ʻO ka gel Clindamycin: nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana

ʻO ka wehewehe e pili ana i 13.03.2016

Palapala Latin: Clindamycin
ʻĀkau ATX: J01FF01
Mea waiwai: Clindamycin (Clindamycin)
Mea Hana: Hemofarm (Serbia), VERTEX (Russia)

ʻO ka hui nā lula a clindamycin ua hoʻokomo ʻia ka mea komo clindamycin(ka puka hydrochloride), nā kumuwaiwai hou: talc, ka lōmole lactose, kaʻai palaoa, ka pā o ka magnesium.

Hoʻopau ka mea i ka clindamycin hāmeʻa ikaika (kahi ʻano o ka pospate), a me nā mea kōkua o ka huina: benzyl alkohol, disodium edetate, ka wai.

Clindamycin Kukulu I loko o ka pūpū pili me ka clindamycin hāmeʻa ikaika (kahi ʻano o ka pospate), a me nā mea kōkua kaiʻai: macrogol 1500, ka mea aila ʻaila, sodium benzoate, propylene glycol, emulsifier No. 1.

E hoʻokuʻu i ke ʻano

Hoʻohana ʻia ka hāmeʻa ma ke ʻano o mau kapala, kūlohelohe a ʻūpū ʻaʻano.

He kapa poni a kapa gelatin a he ʻulaʻula. I loko o loko ka piha paha, ka mea ʻulaʻula keʻokeʻo a ʻulaʻula paha. Hoʻopili ʻia nā ʻōpili i nā pololi o 8 p.., I loko o kahi ʻeke no ke kāleka no 2 mau blisters.

ʻO ka hālea, ka mea i lawelawe ʻia intravenously a i ʻole intramuscularly, he kūlohelohe, hiki ke ulaula a he melemele paha. Kuhi i nā ampoule o 2 ml. I loko o nā pā he 5 o nā ampoules, i kahi pūpū kāleka o 2 mau pā.

ʻOi aila ʻaihue 2% paha he keʻokeʻo, ʻeleʻele-keʻokeʻo, ʻulaʻula ʻula. He palupalu kiko pāwaliwali ikaika. Loaʻa ma loko o nā paena konahi o 20 g a 40 paha, ua hoʻokomo ʻia ka mea noi ma ka waihona.

Ka hana lāʻau lapaʻau

ʻO ka waiwai clindamycin e pili i ka hui o antibiotics-lincosamides. He pālahalaha ākea ia, he bacteriostatic.

I ke kino, nakinaki ia i ka 50unit subunit o ka ribosome a pale i ka synthesis o ka protein ma microorganisms. He hana i pili i ka Staphylococcus spp., Streptococcus spp. (ʻokoʻa ke Enterococcus spp.), ʻO ka maʻi pīkoi streptococcus, anaerobic a me microaerophilic gram-maikaʻi cocci, Clostridium tetani, Hoʻolaha Clostridium, Diphtheriae Corynebacterium, Mycoplasma spp., ʻO nā Bacteroides spp. (komo ʻO nā melagingenicus Bacteroides a Hoʻokomo nā huapili) Hoʻike pū kekahi i nā hana i kū i ka gram anaerobic-positive, non-spore form, bacilli.

Hoʻolauna ka hapa nui i kēia ʻike. Hoʻolaha Clostridium, akā, ʻo nā ʻanoʻokoʻa o ka clostridia (ma ke ʻano ʻOiʻo Clostridium tertium, ʻO nā sporogenes a Clostridium) e hōʻike i ka pale ʻana i kēia lāʻau. Ma kēia mea, me nā maʻi i hoʻonāukiuki ʻia Clostridium spp.Manaʻo ʻia e lawe ʻia ka antibiotic ma mua o ka hoʻomaka ʻana o ka mālama ʻana.

ʻO ka hoʻolālā o ka hana o kēia lāʻau a me kāna kikoʻī antimicrobial i kokoke loa i ka lincomycin.

ʻO ke ʻano o ka mea clindamycin phosphate he hana i ka vitro, eia naʻe, ke wikiwiki nei i ka hydrolyzed ma vivo, a hoʻokumu ʻia ai clindamycin, ka mea e hōʻike ana i ka hana antibacterial.

Pharmacokinetics a me ka lāʻau lapaʻau

Hoʻopau piha loa ʻia ʻo Clindamycin mai ka gastrointestinal tract, ʻoiai e ʻai ana, e maloʻo ana ke komo ʻana, akā ke ʻano ʻole ka ulu ʻana o ka mea i loko o ke plasma. Hoʻokomo ʻia i loko o nā ʻili o ke kino a me nā wai, no ka palu maikaʻi ʻole ma o ka BBB, akā inā maʻa ka hoʻonāukiuki ʻana o nā membranes o ka pūpū, hoʻonui ʻia ka hāmeʻe.

Loaʻa ka noʻonoʻo kiʻekiʻe i loko koko ua hoʻomaopopo ʻia i ka wā i lawe ʻia ai i ka waha ma hope o 0.75-1 mau hola, inā e hoʻokele ʻia ka hana intramuscular, ma hope o ka hola 1 i ka mea maʻi maʻi a ma hope o 3 mau keiki i nā keiki. Ke mālama ʻia ma ka intravenously, ʻike ʻia ka ʻike kiʻekiʻe loa ma ka hope o ka infusion.

Aia nā hopena therapeutic i loko o ke koko no 8-12 mau hola. ʻO ka hapalua hapalua he 2.4 hola. Hāpai e kū ana i nā leʻa, ʻoiai e ikaika a nau ʻole nā metabolites. ^ E Ha yM. Hana ka excretion i nā lā 4 ma o ke akea a ma o nā ʻōpū.

I ka wā e hoʻolako ʻia intravaginally, ma kahi o 3% o ka paukana i hoʻomoʻa ʻia e hoʻomaʻamaʻa i ka ʻōnaehana o ka ʻōnaehana.

Nā hōʻailona no ka hoʻohana ʻana

Hoʻohana ʻia ka hoʻonā Clindamycin a me nā papa no ia mau maʻi a me nā ʻano:

nā maʻi lēpa a me ka maʻi i hoʻonā ʻia e ka hana a nā microorganism i ka naʻau clindamycin,
nā maʻi āpau o ke kino ENT, a me nā maʻi pūpū o ka ʻōpū hanu o luna a me nā ʻōpū hanu haʻahaʻa,
diphtheria, ʻōpio ʻōpio,
maʻi maʻi urogenital
nāʻiʻi o ka lua waha, ka ʻōpū o ka ʻōpū,
nā kūwaha palē a me nā maʻi,
septicemia (ma laila anaobobic),
osteomyelitisʻeha a me ke ʻano
endocarditis pepili ʻia
ka hoʻopiʻi ʻana no ke kaohi ʻana o ke kō o intraperitoneal a me ka peritonitis ma hope o ka hoʻonaninani ʻana o ka ʻōpū a i ʻole ma hope o ka maʻi traumatic (i hui pū ʻia me aminoglycosides).

Hoʻohana ʻia ka kima a me ka gel Clindamycin no ka maʻi bacterin.

Nā hōʻailona no ka hoʻohana ʻana o nā manaʻo me ka clindamycin:

bacterial vaginosis, hoʻonāukiuki e nā microorganism i ka manaʻo o ka mea.

Nā Hoʻohui

Hoʻopili ʻia ka hoʻohana ʻana o kēia pono:

ma Hoʻokomo pūnana bronchial,
ma pilina myasthenia,
me ka ulcerative polū,
me nā maʻi līlū o kahi ʻano hoʻoilina (ka nele o ka lactase, intolerance galactose, ka malabsorption glucose-galactose).
ma o ka hāpai ʻana a hānai wahine,
i nā makahiki o kē keiki ma lalo o 3 mau makahiki he kolohe, ka hui ʻana o intravenous a me Intramuscular, i ka makahiki o 8 mau makahiki, ua hui a hoʻomōhala ʻia nā kāpena.
ʻike kiʻekiʻe i nā mea o ka lāʻau lapaʻau.

Hoʻomaʻamaʻa ʻia ka mālama ʻana i nā poʻe e loaʻa ana i ka maʻi renal a i ʻole ka hepatic insufficiency, nā mea maʻi maʻi.

Nā hopena hopena

Ke lawe nei i ka lāʻau lapaʻau, hiki i nā maʻi ke loaʻa i nā hopena ʻaoʻao:

nenoai: nā maʻi dyspeptic, jaundice, esophagitis, pseudomembranous enterocolitis, hyperbilirubinemia, nā maʻi kūhālawelawe aho ʻaia,
ʻōnaehana musculoskeletal: i nā hanana kūleʻa, hiki i ka hala ke hoʻoponopono i ka hoʻokele neuromuscular,
hematopoiesis: leukopenia, neutropenia, agranulocytosis, thrombocytopenia,
nā hui allergyʻohiʻala kaʻiliʻili, urticaria, i kekahi manawa - dermatitis, anaphylactoid manifestations, eosinophilia,
nā ipu naʻau a me ke koko: i ka manawa o ke kūleʻa ʻana e hoʻokele a me ka wikiwiki - hoʻemi he pili kokonāwaliwali āhāhuʻe,
nā hōʻike kūloko: ʻeha a thrombophlebitis(ma ka pūnaewele inikua), huhū,
nā hopena ʻē aʻe: keahi ʻana.

Ke hoʻohana nei i ka Clindamycin cream, hiki i nā hopena like ʻole ke ulu:

kou māmā: hoʻonāukiuki i ka mucosa a me ka vulva, kandidiasisvaginal, vulvovaginitis, trichomonas vaginitis, maʻi ʻeha, maʻi ʻōpū lulan, mahina ʻōpū o ka ʻōpū, ʻehaʻeha, dysuria, ke ʻano o nā mea huna. endometriosisglucosuria proteinuria,
nā hōʻike maʻamau: ʻeha a me nā puʻupuʻu, pua, pua, pua a me nā maʻi piʻi, lie kanikelamea hanu ka māla ʻana nā hana ʻeha, ka ʻeha i ka ʻōpū ma lalo, maʻi o ka ʻōpū o ke kaʻa ʻana, ʻeha hoʻi ka hope, nā mea hoʻonāukiuki,
ʻōnaehana o ka gastrointestinal: manaahu nā ninia, constipationutuka he ʻano hūnā, ka dyspepsia, kūleʻa huina o ke akee,
ʻili kūloko: ʻeha o ka ʻili, ʻula, rash, kandidiasis, urticaria,
ʻōnaehana endocrine: pālahalaha,
CNS: āhāhuʻe,
ʻōnaehana o ka ʻōpū: nā waihohelena.

Ke keu

Inā hele mai kahi overdose o ka lāʻau, hiki ke hoʻonui ʻia nā hopena maikaʻi loa i hōʻike ʻia ma luna nei. Haka kikoʻī hoʻololi pū ʻia ʻaʻole, i ka hihia o kahi overdose, hana ʻia ke ʻano hōʻailona maʻi.

ʻAʻohe mea ʻike e pili ana i ka overdose o kaʻaila. I kahi hihia kūlohelohe o ka lāʻau lapaʻau, hiki i nā hopena kikoʻī ke hoʻomohala i hiki mai ma hope o ke kau ʻana i ka mea i ka maʻi maʻamau.

Hoʻohui

Aia ka hoʻonuiʻana i ka hana a streptomycin aminoglycosides, ʻĀlinini, Rifampicin ʻoiai e lawe ana me ka clindamycin.

Hoʻoulu ia i ka hopena o nā mea hoʻokalakupua o ka hoʻokalakupua o ka puʻuwai, me ka hoʻomaha ʻana i ka pehu, e hōʻeha ana i nā n-anticholinergics.

Antagonism me ka chloramphenicol a Erythromycin.

ʻAʻole kūkā ʻia e lawe pū ʻia i nā hopena me nā mea pili i ka paʻakikī huaora hui B, phenytoins, aminoglycosides.

ʻAʻole hiki ke kuhikuhi ʻia nā lāʻau ʻo Clindamycin a me antidiarrheal i ka manawa like, ʻoiai he nui ka ulu ʻana o ka colse pseudomembranous.

Ke hoʻohana ʻia i ka manawa like me ka opioid analgesics hiki ke hoʻonui ʻia ka hopena o ka hanu hanu, a hiki i ka hoʻomohala ʻana ʻneapiha.

Hoʻomaopopo ka pale kūʻē ma waena o lincomycin a me clindamycin. Hōʻike pū ʻia ka antagonism ma waena o erythromycin a me clindamycin.

ʻAʻole ia e noʻonoʻo i ka hoʻohana ʻana me nā lāʻau ʻē aʻe no ka hoʻokō intravaginal.

Nā ʻōlelo kikoʻī

ʻO ka hōʻike ʻana o ka colitis pseudomembranous hiki ke mālama ʻia i ka lāʻau lapaʻau, a me 2-3 mau pule ma hope o ka pau ʻana o ka lapaʻau. Me kēia ʻano, hōʻike kahi kanaka iā ia iho nā ninia, fiva, palukaioʻeha ka ʻōpū.

Inā ulu kēlā mau hōʻailona, pono ʻoe e kāpae i ka lāʻau lapaʻau a lawe i nā resins ion-exchange. I loko o kahi colitis nui, pono e hoʻopiʻi i ka wai o ka nalowale, ka palaka a me nā electrolytes, e kuhikuhi ai i ka intake o Vancomycin a i Metronidazole.

I ka wā mālama, ʻaʻole hiki iā ʻoe ke lawe i nā lāʻau lapaʻau e pale i ka ʻōpū o ka ʻōpū.

Inā hoʻohana ʻia ka lāʻau lōʻihi e nā keiki, pono ʻoe e nānā maʻamau i ke ʻano aʻoaʻo koko a me ke ʻano maʻi o ka maʻi. Ke lawe nui nei i ka nui o ka lāʻau, pono ka lāʻau clindamycin pili koko.

Pono e ʻike ʻia nā poʻe e hōʻike ʻia ana ma ka palupaleka maʻa pono.

Ma mua o ka lawe ʻana i ka lāʻau lapaʻau intravaginally, pono ʻoe e haʻalele i ka kikowaena Chachydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Candida albicans, Herpes simplex, ka mea nui e hoʻonāukiuki i ka hoʻomohala ʻana o ka maʻi vulvovaginitis.

Ke hoʻohana ʻana i clindamycin intravaginally, e ulu nui paha ka hoʻomohala ʻana o nā microorganism insensitive, i nā fungi like-ye like.

ʻO ka mea hiki ke loaʻa iki paha o ka hoʻōla ʻana o nā mea lapaʻau, hiki ke hoʻomohala ʻia ka maʻi me ka hoʻohana ʻana i nā suppositories a i ʻole kaʻaila. I kēia hihia, ua kāpae ʻia ka hāmeʻa.

Pono e hoʻomaopopo ʻia i ka wā o ka mālama ʻia e pono ai ʻoe e pale aku i ka moekolohe a ʻaʻole hoʻohana i nā lāʻau lapaʻau ʻē aʻe no ka hoʻohana intravaginal.

ʻO ka ʻano o kēia lāʻau lapaʻau ka mea i hiki i nā mea i hiki ke hana i nā huahana huila, ka liʻiliʻi o ka lōʻihi. No laila, ʻaʻole i kauoha ʻia e hoʻohana i nā condoms, diaphragms a me nā mea ʻē aʻe mai ka powa.

ʻAʻole pili i ka hiki ke alakaʻi i kahi kaʻa a komo paha i nā hana ʻē aʻe e koi ai i ka noʻonoʻo.

I ka wā hāpai a me ka lactation

Hiki iā ʻoe ke hoʻohana i ka lāʻau lapaʻau intravaginally i loko o nā wahine ma ka trimesters ʻelua a me ke kolu o ka hapai. I nā mahina mua o ka wā hāpai, ua kuhikuhi ʻia inā wale nō ʻoi aku ka pōmaikaʻi o ka mea i hiki ke hōʻeha me ka hoʻohana ʻana i kaʻaila a i ʻole suppositories. I ka wā lactation, pono ʻoe e kaupaona pono i nā pono i manaʻo ʻia a me nā pōʻino paha. E hoʻohana wale i ka huahana ma lalo o ka nānā ʻana o kahi kauka.

Nā hopena hopena

Hoʻomaopopo ka ʻōlelo aʻo i ka hiki ke hoʻomohala i nā hopena ʻaoʻao aʻe ke kuhikuhi ana i ka clindamycin:

nā ʻeke ʻolilo maikaʻi i loko o ka waha, phlebitis (me ka hoʻokō intravenous ma nā keena kiʻekiʻe),
holo, ka lua, ke kaʻaole, ka ʻōpū o ka ʻōpū, ʻeha.
nā hanana o ka esophagitis (me ka hoʻohana ʻana o nā papa clindamycin),
mahuahua i ka bilirubin me ka hana hepatic transaminase,
ʻeha, nāwaliwali, hoʻoneʻe i ke koko (me ka hoʻokele wikiwiki ʻana i loko o ka lā),
ʻitislelo poloka
kandidiasis.

I nā hihia hoʻokaʻawale, hiki iā ia ke hoʻonāukiuki i ka hoʻomohala ʻana i ka maʻi lapaʻau a me ke ake ʻana, a me ka thrombocytopenia hoihoi, leukopenia, neutropenia a me agranulocytosis.

Ma nā hihia lohi, hiki i nā hanana kūloko ke hele aku (hoʻonāukiuki ma ka wahi o ka injection, ka hoʻomohala ʻana o kahi ʻōpū a i ʻole infiltrate).

Hiki i ka gel Clindamycin ke hoʻonāukiuki i ka pūnaewele o ka noi, a me ka hoʻomohala ʻana i ka dermatitis e hoʻopili ai. Me ka hoʻohana mau ʻana, hiki i nā hopena ʻaoʻao ke ʻano ka hoʻomohala ʻana.

ʻO nā ala kumumanaʻo o ka lāʻau (nā supositor a me ka cream) i loaʻa nā hopena ʻē aʻe e like me ka vaginitis, cervicitis a me ka hoʻonāukiuki vulvovaginal.

Me ka naʻau o kēlā me kēia kanaka, hiki i nā hopena alia ke ulu - urticaria, erythema multiforme, ka ʻala, ka edema o Quincke, a i ʻole ka pīhoihoi anaphylactic.

Hiki i ka colse Pseudomembranous ke hele a ʻelua i ka wā e lawe ai i ka clindamycin, a me 2-3 mau pule ma hope o ka hōʻea ʻana i ka mālama ʻana (3-15% o nā hihia). Hōʻike ia iā ia iho ʻo ka maʻi o ka maʻi, leukocytosis, ka maʻi, ka ʻeha o ka ʻōpū (i kekahi manawa i hele ʻia me ka excretion me nā fecal masses o ke koko a me ka mucus).

Nā Hoʻohui

Hoʻohui ʻia ia e kuhikuhi i nā clindamycin i kēia mau pilikia aʻe:

pilina myasthenia
ʻOiaʻiʻo
colitis ulcerative (mōʻaukala)
nā maʻi hoʻohemo ʻano nui, e like me ka galactose intolerance, ka hapa lactase a i ʻole ka malabsorption glucose-galactose (no ka capsules),
hapai a me lactation,
a hiki i nā keiki he 3 a hiki i ka 3 mau makahiki - no kahi hoʻonā no ka hoʻokele intravenous a me intramuscular (ma muli o ka ʻike ʻole o ka ʻike i ka palekana o ka hoʻohana ʻana i ka waiʻona benzyl).
keiki mai nā keiki a hiki i 8 mau makahiki no nā kapules (ʻokoʻa ka nui o ke keiki ma lalo o 25 kg),
haaheo.

Hoʻohana ʻia ʻo Clindamycin me ka akahele i nā mea maʻi me ka maʻi hepatic koʻikoʻi a / a i ʻole hana renal i loko o nā maʻi maʻi.

I ka wā mālama, ʻaʻole hiki iā ʻoe ke lawe i nā lāʻau lapaʻau e pale i ka ʻōpū o ka ʻōpū.

Ke keu

I ka hihia o ka overdose, hiki i ka hopena ke piʻi aʻe.

Lawe ʻia ka maʻi Symptomatic, ʻaʻohe ʻano antidote kūikawā. ʻAʻohe maikaʻi ka Hemodialysis a me nā diit peraloneal.

Lapaʻau

Hoʻopaʻa a ia i ka subunit 50S ribosomal o ka microbial cell a ke pale aku i ka synthes o nā protein o nā microorganisms kūpono. Loaʻa ia i kahi hopena bacteriostatic, i nā koi kiʻekiʻe a me ka mahalo i nā microorganisms koʻikoʻi loa e hōʻike i ka hopena bactericidal. E like me ka ʻoihana o ka hana a me ka molowa antimicrobial, kokoke ia i ka lincomycin (e pili ana i kekahi mau ʻano microorganism ʻo ia he 2-10 mau manawa hou aku).

I ka lawe ʻana i ka clindamycin ma ka ʻōlelo maʻamau, hikiwawe ka hydrochloride a lawe maikaʻi ʻia mai ka digestive tract (ʻoi aku ka maikaʻi ma mua o ka lincomycin), bioavailability 90%, ka manawa maʻalahi e hoʻomoʻi ana i ka hoʻoluʻu ʻana, me ke ʻano ʻole o ka hoʻololi ʻana o ke kahe o ka piha ʻana. ʻO ka pilina Protote ka 92–94%. E komo maʻalahi i nā waiolima, nā hui a me nā kiko o ke kino, e komo pū ana tonsils, māhina a me nā iwi ʻōpala (kokoke i 40% o ka paʻa o ke koko), bronchi, māmā, pleura, pleura fluid (50-90%), bile ducts, appendix, fallopian tubes, prostate gland, synovial fluid (50%), ka lawaiʻa ka huʻu (30-75%), hoʻoiho i nā hōʻeha. E hala iki ma waena o ka BBB (me ka hoʻonāukiuki o nā meninges, hoʻonui ʻia ka mana BBB). ʻO ka nui o ka hoʻoili ʻana i nā pākeke ma kahi o 0.66 l / kg, i nā keiki - 0.86 l / kg. E hala koke ma waena o ka plasenta, aia i loko o ke koko o ka kuʻi (40%), komo i ka waiū umauma (50-100%).

ʻO Clindamycin palmitate a clindamycin phosphate ʻaʻole hana ikaika, hoʻopili koke lākou i ke kino i ke clindamycin ikaika.

C_max i loko o ka serum waha, ua loaʻa ia ma hope o ka 0.75-1-1 h, ma hope o ka uʻi i / m - ma hope o 3 h (nā mākua) a i ʻole 1 h (nā keiki), me ka iv infusion - e ka hopena o ka pau ʻana. Hoʻomiliʻia ia i ka puʻuwai me ka hoʻokumu i hana ikaika (N-dimethylclindamycin a me clindamycin sulfoxide) a me nā metabolite hana ʻole. Hoʻohālikelike ʻia i loko o nā lā he 4 me ka mū (10%) a ma waena o nā mauʻu (3.6%) ma ke ʻano he kikowaena ikaika, ʻo ke koena e like me ka metabolite ʻole. T_1/2 me ka hana hāmeʻa maʻamau i nā pākeke he 2.4-3 mau hola, i nā pēpē a me nā keiki kahiko - 2.5-3 mau hola, i nā pēpē makua mua - 6.3–8.6 mau hola. hana ʻoi loa ʻole ka maʻi hepatic hana, ua emi iho ʻo clindamycin e hoʻopau (T_1/2 i nā pākeke - 3-5 mau hola). ʻAʻole hoʻoiho.

Me ka hoʻokolohua intravaginal o 100 mg o clindamycin phosphate ma ke ʻano o ka 2% vaginal cream 1 ka manawa no ka lā no 7 mau lā i nā wahine me 5 nā maʻi maʻi bacterial, ka hoʻopili ʻana o nā ʻōnaehana ma kahi o 5% (i ka pae ana o 2-8%) o ka lāʻau hoʻōla. ʻĀina C_max ma ka lā ʻehā - kahi he 13 ng / ml (mai 3 a 34 ng / ml), ma ka lā ʻehiku - he awelika o 16 ng / ml (mai 7 a 26 ka / ml), T_max - aneane 16 mau hola (ma kahi o 8-24 mau hola) ma hope o ka palapala noi. Me ka hoʻohana pinepine ʻana i intravaginal, ua hala ʻole ka ʻōnaehana o ka ʻōnaehana a i ʻole hoʻokele ʻole ʻia. T_1/2 me ka ʻōpiopio o ka ʻōnaehana - 1.5-2.6 hola

Ke hoʻohana nei i ka clindamycin phosphate intravaginally ma ke ʻano o ka suppositories ma kahi maʻa o 100 mg hoʻokahi i ka lā no 3 mau lā, ma kahi o 30% (6000%) o ka hoʻomoʻa ʻana i mālama ʻia i loko o ka ʻōnaehana hoʻonohonoho, me kahi AUC awelika o 3.2 μg / h / ml (0.42–11 μg / h / ml). C_max ua loaʻa ma kahi o 5 mau hola (1-10 mau hola) ma hope o ka hoʻokele ʻana o ka suport vaginal.

I ka hoʻohana ʻia o ka gel no ka hana waho o clindamycin, hoʻonui koke ʻia ka phosphate e nā phosphatases i nā papa o nā aniani sebaceous me ka hoʻokumu ʻana o clindamycin. Hiki ke komo i ka gel i nā nui e loaʻa ai nā hopena ʻōnaehana.

Sensitive to clindamycin i loko o vitro nā microorganisms ma hope iho: aerobic gram-positive cocci, ʻo ia hoʻi Staphylococcus aureus, Staphylococcus ep> komo nā māka me ka mea e hana ai i ka penicillinase ( i loko o vitro ka wikiwiki o ka hoʻoulu ʻana ʻana o ka clindamycin i kekahi staphylococcal erythromycin resistant strains) Streptococcus spp. (koe wale ʻole Streptococcus faecalis), Pneumococcus spp., anaerobic gram-negative bacilli, komo ʻO Bactero> e komo ka hui B. fragilis a me nā hui B. melaninogenicus), Fusobacterium spp., non-spore anaerobic gram-positive bacilli, a me Propionibacterium spp., Eubacterium spp., Actinomyces spp., anaerobic a me nā microaerophilic gram-positive cocci, ʻoiai Peptococcus spp.,Peptostreptococcus spp., Microaerophilic Streptococcus spp., Clostridia spp. (ʻoi aku ka pale o ka clostridia i ka clindamycin ma mua o ka nui aʻeerobes). Loa Hoʻolaha Clostridium paʻakikī i ka clindamycin, akā, nā mea'ē aʻe, no ka laʻana C. sporogenes a C. tertium, kū pinepine i clindamycin, no laila, pono nā hōʻike hoʻoweliweli.

I nā dosis kiʻekiʻe, hana i kekahi protozoa (Plasmodium falciparum).

Ua hōʻike ʻia ke kūwaʻi kūʻē ma waena o clindamycin a me lincomycin a me antagonism ma waena o clindamycin a me ka erythromycin.

I nā kūlana i loko o vitro ikaika a clindamycin i ka hapa nui o nā microorganisms e hiki ai ke hoʻomakei i nā maʻi bacterial: Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis, Bacteroides spp., Peptostreptococcus spp. Clindamycin no ka hoʻohana intravaginal hikiʻole no ka mālamaʻana o vulvovaginitis i kumu e Trichomonas vaginalis,Chlamydia lachomatis,Neisseria gonorrhoeae, Candida albicans a he virus paha Herpes simplex.

ʻO ka hopena anti-hakihaki no ka hoʻohana ʻana i waho ka mea i hoʻopiʻi ʻia e ka clindamycin i ka hoʻoneʻe ʻana o ka hoʻokaʻawale o nā momona momona i ka ʻili a pale i ka hana hou. ʻO nā mea kanu propionibacterium - Loaʻa kekahi anaerobic i nā kelima sebaceous a me nā follicle. Hōʻike ʻia ka ʻike ʻana o nā kuʻuna i noiʻi ʻia. P. kaona i clindamycin i loko o vitro (MIC 0.4 μg / ml).

Carcinogenicity, mutagenicity, hopena i ka mahele

ʻO nā haʻawina lāʻau lōʻihi no ka loiloi ʻana i ka hiki ʻana mai o ka carcinogenicity o clindamycin. ʻAʻole i ʻike ʻia ka hana Mutagenic ma ka hōʻike ʻo Ames a me ka hōʻike ʻo ka micronuclear i nā kihe. Nā hopena hopena ma ka hānai a me ka hiki ke kahe ʻana i ʻike ʻia i nā kihe e loaʻa ana i ka clindamycin waha i nā dosis a hiki i ka 300 mg / kg / lā (ma kahi o 1.6 mau kiʻekiʻe ma mua o nā MPD ma nā huaʻama o mg / m 2).

Kahawai I ke aʻo ʻana i ka hoʻohālikelike i nā holoholona (lālulu, nā kiole) e hoʻohana ana i nā waha waha o clindamycin a i ka 600 mg / kg / lā (3.2 a me 1.6 manawa kiʻekiʻe o nā MPD e pili ana i ka mg / m 2, kēlā me kēia) a i ʻole ka sc i nā doses a hiki i 250 mg / kg / lā (1.3 a 0.7 mau manawa i kiʻekiʻe ma mua o ka MPDC ma nā ʻōlelo o mg / m 2, kēlā) ʻaʻole i ʻike ʻia ka hopena teratogenic. I loko o kekahi hoʻokolohua ma kahi me nā kiʻī, ua ʻike ʻia kahi huki o ka palate i ka pēpē (ʻaʻole i hōʻoia ʻia kēia hopena i nā hoʻokolohua ma luna o nā holoholona ʻē aʻe a me nā laina ʻē aʻe o nā maulehe nui.

ʻŌpū a me ka lactation

I ka wā hāpai, hiki i ka hopena ke ʻoi aku ka hopena o ka hopena i ka mea maʻi (ʻaʻohe mea kūpono a hoʻopaʻa ʻia i nā haʻawina ma nā wahine hāpai, ʻo ka clindamycin e hele i ka plasenta a hiki ke kāohi i loko o ka lā fetal, akā ʻaʻohe mea i hoʻopiʻi ʻia i nā kāne). ʻAʻole paʻa i nā noiʻi inā ʻoi aku ka mālama ʻana o ka maʻi vaginosis i ka hōʻemi ʻana o ka hopena i loaʻa i ka hopena e like me ka neʻe mua o nā membranes, ka hoʻomaka ʻana o ka hana, a i ka hāʻawi mua ʻana.

ʻO ka FDA keʻano o ka hana ma ka pūpū - B.

Pono e hana nui ʻia ma ka wā e hoʻohana ʻia i ka wā o ka umauma (ʻaʻole i ʻike ʻia inā hiki ke clindamycin i loko o ka umauma waiū ma hope o ka hoʻohana ʻana o waho a me ka intravaginal, akā ʻike ʻia i ka waiū umauma ma hope o ka waha a ma ka lawelawe makua.

Pharmacodynamics a me ka pharmacokinetics

Hoʻopili maikaʻi ʻo Clindamycin i loko o nā kaila ākea, nā palekele palalike o ke kino a me nā iwi. Ke pale nei ka lāʻau lapaʻau i ka hoʻokaʻawale ʻana o nā protein i nā pūnaʻi o nā microorganism pathogenic, e hōʻike ana i ka hopena bacteriostatic a me ka bactericidal. Nui kekahi o nā huakini i kū i kēia mau maʻi:

ʻO nā maʻi i loaʻa i kēia mau bakia

nā mea i kuʻi ai i ka hae flagellar

meningitis, bacteriaemia, dysbiosis

botulism, tetanus, gas gangrene, hoʻopili kai clostridial

Ka ʻike nui loa o ka waihona therapeutic i loko o ke koko me ka hoʻokele waha e mālama ʻia ma mua o ka hoʻomehana intramuscular. ʻO ka mea ikaika e komo i ke koko 1-3 mau hola ma hope o ka lawe ʻana (ka hoʻokō) ʻana i ka lāʻau lapaʻau. Ua hiki i ka ʻāina i loaʻa, ke hoʻomau ʻia nei i loko o ke kino no kahi mau hola 12, ʻoiai ua kokoke 90% o ka mea e hoʻopaʻa ai i nā protein o nā microorganisms pathogenic. ʻAʻole i hōʻike ʻia nā haʻawina haukaʻi e hōʻiliʻili ana i nā mea ikaika o ka lāʻau. Hoʻoili ʻia kēia e ka ʻōpala. Hoʻopau piha nā metabolites ma hope o 4 mau lā me ka urine, bile a me nā feces.

ʻLoe a me ke kākele

Hoʻopili paʻa loa ka lāʻau Antibiotic ma lalo o ka mālamaʻana o kahi kauka. ʻO ke koho o ke ʻano o ka lāʻau lapaʻau, kona hewa a me ke manawa o ka hoʻokele ʻana, hilinaʻi ʻia:

hoʻomanawanui
kona hānai
nā wahi o ke kino o ke kino,
uhai o ke ano o ka maʻi,
ka ʻike o ka pathogen i ka hana ikaika o ka lāʻau.

No nā maʻi pūpū, ua hoʻonoho ʻia ka lāʻau maʻi i ke ʻano o kahi kinikini no ka hoʻohana intervaginal. Hoʻokomo ʻia kahi mea noi hoʻihoʻi (i waiho ʻia) ma luna o ke kīʻaha o kaʻaila a piha me ia. No ka hana ʻana i kēia, ke kaomi ma ke alapine e ʻole ka huki i ka piston o ka mea noi. Hoʻokomo ʻia hoʻokahi hapalua o ka lāʻau lapaʻau (5 mg) i loko o ka pūpū hoʻokahi i ka lā ma mua o ka hiamoe. ʻO ka lōʻihi o ka mālamaʻana he 7 lā.

No nā poʻe pākeke, hoʻohana ʻia kahi hopena no ka inikua intramuscular (intravenous) i ʻelua manawa i ka lā, 300 mg kēlā me kēia. Me kahi papa koʻikoʻi o ka maʻi, hiki i ka hoʻonui ʻia o ke ʻano i kēlā lā i kēia lā ka lāʻau i ka 2700 mg hiki. Ua mahele ʻia i 3-4 injections. I kēia hihia, ʻaʻole pono kahi lawelawe o ka luna hoʻokahi ma mua o 600 mg. Ua kuhikuhi ʻia nā keiki mai 3 mau makahiki o 15-25 mg no 1 kg o ka paona a ua mahele ʻia i nā ʻāpana like i nā inikini 3-4. Ma nā maʻi ʻino, e hoʻonui ʻia ka nui o nā keiki i ke 40 mg i kēlā me kēia lā.

No ka hoʻohana ʻana, hoʻoneʻe ʻia ka lāʻau lapaʻau me kahi hopena o 0.9% sodium klorida a i ʻole 5% dextrose i kahi kaila o ka ʻike ʻole o ka 6 mg / ml. ʻO ka hopena hopena e mālama ʻia ma ke ʻano he 10 a 60 mau minuke (ma muli o ke ʻano). ʻO ka nui o ka nui o ka ʻimi i loko o kahi hoʻoponopono i hoʻokahi intravenous ʻo 1,2 g. Inā ʻike kahi 8 mau hola ma waena o nā mea hana manuahi, ʻike ʻia nā maʻi me ka maʻi renal (hepatic) i ka hopena maʻamau o kēia ʻano hoʻonaninani.

ʻAʻole kuhikuhi nā keiki ma lalo o 12 mau makahiki i ka capsule antibiotic. ʻO ka maʻi no nā maʻi o nā ʻōpiopio ʻē aʻe penei:

ʻO ka nui o nā manaʻo i kēlā me kēia lā

ʻO ka hōʻemi maʻamau o ka maʻi, ka nui o nā capsules (pcs.)

ʻO ka papa maʻi o ka maʻi, ka nui o nā capsules (pcs.)

Hoʻohana ʻia nā koho Clindamycin e mālama i ka manawa 1 i kēlā me kēia lā ma mua o ka hiamoe. I ke kūlana o ka supine, pono ia e hoʻomau i ka suporidene i loko o ka pūpū. ʻO ke papa he 3-7 mau lā.

Nā maʻi ʻehaʻeha ma luna o ka ʻili me nā maʻi bacterial i ukali ʻia e ka ʻōpala i ke ʻano o ka huehue. No nā maʻi ʻili, hiki i ke kauka ke kuhikuhi i nā kapena a me nā gel no ka mālama like ʻana. Paila like-gel me ka clindamycin e hoʻohana no ka hoʻohana waho. Hoʻopili ʻia ka gel i ka māno manawaleʻa ma luna o nā huehue a me nā wahi me ka hoʻomehana ma hope o ka hoʻomaʻemaʻe ʻana i ka ʻili.

I ke wā kamaliʻi

Hāʻawi ʻia nā keiki ma lalo o 8 mau makahiki i kahi antibiotika waha i ke ʻano o ka mākona. Hoʻolālā ʻia ka mākaukau Granular no ka mākaukau pono ʻana o ka ʻaila (suspension). Pono ka kīʻaha me nā granule i 60 ml o ka wai a lulu maikaʻi. Hoʻokomo ʻia ka helu ʻana o ka hopena o ka lāʻau lapaʻau ma ke kaumaha o ke kino a me ke ʻano o ke keiki. ʻO ka inikua o kēlā me kēia lā no nā keiki he ʻoi aku ma mua o ka malama he 8-25 mg no ka pāpaona o ke kaumaha, hoʻokaʻawale ʻia i 4 mau papa. ʻO ka hapa liʻiliʻi loa no nā keiki ke kaupaona ʻana ma lalo o 10 kg he 37 mg (1/2 tī) ʻo ia ma 8 mau hola.

Hoʻohana ʻia kēia antibiotic ma ka makua i nā keiki:

Hoʻohui nūhou

Clindomycin, i ka wā e launa pū me nā lāʻau ʻē aʻe, i kekahi manawa he hopena maikaʻi ʻole o ke kino o ka mea maʻi. E noʻonoʻo pono kēia i ke kuhikuhi ʻana i ka lāʻau i loko o ka hōʻeha kaumaha.

ʻAʻole kūpono me nā barbiturates. Hoʻohui ʻia ka hoʻohana ʻana o nā lāʻau.
Hoʻonui i ka hoʻomaha ʻoluʻolu e ka n-anticholinergic blockers.
He antagonistic i ka erythromycin a me chloramphenicol.
Co-hoʻokele me Fortum he hopena hopena o nā keiki.
Hoʻonui i ka hana a aminoglycosides.
Me nā lāʻau antidiarrheal hiki ke alakaʻi i ka colitis pseudomembrane.
Hāʻalo kēia i ka hanu (a hiki i apnea) i ka manawa i hoʻohana pū ʻia me ka hoʻomākaukau ʻana i ka analgesic o ka series opium.
ʻAʻole kūpono me nā hoʻomākaukau haʻahaʻa ʻē aʻe.

Nā ʻōlelo a ke kūʻai a me ka waiho ʻana

Hiki ke kūʻai aku i ka Clindamycin ma nā ʻano āpau ma nā lāʻau lapaʻau ma o ka lāʻau lapaʻau. Kūʻai ma kahi maloʻo maloʻo mau loa mai ka hiki ʻole o nā keiki. ʻO ke ola o kēia lāʻau lapaʻau i ke ʻano o:

kaʻae no ka hoʻolālā intravenous a intramuscular - 2 mau makahiki mai ka lā o ka hana ʻana (i hōʻike ʻia ma kēlā me kēia ampoule a ma luna o ka paena),
mau kākoi - 3 mau makahiki,
kirīmi - 2 mau makahiki,
Nāʻaila - 3 mau makahiki.

Inā hiki ʻole ke hoʻohana ʻana i ka clindamycin no kekahi mau kumu, ua kuhikuhi ke kauka i kāna mea e hoʻopili ai:

Klindatop. ʻO ka topical gel no ka mālamaʻana i nā hopena maʻalahi i nā ʻano o ka huehue.
Klimitsin. Hoʻokomo ʻia ma ke ʻano o nā momi no ka hoʻomākaukau ʻana o ka pēpē pēpē a me ka ʻōlelo ʻana.
Dalacin. Loaʻa i ke ʻano o nā capsules, injection, granules, gel, cream vaginal and suppositories.
Zerkalin. ʻO ka lāʻau lapaʻau no ka mālamaʻana i nā hakihaki.