Ama-antibiotic "zyvox": yokusetshenziswa, analogs

Ekwelapheni webhaktheriya izifo udokotela ngokuvamile antibiotic. Le mithi kufanele lenqwaba izinhlobo. Yiqiniso, zonke izinhlobo imikhiqizo isinqandakuvunda ezithaka imithi akunakwenzeka ukwazi, kodwa eminye ke imithi ngokumelene izifo ezibangelwa amagciwane Sinesithakazelo ngokukhethekile.

Omunye amaphilisi anamuhla, okuyinto uvezwa emakethe yethu yemithi - kuyinto "zyvox". Yokusetshenziswa zomuthi ikhomba ukuthi lokhu ejenti elwa namagciwane zokwenziwa imvelaphi. It kungokwalabo iqembu elikhethekile - oxazolidinone. The main isithako esebenzayo linezolid. umphumela lesi sidakamizwa "zyvox", yokusetshenziswa, analogs, side effects kanye Izimo: Landelayo siye ulwazi elandelayo kuzoxoxwa ngayo.

Ngayiphi ifomu ikhiqizwa?

Umuthi itholakala amafomu amabili Isikali:

• Ngesimo granules, obudaywe omhlophe noma aphuzi ngombala futhi ukunambitheka orange. Kulawa, elithi a pereoralnogo isixazululo ukusetshenziswa ne ukulindela ukuthi 5ml sokumiswa eseqedile sizoqukatha 100 mg linezolid. I elimbudumbudu zafakwa umthamo ezinwabuzelayo 150 ml. Futhi esikhathini iphakethe has a spoon yokulinganisa ne iziqu (2.5 no-5 ml ukumiswa).
• Ngesimo amaphilisi equkethe 600 mg linezolid. Iphakheji has a ibhamuza amaphilisi 10 ngaphakathi.
• isixazululo ukumnika equkethe 2 mg linezolid / 1 ml, e amaphakheji 100, 200, 300 ml.

Uyini umphumela kwemithi zomuthi?

Active izidakamizwa linezolid unekhono ukungena iseli webhaktheriya, ukuhlanganisa uxhumano nomsebenzisi ribosomes yabo futhi zivimbele amaprotheni zamagama. Ngenxa yalokho, izilokazane ezincane ayafa.

Against iyiphi nezilwanyana ezincane kusiza izidakamizwa?

Izidakamizwa "zyvox" imfundo manual okuhambisana iphasela ngalinye nge imithi ukuthi ngempumelelo enza izilokazane ezincane ezilandelayo:

• amagciwane aerobic Gram-HIV: Enterococcus, Corynebacterium, Staphylococcus, Streptococcus;
• Gram-negative amagciwane aerobic of the Pasteurella uhlobo lwe;
• Gram-HIV anaerobic amagciwane: Clostridium futhi peptostreptokokki;
• Gram-negative anaerobic ngama-bacterium izizukulwane prevotella, bakteroides, i-chlamydia.

Ukuze linezolid amagciwane ngokulinganisela singangena we izizukulwane Moraxella, Legionella, Mycoplasma.

Kukhona futhi nezilwanyana ezincane okuyinto abonise ukumelana linezolid, ingxenye izidakamizwa "zyvox". Yokusetshenziswa abonisa nesigqi elandelayo nemithi: bacterium haemophilus, kanye ukulethwa enterobakteriatsea, nizera futhi Pseudomonas.

Ngayiphi izifo sikhonjiswa umuthi?

"Zyvox" Ama-antibiotic okwabelwe lezi zifo ezilandelayo:

• Izifo ezithathelwanayo kanye ukuvuvukala ezibangwa amagciwane ebucayi emuthini okunikeziwe.
• Ezimweni pneumonia nosocomial noma umphakathi-kuluthola.
• Nge izilonda ezithathelwanayo we isikhumba nezicubu ezithambile zomzimba womuntu.
• Ephambi kwezinduna izifo, ama-ejenti okuyizinto enterococci bembonisa ukumelana vancomycin.

