Kefsepim - malangizo a boma ogwiritsira ntchito

Zisonyezero zamankhwala Kefsepim ndi:
- chibayo (chochepa komanso chovuta) choyambitsidwa ndi Streptococcus pneumoniae (kuphatikizapo milandu yoyanjana ndi concomitant bacteremia), Pseudomonas aeruginosa, Klebsiella pneumoniae kapena Enterobacter spp,
- matenda amkodzo thirakiti (yovuta komanso yopanda zovuta),
- Matenda opatsirana pakhungu ndi minofu yofewa,
- zovuta zamkati mwa m'mimba (kuphatikiza ndi metronidazole) zomwe zimayambitsidwa ndi Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter spp.
- njira zopatsirana zomwe zimayambika motsutsana ndi maziko a chitetezo cha mthupi (mwachitsanzo, febrile neutropenia)
- kupewa matenda opaleshoni yam'mimba,

Zotsatira zoyipa

Kuchokera mmimba: kupukusa m'mimba, kusanza, kusanza, kudzimbidwa, kupweteka pamimba, dyspepsia,
Matenda a mtima: kupweteka kumbuyo kwa sternum, tachycardia,
Thupi lawo siligwirizana: kuyabwa, zotupa pakhungu, anaphylaxis, malungo
Pakati mantha dongosolo: mutu, kukomoka, kusowa tulo, paresthesia, nkhawa, chisokonezo, kukokana,
Njira yodzikonzera: chifuwa, zilonda zam'mimba, kufupika kwa mpweya,
Zomwe zimachitika mdelalo: makonzedwe amkati - phlebitis, ndi makonzedwe a mu mnofu - hyperemia ndi ululu pamalo a jekeseni,
Zina: asthenia, thukuta, vaginitis, zotumphukira edema, kupweteka kumbuyo, leukopenia, neutropenia, kuchuluka kwa prothrombin nthawi,

Mimba

Kugwiritsa ntchito mankhwala osokoneza bongo Kefsepim pakati pa mayi ndi pokhapokha pokhapokha ngati phindu lomwe limaperekedwa kwa mayi limaposa chiwopsezo cha mwana wosabadwayo.
Ngati ndi kotheka, kugwiritsa ntchito mankhwalawa panthawi yoy mkaka wa m'mawere ayenera kuganizira za kuyamwitsa.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito Mlingo waukulu wa aminoglycosides nthawi imodzi ndi mankhwala KefsepimChisamaliro chiyenera kutengedwa kuti ayang'anire ntchito yaimpso chifukwa cha vuto la nephrotoxicity komanso ototoxicity ya aminoglycoside antibayotiki. Nephrotoxicity imawonedwa pambuyo pa kugwiritsa ntchito pamodzi kwa mitundu ina ya cephalosporins ndi okodzeya, monga furosemide. Mankhwala osapatsirana omwe amaletsa kutupa, amachepetsa kuchotsedwa kwa cephalosporins, amawonjezera magazi. Kefsepim ndende kuchokera 1 mpaka 40 mg / ml. yogwirizana ndi zothetsera zoterezi: 0.9% sodium chloride njira yothetsera jakisoni, 5% ndi 10% shuga yankho, jakisoni wa 6M sodium lactate, jakisoni 5% ndi 0.9% sodium chloride yankho la jakisoni, yankho la Ringer ndi lactate ndi 5% dextrose yankho la jakisoni. Pofuna kupewa kuyanjana ndi mankhwala ena ndi mankhwala ena, mayankho a Kefsepim (monga mankhwala ena a beta-lactam) sayenera kutumikiridwa nthawi yomweyo ndi mayankho a metronidazole, vancomycin, gentamicin, tobramycin sulfate ndi netilmicin sulfate. Pankhani yoika Kefsepim ndi mankhwalawa, muyenera kulowa mankhwala aliwonse payokha.

Fomu ya Mlingo:

ufa wowonjezera yankho la intravenous and intramuscular management

mu botolo limodzi muli:

Mutu

Kapangidwe, g

0,5 g

1 g

Cefepime hydrochloride monohydrate, yowerengedwa ndi cefepime

(mpaka pH kuchokera ku 4.0 mpaka 6.0)

ufa kuchokera kuzoyera mpaka zoyera zachikasu.

Zotsatira za pharmacological

Mankhwala

Cefepime ndi mankhwala oteteza khungu la cephalosporin. Cepepime imalepheretsa kuphatikizika kwa mapuloteni amtundu wa bakiteriya, omwe ali ndi mawonekedwe ambiri a bactericidal kanthu motsutsana ndi gram-bacteria komanso gram-negative, kuphatikiza mitundu ingapo yolimbana ndi aminoglycosides kapena m'badwo wachitatu wa cephalosporin mankhwala opatsirana ngati ceftazidime.

Cepepime imagwirizana kwambiri ndi hydrolysis yama beta-lactamases ambiri, imakhala ndi kuchepa kwa beta-lactamases ndipo imalowa mwachangu mu ma cell mabakiteriya osagwiritsa ntchito gramu.

Zatsimikiziridwa kuti cefepime ali ndi mgwirizano wapamwamba kwambiri wamtundu wa 3 penicillin womanga mapuloteni (PSB), mgwirizano wapamwamba wamtundu 2 PSB, komanso mgwirizano wapakatikati wamtundu wa 1a ndi 16 PSB. Cepepime imakhala ndi mabakiteriya ambiri pamitundu yambiri.

Cepepime imagwira ntchito motsutsana ndi tizilombo:

Staphylococcus aureus (kuphatikiza zingwe zomwe zimatulutsa beta-lactamase), Staphylococcus epidermidis (kuphatikiza mitundu yopanga beta-lactamase), mitundu ina ya Staphylococcus spp. C), Streptococcus pneumonia (kuphatikiza tizilombo ta kukana kwapenicillin - ndende yochepetsetsa yotsalira kuyambira 0.1 mpaka 1 μg / ml), beta-hemolytic Streptococcus spp. (magulu C, G, F), Streptococcus bovis (gulu D), Streptococcus spp. magulu a viridian,

Chidziwitso: Mitundu yambiri ya enterococcal, monga Enterococcus faecalis, ndi sticylococci yoletsedwa ndi methicillin imalephera kugonjetsedwa ndi mankhwala ambiri a cephalosporin, kuphatikizapo cefepime.

Acinetobacter calcoaceticus (magawo a anitratus, lwofii),
Aeromonas hydrophila,
Capnocytophaga spp.,
Citrobacter spp. (kuphatikizapo Citrobacter diversus, Citrobacter freundii),
Campylobacter jejuni,
Enterobacter spp. (kuphatikiza Enterobacter cloacae, Enterobacter aerogene, Enterobacter sakazakii),
Escherichia coli,
Gardnerella vaginalis,
Haemophilus ducreyi,
Haemophilus influenzae (kuphatikizapo beta-lactamase yopanga tizilombo ta),
Haemophilus parainfluenzae, Hafnia alvei,
Klebsiella spp. (kuphatikiza Klebsiella pneumoniae, Klebsiella oxytoca, Klebsiellaaleenae),
Legionella spp.,
Morganella morganii,
Moraxella catarrhalis (Branhamella catarrhalis) (kuphatikiza zingwe zopanga beta-lactamase),
Neisseria gonorrhoeae (kuphatikiza tizilombo tina totulutsa beta-lactamase),
Neisseria meningitidis,
Pantoea agglomerans (omwe kale ankadziwika kuti Enterobacter agglomerans),
Proteus spp. (kuphatikiza Proteus mirabilis ndi Proteus vulgaris),
Providencia spp. (kuphatikiza Providencia rettgeri, Providencia stuartii),
Pseudomonas spp. (kuphatikiza Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas stutzer),
Salmonella spp.,
Serratia spp. (kuphatikiza Serratia marcescens, Serratia liquefaciens),
Shigella spp.,
Yersinia enterocolitica,

Zindikirani: nthawi ya cefepime imagwira ntchito molimbana ndi mitundu yambiri ya Stenotrophomonas maltophilia, yomwe kale imadziwika kuti Xanthomonas maltophilia ndi Pseudomonas maltophilia).

Anaerobes:

Bacteroides spp.,
Clostridium perfringens,
Fusobacterium spp.,
Mobiluncus spp.,
Peptostreptococcus spp.,
Prevotella melaninogenica (wotchedwa Bacteroides melaninogenicus),
Veillonella spp.,

Zindikirani: Cepepime sigwira ntchito motsutsana ndi Bacteroides fragilis ndi Clostridium Hardile. Kukana kwachiwiri kwa tizilombo tosakhazikika m'mimba kumayamba pang'onopang'ono.

Pharmacokinetics

Ambiri plasma wozungulira cefepime mu wathanzi achikulire mosiyanasiyana pambuyo limodzi mtsempha wamagazi kwa mphindi 30 mpaka 12 ndi kuzungulira kwakukulu (C_mosamala) aperekedwa pagome pansipa.

Ambiri plasma cefepime woipa (μg / ml) pambuyo mtsempha wa magazi makonzedwe.