"Meropenem": malangizo ntchito, ndemanga. analogues mankhwala

Ndi mankhwala kupanga monga carbapenems gulu, nthumwi zomwe ndi mankhwala "meropenem" chifukwa makonzedwe parenteral. Chifukwa kanthu bactericidal ndi bacteriostatic wa chigawo yogwira mankhwala akhoza ziletsa kukula ndi kubereka mabakiteriya amene amayambitsa matenda osiyanasiyana yotupa.

Kufotokozera mankhwala

The medicament "meropenem" imatengedwa chachikulu-sipekitiramu mankhwala ndi loyera kapena zoyera ndi chikasu kum'chitira ufa njira. Lowani mu mtsempha bolus kapena kulowetsedwa.

Kumasulidwa mu mbale ndi buku la 10 ndi 20 ml. Mlingo wa lyophilisate anali 0,5 ga kapena 1 g wa mankhwala "meropenem". Mapiritsi ndi njira injectable jekeseni mu mnofu ntchito maantibayotiki sanakhaleko. Pali mtundu umodzi wokha wa kumasulidwa.

mankhwala

Mbali yogwira amachita mu mawonekedwe meropenem trihydrate. Pofotokoza zikuchokera pa, masamu pa vial 1, akusonyeza kuchuluka kwa mankhwala yogwira: meropenem trihydrate ya 0,570 ga, kapena 1.140 ga, ndi lagona pa ufulu meropenem 0,5 ga kapena 1 g, motero. Zitsanzo za zinthu wothandiza monga ndi sodium carbonate ufa.

Main Anzawo ndi opanga awo

meropenem mankhwala oyambirira zochokera mankhwala "Meronem" mu mawonekedwe a ufa 0,5 ga Izo ntchito kupanga jekeseni amene kutumikiridwa m'nsinga. mankhwala amene amapangidwa British kampani "Astra Zeneca Co., Ltd.", zochokera kumene zikuchokera ndi mlingo wa mankhwala, anachititsa mayesero chisanadze matenda ndi matenda. kukonzekera zina ndi meropenem amaonedwa generic ndi chinaonekeranso mwa chifaniziro cha pachiyambi.

Mu generic "Meropenem" analogues zilipo monga dzina malonda, imodzimodzi ndi dzina mayiko sanali kampani, ndi pansi pa malonda ena kuposa analandira alendo. Kumasulidwa mawonekedwe, mlingo ndi zikuchokera kwa "Meronem" mankhwala onse a mankhwala angaperekedwe m'mafanizidwe a yemweyo, zimene zikusonyeza interchangeability awo.

The mankhwala ndi malonda dzina "Meropenem" opangidwa ndi mafakitale ambiri mankhwala padziko lonse. Mwachitsanzo, Indian kampani "M. J .. Biopharm Pvt. Co., Ltd. "manufactures mankhwala, ndi ma CD ikuchitika mu Russian kampani CJSC" Biotec MFPDK ". makampani Chiyukireniya "Lekhim", "Pharma Moyo" kubala maantibayotiki "Meropenem". Analogs anyamula mu dzina lake komanso dzina la Mlengi. Zitsanzo mu dziko la mankhwala zambiri. Makamaka, kudziwika kukonzekera "meropenem Vero". Ndi mankhwala a kampani Chinese "Shenzhen Haibin mankhwala Co .. Ltd ".

Medicament "Meropenem Dzhodas" - Indian analogue wa yotakata-sipekitiramu mankhwala opangidwa ndi LLC "Dzhodas Ekspoim". Izo zinabala mu mawonekedwe ufa kupanga jekeseni njira 500 mg kapena 1000 mg.

kampani Russian "ABOLmed" LLC anapanga mankhwala "Meropenabol" pamaziko a meropenem antibacterial wothandizira. Kuchokera ufa, yankho kwa makonzedwe mtsempha.

