.

The drug is diluted immediately before use; storing the diluted antibiotic is not permissible. For dilution, use sterile water for injection, physiological sodium chloride solution in

or 0.25-0.5% solution of novocaine. In the latter case, pain due to the anesthetic effect of novocaine will be less pronounced. Do not use a cold solution for dilution. It is better to warm the ampoule in your palms for 5-8 minutes.

After the medicinal substance is drawn into the syringe, it is necessary to replace the needle with a new sterile one and immediately inject the drug into the gluteal muscle, into its upper outer quadrant. The needle is inserted as deep as possible, leaving about 0.5-1 cm to the cannula; Bicillin is injected slowly, without jerking. The last 0.1-0.2 ml is not injected to prevent accidental entry of air into the muscle. If the drug crystallized during administration, it is necessary to remove the needle, dilute a new dose of the drug and inject the drug again.

Before administering Bicillin, the skin on the buttock is wiped with an alcohol wipe, which can be purchased at a pharmacy. It is recommended to wear sterile gloves during the injection to prevent the risk of infection.

Injections are given alternately in each buttock to reduce the likelihood of painful lumps. After the injection, used syringes and ampoules are disposed of; it is better to place the disassembled syringe and needle in a disinfectant solution for one hour, for example in liquid chlorine bleach. It is recommended to break or bend the needle so that children who accidentally find the syringe cannot harm themselves with it.

How to dilute bicillin

The antibacterial drug Bicillin belongs to the group of natural penicillins. It has a bactericidal effect and has a wide spectrum of effects. Gram-positive and gram-negative bacteria, some protozoa, are susceptible to harmful effects. The product is available only in bottles with white powder for dilution. Method of administration: intramuscular administration only.

The product has several generations, which include different combinations of penicillin salts.

Bicillin 1 is the first generation, which contains only one benzathine salt, benzylpenicillin. In pharmacies you can find 2 dosages: 1,200,000 and 600,000 units (action units: the video below explains how to correctly calculate the dosage and administer the injection solution).
Bicillin 3 - second generation. It contains 3 salts: benzathine benzylpenicillin, benzylpenicillin sodium and benzylpenicillin novocaine salt. The dosage also has 2 gradations: 200,000 and 400,000 units.
Bicillin 5 is the latest generation of the drug, the composition of which has been adjusted. Now the powder contains benzathine benzylpenicillin 1,200,000 units and novocaine salt of benzylpenicillin 300,000 units. The medicine is available in only one dose.

Any type of medicine is available in identical 10 ml bottles. There are 50 bottles in a package. Inside there is a homogeneous white powder. Bicillin 3 has its own characteristics. In this generation of the drug, the color may be white or light yellow.

The powder is practically odorless. The taste is bitter. After contact with water, it takes on a homogeneous structure, forming a stable suspension. If the resulting solution is not administered within 1 hour, the properties change. The solution becomes loose with many small lumps, which makes further administration impossible.

The price of the antibiotic Bicillin is very low. Now Bicillin 1 has almost gone out of circulation, since it was replaced by a similar Bicillin 5. But if you can find it, then the average price for 1 bottle of such salt will be 10 rubles. Bicillin 3 and 5 do not differ much in the price category, the range ranges from 30-50 rubles per bottle.

Shelf life must be indicated on each individual bottle. The duration of possible use is 3 years. It is advisable to store at a temperature of 8-15°C in a dark place protected from children. If the conditions are violated, the active substance may lose its properties.

Pharmacodynamics are the same and do not depend on the generation used. The drug has a bactericidal effect on many strains due to beta-lactams. These particles are inhibitors of peptidoglycan synthesis. Beta-lactams and the complex proteins mentioned have a similar “key” structure to the receptor. In case of exposure to the antibiotic Bicillin, beta-lactams are integrated into the synthesized genetic chain, blocking further production.

Peptidoglycan is a complex protein that is part of the protective shell of many bacteria. Without this protein, the cell cannot function normally and protect itself. Therefore, it is quickly found by macrophages of the human body, and the pathogenic agent is amenable to lysis (cleavage with the help of enzymes).

It has a great effect on gram-positive flora (Staphylococci, streptococci, diphtheria bacilli, anthrax pathogens), inhibits the growth of anaerobic microorganisms. And in some cases it is sensitive to gram-negative representatives (meningococci, Treponema pallidum, gonorrhea pathogen).

Pharmacokinetics is also an important link. Since it is the slow elimination of the drug from the body that makes it indispensable in the prevention of streptococcal complications.

Therapeutic concentration in the blood is achieved within the first hours after injection (2-6 hours). Maximum numbers can be seen after 12 hours. It is important that Bicillin 3 is in a therapeutic dose in the blood for at least 6-7 days after administration, and Bicillin 5 persists for 28 days. This is due to the slow biotransformation of the drug and its gradual release. The antibiotic is excreted primarily by the kidneys in the form of inactivated forms.

Over the long existence of antibiotics, bacterial microflora has managed to mutate and develop resistance to their action. In our case, bacteria have learned to produce beta-lactamases capable of breaking down beta-lactams. To protect against inactivation of action, clavulanic acid and sulbactam with tazobactam are added to penicillins.

Since this product does not have protection, it is more often used to combat the consequences of the activity of group A beta-hemolytic streptococcus, gonorrhea and treponema pallidum.

Indications for use are:

syphilis;
gonorrhea;
erysipelas;
severe scarlet fever;
prevention of rheumatism after a complex sore throat;
tonsillitis;
leishmaniasis;
treatment of streptococcal carditis and glomerulonephritis.

An advantage in the treatment of the above diseases is given to Bicillin due to its long-term cumulative ability.

The instructions for use indicate the required dosages and the principle of administration, but do not specify how to dilute bicillin or how to inject the medicine. Since Bicillin injections are often given at home by parents, it is necessary to specify some details that were missed in the instructions for use. First, let’s clarify how to dilute the drug.

Bicillin 1 and 3 are diluted exclusively with saline or water for injection. Diluting the powder with novocaine is contraindicated. Bicillin 5 is the only representative that can be diluted with an anesthetic. But under 8 years old this is also not allowed.

Let's get down to the question of how to dilute bicillin. To do this, you need to draw 5 ml of solvent into a syringe, pierce the rubber cap of the bottle with a needle, and inject it inside under pressure. Then shake for 20 seconds until the suspension is homogenized. Draw the prepared solution back into the syringe.

Immediately after dilution, inject. The injection is given intramuscularly in the upper outer quadrant deep into the buttock. After inserting the needle, you need to make sure that it does not fall into the vessel. To do this, pull the piston towards you. If blood does not enter the syringe, then slowly inject the solution.

The instructions for use indicate the average dosage of the drug. It must be remembered that the doctor will select the optimal dose of the medicine, taking into account the individual characteristics of the patient and the disease that needs to be dealt with.

On average, the doses used are:

Bicillin 1 - 1.2 million IU 2 times a month or 600,000 IU 1 time a week;
Bicillin 3 - 1 day - 300,000 IU, 4 day - 600,000 IU, then 600,000 every 6 days;
Bicillin 5 - 1.5 million IU once a month.

The main contraindication to use is individual intolerance to the components. You should pay attention to a history of allergies to sulfonamides and cephalosporins. They have a similar structure and operating principle.

It should not be taken by patients with bronchial asthma and hay fever, during lactation. Particular attention should be paid to patients suffering from other allergic diseases (hay fever, food and contact allergies). The medicine is prescribed with caution to pregnant women, patients with chronic renal failure and pseudomembranous colitis.

Alcohol is also prohibited. If acetaldehyde enters the body, the effect of the drug is minimized or may be distorted. This will slow down the achievement of the desired result and increase the risk of developing resistance.

The main side effect is the development allergic reaction:

hives;
Quincke's edema;
anaphylactic shock;
bronchospasm.

Reaction from outside is rarely observed hematopoietic system:

coagulopathy;
anemic syndrome;
thrombocytopenic purpura;
leukopenia.

General symptoms inherent in antibiotics:

headache;
unmotivated weakness;
diarrhea;
dysbacteriosis;
glossitis and stomatitis;
joint pain;
fever of unknown origin.

Long-term use of an antibiotic with non-compliance with the indicated dosages and frequency of use can lead to the development of superinfection due to the development of bacterial resistance to antibacterial drugs from the beta-lactam group.

Children, pregnant women and elderly people have their own individual physiological characteristics. Therefore, the pharmacokinetics, the direct effect of the drug, may be perverted.

Penicillins are not included in the list of teratogenic factors. But their use is undesirable. Therefore, there are strict guidelines during pregnancy. It is prescribed only when the benefit to the mother far outweighs the risk to the fetus. Dosages are selected individually by the attending physician, taking into account the characteristics.

The lactation period is a contraindication, since a small concentration passes into breast milk. This may cause an allergic reaction or the development of resistance to bacterial flora.

Pharmacies offer many analogues of each drug, and this product is no exception. Depending on the constituent components, a number of other drugs are isolated.

Bicillin 1:

Benzicillin 1;
Retarpen;
Moldamin;
Extensillin.

Bcillin 3:

Dicillin 3;
Benzicillin 3.

Bicillin 5:

Dicillin 5;
Benzicillin 5.

Since this drug has been on the pharmaceutical market for a long time, there are many reviews about its effectiveness. Every doctor has tried it in action.

Based on expert reviews, it is effective in the treatment of chronic diseases caused by flora sensitive to beta-lactams, as they require long-term therapy. If Bicillin 1 had more pronounced side effects, then the new generation treats diseases with rare side effects.

The antibiotic received positive reviews in the prevention of rheumatic fever in children and adults. After a course of Bicillin 5, the incidence of sore throat decreased by 82%, which indicates its high effectiveness.

Bicillin is a long-acting antibiotic. Available in bottles

300000 units, 600000 units, 1200000 units, 1500000 units.

Dissolve only with 0.9% saline solution, since novocaine crystallizes bicillin powder.

Dilution rule: for 300,000 units take 2.5 ml of 0.9% physiological solution;

for 600,000 units, take 5 ml of 0.9% physiological solution;

for 1,200,000 units, take 10 ml of 0.9% saline solution.

Concentrated administration is not used. Dilution is done after the patient is placed in bed and administered quickly. After the injection, put on a heating pad, as bicillin does not absorb well.

Definition of the upper outer quadrant.

The 5th lumbar vertebra and the diseased trochanter of the femur are identified. A diagonal is drawn between them. Above this line an injection is made. In the right or left buttock. The injection site is first palpated. If there is a compaction, the injection is made in another place.

Manipulation “Features of the administration of bicillin.”

Bicillin is a long-acting penicillin preparation. Available in bottles of 300,000 units, 600,000 units and 1,500,000 units (Bicillin - 1, Bicillin - 3, Bicillin - 5). This is a white powder.

Bicillin is used to create a long-term therapeutic concentration of penicillin in the blood.

Indications: rheumatism, syphilis, infectious diseases.

Contraindications: individual intolerance to penicillin.

Bicillin dilution.

Bicillin is diluted with water for injection or 0.9% sodium chloride solution (saline) immediately before administration (foaming of the suspension is not allowed).

300,000 units – 3 ml of solvent

600,000 units – 6 ml of solvent

1,500,000 units – 10 ml of solvent

When bicillin powder is diluted, a suspension is formed.

Bicillin is administered only intramuscularly in a two-step manner!

Before its administration, it is necessary to palpate the injection site (it is injected only into the upper outer quadrant of the buttock deep into the muscle); after administration, a heating pad is applied to the injection site.

Manipulation “Dilution of antibiotics for injection”

Target: prepare antibiotics for administration.

Indications: fulfilling doctor's orders.

Contraindications: erased inscription on antibiotic bottles (ampoules) and

solvent, discrepancy in expiration date, change in their physical properties

(change in color, appearance of flakes, cloudiness of the solution, etc.).

Equipment: tray with a sterile diaper, sterile balls, 70 alcohol, sterile syringe and needle for collecting solvent from an ampoule or bottle, needle for introducing solvent into a bottle with an antibiotic, sterile tweezers, nail files, scissors, antibiotics, solvents for antibiotics, trays for used needle balls , containers with disinfectant. r-mi, mask, gloves.

Manipulation algorithm

Sequencing

Rationale

Preparation for manipulation.

Prepare everything necessary for the manipulation.

Wear a mask, sanitize your hands and put on gloves.

Check the name, dose, and expiration date of the antibiotic.

1.4. Check the name, dose, expiration date of the solvent (0.9% NaCl; 0.25% or 0.5% novocaine solution, water for injection).

Efficiency of the procedure.

Infection safety.

Correct execution of the prescription, prevention of complications.

Performing manipulation.

Treat the bottle (ampoule) with antibiotic twice with a sterile bead containing alcohol (see the procedure “set of solution from a bottle”).

Treat the bottle (ampoule) with solvent twice with a sterile bead containing alcohol (see manipulation “Set of solution from a bottle”).

Using a syringe with a needle for the kit, draw out the amount of solvent corresponding to the dose of the antibiotic in the bottle (for example: there are 1000,000 units in the antibiotic bottle. The solvent should be injected

2.4. Use a needle to pierce the rubber stopper of the bottle

with an antibiotic, pre-treated

aluminum bottle cap and rubber

stopper with a sterile ball of alcohol, insert

solvent into a bottle with an antibiotic.

Remove the bottle along with the needle from the needle

cone and shake the bottle until the powder is completely dissolved.

Place the needle with the bottle onto the needle cone.

Lift the bottle upside down and, holding it with your finger, draw the contents of the bottle or part of it into the syringe.

Remove the bottle along with the needle from the needle cone (without removing the needle - it may be needed to collect the remaining antibiotic) or remove the needle and syringe from the bottle (if there is no need to refill).

Infection safety.

Compliance with breeding rules

antibiotics.

Compliance with breeding rules

antibiotics.

The required concentration of antibiotic in the solvent.

For a set of medicines.

Compliance with typing technique.

End of manipulation.

Immerse the needle in a disinfectant solution.

Change the needle for intramuscular injection.

Check the patency of the needle by passing a little solution through the needle.

When administering an antibiotic intramuscularly, see the manipulation “Technique for intramuscular injection.”

Infection safety.

Efficiency of the procedure.

IM injection technique.

Standard answers to test tasks

1 – a, b; 2 – b
5.0 ml. or 7.5 ml.

suspensions

lying on your stomach or side

1 – B; 2 – B, 3 – C, 4 – B, C, 5 – A

you may not hit the muscle

hit the sciatic nerve

sharp needles; compliance with: sterility, injection technique; examination of the injection site; a heating pad after injection if the medication is poorly absorbed.

How to properly administer bicillin 3

asterisk1. Please tell me what the secret is. I just can’t seem to get a normal, full-fledged injection of Bicillin 3. Perhaps there are some nuances?

zubari. Method of administration and dosage: Injected deep IM into the upper outer quadrant of the gluteal muscle (IV administration is prohibited) at a dose of 300 thousand units. If 2 injections are necessary, they are given in different buttocks. Repeated injections are made 4 days after the previous injection. A dose of 600 thousand units is administered once every 6 days. The main thing here is not to get into the vessel.

zubari. star1 writes: It’s impossible to give a normal, full-fledged injection Why doesn't it work?

Mora. asterisk1, what are you breeding with? Sometimes a poorly dissolved drug clogs the needle. Or is the dog twitching and you cannot inject the contents of the syringe?

asterisk1. I dilute with novocaine 05%. 4 ml. I dissolve it very carefully. but it is possible to enter only half, because... the solution #34;thickens#34; and the needle gets clogged. I took another needle from 10 cc. syringe, it has a larger hole, and I read somewhere else that the needle should be absolutely dry, but the result is the same. Maybe it takes a certain amount of time to dissolve or something else?

Yenish. asterisk1. take a needle from a 20 cc syringe. Even better is a veterinary needle and glass syringe. Why do you make bicillin with today’s wide selection of antibiotics? Half of the strains microflora have long been resistant to it.

asterisk1. I see. Thank you very much. We will try.

vasyl. bicillin3. 5. dissolve with distilled water. but it's very painful. That's why in the treatment In institutions it is diluted with a 0.25% novocaine solution. There is no such novocaine on sale. but you can dilute the dist. water 0.5% novocaine. The diameter of the needle does not matter. since in a concentration greater than 0.25% it still coagulates.

asterisk1. I am already convinced that the diameter of the needle does not play a big role. Maybe you really need less concentration, otherwise it coagulates instantly. But I can’t give the injection quickly, I’m afraid it will get into the bone.

Yenish. star1 writes: I'm afraid of hitting a bone. What place are you going to? If it’s where it’s usually given to dogs intramuscularly, then you certainly won’t hit the bone. star1 writes: I am already convinced that the diameter of the needle does not play a big role. It has. At one time they used bicillin a lot - the cow’s needle never got clogged

Marisha. When you dilute the drug Bicilin 5, do you need to shake the bottle? And then how to fill it up, it foams and you can’t see anything. whether air got into the syringe or not

Yenish. You should not shake it vertically, but roll it in your palms. then it won't foam. it crystallizes even more strongly in the needle than bicillin-3, so choose a needle with a large diameter.

Bilkis. Personally, I administer this drug with a veterinary syringe with a thick needle. It is drawn normally, the needle does not get clogged. Such syringes and needles are reusable, you have to boil them.

Marta Kemerovof. And the reason to put it? What kind of pain do you have? Enish has already written to you that there are already modern drugs. Write and the veterinarians will answer you.

Bicillin 3 is an antibacterial agent and is used against gram-positive and gram-negative bacteria, as well as other microorganisms susceptible to penicillin. Bicilin 3, the use of which does not require daily injections, has gained great popularity. After all, there is no need to constantly visit the treatment room, and in the absence of contraindications, injections can be done at home.

The drug is prescribed to treat infections of bacteria susceptible to this medication. It is especially important to use Bicillin 3 in therapy that requires long-term maintenance of the concentration of active substances in the body. These include:

The drug is widely used for the treatment of rheumatism and its prevention.

The preparation of the composition must occur immediately before its use; the diluted product cannot be stored. For dilution, saline solution and water for injection are used. It is recommended to warm the ampoules in your hands for a while, since cold formulations cannot be administered. In addition to the listed remedies, Bicillin 3 can be diluted with Novocaine. To do this, an anesthetic solution (0.25-0.5%) is drawn into a syringe (5 ml), poured into a bottle with an antibiotic and stirred until a uniform structure is obtained. Thanks to the use of such a solution, the pain of the procedure is significantly reduced.

The suspension is administered intramuscularly; intravenous use of the drug is not allowed. After preparing the solution, the medicine is drawn into a syringe and injected deep into the muscle layer of the buttock. Two injections are given at once, one on each buttock. During the procedure, you need to make sure that the needle does not touch a blood vessel. If blood appears, then you need to choose another injection site.

Bicillin is used by adults once every six days, 1,200,000 units. To prevent relapses of rheumatism, along with an antibiotic, the doctor prescribes taking Aspirin or Analgin one gram per day.

For syphilis, the dosage is 1.8 million units. The first injection is given at a dosage of 0.3 million units, and a day later it is given in full. Subsequent treatment involves administering the drug twice a week.

Contraindications to the use of the drug are:

allergic reactions;
hay fever;
bronchial asthma.

Preparing for the injection

The drug is diluted immediately before use; storing the diluted antibiotic is not permissible. For dilution, use sterile water for injection, physiological sodium chloride solution in ampoules or 0.25-0.5% novocaine solution. In the latter case, pain due to the anesthetic effect of novocaine will be less pronounced. Do not use a cold solution for dilution. It is better to warm the ampoule in your palms for 5-8 minutes.

To administer Bicillin, you must use syringes with long needles. You will also need sterile needles in individual packaging, since the drug is diluted using one needle and injected with another. This is due to the fact that the drug quickly crystallizes and can clog the needle.

1 bottle (Bicillin-1) with powder for preparing an injection solution for intramuscular administration contains benzathine benzylpenicillin 600,000 units or 1,200,000 units. 1 bottle (Bicillin-3) with powder for preparing an injection solution for intramuscular administration contains benzathine benzylpenicillin, benzylpenicillin sodium and benzylpenicillin novocaine salt, 200,000 units or 400,000 units; in bottles of 10 ml or in bottles of 10 ml, in a box there are 50 bottles. 1 bottle with a capacity of 10 ml (Bicillin-5) with powder for the preparation of an injection solution for intramuscular administration contains benzathine benzylpenicillin 1,200,000 units and benzylpenicillin novocaine salt 300,000 units.

Characteristic

Bicillin-1 is a white, odorless or almost odorless powder, which forms a stable suspension when water is added. Bicillin-3 is a white or white powder with a slightly yellowish tint, which forms a stable suspension when water is added. Bicillin-5 is an odorless, bitter, white powder taste, forming a homogeneous suspension of milky turbidity when adding water, saline or 0.25-0.5% novocaine solution. With prolonged contact with water or other solutions, the physical and colloidal properties of the drug change (the suspension becomes uneven and difficult to flow through the syringe needle).

pharmachologic effect

Pharmacological effects - bactericidal, antibacterial.

Inhibits the synthesis of peptidoglycan in the cell wall of microorganisms.

Pharmacodynamics

Active against gram-positive microorganisms, incl. Staphylococcus spp. (except for strains producing penicillinase), Streptococcus spp. (including Streptococcus pneumoniae), Corynebacterium diphtheriae, anaerobic spore-forming bacilli Bacillus anthracis, some gram-negative microorganisms (including Neisseria gonorrhoeae, Neisseria meningitidis), Actinomyces israelii, as well as Treponema spp. Not useful against viruses (causative agents of influenza, polio, smallpox, etc.), mycobacterium tuberculosis, protozoa, rickettsia, fungi, as well as most gram-negative microorganisms.

Pharmacokinetics

When administered intramuscularly, bicillin-1 is slowly absorbed, hydrolyzed to release benzylpenicillin, and enters the bloodstream over a long period of time. Cmax is reached after 12-24 hours, therapeutic concentration is achieved after 3-6 hours. Bicillin-3 after intramuscular administration is slowly hydrolyzed to release benzylpenicillin. With a single injection, the therapeutic concentration in the blood is maintained for 6-7 days, Cmax is achieved 12-24 hours after injection. On the 14th day after administration at a dose of 2.4 million units, the serum concentration is 0.12 mcg/ml, on the 21st day after administration of 1.2 million units - 0.06 mcg/ml (1 unit = 0. 6 mcg). Binding to blood proteins is 40-60%. Penetration into liquids is high, into tissues low. It flows through the placental barrier and enters breast milk. It is biotransformed to a small extent and is excreted mainly by the kidneys. With the intramuscular administration of Bicillin-5, high concentrations in the blood are created already in the first hours after the injection. After administration of 1.2-1.5 million units in most patients (adults and children), the therapeutic concentration in plasma (0.3 units/ml) remains for 28 days or more.

Indications of the drug Bicillin-5

Infectious diseases caused by microorganisms sensitive to the drug (especially when long-term maintenance of therapeutic concentration is necessary), incl. acute tonsillitis, scarlet fever, wound infections, erysipelas; rheumatism (prevention and treatment) caused by treponemes (syphilis, yaws), leishmaniasis.

Contraindications

Hypersensitivity (including to other penicillins and drug components). With caution - bronchial asthma, hay fever, urticaria and other allergic diseases; hypersensitivity to various drugs, incl. to antibiotics and sulfonamides (in history).

Side effects

From the cardiovascular system and blood (hematopoiesis, hemostasis): anemia, thrombocytopenia, leukopenia, hypocoagulation. Allergic reactions: rash on the skin and mucous membranes, urticaria, eosinophilia, joint pain, erythema multiforme, exfoliative dermatitis, Quincke's edema, anaphylactic shock. Others: headache, fever, arthralgia, stomatitis, glossitis, pain at the injection site; with long-term therapy - superinfection caused by drug-resistant microorganisms and fungi.

Interaction

Bactericidal antibiotics (including cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides) have a synergistic effect, while bacteriostatic ones (including macrolides, chloramphenicol, lincosamides, tetracyclines) have an antagonistic effect. Reduces the effectiveness of oral contraceptives and ethinyl estradiol (risk of breakthrough bleeding). Diuretics, allopurinol, phenylbutazone, NSAIDs reduce tubular secretion and increase concentration. Allopurinol will increase the risk of allergic reactions (skin rash).

Directions for use and doses

IM, deep, into the upper outer quadrant of the gluteal muscle (IV administration is prohibited). Bicillin−1 for the prevention and treatment of infectious diseases for adults - 300,000 units and 600,000 units once a week or 1.2 million units 2 times a month. When treating rheumatism in adults, the dose is increased to 2.4 million units 2 times a month. To prevent relapses of rheumatism - 600,000 units once a week for 6 weeks in combination with taking acetylsalicylic acid or other NSAIDs. Treatment of syphilis is carried out according to special instructions. The average dosage is 2.4 million units 2-3 times at intervals of 8 days. Bicillin−3- at a dose of 300,000 units (if necessary, 2 injections are given into various buttocks). Repeated injections are carried out 4 days after the previous injection. A dose of 600,000 units is administered once every 6 days. For the treatment of primary and secondary syphilis, a single dosage is 1.8 million units. The course of treatment is 7 injections. The first injection is carried out at a dose of 300,000 units, the second injection - after 1 day at the full dose, subsequent injections are carried out 2 times a week. When treating secondary recurrent and latent early syphilis, a dosage of 300,000 units is used for the first injection, for subsequent injections - 1.8 million UNITS Injections are carried out 2 times a week. The course of treatment is 14 injections. Bicillin−5 adults - 1.5 million units once every 4 weeks, children under 8 years old - 600,000 units once every 3 weeks, children over 8 years old - 1.2-1.5 million units once every 4 weeks. The suspension is prepared in under aseptic conditions immediately before use (5-6 ml of sterile distilled water, 0.9% sodium chloride solution or 0.25-0.5% novocaine solution are injected into a bottle containing 1.5 million units). The mixture in the bottle is shaken for 30 s in the direction of the longitudinal axis until a homogeneous suspension (or suspension) is formed and immediately administered.

Precautionary measures

If blood appears in the syringe during an intramuscular injection (indicating that the needle has entered a blood vessel), remove the syringe and inject elsewhere. At the end of the injection, the injection site is pressed down with a cotton swab, which prevents the drug from entering the muscle tissue into the subcutaneous tissue (rubbing the buttock after the injection is not suggested). If an allergic reaction develops, treatment is immediately stopped. When the first signs of anaphylactic shock appear, urgent measures must be taken to remove the patient from this state: administration of norepinephrine, glucocorticoids, etc., and, if necessary, mechanical ventilation. When treating sexually transmitted diseases, if syphilis is suspected, before starting therapy and then for 4 months microscopic and serological studies are necessary. Due to the ability to develop fungal infections, it is advisable to prescribe B vitamins and vitamin C, and, if necessary, nystatin and levorin. It should be borne in mind that using the drug in insufficient doses or stopping treatment too early often leads to the emergence of resistant strains of pathogens.

special instructions

It is forbidden to allow intravenous administration of the medication (the development of Wanier syndrome is likely - the development of a feeling of depression, anxiety and visual impairment).

Storage conditions for the drug Bicillin-5

In a dry place, at a temperature not exceeding 20 °C.

Keep out of the reach of children.

Shelf life of the drug Bicillin-5

Do not use after the expiration date stated on the package.

Manufacturer: SINTEZ, JSC (Russia)

Update of description and photo: 11/14/2017

Prices in pharmacies: from 17 rubles.

Bicillin-5 is an antibiotic (biosynthetic penicillin).

Release form and composition

The drug is produced in the form of a powder for the preparation of a suspension for intramuscular administration: a white or white with a yellowish tint, a powdery mass prone to clumping, with the addition of water it forms a stable suspension (10 ml in bottles; in a cardboard pack 1, 5, 10 or 50 bottles) .

Powder composition (per 1 bottle):

benzylpenicillin procaine (benzylpenicillin novocaine salt) –ED;
benzathine benzylpenicillin – units.

Pharmacological properties

Pharmacodynamics

Bicillin-5 is a bactericidal combination antibiotic containing two long-acting benzylpenicillin salts. Inhibits the synthesis of the cell wall of pathogenic microorganisms.

Active against the following microbes:

gram-positive: Streptococcus spp. (including Streptococcus pneumoniae), Staphylococcus spp. (not forming penicillinase), Bacillus anthracis, Clostridium spp., Corynebacterium diphtheriae, anaerobic spore-forming rods, Actinomyces israelii;
gram-negative: Treponema spp., Neisseria gonorrhoeae, Neisseria meningitidis.

Penicillinase-producing strains of Staphylococcus spp. are resistant to the drug.

Pharmacokinetics

Bicillin-5 is a long-acting antibiotic; its high concentration in the blood remains for 4 weeks.

Benzathine benzylpenicillin hydrolyzes very slowly after intramuscular injection, releasing benzylpenicillin. The maximum concentration (Cmax) in the blood serum is achieved 12–24 hours after administration. The long half-life ensures long-term and stable drug concentrations in the blood: on day 14 after ME injection, the drug concentration in serum is 0.12 μg/ml; on the 21st day after administration - ME concentration is 0.06 μg/ml (1 ME = 0.6 μg). Diffusion of the substance in tissue is very weak, in liquid it is complete. Plasma protein binding is 40–60%. Benzathine benzylpenicillin passes in small volumes through the placental barrier and also passes into breast milk. Biotransformation is insignificant, mainly excreted unchanged by the kidneys, up to 33% of the administered dose is excreted in 8 days.

60%. The substance penetrates into tissues, organs and biological fluids, except for eye tissue, cerebrospinal fluid and prostate gland. Passes through the blood-brain barrier during inflammation of the meningeal membranes. Penetrates the placenta and enters breast milk. It is excreted unchanged by the kidneys.

Indications for use

Bicillin-5 is used for the treatment of the following infectious and inflammatory diseases/conditions provoked by pathogens sensitive to the drug:

rheumatism – for year-round long-term prevention of relapses;
syphilis;
yaws;
streptococcal infections (except for infections caused by group B streptococci) - scarlet fever, acute tonsillitis, erysipelas, wound infections.

Contraindications

breastfeeding period;
hypersensitivity to any components of the drug and other beta-lactam antibiotics.

bronchial asthma;
burdened allergy history;
pregnancy;
renal failure;
pseudomembranous colitis.

Instructions for use of Bicillin-5: method and dosage

A suspension prepared from powder is administered intramuscularly (i.m.).

children under 8 years old: food + food once every 3 weeks;
children over 8 years old: food + food once every 4 weeks;
adults: ED + ED once every 4 weeks.

The suspension is prepared under aseptic conditions, immediately before use (ex tempore): 5-6 ml of solvent is slowly introduced into a bottle with Bicillin-5 under pressure (at a rate of 5 ml in 20-25 seconds). The contents are mixed and shaken along the longitudinal axis of the bottle until a homogeneous suspension is formed. There may be bubbles near the walls of the bottle on the surface of the suspension.

The finished drug must be injected deep intramuscularly into the upper outer quadrant of the gluteal muscle immediately after preparation. It is not recommended to rub the gluteal muscle after the injection. If administration is delayed after preparation, the colloidal and physical properties of the suspension change, as a result of which its movement through the syringe needle may be difficult.

Side effects

allergic reactions: anaphylactoid reactions, fever, urticaria, angioedema, arthralgia, exfoliative dermatitis, exudative erythema multiforme, anaphylactic shock;
laboratory parameters: leukopenia, thrombocytopenia, anemia, hypocoagulation;
others: glossitis, stomatitis.

Overdose

There is no information about overdose.

special instructions

Intravenous, endolumbar and subcutaneous administration of the suspension, as well as injections into body cavities, is not allowed. With unintentional intravascular administration, a transient feeling of anxiety, depression and visual disturbances (Wanier syndrome) may occur. To avoid inadvertent intravascular injection of the drug, aspiration should be performed before intramuscular injection in order to identify possible needle entry into the vessel.

When treating syphilis, serological and microscopic studies should be carried out before starting treatment and for 4 months. Due to the development of fungal infections, it is advisable to prescribe vitamin C and B vitamins at a time, and if necessary, prescribe antifungal agents for systemic use. It is important to consider that stopping therapy too early or using an insufficient dosage of Bicillin a-5 can lead to the emergence of resistant strains of pathogens.

Use during pregnancy and lactation

According to the instructions, Bicillin-5 penetrates into mother's milk and through the placental barrier in small quantities. Its use during pregnancy is allowed only when the expected benefit to the mother outweighs the potential risk to the fetus.

If it is necessary to prescribe the drug during lactation, breastfeeding should be discontinued.

Drug interactions

bactericidal antimicrobial drugs, including vancomycin, cephalosporins, aminoglycosides, rifampicin: have a synergistic effect;
bacteriostatic antimicrobial drugs, including chloramphenicol, macrolides, tetracyclines, lincosamides: have an antagonistic effect;
indirect anticoagulants: their effectiveness increases due to the inhibition of intestinal microflora and a decrease in the prothrombin index;
oral contraceptives, drugs whose metabolism occurs with the formation of para-aminobenzoic acid, ethinyl estradiol: the antibiotic reduces their effectiveness, increasing the risk of breakthrough bleeding;
blockers of tubular secretion, diuretics, allopurinol, non-steroidal anti-inflammatory drugs, phenylbutazone: reduce tubular secretion, increase the concentration of benzylpenicillin in tissues and blood;
allopurinol: increases the risk of allergic reactions such as skin rash.

Analogues

Analogues of Bicillin-5 are: Benzylpenicillin, Benzylpenicillin sodium salt, Benzylpenicillin sodium salt-Vial, Benzylpenicillin novocaine salt.

Terms and conditions of storage

Store at a temperature not exceeding 25 °C. Keep away from children.

Shelf life – 3 years.

Conditions for dispensing from pharmacies

Dispensed by prescription.

Reviews of Bicillin-5

Positive reviews of Bicillin-5 most often talk about its high effectiveness at a relatively low cost. The antibiotic is characterized as low-toxic, noting its ultra-long action. Those who have received Bicillin-5 injections warn that the procedure must be carried out with caution and with certain skills. Sometimes negative effects such as painful injections and the inhibitory effect of therapy on the intestinal microflora are noted.

Price for Bicillin-5 in pharmacies

The price for Bicillin-5 is approximately 730 rubles.

Bicillin-5 powder for preg. solution for injection ED No. 1 vial.

Bicillin-5 powder 1.5 million units 10 ml

Bicillin-5 por. d/prig. susp. for IM insertion 1.2 million units + 300 thousand units No. 50

Bicillin-5 powder for preg. solution for injection ED No. 50 fl.

Education: First Moscow State Medical University named after I.M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes and does not replace official instructions. Self-medication is dangerous to health!

The rarest disease is Kuru disease. Only members of the For tribe in New Guinea suffer from it. The patient dies of laughter. The disease is believed to be caused by eating human brains.

The highest body temperature was recorded in Willie Jones (USA), who was admitted to the hospital with a temperature of 46.5°C.

When lovers kiss, each of them loses 6.4 calories per minute, but at the same time they exchange almost 300 types of different bacteria.

During operation, our brain expends an amount of energy equal to a 10-watt light bulb. So the image of a light bulb above your head at the moment an interesting thought arises is not so far from the truth.

More than $500 million a year is spent on allergy medications in the United States alone. Do you still believe that a way to finally defeat allergies will be found?

The human brain weighs about 2% of the total body weight, but it consumes about 20% of the oxygen entering the blood. This fact makes the human brain extremely susceptible to damage caused by a lack of oxygen.

Tooth decay is the most common infectious disease in the world, which even the flu cannot compete with.

Each person has not only unique fingerprints, but also tongue prints.

Many drugs were initially marketed as medicines. Heroin, for example, was originally brought to market as a cure for children's coughs. And cocaine was recommended by doctors as an anesthesia and as a means of increasing endurance.

According to statistics, on Mondays the risk of back injuries increases by 25%, and the risk of a heart attack by 33%. Be careful.

According to many scientists, vitamin complexes are practically useless for humans.

The well-known drug Viagra was originally developed for the treatment of arterial hypertension.

The first vibrator was invented in the 19th century. It was powered by a steam engine and was intended to treat female hysteria.

An educated person is less susceptible to brain diseases. Intellectual activity promotes the formation of additional tissue that compensates for the disease.

You are more likely to break your neck if you fall off a donkey than if you fall off a horse. Just don't try to refute this statement.

An infectious inflammatory process in the kidneys associated with the development of bacteria in the urinary system is called pyelonephritis. This serious illness is observed in...

Bicillin 5 how to dilute and inject

Preparing for the injection

The drug is diluted immediately before use; storing the diluted antibiotic is not permissible. For dilution, use sterile water for injection, physiological sodium chloride solution in

How to dilute bicillin

The drug Bicillin-1 contains the active substance: benzathine benzylpenicillin.

The composition of Bicillin-3, in addition to benzathine benzylpenicillin, also includes benzylpenicillin novocaine salt and benzylpenicillin sodium.

Bicillin-5 contains benzathine benzylpenicillium and benzylpenicillin novocaine salt.

Bicillin is available in powder form for the preparation of an injection solution, which is intended for intramuscular administration. The drug is packaged in glass bottles of 10 ml.

Bicillin has bactericidal and antibacterial effects.

Pharmacodynamics and pharmacokinetics

The activity of this drug is aimed at various gram-positive microorganisms, anaerobic spore-forming bacilli, some gram-negative microorganisms, and so on. Bicillin is not effective against viruses that cause polio, smallpox, influenza, fungi, most gram-negative microorganisms, as well as strains that produce penicillinase.

With intramuscular administration of Bicillin-1, its slow absorption was noted. Then the drug is hydrolyzed, releasing benzylpenicillin, which will continue to enter the bloodstream. The maximum concentration is reached later, and the therapeutic effect appears after 3-6 hours.

The drug Bicillin-3 is also characterized by hydrolysis with slow release of benzylpenicillin. A single administration allows you to maintain a therapeutic concentration in the blood for 6-7 days, the maximum concentration is reached after the moment of administration. At the same time, high penetration of the substance into physiological fluids and low penetration into tissues was established. The drug also passes through the placental barrier and enters breast milk. The drug is biotransformed to a small extent; excretion occurs primarily through the kidneys.

As a result of intramuscular administration of Bicillin-5, its increased concentration in the blood is detected already in the first hours. In this case, the therapeutic effect lasts for 28 days.

Indications for use of Bicillin

The main indications for the use of Bicillin are the treatment of various infectious diseases caused by microorganisms sensitive to the drug.

Therefore, the drug is prescribed for:

Contraindications for use

The drug is not prescribed for hypersensitivity to its components and other penicillins.

Care must be taken when treating patients with bronchial asthma, hay fever, urticaria and other allergic diseases, intolerance to various drugs.

When treated with Bicillin, various side effects may develop that affect the activity of the cardiovascular system and hematopoiesis, manifesting itself in the form of anemia, thrombocytopenia, leukopenia and hypocoagulation.

Allergic reactions are also possible, for example: irritation and rash on the mucous membranes and skin, urticaria, joint pain, exfoliative dermatitis, swelling, and so on.

General undesirable manifestations cannot be excluded: headache, high fever, arthralgia, glossitis, stomatitis, pain at the injection site. Long-term therapy can cause superinfections, the causative agents of which are microorganisms and fungi resistant to the drug.

Bicillin - instructions for use (Method and dosage)

According to the instructions for use of Bicillin-1, this drug is used as a preventive and therapeutic agent for infectious diseases. In this case, the peculiarities of the injection are that the injections are made deep, in the upper part of the gluteal muscle. The dosage and treatment regimen for various conditions is determined by the attending physician.

Bicillin-3 instructions for use recommend administration in a dosage of ED, if necessary - into different buttocks. You need to repeat the injections after 3 days, ultimately you can administer 6 days before meals. Therapy of primary or secondary syphilis involves the administration of a single dosage of 1.8 million units. A total of 7 injections are given according to a certain scheme: the first and second meals with an interval of 24 hours, then 2 times a week. Other diseases according to indications also require the use of certain dosages, regimens and duration of treatment.

Preparation of the suspension is allowed strictly before use, subject to aseptic conditions. The annotation for each type of drug describes exactly what to dilute and how to dilute Bicillin-5, and so on. Usually the contents of the bottle are dissolved in sterile distilled water, 0.9% sodium chloride solution or 0.25-0.5% novocaine solution. Then the resulting mixture is shaken well and administered immediately.

This drug is also actively used in veterinary medicine. It is suitable for cats and dogs, and is also used to treat fish and small mammals.

Cases of overdose have not been reported in clinical practice.

The simultaneous use of this drug with bactericidal antibiotics, for example: cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides can cause a synergistic effect. Combination with bacteriostatic agents: macrolides, chloramphenicol, lincosamides and tetracyclines causes an antagonistic effect.

In addition, a decrease in the effectiveness of oral contraceptives or ethinyl estradiol was noted. Diuretics, phenylbutazone, allopurinol and NSAIDs can reduce tubular secretion or increase drug concentrations. The combination with allopurinol often causes allergic reactions, mainly in the form of skin manifestations.

Before starting treatment, you need to clarify how to dilute Bicillin-3 or other types of the drug. Usually a prescription is written in Latin, so it is best to immediately find out from the doctor how to inject the medicine, in what dosage and other features of therapy.

If blood appears in the syringe during an injection, it means that the needle has entered a blood vessel. In such cases, you need to remove the syringe and inject in another place. After this, the injection site is pressed with a cotton swab, but not rubbed.

Discontinuation of therapy requires the development of allergic reactions, regardless of the form of manifestation.

During the treatment of sexually transmitted diseases, especially syphilis, microscopic and serological studies should be carried out before starting therapy and in the next 4 months.

To prevent the development of fungal infections, it is recommended to take vitamins B and C, as well as nystatin and levorin. When the drug is used in insufficient dosages or therapy is stopped prematurely, this can cause the development of resistant strains of pathogens.

When using Bicillin-3 in veterinary medicine, you also need to take into account all the prescriptions of specialists for animals, which have many features.

The medicine is available by prescription.

The drug should be stored in a dry, dark, cool place, out of reach of children.

AnalogsMatches by level 4 ATX code:

The main analogues are represented by the following drugs: Benzathine benzylpenicillin, Benzicillin, Moldamine, Retarpen and Extensillin.

When treating with Bicillin, drinking alcohol is not recommended, as this can significantly reduce or enhance the therapeutic effect.

Reviews of Bicillin

In most cases, reviews of Bicillin-5 are found on various medical forums and websites, the topics of which are related to the treatment of infectious diseases that require a long stay inside the body.

As reviews of Bicillin-3 show, this particular drug is prescribed for the treatment of various ENT infections. In this case, therapy is almost always quite successful.

However, before starting treatment with this antibiotic, it is necessary to check the sensitivity of the pathogen to this medicine.

In addition, during treatment with Bicillin, allergic reactions often occur. If they manifest themselves as complex side effects, the drug is discontinued. In any case, both the prescription and withdrawal of treatment remain within the competence of the attending physician.

Bicillin price, where to buy

You can buy this drug in pharmacies or online pharmacies.

At the same time, the price of Bicillin-5 in the form of powder for preparing a suspension ranges from 10 rubles per bottle.

The price of Bicillin-3 varies between 7-10 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

WER.RU

Bicillin-3 powder 600 thousand units 10 mlSintez OJSC

Bicillin-5 powder 1.5 million units 10 mlSintez OJSC

ZdravZone

Bicillin-5 powder for preg. solution for injection ED No. 1 vial. Sintez OJSC

Bicillin-3 powder for preg. injection solution ED No. 50 fl. Sintez OJSC

Bicillin-3 powder for preg. solution for injection ED No. 1 vial. Sintez OJSC

Bicillin-5 powder for preg. injection solution ED No. 50 fl. Sintez OJSC

Pharmacy24

Bicillin-3Kievmedpreparat (Ukraine, Kyiv)

Bicillin-5Kievmedpreparat (Ukraine, Kyiv)

PaniPharmacy

Bicillin-5 por. d/in.ED

BIOSPHERE

Bicillin ED No. 1 (50 pcs per box) pores. d/in.fl. Sintez OJSC (Russia)

BicillinED No. 1 por. d/in.fl. Sintez OJSC (Russia)

NOTE! Information about medications on the site is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment. Before using Bicillin, be sure to consult your doctor.

How to properly administer bicillin 3

asterisk1. Please tell me what the secret is. I just can’t seem to get a normal, full-fledged injection of Bicillin 3. Perhaps there are some nuances?

zubari. Method of administration and dosage: Injected deep IM into the upper outer quadrant of the gluteal muscle (IV administration is prohibited) at a dose of 300 thousand units. If 2 injections are necessary, they are given in different buttocks. Repeated injections are made 4 days after the previous injection. A dose of 600 thousand units is administered once every 6 days. The main thing here is not to get into the vessel.

zubari. star1 writes: It’s impossible to give a normal, full-fledged injection Why doesn't it work?

Mora. asterisk1, what are you breeding with? Sometimes a poorly dissolved drug clogs the needle. Or is the dog twitching and you cannot inject the contents of the syringe?

asterisk1. I dilute with novocaine 05%. 4 ml. I dissolve it very carefully. but it is possible to enter only half, because... the solution #34;thickens#34; and the needle gets clogged. I took another needle from 10 cc. syringe, it has a larger hole, and I read somewhere else that the needle should be absolutely dry, but the result is the same. Maybe it takes a certain amount of time to dissolve or something else?

Yenish. asterisk1. take a needle from a 20 cc syringe. Even better is a veterinary needle and glass syringe. Why do you make bicillin with today’s wide selection of antibiotics? Half of the strains microflora have long been resistant to it.

asterisk1. I see. Thank you very much. We will try.

vasyl. bicillin3. 5. dissolve with distilled water. but it's very painful. That's why in the treatment In institutions it is diluted with a 0.25% novocaine solution. There is no such novocaine on sale. but you can dilute the dist. water 0.5% novocaine. The diameter of the needle does not matter. since in a concentration greater than 0.25% it still coagulates.

asterisk1. I am already convinced that the diameter of the needle does not play a big role. Maybe you really need less concentration, otherwise it coagulates instantly. But I can’t give the injection quickly, I’m afraid it will get into the bone.

Yenish. star1 writes: I'm afraid of hitting a bone. What place are you going to? If it’s where it’s usually given to dogs intramuscularly, then you certainly won’t hit the bone. star1 writes: I am already convinced that the diameter of the needle does not play a big role. It has. At one time they used bicillin a lot - the cow’s needle never got clogged

Marisha. When you dilute the drug Bicilin 5, do you need to shake the bottle? And then how to fill it up, it foams and you can’t see anything. whether air got into the syringe or not

Yenish. You should not shake it vertically, but roll it in your palms. then it won't foam. it crystallizes even more strongly in the needle than bicillin-3, so choose a needle with a large diameter.

Bilkis. Personally, I administer this drug with a veterinary syringe with a thick needle. It is drawn normally, the needle does not get clogged. Such syringes and needles are reusable, you have to boil them.

Marta Kemerovof. And the reason to put it? What kind of pain do you have? Enish has already written to you that there are already modern drugs. Write and the veterinarians will answer you.

Bicillin 3 – application

Indications for use of Bicillin 3

The drug is widely used for the treatment of rheumatism and its prevention.

How to dilute Bicillin 3?

How to inject Bicillin?

Bicillin is used by adults once every six days per meal. To prevent relapses of rheumatism, along with an antibiotic, the doctor prescribes taking Aspirin or Analgin one gram per day.

Contraindications to the use of the drug are:

How to dilute bicillin

Preparing for the injection

Dilution of the drug and its intramuscular administration

It is necessary to wash your hands, wipe the ampoule with solvent with an alcohol wipe, open the ampoule, and take 5 ml of solvent. Wipe the stopper of the bottle at the injection site, carefully insert the needle and slowly, pressing the syringe plunger, inject the liquid. Without pulling out the syringe, quickly shake the components, after mixing completely, turn the bottle upside down, pull the syringe barrel so that only the end of the needle touches the liquid, and draw the required amount of antibiotic. The dose is calculated in medical units and may vary depending on the type of disease and the age of the patient.

Sources: No comments yet!

Compound

The product has several generations, which include different combinations of penicillin salts.

Bicillin 1 is the first generation, which contains only one benzathine salt, benzylpenicillin. In pharmacies you can find 2 dosages: iED (action units: the video below explains how to correctly calculate the dosage and administer the injection solution).
Bicillin 3 - second generation. It contains 3 salts: benzathine benzylpenicillin, benzylpenicillin sodium and benzylpenicillin novocaine salt. The dosage also has 2 gradations: iED.
Bicillin 5 is the latest generation of the drug, the composition of which has been adjusted. Now the powder contains benzathine benzylpenicillin ED and novocaine salt benzylpenicillin ED. The medicine is available in only one dose.

Characteristic

Mechanism of action and elimination time

Pharmacokinetics is also an important link. Since it is the slow elimination of the drug from the body that makes it indispensable in the prevention of streptococcal complications.

Indications for use

Since this product does not have protection, it is more often used to combat the consequences of the activity of group A beta-hemolytic streptococcus, gonorrhea and treponema pallidum.

Indications for use are:

syphilis;
gonorrhea;
erysipelas;
severe scarlet fever;
prevention of rheumatism after a complex sore throat;
tonsillitis;
leishmaniasis;
treatment of streptococcal carditis and glomerulonephritis.

An advantage in the treatment of the above diseases is given to Bicillin due to its long-term cumulative ability.

Rules of application

Bicillin 1 and 3 are diluted exclusively with saline or water for injection. Diluting the powder with novocaine is contraindicated. Bicillin 5 is the only representative that can be diluted with an anesthetic. But under 8 years old this is also not allowed.

On average, the doses used are:

Bicillin 1 - 1.2 million IU 2 times a month or IU 1 time a week;
Bicillin 3 - 1 day - IU, 4th day - IU, then every 6 days;
Bicillin 5 - 1.5 million IU once a month.

Contraindications

Side effects

The main side effect is the development of an allergic reaction:

Reactions from the hematopoietic system are rarely observed:

coagulopathy;
anemic syndrome;
thrombocytopenic purpura;
leukopenia.

Common symptoms associated with antibiotics:

headache;
unmotivated weakness;
diarrhea;
dysbacteriosis;
glossitis and stomatitis;
joint pain;
fever of unknown origin.

Features of use in different population groups

Children, pregnant women and elderly people have their own individual physiological characteristics. Therefore, the pharmacokinetics, the direct effect of the drug, may be perverted.

Pregnancy and lactation period

The lactation period is a contraindication, since a small concentration passes into breast milk. This may cause an allergic reaction or the development of resistance to bacterial flora.

Aged people

Analogues

Pharmacies offer many analogues of each drug, and this product is no exception. Depending on the constituent components, a number of other drugs are isolated.

How to inject Bicilin

Recommendations for the use of the drug Bicilin

Becillin-5 - a penicillin antibiotic - is active against various microorganisms that provoke the occurrence of gonorrhea, staphylococcus infections, meningitis, streptococcus, diphtheria, as well as other anaerobic infections.

Powerless against the effects of microorganisms that produce penicillinase. Many gram-negative bacteria, viruses and fungi are resistant to the influence of the drug.

Can and should be used for the following diseases:

Infectious and inflammatory diseases
Against pathogens
Prevention of relapse (against some diseases)
Group of sexually transmitted infections
Types of infections: streptococcus, staphylococcus
Against erysipelas.

One 10 ml bottle contains powder: benzathine benzylpenicillin - 1,200,000 units of antibiotic, benzylpenicillin novocaine salt in 10 ml - 300,000 units.

It is effective against gram-positive microorganisms, anaerobic bacilli - streptococcus, and some gram-negative organisms. Used to treat diseases caused by the action of streptococcus and other bacteria. Not used to treat viruses - smallpox, influenza, fungus, rickettsia. Can be used in gynecology and urology.

The drug is slowly absorbed, then during treatment it is released over a long period of time and enters the blood. Its maximum concentration in plasma is achieved 2-4 hours after taking the drug. After 1.2-1.5 million units have been administered.

The antibiotic is excreted only through the kidneys; before this, the drug is effective. Only about 5% (out of 10 ml) comes out through sputum, saliva, sweat, breast milk, and tears.

Price from 180 rubles.

Bicillin-5 10 ml - is a white or yellowish powder for injection; small lumps may form on it during storage. It has no taste or smell.

For adults: it is administered in the amount of 1,200,000 units + 300,000 units, injected once every 4 weeks.
For children over 8 years old, the injection is given in the amount of 960,000 units + 240,000 units, the injection should be done once every 4 weeks.
For children under 8 years old – 480,000 units + 120,000 units, inject once every 3 weeks.
Can be diluted in sterile water, isotonic sodium chloride solution, procaine. You can also dilute with novocaine or lidocaine up to 10 ml.

The solution must retain its characteristics, so it is prepared only before use. To do this, a solvent in an amount of less than 10 ml is slowly introduced into the bottle under pressure. This is done for 25 seconds. You need to mix the contents of the bottle, shake it until a homogeneous whitish suspension appears. Bubbles may appear on the surface of the walls.

Injected intramuscularly into the upper outer square in the buttock area. After this, you need to rub the gluteal muscle and lie down for a while.

Bicillin-5 may be found in breast milk. It can be used during pregnancy only when the benefit to the mother is not inferior to the degree of harm and risk to the fetus. If the use of the drug is prescribed for bacteria such as streptococcus and others, it is recommended to refrain from breastfeeding.

Precautionary measures

If blood forms in the syringe during an injection, this indicates that the needle has entered a blood vessel. Actions: you can take out the needle and inject in another place. After administration of the drug, the affected area is treated with a sterile treated cotton swab. You should not rub your buttock after the injection is given.
If an allergic reaction is observed during the injection on the skin - itching, redness and other manifestations, then treatment is stopped. If certain signs of anaphylactic shock occur, urgent measures are taken.
If Bicillin-5 is used against sexually transmitted diseases, then before starting treatment it is important to undergo a series of studies.
There is a risk of developing a fungus during the injection, so vitamins (group B, C) are sometimes prescribed along with the drug. Early termination of the treatment process and use of the drug in small doses leads to the formation of pathogen strains.
If streptococcus is being treated, it is necessary to consult a specialist before use, because it may have a negative effect.

Interaction with other drugs

The synergistic effect of the injection is bactericidal antibiotics - rifampicin, aminoglycosides, macrolides, chloramphenicol, tetracyclines.
It helps to increase the activity of indirect anticoagulants, suppress intestinal microflora, and reduce the effectiveness of contraceptives. If you inject with ethinyl estradiol and treat streptococcus, there is a high probability of breakthrough bleeding. Diuretics are responsible for increasing the concentration of the drug in tissues and blood. Combined use with allopurinol increases the risk of developing allergies, and a skin rash may form.

The injections have side effects:

Cardiac and vascular system: formation of leukopenia, hypocoagulation, thrombocytopenia, manifestation of anemia
Allergies: skin rash formation, urticaria, itching, redness, dermatitis
Others: headache, fever, stomatitis
When combined with lidocaine, it may cause weakness.

If headaches interfere with your usual lifestyle, we recommend the article: eliminating headaches.

If the norms for use in units and doses are not observed, allergic reactions and other side effects during injection may occur.

The antibiotic is stored in a dry place, temperature - no more than +20 C, away from sunlight. Keep away from children. The shelf life of the drug is 3 years.

Attention! The information is provided for informational purposes only. This instruction should not be used as a guide to self-medication. The need for prescription, methods and doses of the drug are determined exclusively by the attending physician.

Description of the drug: Bicilin

Compound: 1 bottle contains sterile benzathine benzylpenicillin 1,200,000 units, benzylpenicillin novocaine salt sterile 300,000 units.

Basic physical and chemical properties: white or white powder with a slightly yellowish tint;

Penicillins sensitive to the action of β-lactamases.

Bicillin-5 CMP is administered only intramuscularly! Suspension ( Suspension- a liquid dosage form, which is a dispersed system containing one or more solid medicinal substances suspended in an appropriate liquid. Suspensions are used for internal and external use, as well as for injections) Bicillin-5 CMP is prepared aseptically, immediately before use: 9 ml of sterile water for injection or 0.9% sodium chloride solution, or 0.25 –0.5% novocaine solution. The contents of the bottle are mixed until a homogeneous suspension is formed. The suspension is injected deep into the upper outer quadrant of the buttock (2 injections are made into different buttocks).
Bicillin-5 CMP is administered to adults at a dose of 1,500,000 units once every 4 weeks. For preschool children, Bicillin-5 CMP is administered at a dose of 600,000 units once every 3 weeks, for children over 8 years old - at a dose of 1,200,000 units once every 4 weeks. Injecting Bicillin-5 CMP more frequently is contraindicated.

Some patients, especially those with hypersensitivity to penicillins and novocaine, experience headache, fever, and urticaria ( Hives– a disease characterized by the formation of limited or widespread itchy blisters on the skin and mucous membranes), rash on the skin and mucous membranes, joint pain ( Joints- movable joints of bones that allow them to move relative to each other. Auxiliary formations - ligaments, menisci and other structures), eosinophilia, angioedema ( Angioedema- (Quincke's edema), acute limited paroxysmal swelling of tissues. Quincke's edema is the body's reaction to an allergen. Externally, Quincke's edema manifests itself as sharply limited swelling of tissues (mainly lips, eyelids, cheeks), sometimes skin rashes at the site of swelling, usually without itching and pain), anaphylactic shock ( Anaphylactic shock- a symptom complex of acutely occurring general severe manifestations of immediate-type allergic reactions, mainly characterized by initial excitation and subsequent depression of the function of the central nervous system, bronchospasm, severe arterial hypotension) and other allergic reactions. After injection of the drug (like other long-acting penicillin preparations), pain at the injection site is possible.
Patients who have experienced unusual reactions to the drug should be under constant and direct medical supervision until the reactive phenomena completely disappear. In severe cases, it is prescribed
injections of atropine 0.1% – 0.5–0.6 ml;
inhalation of ammonia;
injections of 0.1% adrenaline ( Adrenalin- hormone of the adrenal medulla of animals and humans. Entering the blood, it increases oxygen consumption and blood pressure, blood sugar, stimulates metabolism, etc. Emotional experiences and increased muscle work increase the content of adrenaline in the blood) - 1 ml or ephedrine 5% - 1 ml;
injections of 2% suprastin – 1–2 ml.

Treatment of infections caused by microorganisms sensitive to benzylpenicillin, if long-term exposure to the latter is necessary.
The use of Bicillin-5 KMP is especially indicated for year-round prevention of relapses of rheumatism in adults and children.

Do not mix Bicillin-5 KMP solution with other injection solutions. It is not recommended to combine the administration of the drug with the use of indomethacin, phenylbutozol and salicylates. Prescribe with caution in case of hypersensitivity to cephalosporin antibiotics ( Antibiotics- substances that have the ability to kill microbes (or prevent their growth). They are used as drugs that suppress bacteria, microscopic fungi, some viruses and protozoa; there are also antitumor antibiotics) (due to possible cross-allergy).

For patients prone to allergic reactions, the drug is prescribed with caution. If signs of allergic reactions appear, Bicillin-5 CMP should be discontinued and appropriate therapy prescribed.

Storage conditions and period: Store out of the reach of children, in a dry place, protected from light at a temperature of 15 °C to 25 °C. Shelf life – 3 years.
Do not use the drug after the expiration date indicated on the package!

Terms of sale: On prescription.

Package: 1,500,000 units in bottles

Manufacturer. Arterium Corporation.

Location. 01032, Ukraine, Kiev, st. Saksagansky, 139.

Website. www.arterium.ua

This material is presented in free form on the basis of the official instructions for medical use of the drug.

Bicillin-5 is an antibiotic (biosynthetic penicillin).

Powder composition (per 1 bottle):

benzylpenicillin procaine (benzylpenicillin novocaine salt) – 300,000 units;
benzathine benzylpenicillin – 1,200,000 units.

Pharmacodynamics

Bicillin-5 is a bactericidal combination antibiotic containing two long-acting benzylpenicillin salts. Inhibits the synthesis of the cell wall of pathogenic microorganisms.

Active against the following microbes:

gram-positive: Streptococcus spp. (including Streptococcus pneumoniae), Staphylococcus spp. (not forming penicillinase), Bacillus anthracis, Clostridium spp., Corynebacterium diphtheriae, anaerobic spore-forming rods, Actinomyces israelii;
gram-negative: Treponema spp., Neisseria gonorrhoeae, Neisseria meningitidis.

Penicillinase-producing strains of Staphylococcus spp. are resistant to the drug.

Bicillin-5 is a long-acting antibiotic; its high concentration in the blood remains for 4 weeks.

Benzathine benzylpenicillin hydrolyzes very slowly after intramuscular injection, releasing benzylpenicillin. The maximum concentration (Cmax) in the blood serum is achieved 12–24 hours after administration. The long half-life ensures a long and stable concentration of the drug in the blood: on the 14th day after injection of 2,400,000 IU, the drug concentration in serum is 0.12 μg/ml; on the 21st day after administration - 1,200,000 IU, the concentration is 0.06 μg/ml (1 IU = 0.6 μg). Diffusion of the substance in tissue is very weak, in liquid it is complete. Plasma protein binding is 40–60%. Benzathine benzylpenicillin passes in small volumes through the placental barrier and also passes into breast milk. Biotransformation is insignificant, mainly excreted unchanged by the kidneys, up to 33% of the administered dose is excreted in 8 days.

Benzylpenicillin reaches its maximum concentration in blood plasma when administered intramuscularly after 20–30 minutes. The half-life is 0.5–1 hour; in the presence of renal failure, this figure increases to 4–10 hours or more. Plasma protein binding ~ 60%. The substance penetrates into tissues, organs and biological fluids, except for eye tissue, cerebrospinal fluid and prostate gland. Passes through the blood-brain barrier during inflammation of the meningeal membranes. Penetrates the placenta and enters breast milk. It is excreted unchanged by the kidneys.

Bicillin-5 is used for the treatment of the following infectious and inflammatory diseases/conditions provoked by pathogens sensitive to the drug:

rheumatism – for year-round long-term prevention of relapses;
syphilis;
yaws;
streptococcal infections (except for infections caused by group B streptococci) - scarlet fever, acute tonsillitis, erysipelas, wound infections.

Absolute:

breastfeeding period;
hypersensitivity to any components of the drug and other beta-lactam antibiotics.

Relative:

bronchial asthma;
burdened allergy history;
pregnancy;
renal failure;
pseudomembranous colitis.

A suspension prepared from powder is administered intramuscularly (i.m.).

children under 8 years old: 480,000 units + 120,000 units once every 3 weeks;
children over 8 years old: 960,000 units + 240,000 units once every 4 weeks;
adults: 1,200,000 units + 300,000 units once every 4 weeks.

Overdose

There is no information about overdose.

When treating syphilis, serological and microscopic studies should be carried out before starting treatment and for 4 months. Due to the development of fungal infections, it is advisable to prescribe vitamin C and B vitamins at a time, and if necessary, prescribe antifungal agents for systemic use. It is important to consider that stopping therapy too early or using an insufficient dosage of Bicillin-5 can lead to the emergence of resistant strains of pathogens.

If it is necessary to prescribe the drug during lactation, breastfeeding should be discontinued.

Analogues of Bicillin-5 are: Benzylpenicillin, Benzylpenicillin sodium salt, Benzylpenicillin sodium salt-Vial, Benzylpenicillin novocaine salt.

Store at a temperature not exceeding 25 °C. Keep away from children.

Shelf life – 3 years.

Dispensed by prescription.

The price for Bicillin-5 is approximately 730 rubles.

And other anaerobic infections.

Bicillin 5 is a penicillin antibiotic with a powerful antimicrobial effect.

What diseases are treated with Bicillin 5, and how to properly use the drug in the treatment of various diseases?

Description of the drug and indications for use

Bicillin 5 is produced in the form of a powder, which, when added to it, is converted into a stable suspension. The powder is packaged in 10 ml bottles, each of which contains 1.2 million units of benzathine-benzylpenicillin and 300 thousand units of benzylpenicillinaprocaine.

The components of the drug are active against gram-positive and gram-negative bacteria and anaerobic spore-forming rods.

Note! The drug is powerless against strains of microorganisms that produce penicillinase (group B).

Bicillin 5 is used to treat infectious pathologies whose pathogens are sensitive to benzylpenicillin. These include:

Rheumatism;
Wound infections;
Erysipelas;
Spicy ;
Scarlet fever;
Leishmaniasis;
Yaws.

The medicine has a prolonged effect, because its therapeutic effect lasts for four weeks from the moment of intramuscular administration. The maximum concentration of the active substance in the body is reached approximately half an hour after administration.

Dosages and regimen of use

The antibiotic can be diluted with novocaine, for injection, or saline.

The antibiotic Bicillin 5 is used exclusively intramuscularly. For this purpose, a special suspension is prepared from the powder:

To prepare a suspension, you can use a solution of novocaine or procaine (0.25-0.5%), sterile water for injection, isotonic sodium chloride solution.
A solvent in a volume of 5-6 ml is slowly introduced into the bottle with the powder.
The contents of the bottle are mixed by shaking until a suspension is formed.

The suspension is made immediately before administration and under aseptic conditions. The resulting solution is injected deep into the upper quadrant of the buttock intramuscularly. However, after administering the injection, you should not rub the gluteal muscle.

Note! The use of the drug is possible only from the age of three.

The drug should be administered only after a doctor's prescription and under strict medical supervision due to the high risk of developing serious negative manifestations.

special instructions

Bicillin 5 should not be used if there is hypersensitivity to the components of the drug and if there is an individual intolerance to elements such as procaine, penicillin, and similar beta-latam antibiotics.

Bicillin 5 is used with caution and under strict medical supervision for:

Impaired kidney function;
Pseudomembranous form;
Allergic pathologies (hay fever, bronchial).

Treatment with the drug during pregnancy and lactation is possible, if permitted by a doctor. But during the period of bearing a child, it is strictly forbidden to use Bicillin 5 in the first trimester, and during lactation, when using the medicine, breastfeeding should be stopped for a while.

Bicillin 5 can cause serious negative effects, which most often occur when the course of treatment and dosage of the drug is violated.

After the first injection you may develop:

Allergic reactions: exfoliative, itching, swelling, urticaria, chills, arthralgia, exudative erythema multiforme.

After administration of an antibiotic, it may occur.

Laboratory abnormalities: hypocoagulation, thrombocytopenia, leukopenia, .
Other reactions: , glossitis.

In case of an overdose, negative reactions from the central nervous system may appear: pain in the back of the head, reflex excitation, convulsions, vomiting, arthralgia, myalgia.

Important! It is prohibited to administer Bicillin 5 subcutaneously, intravenously, into the spinal canal, or into body cavities.

Drug interactions Bicillin 5 with other antibiotics:

With bactericidal antibiotics (rifampicin, vancomycin, aminoglycosides, cephalosporins) - enhance the effect;
With bacteriostatic antibiotics (tetracyclines, chloramphenicol, lincosamides, macrolides) - weaken the effect;
With indirect-acting anticoagulants, their effectiveness increases;
With ethinyl estradiol, oral - their therapeutic effect decreases.
With allopurinol, the risk of allergic reactions increases.

Treatment of syphilis with Bicillin 5 is carried out with microscopic and serological studies before starting therapy and in the next 4 months. It is recommended to take group B, vitamin C and systemic vitamins at the same time.

Price and analogues

Bicillin 5 is produced only by domestic pharmaceutical companies, so the cost of the drug depends only on the number of bottles in the package and the pharmacy chain that sets markups.

Note! You can buy Bicillin 5 on average in Russia for 70 rubles. for a package with five bottles, and for 700 rubles a package with 50 bottles.

If after using the medicine the expected therapeutic effect did not occur or negative side effects developed, you can select analogues that differ little from Bicillin 5 in action and cost:

Analogs in chemical composition: Benzicillin 3, ;

– an analogue of Bicillin 5, has the same chemical composition.

Analogs by mechanism of action: Augmentin, Amoxiclav, Ampiox, Oxamp-sodium.

Before replacing the drug with analogues, medical consultation is necessary.

What is possible and not possible during the Nativity Fast?

In 2018, the Nativity Fast will begin on November 28. During this period, Orthodox believers prepare to celebrate Christmas...
A powerful prayer from her husband's mistress

Starting a family is the dream of most women. They want to have a loving husband and a bunch of kids. But it's not always a relationship...
Prayer to prevent divorce from your husband Prayer to keep your husband before divorce

This article contains: the most powerful prayer for divorce - information taken from all corners of the world, the electronic network and...
Strong prayer against quarrels and insults with your husband or wife Prayer not to divorce your wife

Information site about icons, prayers, Orthodox traditions. Prayer for scandals and quarrels in the family, with husband, with children...
Herring under a fur coat - a classic recipe

What would New Year be without champagne, tangerines, Olivier, aspic and everyone’s favorite “Herring under a fur coat”. With the last one...
How to make oatmeal cookies from oatmeal at home

Let's prepare the necessary ingredients for the cookies. The first thing to do is put the water to boil. We need...

2024-01-29 02:58:13

The financial director has it in his genes that the chief accountant must report to him. The difference between a financial director and a chief accountant.

Is it possible to register an employee for the position of financial director - chief accountant? The chief accountant claims...
2024-01-29 02:58:13

Development of enterprise budgets using the example of Uyut LLC Drawing up an annual budget for an enterprise

The head of a small business can easily manage the budget independently. CHECKED! If you manage...

2024-01-29 02:58:13

Place of a business plan in the life cycle

The creation of new projects involves a preliminary economic justification for their feasibility, subsequent...
2024-01-29 02:58:13

Development of a risk management program at the enterprise Risk report plan form

Reporting is generated by the RM, is agreed upon (approved) by the Risk Committee under the Management Board and transmitted to...

2024-01-28 03:22:01

Ecological tales about ladybugs

At the edge of a large, very large meadow, on a long emerald blade of grass lived a tiny Ladybug. God's little...
2024-01-27 04:33:53

Compatibility of Libra with other zodiac signs

Nowadays, it is quite common for people to turn to the stars. With the help of a horoscope a person can find out...

2024-01-27 04:33:53

Why do you dream of catching up with a man? Why do you dream of catching up with your loved one?

Business or friendly. If you were pursuing a stranger, it means your level of trust in the female sex...
2024-01-27 04:33:53

Dream Interpretation: Why do you dream about fish?

according to Freud's dream book If you dreamed about how you were fishing, it means that in real life you can hardly switch off...

2024-01-26 02:52:15
New Year's salad recipes (2016) Meat salad with prunes

The New Year's whirlwind will spin us around so quickly and rapidly that it's time to thoroughly think through the New Year's...
2024-01-26 02:52:15
Vinaigrette with homemade pickles

The article offers you some of the most delicious recipes for making vinaigrette. Vinaigrette is a delicious salad...
2024-01-26 02:52:15
Recipe: Cookies "Straws" - salted Recipes for salted straws for tea

July 4th, 2015 , 08:33 pm Lately, our Nastena has been completely giving up sweets (and thank God),...
2024-01-26 02:52:15
Soviet recipes for Negro kiss cake

Fragrant, very tasty chocolate cake, you can’t stop eating! The Negro’s Kiss cake is very easy to prepare,...
2024-01-25 01:29:08
Dream interpretation of a dead man being alive

Dream interpretation is an ancient art that allows you to at least assess the psychological status...
2024-01-25 01:29:08
Why accidentally break a mirror at home?

As soon as the first mirrors were born, people immediately endowed them with all sorts of mystical...
2024-01-31 04:57:39
What is possible and not possible during the Nativity Fast?

In 2018, the Nativity Fast will begin on November 28. During this period, Orthodox believers prepare to meet...

2024-01-31 04:57:39

A powerful prayer from her husband's mistress

Starting a family is the dream of most women. They want to have a loving husband and a bunch of kids. But it's not always...
2024-01-31 04:57:39

Prayer to prevent divorce from your husband Prayer to keep your husband before divorce

This article contains: the most powerful prayer for divorce - information taken from all over the world, electronic...

Preparing for the injection

Characteristic

pharmachologic effect

Pharmacodynamics

Pharmacokinetics

Indications of the drug Bicillin-5

Contraindications

Side effects

Interaction

Directions for use and doses

Precautionary measures

special instructions

Storage conditions for the drug Bicillin-5

Shelf life of the drug Bicillin-5

Release form and composition

Pharmacological properties

Pharmacodynamics

Pharmacokinetics

Indications for use

Contraindications

Instructions for use of Bicillin-5: method and dosage

Side effects

Overdose

special instructions

Use during pregnancy and lactation

Drug interactions

Analogues

Terms and conditions of storage

Conditions for dispensing from pharmacies

Reviews of Bicillin-5

Price for Bicillin-5 in pharmacies

Bicillin 5 how to dilute and inject

Preparing for the injection

WER.RU

ZdravZone

Pharmacy24

PaniPharmacy

BIOSPHERE

Bicillin 3 – application

Indications for use of Bicillin 3

How to dilute Bicillin 3?

How to inject Bicillin?

How to dilute bicillin

Preparing for the injection

Dilution of the drug and its intramuscular administration

Compound

Characteristic

Mechanism of action and elimination time

Indications for use

Rules of application

Contraindications

Side effects

Features of use in different population groups

Pregnancy and lactation period

Aged people

Analogues

How to inject Bicilin

Recommendations for the use of the drug Bicilin

Description of the drug: Bicilin

Pharmacodynamics

Description of the drug and indications for use

Dosages and regimen of use

special instructions

Price and analogues

Random articles

Advertising

Low hemoglobin

ALT and AST

Lymphocytes

Leukocytes

New

Popular