Amikacin - cov lus qhia rau kev siv tshuaj tua kab mob hauv cov hmoov thiab kev daws teeb meem

Cov tshuaj no belongs rau cov tshuaj tua kab mob ntawm aminoglycosides, uas muaj kev pom dav dav hauv cov kab mob bactericidal. Cov chaw tsim hluav taws xob tseem ceeb ntawm cov tshuaj yog lub tuam txhab Synthesis. Nws raug tso tawm hauv cov khw muag tshuaj tsuas yog muaj ntawv pov thawj thiab tsis tuaj yeem tso tawm yog tsis muaj nws. Muag nyob rau hauv daim ntawv ntawm kev daws los yog hmoov rau intramuscular lossis intravenous thawj coj.

Cov lus qhia rau siv Amikacin

Amikacin tshuaj tua kab mob belongs rau cov tshuaj semisynthetic los ntawm aminoglycoside pawg. Cov tshuaj cuam tshuam rau cov kab mob me me bacteriostatically, bactericidal, inhibiting cov txheej txheem ntawm lawv lub neej, uas ua rau kev tuag ntawm cov kab mob. Nyob rau hauv qhov chaw muaj pathogenic, kev tawm tsam cov tshuaj muaj qeeb qeeb, yog li ntawd, cov tshuaj muaj txoj hauv kev ua tau zoo hauv pawg aminoglycosides. Cov tshuaj yog rau cov tshuaj tua kab mob ntev-loj, nws muaj kev tiv thaiv hnyav:

Qee cov kab mob micro-positive: staphylococci (staphylococcus), uas tiv taus methicillin, cephalosporins, penicillin, qee yam ntawm streptococci (streptococcus).
Gram-negative: Aeruginosa, Enterobacter, Escherichia, Klebsiella, Prov>

Kev Sib Sau thiab daim ntawv ntawm tso tawm

Kev npaj tau ua nyob rau hauv daim ntawv ntawm ib qho kev hais daws lossis hmoov rau qhov kev npaj ntawm kev daws teeb meem. Cov tshuaj yog muab tshuaj intramuscularly lossis intravenously, muaj nyob hauv kev siv tshuaj hauv qab no:

2 ml ampoules ntawm 500 mg (250 mg / 1 ml), ntim ntawm 5 lossis 10 daim,
4 ml ampoules ntawm 1 g ntawm 5 thiab 10 pcs. ntim
hmoov hauv cov hwj 500 thiab 1000 mg, ntim 1, 5, 10 pcs.

Sab nraud, cov tshuaj yog cov tshuaj pom tseeb, muaj cov hauv qab no thiab cov khoom siv ntxiv:

cov khoom siv tseem ceeb yog amikacin, ml muaj 250 mg,
Cov khoom xyaw pabcuam - sodium citrate, dej rau txhaj, diluted sulfuric acid, sodium disulfite.

Pharmacodynamics thiab pharmacokinetics

Qhov no yog cov tshuaj tua kab mob los ntawm koob thib 3 aminoglycoside pawg. Nws muaj cov kab mob bacteriostatic (tua cov kab mob hauv lub cev) hauv kev sib raug zoo ntawm ntau cov kab mob sib txawv pathological. Cell kev puas tsuaj tshwm sim vim kev sib khi rau 30S qhov tseem ceeb ntawm lub cev, cuam tshuam ntawm kev tsim tawm ntawm cov protein molecules, uas ua rau kev tuag ntawm cov kab mob ntawm tes. Cov tshuaj yog nquag tawm tsam feem ntau cov kab mob gram-zoo thiab qee yam gram-tsis zoo.

Cov tshuaj tsis muaj kev cuam tshuam rau cov kab mob anaerobic (cov kab mob me me uas tuaj yeem txhim kho tsuas yog tsis muaj oxygen). Amikacin yog ib qho tshuaj zoo tiv thaiv cov kab mob tiv thaiv rau lwm cov tshuaj tua kab mob. Tom qab txhaj tshuaj rau cov ntshav, cov tshuaj tshwm sim sai rau hauv cov ntshav thiab tau faib tawm thoob plaws lub cev hauv 10-15 feeb. Cov tshuaj yooj yim nkag mus rau cov ntshav-hlwb teeb meem, cov txiaj ntsig (thaum cev xeeb tub, nkag mus rau hauv lub cev ntawm tus menyuam), kis mus rau niam mis. Lawv lub cev yog tug tsis hloov pauv.

Kev ntsuas rau siv

Qhov laj thawj tseem ceeb ntawm kev siv tshuaj tiv thaiv yog cov kab mob sib kis loj heev uas tau tsim los ntawm cov kab mob gram-negative (tshwj xeeb yog tias lawv tiv taus lwm cov tshuaj hauv pawg no). Cov kab mob hauv qab no yog qhov taw qhia rau kev siv tshuaj:

Cov txheej txheem ntawm kev sib kis ntawm kev ua pa ntawm lub ntsws: mob ntsws ua paug, kab mob ntsws, ua mob ntsws, empyema ntawm pleura (tsub zuj zuj ntawm pus hauv pleural kab noj hniav).
Sepsis. Qhov no yog tus txheej txheem sib kis nrog kev loj hlob nquag thiab rov ua dua ntawm cov kab mob pathogenic hauv cov ntshav.
Kab mob hauv lub hlwb: mob rau daim npluag paj hlwb, cov mob txha caj qaum, txha caj qaum.
Cov kab mob endocarditis. Cov txheej txheem sib kis yog feem ntau purulent ntawm txheej sab hauv ntawm lub siab.
Kev kis mob ntawm daim tawv nqaij, cov nqaij mos, cov nqaij mos subcutaneous: phlegmon, abscesses, siab qhov ncauj tawm nrog necrosis, txheej txheem ua qog ntshav, hlawv roj.
Kab mob peritonitis thiab lwm yam txheej txheem muaj kab mob hauv lub plab ua kom plab.
Cov kab mob kis tau rau hauv lub cev, qhov chaw tso zis - mob qog ntshav, mob siab, empyema ntawm lub zais zis zais zis, cholecystitis.
Osteomyelitis (mob pob txha), mob txha caj qaum.
Cov kab mob uas cuam tshuam rau cov hnyuv, lub plab.

Tsuas tshuaj thiab tswj hwm

Ua ntej yuav muab tshuaj rau tus kws kho mob, tus kws kho mob yuav tsum ua txhua yam tsim nyog kuaj mob. Qhov ntau npaum li cas yog tsim, cov txheej txheem ntawm daim ntawv thov, coj mus rau hauv tus account lub zos kev ua kom muaj tus kab mob, qhov hnyav ntawm pathology, thiab qhov rhiab ntawm cov kab mob. Muaj kev hloov pauv ntawm kev tswj hwm intramuscular thiab leeg ntshav (txia lossis dav hlau rau 2 teev).

Amikacin tso leeg ntshav

Qhov tob ntawm cov tshuaj hauv cov tshuaj rau kev txhaj tshuaj txhaj tshuaj tsis pub tshaj 5 mg / ml. Yog tias tsim nyog, kev kho mob nrog hom qauv no tuaj yeem siv tshuaj Amikacin, uas yog siv rau kev tswj hwm intramuscular. Yuav tsum tov 5% piam thaj ntawm 200 ml lossis ib qho tshuaj sodium isotonic sodium chloride xav tau. Kev qhia txog kev tso tawm yog nqa tawm ntawm 60 tee / feeb, dav hlau - rau 3-7 feeb. nws yog qhov tsim nyog thaum lub sij hawm kho mob los saib xyuas kev ua haujlwm ntawm cov tshuaj ntawm lub paj hlwb, ob lub raum, lub tshuab ua pa.

Amikacin intramuscularly

Kev daws yog npaj los ntawm kev ntxiv dej rau kev txhaj rau cov hmoov kom qhuav los ntawm lub iav. Yog tias tsim nyog, txhaj tshuaj intramuscular yuav xav tau 2-3 ml dej ib 05 g ntawm hmoov. Thaum ua kom paub cov kua, ua kom tsis muaj menyuam. Co lub raj mis kom cov ntsiab lus zoo nyob hauv dej. Tom qab ntawd, muab cov tshuaj tov rau hauv cov koob txhaj tshuaj thiab ua kev txhaj tshuaj hauv intramuscular.

Cov lus qhia tshwj xeeb

Muaj cov npe teev cov kev cai uas yuav tsum tau txiav txim siab thaum siv tshuaj. Tsuas yog tus kws kho mob tau sau ntawv rau nws thiab tus neeg mob yuav tsum ua raws li lub caij nyoog tau teev tseg los ntawm tus kws tshaj lij. Cov lus qhia tshwj xeeb hauv qab no muaj nyob:

Rau cov menyuam yaus txog li 1 hlis thiab menyuam yug tshiab, cov tshuaj tuaj yeem raug tswj hwm tsuas yog nyob hauv kev saib xyuas mob nkeeg nruj me ntsis, thiab yog tias muaj mob hnyav, yuav tsum tau txhaj 10 mg / kg lub cev hnyav. Dosage tau muab faib ua 10 hnub.
Thaum tsis muaj kev kho kom zoo, 2-3 hnub tom qab pib kho, yuav tsum muaj kev txiav txim siab los hloov lub tswv yim kho tus mob ntawm pathology lossis tshuaj tua kab mob.
Amikacin yuav tsum tau siv nrog kev ceev faj zoo nrog rau lwm cov tshuaj, nws yog ib qhov tsim nyog los saib xyuas kev ua haujlwm ntawm lub raum, mob siab, thiab lub paj hlwb.
Hauv kev tswj nruj, ib qho tshuaj yog siv yog tias tus neeg mob muaj tus kab mob Parkinsonisms, myasthenia gravis (leeg tsis muaj zog).

Amikacin thaum cev xeeb tub

Kev siv tshuaj yaj yeeb raug tso cai rau cov cim tseem ceeb thaum cev xeeb tub, lactation. Nws yuav tsum tau yug los rau hauv lub siab tias cov tshuaj muaj peev xwm nkag mus rau lub cev nqaij daim tawv, tom qab ntawd nws pom nyob rau hauv cov ntshav ntawm tus me nyuam hauv plab, muaj kev pheej hmoo ntawm kev txuam nrog cov tshuaj mob hauv lub raum ntawm tus menyuam, uas muaj cov nyhuv nephro thiab ototoxic rau lawv. Nws yog txiav txim me me hauv cov kua mis. Los ntawm cov hnyuv hauv plab, kev nqus ntawm aminoglycosides tsis muaj zog. Thaum pub niam mis muaj teeb meem vim kev noj tshuaj rau menyuam yaus tsis pom.

Amikacin rau menyuam yaus

Tus kws kho mob tau yuav tshuaj los ntawm kev yug los yog pub. Amikacin rau cov menyuam yaus siv raws li hauv qab no:

cov menyuam yug ua ntej: thawj koob tshuaj yog 10 mg / kg, tom qab ntawd 7.5 mg txhua 24 teev,
yug me nyuam thiab mus txog 6 xyoo: thawj zaug txhaj yog 10 mg / kg, tom qab ntawd 7.5 mg txhua 12 teev.

Rau ib nrab ib teev, cov tshuaj no tau muab tso ncaj rau cov menyuam yaus, nyob rau hauv cov teeb meem nyuaj rau ib teev. Nrog rau kev loj hlob ntawm kev mob hnyav, kev tswj hwm dav hlau tau tso cai rau 2 feeb, tab sis tsuas yog nyob ntawm tus kws kho mob thiab nrog kev tso cai. Ua ntej siv cov khoom, nws yog diluted hauv kev daws sodium sodium (0.09%) lossis dextrose (5%). Raws li qhov tshwm sim, qhov kev kub siab ntawm cov tshuaj nquag yuav tsum tsis pub tshaj 5 mg rau 1 kg ntawm huab hwm coj.

Yeeb tshuaj sib cuam tshuam

Amikacin yog synergistic thaum sib cuam tshuam nrog benzylpenicillin, carbenicillin, cephalsporins (muaj kev pheej hmoo ntawm txo cov hauj lwm zoo ntawm aminoglycosides thaum siv ua ke nrog beta-lactam tshuaj tua kab mob hauv cov neeg mob uas mob raum tsis ua haujlwm ntev). Kev phom sij ntawm oto- thiab nephrotoxicity nce thaum sib tham nrog polymyxin B, nalidixic acid, vancomycin, cispalitic.

Penicillins, cephalosporins, diuretics (tshwj xeeb tshaj yog furosemide), NSAIDs, sulfonamides tsim kev sib tw rau kev ua kom muaj kev sib cais hauv cov tub ntawm nephron. Qhov no ua rau thaiv kev tshem tawm cov aminoglycosides, nce lawv cov kev xav hauv cov ntshav, nce neuro- thiab nephrotoxicity. Amikacin thaum sib cuam tshuam nrog cov tshuaj zoo li curare txhim kho cov leeg txo qis.

Kev phom sij ntawm kev ua pa thaum lub sijhawm ntes ntshav nrog cov tshuaj tiv thaiv citrate, kev siv cov tshuaj uas thaiv cov neuromuscular kis thiab noj Amikacin ntau ntxiv. Nrog rau kev tswj hwm hauv tsoomfwv ntawm indomethacin, kev pheej hmoo ntawm kev phiv los ntawm aminoglycosides ntau ntxiv. Cov tshuaj txo qis ntawm cov tshuaj tiv thaiv myasthenic. Amikacin yog sib xyaw nrog heparin, penicillins, cephalosporins, amphotericin B, capreomycin, erythromycin, vitamins ntawm pab pawg C, B, potassium chloride.

