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 详细处方信息以本药内容附件PDF文件（201241020263037.pdf）的“原文Priscribing Information”为准
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部分中文哌拉西林处方资料（仅供参考）

哌拉西林 - 别名
氧哌嗪青霉素、PiPRAcil、PiPRL、Tazocin、Piperacillin

哌拉西林 - 分类
抗微生物、抗生素、青霉素类

哌拉西林 - 抗菌谱
敏感菌：铜绿假单孢菌、大肠埃希菌、变形杆菌、肺炎克雷伯杆菌、淋球菌、不产β－内酰胺酶的沙门菌属、志贺菌属、脆弱类杆菌、肠球菌
不敏感菌：产气杆菌、枸橼酸杆菌、普鲁威登菌和不动杆菌、沙雷菌属、产酶流感嗜血杆菌

哌拉西林 - 性状
本品为白色结晶性粉末；无臭，略有引湿性。本品在甲醇中易溶，以无水乙醇或丙酮中溶解，在水中极微溶解。比旋度 取本品，精密称定，加无水乙醇溶解并稀释成每1ml中含10mg的溶液，依法测定，比旋度为+160度至+178度。

哌拉西林 - 适应症
1、敏感菌所致感染，如败血症、尿路感染、呼吸道感染、胆道感染、腹腔感染、盆腔感染及皮肤、软组织感染等。
2、与氨基糖甙类药连用于粒细胞减少症免疫缺陷患者的感染

哌拉西林 - 用法用量
中度感染者：4g/次，2次/天，静脉注射
重度感染者：3～4g/次，4次/天，静脉注射

哌拉西林 - 儿童、孕妇、哺乳妇女
儿童：50～200mg/kg/次，2～4次/天
孕妇：未发现本药对动物胚胎有害，但请遵医嘱
哺乳妇女：药物可经过乳汁分泌，使用遵医嘱

哌拉西林 - 禁忌
青霉素过敏或对本药过敏

哌拉西林 - 慎用
1、有过敏史
2、有出血史
3、溃疡性结肠炎、克罗恩病或假膜性肠炎
4、体弱者

哌拉西林 - 不良反应
1.能抑制血小板聚集，大剂量或长期应用易引起凝血功能障碍导致出血。2.少数患者在用药过程中出现皮疹、皮肤瘙痒或发热症状，并可引起白细胞减少、血清转氨酶升高等。3.静脉注射速度过快可致恶心、胸部不适、咳嗽、发热、口腔异味和眼结膜出血等。

哌拉西林 - 相互作用
1、头孢西丁：可拮抗本药对铜绿假单孢菌、沙雷菌属、变形杆菌属、肠杆菌属的抗菌作用
2、丙磺舒：减少本药在肾小管的排泄，升高本药血药浓度
3、阿米卡星、庆大霉素、妥布霉素、等氨基糖甙类药：对铜绿假单孢菌、沙雷菌、克雷伯菌、吲哚阳性变形杆菌、普鲁威登菌、其他肠杆菌、葡萄球菌属的敏感菌株有协同杀菌作用
4、某些头孢菌素：对大肠杆菌、铜绿假单孢菌、克雷伯菌、变形杆菌属的某些敏感菌株有协同抗菌作用
5、非甾体类止痛药（如阿司匹林、二氟尼柳）、其它水杨酸制剂：对血小板功能抑制作用可累加，增加出血危险
6、抗血凝药（肝素、香荚兰醛、茚满二酮等）；可增加凝血机制障碍和出血的危险
7、溶栓药：可发生严重出血
8、庆大霉素：对粪肠球菌无协同作用。

Pipracil - General Information:
Semisynthetic, broad-spectrum, ampicillin derived ureidopenicillin antibiotic proposed for pseudomonas infections. It is also used in combination with other antibiotics.

Pharmacology:
Pipracil is a penicillin beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually gram-positive, organisms. The name "penicillin" can either refer to several variants of penicillin available, or to the group of antibiotics derived from the penicillins. Pipracil has in vitro activity against gram-positive and gram-negative aerobic and anaerobic bacteria. The bactericidal activity of Pipracil results from the inhibition of cell wall synthesis and is mediated through Pipracil binding to penicillin binding proteins (PBPs). Pipracil is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases.

Pipracil Interactions
Aminoglycosides

The mixing of piperacillin with an aminoglycoside in vitro can result in substantial inactivation of the aminoglycoside.

Vecuronium
When used in the perioperative period, piperacillin has been implicated in the prolongation of the neuromuscular blockade of vecuronium. Caution is indicated when piperacillin is used perioperatively. In one controlled clinical study, the ureidopenicillins, including piperacillin, were reported to prolong the action of vecuronium. Due to their similar mechanism of action, it is expected that the neuromuscular blockade produced by any of the non-depolarizing muscle relaxants could be prolonged in the presence of piperacillin.

Probenecid
The oral combination of probenecid before intramuscular injection of PIPRACIL produces an increase in piperacillin peak serum level of about 30%.

Anticoagulants
Coagulation parameters should be tested more frequently and monitored regularly during simultaneous administration of high doses of heparin, oral anticoagulants, or other drugs that may affect the blood coagulation system or the thrombocyte function.

Methotrexate
Piperacillin sodium may reduce the excretion of methotrexate. Therefore, serum levels of methotrexate should be monitored in patients to avoid drug toxicity.

Drug/Laboratory Test Interactions
As with other penicillins, the administration of PIPRACIL may result in a false-positive reaction for glucose in the urine using a copper-reduction method. It is recommended that glucose tests based on enzymatic glucose oxidase reactions be used.

There have been reports of positive test results using the Bio-Rad Laboratories Platelia Aspergillus EIA test in patients receiving piperacillin/tazobactam injection who were subsequently found to be free of Aspergillus infection. Cross-reactions with non-Aspergillus polysaccharides and polyfuranoses with the Bio-Rad Laboratories Platelia Aspergillus EIA test have been reported.

Therefore, positive test results in patients receiving piperacillin should be interpreted cautiously and confirmed by other diagnostic methods.

Pipracil Contraindications
PIPRACIL is contraindicated in patients with a history of allergic reactions to any of the betalactams, including penicillins and/or cephalosporins.

Additional information about Pipracil
Pipracil Indication: For the treatment of polymicrobial infections.
Mechanism Of Action: By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, Pipracil inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that Pipracil interferes with an autolysin inhibitor.
Drug Interactions: Methotrexate The penicillin increases the effect and toxicity of methotrexate
Anisindione The IV penicillin increases the anticoagulant effect
Dicumarol The IV penicillin increases the anticoagulant effect
Acenocoumarol The IV penicillin increases the anticoagulant effect
Warfarin The IV penicillin increases the anticoagulant effect
Atracurium The agent increases the effect of the muscle relaxant
Gallamine Triethiodide The agent increases the effect of the muscle relaxant
Metocurine The agent increases the effect of the muscle relaxant
Mivacurium The agent increases the effect of the muscle relaxant
Pancuronium The agent increases the effect of the muscle relaxant
Pipecuronium The agent increases the effect of the muscle relaxant
Rocuronium The agent increases the effect of the muscle relaxant
Succinylcholine The agent increases the effect of the muscle relaxant
Tubocurarine The agent increases the effect of the muscle relaxant
Vecuronium The agent increases the effect of the muscle relaxant
Tetracycline Possible antagonism of action
Rolitetracycline Possible antagonism of action
Oxytetracycline Possible antagonism of action
Minocycline Possible antagonism of action
Methacycline Possible antagonism of action
Doxacurium The agent increases the effect of the muscle relaxant
Demeclocycline Possible antagonism of action
Doxycycline Possible antagonism of action
Ethinyl Estradiol This anti-infectious agent could decrease the effect of the oral contraceptive
Mestranol This anti-infectious agent could decrease the effect of the oral contraceptive
Food Interactions: Not Available
Generic Name: Piperacillin
Synonyms: Piperacillin Anhydrous
Drug Category: Anti-Bacterial Agents; Penicillins
Drug Type: Small Molecule; Approved
Other Brand Names containing Piperacillin: Pipracil;
Absorption: Not absorbed following oral administration.
Toxicity (Overdose): Not Available
Protein Binding: Not Available
Biotransformation: Largely not metabolized.
Half Life: 36-72 minutes
Dosage Forms of Pipracil: Powder, for solution Intravenous
Powder, for solution Intramuscular
Chemical IUPAC Name: (2S,5R,6R)-6-[[(2R)-2-[(4-ethyl-2,3-dioxopiperazine-1-carbonyl)amino]-2-phenylacetyl]amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
Chemical Formula: C23H27N5O7S
Organisms Affected: Enteric bacteria and other eubacteria

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 详细处方信息以本药内容附件PDF文件（201241020263037.pdf）的“原文Priscribing Information”为准
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