Yuav siv cov Rotomox li cas?

Yuav siv peb cov lus qhia ntawm lub xaib li cas rau cov ntsiav tshuaj thiab lwm yam tshuaj OnlineManuals.ru
Peb lub hom phiaj yog los muab kev pabcuam rau koj kom sai rau cov ntsiab lus ntawm cov lus qhia rau cov tshuaj Rotomox. Nrog kev pab ntawm saib online, koj tuaj yeem saib sai sai cov ncauj lus ntawm cov lus qhia rau cov tshuaj Rotomox.

Kom koj nyob tau yooj yim
Yog tias koj xau tawm los ntawm cov lus qhia rau kev siv rau cov tshuaj Rotomox ncaj qha rau ntawm qhov chaw, nws tsis yooj yim rau koj, nws muaj ob txoj hauv kev daws tau:

• Saib nyob rau hauv hom puv npo - nws yooj yim los saib cov lus qhia rau kev siv (tsis tas rub tawm rau koj lub computer), koj tuaj yeem siv hom puv npo saib. Txhawm rau saib cov lus qhia "rau Rotomox hauv puv npo, siv lub pob" Qhib hauv Pdf-saib "khawm.
• Rub mus rau lub koos pis tawj - Koj tseem tuaj yeem rub tawm cov lus qhia rau kev npaj Rotomox hauv koj lub computer thiab khaws cia hauv cov ntawv.

Coob tus neeg nyiam nyeem cov ntaub ntawv tsis nyob ntawm kev tshuaj ntsuam, tab sis hauv kev luam ntawv. Muaj peev xwm luam tawm cov lus qhia rau cov tshuaj thiab cov ntsiav tshuaj kuj tau muab rau hauv peb lub vev xaib, thiab koj tuaj yeem siv nws los ntawm nias rau "luam" icon hauv Pdf-saib. Tsis tas yuav luam tawm tag nrho cov lus qhia rau kev npaj Rotomox, koj tuaj yeem xaiv xwb cov nplooj ntawv tsim nyog ntawm kev qhia rau kev siv cov tshuaj lossis cov ntsiav tshuaj tshwj xeeb.

Cov lus qhia rau kev siv tshuaj Rotomox tuaj yeem rub tawm hauv qab no:

Pharmacological pawg

Raws li cov kws kho mob lub rooj xav (2009), moxifloxacin yog qhia rau kev kho mob kis mob los ntawm kev kis tus kab mob ntawm cov kab mob me me hauv cov neeg laus (laus dua 18 xyoos).

Mob ntsws mob hlwbtshwm sim los ntawm Kab mob ntsws Streptococcus mob ntsws, Haemophilus influenzae lossis Moraxella catarrhalis.

Exacerbation kev mob ntsws ntev uas cuam tshuam nrog ib tus mob(Cov kab mob hu ua Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, methicillin-rhiab Dab Tsi Staphylococcus aureus lossis Moraxella catarrhalis).

Kev mob ntsws los ntawm zej zogtshwm sim los ntawm Kab mob ntsws dej liab (suav nrog tshwm sim los ntawm cov kab mob tshwm sim ntawm cov kab mob nrog ntau yam tshuaj tiv thaiv kab mob *), Haemophilus khaub thuas, Moraxella catarrhalis, methicillin-rhiab Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma mob ntsws lossis Chlamydia mob ntsws dej.

Kev tsis yooj yim kis cov kab mob ntawm daim tawv nqaij thiab nws txoj kev txuas ntxivtshwm sim los ntawm methicillin-rhiab Dab Tsi Staphylococcus aureus lossis Cov kab mob Streptococcus pyogenes.

Raug Mob Los Ntawm Kev Mob Kab Mob Intraabdominalsuav nrog kev kis mob polymicrobial xws li kev ua kom tshwm sim los ntawm Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Cov kab mob Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron lossis Peptostreptococcus spp.

Nyuaj sib kis cov kab mob ntawm daim tawv nqaij thiab nws cov appendagestshwm sim los ntawm methicillin-rhiab Dab Tsi Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae lossis Cov kab mob qa qws.

