"Meropenem": imiyalelo ukusetyenziswa, ncomo. analogue iziyobisi

Ngu antibiotics eyenziweyo ziquka iqela carbapenems, ummeli apho i "meropenem" kweziyobisi ngenxa yolawulo parenteral. Ngenxa amanyathelo bactericidal kwaye bacteriostatic ye njengesakhi isiyobisi esebenzayo uyakwazi zinqanda ukukhula nokukotshwa iintsholongwane ezibangela izifo ezahlukeneyo arhabaxa.

inkcazelo amayeza

Le medicament "meropenem" kugqalwa zintsholongwane ebanzi-spectrum kwaye omhlophe okanye amhlophe ngumgubo namona emthubi ukuba isisombululo. Faka bolus efakwa okanye ukumnika.

Ukukhulula oko ezineengqayi kwaye inomthamo ml-10 no-20. Le umthamo lo lyophilisate yaba 0.5 g okanye 1 g le "meropenem" iziyobisi. Iipilisi kunye nezisombululo injectable ukuba isitofu intramuscular usebenzisa zintsholongwane ayivelanga. Inye kuphela uhlobo ukukhululwa.

ichiza

Icandelo esebenzayo izenzo ifomu meropenem trihydrate kulo. Xa inkcazo ekwakhiweni, ibalwa igutyana 1, ibonisa ubungakanani into esebenzayo: meropenem trihydrate ka-0,570 g, okanye 1.140 g, yaye, ezisekelwe phezu ezamahala meropenem 0.5 g okanye 1 g, ngokulandelelana. Imizekelo kwezinto abancedisayo ziquka nomgubo sodium carbonate.

nabalingani Main kunye nabenzi babo

Original meropenem ichiza lusekelwe iziyobisi "Meronem" ngokohlobo umgubo 0.5 g Isetyenziswa ngokwenza isitofu yeminikelo ilungiselelwayo yegazi. Le zintsholongwane lukhutshwe inkampani yaseBritani "Astra Zeneca Co., Ltd.", ngokusekelwe eyathi yaqulunqa ubume kunye umthamo ichiza, baqhuba iimvavanyo pre-lwezonyango kunye clinical. Amanye amalungiselelo kunye meropenem kuthathwa generic kwaye iveliswe umfanekiselo yokuqala.

In generic "Meropenem" nucleoside ezikhoyo njengoko negama lorhwebo, coinciding kunye ngamazwe igama non-wezindlu, naphantsi urhwebo ngaphandle Inn ifunyenwe. Bakhulule ifomu, idosi kunye nokwakhiwa zonke "Meronem" lwemithi amayeza ngokubanzi, efana enye, nto leyo ibonisa interchangeability zabo.

Ichiza kunye negama lorhwebo "Meropenem" eziveliswa mveliso amaninzi amayeza ehlabathini lonke. Umzekelo, inkampani Indian "M. J .. Biopharm Pvt. Co., Ltd. "silwenza iyeza, yaza yahonjiswa oluqhutywa inkampani Russian Cjsc" Biotec MFPDK ". Iinkampani Ukrainian "Lekhim", "Pharma Life" kwakhona avelisa i zintsholongwane "Meropenem". Analogs inokuba liqulathe egameni layo kwakhona igama umenzi. Imizekelo ehlabathini imithi iqashiso. Ngokukodwa, ukulungiswa eyaziwa "meropenem Vero". It yimveliso yenkampani Chinese "Shenzhen Haibin Co Pharmaceutical .. Ltd ".

Medicament "Meropenem Dzhodas" - Indian analogu of zintsholongwane ebanzi-spectrum eveliswe yi LLC "Dzhodas Ekspoim". Oveliswa kwifomu olungumgubo eyimveliso sisombululo inaliti 500 mg kunye 1000 mg.

inkampani Russian "ABOLmed" LLC wenza amayeza "Meropenabol" ngokwesiseko yomenzeli meropenem antibacterial. Ukususela powder, isisombululo lolawulo efakwa.

Drug "Meropenem Spencer»

Esi sixhobo yenye Indian analogue wenza ngoku, "Cooper Pharma" for "Spencer UKey Pharma Limited", India. Iveliswe ifomu trihydrate meropenem yi kwaye inxulumene qela carbapenems. Zintsholongwane "meropenem Spencer" ebonisa isiphumo antibacterial nxamnye iintsholongwane gram-HIV kunye gram-ezingentle izifo ukudumba kunye esosulelayo. Isetyenziswa lolawulo parenteral.

iipropati kwemithi

Isiphumo ezingundoqo manual kweziyobisi meropenem uqeqesho uchaza isenzo bactericidal of spectrum ngokubanzi, nto leyo inxulunyaniswa kwezithandani of ekumisweni ndizayo yebhaktiriya. Ukukwazi sisizekabani sokufa kwelungisa iintsholongwane aerobic kunye anaerobic ngenxa umthondo zintsholongwane ngalo eludongeni silwanyana, egalelwe ngokumalunga beta-lactamases kunye ngobuhlobo omkhulu kwizakhiwo protein, yokuhlanganisa penicillin.

Ngokuzibophelela kwi receptors protein phezu inwebu le icytoplasm iintsholongwane lokunciphisa maleko peptidoglycan yeseli udonga ingcinezelo transpeptidase wakhululwa enzayim autolytic eludongeni yeseli ukuphazamisana isakhiwo sayo kunye kukhokelele ekutyeni nasemakhalaneni ekufeni.

Yintoni kwaziwe antibiotics?

Lokulungiselela "Meropenem" umyalelo kwi isicelo kubandakanya ukusetyenziswa aerobes anti-Igram-HIV, eziquka Enterococcus fekalis, Stafilokk aurelus, iStreptococcus agalactia, iStreptococcus inyumoniya ngovakalelo ku
penicillin, iStreptococcus piogenez, iStreptococcus viridans.

Umsebenzi eliphezulu zintsholongwane nxamnye aerobes ezimbi-Igram, phakathi apho Escherichia coli uyazimela, Haemofilus influentsa, Klebsiella inyumoniya, meningitidis Neisseria, Pseudomonas aeruginoza, Proteus mirabilis.
Meropenem enza ngayo iintsholongwane anaerobic, ezifana: Bakteroides flagilis, Peptostreptokokkus spp.

Ukusebenza ichiza kungqinwe nxamnye iintsholongwane zilandelayo zophando vitro kuphela, kodwa akukho bungqina ngempumelelo onyango.
Gram-HIV aerobes baphathe Stafilokokus epidermidis kunye metitsillinovoy ubuntununtunu kunye aerobes ezingalunganga-gram: Atsinetobakter spp, Aeromonas hydrophile Campylobacter Jaejoong, tsitrobakter diversus, tsitrobakter Freund, Enterobacter cloaca, Hafnie, Klebsiellla oksitoka, Morakella katarrhalis, Morganella Morgan, nePasteurella multotsida, Proteus vulgaris. , iSalmonella spp., Serrat martsestsens, Shigella spp., Ursino enterocolitis.

-In vitro ulwa iintsholongwane anaerobic :. distasonis Bakteroides, Bakteroides ovatus, uniformis Bakteroides, Bakteroides ureolitikus, Bakteroides vulgaris, zeClostridium difficile, perfringens zeClostridium, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes.

Ophatha iziyobisi

Ngenxa yokuba banzi koluhlu yintshukumo esebenzayo imiyalelo iziyobisi meropenem ngokusetyenziswa ekucetyiswa zezigulo ezahlukeneyo esosulelayo kwaye ukudumba njenge medicament esinye okanye kunyango zidityaniswe.

Ezi zibandakanya ezi zifo zintsholongwane-onovakalelo echaphazela:

• iphecana ukungaphefumli, libonakaliswa yi ukudumba emiphungeni, kuquka inyumoniya nosocomial;
• inkqubo wokuchama njengoko pyelonephritis, pielita;
• isikhumba kunye kwizihlunu ezithambileyo ngohlobo erysipelas, pyoderma, dermatoses eziziisekondari bosulelwa;
• ngokwamalungu isinqe, kuquka ukudumba inwebu kwiinwebu isibeleko;
• ngokwamalungu kwisisu, kuquka nemeko nzima appendicitis, peritonitis, pelvioperitonita.

Drug ubonisa sokusebenza meningitis bacteria nosuleleko negazi. Abantu abane neutropenia febrile, olwa ezisetyenziswa kunye arhente antiviral okanye nokubola.

IMithetho sisombululo iziyobisi

Ukuchithwa beziyobisi kufuna ukunamathela izilumkiso aseptic kunye kubola. Ezineengqayi ngesisombululo esetyenziswa kanye akuvumelekanga ngaxeshanye ukuxuba amachiza zintsholongwane kunye nezinye.

"Meropenem" zintsholongwane ngohlobo powder ludlolo injectable bungxengwe ngamanzi olunye bolus efakwa. Ukunyibilika 1 g meropenem usebenzisa ml-20 zamanzi, ongqamana iqela 50 mg nganye 1 ml. Le fluid uzilungiselele ongowona ecacileyo, ezingenambala okanye ukukhanya-yellow ezincinane.

Kukusetyenziswa 50-200 wesinyibilikisi ukulungiselela ml isisombululo ukumnika ehambelanayo "meropenem". Ezi ziquka:

• sodium chloride 0.9%;
• dextrose-5% okanye 10%.

Phambi ulawulo efakwa ye engamanzi bungxengwe yazanyazanyiswa.

uhlengahlengiso balawule

amayeza abadala "Meropenem" umyalelo ncwadana inika umlinganiselo ongama-500 mg, nto leyo iyaphindwa emva kweeyure-8. Ngokutsho eli cebo okunyanga isifo sokukrala kwemiphunga, izifo womchamo, izifo ezosulelayo kunye ukudumba kwi amalungu isinqe encinane, usulelo yesikhumba kunye inyama kwezihlunu.

inyumoniya Nosocomial, peritonitis, septicemia, iimpawu zosulelo kwegciwane izigulane febrile neutropenic ifuna ukusetyenziswa zintsholongwane ka-3 ngosuku kunyaka-1 Xa meningitis ekucetyiswa ithamo 2 g qho kwiiyure 8.

Kuxhomekeka ebukhulwini kunye nohlobo zokugula nomthamo ukhethe ugqirha yomguli kunye nobude unyango.

Ngokuqhelekileyo, ukuphululwa ubude kuxhomekeke indlela wolawulo. An bolus efakwa bondle sisombululo exutywe ikhutshwa phandle malunga 5 imizuzu, kunye nokufakwa efakwa ka - ukususela-15 ukuya kwengama-30. Medicament "Meropenem" im akafakanga.
ukusilela Chronic kwezintso ifuna ukulungiswa nomthamo ngokungqinelana ne yokususwa creatinine :

• e ml 26-50 ngomzuzu, iidosi 500 mg ukuya grams-2 qho kwiiyure ezili-12;
• e ml 10-25 ngomzuzu, iidosi ukususela 250 mg 1 g, zonke iiyure 12;
• ngaphantsi kwe-10 ml ngomzuzu, iidosi ukususela 250 mg 1 g, kanye qho kwiiyure ezingama-24.

izigulane abadala nokusebenza eqhelekileyo kunye ukucoca creatinine sezintso mkhulu ml-50 ngomzuzu nomthamo ukhethe. ukusilela Isibindi akukho sizathu sokuba uhlengahlengiso ithamo.

Ngexesha ihaemodialysis kukho kukhuthaza meropenem, kwaye ichiza ilawulwa ekupheleni kwale nkqubo. Oku kuyinyaniso ngakumbi sokubuyisela unyango ixesha elide i igazi xi ngempumelelo olwa nawo.
Xa abantwana abaneminyaka kwiinyanga ezi-3 ukuya kwiminyaka 12 zisetyenziswa yegazi 10-20 mg beziyobisi 1 kg ubunzima bomzimba nganye ngexesha lokuphumla iiyure ezisi-8. Oyidlayo kuxhomekeke pathogen nobuzaza yayo nemithi kunye sifo.
Ukuba abantwana abangaphantsi kweminyaka eli-12 ubunzima bomzimba kune-50 kg, abelwe isikalo abadala.

Meropenem therapy kwabantwana umsebenzi sezintso kakuhle alikhange kufundwe.
Xa unyango lwe meningitis ngokusebenzisa-40 mg nganye 1 kg ubunzima emva kweeyure-8.

Le unyango contraindicated

Kubalulekile ukwazi ukuba bonke ichiza ingasetyenziswa, ingakumbi xa kukho hypersensitivity ukunyuka kule zintsholongwane, okanye arhente ezifana beta-lactam antibacterial ngaphambili.

abantwana Small ukuya kwiinyanga ezi-3 musa ukumisela amayeza, "Meropenem". Baqinisekiswa kubonisa isicelo eluncedo ngayo iziyobisi ezinempembelelo zinetyhefu kwi nezintso, kunye nezifo esiswini.
Ngexa lokukhulelwa, ichiza ayisetyenziswa, ngaphandle kweemeko apho iinzuzo zintsholongwane idlula nefuthe elibi uphuhliso usana olungekazalwa. Lwebele-nokutyisa ngexesha unyango akukhuthazwa ngoogqirha.

imiphumela emibi

Kwi yokulungiselela "Meropenem 'ukureyithwa lubonisa kuphuhliso neziphumo ezibi kwiindawo ezahlukeneyo omzimba kunokwenzeka.

luvo kwaye ibone amalungu esinokusabela ngayo imbonakaliso zintsholongwane ye intloko ebuhlungu, isiyezi, isiza ndindisholo, ukuntlontlozela kunye esibuhlungu, ukuvukelwa olomeleleyo ngokweemvakalelo, ukwazi kakuhle, ukuxhuzula epileptiform, yombono.

Ngelo yegazi, ukulungiselela amalungu hematopoiesis kuba nefuthe elibi anxulumene nala ukunyusa inani eosinophils neeplatelets kwi plasma yegazi peripheral, kwaye ukuhla zegazi kunye leukocyte iiseli, amanqanaba ihemoglobin, kunciphise ixabiso hematocrit kunye nenani neutrophils, okukhokelela agranulocytosis, kunciphisa thromboplastin kunye nexesha prothrombin.

Ezinye izigulane uphawula utshintsho enxulumene amalungu phecana zesisu, sikubonise iintlungu esiswini, ubucaphucaphu, ukugabha, urhudo, ukuqhina, ukungacoleki kokutya, senyongo. Kwakhona kumanqanaba of yibilirubin kwi plasma yegazi kunokwenzeka, ukwandisa umsebenzi kwi-enzayim aminotransferase alanine, aminotransferase aspartate, phosphatase obrak, kunye dehydrogenase zincancise. Kwiimeko ezinqabe kakhulu, uqala imeko pseudomembranous sikabhobhosi, okanye, ukwenzakala isifo ngomlomo kuvela candidiasis.

Kukho iimeko zolwaphulo ezichaphazela inkqubo genitourinary. Ezi ziquka: nzima ukuchama, iindumbisa ancedisana ezithambileyo karhulumente, waphula umthetho kidney ezinxulumene hypercreatininemia, ukwandisa amanqanaba urea egazini, hematuria, thrush.

Antibiotics esikwaziyo ukuvelisa ezahlukeneyo negazi lakho. Bona kubonakaliswa ukurhawuzelela, irhashalala, urticaria, erythema multiforme, Stevens-Johnson syndrome, ityhefu epidermal necrolysis, angioedema, Njengokungeniswa anaphylactic.

Phakathi kwezinye ziziphumo ebezingalindelekanga, kukho uhlaziyo iziniki-potassium ivela emzimbeni, ukwandisa umthamo wegazi kwi kwegazi, ngqo okanye antiglobulin ngqo positive Coombs. reactions Local ngolawulo efakwa zinxulunyaniswa nangokurhala, phlebitis, thrombophlebitis, ukudumba kwindawo efakwe kuyo inaliti.

Ezinye izigulane ziye ezinxulumene ziziphumo ebezingalindelekanga olwa nawo ukuba nemibono, ukudakumba, ukuba nochuku, sokulibala, ukusilela intliziyo, ukusilela intliziyo, tachycardia, bradycardia, engabalulekanga intliziyo kwezihlunu, amathontsi uxinzelelo lwegazi, ukuphelelwa umoya, niphele kunye ixhala, nangona indima ethile meropenem ezi mpawu .