Cov lus qhia rau kev siv "Ceftriaxone" rau mob ntsws thiab lwm yam kab mob qhia tau hais tias nws cov kab mob bactericidal yog ua tiav los ntawm inhibiting cov synthesis ntawm cov kab mob ntawm cov phab ntsa ntawm tes (gram-negative aerobic thiab anaerobic, gram-positive aerobic microorganisms). Raws li kev kuaj mob, kev ua haujlwm tau raug tsim los tawm tsam feem ntau ntawm cov kab mob hauv qab no:
- citrobacter freundi;
- Kev;
- salmonella;
- streptococci;
- shigella;
- genus Bacteroids thiab lwm yam.
Raws li cov lus qhia rau kev siv "Ceftriaxone", methicillin-resistant staphylococci yog insensitive rau cov tshuaj, nrog rau lwm yam cephalosporins. Streptococci gr. kuj tiv taus cov tshuaj tua kab mob no. D, as well as enterococci (xws li E. faecalis).
Pharmacokinetics ntawm cov tshuaj
"Ceftriaxone" thaum muab tshuaj intramuscularly yog sai sai thiab tag nrho absorbed rau hauv cov hlab ntsha, nkag mus rau hauv cov ntaub so ntswg, kabmob thiab lub cev kua. Yog muaj kab mob meningealzoo nkag mus rau hauv cerebrospinal kua. Lub bioavailability ntawm cov tshuaj rau kev txhaj tshuaj intramuscular yog 100%. Hauv cov neeg laus, hauv 2 hnub, 50-60% ntawm "Ceftriaxone" raug tshem tawm tsis hloov pauv los ntawm cov zis, li 40-50% mus rau cov hnyuv ua ib feem ntawm cov kua tsib, qhov uas nws hloov mus rau hauv cov khoom lag luam metabolic tsis muaj zog. Hauv cov menyuam yug tshiab, kwv yees li 70% ntawm cov tshuaj tau tawm hauv cov zis.
Ib daim foos
Tso tawm rau hauv daim ntawv ntawm cov hmoov rau diluting cov kev daws teeb meem uas tau muab tso rau hauv cov hlab ntsha (kwj lossis drip) thiab intramuscularly hauv ntau qhov koob tshuaj: 0.5 grams; 1 g yog'; 2g ua. Ceftriaxone tsis muaj nyob rau hauv cov ntsiav tshuaj.
Cov lus qhia rau kev siv
Kab mob nrog cov kab mob cephalosporin-susceptible. Hauv qab no yog cov npe qhia rau Ceftriaxone:
- kis kab mob hauv plab, kab mob hauv plab, peritonitis, mob purulent cholecystitis;
- mob ntawm cov kab mob ua pa (pneumonia, ntsws abscess, purulent pleurisy, thiab lwm yam);
- kis kab mob ntawm lub cev pob txha thiab pob qij txha;
- qhov txhab ntawm daim tawv nqaij thiab cov ntaub so ntswg;
- purulent qhov txhab thiab kub hnyiab;
- endocarditis;
- meningitis;
- mob ntawm cov zis (piv txwv li, pyelonephritis);
- sepsis;
- salmonellosis thiab carriage ntawm salmonella;
- typhoid;
- tick-borne borreliosis (Lyme disease);
- syphilis;
- chancroid;
- gonorrhea;
- kab mob sib kis hauv cov neeg mob immunocompromised;
- tiv thaiv kab mob tom qab phais.
Nov yog ib daim ntawv me me ntawm Ceftriaxone pab nrog. Cov cuab yeej muaj ntau qhov kev ua haujlwm thiab siv rau ntau yam kab mob.
YContraindications
Feem ntau, cov tshuaj tau txais txiaj ntsig zoo los ntawm lub cev. Nrog nws cov kev taw qhia nrog cov kev mob tshwm sim, cov neeg mob tsis tshua muaj. Tab sis tseem muaj cov xwm txheej uas yuav tsum tsis txhob siv cov tshuaj, vim nws muaj peev xwm ua rau muaj kev phom sij rau lub cev. Nws yog nruj me ntsis txwv tsis pub siv cov tshuaj nyob rau hauv cov ntaub ntawv ntawm hypersensitivity rau ib qho ntawm nws cov khoom xyaw. Ib qho tseem ceeb contraindication yuav yog mob hnyav nyob rau hauv cov kab mob ntawm lub raum thiab lub siab. Cov tshuaj tsis raug sau tseg hauv thawj peb lub hlis twg rau cov poj niam hauv txoj haujlwm. Cov tshuaj Ceftriaxone tsis yog siv thaum pub niam mis, vim nws muaj ntau nyob rau hauv cov mis nyuj, uas yuav cuam tshuam rau tus menyuam tus mob. Nrog rau kev ceev faj ntxiv, cov tshuaj tau muab rau cov menyuam yaus uas muaj tus kab mob jaundice, cov neeg mob uas muaj kab mob hauv plab hnyuv, nrog rau enteritis thiab colitis.
Side effects
Cov lus qhia rau kev siv "Ceftriaxone" hais tias thaum siv cov tshuaj no ob leeg txhaj tshuaj thiab intramuscularly, tus kws kho mob tuaj yeem ua rau muaj kev phiv. Lub plab zom mov tuaj yeem teb rau kev noj cov nyiaj. Tom qab kev qhia txog cov tshuaj, daim tawv nqaij thiab sclera yuav kis tau cov xim daj.
Cov neeg mob tau ntsib qhov mob ntawm txoj hnyuv loj. Cov menyuam yaus yws yws ntawm kev chim siab lossis mob plab. Feem ntau cov neeg mob tom qabKev siv tshuaj ceeb toom kev ua xua tshwm sim: o, khaus khaus, liab, khaus, pob khaus.
Kev mob ntshav qab zib thiab anaphylactic shock tshwm sim. Nrog rau kev qhia txog cov tshuaj intravenously los yog hauv zos, qhov kub thiab txias yuav nce, lub xeev febrile yuav tshwm sim, nrog rau txias, tsis meej pem, ntxhov siab vim. Xuab zeb tuaj yeem tsim muaj zog hauv lub raum, thiab cov ntsiab lus ntawm eosinophils hauv cov ntshav tuaj yeem nce ntxiv.
Thaum siv cov tshuaj tso rau hauv cov hlab ntsha lossis intramuscularly, nws yog txwv tsis pub haus cawv, vim tias ethanol tuaj yeem ua rau muaj zog hauv plab hnyuv, ua rau muaj ntshav siab sai.
Yuav txhaj Ceftriaxone pes tsawg hnub rau kev mob ntsws thiab lwm yam kab mob?
Cov neeg mob hnub nyoog tshaj 12 xyoos tau muab tshuaj noj 1-2 g / hnub lossis 0.5-1 g txhua kaum ob teev. Qhov siab tshaj plaws ntawm 4 g ntawm cov tshuaj yog noj ib hnub. Cov me nyuam hnyav 50 kilograms los yog ntau dua siv cov neeg laus noj.
Cov menyuam mos yug tshiab (txog li ob lub lis piam) tau tso cai "Ceftriaxone" ntawm qhov ntau npaum li 0.02-0.05 g / kg ntawm lub cev hnyav ib hnub. Qhov koob tshuaj rau cov menyuam mos thiab menyuam yaus hnub nyoog qis dua 12 xyoos yog 0.02 - 0.08 g / kg lub cev hnyav ib hnub.
Lub sijhawm ntawm chav kho mob tau txiav txim siab, suav nrog qhov xwm txheej ntawm chav kawm thiab qhov hnyav ntawm tus kab mob. Piv txwv li, rau cov kab mob meningitis, cov me nyuam mos thiab cov me nyuam yaus raug muab 0.1 g / kg ib hnub ib zaug. Ntau tshaj 4 g ib hnub twg. Nyob ntawm tus kab mob ua rau tus kab mob yog xamDuration ntawm kev kho: los ntawm 4 hnub rau meningeal kab mob tshwm sim los ntawm gram-negative diplococci, mus txog 10-14 hnub rau kab mob enterobacteria.
Cov menyuam yaus raug tshuaj "Ceftriaxone" ntawm qhov koob tshuaj 1 zaug hauv ib hnub 0.05-0.75 g / kg ntawm lub cev hnyav, lossis ib nrab ntawm qhov koob tshuaj no txhua 12 teev, tab sis tsis pub ntau tshaj 2 g / hnub. Rau lwm hom kab mob, cov menyuam yaus raug muab tshuaj 0.03 g / kg txhua 12 teev, zoo ib yam, koob tshuaj yuav tsum tsis pub tshaj 2 g ib hnub. Nyob rau hauv cov ntaub ntawv ntawm otitis media, cov tshuaj yog muab intramuscularly ntawm 0.05 g / kg ntawm lub cev hnyav, tab sis tsis ntau tshaj 1000 mg nyob rau hauv tag nrho.
Thaum lub raum tsis ua haujlwm, kev hloov pauv yuav tsum tsuas yog thaum lub raum tsis ua haujlwm kawg (creatinine tshem tawm qis dua 0.01 ml / min) raws li cov lus qhia siv. Cov chav kawm ntawm "Ceftriaxone" yuav ua raws li hauv qab no: qhov ntim txhua hnub yuav tsum tsis pub tshaj 2 g.
"Ceftriaxone" rau kab mob gonorrhea 0.25 g yog tshuaj ib zaug intramuscularly. Raws li kev tiv thaiv kab mob ntawm cov kab mob tom qab phais mob, koob tshuaj 1-2 g tau muab tshuaj (siv rau theem ntawm kev pheej hmoo ntawm kev kis kab mob) ib zaug ua ntej kev phais 30-90 feeb ua ntej kev phais. Thaum ua haujlwm ntawm txoj hnyuv loj, nws raug nquahu kom qhia txog cov tshuaj ntxiv los ntawm pawg 5-nitroimidazoles.
Txoj cai rau kev dilution thiab siv "Ceftriaxone"
Ntau tus xav paub yuav ua li cas dilute Ceftriaxone txhaj. Cov ntsiav tshuaj tsis tsim, txawm hais tias lawv yuav yooj yim dua rau siv. Kev npaj rau kev txhaj tshuaj yog diluted txoj cai ua ntej txhaj tshuaj. Freshly npaj tshuaj "Ceftriaxone" nyob rau hauv chav tsev kubkhaws nws cov khoom siv tshuaj txog li 6 teev.
Ceftriaxone tov nrog lidocaine rau intramuscular txhaj: ib nrab ib gram ntawm cov tshuaj rau 2 ml ntawm lidocaine, thiab ib gram rau 3.5 ml ntawm cov kuab tshuaj. Hauv qhov thib ob, cov nyhuv ntawm cov tshuaj tsis hloov, tab sis nws yuav mob ntau dua thaum siv. Nws raug nquahu kom tsis pub ntau tshaj 1 gram ntawm cov tshuaj hauv ib lub pob tw. Ceftriaxone nrog lidocaine yog cov tshuaj kho mob tshaj plaws rau cov xwm txheej saum toj no.
Ceftriaxone tov rau kev txhaj tshuaj (txhaj tshuaj) yog npaj rau hauv cov proportions nram qab no: ib nrab ib gram ntawm cov tshuaj ib 5 ml, thiab 1 gram ib 10 ml ntawm tshwj xeeb sterile dej. Cov tshuaj npaj tau muab tso rau hauv cov leeg maj mam: hauv li 2-4 feeb. Tus kws kho mob yuav qhia pes tsawg hnub txhaj tshuaj Ceftriaxone, thiab cov tshuaj no pab tau dab tsi.
Cov kev daws rau cov tshuaj tua kab mob hauv cov hlab ntsha yog npaj raws li hauv qab no: dilute 2 g ntawm "Ceftriaxone" nrog 40 ml ntawm ib qho ntawm cov kuab tshuaj no: 0.9% sodium chloride tov, los yog 5% levulose, los yog 5-10% - ceg qabzib.. Qhov koob tshuaj ntawm cov tshuaj yog 0.05 g / kg ntawm qhov hnyav thiab siab dua, muab tso rau hauv cov hlab ntsha nrog lub tee rau ib nrab teev.
Kev sib tham nrog lwm yam txhais tau tias
Tshuaj yog incompatible nrog antimicrobials. Nrog nws siv, cov nyhuv ntawm aminoglycosides nce. Cov tshuaj tsis-steroidal anti-inflammatory tuaj yeem ua rau muaj kev pheej hmoo los ntshav. Lub raum toxicity tuaj yeem tshwm sim los ntawm cov tshuaj nephrotoxic thiab diuretics.
Ntau tshaj
Thaumoverdose ntawm ib tug kws tshuaj yuav ua rau muaj kev phiv. Kev kho mob yog ua raws li cov tsos mob nyem. Hauv qhov no, peritoneal dialysis thiab hemodialysis yuav tsis muaj txiaj ntsig.
Cov lus qhia tshwj xeeb
Nrog rau kev kho mob ntev, nws yog ib qho tsim nyog los saib xyuas cov ntshav, ntshav, thiab ob lub raum. Nyob rau hauv tsawg zaus, thaum lub sij hawm ntawm ultrasound ntawm lub gallbladder, kws kho mob sau blackouts. Lawv ploj tam sim ntawd tom qab cov tshuaj raug muab tso tseg. Kev siv tshuaj tua kab mob tsis cuam tshuam, txawm tias tus neeg mob pib yws ntawm qhov mob hauv qab tav, txawm li cas los xij, kev kho mob yuav ua tiav.
Thawj qhov kev txhaj tshuaj nrog lidocaine yog ua nrog txhua yam kev ceev faj, vim tias cov tshuaj ua rau muaj kev fab tshuaj. Ua ntej pib kev kho mob, nws yog qhov zoo tshaj plaws los ua ib qho kev sim: me ntsis tshuaj yog txhaj rau hauv cov leeg thiab tus neeg mob tus mob yog saib xyuas. Yog tias tsis muaj qhov tshwm sim ntawm qhov tsis zoo, ces cov tshuaj tuaj yeem nqa tau. Txawm li cas los xij, lwm lub pob tw yog siv rau qhov no.
Rocefin
Cov tshuaj no yog siv rau cov kab mob o: peritonitis, kab mob ntawm txoj hnyuv, kab mob plab, mob ntsws, ntsws abscess, bronchitis, kab mob ntawm pob txha thiab pob qij txha, daim tawv nqaij thiab cov leeg.
Rocefin prophylaxis tuaj yeem ua tiav tom qab kev phais. Nws yog tshuaj rau cov neeg uas muaj lub cev tsis muaj zog heev.
Cefotaxime
"Cefotaxime" - cephalosporintshuaj tua kab mob npaj rau kev tswj xyuas parenteral. Ua nyob rau hauv daim ntawv ntawm cov hmoov rau kev txhaj tshuaj. Qhov kev txiav txim yog ua los ntawm inhibiting lub synthesis ntawm mucopeptide nyob rau hauv lub cell phab ntsa ntawm cov kab mob. Tshem tawm cov kev ua ntawm cov kab mob uas tuaj yeem ua rau muaj kev tiv thaiv rau lwm cov tshuaj tua kab mob. "Cefotaxime" yog ib qho analogue ntawm "Ceftriaxone". Cov lus qhia hauv qab no tau muab rau hauv cov lus qhia rau kev siv:
- kab mob sib kis;
- gonorrhea;
- sepsis;
- salmonella;
- mob qhov txhab thiab kub hnyiab;
- peritonitis;
- kab mob immunodeficiency.
Y"Cefazolin"
Cefazolin yog tshuaj tua kab mob cephalosporin. Cov lus piav qhia luv luv:
- muaj cov kab mob bactericidal;
- cuam tshuam nrog penicillin-binding proteins;
- tawm tsam kab mob.
Thaum siv cov tshuaj, muaj ntau yam kev phiv tshwm sim (mob plab hnyuv, kev tsis haum tshuaj, dysbacteriosis).
Indications:
- cov ntaub so ntswg mos;
- endocarditis;
- gonorrhea;
- pneumonia;
- osteomyelitis;
- sepsis, thiab lwm yam.
Hauv khw muag tshuaj, cov tshuaj tau nthuav tawm hauv ob hom kev tso tawm - hmoov (1000 thiab 500 mg). Ib pob muaj 1-50 vials.
Azaran
Power rau kev daws cov tshuaj txhaj rau hauv cov leeg lossis cov leeg ntawm cov leeg dawb mus rau cov xim dajntxoov ntxoo. Nws muaj cov nyhuv antiseptic, inhibiting kev faib ntawm cov kab mob ntawm cov kab mob ntawm tes.
Indications "Azaran" - ib qho analogue ntawm "Ceftriaxone":
- peritonitis;
- kab mob hauv plab;
- pob txha thiab kab mob sib koom;
- kab mob urinary;
- ntshav lom;
- kab mob meningitis.
