Aminoglycosides tshuaj (daim ntawv teev npe, kev faib tawm, daim ntawv thov cov lus qhia)

Cov tsos rau hauv lub pharmacological ua lag luam tshiab tshuaj tua kab mob nrog ib tug ntau ntawm cov teebmeem, xws li fluoroquinolones, cephalosporins, tau coj mus rau lub fact tias cov kws kho mob pib muab aminoglycosides tsis tshua (tshuaj). Ib daim ntawv ntawm cov tshuaj muaj nyob rau hauv pab pawg neeg no yog heev uas nws kim heev thiab muaj xws li xws zoo-paub cov tshuaj raws li "penicillin", "Gentamycin", "Amikacin." Kom txog rau thaum hnub no, nyob rau hauv intensive kev saib xyuas thiab kev phais departments ntawm cov feem ntau nrov tshuaj yog raws nraim lub aminoglycoside series.

Qhia qhov tseemceeb txog ntawm cov pab pawg neeg

Aminoglycosides - tshuaj (tshuaj daim ntawv teev hauv qab no los sib tham), lwm yam tshaj li ib tug semi-hluavtaws los yog tej yam ntuj tso keeb kwm. Qhov no pab pawg neeg ntawm tshuaj tua kab mob muaj ib tug sai thiab muaj zog bactericidal ntxim rau lub cev.

Tshuaj peculiar mus rau ib tug ntau yam ntawm kev ua. Lawv antimicrobial kev ua si cov lus hais tiv thaiv Gram-tsis zoo kab mob, tab sis yog significantly txo nyob rau hauv sib ntaus tawm tsam kab-zoo microorganisms. Thiab aminoglycosides kiag li tawg paj txi txiv tiv thaiv anaerobes.

Qhov no pab pawg neeg ntawm cov tshuaj ua ib qho zoo heev bactericidal nyhuv nws muaj peev xwm irreversibly inhibit protein synthesis nyob rau hauv raug kab mob nyob rau hauv lub ribosome theem. Tshuaj yog active rau ob lub yug me nyuam thiab lub hlwb nyob rau hauv lub quiescent lub xeev. Raws li ntawm tshuaj tua kab mob kev ua si yog lig nyob rau ntawm lawv cov concentration hauv cov ntshav ntshiab ntawm tus neeg mob.

aminoglycoside siv niaj hnub no txaus no xwb. Qhov no yog vim lub high toxicity ntawm cov tshuaj no. Feem ntau cov feem ntau txom nyem los ntawm raum tshuaj thiab lub rooj sib hais kabmob.

Ib qho tseem ceeb feature ntawm cov cuab yeej yog cov tsis muaj peev xwm ntawm lawv cov allergic rau hauv nyob hlwb. Yog li, aminoglycosides kiag powerless nyob rau hauv sib ntaus tawm tsam intracellular kab mob.

Zoo thiab tsis zoo

Cov tshuaj tua kab mob yog lug siv raws li cov saum toj no hais, nyob rau hauv phais xyaum. Thiab nws yog tsis muaj coincidence. Cov kws kho mob kev nyuaj siab lub ntau yam zoo muaj los ntawm aminoglycosides.

Cov tshuaj nyob rau hauv lub cev yog txawv li zoo lub sij hawm:

• siab antibacterial kev ua si;
• tsis tuaj kawm ntawv ntawm cov tshuaj tiv thaiv mob (cov kev txhaj tshuaj thawj coj);
• tsawg tshwm sim ntawm kev ua xua;
• muaj peev xwm mus tua cov kab nteg qe;
• enhanced kho nyhuv nyob rau hauv ua ke nrog nrog beta-lactam tshuaj tua kab mob;
• siab ua si nyob rau hauv sib ntaus tawm tsam txaus ntshai tus kab mob.

Txawm li cas los, nrog rau qhov zoo piav saum toj no, qhov no pab pawg neeg ntawm medicaments thiab muaj disadvantages.

Outs yog aminoglycosides:

• tsawg yam kev ua si ntawm cov tshuaj nyob rau hauv qhov qhaj ntawv los ntawm cov pa los yog nyob rau hauv ib tug acidic nruab nrab;
• cov neeg pluag allergic ntawm qhov yooj yim tshuaj nyob rau hauv lub cev tawm dej (kua tsib, txha caj kua, hnoos qeev);
• tsos ntawm ib tug plurality ntawm sab-los.

kev faib ntawm cov tshuaj

Muaj ntau ntau classifications.

