Cefepim - nā ʻōlelo aʻoaʻo no ka hoʻohana, nā analogues, nā loiloi a me ka hoʻokuʻu i nā puka (injections in ampoules for injections of a antibiotic per 1 gram, papa) lāʻau lapaʻau no ka mālama ʻana o bronchitis, pneumonia, cystitis i nā pākeke, nā keiki a me ka hānau ʻana

I kēiaʻatikala, hiki iā ʻoe ke heluhelu i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau Cefepim. ^ E Ha yM. Hāʻawi i ka hoihoi mai ka poʻe kipa i ka pūnaewele - nā mea kūʻai o kēia lāʻau lapaʻau, me nā manaʻo o nā loea lapaʻau e pili ana i ka hoʻohana ʻana i ka antibiotika cefepime i kā lākou hoʻomaʻamaʻa. ʻO kahi noi nui, ʻo ia ke hoʻoikaika ikaika i kāu mau loiloi e pili ana i ka lāʻau lapaʻau: kōkua ka lāʻau lapaʻau a ʻaʻole hoʻi i kōkua i ka hoʻopiʻi ʻana i ka maʻi, nā mea hoʻopiʻi a me nā hopena ʻaoʻao, ua ʻike ʻia, ʻaʻole paha e hoʻolaha ʻia e ka mea hana ma ka palapala. Nā kikowaena o Cefepime ma ke alo o nā kikowaena hoʻonohonoho ʻenehana. Hoʻohana no ka mālama ʻana o ka bronchitis, nā paila, ka cystitis a me nā maʻi ʻē aʻe o ka maʻi i nā pākeke, nā keiki, me ka wā hāpai a me ka lactation. ʻO ka hiʻohiʻona o ka lāʻau lapaʻau.

Cefepim - cephalosporin antibiotic mai ka 4 pūkaha hui no ka hoʻohana makua. Loaʻa ia i kahi hopena bactericidal, kahi e hōʻole i ka synthesis o nā paia o ka pā o nā microorganisms.

ʻO ke kūleʻa e pili ana i ka hapanui o ka nui o nā pauka huina, incl. ka hana ʻana i ka beta-lactamases, kahi hoʻi o Pseudomonas aeruginosa. ʻOi aku ka ikaika ma mua o nā cephalosporins 3 mau hanauna, e kūleʻa ana i ka cocci kūloko.

ʻAʻole i kūmole i ka Enterococcus spp. (enterococcus), Listeria spp. (Listeria), Legionella spp. (Legionella), kekahi mau bakere anaerobic (Bacteroides fragilis, Clostridium difficile).

Hāʻawi ʻia ka Cepepime e ka hoʻokūkū kiʻekiʻe e kū aʻe i nā ʻano plasmid a me nā chromosomal beta-lactamases.

Hōʻike

Cefepima hydrochloride + mea kūʻai.

Lapaʻau lāʻau

ʻO ka liʻiliʻi o ka protein protein i liʻiliʻi ma mua o 19% a kūʻokoʻa mai ka ʻike cefepime serum. Loaʻa nā hakahaka o ka cefepime i ka urine, bile, peritoneal fluid, exudate o nā kohu, mucous secretion o ke kauā, sputum, prostate tissue, appendix a me ka palakeke, cerebrospinal fluid me ka meningitis. I nā poʻe olakino, me ke kaʻi ʻana o ka cefepime i loko o kahi pākaʻi o 2 g me kahi huakaʻi o 8 mau hola no 9 mau lā, ʻaʻohe cumulation i loko o ke kino ua nānā ʻia. Hoʻopili ʻia ke cefepime e nā keiki, ma ka nui o ka filtration glomerular (ʻokoʻa renal clearance - 110 ml / min). I loko o ka ihi, ʻike ʻia e 85% o nā cefepime i lawelawe ʻia i loli ʻole. I nā mea maʻi i hala 65 mau makahiki a keu paha me ka hana maʻamau maʻamau, ʻoi aku ka liʻiliʻi o ka hoʻomaʻamaʻa ʻana i ka renal ma mua o nā mea maʻi maʻi. ʻO ka pharmacokinetics o cefepime i loko o nā mea maʻi me ka hana aho kīnā ʻole, ʻaʻole i loli ka cystic fibrosis.

Nā Hōʻike

Ke hoʻomau nei i nā maʻi maʻi pāpaʻi a me nā maʻi nā ʻia o nā microorganisms cefepime-sensitive:

ʻōpū o ka hanu haʻahaʻa haʻahaʻa (me ka maʻi pneumonia a me ke bronchitis),
nā maʻi maʻi urinary (maʻa a paʻakikī a paʻa ʻole),
nāʻiʻi o ka ʻili a me nā pāwī palupalu,
maʻi hana intra-abdominal (e komo pū ana me nā peritonitis a me nā pāpaʻi o ka biliary),
maʻi maʻi gynecological
septicemia
maʻi lahilahi (e like me ka empirical therapy),
nā meningitis huakini i nā keiki.

ʻO ka pale ʻana i nā maʻi i ka wā o ka ʻoihana ʻeha.

E hoʻokuʻu i nā palapala

ʻO ka pauka no ka hoʻomākaukau ʻana i kahi hopena no ka hoʻokō intravenous a me ka intramuscular hoʻokō o 1 grama (injections ma ampoules no ka maʻi injection).

ʻO nā pepa dosage ʻē aʻe, he mau papa a he kapa hoʻi, ʻaʻole i noho.

Nā ʻōkuhi no ka hoʻohana a me ka helu ʻana

ʻO ke kanaka hoʻokahi, e pili ana i ka naʻau o ka pathogen, ka uluʻana o ka maʻi, a me ka kūlana o ka hana o ka renal.

Hoʻohana ʻia kahi ala intravenous hoʻokele no ka poʻe maʻi me nā maʻi koʻikoʻi a ola paha paha, ʻo ia hoʻi me ka loaʻa aʻe o ka pīhoihoi.

Me ka hoʻokele intramuscular a intravenous paha i ka poʻeʻelemakule a me nā keiki e kaupaona ana ma mua o 40 kg me ka hana maʻamau pono ʻole, hoʻokahi pākahi he 0.5-1 g, he kikowaena ma waena o nā lawelawe he mau hola 12. No ka maʻi koʻikoʻi, e lawelawe ʻia ana ma loko o kahi wai o 2 g kēlā me kēia mau hola 12.

I mea e pale ai i nā maʻi maʻi i ka wā o ka hōʻeha o ka ʻōpū, ua hoʻohana ʻia lākou me ka metronidazole e like me ka ʻōnaehana.

No nā keiki mai 2 mau makahiki o ka makahiki, ʻaʻole pono ka nui o ka ʻāpopo nui loa i ʻōlelo ʻia i manaʻo ʻia no nā pākeke. ʻO ka awelika haʻahaʻa no nā keiki ke kau nei a hiki i 40 kg me ka paʻakikī a i ʻole ka hoʻopiʻi ʻana i nā maʻi urinary (komo pyelonephritis), nā maʻi kīnā ʻole o ka ʻili a me nā palupalu palupalu, nā maʻi maʻi, a me ka hoʻomaʻamaʻa ʻana o ka maʻi neutropenic he 50 mg / kg i kēlā me kēia mau hola 12.

ʻO nā mea maʻi me ka maʻi neutropenic a me nā meningitis bacteria - 50 mg / kg i kēlā me kēia 8 hola.

ʻO ka manawa maʻamau o ka lapaʻau he 7-10 lā. I nā maʻi hōʻeha nui, e koi ʻia ka hoʻōla lōʻihi.

I ka hihia o ka hana renal impaired (CC ma mua o 30 ml / min), pono ke hoʻoponopono ʻana i ka hoʻoponopono ʻia dosage. Pono ka pilina o ka cefepime e like me ka poʻe maʻi me ka hana maʻamau maoli. Hoʻoholo ʻia nā ʻōlapa mālama e pili ana i nā waiwai o QC a i ʻole ʻike serum creatinine.

Me nā hemodialysis i nā hola 3, ma kahi o 68% o ka nui o ka cefepime e lawe ana mai ke kino. I ka hopena o kēlā me kēia hālāwai, pono e hoʻopuka i kahi kinikona i like me ka pane mua. I nā poʻe maʻi e hoʻomau nei i ka dialysis peritoneal mau, hiki ke hoʻohana ʻia i ka cefepime i nā awelika i ʻōlelo ʻia i kaʻaila, i.e. 500 mg, 1 g a 2 g paha, nā mea e pili ana i ka nui o ka maʻi, me ka kikowaena ma waena o nā lawelawe ʻana o kahi pākahi o 48 mau hola.

No nā keiki me ka hana pūnāwai kīnā ʻole, ʻo nā loli like o ka regimen dosage ua ʻōlelo ʻia e nā mākua, ʻoiai ua like nā pharmacokinetics o cefepime i nā pākeke a me nā keiki.

Loaʻa ka hopena

nā ʻeha, hoʻohemo ʻana,
paila, mamaila,
colitis (komo i ka colitis pseudomembranous)
ʻeha ka ʻōpū
hoʻololi loli
ʻohiʻala
pohuo
urticaria
anaphylactic mau hiʻohiʻona,
poʻomanaʻo
āhāhuʻe
aloha
nahoa
ʻulaʻula ʻulaʻula
anemia
nā hana hoʻonui nui o ALT, AST, alkatine phosphatase,
hoʻonui i ka bilirubin,
eosinophilia, thrombocytopenia transient, leukopenia transiente a me neutropenia,
hoʻonui i ka manawa prothrombin,
hoʻokolohua maikaʻi ʻo Coombs me ka hemolysis,
fiva
vaginitis
erythema
genital ukana
oleia
ʻo ka phlebitis (me ka hoʻokele intravenous),
me ka hoʻokele intramuscular, ʻehaʻeha a hōʻeha paha ma ka wahi i ʻōlelo ʻia ai he hiki.

Nā Hoʻohui

hypersensitivity o cefepime a L-arginine, a me ka cephalosporin antibiotics, penicillins a me nā antibiotika beta-lactam.

ʻŌpū a me ka lactation

ʻO ka ʻike kūpono a ʻike paʻa ʻia i ka palekana o ka cefepime i ka wā hāpai ʻia ʻaʻole i lawe ʻia, hiki ke hoʻohana ʻia ma ke ʻano o ke kauka wale nō.

Hoʻokumu ʻia ka Cepepime i ka waiū umauma ma nā liʻiliʻi haʻahaʻa loa. I ka wā lactation, hoʻohana me ka akahele.

Ma nā hoʻokolohua hoʻokolohua, ʻaʻole i hōʻike ʻia kahi hopena o ka hana hoʻohua a me ka hopena fetotoxic o cefepime.

Hoʻohana i nā keiki

ʻAʻole paʻa ma ka palekana a me ka hana o ka cefepime i nā keiki ma lalo o 2 mau makahiki o ka makahiki. No nā keiki i ʻoi aku o 2 mau mahina (me nā pēpē) hiki ke hoʻohana ʻia e like me ka regimen dosage. No nā keiki me ka hana pūnāwai kīnā ʻole, ʻo nā loli like o ka regimen dosage ua ʻōlelo ʻia e nā mākua, ʻoiai ua like nā pharmacokinetics o cefepime i nā pākeke a me nā keiki.

Nā ʻōlelo kikoʻī

I ka wā e hoʻohana ʻia ai i ka mea maʻi ma ka nui o ka maʻi o ka maʻi ma muli o ke kāwili ʻana o ka microflora aerobic / anaerobic (komo i nā hihia i loaʻa i nā mea pīpī Bacteroides kekahi o nā pathogens), pono ʻia e kuhikuhi i ka lāʻau lapaʻau e hana ana i ka Cefepim i ka manawa like me ka pathogen anaerobes.

E hoʻohana me ka akahele o ka poʻe maʻi e hōʻeha i ka hoʻomohala ʻana i nā hopena kūlohelohe, ʻoi aku hoʻi i nā lāʻau lapaʻau.

Me ka hoʻomohala ʻana o nā hopena alerine, pono e hoʻokaʻawale ke cefepime.

Ma nā hopena e pili ana i ka maʻi hypersensitivity koke, e pono ai i ka epinephrine (adrenaline) a me nā ʻano hana ʻē aʻe e kākoʻo ai.

Ke hele nei ka huehue i ka wā e mālama ai, pono e noʻonoʻo ʻia ka hoʻomohala ʻana i ka colitis pseudomembranous. I kēlā mau hihia, pono e hoʻihoʻi ʻia cefepime a kūpono hoʻi e kuhikuhi ʻia ka lāʻau kūpono inā pono.

Me ka hoʻolālāʻana o ka superinfection, pono koke ke kāpae ʻia ʻana o Cefepim a me nā hana kūpono i hōʻike ʻia.

Ke hoʻohana nei i nā antibiotika hou o ka pūʻulu cephalosporin, urticaria, Stevens-Johnson syndrome, erythema multiforme, ʻehā necrolysis epicmal, colitis, hana ʻole loa o ka hana, ka pehu nephropathy, anemia aplastic, hemolytic anemia, pehu, hoʻowalewale, hana ʻole i ka naʻau, me ka cholestasis, hopena hopena maikaʻi ʻole i nānā ʻia. glucose mū.

Me ka mālama kūikawā, hoʻohana pū ʻia cefepime me aminoglycosides a me "diuretics" loop ".

Hoʻohui nūhou

Me ka hoʻomohala pinepine ʻana o ka hopena cefepime me nā hopena o ka metronidazole, vancomycin, gentamicin, tobramycin sulfate a me ka netilmicin sulfate, hiki i ka hoʻopili lāʻau lapaʻau.

Nā hōʻike o ka lāʻau Cefepim

Hoʻololi nā kumu hoʻohālike o ka waiwai ikaika: