"Imipenem + Cilastatin": hauj lwm, cov neeg siv kev thiab kev xyuas

Ib txhia kab mob yeej tsis yog li ntawd yooj yim. Lawv yuav tsis tau tsuas yog tiag tsis tau noj qab haus huv, tab sis twb tsim tau ib tug tiag tiag kev hem thawj rau lub neej ntawm tus neeg mob. Nyob rau hauv xws li mob, lawv yuav tsum tau siv los yeej zoo siab thiab zoo tshuaj uas muaj peev xwm ntse defeat ib tug txaus ntshai kis kab mob thiab restore noj qab haus huv. Yuav kom tshwj kom txhob muaj ntau yam kab mob kab mob yog feem ntau siv txhais tau tias "Imipenem + Cilastatin". Raws li cov lus teb ntawm cov neeg mob thiab cov kws kho mob, nws yog incredibly zoo. Ua ntej koj yuav txiav txim siab mus pib kev kho mob ntawm cov nyiaj, nws yog tsim nyog los nrhiav kom ntau npaum cov lus qhia txog cov tshuaj "Imipenem + Cilastatin": cov lag luam tawm lub npe ntawm cov tshuaj, tshwj xeeb tshaj yog kev txiav txim thiab cov qauv ntawm cov nws daim ntawv thov. Leej twg yuav tsum tau siv cov tshuaj nyob rau hauv lo lus nug? Yuav ua li cas yog cov contraindications? Yuav ua li cas tshwm sim tsis zoo Kuv yuav tau txais? Tag nrho cov ntaub ntawv no koj yuav kawm tau los ntawm kev nyeem no tsab xov xwm.

qauv

Cov kev npaj "+ Imipenem Cilastatin" yog tib yam cilastatin ua ke (uas yog ib tug inhibitor ntawm lub enzyme raum digidropeptidazy) thiab sodium ntsev ntawm imipenem (tshuaj tua kab mob). Ib tug minyuam lam fwj tshuaj npaj feem ntau muaj tsib puas milligrams ntawm ob yam tshuaj.

tso tawm daim ntawv

Saib cov tshuaj "+ Imipenem Cilastatin" yog muaj nyob rau hauv cov hmoov daim ntawv no rau tshuaj (tso dej raws leeg thawj coj) nyob rau hauv vials ntawm ntau ntau thiab tsawg, namely caum thiab ib puas thiab nees nkaum milliliters. Qhov no hmoov yuav tsum ua neej nyob hauv cov tshuaj (buffered) nrog sodium hydrogen carbonate.

Nyob rau hauv lub rooj plaub uas cov tshuaj yog tshuaj rau intramuscular thawj coj yuav tsum tau vials, txhua muaj 0.5 los yog 0.75 gram ntawm imipenem thiab cilastatin (nyob ntawm seb koob tshuaj, uas yog siv rau cov neeg mob los ntawm tus kws kho mob).

indications

Lub medicament "Imipenem + Cilastatin" kws kho rau kev siv los ntawm cov neeg mob nyob rau hauv lub xub ntiag ntawm kab thiab inflammatory kab mob uas yuav muaj tau tshwm sim los ntawm tej sensitive rau qhov kev txiav txim ntawm qhov yooj yim active tshuaj los ntawm kab mob ntawm cov tshuaj, uas muaj xws li ob qho tib si polymicrobial li mixed aerobic-co kab mob (no muaj xws li kab cov kab mob ntawm lub mob txeeb zig thiab qis pa ib ntsuj av tau, sepsis, kab mob ntawm cov pob qij txha thiab cov pob txha; peritonitis, intra-plab kab mob, inflammatory, etc. dab uas tshwm sim nyob rau hauv lub pelvic kabmob ,. ntau yam kab mob kab mob ntawm daim tawv nqaij thiab nqaij mos mos, raws li zoo raws li endocarditis Tsis tas li ntawd, cov tshuaj yog zoo siv raws li ib tug tiv thaiv muaj teeb meem tom qab phais.

pharmacological los

Miv nyuas siv zug ntawm cov tshuaj "+ Imipenem Cilastatin" conditioned kev vam meej ua ke nrog ntawm ob yam kom nquag plias yam. Ua ntej, imipenem, nruab nrab yog ib tug beta-lactam tshuaj tua kab mob uas tua nquag kab mob (li muab bactericidal nyhuv). Qhov no cov ntaub ntawv uas muaj ib tug txaus sab spectrum ntawm kev ua si. Qhov no txhais tau tias hais tias muaj ntau pathogens yog nkag rau nws cov teebmeem. Qhov thib ob feem, cilastatin sodium yog nquag ua hauj lwm nyob rau hauv lub enzyme uas decomposes imipenem nyob rau hauv lub raum ntawm tus neeg mob, cheeb qhov kev txiav txim, uas muaj txhawb rau ib tug txaus nce nyob rau hauv lub concentration ntawm cov saum toj no tshuaj tua kab mob nyob rau hauv unmodified daim ntawv nyob rau hauv tus neeg mob. Li ntawd, cov zuag qhia tag nrho cov hauj lwm zoo ntawm cov tshuaj "Imipenem + Cilastatin" khoo.

daim ntawv thov

Yuav kom ua tau tus loj tshaj nyhuv, thiab nyob rau hauv kev txiav txim kom tsis txhob muaj kev phiv los ntawm txoj kev kho yog ib qho tseem ceeb los ua tib zoo ua raws li cov tswv yim pom zoo nyob rau kev siv ntawm cov tshuaj. Lub medicament "Imipenem thiab Cilastatin Dzhodas" yog muab rau ib tug neeg mob intravenously (nrog).

Txawm tias muaj tseeb hais tias phau ntawv no muaj qhov nruab nrab koob tshuaj ntawm cov tshuaj, ua ntej pib kho mob, nws yog ib qho tseem ceeb yuav tau kho cov tswvyim ntawm txoj kev kho ncaj qha los ntawm tus kws kho mob uas yuav kom nruab tus haum ntau npaum nyob rau hauv view ntawm tus neeg mob lub keeb kwm thiab nws cov kev nta.

Koob uas muaj cov medicament "+ Imipenem Cilastatin" qhia rau qhov suav hais tias tej yam khoom uas npaj rau cov neeg cov neeg mob uas nws hnyav tshaj xya caum kilogram. Cov neeg mob uas nws lub cev hnyav yog qhov tsawg, yuav tsum tau txo nyob rau hauv kev faib ua feem rau cov ua hauj lwm koob tshuaj ntawm cov tshuaj (nws yog ib qho tseem ceeb uas tus txheej txheem no coj los ntawm ib tug competent neeg).

Rau cov neeg laus cov neeg mob ib hnub pheej koob ntawm cov tshuaj "Imipenem thiab Cilastatin Dzhodas" yog ib - ob grams, muab nws cov kev faib mus rau hauv peb - plaub thawj coj. Nyob rau tib lub sij hawm, lub siab tshaj plaws tshuaj uas yog siv tau rau kev tswj hwm rau ib hnub yog plaub thiab tsib caug grams los yog milligrams ib kilogram ntawm lub cev qhov ceeb thawj (cov kev xaiv yuav tsum poob rau hauv me me ntawm lub ob pub koob tshuaj).

Tsis tas li ntawd, lub koob tshuaj mas nws txawv nyob ntawm seb qhov heev ntawm tus kab mob. Yog li, nyob rau hauv cov ntaub ntawv ntawm ib tug neeg mob nrog me me heev ntawm tus kab mob, cov ua hauj lwm koob tshuaj rau nws yuav tsum tau ob puas thiab tsib caug milligrams (rov tshuaj yuav tsum muaj plaub lub sij hawm ib hnub twg). Yog hais tias qhov nruab nrab degree ntawm heev, tus nqi ntawm cov formulation rau ib thawj coj yuav tsum muaj tsib puas milligrams. Tswv yim txhais tau tias yuav tsum ua tau peb zaug ib hnub twg. Yog hais tias tus kab mob no yog teeb meem loj, ces cov tshuaj ntawm tshuaj yuav tsum tau siv plaub zaug ib hnub. Thaum tus neeg mob tus mob yog li ntawd loj heev hais tias muaj yog ib tug loj kev hem thawj rau nws lub neej, nws yuav tsum tau muab dua ib gram ntawm peb - plaub zaug ib hnub twg. Cov tshuaj yuav tsum tau muab qeeb (grams tauj ib teev, ob puas tsib caug - tsib puas milligrams - rau nees nkaum - peb caug feeb).

Yog hais tias cov tshuaj no yog siv rau kev tiv thaiv ntawm postoperative kab mob yog ib qho tseem ceeb kom paub ib tug gram thaum lub sij hawm tshuaj loog thiab tib koob tshuaj, peb teev tom qab ntawd.

Yog hais tias thaum lub sij hawm lub lag luam muaj ib tug kev hem thawj ntawm txhua yam ntawm kab mob (tshwj xeeb tshaj yog txoj kev ua hauj lwm nyob rau hauv lub qhov quav thiab cov nyuv), "Imipenem + Cilastatin" cov lus qhia rau kev siv xav mus nkag rau tsib puas milligrams, yim thiab kaum teev tom qab tshuaj loog.

