Lithethefatsi Amikacin sulfate: litaelo tsa ho sebelisoa

Phofo bakeng sa ho etsa tharollo e etselitsoeng tsamaiso ea methapo kapa ea methapo e lula e tšoeu kapa e le haufi le bosoeu, hygroscopic.

1000, 500 kapa 250 mg ea phofo e joalo ka botlolong ea 10 ml, 1, 5, 10 kapa 50 ea libotlolo tse joalo ka paketeng ea pampiri.

Tharollo (entravenous, intramuscular) hangata e hlakile, e mebala-bala kapa e se na 'mala.

Mokhoa oa ho lokolloa matlapeng ha o eo.

Pharadodynamics

Amikacin (lebitso ho risepe e fumanehang Latin Amikacin) e entsoe ka halofo aminoglycoside (lithibela-mafu) ho sebetsana le likokoana-hloko tse fapaneng. Melemo bactericidal ketso. E kenella ka potlako ka leboteng la sele ea pathogen, e kenella ka tieo ho subunit ea ribsome ea 30S ea sele ea kokoanahloko mme e thibela biosynthesis ea protheine.

Tšusumetso e phatlalalitsoeng ka likokoana-hloko tsa gram-negative aerobic: Salmonella spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Shigella spp., Serratia spp., Providencia stuartii.

E sebetsa ka tsela e leka-lekaneng khahlano le libaktheria tse ntle le gram: Staphylococcus spp. (ho kenyelletsa le mefuta e meng e thibelang methylene), mefuta e mengata Streptococcus spp.

Libaktheria tsa aerobic ha li na taba le amikacin.

Mofumahali

Kamora ts'ebetso ea intramuscular, e kenella ka mafolofolo molumo o felletseng o tsamaisoang. E kenella linthong tsohle le ka har'a litšitiso tsa nalane ea histo. Ho tlama liprotheine tsa mali ho fihla ho 10%. Ha e tlas'a phetoho. E pepesoa ka liphio li sa fetohe. Ho felisoa ha halofo ea bophelo ho atamela lihora tse 3.

Matšoao Amikacin

Matšoao a ho sebelisoa Amikacin ke lefu le tšoaetsanoang le tšoaetsanoang le bakoang ke likokoana-hloko tse mpe tsa gram (le hanyetsanang le bonolo, kanamycin kapa sisomycin) kapa ka nako e tšoanang likokoana-hloko tsa gram tse ntle le gram tse mpe:

tšoaetso ea phefumoloho (makhopho a sefahleho, makhopho a sefahleho sa mokokotlo),
sepsis,
ts'oaetso endocarditis,
ts'oaetso ea boko (ho kenyeletsa meningitis),
ts'oaetso ea pampitšana ea urinarycystitis, pyelonephritis, urethritis),
tšoaetso ea ka mpeng (ho kenyelletsa peritonitis),
tšoaetso ea lisele tse bonolo, li-tiske tse kenang le letlalo la tlhaho e nang le letsoai (ho kenyeletsa le liso tsa kahare, ho chesoa, liso tsa khatello),
tšoaetso ea hepatobiliary
tšoaetso ea manonyeletso le masapo (ho kenyeletsa osteomyelitis),
maqeba a tšoaelitsoeng
mathata a ts'oaetso a ts'oaetso.

Litlamorao

Litla-morao: feberu, makhopho, ho hlohlona, angioedema.
Setso sa tsamaiso ea lijo: hyperbilirubinemiats'ebetso hepatic transaminasesho nyekeloa ke pelo, ho hlatsa.
Likarabo tse tsoang tsamaisong ea hematopoietic: leukopenia, granulocytopenia, anemia, thrombocytopenia.
Likarabo tse tsoang tsamaisong ea methapo: phetoho ea phetiso ea methapo, ho otsela, hlooho e bohloko, ho se utloe litsebeng (ho sa utloe litsebeng ho ka etsahala), mathata a lisebelisoa tsa vestibular.
Ho tsoa ts'ebetsong ea genitourinary: proteinuria, oliguria, micromaturiaho hloleha ha rems.

Litaelo tsa ho sebelisoa Amikacin (Mokhoa le litekanyetso)

Litaelo tsa Amikacin tsa ente bakeng sa tšebeliso li u lumella ho tsamaisa lithethefatsi ka mokhoa oa intra kapa methapo.

Foromo ea litekanyetso tse joalo ka litafole tsa tsamaiso ea molomo ha e eo.

Pele ho ente, ho hlokahala ho etsa tlhahlobo e kenang ea methapo ea kutlo ho moriana, haeba ho se na li-contraindication bakeng sa ts'ebetso ea ona.

Amikacin e ka etsoa joang le joang? Tharollo ea moriana e lokisoa pele ho tsamaiso ka ho hlahisa 2-3 ml ea metsi a belisitsoeng a reretsoeng ente ho se kahare ho veine. Tharollo e fanoa hang hang ka mor'a ho itokisa.

Litekanyetso tse tloaelehileng tsa batho ba baholo le bana ho tloha khoeli e le 'ngoe ke 5 mg / kg makhetlo a mararo ka letsatsi kapa 7.5 mg / kg habeli ka letsatsi matsatsi a 10.

Tekanyetso e kholo ea letsatsi le letsatsi bakeng sa batho ba baholo ke 15 mg / kg, e arotsoe ka liente tse peli. Maemong a boima haholo le ho mafu a bakoang ke Pseudomonas, tekanyetso ea letsatsi le letsatsi e arotsoe ka litsamaiso tse tharo. Tekanyo e phahameng ka ho fetisisa e fanoeng bakeng sa phekolo eohle ha ea lokela ho ba ligrama tse fetang 15.

Bana ba sa tsoa tsoaloa ba qala ho fuoa 10 mg / kg, ebe ba fetela ho 7.5 mg / kg matsatsi a 10.

Tšusumetso ea kalafo hangata e etsahala matsatsing a 1-2, haeba kamora matsatsi a 3-5 kamora ho qala kalafo phello ea moriana e sa bonoe, e lokela ho emisoa mme maano a kalafo a fetotsoe.

Bongata

Matšoao: ataxiatahlehelo ya kutlo ho tsekela, lenyora, mathata a ho ntša, ho hlatsa, ho nyekeloa le pelo, tinnitus, ho hloleha ho phefumoloha.

Phekolo: bakeng sa ho emisa mathata a ho fetisoa ha mesifa hemodialysisletsoai calcium, mahlahana a li-anticholinesterase, Ho kenella ka moea mochinihammoho le kalafo ea matšoao.

Tšebelisano

Nephrotoxic phello e ka etsahala ha o ntse o sebelisa le vancomycin, amphotericin B, methoxyflurane,Basebelisi ba phapang ea X-ray, lithethefatsi tse seng khahlanong le ts'oaetso tsa lithethefatsi, enflurane, cyclosporine, cephalotin, cisplatin, polymyxin.

Matla a Ototoxic a khonahala ha o ntse o sebelisa le ethaconic acid, furosemide, cisplatin.

Ha e kopantsoe le penicillin (ka tšenyo ea liphio) phello ea antimicrobial ea fokotseha.

Ha o arolelana le li-blocker tsa methapo le ethyl ether monyetla oa khatello ea maikutlo oa ho hema oa eketseha.

Amikacin ha e lumelloe ho kopanngoa ka tharollo le cephalosporins, penicillin, amphotericin B, erythromycin, chlorothiazide, heparin, thiopentone, nitrofurantoin, tetracyclineslivithamini tsa sehlopha B, asiti ea ascorbic le potasiamo chloride.

Amikacin analogues

Li-analog Amikacin sulfate (phofo bakeng sa tharollo) Ambiotic (ente) Amikacin-Kredofarm (phofo bakeng sa tharollo) Loricacin (ente) Flexelite (tharollo ea ente).

Ka lebaka la ho amohuoa bohle hantle aminoglycosides Li-analogues tsa Amikacin ha li fumanehe ho tsoa mala ka matlapeng.

Bana ba ka tlase ho lilemo tse 6 ba beoa tekanyetso ea pele ea 10 mg / kg, ebe 7.5 mg / kg habeli ka letsatsi.

Matšoao Amikacin sulfate

Tšoaetso e matla e bakoang ke likokoana-hloko tse amehang kahare ho moriana: sepsis, meningitis, peritonitis, septic endocarditis, mafu a tšoaetsanoang le a tšoaetsanoang a tsamaiso ea phefumoloho (pneumonia, pleural empyema, lesapo la matšoafo), ts'oaetso ea phepelo ea liphio le urinary, hangata e rarahaneng ebile hangata e etsahala khafetsa (pyelonephritis, urethritis cystitis), chesa e nang le tšoaetso, jj.

