Pesquisas Científicas - Componentes Gold Spell Lisos:

In which cases is EXTENCILLINE used?

They result from the antibacterial activity and pharmacokinetic characteristics of benzathine benzylpenicillin. They take into account both the clinical studies that gave rise to this drug and its place in the range of antibacterial products currently available.

- They are limited to infections due to germs defined as sensitive and include:

  • prophylaxis of relapses of rheumatic fever,
  • treatment of syphilis and yaws.

- Official recommendations concerning the appropriate use of antibacterials should be taken into account.

Pathologies for which this drug may be prescribed
Prophylaxis of relapses of rheumatic fever Syphilis or yaws
How to administer and administer the drug EXTENCILLINE
To be injected by deep IM only. Do not inject IV.
- Prophylaxis of relapses of rheumatic fever:
1 IM injection every 15 days from:
. 2.4 MIU in adults;
. 600000 IU at 1.2 MIU in children, depending on age.
- Cure of treponematoses:
1 IM injection every 8 days of 2.4 MUI.
Composition of the drug EXTENCILLINE
Active ingredient Powder for suspension for injection (IM)
Benzathine benzylpenicillin 1.2 MUI *
* per unit dose
Active ingredients: Benzathine benzylpenicillin
Excipients with known effects? : Presence of: Sodium
Other excipients: Carmellose (E466) sodium, Sodium citrate (E331) anhydrous, Povidone (E1201),
Effects on ability to drive and use machines
Not applicable.

Contraindications: when not to use this medicine?

Allergy Penicillins Allergy Cephalosporins Route IV
CONTRAINDICATED:
Known allergy to the antibiotics of the beta-lactam family (penicillins and cephalosporins): take into account the risk of cross-reactivity with antibiotics in the cephalosporin group.
Do not inject IV.
NOT RECOMMENDED :
Association advised against: methotrexate.
Warning and precautions for use
Renal insufficiency Low sodium diet Deodized diet Breastfeeding

WARNINGS :
- The occurrence of any allergic manifestation requires the cessation of treatment and the establishment of appropriate treatment.
- Severe and sometimes fatal hypersensitivity reactions (anaphylaxis) have been observed exceptionally.
The administration of penicillin therefore requires an examination for discovery. Given a history of allergy typical of these products, the contraindication is formal.
- Allergy to penicillins is crossed with cephalosporin allergy in 5 to 10% of cases. This leads to proscribing penicillins when the subject is a known allergic to cephalosporins.

PRECAUTIONS FOR EMPLOYMENT:

- In case of renal insufficiency, adjust the dosage according to the clearance of creatinine.
- Take into account the sodium content.
- Breast-feeding: The passage of benzathine benzylpenicillin in breast milk is low and the amounts ingested are much lower than the therapeutic doses. As a result, breastfeeding is possible when taking this antibiotic. However, discontinue breastfeeding (or medication) if children develop diarrhea, candidiasis, or rash.
Mechanism of action: how does it work?

ANTIBIOTICS OF THE GROUP OF PENICILLINS.

(J: anti-infectious).
Benzathine benzylpenicillin is an antibiotic of the beta-lactam family of the G-type penicillin group.
Injectable benzathine benzylpenicillin provides effective and very prolonged penicillinemia after single administration.

SPECTRUM OF ANTIBACTERIAL ACTIVITY:

The prevalence of acquired resistance may vary depending on geography and time for some species. It is therefore useful to have information on the prevalence of local resistance, especially for the treatment of severe infections. These data can only provide an orientation on the probabilities of the susceptibility of a bacterial strain to this antibiotic.
When the variability of the prevalence of resistance in France is known (> 10%) (extreme values) for a bacterial species, it is indicated below:
SENSITIVE SPECIES:
- Gram-positive aerobes:
Streptococcus.
- Other:
Treponema.
Interactions: do not take this medicine with ...

ASSOCIATION DISCOUNTED:

Methotrexate: increased effects and haematological toxicity of methotrexate by inhibition of renal tubular secretion by penicillins.

