Amikacin - malangizo ogwiritsa ntchito maantibayotiki mu ufa ndi yankho

Mankhwalawa ndi amodzi mwa mankhwala a aminoglycosides, omwe ali ndi zochita zambiri za bacteria. Wopanga wamkulu wa mankhwalawo ndi kampani Synthesis. Amatulutsidwa m'mafakisoni pokhapokha atangopatsidwa mankhwala ndipo sangathe kumasulidwa popanda iwo. Kugulitsidwa mu mawonekedwe a yankho kapena ufa wa mu mnofu kapena wamkati wamkati.

Malangizo ogwiritsira ntchito Amikacin

Mankhwala a Amikacin ndi amodzi a mankhwala osokoneza bongo ochokera ku gulu la aminoglycoside. Mankhwalawa amakhudza tizilombo tating'onoting'ono toyambitsa matenda, bactericidal, tikuletsa zochita za moyo wawo, zomwe zimapangitsa kuti mabakiteriya afe. M'malo okhala ndi tizilombo toyambitsa matenda, kukana mankhwalawa kumayamba pang'onopang'ono, motero, mankhwalawa amatha kutsogolera gulu la aminoglycosides. Mankhwalawa ndi a anti-sipekitiramu ambiri, amagwira ntchito kwambiri motsutsana:

Tizilombo tating'onoting'ono ta gram: staphylococci (staphylococcus), tomwe timagwirizana ndi methicillin, cephalosporins, penicillin, ena a gerptococci (streptococcus).
Gram-negative: Aeruginosa, Enterobacter, Escherichia, Klebsiella, Prov>

Kupanga ndi mawonekedwe a kumasulidwa

Kukonzekera kumapangidwa mwanjira yothetsera kapena ufa pokonzekera mayankho. Mankhwalawa amaperekedwa kudzera mu intramuscularly kapena kudzera m'mitsempha, amapezeka motere:

2 ml ampoules a 500 mg (250 mg / 1 ml), paketi ya 5 kapena 10 zidutswa,
4 ml ampoules a 1 g a 5 ndi 10 ma PC. kunyamula
ufa m'mabotolo a 500 ndi 1000 mg, ma CD 1, 5, 10 ma PC.

Kunja, mankhwalawa ndi njira yodziwikiratu, ili ndi zida zazikuluzikulu zotsatirazi:

Chofunikira chachikulu ndi amikacin, ml ili ndi 250 mg,
zothandizira - sodium citrate, madzi a jakisoni, kuchepetsedwa wa sulfure acid, sodium disulfite.

Pharmacodynamics ndi pharmacokinetics

Izi ndi mankhwala ochokera ku gulu lachitatu la aminoglycoside. Imakhala ndi bacteriostatic effect (imapha ma cell mabakiteriya) molingana ndi mitundu yosiyanasiyana ya tizilombo tambiri. Kuwonongeka kwa maselo kumachitika chifukwa chomangirira gawo la 30S la nthiti, kusokonezedwa kwa kupanga mamolekyulu a protein, omwe amachititsa kufa kwa khungu la bakiteriya. Mankhwalawa amagwira ntchito polimbana ndi tizilombo toyambitsa matenda ambiri a gramu komanso ena wopanda gram.

Mankhwalawa alibe mphamvu iliyonse pa mabakiteriya a anaerobic (tizilombo tating'onoting'ono tomwe timene timatha kupanga pokhapokha ngati palibe mpweya). Amikacin ndi mankhwala othandiza kupewetsa mabakiteriya ena ku maantibayotiki ena. Pambuyo pa jekeseni wamitsempha, mankhwala omwe amapezeka m'magazi amalowa m'magazi ndikugawidwa mthupi lonse mu mphindi 10-15. Mankhwalawa amalowa mosavuta mu chotchinga cha magazi, chotuluka (nthawi ya pakati, ikalowa m'thupi la mwana), imadutsa mkaka wa m'mawere. Matupi awo amachotsedwa osasinthika.

Zizindikiro zogwiritsidwa ntchito

Chifukwa chachikulu chogwiritsira ntchito maantibayotiki ndi matenda opatsirana omwe amakwiya ndi mabakiteriya osagwiritsa ntchito gramu (makamaka ngati akukana mankhwala ena omwe ali mgululi). Matenda otsatirawa ndi njira zomwe mungagwiritsire ntchito mankhwalawa:

Njira za matenda amtundu wa kupuma: mapapu, chimbudzi, chibayo, kuponderezedwa kwa mafinya.
Sepsis. Iyi ndi njira yopatsirana yomwe ikukula komanso kubereka bacteria wa pathogenic m'magazi.
Matenda aubongo: meningitis, meningoencephalitis, encephalitis.
Bacterial endocarditis. Matenda opatsirana nthawi zambiri amakhala oyera mtima.
Matenda a pakhungu, minofu yofewa, minyewa yodutsa: ma phlegmon, zilonda zam'mimba, zotupa zamkati ndi necrosis, njira zapagulu, zimayaka.
Peritonitis ndi njira zina za bakiteriya zam'mimba.
Matenda opatsirana mwa maliseche, kwamikodzo dongosolo - abscess wa CHIKWANGWANI, chiwindi, kuphatikizira kwa chikhodzodzo, cholecystitis.
Osteomyelitis (kufala kwa mafupa), nyamakazi ya purulent.
Matenda omwe amakhudza matumbo, m'mimba.

Mlingo ndi makonzedwe

Asanapereke mankhwala, dokotala ayenera kuchita zonse zofunikira za matenda. Mlingo wakhazikitsidwa, njira yogwiritsira ntchito, poganizira kutengera kwa matenda, kuopsa kwa matenda, komanso kuzindikira kwa tizilombo toyambitsa matenda. Pali mitundu yosiyanasiyana ya kayendetsedwe ka intramuscular and intravenous (kukapumira kapena ndege kwa maola awiri).

Amikacin kudzera m'mitsempha

The kuchuluka kwa mankhwala mu njira yothetsera jakisoni kudzera m`mitsempha sangathe kuposa 5 mg / ml. Ngati ndi kotheka, chithandizo ndi njira iyi chingagwiritsidwe ntchito Amikacin yankho, lomwe limagwiritsidwa ntchito pakuwongolera makonzedwe. Njira ya shuga ya 5% ya 200 ml kapena isotonic sodium chloride solution imafunika. Kuyambitsa dontho kumachitika mwachangu madontho / mphindi 60, ndege - kwa mphindi 3-7. ndikofunikira munthawi yamankhwala kuti muwunikire ntchito ya mtima, impso, zida zamagetsi.

Amikacin kudzera m'mitsempha

Yankho limakonzedwa ndikuwonjezera madzi a jakisoni ndi ufa wouma kuchokera ku vial. Ngati ndi kotheka, jekeseni wamitsempha adzafunika 2-3 ml ya madzi pa 05 g ya ufa. Mukamayambitsa madzi, samayenera kuwonedwa. Sansani botolo kuti zonse zisungunuke bwino m'madzi. Pambuyo pake, ikani yankho mu syringe ndikuchita jekeseni wamitsempha.

Malangizo apadera

Pali mndandanda wa malamulo omwe amayenera kuganiziridwa mukamagwiritsa ntchito mankhwala. Dokotala yekha ndi amene amamulembera ndipo wodwala amakakamizika kutsatira dongosolo la kudya lomwe walangizidwa ndi katswiri. Malangizo apadera otsatirawa alipo:

Kwa ana osakwana mwezi umodzi ndi wakhanda, mankhwalawa amatha kuthandizidwa pokhapokha ngati akufunika kwambiri, ndi 10 mg / kg thupi. Mlingo umagawidwa masiku 10.
Pakakhala zochizira, pakatha masiku atatu chiyambireni chithandizo, lingaliro liyenera kuperekedwa m'malo mwa njira zamankhwala zothandizira matenda.
Amikacin ayenera kugwiritsidwa ntchito mosamala kwambiri ndi mankhwala ena, ndikofunikira kuyang'anira ntchito ya impso, chiwindi, ndi dongosolo lamanjenje.
Poyang'aniridwa mwamphamvu, mankhwala amagwiritsidwa ntchito ngati wodwala ali ndi parkinsonisms, myasthenia gravis (kufooka kwa minofu).

Amikacin pa nthawi yoyembekezera

Kugwiritsira ntchito mankhwalawa kumaloledwa pazizindikiro zofunika panthawi yoyembekezera, mkaka wa m`mawere. Tiyenera kukumbukira kuti mankhwalawa amatha kulowa mu placenta, ndiye kuti amapezeka m'magazi a mwana wosabadwayo, pali chiopsezo chokhala ndi impso ya mwana, yomwe imakhala ndi nephro komanso ototoxic pa iwo. Amatsimikiza pang'ono m'mkaka wa m'mawere. Kuchokera m'matumbo am'mimba, mayamwidwe aminoglycosides ndi ofooka. Pamene mavuto oyamwitsa chifukwa chomwa mankhwala kwa ana sanapezeke.

Amikacin wa ana

Mankhwala omwe mumalandira kuchokera pakubadwa amaloledwa. Amikacin ya ana imagwiritsidwa ntchito motere:

makanda asanakwane: mlingo woyamba ndi 10 mg / kg, ndiye 7.5 mg maola 24 aliwonse,
kobadwa nako mpaka zaka 6: jakisoni woyamba ndi 10 mg / kg, ndiye 7.5 mg maola 12 aliwonse.

Kwa theka la ola, mankhwalawa amaperekedwa kwa ana, m'malo ovuta kwa ola limodzi. Ndi kukula kwa matenda oopsa, oyendetsa ndege amaloledwa kwa mphindi ziwiri, koma pamaso pa dokotala komanso chilolezo chake. Musanagwiritse ntchito, imaphatikizidwa ndi yankho la sodium chloride (0,09%) kapena dextrose (5%). Zotsatira zake, kugwiritsidwa ntchito kwa zinthu zomwe sizigwira ntchito sikuyenera kupitirira 5 mg pa 1 makilogalamu.

Kuyanjana kwa mankhwala osokoneza bongo

Amikacin ndi synergistic mukamayanjana ndi benzylpenicillin, carbenicillin, cephalsporins (pamakhala vuto loti kuchepa kwa mphamvu ya aminoglycosides akagwiritsidwa ntchito limodzi ndi mankhwala a beta-lactam odwala omwe ali ndi vuto lalikulu la aimpso. Chiwopsezo cha oto- ndi nephrotoxicity chimawonjezeka mukamayanjana ndi polymyxin B, nalidixic acid, vancomycin, cispalitic.

Penicillins, cephalosporins, diuretics (makamaka furosemide), NSAIDs, sulfonamides amapanga mpikisano wokhudzana ndi katulutsidwe m'matumbu a nephron. Izi zimabweretsa kutsekereza kuthetseratu kwa aminoglycosides, kuonjezera kuyika magazi, kuonjezera neuro- ndi nephrotoxicity. Amikacin mukamayanjana ndi mankhwala onga ofunikira mumathandizanso kupuma minofu.

Chiwopsezo cha kumangidwa pakupuma pakumayikiridwa magazi ndi mankhwala a citrate, kugwiritsa ntchito mankhwala omwe amalepheretsa kufalikira kwa mitsempha komanso kumwa Amikacin. Ndi kholo makonzedwe a indomethacin, chiopsezo cha poizoni wa aminoglycosides ukuwonjezeka. Mankhwala amachepetsa mphamvu ya anti-myasthenic mankhwala. Amikacin sagwirizana ndi heparin, penicillin, cephalosporins, amphotericin B, capreomycin, erythromycin, mavitamini a gulu C, B, potaziyamu chloride.

