Amikacin - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana i ka lāʻau lāʻau i ka pauku a me ka hoʻonā ʻana

Aia kēia lāʻau lāʻau i ka antibiotics o aminoglycosides, he ākea ka nui o ka hana bactericidal. ʻO ka mea hana nui o ka lāʻau lapaʻau ka ʻoihana Synthesis. Hoʻokuʻu ʻia i nā lāʻau lapaʻau wale nō ma ke kau inoa ʻana a ʻaʻole hiki ke hoʻokuʻu ʻia. Kuhi ʻia i ke ʻano o ka hopena a i ʻole ka pauka no ka hoʻokele intramuscular a i ʻole intravenous.

Nā ʻōkuhi no ka hoʻohana ʻana iā Amikacin

ʻO ka antibiotik Amikacin e pili ana i nā lāʻau semisynthetic mai ka hui aminoglycoside. Ka lāʻau lapaʻau e pili ana i ka microorganisms bacteriostatically, bactericidal, pale i nā kaʻina hana i ko lākou ola, e alakaʻi ana i ka make o nā huakini. I loko o kahi puʻukū pathogenic, hoʻomohala ka pale ʻana i ka lāʻau lapaʻau, no laila, he hopena koʻikoʻi ka lāʻau lapaʻau i ka hopena i loko o ka hui o aminoglycosides. No ka lāʻau lapaʻau i nā antibiotics ākea ākea-ākea neʻe ikaika loa ʻia:

1. Kekahi mau microorganism maikaʻi: staphylococci (staphylococcus), kahi kūpaʻa i ka methicillin, cephalosporins, penicillin, kekahi mau kaha o ka streptococci (streptococcus).
2. ʻAkuhi-hewa: Aeruginosa, Enterobacter, Escherichia, Klebsiella, Prov>

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

Hana ʻia ka hoʻomākaukau ma ke ʻano o kahi hopena a ʻōpala paha no ka hoʻomākaukau ʻana i nā hoʻonā. Hoʻohana ʻia ka lāʻau lāʻau intramuscularly a i ʻole intravenously, i loaʻa i kēia mauʻu:

• 2 ml mau pahuʻi o 500 mg (250 mg / 1 ml), mau pā o 5 a 10 mau ʻāpana,
• 4 ml ampoules o 1 g o 5 a 10 popo. Ke hoʻokau ʻana
• pauku i loko o nā hue he 500 a me 1000 mg, pahu pāpau, 1, 5, 10 mau pā.

Externally, ke kīleʻaleʻa he hopena kūlohelohe, loaʻa i kēia nā ʻĀina a me nā mea hou aʻe:

• ke kumu nui o ka ʻōmole amikacin, ml 250 mg,
• nā mea kōkua - ka sodium citrate, ka wai no ke kau ʻana, i hoʻoheheʻe wai ʻia i ka wai, ʻo ka sodium disulfite.

Pharmacodynamics a me ka pharmacokinetics

ʻO kēiaʻano hoʻonāukiuki mai ka hui 3 o ka makahiki aminoglycoside. Loaʻa ia he hopena bacteriostatic (make i nā cell bacteria bacterial) e pili ana i kahi ākea o nā microorganism pathological ʻano like ʻole. Hoʻoulu ʻia ka luku ʻana ma muli o ka hoʻopili ʻana i ka subunit 30S o ka ribosome, ka uhaʻi ʻana i ka hōʻemi o ka molika o ka mololi, ke kumu o ka make ʻana o kahi cell bacteria. Hoʻomaʻamaʻa ka lāʻau lapaʻau e kūʻē i ka hapa nui o nā microorganisms kūpono a me kekahi mau gram-maikaʻi.

ʻAʻole loaʻa ka hopena o ka lāʻau lapaʻau i nā maʻi anaerobic (kēlā mau microorganism i hiki ke ulu wale i ka nele o ka oxygen). ʻO Amikacin kahi lāʻau lapaʻau maikaʻi e kū'ē i nā maʻi kūlohelohe i nā antibiotics ʻē aʻe. Ma hope o ka hoʻonā ʻana o ka intramuscular, komo koke ka lāʻau lapaʻau i ke kahe a hoʻokaʻawale ʻia ma ke kino ma loko o nā minuke 10-15. ʻO ka lāʻau lapaʻau e komo maʻalahi i ka punawai koko-lolo, ka placenta (i ka wā hāpai, e komo ana i ke kino o ka pēpē), komo i ka waiū umauma. ʻAʻole loli i ko lākou kino.

Nā hōʻailona no ka hoʻohana ʻana

ʻO ke kumu nui no ka hoʻohana ʻana i ka lāʻauʻawaʻawa ʻo nā maʻi maʻi infectious e hoʻonāukiuki ʻia e ka bacteria-negative bacteria (ʻoiai inā kūpaʻa lākou i nā lāʻau lapaʻau ʻē aʻe i kēia hui). ʻO kēia mau maʻi maʻi hōʻike ʻia no ka hoʻohana ʻana i ka lāʻau lapaʻau:

1. ʻO nā kaʻina o ka infectious o ke ʻano o ka papa hanu: abscess baga, bacterial bronchitis, pneumonia, empyema o ka pleura (hōʻemi o ka pus i ka pleural rongoa).
2. Sepsis. ʻO kēia kahi hana infectious me ka ulu a me ka hoʻoulu houʻana o nā maʻi pathogenic i ke koko.
3. Nā maʻi Brain: meningitis, meningoencephalitis, encephalitis.
4. ʻO ka endocarditis Bacterial. ʻO ka kaʻina infectious e maʻamau ka hoʻomaʻemaʻe ʻana o ka loko o ka naʻau.
5. Hoʻokomo ʻia nā ʻōpū o nā ʻili, nā palupalu palupalu, nā kiko subcutaneous: phlegmon, abscesses, pressure sores with necrosis, gangrenous process, Burns.
6. ʻO ka peritonitis a me nā hana baki pathological ʻē aʻe i loko o ke ana o ka ʻōpū.
7. Nā maʻi maʻi i loko o ka ʻōpū, ka urinary system - i ʻole o ka iʻa, nā ʻāpana ʻāwīwī, ka emeema o ka ʻōpū o ke au, i ka cholecystitis.
8. ʻOsteomyelitis (maʻi i ka iwi), arumini purulent.
9. ʻO nā maʻi e hoʻopilikia i ka ʻōpū, ʻōpū.

ʻLoe a me ke kākele

Ma mua o ke kuhikuhi ʻana i nā lāʻau lapaʻau, pono ke kauka ke kauka i nā ʻano maʻi āpau e pono ai. Ua hoʻokūpaʻa ʻia ka dosage, ke ʻano o ke noi ʻana, me ka noʻonoʻo e pili ana i ke ʻano o kahi o ka maʻi ʻeha, ka hōʻeha o ke ʻano hana, a me ke ʻano o ka pathogen. Aia kekahi ʻano no ka hoʻokele intramuscular a me ka hana intravenous (waʻa a i ʻole ka lele no 2 mau hola).

Hoʻopili maikaʻi loa ʻia ʻo Amikacin

Hiki i ka ʻike ʻana o ka lāʻau i ka hopena no ka inikini intravenously ʻaʻole hiki i nā 5 mg / ml. Inā pono, ʻo ka mālama ʻana me kēia ʻano e hiki ke hoʻohana ʻia i ka hopena ʻo Amikacin, kahi i hoʻohana ʻia no ka hoʻoponopono intramuscular. Pono ka hopena o ka glucose 5% o 200 ml a i ʻole ka hopena isotonic sodium chloride. Ke hoʻokō nei ka hoʻopuka Drop ma ka wikiwiki o 60 mau minuke / minuke, jet - no 3-7 mau minuke. pono ia i ka wā o ka mālama ʻana e nānā i ka hana o ke nerve auditory, nā pōpoki, apparatus vestibular.

Amikacin intramuscularly

Hoʻomau ʻia ka hoʻonā ʻana ma ka hoʻohui ʻana i ka wai no ka injection i kahi pauma maloʻo mai kahi pahu. Inā pono, e koi ka intramuscular injection i ka 2-3 ml wai no kēlā me 5 g o ka pauma. I ka wā e hoʻolaha ai i kahi wai, pono e mālama ʻia. E lūlū i ka ʻeke i pau nā kiko o ka wai. Ma hope o kēlā, kau i ka hoʻonā i loko o ka syringe a hana i ke aloha intramuscular.

Nā ʻōlelo kikoʻī

Aia kekahi papa inoa o nā kānāwai e pono ai e noʻonoʻo i ka wā e hoʻohana ai i nā lāʻau lapaʻau. Hoʻokahi wale ke kauka kauka iā ia a ke kuleana ka mea maʻi e hoʻokō me ka papa hana i hoʻoluhi ʻia e ka loea. Ua loaʻa nā ʻōlelo kikoʻī kūikawā:

1. No nā keiki a hiki i ka 1 mau makahiki a me nā pēpē, hiki ke mālama ʻia i ka lāʻau lapaʻau ma lalo o ka mākaʻi ʻana ma ke ʻano he nui, a inā he maʻi koʻikoʻi, he dosis o 10 mg / kg momona kino. Ua hoʻokaʻawale ʻia ka dosis i 10 mau lā.
2. I ka hana ʻole o ka hopena therapeutic, 2-3 mau lā ma hope o ka hoʻomaka ʻana o ka mea lapaʻau, pono hana i ka hoʻoholo ʻana ma ke kau ʻana i nā hana lapaʻau o ka pathology a i ʻole antibiotic.
3. Pono e hoʻohana ʻia ʻo Amikacin me ka akahele nui me nā lāʻau ʻē aʻe, pono ia e nānā i nā hana hana o nā huʻala, nā aʻa, a me nā papa nūna.
4. Ma lalo o ka kāohi paʻa ʻana, hoʻohana ʻia kahi lāʻau lapaʻau inā he maʻi nā maʻi o ka mea maʻi, nāʻu palupalu myasthenia.

Amikacin i ka wā hāpai

Hoʻohana ʻia ka hoʻohana ʻana o ka lāʻau no nā hōʻailona koʻikoʻi i ka wā hāpai, lactation. Pono e noʻonoʻo i ka lāʻau lapaʻau i hiki ke komo i ka plasenta, a laila ʻike ʻia ma ke koko o ka pūpū, aia kahi hopena o ka hōʻiliʻili o ka waiwai i loko o nā keiki o ke keiki, ka mea e loaʻa ai ka hopena nephro a ototoxic ma luna o lākou. Hoʻoholo ʻia ia ma nā wahi liʻiliʻi o ka waiū umauma. Mai ka gastrointestinal tract, nāwaliwali o ka hoʻopili ʻana o ka aminoglycosides. I ka loaʻa ʻana o nā ʻōpiopio umauma ma muli o ka lawe ʻana i ka lāʻau lapaʻau i nā keiki, ʻaʻole i ʻike ʻia.

ʻAmike ʻAikaka no nā keiki

ʻAe ʻia ke ʻano o kahi lāʻau lapaʻau mai ka hānau ʻana. Hoʻohana ʻia ʻo ʻAikakein no nā keiki:

• nā pēpē mua: ʻo ka hapa mua he 10 mg / kg, a laila 7.5 mg i kēlā me 24 hola,
• congenital a hiki i nā makahiki 6: ʻo ka mua mua i ka 10 mg / kg, a laila 7.5 mg i kēlā me 12 mau hola.

No ka hapalua hola, e mālama ʻia ka lāʻau lapaʻau i nā keiki, i nā pilikia paʻakikī no hoʻokahi hola. Me ka hoʻolālā ʻana o kahi maʻi koʻikoʻi, ua ʻae ʻia ka hoʻokele jet no 2 mau minuke, akā aia wale nō i mua o ke kauka a me kāna ʻae. Ma mua o ka hoʻohana ʻana i ka huahana, e hoʻoheheʻe ʻia i ka hopena o ka sodium chloride (0.09%) a i ʻole dextrose (5%). I ke hopena, ʻaʻole eʻoi aku o ka neʻe ʻana o ka hana ikaika ma mua o 5 mg no ka 1 kg o ka lehulehu.

Hoʻohui nūhou

ʻO Amikacin kahi synergistic i ka wā e hoʻopili ai me ka benzylpenicillin, carbenicillin, cephalsporins (aia kahi pilikia o ka hōʻemi ʻana i ka hopena o nā aminoglycosides i ka wā i hoʻohana pū ʻia me nā antibiotika beta-lactam i nā mea maʻi me nā maʻi ʻoi aku ka hopena maʻi). Ka hopena o ka oto - a me ka nephrotoxicity i ka wā e hoʻopili ana me ka polymyxin B, ka waila nalidixic, vancomycin, cispalitic.

ʻO Penicillins, cephalosporins, diuretics (a ʻo ka furosemide wale nō), nā NSAIDs, sulfonamides e hoʻokūkū i ka hoʻokūkū no ka hana huna ʻana i nā ʻōpala o ka nephron. Ke alakaʻi nei kēia i kahi paʻa i ka hoʻopau ʻana o nā aminoglycosides, hoʻonui i ko lākou kao i ke koko, hoʻonui iā neuro- a me nephrotoxicity. ʻO Amikacin i ka hui pū ʻana me nā lāʻau lapaʻau like-curare e hoʻonui i ka hopena hoʻomaha hoʻomaha.

ʻO ka hopena o ka hopu ʻana i ka hanu ma ka wā hoʻokaʻina i ke koko me ka cerv preservatives, ka hoʻohana ʻana i nā lāʻau lapaʻau e ālai ana i ka hoʻoiho ʻana o ka neuromuscular a lawe aku i ka hoʻonui ʻana iā Amikacin Me ka hoʻokele makua o ka indomethacin, hoʻonui i ka hopena o ka hopena o ka hopena o ka aminoglycosides. Hoʻemi ka lāʻau i ka hopena o nā lāʻau anti-myasthenic. ʻAuʻi ka Amikacin me ka heparin, penicillins, cephalosporins, amphotericin B, capreomycin, erythromycin, mau huaora o ka hui C, B, potassium chloride.

Nā ʻāpana ʻaoʻao o Amikacin

ʻO nā mea kōkua a amikacin sulfate paha ma hope o ka hoʻopili ʻana i ke kino e hiki ke hoʻonāukiuki i kekahi mau hopena hopena leʻaleʻa. I waena o nā hopena kūlike ʻole:

1. Mai ka huelo gastrointestinal, hiki ke ʻike ʻia ka nui o ka pae o nā enzyme o ka pēpē me AST a me ALT i ke koko, kahi e hōʻike ana i ka luku ʻia o nā wahī aʻai (hepatocytes), he nui ka piʻi ʻana o ka bilirubin i loko o ke koko, ka luaʻi a me ka lua.
2. He hopena maʻi kūlohelohe. Aia kahi ʻokoʻa ʻē aʻe o ke koʻikoʻi, mai ka hakakaha a me ka wikiwiki i ka pīhoihoi anaphylactic (kahi ulu ʻana o ka nui o ka maikaʻi o ke kino ma muli o ka emi ʻana o ke kahe o ke koko). Kekahi mea hōʻike hou aʻe ʻo ka urticaria (kahi hāwau iki a me ka hōʻino ʻana i ka ʻili e like me kahi ʻōpala palupalu), i ka edema Quincke, a me ka ʻala.
3. Hōʻike ʻia ka hopena maikaʻiʻole mai ka hemopoiesis i ke ʻano o ka leukopenia (kahi i hoʻokaʻawale ʻia o ka nui o nā leukocytes), thrombocytopenia (hoʻemi i ka pae o nā platelets), anemia (he panee i ka pae o hemoglobin, ke kiʻekiʻe o nā hanana koko ʻulaʻula).
4. Mai ka pūnaehana genitourinary, ʻike ʻia ka hoʻomohala ʻana o ka hiki ʻole o ka renal, albuminuria (protein i loko o ka urine), hiki i ka microhematuria (he liʻiliʻi nui o ke koko i ka urine) hiki ke ʻike.

Ke keu

Pono ʻoe e lawe i ka lāʻau lapaʻau ma ka inea i hōʻike ʻia e ke kauka. Inā ʻoe e hōʻino i nā ʻōlelo hōʻike hiki ke hopena i nā hopena maikaʻi ʻole. Ke mālama ʻia nei ka overdose ma ka mālama ulu ʻana. E hoʻohana i ka hemodialysis, kahi maʻi lapaʻau e hoʻoiho ai i ka lāʻau mai ke kino. ʻO nā hōʻailona nei o kahi overdose:

• maʻi kaumaha,
• hee nani, he lua, ka makewai,
• ataxia - staggering gait ma muli o ka hoʻomohala ʻana i ka ʻōpū,
• me ka hanu ʻana o ka hanu a me ka pōkole o ka hanu,
• maʻi urination
• ke hāhai nei i nā pepeiao, ua nui ka nānā ʻana i ka lohe a hiki i ke kuli.

Nā Hoʻohui

He hopena koʻikoʻi ka lāʻau lapaʻau i ke kino, no laila ua hōʻa ʻia ʻia e ka lāʻau lapaʻau i loko o kahi lāʻau lapaʻau. ʻO nā kumupaʻa no ka lawe ʻana i ka lāʻau lapaʻau nā ʻano like ʻole:

1. Ke hoʻomanawanui ʻole ʻana o nā maʻi amikacin sulfate, nā maʻi kūlohelohe i nā mea ikaika a me nā mea kōkua.
2. ʻO nā maʻi o ka puʻuwai o loko, hele pū me ka mānoanoa o ka nerve auditory. Hiki i kahi lāʻau lapaʻau ke alakaʻi i ka hōʻemi a i ʻole ka lohe ʻana ma muli o ka hanaʻino o ka nerve.
3. ʻO nā maʻi ʻino o ka pūpū, ka ate, ka mea i hui pū ʻia e kā lākou hemahema.
4. Kahawai

Nā ʻōlelo a ke kūʻai a me ka waiho ʻana

Hiki iā ʻoe ke mālama i ka lāʻau lapaʻau i loko o nā mea i hoʻopaʻa ʻia no nā makahiki 3. Pono ke mālama ʻia i ka lāʻau i kahi maloʻo a ʻeleʻele a me ka maikaʻi ʻole o ke komo ʻana i nā keiki. Ke aohue ea ea +25 degere Celsius. Koko ʻia ka lāʻau lapaʻau ma loko o nā hale kūʻai a me nā hale kūʻai pūnaewele.

Aia kekahi mau lāʻau lāʻau i ka like waiwai like. Loaʻa lākou kahi hopena like iā Amikacin. Ma waena o nā koho kaulana i kēia nā lāʻau lapaʻau:

• ʻIliiki
• Loricacin
• Hoʻoikaika
• Vancomycin
• Meropenem
• Cefepim
• Tobramycin,
• Kanamycin,