Nyob rau xyoo tas los no, cov tshuaj tua kab mob hluavtaws tau siv los kho ntau yam kab mob. Qhov no yog vim qhov tseeb tias ntau cov kab mob microorganisms tsim kev tiv thaiv rau cov tshuaj tua kab mob ntawm lub hauv paus chiv keeb. Tsis tas li ntawd, cov kab mob sib kis tau hnyav dua, thiab nws tsis yog ib txwm ua tau kom txiav txim siab tus kab mob tam sim ntawd. Yog li ntawd, muaj kev xav tau ntau ntxiv rau cov tshuaj tua kab mob dav dav, uas feem ntau cov kab mob yuav nkag siab. Ib pawg ntawm cov tshuaj zoo tshaj plaws nrog cov khoom zoo li no yog fluoroquinolones. Cov kev npaj no tau txais synthetically thiab tau dav paub txij li 80s ntawm lub xyoo pua 20th. Cov txiaj ntsig kev kho mob ntawm cov neeg ua haujlwm no tau ua pov thawj tias muaj txiaj ntsig zoo dua li cov tshuaj tua kab mob uas paub ntau.
Dab tsi yog pawg fluoroquinolone
Tshuaj tua kab mob yog cov tshuaj uas muaj cov tshuaj tua kab mob thiab feem ntau muaj qhov ntuj tsimkeeb kwm. Raws li txoj cai, fluoroquinolones tsis yog tshuaj tua kab mob. Cov no yog cov tshuaj ntawm cov khoom siv hluavtaws tau los ntawm quinolones los ntawm kev ntxiv fluorine atoms. Nyob ntawm lawv tus lej, lawv muaj kev ua haujlwm sib txawv thiab lub sijhawm tshem tawm.
Ib zaug hauv lub cev, cov tshuaj ntawm pawg fluoroquinolone tau muab faib rau txhua cov ntaub so ntswg, nkag mus rau hauv cov kua dej, cov pob txha, nkag mus rau hauv cov placenta thiab cov hlab ntsha-hlwb barrier, nrog rau cov kab mob. Lawv muaj peev xwm txo tau txoj haujlwm ntawm lub ntsiab enzyme ntawm cov kab mob, yam tsis muaj DNA synthesis nres. Qhov kev ua tshwj xeeb no ua rau cov kab mob tuag.
Vim tias cov tshuaj no tau xa mus thoob plaws lub cev, lawv tau zoo dua li lwm cov tshuaj tua kab mob.
Cov kab mob dab tsi yog fluoroquinolones tawm tsam
Cov no yog cov tshuaj broad-spectrum. Nws ntseeg tau tias lawv muaj txiaj ntsig zoo rau feem ntau cov kab mob gram-positive thiab gram-negative kab mob, mycoplasmas, chlamydia, mycobacterium tuberculosis, thiab qee qhov protozoa. Lawv rhuav tshem cov hnyuv, Pseudomonas aeruginosa thiab Haemophilus influenzae, pneumococci, salmonella, shigella, listeria, meningococci thiab lwm yam. Intracellular microorganisms kuj rhiab heev rau lawv, uas nyuaj rau tiv nrog lwm yam tshuaj.
Tsuas muaj ntau yam kab mob fungi thiab kab mob, nrog rau cov kab mob ua rau mob syphilis, tsis hnov tsw rau cov tshuaj no.
Qhov txiaj ntsig ntawm kev siv cov tshuaj no
Ntau yam kab mob hnyav thiab sib xyaw tsuas tuaj yeem kho nrog fluoroquinolones. tshuaj,siv rau qhov no yav dhau los, tam sim no nce ua tsis tau zoo. Thiab fluoroquinolones, piv nrog rau lawv, tau yooj yim dua los ntawm cov neeg mob, tau nqus sai sai, thiab cov kab mob tseem tsis tuaj yeem tsim kev tiv thaiv rau lawv. Ntxiv rau, cov tshuaj hauv pab pawg no muaj lwm yam txiaj ntsig:
- rhuav tshem cov kab mob, tsis ua rau lawv tsis muaj zog;
- muaj ntau qhov kev txiav txim;
- nkag mus rau hauv txhua lub cev thiab cov ntaub so ntswg;
- tiv thaiv septic shock;
- yuav ua ke nrog lwm yam tshuaj tua kab mob;
- muaj lub sijhawm tshem tawm ntev, uas ua rau lawv muaj txiaj ntsig zoo;
- tsis tshua muaj tshwm sim.
YYuav ua li cas fluoroquinolones ua haujlwm
Tshuaj tua kab mob yog cov tshuaj uas ua rau muaj kev phiv ntau. Thiab tam sim no ntau cov kab mob ntau ntxiv tau dhau los ua tsis zoo rau cov neeg ua haujlwm zoo li no. Yog li, fluoroquinolones tau dhau los ua lwm txoj hauv kev zoo rau cov tshuaj tua kab mob hauv kev kho cov kab mob sib kis. Lawv muaj lub peev xwm tshwj xeeb los tiv thaiv kev tsim cov kab mob ntawm cov kab mob, uas ua rau lawv qhov kawg tuag. Qhov no tuaj yeem piav qhia qhov ua tau zoo ntawm cov tshuaj ntawm pawg fluoroquinolone. Cov yam ntxwv ntawm lawv qhov kev txiav txim kuj muaj xws li bioavailability siab. Lawv nkag mus rau hauv tag nrho cov ntaub so ntswg, kabmob thiab cov kua dej ntawm tib neeg lub cev hauv 2-3 teev. Cov tshuaj no feem ntau yog tawm hauv cov zis. Thiab tsawg dua yuav ua rau muaj kev phiv ntau dua li cov tshuaj tua kab mob.
Cov lus qhia rau kev siv
Tshuaj tua kab mob ntawm pawg fluoroquinolone yog davyog siv rau cov kab mob nosocomial, kab mob loj heev ntawm cov kab mob ua pa thiab genitourinary system. Txawm tias cov kab mob loj xws li anthrax, typhoid fever, salmonellosis, yog kho tau yooj yim. Lawv tuaj yeem hloov cov tshuaj tua kab mob feem ntau. Fluoroquinolones muaj txiaj ntsig zoo hauv kev kho mob hauv qab no:
- chlamydia;
- gonorrhea;
- kab mob prostatitis;
- cystitis;
- Ypyelonephritis;
- typhoid;
- mob plab;
- salmonellosis;
- mob ntsws lossis mob ntsws ntev;
- TB.
Cov lus qhia siv cov tshuaj no
Fluoroquinolones feem ntau muaj nyob rau hauv cov ntsiav tshuaj ntawm qhov ncauj. Tab sis muaj kev daws teeb meem rau kev txhaj tshuaj intramuscular, nrog rau cov tee hauv qhov muag thiab pob ntseg. Txhawm rau kom tau txais cov txiaj ntsig kho mob xav tau, koj yuav tsum ua raws li txhua tus kws kho mob cov lus pom zoo ntawm qhov ntau npaum thiab cov yam ntxwv ntawm kev noj tshuaj. Cov ntsiav tshuaj yuav tsum tau noj nrog dej. Nws yog ib qho tseem ceeb kom tswj tau lub caij nyoog uas yuav tsum tau noj ntawm ob koob tshuaj. Yog tias nws tshwm sim tias tsis tau txhaj tshuaj ib zaug, koj yuav tsum noj cov tshuaj sai li sai tau, tab sis tsis yog tib lub sijhawm ntawm koob ntxiv.
Thaum noj tshuaj ntawm pab pawg fluoroquinolone, koj yuav tsum ua raws li tus kws kho mob cov lus pom zoo txog lawv cov kev sib raug zoo nrog lwm cov tshuaj, vim tias qee qhov ntawm lawv tuaj yeem txo cov tshuaj tua kab mob thiab ua rau muaj kev phiv ntau ntxiv. Nws tsis pom zoo kom nyob hauv tshav ntuj ncaj qha ntev ntev thaum kho.
cov lus qhia tshwj xeeb rau kev nkag
Fluoroquinolones tam sim no suav tias yog cov tshuaj tua kab mob zoo tshaj plaws. Cov tshuaj no tau muab rau ntau pawg ntawm cov neeg mob uas muaj contraindicated nyob rau hauv lwm yam tshuaj tua kab mob. Txawm li cas los xij, muaj qee qhov kev txwv rau lawv siv. Fluoroquinolones raug txwv nyob rau hauv xws li:
- cov menyuam yaus hnub nyoog qis dua 3 xyoos, thiab rau qee cov tshuaj tiam tshiab - txog li 2 xyoos, tab sis thaum yau thiab hluas lawv tsuas yog siv rau qhov hnyav xwb;
- thaum cev xeeb tub thiab pub niam mis;
- nrog atherosclerosis ntawm cerebral hlab ntsha;
- nrog tus neeg intolerance rau cov khoom ntawm cov tshuaj.
Thaum muab tshuaj fluoroquinolones ua ke nrog cov tshuaj tiv thaiv acid, lawv cov txiaj ntsig tau txo qis, yog li xav tau kev so ntawm ob peb teev ntawm lawv. Yog tias koj siv cov tshuaj no ua ke nrog methylxanthines lossis tshuaj npaj hlau, ces cov nyhuv tshuaj lom ntawm quinolones nce.
Muaj kev phiv tshwm sim
Fluoroquinolones yog qhov yooj yim tshaj plaws zam ntawm tag nrho cov kab mob tua kab mob. Cov tshuaj no tuaj yeem ua rau qee qhov kev phiv xws li:
- mob plab, kub siab, plob tsis so tswj;
- mob taub hau, kiv taub hau;
- pw tsis tsaug zog;
- cramps, trembling nqaij;
- pom lossis tsis hnov lus;
- tachycardia;
- daim siab lossis lub raum ua haujlwm tsis zoo;
- kab mob fungal ntawm daim tawv nqaij thiab mucous daim nyias nyias;
- Ntau rhiab heev rau ultraviolet hluav taws xob.
YKev faib tawm ntawm fluoroquinolones
Tam sim no muaj plaub tiam ntawm cov tshuaj hauv pawg no.
Lawv pib ua ke rau xyoo 60s, tab sis lawv tau koob meej tsuas yog thaum kawg ntawm lub xyoo pua. Muaj 4 pawg ntawm fluoroquinolones nyob ntawm lub sijhawm pom thiab ua haujlwm tau zoo.
- Thawj tiam yog cov khoom lag luam uas tsis muaj txiaj ntsig tiv thaiv kab mob Gram-zoo. Cov fluoroquinolones no suav nrog kev npaj muaj oxolinic acid lossis nalidixic acid.
- tshuaj tiam thib ob yog tawm tsam cov kab mob uas tsis nkag siab rau penicillins. Lawv kuj ua rau cov kab mob atypical. Cov fluoroquinolones no feem ntau yog siv rau kev kis mob hnyav ntawm cov kab mob ua pa thiab plab hnyuv. Cov tshuaj hauv pawg no suav nrog cov hauv qab no: Ciprofloxacin, Ofloxacin, Lomefloxacin thiab lwm yam.
- 3rd tiam fluoroquinolones tseem hu ua ua pa fluoroquinolones, vim tias lawv muaj txiaj ntsig tshwj xeeb tiv thaiv kab mob ntawm lub ntsws sab sauv thiab sab qis. Cov no yog Sparfloxacin thiab Levofloxacin.
- 4 tiam ntawm cov tshuaj hauv pab pawg no tau tshwm sim tsis ntev los no. Lawv muaj zog tiv thaiv kab mob anaerobic. Txog tam sim no, tsuas yog ib qho tshuaj tau muab faib - Moxifloxacin.
1st thiab 2nd tiam fluoroquinolones
Thawj qhov hais txog tshuaj ntawm pab pawg no tuaj yeem pom nyob rau xyoo 60s ntawm xyoo pua 20th. Thaum xub thawj, xws li fluoroquinolones tau siv los tiv thaiv kab mob ntawm qhov chaw mos thiab cov hnyuv. Cov tshuaj, cov npe uas tam sim no tsuas yog paub rau cov kws kho mob, txij li lawv twb muaj lawmyuav luag tsis tau siv, muaj tsawg efficiency. Cov no yog cov tshuaj raws li nalidixic acid: Negram, Nevigramone. Cov tshuaj thawj tiam no hu ua quinolones. Lawv ua rau muaj kev phiv ntau, thiab ntau cov kab mob tsis hnov tsw rau lawv.
Tab sis kev tshawb fawb ntawm cov tshuaj no txuas ntxiv mus, thiab 20 xyoo tom qab, 2nd tiam fluoroquinolones tshwm sim. Lawv tau txais lawv cov npe vim yog kev qhia txog fluorine atoms rau hauv quinolone molecule. Qhov no ua rau muaj kev ua tau zoo ntawm cov tshuaj thiab txo cov kev mob tshwm sim. Thib ob tiam fluoroquinolones suav nrog:
- Ciprofloxacin, tseem hu ua Ciprobay lossis Cyprinol;
- "Norfloxacin", lossis "Nolicin".
- Ofloxacin, uas tuaj yeem yuav los ntawm lub npe Ofloxin lossis Tarivid.
- "Pefloxacin", lossis "Abactal".
- "Lomefloxacin", lossis "Maksakvin".
3rd tiam thiab 4th tiam tshuaj
Kev tshawb fawb txog cov tshuaj no txuas ntxiv mus. Thiab tam sim no qhov zoo tshaj plaws yog fluoroquinolones niaj hnub. Cov npe ntawm cov tshuaj ntawm tiam 3 thiab 4th tseem tsis tau loj heev, vim tsis yog txhua tus ntawm lawv tseem tau dhau los ntawm kev sim tshuaj thiab raug pom zoo siv. Lawv muaj kev ua haujlwm siab thiab muaj peev xwm nkag mus rau hauv txhua lub cev thiab cov ntaub so ntswg. Yog li ntawd, cov tshuaj no yog siv rau kev mob hnyav ntawm cov kab mob ua pa, genitourinary system, digestive ib ntsuj av, daim tawv nqaij thiab pob qij txha. Cov no suav nrog Levofloxacin, tseem hu ua Tavanic. Nws muaj txiaj ntsig txawm tias kev kho mob anthrax. Rau plaub tiam tshuajfluoroquinolones suav nrog "Moxifloxacin" (los yog "Avelox"), uas yog nquag tawm tsam cov kab mob anaerobic. Cov tshuaj tshiab no tshem tawm feem ntau ntawm qhov tsis txaus ntawm lwm cov tshuaj, yooj yim rau kev zam los ntawm cov neeg mob thiab ua tau zoo dua.
Fluoroquinolones yog ib qho kev kho mob zoo tshaj plaws rau cov kab mob sib kis loj. Tab sis lawv tsuas yog siv tau tom qab kws kho mob cov tshuaj.
