Mapiritsi a Gentamicin: malangizo ogwiritsira ntchito

Kufotokozera kogwirizana ndi 09.06.2016

Dzina lachi Latin: Gentamicin
Code ya ATX: S01AA11
Chithandizo: Gentamicin (Gentamicin)
Wopanga: Belmedpreparaty RUE (Republic of Belarus), Warsaw Pharmaceutical Works Polfa (Poland), Moscow Endocrine Chomera, NIZHFARM, Sintez OAO, Microgen NPO FSUE, Pharmstandard-UfaVITA (Russia), ndi zina zambiri.

Yopangidwa ndi Njira yothetsera makonzedwe amkati ndi intramuscularly muli yogwira pophika mankhwalawa sulfatekomanso zina zingapo zowonjezera: sodium metabisulfite, mchere wa disodium wa ethylenediaminetetraacetic acid, madzi.

Diso limatsika yikani pophika mankhwalawa sulfatekomanso zina zowonjezera: sodium dihydrogen phosphate monohydrate, sodium chloride, sodium hydrogen phosphate dodecahydrate, benzalkonium chloride solution, madzi.

Zotsatira za pharmacological

Gentamicin ndiye mankhwala, yowonetsa zovuta zingapo, ndi gulu la aminoglycosides. Mu thupi, limagwirizanitsa ndi 30un subunit ya ribosomes, chifukwa chomwe kuphatikiza kwapuloteni kumasokonezeka, kupanga kwa kayendedwe kazinthu zovuta ndi RNA kuyimitsidwa. Kuwerenga molakwika kwa RNA kumadziwika ndipo mapuloteni osagwira ntchito amapangidwa. Mphamvu ya bactericidal imawonedwa - malinga ndi kuchuluka kwa zinthu, zimachepetsa zotchingira michere ya cytoplasmic, chifukwa chomwe tizilombo tomwe timafa.

Kuzindikira kwakukulu kwa maantibayotiki ena kuchokera kuma gramu ena osavomerezeka amadziwika.

Zowonekeranso ndikumvetsetsa kwazinthu zingapo zamagetsi zabwino.

Kukana kwa antibiotic kwawonetsedwa ndi: Nisseria meningitidis, Providencia rettgeri, Clostridium spp., Treponema pallidum, Bacteroides spp., Streptococcus spp.

Ngati gentamicin ikuphatikizidwa penicillin, ntchito zake mokhudzana ndi Enterococcus faecium, Enterococcus faecalis, Enterococcus avium, Enterococcus durans, Streptococcus faecium, Streptococcus durans, Streptococcus faecalis.

Kukana kwa tizilombo tosiyanasiyana ndi mankhwalawa kumayamba pang'onopang'ono, koma zovuta zomwe zimawonetsa kukana neomycin ndi kanamycinamathanso kugonjetsedwa ndi glamicin. Bowa, protozoa, ma virus sachitapo kanthu.

Pharmacokinetics ndi pharmacodynamics

Pambuyo makonzedwe, kuyamwa mwachangu komanso kokwanira kwa chinthu kumachitika modabwitsa. Pazitali ndende mu thupi pambuyo makonzedwe intramuscularly zimatheka pambuyo 0,5-1,5 maola. Pambuyo pa kulowetsedwa kwa mphindi 30, pambuyo pa mphindi 30, pambuyo pobowoleza kwamphindi 60, pambuyo pa mphindi 15.

Amamangiriza mapuloteni ochepa a plasma - mpaka 10%. Zochitika zochizira zimapezeka mu impso, chiwindi, mapapu, komanso madzi amthupi - peritoneal, ascitic, synovial, pericardial, pleural, lymphatic, omwe amapezeka ndi mafinya, amachotsa mabala, grangement, mkodzo.

Kuzungulira kwa zinthu kumawonedwa mu minofu, minofu ya adipose, mkaka wa m'mawere, bile, mafupa, sputum, mawonekedwe a bronchial, madzi am'mimba, komanso chinyezi cha maso.

Kudzera mwa BBB, mwa odwala akuluakulu, sikulowa mkati, kulowa mkati mwa placenta.

Kuchuluka kwa madzimadzi a cerebrospinal mu makanda atsopano ndikwapamwamba kuposa akulu.

Metabolism m'thupi saululika. Hafu ya moyo wa anthu akuluakulu ndi maola 2-4, mwa ana ochepera miyezi 6 - 3-3,5 maola.