Phiv los ntawm Amikacin

Ntu cov khoom siv lossis amikacin sulfate tom qab noj lub cev yuav ua rau qee qhov tsis zoo. Ntawm cov kev phiv tshuaj uas nquag muaj yog:

Los ntawm lub plab zom mov, kev nce qib ntawm daim siab enzymes AST thiab ALT hauv cov ntshav tuaj yeem pom, uas qhia tau tias kev rhuav tshem cov kab mob siab (hepatocytes), kev nce siab ntawm cov bilirubin hauv cov ntshav, ntuav thiab xeev ntuav.
Kev fab tshuaj tiv thaiv. Muaj qhov sib txawv ntawm qhov mob hnyav, los ntawm khaus thiab tawm pob rau anaphylactic kev poob siab (qhov kev nthuav dav ntawm ntau yam hauv lub cev tsis ua haujlwm vim qhov txo qis hauv cov ntshav siab). Lwm qhov uas yuav ua tau yog urticaria (me ntsis o thiab ua pob rau ntawm daim tawv nqaij uas zoo li muaj cov tawv nqaij nettle), Quincke's edema, thiab ua npaws.
Cov kev tsis zoo tshwm sim los ntawm cov ntshav hemopoiesis yog tshwm sim hauv daim ntawv ntawm leukopenia (txo qis ntawm cov leukocytes), thrombocytopenia (txo qis hauv cov ntshav platelets), ua haujlwm ntshav qis (txo qis ntawm hemoglobin, qib ntshav liab).
Los ntawm cov kab ke genitourinary, kev txhim kho lub raum ua kom tsis zoo, albuminuria (protein nyob hauv cov zis), microhematuria (ntshav me me hauv cov zis) tuaj yeem pom.

Noj ntau dhau

Koj yuav tsum tau noj tshuaj nruj me ntsis ntawm kev noj tshuaj uas qhia los ntawm kws kho mob. Yog tias koj ua txhaum cov lus pom zoo yuav ua rau muaj kev phiv tsis zoo. Overdose kev kho mob yog nqa tawm hauv kev saib xyuas hnyav. Siv cov tshuaj hemodialysis, kev kho mob cov tsos mob kom tshem tawm cov tshuaj tawm hauv lub cev. Cov cim hauv qab no ntawm kev siv ntau dhau yog:

kiv taub hau heev,
ntuav, xeev siab, nqhis dej,
ataxia - staggering gait vim kev sib koom tes tsis zoo,
ua tsis taus pa thiab ua pa tsis nto,
tso zis tsis meej
co lub pob ntseg, pob ntseg kom hnov lus zoo rau lag ntseg.

Cov Yuav Tsum Tau Ua

Cov tshuaj muaj cov nyhuv tseem ceeb rau lub cev, yog li nws tau faib los ntawm cov tshuaj hauv khw muag tshuaj. Cov txheej txheem ua kom tsis txhob noj tshuaj yog cov xwm txheej hauv qab no:

Cov tib neeg tsis kam rau amikacin sulfate, kev fab tshuaj rau cov tshuaj nquag thiab koom nrog pabcuam.
Kab mob ntawm lub pob ntseg sab hauv, nrog los ntawm o ntawm cov leeg hnov mob. Cov tshuaj tuaj yeem tuaj yeem ua rau tuaj yeem lossis hnov lus tsis zoo vim yog lub paj hlwb tsis zoo.
Cov kab mob hnyav ntawm lub raum, mob siab, uas nrog lawv cov tsis muaj txhij txhua.
Cev xeeb tub

Cov nqe lus ntawm kev muag khoom thiab kev cia khoom

Koj tuaj yeem khaws cov tshuaj hauv cov ntawv kaw rau 3 xyoos. Cov tshuaj yuav tsum cia nyob hauv qhov chaw qhuav, tsaus thiab txias qhov tsis muaj kev nkag tau rau menyuam yaus. Pom zoo kom huab cua kub +25 degrees Celsius. Daim ntawv yuav tshuaj muaj muag nyob hauv cov khw muag tshuaj thiab cov khw muag online.

Muaj cov tshuaj uas muaj tib cov tshuaj nquag. Lawv muaj cov nyhuv zoo sib xws rau Amikacin. Ntawm cov kev xaiv nrov yog cov tshuaj hauv qab no: