Amikacin sulfate (Amikacini sulfas)
Lub hmoov rau kev tsim cov tshuaj uas tau npaj rau kev tso dej khov los yog tshuaj intramuscular yog ib txwm dawb los yog ze rau dawb, hygroscopic.
1000, 500 lossis 250 mg ntawm cov hmoov zoo li no hauv lub raj mis uas muaj 10 ml, 1, 5, 10 lossis 50 ntawm cov kua txiv zoo li no hauv ib pob ntawv.
Txoj kev daws teeb meem (tso ncaj, intramuscular) feem ntau yog ntshiab, straw-xim lossis tsis muaj kob.
Daim ntawv tso tawm hauv cov tshuaj tsis muaj nyob.
Cov Tshuaj Hauv Tshuaj
Amikacin (npe hauv daim ntawv qhia hauv Latin Amikacin) yog hluavtaws ib nrab aminoglycoside (tshuaj tua kab mob) Ua rau ntawm ntau cov pathogens. Muaj tua kab mob ntawv. Nws nkag mus sai heev los ntawm cov xovtooj ntawm phab ntsa ntawm cov pathogen, khov kho rau ntawm 30S ribosome ntawm cov kab mob ntawm tes thiab inhibits protein biosynthesis.
Tshaj tawm cov nyhuv ntawm gram-negative aerobic pathogens: Salmonella spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Shigella spp., Serratia spp., Providencia stuartii.
Kev nquag tiv thaiv cov kab mob muaj txiaj ntsig: Dab Tsi Staphylococcus spp. (suav nrog hom kab ke-tiv taus-resistant), muaj ntau hom Streptococcus spp.
Cov kab mob aerobic tsis muaj qhov tsis haum rau amikacin.
Cov Tshuaj Pharmacokinetics
Tom qab kev tswj hwm intramuscular, nws ua kom nquag plias nyob rau hauv tag nrho cov ntim tau muab. Nkag mus rau hauv tag nrho cov ntaub so ntswg thiab los ntawm kev paub txog keeb kwm. Kev khi rau cov ntshav muaj ntshav nce txog li 10%. Tsis raug hloov. Nws yog tawm los ntawm lub raum tsis hloov. Kev tshem tawm ib nrab-lub neej ze 3 teev.
Kev Ntsuas Amikacin
Kev qhia txog kev siv Amikacin yog ib hom kev kis mob uas tshwm sim los ntawm kab mob-gram tsis zoo (tiv taus gentamicin, kanamycin lossis sisomycin) lossis ib txhij kab mob loj thiab cov gram-tsis zoo:
- mob ua pamob ntsws, empyema ntawm pleura, mob ntsws, ntsws ntsws),
- sepsis,
- kis tau endocarditis,
- mob hlwb (suav nrog mob hlwb),
- mob txeeb zigcystitis, pyelonephritis, urethritis),
- mob plab hauv plab (suav nrog mob caj pas),
- kis kab mob ntawm cov nqaij mos, cov nqaij mos thiab tawv nqaij kom huv ntawm daim tawv nqaij (nrog rau cov mob voos, hlawv, siab tawm),
- cov kab mob ntawm tus kab mob hepatobiliary,
- sib koom ua ke thiab pob txha mob (suav nrog osteomyelitis),
- mob kiav txhab
- kev kis tus mob tom qab tau mob hnyav ntxiv.
Sab sij huam
- Kev tsis haum tshuaj: npaws, ua pob, khaus, angioedema.
- Cov kab mob plab zom mov: hyperbilirubinemiakev ua kom tau zoo hepatic transaminases, xeev siab, ntuav.
- Cov tshuaj tiv thaiv los ntawm cov kab mob hematopoietic: leukopenia, granulocytopenia, anemia, thrombocytopenia.
- Cov tshuaj tiv thaiv los ntawm cov hlab ntsha tawg: hloov pauv ntawm neuromuscular kis, tsaug zog, mob taub hau, kev hnov lus tsis zoo (lag ntseg yog qhov ua tau), cuam tshuam ntawm lub tshuab vestibular.
- Los ntawm genitourinary system: proteinuria, oliguria, microhematurialub raum tsis ua hauj lwm.
Cov lus qhia rau kev siv Amikacin (Txoj kev thiab ntau npaum li cas)
Cov lus qhia Amikacin rau kev txhaj tshuaj tso cai rau koj los tswj cov tshuaj intramuscularly lossis intravenously.
Xws li daim ntawv ntau npaum li cov ntsiav tshuaj rau qhov ncauj tswj hwm tsis muaj nyob.
Ua ntej txhaj tshuaj, nws yog ib qhov tsim nyog yuav tau ua qhov kev sim tshuaj rau qhov tob tob rau qhov tshuaj mob, yog tias tsis muaj qhov tsis sib xws rau nws txoj kev ua tau zoo.
Yuav ua li cas thiab yuav ua li cas yug Amikacin? Ib qho kev daws teeb meem ntawm cov tshuaj yog npaj ua ntej tswj hwm los ntawm kev qhia 2-3 ml ntawm cov dej distilled npaj rau kev txhaj tshuaj rau hauv cov ntsiab lus ntawm lub vial. Qhov kev daws teeb meem tau muab tshuaj tam sim tom qab kev npaj.
Cov koob tshuaj txheem rau cov neeg laus thiab menyuam yaus los ntawm ib hlis yog 5 mg / kg peb zaug ib hnub lossis 7.5 mg / kg ob zaug ib hnub rau 10 hnub.
Qhov siab tshaj plaws txhua hnub rau cov neeg laus yog 15 mg / kg, muab faib ua ob koob. Hauv kev muaj mob hnyav thiab hauv cov kab mob tshwm sim los ntawm Pseudomonas, koob tshuaj txhua hnub tau muab faib ua peb txoj haujlwm tswj hwm. Qhov siab tshaj plaws muab rau tag nrho cov chav kho mob yuav tsum tsis pub ntau tshaj 15 grams.
Cov menyuam yug tshiab tau muab thawj zaug 10 mg / kg, tom qab ntawd txav mus rau 7.5 mg / kg rau 10 hnub.
Cov txiaj ntsig kho feem ntau tshwm sim li ntawm 1-2 hnub, yog tias tom qab 3-5 hnub tom qab pib kho cov nyhuv ntawm cov tshuaj tsis pom, nws yuav tsum tau txiav tawm thiab kho cov kev hloov pauv hloov.
Noj ntau dhau
Cov paib: ataxiahnov lus kiv taub hau, nqhis dej, tso zis muaj teeb meem, ntuav, xeev siab, tinnitus, ua tsis taus pa ua pa.
Kev Kho Mob: rau kev txwv tsis pub xa cov leeg mob leeg hemodialysisntsev calcium, anticholinesterase cov neeg ua hauj lawm, Lub tshuab cua tshuab tawmraws li kev kho mob yam ntxwv.
Kev sib txuam
Cov nyhuv ntawm Neesrotoxic yog qhov ua tau thaum siv nrog vancomycin, amphotericin B, methoxyflurane,Cov kab mob xoo hluav taws xob tsis zoo, cov tshuaj tsis haum steroidal, enflurane, cyclosporine, cephalotin, cisplatin, polymyxin.
Ototoxic cov nyhuv yog tau thaum siv nrog ethacrylic acid, furosemide, cisplatin.
Thaum muab sib xyaw nrog tshuaj penicillins (nrog rau lub raum puas tsuaj) cov nyhuv antimicrobial tsawg dua.
Thaum sib qhia nrog neuromuscular blockers thiab ethyl ether tau ntawm kev ua pa nyuaj zuj zus ntxiv.
Amikacin tsis raug tso cai kom muab coj los sib xyaw ua ke nrog kev daws cephalosporins, penicillins, amphotericin B, erythromycin, chlorothiazide, heparin, thiopentone, nitrofurantoin, tetracyclines, cov vitamins los ntawm pawg B, ascorbic acid thiab poov tshuaj tshuaj dawb.
Amikacin analogues
Cov lus qhia: Amikacin sulfate (hmoov rau tov) Neeg siab phem (txhaj) Amikacin-Kredofarm (hmoov rau tov) Loricacin (txhaj) Flexelite (kev daws rau kev txhaj tshuaj).
Vim yog qhov tsis zoo ntawm txhua yam aminoglycosides Amikacin analogues tsis muaj nyob hauv cov hnyuv hauv cov ntsiav tshuaj.
Cov menyuam yaus hnub nyoog qis dua 6 xyoo raug txwv kom muab thawj koob tshuaj 10 mg / kg, tom qab ntawd 7.5 mg / kg ob zaug ib hnub.
Kev taw qhia Amikacin sulfate
Cov mob hnyav rau mob los ntawm cov kab mob me me nkag siab rau cov tshuaj: mob sepsis, mob rau daim npluag paj hlwb, peritonitis, mob septic endocarditis, mob sib kis thiab mob ua pa ntawm cov hlab ntsws (mob ntsws, pleural empyema, mob ntsws ua paug), mob raum thiab mob tso zis, tshwj xeeb tshaj yog muaj teeb meem thiab rov tshwm sim dua (pyelonephritis, urethritis cystitis), mob kub hnyiab, thiab lwm yam.
Tsuas tshuaj thiab tswj hwm
Hauv / m lossis hauv / hauv (nrog kua). Cov neeg laus thiab cov hluas nrog lub raum rov qab ua haujlwm - 15 mg / kg / hnub (5 mg / kg txhua 8 teev lossis 7.5 mg / kg txhua 12 teev), cov menyuam muaj qhov pib siv ib zaug - 10 mg / kg, tom qab ntawd 7,5 mg / kg txhua 12 teev. Qhov siab tshaj plaws txhua hnub yog 1.5 g, koob tshuaj txhua chav kawm tsis ntau tshaj 15 g. Yog tias tsis muaj kev cuam tshuam, lawv hloov mus rau kev kho mob nrog lwm yam tshuaj nyob rau 5 hnub. Lub sijhawm tiv thaiv yog 7-10 hnub.
Cov neeg mob raum tsis ua haujlwm yuav tsum tau txhaj tshuaj ntau ntxiv lossis nce ntxiv ntawm cov kev coj noj coj ua yam tsis tas hloov ib koob tshuaj. Lub sijhawm luv yog xam los ntawm cov mis: koob tshuaj creatinine concentration x 9. Thawj koob tshuaj rau cov neeg mob raum tsis ua hauj lwm yog 7.5 mg / kg, rau kev suav ntawm kev siv tshuaj tom ntej siv cov mis: Cl creatinine (ml / min) x koob tshuaj thawj zaug (mg) / Cl creatinine li qub (ml / min).
Kev tiv thaiv kev nyab xeeb
Hauv cov neeg mob uas lub cev tsis haum tshuaj mus rau lwm cov aminoglycosides, kev fab tshuaj tiv thaiv kab mob rau amikacin yuav tshwm sim. Thaum muaj kev tsis haum tshuaj, cov tshuaj tau raug muab tso tseg thiab diphenhydramine, calcium chloride, thiab lwm yam yog raug cai. Txhawm rau tiv thaiv cov nyom, nws raug nquahu kom siv cov tshuaj nyob rau hauv kev tswj hwm ntawm lub raum, hnov lus thiab lub luag haujlwm (tsawg kawg 1 zaug hauv ib lub lis piam). Qhov xwm txheej ntawm vestibular thiab hnov cov teeb meem ntau ntxiv nrog lub raum tsis ua haujlwm. Qhov ntxim nyiam ntawm kev txhim kho ntawm oto- thiab nephrotoxicity nce nrog siv ntev thiab siab siab. Ntawm thawj cov cim ntawm kev thaiv ntawm neuromuscular conduction, nws yog ib qho tsim nyog yuav tsum tau txiav txoj kev tswj hwm ntawm cov tshuaj thiab tam sim ntawd txhaj cov iv tov ntawm calcium chloride lossis sc kev daws teeb meem ntawm proserin thiab atropine, yog tias tsim nyog, tus neeg mob pauv mus rau kev tswj hwm ua pa.
