Cefepim - cov lus qhia rau kev siv, tshuaj yeeb yaj kiab, tshuaj xyuas thiab tso tawm cov ntawv (txhaj rau hauv ampoules rau kev txhaj tshuaj ntawm cov tshuaj tiv thaiv ib 1 gram, ntsiav tshuaj) tshuaj rau kev kho mob ntsws txhaws, mob ntsws, cystitis rau cov laus, menyuam yaus thiab cev xeeb tub

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb CefepimCov. Muab tswv yim los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg tau txais kev pab ntawm cov tshuaj no, nrog rau kev tawm tswv yim ntawm cov kws paub txog kev kho mob txog kev siv tshuaj tua kab mob nqaij hauv lawv cov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Cov qauv ntawm Cefepime nyob rau hauv muaj cov qauv txheej txheem tam sim no. Siv rau kev kho mob ntawm mob ntsws, mob ntsws, mob ntsws thiab lwm yam kab mob sib kis hauv cov neeg laus, menyuam yaus, nrog rau lub sijhawm cev xeeb tub thiab lactation. Cov tshuaj muaj pes tsawg leeg.

Cefepim - cephalosporin tshuaj tua kab mob los ntawm pab pawg 4 tiam rau kev siv niam txiv. Nws muaj cov kab mob bactericidal, cuam tshuam nrog kev sib txuas ntawm cov xovtooj ntawm phab ntsa ntawm cov kab mob me me.

Nquag nquag tawm tsam feem ntau cov kab mob gram-negative, incl. tsim cov beta-lactamases, suav nrog Pseudomonas aeruginosa. Kev nquag tshaj cephalosporins 3 tiam, tawm tsam gram-zoo cocci.

Tsis nquag tawm tsam Enterococcus spp. (enterococcus), Listeria spp. (Listeria), Legionella spp. (Legionella), qee cov kab mob anaerobic (Bacteroides fragilis, Clostridium difficile).

Cepepime yog tus cwj pwm los ntawm kev ruaj khov tiv thaiv ntau yam plasmid thiab chromosomal beta-lactamases.

Muaj pes tsawg leeg

Cefepima hydrochloride + excipients.

Cov Tshuaj Pharmacokinetics

Plasma protein khi yog qis dua li 19% thiab yog qhov ywj siab ntawm cov ntshav dej haus cawv kom pom tseeb. Kev kho cov zaub mov kom ntau yog muaj nyob hauv cov zis, cov kua tsib, cov kua dej peritoneal, exudate ntawm lub hlwv, hnoos qeev ua pa ntawm hnoos qeev, hnoos qeev, prostate nqaij, ntxiv mus thiab tsib lub zais zis, ua kua cerebrospinal nrog rau cov leeg mob. Hauv cov neeg muaj kev noj qab haus huv, nrog kev tswj hwm kev noj qab haus huv ntawm cefepime hauv ib koob ntawm 2 g nrog ib ncua sijhawm ntawm 8 teev rau 9 hnub, tsis muaj kev nkag mus hauv lub cev. Cov zaub mov txig yog cov tawm los ntawm lub raum, feem ntau los ntawm glomerular pom (qhov nruab nrab lub raum tshem tawm - 110 ml / min). Hauv cov zis, kwv yees li 85% ntawm kev muab zaub mov rau noj yog tshawb pom tias tsis hloov pauv. Hauv cov neeg mob uas muaj hnub nyoog 65 xyoos lossis laus dua nrog lub raum tsis ua haujlwm, kev kho lub raum tau qis dua li cov neeg mob hluas. Cov chaw muag tshuaj ntawm cefepime hauv cov neeg mob uas lub siab tsis ua haujlwm, cystic fibrosis tsis tau hloov.

Cov Khoom Qhia

Kev kho mob ntawm kis mob thiab mob tshwm sim los ntawm cov kab mob ua kab mob cefepime-rhiab:

qis cov kab mob ua pa (nrog rau mob ntsws thiab mob ntsws),
mob txeeb zig (ob qho tib si nyuaj thiab tsis yooj yim),
kis ntawm daim tawv nqaij thiab cov nqaij mos,
Kab mob rau hauv plab (suav nrog rau mob peritonitis thiab kab mob biliary),
cov kab mob gynecological
septicemia
neutropenic ua npaws (raws li kev kho mob tiag tiag),
cov mob meningitis nyob hauv cov menyuam yaus.

Tiv thaiv kev kis kab mob thaum phais plab.

