Ke lāʻau Moxifloxacin: kuhikuhi i ka hoʻohana > He hoʻomaʻemaʻe a me ke pale aku

ʻO ka wehewehe e pili ana i 30.01.2015

Palapala Latin: Moxifloxacine
ʻĀkau ATX: J01MA14
Mea waiwai: Moxifloxacin (Moxifloxacin)
Mea Hana: Vertex (Lūkini), kahi lāʻau lapaʻau me Macleods (India).

1 papa pākaukau molenaikola moxifloxacin 400 mg

ʻO ka selulosa, lactose monohala, hydroxypropyl cellulose, magnesium stearate, hypromellose, polyethylene glycol, titanium dioxide, talc, ka hao oxide ulaula, e like me nā mea e loaʻa.

Pharmacodynamics a me ka pharmacokinetics

Lapaʻau lāʻau

ʻO ka lāʻau antibacterial mai ka pūʻulu o ka hanauna he IV quinolones (trifluoroquinolone), i hana bactericidal. Hoʻokomo ʻia i loko o ke ʻano o ka pathogen a pākuʻi like i ʻelua mau manawa hoʻōlakomo i ka hana hoʻoponopono DNA a me ka kāohi ʻana i nā waiwai o ka DNA, ka mea e alakaʻi ai i nā loli hohonu i ka pā o ka cell, paʻa i ka hana DNA a me ka make o ka pathogen.

Hōʻike ka Moxifloxacin bactericidalhana e pili ana i ka pathogens intracellular, gram-maikaʻi a me nā micro-kino microorganisms. Hoʻomaʻaʻa i ke kū'ē i ka anaerobes, ke kūpaʻa a me ka maʻi atypical. ʻO ia kekahi o nā mea ikaika e kūʻē i ka staphylococci, e komo pū ana me ka staphylococci-kūmea methicillin. I ka hana ma luna o mycoplasmas luna Levofloxacina aia i luna o chlamydia - Ofloxacin.

ʻAʻohe kūʻae me penicillins, kaʻaoglikua, macrolidesa cephalosporins. ^ E Ha yM. Ua haʻahaʻa ka lohi o ka pale ʻana i ka lāʻau lapaʻau, ulu i ka kūʻē i ke kūleʻa ʻana. ʻAʻohe o ka lāʻau lapaʻau i ka hopena photosensitizing. Hoʻohālikelike ka hopena o ka lāʻau i kona kikowaena ʻana i loko koko a me nā ʻili a ua hui pū ʻia me ka hoʻoiho iki ʻole nā mea huʻalano laila, ʻaʻohe pilikia o ka holo hoʻohālikelike e kūʻē i ka mea o ka mālama ʻana.

Lapaʻau lāʻau

ʻO Moxifloxacin ma hope o ke kūpeʻe waha. ʻO Bioavailability ʻo 91%. Ka ʻike ʻia o ka lōʻihi loa o ka lāʻau lapaʻau ma hope o nā hola 0.5-4, a ma hope o ʻekolu mau lā o ka hana maʻamau, ʻike ʻia kona pae paʻa. Kuhi ʻia ka lāʻau lapaʻu i loko o nā lau, a me ka ʻike koʻikoʻi o ia mau mea i hoʻoholo ʻia i loko o ka pūnao a me ka ʻili. Ka manawa T 1/2 - 12 hola. Hoʻopili ʻia ia e nā pōpoki a ma o ke kaomi hana ʻana.

Nā hōʻailona no ka hoʻohana ʻana

Kūmole (i hui pū me nā lāʻau lapaʻau anti-TB ʻē aʻe, e like me ka lālani laina lua ʻole).
maʻi ʻeha: hr ʻOluomini i ke kuʻuna, sinusitis, wahi maʻi pneumonia,
ʻōpū a me ka urogenital maʻi ʻana,
nāʻiʻi o ka ʻili a me nā ʻiʻo palupalu.

Nā Hoʻohui

kaumaha pūpū hema,
haaheo
ʻitislelo poloka
makahiki i 18 makahiki
hiki ke ulu i nā mea kuʻuna,
hapai.

Ua hoʻohālikelike ʻia ʻo C me ka mālama ʻana i ka wā Q-T, ischemia myocardial, bradycardia koʻikoʻi, hypokalemia, ʻoiai e lawe ana i ka corticosteroids.

Nā hopena hopena

ʻEha ka ʻōpū pepeke, utuka, konawai,mahuahua nā level transaminases, waha maloʻo, anorexia, kandidiasis ka waha e pili anagastritis, dysphagia,discolavola o ka ʻōlelo,
huki, asthenia, insomnia, hōʻeha, manaʻo hopohopo, paresthesia. Nui loa - kamaʻilio ʻōlelo, poloka, cramps,hilahila
loli a ʻala ʻole o ka hoʻonaninani ʻana,
tachycardiaʻeha ka puʻu, hoʻonui HANʻIQ-T ka hoʻolōʻihi l,
ʻaʻano pōkolelohi - lawe mai Hoʻokomo pūnana bronchial,
aolailaʻeha ke kaumaha
hoʻokipa kandidiasishuakaʻi renal function,
ʻohi, urticaria,
leukopenia, eosinophilia, anemia, thrombocytosis, hyperglycemia.

Hoʻohui

Antacids, multivitaminsme na minela a Ranitidine hoʻonāukiuki a me ka hoʻohaʻahaʻa ʻana i ka paʻa o ka lāʻau i loko o ka plasma. Pono lākou e kuhikuhi i 2 mau hola ma hope o ka lawe ʻana i ka lāʻau lapaʻau nui. Nā mākaukau hao, hoʻopōmaikaʻi hoʻemi nui i ka bioavailability, pono e hoʻohana ʻia ma hope o 8 mau hola.

