Tshuaj tua kab mob "zyvox": cov lus qhia rau kev siv, analogs

Nyob rau hauv cov kev kho mob ntawm cov kab mob cov kab mob tus kws kho mob feem ntau yog muab tshuaj tua kab mob. Cov tshuaj muaj ib tug lossis loj tus naj npawb ntawm ntau ntau yam. Ntawm cov hoob kawm, tag nrho cov hom ntawm antiseptic kws tshuaj yog tsis yooj yim sua kom koj paub, tab sis ib txhia tshuaj tiv thaiv kab mob kab mob yog kev txaus siab.

Ib tug ntawm cov niaj hnub tshuaj tua kab mob, uas yog nyob rau hauv peb cov kev ua lag luam ntawm cov tshuaj - yog "zyvox". Cov lus qhia rau kev siv ntawm cov tshuaj ntawd hais tias qhov no antimicrobial neeg sawv cev ntawm cov khoom cua keeb kwm. Nws belongs rau ib tug tshwj xeeb pab pawg neeg - oxazolidinone. Lub ntsiab active ingredient yog linezolid. nyhuv ntawm cov tshuaj "zyvox", cov lus qhia rau kev siv, analogs, tshwm sim thiab contraindications: Tom ntej no peb muaj cov nram qab no cov ntaub ntawv yuav muab suav hais tias.

Nyob rau hauv dab tsi daim ntawv no yog ua?

Cov tshuaj no muaj nyob rau ob ntau npaum cov ntaub ntawv:

• Nyob rau hauv daim ntawv ntawm granules, dyed dawb los yog yellowish nyob rau hauv cov xim thiab nrog txiv kab ntxwv tsw. Ntawm no, ib tug tov pereoralnogo rau cov expectation tias nyob rau hauv 5ml ntawm tas ncua kev kawm ntawv yuav muaj 100 mg ntawm linezolid. Lub granules tau muab tso rau hauv ib tug creeping peev xwm ntawm 150 ml. Tsis tas li ntawd nyob rau hauv lub pob muaj ib tug ntsuas diav nrog graduations (2.5 thiab 5 ml ntawm kev ncua).
• Nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj uas muaj 600 mg ntawm linezolid. Cov pob muaj ib tug sawv hlwv nrog 10 ntsiav tshuaj hauv.
• Txoj kev lis ntshav tov uas muaj 2 mg linezolid / 1 ml, nyob rau hauv tej pob khoom ntawm 100, 200, 300 ml.

Yuav ua li cas yog lub pharmacological nyhuv ntawm cov tshuaj?

Active tshuaj linezolid muaj lub peev xwm mus txeem mus rau hauv tus kab mob ntawm tes, mus khi rau lawv ribosomes thiab inhibit protein synthesis. Raws li ib tug tshwm sim, lub kab mob raug tua.

Tawm tsam tej yam kab mob yuav pab tshuaj?

Tshuaj "zyvox" phau ntawv qhia uas nrog txhua pob nrog ib tug tshuaj uas zoo ua nyob rau hauv cov nram no kab mob:

• Gram-zoo aerobic kab mob: Enterococcus, Corynebacterium, Staphylococcus, tus kab mob Streptococcus;
• Gram-tsis zoo aerobic kab mob ntawm lub genus Pasteurella;
• Gram-zoo co kab mob: Clostridium thiab peptostreptokokki;
• Gram-tsis zoo co kab mob ntawm cov genera prevotella, bakteroides, chlamydia.

Yuav kom linezolid mob pesnrab raug cov kab mob ntawm lub genera Moraxella, Legionella, Mycoplasma.

Tseem muaj kab mob uas muaj kuj yuav linezolid, ib feem ntawm cov tshuaj "zyvox". Cov lus qhia rau kev siv qhia cov nram qab no resistant kab mob los ntawm: Haemophilus cov kab mob, raws li tau zoo raws li tus me nyuam enterobakteriatsea, nizera thiab Pseudomonas.

Nyob rau hauv dab tsi kab mob nws yog qhia cov tshuaj?

Tshuaj tua kab mob "zyvox" yog muab rau cov nram qab cov kab mob:

• Kis kab thiab inflammatory kab mob uas yog tshwm sim los ntawm cov kab mob uas yog nkag mus rau lub muab tshuaj.
• Nyob rau hauv tus neeg mob ntawm nosocomial los yog lub zej lub zos-kis tau mob ntsws dej.
• Nrog kab txhab ntawm daim tawv nqaij thiab nqaij mos mos ntawm lub cev tib neeg.
• Nyob rau hauv lub xub ntiag ntawm cov kab mob, kab mob uas yog Enterococci seeb kuj mus vancomycin.

Tsis tas li ntawd, "zyvox" tshuaj tua kab mob yuav siv tau raws li ib feem ntawm ib tug neej coj hom ntawm txoj kev kho tiv thaiv kab mob uas tshwm sim taus vim gram-tsis zoo kab mob.

tshuaj

Linezolid yog yus muaj los ntawm haum sai absorbability los ntawm cov hnyuv mus rau hauv cov hlab ntsha, hais txog ntawm daim ntawv tso tawm neeg sawv cev. Twb tom qab 2 xuab moos tom qab thawj coj ntawm cov tshuaj, nws concentration nyob rau hauv cov ntshav nce mus txog ib tug tshaj plaws. Linezolid yog tsiag ntawv los ntawm tag nrho cov bioavailability thiab sai sai yog nws tis rau nruab nrog cev thiab cov nqaij. Txawm li cas los ntawm yog dab tsi lub concentration ntawm tshuaj tua kab mob nyob rau hauv cov ntshav 31% ua txhua yam rau ntshav proteins.

Nyob rau hauv tib neeg, lub linezolid yog metabolized los ntawm oxidation mus rau lub ob yam khoom uas tsis muaj antimicrobial kev txiav txim. Lawv tas los ntawm ob lub raum (kwv yees li 50%) thiab cov hnyuv (mus txog 6%). Mus txog 35% uas tsis yog-metabolized tshuaj tua kab mob tas nrog zis.

Cim los ntawm ruaj khov tshuaj, uas yog tsiag ntawv los ntawm tshuaj "zyvox". Cov lus qhia rau kev siv nyob rau cov tsis muaj cov tshuaj kuaj nyob rau hauv tus neeg mob lub hnub nyoog. Yog li ntawd, cov neeg laus tsis yuav tsum tau lub adaptation ntawm cov tshuaj tus kws khoom.

ntau npaum

Lub medicament "zyvox" tej zaum yuav raug muab tso rau ib tug kws kho mob rau ib tug neeg mob rau qhov ncauj thawj coj los yog nyob rau hauv daim ntawv ntawm cov tso dej Txoj kev lis ntshav thawj coj. Ntxiv mus, tus neeg mob yuav tsum kis los ntawm ib hom mus rau lwm lub haus tsis poob cov hauj lwm zoo ntawm kev kho mob.

Tshuaj ntau npaum, ntev ntawm lub chav kawm yuav tsum xaiv tus kws kho mob, thiab kev kho mob ntawm cov yam yog tshwm sim los ntawm cov nram qab no yam:

• zoo li cas ntawm cov kab mob yog tshwm sim los ntawm tus kab mob;
• laus kab mob;
• lub heev ntawm tus kab mob no;
• soj ntsuam kev pab los ntawm txoj kev kho.

Thaum streptococcal mob ntsws, lub zej lub zos-nrhiav thiab tsev kho mob-hom rau cov neeg laus thiab cov me nyuam muaj 12 xyoos tshuaj 600 mg ntawm "zyvox" tshuaj. Phau ntawv ntawd hais tias noj ib koob tshuaj noj tshuaj yuav tsum muab los siv txhua txhua 12 teev thiab tus kawg ntev yog 10-14 hnub.

Rau kab mob ntawm daim tawv nqaij los yog nqaij mos mos, nyuab los yog uncomplicated tshwm sim los ntawm staphylococci, streptococci thiab Enterococci resistant rau vancomycin, xws li ntshav qab zib ko taw syndrome (tsis muaj osteomyelitis) muab koob tshuaj "zyvox" 600 mg. Instruction kuj qhia tias lub luv ntawm kev noj cov tshuaj yuav tsum tau 12 teev. Hoob no ntawm kev kho mob kav 10-14 hnub, tab sis tej zaum yuav kav mus txog 28 hnub rau kev kho mob tshuaj.

Yog hais tias tus neeg mob muaj hlaus kev tsis taus, cov tshuaj haum ntawm cov tshuaj nws xav tau kev pab. Nyob rau hauv hemodialysis cov txheej txheem linezolid yog muab tshem tawm tshaj ib lub sij hawm lub sij hawm 3 h. Nyob rau hauv kev twb kev txuas nrog rau qhov no, cov tshuaj yuav tsum tau noj tom qab cov kev tshwm sim nyob rau hauv lub purification ntawm cov ntshav. Cov neeg mob uas muaj mob daim siab tsis ua hauj lwm, thiab tsis yuav tsum tau lub adaptation ntawm cov tshuaj.

Cov neeg mob muaj hnub nyoog yau tshaj 12 xyoo yog muab tsuas rau hauv daim ntawv ntawm cov tshuaj Txoj kev lis ntshav "zyvox". Instruction rau siv nyob rau hauv cov me nyuam mos thiab cov me nyuam ntawd hais tias cov linezolid yuav noj nyob rau hauv ib tug ntau npaum ntawm 10 mg / kg lub cev hnyav ntawm tus me nyuam ntawm ib zaus nyob rau hauv txhua txhua 8 teev. Hoob no ntawm kev kho mob yog los ntawm 10 mus rau 14 hnub. Qhov no ntau npaum ntawm cov tshuaj rau cov tshuaj pleev kho nyob rau hauv lub zej lub zos-nrhiav thiab nosocomial mob ntsws, nqaij mos, thiab daim tawv nqaij, raws li zoo raws li nrog enterococcal kab mob.

Tiv sheath ua los ntawm ntawv ci, yog muab tshem tawm sai li sai tau ua ntej mus rau lub Txoj kev lis ntshav txoj kev. Nws yog tsim nyog los saib lub pob rau txia los ntawm cia li muab nws rau 1 feeb. Leaky ntim unusable vim tsis-sterility. Cov Txoj kev lis ntshav tov yog muab tshaj ib lub sij hawm lub sij hawm ntawm 30-120 feeb.

Nta ntawm daim ntawv thov

Muaj ib co nta txais tos "zyvox" tshuaj. Phau ntawv ntawd hais tias yog hais tias tus kab mob yog tshwm sim los ntawm Gram-tsis zoo kab mob, nws yog tsim nyog los txuas ntxiv tshuaj nrog ua si tiv thaiv no pab pawg neeg ntawm microorganisms.

Thaum tau txais linezolid ib co neeg mob tej zaum yuav tshwm sim reversible myelosuppression. Nyob rau lub caij ntawm txoj kev kho yog yus muaj los ntawm anemia, leukopenia, thrombocytopenia los yog pancytopenia. Raws li cov ntaub ntawv no, saib xyuas cov ntshav suav yuav tsum tau ua nyob rau hauv cov neeg mob uas muaj feem yuav los ntshav. Tsis tas li ntawd, cov kev ntsuas uas tsim nyog yog hais tias tus neeg mob muaj ib tug keeb kwm ntawm myelosuppression los yog nws yuav siv sij hawm cov tshuaj uas txo theem ntawm hemoglobin thiab platelets los yog lawv cov kev ua. Kev soj ntsuam ntawm cov ntshav suav no kuj tsim nyog thaum lub sij hawm heev kev kho mob lub sij hawm (14 hnub).

Ib txhia neeg uas tau txais linezopida yuav tsum tau nrog los ntawm kev pheej hmoo ntawm mob plab, pseudomembranous xwm ntawm ntau hom ntawm lub ntiajteb txawj nqus.

Zawv plab yog ib qho nyob rau hauv cov neeg noj tshuaj tua kab mob feem ntau. Raws li ntawm no sab nyhuv tej zaum yuav txawv los ntawm me me mus rau mob loj heev. Thaum noj cov tshuaj, "zyvox" ntsiav tshuaj los yog raug tshem tawm yog, muaj yog tsuj ntawm tej plab hnyuv microflora thiab overgrowth ntawm cov kab mob ntawm lub genus Clostridium. Nyob rau hauv tus txheej txheem ntawm lawv lub neej no kab ua toxins A thiab B pawg, thiab lawv ua rau raws plab. Kom ntau ntawm cov Cheebtsam yuav ua tau kom neeg tuag taus rau cov neeg mob. Tag nrho cov neeg mob uas tau undergone no hom ntawm raws plab, yuav tsum ceev faj kho mob saib xyuas rau ib lub sij hawm ntawm 2 lub hlis.

Nyob rau hauv tej rooj plaub, ib tug deterioration nyob rau hauv cov kev kho mob ntawm cov tshuaj "zyvox". Cov lus qhia rau kev siv nyob rau hauv cov me nyuam thiab cov laus, cim tias seb thaum ib tug ua tau hloov nyob rau hauv cov xim xaav, pom tau qhov sib ua kom pom tseeb, teb tsis xws luag, qhov muag plooj. Nyob rau hauv cov neeg mob, tus neeg mob yuav tsum tam sim ntawd sab laj kws kho qhov muag. Yog hais tias yam tshuaj no yog coj los ntawm tus neeg mob tshaj ib lub sij hawm ntev ntawm lub sij hawm (ntau tshaj 3 lub hlis), ces nws yog yuav tsum tau los mus ua kom cov kev tswj ntawm. Thaum tshwm sim thiab kev loj hlob ntawm cov txheej xwm xws li peripheral neuropathy los yog optic paj, rau lo lus nug ntawm lub cessation ntawm yeeb tshuaj kho yog tias cov kev pab cuam los ntawm nws yog tsawg tshaj li qhov kev puas tsuaj ua rau kev kho mob.

Tsis tas li ntawd, muaj neeg mob ntawm lactic acidosis thaum noj "zyvox". Nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm cov xeev siab, ntuav, acidosis los yog unjustified yuav txo tau ntawm carbonate anions. Qhov no tshwm sim yuav tsum tau ua tib zoo saib xyuas kev kho mob tshwj xeeb.

Yog hais tias tus neeg mob muaj ib tug xav tau nyob rau hauv nrog cov "zyvox" noj xim serotonin reuptake inhibitors, nws yuav tsum tau noj nyob rau hauv kev kho mob saib xyuas nyob rau hauv kev txiav txim mus ntes serotonin syndrome: ib tug tsis ua hauj lwm ntawm kev txawj ntse muaj nuj nqi, hyperreflexia, hyperpyrexia, thiab incoordination. Nyob rau hauv lub xub ntiag ntawm lub piav phenomena ua discontinuation ntawm ib tug los yog ob qho tib si ntawm cov tshuaj. Yog li muaj yog heev ntawm hniav enamel, uas yog muab tshem tawm los ntawm kev tu.

Yog lwm caveat tau txais "zyvox" tshuaj. Cov lus qhia rau kev siv (ntsiav tshuaj nws los yog granules rau ncua kev kawm ntawv - tsis) hais tias: cov kev kho mob nrog linezolid yog tsis pom zoo tsav tsheb tsheb, tshwj xeeb cov khoom tswj hauj lwm thiab cov uas muaj kev pheej hmoo rau lub neej thiab noj qab haus huv.

Yuav ua li cas yog cov kev phiv los ntawm ib tug yeeb tshuaj?

Phiv tshua uas tej zaum yuav tshwm sim nyob rau hauv ib tug neeg mob thaum noj ntawm tus kws neeg sawv cev "zyvox 600 mg" txwv kom muab zais los ntawm cov hav zoov zaus los ntawm heev heev (10%) rau heev tsawg (0.01%).

Feem ntau, cov kev phiv nyob rau hauv cov kev kho mob ntawm cov tshuaj "zyvox" cov lus qhia rau kev siv, tshuaj no los yog ntsiav tshuaj, phenomenon hu ua me me los yog muaj mob loj tsawv heev. Tshwj xeeb nqi muaj cov nram qab muab:

• xeev siab;
• raws plab;
• mob taub hau.

Nyob rau hauv neeg laus cov neeg mob tej zaum kuj yuav muaj kev cem quav, ntuav, mob nyob rau hauv lub plab mog, tsam plab, thiab vulvovaginal kab mob ntawm lub qhov ncauj kab noj hniav.

By tsis tshua tshwm sim tshwm sim los ntawm cov tshuaj "zyvox" cov lus qhia rau kev siv (rau cov me nyuam saum toj no 12 xyoo thiab cov neeg laus) hu cov kev hloov nyob rau hauv cov xim ntawm cov lus ntawm cov xim.

Raws li tshawb nrhiav, nws yuav sib cav hais tias thaum lub sij hawm kev kho mob nrog rau qhov no tshuaj tua kab mob yog feem ntau ntes tau thrombocytopenia. Tsis li ntawd, tsis tu ncua cai nce nyob rau hauv cov ntshav theem ntawm triglycerides, txawv txav kom lub siab enzymes ALT, AST, alkaline phosphatase, LDH thiab lipase thiab amylase. nce nyob rau hauv concentration ntawm tag nrho cov bilirubin, creatine thiab prolactin kuj kaw.

Lub paj hlwb ntawm tus neeg mob tej zaum yuav xav li cas rau cov tshuaj noj linezolid. Qhov no yog feem ntau qhia nyob rau hauv Kiv tauv hau thiab yastes yastaw, raws li zoo raws li tu-sauv. Rarer ces tshuaj phiv mob saj perversion.

Cov kev hloov nyob rau hauv lub qub hauj lwm ntawm lub hauv paus poob siab system yuav ua rau "zyvox" (ntsiav tshuaj). Phau Ntawv Qhia qhia heev insomnia nyob rau hauv cov neeg mob thaum lub sij hawm hauv chav kawm ntawm kev kho mob nrog rau qhov no kws npaj.

Lub lag luam ntawm lub genitourinary system txoj kev kho siv "zyvox" yuav thaws rov los nyob rau hauv daim ntawv ntawm lub paum Candidiasis.

Feem ntau muaj thiab cutaneous ces linezolid kev kho mob nyob rau hauv daim ntawv ntawm cov ua pob ua xyua.

Cov lwm sab los yuav tau hu ua febrile phenomena thiab opportunistic fungal kab mob, uas tshwm sim ncaw.

Tsis tas li ntawd, thaum "zyvox" txoj kev tshawb no tshuaj muaj cai neeg mob ntshav siab, khaus thiab kem plab.

Linezolid nyob rau hauv cov kev kho mob ntawm cov tub ntxhais hluas cov neeg mob muaj hnub nyoog 12 mus rau 17 xyoo, feem ntau pom muaj nyob rau nram qab no undesirable los:

• raws plab, ntuav, xeev siab, mob plab;
• kiv tauv hau, migraine;
• sawv pob;
• kis kab mob ntawm lub sab sauv tej hlab cua txhob, hnoos, mob caj pas;
• kub taub hau;
• mob uas yog ib qhov nyuaj rau piav qhia txog lub localization.

Cov nram qab no tshwm sim muaj peev xwm tshwm sim kuj yus muaj los ntawm ib tug qis zaus:

• eosinophilia;
• nce nyob rau triglycerides, ALT, lipase thiab creatine;
• khaus.

ntxiv phiv tau kuaj ntawm kev soj ntsuam tshawb, uas yog yus muaj los ntawm "zyvox" (tshuaj, thiab cov ntsiav tshuaj). Cov muaj xws li:

• reversible myelosuppression;
• neuropathy ntawm lub optic paj;
• anaphylaxis;
• cim angioneurotic edema;
• lactic acidosis;
• peripheral neuropathy cim;
• heev ntawm txha hniav laus;
• ua daus no;
• qaug zog;
• serotonin syndrome.

Raws li "zyvox" nws yog ua ke nrog lwm yam tshuaj?

Thaum pa roj carbon monoxide-xeem nrog cytochrome tsis muaj kev hloov yog pom nyob rau hauv lub xeem ua si.

Yog hais tias nyob rau tib lub sij hawm kho nrog linezolid thiab monoamine oxidase inhibitors, lub tom kawg cov nyhuv yog kho kom zoo. Raws li nyob rau hauv no qhov tseeb, nws yog tsim nyog los txo cov tshuaj ntawm agonists thiab Dofaminomimetiki.

Thaum pa roj carbon monoxide-xeem tshuaj "zyvox" thiab antidepressants uas inhibit qhov kev uptake ntawm serotonin, serotonin syndrome zaum yuav tshwm sim.

Nyob rau hauv cov ntaub ntawv ntawm co-thawj coj nrog "aztreonam" los yog "Gentamycin" farmakinetika linezolid twb tsis cai.

Co-thawj coj nrog "Rifampicin" yuav txos lub concentration makismalnaya "zyvox" - mus txog rau 32%.

Contraindications

Cov tshuaj yog tsis tsim nyog rau siv los ntawm cov neeg mob uas muaj zog rhiab heev rau lub ntsiab los yog ntxiv licas hauv nws cov qauv.

Yog hais tias tus neeg mob yuav siv sij hawm phenelzine los yog isocarboxazid, linezolid ces nws yuav tsis tau noj thaum lub sij hawm txoj kev kho, thiab 2 lub lis piam tom qab ntawd.

Yog hais tias koj muaj peev xwm tswj tsis tau cov ntshav siab, lub "zyvox" tsis tsim nyog los kho cov neeg mob nrog rau cov nram qab no cov kab mob:

• tsis ruaj tsis khov tawg;
• hyperthyroidism;
• pheochromocytoma;
• raws li zoo raws li ib tug sib koom txais tos nrog agonists thiab Dofaminomimetiki.

Thaum impossibility ntawm ceev faj kev soj xyuas tus neeg mob yuav tau txoj kev pheej hmoo ntawm serotonin syndrome "zyvox" yuav tsis raug muab tso nyob rau hauv lub qab no:

• muaj carcinoid kab mob;
• koom haum saib xyuas ntawm cov tshuaj uas inhibit qhov kev reuptake ntawm serotonin, tricyclic antidepressants hom triptans "Miperedina" thiab "buspirone".

Ntsiav tshuaj daim ntawv "zyvox" yog ua rau cov me nyuam nyob rau hauv 12 lub xyoos vim ntawm cov impossibility ntawm cov kev xaiv kom txaus npaum li cas.

Cov tshuaj no yog qhia rau kev kho mob thaum cov kev pab cuam yuav tsum los ntawm nws tshaj txoj kev pheej hmoo nyob rau hauv cov nram no mob:

• raum thiab hepatic insufficiency;
• mauj mob;
• Cev xeeb tub thiab lactation.

Yuav yog ib tug yeeb tshuaj overdose?

Nyob rau hauv kev tshawb fawb, raws li zoo raws li tau siv ntawm cov kev npaj "zyvox" nyob rau hauv lub tsev kho mob los yog lub zej lub zos-kis tau daim ntawv thov overdose yog tsis kuaj. Thaum zoo li no tshwm sim nws yog pom zoo kom symptomatic txoj kev kho.

Cia thiab tso tawm

Tshuaj "zyvox" muaj nyob rau hauv khw muag tshuaj los ntawm cov tshuaj. Cia nws yuav tsum nyob rau hauv qhov chaw, txwv los ntawm dej thiab ncaj qha tshav ntuj ntawm kub tsis ntau tshaj 30˚C, txwv tsis pub cov me nyuam nkag.

analogs

Nyob rau hauv cov ntaub ntawv ntawm lub unacceptability ntawm kev kho mob "zyvox" analogs ntawm kev zoo sib thooj xav txog kev teem tej zaum yuav raug muab tso rau lub ntsiab kev kho mob los ntawm lub active tshuaj:

• Thaum mob ntsws dej thiab ntsws - "Doxycycline hydrochloride" "Bronhorus" "Arlette".
• Thaum bakteialnyh kab mob - "chloramphenicol 0.25 g", "Vankomabol", "Lifakson".
• Nrog kab mob ntawm daim tawv nqaij - "Benzathine Benzylpenicillin", "Sulfadimetoksin".
• Thaum nonhealing txhab - "Tsifaleksina sodium ntsev", "Liphuzol".

Yuav kom muab lawv nyob rau hauv daim ntawv no yuav tsum tsuas kws kho mob, vim hais tias txhua tshuaj nws muaj nws indications, contraindications, thiab tshwj xeeb tshaj yog cov txais tos.