"Amphotericin B": kev qhia, cov mechanism ntawm qhov kev txiav txim. Testimonials txog cov tshuaj

Fungal daim tawv nqaij coj loj tsis xis nyob rau tus neeg mob. Ntxiv mus, xws kis kab mob. Yog li ntawd, thaum thawj cov cim qhia ntawm lub pwm yuav tsum tau xa mus rau ib tug tshwj xeeb. Tom qab dua cov kev kho mob ntsuam xyuas thiab lwm yam kev kuaj tus kws kho mob yog yuam ua hauj lwm kom taw ib tug neeg mob zoo tshuaj.

Heev feem ntau, rau cov kev kho mob ntawm fungal kab mob siv ib tug ntau yam ntawm tshuaj pleev thiab tshuaj. Txawm li cas los, feem ntau cov kws kho mob hais tias xws li ib tug pathological mob yog qhov zoo tshaj plaws kho los ntawm tso dej txhaj tshuaj. Tom qab tshuaj ntawm cov tshuaj sai li sai tau pib ua rau kab mob uas muaj ib tug kev rhiab heev rau nws.

Cov ntau npaum thiab zoo txoj kev uas yuav nqa tshuaj los mus tshem tawm cov kab mob fungal "Amphotericin B". Cov lus qhia, cov ntaub ntawv ntawm kev tso cai thiab testimonials txog cov tshuaj uas hais no hauv qab no.

Form, muaj pes tsawg leeg, kev piav qhia thiab ntim ntawm tshuaj tua kab mob

Tau pom tias cov tshuaj yuav ua tau nyob rau hauv cov nram no cov ntaub ntawv:

• Lyophilisate "Amphotericin B". Xyuas tau qhia hais tias qhov no daim ntawv ntawm cov tshuaj yog ib tug ntxeem tau hygroscopic loj daj xim nrog tsis muaj pronounced tsw. Nws yog tsim los rau qhov kev npaj ntawm Txoj kev lis ntshav tov. Lub active feem ntawm cov tshuaj yog amphotericin B. Lub Cheebtsam yog siv raws li koom haum pab tshuaj xws li monobasic sodium phosphate thiab deoxycholic acid. Nyob rau hauv lub qhov muag ntawm tus medicament nkag nyob rau hauv vials ntawm 10 ml, thiab daim ntawv cartons.

• Tshuaj pleev "Amphotericin B". Daim ntawv thov ntawm no txhais tau tias yog qhia raws li ib tug ntxiv tshuaj nyob rau hauv ua ke nrog txoj kev kho. Noj tshuaj pleev tsuas yog siv externally. Nws yog daj thiab muaj cov active ingredient ntawm lub tib lub npe. Raws li rau lub ntxiv cheebtsam uas yog siv raws li ntxhia roj, petrolatum, thiab polysorbate 80. Muas tshuaj no yuav ua tau nyob rau hauv lub thawv ntawm 30 los yog '15

Lub mechanism ntawm qhov kev txiav txim ntawm cov tshuaj protivogribkvogo

Yuav ua li cas yog cov tshuaj "Amphotericin B"? Cov lus qhia rau kev siv (ntsiav tshuaj nrog rau cov tib yam kom nquag plias khoom sib ua zaub mov nyob heev problematic) qhia tias nws yog ib tug macrocyclic polyene tshuaj tua kab mob nrog noj ua si. Nws yog ua los ntawm Streptomyces nodosus, thiab muab fungistatic thiab fungicidal txiav txim (nyob ntawm seb lub concentration ntawm cov tshuaj nyob rau hauv lom kua thiab nyhav).

Tom qab cov tshuaj uas nkag mus rau hauv cov hlab ntsha nws uake mus sterols uas muaj nyob rau hauv lub cell daim nyias nyias ntawm fungi rhiab mus rau yeeb tshuaj. Raws li ib tug ntawm xws li raug tus kab mob yog ntxhov permeability thiab tshem tawm cov intracellular Cheebtsam tshwm sim nyob rau hauv lub extracellular qhov chaw.

Cov tshuaj yog "amphotericin B" yog active tiv thaiv ntau hom thiab muaj mob pesnrab active tiv thaiv protozoa fungi.

Nws yuav tsum tau muab sau tseg tias los ntawm qhov no txhais tau resistant Fusarium spp. thiab Pseudallescheria boydii. Nyob rau hauv tas li ntawd, cov tshuaj no yog tsis zoo tiv thaiv rickettsiae, cov kab mob thiab cov kab mob.

Cov kev tig tau thaj chaw ntawm cov tshuaj

Tam sim no koj paub tias yog zoo li no ib tug noj neeg sawv cev, raws li "Amphotericin B". Lub mechanism ntawm qhov kev txiav txim ntawm no neeg sawv cev twb tau piav saum toj no.

Tom qab tso dej thawj coj ntawm cov tshuaj nyob rau hauv ib koob tshuaj nyob rau hauv cov ntshav tam sim ntawd tsim nws zoo concentration uas yog tswj thoob plaws hauv lub hnub. C cov nqaijrog uake rau lub cuab tam ntshav los ntawm 90 feem pua.

Saib medicament faib nyob rau hauv lub siab, mob ntsws, mob raum, tus po, cov leeg, adrenal caj pas thiab lwm yam kabmob thiab ntaub so ntswg. Nws nyob rau hauv concentration pleural effusion, peritoneal thiab synovial kua raws li aqueous lom zem nce mus txog 2/3 ntawm lub concentration hauv cov ntshav.

Txoj kev kawm no txhais tau tias tsis paub hais tias. Nyob rau hauv cov zis thiab kua tsib txog 98 feem pua ntawm cov tshuaj uas tam sim no nyob rau hauv daim ntawv ntawm cov metabolites. Tso tawm maj mam los ntawm ob lub raum. Thawj zaug ib nrab-lub neej ntawm cov tshuaj nyob rau hauv cov neeg laus uas yog 24 teev, nyob rau hauv cov me nyuam - 6-40 teev, thiab cov me nyuam mos - 20-60 lub sij hawm. Terminal ib nrab-lub neej yog 15 hnub.

indications tshuaj tua kab mob

Uas hlub kab mob tshuaj "Amphotericin B"? Nws tau raug tsa nyob rau hauv hnyav, lub neej-hem fungal kab mob uas tau tshwm sim los ntawm raug kab mob:

• histoplasmosis, disseminated cryptococcosis, coccidioidomycosis;
• cryptococcal meningitis, paracoccidioidomycosis, chromomycosis;
• meningitis tshwm sim los ntawm lwm yam fungi, North American blastomycosis;
• metastatic thiab tus aspergillosis, phycomycosis (zygomycosis);
• tsim disseminated Candidiasis gialogifomikoza;
• pwm mycosis, mob mycetoma;
• disseminated sporotrichosis, mob plab kab mob (xws li peritonitis);
• endophthalmitis, endocarditis, fungal sepsis;
• Visceral leishmaniasis, fungal mob txeeb zig;
• American cutaneous visceral leishmaniasis.

Contraindications noj neeg sawv cev

Xav txog dab tsi lub xeev mus thov cov txwv tsis pub siv yeeb tshuaj "Amphotericin B" (ntsiav tshuaj los ntawm ib cov pwm ntawm tib lub npe yog tsis ua). Raws li cov lus qhia, qhov cuab tam yog txhob:

• mob raum tsis ua hauj lwm;
• nyob rau hauv npau taws me ntsis;
• thaum lub sij hawm pub niam mis.

Nrog kev saib xyuas active medicament siv nyob rau hauv lub raum kab mob (xws li glomerulonephritis), amyloidosis, daim siab mob npuas paug, kab mob siab, anemia, agranulocytosis, cev xeeb tub thiab cov ntshav qab zib.

Lyophilisate "Amphotericin B": cov lus qhia rau kev siv

Rau kev npaj ntawm ib qho kev tso dej tshuaj tov twb siv nrog ib tug thawj zaug concentration ntawm 5 mg / ml. Los ntawm ib tug syringe 10 ml ntawm muaj menyuam tsis taus dej rau txhaj yuav ua rau lub minyuam lam fwj tshuaj nrog rau cov medicament. Tom ntej no, lub txheem shaken tsim tau ib pob tshab colloidal kua.

Tso dej tshuaj no yog muab tsis pub dhau ib teev nyob rau hauv cov kev tswj ntawm cov ntshav siab, lub cev kub thiab lub plawv dhia ntawm tus neeg mob. Nyob rau hauv nws zoo kam tshuaj twb pom zoo txhua hnub ntau npaum ntawm 0.25-0.3 mg ib kg lub cev qhov ceeb thawj (nyob ntawm seb lub heev ntawm tus kab mob no).

Nyob rau hauv cov kab mob ntawm lub plawv thiab cov hlab ntsha, muaj rhiab heev thiab txaus los khi lub raum muaj nuj nqi, kev kho mob yog pib nrog me me noj tshuaj npaum cas (5-10 mg), uas yog maj nce los ntawm 5-10 mg ib hnub twg thiab yog tom kom 0.5-0.7 mg ib kg.

Thaum sporotrichosis kawg koob tshuaj yog 2.5 g, thiab qhov ntev ntawm txoj kev kho - yam tsawg kawg yog 9 lub hlis.

Thaum lub cuab tam aspergillosis ntau npaum yog 3.6 g, thiab qhov ntev ntawm kev kho mob - yam tsawg kawg 11 lub hlis.

Cov me nyuam mos thaum pib ntawm txoj kev kho xeem 0.25 mg ib kg lub cev hnyav ib hnub twg thiab ces nce maj mam mus rau ib tug tshaj plaws tshuaj (1 mg ib kg).

Tshuaj pleev "Amphotericin B": cov lus qhia rau kev siv

Ntsiav tshuaj nyob rau hauv tib luam lub npe nyob rau hauv pharmacies yog tsis muag. Yog li ntawd, rau cov kev hloov ntawm cov tshuaj no yuav tsum tau nrog ib tug kws kho mob.

Yog hais tias tsim nyog siv lub tshuaj pleev "Amphotericin B" nyias txheej yog thov rau cov chaw ib hnub ob zaug. Cov kev kho mob kawg nyob rau hauv lub muaj pov thawj:

• nrog Candidiasis ntawm daim tawv nqaij folds - txog 1-3 lub lis piam;
• nrog pob tw ntse nyob rau hauv cov me nyuam - kwv yees li 7-14 hnub;
• nrog paronychia thiab interdigital tej qhov chaw xwb - 2-4 lub lis piam.

phiv

Kev npaj "Amphotericin B" tej zaum yuav ua rau cov hauv qab no phiv:

• mob taub hau, qaug dab peg, peripheral neuropathy, nraum Kiv tauv hau, encephalopathy;
• tsis qab los noj mov, ntuav, dyspepsia, xeev siab, gastralgia, raws plab, hepatotoxicity, mob siab tsis ua hauj lwm, jaundice, kab mob siab, melena, haemorrhagic Gastroenteritis;
• normochromic normocytic anemia, leukopenia, txhaws tsis meej, thrombocytopenia, agranulocytosis, hemolytic anemia, eosinophilia, leukocytosis;
• qhov muag plooj tsis pom kev, tsis hnov lus, diplopia, tinnitus;
• tachypnea, dyspnea, pulmonary edema, arrhythmia thiab npau taws me ntsis pneumonitis;
• poob los yog muaj zog ntshav siab, khaus, kev hloov nyob rau hauv ECG tsis, lub plawv tsis ua hauj lwm, poob siab, lub plawv tsis ua hauj lwm;
• anaphylactoid tshua, txham, nephrogenic mob ntshav qab zib insipidus, bronchospasm, nephrocalcinosis, tawm pob, eksfoliativiy dermatitis, tshuaj lom epidermal necrolysis
• raum tsis ua hauj lwm, hypokalemia, gipostenuriyu, raum tubular acidosis, Stevens - Johnson syndrome, mob raum tsis ua hauj lwm, oliguria, anuria;
• thrombophlebitis thiab hlawv ntawm lub qhov koob;
• kub taub hau, myalgia, poob phaus, arthralgia, kev tsis muaj zog.

tus neeg mob ntawm overdose

Thaum muab loj koob tshuaj noj tshuaj ib tug neeg mob tej zaum yuav ua tsis taus pa thiab lub plawv. Yog li ntawd, nyob rau hauv lub chav kawm ntawm kev kho yuav tsum nruj me ntsis raws li cov pom zoo npaum tus kws kho mob. Nws tseem yog tsim nyog los saib xyuas qhov ua pa thiab mob, lub raum thiab lub siab muaj nuj nqi, peripheral ntshav duab, raws li zoo raws li nws cov ntsiab lus ntawm electrolytes.

Compatibility nrog lwm yam tshuaj

Lub medicament "Amphotericin B" yuav ua kom nrov loj los yog attenuate cov teebmeem ntawm lwm yam tshuaj, raws li zoo raws li kom lawv cov tshuaj muaj taug. Yog li ntawd, qhov no tshuaj yog tshuaj nrog ceev faj nyob rau hauv cov kev kho mob.

Nyob rau hauv lub sij hawm ntawm lub hais tias neeg sawv cev rau ib tug neeg mob, yuav tsum qhia rau koj tus kws kho mob txog kev noj lwm yam tshuaj. Txwv tsis pub, siv cov "Amphotericin B" (tso dej) tej zaum yuav detrimental rau lub noj qab haus huv thiab zuag qhia tag nrho zoo ntawm tus txiv neej.

tej tswv yim pom zoo

• Cov tshuaj yog "amphotericin B" yuav tsum tau siv tsuas yog rau cov kev kho mob ntawm lub neej-tuag thiab hnyav fungal kab mob.
• Nrog heev siv cov ntxim yuav zoo siv ntawm tshuaj lom los yuav tsub kom.
• Thaum qhov kev siv ntawm cov tshuaj yuav tsum tau txiav anemia.

Xyuas

Tam sim no koj paub yuav ua li cas cov tshuaj ua "Amphotericin B". Lub ncua kev kawm ntawv nrog tib lub npe yog tsis rau cov muag khoom nyob rau hauv pharmacies. Yog li ntawd, rau qhov ncauj cov thawj coj, koj yuav tsum xaiv ib cov tshuaj nrog ib tug zoo xws li cov txiav txim.

Raws li feem ntau ntawm cov neeg mob, xam tau tias yog ib tug txhais tau tias zoo tiv nrog lub hauj lwm. Nws yog txig kho fungal daim tawv nqaij qhov chaw mob, xa lub cev thiab lub hlwb tsis xis nyob ntawm tus neeg mob.

Lub ntsiab drawback ntawm cov tshuaj no yog ib tug loj tus naj npawb ntawm cov kev phiv. Thaum lub sij hawm kev kho mob, qhov cuab tam phiv tshuaj tej zaum yuav tshwm sim nyob rau ib feem ntawm tag nrho cov nruab nrog cev thiab tshuab. Yog li ntawd, nws yuav tsum tau mus thov tsuas nyob rau hauv tshwj xeeb indications.