Mankhwala "Meropenem Spencer»

Chida ichi ndi wina analogues Indian anapanga tsopano, "Cooper Pharma" chifukwa "Spencer UKey Pharma Limited", India. Yopangidwa ndi meropenem mawonekedwe trihydrate ndi chikukhudza carbapenems gulu. Mankhwala "meropenem Spencer" akusonyeza zimakhudzanso antibacterial ndi mabakiteriya galamu HIV ndi galamu alibe matenda yotupa ndi matenda. Ntchito yoyang'anira parenteral.

katundu pharmacological

Zotsatira yaikulu ya buku mankhwala meropenem malangizo akufotokoza kanthu bactericidal a sipekitiramu lonse, amene amagwirizana ndi yimitsira mapangidwe nembanemba bakiteriya. Luso imfa ya aerobic mabakiteriya ndi anaerobic chifukwa malowedwe mankhwala khoma la bakiteriya a, inert ndi kulemekeza beta-lactamases ndi kuyandikana ndithu kuti nyumba mapuloteni, binders Penicillin.

Ndi kumanga kwa maselo mapuloteni pa nembanemba wa cytoplasm mabakiteriya kuchepetsa peptidoglycan wosanjikiza selo khoma yimitsira transpeptidase anamasulidwa michere autolytic mpanda selo kusokoneza matabwa ake ndi kutsogolera kwa tiziromboti imfa.

Kodi tizilombo mankhwala?

Kukonzekera "Meropenem" malangizo ntchito zimaphatikizapo kugwiritsa ntchito aerobes odana galamu HIV, monga Enterococcus fekalis, Stafilokk aurelus, Streptococcus agalactia, Streptococcus chibayo ndi kudziwa
penicillin, Streptococcus piogenez, Streptococcus viridans.

Mkulu mankhwala ntchito ndi aerobes galamu alibe, Pakati Escherichia coli n'kopanda, Haemofilus influentsa, Klebsiella chibayo, Neisseria meningitidis, Pseudomonas aeruginoza, Proteus mirabilis.
Meropenem amachita pa mabakiteriya anaerobic, monga: Bakteroides flagilis, Peptostreptokokkus spp.

Mphamvu ya mankhwala linatsimikizidwa ndi mabakiteriya potsatira kafukufuku m'galasi chokha, koma palibe umboni wa mogwira matenda.
Galamu HIV aerobes kunyamula Stafilokokus epidermidis ndi metitsillinovoy tilinazo ndi aerobes galamu alibe: Atsinetobakter spp, Aeromonas hydrophile Campylobacter Jaejoong, tsitrobakter diversus, tsitrobakter Freund, Enterobacter cloaca, Hafnie, Klebsiellla oksitoka, Morakella katarrhalis, Morganella Morgan, Pasteurella multotsida, Proteus vulgaris. , nsomba spp., Serrat martsestsens, Shigella spp., Ursino enterocolitis.

Mu m'galasi amalimbana anaerobic mabakiteriya :. Bakteroides distasonis, Bakteroides ovatus, Bakteroides uniformis, Bakteroides ureolitikus, Bakteroides vulgaris, Clostridium difficile, Clostridium perfringens, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes.

Kuti amachitira mankhwala

Chifukwa zosiyanasiyana za lonse kanthu za yogwira mankhwala meropenem malangizo pa ntchito akulimbikitsidwa matenda osiyanasiyana opatsirana ndi yotupa monga medicament limodzi kapena mankhwala osakaniza.

Zikuphatikizapo mankhwala-tcheru matenda zokhudza:

• m'munsi kupuma thirakiti, anaonetsa kutupa mapapo, kuphatikizapo chibayo nosocomial;
• dongosolo mkodzo monga pyelonephritis, pielita;
• khungu ndi minofu zofewa mu mawonekedwe a erysipelas, pyoderma, dermatoses sekondale kachilombo;
• ziwalo mu mafupa a chiuno, kuphatikizapo kutupa nembanemba mucous ya m'chiberekero;
• ziwalo mu zonse m'mimba, kuphatikizapo boma la kobvuta appendicitis, peritonitis, pelvioperitonita.

Mankhwala zikusonyeza efficacy mu meninjaitisi bakiteriya ndi matenda magazi. Anthu ndi neutropenia febrile, mankhwala ntchito limodzi ndi nthumwi mavairasi oyambitsa kapena antifungal.

Malamulo a njira mankhwala

Kuvunda kwa mankhwala kumafuna kutsatira mosamala aseptic ndi antiseptic. Mbale ndi njira ntchito kamodzi sikuloledwa imodzi kusakaniza ndi mankhwala mankhwala ndi zina.

Mankhwala "meropenem" mu mawonekedwe a wosabala injectable ufa wasukuluka ndi madzi zina mtsempha bolus. Kupasuka 1 g wa meropenem ntchito 20 ml ya madzi, Chofanana ndende ya 50 mg pa 1 ml. Madzimadzi okonzeka ndi amangoona bwino, colorless kapena kuwala chikasu nuance.

Akhoza kugwiritsa ntchito 50-200 ml ya n'zogwirizana kulowetsedwa njira zosungunulira "meropenem" kukonzekera. Njirazi ndi monga:

• kolorayidi ndi sodium 0,9%;
• dextrose 5% kapena 10%.

Patsogolo makonzedwe mtsempha wa madzi kuchepetsedwa anagwedezeka.

kusintha mlingo

mankhwala wamkulu "Meropenem" malangizo Buku lili ndi mlingo wa 500 mg, amene akubwerezedwa pambuyo maola 8. Malinga chiwembu azichitira chibayo, mkodzo thirakiti matenda, matenda opatsirana ndi yotupa mu ziwalo yaing'ono mafupa a chiuno, matenda a khungu ndi minofu minofu.

Nosocomial chibayo, peritonitis, septicemia, zizindikiro za matenda bakiteriya odwala febrile neutropenic amafuna kugwiritsa ntchito mankhwala 3 pa tsiku 1 chaka Pamene meninjaitisi analimbikitsa mlingo wa 2 ga mawola 8.

Malinga ndi kusalekerera ndi mtundu wa matenda osankhidwa dokotala dosing wodwalayo ndi nthawi ya mankhwala.

Childs, nthawi mpheto zimadalira njira utsogoleli. An bolus mtsempha kudyetsa njira sitimadzipereka ikuchitika pafupifupi 5 Mphindi, ndi mtsempha kulowetsedwa wa - kuchokera 15 Mphindi 30. Medicament "Meropenem" im sanakwere.
Matenda aimpso kulephera amafuna kudzudzulidwa dosing malinga ndi creatinine chilolezo :

• pa 26-50 ml ya pa mphindi, mlingo kwa 500 mg magalamu 2 mawola 12;
• pa 10-25 ml ya pa mphindi, mlingo kwa 250 mg kwa 1 g, mawola 12;
• zosakwana 10 ml pa mphindi, mlingo kwa 250 mg kwa 1 g, kamodzi pa maola 24.

Achikulire odwala ndi ntchito zabwinobwino ndipo ndi aimpso creatinine chilolezo kuposa mL 50 pa mphindi dosing optionally kusankha. Chiwindi kulephera si chifukwa kusintha mlingo.

Pa hemodialysis pali excretion wa meropenem, ndi mankhwala chikuyendetsedwera kumapeto kwa ndondomeko. Izi ndi zoona makamaka kwa kubwezeretsa nthawi yaitali mankhwala magazi wothandiza ambiri antibayotikiyo.
Ana a zaka 3 months zaka 12 ntchito m'nsinga 10-20 mg wa mankhwala pa 1 makilogalamu thupi pa imeneyi ya maola 8. Mlingo zimadalira tizilomboto ndi tcheru chake kwa mankhwala ndi matenda.
Ngati ana osakwana zaka 12 thupi kuposa makilogalamu 50, akutumikira mlingo wamkulu.

Meropenem mankhwala a ana ndi kuwona ntchito impso sichinayambe kuphunzira.
Mankhwalawa matenda oumitsa khosi ndi ntchito 40 mg wa pa makilogalamu 1 kulemera pambuyo maola 8.

Mankhwalawa ndi contraindicated

Nkofunika kudziwa kuti si mankhwala onse angagwiritsidwe ntchito, makamaka pamene pali chinawonjezeka hypersensitivity kuti mankhwala, kapena ngati beta-lactam wothandizila antibacterial m'mbuyomu.

ana ang'ono mpaka miyezi 3 mulibe mankhwala, "Meropenem". Umboni kusonyeza angagwiritsire ntchito ndi mankhwala amene ali ndi zotsatira poizoni pa impso ndi matenda m'mimba.
Woyembekezera, mankhwala si ntchito, kupatulapo nthawi imene ubwino mankhwala kuposa ingafooketse chitukuko cha mwana wosabadwayo. Kuyamwitsa pamene mankhwala ali osavomerezeka ndi madokotala.

zotsatira zoyipazi

Pa tsiku lokonzekera "Meropenem" mavoti amasonyeza zotheka chitukuko cha mavuto mu madera osiyana a thupi.

mantha dongosolo ndi kuona ziwalo angalankhule mankhwala chiwonetsero cha mutu, chizungulire, dzanzi malo, kumva kulasalasa ndi kumva kulasalasa, wamphamvu maganizo chilakolako chogonana, mkhutu kutsitsimuka, epileptiform khunyu, zopweteka.

Pa dongosolo mtima, ziwalo hematopoiesis kukonzekera kumakhudza tikapatsidwa kuwonjezera chiwerengero cha eosinophils ndi maselo othandiza magazi kuundana ndi madzi a m'magazi zotumphukira, ndipo kuchepa kupatsidwa zinthu za m'mwazi ndi leukocyte maselo, milingo hemoglobin, yafupika hematocrit mtengo ndipo chiwerengero cha neutrophils, zikubweretsa agranulocytosis, zowononga thromboplastin ndi prothrombin nthawi.

Odwala ena zindikirani kusintha kugwirizana ndi ziwalo thirakiti m'mimba, anaonetsa ululu pamimba, nseru, kusanza, kutsekula m'mimba, kudzimbidwa, kudzimbidwa, matenda a chikasu ndiyo. Ndi zotheka kuchuluka misinkhu ya bilirubin mu madzi a m'magazi, kuwonjezera ntchito ya michere alanine aminotransferase, aspartate aminotransferase, phosphatase zamchere, ndi lactate dehydrogenase. Nthawi zina, akufotokozera chikhalidwe pseudomembranous matenda a m'matumbo, kapena m'kamwa mucosa zotupa kuoneka candidiasis.

Pakhala milandu kuyan'anila zokhudza dongosolo genitourinary. Njirazi ndi monga: vuto pokodza, kutupa kwa zimakhala zofewa a boma, kuphwanya impso kugwirizana ndi hypercreatininemia, amaika urea mu magazi, hematuria, thrush.

Maantibayotiki angathe kubala zosiyanasiyana thupi lawo siligwirizana. Iwo akuwonetseredwa ndi kuyabwa zidzolo, urticaria, erythema multiforme, syndrome Stevens-Johnson, poizoni epidermal necrolysis, angioedema, anaphylactic mantha.

Mwa zotsatira zina mbali, pali ndemanga za leaching wa potaziyamu m'thupi, kuwonjezera buku la magazi zokhudza zonse kufalitsidwa, chenichenicho mwachindunji kapena mozungulira antiglobulin Coombs. zochita Local pa makonzedwe mtsempha imakhudzana ndi kutupa, phlebitis, thrombophlebitis, kutupa ndi soreness pa malo jekeseni.

Odwala ena akhala akusonkhana ndi mphamvu ya mankhwala kuyerekezera zinthu m'maganizo, maganizo, irritability, kusowa tulo, matenda a mtima, matenda a mtima, tachycardia, bradycardia, m'mnyewa wamtima minofu mtima, kuthamanga kwa magazi madontho, kufupika kwa mpweya, kukomoka ndi nkhawa, ngakhale ena udindo meropenem zizindikiro .