SPECIAL PROBLEMS OF INR IMBALANCE:

Many cases of increased activity of oral anticoagulants have been reported in patients receiving antibiotics. The marked infectious or inflammatory context, the age and the general state of the patient appear as risk factors. In these circumstances, it seems difficult to distinguish between the infectious pathology and its treatment in the occurrence of the imbalance of the INR. However, some classes of antibiotics are more involved, including fluoroquinolones, macrolides, cyclins, cotrimoxazole and some cephalosporins.
incompatibility
Not applicable.

How to react in case of overdose?
Not applicable.

EXTENCILLINE: Pregnancy, lactation and fertility

Pregnancy :
Studies in animals have not shown any teratogenic effect. In the absence of teratogenic effect in animals, a malformative effect in the human species is not expected. Indeed, to date, the substances responsible for malformations in the human species have proved teratogenic in animals in well conducted studies on two species.

In clinical studies, the analysis of a high number of exposed pregnancies apparently did not reveal any particular malformative or fetotoxic effect of benzathine benzylpenicillin. However, only epidemiological studies would verify the absence of risk.

As a result, benzathine benzylpenicillin may be prescribed during pregnancy, if necessary.
Breastfeeding:

The passage of benzathine benzylpenicillin in breast milk is low and the amounts ingested are well below therapeutic doses. As a result, breastfeeding is possible when taking this antibiotic.
However, discontinue breastfeeding (or medication) if children develop diarrhea, candidiasis, or rash.

Possible side effects of the drug EXTENCILLINE

Urticaria Eosinophilia Quincke's edema Breathing discomfort Anaphylactic shock Maculopapular rash Nausea Vomiting See more - Allergic manifestations, including urticaria, eosinophilia, angioedema, shortness of breath; exceptionally, anaphylactic shock.
- Maculopapular rashes of allergic origin or not.
- Digestive disorders: nausea, vomiting, diarrhea, candidiasis.
- Other manifestations of immunoallergic origin have been reported, more rarely: moderate and transient increase in serum transaminases, anemia, leukopenia, reversible thrombocytopenia, acute interstitial nephritis.
- Some cases of pseudomembranous enterocolitis after administration have been described.
- The administration of high doses of beta-lactams, especially in patients with renal insufficiency, may lead to encephalopathies (disorders of consciousness, abnormal movements, seizures).
Other information
Pharmaceutical form: Powder for suspension for injection (IM)
Route of administration: Im
ATC Code: J01CE08
Pharmacotherapeutic group: Benzathine benzylpenicillin
Prescription and dispensing conditions: Medicinal product withdrawn from the market on 14/02/2014
Specialty Identification Code (CIS): 64291789
Laboratory licensee AMM: Sanofi-aventis France (27/04/1960)
Laboratory operator: Sanofi-aventis France
This medicine does not belong to any generic group.

Sources:

Summary of Product Characteristics (RCP) of French and European Marketing Authorizations (MAs)
Drug interaction booklet of the National Agency for the Safety of Medicines and Health Products (ANSM)

Generic Directory of ANSM

Reference documents from the French High Authority for Health (HAS): transparency sheets, good use sheets, SAM documents (Drug Decision Support System)
Prices and reimbursements of the Economic Committee for Health Products (CEPS)
Information from laboratories that hold a marketing authorization (CF supra in the "Other information" tab of this page)
Wholesale distributor information
Health Insurance (CNAMTS): Guide for Long-Term Assignments (ALD)
Technical Agency for Hospital Information (ATIH): CIM10 classification
World Health Organization (WHO): ATC Classification
European Pharmacopoeia: Standard Terms and EPhMRA Classification
Ministry of Health: doping substances

Tannic acid

Tannic acid is a specific form of tannin, a type of polyphenol. Its weak acidity (pKa around 6) is due to the numerous phenol groups in the structure. The chemical formula for commercial tannic acid is often given as C76H52O46, which corresponds with decagalloyl glucose, but in fact it is a mixture of polygalloyl glucoses or polygalloyl quinic acid esters with the number of galloyl moieties per molecule ranging from 2 up to 12 depending on the plant source used to extract the tannic acid. Commercial tannic acid is usually extracted from any of the following plant parts: Tara pods (Caesalpinia spinosa), gallnuts from Rhus semialata or Quercus infectoria or Sicilian Sumac leaves (Rhus coriaria).

According to the definitions provided in external references such as international pharmacopoeia, Food Chemicals Codex and FAO-WHO tannic acid monograph only tannins sourced from the above-mentioned plants can be considered as tannic acid. Sometimes extracts from chestnut or oak wood are also described as tannic acid but this is an incorrect use of the term. It is a yellow to light brown amorphous powder; 2850 grams dissolves in one litre of water (1.7 moles per liter).

While tannic acid is a specific type of tannin (plant polyphenol), the two terms are sometimes (incorrectly) used interchangeably. The long-standing misuse of the terms, and its inclusion in scholarly articles has compounded the confusion. This is particularly widespread in relation to green tea and black tea, both of which contain tannin but not tannic acid.

Tannic acid is not an appropriate standard for any type of tannin analysis because of its poorly defined composition.

Quercitannic and gallotannic acids

Quercitannic acid is one of the two forms of tannic acid found in oak bark and leaves. The other form is called gallotannic acid and is found in oak galls.

The quercitannic acid molecule is also present in quercitron, a yellow dye obtained from the bark of the Eastern black oak (Quercus velutina), a forest tree indigenous in North America. It is described as a yellowish-brown amorphous powder.

In 1838, Jöns Jacob Berzelius wrote that quercitannate is used to dissolve morphine.

In 1865 in the fifth volume of "A dictionary of chemistry", Henry Watts wrote :

It exhibits with ferric salts the same reactions as gallotannic acid. It differs however from the latter in not being convertible into gallic acid, and not yielding pyrogallic acid by dry distillation. It is precipitated by sulfuric acid in red flocks. (Stenhouse, Ann. Ch. Pharm. xlv. 16.)
According to Rochleder (ibid lxiii. 202), the tannic acid of black tea is the same as that of oak-bark.

In 1880, Etti gave for it the molecular formula C17H16O9. He described it as an unstable substance, having a tendency to give off water to form anhydrides (called phlobaphenes), one of which is called oak-red (C34H30O17). For him, it was not a glycoside.

In Allen's "Commercial Organic Analysis", published in 1912, the formula given was C19H16O10.

Other authors gave other molecular formulas like C28H26O15, while another formula found is C28H24O11.

According to Lowe, two forms of the principle exist – one soluble in water, of the formula C28H28O14, and the other scarcely soluble, C28H24O12. Both are changed by the loss of water into oak red, C28H22O11.

Quercitannic acid was for a time a standard used to assess the phenolic content in spices, given as quercitannic acid equivalent.

In an interesting historical note, the inventor Edward G. Acheson (Inventor of Carborundum) discovered that gallotannic acid greatly improved the plasticity of clay. In his report of this discovery in 1904 he noted that the only known historical reference to the use of organic material added to clay is the use of straw mixed with clay described in the Bible, Exodus 1:11 and that the Egyptians must have been aware of his (re-)discovery. He stated "This explains why the straw was used and why the children of Israel were successful in substituting stubble for straw, a course that would hardly be possible, were the fibre of the straw depended upon as a bond feasible for the clay, but quite reasonable where the extract of the plant was used."

Uses

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Tannins are a basic ingredient in the chemical staining of wood, and are already present in woods like oak, walnut, and mahogany. Tannic acid can be applied to woods low in tannin so chemical stains that require tannin content will react. The presence of tannins in the bark of redwood (Sequoia) is a strong natural defense against wildfire, decomposition and infestation by certain insects such as termites. It is found in the seeds, bark, cones, and heartwood.

Tannic acid is a common mordant used in the dyeing process for cellulose fibers such as cotton, often combined with alum and/or iron. The tannin mordant should be done first as metal mordants combine well with the fiber-tannin complex. However this use has lost considerable interest.