Yuav kom npaj cov ua hauj lwm daws nyob rau hauv lub minyuam lam fwj tshuaj yog tsim nyog los ntxiv hmoov khoom puas milliliters tshwj xeeb hnyav, uas muaj tsib feem pua los yog kaum feem pua aqueous dextrose, 0.9% sodium chloride tshuaj. Cov tshuaj no imipenem tshuaj tua kab mob concentration yuav tsum tsis txhob ntau tshaj tsib milligrams ib milliliter.

Nws yuav tsum tsis txhob muab suav hais tias siv ib tug yeeb tshuaj nyob rau hauv nrog lwm yam antibacterial tshuaj, raws li zoo raws li lub ntsev ntawm lactic acid.

Cov tshuaj yeeb dej caw yog tsis tau tshaj nrog rau lwm cov beta-lactam tshuaj tua kab mob (uas muaj xws li cephalosporin, penicillin thiab monobactam). Lawv simultaneous siv tej zaum yuav ua rau tus ntoo khaub lig-kev tsis haum tshuaj loj.

Sis nrog ganciclovir tej zaum provokes generalized convulsions.

Ntau yam tshuaj uas thaiv tubular secretion, ua rau kom lub concentration ntawm imipenem nyob rau hauv cov ntshav ntshav, thiab nws cov ib nrab-lub neej lub sij hawm. Yog li, yog hais tias rau txoj kev kho yuav tsum tau muab tus neeg saib xyuas nyob rau hauv siab koob tshuaj nws yog tsis tsim nyog los siv cov pab pawg ntawm tshuaj ib txhij.

Nws yog txwv tsis pub siv cov tshuaj nyob rau hauv lo lus nug nyob rau hauv lub sij hawm ntawm hnub ntawm tus me nyuam, raws li tau zoo raws li thaum lub sij hawm pub niam mis.

Cov tshuaj yuav tsum tsis txhob siv rau tshwj kom txhob meningitis.

Cov Kev Kuaj Zis thaum lub sij hawm kev kho tej zaum yuav ib nyuag dawb lias nyob rau hauv ib tug liab pliv zas.

Ntau npaum daim ntawv ntawm cov tshuaj (tso dej raws leeg thiab rau intramuscular thawj coj) yuav tsum tau siv nruj me ntsis rau lub hom phiaj ntawd. Lawv yog cov tsis interchangeable. Ua ntej yuav pib kev kho mob tshuaj rau qhov suav hais tias ib qho tseem ceeb rau kev ib txhij txhua cov kev tshawb fawb nyob rau hauv cov kev kawm ntawm kev tsis haum tshuaj los yog ib tug neeg npau taws me ntsis rau beta-lactam tshuaj tua kab mob.

Yog hais tias ib tug neeg mob twb muaj lwm yam kab mob ntawm tus mob huam, xws li mob plab, hais tias thaum siv cov tshuaj nyob rau hauv kev ntsuam xyuas, muaj ib tug tau ntawm pseudomembranous enterocolitis.

Nyob rau hauv thiaj li yuav ntse tsis txhob muaj untoward tshua nyob rau hauv lub central lub paj hlwb nyob rau hauv cov neeg mob uas muaj tej yam kev raug mob rau lub paj hlwb los yog raug kev txom nyem convulsions nrog pom zoo tshuaj kho zoo antiepileptic agents.

Nws yuav tsum tau borne nyob rau hauv lub siab hais tias nyob rau hauv cov neeg laus cov neeg mob yuav muaj hnub nyoog txog lub raum tsis ua hauj lwm, uas yuav tsum tau txhaj koob tshuaj yuav txo tau.

Nws yog ib qho tseem ceeb kom nco ntsoov tias cov laus cov neeg mob yuav tsum tau siv cov tshuaj nrog ceev faj. Raws li ib tug txoj cai, lawv qhia cov tsos mob ntawm ib tug ntau yam ntawm muaj hnub nyoog txog mob nyob rau hauv lub hauj lwm ntawm ob lub raum. Nyob rau hauv cov ntaub ntawv no, yog tias tsim nyog, siv cov tshuaj "Imipenem + Cilastatin" phau ntawv qhia xav kom koj tham nrog koj tus kws kho mob rau kom txhob muaj yeeb tshuaj ntau npaum siv.

Muaj ib co tshwj xeeb tej yam kev mob ntawm daim ntawv thov ntawm cov tshuaj no rau cov me nyuam. Yog hais tias lawv lub cev hnyav tshaj plaub caug kilogram, tib cov txheej txheem yuav tsum muaj ntaub ntawv mus rau lawv raws li rau cov neeg laus. Yog hais tias tus me nyuam yog laus tshaj peb lub hlis, thiab nws cov luj yog tsawg tshaj li plaub caug kilos, lub siab tshaj plaws txhua txhua hnub koob tshuaj xws li ib tug neeg mob yuav tsum muaj ob tug grams. Lawv yuav tsum tau muab kaum tsib milligrams ib kilogram plaub zaug ib hnub twg.

Nyob rau hauv tsis muaj cov ntaub ntawv yuav siv tsis tau cov tshuaj "Imipenem + Cilastatin" rau cov me nyuam uas tseem tsis tau mus txog peb lub hlis, thiab cov neeg cov me nyuam uas cuam tshuam rau tej hauj lwm ntawm lub ob lub raum, uas yuav tsum tau qhia nyob rau hauv cov theem ntawm ntshiab creatinine concentration siab tshaj ob milligrams per deciliter.

Contraindications

Muaj ib co nuances uas yuav tsum tau raug xam tias yog thaum uas siv cov "+ Cilastatin Imepenem". Instruction xav ua tib zoo kawm txog cov contraindications rau cov tshuaj no. Thiab ntawm lawv yog cov nram qab no:

• lub sij hawm ntawm hnub ntawm tus me nyuam;
• kev pub niam mis;
• Cov me nyuam nyob rau hauv lub hnub nyoog ntawm peb lub hlis;
• Cov me nyuam uas txom nyem tsis hnov raum hauj lwm uas txuam nrog END ntawm ntshiab creatinine;
• ib tug neeg rhiab heev rau tus neeg Cheebtsam ntawm cov tshuaj nyob rau hauv kev saib xyuas, li zoo li mus rau lwm cov beta-lactam tshuaj tua kab mob thiab carbapenems.

Nws yog ib qho tseem ceeb los ua tim nyob rau hauv lub siab tias cov neeg laus cov neeg mob thiab cov neeg uas raug kev txom nyem los yog tau puas raug kev txom nyem los ntawm cov kab mob ntawm lub hauv paus poob siab system los yog cov kab mob ntawm tus mob huam yuav tsum tau cov tshuaj nrog ceev faj nyob rau hauv lub qhov kev saib xyuas ntawm ib tug kws kho mob. Hais tias nws yuav competently muab qhov tseeb ntau npaum ntawm cov tshuaj "Imipenem + Cilastatin". Contraindications tseem ceeb heev rau kawm ua ntej koj pib kho mob.

phiv

Nws yog ib qho tseem ceeb kom paub tias ib tug xav paub ntau tshaj txog lub cuab tam "Imipenem + Cilastatin". Formula npaj yog tias ib txhia cov neeg mob tej zaum yuav muaj ib co sab tshua nyob rau hauv ntau lub cev. Ntawm lawv yog cov: thrombophlebitis, saj ntxaug, Candidiasis, oliguria, myoclonus, hallucinations, paresthesia, tsis meej pem, mob raum tsis ua hauj lwm, puas siab puas ntsws, qaug dab peg, polyuria, anuria, raws plab, kab mob siab, xeev siab thiab ntuav, leukopenia, pseudomembranous enterocolitis, lymphocytosis, hyperbilirubinemia, eosinophilia, pruritus, leukopenia, daim tawv nqaij ua pob liab vog, thrombocytosis, hypercreatininemia, monocytosis, urticaria, basophils, ib tug zoo ncaj Coombs xeem.

Muaj yog tsis muaj leej ntaub ntawv raws li yuav ua li cas nrog rau ib qho overdose ntawm cov tshuaj nyob rau hauv kev saib xyuas. Txawm li cas los nws yog lub npe hu hais tias cov active cov khoom xyaw rau ntse yauv mus hemodialysis. Cuaj kaum, nws yog tseem tsis paub hais tias yuav ua li cas zoo li no txoj kev yog nyob rau hauv cov ntaub ntawv ntawm ib tug overdose. Nws yog yog li ntawd ib qho tseem ceeb mus saib tag nrho cov tswv yim pom zoo, uas muaj txhais tau tias kev thov "+ Imipenem Cilastatin" piav qhia txog cov kev npaj.

cia tej yam kev mob

Nyob rau hauv kev txiav txim tias daim ntawv thov ntawm cov tshuaj yuav tsum tau zoo, nws yog ib qho tseem ceeb coj mus rau hauv tus account ib qho tseem ceeb point. Namely, yuav ua li cas cia cov tshuaj "Imipenem + Cilastatin". Hauj lwm ntawm lub substance muaj cov tswv yim nram no.

Lub hmoov yuav tsum tau muaj nyob rau hauv lub chav tsev nyob rau hauv uas lub chav tsev kub yog fwm. yuav tsum tau siv los npaj ua hauj lwm tov tsis pub dhau ib teev tom qab fabrication. sodium tshuaj dawb tov ntawm chav tsev kub yuav tsum khaws cia rau ntau tshaj li kaum lub sij hawm thiab nyob rau hauv lub tub yees - tsis ntau tshaj plaub caug-yim. piam thaj cov ntsiab yuav khaws cia rau tsis muaj ntau tshaj plaub thiab nees nkaum plaub teev, ntsig txog.

analogs

Muaj ib tug xov tooj ntawm cov tshuaj uas yog ib feem ntawm ib pab pawg neeg txhais tau tias analogues "Imipenem + Cilastatin". Hloov xam tau tias yog tshuaj - "Inemplyus", "Miksatsil", "Lastin", "Sinerpen", "Tiaktam", "Piminov", "Supranem" thiab "Tienam". Raws li ib tug txoj cai, tag nrho cov ntawm cov tshuaj muaj tib lub active ingredient li cov tshuaj xam tau tias yog. Lub ntsiab active cov khoom xyaw ntawm cov tshuaj - imipenem, cilastatin (luam lub npe thiab cov uas muaj kev cuam tshuam cov tshuaj no). Yog li, cov tshuaj no yeej zoo li qub, thiab contraindications thiab tshwm sim thiab pharmacological los. Txawm li cas los, nws yuav tsum tau nco ntsoov tias ntau npaum yuav tsum appoint ib tug kws kho mob uas yuav tsum tau xav txog tag nrho cov nuances. Cov tshuaj "Imipenem + Cilastatin" analogues tshuaj yuav tsum tsis txhob siv los ntawm cov neeg mob tsis tau tso cai, tsis muaj tus kho tus kws kho mob thiab nws qhov kev tswj. Nrog nws lub tswv yim yog xav tau thiab cov kev xaiv uas tsim nyog analogy.

generalization

Xyaum qhia cov hauj lwm zoo ntawm cov tshuaj "+ Imipenem Cilastatin". Xyuas tau qhia kev vam meej kev kho mob tshwm sim. Txawm li cas los, ob leeg kws kho mob thiab cov neeg mob tau teem rau li cas yog ib qho tseem ceeb kom meej ua raws li cov tswv yim pom zoo uas muaj nyob rau hauv cov lus qhia thiab muaj cov kws kho mob. Tsuas yog no txoj kev ntawm kev kho mob yuav nqa cov kev pab cuam mus rau lub cev ntawm tus neeg mob.

Yuav tsum tsis raug ignored contraindications, lub xub ntiag ntawm uas tsis pub kom pib cov kev kho mob xam tau tias yog ib tug yeeb tshuaj. Txwv tsis pub, nws daim ntawv thov yuav tsis tau tsuas yog muab ib tug zoo tshwm sim, tab sis kuj ua rau loj puas tsuaj rau lub cev mob ntawm tus neeg mob. Tsis tas li ntawd, tsis yog siv qhov suav hais tias cov tshuaj yuav ua rau kev phiv, ib co kev uas yuav ho paug tus neeg mob tus mob. Nws yog ib qho tseem ceeb uas cov kev kho mob coj qhov chaw nyob rau hauv lub saib xyuas ntawm ib tug competent tus kws kho mob, uas yuav tsis tsuas tau zoo-paub cov peculiarities ntawm daim ntawv thov ntawm cov tshuaj, tab sis kuj muaj mastered qhov tsim nyog kev txawj ntse thiab kev txawj ntse los tiv nrog lub emergent nyuaj. Koj tus kws kho yuav tsum tau nyob rau hauv lub ob txhais tes ntawm yeej muaj tseeb cov tub txawg.

Ua ntej koj yuav txiav txim siab mus pib kho mob yog ib tug yeeb tshuaj, nws yog ib qho tseem ceeb mus ua tib zoo nyeem tag nrho cov lus qhia txog nws, uas qhia cov yam ntxwv ntawm nws cov teebmeem rau lub cev. Txhua yam koj yuav tsum paub txog lub peev xwm rau kev phiv tshuaj, qhov tshwm sim ntawm uas yuav xa ib tug ntau ntawm txaav rau tus neeg mob thiab cov teeb meem ntawm nws tus kws kho mob.

Los ntawm cov kev xaiv ntawm kev kho mob yog ib qho tseem ceeb los kho tiv. Xaiv lub siab tshaj plaws cov khoom uas zoo!