Cov kab mob fungal ua rau tus neeg mob tsis xis nyob. Ntxiv mus, cov kab mob no kis tau. Yog li ntawd, thaum thawj cov cim qhia ntawm cov kab mob tshwm sim, koj yuav tsum tau hu rau tus kws kho mob tshwj xeeb. Tom qab dhau kev kuaj mob thiab lwm yam kev kuaj mob, tus kws kho mob yuav tsum tau sau cov tshuaj zoo rau tus neeg mob.
Ntau zaus, ntau cov tshuaj pleev thiab cov ntsiav tshuaj yog siv los kho cov kab mob fungal. Txawm li cas los xij, feem ntau cov kws kho mob sib cav hais tias xws li cov kab mob pathological yog kho tau zoo tshaj plaws nrog kev txhaj tshuaj intravenous. Tom qab txhaj tshuaj, cov tshuaj yuav pib ua rau cov kab mob uas tshwj xeeb rau nws.
Qhov zoo tshaj plaws thiab muaj txiaj ntsig txhais tau tias tshem tawm cov kab mob fungal suav nrog cov tshuaj "Amphotericin B". Cov lus qhia, cov ntawv tso tawm thiab tshuaj xyuas cov tshuaj no yuav qhia hauv qab no.
Suab, muaj pes tsawg leeg, piav qhia thiab ntim cov tshuaj tua kab mob
Koj tuaj yeem yuav cov tshuaj hauv nqe lus nug hauv cov ntawv hauv qab no:
Lyophilisate "Amphotericin B". Kev tshuaj xyuas qhia tias daim ntawv noCov tshuaj yog ib tug ntxeem tau hygroscopic huab hwm coj ntawm daj xim tsis muaj ib tug pronounced tsw. Nws yog npaj rau kev npaj ntawm ib tug infusion tov. Lub active tivthaiv ntawm cov tshuaj no yog amphotericin B. Cov tshuaj xws li monosubstituted sodium phosphate thiab deoxycholic acid yog siv los ua auxiliary Cheebtsam. Cov tshuaj no tau muag hauv 10 ml lub raj mis thiab cov thawv ntawv
Tshuaj "Amphotericin B". Kev siv tus neeg sawv cev no tau qhia tias yog ib qho tshuaj ntxiv hauv kev kho mob. Antifungal ointment tsuas yog siv sab nraud. Nws muaj xim daj thiab muaj cov tshuaj nquag ntawm tib lub npe. Raws li cov khoom xyaw ntxiv, lawv siv cov roj vaseline, tshuaj vaseline thiab polysorbate 80. Koj tuaj yeem yuav cov tshuaj no hauv cov hlab ntawm 30 lossis 15 g
Mechanism of action of an antifungal drug
Amphotericin B tshuaj yog dab tsi? Cov lus qhia rau kev siv (cov ntsiav tshuaj nrog tib cov tshuaj nquag muaj teeb meem heev los nrhiav) qhia tias qhov no yog tshuaj tua kab mob macrocyclic polyene nrog cov tshuaj tua kab mob. Nws yog tsim los ntawm Streptomyces nodosus, thiab tseem muaj cov kab mob fungistatic thiab fungicidal (nyob ntawm qhov concentration ntawm cov tshuaj nyob rau hauv cov kua roj ntsha thiab rhiab heev ntawm cov kab mob).
Tom qab cov tshuaj nkag mus rau hauv cov hlab ntsha, nws khi rau cov sterols pom nyob rau hauv cov cell membranes ntawm cov tshuaj-sensitive fungus. Raws li qhov tshwm sim ntawm qhov noKev cuam tshuam cuam tshuam lawv cov permeability thiab tshem tawm cov khoom siv hauv nruab nrog cev rau hauv qhov chaw extracellular.
Amphotericin B yog nquag tawm tsam ntau hom kab mob thiab ua haujlwm nruab nrab tawm tsam protozoan fungi.
Nws tseem yuav tsum tau sau tseg tias Fusarium spp. thiab Pseudallescheria boydii. Tsis tas li ntawd, cov tshuaj no tsis muaj txiaj ntsig tiv thaiv rickettsiae, kab mob thiab kab mob.
Kinetic zog ntawm cov tshuaj
Tam sim no koj paub tias tshuaj tiv thaiv kab mob zoo li Amphotericin B yog dab tsi. Cov txheej txheem ntawm kev txiav txim ntawm qhov kev daws teeb meem no tau piav qhia saum toj no.
Tom qab kev tswj hwm cov tshuaj hauv cov tshuaj hauv ib koob, nws cov concentration tau tsim tawm tam sim ntawd hauv cov ntshav, uas nyob mus ib txhis. Tus neeg sawv cev no yog 90 feem pua uas khi rau plasma proteins.
