Cephalosporins amaphilisi yesizukulwane esingu-4. Imithi elwa namagciwane-cephalosporins yesizukulwane esingu-4

Cephalosporins basonta beta-lactam izidakamizwa. Besenkolweni omunye amakilasi elikhulu izidakamizwa elwa namagciwane.

Uhlolojikelele

Empeleni esasisesisha ezibhekwa cephalosporins yesizukulwane esingu-4. amafomu Oral kuleli qembu azitholakali. Laba bobathathu asele amelwa izindlela yokusetshenziswa temlomo na parenteral. Cephalosporins ube umkhiqizo eliphezulu futhi ubuthi iphansana. Ngenxa-ke anesikhundla ehola phezu nokuvama ukusetshenziswa ku practice emitholampilo yazo zonke ejenti elwa namagciwane.

Izinkomba Zokusetshenziswa ngayinye cephalosporins isizukulwane zincike pharmacokinetic yabo izakhiwo kanye umsebenzi elwa namagciwane. Imithi kufanele ukufana kwesakhiwo kuya penicillin akuzange kusize. Ithola indlela umfaniswano imiphumela elwa namagciwane, kanye cross-njengemithi yokungezwani komzimba nokuthile kwezinye iziguli.

uhla umsebenzi

Cephalosporins nomphumela amagciwane. Ixhumeke nge ukuhlukumeza ezazakhe izindonga cell kwamagciwane. Phakathi kwabokuqala lwesithathu isizukulwane ukuthambekela kakhulu sandise uhla isinyathelo futhi ukuthuthukisa umsebenzi elwa namagciwane namagciwane Gram-emibi kancane umphumela ukwehlisa ku nezilwanyana ezincane igremu-HIV. Ukuze jikelele kuzo zonke izinto abezindaba zihlanganisa ukungabi khona nomthelela kwi enterococci namanye amagciwane.

Iziguli eziningi unesithakazelo, kungani hhayi kudedelwa 4th cephalosporins isizukulwane amaphilisi? Iqiniso lokuthi le mithi abe ukwakheka kwama-molecule ekhethekile. It ayikuvumeli izithako ezisebenzayo ukungena isakhiwo se-emathunjini mucosa amaseli. Ngakho-ke, i-4th cephalosporins isizukulwane amaphilisi ayitholakali. Zonke imithi kuleli qembu zenzelwe abaphathi parenteral. Itholakala 4 izizukulwane cephalosporins e ampoules ne kuphela.

4th cephalosporins isizukulwane

Izidakamizwa kuleli qembu abelwa kuphela by ongoti. Lolu uhlobo empeleni esasisesisha kwemithi. Cephalosporins 3, 4 izizukulwane kufanele ububanzi afanayo nemiphumela. Umahluko wukuthi ayinayo imiphumela eminingi engemihle eqenjini lesibili. Kusho "Cefepime", isibonelo, inombolo nemingcele eduze izidakamizwa oyisizukulwane sesithathu. Kodwa ngenxa ezinye izici ku isakhiwo sazo sekhemikhali, it has ikhono ukungena ngokusebenzisa udonga lwangaphandle microorganism igremu-HIV. Kulokhu kusho "Cefepime" azinzile ukuze hydrolysis ngu-beta-lactamases (chromosomal) C-class. Ngakho-ke, ngaphandle izici eziyizici 3rd isizukulwane cephalosporins (elisho ukuthi "ceftriaxone" "Cefotaxime"), ziphephile izidakamizwa izici ezifana:

• umthelela microbial overproducing beta-lactamases (chromosomal) C-class;
• okusezingeni eliphezulu umsebenzi isihlobo ukuba nezilwanyana ezincane ze-non-fermenting;
• ukumelana ngaphezulu ukuze hydrolysis we-beta-lactamase ukusabalala spectrum (ukubaluleka lesi sici Akucaci kuze kube sekupheleni).

nemithi Ingibitorzaschischennye

Leli qembu kuhlanganisa omunye izidakamizwa "Cefoperazone / Sulbactam". Uma eqhathaniswa monosredstvom, nomuthi kuhlanganiswe kwenze nomkhakha we umsebenzi. Kuthinta izilokazane ezincane anaerobic, iningi amagciwane Enterobacteriaceae, akwazi beta-lactamases.

Pharmacokinetics

Parenteral Cephalosporins 3, 4, isizukulwane kahle kakhulu ugxile lapho iqondiswa ku imisipha. Ukuthaka imithi ngendlela kwezokuphatha temlomo elinesimo ukumuncwa high in the ipheshana emathunjini. Bioavailability kuzoncika nomuthi ethile. Kuyinto kule ezahlukene 40-50% (izidakamizwa "Cefixime", isibonelo) 95% (izimali "Cefaclor" "cefadroxil" "Cephalexin"). ukumuncwa Oral imithi ethile kungaba ijubane ukudla. Kodwa izidakamizwa ezifana "Cefuroxime atehlukanisa" ngesikhathi ukumuncwa hydrolyzed. Ukukhululwa Okuningi okusheshayo ingxenye esebenzayo lapho ikhuthaza nokudla.

4th cephalosporins isizukulwane basakazwa kwezicubu eziningi izitho (kungabalwa wendlala), kanye izimfihlo kahle. Ngezinye okusezingeni eliphezulu izidakamizwa lokuhlala atholakala uketshezi lwamalunga futhi peritoneal, pericardial futhi pleural, amathambo kanye isikhumba, izicubu zomzimba ezithambile, isibindi, imisipha, izinso kanye namaphaphu. Ikhono kudlule Bbb bese bakha lokuhlushwa zokwelapha e CSF evelele ngaphezulu izidakamizwa oyisizukulwane sesithathu ezifana "Ceftazidime" "ceftriaxone" kanye "Cefotaxime 'kanye nommeleli lesine - kusho" Cefepime ".

Umzimba futhi kukhuthaza

Iningi cephalosporins awekho ngaphansi kwamazinyo. Wenza okuhlukile kubhekwa umuthi "cefotaxime". It biotransfomiruetsya kulandele kumiswa umkhiqizo asebenzayo. cephalosporins excreted yesizukulwane esingu-4, kanye nabamele amanye, ikakhulukazi izinso. Lapho lantambama e umchamo atholakala lokuhlala kuqhathaniswa eliphezulu.

Imithi "Cefoperazone" futhi "Ceftriaxone" elinesimo ukuqedwa double - kwesibindi nezinso. Ukuze cephalosporins kakhulu nengxenye-ukuphila kungakapheli amahora amabili. Isikhathi eside iyadingeka ukuze izimali "ceftibuten," "Cefixime" (3-4 amahora) kanye "Ceftriaxone" (emahoreni angu-8.5). Lokhu kwenza kube nokwenzeka ukuba wona kanye ngosuku. In iziguli nokwehluleka kwezinso, umthamo imithi edinga ukulungiswa.

side effects

Imithi elwa namagciwane - cephalosporins yesizukulwane esingu-4 - kubangele eziningi imiphumela engemihle, kuhlanganise:

• Yokungezwani komzimba. Iziguli bangezwa erythema multiforme, ukuqubuka, urticaria, ukugula serum, eosinophilia. Imiphumela engemihle yalo mkhakha futhi zihlanganisa ukushaqeka anaphylactic, imfiva, angioedema, bronchoconstriction.
• ukusabela Hematologic. Phakathi kwazo ukuhlinzeka omuhle Coombs, ehlatshwe leucopenia, eosinophilia (into engavamile), anaemia hemolytic, neutropenia.
• Okungabangela inkinga yezinzwa. Ngo isicelo amazinga okukhishwa ephakeme in iziguli ukungasebenzi kwezinso waphawula Ukudlikizela.
• Isibindi: anda transaminases.
• iziyaluyalu wokugaya ukudla. Phakathi imiphumela emibi kukhona isifo sohudo wandile, nesifo pseudomembranous, ukuhlanza kanye ukucanuzela kwenhliziyo, ubuhlungu esiswini. Endabeni izigqiki ketshezi ngegazi izingcezwana izidakamizwa amankeyane.
• ukusabela Local. Lezi zihlanganisa kokuziphatha futhi soreness endaweni ujove esicutshini futhi phlebitis nge umjovo emthanjeni.
• Okunye imiphumela ivezwa ngendlela candidiasis lwesitho sangasese sowesifazane kanye ngomlomo.

Izinkomba kanye contraindications

yesizukulwane esingu-4 cephalosporins esinikeziwe uma nizkominalnyh esindayo okungcono izifo zibangelwa microflora ehlukahlukene nemithi. Lezi zihlanganisa empyema pleura, ithumba e iphaphu, inyumoniya, septicemia, ithambo neziyaluyalu ngokuhlanganyela. 4 kubonisa isizukulwane cephalosporins izifo nzima uthayiphe ngomgudu womchamo, ngokumelene neutropenia nezinye uthi immunodeficient. Imithi kungukuthi eyabelwe ukungabekezelelani ngabanye.

izinyathelo zokuqapha

Lapho ebonisa indlela lo yokungezwani komzimba cross-uhlobo uyalandelwa. Iziguli singayivumeli penicillin akuzange kusize lalibonisa ukusabela okufanayo kuya cephalosporins-lokuqala isizukulwane. njengemithi yokungezwani komzimba nokuthile Cross lapho usebenzisa isigaba wesibili noma wesithathu mancane (e 1-3% of amacala). Nge umlando uhlobo ngokushesha ukusabela (isib ukushaqeka anaphylactic , noma urticaria), imithi isizukulwane sokuqala babelwa ngokuqapha. Umuntu unamasu mikhakha elandelayo (ikakhulukazi lesine) kuphephe.

Nokukhulelwa kanye lactation

Cephalosporins aqokwa yabakhulelwe ngaphandle kwemingcele ekhethekile. Nokho, ezanele izifundo zilawulwa ukuphepha nemithi awazange olwenziwa. Ngezinye lokuhlala eliphansi cephalosporins ukungena ubisi. Against isizinda izidakamizwa ngesikhathi lactation singashintsha ku microflora emathunjini, candidiasis, ukuqubuka kwesikhumba, ukukhishwa sensitization kwezingane.

Pediatrics asebekhule

Ngo isicelo osanda kuzalwa kuzoba cishe ukwandisa nenxenye ukuphila isizinda okusithiyayo of excretion kwezinso. Ezigulini esezikhulile, ushintsho umsebenzi kwezinso, Ngakho-ke futhi Ukwehla Cishe ekususeni imithi. Lokhu kungadinga wesifunda isicelo ukulungiswa kanye umthamo.

ukungasebenzi kwezinso

Njengoba ukususwa cephalosporins kakhulu kwenzeka ngokuyinhloko ngokusebenzisa uhlelo kwezinso ngendlela esebenzayo, eziyalezweni Isikali kumele zihlelwe ukuze zikhombise izici umzimba. Ngezinye ebulilini, ikakhulukazi lihambisana iluphu isisu, aminoglycoside noma kungenzeka nesenzakalo umphumela nephrotoxic.

isibindi ukungasebenzi

Abanye imithi excreted ku Bile, futhi ngenxa yalokho iziguli ezine ezinzima isibindi isifo, umthamo kumele kungancipha. Kulezi iziguli kukhona propensity ephezulu ukopha gipoprotrombinemii e isicelo kusho "Cefoperazone". Njengoba isilinganiso izifo Kunconywa Vitamin K.