* - hom kab mob sib kis nrog ntau yam tshuaj tiv thaiv kab mob (Ntau hom tshuaj tiv thaiv Kab mob ntsws dej liab - MDRSP), nrog rau cov kab uas yav dhau los hu ua PRSP (Penicillin-resistant S. txhaws txhaws ntswg) thiab cov kab mob uas tiv taus ob lossis ntau dua ntawm cov tshuaj tiv thaiv hauv qab no: penicillin (nrog MPC ≥2 μg / ml), cephalosporins thib ob (xws li cefuroxime), macrolides, tetracyclines thiab trimethoprim / sulfamethoxazole.

Cev xeeb tub thiab lactation

Siv thaum cev xeeb tub yog ua tau yog tias qhov xav pom ntawm kev kho mob ntau dua qhov kev pheej hmoo rau tus me nyuam hauv plab (kev tshawb fawb txaus thiab nruj txog kev nyab xeeb ntawm kev siv hauv cov poj niam cev xeeb tub tsis tau ua).

Teratogenic cuam tshuam. Moxifloxacin tsis muaj teebmeem teratogenic thaum muab rau cov menyuam cev xeeb tub thaum lub sijhawm organogenesis ntawm koob tshuaj ntau dua 500 mg / kg / hnub, uas tau sib piv kwv yees li 0.24 MPDs (raws li AUC qhov tseem ceeb), tab sis muaj kev poob qis hauv lub cev hauv lub cev thiab cov qeeb me ntsis hauv cov pob txha tsim, qhia txog fetotoxicity.

Thaum siv tshuaj rau cev xeeb tub nrog moxifloxacin ntawm koob tshuaj 80 mg / kg / hnub (kwv yees 2 zaug siab dua MPD, xam rau lub cev nqaij (mg / m 2), tshuaj lom tau pom rau cov poj niam thiab cov ntxim nyiam ntawm tus me nyuam hauv plab, hnyav thiab pom ntawm lub cev. Nrog rau kev txhaj tshuaj rau saum toj no 80 mg / kg / hnub, tsis pom muaj teebmeem teratogenic. IV coj mus rau luav lub sijhawm cev xeeb tub thaum lub sijhawm ntawm organogenesis li ntawm 20 mg / kg / hnub (kwv yees li zoo li MPD thaum noj ntawm qhov ncauj) ua rau muaj qhov txo qis hauv lub cev menyuam hauv lub cev qhov hnyav. thiab cov cim ossification ntawm lub cev pob txha Tsis muaj qhov ua tuag, nchuav menyuam, qhov tsawg ntawm cov zaub mov noj, qhov dej tsawg dua, thiab qhov ua kom siab ntsws ntawm cov koob tshuaj no tsis muaj qhov ncauj pov thawj ntawm teratogenicity hauv Cynomolgus liab ntawm ib koob ntawm 100 mg / kg / hnub (2.5 MRDI). nce ntxiv ntawm koob tshuaj 100 mg / kg / hnub. Hauv nas, nws tau pom tias nrog qhov ncauj ntawm 500 mg / kg / hnub, cov kev mob tshwm sim hauv qab no: qhov nce me ntsis hauv lub sijhawm nws cev xeeb tub, poob ua ntej, txo qhov hnyav hauv cov menyuam mos. s hluas, tsis neonatal ciaj sia taus. Qhov ua kom mob lom moxifloxacin ntawm lub tsev menyuam yog tshwm sim thaum koob 500 mg / kg / hnub tau muab rau cov nas thaum xeeb menyuam.

FDA qeb ntawm kev txiav txim ntawm tus me nyuam - C.

Moxifloxacin ua tawm hauv niam cov kua mis ntawm cov nas tsuag. Txij li moxifloxacin tuaj yeem nkag mus rau lub mis niam ntawm cov poj niam muaj menyuam mos thiab ua rau muaj kev phiv tshuaj ntau ntxiv hauv cov menyuam yaus noj niam mis, cov poj niam tu menyuam yuav tsum tso tseg tsis pub mis lossis siv moxifloxacin (muab qhov tseem ceeb ntawm cov tshuaj rau leej niam).

Sab sij huam

Thaum lub sijhawm kev kuaj mob koom nrog ntau dua 9,200 cov neeg mob uas tau txais moxifloxacin ntawm qhov ncauj thiab iv (ntau tshaj 8600 tus neeg mob tau txais nws ntawm 400 mg), feem ntau cov kev mob tshwm sim tau hais tias mob sib khuav thiab tsis mob thiab tsis tas siv tshuaj kho. Kev kho mob tsis tu ncua vim tshwm sim tshwm sim ntawm cov kev mob tshwm sim los ntawm cov tshuaj hauv 2.9% ntawm cov neeg mob thaum noj ntawm qhov ncauj thiab 6.3% ntawm cov neeg mob uas tau txais nws tom qab (iv thiab ntawm qhov ncauj).

Cov kev mob tshwm sim hauv qab no tau muab los txiav txim siab yam tsawg kawg yog tshuaj sib cuam tshuam thiab tau soj ntsuam hauv ≥2% ntawm cov neeg mob: xeev siab (6%), raws plab (5%), kiv taub hau (2%).

Clinically cov kev mob tshwm sim uas tau txheeb xyuas tsawg kawg yog qhov cuam tshuam txog kev noj tshuaj thiab pom hauv QT, leukopenia, txo qis prothrombin (nce prothrombin lub sijhawm / nce INR), eosinophilia, thrombocythemia, ECG, tawg, hypotension, peripheral edema, nce prothrombin (txo qis hauv prothrombin sijhawm / txo INR), thrombocytopenia, supraventricular tachycardia, txo qis hauv thromboplastin, ventricular tachycardia.

Los ntawm cov hnyuv: ≥0.1% suav nrog mob hauv siab, nraub qaum, ceg, mob pelvic mob, mob hawb pob, tawm pob ntsej muag, hyperglycemia, hyperlipidemia, kub siab, hypesthesia, photosensitivity / phototoxicity tshua, syncope, tenopathy.

Hauv tom qab ua kev tshawb fawb Cov kev mob tshwm sim hauv qab no tau tshaj tawm: anaphylactic tshua, angioedema (suav nrog rau lub laryngeal edema), mob siab (tsis hais txog kev tuag taus), mob siab (feem ntau cholestatic), photosensitivity / phototoxicity tshua, kev xav tshwm sim ntawm lub hlwb, Stevens-Johnson syndrome, pob txha caj qaum, mob ua paug rau lub cev thiab ventricular tachyarrhythmia (suav nrog feem ntau tsis tshua muaj neeg mob plawv thiab torsade de pointes feem ntau hauv cov neeg mob nrog concomitant loj proarrhythmic cov tsos mob).

Kev tiv thaiv kev nyab xeeb

Tawm tsam keeb kwm ntawm moxifloxacin, kev nce QT ntau ntxiv, yog li ntawd, nws yuav tsum tau siv nrog ceev faj hauv cov neeg mob tau txais lwm yam tshuaj nyob rau tib lub sijhawm uas tseem txuas ntxiv QT interval (cisapride, erythromycin, antipsychotics, tricyclic antidepressants), vim tias additive nyhuv tsis tuaj yeem raug txiav tawm.

Nrog kev ceev faj, lawv tau sau tseg tawm tsam keeb kwm ntawm cov tshuaj tiv thaiv antiarrhythmic ntawm chav kawm IA (quinidine, procainamide) lossis qeb III (amiodarone, sotalol).

Vim tias cov ntaub ntawv kho mob tsawg tsawg ntawm kev siv moxifloxacin hauv cov neeg mob uas muaj cov kab mob tseem ceeb hauv bradycardia thiab nrog cov tsos mob ntawm myocardial ischemia, nws yuav tsum siv nrog ceev faj hauv cov neeg mob no. Qhov ntsuas ntawm lub caij nyoog ntev ntawm QT luv tuaj yeem nce nrog kev nce siab ntawm cov tshuaj thiab qhov nce ntawm cov nqi infusion nrog iv kev tswj hwm, yog li ntawd, cov koob tshuaj pom zoo thiab lub sijhawm ntawm kev tswj hwm tshuaj yuav tsum tsis pub dhau. Ib qho kev nce ntxiv hauv QT cuam tshuam tuaj yeem ua rau muaj kev pheej hmoo siab ntawm ventricular arrhythmias, suav nrog torsade de pointes. Tsis muaj ib tus neeg mob morbidity lossis kev tuag ua rau muaj sijhawm ntev ntawm QT ntu hauv cov chaw kho mob tau soj ntsuam nrog kev siv moxifloxacin ntau dua 9,200 tus neeg mob (suav nrog 223 cov neeg mob hypokalemia thaum pib kho), thiab tsis muaj kev nce hauv lub neej ntawm 18 txhiab tus neeg mob noj moxifloxacin sab hauv, nyob rau lub sijhawm ntawm kev tshawb fawb tom qab muag yam tsis muaj ECG tswj.

Kev siv ntawm quinolones cuam tshuam nrog kev pheej hmoo ntawm kev tsim kev qaug dab peg, nrog rau lwm qhov kev cuam tshuam ntawm lub hauv nruab nrab cov hlab ntsha (kiv taub hau, tsis meej pem, tshee tshee, hnov ​​qab, nyuaj siab, thiab tsis tshua muaj, xav tua tus kheej lossis ua haujlwm). Cov kev tsis haum no tuaj yeem pom tom qab txhaj thawj koob tshuaj. Thaum muaj qhov tshwm sim zoo li no, moxifloxacin yuav tsum tsis ua mus ntxiv. Zoo li lwm yam quinolones, moxifloxacin yuav tsum siv nrog ceev faj thaum muaj mob los yog kev xoom xaim ntawm cov kab mob hlab ntsha hauv lub cev (suav nrog rau cov hlab ntsha tsis ua haujlwm, mob vwm) lossis nyob rau ntawm lwm yam cuam tshuam txog kev qaug dab peg lossis txo qis ntawm kev qaug dab peg.

Cov kab mob ntawm kev loj hlob ntawm kev tsis haum tshuaj loj thaum noj tshuaj hauv cov neeg mob noj quinolones, suav nrog moxifloxacin, tau tshaj tawm. Muaj qee kis, cov tshuaj tiv thaiv no tau nrog mob plawv voos, tsis nco qab, tsaus muag, o ntawm caj pas lossis ntsej muag, mob qa, urticaria, thiab khaus. Thaum muaj kev phiv tshuaj tiv thaiv, yuav tsum tau ua haujlwm ntawm epinephrine sai. Yog tias daim tawv nqaij sawv pob los yog lwm cov cim ntawm kev tsis haum lub zog tshwm sim, kev kho moxifloxacin yuav tsum tsis ua ntxiv thiab kev kho kom rov zoo tsim nyog (yog tias tsim nyog).

Nws yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv qhov kev muaj peev xwm ntawm kev tsim muaj mob pseudomembranous colitis, yog tias mob raws plab hauv cov neeg mob tau txais cov tshuaj tua kab mob. Kev kho mob nrog cov tshuaj tua kab mob ua rau muaj kev hloov kho ntawm cov tsiaj ib txwm ntawm cov hnyuv loj thiab tuaj yeem ua rau muaj kev nce ntxiv ntawm clostridia. Thaum kuaj mob ntawm tus mob pseudomembranous mob plab, tsim nyog kho txoj kev kho kom zoo.

Thaum kho nrog fluoroquinolones, suav nrog moxifloxacin, kev txhim kho ntawm txoj leeg mob thiab txoj hlab hlwb (Achilles thiab lwm tus) muaj peev xwm ua tau. Kev soj ntsuam tom qab tshaj tawm tau tshaj tawm tias muaj kev pheej hmoo ntau hauv cov neeg mob tau txais corticosteroids ib txhij, tshwj xeeb tshaj yog cov neeg laus dua 60 xyoo. Yog li no, thaum mob, mob los yog mob rwj ntawm cov leeg ntshav tshwm sim, kev tswj hwm ntawm moxifloxacin yuav tsum tsis ua mus ntxiv. Nws yuav tsum tau yug los rau hauv lub siab tias kev mob caj dab tuaj yeem tshwm sim thaum lossis tom qab kev kho mob quinolone (suav nrog moxifloxacin).

Cov lus qhia tshwj xeeb

Ua ntej kev kho mob, kev kuaj mob tsim nyog yuav tsum tau ua kom paub cov kab mob me me uas ua rau muaj tus kab mob thiab ntsuam xyuas rhiab rau moxifloxacin. Moxifloxacin txoj kev kho tuaj yeem pib ua ntej cov txiaj ntsig ntawm cov kev ntsuas no. Thaum cov txiaj ntsig ntawm cov ntawv xeem tau paub, cov kev kho tsim nyog yuav tsum txuas ntxiv.