Amikacin sulfate (Amikacini sulfas)

The ufa wopangira njira yofunira kudzera m'mitsempha kapena makonzedwe amkati amakhala oyera nthawi zonse kapena pafupi ndi oyera, a hygroscopic.

1000, 500 kapena 250 mg wa ufa wotere mu botolo la 10 ml, 1, 5, 10 kapena 50 mabotolo oterowo mumapepala.

Njira yothetsera vutoli (intravenous, intramuscular) nthawi zambiri imakhala yomveka bwino, yopaka mtundu kapena yopanda utoto.

Njira yotulutsidwa m'mapiritsi mulibe.

Mankhwala

Amikacin (dzina mu Chinsinsi ku Latin Amikacin) ndiwopanga aminoglycoside (mankhwala) kuchitapo kanthu pamagulu osiyanasiyana opha tizilombo toyambitsa matenda. Zinthu bactericidal machitidwe. Imalowera mwachangu kudzera pa khoma la pathogen, ndipo imangiriza zolimba za 30S ribosome ya cell bacterial ndikulepheretsa mapuloteni a biosynthesis.

Zotsatira zomwe zimapangitsa kuti tizilombo toyambitsa matenda tisamayende bwino: Salmonella spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Shigella spp., Serratia spp., Providencia stuartii.

Yogwira ntchito motsutsana ndi mabakiteriya okhala ndi gramu: Staphylococcus spp. (kuphatikiza zovuta zophatikiza ndi methylene), zovuta zingapo Streptococcus spp.

Mabakiteriya a Aerobic sazindikira amikacin.

Pharmacokinetics

Pambuyo pamakonzedwe a intramuscular, amathandizira mwachangu mu buku lathunthu lomwe limayendetsedwa. Imalowa mu minofu yonse komanso kudzera mu zotchinga za histoeticological. Kumangiriza kwa mapuloteni amwazi ndi mpaka 10%. Osati zogwirizana ndi kusinthika. Imafufutidwa kudzera mu impso osasinthika. Kuthetsa theka-moyo wafika 3 maola.

Zisonyezo Amikacin

Zisonyezero zakugwiritsira ntchito Amikacin ndimatenda opatsirana omwe amayamba chifukwa cha gram alibe tizilombo (kugonjetsedwa ndi amphan, kanamycin kapena sisomycin) kapena munthawi yomweyo michere yama gramu komanso yama gramu-negative:

• matenda opuma (chibayo, kuphatikizika kwa pleura, bronchitis, mapapo),
• sepsis,
• zopatsirana endocarditis,
• matenda aubongo (kuphatikiza meningitis),
• matenda a kwamkodzo thirakiticystitis, pyelonephritis, urethritis),
• matenda am'mimba (kuphatikizapo peritonitis),
• matenda a minofu yofewa, minofu yolowerera komanso khungu lamafuta oyera (kuphatikiza zilonda zam'mimba, kutentha, zironda),
• matenda a hepatobiliary dongosolo,
• zotupa ndi mafupa (kuphatikiza osteomyelitis),
• mabala opatsirana
• matenda opatsirana a postoperative.

Zotsatira zoyipa

• Zotsatira zoyipa: malungo, zotupa, kuyabwa, angioedema.
• Matumbo dongosolo hyperbilirubinemiakuchitapo kanthu hepatic transaminases, nseru, kusanza.
• Zotsatira za hematopoietic system: leukopenia, granulocytopenia, kuchepa magazi, thrombocytopenia.
• Zochokera ku dongosolo lamanjenje: kusintha kwa kufalikira kwamitsempha, kugona, mutu, kusamva kwa makutu (ugonthi ndikotheka), kusokonezeka kwa zida za vestibular.
• Kuchokera ku genitourinary system: proteinuria, oliguria, micromaturiakulephera kwa aimpso.

Malangizo a Amikacin (Njira ndi Mlingo)

Jekeseni malangizo a Amikacin ogwiritsira ntchito amakulolani kuperekera mankhwala kudzera mu mnofu kapena kudzera m'mitsempha.

Fomu ya mankhwalawa monga mapiritsi olankhulira pakamwa kulibe.

Pamaso jakisoni, ndikofunikira kuchita mayeso a intradermal kuti mumve mankhwala, ngati palibe zotsutsana pazomwe zimagwira.

Amikacin komanso motani? Njira yothetsera mankhwalawa imakonzedwa musanayambe makonzedwe a 2-3 ml a madzi osungunuka omwe amapangira jekeseni wazinthu zamkati. Njira yothetsera vutoli imaperekedwa mukangokonzekera.

Mlingo wokhazikika kwa akulu ndi ana kuyambira mwezi umodzi ndi 5 mg / kg katatu patsiku kapena 7.5 mg / kg kawiri pa tsiku kwa masiku 10.

Mlingo wapamwamba wa tsiku lililonse kwa akulu ndi 15 mg / kg, wogawidwa pawiri. Mu milandu yoopsa kwambiri komanso matenda oyambitsidwa ndi Pseudomonas, mlingo wa tsiku ndi tsiku umagawika m'magulu atatu. Mlingo wapamwamba kwambiri womwe umaperekedwa kwa njira yonse ya chithandizo sayenera kupitilira magalamu 15.

Makanda obadwa kumene amasankhidwa woyamba 10 mg / kg, kenako amasamukira ku 7.5 mg / kg kwa masiku 10.

Chithandizo cha achire nthawi zambiri chimachitika mkati mwa masiku 1-2, ngati pambuyo pa masiku atatu ndi theka chiyambi cha mankhwala sichinawonedwe, ziyenera kusiyidwa ndipo njira zamankhwala zimasinthidwa.

Bongo

Zizindikiro: ataxiakusamva chizungulire, ludzu, matenda a mkodzo, kusanza, nseru, tinnitus, kulephera kupuma.

Chithandizo: Kuyimitsa matenda a kufalikira kwa minofu hemodialysismchere calcium, anticholinesterase othandizira, Makina mpweya wabwinokomanso chithandizo chamankhwala.

Kuchita

Mphamvu ya Nephrotoxic ndiyotheka ndikugwiritsa ntchito vancomycin, amphotericin B, methoxyflurane,Othandizira osiyanasiyana a X-ray, mankhwala osapweteka a antiidal enflurane, cyclosporine, cephalotin, cisplatin, polymyxin.

Mphamvu ya Ototoxic ndiotheka kugwiritsa ntchito ethaconic acid, furosemide, cisplatin.

Akaphatikizidwa ndi penicillin (ndi kuwonongeka kwa impso) mphamvu yotsatsira imachepa.

Mukamagawana ndi neuromuscular blockers ndi ethyl ether kuthekera kwa kupuma kwamphamvu kumawonjezereka.

Amikacin saloledwa kukhala osakanikirana ndi cephalosporins, penicillins, amphotericin B, erythromycin, chlorothiazide, heparin, thiopentone, nitrofurantoin, tetracyclines, mavitamini a gulu B, ascorbic acid ndi potaziyamu mankhwala enaake.

Amikacin analogues

Analogs: Amikacin sulfate (ufa wothira) Ambiotic (jekeseni) Amikacin-Kredofarm (ufa wothira) Loricacin (jekeseni) Flexelite (yankho la jakisoni).

Chifukwa cholowetsedwa bwino ndi onse aminoglycosides Ma analogi a Amikacin sapezeka m'matumbo a mapiritsi.

Ana osakwana zaka 6 amafunsidwa koyamba 10 mg / kg, ndiye 7.5 mg / kg kawiri pa tsiku.

Zisonyezero Amikacin sulfate

Matenda owopsa omwe amayambitsidwa ndi tizilombo tating'onoting'ono ta mankhwalawa: sepsis, meningitis, peritonitis, septic endocarditis, matenda opatsirana ndi zotupa za kupuma kwamatenda (chibayo, kuperekera mphamvu kwa magazi, kuperewera kwa m'mapapo), matenda a impso komanso kwamikodzo; cystitis), kachilombo koyatsira, etc.

Mlingo ndi makonzedwe

Mu / m kapena mu / mu (dontho). Akuluakulu ndi achinyamata omwe ali ndi vuto lachilendo - 15 mg / kg / tsiku (5 mg / kg maola 8 aliwonse kapena 7.5 mg / kg maola 12 aliwonse), ana omwe ali ndi mlingo umodzi woyamba - 10 mg / kg, ndiye 7.5 mg / kg maola 12 aliwonse. Mlingo wambiri watsiku ndi tsiku ndi 1.5 g, mlingo wonse wa maphunzirowo suwaposa g 15. Ngati palibe zotsatira, amasinthana ndi mankhwalawa kwa masiku asanu. Kutalika kwa chithandizo ndi masiku 7-10.

Odwala omwe ali ndi vuto la aimpso amafunikira kuchepetsedwa kwa mlingo kapena kuwonjezeka pakatikati pa mabungwe popanda kusintha mlingo umodzi. Mlingowu umawerengeredwa ndi njira: serum creatinine ndende x 9. Mlingo woyamba wa odwala omwe ali ndi vuto la aimpso ndi 7.5 mg / kg, pakuwerengera Mlingo wotsatira mugwiritse ntchito njira: Cl creatinine (ml / min) x yoyamba mlingo (mg) / Cl creatinine zabwinobwino (ml / mphindi).

Njira zopewera kupewa ngozi

Odwala omwe ali ndi hypersensitivity ena aminoglycosides, pamakhala mavuto ena omwe amikacin angayambike. Ngati thupi lanu lisagwedezeka, mankhwalawo amathetsedwa ndipo diphenhydramine, calcium chloride, zinalembedwera. Kuti apewe zovuta, tikulimbikitsidwa kugwiritsa ntchito mankhwalawa motsogozedwa ndi impso, kumva ndi vetibular ntchito (osachepera 1 pa sabata). Ziwopsezo zamavuto amtsempha komanso makosi zimawonjezeka ndi kulephera kwa impso. The mwayi chitukuko cha oto- ndi nephrotoxicity kumawonjezera ndi ntchito kwa nthawi yayitali komanso waukulu. Pazizindikiro zoyambirira za kuphatikizika kwa ma neuromuscular conduction, ndikofunikira kuyimitsa makonzedwe a mankhwalawo ndipo nthawi yomweyo jambulani yankho la calcium chloride kapena sc solution ya proserin ndi atropine, ngati kuli kotheka, wodwalayo amapatsidwa mphamvu yopumira.

Malangizo apadera

Musanagwiritse ntchito mankhwalawa, ndikofunikira kudziwa kuthamanga kwa maantibayotiki kwa antibayotiki (gwiritsani ntchito ma disks okhala ndi 30 μg ya amikacin sulfate). Ndi mainchesi mainchesi 17 mm kapena kupitilira apo, ma microorganism amaonedwa kuti ndi otsika, 15-16 mm ndiwofatsa, ndipo osachepera 14 mm ndi okhazikika. Mankhwala, zomwe zimagwiritsidwa ntchito m'magazi m'magazi ziyenera kuyang'aniridwa (ndende siyenera kupitilira 30 μg / ml).

Kwa makina a i / m, yankho lomwe lidakonzedwa kale kuchokera ku ufa wa lyophilized ndikuwonjezera kwa 2-3 ml ya madzi a jekeseni pazomwe zili mu vial (250 mg kapena 500 mg ya ufa) amagwiritsidwa ntchito. Kwa iv makonzedwe, sinthani mu 200 ml ya shuga 5% kapena mayankho a 0.9% sodium chloride. Kuchuluka kwa amikacin mu njira yothetsera utsogoleri wa iv sayenera kupitirira 5 mg / ml.

Contraindication

Hypersensitivity (kuphatikizapo mbiri ya aminoglycosides ena), minyewa yamitsempha, kukanika kwaimpso ndi azotemia ndi uremia, kutenga pakati. Myasthenia gravis, parkinsonism, botulism (aminoglycosides angayambitse kuphwanya kwa mitsempha, yomwe imabweretsa kufooka kwa minofu yamafupa), kufooka kwa thupi, kulephera kwa impso, nthawi yaubongo, kusakhazikika kwa ana, ukalamba, kuyamwa.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

V / m, iv (mu ndege, kwa 2 min kapena kukapumira), 5 mg / kg maola 8 aliwonse kapena 7.5 mg / kg maola 12 aliwonse, mabakiteriya amatenda a kwamkodzo thirakiti (losavuta) - 250 mg maola 12 aliwonse, Pambuyo pa gawo la hemodialysis, mlingo wowonjezera wa 3-5 mg / kg ukhoza kutumikiridwa. Mlingo waukulu wa akuluakulu ndi mpaka 15 mg / kg / tsiku, koma osapitirira 1.5 g / tsiku kwa masiku 10.

Kutalika kwa mankhwalawa ndi / m'mawu oyamba ndi masiku 3-7, ndi / m - masiku 7-10.

Kwa ana akhanda asanabadwe, mlingo woyambirira ndi 10 mg / kg, ndiye 7.5 mg / kg maola 18-18 aliwonse, kwa ana akhanda, mlingo woyambira ndi 10 mg / kg, ndiye 7.5 mg / kg maola 12 aliwonse kwa masiku 7-10.

Odwala aimpso kulephera amafuna kukonzanso mlingo.

Odwala omwe amawotcha angafunike mlingo wa 5-7.5 mg / kg maola 6 aliwonse chifukwa cha kufupika T1 / 2 (maola 1-1,5) mwa odwalawa.

Mwa kuyang'anira kwa i / m, yankho lomwe lidakonzedwa kuchokera ku ufa wa lyophilized ndikuwonjezera kwa 2-3 ml ya madzi a jekeseni wazomwe zili mu vial (0,25 kapena 0,5 g wa ufa) umagwiritsidwa ntchito. Kwa i / v makonzedwe, njira zomwezi zimagwiritsidwa ntchito ngati i / m, mutazithira ndi 200 ml ya 5% dextrose solution kapena 0,9% NaCl yankho. Kuchuluka kwa amikacin mu njira yothetsera utsogoleri wa iv sayenera kupitirira 5 mg / ml.

Zotsatira za pharmacological

Semi-yopanga yotakata sipekitiramu yothandizira, bactericidal. Mwa kumangiriza ku 30un subunit ya ribosomes, imalepheretsa mapangidwe azovuta kuyendetsa ndi mthenga RNA, imalepheretsa kuphatikizika kwa mapuloteni, ndikuwonongeranso ma cell bacteria.

Wogwira kwambiri motsutsana ndi aerobic gram-hasi tizilombo - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp., Shigella spp., Michere ina yama gramu-Staphylococcus (kuphatikizapo kugonjetsedwa ndi penicillin, ena cephalosporins),

wogwira mtima motsutsana ndi Streptococcus spp.

Ndi munthawi yomweyo makonzedwe a benzylpenicillin, imakhala ndi mgwirizano pakulimbana ndi Enterococcus faecalis tizilombo ta.

Zosakhudzana ndi anaerobic tizilombo.

Amikacin sataya ntchito mothandizidwa ndi ma enzyme omwe amachititsa kuti ena azikhala aminoglycosides, ndipo amatha kukhalabe olimbana ndi mavuto a Pseudomonas aeruginosa osagwirizana ndi tobramycin, gentamicin ndi netilmicin.

Mankhwala ofanana:

• Mapiritsi a Augmentin (Augmentin)
• Augmentin Powder pakuyimitsidwa pakamwa
• Orzipol (ORCIPOL) mapiritsi amlomo
• Dioxidin (Dioxydin) Mouthwash
• Tsifran OD (Cifran OD) mapiritsi a Oral
• Gentamicin (Gentamicin) jekeseni
• Amoxicillin Sandoz (Amoxicillin Sandoz) Mapiritsi
• Ufa wa Augmentin EU (Augmentin ES) yankho la pakamwa
• Sumamed Aerosol
• Hiconcil Capsule

** Maupangiri a Mankhwala ndi a zidziwitso zokha. Kuti mumve zambiri, chonde onani zomwe akupanga. Osadzilimbitsa nokha, musanayambe kugwiritsa ntchito Amikacin Sulfate, muyenera kufunsa dokotala. EUROLAB sikuti ali ndi vuto pazotsatira zomwe zimadza chifukwa chogwiritsa ntchito chidziwitso chomwe chatumizidwa pa tsamba. Zomwe zili patsamba lililonse sizilowa m'malo mwa upangiri waudokotala ndipo sizingakhale chitsimikizo cha mankhwala.

Kodi mumakondwera ndi Amikacin Sulfate? Kodi mukufuna kudziwa zambiri kapena mukuyenera kukaonana ndi dokotala? Kapena mukufuna kuyesedwa? Mutha kutero pangana ndi adokotala - Euro yachipatala labu nthawi zonse pantchito yanu! Madotolo abwino amayeserera, kukulangizani, kukupatsani chithandizo choyenera ndikupanga matenda. Mukhozanso Itanani dokotala kunyumba. Chipatala cha Euro labu tsegulani kwa inu nthawi yonse yoyandikira.

** Tcheru! Zomwe zawonetsedwa mu bukhuli zamankhwala ndizothandiza akatswiri azachipatala ndipo siziyenera kukhala chifukwa chodzidziwira nokha. Malongosoledwe a mankhwala Amikacin sulfate amaperekedwa kuti awonetsetse ndipo sanapangidwe kuti aikidwe popanda kulandira dokotala. Odwala amafunikira upangiri waluso!

Ngati mukufunabe mankhwala ndi mankhwala ena aliwonse, mafotokozedwe awo ndi malangizo ogwiritsira ntchito, chidziwitso cha kapangidwe ndi mawonekedwe amamasulidwe, zikuwonetsa ntchito ndi zovuta zake, njira zogwiritsira ntchito, mitengo ndi kuwunika kwa mankhwala, kapena kodi muli ndi mafunso ena ndi malingaliro - tilembereni, tiyesetsa kukuthandizani.

Zotsatira zoyipa

Pogwiritsa ntchito nthawi yayitali kapena mankhwala a amikacin sulfate amatha kukhala ndi oto- komanso nephrotoxic. Mphamvu ya ototoxic ya amikacin sulfate imawonetsedwa mwa njira yochepetsera khutu (kuchepa kwa kuzindikira kwa tans apamwamba) zamavuto a vestibular apparatus (chizungulire). Ziwopsezo zamavuto amtsempha komanso makosi zimawonjezeka ndi kulephera kwa impso. Mphamvu ya nephrotoxic ya amikacin sulfate imadziwika ndi kuwonjezeka kwatsalira a seramu nitrogen, kuchepa kwa creatine

nthawi zambiri zimasinthidwa. Pofuna kupewa zovuta komanso kuchepetsa kuchuluka kwa chitukuko, mankhwalawa amathandizidwa kuti azigwiritsidwa ntchito motsogozedwa ndi impso, makutu ndi ntchito za vetibular (kamodzi pa sabata).

Njira yovuta kwambiri ndi ma neuromuscular blockade. Limagwirira izi ali pafupi ndi zochita za antidepolarizing mtundu minofu omasuka. Pazizindikiro zoyambirira za neuromuscular conduction blockade, ndikofunikira kuyimitsa makonzedwe a amikacin sulfate ndipo nthawi yomweyo perekani yankho la calcium chloride kapena subcutaneous yankho la proserin ndi atropine. Ngati ndi kotheka, wodwalayo amasinthidwira kupuma kolamulira.

Mukamagwiritsa ntchito amikacin sulfate, thupi lanu siligwirizana. (Zotupa pakhungu, kutentha thupi, mutu, ndi zina). Zikaonekera, mankhwalawo amathetsedwa ndipo mankhwala amayamba kufooketsa (diphenhydramine, calcium chloride, etc.). Mothandizidwa ndi mankhwala opha maantibayotiki, kupezeka kwa phlebitis ndi periphlebitis ndikotheka.

Mafunso, mayankho, ndemanga pa mankhwala a Amikacin sulfate

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga.Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.