Zotsatira za kugwiritsa ntchito Amikacin 1000 mg ndi prostatitis

Mankhwalawa amapangidwa ngati ufa woyera, kuchokera pamenepo ndikofunikira kukonzekera yankho la intramuscular and intravenous management.

Zomwe zimagwira ndi amikacin sulfate, pomwe botolo limodzi limatha kukhala 1000 mg, 500 mg kapena 250 mg. Zothandiza zothandizidwanso zimapezekanso: madzi, disodium edetate, sodium hydrogen phosphate.

Zotsatira za pharmacological

Mankhwalawa ndi anti-spectrum antiotic. Mankhwala ali ndi antibacterial, amawononga mitundu ya mabakiteriya osagwirizana ndi cephalosporins, amawononga ma membala awo a cytoplasmic. Ngati benzylpenicillin adayikidwa pamodzi ndi jakisoni, zimayenderana ndi zovuta zina. Mankhwalawa samakhudza ma anaerobic tizilombo.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amapezeka mu mawonekedwe a ufa, pomwe yankho limakonzekera jakisoni wamitsempha ndi mtsempha. Ndi mafuta okhala ndi mtundu wa hybroscopic wa microcrystalline wokhala ndi zonunkhira omwe amaperekedwa m'mabotolo 10 a galasi omveka bwino. Vial iliyonse imakhala ndi amikacin sulfate (1000 mg). Mabotolo 1 kapena asanu amayikidwa pabokosi lamakhadi okhala ndi malangizo.

Pharmacokinetics

Pambuyo jakisoni wa mu mnofu, mankhwalawa amatengeka 100%. Imalowa m'matumbo ena. Mpaka 10% imamangiriza kumapuloteni amwazi. Kusintha mthupi sikumawululidwa. Amayamwa ndi impso zosasinthika pafupifupi maola atatu. The kuchuluka kwa amikacin mu madzi am`magazi amakhala pazipita maola 1.5 pambuyo jekeseni. Kuchotsera kwina - 79-100 ml / min.

Zomwe zimagwira ndi amikacin sulfate, pomwe botolo limodzi limatha kukhala 1000 mg, 500 mg kapena 250 mg.
Amikacin ali ndi antibacterial, amawononga mitundu ya mabakiteriya osagwirizana ndi cephalosporins, amawononga ma membala awo a cytoplasmic.
Mankhwalawa amapangidwa ngati ufa woyera, kuchokera pamenepo ndikofunikira kukonzekera yankho la intramuscular and intravenous management.

Mankhwala

Amikacin ali ndi bactericidal. Mphamvu yogwira imalumikizana ndi 30S subunits ya ribosomes ndikuletsa mapangidwe a matrix ndi ma RNA maofesi. Maantibayotiki amalepheretsa kupanga mapuloteni omwe amapanga cytoplasm ya cell bacteria. Mankhwala amagwira ntchito motsutsana:

• Bakiteriya wa a grob-negative aerobic (pseudomonas, Escherichia, Klebsiella, serration, zosowa, Enterobacter, Salmonella, Shigella),
• Tizilombo toyambitsa matenda a gramu (staphylococci, kuphatikiza tizilombo ta penicillin ndi 1st cephalosporins).

Zodziwikiratu zosiyanasiyana za amikacin zili ndi:

• streptococci, kuphatikiza zovuta za hemolytic,
• fecal enterococcus (mankhwalawa ayenera kuperekedwa limodzi ndi benzylpenicillin).

Mphamvu ya mankhwalawa sigwira mabakiteriya a anaerobic ndi majeremusi okhudzana ndi intracellular. Maantibayotiki sawonongedwa ndi ma enzyme omwe amachepetsa zochitika za aminoglycosides ena.