Tso Tawm Cov Ntawv

Hmoov rau qhov kev npaj ntawm kev daws rau kev tso dej thiab tshuaj intramuscular ntawm 1 gram (kev txhaj tshuaj hauv ampoules rau kev txhaj tshuaj).

Lwm cov ntaub ntawv ntau npaum li cas, tsis pub muaj ntsiav tshuaj lossis tsiav tshuaj, tsis muaj nyob.

Cov lus qhia rau kev siv thiab ntau npaum li cas

Cov tib neeg, nyob ntawm qhov nkag siab ntawm cov kab mob, qhov hnyav ntawm tus kab mob, nrog rau lub xeev ntawm lub raum ua haujlwm.

Kev mob siab rau txoj kev tswj hwm yog pom zoo rau cov neeg mob uas muaj kab mob hnyav lossis ua rau muaj sia, tshwj xeeb nrog kev phom sij.

Nrog kev siv tshuaj intramuscular lossis tso ntshav rau cov neeg laus thiab menyuam yaus uas hnyav dua 40 kg nrog lub raum ib txwm muaj, kev noj tshuaj ib zaug yog 0.5-1 g, lub sijhawm nruab nrab ntawm kev tswj hwm yog 12 teev. Rau kev kis mob hnyav, nws tau txhaj tshuaj rau 2 koob tshuaj txhua 12 teev.

Txhawm rau tiv thaiv kev kis mob thaum phais plab, lawv siv nrog metronidazole raws li tus qauv.

Rau cov menyuam muaj hnub nyoog 2 hlis, koob tshuaj ntau tshaj plaws yuav tsum tsis pub tshaj qhov koob tshuaj pom zoo rau cov neeg laus. Qhov nruab nrab cov koob tshuaj rau cov menyuam yaus hnyav txog 40 kg nrog qhov nyuaj lossis tsis mob tso zis mob (nrog rau pyelonephritis), kev kis tsis yooj yim ntawm daim tawv nqaij thiab cov nqaij mos, mob ntsws, thiab kev kho mob rau tus mob neutropenic yog 50 mg / kg txhua 12 teev.

Cov neeg mob uas mob neutropenic ua npaws thiab mob rau daim npluag paj hlwb - 50 mg / kg txhua 8 teev.

Qhov nruab nrab ntawm kev kho mob yog 7-10 hnub. Yog mob hnyav, yuav tau kho ntev dua.

Yog tias tsis pom lub raum kev ua haujlwm (CC tsawg dua 30 ml / min), kev kho ntawm cov tshuaj ntau dua yog tsim nyog. Thawj qhov tshuaj noj ntawm cefepime yuav tsum yog tib yam li rau cov neeg mob uas lub raum ua haujlwm. Cov koob tshuaj txij nkawm yog txiav txim siab nyob ntawm qhov muaj nuj nqis ntawm QC lossis ntshav dej creatinine concentration.

Nrog hemodialysis hauv 3 teev, kwv yees 68% ntawm tag nrho cov nyiaj ntawm cefepime tawm ntawm lub cev. Thaum kawg ntawm txhua ntu, nws yog qhov yuav tsum tau qhia qhov rov qab ua kom zoo li qhov sib npaug nrog thawj zaug. Hauv cov neeg mob uas tau tso tshuaj ntxiv mus rau kev tso tshuaj tua kab mob peritoneal lim ntshav, noj zaub mov noj tuaj yeem siv rau hauv nruab nrab cov koob tshuaj pom zoo, i.e. 500 mg, 1 g lossis 2 g, nyob ntawm qhov mob hnyav ntawm tus kab mob, nrog lub sijhawm nruab nrab ntawm kev tswj hwm ntawm ib zaug ntawm 48 teev

Rau cov menyuam yaus uas lub raum tsis zoo, kev hloov pauv hauv cov tshuaj ntau npaum li cas yog pom zoo rau cov neeg laus, vim tias pharmacokinetics ntawm cefepime hauv cov laus thiab cov menyuam yaus zoo sib xws.

Sab sij huam

raws plab, cem quav,
xeev siab, ntuav,
mob plab (nrog rau pseudomembranous colitis),
mob plab
saj hloov
ua pob
khaus
urticaria
tshuaj tiv thaiv anaphylactic,
mob taub hau
kiv taub hau
paresthesia
cramps
daim tawv nqaij liab
anemia
nce kev ua haujlwm ntawm ALT, AST, phosphatase alkaline,
nce nyob rau hauv tag nrho bilirubin,
eosinophilia, mob qa nrawm, mob hloov pauv sai sai thiab neutropenia,
nce nyob rau hauv lub sij hawm prothrombin,
kev kuaj Coombs tsis muaj hemolysis,
npaws
vaginitis
erythema
qhov chaw mos khaus
tsis hais txog tus mob candidiasis,
phlebitis (nrog kev tswj hwm ntshav),
nrog kev tso tshuaj intramuscular, mob lossis mob ntawm qhov chaw txhaj tshuaj yog ua tau.

Cov Yuav Tsum Muaj

muaj qhov tsis haum rau cefepime lossis L-arginine, ntxiv rau cov tshuaj tua kab mob cephalosporin, tshuaj penicillins lossis lwm yam tshuaj tua kab mob beta-lactam.

Cev xeeb tub thiab lactation

Kev tshawb nrhiav qhov muaj txiaj ntsig thiab kev tswj hwm ntawm kev nyab xeeb ntawm zaub mov noj thaum cev xeeb tub tsis tau nqa tawm, kev siv yog ua tau tsuas yog nyob ntawm kev saib xyuas ntawm kws kho mob.

Cepepime raug nthuav tawm hauv niam cov kua mis nyob rau hauv qhov ntau heev. Thaum lub sijhawm lactation, siv nrog ceev faj.

Hauv kev sim tshuaj, tsis muaj dab tsi cuam tshuam rau kev ua me nyuam thiab kev muaj txiaj ntsig ntawm cefepime tau tshwm sim.

Siv rau menyuam yaus

Muaj kev nyab xeeb thiab ua tau ntawm zaub mov noj rau cov menyuam yaus uas muaj hnub nyoog 2 hlis tsis tau tsim. Rau cov menyuam yaus hnub nyoog ntau dua 2 hlis (suav nrog cov menyuam mos), siv tau raws li cov kev noj ntau dua. Rau cov menyuam yaus uas lub raum tsis zoo, kev hloov pauv hauv cov tshuaj ntau npaum li cas yog pom zoo rau cov neeg laus, vim tias pharmacokinetics ntawm cefepime hauv cov laus thiab cov menyuam yaus zoo sib xws.

Cov lus qhia tshwj xeeb

Thaum siv nyob rau hauv cov neeg mob muaj kev pheej hmoo kis tus kab mob vim muaj kev sib xyaw nrog aerobic / anaerobic microflora (suav nrog rau qee kis uas Bacteroides fragilis yog ib qho ntawm cov pathogens), nws raug nquahu kom muab tshuaj uas ua tawm tsam Cefepim ib txhij nrog cov kab mob. anaerobes.

Siv nrog ceev faj hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev fab tshuaj, tshwj xeeb yog rau cov tshuaj.

Nrog rau kev txhim kho kev ua xua, kev ua noj ua haus yuav tsum tau tsum txuas mus ntxiv.

Yog muaj qhov tshwm sim tam sim ntawd rau kev hloov pauv sai, epinephrine (adrenaline) thiab lwm yam kev pab txhawb nqa yuav tsum tau ua.

Thaum mob raws plab thaum lub sijhawm kho, qhov ua tau kom muaj tus kabmob pseudomembranous mob plab. Nyob rau hauv cov xwm txheej zoo li no, zaub mov cij yuav tsum tau thim tawm tam sim ntawd thiab kev kho mob tsim nyog yuav tsum tau sau tseg yog tias tsim nyog.

Nrog kev txhim kho superinfection, Cefepim yuav tsum tau tso tseg tam sim ntawd thiab kev kho mob tsim nyog.

Thaum siv lwm cov tshuaj tua kab mob ntawm cov pab pawg cephalosporin, urticaria, Stevens-Johnson syndrome, erythema multiforme, cov tshuaj lom mob hauv lub cev, mob plab, ua rau lub raum tsis ua haujlwm, mob nephropathy, ntshav tsis txaus, ntshav tsis txaus ntshav, ua kom mob, ua kom tsis txaus, ua rau lub siab ua haujlwm tsis zoo, suav nrog cholestasis, cov txiaj ntsig tsis zoo tau raug soj ntsuam. piam thaj.

Nrog rau kev saib xyuas tshwj xeeb, zaub mov noj siv ua ke nrog aminoglycosides thiab "voj" diuretics.

Yeeb tshuaj sib cuam tshuam

Nrog rau kev coj ua ke ntawm kev daws teeb meem zoo nrog cov kev daws teeb meem ntawm metronidazole, vancomycin, gentamicin, tobramycin sulfate thiab netilmicin sulfate, kev sib txuam tshuaj yog tau.

Analogues ntawm cov tshuaj Cefepim

Cov qauv ntawm cov qauv ua haujlwm: