Ana ndi achinyamata ochepera zaka 18 zakubadwa, pakati, mkaka wa m`mawere (nthawi yoyamwitsa), hypersensitivity kwa mankhwalawa.

Mochenjera, onani mapiritsi a mankhwalawa a khunyu (kuphatikizapo mbiri), khunyu, kusowa kwa chiwindi, matenda a kutalika kwa nthawi ya QT.

Moxifloxacin

Moxifloxacin: malangizo ogwiritsira ntchito ndi kuwunika

Dzina lachi Latin: Moxifloxacine

Code ya ATX: J01MA14

Zogwira pophika: moxifloxacin (moxifloxacin)

Wopanga: Verteks AO (Russia), Hetero Labs Limited (India), PFK Alium, LLC (Russia), Virend International, LLC (Russia), Promomed Rus, LLC (Russia)

Sinthani mafotokozedwe ndi chithunzi: 11/22/2018

Mitengo muma pharmacies: kuchokera ku 396 rubles.

Moxifloxacin ndi antibacterial wothandizira pazinthu zingapo za bactericidal.

Zotsatira za pharmacological

Wothandizira antimicrobial kuchokera pagulu la fluoroquinolones, amachita bactericidal. Imagwira pakulimbana ndi tizilombo tating'onoting'ono tambiri ta gramu-gramu komanso gram-negative, anaerobic, acid osagwira komanso mabacteria atypical: Mycoplasma spp., Chlamydia spp., Legionella spp. Kugwiritsa ntchito polimbana ndi mabakiteriya okhala ndi beta-lactams ndi macrolides. Imagwira pakulimbana ndi tizilombo tosiyanasiyana tambiri tating'onoting'ono: gram-positive - Staphylococcus aureus (kuphatikiza zingwe zomwe sizimvera kwambiri methicillin), Streptococcus pneumoniae (kuphatikiza tizilombo ta penicillin ndi macrolides), Streptococcus pyogene (gulu A), gram-negative - kuphatikizapo hememilus ndi mitundu yopanda beta-lactamase yopangira), Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis (kuphatikiza mitundu yopanda-beta komanso ya beta-lactamase yopangira), Escherichia coli, Enterobacter cloacae, atypical Chlamydia pneumonia.

Zotsatira zoyipa

Kuchokera pamimba: kupweteka kwam'mimba, nseru, kutsegula m'mimba, kusanza, kutsetsereka, kudzimbidwa, kuwonjezeka kwa ntchito ya hepatic transaminases, kusokoneza kukoma.

Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: chizungulire, kusowa tulo, mantha, nkhawa, asthenia, mutu, kugwedezeka, paresthesia, kupweteka kwa mwendo, kukokana, chisokonezo, kukhumudwa.

Kuchokera pamtima dongosolo: tachycardia, zotumphukira edema, magazi ochulukirapo, palpitations, kupweteka pachifuwa.

Pa gawo la magawo a labotale: kuchepa kwa prothrombin, kuchuluka kwa ntchito za amylase.

Kuchokera ku hemopoietic dongosolo: leukopenia, eosinophilia, thrombocytosis, thrombocytopenia, kuchepa magazi.

Kuchokera ku minculoskeletal system: kupweteka kumbuyo, arthralgia, myalgia.

Kuchokera pakubala: vagidi candidiasis, vaginitis.

Thupi lawo siligwirizana: zotupa, kuyabwa, urticaria.

Kuchita

Ndi munthawi yomweyo kugwiritsa ntchito maantacid, mchere, ma multivitamini amachepetsa mayamwidwe (chifukwa cha mapangidwe a chelate complexes ndi polyvalent cations) ndikuchepetsa kuchuluka kwa mankhwalawa mu plasma (munthawi yomweyo makonzedwe angagwiritsidwe ntchito ndi maola 4 isanachitike kapena maola awiri mutatha kumwa mankhwalawa.

Mankhwalawa ndi mankhwalawa pomwe ena fluoroquinolones amagwiritsidwa ntchito, kukulitsa kusintha kwa zithunzi kumatha kuchitika.

Ranitidine amachepetsa kuyamwa kwa mankhwalawa.

Mafunso, mayankho, ndemanga pa Rotomox

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.

Momwe mungagwiritsire ntchito Rotomox 400?

Rotomox 400 ndi gulu la antimicrobials. Ichi ndi chimodzi mwa mankhwala. Mapiritsiwa amaphatikizidwa kuti achepetse kumasulidwa kwa chinthu chomwe chikugwira. Mankhwalawa amagwira ntchito bwino polimbana ndi tizilombo toyambitsa matenda, omwe amadziwika ndi kukana maantibayotiki ena, mwachitsanzo, macrolides. Pakupanga kwa mankhwalawa, mlingo wa yogwira ntchito (400 mg) umasungidwa.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapangidwa molimba. Mapiritsi ali ndi 400 mg yogwira ntchito. Momwemo, moxifloxacin amachitapo kanthu. Mankhwalawa alinso ndi zinthu zina, komabe, sizikuwonetsa zochita za antibacterial, koma zimagwiritsidwa ntchito popanga mankhwala a kufunika kosasinthika. Izi zikuphatikiza:

• wowuma chimanga
• cellcrystalline mapadi,
• sodium methyl parahydroxybenzoate,
• talcum ufa
• magnesium wakuba,
• silica colloidal
• sodium carboxymethyl wowuma.

Mankhwala amaperekedwa m'mapaketi okhala ndi 5 ma PC. mapiritsi.

Momwe mungagwiritsire ntchito moxifloxacin pa matenda ashuga?

Pharmacokinetics

The yogwira pophika mankhwala amapezeka mwachangu. Komanso, chigawochi chimakhala chokhazikika. Kukula kwa njirayi sikuchepa pomwe mukudya. Ubwino wa mankhwalawa umaphatikizapo kukwera kwakukulu kwa bioavailability (ukufika 90%). Chomwe chimagwira chimagwira kumapuloteni a m'madzi a m'magazi. Kuchuluka kwa moxifloxacin osapitilira 40% ya kuchuluka kwazomwe zimachitika panjira iyi.

