"Amphotericin B": imfundiso, indlela amanyathelo. Baqinisekiswa ngalo ichiza

isikhumba ezinzwaneni uzise ukungaphatheki eqaphelekayo isigulane. Ngaphezu koko, izifo ezosulelayo ezifana. Ngoko ke, xa imiqondiso yokuqala ngundo kufuneka nakanjani ebhekisela yincutshe. Emva kokuphumelela iimvavanyo zonyango kunye nezinye leemviwo ugqirha linyanzelekile ukuba ukumisela amayeza isigulane olusebenzayo.

Amaxesha amaninzi, ukuze unyango lwezifo ezinzwaneni usebenzisa namafutha aqholiweyo ezahlukeneyo kunye namacwecwe. Noko ke, oogqirha abaninzi bathi ukuba imeko zophendlo lwezifo ezifana kungcono iphathwa ngenaliti efakwa. Emva isitofu ichiza nangoko baqale ukwenza Cya ebonisa uvakalelo ethile kuyo.

Iindlela efanelekileyo nesebenzayo ukuthwala amayeza ukuphelisa izifo ezinzwaneni "amphotericin B". Imiyalelo, iintlobo woyekelelo yakhe namaxwebhu angqina ngaye malunga ichiza zithiwe thaca apha ngasezantsi.

Form, ukwakheka, inkcazo nokufakwa olwa

Zuza ingqalelo ichiza banokuba ezi fom zilandelayo:

• Lyophilisate "amphotericin B". Ukuphonononga baxele ukuba olu hlobo ichiza ubunzima aneentunja hygroscopic imibala etyheli kungekho livumba ngokukhawuleza. It yenzelwe ukulungiselela yezisombululo ukumnika. Ilungu elikhutheleyo ichiza amphotericin B. Ezi zixhobo zisetyenziswa izinto abangabancedani ezifana monobasic phosphate sodium kunye deoxycholic acid. Xa intengiso medicament ikhutshwa ngazo nengqayi ye ml-10, kunye iibhokisana iphepha.

• Wamafutha "amphotericin B". Ukusetyenziswa kwale ndlela iboniswa njenge iziyobisi supplementary kunyango udibaniso. amafutha nokubola kusetyenziswa ngaphandle nje. Kuso olulubhelu iqulethe isithako esebenzayo kwegama elifanayo. Njengoko yezigqeba ezongezelelweyo ukuba zisetyenziswa yezimbiwa oyile, petrolatum, kunye polysorbate 80. Thenga le kungaba kwibhokisi-30 okanye '15

Indlela yokusebenza ye protivogribkvogo iziyobisi

Yintoni na ichiza "amphotericin B"? Imiyalelo yokusebenzisa (amacwecwe kunye isithako efanayo esebenzayo efumaneka kakhulu yingxaki) ingxelo ukuba i polyene zintsholongwane macrocyclic kunye nomsebenzi nokubola. Kokuba lukhutshwe Streptomyces nodosus, kwaye ibonelela fungistatic kunye namanyathelo fungicidal (ngokuxhomekeke uyondelelwano lwee- ichiza eziphilayo ulwelo kunye susceptibility).

Emva ichiza nghena egazini sibopha ukuthi sterols abafunyanwa inwebu iseli ye fungi ingqalelo ichiza. Ngenxa yokuba sesichengeni loo aphazanyiswa permeability kunye nokususa components intracellular kwenzeka kwisithuba extracellular.

Ichiza "amphotericin B" iyasebenza nxamnye Ngeentlobo ezininzi kwaye abangaxhalabisiyo esebenzayo nxamnye zomngundo lenyama.

Kufuneka kuqatshelwe ukuba oku kuthetha ukumelana Fusarium spp. kunye Pseudallescheria boydii. Ukongeza, eli chiza ayikho olusebenzayo ngokuchasene rickettsiae, iintsholongwane kunye neentsholongwane.

Iimpawu kwikinetiki ye ichiza

Ngoku uyazi ukuba onjalo arhente nokubola an, njengoko "amphotericin B". Indlela yesenzo le arhente sele kuchaziwe ngentla.

Emva ulawulo efakwa beziyobisi idosi enye egazini ngokukhawuleza wadala eyavela olusebenzayo egcinwe imini yonke. iiproteni C enebana plasma sixhobo 90 ekhulwini.

medicament kujongwa zasasazwa esibindini, umphunga, zezintso, udakada, izihlunu, nobubovu adrenal kunye namanye amalungu kunye namalaphu. Ayithandi effusion pleural, peritoneal kunye ulwelo lwamalunga kwakunye uburharha zolwelo ifikelela 2/3 ye xi egazini.

Le endleleni kuthetha ayaziwa. Xa umchamo inyongo malunga 98 ekhulwini langoku kweziyobisi ngohlobo metabolites. Ibonakala kancinci nge nezintso. I sokuqala isiqingatha-ubomi beziyobisi abadala iiyure ezingama-24, abantwana - Iiyure 6-40, kunye nosana - Iiyure 20-60. Yesiphelo isiqingatha-ubomi iintsuku ezili-15.

eziveza isibulala-zintsholongwane

Lokunyanga izifo amayeza "amphotericin B"? Waye waqeshwa eqhubela phambili, amagciwane izifo ezisongela ubomi ukuba sabangela amagciwane sifo:

• histoplasmosis, cryptococcosis zasasazwa, coccidioidomycosis;
• cryptococcal meningitis, paracoccidioidomycosis, chromomycosis;
• meningitis ebangelwa ezinye nomngundo, blastomycosis North American;
• kuwenza kunye aspergillosis yeli lizwe, phycomycosis (zygomycosis);
• kuba zisasazwe candidiasis gialogifomikoza;
• ngumngundo mycosis, mycetoma ezingapheliyo;
• sporotrichosis nezisasaziweyo, usulelo esiswini (kubandakanywa peritonitis);
• endophthalmitis, endocarditis, nokudumba ezinzwaneni;
• leishmaniasis Visceral, usulelo fungal womchamo;
• American leishmaniasis cutaneous visceral.

Izimo umenzeli nokubola

Khawuve oko urhulumente ukuba asebenzise ichiza akuvumelekanga "amphotericin B" (amacwecwe ngundo kwegama elifanayo akubangelwa). Ngokutsho imiyalelo, esi sixhobo contraindicated:

• ukusilela kwezintso ezingapheliyo;
• ku hypersensitivity;
• ngexesha lokuncancisa.

Ngenyameko medicament esebenzayo ezisetyenziswa isifo sezintso (kubandakanywa glomerulonephritis), amyloidosis, isibindi ukuqina, hepatitis, ianemia, agranulocytosis, ukukhulelwa kunye seswekile.

Lyophilisate "amphotericin B": imiyalelo yokusebenzisa

Kuba ukulungiselela isisombululo amayeza efakwa yasetyenziswa ne ndzo yokuqala 5 mg / ml. Ngesirinji 10 ml yamanzi ludlolo ukuba isitofu ukwenza igutyana kunye medicament. Okulandelayo, imixholo, izanyazanyiswa ukwenza ulwelo colloidal ngaphaya.

ngokuzitofa iphethwe kwisithuba seyure phantsi kolawulo uxinzelelo lwegazi, ubushushu bomzimba kunye nezinga intliziyo yesigulana. Xa ukunyamezelana imithi elungileyo ekucetyiswa idosi yemihla ngemihla ka 0.25-0.3 mg nganye ubunzima bomzimba kg (ngokuxhomekeke nobungozi besi sifo).

Xa izifo zentliziyo kunye nempahla yegazi, ubuzaza eyonyukileyo kunye nokusebenza kwezintso asanelanga, nokunyanga kunye iidosi ezincinane (5-10 mg), nto leyo ngcembe linyuke nge 5-10 mg ngosuku kwaye nokutshintswa 0.5-0.7 mg kg nganye.

Xa sporotrichosis iyeza idosi khosi 2.5 g, kunye nobude unyango - kangangeenyanga ezili-9.

Xa oyidlayo isixhobo aspergillosis ngu 3.6 g, kunye nobude unyango - iinyanga ezili-11.

Iintsana ekuqaleni unyango ezilawulwa 0.25 mg nganye ubunzima bomzimba kg ngosuku uze landa ngokuthe ngcembe ukuba idosi iphezulu (1 mg kg nganye).

Wamafutha "amphotericin B": imiyalelo yokusebenzisa

Amacwecwe phantsi efanayo igama lorhwebo ezikhemisti akathengiswa. Ngako oko, kuba ukutshintshwa olu nyango kufuneka udibane nogqirha.

Ukuba ukusetyenziswa kuyimfuneko wamafutha "amphotericin B" umaleko obhityileyo lisetyenziswa kwiindawo ezichaphazelekayo kabini yonke imihla. Ikhosi unyango ixhomekeke ubungqina:

• kunye candidiasis le Imihlubulo ulusu - malunga 1-3 iiveki;
• kunye ilweyile irhashalala ebantwaneni - malunga 7-14 iintsuku;
• kunye paronychia kunye neendawo interdigital laloyisa - iiveki 2-4.

imiphumela emibi

Ukulungiselela "amphotericin B" kunokubangela iziphumo ebezingalindelekanga ilandelayo:

• intloko, ukuxhuzula, peripheral neuropathy, vertigo zezomzuzwana, Encephalopathy;
• ukungabi namdla, ukugabha, ukuqunjelwa, isicaphucaphu, gastralgia, urhudo, hepatotoxicity, sisibindi, nenyongo, hepatitis, melena, gastroenteritis haemorrhagic;
• igazi normochromic normocytic, leukopenia, ukuphazamiseka kwamahlwili, thrombocytopenia, agranulocytosis, igazi hemolytic, eosinophilia, leukocytosis;
• ukungaboni, bakuva ilahleko, diplopia, ukuduma;
• tachypnea, dyspnea, nokudumba yemiphunga, arrhythmia kunye hypersensitivity pneumonitis;
• ukuncipha okanye ukwanda uxinzelelo lwegazi, ukurhawuzelela, utshintsho parameters ECG, ukusilela intliziyo, ukothuka, ukusilela intliziyo;
• reactions anaphylactoid, ukuthimla, nephrogenic seswekile insipidus, bronchospasm, nephrocalcinosis, irhashalala, dermatitis eksfoliativiy, ityhefu epidermal necrolysis
• ukusilela kwezintso, hypokalemia, gipostenuriyu, lactic sezintso tubular, Stevens - Johnson syndrome, ukusilela etsolo kwezintso, oliguria, anuria;
• thrombophlebitis aqhumisele kuyo inaliti;
• fever, myalgia, ukwehla kobunzima, arthralgia, ubuthathaka jikelele.

amacala libanda

Xa ufakwe amathamo ezinkulu amayeza isigulane ukuze bayeke ukuphefumla nentliziyo. Ngoko ke, ngethuba unyango kufuneka alandele ngqo ugqirha nesilinganiso ekhuthazwayo. Kuyimfuneko ukuba iliso bokuphefumla kwentliziyo, sezintso zesibindi umsebenzi, picture igazi peripheral, kwanolwazi oluqulethweyo yalo electrolytes.

Ukuhambelana namanye amayeza

Le medicament "amphotericin B" zandisa okanye ukuphuphumala iimpembelelo namanye amachiza, kwakunye ukwandisa letyhefu zabo. Ngoko ke, eli chiza kumiselwe ngobunono unyango.

Ekuqeshweni yomenzeli wathi umguli, qiniseka ukuba wazise ugqirha wakho malunga nokuthatha amanye amachiza. Kungenjalo, ukusetyenziswa "amphotericin B" (emthanjeni) inokuba yingozi kwimpilo jikelele kakuhle-ntle yomntu.

izincomo ezithile

• Ichiza "amphotericin B" iya kusetyenziswa kuphela unyango losulelo ubomi emngciphekweni yaye ezinzwaneni okuqhubekayo.
• Nokusebenzisa elide amathuba neziphumo enetyhefu ukunyuka.
• Xa ukusetyenziswa ichiza kufuneka anemia ephelisiweyo.

reviews

Ngoku uyazi indlela ichiza enze "amphotericin B". Ukurhoxiswa enegama elifanayo ayikho ezithengiswayo ekhemesti. Ngako oko, kuba ulawulo ngomlomo, kufuneka ukhethe kwelinye ichiza kunye isenzo efanayo.

Ngokutsho uninzi lwezigulane, ingqalelo indlela ukumelana ngempumelelo umsebenzi. Oku ngokupheleleyo ngayo kolusu fungal, ukuphelisa ubuhlungu ngokwasemzimbeni nangokwasengqondweni isigulane.

Eyona ethile iphambili yale ichiza inani elikhulu yeziphumo ebezingalindelekanga. Ngexesha unyango, esi sixhobo ngayo ezibi esinokubakho ngakwicala onke amalungu kunye neenkqubo. Ngoko ke, kufuneka isetyenziswe kuphela ezibonisa ezizodwa.