Ke lāʻau lapaʻau Amikacin 500: kuhikuhi i ka hoʻohana

ʻO ka Semi-synthetic ākea ākea-spacric antibiotic me ka bactericidal hana. Ma ka mākaʻi ʻana i ka 30unit subunit o ka ribosom, e pale i ka hoʻokumu ʻana o kahi paʻakikī o kahi halihali a me ka mea hoʻouna aku RNA, poloka i ka synthesis o ka protein, a e hoʻopau pū i ka membiosa o ka cytoplasmic.

Ka hana i kū'ē loa i nā microorganism aerobic gram-negatif - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp., Shigella spp., Indole-positibo a me indole-hewa Acinotea pilika Proteus mollin. ), kekahi mau microorganisms maikaʻi - koʻikoʻi Staphylococcus spp. (me nā mea kū i ka penicillin, kekahi cephalosporins), a ʻeha palē kūʻē i Streptococcus spp.

Me ka hoʻokolohua ʻōwili ʻana me ka benzylpenicillin, loaʻa iā ia kahi hopena synergistic e pili ana i nā manaʻo Enterococcus faecalis.

ʻAʻole pili i ka microorganisms anaerobic.

ʻAʻole i nalowale ka Amikacin hana i lalo o ka hana a nā enzyme e hana ʻole i ka glycosides amino ē aʻe, a hiki ke hoʻomau i ka kūʻē i ke kuamoʻo o Pseudomonas aeruginosa kūlia i ka tobramycin, gentamicin a me ka netilmicin.

Lapaʻau lāʻau

Ma hope o ka hoʻokele intramuscular (IM), ua hoʻopili nui ʻia a holo piha. ʻO ka kiʻekiʻe loa (Stax) me kahi kaila / m ka maʻa ma kahi o 7.5 mg / kg ka 21 μg / ml. ʻO ka manawa e hiki ai i ka lōʻihi loa o ka ʻāʻī o (TSmax) ma kahi o 1.5 mau hola ma hope o ka hoʻokele i / m. Ke kamaʻilio pū ʻana me nā protein plasma - 4-11%.

Ua hoʻolilo maikaʻi ʻia i ka extracellular fluid (nā kumuhana o ka abscesses, pleural effusion, ascitic, pericardial, synovial, lymphatic a peritoneal

wai kaohi), ma nā puʻina kiʻekiʻe i ʻike ʻia i ka urine, ma ka haʻahaʻa - ma ka bile, ka umauma waiū, ka wai hoʻohaʻahaʻa o ka maka, nā mea huna bronchial, ka huʻi a me ka wai cerebrospinal (CSF). E komo maikaʻi i loko o nā ʻōpili a pau o ke kino kahi e hōʻiliʻili ai i ka intracellularly, ʻike ʻia nā ʻike kiʻekiʻe i nā ʻōpū me nā hoʻokahe koko maikaʻi: nā māpuna, ka pepeka, myocardium, spleen, a ma nā ʻili, kahi e kohi ai i loko o ke kaila cortical, haʻahaʻa haʻahaʻa - ma nā uaua, ka adipose tissue a me nā iwi.

I ka hoʻohālikelike ʻia ʻana i nā pupu therapeutic medium i ka pākeke, amikacin ʻaʻole komo i ka pili koko-lolo, me ka hoʻoulu ʻia ʻana o nā meninges, piʻi nui ka haki. I nā keiki hou, ʻike ʻia nā ʻoi aku o nā mea kiʻekiʻe ma ka CSF ma mua o nā pākeke, hele i ka plasenta - aia ia i loko o ke koko o ka pūpū a me ka wai fetio amniotic. ʻO ka helu hāpana i nā pākeke - 0.26 l / kg, i nā keiki - 0.2-0.4 l / kg, i nā keiki hou - ʻoi aku nā keiki ma mua o 1 pule a me ke koʻikoʻi o ke kino ma mua o 1.5 kg - a hiki i 0.68 l / kg emi iho malalo o 1 pule a kaupaona kino ma mua o 1,5 kg - a hiki i 0.58 l / kg, i nā mea maʻi me ka cystic fibrosis - 0.3-0.39 l / kg. ʻO ka awelika therapeutic koʻikoʻi me ka hoʻokele i / m e mālama ʻia no nā hola 10-12.

ʻAʻole i hoʻemi ʻia. ʻO ka hapalua-ola (T1 / 2) i nā pākeke he 2-4 mau hola, i loko o nā pēpē -5-8 mau hola, i nā keiki makua - 2.5-4 mau hola. ʻO ka lōʻihi o ka T1 / 2 ʻoi aku ma mua o 100 mau hola (e hoʻokuʻu i nā depots intracellular) . ^ E Ha yM.

Hoʻokuʻu ʻia ia e nā keiki ma ka kānana glomerular (65-94%), nui ʻole i loli. Hoʻololi ʻo Renal - 79-100 ml / min.

Hoʻololi ʻo T1 / 2 i nā pākeke me ka hana ʻole kīnā ʻole ma mua o ka hopena o ka hōʻemi - a hiki i 100 mau hola, i nā mea maʻi me nā cystic fibrosis -1-2 mau hola, i nā mea maʻi me nā mumū a me hyperthermia, hiki i ka T1 / 2 ka pōkole ma mua o ka nui ma mua o ka hoʻonui ʻana. . ^ E Ha yM.

Hoʻokuʻu ʻia ia i ka wā hemodialysis (50% i nā hola 4-6), ʻoi aku ka maikaʻi o ka dialy peritoneal (25% ma 48-72 mau hola).

Nā hōʻailona no ka hoʻohana ʻana

Hoʻoulu ia no ka mālama ʻana i nā maʻi maʻi pāpaʻi a me nā maʻi na ʻia e nā microorganism i hōʻeha ʻia i ka amikacin: ka ʻōpū o ka ʻōpū (bronchitis, pneumonia, empyema, abscessation), sepsis, septic endocarditis, ka punawai i hoʻopili ʻia i ke kikowaena (me nā meningitis), a me ka ʻōpū o ka ʻōpū (komo. peritonitis), kahi kiko genitourinary (pyelonephritis, cystitis, urethritis), ʻili a me nā ʻili nāwaliwali (e komo pū ana, nā ʻōpū a me nā ʻōpū puʻuwai o nā ʻano like ʻole), ka pipi biliary, nā iwi a me nā ʻili (komo i ka osteomyelitis) ʻeha infe ktsiya, kahi maʻi postoperative.

Nā Hoʻohui Hypersensitivity (e pili ana i ka mōʻaukala o nā aminoglycosides āpau), nā neuritis auditory, ka hoʻopuka kino a me ka maʻi renal (CRF) me ka azotemia a me ka uremia, ka hapai, ka lactation ..

Me ka makaʻala. ʻO Myasthenia gravis, parkinsonism, botulism (aminoglycosides hiki i ka hoʻopiʻi ʻana i ka hoʻouna ʻana o nā neuromuscular transmission, ka mea e alakaʻi hou ai i nā nāwaliwali o nā ʻōpū), nā puʻuwai, ka hiki ʻole o ka pilikia, ka wā neonatal, ka wā kahiko o nā keiki, ka nui o nā makahiki.

ʻŌpū a me ka lactation

. ^ E Ha yM. Hoʻopili ʻia ka hoʻohana ʻana o ka amikacin i ka wā hāpai. Hiki ke hoʻopiʻi ʻia ʻo Aminoglycosides i ka hoʻolālā embryo i ka wā i hāʻawi ʻia i ka wahine hāpai. Hoʻopuka ʻo Aminoglycosides i ka pliono; hoʻomohala ʻana i ke kuli bilenua kumulapule i nā keiki i loaʻa i ka makuahine ke ala o ka streptomycin i ka wā hapai. ʻOiai ʻaʻole i loaʻa nā hopena koʻikoʻi ma ka ʻili a i nā keiki hou i ka wā i hāʻawi ʻia ai nā aminoglycosides e hāʻawi ʻia i nā wahine hāpai, hiki i ka make paha. Nā hōʻike haʻawina o ka amikacin i nā kiʻī a me nā hoki maikaʻi ʻole, ʻaʻole i hōʻike ʻia nā hōʻailona o ka nui o ka maluhia a me nā pōʻino i hoʻopili ʻia e pili ana me ka lawe ʻana i ka amikacin.

ʻAʻole i ʻike ʻia inā komo ka amikacin i ka waiū umauma. I ka wā o ka hoʻohana ʻana i ka amikacin, ʻaʻole i ʻōlelo ʻia ka umauma.

ʻLoe a me ke kākele

No ka hapanui o nā maʻi, hāʻawi ʻia ka hoʻokele intramuscular. Ma ka hopena o ka hoʻoulu ʻia ʻana o ke ola a i ʻole hiki ke hoʻōla ʻia intramuscular, ua ʻōkuhi lākou i ka holo lōlani, me ka lele (2-3 mau minuke), a i ʻole infusion (0.25% hoʻonā no 30 mau minuke).

ʻO ka hoʻokele Intramuscular a me ka hana intravenous

Hiki ke lawelawe ʻia ʻo Amikacin i loko o ka intramuscularly a me ka hana maʻalahi. I ka manawa i kuhikuhi ʻia ai i nā pilala i makemake ʻia no nā maʻi uncomplicated i kumu ʻia e nā microorganism hiki i ke kau ʻia, hiki ke loaʻa kahi pane lapaʻau i loko o nā hola 24-48.

Inā ʻaʻole e loaʻa ka pane lapaʻau i waena o nā lā 3-5, e pono no e kuhikuhi ʻia ke ʻano o ka maʻi maʻi.

Ma mua o ka koho ʻana i ka amikacin, pono ʻoe:

• e loiloi i ka hana renal ma ke ana ʻana i ka ʻike serum creatinine a i ʻole ma ka helu ʻana i ka pae ʻana o ka creatinine clearance (pono e loiloi i ka hana maʻamau i ka hana renal i ka wā hoʻohana o ka amikacin).

Inā hiki, pono ke hoʻoholo ʻia ka serum amikacin (ʻoi ka nui a me ka minamina o ka serum i kēlā me kēia manawa

Hōʻalo i kahi kiʻekiʻe serum nui o ka amikacin (30-90 mau minuke ma hope o ke kēkia) ʻoi aku ma mua o 35 /g / ml, kahi kikoʻuku o ka serum (ma mua aʻe o ka hopena o ka hopena) o ka ma mua o 10 μg / ml.

I nā mea maʻi me ka hana renal maʻamau, hiki i nā amikacin ke kuhikuhi i ka manawa 1 i kēlā me kēia lā, ma kēia hihia, i ka nui o ka serum kiʻekiʻe hiki ke hoʻonui aku i 35 μg / ml. ʻO ka lōʻihi loa o ka lāʻau 7 7 lā mau lā.

ʻO ka huina holoʻokoʻa, me kahi o ka pae o ka hoʻokele, ʻaʻole pono e ʻoi aku ma mua o 15-20 mg / kg / lā.

Ma nā hopena paʻakikī, i ka wā e pono ai ke mālama ʻia o kahi papa o ka mālama ʻana i nā lā he 10, pono ka hana o ke keiki, ka auditory a me nā palapala sensory vestibular, a me ka pae serum amikacin e nānā pono ʻia.

Inā ʻaʻohe holomua holomua i loko o nā lā 3-5, pono e hooki ʻia ka hoʻohana ʻana o ka amikacin, a me ka nānā ʻana i nā microorganisms i ka amikacin e nānā hou ʻia.

ʻO nā pākeke a me nā keiki ma mua o 12 mau makahiki - me ka hana maʻamau o ke keiki (ka hana ʻana i hana ʻia ʻo 50inl / min) i / m a i ʻole iv 15 mg / kg / lā 1 manawa i kēlā lā a i ʻole 7.5 mg / kg i kēlā me kēia mau hola 12. ʻAʻole kū pono ka nui o kēlā me kēia lā e pili ana i ka 1.5 g. No ka endocarditis a me ke neutropenia febrile, pono e hoʻokaʻawale ʻia ka nui o kēlā me kēia lā i nā puʻupuʻu 2, no ka mea lawa ʻole nā ​​ʻike ma ke komo ʻana i ka manawa 1 i kēlā me kēia lā.

ʻO nā keiki he 4 mau hebedoma - 12 mau makahiki - me ka hana maʻamau o ka renal (clearance hana> 50 ml / min) i / m a i iv (i kahi lōlō i ka lōlihi) 15-20 mg / kg / lā 1 manawa i ka lā a i ʻole

7.5 mg / kg i kēlā me kēia mau hola 12. Me ka neutropenia endocarditis a me nā neutropenia febrile, pono e hoʻokaʻawale i kēlā me kēia lā i 2 mau helu, no ka mea lawa ʻole nā ​​ʻike ma ke komo ʻana i ka manawa 1 i kēlā me kēia lā. Nā pēpē hou - ʻo ka helu kau mua mua o 10 mg / kg, a laila 7.5 mg / kg i kēlā me kēia mau hola 12.

Nā keiki ʻōpiopio - 7.5 mg / kg i kēlā me kēia mau hola 12.

Nā ʻōlelo kūikawā no ka hoʻokele intravenous. No nā pākeke a me nā keiki, ua hoʻopau pinepine ʻia ka hoʻonā amikacin ma loko o kahi manawa o 30-60 mau minuke.

Pono e paʻi ʻia nā keiki ma lalo o 2 mau makahiki no 1 a hiki i 2 mau hola.

ʻAʻole hoʻi e hui ʻia ʻo Amikacin me nā lāʻau ʻē aʻe, akā e lawelawe pono ʻia e like me ka ʻōmole i ʻōlelo ʻia a me ke ala o ka hoʻokele.

Nā ʻelemaka makua. Aua hoʻopā ʻia ʻo mycacin e nā keiki. Pono ke loiloi i ka hana a me ke ʻano i hoʻākāka ʻia ʻia e like me ka hihia o ka hana renal excretory.

Hoʻoweliweli ka hana ʻana a me / a i kumu a Pseudomonas. Dhiki ke hoʻonui ʻia ʻoz o kekahi makua i 500 mg i kēlā me kēia 8 mau hola, akā ʻaʻole pono e lawelawe ʻia ka amikacin ma kahi ohe ʻoi aku

1,5 g pākahi lā, ʻaʻoleʻoi aku ma mua o 10 mau lā. ʻAʻole pono ka nui o ka papa kaukau holoʻokoʻa ma mua o 15 mau grama.

Nā maʻi pepeke urinary (ʻo nā mea ʻē aʻe ʻaʻole i hoʻokumu ʻia e Pseudomonas). Nā kūlike like

7.5 mg / kg / lā i hoʻokaʻawale ʻia i 2 mau like kaulike (ʻo ka mea ma nā pākeke he like me ka 250 mg 2 mau manawa i ka lā).

Ka helu 'ana i ka mahele o ka amikainin pui impaired renal excretory function (hana holo hana

Ke keu

Nā hōʻailona: nā hopena o nā mea make (ka lohe lohe, ataxia, hōʻeha, ka maʻi urination, ka make wai, ka make ʻana o ka makemake, ka ʻōpū, ka luaʻi, ke kani ʻana a i ʻole ka manaʻo ʻana o ka mea i loko o nā pepeiao, ka hoʻopiʻi ʻana o ka ea).

Hoʻomaʻamaʻa: e wehe i ka poloka o ka hoʻokele neuromuscular a me kona mau hopena - hemodialysis a i kēlā me ke dialy peritoneal, nā lāʻau anticholinesterase, ka paʻakai kaleka, nā hoʻoili uila, nā hana hōʻailona a me ke kākoʻo kākoʻo.

Hoʻopili pū me nā lāʻau ʻē aʻe

Hoʻohana a hoʻonaninani a i ʻole me nā mea ʻē aʻe nephrotoxic a i ʻole nā ​​lāʻau ototoxic e pale aku ma muli o nā hopena hoʻohui. Ke hoʻonui nei i ka nephrotoxicity e pili me ka hui pū ʻana o ka aminoglycosides a me cephalosporins. ʻO ka hoʻohana pono ʻana me ka cephalosporins e hoʻonui hoʻonui i ka serum creatinine i ka wā i hoʻoholo ʻia ai. Hoʻopilikia ka pilikia o ka ototoxicity me ka hoʻohana pinepine ʻana i ka amikacin me ka wikiwiki diuretics hana, ʻoi aku ka wā o ka diuretic e mālama ʻia i ka hana intravenously. Hiki i nā diuretics ke hoʻonui i nā kao o ka aminoglycosides a hiki i ka ototoxicity hikiʻole ke loli no ka hoʻololi ʻana i ka hoʻoliʻiliʻi o nā antibiotics ma ka serum a me ke kiko. ʻO kēia mau nā furosemide a me ka ethacrylic acid, ma loko ona kahi lāʻau lapaʻau ototoxic.

ʻAʻole ke kuhikuhi ʻia ka paʻahana Intraperitoneal o ke amikacin i ka poʻe maʻi ma lalo o ka mana o ka anesthetics a i ʻole nā ​​hanana hoʻoliʻi manawa. (E pili ana i ka eter, halothane, D-tubocurarine, succinylcholine a me decametonium), blockade neuromuscular a ma muli o ke kaumaha hanu. ,

E hoʻonui paha ka Indomethacin i ka kaila o ka amikacin i loko o ka plasma i loko o nā keiki hou.

I ka poʻe maʻi me ka hoʻonāukiuki ʻana o ka hana haneli, hiki ke emi iho ka hana o ka hana aminoglycoside me ka hoʻohana ʻana i ka hoʻohana ʻana o nā mea penicillin.

ʻO ka hoʻonui pinepine ʻana o ka hypocalcemia me ka hui pū ʻana o ka aminoglycosides me nā bisphosphonates.

I ka hoʻonui ʻia ʻana o ka nephrotoxicity a me ka ototoxicity me ka hui pū ʻana o nā aminoglycosides me nā pūlima platinum.

Nā ʻōhumu kūikawā a me ka mālama mua

Hoʻohana me ka makaʻala ʻana i nā mea maʻi me ka hiki ʻole o ka renal, a i ʻole ka hōʻino i ka hālāwai a me ka vestibular apparatus. E ʻike pono nā mea maʻi e pili ana i ka hiki i ka ototoxicity a me nā nephrotoxicity o aminoglycosides. ʻAʻole paʻa i ka palekana no ka mālama ʻana ma mua o 14 mau lā. Pono e mālama ʻia nā ʻōkuhi me ka lawa ʻana o ka hydration.

I nā mea maʻi me ka hana renal impaired a i ʻole ka hōʻemi ʻana i ka filtration glomerular, pono ka nānā ʻana i ka hoʻomaʻamaʻa ʻia e nā ʻano hana kuʻuna ma mua o ka mālama ʻana a me kekahi manawa i ka wā mālama. Pono e hōʻemi ʻia nā koina o kēlā me kēia lā a i ʻole ke ʻano o ka wawa i waena o nā inikua e pili ana i ka kukuna serum creatinine e pale ai i ka hōʻuluʻulu ʻana o nā kiʻekiʻe abnormally i loko o ke koko a hoʻoemi i ka hōʻemi o ka ototoxicity. ʻO ka mālama pinepine ʻana i ka serum konsentrate o ka lāʻau a me ka hana renal ka mea nui loa i ka poʻe maʻi maʻi nona ka hōʻemi o ka hana renal i hiki ke ʻano, i ʻike ʻole ʻia paha i nā hopena o nā hōʻike screening maʻamau e like me ke kō urea a me ka serum creatinine.

Inā he mau lā ʻehiku a ʻoi aku paha i nā mea maʻi me ka pilikia ʻole, a i ʻole mau lā 10 i loko o nā mea maʻi ʻē aʻe, ʻike ʻia ka ʻike kikoʻī ma mua o ka audiogram a ʻike hou ʻia i ka wā o ka hōʻola. Pono e hoʻokuʻu ʻia ka lāʻau ʻo Amikacin inā he manaʻo pili i ka tinnitus a i ʻole ka lohe ʻana i ka lohe, a i ʻole e hōʻike ana i nā moʻolelo i hala.

Ke kū ʻia nā hōʻailona o ka huhū o ka ʻōpū o ka pēpē (e.g., albuminuria, ʻoka aʻīula koko a i ʻole nā ​​lymphocytes), pono e hoʻonui ʻia ka hydration a pono ke hoʻēmi ʻia i ka nui o ka lāʻau. Hōʻalo ʻia kēia mau maʻi inā ua pau ka mālama ʻana. Eia nō naʻe, inā e loaʻa ʻo azotemia a me / a i kahi hōʻemi holomua i ka hopena o ka urine, pono e hoʻokaʻawale ʻia ka mālama ʻana.

Neuro / Ototoxicity. ʻO ka neurotoxicity, i hōʻike ʻia i ke ʻano o ka vestibular a / a i ʻole ototoxicity auditor bilateral, hiki i nā mea maʻi ke loaʻa i ka aminoglycosides. ʻOi aku ka nui o ka loaʻa ʻana o ka ototoxicity-aminoglycoside-induction ka nui i loko o nā poʻe maʻi me ka hana ʻole ʻana o ka renal, a i ka wā e loaʻa ai nā koina kiʻekiʻe, a ʻo ka lōʻihi o ka huli ʻana ma mua o 7 mau lā. ʻO ka hōʻeha e hōʻike paha i ka poino vestibular. ʻO nā hōʻike ʻē aʻe o ka neurotoxicity e loaʻa paha i ka palupalu, ke nānā ʻana i ka ʻili, ka ʻūʻī ʻana o ka iʻa, a me ka cramping. Hōʻalo ka piʻi o ka ototoxicity me ka hoʻonui nui ʻana o ka hoʻolaha i kekahi kiʻekiʻe mau a kiʻekiʻe a i ʻole ka mea kiʻekiʻe koʻikoʻi serum. ʻO ka hoʻohana ʻana i ka amikacin i nā mea maʻi me ka alerine i ka aminoglycosides, a i ʻole ka hōʻino ʻole ʻana o ka renal, a i ʻole ke hōʻino i ka ʻewalu o ke ʻano neʻi e nā alakaʻi mua o ka nephrotoxic a / a i nā lāʻau ototoxic (streptomycin, dihydrostreptomycin, gentamicin, tobramycin, kanamycin, kanamycin Bmy , cephaloridine, a i ole viomycin) e pono e noʻonoʻo me ka akahele, no ka mea e hoʻonui ʻia ka pehu. I kēia mau maʻi maʻi, ua hoʻohana ʻia ka amikacin inā, e like me ke kauka, ʻo ka pono o ka therapeutic e ʻoi aku nei ma mua o nā pōʻino.

Neuromuscular toxicity. ʻO ka neuromuscular blockade a me ka hoʻopale ʻana o ka hanu ua hoʻopaʻa ʻia ma hope o ka hoʻomalu makua, ka hoʻohuihui (ma ka hana orthopedic, ka huhū o ka ʻōpū o ka ʻōpū, ka mālama ʻana o ka empyema), a ma hope o ke kaʻi ʻana i ka waha o aminoglycosides. ʻO ka pono o ka maʻi pākēneka e pono e noʻonoʻo me ka hoʻopuka o ka aminoglycosides ma kekahi ʻano, ʻoi aku hoʻi i nā mea maʻi e loaʻa ana he ana, mea hoʻomaha ʻāʻī (tubocurarine, succinylcholine, decametonium), a i loko o nā mea maʻi e loaʻa ka nui o ke kao o ka koko citrate-anticoagulated. Inā hele mai ka poli neuromuscular blockage, hemo aku nā paʻakai kalaiwa i ka maʻi pākēnē, akā pono ka pono ponoʻī. Pono e hoʻohana ʻia nā Aminoglycosides me ka makaʻala i nā mea maʻi me ka maʻi ʻeha (myasthenia gravis a i ka parkinsonism), no ka mea hiki iā lākou ke hoʻonui i ka nāwaliwali o ka naʻau ma muli o nā hopena curariform e pili ana i ka hoʻoiho neuromuscular.

Inea hoʻonani. Aminoglycosides hiki i ke nephrotoxic. ʻOi aku ka kiʻekiʻe o ka hoʻomohala ʻana i ke nephrotoxicity i nā mea maʻi me ka hana ʻoi aku ka maikaʻi o ka pūpū, me ka hōʻea ʻana i nā dosie kiʻekiʻe a me nā lāʻau lōʻihi. Pono ka hydration maikaʻi i ka wā o ka mālama ʻana; e nānā ʻia ka hana o ka maʻi me ka hoʻohana ʻana i nā ʻano hana ma mua a i ka wā ʻo ka mālama ʻana. Pono e hoʻokaʻawale ka mālama ʻana me ka hoʻonui ʻana o ka azotemia a i ʻole ka hoʻonui ʻana i ka nui i ka urine.

I nā poʻe maʻi maʻi, hiki i ka emi ʻana o nā hana hana i ka mea hana, ʻaʻole paha e ʻike ʻia i nā hoʻokele screening maʻamau (serum nitrogen urea a i ʻole serum feathein). ʻO ka koho ʻana i ka cleince creatinine e ʻoi aku ka maikaʻi ma ia mau hihia. ʻO ka kiaʻi ʻana i ka hana hoka i nā poʻe maʻi maʻi i ka wā o ka mālama ʻana me ka aminoglycosides ka mea nui loa.

Renal function a ʻewalu hana cranial nerve koi i ke kiaʻi ʻana i nā maʻi i ʻike ʻia a i ʻole ka mea i hana ʻia i ka hana renal i ka hoʻomaka ʻana o ka hana ʻana, a i ka poʻe maʻi me ka hana maoli renal maʻamau, akā me nā hōʻailona o ka hana renal impaired i ka wā o ka mālama ʻana. Pono e nānā pono ʻia ka ʻikekikika ʻo Amikacin e hōʻoia i ka nui o ka nui a me ke pale ʻana i nā nui o ka ʻona. Pono ka nānā ʻana o ka urine no ka hoʻohaʻahaʻa i ka gravity kūikawā, hoʻonui i ka protein excretion, a me erythrocyturia. ʻO ka urea koko, kahi serum creatinine, a i ʻole cāinake hana hoʻomaʻamaʻa paha e hoʻopaʻa ʻia i kēlā me kēia manawa. Pono e loaʻa i nā ʻōmālike serial ka poʻe maʻi maʻi, ʻoi aku hoʻi i nā maʻi maʻi kiʻekiʻe. ʻO nā hōʻailona o ototoxicity (dizziness, tinnitus, tinnitus a me ka nalowale hoʻolohe) a i ʻole nephrotoxicity e koi i ka hōʻemi ʻana i ka lāʻau a hoʻoponopono paha i ka hopena.

ʻO ka hoʻohana pū ʻana a me / a i ʻole ka hopena i nā lāʻau neurotoxic a i ʻole nephrotoxic (bacitracin, cisplatin, amphotericin B, cephaloridin, paromomycin, viomycin, polymyxin B, colistin, vancomycin, a me nā aminoglycosides ʻē aʻe). ʻO nā mea ʻē aʻe e hoʻonui ai i ka hōʻeha o ka maʻi o ka maʻi ke ola nui a me ka dehydration.

Misc. ʻO Aminoglycosides ka wikiwiki a paʻa loa i ka wā e hoʻopili pono ʻia, i hui pū ai me nā kaʻina hana. ʻO ke kuli hiki ʻole, hoʻololi ʻole a me ka make ma muli o ka palaka neuromuscular i hōʻike ʻia i ka wā o ka hōʻiliʻili ʻana o nā kīhāpai nui a liʻiliʻi.

E like me nā antibiotics'ē aʻe, hiki i ka hoʻohanaʻana o amikacin ke alakaʻi i ka ulu nui o nā microorganisms insensitive. I kēia hihia, pono ke kuhikuhi ʻia o ka lāʻau kūpono.

ʻO nā ala o ka pau ʻole o ka ʻike i hōʻike ʻia ma hope o ka hoʻonā ʻana i ka amikacin i loko o ka vitreous o ka maka.

E hoʻokuʻu i ke ʻano a me ka ʻano

Hoʻokuʻu ʻia ka lāʻau lapaʻau ma ke ʻano o:

• I kēia hopena ka hopena no ka / i me ka hoʻokele iv, 1 ml nona ka 250 mg o ka amikacin, i loko o 2 a me 4 ml,
• ʻO ka pauku mai kahi i hoʻomākaukau ʻia ai ka hoʻonā no ka inikō, i loko o kahi pahu (10 ml) kahi i loaʻa ai ka 250 mg, 500 mg a i ʻole 1 grama o amikacin.

Nā Hoʻohui

Wahi a ka annotation i ka lāʻau lapaʻau, contaguicated ke hoʻohana ʻana o Amikacin:

• Nā wahine hāpai
• Me ka neuritis o ka nū auditory,
• ʻO ka poʻe maʻi me ka hiki ʻole o ke aʻalolo puhaluhi hiki i hele me ka uremia a me / a me azotemia,
• Ma ke alo o ka hypersensitivity i amikacin, kekahi mea kōkua o ka lāʻau lapaʻau, ʻokoʻa aminoglycosides (me ka mōʻaukala).

Hoʻonohonoho ʻia ʻo Amikacin, akā me ka mālama nui a ma lalo o ka mālama mālama ʻana i nā lāʻau lapaʻau:

• Me ka huehue,
• Wahine i ka wā lactation
• Me kaʻuʻu graasthenia,
• ʻO nā mea maʻi me ka parkinsonism
• Me ka hāʻule ʻole ʻana,
• Nā pēpē hou a me nā keiki mua
• Poʻe kānaka
• Me ka botulism.

ʻO ka helu a me ka hoʻokele ʻana ʻo Amikacin

ʻO ke kūleʻa (me ka hoʻomākaukau ʻia mai ka pauma) ʻo Amikacin, e like me ke kuhikuhi ʻana, pono e lawelawe ʻia intramuscularly a i ʻole intravenously.

ʻO ka makeʻana no nā pākeke a me nā keiki ma mua o 6 mau makahiki he 5 mg no ka kilokina o ke kaumaha o ke kino, kahi mea e lawelawe ʻia ana ma kahi manawa o 8 mau hola, a i ʻole 7.5 mg / kg i kēlā me kēia mau hola 12. Me ka unuhi i ka maʻi ʻōiwi o ka genitourinary tract, hiki ke kuhikuhi i kahi pākēnē o 250 mg i kēlā me kēia mau hola 12. Inā makemake ʻoe i ka hālāwai hemodialysis ma hope o ia mea, hiki iā ʻoe ke hana i kahi maʻi hou ma ke ana o 3-5 mg no 1 kg o ke kaumaha.

ʻO ka dosage kiʻekiʻe i kēlā me kēia lā no 15 mau lā he 15 mg / kg, akā ʻaʻole iʻoi aku ma mua o 1.5 ka grama i kēlā me kēia lā. ʻO ka lōʻihi o ka mālamaʻana, e like me ke kānāwai, he 3-7 mau lā - me kahi / i ka hoʻolaha, 7-10 lā - me kahi / m.

ʻAe ʻia ʻo ʻAikikinika no nā keiki penei:

• Nā pēpē mua: ʻo ka hapa mua loa he 10 mg no ka kg, a laila 7.5 mg / kg i nā hola 18-24.
• No nā pēpē a me nā pēpē a hiki i nā makahiki 6: ʻo ka nui o ka mauʻu he 10 mg / kg, a laila 7.5 mg / kg i kēlā me kēia mau hola 12.

I ka hihia o nā puhi o ka maʻi i hoʻopiha ʻia, ma muli o ka hapalua o ka hapa hapa o ka amikacin i kēia māhele o nā mea maʻi, ʻo ka nui o ka lāʻau no ka maʻi 5-7.5 mg / kg, akā hoʻonui ka nui o ke alakaʻi - kēlā me kēia mau hola 4-6.

Kuhi ʻia ʻia ʻo Amikacin i loko o kahi manawa o 30-60 mau minuke. Ma ke ʻano he koi wikiwiki, ua ʻae ʻia ka ʻōlelo lele no ʻelua mau minuke.

No ka hoʻokele drip intravenous, hoʻoheheʻe ʻia ka lāʻau lapaʻau me ka hopena o ka sodium chloride 0.9% a i ʻole 5% dextrose solution i mea ʻole o ka manaʻo o ka mea hana iʻoi aku ma mua o 5 mg / ml.

ʻO ka hōʻemi ʻana i ka nui a i ʻole ka hoʻonui ʻana i ka wā ma waena o nā inikini e pono ai no nā mea maʻi me ka hana exaletal ainima.

Nā ʻāpana ʻaoʻao o Amikacin

E like me nā loiloi o nā mea maʻi i hana ʻia me Amikacin, he loaʻa paha kēia lāʻau lapaʻau, e like me:

• Hoʻomau, luaʻi, paʻa ka hana ate,
• Leukopenia, thrombocytopenia, anemia, granulocytopenia,
• ʻO ka ʻeha, ka ʻeha, ka hoʻopuka hele ʻana o ka neuromuscular (a i ka hopu ʻana i ka hanu), ka hoʻomohala ʻana i ka hopena neurotoxic (tingling, keʻaluhi, ka ʻūhā puʻuhū, nā kuʻekahi epileptic).
• ʻO ka hoʻolohe ʻana i nā nalo, nā kuli ʻole hiki ʻole, ke labyrinth a me nā vestibular pilikia,
• Oliguria, microhematuria, proteinuria,
• Nā maʻi kūlou: ka hyperemia ʻili, ʻūlū, ke kuni, ka ʻeha, ka edema o Quincke.

Eia kekahi, me kahi hoʻokele intravenous o Amikacin, e like me nā loiloi, ka hoʻomohala ʻana o ka phlebitis, dermatitis a me periphlebitis, me ka hōʻeha o ka ʻeha ma ka pūnaewele hōʻemi, hiki.

Nā ʻōlelo kikoʻī

Ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono e hoʻoholo i ka nānā ʻana o nā pathogens i koho iā ia.

I ka wā o ka mālama ʻana me Amikacin, ma kahi o hoʻokahi pule, e nānā ʻia nā hana o nā pūpū, kahi ʻāpana vestibular a me ka nerve auditory.

Amikacin lapaʻau ʻole hiki ole i nā huaola B a me C, cephalosporins, penicillins, nitrofurantoin, potassium chloride, erythromycin, hydrochlorothiazide, capreomycin, heparin, amphotericin B.

ʻO ka poʻe maʻi e hoʻomaʻi ana i ka mālama ʻana no nā maʻi maʻi infectious a me ka maʻi o ka urinary tract e pono e inu i nā ʻano o nā likika (i hāʻawi ʻia i nā diuresis kūpono).

Pono e noʻonoʻo i ka hoʻohana lōʻihi ʻana o Amikacin, hiki i ka hoʻomohala ʻana o nā microorganisms kūloko. No laila, i ka loaʻa ʻole o nā dinamika lapaʻau kūpono, pono ia e kāpae i kēia lāʻau lapaʻau a mālama i ka lāʻau kūpono.

Hoʻolālā ʻAmelika ʻAmelika

ʻO nā mea hoʻohālikelike Stractural o Amikacin ʻo Amikacin-Ferein, Amikacin-Vial, Amikacin Sulfate, Amikin, Amikabol, Selemicin, Hemacin.

Ke komo pū ʻana i ka hui pharmacological like a me ka like o ka hoʻopiha ʻana o nā mākana, hiki i kēia mau huaʻōlelo ke hoʻohālikelike ʻia i nā aka o Amikacin: Bramitob, Gentamicin, Kanamycin, Neomycin, Sisomycin, Florimycin sulfate, etc.

Nā kuleana a me nā kūlana e waiho ai

ʻO Amikacin kahi hui B kahi lāʻau lapaʻau i hoʻopau ʻia mai nā lāʻau lapaʻau ma o ka lāʻau lapaʻau. ʻO ka ola o kahi pale he 2 mau makahiki ma muli o ka hoʻokō ʻana i nā rula o ka mālama i mālama ʻia e ka mea hana - ke kauwela 5-25 ºС, kahi maloʻo a me kahi pouli.

Loaʻa kahi hewa i loko o ka kikokikona? Koho ia a kaomi Ctrl + Enter.

E hoʻokuʻu i ke ʻano, ka pūpū a me ka hoʻonohonoho Amikacin

ʻO ke kūpaʻa no ka hoʻolālā intravenous a me intramuscular i ke aniani, ʻaʻohe ʻulaʻula a ʻokoʻa paha ke kala.

Nā mea kūʻai: sodium disulfite (sodium metabisulfite), sodium citrate d / i (sodium citrate pentasesquihydrate), huehu sulfuric diluted, wai d / i.

2 ml - mau pahu pahu aniani (5) - mau pā blister (1) - nā pā o ka papalepa.
2 ml - mau pahu pahu aniani (5) - mau pā blister (2) - nā pā o ka papalepa.
2 ml - mau pahu bele (10) - nā pahu pā (1) - nā kīwaha o nā kāleka.
2 ml - mau pahu hāmole (10) - mau pahu pahu.

ʻO ke kūpaʻa no ka hoʻolālā intravenous a me intramuscular i ke aniani, ʻaʻohe ʻulaʻula a ʻokoʻa paha ke kala.

Nā mea kūʻai: sodium disulfite (sodium metabisulfite), sodium citrate d / i (sodium citrate pentasesquihydrate), huehu sulfuric diluted, wai d / i.

4 ml - mau pahu kīpolo (5) - mau pā blister (1) - nā pā o ka pahu paʻi.
4 ml - mau ʻūpā aniani (5) - nā pahu pā (2) - nā pā kīpē o ke kāleka.
4 ml - mau ʻūpā aniani (10) - nā pahu pā (1) - nā kīwaha o ke kāleka.
4 ml - mau ʻāpana aniani (10) - mau pahu pahu.

ʻO ka pauka no ka hoʻomākaukau ʻana i kahi hopena no ka hoʻokele intravenous a me intramuscular keʻokeʻo o ka ʻulaʻula a i ʻole hoʻi ke keʻokeʻo he hygroscopic.

ʻO nā pahu momona me kahi hiki o 10 ml (1) - nā pahu o ka pahu paʻi.
ʻO nā pahu momona me kahi hiki o 10 ml (5) - nā pahu o ka pahu paʻi.
ʻO nā pahu momona me kahi hiki o 10 ml (10) - nā pahu o ka pahu paʻi.

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Nā kumukūʻai i nā lāʻau lapaʻau ma Moscow

Waiho i kāu manaʻo

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Nā lāʻau lapaʻau ikaika a koʻikoʻi

ʻO nā palapala hōʻoia inoa ʻAikake

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• LSR-002156/09

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• P N003221 / 01

• S-8-242 N008784

• S-8-242 N008266

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ʻOi aku nā mea hoihoi aʻe

Iwai a aie ke dttla.

ʻAʻole ʻae ʻia ka hoʻohana ʻana i nā ʻoihana.

ʻO ka ʻike e hana no nā lāʻau lapaʻau.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

Ma hope o ka hoʻokele intramuscular (IM), ua hoʻopili nui ʻia a holo piha. ʻO ka paonaʻoi loa (Cmax) me ka hoʻokele i / m ma kahi ʻoka o 7.5 mg / kg ʻo 21 μg / ml. ʻO ka manawa e hiki aku ai i ka lōʻihi o ka ʻāʻī nui (TCmax) ma kahi o 1.5 mau hola ma hope o ka hoʻokele i / m. Ke kamaʻilio pū ʻana me nā protein plasma - 4-11%.

Ua hoʻolilo ʻia ia i ka hoʻonaninui (extracellular fluid) (nā kiko o nā abscesses, pleural effusion, ascitic, pericardial, synovial, lymphatic a peritoneal fluid), ʻike ʻia i nā mea kiʻekiʻe o ka uʻai, i ka haʻahaʻa - ma ka bile, ka waiū waiū, ka maʻi hoʻonaninani o ka maka, secretion bronchial, sputum a me spinal cord. waiʻai (CSF). E komo maikaʻi i loko o nā ʻōwili āpau o ke kino kahi e hōʻiliʻili ai i ka intracellularly, ʻike ʻia nā ʻike kiʻekiʻe loa i nā hui me nā hoʻokahe koko maikaʻi: nā māpuna, ka pepeka, myocardium, spleen, a ma nā ʻili, kahi e kohi ai i loko o ke kaila cortical, haʻahaʻa haʻahaʻa - ma nā uaua, ka adipose a me nā iwi . ^ E Ha yM.

I kahi i hoʻohālikelike ʻia i nā ʻōkole therapeutic maʻamau (maʻamau) no nā pākeke, ʻaʻole ke komo ka amikacin i ka hala-koko-lolo (BBB), me ka hoʻoulu ʻana o nā meninges, piʻi nui ka piʻi. I nā keiki hou, ʻike ʻia nā ʻoi aku o nā mea kiʻekiʻe ma ka CSF ma mua o nā pākeke, hele i ka plasenta - aia ia i loko o ke koko o ka pūpū a me ka wai fetio amniotic. Ka helu hāpana i nā pākeke - 0.26 l / kg, i nā keiki - 0.2 - 0.4 l / kg, i nā keiki hou - i nā makahiki he emi mai ka 1 pule. a me ke kaumaha o ke kino ma mua o 1,5 kg - a hiki i 0.68 l / kg, mau makahiki ma mua o 1 pule. a kaupaona kino ma mua o 1,5 kg - a hiki i 0.58 l / kg, i nā mea maʻi me ka cystic fibrosis - 0.3 - 0.39 l / kg. ʻO ka awelika therapeutic koʻikoʻi me ka hoʻokele intravenous a i ʻole intramuscular e mālama nei no nā hola 10-12.

ʻAʻole i hoʻemi ʻia. ʻO ka hapalua-ola (T1 / 2) i nā pākeke he 2 a me 4 mau hola, i nā keiki hou he 5 a 8 mau hola, i nā keiki makua he 2,5 a 4. Aia ka lōʻihi o ka T1 / 2 ma mua o ka 100 mau hola (e hoʻokuʻu mai nā depact intracellular. )

Hoʻokuʻu ʻia ia e nā keiki ma ka kānana glomerular (65 - 94%), nui ʻole i loli. Hoʻololi ʻo Renal - 79-100 ml / min.

Hoʻololi ʻo T1 / 2 i nā pākeke me ka hana ʻole kīnā ʻole ma mua o ka hopena o ka hōʻemi - a hiki i 100 mau hola, i nā mea maʻi me ka cystic fibrosis - 1 - 2 mau hola, i nā mea maʻi me nā kuniahi a me hyperthermia, hiki i ka T1 / 2 ka pōkole ma mua o ka nui ma muli o ka hoʻonui ʻana. . ^ E Ha yM.

Hoʻokuʻu ʻia ia i ka wā hemodialysis (50% i nā hola 4 - 6), ʻoi aku ka maikaʻi o ka dialy peritoneal (25% ma 48 - 72 mau hola).

Lapaʻau lāʻau

ʻO ka Semi-synthetic ākea ākea-spacric antibiotic me ka bactericidal hana.Ma ka mākaʻi ʻana i ka 30unit subunit o ka ribosom, e pale i ka hoʻokumu ʻana o kahi paʻakikī o kahi halihali a me ka mea hoʻouna aku RNA, poloka i ka synthesis o ka protein, a e hoʻopau pū i ka membiosa o ka cytoplasmic.

Ka hana ikaika i ka microorganism aerobic gram-hewa - Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Serratia spp., Providencia spp., Enterobacter spp., Salmonella spp., Shigella spp., Kekahi mau micro-positio microorganism - Staphyloccus spp. (me nā mea kū i ka penicillin, kekahi cephalosporins), hana ikaika e kū'ē i Streptococcus spp.

Me ka hoʻokolohua ʻōwili ʻana me ka benzylpenicillin, loaʻa iā ia kahi hopena synergistic kūʻē Enterococcus faecalis strains.

ʻAʻole pili i ka microorganisms anaerobic.

ʻAʻole i nalowale ka Amikacin hana i lalo o ka hana a nā enzyme e kaohi ʻole i nā aminoglycosides ʻē aʻe, a hiki ke hoʻomau i ka ikaika i nā mana o Pseudomonas aeruginosa e kūpaʻa i ka tobramycin, gentamicin a me ka netilmicin.

Hoʻopili i nā lāʻau lapaʻau

ʻAʻole pono i kūpaʻa ka lāʻau me ka penicillins, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, nā huaora B a me C, a me ka potassium chloride.

Hōʻike i ka synergism i ka wā e launa me ka carbenicillin, benzylpenicillin, cephalosporins (i loko o nā mea maʻi me ka hiki ke hoʻomaluhi ʻole i nā maʻi renal, i hui pū ʻia me nā antibiotika beta-lactam, ka hopena o ka aminoglycosides e emi). ʻO ka hoʻoneʻe ʻana o Nalidixic, polymyxin B, cisplatin a me vancomycin e hoʻonui i ka hōʻeha o ka oto- a me ka nephrotoxicity.

Diuretics (ʻoi aku ka furosemide, acid ethacrylic), cephalosporins, penicillins, sulfonamides a me nā lāʻau anti-inflammatory non-steroidal, hoʻokūkū no ka hana huna ʻana i nā tubules nephron, ālai i ka hoʻopau ʻana o ka aminoglycosides a hoʻonui i ko lākou neʻe ʻana i ka serum koko, e hoʻonui ana nephro- a me ka neurotoxicity.

Hoʻohana ʻole ʻia ka hoʻohana pū kekahi me nā lāʻau ʻē aʻe nephrotoxic a i ʻole nā ​​lāʻau ototoxic no ka hopena kūpono o ka hopena o nā ʻaoʻao.

ʻO ka piʻi ʻana o ka nephrotoxicity i hōʻike ma hope o ka hoʻokele makua makua o ka aminoglycosides a me cephalosporins. ʻO ka hoʻohana pinepine ʻana o cephalosporins e hoʻonui hoʻonui i ka serum creatinine.

Hoʻonui i ka hopena hoʻomaha hoʻomaha o ka lāʻau lapaʻau i nā lāʻau lapaʻau curariform.

ʻO Methoxyflurane, polymyxins makua, capreomycin, a me nā lāʻau lapaʻau ʻē aʻe e ālai ana i ka hoʻoiho ʻana o ka neuromuscular (halogenated hydrocarbons as inhalation anesthetics, opioid analgesics), a me nā nui o ka hoʻokahe koko me nā cerv preservatives e hoʻonui i ka hōʻeha o ka hopu ʻana i ka hanu.

Hoʻonui ka mālama makua i ka maʻi indomethacin i ka hōʻeha o ka hopena o nā hopena o ka aminoglycosides (e hoʻonui i ka hapalua-ola a hoʻemi i ka clearance).

Hoʻemi i ka hopena o nā lāʻau anti-myasthenic.

Aia ka hoʻonui pinepine nui o ka hypocalcemia me ka hoʻopili pū ʻana me aminoglycosides me nā bisphosphonates. ʻO ka hoʻonui nui aʻe o ka nephrotoxicity a hiki i ka ototoxicity ka mea me ke ka hui pū ʻana o ka aminoglycosides me nā papa o ka platinum.

Me ka hoʻokolohua pinepine ʻana o ka thiamine (huaʻai B1), hiki ke hoʻopau ʻia ka mea hoʻohui o ka sodium bisulfite i ke ʻano amikacin sulfate.

E hoʻokuʻu i ke ʻano a me ka pale

500 mg o ka waiwai ikaika i loko o nā pahu kuhi i hoʻopaʻa ʻia me nā ʻōpala, i hoʻopili ʻia me nā pale konumona a hoʻopili ʻia nā ʻōpiʻi "FLIPP OFF".

Hoʻopili ʻia kahi pahu i hana ʻia i ka pepa a i kākau ʻia paha i kēlā me kēia poli, a i ʻole ke kahili i kahi kāpili ponoi.

ʻO kēlā me kēia bili, me nā kauoha i ʻae ʻia no ka hoʻohana ʻana i nā lāʻau lapaʻau ma ka mokuʻāina a me nā ʻōlelo Lūkia, e kau ʻia ana i loko o kahi kīʻaha pepa.

Nā ʻōmole o ka lāʻau ʻAmelika

Nā maʻi hōʻeha a me nā maʻi nā ʻia o nā microorganisms gram-hewa (kū i ka gentamicin, sisomycin a me kanamycin) a i nā hui ʻana o nā microorganisms gram-maikaʻi a me ka gram-negative:

• ʻeha o nā ʻōpū hanu (bronchitis, pneumonia, empyema pleural, ʻōpū o ka pūpū),
• sepsis
• Endoʻoliki septic,
• Nā maʻi CNS (me ka meningitis),
• nā maʻi āpau o ka ʻōpū ʻeha (me ka peritonitis),
• nā maʻi urinary tract (pyelonephritis, cystitis, urethritis),
• nā maʻi maʻemaʻe o ka ʻili a me nā umulepa palepa (komo i ke ʻano o ka puhi ʻana, nā ʻōpū maʻi maʻi a me nā ʻōkuhi o ke ʻano o nā kumu ʻano mua),
• hopu i ka maʻi kikoʻeha
• nā hopena o nā iwi a me nā ʻuʻuku (me ka osteomyelitis),
• maʻi ʻeha
• maʻi maʻi postoperative.

Ka hoʻoponopono ʻia ʻana

Hoʻohana ʻia ka lāʻau lapaʻau i ka intramuscularly, intravenously (i loko o kahi pahu, no 2 mau minuke a he drip) paha no nā pākeke a me nā keiki ma mua o 6 mau makahiki - 5 mg / kg i kēlā mau hola 8 a i ʻole 7.5 mg / kg i kēlā me kēia mau hola 12. Ma ka hihia o ka maʻi bacterial o ka urinary tract ( uncomplicated) - 250 mg i kēlā me kēia mau hola 12, ma hope o ka hālāwai hemodialysis, hiki ke kuhikuhi ʻia he ʻai hou aʻe o 3-5 mg / kg.

ʻO ka palena loa no nā pākeke he 15 mg / kg / lā, akā ʻaʻole iʻoi aku ma mua o 1.5 g / lā no 10 lā. ʻO ka lōʻihi o ka mālamaʻana me kahi / i ka hoʻomakaʻana he 3-7 mau lā, me kahi / m - 7-10 lā.

No nā pēpē mua ma mua, ʻo ka nui o ka pā kau mua hoʻokahi he 10 mg / kg, a laila 7.5 mg / kg i kēlā me nā hola 18-24, no nā pēpē hou a me nā keiki ma lalo o ke ʻano he 6, ʻo ka hopena mua he 10 mg / kg, a laila 7.5 mg / kg i kēlā me kēia 12 h no 7-10 lā.

I nā pūahi puhi i hoʻoulu ʻia, e pono ke koi i kahi maʻi o 5-7.5 mg / kg i kēlā me kēia mau hola 4-6 ma muli o ka nui o ka manawa T 1/2 (1-1,5 hola) i kēia mau maʻi o nā maʻi.

I loko o / i ka amikacin e mālama ʻia ana i mau minuke no 30-60 mau minuke inā pono, na ka jet.

No ka lōnaehana iv (drip), inu mua ka lāʻau i ka 200 ml o ka hopena o 5% dextrose (glucose) a i ʻole he 0.9% hopena o ka sodium chloride. Pono ka ʻike o ka amikacin i ka hopena no ka hoʻomake ʻana ʻo iv no ka 5 mg / ml.

I ka hihia o ka hana renal excretory hana, he hōʻemi hōʻaiʻē a hoʻonui paha paha i waena o nā lawelawe pono. Ma ka hihia o ka hoʻonui i waena o nā ʻoihana (inā ʻike ʻole ʻia ka waiwai QC, a paʻa ka ʻano o ka mea maʻi), ʻo ke kikowaena waena o ka lawelawe ʻana i ka lāʻau lapaʻau ʻia ua hoʻokumu ʻia e kēia ʻatikala penei:

huina (h) = serum creatinine concentration × 9.

Inā makemake ʻia ka lawelawe ʻana o ka serum creatinine he 2 mg / dl, a laila e lawelawe ʻia i hoʻokahi manawa i ʻōlelo ʻia (7.5 mg / kg) i kēlā me kēia hola 18. Me ka piʻi ʻana o ka manawa, ʻaʻole e loli ʻia ka pākahi.

Ma ke kaʻina o ka emi ʻana o kahi pā i hoʻokahi me ka regimen doli ʻole i loli, ʻo ka ʻaina mua no ka poʻe maʻi me ka renal ka hopena o ka 7.5 mg / kg. Kuhi ʻia ka ʻike ʻana o nā pilala e like me kēia ʻano iho.

ʻO ka dosis hou (mg), lawelawe ʻia i kēlā me kēia mau hola 12 = KK (ml / min) i ka mea maʻi ma ka maʻi mua (mg) / KK ka maʻi maʻamau (ml / min).

Loaʻa ka hopena

Mai ka pūnaehana hana ʻana: ka nausea, luaʻi, hana i ka hana ate (hoʻonui i ka hana o ka transaminases hepatic, hyperbilirubinemia).

Mai ka pūnaehana hemopoietic: anemia, leukopenia, granulocytopenia, thrombocytopenia.

Mai ka ʻaoʻao o ka pūnaehana kaila ma waena o ka pūnaehana neʻe o ka peripheral: hopohopo, hōʻeha, neurotoxic hopena (hoʻowalewale i ka naʻau, ʻuhuhi, puʻupuʻu, hoʻoluhi epileptic), hoʻopuka i ka neʻe ʻana o ka neuromuscular (hopu i ka hanu).

Mai nā naʻau sensory: ototoxicity (ke hoʻolohe lohe, vestibular a me labyrinth disorders, maʻi ʻole e hoʻohuli), nā hopena ʻona i ka vestibular apparatus (discoordination of movement, dizziness, nausea, utuka).

Mai ka urinary system: nephrotoxicity - nā hana pono ʻole o ka pūmaʻa (oliguria, proteinuria, microhematuria).

He maʻi kūlohelohe: ʻāwili i ka ʻili, ʻeha, ka holo ʻana o ka ʻili, ke kuni, ka edema o Quincke.

Nā kūloko kūloko: ʻeha ma ka wahi ʻoi, dermatitis, phlebitis a me periphlebitis (me ka hoʻomehana iv).

ʻŌpū a me ka lactation

Hoʻokomo ʻia ka lāʻau lapaʻau ma ka wā hāpai.

Ma ke alo o nā hōʻailona koʻikoʻi, hiki ke hoʻohana i ka lāʻau lapaʻau ma ka lactating wahine. Pono e noʻonoʻo ʻia e hoʻopili ʻia nā aminoglycosides i loko o ka umauma umauma i nā liʻiliʻi liʻiliʻi. ʻAno lākou i ka hoʻopono mai ka gastrointestinal tract, a me nā hoʻopiʻi e pili ana i nā pēpē.

Hoʻohui nūhou

Hōʻike i ka synergism i ka wā e launa me ka carbenicillin, benzylpenicillin, cephalosporins (i loko o nā mea maʻi me ka hiki ke hoʻomaluhi ʻole i nā maʻi renal, i hui pū ʻia me nā antibiotika beta-lactam, ka hopena o ka aminoglycosides e emi).

ʻO ka hoʻoneʻe ʻana o Nalidixic, polymyxin B, cisplatin a me vancomycin e hoʻonui i ka hōʻeha o ka oto- a me ka nephrotoxicity.

Diuretics (ʻoi aku ka furosemide), cephalosporins, penicillins, sulfanilamides a me NSAIDs, e hoʻokūkū ana no ka ʻimi huna ʻana i nā tubula o nā nephron, ālai i ka hoʻopau ʻana o nā aminoglycosides, hoʻonui i kā lākou kao i loko o ka serum o ke koko, e hoʻonui ana nephro- a me ka neurotoxicity.

Hoʻoulu ʻo Amikacin i ka hopena hoʻomaha hoʻomaha o ka lāʻau ma nā lāʻau lapaʻau curariform.

Inā hoʻohana ʻia me amikacin, methoxyflurane, polymyxins makua, capreomycin a me nā lāʻau ʻē aʻe e ālai ana i ka hoʻoiho ʻana o ka neuromuscular transmission (halogenated hydrocarbons - inhalation anesthesia, opioid analgesics), he nui nui o ke kahe koko me ka cerv preservatives e hoʻonui i ka hōʻeha o ka hopu ʻana i ke ea.

Hoʻonui ka mālama makua i ka maʻi indomethacin i ka hōʻeha o ka hopena o nā hopena o ka aminoglycosides (e hoʻonui i ka T 1/2 a i ka hoʻemi ʻana i ka hoʻomaʻemaʻe).

Hoʻopau ʻo Amikacin i ka hopena o nā lāʻau anti-myasthenic.

ʻAʻole pono i kūpaʻa ka lāʻau me ka penicillins, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, nā huaora B a me C, a me ka potassium chloride.