Tekanyetso le tsamaiso

Ho / m kapa ho / in (ho hlohlona). Batho ba baholo le ba lilemong tsa bocha ba nang le ts'ebetso e tloaelehileng ea renal - 15 mg / kg / letsatsi (5 mg / kg nako le nako ka lihora tse 8 kapa 7.5 mg / kg nako le nako ka lihora tse 12), bana ba nang le lethal dose le le leng la pele - 10 mg / kg, ebe 7.5 mg / kg ka mor'a lihora tse ling le tse ling tse 12. Tekanyetso e kholo ea letsatsi le letsatsi ke 1.5 g, tekanyetso e felletseng ea netefalo ha e sa fetisa ligrine tse 15. Haeba ho se na phello, ba fetohela kalafong le lithethefatsi tse ling matsatsi a 5. Nako ea kalafo ke matsatsi a 7-10.

Bakuli ba nang le bothata ba ho phekoloa ka lipholiso ba hloka phokotso ea tekanyetso kapa keketseho lipakeng tsa tsamaiso ntle le ho fetola tekanyetso e le 'ngoe. Nako e lekantsoe e baloa ka foromo: serum creatinine mahloriso x 9. Tekanyetso ea pele bakeng sa bakuli ba nang le ho fokola ha methapo ke 7.5 mg / kg, hobane lipalo tsa litekanyetso tse latelang li sebelisa foromo: Cl creatinine (ml / min) x lethal dose la pele (mg) / Cl creatinine tloaelehileng (ml / min).

Litlhokahalo tsa polokeho

Ho bakuli ba nang le hypersensitivity ho aminoglycosides e meng, ho ka ba le karohano ea lintho tse ka mpefatsang Amikacin. Ha litla-morao li hlaha, sethethefatsi sea hlakoloa 'me ho entsoe diphenhydramine, calcium chloride, joalo-joalo. Ho thibela mathata, ho khothalletsoa ho sebelisa lithethefatsi tlas'a taolo ea liphio, kutlo le ts'ebetso ea vestibular (bonyane nako e le' ngoe ka beke). Keketseho ea mathata a vestibular le ea pherekano e eketseha ka ho se sebetse hantle ha methapo. Monyetla oa nts'etsopele ea oto- le nephrotoxicity e eketseha ka tšebeliso ea nako e telele le litekanyetso tse phahameng. Mats'oao a pele a thibelo ea methapo ea methapo, ho hlokahala hore o emise ts'ebetso ea lithethefatsi mme hang hang a kenelle tharollo ea iv ea calcium chloride kapa tharollo ea sc ea proserin le atropine, haeba ho hlokahala, mokuli o fetisetsoa ho phefumoloha e laoloang.

Litaelo tse khethehileng

Pele o sebelisa moriana, ho hlokahala ho tsebahatsa kutloisiso ea methapo ea kutlo ho sethibela-mafu (sebelisa li-disk tse nang le 30 μg ea amikacin sulfate). Ka bophara ba bophara ba limilimithara tse 17 kapa ho feta, likokoana-hloko li nkuoa li le bobebe, 15-16 limilimithara li tebile haholo, 'me limilimithara tse 14 li sa tsitsa. Nakong ea kalafo, litaba tsa moriana o thibelang plasma ea mali li lokela ho hlahlojoa (mahloriso ha aa lokela ho feta 30 μg / ml).

Bakeng sa tsamaiso ea methapo ea kutlo, ho sebelisoa tharollo e lokiselitsoeng ha u tsoa phofo e tsoang ka phofo e kopantsoeng le keketso ea metsi ka makhetlo a 2-3 ml bakeng sa ente ea litaba tsa vial (250 mg kapa 500 mg ea phofo). Bakeng sa tsamaiso ea iv, hlapolla ka 200 ml ea tharollo ea glucose ea 5% kapa tharollo ea 0,9% ea sodium chloride. Ts'ebetso ea amikacin tharollong ea tsamaiso ea iv ha ea lokela ho feta 5 mg / ml.

Contraindication

Hypersensitivity (ho kenyelletsa nalane ea li-aminoglycosides tse ling), lefu la methapo ea kutlo, ho se sebetse hantle ha real le azotemia le uremia, ho ima. Myasthenia gravis, parkinsonism, botulism (aminoglycosides e ka baka tlolo ea phetisetso ea methapo, e lebisang ho fokoliseng le ho fokola ha mesifa ea marapo), ho felloa ke metsi, ho se sebetse hantle, nako ea ho ruruha, prematurity ea bana, botsofe, ho ruruha.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

V / m, iv (ka jete, bakeng sa metsotso e 2 kapa ho oela), 5 mg / kg nako le nako ka lihora tse 8 kapa 7.5 mg / kg nako le nako ka lihora tse 12, tšoaetso ea baktheria ea ts'ebetso ea urine (e sa rarahaneng) - 250 mg ka mor'a lihora tse 12, kamora seboka sa hemodialysis, ho ka fanoa ka tekanyetso e eketsehileng ea 3-5 mg / kg. Tekanyetso e kholo bakeng sa batho ba baholo e fihla ho 15 mg / kg / letsatsi, empa eseng ho feta 1.5 g / letsatsi bakeng sa matsatsi a 10.

Nako ea kalafo e nang le / ho kenyelletsa ke matsatsi a 3-7, ka nako ea matsatsi a 8-10.

Bakeng sa masea a tlang pele ho nako, tekanyetso ea pele ke 10 mg / kg, ebe 7.5 mg / kg nako le nako ka lihora tse 18-24, bakeng sa masea a sa tsoa tsoaloa, tekanyetso ea pele ke 10 mg / kg, ebe 7.5 mg / kg nako le nako lihora tse 12 bakeng sa matsatsi a 7-10.

Bakuli ba nang le bothata ba ho phekoloa ka lipholiso ba hloka ho lokisoa ha mofuta oa moriana.

Bakuli ba tukang ba ka 'na ba hloka tekanyetso ea 5-7,5 mg / kg ka mor'a lihora tse' ne ka lebaka la bokhutšoanyane ba T1 / 2 (lihora tse 1-1,5) ho bakuli bana.

Bakeng sa tsamaiso ea methapo ea kutlo, ho sebelisoa tharollo e lokiselitsoeng ha u tsoa phofo e tsoang ka phofo e kopantsoeng le keketso ea metsi ka makhetlo a 2-3 ml bakeng sa ente ea litaba tsa vial (0.25 kapa 0.5 g ea phofo). Bakeng sa tsamaiso ea i / v, ho sebelisoa litharollo tse tšoanang le bakeng sa i / m, kamora ho li hlapolla ka 200 ml ea 5% dextrose solution kapa 0.9% NaCl tharollo. Ts'ebetso ea amikacin tharollong ea tsamaiso ea iv ha ea lokela ho feta 5 mg / ml.

Ketso ea pharmacological

Semi-synthetic e pharaletseng sebopeho sa lithibela-mafu, bactericidal. Ka ho tlamahana ho subunit ea 30S ea li-ribosomes, e thibela ho theoa ha moralo oa lipalangwang le morumuoa RNA, e thibela synthesis ea protheine, hape e senya lera la libaktheria.

E mafolofolo khahlano le likokoana-hloko tse mpe tsa aerobic gram-negative - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp, Salmonella spp., Shigella spp. (ho kenyelletsa ho hanyetsa penicillin, li-cephalosporins tse ling),

e sebetsang ka tsela e leka-lekaneng khahlanong le Streptococcus spp.

Ka tsamaiso e ts'oanang ka benzylpenicillin, e na le phello ea selekane khahlanong le mefuta ea Enterococcus faecalis.

Ha e ame likokoana-hloko tsa anaerobic.

Amikacin ha e lahleheloe ke mosebetsi tlasa ts'ebetso ea li-enzyme tse sebelisang li-aminoglycosides tse ling, 'me e ka lula e le mafolofolo khahlanong le mefuta ea Pseudomonas aeruginosa e hananang le tobramycin, gentamicin le netilmicin.

Lithethefatsi tse tšoanang:

Matlapa a molomo oa Augmentin (Augmentin)
Augmentin Powder bakeng sa ho emisoa ka molomo
Matlapa a molomo oa Orzipol (ORCIPOL)
Dioxidin (Dioxydin) Mouthwash
Matlapa a molomo oa Tsifran OD (Cifran OD)
Ente ea Gentamicin (Gentamicin)
Amoxicillin Sandoz (Amoxicillin Sandoz) Matlapa
Phofo ea Augmentin EU (Augmentin ES) bakeng sa tharollo ea molomo
Sumamed Aerosol
Hiconcil Capsule

** Tataiso ea ho fana ka litlhare ke bakeng sa tlhahisoleseling. Bakeng sa tlhaiso-leseling e batsi, ka kopo sheba litlhaloso tsa moetsi. Se ke oa ikoetlisa, pele u qala ho sebelisa Amikacin Sulfate, o lokela ho etela ngaka. EUROLAB ha e ikarabelle bakeng sa litlamorao tse bakoang ke ts'ebeliso ea tlhaiso-leseling e hatisitsoeng portal. Tlhahiso-leseling efe kapa efe e teng sebakeng sa marang-rang ha e nke sebaka sa keletso ea ngaka ebile e ke ke ea fana ka tiiso ea litlamorao tsa lithethefatsi.

Na o thahasella Amikacin Sulfate? Na u batla ho tseba lintlha tse qaqileng kapa ho hlokahala hore u ee ngakeng? Kapa o hloka tlhahlobo? O ka khona etsa tumellano le ngaka - Euro tleliniki lab kamehla ts'ebetsong ea hau! Lingaka tse ntle li tla u hlahloba, ho u eletsa, ho fana ka thuso e hlokahalang le ho etsa tlhahlobo ea mafu. U ka khona letsetsa ngaka lapeng. Clinic Euro lab e buletsoe nako eohle.

** Hlokomela! Tlhahisoleseling e hlahisitsoeng tataisong ena ea meriana e etselitsoe litsebi tsa bongaka 'me ha ea lokela ho ba mabaka a ho itlhalosa. Tlhaloso ea lithethefatsi Amikacin sulfate e fanoa bakeng sa ho buuoa mme ha e reretsoe ho khethoa ha kalafo ntle le ho nka karolo ha ngaka. Bakuli ba hloka boeletsi bo ikhethang!

Haeba o ntse o thahasella meriana le litlhare tse ling, litlhaloso tsa bona le litaelo tsa tšebeliso, tlhaiso-leseling mabapi le sebopeho le mofuta oa tokollo, matšoao a ts'ebeliso le litlamorao, mekhoa ea ts'ebeliso, litheko le litlhahlobo tsa meriana, kapa na u na le lipotso tse ling le litlhahiso - re ngolle, ka sebele re tla leka ho u thusa.

Litla-morao

Ka tšebeliso ea nako e telele kapa overdose ea amikacin sulfate e ka ba le phello ea oto- le nephrotoxic. Boitšoaro ba ototoxic ba amikacin sulfate bo bonahatsoa ka mokhoa oa ho fokotseha hoa kutlo (ho fokotseha hoa pono ea litanka tse phahameng) tsa mathata a apparatus ea vestibular (dizziness). Keketseho ea mathata a vestibular le ea pherekano e eketseha ka ho se sebetse hantle ha methapo. Phello ea nephrotoxic ea amikacin sulfate e tšoauoa ka keketseho ea naetrojene e setseng ea serum ea mali, ho fokotseha hoa pepeneneng ea creatine ho, ekaba ka guria, protheine e nang le uria, cylindruria le

hangata e fetoha. Ho thibela mathata le ho fokotsa khafetsa ea kholo ea bona, moriana o khothalletsoa hore o sebelisoe tlasa taolo ea methapo ea kutlo, litsebe le lisebelisoa tse sebelisoang (bonyane hang ka beke).

Mokhoa o rarahaneng haholo ke "neuromuscular blockade". Mochine oa phello ena o haufi le ketso ea li-restidepolarizing mofuta oa mesifa ea ho phomola. Matšoao a pele a neuromuscular conduction blockade, ho hlokahala ho emisa tsamaiso ea amikacin sulfate mme hang-hang a fane ka tharollo ea calcium chloride kapa tharollo ea subcutaneous ea proserin le atropine. Haeba ho hlokahala, mokuli o fetisetsoa phefumong e laoloang.

Ha u sebelisa amikacin sulfate, ho kulisoa ke lintho tse kulang le tsona hoa khoneha (lekhopho la letlalo, feberu, hlooho, joalo-joalo). Ha li hlaha, lithethefatsi li felisitsoe 'me ho fanoa ka phekolo ea takatso e matla (diphenhydramine, calcium chloride, joalo-joalo). Ka ts'ebetso e kenang ea moriana o thibelang likokoana-hloko, nts'etsopele ea phlebitis le periphlebitis e khonahala.

Lipotso, likarabo, litlhahlobo mabapi le lithethefatsi Amikacin sulfate

Tlhahisoleseling e fanoeng e reretsoe litsebi tsa bongaka le tsa meriana. Tlhahisoleseling e nepahetseng ka ho fetelletseng ka lithethefatsi e fumaneha litaelong tse tlamelletsoeng ke moqapi.Ha ho na tlhahisoleseling e thathamisitsoeng leqepheng lena kapa leha e le efe ea sebaka sa rona sa marang-rang e ka sebeletsang e le sebaka sa boipiletso ba motho ho setsebi.