Augmentin mu mawonekedwe a kuyimitsidwa: malangizo ogwiritsira ntchito ana
Ufa pakukonzekera kuyimitsidwa kwa pakamwa yoyera kapena yoyera, yokhala ndi fungo labwino, ikaphatikizidwa, kuyimitsidwa koyera kapena pafupifupi kuyera kumapangidwa, kuyimirira, kuyimira koyera kapena pafupifupi koyera kumapangidwa pang'onopang'ono.
| 5 ml ya kuyimitsidwa kotsiriza. | |
| amoxicillin (munthawi ya amoxicillin trihydrate) | 125 mg |
| clavulanic acid (munthawi ya potaziyamu clavulanate) * | 31.25 mg |
Othandizira: xanthan chingamu - 12,5 mg, aspartame - 12.5 mg, succinic acid - 0,84 mg, colloidal silicon dioxide - 25 mg, hypromellose - 150 mg, kukoma kwa lalanje 1 - 15 mg, kukoma kwa lalanje 2 - 11.25 mg, kukoma kwa rasipiberi - 22,5 mg, kulawa "Bright molasses" - 23,75 mg, silicon dioxide - 125 mg.
11.5 g - mabotolo agalasi (1) okwanira ndi kapu yoyezera - mapaketi a makatoni.
Ufa pakukonzekera kuyimitsidwa kwa pakamwa yoyera kapena yoyera, yokhala ndi fungo labwino, ikaphatikizidwa, kuyimitsidwa koyera kapena pafupifupi kuyera kumapangidwa, kuyimirira, kuyimira koyera kapena pafupifupi koyera kumapangidwa pang'onopang'ono.
| 5 ml ya kuyimitsidwa kotsiriza. | |
| amoxicillin (munthawi ya amoxicillin trihydrate) | 200 mg |
| clavulanic acid (munthawi ya potaziyamu clavulanate) * | 28,5 mg |
Othandizira: xanthan chingamu - 12,5 mg, aspartame - 12.5 mg, succinic acid - 0,84 mg, colloidal silicon dioxide - 25 mg, hypromellose - 79.65 mg, kukoma kwa lalanje 1 - 15 mg, kukoma kwa lalanje 2 - 11.25 mg, kukoma kwa rasipiberi - 22,5 mg, Maso "Molasses" - 23,75 mg, silicon dioxide - mpaka 552 mg.
7.7 g - mabotolo agalasi (1) okwanira ndi kapu yoyezera - mapaketi a makatoni.
Ufa pakukonzekera kuyimitsidwa kwa pakamwa yoyera kapena yoyera, yokhala ndi fungo labwino, ikaphatikizidwa, kuyimitsidwa koyera kapena pafupifupi kuyera kumapangidwa, kuyimirira, kuyimira koyera kapena pafupifupi koyera kumapangidwa pang'onopang'ono.
| 5 ml ya kuyimitsidwa kotsiriza. | |
| amoxicillin (munthawi ya amoxicillin trihydrate) | 400 mg |
| clavulanic acid (munthawi ya potaziyamu clavulanate) * | 57 mg |
Othandizira: xanthan chingamu - 12,5 mg, aspartame - 12.5 mg, succinic acid - 0,84 mg, colloidal silicon dioxide - 25 mg, hypromellose - 79.65 mg, kukoma kwa lalanje 1 - 15 mg, kukoma kwa lalanje 2 - 11.25 mg, kukoma kwa rasipiberi - 22,5 mg, kulawa "Bright molasses" - 23,75 mg, silicon dioxide - mpaka 900 mg.
12,6 g - mabotolo agalasi (1) okwanira ndi kapu yoyezera - mapaketi a makatoni.
* popanga mankhwalawa, potaziyamu clavulanate amaikidwa ndi 5% yowonjezera.
Zotsatira za pharmacological
Amoxicillin ndi mankhwala osokoneza bongo owoneka bwino omwe ali ndi ntchito yolimbana ndi ma gram ambiri komanso gram alibe tizilombo. Nthawi yomweyo, amoxicillin imayamba kuwonongeka ndi β-lactamases, chifukwa chake zochitika za amoxicillin sizingofikira ku tizilombo tating'onoting'ono timene timatulutsa enzymeyi.
Clavulanic acid, β-lactamase inhibitor yokhudzana ndi penicillin, amatha kutulutsa ma β lactamase osiyanasiyana opezeka mu penicillin ndi cephalosporin zosagwira tizilombo. Clavulanic acid imakhala ndi mphamvu yokwanira yolimbana ndi plasmid β-lactamases, yomwe nthawi zambiri imatsimikiza kukana kwa mabakiteriya, komanso osagwiritsidwa ntchito motsutsana ndi chromosomal β-lactamases ya mtundu 1, omwe saletsedwa ndi clavulanic acid.
Kupezeka kwa clavulanic acid mu Augmentin ® kukonzekera kumateteza amoxicillin kuti asawonongedwe ndi ma enzyme - β-lactamases, yomwe imalola kukulitsa mawonekedwe a antibacterial a amoxicillin.
Otsatirawa ndi ntchito ya vitro yosakanikirana ya amoxicillin yokhala ndi clavulanic acid.
Bacteria imakonda kuphatikizidwa ndi amoxicillin ndi clavulanic acid
Ma gror-positive aerobes: Bacillus anthracis, Enterococcus faecalis, Listeria monocytogene, Nocardia asteroides, Streptococcus pyogene 1,2, Streptococcus agalactiae 1,2, Streptococcus spp. (beta hemolytic streptococci) 1,2, Staphylococcus aureus (wokhudzidwa ndi methicillin) 1, Staphylococcus saprophytaci (wogwira methicillin), Staphylococcus spp. (coagulase-hasi, amakhudzidwa ndi methicillin).
Ma grram-negative aerobes: Bordetella pertussis, Haemophilus fuluwenza 1, Helicobacter pylori, Moraxella catarrhalis 1, Neisseria gonorrhoeae, Pasteurella multocida, Vibrio cholerae.
Ma anaerobes a gram-positive: Clostridium spp., Peptococcus niger, Peptostreptococcus magnus, Peptostreptococcus micros, Peptostreptococcus spp.
Gram-negative anaerobes: Bacteroides fragilis, Bacteroides spp., Capnocytophaga spp., Eikenella corrodens, Fusobacterium nucleatum, Fusobacterium spp., Porphyromonas spp., Prevotella spp.
Ena: Borrelia burgdorferi, Leptospira icterohaemorrhagiae, Treponema pallidum.
Bacteria yomwe idayamba kukana kuphatikiza amoxicillin ndi clavulanic acid ndiyotheka
Gram-negative aerobes: Escherichia coli 1, Klebsiella oxytoca, Klebsiella pneumoniae 1, Klebsiella spp., Proteus mirabilis, Proteus vulgaris, Proteus spp., Salmonella spp., Shigella spp.
Ma gror-positive aerobes: Corynebacterium spp., Enterococcus faecium, Streptococcus pneumoniae 1,2, Streptococcus group Viridans 2.
Bacteria yomwe imagwirizana mwachilengedwe pakuphatikizidwa kwa amoxicillin ndi clavulanic acid
Gram-negative aerobes: Acinetobacter spp., Citrobacter freundii, Enterobacter spp., Hafnia alvei, Legionella pneumophila, Morganella morganii, Providencia spp, Pseudomonas spp., Serratia spp., Stenotrophomonas maltophilia, Yersinia kulowa
Ena: Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia spp., Coxiella burnetti, Mycoplasma spp.
1 Mwa mitundu iyi ya tizilombo tating'onoting'ono, kufunikira kwa zamankhwala kosakanikirana kwa amoxicillin ndi clavulanic acid kwawonetsedwa mu maphunziro azachipatala.
2 Zovuta za mitundu yama bakiteriya sizitulutsa β-lactamases. Kuzindikira ndi amoxicillin monotherapy kumasonyezanso chidwi chofanana ndi kuphatikiza kwa amoxicillin ndi clavulanic acid.
Pharmacokinetics
Magulu onse awiriwa a mankhwalawa Augmentin ®, amoxicillin ndi clavulanic acid, amatengeka msanga komanso kwathunthu kuchokera m'mimba thirakiti pambuyo pakamwa. Kuyamwa kwa yogwira zinthu ndi mulingo woyenera kumwa mankhwala kumayambiriro kwa chakudya.
Augmentin ® 125 mg / 31.25 mg pa 5 ml ya kuyimitsidwa kwamlomo
Ma paracokinetic magawo a amoxicillin ndi clavulanic acid omwe amapezeka mu maphunziro osiyanasiyana akuwonetsedwa pansipa, pamene odzipereka athanzi omwe ali ndi zaka 2 mpaka 12 pamimba yopanda kanthu amatenga 40 mg / 10 mg / kg thupi / tsiku la mankhwala a Augmentin ®, ufa kuti ayimitsidwe pakayendetsedwe ka 3 Mlingo ndi pakamwa, 125 mg / 31.25 mg mu 5 ml (156.25 mg).
Magawo a pharmacokinetic oyambira
| Kukonzekera | Mlingo (mg / kg) | C max (mg / l) | T max (h) | Auc (mg × h / l) | T 1/2 (h) |
| Amoxicillin | |||||
| Augmentin ® 125 mg / 31.25 mg pa 5 ml | 40 | 7.3±1.7 | 2.1 (1.2-3) | 18.6±2.6 | 1±0.33 |
| Clavulanic acid | |||||
| Augmentin ® 125 mg / 31.25 mg pa 5 ml | 10 | 2.7±1.6 | 1.6 (1-2) | 5.5±3.1 | 1.6 (1-2) |
Augmentin ® 200 mg / 28,5 mg mu 5 ml ya kuyimitsidwa kwamlomo
Ma paracokinetic magawo a amoxicillin ndi clavulanic acid omwe amapezeka mu maphunziro osiyanasiyana akuwonetsedwa pansipa, pamene odzipereka athanzi azaka 2 mpaka 12 pamimba yopanda kanthu amatenga Augmentin ®, ufa kuti ayimitsidwe pakamwa, 200 mg / 28,5 mg mu 5 ml (228,5 mg) pa mlingo wa 45 mg / 6.4 mg / kg / tsiku, logawidwa mu 2 waukulu.
Magawo a pharmacokinetic oyambira
| Zogwira ntchito | C max (mg / l) | T max (h) | AUC (mg × h / l) | T 1/2 (h) |
| Amoxicillin | 11.99±3.28 | 1 (1-2) | 35.2±5 | 1.22±0.28 |
| Clavulanic acid | 5.49±2.71 | 1 (1-2) | 13.26±5.88 | 0.99±0.14 |
Augmentin ® 400 mg / 57 mg ufa wamkamwa mu 5 ml
Ma paracokinetic magawo a amoxicillin ndi clavulanic acid omwe amapezeka mu maphunziro osiyanasiyana akuwonetsedwa pansipa, pomwe odzipereka athanzi atatenga mlingo umodzi wa Augmentin ®, ufa woyimitsidwa pakamwa, 400 mg / 57 mg mu 5 ml (457 mg).
Magawo a pharmacokinetic oyambira
| Zogwira ntchito | C max (mg / l) | T max (h) | AUC (mg × h / l) |
| Amoxicillin | 6.94±1.24 | 1.13 (0.75-1.75) | 17.29±2.28 |
| Clavulanic acid | 1.1±0.42 | 1 (0.5-1.25) | 2.34±0.94 |
Monga iv yoyikapo yophatikizira amoxicillin ndi clavulanic acid, achire poyerekeza acid ndi clavulanic acid amapezeka mu ziwalo zosiyanasiyana ndi minyewa, mkati mwa madzi (ziwalo zam'mimba, adipose, mafupa ndi minyewa, zotumphukira ndi zotumphukira, khungu, bile, ndi zotuluka zotulutsa) )
Amoxicillin ndi clavulanic acid ali ndi malire ofooka a mapuloteni a plasma. Kafukufuku wasonyeza kuti pafupifupi 25% ya kuchuluka kwathunthu kwa clavulanic acid ndi 18% ya amoxicillin imamangiriza mapuloteni a plasma.
M'maphunziro a zinyama, kuwerengetsa kwa zigawo za mankhwala a Augmentin ® sikunapezeke.
Amoxicillin, monga ma penicillin ambiri, amadutsa mkaka wa m'mawere. Zotsatira za clavulanic acid zapezekanso mkaka wa m'mawere. Kupatula kuthekera kwa kutengeka, chitukuko cha matenda otsegula m'mimba ndi michere ya mucous nembanemba, palibe zovuta zina za amoxicillin ndi clavulanic acid pa thanzi la ana oyamwa. Kafukufuku wokhudzana ndi kubereka mu nyama adawonetsa kuti amoxicillin ndi clavulanic acid amawoloka chotchinga, popanda zizindikilo za zovuta pa mwana wosabadwayo.
10-25% ya mlingo woyambirira wa amoxicillin amuchotseredwa ndi impso mu mawonekedwe a metabolite wa penicilloic acid. Clavulanic acid imapangidwa modabwitsa kwambiri mpaka 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid ndi 1-amino-4-hydroxy-butan-2-amodzi ndipo impso ndi impso. kudzera m'mimba, komanso ndi mpweya wotha ntchito mu mpweya wa kaboni.
Monga ma penicillin ena, amoxicillin amathandizidwa ndi impso, pomwe clavulanic acid imachotsedwanso ndi machitidwe a impso komanso owonjezera. Pafupifupi 60-70% ya amoxicillin ndi 40-65% ya clavulanic acid amachotsedwa ndi impso zosasinthika maola 6 atangotenga piritsi limodzi la 250 mg / 125 mg kapena piritsi limodzi la 500 mg / 125 mg.
Zowonetsa Augmentin ®
Bacteria matenda oyambitsidwa ndi tizilombo tating'ono ta mankhwala:
- matenda am'mapapo kwambiri a m'mapapo komanso ziwalo za ENT (mwachitsanzo, tenillitisitis, sinusitis, otitis media), zomwe nthawi zambiri zimayamba chifukwa cha Streptococcus pneumoniae, Haemophilus influenzae *, Moraxella catarrhalis *, Streptococcus pyogene,
- matenda apumidwe am'mimba thirakiti: kukokoloka kwa chifuwa cham'mimba, chibayo ndi bronchopneumonia, yomwe nthawi zambiri imayamba chifukwa cha Streptococcus pneumoniae, Haemophilus influenzae * ndi Moraxella catarrhalis *,
- matenda a kwamkodzo thirakiti: cystitis, urethritis, pyelonephritis, matenda amtundu wamkazi, omwe nthawi zambiri amayamba chifukwa cha mitundu ya banja la Enterobacteriaceae (makamaka Escherichia coli *), Staphylococcus saprophyticus ndi mitundu ya mtundu wa Enterococcus,
- chinzonono chifukwa cha Neisseria gonorrhoeae *,
- matenda a pakhungu ndi minofu yofewa, yomwe nthawi zambiri imayamba chifukwa cha Staphylococcus aureus *, Streptococcus pyogene ndi mitundu ya mtundu wa Bactero> * Oimira ena amtundu wa tizilombo tating'onoting'ono amatulutsa β-lactamase, yomwe imawapangitsa kuti asamve chidwi ndi amoxicillin.
Matenda oyambitsidwa ndi tizilombo tomwe timayamwa amoxicillin amatha kuthandizidwa ndi Augmentin ®, chifukwa amoxicillin ndi chimodzi mwazomwe zimagwira.
Augmentin ® amasonyezedwanso zochizira matenda osakanikirana omwe amayambitsidwa ndi ma tizilombo tating'onoting'ono tokhudza amoxicillin, komanso ma tizilombo tating'onoting'ono timene timatulutsa β-lactamase, tcheru ndi kuphatikiza kwa amoxicillin ndi clavulanic acid.
Mphamvu ya mabakiteriya kuphatikiza kwa amoxicillin ndi asidi wa clavulanic amasiyanasiyana malinga ndi dera komanso nthawi. Ngati kuli kotheka, zosowa zamderalo ziyenera kukumbukiridwa. Ngati ndi kotheka, zitsanzo za tizilombo ting'onoting'onoting'ono ziyenera kusungidwa ndikuwunikiridwa kuti mumve ma bacteria.
Nambala za ICD-10| Khodi ya ICD-10 | Chizindikiro |
| A54 | Matenda a gonococcal |
| H66 | Makanema a puritis komanso osadziwika otitis |
| J01 | Pachimake sinusitis |
| J02 | Pachimake pharyngitis |
| J03 | Pachimake tonsillitis |
| J04 | Pachimake laryngitis ndi tracheitis |
| J15 | Bacterial chibayo, osati kwina |
| J20 | Pachimake bronchitis |
| J31 | Matenda a rhinitis, nasopharyngitis ndi pharyngitis |
| J32 | Matenda a sinusitis |
| J35.0 | Matenda a tonsillitis |
| J37 | Matenda a laryngitis ndi laryngotracheitis |
| J42 | Matenda a bronchitis, osadziwika |
| L01 | Impetigo |
| L02 | Khungu lotupa, chithupsa ndi carbuncle |
| L03 | Phlegmon |
| L08.0 | Pyoderma |
| M00 | Nyamakazi ya Pyogenic |
| M86 | Osteomyelitis |
| N10 | Pachimake tubulointerstitial nephritis (pachimake pyelonephritis) |
| N11 | Matenda a tubulointerstitial nephritis (pyelonephritis) |
| N30 | Cystitis |
| N34 | Matenda a urethritis ndi urethral |
| N41 | Matenda otupa a prostate |
| N70 | Salpingitis ndi oophoritis |
| N71 | Matenda a kutupa kwa chiberekero, kupatula khomo lachiberekero (kuphatikiza ndi endometritis, myometritis, metritis, pyometra, chotupa cha uterine) |
| N72 | Kutupa kwa khomo lachiberekero (kuphatikizapo cervicitis, endocervicitis, exocervicitis) |
| T79.3 | Matenda owopsa a pachilonda, osati kwina |
Mlingo
Mankhwala amatengedwa pakamwa.
Mlingo wa mankhwalawa umayikidwa payekha kutengera zaka, kulemera kwa thupi, impso ya wodwalayo, komanso kuopsa kwa matendawa.
Pofuna kuyamwa bwino komanso kuchepetsa zotsatira zoyipa kuchokera kugaya dongosolo, Augmentin ® ndikulimbikitsidwa kuti idzatenge kumayambiriro kwa chakudya.
Njira yochepetsetsa ya mankhwala opha maantibayotiki ndi masiku 5.
Kuchiza sikuyenera kupitilira masiku opitilira 14 osanenapo za matenda.
Ngati ndi kotheka, n`kotheka kuchita magawo mankhwala (kumayambiriro kwa mankhwala, makolo makonzedwe a mankhwala ndi kusintha kwa m`kamwa makonzedwe).
Akuluakulu ndi ana opitirira zaka 12 kapena masekeli 40 kapena kupitilira
Ndikulimbikitsidwa kugwiritsa ntchito mitundu ina ya Augmentin ® kapena kuyimitsidwa ndi kachulukidwe ka amoxicillin ku clavulanic acid 7: 1 (400 mg / 57 mg mu 5 ml).
Ana a zaka zitatu mpaka zaka 12 okhala ndi thupi lochepera 40 makilogalamu
Kuwerengera Mlingo kumachitika malinga ndi zaka komanso kulemera kwa thupi, zomwe zimawonetsedwa mu mg / kg thupi / tsiku (kuwerengera malinga ndi amoxicillin) kapena ml ya kuyimitsidwa.
Kuchulukitsa kwa kuyimitsidwa kwa 125 mg / 31.25 mg mu 5 ml ndi katatu kapena tsiku lililonse maola 8 aliwonse.
Kuchulukitsa kwa kuyimitsidwa 200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml - 2 kawiri / tsiku lililonse maola 12.
Mlingo woyeserera komanso kuchuluka kwa makonzedwe akufotokozedwa pansipa.
Mlingo wa manambala a Augmentin ®
| Kuchulukitsa kuvomerezeka - katatu kapena tsiku Kuyimitsidwa 4: 1 (125 mg / 31.25 mg mu 5 ml) | Kuchulukana kwa kuvomerezeka - 2 times / tsiku Kuyimitsidwa 7: 1 (200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml) | |
| Mlingo wotsika | 20 mg / kg / tsiku | 25 mg / kg / tsiku |
| Mlingo waukulu | 40 mg / kg / tsiku | 45 mg / kg / tsiku |
Mlingo wocheperako wa Augmentin ® amagwiritsidwa ntchito pochiza matenda amkhungu komanso minyewa yofewa, komanso matendawa.
Mlingo wambiri wa Augmentin ® amagwiritsidwa ntchito pochiza matenda monga otitis media, sinusitis, kupumira kwamatumbo ndi matenda amkodzo, komanso matenda amfupa ndi olowa.
Palibe chidziwitso chokwanira chachipatala chovomerezera kugwiritsidwa ntchito kwa Augmentin ® muyezo wa 40 mg / kg / tsiku mu 3 Mlingo wogawika (4: 1 kuyimitsidwa) ndi 45 mg / kg / tsiku m'magawo awiri ogawanika (7: 1 kuyimitsidwa) osakwanira pazachipatala kuti mulimbikitse kugwiritsa ntchito Mlingo wa ana osakwana zaka 2.
Ana kuyambira pakubadwa mpaka miyezi itatu
Chifukwa cha kusakhazikika kwa mawonekedwe a impso, mlingo woyenera wa Augmentin ® (kuwerengera amoxicillin) ndi 30 mg / kg / tsiku mu 2 waukulu magawo a 4: 1.
Kugwiritsa ntchito kuyimitsidwa kwa 7: 1 (200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml) ndikutsutsana.
Ana asanakwane
Palibe malingaliro pa mtundu uliwonse wa mankhwalawo.
Odwala okalamba
Palibe kusintha kwa mlingo komwe kumafunikira. Okalamba odwala mkhutu aimpso ntchito, mlingo uyenera kusinthidwa motere kwa akuluakulu omwe ali ndi vuto laimpso.
Odwala ndi mkhutu aimpso ntchito
Kusintha kwa dose kumakhazikitsidwa ndi mlingo woyenera wambiri wa amoxicillin ndipo umachitika poganizira mfundo za QC.
| QC | Kuyimitsidwa 4: 1 (125 mg / 31.25 mg mu 5 ml) |
| > 30 ml / mphindi | Palibe kusintha kwa mlingo wofunikira |
| 10-30 ml / mphindi | 15 mg / 3.75 mg / kg 2 nthawi / tsiku, mlingo waukulu ndi 500 mg / 125 mg 2 nthawi / tsiku |
| odwala CC> 30 ml / mphindi, kusintha kwa mankhwalawa sikofunikira. Nthawi zambiri, ngati kuli kotheka, chithandizo cha makolo chiyenera kukondedwa. Odwala a hememalysis Mlingo wovomerezeka ndi 15 mg / 3.75 mg / kg 1 nthawi / tsiku. Pamaso gawo la hemodialysis, mlingo umodzi wowonjezera wa 15 mg / 3.75 mg / kg uyenera kuperekedwa. Kubwezeretsa ndende ya magawo a mankhwala a Augmentin ® m'magazi, muyeso wachiwiri wa 15 mg / 3.75 mg / kg uyenera kuperekedwa pambuyo pa gawo la hemodialysis. Odwala omwe ali ndi vuto la chiwindi Kuchiza kumachitika mosamala; ntchito ya chiwindi imayang'aniridwa nthawi zonse. Palibe deta yokwanira kuti ikonzere kuchuluka kwa odwala mu gulu ili. Malamulo pokonzekera kuyimitsidwa Kuyimitsidwa kumakonzedwa nthawi yomweyo asanagwiritse ntchito koyamba. Kuyimitsidwa (125 mg / 31.25 mg mu 5 ml): onjezani pafupifupi 60 ml ya madzi owiritsa owiritsa kuti asungunuke m'chipinda cha botolo la ufa, ndiye kutseka botolo ndi chivindikiro ndikugwedeza mpaka ufa utatha, lolani botolo kuti liyime kwa mphindi 5 kuti mutsimikizire kuti kuswana. Kenako yikani madzi pachizindikiro pa botolo ndikugwedezaninso botolo. Pazonse, pafupifupi 92 ml ya madzi amafunikira kuti ayimitse kuyimitsidwa. Kuyimitsidwa (200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml): onjezani pafupifupi 40 ml ya madzi owiritsa ozizira kuti asungunuke m'chipinda cha botolo la ufa, ndiye kutseka botolo ndi chivindikiro ndikugwedeza mpaka ufa utasungunuka kwathunthu, perekani imirirani kwamphindi kwa mphindi 5 kuti muwonetsetsetsetsetsetsetsetsetsetse kuti mwakonzeka. Kenako yikani madzi pachizindikiro pa botolo ndikugwedezaninso botolo. Pazonse, pafupifupi 64 ml ya madzi amafunikira kuti ayimitse kuyimitsidwa. Kwa ana osakwana zaka 2, muyezo umodzi wokha wa kuyimitsidwa kwa Augmentin ® ukhoza kuchepetsedwa ndi madzi muyezo wa 1: 1. Botolo liyenera kugwedezedwa bwino musanagwiritse ntchito. Kuti mupeze dosing yolondola ya mankhwala, chipewa choyezera chiyenera kugwiritsidwa ntchito, chomwe chimayenera kutsukidwa bwino ndi madzi mukatha kugwiritsa ntchito. Pambuyo pa kuchepetsedwa, kuyimitsidwa kuyenera kusungidwa osaposa masiku 7 mufiriji, koma osapanga chisanu. Zotsatira zoyipaZochitika zoyipa zomwe zaperekedwa pansipa zalembedwa malinga ndi kuwonongeka kwa ziwalo ndi ziwalo zamagulu ndi pafupipafupi zomwe zimachitika. Pafupipafupi zomwe zimachitika zimatsimikiziridwa motere: pafupipafupi (≥1 / 10), nthawi zambiri (≥1 / 100, Matenda opatsirana komanso ma parasitic: nthawi zambiri - candidiasis a pakhungu ndi mucous nembanemba. Kuchokera pa hemopoietic dongosolo: kawirikawiri - kusinthika kwa leukopenia (kuphatikizapo neutropenia) komanso kusintha kosinthika kwa magazi, osowa - kusintha kwa agranulocytosis komanso kusinthika kwa hemolytic anemia, kutalika kwa prothrombin nthawi ndi nthawi ya magazi, kuchepa magazi, eosinophilia, thrombocytosis. Kuchokera ku chitetezo chamthupi: kawirikawiri - angioedema, anaphylactic zimachitika, matenda ofanana ndi seramu matenda, matsekedwe a vasculitis. Kuchokera kwamitsempha yamitsempha: chizungulire - chizungulire, kupweteka mutu, kawirikawiri - kusinthanso mphamvu, kupweteka (kupweteka) kumachitika mwa odwala omwe ali ndi vuto laimpso, komanso mwa omwe amalandira kuchuluka kwa mankhwalawa), kusowa tulo, kukhumudwa, nkhawa, kusintha kwa machitidwe . Kuchokera pamimba yodyetsera: akulu: pafupipafupi - kutsegula m'mimba, kusanza, kusanza, ana - pafupipafupi - kutsegula m'mimba, kusanza, kusanza, anthu onse: nseru zimakonda kuledzera. Ngati mutayamba kumwa mankhwalawa pakakhala zosafunikira m'mimba, amatha kutha ngati mumwa mankhwalawa koyambirira kwa chakudya. Nthawi zambiri - zovuta zakudya zam'mimba, kawirikawiri - ma colitis omwe amagwiritsidwa ntchito ndi ma antibayotiki omwe amamwa ma antibayotiki (kuphatikizapo pseudomembranous colitis ndi hemorrhagic colitis), lilime lakuda, gastritis, stomatitis. Ana, mukamagwiritsa ntchito kuyimitsidwa, kusinthasintha kwa mawonekedwe a mano a enamel kumachitika kawirikawiri. Kumbali ya chiwindi ndi chithokomiro chamadongosolo: pafupipafupi - kuwonjezeka kwapang'onopang'ono kwa ntchito ya ACT ndi / kapena ALT (yowonetsedwa mwa odwala omwe amalandila beta-lactam antiotic therapy, koma tanthauzo lake lamankhwala silidziwika), kawirikawiri - hepatitis ndi cholestatic jaundice (zochitika izi zimadziwika panthawi ya mankhwala ndi ena penicillin ndi cephalosporins), kuchuluka kwa bilirubin ndi zamchere phosphatase. Zochitika zoyipa kuchokera ku chiwindi zimawonedwa makamaka mwa abambo ndi odwala okalamba ndipo amatha kuyanjana ndi chithandizo cha nthawi yayitali. Zochitika zoyipa izi sizimawonedwa kawirikawiri mwa ana. Zizindikiro zomwe zalembedwazo zimakonda kuchitika pakumala kapena atangomaliza kumene chithandizo, komabe nthawi zina mwina sangawonekere kwa milungu ingapo atamaliza kulandira chithandizo. Zochitika zoyipa nthawi zambiri zimasinthidwa. Zochitika zoyipa za chiwindi zimatha kukhala zowopsa, nthawi zina pamakhala nkhani zakufa. Pafupifupi nthawi zonse, awa anali anthu omwe anali ndi vuto lalitali kapena omwe amamwa nthawi yomweyo mankhwala a hepatotoxic. Kuchokera pakhungu ndi minyewa yodutsa: mosakhazikika - kuyabwa, urticaria, kawirikawiri - erythema multiforme, kawirikawiri - Stevens-Johnson syndrome, poermal necrolysis, bullous exfoliative dermatitis, pachimake pantulosis yayikulu. Kuchokera kwamikodzo dongosolo: kawirikawiri - interstitial nephritis, crystalluria, hematuria. Contraindication
Chenjezo: Kuwonongeka kwa chiwindi. Mimba komanso kuyamwaMu maphunziro a ntchito yolereka mu nyama, makamwa ndi utsogoleri wa Augmentin ® sizinayambitse zotsatira za teratogenic. Pa kafukufuku m'modzi mwa azimayi omwe ali ndi matuza kusanachitike, anapezeka kuti mankhwala a prophylactic amatha kuphatikizidwa ndi chiopsezo chowonjezeka cha necrotizing enterocolitis akhanda. Monga mankhwala onse, Augmentin ® siyikulimbikitsidwa kuti mugwiritse ntchito panthawi yomwe muli ndi pakati, pokhapokha ngati phindu lomwe likuyembekezeredwa kwa mayi limaposa chiwopsezo cha mwana wosabadwayo. Mankhwala Augmentin ® angagwiritsidwe ntchito poyamwa. Kupatula kuti mwina kungayambitse matenda otsegula m'mimba kapena maselo a mucous nembanemba amkamwa omwe amaphatikizidwa ndi kulowetsedwa mkaka wa m'mawere akutsatira kuchuluka kwa zomwe zimagwiritsidwa ntchito ndi mankhwala, palibe zovuta zina zomwe zimawonedwa mu makanda oyamwa. Pankhani yovuta ya makanda omwe akuyamwitsa, ndikofunikira kusiya kuyamwitsa. Malangizo apaderaMusanayambe chithandizo ndi Augmentin ®, ndikofunikira kusaka mbiri yakale yokhudzana ndi zam'mbuyomu zomwe zimachitika m'matumbo a penicillin, cephalosporins kapena zinthu zina zomwe zimapangitsa kuti wodwala azigwirizana. Zowopsa, ndipo nthawi zina zakupha, hypersensitivity reaction (anaphylactic reaction) ku penicillins amafotokozedwa. Chiwopsezo chotere chimakhala chokwanira kwambiri kwa odwala omwe ali ndi mbiri ya hypersensitivity reaction ku penicillins. Ngati thupi siligwirizana, ndikofunikira kusiya mankhwala ndi Augmentin ® ndikuyamba njira zina zoyenera. Pankhani ya vuto lalikulu la hypersensitivity, epinephrine iyenera kutumikiridwa nthawi yomweyo. Thandizo la okosijeni, iv makonzedwe a GCS ndi kuperekedwa kwa airway patency, kuphatikizapo intubation, ingafunikenso. Ngati akukayikira matenda opatsirana a mononucleosis, Augmentin ® sayenera kugwiritsidwa ntchito, chifukwa mwa odwala omwe ali ndi matendawa, amoxicillin angayambitse zotupa ngati khungu, zomwe zimapangitsa kuti azindikire matendawa. Kuchiza kwa nthawi yayitali ndi Augmentin ® nthawi zina kumabweretsa kubalanso kwakukulu kwa tizilombo tating'onoting'ono. Mwambiri, Augmentin ® imalekeredwa bwino ndipo imakhala ndi poizoni wambiri wa ma penicillin onse. Pa chithandizo cha nthawi yayitali ndi Augmentin ®, tikulimbikitsidwa kuti nthawi ndi nthawi muziwona ntchito ya impso, chiwindi ndi hematopoiesis. Milandu ya kupezeka kwa pseudomembranous colitis mukamamwa maantibayotiki akufotokozedwa, kuwopsa kwake komwe kumatha kusiyanasiyana kuchokera pangozi. Chifukwa chake, ndikofunikira kuganizira za mwayi wokhala ndi pseudomembranous colitis kwa odwala omwe ali ndi matenda am'mimba nthawi kapena atatha kugwiritsa ntchito maantibayotiki. Ngati matenda otsegula m'mimba amakhala nthawi yayitali kapena woopsa kapena wodwalayo akukumana m'mimba, chithandizo chikuyenera kuyimitsidwa pomwepo ndipo wodwalayo ayesedwe. Odwala omwe amalandila amoxicillin ndi clavulanic acid limodzi ndi ma anticoagulants osalunjika, mwanjira zina, kuchuluka kwa prothrombin nthawi (kuchuluka kwa MHO) kunanenedwa. Ndi kuphatikiza molunjika kwa anticoagulants osalunjika (pakamwa) osakanikirana a amoxicillin ndi clavulanic acid, kuyang'anira zisonyezo ndikofunikira. Kusunga kufunika kwa anticoagulants pakamwa, kusintha kwa mankhwala kungafunikire. Odwala omwe ali ndi vuto laimpso, mlingo wa Augmentin ® uyenera kuchepetsedwa. Odwala ochepetsedwa diuresis, crystalluria sizichitika kawirikawiri, makamaka ndi chithandizo cha makolo. Ndi kukhazikitsidwa kwa amoxicillin mu milingo yayitali, tikulimbikitsidwa kuti timwe madzi okwanira ndikukhalanso ndi diuresis yokwanira kuti muchepetse mapangidwe a makhwala a amoxicillin. Mukatenga Augmentin ® mkatikati, mumakhala mapangidwe am'madzi am'madzi mu mkodzo, zomwe zimatha kubweretsa zotsatira zabodza pakupanga shuga mumkodzo (mwachitsanzo, mayeso a Benedict, mayeso a Fel). Poterepa, tikulimbikitsidwa kugwiritsa ntchito njira ya glucose oxidant pofufuza kuchuluka kwa shuga mumkodzo. Clavulanic acid imatha kuyambitsa kusalinganika kopanda mkaka G immunoglobulin ndi albumin kupita kumitsempha ya erythrocyte, zomwe zimabweretsa zotsatira zabodza za mayeso a Coombs. Kusamalira pakamwa kumathandiza kuti khungu lisasokonekere chifukwa chomwa mankhwalawa, popeza kutsuka mano ndikokwanira. Kuzunza ndi kudalira mankhwala osokoneza bongo Palibe kudalira mankhwala, mankhwala osokoneza bongo komanso kusinthasintha kwakukhudzana ndi kugwiritsa ntchito mankhwalawa Augmentin ®. Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu Popeza mankhwalawa angayambitse chizungulire, ndikofunikira kuchenjeza odwala za kusamala poyendetsa kapena kugwiritsa ntchito makina osunthira. BongoZizindikiro: Zizindikiro zam'mimba komanso kusowa kwa madzi m'magetsi kumatha kuchitika. Amoxicillin crystalluria akufotokozedwa, nthawi zina kumabweretsa kukula kwa aimpso. Convulsions amatha kuchitika kwa odwala mkhutu aimpso ntchito, komanso kwa iwo omwe amalandira kuchuluka kwa mankhwalawa. Chithandizo: Zizindikiro zam'mimba - chidziwitso cha mankhwala, kulabadira makamaka kutulutsa bwino zamagetsi am'madzi. Ngati bongo, amoxicillin ndi clavulanic acid amatha kuchotsedwa m'magazi ndi hemodialysis. Zotsatira za kafukufuku woyembekezeredwa yemwe adachitika ndi ana 51 kumalo operekera poizoni adawonetsa kuti kuyang'anira amoxicillin pamlingo wochepera 250 mg / kg sizinachititse kuti pakhale ndi zidziwitso zazikulu zakuchipatala ndipo sizinafune kuti pakhale chiphuphu. Terms a Tchuthi cha PharmacyAmamasulidwa pa mankhwala. Kodi Augmentin Kuyimitsidwa ndi ndalama zingati? Mtengo wamba muma pharmacies ndi:
Kuyanjana kwa mankhwalaKugwiritsa ntchito munthawi yomweyo mankhwala a Augmentin ® ndi phenenecid osavomerezeka. Probenecid imachepetsa katulutsidwe katulutsidwe ka amoxicillin, chifukwa chake, munthawi yomweyo kugwiritsa ntchito mankhwalawa Augmentin ® ndi phenenecide kungayambitse kuchuluka komanso kulimbikira kwa ndende ya magazi ya amoxicillin, koma osati clavulanic acid. Kugwiritsa ntchito munthawi yomweyo allopurinol ndi amoxicillin kungakulitse chiopsezo cha khungu losokonezeka. Pakadali pano, palibe zambiri m'mabuku zomwe zimagwiritsidwa ntchito nthawi imodzi yophatikizira amoxicillin ndi clavulanic acid ndi allopurinol. Ma penicillin amatha kuchepetsa mayankho a methotrexate m'thupi mwa kuletsa kubisalira kwake, chifukwa chake, kugwiritsa ntchito mankhwalawa Augmentin ® ndi methotrexate kungakulitse chiwopsezo cha methotrexate. Monga mankhwala ena a antibacterial, kukonzekera kwa Augmentin ® kungakhudze microflora yamatumbo, zomwe zimayambitsa kuchepa kwa mayamwidwe a estrogen kuchokera m'matumbo am'mimba komanso kuchepa kwa magwiridwe antchito opatsirana pakamwa. Mabukuwa amafotokoza zochitika zapafupipafupi za kuwonjezeka kwa MHO mwa odwala omwe amaphatikizana ndi acenocumarol kapena warfarin ndi amoxicillin. Ngati pakufunika kutumiza nthawi yomweyo Augmentin ® ndi anticoagulants, nthawi ya prothrombin kapena MHO iyenera kuyang'aniridwa mosamala popereka kapena kuletsa Augmentin ®, kusintha kwa anticoagulants pakamwa kungafunike. Odwala omwe amalandila mycophenolate mofetil, atayamba kugwiritsa ntchito mankhwala osakanikirana a amoxicillin ndi clavulanic acid, kuchepa kwa ndende yogwira metabolic, mycophenolic acid, adawonedwa asanamwe mlingo wotsatira wa mankhwalawa pafupifupi 50%. Zosintha pamawonekedwe awa sizingawonetse moyenera kusintha kwamtundu wa mycophenolic acid. Kutulutsa mawonekedwe ndi kapangidwe kakeMankhwalawa ndi:
Amapezeka mumitundu yosiyanasiyana:
Powder yothandizira kupanga kuyimitsidwa ikupezeka ku UK (SmithKline Beecham Pharmaceuticals). MankhwalaMphamvu ya bacteriolytic imadziwika. Mankhwalawa amagwira ntchito muyezo wa aerobic / anaerobic gramu, aerobic gram-negative. Imagwira bwino kwambiri polimbana ndi zovuta zomwe zimatha kupanga beta-lactamase. Mothandizidwa ndi clavulanic acid, kukana kwa amoxicillin kukakamizidwa ndi chinthu monga beta-lactamase kumatheka. Poterepa, pali kuwonjezereka kwa zotsatira za chinthu ichi. Mankhwala amagwira ntchito motsutsana:
Popereka mankhwala kwa mwana, adokotala ayenera kumuwerengera kuchuluka koyenera kwa kuyimitsidwa kwake. Zizindikiro zogwiritsidwa ntchitoAugmentin amatchulidwa kuti apatsidwe matenda oyambitsidwa ndi mabakiteriya omwe amayang'anira maantibayotiki:
Komanso, mankhwalawa amagwiritsidwa ntchito pochiza, kupewa matenda opatsirana omwe amatha kuchitika pakudya pamimba, khosi, mutu, pelvis, impso, mafupa, mtima, bile ducts.
ContraindicationMitundu yonse ya Augmentin contraindicated kuti mugwiritse ntchito pamaso pa zinthu zotsatirazi kapena matenda mwa munthu:
Mitundu ina ya Augmentin kuphatikiza pa zomwe zawonetsedwa pali zotsutsana zina zotsatirazi: 1. Kuyimitsidwa 125 / 31.25: 2. Kuyimitsidwa 200 / 28.5 ndi 400/57:
3. Mapiritsi amiyala yonse (250/125, 500/125 ndi 875/125):
Malangizo ogwiritsira ntchitoAna osaposa zaka 12 kapena okhala ndi thupi lochepera makilogalamu 40 ayenera kumwa Augmentin pokhapokha akaimitsidwa. Pankhaniyi, ana ochepera miyezi 3 atha kupatsidwa kuyimitsidwa ndi Mlingo wa 125 / 31.25 mg. Mwa ana osaposa miyezi itatu, amaloledwa kugwiritsa ntchito kuyimitsidwa ndi Mlingo uliwonse wa zofunikira. Chifukwa chakuti kuyimitsidwa kwa Augmentin kumapangidwira ana, nthawi zambiri amatchedwa "Ana a Augmentin," popanda kuwonetsa fomu ya kuyimitsidwa (kuyimitsidwa). Mlingo wa kuyimitsidwa umawerengeredwa payekha kutengera zaka komanso kulemera kwa mwana. Malangizo ogwiritsira ntchito akuwonetsa kuti kuchuluka komwe akufuna kuti ayimitse (yankho) kumayesedwa pogwiritsa ntchito kapu kapena syringe. Kutenga mankhwalawa kwa ana, mutha kusakaniza kuyimitsidwa ndi madzi, muyezo wa limodzi ndi umodzi, koma pokhapokha patapezeka kuti mufunika mankhwala.
Kuti muwerenge kuchuluka kwa mankhwalawa, muyenera kugwiritsa ntchito mfundo zotsatirazi: Kuyimitsidwa 200 mg.
Kuyimitsidwa 400 mg.
Kuyimitsidwa 125 mg.
Mlingo wa mankhwalawa amawerengedwa kutengera mtundu wa matenda, gawo, kumene, kulemera ndi msinkhu wa wodwala. Tiyenera kukumbukira kuti ndi dokotala yekha omwe angatchule wodwala mlingo. Mukamawerengera kuchuluka kwa mankhwalawa, tikulimbikitsidwa kuti tiziganizira zokhazokha za sodium amoxicillin. Malamulo pokonzekera kuyimitsidwaKuyimitsidwa kuyenera kukonzedwa nthawi yomweyo musanamwe mankhwalawa. Malamulo O kuphika:
Chidebe chamankhwala chimayenera kugwedezeka bwino musanagwiritse ntchito. Kuti tiwonetsetse kuchuluka kwa mankhwalawa, tikulimbikitsidwa kugwiritsa ntchito kapu yoyezera, yomwe imaphatikizidwa. Chipewa choyezera chiyenera kutsukidwa bwino mukamagwiritsa ntchito iliyonse. Moyo wa alumali wakuyimitsidwa sunapose sabata 1 mufiriji. Kuyimitsidwa sikuyenera kuzizira. Kwa odwala omwe ali ndi zaka zosakwana ziwiri, muyezo umodzi wa mankhwala mutha kuchepetsedwa ndi madzi owiritsa 1: 1. Zotsatira zoyipaMaantibayotiki amaonedwa ngati otetezeka m'thupi la ana. Mankhwalawa adayesedwa kwa zaka zambiri, chifukwa chaichi, mapangidwe ake machitidwe ake amaphunziridwa bwino. Mwachilengedwe, zotsatira zoyipa zimatha kuchitika, koma mwayi woti zimachitika ndi zochepa.
Mndandanda wathunthu wazotsatira zoyipa za Augmentin za ana zimatha kupezeka mu malangizo a mankhwalawa. Komanso malangizo ogwiritsira ntchito ali ndi mndandanda wathunthu wa malingaliro ndi kumwa momwe mungapangire njira ya mankhwala othandizira. Pofuna kuteteza thupi la mwana ku zinthu zosafunikirazi, ndikofunikira kuyang'anitsitsa mlingo wa mankhwalawa woperekedwa ndi katswiri woyenera. Zosungirako ndi moyo wa alumaliNdikulimbikitsidwa kusunga phukusi lomwe lili ndi mankhalawo ngodya pomwe ana sangafikire. Ndikofunikira kusankha malo owuma, kutentha kwake sikuyenera kupitirira 25 0 C. Kwa masiku 7-10 mutha kusungitsa kuyimitsidwa pamtunda wa madigiri 2-8. Njira yothetsera jakisoni mu mtsempha iyenera kugwiritsidwa ntchito mukangokonzekera.
|
