Dalacin (makapisozi): malangizo ogwiritsira ntchito

Makapisozi 150 mg, 300 mg

Makapu amodzi ali:

ntchito yogwira ndi clindamycin hydrochloride 177.515 mg kapena 355.030 mg (ofanana ndi clindamycin 150 mg kapena 300 mg),

zotulutsa: magnesium stearate, wowuma chimanga, talc, lactose monohydrate,

kapisozi kapisozi: titanium dioxide (E 171), gelatin.

Makapisozi olimba a gelatin olimba okhala ndi chivindikiro ndi thupi loyera, inki yakuda yosindikizidwa "Pfizer" ndi code "Clin 150". Zomwe zili m'mabotolo ndi ufa woyera (wa mulingo wa 150 mg).

Makapisozi olimba a gelatin olimba okhala ndi chivindikiro ndi thupi loyera, inki yakuda yosindikizidwa "Pfizer" ndi code "Clin 300". Zomwe zili m'mabotolo ndi ufa woyera (wa 300 mg).

Mankhwala

Pambuyo pakamwa, clindamycin imathamanga ndipo imafikika kwathunthu (90% ya mlingo womwe umamwa).

Zakudya zomwezi munthawi yomweyo sizikhudzanso kuchuluka kwa mankhwalawa m'madzi a m'magazi.

Kuzindikira kwa Serum

Akuluakulu wathanzi, kuchuluka kwa plasma wozungulira kuli pafupifupi 2 mg / L ndipo amawonedwa ola limodzi pambuyo pakukonzekera kwa 150 mg ya clindamycin hydrochloride kapena 4-5 mg / L pambuyo pakamwa 300 mg. Kenako, ndende ya plasma imatsika pang'onopang'ono, yotsalira pamwamba pa 1 mg / L kwa maola opitilira 6.
Kuzunzidwa kwa plasma kumawonjezeka motsatana malinga ndi kuchuluka kwa mlingo womwe umamwa.
Kuzungulira kwa Serum kumanenedwa kuti kumachepera pang'ono kwa odwala matenda ashuga kuposa odwala athanzi.
Wachilengedwe wamba theka la moyo wa clindamycin ku seramu ndi maola 2,5.

Kumanga Mapuloteni a Plasma

Kulumikizira mapuloteni a plasma ndikuyambira 80 mpaka 94%.

Kufalitsidwa mu minyewa ndi madzi amthupi

Clindamycin imagawidwa kwambiri m'mazinthu azambiri kwambiri mumadzi am'magulu am'madzi am'mimba komanso amtundu wambiri. Kusiyanitsa mu madzi a cerebrospinal ndizochepa.

Clindamycin imapukusidwa mu chiwindi.

Pafupifupi 10% ya mankhwalawa amagwiritsidwa ntchito mu mkodzo ndipo 3,6% imachotsedwa ndowe. Chotsalacho chimachotseredwa ngati ma metabolites osagwira.

Serum clindamycin wozungulira sasintha monga hemodialysis kapena peritoneal dialysis.

Malingaliro akumva otsatirawa osachepera mphamvu yoletsa kuzungulira (MIC) amagwiritsidwa ntchito kusiyanitsa pakati pa zinthu zomwe zikuwoneka, zinthu zomwe zimakhala ndi gawo lapakati, komanso zokhala ndi zofunikira pakati pazinthu zosagwirizana:

S ≤ 2 mg / L ndi R> 2 mg / L.

Kuchuluka kwa kukana kumene kungatengedwe kungasiyane kwa mitundu inayake malingana ndi dera komanso nthawi, ndipo ndikofunikira kuti mukhale ndi chidziwitso pazigawo zomwe zikuwonetsa kukana, makamaka pochiza matenda oopsa. Chidziwitsochi chimangotipatsa lingaliro lokhazikika la kuthekera kwa chamoyo cha maantibayotiki.

Grram zabwino cocci, kuphatikiza:

- Streptococci yomwe siali m'magulu aliwonse

Gram-alibe bacilli, kuphatikiza:

- Clostridium (kupatula maantifrijini ndi zovuta)

- Enterococci (kupatula Enterococcus faecium)

Bakiteriya wa a grob-aerobic

- Yopanda mphamvu ya gramu yopanda mphamvu

- (Acinetobacter, Pseudomonas, etc.)

Clindamycin amawonetsa mu vitro komanso ntchito ya vivo motsutsana ndi Toxoplasma gondii.

* Kuchuluka kwa kukana kwa methicillin pafupifupi 30 mpaka 50% kwa staphylococci onse ndipo kumachitika kwambiri kuchipatala.

Zizindikiro zogwiritsidwa ntchito

Clindamycin adapangira zochizira matenda oyambitsidwa ndi tizilombo tating'onoting'ono:

- matenda a makutu, mphuno ndi mmero,

- matenda opatsirana pamimba,

Kusiyana kwake ndi matenda am'mimba, ngakhale atayambitsidwa ndi tizilombo tating'onoting'ono, popeza Dalacin ® siimagwiritsa ntchito madzi amomwe amapezeka mu ubongo.

Kupewa matenda a endocarditis mu mano ndi chithandizo cham'mimba chodwala.

Malingaliro aupangiri wovomerezeka wogwiritsa ntchito antibacterial othandizira ayenera kuganiziridwa.

Mlingo ndi makonzedwe

Mankhwalawa amagwiritsidwa ntchito mkati, pofuna kupewa kukhumudwa, makapisozi akuyenera kutsukidwa ndi kapu yonse ya madzi (250 ml).

Mankhwala tsiku lililonse ndi 600-1800 mg / tsiku, logawidwa 2, 3 kapena 4 waukulu. Mlingo wambiri watsiku ndi tsiku ndi 2400 mg.

Odwala odwala

Mlingo wa 8-25 mg / kg pa tsiku, logawidwa mu 3 kapena 4 Mlingo wofanana.

Gwiritsani ntchito mwa ana akuwonetsedwa ngati angathe kumeza kapisozi yonse.

Odwala okalamba

Kafukufuku wa Pharmacokinetic atagwira pakamwa kapena kudzera m'mitsempha yamitsempha yamagazi siinawonetse kusiyana kofunikira pakati pa achinyamata ndi okalamba omwe ali ndi vuto lofanana ndi chiwindi komanso chobwinobwino (poganizira zaka) za ntchito yaimpso. Pankhaniyi, kusintha kwa okalamba odwala omwe ali ndi chiwindi chokwanira komanso chobwinobwino (poganizira zaka zapambuyo) ntchito yaimpso siyofunika.

Odwala ndi mkhutu aimpso ntchito

Odwala aimpso kulephera, kusintha kwa clindamycin sikofunikira.

Odwala omwe ali ndi vuto la chiwindi

Odwala ndi hepatic kusowa, kusintha kwa clindamycin sikofunikira.

Mlingo wa zisonyezo zapadera

Chithandizo cha Matenda a Beta Hemolytic Streptococcus

Malingaliro a Mlingo ofanana ndi Mlingo wa pamwambapa wa akulu ndi ana. Chithandizo ziyenera kupitilizidwa kwa masiku osachepera 10.

Chithandizo cha pachimake streptococcal tonsillitis kapena pharyngitis

Mlingo woyenera ndi 300 mg kawiri tsiku lililonse kwa masiku 10.

Kulimbikitsa matenda a kutupa matenda a m'chiuno ziwalo

Mankhwalawa amayenera kuyamba ndi njira yothetsera mtsempha wa magazi Dalacin C Phosphate (pa 900 mg maola 8 aliwonse osakanikirana ndi mankhwala opha ululu omwe ali ndi mawonekedwe oyenera ochita zinthu motsutsana ndi gram-hasi aerobic tizilombo), mwachitsanzo, ndi mankhwalawa pa gramu ya 2.0 mg / kg, ndikutsatira. Mlingo wa 1.5 mg / kg maola 8 aliwonse omwe ali ndi matenda abwinobwino aimpso. Kulowetsa mankhwala osokoneza bongo kuyenera kupitilizidwa kwa masiku osachepera 4 komanso maola 48 atadwala.

Kenako, muyenera kupitiliza kumwa Dalacin ® pakumwa 450-600 mg maola 6 aliwonse tsiku lililonse mpaka kumaliza maphunziro onse ndi masiku 10-14.

Mafupa ndi mafupa olowa

Mlingo woyenera ndi 7.5 mg / kg maola 6 aliwonse.

Kupewa kwa endocarditis mwa odwala omwe ali ndi vuto la penicillin

Odwala achikulire, mlingo woyenera ndi 600 mg 1 ola limodzi asanatero, ana: 20 mg / kg 1 ola limodzi asanatero.

Contraindication

- hypersensitivity kwa yogwira thunthu clindamycin, lincomycin kapena aliyense mwa opezedwa

- ana osakwana zaka 6

- trimester yoyamba ya mimba ndi mkaka wa m`mawere

- cholowa cholowa lactase, cholowa tsankho la gluctose, shuga / galactose malabsorption

Zochita zamankhwala osokoneza bongo

Vitamin K Antagonists

Kupititsa patsogolo anti-Vit K K ndi / kapena magazi, kuyang'anira pafupipafupi kwa chiyezo chapadziko lonse lapansi (INR). Ngati ndi kotheka, mlingo wa antivitamin K umasinthidwa panthawi ya mankhwala a clindamycin pambuyo poti wachoka.

Njira zogwiritsira ntchito apakhungu matenda am'mimba, ma ma antacid ndi adsorbents

Njira zogwiritsira ntchito apakhungu matenda am'matumbo, njira yothandizira makala ndi maantacid (aluminium, calcium ndi magnesium salt) pazokha komanso kuphatikiza ndi alginates kumachepetsa kuyamwa kwa mankhwala ena ofanana pamatumbo am'mimba. Mwa zina mwa mankhwala omwe amachepetsa mayamwidwe am'mimba ndi acetylsalicylic acid, H2-blockers ndi lansoprazole, bisphosphonates, exchangeation a cation, ma virus a magulu ena (fluoroquinolones, tetracyclines ndi lincosamides) ndi mankhwala ena a anti-TB, glucocorticoids mahomoni a chithokomiro, phenothiazine antipsychotic, sodium, beta-blockers, penicillamine, ions (chitsulo, phosphorous, fluorine), chloroquine, ulipristal ndi fexofenadine.

Monga kusamala, mankhwalawa amayenera kumwedwa kuti agwiritsidwe ntchito ngati matenda a m'matumbo kapena ma antacid omwe ali ndi nthawi yanthawi yokhudzana ndi kumwa mankhwala ena aliwonse (ngati nkotheka, kupitilira maola awiri).

Kuchepa kwa magazi kwa immunosuppress mankhwala ogwirizana ndi chiopsezo chotayika cha immunosuppressive. Kuwunikira pafupipafupi kuchuluka kwa kuchuluka kwa cyclosporine m'magazi ndipo, ngati kuli kotheka, kuwonjezereka kwa mlingo wake.

Kuchepa kwa magazi kwa immunosuppress mankhwala ogwirizana ndi chiopsezo chotayika cha immunosuppressive. Kuwunikira pafupipafupi kwa kuchuluka kwa tacrolimus m'magazi ndipo, ngati kuli kotheka, kuwonjezereka kwa mlingo wake.

Zovuta zokhudzana ndi kusintha kwa INR

Zochulukitsa zingapo za antivitamin K zochitika zanenedwa mwa odwala omwe amalandila maantibayotiki. Zomwe zimachitika pachiwopsezo zimaphatikizapo kuopsa kwa matendawa kapena kutupa, komanso zaka komanso zovuta za wodwalayo. Zikatero, nkovuta kudziwa chomwe chinayambitsa kusintha kwa INR - matenda kapena chithandizo. Komabe, magulu ena a maantibayotiki okhudzana ndi izi amatchulidwa kawirikawiri kuposa ena, monga fluoroquinolones, macrolides, cyclins, cotrimoxazole ndi cephalosporins ena.

Malangizo apadera

Pseudomembranous colitis ndi colitis yokhudzana ndi kugwiritsa ntchito maantibayotiki adawonedwa ndi ma antibacterial othandizira onse, kuphatikiza clindamycin, ndipo kuopsa kwawo kungayambike kuyambira pang'onopang'ono mpaka kuwopsa. Chifukwa chake, ndikofunikira kulingalira za kupezeka kwa matendawa ngati matenda am'mimba akuchitika pakanthawi kantchito kapena pambuyo pake. Ngati colitis yokhudzana ndi mabakiteriya ikayamba, clindamycin iyenera kutha pomwepo, dokotala ayenera kufunsidwa ndipo chithandizo choyenera chiyenera kuyambitsidwa, kuphatikiza chithandizo chapadera chotsutsana ndi Clostridium Hardile. Panthawi imeneyi, kugwiritsa ntchito mankhwala omwe amachepetsa matumbo athu kumatsutsana.

Hypersensitivity komanso thupi lawo siligwirizana angayambe, kuphatikizapo anaphylactic zimachitika zomwe zingakhale pangozi moyo. Zikatero, clindamycin iyenera kusiyidwa ndikuyenera kuyambitsidwa.

Clindamycin iyenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi mbiri ya mphumu ndi zina.

Kuwoneka koyambirira kwa mankhwala a erythema ophatikizidwa ndi malungo ndi mafinya akhoza kukhala chizindikiro cha pustulosis yodziwika bwino, mankhwalawa ayenera kuyimitsidwa, kugwiritsidwa ntchito kwina kulikonse kwa clindamycin kumatsutsana.

Kuwonongeka kwa chiwindi

Ngati chiwindi ntchito, chiwindi clindamycin woipa ndi kuchuluka kwa theka moyo akhoza kuonedwa.

Pankhani ya chithandizo chazitali, ndikofunikira kuyang'anitsitsa mawonekedwe a magazi, michere ya chiwindi ndi impso.

Kugwiritsa ntchito maantibayotiki, makamaka kwa nthawi yayitali, kumatha kubweretsa mawonekedwe ndi kusankha mabakiteriya osagonjetseka kapena kukula kwa bowa. Pankhani yakukondweretsedwa, ndikofunikira kuyambitsa chithandizo choyenera.

Dalacin ® sangagwiritsidwe ntchito pochiritsa meningitis, chifukwa clindamycin simalowa mokwanira mu madzi a cerebrospinal.

Dalacin ® ili ndi lactose. Kugwiritsa ntchito kwake kuyenera kupewedwa mwa odwala omwe ali ndi lactose tsankho, kuchepa kwa lactase kapena glucose ndi galactose malabsorption syndrome (matenda osowa mwabadwa).

Mu embryonic maphunziro a chitukuko cha mwana wosabadwayo, palibe zoyipa pa mwana wosabadwayo anati, kupatula milandu ya makonzedwe Mlingo poizoni mayi.

Clindamycin amadutsa chikhodzodzo.

Zambiri pazotsatira za clindamycin panthawi yodziwika kapena yogwiritsidwa ntchito panthawi yoyambirira yamimba ndizochepa.

M'masamba ambiri omwe amapezeka pa kugwiritsidwa ntchito kwa clindamycin nthawi yachiwiri ndi yachitatu ya kubereka, palibe zomwe zikuwonetsa kubadwa kwa mwana wosabadwa.

Chifukwa chake, chifukwa cha zomwe zilipo, sikulimbikitsidwa kugwiritsa ntchito clindamycin nthawi yoyamba ya mimba.

Ngati ndi kotheka, komwe kumakhazikitsidwa ndi dokotala, clindamycin angagwiritsidwe ntchito panthawi yachiwiri komanso yachitatu ya amayi omwe ali ndi pakati.

Clindamycin yaying'ono yozama imapukusidwa mkaka wa m'mawere. Pali chiopsezo chokhala ndi vuto la m'mimba mwa makanda. Chifukwa chake, ngati kusamala, kuyamwitsa kuyenera kupewedwa panthawi ya mankhwala.

Maphunziro a chonde mu makoswe omwe amathandizidwa ndi clindamycin sanawonetse mphamvu ya mankhwalawa pakukula kapena kuthekera.

Zambiri za momwe mankhwalawa amatha kuyendetsa magalimoto ndikugwiritsa ntchito njira zowopsa

Dalacin ® sizimakhudza kuyendetsa magalimoto ndi kugwira ntchito ndi zida kapena kumakhudza pang'ono.