ʻO ka lāʻau Cefepim: kuhikuhi i ka hoʻohana > He hoʻomaʻemaʻe a me ke pale aku

ʻO ke kumu o ka hopena koʻikoʻi e pili ana i ka luku ʻia o ka pā o nā pali o nā mikrobial cell, hana ʻia ka lāʻau bactericidal.

Ke hōʻike nei ka lāʻau lapaʻau i nā hana antibacterial kiʻekiʻe e kūʻē ana i nā hana i kū i nā hana o ka 3th cephalosporins, kaʻaoglikua. ^ E Ha yM. Ua komo koke ka waiwai o ka mea hana i loko o nā pupu microbial kino hewa, ʻoiai ke loaʻa ka pale kiʻekiʻe i ka hydrolysis o nā beta-lactamases. ʻO ka pahuhopu nui i loko o ke kōpona no ka cefepime ka protein protein penicillin-bind.

ʻO ka Cefepim antibiotic e hana i ka flora-positora flora a me nā peke i ka gram-negatif i ka vitro a ma ka vivo: streptococci, enterobacteria, Escherichia coli, Klebsiella, clostridia, protea, etc.

Nā hōʻailona no ka hoʻohana ʻana i ka cefepime

Hoʻomaopopo ʻia kahi papa maʻi maʻi no ka papa maʻa mau a maʻalahi. wahi maʻi pneumoniama muli o ke streptococci, enterococci, Klebsiella a me nā mea ʻai ʻē aʻe e pili ana i ka hana a ka lāʻau.

Nā ʻōlelo no ka hoʻohana ʻana o Cefepima i kēia mau ʻike ʻana no ka hoʻohana ʻana i ka lāʻau lapaʻau: nā hōʻeha hopohopo o ka urinary tract (paʻakikī a ʻano paʻakikī ʻole paha), ʻōpala neutropenia, ka hoʻopihapiha ʻole ʻia nā maʻi o ka ʻili a me nā palupalu palupalu.

Hoʻokomo ʻia ka lāʻau lapaʻau no ka hoʻohana ʻana i nā mahele infectious maʻi intra-abdominal (i loko o ka hui pū me ka metronidazole).

Nā hopena hopena

Hiki i ke Cepepime ke hana i nā hopena kūlohelohe i ke ʻano o ke kuni, ka ʻeha, e nā laury erythematous ma ka ʻili, ka ʻāhewa o ka eprimasis epidermal, erythema exryative, hopena anaphylactoid.

ʻO ke kūpaʻa ʻana i ke ʻano o ka mālama ʻana i nā lāʻau lapaʻau, hiki ke hoʻopaʻa ʻia i kahi pane Coomb maikaʻi.

Me ka hoʻokele intramuscular, ʻike ʻia ka ʻeha a me ka ʻulaʻula i ka wahi i ʻōlelo ʻia, ʻike pinepine ʻia ka phlebitis ma hope o ka infusion intravenous.

Ho? Oholo urinary: haunaele i ka hana hana o ka ʻōiwi.

ʻĀpana kikoʻī: nā hōʻailona dyspeptic pseudomembranous colitis, constipation, epigastric pain, puhi, kahaha.

Hematopoietic hui: hoʻāla pinepine ʻole me ka antibiotic therapy,anemia, ka leukopenia, kahi iho o kahi helu o nā platelets, neutrophils.

Mai ka papa huhū aia ka uukū.

Pūnaehana Cardiovascular: peripheral edema, palpitations, pōkole o ka hanu.

Nā hōʻike hōʻike o ke kikowaena a me nā hana noiʻi noiʻi:pālahalewahoonui manawa, pālahalaha hyperbilirubinemia, i hoʻonui i nā pae o ka urea, nā enzyme ati a me ka phosphatase alkaline, hoʻopaʻa inoa luhi.

E kūʻē i ke kūpaʻa o ka mālama ʻana, hiki i ka hoʻomohala ʻana o nā candidiasis oropharyngeal, asthenia, ʻeha ka umauma umauma, māhuahuaʻeha ma ke kua a me ka ʻāʻī.

Cefepim, nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana (Ke ʻano a me ke ʻano)

Hoʻōla ʻia ka lāʻau lapaʻau infusion intravenously (ʻo ka lōʻihi o ka infusion e lilo i ka hapalua hola). I kekahi manawa, ʻae ʻia ka hoʻokele intramuscular o ka lāʻau (no nā maʻi o ka ʻōnaehana genitourinary i hoʻokumu ʻia e E. coli).

Hoʻomukonia Pneumonia: ka hoʻokō ʻana i loko o ka lua o ka 1-2 o ka antibiotic i ʻelua mau lā i ka lā no 10 mau lā.

Hoʻomaʻamaʻa empirical ʻōpala neutropenia: Hoʻohui i nā 2 mau mau o ka lāʻau i ka intravenously i kēlā me kēia 8 mau hola, ke mālama ʻia nei ka maʻi a hiki i ka pau ʻana o ka maʻi.

Maʻa o ka hōʻeha ʻana o nā maʻiʻeha o ka genitourinary tract: infusion intravenous infusion o ka 0.5-1 mau cefepime i kēlā me kēia mau hola 12, kahi papa o ka antibacterial therapy e hoʻolālā ʻia no 7-10 lā.

I nā hihia koʻikoʻi o nā maʻi ma luna, ua hoʻonui ʻia ka nui o nā lāʻau lapaʻau i ka 2 mau gram, e hoʻolālā ʻia ka lāʻau no 10 mau lā.

I ka lā mua o ke ʻano o ka maʻi antibacterial, e hāʻawi ʻia nā mea maʻi e loaʻa ana i ka hemodialysis 1 kākā o ke cefepime, a laila 0,5 ka ninini ʻia i kēlā me kēia lā (no ka futile neutropenia, hoʻonui ʻia ka nui i ka 1 kākela). Hoʻomaopopo ʻia ka lāʻau lapaʻau e lawelawe koke ʻia ma hope o ka pau ʻana o ka hālāwai hemodialysis.

Pehea e hānai ai i ka cefepime no ka injra intravenous: hoʻāalo ʻia ka pauku ma mua o ka infusion i loko o kahi 5% o ka hopena o ka dextrose (ʻoi ka hopena o ka sodium klorida o 0.9%) hiki a hoʻopau ʻia. Ma mua o kēia kaila intramuscular, ua hoʻoheheʻe ʻia ka lāʻau i loko o ka wai kūikawā no ka hoʻonā ʻana me ka wai ʻona benzyl a i ʻole paraben. ʻOi paha ka hoʻohana ʻana o kahi hopena o ka paʻu lidocaine o ka 0,5 a me ka 1%.

Hoʻohui

Hiki i nā Cefepime ke hoʻonui ototoxicity a hoʻonui i ka pōʻino i ka ʻōnaehana ʻoihana ma ke ʻano me ka aminoglycosides.

ʻAʻole kūpono ka antibiotic me ka heparin a me nā mea antimicrobials. ʻAʻole pono e lawelawe pū ʻia ka lāʻau lapaʻau me ka hoʻonā o ka metronidazole.

Nā ʻōlelo kikoʻī

ʻAʻole i loaʻa ka Cepepime i nā papa.

Hoʻokuʻu ʻia ka lāʻau lapaʻau me ka hoʻomohala ʻana o ka colitis pseudomembranous me kahi maʻi maʻamau o ka lōʻihi lōʻihi (ʻoi ʻia ʻo ia e hoʻololi i ka metronidazole a me vancomycin).

I ka poʻe maʻi me ka mōʻaukala o nā pane kūloko i ka penicillin, hiki i ka hoʻokūkū ʻana o ka hypersensitivity cross-allergic.

ʻO nā mea maʻi me nā maʻi o ka ʻōnaehana hepatic a me nā maʻi e pono ai ka mālama pinepine ʻana i ka neʻe ʻana o ka mea ikaika ma ke koko (ke hoʻoponopono ʻia ʻana o ka hoʻoponopono dosage e hana e like me ka pae o QC).

Me ka mea i kāwili ʻia ai ka maʻi anaerobic-aerobic, ʻae ʻia kahi papa kuhikuhi hou o ka lāʻau antibacterial a hiki i ka ʻike piha ʻana i nā pathogens nui.

E kūlike i ke ʻano o ka mālama ʻana, hiki ke hoʻopaʻa inoa i kahi hopena maikaʻi ʻole i ka wā e mālama ana i ka hoʻāʻo ʻana i ka wai kōpō.

ʻAʻole nalowale ka hana antibacterial o ka lāʻau inā loli nā kala o ka hoʻonā hoʻomākaukau ʻia.

Pākuʻi helu

ʻO ka paukahi no ka hoʻonā ʻana no ka maʻi he 0.5 g a me 1.0 g

Hoʻokomo kahi pahu

mea waiwai - ka citrepime hydrochloride (ma nā huaʻōlelo cefepime) 0,5 g a i ʻole 1.0 g,

ouʻeke - kūpaʻa.

I ke ʻano o ka kāwili ʻana o ka citrepime hydrochloride a me arginine.

ʻO ke keʻokeʻo, kokoke i ka keʻokeʻo a i ka melemele paha, hygroscopic.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO ka manawa e hiki ai i ka lōʻihi loa o ke cefepime i loko o ka serum o ke koko me ka intramuscular injection ma kahi maʻa o 0,5 g ka mau hola 1-2, me ka hoʻokele intravenous i kahi maʻa o 0.5 g - ma ka hopena o ka infusion. ʻO ka awelika ʻana o ka plasma cefepime i ka wā e hoʻōla ʻia ma ka hapa 0.25 g, 0,5 g, 1 g a me 2 g mau 18, 39, 82, a me 164 μg / ml, ma kēlā me kēia, me kahi hōʻaiʻe intramuscular hoʻokahi ma kahi maʻa o ka 0.5 g, 1 g a me 2 g - 14, 30 a 57 μg / ml, kēlā me kēia. ʻO ka manawa e hōʻea ai i ka huliʻana o ka plasma therapeutic maʻamau he 12 mau hola. Ka awelika therapeutic ʻano me ka hoʻokele intravenous o 0.7 μg / ml, me ka hoʻokele intramuscular - 0.2 g / ml. Loaʻa nā hakahaka i loko o ka cefepime i ka urine, bile, peritoneal fluid, bronchial mucosa, sputum, prostate, appendix a me ka gall bladder. Ka helu hāpana 0.25 l / kg, i nā keiki mai 2 mau mahina a 16 mau makahiki - 0.33 l / kg. Hoʻomili ʻia ia i ka puʻuwai a me nā pōpoki o 15% me ka hoʻokumu ʻana o N-methylpyrrolidine, e huli koke i ka pili o N-oxide. Ma kahi o 80% o cefepime i hoʻololi ʻole ʻia i ka urine, ʻoi aku ka nui o ka filtration glomerular, hōʻemi ʻia ma mua o 1% o nā lawelawe i hāʻawi ʻia i loko o ka urine ma ke ʻano o N-methylpyrrolidine. ʻO ka paʻa ʻana o cefepime i ka protein serum ka liʻiliʻi ma mua o 19% a ʻaʻole ia e hilinaʻi i ka nānā ʻana o ka antibiotika ma ka koko. ʻO 85% kahi i hoʻopiʻi ʻia e nā keiki e ka glomerular filtration i loli ʻole. ʻO nā hoʻohālikelike pharmacokinetic o cefepime i loko o nā keiki ma hope o ke ke alakaʻi ʻana i ka maʻa o kahi maʻa o 50 mg / kg i hoʻohālikelike ʻia i ka ʻike ma nā pākeke ma hope o kahi maʻi intravenous o 2 g. Penetrates i loko o ka waiū umauma.

ʻO ka hoʻomaʻemaʻe piha o ka lāʻau ka 120 ml / min. ʻO ka hoʻomaʻemaʻe kino ākea cefepime ʻo 110 ml / min. ʻAʻole nui ka loli o ka pharmacokinetics o cefepime i nā mea maʻi me ka hana aho lēwa a i ʻole me ka cystic fibrosis (ʻaʻole koi ʻia ka hoʻoponopono hoʻoponopono). Me ka nele o ka renal, ka hapalua hapalua o nā cefepime hoʻonui, ʻoiai aia kahi pilina laina ma waena o ka mākaukau piha o cefepime a me ka wehe ʻana o ka creatinine. ʻO ka hapalua o ka cefepime he 2 mau hola, i ka wā hemodialysis - he 13 mau hola, me ka hoʻomau mau ʻia o ka dialysis peritoneal - nā hola 19. ʻAʻole ia i hōʻiliʻili i ke kino.

Lapaʻau lāʻau

ʻO ka wā kanu cephalosporin IV. Hana ia i ka bactericidal, ka hoʻopau ʻana i ka synthes o ka pā o ka pā o nā microorganisms. He palahalaha nui o ka hana. ʻO ka hoʻōla kūleʻa ʻana i ka bakela gram-maikaʻi a me ka bacteria-Negative, ʻo ka hapa nui o ka pale ʻana i ka aminoglycosides a i ʻole nā hanana o ka cephalosporin hanauna kūhelu. Hiki i ke Cepepime ke kū'ē i ka hana a ka hapa nui o β-lactamases, he haʻahaʻa haʻahaʻa no ka beta-lactamases i hoʻopuni ʻia e nā gen chromosomal, a komo koke i ka maʻi bacteria-hewa. ʻO ka pālākiō o MBC (ka liʻiliʻi o ka nānā ʻana i ka bactericidal) / MIC (ka liʻiliʻi o ka hoʻokaʻawale ʻana) no ka cefepime ka mea ma mua o 2 no ka ʻoi aku ma mua o ka 80% o nā kaʻawale o nā mea āpau a pau i ka maikaʻi a me ka micro-negatif microorganism.

Hoʻomaʻamaʻa ka lāʻau lapaʻau i ka hapa nui o nā microorganisms.

Aerobic gram-maikaʻi bacteria: Staphylococcusaureus,Staphylococcusepidermidis (e komo pū ana me nā hana o ka mana o ka beta-lactamase), a me nā kaha o ka staphylococci Staphylococcushominis,Staphylococcussaprophyticus,Streptococcusnā pyogenes (A pūʻulu A streptococci),Streptococcusahalactiae (ʻO ka hui Streptococcus B),Streptococcuswahi maʻi pneumoniae (e komo pū me ka pale penicillin hōʻemi - MIC mai 0.1 a 0.3 μg / ml), nā hua palapala ʻē aʻe beta hemolytic (nā pūʻulu C, G, F),Streptococcusnā bovis (Kelepa D),Streptococcuswahine puʻupaʻa.

ʻO ka hapa nui o ka enterococci, no ka laʻana ʻO Kaukaʻāinamoʻoʻala a me ka staphylococci-methicillin-pale i ka cefepime.

ʻAʻole paʻa ka Cepepime i kekahi palaka Xanthomonas maltpphilia (Pseudomonas maltophilia).

Anaerobes: Prevotella spp. ^ E Ha yM. (komo ʻO ka Prevotella melaninogenicus) ʻO nā Bacteroides spp., komo me ʻO nā Bacteroides melaninogenicus a me nā mea ʻokoʻa ʻē aʻe o ka pūpū pili e pili ana ʻO nā Bacteroides, Clostridium perfringens, Fusobacterium spp., Mobiluncus spp., Peptostreptococcus spp., Veilonella spp.. ^ E Ha yM. ʻAʻole kūleʻa ʻia ʻo Cepepime ʻO nā ʻōpili bakteriaHoʻolaha Clostridium.

ʻ a me ke kākele

Hoʻohana ʻia ka lāʻau lapaʻau i ka hana intravenously (lohi ma luna o 3-5 mau minuke) a me intramuscularly (hohonu i loko o kaʻili). Hoʻonohonoho ʻia ka regimen dosage i ke kanaka hoʻokahi, e noʻonoʻo ana i ka nui o ka maʻi, ka ʻano o ke ʻano pathogen a me kona ʻano i ka cefepime. 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.

ʻO nā pākeke a me nā keiki ke kaupaʻa ʻana ma mua o 40 kg me nā maʻi pā o ka urinary - 0.5-1 g 2 mau manawa i ka lā,

me nā maʻi o kahi wahi ʻē aʻe - 1 g intravenously a i ʻole intramuscularly i kēlā me kēia mau hola 12, me nā maʻi koʻikoʻi, hoʻonui ka nui i ka maʻi 2 g 2 mau manawa i ka lā,

no nā mea e hoʻoweliweli ʻana i ke ola, 2 g intravenously i kēlā me kēia hola 8 no 7 mau lā, e lawe ana i nā lā holoʻokoʻa o kēlā me kēia lā he 12 g.

me neutropenia febrile - 2 g intravenously i kēlā me kēia 8 hola no 7 lā,

no ka pale ʻana i nā maʻi neʻe i ka wā mua a me ka wā postoperative - 2 g intravenously no 30 mau minuke (ma ka hopena o ka hoʻomalu ʻana, metronidazole 500 mg e hoʻohui pū ʻia me intravenously) 1 hola ma mua o ka hana, ma ke ʻano lōʻihi, hana hoʻomalu ʻia ma hope o 12 mau hola ma ke ʻano hoʻokahi , i ukali ʻia e ka hoʻomaka ʻana o ka metronidazole.

I loko o nā maʻi urinary uncomplicated (e pili ana i ka pyelonephritis), nā maʻi pneumonia, a me ka hoʻōki ʻana o ka maʻi neutropenic i nā keiki i kaupaona ʻia ma mua o 40 kg - 50 mg / kg i kēlā me kēia mau hola 12.

Me ka maʻi o ka neutropenic, ka meningitis huakini i nā keiki e kaupaona ana ma mua o 40 kg - 50 mg / kg i kēlā me kēia 8 hola.

Ma kahi o ka hana renal impaired, pono ke hoʻoponopono ʻia ka ʻona. Me ka clearance creatinine o 30-60 ml / min, ma muli o ka nui o ka maʻi o ka maʻi - 0.5, 1 a i ʻole 2 g 1-2 mau lā i ka lā, me ka cleinine clearance o 10-30 ml / min - 0,5, 1 a i ʻole 2 g 1 manawa i ka lā clearance hana

E hoʻokuʻu i ke ʻano a me ka ʻano

Nā palapala kiko o ka cefepime:

ka paukū no ka hoʻomākaukau ʻana i kahi hopena no ka hoʻokele intramuscular (IM): mai ke keʻokeʻo a keʻokeʻo me kahi kala melemele, 0,5 g a i ʻole g 1 i kēlā me kēia mau pahu: i loko o kahi pahu pahu pahu o 10 a 50 mau kīwaha (no ka haukapila), ma kahi ʻāpana pepa kākā 1 bole. i loko o kahi pahu kāleka 1 pahu haki piha me ka hoʻoneʻe (1 pahu ʻōpala o 3,5 ml kēlā me kēia me ka pane o ka pa i ka Coverocaine no ka ʻomaʻi 10 mg / ml), ma kahi pahu kāwele pepa 1 piha piha me kahi kala (1 mau kīʻaha piha i loko o hoʻokahi pahu o 3,5 ml me kahi pane o ka Coverocaine no ka pahu 10 mg / ml a me 1 ampoule o 5 ml me ka wai no ka paʻi), 1 g i loko o nā pahu, ma kahi pahu pahu e ka mea 5 paha 30 hue
ka pauku no ka hoʻomākaukau ʻana i kahi hopena no ka hoʻokō intravenous (iv) a me ka intramuscular (i / m): keʻokeʻo me kahi ʻāpana ʻāpana o 0.5 g i loko o kahi pahu, ma kahi pahu pahu pahu 1 pahu, ma loko o kahi pahu pahu o 10, 50, 270 a 300 mau ipu (no ka hakahaka), he 0.5 g a i ʻole g 1 i loko o nā pahu, i nā pahu kīlei o 1 a i ʻole mau pahu kīʻaha, i loko o ka pūlima pahu kākela 1 piha me ka 1 a i ʻole mau pahu kīʻaha me 5 me ka solvent (wai no ka inake), 1 g kēlā poʻa, i loko o kahi pahu kāleka 1 pahu hū, i loko o ka pahu pahu pahu 10, 14, 25, 50, 270, 300 a 1000 mau kīʻaha (no ka haukapila), 2 g i loko o kahi hue, i loko o nā pahu 1 hue pack, i loko o ka carton 50 a 300 hue (no ka haukapila).

I ka pahu 1 me kahi pōpoki no ka hoʻoponopono / i ka hoʻokolokolo:

mea hoʻonaʻauao: cefepime hydrochloride monohala e pili ana i ka cefepime - 0,5 g a i ʻole g 1
ʻōnaehana kōkua: arginine.

I ka pahu bolo me ka pauka no ka iv a me ka v / m ka mana:

mea waiwai: cefepime hydrochloride e pili ana i ka cefepime - 0,5 g, 1 g a i ʻole g g,
ʻōnaehana kōkua: arginine.

Lapaʻau lāʻau

ʻO ka bioavailability o cefepime he 100%.

Ka hoʻokūkū nui (C_max) kahi lāʻau lapaʻau i loko o ke koko koko me kahi kuʻina intravenous hoʻokahi o 1000 mg o cefepime no nā hola 0,5 he 0.0787 mg / ml 0.5 mau hola ma hope o ka pau ʻana o ka infusion. Ma hope o 12 mau hola, ʻoi aku ka maikaʻi o ka lāʻau ma loko o ke kaila plasma he 0.0006 mg / ml. ʻO ka huina holoʻokoʻa (AUC) o ka lāʻau i loko o ka plasma i kahi hola he 0.1485 mg / ml.

Ma hope o ka hoʻomoe / i ka hoʻokele m, ua hoʻopuka piha ka cefepime. C_max me kahi hoʻolaha / m, ua loaʻa ka 1000 mg o ka lāʻau i ka 0,0263 mg / ml ma hope o 2 mau hola. AUC - 0.137 mg / ml / h.

ʻO ka nui o ka hoʻoili ʻana i ka pākeke ma ka 0.25 l / kg, i nā keiki - 0.33 l / kg.

Ma aneʻi 20% o nā minuke i hoʻokele ʻia i nā protein protein.

Hoʻoholo ka Cefepime i nā kuʻuna kiʻekiʻe, i ka wai pā peritoneal, urine, bile, gall, gall blderder, sputum, bronchial mucosa, exudate blister, prostate gland a me nā hoʻopili.

ʻO ka hapa hapalua he 2 mau hola, me ka hemodialysis - 13 mau hola, me ka hoʻomau dialy peritoneal - 19 mau hola.

Ma kahi o 15% o ka nui o ka huakaʻi i hoʻoneʻe ʻia i ka pūpū a me nā ʻōpū, ma kahi o 85% e kahakaha ʻia i hoʻololi ʻia i loko o ka pāʻai.

ʻO ka pauka no ka hoʻomākaukau ʻana i kahi hopena no ka ʻoila iv a me / ka hoʻokele ʻana o ka hoʻokele

ʻO ka pneumonia paona a me ka maʻi kaumaha e Pseudomonas aeruginosa, Streptococcus pneumoniae (me nā hihia pili i ka maʻi palupia concomitant), Klebsiella pneumoniae, Enterobacter spp.,
pyelonephritis me nā maʻi hopohopo ʻaʻole i hoʻopili a paʻakikī i ka maʻi o ka urinary tract i kumu ʻia e ka Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis,
neutropenia febrile - kahi hana lapaʻau,
ʻO nā hopena hoʻonā i loko o ka ʻōpū o ka ʻōpū ma muli o Enterobacter spp., Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Bactero>

ʻŌpū a me ka lactation

Hiki paha ke hoʻohana ʻana i ka cefepime i nā hihia kūikawā wale aku, i ka wā i manaʻo ʻia ai ka hopena i hoʻōla ʻia no ka makuahine i ka nui o ka hoʻoweliweli ʻana i ka pēpē:

i ke ʻano o kahi pauka no IV a me ka hoʻokele IM - i loko o kā II a me III na mea hoʻomaʻamaʻa o ka hapaha (I trimester is the contraindication pololei for this dosage form),
i ke ʻano o kahi pauka no ka hoʻokele i / m - ka wā āpau o ka hāpai ʻana.

Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau i ka wā lactation. No nā ʻōmaʻomaʻo koʻikoʻi e koi ana i ka hoʻokele ʻana o ka cefepime, hoʻopau ʻaʻa umauma i kahi manawa iki.

Hoʻohui nūhou

Me ka hoʻohana ʻana o ka cefepime:

aminoglycosides, diuretics, polymyxin B e hōʻemi i ka hoʻemi ʻana i ka ʻiloi tubular o ka cefepime, hoʻonui i ka hapalua-ola a hoʻonui i kona kao i loko o ke koko, e hoʻonui ana i ka nephrotoxicity,
No-ole nā lāʻau lapaʻau anti-inflammatory e kōkua lohi i ka hoʻopau ʻana o nā cephalosporins, e hoʻonui i ka hōʻalo o ke koko,
macrolides, chloramphenicol, tetracyclines e hōʻike i ka antagonism i ka lāʻau lapaʻau,
aminoglycosides like na ʻano.

ʻAʻole pono ke kāwili ʻia ka lāʻau i loko o ka pūlima like me ka ʻōlelo o ka metronidazole, gentamicin, vancomycin, tobramycin, aminophylline a netilmicin. Inā loaʻa, pono e hoʻokaʻawale ʻē ʻia nā ʻano o kēlā me kēia lāʻau lapaʻau.

Hiki ke hoʻohui i nā hoʻonā Ampicillin a me cefepime i loko o kahi syringe ma ke kikowaena o kēlā me kēia ʻoi ʻaʻole i kiʻekiʻe ma mua o 40 mg no 1 ml.

ʻO nā ʻāpana o nā cefepime nā: Maksipim, Ladef, Movizar, Tsepim, Efipim.

Nā Hoʻohui

Ma mua o ka hoʻomaka ʻana i ka maʻi me Cefepim, pono e noʻonoʻo pono nā mea maʻi i nā ʻōlelo ukali. ʻAʻole kuhikuhi ʻia nā ʻōkuhi inā loaʻa i nā maʻi hoʻokahi a keu paha:

nā makahiki o nā keiki a hiki i ka 2 mau mahina (no ka hoʻokele intravenous) - ma muli kēia i ka nele o ka ʻike i ka hoʻohana a me ka palekana pono ʻole.
i nā makahiki a hiki i 12 mau makahiki no ka maʻi intramuscular o ka lāʻau,
ka hoʻomaloka pilikino i ka lāʻau,
nā hihia o nā hopena maʻi kūloko loa i nā pics mai ka hui o cephalosporins,
hypersensitivity o penicillins - hiki i ʻole ke intolerance kea i cephalosporins,
pseudomembranous colitis, me ka mōʻaukala o
hapai a me ka wā o ka umauma.

ʻO nā contraindications pili i ke kapena o nā inikua Cefepim he maʻi maʻi paleka, nāitisitis ulcerative, nā mea maʻi ma luna o 65 mau makahiki o kona mau makahiki.

Lilo i ka lāʻau lapaʻau i ka wā hāpai a me ka lactation

Ma ka trimester mua o ka hāpai ʻana, ʻaʻole i kuhikuhi ʻia nā inikua cefepim i nā makuahine e kali ana, no ka mea, ʻo ke ʻano ikaika o nā mea maʻi e komo koke ana i ka pale plenta a hiki ke hoʻonāukiuki i ka ulu ʻana o nā hemahema a me ka abnormalities ma ka pūpū.

Ma ka lua a me ke kolu o ka hoʻokalakupua o ka hapai, hiki i ka hoʻohana ʻana o kahi lāʻau lapaʻau wale nō inā he pono ka loaʻa ʻana o ka waiwai i ka makuahine ma mua o ka pūpū. Hoʻolaha ʻia ka mālama ʻia i loko o kahi haukapila ma lalo o ka mākaʻikaʻi koʻikoʻi o nā kauka.

ʻO ka hoʻohana ʻana o nā cefepim injections i ka wā o ka hoʻoulu ʻana i kekahi mau hihia e koi ai i ka hoʻopau ʻana o ka lactation, ʻoiai ʻo ke ʻano ikaika o ka hoʻonā ʻana i pau ai i loko o ka waiū a i loko o ke kino o ka pēpē.

ʻO nā hopena ʻino

I ka wā o ka mālama ʻana me nā inikini Cefepim, hiki i nā mea maʻi me ke hypersensitivity i cephalosporins e ʻike i nā pōʻino i hōʻike ʻia e hōʻike pū ʻia ai ka maʻi penei:

mai ka ʻōnaehana oʻehā - ʻeha, nā puʻupuʻu, luhi, apathy, paresthesia, ʻike ʻole ʻia, hoʻopaʻapaʻa, encephalopathy,
mai ka pānaʻi ʻana o ka ʻalā ,
kūwaho āpau - urticaria, pruritus, dermatitis, necrolysis epidermal i nā mea e hoʻomohala ana, hoʻomohala i ka angededema, hana anaphylactic,
mai nā lālā hemopoietic - leukopenia, kahi i hoʻokaʻawale i nā helu platelet, agranulocytopenia, hemolytic anemia, kahi hoʻololi i ka manawa prothrombin i luna,
mai nā kino o nā pūnaehana urinary - hana ʻole o ka renal functioning, ka hoʻomohala ʻana o ka nephritis interstitial, ka hoʻomohala ʻana o ka pilikia ʻole o ka renal,

mai ka ʻōnaehana o ka huahelu - ka ʻili o ka ʻōpū, ka puhipuhī o ke kino, ka ʻūlū, ka ʻano o ke kuʻuna o ke kuʻuna me kahi mea ʻalaʻewa ʻole.
ma ka ʻōpū o ka ʻōpū o ka ʻōpū - ka huhū, ka umauma ʻeha ke komo ʻana, bronchospasm, paʻakikī ka ea, ka ʻike ʻana i ka nele o ka ea,
mai ka pūnaehana cardiovascular - nā maʻi palpani o ka puʻuwai, ka pōkole o ka hanu, ka ʻā ʻana o nā ohe.
waeika o ka laboratorium - ka emi ana o ka hematocrit, kahi nui o ka neʻe ʻana o ka urea, ka nui o ke kiʻekiʻe o ka calcium a me ka hana i loko o ke koko,
nā kūloko kūloko - punousure puncture, hoʻokumu hematoma, ʻā ʻia a me ka ʻeha ma ke kauā i ka wā o ka mālama ʻana i ka lāʻau, phlebitis, thromboembolism, me ka hoʻopuka ʻana o intramuscular o kahi ʻano maʻi maʻi, kahi maʻi ʻehaʻeha, ʻulaʻula, a me ka ʻeha ʻana o ka ʻili o ka ʻili ma ka wahi i ʻōlelo ʻia.

I kahi hihia o ka huki ʻana, nā pōkole o ka hanu, hoʻonui nui ʻia ka ʻōpū a i ʻole ka pouli i nā maka i ka wā o ka hoʻokele ʻana i ka lālani intravenously, pono ʻoe e hoʻomaopopo i kāu kauka e pili ana i kēia a hoʻopaʻa i ka infusion.

Ke keu

Hiki i kahi overdose o ke anikine inā loaʻa ka mea maʻi i nā inikini no ka manawa lōʻihi a makemake paha e ʻoi aku ka nui o ka lāʻau lapaʻau i ʻōlelo ʻia ʻia. ʻO nā maʻi, ʻike ʻia nā hōʻailona o kahi overdose e ka piʻi ʻana o nā hopena ʻokoʻa i hōʻike ʻia ma luna nei, ka hoʻomohala ʻana o ka renal, ka puʻuwai a me ka palaualohi ʻana, encephalopathy.

Hoʻokomo ʻia ka hopena o kahi overdose i ka hoʻopau koke ʻana o ka hoʻomehana o ka maʻi, hemodialysis no ka mea maʻi a me ka hoʻopau ʻana i nā hōʻailona o ka hoʻōla a antibiotic.

Nā kuʻina o nā inikua cefepim

ʻO nā hui o ka lāʻau Cefepim:

Hoʻomaha mākou i ka pauka no ka hoʻomākaukau o kahi hopena no nā injections,
Ladef pauka no ka hoʻomākaukau ʻana i kahi hopena no ka injections,
Ka honu Cefomax,
ʻO ka paule Movizar no ka hoʻomākaukau ʻana i ka hopena.

Ke hoʻololi nei i ka lāʻau lapaʻau i kauoha ʻia me ka analogue i hōʻike ʻia, pono pono e makaʻala nui i ka make ʻana o ka lāʻau o ka lāʻau.

Waihona a me nā kūlana waiho

Hoʻokuʻu ʻia ka pauka Cefepim mai nā lāʻau lapaʻau ma o ka lāʻau lapaʻau. Hoʻomaopopo ʻia e mālama i nā waihona o ka lāʻau lapaʻau i loko o ka friji a i kahi anu anu maloʻo paha. Mai mālama i nā keiki.

Kūkā ʻia kahi hopena no nā inikua i mua o ka hoʻokele. Mai kūʻai i ka hopena i hoʻopau ʻia a hiki i kahi maʻi hou aʻe!

ʻO 2 mau makahiki noho i ka pale o ka pauma, ʻaʻole e hoʻohana i ka lāʻau lapaʻau me kahi ola i hoʻopau ʻia.

Nā ʻōkuhi no ka hoʻohana ʻana i ka cefepime, dosage

Ke kāwili ʻana no ka maʻi intramuscular

ʻO ka hopena hoʻonā i manaʻo ʻia no ka hoʻokele intramuscular wale nō.

Pehea e hoʻoheheʻe ai i ka cefepime no ka hoʻokele intramuscular? Hiki ke hoʻohana ʻia nā hoʻoiho i lalo e hoʻoheheʻe i ka pauku: wai kaila no ka ʻōlelo ʻana, ka hoʻokaʻina 5% glucose no ka hōʻōlaʻi ʻia, 0.9% hopena pākuʻi sodium klorida no ka wīwī, ka wai bacteriostatic no ka ʻikepili me ka wai ʻaloʻo Benzyl a i ʻole paraben, he 0.5% a i ʻole 1% hoʻonā wai o ka Coverocaine hydrochloride . ^ E Ha yM. No ka hoʻomakaʻana o ka 0,5 g o ka pauka, pono e hoʻopau ʻia i loko o ka 1,3 ml, no ka hoʻopuka ʻana i ka 1 g i ka 2.4 ml o ka pulima.

Hoʻoholo ke kauka i ka ʻeha a me nā manawa o ka mālama ʻana e pili ana i nā hōʻike maʻi, ka nui o ka maʻi, a me ke ʻano hana o nā keiki.

ʻO ka nui o ka cefepime i ʻōlelo ʻia e nā ʻōkuhi no ka hoʻohana ʻana he 0.5-1 g i kēlā me kēia mau hola 12, ʻo ka lā lapaʻau o 7 lā lā. Me ka hana renal impaired me ka creatinine clearance (CC) ma mua o 30 ml / min, pono nā mea maʻi e hoʻoponopono hou i ka regimen dosage. ʻO ka ʻōmua mua ka mea maʻamau o ka lāʻau.

ʻO ka hoʻomākaukau ʻana no ka hoʻonā ʻana no ka iv a me ka hoʻokele intramuscular

Hoʻolālā ʻia ka mākaukau mākaukau ʻo Cefepime no ka hoʻokele intramuscular (aia wale nō i ka mālama ʻana i ka maʻi urinalia ʻole uncomplicated a paʻakikī hoʻi i ka maʻi o ka maʻi maʻalahi a me ka pehu i hoʻokumu ʻia e Escherichia coli) a i ʻole no ka jet and drip iv administration.

No ka hoʻomākaukau i ka hopena no ka inikua iv, pono ia e hoʻohui i ka 10 ml o kekahi o nā kumukūʻai i ka 1 g o ka hoʻomākaukau: wai wai no ka hoʻonāʻai ʻana, 5% hopena o ka dextrose (glucose), hoʻonā waiʻo sodium klorida. Hoʻoponopono ʻia ka hopena hoʻonā i loko o 3-5 mau minuke.

No ka hoʻomākaukau i ka hopena no ka drip iv, hiki iā ʻoe ke hoʻohana i kekahi o nā pelekane i lalo iho: 0.9% kalima aila sodium klorida, ʻōmole sodium lactate, 5% a 10% kūpono o ka dextrose (glucose), kahi kāwili o ka lactate Ringer a me 5% hopena o ka dextrose, kāwili 5 % a? anoea o ka dextrose a me 0.9% pa? a? aci? a? ohii? a. Kuhi mua ka ʻike o ka vial (1 g o ka pauka) i ka 5-10 ml o kekahi o kēia mau hoʻonā, a laila i hui ʻia i loko o kahi pahu infusion me nā hopena like, e lawe iā ia i 50 ml a 100 ml paha. ʻO 30 mau ka lōʻihi o ka infusion.

No ka hoʻomākaukau i ka hopena no ka inikua intramuscular, hiki iā ʻoe ke hoʻohana i ka wai i ka wai no ka ʻoa ʻana, he 0.9% hopena o ka paʻakai sodium a i ʻole he 0.5-1% hopena o ka poki hydrocloride. No 1 g o ka pauka, pono ka hoʻohui ʻana he 2.4 ml i ka pahu kime. Pono e hoʻolilo ʻia ka intramuscular injection ma hope o ka makemake mua e pale aku ai i ka lāʻau lāʻau i loko o ka moku a hoʻolauna i ka hopena i loko o ke koko (ʻo ka makeococaine maoli)! Hoʻonohonoho ʻia ka hopena i ka hohonu i ka mākona i ka quadrant o waho o ka poki.

I kēlā me kēia o nā hoʻonā i hoʻomākaukau ʻia, ʻaʻole ʻae ʻia ka maikaʻi o nā ʻāpana ʻē aʻe!

Ka mālama ʻana o ka maʻi pneumonia: ka hoʻokele intravenous o 1-2 grika o ka antibiotic i ʻelua mau manawa i ka lā no 10 mau lā.

Hoʻololi i ka maʻi neutropenia pīpī: i kēlā me kēia 2 hola, e lawelawe i ka 2 mau o ka lāʻau i ka intravenously, hana ʻia ka maʻi a hiki i ka pau ʻana o ka maʻi.

Ke mālama nei i nā hōʻeha maʻi hopohopo o ka genitourinary tract: intravenous infusion o ka 0.5-1 mau pā cefepime i kēlā me kēia mau hola 12, kahi papa o ka antibacterial therapy e hoʻolālā ʻia no 7-10 lā.

I nā hihia koʻikoʻi o nā maʻi ma luna, ua hoʻonui ʻia ka nui o nā lāʻau lapaʻau i ka 2 mau gram, e hoʻolālā ʻia ka lāʻau no 10 mau lā.

Nā ʻōlelo kikoʻī

Inā pseudomembranous colitis me ka lōʻihi o ka maʻi, e kāpae i ka lawe a e kuhikuhi i ka vancomycin (e ka waha) a i ka metronidazole.

Hiki i nā cross-hypersensitivity i nā maʻi me nā hopena kūlohelohe i nā penicillins.

Me ka pūpū paʻakikī a me ka lawaʻole o ka hepatic, pono ke hoʻoholo pinepine ʻia ka pilina o ka lāʻau (e hoʻoponopono ʻia ana ka hoʻoponopono ma muli o ka CC).

Me ka lōʻihi o ka mālama ʻana me Cefepim, kiaʻi pinepine ka nānā ʻana i ke koko o peripheral, ʻāpika a me nā ʻōluhi kūlana hana pono.

I loko o nā hui aerobic-anaerobic i hui ʻia, ka ʻike ʻana i nā pathogens e pono ai kahi hui me nā lāʻau lapaʻau e kū'ē i ka anaerobes.

ʻO nā mea maʻi e loaʻa nei i nā puʻupuʻu meningeal mai kahi wahi mamao loa o ka maʻi i manaʻo ʻia he meningitis a i ʻole ka hōʻoia ʻia ʻana o ka meningitis e hōʻoia ʻia, he ʻano ʻoniʻoni me ke ʻano ʻoihana lapaʻau e hōʻoia ʻia no kēia kūlana.

Hiki i kahi ʻike o ka hoʻokolohua Coombs maikaʻi, nā hōʻike kūpono ʻole no ka glucose i loko o ka pā.

E mālama i ka hoʻonā ʻana cefepime i hoʻomākaukau ʻia no nā hola 24 o ka lumi lumi a i ʻole 7 mau lā i loko o ka friji. ʻAʻole pili ka hoʻololi i ka kala i ka hana o ka lāʻau lapaʻau.

Nā hopena hopena

Hoʻomaopopo ka ʻōlelo aʻo i ka hiki o ka hoʻomohala ʻana i nā hopena ʻaoʻao aʻe inā ke kuhikuhi ʻana iā Cefepim:

He hopena alerika: ka ʻili o ka ʻili (me nā rashes erythematous), ka huhū, ka maʻi, nā hopena anaphylactoid, ka hopena maikaʻi o Coombs, eosinophilia, erythema multiforme exudative (e pili ana i ka maʻi Stevens-Johnson), maʻa - i ʻole ke ʻano o ka necrolysis epidermal (ʻeha Lyella).
Nā kūloko kūloko: me ka hoʻomehana iv - phlebitis, me ka hoʻomehana intramuscular - hyperemia a me ka ʻeha ma ka wahi o ka ʻōlelo.
Mai ka pūnaehana pīhoihoi: headache, dizziness, insomnia, paresthesia, hopohopo, haunaele, hoʻopaʻapaʻa.
Mai ka pūnaehana genitourinary: vaginitis.
Mai ka pūnaehana urinary: hana renal impaired.
Mai ka pūnaehana hana ʻana: ka ʻōpū, ka lua, ka luaʻi, ka constipation, ka ʻōpū o ka ʻōpū, ka dyspepsia, pseudomembranous colitis.
Mai nā kino hemopoietic: anemia, thrombocytopenia, leukopenia, neutropenia, pancytopenia, hemolytic anemia, pehu.
Mai ka papa hana hanu: mū.
Mai ka CCC: tachycardia, pōkole o ka hanu, edema peripheral.
Nā hōʻailona o ka laboratory: kahi hōʻemi i ka hematocrit, kahi hoʻonui i ka manawa prothrombin, ka nui o ka urea konsentrate, hypercreatininemia, hypercalcemia, he hoʻonui nui aʻe o ka hana o ka transaminases hepatic a me ka alkatine phosphatase, a me ka hyperbilirubinemia.
ʻO kekahi: ʻehaʻeha, ʻehaʻeha, hōʻeha, ʻeha hope, asthenia, ka hoʻomohala ʻana o ka superinfection, oropharyngeal kandidiasis.

Nā Hoʻohui

Hoʻohui ʻia ia e kuhikuhi i nā cefepime i kēia mau helu:

nā makahiki o nā keiki a hiki i ka 2 mau mahina (no ka hoʻokele intravenous) - ma muli kēia i ka nele o ka ʻike i ka hoʻohana a me ka palekana pono ʻole.
i nā makahiki a hiki i 12 mau makahiki no ka maʻi intramuscular o ka lāʻau,
ka hoʻomaloka pilikino i ka lāʻau,
nā hihia o nā hopena maʻi kūloko loa i nā pics mai ka hui o cephalosporins,
hypersensitivity o penicillins - hiki i ʻole ke intolerance kea i cephalosporins,
pseudomembranous colitis, me ka mōʻaukala o
hapai a me ka wā o ka umauma.

ʻO nā contraindications e pili ana i ka hoʻokō ʻana i nā huaʻōlelo Cefepim he maʻi maʻi paleka, nāitisitis ulcerative, nā mea maʻi ma luna o 65 mau makahiki o kona mau makahiki.

Ke keu

Aia ka hoʻonuiʻana i nā hopena hopena. ʻO nā hōʻailona o kahi overdose ka hilahila, hallucinations, stupor, coma, myoclonia.

ʻO ka mālama maʻi. He ʻola a hemodialysis.

Kiiila Cefepim, kumukūʻai i nā lāʻau lapaʻau

Inā pono, hiki iā ʻoe ke kahuli i Cefepim me kahi analogue o ka hana ikaika - he mau lāʻau lapaʻau kēia:

Ke koho nei i nā kikoʻī, pono ia e hoʻomaopopo i ka ʻōlelo aʻo no ka hoʻohana ʻana o Cepepim, ʻaʻole pili ʻia nā kumukūʻai a me nā loiloi i nā lāʻau lapaʻau like like. He mea nui ia e kamaʻilio pū me ke kauka kauka a ʻaʻole hoʻi e hana i kahi loli kūʻokoʻa kūʻokoʻa.