Cov tshuaj hauv nqe lus nug tau muab faib rau hauv daim siab, ntsws, ob lub raum, spleen, cov leeg, qog adrenal thiab lwm yam kabmob thiab cov ntaub so ntswg. Nws cov concentration hauv pleural effusion, synovial thiab peritoneal kua, nrog rau kev lom zem aqueous nce mus txog 2/3 ntawm cov concentration hauv cov ntshav.
Txoj kev ntawm cov metabolism ntawm cov tshuaj no tsis paub. Hauv cov zis thiab cov kua tsib, kwv yees li 98 feem pua ntawm cov tshuaj yog tam sim no ua metabolites. Nws yog excreted maj mam los ntawm lub raum. Thawj ib nrab-lub neej ntawm cov tshuaj nyob rau hauv cov neeg laus yog 24 teev, nyob rau hauv cov me nyuam - 6-40 teev, thiab cov me nyuam mos - 20-60 teev. Lub davhlau ya nyob twg ib nrab-lub neej yog 15 hnub.
Cov lus qhiatshuaj tua kab mob
Amphotericin B kho kab mob dab tsi? Nws tau raug sau tseg rau cov kab mob loj zuj zus, ua rau muaj kev phom sij rau lub neej uas tau tshwm sim los ntawm cov kab mob kis tau yooj yim:
- histoplasmosis, tshaj tawm cryptococcosis, coccidioidomycosis;
- cryptococcal meningitis, paracoccidiooidomycosis, chromomycosis;
- meningitis tshwm sim los ntawm lwm yam fungi, North American blastomycosis;
- disseminated thiab invasive aspergillosis, phycomycosis (zygomycosis);
- disseminated daim ntawv ntawm candidiasis, hyalohyphomycosis;
- pwm mycosis, chronic mycetoma;
- disseminated sporotrichosis, kab mob plab (nrog rau peritonitis);
- endophthalmitis, endocarditis, fungal sepsis;
- visceral leishmaniasis, kab mob fungal ntawm lub tso zis;
- American visceral leishmaniasis.
Contraindications rau tus neeg sawv cev tiv thaiv kab mob
Cia peb xav txog yam xwm txheej txwv tsis pub siv tshuaj "Amphotericin B" (cov tshuaj los ntawm cov fungus nrog tib lub npe tsis tsim). Raws li cov lus qhia, qhov kev kho no yog contraindicated:
- rau lub raum tsis ua haujlwm ntev;
- rau siab;
- thaum pub mis niam.
Nrog ceev faj, cov tshuaj no yog siv rau cov kab mob hauv lub raum (xws li glomerulonephritis), amyloidosis, mob siab cirrhosis, kab mob siab, ntshav ntshav, agranulocytosis, cev xeeb tub thiab ntshav qab zib.
Lyophilizate "Amphotericin B":cov lus qhia rau kev siv
Rau qhov kev npaj ntawm cov tshuaj hauv cov hlab ntsha, cov tshuaj yog siv nrog thawj zaug ntawm 5 mg / ml. Siv lub syringe sterile syringe, 10 ml dej rau txhaj tshuaj yog nkag mus rau hauv lub vial nrog cov tshuaj. Tom qab ntawd nws cov ntsiab lus tau shaken kom txog thaum cov kua pob tshab colloidal tsim.
Intravenously, cov tshuaj yog muab rau ib nrab ib teev nyob rau hauv kev tswj ntawm cov ntshav siab, lub cev kub thiab mem tes ntawm tus neeg mob. Nrog rau kev ua siab ntev ntawm cov tshuaj, nws pom zoo noj txhua hnub yog 0.25-0.3 mg ib kg ntawm lub cev hnyav (nyob ntawm qhov hnyav ntawm tus kab mob).
Nyob rau hauv cov kab mob ntawm lub plawv thiab cov hlab ntsha, hypersensitivity thiab lub raum tsis ua hauj lwm tsis txaus, kev kho mob pib nrog me me koob tshuaj (5-10 mg), uas yog maj nce los ntawm 5-10 mg ib hnub twg thiab hloov mus rau 0.5-0.7 mg. ib kg.
Nrog sporotrichosis, chav kawm ntawm cov tshuaj yog 2.5 g, thiab lub sijhawm kho yog tsawg kawg 9 lub hlis.
Rau aspergillosis, qhov koob tshuaj ntawm qhov tshuaj no yog 3.6 g, thiab lub sijhawm kho yog tsawg kawg 11 lub hlis.
Cov menyuam yaus raug muab 0.25 mg rau ib kg ntawm lub cev hnyav ib hnub thaum pib kho, thiab tom qab ntawd maj mam nce mus rau qhov siab tshaj plaws (1 mg ib kg).
Amphotericin B ointment: cov lus qhia rau kev siv
Cov tshuaj nyob rau hauv tib lub npe lag luam tsis raug muag hauv khw muag tshuaj. Yog li, txhawm rau hloov cov tshuaj no, koj yuav tsum sab laj nrog kws kho mob.
Yog tias nws yuav tsum siv Amphotericin B ointment, thov nws rau hauv ib txheej nyias mus rau qhov chaw cuam tshuam ob zaug ib hnub. Cov chav kho mob nyob ntawm qhov muajindications:
- nrog candidiasis ntawm daim tawv nqaij quav - txog 1-3 lub lis piam;
- rau cov pob khaus hauv cov menyuam yaus - kwv yees li 7-14 hnub;
- nrog paronychia thiab qhov txhab ntawm qhov chaw interdigital - 2-4 lub lis piam.
Side effects
Amphotericin B tuaj yeem ua rau muaj kev phiv hauv qab no:
- mob taub hau, qaug dab peg, peripheral neuropathy, hloov pauv vertigo, encephalopathy;
- qab los noj mov, ntuav, dyspepsia, xeev siab, gastralgia, raws plab, hepatotoxicity, mob siab tsis ua hauj lwm, jaundice, kab mob siab, melena, hemorrhagic gastroenteritis;
- normochromic normocytic anemia, leukopenia, coagulation disorder, thrombocytopenia, agranulocytosis, hemolytic anemia, eosinophilia, leukocytosis;
- pom kev tsis pom kev, hnov tsis hnov lus, diplopia, tinnitus;
- tachypnea, ua tsis taus pa, pulmonary edema, arrhythmia thiab allergic pneumonitis;
- txo qis lossis siab dua ntshav siab, khaus khaus, ECG hloov pauv, plawv nres, poob siab, plawv tsis ua haujlwm;
- tshuaj tiv thaiv anaphylactoid, txham, nephrogenic mob ntshav qab zib insipidus, bronchospasm, nephrocalcinosis, pob liab liab, exfoliative dermatitis, tshuaj lom epidermal necrolysis
- raum tsis ua haujlwm, hypokalemia, hypostenuria, raum tubular acidosis, Stevens-Johnson syndrome, mob raum tsis ua haujlwm, oliguria, anuria;
- thrombophlebitis thiab hlawv ntawm qhov chaw txhaj tshuaj;
- kub taub hau, myalgia, poob phaus, mob caj dab, tsis muaj zog.
Cov mob ntau dhau
Thaumkev tswj hwm ntawm koob tshuaj ntau, tus neeg mob yuav ntsib kev ua pa thiab mob plawv. Yog li ntawd, nyob rau hauv lub chav kawm ntawm kev kho mob, ib tug yuav tsum nruj me ntsis raws li cov tshuaj pom zoo los ntawm tus kws kho mob. Nws kuj tseem yuav tsum tau saib xyuas kev ua haujlwm ntawm kev ua pa thiab lub plawv, lub raum thiab lub siab ua haujlwm, daim duab ntawm cov ntshav peripheral, nrog rau cov ntsiab lus ntawm electrolytes hauv nws.
Kev sib raug zoo nrog lwm yam tshuaj
Cov tshuaj "Amphotericin B" tuaj yeem nce lossis txo cov txiaj ntsig ntawm lwm yam tshuaj, nrog rau kev ua kom muaj tshuaj lom. Hauv qhov no, cov tshuaj no tau sau tseg nrog ceev faj hauv kev kho mob nyuaj.
Thaum sau cov tshuaj tau hais tseg, tus neeg mob yuav tsum paub tseeb qhia nws tus kws kho mob txog kev noj lwm yam tshuaj. Tsis tas li ntawd, kev siv "Amphotericin B" (txhaj tshuaj) tuaj yeem cuam tshuam rau kev noj qab haus huv thiab kev noj qab haus huv ntawm tib neeg.
Special Recommendations
- Amphotericin B yuav tsum tsuas yog siv los kho tus kab mob ua rau lub neej thiab kis kab mob fungal.
- Nrog rau kev siv sijhawm ntev, qhov tshwm sim ntawm kev tsim cov tshuaj lom neeg nce ntxiv.
- Yog tias muaj ntshav tsis txaus, kev siv tshuaj yuav tsum raug txiav tawm.
Reviews
Tam sim no koj paub tias Amphotericin B ua haujlwm li cas. Kev ncua nrog lub npe no tsis muaj muag hauv khw muag tshuaj. Yog li ntawd, rau kev tswj hwm qhov ncauj, koj yuav tsum xaiv lwm yam tshuaj uas muaj txiaj ntsig zoo sib xws.
Raws li cov neeg mob feem ntau, cov lus nug daws tau zooua haujlwm. Nws zoo kawg nkaus kho cov kab mob ntawm daim tawv nqaij, tshem tawm lub cev thiab kev puas siab puas ntsws tsis xis nyob ntawm tus neeg mob.
Qhov tsis zoo ntawm cov tshuaj no yog muaj ntau yam kev phiv. Thaum kho nrog cov tshuaj no, cov kev phiv tshwm sim tuaj yeem tshwm sim los ntawm txhua lub cev thiab lub cev. Yog li ntawd, nws yuav tsum tau siv tsuas yog rau cov qhia tshwj xeeb.
