Zintsholongwane "zyvox": imiyalelo, analogs

Xa unyango lwezifo ugqirha ziibhakteriya bavame ukuyala antibiotics. La machiza kufuneka inani enkulu kwiintlobo. Kakade ke, nazo zonke iindidi zemveliso zoxubo kubola akunakwenzeka ukuba ukwazi, kodwa amanye amayeza nxamnye kwezifo umdla ethile.

Enye antibiotics mihla, nto leyo inikwa kurhwebo lwethu lwamayeza - yi "zyvox". Imiyalelo zokusetyenziswa ichiza ibonisa ukuba le arhente elwa lwe imvelaphi zokwenziwa. Lukamongameli iqela elikhethekileyo - oxazolidinone. Eyona nto iphambili esebenzayo i linezolid. Ifuthe ichiza "zyvox", imiyalelo ukusetyenziswa, analogs, iziphumo ebezingalindelekanga kunye Izimo: Okulandelayo ukuba ezi nkcukacha zilandelayo ziya kuqwalaselwa thina.

Ziziphi ifomu iveliswa?

Ichiza ifumaneka iintlobo ezimbini balawule:

• Xa uhlobo granules, zenziwe ezimhlophe okanye bulubhelu ngebala kunye incasa-orenji. Kwezi, i pereoralnogo isisombululo ukusetyenziswa okulindelekileyo ukuba 5ml of ugqibile lokunqunyanyiswa kuya kuba 100 mg linezolid. Le granules babekwa ngendlela izinambuzane nomthamo ml 150. Kwakhona kwi iphakheji ngecephe umlinganiselo kunye iziqu (2.5 kunye ml 5 yokumisa).
• Xa uhlobo lwe amacwecwe aqulethe 600 mg linezolid. Lo mqulu uba blister kunye tablets 10 ngaphakathi.
• isisombululo ukumnika equlathe 2 mg linezolid / 1 ml, xa upakisho ka-100, 200, ml 300.

Yintoni na isiphumo amayeza na ichiza?

linezolid into esebenzayo uyakwazi ukungena kwi yeseli ziibhakteriya, ukubophelela ribosomes zabo kwaye zinqanda protein yokuqaphela. Ngenxa yoko, magciwane ayabulawa.

Against naziphi Cya inceda iziyobisi?

Drug "zyvox" yesikhokelo okuhambisana impahla ngasinye iyeza ngempumelelo izenzo phezu kwala magciwane zilandelayo:

• iintsholongwane aerobic gram-HIV: Enterococcus, Ezi, Staphylococcus, iStreptococcus;
• Gram-HIV iintsholongwane aerobic le nePasteurella uhlobo;
• Gram-HIV iintsholongwane anaerobic: zeClostridium kunye peptostreptokokki;
• Gram-HIV iintsholongwane anaerobic le kwisizukulwana prevotella, bakteroides, chlamydia.

Ukuze linezolid iintsholongwane abangaxhalabisiyo zithandwa le kwisizukulwana Moraxella, Legionella, Mycoplasma.

Kukho kwakhona Cya leyo kombisa ukumelana linezolid, inxalenye ichiza "zyvox". Imiyalelo yokusebenzisa lubonisa ezimelene nemithi zilandelayo: iintsholongwane Haemophilus influenzae, kwakunye enterobakteriatsea delivery, nizera kunye Pseudomonas.

Ziziphi izifo kokuba kuboniswe iyeza?

"Zyvox" isibulala-zintsholongwane wabelwa ukuba zifo zilandelayo:

• Izifo ezosulelayo kunye ukudumba ukuba zibangelwa amagciwane avelana ichiza elinikiweyo.
• Kwiimeko yinyumoniya nosocomial okanye yoluntu ezifunyanwa.
• Kunye amanxeba ezosulelayo ulusu kunye kwizihlunu ezithambileyo omzimba womntu.
• Xa ukubakhona kwezifo, arhente ezo enterococci abonise ukuxhathisa vancomycin.

Kwakhona, "zyvox" isibulala-zintsholongwane zingasetyenziswa njenge njengenxalenye uhlobo odityanisiweyo unyango nxamnye zosulelo evela ngenxa iintsholongwane ezimbi gram-to.

pharmacokinetics

Linezolid luphawulwa absorbability ngokwanelisayo ekhawulezileyo ukusuka wokugaya kumlanjana igazi, nokuba le arhente ifomu ukukhululwa. Kakade emva iiyure ezi-2 emva kokuba ulawulo ichiza, eyavela kwi plasma efikelela ubuninzi. Linezolid luphawulwa bioavailability ngokupheleleyo yaye ngokukhawuleza ukuba ukwabiwa yayo Amalungu nezihlunu. Kungakhathaliseki ukuba yintoni na lwee- zintsholongwane egazini-31% bebotshiwe iiproteni plasma.

Kubantu, linezolid umzimba igcwala ukuya iimveliso ezimbini ecingisisiweyo inyathelo elwa. Bona kwazona yi izintso (malunga nama-50%) kunye namathumbu (ukuya kwi-6%). Ukuya ku-35% nemithi non-umzimba kwazona kunye nomchamo.

Kuphawulwa pharmacokinetics kuzinza, nto leyo luphawulwa ichiza "zyvox". Imiyalelo zokusetyenziswa ngokuxhomekeke ngokungabi ngokovavanyo kubudala yesigulane. Ngoko ke, abadala musa ukuba kukhubazeko nokulungiswa idosi kwimveliso amayeza.

balawule

Le medicament "zyvox 'ukuze yabelwe kugqirha ukuba umguli yolawulo yomlomo okanye ngohlobo yolawulo ukumnika efakwa. Ngaphezu koko, isigulane ke zidluliselwe ukusuka kolunye uhlobo ukuya kolunye kokungenisa ngaphandle kokulahlekelwa ukusebenza konyango.

Amayeza umthamo, lokuqhubeka kwekhosi iya konyula igqirha, kunye nonyango yezi meko zibangelwa zinto zilandelayo:

• luni lwegciwane kubangelwe sesi sifo;
• usuleleko lendawo;
• ubungqongqo sifo;
• inzuzo kwezonyango evela unyango.

Xa streptococcal pneumonia, uluntu ezifunyanwa kunye esibhedlele-uhlobo abadala kunye nabantwana abangaphezu kweminyaka eli-12 emiselweyo 600 mg of "zyvox" iziyobisi. Manual libonisa ukuba ukuthatha ithamo amayeza kufuneka luphunyezwe rhoqo emva kweeyure ezili-12 kwaye ubude khosi ziintsuku 10-14.

Kuba zifo esikhumba okanye izicwili ethambileyo, unzima okanye nokunga okubangelwa staphylococci, streptococci kunye enterococci ukumelana vancomycin, kuquka isifo seswekile unyawo syndrome (ngaphandle osteomyelitis) umsebenzi ithamo "zyvox" 600 mg. Umyalelo uphakamisa ukuba lekhefu phakathi ukuthatha iyeza kufuneka iiyure ezili-12. Ikhosi ye unyango ihlala iintsuku 10-14, kodwa ungatsala ukuya kwiintsuku 28 kwi kagqirha zonyango.

Ukuba isigulana umntu ongaboniyo kwezintso, olo hlengahlengiso ithamo amayeza alisweleyo. Xa iinkqubo ihaemodialysis linezolid isusiwe phezu ixesha 3 h. Ngokuphathelele oku, ichiza kufuneka athathwe emva kwesiganeko kwi kungengokwentlambululo yendawo igazi. Izigulane abafunyaniswe isibindi, kwaye musa ukuba kukhubazeko nokulungiswa idosi.

Izigulane kweminyaka emi-12 ubudala yabelwa kuphela uhlobo nokuhlanganiswa iziyobisi "zyvox". Imiyalelo ukuba isetyenziswe kwiintsana kunye nabantwana ibonisa ukuba linezolid kuthathwa kukho umthamo-10 mg / kg umzimba ubunzima womntwana kumaza e kuzo zonke iiyure ezisi-8. Ikhosi ye unyango ukusuka kwiintsuku ezili-10 ukuya kweli-14. Le umthamo ichiza kuthomalaliso mlonyeni kwindawo ezifunyanwa kwaye nosocomial pneumonia, zizifo kwizihlunu ezithambileyo, nezikhumba, kwakunye ukujongana izifo enterococcal.

esingxotyeni zothintelo eyenziwe ngefoyile, isuswa ngokukhawuleza phambi kokuba inkqubo ukumnika. Kuyimfuneko ukukhangela iphakheji ezivuzayo abenze kuba umzuzu 1. zokubopha oluvuzayo yaphela ngenxa non-inzalo. Isisombululo ukumnika ilawulwa ngokuhamba kwexesha ubuncinane imizuzu 30-120.

Iimpawu ze isicelo

Kukho ezinye iinkalo lolwamkelo esikolweni "zyvox" iziyobisi. Manual ibonisa ukuba xa usulelo ibangelwa Igram-HIV iintsholongwane, kuyimfuneko ukuba ukuqhagamshela iziyobisi ezongezelelweyo umsebenzi kulo qela ezincinane.

Xa ufumana linezolid ezinye izigulane esinokubakho myelosuppression ingathityazwa. Kuxhomekeka ixesha unyango luphawulwa kwegazi, leukopenia, thrombocytopenia okanye pancytopenia. Ngokusekelwe kwezi data, esweni ukubalwa igazi kufuneka kwenziwe izigulane kunye nengozi ukopha. Kwakhona, la manyathelo afanelekileyo ukuba isiguli imbali myelosuppression okanye uthabatha iziyobisi zokunciphisa amanqanaba mpilo kunye platelets okanye umsebenzi wabo. Uvavanyo ukubalwa igazi kuyimfuneko ngexesha unyango elide (iintsuku ezili-14).

Ezinye izigulane abafumana linezopida kufuneka sikhatshwe ingozi yokudumba, pseudomembranous uhlobo iintlobo ezahlukeneyo womxhuzulane.

Urhudo kuxhaphakile abantu abathatha antibiotics rhoqo. Ububanzi balo isiphumo icala ingahluka ngobulali esiqatha. Ngoxa ezithatha ichiza, "zyvox" ipilisi okanye ukumiswa na, kukho ingcinezelo of microflora oluqhelekileyo amathumbu kunye imithana bacterium sodidi zeClostridium. Xa inkqubo yobomi babo kule ephilayo ivelisa ityhefu A kunye namaqela B, kwaye zibangela urhudo. imigangatho ephakamileyo kula macandelo inokubulala kwizigulane. Zonke izigulane abanikwe olu hlobo urhudo, kufuneka kweliso zonyango ngenyameko ixesha leenyanga ezi-2.

Kwezinye iimeko, ukwehla kwi unyango "zyvox" iziyobisi. Imiyalelo ukusetyenziswa abantwana kunye nabantu abadala, ebonisa ukuba utshintsho kunokwenzeka umbala mbono, kugxilwe ezibonwayo, iziphene intsimi, imfiliba. Kule meko, isigulane kufuneka ngoko nangoko udibane nogqirha wamehlo. Ukuba le iyeza ethatyathwa isigulana kwithuba elide (ngaphezu kweenyanga ezi-3), ngoko ke inyanzelekile ukuba kulawulo. Xa ukwenzeka kunye nophuhliso iziganeko ezifana peripheral neuropathy okanye luvo optic, umbuzo zokuyeka unyango ngamachiza ukuba iinzuzo kulo lingaphantsi kwe umonakalo owenziwe empilweni.

Kwakhona, kwakukho amatyala lactic acidosis ngexesha uthatha "zyvox". Oku kubonakala ngokohlobo isicaphucaphu, ukugabha, asidi okanye ukuncitshiswa ngokungenabulungisa ngenxa anions carbonate. Lo mkhwa kufuneka esweni ngenyameko specialist zonyango.

Ukuba isigulana kukho imfuneko ngokudibene "zyvox" ukuthatha uyakhetha serotonin reuptake inhibitors, kufuneka zithathwe phantsi kweliso zonyango ukuze ukubona serotonin syndrome: ukungasebenzi umsebenzi kwengqondo, hyperreflexia, hyperpyrexia, kunye incoordination. Xa ubukho nesenzeko ezichazwe avelise ukupheliswa amachiza omnye okanye zombini. Ngenxa yoko kukho kombala izinyo lwawo, nto leyo isuswe ukucoca abaqeqeshiweyo.

