"Amphotericin B": malangizo, limagwirira ntchito mwakhama. Umboni za mankhwala

Fungal khungu kubweretsa mavuto osiyanasiyana m'thupi la wodwalayo. Komanso, monga matenda opatsirana. Choncho, pamene zizindikiro woyamba wa bowa ndi ayenera amatchula katswiri. Atayendetsa atamuyezanso ndi mayeso ena dokotala ayenera kusankha mankhwala wodwala ogwira.

Nthawi zambiri, zochizira matenda a mafangasi ntchito zosiyanasiyana mafuta ndi mapilitsi. Komabe, madokotala ambiri amanena kuti chikhalidwe chotere pathological bwino ankachitira jekeseni mtsempha. Pambuyo jekeseni wa mankhwala yomweyo anayamba kuchita tizilombo kuti kuonetsa tilinazo makamaka kwa izo.

Kwambiri kothandiza ndiponso ogwira njira kunyamula mankhwala kuthetsa matenda a mafangasi "Amphotericin B". Malangizo, mitundu ya kumasuka ndi umboni za mankhwala omwe anapereka m'munsimu.

Fomu, zikuchokera, kufotokoza ndi ma CD a mankhwala

Tatenga ankaona mankhwala akhoza kukhala m'njira zotsatirazi:

• Lyophilisate "Amphotericin B". Reviews onena kuti mtundu uwu wa mankhwala ndi porous hygroscopic unyinji wa mtundu wachikasu popanda fungo kutchulidwa. Bukuli lakonzedwa kuti ntchito yokonza njira kulowetsedwa. The yogwira zikuluzikulu za mankhwala ndi amphotericin B. The zigawo zikuluzikulu ntchito ngati mankhwala othandiza monga monobasic mankwala ndi sodium ndi asidi deoxycholic. Mu kugulitsa medicament ndi umaperekedwa mu vayozi wa 10 ml, ndi makatoni pepala.

• Mafuta "Amphotericin B". Ntchito njira imeneyi akuonetsedwa ngati mankhwala zapadera mu mankhwala osakaniza. Antifungal mafuta ntchito kunja kokha. Ndi chikasu ndipo lili ndi yogwira pophika dzina chomwecho. Koma zigawo zina kuti ntchito ngati mafuta mchere, petrolatum, ndi polysorbate 80. Buy mankhwala akhoza kukhala mu bokosi la 30 kapena 15 g

Limagwirira cha zochita za protivogribkvogo mankhwala

ndi mankhwala "Amphotericin B" n'chiyani? Malangizo ntchito (mapiritsi yemweyo yogwira pophika anapeza mabvuto ndithu) akusimba kuti ndi macrocyclic polyene mankhwala ntchito antifungal. Chifukwa amapangidwa ndi Streptomyces nodosus waperekedwa ndipo fungistatic ndi kanthu fungicidal (malingana ndi ndende ya mankhwala mu madzi kwachilengedwenso ndi chiwopsezo).

Pambuyo mankhwala kulowa magazi mtsinje izo chimamanga kuti sterols amene ali nembanemba selo wa bowa tcheru mankhwala. Chifukwa cha kukhudzana amenewa anawawidwa permeability ndi kuchotsa zigawo okhudza maselo ambiri zimachitika danga extracellular.

The mankhwala ndi "amphotericin B" akugwira ntchito ndi tizilombo ta ambiri ndi amtengo yogwira ndi bowa mogwirizana.

Iwo ayenera kukumbukira kuti mwa njira imeneyi kugonjetsedwa Fusarium spp. ndipo Pseudallescheria boydii. Komanso, mankhwala si polimbana rickettsiae, mabakiteriya ndi tizilombo tina.

The kayendedwe katundu wa mankhwala

Tsopano inu mukudziwa kuti amenewa ndi antifungal wothandizira, monga "Amphotericin B". Limagwirira cha zochita za wothandizila wakhala tafotokozazi.

Pambuyo makonzedwe mtsempha wa mankhwala mlingo umodzi mu magazi nthawi yomweyo analenga ndende ake aluso amene anakhalabe tsiku lonse. C mapuloteni chimamanga kwa plasma chida ndi 90 peresenti.

