Ama-antibiotic "Ikhambi": yokusetshenziswa, nozakwabo yangempela

ukuphathwa yamanje izinqubo ezithathelwanayo, akunakwenzeka ngaphandle ukusetshenziswa kwezidakamizwa elwa namagciwane. I ukumelana nanini nyuka microorganism kwenza search for izidakamizwa amasha noma ukusetshenziswa inhlanganisela wasendulo, imithi elwa namagciwane efakazelwe. Hhayi esivuna ukusetshenziswa okunengqondo antimicrobial kufakazelwa ukuqashwa kukaNksz engalawuliwe imithi ebulala izinhlobonhlobo zamagciwane, esikhundleni kokuhlaziywa kokuqala nozwela flora kuya izidakamizwa kuleli qembu. Izidakamizwa "Ikhambi", ekubeni pharmacokinetic abalulekile kanye nezinzuzo pharmacodynamic eziningi fluoroquinolones ngokwethukela kusetshenziswa kakhulu ekwelapheni izifo ezithathelwanayo of etiologies ezahlukene.

izici Clinico-kwemithi

I nomuthi "Ikhambi" noma "levofloxacin" (International Nonproprietary Igama) kuyinto-antibiotic kusukela fluoroquinolones chungechunge, senzelwe imizila enteral and parenteral yokuphathwa.

Iyafika "Ikhambi" (incwadi yeziyalezo inikeza ukwaziswa ncamashi enjalo) kuyinto monoftorhinolonom - isomer ka ofloxacin, futhi uma siqhathanisa nabanye izidakamizwa, possesses pharmacokinetic Izinzuzo ebaluleke:

• bioavailability temlomo 100%, ngezinga lobuhlobo plasma amaprotheni eliphezulu njengoba u-40%;
• esiphezulu igazi serum izidakamizwa siyenzeka 1-2 amahora ngemva kokuphathwa temlomo ifaniswe ukuthi abaphathi elandelayo emthanjeni;
• "Ikhambi" libhekene i elithé yokusabalalisa emzimbeni, ngenxa Ukungena olunzulu nezicubu;
• It has a eside isigamu-ukuphila umzimba ebangela kuphela umthamo owodwa we izidakamizwa ngosuku.

Njengoba sazi ukuthi inani elikhulu zokwelapha umphumela fluoroquinolones kubangela izinga okusheshayo ukwanda okuhlushwa igazi izidakamizwa zokwelapha, eshiwo ngenhla imingcele pharmacokinetic ukunikeza izimo ezikahle bawabulale oluphelele izilokazane ezincane.

Ngokusho uhlobo kwabo isinyathelo ukukhula nasekuvezeni izithombo zaso ezintsha zama-bacterium, "Ikhambi" unethonya amagciwane, nomthelela hhayi kuphela izinhlobo esebenzayo ye namagciwane abangela izifo, kodwa futhi vegetative futhi angasebenzi.

Umzimba ezinye izidakamizwa kwenzeka hepatocytes ngu deacetylation noma namachibi. Nokho, cishe 5% of the izidakamizwa excreted ngu izinso njengoba metabolites, futhi okusele ikhishwe ngokusebenzisa filtration glomerular futhi uketshezi ijabulise. Kufanele kuqashelwe ukuthi ngemva kokuphathwa ngemlomo ngaloko lokusandza kwenteka Ingcenye eqakathekileko yomsebenzi wehlelo izidakamizwa (70%) is excreted kusukela umzimba emahoreni angu-24 elivela emchamweni, futhi mayelana 80% umthamo siqedwa ngemva kwamahora angu-48. I isabelo excretion zomuthi ngokusebenzisa pheshana emathunjini uphansi futhi% mayelana 4 kuphela.

Uma usebenzisa izidakamizwa e esenikwe kuka-1000 mg ngelanga (amaphilisi kabili-nsuku ezingu-500 mg) kukhona amathuba kancane ekuthuthukiseni umphumela ezuziwe.

mshini wezenzo

Lo mshini wezenzo izidakamizwa esekelwe okusithiyayo of enzyme ethile okuthiwa yi-DNA gyrase, okuyinto ehilelekile izinqubo ukufanisana ka nesidoda okunikelwe by uthunge ohlobo omuhle e Helix negative DNA. Ngenxa okusithiyayo of enzyme i- izinqubo ye-DNA ukufanisana, cell division, ukufa kwamangqamuzana okwenzeka.