Kukho omnye caveat ukufumana 'zyvox "iziyobisi. Imiyalelo yokusebenzisa (tablets okanye granules kukunqunyanyiswa - Akukhathaliseki) uthi: unyango kunye linezolid akunconywa iimoto uqhuba, ulawulo izixhobo ezizodwa imisebenzi ebandakanya umngcipheko ebomini kunye nempilo.

Zintoni iziphumo ebezingalindelekanga isiyobisi?

reactions Ezingalunganga ezinokuthi zenzeke kule isigulana ngexesha uthatha yomenzeli amayeza "zyvox 600 mg" zihlelwa ubukho zobungakanani ukusuka rhoqo kakhulu (10%) ukuya ezinqabileyo kakhulu (0.01%).

Ngokuqhelekileyo, iziphumo ebezingalindelekanga kwi unyango "zyvox" imiyalelo iziyobisi ukusetyenziswa, esi sisombululo okanye tablet, ngumkhuba ekuthiwa nobukhulu qatha okanye ngcathu. izinga Special unawo iimpawu zilandelayo:

• isicaphucaphu;
• sorhudo;
• intloko.

Xa izigulane abadala nabo bangafumana ukuqhina, ukugabha, iintlungu esiswini, ukuqumba, nezifo vulvovaginal le kwisisu ngomlomo.

Ngu enqabile ziyenzeka imiphumela emibi "zyvox" imiyalelo iziyobisi zokusetyenziswa (abantwana ngasentla iminyaka eli-12 kunye nabantu abadala) ibiza notshintsho umbala ulwimi umbala.

Ngokusekelwe izifundo elebhu, oko Kungaphikiswa ukuba ngexesha unyango ngale zintsholongwane idla bekubona thrombocytopenia. Hayi njalo waphawula ukwanda kumanqanaba igazi triglycerides, ukusebenza okungaqhelekanga kwesibindi enzyme ALT, AST, phosphatase obrak, LDH kunye lipase kunye amylase. Ukunyuka yoxinaniso iyonke yibilirubin, creatine kunye prolactin nazo zibhaliwe.

Luvo lwe isiguli basabela njani ichiza kunye linezolid. Oku kudla ngokuboniswa vertigo kunye uqaqanjelwa, ngokunjalo amahlaba. obubonakala anqabe yeziphumo ebezingalindelekanga echiza amatyala eve enxamnye nemvelo.

Utshintsho kwi eqhelekileyo yokusebenza kwenkqubo luvo kunokubangela "zyvox" (tablets). Guide ibonisa ugwayi eziqhelekileyo izigulane ebudeni unyango nale ukulungiselela amayeza.

Nokusebenza nothomalaliso inkqubo genitourinary usebenzisa 'zyvox "engabonakaliswa ngokohlobo candidiasis lobufazi.

Ngokufuthi apho cutaneous izenzo unyango linezolid ngohlobo irhashalala.

Phakathi kwezinye ziphumo bezingalindelekanga kubizwa ngokuba nesenzeko febrile nosuleleko olungenelelayo ezinzwaneni, nto leyo eyenzeka manqaphanqapha.

Kwakhona, xa iziyobisi "zyvox" sifundo waphawula amatyala high blood pressure, ukurhawuzelela kunye ukungacoleki kokutya.

Linezolid kwi unyango izigulane nomthinjana abaneminyaka eyi-12 ukuya ku-17, ngokufuthi bafumana iziphumo ezingafunekiyo zilandelayo:

• sorhudo, ukugabha, isicaphucaphu, iintlungu esiswini;
• vertigo, migraine;
• ufunga;
• Izifo ezosulelayo eliphezulu yomoya, ukukhohlela, umqala obuhlungu;
• umkhuhlane;
• ntlungu kunzima ukuchaza lizwe.

Le nesenzeko zilandelayo zenzeka linophawu a frequency esezantsi:

• eosinophilia;
• ukwanda triglycerides, ALT, lipase kunye creatine;
• ukulunywa.

ziphumo bezingalindelekanga ezongezelelweyo zabonwa kwi sifundo lwezonyango, esibonakala yi "zyvox" (solution, kunye namacwecwe). Ezi ziquka:

• myelosuppression ingathityazwa;
• peripheral ye-luvo optic;
• anaphylaxis;
• uphawu nokudumba angioneurotic;
• lactic acidosis;
• peripheral ubhalo neuropathy;
• kombala izinyo lwawo;
• Ukugodola;
• nokudinwa;
• serotonin syndrome.

Njengoko "zyvox" kokuba edibene namanye amayeza?

Xa co-elawulwa kunye cytochrome akukho tshintsho iqatshelwe umsebenzi wokugqibela.

Ukuba efanayo ixesha ukuphathwa linezolid kunye monoamine oxidase inhibitors, umphumo yokugqibela zinokukhuliswa. Ngokusekelwe kule nto, ukuba kuyimfuneko ukunciphisa umthamo agonists kunye Dofaminomimetiki.

Xa co-ezilawulwa iziyobisi "zyvox" kunye lakhula leyo zinqanda ukufunxeka serotonin, serotonin syndrome zingenzeka.

Kwimeko co-lezolawulo "aztreonam" okanye "Gentamycin" farmakinetika linezolid ayizange ulandelwe.

Co-lezolawulo "rifampicin" kubandakanya ngokuthotywa makismalnaya xi "zyvox" - ukuya kwi-32%.

Izimo

Ichiza Okwala ukusetyenziswa zizigulane kunye nokwanda uvakalelo amacandelo aphambili okanye ezongezelelweyo phakathi isakhiwo sayo.

Ukuba isigulane phenelzine okanye isocarboxazid, linezolid ngoko ke asikwazi kuthathwe ngexesha unyango, kwaye kwiiveki ezi-2 emva koko.

Ukuba akukwazi ukulawula uxinzelelo lwegazi, i "zyvox" akwamkelekanga ukunyanga izigulana kunye zifo zilandelayo:

• BP eziguquguqukayo;
• hyperthyroidism;
• pheochromocytoma;
• kwakunye ukwamkelwa kunye agonists kunye Dofaminomimetiki.

Xa ukungakwazi uyiqwalasela kakuhle isigulane umngcipheko serotonin syndrome "zyvox" ayikwazi eyabelwe kwezi meko zilandelayo:

• phambi isifo carcinoid;
• ulawulo neziyobisi zinqanda reuptake of serotonin, triptans lakhula tricyclic uhlobo 'Miperedina "yaye" buspirone ".

azipilisi "zyvox" into contraindicated abantwana abangaphantsi kweminyaka eli-12 ngenxa nakwenzeka ngokukhethwa balawule eyaneleyo.

Ichiza iboniswe unyango xa iinzuzo ezilindelekileyo kulo ngaphezu umngcipheko kwezi meko zilandelayo:

• insufficiency uxabane hepatic;
• izifo systemic;
• Ukukhulelwa ne zisanyisa.

Mhlawumbi libanda, iziyobisi?

Kwizifundo zonyango, kwakunye nokusetyenziswa ngakumbi yokulungiselela "zyvox" esibhedlele okanye libanda, isicelo ezifunyenwe yoluntu-ayizange andibhaqwa. Xa kusenzeka oku kucetyiswa unyango nomqondiso.

Ukugcinwa kunye nokukhululwa

Drug "zyvox 'ekhoyo ezikhemisti ngokumiselwa. Kugcine oko kufuneka endaweni, kuphela yi ukufuma kunye kwelanga ngqo kwiqondo lobushushu hayi ngaphezulu kwe 30˚C, ukuba ukungena zabantwana.

analogs

Kwimeko ka ukungamkeleki zonyango "zyvox" analogs lweengcinga kufana ukuze yabelwe neziphumo zonyango iphambili into esebenzayo:

• Xa inyumoniya nokukrala - "hydrochloride Doxycycline" "Bronhorus" "Arlette".
• Xa izifo bakteialnyh - "Chloramphenicol 0.25 g", "Vankomabol", "Lifakson".
• Ekubeni izifo esikhumba - "Benzathine Benzylpenicillin", "Sulfadimetoksin".
• Xa nonhealing amanxeba - "Tsifaleksina sodium ngetyuwa", "Liphuzol".

Ukumisela nabo kolu luhlu kufanele gqirha kuphela, ngokuba ichiza ngayinye inemisebenzi ezibonisa, Izimo, ngokukodwa ulwamkelo.