Lithethefatsi Amikacin 500: litaelo tsa ho sebelisoa

Semi-synthetic e pharaletseng e bonts'ang likokoana-hloko ka mosebetsi oa bactericidal. Ka ho tlamahana ho subunit ea 30S ea li-ribosomes, e thibela ho theoa ha moralo oa lipalangwang le morumuoa RNA, e thibela synthetiki, hape e senya lera la "bacteria" la cytoplasmic.

E sebetsa haholo khahlano le aerobic gram-negative microorganisms - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp. ), likokoana-hloko tse ling tse ntle tsa gram - Staphylococcus spp. (ho kenyelletsa le tse hananang le penicillin, li-cephalosporin tse ling), agavenly ka tsela e leka-lekaneng khahlanong le Streptococcus spp.

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

Ha e ame likokoana-hloko tsa anaerobic.

Amikacin ha e felloe ke ts'ebetso tlasa ts'ebetso ea li-enzyme tse sebelisang li-amino glycosides tse ling hape li ka lula li le mafolofolo khahlanong le mefuta ea Pseudomonas aeruginosa e hananang le tobramycin, gentamicin le netilmicin.

Mofumahali

Kamora ho tsamaiso ea intramuscular (IM), e kenella ka potlako le ka botlalo. Khatiso e kholo (Stax) e nang le tsamaiso ea / m ka tekanyo ea 7.5 mg / kg ke 21 μg / ml. Nako ea ho fihlela mahloriso a phahameng (TSmax) e batla e le lihora tse 1.5 kamora taolo ea i / m. Puisano le liprotheine tsa plasma - 4-11%.

E ajoa hantle ka mokelikeli oa metsi a tsoang kantle ho mokokotlo (lintho tse tsoang ho li-abscesses, tšebetso ea maiketsetso, ascitic, pericardial, synovial, lymphatic le peritoneal)

mokelikeli), ka lipalo tse phahameng tse fumanoang ka har'a moroto, ka tlase - ka har'a bile, lebese la matsoele, mongobo o metsi oa leihlo, secretion ea bronchial, sputum le fluid fluid (CSF). E kenella hantle linthong tsohle tsa 'mele moo e bokellanang ka bongata, ho tsepamisoa likelellong tse ngata tse nang le phepelo e ntle ea mali: mats'oafo, sebete, myocardium, spleen, mme haholo-holo lipong, moo e bokellanang mokokotlong oa cortical, likhahla tse tlase - mesifa, adipose tishu le masapo.

Ha ho fanoa ka litekanyetso tse akaretsang tsa kalafo ho batho ba baholo, amikacin ha e kenelle ka har'a mokoallo oa mali, ka ho ruruha ha meninges, permeability e eketseha hanyane. Ho masea a sa tsoa tsoaloa, ho tsepamisa mohopolo ka holimo ho CSF ​​hoa atleha ho feta ho batho ba baholo, ho feta ka placenta - e fumanoa maling a fetus le amniotic fluid. Bophahamo ba modumo ho batho ba baholo - 0,26 l / kg, ho bana - 0,2-0.4 l / kg, ho bana ba sa tsoa hlaha - ba lilemo tse ka tlase ho beke le boima ba 'mele bo ka tlase ho 1.5 kg - ho fihla ho 0.68 l / kg ka tlase ho beke 1 le boima ba 'mele ho feta 1.5 kg - ho fihlela ho 0.58 l / kg, ho bakuli ba nang le cystic fibrosis - 0,3-0.39 l / kg. Ts'ebetso e akaretsang ea kalafo e tsamaeang le tsamaiso ea i / m e bolokiloe lihora tse 10-12.

Ha e sebelisoe. Halofo ea bophelo (T1 / 2) ho batho ba baholo ke lihora tse 2-4, ho masea a sa tsoa tsoaloa-lihora tse 5-8, ho bana ba baholo - lihora tse 2,5.4 Boleng ba ho qetela ba T1 / 2 ke lihora tse fetang 100 (ho lokolloa ho tsoa ho li-depo tsa intracellular) .

E hloekisoa ke liphio ka glometerular filtration (65-94%), haholo e sa fetoheng. Tlhophiso ea Renal - 79-100 ml / min.

T1 / 2 ho batho ba baholo ba nang le ts'ebetso ea ho ruruha e sa sebetseng e fapana ho latela tekanyo ea ho senyeha - ho fihlela lihora tse 100, ho bakuli ba nang le cystic fibrosis - lihora tse 1-2, ho bakuli ba tukang le hyperthermia, T1 / 2 e ka ba khuts'oane ho feta karolelano ka lebaka la tumello e eketsehileng .

E pepisoa nakong ea haemodialysis (50% ka lihora tse 4-6), peraloneal dialysis ha e sebetse hantle (25% ka lihora tse 48-72).

Matšoao a ho sebelisoa

E etselitsoe kalafo ea mafu a tšoaetsanoang a tšoaetsanoang le a tšoaetsanoang a bakoang ke likokoana-hloko tse anngoeng ke amikacin: mokhoa oa ho hema (bronchitis, pneumonia, empural, mohono oa methapo), sepsis, septic endocarditis, tsamaiso ea methapo ea kutlo (ho kenyeletsa le meningitis), le mokokotlo oa mpa (le ho kenyelletsa lefu la ka mpeng). peritonitis), genitourinary tract (pyelonephritis, cystitis, urethritis), letlalo le lisele tse bonolo (ho kenyeletsa le ho chesoa ke tšoaetso, liso tse nang le tšoaetso le liso tsa khatello ea mefuta e fapaneng), ts'ebetso ea lesapo la mokokotlo, masapo le manonyeletso (ho kenyeletsa le osteomyelitis) leqeba la infe ktsiya, ts'oaetso ea postoperative.

Contraindication Hypersensitivity (ho kenyelletsa le nalane ea li-aminoglycosides tse ling), lefu la methapo ea kutlo, ho se sebetse hantle ha renal (CRF) ka azotemia le uremia, ho ima, ho nyekeloa ..

Ka tlhokomeliso. 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 fokola hoa mmele, ho se sebetse hantle, nako ea ho ruruha, boteng ba bana.

Bokhachane le pelehi

. Ts'ebeliso ea amikacin e kopantsoe le bokhachane. Aminoglycosides e ka kena-kenana le nts'etsopele ea "embryo" ha e fuoa mosali oa moimana. Aminoglycosides a tšela sebaka se seholo sa tlhaho ea bana ba bo-'mè ba amohetseng streptomycin nakong ea kemolo. Le ha litlamorao tse mpe li le litlamong kapa tse sa tsoa hlaha li sa fumanoa ha aminoglycoside e meng e fuoa basali baimana, kotsi e ka bang teng. Boithuto ba ho ikatisa ba amikacin litoeba le litoeba ha bo supe matšoao a ho senyeha ha tsoalo kapa kotsi ea fetal e amanang le ho nka amikacin.