Amachotsedwa m'thupi kudzera mu impso, osasinthika, ochepa mankhwalawo. Ngati ntchito ya impso ya wodwalayo ndiyabwino, ndiye kuti 70-95% ya chinthucho imachotsedwa tsiku loyamba. Mwanjira iyi, kuchuluka kwamadzi μg / ml amadziwika mu mkodzo. Kukonzekera pakubwerezabwereza kukonzekera kumadziwika.

Zizindikiro zogwiritsidwa ntchito

Zisonyezero zogwiritsira ntchito mankhwalawa ndi matenda omwe amabweretsa matenda osachiritsika omwe adapangidwa ndi ma tizilombo tomwe timayang'ana ku ma glamicin.

Kugwiritsa ntchito kwa makolo mankhwala (4% yankho) kumawonetsedwa pamatenda otere:

Jakisoni wa gynecology amagwiritsidwa ntchito pochizira kwambiri.

Kugwiritsidwa ntchito kwina kwa mankhwalawa (mafuta a Gentamicin) amasonyezedwa kumatenda otere:

folliculitis wapamwamba,
pyoderma,
furunculosis,
seborrheic dermatitis kachilombo
paronychia,
sycosis,
ziphuphukachilombo
kuwonekera kwachiwiri kwa bakiteriya matenda a virus ndi fungal matenda apakhungu.
mabala a magwero osiyanasiyana (kuluma, kuwotcha, zilonda, ndi zina).
Zilonda za varicose zopatsirana.

Kugwiritsa ntchito zinthu zamtundu wa Gentamicin (madontho amaso) ndikofunikira kwa matenda otere:

blepharoconjunctivitis,
blepharitis,
conjunctivitis
meibomite,
keratitis,
keratoconjunctivitis,
dacryocystitis.

Contraindication

Mankhwalawa sayenera kugwiritsidwa ntchito pazinthu ngati izi:

kumva kwambiri maantibayotiki komanso ma aminoglycosides,
makutu am'mitsempha,
uremia
kuvulala kwambiri aimpso,
mimba ndi mkaka wa m`mawere.

Pakukonzekera kugwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anira ntchito ya impso nthawi ndi nthawi.

Zotsatira zoyipa

Mukuvomera, zotsatira zoyipa zitha kudziwika:

m'mimba dongosolo: hyperbilirubinemia, nseru ndi kusanza, zochulukitsa za "chiwindi" transaminases,
hematopoiesis: leukopenia, kuchepa magazi, thrombocytopenia, granulocytopenia,
dongosolo lamanjenje: paresthesiakupweteka mutu, kupindika minofu, dzanzi, kugonakuwonetsa psychosis ana,
ziwalo zam'malingaliro: tinnitus, kusokonezeka makutu, labyrinth ndi matenda a vestibular, ugonthi,
pokodza: nephrotoxicity ndi mkhutu aimpso ntchito, kawirikawiri - aimpso chiberekero necrosis,
chifuwa: zotupa pakhungu malungo, pruritus, eosinophilia, angioedema,
magawo a labotale: hypokalemia, hypocalcemia, hypomagnesemia - ana,
mawonetseredwe ena: kupambana.

Bongo

Ndi mankhwala osokoneza bongo a Gentamicin mu ampoules kapena mitundu ina ya mankhwala, kuchepa kwa kuchepa kwa mitsempha mpaka pomanga kupuma kumatha kudziwika.

Pankhani ya kuchuluka kwa odwala akuluakulu, ndikofunikira kuyambitsa anticholinesterase mankhwala (Prozerin), kukonzekera calcium. Asanayambike proserin, wodwalayo amapatsidwa 0,5-0.7 mg Atropinekudzera m'mitsempha, amadikirira mpaka zimachitika, kenako 1.5 mg wa proserin akaperekedwa. Ngati palibe zotsatira pambuyo pa kukhazikitsidwa kwa mlingo wotere, kuchuluka komweko kwa prozerin kumayendetsedwanso. Ndi chitukuko bradycardiapangani jakisoni wowonjezera wa atropine.

Potengera bongo mwa ana, kukhazikitsidwa kwa potaziyamu ndikofunikira. Gentamicin sulfate imachotsedwa m'thupi ndi hemodialysis ndi peritoneal dialysis.

Kuchita

Ngati jakisoni wa Gentamicin kapena kugwiritsa ntchito mitundu ina ya mankhwalawa amachitidwa munthawi yomweyo Vancomycin, aminoglycosides, cephalosporins,ethaconic acid, oto- ndi nephrotoxic zotsatira zimatheka.

Ngati ntchitoyo imagwiritsidwa ntchito ndi Indomethacin, kenako kutsimikizika kwa Gentamicin kumachepa, kukhazikika kwake m'magazi kumawonjezeka, motero, poizoniyo amakula.

Mukamagwiritsa ntchito Gentamicin ndi opioid analgesics, mankhwala a inhalation opaleshoniKuchepetsa kwa mitsempha ya mitsempha kumawonjezeka, kukula ndikotheka ziphuphu.

The kuchuluka kwa mankhwalawa m'magazi kumawonjezera ngati atengedwa nthawi yomweyo"Loop" okodzetsa.

Malangizo apadera

Chenjezo muyenera kuthira mankhwalawa kwa anthu omwe akuvutika myasthenia, parkinsonism, matenda aimpso. Kwa anthu omwe ali ndi vuto laimpso, komanso kugwiritsa ntchito mankhwala kwa nthawi yayitali, chiopsezo cha nephrotoxicity chimawonjezeka. Mankhwala, ndikofunikira kuwunika momwe vutoli limathandizira komanso kumva, komanso ntchito ya impso. Ndikofunikanso kudziwa momwe akumvera. Ngati mayeso a audiometric ndi osakhutiritsa, chithandizo chimaleka.

Tiyenera kudziwa kuti kugwiritsa ntchito mankhwalawa kwakanthawi, kunja kumatha kugwiritsidwa ntchito, komwe mafuta Gentamicin Akos ndi mitundu ina ya mankhwala kunja iyenera kugwiritsidwa ntchito moyenera.

Chifukwa cha kupezeka kwa kapangidwe ka yankho mu ampoulessodium bisulfitemwayi wokhala ndi matupi awonetsero omwe umawonjezeka umawonjezeka, makamaka mwa anthu omwe ali ndi vuto lotsatira.

Anthu omwe amamwa mankhwala ochizira matenda opatsirana komanso otupa a kwamikodzo amalangizidwa kuti amwe madzi ambiri pakumwa.

Munthawi yamankhwala, kukula kwa kukana kwa tizilombo ting'onoting'ono ndikotheka.

Mankhwala, mankhwala angapo a Gentamicin amaperekedwa. Izi ndi mankhwala osokoneza bongo Garamycin, Gentamicin Akos, Gentamicin-Teva, Gentamicin K, Wothandizira, Septopa, Gentacycoletc. Zizindikiro ndi ma contraindication a analogu ali ofanana, koma adotolo ayenera kupanga chisankho chomaliza chamankhwala. Palinso mankhwala angapo omwe zinthu zomwe zimagwira Betamethasone + Gentamicin + Clotrimazole.

Ana aang'ono amapatsidwa mankhwala pokhapokha ngati ali ndi thanzi labwino. Ndikofunika kutsatira mndandanda wamankhwala wovomerezeka ndikuwonetsetsa kuti dokotala amawunika momwe wodwalayo alili.

Pa mimba ndi mkaka wa m`mawere

Pa nthawi yoyembekezera, Gentamicin sayenera kugwiritsidwa ntchito. Ndi osavomerezeka kumwa mankhwalawa komanso poyamwitsa. Amadziwika kuti aminoglycosides amadutsa mkaka wa m'mawere ochepa. Koma samatenga bwino mu chakudya chamagaya, chifukwa chake, zovuta mu makanda sizinakhazikike.

Ndingagwiritse ntchito liti

Malinga ndi malangizo, mankhwalawa sodium 4% yazogwiritsidwa ntchito akhoza kukhala ndi izi:

Matenda amitsempha.
Matenda opatsirana a pakhungu lakunja, komanso kupsa ndi matenda ofewa a minofu.
Septicemia.
Prostatitis.
Matenda a ziwalo za ENT ndi thirakiti la kupumira kwapamwamba.
Matenda a m'mimba.
Matenda omwe amapezeka motsutsana ndi maziko a chitetezo chokwanira.

Kugwiritsa ntchito maantibayotiki mu mtundu uliwonse wa mankhwala sikulimbikitsidwa:

Mimba komanso kuyamwa.
Ana osakwana zaka 3.
Kulephera kwa impso kapena chiwindi.

Kubaya: komwe ungabaye ndi kuchuluka

Mlingo wa Gentamicin mu jakisoni ndi nthawi yayitali ya kugwiritsa ntchito mankhwala ndi dokotala. Perekani jakisoni wamkati kapena mu mnofu wa Getnamycin sulfate 4% yankho, lomwe limagulitsidwa mu ampoules ya 2 ml, No. 10. Mlingo wa maantibayotiki umatsimikizika potengera kulemera kwa wodwalayo. Muyezo ndi mulingo wa 3 mg wa mankhwalawa pa 1 kg ya odwala. Mu 1 ml ya jakisoni (jakisoni) yemwe ali ndi 40 mg yogwira ntchito, mlingo wa tsiku ndi tsiku wa wodwala wolemera makilogalamu 50 uzikhala 150 mg = 4 ml (2 ampoules of 2 ml) of 4% solution. Ndikulimbikitsidwa kupaka jekeseni 80 mg katatu patsiku.

Mlingo wa mankhwalawa amatsimikiza ndi dokotala.

Chithandizo cha matenda a urological

Mankhwalawa amagwiritsidwa ntchito mu urology, makamaka pochiza matenda a prostatitis ndi cystitis. Mlingo wa mankhwala a prostatitis kapena bakiteriya cystitis amatsimikizika malinga ndi muyezo, poganizira mtundu wa wodwala. Pafupifupi, ndi 80 mg 2-3 kawiri patsiku pambuyo pa maola 6-12. Mitundu yovuta ya matendawa ingafune kugwiritsa ntchito mlingo waukulu wa mankhwalawa - mpaka 80 mg pa kilogalamu imodzi ya kulemera, koma musanayambe chithandizo, ndikofunikira kuti muphunzire malangizo ndi malangizo a dokotala. Mukabayidwa njira ya Gentamicin 4%, ndizoletsedwa kuphatikiza mankhwala angapo mu syringe imodzi. Ndi prostatitis ndi cystitis, njira yogwiritsa ntchito maantibayotiki imatha masiku 7-10.

Mankhwalawa prostatitis, ndikofunikira kupanga mayeso osavuta pakumveka kwazomera zamankhwala. Pakapita jakisoni wambiri wa mankhwala opha maantibayotiki, bambo ayenera kukumbukira kuti mwana atha kubereka pambuyo miyezi isanu ndi umodzi yokha. Ndi cystitis ndi prostatitis nthawi ya mankhwala, ndikofunikira kusiya mowa kwambiri kuti muchepetse nephrotoxicity.

Malangizo ogwiritsira ntchito amalimbikitsa kuti musunge mankhwalawo pa kutentha osaposa 25 ° C. Malangizo ogwiritsira ntchito akuti moyo wa alumali ndi zaka zitatu kuyambira tsiku lomwe watulutsa. Kuti malangizo omwe angagwiritsidwe ntchito kuchokera kwa wopanga asatayike panthawiyi, ndibwino kusunga mankhwalawo m'mapaketi ake oyambira, kutali ndi ana. Mafuta ndi madontho amasunga mikhalidwe yawo kwa zaka 3 kuyambira tsiku lotulutsidwa. Kugula mankhwala muchipatala, ndikokwanira kumwa mankhwala omwe ali ndi mankhwalawa komanso nthawi yayitali ya mankhwalawa.

Milandu yapadera

Pazachipatala cha ana, maamamu a sulfate amalembedwa ngati pali chisonyezo chofunikira pamene phindu la mwana limaposa ngozi ya mavuto. Zochizira matenda a ana mpaka chaka chimodzi, mlingo wa tsiku ndi tsiku amawerengedwa molingana ndi kuchuluka kwa 1 mg pa kilogalamu imodzi ya kulemera, kwa ana azaka zitatu mpaka 5, mlingo umakhala 1.5 mg pa 1 kg, kwa ana opitirira zaka 6 - 3 mg pa 1 makilogalamu olemera. Ana ali ndi jakisoni ndi mankhwala intramuscularly 2 times kugogoda pambuyo maola 12.

Mankhwalawa amatha kugwiritsidwa ntchito mwa ana.

Ndi matenda am'matumbo nthawi zina, Gentamicin imalembedwa kwa ana. Zisonyezero zogwiritsira ntchito - kuzindikira kwa tizilombo toyambitsa matenda tokha mwa antibayotikiyu. M'masiku oyamba a 2-3, kugwiritsidwa ntchito kwa glamicin pamatumbo am'mimbamo kumachitika kudzera m'mitsempha, kenako, jakisoni amachitika mosabowoka m'khosi (80 mg 2-3 patsiku pambuyo pa maola 6-12).