ʻO ka hoʻohana like ʻana o nā mea ʻē quinoloneshoʻonui i ka pilikia o ka hoʻolōʻihi i ka pilina Q-T i nā manawa. Hoʻopilikia iki iā Moxifloxacin i ka pharmacokinetics Digoxin.

ʻOiai e lawe ana Warfarin pono ʻoe e kāohi i nā hōʻailona kuhikuhi coagulation. I kahi hoʻokipa corticosteroids hoʻonui mahuahua o ka pala o ka tendon a me ka hōʻike o tendovaginitis.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO Moxifloxacin kahi pālahalaha bactericidal antibacterial lāʻau, 8-methoxyphoroquinolone. ʻO ka hopena bactericidal o moxifloxacin ma muli o ka like ʻana o ka bacterial topoisomerases II a me IV, ke alakaʻi nei i kahi e hoʻohauna ʻia o nā ʻōnaehana o ka hoʻoponopono ʻana, hoʻoponopono hou a me ka lawe ʻana i ka biosynthesis DNA o nā cell microbial a, ma muli o ka make ʻana o nā mikrobial cell.
Hoʻohālikelike ʻia nā hōʻuluʻulu o ka maʻi bactericidal o moxifloxacin e hoʻohālikelike ʻia me nā mea liʻiliʻi o ka pale o ka pale (MICs).
Nā mīkini hana kū'ē

ʻO nā mīkini e alakaʻi i ka hoʻomohala ʻana i ke kūpaʻa o penicillins, cephalosporins, aminoglycosides, macrolides a me tetracyclines ʻaʻole i hoʻopilikia i ka hana antibacterial o moxifloxacin. ʻAʻohe mea kū i ka pale ma waena o kēia mau pūʻulu o nā mea maʻi a me nā moxifloxacin. Ma kēia manawa, ʻaʻohe mau hihia o ka pale plasmid. ʻO ka laulā nui o ka hoʻomohala ʻana o ka pale kūpaʻa me ka liʻiliʻi iki (10 -7 -10 -10). Hoʻokumu maikaʻi ka pale ʻana ʻo Moxifloxacin i nā meʻa he maha. Hōʻike ka hopena o ka moxifloxacin ma microorganism i loko o nā hoʻokū ma lalo o MIC me ka hoʻohui iki wale ʻia me MIC. Kuhi ʻia nā hihia o ke kūʻē o ka quinolones. Eia naʻe, noho palupalu kekahi mau micro-positive a anaerobic kū'ē i nā quinolones ʻē aʻe i ka moxifloxacin.
Ua hoʻokumu ʻia ʻo ka hoʻohui o ka hui methoxy i ke kūlana C8 i ka molekui molekole moxifloxacin e hoʻonui i ka hana o moxifloxacin a hōʻemi i ka hana ʻana o nā mana mutant kūpaʻa o nā bacteria-maikaʻi bacteria. ʻO ka hoʻohui o ka hui bicycloamine ma ke kūlana C7 e pale i ka hoʻomohala ʻana o ka efflux ikaika, kahi hana kū'ē i nā fluoroquinolones.
Moxifloxacin i loko o vitro ka hana kūʻē ʻana i ka pālahalaha pākē a me ka gram-posit microorganisms, anaerobes, nā mea e kūpaʻa ana i ka waikū a me nā huakini atypical e like me Mycoplasma spp., Chlamydia spp., Legionella $ pp.like pū nā huakini i kūʻē i ka ß-lactam a me nā mea hoʻomehana macrolide.
Ka hopena i ka microflora pēpē kanaka

I loko o nā haʻawina ʻelua i hana ʻia ma luna o nā mea hana, hiki ke ʻike ʻia nā loli e like me nā microflora o ka ʻōpū ma hope o ke alakaʻi ʻana o ka moxifloxacin. Ua hoʻomaopopo ʻia kahi emi ʻana o nā mea paʻa. Escherichia coli, Bacillus spp., Bacteroides vulgatus, Enterococcus spp., Klebsiella spp.a me nā anaerobes Bifidobacterium spp., Eubacterium spp., Peptostreptococcus spp. Ua hoʻololi ʻia kēia mau loli i loko o nā pule ʻelua. Nā lōlani Hoʻolaha Clostridium ʻaʻole i loaʻa.
I ka hoʻāʻo ʻana ʻo Vitro Sensitivity

ʻO ka kiko o ke hana antibacterial o moxifloxacin e komo i loko o nā microorganisms like:

Hoʻoikaika	Hoʻolaha kūlike	Hōʻike
He maikaʻi ʻo Gram
ʻOhou palaʻai Gardnerella
ʻO ka maʻi pīkoi streptococcus (me nā pale i kū i nā penicillin a me nā māla me ka pale o ke kūlohelohe nui a me ke ʻano), a me nā pale i kū i ka ʻelua a i ʻole ka antibiotika, e like me ka penicillin (MIC> 2 mg / ml), II generation cephalosporins (e.g. cefuroxime), macrolides, tetracyclines, trimethoprim / sulfamethoxazole
ʻO nā pyogenes Streptococcus (ʻAkuhi A) *
ʻO ka hui Streptococcus milleri (S. anginosus S. constellatus * a me ka interrnedius )
ʻO ka hui Streptococcus viridans (S. viridans, S. mutans, S. mitis, S. sanguinis, S. salivarius, S. thermophilics, S. constellatus)
Streptococcus agalactiae
Streptococcus dysgalactiae
Staphylococcus aureus (komo pū me nā kumu kūlia methicillin)	Staphylococcus aureus (methicillin / ofloxacin ā pale i ʻole) *
Coaphulonegative Staphylococci (S .. cohnii, S. epidermic! Is, S. haemolyticus, S. hominis, S. saprophytic us, S s imulans)Methicillin-hoʻopaʻi kūlia	Coagul operative staphylococci (S.cohnii, S. epidermic / is, S. haemolyticus, S. horn in is, S.saprophytics, S. simulans)kūpaʻa kūleʻa methicillin
Enterococcus faecalis* (kūpaʻa wale nei i nā vancomycin a me ka gentamicin)
Enterococcus avium *
Enterococcus faecium *
Kāpena ʻino
Haemophilus influenzae (komo pū me ka hana ʻana a me ka huahana ʻole-lactamases) *
Haemophillus parainfluenzae*
Moraxella catarrhalis (komo pū me ka hana ʻana a me ka huahana ʻole-lactamases) *
ʻO Bordetella pertussis
ʻO kaʻili paliopila Legionella	Kalei *
Baumanii Acinetobacter	Klebsiella pneumoniae *
Klebsiella oxytoca
Citrobacter freundii *
Enterо bader spp. (E.aerogenes, E.intermedins, E.sakazakii)
Nā pua kahakahu *
Pantoea agglomerans
Pseudomonas aeruginosa
ʻO nā ʻōweʻe Pseudomonas
Burkholderia cepacia
Stenotrophomonas maltophilia
Proteus mirabilis *
Proteus vulgaris
Morganella morganii
Neisseria malonopoi *
Providencia spp. (P. rettgeri, P. Stuartii)
Anaerobes
ʻO nā Bacteroides spp. (B.fragi / is B. Distasoni * In thetaiotaomicron , B. ovatus , B. pena kā o , B. vulgaris )*
Fusobacterium spp.
Peptos treptococcus spp. *
Porphyromonas spp.
Prevotella spp.
Propionibacterium spp.
Clostridium spp. *
Hoʻolaha
Plamoniae plamoniae *
Chiusiadia
Myopoplasma pneumoniae *
Mycoplasma hominis
Myitoplasma genitalium
CoxieIla burnettii
Legionella pneumohila

* Ua hōʻoia ʻia ka Sensitivity i moxifloxacin e ka ʻike maʻi.

ʻAʻole ke aʻo ʻia ka hoʻohana ʻana o ka moxifloxacin i ka mālama ʻana i nā maʻi i hoʻonaninani ʻia e nā kumu kūlohelohe o methicillin o S. aureus (MRSA). I kahi hihia o nā mea i kānalua a i hoʻopaʻa ʻia nō hoʻi e ka MRSA, e hoʻākāka me nā lāʻau lapaʻau kūpono e pono ai.
No kekahi mau pilikia, laha ka loli ʻana i ka loaʻa mai e ka ʻona ʻāina a me ka manawa. Ma kēia e noʻonoʻo ai, i ka hoʻāʻo ʻana i ka maʻa mau o ke kaumaha, ʻoi ke makemake i ka ʻikepili kūloko i ke kūkaʻi, ʻoi aku ka mālama ʻana i nā maʻi ʻino.
Inā ma ka mea maʻi e hoʻomanawanui ai i ka mālama ma ka haukapila, ma ka wahi ma lalo o ke kukū ʻo pharmacokinetic curity (AUC) / MHK₉₀ uaʻoi aku ma mua o 125, a me ka uhaʻi plasma kiʻekiʻe (Cmax) / MIC₉₀ aia i waena o ka 8-10 - e hōʻike kēia i ka holomua holomua. Ma ka outpatients, he mau haʻahaʻa hoʻohālike kēia mau ʻāpana hoʻohālikelike: AUC / MIC₉₀>30-40.

Palapala (pono waiwai)	*AUIC (h)**	Cmax / MIC₉₀ (infusion ma luna o 1 h)
MIKI₉₀ 0.125 mg / ml	313	32,5
MIKI₉₀ 0.25 mg / ml	156	16,2
MIKI₉₀ ʻO 0.5 mg / ml	78	8,1

* AUIC - ka māhele ma lalo o ke kaʻe o ke kaohi (ratio (AUC) / MMK₉₀).

