Aminoglycosides: Diyaargarow (liistada, Magacyada, Qeybinta, tilmaamaha isticmaalka)

muuqaalka suuqa pharmacological of antibiotics cusub oo tiro balaadhan oo ah saamaynta, sida fluoroquinolones, cephalosporins, ayaa keentay in xaqiiqda ah in dhakhaatiirta bilaabay inuu qoro aminoglycosides dhif ah (daawooyinka). Liiska daawooyinka ka mid ah kooxdan waa arrin ballaaran oo ka mid ah daroogada si fiican u yaqaan sida "penicillin", "Gentamycin", "Amikacin." Ilaa maanta, in daryeelka degdegga ah iyo waaxaha qalliinka oo ka mid ah daroogada ee ugu caansan sida saxda ah waa taxane aminoglycoside ah.

Sharaxaad kooban oo ka mid ah kooxda

Aminoglycosides - daroogada (liiska daawooyinka hoos ku wada hadleen), oo aan ka ahayn asal ah semi-dardaro ama dabiiciga ah. Tani group of antibiotics uu leeyahay saamayn bactericidal degdeg ah oo xoog badan oo jidhka ah.

Daawooyinka ku waani inay tiro balaadhan oo ah ficillada. Ay hawl antimicrobial dhawaaqaa bakteeriyada Gram-negative, laakiin waxaa si weyn u dhimay ee dagaalka ka dhanka ah sheyga garaam-positive. Oo aminoglycosides gebi natiijo la'aan ka dhanka ah anaerobes.

Kooxdaan daawooyinka soo saara ah saamayn bactericidal ay awood u fiican in la xakameeyo irreversibly Avv borotiinka ee noolaha xasaasi ah heerka of ribosomes. Daawooyinku waa firfircoon on labada taranta iyo unugyada ee gobolka quiescent. Baaxadda ay leedahay waxqabadka antibiotic waa gebi ahaanba ku tiirsan ay fiirsashada ee serum dhiigga bukaanka ah.

aminoglycoside maanta loo isticmaalaa ku filan waa xaddidan. Tan waxa u sabab sumoobo sare ee daawooyinka, kuwaas oo. Inta badan xanuunsado tan iyo daroogada kelyaha iyo xubnaha maqalka.

Muqaalka muhiimka ah ee qalabka waa awood ay wax lays geliyey unugyada nool. Sayidka, aminoglycosides gebi ahaanba mana karayaan in dagaalka ka dhanka ah bakteeriyada intracellular.

Faa'iidada iyo faa'iido darrada

antibiotics Kuwan waxaa si ballaaran loo isticmaalo sida kor ku xusan, ku dhaqanka qalliinka. Oo waxay soo beegay. Dhakhaatiirta ku adkaysato faa'iidooyinka badan by aminoglycosides.

Daawada waxa on jidhku waa daqiiqado si wanaagsan oo kala duwan:

• waxqabadka bakteeriyada sare;
• Maqnaanshaha cadaanyo daran (maamulka duray);
• dhacdo dhif ah xasaasiyad,
• awooda inuu baabbi'iyo bakteeriyada afgembi;
• wanaajiyey saameyn ku daweyn isku dhafan oo antibiotics beta-lactam;
• waxqabadka sare ee dagaalka ka dhanka ah cudurada halista ah.

Si kastaba ha ahaatee, ay la socdaan faa'iidooyinka kor lagu soo sheegay, kooxdan oo ah medicaments oo uu leeyahay faa'iido darrada.

Mooraal waa aminoglycosides:

• hawl yar yahay oo ah daawooyinka ay ka maqan yihiin oxygen ama dhexdhexaad ah acidic,
• lays saboolka ah walaxda aasaasiga ah ee dareeraha jidhka (bile, dareeraha laf-dhabarta, xaakada);
• muuqaalka hannaanka ah dhibaatooyin soo raaca.

dirka daawo

Waxaa jira dhawr kala saaro.

Tusaale ahaan, siiyey isku xigxiga ee hordhaca galay dhaqanka caafimaad ee aminoglycosides, waa qarni soo socda:

1. Daawada ugu horeysay loo isticmaalo in lagula dagaallamo cudurro faafa ahaayeen "streptomycin", "monomitsin", "neomycin", "Kanamycin", "Paromomycin."
2. Si jiilka labaad waa aminoglycosides cusub (daawooyinka). List Drug "gentamicin," "Tobramycin", "sisomicin", "netilmicin".
3. Kooxdan waxaa ka mid ah daroogada semi-dardaro sida "Amikacin", "Izepamitsin".

On spectrum ficilka iyo bixitaanka iska caabin ah kala saaro aminoglycosides ka yara duwan.

daawooyinka Generation yihiin kuwa soo socda:

1. In 1 group ka mid ah daawooyin sida "streptomycin", "Kanamycin", "monomitsin", "neomycin". daroogada waxay u suurto gal ah in dagaalamo jeermiska TB, iyo qaar ka mid ah bakteeriyada atypical. Si kastaba ha ahaatee, ka dhanka ah noocyo kala duwan oo bakteeriyada garaam-negative iyo ✰Malax mid, ay yihiin bilaa awood.

2. jiilka labaad aminoglycoside - dawadan "gentamicin." Waxaa la kala duwanaayeen a hawlaha bakteeriyada weyn.

3. daawooyinka Hagaajinta. Waxay leeyihiin waxqabadka bakteeriyada sare. Waxaa loo adeegsaday dhanka ah klebisielly, enterobacteria, Pseudomonas aeruginosa waa a-qarnigooda saddexaad u aminoglycosides (daawooyinka). Liiska daawooyinka waa sida soo socota:

- "sisomicin";

- "Amikacin";

- "Tobramycin";

- "netilmicin".

4. daroogada "Izepamitsin" waxa loola jeedaa koox afraad. Waxaa la kala duwanaayeen awood u leh inay wax ku ool ah oo dheeraad ah la tsitobakterom, aeromonasom, nokardiyami ka qabtaan.

In dhaqanka caafimaad, horumariyo kala soocidda kale. Waxay ku salaysan tahay isticmaalka maandooriyeyaasha ku xiran xarumaha caafimaadka ee cudurada, dabeecadda cudurka, iyo sidoo kale codsiga ah ee habka.

kala soocidda noocan oo kale ah ee aminoglycosides sida soo socota:

1. Daawooyinka loogu talagalay soo-gaadhista systemic maamula parenterally (duro). Waayo, daaweynta cudurrada bakteeriyada ka timaato dhaca daran xanaajiyeen by sheyga anaerobic fursad, qoro dawooyinka sida, "Gentamycin", "Amikacin", "Netilmicin", "Tobramycin", "sisomicin". Daaweynta monoinfections halista ah, taas oo ku salaysan yihiin waa wareer ah waajibiyo, wax ku ool ah marka lagu daro daawooyinka therapy, "streptomycin", "Gentomitsin". Marka mycobacteriosis caawimaad daroogada weyn "Amikacin," "streptomycin", "Kanamycin".
2. Daawooyinka loo isticmaalo gudaha oo kaliya tilmaamo gaar ah. Kuwani waa: "Paromitsin", "neomycin", "monomitsin".
3. Daawooyinka codsiga la mariyo. Waxay waxaa loo isticmaalaa daaweynta cudurrada bakteeriyada purulent ee Laryngologie iyo indhaha. Waayo, soo-gaadhista maxaliga ah si ay daroogo horumariyo "gentamicin," "framycetin", "neomycin", "Tobramycin".

Tilmaamayaasha waayo,

Isticmaalka aminoglycosides roon tahay in la burburiyo noocyo kala duwan oo wareer ah garaam-negative laylinta. Medicaments waxaa loo isticmaali karaa sida monotherapy. Inta ay weheliso beta-lactams.

Aminoglycosides waxa lagu tilmaamayaa lagu daaweyn jiray:

• cudurada nosocomial ee deegaamaynta kala duwan;
• dhibaatooyin postoperative carow ah;
• cudurada intra-caloosha;
• sepsis;
• endocarditis infective ;
• baylonfiritis dhaca foomamka aad u daran;
• gubasho cudurka;
• meningitis carow ah bakteeriyada,
• qaaxada;
• cudurrada faafa halis ah (cudurka qaba, brucellosis, tulariimiya);
• septic arthritis xanaajiyeen bakteeriyada garaam-negative,
• cudurada kaadi mareenka,
• cudurada indhaha: blepharitis, keratitis bakteeriyada, konyunktivitv, keratokonyunktivitv, uveitis, dacryocystitis;
• cudurada ENT: otitis externa, rhinopharyngitis, rhinitt, hogaga;
• cudurada protozoal.

waxyeellooyin

Nasiib darro, inta lagu guda jiro daawaynta this category ka mid ah daroogada bukaanka dareemi kartaa taxanaha oo dhan waxyeello ka soo gaartey. khasaare ugu weyn ee daawooyinka - waa heer sare ah sun. Taasi waa sababta kaliya dhakhtar waa qoraan aminoglycosides bukaanka.

Dhibaatooyinka ay keento dhici kara:

1. Ototoxicity. Bukaan-caban maqal la'aanta, sanqadh wacaya. Inta badan waxa ay muujinayaan xanibaadii dhegaha. Inta badan dareen diidmo ka dhacaan ee dadka waayeelka ah, in dad markii hore ka cabanaya maqalka. Dareen-celinta noocan oo kale ah dhacaan in bukaanka qaba therapy muddo dheer ama qaadasho sare.
2. Nephrotoxicity. Bukaanka ayaa u muuqda harraad, kala duwan yihiin xaddiga kaadida (awoodid kororka iyo hoos u dhac labadaba), kor u kacay heerka kariyaatiniin ee dhiigga, hoos sifeynta glomerular. calaamadaha noocan oo kale ah caadiga ah ee dadka ka cabanaya xanuunada shaqada kelyaha.
3. Go'doominta muruqyada. Mararka qaarkood inta lagu jiro daaweynta dhaxalsiiyeen Neefta. Mararka qaar waxaa jira curyaannimo oo ka mid ah murqaha-mareenka. Sida caadiga ah, dareen diidmo oo kale waa sifo in bukaanka qaba cudurada maskaxda ah ama garan karin shaqada kelyaha.
4. xanuunada Vestibular. Waxay muujin xad gudub ku ah isuduwidda, wareer. Inta badan, waxyeelo dhacaan marka "streptomycin" ballan of daroogada si uu bukaan-socodka.
5. xanuunada maskaxda ah. ayaa laga yaabaa inuu paresthesia, encephalopathy. Mararka qaarkood therapy waxaa ku weheliyay dhaawaca ah dareemaha iftiinka.

Aminoglycosides dhif ah keeni dareen diidmo oo xasaasiyadeed sida finan maqaarka.

sababo

daawooyinka tilmaamay leeyihiin xadad qaar loo isticmaalo. aminoglycosides Inta badan ahaan uu u (magacyada kuwaas oo sare lagaa siin) in heley ama xaalado sida:

• diidmo shakhsi;
• xad gudub ku ah shaqada excretory kelyaha,
• xanuunada maqalka;
• horumarinta dareen diidmo oo aad u daran neutropenic;
• xanuunada vestibular;
• daweeyay gravis, botulism, Parkinsonism;
• depression neefsashada, maskax hurudda.

Intaa waxaa dheer, waa in aad ma u isticmaashaa daaweynta haddii bukaanku lahaa taariikh ficil xun in daroogo kasta ka kooxdan.

Ka fiirso aminoglycosides ugu caansan.

"Amikacin"

Daawada waxaa lagu gartaa a fahmayaan bacteriostatic, bactericidal iyo anti-saamaynta on jidhka bini'aadamka. Wuxuu muujinaysaa hawl sare ka dhanka ah bakteeriyada badan Gram-positive iyo Gram-negative. Sidaas waxa ku marag fura "Amikacin" Buuggan daroogada edbinta. Cirbadaha waa wax ku ool ah ee daaweynta ee stafylokok, streptococcus, pneumococcus, salmonella, Escherichia coli Mycobacterium tuberculosis.

dawo ma tahay in la nuugo iyada oo mareenka caloosha iyo mindhicirka awoodaan. Sidaa darteed oo keliya maamusho intravenously ama intramuscularly. tirada ugu badan oo ah walaxda firfircoon lagu arkay serum ka dib markii 1 hr. saameyn ku daweyn wanaagsan ahaataa 10-12 saacadood. Sababo la xiriira hanti ah ee irbadaha waxaa lagu sameeyaa laba jeer maalintii.

Marka ay ku talinaysaa isticmaalka daroogada tilmaamaha "Amikacin" loo isticmaalo? Cirbadaha waxaa lagu muujiyey in ay ballanta ka mid ah cudurrada soo socda:

• pneumonia, boronkiitada, malax sambabada;
• cudurrada faafa ee peritoneum ah (peritonitis, ganaca, cholecystitis);
• Cudurka kaadi mareenka (cystitis, urethritis, baylonfiritis);
• cudurrada maqaarka (lesions kolit, gubasho, boogaha cadaadiska, boogaha cudurka) ;
• osteomyelitis;
• meningitis, sepsis;
• cudurka TB.

Inta badan, qalab this waxaa loo isticmaalaa in dhibaatooyin ay ka xanaajisay by qaliin.

Ogol yahay isticmaalka maandooriyeyaasha ku dhaqanka carruurta. Dhab ahaantii Tani waxaa xaqiijiyay "Amikacin" Buuggan daroogada edbinta. Waayo, carruurta ka maalmood ee ugu horreeya nolosha, daroogada this loo qaadan karaa.

Qaadashada waa go'an yahay oo keliya by dhakhtarka ku xiran da'da qofka bukaanka ah iyo miisaanka jidhkiisa ah.

Waxbarashada siinayaa talooyinka soo socda:

1. miisaanka 1 kg ee bukaanka (dadka waaweyn iyo ilmaha labadaba) waa dhici ilaa 5 mg ah ee daawada. In nidaamka this saaray iyada oo soo noqnoqda duro 8 saacadood.
2. Haddii halkii miisaanka jidhka 1 kg, 7.5 mg ah ee medicament ayaa laga qaadayaa, bareeg u dhexeeya irbado jiray 12 saacadood.
3. Fiiro u yeelo sida talinaysaa daroogada "Amikacin" diiwaanka dhalaanka. Waayo, carruurta, cusub ee u dhashay, qiyaasta waxaa loo xisaabiyaa sida soo socota: 1 kg - 7.5 mg. Xaaladdan oo kale bareeg u dhexeeya irbado - 18 saacadood.
4. Duration daaweynta waxaa laga yaabaa in 7 maalmood (ee / aqbasho) ama maalmo 7-10 (la / th irbado).

"Netilmicin"

Daawada in ay saamayn antimicrobial la mid ah "amikacin". Sidaas awgeed waxaa jira kiisas "Netilmicin" siiyaa oggolyahay sare kuwa micro-organisms, taas oo dawada kor ku xusan waxba.

daroogada waxay leedahay faa'iido weyn marka la barbardhigo aminoglycosides kale. Sida ka muuqata daroogada tilmaamaha "Netilmicin" loo isticmaalo, daroogada uu leeyahay nephrotoxicity hoose iyo ototoksichnostyu. medicament waxaa loogu tala galay oo keliya in loo isticmaalo parenteral.

"Netilmicin" tilmaamaha loo isticmaalo waxaa lagu dhiirigelinayaa inay soo magacaabaan:

• la septicaemia, bacteremia,
• oo lagu daweeyo cudurka fuulaan xanaajiyeen by microbes Gram-negative,
• cudurada nidaamka neef-mareenka, ee Fistula mareenka, maqaarka, seedaha, osteomyelitis;
• staphylococcal Dhalaanka ee case of cudurada halis ah (sepsis ama pneumonia);
• at nabarka, iyo cudurada lamaguraan intraperitoneal;
• in ay dhacdo halista jahawareerka postoperative in bukaanka qaliinka;
• cudurrada faafa ee mareenka caloosha iyo mindhicirka.

qiyaasta lagula taliyey waxaa ka go'an oo kaliya dhakhtar. Waxaa laga yaabaa in 4 ilaa 7.5 mg. Iyadoo ku xiran qiyaasta, bukaanka iyo isaga ama iyada da'da inta lagu jiro maalinta waxaa lagu talinayaa 1-2 duro.

"Penicillin"

daawo Tani waa mid ka mid ah kuwa ugu muhiimsan ee kooxda of antibiotics. Waxay leedahay hawl ka dhanka ah noocyo kala duwan oo sheyga.

Qaar xasaasi ku ah "penicillin":

• streptococci,
• gonococci;
• meningococcus;
• PNEUMOKOCKER;
• diphtheria, anthrax, tetanus, gangrene gaaska;
• nooc ka mid ah stafylokok, Proteus.

Dhakhaatiirta ayaa xusay saamaynta ugu waxtarka badan ee jirka ka aqbasho muruqyada dhexdooda. In irbado sida gudahood 30-60 daqiiqo ugu badnaan fiirsashada daroogada dhiig arkay "penicillin".

Aminoglycosides penicillin magacaabay arrimaha soo socda:

1. daawooyinka xogta baahida Sare ee daaweynta ee sepsis. Waxay waxaa lagu talinayaa in daaweyn jiray gonococcal, meningococcal, cudurada pneumococcal.
2. The daroogada "penicillin" waxa lagu qoray bukaan qaliin qalliin si looga hortago dhibaatooyinka.
3. Tool caawisaa dagaalamaan meningitis purulent, malax maskaxda, jabtada, sycosis, waraabowga. Waxaa lagu talinayaa loogu talagalay gubashada iyo boogaha daran.
4. Therapy "penicillin" daroogada qoro bukaanka ka cabanaya caabuq dhegta, isha.
5. daawo codsatay daaweynta focal iyo lobar pneumonia, cholangitis, cholecystitis, endocarditis septic.
6. Dadka qaba laabotooyinka, daawada laguu qoray ee daaweynta iyo ka hortaga.
7. Daawada loo isticmaalo dhallaanka iyo carruurta yaryar, kuwaas oo laga helay sepsis ah xudunta, ama cudur sun pyosepticemia septic.
8. daroogada waxaa ka mid ahaa in daaweynta oo ka mid ah cudurrada soo socda: otitis, qandho iyo casaan, diphtheria, pleuritis purulent.

By maamulka muruqyada dhexdooda of a qayb firfircoon medicament si degdeg ah nuugo dhex galaan wareegga dhiigga. Laakiin 3-4 saacadood ee daroogada ee jirka ka dib waxaa mar dambe arkay. Taasi waa sababta, si loo hubiyo in fiirsashada lagama maarmaanka ah, waxaa lagu talinayaa in ay ku soo celiyaan irbado 3-4 saacadood kasta saacadood kasta.

Drug "gentamicin"

Waxaa la soo saaray qaab ah oo cadar, xal la isku duro, iyo kiniiniyada. daroogada waxay leedahay guryaha bactericidal. Waxay bixisaa saameyn aad u ba'an ku badan garaam-negative bakteeriyada, Proteus, Campylobacter, Escherichia, Staphylococcus, Salmonella, Klebsiella.

Diyaarinta "Gentamycin" (kiniin ama xal) jirka gasha wada baabbi'iyaa kan wakiilada faafa heer gacanta. Like aminoglycoside kasta, waxa uu siiyaa xadgudub ah ee wareer Avv borotiinka. Sidaas darteed bakteeriyada sida waayi awood u leh inay sii saari waxaana laga yaabaa in aan loo qaybin jidhka oo dhan.

Antibiyootikada cudurada faafa oo saameeya nidaamyada kala duwan iyo xubnaha:

• meningitis,
• peritonitis;
• prostatitis;
• jabtada,
• osteomyelitis;
• cystitis,
• hurgumada kilyaha,
• endometritis;
• empyema;
• boronkiitada, oof-wareen,

Drug "gentamicin" dalabka ku filan in daawada. Waxa ay u ogolaataa bukaanka si aad ugu bogsiisid cudurrada halis ah oo ka mid ah wadooyin cad-mareenka iyo kaadi mareenka. Qalabkani waxa lagu talinayaa in geeddi-faafa, oo daboolaya peritoneum, lafaha, unug jilicsan ama maqaarka.

Aminoglycosides aan loogu talagalay is-therapy. Ha illoobin, dooran antibiotic la doonayo oo kaliya dhakhtarka awoodo u qalma. Sidaa darteed, ma sameeyo is-Dawada. Dhiib xirfadlahaaga caafimaad!