Antibiotics Beta-lactam: indlela amanyathelo kunye nokubekwa

Amagciwane - iqela kweziyobisi kunye Etiotropic indlela amanyathelo. Ngamanye amazwi, la machiza benza ngqo kwi unobangela izifo (kulo mzekelo, esi silwanyana yeyona arhente causative) kwaye wenze oko ngeendlela ezimbini: ukutshabalalisa iintsholongwane (microbicides - penicillins, cephalosporins) okanye zinqanda ukwanda kwabo (bacteriostatic - tetracyclines, sulfonamides).

Kukho isixa esikhulu iziyobisi nto nemithi, kodwa iqela elikhulu kubo - oku beta-lactams. Oku ngazo kwaye kuya kuxoxwa ngazo kweli nqaku.

Ukwahlukanisa antibiotics

Kwi indlela yokusebenza kwala machiza bohlulwa babe ngamaqela amathandathu eziphambili:

1. Zifo zinqanda Yindibanisela amacandelo cell inwebu: penicillins, cephalosporins, kunye nabanye.
2. Amayeza kuthintela eqhelekileyo yokusebenza udonga yeseli: polyenes polymyxins.
3. Iziyobisi anqanda protein amagama: macrolides, tetracyclines, aminoglycoside kunye nabanye.
4. Inhibitory RNA yokuqaphela kwinqanaba inyathelo RNA polymerase: rifamycins, sulphonamides.
5. Inhibitory RNA yokuqaphela kwinqanaba intshukumo ye DNA polymerase: actinomycins et al.
6. DNA ezwi blocker: anthracyclines, nitrofurans kunye nabanye.

Noko ke, oluhlobo ayikho elula kakhulu. Ukuziqhelisa lwezonyango, wenza ukwahlulwa zilandelayo antimicrobials:

1. Penicillins.
2. Cephalosporins.
3. Macrolides.
4. Aminoglycosides.
5. Polymyxin kunye polyenes.
6. Tetracyclines.
7. Sulfonamides.
8. Aminohinolonov yezabelo.
9. Nitrofurans.
10. Fluoroquinolones.

antibiotics Beta-lactam. Isakhiwo kunye nendlela yokusebenza

Eli qela lamachiza ukususela bactericidal kwaye uluhlu olubanzi ngokwaneleyo kwakuthethwa zokusetyenziswa. antibiotics Beta-lactam ziquka penicillins, cephalosporins, carbapenems, monobactams. Bonke bephela luphawulwa kahle eliphezulu kwaye zinetyhefu esezantsi kakhulu, okwenza ukuba amachiza kakhulu ngokuqhelekileyo ezimiselweyo unyango lwezifo ezininzi.

Indlela yokusebenza-ntsholongwane beta-lactam ngenxa ubume babo. iinkcukacha ezininzi apha nantoni na, kufanelekile ukuba sikhankanye kuphela malunga zizeyeyona nto ibalulekileyo, nto leyo wamnika igama yonke iqela iziyobisi. Okuqukiweyo molecule ring beta-lactam kwaye inika isiphumo ngokukhawuleza bactericidal, apho kuboniswa ngokubhloka le Yindibanisela kumacandelo iseli zodonga gciwane. Noko ke, iintsholongwane abaninzi bayakwazi ukuvelisa enzyme, leyo waphula isakhiwo lo msesane, ngaloo ndlela ukubandezana olwa eyona isixhobo wayo. Kungenxa yoko le nto ukusetyenziswa kweziyobisi kwi unyango yokungabi okunqanda beta-lactamases, angabi.

Ngoku besiba baninzi antibiotics qembu Beta-lactam, ekhuselweyo kugwayimbo enqanda bacteria. ukwakhiwa kwawo ziquka izinto ezithintela le Yindibanisela beta-lactamase, ezifana clavulanic acid. ekhuselweyo antibiotics beta-lactam (ezifana "Amoxiclav") wadala ngaloo ndlela. Ezinye inhibitors ze enzyme ziibhakteriya ziquka "Sulbactam" yaye "tazobactam."

Amayeza evela kwiqela penicillins: Background Historical

Amalungiselelo kolu ngcelele baba antibiotics yokuqala, isiphumo konwaywa lowo ubesazeka abantu. Kangangexesha elide baye esisetyenziswa ngokubanzi kwi unyango lwezifo kunye kwiminyaka yokuqala isicelo phantse a ilikhubalo. Noko ke, kungekudala kwacaca ukuba impumelelo zabo chu, njengoko nasekusungulweni kwihlabathi iintsholongwane akuthethi ukuma. Micro-eziphilayo bayakwazi ukuziqhelanisa ngokukhawuleza kwiintlobo ngeentlobo iimeko entsonkothileyo yobukho, isishiya isizukulwana ekukhanyeni iintsholongwane zintsholongwane ezingatshiyo.

Ubukho penicillin kwakhokelela ekukhuleni ngokukhawuleza iintlobo ezingezizo singangena amagciwane kubo, ngoko uhlobo yayo osulungekileyo ngoku iziyobisi kweli qela olungasebenziyo kananjalo nezingasetyenziselwa. okusemandleni ukuba zisetyenziswa xa zidityaniswe kunye ziimveliso ukuphucula ukusebenza kwabo bactericidal, kananjalo abangaphangeliyo iindlela bacteria zokhuselo.

Amalungiselelo penicillin

Esi beta-lactam nemithi, lucalulo apho kumba kakhulu:

1. Le penicillins zendalo (umz, "Benzilpenitsillin").
2. Anti-staphylococcal ( "Oxacillin").
3. Penicillins, eyandisiweyo-spectrum ( "Ampicillin" "Amoxicillin").
4. Pseudomonas ( "azlocillin").
5. penicillins eziKhuselweyo (kudityaniswe clavulanic acid "sulbactam", "tazobactam").
6. Iziyobisi, kuqukwa ubulungu balo ezimbalwa antibiotics penicillin.

Wayo iziyobisi ngoweqela Lendlela Yeqela penicillin i

Le penicillins yendalo ukucinezela ngempumelelo umsebenzi zombini gram-HIV kunye gram-elibi iintsholongwane. Kubo yokugqibela, eyona vakalelo kweli qela ibeta-lactam antibiotics iStreptococcus kunye noonobangela meningitis. Le ntsholongwane eseleyo ukuya kumhla abazifumene iindlela zokhuselo. penicillins zendalo zisebenza kakuhle nxamnye anaerobes :. Clostridial peptokokki, peptostreptokokkov njl La machiza ayinabungozi yaye inani elincinane ngokwentelekiso iziphumo ezibi, uluhlu apho yehliswe ikakhulu negazi, nangona libanda lunokwenzeka kwaye uphuhliso sokuwa, kunye ukubonakala iimpawu yityhefu ngu amalungu kwinkqubo yokwetyisa.

Ukususela penicillins anti-staphylococcal ixabiso inkulu ye olwa beta-lactam njenge "Oxacillin". Le ukulungiselela isicelo emxinwa, ekubeni lujolise ikakhulu ekulweni S. aureus. Kungenxa kule pathogen (kuquka neentlobo penitsillinrezistentnyh) "Oxacillin" kuyaphumelela. ziphumo bezingalindelekanga ziyafana nezo amanye amalungu eli qela iziyobisi.

Penicillins, elandisiweyo-spectrum ngaphandle i gram-HIV, gram-HIV kunye anaerobic flora nazo asebenzayo ngokuchasene agents causative le zizifo emathunjini. Iziphumo ezingalindelekanga zange kwahluka ukusuka ngentla, nangona la machiza luphawulwa amathuba ephezulu ephezulwana ukuphazamiseka kwenkqubo yokwetyisa.

"Azlocillin" isibulala-zintsholongwane Beta-lactam (ummeli iqela sesine penicillins) yenzelwe ukujongana Pseudomonas aeruginosa. Noko ke, kule nomzuzu pathogen kutyhilwa uxhathiso iziyobisi kolu ngcelele, nto leyo eyenza ukusebenzisa kwabo kakuhle kangaka.

penicillins Malunga Protected zikhankanywe ngasentla. Ngenxa yokuba la machiza ziquka nezinto nokubunjwa kwayo anqanda beta-lactamase ukuvelisa iibhaktheriya, bayaphumelela ngakumbi unyango lwezifo ezininzi.

Iqela lokugqibela - yinto indibanisela ngabameli eziliqela penicillin, olugunyazisa macala inyathelo ngalinye zomnye.

Izizukulwana ezine iintsholongwane abalwa

antibiotics Beta-lactam kunye cephalosporins na. La machiza, ezifana penicillin, mbongeni ezinye ngeentlobo amanyathelo kunye neziphumo ebezingalindelekanga ezimbalwa.

Kukho amaqela (isizukulwana) cephalosporins ezine:

1. Abameli ubalaseleyo besizukulwana sokuqala - "Cefazolin" yaye "Cephalexin". ikakhulu zenzelwe ukuba kuliwe staphylococci, streptococci, meningococci kunye gonococci, kwakunye nezinye izinto gram-negative.
2. Isizukulwana yesibini - kuba "Cefuroxime 'beta-lactam olwa nawo. indawo lwakhe uxanduva iquka Cya ikakhulu gram-negative.
3. "Cefotaxime", "Ceftazidime" - abameli iqela lesithathu le yokuhlela. Bayaphumelela kakhulu enterobacteria kwaye kutshabalalisa flora of nosocomial (iintlobo esibhedlele ezincinane).
4. nakwesesine isizukulwana imveliso engundoqo - ". Cefepime" Inazo zonke iingenelo amachiza ngasentla, koko, uzinzile kakhulu beta-lactamases neentsholongwane kwaye umsebenzi nxamnye Pseudomonas aeruginosa.

Cephalosporins kunye nemithi beta-lactam jikelele iphawulwa isiphumo ngokukhawuleza bactericidal.

Ngenxa yendlela egwenxa nolawulo iziyobisi ezininzi ingqalelo bafanelwe data reactions ezahlukeneyo komzimba (ukungxama ukusuka ezingephi ebomini-ukusongela, ezifana umothuko anaphylactic), kwezinye iimeko ukuphazamiseka ze izitho zokugaya.

iimali ezibekelelweyo

'Imipenem "- a zintsholongwane beta-lactam ngoweqela Lendlela Yeqela carbapenem kulo. Yena, kwakunye "Meropenem" impembelelo yokusebenza akukho edumileyo kangako ukuxhathisa kwamanye amachiza kwi microflora unako ukunika amathuba nkqu cephalosporins kwesesithathu nakwesesine isizukulwana.

Beta-lactam zintsholongwane zelo qela carbapenem - isiyobisi esetyenziswa kwiimeko eziqatha, xa kwamagciwane kodwa efanele unyango ngamanye amachiza.

Esemva kuthetha inombolo ezimbini

"Aztreonam" - ummeli ubalaseleyo monobactams, oko lubonakala ngokuba spectrum elimxinwa noko amanyathelo. Le zintsholongwane beta-lactam kuyaphumelela nxamnye gram-negative aerobic. Nakuba kunjalo, kufanele kuqatshelwe ukuba i "Imipenem" "Aztreonam" kakhulu ongenandaba beta-lactamases, nto leyo eyenza ukuba eli chiza lukhetho iintlobo kakhulu izifo kubefundisi ezi magciwane, ingakumbi xa ukusilela unyango nezinye antibiotics.

LwaseNtshona Koloni ziba ntshukumo antibiotics beta-lactam

Ngamafutshane, kufuneka kuqatshelwe ukuba amalungiselelo ala maqela kuba nefuthe inani elikhulu kweentlobo kwamagciwane. Indlela yesenzo ibeta-lactam antibiotics enjalo ushiya akukho ithuba amagciwane lokusinda: iseli udonga amagama kwafa - isigwebo sokufa ngenxa iintsholongwane.

Gram-HIV kunye navumelanayo-gram izinto, aerobic kunye anaerobic ... Kuzo zonke ezi abameli flora yayintsholongwane eyosulela kukho iziyobisi kakuhle kakhulu. Kakade ke, kukho phakathi kwezi antibiotics kunye nezixhobo ezizodwa kakhulu, kodwa inkoliso zimlindile ukulwa ne-arhente ezininzi esosulelayo. antibiotics Beta-lactam bayakwazi ukumelana nokuba abameli flora nosocomial, zezona ukumelana kakhulu unyango.

Yintoni na strains esibhedlele?

Sithetha micro-eziphilayo ezikhoyo kumaziko ezempilo. Imithombo imbonakalo yazo bakhonza izigulane kunye nabasebenzi bezonyango. Ingakumbi yingozi efihlakeleyo, iintlobo odangeleyo kwezifo. Hospital - indawo ogqibeleleyo ukuqokelela bonke abathwali izifo ezosulelayo kunokwenzeka. Yokunyhashwa lwemithetho zococeko kunye nezithethe ukuba umhlaba ochumileyo weli nezihluma ufumene niche sobukho, apho saphila, uhlobo kunye nokufuna ukuxhathisa kwiziyobisi.

Ngeentlobo isibhedlele ukumelana High ngenxa ngokuyintloko yokuba, xa izibhedlele yabo yokuhlala, iintsholongwane bayakwazi ukunxibelelana ezahlukeneyo iziyobisi. Ngokwendalo, imiphumela iziyobisi eziphilayo kwenzeka ngengozi, ngaphandle kokuba atshabalalise kujoliswe, kwaye iingedosi ezincinane, yaye oku kunegalelo yokuba nabameli microflora esibhedlele ukuphuhlisa likhusi iindlela yatshabalalisa ukuba bafunde ukumelana nawo. Nobunzima kubonakala ukuba balwe ukuba kunzima kakhulu, yaye ngamanye amaxesha kubonakala ukuba akunakwenzeka.

antibiotics Beta-lactam kwiqela ngendlela enye okanye omnye uzama ukusombulula le ngxaki ezintsonkothileyo. Phakathi kwazo kukho abameli nga kukuba ukulwa ngempumelelo nkqu kakhulu ongenandaba lwamachiza iintsholongwane. Eli chiza reserve. ukusebenzisa lawo lilinganiselwe, njengoko baqeshwa kuphela xa kuyimfuneko. Ukuba le mithi ziyasetyenziswa ngokungeyomfuneko rhoqo, ngoko, mhlawumbi, iza kuphela ukuwa impumelelo yabo, ngenxa yokuba ngoko iintsholongwane banethuba ukusebenzisana iingedosi ezincinane ala machiza, ukuba ifundwe kunye nokuphuhlisa iindlela zokukhusela.

Xa ufakwe antibiotics beta-lactam?

Iimpawu zibonisa ukuba ukusetyenziswa kwale qela iziyobisi ngenxa ngokuyintloko ukuba ezinye amanyathelo. Bekuya kuba ngcono ukuba amisele zintsholongwane beta-lactam kwi usuleleko, apho gciwane ingqalelo isenzo beziyobisi.

Penicillins zaziwa kakuhle kunyango pharyngitis, tonsils, inyumoniya, ifiva nebomvu, kwenwebu endocarditis ziibhakteriya, actinomycosis, usulelo anaerobic, Leptospirosis, salmonellosis, shigellosis, izifo ezosulelayo yesikhumba kunye kwizihlunu ezithambileyo. Musa ukulibala malunga iziyobisi kulwa Pseudomonas aeruginosa.

Cephalosporins babe spectrum efanayo komsebenzi, kwaye ngoko ke kubonakala kubo phantse iyafana naleyo ukuze penicillins. Nakuba kunjalo, kufuneka kunokuthiwa ukusebenza cephalosporins, ingakumbi kwizizukulwana ezimbini zokugqibela, hayi mzekelo ungentla.

Monobactams kunye carbapenems ziyilelwe ukuba kuliwe sifo kakhulu kwaye kakuhle ziyanyangeka, kuquka ezo zibangelwa strains esibhedlele. Kwakhona ngempumelelo nokudumba nokothuka yokubolisa.

imiphumela angafuneki

Njengoko sele kuchaziwe, le ntsholongwane beta-lactam (iziyobisi ngoweqela zidweliswe ngasentla eli qela) ahluka linani elincinane neziphumo eziyingozi emzimbeni. unditsho Rare and iimpawu esiswini azikho ezisongela ubomi. Le yingozi ngokwenene inokuba sokungamelani namachiza okanye nezidlo ukuba amayeza phakathi antibiotics beta-lactam.

Irhashalala, pruritus, nokuthimliswa kunye conjunctivitis ayikho ubomi emngciphekweni, nangona zingambi kakhulu. Yintoni okunene ukuba kukoyikwa, ngenxa yokuba ngayo ezifana ngokuqatha angioedema (ingakumbi kummandla we kwingqula, nto leyo sikhatshwa dyspnea kakhulu de nokungakwazi ukuphefumla) kunye nokothuka anaphylactic. Ngoko ke, ichiza angamana kuphela emva kokwenza uvavanyo ukuze uyaliwa.

Kunokwenzeka cross-ngayo. Beta-lactam antibiotics zokuhlela leyo ithetha ubukho kukho inani elikhulu amaqela iziyobisi, ezakheke efana kakhulu omnye komnye, oko kuthetha ukuba xa kwimeko ukunyamezelana komnye wabo, wonke umntu uya kuba waqonda yi umzimba nje allergen.

A amagama ambalwa malunga izinto ezandisa ukungawi iintsholongwane

Ukucutheka kancinane ukusebenza amachiza antibacterial (kubandakanywa antibiotics beta-lactam) ngenxa engenasizathu rhoqo yaye ngokufuthi engachanekanga isicelo. Ikhosi engaphelelanga konyango, ukusetyenziswa iingedosi ezincinane imithi ungakuvumeli alulame kodwa ukuthintela Cya ithuba "uloliwe", ukuba zizakhele nokuphuhlisa iindlela zokuzikhusela iziyobisi. Ngoko ke, ngaba iyamangalisa into yokugqibela ukuba angasebenzi ngokuhamba kwexesha?

Nangona ngoku antibiotics kwaye kukhululwa nakwiikhemisti ngaphandle kwencwadi kagqirha ukuze bonke unako. Oku kuthetha ukuba i-self kunye neengxaki ezinxulumene (usebenzisa lonke ixesha ziyobisi, uphazamiseko ngqiqweni unyango, idosi engachanekanga njalo njalo.) Uya kuhlala, ukudala iimeko ukuze kulinywe iintlobo-enganyangekiyo ngamachiza.

Kulapha ukuba bahlale kunye nezityalo e-esibhedlele, ukuba ithuba ukunxibelelana ngomdla zeziyobisi ezahlukeneyo ceba iindlela ezintsha ukulwa nabo.

Yintoni ukwenza ntoni? Musa self-medicate, ukuba enze iingcebiso igqirha ukuya: ukuthatha amayeza kangangoko kuyimfuneko, kwaye ngokwemithamo efanelekileyo. Kunye flora nosocomial ukulwa, Kakade ke, kunzima ngakumbi, kodwa kunokwenzeka. Zokuqinisa imithetho zococeko kunye nokuphunyezwa yazo engqongqo iza kunciphisa amathuba ekudaleni iimeko azivumi ukuba ukufuya izihluma enganyangekiyo.

A amagama ambalwa esiphelweni

A isihloko ebanzi kakhulu - beta-lactam antibiotics. Pharmacology (inzululwazi amayeza kunye nefuthe lazo eziphilayo) wayingcwalisayo kubo izahluko ezininzi eziquka iimpawu ngokubanzi nje kuphela elo qela, kodwa siqulathe inkcazelo elaziwa abameli balo. Eli nqaku ayenzelwanga ukuba ibe banzi, kodwa izama ukungenisa iimbalasane, ukwazi ukuba yeyiphi kwezi imithi kuyimfuneko.

Cheers kwaye musa ukulibala; phambi kokusebenzisa eli okanye zintsholongwane ufunde le miyalelo ngocoselelo uze ulandele ngokungqongqo iingcebiso, okanye okungcono kodwa, athethane oyingcali.