Zotsatira zoyipa za Amikacin

Zothandiza zothandizira kapena amikacin sulfate pambuyo pakulowa m'thupi zimatha kuyambitsa zovuta zina. Zina mwazomwe zimachitika kawirikawiri ndiz awa:

Kuchokera m'matumbo am'mimba, kuwonjezeka kwa michere ya chiwindi AST ndi ALT m'magazi kungaonedwe, zomwe zikuwonetsa kuwonongedwa kwa maselo a chiwindi (hepatocytes), kuwonjezeka kwa kuchuluka kwa bilirubin m'magazi, kusanza ndi mseru.
Momwe thupi limasokoneza. Pali kusiyanasiyana kosiyanasiyana, kuyambira poyimitsa komanso kuthamanga mpaka kufika pakung'ambika. (Kukula koopsa kwa ziwalo zingapo chifukwa chakuchepa kwa magazi). Chowonetsera china chomwe chingachitike ndi urticaria (kutupa pang'ono ndi totupa pakhungu lomwe limafanana ndi kuwotcha khunyu), edema ya Quincke, ndi malungo.
Zotsatira zoyipa kuchokera ku hemopoiesis zimawonetsedwa mu mawonekedwe a leukopenia (kuchepa kwa chiwerengero cha leukocytes), thrombocytopenia (kutsika kwa kuchuluka kwa mapulateleti, kuchepa kwa magazi (kuchepa kwa gawo la hemoglobin, kuchuluka kwa maselo ofiira a magazi).
Kuchokera ku genitourinary system, chitukuko cha kulephera kwa impso, albuminuria (mapuloteni mu mkodzo), ma microometuria (magazi ochepa mkodzo) amawonekera.

Bongo

Muyenera kumwa mankhwalawo mosamala mlingo womwe adokotala akuwonetsa. Mukaphwanya malangizowo zingayambitse mavuto. Mankhwala osokoneza bongo amachitika kwambiri. Gwiritsani ntchito hemodialysis, chithandizo chamankhwala kuti muchotse mankhwalawa m'thupi. Zizindikiro zotsatirazi za bongo ndi:

chizungulire chachikulu,
kusanza, mseru, ludzu,
ataxia - kugwedezeka kwamphamvu chifukwa cha kulumikizana,
kulephera kupuma komanso kufupika,
matenda okodza
kulira m'makutu, kuchepa kwa chidwi kwa ogontha.

Contraindication

Mankhwalawa amathandizira thupi, motero amaperekedwa ndi mankhwala. Contraindication kumwa mankhwalawa ndi awa:

Kusalolera payekha kwa amikacin sulfate, matupi awo sagwirizana ndi zinthu zothandiza komanso zothandiza.
Matenda a khutu lamkati, limodzi ndi kutupa kwamitsempha yamagetsi. Chithandizo cha mankhwala chimatha kubweretsa kusokonezeka kapena kusamva chifukwa cha kuwonongeka kwa mitsempha ya poizoni.
Matenda akulu a impso, chiwindi, omwe amakhala ndi kuperewera kwawo.
Mimba

Migwirizano yogulitsa ndikusunga

Mutha kusunga mankhwala kwa zaka zitatu. Mankhwalawa amayenera kusungidwa m'malo owuma, amdima komanso ozizira popanda mwayi wofikira ana. Kutentha kwa mpweya + 25 digiri Celsius. Mankhwala othandizira amagulitsidwa ku malo ogulitsa mankhwala ndi m'masitolo a intaneti.

Pali mankhwala omwe ali ndi zinthu zomwezi. Amakhala ndi zofanana ndi Amikacin. Mwa zina mwazodziwika bwino ndi awa: