Magungunan Heinemox: umarnin don amfani

Allunan, an rufe su da wani ruwan hoda mai launin ruwan hoda, masu kyau, biconvex, tare da daraja, hutu - taro daga fari zuwa haske launin rawaya mai launin shuɗi.

Fitowa: sitaci masara - 52 MG, lactose monohydrate - 68 mg, sodium lauryl sulfate - 7.5 MG, tsabtace talc - 15 MG, magnesium stearate - 6.5 MG, sodium carboxymethyl sitaci - 20 MG, anhydrous colloidal silicon dioxide - 3.5 mg, croscarmellose sodium - 6.5 mg microcrystalline cellulose - 130.7 mg.

Haɗin Shell: Opadry fari 85G58997 Makc-Colorcon (polyvinyl barasa, titanium dioxide, talc, macrogol 3000, lecithin (soya)) - 17.32 mg, jan ƙarfe baƙin ƙarfe - 0.68 mg.

5 inji mai kwakwalwa. - blister (1) - fakitoci na kwali.
7 inji mai kwakwalwa - blister (1) - fakitoci na kwali.
10 inji mai kwakwalwa - blister (1) - fakitoci na kwali.
5 inji mai kwakwalwa. - blister (2) - fakitoci na kwali.
7 inji mai kwakwalwa - blister (2) - fakitoci na kwali.
10 inji mai kwakwalwa - blister (2) - fakitoci na kwali.
5 inji mai kwakwalwa. - blisters (10) - fakitoci na kwali.
7 inji mai kwakwalwa - blisters (10) - fakitoci na kwali.
10 inji mai kwakwalwa - blisters (10) - fakitoci na kwali.
Guda 100 - jaka (1) (na asibitoci) - gwangwani filastik.
500 inji mai kwakwalwa - jaka (1) (na asibitoci) - gwangwani filastik.
1000 inji mai kwakwalwa - jaka (1) (na asibitoci) - gwangwani filastik.

Aikin magunguna

Wani wakili na rigakafi daga ƙungiyar fluoroquinolones, yana kashe ƙwayoyin cuta. Yana da ƙarfi a kan da yawa kewayon gram-tabbatacce kuma gram-korau microorganisms, anaerobic, acid-resistant da kuma atypical kwayoyin: Mycoplasma spp., Chlamydia spp., Legionella spp. Inganci a kan cututtukan ƙwayoyin cuta masu jure beta-lactams da macrolides. Yayi aiki da akasarin cututtukan ƙwayoyin cuta: gram-tabbatacce - Staphylococcus aureus (gami da nau'ikan da basu da hankali ga methicillin), Streptococcus pneumoniae (wanda ya haɗa da kwayar cutar penicillin da macrolides), Streptococcus pyogenes (rukunin A), gram-korau - Haemophilus mura da cututtukan da ba na beta-lactamase ba), Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis (wanda ya hada da rashin samar da beta da lactamase wanda ba shi da beta-lactamase), Escherichia coli, Enterobacter cloacae, Chlamydia pneumonia. Dangane da bincike-binciken vitro, kodayake ƙananan ƙwayoyin da aka lissafa a ƙasa suna kula da moxifloxacin, duk da haka, amincinsa da tasirinsa a cikin magance cututtukan cututtuka ba a kafa su ba. Gram-tabbatacce kwayoyin: Streptococcus milleri, Streptococcus mitior, Streptococcus agalactiae, Streptococcus dysgalactiae, staphylococcus cohnii, staphylococcus epidermidis (ciki har da damuwa, methicillin m), staphylococcus haemolyticus, staphylococcus hominis, staphylococcus saprophyticus, staphylococcus simulans, Corynebacterium diphtheriae. Kwayoyin gram-korau: Bordetella pertussis, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter Intermedius, Enterobacter nazaki, Proteus mirabilis, kariya ta kariya, Morganella morganii, Providencia rettgeri, Providencia stuartii. Anaerobic microorganisms: Bacteroides distasonis, Bacteroides eggerthii, Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaornicron, Bacteroides uniformis, Fusobacterium spp, Porphyromonas spp, Porphyromonas anaerobius, Porphyromonas asaccharolyticus, Porphyromonas Magnus, Prevotella spp, Propionibacterium spp, Clostridium perfringens, Clostridium .... ramosum. Orarancin ƙananan ƙwayoyin cuta: Legionella pneumophila, Caxiella burnettii.

Tubalan topoisomerases II da na IV, enzymes wadanda ke tafiyar da abubuwan topological na DNA, kuma suna da nasaba da kwayar halittar DNA, gyarawa, da kuma kwayar halitta. Tasirin moxifloxacin ya dogara da maida hankali ne cikin jini da kyallen takarda. Imumarancin ƙananan ƙwayoyin cuta kusan ba su bambanta da ƙananan abubuwan hana ƙwaƙwalwa ba.

Hanyoyin haɓaka ayyukan haɓakawa, hana aiki da penicillins, cephalosporins, aminoglycosides, macrolides da tetracyclines, basu tasiri ayyukan hana ƙwayoyin cuta na moxifloxacin. Babu jurewa tsakanin moxifloxacin da wadannan kwayoyi. Ba a lura da matakan plasmid-matsakaiciyar juriya na cigaba ba. Gabaɗaya yanayin juriya yana ƙasa. Binciken in vitro ya nuna cewa juriya ga moxifloxacin yakan zama sannu a hankali sakamakon jerin maye gurbi. Tare da maimaitawa ga microorganisms tare da moxifloxacin a cikin ƙananan abubuwan hanawa, alamu na BMD kawai ƙara haɓaka. An lura da juriya tsakanin kwayoyi tsakanin ƙwayoyin fluoroquinolone. Koyaya, wasu ƙwayoyin-gram-tabbatacce da anaerobic microorganisms waɗanda suke tsayayya da sauran fluoroquinolones suna kula da moxifloxacin.

Pharmacokinetics

Bayan gudanar da baki, moxifloxacin yana tunawa da sauri kuma kusan gaba daya. Bayan kashi daya na moxifloxacin a kashi 400 MG C max a cikin jini ana samunsa tsakanin awa 0,5-4 kuma shine 3.1 mg / L.

Bayan jiko guda ɗaya a kashi na 400 MG don 1 h, an isa C max a ƙarshen jiko kuma shine 4.1 mg / l, wanda yayi daidai da karuwar kusan 26% idan aka kwatanta da darajar wannan mai nuna alama yayin ɗauka ta baka. Tare da infusions na IV da yawa a cikin adadin 400 MG na 1 hour, C max ya bambanta a cikin kewayon daga 4.1 mg / l zuwa 5.9 mg / l. Matsakaicin C ss na 4.4 mg / L an kai shi a ƙarshen jiko.

Cikakken bayanin bioavailability kusan kashi 91%.

Magungunan magani na moxifloxacin lokacin da aka ɗauki su a allurai guda ɗaya daga 50 MG zuwa 1200 MG, haka kuma a cikin adadin 600 mg / rana tsawon kwanaki 10, layin ne.

An cimma matsayin daidaituwa tsakanin kwanaki 3.

Haɗin zuwa sunadarai na jini (galibi albumin) kusan kashi 45%.

Moxifloxacin an rarraba shi da sauri a cikin gabobin da kyallen takarda. V d kusan 2 l / kg.

Babban adadin moxifloxacin, wanda ya wuce wadanda ke cikin plasma, an kirkireshi ne a cikin huhu na huhu (gami da alveolar macrophages), a cikin mucous membrane na bronchi, a cikin sinuses, a cikin kyallen takarda mai laushi, fata da kuma tsarin tsinke, cutarwa na kumburi. A cikin ruwa mai shiga tsakanin ciki da cikin gaɓa, an ƙaddara magungunan ta hanyar da babu tsari, wanda ba sinadarin gina jiki ba, a babban taro sama da na plasma. Bugu da kari, ana tantance babban hadadden abu mai aiki a jikin gabobin ciki da na hanjin ciki, da kuma cikin kashin jikin mace.

Biotransformed zuwa ƙwayoyin sulfo mara aiki da glucuronides. Moxifloxacin ba biotransformed da enzymes hanta microsomal na tsarin cytochrome P450.

Bayan wucewa ta kashi na 2 na biotransformation, moxifloxacin an cire shi daga jiki ta hanyar kodan da ta cikin hanji, duka ba canzawa ba kuma a cikin nau'ikan kwayoyin sulfo marasa aiki da glucuronides.

An keɓance shi a cikin fitsari, haka kuma tare da feces, duka ba su canzawa ba kuma a cikin nau'i na metabolites marasa aiki. Tare da kashi ɗaya na 400 MG, kusan 19% an cire shi a cikin fitsari, kimanin 25% tare da feces. T 1/2 shine kimanin awa 12. Matsakaicin tsabtacewa bayan gudanarwa a kashi na 400 MG shine daga 179 ml / min zuwa 246 ml / min.

Alamu da magunguna:

cututtukan cututtukan cututtukan ƙwayoyin cuta na al'umma, ciki har da maganin cutar huhu da al'umma ke samu, abubuwan da ke haifar da ƙananan ƙwayoyin cuta tare da tsayayya da kwayoyi masu kashe ƙwayoyin cuta *,

m na kwayan cuta sinusitis,

rikitattun abubuwa masu rikitarwa da rikitarwa na fata da kyallen takarda mai laushi (gami da ƙafar masu ciwon sukari),

rikitattun cututtukan ciki-ciki, ciki har da cututtukan polymicrobial, ciki har da cikin rashin lafiyar,

cututtukan mahaifa da ba a haɗa su da gabobin pelvic (ciki har da salpingitis da endometritis).

Hauki hinemoks a ciki, hadiye duka, baya cin abinci, shan ruwa mai yawa, zai fi dacewa bayan cin abinci. Karka wuce shawarar da aka bada shawarar.

Kamuwa da cuta Kwayoyin a cikin sa'o'i 24 (na lokaci ɗaya a kowace rana), mg Muddin magani, kwanaki Cutar huhu da keɓaɓɓun ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa ta 4005-10 Ciwon ƙwayar cuta mara ƙwayar cuta 4007 Kwayoyin cuta marasa fata na fata da laushin taushi 4007 Cutar da ke tattare da fata da kuma tsarin keɓaɓɓen cuta 4007-25

Karka wuce lokacin da aka bayar da shawarar magani.

Ba a canza canji a tsarin kulawa ba: a cikin tsofaffi marassa lafiya, marasa lafiya da ke fama da aikin hanta (aji A, B akan sikelin-Yara), marasa lafiya da ke fama da rauni game da aikin fida (gami da gajiya mai girma ta kasa da creatinine Cl ≤30 ml min / 1.73 m2, kazalika da waɗanda ke ci gaba da cutar hemodialysis da cututtukan ƙwaƙwalwar ƙwayar cuta na tsawon lokaci), marasa lafiya na kabilu daban-daban.

Side effects

Allergic halayen ga Heinemox aka gyara: kurji, itching, urticaria.

Daga tsarin zuciya: tachycardia, na gefe na haɓaka, haɓaka hawan jini, palpitations, ciwon kirji.

Daga tsarin narkewa: zafin ciki, tashin zuciya, zawo, amai, dyspepsia, flatulence, maƙarƙashiya, ƙara yawan aikin hepatic transaminases, ɓarna da haɗari.

A ɓangaren sigogi na dakin gwaje-gwaje: raguwa a cikin matakan prothrombin, karuwa a cikin amylase.

Daga tsarin hawan jini: leukopenia, eosinophilia, thrombocytosis, thrombocytopenia, anemia.

Daga gefen tsarin juyayi na tsakiya da tsarin juyayi na farji: danshi, rashin bacci, tashin hankali, damuwa, matsanancin, ciwon kai, rawar jiki, paresthesia, ciwon kafa, huɗa, rikicewa, damuwa.

Daga tsarin musculoskeletal: ciwon baya, arthralgia, myalgia.

Daga tsarin haihuwa: candidiasis na farji, farji.

Tambayoyi, amsoshi, sake dubawa game da miyagun ƙwayoyi Heinemoks

Bayanin da aka bayar an yi shi ne don ƙwararrun likitoci da magunguna. Cikakken bayani game da magani yana kunshe ne a cikin umarnin da aka haɗe zuwa marufin da mai masana'anta. Babu wani bayani da aka sanya akan wannan ko wani shafin yanar gizon mu wanda zai iya canza matsayin roko na musamman ga kwararrun.

Tsarin ilimin rayuwa (ICD-10)

Abun ciki da nau'i na saki

Allunan - 1 kwamfutar hannu:

• Abunda yake aiki: moxifloxacin hydrochloride 436.3 MG, wanda yayi dace da abubuwan moxifloxacin 400 MG.
• Abubuwan da ke cikin: sitaci masara - 52 MG, lactose monohydrate - 68 mg, sodium lauryl sulfate - 7.5 mg, tsabtace talc - 15 mg, magnesium stearate - 6.5 mg, sitaci carboxymethyl sitaci - 20 mg, silsila mai narkewa mai narkewa - 3.5 mg, croscarmellose sodium - M 6.5 mg, microcrystalline cellulose - 130.7 mg.
• Haɗin Shell: Opadry fari 85G58997 Makc-Colorcon (polyvinyl barasa, titanium dioxide, talc, macrogol 3000, lecithin (soya)) - 17.32 mg, jan ƙarfe baƙin ƙarfe - 0.68 mg.

5 inji mai kwakwalwa. - blister (1) - fakitoci na kwali.

Allunan, an rufe su da wani ruwan hoda mai launin ruwan hoda, masu kyau, biconvex, tare da daraja, hutu - taro daga fari zuwa haske launin rawaya mai launin shuɗi.

Wani wakili na rigakafi daga ƙungiyar fluoroquinolones, yana kashe ƙwayoyin cuta. Yana da ƙarfi a kan da yawa kewayon gram-tabbatacce kuma gram-korau microorganisms, anaerobic, acid-resistant da kuma atypical kwayoyin: Mycoplasma spp., Chlamydia spp., Legionella spp. Inganci a kan cututtukan ƙwayoyin cuta masu jure beta-lactams da macrolides. Yayi aiki da akasarin cututtukan ƙwayoyin cuta: gram-tabbatacce - Staphylococcus aureus (gami da nau'ikan da basu da hankali ga methicillin), Streptococcus pneumoniae (wanda ya haɗa da kwayar cutar penicillin da macrolides), Streptococcus pyogenes (rukunin A), gram-korau - Haemophilus mura da cututtukan da ba na beta-lactamase ba), Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis (wanda ya hada da rashin samar da beta da lactamase wanda ba shi da beta-lactamase), Escherichia coli, Enterobacter cloacae, Chlamydia pneumonia. Dangane da bincike-binciken vitro, kodayake ƙananan ƙwayoyin da aka lissafa a ƙasa suna kula da moxifloxacin, duk da haka, amincinsa da tasirinsa a cikin magance cututtukan cututtuka ba a kafa su ba. Gram-tabbatacce kwayoyin: Streptococcus milleri, Streptococcus mitior, Streptococcus agalactiae, Streptococcus dysgalactiae, staphylococcus cohnii, staphylococcus epidermidis (ciki har da damuwa, methicillin m), staphylococcus haemolyticus, staphylococcus hominis, staphylococcus saprophyticus, staphylococcus simulans, Corynebacterium diphtheriae. Kwayoyin gram-korau: Bordetella pertussis, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter Intermedius, Enterobacter nazaki, Proteus mirabilis, kariya ta kariya, Morganella morganii, Providencia rettgeri, Providencia stuartii. Anaerobic microorganisms: Bacteroides distasonis, Bacteroides eggerthii, Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaornicron, Bacteroides uniformis, Fusobacterium spp, Porphyromonas spp, Porphyromonas anaerobius, Porphyromonas asaccharolyticus, Porphyromonas Magnus, Prevotella spp, Propionibacterium spp, Clostridium perfringens, Clostridium .... ramosum. Orarancin ƙananan ƙwayoyin cuta: Legionella pneumophila, Caxiella burnettii.

Tubalan topoisomerases II da na IV, enzymes wadanda ke tafiyar da abubuwan topological na DNA, kuma suna da nasaba da kwayar halittar DNA, gyarawa, da kuma kwayar halitta. Tasirin moxifloxacin ya dogara da maida hankali ne cikin jini da kyallen takarda. Imumarancin ƙananan ƙwayoyin cuta kusan ba su bambanta da ƙananan abubuwan hana ƙwaƙwalwa ba.

Hanyoyin haɓaka ayyukan haɓakawa, hana aiki da penicillins, cephalosporins, aminoglycosides, macrolides da tetracyclines, basu tasiri ayyukan hana ƙwayoyin cuta na moxifloxacin. Babu jurewa tsakanin moxifloxacin da wadannan kwayoyi. Ba a lura da matakan plasmid-matsakaiciyar juriya na cigaba ba. Gabaɗaya yanayin juriya yana ƙasa. Binciken in vitro ya nuna cewa juriya ga moxifloxacin yakan zama sannu a hankali sakamakon jerin maye gurbi. Tare da maimaitawa ga microorganisms tare da moxifloxacin a cikin ƙananan abubuwan hanawa, alamu na BMD kawai ƙara haɓaka. An lura da juriya tsakanin kwayoyi tsakanin ƙwayoyin fluoroquinolone. Koyaya, wasu ƙwayoyin-gram-tabbatacce da anaerobic microorganisms waɗanda suke tsayayya da sauran fluoroquinolones suna kula da moxifloxacin.

Bayan gudanar da baki, moxifloxacin yana tunawa da sauri kuma kusan gaba daya. Bayan kashi daya na moxifloxacin a kashi 400 MG _max a cikin jini an kai shi tsakanin awanni 0.5-4 kuma shine 3.1 mg / l.

Bayan jiko guda ɗaya a kashi na 400 MG na 1 h C _max wanda aka cimma a ƙarshen jiko kuma shine 4.1 mg / l, wanda ya dace da haɓaka kusan 26% idan aka kwatanta da darajar wannan alamar yayin ɗauka ta baka. Tare da yawan infusions na IV a cikin kashi na 400 MG mai ɗorewa 1 h C _max ya bambanta cikin kewayon daga 4.1 mg / l zuwa 5.9 mg / l. Matsakaicin Css na 4.4 mg / L an kai shi a ƙarshen jiko.

Cikakken bayanin bioavailability kusan kashi 91%.

Magungunan magani na moxifloxacin lokacin da aka ɗauki su a allurai guda ɗaya daga 50 MG zuwa 1200 MG, haka kuma a cikin adadin 600 mg / rana tsawon kwanaki 10, layin ne.

An cimma matsayin daidaituwa tsakanin kwanaki 3.

Haɗin zuwa sunadarai na jini (galibi albumin) kusan kashi 45%.

Moxifloxacin an rarraba shi da sauri a cikin gabobin da kyallen takarda. Vd kamar 2 L / kg.

Babban adadin moxifloxacin, wanda ya wuce wadanda ke cikin plasma, an kirkireshi ne a cikin huhu na huhu (gami da alveolar macrophages), a cikin mucous membrane na bronchi, a cikin sinuses, a cikin kyallen takarda mai laushi, fata da kuma tsarin tsinke, cutarwa na kumburi. A cikin ruwa mai shiga tsakanin ciki da cikin gaɓa, an ƙaddara magungunan ta hanyar da babu tsari, wanda ba sinadarin gina jiki ba, a babban taro sama da na plasma. Bugu da kari, ana tantance babban hadadden abu mai aiki a jikin gabobin ciki da na hanjin ciki, da kuma cikin kashin jikin mace.

Biotransformed zuwa ƙwayoyin sulfo mara aiki da glucuronides. Moxifloxacin ba biotransformed da enzymes hanta microsomal na tsarin cytochrome P450.

Bayan wucewa ta kashi na 2 na biotransformation, moxifloxacin an cire shi daga jiki ta hanyar kodan kuma ta cikin hanji, duka ba canzawa ba kuma a cikin nau'ikan kwayoyin sulfo marasa aiki da glucuronides.

An keɓance shi a cikin fitsari, haka kuma tare da feces, duka ba su canzawa ba kuma a cikin nau'i na metabolites marasa aiki. Tare da kashi ɗaya na 400 MG, kusan 19% an cire shi a cikin fitsari, kimanin 25% tare da feces. T1 / 2 kimanin awa 12. Matsakaicin tsabtacewa bayan aiwatarwa a kashi na 400 MG shine daga 179 ml / min zuwa 246 ml / min.

Magungunan rigakafin ƙwayar cuta na kungiyar fluoroquinolone.

Sashi na Heinemox

A ciki, 400 MG 1 lokaci / rana. A hanya na lura da wuce gona da iri na mashako - na kwanaki 5, ciwon huhu da al’umma ta samu - kwana 10, matsanancin sinusitis, kamuwa da fata da laushin taushi - 7 kwana.

An wajabta moxifloxacin tare da taka tsantsan idan akwai matsala na cututtukan ƙwayar cuta (ciki har da tarihin), amai, gazawar hanta, ciwo na tsawaita tazara QT.

Yayin jiyya tare da fluoroquinolones, kumburi da rushewar jijiya na iya haɓaka, musamman a cikin tsofaffi marasa lafiya da kuma a cikin marasa lafiya da ke karbar corticosteroid concomitant. A alamun farko na jin zafi ko kumburi da jijiyoyin jiki, ya kamata marasa lafiya su dakatar da jiyya kuma su saki ƙafar da aka shafa daga nauyin.

Pharmacodynamics

Moxifloxacin wani kwayar cuta ce ta kwayan cuta mai kashe kwayoyin cuta ta rigakafin cutar fluoroquinolone, 8-methoxy fluoroquinolone. Yana hana topoisomerase na II da topoisomerase IV, yana lalata supercoiling da haɗin giciye na hutu na DNA, yana hana ƙirar DNA, yana haifar da canje-canje mai zurfi a cikin cytoplasm, bangon sel da membranes na microorganisms masu hankali.Imumaramin maida hankali na ƙwayoyin cuta na moxifloxacin duka ana iya kwatanta su da ƙananan ƙananan ƙwayoyin inhibitory (MICs).

Hanyoyin da ke haifar da ci gaban juriya ga maganin penicillins, cephalosporins, aminoglycosides, macrolides da tetracyclines ba su keta ayyukan antibacterial na moxifloxacin. Babu juriya tsakanin-wadannan kungiyoyi na kwayoyi masu kashe kwayoyin cuta da moxifloxacin. Ya zuwa yanzu, har ila yau, ba a sami maganganun juriya na plasmid ba. Matsayin gaba ɗaya na haɓakar juriya kaɗan ne (10 -7-10 -10). Resistancewar moxifloxacin yana haɓaka sannu a hankali ta hanyar rikida abubuwa da yawa. Yawan maimaita moxifloxacin akan ƙananan ƙwayoyin cuta a cikin abubuwan da ke ƙasa da MIC yana haɗuwa da kawai ƙara ƙima a cikin MIC. Akwai lamunin giciye-tsayayya ga quinolones. Koda yake, wasu kwayoyin-gram-tabbatacce kuma anaerobic microorganisms masu tsayayya da sauran quinolones suna kula da moxifloxacin.

Moxifloxacin a cikin vitro aiki da yawa daga gram-korau da na gram-tabbatacce microorganisms, anaerobes, kwayoyin-acid-resistant kwayoyin cuta da-atomatik kamar Mycoplasma spp., Chlamydia spp., Legionella spp.kazalika da kwayoyi masu tsayayya da maganin beta-lactam da maganin macrolide.

Kwayar kwayar cutar hana kwayoyi na moxifloxacin ya hada da wadannan kwayoyin.

Gram-tabbatacce: Gardnerella vaginalis, Kwayar cutar hucin ciki * (gami da nau'in da zai iya maganin penicillin da nau'ikan juriyar kwayoyi masu guba), Pyogenes mai ƙarfi (rukunin A) *, rukuni Mitar Millencoccus na ƙarfi (S. anginosus *, S. constellatus *, S. intermedius *), kungiyar Budurcin budurwai (S. budurwai, S. mutans, S. mitis, S. sanguinis, S. salivarius, S. thermophilus, S. constellatus), Ciwankulususususususus, Dansgalactiae, Sifarinuscoccus dysgalactiae, Staphylococcus aureus (gami da cututtukan methicillin-m damuwa) *, coagulase-korau staphylococci (S. cohnii, S. epidermidis, S. haemolyticus, S. hominis, S. saprophyticus, S. simulans), gami da cututtukan methicillin.

Gram-korau: Haemophilus mura (gami da nau'ikan samarwa da wadanda ba sa fitar da beta-lactamases) *, Haemophilus parainfluenzae *, Moraxella catarrhalis (gami da nau'ikan samarwa da wadanda ba sa fitar da beta-lactamases) *, Bordetella pertussis, Legionella pneumophila, Acinetobacter baumannii, Proteus vulgaris.

Anaerobes: Fusobacterium spp., Porphyromonas spp., Prevotella spp., Propionibacterium spp.

Na zamani: Chlamydia pneumoniae *, Chlamydia trachomatis *, Mycoplasma pneumoniae *, Mycoplasma hominis, Mycoplasma genitalium, Legionella pneumophila *, Coxiella burnetii.

Gram-tabbatacce: Encerococcus faecalis * (kawai suna kula da vancomycin da Gentamicin) Eniumin Kwayoyin cuta *, Enterococcus faecium *.

Gram-korau: Escherichia coli *, Klebsiella pneumoniae *, Klebsiella oxytoca, Citrobacter freundii *, Enterobacter spp. (E. aerogenes, E. intermedius, E. tizakii), Enterobacter cloacae *, Pantoea agglomerans, Pseudomonas fluorescens, Burkholderia cepacia, Stenotrophomonas maltophilia, Proteus mirabilis *, Morganella morganii, Neisseria gonorrhoeae * Prov. (P. rettgeri, P. stuartii).

Anaerobes: Bacteroides spp. (B. fragilis *, B. distasonis *, B. thetaiotaomicron *, B. ovatus *, B. uniformis *, B. vulgaris *), Peptostreptococcus spp., Clostridium spp.

Gram-tabbatacce: Amintakarwa (methicillin / ofloxacin resistant damuwa) **, coagulase-korau staphylococci (S. cohnii, S. epidermidis, S. haemolyticus, S. hominis, S. saprophyticus, S. simulans)methicillin resistant damuwa.

Gram-korau: Kafa aeruginosa.

* Rashin hankali shine moxifloxacin an tabbatar dashi ta bayanan asibiti.

** Ba'a bada shawarar amfani da Heinemox don magance cututtukan cututtukan da ke haifar da damuwa. S. aureustsayayya da methicillin (MRSA). Game da wadanda ake zargi ko tabbatar da kamuwa da cuta ta hanyar MRSA, Ya kamata a tsara magani tare da magungunan ƙwayoyin cuta masu dacewa.

Alamu na Heinemox

Cututtuka da cututtuka masu kumburi da ke haifar da ƙwayoyin cuta da ke haifar da moxifloxacin:

cututtukan cututtukan cututtukan ƙwayoyin cuta na al'umma, ciki har da maganin cutar huhu da al'umma ke samu, abubuwan da ke haifar da ƙananan ƙwayoyin cuta tare da tsayayya da kwayoyi masu kashe ƙwayoyin cuta *,

wuce gona da iri na mashako,

m na kwayan cuta sinusitis,

rikitattun abubuwa masu rikitarwa da rikitarwa na fata da kyallen takarda mai laushi (gami da ƙafar masu ciwon sukari),

rikitattun cututtukan ciki-ciki, ciki har da cututtukan polymicrobial, ciki har da cikin rashin lafiyar,

cututtukan mahaifa da ba a haɗa su da gabobin pelvic (ciki har da salpingitis da endometritis).

* Kwayar cutar huda ciki tare da juriya na kwayar cuta da yawa sun hada da maganin penicillin mai jurewa da raunin da zai iya magance biyu ko fiye da maganin rigakafi daga ƙungiyoyi kamar su penicillins (tare da MICs ≥ 2 μg / ml), cephalosporins na biyu (cefuroxime), macrolides, tetracyclines da trimethoprim / Sankarin Shinzo

Contraindications

hypersensitivity to moxifloxacin, wasu quinolones ko wasu abubuwan maganin,

rashin lafiyan halayen da gyada ko soya,

lalacewar jijiya tare da magani na baya tare da quinolones,

amfani da magunguna guda daya wanda ke kara tazara QT (gami da magungunan antiarrhythmic na aji IA, III) - duba “hulda”,

marasa lafiya da na cikin gida ko aka samu bayanan tsawan na lokacin QT, nakasasshe na electrolyte (musamman rashin ingantaccen hypokalemia), ingantacciyar hanyar bradycardia, mummunan tasiri gazawar zuciya tare da rage raguwar raguwar ventricular ejection, tarihin rudani ya rikice tare da bayyanar cututtuka na asibiti (yin amfani da moxifloxacin Q yana haifar da ),

marassa lafiya da ke fama da cutar hanta (Tsararren aji-C class class) da kuma karuwa a cikin aikin transaminase sama da sau 5 sama da VGN,

yara ‘yan kasa da shekara 18.

Tare da kulawa: Cututtukan CNS (ciki har da waɗanda ke da shakkun shiga cikin CNS) suna hango tashin hankali da rage ƙarancin aiki, masu haƙuri da tarihin psychosis da cututtukan kwakwalwa, marasa lafiya waɗanda ke da yiwuwar yanayin cutar, irin su ischemia na myocardial, musamman a cikin mata da tsofaffi marasa lafiya, myasthenia gravis gravis, cirrhosis hanta, amfani da kwanciyar hankali tare da kwayoyi waɗanda ke rage potassium.

Haɗa kai

Babu wata muhimmiyar hulɗar asibiti ta moxifloxacin tare da atenolol, ranitidine, kari na alli, theophylline, maganin hana haihuwa, glibenclamide, itraconazole, digoxin, morphine, probenecid. Gyara hanyoyin yin allurai idan aka hada su da wadannan kwayoyi ba a bukatar su.

Antacids, ma'adanai da multivitamins. Yin amfani da lokaci guda na moxifloxacin da shirye-shiryen antacid, ma'adinai da multivitamins na iya rushe shayewar moxifloxacin saboda samuwar chelate hadaddun magunguna tare da magungunan polyvalent wadanda ke cikin wadannan kwayoyi, sabili da haka rage yawan moxifloxacin a cikin jini na jini. A wannan batun, antacid, antiretroviral kwayoyi (misali didanosine) da sauran magunguna waɗanda ke ɗauke da magnesium, aluminum, sucralfate, baƙin ƙarfe, zinc ya kamata a dauki akalla sa'o'i 4 kafin ko 4 hours bayan maganin baka na moxifloxacin.

Magunguna waɗanda ke tsawaita Tsakanin QT. Tunda moxifloxacin yana shafar tsawan tsaka-tsakin QT, hadewar moxifloxacin tare da magungunan da ke gaba yana contraindicated: antiarrhythmic IA (quinidine, hydroquinidine, a zina, da dai sauransu) da III (amiodarone, sotalol, dofetilide, ibutilide, da sauransu) azuzuwan, tricy-lukle phenothiazines, pimozide, sertindole, haloperidol, sultopride, da sauransu), antimicrobial (sparfloxacin, erythromycin, pentamidine, magungunan antimalarial, musamman halofantrine), antihistamines (astemizole, terfenadine, misolastine) da sauransu (cis) girman kai, vincamine, bepridil, difemanil) kudi.

Warfarin. Lokacin da aka haɗu da warfarin, PV da sauran sigogin jini ba su canzawa. Koyaya, a cikin marasa lafiya waɗanda ke karɓar maganin anticoagulants a hade tare da maganin rigakafi, gami da tare da moxifloxacin, akwai lokatan lokuta na ƙara yawan aikin anticoagulation na magungunan anticoagulant. Abubuwan haɗari sune kasancewar wata cuta mai kamuwa da cuta (da kuma tsarin kumburi), shekaru da kuma yanayin mai haƙuri. Duk da gaskiyar cewa ba a gano hulɗar tsakanin moxifloxacin da warfarin ba, a cikin marasa lafiya da ke karɓar magani tare da waɗannan kwayoyi, ya zama dole don saka idanu kan ƙimar INR kuma, idan ya cancanta, daidaita kashi na maganin rashin daidaituwa.

Digoxin. Moxifloxacin da digoxin basa tasiri sosai ga tsarin sashin magunguna. Tare da maimaita allurai na moxifloxacin C_max digoxin ya karu da kusan 30%, yayin da darajar AUC da C_min digoxin bai canza ba.

Carbon mai aiki. Ta hanyar amfani da carbon da moxifloxacin mai aiki a lokaci guda cikin kashi 400 MG, tsari na bioxvus na moxifloxacin yana raguwa da sama da 80% a sakamakon hana sha shi.

GCS. Ta hanyar amfani da moxifloxacin da corticosteroids a lokaci guda, hadarin kamuwa da cutar jijiyoyin jiki da raunin jijiya yana ƙaruwa.

Sashi da gudanarwa

A ciki hadiye duka, baya cin abinci, shan ruwa mai yawa, zai fi dacewa bayan cin abinci. Karka wuce shawarar da aka bada shawarar.

Karka wuce lokacin da aka bayar da shawarar magani.

Ba a canza canji a tsarin aikin da ake buƙata ba: a cikin tsofaffi marasa lafiya, marasa lafiya da ke fama da aikin hanta (aji A, B akan sikelin -aukar-Yara), marasa lafiya da ke fama da rauni game da aikin ƙirar (ciki har da gazawar renal mai yawa tare da creatinine Cl ≤30 ml / min / 1.73 m 2, kazalika da waɗanda ke ci gaba da cutar hemodialysis da cututtukan cututtukan ƙwayar cuta na tsararraki na tsawon lokaci), marasa lafiya na kabilu daban-daban.

Yawan abin sama da ya kamata

Jiyya: Idan an sami yawan abin sama da ya kamata, mutum ya kamata ya bishe shi ta hanyar asibiti kuma a gudanar da aikin tallafawa alamomin ta hanyar ECG. Gudanar da carbon wanda aka kunna shi nan da nan bayan maganin maganin na maganin zai iya taimakawa hana wuce haddi na kamuwa da kwayar moxifloxacin a cikin yanayin yawan zubar da ruwa.

Umarni na musamman

A wasu halaye, bayan amfani da farko na miyagun ƙwayoyi, rashin lafiyar jiki da halayen rashin lafiyan na iya haɓaka, wanda ya kamata a sanar da likita nan da nan. Da wuya, halayen anaphylactic zai iya ci gaba zuwa barazanar rayuwa mai haɗari anaphylactic, koda bayan amfani da farko na miyagun ƙwayoyi. A cikin waɗannan halayen, ya kamata a dakatar da jiyya tare da Heinemox kuma an dauki matakan magani da suka dace (gami da anti-shock).

Lokacin amfani da maganin Heinemox a wasu marasa lafiya, ana iya fadada fadada ta tsakanin Qt. Tsawaita tazara na QT yana da alaƙa da haɓakar haɗarin haɓakar arrhythmias, ciki har da polymorphic ventricular tachycardia. Akwai hulɗa ta kai tsaye tsakanin haɓakar moxifloxacin da karuwa a cikin tazara QT. A sakamakon haka, shawarar da aka ba da shawarar (400 MG / rana) bai kamata ya wuce ba.

Tsofaffi marasa lafiya da mata sun fi kulawa da magungunan da ke tsawaita lokacin QT. Lokacin amfani da magani na Heinemox, haɗarin haɓakar arrhythmias na ventricular a cikin marasa lafiya tare da yanayin tsinkaye ga arrhythmias na iya ƙaruwa. Dangane da wannan, Ba za a iya amfani da Hainemox a waɗannan lamurran masu zuwa ba: haihuwar haihuwa ko samu tsawanta na tsaka-tsakin QT, rashin daidaituwa hypokalemia, asibiti mai mahimmanci bradycardia, ƙayyadaddun ƙwaƙwalwar zuciya tare da raguwar raguwar ventricular ejection, tarihin ƙayyadaddun lamura wanda ke tattare da alamomin asibiti, na lokaci mai kulawa kwayoyi suna tsawaita Tsakanin QT (gami da magungunan antiarrhythmic na aji IA, III) da sauransu (duba "hulɗa").

Lokacin amfani da miyagun ƙwayoyi Heinemox, an lura da maganganun ci gaban hepatitis, mai haifar da ci gaban haɓakar hanta. Idan alamun bayyanar cututtukan hanta sun faru, yakamata a nemi likita kafin a ci gaba da magani tare da magani.

Lokacin shan magungunan Heinemox, an ba da rahoton shari'o'in haɓakar raunuka fata (cututtukan Stevens-Johnson ko guba da ƙwayar cutar epidermal necrolysis). Yakamata a sanar da mara lafiyar cewa idan akwai alamun fata ko membranes na mucous, ya zama dole a nemi likita kafin a ci gaba da shan Heinemox.

Yin amfani da magungunan quinolone yana da alaƙa da haɗarin yiwuwar kamuwa da cuta. Ya kamata a yi amfani da Heinemox tare da taka tsantsan a cikin marasa lafiya da cututtukan cututtukan da ke cikin juyayi na tsakiya tare da rikice-rikice na tsarin juyayi na tsakiya wanda ke haifar da abin da ya faru na ɓacin rai ko runtsewa da ƙima na aiki mai ɗaci.

Ya kamata a yi amfani da Heinemox tare da taka tsantsan a cikin marasa lafiya tare da myasthenia gravis. gravis dangane da yiwuwar fashewar cutar.

Ya kamata a yi amfani da Heinemox tare da taka tsantsan a cikin marasa lafiya tare da raunin glucose-6-phosphate dehydrogenase saboda yiwuwar haɓakar halayen hemolytic.

Yin amfani da magungunan rigakafi masu saurin gaske, ciki har da Heinemox, ana haɗuwa da haɗarin cututtukan cututtukan cututtukan ƙwayoyin cuta. Dole ne a kawo wannan maganin cikin tunani a cikin marasa lafiya waɗanda aka lura da cutar zazzabin cizon sauro yayin lura da Heinemox. A wannan yanayin, ya kamata a dakatar da miyagun ƙwayoyi kuma an tsara maganin da ya dace. Magungunan da ke hana motsin hanji suna tazara cikin haɓakar zazzabin cizon sauro.

A bango na maganin quinolone, ciki har da moxifloxacin, haɓakar tendonitis da rushewar jijiya mai yiwuwa ne, musamman a cikin tsofaffi marasa lafiya da marasa lafiya da ke karɓar corticosteroids na lokaci guda. A alamomin farko na jin zafi ko kumburin jijiyoyin jiki, ya kamata ku daina shan miyagun ƙwayoyi kuma ku iya rage ƙwayar da abin ya shafa.

Moxifloxacin bashi da tasirin hoto, duk da haka, an bada shawara don gujewa radadin UV yayin jiyya tare da miyagun ƙwayoyi, gami da hasken rana kai tsaye.

Yin amfani da moxifloxacin don maganin cututtukan da ke haifar da damuwa ba da shawarar ba. Amintakarwatsayayya da methicillin (MRSA). Game da wadanda ake zargi ko tabbatar da kamuwa da cuta ta hanyar MRSA, magani tare da magungunan ƙwayoyin cuta masu dacewa da yakamata ya kamata a tsara su (duba. Pharmacodynamics).

Thearfin magungunan Heinemox don hana haɓakar mycobacteria na iya haifar da hulɗa a cikin vitro moxifloxacin tare da gwaji don Mycobacterium spp., haifar da sakamako mara kyau na karya a cikin nazarin samfuran marasa lafiya waɗanda ke kula da Heinemox a cikin wannan lokacin.

A cikin marasa lafiya waɗanda aka bi da su tare da quinolones, ciki har da Heinemox, an bayyana yanayin maganganu na firikwensin ko sensorimotor polyneuropathy, wanda ke haifar da paresthesia, hypesthesia, dysesthesia, ko rauni. Ya kamata a faɗakar da marasa lafiyar da ke fama da cutar Heinemox game da buƙatar yin tuntuɓar likita nan da nan kafin a ci gaba da magani idan akwai alamun cututtukan neuropathy, ciki har da jin zafi, ƙonawa, tinging, ƙamus ko rauni (duba “Side effects”).

Abubuwan da ke tattare da tunanin mutum na iya faruwa ko da bayan saduwa ta farko na fluoroquinolones, gami da moxifloxacin. A lokuta mawuyacin hali, bacin rai ko halayen psychotic suna ci gaba zuwa tunani da kuma kisan kai tare da sha'awar cutar da kai, gami da yunƙurin kashe kansa (duba “Tasirin sakamako”). Idan irin waɗannan halayen suka ci gaba a cikin marasa lafiya, ya kamata a dakatar da maganin Heinemox kuma dole a dauki matakan da suka dace.

Sakamakon yaduwar cuta da haɓakar ƙwayoyin cuta wanda ke haifar da ƙwayar cuta ta fluoroquinolone Neisseria gonorrhoeae, a cikin lura da marasa lafiya da cututtukan kumburi na gabobin pelvic, moxifloxacin monotherapy bai kamata a aiwatar da shi ba. Banda lokacinda kasancewar fluoroquinolone mai iya jurewa N. gonorrhöeae cire. Idan ba zai yiwu a ware bayyanar cututtukan fluoroquinolone ba N. gonorrhoe, Wajibi ne a magance batun karin magani tare da moxifloxacin tare da maganin da ya dace wanda yake yin tsayayya da N. gonorrhöeae (misali cephalosporin).

Tasiri kan iya tuka mota da injin motsawa. Fluoroquinolones, ciki har da moxifloxacin, zai iya lalata ikon marasa lafiya don fitar da mota da shiga cikin wasu ayyukan masu haɗari waɗanda ke buƙatar ƙara kulawa da saurin halayen psychomotor sakamakon tasirin tsarin juyayi na tsakiya da rauni na gani.

Mai masana'anta

Highglans dakunan gwaje-gwaje Pvt. Ltd. E-11, 12 & 13, Site-B, UPSIDC, Surajpur, Yankin Masana'antu, Greater Noida-201306, (U.P.), India.

Waya: +91 (120) 25-69-742, fax: +91 (120) 25-69-743.

e-mail: [email protected], www.higlance.com

Wakilin masana'anta a cikin Federationungiyar Rasha: Pharma Group LLC. 125284, Moscow, st. Gudun, 13.

Tel./fax: +7 (495) 940-33-12, 940-33-14.

Saki siffofin da abun da ke ciki

Magungunan antimicrobial yana kan siyar a cikin nau'ikan allunan 400 mg na moxifloxacin (bangaren mai aiki).

Sauran abubuwa a cikin abun da ke ciki:

• anhydrous colloidal silicon dioxide,
• makarin sodium,
• celclostc microcrystals,
• magnesium stearate,
• mai ladabi talcum foda
• sodium lauryl sulfate,
• 3000 macrogol
• soya lecithin,
• baƙin ƙarfe baƙin ƙarfe,
• White Opadry 85G58977.

Alamu don amfani

Wadannan cututtukan da ke biyo baya da cututtukan cututtukan cututtukan ƙwayar cuta waɗanda ke haifar da ƙananan ƙwayoyin cuta suna kula da maganin:

• maganin cutar huhun jama'a da al'umma suka samu ta hanyar tsokanar su daga tsofaffin ƙwayoyin cuta da ƙwaƙwalwar ƙwayoyin cuta,
• m mataki na na kullum irin mashako,
• sinusitis (m), tsokani da kwayoyin cuta na kwayar cuta,
• ciki-ciki na ciki cututtuka (ciki har da cututtuka na polymicrobial),
• fata da cututtukan fata da laushin taushi,
• cututtukan ƙwayar cuta na pelvic, ciki har da endometritis da salpingitis.

An wajabta heinemox don cututtukan kumburi daga gabobin pelvic.
Tare da cututtukan fata, an wajabta Heinemox.Ba a sanya Thrombomagum don lalata tsarin numfashi ba.
An wajabta shan magungunan don ciwon huhu.
Tare da sinusitis, al'ada ce don tsara Heinemox.

Yadda ake ɗaukar Heinemox

Ya kamata a ɗauki allunan rigakafin ƙwayoyin cuta ta baki baki ɗaya, a wanke da ruwa. Yana da kyau a yi haka bayan cin abinci.

• ciwon huhu (nau'in da aka samo a cikin al'umma): ana ɗaukar magunguna a cikin kashi na 400 MG, maganin yana daga 1 zuwa 2 makonni,
• mashako (tare da wuce gona da iri): adadin kwayoyi yau da kullun - 400 MG, tsawon lokacin gudanarwa - 5-10 kwana,
• kwayar sinusitis: kwayar cuta ana amfani da 400 MG kowace rana, tsawon lokacin kulawa shine mako 1,
• fata / ƙananan cututtukan fata: kashi - 400 MG, tsawon lokacin magani - daga 1 zuwa 3 makonni,
• cututtukan ciki - ciki na ciki - 400 mg, lokacin magani - daga 5 zuwa 14 kwanaki,
• rauni mai rauni (wanda ba a haɗa shi ba), an sanya shi cikin gabobin ƙashin ƙugu: matsakaicin yau da kullun - 400 MG, tsawon lokacin gudanarwa - makonni 2.

Ya kamata a ɗauki allunan rigakafin ƙwayoyin cuta ta baki baki ɗaya, a wanke da ruwa.

Gastrointestinal fili

• ciwon ciki
• tashin zuciya
• zawo
• rashin tsoro
• rage cin abinci
• stomatitis
• dysphagia
• colitis (nau'in cutar sihiri),
• gastroenteritis.

Yayin gudanar da maganin, ƙwayar tsoka na iya faruwa.
Jin zafi a cikin ciki shine sakamakon sakamako na miyagun ƙwayoyi Thrombomag.
Yayin magani tare da Heinemox, raguwar ci yana yiwuwa.
Magungunan na iya haifar da gudawa.Yayin shan thrombomag, tashin zuciya da amai na iya faruwa.

Tsarin juyayi na tsakiya

• tsananin farin ciki
• dysesthesia / paresthesia,
• barna a cikin dandano
• rikice,
• rashin bacci
• bacin rai
• vertigo
• gajiya
• nutsuwa
• Abubuwan mamaki
• matsaloli tare da aikin magana,
• maganin rashin karfin jiki.

Yayin shan magungunan, bayyanar rauni gaba ɗaya yana yiwuwa.
Zzoƙari mai narkewa shine tasirin sakamako na shan Asfirin.
Rashin damuwa shine ɗayan gefen sakamako na miyagun ƙwayoyi.
Heinemox na iya haifar da nutsuwa.

Daga gefen metabolism

• hawan jini
• karuwar bilirubin,
• hawan jini
• basir.

• eosinophilia
• anaphylactic halayen,
• kurji
• Harshen Quincke's edema
• laryngeal busa (barazanar rayuwa).

Rushewar jiji da dyspnea na iya fitowa wasu lokuta.

Yayin jiyya tare da Heinemox, bayyanuwar rashin aiki na zuciya mai yiwuwa ne.

Amfani da barasa

Mai ƙera kaya ba ya ba da bayani game da irin wannan haɗin.

Avelox sigar analog ce ta Heinemox.
Haraji na miyagun ƙwayoyi Heinemox - Maxiflox.
Madadin Heinemox, Vigamox wani lokacin ana wajabta shi.Rotomox wani lokaci ana wajabta shi maimakon Heinemox.

• Dabbatarwa,
• Maxiflox
• Vigamox
• Moksimak,
• Moxigram
• Aquamax
• Alvelon MF,
• Ultramox
• Simoflox,
• Rotomox
• Plevilox,
• Moflaxia.