Ciprofloxacin tshuaj pleev: cov lus qhia rau kev siv

Hauv ophthalmology: mob sib kis thiab mob qhov muag (mob sib luag thiab subacute conjunctivitis, blepharitis, blepharoconjunctivitis, keratitis, keratoconjunctivitis, kab mob corneal, mob dacryocystitis, mob meibomitis (barley), mob sib kis ntawm lub qhov muag tom qab raug mob lossis mob hauv qhov txhab) cov teeb meem sib kis hauv ophthalmic phais.

Hauv otorhinolaryngology: otitis externa, kev kho mob ntawm kev mob kis mob tom qab.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Hauv zos. Rau cov mob sib khuav me thiab mob pesnrab, 1-2 tee tso rau hauv hnab looj tes sib txuas ntawm lub qhov muag cuam tshuam txhua 4 teev, thiab rau kev kis mob hnyav, 2 ncos txhua teev. Tom qab kev txhim kho, qhov koob tshuaj thiab ntau zaus ntawm instillations txo.

Thaum muaj mob rau cov pob kiav txhab: 1 lub hau txhua 15 feeb rau 6 teev, tom qab ntawd 1 lub taub hau txhua 30 feeb thaum lub sijhawm so, nyob rau hnub 2 - 1 lub taub hau txhua teev thaum lub sijhawm sawv, los ntawm 3 mus rau 14 hnub - 1 lub hau txhua 4 teev hauv lub sijhawm so. Yog tias tom qab 14 hnub ntawm kev kho mob epithelization tsis tau tshwm sim, kev kho mob tuaj yeem txuas ntxiv.

Cov tshuaj pleev qhov muag tau tso rau hauv qab tawv muag ntawm lub qhov muag cuam tshuam.

Pharmacological kev txiav txim

Tus neeg sawv cev dav dav-antimicrobial, tus neeg ua fluoroquinolone, los tiv thaiv 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, kab mob loj hlob thiab faib, thiab ua rau tawm suab morphological. cov kev hloov pauv (suav nrog cell ntsa 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 thaum lub sijhawm so thiab faib (vim nws cuam tshuam tsis tsuas yog DNA gyrase, tab sis kuj ua rau lysis ntawm phab ntsa cell), thiab cov kab mob gram-zoo tsuas yog nyob rau lub sijhawm faib.

Tsis tshua muaj tshuaj lom rau macroorganism hlwb tau piav qhia los ntawm qhov tsis muaj DNA gyrase hauv lawv. Thaum noj ciprofloxacin, tsis muaj ib qho kev loj hlob ntawm cov txheej txheem tiv thaiv rau lwm cov actibiotics uas tsis koom nrog cov pab pawg ntawm cov tshuaj tiv thaiv gyrase, uas ua rau nws muaj txiaj ntsig zoo rau cov kab mob uas tiv taus, piv txwv li, rau aminoglycosides, penicillins, cephalosporins, tetracyclines thiab ntau lwm yam tshuaj tua kab mob.

Cov kab mob gram-negative aerobic raug tau rau ciprofloxacin: enterobacteria (Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescensa. , Morganella morganii, Vibrio spp., Yersinia spp.), Lwm cov kab mob gram-tsis zoo (Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campyunlobacterium. Tus mob legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Corynebacterium diphtheriae,

Cov kab mob aerobic Gram-positive: Staphylococcus spp. (Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Cov kab mob Streptococcus spp. (Cov kab mob Streptococcus pyogenes, Cov kab mob Streptococcus agalactiae).

Feem ntau cov tshuaj methicillin-resistant staphylococci kuj tiv taus ciprofloxacin. Qhov rhiab ntawm Streptococcus pneumoniae, Enterococcus faecalis, Mycobacterium avium (nyob rau hauv intracellularly) yog muaj mob pes tsawg (qhov siab xav tau yuav tsum tau txwv lawv).

Cov tshuaj tiv thaiv: Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Kev ua tsis tau zoo tiv thaiv Treponema pallidum.

Kev tawm tsam maj mam pib qeeb qeeb, vim tias, ntawm ib sab, tom qab qhov kev ua ntawm ciprofloxacin muaj kev xyaum tsis muaj cov kab mob tsis tu ncua, thiab ntawm qhov tod tes, cov kab mob hlwb tsis muaj enzymes uas inactivate nws.

Sab sij huam

Kev tsis haum tshuaj, khaus, kub, mob me thiab mob hyperemia ntawm lub qhov muag los yog hauv lub qog tympanic, xeev siab, tsis tshua muaj - o ntawm daim tawv muag, photophobia, lacrimation, qhov txawv ntawm lub cev txawv teb chaws hauv lub qhov muag, qhov tsis zoo tom qab hauv lub qhov ncauj tam sim ntawd tom qab instillation, qhov muag tsis pom, qhov tshwm sim ntawm lub ntsej muag dawb. nag lossis daus nyob rau hauv cov neeg mob uas mob caj dab, mob keratitis, keratopathy, qhov tshwm sim ntawm me ntsis lossis mob pob txha, kev txhim kho superinfection.

Cov Tshuaj Hauv Tshuaj

Ciprofloxacin neutralizes DNA gyrase ntawm cov kab mob cell, inhibits cov kev ua ntawm topoisomerases kev koom tes hauv kev tsis tsim nyog ntawm DNA molecule. Cov tshuaj txwv tsis pub luam tawm ntawm cov khoom siv keeb ntawm cov kab mob, txwv kev loj hlob thiab rov tsim cov kab mob me. Nws muaj cov nyhuv bactericidal ntawm cov kab mob gram-negative pathogenic microorganisms nyob hauv lub xeev dormant thiab nquag ua haujlwm. Cov kab mob Gram-zoo raug rau cov tshuaj tua kab mob tsuas yog thaum faib. Rhiab rau ciprofloxacin:

• Gram-negative aerobic microorganisms (Escherichia, Salmonella, Shigella, Citrobacter, Klebsiella, Enterobacter, Proteus, Cholera Vibrio, Serrations),
• lwm cov kab mob gram-tsis zoo (pseudomonads, moraxella, aeromonads, pasteurella, campylobacter, gonococcus, meningococcus),
• Kab mob intracellular (legionella, brucella, chlamydia, listeria, tubercle bacillus, diphtheria bacillus),
• gram-positive aerobic microorganisms (staphylococci, streptococcus).

Kuj tsis paub meej rhiab muaj:

Cov tshuaj tsis cuam tshuam rau:

• ureaplasma urealitikum,
• methicillin-resistant staphylococci,
• clostridia
• tsis muaj ntawv qhia
• treponema daj ntseg.

Kev ruaj khov txhim kho maj mam. Tom qab siv ciprofloxacin, cov kab mob tsis tu ncua tsis nyob. Tsis tas li ntawd, cov pathogens tsis tsim cov enzymes uas tua cov tshuaj tua kab mob.

Cov Tshuaj Pharmacokinetics

Thaum siv hauv zos, mentsis cov tshuaj nqus rau hauv cov ntshav. Ciprofloxacin accumulates hauv cov ntaub so ntswg uas cuam tshuam, ua rau lub zog hauv cheeb tsam. Kev siv tshuaj tua kab mob kom pom tseeb tau ntev li 60-90 feeb tom qab kev muab tshuaj pleev.

Daim ntawv thov thiab qhov ntau npaum li cas

1-1.5 cm tshuaj pleev yog muab tshaj pob muag qis 3 zaug hauv ib hnub. Lawv raug kho rau 2 hnub, tom qab ntawd tus lej ntawm cov txheej txheem raug txo mus rau 2 nyob rau ib hnub. Thaum muaj mob hnyav, tau siv tshuaj pleev txhua 3 teev. Qhov ntau ntawm cov txheej txheem raug txo kom tsawg vim tias cov cim ntawm qhov mob huam ploj. Txoj kev kho kom zoo yuav tsum tsis pub ntev tshaj 14 hnub. Ua ntej qhia tawm ntawm cov roj pleev, daim tawv muag yuav tsum pauv qis. Cov tshuaj pleev yog maj mam muab nyem tawm ntawm cov raj thiab qhia rau hauv hnab looj tes kev sib txuas. Daim tawv muag tau tso tawm thiab me ntsis nias tawm ntawm daim tawv muag rau 60-120 vib nas this. Tom qab qhov no, tus neeg mob yuav tsum pw nrog nws lub qhov muag kaw li 2-3 feeb.

Cov tshuaj tiv thaiv kom tsis haum rau kev siv tshuaj pleev ciprofloxacin

Tshuaj pleev siv tsis tau nrog:

• kev tsis qaug rau cov tshuaj nquag thiab cov khoom xyaw pabcuam,
• kis mob kas cees,
• fungal kab mob ntawm lub qhov muag.

Daim ntawv ntawm tus txheeb ze contraindications suav nrog:

• hais atherosclerotic txhab ntawm lub cerebral hlab ntsha,
• cov kev huam yuaj ntawm cerebrovascular,
• txawj nyeem ntawv zuj zus.

Noj ntau dhau

Thaum siv tshuaj pleev rau nws lub hom phiaj, ib qho kev tshaj tawm tsis zoo. Yog tias cov yeeb tshuaj poob rau hauv lub plab, ntuav, tso quav tawm, mob taub hau, ntxhov siab, thiab tsaus muag. Cov kev pabcuam thaum xub thawj ua rau rov ua kom cov dej-ntsev sib npaug ntawm lub cev, nce acidity ntawm cov zis, uas tiv thaiv kom tsis txhob tsim cov pob zeb hauv lub raum thiab zais zis.

Yeeb tshuaj sib cuam tshuam

Kev siv cov roj pleev ntau ntau tuaj yeem pab txhawb lub zog theophylline concentration hauv cov ntshav, maj mam ua kom cov caffeine ua kom zoo ntxiv thiab txhim kho cov nyhuv ntawm qhov tsis ncaj. Kev siv ciprofloxacin txuam nrog cyclosporine tuaj yeem ua rau kev nce ntxiv ib ntus nyob rau hauv kev saib xyuas cov creatinine hauv cov ntshav.

Cov tshuaj hauv qab no muaj cov txiaj ntsig zoo ib yam:

• Cypromed
• Tsiprolet,
• Oftocipro,
• Ciprofloxacin (tee),
• Ciprofloxacin (ntsiav tshuaj-coated ntsiav tshuaj).

Cov yam ntxwv Pharmacological:

Cov Tshuaj Hauv Tshuaj

Antimicrobial tus neeg sawv cev ntawm ntau qhov kev pom ntawm kev ua ntawm pab pawg ntawm fluoroquinolones. Nws muaj cov nyhuv bactericidal. Txhawb nqa DNA gyrase thiab thaiv cov kab mob DNA sib txuas ua ke.

Mob siab rau feem ntau tiv thaiv cov kab mob gram-tsis zoo: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

Siv tiv thaiv Staphylococcus spp. (suav nrog cov kab tsim tawm thiab tsis tsim cov tshuaj penicillinase, cov kab mob tiv thaiv kabmob methicillin), qee yam ntawm Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

Ciprofloxacin nquag ua haujlwm tiv thaiv cov kab mob uas tsim cov beta-lactamases.

Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides tiv taus ciprofloxacin. Qhov kev txiav txim tawm tsam Treponema pallidum tsis to taub zoo.

Cov Tshuaj Pharmacokinetics

Sai sai nqus los ntawm cov hnyuv. Txoj kev ntsuam xyuas kev nyab xeeb tau tom qab tswj hwm ntawm qhov ncauj yog 70%. Noj khoom ib nyuag qhov cuam tshuam kev nqus ntawm ciprofloxacin. Kev khi rau cov ntshav plasma protein yog 20-40%. Nws tau faib tawm hauv cov ntaub so ntswg thiab dej ntawm lub cev. Nws nkag mus rau hauv cov kua dej cerebrospinal: cov ntsiab lus ntawm ciprofloxacin nrog tus kabmob tsis muaj peev xwm ncav cuag li 10%, nrog cov kabmob uas muaj kabmob - txog 37%. Qhov ntau ntau tau tiav hauv bile. Muaj nyob hauv chaw tso zis thiab kua tsib.

Muab thiab kev coj:

Ib Leeg. Sab hauv - 250-750 mg 2 zaug / hnub. Lub sijhawm tiv thaiv yog ntawm 7-10 hnub txog 4 lub lis piam.

Rau kev tswj hwm kev tso ntshav, ib koob tshuaj yog 200-400 mg, qhov ntau zaus ntawm kev tswj hwm yog 2 zaug / hnub, lub sijhawm siv tshuaj kho yog 1-2 lub lis piam, yog tias tsim nyog siv. Nws muaj peev xwm los tswj kev iv hauv ib lub dav hlau, tab sis zoo dua, muaj kev tswj hwm droplet rau 30 feeb.

Thaum ua ntawv thov saum toj, 1-2 tee tau siv rau hauv cov hnab ntim qis ntawm qhov muag cuam tshuam txhua 1-4 teev. Tom qab kev txhim kho, qhov sib txuas ntawm cov instillations tuaj yeem muaj ntau ntxiv.

Qhov siab tshaj plaws txhua hnub koob rau cov neeg laus, thaum noj ntawm qhov ncauj yog 1.5 g.

Sab sij huam:

Los ntawm lub plab zom mov: xeev siab, ntuav, raws plab, mob plab, nce kev ua haujlwm ntawm hepatic transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis.

Los ntawm sab ntawm lub hauv nruab nrab hauv lub paj hlwb: mob taub hau, kiv taub hau, zoo li nkees, pw tsaug zog, npau suav phem, daig dej, tsaus muag, pom kev puas ntsoog.

Los ntawm cov kab mob urinary: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, muaj kev hloov pauv ntawm cov ntshav creatinine.

Los ntawm cov kab ke hemopoietic: eosinophilia, leukopenia, neutropenia, hloov platelet suav.

Los ntawm sab ntug ntawm cov hlab plawv: tachycardia, lub plawv sib dhos cuam tshuam, kev mob ntshav siab hypotension.

Kev tsis haum tshuaj: mob pruritus, urticaria, Quincke's edema, Stevens-Johnson syndrome, mob caj dab.

Cov kev phiv tshuaj los cuam tshuam nrog kev siv tshuaj kho mob: candidiasis.

Cov tshuaj tiv thaiv hauv zos: mob, phlebitis (nrog rau kev tswj hwm iv). Nrog kev siv qhov muag pom, qee qhov mob me me thiab mob qhov muag hyperemia tuaj yeem ua tau.

Cov tshuaj pleev zoo li cas

Cov lus piav qhia rau cov tshuaj tau hais tias nws belongs rau chav kawm ntawm fluoroquinolones. Cov tshuaj ntawm cov pab pawg no pab txhawb kev ua kom zoo tiv thaiv cov kab mob microbial uas tshwm sim los ntawm daim ntawv aerobic ntawm lawv qhov kev nthuav qhia

Qhov kev txiav txim yog nyob ntawm thaj tsam hauv cheeb tsam, tsuas yog daim ntawv ntsiav tshuaj ntawm kev tso tawm yog ua txoj haujlwm.

Tus txheej txheem kho tshwm sim tom qab lub sijhawm luv luv. Txoj kev kho yuav tsis ua rau muaj ntau ntawm kev phiv.

Ciprofloxacin ophthalmic ointment pab kom sai thiab nyab xeeb kom tshem tawm cov tsos mob ntawm tus kab mob.

Cov tshuaj nquag thiab muaj pes tsawg leeg

Hauv plawv ntawm qhov mob tshwm sim rau lub cev yog ib qho khoom siv hu ua ciprofloxacin.

Nws tau siv rau hauv kev kho mob rau lub sijhawm ntev heev thiab twb tau tswj hwm los tsim nws tus kheej ua qhov cuab yeej zoo.

Nws cuam tshuam DNA cov lwg me me ntawm cov kab mob, inhibits nws txoj kev loj hlob ntxiv thiab rov ua dua haujlwm, uas ua rau tuag tsis muaj peev xwm rov kis mob dua.

Thaum lub sijhawm tshuaj ntsuam xyuas mob, nws pom tias muaj feem rau qee cov kev txawv txav, cov haujlwm yog xoom. Ntawd yog, nyob rau hauv qhov xwm txheej, nws yog qhov yuav tsum tau siv analogues ntawm ciprofloxacin qhov muag tee.

Cov nkauj muaj xws li:

• hydrochloric acid (diluted),
• kua paraffin
• lim dej
• Trilon B
• ciprofloxacin.

Lawv feem ntau tsis cuam tshuam rau txoj haujlwm ntawm lub cev.

Nyob rau hauv lub xub ntiag ntawm intolerance, tsis txhob tsis saib xyuas cov uas tau pom nyob rau hauv tsis tshua muaj ntau. Qhov no tuaj yeem ua rau tsis muaj kev puas tsuaj rau kev noj qab haus huv.

Cev xeeb tub thiab lactating cov poj niam thaum yau

Thaum cev xeeb tub thiab lactation yog contraindicated. Tsis muaj qhov tshwj xeeb txawm hais tias qhov muaj txiaj ntsig rau leej niam yog qhov ntau dua qhov kev raug mob rau cov menyuam hauv plab.

Hauv cov menyuam hnub nyoog qis dua 18 xyoo, txwv tsis pub siv yog yam raug txwv.

Kev cuam tshuam nrog lwm cov tshuaj:

Nrog rau kev siv ciprofloxacin sib xyaw nrog didanosine, qhov nqus ntawm ciprofloxacin yog txo vim qhov tsim ntawm ciprofloxacin complexones nrog aluminium thiab magnesium buffers muaj nyob hauv didanosine.

Nrog rau kev siv ua ke nrog warfarin, qhov txaus ntshai los ntshav ntau ntxiv.