Zowonetsa ntchito Amikacin 1000 mg

Zisonyezero zakukhazikitsidwa kwa mankhwalawa ndi:

• matenda opatsirana a kupuma dongosolo (chibayo, kufalikira kwa chifuwa, purulent pleurisy, pulmonary abscess),
• septicemia yoyambitsidwa ndi mabakiteriya ozindikira amikacin,
• mabakiteriya owononga thumba la mtima,
• matenda opatsirana a mitsempha (meningitis, meningoencephalitis),
• matenda am'mimba (cholecystitis, peritonitis, pelvioperitonitis),
• matenda opatsirana komanso otupa a kwamikodzo (kutupa kwa impso ndi chikhodzodzo, zotupa za urethra),
• zotupa za purulent zamankhwala ofewa (zotupa, zotupa zomwe zimayambitsa matendawa komanso kupindika kwa herpetic, zilonda zam'mimba zam'mimba zosiyanasiyana, pyoderma, phlegmon),
• zotupa mu ziwalo za m'chiuno (prostatitis, cervicitis, endometritis),
• zotupa zamafupa ndi ma cartilage (septic nyamakazi, osteomyelitis),
• zovuta zaoperative zokhudzana ndi kulowa kwa mabakiteriya.

Zinthu Zowonetsedwa

Zambiri Zogulitsa

• Mlingo: 1000 mg
• Kutulutsa Fomu: ufa pokonzekera yankho la d / in / in and / m koyambitsa Chithandizo chogwira: ->
• Kuyika: fl.
• Wopanga: Synthesis OJSC
• Zomera Zopanga: Synthesis (Russia)
• Zogwira ntchito: amikacin

Ufa pakukonzekera yankho la mtsempha wa magazi amkati ndi mu mnofu - 1 vial:

Mphamvu yogwira: Amikacin (munthawi ya sulfate) 1 g.

Botolo la 1000 ml, chidutswa chimodzi mu paketi ya makatoni.

The ufa pakukonzekera njira yothetsera kuphatikizira kwamitsempha yama cell oyera kapena pafupifupi oyera ndi a hygroscopic.

Pambuyo pa kayendetsedwe ka i / m, imayamwa mwachangu komanso mokwanira. Cmax mu madzi am`magazi ndi i / m makonzedwe pa 7.5 mg / kg - 21 μg / ml, pambuyo mphindi 30 iv kulowetsedwa pa mlingo wa 7.5 mg / kg - 38 μg / ml. Pambuyo mu mnofu jakisoni wa Tmax - pafupifupi 1.5 maola

Ambiri achire ndende ndi iv kapena mu mnofu makonzedwe amasungidwa kwa maola 10-12.

Kumangiriza kwa mapuloteni a plasma ndi 4-11%. Vd mu akulu - 0,26 l / kg, mwa ana - 0,2-0.4 l / kg, mwa akhanda: pa zaka zosakwana 1 sabata ndipo masekeli osakwana 1500 g - mpaka 0,68 l / kg, wazaka zosakwana sabata 1 ndikulemera kuposa 1500 g - mpaka 0,58 l / kg, odwala ndi cystic fibrosis - 0,3-0.39 l / kg.

Imagawidwa bwino mu madzi am'madzi am'mimba (zomwe zimapezeka mu ma abscesses, pleural effusion, ascitic, pericardial, synovial, lymphatic and peritoneal fluid), zimapezeka kwambiri poyerekeza mkodzo, m'munsi - mu ndulu, mkaka wamawere, kuseka kwakumaso kwa diso, kubisala kwa sponchial zakumwa. Imalowerera mu ziwalo zonse za thupi momwe imadziunjikira mwachisangalalo, kutsekemera kwakukulu kumawonedwa mu ziwalo zam'magazi abwino: mapapo, chiwindi, myocardium, ndulu, komanso impso, momwe zimadziunjikira mu cortical, kutsika kozama - minofu, adipose minofu ndi mafupa .

Amikacin akapatsidwa mankhwala olimbitsa Mlingo woyenera (okhazikika) samalowa mu BBB, ndikutupa kwa mankhwalawa, kupezeka kwamankhwala kumawonjezeka pang'ono. Mu makanda, chidwi chachikulu m'madzimadzi a cerebrospinal chimatheka kuposa akuluakulu. Imalowa kudzera mu chotchinga chachikulu: chopezeka m'magazi a mwana wosabadwayo ndi madzi amniotic.

T1 / 2 mwa achikulire - maola 2-4, mwa ana obadwa kumene - maola 5-8, mwa ana okulirapo - maola 2 - 2 mpaka 5. Final T1 / 2 - maola opitilira 100 (kumasulidwa ku malo obisalamo a intracellular).

Imadziwitsidwa ndi impso ndi kusefera kwa glomerular (65-94%), yosasinthika. Kuchotsera kwina - 79-100 ml / min.

Pharmacokinetics mu milandu yapadera yamankhwala.

T1 / 2 mwa anthu akuluakulu omwe ali ndi vuto la impso zimasiyanasiyana malinga ndi kuwonongeka kwapafupipafupi - mpaka maola 100, odwala omwe ali ndi cystic fibrosis - maola 1-2, odwala omwe atentha ndi matenda oopsa, T1 / 2 amatha kufupikirapo kuposa pafupifupi chifukwa chovomerezeka .

Amachotseredwa pa hemodialysis (50% mu maola 4-6), peritoneal dialysis siyothandiza (25% mu maola 48-72).

Semi-yopanga yotakata sipekitiramu yoletsa kukonzekera gulu la aminoglycosides, amachita bactericidal. Mwa kumangiriza ku 30un subunit ya ribosomes, imalepheretsa mapangidwe azovuta kuyendetsa ndi mthenga RNA, imalepheretsa kuphatikizika kwa mapuloteni, ndikuwonongeranso nembanemba ya ma cytoplasmic a bacteria.

Wogwira ntchito kwambiri motsutsana ndi tizilombo tosiyanasiyana ta aerobic gram-hasi: Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp., Shigella spp. (kuphatikizapo kugonjetsedwa ndi penicillin, ena cephalosporins). Yogwira ntchito motsutsana ndi Streptococcus spp.

Ndi munthawi yomweyo makonzedwe a benzylpenicillin, amawonetsa mgwirizano pakulimbana ndi Enterococcus faecalis tizilombo ta. Ma tizilombo a anaerobic amagwirizana ndi mankhwalawa. 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.

Maantibayotiki a gulu la aminoglycoside.

Mu / amikacin imayendetsedwa kwa mphindi 30-60 ngati ndi kotheka, ndi ndege.

Ngati vuto la kuwonongeka kwa aimpso, kuchepetsedwa kwa mlingo kapena kuwonjezeka kwapakati pakati pa kayendetsedwe ndikofunikira. Pankhani yowonjezereka pakadali pakati pa oyang'anira (ngati phindu la QC silikudziwika, komanso momwe wodwalayo alili), nthawi yapakati pakukhazikitsidwa kwa mankhwala imakhazikitsidwa ndi njira yotsatirayi:

Mwa iv (drip), mankhwalawa amathandizidwa kale ndi 200 ml ya 5% dextrose (glucose) kapena 0,9% sodium chloride solution. Kuchuluka kwa amikacin mu njira yothetsera utsogoleri wa iv sayenera kupitirira 5 mg / ml.

Nthawi (h) = seramu creatinine ndende × 9.

Ngati kuchuluka kwa seramu creatinine ndi 2 mg / dl, ndiye kuti mlingo umodzi wovomerezeka (7.5 mg / kg) uyenera kutumikiridwa maola aliwonse 18. Ndi kuchuluka kwakutali, gawo limodzi silinasinthidwe.

Ngati kuchepa kwa limodzi mlingo ndi dosing regimen, woyamba mlingo kwa odwala ndi aimpso kulephera ndi 7.5 mg / kg. Kuwerengera Mlingo wotsatira kumachitika potsatira njira zotsatirazi:

Mlingo wotsatira (mg), womwe umaperekedwa kwa maola 12 aliwonse = KK (ml / min) wodwala × mlingo woyambayo (mg) / KK ndi wabwinobwino (ml / min).

• Matenda opatsirana amathirakiti (bronchitis, chibayo, kupemphedwa kwam'mimba, zotupa zam'mapapo),
• sepsis
• septic endocarditis,
• Matenda a CNS (kuphatikizapo meningitis),
• matenda am'mimba, kuphatikizapo peritonitis,
• matenda a kwamkodzo thirakiti (pyelonephritis, cystitis, urethritis),
• matenda opatsirana oyipa a pakhungu ndi zimakhala zofewa (kuphatikiza zilonda zamatenda, zilonda zoyambitsidwa ndi zilonda zamphamvu zamayendedwe osiyanasiyana),
• biliary matenda opatsirana
• matenda am'mafupa ndi mafupa (kuphatikizira osteomyelitis),
• matenda opweteka
• matenda opatsirana.

• Auditory nerve neuritis,
• aakulu kulephera aimpso ndi azotemia ndi uremia,
• mimba
• Hypersensitivity pamagawo a mankhwala,
• Hypersensitivity kwa ena aminoglycosides m'mbiri.

Mochenjera, mankhwalawa amayenera kugwiritsidwa ntchito ngati myasthenia gravis, parkinsonism, botulism (aminoglycosides angayambitse kuphwanya kwa mitsempha, yomwe imapangitsa kufooka kwa minofu yamafupa), kusowa kwam'mimba, kulephera kwa impso, nthawi yammbuyo, makanda asanakwane, odwala okalamba, munthawi kuyamwa.

Odwala mu pakati ndi ana ochepera zaka 6.

Kuchokera mmimba dongosolo: nseru, kusanza, chiwindi ntchito (kuchuluka kwa hepatic transaminases, hyperbilirubinemia).

Kuchokera ku hemopoietic dongosolo: kuchepa magazi, leukopenia, granulocytopenia, thrombocytopenia.

Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: mutu, kugona, neurotoxic zotsatira (minyewa, kugona, dzanzi, kumva kugwedezeka, khunyu).

Kuchokera ku ziwalo zam'malingaliro: ototoxicity (kusowa kwa makutu, vuto lakumaso ndi labyrinth, kusamva kosagwirizana), zotsatira zoyipa pazida za vestibular (kuzindikira kusuntha, chizungulire, kusanza, kusanza).

Kuchokera kwamikodzo dongosolo: nephrotoxicity - mkhutu aimpso ntchito (oliguria, proteinuria, microcaluria).

Thupi lawo siligwirizana: zotupa pakhungu, kuyabwa, kutentha kwa khungu, kutentha thupi, edema ya Quincke.

Zomwe zimachitika m'deralo: kupweteka kwa malo a jakisoni, dermatitis, phlebitis ndi periphlebitis (yolamulira ndi iv).

Ndiosagwirizana ndimankhwala okhala ndi penicillin, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, mavitamini B ndi C, ndi potaziyamu chloride.

Mlingo waukulu wa akuluakulu ndi 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 osabereka, muyezo umodzi woyamba ndi 10 mg / kg, ndiye 7.5 mg / kg pa maola 18-24 aliwonse, kwa wakhanda ndi ana osakwana zaka 6, mlingo woyamba ndi 10 mg / kg, ndiye 7.5 mg / kg aliyense 12 h kwa masiku 7-10.

Pa kuyaka kwa kachilomboka, mlingo wa 5-7.5 mg / kg maola aliwonse a 4-6 ungafunikire chifukwa cha kufupika kwa T1 / 2 (maola 1-1,5) m'gululi.

Zokhudza poizoni - kutaya kwa makutu, ataxia, chizungulire, kusokonekera kwam'mimba, ludzu, kusowa chilimbikitso, kusanza, kusanza, kulira kapena kumva kutulutsa m'makutu, kulephera kwa kupuma.

Momwe mungatenge Amikacin-1000

Mankhwalawa amalowetsedwa m'thupi mothandizidwa ndi jakisoni. Muyenera kufunsa dokotala kuti akasankhe mitundu yoyenera ya mankhwala kapena werengani malangizo a mankhwalawo.

Musanayambe kugwiritsa ntchito, kuyesa kumvetsetsa kuyenera kuchitidwa. Chifukwa cha izi, maantibayotiki amatumizidwa pansi pakhungu.

Kwa ana ochepera mwezi umodzi ndi akulu, kusankha kwa mitundu iwiri ndikotheka: 5 mg pa kilogalamu imodzi ya kulemera kwa munthu katatu pa tsiku kapena 7.5 mg pa kilogalamu 1 ya kulemera kwa munthu kawiri pa tsiku. Njira ya mankhwala kumatenga masiku 10. Mlingo waukulu patsiku ndi 15 mg.

Sizoletsedwa kugwiritsa ntchito mankhwalawa potupa m'mitsempha yamagazi.
Amikacin amaletsedwa kuwonongeka kwambiri kwa impso.
Muyenera kufunsa dokotala kuti akasankhe mitundu yoyenera ya mankhwala.
Mankhwalawa amalowetsedwa m'thupi mothandizidwa ndi jakisoni.
Musanagwiritse ntchito mankhwalawa, ndikofunikira kuyesa kuyesa, chifukwa maantibayotiki amaperekedwa pansi pa khungu.
Njira ya mankhwala ndi Amikacin kumatenga masiku 10.

Kwa akhanda, makhwala azamankhwala azikhala osiyanasiyana. Choyamba, amapatsidwa 10 mg patsiku, kenako mlingo umachepetsedwa mpaka 7.5 mg patsiku. Musamachize ana osapitirira masiku 10.

Zotsatira zamankhwala othandizira komanso othandizira zimawonekera tsiku loyamba kapena lachiwiri.

Ngati patatha masiku 3-5 kuti mankhwalawo sanagwire ntchito monga amafunikira, muyenera kufunsa dokotala kuti musankhe mankhwala ena.

Matumbo

Munthu akhoza kukhala ndi nseru, kusanza, hyperbilirubinemia.

Muyenera kusamala mukamamwa mankhwalawa mukalamba.
Thupi lawo siligwirizana ndi mankhwalawa limadziwika ndi zotupa pakhungu.
Sitikulimbikitsidwa kuyendetsa galimoto ngati zotsatira zoyipa zadziwika: izi zitha kukhala zowopsa kwa woyendetsa ndi ena.

Malangizo apadera

Anthu ena ayenera kutsatira malamulo apadera a kumwa mankhwalawo.

Mankhwala amatha kuperekedwa kwa ana ngati phindu la mankhwalawo limaposa kuvulaza komwe kungachitike.
Mankhwalawa amawerengedwa kwa azimayi oyembekezera pokhapokha ngati mayi atenga mankhwalawo.
Mankhwala ndi oletsedwa pa mkaka wa m`mawere.

Kuchita ndi mankhwala ena

Pogwiritsa ntchito nthawi yomweyo ndi mankhwala ena, zotheka sizotheka. Ndikulimbikitsidwa kugwiritsa ntchito zodzola, njira zamagalasi olumikizana mosamala pakumwa.

Pogwiritsa ntchito mankhwalawa, tikulimbikitsidwa kugwiritsa ntchito zodzikongoletsera mosamala.
Ndi mankhwala osokoneza bongo ambiri, wodwalayo akumva ludzu.Ngati kuchuluka kwa mankhwalawa kumachitika, ambulansi iyenera kuyitanidwa.

Kuphatikiza komwe kumafunikira kusamala

Ndi cyclosporine, methoxyflurane, cephalotin, vancomycin, NSAIDs, gwiritsani ntchito mosamala, popeza mwayi wokhala ndi vuto laimpso ukuwonjezeka. Kuphatikiza apo, mutengedwe mosamala ndi ma loopture okweza, chisplatin. Kuopsa kwa zovuta kumakulira pamene mukumana ndi ma heentatic agents.

Kuyenderana ndi mowa

Ndi zoletsedwa kumwa mowa panthawi yamankhwala.

Analogs akupezeka monga yankho. Othandizira ogwira ntchito ndi Ambiotik, Lorikacin, Flexelit.

Ndi zoletsedwa kumwa mowa panthawi yamankhwala.
Analogue yogwira mankhwalawa ndi Loricacin.
Ndikosatheka kupeza mankhwala ngati sanalembedwe ndi dokotala.

Ndemanga za Amikacin 1000

Diana, wazaka 35, Kharkov: “Dokotala wa urologist ndiye adapereka mankhwalawa pochiza cystitis.Anatenga nthawi yomweyo mankhwala ena, wowerengeka azitsamba. Zinandithandiza mwachangu, ndinazindikira mpumulo kuyambira tsiku loyamba. Chipangizochi ndichothandiza komanso sichotsika mtengo. "

Dmitry, wazaka 37, Murmansk: “Anachiza mapapo ndi Amikacin. Mankhwala othamanga, othandiza, amathandizanso, ngakhale ndizosasangalatsa kupereka jakisoni kawiri pa tsiku. Zosangalatsa komanso zotsika mtengo. "