Lapaʻau lāʻau
Kapehu
Ma hope o ka infusion hoʻokahi moxifloxacin ma kahi o ka 400 mg no ka 1 h, hiki loa ka C max i ka hopena o ka infusion a ma kahi o 4.1 mg / l, kahi mea e pili ana i ka hoʻonui o 26% e hoʻohālikelike ʻia me ka waiwai o kēia māka ke lawe ʻana i ka moxifloxacin e ka waha. ʻO ka hoʻolaha o moxifloxacin, i hoʻoholo ʻia e ka mākuhi AUG, ka nui ma mua o ka lawelawe waha o moxifloxacin. ʻO ka bioavailability piha kūpono e pili ana i ka 91%. Ma hope o ka hoʻomau ʻia o ka infra intravenous moxifloxacin ma kahi o 400 mg no 1 mau hola, ʻoi loa ka nui a me ka hōʻemi o ka hoʻonaninani ʻana mai 4.1 mg / L a 5.9 mg / L a mai 0.43 mg / L a 0.84 mg / L, ia wa. Loaʻa ka ʻike paʻa paʻa o 4.4 mg / L i ka hopena o ka infusion.
Kahele
Hoʻopuka koke ʻia ʻo Moxifloxacin i loko o nā palu a me nā ʻāpana a hoʻopaʻa i nā protein koko (ʻoiaiʻo albumin) ma kahi o 45%. ʻO ka nui o ka hoʻoili e pili ana i 2 l / kg.
ʻO nā manaʻo kiʻekiʻe o moxifloxacin, i mea keu aku i ka plasma koko, i hana ʻia i loko o ka ʻōpū o ka pūpū (me nā hua epithelial, alveolar macrophages), i nā sinuses (maxillary a me nā ethmoid sinuses), i nā polips nasal, i ka foci o nā mumū (i loko o nā kiko o nā blisters me nā ʻili ʻōili). I ka wai kai interstitial a me ka wai kai, ua hoʻoholo ʻia ka moxifloxacin i kahi ʻano manuahi ʻole, ʻaʻole i hoʻopaʻa ʻia nā protein, ma kahi hoʻokūkū kiʻekiʻe ma mua o nā kaila koko. Eia kekahi, ʻike ʻia nā kiʻekiʻe kiʻekiʻe o ka moxifloxacin i loko o nā kiko o nā ʻōpū o ka ʻōpū, peritoneal fluid, a me nā kāne o nā kāne.
Hāpai
Moxifloxacin e hana i ka biotransformation o ka lā 2 a lawe ʻia mai ke kino e nā ʻōpū a me nā ʻōpū, ʻelua i hoʻololi ʻia a me ke ʻano o nā pūhui sulfo aktive (Ml) a me glucuronides (M2).
ʻAʻole ke kaha nā Moxifloxacin e ka ʻōnaehana mikrosomal cytochrome P450. Aia ka Metabolites Ml a me M2 i ka plasma koko i loko o kaʻili o lalo ma mua o ka pūnao makua. Wahi a nā hopena o nā noi preclinical, ua hōʻike ʻia ʻaʻole i loaʻa ka hopena maikaʻi loa o kēia mau metabolite i ke kino ma ke ʻano o ka palekana a me ka hoʻomau.
Leʻaleʻa
ʻO ka hapalua o ka ola o moxifloxacin e pili ana i nā hola he 12. ʻO ka nui o ka hoʻomaʻemaʻe ʻana ma hope o ka lawelawe ʻana ma kahi ana o 400 mg ʻo 1 79-246 ml / min. ʻO ka wehe kahi Renal ʻo 24-53 ml / min. Hōʻike kēia i ka ʻāpana pūhaka reabsorption o moxifloxacin.
ʻO ka kaulike no ka hoʻohui hoʻomaka ʻana a me nā metabolits 2 i kahi kokoke i 96-98%, e hōʻike ana i ka haʻalele o ka metabolism oxidative. Ma kahi o 22% o hoʻokahi pākahi (400 mg) ke hoʻololi ʻia e nā keiki, ma kahi o 26% - e ka ʻōpū.
Pharmacokinetics i loko o nā hui hoʻomanawanui
ʻO ka makahiki, ke kāne a me ka lāhui
ʻO kahi haʻawina o ka pharmacokinetics o moxifloxacin i nā kāne a me nā wahine i hōʻike i nā kūʻokoʻa o 33% ma nā ʻōlelo ʻo AUC a me Cmax. ʻO ke kō o ka moxifloxacin ʻaʻole i hilinaʻi i ka wahine. ʻO nā ʻokoʻa ma AUC a me Cmax ma muli o ke ʻano ʻokoʻa o ka nui o ke kino ma mua o ke kāne a ʻaʻole nui nā koʻikoʻi.
ʻAʻohe kūlike koʻikoʻi i nā maʻi i ka pharmacokinetics o moxifloxacin i nā mea maʻi o nā ʻohana ʻē aʻe o nā ʻano like ʻole.
E na keiki
ʻAʻole i aʻo ʻia nā pharmacokinetics o moxifloxacin i nā keiki.
ʻO Renal hiki ʻole
ʻAʻole i loli nui ka loli ma ka pharmacokinetics o moxifloxacin i nā mea maʻi me ka hana ʻole o ka hanu (me nā mea maʻi me ka creinine clearance 2) a i nā mea maʻi e hoʻomau nei i ka hemodialysis hoʻomau a me ka lōʻihi o ka dialy peritoneal peritoneal.
Hōʻeha ka hana ʻoluʻolu
ʻAʻohe ʻano nui o ka neʻe i ka moxifloxacin i nā mea maʻi me ka hana aho ʻole ʻoi aku (ʻo nā keiki papa Pugh )

ʻLoe a me ke kākele

Noi ʻia ka hoʻoponopono ʻia o moxifloxacin: 400 mg (250 ml o ka hoʻonela no ka infusion) 1 ka manawa i kēlā me kēia lā me nā maʻi i hōʻike ʻia ma luna. Mai pā i ke ʻano momona.
Hoʻolālā lōʻihi

Hoʻoholo ʻia ka lōʻihi o ka mālama ʻia e ke wahi a me ka hōʻeha o ka maʻi, me ka hopena hopena.

Loaʻa i nā maʻi pneumonia a nā kaiāulu: ʻo ka nui o ka lōʻihi o ka hoʻokalakupua me ka moxifloxacin (ka hoʻokō intravenous i ukali ʻia e ka waha waha) ʻo 7-14 mau lā,
ʻO ka maʻi ʻeha o ka ʻili a me nā hoʻolālā subcutaneous: ʻo ka nui o ka lōʻihi o ka hoʻokalakupua ʻana me ka moxifloxacin he 7-21 lā,
Hoʻopilikia i nā maʻi intra-abdominal: ʻo ka lōʻihi o ka lōʻihi o ka hoʻokolohua ʻana me ka moxifloxacin i ka lā 5-14.

ʻAʻole iʻoi aku i ka lōʻihi o ka mālama ʻia. Wahi a nā haʻawina loea, hiki i ka lōʻihi o ka mālama ʻana me ka moxifloxacin i nā lā 21.
Nā maʻi maʻi maʻi

ʻAʻole pono ke hoʻololi ʻana i ka hoʻoponopono ʻia i ka poʻe maʻi maʻi.
E na keiki

ʻAʻole paʻa ka hopena a me ka palekana o ka hoʻohana ʻana i ka moxifloxacin i loko o nā keiki a me nā ʻōpio.
Hōʻailona leʻa keiki (ʻAi a Pugh keiki L a me B)

ʻAʻole pono nā mea maʻi me ka puʻuwai lēwaheʻe e hoʻololi i ka regimen dosage (no ka hoʻohana ʻana i nā mea maʻi me ka cirrhosis, e ʻike i ka mahele ʻāpana "Kūlana Kūlana").
ʻO Renal hiki ʻole

I nā mea maʻi me ka hana renal impaired (e pili ana i ka poʻe me ka maikaʻi ʻole o ka renal clearance me ka 30 cle / min / 1,73 m 2), me nā mea maʻi e hoʻomau nei i ka hemodialysis me ka lōʻihi o ka dialyne peritoneal lōʻihi, ʻaʻole pono ke kau ʻia. . ^ E Ha yM.
Hoʻohana i nā mea maʻi i nā ʻōiwi like ʻole

ʻAʻole pono ka hoʻololi ʻana i ka hoʻoponopono ʻia.
Ke ʻano o ka noi

Hoʻohana ʻia ka lāʻau lapaʻau ma ke ʻano o ka infusion e mau ma ka liʻiliʻi loa he 60 mau minuke, ʻelua i kapa ʻia a hui pū ʻia me nā hopena like me kēia (me ka hoʻohana ʻana i kahi ʻano T-ʻano like).

wai no ka uliaa
ʻO 0.9% hoʻonā paʻakai sodium,
ʻOi aku ka hopena o ka sodium chloride,
ʻOi 5% hoʻonā ikehu
ʻOi ka hopena o 10% dextrose,
ʻO 40% ka hopena o ka dextrose,
ʻO 20% xylitol hopena,
hoʻonā manaʻo o ka mea kani
nā mea pane lima i ka lactate,

Inā hoʻohana ʻia ka lāʻau moxifloxacin, he hopena no ka infusion, i hui pū ʻia me nā lāʻau ʻē aʻe, a laila e hoʻokaʻawale ʻia kēlā me kēia lāʻau lapaʻau.
Hoʻohui mau ka wai o ka hopena o ka lāʻau lapaʻau me nā hopena infusion i luna ke kū nei no 24 mau hola ma ka mahana o ka lumi.
ʻAʻole hiki ke hoʻokaʻawale ʻia a hoʻomaha ʻia paha ka hoʻonā, ʻaʻole hiki ke mālama ʻia i loko o ka friji. Ma ka hoʻolele ʻana, e hoʻolalelele nā nanu e hoʻoheheʻe ana i ka mahana o ka lumi. Pono e mālama i ka hoʻonā i kāna pahu. Hoʻohana wale ʻia ka hopena maʻalahi.

Loaʻa ka hopena

ʻAʻole hiki iā ʻoe ke komo i ka hopena o ka infusion o moxifloxacin i ka manawa like me nā hopena ʻē aʻe i kūpono ʻole me ia, ʻo ia ka:

ʻOi ka hopena o 10 sodium klorida,
ʻO 20% ka hopena o ka sodium klorida,
ʻO 4.2% hopena pākuʻi sodium bicarbonate,
ʻO 8.4% hoʻonā paʻakai sodium bicarbonate.

Nā ʻōlelo kikoʻī

Hoʻopilikia i ka hiki ke hoʻokau i nā kaʻa a me nā māka

Hiki i nā Fluoroquinolones, me ka moxifloxacin, hiki ke hōʻeha i ka hiki o nā mea maʻi e hoʻokau i nā kaʻa a komo i nā hana ʻē aʻe e pili ana i ka hoʻoulu ʻia ʻana a me ka wikiwiki o ka hopena psychomotor ma muli o ka hopena i ka pūnaehana poʻomanaʻo a me ka hoʻopiʻi ʻana o nā ʻike.

Mea hana

Palapala palapala kākau inoa
LLC ALOHA RUS, Rusia,
101000, Moscow, Arkhangelsky Lane, 1, hale 1

Wā i kū kānāwai:
Lūkia, Repubalika o Mordovia,
430030, Saransk, st. Vasenko, 1 5A.

Ka helu o kahi wahi e hana ai:
Lūkia, Repubalika o Mordovia,
430030, Saransk, st. Vasenko, 15A.

ʻAno, inoa a me ka helu kelepona o kahi hui i ʻāpono ʻia no nā kontak (e hoʻouna ana i nā hoʻopiʻi a me nā hoʻopiʻi)
LLC ALOHA RUS, Rusia,
129090, Moscow, Prospect Mira, d. 13, p.

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

Loaʻa nā Moxifloxacin i loko o ʻekolu ʻano: moho no ka infusion, nā papa no ka hoʻoponopono waha a me ka hāʻule o nā maka. ʻO kā lākou:

ʻO ka papa meli Biconvex

ʻO ka paʻa o nā moxifloxacin hydrochloride, mg

Kōkō hao hao ʻona, kalsium stearate, titanium dioxide, mais starch, talc, croscarmellose sodium, macrogol, polyvinyl alkohol, mannitol, opadra, microcrystalline cellulose, povidone, hydroxypropyl cellulose, hypromellose, polyethylene glycol

Sodium Chloride, Sodium Hydroxide, Hydrochloric Acid, Wai

Sodium hydroxide, sodium klorida, hydrochloric acid, boric acid, ka wai

Kahu no 5 pcs., 1 a i 2 paha blister i loko o kahi pā

250 ml mau hūa

5 ml ipu wai polyethylene dropper

ʻLoe a me ke kākele

Loaʻa nā ʻano like ʻole o ka hoʻokuʻu ʻana i ka lāʻau i nā ala o ka hoʻohana ʻana. Kuhi ʻia nā papa no ka hoʻokō waha, e mālama ʻia ka hopena i ka makua, a na nā kulu i hoʻokomo ʻia i loko o nā maka me nā maʻi maʻi maʻi like. Hoʻokomo ka dosis ma ke koʻikoʻi o ka maʻi, kāna ʻano, kēlā me kēia ʻano o ka mea maʻi. Hāʻawi ʻia ka ʻike i nā ʻōlelo kuhikuhi.

