Aminoglycosides: amachiza (igama uluhlu, Ukuhlelwa, imiyalelo isicelo)

Inkangeleko kwimarike amayeza-ntsholongwane esitsha kunye uluhlu olubanzi yeziphumo, ezifana fluoroquinolones, cephalosporins, kukhokelele kwinto yokuba oogqirha baqalisa ukumisela aminoglycosides kunqabile (ARVs). Uluhlu amayeza zifakiwe kweli qela kumba kakhulu yaye iquka iziyobisi ezaziwayo-kakuhle ezifana "penicillin", "Gentamycin", "Amikacin." De namhlanje, kwigumbi labagula kakhulu kunye namasebe zoqhaqho amachiza ithandwayo ncam series aminoglycoside.

Inkcazelo emfutshane qela

Aminoglycosides - amachiza (uluhlu amayeza kuxoxwa ngezantsi), ngaphandle kokuba imvelaphi semi-eyenziweyo okanye yendalo. Eli qela imithi na isiphumo ngokukhawuleza kwaye womelele bactericidal emzimbeni.

Amayeza eziziimpawu kuluhlu olubanzi izenzo. umsebenzi wabo elwa abuthethileyo iintsholongwane Igram-HIV, kodwa kunciphise kakhulu ekulweni microorganisms gram-HIV. Kunye aminoglycosides nokungaphumeleli kwawo ngokupheleleyo nxamnye anaerobes.

Eli qela amachiza ivelise kakhulu isiphumo bactericidal ukukwazi layo ukuze kuthintelwe lisenza protein amagama in amagciwane abanobuntuntunu kwinqanaba ribosome. Nemithi asebenzayo zombini kufuywe iiseli sikarhulumente quiescent. Indlela yomsebenzi zintsholongwane uxhomekeke ngokupheleleyo kwi ingqalelo egazini serum lomguli.

aminoglycoside esetyenziswayo namhlanje ngokwaneleyo anqongophele. Oku kungenxa ubuthi aphezulu la mayeza. Amaninzi ubunzima kwiziyobisi wezintso kwaye amalungu zokuva.

Into ebalulekileyo ezi zixhobo kukungakwazi elalana yabo ezikwiiseli eziphilayo. Ngenxa yoko, aminoglycosides bengenamandla ngokupheleleyo ukulwa iintsholongwane intracellular.

Ubuhle lobubi

Le mithi zisetyenziswa kakhulu njengoko ngentla, xa kusenziwa utyando. Kwaye nje kwenzeka. Oogqirha xi eziluncedo ezininzi yababephethwe aminoglycosides.

Le iziyobisi umzimba amathuba ezahlukeneyo mihle:

• umsebenzi antibacterial phezulu;
• engekho yokusabela kabuhlungu (yolawulo ziphene);
• isahlakalo ezinqabileyo of komzimba;
• ukukwazi ukutshabalalisa iintsholongwane ukuzala;
• ngcono ukusebenza therapeutic xa zidityaniswe ne-antibiotics beta-lactam;
• umsebenzi eliphezulu ekulweni izifo ezinobungozi.

Nangona kunjalo, kunye izinto ezichazwe ngasentla, eli qela imithi kwaye neengxaki.

Skunye are aminoglycosides:

• umsebenzi esezantsi iziyobisi kungekho oksijini okanye olune medium;
• Ukungena abaziintsizana into esisiseko kwi incindi yomzimba (inyongo, ulwelo spinal, isikhohlela);
• Ukubonakala nobuninzi icala elingenzi nto-.

ngezigaba amayeza

Kukho ukuhlelwa eziliqela.

Umzekelo, banikwe ukulandelelana ngokuqaliswa ibe yezonyango of aminoglycosides, zezona kwisizukulwana esilandelayo:

1. Ichiza yokuqala kusetyenziselwa ukulwa izigulo ezosulelayo baba "streptomycin", "monomitsin", "neomycin", "kanamycin", "Paromomycin."
2. Ukuya kwisizukulwana lwesibini aminoglycosides amatsha (ARVs). Uluhlu Drug "Gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. Eli qela libandakanya iziyobisi semi-zokwenziwa njenge "Amikacin", "Izepamitsin".

Ngomhla spectrum amanyathelo kunye ukuvela ukuxhathisa ngokweendidi aminoglycosides ezahlukeneyo kancinane.

amayeza sizukulwana kukho ezi zilandelayo:

1. Ukuze 1 libandakanya ezo amachiza "streptomycin", "kanamycin", "monomitsin", "neomycin". La machiza kwenza kube lula ukuba ukulwa iintsholongwane ze-TB, kwaye ezinye iintsholongwane Nedlac. Noko ke, phezu ezahlukeneyo iintsholongwane kunye staphylococci negram enye i-HIV, ukuba abanamandla.

2. Second-generation aminoglycoside - eli yeza "gentamicin." Oku azakubalulwa umsebenzi omkhulu antibacterial.

3. imithi Ukuphucula. Baye umsebenzi eliphezulu antibacterial. Isetyenziswa nxamnye klebisielly, enterobacteria, Pseudomonas aeruginosa sesithathu-isizukulwana aminoglycosides (ARVs). Uluhlu iziyobisi na ngolu hlobo lulandelayo:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. iziyobisi "Izepamitsin" libhekisela kwiqela yesine. Oku azakubalulwa ukukwazi ukujongana kakuhle kakhulu tsitobakterom, aeromonasom, nokardiyami.

, Xa yezonyango kwavela elinye yokuhlela. Oku kusekelwe ukusetyenziswa kweziyobisi kuxhomekeka iikliniki sifo, uhlobo usuleleko, kwakunye nokusetyenziswa indlela.

Loo ukuhlelwa aminoglycosides ngolu hlobo lulandelayo:

1. Iziyobisi yokuvela zenkqubo ezilawulwa parenterally (ngenaliti). Kuba unyango lwezifo suppurative bacteria esathi kakhulu kwavusa amagciwane anaerobic olungenelelayo, ekuyaleleni imithi enjalo, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Unyango lwe monoinfections eyingozi, ezo Iintsholongwane uyawabophelela kakuhle xa ifakwe kunyango "streptomycin" amalungiselelo "Gentomitsin" esekelwe. Xa mycobacteriosis iziyobisi uncedo olukhulu "Amikacin," "streptomycin", "kanamycin".
2. Amachiza asetyenziswa ngaphakathi kuphela ezibonisa ezithile. Ezi zezi: "Paromitsin", "neomycin", "monomitsin".
3. Amayeza lokusebenza mlonyeni. Zisetyenziswa ukuba unyango lwezifo ubovu kwegciwane otorhinolaryngology kunye zamehlo. Yokuvela lendawo kumachiza kuphuhliswa "Gentamicin," "framycetin", "neomycin", "Tobramycin".

Ubungqina obubonakalayo buxela ukuba

Ukusetyenziswa aminoglycosides kunilungele ukuba bayitshabalalise iintlobo kwamagciwane gram-negative aerobic. Imithi ukuze isetyenziswe njengendawo monotherapy. Ngokufuthi ukuba kudityaniswe beta-lactams.

Aminoglycosides kuboniswa ngenxa yonyango:

• izifo nosocomial of eyendawo ezahlukeneyo;
• kwiingxaki ubovu postoperative;
• izifo intra-esiswini;
• nokudumba;
• endocarditis infective ;
• pyelonephritis esivulekayo iifomu kakhulu;
• ukutsha ezisulelweyo;
• bacteria meningitis ubovu;
• tuberculosis;
• izifo eziyingozi ezosulelayo (isibetho, iBrucellosis, tularemia);
• samathambo yokubolisa kwavusa ziibhaktheriya gram-negative;
• izifo womchamo;
• Izifo lwamehlo: blepharitis, keratitis ziibhakteriya, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• izifo ENT: otitis angaphandle, rhinopharyngitis, nokuthimliswa, sinusitis;
• izifo protozoal.

imiphumela emibi

Ngelishwa, ngexesha unyango kolu didi lwe chiza isigulane banokuziva yonke uthotho neziphumo ezibi. Eyona ethile ezingundoqo amayeza - oko ityhefu kakhulu. Yiloo nto kuphela ugqirha kufuneka amisele aminoglycosides nomonde.

Iziphumo ezingalindelekanga kungenzeka:

1. Ototoxicity. Izigulane ezikhala ukuva ilahleko, ingxolo yokhaliso. Ngokufuthi zibonisa ekuphazamiseni ngeendlebe. Inkoliso yezi reactions kwenzeka abadala, abantu ekuqaleni abanengxaki ukungase-. ukusabela okunjalo kwenzeka izigulane kunyango ixesha elide okanye ngeedosi eziphezulu.
2. Nephrotoxicity. Isigulane ivela unxano, iyahluka ubungakanani umchamo (okwazi ukwanda kunye ukuncipha), inqanaba creatinine ukwanda egazini, kwanciphisa product glomerular. iimpawu ezinjalo ngokuqhelekileyo abantu abaneengxaki umsebenzi sezintso.
3. ukuvimba Neuromuscular. Ngamaxesha unyango elinganeno nokuphefumla. Kwezinye iimeko kukho ukushwabana izihlunu zifo. Ngokuqhelekileyo, ukusabela ezinjalo uphawu kwizigulane kunye nezifo luvo okanye kakuhle umsebenzi zezintso.
4. izifo Vestibular. Abazibonakalisayo iphula lonxulumelwano, ukuba nesiyezi. Amaxesha amaninzi, ezi ziphumo bezingalindelekanga kwenzeka xa "streptomycin 'ukuqeshwa ichiza kumguli.
5. zizigulo zemithambo. Kubonakale paresthesia, Encephalopathy. Maxa wambi uthomalaliso sikhatshwa sisilonda esidumbileyoesingaphakathi ye-luvo optic.

Aminoglycosides kunqabile baxabane nomzimba ezifana irhashalala.

Izimo

amayeza ezichazwe kunzima ezithile ukuze zisetyenziswe. aminoglycosides amaninzi contraindicated (amagama inikeziwe ngasentla) e ezimbi okanye iimeko ezinjalo:

• hypersensitivity ngabanye;
• kophulwa umthetho umsebenzi sezintso excretory;
• ukuva yokudla;
• uphuhliso ukusabela neutropenic eziqatha;
• izifo vestibular;
• myasthenia gravis, yesi sifo, Parkinsonism;
• ukuxinezeleka yokuphefumla, wobuthongo.

Ukongeza, awunakusebenzisa zona ukuba unyango ukuba ngaba isigulane waba imbali yokusabela okubi nasiphi na isiyobisi kweli qela.

Cinga aminoglycosides athandwa kakhulu.

"Amikacin"

Ichiza lubonakala ngokuba iqapheleka bacteriostatic, bactericidal kunye anti-iziphumo emzimbeni womntu. Ubonisa umsebenzi phezulu nxamnye iintsholongwane ezininzi Igram-HIV kunye navumelanayo-Igram. Ngoko ke ubungqina ichiza "Amikacin" umyalelo manual. Iinaliti ezisebenza kunyango staphylococcus, iStreptococcus, pneumococcus, salmonella, Escherichia coli, Mycobacterium tuberculosis.

Iyeza kukuba nako ifunxwe iphecana zesisu. Ngoko kuphela ezilawulwa yegazi okanye intramuscularly. Ukufumaneka ephezulu into esebenzayo iqatshelwe serum emva 1 hr. ukusebenza entle therapeutic buhlala iiyure 10-12. Ngenxa kule propati lwezitofu yenziwa kabini ngemini.

Xa uncoma ukusetyenziswa kwemiyalelo "Amikacin" ichiza ukusetyenziswa? Iinaliti ziboniswa ukuba ukuqeshwa kwezi izifo zilandelayo:

• pneumonia, iphika, umphunga ithumba;
• Izifo ezosulelayo le peritoneum (peritonitis, pancreatitis, cholecystitis);
• isifo womchamo (Ngokuzimela, urethritis, pyelonephritis);
• zezikhumba (izilonda emathunjini, ukutsha, izilonda uxinzelelo, amanxeba ezosulelekileyo) ;
• osteomyelitis;
• meningitis, nokudumba;
• usulelo lwe-TB.

Ngokufuthi, le sixhobo lisetyenziswa iingxaki nomsindo uqhaqho.

Wavumela ukusetyenziswa kweziyobisi okwenziwayo ezingabantwana. Oku kwabethelelwa ichiza "Amikacin" umyalelo manual. Ngokuba abantwana ukususela kwimihla yokuqala yobomi, eli chiza nga ufakwe.

Iidosi azimisele kuphela ngugqirha ngokuxhomekeka kubudala yomguli kunye ubunzima yomzimba wakhe.

Imiyalelo unika zincomo zilandelayo:

1. 1 kg ubunzima ngomonde (zombini omdala nomntwana) kufuneka kuwa phezu 5 mg beziyobisi. Xa eli cebo lonke phindwa ngenaliti iiyure ezisi-8.
2. Ukuba 1 kg ubunzima bomzimba nganye, 7.5 mg medicament ayemka, lekhefu phakathi izitofu iiyure ezili-12.
3. Phawula indlela icebisa lweentsana iziyobisi "Amikacin" umyalelo manual. Ngokuba abantwana, usana olulele, idosi ibalwa ngale ndlela ilandelayo: 1 kg - 7.5 mg. Kulo mzekelo lekhefu phakathi izitofu - Iiyure ezi-18.
4. Ubude unyango inokuba iintsuku ezisi-7 (e / igalelo) okanye iintsuku 7-10 (kunye / th izitofu).

"Netilmicin"

Iyeza ukusebenza kwayo elwa efanayo "amikacin". Ngoko ke kukho iimeko apho "Netilmicin" yanika ngempumelelo phezulu nxamnye nabo micro-eziphilayo apho amayeza ngasentla nto.

Eli chiza luncedo ebalulekileyo xa kuthelekiswa namanye aminoglycosides. Njengoko kuboniswe "Netilmicin" imiyalelo ichiza ukusetyenziswa, eli chiza a nephrotoxicity ophantsi ototoksichnostyu. Le medicament senzelwe kuphela ukusetyenziswa parenteral.

bakhuthazwe "Netilmicin" imiyalelo yosetyenziso ukuba batyumbe:

• kunye septicemia, bacteremia,
• ngokuba unyango losulelo lokubonwa nomsindo iintsholongwane abangenayo i-Igram;
• usulelo lwe isixokelelwano sokuphefumla, i enzala phecana, ulusu, nemisipha, osteomyelitis;
• staphylococcal ezisanda kuzalwa xa lwezifo kakhulu (nokudumba okanye inyumoniya);
• e inxeba, kunye nosulelo ipreoperative intraperitoneal;
• kwimeko umngcipheko iingxaki postoperative kwizigulane utyando;
• Izifo ezosulelayo of phecana zesisu.

Umthamo ecetyiswayo kumiselwa kuphela gqirha. Kusenokuba ukusuka-4 ukuya 7.5 mg. Kuxhomekeka oyidlayo, umguli kunye nobudala kwakhe emini kucetyiswa inaliti 1-2.

"Penicillin"

Olu nyango yenye yezinto ezibalulekileyo kwiqela imithi. It has umsebenzi ngokuchasene izinto ezincinane.

Iqaphela ukuba "penicillin":

• streptococci;
• gonococci;
• meningococcus;
• pneumococci;
• isifo somqala omhlophe, anthrax, uminxano, babe igesi;
• iintlobo ezithile staphylococcus, Proteus.

Amagqirha waphawula mpembelelo iphumelela umzimba igalelo intramuscular. Xa kwizitofu ezifana ngaphakathi 30-60 imizuzu esiphezulu waphawula igazi iziyobisi xi "penicillin".

Aminoglycosides penicillin abaqeshwe kwezi meko zilandelayo:

1. amayeza data imfuno eziphakamileyo unyango nokudumba. Bona Kucetyiswa ukuba unyango losulelo gonococcal, meningococcal, Pneumococcal.
2. I 'penicillin "ichiza eyabelwe iziguli iinkqubo zotyando ukwenzela ukuthintela iingxaki.
3. Tool inceda ukulwa ubovu meningitis, ithumba ingqondo, ukuvuza ngaphantsi, sycosis, negcushuwa. Kucetyiswa ukuba ukutsha kakhulu kunye amanxeba.
4. Therapy "penicillin" iziyobisi emiselweyo ukuba izigulana ukudumba indlebe, iliso.
5. Isicelo iyeza yonyango focal kunye lobar pneumonia, cholangitis, cholecystitis, endocarditis yokubolisa.
6. Abantu abanengxaki rheumatism, iyeza emiselweyo unyango kunye nothintelo.
7. Iyeza lisetyenziswa ezisanda kuzalwa kunye nabantwana, ngubani kwafunyaniswa ukuba i nokudumba yosana, okanye pyosepticemia yokubolisa isifo ityhefu.
8. Ichiza ifakiwe yonyango izifo zilandelayo: otitis, ifiva nebomvu, isifo somqala omhlophe, ubovu pleuritis.

Ngabaphethe intramuscular ye kubalulekile medicament esebenzayo ngokukhawuleza iye yangena egazini. Kodwa emva kweeyure 3-4 beziyobisi emzimbeni kuphinda uyabonakala. Kungenxa yoko le nto, ukuba ukuqinisekisa yoxinaniso kuyimfuneko, kucetyiswa ukuphinda izitofu qho kwiiyure 3-4.

Drug "Gentamicin"

Oveliswa ngokohlobo yobulawu, isisombululo inaliti, yaye amacwecwe. Eli chiza a iipropati bactericidal. Inika isiphumo emibi gram-negative ezininzi iintsholongwane, Proteus, Campylobacter, Escherichia, Staphylococcus, Salmonella, Klebsiella.

Ukulungiselela "Gentamycin" (macwecwe okanye isisombululo) ngokungenisa umzimba siyitshabalalise ezasulelayo kumgangatho zeselula. Njengaye nawuphi aminoglycoside, ibonelela ekugxojweni kwamagciwane protein yokuqaphela. Ngenxa yoko iintsholongwane ezinjalo balahlekelwe ikhono ukuzala ngakumbi kwaye akufunekanga kusiwa kuwo wonke umzimba.

Antibiotics zizifo ezosulelayo echaphazela iinkqubo ezahlukeneyo kunye namaziko:

• meningitis;
• peritonitis;
• prostatitis;
• ukuvuza ngaphantsi;
• osteomyelitis;
• Ngokuzimela;
• pyelonephritis;
• endometritis;
• empyema;
• iphika, inyumoniya;

Drug "Gentamicin" enesidingo amayeza. It ivumela izigulane ukuba aphilise izifo kakhulu amaphecana bokuphefumla womchamo. Esi sixhobo kuyacetyiswa kwiinkqubo esosulelayo, agqume peritoneum, ithambo, ithishu okanye isikhumba ethambileyo.

Aminoglycosides ezingenzelwanga ukuba self-unyango. Musa ukulibala, khetha ungakwazi kuphela ugqirha abaqeqeshiweyo olwa oyifunayo. Ngoko ke, musani ukwenza self-medicate. Ke kubeke impilo yakho professional!