Ha ho tsejoe hore na amikacin e fetela lebeseng la matsoele. Nakong ea ts'ebeliso ea amikacin, ho anyesa ha ho khothalletsoe.

Tekanyetso le tsamaiso

Bakeng sa tšoaetso e ngata, ho khothalletsoa tsamaiso ea methapo. Maemong a tšoaetsanoang ke bophelo kapa haeba ts'ebetso ea methapo ea methapo e sa khonehe, li beoa butle-butle kahare ka jete (metsotso e 2-3), kapa infusion (tharollo ea 0,25% bakeng sa metsotso e 30).

Tsamaiso ea methapo le methapo

Amikacin e ka tsamaisoa ka methapo le kahare. Ha ho fanoa ka litekanyetso tse khothalletsoang bakeng sa ts'oaetso e sa rarahaneng e bakoang ke likokoana-hloko tse ka kenang habonolo, karabelo ea kalafo e ka fumaneha nakong ea lihora tse 24-48.

Haeba ho se karabelo ea kliniki e fumanoang matsatsing a 3-5, ho ka fanoa ka phekolo e 'ngoe.

Pele o fana ka amikacin, o lokela ho:

• Hlahloba ts'ebetso ea ho hlaba ka ho lekanya mahloriso a serum creatinine kapa ka ho bala palo ea clearinine clearance (ho hlokahala hore nako le nako ho hlahlobe ts'ebetso ea renal nakong ea ts'ebeliso ea amikacin),

Haeba ho khonahala, mohopolo oa serum amikacin o lokela ho khethoa (boholo le botebo ba serum nako le nako nakong

Qoba palo e phahameng ea serum ea amikacin (metsotso e 30-90 kamora ho kenngoa ente) tse fetang 35 /g / ml, mahloriso a serum a fokolang (hang-hang pele ho lethal dose le latelang) a fetang 10 μg / ml.

Ho bakuli ba nang le ts'ebetso e tloaelehileng ea renal, amikacin e ka beoa nako e le 'ngoe ka letsatsi, boemong bona, khatello e phahameng ea serum e ka feta 35 μg / ml. Nako ea kalafo ke matsatsi a 7-10.

Tekanyetso e felletseng, ho sa tsotelehe tsela ea tsamaiso, ha ea lokela ho feta 15-20 mg / kg / letsatsi.

Ho ts'oaetso e rarahaneng, ha mokhoa oa kalafo o nka matsatsi a fetang 10 o hlokahala, ts'ebetso ea liphio, methapo ea kutlo le li-vestibular sensory, hammoho le boemo ba serum amikacin bo lokela ho hlahlojoa ka hloko.

Haeba ho se na ntlafatso ea tleliniki nakong ea matsatsi a 3-5, ts'ebeliso ea amikacin e tlameha ho emisoa, le kutloisiso ea li-microorganisms ho amikacin e lokela ho hlahlojoa bocha.

Batho ba baholo le bana ba kaholimo ho lilemo tse 12 - ba na le ts'ebetso e tloaelehileng ea menoana (clearinine clearance> 50 ml / min) i / m kapa iv 15 mg / kg / letsatsi 1 nako ka letsatsi kapa 7.5 mg / kg nako le nako ka lihora tse 12. Tekanyo ea kakaretso ea letsatsi le letsatsi ha ea lokela ho feta 1.5 g bakeng sa endocarditis le febrile neutropenia, tekanyetso ea letsatsi le letsatsi e lokela ho aroloa ka litekanyetso tse peli, hobane data e sa lekanang mabapi le ho amoheloa ka nako e le 'ngoe ka letsatsi.

Bana ba libeke tse 4 - ba lilemo li 12 - ba na le ts'ebetso e tloaelehileng ea renal (clearinine clearance> 50 ml / min) i / m kapa i / v (infravenously infusion butle butle) 15-20 mg / kg / letsatsi 1 nako ka letsatsi kapa

7.5 mg / kg nako le nako ka lihora tse 12. Ka endocarditis le febrile neutropenia, tekanyetso ea letsatsi le letsatsi e lokela ho aroloa ka litekanyetso tse peli, hobane data e sa lekanang mabapi le ho amoheloa ka nako e le 'ngoe ka letsatsi. Bana ba sa tsoa hlaha - tekanyetso ea pele ea ho kenya ke 10 mg / kg, joale 7.5 mg / kg ka mor'a lihora tse 12.

Masea pele ho nako - 7.5 mg / kg ka lihora tse ling le tse ling tse 12.

Litlhahiso tse khethehileng bakeng sa tsamaiso ea methapo. Bakeng sa batho ba baholo le bana, tharollo ea amikacin hangata e kenngoa nako e telele ea metsotso e 30-60.

Bana ba ka tlase ho lilemo tse peli ba lokela ho kenngoa lihora tse 1 ho isa ho tse peli.

Amikacin ha ea lokela ho kopanngoa le lithethefatsi tse ling, empa e lokela ho fanoa ka thoko ho latela tekanyetso le mokhoa oa tsamaiso.

Litokelo tsa batho ba baholo. Amycacin e epolloa ke liphio. Ts'ebetso ea manonyeletso e lokela ho hlahlojoa le hore na lethal dose le fuoe joalo ka ts'ebetso ea ho senyeha ha renal.

Bophelo bo sokela le / kapa bo bakoang ke Pseudomonas. Doz o moholo o ka eketsoa ho 500 mg ka mor'a lihora tse ling le tse ling tse 8, empa amikacin ha ea lokela ho fanoa ka tekanyetso ea tse ling

1.5 g ka letsatsi, 'me ha ho matsatsi a fetang 10. Tekanyo e kholo ea kakaretso ea thuto ha ea lokela ho feta ligrama tse 15.

Likokoana-hloko tsa 'marang-rang (tse ling ha li bakoe ke Pseudomonas). Tekanyetso e lekanang

7.5 mg / kg / letsatsi le arotsoe ka litekanyetso tse 2 tse lekanang (tseo ho batho ba baholo li lekanang le makhetlo a 250 mg ka makhetlo a mabeli ka letsatsi).

Ho baloa ha lethal dose ea amikainin pui e sitisang mosebetsi oa ho hlaba ka lesapo la mokokotlo

Bongata

Matšoao: ho arabela ka chefo (tahlehelo ea litsebe, ataxia, ho tsekela, ho ruruha, lenyora, ho felloa ke takatso ea lijo, ho nyekeloa ke pelo, ho hlatsa, ho lla kapa ho ikutloa eka ke litsebeng litsebeng, ho hloleha ho phefumoloha).

Phekolo: ho tlosa blockade ea phetisetso ea methapo le litlamorao tsa eona - hemodialysis kapa peritoneal dialysis, lithethefatsi tsa anticholinesterase, letsoai la khalsiamo, moea o kenang ka mochine, moea o mong o bontšang matšoao le tšehetso.

Ho sebelisana le lithethefatsi tse ling

Ts'ebeliso ea tloaelo kapa ea lehae ka nako e le 'ngoe le lithethefatsi tse ling tse ka' nang tsa nephrotootic kapa ototoxic li lokela ho qojoa ka lebaka la litlamorao tse ka eketsang. Keketseho ea nephrotoxicity e etsahala le tsamaiso e kopaneng ea aminoglycosides le cephalosporins. Tšebeliso e kopanetsoeng le cephalosporins e ka eketsa seriti ea silumine ha e ikemiselitse. Monyetla oa ho ototoxicity o eketseha ka tšebeliso e ts'oanang ea amikacin e nang le diuretics tse sebetsang ka potlako, haholo ha diuretic e tsamaisoa kahare. Diuretics e ka eketsa chefo ea aminoglycosides ho fihlela e sa fetoheng ototoxicity ka lebaka la liphetoho phepong ea lithibela-mafu ka serum ea mali le lisele. Tsena ke furosemide le ethaconic acid, eo ka boyona e leng sethethefatsi sa ototoxic.

Tsamaiso e kenelletseng ea amikacin ha e khothalletsoe ho bakuli ba tlas'a tšusumetso ea lithethefatsi tse thethefatsang kapa tse fokotsang mesifa (ho kenyeletsa ether, halothane, D-tubocurarine, ancinylcholine le decametonium), neuromuscular blockade le khatello ea maikutlo ea morao-rao tse ka bakang khatello ea maikutlo. ,

Indomethacin e ka eketsa bongata ba amikacin ho plasma ho masea a sa tsoa hlaha.

Ho bakuli ba nang le bothata ba ho ruruha ba renal, ho fokotseha hoa ts'ebetso ea aminoglycoside ho ka hlaha ka tšebeliso e tšoanang ea lithethefatsi tsa penicillin.

Kotsi e eketsehileng ea hypocalcemia le tsamaiso e kopaneng ea aminoglycosides e nang le li-bisphosphonates.

Keketseho e eketsehang ea nephrotooticity le mohlomong ototoxicity le tsamaiso e kopaneng ea aminoglycosides le likhomphutha tsa platinamo.

Litemoso le likeletso tse ikhethang

Sebelisa ka hloko ho bakuli ba nang le bothata ba ho phekoloa ke masapo, kapa tšenyo ea tsebe kapa ea methapo ea kutlo. Bakuli ba lokela ho beoa leihlo ka hloko ka lebaka la ho ba teng ha ototoxicity le nephrotoxicity ea aminoglycosides. Tšireletso bakeng sa nako ea kalafo e fetang matsatsi a 14 ha e so theoe. Litekanyetso tsa litekanyetso le hydrate tse lekaneng li lokela ho bonoa.

Bakeng sa bakuli ba nang le bothata ba ho sebetsa ha renal kapa ho fokotseha ha moea o litšila, ho sebetsa ha liphio ho lokela ho hlahlojoa ka mekhoa e tloaelehileng pele ho kalafo le nako le nako nakong ea kalafo. Litekanyetso tsa letsatsi le letsatsi li lokela ho fokotsoa le / kapa karohano lipakeng tsa litekanyetso li lokela ho atolosoa ho latela motsoako oa serum creatinine e le ho qoba ho bokellwa ha maemo a phahameng haholo maling le ho fokotsa kotsi ea ho ba le lefutso. Ho beha leihlo nako le nako ha motsoako oa litla-morao tsa lithethefatsi le liphekolo li le bohlokoa haholo ho bakuli ba tsofetseng bao ho fokotsang tšebetso ea liphio ho ka etsahalang, ho ke keng ha totobala liphetho tsa liteko tsa kemiso e tloaelehileng joalo ka mali urea le serum creatinine.

Haeba kalafo e ka nka matsatsi a supileng kapa ho feta ho bakuli ba nang le bothata ba ho phekoloa ke masapo, kapa matsatsi a 10 ho bakuli ba bang, tlhaiso-leseling ea audiogram ea pele e lokela ho fumanoa le ho hlahlojoa bocha nakong ea kalafo. Phekolo ea Amikacin e lokela ho emisoa haeba maikutlo a kenang a tinnitus kapa tahlehelo ea kutlo a hlaha, kapa haeba li-audiogram tsa morao-rao li bontša ho fokotseha ho hoholo hoa pono ea maqhubu a phahameng.

Haeba ho na le matšoao a ho halefisa lisele tsa menoana (mohlala, albinuria, lisele tse khubelu tsa mali kapa li-lymphocyte), hydration e lokela ho eketseha 'me litekanyetso tsa moriana li lokela ho fokotsoa. Hangata mathata ana a nyamela ha kalafo e felile. Leha ho le joalo, haeba azotemia le / kapa ho fokotseha ho tsoelang pele ha moroto ho hlaha, kalafo e lokela ho emisoa.

Neuro / Ototoxicity. Neurotoxicity, e bonts'itsoeng ka mokhoa oa vestibular le / kapa oa naha o kopanetsoeng oa li-odotootic, e ka hlaha ho bakuli ba fumanang aminoglycosides. Kotsi ea ho ba le aminoglycoside-induction ototoxicity e kholo ho bakuli ba nang le ts'oaetso ea renal, le ha ba fumana tekanyetso e phahameng, kapa nako ea kalafo e feta matsatsi a 7. Ho tsekela tse ka bonts'a tšenyo ea vestibular. Matšoao a mang a ho fetoha ha neurotoxicity a ka kenyelletsa ho tsitsipana, ho tsikinyeha ha letlalo, mesifa ea mesifa le ho phunyeha. Kotsi ea ototoxicity e eketseha ka ho pepeseha ho eketsehileng, ekaba tlhoro e phahameng e phehellang kapa khatello e phahameng ea masalela. Ts'ebeliso ea amikacin ho bakuli ba nang le allergy ho aminoglycosides, kapa subclinical renal imension, kapa tšenyo ea methapo ea borobeli e bakoang ke ts'ebetso ea pele ea lithethefatsi tsa nephrotoxic le / kapa ototoxic (streptomycin, dihydrostreptomycin, glamiccin, tobramycin, kanamyciny, kanamycinycin, kanamycinym , cephaloridine, kapa viomycin) e lokela ho nahaneloa ka hloko, hobane chefo e ka ntlafatsoa. Ho bakuli bana, amikacin e sebelisoa haeba, ho latela ngaka, melemo ea kalafo e feta likotsi tse ka bang teng.

Ho ba le chefo ea methapo. Neuromuscular blockade le ho holofala ha litho tsa matšoafo li tlalehiloe kamora ho tsamaisoa ke batsoali, ho kenya letsoho (ts'ebetsong ea methapo, ho nosetsa ha mpa ea mpa, kalafo ea lehae ea empema), le kamora tsamaiso ea molomo ea aminoglycosides. Monyetla oa ho holofala hoa matšoafo ho lokela ho nahanoa ka ho kenngoa ha aminoglycosides ka tsela efe kapa efe, haholo ho bakuli ba fumanang lithibela-mafu, li-resteed tsa mesifa (tubocurarine, presinylcholine, decametonium), kapa ho bakuli ba fumanang phetisetso e kholo ea mali a citrate-anticoagulated. Haeba neuromuscular blockade e etsahala, letsoai la khalsiamo le felisa ho holofala ha moea, empa ho ka ba bonolo hore moea o kenang o sebelisoe. Aminoglycosides e lokela ho sebelisoa ka hloko ho bakuli ba nang le mathata a mesifa (myasthenia gravis kapa parkinsonism), kaha li ka mpefatsa bofokoli ba mesifa ka lebaka la litlamorao tse ka bang teng pakeng tsa phetiso ea methapo.

Chefo ea letsoai. Aminoglycosides e ka ba nephrotoxic. Kotsi ea ho ba le nephrotoxicity e phahame ho bakuli ba nang le ts'ebetso ea renal e sa sebetseng, hammoho le ha ba fumana litekanyetso tse phahameng le kalafo ea nako e telele. Ho sebelisa hydrate hantle ho hlokahala nakong ea kalafo; ts'ebetso ea liphio e lokela ho hlahlojoa ho sebelisoa mekhoa e tloaelehileng pele le nakong ea kalafo. Phekolo e lokela ho khaotsa ka ho eketseha ha azotemia kapa ho fokotseha butle-butle ha moroto.

Bakeng sa bakuli ba tsofetseng, ho fokotseha ha ts'ebetso ea renal hoa khoneha, ho ka 'nang ha se bonahale litekong tse tloaelehileng tsa tlhahlobo ea serum (serum nitrogen urea kapa serum feathein). Ho khetholla clearinine clearance ho ka ba molemo haholo maemong a joalo. Ho beha leihlo ts'ebetso ea ho ba le kalafo ho bakuli ba tsofetseng nakong ea kalafo le aminoglycosides ho bohlokoa haholo.

Ts'ebetso ea manonyeletso le ts'ebetso ea borobeli ea methapo ea kutlo e hloka ho lekola bakuli ba nang le ts'oaetso ea renal e tsejoang kapa e belaelloang qalong ea kalafo, hammoho le ho bakuli ba nang le ts'ebetso e tloaelehileng ea renal, empa ba e-na le matšoao a ho se sebetse hantle ha renal nakong ea kalafo. Ts'oaetso ea Amikacin e tlameha ho hlahlojoa ho netefatsa litekanyetso tse lekaneng le ho qoba maemo a ka bang chefo. Motsoako o lokela ho beoa leihlo bakeng sa ho fokotsa matla a khoheli a itseng, ho eketseha ha protheine le erythrocyturia. Urea ea mali, serum creatinine, kapa tumello ea creatinine e lokela ho lekanngoa nako le nako. Li-audi audiogram li lokela ho fumanoa ho bakuli ba tsofetseng, haholo-holo ho bakuli ba kotsing e kholo. Matšoao a ototoxicity (kizungu, tinnitus, tinnitus le tahlehelo ea litsebe) kapa nephrotooticity e hloka ho hlakoloa ha moriana kapa litekanyetso tsa lethal dose.

Tšebeliso e tšoanang le / kapa tse ling tse sebelisang lithethefatsi tse ling tsa neurotoxic kapa nephrotootic (bacitracin, cisplatin, amphotericin B, cephaloridin, paromomycin, viomycin, polymyxin B, colistin, vancomycin, kapa li-aminoglycosides tse ling) li lokela ho qojoa. Lintho tse ling tse eketsang kotsi ea chefo ke botsofali le ho omella hoa mmele.

Tsietsi. Aminoglycosides e potlakela ebile e batla e kenella ka botlalo ha e sebelisoa kaholimo, hammoho le lits'ebetso tsa ho buoa. Ho se utloe litsebeng tse sa fetoheng, ho se sebetse hantle ka leretho le lefu ka lebaka la methapo ea methapo ea methapo nakong ea nosetso ea masimo a maholo le a manyane a ts'ebetso ea bongaka.

Joalo ka lithibela-mafu tse ling, tšebeliso ea amikacin e ka lebisa kholo e kholo ea likokoana-hloko tse sa tsotelleng. Tabeng ena, kalafo e loketseng e lokela ho fanoa.

Ho tlalehiloe taba ea ho lahleheloa ke pono e ke keng ea fetoloa ka mor'a ho kenngoa ka jareteng ea amikacin ka har'a mahlo a mahlo.

Sokolla foromo le sebopeho

Ho fanoa ka moriana ka mokhoa oa:

• Tharollo e reretsoeng i / m le tsamaiso ea iv, 1 ml e na le li-250 mg tsa amikacin, kahare ea 2 le 4 ml,
• Phofo eo tharollo ea ente e lokiselitsoeng ka eona, ka botlolong e le 'ngoe (10 ml) eo e kanna ea ba le 250 mg, 500 mg kapa 1 gram ea amikacin.

Contraindication

Ho latela litlatsetso ho moriana, ts'ebeliso ea Amikacin e patiloe:

• Basali ba baimana
• Ka lefu la methapo ea kutlo,
• Bakuli ba nang le bothata bo matla ba ho phekola ba 'mele bo sa foleng bo tsamaeang le uremia le / kapa azotemia,
• Ka boteng ba hypersensitivity ho amikacin, eng kapa eng e thusang karolo ea lithethefatsi, li-aminoglycosides tse ling (ho kenyeletsa nalane).

Amikacin e laetsoe, empa ka tlhokomelo e kholo le ka tlasa tlhokomelo ea kamehla ea bongaka:

• Ka ho omella,
• Basali nakong ea lebone la pelehi
• Le myasthenia gravis,
• Bakuli ba nang le parkinsonism
• Ka ho hloleha ha methapo,
• Masea le masea a hlahileng pele ho nako,
• Batho ba baholo
• Ka botulism.

Tekanyetso le tsamaiso Amikacin

Tharollo (ho kenyelletsa le e lokiselitsoeng ho tsoa phofo) Amikacin, ho latela litaelo, e lokela ho fanoa ka methapo kapa kahare.

Tekanyetso ho batho ba baholo le ho bana ba kaholimo ho lilemo tse 6 ke 5 mg ka kilogram ea boima ba 'mele, e fanoang ka linako tse ling tsa lihora tse 8, kapa 7.5 mg / kg ka lihora tse 12. Ka tšoaetso e sa rarahanang ea baktheria ea genitourinary trendara, ho ka khonahala ho fana ka moriana ka tekanyetso ea 250 mg ka mor'a lihora tse 12. Haeba u hloka karolo ea hemodialysis kamora eona, o ka etsa ente e ngoe ka tekanyo ea 3-5 mg ka boima ba kilo e le ngoe.

Tekanyetso e kholo ea letsatsi le letsatsi bakeng sa batho ba baholo ke 15 mg / kg, empa eseng ho feta ligrama tse 1,5 ka letsatsi. Nako ea kalafo, joalo ka molao, ke matsatsi a 3-7 - ka / kenyelletsong, matsatsi a 7-7 - ka a / m.

Amikacin e laetsoe bana ka tsela e latelang:

• Masea pele ho nako: lethalinyana la pele ke 10 mg ka kilog, ebe 7.5 mg / kg nako tsohle ka lihora tse 18-25,
• Bakeng sa masea le masea ho fihlela ho lilemo tse 6: litekanyetso tsa pele ke 10 mg / kg, ebe 7.5 mg / kg nako le nako ka lihora tse 12.

Tabeng ea ho chesoa ke tšoaetso, ka lebaka la bophelo bo bokhutšoanyane ba bophelo ba amikacin sehlopheng sena sa bakuli, tekanyo ea lithethefatsi hangata e le 5-7,5 mg / kg, empa khafetsa ea tsamaiso e eketseha - lihora tse ling le tse ling tsa 4-6.

Amikacin e kenngoa kahare ka nako e fetang metsotso e 30-60. Ha ho hlokahala ka potlako, ente ea jete e lumelloa metsotso e 'meli.

Bakeng sa tsamaiso ea methapo ea methapo, lithethefatsi li hlapolotsoe ka tharollo ea 0,9% ea sodium chloride kapa tharollo ea 5% e le hore mahloriso a ntho e sebetsang a se ke a feta 5 mg / ml.

Ho fokotsa tekanyetso kapa ho eketsa nako ea lipakeng tsa liente ho hlokahala ho bakuli ba nang le ts'ebetso ea mokokotlo ea renal.

Litla-morao tsa Amikacin

Ho latela liphuputso tsa bakuli ba sebelitseng kalafo ea Amikacin, sethethefatsi sena se ka ba le litlamorao tse kang:

• Ho phefumoloha, ho nyekeloa ke pelo, ho senyeha hoa tšebetso ea sebete,
• Leukopenia, thrombocytopenia, anemia, granulocytopenia,
• Ho otsela, ho opeloa ke hlooho, ho holofala hoa methapo ea pelo (ho fihlela ho ts'oara phefumoloho), nts'etsopele ea phello ea methapo (ho akheha, ho tsitsipana, ho sisinyeha ha mesifa, ho ruruha ha sethoathoa),
• Ho utloa tahlehelo, ho se utloe litsebeng, mathata a labyrinth le vestibular,
• Oliguria, micromaturia, proteinuria,
• Litla-morao: Matsoafo a letlalo, lekhopho, feberu, ho hlohlona, ​​edema ea Quincke.

Ntle le moo, ka ts'ebetso e kenelletseng ea Amikacin, ho latela litekolo, nts'etsopele ea phlebitis, dermatitis le periphlebitis, hammoho le maikutlo a bohloko sebakeng sa ente, a khonahala.

Litaelo tse khethehileng

Pele o sebelisa moriana, ho hlokahala ho tseba hore na likokoana-hloko tse khethiloeng ke eng ho eena.

Nakong ea kalafo le Amikacin, bonyane hang ka beke, ts'ebetso ea liphio, lisebelisoa tsa vestibular le nerve ea methapo e lokela ho hlahlojoa.

Amikacin ha e lumellane le li-vithamine tsa B le C, li-cephalosporins, penicillin, nitrofurantoin, potasiamo chloride, erythromycin, hydrochlorothiazide, capreomycin, heparin, amphotericin B.

Bakuli ba fumanang kalafo bakeng sa mafu a tšoaetsanoang le a tšoaetsanoang a ts'ebetso ea moroto ba hloka ho noa metsi a mangata (ho fanoe ka diuresis tse lekaneng).

Re lokela ho hopola hore ka ts'ebeliso ea nako e telele ea Amikacin, kholo ea likokoana-hloko tse loantšang li ka khonahala. Ka hona, ho sa sebetse matla a kliniki, ho bohlokoa ho hlakola sethethefatsi sena le ho etsa kalafo e loketseng.

Amikacin analogues

Amikacin e hlophisehileng ea sebopeho ke Amikacin-Ferein, Amikacin-Vial, Amikacin Sulfate, Amikin, Amikabol, Selemicin, Hemacin.

Ka ho ba sehlopheng se le seng sa lithethefatsi le ho tšoana ha methati ea ts'ebetso, litlhare tse latelang li ka nkuoa li tšoana le Amikacin: Bramitob, Gentamicin, Kanamycin, Neomycin, Sisomycin, Florimycin sulfate, jj.

Lipehelo le maemo a polokelo

Amikacin ke sehlopha sa lithibela-mafu sa sehlopha sa B se phatlalalitsoeng ho litlhare ka meriana. Bophelo ba Shelf ke lilemo tse 2 ho latela melao ea polokelo e khothalletsoang ke moetsi - mocheso 5-25 ºº, sebaka se omileng le se lefifi.

O fumane phoso mangolong? Khetha eona ebe o tobetsa Ctrl + Enter.

Fomati e lokollang

Tharollo bakeng sa tsamaiso ea methapo le methapo e pepeneneng, e sa mebala kapa e mebala hanyane.

Bahlomphehi: sodium disulfite (sodium metabisulfite), sodium citrate d / i (sodium citrate pentasesquihydrate), sulfuric acid e hlapolotsoe, metsi d / i.

2 ml - li-ampoules tsa khalase (5) - lipakete tsa blister (1) - liphutheloana tsa karete.
2 ml - li-ampoules tsa khalase (5) - lipakete tsa blister (2) - liphutheloana tsa karete.
2 ml - li-ampoules tsa khalase (10) - lipakete tsa blister (1) - liphutheloana tsa karete.
2 ml - li-ampoules tsa khalase (10) - mabokose a karete.

Tharollo bakeng sa tsamaiso ea methapo le methapo e pepeneneng, e sa mebala kapa e mebala hanyane.

Bahlomphehi: sodium disulfite (sodium metabisulfite), sodium citrate d / i (sodium citrate pentasesquihydrate), sulfuric acid e hlapolotsoe, metsi d / i.

4 di ml - li-ampoules tsa khalase (5) - lipakete tsa blister (1) - liphutheloana tsa karete.
4 di ml - li-ampoules tsa khalase (5) - lipakete tsa blister (2) - liphutheloana tsa karete.
Li-4 ml - li-ampoules tsa khalase (10) - lipakete tsa blister (1) - liphutheloana tsa karete.
4 ml - li-ampoules tsa khalase (10) - mabokose a karete.

Phofo bakeng sa ho hlophisoa ha tharollo bakeng sa taolo ea methapo le methapo ea 'mala o mosoeu kapa o batlang o le tšoeu ke hygroscopic.

Mabotlolo a nang le boholo ba 10 ml (1) - lipakete tsa karete.
Mabotlolo a nang le boholo ba 10 ml (5) - lipakete tsa karete.
Mabotlolo a nang le boholo ba 10 ml (10) - lipakete tsa karete.

Polelo ea lihlopha tsa nosological

Litheko makaleng a litlama a litsobotsi tsa meriana Moscow

Tlohela maikutlo a hau

Lenaneo la Hona Joale la Lintlha

Lithethefatsi tse Ngotsoeng tsa Bohlokoa le Tse Hlokahalang

Setifikeiti sa ho ngolisa sa Amikacin

• P N001175 / 01

• LP-003317

• LP-004398

• LP-003391

• LSR-002156/09

• LSR-002348/08

• LS-000772

• LSR-006572/09

• P N003221 / 01

• S-8-242 N008784

• S-8-242 N008266

Webosaete ea semmuso ea k'hamphani RLS ®. Encyclopedia ea mantlha ea lithethefatsi le thepa ea bongaka ea semmuso ea Marang-rang ea Russia. Lenane la lithethefatsi Rlsnet.ru le fa basebelisi monyetla oa ho fumana litaelo, litheko le litlhaloso tsa lithethefatsi, tlatsetso ea lijo, lisebelisoa tsa bongaka, lisebelisoa tsa bongaka le lihlahisoa tse ling. Tataiso ea meriana e kenyelletsa tlhahisoleseling mabapi le sebopeho le mofuta oa tokollo, ts'ebetso ea meriana Sesebelisoa sa lithethefatsi se na le litheko tsa meriana le lihlahisoa tsa meriana ho la Moscow le metseng e meng ea Russia.

Ho thibetsoe ho fetisa, ho kopitsa, ho tsamaisa tlhahisoleseling ntle le tumello ea RLS-Patent LLC.
Ha u qotsa lisebelisoa tsa tlhahisoleseling tse phatlalalitsoeng maqepheng a sebaka sa marang-rang sa www.rlsnet.ru, ho hokela mohloli oa mohloli oa tlhaiso-leseling.

Lintho tse ling tse ngata tse khahlang

Litokelo tsohle li sirelelitsoe.

Ts'ebeliso ea thepa ea khoebo ha e lumelloe.

Tlhahisoleseling ena e etselitsoe litsebi tsa bongaka.

Mali

Mofumahali

Kamora ho tsamaiso ea intramuscular (IM), e kenella ka potlako le ka botlalo. Khatiso e kholo (Cmax) e tsamaisang i / m ka tekanyetso ea 7.5 mg / kg ke 21 μg / ml. Nako ea ho fihlela mahloriso a phahameng (TCmax) e batla e le lihora tse 1.5 kamora taolo ea i / m. Puisano le liprotheine tsa plasma - 4-11%.

E ajoa hantle ka mokelikeli oa extracellular fluid (litaba tsa li-abscesses, pleural effusion, ascitic, pericardial, synovial, lymphatic le peritoneal fluid), e fumaneha maemong a phahameng a moroto, ka tlase - ka bile, lebese la matsoele, metlae e meholo ea leihlo, sephiri sa mokokotlo, lesapo la mokokotlo le lesapo la mokokotlo mokelikeli (CSF). E kenella hantle linthong tsohle tsa 'mele moo e bokellanang ka bongata, ho tsepamisoa likelellong tse ngata tse nang le phepelo e ntle ea mali: mats'oafo, sebete, myocardium, spleen, mme haholo-holo lipong, moo e bokellanang mokokotlong oa cortical, likhahla tse tlase - mesifa, adipose tishu le masapo .

Ha ho fanoa ka litlolo tse tloaelehileng tsa kalafo e tloaelehileng (e tloaelehileng) ho batho ba baholo, amikacin ha e kenelle mothong oa mali (BBB), ka ho ruruha ha methapo ea maoto, boemo bo eketseha hanyane. Ho masea a sa tsoa tsoaloa, ho tsepamisa mohopolo ka holimo ho CSF ​​hoa atleha ho feta ho batho ba baholo, ho feta ka placenta - e fumanoa maling a fetus le amniotic fluid. Bophahamo ba thomello ho batho ba baholo - 0,26 l / kg, ho bana - 0,2 - 0,4 l / kg, ho masea a sa tsoa hlaha - a le ka tlase ho beke e le 'ngoe. le boima ba 'mele bo ka tlase ho 1.5 kg - ho fihla ho 0,68 l / kg, ea lilemo tse ka tlase ho beke e le' ngoe. le boima ba 'mele ho feta 1.5 kg - ho fihlela ho 0.58 l / kg, ho bakuli ba nang le cystic fibrosis - 0.3 - 0.39 l / kg. Karolelano ea kalafo e tloaelehileng e nang le methapo kapa tsamaiso ea methapo ea kutlo e bolokoa lihora tse 12-25.

Ha e sebelisoe. Nako ea halofo ea bophelo (T1 / 2) ho batho ba baholo ke lihora tse 2 ho isa ho tse 4, ho masea a sa tsoa tsoaloa ke lihora tse 5 ho isa ho tse 8, ho bana ba baholo ke lihora tse 2,5 ho isa ho tse 4. T1 / 2 ea ho qetela ke lihora tse fetang 100 (tokollo ho tsoa lithepeng tse ka hare ho naha )

E hloekisoa ke liphio ka ho hlohlona ha glomerular (65 - 94%), haholo e sa fetoheng. Tlhophiso ea Renal - 79-100 ml / min.

T1 / 2 ho batho ba baholo ba nang le ts'ebetso ea ho ruruha e sa sebetseng e fapana ho latela tekanyo ea ho senyeha - ho fihlela lihora tse 100, ho bakuli ba nang le cystic fibrosis - lihora tse 1 - 2, ho bakuli ba nang le ho otsela le hyperthermia, T1 / 2 e ka ba khuts'oane ho feta karolelano ka lebaka la clearance e eketsehang .

E pepisoa nakong ea haemodialysis (50% ho lihora tse 4 - 6), peraloneal dialysis ha e sebetse hantle (25% ho lihora tse 48 ho isa ho tse 72).

Mofumahali

Semi-synthetic e pharaletseng e bonts'ang likokoana-hloko ka mosebetsi oa bactericidal.Ka ho tlamahana ho subunit ea 30S ea li-ribosomes, e thibela ho theoa ha moralo oa lipalangwang le morumuoa RNA, e thibela synthetiki, hape e senya lera la "bacteria" la cytoplasmic.

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 tse hananang le penicillin, li-cephalosporin tse ling), e sebetsang ka mokhoa o 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.

Ho sebelisana le lithethefatsi

Ha e lumellane le meriana le penicillin, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, livithamini B le C, le chloride ea potasiamo.

E bonts'a synergism ha e sebelisana le carbenicillin, benzylpenicillin, cephalosporins (ho bakuli ba nang le ho hloleha ho sa feleng ha renal, ha e kopantsoe le lithibela-mafu tsa beta-lactam, ts'ebetso ea aminoglycosides e kanna ea fokotseha). Nilidiotic acid, polymyxin B, cisplatin le vancomycin li eketsa kotsi ea oto- le nephrotoxicity.

Diuretics (haholo-holo furosemide, ethaconic acid), cephalosporins, penicillin, sulfonamides le lithethefatsi tse seng khahlanong le 'mele tse thibelang mafu, tse hlolisang secretion e sebetsang ka har'a li-nephron tubules, li thibela ho felisoa ha li-aminoglycosides le ho eketsa ho tsitsisa ha tsona ka serum ea mali, li eketsa nephro- le neurotoxicity.

Ts'ebeliso e tšoanang le lithethefatsi tse ling tse ka 'nang tsa nephrotoxic kapa ototoxic ha e khothalletsoe ka lebaka la kotsi e ka bang teng ea litlamorao.

Keketseho ea nephrotoxicity e tlalehiloe ka mor'a taolo e tšoanang ea botsoali ea aminoglycosides le cephalosporins. Ts'ebeliso e lekanang ea cephalosporins e kanna ea eketsa bohata ka serum.

E ntlafatsa phello ea mesifa e khathollang ea lithethefatsi tsa curariform.

Methoxyflurane, polymyxins ea motsoali, capreomycin, le lithethefatsi tse ling tse thibelang phetisetso ea methapo (li-hydrocarbons tsa halogenated e le inhalation anesthetics, analgesics ea opioid), le tšelo e ngata ea tšelo ea mali ka li-preservices tsa citrate li eketsa kotsi ea ho tšoaroa ka phepo.

Tsamaiso ea botsoali ea indomethacin e eketsa kotsi ea litlamorao tsa chefo ea aminoglycosides (keketseho ea halofo ea bophelo le tumello e fokotsehile).

Fokotsa phello ea lithethefatsi tse khahlanong le myasthenic.

Ho na le menyetla e eketsehileng ea hypocalcemia le tsamaiso ea tšebelisano ea aminoglycosides e nang le bisphosphonates. Kotsi e eketsehileng ea nephrotoxicity mme mohlomong ototoxicity e ka etsahala ka tsamaiso e kopaneng ea aminoglycosides ka litokisetso tsa platinamu.

Ka tsamaiso e le 'ngoe ea thiamine (vithamine B1), motsoako o sebetsang oa sodium bisulfite motsoako oa amikacin sulfate o ka senngoa.

Fomu ea ho lokolla le ho paka

500 mg ea ntho e sebetsang ka libotong tse tiisitsoeng ka mokhoa o tiisitsoeng ka lisiti tsa rabara, e halikiloeng ka likhalase tsa aluminium le likepisi tse kenngoeng tsa "FLIPP OFF".

Letlapa le entsoeng ka pampiri ea ho ngola kapa ho ngola le tlatselletsoa botlolong e 'ngoe le e' ngoe, kapa ho kenngoa lengolo la boikemelo.

Botoro ka leng, hammoho le litaelo tse lumelletsoeng tsa tšebeliso ea bongaka maemong a mmuso le a Serussia, li beoa ka har'a pakete ea karete.

Matšoao a lithethefatsi Amikacin

Mafu a tšoaetsanoang le a tšoaetsanoang a bakoang ke likokoana-hloko tse mpe tsa gram (tse hananang le gramicin, sisomycin le kanamycin) kapa mekhatlo ea likokoana-hloko tse ntle tsa gram le gram-negative:

• ts'oaetso ea pampiri ea phefumoloho (bronchitis, pneumonia, empallyma ea pleural, lesapo la matšoafo),
• sepsis
• septic endocarditis,
• Tšoaetso ea CNS (ho kenyeletsa le meningitis),
• tšoaetso ea litho tsa ka mpeng (ho kenyeletsa le peritonitis),
• ts'oaetso ea pampitšana ea urinary (pyelonephritis, cystitis, urethritis),
• tšoaetso ea letlalo la lets'oaetso la letlalo le linama tse bonolo (ho kenyeletsa le ho chesoa ke tšoaetso, ulcers le tšoaetso le liso tsa khatello ea methapo e fapaneng)
• tšoaetso ea phepelo ea methapo
• ts'oaetso ea masapo le manonyeletso (ho kenyeletsa osteomyelitis),
• ts'oaetso ea leqeba
• ts'oaetso ea postoperative.

Melemo ea litekanyetso

Moriana o fanoa ka methapo, kahare (kahare, bakeng sa metsotso e 2 kapa ho ts'oaroa) ho batho ba baholo le bana ba kaholimo ho lilemo tse 6 - 5 mg / kg nako le nako ka lihora tse 8 kapa 7.5 mg / kg ka mor'a lihora tse 12. uncomplex) - 250 mg ka mor'a lihora tse ling le tse ling tse 12, kamora seboka sa hemodialysis, ho ka fanoa ka tekanyetso e eketsehileng ea 3-5 mg / kg.

Tekanyetso e kholo ho batho ba baholo ke 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 hlahileng pele ho nako, tekanyo ea pele e le 'ngoe ke 10 mg / kg, joale 7.5 mg / kg nako le nako ka lihora tse 18-24, bakeng sa masea a sa tsoa tsoaloa le bana ba ka tlase ho lilemo tse 6, tekanyetso ea pele ke 10 mg / kg, ebe 7.5 mg / kg ka mong le e mong 12 h bakeng sa matsatsi a 7-10.

Ha ho chesoa ke ts'oaetso, lethal dose ea 5-7,5 mg / kg ka mor'a lihora tse 'ne le tse ling e ka hlokahala ka lebaka la bokhutšoanyane ba T 1/2 (lihora tse 1-1,5) sehlopheng sena sa bakuli.

In / in amikacin e tsamaisoa ka mokhoa o tlohang metsotso e 30-60, haeba ho hlokahala, ka jete.

Bakeng sa tsamaiso ea iv (drip), moriana o tlotsoa pele le 200 ml ea tharollo ea glucose ea 5% kapa tharollo ea 0,9% sodium chloride. Ts'ebetso ea amikacin tharollong ea tsamaiso ea iv ha ea lokela ho feta 5 mg / ml.

Ha ho sebetsoa ka mokhoa o sa sebetseng oa renal, ho fokotsa tekanyetso kapa ho eketseha ha nako le nako lipakeng tsa tsamaiso. Tabeng ea keketseho ea karohano lipakeng tsa tsamaiso (haeba boleng ba QC bo sa tsejoe, le boemo ba mokuli bo tsitsitse), nako ea lipakeng tsa taolo ea lithethefatsi e thehiloe ka foromo e latelang:

karohano (h) = serum creatinine mahloriso x 9.

Haeba khatello ea serum creatinine e le 2 mg / dl, joale lethal dose e le 'ngoe e khothalletsoang (7.5 mg / kg) e tlameha ho fanoa ka mor'a lihora tse ling le tse ling tse 18. Ka keketseho ea nako, tekanyetso e le' ngoe ha e fetoloe.

Ketsahalong ea ho fokotseha ha tekanyetso e le 'ngoe le mofuta o sa fetoheng oa dosing, tekanyetso ea pele bakeng sa bakuli ba nang le bothata ba ho phekoloa ke methapo ke 7.5 mg / kg. Khokahanyo ea litekanyetso tse latelang e etsoa ho latela foromo e latelang:

Pilisi e latelang (mg), e fanoang ka mor'a lihora tse ling le tse ling tse 12 = KK (ml / min) ho mokuli × lethal dose la pele (mg) / KK ke ntho e tloaelehileng (ml / min).

Litla-morao

Ho tsoa ho tsamaiso ea tšilo ea lijo: ho nyekeloa ke pelo, ho hlatsa, ts'ebetso ea seteraeke (mosebetsi o eketsehileng oa hepatic transaminases, hyperbilirubinemia).

Ho tsoa ho tsamaiso ea hemopoietic: anemia, leukopenia, granulocytopenia, thrombocytopenia.

Ho tloha lehlakoreng la ts'ebetso ea methapo e bohareng le tsamaiso ea methapo ea methapo: ho opeloa ke hlooho, ho otsela, mokokotlo oa mokokotlo (ho sisinyeha ha mesifa, ho tsitsipana, ho ruruha, ho ruruha ha sethoathoa), ho senyeha ha methapo ea methapo (ho ts'oara ho phefumoloha).

Ho tsoa ho litho tsa kutlo: ho utloa bohloko: ho se utloe hantle litsebeng, ho se utloe hantle litsebeng le ho se utloe hantle litsebeng, litla-morao tse nang le ts'ebeliso ea lisebelisoa tse mpe (ho khetholla ho sisinyeha, ho tsekela, ho nyekeloa, ho hlatsa).

Ho tsoa ts'ebetsong ea moroto: nephrotooticity - ts'ebetso ea mokokotlo oa mokokotlo (oliguria, proteinuria, micromaturia).

Boitlhotlhollo: Ho ruruha ha letlalo, ho hlohlona, ​​ho fifala ha letlalo, feberu, edema ea Quincke.

Boitšoaro ba lehae: bohloko sebakeng sa ente, dermatitis, phlebitis le periphlebitis (ka tsamaiso ea iv).

Bokhachane le pelehi

Moriana o kopantsoe le ho ima.

Boteng ba lipontšo tse bohlokoa, moriana o ka sebelisoa ho lactating basali. Re lokela ho hopola hore li-aminoglycosides li pepesoa lebese la matsoele ka bongata bo fokolang. Ha li kenngoe hantle ka mpeng ea gastrointestinal, mme mathata a amanang le ona ho masea ha a ngolisoa.

Ho sebelisana le lithethefatsi

E bonts'a synergism ha e sebelisana le carbenicillin, benzylpenicillin, cephalosporins (ho bakuli ba nang le ho hloleha ho sa feleng ha renal, ha e kopantsoe le lithibela-mafu tsa beta-lactam, ts'ebetso ea aminoglycosides e kanna ea fokotseha).

Nilidiotic acid, polymyxin B, cisplatin le vancomycin li eketsa kotsi ea oto- le nephrotoxicity.

Diuretics (haholo-holo furosemide), cephalosporins, penicillin, sulfanilamides le NSAIDs, tse hlolisang secretion e sebetsang ka har'a li-tubules tsa nephron, li thibela ho felisoa ha aminoglycosides, li eketsa khatello ea tsona setsing sa mali, li eketsa nephro- le neurotoxicity.

Amikacin e ntlafatsa matla a ho phomola ha mesifa ea lithethefatsi tsa curariform.

Ha e sebelisoa le amikacin, methoxyflurane, polymyxins ea motsoali, capreomycin le lithethefatsi tse ling tse thibelang phetisetso ea li-neuromuscular (halogenated hydrocarbons - inhalation anesthesia, opioid analgesics), ho tšeloa mali ka bongata le litlhare tsa cucrate ho eketsa kotsi ea ho tšoaroa ka phefumoloho.

Tsamaiso ea botsoali ea indomethacin e eketsa kotsi ea litlamorao tsa chefo ea aminoglycosides (keketseho ea T 1/2 le ho fokotseha ha tumello).

Amikacin e fokotsa katleho ea lithethefatsi tse khahlanong le myasthenic.

Ha e lumellane le meriana le penicillin, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, livithamini B le C, le chloride ea potasiamo.