Kefsepim - cov lus qhia ua ntej rau kev siv

Kev qhia rau kev siv tshuaj Kefsepim yog:
- mob ntsws (mob pesnrab thiab mob hnyav) tshwm sim los ntawm tus kab mob Streptococcus pneumoniae (suav nrog cov neeg koom nrog concomitant bacteremia), Pseudomonas aeruginosa, Klebsiella pneumoniae lossis Enterobacter spp.,
- mob txeeb zig (ob qho tib si nyuaj thiab tsis muaj teeb meem),
- kis kab mob ntawm daim tawv nqaij thiab cov nqaij mos,
- muaj mob sib kis hauv plab (ua ke nrog metronidazole) tshwm sim los ntawm Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter spp.,
- cov txheej txheem sib kis tau tsim tawm los ntawm keeb kwm ntawm kev txhaj tshuaj tiv thaiv kab mob hauv lub xeev (piv txwv li, febrile neutropenia),
- kev tiv thaiv tus kab mob thaum phais plab,

Sab sij huam

Los ntawm lub plab zom mov: raws plab, xeev siab, ntuav, cem quav, mob plab, dyspepsia,
Lub plawv mob: mob qab pob tw, tachycardia,
Ua xua: khaus, tawv nqaij ua pob khaus, anaphylaxis, ua npaws,
Nruab nrab hauv cov hlab ntsha: mob taub hau, tsaus muag, pw tsaug zog, mob plab, ntxhov siab, ntxhov siab, kho mob,
Cov kab mob ua pa: hnoos, mob caj pas, ua pa luv,
Cov tshuaj tiv thaiv hauv zos: nrog kev tswj hwm mob plab - phlebitis, nrog kev tswj hwm intramuscular - hyperemia thiab mob ntawm qhov chaw txhaj tshuaj,
Lwm yam: asthenia, tawm hws, vaginitis, peripheral edema, mob nraub qaum, mob leukopenia, neutropenia, nce prothrombin lub sijhawm,

Cev xeeb tub

Kev siv yeeb tshuaj Kefsepim lub sijhawm cev xeeb tub tsuas yog ua tau hauv qhov xwm txheej uas tau pab rau tus niam ntau dua qhov muaj feem yuav ua rau muaj menyuam hauv plab.
Yog tias tsim nyog, kev siv cov tshuaj thaum lactation yuav tsum txiav txim siab txog kev txiav kev pub niam mis.

Kev cuam tshuam nrog lwm yam tshuaj

Siv cov koob tshuaj ntawm aminoglycosides ib txhij nrog cov tshuaj KefsepimKev saib xyuas yuav tsum tau ua los saib xyuas lub raum kev ua haujlwm vim muaj peev xwm ntawm nephrotoxicity thiab ototoxicity ntawm aminoglycoside cov tshuaj tua kab mob. Nephrotoxicity tau pom tom qab siv tib lub cephalosporins nrog diuretics, xws li furosemide. Nonsteroidal anti-inflammatory tshuaj, maj mam txo qis kev txiav tawm ntawm cephalosporins, nce kev pheej hmoo ntawm los ntshav. Kefsepim concentration los ntawm 1 txog 40 mg / ml. sib xyaw nrog cov kev daws teeb meem rau niam txiv: 0.9% sodium chloride tov rau kev txhaj tshuaj, 5% thiab 10% kua qabzib rau kev txhaj tshuaj, 6M sodium lactate tov rau kev txhaj tshuaj, 5% piam thaj thiab 0.9% sodium chloride tov rau kev txhaj tshuaj, Ringer's tov nrog lactate thiab 5% dextrose kev daws rau kev txhaj tshuaj. Txhawm rau kom tsis txhob muaj kev cuam tshuam yeeb tshuaj nrog lwm cov tshuaj, kev daws teeb meem ntawm Kefsepim (zoo li feem ntau lwm yam tshuaj tua kab mob beta-lactam) yuav tsum tsis txhob siv ib txhij nrog cov tshuaj ntawm metronidazole, vancomycin, gentamicin, tobramycin sulfate thiab netilmicin sulfate. Nyob rau hauv kev kis tau tus mob Kefsepim nrog cov tshuaj no, koj yuav tsum nkag mus rau txhua yam tshuaj tua kab mob nyias nyob nyias.

Daim ntawv noj tshuaj:

hmoov rau kev daws rau kev tso ntshav thiab tshuaj intramuscular

hauv ib fwj muaj:

Npe

Sau cia, g

0.5 g

1 g

Cefepime hydrochloride monohydrate, suav nrog zaub mov me me

(nce txog pH los ntawm 4.0 txog 6.0)

hmoov los ntawm dawb dawb mus rau daj dawb.

Pharmacological kev txiav txim

Cov Tshuaj Hauv Tshuaj

Cefepime yog ib qhov tshuaj tua kab dav dav cephalosporin tshuaj lom neeg. Cepepime inhibits lub synthesis ntawm cov kab mob cell cell phab ntsa, muaj kev pom dav dav ntawm cov kab mob ua rau cov kab mob gram-positive thiab gram-tsis zoo, suav nrog feem ntau cov kab mob tiv taus aminoglycosides lossis peb tiam cephalosporin cov tshuaj tua kab mob xws li ceftazidime.

Cepepime muaj peev xwm tiv taus qhov hydrolysis ntawm feem ntau beta-lactamases, nws muaj qhov tsis tshua zoo rau beta-lactamases thiab nkag mus sai rau cov kab mob ntawm cov kab mob gram-negative.

Nws tau raug pov thawj tias cefepime muaj kev sib txuam zoo heev rau hom 3 penicillin khi protein (PSB), muaj kev sib raug zoo rau hom 2 PSB, thiab muaj kev cuam tshuam tsawg rau hom 1a thiab 16 PSB. Cepepime muaj cov nyhuv bactericidal ntawm ntau cov kab mob.

Cepepime nquag ua si tawm tsam cov kab mob hauv qab no:

Staphylococcus aureus (suav nrog cov tsiaj uas ua cov beta-lactamase), Staphylococcus epidermidis (suav nrog kev tsim cov beta-lactamase), lwm yam kab mob ntawm Staphylococcus spp. C), Kab mob ntsws Streptococcus mob ntsws (nrog rau cov neeg muaj mob tiv thaiv penicillin tsawg kawg - qhov qis tshaj plaws yog txwv ntawm 0.1 txog 1 μg / ml), lwm yam beta-hemolytic Streptococcus spp. (pawg C, G, F), Streptococcus bovis (pawg D), Streptococcus spp. pawg ntawm viridians,

Nco tseg: Feem ntau cov kab mob enterococcal, xws li Enterococcus faecalis, thiab methicillin-resistant staphylococci yuav tiv taus cov tshuaj tua kab mob cephalosporin ntau, suav nrog kev noj zaub mov.

Acinetobacter calcoaceticus (sub-lim ntawm anitratus, lwofii),
Aeromonas hydrophila,
Capnocytophaga spp., Suav paub tab.
Citrobacter spp. (suav nrog Citrobacter diversus, Citrobacter freundii),
Campylobacter jejuni,
Enterobacter spp. (suav nrog Enterobacter cloacae, Enterobacter aerogenes, Enterobacter sakazakii),
Escherichia coli,
Gardnerella qhov chaw mos,
Haemophilus ducreyi,
Haemophilus influenzae (suav nrog beta-lactamase ua cov leeg ntshav),
Haemophilus parainfluenzae, Hafnia alvei,
Klebsiella spp. (suav nrog Klebsiella pneumoniae, Klebsiella oxytoca, Klebsiella ozaenae),
Legionella spp.,.
Morganella morganii,
Moraxella catarrhalis (Branhamella catarrhalis) (suav nrog cov kab tsim tawm beta-lactamase),
Neisseria gonorrhoeae (suav nrog kev tsim cov kab mob beta-lactamase),
Neisseria meningitidis,
Pantoea agglomerans (lub npe hu ua Enterobacter agglomerans),
Proteus spp. (suav nrog Proteus mirabilis thiab Proteus vulgaris),
Providencia spp. (suav nrog Providencia rettgeri, Providencia stuartii),
Pseudomonas spp. (suav nrog Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas stutzer),
Salmonella spp.,
Serratia spp. (suav nrog Serratia marcescens, Serratia liquefaciens),
Shigella spp.,.
Yersinia enterocolitica,

Lus khaws xav: cefepime tsis ua haujlwm tawm tsam ntau yam kab mob ntawm Stenotrophomonas maltophilia, lub npe hu ua Xanthomonas maltophilia thiab Pseudomonas maltophilia).

Anaerobes:

Cov ntsiab lus Bacteroides spp.,
Clostridium perfringens,
Fusobacterium spp.,.
Mobiluncus spp.,
Peptostreptococcus spp.,
Prevotella melaninogenica (paub li Bacteroides melaninogenicus),
Veillonella spp.,.

Lus khaws xav: Cepepime tsis ua haujlwm tawm tsam Bacteroides fragilis thiab Clostridium difficile. Secondary tsis kam ntawm microorganisms mus rau cefepime kev loj hlob qeeb.

Cov Tshuaj Pharmacokinetics

Qhov nruab nrab ntshav ntshav ntau ntawm cefepime hauv cov neeg laus noj qab haus huv ntau lub sijhawm tom qab kev tso ib leeg tshuaj rau 30 feeb txog 12 teev thiab qhov ntau ntau (C)_tah) muab rau hauv cov lus hauv qab no.

Qhov nruab nrab plasma cefepime ntau (μg / ml) tom qab kev tso dej khov.