Nrog rau kev siv txia ciprofloxacin thiab theophylline, nce theophylline concentration hauv cov ntshav ntshav, nce ntxiv hauv T, yog ua tau_1/2 theophylline, uas ua rau muaj kev pheej hmoo ntau ntxiv ntawm kev tsim cov tshuaj lom cuam tshuam nrog theophylline.

Kev tswj hwm ib txhij ntawm cov tshuaj tiv thaiv kab mob, nrog rau kev npaj muaj aluminium, zinc, iron lossis magnesium ions, tuaj yeem ua rau txo qis ntawm kev nqus ntawm ciprofloxacin, yog li cov sijhawm nruab nrab ntawm kev teem caij cov tshuaj yuav tsum yog tsawg kawg 4 teev.

Cov lus qhia tshwj xeeb thiab cov kev ceev faj:

Hauv cov neeg mob uas lub raum khiav tsis zoo, yuav tsum tau kho tshuaj ntau dua. Nws yog siv nrog kev ceev faj nyob rau hauv cov neeg mob laus, nrog mob cerebral arteriosclerosis, mob cerebrovascular, mob vwm, mob vwm, mob hlwb tsis paub meej ntawm tus mob tsis meej.

Thaum kho, cov neeg mob yuav tsum tau haus dej txaus.

Yog tias mob raws plab tsis tu ncua, ciprofloxacin yuav tsum tsis ua mus ntxiv.

Nrog tib lub sijhawm ntsuas kev tswj hwm ntawm ciprofloxacin thiab barbiturates, tswj lub plawv dhia, ntshav siab, ECG yog qhov tsim nyog. Thaum kho, nws yog ib qho tsim nyog los tswj lub siab ntawm urea, creatinine, thiab hepatic transaminases hauv cov ntshav.

Thaum lub sijhawm kev kho mob, txo qis kev ua haujlwm tau yog (tshwj xeeb thaum siv ua ke nrog cawv).

Kev qhia txog ciprofloxacin subconjunctival lossis nkag ncaj qha rau chav sab xub ntiag ntawm qhov muag tsis tso cai.

Nrog lub raum tsis ua haujlwm

Hauv cov neeg mob uas lub raum khiav tsis zoo, yuav tsum tau kho tshuaj ntau dua.

Siv rau lub sijhawm qub

Siv nrog ceev faj hauv cov neeg laus cov neeg laus.

Siv rau thaum yau

Contraindicated rau cov menyuam yaus thiab cov hluas hauv qab 15 xyoo.

Tshuaj los qhia

Cov kab mob sib kis thiab mob tau tshwm sim los ntawm cov kab mob me me uas nkag rau ciprofloxacin, suav nrog cov kab mob ntawm cov kab mob ua pa, mob plab thiab pelvic plab hnyuv siab raum, pob txha, pob qij txha, tawv nqaij, septicemia, muaj mob hnyav ntawm cov kabmob ENT. Kev kho mob tom qab kis mob. Kev tiv thaiv thiab kho kab mob hauv cov neeg mob uas txo qis tiv thaiv.

Rau kev siv tshuaj: mob caj dab thiab mob subacute conjunctivitis, blepharoconjunctivitis, blepharitis, kab mob corneal mob, keratitis, keratoconjunctivitis, mob dacryocystitis, mob meibomites. Cov kab mob qhov muag pom tom qab raug mob los yog lub cev txawv teb chaws. Preoperative prophylaxis hauv kev phais mob ophthalmic.

Kev noj tshuaj ntxiv

Ib Leeg. Sab hauv - 250-750 mg 2 zaug / hnub. Lub sijhawm tiv thaiv yog ntawm 7-10 hnub txog 4 lub lis piam.

Rau kev tswj hwm kev tso ntshav, ib koob tshuaj yog 200-400 mg, qhov ntau zaus ntawm kev tswj hwm yog 2 zaug / hnub, lub sijhawm siv tshuaj kho yog 1-2 lub lis piam, yog tias tsim nyog siv. Nws muaj peev xwm los tswj kev iv hauv ib lub dav hlau, tab sis zoo dua, muaj kev tswj hwm droplet rau 30 feeb.

Thaum ua ntawv thov saum toj, 1-2 tee tau siv rau hauv cov hnab ntim qis ntawm qhov muag cuam tshuam txhua 1-4 teev. Tom qab kev txhim kho, qhov sib txuas ntawm cov instillations tuaj yeem muaj ntau ntxiv.

Qhov koob tshuaj txhua hnub rau cov neeg laus thaum noj ntawm qhov ncauj yog 1.5 g.