Antibiotic "zyvox": tilmaamaha loo isticmaalo, analogs

In daaweynta dhakhtarka cudurada bakteeriyada sida caadiga ah kuu qori antibiotics. daawooyinka waxay leeyihiin tiro badan oo kala duwan. Dabcan, dhammaan noocyada kala duwan ee wax soo saarka dawooyinka aalkolada waa wax aan macquul aheyn in la ogaado, laakiin qaar ka mid ah daawooyinka cudurada bakteeriyada waxaa ka mid ah xiiso gaar ah.

Mid ka mid ah antibiotics casriga ah, kaas oo la soo bandhigay ee suuqa daawooyinka our - waa "zyvox". Tilmaamaha isticmaalka daroogada waxay muujinaysaa in this wakiilka antimicrobial asal dardaro. Waxaa iska leh koox gaar ah - oxazolidinone. The qayb weyn ee firfircoon yahay linezolid. saamaynta daroogada "zyvox" ah, tilmaamaha loo isticmaalo, analogs, waxyeelo iyo sababo: Next aannu macluumaadka soo socda waxaa loo tixgelin doonaa.

In waxa foomka la soo saaray?

daroogada waxaa laga heli karaa laba nooc qiyaasta:

• In foomka of dhagaxyada ah, la caseeyey caddaan ama hurdi in color iyo dhadhan orange. Kuwaas oo kala ah, pereoralnogo xal loogu isticmaalo ee rajaynaya in a in 5ml of ganaax ku dhameysatay kaalinta waxaa ku jiri doona 100 mg ah linezolid. dhagaxyada ah ayaa la dhigay in awoodda ka mid ah 150 ml oo gurguurta. Sidoo kale in xirmo waxay leedahay qaaddo wax lagu qiyaaso oo la qalin jabinta (2.5 iyo 5 ml of ganaax).
• In foomka of kiniin ka kooban 600 mg ah linezolid. xirmo waxay leedahay khariidad 10 kiniin gudaha.
• xal faleebo ku jirto 2 linezolid mg / 1 ml, baakadaha ah 100, 200, 300 ml.

Waa maxay saamaynta pharmacological sida daroogada?

linezolid walax firfircoon uu awood u leeyahay in ay dhex gasho galay gacanta bakteeriyada, inay xidhxidhaan si ribosomes iyo joogsada in Avv borotiinka. Sidaas darteed, sheyga waa la dilay.

Against sheyga wax caawiyaa daroogada?

Drug "zyvox" diiwaanka taas oo uu weheliyo xirmo kasta daawo ah oo wax ku ool ah u dhaqmo on the sheyga soo socda:

• bakteeriyada laylinta Gram-positive: Enterococcus, Corynebacterium, Staphylococcus, Streptococcus;
• bakteeriyada laylinta ee Pasteurella panulirus ku Gram-negative,
• Gram-positive bakteeriyada anaerobic: Clostridium iyo peptostreptokokki;
• Gram-negative bakteeriyada anaerobic of prevotella genera ah, bakteroides, chlamydia.

Si linezolid bakteeriyada si dhexdhexaad ah u nugul ee genera ku Moraxella, Legionella, Mycoplasma.

Waxaa sidoo kale jira sheyga oo muujiyaan caabiga linezolid, qayb ka mid ah "zyvox" daroogada. Tilmaamaha loogu isticmaalo tilmaamaya soo socda nooc u adkaysta of: bakteeriyada Haemophilus, iyo sidoo kale enterobakteriatsea gaarsiinta, nizera iyo Pseudomonas.

In waxa cudurada waxaa lagu muujiyay daawada?

Antibiotic "zyvox" waxaa loo xilsaaray ee cudurada soo socda:

• cudurrada faafa iyo bararka in waxa keena bakteeriya ama in u nugul yihiin daroogada siiyey.
• Xaaladaha of pneumonia nosocomial ama bulshada helay.
• Iyada oo lesions faafa ee maqaarka iyo unugyada jilicsan ee jidhka bini'aadamka.
• In jiritaanka cudurro, wakiilada kuwaas oo enterococci soo bandhigista caabiga vancomycin.

Sidoo kale, "zyvox" antibiotic loo isticmaali karaa sida qayb ka mid ah nooc ka mid ah isku darka of therapy cudurada timi bakteeriyada in garaam-negative sabab.

pharmacokinetics

Linezolid waxa lagu gartaa absorbability si caddaalad ah oo degdeg ah ka marinka dheef shiidka marinada dhiigga, iyadoo aan loo eegin qaab wakiilka sii daayo. Horeba 2 saacadood ka dib markii maamulka ee daroogada ka dib, ay fiirsashada ee plasma gaaro ugu badnaan. Linezolid waxa lagu gartaa bioavailability buuxda oo si deg deg ah waa in ay qaybinta ee xubnaha iyo unugyada. Wax kasta oo fiirsashada of antibiotic in dhiig 31% ay ku xidhan tahay borotiinada plasma.

In aadanaha, linezolid la metabolized by qayilo in labada wax soo saarka taas oo aan haysan tallaabo antimicrobial. Waxay yihiin saxarrada kelyaha (ku dhowaad 50%) iyo mindhicirrada ah (ilaa 6%). Ilaa 35% antibiotics non-metabolized raaca kaadida.

Calaameeyay pharmacokinetics deggan, taas oo ah waxa lagu gartaa daroogada "zyvox" ah. Tilmaamaha loogu isticmaalo ku xiran la'aanta ah ee baaritaanka daroogada da'da bukaanka. Sidaa darteed, dadka waayeelka ah uma baahna qabsashada ee qiyaasta of sheyga dawooyinka.

qiyaasta

"Zyvox" medicament waxaa laga yaabaa in loo xilsaaro inuu dhakhtar bukaanka ah ee maamulka afka ama qaab maamulka galiyey xididka. Waxaa intaa dheer, bukaanka loo gudbin karaa mid ka mid ah noocyada si qofku cuno kale oo aan laga badinin waxtarka daawada.

qiyaasta daawada, muddada koorsada u xil doonaa dhakhtarka, iyo daweynta xaaladahan waxaa sababa arrimaha soo socda:

• nooca bakteeriyada waxaa sabab u ahaa cudurka;
• cudurka goosgoos ah;
• darnaanta cudurka;
• lacagta caafimaad oo ka therapy.

Marka Streptococcus pneumonia, bulshada-helay iyo nooca isbitaalka-in dadka waaweyn iyo carruurta ka weyn 12 sano qoray 600 mg ah "zyvox" daroogada. Buugga muujinaysaa in qaadashada qiyaas daawo waa in la fuliyey 12 saacadood ee kasta iyo muddada koorsada waa 10-14 maalmood.

Waayo, cudurada maqaarka ama unugyada jilicsan, adag ama aan xumayn sababa ✰Malax mid, streptococci iyo enterococci adkaysi u vancomycin, oo ay ku jiraan macaanka syndrome cagta (aan osteomyelitis) xilsaaray dose "zyvox" 600 mg. Waxbarashada ayaa sidoo kale soo jeedisay in bareeg u dhexeeya qaadashada daawada waa in ay 12 saacadood. koorsada daawada socdaa 10-14 maalmood, laakiin kor socon karaa 28 maalmood on qoro caafimaad.

Haddii bukaanku leeyahay dhantaalan kelyaha, sixitaanka dose of dawada uu u baahan yahay. In nidaamka kelyaha linezolid laga saaro muddo waqti 3 h a. In xidhiidh la leh this, daroogada waa in la qaato ka dib markii ay dhacdo on isdaahirinta dhiigga. Bukaanka ayaa laga helay beerka, iyo uma baahna qabsashada ee qiyaasta.

Bukaan-socodka da'doodu ka yar tahay 12 sano jir waxa lagu qoray oo kaliya in ay qaab galiyey daroogada "zyvox" ah. Waxbarashada si loogu isticmaalo dhallaanka iyo carruurta waxay muujinaysaa in linezolid laga qaadi in qiyaasta a of 10 mg / kg miisaankiisa jirka ee ilmaha at inta jeer ah 8 saacadood kasta. koorsada daawada waa laga bilaabo 10 ilaa 14 maalmood. Tani qiyaasta of daroogada si uu daawada jirka la mariyo ee bulshada-helay iyo nosocomial pneumonia, cudurada unugyada jilicsan, iyo maqaarka, iyo sidoo kale in la infekshanada enterococcal ka qabtaan.

galkeeda Protective of-bireed sameeyey, laga saaro isla markiiba ka hor habka galiyey. Waxaa lagama maarmaan ah si loo hubiyo xirmada daadanaayo waxaa Tuujiya 1 daqiiqo. Baakadaha Asia istimaalaynin sabab u non-dhalaysnimo. xal galiyey waxaa maamula muddo waqti ah 30-120 daqiiqo ah.

Features of codsiga

Waxaa jira qaar ka mid ah soo dhoweynta muuqaalada "zyvox" daroogada. Buugga muujinaysaa in haddii cudurka ay keento bakteeriyada loo Gram-negative, waxaa lagama maarmaan ah in ay ku xidhmaan daawooyin dheeraad ah hawlaha ka dhanka ah kooxdan oo ah sheyga.

Marka la helo linezolid bukaanka qaarkood laga yaabaa inuu dhaco myelosuppression karo. Iyada oo ku xidhan muddada daawaynta lagu gartaa dhiig, leukopenia, Torombositobiiniya ama pancytopenia. Saldhiga macluumaadkan, la socodka dambi oo dhiig waa in la sameeyaa in bukaanka qaba halista ah ee dhiig-bax. Sidoo kale, qiyaastaas oo ku haboon yihiin haddii bukaanku lahaa taariikh myelosuppression ama uu qaato daawo yareeyo heerarka haemoglobin iyo platelets ama waxqabad. Qiimaynta dhiig dacwadood ayaa sidoo kale loo baahan yahay inta lagu jiro muddada daawaynta dheer (14 maalmood).

Bukaanjiifka qaar ayaa qaata linezopida ay wehlin karaan halista ah ee colitis, pseudomembranous dabiiciga ah ee noocyada kala duwan ee cuf.

Shuban waa wax caadi ah in dadka qaadanaya antibiotics si joogto ah. Baaxadda ay leedahay kooxda this saameyn kala duwanaan karaa ka fudud si ay u daran. Iyadoo qaadashada daroogada, "zyvox" pill ama ganaax ku jiro, waa xakamaynta ee microflora xiidmaha ee caadiga ah iyo juqda bakteeriyada ee panulirus ku Clostridium. In geeddi-socodka ah ee ay nolosha u shaqeeyo this saarta sunta A iyo kooxaha B, iyo waxay keeni shuban. Heerarka sare ee qaybaha u noqon karaan dilaa ah dadka bukaanka ah. Dhammaan bukaanka soo maray noocan ah shuban, u baahan kormeer caafimaad taxadir muddo 2 bilood ah.

Xaaladaha qaarkood, xumaatay in daaweyn jiray daroogada "zyvox". Tilmaamaha loogu isticmaalo carruurta iyo dadka waaweyn, taasoo muujinaysa isbedel suurto gal ah in aragtida midabka, muuqaal focus, cilladaha beerta, isku darsamay. Xaaladahan, bukaanka waa in isla markiiba la tasho dhakhtarkaaga indhaha. Haddii dawadan loo qaato by bukaanka muddo dheer (ka badan 3 bilood), markaas waa waajib in la sameeyo gacanta ugu. At dhacdo iyo horumarka ka mid ah dhacdooyinka sida neuropathy ugu sarreeya ama dareemaha optic, su'aasha ah ee joojinta daaweynta daroogada haddii faa'iidooyinka ka yar tahay burburka lagu sameeyey caafimaadka.

Sidoo kale, waxaa jiray kiisas aysiidh jėrto inta aad qaadanaysid "zyvox". Waxaa muuqato qaab lallabo, matag, aysiidh ama hoos u ahayn of anions carbonate. Tani waxay ifafaale waa in si taxadir leh loo socdo takhasus caafimaad.

Haddii bukaanka u baahan yahay in lala ah "zyvox" qaadashada reuptake inhibitors serotonin xushay, waa in la qaaday iyada oo ay kormeerayaan caafimaad si ay u ogaan serotonin syndrome: failure ah function garashada, hyperreflexia, hyperpyrexia, iyo incoordination. In ay joogaan ka mid ah ifafaale ku tilmaamay soo saaray joojiyo mid ama labada daroogada. Haddaba waxaa jira midab of dhaldhalaalka iliga, kaas oo laga saaray by nadiifinta xirfadeed.

Waxaa jira digtoonyey kale si ay u helaan "zyvox" daroogada. Tilmaamaha loogu isticmaalo (kiniin ama dhagaxyada ah la joojiyo - ma ahan) dhigayaa in: daaweynta la linezolid laguma talinayo baabuur wadidda, maamulka qalab gaar ah iyo hawlaha ku lug leh halis nolosha iyo caafimaadka.

Waa maxay saamaynta dhinaca of daroogada?

dhibaato taas oo dhici kara in bukaanka ah inta aad qaadanaysid of wakiilka dawooyinka "zyvox 600 mg" lagu tilmaamay inay by jiritaanka inta jeer ka aad si joogto ah (10%) in aad dhif u ah (0.01%).

Caadi ahaan, dhibaatooyinka soo raaca ee daaweynta ee daroogada tilmaamaha "zyvox" loo isticmaalo, xal this ama kiniin, ifafaale u yeedhay darnaanta fudud ama dhexdhexaad ah. heerka gaarka ah uu leeyahay sifooyin soo socda:

• lalabo,
• shuban;
• madax xanuun.

In bukaanada qaangaarka ah ayaa sidoo kale la kulmi karaan calool, matag, xanuunka caloosha, dibiro, iyo cudur vulvovaginal ee saabka afka.

By dhif dhaca waxyeelo daroogada tilmaamaha "zyvox" loo isticmaalo (ee carruurta kor ku xusan 12 sano iyo dadka waaweyn) oo ku baaqay in isbedel ah ee midabka ah ee afka midabka.

Iyada oo ku saleysan cilmiga shaybaarka, waxaa lagu murmi karaa in inta lagu jiro daaweynta leh antibiotic this waxaa badanaa loo ogaado Torombositobiiniya. Aan si joogto ah lagu arkay korodhka heerka dhiigga triglycerides, dardargelinta aan caadi ahayn oo ku dhaca beerka ensaymes ALT, AST, phosphatase xumadoodu, LDH iyo lipase iyo amylase. korodhka fiirsashada of bilirubin total, creatine iyo prolactin sidoo kale la duubay.

habka dareemayaasha jirka bukaanka waxaa laga yaabaa in ay fal daroogada la linezolid. Tan waxaa badanaa ka muujiyay in vertigo iyo jaf, iyo sidoo kale casiraad. daliilka kuwaas ka yar ee waxyeelo daroogada jira kiisas dhadhamin qasnaan.

Isbeddelka ku hawlaha caadiga ah ee habka dhexe ee neerfayaasha waxay keeni kartaa "zyvox" (kiniin). Guide muujinaysaa hurdo la'aan iska caadi in bukaanka inta lagu guda jiro daawaynta this diyaarinta dawooyinka.

Hawlgalka ayaa ka mid ah daaweynta nidaamka genitourinary isticmaalaya "zyvox" laga arki karo oo ah qaab candidiasis siilka.

Inta badan waxaa jira iyo cutaneous daliilka daaweynta linezolid qaab finanka.

Ka mid ah waxyeelo kale oo la odhan karaa ifafaale xummada iyo caabuq fangas fursad, taasoo qabsiyada dhacdaa.

Sidoo kale, markii daroogada "zyvox" daraasad lagu arkay kiis oo cadaadis dhiig oo sareeya, cuncun saxarada iyo.

Linezolid lagu daaweeyo bukaanka tobaneeyo ay da'doodu u dhaxayso 12 ilaa 17 sano, inta badan ka helay saamaynta soo socda aan loo baahnayn:

• shuban, matag, yalaalugo, calool xanuun,
• vertigo, xanuunka dhanjafka,
• finan;
• cudurrada faafa marinnada hawada, qufac, cune xanuun sare;
• qandho,
• xanuun in ay adag tahay in lagu qeexo deegaamaynta ah.

The ifafaale soo socda dhici sidoo kale lagu gartaa karo by inta jeer ee hoose:

• eosinophilia;
• kordhiyo triglycerides, ALT, lipase iyo creatine;
• cuncun.

waxyeelo dheeraad ah ayaa la soo helo inta uu daraasad kiliinikada, taas oo ah waxa lagu gartaa "zyvox" (xalka, iyo murriyado). Kuwaas waxaa ka mid ah:

• myelosuppression karo;
• neuropathy ee dareemaha iftiinka;
• anaphylaxis;
• qof bararka angioneurotic;
• aysiidh jėrto;
• qof neuropathy durugsan;
• midab of dhaldhalaalka iliga;
• qarqaryo,
• daal,
• serotonin syndrome.

Sida "zyvox" waxaa lala qaato daawooyin kale?

Markii wada-maamusho la cytochrome isbedel lahayn ayaa lagu arkay waxqabad ee la soo dhaafay.

Haddii waqti isku mid ah loola dhaqmo si linezolid iyo oxidase monoamine inhibitors, saamaynta danbe la wanaajiyey. Iyada oo ku saleysan xaqiiqda this, waxaa lagama maarmaan ah si loo yareeyo qiyaasta of agonister iyo Dofaminomimetiki.

Markii wada-maamusho daroogada "zyvox" iyo murugada oo la xakameeyo qaadashada ee serotonin, serotonin syndrome laga yaabaa inuu dhaco.

In the case of co-maamulka leh "aztreonam" ama "Gentamycin" farmakinetika linezolid aan la arkay.

Co-maamulka leh "Rifampicin" lug ku hoos makismalnaya ka fiirsashada "zyvox" - ilaa 32%.

sababo

Daawada aan la aqbali karin si ay u isticmaalaan dadka qaba dareenka korodhay in qaybaha ugu muhiimsan ama dheeraad ah gudaheeda dhismeedkooda.

Haddii bukaanka qaadataa phenelzine ama isocarboxazid, linezolid ka dibna waxa aan la qaadan karo inta lagu jiro daaweynta ah, iyo 2 toddobaad ka dib.

Haddii aan xakamayn karto cadaadiska dhiigga, ee "zyvox" aan la aqbali karin in lagu daweeyo bukaanka qaba cudurada soo socda:

• hypertension deganayn,
• tayroodh;
• pheochromocytoma;
• iyo sidoo kale soo dhoweynta si wadajir ah la agonister iyo Dofaminomimetiki.

At adagtahay in daawashada taxadir bukaanka halista ah ee serotonin syndrome "zyvox" laguma qori karaa xaaladahan soo socda:

• joogitaanka cudurka carcinoid;
• Maamulka daroogooyinka oo la xakameeyo reuptake ee serotonin, triptans murugada tricyclic noocyada "Miperedina" iyo "buspirone".

foomka Tablet "zyvox" waa u in carruurta ka yar 12 sano, sababtoo ah ee ay adagtahay ee doorashada ee qiyaasta ku filan.

Daawada waxaa lagu tilmaamay loogu daweeyo marka faa'iidooyinka la filayo ka badan halista in arrimaha soo socda:

• kaafi kelyaha iyo cagaarshowga,
• cudurada systemic;
• Uurka iyo nuujinta.

waxay noqon kartaa badinta daroogada ah?

In waxbarashada clinical, iyo sidoo kale isticmaalka sii diyaarinta "zyvox" ee isbitaalka ama badinta codsiga bulshada-urursaday lama ogaan karo. Marka ay taasi dhacdo waxaa lagu talinayaa therapy astaamaha.

Kaydinta iyo sii daayo

Drug "zyvox" heli karaa farmasiyada by qoro. Sii wad waa meel, xadiday qoyaan iyo qorraxdu si toos ah heerkulka ma ka badan 30˚C, inay xaddido helitaanka carruurta.

analogs

In the case of unacceptability daaweynta "zyvox" analogs of tixgelin la mid ah waxaa laga yaabaa in loo xilsaaray in ay saameynta ugu weyn ee daaweynta oo ah walaxda firfircoon:

• Marka pneumonia iyo boronkiitada - "hydrochloride Doxycycline" "Bronhorus" "Arlette".
• Marka caabuqyada bakteialnyh - "Chloramphenicol 0,25 g", "Vankomabol", "Lifakson".
• Iyadoo cudurada maqaarka - "Benzathine benzylpenicillin", "Sulfadimetoksin".
• Marka nonhealing nabarrada - "Tsifaleksina sodium cusbo", "Liphuzol".

Si ay iyaga ugu qori in liiskan waa dhakhtar oo kaliya, maxaa yeelay, daawo kasta waxay leedahay tilmaamo, sababo, iyo gaar ahaan soo dhaweynta.