Ciprofloxacin: litaelo tsa tšebeliso

Litafole tsa Ciprofloxacin ke moemeli oa antibacterial oa sehlopha sa fluoroquinolone. Li sebelisoa ho phekola li-pathologies tse fapaneng tsa ts'oaetso tse bakoang ke libaktheria tse amehang nthong e sebetsang ea lithethefatsi.

Mofuta oa litekanyetso, sebopeho

Matlapa a Ciprofloxacin a kopantsoe le filimi e koahetsoeng ka koae ea enteric. Li na le 'mala o mosoeu ebile li boreleli. Motsoako o ka sehloohong oa sethethefatsi ke ciprofloxacin. Likahare tsa eona ke letlapeng le le leng ke 250 le 500 mg. Hape, sebopeho sa eona se kenyeletsa likarolo tse thusang, tse kenyeletsang:

Colloidal silicon anhydrite.
Povidone.
Methylene chloride.
Microcrystalline cellulose.
Magnesium stearate.
Isopropyl joala.
Hydroxypropyl methylcellulose.
Talc e hloekisitsoeng.
Sodium starch glycolate.

Matlapa a Ciprofloxacin a kentsoe ka har'a pakete ea blister ea likotoana tse 10. Pakete ea karete e na le blister e le 'ngoe e nang le matlapa, hammoho le litaelo tsa ho li sebelisa.

Phello ea kalafo

Karolo ea mantlha e sebetsang ea matlapa a ciprofloxacin ke a li-antibacterial agents tsa sehlopha sa fluoroquinolone. E na le ts'oaetso ea bactericidal, e lebisang lefung la libaktheria tse bohloko. Ketso ena e lemohuoa ka ho hatella tšebetso e matla ea baktheria ea lisele tsa bacterial DNA gyrase. Sena se lebisa ho sitisoeng ha replication (habeli) ea DNA le lefu la sele ea bacteria. Setlhare se na le ts'ebetso e lekaneng khahlanong le lisele tse sebetsang tsa ho arola le tse sa sebetseng. E na le litlamorao tsa bactericidal khahlanong le palo e kholo ea li-gram-positive (staphylococci, streptococci) le gram-negative (E. coli, Pseudomonas aeruginosa, Proteus, Klebsiella, Yersinia, Salmonella, Shigella, Gonococcus). Hape, lithethefatsi li lebisa lefung la libaktheria tse ikhethileng tseo e leng lisele tsa lefutso (Mycobacterium lefuba, Legionella, Mycoplasma, Ureaplasma, Chlamydia). Ketso ea matlapa a Ciprofloxacin khahlano le treponema (moemeli oa causative oa syphilis) e ntse e sa utloisisoe ka botlalo.

Kamora ho nka letlapa la ciprofloxacin kahare, karolo e sebetsang e kenella hantle tsamaisong ea mali mme e ajoa ka ho lekana lithong, moo e nang le phello ea kalafo.

Matlapa a Ciprofloxacin a bontšoa bakeng sa kalafo ea etiotropic (kalafo e reretsoeng ho bolaea moemeli ea tšoaetsanoang) ea mafu a fapakaneng a bakoang ke baktheria e amehang ka karolo e sebetsang ea moriana:

Ho hlōloa ha mokhoa o ka holimo, o fokolang oa ho hema.
Lits'ebetso tsa "bacteria" tse fokotsang litho tsa ENT.
Tšoaetso ea likarolo tsa mochine oa urine le liphio.
Ts'oaetso e tobileng le e sa tobang ea bong.
Ts'ebetso ea ts'oaetso ea ts'ebetso ea tšilo ea lijo, ho kenyelletsa meno le mehlahare.
Mekhoa ea ho ruruha e fumanehang sebakeng sa gallbladder le likarolo tse ling tsa sistimi ea hepatobiliary.
Ts'oaetso le ts'ebetso ea ho ruruha hoa letlalo, manonyeletso a tlase le lisele tse bonolo tsa ho ikamahanya le maemo.
Ts'ebetso ea ho ruruha ea ho ruruha ea metsoako ea musculoskeletal system, ho kenyelletsa osteomyelitis.
Sepsis (tšenyo ea mali ea baktheria) le peritonitis (ts'ebetso ea ho ruruha ho peritoneum).

Setlhare se boetse se sebelisetsoa ho thibela mekhoa ea tšoaetso ho bakuli ba nang le ts'ebetso e fokotsang ea boits'ireletso ba mmele.

Contraindication

Matlapa a Ciprofloxacin a kopantsoe nakong ea bokhachane nakong efe kapa efe ea thupelo, nakong ea ho anyesa (lactation), ho bana ba ka tlase ho lilemo tse 18, hammoho le maemong a ho se mamellane ho ciprofloxacin kapa baemeli ba bang ba sehlopha sa fluoroquinolone. Pele o fana ka matlapa a ciprofloxacin, ngaka e etsa bonnete ba hore ha ho na li-contraindication.

Matlapa a Ciprofloxacin a etselitsoe ho tsamaisoa ka molomo ka mpa e se nang letho. Li metsoa li felletse, ha li qhekelloe 'me li hlatsuoa ka metsi a lekaneng. Tekanyetso le litekanyetso li nka mofuta oa ts'oaetso. Boemong bo sa rarahanang ba ts'oaetso ea ts'oaetso, matlapa a ciprofloxacin hangata a sebelisoa ho litekanyetso tsa 250 mg makhetlo a 2 ka letsatsi. Boemong bo rarahaneng kapa bo boima, hammoho le tšenyo ea masapo, liphatsa tsa lefutso - 500 mg makhetlo a 2 ka letsatsi. Bakeng sa bakuli ba tsofetseng, hammoho le sekhahla sa ho fokotseha ho lekanang hoa ts'ebetso ea liphio, tekanyo ea sebete e fokotsehile. Nako e tloaelehileng ea boikoetliso ke matsatsi a 7-10, ka ts'ebetso e matla ea ts'oaetso e ka eketseha. Maemong a mangata, ngaka e beha mofuta oa kalafo, litekanyetso le hore na nako ea phekolo e le 'ngoe ka e ngoe e lebisitsoe ho mokuli e mong le e mong.

Litlamorao

Khahlano le semelo sa ho nka matlapa a ciprofloxacin, nts'etsopele ea liphetoho tse mpe tsa methapo ea litho le lits'ebetso tse fapaneng e ka etsahala:

Ts'ebetso ea lijo tsa methapo - ho nyekeloa hoa pelo, ho tsamaisana le ho hlatsa nako le nako, letšollo, bohloko bo ka mpeng, nts'etsopele ea pseudomembranous colitis.
Ts'ebetso ea methapo - hlooho e opang, ho ts'oaroa ka linako le linako ha motho a tšoenyeha ka ho teba, ho ikutloa a khathetse, mathata a fapaneng a boroko, ho hlaha ha litoro, ho akheha, ho ferekana ha pono, ho utloa mantsoe kapa ho bona lintho ka mahlo.
Ts'ebetso ea pelo le methapo - ho eketseha ha sekhahla sa pelo (tachycardia) ka ts'oenyeho ea morethetho (arrhythmia), khatello ea mali ea systemic (arterial hypotension).
Sisteme ea urinary - tlolo ea "urinary excretion" (dysuria, ho boloka urine), ponahalo ea likristale (crystalluria), mali (hematuria) le protheine (albinuria) ka moroto, ts'ebetso ea ho ruruha liphatseng (glomerulonephritis, interstitial nephritis).
Motso le mali a masapo a khubelu - ho fokotseha ha palo ea leukocytes (leukopenia), liplatele (thrombocytopenia), neutrophils (neutropenia) maling, keketseho ea palo ea eosinophils (eosinophilia).
Sistimi ea musculoskeletal - bohloko bo kopaneng (arthralgia), matla a fokotsehileng a methapo le methapo ea methapo ea tsamaiso ea masculoskeletal, e tsamaisana le ts'ebetso ea ho ruruha le riptures ea methapo.
Matšoao a laboratori - keketseho ea palo ea li-creatinine, urea maling, keketseho ea tšebetso ea li-enzymes tsa sebete (ALT, AST).
Letlalo le lihlahisoa tsa lona - nts'etsopele ea photosensitivity (ho eketsa kutloisiso ea letlalo ho khanya).
Bohloko ba mokokotlo - lekhopho la letlalo, ho hlohlona, liphetoho tsa sebopeho se tšoana le ho chesoa ha nettle (urticaria), ho ruruha ho matla ha litho tse bonolo tsa sefahleho le genitalia ea ka ntle (angioedema, edincke's edema), lesapo la letlalo la necrotic (Stevens-Johnson, lefu la Lyell).

Haeba matšoao a nts'etsopele ea karabelo e mpe ea methapo a hlaha ha u ntse u nka matlapa a Ciprofloxacin, o lokela ho ikopanya le ngaka ea bongaka.

Thutela-litso

E thibela libaktheria tsa DNA gyrase (topoisomerases II le IV, e ikarabellang ts'ebetsong ea ho bokella DNA ea chromosomal ho potoloha RNA ea nyutlelie, e hlokahalang bakeng sa ho bala tlhaiso-leseling ea lefutso, e sitisa motsoako oa DNA, kholo le karohano ea baktheria, e baka liphetoho tse boletsoeng morphological (ho kenyeletsa le lebota la lisele le li-membrane) le lefu le potlakileng la sele ea kokoana-hloko.

E sebetsa ka bactericidal ho likokoana-hloko tse mpe tsa gram nakong ea ho phomola le ho arohana (kaha ha e ame feela gyrase ea DNA, empa e boetse e baka leqhubu la lebota la sele), hape e sebetsa ka likokoana-hloko tse ntle tsa gram feela nakong ea karohano.

Ho ba le chefo e fokolang ho lisele tsa macroorganism ho hlalosoa ke ho haella ha li-gyrase tsa DNA ho tsona. Khahlano le semelo sa ciprofloxacin, ha ho na tsoelopele e ts'oanang ea ho hanana le litlhare tse ling tsa antibacterial tseo e seng karolo ea sehlopha sa li-inhibitors tsa DNA, tse etsang hore e sebetse hantle haholo khahlanong le libaktheria tse loantšang, mohlala, aminoglycosides, penicillin, cephalosporins, tetracyclines.

Ho hanela in vitro ho ciprofloxacin hangata e bakoa ke liphetoho tse hlakileng tsa bacterius topoisomerases le DNA gyrase 'me li ntlafala butle butle ka phetoho e ngata.

Phetoho e le 'ngoe e ka lebisang ho fokotseheng ha kutloelo-bohloko ho feta ho nts'etsopele ea khatello ea bongaka, leha ho le joalo, liphetoho tse ngata li lebisa ho nts'etsopele ea khatello ea bongaka ea ciprofloxacin le ho hanyetsa sefapano sa lithethefatsi tsa quinolone.

Ho hanyetsa ciprofloxacin, hammoho le lithethefatsi tse ling tse ngata tsa antibacterial, li ka ba teng ka lebaka la ho fokotseha ha boteng ba leseli la baktheria (joalo ka ha ho le joalo hangata ka Pseudomonas aeruginosa) le / kapa ts'ebetso ea ho tlosa lintho tse tsoang seleng e le 'ngoe e ntle (efflux). Nts'etsopele ea ho hanyetsa ka lebaka la mofuta oa coding e fumanehang ho plasmids e tlalehiloe Qnr. Mekhoa ea ho hanyetsa e lebisang ho inactivation ea penicillin, cephalosporins, aminoglycosides, macrolides, le tetracyclines mohlomong ha e kena-kenane le ts'ebetso ea antibacterial ea ciprofloxacin. Likokoana-hloko tse loantšang lithethefatsi tsena li kanna tsa ameha ka ciprofloxacin.

Tekanyetso e tlase ea bactericidal (MBC) hangata ha e fetise bonyane ba "inhibitory" (MIC) ka makhetlo a fetang a mabeli.

Ka tlase ho na le mekhoa ea ho hlahisa liteko bakeng sa ho leka ho utloisisa sensopivity ho ciprofloxacin, e amohetsoeng ke Komiti ea Europe bakeng sa qeto ea Sensitivity ho Li-antibacterial Agents (Eucast) Litekanyetso tsa moeli oa MIC (mg / l) li fanoa tlasa maemo a kliniki bakeng sa ciprofloxacin: palo ea pele ke ea likokoana-hloko tse utluoang ka ciprofloxacin, ea bobeli ke ea tse hanyetsanang.

- Enterobacteriaceae ≤0,5, >1.

- Pseudomonas spp. ≤0,5, >1.

- Spinetobacter spp. ≤1, >1.

- Staphylococcus 1 spp. ≤1, >1.

- Streptococcus pneumoniae 2 2.

- Haemophilus influenzae le Moraxella catarrhalis 3 ≤0,5, >0,5.

- Neisseria gonorrhoeae le Neisseria meningitidis ≤0,03, >0,06.

- Boundary boleng bo sa amaneng le mefuta ea likokoana-hloko tsa 4 ≤0.5,> 1.

1 Staphylococcus spp: Melao ea bohlokoa ea ciprofloxacin le ofloxacin e amana le kalafo ea tekanyetso e phahameng.

2 Streptococcus pneumoniae: mofuta oa hlaha S. pneumoniae Ha e nkuoe e nahanela ciprofloxacin mme, ka hona, ke ea sehlopha sa li-microorganism tse nang le maikutlo a mahareng.

Li-strains tse nang le boleng ba MIC kaholimo ho kamohelo ea tsona li tebile haholo / ha li na tlhalohanyo hangata, 'me ho fihlela joale ha ho e-so be le litlaleho tsa tsona. Liteko tsa boitsebahatso le kutloelo-bohloko ea ho hlaseloa ha likolone tse joalo li tlameha ho phetoa, 'me liphetho li tlameha ho netefatsoa ke tlhahlobo ea likolone ka laboratoring ea boits'oaro. Ho fihlela bopaki ba karabelo ea bongaka bo fumaneha bakeng sa mafu a nang le litekanyetso tse netefalitsoeng tsa MIC tse fetang tekanyetso ea hona joale ea khanyetso, li lokela ho nkuoa li le thata. Haemophilus spp./Moraxella spp: ho tsebahala ka mefuta e ka khona H. influenzae ka kutloisiso e tlase ea fluoroquinolones (MIC bakeng sa ciprofloxacin - 0.125-0.5 mg / l). Bopaki ba bohlokoa ba kliniki ea ho hanyetsa ho tlase maemong a phefumoloho a bakoang ke H. influenzaeche.

4 Melao ea boleng bo fapaneng e sa amaneng le mefuta ea likokoana-hloko e ikemiselitsoe haholo motheong oa li-pharmacokinetics / pharmacodynamics mme ha e ea itšetleha ka phetiso ea li-MIC bakeng sa mefuta e ikhethang. Li sebetsa feela ho mefuta eo tlholeho e ikhethang ea kutloisiso e sa khetholloang, mme eseng ho mefuta e sa khothaletsoang tlhahlobo ea sensitivity. Bakeng sa likhathatso tse itseng, ho ata ha khanyetso e fumanoeng ho ka fapana ka sebaka le ka nako. Mabapi le sena, ho hotle ho ba le tlhaiso-leseling e nepahetseng mabapi le ho hanyetsa, haholo kalafo ea tšoaetso e kholo.

Lintlha tse latelang ke lintlha tse tsoang ho Setheo sa Melao ea Tleliniki le ea Laboraro (CLSI), ho beha litekanyetso tsa "reproducible values" tsa MIC (mg / L) le tlhahlobo ea infusion (bophara bophara ba limilimithara, limilimithara) o sebelisa li-disc tse nang le 5 μg ciprofloxacin. Ka litekanyetso tsena, likokoana-hloko li khetholloa e le tse mahlonoko, tse bohareng le tse loantšang.

- MIC 1: tlhwahlwa - 4.

- Tlhatlhobo e fapaneng le ea 2: e tebile -> 21, mahareng - 16-20, e loantšang - libaktheria tse ling tseo e seng tsa lelapa Enterobacteriaceae

- MIC 1: tlhwahlwa - 4.

- Tlhatlhobo e fapaneng le ea 2: e tebile -> 21, mahareng - 16-20, e hanyetsang - 1: e tebile - 4.

- Teko ea ho khetholla 2: e tebile -> 21, e mahareng - 16- 20, e hanang - 3: e tebile - 4: e tebile -> 21, mahareng - -, e hanyetsane - -.

- MIC 5: ntshwarele - 1.

- Teko ea bohlano bo 5: e tebile -> 41, e mahareng - 28-40, e hanang - 6: e tebile - 0.12.

- Teko ea bo-7: e tebile -> 35, e mahareng - 33- 34, e hanang - 1: e tebile - 3: e tebile - 1 Tekanyetso ea mookotaba e sebetsa feela ho litlatsetso tsa moro o sebelisang cationic e lokisitsoeng Mueller-Hinton moro (SAMNV), e koahelang moea ka mocheso oa (35 ± 2) ° C bakeng sa 16-20 h bakeng sa mefuta Enterobacteriaceae, Pseudomonas aeruginosalibaktheria tse ling tseo e seng tsa lelapa Enterobacteriaceae, Staphylococcus spp., Enterococcus spp. le Bacillus anthracis, 20-24 h bakeng sa Spinetobacter spp., 24 h bakeng sa Y. pestis (molemong oa kholo e sa lekaneng, incubate lihora tse ling tse 24).

2 Tekanyetso e ka sebelisoang e sebetsa feela litlhahlobong tsa infusion u sebelisa li-disc tse sebelisang Muller-Hinton agar (SAMNV), e koahelang moea ka mocheso oa (35 ± 2) ° C bakeng sa lihora tsa 16-18.

3 Tekanyetso ea ho ikatisa e sebetsa feela ho liteko tsa infusion tse sebelisang li-disc ho khetholla kutloisiso ho Haemophilus influenzae le Haemophilus parainfluenzae sebelisa broth liteko tsa mahareng bakeng sa Haemophilus spp. (NTM), e koahelang moea ka mocheso oa (35 ± 2) ° C bakeng sa lihora tse 20-24.

4 Tekanyetso e ikatisang e sebetsa feela litekong tsa ho hlapanya u sebelisa li-disc u sebelisa tikoloho ea liteko NTMe koahetsoeng ho 5% CO₂ ka mocheso oa (35 ± 2) ° C bakeng sa lihora tsa 16-18

5 Tekanyetso e hlahisoang e sebetsa feela litekong tsa sensitivity (liteko tsa infusion tse sebelisang li-disc bakeng sa libaka le tharollo ea agar bakeng sa MIC) sebelisa gonococcal agar le 1% tlatsetso ea kholo holima mocheso oa (36 ± 1) ° C (o sa feteng 37 ° C) oa 5 % CO₂ nakong ea lihora tse 20-24

6 Tekanyetso e hlahisoang hantle e sebetsa feela ho liteko tsa moro o sebelisang 'moeller-Hinton.SAMNV) le kenyelletso ea mali a linku a 5%, a kentsoeng ka 5% CO₂ ka (35 ± 2) ° C bakeng sa lihora tse 20-25

7 Tekanyetso e hlahisoang hantle e sebetsa feela litekong tse sebelisitsoeng ho cationic ukulungisa Mueller-Hinton broth (SAMNV) ka kenyelletso ea tlatsetso e ikhethileng ea 2% ea ho hola, e kentsoeng ka moea ho (35 ± 2) ° C lihora tse 48.

Boikutlo ba vitro ho ciprofloxacin

Bakeng sa likhathatso tse itseng, ho ata ha khanyetso e fumanoeng ho ka fapana ka sebaka le ka nako. Mabapi le sena, ha ho hlahlojoa maikutlo a khatello ea methapo, ho hotle ho ba le tlhaiso-leseling e nepahetseng mabapi le ho hanyetsa, haholo kalafo ea ts'oaetso e matla. Haeba ho ata ha tšoaetso ho atile hoo melemo ea ho sebelisa tšoaetso ea profrofloxacin bonyane mefuta e 'maloa ea tšoaetso e belaetsang, etela setsebi. In vitro Ketsahalo ea ciprofloxacin khahlano le likarolo tse latelang tse thata tsa likokoana-hloko.

Likokoana-hloko tsa Aerobic Gram-Positive - Bacillus anthracis, Staphylococcus aureus (methicillin-sens Staphylococcus saprophyticus, Streptococcus spp.

Likokoana-hloko tse mpe tsa aerobic gram-negative - Aeromonas spp., Moraxella catarrhal is, Brucella spp., Neisseria meningitidis, Citrobacter koseri, Pasteurella spp., Francisella tularensis, Salmonella spp., Haemophilus ducreyi, Shigella spp., Haemophilus influenzae, Vibo. Legri..

Likokoana-hloko tsa Anaerobic - Mobiluncus spp.

Likokoana-hloko tse ling - Chlamydia trachomatis, Chlamydia pneumoniae, Mycoplasma hominis, Mycoplasma pneumoniae.

Tekanyo e fapaneng ea ho ba le kutloisiso ho ciprofloxacin e bontšitsoe bakeng sa likokoana-hloko tse latelang: Acinetobacter baumanii, Burkholderia cepacia, Campylobacter spp. Pseudomonas fluorescens, Serratia marcescens, Streptococcus pneumoniae, Peptostreptococcus spp., Propionibacterium acnes.

Ho lumeloa hore ciprofloxacin ka tlhaho e hana. Staphylococcus aureus (methicillin-thibela) Stenotrophomonas maltophilia, Actinomyces spp. Enteroccus faecium, Listeria monocytogene, Mycoplasma genitalium, Ureaplasma urealyticumlikokoana-hloko tsa anaerobic (ntle le Mobiluncus spp., Peptostreptococus spp., Propionibacterium acnes).

Suction. Kamora ho tsamaisoa ha iv ea 200 mg ea ciprofloxacin T_max ke metsotso e 60, C_max - 2.1 μg / ml, puisano le liprotheine tsa plasma - 20-40%. Ka tsamaiso ea iv, pharmacokinetics ea ciprofloxacin e ne e le mola ka har'a lethal dose ho fihlela ho 400 mg.

Ka tsamaiso ea iv makhetlo a 2 kapa a 3 ka letsatsi, cumulation ea ciprofloxacin le metabolites ea eona ha lia ka tsa bonoa.

Kamora ho tsamaisoa ka molomo, ciprofloxacin e kenella ka potlako ho tsoa mokokotlong oa lijo, haholo-holo ho duodenum le jejunum. Le_max ka serum e fihlelloa kamora lihora tse 1-2 le ha ho nkuoa ka molomo 250, 500, 700 le 1000 mg ea ciprofloxacin 1.2, 2.4, 4.3 le 5.4 μg / ml, ka ho latellana. Bioavailability e batla e le 70-80%.

C boleng_max le keketseho ea AUC ka tekanyo ea tekanyetso. Ho ja (ntle le lihlahisoa tsa lebese) ho fokotsa ho monya, empa ha ho fetole C_max le bioavailability.

Kamora ho kenella ka har'a conjunctiva ka matsatsi a 7, ho kopanngoa ha ciprofloxacin ka har'a plasma ea mali ho tloha ho quaring e sa lekaneng (C_max ka plasma ea mali e ne e le ka tlase ho makhetlo a 450 ka tlase ho kamora ho tsamaiso ea molomo ka lethal dose ea 250 mg.

Tsamaiso. Sesebelisoa se sebetsang se teng ka har'a lero la mali haholo ka mokhoa o sa khetholloang. Ciprofloxacin e tsamaisoa ka bolokolohi liseleng le maro a 'mele. V_d 'meleng ke 2-3 l / kg.

Khokahano ea lisele e ka makhetlo a 2-12 ho feta plasma ea mali. Metsoako ea phekolo e fumaneha manonyeletsong, methapo, sebete, lesapo la mokokotlo, bile, mala, litho tsa ka mpeng le masapo a mokokotlo (endometrium, methapo ea fallopian le mahe a ka popelong), mokelikeli oa seminal, lithane tsa lefu la matsoele, liphio le litho tsa mokokotlo, lithane tsa mpa. secretion, mesifa ea masapo, mesifa, mokelikeli oa methapo ea kutlo le mokelikeli oa sefahleho, mokelikeli oa peritoneal, letlalo. E kenella ka har'a mokelikeli oa "cerebrospinal" ka tekanyo e nyane, moo ts'oaetso ea eona e leng sieo ho ts'oaetso ea meninges ke 6-10% ea seo se kahara plasma ea mali, mme ha o ka kenella ke 14 - 37%. Ciprofloxacin hape e kenella hantle ka har'a mokelikeli oa mahlo, pleura, peritoneum, lymph, ka placenta. Khokahano ea ciprofloxacin ho li-neutrophils tsa mali e phahame ka makhetlo a 2-7 ho feta plasma ea mali.

Metabolism. Ciprofloxacin e hlophisitsoe ka biotransformed ka har'a sebete (15-30%). Li-metabolite tse 'ne tsa profrofloxacin ka har'a maemo a tlase li ka bonoa maling - diethylcycrofloxacin (M1), sulfociprofloxacin (M2), oxociprofloxacin (M3), formylcycrofloxacin (M4), formylcycrofloxacin (M4), tse tharo tseo (M1 - M3) li bonts'ang ts'oaetso ea antibacterial. in vitro bapisoa le mosebetsi oa nalidixic acid. Ts'ebetso ea antibacterial in vitro metabolite M4, e teng ka bongata bo nyane, e amana hantle le ts'ebetso ea norfloxacin.

Ho tsala. T_1/2 ke lihora tse 3-6, 'mele o sa sebetse hantle - ho isa ho lihora tse 12. E hloekisoa haholo ke liphio ka ho sefuoe ha tlhaho le sephiri se sa fetoheng (50-70%) le ka mokhoa oa metabolites (10%), phomola ka ho ohla. Hoo e ka bang karolo ea 1% ea lethal dose e laetsoeng e pepesitsoe ka har'a bile. Kamora ho tsamaisoa ha iv, ho kenella ka har'a moroto nakong ea lihora tse peli tsa pele kamora ts'ebetso ho phahame makhetlo a 100 ho feta ho plasma ea mali, e fetang haholo BMD bakeng sa ts'oaetso e ngata ea mofets'e ea moroto.

Ho hlakisoa ha molao ka kotloloho - 3-5 di ml / min / kg, ho hlakisoa ka botlalo - 8-10 ml / min / kg.

Ho sa sebetseng hantle ha renal (Cl creatinine> 20 di ml / min), li-excretion ka liphio lia fokotseha, empa cumulation 'meleng ha e hlahe ka lebaka la keketseho e lekantsoeng ea metabolism ea ciprofloxacin le excretion ka mpeng ea mpa.

Bana. Thutong ea bana, litekanyetso tsa C_max mme AUC e ne e le lilemo li ikemetse. Keketseho e hlokomelehang C_max le AUC e nang le tsamaiso e pheta-phetoang (ka tekanyo ea 10 mg / kg makhetlo a 3 ka letsatsi) ha ea ka ea bonoa. Ho bana ba 10 ba nang le sepsis e boima ba ka tlase ho selemo se le seng, boleng ba C_max e bile 6.1 mg / l (ho tloha ho 4,6 ho isa ho 8,3 mg / l) kamora ho kenngoa nako e le 'ngoe nako e le' ngoe ka tekanyo ea 10 mg / kg, le ho bana ba lilemo li 1 ho isa ho 5 - 7.2 mg / l (ho tloha ho 4,7 ho isa ho 11.8 mg / l). Litekanyetso tsa AUC ka lihlopha tsa lilemo tse fapaneng e ne e le 17.4 (ho tloha ho 11.8 ho isa ho 32 mg · h / l) le 16.5 mg · h / l (ho tloha ho 11 ho isa ho 23,8 mg · h / l). Litaelo tsena li tsamaisana le bakuli ba baholo ba sebelisang tekanyetso ea kalafo ea ciprofloxacin. Ho ipapisitsoe le tlhahlobo ea pharmacokinetic ho bana ba nang le ts'oaetso e fapaneng, kholo e bolelang T_1/2 hoo e ka bang lihora tse 4-5

Likarolo tsa ts'ebeliso

Pele a fana ka matlapa a Ciprofloxacin, ngaka e lokela ho ela hloko likarolo tse 'maloa tsa tšebeliso e nepahetseng ea lithethefatsi, tse boletsoeng ho kenyelletso:

Ka tlhokomeliso e fetelletseng, sethethefatsi sena se sebelisoa ho bakuli ba nang le lefu la sethoathoa, boteng ba ho ts'oaroa ka mokhoa o kholisang oa methapo e fapaneng, le khahlano le semelo sa methapo ea methapo ea methapo ea methapo ea boko. Ka nako e ts'oanang, matlapa a ciprofloxacin a khethoa feela ka mabaka a bophelo.
Nts'etsopele ea letšollo le tšoarellang nakong ea kalafo ka moriana ona ke motheo oa boithuto bo eketsehileng ho khetholla pseudomembranous colitis. Haeba ts'oaetso e netefalitsoe, moriana o felisoa hanghang.
Ha bohloko bo ka har'a ligaments kapa tendon bo hlaha, sethethefatsi sea hlakoloa, haholo ho bakuli ba tsofetseng, se amanang le kotsi e kholo ea likotsi tsa methapo.
Ha ho khothalletsoe ho etsa mosebetsi o boima oa 'mele ha u ntse u nka matlapa a ciprofloxacin.
Ho khothalletsoa ho qoba ho pepesetsoa khanya ea letsatsi ka ho toba letlalong nakong ea kalafo ka moriana ona.
Ha o nka matlapa a Ciprofloxacin, o lokela ho sebelisa metsi a lekaneng ho fokotsa menyetla ea ho lla.
Ha e kenyeletse joala bo bongata nakong ea kalafo le moriana.
Karolo e sebetsang ea matlapa a ciprofloxacin a ka sebelisana le lithethefatsi tsa lihlopha tse ling tsa meriana, ka hona, haeba li sebelisoa, ngaka e eang e lokela ho lemosoa ka sena.
Nakong ea phekolo, tlhokomelo e khethehileng e lokela ho nkoa ha ho etsoa mosebetsi o ka bang kotsi o hlokang tlhokomelo e eketsehileng le lebelo le lekaneng la karabelo ea psychomotor.

Ka marang-rang a litlama, matlapa a ciprofloxacin ke lingaka. Ts'ebetso ea bona ea boits'oaro ha e khethoe ntle le lengolo la ngaka le nepahetseng, kaha sena se ka baka litlamorao tse mpe tsa bophelo bo botle.

Bongata

Ha motho a e-na le litekanyetso tse ngata tsa kalafo tse khothalelitsoeng tsa matlapa a ciprofloxacin, ho nyekeloa ke pelo, ho hlatsa, ho opeloa ke hlooho, ho tsekela, ho sitisoa ho tseba ho teba ha mesifa, ho fokola hoa mesifa, ho ba le lipono. Tabeng ena, mala le mala a hlatsuoa, ho laetsoe mala a ka mpeng, 'me ho phekoloa ka matšoao ho boetse ho etsoa haeba ho hlokahala, kaha ha ho na pheko e tobileng ea sehlahisoa sena.

Likhakanyo tsa matlapa a ciprofloxacin

E tšoanang sebopeho le litlamorao tsa kalafo bakeng sa matlapa a ciprofloxacin ke litokisetso tsa Ecocifol, Ciprobay, Ciprinol, Ciprolet.

Bophelo ba sehatsetsing matlapa a ciprofloxacin ke lilemo tse 2 ho tloha ka letsatsi la tlhahiso. Li lokela ho bolokoa ka har'a lipakete tse sa senyehang, sebakeng se lefifi, se ommeng se sa fumaneheng ho bana mochesong oa moea o sa feteng 25 + C.

Sokolla foromo le sebopeho

Ciprofloxacin e fumaneha ka mefuta e latelang:

matlapa a 250, 500 kapa 750 mg, filimi e koahetsoeng. Matlapa a pota-potileng a biconvex a 250 mg a na le 'mala o pinki. Matlapa a 500mm a nang le sebopeho sa capsule a na le khetla e pinki mme a kotsing ka lehlakoreng le le leng. Matlapa a 750 mg a capsule e nang le sebopeho a na le bosoeu. Setlhare se ka kenngoa ka har'a marang-rang (matlapa a 10 kapa a 20) le mekotleng ea karete (1, 2, 3, 4, 5, kapa 10 blacks ka paketeng). Hape, matlapa a ciprofloxacin a ka kenngoa ka mekotleng ea polasetiki (likotoana tse 30, 50, 60, 100, kapa tse 120), ka bomong tse pakiloeng ka lijaneng tsa polasetiki. Ntle le moo, setlhare se fumaneha ka sekotong sa polyethylene (matlapa a 10 kapa a 20), a behiloeng ka lebokoseng la karete.
tsepamisa mohopolo bakeng sa tharollo ea infusion 10 mg / ml. Mokelikeli o sa bonahaleng kapa o 'mala o botala bo bosehla o tšeloa ka khalase e sa bonahaleng ea likhalase tsa 10 ml. Setlhare sena se kentsoe ka lipaketeng tsa karete (libotlolo tse 5 ka ngoe),
tharollo ea infusion 2 mg / ml. Mokelikeli o bosehla o mosehla kapa o se nang 'mala o tšeloa ka libotlolong tsa polasetiki tse 100 ml, tse pakiloeng ka mekotleng ea polasetiki le mabokoseng a karete (1 bag ka lebokose)
tsebe le leihlo li theoha ka 0,3%. Mokelikeli o hlakileng, o se nang 'mala kapa o moputsoa hanyane o tšeloa ka libotlolong tse tšoeu tsa polymer tse tšoeu (5 ml ka ngoe), tse pakiloeng ka mabokoseng a karete (1 botlolo ka' ngoe).

Moetso oa Letlapa le le leng o kenyelletsa:

ntho e sebetsang: ciprofloxacin - 250, 500 kapa 750 mg,
excipients: starch, microcrystalline cellulose, talc, magnesium stearate, colloidal silicon dioxide (aerosil), hydroxypropyl methyl cellulose 15 CPS, sodium starch glycolate, diethyl phthalate, titanium diode, polasetiki ea letsatsi e putsoa, polasetiki ea daemane e boreleli, varnish ea carmoisine.

Sebopeho sa botlolo e le 'ngoe e nang le mohopolo bakeng sa ho hlophisoa ha tharollo ea infusion e kenyeletsa:

ntho e sebetsang: ciprofloxacin - 100 mg,
excipients: disodium edetate dihydrate, lactic acid, sodium hydroxide, hydrochloric acid, metsi a ente.

Karolo ea 100 ml ea tharollo ea infusion e kenyelletsa:

ntho e sebetsang: ciprofloxacin - 200 mg,
excipients: disodium edetate, sodium chloride, metsi a ente.

Sebopeho sa 1 ml ea marotholi a tsebe le mahlo se kenyeletsa:

ntho e sebetsang: ciprofloxacin - 3 mg,
li-excipients: mannitol, sodium acetate trihydrate, chloride ea benzalkonium, disodium edetate dihydrate, glacial acetic acid, metsi a hloekisitsoeng.

Matlapa, tsepamisa mohopolo, tharollo ea infusion

Ciprofloxacin e sebelisoa ho phekola mafu a latelang a rarahaneng le a sa rarahanang a bakoang ke likokoana-hloko tse anngoeng ke ntho e sebetsang:

Mafu a tšoaetsanoang a ts'oaetso ea phefumoloho, ho kenyelletsa le pneumonia e bakoang ke Enterobacter spp., Klebsiella spp., Escherichia coli, Proteus spp, Haemophilus spp., Pseudomonas aeruginosa, Legionella spp, Staphylococcus spp.
ts'oaetso ea li-sinuse (haholo-holo, sinusitis) le tsebe e bohareng (ka mohlala, mecha ea litaba ea otitis), haholo haeba mafu ana a bakoa ke likokoana-hloko tse mpe tsa gram, ho kenyelletsa le Staphylococcus spp. le Pseudomonas aeruginosa,
ts'oaetso ea mahlo (ntle le matlapa),
pampitsana ea urine le mafu a liphio
tšoaetso ea setho sa botšehali, ho kenyelletsa le lefu la tsoekere, prostatitis, adnexitis,
tšoaetso ea baktheria ea bokhoni ba mpa ea ka mpeng (tšoaetso ea seteraeke sa mokelikeli, ho kenella ka mpeng, peritonitis),
sepsis
lisele tse bonolo le tšoaetso ea letlalo (ntle le matlapa),
thibelo ea tšoaetso kapa tšoaetso ho bakuli ba nang le tšoaetso e fokotsang (bakuli ba nang le neutropenia kapa bakuli ba nkang li-immunosuppressants),
kalafo ea ho khetha decontamination ea mala ho bakuli ba fokotsehileng boits'ireletso,
kalafo le thibelo ea anthrax ea pulmonary e bakoang ke Bacillus anthracis (ntle le matlapa).

Tsebe le mahlo li oa

Ha o sebelisa marotholi a mahlo ho ophthalmology, moriana o sebelisetsoa ho phekola maloetse a joalo a tšoaetsanoang le a sa foleng:

subacute le a hlobaetsang le conjunctivitis,
blepharoconjunctivitis,
blepharitis
keratoconjunctivitis,
keratitis
dacryocystitis e sa foleng
baking
maqeba a tšoaetsanoang kamora 'mele ea kantle kapa likotsi,
meibomite (harese).

Ha o sebelisa marotholi a mahlo ho bueng mahlo ka litlhare, moriana o sebelisetsoa ho thibela pelehi le ka mora ts'ebetso ea mathata a tšoaetsanoang.

Ha o sebelisa marotholi a tsebe ho otorhinolaryngology:

kalafo ea mathata a tšoaetsanoang ka mora ts'ebetso,
otitis externa.

Matlapa a 250, 500 kapa 750 mg

Setlhare se fanoa ka molomo - ka mpeng e se nang letho, ka mokelikeli o lekaneng. Litekanyetso li khethoa ho latela boteng ba lefu lena, boemo ba 'mele, mofuta oa ts'oaetso, boima, ts'ebetso ea liphio le lilemo tsa mokuli. Melemo e latelang e khothalletsoa hangata:

bakeng sa mafu a sa rarahanang a tsamaiso ea moroto le liphio - 250 mg makhetlo a 2 ka letsatsi, le mafu a rarahaneng - 500 mg,
ka lefu le leka-lekaneng la 'mele oa ho hema ka tlase - makhetlo a 2 ka letsatsi, 250 mg, mme le boima - 500 mg,
le gonorrhea hang - 250-500 mg,
le mafu a gynecological, colitis le enteritis (foromo e matla, feberu e phahameng), osteomyelitis, prostatitis - makhetlo a 2 ka letsatsi, 500 mg ka 'ngoe. Ka letšollo la banal, ho kgothaletswa ho nka 250 mg ea moriana makhetlo a 2 ka letsatsi.

Nako ea kalafo e khethoa ho latela boteng ba lefu lena, leha ho le joalo, kalafo e lokela ho tsoelapele ka bonyane matsatsi a 2 kamora hore matšoao a nyamele. Nako e tloaelehileng ea kalafo ke matsatsi a 7-10.

Tharollo ea infusion 2 mg / ml

Setlhare sena se fanoa ka methapo. Tharollo ea infusion e tlameha ho kenngoa butle-butle ka mothapong o moholo ho thibela nts'etsopele ea maloetse sebakeng sa infusion. Tharollo e tsamaisoa e le mong kapa e kopane le tharollo e lumellanang ea infusion (Tharollo ea Ringer, tharollo ea sodium chloride ea 0,9%, 10% kapa 5% dextrose, tharollo ea 10% ea tructose, tharollo ea 5% dextrose, 0,2525 kapa 0,45 tharollo ea sodium chloride). %).

Nako ea infusion ka tekanyo ea 200 mg ke metsotso e 30, ka tekanyo ea 400 mg - metsotso e 60. Khafetsa ea tsamaiso ke makhetlo a 2-3 ka letsatsi.

Nako ea kalafo e itšetlehile ka thupelo ea bongaka, botebo le pheko ea lefu lena. Moriana o fuoa matsatsi a mang a 3 kamora ho felisoa ha matšoao a kliniki.

Nako e tloaelehileng ea kalafo:

le gonorrhea e boima e bohloko - 1 letsatsi,
ka tšoaetso ea liphio, litho tsa ka mpeng, mokhoa oa ho ntša metsi - ho fihlela matsatsi a 7,
ka ho itšireletsa mafung - nako eohle ea neutropenia,
le osteomyelitis - matsatsi a sa feteng 60,
le Chlamydia spp. kapa Streptococcus spp. tšoaetso - bonyane matsatsi a 10,
le tšoaetso e 'ngoe - matsatsi a 7-14.

Tekanyetso ea lithethefatsi e khethoa ho latela mofuta oa lefu:

le ts'oaetso ea ts'oaetso ea phepelo - makhetlo a 2-3 ka letsatsi, 400 mg ka 'ngoe,
a tšoaetso e matla haholo ea genitourinary system - makhetlo a 2 ka letsatsi, 200 kapa 400 mg,
le tšoaetso e rarahaneng ea genitourinary system - makhetlo a 2-3 ka letsatsi, 400 mg ka 'ngoe,
le prostatitis, adnexitis, orchitis, epididymitis - makhetlo a 2-3 ka letsatsi, 400 mg ka 'ngoe,
le lets'ollo - makhetlo a 2 ka letsatsi, 400 mg ka ngoe,
le tšoaetso e 'ngoe - makhetlo a 2 ka letsatsi, 400 mg ka' ngoe,
ts'oaetso e mpe e ka behang bophelo kotsing (haholo boteng ba Staphylococcus spp., Streptococcus spp., Pseudomonas spp.) Haholo-holo, pneumonia e bakoang ke Streptococcus spp., le tšoaetso ea morao-rao e nang le cystic fibrosis ea matšoafo, ts'oaetso ea manonyeletso le masapo, le septicemia, peritonitis - makhetlo a 3 ka letsatsi, 400 mg ka 'ngoe,
ka thibelo le kalafo ea anthrax ea pulmonary - makhetlo a 2 ka letsatsi, 400 mg.

Ho hlophisoa ha tharollo ea infrate ea bohlokoa

Pele o sebelisoa, litaba tsa 1 vial ea concentrate li tlameha ho hlapolleloa ho bonyane bonyane 50 di ml ka tekanyo e lekaneng ea tharollo (tharollo ea Ringer, tharollo ea sodium chloride 0.9%, tharollo ea dextrose 10 kapa 5% ka tharollo ea fructose 10%, tharollo e nang le 5% dextrose solution. , tharollo ea sodium chloride 0,2525 kapa 0,45%).

Tharollo e lokela ho sebelisoa kapele kamoo ho ka khonehang ka lebaka la ho utloahala ha ciprofloxacin ho bobebe, hammoho le ho boloka botsitso ba eona. Ka hona, botlolo e tlameha ho tlosoa lebokoseng feela pele e sebelisoa. Haeba ho na le khanya ea letsatsi e tobileng, tharollo e netefalitsoe hore e tsitse ka matsatsi a 3. Ha o boloka tharollo ka lithemparetjha tse tlase, ho ka thehoa moea o fokang, o qhibiliha ka mocheso oa kamoreng, ka hona ha ho khothalletsoe ho theola tharollo ea infusion kapa ho e boloka ka sehatsetsing. Sebelisa tharollo e hlakileng le e hlakileng feela.

Haeba ho lumellana le tharollo / litokisetso tse ling tsa infusion ho sa netefatsoe, ciprofloxacin e lokela ho tsamaisoa ka thoko. Matšoao a hlakileng a ho se lumellane: pula, tharollo kapa tharollo ea maru.Setlhare ha se lumellane le litharollo tsohle tse sa tsitsang ka tšebeliso ea lik'hemik'hale kapa tsa mmele ho pH ho tloha 3.9 ho isa ho 4.5 (mohlala, tharollo ea heparin, penicillin), hammoho le tharollo e fetolang pH ho lehlakoreng la alkaline.

Leihlo le tsebe lea theoha

karabelo
ho tuka
ho hlohlona
hyperemia le bonolo bo bonolo ba conjunctiva ebang ke karolong ea membrane ea tympanic le canal e tsoang ka ntle ea likhalase,
ho nyekeloa
Photophobia
Ho ruruha ha lintshi,
maikutlo a kantle ho leihlo,
lacrimation
hang kamora ho kenngoa - tatso e sa thabiseng kaharepeng ea molomo,
ho bakuli ba nang le lisele tsa corneal - lera le tšoeu le bitsang,
ho fokotseha hoa pono,
keratopathy
keratitis
ho kenella ka hare ho corneal kapa ponahalo ea matšoao a khoheli,
nts'etsopele ea bonohe.

Litaelo tse khethehileng

Ciprofloxacin ha e khothalletsoe kalafo ea tšoaetso e bakoang ke Streptococcus pneumoniae, kaha sethethefatsi ha se sebetse hantle khahlanong le pathogen. Tabeng ea tšoaetso e 'ngoe, pele u fana ka taelo ea Ciprofloxacin, o lokela ho etsa bonnete ba hore e ea sebetsa khahlano le mefuta ea likokoana-hloko tse tsamaellanang.

Nakong ea kalafo ea nako e telele le moriana, ho khothalletsoa ho sekaseka tlhaiso ea mali, ea sebete le ea liphio ka kakaretso.

Tabeng ea tsamaiso ea methapo e kopantsoeng ea ciprofloxacin le lithethefatsi tse tsoang sehlopheng sa lithibelo tsa acid tsa barbituric tse sebelisetsoang ho opa hlooho ka kakaretso, ho hlokahala hore ho lekane khatello ea mali kamehla, sekhahla sa pelo, le electrocardiogram.

Ho thibela nts'etsopele ea "crystalluria", ha ho amohelehe ho feta tekanyetso ea letsatsi le letsatsi e khothalletsoang. Hoa hlokahala le ho netefatsa hore ho bolokoa motsoako oa acidic le moriana oa metsi o lekaneng.

Ho na le kotsi ea ho holofatsa maikutlo le ka lebaka la tšebeliso ea pele ea ciprofloxacin. Maemong a sa tloaelehang, maikutlo a maikutlo kapa khatello ea maikutlo e ka tsoella ho menahano ea ho ipolaea le boits'oaro bo kotsi (mohlala, liteko tse sa atleheng le tse atlehileng tsa ho ipolaea). Maemong ana, o lokela ho emisa hang hang ho sebelisa lithethefatsi le ho ea ngakeng. Bakuli ba nang le nalane ea ho ts'oaroa le nalane ea lefu la sethoathoa, ho senyeha hoa boko le manyolo ka lebaka la kotsi ea karabelo e mpe, ciprofloxacin e lokela ho fuoa mabaka a bophelo bo botle.

Ciprofloxacin, joalo ka fluoroquinolones tse ling, e ka fokotsa monyako oa ho ikemisetsa ho ts'oaroa le ho tsosa likhoka. Haeba li etsahala, o lokela ho khaotsa ho sebelisa lithethefatsi.

Phekolo ea bakuli ba nkang fluoroquinolones (ho kenyeletsoa ciprofloxacin), linyeoe tsa sensorimotor kapa sensor polyneuropathy, dysesthesia, hypesthesia, le bofokoli li tlalehiloe. Ha ho na le matšoao a kang ho chesa, bohloko, ho akheha, ho lora, ho fokola, mokuli o lokela ho khaotsa ho sebelisa moriana oo 'me a ee ngakeng.

Nakong ea ts'ebeliso ea ciprofloxacin, linyeoe tsa nts'etsopele ea boemo ba sethoathoa li tlalehiloe.

Haeba letšollo le lelelele, le matla le hlaha kamora 'kalafo kapa nakong ea kalafo, ho hlokahala hore ho kenyele tharollo ea pseudomembranous colitis, e hlokang ho khaotsa hanghang ha lithethefatsi le ho khethoa ha kalafo e lekaneng.

Nakong ea kalafo le Ciprofloxacin, linyeoe tsa bophelo bo botle ba ho se sebetse hantle ha sebete le necrosis li ile tsa hlokomeloa. Haeba u na le matšoao a lefu la sebete (ho ipolaisa tlala, moroto o lefifi, jaundice, bonolo ba ka mpeng, ho hlohlona), o lokela ho emisa ho sebelisa moriana.

Ho bakuli ba kileng ba ba le lefu la sebete 'me ba ntse ba nka ciprofloxacin, ts'ebetso ea alkaline phosphatase, li-transaminase tsa hepatic li ka eketseha ka nakoana, kapa jaundice ea cholestatic e ka hlaha. Bakuli ba nang le gravis myasthenia gravis e matla ba lokela ho fuoa kalafo ka hloko ka hloko, hobane matšoao a ka mpefala.

Nakong ea phekolo, hoa hlokahala ho qoba ho ba mahlaseling a tobileng a letsatsi, hammoho le mehloli e meng ea mahlaseli a kotsi a kotsi.

Ha ho nka Ciprofloxacin e se e ntse e le matsatsing a pele a 2 kamora ho qala kalafo, ho ne ho na le maemo a tendonitis, hammoho le ho phatloha ha tendon (hangata hangata tendon ea Achilles, ho kenyeletsoa le tse peli). Ho ruruha le ho phatloha ha tendon le hona ho tlalehiloe likhoeli tse 'maloa ka mor'a kalafo. Ho bakuli ba tsofetseng, ho bakuli ba nang le lefu la tendon ba fumanang kalafo e tšoanang le glucocorticosteroids, ho na le kotsi e eketsehileng ea tendinopathy. Tabeng ea ho khetholla matšoao a pele a tendonitis (ho ruruha, ho ruruha ho bohloko mokokotlong), ts'ebeliso ea Ciprofloxacin e tlameha ho emisoa, ha e ntse e qhela mesebetsi ea 'mele, kaha ho na le kotsi ea ho phatloha ha tendon. Setlhare sena se tlameha ho sebelisoa ka hloko bakeng sa kalafo ea bakuli ba nang le mafu a tendon a amanang le ts'ebeliso ea li-quinolones.

Tabeng ea kalafo ea ts'oaetso e matla, tšoaetso e bakoang ke baktheria ea anaerobic, le tšoaetso ea staphylococcal, ciprofloxacin e lokela ho sebelisoa hammoho le meriana e nepahetseng ea antibacterial. Bakeng sa tšoaetso e bakoang ke ho pepesetsoa ke mafu a hanyetsanang le fluoricololone ea Neisseria, datha ea lehae mabapi le ho hanyetsa ntho e sebetsang e lokela ho tsotelloa le kutloisiso ea pathogen e netefalitsoeng nakong ea liteko tsa laboratori.

Ciprofloxacin e ama keketseho ea nako ea QT. Kaha basali ba na le karohano e telele ea QT ha ba bapisoa le banna, ba tsotella lithethefatsi tse etsang hore QT e qete nako e telele e sa sebetse. Bakuli ba seng ba tsofetse ba boetse ba khetholloa ka ho eketseha ha maikutlo ho lithethefatsi tse bakang ho atolosoa ha nako ea QT. Mabapi le se boletsoeng ka holimo, hoa hlokahala ho sebelisa ciprofloxacin ka hloko maemong a latelang:

mmoho le lithethefatsi tse eketsang sekhahla sa QT (mohlala, lithethefatsi tsa antiarrhythmic tsa sehlopha sa III le IA, li-antidepressants tsa li-trickclic, li-antipsychotic le macrolides),
kalafo ea bakuli ba nang le monyetla oa ho eketseha oa maiketsetso o joalo ka pirouette kapa ho lelefatsa nako ea QT (mohlala, le matšoao a tlhaho a ho lelefatsa nako ea QT, ho se leka-lekane hoa li-electrolyte, ho kenyelletsa hypomagnesemia le hypokalemia),
le mafu a pelo ho bakuli ba nang le ho nyekeloa ke pelo, bradycardia, infraction ea myocardial).

Kamora ts'ebeliso ea pele ea ciprofloxacin, ho tlalehiloe liketsahalo tse sa tloaelehang tsa ts'usumetso ea anaphylactic, ho kenyeletsoa le ho thothomela ha anaphylactic. Sena se hloka ho felisoa ha moriana hang-hang le kalafo e loketseng.

Ka tsamaiso e kenang ea tharollo ea tharollo, maikutlo a lehae sebakeng sa ente a khoneha (bohloko, ho ruruha). Boitšoaro bona bo atile haholo haeba nako ea tšelo e ka tlase ho metsotso e 30. Kamora ho felisoa ha ts'ebetso, karabelo e feta kapele, ntle le ho ba tlolo ea taolo e tsoelang pele ea Ciprofloxacin (haeba e sa tsamaisane le thupelo e rarahaneng).

Ciprofloxacin ke inhibitor e leka-lekaneng ea CYP450 1A2 isoenzyme, ka hona, tlhokomeliso e lokela ho sebelisoa haeba e sebelisoa ka mokhoa o ts'oanang le lithethefatsi tse entsoeng ka enzyme ena (ho kenyelletsa methylxanthin, theophylline, duloxetine, caffeine, ropinirole, clozapine, olanzapine lebaka, ka lebaka la ho eketseha ha mali ka bongata karabelo e khethehileng.

Litekong tsa laboratori tsa vitro, ciprofloxacin e thibela kholo ea Mycobacterium spp. Sena se ka lebisa ho sephetho se fosahetseng sa tšoaetso ea pathogen ho bakuli ba khethiloeng ciprofloxacin.

Ka khaello ea "glucose-6-phosphate dehydrogenase", maikutlo a hemolytic a ile a bonoa ho bakuli ba fumanang moriana. Ts'ebeliso ea ciprofloxacin bakeng sa kalafo ea mokha ona e ka khoneha feela ka melemo e ka bang teng ho kotsi ea ts'ebeliso ea eona. Boemong bona, ho hlokahala ho netefatsa ho beha leihlo mokuli.

Ha u phekola bakuli ba nang le thibelo ea sodium (ho fokola ha renal, ho nyekeloa ke pelo, lefu la nephrotic), ho hlokahala hore u nahane ka khatello ea sodium chloride e fumanehang ho Ciprofloxacin.

Marotholi a mahlo ha a etsetsoa ente ea intraocular. Tabeng ea ho sebelisa litlolo tse ling tsa mahlo, nako ea ho busa ea metsotso e 5 kapa ho feta e lokela ho bonoa. Ts'ebeliso ea ciprofloxacin e lokela ho emisoa haeba ho na le matšoao a hypersensitivity. Mokuli o lokela ho tsebisoa hore maemong a marotholi, conjunctival hyperemia e ka nts'etsapele (boemong bona, o tlameha ho tlohela tšebeliso ea lithethefatsi mme o batle keletso ea ngaka). Nakong ea kalafo e nang le marotholi a Ciprofloxacin, ho khothalletsoa ho hana ho roala lilense tse bonolo tsa puisano. Tabeng ea ho sebelisa lilense tse thata tsa puisano pele ho ts'ebetso, li lokela ho tlosoa ebe li kenngoa hape feela metsotso e 20 ka mor'a ho kenya moriana.

Bokhachane le pelehi

Nakong ea kemolo, moriana o thibetsoe.

Kaha ciprofloxacin e fetela lebese la matsoele, moriana ona ha oa lokela ho sebelisoa kalafo ea bo-'mè ba anyesang. Haeba ho hlokahala, ho khethoa ha ciprofloxacin nakong ea lebone pele o qala kalafo, o lokela ho emisa ho anyesa.

Sebelisa bongoaneng

Sesebelisoa ha se lumelloe ho sebelisoa ho phekola tšoaetso ho bana ba ka tlase ho lilemo tse 18, ntle le linyeoe tse latelang:

bakeng sa kalafo ea tšoaetso e nang le cystic fibrosis - makhetlo a 3 ka letsatsi 10 mg ka 1 kg ea boima ba 'mele (lethal dose e phahameng ea lithethefatsi ke 400 mg),
bakeng sa kalafo ea anthrax ea pulmonary - makhetlo a 2 ka letsatsi 10 mg ka 1 kg ea boima ba 'mele (lethal dose e phahameng ea lithethefatsi ke 400 mg). Nako ea kalafo ea ciprofloxacin ke likhoeli tse peli.

Phekolo e lokela ho qala hang hang kamora ts'oaetso e netefalitsoeng kapa e belaelloang. Mabapi le kotsi ea ts'ebetso e senyehileng ea manonyeletso le litho tse potileng, kalafo e lokela ho etsoa ke ngaka e nang le boiphihlelo ba ho alafa mafu a khethehileng a khethehileng baneng. Setlhare se tlameha ho laeloa kamora ho lekola karolelano ea kotsi le molemo.

Ha u sebelisa ciprofloxacin ho bana, nts'etsopele ea arthropathy e ne e rekota hangata.

Ka mosebetsi o sa sebetseng oa renal

Bakuli ba nang le ts'oaetso e matla ea a reculment ba fuoe tekanyo ea halofo ea moriana.

Ha ho nooa ka molomo, litekanyetso li beiloe ka tsela e latelang:

ka tumello ea creatinine e kholo ho feta 50 ml / min, mokhoa o tloaelehileng oa litekanyetso li bonoa,
ka tumello ea creatinine ea 30-50 ml / metsotso - lihora tse ling le tse ling tse 12, 250-500 mg ka ngoe,
ka tumello ea creatinine ea 5 - 29ml / metsotso - lihora tse ling le tse ling tse 18, 250-500 mg,
bakeng sa bakuli ba ntseng ba angoa ke lefu la hemo- kapa peritoneal, kamora ts'ebetso, 250-500 mg ka mor'a lihora tse ling le tse ling tse 24.

Ka tsamaiso ea methapo, litekanyetso tsa ciprofloxacin ke tse latelang:

ka ho se sebetse hantle hantle ha renal (CC 30-60 ml / metsotso / 1.73 m 2) kapa ka mahlaseli a creatinine ka har'a plasma ea mali ka bophara ba 1.4-1.9 mg / 100 ml, lethaliti la letsatsi le letsatsi ha lea lokela ho feta 800 mg,
ka ho se sebetse hantle haholo ha renal (CC ho fihlela ho 30 ml / min / 1.73 m 2) kapa ka mahloriso a creatinine ho plasma ea mali e fetang 2 mg / 100 ml, tekanyetso ea letsatsi le letsatsi ea lithethefatsi ha ea lokela ho feta 400 mg.

Bakeng sa bakuli ba hemodialysis, le tsamaiso ea methapo, litekanyetso li tšoana. Ciprofloxacin e nang le dialysate e tsamaisoa ka mokhoa o makatsang ka bongata ba 50 mg ka ho ya ka litara e le 1 ea dialysate. Khafetsa - lihora tse ling le tse ling tse 6 ka makhetlo a 4 ka letsatsi.

Ho sebelisana le lithethefatsi

Ts'ebeliso e ts'oanang ea ciprofloxacin le phenytoin li ka lebisa ho fokotseha kapa keketseho ea khatello ea khatello ea mali ka mpeng ea mali, ka hona ho khothalletsoa ho beha leihlo tlhokomelo ea litlhare tse tsamaellanang. Ka lebaka la ho fokotseha hoa ts'ebetso ea li-microsomal oxidation process ho hepatocytes, lithethefatsi li lelefatsa bophelo ba halofo mme li eketsa khatello ea theophylline le li-xanthine tse ling (ho kenyeletsa le caffeine).

Boithuto bo kenyeletsang baithaopi ba phetseng hantle bo bonts'itse hore ts'ebeliso e le 'ngoe ea lithethefatsi tse nang le lidocoin le Ciprofloxacin ka 22% e fokotsa ho hlakoloa ha lidocaine ha e fanoa kahare. Le ha lidocaine e mamelletsoe hantle, tsamaiso ea kopanelo le ciprofloxacin e ka eketsa litlamorao.

Sebakeng sa ts'ebeliso e tšoanang ea ciprofloxacin ka lithethefatsi tsa molomo tsa hypoglycemic (hangata litokisetso tsa sulfonylurea, mohlala, glimepiride, glibenclamide), phello ea morao e ka ntlafatsoa.

Ts'ebetso e ts'oanang ea intravenous ea ciprofloxacin le anticoagulants e sa tobang e eketsa nako ea prothrombin.

Ts'ebeliso e ts'oanang ea ciprofloxacin e nang le antagonists ea vithamine K (mohlala, acenocoumarol, warfarin, fluindone, fenprocoumone) e ka ntlafatsa phello ea bona ea anticoagulant. Botebo ba phello ena bo angoa ke ts'oaetso e atamelaneng, maemo a akaretsang le lilemo tsa mokuli, ka hona ho thata ho lekola tšusumetso ea lithethefatsi mabapi le ho eketseha ha INR. Ho khothalletsoa hore tlhahlobo ea INR e atisang ho etsoa hangata maemong a tšebeliso e kopaneng ea lihanyetsi tsa vithamine K le Ciprofloxacin, le bakeng sa nakoana kamora ho fela ha phekolo ea ho kopanya.

Ha e kopantsoe le lithibela-mafu tse ling (aminoglycosides, metronidazole, clindamycin, lithibela-mafu tsa beta-lactam), hangata synergism e bonoa. Ciprofloxacin e ka sebelisoa ka katleho hammoho le ceftazidime le azlocillin ho phekola tšoaetso e bakoang ke Pseudomonas spp. Ha e kopantsoe le lithibela-mafu tsa beta-lactam (mohlala, azlocillin le meslocillin), setlhare se ka sebelisoa bakeng sa ts'oaetso ea lefutso la streptococcal. Hammoho le vancomycin le isoxazolylpenicillins, Photrofloxacin e sebelisoa bakeng sa tšoaetso ea staph. Setlama hammoho le clindamycin le metronidazole li sebetsa hantle ho tšoaetso ea anaerobic.

Ha u sebelisa ciprofloxacin e nang le cyclosporine, phello ea nephrotoxic ea morao e matlafatsoa, mme ho eketseha ha khatello ea serum creatinine. Ha u phekola bakuli ba joalo makhetlo a 2 ka beke, ho hlokahala hore ho hlahlojoe ts'ebetso ea renal.

Ka ts'ebeliso e kopaneng ea ciprofloxacin le lithethefatsi tse seng khahlanong le ts'oaetso tsa motsoako (ntle le asiti ea acetylsalicylic), menyetla ea ho tsitsa e eketseha. Ts'ebeliso e tšoanang ea lithethefatsi tsa uricosuric le ciprofloxacin e liehisa ho chesa (ho fihla ho 50%) mme e eketsa khatello ea plasma ea morao.

Ciprofloxacin e eketseha ka makhetlo a 7 palo e kaholimo ea palo ea li-tizanidine (Cmax) maling (phapang e fapaneng ea letšoao lena ke makhetlo a 421) mme e eketseha ka makhetlo a 10 sebakeng se tlas'a khatello ea nako ea pharmacokinetic curve (makhetlo a 6 - 24), e eketsang kotsi ea ho otsela le ho theola khatello ea mali. Ka hona, tšebeliso e tšoanang ea lithethefatsi tse nang le zizanidin le ciprofloxacin li kopantsoe.

Tharollo ea infusion ea lithethefatsi ha e lumellane le lithethefatsi le tharollo ea infusion, e sa tsitsang 'meleng le lik'hemikhaleng tikolohong e nang le asiti (pH ea Ciprofloxacin tharollo ea infusion ke 3.9-4.5). Ho thibetsoe ho kopanya tharollo ea iv le tharollo le pH e kaholimo ho 7. Ha u sebelisa ciprofloxacin le lithethefatsi tse eketsang nako ea QT (li-antidepressants tsa tricyclic, lithethefatsi tsa antipsychotic, litla-morao tsa antiarrhythmic tsa lihlopha tsa III kapa IA, macrolides), ho hlokahala tlhokomeliso.

Ts'ebeliso e tšoanang ea phenenecid le ciprofloxacin e lebisa keketseho ea khatello ea mali le mali ka bongata, hobane sekhahla sa liphio se fokotseha.

Ka tšebeliso ea nako e tšoanang ea omeprazole le ciprofloxacin, khatello e phahameng ea lithethefatsi ho plasma e kanna ea fokotseha hanyane, mme sebaka se katlasehong ea "mahloriso - nako" le sona sea fokotseha.

Ts'ebeliso e ts'oanang ea ciprofloxacin le methotrexate e ka liehisa metabolism ea renal ea morao, e tsamaeang le keketseho ea khatello ea eona plasma ea mali le kotsi e eketsehileng ea litlamorao tsa methotrexate. Ha ho khothalletsoe ho sebelisa ciprofloxacin le methotrexate ka nako e le 'ngoe.

Ka tšebeliso e tšoanang ea li-inhibitors tse nang le matla tsa CYP450 1A2 isoenzyme (mohlala, fluvoxamine) le duloxetine, keketseho ea Cmax le AUC ea duloxetine e ka bonoa. Leha ho na le tlhaiso-leseling mabapi le tšebelisano e ka etsahalang le duloxetine e nang le profrofloxacin, ts'ebelisano e tšoanang e ka etsahala haholo haeba li sebelisoa ka nako e le ngoe.

Ts'ebeliso e ts'oanang ea ciprofloxacin le ropinirole e lebisa keketseho ea AUC le Cmax ea ho qetela ka 84 le 60%, ka ho latellana. Ho khothalletsoa ho beha leihlo litlamorao tsa ropinirole ha e sebelisoa hammoho le ciprofloxacin, hape le bakeng sa nakoana kamora ho fela ha phekolo ea ho kopanya.

Ts'ebeliso e ts'oanang ea ciprofloxacin (250 mg bakeng sa matsatsi a 7) le clozapine e baka kotsi ea kholo ea likhahla tsa serum tsa morao-rao le N-desmethylclozapine ka 29 le 31%, ka ho latellana. Hoa hlokahala ho lokisa mofuta oa mofuta oa clozapine ha o sebelisoa hammoho le ciprofloxacin, hammoho le nakoana kamora ho fela ha phekolo ea ho kopanya.

Tšebeliso e le 'ngoe ea ciprofloxacin (500 mg) le sildenafil (50 mg) e ka lebisa keketseho e habeli ea AUC le Cmax ea ho qetela. Morero oa motsoako ona o etsoa feela ka mor'a ho hlahloba kamano pakeng tsa melemo e ka bang teng le likotsi tse ka bang teng.

Analogues tsa Ciprofloxacin ke Vero Ciprofloxacin, Basij, Betatsiprol, Kvintor, Infitsipro, Nirtsil, Oftotsipro, Tseprova, Rotsip, Protsipro, Tsiprobid, Tsiprobay, Tsiproksil, Tsiprodoks, Tsiprolet, Tsiprolaker, Tsipromed, Tsiprolon, Tsiprofloksabol, Tsiprolan, Tsifroksinal, Ekotsifol, Tsifratsid , Digital.

Lipehelo le maemo a polokelo

Bophelo ba lishelefo tsa lithethefatsi matlapeng ke lilemo tse 3.

Matlapa a lokela ho bolokoa sebakeng se ommeng le se lefifi moo bana ba sa khoneng ho se fihlela ka mocheso ho isa ho 30 ° C.

Bophelo ba sehatsetsing ba ho tsepamisa maikutlo ke lilemo tse peli.

Ho tsepamisa mohopolo ho tlameha ho bolokoa sebakeng se lefifi se sa fumaneheng ho bana ka lithemparetjha ho fihla ho 25 ° C. Se ke oa chesa.

Bophelo ba sethala sa tharollo ke lilemo tse 3.

Tharollo e lokela ho bolokoa e sa fihlelloe ke bana ka lithemparetjha ho fihla ho 25 ° C. Se ke oa chesa.

Polelo ea marotholi a tsebe le mahlo ke lilemo tse 3.

Setlhare se ka sebelisoa nakong ea libeke tse 4 kamora ho bula botlolo.

Theko ea ciprofloxacin libakeng tsa meriana

Theko ea Ciprofloxacin 250 mg (litafole tse 10 ka pakete) e ka ba li-ruble tse 20.

Theko ea Ciprofloxacin 500 mg (litafole tse 10 ka pakete) ke li-ruble tse ka bang 40.

Theko ea ciprofloxacin ka mokhoa oa tharollo ea infusion (100 ml) e ka ba li-ruble tse 35.

Theko ea ciprofloxacin ka mokhoa oa marotholi a mahlo (5 ml) ke li-ruble tse ka bang 25.

Tlhahlobo ho Ciprofloxacin

Litlhahlobo mabapi le ciprofloxacin ka mokhoa oa litafole li likhang haholo: basebelisi ba bang ba bitsa lithethefatsi hore li sebetsa hantle, ba bang ha ba bone ntlha ts'ebeliso ea lona. Boholo ba litlhahlobo bo bua ka litla-morao.

Tlhahlobo ea marotholi a mahlo e nepahetse.

Ho ea ka lingaka, ciprofloxacin e na le melemo e latelang:

mamello e ntle
Monyetla oa ho sebelisa tikoloho ea sepetlele bakeng sa kalafo ea antibacterial e matla ea tšoaetso e matla, hammoho le kalafo ea mafu a fumanoeng ke sechaba le a sepetlele a hoo e ka bang lefelong lefe kapa lefe,
ts'ebetso e phahameng ea bactericidal le antimicrobial,
Nako e telele-bophelo le litlamorao tsa lithibela-mafu (li u lumella ho nka moriana makhetlo a mabeli feela ka letsatsi).

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Tšebeliso ea sehlahisoa ciprofloxacin

Ts'oaetso e sa rarahanang le e rarahaneng e bakoang ke likokoana-hloko tse utluoang ke ciprofloxacin.

Tšoaetso ea phepelo ea phefumoloho, ho kenyelletsa a hlobaetsang le a sa foleng (mokhatlong o matla) bronchitis, bronchiectasis, mathata a tšoaetsanoang a cystic fibrosis, pneumonia e bakoang ke Klebsiella spp., Enterobacter spp., Proteus spp., Esherichia coli. Pseudomonas aeruginosa, Haemophilus spp., Moraxella catarrhalis, Legionella spp. le staphylococci, ts'oaetso ea litho tsa ENT, ho kenyeletsoa tsebe e bohareng (otitis media), paranasal sinuses (sinusitis, ho kenyelletsa le a hlobaetsang le), haholoholo e hlahisoang ke likokoana-hloko tse mpe tsa gram Pseudomonas aeruginosa kapa staphylococci, ts'oaetso ea genitourinary system (ho kenyelletsa cystitis, pyelonephritis, adnexitis, bactericitis e sa foleng ea mokokotlo, orchitis, epididymitis, gonorrhea e sa rarahanang, tšoaetso ea methapo ea mpa (hammoho le metronidazole), ho kenyelletsa peritonitis, gallbladder le tšoaetso ea phepelo ea methapo ea letlalo, tšoaetso ea letlalo le bonolo ea lithane (maqeba a nang le tšoaetso, maqeba, ho chesa, abscesses, phlegmon), lesapo le tšoaetsanoang (osteomyelitis, ramatiki septic), sepsis, typhoid fever, campylobacteriosis, shigellosis, lefu la lets'ollo, tšoaetso kapa prophylaxis ea ts'oaetso ho bakuli ba immunocompromised (bakuli ba nkang lithethefatsi tsa immunosuppressive kapa bakuli ba nang le neutropenia), mokokotlo oa mokokotlo oa mokokotlo ho bakuli ba immunocompromised, thibelo le kalafo ea anthrax ea pulmonary. liso tsa ka maleng rskoy (tshwaetso Bacillus anthracis), thibelo ea tšoaetso e hlaselang e bakoang ke Neisseria meningitidis.

Phekolo ea mathata a bakoang ke Pseudomonas aeruginosa, ho bana ho tloha ho lilemo tse 5 ho isa ho 17 le pulmonary cystic fibrosis, thibelo le kalafo ea anthrax ea pulmonary Bacillus anthracis).

Ka lebaka la liketsahalo tse bohloko tse tsoang manonyeletsong le / kapa lisele tse potileng (bona "Litla-morao"), ngaka e lokela ho qala kalafo ka boiphihlelo ba ho alafa tšoaetso e matla ho bana le lilemong tsa bocha le kamora tlhahlobo e hlokolosi ea sekhahla sa kotsi.

Bakeng sa ts'ebeliso ea ophthalmic. Phekolo ea liso tsa ka mpeng le ts'oaetso ea karolo e ka ntle ea leihlo la mahlo le litlatsetso tsa eona tse bakoang ke baktheria e amehang haholo ho ciprofloxacin ho batho ba baholo, masea a sa tsoa hlaha (ho tloha matsatsing a 0 ho isa ho a 27), masea le masea (ho tloha matsatsing a 28 ho isa ho a 23). dilemo) le bacha (ba lilemo tse 12 ho isa ho 18).

Lithibelo tsa kopo

Metsi a tebileng a methapo ea mokokotlo ea mokokotlo, kotsi ea mokokotlo, kotsi e eketsehileng ea ho lelefatsa nako ea QT kapa nts'etsopele ea mofuta oa pirouette mofuta arrhythmias (mohlala, nako ea nako ea karolelano ea karohano ea QT, lefu la pelo (ho nyekeloa ke pelo, inflation ea myocardial, bradycardia), ho se leka-lekane ha methapo ea methapo, ho ba le bothata ba methapo ea methapo, hyprollteia ), khaello ea glucose-6-phosphate dehydrogenase, ts'ebeliso e tšoanang ea lithethefatsi tse eketsang nako ea QT (ho kenyeletsa le lithethefatsi tse tlatselletsang tsa sehlopha sa IA le III, li-antidepressants tsa li-macrode, li-macrolides, methapo oleptics), ts'ebeliso e le 'ngoe le li-inhibitors tsa CYP1A 2 isoenzyme, ho kenyelletsa methylxanthines, ho kenyelletsa theophylline, caffeine, duloxetine, clozapine, ropinirole, olanzapine (bona "Precautions"), bakuli ba nang le nalane ea tšenyo ea tendon e amanang le ka ts'ebeliso ea li-quinolones, bokuli ba kelello (khatello ea maikutlo, psychosis), lefu la methapo ea methapo (lefu la sethoathoa, le fokotse ho tsubella (kapa nalane ea ho ts'oaroa), ts'ebetso ea ts'ebetso ea ts'ebetso ea mokokotlo kapa lefu la stroke gravisho ruruha ho matla le / kapa ho hloleha ha sebete, botsofe.

Tšebelisano

Lithethefatsi tse bakang ho lelefatsa nako ea QT. Ho lokela ho ba hlokolosi ha u sebelisa ciprofloxacin, joalo ka fluoroquinolones e 'ngoe ho bakuli ba fumanang lithethefatsi tse bakang nako ea ho lieha ha QT (mohlala, li-IA kapa lithethefatsi tsa antiarrhythmic tsa li-antiarrhcyic, li-macrolides, li-antipsychotic) (bona "Precautions").

Theophylline. Ts'ebeliso e tšoanang ea ciprofloxacin le lithethefatsi tse theophylline li ka baka keketseho e sa rateheng ea khatello ea theophylline le plasma ea mali, ka hona, ponahalo ea liketsahalo tse bohloko tsa theophylline, maemong a sa tloaelehang haholo, litla-morao tsena li ka beha bophelo bo botle ho mokuli. Haeba tšebeliso ea nako e tšoanang ea ciprofloxacin le lithethefatsi tse theophylline li ka se qojoe, ho kgothaletsoa ho beha leihlo nako le nako phapusing ea mali mme ha ho hlokahala, fokotsa tekanyetso ea theophylline.

Lintho tse ling tse tsoang ho xanthine. Ts'ebeliso e ts'oanang ea ciprofloxacin le caffeine kapa pentoxifylline (oxp unkillin) e ka lebisa ho eketseha ha khatello ea likhakanyo tsa xanthine tse tsoang serum.

Phenytoin. Ka tšebeliso e tšoanang ea ciprofloxacin le phenytoin, phetoho (ho eketsa kapa ho fokotseha) hoa litaba tsa phenytoin maling a mali e ile ea bonoa. Bakeng sa ho qoba lits'isinyeho tse amanang le ho fokotseha hoa khatello ea phenytoin, hammoho le ho thibela liketsahalo tse bohloko tse amanang le phenytoin overdose ha ciprofloxacin e felisoa, ho khothalletsoa ho lekola kalafo ea phenytoin ho bakuli ba nkang ciprofloxacin, ho kenyelletsa boikemisetso ba dikahare tsa phenytoin ho plasma ea mali nakong eohle. Tšebeliso e tšoanang le nako e khuts'oane ka mor'a ho qeta kalafo ea ho kopanya.

NSAIDs. Ho kopana ha litekanyetso tse phahameng tsa quinolones (DNA gyrase inhibitors) le NSAIDs tse ling (ntle le acetylsalicylic acid) ho ka baka ts'abo.

Cyclosporin. Ka tšebeliso e tšoanang ea ciprofloxacin le lithethefatsi tse nang le cyclosporine, keketseho ea nakoana ea nakoana ea khatello ea plasma creatinine e ile ea bonoa. Maemong a joalo, ho hlokahala ho tseba hore na motsoako oa creatinine o maling maling makhetlo a mabeli ka beke.

Litho tsa molomo tsa hypoglycemic le insulin. Ka ts'ebeliso e ts'oanang ea koprofloxacin le li-agents tsa hypoglycemic tsa molomo, haholo-holo sulfonylureas (mohlala, glibenclamide, glimepiride), kapa insulin, nts'etsopele ea hypoglycemia e ka bakoa ke keketseho ea ketso ea li-agents tsa hypoglycemic (bona "Litlamorao"). Ho hlahlojoa ka hloko ea boemo ba tsoekere ea mali hoa hlokahala.

Propenecid. Probenecid e liehisa sekhahla sa excretion ea ciprofloxacin ke liphio. Ts'ebeliso e tšoanang ea ciprofloxacin le lithethefatsi tse nang le probenecid li lebisa ho eketseha ha khatello ea ciprofloxacin e serum ea mali.

Methotrexate Ka tšebeliso e tšoanang ea methotrexate le ciprofloxacin, tsamaiso ea methapo ea methapo ea methapo ea methapo e ka theoha butle, e ka tsamaeang le keketseho ea khatello ea methotrexate maling a mali. Maemong ana, menyetla ea ho hlaha litlamorao tsa methotrexate e ka eketseha. Tabeng ena, bakuli ba fumanang methotrexate le ciprofloxacin ba lokela ho betoa leihlo.

Tizanidine. Ka lebaka la tlhahlobo ea bongaka e kenyelletsang baithaopi ba phetseng hantle ka tšebeliso e tšoanang ea ciprofloxacin le lithethefatsi tse nang le zivanidine, ho ile ha senoloa keketseho ea khakanyo ea tizanidine maling a mali_max Makhetlo a 7 (ho tloha makhetlo a 4 ho isa ho a 21) le AUC - makhetlo a 10 (ho tloha makhetlo a 6 ho isa ho a 24). Ka keketseho ea khoholeho ea tizanidine ho serum, hypotensive (ho theola khatello ea mali) le litlamorao (ho otsela, lethargy) litla-morao li amana. Ts'ebeliso e tšoanang ea ciprofloxacin le lithethefatsi tse nang le tizanidine li kopantsoe.

Omeprazole Ka tšebeliso e kopaneng ea ciprofloxacin le lithethefatsi tse nang le omeprazole, ho ka bonoa ho fokotseha hanyane ho C_max ciprofloxacin ho plasma le ho fokotseha ha AUC.

Duloxetine Litekong tsa bongaka, ho ile ha bontšoa hore tšebeliso ea nako e tšoanang ea duloxetine le potent inhibitors ea CYP1A 2 isoenzyme (joalo ka fluvoxamine) e ka lebisa keketseho ea AUC le C_max duloxetine. Leha ho na le tlhaiso-leseling ea kliniki mabapi le tšebelisano e ka bang teng le ciprofloxacin, hoa khoneha ho bolela monyetla oa ts'ebelisano e joalo le ts'ebeliso e tšoanang ea koprofloxacin le duloxetine.

Ropinirol. Tšebeliso e le 'ngoe ea ropinirole le ciprofloxacin, inhibitor e leka-lekaneng ea eyeenzyme CYP1A 2, e lebisa keketseho ea C_max le ropinirole AUC ka 60 le 84%, ka ho latellana. Litla-morao tsa ropinirole li lokela ho beoa leihlo ha li sebelisoa hammoho le ciprofloxacin le bakeng sa nakoana kamora ho qeta kalafo ea ho kopanya.

Lidocaine. Phuputsong e amang baithaopi ba phetseng hantle, ho ile ha fumaneha hore tšebeliso e le 'ngoe ea lithethefatsi tse nang le lidocaine le ciprofloxacin, inhibitor e leka-lekaneng ea isoenzyme CYP1A 2, e lebisa ho fokotseha ha hlakolo ea lidocaine ka 22% ka tsamaiso ea iv. Leha ho na le mamello e ntle ea lidocaine, le ts'ebeliso e ts'oanang le ciprofloxacin, litla-morao ka lebaka la tšebelisano li ka matlafatsoa.

Clozapine. Ka ts'ebeliso e ts'oanang ea clozapine le ciprofloxacin ka tekanyetso ea 250 mg bakeng sa matsatsi a 7, keketseho ea serum e tsepamisitsoeng haholo ea clozapine le N-desmethylclozapine e ile ea bonoa ke 29 le 31%, ka ho latellana. Boemo ba mokuli bo lokela ho beoa leihlo mme, haeba ho hlokahala, e lokise mofuta oa dosing ea clozapine nakong ea ts'ebeliso ea eona e kopaneng le ciprofloxacin le ka nako e khutšoane kamora ho qeta kalafo ea ho kopanya.

Sildenafil. Ka tšebeliso ea ciprofloxacin ka tekanyo ea 500 mg le sildenafil ka tekanyo ea 50 mg ho baithaopi ba phetseng hantle, keketseho ea C e ile ea bonoa._max le AUC ea sildenafil makhetlo a 2. Mabapi le sena, ts'ebeliso ea motsoako ona e ka etsahala feela kamora ho hlahloba sekhahla sa phaello / kotsi.

Li-antagonists tsa Vitamin K Ts'ebeliso e kopaneng ea aphrofloxacin le li-antagonists tsa Vitamin K (mohlala, warfarin, acenocumarol, fenprocoumon, fluindione) li ka lebisa ho eketseha ha phello ea bona ea anticoagulant. Boholo ba phello ena bo ka fapana ho latela tšoaetso e tšoanang, lilemo le boemo ba mokuli ka kakaretso, kahoo ho thata ho lekola phello ea ciprofloxacin mabapi le keketseho ea INR. Hangata ho lekane ho laola INR ka tšebeliso e kopaneng ea li-antagonists tsa Vitrofloxacin le vithamine K, hammoho le bakeng sa nakoana kamora ho qeta kalafo ea ho kopanya.

Lithethefatsi tsa cationic. Tsamaiso ea molomo e tšoanang ea koprofloxacin le lithethefatsi tsa cationic - litlatsetso tsa liminerale, magnesium, aluminium, tšepe, sucralfate, antacids, polymeric phosphate compress (mohlala, sevelamer, lanthanum carbonate) le lithethefatsi tse nang le bokhoni bo boholo ba buffer (mohlala didanosine) tse nang le magnesium, aluminium kapa aluminium kapa aluminium kapa aluminium kapa aluminium kapa aluminium kapa aluminium kapa aluminium. calcium - e fokotsa ho kenngoa ha ciprofloxacin. Maemong a joalo, ciprofloxation e lokela ho nkuoa pele ho lihora tse 1-2 pele kapa lihora tse 4 kamora ho sebelisa lithethefatsi tse joalo.

Lihlahisoa tsa ho ja le tsa lebese. Ts'ebetso ea molomo e kopanang ea koprofloxacin le lihlahisoa tsa lebese kapa lino tse matlafatsoang ka liminerale (mohlala lebese, yoghur, likhalase tse nang le calcium) li lokela ho qojoa, kaha ho koaloa ha ciprofloxacin ho ka fokotsoa. K'halsiamo e fumanehang ka har'a lijo tse tloaelehileng ha e ame hantle ho kenngoa ha ciprofloxacin.

Lithuto tse khethehileng tsa tšebelisano e sebelisang mekhoa ea ophthalmic ea ciprofloxacin ha li e-so tšoaroe. Ho nka karolelano e tlase ea ciprofloxacin ka plasma ea mali ka mor'a ho kenngoa kahare ho pelo e kopaneng, tšebelisano pakeng tsa lithethefatsi tse sebelisoang hammoho le ciprofloxacin ha e na monyetla. Tabeng ea tšebeliso e kopaneng le litokisetso tse ling tsa lehae tsa maiketsetso, nako e pakeng tsa ts'ebeliso ea bona e lokela ho ba bonyane metsotso e 5, ha litlolo tsa mahlo li lokela ho sebelisoa la ho qetela.

Litšireletso

Tšoaetso e matla, tšoaetso ea staphylococcal le tšoaetso e bakoang ke libaktheria tse ntle tsa gram le anaerobic. Ha ho phekoloa tšoaetso e matla, tšoaetso ea staph le tšoaetso e bakoang ke baktheria ea anaerobic, ciprofloxacin e lokela ho sebelisoa hammoho le li-antibacterial agents.

Tšoaetso ka lebaka la Streptococcus pneumoniae. Ciprofloxacin ha e khothalletsoe kalafo ea tšoaetso e bakoang ke Streptococcus pneumoniae, ka lebaka la ts'ebetso ea eona e fokolang khahlanong le pathogen ena.

Tšoaetso ea pampitšana ea genital. Bakeng sa tšoaetso ea setho sa botšehali ho bakoa ke mathata Neisseria gonorrhoeaee hanyetsanang le fluoroquinolones, tlhahisoleseling mabapi le ho hanyetsa sebakeng seo ciprofloxacin e lokela ho tsotelloa mme kutloisiso ea pathogen e lokela ho netefatsoa ka liteko tsa laboratori.

Tlokotsi ea pelo. Ciprofloxacin e ama ho atolosoa ha nako ea QT (bona "Litlamorao"). Ha ho nahanoa hore basali ba na le nako e telele ea nako ea QT ha ba bapisoa le banna, ba ameha haholo ho lithethefatsi tse etsang hore nako ea QT e be telele. Ho bakuli ba tsofetseng, ho na le maikutlo a eketsehileng a ketso ea lithethefatsi, a baka ho eketsoa ha nako ea QT. Ka hona, ciprofloxacin e lokela ho sebelisoa ka hloko ho kopants'oa le lithethefatsi tse eketsang nako ea QT (mohlala, lithethefatsi tsa sehlopha sa IA le III, li-antidepressants tsa tricyclic, li-macrolides le lithethefatsi tsa antipsychotic) (bona "Ho kenella"), kapa ho bakuli ba nang le kotsi e kholo ea ho lelefatsa nako ea QT kapa ho hola. pirouette mofuta arrhythmias (mohlala, qobello ea nako e telele ea QT, ho se leka-lekane ha electrolyte, joalo ka hypokalemia kapa hypomagnesemia, le mafu a pelo a kang ho hloleha ha pelo, inf myocardial artery, bradycardia).

Sebelisa ho bana. Ho fumanoe hore ciprofloxacin, joalo ka lithethefatsi tse ling tsa sehlopha sena, e baka arthropathy ea manonyeletso a maholo liphoofolong.

Tlhahlobo ea tlhaiso-leseling ea polokeho ea tšebeliso ea ciprofloxacin ho bana ba ka tlase ho lilemo tse 18, eo boholo ba eona e nang le cystic fibrosis, ha ea ka ea theha kamano pakeng tsa ho senyeha ha lefufuru kapa manonyeletso a ciprofloxacin. Ha ho kgothaletswe ho sebelisa ciprofloxacin ho bana ba lilemo tse 5 ho isa ho 17 bakeng sa kalafo ea mafu a mang, ntle le mathata a cystic fibrosis a amanang le Pseudomonas aeruginosa, hammoho le kalafo le thibelo ea anthrax ea pulmonary (kamora tšoaetso e belaelloang kapa e netefalitsoeng Bacillus anthracis).

Hypersensitivity. Ka linako tse ling ka mor'a ho nka tekanyetso ea pele ea ciprofloxacin, hypersensitivity e ka hlaha, ho kenyelletsa litla-morao, tse lokelang ho tlaleheloa ho ngaka e eang (bona "Litla-morao"). Maemong a sa tloaelehang, kamora ts'ebeliso ea pele, ho se tsitsinyehe ha anaphylactic ho ka ba le ho makala ha anaphylactic. Maemong ana, ts'ebeliso ea ciprofloxacin e lokela ho emisoa hanghang mme kalafo e nepahetseng e lokela ho etsoa.

Phekolo ea ka mpeng. Haeba letšollo le matla le le lelelele le ba teng nakong ea kapa ka mor'a kalafo ka ciprofloxacin, ts'oaetso ea pseudomembranous colitis e lokela ho qheleloa ka thoko, e hlokang ho tlosoa ka potlako ea profrofloxacin le ho ts'oaroa ha kalafo e nepahetseng (molomo oa vancomycin ka tekanyetso ea makhetlo a 250 mg ka makhetlo a 4 ka letsatsi) (bona "Litlamorao").

Ts'ebeliso ea lithethefatsi tse hatellang motility ea mala e patiloe.

Mokhoa oa Hepatobiliary. Ka tšebeliso ea ciprofloxacin, ho bile le maemo a ho fokola ha sebete le ho fokola ha sebete. Haeba ho na le matšoao a lefu la sebete, a joalo ka anorexia, jaundice, moroto o lefifi, ho hlohlona, bohloko bo ka mpeng, ciprofloxacin e lokela ho emisoa (bona "litlamorao").

Ho bakuli ba nkang ciprofloxacin le ba nang le lefu la sebete, ho ka bonoa keketseho ea nakoana ea tšebetso ea hepatic transaminases, alkaline phosphatase, kapa choleundatic choleundatic (bona "Litlamorao").

Sistimi ea musculoskeletal. Bakuli ba boima myasthenia gravis ciprofloxacin e lokela ho sebelisoa ka hloko, joalo ka ho mpefala ha matšoao hoa khoneha.

Ha o nka ciprofloxacin, ho kanna ha ba le maemo a ho ruruha ha tendonitis le tendon (haholo Achilles), ka linako tse ling tse peli, kamora lihora tse 48 tsa pele kamora ho qala kalafo. Tendon ho ruruha le ho phatloha ho ka hlaha esita le likhoeli tse 'maloa ka mor'a hore ciprofloxacin e khaotsoe. Ho bakuli ba tsofetseng le bakuli ba nang le mafu a tendon ba fumanang kalafo ka nako e le 'ngoe, ho na le kotsi e eketsehileng ea tendinopathy.

Ho matšoao a pele a tendonitis (ho ruruha ho bohloko ha manonyeletso, ho ruruha), ts'ebeliso ea ciprofloxacin e lokela ho emisoa, ts'ebetso ea 'mele e lokela ho laoloa, hobane, ho na le kotsi ea ho phatloha ha tendon, mme o bone ngaka. Ciprofloxacin e lokela ho sebelisoa ka hloko ho bakuli ba nang le nalane ea mafu a tendon a amanang le ts'ebeliso ea li-quinolones.

Tsamaiso ea methapo. Ciprofloxacin, joalo ka fluoroquinolones tse ling, e ka baka tsitsipano mme ea fokotsa monyako oa ho ikemisetsa ho ts'oaroa. Ho bakuli ba nang le lefu la sethoathoa le ba tšoaroang ke mafu a methapo ea methapo (mohlala, ho fokotseha ha monyako oa ho ts'oaroa, nalane ea ho ts'oaroa, likotsi tsa lets'ollo, ho senyeha hoa mokokotlo, kapa stroke), ka lebaka la kotsi ea karabelo e mpe ea CNS, ciprofloxacin e lokela ho sebelisoa feela ha ho lebeletsoe litlamorao tsa kliniki li feta kotsi e ka bang teng ea litlamorao.

Ha u sebelisa ciprofloxacin, ho tlalehiloe linyeoe tsa ntlafatso ea boemo ba setho (bona "Litlamorao"). Haeba ho tsitsipana ho hlaha, ts'ebeliso ea ciprofloxacin e lokela ho emisoa. Boitšoaro ba kelello bo ka hlaha le kamora ts'ebeliso ea pele ea fluoroquinolones, ho kenyelletsa ciprofloxacin. Maemong a sa tloaelehang, khatello ea maikutlo kapa maikutlo a kelello a ka tsoela pele menahanong ea ho ipolaea le boits'oaro bo kotsi, joalo ka liteko tsa ho ipolaea, incl. boitlamo (bona "Litlamorao"). Haeba mokuli a e-ba le e 'ngoe ea liphetoho tsena, o lokela ho khaotsa ho nka ciprofloxacin mme o tsebise ngaka ea hau.

Bakuli ba nkang fluoroquinolones, ho kenyeletsa ciprofloxacin, ba tlalehile linyeoe tsa sensory kapa sensorimotor polyneuropathy, hypesthesia, dysesthesia kapa bofokoli. Haeba matšoao a kang ho opa, ho chesa, ho tsikinyeha, ho ba le bofokoli, ho fokola, bakuli ba lokela ho tsebisa ngaka ea bona pele ba tsoela pele ka ciprofloxacin.

Letlalo. Ha u nka ciprofloxacin, karabelo ea photosensitization e ka hlaha, ka hona bakuli ba lokela ho qoba ho kopana le khanya ea letsatsi le khanya ea UV. Phekolo e lokela ho emisoa haeba ho bonoa matšoao a ho fopola mahlo (mohlala, phetoho letlalong le tšoana le ho chesoa ke letsatsi) (bona "Litlamorao").

Cytochrome P450. Hoa tsebahala hore ciprofloxacin ke inhibitor e leka-lekaneng ea isoenzyme CYP1A 2. Ho lokela hore ho sebelisoe tlhokomeliso ha u ntse u sebelisa ciprofloxacin le lithethefatsi tse thehiloeng ke isoenzyme ena. methylxanthine, ho kenyelletsa theophylline le caffeine, duloxetine, ropinirole, clozapine, olanzapine, joalo ka keketseho ea bongata ba lithethefatsi tsena serumeng ea mali, ka lebaka la thibelo ea metabolism ea tsona ka ciprofloxacin, e ka baka karabelo e khethehileng.

Boitšoaro ba lehae. Ka ho qala / ha ho qala ciprofloxacin, ts'oaetso ea ts'oaetso ea lehae e ka hlaha sebakeng sa ente (edema, bohloko). Karabelo ena e atile haholo haeba nako ea infusion e le metsotso e 30 kapa ka tlase ho moo. Karabelo e potlakela ho feta kamora ho felisoa ha ts'usumetso mme ha se bosholu bakeng sa tsamaiso e latelang, ntle le haeba tsela ea eona e rarahane.

E le ho qoba nts'etsopele ea "crystalluria" Ka tsamaiso e ts'oanang ea iv ea koprofloxacin le anesthetics ka kakaretso ho tsoa sehlopheng sa li-barbituric acid tse tsoang, ho lula ho lekola sekhahla sa pelo, khatello ea mali, ECG e hlokahala. In vitro ciprofloxacin e ka kena-kenana le tlhahlobo ea baktheria Lefuba la Mycobacterium, e hatella kholo ea eona, e ka lebisang liphellong tse mpe tse fosahetseng ho fumanoeng ha pathogen ena ho bakuli ba nkang ciprofloxacin.

Tšebeliso ea nako e telele le e pheta-phetoang ea profrofloxacin e ka lebisa ho superinitness ka libaktheria tse loantšang kapa likokoana-hloko tsa tšoaetso ea fungal.

Tšusumetso ho bokhoni ba ho khanna makoloi le mekhoa. Nakong ea kalafo, ho tlameha ho ba hlokolosi ha u khanna makoloi le mekhoa, hammoho le ha u etsa lintho tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea psychomotor. Ka nts'etsopele ea karabelo e sa rateheng ho tsoa ho tsamaiso ea methapo (mohlala, ho tsekela, ho tsitsipana), motho o lokela ho hana ho khanna le ho etsa lintho tse ling tse hlokang ho tsepamisa maikutlo le ho potlaka haholo ha karabelo ea psychomotor.

Boiphihlelo ba kliniki le ciprofloxacin ho bana ba ka tlase ho selemo se le seng bo lekanyelitsoe. Ts'ebeliso ea ciprofloxacin ho ophthalmia ea masea a sa tsoa tsoaloa ka gonococcal kapa chlamydial etiology ha e khothalletsoe ka lebaka la tlhaiso ea tlhaiso-leseling mabapi le ts'ebeliso ea sehlopha sena sa bakuli. Bakuli ba nang le neonatal ophthalmia ba lokela ho fumana kalafo e loketseng ea etiotropic.

Ka ts'ebeliso ea ophthalmic ea ciprofloxacin, monyetla oa phallo ea rhinopharyngeal o lokela ho tsotelloa, e leng se ka lebisang keketseho ea khafetsa ea liketsahalo le keketseho e mpe ea khatello ea baktheria.

Bakeng sa bakuli ba nang le leqeba la mokokotlo, ho ile ha bonoa ponahalo ea lera le tšoeu la kristale, e leng masala a sethethefatsi. Melao ha e kena-kenane le ts'ebeliso e eketsehileng ea ciprofloxacin ebile ha e ame phello ea eona ea kalafo. Ponahalo ea precipitate e bonoa nakong ea ho tloha lihora tse 24 ho isa ho matsatsi a 7 ka mor'a ho qala kalafo, 'me ho ts'oaroa hoa eona ho etsahala hape kamora ho etsoa le ka nako ea matsatsi a 13 kamora ho qala kalafo.

Ho roala lilense tsa khokahano ha ho khothalletsoe nakong ea kalafo.

Kamora ts'ebeliso ea ophthalmic ea ciprofloxacin, ho fokotseha ka mokhoa o hlakileng oa pono ea pono ho ka khoneha, ka hona, hang ka mor'a ts'ebeliso, ha ho khothalletsoe ho khanna koloi le ho etsa lintho tse hlokang tlhokomelo e potlakileng le lebelo la karabelo ea psychomotor.