Aminoglycosides: lithethefatsi (lethathamo lebitso, tlhophiso, kopo litaelo)

Ponahalo ka 'maraka diokobatsi ea lithibela-mafu tse ncha le mefuta e fapaneng mefuta e sa litla, tse kang fluoroquinolones, cephalosporins, ho entse hore' nete ea hore lingaka li qala ho laela aminoglycosides seoelo (lithethefatsi). Lenane la meriana kenyelelitsoe sehlopha sena ke a pharaletseng a haholo 'me e akarelletsa lithethefatsi tse joalo tsebahalang e le "penicillin e", "Gentamycin", "Amikacin." Ho fihlela kajeno, ka tlhokomelo e matla le ho mafapha a buoa ea lithethefatsi ka ho fetisisa ratoa ke hantle aminoglycoside letoto lena.

Tlhaloso e Khutšoanyane ea sehlopha

Aminoglycosides - lithethefatsi (meriana lethathamo tšohloa ka tlase), tse ling tse ho feta ka hlahang ho yona seka-maiketsetso kapa likoluoa tsa tlhaho. This sehlopha ea lithibela-mafu e na le ka potlako 'me matla bactericidal ama' mele.

Meriana Phoofolo ho mefuta e fapaneng mefuta e sa liketso. mosebetsi oa tsona oa loantsang likokoana bitsoa khahlanong le libaktheria mob mobile-mpe, empa e haholo tsa fokotswa ho loantša microorganisms a mob mobile ea HIV. Le aminoglycosides feletseng thuso khahlanong anaerobes.

Sehlopha sena sa ho sebelisa lithethefatsi hlahisa o babatsehang bactericidal e le hantle matla a ho irreversibly thibela metsoako protheine tswakana ka microorganisms habonolo ka phahameng ka ho ribosome. Meriana ba mafolofolo ka bobeli le ho ikatisa le lisele tse ka boemo quiescent. boholo ba mosebetsi lithibela-mafu ke e itšetlehileng ka ho feletseng ka mahloriso bona ka serum mali a mokuli.

aminoglycoside sebelisoa kajeno lekana e lekanyelitsoe. Sena ke ka ntlha ya go ho toxicity phahameng tsa meriana ena. Hangata ka ho fetisisa utloa bohloko ho tswa ho lithethefatsi a liphio le ho makala utloa.

Ntho ea bohlokoa e lisebelisoa tsena ke ho hloleha ea ho kenella ka hare ho ea kena liseleng tse phelang. Kahoo, aminoglycosides ho feletseng matla a ho loantša libaktheria intracellular.

Le melemo le mathata

lithibela-mafu tsena li sebelisoa hohle joalokaha ho boletsoe ka holimo, ho ka go ikatisetsa ho buoa. 'Me e ke ha ho makatse. Lingaka li hatisa menyetla ngata ena ke aminoglycosides.

The lithethefatsi ka 'mele ke fapaneng linako le joalo o positive:

• phahameng antibacterial mosebetsi;
• sieo ha bohloko itšoara joang (bakeng sa tsamaiso ente);
• seoelo ketsahalo e sa kulisoa;
• matla a ho timetsa libaktheria ikatisa;
• ntlafatsoa e le hantle phekolo hammoho le lithibela-mafu beta-lactam;
• mosebetsi phahameng ho loantša tšoaetso ea kotsi.

Leha ho le joalo, hammoho le menyetla e hlalositsoeng ka holimo, sehlopha sena sa medicaments le nang le go tlhoka mesola.

Moseho ke aminoglycosides:

• mosebetsi tlaase ea lithethefatsi ka ho ba sieo ha oksijene kapa ka mahareng asiti;
• empa mafutsana ho kenella ka hare tsa ntho mantlha 'meleng mokelikeli (bile, lesapo la mokokotlo mokelikeli, sekhohlela);
• ponahalo ea ka plurality tsa ditlamorao.

tlhophiso ea meriana

Ho na le classifications 'maloa.

Mohlala, ba fuoa tatelano ya selelekela sebelisa bongaka aminoglycosides, ke moloko tse latelang:

1. Lithethefatsi pele sebelisoa ho loantša mafu a tšoaetsanoang ba ne ba "streptomycin", "monomitsin", "neomycin", "Kanamycin", "Paromomycin."
2. Ho moloko oa bobeli ke aminoglycosides mocha (lithethefatsi). List lithethefatsi "Gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. sehlopha sena se akarelletsa ho sebelisa lithethefatsi seka-a maiketsetso a kang "Amikacin", "Izepamitsin".

Ka manyenyane ea nkang khato le ho hlaha ha ho hanyetsa go arologana aminoglycosides fapaneng hanyenyane.

Molokong o mong ka meriana ke tse latelang:

1. Ho 1 sehlopha se akarelletsa lithethefatsi tse joalo "streptomycin", "Kanamycin", "monomitsin", "neomycin". lithethefatsi tsena li ka etsa hore ho ka khoneha ho loantša likokoana-hloko le TB, 'me libaktheria tse ling li atypical. Leha ho le joalo, khahlanong le mefuta e fapaneng ya libaktheria mob mobile-mpe le staphylococci, ba se nang matla a.

2. Ea bobeli-molokong o mong ka aminoglycoside - moriana ona "gentamicin." E khetholloa ke mosebetsi moholo antibacterial.

3. Ntlafetseng meriana. Ba na le phahameng mosebetsi antibacterial. Sebelisoa khahlanong klebisielly, enterobacteria, Pseudomonas aeruginosa ke boraro-molokong o mong ka aminoglycosides (lithethefatsi). Lethathamo la lithethefatsi e tjena:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. lithethefatsi "Izepamitsin" le bolela sehlopha se bone. E khetholloa ka matla a ho tsela e atlehang haholo sebetsana le tsitobakterom, aeromonasom, nokardiyami.

Ikatisetsa tsa bongaka, o ile tlhophiso e 'ngoe. E thehiloe tabeng ea ho sebelisa lithethefatsi ho itšetlehile ka litleliniki le lefu, mofuta wa tshwaetso, hammoho le ho sebelisa mokhoa oo.

Jwalo tlhophiso ea aminoglycosides tjena:

1. Lithethefatsi bakeng sa systemic kgahlamelo ya maqhubu a tsamaisoa parenterally (by ente). Bakeng sa ho phekoloa mafu a tsoaetsanang suppurative baktheria etsahalang haholo halefisoa ke microorganisms monyetla anaerobic, ho laela meriana e joalo, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Phekolo ea monoinfections kotsi, tse thehiloeng likokoana-hloko tlama tsela e nepahetseng ha kenyelletsoa ka phekolo "streptomycin" litokisetso "Gentomitsin". Ha mycobacteriosis haholo thuso lithethefatsi "Amikacin," "streptomycin", "Kanamycin".
2. Lithethefatsi tse sebelisoang lekgotleng feela ho bonahala ka ho khetheha. Tsena ke: "Paromitsin", "neomycin", "monomitsin".
3. Meriana bakeng sa kopo ea lihlooho tsa puisano. Ba sebelisoa bakeng sa ho phekoloa mafu a tsoaetsanang purulent baktheria ka otorhinolaryngology le ophthalmology. Bakeng sa ho pepesehela ea moo ho lithethefatsi pele "Gentamicin," "framycetin", "neomycin", "Tobramycin".

bontšang bakeng sa

Tshebediso ya aminoglycosides e expedient ho timetsa tse sa tšoaneng aerobiki likokoana-hloko a mob mobile-negative. Medicaments e ka sebediswa e le monotherapy. Hangata ba ba ho kopantswe le beta-lactams.

Aminoglycosides e bontšoa bakeng sa kalafo ya:

• tsoaetsanang nosocomial ya selegae le tse fapa-fapaneng;
• purulent postoperative mathata;
• tsoaetsanang intra-ka mpeng;
• sepsis;
• infective endocarditis ;
• pyelonephritis etsahalang ka mefuta e matla;
• chesa nang le tšoaetso;
• baktheria purulent meningitis;
• lefuba;
• mafu a kotsi a tšoaetsanoang (seoa, brucellosis, tularemia);
• maswe ramatiki halefisoa ke libaktheria mob mobile-mpe;
• mosese pampitšana tšoaetso ea;
• mafu a mahlo: blepharitis, baktheria keratitis, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• mafu Ent: nattokinase externa, rhinopharyngitis, rhinitis, sinusitis;
• tsoaetsanang protozoal.

litla-morao

Ka bomalimabe, nakong ea kalafo ea sehlopha sena sa lithethefatsi mokuli ka ikutloa kaofela letoto la litla boima. The drawback ka sehloohong ea meriana - e haholo nang le chefo e. Ke ka lebaka leo feela ngaka lokela ho laela ea aminoglycosides mamello.

Le litla-morao le ka etsahala:

1. Ototoxicity. Bakuli ba tletleba ba utloa ba tahlehelo, lerata ringing. Hangata ba bontša obstruction litsebe. Boholo ba liphetoho tsena li etsahala ka batho ba hōlileng, ka ho batho ba qalong ba nang le utloa kholofalo. itšoare joalo etsahala bakuli ba nako e telele phekolo kapa tekanyetso e phahameng.
2. Nephrotoxicity. Mokuli bonahala lenyora, fapana ka tjhelete e ya moroto (ka bobeli keketseho e le fokotseha), e ile ea eketseha creatinine boemo ba maling, fokotswa glomerular karaoke set. matšoao ao a tloaelehileng tsa batho ba nang le mafu a ea mosebetsi liphio.
3. Neuromuscular thibela likepe. Ka linako tse ling nakong ea phekolo thibang respiration. Maemong a mang ho na le shoele litho tsa mesifa matšoafo. Ka tloaelo ho, liphetoho tse joalo li khethollang ho bakuli ba mafu a methapo ea kutlo kapa litsebeng liphio mosebetsi.
4. mafu a skeletal. Ba bontša tlōla tšebelisano, ho tsekela. hangata haholo, liphello tsena lehlakoreng etsahala'ng ha "streptomycin" kgethwa ha lithethefatsi ho mokuli.
5. mafu a methapo ea kutlo. A ka hlaha paresthesia, magazine. phekolo ka linako tse ling e tsamaea le lethopa tsa methapo ea kutlo optic.

Aminoglycosides seoelo bakela kulisa kang letlalo lekhopho.

Contraindications

O ile a hlalosa meriana na likhaello tse itseng ho sebelisoa. aminoglycosides Hangata ka ho fetisisa contraindicated (mabitso a tse fanoeng ka holimo) ka pathologies joalo kapa maemo a:

• motho hypersensitivity;
• tlōlo ea mosebetsi renal excretory;
• utloa mafu a;
• ntshetsopeleng a itšoare neutropenic haholo;
• mafu a skeletal;
• myasthenia gravis, botulism, Parkinsonism;
• ho hema ho tepella maikutlo, stupor.

Ho phaella moo, u se ke ua li sebelisa bakeng sa kalafo haeba mokuli o ne a histori ea kamoo ba ileng mpe ho lithethefatsi efe kapa efe ho tswa ho sehlopha sena.

Nahana ka aminoglycosides ratoang ka ho fetisisa.

"Amikacin"

moriana o tšoauoa ka e lebisitsoeng bacteriostatic, bactericidal le-ba khahlanong le litla ka 'mele oa motho. O bontša mosebetsi phahameng khahlanong le libaktheria tse ngata a mob mobile ea HIV le a mob mobile-negative. Kahoo, ho tiisa hore ho lithethefatsi "Amikacin" taeo pukwanana. Liente tse atleha ho phekola staphylococcus, streptococcus, nyumonia, salmonella, Escherichia coli, Mycobacterium lefuba.

moriana ke sa khone ho ho ikakhela ka setotsoana ka pampitšana ea gastrointestinal. Ka hona feela laolwa entoe kapa intramuscularly. Ea mahloriso phahameng ka ho fetisisa ya ntho mafolofolo nakong e hlokometse ka serum ka mor'a 1 lebelo. Positive, phekolo e le hantle nka lihora tse 10-12. Ka lebaka la thepa ena ea liente li phethile habeli ka letsatsi.

Ha e re khothalletsa hore tšebeliso ea lithethefatsi "Amikacin" litaelo bakeng sa ho sebelisoa? Liente ho bontšoa hore ho kgethwa ha maloetse a latelang:

• serame sa matšoafo, la bronchitis, matšoafo abscess;
• mafu a tšoaetsanoang a peritoneum (peritonitis, pancreatitis, cholecystitis);
• lefu pampitšana mosese (cystitis, urethritis, pyelonephritis);
• mafu a letlalo (diso ulcerative, chesa, liso tsa ka maleng khatello, maqeba a nang le tšoaetso) ;
• osteomyelitis;
• meningitis, sepsis;
• TB tshwaetso.

Hangata, ke sesebelisoa sena e sebediswa ka mathata a ka halefisoa ke ho buoa.

O ile a lumella tšebeliso ea lithethefatsi ka ka go ikatisetsa kokelo ea bana. Ha e le hantle ena e tiisoa ho lithethefatsi "Amikacin" taeo pukwanana. Bakeng sa bana ho tloha matsatsing a pele a ea bophelo, lithethefatsi ena ka tsamaisoa.

Dosages ba ikemiselitse feela ke ngaka ho itšetlehile ka lilemo tsa ho ba le mamello e le boima ba 'mele oa hae.

Thupelo ea neha likhothaletso tse latelang:

1. 1 kg tsa boima ba 'mele le mamello (bobeli batho ba baholo le ngoana) lokela ho a oa ka 5 mg, ea moriana. Ka morero ona beha ka a pheta ente lihora tse 8.
2. Haeba ka 1 lik'hilograma boima ba 'mele, 7,5 mg, ea moriana o ba isoa, e karohano pakeng tsa liente ne lihora tse 12.
3. Hlokomela kamoo e khothalletsa neonatal lithethefatsi "Amikacin" taeo pukwanana. Bakeng sa bana, ba sa tsoa tsoaloa, litekanyetso li behoa e balwa ka tsela e latelang: 1 lik'hilograma - 7,5 mg,. Tabeng ena e karohano pakeng tsa liente - lihora tse 18.
4. Nako ea phekolo e ka ba matsatsi a 7 (ka / input) kapa matsatsi a 7-10 (le / th, liente).

"Netilmicin"

The moriana e le hantle lona loantsang likokoana tšoanang le "amikacin". Ka tsela eo ho na le Maemong a moo "Netilmicin" feela phahameng bohlokwa ba tsamaiso khahlanong le ba dikokwanyana eo moriana ka holimo e ne e ha ho letho le.

Lithethefatsi na le Molemo bohlokoa ha a bapisoa le aminoglycosides tse ling. Joalokaha ho bontšitsoe ka lithethefatsi "Netilmicin" litaelo bakeng sa ho sebelisoa, e leng sethethefatsi se na le nephrotoxicity tlaase le ototoksichnostyu. moriana o le e reretsoe feela bakeng sa tshebediso ya parenteral.

"Netilmicin" litaelo bakeng sa ho sebelisoa ba khothalletsoa hore ba thonya:

• le septicemia, bacteremia,
• bakeng sa kalafo ya tshwaetso nkuwe a se halefisoa ke likokoana-hloko a mob mobile-mpe;
• tsoaetsanang ea tsamaiso ea ho hema, ho urogenital pampitšana, letlalo, ligaments, osteomyelitis;
• Neonatal staphylococcal tabeng ea tšoaetso ea e le tse tebileng (sepsis kapa serame sa matšoafo);
• ka leqeba leo a, 'me mafu a tsoaetsanang preoperative intraperitoneal;
• tabeng ea kotsi ea mathata postoperative bakuli buoa;
• mafu a tšoaetsanoang tsa pampitšana gastrointestinal.

The litekanyetso li behoa kgothaletswa ikemiselitse feela ke ngaka. E ka 'na ho tloha 4 ho ea ho 7,5, mg. Ho itšetlehile ka litekanyetso li behoa ea, mokuli le lilemo tsa hae motšehare buelloa 1-2 ente.

"Penicillin e"

meriana ena ke e 'ngoe ea bohlokoa ka ho fetisisa sehlopha sa ea lithibela-mafu. Ho na le mosebetsi o khahlanong le mefuta e fapaneng ya microorganisms.

Ela hloko "penicillin e":

• streptococci;
• gonococci;
• meningitis;
• pneumococci;
• metso o mosoeu, koatsi, ha mesifa ea mehlahare, khase seso se kekang;
• mefuta e itseng ea staphylococcus, Proteus.

Lingaka li hlokometse sephetho atlehang ka ho fetisisa 'mele ke input intramuscular. Ka liente joalo mor'a metsotso 30-60 lebetsoeng le hlokometse mali mahloriso lithethefatsi "penicillin e".

Aminoglycosides penicillin e khethiloeng ka Maemong a latelang:

1. ya data meriana phahameng tlhokeho ea ho phekola ba sepsis. Ba ba kgothaletswa bakeng sa ho phekoloa, meningococcal tsoaetsanang gonococcal, pneumococcal.
2. Lithethefatsi "penicillin e" o abetsoe ho bakuli ba ntse mekgwatshebetso ya ho buoa e le hore ho thibela mathata.
3. Sesebelisoa thusa lwantsha purulent meningitis, boko abscess, qhoshola, sycosis, mokaola. E kgothaletswa ho chesa haholo 'me maqeba a.
4. Therapy "penicillin e" lithethefatsi laetsoeng ho bakuli ba nang le ho ruruha ea tsebe, ho leihlo.
5. Sebelisoa moriana bakeng sa kalafo ya tsepamiso le lobar serame sa matšoafo, cholangitis, cholecystitis, maswe endocarditis.
6. Batho ba nang le rheumatism, meriana e beuweng bakeng sa kalafo le thibelo.
7. moriana e sebediswa bakeng sa masea le masea, ea ileng a fumanoa e sepsis lelana, kapa maswe pyosepticemia lefu nang le chefo e.
8. Lithethefatsi e ne e akarelletsa ho phekola ba maloetse latelang: nattokinase, feberu sekareleta, metso o mosoeu, purulent pleuritis.

Ke tsamaiso intramuscular a moriana o le mafolo-folo motsoako o ka potlako kena maling. Empa ka mor'a ho lihora tse 3-4 tsa lithethefatsi 'meleng e ha e sa a hlokomela. Ke ka lebaka leo, ho etsa bonnete ba tsa mahloriso ho hlokahala, e kgothaletswa ho pheta liente mong le e mong lihora tse 3-4.

Lithethefatsi "Gentamicin"

E ya hlahiswa ka mokgwa wa mafura, tharollo bakeng sa ente, 'me matlapa a. Lithethefatsi o na le makgetha a ho bactericidal. E fana ka ba le phello e senyang tse ngata a mob mobile-mpe libaktheria, Proteus, Campylobacter, Escherichia, Staphylococcus, Salmonella, Klebsiella.

Ho lokisetsa "Gentamycin" (matlapa kapa tharollo) kena 'mele timetsa mahlahana a tšoaetsanoang ka boemo ba ka lisele. Joaloka aminoglycoside efe kapa efe, ho fana ka khahlanong le protheine tswakana likokoana-hloko. Ka lebaka la libaktheria joalo lahleheloa ke matla a ho ikatisa ka ho eketsehileng 'me a ke ke a aba ho pholletsa le' mele.

Lithibela-mafu bakeng sa mafu a tšoaetsanoang amang tsamaiso ea tse fapa-fapaneng le ho makala:

• meningitis;
• peritonitis;
• prostatitis;
• qhoshola;
• osteomyelitis;
• cystitis;
• pyelonephritis;
• endometritis;
• empyema;
• la bronchitis, serame sa matšoafo;

Lithethefatsi "Gentamicin" tlhokeho lekaneng ka moriana. E lumella bakuli ho folisa ho tloha tšoaetso ea e tebileng ea lipampitšana matšoafo le mosese. sesebelisoa sena buelloa ka dithulaganyo tšoaetsanoang, koahetse peritoneum, lesapo, dinama tse nyenyane tse bonolo kapa letlalo.

Aminoglycosides ha ba ne a rerile hore ho intša phekolo. Se ke ua lebala, kgetha ho lakatsa lithibela-mafu ka feela ba tšoanelehang ngaka. Ka hona, le se ke la etsa ho intša medicate. Beha bophelo ba hao litsebi!