Cov lus qhia tshwj xeeb
Ua ntej siv cov tshuaj, nws yog qhov yuav tsum txiav txim siab qhov rhiab ntawm microorganisms mus rau cov tshuaj tua kab mob (siv cov disks uas muaj 30 μg ntawm amikacin sulfate). Nrog rau cheeb tsam cheeb ntawm 17 mm los yog ntau dua, cov kab mob me me tau pom tias yog rhiab, 15-16 hli yog qhov kub tsis tshua muaj pes tsawg, thiab tsawg dua 14 hli yog ruaj khov. Thaum kho, cov ntsiab lus ntawm cov tshuaj tua kab mob hauv cov ntshav cov ntshav yuav tsum raug saib xyuas (qhov siab yuav tsum tsis pub ntau tshaj 30 μg / ml).
Rau i / m tswj hwm, txoj kev daws teeb meem npaj ex tempore los ntawm lyophilized hmoov nrog ntxiv ntawm 2-3 ml dej rau kev txhaj tshuaj rau cov ntsiab lus ntawm lub vial (250 mg lossis 500 mg hmoov hmoov) siv. Rau kev tswj hwm iv, dilute hauv 200 ml ntawm 5% kua nplaum tov lossis 0.9% sodium chloride tov. Qhov siab ntawm amikacin hauv kev daws rau iv kev tswj hwm yuav tsum tsis pub ntau dua 5 mg / ml.
Cov Yuav Tsum Muaj
Hypersensitivity (nrog rau keeb kwm ntawm lwm cov aminoglycosides), hnov mob neuritis, mob raum tsis ua haujlwm nrog mob azotemia thiab uremia, cev xeeb tub. Myasthenia gravis, parkinsonism, botulism (aminoglycosides tuaj yeem ua rau kev ua txhaum ntawm neuromuscular kis, uas ua rau cov leeg pob txha tsis muaj zog ntau ntxiv), lub cev qhuav dej, lub raum tsis ua haujlwm, lub sijhawm neonatal, ua ntej yug menyuam, laus laus, lactation.
Yuav siv li cas: noj ntau thiab hom tshuaj kho
V / m, iv (hauv dav hlau, rau 2 feeb los yog kua dej), 5 mg / kg txhua 8 teev lossis 7.5 mg / kg txhua 12 teev, kab mob muaj kab mob ntawm cov mob tso zis (tsis yooj yim) - 250 mg txhua 12 teev, tom qab kev kho mob hemodialysis, ib koob tshuaj ntxiv ntawm 3-5 mg / kg tuaj yeem raug kho. Qhov siab tshaj plaws rau cov neeg laus yog txog li 15 mg / kg / hnub, tab sis tsis ntau tshaj 1.5 g / hnub rau 10 hnub.
Lub sijhawm ntawm kev kho nrog a / hauv kev taw qhia yog 3-7 hnub, nrog rau / m - 7-10 hnub.
Rau cov menyuam mos thaum yug ntxov, thawj zaug yog 10 mg / kg, tom qab ntawd 7.5 mg / kg txhua 18-24 teev, rau cov menyuam yug tshiab, thawj koob yog 10 mg / kg, tom qab ntawd 7.5 mg / kg txhua 12 teev rau 7-10 hnub.
Cov neeg mob uas lub raum tsis ua hauj lwm yuav tsum tau kho qhov ntau npaum li cas.
Cov neeg mob uas kub cev yuav tsum tau koob tshuaj 5-7.5 mg / kg txhua 4-6 teev vim yog luv T1 / 2 (1-1.5 teev) hauv cov neeg mob no.
Rau i / m tswj hwm, txoj kev daws teeb meem npaj ex tempore los ntawm lyophilized hmoov nrog ntxiv ntawm 2-3 ml dej rau kev txhaj tshuaj rau cov ntsiab lus ntawm lub vial (0.25 lossis 0.5 g ntawm hmoov) yog siv. Rau i / v tswj hwm, tib txoj kev daws teeb meem yog siv rau i / m, tom qab diluting lawv nrog 200 ml ntawm 5% dextrose kev daws teeb meem lossis 0.9% NaCl daws. Qhov siab ntawm amikacin hauv kev daws rau iv kev tswj hwm yuav tsum tsis pub ntau dua 5 mg / ml.
Pharmacological kev txiav txim
Semi-hluavtaws dav-tshuaj tua kab mob, tshuaj tua kab mob. Los ntawm kev khi rau 30S subunit ntawm ribosomes, nws tiv thaiv qhov tsim los ntawm txoj kev thauj mus los thiab kev xa xov RNA, nplov cov protein synthesis, thiab kuj rhuav tshem cov kab mob cell cell.
Muaj kev ua haujlwm zoo tiv thaiv aerobic gram-tsis zoo microorganisms - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp., Shigella spp., Qee hom kab mob gram-positive - Staphylococcus. (suav nrog kev tiv thaiv ntawm penicillin, qee cov cephalosporins),
koom tes tiv thaiv kab mob Streptococcus spp.
Nrog rau kev tswj hwm tib lub sijhawm nrog benzylpenicillin, nws muaj cov nyhuv synergistic tiv thaiv Enterococcus faecalis leeg.
Tsis cuam tshuam rau tus kab mob anaerobic microorganisms.
Amikacin tsis plam cov haujlwm hauv qhov kev nqis tes ua ntawm cov enzymes uas inactivate lwm aminoglycosides, thiab tuaj yeem ua haujlwm tiv thaiv kab mob ntawm Pseudomonas aeruginosa tiv taus tobramycin, gentamicin thiab netilmicin.
Zoo tshuaj:
- Augmentin (Augmentin) Cov ntsiav tshuaj ntawm qhov ncauj
- Augmentin Hmoov rau kev tshem tawm qhov ncauj
- Orzipol (ORCIPOL) cov ntsiav tshuaj ntawm qhov ncauj
- Dioxidin (Dioxydin) Cov Tshuaj Txhuam Hniav
- Tsifran OD (Cifran OD) Cov ntsiav tshuaj ntawm qhov ncauj
- Gentamicin (Gentamicin) Txhaj Tshuaj
- Amoxicillin Sandoz (Amoxicillin Sandoz) Ntsiav tshuaj
- Augmentin EU (Augmentin ES) Hmoov rau tshuaj tov qhov ncauj
- Tshaj tawm Aerosol
- Hiconcil tshuaj ntsuab
** Qhia Txog Kev Siv Tshuaj Kho Mob yog rau cov lus qhia xwb. Xav paub ntau ntxiv, thov hu rau cov khw muag khoom ntim ntawv. Tsis txhob noj tshuaj rau yus tus kheej, ua ntej koj pib siv Amikacin Sulfate, koj yuav tsum sab laj nrog kws kho mob. EUROLAB tsis yog lub luag haujlwm rau lub txim vim tshwm sim los ntawm kev siv cov ntaub ntawv tshaj tawm ntawm lub portal. Txhua yam ntaub ntawv ntawm lub vev xaib tsis hloov cov kws kho mob cov lus qhia thiab tsis tuaj yeem ua lub luag haujlwm ntawm lub luag haujlwm zoo ntawm cov tshuaj.
Koj puas txaus siab rau Amikacin Sulfate? Koj puas xav paub cov ncauj lus ntxaws ntxaws lossis koj puas xav ntsib kws kho mob? Lossis koj puas xav tau tshuaj xyuas? Koj ua tau teem sijhawm nrog tus kws kho mob - chaw kho mob Euro lab ib txwm nyob ntawm koj qhov kev pabcuam! Cov kws kho mob zoo tshaj plaws yuav tshuaj xyuas koj, tawm tswv yim, muab kev pabcuam tsim nyog thiab ua kev kuaj mob. Koj tuaj yeem ua tau hu kws kho mob tom tsevCov. Chaw Kho Mob Euro lab qhib rau koj ib ncig ntawm lub moos.
** Mloog! Cov lus qhia hauv phau ntawv qhia tshuaj no yog npaj rau cov kws kho mob thiab tsis yog lub hauv paus rau kev siv tus kheej. Cov lus piav qhia ntawm cov tshuaj Amikacin sulfate yog muab rau kev siv thiab tsis yog rau kev teem caij kho mob yam tsis muaj kev koom tes los ntawm kws kho mob. Cov neeg mob xav tau tswv yim tshwj xeeb!
Yog tias koj txaus siab rau lwm yam tshuaj thiab cov tshuaj, lawv cov lus piav qhia thiab cov lus qhia rau kev siv, cov lus qhia txog kev tsim thiab cov qauv ntawm kev tso tawm, qhia txog kev siv thiab kev phiv, txoj kev siv, nqi thiab tshuaj xyuas cov tshuaj, lossis koj puas muaj ib yam lwm cov lus nug thiab cov lus qhia - sau ntawv rau peb, peb yuav sim pab koj.
Sab sij huam
Nrog rau kev siv ntev lossis kev siv ntau tshaj ntawm amikacin sulfate tuaj yeem muaj oto- thiab cov nyhuv nephrotoxic. Qhov tshwm sim ototoxic ntawm amikacin sulfate yog nthuav tawm hauv daim ntawv ntawm qhov tsis hnov lus (poob qis ntawm kev nkag siab siab txog kev coj ua zoo) ntawm kev ua kom lub ntsej muag tsis haum (kiv taub hau). Qhov xwm txheej ntawm vestibular thiab hnov cov teeb meem ntau ntxiv nrog lub raum tsis ua haujlwm. Cov nyhuv nephrotoxic ntawm amikacin sulfate yog tus cwj pwm los ntawm kev nce ntxiv hauv cov ntshiab pa nitrogen, ib qho kev txo qis ntawm creatine
feem ntau yog reversible. Txhawm rau tiv thaiv cov teeb meem thiab txo qis ntau zaus ntawm lawv txoj kev loj hlob, cov tshuaj tau pom zoo kom siv los tswj cov raum, hnov lus thiab cov haujlwm lub zog (tsawg kawg ib zaug ib lub lim tiam).
Ib hom mob hnyav dhau heev yog thaiv ntawm neuromuscular. Tus txheej txheem ntawm cov txiaj ntsig no tau ze rau qhov kev ua ntawm antidepolarizing hom leeg ua kom zoo nkauj. Ntawm thawj cov cim ntawm neuromuscular conduction blockade, nws yog ib qho tsim nyog yuav tsum tau txwv tsis pub cov thawj coj ntawm amikacin sulfate thiab tam sim ntawd tswj kev daws teeb meem ntawm calcium chloride lossis subcutaneous tov ntawm proserin thiab atropine. Yog tias tsim nyog, tus neeg mob hloov mus rau kev tswj hwm ua pa.
Thaum siv cov tshuaj amikacin sulfate, kev ua xua tuaj yeem ua tau (mob pob hauv daim tawv, ua npaws, mob taub hau, thiab lwm yam). Thaum lawv tshwm sim, cov tshuaj raug muab tso tseg thiab cov kev kho mob desensitizing yog tau sau tseg (diphenhydramine, calcium chloride, thiab lwm yam). Nrog kev siv tshuaj tiv thaiv ntawm cov tshuaj tua kab mob, kev txhim kho ntawm phlebitis thiab periphlebitis yog ua tau.
Cov lus nug, lus teb, tshuaj xyuas ntawm tshuaj Amikacin sulfate
Cov ntaub ntawv muab yog npaj rau kev kho mob thiab kws tshaj lij. Cov ntaub ntawv muaj tseeb tshaj plaws txog cov tshuaj muaj nyob hauv cov lus qhia uas txuas nrog lub ntim los ntawm cov kws tsim khoom lag luam.Tsis muaj cov ntaub ntawv tso tawm rau ntawm no lossis lwm nplooj ntawv ntawm peb lub xaib tuaj yeem hloov chaw rau qhov tsis txaus siab tus kheej rau tus kws tshaj lij.