Similarly tannic acid can also be used as an aftertreatment to improve wash fastness properties of acid dyed polyamide. It is also an alternative for fluorcarbon aftertreatments to impart anti-staining properties to polyamide yarn or carpets. However, due to economic considerations currently the only widespread use as textile auxiliary is the use as an agent to improve chlorine fastness, i.e. resistance against dye bleaching due to cleaning with hypochlorite solutions in high-end polyamide 6,6-based carpets and swimwear. It is, however, used in relatively small quantities for the activation of upholstery flock; this serves as an anti-static treatment.

Tannic acid is used in the conservation of ferrous (iron based) metal objects to passivate and inhibit corrosion. Tannic acid reacts with the corrosion products to form a more stable compound, thus preventing further corrosion from taking place. After treatment the tannic acid residue is generally left on the object so that if moisture reaches the surface the tannic acid will be rehydrated and prevent or slow any corrosion. Tannic acid treatment for conservation is very effective and widely used but it does have a significant visual effect on the object, turning the corrosion products black and any exposed metal dark blue. It should also be used with care on objects with copper alloy components as the tannic acid can have a slight etching effect on these metals.

Tannic acid is also found in commercially available iron/steel corrosion treatments, such as Hammerite Kurust.

Use in food

Use of tannic acid in food applications is far more widespread[clarification needed] and significant amounts are used as process aids in beer clarification, aroma compound in soft drinks and juices. Equally important are applications in the wine industry, where it finds use as a natural clarifying agent, colour stabilizer and taste enhancer.

In many parts of the world, such uses are permitted. In the United States, tannic acid is generally recognized as safe by the Food and Drug Administration.

According to EU directive 89/107/EEC tannic acid cannot be considered as a food additive and consequently does not hold an E number. Under directive 89/107/EEC tannic acid can be referred to as a food ingredient. The E-number E181 is sometimes incorrectly used to refer to tannic acid; this in fact refers to the INS number assigned to tannic acid under the FAO-WHO Codex Alimentarius system.

Uses as a medication

In conjunction with magnesium and sometimes activated charcoal, tannic acid was once used as a treatment for many toxic substances, such as strychnine, mushroom, and ptomaine poisonings in the late 19th and early 20th centuries.

The introduction of tannic acid treatment of severe burn injuries in the 1920s significantly reduced mortality rates.

During World War I, tannic acid dressings were prescribed to treat "burns, whether caused by incendiary bombs, mustard gas, or lewisite. After the war this use was abandoned due to the development of more modern treatment regimens.

Tannic acid is still used in pharmaceutical applications to produce albumin tannate which is used as an antidiarrheal agent. Tannic acid is also used to produce tannate salts of certain antihistamine and antitussive products to impart increased stability or slow release properties to the active pharmaceutical ingredient. Further to this, tannic acid is the principle but perhaps minimally effective ingredient in antiallergen sprays.

Tannins have also been reported to exert many physiological effects, such as to accelerate blood clotting, reduce blood pressure, decrease the serum lipid level, produce liver necrosis, and modulate immunoresponses. This would explain common folklore such as that soaking feet in tannic acid (or strong tea) can treat or prevent blisters, foot odor and rough, dry feet.

Hazards

Tannic acid could cause potential health hazards such as damage to the eye, skin, respiratory tract, and gastrointestinal tract. It may cause irritation, redness, pain, blurred vision, and possible eye damage. When tannic acid is absorbed through the skin in harmful amounts, it may cause irritation, redness, and pain. Nausea, vomiting and diarrhoea are symptoms of tannic acid ingestion and prolonged exposure may cause liver damage. Upon inhalation, tannic acid may cause respiratory tract irritation.

Crocodilian coloration

Skin color in Crocodilia (crocodiles and alligators) is very dependent on water quality. Algae-laden waters produce greener skin, while tannic acid in the water from decay of leaves from overhanging trees (which produces some types of blackwater rivers) often produce darker skin in these animals.