"Meropenem": cov lus qhia rau kev siv, tshuaj xyuas. Tshuaj analogues

Los ntawm hluavtaws tshuaj tua kab mob muaj xws li carbapenems pab pawg neeg, ib tug neeg sawv cev uas yog cov tshuaj "meropenem" rau parenteral thawj coj. Vim bactericidal thiab bacteriostatic kev txiav txim ntawm cov khoom xyaw, cov tshuaj muaj peev xwm ntxig txoj kev loj hlob thiab sib npaug ntawm cov kab mob uas ua rau muaj ntau yam kab mob rau cov kab mob.

Nqe lus piav txog cov tshuaj

Kev siv tshuaj yeeb "Meropenem" yog ib qho tshuaj tua kab mob ntau-thoob thiab yog xim dawb los yog dawb uas muaj daj ntxoov ntxoo rau kev npaj kho. Muab cov kab mob mus rau hauv los yog kab mob infusion.

Tso nws hauv vials nrog lub ntim ntawm 10 thiab 20 ml. Qhov ntau npaum li cas ntawm lyophilizate yog 0.5 g los yog 1 g ntawm yeeb tshuaj Meropenem. Cov tshuaj ntsiav thiab tshuaj txhaj rau cov tshuaj txhaj tiv thaiv kab mob siv tshuaj tua tsis tau yog tsis ua. Tsuas muaj ib daim ntawv tso tawm xwb.

Lub qauv ntawm kev npaj

Raws li cov khoom muaj nyob hauv seem zoo nkaus li meropenem hauv daim ntawv ntawm trihydrate. Nyob rau hauv qhov kev piav qhia ntawm qhov muaj pes tsawg leeg, xam rau 1 lub raj mis, tus nqi ntawm cov khoom nquag yog qhia: meropenem trihydrate ntawm 0.570 g, los yog 1.140 g, thiab ntawm cov dawb meropenem, 0.5 g lossis 1 g feem. Cov khoom ntim ntawm hmoov yog muaj sodium carbonate.

Cov ntsiab analogues thiab lawv cov neeg tsim tawm

Tus thawj cov tshuaj raws li meropenem yog yeeb tshuaj "Meronem" nyob rau hauv daim ntawv ntawm ib tug ntawm 0.5 g. Nws yog siv los ua ib qho kev txhaj tshuaj, uas yog siv intravenously. Cov tshuaj tua kab mob no yog tsim los ntawm cov tuam txhab British Astra Zeneca Ltd, vim tias cov tshuaj no muaj pes tsawg thiab tau noj tshuaj ntau npaum li cas. Cov seem uas tau npaj tseg nrog meropenem yog suav tias yog cov generic thiab kev luam tawm nyob rau hauv lub yam ntxwv ntawm tus thawj.

Cov generics "Meropenem" yog muab los ntawm ob lub npe, uas coincides nrog lub npe thoob ntiaj teb tsis-npe, thiab nyob rau hauv kev lag luam, sib txawv ntawm cov lees INN. Daim ntawv tso tawm, ntau npaum li cas thiab muaj pes tsawg leeg ntawm tag nrho cov tshuaj tawm tswv yim hauv cov yam ntxwv ntawm "Meronem" coincide, uas qhia lawv cov kev hloov.

Cov tshuaj siv nrog lub npe hu ua "Meropenem" yog tsim los ntawm ntau lub tsev muag tshuaj nyob thoob qab ntuj. Piv txwv, lub tuam txhab Indian "M. J. Biofarm Pvt. Ltd. tsim tshuaj, thiab ntim yog nqa ntawm lub tuam txhab Lavxias teb sab CJSC BIOTEK MIPPDK. Ukrainian tuam txhab "Lekhim", "Pharma Life" kuj ua rau cov tshuaj tua kab mob "Meropenem". Analogues kuj muaj lub npe ntawm lub khw tsim ua lawv lub npe. Muaj ntau cov qauv hauv lub khw muag tshuaj lub ntiaj teb. Hauv particular, cov tshuaj "Meropenem-Vero" paub. Qhov no yog qhov khoom ntawm tuam txhab suav choj Shenzhen Heibin Pharmaceutical Co. Ltd. ".

Kev kho mob "Meropenem Jodas" yog ib qho Anad analog ntawm ib qho tshuaj tua kab mob dav dav uas tsim los ntawm Jodas Expo. Ua rau nyob rau hauv daim ntawv ntawm cov hmoov rau lub chaw ua khoom ntawm txhaj tshuaj ntawm 500 mg thiab 1000 mg.

Lub tuam txhab Lavxias teb sab LLC "ABOLmed" ua rau cov tshuaj "Meropenabol" nyob rau ntawm tus neeg saib xyuas kev tiv thaiv antibacterial. Ib qho kev daws rau kev tso dej tshuaj qhuav yog npaj los ntawm hmoov.

Cov tshuaj "Meropenem Spencer"

Qhov cuab yeej no yog lwm Indian counterpart uas ua los ntawm Cooper Pharma rau Spencer Pharma Yukey Limited, Is Nrias teb. Nws yog ua raws li ntawm meropenem nyob rau hauv daim ntawv ntawm trihydrate thiab belongs rau cov pab pawg neeg ntawm carbapenems. Cov tshuaj tiv thaiv Meropenem Spencer muaj kev tiv thaiv kev tiv thaiv kab mob gram-positive thiab gram-negative bacteria hauv kab mob thiab kis kab mob. Siv kev tswj hwm kev noj qab haus huv.

Pharmacological zog

Lub ntsiab ntawm cov khoom siv loj ntawm meropenem rau cov lus qhia rau kev siv tus cwj pwm ntawm cov kab mob loj, uas yog txuam nrog kev tsim ntawm cov kab mob bacterial membrane. Lub peev xwm los ua rau tuag ntawm aerobes thiab kev coj noj coj ua yog vim cov tshuaj tiv thaiv kab mob los ntawm phab ntsa ntawm cov kab mob hauv cov kab mob, kev sib tsoo hauv kev sib raug zoo nrog beta-lactamases thiab kev sib raug zoo rau cov protein ntau uas khi cov tshuaj penicillin.

Los ntawm kev sib tw rau protein receptors rau membrane ntawm cytoplasm ntawm cov kab mob, txo cov peptidoglycan txheej hauv cell phab ntsa, thiab suppressing transpeptidase, autolytic enzymes tso rau hauv lub phab ntsa xovtooj, rhuav tshem nws cov qauv thiab ua rau tuag ntawm cov cab.

Cov tshuaj tua kab mob ua rau cov tshuaj tua kab mob licas?

Rau cov tshuaj "Meropenem" cov lus qhia siv rau kev siv tiv thaiv Gram-positive aerobes, uas muaj xws li Enterococcus fecalis, Staphylococcy aureus, Streptococcus agalactia, Streptococcus pneumonia nrog rhiab heev rau
Penicillin, Streptococcus pyogenesis, Streptococcus viridance.

Cov tshuaj tua kab mob yog ua rau tiv thaiv Gram-tsis zoo aerobes, ntawm cov kab mob E. coli, Hemofilus influenza, Klebsiella pneumonia, Neisseria meningitis, Pseudomonas auruginosa, Proteus mirabilis yog raug rho tawm.
Muaj meropenem rau cov kab mob xws li: Bacteroid flagylis, Peptostreptococcus spp.

Kev siv tshuaj ntawm kev siv tshuaj yog pom tseeb tawm tsam cov kab mob hauv qab no los ntawm cov kev tshawb fawb hauv vitro, tiam sis tsis muaj pov thawj ntawm kev kho mob.
Gram-zoo aerobes muaj xws li Staphylococcus epidermidis nrog methicillin rhiab heev, thiab Gram-tsis zoo aerobes: Acinetobacter spp., Aeromonas hydrophilus, Campylobacter jediuni, Citrobacter diversia, Citrobacteracter freundi, Enterobacter cloaci, Hafnieh, Klebsiella psitta, Moralella katarrhalis, Morganella Morgani, Pasterella multocida, Proteus vulgaris , Salmonella spp., Serratia marcesens, Shigella spp., Ursina enterocolitis.

Nyob rau hauv vitro fights co kab mob :. Bakteroides distasonis, Bakteroides ovatus, Bakteroides uniformis, Bakteroides ureolitikus, Bakteroides vulgaris, Clostridium difficile, Clostridium perfringens, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes.

Dab tsi cov tshuaj tua

Vim yog qhov dav dav ntawm kev ua haujlwm ntawm cov khoom lag luam meropenem, cov lus qhia rau kev siv tau raug pom zoo rau kev siv ntau hom kab mob thiab cov kab mob thaum sib cais los yog ib feem ntawm kev kho kom haum.

Cov no muaj xws li cov tshuaj tua kab mob tua kab mob, uas cuam tshuam rau:

• Cov kab mob nqus pa, tshwm sim los ntawm kev mob ntsws, nrog rau tsev kho mob ntsws;
• Cov kab mob urinary nyob rau hauv daim ntawv ntawm pyelonephritis, pyelitis;
• Cov tawv nqaij thiab cov nqaij mos nyob rau hauv daim ntawv ntawm erysipelas, pyoderma, secondary dermatosis;
• Organs nyob rau hauv lub me me pelvis, nrog rau cov txheej txheem inflammatory ntawm uterine mucosa;
• Organs nyob rau hauv lub plab kab noj hniav, nrog rau qhov mob ntawm cov nyom appendicitis, peritonitis, pelvioperitonitis.

Cov tshuaj no yuav siv tau rau kab mob bacterial meningitis thiab blood infections. Cov neeg uas muaj febrile neutropenia siv cov tshuaj tua kab mob no ua ke nrog tshuaj antiviral lossis tshuaj tiv thaiv kab mob.

Cov kev cai rau kev npaj kho

Kev tshem tawm ntawm kev siv yeeb tshuaj yuav tsum ua raws li aseptic thiab antiseptic kev ntsuas kev nyab xeeb. Vial fwj tshuaj muaj kua tshuaj yog siv ib zaug, nws tsis muaj cai tua cov tshuaj tua kab mob thiab lwm yam tshuaj.

Antibiotic "Meropenem" nyob rau hauv daim ntawv ntawm hmoov yog diluted nrog sterile injectable dej rau ntxiv intravenous bolus coj. Yuav kom yaj 1 g ntawm meropenem, 20 ml ntawm dej yog siv, uas sib sau mus rau ib tug concentration ntawm 50 mg ib ml. Qhov npaj tau kua yog feem ntau meej, tsis muaj qab hau los yog nrog lub teeb daj tinge.

Raws li qhov hnyav rau yeeb tshuaj "Meropenem" koj tuaj yeem siv 50-200 ml ntawm cov tshuaj tua kab mob sib kis tau yooj yim. Lawv muaj xws li:

• Tshuaj ntawm sodium chloride 0,9%;
• Kev daws ntawm dextrose 5% lossis 10%.

Ua ntej tso dej tshuaj tua kabmob, cov kua dej uas raug muab ntsev pov tseg.

Dos ntawm yeeb tshuaj

Rau cov neeg laus, kev siv tshuaj "Meropenem" rau kev siv rau ib koob ntawm 500 mg, uas yog rov tom qab 8 xuab moos. Raws li lub tswv yim no, mob ntsws muaj dej, mob txeeb zig, mob thiab kab mob ntawm cov kabmob hauv plab me me, cov kab mob ntawm daim tawv nqaij thiab cov nqaij ntawm cov leeg kho.

