Momwe mungagwiritsire ntchito Rotomox?

Momwe mungagwiritsire ntchito malangizo athu pamasamba ndi mankhwala ena OnlineManuals.ru
Cholinga chathu ndikukupatsani mwayi wofulumira kupeza zomwe zili mu malangizo a Rotomox. Mothandizidwa ndikuwonera pa intaneti, mutha kuwona zomwe zalembedwa pa Rotomox pazomwe zikutsatira.

Kuti mukhale ndi chidwi
Mukasiyira malangizo ogwiritsira ntchito mankhwalawa Rotomox mwachindunji pamalowo, sizingakhale zabwino kwambiri kwa inu, pali njira ziwiri zothetsera:

• Onani mumayendedwe athunthu - ndikosavuta kuwona malangizo ogwiritsira ntchito (popanda kutsitsa nawo kompyuta yanu), mutha kugwiritsa ntchito mawonekedwe onse pazenera. Kuti muwone malangizo "a Rotomox pazenera lonse, gwiritsani ntchito batani la" Open in Pdf-Viewer ".
• Tsitsani ku kompyuta - Muthanso kukopera malangizo a Rotomox pakompyuta yanu ndikusunga mafayilo.

Anthu ambiri amakonda kuwerenga zolemba osati pazenera, koma zolembedwa. Kutha kusindikiza malangizo amankhwala ndi mapiritsi kunaperekedwanso patsamba lathu, ndipo mutha kugwiritsa ntchito podina chizindikiro cha "kusindikiza" mu Pdf-Viewer. Palibe chifukwa chosindikizira malangizo onse pokonzekera Rotomox, mutha kusankha masamba okha ofunikira kuti mugwiritse ntchito mankhwala kapena mapiritsi enaake.

Malangizo ogwiritsira ntchito mankhwala Rotomox akhoza kutsitsidwa pansipa:

Gulu la mankhwala

Malinga ndi a Doctor Desk Reference (2009), moxifloxacin akuwonetsedwa kuti azichiza matenda omwe amayamba chifukwa cha zovuta zopezeka mu tizilombo tating'onoting'ono ta odwala akuluakulu (opitilira zaka 18).

Pachimake bakiteriya sinusitischifukwa Streptococcus pneumoniae, Haemophilus fuluwenza kapena Moraxella catarrhalis.

Kuchulukitsa kwa matenda osakhazikika omwe amayamba chifukwa cha kachilombo ka bakiteriya(Streptococcus pneumoniae, Haemophilus fuluwenza, Haemophilus parainfluenzae, Klebsiella pneumoniae, wodwala methicillin Staphylococcus aureus kapena Moraxella catarrhalis).

Chibayo chopezeka paguluchifukwa Streptococcus pneumoniae (kuphatikizapo oyambitsidwa ndi tizilombo tosiyanasiyana tomwe tili ndi ma antioxotic angapo *, Haemophilus influenzae, Moraxella catarrhalis, wodwala methicillin Staphylococcus aureus, Klebsiella chibayo, Mycoplasma pneumoniae kapena Chlamydia chibayo.

Matenda opatsirana osavuta a pakhungu ndi zomwe zimagwirachifukwa cha methicillin Staphylococcus aureus kapena Streptococcus pyogene.

Matenda Ovuta a Intraabdominalkuphatikizapo matenda a polymicrobial monga mapangidwe a abscess oyambitsidwa ndi Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron kapena Peptostreptococcus spp.

Matenda opatsirana opweteka a pakhungu ndi zophatikizika zakechifukwa cha methicillin Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae kapena Enterobacter cloacae.

* - - mavuto okhala ndi antibayotiki ambiri Streptococcus pneumoniae - MDRSP), kuphatikiza zingwe zomwe kale zimadziwika kuti PRSP (Penicillin zosagwira S. chibayo) ndi zovuta zosagwirizana ndi mitundu iwiri kapena kupitilira apo: ma penicillin (omwe ali ndi MIC ≥2 μg / ml), cephalosporins m'badwo wachiwiri (mwachitsanzo cefuroxime), macrolides, tetracyclines ndi trimethoprim / sulfamethoxazole.

Mimba komanso kuyamwa

Kugwiritsa ntchito pa nthawi ya pakati ndikotheka ngati chithandizo chamankhwala chikuyembekezeka kupitilira chiwopsezo cha mwana wosabadwayo (maphunziro okwanira komanso okhwima mosamala otetezeka ogwiritsira ntchito amayi apakati sanachitike.

Zotsatira za Teratogenic. Moxifloxacin analibe zotsatira za teratogenic ataperekedwa kwa makoswe apakati pa nthawi ya organogenesis pamtunda wopitilira 500 mg / kg / tsiku, lomwe limafanana ndi pafupifupi 0.24 MPD (kutengera mfundo za AUC), koma panali kuchepa kwa misa ya thupi la fetal komanso kuchedwa pang'ono pakupanga mafupa. fetotoxicity.

Ndi iv yoyendetsera makoswe apakati a moxifloxacin pa mlingo wa 80 mg / kg / tsiku (pafupifupi 2 nthawi kuposa MPD, yowerengedwa padziko la thupi (mg / m 2), kawopsedwe amawoneka kuti ndi achikazi komanso osakwanira kwambiri pa mwana wosabadwayo, kulemera kwake komanso mawonekedwe ake. Ndi Mlingo wa iv pamtunda wa 80 mg / kg / tsiku, palibe mphamvu ya teratogenic yomwe inawonedwa. IV ikamayesedwa kwa akalulu nthawi yapakati nthawi ya tekinolojeni ya 20 mg / kg / tsiku (pafupifupi ndendende ndi MPD pakamwa) idatsitsa kuchepa kwa thupi la fetal ndikuchedwa kutsegulanso mafupa Panali zowopsa, zolakwika, kuchepa kwa chakudya, kuchepa kwa madzi, komanso kuchepa kwa mankhwala pamiyeso iyi. Panalibe umboni wapakamwa wa nyani wa Cynomolgus pa 100 mg / kg / tsiku (2,5 MRDI). kuchuluka kwa mlingo wa 100 mg / kg / tsiku .. Mu makoswe, zidapezeka kuti pakamwa mlingo wa 500 mg / kg / tsiku, zotsatirazi zimawonedwa: kuwonjezeka pang'ono kwa nthawi yayitali ya kubereka, kuchepa kwa prenatal, kuchepetsa kuchepa kwa mwana wakhanda m wamng'ono, utachepa neonatal kupulumuka. Kuwopsa kwa moxifloxacin pazinthu zachiberekero kuwonekera pamene mlingo wa 500 mg / kg / tsiku umaperekedwa kwa makoswe panthawi yapakati.

FDA gulu la zochita za mwana wosabadwa - C.

Moxifloxacin amapukusidwa mkaka wa m'mawere wa makoswe. Popeza moxifloxacin amatha kudutsa mkaka wa m'mawere azimayi oyamwitsa ndikuwachititsa kuyamwitsa kwambiri makanda oyamwitsa, amayi oyamwitsa ayenera kusiya kuyamwitsa kapena kugwiritsa ntchito moxifloxacin (chifukwa cha kufunika kwa mankhwalawo kwa mayi).

Zotsatira zoyipa

Panthawi ya mayesero azachipatala okhudzana ndi odwala oposa 9,200 omwe adalandira moxifloxacin pakamwa ndi iv (opitilira 8600 odwala adalandira ndi 400 mg), zoyipa zambiri zomwe zidanenedwa zinali zochepa komanso zolimbitsa thupi ndipo sizinafune kusiya chithandizo. Mankhwalawa anathetsedwa chifukwa cha kupezeka kwa zovuta zomwe zimakhudzana ndi kumwa mankhwalawa mu 2.9% ya odwala pamene amamwa pakamwa ndi 6.3% ya odwala omwe adalandira mobwerezabwereza (iv komanso pakamwa).

Zotsatira zotsatirazi adaziwona ngati zokhudzana ndi mankhwalawo ndipo zimawonedwa mu ≥2% ya odwala: nseru (6%), matenda am'mimba (5%), chizungulire (2%).

Zotsatira zoyipa zowonetsedwa mwazomwe zimayesedwa mwinanso zokhudzana ndi mankhwala ndikuwona QT, leukopenia, kuchepa kwa prothrombin (kuchuluka kwa prothrombin nthawi / kuchuluka kwa INR), eosinophilia, thrombocythemia, ECG, matenda oopsa, hypotension, edipheral edema, prothrombin (kuchepa kwa prothrombin nthawi / kuchepa kwa INR), thrombocytopenia, supraventricular tachycardia, kuchepa kwa thromboplastin, ventricular tachycardia.

Kuchokera mmimba: ≥0.1% kuphatikiza kupweteka pachifuwa, kumbuyo, miyendo, kupweteka kwa m'chiuno, mphumu, kutupira kwa nkhope, hyperglycemia, hyperlipidemia, matenda oopsa, Hypesthesia, photosensitivity / Phototoxicity reaction, syncope, tenopathy.

Mu kafukufuku wotsatsa Zotsatira zotsatirazi zanenedwapo: anaphylactic reaction, angioedema (kuphatikizapo laryngeal edema), kulephera kwa chiwindi (kuphatikizapo milandu yakupha), hepatitis (makamaka cholestatic), photosensitivity / Phototoxicity reaction, psychotic reaction, Stevens-Johnson syndrome, tendon rupture, toxic epidermal necrolysis ndi yamitsempha yamagazi tachyarrhythmia (kuphatikiza milandu yovuta kwambiri yamtima wamtima ndi omasulira nthawi zambiri mwa odwala omwe ali ndi vuto lofanana ndi proarrhasmic).

Njira zopewera kupewa ngozi

Poyerekeza ndi moxifloxacin, kuchuluka kwa nthawi ya QT ndikotheka, motero, kuyenera kugwiritsidwa ntchito mosamala kwa odwala omwe amalandila mankhwala ena nthawi yomweyo omwe amakulitsanso nthawi ya QT (cisapride, erythromycin, antipsychotic, tricyclic antidepressants), chifukwa zotsatira zowonjezera sizingatheke.

Mosamala, adapangidwa motsutsana ndi maziko a antiarrhythmic mankhwala a kalasi IA (quinidine, procainamide) kapena kalasi III (amiodarone, sotalol).

Chifukwa cha kuchuluka kwa manambala azachipatala pakugwiritsa ntchito moxifloxacin odwala omwe ali ndi vuto lalikulu la bradycardia komanso zizindikiro za ischemia yovuta kwambiri, iyenera kugwiritsidwa ntchito mosamala mwa odwalawa. Kuchulukitsa kwa nthawi ya QT kumatha kuwonjezeka ndikuwonjezereka kwa kuchuluka kwa zinthu komanso kuwonjezeka kwa kulowetsedwa ndi iv, chifukwa chake, Mlingo woyenera ndi nthawi ya mankhwala sayenera kupitilira. Kuwonjezeka kwa gawo la QT kumatha kubweretsa chiwopsezo chowonjezeka cha regricular arrhythmias, kuphatikizapo omasulira. Panalibe milandu yodwala kapena kufa kumene komwe kumakhudzana ndi kuchuluka kwa nthawi ya QT m'mayesero owongolera omwe amagwiritsidwa ntchito ndi moxifloxacin odwala oposa 9,200 (kuphatikiza odwala 223 omwe ali ndi hypokalemia koyambirira kwa chithandizo), ndipo palibe kuchuluka kwa kufa kwa odwala 18,000 omwe akutenga moxifloxacin mkati, munthawi yakusaka kochita malonda osagwiritsa ntchito ECG.

Kugwiritsidwa ntchito kwa quinolones kumalumikizidwa ndi chiopsezo chotenga matenda okhudzidwa, komanso zovuta zina zamagulu amanjenje (chizungulire, chisokonezo, kunjenjemera, kuyerekezera zinthu m'maganizo, kukhumudwa, komanso malingaliro osafuna kudzipha kapena zochita zina). Izi zimawonedwa pambuyo pa mlingo woyamba wa mankhwalawa. Pakachitika izi, moxifloxacin ayenera kusiyidwa. Monga quinolones ena, moxifloxacin ayenera kugwiritsidwa ntchito mosamala pamaso kapena kukayikira kwa matenda apakati amanjenje (kuphatikizapo matenda oopsa a ubongo), khunyu kapena pamaso pazinthu zina zomwe zikufuna kulanda kapena kuchepa kwa gawo la kulanda.

Nkhani za chitukuko cha kusokonezeka kwakukulu kwa anaphylactic mukamamwa mankhwala omwe odwala amamwa ma quinolones, kuphatikizapo moxifloxacin, akuti. Nthawi zina, izi zimachitika limodzi ndi kugwa kwa mtima, kuiwala, kukomoka, kutupika kwa pakhosi kapena nkhope, dyspnea, urticaria, komanso kuyabwa. Pankhani ya anaphylactic zochita, makonzedwe aposachedwa a epinephrine amafunikira. Ngati zotupa pakhungu kapena ngati zizindikiro zina za hypersensitivity zikuwoneka, mankhwala a moxifloxacin ayenera kusiyidwa ndipo njira zoyenera zothetsedwera ziyenera kumwedwa (ngati kuli kofunikira).

Ndikofunika kuganizira za mwayi wokhala ndi pseudomembranous colitis, ngati kutsegula m'mimba kumawonekera mwa odwala omwe amalandila antibacterial. Kuchiza ndi antibacterial wothandizila kumayambitsa kusintha kwamtundu wamatumbo akuluakulu ndipo kungayambitse kukula kwa clostridia. Ngati matenda a pseudomembranous colitis akhazikitsidwa, chithandizo choyenera chiyenera kukhazikitsidwa.

Pa mankhwala ndi fluoroquinolones, kuphatikizapo moxifloxacin, kukula kwa tendonitis ndi kupindika kwa tendon (Achilles ndi ena) ndikotheka. Kuwona pambuyo pakutsatsa kwati kwachitika ngozi zambiri kwa odwala omwe amalandila corticosteroids, makamaka azaka zopitilira 60. Chifukwa chake, kupweteka, kutupa kapena kupindika kwa tendon kumachitika, makonzedwe a moxifloxacin ayenera kusiyidwa. Tiyenera kukumbukira kuti kuperewera kwa tendon kumatha kuchitika kapena pambuyo pa quinolone mankhwala (kuphatikizapo moxifloxacin).

Malangizo apadera

Asanalandire chithandizo, ziyeso zoyenera ziyenera kuchitika kuti zizindikire tizilombo tating'onoting'ono tomwe timayambitsa matendawa ndikuwunika kudziwa moxifloxacin. Mankhwala a Moxifloxacin akhoza kukhazikitsidwa zotsatira za mayeserowa zisanafike. Zotsatira zoyeserera zikadziwika, chithandizo chokwanira chiyenera kupitilizidwa.