Clindamycin ndi mankhwala: ntchito

Mankhwalawa amapangidwa mwanjira ya makapisozi a gelatin okhala ndi thupi lofiirira komanso kapu yofiyira. Makapisozi amakhala ndi ufa woyera kapena wachikasu. Aliyense kapisozi muli 150 mg yogwira zigawo za clindamycin mu mawonekedwe a hydrochloride.

Talc, lactose monohydrate, magnesium stearate ndi wowuma chimanga amagwiritsidwa ntchito ngati zinthu zina.

Mankhwala

Clindamycin imakhala ndi zotsatirapo zosiyanasiyana ndipo ndi bacteriostatic yomwe imalepheretsa kupanga kwa mapuloteni mu tizilombo tating'onoting'ono. Gawo lalikulu limagwira ntchito yolimbana ndi gramu-cocoa ndi microaerophilic cocci, komanso anaerobic gram-positive bacilli, yomwe simapanga spores.

Mitundu yambiri ya clostridia imatsutsana ndiantiotic. Pamenepa, ngati wodwala ali ndi kachilombo koyambitsa matenda amtunduwu, ndikulimbikitsidwa kuti maantibayotiki azitsimikiza kaye.

Mukatha kugwiritsa ntchito, mankhwalawo amatengedwa m'matumbo. Kudya kumachepetsa mayamwidwe, koma sizikhudzanso kuchuluka kwa mankhwalawo m'magazi. Mankhwalawa ali ndi kusayenda bwino kudzera mu zotchinga za magazi, koma amalowa mosavuta mu minyewa ndi mapapu, malovu, matalala, thirakiti, mabala am'mimba, misozi yam'mimba, bronchi, mafupa ndi minofu, sputum, madzimadzi okhathamira, zotupa za bile, Prostate gland, zowonjezera. Pamaso pa njira yotupa m'mankhwala, kupezeka kwa maantibayotiki kudzera mu chotchinga cha magazi kumawonjezeka.

Kuchuluka kwa mankhwalawa kumawonedwa m'magazi ola limodzi pambuyo pa kugwiritsa ntchito makapisozi. Gawo lalikulu la mankhwalawa limachotsedwa m'thupi kwa masiku anayi mothandizidwa ndi impso ndi matumbo.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amalembera matenda otsatirawa:

• Kupewa kwamatumbo ndi peritonitis pambuyo pakupaka kapena kuvulala kwamatumbo,
• Septicemia
• Matenda opatsirana a minofu yofewa ndi khungu (panaritium, abscesses, mabala omwe ali ndi matendawa, zithupsa), komanso mkamwa ndi m'mimba m'mimba (abscess ndi peritonitis),
• Matenda opatsirana a chapamwamba kupuma dongosolo ndi ziwalo za ENT (sinusitis, pharyngitis, otitis media ndi tonsillitis), kupuma kochepa (kupuma kwamankhwala, kupweteka kwa chibayo, chifuwa chachikulu ndi chifuwa cham'mapapo), diphtheria, kutentha thupi,
• Endocarditis ya mabakiteriya,
• Osteomyelitis mu nyengo kapena pachimake,
• Matenda opatsirana a ziwalo za urogenital system (tubo-ovarian yotupa njira, endometritis, chlamydia, matenda opatsirana mwa ukazi),
• Matenda opatsirana omwe amaphatikizidwa ndi njira yotupa komanso oyambitsidwa ndi tizilombo tating'onoting'ono timayang'anira ma cell a tizilombo toyambitsa matenda.

Mlingo

Makapisozi ndi oyendetsa pakamwa. Nthawi zambiri zotchulidwa kumwa mlingo wa 150 mg ndi nthawi ya 6 kapena 8 maola. Ngati wodwala akudwala matenda oopsa, mlingowo ungathe kuwonjezeka mpaka 300 kapena 450 mg. Mukamapereka mankhwala kwa ana amwezi umodzi wazaka, amatsogozedwa ndi kuwerengera kwa 8 kapena 25 mg pa kilogalamu ya thupi. Masana ayenera 3 kapena 4 waukulu.

Bongo

Mukamagwiritsa ntchito mankhwala osokoneza bongo omwe amawonjezera achire, zotsatira zoyipa zimachulukirachulukira.

Ngati mankhwala osokoneza bongo, chithandizo chikuchitika umalimbana kupondereza zizindikiro zake. Tiyenera kukumbukira kuti mankhwalawa alibe antidote, ndipo dialysis ndi hemodialysis sizikhala ndi ntchito yofunikira.

Kuyanjana kwa mankhwala osokoneza bongo

Kufanana kwa makonzedwe a glamicin, streptomycin, aminoglycosides ndi rifampicin onse kumaonjezera mphamvu ya mankhwala omwe ali pamwambawa ndi clindamycin.

Pamodzi ndi mpikisano wopuma wa minofu, kupumula kwa minofu, komwe kumayambitsidwa ndi anticholinergics, kumatha kuchuluka.

Mankhwala Clindamycin sangatengedwe ndi mankhwala monga magnesium sulfate, aminophylline, ampicillin, calcium gluconate ndi barbiturates.

Kukondera kumawonetsedwa pokhudzana ndi chloramphenicol ndi erythromycin.

Sipangofunika kugwiritsa ntchito mankhwalawa molumikizana ndi mankhwala monga phenytoin, vitamini B complexes, aminoglycosides.

Momwemonso kugwiritsa ntchito mankhwala antidiarrheal, kuthekera kwa pseudo-nembanemba colitis kumakulanso.

Kugwiritsa ntchito ma analgesics a narcotic (opioid) kungakulitse kupuma (ngakhale apnea asanafike).

Zotsatira zoyipa

Kugwiritsa ntchito mankhwalawa kungapangitse mawonekedwe otsatirawa:

• Mtima dongosolo: chizungulire, kumva kufooka,
• Hematopoietic ziwalo: thrombocytopenia, neutropenia, leukopenia, agranulocytosis,
• Matumbo a dongosolo: dysbiosis, chiwindi ntchito, esophagitis, pseudomembranous enterocolitis, kuchuluka kwa bilirubin, jaundice, matenda osokoneza bongo,
• Mawonekedwe a thupi lawo: chiwonetsero cha eosinophilia, urticaria, mawonekedwe a anaphylactoid, dermatitis, pruritus, zidzolo,
• Musculoskeletal system: kusintha kwa ma neuromuscular conduction,
• Zina: kupambana.

Contraindication

Mankhwalawa sayenera kufotokozeredwa motere:

• Kukhudzidwa kwambiri ndi mankhwala aliwonse
• Kuchepetsa
• Kukhalapo kwa matenda achilengedwe obadwa nawo,
• Mphumu ndi bronchial,
• Zaka zochepera zaka 3 (kulemera kwa thupi la mwana sikuyenera kukhala kosakwana 25 kg),
• Nthawi yamimba
• Amatulutsa pamaso pa chilonda
• Myasthenia gravis

Chenjezo liyenera kuthandizidwa popereka mankhwala kwa odwala okalamba, komanso pakakhala kulephera kwa impso ndi chiwindi.

Malangizo apadera

Pseudomembranous colitis imatha kuonekera onse mukamalandira chithandizo komanso kutha kwa chithandizo. Zotsatira zoyipa zimawonekera mu mawonekedwe am'mimba, leukocytosis, malungo ndi kupweteka m'mimba (nthawi zina, ndowe zimakhala ndi ntchofu ndi magazi).

Zikakhala choncho, ndikwaniritsa kuletsa mankhwalawo ndikupereka ma ion-exchange resins mu mawonekedwe a colestipol ndi colestyramine. Milandu yayikulu ya matendawa, ndikofunikira kulipiritsa kutayika kwa madzi, mapuloteni ndi ma electrolyte ndikusankha metronidazole ndi vancomycin.

Pa mankhwalawa, amadzipaka mankhwala okhawo omwe amalepheretsa matumbo kuyenda.

Chitetezo pakugwiritsa ntchito mankhwalawa Clindamycin m'magulu a ana sichinakhazikitsidwe mokwanira, chifukwa chake, ndi chithandizo cha nthawi yayitali mu ana, mawonekedwe a magazi ndi magwiridwe antchito a chiwindi amayenera kuyang'aniridwa pafupipafupi.

Mukamamwa mankhwalawa muyezo waukulu, muyenera kuwongolera kuchuluka kwa mankhwalawa m'magazi.

Odwala omwe akuvutika kwambiri ndi vuto la chiwindi ayenera kuyang'anira ntchito ya chiwindi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Clindamycin ikupezeka mu mitundu ili:

• Vaginal kirimu 2% - kuchokera oyera ndi oterera wowoneka bwino kapena achikasu mpaka oyera, onunkhira wopanda mphamvu (20 g ndi 40 g mu machubu a zotayidwa, 1 chubu lililonse lokhala ndi wofunsira),
• Makapisozi a Gelatin - wokhala ndi kapu wofiirira komanso pepala lofiirira, saizi Na. 1, zomwe zili m'mabotolowo ndi ufa kuyambira wachikasu mpaka zoyera pakhungu (ma PC 8. M'matumba, matuza awiri mumapaketi a makatoni, ma PC 6. M'matumba awiri, awiri 5 ndi matuza 10 m'mathumba okhala ndi makatoni),
• Njira yothetsera jakisoni (jekeseni wamitsempha)

Kapangidwe ka 100 g kirimu kirimu ndi:

• Zogwira ntchito: clindamycin (munthawi ya phosphate) - 2 g,
• Zothandiza monga: sodium benzoate, macrogol-1500 (polyethylene oxide-1500), mafuta a castor, emulsifier No. 1, propylene glycol.

The kapangidwe 1 kapisozi zikuphatikiza:

• Zogwira ntchito: clindamycin (mu mawonekedwe a hydrochloride) - 0,15 g,
• Zothandiza pazinthu: wowonda chimanga, talc, lactose monohydrate, magnesium stearate,
• Kuphatikizidwa kwa chivundikiro cha kapisozi: utoto wakuda wa diamondi (E151), utoto wa azorubine (E122), utoto wa quinoline chikasu (E104), utoto wa ponce Ponceau 4R (E124), gelatin,
• Mapangidwe a thupi la kapisozi: utoto wakuda wa diamondi (E151), utoto wa azorubine (E122), gelatin.

The 1 ml ya yankho la jakisoni ndi:

• Zogwira ntchito: clindamycin (munthawi ya phosphate) - 0,15 g,
• Zinthu zothandiza: edetate disodium, benzyl mowa, madzi a jakisoni.

Mlingo ndi makonzedwe

Wodwala matenda oopsa a akulu ndi ana azaka 15 (wolemera 50 makilogalamu kapena kupitilira apo), Clindamycin amatchulidwa 1 kapisozi (150 mg) kanayi pa tsiku pafupipafupi. Mu matenda oopsa, kumwa kamodzi kumatha kuwonjezeredwa ndi katatu.

Ana ang'onoang'ono nthawi zambiri amaperekedwa:

• Zaka 8-12 (kulemera - 25-25 makilogalamu): matenda oopsa - kanayi pa tsiku, kapisozi 1, pazipita tsiku - 600 mg,
• Zaka 12-15 (kulemera - 40-50 makilogalamu): kuchuluka kwa matendawa ndi katatu katatu patsiku, kapisozi 1, matenda oopsa - katatu pa tsiku, makapisozi 2, tsiku lililonse - 900 mg

Mulingo woyenera wa akuluakulu kuti mu makonzedwe amkati ndi mtsempha wa magazi ndi 300 mg kawiri pa tsiku. Mankhwalawa matenda opatsirana kwambiri, 1.2-2.7 g patsiku amalembedwa, amagawidwa majekeseni atatu. Kukula kwa makulidwe amodzi a mankhwala opitilira 600 mg osavomerezeka. Mulingo umodzi wambiri wa mtsempha wa mtsempha wa magazi ndi 1.2 g pa ola limodzi.

Kwa ana a zaka zitatu, Clindamycin ndi mankhwala a 15-25 mg / kg patsiku, amagawika magawo atatu ofanana. Pochizira matenda oopsa, tsiku lililonse mlingo umatha kuonjezeredwa mpaka 25-40 mg / kg ndi pafupipafupi momwe mungagwiritsire ntchito.

Odwala kwambiri aimpso ndi / kapena chiwindi kulephera, ntchito mankhwala osokoneza bongo osachepera maola 8, kusintha kwa mlingo sayenera.

Kwa mtsempha wa mtsempha wa magazi, clindamycin iyenera kuchepetsedwa ndikuikidwa kosaposa 6 mg / ml. Njira yothetsera vutoli ndi jekeseni wamitseko kwa mphindi 10-60.

Jekeseni wamkati ali osavomerezeka.

Monga zosungunulira, mutha kugwiritsa ntchito mayankho: 0.9% sodium chloride ndi 5% dextrose. Kukonzekera ndi kutalika kwa kulowetsedwa kumalimbikitsidwa kuchitidwa molingana ndi chiwembu (mlingo / kuchuluka kwa zosungunulira / nthawi ya kulowetsedwa):

• 300 mg / 50 ml / 10 mphindi
• 600 mg / 100 ml / mphindi 20
• 900 mg / 150 ml / mphindi 30
• 1200 mg / 200 ml / mphindi 45.

Vaginal kirimu imagwiritsidwa ntchito kudzera m'mitsempha. Mulingo umodzi - wowerengeka wowonjezera zonona (5 g), makamaka asanagone. Kutalika kwa ntchito ndi masiku 3-7 tsiku lililonse.