"Azaran" kuj yog siv rau lwm yam kab mob sib kis. Contraindications yog ib tug neeg intolerance rau cov enzymes ntawm cov tshuaj, kab mob ntawm lub siab, ob lub raum.
Y"Amoxiclav"
"Amoxiclav" yog cov tshuaj tua kab mob dav dav. Cov tshuaj nquag: clavulanic acid, uas ua rau muaj kev cuam tshuam ntawm ntau b-lactamases, amoxicillin thiab penicillin. Qhov kev sib xyaw ua ke ntawm cov tshuaj nquag "Amoxiclav" tso cai rau koj kom ua tiav cov kab mob bactericidal ntawm cov tshuaj. Clavulanic acid tiv thaiv kev degradation ntawm amoxicillin enzymes nyob rau hauv tus ntawm b-lactamases. Vim tias muaj cov kab mob bactericidal ntawm ntau hom kab mob, txawm tias cov neeg uas muaj cov tshuaj tiv thaiv kab mob los ntawm kev tsim cov b-lactamases. Qhov taw qhia ntawm "Ceftriaxone" analogue yog kev kho mob ntawm cov kab mob sib kis:
- tawv;
- poj niam deev luag poj luag txiv;
- urinary system;
- pob txha thiab pob qij txha;
- kab mob biliary;
- kab mob ua pa (mob ntev thiab mob ntawm otitis media, sinusitis, tonsillitis thiab pharyngitis)
Rau cov neeg laus - 375mg (1 ntsiav tshuaj) peb zaug ib hnub twg. Nrog rau cov kab mob nyuaj, cov koob tshuaj tuaj yeem nce mus rau 625 mg peb zaug hauv ib hnub.
Cephalexin
Ib ntsiav tshuaj muaj cov tshuaj nquag: 250 g ntawm cephalexin. Cov Khoom Siv Ntxiv:
- cellulose ether thiab methadone;
- calcium ntsev thiab stearic acid;
- qos yaj ywm starch.
Nyuaj rau kov daj gelatin capsules. Lub capsule muaj ib tug hmoov nrog granules ntawm dawb-daj xim, muaj ib tug pungent tsw. Qee lub sij hawm cov tshuaj no tuaj yeem pom nyob rau hauv cov kab nrib pleb ntom ntom lossis hauv cov ntsiav tshuaj. Cov tshuaj no yooj yim heev thiab tej zaum yuav crumble nyob rau hauv siab.
Lub pob tseem ceeb muaj 10 ntsiav tshuaj (cov ntsiav tshuaj) thiab 3 lub pob hlwv nrog cov ntawv qhia siv. Thiab nyob rau hauv tej pob khoom rau tsev kho mob, contour lub thawv yog muab tso rau - 150 daim thiab tus naj npawb ntawm cov ntawv qhia rau kev siv. Txhua yam yog muab tso rau hauv lub thawv ntawv loj.
Y"Amoxicillin"
"Amoxicillin" yog ib qho analogue ntawm "Ceftriaxone". Qhov no yog tshuaj, bactericidal kev txiav txim. Nws yog siv rau feem ntau cov kab mob, tshwj tsis yog rau cov kab mob anaerobic. Cov tshuaj tua kab mob nkag mus yam tsis muaj teeb meem rau txhua lub cev thiab cov ntaub so ntswg. Nws yog siv los kho cov kab mob tshwm sim los ntawm cov kab mob rhiab heev microflora.
"Amoxicillin" yog tsim los ntawm cov ntsiav tshuaj, tshuaj ntsiav. Kev txais tos ua ntej lossis tom qab noj mov, 0.5 g peb zaug ib hnub. Cov neeg mob 5 txog 10xyoo, ib ntsiav tshuaj (250 mg) tau muab peb zaug ib hnub. Cov menyuam kawm ntawv preschool tau txais koob tshuaj 125 mg. Rau cov hnub nyoog qis dua 2 xyoos, qhov koob tshuaj ntawm 20 mg rau ib kilogram ntawm lub cev qhov hnyav yog xam. Cov chav kawm ntawm kev kho mob yog hais txog ib lub lim tiam, nyob ntawm seb qhov mob hnyav ntawm tus kab mob. Rau kab mob gonorrhea, koob tshuaj yog 3 g ib zaug.