I ka wā hāpai

I ka wā o ka hānau ʻana o kahi keiki, lawe ʻia ka antibiotika me ka contraindicated, ke ʻole ʻo ka pōmaikaʻi o ka makuahine ʻaʻole iʻoi aku ka nui o ka pūpū. ʻAʻole i mālama ʻia nā haʻawina e pili ana i ka palekana o ka lāʻau i ka wā hāpai. I ka helu ʻana i ka lāʻau lapaʻau i ka wā lactation, pono loa e hōʻoki ʻia ka umauma o ka pēpē, no ka mea ikaika ka mana o ka pūhui i loko o ka waiū umauma a hoʻopilikia koʻikoʻi i ke olakino o ke pēpē.

Hoʻohui nūhou

Ma mua o ka hoʻomaka ʻana i ka maʻi me Moxifloxacin, pono e ʻike ʻia ka launa pū ʻana me nā lāʻau ʻē aʻe. Hoʻohui a me nā hopena:

Hoʻokomo ʻia nā antacids e pili ana i ka magnesium a i ʻole alumina hydroxide, sucralfate, zinc a me ka hoʻomākaukau ʻana i nā hao i ka hoʻoluhiluhi ʻana o ka lāʻau.
Hoʻonui ka lāʻau lapaʻau i ka piʻi loa o ka digoxin, e hoʻemi ana i ka maikaʻi o ka glibenclamide.
Hoʻopau ke Ranitidine i ka hoʻopiliʻana o ka antibiotic i loko o ke koko, hiki ke loaʻa ka kandidiasis.
ʻO ka hui pū ʻana o ka lāʻau me nā fluoroquinolones ʻē aʻe, hoʻonui ʻo Penicillin i ka hopena phototoxic.

Ke keu

Ke hōʻike nei i ka nui o ke ʻano o ka maʻi i ka hopena i hoʻonui ʻia. Ke hele kahi overdose, pono ʻoe e holoi i ka ʻōpū, hoʻopau i ka lāʻau lapaʻau, hoʻohana i nā sorbents e hoʻoneʻe i nā toxins (Smecta, carbon carbon, Enterosgel, Sorbex). Me ka hoʻohālikelike, lawe ʻia nā hana intravenous i nā hoʻonā detoxification, ua ʻae ʻia ka hoʻohana ʻana i nā lāʻau lapaʻau hōʻailona, multivitamins.

Ka hana lāʻau lapaʻau

ʻO Moxifloxacin ka lāʻau bacteracidal lāʻau lapaʻau me ka laulā ākea o ka fluoroquinolone. Hōʻike ka Moxifloxacin i ka hana vitro e kūʻē i kahi pālahalaha nui o ka nui o kaola-maikaʻi a me nā pakanui-kino, anaerobic, kūleʻa a me ka bacteria atypical, no ka laʻana Chlamidia spp., Mycoplasma spp. a me Legionella spp. ʻO ka hopena bactericidal o ka lāʻau ma muli o ke kaohi o nā bacterial topoisomerases II a me IV, ke alakaʻi nei i ka hana hewaʻole o ka biosynthesis o ka DNA o ka huina mikrobial a, ma muli o ia, i ka make ʻana o nā mea mikrobial. Hoʻohālikelike ka nānā ʻana o nā maʻi bactericidal liʻiliʻi ma ka liʻiliʻi.

Loaʻa i ka Moxifloxacin ka hopena bactericidal i ka pale i kū i ka p - lactam antibiotics a me macrolides.

ʻO nā mīkini e alakaʻi i ka hoʻomohala ʻana i ke kūpaʻa o nā penicillins, cephalosporins, aminoglycosides, macrolides a me tetracyclines i ʻole e haʻalele i ka hana antibacterial o moxifloxacin. ʻAʻohe mea kū i ka pale ma waena o kēia mau pūʻulu o nā mea maʻi a me nā moxifloxacin. ʻAʻole i nānā ʻia e ke kūleʻa o Plasmid-mediated. He liʻiliʻi iki ka nui o ka kūʻē o ke kūpaʻa (10 '- 10 "). Ke kūʻē nei ka pale ʻana i ka moxifloxacin e hoʻomohala a me ka maha o nā mutations. Eia naʻe, noho palupalu kekahi mau micro-positive a anaerobic kū'ē i nā quinolones ʻē aʻe i ka moxifloxacin.

ʻO ka kiko o ke hana antibacterial o moxifloxacin e komo i loko o nā microorganisms like:

1. Gram-maikaʻi - Streptococcus pneumoniae (me ke kanana nei hoʻopale i ka penicillin a me macrolides a me ke kanana nei me ka mau ia'ku i antibiotics) *, Streptococcus pyogenes (Group A) *, Streptococcus milleri, Streptococcus mitis, Streptococcus agalactiae *, Streptococcus dysgalactiae, Streptococcus anginosus *, Streptococcus konst * hoʻokūkū i nā vancomycin a me gentamicin) *.

2. Gram-negative - Haemophillus influenzae (me nā hana i ka hana a me ka mea ʻole-hua (3-lactamases) *, Haemophillus parainfluenzae *, Klebsiella pneumoniae *, Moraxella catarrhalis (me nā hana o ka hana a me ka hua ʻole (3-lactamases) *, Escherobacteria coli * , Bordetella pertussis, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter intermedius, Enterobacter sakazaki, Proteus mirabilis *, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Providencia stuartii.

3. anaerobes - Bacteroides distasonis, Bacteroides eggerthii, Bacteroides fragilis *, Bacteroides ovatum, Bacteroides thetaiotaomicron *, Bacteroides uniformis, Fusobacterium spp, Peptostreptococcus spp *, Porphyromonas spp, Porphyromonas anaerobius, Porphyromonas asaccharolyticus, Porphyromonas magnus, Prevotella spp, .... Propionibacterium spp., Clostridium perfringens *, Clostridium ramosum.

4. Ipiipio - Plamoniae Chlamydia *, Mycoplasma pneumoniae *,

Legionella pneumophila *, Coxiella bumetti.

* - ua hōʻoia ʻia ka ʻike naʻau ma moxifloxacin e ka ʻikepili ʻike.

ʻOi aku ka hana o Moxifloxacin i kū ʻole i ka Pseudomonas aeruginosa, nā Pseudomonas fluorescens, Burkholderia cepacia, Stenotrophomonas maltophilia.

Lapaʻau lāʻau

Ma hope o ka infusion hoʻokahi o moxifloxacin ma kahi o 400 mg no 1 mau hola, ʻoi ka nui o ka nui o ka lāʻau (C_tah) ka mea i hoʻokō ʻia ma ka hopena o ka infusion a ma kahi o 4.1 mg / l, kahi mea e pili ana i ka hoʻonui ʻana o kahi kokoke he 26% hoʻohālikelike ʻia me ka waiwai o kēia hōʻailona ma ka lawe ʻana i ka lāʻau lapaʻau i loko. ʻO ka hōʻikeʻana o ka lāʻau lapaʻau, hoʻoholo ʻia e AUC (ʻo ka wahi ma lalo o ka pihi-ʻoi aku ka manawa), he keu i ka wā e lawe ana i ka lāʻau i loko. ʻO ka bioavailability piha kūpono e pili ana i ka 91%.

Ma hope o ka hoʻoulu ʻia ʻana o ka infra intravenous o ka moxifloxacin ma kahi o 400 mg no 1 mau hola, ke kiʻekiʻe a me ka minamina o ka plasma i loko o kahi kūlana (400 mg hoʻokahi lā i kēlā lā) e hōʻea i nā waiwai mai 4.1 a 5.9 mg / l a mai 0.43 a 0.84 mg / l, kekona. I kahi kūlana paʻa, ʻo ka hopena o kahi hopena moxifloxacin i loko o ke anawaena o ka dosage he 30% nui aʻe ma mua o ka hopena o ka hopena mua. Loaʻa nā awelika paʻa o 4.4 mg / L i ka hopena o ka infusion.

Hoʻopuka koke ʻia ʻo Moxifloxacin i loko o nā palu a me nā ʻāpana a hoʻopaʻa i nā protein koko (ʻoiaiʻo albumin) ma kahi o 45%. ʻO ka nui o ka hoʻoili e pili ana i 2 l / kg.

Moxifloxacin e hana i ka biotransformation o ka lā 2 a ua lawe ʻia ʻia mai ke kino e nā keiki, a me nā feces kekahi, ʻaʻole i loli a me ka ʻano o ka pūhui sulfo hana ʻole a me ka glucuronides. ʻAʻole ke kaha nā Moxifloxacin e ka ʻōnaehana mikrosomal cytochrome P450. ʻO ka hapalua o ka ola o ka lāʻau lapaʻau ma kahi o 12 mau hola. ʻO ka awelika huakaʻi awelika ma hope o ka hoʻokele ʻana ma kahi maʻa o 400 mg ka 179 a 246 ml / min. Ma kahi o 22% o hoʻokahi pākahi (400 mg) ke hoʻololi i ka loli ʻana, ma kahi o 26% - me nā feces.

ʻO nā mea mālama palekana

I kekahi mau pilikia, ma hope o ka hoʻohana mua ʻana o ka moxifloxacin, hiki i ka hypersensitivity a me nā hopena alia ke ulu. Kuhi iki loa, hiki i nā hopena anaphylactic ke holomua i ka hana hoʻoweliweli hoʻoweliweli o ke ola, ʻoiai ma hope o ka hoʻohana mua ʻana o ka lāʻau. I kēia mau hihia, pono e hoʻoneʻe ʻia ka moxifloxacin a me nā ʻano lāʻau lapaʻau e pono i lawe ʻia (me ke ʻano anti-shock).

Me ka hoʻohana ʻana o moxifloxacin i kekahi mau mea maʻi, hiki ke hoʻomaopopo ʻia kahi hoʻonui o ka lā QT.

Hāʻawi ʻia i nā wahine e hoʻolōʻihi i ka waena o QT i hoʻohālikelike ʻia i nā kāne. Mahele aku nā ʻōpūʻelemakule i nā lāʻau lapaʻau e pili ana i ka manawa QT.

Hiki i ka nui o ka hoʻonui ʻana i ka palena ʻo QT ke hoʻonui me ka hoʻonui ʻana i ka lāʻau, no laila, ʻaʻole ʻoe eʻoi aku i ka mea i ʻōlelo ʻia a me ka infusion rate (400 mg i 60 mau minuke). Eia nō naʻe, i nā mea maʻi me ka maʻi pīpī, ʻaʻohe correlation ma waena o ka neʻe o ka moxifloxacin i loko o ke koko koko a me ka lōʻihi o ka manawa QT. ʻO ka hoʻonui ʻana i ke anawaʻina ʻo QT ua pili i ka nui o ka loaʻa o ka arrhythmias ventricular, me ka tachycardia polymorphic ventricular. ʻAʻole kekahi o nā mea maʻi 9,000 i mālama ʻia me ka moxifloxacin i loaʻa i nā hoʻopiʻi cardiovascular a i nā hihia lethal e pili ana me ka hoʻolōʻihi i ka wā QT. Eia nō naʻe, i nā mea maʻi me nā kūlana i manaʻo mua i nā arrhythmias, hiki i ka hoʻohana ʻana i ka moxifloxacin e hoʻonui i ka nui o ka arrhythmias ventricular.

I kēia mea, pono ke ʻalo ʻia ka hoʻokele o moxifloxacin i ka poʻe maʻi me ka hoʻokaʻawale QT lōʻihi, hypokalemia uncorrected, a me ka poʻe e loaʻa ana i nā lāʻau antiarrhythmic o nā papa IA (quinidine, procainamide) a i ʻole kelas III (amiodarone, sotalol), mai ka ʻike i ka hoʻohana ʻana i ka moxifloxacin i kēia mau ʻO nā maʻi nā mea maʻi.

Pono ke ʻano o ka Moxifloxacin me ka akahele, ʻoiai

ʻaʻole hiki ke hoʻokaʻawale ʻia ka hopena hoʻohui o moxifloxacin i loko o kēia mau pilikia:

- i nā mea maʻi e loaʻa ana ka lāʻau lapaʻau concomitant e hoʻolōʻihi i ka kikowaena QT (cisapride, erythromycin,

nā lāʻau lapaʻau antipsychotic, antidepicants tricyclic),

- i nā mea maʻi me nā kūlana i koho mua i nā arrhythmias, e like me ka bradycardia koʻikoʻi i nā maʻi nui, ischemia myocardial koʻikoʻi,

- i nā mea maʻi me ka cirrhosis, ʻoiai me ka loaʻa ʻana o kahi pālahalaha o ka interval QT i loko o lākou ʻaʻole hiki ke haʻalele ʻia,

- i nā wahine a i nā mea maʻi maʻi paha, ʻoi aku ke koʻikoʻi i nā lāʻau lapaʻau e hoʻonui i ka manawa QT. ʻO nā hihia o ka hoʻomohala ʻana o ka hepatitis fulminant, hiki i ke alakaʻi ʻana i ke ola kōpū o ke ola, me ka make, ua hōʻike ʻia. Inā ʻike ʻia nā hōʻailona o ka ate, pono e nīnau aku nā mea maʻi i ke kauka ma mua o ka hoʻomau ʻana i ka mālama ʻana.

ʻO nā kumu o ka hopena o ka ʻili o ka pūlima, no ka laʻana, ʻo ka maʻi Stevens-Johnson a i ʻole nā mea ʻole ʻia a me ka epacmalsis epidermal (e pili ana i ka ola). Inā hele mai nā hopena ma ka ʻaoʻao o ka ʻili a me / a i ʻole nā membous mucous, pono ʻoe e nīnau koke i ke kauka ma mua o ka hoʻomau ʻana i ka mālama ʻana. ʻO ka hoʻohana ʻana i nā lāʻau quinolone e pili ana i ka hiki i ka hoʻomohala ʻana i ka lawe ʻaʻi ʻana. Pono ke hoʻohana ʻia ʻo Moxifloxacin me ka mālama ʻana i nā maʻi me ka maʻi ʻōnaehana o ka nūnū a me nā kūlana e kānalua nei i ka hoʻopili ʻana o nā hanana ʻōnaehana waena, e kuhi ana i ka mea e hoʻokuʻi ʻia nā hoʻokuʻi, a me ka hoʻohaʻahaʻa ʻana i ka paepae no ka hana hoʻomanawanui.

ʻO ka hoʻohana ʻana i nā lāʻau antibacterial ākea ākea, me ka moxifloxacin, e pili pū me ka pilikia o ka hoʻomohala ʻana i ka colitis pseudomembranous i pili me ka lawe ʻana i ka antibiotics. Pono e mālama i kēia maʻi i loko o nā poʻe maʻi e ʻike i ka maʻi kaumaha ma ka wā me ka moxifloxacin. I kēia hihia, pono e hoʻomaopopo koke i ka lāʻau kūpono. ʻO nā maʻi i loaʻa i ka maʻi palaualelo e pāpā ʻia i nā lāʻau lapaʻau e pale i ka ʻōpū o ka wahī.

Pono ke hoʻohana ʻia ka Moxifloxacin me ka makaʻala me nā poʻe maʻi me Gravis myasthenia gravis, no ka mea hiki i ka lāʻau lapaʻau ke hoʻonui i nā hōʻailona o kēia maʻi.

I ka wā o ka maʻi me ka fluoroquinolones, me ka moxifloxacin, ka mea nui i ka poʻeʻelemakule a me nā mea maʻi e loaʻa ana i ka glucocorticosteroids, hiki i ka hoʻomohala ʻana o ka tendonitis a me ka tendture tendon. I nā maka mua o ka hōʻeha a me ka mumū paha ma ka pūnaewele hōʻino ʻia, pono e hoʻoneʻe i ka lāʻau a hōʻoluʻolu ʻia ka umauma i hoʻopilikia ʻia.

No nā mea maʻi me nā maʻi maʻi paʻakikī o nā pelvic organ (no ka laʻana, ka pili me ka tubo-ovarian a i ʻole nā pelvic abscesses) i hōʻike ʻia no ka maʻi intravenous, ʻo ka hoʻohana ʻana o ka moxifloxacin i nā papa 400 mg ʻaʻole ʻia.

Ke hoʻohana nei i ka quinolones, ʻike ʻia nā hōʻike photosensitivity. Eia nō naʻe, i ka wā o ka preclinical, hoʻopaʻa haʻawina, a me ka hoʻohana ʻana i ka moxifloxacin i loko o ka hoʻomaʻamaʻa, ʻaʻohe ʻike ma ka photosensitivity. Eia naʻe, ʻo nā mea maʻi e loaʻa ana i ka moxifloxacin e pale pono i ka lā a me ka radiation ultraviolet.

No nā mea maʻi ma kaʻai haʻahaʻa ma ka sodium (no ka hāʻule ʻole o ka naʻau, ka hiki ʻole o ka pilikia, a me ka nephrotic syndrome), ʻoi aku ka hoʻohui ʻana o ka sodium me kahi hopena infusion.