Cefepim - umarnin don amfani, analogues, sake dubawa da kuma sakin siffofin (injections a cikin ampoules don injections na wani kwayar rigakafi ta 1 gram, Allunan) magunguna don lura da mashako, ciwon huhu, cystitis a cikin manya, yara da ciki

A cikin wannan labarin, zaku iya karanta umarnin don amfani da miyagun ƙwayoyi Cefepim. Yana ba da ra'ayi daga baƙi zuwa rukunin yanar gizon - masu amfani da wannan magani, kazalika da ra'ayoyin masana kiwon lafiya game da amfani da ƙwayar cuta ta cefepime a cikin aikin su. Babban buƙatar shine a ƙara ra'ayoyinku game da miyagun ƙwayoyi: maganin ya taimaka ko bai taimaka kawar da cutar ba, menene rikice-rikice da sakamako masu illa da aka lura, mai yiwuwa ba sanar da mai masana'anta a cikin bayanin ba. Analogs na lokaci-lokaci a gaban wadatar analogues na tsarin analogues. Yi amfani da shi don maganin mashako, ciwon huhu, cystitis da sauran cututtukan da ke aukuwa a cikin tsofaffi, yara, har ma yayin daukar ciki da lactation. Abun da magani.

Cefepim - maganin kwayoyin cutar cephalosporin daga rukunin mutanen ƙarni na 4 don amfani da parenteral. Yana da tasirin kwayan cuta, yana rushe tsarin kwayar tantanin halitta.

Aiki da akasarin ƙwayoyin cuta na giram, incl. samar da beta-lactamases, gami da Pseudomonas aeruginosa. Activearin aiki fiye da cephalosporins 3 ƙarni, a kan cocci na gram-tabbatacce.

Ba aiki da Enterococcus spp. (enterococcus), Listeria spp. (Listeria), Legionella spp. (Legionella), wasu ƙwayoyin anaerobic (Bacteroides fragilis, Clostridium difficile).

Cepepime an kwatanta shi da babban kwanciyar hankali a kan plasmid daban-daban da kuma beta-lactamases na chromosomal.

Abun ciki

Cefepima hydrochloride + magabata.

Pharmacokinetics

Ingarfafa furotin na Plasma ƙasa da 19% kuma yana da 'yanci daga taro mai hankali na serum. Ana samun abubuwan warkewa na lokacin haila a cikin fitsari, da zazzagewa, da ruwa na ciki, da fitar hanji, hanji na hanji, hanji, kwancen hanji, gurnar ciki da gall, fitsarin mahaifa tare da meningitis. A cikin mutane masu lafiya, tare da gudanar da jijiyar ciki na cefepime a cikin kashi 2 na g tare da tazara na 8 hours don kwanaki 9, babu tara a cikin jikin da aka lura. Kodan an ware shi da kodan, akasarinsu ne ta hanyar lalata dunƙulewar ƙasa (matsakaicin keɓaɓɓiyar karɓa - 110 ml / min). A cikin fitsari, kusan kashi tamanin cikin dari na abubuwan da aka gudanar an gano ba su canzawa. A cikin marasa lafiya masu shekaru 65 ko mazan da ke da aikin na al'ada, aikin keɓaɓɓe ya ƙasa da na matasa marasa lafiya. Magungunan magunguna na lokacin kaka a cikin marasa lafiya da ke fama da aikin hanta, ba a canza cystic fibrosis.

Alamu

Jiyya na cututtuka da kumburi da lalacewa ta hanyar microfeganisms-cefepime:

ƙananan ƙwayoyin cuta na ciki (ciki har da ciwon huhu da mashako),
urinary fili cututtuka (duka biyu masu rikitarwa da kuma ba rikitarwa),
cututtukan fata da kyallen takarda,
cikin ciki-ciki cututtuka (ciki har da peritonitis da biliary fili cututtuka),
cututtukan mahaifa
cutar sanƙarau
zazzabin cizon sauro (kamar yadda maganin kewaya),
cututtukan ƙwayar cuta na ƙwayar cuta a cikin yara.

Yin rigakafin kamuwa da cuta yayin tiyata.

Sakin Fom

Foda don shirye-shiryen samar da mafita don gudanar da jijiyoyin zuciya da sarrafawa na 1 gram (injections a cikin ampoules don allura).

Sauran nau'ikan sashi, koda Allunan ko kuma kwansonsu, babu su.

Umarnin don amfani da sashi

Mutane daban-daban, dangane da hankali na pathogen, tsananin tsananin kamuwa da cuta, kazalika da kan yanayin aikin koda.

Hanyar sarrafawa ta wucin gadi an fi son marasa lafiya waɗanda ke fama da mummunar cuta ko barazanar rayuwa, musamman tare da haɗarin rawar jiki.

Tare da gudanarwa na ciki ko na jijiyoyin jiki ga manya da yara masu nauyin sama da kilo 40 tare da aikin sikelin na al'ada, kashi ɗaya shine 0.5-1 g, tazara tsakanin gwamnoni shine sa'o'i 12. Don kamuwa da cuta mai zafi, ana gudanar dashi a cikin kwatankwacin 2 g a kowane sa'o'i 12.

Don hana kamuwa da cuta yayin tiyata, ana amfani da su a hade tare da metronidazole bisa ga tsarin.

Ga yara daga watanni 2 da haihuwa, matsakaicin kashi bai wuce shawarar da aka ba da shawarar manya ba. Matsakaicin matsakaici ga yara masu nauyin 40 zuwa kilogiram tare da rikicewar cututtukan urinary mai rikitarwa (ciki har da pyelonephritis), cututtukan da ba a daidaita su ba na fata da kyallen takarda mai laushi, ciwon huhu, da kuma kula da zafin cutar zazzabin cizon sauro shine 50 mg / kg a kowane sa'o'i 12.

Marasa lafiya tare da zazzabi na neutropenic da cututtukan ƙwayar cuta na ƙwayar cuta - 50 MG / kg a kowace 8 hours.

Matsakaicin tsawon maganin shine 7-10 kwana. A cikin mummunan cututtuka, ana iya buƙatar magani mai tsawo.

Idan akwai matsala game da aiki na keɓaɓɓen aiki (CC kasa da 30 ml / min), gyaran hanyoyin yin magani ya zama dole. Matsayi na farko na Cefepime ya zama daidai da na marasa lafiya da keɓaɓɓen aikin koda. Ana ƙaddara hanyoyin kiyayewa gwargwadon ƙimar QC ko maida hankali akan ƙwayoyin ƙwayoyin cuta.

Tare da maganin hemodialysis a cikin awanni 3, kimanin 68% na yawan adadin lokacin cin abinci yana cire daga jiki. A ƙarshen kowane zama, ya wajaba don gabatar da maimaita yawan daidai da kashi na farko. A cikin marasa lafiyar da ke ci gaba da yin gwaje-gwajen yanayin motsa jiki na ambulatory peritoneal, ana iya amfani da cefepime a cikin matsakaicin shawarar allurai, i.e. 500 MG, 1 g ko 2 g, gwargwadon tsananin kamuwa da cuta, tare da tazara tsakanin gwamnatocin guda na awoyi 48

Ga yara da ke fama da matsalar aiki na yara, iri ɗaya canje-canje a cikin tsarin magunguna ana bada shawarar su ga manya, tun da kantin magani a cikin lokacin yara a cikin manya da yara sun yi kama.

Side sakamako

zawo, maƙarƙashiya,
tashin zuciya, amai,
colitis (gami da cututtukan cututtukan cututtukan zuciya),
ciwon ciki
canjin dandano
kurji
itching
cututtukan mahaifa
anaphylactic halayen,
ciwon kai
tsananin farin ciki
paresthesia
katsewa
jan fata
anemia
increasedarin ayyukan ALT, AST, alkaline phosphatase,
karuwa a total bilirubin,
eosinophilia, thrombocytopenia na yau da kullun, leukopenia na lokaci da juriya,
karuwa a cikin lokacin prothrombin,
tabbatacce gwajin Coombs ba tare da haemolysis ba,
zazzabi
farji
erythema
itching na ciki
takamaiman candidiasis,
phlebitis (tare da gudanarwa na ciki),
tare da gudanarwar intramuscular, kumburi ko jin zafi a wurin allurar yana yiwuwa.

Contraindications

hypersensitivity zuwa cefepime ko L-arginine, kazalika da maganin rigakafi na cephalosporin, maganin penicillins ko wasu rigakafin beta-lactam.

Haihuwa da lactation

Ba a gudanar da cikakken isasshen bincike mai zurfi game da amincin lokacin hana haihuwa lokacin daukar ciki ba, yin amfanin zai yuwu ne kawai a ƙarƙashin kulawar likita.

Cepepime an ware shi a cikin madara mai nono a cikin raguwa sosai. Yayin lactation, yi amfani da hankali.

A cikin nazarin gwaji, babu wani tasiri kan aikin haihuwa da tasirin fetotoxic na lokacin farin ciki.

Yi amfani da yara

Ba a tsaida aminci da ingancin lokacin lokacin yara a cikin yara masu shekaru 2 ba. Ga yara da suka girmi watanni 2 (gami da jarirai), amfani mai yiwuwa ne gwargwadon tsarin aikin. Ga yara da ke fama da matsalar aiki na yara, iri ɗaya canje-canje a cikin tsarin magunguna ana bada shawarar su ga manya, tun da kantin magani a cikin lokacin yara a cikin manya da yara sun yi kama.

Umarni na musamman

Lokacin da ake amfani da shi a cikin marasa lafiya a cikin haɗarin kamuwa da cuta saboda cakuda microflora naerobic / anaerobic (hade da lokuta inda Bacteroides fragilis shine ɗayan kwayar cutar), ana bada shawara don ƙirƙirar ƙwayar da ke aiki da Cefepim lokaci guda tare da pathogen anaerobes.

Yi amfani da hankali a cikin marasa lafiya a hadarin haɓaka halayen halayen ƙwayoyin cuta, musamman ga kwayoyi.

Tare da haɓaka halayen rashin lafiyan, ya kamata a daina dakatar da cefepime.

A cikin maganganun tashin hankali na gaggawa mai zurfi, epinephrine (adrenaline) da sauran nau'ikan taimako na tallafi na iya buƙata.

Lokacin da zawo ya kamu a yayin jiyya, to yakamata a yi la'akari da yiwuwar haɓakar cututtukan cututtukan ƙwayar cuta. A irin waɗannan halayen, ya kamata a cire cajin lokacin kai tsaye kuma ya kamata a tsara magani mai dacewa idan ya cancanta.

Tare da haɓaka superinfection, ya kamata a soke Cefepim nan da nan kuma an wajabta maganin da ya dace.

Lokacin amfani da wasu ƙwayoyin rigakafi na kungiyar cephalosporin, urticaria, Stevens-Johnson syndrome, erythema multiforme, mai guba epidermal necrolysis, colitis, aiki na ƙarancin ƙwayar cuta, nephropathy, cututtukan ƙwaƙwalwa na hanji, zubar jini, hawan jini, zubar jini, rashin ƙarfi, aikin hanta mai illa, gami da sakamako mai inganci, an tabbatar da sakamakon karya, fitsari na fitsari.

Tare da kulawa ta musamman, ana amfani da cefepime tare da aminoglycosides da "madauki" diuretics.

Hulɗa da ƙwayoyi

Tare da gudanar da sabis na lokaci-lokaci na mafita na lokacin cin abinci tare da mafita na metronidazole, vancomycin, gentamicin, tobramycin sulfate da ƙwaƙwalwar ƙwayoyin netilmicin, hulɗar magunguna yana yiwuwa.

Analogues na miyagun ƙwayoyi Cefepim

Tsarin analogues na mai aiki abu: