Aminoglycosides: mankhwala (mndandanda dzina, gulu, ntchito malangizo)

Maonekedwe pa msika pharmacological wa mankhwala atsopano ndi osiyanasiyana zotsatira, monga fluoroquinolones, cephalosporins zachititsa chakuti madokotala anayamba mankhwala aminoglycosides kawirikawiri (mankhwala). A mndandanda wa mankhwala mgulu lino ndi yaikulu kwambiri ndipo zikuphatikizapo mankhwala odziwika bwino monga "Penicillin", "Gentamycin", "Amikacin." Mpaka lero, odwala mwakayakaya ndi madipatimenti opaleshoni ya mankhwala wotchuka kwambiri ndi ndendende aminoglycoside zino.

Kufotokoza mwa chidule za gulu

Aminoglycosides - mankhwala (mankhwala mndandanda zafotokozedwa pansipa), ena kuposa chiyambi theka-kupanga kapena zachilengedwe. Izi gulu la mankhwala ali mofulumira ndi amphamvu bactericidal tingati pa thupi.

Mankhwala achilendo osiyanasiyana zochita. ntchito yawo antimicrobial adzasonyeza mabakiteriya galamu alibe, koma kwambiri yafupika polimbana ndi tizilombo galamu HIV. Ndipo aminoglycosides kwathunthu osamveka ndi anaerobes.

Gulu la mankhwala imatulutsa kwambiri bactericidal tingati mphamvu yake irreversibly ziletsa mapuloteni kaphatikizidwe ku tizilombo atengeke pa mlingo ribosome. Mankhwala yogwira pa onse kuswana ndi maselo m'chigawo quiescent. mmene ntchito maantibayotiki amadalira pa maganizo awo mu seramu magazi a wodwalayo.

aminoglycoside ntchito lero zokwanira yochepa. Ichi ndi chifukwa cha kawopsedwe mkulu wa mankhwala awa. Nthawi zambiri amadwala mankhwala impso ndi ziwalo kumva.

Chinthu chofunika kwambiri pa zida izi ndi kulephera kwa malowedwe awo ku maselo amoyo. Choncho, aminoglycosides kwathunthu wopanda mphamvu polimbana ndi mabakiteriya okhudza maselo ambiri.

Ubwino ndi Kuipa

mankhwala awa ankagwiritsa ntchito monga tanenera pamwambapa, kuchita opaleshoni. Ndipo palibe mwangozi. Madokotala kutsindika ubwino ambiri wogwidwa ndi aminoglycosides.

The mankhwala pa thupi zosiyana mphindi wotsimikiza:

• mkulu antibacterial ntchito;
• pakalibe chowawa anachita (kwa makonzedwe jekeseni);
• osowa yatsoka a chifuwa;
• luso kuwononga mabakiteriya kuswana;
• kumatheka zotsatira achire limodzi ndi mankhwala beta-lactam;
• ntchito yapamwamba polimbana ndi matenda oopsa.

Komabe, pamodzi ndi ubwino tafotokozazi, gulu la medicaments ndipo ali kuipa.

Zakunja ndi aminoglycosides:

• ntchito otsika mankhwala, pakalibe mpweya kapena mu sing'anga acidic;
• osauka malowedwe a thunthu kwakukulu mu thupi madzimadzi (ya ndulu, msana madzimadzi, sputum);
• maonekedwe a kuchuluka kwa mbali-zotsatira.

gulu la mankhwala

Pali classifications angapo.

Mwachitsanzo, anapatsidwa ndondomeko ya mawu oyamba mu ntchito zachipatala a aminoglycosides, ndi m'badwo zotsatirazi:

1. Mankhwala oyamba ntchito kulimbana ndi matenda opatsirana anali "Streptomycin", "monomitsin", "neomycin", "Kanamycin", "Paromomycin."
2. Kuti m'badwo wachiwiri ndi aminoglycosides atsopano (mankhwala). List mankhwala "gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. gulu Izi zikuphatikizapo mankhwala theka-kupanga monga "Amikacin", "Izepamitsin".

Pa sipekitiramu wa kanthu ndi zikamera kukaniza m'kagulu aminoglycosides yosiyaniranapo.

Generation mankhwala zotsatirazi:

1. 1 gulu zikuphatikizapo mankhwala "Streptomycin", "Kanamycin", "monomitsin", "neomycin". Mankhwalawa n'zotheka kulimbana ndi majeremusi TB, ndi ena mabakiteriya atypical. Komabe, ndi zosiyanasiyana mabakiteriya galamu alibe ndi staphylococci, iwo alibe mphamvu.

2. Wachiwiri m'badwo aminoglycoside - mankhwalawa "gentamicin." Iwo kusiyana ndi ntchito yaikulu antibacterial.

3. Kukweza mankhwala. Iwo ndi mkulu ntchito antibacterial. Ntchito ndi klebisielly, enterobacteria, Pseudomonas aeruginosa ndi wachitatu m'badwo aminoglycosides (mankhwala). Mndandanda wa mankhwala chiri motere:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. mankhwala "Izepamitsin" amatanthauza gulu chachinayi. Iwo kusiyana ndi luso bwino kuthana ndi tsitobakterom, aeromonasom, nokardiyami.

Mu yochizira matenda, anayamba gulu lina. Bukuli lili ntchito mankhwala malingana zipatala matenda, chikhalidwe cha matenda, komanso kugwiritsa ntchito njira.

Chotero gulu la aminoglycosides motere:

1. Mankhwala zokhudza zonse kukhudzana kutumikiridwa parenterally (jekeseni). Zochizira matenda suppurative bakiteriya kunachitika aakulu chikwiyire ndi tizilombo osadziwika anaerobic, mankhwala amenewa, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Chithandizo cha monoinfections Wowopsa, zomwe ndi zochokera toyambitsa ziyenera bwino pamene kuwonjezekeredwa mu mankhwala "Streptomycin" kukonzekera "Gentomitsin". Pamene mycobacteriosis kwambiri thandizo mankhwala "Amikacin," "Streptomycin", "Kanamycin".
2. Mankhwala ntchito internally okha zizindikiro zenizeni. Awa: "Paromitsin", "neomycin", "monomitsin".
3. Mankhwala ntchito apakhungu. Iwo ntchito zochizira matenda purulent bakiteriya mu otorhinolaryngology ndi pochiza matenda a maso. Pakuti kukhudzana wamba mankhwala anayamba "gentamicin," "framycetin", "neomycin", "Tobramycin".

zikuonetsa kuti

Ntchito aminoglycosides nkokoma kuwononga zosiyanasiyana aerobic tizilombo toyambitsa matenda galamu-negative. Medicaments akhoza kugwiritsidwa ntchito ngati monotherapy. Nthawi zambiri amaphatikizidwa ndi beta-lactams.

Aminoglycosides akusonyeza zochizira:

• matenda nosocomial ya kutanthauzira osiyanasiyana;
• purulent postoperative zosokonezeka;
• matenda kwapakati pa-m'mimba;
• sepsis;
• infective endocarditis ;
• pyelonephritis zikuchitika m'njira chaukali;
• amayaka kachilombo;
• bakiteriya purulent meninjaitisi;
• chifuwa chachikulu;
• matenda oopsa opatsirana (mliri, brucellosis, tularemia);
• septic nyamakazi chikwiyire mabakiteriya galamu alibe;
• mkodzo thirakiti matenda;
• matenda ophthalmic: blepharitis, bakiteriya keratitis, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• matenda ENT: otitis externa, rhinopharyngitis, rhinitis, sinusitis;
• matenda protozoal.

zotsatira zoyipazi

Mwatsoka, pa mankhwala a gulu la mankhwala wodwala kumva lonse mndandanda wa mavuto. The drawback waukulu wa mankhwala - izo kwambiri poizoni. N'chifukwa chake chokha dokotala ayenera mankhwala a aminoglycosides mtima.

Zotsatira zoyipa kumachitika:

1. Ototoxicity. Odwala amadandaula kumva imfa, phokoso akulira. Nthawi zambiri amasonyeza kutsekeka kwa makutu. Ambiri mwa zochita izi zichitike achikulire, anthu poyamba akudwala kumva kuwonongeka. Zimenezi zimachitika odwala yaitali mankhwala kapena mlingo waukulu.
2. Nephrotoxicity. Wodwalayo amaoneka ludzu, zimasiyanasiyana kuchuluka kwa mkodzo (mungathe onse achuluke kuchepa), kuchulukitsidwa creatinine mlingo mu magazi, yafupika glomerular kusefera. zizindikiro chotero ankaikira anthu odwala matenda a ntchito impso.
3. Neuromuscular anatseka misewu. Nthawi zina m'nyengo mankhwala akulephera kupuma. Nthawi zina pali ziwalo za minofu kupuma. Childs, maganizo ndi khalidwe odwala matenda a ubongo kapena kulemala impso ntchito.
4. matenda Vestibular. Amasonyeza kuphwanya kuyenda, chizungulire. Nthawi zambiri, zotsatirapo zimenezi zimachitika pamene "Streptomycin" Kusankhidwa kwa mankhwala kwa wodwalayo.
5. matenda a ubongo. Zingaoneke paresthesia, encephalopathy. mankhwala zina limodzi ndi chotupa cha mitsempha chamawonedwe.

Aminoglycosides kawirikawiri chifukwa thupi lawo siligwirizana monga zotupa pa khungu.

contraindications

Anafotokoza mankhwala sangachite ntchito. aminoglycosides zambiri contraindicated (maina a omwe apatsidwa pamwamba) mu pathologies ngati kapena mikhalidwe:

• munthu hypersensitivity;
• kuphwanya ntchito aimpso excretory;
• kumva matenda;
• chitukuko cha zochita neutropenic chaukali;
• matenda vestibular;
• myasthenia gravis, botulism, Parkinsonism;
• kupuma maganizo, stupor.

Komanso, sayenera kuzigwiritsa mankhwala ngati wodwalayo anali ndi mbiri zotani zoipa mankhwala aliwonse gulu limeneli.

Taganizirani aminoglycosides otchuka.

"Amikacin"

mankhwala amakhala ndi kutchulidwa bacteriostatic, bactericidal ndi odana ndi mmene thupi la munthu. Iye amasonyeza ntchito yapamwamba ndi mabakiteriya ambiri galamu HIV ndi galamu-negative. Choncho umboni mankhwala "Amikacin" malangizo Buku. Majekeseni ogwira mankhwalawa staphylococcus, streptococcus, pneumococcus, nsomba, Escherichia coli, Mycobacterium TB.

Mankhwalawa ndi wokhoza odzipereka mwa mundawo m'mimba. Motelo kutumikiridwa m'nsinga kapena intramuscularly. Ndende apamwamba mankhwala yogwira zimawonedwa ku seramu pambuyo 1 hr. Zabwino achire zotsatira kumatenga maola 10-12. Chifukwa chuma ichi cha jakisoni zimagwiridwa kawiri pa tsiku.

Pamene akuonetsa ntchito mankhwala "Amikacin" malangizo ntchito? Majekeseni asonyezedwa woika ndi matenda otsatirawa:

• chibayo, chifuwa, m'mapapo abscess;
• matenda a peritoneum (peritonitis, kapamba, cholecystitis);
• matenda thirakiti mkodzo (cystitis, urethritis, pyelonephritis);
• matenda khungu (zotupa anam'peza, zilonda zamoto, zilonda kuthamanga, mabala kachilombo) ;
• osteomyelitis;
• meninjaitisi, sepsis;
• TB ndi matenda.

Nthawi zambiri, chida ichi ntchito mavuto a chikwiyire ndi opaleshoni.

Anandilola ntchito mankhwala kuchita Dokotala. Zimenezi zikutsimikiziridwa mankhwala "Amikacin" malangizo Buku. Ana kuchokera m'masiku oyambirira a moyo, mankhwala angathe kuperekedwa.

Mlingo ofunitsitsa basi ndi dokotala malingana ndi msinkhu wa wodwala ndi thupi lake.

Malangizo amapereka malangizo otsatirawa:

1. 1 makilogalamu kulemera mtima (onse akuluakulu ndi mwana) angagwe pa 5 mg wa mankhwala. Mu chiwembu izi ndaika mobwerezabwereza jekeseni maola 8.
2. Ngati pa 1 makilogalamu thupi, 7.5 mg wa medicament atengedwa, ndi imeneyi pakati jekeseni anali maola 12.
3. Zindikirani momwe akuonetsa neonatal mankhwala "Amikacin" malangizo Buku. Ana wongobadwa, mlingo ndi kuchita masamu motere: 1 makilogalamu - 7.5 mg. Pankhaniyi imeneyi pakati jekeseni - maola 18.
4. Nthawi mankhwala kungakhale masiku 7 (mu / athandizira) kapena masiku 7-10 (ndi / TH jekeseni).

"Netilmicin"

The mankhwala zotsatira zake antimicrobial ofanana "amikacin". Choncho pali milandu kumene "Netilmicin" anapereka mkulu efficacy ndi anthu yaying'ono-zamoyo imene mankhwala pamwambapa kanthu.

Mankhwala ali ndi mwayi kwambiri poyerekeza ndi aminoglycosides ena. Monga mmene mankhwala "Netilmicin" malangizo ntchito, mankhwala ali nephrotoxicity m'munsi ndi ototoksichnostyu. medicament The cholinga pongofuna ntchito parenteral.

"Netilmicin" malangizo ntchito akulimbikitsidwa kuti asankhe:

• ndi septicemia, bacteremia,
• zochizira matenda ngoziyi chikwiyire ndi tizilombo ting'onoting'ono galamu alibe;
• matenda a dongosolo kupuma, ndi urogenital thirakiti, khungu, Mitsemphayi, osteomyelitis;
• Neonatal staphylococcal vuto la matenda aakulu (sepsis kapena chibayo);
• pa chilonda ndi matenda preoperative intraperitoneal;
• mu nkhani ya chiopsezo cha matenda oyamba postoperative odwala opaleshoni;
• matenda opatsirana a thirakiti m'mimba.

Mlingo analimbikitsa anatsimikiza yekha ndi dokotala. Izo zikhoza kukhala pa 4 ndi 7.5 mg. Malinga mlingo, wodwalayo ndi zaka wake masana tikulimbikitsidwa 1-2 jekeseni.

"Penicillin"

mankhwala Ichi ndi chimodzi mwa zinthu zofunika kwambiri gulu la mankhwala. Ndi kugwira ntchito ndi zosiyanasiyana tizilombo.

Tcheru "Penicillin":

• streptococci;
• gonococci;
• meningococcus;
• pneumococci;
• diphtheria, tizilombo ta matenda, kafumbata, gasi chilonda;
• mitundu ina ya staphylococcus, Proteus.

Madokotala taonera Impact yothandiza kwambiri pa thupi ndi athandizira mu mnofu. Mu jakisoni oterowo Mphindi 30-60 pazipita anati magazi ndende mankhwala "Penicillin".

Aminoglycosides Penicillin amaikidwa milandu zotsatirazi:

1. deta mankhwala mkulu kufunika mankhwalawa sepsis. Iwo analimbikitsa zochizira, meningococcal matenda gonococcal, pneumococcal.
2. Mankhwala "Penicillin" akapatsidwa odwala likufa popanga munthu opaleshoni pofuna kupewa mavuto.
3. Chida amathandiza kulimbana purulent meninjaitisi, ubongo abscess, chinzonono, sycosis, chindoko. Ndi bwino kuti zilonda zamoto ndi mabala.
4. Therapy "Penicillin" mankhwala Kwalamulidwa kwa odwala matenda kutupa kwa khutu, diso.
5. Ntchito mankhwala zochizira mogwirizana ndi lobar chibayo, cholangitis, cholecystitis, septic endocarditis.
6. Anthu akuvutika misempha, mankhwala amene wapatsidwa kwa mankhwala ndi kupewa.
7. Mankhwalawa amagwiritsidwa ntchito pa ana ndi makanda, amene anapezeka ndi sepsis umbilical, kapena septic pyosepticemia matenda oopsa.
8. Mankhwala m'gulu mankhwala a matenda otsatirawa: otitis, fever, diphtheria, purulent pleuritis.

Ndi utsogoleli mu mnofu wa medicament yogwira pophika mofulumira odzipereka mu m'magazi. Koma pambuyo maola 3-4 ya mankhwala mu thupi salinso anati. N'chifukwa chake, kuonetsetsa ndende zofunika, Ndi bwino kubwereza jekeseni mawola 3-4.

Mankhwala "gentamicin"

Izo zinabala mu mawonekedwe a mafuta, njira jekeseni, ndi miyala. Mankhwala ali ndi katundu bactericidal. Imakhala mavuto aakulu ambiri galamu alibe mabakiteriya, Proteus, Campylobacter, Escherichia, Staphylococcus, nsomba, Klebsiella.

Kukonzekera "Gentamycin" (mapiritsi kapena njira) kulowa m'thupi wawononga wothandizila opatsirana pa mlingo ma. Ngati aminoglycoside chilichonse, lili ndi kuphwanya mapuloteni kaphatikizidwe tizilombo toyambitsa matenda. Chifukwa cha tizilombo ngati kutaya luso kubereka zina ndipo sadzachepetsedwa anagawira thupi lonse.

Mankhwala kwa matenda opatsirana zokhudza machitidwe osiyanasiyana ndi ziwalo:

• meninjaitisi;
• peritonitis;
• prostatitis;
• chinzonono;
• osteomyelitis;
• cystitis;
• pyelonephritis;
• endometritis;
• empyema;
• matenda, chibayo;

Mankhwala "gentamicin" ankafuna okwanira mu mankhwala. Timatha odwala kuchiritsa kwa matenda aakulu a timapepala kupuma ndi mkodzo. Chida ichi bwino mu njira opatsirana, kuphimba peritoneum, fupa minofu zofewa kapena khungu.

Aminoglycosides sizili kaamba kudziletsa mankhwala. Musaiwale, kusankha kufunika mankhwala angakhoze kokha oyenerera dokotala. Choncho, musalankhule medicate. Ndipatse thanzi lanu akatswiri!