Cefepim - malangizo, ntchito, maupangiri, ma piritsi, ma piritsi a ma piritsi a antibayotiki 1 gramu, mapiritsi, mankhwala a matenda a bronchitis, chibayo, cystitis akuluakulu, ana ndi mimba

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Cefepim. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito mankhwala osokoneza bongo a cefepime. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, mwina sizinalengezedwe ndi wopanga. Analogs a cefepime pamaso pa zomwe zimapangidwa kale. Gwiritsani ntchito mankhwalawa bronchitis, chibayo, cystitis ndi matenda ena opatsirana akuluakulu, ana, komanso pa nthawi ya pakati ndi mkaka wa m`mawere. The zikuchokera mankhwala.

Cefepim - mankhwala a cephalosporin kuchokera ku gulu la 4th kuti makolo azigwiritsa ntchito. Imakhala ndi bactericidal kwambiri, ikusokoneza kapangidwe ka khungu la ma cellorgan tizilombo.

Yogwira motsutsa mabakiteriya ambiri opanda gramu, incl. kupanga beta-lactamases, kuphatikizapo Pseudomonas aeruginosa. Ogwira ntchito kwambiri kuposa mibadwo 3 ya cephalosporins, motsutsana ndi gram-cocci cocci.

Yogwira ntchito motsutsana ndi Enterococcus spp. (enterococcus), Listeria spp. (Listeria), Legionella spp. (Legionella), bacteria wina wa anaerobic (Bacteroides fragilis, Clostridium Hardile).

Cepepime imadziwika ndi kusasunthika kwakukulu motsutsana ndi ma plasmid osiyanasiyana komanso chromosomal beta-lactamases.

Kupanga

Cefepima hydrochloride + Excipients.

Pharmacokinetics

Kumanga mapuloteni a Plasma kumakhala kochepera 19% ndipo kumayimira pawokha ndende ya serum cefepime. Achire zozama za cefepime zimapezeka mu mkodzo, ndulu, peritoneal madzimadzi, exudate wa zotupa, mucous secretion wa bronchi, sputum, Prostate minofu, zakumwa ndi ndulu, chithokomiro chamitsempha yokhala ndi meningitis. Mu wathanzi anthu, ndi mtsempha wa magazi makonzedwe a cefepime muyezo wa 2 g ndi imeneyi ya maola 8 kwa masiku 9, palibe kuwunika m'thupi kunawonedwa. Cefepime amuchotsetsa impso, makamaka ndi kusefera kwake (kupweteka kwakanthawi impso - 110 ml / min). Mumkodzo, pafupifupi 85% ya nthawi yam'mbuyomu yomwe amapezeka imapezeka kuti sinasinthe. Odwala a zaka zapakati pa 65 kapena kuposapo omwe ali ndi vuto laimpso, chilolezo cha impso ndi chochepa kuposa odwala achinyamata. Pharmacokinetics ya cefepime mwa odwala omwe ali ndi vuto la chiwindi, cystic fibrosis sichinasinthidwe.

Zizindikiro

Chithandizo cha matenda opatsirana komanso otupa oyambitsidwa ndi tizinthu tating'onoting'ono ta cefepime:

matenda ochepa kupuma thirakiti (kuphatikizapo chibayo ndi bronchitis),
matenda a kwamkodzo thirakiti (yovuta komanso yosavuta),
matenda a pakhungu ndi minofu yofewa,
matenda amkatikati mwa m'mimba (kuphatikizapo peritonitis ndi matenda ammimba oyamba),
matenda azamatenda
septicemia
neutropenic fever (monga mankhwala othandizira),
bakiteriya meningitis ana.

Kupewa matenda opaleshoni yam'mimba.

Kutulutsa Mafomu

Ufa pakukonzekera njira yothetsera mtsempha wa intravenous ndi mu mnofu wa 1 gramu (jakisoni m'mapiritsi a jakisoni).

Mitundu ina ya kumwa, ngati mapiritsi kapena mapiritsi, kulibe.

Malangizo ogwiritsira ntchito ndi mlingo

Munthu payekha, kutengera kuzindikira kwa tizilombo toyambitsa matenda, kuopsa kwa matendawa, komanso momwe boma limagwirira ntchito.

Njira yolowerera yoyendetsera imakonda odwala omwe ali ndi matenda oopsa kapena oopsa, makamaka ndi chiopsezo chodzidzimutsa.

Mothandizidwa ndi intramuscular kapena intravenous kwa akulu ndi ana olemera oposa 40 makilogalamu okhala ndi vuto laimpso, gawo limodzi ndi 0,5-1 g, nthawi yokhazikitsidwa ndi maola 12. Kwa matenda oopsa, amathandizira kudzera m'mitsempha ya 2 g maola 12 aliwonse.

Pofuna kupewa matenda pakachitika m'mimba, amagwiritsidwa ntchito limodzi ndi metronidazole malinga ndi chiwembu.

Kwa ana a zaka zakubadwa ziwiri, mlingo woyenera sayenera kupitirira mlingo woyenera wa akulu. Mlingo wamba wa ana olemera mpaka 40 kg wokhala ndi zovuta zamkodzo matenda opatsirana (kuphatikiza pyelonephritis), matenda osavuta a pakhungu ndi minofu yofewa, chibayo, komanso chithandizo chamankhwala cha neutropenic fever ndi 50 mg / kg maola 12 aliwonse.

Odwala omwe ali ndi vuto la neutropenic fever ndi bacteri meningitis - 50 mg / kg maola 8 aliwonse.

Nthawi yayitali ya mankhwala ndi masiku 7-10. M'matenda akulu, chithandizo chachitali chingafunike.

Ngati vuto la impso (CC zosakwana 30 ml / min), kukonza kwa dongosolo lofunikira ndikofunikira. Mlingo woyamba wa cefepime uyenera kukhala wofanana ndi kwa odwala omwe ali ndi vuto laimpso. Mlingo wokonza umatsimikiziridwa malinga ndi mfundo za QC kapena serum creatinine ndende.

Ndi hemodialysis mu maola atatu, pafupifupi 68% ya kuchuluka kwa nthawi yonse ya cefepime imachotsedwa. Pamapeto pa gawo lililonse, ndikofunikira kukhazikitsa mlingo wobwereza wofanana ndi mlingo woyamba. Odwala omwe akupitiliza kukonzekera kwa peritoneal dialysis, nthawi ya cefepime ingagwiritsidwe ntchito muyezo waukulu, i.e. 500 mg, 1 g kapena 2 g, malingana ndi kuopsa kwa matendawa, ndi kuyimitsidwa pakatikati pa gawo limodzi la maola 48

Kwa ana omwe ali ndi vuto la impso, kusintha komweku mumalingaliro kumalimbikitsidwa ngati kwa achikulire, popeza pharmacokinetics ya cefepime mwa akulu ndi ana ndi chimodzimodzi.

Zotsatira zoyipa

kutsegula m'mimba, kudzimbidwa,
kusanza, kusanza,
colitis (kuphatikizapo pseudomembranous colitis),
kupweteka m'mimba
kusintha kwa kukoma
zotupa
kuyabwa
urticaria
anaphylactic reaction,
mutu
chizungulire
paresthesia
kukokana
khungu red
kuchepa magazi
kuchuluka kwa ALT, AST, zamchere phosphatase,
kuchuluka kwa bilirubin,
eosinophilia, wosakhalitsa thrombocytopenia, wosakhalitsa leukopenia ndi neutropenia,
kuchuluka kwa prothrombin nthawi,
mayeso abwino a Coombs popanda hemolysis,
malungo
vaginitis
erythema
kuyamwa
candidiasis osalunjika,
phlebitis (ndi mafupa amkati),
ndi makonzedwe a intramuscular, kutupa kapena ululu pamalowa jakisoni ndikotheka.

Contraindication

Hypersensitivity to cefepime kapena L-arginine, komanso mankhwala a cephalosporin, penicillin kapena mankhwala ena a beta-lactam.

Mimba komanso kuyamwa

Maphunziro okwanira komanso osamalitsa okhazikika a chitetezo cha cefepime panthawi yomwe ali ndi pakati sanachitike, kugwiritsa ntchito kumatheka pokhapokha kuyang'aniridwa ndi dokotala.

Cepepime imachotsedwa mkaka wa m'mawere mozama kwambiri. Panthawi yoyamwa, gwiritsani ntchito mosamala.

M'maphunziro oyesera, sizinakhudze ntchito ya kubereka komanso zotsatira za nthawi ya phefes.

Gwiritsani ntchito ana

Chitetezo ndikugwiritsa ntchito mwanzeru kwa ana osaposa miyezi iwiri sizinakhazikitsidwe. Kwa ana ochepera miyezi iwiri (kuphatikiza makanda), kugwiritsa ntchito ndikotheka malinga ndi kuchuluka kwa mankhwalawa. Kwa ana omwe ali ndi vuto la impso, kusintha komweku mumalingaliro kumalimbikitsidwa ngati kwa achikulire, popeza pharmacokinetics ya cefepime mwa akulu ndi ana ndi chimodzimodzi.

Malangizo apadera

Ikagwiritsidwa ntchito kwa odwala omwe ali pachiwopsezo chachikulu cha matenda chifukwa cha michere ya aerobic / anaerobic microflora (kuphatikiza pazovuta pomwe Bacteroides fragilis ndi amodzi mwa tizilombo toyambitsa matenda), tikulimbikitsidwa kupereka mankhwala omwe amagwira motsutsana ndi Cefepim nthawi yomweyo ndi tizilombo toyambitsa matenda anaerobes.

Gwiritsani ntchito mosamala odwala omwe ali pachiwopsezo chodwala matendawa, makamaka mankhwala osokoneza bongo.

Ndi chitukuko cha thupi lawo siligwirizana, nthawi ya mphiri iyenera kusiyidwa.

Mukuvutikira kwambiri kwa hypersensitivity reaction, epinephrine (adrenaline) ndi mitundu ina ya chithandizo chothandizira chingafunike.

Ngati kutsegula m'mimba kumachitika pakumwa, kuganiziranso za kukhala ndi pseudomembranous colitis kuyenera kuganiziridwanso. Zikatero, nthawi yakumapeto ya mgonero iyenera kuchotsedwa nthawi yomweyo ndipo chithandizo choyenera chikuyenera kuperekedwa ngati kuli kofunikira.

Ndi kukula kwa superinitness, Cefepim iyenera kuthetsedwa yomweyo ndikuyenera kulandira chithandizo chamankhwala.

Mukamagwiritsa ntchito maantibayotiki ena a gulu la cephalosporin, urticaria, Stevens-Johnson syndrome, erythema multiforme, poyizoni epermosis, colitis, kuperewera kwaimpso, magazi, kupweteka, kuchepa kwa chiwindi, kuchepa kwa magazi, kuphatikiza cholestasis, zotsatira zabodza zabwino. shuga mkodzo.

Ndi chisamaliro chapadera, nthawi ya cefepime imagwiritsidwa ntchito limodzi ndi aminoglycosides ndi "loop" diuretics.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi munthawi yomweyo makonzedwe a cefepime ndi mayankho a metronidazole, vancomycin, boreamicin, tobramycin sulfate ndi netilmicin sulfate, kuyanjana kwa mankhwala ndizotheka.

Mndandanda wa mankhwala Cefepim

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