Penicillin tshuaj tua kab mob muaj zog tiv thaiv qee cov kab mob Gram-negative thiab feem ntau Gram-zoo kab mob. Cov tshuaj tua kab mob ntawm cov tshuaj no yog txuam nrog lawv lub peev xwm los cuam tshuam cov synthesis ntawm cov kab mob ntawm cov phab ntsa.
Penicillin tshuaj tua kab mob yog siv rau kev kis kab mob, suav nrog cov mob hnyav. Ib qho tshuaj zoo li no yog Carbenicillin. Cov lus qhia rau kev siv cov cuab yeej no, nws cov lus qhia rau kev siv, mechanism ntawm kev txiav txim thiab lwm yam ntaub ntawv qhia hauv qab no.
Tshuaj kho mob daim ntawv thiab muaj pes tsawg leeg
Raws li cov lus qhia rau kev siv, "Carbenicillin" mus muag hauv daim ntawv ntawm cov hmoov npaj rau kev npaj cov tshuaj txhaj. Cov yav tas yog siv rau intramuscular thiab intravenous tswj.
Carbenicillin disodium ntsev yog cov ntxeem tau (hmoov) ntawm cov xim dawb lossis xim dawb. Nws yog hygroscopic, yooj yim soluble hauv dej thiab maj mam soluble hauv ethanol. Carbenicillin disodium ntsev yog insoluble hauv chloroform thiabtshaj tawm. Nws qhov hnyav molecular yog 422.36.
Lub luag haujlwm tseem ceeb ntawm tus neeg sawv cev hauv nqe lus nug yog cov tshuaj tua kab mob semi-synthetic los ntawm pawg penicillin. Nws yog acid-resistant thiab tsuas yog rhuav tshem los ntawm beta-lactamases. Qhov hnyav molecular ntawm carbenicillin yog 378.40.
Mechanism of drug action
Cov tshuaj tua kab mob "Carbenicillin" yog dab tsi? Xws li ib tug dav-spectrum tshuaj muaj bactericidal thiab antibacterial zog. Nws cov active tivthaiv muaj peev xwm mus acetylate lub membrane-bound enzyme transpeptidase, nrog rau thaiv cov synthesis thiab permeability ntawm cell phab ntsa peptidoglycans, ua rau osmotic instability ntawm cov kab mob.
Raws li cov lus qhia rau kev siv, "Carbenicillin" muaj zog tiv thaiv kab mob gram-tsis zoo (indole-zoo kab mob), nrog rau qee cov kab mob anaerobic thiab gram-zoo. Tib lub sijhawm, cov tshuaj hauv nqe lus nug tsis cuam tshuam rau cov kab mob staphylococci uas rhuav tshem penicillinase.
Nws tseem yuav tsum tau sau tseg tias kev siv cov tshuaj no rau kev kis kab mob los ntawm cov kab mob gram-zoo yog qhov tsis tsim nyog.
Pharmacokinetic nta
Nyob rau hauv tus txheej txheem ntawm kev siv tshuaj tua kab mob nrog carbenicillin, nws yuav tsum tau nco ntsoov tias tom qab intramuscular tswj cov tshuaj, qhov siab tshaj plaws concentration ntawm cov tshuaj hais nyob rau hauv tus neeg mob cov ntshav mus txog tsuas yog tom qab 60 feeb. Txog 50-60% ntawm cov tshuaj khi rau cov protein. Nwsnkag mus rau tag nrho cov ntaub so ntswg thiab kua, nrog rau cov kua tsib, peritoneal kua, pleural effusion, plab hnyuv mucosa, nruab nrab pob ntseg kua, ntsws, gallbladder thiab qhov chaw mos.
Kev hloov pauv lom neeg ntawm carbenicillin hauv daim siab tsuas yog ib feem me me ntawm nws (li 2%). Ib nrab-lub neej ntawm cov tshuaj tua kab mob yog 1-1.5 teev. Cov tshuaj yog tawm los ntawm ob lub raum (tsis hloov, kwv yees li 60-90%). Qhov no tsim kom muaj ntau ntau ntawm carbenicillin hauv cov zis.
Cov tshuaj hauv nqe lus nug dhau los ntawm cov placenta thiab tseem nkag mus rau hauv cov kua mis (hauv qhov me me).
Cov lus qhia rau cov tshuaj
Yuav ua li cas cov neeg mob tuaj yeem muab tshuaj nrog cov tshuaj nquag xws li carbenicillin? Cov lus qhia rau kev siv cov tshuaj no yog cov kab mob kab mob uas tshwm sim los ntawm cov kab mob uas nkag mus rau cov tshuaj uas tau teev tseg. Feem ntau cov tshuaj nyob rau hauv nqe lus nug yog muab rau cov kab mob ntawm lub plab mog, pob qij txha thiab pob txha, urinary thiab biliary ib ntsuj av, peritonitis, sepsis, septicemia thiab pneumonia. Tsis tas li ntawd, "Carbenicillin" zoo kho lub hlwb abscess, kis kab mob thiab inflammatory kab mob ntawm cov nqaij mos thiab tawv nqaij, meningitis. Feem ntau nws yog siv rau cov teeb meem purulent tom qab kev phais, thaum yug me nyuam, kab mob kub hnyiab thiab otitis media.
Contraindications rau kev sau ntawv
Thaum twg nws txwv tsis pub siv tshuaj "Carbenicillin"? Contraindications rau kev siv ntawm xws li ib tug tshuajyog:
- hypersensitivity rau cov tshuaj nquag, suav nrog lwm cov tshuaj tua kab mob beta-lactam;
- hlab ntshav siab;
- mob plawv tsis ua hauj lwm;
- bronchial hawb pob;
- enteritis;
- ulcerative colitis;
- eczema;
- angioedema;
- mob raum tsis ua haujlwm;
- ntshav ntau ntau (nrog rau keeb kwm).
Cov lus qhia rau kev siv "Carbenicillin"
Cov tshuaj tua kab mob hauv nqe lus nug yog nruj me ntsis rau tus kheej. Nws yuav tsum tau txiav txim siab tsuas yog los ntawm tus kws kho mob tshwj xeeb, nyob ntawm qhov hnyav ntawm tus kab mob, lub hnub nyoog ntawm tus neeg mob thiab rhiab heev ntawm cov kab mob. Piv txwv li, nrog ib qho abscess ntawm lub hlwb thaum txhaj tshuaj intravenously, ib koob ntawm cov tshuaj no yog 50-80 mg / kg (4-6 zaug ib hnub). Lub sijhawm ntawm cov txheej txheem kho mob nrog lub koob txhaj tshuaj yog 3-4 feeb, nrog lub kaw lus - 30-40 feeb.
Yog tias cov tshuaj tau muab tshuaj rau kev kho cov kab mob urinary hauv cov poj niam, ces nws yuav tsum nco ntsoov tias yog tias lub raum tsis ua haujlwm, cov koob tshuaj carbenicillin txo qis, thiab cov sijhawm ntawm kev txhaj tshuaj yog nce.
Kev ua ntawm tus cwj pwm thib ob
Zoo li txhua yam tshuaj tua kab mob ntawm cov tshuaj penicillin, cov tshuaj "Carbenicillin" muaj nws cov kev phiv. Cov no suav nrog cov hauv qab no:
- mob plab, thrombocytopenia, angioedema, neutropenia, conjunctivitis, leukopenia, qaug dab peg, hemorrhagic syndrome;
- xeev siab, hloov pauv hauv cov qib poov tshuajthiab sodium hauv cov ntshav, interstitial nephritis, ntuav, anaphylactic shock, siab siab transaminases, dysbacteriosis, eosinophilia, pseudomembranous colitis;
- hypovitaminosis, urticaria, qhov chaw mos candidiasis, erythema, angioedema, rhinitis.
Tsis tas li, thaum noj cov tshuaj hauv nqe lus nug, tus neeg mob tuaj yeem tsim cov kab mob superinfection los ntawm cov kab mob uas tiv taus carbenicillin (ntawm ntau npaum li cas). Nrog rau kev txhaj tshuaj intramuscular, cov tshuaj tiv thaiv hauv zos xws li mob ntawm qhov chaw txhaj tshuaj feem ntau tshwm sim, thiab nrog kev txhaj tshuaj intravenous, phlebitis tshwm sim.
Kev Sib Tham Tshuaj
Cov tshuaj "Carbenicillin" tuaj yeem txhim kho qhov cuam tshuam ntawm cov tshuaj tiv thaiv tsis ncaj thiab ncaj qha, nrog rau cov tshuaj fibrinolytics thiab cov tshuaj tiv thaiv kab mob. Tsis tas li, cov cuab yeej no ua rau muaj qhov tshwm sim tsis zoo thaum ua ke nrog NSAIDs.
"Carbenicillin" yog qhov tsis sib xws nrog cov kab mob bacteriostatics (muaj cov kab mob bactericidal), tetracycline tshuaj tua kab mob, macrolides thiab chloramphenicol. Tsis tas li ntawd, cov tshuaj no yuav tsum tsis txhob tov nrog aminoglycosides.
Tseem ceeb kom paub
Ua ntej parenteral siv cov tshuaj, yuav tsum tau kuaj intradermal rau tus kheej rhiab heev (siv 0.1 ml ntawm cov tshuaj). Cov txiaj ntsig ntawm qhov kev xeem raug ntsuas tom qab ib nrab teev.
Yog tias muaj kev tsis haum tshuaj tshwm sim thaum kho, cov tshuaj yuav tsum tau txiav thiab kho desensitizing yuav tsum tau ua.
Tshuaj tua kab mob "Carbenicillin" tuaj yeem ua kom lub sijhawmlos ntshav.
Thaum muab tso rau hauv cov hlab ntsha, cov ntshav sodium thiab potassium ion ntau ntau thiab lub sijhawm los ntshav yuav tsum tau.
Thaum siv tshuaj tua kab mob intramuscularly, tsis txhob txhaj tshuaj rau tib qhov chaw hauv qhov ntau dua 2 g.
