Moflaxia® (Moflaxia)

* Kuzindikira kwa moxifloxacin kumatsimikiziridwa ndi zidziwitso zamankhwala.

** Kugwiritsa ntchito mankhwala Moflaxia sikulimbikitsidwa pochiza matenda oyambitsidwa ndi zironda S. aureuskugonjetsedwa ndi methicillin (MRSA). Pankhani ya matenda okayikiridwa kapena otsimikiziridwa omwe amayambitsidwa ndi MRSA, mankhwala omwe ali ndi antibacterial mankhwala oyenera ayenera kuperekedwa.

Kwa zovuta zina, kufalikira kwa kukhudzika komwe kumachitika kungasiyane ndi dera komanso nthawi. Pankhaniyi, poyesa kumva kupsinjika, ndikofunikira kukhala ndi chidziwitso chakudziko chokana, makamaka pochiza matenda oopsa.

Ngati odwala akumalandira chithandizo kuchipatala, mtengo wa AUC / MIC₉₀zopitilira 125, ndi C_max m'magazi am'magazi / MIC₉₀ ili pamtundu wa 8-10, izi zikusonyeza kusintha kwamankhwala. Muzochitika, malingaliro a magawo azotsatira nthawi zambiri amakhala ocheperako: AUC / MIK₉₀ >30–40.

*AUIC - dera lomwe lili pansi pa chipondacho (AUC / MIK)₉₀)

Pharmacokinetics

Zogulitsa. Ikaperekedwa, moxifloxacin imagwira msanga komanso pafupifupi. Mtheradi bioavailability pafupifupi 91%. Mankhwala a moxifloxacin atamwa pa 50 mpaka 1200 mg kamodzi, komanso 600 mg / tsiku kwa masiku 10, ali pamzere. Dera lolingana limafikiridwa pakatha masiku atatu.

Pambuyo limodzi mlingo wa 400 mg moxifloxacin C_max mu madzi am'magazi amafikira mkati mwa maola 0 ndi 0,5 ndipo ndi 3.1 mg / l. Pambuyo m`kamwa makonzedwe a 400 mg a moxifloxacin 1 nthawi patsiku C_{ma (max)} ndi C_{ss (min)} ndi 3.2 ndi 0,6 mg / l, motsatana.

Mukamamwa moxifloxacin ndi chakudya, pali kuwonjezeka pang'ono kwa T_max (pa 2 h) ndi kuchepa pang'ono kwa C_max (pafupifupi 16%), pomwe nthawi ya mayamwidwe sikusintha. Komabe, izi ndizosafunikira, ndipo moxifloxacin amatha kugwiritsidwa ntchito mosasamala nthawi yakudya.

Kugawa. Moxifloxacin imagawiridwa mwachangu mu minofu ndi ziwalo ndipo imagwirizana ndi mapuloteni a plasma (makamaka omwe ali ndi albumin) ndi pafupifupi 45%. V_d pafupifupi 2 l / kg.

Kuzungulira kwa moxifloxacin, wopitilira omwe ali m'madzi am'magazi, amapangidwa m'matumbo am'mapapu (kuphatikizapo epithelial fluid, alveolar macrophages), ma paranasal sinuses (maxillary and ethmoid labyrinth), ma polyps amphuno, maziko a kutupa (pazinthu zamatuza a zotupa za pakhungu) . Pazipinda zamkati komanso malovu, moxifloxacin amatsimikiza mwa mawonekedwe aulere, osakhala ndi mapuloteni, pamsasa wozungulira kuposa plasma wamagazi. Kuphatikiza apo, ma moxifloxacin amadziwika kwambiri pamatumbo am'mimba, zotupa za peritoneal, komanso ziwalo zoberekera wamkazi.

Kupenda. Moxifloxacin imadutsa biotransfform ya gawo lachiwiri ndipo imachotsedwa m'thupi ndi impso, komanso m'matumbo, osasinthika komanso mawonekedwe osakanikirana a mankhwala a soffo (M1) ndi glucuronides (M2). Moxifloxacin sanapangidwe biocransformed ndi microsomal cytochrome P450 system. Ma metabolabolites M1 ndi M2 amapezeka m'magazi am'magazi mozama kwambiri kuposa potengera makolo. Malinga ndi zotsatira za maphunziro oyamba, zimatsimikiziridwa kuti ma metabolites awa samakhala ndi vuto lililonse mthupi poteteza komanso kulolera.

Kuswana. T_1/2 moxifloxacin ndi pafupifupi maola 12. Nthawi zonse chilolezo chotsatira cha 400 mg ndi 179-66 ml / mphindi.

Chilolezo chotsimikizika ndi 24-53 ml / mphindi. Izi zikuwonetsa kubwezeretsanso kwakanthawi kwa moxifloxacin.

Kuchuluka kwa miyeso yoyambira ndi gawo lachiwiri la metabolites kuli pafupi 96-98%, zomwe zikuwonetsa kusowa kwa metabolid oxidative. Pafupifupi 22% ya mlingo umodzi (400 mg) umachotsedwa osagwirizana ndi impso, pafupifupi 26% - kudzera m'matumbo.

Pharmacokinetics m'magulu osiyanasiyana odwala

Zaka, jenda komanso fuko. Kafukufuku wa pharmacokinetics a moxifloxacin mwa amuna ndi akazi adawonetsa kusiyana mu 33% malinga ndi AUC ndi C_max . Kuyamwa kwa moxifloxacin sikunadalire jenda. Kusiyana mu AUC ndi C_max zidachitika chifukwa chosiyana kulemera kuposa jenda, ndipo sizowonedwa kuti ndizofunika kwambiri pakubadwa.

Panalibe kusiyana kwakukulu kachipatala mu pharmacokinetics ya moxifloxacin mwa odwala amitundu yosiyanasiyana ndi mibadwo yosiyana.

Ana. Ma pharmacokinetics a moxifloxacin mwa ana sanaphunzire.

Matenda aimpso. Panalibe kusintha kwakukulu mu pharmacokinetics ya moxifloxacin mwa odwala omwe ali ndi vuto la Impso (kuphatikiza odwala a Cl creatinine 2) ndi odwala omwe akupitilira hemodialysis wopitilira nthawi yayitali.

Kuwonongeka kwa chiwindi. Panalibe kusiyana kwakukulu mu kuchuluka kwa moxifloxacin mwa odwala omwe ali ndi vuto la chiwindi (Makulidwe amtundu wa A-A ndi gulu la A ndi B) poyerekeza ndi odzipereka athanzi komanso odwala omwe ali ndi chiwindi chokwanira.

Zisonyezo za mankhwala Moflaxia ®

Matenda opatsirana komanso otupa omwe amayambitsidwa ndi tizilombo tating'onoting'ono ta moxifloxacin:

kuchuluka kwa matenda opatsirana,

matenda osavuta a pakhungu ndi kapangidwe kake,

chibayo chopezeka pagulu, kuphatikizapo chibayo chomwe chimapezeka m'deralo, zomwe zimapangitsa kuti pakhale mitundu ya tizilombo tating'onoting'ono tokhala ndi ma antibayotiki ambiri.

matenda ovuta a pakhungu ndi kapangidwe kazinthu zina (kuphatikizapo phazi la matenda ashuga),

zovuta zamkati zam'mimba, kuphatikizapo matenda a polymicrobial, kuphatikizapo makasitomala amkati,

zovuta zotupa matenda a m'chiuno ziwalo (kuphatikizapo salpingitis ndi endometritis).

*Streptococcus pneumoniae Ndi mitundu yambiri yoletsa kukonzekera imaphatikizira penicillin zotupa ndi zovuta zomwe zimagonjetsedwa ndi ma cell awiri kapena angapo kuchokera ku magulu monga penicillin (omwe ali ndi MICs ≥ 2 μg / ml), cephalosporins wotsatira (cefuroxime), macrolides, tetracyclines ndi trimethoprim / sulfamethoxazole. Ndikofunikira kuganizira zitsogozo zomwe zikuchitika pakalipano pa malamulo ogwiritsira ntchito antibacterial othandizira.

Contraindication

Hypersensitivity kuti moxifloxacin, ma quinolones kapena mankhwala ena aliwonse

mbiri ya tendon pathology yomwe idayamba chifukwa chothana ndi maantibayotiki pazotsatira za quinolone,

odwala a awa: pambuyo pa moxifloxacin, kusintha pamagetsi am'mitima ya mtima adawonedwa, akuwonetsedwa kupezeka pakukweza nthawi ya QT),

gwiritsani ntchito ndi mankhwala ena omwe amakulitsa nthawi ya QT,

odwala omwe ali ndi vuto la chiwindi (gulu la ana-Pugh gulu C) komanso odwala omwe akuwonjezeka ndi zochitika za transaminase mopitilira kasanu kuposa VGN (chifukwa cha kuchuluka kwazidziwitso zamankhwala).

nthawi yoyamwitsa,

wazaka 18.

Ndi chisamaliro: matenda a chapakati mantha dongosolo (kuphatikiza iwo omwe akukayikira kuphatikizidwa kwa dongosolo lamkati lamanjenje), akuwonetsetsa kuti agwiritse ntchito ndikutsitsa njira yolimbirana, odwala omwe ali ndi mbiri ya psychoses ndi / kapena matenda ena amisala, odwala omwe ali ndi vuto la proarrhythmic (makamaka azimayi ndi odwala okalamba ), monga pachimake myocardial ischemia ndi mtima kumangidwa, odwala ndi matenda enaake, myasthenia gravis gravis, munthawi yomweyo kugwiritsa ntchito mankhwala ochepetsa potaziyamu, odwala omwe ali ndi vuto lobadwa nawo kapena kupezeka kwenikweni kwa shuga-6-phosphate dehydrogenase.

Mimba komanso kuyamwa

Chitetezo pakugwiritsa ntchito moxifloxacin pa nthawi ya pakati sichinakhazikitsidwe, chifukwa chake kugwiritsidwa ntchito kumatsutsana. Milandu yakuwonongeka kwaphatikizidwe kwa ana omwe amalandila ma quinolones ena amafotokozedwa, komabe, kuwonekera kwa izi mwa mwana wosabadwayo (akagwiritsidwa ntchito ndi amayi panthawi yapakati) sizinanenedwe.

Kafukufuku wazinyama adazindikira kuwopsa kwa kubereka. Chiwopsezo chomwe chilipo kwa anthu sichikudziwika.

Monga mitundu ina ya quinolones, moxifloxacin imapangitsa kuwonongeka kwa malowedwe akulu azinyama zazikulu.

Kafukufuku wofufuza wapeza kuti moxifloxacin wocheperako amamuyamwa mkaka wa m'mawere. Zomwe zimagwiritsidwa ntchito mwa azimayi pa nthawi yotsala sizikupezeka. Chifukwa chake, kugwiritsa ntchito moxifloxacin pa yoyamwitsa kumatsutsana.

Zotsatira zoyipa

Zambiri pamachitidwe osagwirizana omwe amalembedwa ndikugwiritsa ntchito moxifloxacin 400 mg (pakamwa, ndi chithandizo chamankhwala (iv oyang'anira a moxifloxacin akutsatiridwa ndi makonzedwe apakamwa) ndipo iv okha ndi omwe amapezeka kuchokera ku maphunziro azachipatala ndi mauthenga atangotsatsa posachedwa (m'zolemba). Zotsatira zoyipa zomwe zalembedwa m'gulu la "nthawi zambiri" zimachitika ndi pafupipafupi 3%, kupatula mseru ndi m'mimba.

Pafupipafupi pamakhala zotsatidwa motere: nthawi zambiri (kuyambira ≥1 / 100 mpaka kuphatikizira zoopsa) Pa gawo la kagayidwe ndi zakudyaHyperlipidemiaHyperglycemia, hyperuricemiaHypoglycemia Mavuto amisalaKuda nkhawa, psychomotor hyperacaction / kukwiyaKutaya mtima, kutaya mtima (nthawi zina, kuchita zinthu zodzivulaza, monga malingaliro ofuna kudzipha kapena kuyesa kudzipha, nkotheka), kuyerekezera zinthu zina.Kuzindikira machitidwe, malingaliro okhudzidwa (mwanjira yowonetsedwa mwa chizolowezi chodzivulaza, monga malingaliro ofuna kudzipha kapena kuyesa kudzipha) Kuchokera ku dongosolo lamanjenjeMutu, chizungulireParesthesia / dysesthesia, kusokonezeka kwa chidwi chamtopola (kuphatikiza, mwanjira zosowa kwambiri, zam'mbuyo), chisokonezo ndi chisokonezo, kusokonezeka kwa kugona, kugwedezeka, Vertigo, kugonaHypesthesia, kusokonezeka kwa fungo (kuphatikiza elemia), maloto atypical, kusokonezeka kwa mgwirizano (kuphatikizapo kupunduka kwa gait chifukwa cha chizungulire kapena vertigo, m'malo osowa kwambiri omwe akutsogolera kuvulala chifukwa cha kugwa, makamaka odwala okalamba), amagwidwa ndi matenda osiyanasiyana owonetsa (i.e. h. kukoka wamkulu mal), kusokonezeka kwa chidwi, kusokonezeka kwa mawu, amnesia, zotumphukira mu mitsempha ndi polyneuropathyHypewhesia Pa mbali ya gawo la masomphenyawoKuwonongeka kwamawonekedwe (makamaka ndi zochitika kuchokera kumanjenje yayikulu)Kutayika kwakanthawi kochepa (makamaka mokhudzana ndi maziko a zochita zamkati mwamanjenje) Kumva ziwalo zamagulu ndi labyrinthineTinnitus, kuchepa kwa makutu, kuphatikizapo kugontha (nthawi zambiri kumatha kusintha) Kuchokera mumtima ndi m'mitsempha yamagaziKuchulukitsa kwa QT kwa odwala ndi concomitant hypokalemiaKutalika kwa QT, palpitations, tachycardia, vasodilationVentricular tachyarrhythmias, syncope, kuchuluka / kuchepa kwa kuthamanga kwa magaziNonspecific arrhythmias, polymorphic yamitsempha yamagazi tachycardia, mtima kumangidwa (makamaka mwa anthu omwe ali ndi chiyembekezo choganiza za arrhythmias, monga kwambiri bradycardia, pachimake myocardial ischemia) Kuchokera pakapumidwe, m'chifuwa ndi ziwalo zam'mimbaKupuma pang'ono (kuphatikiza ndi mphumu) Kuchokera m'mimba thirakitiKusanza, kusanza, kupweteka kwam'mimba, kutsegula m'mimbaKuchepa kwa chakudya ndi kuchepa kwa kudya, kudzimbidwa, kutha, kugona, gastroenteritis (kupatula kukokoloka kwa gastroenteritis), kuchuluka kwa ntchito ya plasma amylaseDysphagia, stomatitis, pseudomembranous colitis (nthawi zina zomwe zimakhudzana ndi zovuta zowopsa) Pa mbali ya chiwindi ndi biliary thirakitiKuchulukitsa kwa hepatic transaminasesHepatic dysfunction (kuphatikizapo kuchuluka kwa LDH), kuchuluka kwa bilirubin, kuchuluka kwa GGT, kuchuluka kwa plasma ya alkaline phosphataseJaundice, chiwindi (makamaka cholestatic)Fulminant hepatitis, yomwe ingayambitse chiwopsezo cha chiwopsezo cha moyo (kuphatikizapo milandu yakupha) Pa khungu ndi subcutaneous minofuZokhudza khungu pakhungu, monga Stevens-Johnson syndrome kapena poyidermerm necrolysis (yomwe ikhoza kuwononga moyo) Kuchokera minofu ndi mafupaArthralgia, myalgiaTendonitis, kamvekedwe ka minofu ndi kukokana, kufooka kwa minofuMatenda a Tendon, nyamakazi, vuto la gait chifukwa cha kuwonongeka kwa minofu yam'mimba, kuchuluka kwa matumbo a myasthenia gravis Kuchokera impso ndi kwamikodzoKuthetsa madzi m'thupi (chifukwa cha kutsekula m'mimba kapena kuchepa kwa magazi)Kuwonongeka kwa impso, kulephera kwa impso (chifukwa cha kuchepa madzi m'thupi, komwe kungayambitse kuwonongeka kwa impso, makamaka kwa okalamba omwe ali ndi vuto la impso) Zovuta ndi zovuta zina pamalo a jakisoniKubaya / kulowetsedwaGeneral malaise, kupweteka kwamkhutu, thukuta kwambiri, phlebitis / thrombophlebitis pa malo a kulowetsedwaKutupa

Zomwe zimachitika potsatira zotsatidwazi zinali zochuluka pagulu lomwe limalandira chithandizo chambiri: nthawi zambiri - kuchuluka kwa ntchito ya GGT, mosachepera - tricyythhythmias yamitsempha, kuchepa kwa magazi, edema, pseudomembranous colitis (m'malo osowa kwambiri omwe amakhudzana ndi zovuta zowonongeka), kuphatikizapo kulanda wamkulu mal), kuyerekezera zinthu m'magazi, kuwonongeka kwa impso, kulephera kwa impso (chifukwa cha kuchepa madzi m'thupi, komwe kungayambitse kuwonongeka kwa impso, makamaka kwa okalamba omwe ali ndi vuto la impso).

Kuchita

Pogwiritsa ntchito munthawi yomweyo mankhwala a atenolol, ranitidine, zina zowonjezera calcium, theophylline, cyclosporine, njira zothandizira pakamwa, glibenclamide, itraconazole, digoxin, morphine, probenecid (kusowa kwa mgwirizano wachipatala ndi moxifloxacin sikunatsimikizike) kusintha kwa mankhwalawa sikofunikira.

Mankhwala omwe amakulitsa nthawi ya QT. Kuchulukitsa komwe kungachitike pakukula kwa QT ya moxifloxacin ndi mankhwala ena omwe amakhudza kutalika kwa nthawi ya QT ayenera kuganiziridwanso. Chifukwa cha munthawi yomweyo moxifloxacin ndi mankhwala omwe amakhudza kutalika kwa gawo la QT, chiopsezo chokhala ndi cyricular arrhythmias, kuphatikiza polymorphic ventricular tachycardia, chikuwonjezeka.

Kugwiritsira ntchito pamodzi kwa moxifloxacin ndi mankhwala otsatirawa omwe amakhudza kutalika kwa nthawi ya QT ndi otsutsana:

- Class IA antiarrhythmic mankhwala (kuphatikizapo quinidine, hydroquinidine, disopyramide),

- Mankhwala othandizira odwala omwe ali ndi gulu la III (kuphatikizapo amiodarone, sotalol, dofetilide, ibutilide),

- antipsychotic (kuphatikizapo phenothiazine, pimozide, sertindole, haloperidol, sultopride),

- mankhwala antimicrobial (sparfloxacin, erythromycin (iv), pentamidine, antimalarial mankhwala, makamaka halofantrine),

- antihistamines (terfenadine, astemizole, misolastine),

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

Maantacidiyamu, multivitamini ndi michere. Kugwiritsidwa ntchito kwa moxifloxacin nthawi imodzi ndi maantacid, multivitamini ndi mchere ungayambitse kuyamwa kwa moxifloxacin, chifukwa cha mapangidwe a chelate complexes okhala ndi ma cation angapo omwe ali ndi mankhwalawa. Zotsatira zake, kuchuluka kwa moxifloxacin m'madzi a m'magazi kumatha kutsikira kwambiri kuposa momwe mukufunira. Mwanjira iyi, mankhwala a antacid, mankhwala ochepetsa mphamvu ya kachilomboka (mwachitsanzo didanosine) ndi mankhwala ena okhala ndi magnesium kapena aluminium, sucralfate ndi mankhwala ena okhala ndi chitsulo kapena zinki ayenera kugwiritsidwa ntchito osachepera maola 4 asanafike kapena maola 4 pambuyo pakulamula kwa moxifloxacin.

Warfarin. Pogwiritsa ntchito munthawi yomweyo ndi warfarin, PV ndi magawo ena okoka magazi samasintha.

Sinthani mtengo wa INR. Odwala omwe amalandira anticoagulants mogwirizana ndi maantibayotiki, incl. ndi moxifloxacin, pakhala pali milandu yowonjezera anticoagulant ya mankhwala anticoagulant. Zoyipa ndi kukhalapo kwa matenda opatsirana (ndi kupatsirana kwakanthawi), m'badwo komanso chikhalidwe cha wodwalayo. Ngakhale kuti kulumikizana pakati pa moxifloxacin ndi warfarin sikunapezeke, mwa odwala omwe amalandira mankhwalawa nthawi yomweyo, ndikofunikira kuyang'anira INR ndipo, ngati pakufunika kusintha, musinthe ma anticoagulants osadziwika.

Digoxin. Moxifloxacin ndi digoxin sizikhudza kwambiri magawo a pharmacokinetic wina ndi mnzake. Ndi Mlingo wa moxifloxacin wobwerezabwereza_max plasma digoxin inakula pafupifupi 30%, pomwe mfundo za AUC ndi C_mphindi digoxin sanasinthe.

Yoyambitsa kaboni. Pogwiritsa ntchito munthawi yomweyo kugwiritsa ntchito kaboni yodziyimira ndi moxifloxacin pamiyeso ya 400 mg pamlomo, dongosolo la bioavailability la moxifloxacin limachepetsedwa ndi oposa 80% chifukwa cha kuchepa kwa mayamwidwe ake. Ngati bongo umagwiritsidwa ntchito, kugwiritsa ntchito kaboni yokhoma kumayambiriro kwa mayamwa kumalepheretsa kuwonekera kwina.

Mlingo ndi makonzedwe

Mkati 1 tabu. (400 mg) 1 nthawi patsiku ndimatenda omwe awonetsa pamwambapa. Musapitirire mlingo woyenera. Mapiritsiwo ayenera kumezedwa lonse, osafuna kutafuna, ndi madzi okwanira, osasamala nthawi yakudya.

Kutalika kwa chithandizo. Zimadziwika ndi kuwopsa kwa matendawa, komanso matenda ake:

- kuchuluka kwa bronchitis masiku 5-10,

- pachimake sinusitis 7 masiku,

- Matenda osavuta a pakhungu ndi mawonekedwe a masiku 7,

- chibayo chomwe chimapezeka pagulu, nthawi yonse ya mankhwala otalikirana (iv. yoyang'anira pakamwa) ndi masiku 7 mpaka 14,

- Matenda owopsa a pakhungu ndi kapangidwe kake kakang'ono - kutalika kwamankhwala othandizira pakamwa ndi moxifloxacin (iv yoyendetsedwa ndi makonzedwe amkamwa) ndi masiku 7 mpaka 21,

- Matenda amkatikati mwa m'mimba - Kutalika konse kwa mankhwalawa (iv omwe amayamba kutsata pakamwa) ndi masiku 5 mpaka 14,

- Matenda osagwirizana ndi zotupa za m'chiberekero kwa masiku 14.

Musapitirire nthawi yolimbikitsidwa. Malinga ndi kafukufuku wazachipatala, kutalika kwa mankhwalawa ndi Moflaxia pamapiritsi kumatha kufika masiku 21.

Magulu apadera a odwala

Ukalamba. Kusintha kwa dongosolo la odwala okalamba sikofunikira.

Ana. Kuchita bwino ndi chitetezo cha kugwiritsa ntchito moxifloxacin mwa ana ndi achinyamata sichinakhazikitsidwe.

Kuwonongeka kwa chiwindi. Odwala omwe ali ndi vuto la chiwindi cholakwika (gulu la ana-Pugh A ndi B) safunikira kusintha mtundu wa mankhwalawa (kuti mugwiritse ntchito odwala omwe ali ndi matenda amisempha, onani "Special Institutionions").

Matenda aimpso. Odwala ndi mkhutu aimpso ntchito (kuphatikizapo kuvulala kwambiri aimpso ndi Cl creatinine ≤30 ml / mphindi / 1,73 m 2), komanso odwala omwe akupitilira hemodialysis ndi nthawi yayitali ya peritoneal dialysis, kusintha kwa muyezo wamankhwala. osafunikira.

Mitundu. Kusintha kwa dongosolo la odwala mu mitundu yosiyanasiyana sikofunikira.

Bongo

Pali umboni wochepa wa mankhwala ochulukirapo a moxifloxacin. Palibe zoyipa zomwe zidadziwika kuti zimagwiritsidwa ntchito moxifloxacin muyezo wa 1200 mg kamodzi ndi 600 mg kwa masiku 10 kapena kuposerapo.

Chithandizo: vuto la bongo, munthu akuyenera kutsogoleredwa ndi chithunzi cha chipatala ndikuwonetsa pothandizidwa ndi ECG powunikira. Kugwiritsa ntchito kaboni yodziyambitsa mukangomamwa pakamwa kungathandize kupewa kudziwonetsa moxifloxacin wambiri.

Malangizo apadera

Nthawi zina, mankhwalawa atagwiritsidwa ntchito koyamba, Hypersensitivity ndi mziwopsezo zimachitika, zomwe zimayenera kuuzidwa kwa adotolo. Nthawi zambiri, ngakhale atatha kugwiritsa ntchito mankhwalawa, mapangidwe a anaphylactic amatha kupita patsogolo mpaka kufika poopseza anaphylactic. Muzochitika izi, chithandizo ndi Moflaxia ziyenera kutha ndipo njira zochiritsira zofunikira (kuphatikizapo anti-shock) ziyenera kuyambitsidwa nthawi yomweyo.

Pogwiritsa ntchito mankhwalawa Moflaxia mwa odwala ena, kuwonjezereka kwa nthawi ya QT kungaoneke. Moflaxia iyenera kugwiritsidwa ntchito mosamala mwa amayi ndi odwala okalamba. Popeza azimayi amakhala ndi nthawi yayitali ya QT poyerekeza ndi amuna, amatha kukhala osamala ndi mankhwala omwe amawonjezera nthawi imeneyi. Odwala okalamba amathanso kutenga mankhwala omwe amakhudza nthawi ya QT.

Kutalika kwa nthawi ya QT kumalumikizidwa ndi chiwopsezo chowonjezeka cha chamitsempha yama cell, kuphatikiza polymorphic ventricular tachycardia.

Kuchulukitsa kwa nthawi ya QT kumatha kuwonjezeka ndi kuwonjezeka kwa kuchuluka kwa moxifloxacin m'madzi a m'magazi, motero, mlingo woyenera sayenera kupitirira. Komabe, odwala chibayo, kulumikizana pakati pa kuchuluka kwa moxifloxacin m'madzi a m'magazi komanso kutalika kwa nthawi ya QT sikunachitike. Palibe wa 9,000 odwala omwe amathandizidwa ndi moxifloxacin omwe anali ndi vuto la mtima kapena milandu yakupha yomwe imakhudzana ndikukulitsa nthawi ya QT. Ndi kugwiritsa ntchito mankhwala Moflaxia, chiopsezo chotukukira kwamitsempha yamagazi kwa odwala omwe ali ndi vuto lomwe lingakonzekere kupanga arrhythmias angachuluke.

Momwemo, mankhwala a Moflaxia amapatikiridwa pokhapokha ngati pakusintha magawo a mtima wamagetsi, akufotokozedwa pakukweza kwa nthawi ya QT (kusinthika kwatsopano kapena kutengedwa kotumizidwa kwa QT), kusokonezeka kwa ma electrolyte, makamaka kufooka kwa hypokalemia, kukomoka kwakukulu kwa mtima kwachepa. , kupezeka kwa mbiri yakusokonekera kwa mitsempha, limodzi ndi zizindikiro zamankhwala, kuphatikiza ndi mankhwala ena, yayuschimi imeneyi QT (cm. "mogwirizana").

Mankhwala Moflaxia ayenera kugwiritsidwa ntchito mosamala:

- odwala omwe ali ndi vuto la proarrhythmic, monga pachimake myocardial ischemia ndi mtima womangidwa,

- odwala omwe ali ndi matenda a cirrhosis (popeza m'gulu ili la odwala, chiopsezo chotenga nthawi yayitali ya QT sichitha kuthana).

Mukamamwa moxifloxacin, milandu yodwala matenda otupa a hepatitis imanenedwa, zomwe zingayambitse kukula kwa chiwindi (kuphatikizapo milandu yakupha). Wodwala ayenera kudziwitsidwa kuti ngati pali zizindikiro za kulephera kwa chiwindi, ndikofunikira kukaonana ndi dokotala musanapitirize kulandira chithandizo ndi Moflaxia.

Mukamamwa moxifloxacin, milandu yokhudzana ndi zotupa zamkati zamkati, monga Stevens-Johnson syndrome kapena poizoni wa khungu loopsa, adanenedwa (onani "Zotsatira zoyipa"). Wodwala ayenera kudziwitsidwa kuti ngati pali zizindikiro za pakhungu kapena mucous, ndikofunikira kukaonana ndi dokotala musanapitirize chithandizo cha Moflaxia.

Kugwiritsa ntchito mankhwala a quinolone kumalumikizidwa ndi chiopsezo chogwidwa. Mankhwala Moflaxia ayenera kugwiritsidwa ntchito mosamala odwala matenda a chapakati mantha dongosolo ndi kusokonezeka kwa chapakati mantha dongosolo, poganiza khunyu kapena kutsitsa poyambira matenda oopsa.

Kugwiritsa ntchito mitundu yotakata ya antibacterial, kuphatikizapo mankhwala a Moflaxia, kumalumikizidwa ndi chiopsezo cha pseudomembranous colitis. Kuzindikiritsa izi kuyenera kukumbukiridwa mwa odwala omwe adayamba kutsekula m'mimba nthawi ya mankhwala ndi Moflaxia. Pankhaniyi, chithandizo choyenera chikuyenera kuperekedwa nthawi yomweyo. Mankhwala omwe amalepheretsa matumbo kuyenda amayambitsidwa ndikukula kwa matenda otsegula m'mimba.

Moflaxia iyenera kugwiritsidwa ntchito mosamala odwala omwe ali ndi myasthenia gravis. gravis mogwirizana ndi kufalikira kwa matendawa.

Pa maziko a quinolone mankhwala, kuphatikizapo moxifloxacin, kukulitsa kwa tendonitis ndi kupindika kwa tendon ndikotheka, makamaka kwa odwala okalamba ndi odwala omwe amalandila corticosteroids. Milandu yomwe idachitika patangotha ​​miyezi yochepa atamaliza kulandira chithandizo afotokozedwa. Pazizindikiro zoyambirira (kupweteka kapena kutupa pamalo ovulala), mankhwala a Moflaxia amayenera kuyimitsidwa ndikuwathandiza.

Pogwiritsa ntchito quinolones, mawonekedwe a photosensitivity amadziwika. Komabe, pa maphunziro a preclinical and clinical, komanso kugwiritsa ntchito moxifloxacin muzochita zamankhwala, palibe mawonekedwe a photosensitivity omwe adawonedwa. Komabe, odwala omwe amalandila Moflaxia ayenera kupewa kuwonekera pakayendedwe ka dzuwa ndi radiation ya UV.

Kugwiritsa ntchito mankhwala Moflaxia mwanjira ya mapiritsi amkamwa osakhudzidwa sikulimbikitsidwa kwa odwala omwe ali ndi zovuta zotupa za ziwalo zamkati (mwachitsanzo, zimagwirizanitsidwa ndi tubo-ovarian kapena pelvic abscesses).

Kugwiritsa ntchito moxifloxacin pochiza matenda oyambitsidwa ndi zotsekemera sikulimbikitsidwa. Staphylococcus aureuskugonjetsedwa ndi methicillin. Pankhani ya matenda okayikiridwa kapena otsimikiziridwa omwe amayambitsidwa ndi MRSA, mankhwala oyenera a antibacterial ayenera kugwiritsidwa ntchito pochiza (onani. Pharmacodynamics). Kutha kwa moxifloxacin poletsa kukula kwa mycobacteria kungayambitse kuyanjana pansi pamikhalidwe mu vitro moxifloxacin ndi mayeso a Mycobacterium spp., zomwe zimabweretsa zotsutsa zabodza posanthula zitsanzo za odwala omwe amathandizidwa ndi Moflaxia panthawiyi.

Odwala omwe adathandizidwa ndi quinolones, kuphatikizapo moxifloxacin, milandu yokhudza kupweteka kapena sensorimotor polyneuropathy afotokozedwa, zomwe zimatsogolera paresthesia, hypesthesia, dysesthesia, kapena kufooka. Odwala omwe amathandizidwa ndi Moflaxia ayenera kuchenjezedwa za kufunika kofunsa dokotala musanapitirize kulandira chithandizo ngati muli ndi vuto la neuropathy, kuphatikizapo kupweteka, kuwotcha, kumva, kugona kapena kufooka (onani "Zotsatira zoyipa"). Machitidwe amakhudzidwa amatha kuchitika ngakhale mutayamba kugwiritsa ntchito fluoroquinolones, kuphatikiza moxifloxacin. Nthawi zina, kukhumudwa kapena kuchitapo kanthu kumachitika pakubwera kwa malingaliro ofuna kudzipha ndi chikhalidwe chodzivulaza, kuphatikizapo kuyesayesa kudzipha (onani "Zotsatira zoyipa"). Ngati zoterezi zikuchitika mwa odwala, mankhwalawa a Moflaxia ayenera kusiyidwa ndipo pakufunika kuchitapo kanthu. Chenjezo liyenera kuchitika mukamagwiritsa ntchito mankhwala a Moflaxia odwala omwe ali ndi mbiri ya psychosis ndi matenda amisala.

Chifukwa chofalikira komanso kuchuluka kwa matenda omwe amayamba chifukwa cha fluoroquinolone Neisseria gonorrhoeae, pa mankhwala a odwala omwe ali ndi zotupa za m'chiuno, moxifloxacin monotherapy sayenera kuchitika, pokhapokha pamaso pa fluoroquinolone N. gonorrhoeae kupatula.Ngati sizotheka kupatula kukhalapo kwa fluoroquinolone N. gonorrhoeae, ndikofunikira kuthetsa nkhani yothandizira mankhwala othandizira ndi moxifloxacin wokhala ndi antibayotiki woyenera womwe umagwira ntchito motsutsana N. gonorrhoeae (mwachitsanzo cephalosporin).

Monga momwe zimakhalira ndi fluoroquinolones, kugwiritsa ntchito mankhwala a Moflaxia adawonetsa kusintha kwa kuchuluka kwa shuga m'magazi, kuphatikiza hypo- ndi hyperglycemia. Pa mankhwalawa ndi moxifloxacin, dysglycemia imapezeka makamaka mwa odwala okalamba omwe ali ndi matenda osokoneza bongo omwe amalandila chithandizo chofanana ndi mankhwala a hypoglycemic pakumwa pakamwa (mwachitsanzo, kukonzekera kwa sulfonylurea) kapena insulin. Pochiza odwala matenda ashuga, kuyang'aniridwa mosamala kwa shuga wamagazi ndikulimbikitsidwa (onani "Zotsatira zoyipa").

Kukopa pa kuthekera kochita zoopsa zomwe zimafunikira chisamaliro chapadera komanso kuchitapo kanthu mwachangu (mwachitsanzo, kuyendetsa, kugwira ntchito ndi makina osunthira). Fluoroquinolones, kuphatikiza moxifloxacin, imatha kuwononga magwiridwe antchito oyendetsa galimoto ndikuchita zina zina zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor chifukwa cha zotsatira zamagetsi apakati komanso kuwonongeka kwa mawonekedwe.

Kutulutsa Fomu

Mapiritsi okhala ndi mafilimu, 400 mg. Mapiritsi a 5, 7 kapena 10 mumchimake kuchokera ku zophatikizika za OPA / Al / PVC - zojambulazo. 1 kapena 2 bl. (Mapiritsi 5), kapena 1 bl. (Mapiritsi 7), kapena 1 bl. (Mapiritsi 10) aikidwa mu katoni.

Za zipatala: 5, 10, 14, 16 kapena 20 bl. (Mapiritsi 5) kapena 10 bl. (Mapiritsi 7), kapena 5, 7, 8, kapena 10 bl. (Mapiritsi 10) aikidwa mu katoni.

Fomu ya Mlingo:

mapiritsi okhala ndi filimu

Piritsi limodzi lachifundo 1

Moxifloxacin hydrochloride 454.75 mg, wofanana ndi moxifloxacin 400.00 mg

Othandizira: microcrystalline cellulose 186.05 mg, croscarmellose sodium 32,00 mg, magnesium stearate 6.00 mg

Kanema wa Shell: hypromellose 12.60 mg, macrogol-4000 4.20 mg, titanium dioxide (E171) 3.78 mg, utoto wa utoto wazitsulo (E172) 0,42 mg

Mapiritsi okhala ndi mawonekedwe a Capsule, biconvex, utoto wamafilimu, pinki yakuda.

Mawonekedwe apamtunda: Unyinji wowala wachikaso wowala ndi utoto wamafuta wakuda bii.

Mankhwala

Mankhwala

Moxifloxacin ndi mankhwala osiyanasiyana a bactericidal antibacterial, 8-methoxy fluoroquinolone.

Mphamvu ya bactericidal ya moxifloxacin imachitika chifukwa cha kuletsa kwa bakiteriya topoisomerases II ndi IV, komwe kumayambitsa kusokonezeka kwa njira zobwereza, kukonza ndi kusindikiza kwa DNA biosynthesis yama cell tizilombo tating'onoting'ono ndipo, chifukwa chake, pakufa kwa maselo okhala ndi ma cell ochepa.

Ma bactericidal ochepera poyerekeza moxifloxacin nthawi zambiri amakhala ofanana ndi zochepa zoletsa zake.

Njira zomwe zimatsogolera pakupanga kukana kwa penicillins, cephalosporins, aminoglycosides, macrolides ndi tetracyclines sizimakhudzana ndi antibacterial zochita za moxifloxacin.

Palibe kutsutsana kwapakati pa magulu awa a antibacterial mankhwala ndi moxifloxacin. Pakadali pano, sipanakhalepo zochitika za kukana kwa plasmid. The pafupipafupi kukula kwa kukana ndi ochepa kwambiri (10 -7 -10 -10).

Kukana kwa Moxifloxacin kumayamba pang'onopang'ono kudzera pakusintha kambiri. Kuwonetsedwa mobwerezabwereza kwa moxifloxacin kuzinthu zamagetsi zomwe zimakhala m'munsi mwa zochepa zoletsa ndende (MIC) zimayendera limodzi ndi kuwonjezeka pang'ono kwa MIC. Milandu yotsutsana ndi quinolones imadziwika. Komabe, tizilombo tating'onoting'ono tokhala ndi gramu komanso anaerobic osagwirizana ndi ma quinolones ena timawaganizirabe moxifloxacin.

Kukhazikitsidwa kuti kuwonjezeranso kwa gulu la methoxy mu mawonekedwe a C8 ku moxifloxacin mamolekedwe a moxifloxacin kumawonjezera ntchito ya moxifloxacin ndikuchepetsa mapangidwe a mabakiteriya osintha a mabakiteriya oyenera. Kuphatikizidwa kwa gulu la bikcloamine paudindo C7 kumalepheretsa kukhazikika kwa yogwira ntchito, njira yotsutsana ndi fluoroquinolones.

Moxifloxacin m'malo muvitro yogwira polimbana ndi tizilombo tating'onoting'ono ta gramu-gramu komanso gramu-yoyenera, anaerobes, mabakiteriya osagwira asidi ndi mabakiteriya atypical monga Mycoplasmaspp..Chlamydiaspp.,Legionellaspp., komanso mabakiteriya olimbana ndi mankhwala a P-lactam ndi macrolide.

Zokhudza matumbo microflora

M'maphunziro awiri omwe adachitika pa odzipereka, kusintha kwa microflora yam'mimba kunawonekera pambuyo pakukonzekera kwa moxifloxacin. Kutsika kwazowonetseratu kunadziwika. Esherichiacoli,Bacillusspp.,Mabakiteriyavulgatus,Enterococcusspp.,Klebsiellaspp., komanso anaerobes Bifidobacteriumspp.,Eubacteriumspp.,Peptostreptococcusspp. Kusintha kumeneku kunasinthidwa mkati mwa milungu iwiri. Toxin Clostridiumzovuta osadziwika.

Kuyesa kumvetsetsamuvitro

Mphamvu ya antibacterial zochita za moxifloxacin imaphatikizanso zotsatirazi:

* Kuzindikira kwa moxifloxacin kumatsimikiziridwa ndi zidziwitso zamankhwala.

+ Kugwiritsa ntchito mankhwala a Moflaxia sikulimbikitsidwa pochiza matenda oyambitsidwa ndi zironda S.aureus, methicillin zosagwira (MRSA). Pankhani ya matenda okayikiridwa kapena kutsimikiziridwa oyambitsidwa ndi MRSA, mankhwala omwe ali ndi antibacterial mankhwala oyenera ayenera kuyikidwa.

Kwa zovuta zina, kufalikira kwa kukhudzika komwe kumachitika kungasiyane ndi dera komanso nthawi. Pankhaniyi, poyesa kumva kupsinjika, ndikofunikira kukhala ndi chidziwitso chakudziko chokana, makamaka pochiza matenda oopsa.

Ngati odwala akumalandira chithandizo kuchipatala, kufunika kwa malo omwe ali pansi pa nthawi ya pharmacokinetic curve (AUC) / MHK9o kupitirira 125, ndipo kuchuluka kwambiri kwa plasma (Cmax) / MIC90 kuli m'gulu la 8-10, ndiye izi zikutanthauza zaumoyo kusintha. Muzochitika kunja, malingaliro a magawo azotsatira nthawi zambiri amakhala ocheperako: AUC / MHK90> 30-40.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapezeka piritsi. Piritsi limodzi lili osachepera 400 mg ya mankhwala othandizira - moxifloxacin hydrochloride. Kuphatikiza apo, kapangidwe kake ka mankhwalawa kumaphatikizapo macrogol, titanium dioxide, hypromellose, utoto. Mapiritsiwo ali ndi mawonekedwe a biconvex. Amakutidwa ndi utoto wapa pinki. Mapiritsi a Moxilia amaikidwa m'matumba a 5, 7 kapena 10 ma PC. Mabulogu amadzaza matcheni okhala ndi makatoni. Mankhwala mu mawonekedwe a njira yothetsera mu mnofu ndi mtsempha wamkati samapezeka.

Mankhwala amapezeka piritsi.

Zotsatira za pharmacological

Mankhwala a Moflaxia ndi a gulu la fluoroquinolones, chifukwa chake ali ndi mphamvu ya antibacterial pamitundu ingapo yama tizilombo tating'onoting'ono. Kuchita kwa mankhwalawa kumachitika chifukwa cha kulepheretsa yogwira popanga mabakiteriya topoisomerases a mitundu 2 ndi 4, chifukwa chomwe michere ya DNA imasokonekera m'maselo a tizilombo tating'onoting'ono, timene timayambitsa kufa kwa mabakiteriya.

Mankhwala a Moflaxia amagwira zama gramu zabwino komanso gram alibe tizilombo. Kuphatikiza apo, mankhwalawa amagwira ntchito mwa kugonjetsedwa ndi microflora ya pathogenic.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa atha kuperekedwa kwa matenda osiyanasiyana opatsirana, limodzi ndi kutupa kwambiri. Ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa pokhapokha ngati wodwala akutsimikizira kupezeka kwa microflora tcheru ndi Moflaxia. Zowonetsa kugwiritsa ntchito mankhwalawa zimatha kukhala sinusitis yovuta kwambiri.

Mankhwala tikulimbikitsidwa kuti mugwiritse ntchito kufalikira kwa mawonekedwe a bronchitis. Kukhazikitsidwa kwa Moflaxia kumaloledwa pa matenda a khungu lakukhazikika, kumapitirira popanda kutchulidwa. Kugwiritsa ntchito Moflaxia pochiritsa anthu kumakhala koyenera kuthandizira chibayo cha anthu wamba, kuphatikizapo omwe amayamba chifukwa cha zovuta zotsutsana ndi maantibayotiki.

Moflakia amasonyezedwa sinusitis.
Akatswiri amalimbikitsa kugwiritsa ntchito mankhwala a bronchitis.
Kukhazikitsidwa kwa Moflaxia kumavomerezeka pochiza matenda amtundu wakhungu.
Monga gawo la mankhwala okwanira, mankhwalawa amalimbikitsidwa kuti apatsidwe sinusitis.
Kugwiritsa ntchito Moflaxia kuli koyenera kuthandizira matenda opatsirana a ziwalo zoberekera za akazi.

Monga gawo la mankhwala okwanira, mankhwalawa amalimbikitsidwa kuti apatsidwe sinusitis. Moflaxia wocheperako amatha kugwiritsidwa ntchito pazovuta zovuta pakhungu. Ndi mankhwalawa, mutha kuchiza matenda osokoneza bongo, ophatikizika ndi kuwonjezeranso matenda ena.

Zisonyezero zakugwiritsidwa ntchito kwa mankhwalawa ndi zamkati zam'mimba ndi zotupa zamkati mwa m'mimba. Kugwiritsa ntchito Moflaxia kuli koyenera kuthandizira matenda opatsirana a ziwalo zoberekera za akazi. Kuphatikiza apo, mankhwalawa angagwiritsidwe ntchito ku prostatitis yachilengedwe.

Ndi chisamaliro

Mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe ali ndi CNS pathologies, limodzi ndi mawonekedwe a kugwidwa. Kuwunikira mwapadera mkhalidwe wa wodwala ndi ogwira ntchito kuchipatala ndikofunikira ngati wodwala ali ndi vuto lamaganizidwe.

Kuphatikiza apo, mankhwalawa amayenera kugwiritsidwa ntchito mosamala pochiza odwala omwe akudwala matenda a mtima komanso kukhala ndi mbiri yakumangidwa kwa mtima. Mankhwala a Moflaxia kwa odwala omwe ali ndi matenda enaake amayenera kuchitika moyang'aniridwa ndi katswiri. Mu gulu ili la odwala, chiopsezo chotukula zotsatira zoyipa ndikuchulukitsa njira ya zomwe zilipo za pathological zimachulukitsidwa.

Mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe ali ndi CNS pathologies.

Momwe mungatenge Moflaxia

Mankhwalawa adapangira kuti azigwiritsidwa ntchito mkati. Pochiza matenda opatsirana omwe amayamba chifukwa cha mabakiteriya omwe amagwiritsidwa ntchito ndi mankhwalawa, mankhwalawa amayenera kumwa piritsi la 400 mg kamodzi pa tsiku. Piritsi liyenera kumeza popanda kutafuna, ndipo onetsetsani kuti mumamwa ndi madzi. Kuti mukwaniritse zochizira zambiri za matenda opatsirana, kumwa mankhwala kwa masiku 5-7 ndikokwanira. Ndi matenda ovuta a pakhungu ndi m'mimba, njira ya mankhwalawa imatha kuyambira masiku 14 mpaka 21.

Kumwa mankhwala a shuga

Odwala omwe ali ndi matenda osokoneza bongo a shuga amapatsidwa mankhwala pa mlingo wa 400 mg tsiku lililonse, koma kuwunika kosamala kwamagazi a shuga kumafunika.

Odwala omwe ali ndi matenda a shuga, mankhwalawa amadziwitsidwa muyezo wa 400 mg tsiku lililonse.

Matumbo

Kulandilidwa kwa Moflaxia kumakhudzanso chakudya cham'mimba ndipo kumayambitsa kusintha kwamatumbo am'mimba, komwe kumawonjezera chiopsezo cha zotsatira zoyipa kuchokera kugaya chakudya. Malinga ndi kuchuluka kwa zamankhwala, odwala nthawi zambiri atatha Moflaxia amakhala ndi zodandaula za mseru, kusokonezeka kwa chopondapo ndi kupweteka kwam'mimba. Pocheperapo pafupipafupi ndi mankhwala a Moflaxia, kuchepa kwa chakudya kumawonedwa. Kuphatikiza apo, kukulitsa kwa flatulence ndi dyspepsia ndikotheka. Nthawi zina, stomatitis, erosive gastritis, dysphagia, ndi colitis zimawonekera pakumwa mankhwala.

Moflaxia imatha kuyambitsa zisokonezo.
Nthawi zina, matenda a anorexia angachitike.
Mukumwa mankhwalawo, wodwalayo amatha kusokonezedwa ndi mseru.
Nthawi zina, mankhwalawa amatha kuyambitsa stomatitis.

Pakati mantha dongosolo

Mankhwalawa a Moflaxia, kuwoneka kwa zovuta zamaganizo, zomwe zimafotokozedwa ndikuwonjezeka kwa psychomotor ndi nkhawa, ndizotheka. Odwala ena amakhala ndi nkhawa komanso amakhala ndi nkhawa. Kuwunika ndi kusokonezeka kwa kugona ndizotheka. Ndi chithandizo cha Moflaxia, chizungulire ndi mutu zimatha kuchitika. Zosokoneza zomwe zingatheke pakuwona kukoma ndi kununkhira, dysesthesia, paresthesia ndi zotumphukira za polyneuropathy.

Kuchokera kwamikodzo

Zotsatira zoyipa zogwiritsidwa ntchito ndi Moflaxia ku genitourinary system ndizosowa. Pakhoza kukhala zizindikiro za vuto laimpso. Kulephera kwamakina kumatha kuchitika.

Moflaxia imatha kudzetsa nkhawa komanso kukhumudwa.
Nthawi zina, odwala anali ndi vuto kugona.
Mankhwalawa amatha kuyambitsa chizungulire komanso migraines.
Moflaxia imatha kuyambitsa kupumira komanso kuukira kwa mphumu.
Njira ya kwamikodzo imatha kusokonezedwa ndi kulephera kwa impso.
Pomwe mumamwa mankhwalawa, kulawa ndi kununkhiza sikunathe.

Kuchokera pamtima

Mukamagwiritsa ntchito Moflaxia, kuukira kwa tachycardia, kumalumpha m'magazi ndi kukomoka chifukwa cha kuphwanya kwamtima kumachitika.

Mukamagwiritsa ntchito Moflaxia, kuukira kwa tachycardia ndi kudumphira m'magazi kungachitike.

Kuchokera minofu ndi mafupa

Potengera maziko akumwa mankhwalawa, kuoneka kwa myalgia ndi arthralgia ndikotheka. Mwa odwala ena, kamvekedwe ka minofu ndi kukokana kunawonedwa. Kuphukika kwa Tendon komanso kukula kwa nyamakazi sikumawonedwa kawirikawiri.

Mankhwalawa Moflaxia, thupi lawo siligwirizana angayambe, zotchulidwa ngati zotupa pakhungu, kuyabwa, ndi urticaria. Nthawi zina, angioedema ndi anaphylaxis ndizotheka.

Zokhudza mphamvu pakuwongolera njira

Mukamalandira chithandizo ndi Moflaxia, muyenera kukana kuyendetsa galimoto ndikuwongolera njira zina zovuta.

Mukamalandira chithandizo ndi Moflaxia, muyenera kukana kuyendetsa galimoto.

Kugwiritsa ntchito kwa vuto la chiwindi

Pazovuta za chiwindi ndi vuto la chiwindi, a Moflaxia amatha kugwiritsidwa ntchito pochiza matenda, koma odwala omwe ali ndi ma pathologies amenewa amafunikira kuwunikira kwapadera kwa ogwira ntchito kuchipatala.

Pogwiritsa ntchito chiwindi pakhungu ndi kupezeka kwa kulephera kwa chiwindi, Moflaxia angagwiritsidwe ntchito pochiza matenda.

Kuyenderana ndi mowa

Mukamalandira mankhwala othana ndi antioxotic, muyenera kukana kumwa mowa.

Pali mitundu ingapo ya mankhwala omwe amatha kulowa m'malo a Moflaxia, kuphatikiza:

Avelox ndi amodzi mwa fanizo la Moflaxia.

Ndemanga za Moflaxia

Irina, wazaka 32, Chelyabinsk

Ndimagwiritsa ntchito Moflaxia ndimatenda ochulukitsa a bronchitis. Matendawa amakhala ndi mawonekedwe anga ndipo miyezi iliyonse 2-3 imawonetsedwa ndi zizindikiro zazikulu. Ndimagwiritsa ntchito Moflaxia kwa masiku 2-3 ndipo zizindikiro zonse zimachepa msanga. Mankhwalawa samangoletsa mwachangu mawonetsedwe a matendawa, komanso samandibweretsera mavuto. Ndikukonzekera kupitiliza kugwiritsa ntchito mankhwalawa.

Maxim, wazaka 34, Moscow

Pafupifupi chaka chapitacho, mvula idagwa ndipo atafika kunyumba adagona, osapukuta tsitsi lake. M'mawa ndinapanikizika ndimaso komanso mutu wopweteka. Malingaliro ake anali osapirira, kotero ndinapita kwa dokotala yemwe anandipeza ndi matenda owopsa a sinusitis. Adotolo adamuuza Moflaxia. Mankhwalawa agwiritsidwa ntchito kwa milungu iwiri. Ndimamva kusintha tsiku lachiwiri, koma ndidaganiza zopita kumapeto, ndikuopa zovuta. Mankhwalawa amapereka zotsatira zabwino.

Kristina, wazaka 24, Sochi

Pafupifupi chaka chapitacho adagwira chimfine. Poyamba, ngakhale ndimatenthedwe, sindinayang'anire, koma kenako zinthu zinayamba kuwonongeka, motero ndinayimbira ambulansi. Chipatala chinaulula chibayo. Povomerezedwa ndi adotolo, adayamba kumwa Moflaxia. Nditayamba kumwa mankhwalawa, ndidayamba kusanza pang'ono. Mankhwalawa sanakane kumwa ndipo patatha masiku ochepa ndinamva bwino. Ndidalandira chithandizo chamankhwala, chomwe chidatenga masiku 14, ndipo ndikhutira.

Igor, wazaka 47, Saint Petersburg

Ndili ndi matenda osokoneza bongo ndipo ngakhale ndimatsatira mosamala zakudya ndikuwongolera shuga, chilonda chophweka chinawoneka pa mwendo wanga, womwe unakula msanga ndipo umandithandizira. Monga adanenera dotolo, adagwiritsa ntchito Moflaxia monga gawo la zovuta mankhwala. Chida chija chinathandiza kwambiri. Chilondacho chinachepera masiku angapo ndikuyamba kuchira. Ndinagwiritsa ntchito maantibayotiki kwa masiku 14. Sanatchulidwe zoyipa zilizonse.

Analogs popanga ndi chisonyezo chogwiritsidwa ntchito

Mndandanda womwe uli pamwambapa wa analogies ya mankhwala, omwe akuwonetsa Moflaxia wogwirizira, ndizabwino kwambiri chifukwa zimakhala ndi zinthu zomwe zimagwirizana ndipo zimagwirana molingana ndi chisonyezo chogwiritsidwa ntchito

Kuphatikizika kosiyanasiyana, kungagwirizane mukuwonetsa ndikugwiritsa ntchito njira

Kodi mungapeze bwanji analogue yotsika mtengo ya mankhwala okwera mtengo?

Kuti mupeze chiwonetsero chotsika mtengo cha mankhwala, chofananira kapena chofanana, choyambirira timalimbikitsa kulabadira kapangidwe kake, zomwe ndi zinthu zomwezo zomwe zikugwira komanso zomwe zikugwiritsidwa ntchito. Zomwe zimagwiritsidwanso mosiyanasiyana ndi mankhwalawa zimawonetsa kuti mankhwalawo ndi ofanana ndi mankhwalawo, monga mankhwala ena kapena mitundu ina. Komabe, musaiwale za zovuta zomwe zimagwiritsidwa ntchito ndi mankhwala ofanana, omwe angakhudze chitetezo ndi kugwiranso ntchito. Musaiwale za malangizo a madotolo, kudzipereka nokha kungawononge thanzi lanu, chifukwa chake onani dokotala wanu musanagwiritse ntchito mankhwala.

Malangizo a Moflaxia

MALANGIZO
pa kugwiritsa ntchito mankhwalawa
Moflaxia

Zogwira ntchito
Moxifloxacin

Fomu ya Mlingo:
Mapiritsi okhala ndi mafilimu.

Zopangidwa:
Piritsi limodzi lachifundo 1
Kernel:
yogwira mankhwala: moxifloxacin hydrochloride 454.75 mg, wofanana ndi moxifloxacin 400.00 mg,
zotuluka: microcrystalline cellulose 186.05 mg, croscarmellose sodium 32,00 mg, magnesium stearate 6.00 mg,
Filamu sheath: hypromellose 12,60 mg, macrogol-4000 4.20 mg, titanium dioxide (E171) 3,78 mg, utoto wa iron oxide ofiira (E172) 0,42 mg.

Kufotokozera:
Mapiritsi okhala ndi mawonekedwe a Capsule, biconvex, utoto wamafilimu, pinki yakuda.
Mawonekedwe apamtunda: Unyinji wowala wachikaso wowala ndi utoto wamafuta wakuda bii.

Gulu la Pharmacotherapeutic:
antimicrobial wothandizila - fluoroquinolone

ICD-10:
X.J00-J06.J01 pachimake sinusitis
X.J10-J18.J13 chibayo cha Streptococcus chibayo
X.J10-J18.J14 chibayo choyambitsidwa ndi Haemophilus fuluwenza wokhala ndi ndodo ya Afanasyev-Pfeiffer
X.J10-J18.J15 Bacteria chibayo, osati kwina
X.J10-J18.J15.0 Klebsiella chibayo mabayo
X.J10-J18.J15.7 Chibayo chifukwa cha chibayo cha Mycoplasma
X.J10-J18.J16.0 Chlamydia chibayo
X.J10-J18.J16.8 Chibayo chifukwa cha omwe adawatulutsa
X.J20-J22.J20 bronchitis pachimake
X.J20-J22.J20.1 Bronchitis pachimake chifukwa cha Haemophilus fuluwenza ndi ndodo ya Afanasyev-Pfeiffer
X.J20-J22.J20.2 Bronchitis pachimake chifukwa cha streptococcus
X.J20-J22.J20.8 Bronchitis pachimake chifukwa cha othandizira ena
X.J40-J47.J42 Matenda a bronchitis, osadziwika
XI.K65-K67.K65 Peritonitis
XII.L00-L08.L01 Impetigo
XII.L00-L08.L02 Muli pakhungu, chithupsa ndi carbuncle
XII.L00-L08.L03 Phlegmon
XII.L00-L08.L08.0 Pyoderma
XII.L00-L08.L08.9 Matenda a pakhungu ndi minofu yolowerera, osadziwika

ATX:
J.01.M.A.14 Moxifloxacin

Mankhwala:
Njira yamachitidwe
Moxifloxacin ndi mankhwala osiyanasiyana a bactericidal antibacterial, 8-methoxy fluoroquinolone.
Mphamvu ya bactericidal ya moxifloxacin imachitika chifukwa cha kuletsa kwa bakiteriya topoisomerases II ndi IV, komwe kumayambitsa kusokonezeka kwa njira zobwereza, kukonza ndi kusindikiza kwa DNA biosynthesis yama cell tizilombo tating'onoting'ono ndipo, chifukwa chake, pakufa kwa maselo okhala ndi ma cell ochepa.
Ma bactericidal ochepera poyerekeza moxifloxacin nthawi zambiri amakhala ofanana ndi zochepa zoletsa zake.
Njira zopewera
Njira zomwe zimatsogolera pakupanga kukana kwa penicillins, cephalosporins, aminoglycosides, macrolides ndi tetracyclines sizimakhudzana ndi antibacterial zochita za moxifloxacin.
Palibe kutsutsana kwapakati pa magulu awa a antibacterial mankhwala ndi moxifloxacin. Pakadali pano, sipanakhalepo zochitika za kukana kwa plasmid. Pafupipafupi kukula kwa kukana ndikochepa kwambiri (10-7-10-10).
Kukana kwa Moxifloxacin kumayamba pang'onopang'ono kudzera pakusintha kambiri. Kuwonetsedwa mobwerezabwereza kwa moxifloxacin kuzinthu zamagetsi zomwe zimakhala m'munsi mwa zochepa zoletsa ndende (MIC) zimayendera limodzi ndi kuwonjezeka pang'ono kwa MIC. Milandu yotsutsana ndi quinolones imadziwika. Komabe, tizilombo tating'onoting'ono tokhala ndi gramu komanso anaerobic osagwirizana ndi ma quinolones ena timawaganizirabe moxifloxacin.
Kukhazikitsidwa kuti kuwonjezeranso kwa gulu la methoxy mu mawonekedwe a C8 ku moxifloxacin mamolekedwe a moxifloxacin kumawonjezera ntchito ya moxifloxacin ndikuchepetsa mapangidwe a mabakiteriya osintha a mabakiteriya oyenera. Kuphatikizidwa kwa gulu la bikcloamine paudindo C7 kumalepheretsa kukhazikika kwa yogwira ntchito, njira yotsutsana ndi fluoroquinolones.
In vitro moxifloxacin imagwira ntchito motsutsana ndi michere yambiri yama gram-negative ndi gram-virus, anaerobes, mabakiteriya osagwira asidi ndi mabakiteriya atypical monga Mycoplasma spp., Chlamydia spp., Legionella spp.
Zokhudza matumbo microflora
M'maphunziro awiri omwe adachitika pa odzipereka, kusintha kwa microflora yam'mimba kunawonekera pambuyo pakukonzekera kwa moxifloxacin. Kutsika kwa kuzungulira kwa Escherichia coli, Bacillus spp. Bacteroides vulgatus, Enterococcus spp., Klebsiella spp., Komanso anaerobes Bifidobacterium spp., Eubacterium spp., Peptostreptococcus spp. Kusintha kumeneku kunasinthidwa mkati mwa milungu iwiri. Clostridium Hardile poizoni sapezeka.

Pharmacokinetics:
Zogulitsa
Ikaperekedwa, moxifloxacin imagwira msanga komanso pafupifupi. Mtheradi bioavailability pafupifupi 91%.
Mankhwala a moxifloxacin atamwa pa 50 mpaka 1200 mg kamodzi, komanso 600 mg / tsiku kwa masiku 10, ali pamzere. Dera lolingana limafikiridwa pakatha masiku atatu.
Pambuyo pa ntchito imodzi yokha ya 400 mg ya moxifloxacin Cmax mu plasma yamagazi imatheka mkati mwa maola 0,5 ndi 3 ndi 3.1 mg / L. Pambuyo pakamwa 400 mg a moxifloxacin kamodzi patsiku, Cssmax ndi Cssmin (pazoyenera komanso zochepa pazofanana) ndi 3.2 mg / L ndi 0,6 mg / L, motsatana.
Mukamamwa moxifloxacin ndi chakudya, pamakhala kuwonjezeka pang'ono panthawiyi kuti mufikire Cmax (pofika maola 2) ndi kuchepa pang'ono kwa Cmax (pofika pafupifupi 16%), pomwe nthawi yolemba sichisintha. Komabe, izi sizothandiza m'thupi, ndipo moxifloxacin amatha kugwiritsidwa ntchito mosasamala nthawi yakudya.
Kugawa
Moxifloxacin imagawiridwa mwachangu mu minofu ndi ziwalo ndipo imagwirizana ndi mapuloteni amadzi a m'magazi (makamaka albin) ndi pafupifupi 45%. Kuchuluka kwa magawo ndi pafupifupi 2 l / kg.
Kuzungulira kwa moxifloxacin, ochulukirapo kwa omwe ali m'madzi am'magazi, amapangika m'matumbo am'mapapu (kuphatikizapo epithelial fluid, alveolar macrophages), mu ma cell a epanasal (maxillary and ethmoid labyrinth), m'mitsempha yam'mphuno, malo osakanikirana ndi zotupa (pazomwe zimaphatikizidwa ndi zotupa zamkhungu). ) Pazipinda zamkati komanso malovu, moxifloxacin amatsimikiza mwa mawonekedwe aulere, osakhala ndi mapuloteni, pamsasa wozungulira kuposa plasma wamagazi. Kuphatikiza apo, ma moxifloxacin amadziwika kwambiri pamatumbo am'mimba, zotupa za peritoneal, komanso ziwalo zoberekera wamkazi.
Kupenda
Moxifloxacin imadutsa biotransfform ya gawo lachiwiri ndipo imachotsedwa m'thupi ndi impso, komanso m'matumbo, osasinthika komanso mawonekedwe osakanikirana a mankhwala a soffo (M1) ndi glucuronides (M2). Moxifloxacin sanapangidwe biocransformed ndi microsomal cytochrome P450 system. Ma metabolabolites M1 ndi M2 amapezeka m'magazi am'magazi mozama kwambiri kuposa potengera makolo. Malinga ndi zotsatira za maphunziro oyamba, zimatsimikiziridwa kuti ma metabolites awa samakhala ndi vuto lililonse mthupi poteteza komanso kulolera.
Kuswana
Hafu ya moyo wa moxifloxacin pafupifupi maola 12. Wapakati chilolezo chotsatira pambuyo makonzedwe a 400 mg ndi 179-246 ml / mphindi. Chilolezo cha renal ndi 24-53 ml / min. Izi zikuwonetsa kubwezeretsanso kwakanthawi kwa moxifloxacin.
Kuchuluka kwa kuchuluka kwa poyambira komanso metabolites a gawo lachiwiri ndi pafupifupi 96-98%, zomwe zikuwonetsa kusowa kwa metabolid oxidative. Pafupifupi 22% ya mlingo umodzi (400 mg) umatuluka osagwirizana ndi impso, pafupifupi 26% - kudzera m'matumbo.
Pharmacokinetics m'magulu osiyanasiyana odwala
Zaka, jenda komanso fuko
Kafukufuku wokhudza pharmacokinetics wa moxifloxacin mwa amuna ndi akazi adawonetsa kusiyana kwama 33% malinga ndi AUC ndi Cmax. Kuyamwa kwa moxifloxacin sikunadalire jenda. Kusiyana kwa AUC ndi Cmax kunachitika chifukwa chosiyana kulemera kuposa jenda ndipo sikuti ndiwofunika kwambiri pakubwera.
Panalibe kusiyana kwakukulu kachipatala mu pharmacokinetics ya moxifloxacin mwa odwala amitundu yosiyanasiyana ndi mibadwo yosiyana.
Ana
Ma pharmacokinetics a moxifloxacin mwa ana sanaphunzire.
Matenda aimpso
Panalibe kusintha kwakukulu mu pharmacokinetics ya moxifloxacin mwa odwala omwe ali ndi vuto la Impso (kuphatikiza odwala omwe ali ndi creatinine chilolezo (QC). Zonsezi zimaperekedwa pazachidziwitso ndipo sizifukwa zodzipangira nokha kapena kumwa mankhwala.