Aminoglycosides: mazano (mazita, mazita, maitiro, mirayiridzo yekushandiswa)

Pakuonekwa pamusoro pharmacological pamusika inorwisa mabhakitiriya itsva zvakawanda zvinokonzerwa, zvakadai fluoroquinolones, cephalosporins, zvakakonzera chokwadi kuti vanachiremba vakatanga taurira aminoglycosides Kashoma (zvinodhaka). A pamazita mishonga yaisanganisira muboka iri rakanyatsojeka rakakura uye kunosanganisira inonyatsozivikanwa mishonga akadai "Penicillin", "Gentamycin", "Amikacin." Kusvikira nhasi, ari yevanorwara zvikuru uye zvomusejari madhipatimendi zvikuru nevakawanda mishonga ndivo aminoglycoside akatevedzana chaizvo.

tsanangudzo pfupi pamusoro boka

Aminoglycosides - zvinodhaka (mishonga mazita inokurukurwa pazasi), vamwe pane Semi-chakaita zvokugadzirwa kana dzinongozviitikira mavambo. Ichi boka inorwisa mabhakitiriya ine nokukurumidza uye simba bactericidal zvainoita muviri.

Medicines yaingowanikwa-siyana nezviito. inorwisa utachiona basa ravo pamusoro giremu negative utachiona, asi zviri kuderedzwa pakurwisa giremu-akanaka tusingaoneki. Uye aminoglycosides zvachose basa pamusoro anaerobes.

Ichi boka zvinodhaka pave rakaisvonaka bactericidal zvazviri kugona aro irreversibly tunodzivisa mapuroteni usage mu muvamwe zvigare pasi ribosome chechetere. Medicines zvinoshingaira ari zvose maberekero uye masero ari quiescent mamiriro. Rwakadini asingaurayiwi basa kunobva pachido wevasungwa dzavo muropa serum murwere.

aminoglycoside kushandiswa nhasi zvakakwana ipfupi. Izvi imhaka yakakwirira toxicity mishonga iyi. Most vanowanzotambura kubva itsvo zvinodhaka uye kunzwa nenyere.

Chinokosha maturusi izvi ndiwo kutadza kwakaita kupinda yavo masero mapenyu. Saka, aminoglycosides simba zvachose pakurwisa intracellular utachiona.

Zvakanakira nekuipira

mishonga izvi dzinoshandiswa nevakawanda sezvo yekunwa, mune kuvhiya tsika. Uye haasi masanga. Doctors vanosimbisa zvazvakanakira vazhinji vaiva vakabatwa aminoglycosides.

Mishonga iri muviri zvakasiyana saka zvakanaka nguva:

• yakakwirira antibacterial basa;
• kusavapo anorwadza maitiro (nokuti jekiseni vaitarira);
• isingawanzowanikwi panowanikwa Kurwara;
• kukwanisa kuparadza mabhakitiriya ruminant;
• kunowedzera kuchirapa mugumisiro akabatana Beta-lactam inorwisa mabhakitiriya;
• soro basa pakurwisa zvirwere ngozi.

Zvisinei, pamwe zvazvakanakira pamusoro apa, boka iri medicaments uye ane nekuipira.

Outs vari aminoglycosides:

• yakaderera basa zvinodhaka pasina okisijeni kana iri acidic svikiro;
• murombo kupinda anokosha fuma mumuviri Urume (bile, musana fluid sputum);
• nezve muzvizhinji parutivi-anokonzerwa.

kupatsanura mishonga

Pane classifications akawanda.

Somuenzaniso, akapa kutevedzana kwezviitiko pakusuma kupinda okurapa pakati aminoglycosides, ndivo runotevera:

1. Wokutanga mushonga yaishandiswa kurwisa zvirwere zvirwere vakanga "streptomycin yakawanikwa", "monomitsin", "neomycin", "Kanamycin", "Paromomycin."
2. Kuchizvarwa wechipiri vari vatsva aminoglycosides (zvinodhaka). Drug List "Gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. boka iri zvinosanganisira mishonga Semi-chakaita zvokugadzirwa akadai "Amikacin", "Izepamitsin".

Musi chakarondedzera chiito uye chidzoke kurwisa patsanura aminoglycosides siyanei.

Generation mishonga ndeizvi:

1. 1 boka zvinosanganisira mishonga yakadaro "streptomycin yakawanikwa", "Kanamycin", "monomitsin", "neomycin". zvinodhaka izvi kuti tikwanise kurwisa TB utachiona, uye mamwe mabhakitiriya atypical. Zvisinei, pamusoro siyana giremu negative utachiona uye staphylococci, vane simba.

2. Second-chizvarwa aminoglycoside - mushonga uyu "gentamicin." Zvinonzi kusiyaniswa guru antibacterial basa.

3. Kuvandudzwa mishonga. Vane yakakwirira antibacterial basa. Unoshandiswa pamusoro klebisielly, enterobacteria, Pseudomonas aeruginosa ari wechitatu-chizvarwa aminoglycosides (zvinodhaka). List zvinodhaka riri sezvinotevera:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. zvinodhaka "Izepamitsin" rinoreva boka rechina. Zvinonzi kusiyaniswa kukwanisa zvinobudirira kukurira tsitobakterom, aeromonasom, nokardiyami.

In okurapa, yakatanga imwe kupatsanura. Zvinonzi inobva kushandisa zvinodhaka zvichienderana chirwere makiriniki, hunhu utachiona, uyewo pokushandisa nzira.

mumwe kupatsanura zvakadai aminoglycosides sezvinotevera:

1. Zvinodhaka kuti systemic kuona dzakabatwa parenterally (by jekiseni). Nokuti pakurapa suppurative zvinokonzerwa noutachiona zvichiitika kwazvo kushatiriswa mikana anaerobic tupukanana tusingaoneki, mishonga yakadaro, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Mabatirwo Ngozi monoinfections, iyo yakavakirwa unosungira utachiona zvinobudirira kana achitaurwa nevanopinda kurapa "streptomycin yakawanikwa" kugadzirira "Gentomitsin". Kana mycobacteriosis kukuru rubatsiro zvinodhaka "Amikacin," "streptomycin yakawanikwa", "Kanamycin".
2. Zvinodhaka kuti anoshandiswa chete nechomukati kuti dzakananga zvairatidza. Ava: "Paromitsin", "neomycin", "monomitsin".
3. Mishonga kukamura uchishandisa kushanda. Ivo inoshandiswa pakurapa purulent zvinokonzerwa noutachiona mu otorhinolaryngology uye ophthalmology. For zvomunharaunda kugarotamba dzakabudirira mishonga "Gentamicin," "framycetin", "neomycin", "Tobramycin".

zvairatidza kuti

Kushandiswa aminoglycosides Zvakakunakirai kuparadza-siyana Kurovedza giremu negative utachiona. Medicaments angashandiswa sezvo monotherapy. Kazhinji vanenge pamwe Beta-lactams.

Aminoglycosides inoratidzwa kuti pakurapa:

• nosocomial Zvirwere zvakasiyana siyana localization;
• purulent postoperative yematambudziko;
• intra-abdominal noutachiona;
• sepsis;
• infective endocarditis ;
• pyelonephritis kuitika kwazvo siyana;
• utachiona Unopisa;
• kwemabhakitiriya purulent yomumuzongoza;
• tiibhii;
• ngozi zvinotapukira (denda, brucellosis, tularemia);
• septic chearthritis kushatiriswa giremu negative bacteria;
• Urinary turakiti noutachiona;
• ophthalmic zvirwere: blepharitis, kwemabhakitiriya keratitis, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• Pfava zvirwere: otitis externa, rhinopharyngitis, rhinitis, sinusitis;
• protozoal noutachiona.

nemishonga

Zvinosuruvarisa, panguva Mabatirwo muchikwata ichi zvinodhaka murwere anogona kunzwa yose akatevedzana nemigumisiro. The chikuru drawback mishonga - zviri zvikuru muchetura. Ndokusaka chete chiremba anofanira mishonga murwere aminoglycosides.

Nemishonga zvingaitika:

1. Ototoxicity. Varwere vanotsutsumwa kuti kunzwa kurasikirwa, a achirira ruzha. Kazhinji rinoratidza mhingaidzo nenzeve. Most wanda izvi zvichiitika mune vakwegura, vanhu pakutanga kutambura kunzwa vanotaura. Maitiro akadaro kuitika varwere kurapa kwenguva refu kana kumusoro mishonga.
2. Nephrotoxicity. Murwere rinowanika nyota, dzinosiyana uwandu weti (anogona zvose kuwedzera uye kuderera), vakawedzera creatinine pamwero muropa, akaderedza glomerular filtration. Zviratidzo kwakadaro kwese kunoitika vanhu kutambura kubva kusagadzikana itsvo chaitika.
3. Neuromuscular blockade. Dzimwe nguva panguva mushonga hwakaipa afemeruke. Mune zvimwe zviitiko pane kuoma kufema netsandanyama. Kazhinji, Maitiro akadaro mamirire pavarwere vane chetsinga nezvirwere kana vakadhakwa itsvo chaitika.
4. Vestibular zvirwere. Vakaratidza zvaipesana kufambisa, dzungu. Kakawanda, izvi nemishonga kuitika apo "streptomycin yakawanikwa" kugadzwa zvinodhaka murwere.
5. Chetsinga zvirwere. Kuonekwe paresthesia, encephalopathy. Dzimwe nguva kurapa kubatana lesion pamusoro optic etsinga.

Aminoglycosides kashoma kukonzera neutachiona akadai ganda nekumhanyirira.

Contraindications

Zvinorondedzerwa mishonga vane zvimwe zvavasingakwanisi kuita kuti ishandiswe. Kakawanda contraindicated aminoglycosides (mazita zvinopiwa pamusoro) mu pathologies yakadaro kana mamiriro:

• nomumwe hypersensitivity;
• kutyora renal excretory basa;
• kunzwa zvirwere;
• Kugadzirwa neutropenic kwazvo siyana;
• vestibular zvirwere;
• myasthenia gravis, zvanga zvine utachiona uhu, Parkinsonism;
• kufema mwoyo, vadhakwa.

Uyezve, iwe haufaniri kuzvishandisa kunorapwa kana murwere aiva nhoroondo kusafarira chero mushonga kubva boka iri.

Funga zvikuru nevanhu aminoglycosides.

"Amikacin"

The mushonga ari dzinoratidzwa raidudzwa bacteriostatic, bactericidal uye Anti-zvinokonzerwa pamusoro womunhu. Anoratidza yakakwirira basa pamusoro zhinji giremu-akanaka uye giremu negative utachiona. Saka anopupura kuti mushonga "Amikacin" mirayiridzo Chinyorwa. Majekiseni dzinobudirira mukurapa anonzi Staphylococcus, streptococcus, pneumococcus, salmonella, Escherichia coli coli, Mycobacterium tibhii.

Mapiritsi iwayo haasi kukwanisa nyura kuburikidza nemudumbu. Naizvozvo chete raitongwa nomutsinga kana intramuscularly. The soro Kuwanda vanoshingaira fuma iri kuchengetwa ari serum pashure 1 hr. Positive kuchirapa kushanda rinovapo kwemaawa 10-12. Nokuda pfuma iyi majekiseni anoteererwa kaviri pazuva.

Kana rinorumbidza kushandiswa zvinodhaka "Amikacin" mirayiridzo kushandiswa? Majekiseni vanoonekwa kuti kugadzwa zvinotevera zvirwere:

• nemabayo, bronchitis, bapu pute;
• zvirwere zviri peritoneum (peritonitis, pfungwa nomuviri zvemwana asati, cholecystitis);
• Urinary turakiti chirwere (cystitis, urethritis, pyelonephritis);
• ganda zvirwere (maronda maronda, kutsva, kumanikidzwa maronda, maronda utachiona) ;
• osteomyelitis;
• yomumuzongoza, sepsis;
• TB chirwere.

Kazhinji, nzira iyi inoshandiswa nemamwe matambudziko kushatiriswa kuvhiyiwa.

Akabvumira kushandiswa kwezvinodhaka muna chiremba tsika. Izvi yasimbiswa kuti mushonga "Amikacin" mirayiridzo Chinyorwa. Nekuti vana kubvira pamazuva oupenyu okutanga, mushonga uyu unogona kupiwa.

Dosages takatsunga chete nachiremba zvichienderana murwere zera uye muviri wake.

Instruction anopa zvinotevera audzwa:

1. 1 kg nokushivirira uremu (zvose mukuru uye mwana) awire pamusoro 5 MG zvinodhaka. In zano iri kuisa kuburikidza akadzokorora jekiseni 8 maawa.
2. Kana pa 1 kg muviri uremu, 7.5 MG kuti medicament vanobviswa, kuti chinguva pakati majekiseni aiva maawa 12.
3. Cherechedza sei rinokurudzira zvinodhaka neonatal "Amikacin" mirayiridzo Chinyorwa. Nokuti vana, richangobva akaberekwa, chipimo chemushonga rinowanikwa sezvinotevera: 1 kg - 7.5 MG. Panyaya iyi penguva pakati majekiseni - maawa 18.
4. Duration yokurapa kungava 7 days (mu / chiyamuro) kana mazuva 7-10 (pamwe / vakasuwa majekiseni).

"Netilmicin"

The mushonga wayo inorwisa utachiona chaizvoizvo zvakafanana "amikacin". Saka pane zviitiko apo "Netilmicin" akapa mukuru efficacy vaya Micro-zvinenge umo mushonga pamusoro apa yaiva chinhu.

The mushonga ane chinokosha zvinobatsira tichienzanisa nedzimwe aminoglycosides. Sezvinoratidzwa mushonga "Netilmicin" mirayiridzo kushandiswa, mushonga une yakaderera nephrotoxicity uye ototoksichnostyu. The medicament rinotarisirwa kuvinga parenteral kushandiswa.

"Netilmicin" mirayiridzo kushandiswa vanokurudzirwa sarudza:

• pamwe septicemia, bacteremia,
• nokuti pakurapa nokuzvikudza chirwere kushatiriswa giremu negative tupukanana;
• Zvirwere ari kufema ino, kuti urogenital turakiti, ganda, nemarunda, osteomyelitis;
• Neonatal staphylococcal kana kutapukirwa kwakakomba (sepsis kana nemabayo);
• panguva ronda, uye preoperative intraperitoneal zvirwere;
• kune ngozi postoperative yematambudziko Varwere zvomusejari;
• zvirwere zviri nemudumbu.

Zvavakabvumirana chipimo chemushonga kunotemwa chete nachiremba. Zvingava kubvira 4 kusvika 7.5 MG. Zvichienderana chipimo chemushonga, murwere uye zera wake masikati inokurudzirwa 1-2 jekiseni.

"Penicillin"

mishonga iyi ndeimwe anokosha ari boka inorwisa mabhakitiriya. It ane basa pamusoro siyana zvigare.

Tisanzwe "Penicillin":

• streptococci;
• gonococci;
• meningococcus;
• pneumococci;
• diphtheria, hwechigwadara, tetenasi, gasi neronda rinonyenga;
• vamwe utachiona anonzi Staphylococcus, Proteus.

Vanachiremba vakaona inonyatsobudirira kukanganisa muviri intramuscular chiyamuro. In majekiseni akadaro mukati 30-60 maminitsi kunonyanyisa vakachengeta ropa zvinodhaka wevasungwa "Penicillin".

Aminoglycosides kuti penicillin vakagadzwa zvinotevera nyaya:

1. High kudiwa date mishonga yokurapa sepsis. Vari pachii pakurapa gonococcal, meningococcal, zvirwere pneumococcal.
2. The mushonga "kuti penicillin" riri basa varwere kuwana maoparesheni kuitira kudzivirira matambudziko.
3. Danho kunobatsira kurwisa purulent yomumuzongoza, pfungwa pute, mwandabvu, sycosis, njovhera. Zvinokurudzirwa kuti kwazvo kutsva uye maronda.
4. Zvipatara "Penicillin" mushonga waakaudzwa varwere achitambura kuzvimba nzeve, ziso.
5. Ndikarangarira mushonga pakurapa zvatichiri uye lobar nemabayo, cholangitis, cholecystitis, septic endocarditis.
6. Persons kutambura rheumatism, mushonga waakaudzwa kuti kurapwa uye kudzivirira.
7. The mushonga rinoshandiswa kuti vachangoberekwa navacheche, uyo akaonekwa ane achiine rukuvhute sepsis, kana septic pyosepticemia muchetura chirwere.
8. The chinodhaka zvaisanganisira pakurapa zvinotevera zvirwere: otitis, nezvitsvuku fivha, diphtheria, purulent pleuritis.

By intramuscular kwokubatsira munhu medicament vanoshingaira chirungiso yava kunyura kupinda muropa. Asi pashure maawa 3-4 zvinodhaka mumuviri asisiri iri kuchengetwa. Ndokusaka, inonzi zvakafanira wevasungwa, Zvinokurudzirwa kudzokorora majekiseni ose maawa 3-4.

Drug "Gentamicin"

It anogadzirwa muchimiro anonhuwira, mhinduro kuti jekiseni, uye mahwendefa. The mushonga ane bactericidal ehupfumi. Rinotibatsira zvaparadza giremu negative zhinji utachiona, Proteus, Campylobacter, Escherichia coli, anonzi Staphylococcus, Salmonella, Klebsiella.

Kugadzirira "Gentamycin" (Mahwendefa kana mhinduro) kupinda muviri anoparadza kutapuriranwa yomuchipatara uri cellular chechetere. Kufanana upi aminoglycoside, rinopa mitemo mapuroteni usage utachiona. Somugumisiro utachiona dzakadaro havachakwanisi zvakare bereka uye haafanirwi richiparadzirwa munyika muviri.

Mishonga nokuti zvirwere zvirwere kukanganisa siyana gadziriro uye nhengo:

• yomumuzongoza;
• peritonitis;
• prostatitis;
• mwandabvu;
• osteomyelitis;
• cystitis;
• pyelonephritis;
• endometritis;
• empyema;
• bronchitis, mabayo;

Drug "Gentamicin" kudiwa zvakakwana mune zvokurapa. Inoita varwere kuporesa kubva zvirwere zvakakomba pamusoro kufema uye Urinary maturakiti. chokushandisa ichi inokurudzirwa mu zvirwere urongwa, kufukidza peritoneum, mapfupa, nyoro zvinyama kana ganda.

Aminoglycosides hadzina arongera kuzvidzora kurapa. Musakanganwa, kusarudza achida mushonga chiremba anogona vanokwanisa chete. Saka, regai kuzvidzora medicate. Zvipe utano hwako unyanzvi!