Ndi Rhinitis wautali, dokotala atha kulimbikitsa madontho ovuta kuphunza kwa ana ndi akulu. Pokonzekera, muyenera kupereka mankhwala kuchokera kwa dokotala kupita ku pharmacy. Gentamicin sulfate 4% nthawi zambiri imaphatikizidwanso mu Chinsinsi, malinga ndi momwe madontho ovuta m'mphuno amakonzedwa, ngati gawo la bactericidal. Madontho ovuta amatchedwa choncho, chifukwa machitidwe a zigawo zawo nthawi imodzi amakhala ndi mayendedwe angapo: antigergic, bactericidal, vasoconstrictor, decongestant. Sikoyenera kukonzekera zovuta kuzimitsa nokha, ngakhale mutakhala ndi njira yophikira, imaphatikizanso zinthu zingapo zomwe, ngati zingaphatikizidwe molakwika, zitha kukhala ndi zotsatirapo zoyipa. Dokotala adzalemba mankhwala ndi zofunikira zake kwa wodwala aliyense payekhapayekha, poganizira zovuta komanso mtundu wa matenda.

Pa nthawi yoyembekezera, kugwiritsa ntchito mankhwalawa mkati ndi kunja ndizoletsedwa, ngakhale pali umboni. Mankhwalawo amasokoneza makina a mwana wosabadwayo, chifukwa amalowa mkati mwa chikhodzodzo. Ngakhale madontho ovuta samalimbikitsidwa panthawi yomwe ali ndi pakati pochizira matenda a rhinitis.

Mankhwala a matenda ena

Mu ophthalmology, madontho amaso a antibacterial a Dex Gentamicin a 5 ml amagwiritsidwa ntchito m'botolo, ma CD oyambirirawo amakhala obiriwira, monga chithunzi. Mankhwala amtunduwu adziwonetsa okha mu mankhwalawa a purulent conjunctivitis, blepharitis, dacryocystitis, keratitis. Mankhwalawa amawaponyera m'chigoba chambiri cha madontho awiri a 1-2, kwinaku akusuntha kope lakumunsi. Mutha kugulanso mafuta am'maso a 2,5 g, omwe ali pamwamba pa eyelid yotsika ndikugawidwa wogawana m'diso.

Chidachi chimagwiritsidwa ntchito mu ophthalmology.

Wofalitsa kapena wa mabakiteriya wa ziwalo za ENT (purulent otitis media) amathandizidwanso ndi maantibayotiki, mawonekedwe omwe amatulutsidwa ndi madontho a khutu ndi jakisoni. Pa matenda a mmero kapena a nasopharynx, madokotala amatenga njira ya 4% yothetsera pakhungu m'mphuno ndi pakhosi, ndikuigwiritsa ntchito ngati mankhwala a antibacterial am'deralo. Njira yakuchiritsirayi ndiyofunika kwambiri makamaka kwa ana omwe sakonda kulandira jakisoni. Nebulizer amathandiza kupopera mankhwala. Njira yothetsera vutoli imatsanuliridwa m'thupi la nebulizer, ndikupanga kupweteka m'mphuno ndi mmero katatu patsiku pambuyo pa maola 3-4. Kuti mugwiritse ntchito mosavuta, nebulizer imabwera ndi mphuno m'mphuno, pakhosi komanso ndi chigoba.

Gentamicin ndi gawo limodzi la njira zophatikizira zochizira matenda amkati. Zisonyezero zogwiritsira ntchito - eczema, dermatitis ya mziwindi, matenda a bakiteriya, neurodermatitis.Zomwe zimapangidwira mafuta zimaphatikizapo betamethasone, clotrimazole, imagulitsidwa yopangidwa, simukufuna mankhwala kuti apange. Pa nthawi yapakati, sikulimbikitsidwa kugwiritsa ntchito zingwe izi. Mitundu ya mapiritsi a glamicin yokhudza kukonzekera pakamwa ndiyosangalatsa kwa odwala onse. Mankhwalawa sapezeka monga mapiritsi, mapiritsi mungagule mankhwala ena a gulu lomweli la maantibayotiki.

Mavuto omwe angakhalepo

Kugwiritsa ntchito nthawi yayitali, komanso kusalolera kwa mankhwalawo kapenanso zida zake, mankhwalawa amatha kuyambitsa mavuto. Ngati wodwala ali ndi zovuta za mankhwalawa, muyenera kudziwitsa dokotala za iwo. Itha kukhala:

Kusanza, kusanza, kutsekula m'mimba.
Proteinuria, azotemia, oliguria.
Kuphwanya zida zamagetsi, kuwonongeka kwakuthwa m'makutu.
Jekeseni wam'mimba amatha kuthana ndi redness, ululu.

Pharmacology

Amamangirira gawo la 30S logunit ra ribosomes ndikusokoneza kaphatikizidwe ka mapuloteni, kuletsa mapangidwe a zovuta kuyendetsa ndi mthenga RNA, ndipo chibadwa chimawerengedwa molakwika ndipo mapuloteni osagwira ntchito amapangidwa. Pozama kwambiri, imaphwanya cholepheretsa ntchito ya nembanemba ya cytoplasmic ndikuyambitsa kufa kwa tizilombo.