"Ikhambi": yokusetshenziswa nokubonakaliswa

Kuze kube yimanje, izinkomba esiyinhloko enquma izinqubo igciwane omsakazo webhaktheriya, kubangelwa amagciwane e singangena microorganism ukuba lo muthi ezigulini abaneminyaka engama-18.

Ukulungiselela "Ikhambi" indlela enhle wazibonakalisa ekwelapheni izifo zokuphefumula webhaktheriya we yasenhla nemithombo yasenzansi zokuphefumula ipheshana izifo ezifana ukucinana kwemigudu yokuphefumula acute, sinusitis, Izifo ukuvuvukala ijwabu wamaphaphu. Lokhu kungenxa, ngaphezu kwakho konke, enhle kakhulu izidakamizwa Ukungena singene epithelium ze- bronchi namaphaphu lapho ngisho nangemva kokuba ukuphatha izidakamizwa kuqala kudala lokuhlushwa ngempumelelo.

Le mfundiso eyasungulwa ethi oyisebenzise ngempumelelo ukwelapha pheshana urinary ukutheleleka (pyelonephritis, cystitis, urethritis, njll), Biliary ipheshana izifo, prostatitis, tesikhumba, izifo intraabdominal futhi sepsis.

Ukuze ukwelapha izifo ezithathelwanayo of yomoya "Ikhambi" inikezwa (kuncike kobukhulu isifo) izikhathi 1-2 ngosuku ne 500 mg iphilisi ngalinye, noma ukulungiselela nemijovo.

Ukuze ekwelapheni pheshana urinary nezifo kuyinto umthamo ezanele ukulungiselela 1, 250 mg kanye ngelanga, futhi ezimweni ezimbi kakhulu, umthamo wansuku zonke kungaba 500 mg ( "Remedy 500"). Yokusetshenziswa wathi umthamo kabili-nsuku zonke 250 mg kungenziwa indawo eyodwa 500 mg kuye ngobucayi isifo.

Ukuze ukwelapha izifo ezithathelwanayo zesikhumba lwamafinyila "Ikhambi" inikezwa ngezilinganiso 250 mg kabili ngelanga.

Izimo

contraindication Ingabe Ohulumeni Banalo Lonke ukwamukela izidakamizwa hypersensitivity futhi ziyabagulisa khona umlando nemithi fluoroquinolones.

idatha Definitive mayelana nokuphathwa izidakamizwa ngesikhathi sokukhulelwa, hhayi, njengoba izifundo elawulwa nomphumela teratogenic noma embryotoxic engakaze olwenziwa.

Ngenxa yalokhu aphoyintimenti "Ikhambi" kwabesifazane abakhulelwe kufanele kugwenywe, ngaphandle ezimweni lapho ingozi engaba kokuphathwa ketshezi ingaphansi kwe-izinzuzo kuwo.

Endabeni izidakamizwa iziguli porphyria, kungadala okubi kakhulu lesi sifo.

Ngokuqapha isixazululo ekhethekile ukumnika okumele asetshenziswe iziguli izilonda lwangaphambili isimiso sezinzwa esiyinhloko (stroke, ukuhlaselwa isifo senhliziyo, kuhlasimulise okulimala ebuchosheni), ngenxa amathuba eliphezulu uthi convulsive.

Ezigulini abasebenza izakhi eziyinkimbinkimbi emsebenzini noma ukushayela imoto, akukho ziyalezo ekhethekile, kodwa sicabangele ukuthi kungenzeka amathuba okuba nemiphumela engemihle e isimiso sezinzwa esiyinhloko ngesimo ukozela, ukudideka, kanye nabanye. Ngenxa yalesi sizathu kufanele uyeke lo msebenzi.

side effects

Omunye izinto eziphawuleka kakhulu side effects elawula seziguli ezithola fluoroquinolones, ukuphazamiseka umonakalo uqwanga ngenxa chondrocytes epiphyseal kanye nezicubu uqobo. Ngenxa yalokhu izidakamizwa is contraindicated ku abantu abangaphansi kweminyaka engu-18 ubudala kanye nabesifazane abakhulelwe. Kufanele kuqashelwe ukuthi iziguli engaphezu kuka-18 ubudala ngokumelene okwenza ukusetshenziswa eside zomuthi babonakala okuvela arthralgia noma ukungasebenzi kwekhono amalunga omzimba. Phakathi kwezinye imiphumela emibi okulandelayo.

On the ingxenye pheshana emathunjini - isicanucanu, ukuhlanza, ukungakuthandi ukudla, ukubukeka emizweni ungakhululekile esifundeni epigastric, ungase uzizwe ukopha emathunjini kanye nokuthuthukiswa Gastroenteritis; anda transaminases e oketshezini olungenambala lwegazi.

On the ingxenye isimiso sezinzwa esiyinhloko - ukuthuthukiswa izimpawu encephalopathy, ikhanda, isiyezi, nokulahlekelwa ukwazi, izinkinga zokulala, futhi ushintsho njalo kwemizwelo, ukubukeka paresthesias, ukusangana kanye imicabango yokuzakhela.

On the ingxenye izivikeli mzimba - ukuthuthukiswa komzimba nezinto ezifana ukuqubuka kwesikhumba, ukulunywa, futhi ingaqala photodermatitis enikeziwe insolation okusezingeni eliphezulu.

Kusukela uhlelo urinary - ukuthuthukiswa crystalluria.

I zokuphefumula uhlelo Cishe okuvela bronchospasm futhi isimiso sokujikeleza kwegazi - ukwehla elibukhali blood pressure, ukuthuthukiswa kahle kungakhuphula izinga likashukela ukuphendula yi hemostasis cell (ngesimo thrombocytopenia, njll).

Ukuxhumana nezinye izidakamizwa

izidakamizwa fluoroquinolone kungukuthi iqondiswa kanye antacids, njengoba lokhu kwehlisa ukumuncwa futhi bioavailability kwama-antibiotic. Akunconyelwe kanyekanye isicelo "Ikhambi" nensimbi amalungiselelo, kanye izidakamizwa ezithinta umsebenzi ukusebenza kwesimiso semizwa esiyinhloko. Ngaphezu kwalokho, kukhona ubufakazi mayelana nomphumela probenecid futhi cimetidine phezu excretion zomuthi (lezi izinto bekwazi ukunciphisa nokuqedwa-antibiotic).

inkomba ocacile kwezidakamizwa ukusebenzisana levofloxacin cha. Uma sibheka izinkinga ezihlasela umzimba eliphansi izidakamizwa izicubu hepatic kanye nokuntuleka ukuxhumana ngama-enzyme leqembu cytochrome P450 «Ikhambi" akashintshi nomsebenzi wokugcina, kodwa naphezu kwalokhu, njengamanye amalungu fluoroquinolone, umuthi akumele kuhlanganiswe izidakamizwa teofilinovogo uchungechunge futhi engaqondile anticoagulants, ngenxa ukwanda kunokwenzeka emakamu zabo egazini.

Ukusetshenziswa kwezidakamizwa ngesikhathi ibele

Kuze kube manje akukho ulwazi mayelana ikhono zomuthi ukuhlaba zingene ubisi ebeleni likanina. Uma kukhona isidingo ukwelashwa ngemithi elwa namagciwane phakathi ibele, esitobhini zokugcina ngokokuqala Kunconywa (isikhathi incike ngobucayi ukutheleleka kanye nesikhathi okulindeleke yokwelashwa ngemithi elwa namagciwane). Uma kudingekile ukuze silondoloze lactation ukukhiqiza ukudonsa ezikhathini ezithile noma ayeke lactation ngokuphelele ngezindlela zokwelapha.

Ezimweni ezimbi kakhulu, ukuncelisa nemithi elwa namagciwane kungenzeka nokuhlolwa kwabo engozini ngoba nje umntwana nonina.

Khipha ifomu kanye umthamo

"Ikhambi" ikhiqizwa amafomu amabili: kwezokuphatha enteral and parenteral. Ukuze abaphathi ngomlomo khona ifomu tablet equkethe 250 noma 500 mg zomuthi (ngokulandelana ngaphansi amagama okuhweba "Ikhambi 250" futhi "Ikhambi 500"). Ukuze abaphathi parenteral ukumnika etholakalayo isixazululo.

"Ikhambi" Tablets zithathwa izikhathi 1-2 ngosuku ngaphambi kokudla noma phakathi izindlela zayo akuyona ketshezi, isibambo nge namanzi anele. Esimeni isidingo ukwehlukana umthamo ngesigamu zomuthi, ithebhulethi naphula kwilebula zibe izingxenye ezimbili.

Ukuze abaphathi parenteral, isixazululo umjovo itholakala nge esebenzayo isithako lokuhlala 500 mg / 100 ml isixazululo ( "Remedy 500"). Endabeni umjovo emthanjeni, ukwethulwa kwe-izidakamizwa kwakungelona ngokushesha kunokuba ihora elingu-1.

eminye kwathatha ifomu tablet Kunconywa emva ukumnika abaphathi. ubude Okulindelekile incike kobukhulu ukutheleleka nozwela nezilwanyana ezincane pathogenic ukuba lo muthi. Ukwelashwa (ngaphandle kokubheka indlela yokuphathwa) bayakhuthazwa ukuba kuqhubeke 3-4 izinsuku emva ukuzinza lokushisa komzimba. ukwelashwa Hlukanisa uphelela ekuseni zomuthi is hhayi Kunconywa ngenxa ingozi eliphezulu ohlangothini ukusabela nokuthuthukiswa okungenzeka ukumelana microflora izidakamizwa.

Izixwayiso

Ngaphambi ukwelashwa usebenzisa "Ikhambi" imfundo manual uphoqa ubambe amasampula ukuze microbial uhlobo kuvelana izidakamizwa. Nokho, kusukela ngo-spectrum ezibanzi yesenzo, ukwelashwa kungase okuqalwe ngaphandle oqhuba isampula, kulandele ukuzimisela izidakamizwa ephumelela kunazo.

Ukwabela ikhambi "Ikhambi", ukunakekelwa okukhethekile kufanele zikhokhelwe okumayelana ukuhlola kwezinso ukugeleza kwegazi, njengoba ingxenye enkulu yomsebenzi isidakamizwa excreted ngokusebenzisa izinso ke. Lapho ukwephulwa izidakamizwa zokugcina umthamo umsebenzi kufanele silungise ngokuhambisana imvume creatinine endogenous.

ifomu ukumnika ukulungiselela akuvunyelwe nakancane exutshwe izixazululo umjovo azizwani ane-alikhali (i-sodium Bicarbonate), kanye ne heparin. Ngenjongo ukumnika dilutions rasvor "Ikhambi" iyahambisana isotonic isixazululo sodium chloride, isotonic glucose isixazululo "Ringers".

Ngesikhathi yokwamukela, "Ikhambi" kufanele ugweme ukuphuza utshwala, wokuthi ithuthukisa umphumela ezinobuthi of levofloxacin ku isimiso sezinzwa esiyinhloko nokubonakaliswa evelele amathuba okuba nemiphumela engemihle.

Uma Nokho, banquma bebodwa ukusebenzisa "Ikhambi", yokusetshenziswa, analogue, kufanele ngokucophelela ngoba ukugcwala ulwazi nangokuthembela ulwazi ezanele ukulungiselela uyogwema amaphutha.

Isitoreji kanye nokuhlinzekwa Pharmacy

izimo isitoreji Special izidakamizwa ayidingekile. ukuphepha Its waqinisekisa ngaso lokushisa kuma-25 degrees Celsius. Kusukela "Ikhambi" Pharmacy (ama-antibiotic) kadokotela.

Lapho uthenga umkhiqizo kuyadingeka ukuba banake ubuqotho nokuphepha emaphaketheni, usuku ukukhiqizwa futhi eshalofini yokuphila. Kumelwe nakanjani babe samanje ebhokisini wezokwelapha "Ikhambi" imfundo manual. Tablets kumele ibe eliphezulu emaphaketheni. Ungahlola nokuzwakala ethintekayo ngakho (njengoba ungase uzwakale uyisimanga). Lokhu kungenxa yokuthi abaningi ngokuvamile emakethe ezithaka imithi kukhona mbumbulu futhi elinegazi, okuyinto kakhulu abakwazi ukunikeza umphumela ezanele elwa namagciwane uma kuthathwe ngomlomo, futhi neze - kubangele ezinzima engemihle. Ngakho-ke, ukuthola izidakamizwa, musa ubuvila ukubuza usokhemisi mayelana nokuba khona isitifiketi izinga, eqinisekisa umsuka izidakamizwa, "Ikhambi" (amaphilisi). Yokusetshenziswa (kadokotela uthenge) kumele aqukethe ulwazi ngemvelaphi izimali.

ukweqisa izidakamizwa

Uma kwenzeka lingekho ikhambi ukweqisa izidakamizwa ethize. Symptomatology okweqa umthamo kungenxa ngokuyinhloko kwethonya yokugcina umsebenzi ukusebenza kwesimiso semizwa esiyinhloko. Kulokhu kukhona ukudideka engqondweni, ukozela, isiyezi, futhi izimpawu excitation isimiso sezinzwa ngesimo sengqondo, ukuquleka, nabanye.

Ukwelashwa kuhloswe le excretion ngokushesha zomuthi. Banikezwe bioavailability okusezingeni eliphezulu nokusatshalaliswa zomuthi wonke umzimba, izindlela hemodialysis ngokukhishwa kobuthi egazini ayizwakali. Kuyadingeka ukuba ayeke ukugeleza izidakamizwa emzimbeni futhi afeze ukwelashwa lingaze.

Ngenxa nokuqedwa enkulu "Ikhambi" by filtration ku izinso glomeruli indlela ephumelelayo detoxifying kangakanani ukusebenzisa aqueous usawoti izixazululo kanye ukumnika izidakamizwa isisu iluphu uhlobo senzo.

Izibuyekezo sokulungiselela

Ngokuyinhloko waphawula izimpendulo omuhle izidakamizwa ngenxa nokusebenza ngendlela ephakeme ukwelapha izifo ezithathelwanayo of omsakazo ahlukahlukene. Njengoba kwashiwo kuyi-"Ikhambi" yokusetshenziswa we Izibuyekezo izidakamizwa abasele hhayi kuphela iziguli, kodwa futhi odokotela, owaphawula kahle yaso ephezulu, kuze kube ukwelapha izifo nosocomial futhi nosocomial.

Izibuyekezo ezingezinhle nokukhungatheka izidakamizwa zishiywe iziguli main. Lokhu kungenxa ukuthuthukiswa emibi yawo noma kabi "Ikhambi". Nokho, Umyalelo, inika ulwazi kakhulu esibanzi zalo mkhiqizo. Izibuyekezo ezingezinhle kubangelwa ukusetshenziswa kwezidakamizwa ezimweni lapho ayizwakali ngenxa okungathobeli nomkhakha we isinyathelo elwa namagciwane yokutheleleka ngegciwane amagciwane abe nenkani. Kufanele kuqashelwe ukuthi imibono ezibucayi ngokuvamile ashiye iziguli ukuzithiba medicate futhi ukuthatha ozibekile, noma izincomo zabangani noma "Ikhambi" abangane (umyalelo ngesikhathi esifanayo kaningi akunakwa, okuyinto musa sinconywe kakhulu). impendulo engeyinhle kusuka ochwepheshe bezempilo is cishe ningagcini. Lokhu kungenxa ukusetshenziswa ngokufanele futhi okunengqondo kwemithi (ulwazi mayelana "Remedy 500" manual liqukethe ulwazi olwanele ukuze ngendlela yokusebenzisa izidakamizwa).

Izidakamizwa analogue "Ikhambi"

Ukuze ukulungiselela "Ikhambi 'ukufundisa analogs bachazwa futhi ngalendlela: kusukela izidakamizwa kuyinto levofloxacin fluoroquinolone ngemithi elwa namagciwane, ephezulu grade analogue angabhekwa cishe zonke izidakamizwa ukwakheka efanayo. kufanele kuphawulwe kuqala! "Levofloxacin", "sol", "dada", "Levoksimed" Phakathi kwalezi, nabanye abaningi. Ukuze "Ikhambi" (amaphilisi) Isicelo User inikeza analogs izidakamizwa ezifana "Leflok", "Floksium" nabanye.

isiphetho

I asebenzayo ingxenye Laliyini "ikhambi" izidakamizwa - i levofloxacin antibiotic. He is enhle kakhulu ejenti elwa namagciwane nge ezibanzi-spectrum umphumela amagciwane. Ngenxa yezinga eliphansi side effects kanye nokuntuleka ukumelana i zamagciwane webhaktheriya ezahlukene ngemithi elwa namagciwane, isetjentiswe ngempumelelo in emtholampilo umkhuba "Ikhambi". Yokusetshenziswa inikeza ukwaziswa kakhulu esibanzi mayelana nomsebenzi we izidakamizwa.