Gentamicin sulfate: malangizo a ntchito, analogi ndi ndemanga

Njira zambiri zopatsirana komanso kutupa m'magazi sizingachite popanda kugwiritsa ntchito maantibayotiki. Gulu la mankhwalawa limapha tizilombo toyambitsa matenda komanso tizilombo toyambitsa matenda. Chimodzi mwa mankhwala odziwika a antibacterial ndi Gentamicin Sulfate. Amawerengera ngati maantibayotiki omwe amagwiritsidwa ntchito zosiyanasiyana ndipo amagwiritsidwa ntchito pochiza anthu ndi nyama.

Dzinalo Lopanda Padziko Lonse

Dzinalo losafunikira la mankhwalawa ndi Gentamicin (m'Chilatini - Gentamycin kapena Gentamycinum).

Gentamicin Sulfate ndi mankhwala oteteza khungu lanu.

Gentamicin mu mawonekedwe a yankho la jekeseni wapatsidwa code ya anatomical-achire (kemikali ya ATX) J01GB03. Kalatayo J ikutanthauza kuti mankhwalawa ndi antimicrobial and antibacterial ndipo amagwiritsidwa ntchito pochiza mwatsatanetsatane, zilembo G ndi B zikutanthauza kuti ndi a gulu la aminoglycosides.

Khodi ya ATX yamatsitsi amaso ndi S01AA11. Kalatayo S ikutanthauza kuti mankhwalawa amagwiritsidwa ntchito pochiza ziwalo zam'malingaliro, ndipo zilembo AA zikuwonetsa kuti maantibayotiki adapangira kuti agwiritsidwe ntchito mopindulitsa komanso amakhudza kagayidwe.

Khodi ya ATX ya mafuta odzola Gentamicin ndi D06AX07. Kalatayo D ikutanthauza kuti mankhwalawa adapangira kuti agwiritse ntchito dermatology, ndipo zilembo AX - kuti ndi mankhwala opha tizilombo.

Kutulutsa mafomu ndi kapangidwe kake

Gentamicin ali ndi mitundu 4 yotulutsira:

jakisoni yankho
Diso likugwera
mafuta
aerosol.

Mankhwala amapezeka mu mawonekedwe a yankho la jakisoni.
Mankhwala amapezeka mu mawonekedwe a madontho amaso.Mankhwala amapezeka mu mawonekedwe a mafuta.

Chofunikira chachikulu mu mitundu yonse inayi ndi gentamicin sulfate. Zomwe zili mu yankho la jakisoni zimaphatikizapo zinthu zothandiza monga:

sodium metabisulfite
mchere wa disodium
madzi a jakisoni.

Mankhwala amamasulidwa mu ma ampoules a 2 ml, omwe amaikidwa mu ma PC 5. m'matumba otupa. Paketi ili ndi mapaketi 1 kapena 2 (ma 5 kapena 10 ampoules) ndi malangizo ogwiritsira ntchito.

Zothandiza pazinthu zamaso.

mchere wa disodium
sodium kolorayidi
madzi a jakisoni.

Njira yothetsera vutoli imapangidwa mu 1 ml mu timachubu totsikira (1 ml muli 3 mg yogwira ntchito). 1 phukusi limatha kukhala ndi machubu 1 kapena 2 otsikira.

Omwe amapangira mafuta ndi mafuta a parafini:

Mankhwalawa amagulitsidwa m'matumba a 15 mg.

Gentamicin mu mawonekedwe a aerosol ngati gawo lothandiza ali ndi thovu la aerosol ndipo imayikidwa mu 140 g m'mabotolo apadera a aerosol okhala ndi kutsitsi.

Zotsatira za pharmacological

Gentamicin ndi mankhwala othana ndi mabakiteriya omwe amagwiritsidwa ntchito kwambiri pochizira (khungu) komanso matenda amkati. Mankhwalawa amapha tizilombo tating'onoting'ono, ndikuwononga ntchito yawo yotchinga. Mankhwala amagwira ntchito motsutsana ndi mabakiteriya monga:

khalimotz,
streptococci (zovuta zina),
Shigella
nsomba
Pseudomonas aeruginosa,
enterobacter
Klebsiella
mapuloteni.

Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga salmonella.
Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga streptococci.
Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga Klebsiella.
Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga Shigella.
Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga Pseudomonas aeruginosa.
Mankhwalawa amagwira ntchito motsutsana ndi magulu a bakiteriya monga staphylococci.

Mankhwala sikugwira:

treponema (causative agent wa syphilis),
pa neiseria (matenda a meningococcal),
mabakiteriya a anaerobic,
mavairasi, bowa ndi protozoa.

Pharmacokinetics

Mphamvu yofunikira kwambiri mthupi imaperekedwa ndi jakisoni wa intravenous and intramuscular management. Ndi jakisoni wa mu mnofu, ndende ya plasma imalembedwa pambuyo pa mphindi 30-60. Mankhwala amatsimikizika m'magazi kwa maola 12. Kuphatikiza pa plasma yamagazi, Gentamicin imalowa mwachangu ndipo imafotokozedwanso mu minofu ya m'mapapu, impso ndi chiwindi, placenta, komanso sputum ndi zamadzimadzi monga:

Mitundu yotsika kwambiri ya mankhwalawa imapezeka mu bile ndi cerebrospinal fluid.

Mankhwalawa samaphatikizidwa m'thupi: oposa 90% a mankhwalawa amachotsedwa ndi impso. Mlingo wa kuchotserera umatengera m'badwo wa wodwalayo komanso kuchuluka kwa chilolezo cha creatinine. Okalamba odwala impso wathanzi, theka-moyo wa mankhwalawa ndi maola 2-3, ana a zaka 1 sabata mpaka miyezi isanu ndi umodzi - maola 3-3,5, mpaka sabata 1 - maola 5.5, ngati mwana akulemera kuposa 2 kg , komanso maola opitilira 8 ngati ukulu wake ndi wochepera 2 kg.

Hafu ya moyo ikhoza kupitilizidwa ndi:

kuchepa magazi
kutentha kwambiri
kuyaka kwambiri.

Hafu ya moyo wa mankhwala akhoza kuthamanga ndi magazi m'thupi.
Hafu ya moyo wa mankhwalawa imatha kuthamangitsidwa pamatenthedwe okwera.
Hafu ya moyo wa mankhwalawa imatha kupitilizidwa ndi kutentha kwambiri.

Ndi matenda a impso, theka la moyo wa Gentamicin limakulitsidwa ndipo kuthetseratu kwake kungakhale kosakwanira, zomwe zingayambitse kudzikundikira kwa mankhwala m'thupi ndi kupezeka kwa zotsatira zochulukirapo.

Kodi chimagwiritsidwa ntchito ndi chiyani?

Mankhwala amapatsidwa matenda opatsirana ndi kutupa:

Matendawa. Monga:
- pyelonephritis,
- matenda amitsempha
- cystitis
- prostatitis.
Otsika kupuma thirakiti. Monga:
- yabwino
- chibayo
- bronchitis
- kuphatikiza
- chotupa cha m'mapapo.
M'mimba. Monga:
- peritonitis
- cholangitis
- pachimake cholecystitis.
Mafupa ndi mafupa.
Chiwonetsero cha khungu. Monga:
- zilonda zam'mimba
- amayaka
- furunculosis,
- seborrheic dermatitis,
- ziphuphu
- paronychia
- thonje,
- folliculitis.
Diso. Monga:
- conjunctivitis
- blepharitis
- keratitis.
Pakati mantha dongosolo, kuphatikizapo meningitis ndi vermiculitis.

Mankhwala amapatsidwa matenda opatsirana komanso otupa a palowa ndi mafupa.
Mankhwala amapatsidwa conjunctivitis.
Mankhwala amapatsidwa trophic zilonda.
Mankhwala amaperekedwa kuti azisangalala.
Mankhwala amapatsidwa peritonitis.
Mankhwala amapatsidwa pyelonephritis.
Mankhwala amapatsidwa kuti azigwiritsa ntchito meningitis.

Gentamicin imagwiritsidwanso ntchito ngati sepsis chifukwa cha opaleshoni ndi septicemia ya bakiteriya.

Contraindication

Mankhwala si mankhwala ngati wodwala:

silivomereza maantibayotiki a gulu la antiglycoside kapena zinthu zina zomwe zimapanga mankhwalawo.

ali ndi vuto la mitsempha yamitsempha,
wodwala azotemia, uremia,
ali ndi impso kapena kuwonongeka kwa chiwindi,
ali ndi pakati
ndi mayi woyamwitsa
wodwala ndi myasthenia
ali ndi matenda a Parkinson,
ali ndi matenda a vetibular zida (chizungulire, tinnitus),
osakwana zaka 3.

Ndi chisamaliro

Mankhwala amatengedwa mosamala kwambiri, ngati mbiriyakale imakhala ndi chizolowezi chokhudzana ndimomwe zimachitikira, komanso ngati wodwala akudwala:

Mankhwala amatengedwa mosamala kwambiri ngati wodwala akudwala botulism.
Mankhwala amatengedwa mosamala kwambiri ngati wodwala akudwala hypocalcemia.
Mankhwala amatengedwa mosamala kwambiri ngati wodwala akudwala kutopa.

Momwe mungatenge mankhono a slamate?

Kwa odwala azaka zopitilira 14 omwe ali ndi matenda a kwamikodzo, achire ndi 0,4 mg ndi kutumikiridwa katatu patsiku intramuscularly, matenda opatsirana kwambiri ndi sepsis, mankhwalawa amatumikiridwa katatu patsiku, 0,8-1 mg. Mlingo wapamwamba kwambiri sayenera kupitirira 5 mg patsiku. Kutalika kwa chithandizo ndi masiku 7-10. Woopsa, m'masiku atatu oyamba, Gentamicin imayendetsedwa kudzera m'mitsempha, kenako wodwalayo amapatsidwa jakisoni wa intramuscular.

Pakukonzekera kwa mtsempha, njira yokhayo yopanga ndi ma ampoules imagwiritsidwa ntchito;

Gentamicin imatha kutengedwa ngati inhalation pochiza matenda opumira.

Kutupa konyansa pakhungu, ma follicles a tsitsi, furunculosis ndi matenda ena owuma a khungu amathandizidwa ndi mafuta. Choyamba, madera omwe akukhudzidwawo amathandizidwa ndi yankho la Furatsilin kuti achotse zonyansa ndi zotumphukira zakufa, kenako mafuta owonda amawayika katatu patsiku kwa masiku 7-10 (ma bandeji amatha kugwiritsidwa ntchito). Mlingo wa mafuta a tsiku lililonse kwa munthu wamkulu sayenera kupitirira 200 mg.

Matenda amaso amathandizidwa ndi madontho, kuwakhazikitsa mu conjunctival sac katatu patsiku.
Kutupa konyansa pakhungu, ma follicles a tsitsi, furunculosis ndi matenda ena owuma a khungu amathandizidwa ndi mafuta.
Gentamicin imatha kutengedwa ngati inhalation pochiza matenda opumira.
Kwa jekeseni wa mu mnofu, mankhwalawa amakonzedwa musanayambe makonzedwe, kusungunula ufa ndi madzi a jekeseni.
Pakukonzekera kwa mtsempha, njira yokhayo yokonzedwa mu ampoules imagwiritsidwa ntchito.

Aerosol imagwiritsidwa ntchito pochiza matenda akhungu, koma chiwembu chogwiritsidwa ntchito ndi chofanana ndi mafuta. Aerosol amayenera kuthiridwa pansi kuchokera kumtunda pafupifupi 10 cm kuchokera pakhungu.

Matenda amaso amathandizidwa ndi madontho, kuwakhazikitsa mu conjunctival sac katatu patsiku.

Zotsatira zoyipa za Gentamicin Sulfate

Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kupezeka motere:

kugona, chizungulire, kupweteka mutu,
kusowa kwa chakudya, kuchepa mphamvu, kusanza, kusanza, kuchepa thupi.
kupweteka kwa minofu, kupindika, kukokana, dzanzi, paresthesia,
kusokoneza kwamakono
kusamva
kulephera kwa aimpso
kusokonekera kwamikodzo dongosolo (oliguria, micromaturia, proteinuria),
urticaria, malungo, kuyabwa, zotupa pakhungu,
magazi ochepa, magazi, potaziyamu, magnesium ndi calcium m'magazi,
kukwezedwa chiwindi ntchito mayeso.

Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kugwidwa.Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa kwambiri ndipo zimatha kutha ngati kumva.
Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kuwonetsa ngati oliguria.
Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kugona.
Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kuwoneka ngati kulephera kwa impso.Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kuchitika ngati urticaria.
Zotsatira zoyipa chifukwa chotenga Gentamicin ndizosowa ndipo zimatha kutha ngati kusowa kwa chilimbikitso.

Sizotheka kwambiri:

kupweteka kwamitsempha,
phlebitis kapena thrombophlebitis m'munda wa intravenous makonzedwe,
tubular necrosis,
kukula kwamphamvu,
anaphylactic mantha.

Malangizo apadera

Pa chithandizo ndi Gentamicin, ndikofunikira kuyang'ana ntchito za impso, vestibular ndi zothandizira kumva.
Ndikofunikira nthawi zonse kuwunika kuchuluka kwa potaziyamu, magnesium ndi calcium m'magazi.
Kwa odwala omwe amalephera aimpso, kuwongolera chilolezo cha creatinine ndikofunikira.
Wodwala yemwe akudwala matenda owopsa kapena matenda a kwamikodzo (mu gawo la kuchuluka) ayenera kugwiritsa ntchito madzi ambiri panthawi ya mankhwala a Gentamicin.
Kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi zakumwa zoledzeretsa mukamalandira chithandizo ndi Gentamicin ndizoletsedwa.
Chifukwa mankhwalawa amachititsa kuchepa kwa ndende, chizungulire, kuchepa kwa mawonekedwe owonekera, ndikofunikira kusiya magalimoto oyendetsa galimoto nthawi yayitali.

Kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi zakumwa zoledzeretsa mukamalandira chithandizo ndi Gentamicin ndizoletsedwa.
Pa chithandizo ndi Gentamicin, ndikofunikira kuyang'anira nthawi zonse kuchuluka kwa potaziyamu, magnesium ndi calcium m'magazi.
Chifukwa Mankhwala amachititsa kuchepa kwa ndende, ndikofunikira kusiya magalimoto oyendetsa galimoto nthawi yayitali.
Wodwala yemwe akudwala matenda owopsa kapena matenda a kwamikodzo (mu gawo la kuchuluka) ayenera kugwiritsa ntchito madzi ambiri panthawi ya mankhwala a Gentamicin.

Gwiritsani ntchito mu ukalamba

Gentamicin iyenera kugwiritsidwa ntchito mosamala odwala okalamba. Mankhwalawa ali ndi vuto losautsa pamakina am'mutu komanso a vetiwular, ntchito ya impso, ndi okalamba, machitidwe awa, chifukwa cha kusinthana ndi ukalamba, nthawi zambiri amagwira ntchito kale ndi zovuta. Ngati lingaliro liperekedwe kuti lipatsane mankhwala, ndiye kuti mukumwa mankhwalawo ndipo kwakanthawi kwakwaniritsidwa, wodwalayo ayenera kuyang'anitsitsa chilolezo cha creatinine ndikuwunika ndi otolaryngologist.

Kupangira Gentamicin Sulfate kwa Ana

Kwa ana ochepera zaka 14, mphamvu ya makonzedwe a mankhwala imayikidwa pokhapokha pakufunika. Mlingo umodzi umawerengeredwa potengera zaka komanso kulemera kwa mwanayo: kwa ana azaka 6 mpaka 14 - 3 mg / kg, kuyambira 1 mpaka 6 - 1.5 mg / kg, osakwana chaka 1 - 1.5-2 mg / kg. Mlingo wapamwamba kwambiri wa tsiku ndi tsiku kwa odwala onse osakwana zaka 14 sayenera kupitirira 5 mg / kg. Mankhwalawa amatumikiridwa katatu patsiku kwa masiku 7-10.

Kuchiza matenda amtundu wakhungu kapena a maso ndi aerosol, mafuta, kapena madontho amaso sikowopsa ndipo kungathe kuperekedwa kwa odwala omwe ali ndi zaka 14. Zolemba zochizira ndizofanana ndi kwa akuluakulu. Mlingo wa mafuta tsiku lililonse sayenera kupitirira 60 mg.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mankhwalawa amadutsa mosavuta mu placenta ndikulowetsa mkaka wa m'mawere, chifukwa chake, mankhwala ochepetsa mphamvu ya antibacteria saloledwa kwa amayi apakati komanso oyembekezera. Kamodzi m'thupi la mwana, mankhwalawa amayambitsa kuphwanya kwam'mimba ndipo amatha kuyambitsa matenda ototoxicity. Kusiyana ndi momwe zinthu zomwe zingakhale zabwino kwa mayi zimapweteketsa mwana.

Mankhwalawa amalowa mosavuta m'matumba, chifukwa chake, amayi apakati saloledwa kumwa maantibayotiki.
Mankhwalawa amapita mosavuta mkaka wa m'mawere, kotero, mankhwalawa amaletsedwa kwa amayi omwe akuyamwitsa.
Kwa ana ochepera zaka 14, mphamvu ya makonzedwe a mankhwala imayikidwa pokhapokha pakufunika.

Mankhwala ochulukirapo a Gentamicin Sulfate

Kugwiritsa ntchito bongo mopitirira muyeso kumatha chifukwa cha jakisoni wa nobamicin. Mafuta, madontho amaso ndi aerosol sizimapereka zotsatira zofananira. Zizindikiro za bongo zikuphatikiza:

kusanza ndi kusanza
kugona ndi mutu
zotupa pakhungu, kuyabwa,
malungo
ugonthi wosasintha
kuphwanya ntchito za zida zapamwamba,
kulephera kwa aimpso
kuphwanya mkodzo wa kuchotsa mkodzo,
Edema ya Quincke (kawirikawiri).

Njira yothandizira mankhwalawa imaphatikizapo kuchotsedwa kwa mankhwala nthawi yomweyo ndikutsuka magazi ndi hemodialysis kapena dialysis.

Kuchita ndi mankhwala ena

Zosagwirizana kwathunthu ndi gentamicin ndi:

Amphotericin
Heparin
mankhwala a beta-lactam.

Gentamicin molumikizana ndi ethaconic acid ndi furosemide imatha kukulitsa zovuta pa impso ndi makutu othandizira.

Kukula kwa kupuma kwam'mapapo ndi minofu blockade kungayambitse kugwiritsa ntchito nthawi yomweyo ya Gentamicin ndi mankhwala monga:

Sikulimbikitsidwa kuphatikiza Gentamicin ndi mankhwala awa:

Viomycin,
Vancomycin
Chibramycin,
Streptomycin,
Paromomycin,
Amikacin
Kanamycin,
Cephaloridin.

Sitikulimbikitsidwa kuphatikiza Gentamicin ndi Vancomycin.
Sitikulimbikitsidwa kuphatikiza Gentamicin ndi Amikacin.
Sitikulimbikitsidwa kuphatikiza Gentamicin ndi Streptomycin.
Sitikulimbikitsidwa kuphatikiza Gentamicin ndi Kanamycin.
Sitikulimbikitsidwa kuphatikiza Gentamicin ndi Tobramycin.

Ma Analogs a jekeseni yankho ndi:

Gentamicin Sandoz (Poland, Slovenia),
Gentamicin-K (Slovenia),
Gentamicin-Health (Ukraine).

Mndandanda wa mankhwalawa mawonekedwe amatsika amaso ndi:

Gentadeks (Belarus),
Dexon (India),
Dexamethason (Russia, Slovenia, Finland, Romania, Ukraine).

Ma Analogs a mafuta a Gentamicin ndi:

Candiderm (India),
Garamycin (Belgium),
Celestroderm (Belgium, Russia).

Malangizo a Dex-Gentamicin Malangizo a Dexamethasone malangizo a Kalifodi Celestoderm-B malangizo

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa Gentamicin sulfate - jekeseni: wowoneka bwino, wachikasu pang'ono kapena wamtundu wa mamililita awiri am'mililili, mu bokosi la pulasitiki la ma 5 kapena 10 kapenanso makatoni awiri ophatikizidwa ndi 10 ampoules kuchokera kwa wopanga).

Muli 1 ml ya yankho:

yogwira mankhwala: mankhwalawa (mwa mankhwalawa sodiumamu) - 40 mg,
Excipients (kutengera wopanga): sodium metabisulfite, mchere wa disodium wa ethylenediaminetetraacetic acid, madzi a jakisoni, kapena anhydrous sodium sulfite ndi madzi a jakisoni.

Zosungidwa zamankhwala

Mankhwala ayenera kusungidwa kuti ana asawafikire. Kutentha kosungirako yankho la jakisoni ndi madontho amaso kuyenera kukhala + 15 ... + 25 ° С, kwa aerosol ndi mafuta - + 8 ... + 15 ° С.

Mankhwala ayenera kusungidwa kuti ana asawafikire.

Mlingo

Njira yothetsera jakisoni 4%, 2 ml

2 ml yankho lili

ntchito yogwira - girosicin sulfate (malinga ndi

neneamicin) - 80.0 mg,

zokopa: sodium metabisulfite, disodium edetate, madzi a jekeseni.

Wowonekera, wopanda mtundu kapena wamtundu pang'ono

Ndemanga pa Gentamicin Sulfate

Maria, wazaka 25, Voronezh: "Masabata angapo apitawa, china chake chinalowa m'maso. Diso linapepuka kwa tsiku limodzi, linatupa (ndipo linali litatseka) ndipo adamva ululu wosaneneka. Dotolo adalangiza Gentamicin m'matumbo. Ndidayenda molingana ndi malangizo 4 pa tsiku. tsiku lililonse, ndipo lachitatu - Zizindikiro zotsalazo zidadutsa, koma ndidataya masiku onse 7. "

Vladimir, wazaka 40, Kursk: "Ndawotcha mkono wanga kuntchito. Madzulo dzuwa linatuluka, ndipo patangodutsa masiku ochepa chilondacho chinayamba kuphuka ndipo zinali zopweteka kwambiri. Anandilangiza kuti nditenge mankhwala a Gentamicin aerosol mu mankhwala osokoneza bongo ndikuwatsata malinga ndi malangizowo, ndikuphimba ndi bandeji kuchokera pamwamba. Zotsatira zake zimakhala zabwino - patatha masiku awiri chilondacho chinachepa ndipo anayamba kuchira. "

Andrei, wazaka 38, ku Moscow: "Ndinadwala chibayo chaka chatha. Sindinayambe kulandira chithandizo nthawi yomweyo, pomwe nditafika kuchipatala matendawa adayamba chifukwa cha kutentha kwambiri komanso chifuwa chachikulu.

Mawonekedwe ndi kapangidwe ka mankhwala

Mankhwala amapezeka mu mawonekedwe a 4% yankho la jakisoni ndi madontho amaso. Chomwe chimapangidwa ndi mankhwala ndi mankhwalawa sodium 4 mg pa millilita. Ndi gawo la gulu la aminoglycosides ndipo amadziwika kuti ndiwotulutsa mankhwala osiyanasiyana.

Mankhwalawa amalembera njira zopatsirana komanso kutupa m'magazi zomwe zimayambitsidwa ndi ma microorganices omwe amamva ma antiotic. Za makolo:

cystitis
pachimake cholecystitis
zotupa za pakhungu pakhungu,
kutentha kwa madigiri osiyanasiyana,
pyelonephritis,
cystitis
Matenda oyimana ndi mafupa
sepsis
peritonitis
chibayo.

Mukamagwiritsa ntchito kunja:

furunculosis,
folliculitis
seborrheic dermatitis,
kachilombo koyaka
bala pamavuto osiyanasiyana,
sycosis.

blepharitis
blepharoconjunctivitis,
dacryocystitis
conjunctivitis
keratitis.

Ndi ma pathologies oterowo, "Gentamicin sulfate" imagwiritsidwa ntchito. Malangizo ogwiritsira ntchito ali pakatikati pa mankhwala omwe amaphatikizidwa ndi mankhwalawa.

Hypersensitivity mankhwala opha tizilombo,
kwambiri matenda a impso ndi chiwindi,
kuphwanya zamkati,
manja
yoyamwitsa.

Komanso, anti-Gentamicin Sulfate yoletsa mankhwalawa sanaikidwe mu ma ampoules a uremia.

Mankhwalawa amayikidwa aliyense payekha kwa wodwala aliyense. Mlingo umatengera kuuma kwa ndondomekoyi ndi kuchuluka kwa mankhwalawa. Kuyambira 1 mpaka 1.7 mg pa kg iliyonse ya kulemera kwamthupi imayendetsedwa nthawi imodzi. Mankhwalawa amalowetsedwa m'mitsempha kapena m'mitsempha. Mankhwalawa amagwiritsidwa ntchito kawiri kapena kanayi patsiku. Mlingo waukulu patsiku sungakhale woposa 5 mg. Njira ya mankhwala ndi milungu 1.5.

Kuti mugwiritse ntchito modabwitsa, dontho la diso limatsikira 1 maola awiri aliwonse. Kuti mugwiritse ntchito zakunja, zinthu zimaperekedwa mpaka katatu patsiku. Kwa anthu omwe ali ndi vuto la impso, kutengera chithunzi cha chipatala, kukonza kwa mankhwala "Gentamicin Sulfate" kumachitika. Maso akutsikira amathandizidwa mwachindunji mu conjunctiva sac ya maso odwala.

Kuchita ndi njira zina

Kugwirizana ndi mankhwala otsatirawa sikulimbikitsidwa:

Vancomycin
Cephalosporin
"Ethaconic acid",
Indomethacin
mankhwala opha,
analgesics
zida zodulira.

Musanakonzekere chithandizo, ndikofunikira kuphunzira mosamala momwe mankhwalawa amagwiritsidwira ntchito ndi mankhwala Gentamicin Sulfate.

nseru
kusanza
kuchuluka kwa bilirubin m'mwazi,
kuchepa magazi
thrombocytopenia
khansa
migraine
chizungulire
proteinuria
mavuto a vestibular zida.

Itha kuyambitsanso zinthu zomwe sizigwirizana "Gentamicin sulfate." Kuchepa ndi yankho muzochepa zomwe zimapangitsa kuti wodwala a Quincke ademe kapena anaphylactic, omwe ali ndi zovuta zambiri. Mukamagwiritsa ntchito maantibayotiki, ndikofunikira kuwongolera ntchito za impso, makina owonera komanso zida zothandizira.

"Gentamicin sulfate" - maantibayotiki othandizira nyama

Ziweto zimathanso kutenga kachilombo ka bacteria. Pochizira nyama yodwala, magulu apadera a maantibayotiki amagwiritsidwa ntchito. Mankhwalawa akuphatikizapo Gentamicin Sulfate. Ili m'gulu la aminoglycosides ndipo ndi osakaniza a nobamicins C1, C2 ndi C1a. Kapangidwe kake ka mankhwalawa kamaphatikizidwa ndi gramu ya 40 ndi 50 mg mu millilita imodzi ya yankho. Chochita chimasungidwa pamtunda osapitirira 25 digiri, m'malo owuma osavomerezeka ndi ana. Zaka ziwiri - alumali moyo wa mankhwala "Gentamicin sulfate." Malangizo ogwiritsira ntchito nyama azikuwuzani mwatsatanetsatane zisonyezo ndi kuchuluka kwa mankhwalawa.

Mankhwalawa ali ndi zotsatirapo zosiyanasiyana ndipo amagwira ntchito motsutsana ndi gramu-gram komanso tizilombo ta gram. Pambuyo pakukonzekera mankhwalawa, imalowa mu ziwalo zonse ndi machitidwe munthawi yochepa. Pambuyo pa ola limodzi, ntchito yake yayikulu imawonedwa ndikupanga maola 8. Amapukusidwa makamaka mumkodzo komanso pang'ono ndende ndi ndowe.

Zochizira mahatchi, mankhwala opha mabakiteriya amathandizidwa kudzera mu mnofu wa 2,5 mg wa kilogalamu imodzi. Kutalika kwa mankhwalawa kuyambira 3 mpaka 5 masiku. Kwa ng'ombe, mlingo umaperekedwa pa mlingo wa 3 mg pa kilogalamu ya thupi kwa masiku 5. Mankhwalawa amatha kugwiritsidwa ntchito pakamwa pa 8 mg pa kilogalamu yolemera.

Yankho limaperekedwa kwa nkhumba intramuscularly pa 4 mg wa kilogalamu imodzi ya kulemera. Kutalika kwa mankhwalawa sikuyenera kupitilira masiku atatu. Mankhwala kutumikiridwa pakamwa pa 4 mg wa kilogalamu ya thupi kwa masiku 5. Agalu ndi amphaka amapatsidwa intramuscularly 2.5 mg yankho pa kilogalamu imodzi ya kulemera. Chithandizo chimatenga mpaka masiku asanu ndi awiri.

Mukamagwiritsidwa ntchito mkati, mankhwalawa samatengekedwa m'mimba, koma pambuyo pa maola 12 m'matumbo. Ndi veterinarian yekha amene angagwiritse ntchito mankhwala Gentamicin Sulfate intramuscularly. Malangizo a nyama amafotokozera momwe angapangire mankhwala.

Mankhwala "Gentamicin"

Mankhwalawa ndi a antibayotiki a gulu la aminoglycosides, omwe amagwiritsidwa ntchito kwambiri pochiza matenda ambiri. Chipangizochi chili ndi zotsatirazi zina zakepi:

bactericidal
odana ndi yotupa
ali ndi ntchito yayikulu yolimbana ndi mabakiteriya opanda gramu komanso ma gram.

Mankhwala amapezeka mu mawonekedwe a yankho. Pambuyo pokonzanso minyewa, mankhwalawo amalowetsedwa mosavuta m'thupi lathunthu. Bioavailability wapamwamba kwambiri amawonekera pambuyo pa theka la ola. Hafu ya mankhwala itatha 3 hours imathiridwa mkodzo. Imafika pamtunda wa mankhwalawa, motero, sikulimbikitsidwa kupereka mankhwala "Gentamicin" ndi analogi yake "Gentamicin sulfate" panthawi yapakati. Malangizo ogwiritsira ntchito ndalamazi ali ndi chidziwitso chofunikira komanso kufotokoza kwa maantibayotiki.

Zizindikiro ndi contraindication

Chithandizo cha matenda opatsirana komanso otupa omwe amayamba chifukwa cha tizilombo tomwe timakhudzidwa ndi chinthu chogwira ntchito chitha kuchitika pogwiritsa ntchito wothandizira wa Gentamicin. Mankhwalawa amagwiritsidwa ntchito ngati kholo, lakunja ndi wamba.

Hypersensitivity ku gulu la aminoglycoside,
manja
nyere
kulephera kwambiri kwa aimpso,

Musanayambe njira yothandizira mankhwalawa, ndibwino kuti muphunzire mosamala ma contraindication onse kuti mugwiritse ntchito mankhwala Gentamicin ndi Gentamicin Sulfate.

Mankhwalawa amatchulidwa payekhapayekha, mlingo umatengera kuuma kwa matendawa. Kwa makonzedwe a intramuscular and intravenous, mankhwalawa amawerengedwa pa mlingo wa 1 mpaka 1.7 mg wa kilogalamu imodzi ya thupi panthawi. Mankhwalawa amaperekedwa kawiri kapena katatu patsiku. Mlingo woyenera tsiku lililonse kwa munthu wamkulu sayenera kupitirira 5 mg / kg, komanso kwa ana - 3 mg pa kilogalamu ya kulemera. Mankhwalawa amaperekedwa kwa masiku 7. Misozi yamaso imagwiritsidwa ntchito katatu patsiku ndipo imayikidwa dontho limodzi mwachindunji. Kunja, maantibayotiki amawagwiritsa ntchito kanayi patsiku. Mu matenda a impso kwambiri, mankhwalawa amalembedwa molingana ndi chithunzi cha chipatala, ndipo mlingo umatha kusintha. Kwa ana, chizolowezi cha tsiku ndi tsiku chimatengera zaka komanso momwe thupi lakhalira.

Kuyanjana kwa mankhwala

Gentamicin osavomerezeka kuti igwiritsidwe ntchito limodzi ndi mankhwala otsatirawa:

Vancomycin
Cephalosporin
"Ethaconic acid",
Indomethacin
analgesics
mankhwala opaleshoni,
okodzetsa.

Mankhwala "Gentamicin" ndi yankho "Gentamicin sulfate 4%" ali ndi mawonekedwe omwewo ndikuwonetsa momwe angagwiritsire ntchito. Mankhwala onse awiriwa ali ndi katundu wowonjezereka wa bakiteriya komanso anti-yotupa.

Mankhwala "Gentamicin-Ferein"

Mankhwala ndi a gulu la aminoglycosides ndipo amagwiritsidwa ntchito kwambiri pofuna kuchiza ziwalo zambiri ndi machitidwe. Iwonjezera ntchito kuti igwiritsitse mabakiteriya a gram-gramu komanso gram-negative anaerobic. Imakhala ndi bactericidal zotsatira. Pambuyo makonzedwe, maantibayotiki amatengeka mu intramuscularly komanso kudzera mu ziwalo zonse za thupi.

Mlingo wa mankhwala "Gentamicin-Ferein"

Akuluakulu, mankhwalawa amathandizira kuchuluka kwa osaposa 5 mg pa kilogalamu ya thupi patsiku. Pa mlingo umodzi, mlingo umachokera pa 1 mpaka 1.7 mg pa kilogalamu imodzi ya kulemera kwa wodwala. Njira ya mankhwalawa imatengera kuopsa kwa njirayi ndipo imayambira masiku 7 mpaka 10. Mankhwalawa amapezeka kawiri kapena katatu patsiku

Kwa ana, mlingo ndi 3 mg wa kilogalamu imodzi ya kulemera kwa thupi pa makonzedwe. Mankhwalawa amapaka jekeseni kawiri pa tsiku. Kwa odwala omwe amalephera impso, Mlingo wa maantibayotiki umasinthidwa nthawi zonse ndipo zimatengera chiwonetsero chazachipatala.

Misozi yamaso imagwiritsidwa ntchito maola 4 aliwonse ndipo imayikidwa dontho la diso limodzi. Kunja, mankhwalawa amatchulidwa katatu kapena kanayi pa tsiku.

Zotsatira zoyipa:

nseru
kusanza
kuchuluka bilirubin,
kuchepa magazi
leukopenia
kugona
migraine
kusokonezeka kwa zida zamakono,
ugonthi
thupi lawo siligwirizana, mpaka edema ya Quincke.

Zotsatira zoyipa zofananazo zimatha kukhala ndi yankho la "Gentamicin Sulfate 4%" panthawi yochizira matenda opatsirana ndi kutupa m'thupi.

Ndemanga zogwiritsira ntchito modmantin sulfate

Mankhwala siali a mibadwo yatsopano ya maantibayotiki, koma amagwiritsidwa ntchito moyenera masiku ano pochiza matenda opatsirana. Chifukwa chake, msika wogulitsa mankhwalawo uli ndi zinthu zambiri zomwe zimaphatikizapo gentamicin. Izi sizongopangirako jakisoni, komanso mafuta, mafuta, mafuta akutsikira. Mankhwalawa amakhudza chidziwitso cha majini omwe amaphatikizidwa m'maselo a pathogen. Gawo lolimbikira limalowetsedwa m'thupi la thupi m'nthawi yochepa ndikuyamba antibacterial effect.

Nthawi zambiri, mankhwalawa amalekeredwa bwino, koma angayambitse sayanjana. Komanso, maantibayotiki amatha kutha kubadwa. Pali chiwembu chapadera cha kuwerengera za vutoli. Maantibayotiki amagwiritsidwa ntchito kwambiri ngati mankhwala a Chowona Zanyama. Zimathandizira nyama kuchotsa kachiromboka ndikufotokozera ntchito zam'mimba ndi matumbo.

Nthawi zina mankhwalawa "Gentamicin" angapangitse kuti mumve zowawa, ndipo izi ndizowonjezera zake. Kuwerenga mawunikidwe onse, makamaka madokotala, mutha kumvetsetsa kuti maantibayotiki ndi amphamvu bwanji. Ili ndi ntchito yayikulu motsutsana ndi gram-positive ndi gram-negative anaerobic organics. Komanso mu zovuta amatchulidwa zochizira chibayo ndi meningitis. M'pofunika kuonetsetsa mosamala mlingo wa mankhwalawa kuti mupewe zovuta. Malinga ndi akatswiri ambiri, mankhwalawa "Gentamicin sulfate" ndi oopsa. Kugwiritsidwa ntchito kosalekeza kungakhudze ntchito ya machitidwe onse a thupi. Ma antibacterial sayenera kugwiritsidwa ntchito popanda kufunsa katswiri.

Pharmacological zimatha mankhwala Gentamicin sulfate

Mankhwala Gentamicin ndi mankhwala oteteza khungu la gulu la aminoglycoside. Limagwirira ntchito limalumikizidwa ndi chopinga cha 30S ribosomal subunits. Kuyesa іn vitro tsimikizirani ntchito yake mokhudzana ndi mitundu yamagetsi yama gram-positive ndi gram-negative: Escherichia coli, Proteus spp. (indole zabwino ndi indole zoipa), Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., Citrobacter spp., Salmonella spp., Shigella spp. ndi Staphylococcus spp. (kuphatikiza penicillin ndi methicillin zosagwira zovuta).
Ma tizilombo totsatirawa nthawi zambiri amakhala osagwirizana ndi mankhwalawa: Streptococcus pneumoniaemitundu yambiri ya streptococci, enterococci, Nisseria meningitides, Treponema pallidum ndi anaerobic tizilombo monga Bacteroides spp. kapena Clostridium spp.
Pharmacokinetics. Gentamicin imatengeka mosavuta, mpaka kufika pazowonjezera za plasma mphindi 30-60 pambuyo pa u / m makonzedwe.
Achire magazi ozungulira kupitiriza kwa maola 8-10.
Ndi iv drip, kugwiritsidwa ntchito kwa maantibayotiki m'magazi pamaola oyamba kumaposa kuchuluka kwa mankhwalawa komwe kumachitika pambuyo pa kuperekedwa kwa mankhwala a IM. Kumangiriza kwa mapuloteni a plasma ndi 0-10%.
Mu achire zozama, zimatsimikizika mu minofu ya impso, mapapo, mu pleural ndi peritoneal exudates. Nthawi zambiri, ndi makina oyang'anira makolo, ma gramicin amalowa bwino kudzera mu BBB, koma ndi meningitis, ndende ya CSF imakwera. Mankhwalawa amadutsa mkaka wa m'mawere.
Pafupifupi 70% ya gentamicin amachotsedwa mu mkodzo masana ndi kusefera pang'ono. Hafu ya moyo kuchokera m'madzi a m'magazi ndi pafupifupi maola awiri. Ngati vuto la impso lachilendo, ndende imakulanso kwambiri ndipo theka la moyo wa glamicin limakulanso.

Zowonetsa ntchito Gentamicin sulfate

Popeza malire a kutalika kwa mankhwalawa a mankhwalawa, akuyenera kugwiritsidwa ntchito ngati ma cellorganic akulimbana ndi maantibayotiki ena. Gentamicin sulfate ndi mankhwala ochizira matenda oyambitsidwa ndi tizilombo toyambitsa matenda omwe amakhudzidwa ndi mankhwalawa, kuphatikizapo:

sepsis
matenda a kwamkodzo thirakiti
matenda a m'munsi kupuma thirakiti,
matenda opatsirana a pakhungu, mafupa, minofu yofewa,
kachilombo koyaka,
Matenda opatsirana a CNS (meningitis) osakanikirana ndi mankhwala a beta-lactam,
matenda am'mimba (peritonitis).

Kugwiritsa ntchito mankhwala Gentamicin sulfate

Gentamicin sulfate itha kugwiritsidwa ntchito IM kapena IV.
Mlingo, njira yoyendetsera komanso pakati pa Mlingo zimadalira kuopsa kwa matendawo ndi momwe wodwalayo alili.
Mlingo
Akuluakulu. Mulingo wamba wa mankhwala kwa odwala omwe ali ndi zolimbitsa komanso zovuta pa matenda opatsirana ndi 3 mg / kg thupi la IM kapena IV pamawu oyamba a 2-3.Mlingo wapamwamba wa tsiku lililonse kwa akulu ndi 5 mg / kg kulemera kwa jakisoni a 3-4.
Kutalika kwa chizolowezi chogwiritsidwa ntchito kwa odwala onse ndi masiku 7-10.
Ngati ndi kotheka, ngati muli ndi matenda oopsa komanso ovuta, njira yochizira imatha kukulitsidwa. Zikatero, timalimbikitsidwa kuyang'anira ntchito ya impso, makina olimbitsa thupi ndi zida zapakhosi, popeza kuwopsa kwa mankhwalawa kumawonekera patatha masiku opitilira 10.
Kuwerengera thupi zomwe zimakhazikitsidwa ndi glamicin.
Mlingowu umawerengeredwa potengera kulemera kwenikweni kwa thupi (BMI) ngati wodwalayo alibe kulemera kwambiri (ndiye kuti palibe owonjezera 20% ya kulemera koyenera kwa thupi (BMI)). Ngati wodwalayo ali ndi thupi lolemera mopitirira, muyezo umawerengeredwa pazofunikira za thupi (DMT) malinga ndi kakhalidwe:
DMT = BMI + 0.4 (FMT - BMI).
Ana. Kwa ana osakwana zaka 3, glamicin sulfate amangoikidwa chifukwa cha thanzi. Mlingo wa tsiku ndi tsiku ndi: mu makanda ndi makanda - 2-5 mg / kg, ana a zaka 1-5 mpaka 1.5 - mg / kg, zaka 6 - 14 - 3 mg / kg. Mlingo wapamwamba wa tsiku lililonse mwa ana a mibadwo yonse ndi 5 mg / kg. Mankhwalawa amaperekedwa katatu patsiku.
Pankhani ya kuwonongeka kwa impso, ndikofunikira kusintha mtundu wa mankhwalawa kuti mutsimikizire kuchuluka kwa mankhwalawa. M'pofunika kuwongolera ndende ya gentamicin mu seramu yamagazi. Mphindi 30-60 pambuyo pa iv kapena kukonzanso kwamitsempha, kuyika kwa mankhwala mu seramu ya magazi kuyenera kukhala 5-10 μg / ml. Mlingo umodzi woyambirira wa glamicin kwa odwala omwe ali ndi matenda osakhazikika aimpso ndi 1-1.5 mg / kg kulemera kwa thupi, kupitiliza kwa nthawi yayitali komanso kuyimitsidwa pakati pa mabungwe kumatsimikiziridwa kutengera chilolezo chain.

Nthawi yayitali pakati pa oyang'anira (h)

Akuluakulu odwala omwe ali ndi kachilombo ka bakiteriya omwe amafunikira dialysis amapatsidwa 1-1,5 mg ya glamicin pa 1 kg ya kulemera kwa thupi kumapeto kwa dialysis iliyonse.
Ndi peritoneal dialysis mwa akulu, 1 mg ya gentamicin imawonjezeredwa ku 2 l ya dialysis yankho.
Ndi iv yoyendetsedwa, kuchuluka kwa zosungunulira (0,9% yankho la sodium kolorayidi kapena 5% yankho) ndiye 50-300 ml kwa akulu, kwa ana, kuchuluka kwa zosungunulira kuyenera kuchepetsedwa. Kutalika kwa kwa / kulowetsedwa ndi maola 1-2, mankhwalawa amaperekedwa pamlingo wa 60-80 akutsikira 1 min.
Mkulu wa glamicin mu yankho sayenera kupitirira 1 mg / ml - 0%.
Mu / kumayambiriro kwa mankhwalawa amachitika kwa masiku awiri, atatha jekeseni / jakisoni.

Mankhwala

Gentamicin sulfate ndi mankhwala aminoglycoside okhala ndi mawonekedwe osiyanasiyana. Mwa kulowa ma bacteria kudzera mu membrane wa cell ndikumangirira mosavomerezeka ma ribosomes ku 30S subunits, imasokoneza kapangidwe ka protein ya pathogen. Gentamicin imalepheretsa mapangidwe a tRNA (mayendedwe a ribonucleic acid) ndi mRNA (matrix ribonucleic acid), chifukwa chake, mtundu wamtunduwu umawerengedwa molakwika kuchokera ku mRNA ndikupanga mapuloteni osagwira ntchito.

Ma antibiotic okhala mozama kwambiri amathandizira kuchepetsa zotchinga za ma membrane a plasma m'maselo a tizilombo tating'onoting'ono, ndikuti aphe. Izi zimayambitsa mabakiteriya omwe amachititsa mankhwalawa.

M mayeso a in vitro amatsimikizira ntchito ya hamamicin sulfate motsutsana ndi mitundu yotsatirayi ya gram-hasi ndi gram-tizilombo tating'ono: Proteus spp. (indolegative and indolpositive), Escherichia coli, Salmonella spp., Klebsiella spp., Campylobacter spp., Shigella spp., Staphylococcus spp. (kuphatikiza penicillin- ndi methicillin zosagwira zovuta), Pseudomonas spp. (kuphatikiza Pseudomonas aeruginosa), Serratia spp., Providencia spp., Citrobacter spp., Acinetobacter spp.

Ma tizilombo totsatirawa nthawi zambiri amakhala osagwirizana ndi ma glamicin: Streptococcus pneumoniae, mitundu ina yambiri ya streptococci, enterococci, Neisseria meningitides, Treponema pallidum ndi anaerobic tizilombo monga Clostridium spp, Bacteroides spp, Providencia rettgeri.

Gentamicin osakanikirana ndi penicillin (kuphatikizapo benzylpenicillin, ampicillin, oxacillin, carbenicillin), omwe amakhudza khoma la cell la tizilombo, akugwira ntchito motsutsana ndi Enterococcus faechium, Enterococcus faecalis, Enterococcus avium, Enterococcus durans, pafupifupi Streptococcus strapccincapaccin ndi ccincincincincinapore. faecalis zymogene, Streptococcus faecalis liquefaciens), Streptococcus durans, Streptococcus faecium.

Kukula kwa kukana kwa microorganism ku glamicin kumachedwa. Chifukwa chosagwirizana ndi mtanda wokwanira, zingwe zomwe zimawonetsa kukana kwa kanamycin ndi neomycin zimatha kuperewera ndi gentamicin. Maantibayotiki nawonso sachitapo kanthu pa ma virus, bowa, protozoa.

Pambuyo pa intravenous (i / v) kapena intramuscular (i / m) makonzedwe, achire ozungulira am'magazi amafikira pafupifupi maola 0,5-1,5 ndipo amakhala kuyambira maola 8 mpaka 12.

Zotsatira zoyipa za mankhwala Gentamicin sulfate

Totoxicity (kuwonongeka kwa ma VIII awiri amitsempha yama cranial): kusokonezeka kwamakutu ndikuwonongeka kwa zida zamagetsi zitha kupezeka (ndi kugwiritsidwa ntchito koyeserera kwa zida za vestibular, zovuta izi nthawi zina zimatha kukhala zosazindikirika mu magawo oyamba). Ziwopsezo makamaka zimatha kupangitsa kuti chithandizo cha mankhwalawa chidziwike - ndi masabata awiri.
Nephrotoxicity: pafupipafupi komanso kuopsa kwa kuwonongeka kwa impso zimatengera kukula kwa mlingo umodzi, nthawi yayitali ya chithandizo ndi mawonekedwe a wodwalayo, mtundu wa kuwongolera pamankhwala komanso kugwiritsa ntchito munthawi yomweyo mankhwala ena a nephrotoxic.
Kuwonongeka kwa impso kumawonetsedwa ndi proteinuria, azotemia, kawirikawiri - oliguria, ndipo, monga lamulo, ndikusintha.
Zotsatira zina zoyipa ndizovuta: kukwezedwa kwa ma seramu transaminases (ALAT, ASAT), bilirubin, reticulocytes, komanso thrombocytopenia, granulocytopenia, kuchepa magazi, kuchepa kwa seramu calcium, zotupa pakhungu, urticaria, pruritus, malungo, kupweteka kwa mutu, kusanza kupweteka kwa minofu.
Osowa kwambiri, zotsatirapo zoyipa zimachitika: nseru, kuchepa kwa mphamvu, kuchepa kwa chidwi, kuchepa thupi, kuchepera, kufooka kwa m'mimba, kupweteka kwapakati, kugona kwa hypotension komanso kugona, kufooka kwa neuromuscular conduction ndi kupuma kwamatenda ndizotheka.
Patsamba la i / m makonzedwe a gentamicin, kumva kuwawa, ndi / pakukonzekera - kukulira kwa phlebitis ndi zotumphukira.

Gentamicin sulfate

Mankhwala munthawi yomweyo omwe ali ndi poture diuretics (furosemide, ethaconic acid) ayenera kupewedwa, chifukwa chomalizachi chingalimbikitse zotsatira za ototoxic ndi nephrotoxic. Kutheka kwa kupuma koyenera chifukwa cha kupindika kwa mitsempha kwa odwala omwe amalembedwa nthawi yomweyo minofu yolumikizira minofu (desinylcholine, tubocurarine, decamethonium), mankhwala opha ululu, kapena kuwayika magazi koyambirira m'mbuyomu pogwiritsa ntchito mankhwala ogwiritsa ntchito mankhwala a macrate. Kugwiritsa ntchito mchere wamchere ndi anticholinesterase othandizira amatha kuthetsa zotsatira za neuromuscular blockade.
Kugwiritsa ntchito munthawi yomweyo komanso / kapena kugwiritsa ntchito njira zina ndi zina za neuro- komanso / kapena nephrotoxic monga chisplatin, cephaloridin, mankhwala aminoglycoside, polymyxin B, colistin, vancomycin ayenera kupewedwa.
Chiwopsezo cha kuwonongeka kwa impso chimawonjezeka ndikugwiritsira ntchito pamodzi ndi glamicin, indomethacin ndi ena a NSAID, komanso quinidine, cyclophosphamide, ganglion blockers, verapamil, polyglucin. Gentamicin imachulukitsa kuwopsa kwa digoxin.
Ndi munthawi yomweyo makonzedwe a aminoglycosides ndi penicillin, kuwonongeratu theka la moyo kumachepa ndipo zomwe zili mu seramu yamagazi zimachepa.
Hafu yaumoyo imachepetsedwa kwa odwala omwe amawonongeka kwambiri aimpso ndi kuphatikiza kwa carbenicillin ndi gentamicin.
Mukasakanikirana muyeso umodzi wa mankhwala a gulu la aminoglycoside ndi maantibayotiki a gulu la beta-lactam (penicillins, cephalosporins), kuthekera kwothandizika ndikotheka. Gentamicin imakhalanso yogwirizana ndi amphotericin, heparin.

Gentamicin sulfate bongo, zizindikiro ndi mankhwala

Ngati mankhwala osokoneza bongo atachitika kapena poizoni wokhudzana ndi mawonekedwe a nephrotoxicity kapena ototoxicity ndi neuromuscular blockade ndi kupuma kulephera, hemodialysis imathandizira pakuchotsa kwa mankhawala a m'magazi am'magazi, ndi dialysis ya peritoneal, kuchepa kwa mankhwalawa kumachepetsa kwambiri. Mwa makanda, kusinthanitsa magazi ndikotheka.
Mankhwalawa ndi chizindikiro.

Mlingo ndi makonzedwe

Mu / m, mu / kukoka kamodzi katatu patsiku.

Pankhani ya matenda a kwamkodzo thirakiti limodzi, mlingo umodzi ndi 0,4 mg / kg, tsiku lililonse - mpaka 1.2 mg / kg.

Ndi sepsis ndi matenda ena akulu, kumwa kamodzi ndi 0.8-1 mg / kg. Ndalama zatsiku ndi tsiku ndi 2.4-3.2 mg / kg, ndipo gawo lalikulu ndizokwanira 5 mg / kg. Maphunzirowa ndi masiku 7-8.

Mlingo wa tsiku ndi tsiku wa makanda ndi makanda ndi 2-5 mg / kg, wazaka 1-5 mpaka 1.5-5 mg / kg, zaka 6 - 14- 3 mg / kg.

Malangizo a Gentamicin sulfate: njira ndi mlingo

Gentamicin sulfate imayambitsidwa mu / m kapena / mu.

Mwa iv kulowetsedwa, mlingo wa mankhwalawa umaphatikizidwa ndi zosungunulira (mchere wosabala kapena 5% shuga). Akuluakulu, kuchuluka kwa zosungunulira ndi 50-300 ml, kwa ana ayenera kuchepetsedwa. Panjira yothetsera vutoli, kuchuluka kwa mankhwalawa sayenera kupitirira 0,1% (1 mg / ml). Kutalika kwa iv kulowetsedwa kwa Gentamicin sulfate ndi maola 1-2.

Njira yoyendetsera ndi kutsata kwa regamicin sulfate zimatengera momwe wodwalayo alili komanso kuopsa kwa matendawa. Mlingo amawerengedwa kutengera kulemera kwa wodwalayo.

Chifukwa chakuti gentamicin imagawidwa mu madzi akunja ndipo saunjikira minofu ya adipose, mlingo wake uyenera kuchepetsedwa ngati kunenepa kwambiri. Mlingo uyenera kuwerengedwa pa FMT (kulemera kwenikweni kwa thupi), ngati wodwalayo sakulemera kwambiri, ndiye kuti, osapitilira 20% ya BMI (thupi labwino). Ngati onenepa kwambiri ndi 20% kapena kupitirira kwa BMI, mlingo wa kulemera kwa thupi (DMT) amawerengedwa ndi formula: DMT = BMI + 0.4 (FMT - BMI).

Mlingo woyenera:

Akuluakulu ndi ana opitilira zaka 14: kwa matenda olimbitsa thupi komanso owopsa, tsiku lililonse mankhwalawa amalemera 3 mg / kg, ndipo amagawidwa jakisoni awiri. Mlingo wambiri watsiku ndi tsiku ndi 5 mg / kg, wogawidwa majakisoni atatu,
kwa ana: mpaka zaka 3 Gentamicin sulfate amangoikidwa chifukwa cha thanzi. Mlingo wa tsiku ndi tsiku wa akhanda ndi makanda ndi 2-5 mg / kg, kwa ana azaka 1 mpaka 5 - 1.5-3 mg / kg, kwa ana azaka 6 mpaka 14 - 3 mg / kg. Mlingo wambiri watsiku ndi tsiku wa ana azaka zonse ndi 5 mg / kg. Mankhwalawa amaperekedwa katatu patsiku. Ana onse, mosatengera msinkhu, tikulimbikitsidwa kuti mupeze kuchuluka kwa mankhwalawa mu seramu ya magazi tsiku lililonse (ola limodzi pambuyo pa jekeseni, ayenera kukhala pafupifupi 4 μg / ml),
Kwa odwala omwe ali ndi vuto la impso: mulingo woyenera uyenera kusankhidwa kuti uthandizidwe wokwanira wogwiritsa ntchito maantibayotiki. Asanakhale komanso munthawi yonse ya chithandizo, ndikofunikira kuwongolera kuchuluka kwa seramu. Mlingo woyamba umodzi kwa odwala okhazikika aimpso kulephera ndi 1-1.5 mg / kg. 30-60 mphindi pambuyo pa i / m makonzedwe, kuyikiridwa kwa mankhwala mu seramu ya magazi kuyenera kukhala 5-10 μg / ml. M'tsogolomu, mlingo ndi pakati pakati pa jakisoni zimatsimikizika malinga ndi QC (kulengedwa kwa creatinine).

Kutalika kwa nthawi yonse ya mankhwala ndi Gentamicin sulfate kwa odwala onse kuyambira 7 mpaka 10 masiku. Ngati ndi kotheka, ngati muli ndi matenda oopsa komanso ovuta kwambiri opatsirana, njira ya mankhwalawa imatha kukulitsidwa. Popeza kuwopsa kwa maantibayotiki kumawonekera patatha masiku 10 ogwiritsa ntchito, tikulimbikitsidwa kuwunika momwe impso zimagwirira ntchito, komanso kumva ndi njira yayitali yothandizira.

Ngati kuli koyenera kuchitira dialysis ndondomeko, odwala akulu omwe ali ndi matenda opatsirana amapatsidwa 1-1.5 mg / kg gentamicin kumapeto kwa njira iliyonse.

Mimba komanso kuyamwa

Mankhwalawa adapangidwa kuti agwiritsidwe ntchito pa nthawi yomwe ali ndi pakati, popeza ma gramicin amawoloka chotchinga ndipo akhoza kukhala ndi vuto lodana ndi mwana wakhanda.

Gentamicin sulfate ili ndi chuma ch kulowa mkaka wa m'mawere, ngati kuli koyenera kuti mugwiritse ntchito mwa mkazi munthawi ya mkaka wa m'mawere, kuyamwitsa kuyenera kuyimitsidwa.

Ndi mkhutu aimpso ntchito

Odwala kwambiri matenda aimpso ntchito ndi uremia ndi azotemia, komanso odwala ndi pachimake aimpso kulephera, ntchito mankhwala otsutsana.

Chiwopsezo chokhala ndi vuto la nephrotoxic pamankhwala a neamrama limawonjezeka ndi kuwonongeka kwaimpso. Chifukwa chake, musanayambe komanso munthawi yonse ya mankhwalawa, ndikofunikira kuwongolera ndende ya glamicin m'magazi, komanso kuyang'ana ntchito ya impso.

Gentamicin sulfate iyenera kugwiritsidwa ntchito pakuchepa kwa impso molingana ndi dongosolo.

Mtengo wa Gentamicin sulfate m'mafakisi

Mtengo wapakati wa Gentamicin sulfate ndi pafupifupi ma ruble 33 33 pachikwama chilichonse cha 10 ampoules.

Maphunziro: Rostov State Medical University, apadera "General Medicine".

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!

Malinga ndi kafukufuku wa WHO, kuyankhulana kwa theka la ola limodzi pafoni kumawonjezera mwayi wokhala ndi chotupa muubongo ndi 40%.

Poyesera kuti wodwalayo atuluke, madokotala nthawi zambiri amapita kutali kwambiri. Ndiye, mwachitsanzo, Charles Jensen wina mzaka kuyambira 1954 mpaka 1994. adapulumuka ntchito zopitilira 900 neoplasm.

Pogwira ntchito, ubongo wathu umagwiritsa ntchito mphamvu zambiri zofanana ndi babu la 10-watt. Chifukwa chake chithunzi cha babu wapamwamba pamutu panu panthawi yomwe chikuwoneka ngati chosangalatsa sichili kutali ndi chowonadi.

Malinga ndi ziwerengero, Lolemba, chiopsezo cha kuvulala kwammbuyo chimawonjezeka ndi 25%, ndipo chiopsezo chogundidwa ndi mtima - ndi 33%. Samalani.

Ngakhale mtima wa munthu sugunda, akhoza kukhalabe ndi moyo nthawi yayitali, monga asodzi aku Norweji a Jan Revsdal. "Galimoto" yake idayima kwa maola 4 asodzi atasowa ndikugona mu chisanu.

Kuphatikiza pa anthu, cholengedwa chimodzi chokha padziko lapansi - agalu, omwe ali ndi vuto la prostatitis. Awa ndi abwenzi athu okhulupilika kwambiri.

Mu 5% ya odwala, antidepressant clomipramine amayambitsa orgasm.

Poyamba zinkakhala kuti kumatheka kumapangitsa thupi kukhala ndi mpweya wabwino. Komabe, izi zidatsutsidwa. Asayansi atsimikizira kuti pogalamuka, munthu amazizira ubongo ndikusintha magwiridwe ake.

James Harrison wazaka 74 yemwe amakhala ku Australia amakhala wopereka magazi pafupifupi nthawi 1,000. Ali ndi mtundu wamagazi osafunikira, ma antibodies omwe amathandizira akhanda omwe ali ndi vuto lalikulu la magazi kukhala ndi moyo. Chifukwa chake, waku Australia adapulumutsa ana pafupifupi mamiliyoni awiri.

Magazi a anthu "amayenda" kudzera m'matumbo omwe akukakamizidwa kwambiri, ndipo ngati umphumphu wake waphwanyidwa, amatha kuwombera mpaka 10 metres.

Caries ndimatenda ofala kwambiri padziko lonse lapansi omwe ngakhale chimfine sangathe kupikisana nawo.

Pali ma syndromes osangalatsa kwambiri azachipatala, monga kuphatikiza zinthu. M'mimba mwa wodwala m'modzi wodwala mania uyu, zinthu 2500 zakunja zidapezeka.

Asayansi ochokera ku Oxford University adachita kafukufuku wambiri, pomwe adazindikira kuti zamasamba zimatha kuvulaza ubongo wamunthu, chifukwa zimapangitsa kuchepa kwa kuchuluka kwake. Chifukwa chake, asayansi amalimbikitsa kuti asachotsere konse nsomba ndi nyama muzakudya zawo.

Mankhwala akutsokomola "Terpincode" ndi amodzi mwa atsogoleri ogulitsa, ayi chifukwa cha mankhwala ake.

Mankhwala odziwika bwino "Viagra" adapangidwa poyambirira pochizira matenda oopsa.

Kusowa pang'ono kwa mano kapena ngakhale adentia yathunthu imatha kukhala kuvulala, ma caries kapena chiseyeye. Komabe, mano otayika amatha kusinthidwa ndi mano.

Zochita zamankhwala

Kuthekera kotukuka kwa mitsempha ya mitsempha ndi ziwonetsero za kupuma kuyenera kuganiziridwanso m'njira iliyonse ya aminoglycosides mwa odwala omwe amalandira mankhwala oletsa kupweteka kapena mankhwala omwe amachititsa neuromuscular blockade, monga desinylcholine, tubocurarine, decametonium, komanso kwa odwala omwe akuwonjezeredwa kuchuluka kwa citrate. magazi. Neuromuscular blockade ikachitika, mchere wa calcium umaperekedwa.

Kugwiritsa ntchito munthawi yomweyo kapena kutsatira kwina kapena kugwiritsa ntchito mankhwala ena okhala ndi vuto la neurotoxic kapena nephrotoxic, monga cisplatin, cephaloridin, kanamycin, amikacin, neomycin, polymyxin-B, colistin, paromyomycin, streptomycin, tobramycin, vancomycin ndi viomycin.

Pogwiritsa ntchito nthawi yomweyo hydrocortisone ndi indomethacin, mphamvu ya nephrotoxic ya gentamicin imatha kulimbikitsidwa.

Siyenera kugwiritsidwa ntchito nthawi imodzi ndi furosemide ndi ethaconic acid chifukwa chakuti kuwonjezeka kwa zotsatira za ototoxic ndi nephrotoxic ndizotheka. Kuphatikiza apo, kugwiritsidwa ntchito mwamphamvu kwa okodzetsa, kusintha kwa ndende ya maantibayotiki m'matumbo ndi minofu ndikotheka, zomwe zimayambitsa kuwonjezereka kwa poizoni omwe amayamba chifukwa cha aminoglycosides.

Odwala omwe ali ndi vuto la aimpso omwe adalandira onse a carbenicillin ndi glamicin, kuchepa kwa theka la moyo wa glamicin kuchokera ku plasma kunawonedwa.

Mankhwala osagwirizana ndi mankhwala a beta-lactam, heparins, amphotericin.

Tulutsani mawonekedwe ndi ma CD

2 ml amathiridwa mu ma ampoules a syringe odzazidwa osaloleka ndi kapu yokhala ndi mfundo kapena mphete ya kuwundana.

Cholembedwa kuchokera pamapepala okhala ndi zilembo kapena pepala lolemba amachilumikiza pachokwanira chilichonse.

5 kapena 10 ampoules atanyamula mu blister strip ma CD omwe amapanga filimu ya polyvinyl chloride ndi zojambulazo za aluminium.

Ma CD ojambulidwa pamodzi ndi malangizo ovomerezeka ogwiritsira ntchito kuchipatala komanso zilankhulo zaku Russia zimayikidwa pamabhokisi a makatoni ogula kapena ogwiritsira ntchito mafuta.