Kugwiritsa ntchito polimbana ndi mabakiteriya ambiri opanda gramu komanso gramu. Tizilombo toyambitsa matenda a gramu-gramu tosokosera tulo timene timayang'ana ku ma glamicin (MPC ochepera 4 mg / l) - Proteus spp. (kuphatikiza zovuta zopezeka muzoipa ndi zoperewera), Escherichia coli, Klebsiella spp., Salmonella spp., Shigella spp., Campylobacter spp., tizilombo tating'onoting'ono tambiri - Staphylococcus spp. (kuphatikiza ndi penicillin zosagwira), zolimba ndi IPC 4-8 mg / l - Serratia spp., Klebsiella spp., Pseudomonas spp. (kuphatikiza Pseudomonas aeruginosa), Acinetobacter spp., Citrobacter spp., Prov> kuphatikiza ndi benzylpenicillin, ampicillin, carbenicillin, oxacillin), mogwirizana ndi kapangidwe ka cell khoma la tizilombo, akugwira motsutsana Enterococcus faecalis, Enterococcus faecium, Enterococcus durans, Enterococcus avium, pafupifupi mavuto onse Streptococcus faecalis ndi mitundu yawo (kuphatikizapo Streptococcus faecalis liguifaciens, Streptococcus faecalis zymogenes), Streptococcus faecium, Streptococcus durans. Kukana kwa tizilombo tating'onoting'ono tating'onoting'ono kumayamba pang'onopang'ono, komabe, zovuta zosagwirizana ndi neomycin ndi kanamycin zimasonyezanso kukana kwa glamicin (osakwanira pazowonjezera). Zisakhudze anaerobes, bowa, ma virus, protozoa.

M'matumbo am'mimba, samatha kuyamwa bwino, motero, imagwiritsidwa ntchito mwaubwino kuchitira kwadongosolo. Pambuyo pa kayendetsedwe ka i / m, imayamwa mwachangu komanso mokwanira. T_max ndi kuyambitsa / m - maola 0,5-1,5, ndi / koyambitsa, nthawi yofikira C_max ndi: pambuyo pa kulowetsedwa kwa mphindi 30 - mphindi 30, pambuyo pa mphindi 60 kulowetsamo mtsempha - mphindi 15, mtengo wa C_max Pambuyo pa jekeseni wa i / m kapena iv pa mlingo wa 1.5 mg / kg ndi 6 μg / ml. Kumanga mapuloteni a Plasma kumakhala kotsika (mpaka 10%). Kuchuluka kwa magawo akuluakulu ndi 0,26 l / kg, mwa ana - 0.2-0.4 l / kg. Amapezeka mu achire ozama a chiwindi, impso, mapapo, mu pleural, pericardial, synovial, peritoneal, ascitic and lymphatic fluid, mkodzo, mu mabala omwe amatha kugawanika, mafinya, granulation. Kuzungulira kochepa kumawonedwa mu minofu ya adipose, minofu, mafupa, bile, mkaka wam'mawere, kuseka kwamadzimadzi kwa diso, kubisalira kwa bronchial, sputum ndi madzimadzi a cerebrospinal. Nthawi zambiri, mwa akulu, samalowa mkatikati mwa BBB, ndi meningitis, kuphatikiza kwake m'magazi a cerebrospinal kumawonjezeka. Mu makanda, chidwi chachikulu m'madzimadzi a cerebrospinal chimatheka kuposa akuluakulu. Imadutsa mwa placenta. Osapukusidwa. T_1/2 mu akulu - 2-5 maola. Anafukula makamaka ndi impso m'malo osasinthika, ochepa - ndi bile. Odwala omwe ali ndi vuto laimpso, 70-95% amachotseredwa tsiku loyamba, pomwe amaphatikizidwa ndi 100 μg / ml mu mkodzo. Odwala ochepetsedwa glomerular kusefera, chimbudzi amachepetsa kwambiri. Amachotsetseka pa hemodialysis (maola 6 aliwonse, ndende imachepetsa ndi 50%). Peritoneal dialysis siyigwira bwino ntchito (mkati mwa maola 48-72 maola 25% ya mankhwala atulutsidwa). Ndi ma jakisoni obwerezabwereza, amadziunjikira, makamaka m'malo a khutu lamkati mkati ndi khutu la proximal reubu tubules.

Mankhwala akagwiritsidwa ntchito ngati mawonekedwe a madontho amaso, kunyowa sikulephera.

Ikagwiritsidwa ntchito kunja, sikuti imalowa, koma kuchokera kumadera akuluakulu khungu limawonongeka (bala, kuwotcha) kapena yokutidwa ndi minofu ya granulation, kunyowa kumachitika msanga.

Gentamicin mu mawonekedwe a Mlingo wofanana ndi chinkhupule (zigawo za siponji ya collagen yophika mu njira yothetsera ya glamicin sulfate) imadziwika ndi kuthana kwa antibacterial. Pa matenda am'mafupa komanso zofewa (osteomyelitis, abscess, phlegmon, ndi zina), komanso kupewa matenda oyipa pambuyo pa ntchito yamafupa, mankhwalawa amapangidwapo chifukwa cha mbale ndikulowetsedwa m'miyendo ndi mabala, pomwe makonzedwe othandiza a glamicin pamalowo amathandizira 7- Masiku 15. Kukhazikika kwa mankhwalawa m'magazi m'masiku oyamba atayikidwa chinkhupule chimafanana ndi omwe adapangidwa ndi makonzedwe a makolo; Pambuyo pake, maantibayotiki m'magazi amapezeka pazowonjezera zamtundu wina. Kukokomeza kwathunthu kuchokera kumalo okuberekera kumawonedwa mkati mwa masiku 14-20.

Zoletsa ntchito

Zogwiritsa mwatsatanetsatane: myasthenia gravis, parkinsonism, botulism (aminoglycosides angayambitse kuphwanya kwa mitsempha, yomwe imabweretsa kufooka kwa minofu yamafupa), kufooka kwa thupi, kulephera kwa impso, nthawi yammbuyo, ubwana.

Zogwiritsa ntchito zakunja: Ngati ndi kotheka, gwiritsani ntchito khungu lanu - minyewa yamitsempha yamagazi, myasthenia gravis, parkinsonism, botulism, kulephera kwaimpso (kuphatikizapo kuperewera kwambiri kwaimpso ndi azotemia ndi uremia), makanda obadwa kumene ndi makanda asanakwane (ntchito ya impso imapangidwa mosakwanira, zomwe zingayambitse onjezani T_1/2 ndi kuwonetsa kwa zoyipa), ukalamba.

Zotsatira zoyipa

Malangizowa amachenjeza za mwayi wokhala ndi zotsatirapo zoyipa mukamapereka Gentamicin:

kusanza, kusanza,
kuchepa magazi, leukopenia, granulocytopenia, thrombocytopenia,
oliguria
proteinuria
michere
kulephera kwa aimpso
mutu
kugona
kusamva
ugonthi wosasintha
zotupa pakhungu
kuyabwa
urticaria
malungo
Edema wa Quincke.

Contraindication

Gentamicin imatsutsana mu milandu yotsatirayi:

Kusalolera payekha kapena hypersensitivity kwa mosaamicin ndi ena oimira gulu la antioxidicine aminoglycosides.
Azotemia (kuwonjezereka kwa mulingo wa zotsalira wa nayitrogeni m'magazi) motsutsana ndi maziko a kulephera kwakanthawi kapena kupweteka kwa aimpso.
Neuritis (kutupa) kwamitsempha yamagetsi.
Myasthenia gravis ndi kufooka kwa minofu.
Matenda aliwonse amkati ndi khutu la mkati.

Kugwiritsa ntchito moyenera kwa mayi ndi kotheka pazifukwa zaumoyo ngati phindu lomwe mayi akuyembekezera limaposa chiwopsezo cha mwana wosabadwayo.

Malangizo apadera

Ntchito mosamala mu parkinsonism, myasthenia gravis, mkhutu waimpso. Mukamagwiritsa ntchito Gentamicin, ntchito za impso, makina owonera komanso ma vestibular zida ziyenera kuyang'aniridwa.

Kuti mugwiritse ntchito zakunja kwakanthawi pamalo akuluakulu pakhungu, ndikofunikira kulingalira kuthekera kwa kugwiranso ntchito, makamaka kwa odwala omwe ali ndi vuto laimpso.

Kupanga ndi mawonekedwe a kumasulidwa

Pali mitundu inayi ikuluikulu yotulutsira ya Gentamicin, siyopangidwa m'mapiritsi. Kusiyana kwawo kapangidwe, kusasinthasintha ndi ma CD:

Yankho la jakisoni

Chotsani chikasu chikasu

Chotsani chikasu chamadzimadzi

Thovu loyera loyera

Mkulu wa glamicin sulfate, mg

80 pa supu imodzi imodzi (2 ml)

Madzi, sodium metabisulfite, Trilon B

Madzi, benzalkonium chloride, sodium chloride, sodium hydrogen phosphate, sodium dihydrogen phosphate

Kusakaniza kwa paraffin wolimba, wamadzimadzi, ofewa komanso oyera

Kusakaniza kwa mafuta, madzi

Mapaketi a ma ampoules 10

5 ml odontha

Mabotolo a Aerosol 140 g

Pharmacodynamics ndi pharmacokinetics

Pambuyo pa kukhazikika pamitsempha, chigawo chogwira ntchito chimatengedwa mwachangu kuchokera pamalowo jekeseni ndikufika pazowonjezera pambuyo pa mphindi 30-60, zomangiriza mapuloteni a plasma ndi 10%, zimapezeka m'matumbo onse a thupi, kulowa mkati mwa placenta. Kutupa kwa zinthu sikuchitika, chifukwa maola 4-8 amachotsedwa mu ndulu kapena mkodzo. Mukagwiritsidwa ntchito mopitirira, mankhwalawa amamweka pakhungu loyipa ndi 0,1% yokha, ndi khungu lowonongeka - mwachangu komanso mokwanira. Pambuyo pakugwiritsidwa ntchito kwina, chinthucho chimatha maola 8-12, chomwe chimafotokozedwa ndi impso.

Mlingo ndi makonzedwe

Pa gawo liti la thupi lomwe lakhudzidwa ndi matendawa, momwe matendawa aliri, kusankha kwa kumasulidwa kwa mankhwala kumatengera. Ndi zowonongeka zamaso, madontho amaso amasankhidwa, ndi matenda a pakhungu ndi minofu yofewa - mafuta kapena ma eososol, chifukwa cha milandu yayikulu yomwe imafunikira chithandizo chamankhwala, jekeseni ya Gentamicin imalembedwa. Mlingo, njira ndi pafupipafupi ntchito zimaperekedwa ndi dokotala.

Kuyanjana kwa mankhwala osokoneza bongo

Munthawi ya makonzedwe a Gentamicin ndi mankhwala ena, mawonekedwe a zovuta zoyipa amatha. Kuphatikiza kowopsa:

aminoglycosides, vancomycin, cephalosporins, ethacrynic acid imapangitsa ototoxicity ndi nephrotoxicity,
Indomethacin imachepetsa chilolezo chogwira ntchito, imachulukitsa kuchuluka kwake kwa plasma ndipo imabweretsa poizoni.
njira inhalation opaleshoni, opioid analgesics kumaonjezera ngozi ya neuromuscular blockade, mpaka ku ziphuphu,
loop okodzetsa, Furosemide kuonjezera ndende ya gentamicin m'magazi, kuwonjezera ngozi.

Migwirizano yogulitsa ndikusunga

Mitundu yonse ya mankhwalawa imalembedwa, yosungidwa kutentha kwa madigiri 15-25 kwa madontho ndi yankho, madigiri 8-15 a mafuta ndi aerosol. Moyo wa alumali wa madontho ndi zaka zitatu, mafuta ndi aerosol ali awiri, yankho lake ndi asanu. Mutatsegula botolo la madontho, liyenera kusungidwa osapitilira mwezi.

Zofanizira zazikulu ndi mankhwala omwe ali ndi zomwezi. Zosalozera mwachindunji ndi ndalama ndi chinthu china, koma ndi zisonyezo ndi zomwe zimachitika. Ma Analogs akuphatikizapo:

Candiderm - zonona kutengera zomwe zimaphatikizidwa ndi beclomethasone, clotrimazole,
Garamycin ndi chithunzi chokwanira cha mankhwalawa, mwa njira yothetsera, mafuta,
Celestoderm - ili ndi zinthu zomwezo kuphatikiza betamethasone, imapezeka mu mafuta.

Mutha kugula mankhwala kudzera pa nsanja za pa intaneti kapena ma kiosks a pharmacy pamitengo yomwe imadalira mawonekedwe a mankhwalawo, malire a malonda. Mtengo wokwanira wama mankhwala m'makampani opanga mankhwala ku Moscow:

Mimba komanso kuyamwa

Pa nthawi yoyembekezera, zimatheka pokhapokha pazifukwa zaumoyo (maphunziro okwanira komanso olamulidwa mwamphamvu mwa anthu sanachititsidwe. Pali malipoti kuti aminoglycosides ena amachititsa kugontha kwa mwana). Panthawi ya chithandizo, ndikofunikira kusiya kuyamwitsa (kulowa mkaka wa m'mawere).