Lub tsev khomob mob ntsws, mob hauv plab, mob ntshav qab zib, cov kab mob ntawm cov kab mob neutropenia yuav tsum tau siv tshuaj tua kab mob 3 zaug ib hnub twg rau 1 g rau 1 g Rau kev mob meningitis, ib koob 2 g tom qab 8 teev.

Nyob ntawm seb qhov mob hnyav npaum li cas thiab hom kab mob ntawm tus neeg mob, qhov kev siv tshuaj thiab qhov ntev ntawm txoj kev kho yog raug xaiv los ntawm tus kws kho mob.

Feem ntau, ntev npaum li cas ntawm cov kev tswjhwm yog nyob ntawm hom kev tswj hwm. Cov kab mob hauv plab yog pub rau noj kom txog 5 feeb, thiab tso dej los tso rau hauv - los ntawm 15 mus rau 30 feeb. Kev kho mob "Meropenem" tsis yog siv tshuaj tua kab mob.
Mob raum tsis ua hauj lwm yuav tsum tau kho dosing nyob rau hauv raws li creatinine clearance :

• Nyob rau ntawm 26-50 ml ib feeb twg cov tshuaj yog los ntawm 500 mg mus rau 2 g, txhua txhua 12 teev;
• Ntawm 10-25 ml ib feeb twg cov tshuaj yog los ntawm 250 mg mus rau 1 g, txhua 12 teev twg;
• Tsawg tshaj li 10 ml ib feeb twg, cov koob tshuaj yog li ntawm 250 mg mus rau 1 g, txhua 24 teev.

Cov neeg mob laus uas muaj lub cev raum thiab creatinine clearance saum 50 mL ib feeb tsis tas yuav tsum tau txhaj. Siab tsis ua hauj lwm tsis yog ib tug yog vim li cas rau koob tshuaj haum.

Thaum lub caij hemodialysis, qhov kev tshem tawm ntawm meropenem tshwm sim, yog li siv tshuaj yeeb nyob rau ntawm qhov kawg ntawm tus txheej txheem. Qhov no yog qhov tseeb rau txoj kev kho mob ntev los kho cov tshuaj tua kab mob hauv cov ntshav.
Thaum muaj hnub nyoog 3 lub hlis thiab mus txog 12 xyoos, 10-20 mg ntawm cov tshuaj rau ib kg ntawm lub cev qhov hnyav yog siv mus khi nrog 8 feeb. Qhov hnyav nyob ntawm tus neeg mob tus neeg mob ntawm tus kab mob, qhov nws ua rau lub tshuaj tua kab mob thiab tus kab mob.
Yog cov me nyuam tsis tau nto hnub nyoog 12 xyoos hnyav dua 50 kg, lawv raug tso cai rau cov laus siv tshuaj.

Txoj kev kho qhov chaw uas tsis muaj kev puas siab puas ntsws los ntawm cov menyuam uas muaj kev tsis zoo hauv lub plab.
Hauv kev kho mob rau daim npog hlwb, 40 mg ntawm ib lub cev ntawm lub cev hnyav yog siv tom qab 8 teev.

Rau leej twg yog cov tshuaj tiv thaiv

Nws yog ib qho tseem ceeb kom paub tias tsis yog txhua leej txhua tus tuaj yeem siv cov tshuaj, tshwj xeeb tshaj yog thaum muaj kev sib nkag siab ntxiv rau cov tshuaj tua kab mob los yog cov neeg ua hauj lwm beta-lactam antibacterial yav dhau los.

Cov me nyuam me hauv 3 lub hlis tsis tau sau cov tshuaj "Meropenem." Cov neeg mob cov lus pov thawj ua tim khawv rau kev xyaum siv cov tshuaj nrog muaj kev phiv tshuaj rau ntawm ob lub raum thiab cov kab mob ntawm cov hnyuv.
Thaum cev xeeb tub, cov tshuaj tsis siv, tsuas yog thaum muaj txiaj ntsig ntawm tshuaj tua kab mob ntau tshaj qhov tsim teeb meem ntawm kev txhim kho ntawm tus me nyuam hauv plab. Kev pub mis niam rau thaum lub caij kho kuj tsis pom zoo los ntawm kws kho mob.

Tej teebmeem

Txog kev siv yeeb tshuaj "Meropenem" qhia tau hais tias tsim muaj kev tsim muaj cov teebmeem tsis txaus siab nyob rau ntau qhov chaw hauv lub cev.

Cov hlab ntsha thiab lub plab hnyuv siab ntsws tuaj yeem tshwm sim los ntawm qhov tshuaj tua kab mob uas muaj mob taub hau, kiv taub hau, zoo nkaus li loog hauv qhov chaw, zoo nkaus rau tingling thiab creeping, muaj kev ntxhov siab siab, ua txhaum cai ntawm kev tsis nco qab, qaug dab peg, qaug dab peg.

Ntawm cov kab mob hauv lub plawv, cov kabmob ntawm cov tshuaj tua kabmob (hematopoiesis) muaj cov nyhuv tsis zoo los ntawm ob leeg ntawm cov eosinophils thiab platelets hauv cov ntshav ntawm peripheral ntshav, thiab nrog cov qeeb hauv platelet thiab leukocyte, hemoglobin, txo qhov hematocrit me me thiab cov nutrophils ua rau agranulocytosis, Thromboplastin thiab prothrombin lub sijhawm.

Qee cov neeg mob tau pauv cov kev hloov nrog cov kabmob ntawm cov kabmob hauv plab, ua rau mob plab hauv plab, xeev siab, ntuav, raws plab, cem quav, plab hnyuv, xuab zeb. Nws tseem tuaj yeem ua rau kom paub txog qib bilirubin nyob rau hauv cov ntshav ntshav, nce qhov kev ua ntawm enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase thiab lactate dehydrogenase. Feem ntau, lub xeev muaj tus kab mob pseudomembranous colitis, los yog qhov kev tshwm sim candidiasis tshwm rau ntawm qhov mucous membrane ntawm qhov ncauj kab noj hniav.

Muaj qee cov kev ua txhaum kev cuam tshuam cov kab mob genitourinary. Lawv muaj xws li: zis nyuaj, ua kom muaj mob ntawm cov nqaij mos, qhov txawv txav hauv ob lub raum uas muaj cov tshuaj hyperkreatinemia, ntxiv cov tshuaj tua kab mob hauv ntshav, hematuria, nrau.

Qhov kev txiav txim ntawm cov tshuaj tua kab mob yuav ua rau muaj kev tsis haum ntau yam. Lawv manifested los ntawm khaus, tawm pob, urticaria, erythema multiforme, Stevens-Johnson syndrome, tshuaj lom epidermal necrolysis, angioedema, anaphylactic poob siab.

Cov lwm sab los, muaj kev txheeb xyuas ntawm leaching ntawm poov tshuaj los ntawm lub cev, nce lub ntim ntawm cov ntshav nyob rau hauv lub mauj kev, ib tug zoo ncaj los yog indirect antiglobulin Coombs. Kev tswj fab ntawm lub cev los ntawm cov thawj coj hauv nruab nrog cev yog txuam nrog tus mob, phlebitis, thrombophlebitis, mob siab thiab mob ntawm qhov chaw txhaj tshuaj.

Qee cov neeg mob lwm tus neeg muaj kev ntxhov siab, kev nyuaj siab, muaj zog excitability, insomnia, plawv nres, plawv nres, tachycardia, bradycardia, cardiac leeg infarction, hloov ntshav siab, dyspnoea, tsaus muag thiab ntxhov siab, txawm tias tsis muaj lub luag hauj lwm rau meropenem hauv cov tsos mob .