Piv txwv li, muab ib theem zuj zus ntawm cov kev taw qhia mus rau hauv kev kho mob xyaum ntawm aminoglycosides, yog cov nram qab no tiam:

1. Tus thawj tshuaj siv rau tshwj kom txhob kis kab mob twb "streptomycin", "monomitsin", "neomycin", "Kanamycin", "Paromomycin."
2. Yuav kom ob tiam yog newer aminoglycosides (tshuaj). Drug List "Gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. Qhov no pab pawg neeg no muaj xws li semi-hluavtaws tshuaj xws li "Amikacin", "Izepamitsin".

Nyob rau spectrum ntawm kev txiav txim thiab lub rov tshwm sim ntawm kuj cais me ntsis txawv aminoglycosides.

Tiam tshuaj yog cov nram qab no:

1. Yuav kom 1 pab pawg neeg no muaj xws li xws tshuaj "streptomycin", "Kanamycin", "monomitsin", "neomycin". Cov tshuaj ua rau nws tau mus tua cov kab mob TB, thiab ib co atypical kab mob. Txawm li cas los, tiv thaiv ntau yam ntawm gram-tsis zoo kab mob thiab staphylococci, lawv yog powerless.

2. Ob txhais-tiam aminoglycoside - qhov no tshuaj "gentamicin." Nws yog txawv los ntawm ib tug zoo kawg antibacterial kev ua si.

3. Paub cov tshuaj. Lawv muaj siab antibacterial kev ua si. Siv tiv thaiv klebisielly, enterobacteria, Pseudomonas aeruginosa yog ib tug thib peb-tiam aminoglycosides (tshuaj). Daim ntawv teev cov tshuaj yog raws li nram no:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. tshuaj "Izepamitsin" yog hais txog cov plaub pab pawg neeg. Nws yog txawv los ntawm lub peev xwm los zoo nrog tsitobakterom, aeromonasom, nokardiyami.

Nyob rau hauv kev kho mob xyaum, tsim lwm cais. Nws yog raws li nyob rau kev siv ntawm cov tshuaj nyob ntawm seb tus kab mob cov chaw kuaj mob, cov xwm ntawm tus kab mob, raws li tau zoo raws li hauv daim ntawv thov ntawm tus qauv.

Xws li ib tug kev faib ntawm aminoglycosides raws li nram no:

1. Tshuaj rau mauj raug muab parenterally (los ntawm kev txhaj tshuaj). Rau cov kev kho mob ntawm suppurative kab mob kab mob tshwm sim nyob rau hauv mob loj heev provoked los ntawm opportunistic co kab mob, muab tej tshuaj, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Kev kho mob ntawm Tej monoinfections, uas yog raws li obligate pathogens zoo thaum siv nyob rau hauv txoj kev kho "streptomycin" npaj "Gentomitsin". Thaum mycobacteriosis pab tshuaj "Amikacin," "streptomycin", "Kanamycin".
2. Tshuaj uas yog siv tsuas hauv rau tej indications. Cov no yog cov: "Paromitsin", "neomycin", "monomitsin".
3. Tshuaj rau cov tshuaj pleev daim ntawv thov. Lawv yog siv rau cov kev kho mob ntawm purulent kab mob kab mob nyob rau hauv otorhinolaryngology thiab Ophthalmology. Rau hauv zos tau raug tsim tshuaj "Gentamicin," "framycetin", "neomycin", "Tobramycin".

indications rau

Kev siv cov aminoglycosides yog tsim nyog yuav ua kom puas ntau yam ntawm aerobic gram-tsis zoo pathogens. Medicaments tej zaum yuav siv tau raws li monotherapy. Feem ntau lawv ua ke nrog beta-lactams.

Aminoglycosides yog qhia rau cov kev kho mob ntawm:

• nosocomial kab mob los ntawm ntau yam localization;
• purulent postoperative teeb meem;
• intra-plab kab mob;
• sepsis;
• ua kab mob endocarditis ;
• pyelonephritis tshwm sim nyob rau hauv mob loj heev ntaub ntawv;
• tus kab mob kub nyhiab;
• kab mob purulent meningitis;
• tuberculosis;
• txaus ntshai kis kab mob (plague, brucellosis, tularemia);
• lub taub dej khawb rau mob caj dab provoked los ntawm gram-tsis zoo kab mob;
• mob txeeb zig;
• ophthalmic kab mob: blepharitis, kab mob keratitis, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• ENT kab mob: otitis externa, rhinopharyngitis, rhinitis, sinusitis;
• protozoal kab mob.

phiv

Tu siab, thaum lub sij hawm kev kho mob ntawm pawg no ntawm tshuaj tus neeg mob yuav xav tias tag nrho cov series ntawm phiv los. Lub ntsiab drawback ntawm cov tshuaj - nws yog ib co tshuaj lom. Uas yog vim li cas tsuas yog ib tug kws kho mob yuav tsum muab tus neeg mob aminoglycosides.

Sab los tej zaum yuav tshwm sim:

1. Ototoxicity. Cov neeg mob tsis txaus siab ntawm lub rooj sib hais tsis tau, ib tug ringing suab nrov. Feem ntau lawv qhia rhuav txhua ntawm pob ntseg. Feem ntau ntawm cov tshuaj tshwm sim nyob rau hauv cov neeg laus, nyob rau hauv cov neeg chiv kev txom nyem los ntawm lub rooj sib hais kev tsis taus. Tej tshua tshwm sim nyob rau hauv cov neeg mob uas ntev-lub sij hawm kev kho los yog siab koob tshuaj.
2. Nephrotoxicity. Tus neeg mob zoo nkaus li nqhis dej, mas nws txawv tus nqi ntawm cov zis (tau ob qho tib si nce thiab txo), nce creatinine theem nyob rau hauv cov ntshav, txo glomerular filtration. Tej tsos mob raug ntawm cov neeg kev txom nyem los ntawm mob ntawm lub raum muaj nuj nqi.
3. Neuromuscular blockade. Tej zaum thaum lub sij hawm txoj kev kho inhibited respiration. Nyob rau hauv tej rooj plaub muaj tuag tes tuag taw ntawm lub pa nqaij. Feem ntau, xws tshua yog cov yam ntxwv nyob rau hauv cov neeg mob uas neurological kab mob los yog tsis hnov lub raum muaj nuj nqi.
4. Vestibular ntshawv siab. Lawv qhia ua txhaum ntawm kev sib koom tes, kiv taub hau. Heev feem ntau, cov mob tshwm sim los muaj tshwm sim thaum "streptomycin" lub sij hawm ntawm cov tshuaj rau tus neeg mob.
5. Neurological ntshawv siab. Tej zaum yuav tshwm sim paresthesia, encephalopathy. Tej zaum txoj kev kho yog nrog los ntawm ib tug lesion ntawm lub optic paj.

Aminoglycosides tsis tshua ua kom ua xua xws li daim tawv nqaij ua pob liab vog.

Contraindications

Piav cov tshuaj muaj tej yam kev txwv rau kev siv. Feem ntau cov feem ntau txhob aminoglycosides (lub npe ntawm uas tau muab saum toj no) nyob rau hauv xws pathologies los yog tej yam kev mob:

• ib tug neeg npau taws me ntsis;
• ua txhaum ntawm lub raum excretory muaj nuj nqi;
• lub rooj sib hais mob;
• txoj kev loj hlob ntawm neutropenic mob loj heev tshua;
• vestibular mob;
• myasthenia Heavy kev, botulism, Parkinsonism;
• ua pa nyuaj siab, stupor.

Nyob rau hauv tas li ntawd, koj yuav tsum tsis txhob siv lawv rau kev kho mob yog hais tias tus neeg mob muaj ib tug keeb kwm ntawm tsis zoo tshuaj tiv thaiv rau tej yam tshuaj los ntawm qhov no pab pawg neeg.

Xav txog cov feem ntau nrov aminoglycosides.

"Amikacin"

Cov tshuaj no yog yus muaj los ntawm ib tug qhia tau bacteriostatic, bactericidal thiab anti-teebmeem rau tib neeg lub cev. Nws qhia tau hais tias high school ua si tiv thaiv ntau Gram-zoo thiab Gram-tsis zoo kab mob. Yog li ntawd nws ua tim khawv rau cov tshuaj "Amikacin" phau ntawv qhia. Tshuaj yog zoo nyob rau hauv cov kev kho mob ntawm Staphylococcus, tus kab mob Streptococcus, pneumococcus, tus kab mob salmonella, Escherichia coli, Mycobacterium tuberculosis.

Cov tshuaj yog tsis muaj peev xwm yuav absorbed los ntawm cov hnyuv ib ntsuj av. Yog li ntawd xwb muab intravenously los yog intramuscularly. Qhov siab tshaj plaws concentration ntawm active tshuaj yog cai nyob rau hauv lub ntshiab tom qab 1 hr. Zoo kho nyhuv kav rau 10-12 teev. Vim li no cov khoom teejtug uas yog tshuaj yog ua ob zaug ib hnub twg.

Thaum nws xav siv ntawm cov tshuaj "Amikacin" cov lus qhia rau kev siv? Tshuaj no muaj cov sij hawm teem tseg hauv qab no ailments:

• mob ntsws muaj dej, bronchitis, mob ntsws rwj;
• kis kab mob ntawm cov peritoneum (peritonitis, pancreatitis, cholecystitis);
• mob txeeb zig kab mob (cystitis, urethritis, pyelonephritis);
• daim tawv nqaij kab mob (ulcerative txhab, kub nyhiab, siab ulcers, mob txhab) ;
• osteomyelitis;
• meningitis, sepsis;
• TB kab mob.

Feem ntau, qhov cuab tam yog siv nyob rau hauv qhov teeb meem provoked los ntawm kev phais.

Pub txoj kev siv cov tshuaj nyob rau hauv xyuas xyaum. Qhov tseeb yog paub tseeb hais tias mus rau yeeb tshuaj "Amikacin" phau ntawv qhia. Rau cov me nyuam los ntawm tus thawj hnub ntawm lub neej, qhov no tshuaj yuav muab.

Noj tshuaj npaum cas yog txiav txim thiaj tau tuaj los ntawm tus kws kho mob nyob ntawm seb tus neeg mob lub hnub nyoog thiab nyhav ntawm nws lub cev.

Instruction muab cov nram qab tswv yim pom zoo:

1. 1 kg ntawm tus neeg mob hnyav (ob tug neeg laus thiab cov me nyuam) yuav tsum poob rau 5 mg ntawm cov tshuaj. Nyob rau hauv no cov tswvyim muab los ntawm rov txhaj 8 teev.
2. Yog hais tias ib 1 kg lub cev hnyav, 7.5 mg ntawm medicament yog npaum li cas, lub luv ntawm tshuaj yog 12 teev.
3. Daim ntawv ceeb toom yuav ua li cas kom neonatal tshuaj "Amikacin" phau ntawv qhia. Rau cov me nyuam, tshiab khiv yug, ntau npaum yuav muab xam raws li nram no: 1 kg - 7.5 mg. Nyob rau hauv cov ntaub ntawv no hauv lub luv ntawm tshuaj - 18 teev.
4. Duration ntawm kev kho tej zaum yuav 7 hnub (nyob rau hauv / cov tswv yim) los yog hnub 7-10 (nrog rau cov / th tshuaj).

"Netilmicin"

Cov tshuaj nyob rau hauv nws cov antimicrobial nyhuv zoo xws li cov "amikacin". Yog li muaj mob nyob qhov twg "Netilmicin" muab siab miv nyuas siv zug tiv thaiv cov neeg micro-kab nyob rau hauv uas lub saum toj no cov tshuaj yog tsis muaj dab tsi.

Cov tshuaj muaj ib tug tseem ceeb kom zoo dua nyob rau hauv kev sib piv nrog rau lwm cov aminoglycosides. Raws li tau hais rau hauv lub tshuaj "Netilmicin" cov lus qhia rau kev siv, cov tshuaj muaj ib tug tsawg dua nephrotoxicity thiab ototoksichnostyu. Lub medicament yog npaj thiaj tau tuaj rau parenteral siv.

"Netilmicin" cov lus qhia rau kev siv yog xav kom nominate:

• nrog Septicemia, mob,
• rau cov kev kho mob ntawm neb kab mob provoked los ntawm Gram-tsis zoo microbes;
• kab mob ntawm cov pa system, lub urogenital huam, daim tawv nqaij, ligaments, osteomyelitis;
• Neonatal staphylococcal nyob rau hauv cov ntaub ntawv ntawm loj kab mob (sepsis los yog mob ntsws muaj dej);
• ntawm lub qhov txhab, thiab preoperative intraperitoneal kab mob;
• nyob rau hauv cov ntaub ntawv ntawm cov kev pheej hmoo ntawm postoperative teeb meem nyob rau hauv kev phais neeg mob;
• kis kab mob ntawm txoj hnyuv ib ntsuj av.

Cov pom zoo ntau npaum yog txiav txim los ntawm ib tug kws kho mob. Nws yuav tsum yog los ntawm 4 mus rau 7.5 mg. Nyob ntawm seb ntau npaum, tus neeg mob thiab nws los yog nws muaj hnub nyoog thaum lub sij hawm lub hnub yog pom zoo 1-2 txhaj tshuaj.

"Penicillin"

Cov tshuaj no yog ib yam ntawm cov tseem ceeb tshaj plaws nyob rau hauv cov pab pawg neeg ntawm tshuaj tua kab mob. Nws muaj kev ua si tawm tsam ib tug ntau yam ntawm microorganisms.

Sensitive rau "penicillin":

• streptococci;
• gonococci;
• meningococcus;
• pneumococci;
• diphtheria, kab mob anthrax, tetanus, roj gangrene;
• tej yam kab mob los ntawm Staphylococcus, Proteus.

Cov kws kho mob tau sau tseg qhov zoo tshaj tej yam ntawm lub cev los ntawm intramuscular cov tswv yim. Nyob rau hauv xws tshuaj tsis pub dhau 30-60 feeb tshaj plaws cai ntshav tshuaj concentration "penicillin".

Aminoglycosides penicillin tsa nyob rau hauv cov nram no mob:

1. High thov cov ntaub ntawv tshuaj nyob rau hauv cov kev kho mob ntawm sepsis. Lawv pom zoo rau cov kev kho mob ntawm gonococcal, meningococcal, pneumococcal kab mob.
2. Cov tshuaj "penicillin" yog muab rau cov neeg mob niaj phais cov txheej txheem nyob rau hauv thiaj li yuav tiv thaiv kom txhob cov teeb meem.
3. Tool pab tua purulent meningitis, lub hlwb rwj, gonorrhea, sycosis, syphilis. Nws yog pom zoo kom loj Burns thiab cov qhov txhab.
4. Therapy "penicillin" tshuaj kho rau cov neeg mob kev txom nyem los ntawm o ntawm lub pob ntseg, qhov muag.
5. Hos tshuaj rau cov kev kho mob ntawm focal thiab lobar mob ntsws, cholangitis, cholecystitis, lub taub dej khawb endocarditis.
6. Cov neeg kev txom nyem los ntawm rheumatism, cov tshuaj kws kho rau cov kev kho mob thiab kev tiv thaiv.
7. Cov tshuaj no yog siv rau cov me nyuam mos thiab cov me nyuam mos, uas thiaj paub hais tias ib tug hlab sepsis, los yog lub taub dej khawb pyosepticemia lom tus kab mob.
8. Cov tshuaj muaj nyob rau hauv cov kev kho mob ntawm cov nram qab no ailments: otitis, kub taub hau, mob qa hawj foob, purulent pleuritis.

Los ntawm intramuscular thawj coj ntawm ib tug medicament active ingredient yog sai absorbed rau hauv cov hlab ntsha. Tab sis tom qab 3-4 teev ntawm cov tshuaj nyob rau hauv lub cev yog tsis cai. Uas yog vim li cas, los xyuas kom meej qhov tsim nyog concentration, nws yog pom zoo kom rov hais dua cov tshuaj txhua txhua 3-4 teev.

Tshuaj "Gentamicin"

Nws yuav ua nyob rau hauv daim ntawv ntawm cov tshuaj pleev, tshuaj cov kev txhaj tshuaj, thiab ntsiav tshuaj. Cov tshuaj muaj ib tug bactericidal zog. Nws muab ib tug ntsoog loj heev ntxim rau ntau gram-tsis zoo kab mob, Proteus, Campylobacter, Escherichia, Staphylococcus, Salmonella, Klebsiella.

Kev npaj "Gentamycin" (ntsiav tshuaj los sis cov tshuaj) nkag mus rau hauv lub cev txav lub kab agents rau ib tug cellular theem. Zoo li tej aminoglycoside, nws muab ua txhaum uas muaj protein ntau synthesis pathogens. Raws li ib tug ntawm xws li cov kab mob tsis muaj peev xwm mus ntxiv me nyuam thiab tej zaum yuav tsis muab faib thoob plaws hauv lub cev.

Tshuaj tua kab mob rau cov kab mob uas cuam tshuam ntau yam systems thiab kabmob:

• meningitis;
• peritonitis;
• prostatitis;
• gonorrhea;
• osteomyelitis;
• cystitis;
• pyelonephritis;
• endometritis;
• empyema;
• bronchitis, mob ntsws;

Tshuaj "Gentamicin" txaus thov nyob rau hauv cov tshuaj. Nws tso cai rau cov neeg mob yuav kho tsis tau los ntawm mob loj ntawm lub pa thiab mob txeeb tracts. Qhov cuab yeej no yog pom zoo nyob rau hauv kab dab, yuav tsum vov lub peritoneum, cov pob txha, cov nqaij mos los yog daim tawv nqaij.

Aminoglycosides yog tsis npaj rau nws tus kheej-txoj kev kho. Tsis txhob hnov qab, xaiv cov kev kawm tshuaj tua kab mob ua tau tsuas yog tsim nyog tus kws kho mob. Yog li ntawd, tsis txhob self-medicate. Haj yam tso siab rau koj kev kho mob!