Chiwopsezo cha ntchitoyi chimatheka patadutsa maola angapo piritsi limodzi. Kwambiri achire zotsatira zimawonedwa patatha masiku atatu chiyambireni chithandizo. Chochita chogawidacho chimagawidwa m'thupi lonse, koma mokulirapo chimadziunjikira m'mapapu, bronchi, sinuses. Pakukonzekera kagayidwe kazinthu, mankhwala osagwira amamasulidwa. Moxifloxacin sasintha ndipo ma metabolites amafufutidwa kudzera mu impso pokodza komanso kuwonongeka. Mankhwalawa amagwiranso ntchito mochizira amai ndi abambo.

Kukula kwa njirayi sikuchepa pomwe mukudya.

Zizindikiro zogwiritsidwa ntchito

Popeza kuti chinthu chogwira ntchito chimasonkhana kwambiri m'mapapu, bronchi ndi sinuses, Rotomax imapereka zotsatira zabwino kwambiri pochiza ziwalo zopumira. Komabe, mankhwalawa atha kukwaniritsa zina mwa mankhwalawa. Zisonyezero zogwiritsidwa ntchito:

• bronchitis aakulu ndi kuchulukana,
• chibayo (mankhwalawa ndi mankhwala panthawi ya mankhwala kapena kunyumba),
• Matenda a m'chiberekero oyambitsidwa ndi michere yoyipa (mankhwalawa ndi mankhwala ngati palibe zovuta),
• matenda a pakhungu ndi minofu yofewa,
• sinusitis pachimake
• zovuta zamkati pamimba.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa moxifloxacin:

• mapiritsi okhala ndi kanema: biconvex, kutengera wopanga: kapangidwe kake, kapangidwe kake, kuchokera ku lalanje wotumbululuka kupita pinki, olembedwa "80" mbali imodzi ndi "Ine" mbali inayo, kapena ozungulira achikasu pamtanda - pakati ndi pamtunda wachikasu mpaka wachikaso (5, 7 kapena 10 zidutswa zilizonse pamutu, pamakatoni a 1, 2 kapena 3 matuza, 5, 7, 10 kapena 15 mu paketi yazovala, mu makatoni okhala ndi mapaketi a6-6, zidutswa 10 chilichonse mu pulasitiki, mu bokosi lamatabwa a 1 akhoza),
• yankho la kulowetsedwa: chikasu chowoneka bwino chobiriwira chikasu chobiriwira (50 ml chilichonse m'milaga yopanda utoto, Mbale 5 m katoni, 250 ml mumabotolo apulasitiki, mkatoni mthumba 1 kapena popanda thumba losindikizidwa iye, waku zipatala - 1/9 mabotolo opanda mapaketi m'matumba osindikizidwa kapena popanda iwo pabokosi lamatoni).

Piritsi limodzi lili:

• yogwira mankhwala: moxifloxacin hydrochloride - 436.4 mg (lolingana ndi zomwe moxifloxacin - 400 mg),
• zina zowonjezera: povidone K29 / 32 kapena K-30 (Kollidon 30), cellcosestalline cellulose, magnesium stearate, croscarmellose sodium, kutengera wopanga, kuwonjezera - lactose monohydrate, talc ndi silicon dioxide colloidal,
• utoto wamafilimu (kutengera wopanga): mowa wa Opadry II lalanje 85F23452 polyvinyl mowa, titanium dioxide, macrogol, talc, utoto wachikasu utoto wokhala ndi aluminium varnish (E110), utoto wa utoto wa iron oxide (E172) kapena opadray pink 02F540000 hypromellose 2910, titanium dioxide (E171), macrogol, iron oxide utoto wofiirira (E172), iron oxide utoto wachikasu (E172) kapena kusakaniza kowuma kwa filimuyo ya hypromellose, iron oxide chikasu (iron oxide), hyprolose (hydroxypropyl cellulose), titanium dioxide, talc.

Mu 1 ml yankho la kulowetsedwa lili:

• yogwira mankhwala: moxifloxacin hydrochloride - 1,744 mg (malinga ndi moxifloxacin base - 1.6 mg),
• zina zowonjezera: sodium chloride, madzi a jakisoni, sodium hydroxide solution kapena hydrochloric acid solution, kapena (kutengera wopanga) mchere wa ethodiumnediaminetetraacetic acid (sodium hydroxide solution kapena hydrochloric acid solution - wogwiritsidwa ntchito ngati pakufunika kusintha kwa phindu la pH munjira).

Mlingo

Mapiritsi okhala ndi mafilimu, 400 mg

Piritsi limodzi lili

ntchito yogwira - moxifloxacin hydrochloride 436.322 mg (wofanana ndi moxifloxacin 400.00 mg),

obwera: chimanga, cellcrystalline cellulose, sodium starch glycolate, sodium methylhydroxybenzoate, colloidal silicon dioxide, talc, magnesium stearate

kapangidwe ka chipolopolo: Opadry pink 85F540146 (mowa wa polyvinyl, titanium dioxide (E171), macrogol, talc, red iron oxide (E172).

Mapiritsiwa ndi pinki-yokutidwa ndi pinki, wokhala ndi chiopsezo mbali imodzi.

Mankhwala

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, moxifloxacin imagwira mwachangu komanso pafupifupi kwathunthu. Mtheradi bioavailability pafupifupi 91%.

Pambuyo pa mlingo umodzi wa 400 mg wa moxifloxacin, ndende yolemekezeka (Cmax) m'magazi imafikiridwa mkati mwa maola 0.5-4 ndipo ndi 3.1 mg / l.

Peak ndi zochepa za plasma za malo okhazikika (400 mg kamodzi tsiku lililonse) zinali 3.2 ndi 0,6 mg / L, motsatana. Munthawi yokhazikika, kuwonekera kwa mankhwalawa pakadali pakati pa Mlingo wa mankhwala ndi pafupifupi 30% kuposa pambuyo poyambira mlingo woyamba.

Moxifloxacin imagawiridwa mwachangu pamalo owonjezera, atatenga 400 mg ya mankhwalawo, malo omwe ali pansi pa pharmacokinetic curve (AUC) ndi 35 mg / h / L. Voliyumu yogawa zofanana (Vss) ili pafupifupi 2 L / kg. Mu in vitro ndi mu vivo maphunziro, kumangiriza kwa moxifloxacin ku mapuloteni a plasma anali 40-42%, mosasamala kanthu za kuchuluka kwa mankhwalawa. Moxifloxacin makamaka amamangiriza serum albin.

Mfundo zotsatilazi zotsatizanazi (tanthauzo la geometric) zimawonedwa pambuyo pa kumwa pakamwa kamodzi pa moxifloxacin, 400 mg:

Nsalu

Kusintha

Chiwerengero cha ndende ya mankhwala mu minofu ake ndende plasma

Mafuta a Epithelial Lining

Nthenda ya Ethmoid

Akazi achikazi *

* kudzera mtsempha wa magazi limodzi mlingo wa 400 mg

1 mawola 10 mankhwala atamwa

2 ndende yaulere zinthu

3 kuyambira 3 mpaka maola 36 pambuyo pa makonzedwe

4 kumapeto kwa kulowetsedwa

Moxifloxacin amakumana ndi biotransformation yachiwiriyo ndipo amamufufuza kudzera mu impso ndi m'mimba thirakiti yosasinthika, komanso mwa mawonekedwe a sulfo-compound (M1) ndi glucuronide (M2). Ma metabolites awa amagwira ntchito kokha m'thupi laumunthu ndipo samakhala ndi antimicrobial zochita. Kafukufuku wokhudzana ndi metabolic pharmacokinetic mogwirizana ndi mankhwala ena adawonetsa kuti moxifloxacin sikuti ndi biotransformed ndi microsomal cytochrome P450 system. Zowonetsa za oxidative metabolism kulibe.

Hafu ya moyo wa mankhwalawa kuchokera m'madzi a m'magazi pafupifupi maola 12. Nthawi zonse chilolezo chitatenga 400 mg kuchokera pa 179 mpaka 246 ml / min. Kuchotsera penal, pafupifupi 24-53 ml / min, kumachitika mwa kupatsanso kwa mafupa a impso mu impso.

Kuphatikizika kwa ntchito kwa ranitidine ndi phenenecid sikukhudza kuvomerezeka kwa mankhwalawa.

Mosasamala kanthu za kayendetsedwe ka kayendetsedwe, poyambira moxifloxacin pafupifupi 96-98% yopangidwa ndi metabolites ya gawo lachiwiri la metabolism popanda zizindikiro za oxidative metabolism.

Pharmacokinetics m'magulu osiyanasiyana odwala

M'magulu odzipereka athanzi lolemera thupi (mwachitsanzo, azimayi) ndi odzipereka okalamba, kuchuluka kwa plasma kumawonekera.

Mankhwala a moxifloxacin a pharmacokinetic siosiyana kwambiri ndi odwala omwe amadza ndi aimpso (kuphatikizapo creatinine chilolezo> 20 ml / mphindi / 1.73 m2). Ndi kuchepa kwa aimpso ntchito, kukhazikika kwa metabolite M2 (glucuronide) kumawonjezeka chifukwa cha 2,5 (ndi creatinine chilolezo cha 50% mdziko limodzi kapena zingapo.

Mlingo ndi makonzedwe

Mlingo wothandizidwa ndi 400 mg kamodzi tsiku lililonse (250 ml ya njira yothetsera kulowetsedwa). Musapitirire mlingo woyenera.

Pa magawo oyambirira a chithandizo, njira yothetsera kulowetsedwa ingagwiritsidwe ntchito, kenako, kupitiriza chithandizo, ngati pali mawonekedwe azachipatala, mankhwalawa amatha kupatsidwa pakamwa mapiritsi.

Chibayo chopezeka pagulu - analimbikitsa nthawi yayitali ya chithandizo chamankhwala othandizira (mtsempha wa magazi amkati wotsatira wamkamwa) ndi masiku 7-14.

Matenda ovuta a pakhungu ndi minofu yofewa - Kutalika kokwanira kwa chithandizo cha mankhwala opatsirana (kudzera mu mtsempha wotsatira wamkamwa) ndi masiku 7 mpaka 21.

Musapitirire nthawi yolimbikitsidwa.

Ana ndi achinyamata

Moxifloxacin amaphatikizidwa mu ana ndi achinyamata. Mphamvu ndi chitetezo cha moxifloxacin mwa ana ndi achinyamata ochepera zaka 18 sizinakhazikitsidwe.

Odwala okalamba

Kusintha kwa dongosolo la odwala okalamba sikofunikira.

Zosintha mu mtundu wa dosing m'mafuko sizofunikira

Odwala omwe ali ndi vuto la chiwindi

Palibe chidziwitso chokwanira pakugwiritsa ntchito odwala omwe ali ndi vuto la chiwindi.

Odwala ndi zilema ntchito pdiso

Odwala aimpso kulephera (kuphatikizapo creatinine chilolezo kangapo kokwanira.

Zochita zamankhwala osokoneza bongo

Zochita Zamankhwala

Kuchulukitsa kwapakati pakubwera kwa QT kuyenera kuganiziridwa mukamamwa moxifloxacin ndi mankhwala ena omwe angakulitse nthawi ya QTc. Chifukwa cha kuphatikiza kwa moxifloxacin ndi mankhwala omwe amakhudza gawo la QT, chiopsezo chokhala ndi chotupa cham'mimba, kuphatikizapo polymorphic ventricular tachycardia (torsade de pointes), chikuwonjezeka.

Kugwiritsa ntchito moxifloxacin ndi mankhwala aliwonse otsatirawa ndi otsutsana:

- Mankhwala oteteza khungu la IA a Class (monga, quinidine, hydroquinidine, disopyramide)

- Maphunziro a antiarrhythmic ya Class III (mwachitsanzo, amiodarone, sotalol, dofetilide, ibutilide)

antipsychotic (mwachitsanzo phenothiazines, pimozide, sertindole, haloperidol, sultoprid)

- antimicrobial agents (saquinavir, sparfloxacin, iv erythromycin, pentamidine, antimalarials, makamaka halofantrine)

- ma antihistamines ena (terfenadine, astemizole, misolastine)

- ena (chisapride, vincamine iv, bepridil, diphemanil).

