22 November, 2024
    Kev khomob thiab kev tiv thaiv

    Ciprofloxacin (Ciprofloxacin)

    Ciprofloxacin ntsiav tshuaj yog tshuaj tua kab mob ntawm pab pawg fluoroquinolone. Lawv siv los kho ntau yam kab mob sib kis los ntawm tus kab mob rhiab rau cov tshuaj nquag ntawm cov tshuaj.

    Dosage daim ntawv, muaj pes tsawg leeg

    Ciprofloxacin ntsiav tshuaj yog cov yeeb yaj kiab-xaum nrog cov txheej txheej ntxeem tau. Lawv muaj cov xim dawb thiab lub ntsej muag du. Cov tshuaj tiv thaiv tseem ceeb ntawm cov tshuaj yog ciprofloxacin. Nws cov ntsiab lus hauv ib ntsiav tshuaj yog 250 thiab 500 mg. Tsis tas li, nws muaj pes tsawg leeg suav nrog cov khoom siv sib txuam, uas suav nrog:

    • Colloidal silicon anhydrite.
    • Povidone.
    • Methylene chloride.
    • Microcrystalline cellulose.
    • Magnesium stearate.
    • Isopropyl cawv.
    • Hydroxypropyl methylcellulose.
    • Purified Talc.
    • Sodium hmoov txhuv nplej siab glycolate.

    Cov tshuaj Ciprofloxacin yog ntim rau hauv cov hlwv blooj ntawm 10 daim. Ib pob ntawv cardboard muaj 1 lub hlwv nrog ntsiav tshuaj, thiab cov lus qhia rau kev siv.

    Kho nyhuv

    Cov kev ua haujlwm tseem ceeb ntawm cov ntsiav tshuaj ciprofloxacin belongs rau cov tshuaj tua kabmob ntawm pawg fluoroquinolone. Nws muaj cov kab mob bactericidal, ua rau muaj kev tuag ntawm cov kab mob rhiab. Qhov kev txiav txim no tau pom zoo los ntawm kev thim tawm catalytic kev ua haujlwm ntawm cov kab mob cell enzyme DNA gyrase. Qhov no ua rau muaj kev cuam tshuam ntawm kev rov ua dua (ob npaug) ntawm DNA thiab kev tuag ntawm cov kab mob ntawm tes. Cov tshuaj muaj cov dej num txaus tiv thaiv kev cais (faib) thiab ua haujlwm tsis muaj kab mob hauv lub cev. Nws muaj cov kab mob bactericidal tawm tsam ntau tus lej-zoo (staphylococci, streptococci) thiab gram-negative (E. coli, Pseudomonas aeruginosa, Proteus, Klebsiella, Yersinia, Salmonella, Shigella, Gonococcus) cov kab mob. Tsis tas li, cov tshuaj no ua rau muaj kev tuag ntawm cov kab mob tshwj xeeb uas muaj tus kabmob intracellular (Mycobacterium tuberculosis, Legionella, Mycoplasma, Ureaplasma, Chlamydia). Cov kev ua ntawm Ciprofloxacin ntsiav tshuaj tawm tsam daj ntseg treponema (tus neeg sawv cev ntawm tus mob syphilis) tseem tsis to taub.

    Tom qab noj cov ntsiav tshuaj ciprofloxacin sab hauv, cov tshuaj tiv thaiv kom nquag plias zoo rau hauv cov kab ke hauv qhov system thiab tau muab faib rau hauv cov ntaub so ntswg, qhov uas nws muaj qhov ua kom zoo.

    Ciprofloxacin ntsiav tshuaj tau qhia rau kev kho mob etiotropic (kev kho mob txhawm rau tua tus neeg kis tus kab mob) ntawm ntau yam mob tshwm sim los ntawm cov kab mob nkag rau cov tshuaj nquag:

    • Kev swb ntawm lub siab, qis dua ntawm cov pa me me.
    • Cov kab mob o ua haujlwm ntawm cov kabmob ENT.
    • Kev kis mob ntawm kev teeb tsa ntawm lub tso zis thiab lub raum.
    • Kab mob tshwj xeeb thiab tsis tseem ceeb ntawm qhov chaw mos.
    • Kev ua tiav ntawm cov txheej txheem hauv plab, suav nrog cov hniav thiab lub puab tsaig.
    • Cov txheej txheem ua haujlwm hauv cheeb tsam hauv lub plab thiab lwm yam khoom siv hollow ntawm cov txheej txheem hepatobiliary.
    • Kev kis mob thiab purulent-inflammatory txheej txheem ntawm daim tawv nqaij, subcutaneous cov ntaub so ntswg thiab cov nqaij mos ntawm ntau thaj chaw.
    • Purulent-inflammatory txheej txheem ntawm cov kev teeb tsa ntawm cov leeg hlwb pob txha, suav nrog osteomyelitis.
    • Sepsis (kab mob hauv cov ntshav puas tsuaj) thiab mob peritonitis (cov txheej txheem ua mob peritoneum).

    Cov tshuaj tseem siv los tiv thaiv kev sib kis hauv cov neeg mob uas txo qis kev ua haujlwm ntawm lub cev tsis muaj zog.

    Cov Yuav Tsum Muaj

    Ciprofloxacin ntsiav tshuaj yog contraindicated thaum cev xeeb tub nyob rau txhua ntu ntawm chav kawm, thaum pub niam mis (lactation), hauv cov menyuam yaus hnub nyoog qis dua 18 xyoo, zoo li muaj xwm txheej tsis haum rau ciprofloxacin lossis lwm tus neeg sawv cev ntawm pab pawg fluoroquinolone. Ua ntej sau ntawv rau cov ntsiav tshuaj ciprofloxacin, tus kws kho mob nco ntsoov tias tsis muaj kev tiv thaiv dab tsi.

    Ciprofloxacin ntsiav tshuaj yog npaj rau kev tswj hwm ntawm qhov ncauj ntawm lub plab tas. Lawv nqos tag nrho, tsis yog zom thiab ntxhua kom nrog cov dej txaus. Qhov ntau npaum li cas thiab qhov ntau npaum li cas yog nyob ntawm qhov thiab mob hnyav ntawm cov txheej txheem tus kab mob. Hauv qhov tsis yooj yim ntawm cov txheej txheem sib kis, ciprofloxacin ntsiav tshuaj feem ntau yog siv nyob rau ntau npaum ntawm 250 mg 2 zaug hauv ib hnub. Hauv kev nyuaj lossis nyuaj chav kawm, nrog rau kev puas tsuaj rau cov pob txha, caj ces - 500 mg 2 zaug hauv ib hnub. Rau cov neeg laus laus, nrog rau kev tiv thaiv tom qab ntawm cov lus tshaj tawm hais tias txo qis hauv kev ua haujlwm ntawm lub raum, daim siab ua rau txo qis. Qhov nruab nrab ntawm cov sij hawm ntawm qhov kev kho mob yog 7-10 hnub, nrog mob qhov hnyav ntawm cov txheej txheem sib kis, nws tuaj yeem nce ntxiv. Feem ntau, tus kws kho mob teev cov txheej txheem ntawm kev thov, kev noj thiab lub sijhawm ntawm txoj kev kho nrog rau txhua tus neeg mob.

    Sab sij huam

    Tawm tsam keeb kwm yav dhau los ntawm kev noj cov tshuaj ciprofloxacin, kev txhim kho ntawm cov kev mob tshwm sim tsis zoo los ntawm ntau yam plab hnyuv siab raum thiab cov kab ke muaj peev xwm ua tau:

    • Lub plab zom mov - xeev siab, nrog rau ntuav ntuav, raws plab, mob plab, mob plab pseudomembranous mob plab.
    • Lub cev tsis muaj zog - mob taub hau, tsis meej pem uas txawv txav txawv, mloog zoo li nkees, ntau yam pw tsaug zog, cov tsos ntawm tus npau suav phem, tsaus muag, pom kev tsis meej, hnov ​​lus lossis pom tau qhov tseeb.
    • Kab mob hlab plawv - nce lub plawv dhia (tachycardia) nrog lub suab lus tsis sib xws (tsis tuaj yeem), muaj cov kab mob hauv cov ntshav tsawg dua (arterial hypotension).
    • Cov kab mob hauv lub cev - ua txhaum ntawm lub tso zis (dysuria, tso zis cia), cov tsos ntawm tus neeg mob (crystalluria), ntshav (hematuria) thiab protein (albuminuria) hauv cov zis, cov txheej txheem mob hauv lub raum (glomerulonephritis, interstitial nephritis).
    • Cov ntshav thiab cov pob txha pob txha liab - txo qis ntawm cov leukocytes (leukopenia), platelets (thrombocytopenia), neutrophils (neutropenia) hauv cov ntshav, nce ntxiv ntawm eosinophils (eosinophilia).
    • Musculoskeletal system - kev sib koom ua ke mob (mob pob qij txha), txo lub zog ntawm cov leeg thiab cov leeg ntawm cov qauv ntawm cov leeg mus ntawm lub cev, nrog los ntawm cov txheej txheem mob tshwm sim thiab pathological ruptures.
    • Kuaj qhov ntsuas - kev nce siab ntawm kev tsim lub zog ntawm creatinine, urea hauv cov ntshav, nce ntxiv hauv kev ua haujlwm ntawm daim siab transaminase enzymes (ALT, AST).
    • Cov tawv nqaij thiab nws qhov tshwm sim - kev txhim kho ntawm qhov kev ua kom zoo dua qub (nce tawv tawv kom zoo rau cov teeb).
    • Kev tsis haum tshuaj - ua pob tawv nqaij ua pob khaus, ua pob khaus, muaj tus yam ntxwv hloov pauv zoo li kub nyhiab (urticaria), qhov mob hnyav ntawm cov nqaij mos ntawm lub ntsej muag thiab sab cev nqaij daim tawv (angioedema, Quincke's edema), cov tawv nqaij necrotic (qhov tawv nqaij (Stevens-Johnson, Lyell syndrome).

    Yog tias cov cim ntawm kev txhim kho ntawm qhov tshwm sim tsis zoo pathological tshwm sim thaum noj Ciprofloxacin ntsiav tshuaj, koj yuav tsum hu rau tus kws kho mob tshwj xeeb.

    Kws Tshuaj

    Nws inhibits cov kab mob DNA gyrase (topoisomerases II thiab IV, lub luag haujlwm ntawm cov txheej txheem ntawm supercoiling ntawm chromosomal DNA nyob ib ncig ntawm nuclear RNA, uas tsim nyog rau kev nyeem cov ntaub ntawv keeb kwm), cuam tshuam DNA synthesis, kev loj hlob thiab faib cov kab mob, ua rau muaj kev hloov pauv morphological (suav nrog cov xovtooj ntawm tes thiab daim nyias nyias) thiab kev tuag sai sai ntawm ib tus kab mob cell.

    Nws ua cov kab mob ntawm cov kab mob gram-tsis zoo nyob rau lub sij hawm dormancy thiab faib (txij li nws cuam tshuam tsis tsuas DNA gyrase, tab sis kuj ua rau lub cell phab ntsa lysis), thiab ua rau cov kab mob gram-zoo tsuas yog thaum faib lub sijhawm.

    Tsis tshua muaj tshuaj lom rau macroorganism hlwb tau piav qhia los ntawm qhov tsis muaj DNA gyrase hauv lawv. Tawm tsam keeb kwm ntawm ciprofloxacin, tsis muaj txoj kev loj hlob ntawm cov tshuaj tiv thaiv kab mob uas tsis muaj feem nrog cov tshuaj tiv thaiv DNA gyrase inhibitors, uas ua rau nws ua tau zoo tiv thaiv cov kab mob uas tiv taus, piv txwv li, rau aminoglycosides, penicillins, cephalosporins, tetracyclines.

    Kev Tawm Tsam hauv vitro rau ciprofloxacin feem ntau tshwm sim los ntawm kev sib kis ntawm cov kab mob topoisomerases thiab DNA gyrase thiab kev loj hlob maj mam dhau los ntawm kev hloov pauv ntawm cov lus sib txawv.

    Kev hloov pauv ib leeg tuaj yeem ua rau txo qis rhiab ntau dua li kev tsim kho cov kev tiv thaiv kev kho mob, txawm li cas los xij, ntau qhov kev sib hloov tseem ceeb ua rau kev txhim kho cov chaw kuaj mob tiv thaiv ciprofloxacin thiab cross-resistance rau cov tshuaj quinolone.

    Cov tshuaj tiv thaiv ciprofloxacin, ntxiv rau ntau lwm cov tshuaj tua kab mob tiv thaiv kab mob, tuaj yeem tsim cov txiaj ntsig ntawm qhov txo qis ntawm cov kab mob permeability ntawm cov kab mob ntawm tes phab ntsa (zoo li feem ntau Pseudomonas aeruginosa) thiab / lossis ua kom muaj kev tawm ntawm kev nthuav tawm los ntawm microbial cell (efflux). Kev txhim kho ntawm qhov kev tiv thaiv vim tias muaj coding gene hauv zos ntawm plasmids tau tshaj tawm QnrCov. Cov txheej txheem los tiv thaiv uas ua rau cov tsis muaj zog ntawm penicillins, cephalosporins, aminoglycosides, macrolides, thiab tetracyclines tej zaum tsis cuam tshuam nrog cov tshuaj tua kabmob ntawm ciprofloxacin. Cov kab mob me tiv taus cov tshuaj no tej zaum yuav nkag siab zoo rau ciprofloxacin.

    Kev siv tshuaj tua kab mob tsawg kawg nkaus (MBC) feem ntau tsis tshaj qhov qis tshaj plaws inhibitory concentration (MIC) ntau dua 2 zaug.

    Hauv qab no yog qhov rov qab ua dua tshiab rau kev sim tshuaj rhiab rau ciprofloxacin, pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Nyab Xeeb Kev Txiav Txim Siab rau Cov Tshuaj Tiv Thaiv Kab Mob (Eucast) MIC cov ciam tseem ceeb (mg / l) raug muab nyob rau hauv kev mob kho mob rau ciprofloxacin: thawj daim duab yog rau cov kab mob me me nkag siab ciprofloxacin, qhov thib ob yog rau cov tawv tiv taus.

    - Enterobacteriaceae ≤0,5, >1.

    - Pseudomonas spp. ≤0,5, >1.

    - Acinetobacter spp. ≤1, >1.

    - Staphylococcus 1 spp. ≤1, >1.

    - Kab mob ntsws 2 2.

    - Haemophilus mob npaws thiab Moraxella catarrhalis 3 ≤0,5, >0,5.

    - Neisseria gonorrhoeae thiab Neisseria meningitidis ≤0,03, >0,06.

    - Ciam tus nqi tsis cuam tshuam nrog hom microorganisms 4 ≤0.5,> 1.

    1 Dab Tsi Staphylococcus spp.: Cov ciaj ciam qhov tseem ceeb rau ciprofloxacin thiab ofloxacin cuam tshuam nrog kev kho mob siab.

    2 Kab mob ntsws: hom tsiaj S. txhaws txhaws ntswg Nws tsis suav hais tias yog nkag siab rau ciprofloxacin thiab, yog li ntawd, nyob rau qeb ntawm cov kab mob me me nrog kev paub txog nruab nrab.

    3 Txoj hlab ntsha nrog MIC tus nqi tshaj qhov pib ntawm qhov sib piv qhov tsis haum / nruab nrab yog qhov tsis tshua muaj, thiab kom deb li deb tsis tau muaj xov xwm ntawm lawv. Kev ntsuam xyuas rau kev txheeb xyuas tus kheej thiab cov tshuaj tiv thaiv mob hauv txoj kev kuaj pom ntawm cov neeg thaj yeeb yuav tsum tau rov ua dua, thiab cov txiaj ntsig yuav tsum muaj kev paub tseeb los ntawm kev tshawb xyuas cov pawg nyob hauv cov chaw sim. Txog thaum cov pov thawj ntawm cov lus teb soj ntsuam tau txais rau cov kab mob nrog cov paub tseeb txog MIC qhov tseem ceeb uas dhau qhov ntsuas tsis tau tam sim no, lawv yuav tsum txiav txim siab tiv taus. Haemophilus spp./Moraxella spp.: kev qhia kom paub ntawm cov leeg thiaj li ua tau H. mob khaub thuas nrog kev paub tsis tshua zoo txog fluoroquinolones (MIC rau ciprofloxacin - 0.125-0.5 mg / l). Cov ntaub ntawv pov thawj tshawb nrhiav qhov tseem ceeb ntawm kev muaj peev xwm qis ntawm cov pa tshuaj tiv thaiv kab mob los ntawm H. mob khaub thuastsis muaj.

    4 Ciaj ciam tseem ceeb tsis cuam tshuam nrog hom kab mob sib kis tau txiav txim siab feem ntau raws ntawm pharmacokinetics / pharmacodynamics thiab tsis vam khom kev faib tawm MICs rau qee hom. Lawv siv tau rau hom kab uas ib hom tshwj xeeb rhiab kev cuam tshuam tsis tau txiav txim siab, thiab tsis yog rau hom uas kuaj qhov rhiab tsis pom zoo. Rau qee hom kab mob, kev kis tau ntawm kev tawm tsam kuj yuav txawv raws cheeb tsam chaw thiab dhau sijhawm. Hauv qhov no, nws yog ntshaw kom muaj cov ntaub ntawv tsim nyog ntawm kev tawm tsam, tshwj xeeb hauv kev kho mob ntawm cov mob hnyav.

    Hauv qab no yog cov ntaub ntawv los ntawm lub koom haum ntawm chaw soj ntsuam thiab Kuaj (CLSI), teeb tsa cov qauv tsim tau rov qab rau MIC qhov tseem ceeb (mg / L) thiab kuaj kev tsis txawv txav (thaj tsam thaj, hli) siv cov qauv uas muaj 5 μg ciprofloxacin. Los ntawm cov qauv no, cov kab mob me me tau muab cais ua qhov nkag siab, nruab nrab thiab tiv taus.

    - MIC 1: rhiab - 4.

    - Kev kuaj xyuas qhov tsis zoo 2: rhiab heev -> 21, nruab nrab - 16-20, tiv taus - lwm cov kab mob tsis koom nrog tsev neeg Enterobacteriaceae

    - MIC 1: rhiab - 4.

    - Kev kuaj sib txawv 2: rhiab -> 21, ntu - 16-20, tiv taus - 1: rhiab - 4.

    - Kev kuaj sib txawv 2: rhiab -> 21, ntu - 16-20, tiv taus - 1: rhiab - 4.

    - Kev kuaj sib txawv 2: rhiab -> 21, ntu - 16–20, tiv taus - 3: rhiab - 4: rhiab -> 21, ntu nruab nrab - -, tiv taus - -.

    - MIC 5: nkag siab - 1.

    - Kev kuaj sib txawv 5: rhiab -> 41, ntu nruab nrab - 28–40, tiv taus - 6: rhiab - 0.12.

    - Kev kuaj xyuas qhov tsis zoo 7: rhiab -> 35, nruab nrab - 33–34, tiv taus - 1: rhiab - 3: rhiab - 1 tus qauv reproducible tsuas yog siv rau cov kua sib tov uas siv cationic kho cov Mueller-Hinton si (SAMNV), uas muab ncu nrog huab cua ntawm qhov kub ntawm (35 ± 2) ° C rau 16-20 h rau hom Enterobacteriaceae, Pseudomonas aeruginosalwm cov kab mob tsis koom nrog tsev neeg Enterobacteriaceae, Staphylococcus spp., Enterococcus spp. thiab Bacillus anthracis, 20-24 h rau Acinetobacter spp., 24 h rau Y. pestis (nyob rau hauv rooj plaub ntawm kev loj hlob tsis txaus, ncu rau lwm 24 teev).

    2 Cov txheej txheem reproducible tsuas yog siv rau cov kev ntsuas sib txawv siv cov discs siv Muller-Hinton agar (SAMNV), uas muab ncu nrog huab cua ntawm qhov kub ntawm (35 ± 2) ° C rau 16-18 teev.

    3 Cov txheej txheem reproducible tsuas yog siv mus rau cov kev ntsuas diffusion siv discs los txiav txim siab rhiab rau Haemophilus mob npaws thiab Haemophilus parainfluenzae siv broth ntsuas qhov nruab nrab rau Haemophilus spp. (NTM), uas muab ncu nrog huab cua ntawm qhov kub ntawm (35 ± 2) ° C rau 20-24 teev.

    4 Cov txheej txheem reproducible tsuas yog siv mus rau cov kev ntsuas tsis sib xws siv discs siv ib puag ncig ntsuas NTMuas yog muab tso rau hauv 5% CO2 ntawm qhov kub ntawm (35 ± 2) ° C rau 16-18 teev

    5 Cov txheej txheem reproducible tsuas yog siv rau cov kev sim siab (qhov kev ntsuas sib txawv siv cov discs rau aav thiab agar tov rau MIC) siv gonococcal agar thiab 1% tsim kev loj hlob ntxiv ntawm qhov kub ntawm (36 ± 1) ° C (tsis pub dhau 37 ° C) ntawm 5 % CO2 tsis dhau 20-24 teev

    6 Cov txheej txheem reproducible tsuas yog siv rau kev ntsuas cov tshuaj sib tov uas yog siv cov kev kho kom haum Mueller-Hinton (SAMNV) nrog kev ntxiv 5% yaj ntshav, uas muab pov rau hauv 5% CO2 thaum (35 ± 2) ° C rau 20–24 teev

    7 Cov txheej txheem reproducible tsuas yog siv rau kev sim siv cationic kho Mueller-Hinton si (SAMNV) nrog kev sib ntxiv ntawm qhov tshwj xeeb 2% kev loj hlob ntxiv, uas muab nrog huab cua nyob ntawm (35 ± 2) ° C rau 48 teev.

    Hauv vitro rhiab heev rau ciprofloxacin

    Rau qee hom kab mob, kev kis tau ntawm kev tawm tsam kuj yuav txawv raws cheeb tsam chaw thiab dhau sijhawm. Hauv qhov no, thaum kuaj qhov rhiab ntawm tus mob, nws yog ntshaw kom muaj cov ntaub ntawv muaj feem rau kev tiv thaiv, tshwj xeeb hauv kev kho mob ntawm cov mob hnyav. Yog tias txoj kev tiv thaiv kab mob hauv zos yog qhov zoo li no tias qhov txiaj ntsig ntawm kev siv ciprofloxacin rau tsawg kawg yog ob peb hom kev sib kis muaj kev tsis ntseeg, sab laj nrog tus kws tshaj lij. Hauv vitro Kev ua si ntawm ciprofloxacin tawm tsam rau cov kab mob me me hauv qab no tau pom tias muaj tseeb.

    Aerobic gram-cov kab mob zoo - Bacillus anthracis, Staphylococcus aureus (methicillin-rhiab) Staphylococcus saprophyticus, Streptococcus spp.

    Aerobic gram-tsis zoo kab mob - Aeromonas spp., Moraxella catarrhal yog, Brucella spp., Neisseria meningitidis, Citrobacter koseri, Pasteurella spp., Francisella tularensis, Salmonella spp., Haemophilus ducreyi, Shigella spp., Haemophilus influenzae, Vibo..

    Cov kab mob Anaerobic - Mobiluncus spp.

    Lwm yam kab mob me - Chlamydia trachomatis, Chlamydia mob ntsws, Mycoplasma hominis, Mycoplasma pneumoniae.

    Ib qho txawv ntawm kev nkag siab zoo rau ciprofloxacin tau pom tias muaj cov kab mob hauv qab no: Acinetobacter baumanii, Burkholderia cepacia, Campylobacter spp., Citrobacter freundii, Enterococcus faecalis, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Morganeria ganorogana fungis malis. Pseudomonas fluorescens, Serratia marcescens, Streptococcus pneumoniae, Peptostreptococcus spp., Propionibacterium acnes..

    Nws ntseeg tias ciprofloxacin muaj peev xwm tiv taus ntuj. Dab Tsi Staphylococcus aureus (methicillin-resistant) Stenotrophomonas maltophilia, Actinomyces spp., Enteroccus faecium, Listeria monocytogenes, Mycoplasma genitalium, Ureaplasma urealyticumanaerobic microorganisms (tshwj tsis yog Mobiluncus spp., Peptostreptococus spp., Propionibacterium acnes).

    Xuas. Tom qab kev tswj hwm ntawm 200 mg ntawm ciprofloxacin Tmax yog 60 min, Cmax - 2.1 μg / ml, kev sib txuas lus nrog cov ntshav plasma protein - 20–40%. Nrog rau kev tswj hwm iv, lub chaw muag tshuaj ntawm ciprofloxacin tau tawm nyob rau hauv koob tshuaj ntau npaum li 400 mg.

    Nrog kev tswj hwm iv 2 lossis 3 zaug nyob rau ib hnub, kev txuam nrog ciprofloxacin thiab nws cov metabolites tsis tau pom.

    Tom qab kev tswj hwm ntawm qhov ncauj, ciprofloxacin nrawm nrawm los ntawm lub plab zom mov, feem ntau nyob hauv duodenum thiab jejunum. Nrogmax hauv cov ntshiab yog ua tiav tom qab 1-2 teev thiab thaum noj ntawm 250, 500, 700 thiab 1000 mg ntawm ciprofloxacin 1.2, 2.4, 4.3 thiab 5.4 μg / ml, feem. Bioavailability yog li ntawm 70-80%.

    C qhov tseem ceebmax thiab AUC nce nyob rau hauv kev faib ua feem rau koob tshuaj. Noj mov (tsis suav cov khoom noj mis nyuj) ua rau kom nqus qis, tab sis tsis pauv Cmax thiab bioavailability.

    Tom qab instillation mus rau hauv lub conjunctiva rau 7 hnub, cov concentration ntawm ciprofloxacin nyob rau hauv cov ntshav plasma ranged los ntawm qhov tsis txaus ntseeg ntau yam (Cmax hauv cov ntshav ntshav yog kwv yees li 450 npaug tsawg dua tom qab kev tswj hwm ntawm qhov ncauj ntawm ib koob ntawm 250 mg.

    Kev xa Khoom. Cov tshuaj ua dej caw muaj nyob rau hauv ntshav ntshav feem ntau hauv cov ntawv tsis-ionized. Ciprofloxacin yog faib dawb hauv cov nqaij thiab dej hauv lub cev. Vd hauv lub cev yog 2-3 l / kg.

    Cov concentration hauv cov nqaij yog 2-12 zaug ntau dua hauv ntshav ntshav. Kev kho mob ntau yog ua tiav hauv cov qaub ncaug, tonsils, nplooj siab, lub zais zis, lub plab, lub plab hnyuv, lub plab thiab plab hnyuv plab hnyuv siab (endometrium, txoj hlab qe ntshav thiab lub zes qe menyuam, lub tsev me nyuam), kua seminal, prostate nqaij, lub raum thiab lub plab, mob ntsws, bronchial kev tso pa tawm, mob pob txha, mob nqaij, mob synovial thiab pob qij txha mos, cov leeg peritoneal, tawv nqaij. Nws nkag mus rau hauv cov kua qaub ntshav cerebrospinal hauv ib qho me me, qhov nws cov ntsiab lus hauv qhov tsis muaj mob ntawm daim npluag qhwv yog 6-10% ntawm qhov ntawd nyob hauv cov ntshav ntshav, thiab yog tias mob o nws yog 14-37%. Ciprofloxacin kuj nkag mus rau hauv cov kua hauv lub qhov muag, pleura, peritoneum, lymph, dhau ntawm qhov tsis tso ntshav. Qhov kev nkag siab ntawm ciprofloxacin hauv cov ntshav neutrophils yog 2-7 zaug siab dua hauv cov ntshav ntshav.

    Kev zom zaub mov. Ciprofloxacin yog biotransformed hauv daim siab (15-30%). Plaub ciprofloxacin metabolites nyob rau hauv qis ntau tuaj yeem raug kuaj hauv cov ntshav - diethylcycrofloxacin (M1), sulfociprofloxacin (M2), oxociprofloxacin (M3), formylcycrofloxacin (M4), peb ntawm cov no (M1 - M3) qhia cov dej num hauv vitro muab piv rau cov kev ua haujlwm tsis haum kua qaub. Antibacterial kev ua si hauv vitro cov tshuaj metabolite M4, tam sim no hauv cov khoom me me, muaj ntau dua nrog cov kev ua ntawm norfloxacin.

    Chaw Sau Ntawv. T1/2 yog 3-6 teev, nrog mob raum tsis ua haujlwm - txog 12 teev. Nws raug tso tawm feem ntau los ntawm lub raum los ntawm tubular pom thiab lub tso pa tsis hloov (50-70%) thiab hauv daim ntawv ntawm metabolites (10%), tus so los ntawm kev mob plab. Li ntawm 1% ntawm kev siv tshuaj tau muab tso tawm hauv cov kua tsib. Tom qab kev tswj hwm iv, kev saib xyuas hauv cov zis hauv thawj 2 teev tom qab kev tswj hwm yuav luag 100 feem pua ​​ntau dua hauv cov ntshav ntshav, uas ntau tshaj qhov BMD rau feem ntau cov mob txeeb zig.

    Kev tsim kho lub raum - 3-5 ml / min / kg, tag nrho kev tshem tawm - 8-10 ml / min / kg.

    Hauv kev mob raum tsis ua haujlwm (Cl creatinine> 20 ml / min), kev nthuav tawm los ntawm ob lub raum tsawg, tab sis kev nkag mus hauv lub cev tsis tshwm sim vim yog nce ntxiv hauv ciprofloxacin metabolism thiab ua rau lub plab ua haujlwm rau txoj hnyuv.

    Cov menyuam. Hauv kev kawm rau menyuam yaus, txiaj ntsig ntawm Cmax thiab AUC tau muaj hnub nyoog ywj siab. Qhov nce siab hauv Cmax thiab AUC nrog kev tswj hwm rov qab (nyob rau ib koob ntawm 10 mg / kg 3 zaug hauv ib hnub) tsis tau pom. Hauv 10 cov menyuam yaus uas mob sepsis tsawg dua 1 xyoos, tus nqi ntawm Cmax qhov ntau npaum li cas rau 6.1 mg / l (thaj tsam ntawm 4.6 txog 8.3 mg / l) tom qab kev lis ntshav ntev li 1 teev ntawm kev txhaj tshuaj 10 mg / kg, thiab hauv cov menyuam hnub nyoog 1 txog 5 xyoos - 7.2 mg / l (thaj tsam ntawm 4.7 txog 11.8 mg / l). AUC qhov tseem ceeb hauv cov pawg muaj hnub nyoog txawv yog 17.4 (thaj tsam ntawm 11.8 txog 32 mg · h / l) thiab 16.5 mg · h / l (thaj tsam ntawm 11 txog 23.8 mg · h / l). Cov kev ntseeg no sib haum nrog rau kev tshaj tawm rau cov neeg mob laus siv cov koob tshuaj ciprofloxacin. Raws li cov tshuaj pharmacokinetic tsom rau cov menyuam yaus uas muaj ntau yam kabmob, kev kwv yees kwv yees T1/2 kwv yees li 4-5 teev

    Daim ntawv thov nta

    Ua ntej sau ntawv rau cov ntsiav tshuaj Ciprofloxacin, tus kws kho mob yuav tsum them nyiaj rau ntau qhov tshwj xeeb ntawm kev siv tshuaj, uas tau qhia nyob hauv nqe lus:

    • Nrog rau kev ceev faj, cov tshuaj no yog siv rau hauv cov neeg mob concomitant epilepsy, muaj cov qaug dab peg ntawm ntau lub hauv paus pib, nrog rau tiv thaiv keeb kwm ntawm atherosclerotic txhab ntawm cov hlab ntsha ntawm lub paj hlwb. Tib lub sijhawm, ciprofloxacin ntsiav tshuaj tsuas yog kho rau kev noj qab haus huv xwb.
    • Kev txhim kho ntawm kev mob plab mus ntev lub sij hawm ntawm txoj kev kho nrog cov tshuaj no yog lub hauv paus rau kev tshawb fawb ntxiv kom tsis suav nrog pseudomembranous mob plab. Yog hais tias kev kuaj mob pom tseeb, cov tshuaj tam sim ntawd raug muab tso tseg.
    • Thaum kev mob siab rau cov leeg lossis pob tw mob tshwm sim, cov tshuaj tau raug muab tso tseg, tshwj xeeb tshaj yog nyob rau cov neeg laus laus, uas cuam tshuam nrog qhov kev pheej hmoo siab ntawm pathological tawg.
    • Nws tsis pom zoo kom ua haujlwm hnyav lub cev thaum noj ciprofloxacin ntsiav tshuaj.
    • Nws raug nquahu kom tsis txhob raug ncaj qha rau tshav ntuj ntawm daim tawv nqaij thaum lub sijhawm kawm nrog kev kho mob nrog cov tshuaj no.
    • Thaum noj cov tshuaj Ciprofloxacin, koj yuav tsum haus cov dej kom txaus kom txo tau qhov muaj feem ntawm crystalluria.
    • Tsis suav nrog haus cawv thaum lub sij hawm kho nrog cov tshuaj.
    • Cov kev ua haujlwm tseem ceeb ntawm cov tshuaj ciprofloxacin tuaj yeem cuam tshuam nrog cov tshuaj ntawm lwm pawg pharmacological, yog li yog siv, tus kws kho mob koom yuav tsum ceeb toom txog qhov no.
    • Thaum lub sij hawm kho mob, yuav tsum tau saib xyuas tshwj xeeb thaum ua haujlwm tsis zoo uas yuav tsum tau muaj kev saib xyuas ntau dua thiab muaj kev ceev ceev ntawm kev tiv thaiv kev xav.

    Hauv cov khw muag tshuaj network, ciprofloxacin ntsiav tshuaj yog daim ntawv yuav tshuaj. Lawv txoj kev tswj hwm lawv tus kheej tsis suav nrog tsis muaj tshuaj kho mob uas tsim nyog, vim qhov no yuav ua rau muaj kev phom sij tsis zoo.

    Noj ntau dhau

    Yog tias muaj teeb meem ntau dhau los ntawm kev siv tshuaj kho mob ntawm ciprofloxacin ntsiav tshuaj, xeev siab, ntuav, mob taub hau, kiv taub hau, tsis hnov ​​qab ntawm qhov txawv txav, mob nqaij ntshiv, ua kom pom tseeb. Hauv qhov no, lub plab thiab txoj hnyuv raug ntxuav, kev mob plab hnyuv tau raug xaj, thiab kev kho mob kuj tseem ua tau yog tias tsim nyog, vim tias tsis muaj ib qho tshuaj tua tshwj xeeb rau cov tshuaj no.

    Analogues ntawm cov tshuaj ciprofloxacin

    Zoo sib xws hauv cov muaj pes tsawg leeg thiab kev kho mob rau cov tshuaj ciprofloxacin yog kev npaj ntawm Ecocifol, Ciprobay, Ciprinol, Ciprolet.

    Lub txee lub neej ntawm ciprofloxacin ntsiav tshuaj yog 2 xyoos txij li hnub ntawm kev tsim khoom. Lawv yuav tsum muab cia rau hauv cov khoom ntim uas tsis muaj txheej txheem, hauv qhov chaw tsaus, thiab qhov chaw tsis zoo rau cov menyuam yaus ntawm huab cua sov tsis pub siab tshaj + 25 ° C.

    Tso tawm daim ntawv thiab muaj pes tsawg leeg

    Ciprofloxacin muaj nyob rau hauv cov ntawv hauv qab no:

    • ntsiav tshuaj ntawm 250, 500 lossis 750 mg, zaj duab xis-txheej. Biconvex round ntsiav tshuaj ntawm 250 mg muaj xim saum npoo. 500 mg ntsiav tshuaj zoo li tus ntsiav tshuaj muaj lub plhaub paj yeeb thiab muaj qhov pheej hmoo ntawm ib sab. 750 mg ntsiav tshuaj zoo li tus ntsiav tshuaj muaj lub ntsej muag xiav. Cov tshuaj tuaj yeem ntim rau hauv cov hlwv (10 lossis 20 ntsiav tshuaj) thiab hauv pob ntawv los qhia (1, 2, 3, 4, 5, lossis 10 hlwv hauv ib pob). Tsis tas li, cov tshuaj ciprofloxacin tuaj yeem ntim rau hauv hnab yas (30, 50, 60, 100, lossis 120 daim ib qho), uas tau muab cais rau txhua tus hauv lub thawv yas. Ib qho ntxiv, cov tshuaj muaj nyob hauv ib lub taub ntim polyethylene (10 lossis 20 ntsiav tshuaj), muab tso rau hauv lub thawv ntawv thawv,
    • mloog zoo rau kev daws rau kev lis ntshav 10 mg / ml. Cov xim tsis muaj pob tshab lossis xim daj-ntsuab ua kua yog hliv rau hauv cov iav tsis muaj pob tshab ntawm cov xim tsis muaj iav ntawm 10 ml. Cov tshuaj no tau ntim rau hauv pob ntawv qhwv (5 lub fwj ib),
    • daws rau Txoj kev lis ntshav 2 mg / ml. Lub pob tshab daj daj lossis xim tsis muaj kua yog hliv rau hauv 100 ml yas hwj, uas tau ntim rau hauv cov hnab yas thiab cov thawv ntawv (1 lub hnab rau ib lub thawv),
    • pob ntseg thiab qhov muag poob 0.3%. Cov pob tshab, tsis muaj kob lossis daj kua me ntsis tau muab nchuav rau cov kua dej dawb (5 ml ib), uas tau ntim rau hauv cov thawv ntawv thawv (1 lub raj mis rau ib pob).

    Cov muaj pes tsawg leeg ntawm 1 ntsiav tshuaj suav nrog:

    • cov tshuaj nquag: ciprofloxacin - 250, 500 lossis 750 mg,
    • kev zam: cov hmoov txhuv nplej siab, microcrystalline cellulose, talc, magnesium stearate, colloidal silicon dioxide (aerosil), hydroxypropyl methyl cellulose 15 CPS, sodium starch glycolate, diethyl phthalate, titanium dioxide, daj hnub ci polish, xiav pob zeb diamond polish, carmoisine varnish.

    Cov muaj pes tsawg leeg ntawm 1 lub raj mis nrog mloog zoo rau kev npaj ntawm kev daws rau infusion suav nrog:

    • cov tshuaj nquag: ciprofloxacin - 100 mg,
    • kev tshem tawm: disodium edetate dihydrate, lactic acid, sodium hydroxide, hydrochloric acid, dej rau kev txhaj tshuaj.

    Cov tshuaj muaj pes tsawg leeg 100 ml ntawm kev daws rau infusion suav nrog:

    • cov tshuaj nquag: ciprofloxacin - 200 mg,
    • kev tshem tawm: disodium edetate, sodium tshuaj dawb, dej rau txhaj.

    Cov tshuaj muaj pes tsawg leeg 1 ml ntawm pob ntseg thiab qhov muag pom xws li:

    • cov tshuaj nquag: ciprofloxacin - 3 mg,
    • kev tshem tawm: mannitol, sodium acetate trihydrate, benzalkonium chloride, disodium edetate dihydrate, glacial acetic acid, dej lim.

    Cov ntsiav tshuaj, mloog zoo, daws rau Txoj kev lis ntshav

    Ciprofloxacin yog siv los kho cov kab mob hauv qab no uas tsis yooj yim thiab cuam tshuam los ntawm cov kab mob me me uas nkag siab rau cov tshuaj nquag:

    • Cov kab mob sib kis tau ntawm kev ua pa, nrog rau mob ntsws ua los ntawm Enterobacter spp., Klebsiella spp., Escherichia coli, Proteus spp., Haemophilus spp., Pseudomonas aeruginosa, Legionella spp., Staphylococcus spp., Moraxella catarrhalis,
    • kev kis kab mob ntawm cov hlab ntshav (tshwj xeeb, mob ntsws) thiab pob ntseg hauv nruab nrab (piv txwv, otitis media), tshwj xeeb tshaj yog tias cov kab mob no tshwm sim los ntawm cov kab mob gram-tsis zoo, suav nrog Staphylococcus spp. thiab Pseudomonas aeruginosa,
    • mob qhov muag (tshwj tsis yog ntsiav tshuaj),
    • tso zis thiab mob rau lub raum
    • muaj mob rau ntawm chaw mos, nrog rau mob gonorrhea, prostatitis, adnexitis,
    • cov kab mob ntawm lub plab zom mov (kis ntawm lub biliary huam, lub plab zom mov, mob peritonitis),
    • sepsis
    • cov nqaij mos thiab tawv nqaij mob (tshwj tsis yog ntsiav tshuaj),
    • kev tiv thaiv kev kis mob los yog kev kis kab mob hauv cov neeg mob uas muaj kev tiv thaiv qis (cov neeg mob neutropenia lossis cov neeg mob uas siv tshuaj tiv thaiv kab mob),
    • kev kho mob ntawm kev xaiv txoj hnyuv txhaws rau hauv cov neeg mob uas txo kev tiv thaiv,
    • kev kho mob thiab kev tiv thaiv tus mob ntsig txog mob ntsws anthrax los ntawm Bacillus anthracis (tshwj tsis yog rau cov ntsiav tshuaj).