Ankaona medicament anagawira mu chiwindi, m'mapapo, impso, ndulu, minofu, adrenal England ndi ziwalo zina ndi zimakhala. ndende zake effusion pleural, peritoneal ndi madzi synovial komanso nthabwala amadzimadzi ukufika 2/3 ya ndende m'magazi.

njira Izi zikutanthauza osadziwika. Mu mkodzo ndi ya ndulu za 98 peresenti ya pano mankhwala mu mawonekedwe a metabolites. Anasonyeza pang'onopang'ono kudzera impso. Koyamba theka moyo wa mankhwala akulu ndi maola 24, ana - maola 6-40, ndipo wakhanda - maola 20-60. Osachiritsika theka moyo masiku 15.

zikuonetsa maantibayotiki

Amene amachitira matenda mankhwala "Amphotericin B"? Iye anaikidwa m'mbuyo, moyo pachiswe matenda a mafangasi kuti ankayambitsa ndi tizilombo atengeke:

• histoplasmosis, mwiniwakeyo cryptococcosis, coccidioidomycosis;
• cryptococcal meninjaitisi, paracoccidioidomycosis, chromomycosis;
• oumitsa khosi chifukwa cha bowa zina, North America blastomycosis;
• metastatic ndi olanda aspergillosis, phycomycosis (zygomycosis);
• kupanga mwiniwakeyo candidiasis gialogifomikoza;
• nkhungu mycosis, aakulu mycetoma;
• mwiniwakeyo sporotrichosis, matenda m'mimba (kuphatikizapo peritonitis);
• endophthalmitis, endocarditis, mafangasi sepsis;
• Choipidwa leishmaniasis, mafangasi matenda thirakiti mkodzo;
• American cutaneous choipidwa leishmaniasis.

Contraindications antifungal wothandizila

Taganizirani zimene boma kutsatira mankhwala oletsedwa "Amphotericin B" (mapiritsi ku bowa wa dzina omwewo sanakhaleko). Malinga ndi malangizo, chida ichi contraindicated:

• aakulu aimpso kulephera;
• mu hypersensitivity;
• nthawi yoyamwitsa.

Mosamala yogwira medicament ntchito matenda aimpso (kuphatikizapo glomerulonephritis), amyloidosis, chiwindi matenda enaake, matenda a chiwindi, kuchepa magazi, agranulocytosis, mimba ndi matenda a shuga.

Lyophilisate "Amphotericin B": malangizo ntchito

Pakuti yokonza ndi mtsempha mankhwala njira anagwiritsidwa ntchito ndi ndende koyamba 5 mg / ml. Kudzera syringe ndi 10 ml ya madzi wosabala jekeseni kuti mbale ndi medicament lapansi. Kenako, nkhani kugwedezeka kupanga mandala colloidal madzimadzi.

Mtsempha mankhwala ndi kutumikiridwa mu ola m'manja mwa magazi, kutentha thupi ndiponso kugunda kwa mtima wa wodwalayo. Mu kulolerana mankhwala wabwino analimbikitsa mlingo tsiku la 0.25-0.3 mg wa pa thupi makilogalamu thupi (malingana ndi kuopsa kwa matenda).

Mu matenda a mtima ndi mitsempha ya magazi, kuchuluka tilinazo ndi impso ntchito osakwanira, chithandizo amasankha ndi Mlingo yaing'ono (5-10 mg), amene pang'onopang'ono chinawonjezeka ndi 5-10 mg wa patsiku ndi kusintha kwa 0.5-0.7 mg wa pa kg.

Pamene sporotrichosis mankhwala Inde mlingo ndi 2.5 g, ndi nthawi ya mankhwala - kwa miyezi 9.

Pamene chida aspergillosis mlingo ndi 3.6 ga, ndi nthawi ya mankhwala - miyezi 11.

Ana pa chiyambi cha mankhwala kutumikiridwa 0,25 mg wa pa thupi makilogalamu patsiku ndiyeno chinawonjezeka pang'onopang'ono mlingo pazipita (1 mg pa kg).

Mafuta "Amphotericin B": malangizo ntchito

Miyala pansi pa dzina malonda yemweyo mu pharmacies ali kugulisa. Choncho m'malo a mankhwala ayenera dokotala.

Ngati ntchito zofunika mafuta "Amphotericin B" wosanjikiza woonda umagwiritsidwa ntchito m'madera akhudzidwa kawiri pa tsiku. Njira yoperekera chithandizo kumatengera ndi umboni umene ulipo:

• ndi candidiasis a makutu khungu - za 1-3 masabata;
• ndi thewera zidzolo ana - pafupifupi 7-14 masiku;
• ndi paronychia ndi malo interdigital akugonjetsa - masabata 2-4.

zotsatira zoyipazi

Kukonzekera "Amphotericin B" angayambitse zotsatira otsatirawa mbali:

• mutu, khunyu, neuropathy zotumphukira, chosakhalitsa vertigo, encephalopathy;
• kusafuna kudya, kusanza, dyspepsia, nseru, gastralgia, kutsekula m'mimba, hepatotoxicity, pachimake kulephera chiwindi, matenda a chikasu ndiyo, matenda a chiwindi, melena, haemorrhagic gastroenteritis;
• normochromic normocytic magazi m'thupi, leukopenia, clotting chisokonezo thrombocytopenia, agranulocytosis, hemolytic magazi m'thupi, eosinophilia, leukocytosis;
• amaona masomphenya, kumva imfa, diplopia, tinnitus;
• tachypnea, dyspnea, edema m'mapapo mwanga, arrhythmia ndi hypersensitivity pneumonitis;
• utachepa kapena kuthamanga magazi, kuyabwa, kusintha mu magawo ECG, kulephera mtima, mantha, matenda a mtima;
• zochita anaphylactoid, sneezing, nephrogenic shuga insipidus, bronchospasm, nephrocalcinosis, zotupa eksfoliativiy dermatitis poizoni epidermal necrolysis
• aimpso kulephera, hypokalemia, gipostenuriyu, aimpso tubular acidosis, Stevens - Johnson syndrome, pachimake aimpso kulephera, oliguria, anuria;
• thrombophlebitis ndi kutentha pa malo jekeseni;
• malungo, myalgia, kuwonda, arthralgia, kufooka ambiri.

Nthawi cha mankhwala osokoneza bongo

Pamene kutumikiridwa Mlingo waukulu wa mankhwala wodwala akhoza kusiya kupuma ndi mtima. Choncho, mu njira ya mankhwala ayenera mosamalitsa kutsatira analimbikitsa mlingo dokotala. M'pofunikanso kuwayang'anira kupuma ndipo mtima, aimpso ndi chiwindi ntchito, zotumphukira magazi chithunzi, komanso wokhutira wa electrolytes.

Ngakhale ndi mankhwala ena

The medicament "Amphotericin B" umene umakulitsa kapena attenuate zotsatira za mankhwala ena, komanso kuonjezera kawopsedwe awo. Choncho, mankhwala Kwalamulidwa mosamala mu mankhwala.

Poika nthumwi anati kwa wodwala, onetsetsani kuti awadziwitse dokotala wanu za kumwa mankhwala ena. Apo ayi, ntchito "Amphotericin B" (mtsempha) angakhale chimawononga thanzi ndi akukhudzidwira umoyo wa munthu.

ayamikira yeniyeni

• The mankhwala ndi "amphotericin B" adzakhala kugwiritsidwa ntchito zochizira matenda akayakaya ndi kupata mafangasi.
• Ndi ntchito yaitali mosavuta zotsatira poizoni ukuwonjezeka.
• Pamene ntchito mankhwala ayenera anasiya magazi m'thupi.

Reviews

Tsopano inu mukudziwa momwe mankhwala amachita "Amphotericin B". Kuyimitsidwa ndi dzina lomweli si pa malonda mu pharmacies. Choncho, chifukwa makonzedwe m'kamwa, muyenera kusankha mankhwala wina ndi kanthu chimodzimodzi.

Malinga ambiri odwala, tikambirana njira bwino kupirira ntchitoyo. Izo mwangwiro kuchitira zotupa mafangasi kuchotsa thupi ndiponso maganizo kusapeza wodwala.

The drawback waukulu wa mankhwala ndi ambiri mavuto. Pa mankhwala, chida ichi chowawa zochita kumachitika pakati pa ziwalo zonse ndi kachitidwe. Choncho, tiyenera okhawo mu zizindikiro zapadera.