Clindamycin gel: litaelo tsa tšebeliso

Tlhaloso e amanang le 13.03.2016

Lebitso la Latin: Clindamycin
Khoutu ea ATX: J01FF01
Lintho tse sebetsang: Clindamycin (Clindamycin)
Moetsi: Hemofarm (Serbia), VERTEX (Russia)

Moetso li-capsule tsa clindamycin karolo e sebetsang e kenyelelitsoe clindamycin(foromo ea hydrochloride), le lisebelisoa tse ling hape: talc, lactose monohydrate, starch ea poone, magnesium stearate.

Tharollo e na le motsoako o sebetsang oa clindamycin (mofuta oa phosphate), hammoho le lisebelisoa tse thusang: joala ba benzyl, edetate ea disodium, metsi.

Khekhe ea Clindamycin Moetso o na le motsoako o sebetsang oa "clindamycin" (mofuta oa phosphate), hammoho le lisebelisoa tse thusang: macrogol 1500, oli ea castor, sodium benzoate, propylene glycol, emulsifier No. 1.

Fomu ea tokollo

Sesebelisoa se hlahisoa ka mokhoa oa likhapha, tharollo le setlolo sa botšehali.

Li-capsules tsa Gelatin li na le 'mele o pherese le cap e khubelu. Ka hare e na le phofo, e ka 'nang ea e-ba le' mala o mosoeu kapa o mosoeu. Litafole li tletse ka marang-rang a li-pcs tse 8., Ka paketeng ea karete ea lilakane tse peli.

Tharollo, e etsoang ka methapo kapa ka methapo, e bonahala pepeneneng, e ka ba e se nang mebala kapa e 'mala o moputsoa hanyane. E na le li-ampoules tsa 2 ml. Ka mekotla e lutlang ea li-ampoules tse 5, ka lebokoseng la mekotla e 2 ea lipakete.

Asiti ea Vaginal 2% e kanna ea ba le 'mala o mosoeu, o bosehla bo bosehla. E na le monko o itseng o fokolang. E na le li-tub tsa aluminium tsa 20 g kapa 40 g, mokopi o kenyellelitsoe ka har'a sephutheloana.

Ketso ea pharmacological

Ntho eo clindamycin ke ea sehlopha sa lithibela-mafu-lincosamides. E na le litlamorao tse fapaneng, ke bacteriostatic.

Mmeleng, e hokahana le karolo e ka tlase ea 50S ea ribosome mme e thibela synthetiki ea protheine ho li-microorganisms. Ea sebetsa kamanong le Staphylococcus spp., Streptococcus spp. (mokhelo ke Enterococcus spp.), Streptococcus pneumoniae, anaerobic le microaerophilic gram e ntle cocci, Clostridium tetani, Clostridium perfringens, Corynebacterium diphtheriae, Mycoplasma spp., Bacteroides spp. (ho kenyeletsa Bacteroides melaningenicus le Bacteroides fragilis) E boetse e bonts'a ts'ebetso khahlano le anaerobic gram-positive, non-spore forming, bacilli.

Boholo ba mefuta hape bo amehile ka ntho ena. Clostridium perfringens, empa mefuta e meng ea clostridia (haholo-holo Clostridium tertium, Clostridium sporogenes) bontša ho hanyetsa sethethefatsi sena. Ntlheng ena, maloetse a hlohlelletsa Clostridium spp.Ho khothalletsoa hore moriana o thibelang likokoana-hloko o nkoe pele o qala kalafo.

Mokhoa oa ts'ebetso oa sethethefatsi sena le ponahalo ea sona ea antimicrobial e haufi le lincomycin.

Sebopeho sa ntho clindamycin phosphate ha se sebetse ka vitro, leha ho le joalo, e kenella ka potlako ka bongata ho vivo, 'me ho thehoa clindamycin, e bonts'ang ts'ebetso ea antibacterial.

Pharmacokinetics le pharmacodynamics

Clindamycin e kenelle ka botlalo le ka potlako ho tsoa pampiring ea mala, ha e ntse e ja, ho monya ho fokotseha, ha mokokotlo oa ntho e ho plasma o lula o sa fetohe. E kenella ka har'a lisele tsa 'mele le mokelikeli, e feta hampe ka BBB, empa maemong a ho ruruha hoa litho tsa bokong, permeability ea eketseha.

Boholo ba mahloriso ka madi e bonoa ha e nkuoa ka molomo ka mor'a lihora tse 0,75-1, haeba tsamaiso ea methapo e etsoa, kamora hora e le ngoe ho bakuli ba baholo le ka mor'a lihora tse 3 ho bana. Ha e fanoa kahare, ho kenella holimo ho bonoa qetellong ea infusion.

Ho na le methapo ea kutlo e amang mali maling ka lihora tse 8-12. Bophelo ba halofo ke lihora tse 2.4. Metabolism e hlaha ka har'a sebete, ha e ntse e le mafolofolo ebile e sa sebetse metabolites. Bokantle bo nka matsatsi a fetang a 4 ka liphio le mala.

Ha e tsamaisoa ka methapo, hoo e ka bang 3% ea lethal dose e laoloang e kenngoa ka mokhoa o hlophisitsoeng.

Matšoao a ho sebelisoa

Tharollo ea Clindamycin le matlapa li sebelisetsoa mafu le maemo a joalo:

mafu a tšoaetsanoang le a tšoaetsanoang a ileng a bakoa ke ketso ea likokoana-hloko tse anngoeng ke ona clindamycin,
tšoaetso ea litho tsa ENT, hammoho le mafu a tšoaetsanoang a phepelo e phahameng ea ho phefumoloha le mokhoa o tlase oa ho hema,
diphtheria, feberu e bofubelu,
ts'oaetso ea urogenital
tšoaetso ea lesapo la molomo, mpeng ea ka mpeng,
lisele tse bonolo le letlalo,
septicemia (haholo anaerobic),
osteomyelitisa hlobaetsang le a sa foleng
endocarditis baktheria
ho amoheloa bakeng sa thibelo ea li-abscesses tsa intraperitoneal le peritonitis ka mor'a ho ntlafatsoa ka mpeng kapa ka mor'a ts'oaetso e bohloko (e kopantsoeng le aminoglycosides).

C cream le gel Clindamycin e sebelisoa bakeng sa bacteric vaginosis.

Matšoao a ts'ebeliso ea li-suppositories tse nang le clindamycin:

bacterial vaginosis, e halefisitsoeng ke likokoana-hloko tse shebileng ntho ena.

Contraindication

Ts'ebeliso ea sesebelisoa sena e kopantsoe:

ho asthma ea bronchial,
ho myasthenia gravis,
le ulcerative tsikitlanya,
ka mafu a sa tloaelehang a tlhaho ea lefutso (ho haella ha lactase, ho se mamellane ha galactose, glucose-galactose malabsorption),
ho ea boimana le ho anyesa,
ha ngoana a le ka tlase ho lilemo tse 3, tsamaiso ea methapo le kutloano ea tšoaetsanoa, ha a le lilemo li 8, tsamaiso ea capule e hanyetsanoa,
kutloisiso e phahameng ea likarolo tsa moriana.

Ho hlokahala hore ho be le temoso ho batho ba nang le bothata ba ho ba le a renal haholo kapa ba na le ho fokola ka hepatic, bakuli ba tsofetseng.

Litlamorao

Ha ba sebelisa moriana, bakuli ba ka ba le litlamorao tse ling.

tsamaiso ea tšilo ea lijo: matšoao a dyspeptic, jaundice, esophagitis, pseudomembranous enterocolitis, hyperbilirubinemia, dysbiosisho se sebetse hantle ha sebete,
tsamaiso ea musculoskeletal: Maemong a sa tloaelehang, ho ka ba le tlolo ea ts'ebetso ea methapo ea methapo,
hematopoiesis: leukopenia, neutropenia, agranulocytosis, thrombocytopenia,
liponahatso tsa allergymakhopho letlalo la letlalo le boreleli, urticaria, ka linako tse ling - dermatitis, lipontšo tsa anaphylactoid, eosinophilia,
pelo le methapo ea mali: ha tharollo e fanoa ka kotloloho le kapele - fokotseha khatello ea malibofokoli ho tsekela,
liponahatso tsa lehae: bohloko le thrombophlebitis(sebakeng sa ente), ho teneha,
litla-morao tse ling: bokgabane.

Ha u sebelisa tranelate ea Clindamycin, litla-morao tse joalo li ka hlaha:

urination: ho halefisoa ha mucosa ea botšehali le botenya, candidiasisbotšehali, vulvovaginitis, trichomonias vaginitis, tšoaetso ea litho tsa botšehali, mathata a potoloho ea khoeli le khoeli, ho tsoa mali ka popelong, bohloko ba kahare, dysuria, ho hlaha ha li-secretions, endometriosisglucosuria proteinuria,
liponahatso tse tloaelehileng: bohloko ba ka mpeng le mahlaba, ho thunya, fungal le tšoaetso ea baktheria, hlooho e bohlokophefumoloho e mpe ho ruruha ho ruruha, bohloko bo ka mpeng, ho ts'oaetso ea pampiri e kaholimo, bohloko ba morao, liponahatso tsa lintho tse bohloko,
gastrointestinal pampitsana: ho nyekeloa pelo lets'ollo, ho sokelaho hlatsa botlaela, dyspepsia, mathata a tšilo ea lijo,
letlalo le hlakileng: ho hlohlona letlalo, erythema, rash, candidiasis, urticaria,
tsamaiso ea endocrine: hyperthyroidism,
CNS: ho tsekela,
tsamaiso ea ho phefumoloha: nosebleeds.

Bongata

Haeba lithethefatsi tse ngata li etsahetse, litlamorao tse mpe tse hlalositsoeng ka holimo li ka mpefala. E khethehileng antidote che, haeba ho etsoa ka mokhoa o feteletseng, kalafo ea matšoao e etsoa.

Ha ho na tlhahisoleseling mabapi le overdose ea tranelate. Haeba motho a ka kenella ts'ebelisong ea lithethefatsi ka phoso, ho ka hlaha litlamorao tse ka hlahang kamora ho ts'oaroa hoa ntho ena ka molomo.

Tšebelisano

Ho na le keketseho ea ketso ea streptomycin aminoglycosides, Gentamicin, Rifampicin ha o ntse o nka ka clindamycin.

E kenya tšebetsong phello ea tlholisano ea mesifa ea tlholisano, hammoho le boikhathollo ba mesifa, bo bakang n-anticholinergics.

Antagonism le chloramphenicol le Erythromycin.

Ha ho kgothaletswe ho nkuoa ka nako e le ngoe le tharollo e nang le rarahaneng livithamini lihlopha B, phenytoins, aminoglycosides.

Litlhare tsa Clindamycin le antidiarrheal li ke ke tsa hlalosoa ka nako e le ngoe, kaha menyetla ea ho ba le pseudomembranous colitis e eketseha.

Ha e sebelisoa ka mokhoa o ts'oanang le opioid analgesics litlamorao tsa khatello ea maikutlo a ho hema li ka eketseha, ho fihlela nts'etsopele apnea.

Ho hanyetsa ka sefapano ho bonoa pakeng tsa lincomycin le clindamycin. Phapang pakeng tsa erythromycin le clindamycin le eona e bonahatsoa.

Ha ho khothalletsoe ho sebelisa le lithethefatsi tse ling bakeng sa tsamaiso ea intravaginal.

Litaelo tse khethehileng

Pontšo ea pseudomembranous colitis e ka etsahala ka bobeli ba ts'ebetsong moriana, le libeke tse 2-3 kamora ho qeta kalafo. Ka boemo bona, motho o iponahatsa lets'ollo, feberu, leukocytosisbohloko ba ka mpeng.

Haeba matšoao a joalo a ba teng, o hloka ho hlakola lithethefatsi le ho sebelisa li-resin tsa ion-exchange. Ka colitis e matla, ho hlokahala ho lefella mokelikeli o lahlehileng, protheine le li-electrolyte, ho fana ka tlhahiso ea Vancomycin kapa Metronidazole.

Nakong ea kalafo, u ke ke ua sebelisa meriana e thibelang ho tsamaea ka mpeng.

Haeba tšebeliso ea nako e telele ea lithethefatsi e etsoa ke bana, o hloka ho lekola formula nako le nako madi le boemo ba sebete ba mokuli. Ha u sebelisa litekanyetso tse kholo tsa moriana, clindamycin e lokela ho laoloa lero la mali.

Batho ba fumanoang ba e-na le bothata bo matla ba ho se sebetse hantle ha sebete ba lokela ho ba le taolo ea ts'ebetso ea sebete.

Pele o nka moriana kahare, o hloka ho khetholla laboratori Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Li-albicans tsa Candida, Herpes simplex, eo hangata e qholotsang kholo ea vulvovaginitis.

Ha o sebelisa clindamycin kahare, ho ka ba le nts'etsopele e eketsehang ea likokoana-hloko tse sa tsotelleng, haholo-holo li-fungus tse kang tomoso.

Kaha ho na le monyetla oa ho amoheloa ha moriana ka mokhoa o hlophisitsoeng, letšollo le ka hlaha ka ts'ebeliso ea li-supplement kapa tranelate. Tabeng ena, sesebelisoa se hlakotsoe.

Re lokela ho hlokomela hore nakong ea kalafo u hloka ho tlohela ho etsa thobalano mme o se sebelise lithethefatsi tse ling bakeng sa ts'ebeliso ea intravaginal.

Karolo ea moriana ona e na le likarolo tse ka etsang hore lihlahisoa tsa rabara li tšoarelle nako e telele. Ka hona, ha ho khothalletsoe ho sebelisa likhohlopo, li-diaphragms le tse ling tsa thibelo ea bokhachane ho tloha latex.

Ha e ame bokhoni ba ho khanna koloi kapa ho etsa lintho tse ling tse hlokang ho tsepamisa maikutlo.

Nakong ea bokhachane le pelehi

U ka sebelisa lithethefatsi tsena ka bongata ba basali nakong ea bobeli le ea boraro ea baimana. Likhoeling tsa pele tsa bokhachane, ho fanoa feela haeba phaello e lebelletsoeng e feta kotsi e ka bang teng ka tšebeliso ea tranelate kapa liphutheloana. Nakong ea lebollo, o lokela ho sekaseka ka hloko melemo e lebelletsoeng le kotsi e ka bang teng. Sebelisa sehlahisoa feela tlas'a taolo ea ngaka.

Litlamorao

Taeo e hlokomelisa ka monyetla oa ho hlahisa litlamorao tse latelang ha u fana ka taelo ea clindamycin:

tatso e sa thabiseng ea tšepe e tsoang molomong, phlebitis (e nang le tsamaiso ea methapo e phahameng haholo.
ho nyekeloa ke pelo, ho hlatsa, lets'ollo, bohloko ba ka mpeng,
phenomena ea esophagitis (ka ho sebelisa litafole tsa clindamycin),
ho eketseha ha bilirubin le hepatic transaminase,
ho tsekela, ho fokola, ho fokotseha ha khatello ea mali (ka tsamaiso ea methapo e potlakileng),
pseudomembranous colitis,
candidiasis.

Maemong a ikhethileng, e ka baka tšohanyetso ea maloetse a jaundice le sebete, hammoho le thrombocytopenia, leukopenia, neutropenia le agranulocytosis.

Maemong a sa tloaelehang, likarabelo tsa lehae li ka etsahala (ho halefisa setsing sa ente, ntshetsopele ea sekho kapa ho kenella kahare).

Clindamycin gel e ka baka tsitsipano sebakeng sa kopo, hammoho le nts'etsopele ea dermatitis ea ho ikopanya. Ka tšebeliso ea nako e telele, litla-morao tsa tsamaiso li ka hlaha.

Mefuta ea sehlooho ea lithethefatsi (li-suppositories le tranelate) e na le litla-morao tse kang vaginitis, cervicitis le vulvovaginal halefisang.

Ka maikutlo a motho ka mong, ho arohana le maemo a ho kula ho ka hlaha - urticaria, erythema multiforme, feberu, edema ea Quincke, kapa tšabo ea anaphylactic.

Pseudomembranous colitis e ka ba teng ka bobeli ha ho nka clindamycin, le libeke tse 2-3 kamora ho emisa kalafo (3-15% ea linyeoe). E iponahatsa e le lets'ollo, leukocytosis, feberu, bohloko ba ka mpeng (ka linako tse ling e tsamaea le lits'oants'o tse ngata tsa mali le mucus).

Contraindication

Ho fapanyetsanoe ho fana ka taelo ea "clindamycin" maemong a latelang:

myasthenia gravis
asthma ea lefu la bronchial,
ulcerative colitis (nalane)
mafu a lefutsoang ka seoelo, a kang ho se mamelle galactose, khaello ea lactase kapa glucose-galactose malabsorption (bakeng sa li-capsules),
ho ima le ho nyekeloa,
lilemo tsa bana ho fihlela ho lilemo tse 3 - bakeng sa tharollo bakeng sa tsamaiso ea methapo le methapo (ka lebaka la khaello ea ya data mabapi le polokeho ea tšebeliso ea joala ba benzyl),
lilemo tsa bana ho fihlela ho lilemo tse 8 bakeng sa li-capsules (boima ba ngoana bo ka tlase ho 25 kg),
Hypersensitivity

Clindamycin e sebelisoa ka hlokolosi ho bakuli ba nang le bothata bo matla ba hepatic le / kapa ho se sebetse hantle ho bakuli ba tsofetseng.

Nakong ea kalafo, u ke ke ua sebelisa meriana e thibelang ho tsamaea ka mpeng.

Bongata

Litlhare li ka mpefala le ho feta haeba lithethefatsi li le ngata.

Phekolo ea matšoao e etsoa, ha ho na litlhare tse tobileng. Hemodialysis le peritoneal dialysis ha li na thuso.

Thutela-litso

E lumellana le karolo ea 50S ribosomal subunit ea sele ea kokoana-hloko mme e thibela ho hlophisoa ha protheine ea likokoana-hloko tse bobebe. E na le ts'oaetso ea bacteriostatic, maemong a phahameng le litabeng tsa likokoana-hloko tse tebileng haholo e ka bonts'a phello ea bactericidal. Ho latela mochine oa ts'ebetso le sebopeho sa antimicrobial, e haufi le lincomycin (mabapi le mefuta e meng ea likokoana-hloko ke makhetlo a 2-10 a sebetsang haholoanyane).

Ha clindamycin e nkuoa ka molomo, hydrochloride e kenella ka potlako 'me e amoheloa hantle ho tsoa mochesong oa tšilo ea lijo (ho molemo ho feta lincomycin), bioavailability ke 90%, ho kenella ka nako e le' ngoe ho fokotsa ho monya, ntle le ho fetola tekanyo ea ho amoheloa. Protein e tlamang ke 92-94%. E kenella habonolo maro a tlhaho, litho le lisele tsa 'mele, ho kenyeletsoa lithane, mesifa le masapo a masapo (hoo e ka bang 40% ea khatello ea mali), bronchi, matšoafo, pleura, mokelikeli oa mali (50-90%), ducts tsa bile, sehlomelo, li-fallopian gland, gland ea senya, mokelikeli oa synovial (50%), mathe sputum (30-75%), ho tsoa maqeba. E feta hampe ka BBB (ka ho ruruha ha methapo ea maoto, tumello ea BBB e eketseha). Bophahamo ba kabo ho batho ba baholo ke hoo e ka bang 0.66 l / kg, ho bana - 0,86 l / kg. E feta ka potlako ho placenta, e fumanoa maling a fetus (40%), e fetela lebese la matsoele (50-100%).

Clindamycin Palmitate le "clindamycin phosphate" ha li sebetse, li potlakisa hydrolyze 'meleng ho li-clindamycin tse sebetsang.

C_max serum ea molomo, e fihlelloa kamora ts'ebetso ea 0.75-1 h, kamora ho tsamaisoa ha i / m - kamora ts'ebetso ea 3 h (batho ba baholo) kapa 1 h (bana), ka infusion ea i / v - qetellong ea tsamaiso. E tšelisoa ka har'a sebete ho boptjoa ha mafolofolo (N-dimethylclindamycin le clindamycin sulfoxide) le metabolites e sa sebetseng. E tšeloa ka hare ho matsatsi a 4 ka moroto (10%) le ka mala, (3.6%) e le karolo e sebetsang, tse ling kaofela e le metabolites e sa sebetseng. T_1/2 ka ts'ebetso e tloaelehileng ea renal ho batho ba baholo ke lihora tse 2.4-3, ho masea le ho bana ba baholo - lihora tse 2,5, ho3, ka masea a tlang pele ho nako - lihora tse 6.3-8.6. ho imeloa haholo hepatic, ho felisoa ha clindamycin ho fokotsa lebelo (T_1/2 ho batho ba baholo - lihora tse 3-5. Ha e balehe.

Ka tsamaiso ea intravaginal ea 100 mg ea clindamycin phosphate ka mofuta oa 2% tranelate ea basali ka nako e le 'ngoe ka matsatsi a 7 ho basali ba 5 ba nang le bactericosis ea bactericosis, ho ruruha ha systemic e ne e ka ba 5% (ka bophara ba 2-8%) ea lethal dose e laetsoeng. C boleng_max ka letsatsi la pele - ka bang 13 ng / ml (ho tloha ho 3 ho isa ho 34 ng / ml), ka letsatsi la bosupa - karolelano ea 16 ng / ml (ho tloha ho 7 ho isa ho 26 ng / ml), T_max - lihora tse ka bang 16 (bophara ba lihora tse 8-24) kamora kopo. Ka ts'ebeliso e tloaelehileng ea intravaginal, cumulation ea systemic e ne e le sieo kapa e ne e sa lateloe. T_1/2 le monya o rarahaneng - lihora tse 1.5-2.6

Ha o sebelisa clindamycin phosphate kahare ka mokhoa oa li-suppositories ka lethal dose ea 100 mg hang ka letsatsi bakeng sa matsatsi a 3, hoo e ka bang 30% (6-70%) ea lethal dose e laetsoeng e kenngoa ka har'a potoloho ea systemic, ka tekanyo ea AUC ea 3.2 μg / h / ml (0.42-11 μg / h / ml). C_max e fihlelletse hoo e ka bang lihora tse 5 (lihora tse 1-10) ka mor'a ho tsamaisoa ka tšehetso ea botšehali.

Ha e sebelisoa e le gel bakeng sa ts'ebeliso ea kantle ea clindamycin, phosphate e potlakisoa kapele ke lipompoase ka methapong ea litšoelesa tsa sebaceous le sebopeho sa clindamycin. Moriri o ka kenngoa ka bongata bo bakang litlamorao tsa systemic.

E nahanela clindamycin in vitro likokoana-hloko tse latelang: aerobic gram-positive cocci, ho kenyelletsa Staphylococcus aureus, Staphylococcus ep> ho kenyeletsoa Mefuta e hlahisang 'me e sa hlahise penicillinase ( in vitro Tsoelo-pele e potlakileng ea khanyetso ea clindamycin mehateng e meng e thibelang stryylococcal erythromycin e hlokometsoe), Streptococcus spp. (ntle le Streptococcus faecalis), Pneumococcus spp., anaerobic gram-negative bacilli, ho kenyeletsoa Bactero> ho kenyeletsa sehlopha B. fragilis le sehlopha B. melaninogenicus), Fusobacterium spp., non-spore anaerobic gram-positive bacilli, ho kenyeletsoa Propionibacterium spp., Eubacterium spp., Actinomyces spp., anaerobic le microaerophilic gram e ntle cocci, ho kenyeletsoa Peptococcus spp.,Peptostreptococcus spp., Microaerophilic Streptococcus spp., Clostridia spp. (clostridia e hanyetsana le clindamycin ho feta anaerobes a mang a mangata). Boholo Clostridium perfringens tsotella clindamycin, empa mefuta e meng, ka mohlala C. sporogenes le C. tertium, hangata e loantšana le clindamycin, ka hona, liteko tsa kutloisiso lia hlokahala.

Ka tekanyetso e phahameng, e sebetsa ho protozoa e itseng (Plasmodium falciparum).

Ho hanyetsa ka matla pakeng tsa clindamycin le lincomycin le antagonism pakeng tsa clindamycin le erythromycin ho bontšitsoe.

Maemong in vitro clindamycin e sebetsa khahlano le mefuta e mengata ea likokoana-hloko tse latelang tse bakang vaginosis ea baktheria. Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis, Bacteroides spp., Peptostreptococcus spp. Clindamycin bakeng sa ts'ebeliso ea methapo ea kutlo ha e na thuso bakeng sa kalafo ea venvovaginitis e bakoang ke Trichomonas vaginalis,Chlamydia trachomatis,Neisseria gonorrhoeae, Candida albicans kapa vaerase Herpes simplex.

Matla a khahlanong le makhopho bakeng sa tšebeliso ea kantle a kanna a bakoa ke taba ea hore clindamycin e fokotsa bongata ba li-acid tse mahala letlalong mme li sitisa ho ikatisa. Propionibacterium acnes - Anerobic e fumanoang litšoelesa tsa sebaceous le li-follicle. Kutloahalo ea likarolo tsohle tse batlisisitsoeng e bontšoa. P. acnes to clindamycin in vitro (MIC 0.4 μg / ml).

Carcinogenicity, mutagenicity, litlamorao ho tsoalo

Boithuto ba nako e telele ba liphoofolo ba ho hlahloba hore na carcinogenicity ea clindamycin ha e so ka e etsoa. Ts'ebetso ea Mutagenic litekong tsa Ames le tlhahlobo ea micronuclear ho litoeba ha ea ka ea fumanoa. Litlamorao tse mpe tsa bokhoni ba ho ba le bokhoni ba ho ikatisa le ho emola li ile tsa bonoa ho likhoto tse amohelang li-clindamycin ka tekanyetso ho fihlela ho 300 mg / kg / ka letsatsi (hoo e ka bang linako tse 1,6 tse phahameng ho feta tsa li-MPD ho latela mg / m 2).

Boimana Phuputsong ea ho ikatisa liphoofolong (likhoto, litoeba) u sebelisa tekanyetso ea molomo ea clindamycin ho fihlela ho 600 mg / kg / letsatsi (3.2 le linako tse phahameng tsa li-MPD tse phahameng ho latela mg / m 2, ka ho latellana) kapa sc ho tekanyetso ho fihlela 250 mg / kg / letsatsi (makhetlo a 1,3 le 0,7 e phahame ho feta MPDC ho latela mg / m 2, ka ho latellana) ha ho na phello ea teratogenic e fumanoeng. Thutong e 'ngoe ea litoeba, lefika la mahalapa le ile la bonoa ka popelong (sephetho sena ha sea ka sa tiisoa litekong tsa liphoofolo tse ling le mela e meng ea litoeba).

Bokhachane le pelehi

Nakong ea kemolo, ho ka etsahala haeba phello e lebelletsoeng ea kalafo e feta tlokotsi e ka bang teng ho lesea (ho ne ho se na lithuto tse lekaneng le tse laoloang ka tieo ho basali ba baimana, clindamycin e feta ka placenta mme e ka tsepamisa mohopolo ka seleng sa fetal, empa ha ho bile le mathata ho batho). Boithuto ha bo hlahise hore na kalafo ea baktheria vaginosis e fokotsa menyetla ea ho hlahisa litholoana tse bohloko joalo ka ho phatloha peleho ha litho tsa mpa, ho beleha pelehi kapa pelehi.

Sehlopha sa Ketso ea Ts'oaetso ea FDA B.

Ho hlokahala hore ho sebelisoe tlhokomeliso ha e sebelisoa nakong ea matsoele (ha ho tsejoe hore na clindamycin e fetela lebeseng kamora tšebeliso ea kantle le intravaginal, empa e fumanoa lebeseng la matsoele kamora ho tsamaisoa ka molomo kapa ka botsoali).

Pharmacodynamics le pharmacokinetics

Clindamycin e kenella hantle mecheng eohle ea mecha ea phatlalatso, lisele tse bonolo tsa 'mele le masapo. Moriba o thibela ho hlophisoa ha liprotheine liseleng tsa likokoana-hloko tse nyenyane tsa pathogenic, o bonts'a phello ea bacteriostatic le bactericidal. Ho na le libaktheria tse 'maloa tse loantšang lithibela-mafu tsena:

Mafu a bakoang ke libaktheria tsena

unicellular flagellar baktheria

meningitis, bacteremia, dysbiosis

botulism, tetanus, gase ea squren, tšoaetso ea lijo tsa clostridial

Palo e phahameng ea ntho e phekolang e maling le tsamaiso ea molomo e bonoa ka potlako ho feta ka tsamaiso ea methapo. Ntho e sebetsang e kena maling ka mor'a lihora tse 1-3 kamora ho nka (ho tsamaisa) moriana. Ha e se e fihlile sebakeng se tšoaelitsoeng, e bolokiloe 'meleng ka lihora tse ka bang 12, ha hoo e batlang e le 90% ea ntho e tlama liprotheine tsa likokoana-hloko tsa pathogenic. Boithuto ba kliniki ha boa senola ho bokellana ha lintho tse sebetsang tsa moriana. E sebetsoa ke sebete. Metabolites e pepesitsoe ka botlalo kamora matsatsi a 4 ka moroto, bile le makhopho.

Tekanyetso le tsamaiso

Phekolo ea antibiotic e tlas'a tlhokomelo ea ngaka haholo. Khetho ea mofuta oa moriana, litekanyetso le nako ea tsamaiso, li latela:

lilemo tsa mamello
boiketlo ba hae
dikarolo tsa ts'oaetso ea 'mele,
boteng ba lefu lena,
kutloisiso ea pathogen ho ntho e sebetsang ea lithethefatsi.

Bakeng sa tšoaetso ea botšehaling, motsoako o thibelang likokoana-hloko ka mokhoa oa tranelate o laetsoe hore o sebelisoe ka hare. Sesebelisoa sa ho lekanya se lahliloeng (se kenyelelitsoe) se beoa ka mothapo oa tranelate ebe o tlatsoa ka sona. Ho etsa sena, tobetsa ho tube ntle le ho hula piston ea mokopi. Tekanyetso e le 'ngoe ea lithethefatsi (5 mg) e kenngoa ka hara thipa hang ka letsatsi pele ho robala. Nako ea kalafo ke matsatsi a 7.

Bakeng sa batho ba baholo, tharollo ea ente ea intramuscular (intravenous) e sebelisoa makhetlo a 2 ka letsatsi, 300 mg ka 'ngoe. Ka lefu le boima la lefu lena, ho eketseha ha tekanyetso ea letsatsi le letsatsi ea lithethefatsi ho 2700 mg hoa khoneha. E arotsoe ka liente tsa 3-4. Maemong ana, tsamaiso e le 'ngoe ha ea lokela ho feta 600 mg. Bana ba lilemo li 3 ba beiloe 15-25 mg ka kilo e le 'ngoe ea boima mme ba arotsoe likarolo tse lekanang ka liente tsa 3-4. Ho ts'oaetso e matla, litekanyetso tsa bana li eketseha ho 40 mg ka letsatsi.

Bakeng sa ts'ebeliso ea methapo, lithethefatsi li hlapolotsoe ka tharollo ea 0,9% sodium chloride kapa 5% dextrose ho isa ho tse fetang 6 mg / ml. Tharollo e hlahisoang e tsamaisoa ka mokhoa o theohileng ho tloha ho metsotso e 10 ho isa ho e 60 (ho latela tekanyetso). Tekanyo e phahameng e lumellehang ea tsamaiso e le 'ngoe e kenang ea methapo ke 1.2 g. Haeba nako ea lihora tse 8 pakeng tsa ba tlohelang marapo e bonoa, bakuli ba nang le bothata ba ho fokola ba lerep (hepatic) ba fuoa tekanyetso e tloaelehileng ea lithibela-mafu tsena.

Bana ba ka tlase ho lilemo tse 12 ha ba fuoe lithibela-mafu. Melemo ea bakuli ba lilemo tse ling e tjena:

Palo ea likamohelo ka letsatsi

Boholo ba bokuli ba lefu lena, palo ea li-capsules (li-pcs.)

Boholo ba lefu lena, palo ea li-capsules (li-PC.)

Li-supplement tsa Clindamycin li sebelisetsoa ho phekola nako e le 1 ka letsatsi pele ho robala. Boemong ba supine, ho bohlokoa ho boloka tlatsetso e kenella ka hara mpa. Thupelo ke matsatsi a 3-7.

Mekhoa ea ho ruruha letlalong le nang le tšoaetso ea baktheria e tsamaisana le lekhopho ka mokhoa oa makhopho. Bakeng sa mafu a letlalo, ngaka e ka u fa li-capsules tsa antibiotic le gel bakeng sa kalafo e tšoanang. Mafura a kang gel a nang le clindamycin a sebelisetsoa tšebeliso ea kantle. Moriri o kenngoa ka mpeng e tšesaane ka makhopho le libakeng tse nang le lekhoakhoa hang ka mor'a ho hlatsoa letlalo.

Bocheng

Bana ba ka tlase ho lilemo tse 8 ba fuoa lithibela-mafu tsa molomo ka tsela ea sirapo. Boitokisetso ba granular bo etselitsoe ho itokisetsa sirapo (ho emisoa). Viti e nang le granules e tlameha ho tlatsoa ka 60 ml ea metsi le ho tsukutleha hantle. Palo ea tekanyetso ea lithethefatsi e ipapisitse le boima ba 'mele le lilemo tsa ngoana. Sekhahla sa letsatsi le letsatsi sa sirapo bakeng sa bana ba baholo ho feta khoeli e le 8-25 mg ka kilogram ea boima, e arotsoe ka litekanyetso tse 4. Tekanyetso e nyane ea bana ba boima bo ka tlase ho 10 kg ke 37 mg (1/1 tee) lihora tse ling le tse ling tse 8.

Motsoako ona o thibelang likokoana-hloko o fuoa bana hangata:

Ho sebelisana le lithethefatsi

Clindomycin, ha e sebelisana le lithethefatsi tse ling, ka linako tse ling e ba le phello e mpe 'meleng oa mokuli. Sena se lokela ho nahanoa ha u fana ka litlhare ho kalafo e rarahaneng:

Ha e lumellane le li-barbiturates. Ts'ebeliso e kopaneng ea lithethefatsi e thibetsoe.
E ntlafatsa boikhathollo ba mesifa bo bakoang ke li-block-n-anticholinergic blockers.
Ho hlohlelletsa ho erythromycin le chloramphenicol.
Ts'ebelisano-'moho le Fortum e na le tšusumetso liphoofolong.
E ntlafatsa ketso ea aminoglycosides.
Ka lithethefatsi tsa antidiarrheal li ka lebisa ho pseudomembrane colitis.
E nyenyefatsa ho phefumoloha (ho fihlela ho apnea) ha e sebelisoa hammoho le litokisetso tsa analgesic tsa letoto la opium.
Ha e lumellane le litokisetso tse ling tsa botšehali.

Lipehelo tsa thekiso le polokelo

Clindamycin ka mefuta eohle e ka rekoa litlolong tsa litlhare ka taelo ea ngaka. Boloka sebakeng se ommeng le se lefifi moo bana ba ka se fihlelang teng. Bophelo ba Shelf ba moriana ona ka mokhoa oa:

Tharollo bakeng sa tsamaiso ea methapo le methapo - lilemo tse 2 ho tloha ka letsatsi la tlhahiso (e bonts'itsoeng ho ampoule e ngoe le e ngoe le sephuthelong),
kapelo - lilemo tse 3,
tranelate - lilemo tse 2,
likerese - lilemo tse 3.

Haeba ts'ebeliso ea clindamycin e sa khonehe ka lebaka le itseng, ngaka e beha litlhaloso tsa eona:

Klindatop. Li-gel tsa li-topical bakeng sa kalafo ea li-makhopho tse bonolo le tse itekanetseng.
Klimitsin. E teng ka sebopeho sa granules bakeng sa ho hlophisoa ha sirapo ea lesea le ente.
Dalacin. E fumaneha ka sebopeho sa li-capsules, ente, li-granules, gel, tranelate ea vaginal le li-supplement.
Zerkalin. Moriana bakeng sa kalafo ea makhopho.