Moxifloxacin ayenera kugwiritsidwa ntchito mosamala odwala omwe amamwa mankhwala otsitsa a potaziyamu (mwachitsanzo, malupu ndi thiazide okodzetsa, mankhwala opatsirana, enemas (muyezo waukulu), corticosteroids, amphotericin B) kapena mankhwala ogwirizana ndi bradycardia yofunika kwambiri. Kutalikirana pakati pakukonzekera komwe kumakhala ndizosiyanasiyana (mwachitsanzo, ma antacid okhala ndi magnesium kapena aluminium, mapiritsi a didanosine, sucralfate ndi kukonzekera komwe kumakhala ndi chitsulo kapena zinc) ndi moxifloxacin kuyenera kukhala pafupifupi maola 6.

Pamene Mlingo wa moxifloxacin mobwerezabwereza adaperekedwa kwa odzipereka athanzi, chiwopsezo chochuluka (Cmax) cha digoxin chinawonjezeka pafupifupi 30%, pomwe malo omwe ali munthawi yopondera (AUC) ndi ndende yocheperako (Cmin) ya digoxin sanasinthe.

Zotsatira za kafukufuku yemwe wachitika pa odzipereka omwe ali ndi matenda opatsirana a shuga adawonetsa kuti ndi munthawi yomweyo kutsitsa kwa moxifloxacin ndi glibenclamide, kuchuluka kwa glibenclamide m'madzi am'magazi kunatsika pafupifupi 21%, zomwe mwamalemba zingayambitse kukula kwapang'onopang'ono kwa hyperglycemia. Komabe, kusintha kwa pharmacokinetic sikunachititse kuti kusintha kwa magawo a pharmacodynamic (glucose, insulin).

Kusintha mu INR (International Normalised Ratio)

Odwala omwe amalandila ma anticoagulants osakanikirana ndi ma antibacterial othandizira (makamaka fluoroquinolones, macrolides, tetracyclines, cotrimoxazole ndi ena cephalosporins), pali milandu ya anticoagulant yowonjezera ya mankhwala anticoagulant. Zoyipa ndi kukhalapo kwa matenda opatsirana (ndi kupatsirana kwakanthawi), m'badwo komanso chikhalidwe cha wodwalayo. Pankhaniyi, ndizovuta kudziwa ngati kachilomboka kapena chithandizo chake chimayambitsa kuphwanya kwa INR. Ndikofunikira kuyang'anira pafupipafupi za INR ndipo ngati pakufunika kusintha, muthane mankhwala omwe mumamwa anticoagulant.

Kafukufuku wachipatala awonetsa kusowa kwa kuyanjana ndikugwiritsira ntchito pamodzi kwa moxifloxacin ndi mankhwala otsatirawa: ranitidine, probenicide, kulera pamlomo, mankhwala othandizira calcium, morphine wogwiritsa ntchito kholo, theophylline, cyclosporine kapena itraconazole.

Maphunziro a in vitro omwe ali ndi ma enzymes a cytochrome P450 amatsimikizira izi. Popeza izi, titha kudziwa kuti zochita za metabolic zomwe zimaphatikizapo ma enzymes a cytochrome P450 ndizokayikitsa.

Kuyanjana kwa chakudya

Moxifloxacin alibe njira yayikulu yolumikizirana ndi chakudya, kuphatikizapo mkaka.

Zotsatirazi sizikugwirizana ndi yankho la moxifloxacin: yankho la sodium chloride 10% ndi 20%, sodium bicarbonate solution 4.2% ndi 8.4%.

Malangizo apadera

Ubwino wa chithandizo ndi moxifloxacin, makamaka wofatsa pamatenda oyenera, uyenera kukhala wolingana ndi chidziwitso chomwe chili mgawoli.

Kukula kwa nthawi ya QTc ndi zochitika zina zamatenda komwe kungakhale kukugwirizana ndi kutalika kwa nthawi ya QTc

Zinakhazikitsidwa kuti moxifloxacin imachulukitsa nthawi ya QTc pama electrocardiogram a odwala ena. Kuchulukitsa kwa QT kumawonjezera ndi kuchuluka kwa mankhwalawa m'madzi a m'magazi chifukwa cha kulowetsedwa kwaposachedwa. Zotsatira zake, kutalika kwa kulowetsedwa kuyenera kukhala kosachepera mphindi 60 osapitirira muyeso wa 400 mg kamodzi patsiku.

Popeza azimayi amakonda kutalikitsira nthawi ya QTc poyerekeza ndi abambo, amatha kukhala osamala ndi mankhwala omwe amawonjezera nthawi ya QTc. Odwala okalamba amathanso kukhala osamala ndi zovuta za mankhwala omwe amakulitsa nthawi ya QT.

Mankhwala omwe amatha kuchepetsa potaziyamu ayenera kugwiritsidwa ntchito mosamala odwala omwe amalandila moxifloxacin.

Moxifloxacin iyenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi vuto la proarrhythmogenic (makamaka azimayi ndi odwala okalamba), monga pachimake myocardial ischemia kapena nthawi yayitali ya QT, chifukwa izi zimatha kuyambitsa chiopsezo chowonjezeka cha ventricular arrhythmias (kuphatikizapo pirouette tachycardia) ndi kumangidwa kwa mtima. Kuchulukitsa kwa nthawi ya QT kumatha kuwonjezeka ndi kuchuluka kwa mankhwalawa. Chifukwa chake, musapitirire mlingo woyenera.

Ngati pali zizindikiro za mtima pamankhwala, muyenera kusiya kumwa mankhwalawo ndikupanga ECG.

Hypersensitivity ndi thupi lawo siligwirizana adalembedwa pambuyo koyamba makonzedwe a fluoroquinolones, kuphatikizapo moxifloxacin.

Nthawi zambiri, zotsatira za anaphylactic zimatha kupitilira muyeso waumoyo wa anaphylactic, nthawi zina atagwiritsidwa ntchito koyamba kwa mankhwalawa. Mu milandu iyi, makonzedwe a moxifloxacin ayenera kusiyidwa ndipo njira zothandizira achire (kuphatikizapo anti-shock) ziyenera kuchitika.

Kugwiritsa ntchito mankhwala a quinolone kumalumikizidwa ndi chiopsezo chogwira gwiridwe. Chenjezo liyenera kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto lamkati la mitsempha, kapena pamaso paziwopsezo zina zomwe zingapangitse kulanda kapena kuchepetsa kulanda. Pankhani ya kukomoka, makonzedwe a moxifloxacin ayenera kusiyidwa ndi njira zoyenera zochizira zotchulidwa.

Zovuta za sensorimotor polyneuropathy, zomwe zimatsogolera paresthesia, hypesthesia, dysesthesia, kapena kufooka kwa odwala omwe amalandira quinolones, kuphatikizapo moxifloxacin, akuti. Ngati muli ndi vuto la neuropathy, monga kupweteka, kuwotcha, kumva, kugona kapena kufooka, odwala omwe amatenga moxifloxacin ayenera kuonana ndi dokotala asanapitirize chithandizo.

Machitidwe amakhudzidwa amatha kuchitika ngakhale mutayamba kugwiritsa ntchito ma quinolones, kuphatikiza moxifloxacin. Mwakamodzikamodzi, kupsinjika kapena malingaliro atakhazikika amapitilira mpaka kufuna kudzipha komanso kuchita zinthu modzivulaza, monga kufuna kudzipha. Wodwala akayamba kutengera izi, moxifloxacin iyenera kusiyidwa ndikuyenera kuchitapo kanthu. Ndikulimbikitsidwa kusamala makamaka popereka moxifloxacin kwa odwala a psychotic kapena odwala omwe ali ndi mbiri yodwala matenda amisala.

Ndi kugwiritsidwa ntchito kwa moxifloxacin, milandu yokhudzana ndi chiwindi chachikulu cha hepatitis yanena, zomwe zitha kubweretsa chiwopsezo cha chiwopsezo cha moyo, kuphatikizapo zotsatira zakupha. Odwala ayenera kufunsa dokotala nthawi yomweyo asanapitirize kulandira chithandizo ngati pali zizindikiro ndi chiwonetsero chokwanira cha hepatitis, monga kupanga mofulumira asthenia yokhudzana ndi jaundice, mkodzo wakuda, chizolowezi chowononga magazi, kapena hepatic encephalopathy. Pofuna chizindikiro cha kuperewera kwa chiwindi, muyenera kuphunzira kagwidwe ka chiwindi.

Milandu yokhudzana ndi kukhudzana kwa khungu lamphongo, mwachitsanzo, Stevens-Johnson syndrome kapena poermal necrolysis yoopsa (yomwe ikhoza kuwononga moyo), akuti. Ngati zotupa pakhungu ndi / kapena mucous zimachitika, muyenera kufunsa dokotala musanapitirize chithandizo.

Matenda opatsirana opatsirana monga Antibiotic (AAD) ndi matenda othana ndi antipatitis (AAK), kuphatikizapo pseudomembranous colitis ndi Clostridium Hardile- kuphatikiza ndi matenda am'mimba, adanenedwa zokhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo a antibacterial, kuphatikiza moxifloxacin, ndipo amatha kusiyanasiyana kuchokera ku matenda otsekula m'mimba kupita ku colitis yakupha. Chifukwa chake, ndikofunikira kukumbukira izi kuzindikirika kwa odwala omwe amatenga matenda otsekula m'mimba panthawi kapena atatha kumwa moxifloxacin. Ngati AAAD kapena AAK akukayikiridwa kapena kutsimikiziridwa, ndikofunikira kusiya kumwa antibacterial, kuphatikiza moxifloxacin, ndikupereka njira zoyenera zamankhwala. Kuphatikiza apo, njira zoyenera zothetsera matenda ziyenera kutengedwa kuti muchepetse kutenga kachilomboka. Odwala omwe amadwala matenda otsegula m'mimba amatsutsana ndi mankhwala omwe amaletsa matumbo kuyenda.

Moxifloxacin ayenera kugwiritsidwa ntchito mosamala odwala omwe ali ndi myasthenia gravis, popeza mankhwalawa amatha kupititsa patsogolo zizindikiro za matendawa.

Kutupa ndi kupasuka kwa tendons (makamaka tendon ya Achilles), nthawi zina, kumatha kuchitika pakumwa mankhwala a quinolones, kuphatikizapo moxifloxacin, ngakhale patadutsa maola 48 chiyambireni chithandizo, ndipo milandu idanenedwa patangotha ​​miyezi yochepa atasiya chithandizo. Chiwopsezo cha tendonitis ndi kupindika kwa tendon chikuwonjezeka mwa okalamba komanso odwala omwe amathandizidwa ndi corticosteroids nthawi yomweyo. Pachizindikiro choyamba cha kupweteka kapena kutupa, odwala ayenera kusiya kumwa moxifloxacin, kuthetsa miyendo ndi manja omwe akhudzidwa ndipo nthawi yomweyo funsani kwa dokotala kuti alandire chithandizo choyenera (i.e. immobilization).

Pogwiritsa ntchito quinolones, mawonekedwe a photosensitivity adadziwika. Komabe, kafukufuku wasonyeza kuti moxifloxacin ali ndi chiopsezo chotsika cha photosensitivity. Komabe, odwala ayenera kupewa kuyatsidwa ndi radiation ya UV kapena kuwunika mwachindunji pakumwa mankhwala ndi moxifloxacin.

Moxifloxacin ali osavomerezeka pochizira matenda omwe amayamba chifukwa cha methicillin a Staphylococcus aureus (MRSA). Pakakhala matenda okayikiridwa kapena wotsimikizika omwe amayamba ndi methicillin staphylococcus, ndikofunikira kupereka mankhwala ndi antibacterial mankhwala oyenera.

Kutha kwa moxifloxacin poletsa kukula kwa mycobacteria kungasokoneze zotsatira zoyeserera Mycobacterium spp., zomwe zimabweretsa zotsatira zoyipa zabodza mukamafufuza zitsanzo za odwala omwe amathandizidwa ndi moxifloxacin panthawiyi.

Monga ndi fluoroquinolones ena, kugwiritsa ntchito moxifloxacin kunawonetsa kusintha kwa shuga wamagazi, kuphatikiza hypo- ndi hyperglycemia. Pa mankhwalawa ndi moxifloxacin, dysglycemia imapezeka makamaka mwa odwala okalamba omwe ali ndi matenda osokoneza bongo omwe amalandila chithandizo chothandizidwa ndi mankhwala a hypoglycemic (mwachitsanzo, kukonzekera kwa sulfonylurea) kapena insulin. Pochiza odwala matenda ashuga, kuyang'aniridwa mosamala kwa shuga wamagazi kumalimbikitsidwa.

Moxifloxacin ayenera kugwiritsidwa ntchito mosamala odwala okalamba omwe ali ndi matenda a impso ngati sangathe kusunga magazi okwanira, popeza kuchepa madzi m'thupi kumawonjezera mwayi wokhala ndi impso.

Ndi kukula kwa mawonekedwe owoneka bwino kapena zizindikiro zina za maso, muyenera kufunsa katswiri wamaso.

Odwala omwe ali ndi mbiri ya banja kapena kusowa kwenikweni kwa glucose-6-phosphate dehydrogenase amakhala ndi vuto la hemolytic akathandizidwa ndi quinolones. Moxifloxacin ayenera kuikidwa mosamala odwala.

Njira yothetsera kulowetsedwa kwa moxifloxacin ndi ya mtsempha wama mtsempha wokha. Kafukufuku wam'mbuyomu wasonyeza kupezeka kwa kutupa kwapakati pa zotupa pambuyo pa intraarterial makonzedwe a moxifloxacin, chifukwa chake, njira iyi yoyendetsera iyenera kupewedwa.

Mimba komanso kuyamwa

Chitetezo chotenga moxifloxacin pa nthawi ya pakati mwa amayi sichinawunikidwe. Kafukufuku wazinyama awonetsa kawopsedwe kabala. Chiwopsezo chomwe chilipo kwa anthu sichikudziwika. Chifukwa chazidziwitso za kuwonongeka kwa malowedwe akulu a mafupa a fluoroquinolones asanakwane nyama komanso kuvulala kosinthika komwe kukufotokozedwa kwa ana omwe amachitidwa ndi fluoroquinolones, moxifloxacin sayenera kutumizidwa kwa amayi apakati.

Zambiri pakugwiritsa ntchito mankhwalawa azimayi panthawi yoyamwitsa sizipezeka. Kafukufuku wofufuza wapeza kuti moxifloxacin wocheperako amasungidwa mkaka wa m'mawere. Kugwiritsidwa ntchito kwa moxifloxacin pa yoyamwitsa kumatsutsana.

Zambiri za momwe mankhwalawa amatha kuyendetsa magalimoto ndi machitidwe ake owopsa.

Mankhwalawa amatha kulepheretsa wodwala kuyendetsa magalimoto ndi kuchita zina zomwe zingakhale zowopsa zomwe zimafuna kuwonjezeredwa chidwi komanso kuthana ndi psychomotor mwachangu chifukwa cha dongosolo lamkati lamanjenje komanso kuwonongeka kwa mawonekedwe.

Bongo

Zambiri zokhala ndi bongo wambiri zilipo.

Pankhani ya bongo, munthu akuyenera kutsogoleredwa ndi chithunzi cha chipatala ndikuwonetsa polojekiti yokonza mosamala ndi ECG. Kugwiritsa ntchito kaboni yodziyimira kuchitira mankhwala osokoneza bongo a pakamwa kapena kulowetsedwa kwa 400 mg ya moxifloxacin kungakhale koyenera kupewa kutalikirana kwambiri kwa moxifloxacin ndi 80% kapena 20% motsatana.

Wopanga

Scan Biotech Limited, India

Dzinalo ndi dziko laomwe amalembetsa satifiketi

Routec Limited, UK

Adilesi ya bungweli kulandira zovomerezeka kuchokera kwa ogula pamalonda a zinthu (katundu) komanso omwe amayang'anira kuyang'anira kuyang'anira chitetezo cha mankhwala m'dera la Republic of Kazakhstan

St. Dosmukhametova, 89, likulu la bizinesi "Caspian", ofesi 238, Almaty, Republic of Kazakhstan.

Ndemanga za mankhwala

Pafupifupi kuwunika konse kwa wodwala, Moxifloxacin ndiwothandiza kwambiri pothana ndi causative wothandizila matendawa komanso kuwongolera msanga thanzi.

Komabe, ambiri obwereza amadandaula za zovuta zina atatha kumwa mankhwalawa. Mwa iwo, omwe amatchulidwa kwambiri ndi awa: nseru, kutsegula m'mimba, kupweteka kwam'mimba, chizungulire, kupweteka pang'ono pachifuwa, kugona, mutu, tachycardia, kusowa tulo, nkhawa komanso kukhumudwa.

Odwala ena amati kuchotsetsa mavuto kumathandizira pakumwa mapiritsi a Moxifloxacin panthawi ya chakudya ndikumwa madzi amchere ambiri atatha kumwa mankhwalawo.

Ndemanga zingapo zafotokoza kuti kumwa mankhwalawa kunadzetsa chisangalalo mwa akazi, omwe amachotsedwa mosavuta atatenga Difluzole (kapena mankhwala enanso ofanana).

Ndemanga za madontho a diso a Vigamox kwa gawo lalikulu zimangokhala zabwino. Adalekereredwa bwino ndi odwala ndipo sizinayambitse mavuto. Olemba ndemanga amawona kuchotsedwa kwachangu kwa vuto la maso ndi zizindikiro za matenda oyambitsidwa.

Ndemanga za hypersensitivity kuti madontho a Vigamox ndi osowa kwambiri. Muzochitika izi, odwala adazindikira mawonekedwe a kuyabwa ndi redness m'maso. Atasiya kumwa mankhwalawo, zizindikiritso izi zidazimiririka.

Odwala ambiri amayankha pamtengo wa Moxifloxacin ndi mawonekedwe ake monga "okwera."

Mtengo wa mankhwalawa ku Russia ndi Ukraine

Mtengo wa Moxifloxacin zimatengera mtundu wa kumasulidwa, mankhwala ndi mzinda womwe umagulitsa mankhwalawo. Musanagule, muyenera kumveketsa mtengo wake m'mafakitala angapo ndikufunsira kwa dokotala za momwe angathere ndi analogue, chifukwa ndi mankhwalawa omwe sangapezeke ogulitsa nthawi zonse. Nthawi zambiri m'magulu amamasamba amagulitsa ma analogues (ma syonyms) a Moxifloxacin kuposa mankhwalawo pawokha.

Mtengo wamba wa ma analogues (ma synonyms) a Moxifloxacin m'mafakisi ku Russia ndi Ukraine:

• Avelox yankho la kulowetsedwa kwa mtsempha wama 400 mg / 250 ml 1 botolo - 1137-1345 rubles, 600-1066 h scrollnias,
• Moxifloxacin-Farmex yankho la kulowetsedwa kwa mtsempha wama 400 mg / 250 ml 1 botolo - 420-440 hryvnia,
• Njira ya Maxicin yothetsera kulowetsedwa kwa mtsempha wa 400 mg / 250 ml 1 botolo - 266-285 hryvnia,
• Mapiritsi a Avelox 400 mg, zidutswa 5 pa paketi iliyonse - ma 739-861 ma ruble, 280-443 h pantnias,
• Diso la Vigamox limatsika ndi 0,5% 5 ml - ma ruble 205-160, 69-120 hhucnias.

Mankhwala

Moxifloxacin ndi mankhwala antimicrobial a gulu la fluoroquinolone, omwe ali ndi bactericidal zotsatira, limagwirira zake chifukwa cha chopinga cha bakiteriya enzymes topoisomerase II (DNA gyrase) ndi topoisomerase IV, yomwe ndiyofunikira pakubwereza, kusindikiza ndi kukonza kwa deoxyribonucleic acid yotsatira yake. maselo.

Kuchuluka kwa michere ya bactericidal ya chinthu kumakhala kofanana ndi zochepa zake zoletsa (MIC). Ntchito ya antibacterial siyisokonezedwa ndi machitidwe omwe amatsogolera kukana kwa macrolides, aminoglycosides, cephalosporins, penicillin ndi tetracyclines. Palibe kukana kwapakati komwe kunawonedwa pakati pamagulu opha maantiotic ndi moxifloxacin, ndipo palibe milandu ya plasmid yomwe idadziwika. Kutsutsa kwa zinthu zomwe zimayamba kugwira ntchito kumayamba pang'onopang'ono kudutsa masinthidwe angapo. Poyerekeza ndi zotsatira za mobwerezabwereza za mankhwalawa pazinthu zomwe zimakhala pansi pa MIC, kuwonjezeka pang'ono pokha kwa chizindikirocho kunapezeka.Kutsutsa kwa quinolones kunapezeka, komabe, tizilombo tina tokhala ndi gramu komanso anaerobic omwe amawonetsa kukana kwa quinolones ena amawonetsa chidwi cha moxifloxacin.

Kafukufuku wa in vitro adawonetsa ntchito yolimbana ndi ma anaerobes osiyanasiyana, ma gram-negative komanso gram-virus, mabakiteriya atypical komanso acid, kuphatikizapo Legionella spp., Chlamydia spp., Mycoplasma spp. machitidwe a P-lactam ndi macrolide maantibayotiki.

M'maphunziro awiri omwe adachitika pa odzipereka, kutsatira pakamwa pa microflora yamatumbo idawonedwa: kuchepa kwa milingo ya Bacteroides vulgatus, Bacillus spp., Escherichia coli, Klebsiella spp. Enterococcus spp. . ndi Bifidobacterium spp. Kuchuluka kwa tizilombo tating'onoting'ono kameneka kunabweranso masiku awiri okha. Ma sumu a Clostridium zovuta sanapezeka.

Pansipa pali tizilombo tating'onoting'ono tophatikizidwa ndi mawonekedwe a antibacterial zochita za moxifloxacin.

Zovuta za zotsatirazi tizilombo tating'ono timayang'ana machitidwe a mankhwala:

• Ma gram-negative aerobes: Haemophilus influenzae ndi Moraxella catarrhalis (kuphatikiza tizilombo tating'onoting'ono osati kupanga beta-lactamases) *, Haemophilus parainfluenzae *, Proteus vulgaris, Acinetobacter baumannii, Bordetella pertussis,
• Ma gror-positive aerobes: Gardnerella vaginalis, Streptococcus pneumoniae *, kuphatikiza zovuta zopezeka ndi maantibayotiki ambiri komanso zovuta zomwe zimawonetsa kukana kwa penicillin, komanso zovuta zomwe zimatsutsana ndi maanti awiri kapena kuposerapo, monga penicillin (MIC yoposa 2 μg / ml ), tetracyclines, cephalosporins II m'badwo (mwachitsanzo, cefuroxime), trimethroprim-Sulfamethoxazole, macrolides, Streptococcus milleri (Streptococcus constellatus * Streptococcus anginosus * Streptococcus intermedius *), Streptococcus pyogenes (gulu A) * Streptococcus vir>

Zovuta za zotsatirazi tizilombo tating'onoting'ono zimayang'ana modekha zochita za moxifloxacin:

• ma gram-negative aerobes: Enterobacter spp. (Enterobacter sakazakii, Enterobacter intermedius, Enterobacter aerogene), Citrobacter freundii **, Klebsiella pneumoniae *, Escherichia coli *, Klebsiella oxytoca, Pantoea agglomerans, Enterobacter cloacae *, Stenotrophomonas maltophiliaomulululululululululululululululululul wa waulamu wa Malulophomomulululululululululululululululululululul wa waul. Providencia spp. (Providencia stuartii, Providencia rettgeri), Neisseria gonorrhoeae *,
• Ma gram okhala ndi ma grames abwino: Enterococcus faecium *, Enterococcus avium *, Enterococcus faecalis (imangotengera ma glamicin ndi vancomycin) *,
• anaerobes: Clostridium spp. *, Peptostreptococcus spp. *, Bacteroides spp. (Bacteroides vulgaris *, Bacteroides fragilis *, Bacteroides thetaiotaomicron *, Bacteroides distasonis *, Bacteroides sareis *, Bacteroides ovatus *).

Ma tizilombo ena otsatirawa sagwirizana ndi mankhwalawa: coagulase-negative Staphylococcus spp. (methicillin yogonjetsedwa ndi zovuta za Staphylococcus cohnii, Staphylococcus haemolyticus, Staphylococcus epermidis, Staphylococcus saprophyticus, Staphylococcus hominis, Staphylococcus simureans)

* Kuzindikira kwa tizilombo tating'onoting'ono to moxifloxacin kumatsimikiziridwa ndi zidziwitso zamankhwala.

** Kugwiritsa ntchito sikulimbikitsidwa pochiza matenda oyambitsidwa ndi methicillin zosagwira a aureus tizilombo (MRSA). Ngati matenda a MRSA atsimikiziridwa kapena akuwakayikira, mankhwala oyenera a antibacterial amafunikira chithandizo.

Kugawika kwa kukana kwa mankhwala kwamaudzu ena kumatha kukhala kosiyana pakapita nthawi komanso kusinthidwa ndi dera. Mukamayesa kumva kupsinjika, tikulimbikitsidwa kuti pakhale ndi data yotsutsa yakomweko, yomwe ndiyofunika kwambiri pochiza matenda oopsa.

Mimba komanso kuyamwa

Pa nthawi yoyembekezera, mankhwala a moxifloxacin amapatsirana chifukwa chosowa deta yakuchipatala yotsimikizira chitetezo chake panthawiyi. Mu ana omwe amatenga ma quinolones, milandu yovulaza yomwe idasinthidwa idalembedwa, koma palibe malipoti a kupezeka kwa matenda amtunduwu mwana wosabadwayo akagwiritsidwa ntchito ndi amayi awo panthawi yapakati. M'maphunziro a nyama, poizoni wa mankhwala adadziwika, koma chiopsezo kwa anthu sichidadziwike.

Popeza kuchuluka kwa moxifloxacin kumadutsa mkaka wa m'mawere, ndipo palibenso chidziwitso pakugwiritsa ntchito amayi oyamwitsa, kugwiritsidwa ntchito kwake kumatsutsana panthawi ya mkaka wa m'mawere.

Ndi chiwindi ntchito

Moxifloxacin wapangika kuti agwiritse ntchito ngati matenda a chiwindi C asokonekera molingana ndi gulu la ana-Pugh, komanso ndende ya transaminase yoposa kasanu VGN, chifukwa cha kuchuluka kwa mayeso azachipatala. Pamaso pa cirrhosis, imaphatikizika kugwiritsa ntchito mankhwalawa kapena kusamalidwa kwapadera kuyenera kumwedwa (kutengera wopanga).

Odwala omwe ali ndi vuto la chiwindi cha kalasi A ndi B pamawonekedwe a Mwana, palibe chifukwa chosinthira mtundu wa moxifloxacin.

Kuyanjana kwa mankhwala osokoneza bongo

• tricyclic antidepressants, hydroquinidine, quinidine, disopyramide (kalasi IA antiarrhythmics), ibutilide, dofetilide, sotalol, amiodarone (gulu lachitatu antiarrhythmics), halofantrine (antimalarials), pentamidine, erythromycin (ndi iv) ), sultopride, haloperidol, sertindole, pimozide, phenothiazine (antipsychotic), misolastine, astemizole, terfenadine (antihistamines), diphemanil, bepridil, vincamine (ndi iv yoyang'anira), chisapride ndi mankhwala ena omwe amakhudza elongation ndi Tervala QT: ntchito zawo kuphatikiza ndi moxifloxacin ndi contraindicated chifukwa aggravation za chiopsezo arrhythmia yamitsempha yamagazi (kuphatikizapo mtundu yamitsempha yamagazi tachycardia torsade de A pointes ..),
• Kukonzekera komwe kumakhala ndi chitsulo, zinc, magnesium ndi aluminium, maantacid, mankhwala ochepetsa mphamvu ya kachilombo ka HIV kukhala osachepera maola 4
• Kaboni yodziyimira: chifukwa cha kuletsa kuyamwa kwa maantibayotiki, dongosolo lawo la bioavailability limatsika ndi oposa 80% (mukamamwa 400 mg),
• digoxin: palibe kusintha kwakukulu pamapangidwe a pharmacokinetic,
• warfarin: palibe kusintha kwa prothrombin nthawi ndi magawo ena a magazi, koma, ndizotheka kuwonjezera zochitika za mankhwala anticoagulant, zoopsa zimaphatikizapo kukhalapo kwa matenda opatsirana, chikhalidwe chachikulu komanso zaka za wodwalayo, ndikofunikira kuyang'anira INR ndipo, ngati kuli kotheka, musinthe kuchuluka kwa anticoagulants osadziwika,
• cyclosporine, calcium zowonjezera, atenolol, theophylline, ranitidine, pakamwa kulera, itraconazole, glibenclamide, morphine, digoxin, probenecid - osagwirizana kwambiri ndi mankhwalawa ophatikizidwa ndi moxifloxacin adapezeka (kusintha kwa mlingo sikufunika),
• sodium bicarbonate solution ya 4,2 ndi 8,4%, sodium kolorayidi yankho la 10 ndi 20% - zothetsera izi sizigwirizana ndi moxifloxacin kulowetsedwa (nthawi yomweyo ndizoletsedwa kulowa).

Analogs wa moxifloxacin ndi Vigamoks, Alvelon-MF Megafloks, Avelox, Moksigram, Maksifloks, Akvamoks, Moksistar, Moksiflo, Moksispenser, Moksimak, Moxifloxacin Sandoz, Moxifloxacin CHP Moxifloxacin Alvogen, Moflaksiya, Moxifloxacin STADA, Moxifloxacin Canon Moxifloxacin-Verein , Plevilox, Rotomox, Moxifur, Moxifloxacin-TL, Ultramox, Simoflox, Heinemox.