Oryx 500 mg IV Injection

Indication:

Oryx 500 mg IV Injection is indicated for the treatment of-

• Severe Infections: Sepsis, meningitis, and abdominal infections (e.g., peritonitis).
• Respiratory Tract Infections: Severe community-acquired pneumonia and hospital-acquired pneumonia.
• Bone and Joint Infections: Osteomyelitis and septic arthritis.
• Skin and Soft Tissue Infections: Including surgical site infections.
• Urinary Tract Infections: Complicated infections including pyelonephritis.
• Gonorrhoea: Acute uncomplicated gonorrhea (cervical, urethral, and rectal).
• Lyme Disease: Disseminated Lyme borreliosis (early and late stages).
• Surgical Prophylaxis: Prevention of post-operative infections.

Dogase & Adminstration:

Adults and Adolescents (>12 years or >50kg):

• Standard Dose: 1 g to 2 g once daily.
• Severe Infections: Up to 4 g once daily (or in two divided doses).
• Uncomplicated Gonorrhoea: 500 mg as a single IM dose (usually with azithromycin).
• Surgical Prophylaxis: A single dose of 1 g to 2 g administered 30–90 minutes prior to surgery.

Children (Based on BNFC):

• Neonates (up to 14 days): 20–50 mg/kg once daily. (Note: Avoid use in neonates with jaundice or those requiring calcium-containing IV fluids).
• Infants and Children (15 days to 12 years): 50–80 mg/kg once daily. In severe infections, up to 100 mg/kg daily (Max 4 g).

Administration:

• IM Injection: Reconstitute with 1% Lidocaine injection to reduce pain at the site. Inject deep into a large muscle.
• IV Injection: Administer slowly over at least 2–4 minutes.
• IV Infusion: Administer over at least 30 minutes.
• Crucial Note: Must not be mixed or administered simultaneously with calcium-containing solutions (e.g., Ringer’s solution) due to the risk of precipitation.

”রেজিস্ট্রার চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন”

Pharmacology:

• Mechanism of Action: Ceftriaxone is a bactericidal agent. It inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs). This action inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, ultimately leading to cell wall lysis and bacterial death.
• Pharmacodynamics: It exhibits high stability toward bacterial beta-lactamases (both penicillinases and cephalosporinases). It is effective against many organisms that are resistant to other cephalosporins or penicillins.
• Pharmacokinetics: It is characterized by an unusually long elimination half-life (about 8 hours in healthy adults), which allows for once-daily dosing. It is approximately 85% to 95% protein-bound. It penetrates well into tissues and body fluids, including cerebrospinal fluid (CSF) when meninges are inflamed. It is excreted via both urine and bile.

Side Effects:

• Common: Diarrhea, nausea, rash, and eosinophilia.
• Others: Pain/induration at the injection site, transient increase in liver enzymes, and biliary sludge (pseudolithiasis).

Drug Interaction:

• Calcium-containing products: Potential for fatal precipitation in lungs and kidneys, especially in neonates.
• Warfarin: May increase the anticoagulant effect (monitoring INR is recommended).
• Probenecid: Unlike other cephalosporins, probenecid does not significantly affect the excretion of ceftriaxone.

Pregnancy & Lactation:

• Pregnancy: Generally considered safe (Category B), but use only if clearly indicated.
• Lactation: Excreted in low concentrations in breast milk. Use with caution.

Over Dosage:

No specific antidote. Management is symptomatic. It is not significantly removed by hemodialysis.

Therapeutic Class:

Third-generation Cephalosporin; Beta-lactam Antibiotic.

Storage Conditions:

Store vials below 25°C or 30°C, protected from light. Reconstituted solutions should be used immediately.