Futhi, "zyvox" antibiotic ingasetshenziswa njengendlela wengxenye ye uhlobo elihlangene yokwelapha ezifeni ezivukayo amagciwane Gram-negative ngenxa.

pharmacokinetics

Linezolid libhekene absorbability angabacwasi ngokushesha kusukela ipheshana yesisu lwalo emfudlaneni igazi, kungakhathaliseki ukuthi ejenti ifomu ukukhululwa. Kakade emva 2 amahora ngemva nokuphathwa izidakamizwa, emakamu yayo yi-plasma ifinyelela esiphezulu. Linezolid libhekene bioavailability egcwele futhi ngokushesha kuyinto ukusatshalaliswa yayo kwezitho nezicubu. Kungakhathaliseki ukuthi lokuhlushwa-antibiotic egazini 31% nakanjani plasma amaprotheni.

Kubantu, linezolid is akheka ngu namachibi emikhiqizweni ezimbili ezingenakho isenzo elwa namagciwane. Basuke excreted ngu izinso (cishe 50%) kanye amathumbu (kufika ku-6%). Kufika 35% imithi elwa namagciwane-non-akheka excreted nge umchamo.

Ophawuleka pharmacokinetics ezinzile, okuyinto libhekene izidakamizwa "zyvox". Yokusetshenziswa kuncike yokuntuleka uhlolo lwezidakamizwa ngeminyaka lesiguli. Ngakho-ke, abadala angadingi lithathelwe umthamo womkhiqizo ezithaka imithi.

Isikali

I nomuthi "zyvox" ingase yabelwe udokotela isiguli kwezokuphatha bomlomo noma ngesimo emthanjeni ukumnika abaphathi. Ngaphezu kwalokho, isiguli angadluliselwa zenye kwenye kokungenisa ngaphandle kokulahlekelwa ukuphumelela ukwelashwa.

Imithi umthamo, ubude course liyoqoka udokotela, futhi yokwelapha lezi zimo zibangelwa izici ezilandelayo:

• onjani amagciwane kwabangelwa sifo;
• ukutheleleka ehunyushelwe;
• kobukhulu isifo;
• inzuzo emitholampilo kusukela yokwelapha.

Lapho streptococcal inyumoniya, umphakathi-ngazuza futhi esibhedlela-uthayiphe abadala kanye nezingane engaphezu kwengu-12 enqunyiwe 600 mg "zyvox" izidakamizwa. Manual ubonisa ukuthi ukuthatha umthamo imithi lufanele lwenteke njalo ngemva kwamahora angu-12 kanti isikhathi sifundo izinsuku 10-14.

Izifo zesikhumba noma izicubu ezithambile, kuyinkimbinkimbi noma ayinzima kubangelwa staphylococci, streptococci futhi enterococci amelana vancomycin, kuhlanganise nesifo sikashukela ngezinyawo syndrome (ngaphandle osteomyelitis) inikezwa umthamo "zyvox" 600 mg. Ukufundiswa futhi usikisela ukuthi isikhawu esiphakathi ukuthatha imithi kumele kube ngamahora angu-12. Inkambo yokwelashwa ihlala izinsuku 10-14, kodwa ingase ihlale kufikela kuzinsuku ezingu-28 ku-kadokotela.

Uma isiguli ukungakhuli kwezinso, ukulungisa umthamo imithi akudingayo. Ngo izinqubo hemodialysis linezolid isuswe phezu isikhathi 3 h. Ngokuqondene nalokhu, i-izidakamizwa kufanele kuthathwe emva umcimbi ukuhlanzwa ngegazi. Iziguli uxilongwe yokwehluleka kwesibindi, futhi asidingi lithathelwe umthamo.

Iziguli ezingaphansi kweminyaka engu-12 ubudala inikezwa kuphela ifomu zomuthi ukumnika "zyvox". Ukufundiswa ukusetshenziswa kwezinhliziyo zezinsana nezezingane ibonisa ukuthi linezolid zithathwe ngezilinganiso-10 mg isisindo / kg isidumbu sengane at a imvamisa kuzo zonke amahora 8. Inkambo yokwelashwa isuka kuzinsuku 10 kuya 14. Lokhu Isikali zomuthi yokwelapha baqonde izinto ezenzekayo emphakathini-abeyizuzile futhi nosocomial inyumoniya, elithambile izicubu izifo, futhi isikhumba, kanye ukubhekana nezifo enterococcal.

emgodleni Avikelayo eyenziwe ucwecwe, isuswe ngokushesha ngaphambi inqubo ukumnika. Kuyadingeka ukuba uhlole iphakheji ukuvuza ngokuyipitshiza iminithi elingu-1. emaphaketheni eyayivuza engasebenziseki ngenxa yokungakhokhi inzalo. Isixazululo ukumnika iqondiswa phezu isikhathi imizuzu 30-120 of.

Izici isicelo

Kukhona ezinye izici reception "zyvox" izidakamizwa. Manual ubonisa ukuthi uma isifo kubangelwa Gram-negative amagciwane, kubalulekile ukuxhuma izidakamizwa ezengeziwe nomsebenzi ngokumelene leli qembu nezilwanyana ezincane.

Lapho ethola linezolid ezinye iziguli kungenzeka myelosuppression emuva. Kuye isikhathi yokwelapha libhekene kwegazi, leukopenia, thrombocytopenia noma pancytopenia. Ngokusekelwe kulezi idatha, ukuqapha igazi ibala kufanele kwenziwe in iziguli engozini ukopha. Futhi, lezi zinyathelo zilungele uma isiguli waba nomlando myelosuppression noma uthatha imithi ukuthi sinciphise amazinga e-hemoglobin nama-platelet noma umsebenzi wabo. Ukuhlola wegazi ibala Kuyadingeka ngesikhathi isikhathi eside isikhathi ukwelashwa (izinsuku ezingu-14).

Ezinye iziguli kokuthola linezopida kungase kuhambisane ingozi nesifo, pseudomembranous uhlobo izinhlobo ezahlukene adonsela phansi.

Uhudo kuvamile kubantu ukuphuza imithi elwa namagciwane njalo. Izinga le side effect zingahluka kusuka imnene ezinzima. Nakuba ngokuthatha izidakamizwa, "zyvox" iphilisi noma ukumiswa ekhona, kukhona nokucindezela evamile microflora emathunjini bese overgrowth-bacterium bohlobo lwe-Clostridium. Ngo inqubo ukuphila kwabo lokhu umzimba ukhiqiza ubuthi A namaqembu B, futhi kubangele isifo sohudo. amazinga ephakeme kulezi zingxenye zingaba yingozi iziguli. Zonke iziguli ezine-abaye zabhekana lolu hlobo uhudo, kudingeka kokuqondisa ngokucophelela yezokwelapha isikhathi ezingu-2.

Kwezinye izimo, ziwohloke ekwelapheni izidakamizwa "zyvox". Yokusetshenziswa ezinganeni nakubantu abadala, okubonisa ushintsho kungenzeka e kombala, focus ezibukwayo, ukukhubazeka ensimini, esilufifi. Kulezi zimo, isiguli kufanele ngokushesha uxhumane nodokotela iso. Uma lokhu imithi esithathwayo yisiguli phezu isikhathi eside (izinyanga ezingaphezu kwezingu-3), khona-ke kuyinto impoqo ukwenza ukulawula. Ngezinye nesenzakalo nokuthuthukiswa kwemicimbi efana peripheral neuropathy noma emsipheni optic, umbuzo ukumisa ukwelashwa uma izinzuzo kuyo ingaphansi umonakalo owenziwe impilo.

Futhi, kwakukhona amacala lactic acidosis ngenkathi ethatha "zyvox". It kubonakala ngesimo isicanucanu, ukuhlanza, lactic noma ukunciphisa engenabulungisa anions carbonate. Lesi simo esiyingqayizivele sibangelwa kufanele baqashwe ngokucophelela ngochwepheshe.

Uma isiguli sine-isidingo ngokuhlanganyela "zyvox" ukuthatha abakhethayo serotonin reuptake inhibitor, kufanele kuthathwe ngaphansi kweso lwezokwelapha ukuze sithole serotonin syndrome: ukwehluleka umsebenzi engqondweni yethu, hyperreflexia, hyperpyrexia, futhi incoordination. Ephambi kwezinduna izenzakalo ezichazwe ekhiqizwa ukuqedwa esisodwa noma zombili izidakamizwa. Ngakho kukhona ichaza ukushintsha kombala izinyo koqweqwe lwawo, okuyinto isuswa yokuhlanza lochwepheshe.

Kunenye caveat ukuthola "zyvox" izidakamizwa. Yokusetshenziswa (amaphilisi noma elimbudumbudu for ukumiswa - akunandaba) uthi: ukwelashwa nge linezolid is hhayi Kunconywa izimoto ukushayela, ukuphathwa ekhethekile imishini kanye nemisebenzi ezihilela ingozi baphile futhi babe nempilo.

Yiziphi imiphumela emibi umuthi?

ukusabela ezingezinhle okungase kwenzeke endaweni nesineke ngenkathi ethatha ye-ejenti ezithaka imithi "zyvox 600 mg" oluthathwa by ukhona imvamisa kusuka kakhulu njalo (10%) kuya ezingavamile kakhulu (0.01%).

Ngokuvamile, imiphumela emibi ekwelapheni izidakamizwa "zyvox" yokusetshenziswa, lesi sisombululo noma ithebhulethi, mkhuba ngokuthi kobukhulu okuncane noma okusesilinganisweni. Izinga Special has izimfanelo ezilandelayo:

• isicanucanu;
• isifo sohudo,
• ikhanda.

In iziguli omdala futhi bangezwa ukuqunjelwa, ukuhlanza, ubuhlungu esiswini, ukuvuvukala isifo vulvovaginal we ngalo ingaphakathi ngomlomo.

Ngu kuyaqabukela zenzeka-side effects zomuthi "zyvox" yokusetshenziswa (izingane ngenhla engu-12 kanye nabantu abadala) ubiza ushintsho umbala ulimi umbala.

Kususelwa izifundo laboratory, kungashiwo wagomela ukuthi ngesikhathi ukwelashwa nale-antibiotic ngokuvamile itholwa thrombocytopenia. Hhayi njalo waphawula kwamazinga igazi triglyceride, kusebenze okungavamile isibindi enzyme ALT, AST, phosphatase ane-alikhali, LDH futhi lipase futhi Amylase. ukwanda lokuhlushwa bilirubin Imininingwane, creatine futhi prolactin bubhaliwe.

Isimiso sezinzwa isiguli bangase basabele emuthini nge linezolid. Lokhu ngokuvamile obonakaliswe inzululwane futhi migraines, kanye amajaqamba. ukubonakaliswa lingandile kwezidakamizwa side effects izimo ukunambitha ukuphendukezela.

Izinguquko in ukusebenza evamile isimiso sezinzwa esiyinhloko kungabangela "zyvox" (amaphilisi). Umhlahlandlela kubonisa ukuqwasha akuve kuvamile ukuba iziguli ngesikhathi Inkambo yokwelashwa nale ukulungiselela ezithaka imithi.

Ukusebenza kwe-genitourinary yokwelapha uhlelo usebenzisa "zyvox" kungenziwa kubonakala ngesimo candidiasis lwesitho sangasese sowesifazane.

Ngokuvamile lapho futhi cutaneous kuwukubonakaliswa ukwelashwa linezolid ngesimo nesimungumungwane.

Phakathi kwezinye miphumela engemihle ingase ibizwe ngokuthi izenzakalo febrile futhi ezingosomathuba ukutheleleka fungal, okuyinto eyenzeka njalo.

Futhi, lapho izidakamizwa "zyvox" cwaningo babonakala amacala high blood pressure, ukulunywa futhi ukuqunjelwa.

Linezolid ekwelapheni iziguli ingane abaneminyaka engu-12 kuya ku-17, ngokuvamile atholakala imiphumela elandelayo engathandeki:

• uhudo, ukuhlanza, ukucanuzela kwenhliziyo, ubuhlungu besisu;
• inzululwane, migraine;
• ukuqubuka;
• izifo ezithathelwanayo we emigudwini yomoya, ukukhwehlela, umphimbo obuhlungu,
• umkhuhlane;
• ubuhlungu ukuthi kunzima ukuchaza kwasendaweni.

I izenzakalo ezilandelayo ungakwazi zenzeka futhi elinesimo imvamisa engezansi:

• eosinophilia;
• anda triglyceride, ALT, lipase futhi creatine;
• ukulunywa.

ezengeziwe side effects zitholiwe sifunda yomtholampilo, esibonakala by "zyvox" (isixazululo, kanye amaphilisi). Lezi zihlanganisa:

• myelosuppression esethola;
• peripheral we emsipheni optic;
• anaphylaxis;
• uhlamvu edema angioneurotic;
• lactic acidosis;
• neuropathy peripheral uhlamvu;
• ichaza ukushintsha kombala izinyo koqweqwe lwawo;
• Ukugodola;
• ukukhathala;
• serotonin syndrome.

Njengoba "zyvox" it is kuhlanganiswe neminye imithi?

Lapho babambisane zinikwa cytochrome akukho ushintsho ebonwe nomsebenzi wokugcina.

Uma ngesikhathi esifanayo ziphathwe linezolid futhi monoamine oxidase inhibitor, umphumela yokugcina buyathuthuka. Kususelwa kule qiniso, kubalulekile ukunciphisa umthamo agonists futhi Dofaminomimetiki.

Lapho babambisane iqondiswa izidakamizwa "zyvox" kanye nemithi yokunciphisa ukucindezeleka okuyinto zivimbela kwalabo abatholako serotonin, serotonin syndrome zingase zenzeke.

Endabeni co-ukuphatha nge "aztreonam" noma "Gentamycin" farmakinetika linezolid awuzange waphawula.

Co-ukuphatha nge "rifampicin" kuhilela wehlise makismalnaya lokuhlushwa "zyvox" - angafika ku-32%.

Izimo

Umuthi Akwamukelekile ukuthi ukusetshenziswa iziguli ngozwelo anda ukuze izingxenye eziyinhloko noma oligcwele oyiyo.

Uma isiguli kuthatha phenelzine noma isocarboxazid, linezolid ke ngeke kuthathwe ngesikhathi yokwelapha, futhi 2 amaviki kwalokho.

Uma ungakwazi ukulawula blood pressure, i- "zyvox" ingamukeleki abelapha abantu abane-zifo ezilandelayo:

• nomfutho wegazi ophezulu engazinzile;
• i-hyperthyroidism;
• pheochromocytoma;
• kanye reception ezikanye agonists futhi Dofaminomimetiki.

Ngezinye nakwenzeka ngokuqaphelisisa isiguli ukuba ingozi serotonin syndrome "zyvox" alinakunikezwa kulezi zimo ezilandelayo:

• khona isifo carcinoid;
• ukuphatha izidakamizwa okuyinto zivimbela reuptake ka-serotonin, tricyclic antidepressant zinhlobo triptans "Miperedina" futhi "buspirone".

ifomu Tablet "zyvox" is contraindicated ezinganeni ezingaphansi kweminyaka engu-12 ngenxa ukungabi nakwenzeka kwento ukukhethwa umthamo ezanele.

Isidakamizwa siboniswa ukwelashwa uma kwenzeka ukuthi inzuzo ekulindeleke kuyo ingaphezu kwengozi kula macala alandelayo:

• Ukukhubazeka okunomsoco nokuqeda;
• Ukutheleleka kwesistimu;
• Ukukhulelwa nokulahlwa.

Ingabe ukudlula izidakamizwa kungenzeka?

Ezilingo zomtholampilo, kanye nokusetshenziswa okuqhubekayo kweZivox esibhedlela noma ezimweni ezingaphandle kwezibhedlela, akukho amacala okudlula ngokweqile atholakale. Uma kwenzeka isimo esinjalo, kunconywa ukwenza ukwelapha okuyisifo.

Izimo zokugcina nokuhamba

Isidakamizwa esithi "Zivox" sithengiswa ekhemisi ngokudokotela kadokotela. Gcina kufanele kube endaweni enqunyelwe umswakama kanye nokukhanya kwelanga ekushiseni kwe-air okungenani kuka-30 ° C, ukunciphisa ukufinyelela kwezingane.

Ama-analogues

Uma kungenakuvunyelwa ukwelashwa nge-Zivox, izifanekiselo zalo zingabelwa kusukela ekucatshangweni kwemiphumela efanayo yesenzo sensimbi esemqoka:

• Nge-pneumonia ne-bronchitis - i-Doxycycline hydrochloride, iBronchorus, iArlet.
• Ngama-bacterial infections - "Levomycetin 0.25 g", "Vankomabol", "i-Lifaxon."
• With izifo zesikhumba - "Benzatin benzylpenicillin", "Sulfadimetoksin."
• Ngezilonda zokuphulukisa - "Tsifaleksina usawoti sodium", "Lifuzol".

Ukubeka izidakamizwa ohlwini lwazo kufanele kube ngudokotela oya khona kuphela, ngoba imithi ngayinye inezinkomba zayo, izici zokwamukelwa nokuphikisana.