    Pob ntseg thiab qhov muag poob

    Thaum siv cov tshuaj pleev qhov muag rau hauv ophthalmology, cov tshuaj tau siv los kho cov mob sib kis thiab mob ntawm lub qhov muag:

    • subacute thiab mob pob txha caj qaum,
    • blepharoconjunctivitis,
    • blepharitis
    • keratoconjunctivitis,
    • keratitis
    • mob dacryocystitis ntev
    • pob txuv mob txhab,
    • mob txhab ntxiv tom qab lub cev lossis raug mob,
    • meibomite (barley).

    Thaum siv qhov muag pom nyob rau hauv kev phais ophthalmic, cov tshuaj yog siv rau kev npaj ua ntej thiab tom qab kev tiv thaiv kev kis mob.

    Thaum siv pob ntseg ua kua hauv otorhinolaryngology:

    • kev kho mob tom qab kis mob hnyav ntxiv,
    • otitis sab nraud.

    250, 500 lossis 750 mg ntsiav tshuaj

    Cov tshuaj no tau noj ntawm qhov ncauj - ntawm lub plab khoob, nrog cov kua dej txaus. Cov koob tshuaj yog xaiv nyob ntawm qhov mob hnyav, tus mob ntawm lub cev, hom mob, hnyav, lub raum ua haujlwm thiab lub hnub nyoog ntawm tus neeg mob. Cov koob tshuaj hauv qab no feem ntau yog kev pom zoo:

    • rau cov kab mob tsis yooj yim ntawm cov mob txeeb zig thiab lub raum - 250 mg 2 zaug hauv ib hnub, thiab rau cov kab mob nyuaj - 500 mg,
    • nrog cov kab mob me ntawm kev ua pa ntawm qis qis - 2 zaug hauv ib hnub, 250 mg, thiab rau mob hnyav - 500 mg,
    • nrog kab mob gonorrhea - ib zaug 250-500 mg,
    • nrog cov kab mob gynecological, colitis thiab enteritis (mob hnyav, ua npaws siab), osteomyelitis, mob prostatitis - 2 zaug hauv ib hnub, 500 mg txhua. Nrog rau kev mob plab banal, nws pom zoo kom noj 250 mg ntawm cov tshuaj 2 zaug hauv ib hnub.

    Lub sijhawm kho yog xaiv nyob ntawm qhov mob hnyav, txawm li cas los xij, txoj kev kho yuav tsum txuas ntxiv yam tsawg 2 hnub tom qab cov tsos mob ploj mus. Lub sijhawm ib txwm siv los kho yog 7-10 hnub.

    Kev daws rau Txoj kev lis ntshav 2 mg / ml

    Cov tshuaj no tau muab tso quav tshuaj. Txoj kev lis ntshav daws yuav tsum maj mam txhaj rau hauv txoj hlab ntshav loj kom tiv thaiv kev txhim kho ntawm qhov teeb meem ntawm qhov chaw ntawm txoj kev lis ntshav. Txoj kev daws teeb meem yog muab rau ib leeg lossis hauv kev sib xyaw nrog kev sib xyaw infusion daws teeb meem (Lub suab lub ntsiab lus, 0.9% sodium chloride tov, 10% lossis 5% dextrose daws, 10% kua fructose, 5% dextrose daws, 0.225 lossis 0.45 sodium chloride tov) %).

    Lub sijhawm ntawm kev lis ntshav ntawm koob tshuaj 200 mg yog 30 feeb, ntawm ib koob ntawm 400 mg - 60 feeb. Qhov ntau zaus ntawm kev tswj hwm yog 2-3 zaug hauv ib hnub.

    Lub sijhawm kho yog nyob ntawm chav kho mob, mob hnyav thiab kho tus kab mob. Cov tshuaj tau sau tawm rau lwm 3 hnub tom qab tshem tawm ntawm cov tsos mob hauv chaw kuaj mob.

    Qhov nruab nrab ntawm kev kho mob ntev:

    • nrog rau cov kab mob gonorrhea tsis yooj yim - 1 hnub,
    • nrog kev kis mob ntawm lub raum, plab hnyuv plab, cov mob txeeb zig - ntev txog 7 hnub,
    • nrog kev tiv thaiv tsis muaj zog - tag nrho lub sijhawm ntawm neutropenia,
    • nrog osteomyelitis - tsis pub dhau 60 hnub,
    • nrog Chlamydia spp. lossis Streptococcus spp. kis tau tus kab mob - tsawg kawg 10 hnub,
    • nrog rau lwm yam kev kis - 7-14 hnub.

    Qhov ntau npaum ntawm cov tshuaj xaiv nyob ntawm seb hom mob:

    • nrog cov kis ntawm tus mob ua pa - 2-3 zaug hauv ib hnub, 400 mg txhua,
    • nyob rau hauv cov mob tsis yooj yim dua ntawm cov kab mob genitourinary - 2 zaug hauv ib hnub, 200 lossis 400 mg,
    • nrog cov mob sib kis ntawm cov kab mob genitourinary - 2-3 zaug hauv ib hnub, 400 mg txhua,
    • nrog cov mob prostatitis, adnexitis, orchitis, epididymitis - 2-3 zaug hauv ib hnub, 400 mg txhua,
    • nrog mob raws plab - 2 zaug hauv ib hnub, 400 mg txhua,
    • nrog lwm cov mob - 2 zaug hauv ib hnub, 400 mg txhua,
    • tshwj xeeb tshaj yog mob hnyav rau kev tuag taus (tshwj xeeb yog muaj tus kab mob Staphylococcus spp., Streptococcus spp., pseudomonas spp.), tshwj xeeb tshaj yog mob ntsws yog los ntawm tus kab mob Streptococcus spp., nrog rau cov mob sib kis nrog cystic fibrosis ntawm lub ntsws, kis mob ntawm pob qij txha thiab pob txha, nrog septicemia, mob peritonitis - 3 zaug hauv ib hnub, 400 mg txhua,
    • hauv kev tiv thaiv thiab kho mob ntsig txog mob ntsws anthrax - 2 zaug hauv ib hnub, 400 mg.

    Kev npaj ntawm mloog zoo infusion daws

    Ua ntej siv, cov ntsiab lus ntawm 1 vial ntawm kev mloog zoo yuav tsum tau diluted rau qhov ntim ntawm tsawg kawg 50 ml nrog cov txiaj ntsig ntawm Txoj kev lis ntshav (Lub suab lub zog, sodium chloride tov 0.9%, dextrose daws 10 lossis 5% nrog fructose daws 10%, kua uas muaj 5% dextrose tov , kev daws teeb meem ntawm sodium chloride 0.225 lossis 0.45%).

    Kev daws yuav tsum tau siv sai li sai tau vim hais tias ntawm lub rhiab ntawm ciprofloxacin mus rau lub teeb, raws li zoo raws li kom muaj nws sterility. Yog li, lub raj mis yuav tsum tau muab tshem tawm lub npov tsuas yog ua ntej siv. Thaum muaj lub hnub ncaj qha, txoj kev daws teeb meem tau lees tias yuav ruaj khov rau 3 hnub. Thaum khaws cia cov tshuaj nyob rau hauv qis kub, ib qho nag lossis daus yuav tuaj yeem tsim, uas yaj ntawm chav sov, yog li nws tsis pom zoo kom muab cov kua tshuaj pleev rau lossis muab cia rau hauv tub yees. Tsuas siv cov tshuaj ntshiab, thiab siv tau ntau xwb.

    Yog hais tias sib xyaw nrog lwm cov kev daws teeb meem / kev npaj tsis tau lees paus, ciprofloxacin yuav tsum tau muab tshuaj cais. Pom cov cim ntawm kev sib txuam: nag lossis daus, ua kom tshem tawm lossis cov huab tov.Cov tshuaj tsis sib haum nrog txhua txoj kev daws teeb meem uas yog tshuaj lom neeg lossis lub cev tsis khov ntawm pH los ntawm 3.9 mus rau 4.5 (piv txwv li cov tshuaj ntawm heparin, penicillins), nrog rau cov kev daws teeb meem uas hloov pH rau sab alkaline.

    Qhov muag thiab pob ntseg ua kua

    • kev fab tshuaj tsis haum
    • hlawv
    • khaus
    • hyperemia thiab rhiab me ntawm lub qhov muag tsis hais nyob hauv thaj av ntawm lub tympanic membrane thiab cov kwj dej sab nraud,
    • xeev siab
    • photophobia
    • o ntawm daim tawv muag,
    • qhov txawv txav ntawm lub cev qhov muag hauv qhov muag,
    • lacrimation
    • tam sim ntawd tom qab instillation - qhov tsis kaj siab tom qab hauv qhov ncauj kab noj hniav,
    • nyob rau hauv cov neeg mob uas mob caj dab - lub ntsej muag dawb crystalline,
    • txo nyob rau hauv kev pom tseeb tseeb,
    • keratopathy
    • keratitis
    • corneal infiltration lossis ua rau pom ntawm lub ntsej muag pob,
    • kev loj hlob ntawm superinfection.

    Cov lus qhia tshwj xeeb

    Ciprofloxacin tsis pom zoo rau kev kho mob los ntawm tus kab mob Streptococcus pneumoniae, vim tias cov tshuaj tsis muaj txiaj ntsig tiv thaiv cov kab mob. Txhaum lwm yam mob, ua ntej sau ntawv yuav Ciprofloxacin, koj yuav tsum paub tseeb tias nws muaj txiaj ntsig tiv thaiv kab mob ntawm cov kab mob sib haum.

    Thaum lub sij hawm kho ntev nrog cov tshuaj, kev ntsuam xyuas ib txwm muaj ntshav, daim siab thiab lub raum kev ua haujlwm yog pom zoo.

    Thaum muaj kev sib txig ua ke ntawm kev tswj hwm ciprofloxacin thiab tshuaj los ntawm cov pab pawg ntawm barbituric acid derivatives siv rau kev siv tshuaj loog, nws yog qhov yuav tsum tau soj ntsuam tas li ntshav siab, lub plawv dhia, thiab electrocardiogram.

    Txhawm rau tiv thaiv kev txhim kho ntawm crystalluria, nws tsis tuaj yeem lees paub dhau qhov kev pom zoo txhua hnub. Nws kuj yog ib qho tsim nyog yuav tsum tau ua kom ntseeg tau tias cov tshuaj tiv thaiv acidic ntawm cov zis thiab kev nqus ntawm cov kua dej txaus.

    Muaj kev pheej hmoo ntawm kev txhim kho kev mob hlwb txawm tias tshwm sim los ntawm kev siv thawj zaug ntawm ciprofloxacin. Tsis tshua muaj, kev puas siab puas ntsws lossis kev nyuaj siab tuaj yeem xav tua tus kheej txoj kev xav thiab ua rau tus kheej muaj kev phom sij (piv txwv li, tsis ua tiav thiab ua tiav kev tua tus kheej). Hauv qhov no, koj yuav tsum tau txiav tam sim ntawd tsis siv tshuaj thiab sab laj nrog kws kho mob. Cov neeg mob uas muaj keeb kwm ntawm qaug dab peg thiab keeb kwm ntawm qaug dab peg, organic puas hlwb, thiab vascular kab mob vim qhov kev pheej hmoo ntawm kev phiv tshuaj, ciprofloxacin yuav tsum tau tsim tshuaj rau kev noj qab haus huv.

    Ciprofloxacin, zoo li lwm yam fluoroquinolones, tuaj yeem txo qis dua rau kev npaj rau qaug dab peg thiab ua rau qaug dab peg. Yog tias lawv tshwm sim, koj yuav tsum tsis txhob siv cov tshuaj ntxiv.

    Hauv kev kho mob ntawm cov neeg mob noj fluoroquinolones (suav nrog ciprofloxacin), cov xwm txheej ntawm sensorimotor lossis hnov ​​mob polyneuropathy, dysesthesia, hypesthesia, thiab tsis muaj zog. Thaum muaj cov tsos mob xws li hlawv, mob, loog, tingling, tsis muaj zog, tus neeg mob yuav tsum tsis txhob noj cov tshuaj thiab sab laj nrog kws kho mob.

    Thaum lub sij hawm siv ciprofloxacin, raug tus mob ntawm kev txhim kho kev mob raws plab.

    Yog tias mob raws plab ntev, mob tshwm sim tom qab lossis lub sijhawm kho, nws yog ib qho tsim nyog yuav tsum tau tshem tawm kev kuaj mob pseudomembranous mob plab, uas yuav tsum muaj kev tshem tawm sai sai ntawm cov tshuaj thiab kev teem caij kho kom tsim nyog.

    Thaum kho nrog Ciprofloxacin, raug sau tseg tias muaj mob ua rau lub siab ua rau daim siab thiab daim siab necrosis mob siab. Yog tias koj muaj cov tsos mob ntawm daim siab mob (tsis nco qab, tso zis tsaus muag, daj ntseg daj, mob plab, khaus), koj yuav tsum tsis txhob noj cov tshuaj.

    Hauv cov neeg mob uas muaj mob rau daim siab thiab noj ciprofloxacin, kev ua si phuv phiab ua si, kev muaj kab mob siab rau lub cev yuav ua rau ib ntus ntxiv, lossis mob cholestatic daj ntseg. Cov neeg mob uas txom nyem los ntawm kev tiv thaiv kab mob loj hauv myasthenia yuav tsum tau kho mob ciprofloxacin nrog kev ceev faj, vim tias cov tsos mob yuav zoo zuj zus.

    Thaum lub sijhawm kev kho mob, nws yog ib qho tsim nyog kom tsis txhob nyob rau hauv tshav ntuj ncaj qha, nrog rau lwm qhov chaw ntawm ultraviolet hluav taws xob.

    Thaum noj Ciprofloxacin twb dhau hauv thawj 2 hnub tom qab pib kho, muaj qee zaum muaj leeg mob, nrog rau leeg mob (feem ntau feem ntau Achilles leeg, suav nrog ob sab sib luag). Cov mob thiab pob txha ntawm leeg txhaws kuj tau sau tseg ob peb lub hlis tom qab kev kho. Hauv cov neeg mob neeg laus, hauv cov neeg mob uas muaj mob leeg tau txais kev kho mob nrog glucocorticosteroids, muaj kev pheej hmoo ntawm tendinopathy. Txhawm rau kuaj qhov tshwm sim thawj cov tsos mob ntawm leeg (mob, mob nrawm hauv qhov sib koom tes), kev siv Ciprofloxacin yuav tsum nres, thaum tsis suav nrog kev ua haujlwm ntawm lub cev, vim tias muaj kev pheej hmoo ntawm nqaij leeg. Cov tshuaj yuav tsum tau siv nrog ceev faj rau kev kho mob ntawm cov neeg mob uas muaj cov kab mob cuam tshuam nrog kev siv quinolones.

    Hauv kev kho mob los ntawm kev sib kis mob hnyav, kab mob tshwm sim los ntawm tus kab mob anaerobic, thiab staphylococcal kab mob, ciprofloxacin yuav tsum tau siv nrog kev siv tshuaj tua kab mob tsim nyog. Rau kev kis kab mob los ntawm kev kis mob fluoroquinolone-tiv thaiv kab mob ntawm Neisseria gonorrhoeae, cov ntaub ntawv hauv zos ntawm kev tawm tsam cov tshuaj yuav tsum tau coj mus rau hauv tus account thiab qhov nkag siab ntawm cov kab mob raug pom zoo thaum kuaj sim.

    Ciprofloxacin cuam tshuam qhov nce hauv QT luv. Muab hais tias cov poj niam muaj qhov nruab nrab QT ntev dua hauv qhov sib piv nrog cov txiv neej, lawv muaj kev nkag siab ntau dua rau cov tshuaj uas ua rau muaj kev tiv thaiv QT ntev. Cov neeg mob laus hauv lub cev tseem ua rau lub ntsej muag nkag siab ntau dua los ntawm cov tshuaj uas ua rau lub sijhawm QT luv. Hauv kev sib txuas nrog lub dhau los, nws yog ib qho tsim nyog siv ciprofloxacin nrog kev ceev faj nyob rau hauv cov xwm txheej hauv qab no:

    • ua ke nrog cov tshuaj uas txuas ntxiv QT ntu sij hawm (piv txwv li, tshuaj tiv thaiv kab mob ntawm cov chav kawm III thiab IA, tricyclic antidepressants, antipsychotics thiab macrolides),
    • nyob rau hauv kev kho mob ntawm cov neeg mob uas muaj kev muaj peev xwm ntau dua ntawm arrhythmias xws li pirouette lossis kev ncua ntev ntawm QT ntu (piv txwv, nrog kev muaj mob txhawm rau lub sijhawm ntev ntawm QT luv, ib qho tsis txaus ntseeg ntawm electrolytes, suav nrog hypomagnesemia thiab hypokalemia),
    • nrog qee cov kab mob hauv lub plawv hauv cov neeg mob plawv tsis ua haujlwm, bradycardia, myocardial infarction).

    Tom qab siv thawj zaug ntawm ciprofloxacin, cov xwm txheej tsis tshua muaj kev tsis haum tshuaj, nrog rau kev poob siab anaphylactic, tau sau tseg. Qhov no yuav tsum ua kom tsis tu ncua cov tshuaj thiab kev kho mob uas tsim nyog.

    Nrog kev tswj hwm cov dej ntawm txoj kev daws teeb meem, cov tshuaj tiv thaiv hauv zos ntawm qhov chaw txhaj tshuaj yog ua tau (mob, o). Qhov tshuaj tiv thaiv no muaj ntau dua yog tias ntev li ntawm Txoj kev lis ntshav yog tsawg dua 30 feeb. Tom qab qhov kawg ntawm Txoj kev lis ntshav, cov tshuaj tiv thaiv sai sai, tsis muaj kev sib kis rau txoj kev tswj hwm Ciprofloxacin ntxiv (yog tias tsis nrog los ntawm cov kev kawm nyuab).

    Ciprofloxacin yog ib qho tshuaj tiv thaiv ntev ntawm CYP450 1A2 isoenzyme, yog li, yuav tsum tau ceev faj yog tias nws siv ib txhij nrog cov tshuaj metabolized los ntawm cov enzyme no (suav nrog methylxanthin, theophylline, duloxetine, caffeine, ropinirole, clozapine, olanzapine), txij li muaj ntshav nce ntxiv hauv lawv tej kev phiv tshuaj.

    Hauv kev sim tshuaj hauv cov tshuaj tua kab mob hlwb, ciprofloxacin tiv thaiv kev loj hlob ntawm Mycobacterium spp. Qhov no tuaj yeem ua rau muaj qhov tsis zoo tsis zoo tshwm sim hauv kev txheeb xyuas cov kab mob ntawm cov neeg mob uas tau kho ciprofloxacin.

    Nrog lub cev tsis muaj cov piam thaj-6-phosphate dehydrogenase, cov tshuaj tiv thaiv hemolytic tau pom nyob hauv cov neeg mob tau txais cov tshuaj. Kev siv ciprofloxacin rau kev kho mob ntawm hom no yog ua tau tsuas yog muaj cov txiaj ntsig zoo uas tshaj qhov kev pheej hmoo ntawm nws txoj kev siv. Hauv qhov no, nws yog ib qho tsim nyog los xyuas kom tus neeg mob saib xyuas.

    Thaum kho cov neeg mob uas muaj sodium sodium kev txwv (lub raum tsis ua haujlwm, lub plawv tsis ua haujlwm, nephrotic syndrome), nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv tus lej ntawm cov tshuaj sodium sodium uas muaj nyob hauv Ciprofloxacin.

    Qhov muag nti tawm tsis yog npaj rau kev txhaj tshuaj hauv intraocular. Nyob rau hauv cov ntaub ntawv ntawm kev siv lwm yam ophthalmic npaj, lub koom haum saib xyuas ncua ntawm 5 feeb los yog ntau tshaj yuav tsum tau pom. Kev siv ciprofloxacin yuav tsum tsis ua mus ntxiv yog tias muaj qhov taw qhia ntawm kev ua kom tsis haum ntshav. Tus neeg mob yuav tsum tau qhia tias nyob rau hauv cov ntaub ntawv ntawm kev poob qis, kev mob hyperemia yuav tshwm sim (hauv qhov no, koj yuav tsum tso tseg txoj kev siv tshuaj thiab nrhiav cov kws kho mob tawm tswv yim). Thaum kho nrog Ciprofloxacin tee, nws raug nquahu kom tsis txhob hnav lub ntsej muag muag muag. Nyob rau hauv cov ntaub ntawv ntawm kev siv lub lenses nyuaj ua ntej instillation, lawv yuav tsum tau muab tshem tawm thiab muab tso rau dua 20 feeb tom qab instillation ntawm cov tshuaj

    Cev xeeb tub thiab lactation

    Thaum cev xeeb tub, cov tshuaj txwv tsis pub.

    Txij li thaum ciprofloxacin kis mus rau niam mis, cov tshuaj yuav tsum tsis txhob siv rau hauv kev kho mob ntawm leej niam. Yog tias tsim nyog, kev teem sij hawm ntawm ciprofloxacin thaum lactation ua ntej pib kho, koj yuav tsum tsis pub mis niam.

    Siv rau thaum yau

    Cov tshuaj tsis pub coj los siv rau kev kho mob rau menyuam yaus hnub nyoog qis dua 18 xyoo, tshwj tsis yog rau kis mob hauv qab no:

    • rau kev kho mob kis mob cystic fibrosis - 3 zaug ib hnub 10 mg rau 1 kg ntawm lub cev qhov hnyav (qhov tshuaj ntau kawg yog 400 mg),
    • rau kev kho mob ntawm lub ntsws anthrax - 2 zaug hauv ib hnub 10 mg rau 1 kg ntawm lub cev qhov hnyav (qhov tshuaj ntau kawg yog 400 mg). Lub sijhawm tiv thaiv ntawm kev kho mob ciprofloxacin yog 2 hli.

    Txoj kev kho yuav tsum tau pib tam sim ntawd tom qab paub tseeb lossis xav tias muaj tus kab mob. Hauv kev sib txuas nrog qhov kev pheej hmoo ntawm kev ua tsis taus ntawm cov pob qij txha thiab cov nqaij mos uas nyob ib puag ncig, kev kho yuav tsum tau nqa los ntawm tus kws kho mob uas tau ntsib hauv kev kho mob tshwj xeeb rau cov menyuam yaus. Cov tshuaj yuav tsum raug noj tom qab tshuaj xyuas qhov sib piv ntawm kev pheej hmoo thiab txiaj ntsig.

    Thaum siv ciprofloxacin hauv cov menyuam yaus, kev txhim kho ntawm pob qa ntshav feem ntau tau sau tseg.

    Nrog lub raum tsis ua haujlwm

    Cov neeg mob uas mob raum tsis zoo yog kws kho mob ib nrab ib koob ntawm cov tshuaj.

    Thaum noj ntawm qhov ncauj, qhov ntau npaum ntawm ciprofloxacin yog raws li hauv qab no:

    • nrog creatinine qhov kev tshem tawm ntau tshaj 50 ml / min, kev noj tshuaj li ib txwm tau pom,
    • nrog creatinine tshem tawm ntawm 30-50 ml / min - txhua 12 teev, 250-500 mg txhua,
    • nrog creatinine tshem tawm ntawm 5-2 ml / min - txhua 18 teev, 250-500 mg txhua,
    • rau cov neeg mob ua mob hemo- lossis peritoneal lim ntshav, tom qab cov txheej txheem, 250-500 mg txhua 24 teev.

    Nrog kev tswj hwm intravenous, kev noj cov tshuaj ciprofloxacin yog raws li hauv qab no:

    • nrog cov mob raum tsis txaus (CC 30-60 ml / min / 1.73 m 2) lossis nrog kev muaj peev xwm ua yeeb yam hauv cov ntshav plasma ntau npaum li 1.4-1.9 mg / 100 ml, koob tshuaj txhua hnub yuav tsum tsis pub tshaj 800 mg,
    • hauv kev mob raum tsis zoo (CC txog 30 ml / min / 1,73 m 2) lossis nrog rau kev tsim creatinine hauv cov ntshav ntshav ntau dua 2 mg / 100 ml, koob tshuaj txhua hnub yuav tsum tsis pub tshaj 400 mg.

    Rau cov neeg mob rau mob hemodialysis, nrog kev tswj hwm kev tso dej, qhov ntau npaum yog zoo ib yam. Ciprofloxacin nrog dialysate yog muab rau cov tshuaj intraperitoneally hauv qhov nyiaj ntawm 50 mg rau 1 liter ntawm dialysate. Zaus - txhua 6 teev 4 zaug hauv ib hnub.

    Yeeb tshuaj sib cuam tshuam

    Kev siv ua ke nrog ciprofloxacin thiab phenytoin tuaj yeem ua rau txo qis lossis nce ntxiv hauv kev ua kom muaj zog ntawm cov tom kawg hauv cov ntshav ntshav, yog li ntawd nws raug nquahu kom saib xyuas cov tshuaj zoo. Vim tias qhov txo qis hauv cov haujlwm ntawm microsomal oxidation kev ua nyob rau hauv hepatocytes, cov tshuaj lengthens ib nrab-lub neej thiab nce qhov kev xav ntawm theophylline thiab lwm yam xanthines (suav nrog caffeine).

    Cov kev tshawb fawb txog kev noj qab haus huv tuaj pab dawb tau pom tias kev siv cov tshuaj lidocoin-uas muaj kev sib txig sib luag thiab Ciprofloxacin los ntawm 22% txo qhov kev tshem ntawm lidocaine thaum muab tshuaj rau cov ntshav. Txawm hais tias lidocaine muaj kev tiv thaiv zoo, kev coj noj coj ua nrog ciprofloxacin yuav muaj kev phiv ntau ntxiv.

    Kev siv txaws nrog ciprofloxacin nrog qhov ncauj tshuaj hypoglycemic (feem ntau sulfonylurea npaj, piv txwv li, glimepiride, glibenclamide), cov nyhuv ntawm cov tom kawg kuj yuav ua kom zoo dua.

    Txoj kev saib xyuas ib txhij ib zaug ntawm ciprofloxacin thiab cov tshuaj tua kab mob tsis ncaj nce ntxiv lub sijhawm prothrombin.

    Kev siv ciprofloxacin sib xyaw nrog vitamin K antagonists (piv txwv li, acenocoumarol, warfarin, fluindone, fenprocoumone) tuaj yeem txhim kho lawv cov nyhuv anticoagulant. Qhov mob hnyav ntawm cov nyhuv no cuam tshuam los ntawm cov kab mob sib kis, qhov xwm txheej dav dav thiab lub hnub nyoog ntawm tus neeg mob, yog li nws yog qhov nyuaj rau kev soj ntsuam cov theem ntawm cov tshuaj ntawm kev nce INR. Nws raug nquahu tias kev nquag saib xyuas INR raug siv nyob rau kis tau los ntawm kev siv tshuaj vitamin K antagonists thiab Ciprofloxacin, nrog rau lub sijhawm luv luv tom qab kawg ntawm kev kho kom sib xyaw.

    Thaum muab sib xyaw nrog lwm cov tshuaj tua kab mob (aminoglycosides, metronidazole, clindamycin, tshuaj tua kab mob beta-lactam), feem ntau pom muaj synergism. Ciprofloxacin tuaj yeem siv ua ke nrog kev ua tiav nrog ceftazidime thiab azlocillin txhawm rau kho cov mob los ntawm Pseudomonas spp. Thaum muab sib xyaw nrog cov tshuaj tua kab mob beta-lactam (piv txwv li, azlocillin thiab meslocillin), cov tshuaj yuav siv tau rau tus mob streptococcal. Ua ke nrog vancomycin thiab isoxazolylpenicillins, Ciprofloxacin yog siv rau tus mob staph. Cov tshuaj ua ke nrog clindamycin thiab metronidazole muaj txiaj ntsig zoo rau kev mob tsis huv.

    Thaum siv ciprofloxacin nrog cyclosporine, cov nyhuv nephrotoxic ntawm tom kawg tau txhim kho, thiab kev nce siab hauv cov ntshav creatinine siab tau sau tseg. Thaum kho cov neeg mob li 2 zaug hauv ib lub lis piam, nws yog ib qhov tsim nyog los saib xyuas lub raum kev ua haujlwm.

    Nrog kev siv ua ke ntawm ciprofloxacin thiab cov tshuaj tsis haum steroidal (tsis suav nrog acetylsalicylic acid), qhov ntxim nyiam dua ntawm qaug dab peg nce. Kev siv cov tshuaj uricosuric thiab ciprofloxacin qeeb qeeb ib qho tsis pom (txog li 50%) thiab nce cov ntshav plasma concentration ntawm tom kawg.

    Ciprofloxacin tsub kom qhov siab tshaj plaws ntawm tizanidine (Cmax) hauv ntshav los ntawm 7 npaug (qhov ntau ntawm qhov sib txawv ntawm qhov ntsuas no yog 4–21 zaug) thiab nce li 10 npaug ntawm thaj chaw hauv qab qhov tsom mus rau-lub sij hawm pharmacokinetic nkhaus (AUC ntau ntawm 6-24 zaug), uas ua rau muaj kev pheej hmoo ntawm kev nkees nkees thiab txo cov ntshav siab. Yog li ntawd, kev siv cov tizanidin-uas muaj cov tshuaj ib txwm siv thiab ciprofloxacin yog sib kis.

    Txoj kev lis ntshav ntawm cov tshuaj yog pharmaceutically incompatible tshuaj thiab infusion daws, uas yog lub cev thiab tshuaj tsis ruaj nyob rau hauv ib puag ncig acidic (pH ntawm Ciprofloxacin tov rau Txoj kev lis ntshav yog 3.9-4.5). Nws yog txwv tsis pub tov cov tshuaj iv nrog cov kev daws teeb meem nrog pH saum toj no 7. Thaum siv ciprofloxacin thiab cov tshuaj uas txuas ntxiv QT ntu (tricyclic antidepressants, tshuaj tiv thaiv kev puas tsuaj, tshuaj tiv thaiv kev tsis haum ntawm III lossis IA chav kawm, macrolides), yuav tsum ceev faj.

    Kev siv tib lub sij hawm ntawm probenecid thiab ciprofloxacin ua rau kev nce siab hauv qhov kawg ntawm cov ntshav hauv ntshav, vim tias nws qhov feem cuam los ntawm lub raum tsawg dua.

    Nrog tib lub sijhawm siv omeprazole thiab ciprofloxacin, qhov ntau tshaj plaws ntawm cov tshuaj hauv plasma kuj yuav qis me ntsis, thiab thaj chaw hauv qab nkhaus "concentration - sijhawm" kuj tseem poob qis.

    Kev siv tib lub sijhawm ntawm ciprofloxacin thiab methotrexate tuaj yeem ua rau cov metabolism hauv lub raum sai sai, uas nrog nws cov kev nce siab hauv cov ntshav plasma thiab kev pheej hmoo ntawm kev phiv tshuaj methotrexate. Nws tsis pom zoo kom siv ciprofloxacin thiab methotrexate tib lub sijhawm.

    Nrog rau kev siv txuas ntxiv ntawm cov muaj zog inhibitors ntawm CYP450 1A2 isoenzyme (piv txwv li, fluvoxamine) thiab duloxetine, kev nce ntxiv Cmax thiab AUC ntawm duloxetine tuaj yeem pom. Txawm hais tias tsis muaj cov ntaub ntawv hais txog qhov yuav muaj kev cuam tshuam nrog duloxetine nrog ciprofloxacin, ib qho kev cuam tshuam zoo sib xws yog qhov ntau yog tias lawv siv ib txhij.

    Kev siv tib lub sijhawm ciprofloxacin thiab ropinirole ua rau kev nce AUC thiab Cmax ntawm tom kawg los ntawm 84 thiab 60%, feem. Nws raug nquahu kom soj ntsuam cov kev mob tshwm sim ntawm ropinirole thaum siv ua ke nrog ciprofloxacin, ntxiv rau lub sijhawm luv luv tom qab kawg ntawm kev kho kom sib xyaw.

    Kev siv ciprofloxacin sib xyaw ua ke (250 mg rau 7 hnub) thiab clozapine ua rau muaj kev pheej hmoo ntawm kev nce ntshav ntau ntxiv ntawm tom kawg thiab N-desmethylclozapine los ntawm 29 thiab 31%, feem. Nws yog ib qho tsim nyog yuav tau hloov kho cov tshuaj ntau npaum li cas ntawm clozapine thaum siv ua ke nrog ciprofloxacin, ntxiv rau ib ntus luv luv tom qab qhov kawg ntawm kev sib txuam nrog kev kho.

    Kev siv txig ciprofloxacin (500 mg) thiab sildenafil (50 mg) tuaj yeem ua rau muaj 2 npaug ntawm AUC thiab Cmax ntawm tom kawg. Lub hom phiaj ntawm kev sib koom ua ke no tsuas yog ua tom qab ntsuas qhov kev sib raug zoo ntawm cov txiaj ntsig tau muaj thiab kev pheej hmoo txaus ntshai.

    Analogues ntawm Ciprofloxacin yog Vero Ciprofloxacin, Basij, Betatsiprol, Kvintor, Infitsipro, Nirtsil, Oftotsipro, Tseprova, Rotsip, Protsipro, Tsiprobid, Tsiprobay, Tsiproksil, Tsiprodoks, Tsiprolet, Tsiprolaker, Tsipromed, Tsiprolon, Tsiprofloksabol, Tsiprolan, Tsifroksinal, Ekotsifol, Tsifratsid , Digital.

    Cov lus thiab cov xwm txheej ntawm kev cia

    Lub txee lub neej ntawm cov tshuaj hauv cov ntsiav tshuaj yog 3 xyoos.

    Cov ntsiav tshuaj yuav tsum tau muab cia rau hauv qhov chaw qhuav thiab tsaus uas tsis ncav cuag cov menyuam ntawm qhov chaw sov txog li 30 ° C.

    Lub txee lub neej ntawm kev tswj hwm yog 2 xyoos.

    Qhov kub siab yuav tsum muab cia rau hauv qhov chaw tsaus ua tsis tau nkag rau cov menyuam ntawm qhov kub txog 25 ° C. Tsis khov.

    Lub txee lub neej ntawm kev daws yog 3 xyoos.

    Kev daws yuav tsum muab tso rau qhov chaw ncav cuag ntawm cov menyuam ntawm qhov kub txog 25 ° C. Tsis khov.

    Lub sij hawm rau pob ntseg thiab qhov muag pom yog 3 xyoos.

    Cov tshuaj tuaj yeem siv tsis pub dhau 4 lub lis piam tom qab qhib lub raj mis.

    Tus nqi ntawm ciprofloxacin hauv chaw muag tshuaj

    Tus nqi ntawm Ciprofloxacin 250 mg (10 ntsiav tshuaj ib pob) yog li 20 rubles.

    Tus nqi ntawm Ciprofloxacin 500 mg (10 ntsiav tshuaj ib pob) yog kwv yees li 40 rubles.

    Tus nqi ntawm ciprofloxacin nyob rau hauv daim ntawv ntawm tov rau infusion (100 ml) yog li 35 rubles.

    Tus nqi ntawm ciprofloxacin nyob rau hauv daim ntawv ntawm lub qhov muag tee (5 ml) yog kwv yees li 25 rubles.

    Kev txheeb xyuas ntawm Ciprofloxacin

    Kev tshuaj xyuas txog ciprofloxacin nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj yog qhov muaj teeb meem heev: qee cov neeg siv hu rau cov tshuaj muaj txiaj ntsig, lwm tus tsis pom qhov taw tes hauv nws qhov kev siv. Feem ntau ntawm kev txheeb xyuas hais txog kev phiv.

    Kev txheeb xyuas qhov muag pom kev yog qhov zoo.

    Raws li kws kho mob, ciprofloxacin muaj cov zoo li nram no:

    • zoo thev taus
    • siv tau rau hauv tsev kho mob ib puag ncig kom muaj kev kho kab mob rau kev kis mob hnyav, nrog rau kev kho cov neeg muaj mob hauv zej zog thiab tsev kho mob yuav luag txhua qhov chaw,
    • siab bactericidal thiab antimicrobial kev ua si,
    • ntev ib nrab-lub neej thiab tom qab siv tshuaj tua kab mob (tso cai rau koj noj cov tshuaj tsuas yog 2 zaug hauv ib hnub).

    Pom qhov yuam kev hauv cov ntawv nyeem? Xaiv nws thiab nias Ctrl + Enter.

    Kev siv cov tshuaj ciprofloxacin

    Kev kis tsis yooj yim thiab mob uas cuam tshuam los ntawm cov kab mob me me nkag siab ciprofloxacin.

    Kev kis mob ntawm lub ntsws ua pa, suav nrog mob ntsws thiab ntev (nyob rau theem mob huam) mob ntsws, bronchiectasis, kis mob hnyav ntawm cystic fibrosis, mob ntsws los ntawm Klebsiella spp., Enterobacter spp., Proteus spp., Esherichia coli. Pseudomonas aeruginosa, Haemophilus spp., Moraxella catarrhalis, Legionella spp. thiab staphylococci, kis kab mob ntawm ENT plab hnyuv siab raum, suav nrog pob ntseg hauv nruab nrab (otitis media), paranasal sinuses (sinusitis, suav nrog mob siab), tshwj xeeb yog tshwm sim los ntawm kab mob g-tsis zoo, suav nrog Pseudomonas aeruginosa lossis staphylococci, kis kab mob ntawm cov genitourinary system (suav nrog cystitis, pyelonephritis, adnexitis, tus kab mob ntev prostatitis, orchitis, epididymitis, tsis mob gonorrhea), mob plab hauv plab (hauv kev sib xyaw nrog metronidazole), suav nrog mob rau tus kab mob peritonitis, gallbladder thiab biliary mob voos, tawv nqaij thiab cov nqaij mos mos ua mob (mob viav vias, qhov txhab, kub hnyiab, mob qog ntshav, phlegmon), mob pob txha thiab mob sib kis (osteomyelitis, mob leeg rau mob), mob sepsis, mob kub cev, campylobacteriosis, shigellosis, neeg ncig teb chaw, kev sib kis lossis prophylaxis ntawm kev kis kab mob hauv cov neeg mob tiv thaiv kab mob (cov neeg mob siv tshuaj tiv thaiv kab mob los yog cov neeg mob neutropenia), xaiv cov hnyuv txiav tawm hauv cov neeg mob immunocompromised, kev tiv thaiv thiab kho mob ntsws ntsws anthrax rskoy ulcers (kab mob Bacillus anthracis), tiv thaiv kev kis tus kab mob uas yog los ntawm Neisseria meningitidis.

    Kev kho rau qhov teeb meem tshwm sim los ntawm Pseudomonas aeruginosa, hauv cov menyuam yaus hnub nyoog txog 5 txog 17 xyoo nrog mob ntsws pulmonary cystic fibrosis, kev tiv thaiv thiab kev kho mob ntsig txog mob ntsws (mob ntsws) Bacillus anthracis).

    Vim tias muaj qhov tshwm sim tsis zoo ntawm cov pob qij txha thiab / lossis cov nqaij mos uas nyob ib puag ncig (saib "phiv"), tus kws kho mob yuav tsum pib kho nrog kev paub txog kev kho mob hnyav rau cov menyuam yaus thiab cov hluas thiab tom qab ua tib zoo ntsuas ntawm cov txiaj ntsig-kev pheej hmoo.

    Rau kev siv ophthalmic. Kev kho kab mob hauv lub qhov txhab thiab mob ntawm sab xub ntiag ntawm lub pob muag thiab nws cov lus ntxiv tshwm sim los ntawm cov kab mob nkag rau ciprofloxacin hauv cov neeg laus, cov menyuam mos (txij li 0 txog 27 hnub), menyuam mos thiab menyuam mos (txij li 28 hnub txog 23 hlis), menyuam yaus (txij li 2 txog 11 xyoos) xyoo laus) thiab cov hluas (12 txog 18 xyoo).

    Ntawv thov kev txwv

    Cov kab mob hauv lub cev ntau dua, mob cerebrovascular, kev pheej hmoo ntawm lub sijhawm QT ncua ntev lossis kev tsim kho pirouette hom arrhythmias (piv txwv li, kev mob qog ua haujlwm ntawm QT ntu, mob plawv (lub plawv tsis ua haujlwm, myocardial infarction, bradycardia), ntshav tsis txaus (piv txwv li, nrog hypokalemia, hyphyalia ), qhov tsis txaus siab ntawm cov piam thaj-6-phosphate dehydrogenase, kev siv cov tshuaj ib txhij uas txuas QT ntu (suav nrog cov tshuaj tiv thaiv kab mob ntawm cov chav kawm IA thiab III, tricyclic antidepressants, macrolides, neur oleptics), tib lub sijhawm siv nrog cov tshuaj tiv thaiv ntawm CYP1A 2 isoenzyme, suav nrog methylxanthines, suav nrog theophylline, caffeine, duloxetine, clozapine, ropinirole, olanzapine (saib "Ceev faj"), cov neeg mob muaj keeb kwm ntawm cov leeg raug mob uas cuam tshuam nrog nrog rau kev siv quinolones, kev mob hlwb (kev nyuaj siab, kev mob hlwb), kab mob hauv nruab nrab lub paj hlwb (qaug dab peg, txo qis qaug dab peg (lossis keeb kwm ntawm qaug dab peg), organic hlwb puas lossis mob stroke, myasthenia gravis gravismob raum thiab / lossis daim siab ua haujlwm, lub hnub nyoog dhau los.

    Kev sib txuam

    Cov tshuaj uas ua rau lub sijhawm ncua sijhawm QT luv. Kev ceev faj yuav tsum tau siv thaum siv ciprofloxacin, zoo li lwm yam fluoroquinolones, hauv cov neeg mob uas tau txais cov tshuaj uas ua rau muaj lub sijhawm QT ntev (piv txwv, chav kawm IA lossis III tshuaj thim rov qab, tricyclic antidepressants, macrolides, antipsychotics) (saib "Kev Ceev Faj").

    Theophylline. Kev siv tib lub sijhawm ciprofloxacin thiab theophylline uas muaj cov tshuaj yuav ua rau lub theophylline mloog tsis txaus nyob rau hauv cov ntshav thiab, raws li, qhov tshwm sim ntawm theophylline-phiv cov xwm txheej tsis zoo, nyob rau hauv cov xwm txheej tsis tshua muaj, cov kev mob tshwm sim no tuaj yeem ua rau tuag tau rau tus neeg mob. Yog tias siv kev siv ua ke ib zaug ntawm ciprofloxacin thiab theophylline uas muaj cov tshuaj tsis raug xwm yeem, nws raug nquahu kom soj ntsuam theophylline ntau hauv cov ntshav plasma thiab, yog tias tsim nyog, txo cov koob tshuaj theophylline.

    Lwm cov kev sib txuas ntawm xanthine. Kev siv ciprofloxacin thiab caffeine los yog pentoxifylline (oxpentifillin) tib lub sijhawm tuaj yeem ua rau muaj qhov nce ntawm xanthine derivatives hauv kev ntshiab.

    Phenytoin. Nrog tib lub sijhawm siv ciprofloxacin thiab phenytoin, qhov kev hloov pauv (nce los yog txo qis) hauv cov ntsiab lus ntawm phenytoin hauv cov ntshav ntshav tau pom. Txhawm rau kom tsis txhob muaj qhov cuam tshuam nrog kev txo qis ntawm phenytoin concentration, nrog rau kev tiv thaiv cov kev cuam tshuam uas cuam tshuam nrog phenytoin overdose thaum ciprofloxacin raug txiav tawm, nws pom zoo kom soj ntsuam phenytoin kev kho mob hauv cov neeg mob noj ciprofloxacin, suav nrog kev txiav txim siab ntawm cov ntsiab lus phenytoin hauv ntshav plasma thoob plaws lub sijhawm. siv tib txhij thiab lub sijhawm luv luv tom qab ua tiav ntawm kev sib txuas ua ke.

    NSAIDs. Kev sib xyaw ntawm cov koob tshuaj ntawm quinolones (DNA gyrase inhibitors) thiab qee qhov NSAIDs (tsis suav nrog acetylsalicylic acid) tuaj yeem ua rau chua leeg.

    Cyclosporin. Nrog rau kev siv txaws ciprofloxacin thiab cov tshuaj muaj cyclosporine, lub sijhawm luv luv nce ntxiv hauv plasma creatinine concentration tau pom. Hauv cov xwm txheej zoo li no, nws yog qhov tsim nyog los txiav txim siab qhov tsim nyog ntawm creatinine hauv cov ntshav 2 zaug hauv ib lub lis piam.

    Qhov ncauj hypoglycemic tus neeg sawv cev thiab insulin. Nrog rau kev siv txig ciprofloxacin thiab qhov ncauj hypoglycemic, feem ntau yog sulfonylureas (piv txwv li, glibenclamide, glimepiride), lossis insulin, kev txhim kho hypoglycemia yuav yog vim muaj qhov nce hauv kev ua ntawm hypoglycemic agents (saib "Qhov tshwm sim"). Yuav tsum tau ua tib zoo soj ntsuam ntawm cov ntshav qabzib feem ntau.

    Probenecid. Probenecid qeeb qeeb tus nqi ntawm qhov nthuav tawm ntawm ciprofloxacin los ntawm lub raum. Kev siv ciprofloxacin thiab cov tshuaj muaj probenecid ntau ntxiv ua rau muaj kev nce siab ntawm ciprofloxacin hauv cov ntshav cov ntshav.

    Methotrexate. Nrog rau kev siv methotrexate thiab ciprofloxacin tib lub sijhawm, kev thauj cov hlab ntsws ntawm methotrexate tuaj yeem ua rau qeeb, uas tej zaum yuav muaj nrog los ntawm kev nce siab ntawm cov methotrexate hauv cov ntshav ntshav. Hauv qhov xwm txheej no, qhov ntxim nyiam ntawm kev phiv ntawm methotrexate yuav nce ntxiv. Hauv qhov no, cov neeg mob tau txais ob qho methotrexate thiab ciprofloxacin yuav tsum tau saib xyuas kom zoo.

    Tizanidine. Raws li kev tshawb fawb soj ntsuam nrog cov neeg ua haujlwm noj qab haus huv zoo nrog kev siv ciprofloxacin thiab cov tshuaj tizanidine ntau ntxiv, kev nce siab ntawm tizanidine hauv ntshav ntshav tau tshwm sim - Сmax 7 lub sij hawm (los ntawm 4 txog 21 zaug) thiab AUC - 10 zaug (ntawm 6 txog 24 zaug). Nrog rau kev nce siab ntawm tizanidine hauv ntshav dej, hypotensive (txo ntshav siab) thiab sedative (tsaug zog, qaug zog) phiv cuam tshuam yog txuam. Kev siv ib txhij ntawm ciprofloxacin thiab tshuaj muaj tizanidine yog contraindicated.

    Omeprazole Nrog rau kev siv tshuaj ciprofloxacin thiab omeprazole uas muaj cov tshuaj, ib qho kev txo qis hauv C tej zaum yuav raug sau tsegmax ciprofloxacin hauv plasma thiab txo qis hauv AUC.

    Duloxetine Hauv kev sim tshuaj, nws tau pom tias kev siv duloxetine tib si thiab cov muaj zog inhibitors ntawm CYP1A 2 isoenzyme (xws li fluvoxamine) tuaj yeem ua rau nce AUC thiab Cmax duloxetine. Txawm hais tias tsis muaj cov ntaub ntawv soj ntsuam hais txog qhov ua kom muaj kev cuam tshuam nrog ciprofloxacin, nws yog ib qho ua tau los twv seb qhov ua tau ntawm kev cuam tshuam nrog kev siv ciprofloxacin thiab duloxetine tib lub sijhawm.

    Ropinirol. Kev siv tib lub sijhawm ntawm ropinirole thiab ciprofloxacin, cov tshuaj tiv thaiv ntev ntawm isoenzyme CYP1A 2, ua rau muaj kev nce hauv Cmax thiab ropinirole AUC los ntawm 60 thiab 84%, feem. Cov kev mob tshwm sim ntawm ropinirole yuav tsum tau saib xyuas thaum siv ua ke nrog ciprofloxacin thiab rau lub sijhawm luv luv tom qab ua tiav ntawm kev kho mob sib xyaw.

    Lidocaine. Hauv kev tshawb fawb txog cov neeg ua haujlwm pab dawb, tau pom tias kev siv cov tshuaj lidocaine uas muaj kev siv tshuaj ib txhij thiab ciprofloxacin, cov tshuaj tiv thaiv qis ntawm isoenzyme CYP1A 2, ua rau txo qis hauv kev tshem tawm ntawm lidocaine los ntawm 22% nrog kev tswj hwm iv. Txawm hais tias muaj kev zam zoo ntawm lidocaine, nrog kev siv ib txhij nrog ciprofloxacin, kev mob tshwm sim vim kev sib cuam tshuam yuav ua kom zoo dua.

    Clozapine. Nrog rau kev sib xyaw ua ke siv cov tshuaj clozapine thiab ciprofloxacin ntawm koob tshuaj 250 mg rau 7 hnub, kev nce siab ntau ntxiv ntawm clozapine thiab N-desmethylclozapine tau pom los ntawm 29 thiab 31%, feem. Kev mob ntawm tus neeg mob yuav tsum tau saib xyuas thiab, yog tias tsim nyog, kho cov koob tshuaj ntawm clozapine thaum nws siv nrog ciprofloxacin thiab tsis pub dhau lub sijhawm luv luv tom qab ua tiav ntawm kev kho ua ke.

    Sildenafil. Nrog kev siv ciprofloxacin ntawm koob tshuaj 500 mg thiab sildenafil ntawm koob tshuaj 50 mg rau cov neeg tuaj noj qab haus huv noj qab haus huv, kev nce siab hauv C tau sau tsegmax thiab AUC ntawm sildenafil 2 zaug. Hauv qhov no, kev siv ntawm cov kev sib xyaw no yog ua tau tsuas yog tom qab ntsuas xyuas qhov txiaj ntsig / qhov phom sij piv.

    Vitamin K Antagonists Kev siv ua ke ntawm ciprofloxacin thiab vitamin K antagonists (piv txwv li warfarin, acenocumarol, fenprocoumon, fluindione) tuaj yeem ua rau muaj kev nce ntxiv hauv lawv cov nyhuv anticoagulant. Qhov ntau ntawm cov nyhuv no yuav sib txawv raws li cov kab mob sib kis, lub hnub nyoog thiab cov mob ntawm tus neeg mob, yog li nws nyuaj rau kev txheeb xyuas cov nyhuv ntawm ciprofloxacin ntawm kev nce INR. Nws yog feem ntau txaus los tswj INR nrog kev siv tshuaj tiv thaiv ciprofloxacin thiab vitamin K kev tiv thaiv kab mob, nrog rau lub sijhawm luv luv tom qab ua tiav ntawm kev kho mob sib xyaw.

    Cov tshuaj Cationic. Kev tswj hwm lub qhov ncauj ib txhij ntawm ciprofloxacin thiab tshuaj cationic - cov tshuaj ntxhia uas muaj cov calcium, magnesium, aluminium, iron, sucralfate, antacids, polymeric phosphate compounds (piv txwv li, sevelamer, lanthanum carbonate) thiab cov tshuaj muaj qhov loj tsis xws luag (piv txwv li didanosine) uas muaj cov tshuaj magnesium, aluminium lossis calcium - txo qis kev nqus ntawm ciprofloxacin. Hauv cov xwm txheej zoo li no, ciprofloxation yuav tsum tau siv sijhawm li 1-2 teev ua ntej lossis 4 teev tom qab noj cov tshuaj no.

    Noj thiab chaw yuj nyuj khoom. Kev tswj hwm qhov ncauj ib txhij ntawm ciprofloxacin thiab cov khoom noj siv mis lossis haus dej muaj zog nrog cov zaub mov muaj zog (piv txwv li mis, yogurt, kua-calcium uas muaj kua txiv) yuav tsum zam, vim tias kev nqus ntawm ciprofloxacin yuav raug txo tsawg. Cov calcium uas nyob hauv cov zaub mov zoo tsis muaj kev cuam tshuam ntau yam ntawm kev nqus ntawm ciprofloxacin.

    Cov kev kawm tshwj xeeb ntawm kev sib cuam tshuam uas siv cov tshuaj ophthalmic cov ciprofloxacin tsis tau ua. Coj mus rau hauv tus lej qis qis ntawm ciprofloxacin nyob rau hauv cov ntshav ntshav tom qab instillation mus rau hauv kev sib txuas ntawm cov kab noj hniav, kev sib cuam tshuam ntawm cov tshuaj ua ke siv nrog ciprofloxacin tsis zoo li. Thaum muaj kev sib koom tes nrog rau lwm txoj hauv kev hauv zos ophthalmic npaj, lub sijhawm nruab nrab ntawm lawv siv yuav tsum yog tsawg kawg 5 feeb, thaum siv tshuaj pleev qhov muag yuav tsum siv kawg.

    Kev ceev faj Ciprofloxacin

    Cov mob hnyav, mob staphylococcal thiab kis mob vim yog cov kab mob gram-positive thiab anaerobic. Hauv kev kho cov mob hnyav, staph thiab kab mob kis los ntawm tus kab mob anaerobic, ciprofloxacin yuav tsum siv nrog cov tshuaj tiv thaiv kab mob tsim nyog.

    Kev kis mob vim yog mob Streptococcus pneumoniae. Ciprofloxacin tsis pom zoo rau kev kho mob los ntawm kev kis mob los ntawm Kab mob ntsws dej liab, vim nws tau ua hauj lwm tsawg hauv kev cuam tshuam txog cov kab mob no.

    Chaw mos ua paug. Rau qhov muaj mob ntawm chaw mos txawm tuaj yeem cuam tshuam los ntawm hom kis kab mob Neisseria gonorrhoeaekev tsis haum rau fluoroquinolones, cov lus qhia txog kev tawm tsam hauv zos rau ciprofloxacin yuav tsum raug coj mus rau hauv tus lej thiab qhov kev cuam tshuam ntawm cov kab mob yuav tsum tau lees paub los ntawm kev kuaj ntsuas.

    Kev ua txhaum lub siab. Ciprofloxacin cuam tshuam qhov ntev ntawm QT ntu (saib "Sab Cuam"). Xav txog tias cov poj niam muaj lub sijhawm ntev dua QT sib piv nrog cov txiv neej, lawv muaj kev nkag siab ntau dua rau cov tshuaj uas ua rau lub sijhawm ntev ntawm QT luv. Hauv cov neeg laus cov neeg mob, tseem muaj qhov cuam tshuam ntau ntxiv rau kev ua ntawm cov tshuaj, ua rau ncua sijhawm QT luv. Yog li, ciprofloxacin yuav tsum tau siv nrog ceev faj hauv kev sib xyaw nrog cov tshuaj uas txuas ntxiv QT ntu sij hawm (piv txwv li cov chav kawm IA thiab III tshuaj tiv thaiv kab mob, tricyclic antidepressants, macrolides thiab tshuaj tiv thaiv kev tiv thaiv) (saib "Kev cuam tshuam"), lossis hauv cov neeg mob uas muaj kev pheej hmoo ntev ntawm QT ntu lossis tsim kho Pirouette-hom arrhythmias (piv txwv li, kab mob QT sib kis ntev, mob tsis txaus txav tsis haum, xws li hypokalemia los yog hypomagnesemia, as Well as kab mob hauv lub plawv xws li lub plawv tsis ua hauj lwm, inf) myocardial leeg, bradycardia).

    Siv rau menyuam yaus. Nws tau pom tias ciprofloxacin, zoo li lwm yam tshuaj ntawm chav kawm no, ua rau mob caj dab ntawm cov pob qij txha loj hauv cov tsiaj.

    Kev soj ntsuam ntawm cov ntaub ntawv kev nyab xeeb tam sim no ntawm kev siv ciprofloxacin hauv cov menyuam yaus hnub nyoog qis dua 18 xyoo, feem ntau muaj cystic fibrosis, tsis tau tsim kev sib txuas ntawm kev puas tsuaj rau pob txha mos lossis pob qij txha nrog ciprofloxacin. Nws tsis pom zoo kom siv ciprofloxacin hauv cov menyuam yaus hnub nyoog 5 txog 17 xyoo rau kev kho mob ntawm lwm tus kabmob, tsuas yog muaj kev cuam tshuam ntawm cystic fibrosis cuam tshuam nrog Pseudomonas aeruginosa, nrog rau kev kho mob thiab tiv thaiv kab mob ntsws anthrax (tom qab xav tias yog mob los yog pov thawj kis tau tus mob) Bacillus anthracis).

    Kev ua haujlwm tsis zoo. Qee zaum tom qab noj thawj koob ntawm ciprofloxacin, qhov mob hypersensitivity yuav tshwm sim, suav nrog kev tsis haum tshuaj, uas yuav tsum tau qhia tam sim rau tus kws kho mob uas tuaj koom (saib "Sab Cim"). Muaj qee zaus, tom qab siv thawj zaug, tshuaj tiv thaiv anaphylactic tuaj yeem tshwm sim txog kev poob siab anaphylactic. Hauv cov rooj plaub no, kev siv ciprofloxacin yuav tsum nres tam sim ntawd thiab kev kho tsim nyog yuav tsum tau nqa tawm.

    Lub plab zom mov. Yog tias mob raws plab hnyav thiab lub caij ntev tshwm sim thaum lossis tom qab kho nrog ciprofloxacin, kev kuaj mob pseudomembranous colitis yuav tsum tau tshem tawm, uas yuav tsum tau tshem tawm ciprofloxacin tam sim ntawd thiab kev teem sijhawm kho mob kom tsim nyog (noj ntawm qhov ncauj vancomycin ntawm koob tshuaj 250 mg 4 zaug hauv ib hnub) (saib "Sab Cuam").

    Kev siv cov tshuaj uas txhawm rau txhawm plab hnyuv plab yog contraindicated.

    Hepatobiliary system. Nrog rau kev siv ciprofloxacin, tau muaj tus kab mob ntawm daim siab necrosis thiab ua rau lub siab ua rau mob siab. Yog tias muaj cov tsos mob ntawm daim siab mob xws li tsis nco qab, daj ntseg, tso zis tsaus nti, khaus, mob hauv plab, ciprofloxacin yuav tsum tsis ua haujlwm ntxiv (saib "Phiv").

    Hauv cov neeg mob noj ciprofloxacin thiab mob siab rau daim siab, muaj kev nce siab ib ntus hauv kev ua haujlwm ntawm hepatic transaminases, alkaline phosphatase, lossis cholestatic jaundice (saib "Phiv").

    Musculoskeletal system. Cov neeg mob mob hnyav myasthenia gravis ciprofloxacin yuav tsum siv nrog ceev faj, zoo li exacerbation ntawm cov tsos mob yog tau.

    Thaum noj ciprofloxacin, yuav muaj qee zaum muaj leeg mob thiab leeg (feem ntau Achilles), qee zaum ob sab sib luag, twb dhau li ntawm 48 teev tom qab pib kho. Tendon mob thiab mob caj dab tuaj yeem tshwm sim txawm tias ntau lub hlis tom qab ciprofloxacin tshem tawm. Hauv cov neeg mob neeg laus thiab cov neeg mob uas muaj cov leeg mob uas tau txais kev kho mob corticosteroids tib lub sijhawm, muaj kev pheej hmoo ntawm cov leeg pob txha caj qaum.

    Ntawm thawj cov tsos mob ntawm leeg (mob o nyob rau hauv kev sib koom tes, mob), siv cov ciprofloxacin yuav tsum nres, kev ua haujlwm ntawm lub cev yuav tsum raug txiav txim siab, vim tias muaj kev pheej hmoo ntawm kev tawg ntawm cov leeg, thiab sab laj kws kho mob. Ciprofloxacin yuav tsum tau siv nrog kev ceev faj hauv cov neeg mob uas muaj keeb kwm mob nyiam los cuam tshuam nrog kev siv quinolones.

    Kev tswj hwm leeg. Ciprofloxacin, zoo li lwm yam fluoroquinolones, tuaj yeem ua rau nrhoo thiab txo qis zog rau qhov tsim nyog nyeem. Hauv cov neeg mob uas muaj qaug dab peg thiab ua haujlwm rau hauv cov hlab ntsha lub cev (piv txwv li, qhov txo qis ntawm qhov qaug dab peg, keeb kwm ntawm qaug dab peg, cerebrovascular xwm txheej, organic puas tsuaj, lossis mob stroke), vim qhov pheej hmoo ntawm CNS phiv rov qab, ciprofloxacin yuav tsum tau siv tsuas yog thaum qhov kev cia siab cov kev pabcuam hauv tsev kho mob ntau dua qhov muaj feem tshwm sim ntawm kev phiv.

    Thaum siv ciprofloxacin, cov xwm txheej ntawm kev loj hlob ntawm cov xwm txheej mob ntsig txog kabmob (saib "Cov Kev Mob tshwm sim"). Yog tias qhov mob hlwb ntuav tawm, kev siv ciprofloxacin yuav tsum tsis ua mus ntxiv. Cov kev xav hauv lub cev tuaj yeem tshwm sim txawm tias tom qab siv thawj zaug ntawm fluoroquinolones, suav nrog ciprofloxacin. Muaj qee zaus, kev nyuaj siab lossis kev xav ntawm lub hlwb tuaj yeem hloov mus rau kev xav tua tus kheej thiab tus cwj pwm ua rau nws tus kheej, xws li kev sim tua tus kheej, incl. cog lus (saib "phiv"). Yog tias tus neeg mob pib tsim ib qho ntawm cov tshuaj tiv thaiv no, koj yuav tsum tsis txhob noj ciprofloxacin thiab qhia koj tus kws kho mob.

    Cov neeg mob uas siv tshuaj fluoroquinolones, suav nrog ciprofloxacin, tau tshaj tawm cov neeg mob los yog sensorimotor polyneuropathy, hypesthesia, dysesthesia, lossis qaug zog. Yog tias cov tsos mob xws li mob, mob kub hnyiab, tingling, loog, tsis muaj zog, cov neeg mob yuav tsum qhia lawv tus kws kho mob ua ntej txuas nrog ciprofloxacin.

    Cov tawv nqaij. Thaum noj ciprofloxacin, qhov kev tawm tsam qhov pom kev tsis haum xeeb tuaj yeem tshwm sim, yog li cov neeg mob yuav tsum tsis txhob kov cov hnub ncaj qha thiab UV teeb. Kev kho yuav tsum tau tsum tsis ua ntxiv yog tias pom tshwm sim ntawm qhov pom kev ua rau lub ntsej muag (piv txwv, kev hloov pauv ntawm daim tawv nqaij zoo li tshav ntuj tuaj) (saib "Phiv").

    Cytochrome P450. Nws tau paub tias ciprofloxacin yog ib qho tshuaj tiv thaiv ntev ntawm isoenzyme CYP1A 2. Kev ceev faj yuav tsum tau siv thaum siv ciprofloxacin thiab tshuaj metabolized los ntawm isoenzyme no, suav nrog methylxanthines, suav nrog theophylline thiab muaj caffeine, duloxetine, ropinirole, clozapine, olanzapine, xws li kev nce siab ntawm cov tshuaj no hauv cov ntshav cov ntshav, vim yog qhov inhibition ntawm lawv cov metabolism los ntawm ciprofloxacin, tuaj yeem ua rau muaj kev phiv tshuaj tsis zoo.

    Kev tiv thaiv hauv zos. Nrog rau / hauv kev qhia txog ciprofloxacin, ib qho kev hloov pauv ntawm ib cheeb tsam tuaj yeem tshwm sim ntawm qhov chaw txhaj tshuaj (mob edema, mob). Qhov tshuaj tiv thaiv no muaj ntau dua yog tias lub sijhawm infusion 30 feeb lossis tsawg dua. Qhov tshuaj tiv thaiv sai dhau tom qab qhov kawg ntawm Txoj kev lis ntshav thiab tsis yog qhov sib txuam rau kev tswj hwm tom qab, tshwj tsis yog nws cov chav kawm nyuaj.

    Txhawm rau kom tsis txhob muaj kev txhim kho crystalluria, qhov kev pom zoo txhua hnub yuav tsum tsis pub dhau, kev haus dej txaus thiab kev saib xyuas cov kua qaub ua kua tseem ceeb heev. Nrog kev sib txig iv kev coj noj coj ua ntawm ciprofloxacin thiab cov tshuaj loog dav dav los ntawm cov pab pawg ntawm barbituric acid derivatives, tshuaj xyuas lub plawv dhia, ntshav siab, ECG yog qhov tsim nyog. Hauv vitro ciprofloxacin tuaj yeem cuam tshuam kev kuaj mob bacteriological Mycobacterium tuberculosis, txwv nws txoj kev loj hlob, uas tuaj yeem ua rau qhov tsis zoo tshwm sim hauv kev txheeb xyuas tus kab mob no hauv cov neeg mob noj ciprofloxacin.

    Siv sijhawm ntev thiab rov qab siv ciprofloxacin tuaj yeem ua rau superinfection nrog cov kab mob tiv taus lossis cov kab mob ntawm cov kab mob fungal.

    Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tshuab. Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab cov txheej txheem, nrog rau thaum ua haujlwm rau lwm cov kev phom sij uas yuav tsum muaj kev kub siab ntawm kev saib xyuas thiab ceev ntawm cov kev tiv thaiv psychomotor. Nrog rau kev txhim kho ntawm qhov kev tsis txaus siab los ntawm cov leeg hlwb (piv txwv, kiv taub hau, huam), ib qho yuav tsum tsis kam tsav tsheb thiab koom nrog lwm yam kev ua si uas xav tau kev nce siab ntawm kev saib xyuas thiab ceev ntawm psychomotor tshua.

    Cov kev sim kho mob nrog ciprofloxacin hauv cov menyuam yaus hnub nyoog qis dua 1 xyoos txwv. Kev siv ciprofloxacin hauv ophthalmia ntawm cov menyuam tshiab nrog gonococcal lossis chlamydial etiology tsis pom zoo vim tias tsis muaj cov ntaub ntawv hais txog kev siv hauv pawg neeg mob no. Cov neeg mob neonatal ophthalmia yuav tsum tau txais kev kho mob kom zoo.

    Nrog rau ophthalmic siv ciprofloxacin, kev muaj peev xwm ntawm rhinopharyngeal hla yuav tsum raug coj mus rau hauv tus account, uas tuaj yeem ua rau muaj qhov nce ntxiv ntawm qhov nquag tshwm sim thiab qhov nce ntawm qhov mob hnyav ntawm cov kab mob tiv thaiv.

    Hauv cov neeg mob uas mob caj dab, qhov pom ntawm lub ntsej muag dawb crystalline precipitate tau sau tseg, uas yog cov tshuaj seem. Cov nag lossis daus tsis cuam tshuam nrog kev siv ciprofloxacin txuas ntxiv thiab tsis cuam tshuam rau nws txoj kev kho mob. Cov tsos ntawm nag lossis daus tau pom nyob hauv lub sijhawm txij li 24 teev mus rau 7 hnub tom qab pib kho, thiab nws cov resorption tuaj yeem tshwm sim ob qho tib si tam sim ntawd tom qab tsim thiab tsis pub dhau 13 hnub tom qab pib kho.

    Looj lub looj tsom iav tsis pom zoo thaum kho.

    Tom qab ophthalmic siv ciprofloxacin, qhov kev txo qis ntawm qhov pom tseeb ntawm kev pom kev pom yog qhov ua tau, yog li ntawd, tam sim ntawd tom qab siv nws tsis pom zoo kom tsav tsheb thiab koom nrog cov haujlwm uas yuav tsum tau nce siab thiab ceev ntawm psychomotor kev xav.

    Cia Koj Saib

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