Amoxicillin clavulanic acid

Clavulanic acid ndi antibacterial bactericidal wothandizila wa gulu la semisynthetic penicillin. Mankhwalawa amapereka zotsatira zabwino kwambiri kuphatikizapo mankhwala a Amoxicillin, anti-spectrum antiotic. Kuphatikizikako kumakhala ndi kusintha kosasintha kwa ntchito ya beta-lactamases ndipo imagwiritsidwa ntchito pochiza matenda amtundu wa ENT ndi kupuma thirakiti, khungu, dongosolo la urogenital, mafupa ndi mafupa.

Pali mankhwala omwe amoxicillin, clavulanic acid alipo kale. Amapangidwa ngati mapiritsi, ma ufa opangira pakamwa kapena madontho othandizira pakamwa, mu mawonekedwe a madzi, komanso njira zovomerezeka.

Mankhwala "Amoxicillin" ndi clavulanic acid: kanthu ndi katundu

Asidi yeniyeniyo ndi antibacterial ofooka, komabe, imateteza amoxicillin ku kuwonongeka kwa enzymatic, komwe kumapangitsa kuti mphamvu ya antibacterial ikhale yogwira ntchito kwathunthu. Zotsatira za mankhwalawa zimafikira kuchuluka kwama gramu-gramu-gram-negative, anaerobic ndi aerobic tizilombo toyambitsa matenda, kuphatikizapo zovuta zawo zomwe zimagwirizana ndi maantibayotiki.

Amoxicillin ndi clavulanic acid: zikuwonetsa

Mankhwalawa ndi othandizika pochiza matenda am'mapapo, mmero, khutu, mphuno, monga sinusitis, tonsillitis, atitis media, bronchitis, chibayo, mliri, bronchopneumonia, mapapu a m'mapapo.

Kuphatikiza apo, chida chimagwiritsidwa ntchito ngati matenda opatsirana a minofu yofewa komanso khungu (zotupa, zilonda, cellulite, mabala omwe ali ndi kachilombo, panniculitis, phlegmon). Clavulanic acid amagwiritsidwa ntchito pochiza matenda amtunduwu komanso amtundu wa urogenital (kuphatikizapo venereal), monga cystitis, pyelonephritis, urethritis, chancre zofewa, gonorrhea, salpingitis, endometritis, pelvioperitonitis, bacteric vaginitis, salpingo-oophoritis, postpartum sepsis, kunyowa.

Komanso, mankhwalawa amagwiritsidwa ntchito ngati pali matenda a mafupa ndi mafupa m'thupi. Intravenous makonzedwe akuwonetsedwa popewa matenda omwe amachitika chifukwa cha opareshoni.

Mankhwala "Amoxicillin" ndi clavulanic acid: contraindication

Musagwiritse ntchito mankhwalawa ndi hypersensitivity ku penicillin ndi maantibayotiki ena (beta-lactam), kupatula mwayi wofanana ndi anaphylactic. Odwala odwala lymphocytic leukemia ndi matenda mononucleosis.

Mosamala, nthawi yoikika imaperekedwa kwa odwala matenda a hay fever, matupi awo sagwirizana, urticaria, mphumu. Ndikofunika kupewa kugwiritsa ntchito mankhwalawa, monga mankhwala ena, panthawi yomwe muli ndi pakati, ngakhale kuti palibe mawonekedwe owonetsa. Mankhwalawa amayi oyamwitsa, mankhwalawa amapezeka mkaka wa m'mawere.

Mankhwala "Amoxicillin" ndi clavulanic acid: mtengo

Chifukwa cha kuchuluka kwa mitundu, mitundu ndi mitundu ya mankhwalawo, mtengo wake umatha kusiyanasiyana.

Zotsatira za pharmacological

Kuphatikiza kumeneku kunapangidwa kuzungulira 1977/78. Asayansi aku Britain omwe amagwira ntchito ku Beecham (tsopano ndi gawo la GlaxoSmithKline). Patent idaperekedwa mu 1984. Augmentin ndi dzina loyambirira ndipo limagwiritsidwa ntchito ndi amene amayamba.

Zotsatira za pharmacological

Imagwira bactericidal, imalepheretsa kapangidwe ka khoma la bakiteriya. Amoxicillin imagwira ntchito motsutsana ndi mabakiteriya omwe amamva nayo. Chifukwa chophatikizidwa ndi beta-lactamase inhibitor (clavulanic acid) mu mankhwalawa, mankhwalawa amatha kuperekedwanso matenda opatsirana ndi amoxicillin. Amoxycillin osakaniza ndi chuma clavulanic asidi ndi aerobic mabakiteriya galamu HIV (kuphatikizapo tizilombo ta kuti zokolola beta-lactamase): Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus anthracis, Streptococcus pneumoniae, Streptococcus viridans, Enterococcus faecalis, Corynebacterium spp, Listeria monocytogenes ,. mabakiteriya okhala ndi vuto la gramu: Clostridium spp., Peptococcus spp., Peptostreptococcus spp., aerobic gram-negative bacteria (kuphatikizapo beta-lactamase yopanga tizilombo ta): Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp. Salm. Bordetella pertussis, Yersinia enterocolitica, Gardnerella vaginalis, Neisseria meningitidis, Neisseri gonoreae, Moraxella catarrhalis, Haemophilus influenzae, Haemophilus ducreyi, Yersinia multocida (omwe kale anali Pasteurella), Campylobacter jejuni, anaerobic gram-negative bacteria (kuphatikizapo tizilombo ta beta-lactamases): Bacteroides seroilis, kuphatikizapo Bacteroides seroilis, kuphatikizapo Bacteroides seroilis Clavulanic acid imaphatikizira mtundu II, III, IV ndi V mitundu ya beta-lactamases, yosagwira motsutsana ndi mtundu I beta-lactamases wopangidwa ndi Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp ..

Clavulanic acid imakhala yotentha kwambiri chifukwa cha penicillinases, chifukwa imapanga zovuta ndi enzyme, yomwe imalepheretsa kuchepa kwa enzymatic pansi pa mphamvu ya beta-lactamases.

Pamene clavulanic acid iwonjezeredwa amoxicillin, kuwonjezera pakuwonjezeka kwa zochita za antibacterial zam'mbuyo, kuwonjezereka kwa ntchito yapakati pa bactericidal ya polymorphic nyukiliya ya nyukiliya. Ntchito yokhudza chitetezo cha antimicrobial imachulukitsidwa pokhudzana ndi mitundu yama bakiteriya omwe amapanga komanso osapanga beta-lactamase. Kuphatikiza ndi amoxicillin, clavulanic acid imalimbikitsa chemotaxis ndi kudziphatikiza kwa polymorphonuclear leukocytes. Izi zimakhudza zotsatira zamankhwala. Izi zikuyembekezeredwa makamaka pakukonzekera matenda opumira omwe amayamba chifukwa cha chibayo, ngati tilingalira polymorphonuclear leukocytes ngati mzere woyamba wotetezedwa ku matenda a pneumococcal.

Kodi clavulanic acid imagwira ntchito bwanji?

Clavulanic acid ndi membala wa gulu la metabolics (ma enzymes ndi ma antienzymes). Ndi beta-lactamase inhibitor ndipo imapangitsa antimicrobial. Kapangidwe kameneka kamafanana ndi kapangidwe ka nyukiliya ya penicillin. Komabe, mosiyana ndi iyo, m'malo mwa mphete ya thiazolidine, asidi wa clavulanic amakhala ndi mphete ya oxazolidine.

Pambuyo pakamwa, clavulanic acid amalepheretsa beta-lactamases, chifukwa cha gram-negative ndi tizilombo tina. Ma kachitidwe ka zinthuzi ndi motere: clavulanic acid imalowa mkati mwa maselo a bakiteriya ndikuyambitsa ma enzymes omwe ali m'maselo awa ndi m'malire awo. Njira zoletsa beta-lactamase nthawi zambiri imatha kusintha. Zotsatira zake, tizilombo tating'onoting'ono timayamba kulephera kukana maantibayotiki omwe amagwiritsidwa ntchito.

Momwe mungagwiritsire ntchito mankhwala osokoneza bongo a clavulanic acid

Clavulanic acid imapangidwa nthawi imodzi ndi Amoxicillin kapena Ticarcillin pochiza matenda opatsirana komanso otupa oyambitsidwa ndi tizilombo tating'onoting'ono. Mlingo wa mankhwalawa ndiwawokha ndipo amatsimikiziridwa ndi dokotala kutengera zaka zomwe wodwala akuonetsa, mawonekedwe ndi mawonekedwe ake. Kukonzekera kwa Clavulanic acid kumagwiritsidwa ntchito mosamala mosamala kwa odwala omwe ali ndi vuto la chiwindi kwambiri. Ngati ming'oma kapena tinthu tating'onoting'ono taoneka, mankhwala ayenera kuyimitsidwa.

Clavulanic acid ndi contraindicated ngati munthu tsankho. Pa nthawi yoyembekezera, kugwiritsa ntchito mankhwalawa ndi Amoxicillin kapena Ticarcillin amaloledwa pazifukwa zaumoyo. Pa mkaka wa m`mawere, osavomerezeka ntchito mankhwalawa. Zotsatira zoyipa za clavulanic acid zimaphatikizapo: dyspepsia, cholestatic jaundice, kuphwanya chiwindi, hepatitis, pseudomembranous colitis, candidiasis, matupi awo sagwirizana (erythema multiforme, edema ya Quincke, exfoliative dermatitis, urticaria, anaphylactic.

Dzina lamalonda lamankhwala omwe amapezeka ndi clavulanic acid ndi "Potaziyamu Clavulanate + Microcrystalline Cellulose". Mankhwala osakanikirana okhala ndi clavulanic acid: Amovicomb, Amoxiclav, Amoxiclav Quiktab, Arlet, Augmentin, Bactoclav, Verclave, Clamosar, Liclav, Panclave, Ranklav "," Taromentin "," Flemoklav Solyutab "," Ecoclave "," Timentin ".

Kufotokozera kwa clavulanic acid

Clavulanic acid ndi beta-lactamase inhibitor chifukwa cha kapangidwe kake ka beta-lactam, kamene kamapanganso kofanana ndi kapangidwe ka mankhwala opha tizilombo.

Izi zimathandiza kuti mankhwalawo aphatikizidwe ndi mapuloteni okhala ndi penicillin omwe ali pamakoma a mabakiteriya a gramu kapena gram-negative, omwe amachititsa kuti awonongeke.

Kodi asidi imagwira ntchito bwanji

Clavulanic acid imatha kuwonetsa ntchito zochepa motsutsana ndi Pseudomonas aeruginosa, enterococci, sing'anga ndi ulemu wa enterobacteria ndi hemophilus bacillus, komanso wamphamvu ndi bacteroids, moraxella, staphylococci ndi streptococci. Gawo la beta-lactam limakhudza gonococci ndi atypical chlamydia ndi mabakiteriya a gulu la legionella.

Kukonzekera kochokera ku Clavulanic acid

Ma Beta-lactam maantibayotiki amaphatikizana bwino ndi chinthu ichi, chomwe chimakupatsani mwayi wopanga mankhwala opatsirana a antibacterial omwe ali ndi mayina osiyanasiyana amtundu, mwachitsanzo, Amoxil-K, Augmentin, Amoxiclav.

Chithandizo chachikulu ndicho mankhwala "Amoxicillin + clavulanic acid." Amapezeka mu mawonekedwe a mapiritsi, ufa wokonzekera kuyimitsidwa (ndi mankhwala omwe amakhala nawo ndi "forte"), ufa wa madzi ndi jekeseni. Kuphatikizikako kumaphatikizapo amoxicillin trihydrate ndi clavulanic acid mu mawonekedwe a mchere wa potaziyamu m'njira zambiri. Mapiritsiwo ali ndi 500 kapena 250 mg ya antibayotiki ndi mchere wa 125 mg, pomwe zonse zomwe zingakhale ndi 625 mg, 1 g, 375 mg.

Njira yamachitidwe

Yogwira mankhwala amoxicillin ndi mankhwala osokoneza bongo omwe ali ndi mawonekedwe osiyanasiyana ochitapo kanthu moyenera pa gramu yabwino komanso gram alibe tizilombo. Pulogalamuyo imatha kuwonongeka ndikuchita nawo ma β-lactamases, chifukwa chake, sizikhudza tizilombo tating'onoting'ono timene timatulutsa michere.

Clavulanic acid amatanthauza ma β-lactam opanga omwe amatchinga ma enzymes osiyanasiyana chifukwa cha mapangidwe okhazikika a ma inactivated complexes. Kuchita izi kumalepheretsa kuwonongeka kwa enzymatic kwa mankhwala a amoxicillin ndikuthandizira kukulitsa ntchito yake pa tizilombo tating'onoting'ono, tomwe timagwirizana nthawi zambiri.

Mankhwala "Amoxicillin + clavulanic acid" amatha kuchiza matenda a bakiteriya a m'munsi komanso am'munsi kupuma, khungu ndi minofu.

Wothandizirana akulimbana mwachangu ndi matenda amtundu wa genitourinary mu mawonekedwe a cystitis, urethritis, pyelonephritis, sepsis, yomwe imachitika pambuyo pakuchotsa mimba kapena pobereka, ndi matenda a ziwalo zamkati. Mankhwalawa amagwiritsidwa ntchito ngati osteomyelitis, poyizoni wamagazi, kutupa kwa peritoneum, matenda a postoperative, kulumidwa ndi nyama.

Momwe mungamwere mapiritsi

Kwa wodwala aliyense, pamakhala mlingo womwe umasankhidwa payekhapayekha, komwe kukula kwa matendawa, malo ake komanso kudziwa kwake mabakiteriya omwe amakhudzidwa ndi clavulanic acid amawaganizira. Mapiritsi okhala ndi zinthu zonse zomwe zimagwira ntchito 0,375 g kwa akulu ndi ana atatha zaka 12, kukumbukira njira yofatsa kapena yolimbitsa thupi, amayatsidwa 1 unit 3 pa tsiku. Ngati piritsi lokhala ndi zosakaniza zonse 1 ga, amatengedwa chidutswa chimodzi 2 pa tsiku.

Zilonda zopatsirana zambiri zimathandizidwa ndi piritsi limodzi lokhala ndi 0,625 g kapena mapiritsi awiri a 0,375 g, amatenga katatu patsiku.

Kukonzekera komwe kumakhala ndi clavulanic acid, malangizo ogwiritsira ntchito amalimbikitsa kutenga pokhapokha ngati akuwuzani dokotala.

Kugwiritsa ntchito mitundu ina ya mankhwalawa

Mlingo wa mankhwalawa umaperekedwa pamaziko a kutembenuka kwa zomwe zili mu antioxotic. Kwa ana ochepera zaka 12, malangizo a "Amoxicillin + clavulanic acid" a mankhwala samalimbikitsa kuti apatsidwe mankhwala. Ndikwabwino kugwiritsa ntchito kuyimitsa, manyuchi kapena madontho kuti mugwiritse ntchito mkati.

Mlingo umodzi wa tsiku ndi tsiku wa amoxicillin amasankhidwa malinga ndi mibadwo ya anthu:

• makanda omwe sanakwanitse miyezi itatu amapatsidwa 0,03 g pa 1 kg yolemera patsiku 2,
• kuyambira miyezi itatu ya moyo komanso odwala pang'ono, gwiritsani ntchito 0,2525 g pa 1 kg ya kulemera kawiri kapena 0,02 g pa 1 kg ya kulemera katatu,
• matenda oopsa amafuna 0,045 g pa 1 kg ya kulemera kwa thupi patsiku katatu kapena 0,04 g pa 1 kg ya kulemera kwa thupi patsiku katatu
• Akuluakulu ndi ana ochokera wazaka 12, omwe kulemera kwake kumachokera ku 40 kg ndi kupitilira apo, amatha kumwa 0,5 ga 2 nthawi kapena 0,25 g katatu,
• matenda akulu kapena matenda a kupuma ziwalo, 0,875 g 2 pa tsiku zotchulidwa, kapena 0,5 g katatu pa tsiku.

Mlingo woyenera wa tsiku ndi tsiku wa amoxicillin wa akulu ndi ana omwe ali ndi zaka 12 ndi 6 g, ndipo kwa ana osaposa zaka 12 - osaposa 0,045 g pa 1 kg ya thupi.

Mulingo wovomerezeka watsiku ndi tsiku wa clavulanic acid unakhazikitsidwanso: kwa akulu ndi ana omwe ali ndi zaka 12 - 600 mg, kwa ana ochepera zaka 12 - 0,01 g pa 1 kg ya kulemera kwa thupi.

Ngati kumeza nkovuta, kuyimitsidwa kumalimbikitsidwanso kwa akuluakulu. Pokonzekera mitundu ya madzi amadzimadzi, zosungunulira ndi madzi oyera.

Mtsempha wolowa mkati mwa akulu ndi achinyamata patatha zaka 12 amalola kuchuluka kwa 1 ga amoxicillin 4 pa tsiku. Kuchuluka kwa tsiku osapitirira 6. Ana osaposa miyezi itatu mpaka zaka 12 amapatsidwa 0,025 g pa kilogalamu 1 mumiyeso itatu yogawika; chifukwa zotupa zovuta, jakisoni 4 patsiku limagwiritsidwa ntchito.

Makanda ochepera zaka 3 zakubadwa, makanda obadwa masiku asanakwane amakhala ndi jekeseni ya 0,025 g pa 1 mg mu magawo awiri ogawanika patsiku, panthawi yopititsa patsogolo, 0,2525 mg pa kilogalamu 1 mumiyeso itatu yogawidwa.

Kutalika kwa mankhwalawa ndi masabata awiri, ndi atitis otentha kwambiri - pafupifupi masiku 10.

Kupewa matenda pambuyo opaleshoni ntchito opitilira osaposa mphindi 60 mu nthawi ikuchitika ndi mtsempha wa magazi g 1 pa mankhwala oyamba ndi opaleshoni. Kugwirira ntchito kwakutali kumafuna kugwiritsidwa ntchito kwa 1000 mg pambuyo pa maola 6 tsiku lonse. Ngati pali kuthekera kwakukulu kwa matenda, kugwiritsa ntchito mankhwalawa kumapitilizidwa masiku awiri kapena atatu otsatira.

Odwala omwe ali ndi hemodialysis amapatsidwa pakamwa 0,25 g kapena 0,5 g pa ntchito iliyonse kapena 500 mg kutumikiridwa kudzera m`mitsempha. Chochita chowonjezerapo ndikugwiritsa ntchito mlingo umodzi pa nthawi ya dialysis ndi mlingo umodzi kumapeto kwa chinyengo.