Ofloxacin: malangizo ogwiritsira ntchito

Mapiritsi a Ofloxacin ali m'gulu la pharmacological gulu la antibacterial mankhwala opangidwa ndi fluoroquinolones. Amagwiritsidwa ntchito ngati mankhwala a etiotropic (chithandizo chofuna kupha tizilombo toyambitsa matenda) matenda opatsirana omwe amayambitsidwa ndi tizilombo tating'onoting'ono tomwe timakhudzidwa ndi zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mapiritsi a Ofloxacin ali pafupifupi oyera, ozungulira mawonekedwe ndipo ali ndi biconvex kumtunda. Amakutidwa ndi zokupizira za filimu ya enteric. Ofloxacin ndiye chinthu chachikulu chomwe amapangira mankhwalawa; zomwe zimapezeka piritsi limodzi ndi 200 ndi 400 mg. Komanso, momwe zimapangidwira zimaphatikizapo zinthu zothandiza, zomwe zimaphatikizapo:

Microcrystalline cellulose.
Colloidal silicon dioxide.
Povidone.
Wowuma chimanga.
Talc.
Kashiamu yonyowa.
Propylene glycol.
Hypromellose.
Titanium dioxide
Macrogol 4000.

Mapiritsi a Ofloxacin amawaika mu chithuza chamtundu wa zidutswa 10. Phukusi la makatoni mumakhala chithuza chimodzi chokhala ndi mapiritsi ndi malangizo ogwiritsira ntchito mankhwalawa.

Zotsatira za pharmacological

Mphamvu yogwira ya mapiritsi a Ofloxacin inhibits (inhibits) cell cell ya enzyme ya DNA gyrase, yomwe imapangitsa chidwi cha DNA supercoiling reaction (deoxyribonucleic acid). Kusakhalapo kwa izi kumadzetsa kusakhazikika kwa ma bacteria mabakiteriya omwe amafa pambuyo pake. Mankhwalawa ali ndi bactericidal (imatsogolera ku kufa kwa mabakiteriya). Amanena za antibacterial othandizira osiyanasiyana mawonekedwe. Magulu otsatirawa mabakiteriya amakhudzidwa kwambiri ndi izi:

Staphylococci (Staphylococcus aureus, Staphylococcus epidermidis).
Neisseria (Neisseria gonorrhoeae, Neisseria meningitidis).
E. coli (Escherichia coli).
Klebsiella, kuphatikiza Klebsiella chibayo.
Proteus (Proteus mirabilis, Proteus vulgaris, kuphatikizapo indole-positive and indole-negative tizilombo).
Tizilombo toyambitsa matenda m'mimba (Salmonella spp., Shigella spp. Kuphatikiza Shigella sonnei, Yersinia enterocolitica, Campylobacter jejuni, Aeromonas hydrophila, Plesiomonas aeruginosa, Vibrio cholerae, Vibrio parahaemolyticus).
Tizilombo toyambitsa matenda tomwe timayambitsa matenda opatsirana pogonana - (Chlamydia - Chlamydia spp.).
Legionella (Legionella spp.).
Tizilombo toyambitsa matenda a pertussis ndi pertussis (Bordetella parapertussis, Bordetella pertussis).
Wothandizira wa ziphuphu zakumaso ndi Propionibacterium acnes.

Variable kudziwa pophika yogwira Ofloxacin mapiritsi adzalandira Enterococcus faecalis, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus viridans, Serrratia marcescens, Pseudomonas aeruginosa, Acinetobacter spp., Mycoplasma hominis, Mycoplasma pneumoniae, Mycobacterium TB, Mycobacteriurn fortuitum, Ureaplasma urealyticum, Clostridium perfringens, Corynebacterium spp ., Helicobacter pylori, Listeria monocytogene, Gardnerella vaginalis. Nocardia asteroides, mabakiteriya a anaerobic (Bacteroides spp., Peptococcus spp., Peptostreptococcus spp., Eubacterium spp., Fusobacterium spp., Clostridium Hardile) samvera mankhwala. Tizilombo toyambitsa matenda a Syphilis, Treponema pallidum, timalimbana ndi ofloxacin.

Mutatenga mapiritsi a Ofloxacin mkati, omwe amagwira ntchito mwachangu amatha kutengeka kwathunthu kuchokera m'matumbo kuti ayende bwino. Imagawidwanso m'thupi lathu. Ofloxacin amaphatikizidwa pang'ono m'chiwindi (pafupifupi 5% ya kuchuluka kwathunthu). Chidacho chimatulutsidwa mkodzo, kwambiri osasinthika. Hafu ya moyo (nthawi yomwe theka lathunthu la mankhwalawa limachotsedwa m'thupi) ndi maola 4-7.

Zizindikiro zogwiritsidwa ntchito

Kukhazikitsidwa kwa mapiritsi a Ofloxacin akuwonetsedwa mwa matenda angapo opatsirana omwe amayambitsidwa ndi bakiteriya wa pathogenic (pathogenic) omwe amakhudzidwa ndi zomwe zimagwiritsidwa ntchito ndi mankhwala:

Matenda opatsirana komanso otupa a ziwalo za ENT - sinusitis (bacterial lesion of the paranasal sinuses), pharyngitis (kutupa kwa pharynx), otitis media (kutupa kwa khutu lapakati), tonsillitis (bacterication of the tonsils), laryngitis (kutupa kwa larynx).
Matenda opatsirana a m'munsi kupuma thirakiti - bronchitis (kutupa kwa bronchi), chibayo (chibayo).
Zowonongeka pakhungu ndi minofu yofewa ndi mabakiteriya osiyanasiyana, kuphatikizapo kukonza kwa puroses.
Matenda opatsirana a mafupa ndi mafupa, kuphatikizapo poliomyelitis (purulent lesion of pfupa minofu).
Matenda opatsirana komanso otupa a dongosolo la m'mimba ndi kapangidwe ka hepatobiliary system.
Matenda a ziwalo za m'chiberekero mwa azimayi omwe amayamba chifukwa cha mabakiteriya osiyanasiyana - salpingitis (kutukusira kwa machubu a fallopian), endometritis (kutupa kwa chiberekero), oophoritis (kutupa kwa thumba losunga mazira), parametritis (kutukusira kwa khoma lakunja kwa chiberekero), cervicitis (kutukusira kwa khomo lachiberekero).
Matenda otupa a ziwalo zamkati mwa mwamunayo ndi prostatitis (kutukusira kwa gazi lachiberekero), orchitis (kutupa kwa ma testicles), epididymitis (kutupa kwa ziwonetsero za testes).
Matenda opatsirana omwe amakhala ndi matenda opatsirana pogonana - chinzonono, chlamydia.
Matenda opatsirana komanso otupa a impso ndi kwamikodzo thirakiti - pyelonephritis (purifiyamu yotupa ya calyx ndi aimpso), cystitis (kutupa kwa chikhodzodzo), urethritis (kutupa kwa urethra).
Kutupa kosafunikira kwamankhwala bongo ndi msana (meningitis).

Mapiritsi a Ofloxacin amagwiritsidwanso ntchito kupewa matenda opatsirana mwa mabakiteriya omwe amachepetsa mphamvu ya chitetezo cha m'thupi.

Contraindication

Kukhazikitsidwa kwa mapiritsi a Ofloxacin amatsutsana m'njira zingapo za thupi ndi zokhudza thupi.

Hypersensitivity kwa yogwira mankhwala ndi zina zothandiza za mankhwala.
Khunyu (kukula kwakanthawi kwa kukoka kwamphamvu kwa tonic-clonic motsutsana ndi maziko a chikumbumtima chosavomerezeka), kuphatikizapo zakale.
Chotsogolera kukukula kwa khunyu (kutsitsa chimbudzi) motsutsana ndi maziko a kuvulala kwam'mutu, ubongo wamatenda a ziwalo zamkati zamanjenje, komanso kugunda kwa ubongo.
Ana ochepera zaka 18, omwe amalumikizidwa ndi mapangidwe opanda mafupa a mafupa.
Mimba pa gawo lililonse la chitukuko ndi mkaka wa m'mawere (yoyamwitsa).

Mochenjera, mapiritsi a Ofloxacin amagwiritsidwa ntchito ku atherosulinosis (kuyika kwa cholesterol kukhoma kwa ziwongo) zamatumbo am'mimba, zovuta zamagazi muubongo (kuphatikiza zomwe zidasinthidwa kale), zotupa zam'magazi zamkati mwa dongosolo lamanjenje lamkati, komanso kuchepa kwakukulu pantchito yogwira chiwindi. Musanayambe kumwa mankhwalawa, muyenera kuonetsetsa kuti palibe zotsutsana.

Mlingo ndi makonzedwe

Mapiritsi a Ofloxacin amatengedwa wathunthu musanadye kapena pambuyo pake. Sichitafuna ndipo imatsukidwa ndi madzi okwanira. Mlingo ndi njira yogwiritsira ntchito mankhwalawa zimatengera pathogen, chifukwa chake, amatsimikiza ndi dokotala. Mlingo wambiri wa mankhwalawa ndi 200-800 mg patsiku mu Mlingo wachiwiri wogawika, njira yotsatiridwa imasiyanasiyana masiku 7 - 7 (mankhwalawa amatenda osavuta a kwamikodzo, njira yochizira ndi mankhwalawa imatha kukhala masiku atatu kapena atatu). Mapiritsi a Ofloxacin amatengedwa pa mlingo wa 400 mg kamodzi pochizira matenda a chinzonono. Kwa odwala omwe ali ndi kuchepa kwapakati pa ntchito ya impso ndi chiwindi, komanso omwe ali ndi hemodialysis (Hardware kuyeretsa magazi), kusintha kwa mankhwalawa ndikofunikira.

Zotsatira zoyipa

Kukhazikitsidwa kwa mapiritsi a Ofloxacin kungayambitse kukula kwa mayendedwe osiyanasiyana a ziwalo zosiyanasiyana ndi machitidwe:

Matumbo a pakhungu - nseru, kusanza kwakanthawi, kuchepa kwa chakudya, mpaka kufika pakusowa kwathunthu (anorexia), kutsegula m'mimba, kufalikira (kutulutsa magazi), kupweteka kwam'mimba, kuchuluka kwa chiwindi transaminase enzymes (ALT, AST) m'magazi, kuwonetsa kuwonongeka kwa maselo a chiwindi cholestatic jaundice wokwiyitsidwa ndi kusakhazikika kwa ndulu mu ma hepatobiliary system, hyperbilirubinemia (kuchuluka kwa bilirubin m'magazi), pseudomembranous enterocolitis (chotupa cha matenda opatsirana chifukwa cha anaerobic bacterium Clostridi zovuta).
Mitsempha yam'mimba ndi zam'mimba zam'mimba - kupweteka mutu, chizungulire, kusatekeseka poyenda, makamaka yolumikizana ndi kufunika kwa maluso abwino oyendetsa galimoto, kugwedeza (kuthamanga) kwa manja, kupweteka kwakanthawi kwam'magulu osiyanasiyana a minofu yamatumbo, dzanzi pakhungu ndi kupweteka kwake (kuvulala kwamphamvu), zoopsa, zolakwika zosiyanasiyana (anasonyeza mantha a zinthu kapena zochitika zina), kuda nkhawa, kuchuluka kwa chotupa cham'mimba, kutaya mtima (kutsika kwa nthawi yayitali), chisokonezo, kuwonera sihoticheskie anachita, diplopia (awiri masomphenya), chakhungu masomphenya (a mtundu) kulawa, kununkhiza, kumva, bwino, kuthamanga intracranial.
Mtima dongosolo - tachycardia (kuchuluka kugunda kwa mtima), vasculitis (yotupa ya mitsempha), kugwa (chizindikiro kuchepa ochepa mtima toni).
Magazi ndi mafupa ofiira - kuchepa kwa maselo ofiira am'magazi (hemolytic kapena aplastic anemia), maselo oyera amkhungu (leukopenia), mapulateleti (thrombocytopenia), komanso kusakhalapo kwa granulocytes (agranulocytosis).
Kwamikodzo dongosolo - interstitial nephritis (yotupa yotupa a impso), mkhutu magwiridwe antchito a impso, kuchuluka kwa urea ndi creatinine m'magazi, zomwe zikuwonetsa kukula kwa aimpso kulephera.
Musculoskeletal system - kupweteka kwa kuphatikizika (arthralgia), minofu yamatumbo (myalgia), zotupa zotupa zam'magazi (tendivitis), matumba olumikizana molumikizana (synovitis), zotupa za pathological tendon.
Misomali - petechiae (zotupa zotupa pakhungu), dermatitis (zotupa zotupa za pakhungu), zotupa za papular.
Thupi lawo siligwirizana - zotupa pakhungu, kuyabwa, ming'oma (khungu lotupa ndi kutupa kwa khungu lofanana ndi kuwotcha kwachikasu), bronchospasm (kupindika kwa khungu la bronchi chifukwa cha kuphipha), chifuwa cha ziwongo (chifuwa), chifuwa; Quincke's edema (chotupa chachikulu cha nkhope ndi ziwalo zakunja), zilonda zamkati zimayambitsa khungu (Lyell, Stevens-Johnson syndrome), mantha anaphylactic (systemic allergic anachita ndi kuchepa magazi magazi ndi kukula kwa ziwalo zingapo zalephera.

Potukula zotsatira zoyipa atayamba kugwiritsa ntchito mapiritsi a Ofloxacin, makina awo ayenera kuyimitsidwa ndikuyang'ana kwa dokotala. Kuthekera kwa kugwiritsidwanso ntchito kwa mankhwalawa, amasankha payekhapayekha, kutengera mtundu ndi kuwonongeka kwa mavuto.

Malangizo apadera

Musanayambe kumwa mapiritsi a Ofloxacin, muyenera kuwerengera mosamalitsa kwa mankhwalawo. Pali malangizo apadera angapo omwe muyenera kutsatira:

Mankhwala si njira yosankhira chibayo chifukwa cha chibayo.
Pogwiritsa ntchito mankhwalawa, kukhudzana ndi khungu pakhungu ndi dzuwa kapena ma radiation oyipa a ultraviolet kuyenera kupewedwa.
Sitikulimbikitsidwa kumwa mapiritsi oposa miyezi iwiri.
Pankhani ya pseudomembranous enterocolitis, mankhwalawa amathetsedwa, ndipo metronidazole ndi vancomycin ndi mankhwala.
Ndikumamwa mapiritsi a Ofloxacin, kutupa kwa ma tendon ndi ma ligaments kumatha kuyamba, ndikutsatiridwa ndi kupasuka (makamaka, Achilles tendon) ngakhale ndi katundu wochepa.
Potengera momwe mankhwalawo amagwiritsidwira ntchito, azimayi sakuvomerezeka kuti azigwiritsa ntchito tampon pa nthawi ya kusamba chifukwa chochitika kwambiri chotupa cha candidiasis.
Potengera vuto linalake, mutatha kumwa mapiritsi a Ofloxacin, myasthenia gravis (kufooka kwa minofu) kumayamba.
Kuchita zinthu zodziwitsa anthu pokhudzana ndi kuzindikiridwa kwa chifuwa cha chifuwa chachikulu cha chifuwa chachikulu pakumwa mankhwala kungayambitse zotsatira zabodza.
Pankhani ya concomitant aimpso kapena kwa chiwindi kusakwanira, nthawi labotic kutsimikizika kwa ntchito zawo, komanso ndende ya yogwira mankhwala.
Pewani kumwa mowa mutamwa mankhwalawa.
Mankhwala a ana amagwiritsidwa ntchito pokhapokha pothana ndi mavuto omwe amabwera chifukwa cha tizilombo toyambitsa matenda.
Zomwe zimagwiritsidwa ntchito ndi mapiritsi a Ofloxacin amatha kuyanjana ndi mitundu yambiri ya mankhwala ena amtundu wa mankhwala ena, chifukwa chake, dokotala wawo ayenera kuchenjezedwa pakugwiritsa ntchito kwawo.
Pogwiritsa ntchito mankhwalawa, ndikofunikira kusiya ntchito yomwe imakhudzana ndi kufunika kowonjezera chidwi komanso kuthamanga kwa zochitika zama psychomotor, chifukwa zimakhudza ntchito yogwira mtima la cortex.

Pulogalamu yamankhwala, mapiritsi a Ofloxacin amapezeka pamankhwala. Ogwiritsa ntchito pawokha popanda kupatsidwa mankhwala oyenera samachotsedwa.

Bongo

Pankhani ya kuchuluka kwa njira zochizira mapiritsi a Ofloxacin, kusokonezeka kumayamba, chizungulire, kusanza, kugona, kusokonezeka m'malo ndi nthawi. Chithandizo cha bongo chimakhala ndikutsuka kwam'mimba, kumatenga matumbo, komanso chithandiziro kuchipatala.

Mlingo ndi makonzedwe

Mlingo ndi mawonekedwe a mankhwalawa monga mapiritsi ndi njira yothetsera kulowetsedwa amasankhidwa ndi dokotala payekha, kutengera kuwopsa kwa matendawa ndi malo ake, komanso malinga ndi momwe wodwalayo alili, kudziwa kwa tizilombo, komanso chiwindi ndi impso.

Odwala omwe ali ndi vuto la impso ndi creatinine chilolezo cha 20-50 ml / mphindi, mlingo umodzi ndi 50% ya zomwe amalimbikitsa (pafupipafupi makonzedwe a 2 kawiri pa tsiku), kapena mlingo umodzi umodzi umatengedwa kamodzi pa tsiku. Ndi QC