"Imipenem + Cilastatin": incazelo, izilinganiso umsebenzisi kanye nokubuyekeza

Ezinye ezithathelwanayo izifo ukunqotshwa kunjalo elula cha. Abakwazi sina kuphela konakalise impilo, kodwa ngisho ukudala usongo ngempela ukuphila isiguli. Ezimweni ezinjalo, okufanele zisetshenziselwe nekhwalithi ephezulu nemithi ngempumelelo ezingaba ngempumelelo ukunqoba igciwane eyingozi ubuyisele nempilo. Ukuze ulwe ezihlukahlukene izifo ezithathelwanayo livame ukusetshenziswa kusho "Imipenem + Cilastatin". Ngokusho izimpendulo iziguli nodokotela, ke Liyindawo ngempumelelo. Ngaphambi kokuba unqume uqale ukwelashwa izimali, kubalulekile ukuthola ulwazi oluningi mayelana izidakamizwa "Imipenem + Cilastatin": the egameni lendawo yokuhweba noma izidakamizwa, ikakhulukazi isinyathelo futhi indlela elisebenza ngayo. Ubani okufanele ukusebenzisa izidakamizwa e mbuzo? Yiziphi Izimo? Yini miphumela engemihle ingase ngiyilindele? Konke lokhu kwaziswa ungafunda ngokufunda kulesi sihloko.

isakhiwo

Ukulungiswa "+ Imipenem Cilastatin" is equitable cilastatin inhlanganisela (okuyinto inhibitor of enzyme digidropeptidazy kwezinso) kanye sodium nosawoti of imipenem (ama-antibiotic). Omunye ukulungiselela isitsha ngokuvamile iqukethe angu angamakhulu amahlanu kokubili izinto.

ukukhululwa Ifomu

izidakamizwa kubukwa "+ Imipenem Cilastatin" itholakala ifomu powder for imijovo (kwezokuphatha ngomjovo) in vials ezinobukhulu obuhlukahlukene, okungukuthi ayisithupha namakhulu amabili nanye namamililitha. Lokhu powder kumele ziyoncibilika isixazululo (buffered) ne-sodium ne-hydrogen carbonate.

Esimeni lapho izidakamizwa ezinqunyiwe ekuphathweni esicutshini awazuze izitsha eziyisikhombisa, ngamunye equkethe 0.5 noma 0.75 igremu ka imipenem futhi cilastatin (kuncike umthamo, okuyinto saphathwa isiguli nge udokotela ukuba khona).

izinkomba

I nomuthi "Imipenem + Cilastatin" okunqunyiwe ukusetshenziselwa izinhlelo iziguli khona zezifo ezithathelwanayo namakhambi ukuvuvukala ukuthi okudalwe iyiphi nozwelo isenzo izinto asebenzayo eziyisisekelo by nezilwanyana ezincane zomuthi, okuhlanganisa kokubili polymicrobial okuxubile ngakho ukutheleleka aerobic-anaerobic (lezi zihlanganisa ezithathelwanayo yezifo ngomgudu womchamo abese ipheshana zokucinana, sepsis, izifo ngisho namalungu amathambo; peritonitis, izifo naphakathi-besisu, ukuvuvukala, njll izinqubo ezenzeka izifo ezihlukahlukene izitho okhalo ,. ezithathelwanayo we isikhumba nezicubu ezithambile, kanye endocarditis Futhi, isidakamizwa wayisebenzisa njengoba zokuvimbela izinkinga ngemva kokuhlinzwa.

imiphumela kwemithi

Kusebenta izidakamizwa "+ Imipenem Cilastatin" moya inhlanganisela yimpumelelo yezingxenye ezimbili ezisebenzayo. Okokuqala, imipenem, limelela ethile beta-lactam-antibiotic esibulala ngenkuthalo amagciwane (ngalokho lunikeze umphumela amagciwane). Le nto has a spectrum ngokwanele ezibanzi womsebenzi. Lokhu kusho ukuthi amagciwane amaningi nozwelo imiphumela yokuba khona kwawo. Uphiko yesibili, cilastatin sodium ngenkuthalo abasebenza enzyme okuyinto ubola imipenem ku izinso isiguli, kuvimbela ukusebenza kwawo, okuyinto enomthelela ukukhuphuka elanele lokuhlushwa lo muthi ngenhla ifomu unmodified esigulini. Ngenxa yalokho, ukusebenza jikelele zomuthi "Imipenem + Cilastatin" landa.

isicelo

Ukuze kuzuzwe umphumela omkhulu kunayo yonke, futhi ukuze agweme noma yimiphi imiphumela emibi yokwelapha kubalulekile ukulandela ngokucophelela izincomo ukusetshenziswa kwezidakamizwa. I nomuthi "Imipenem futhi Cilastatin Dzhodas" iqondiswa isiguli ngemithambo yegazi (ukuvuza).

Naphezu kweqiniso lokuthi umhlahlandlela inikeza umthamo isilinganiso izidakamizwa, ngaphambi kokuba baqale ukwelashwa, kubalulekile ukuze ulungise uhlelo yokwelapha ngokuqondile udokotela abangakwazi kahle ukufaka umthamo ofanele uma sicabangela umlando lesiguli kanye nezici zayo ethize.

Ukweqiwa equkethe nomuthi "+ Imipenem Cilastatin" afundiswe ketshezi kubhekwe senzelwe labo iziguli kabani isisindo idlula ayisikhombisa kilogram. Labo iziguli isisindo isidumbu incane, kumele kungancipha ngokulingana umthamo ukusebenza izidakamizwa (kubalulekile ukuthi le nqubo ababeholwa umuntu abanekhono).

Ezigulini omdala umthamo wansuku zonke isilinganiso izidakamizwa "Imipenem futhi Cilastatin Dzhodas" ingenye - amagremu ezimbili, uma division yayo ku ezintathu - abane abaphathi. Ngesikhathi esifanayo, umthamo esiphezulu okuyinto akwamukeleki ukuphatha usuku olulodwa kuyinto amane namashumi ayisihlanu amagremu noma angu amakhilogramu esisindo (choice kumelwe bawe phezu encane ngemithamo ezimbili evumelekile) ngayinye.

Futhi, umthamo luyehluka kuye kobukhulu isifo. Ngakho, ngo-Endabeni yesiguli kanzima omnene nesifo, umthamo ukusebenzela kwakhe kuyoba angu angamakhulu amabili namashumi amahlanu (imijovo okuphindaphindiwe kufanele kube kane ngosuku). Uma ngezinga isilinganiso kanzima inani ekwakhiweni kwezokuphatha olulodwa kumele kube angu anamakhulu mahlanu. izindlela wokufaka kufanele kube kathathu ngosuku. Uma ukutheleleka sisibi, umthamo we imithi ke kumele kusetshenziswe kane ngosuku. Lapho isimo lesiguli ibaluleke kakhulu kangangokuthi kukhona usongo olukhulu ekuphileni kwakhe, kufanele iqondiswa ngesoni esisodwa igremu ka ezintathu - kane ngosuku. Umuthi kufanele sinikezwe kancane (amagremu ngehora, abangamakhulu amabili namashumi ayisihlanu - angu anamakhulu mahlanu - I-amabili - imizuzu engamashumi amathathu).

Uma izidakamizwa isetshenziselwa nokuvimbela izifo nasezinkingeni ezilandela ngemva kokuhlinzwa kubalulekile ukwethula omunye igremu ngesikhathi izinzwa kanye umthamo ofanayo, amahora amathathu ngemva kwalokho.

Uma ngesikhathi ukusebenza kwakukhona usongo kwanoma yiluphi uhlobo ukutheleleka (ikakhulukazi maqondana nokusebenza esikhathini ingemuva kanye ikholoni), "Imipenem + Cilastatin" yokusetshenziswa uncoma ukungena angu anamakhulu mahlanu, eziyisishiyagalombili kanye amahora ayishumi nesithupha ngemva kokubulawa izinzwa.

Ukulungisa isixazululo ukusebenza kule isitsha kuyadingeka ukuze ungeze powder impahla engamakhulu namamililitha ka kuphela ezikhethekile, okuhlanganisa amaphesenti ayisihlanu noma amaphesenti ayishumi dextrose aqueous, 0.9% isixazululo sodium chloride. Le isixazululo imipenem-antibiotic lokuhlushwa kumele singeqi angu ezinhlanu ngemililitha ngayinye.

Akumele kubhekwe ukusebenzisa izidakamizwa ngokuhlanganyela neminye imithi elwa namagciwane, kanye usawoti acidosis acid.

Ingqikithi ayihambelani nezinye imithi elwa namagciwane beta-lactam (okuyinto zihlanganisa cephalosporin, penicillin ne monobactam). Ukusebenzisa kwabo kanyekanye kungaholela ukusabela cross-nomzimba.

Ukuxoxa ganciclovir ngezinye izikhathi wenza Ukudlikizela generalized.

izinto ezihlukahlukene ukuthi uvimbele uketshezi ijabulise, ukwandisa lokuhlushwa imipenem e oketshezini olungenambala lwegazi, futhi inkathi yalo isigamu-nokuphila. Ngakho, uma i-ukwelashwa okuphumelelayo kudinga ukuphatha ejenti ebulilini akudingekile ukusebenzisa lezi amaqembu izinto kanyekanye.

Akuvunyelwe ukusebenzisa izidakamizwa okukhulunywa esikhathini esesibelethweni wengane, kanye ngesikhathi uncelisa.

Umuthi akufanele isetshenziswe ukuze silwe meningitis.

Umchamo ngesikhathi yokwelapha ingase kancane amaKhaladi Tint ngokubomvu.

ifomu Isikali zomuthi (ngoba emthanjeni futhi abaphathi esicutshini) ukuze kusetshenziswe ngokuqinile lokho. Ababona nezilandiso. Ngaphambi kokuqala imithi yokwelashwa ukuze kubhekwe kubalulekile ukuqhuba ucwaningo olunzulu ngendaba komzimba noma hypersensitivity ngabanye ukuba beta-lactam antibiotic.

Uma isiguli kuye kwadingeka kakade ezinye izifo yaleli pheshana emathunjini, ezifana nesifo, ukuthi uma usebenzisa izidakamizwa kokubuyekezwa, kukhona kungenzeka enterocolitis pseudomembranous.

Ukuze ngempumelelo ukugwema noma iyiphi ukusabela untoward e isimiso sezinzwa esiyinhloko kulezo iziguli ukuthi babenabo yini kokulimala ubuchopho noma umqhakanyeko wahlupheka elikulesi sihloko Kunconywa yokwelapha imithi qualitative ejenti antiepileptic.

Kumele kukhunjulwe ukuthi ezigulini esezikhulile cishe bayoba nokuthambekela okungafani ezihlobene nokukhula ukungasebenzi kwezinso, okungase kudinge umthamo ukunciphisa.

Kubalulekile ukukhumbula ukuthi iziguli esezikhulile kufanele usebenzise izidakamizwa ngokuqapha. Njengomthetho, babonisa izimpawu ezihlukahlukene nezifo eziphathelene ubudala ekusebenzeni nezinso. Kulokhu, uma kunesidingo, ukusetshenziswa kwezidakamizwa "Imipenem + Cilastatin" imfundo manual incoma ukuthi uthintane nodokotela wakho ukwehlisa izidakamizwa umthamo esetshenziswa.

Kukhona ezinye izimo ezikhethekile kwesicelo lokhu imithi izingane. Uma isisindo somzimba wabo idlula amakhilogramu amane, imihlahlandlela efanayo singasetshenziswa kubo ngokuthi abadala. Uma ingane omdala kunawe izinyanga ezintathu, futhi isisindo salo esingaphansi amane ngamakhilogremu, esiphezulu umthamo zonke izinsuku we isiguli enjalo kungaba amagremu ezimbili. Kufanele ufakwe angu nanhlanu kilogram per kane ngosuku.

Akunakusetshenziswa abakwazi ukusebenzisa imithi "Imipenem + Cilastatin" izingane abaye akukafiki izinyanga ezintathu, futhi labo izingane kwaphazamisa ukusebenza evamile ezinsweni, lapho okwenzeka ungaboniswa ezingeni serum creatinine lokuhlushwa ephakeme kunaleyo angu ezimbili deciliter ngayinye.

Izimo

Kukhona ezinye umehluko wemisindo nemiqondo yamagama ukuthi kudingeka kubhekwe uma usebenzisa "+ Cilastatin Imepenem". Ukufundiswa uncoma ngokucophelela ukufunda Izimo kule izidakamizwa. Futhi phakathi kwabo kukhona lokhu okulandelayo:

• inkathi sokukhulelwa wengane;
• ibele;
• Izingane ezingaphansi kweminyaka engu-izinyanga ezintathu;
• Izingane abaguliswa kahle ukusebenza kwezinso ezihlobene ne lokuhlala eliphezulu creatinine serum;
• ukuzwela ngakunye izingxenye ngabanye zomuthi akhuluma ngayo, kanye neminye imithi elwa namagciwane beta-lactam futhi carbapenems.

Kubalulekile ukukhumbula ukuthi iziguli esezikhulile futhi kulabo abaphethwe noma abake wahlushwa yezifo isimiso sezinzwa esiyinhloko noma izifo pheshana emathunjini kufanele athathe izidakamizwa ngokuqapha ngaphansi ebhekiwe zikadokotela. Ukuthi ungakwazi ngokuphumelelayo nika umthamo efanele kwezidakamizwa "Imipenem + Cilastatin". Izimo ezibalulekile ukuze ufunde ngaphambi kokuba uqale ukwelashwa.

side effects

Kubalulekile ukwazi into eyodwa ngaphezulu mayelana ithuluzi "Imipenem + Cilastatin". Formula nokulungiselela ukuthi ezinye iziguli kungenzeka ngezinye izikhathi kube ukusabela ohlangothini kumasistimu ezihlukahlukene zomzimba. Phakathi kwabo kukhona: thrombophlebitis, ukunambitheka nasiphazamiso, candidiasis, oliguria, myoclonus, ukuhhema, paresthesia, ukudideka, ukwehluleka oyingozi so-renal, nokugula ngengqondo, ukuquleka, polyuria, anuria, uhudo, isifo sokusha kwesibindi, isicanucanu nokuhlanza, leukopenia, enterocolitis pseudomembranous, lymphocytosis, hyperbilirubinemia, eosinophilia, pruritus, leukopenia, ukuqubuka kwesikhumba, ukukhishwa thrombocytosis, hypercreatininemia, monocytosis, urticaria, basophils, omuhle ngqo Coombs test.

Akukho imininingwane eqondile mayelana nendlela yokubhekana ukweqisa izidakamizwa zomuthi enixoxa ngalo. Nokho kuyaziwa ukuthi lezi ezisebenzayo ngempumelelo ibhekane hemodialysis. Noma kunjalo, ayikaziwa kanjani ngempumelelo le nqubo kuba esimweni ukweqisa izidakamizwa. Ngakho-ke kubalulekile ukugcina zonke izincomo, okuyindawo ehlanganisa izindlela sokusebenzisa "+ Imipenem Cilastatin" incazelo nokulungiselela.

izimo isitoreji

Ukuze isicelo zomuthi ukuba siphumelele, kubalulekile ukuba acabangele elinye iphuzu elibalulekile. Okungukuthi, indlela ukugcina imithi "Imipenem + Cilastatin". Incazelo efana siqukethe ngala macebiso alandelayo.

I powder kufanele eziqukethwe egumbini lapho izinga lokushisa Igumbi ugciniwe. kumele kusetshenziswe ukulungiselela isixazululo ukusebenza kungakapheli ihora elilodwa emva bumbela. i-sodium chloride isixazululo ekamelweni lokushisa zingagcinwa isikhathi esingaphezu kwamahora ayishumi kanye esiqandisini - hhayi angaphezu kwamashumi amane nesishiyagalombili. glucose izixazululo singasetshenziswa ligcinwe kungekho angaphezu kwamane futhi umphumela amabili nane amahora, ngokulandelana.

analogs

Kukhona izinhlobo eziningi zezidakamizwa ayingxenye yeqembu kusho analogue "Imipenem + Cilastatin". Esikhundleni kubhekwe izidakamizwa - "Inemplyus", "Miksatsil", "Lastin", "Sinerpen", "Tiaktam", "Piminov", "Supranem" futhi "Tienam". Njengomthetho, zonke lezi mithi isithako ezisebenzayo ezifanayo izidakamizwa kubhekwe. Izithako main asebenzayo yalezi imithi - imipenem, cilastatin (igama ezohwebo kanye ezembula lezi imithi). Ngakho, lezi imithi iyefana, futhi contraindications side effects kanye nemiphumela kwemithi. Nokho, kufanele sikhumbule ukuthi umthamo kumele ukhethe udokotela uzokwazi ukuba bacabangele zonke umehluko wemisindo nemiqondo yamagama. Umuthi 'Imipenem + Cilastatin "analogue imithi akufanele isetshenziswe iziguli ngaphandle kwemvume, ngaphandle udokotela okwelaphayo nokulawula kwakhe njalo. Kubandakanya iseluleko sakhe kuyadinga nokukhetha Isifaniso ezifanele.

nje okungaqondile

Prakthiza kuqinisekisa ukuphumelela izidakamizwa "+ Imipenem Cilastatin". Izibuyekezo babike imiphumela yokwelashwa okuphumelelayo. Nokho, kokubili kodokotela kanye neziguli baye egxile kulokho kubalulekile ngokunembile zithobele izincomo eziqukethwe imiyalelo wanikela udokotela ukuba khona. Kuphela le indlela yokwelashwa kungaletha izinzuzo emzimbeni wesiguli.

Akufanele ishalazelwe Izimo, khona lapho ayivumeli ukuqala ukwelashwa kubhekwe umuthi. Kungenjalo, uhlelo lwayo lokusebenza awukwazi kuphela ukunikeza umphumela omuhle, kodwa futhi umonakalo isimo zomzimba zogulayo. Futhi, ukusetshenziswa kabi kwalokhu izidakamizwa kubhekwe kungadala imiphumela emibi, ezinye zazo kungaba ngokuphawulekayo sibe sibi isimo lesiguli. Kubalulekile ukuthi ukuphathwa zenzeka ngaphansi kokuqondisa kukadokotela abanekhono, ababengeke bagcine nje kahle bajwayelane izici kwesicelo zomuthi, kodwa futhi kahle amakhono adingekayo kanye nolwazi ukuze akwazi ukubhekana nezimo omhlobo nzima. Impilo yakho kufanele ibe ezandleni ochwepheshe kweqiniso.

Ngaphambi kokuba unqume uqale ukwelashwa kubhekwe umuthi, kubalulekile ukufunda ngokucophelela konke ukwaziswa ngakho, okutshengisa izici nemiphumela yayo emzimbeni. Odinga ukukwazi mayelana lungaba ukusabela ezingezinhle, okuvela kuyo ezingasetshenziswa ukuletha eziningi ngokuphazamisa isiguli ubunzima udokotela wakhe.

Ngu kukhethwa welashwe kubaluleke ukwelapha efanele. Khetha imikhiqizo esezingeni lomhlaba!