"Meropenem": umarnin don amfani, sake dubawa. Maganin maganin ƙwayoyi

By roba maganin rigakafi hada carbapenems kungiyar, wani wakilin wanda yake da miyagun ƙwayoyi "meropenem" for parenteral gwamnati. Saboda aikin bactericidal da bacteriostatic na sashi mai aiki, miyagun ƙwayoyi zai iya hana ci gaban da kuma yawan kwayoyin cutar da ke haifar da cututtukan ƙwayoyin cuta.

Bayani na maganin

Maganin miyagun ƙwayoyi "Meropenem" ana daukar su a matsayin kwayoyi masu tsinkaye kuma suna da farin ko farin foda tare da inuwa mai inuwa don shiriyar wani bayani. Sarrafa intravenously bolus ko jiko.

Saki shi a vials tare da girma na 10 da 20 ml. Sashin kwayar lyophilizate shine 0.5 g ko 1 g na miyagun ƙwayoyi Meropenem. Kwamfuta da kuma maganin injectable don ingancin intramuscular ta amfani da kwayoyin halitta ba a samar su ba. Akwai nau'i guda ɗaya daga saki.

Tsarin shiri

Kamar yadda mai aiki aiki ya bayyana meropenem a cikin hanyar trihydrate. A cikin bayanin irin abun da ke ciki, an lissafa shi don kwalban guda ɗaya, adadin abin da ake aiki shine aka nuna cewa: meropenem trihydrate a 0.570 g, ko 1.140 g, kuma a cikin sharuddan kyauta mai sauƙi, 0.5 g ko 1 g kowace. Ƙananan abubuwa na foda sun hada da carbonate sodium.

Muhimman analogu da masu samar da su

Magungunan asalin da ke kan meropenem shine miyagun ƙwayoyi "Meronem" a cikin fom din 0.5 g Ana amfani dashi don yin maganin inuwa, wanda aka gudanar da shi cikin intravenously. Wannan kwayar cutar ta samo asalin kamfanin Astra Zeneca Ltd na Birtaniya, wanda aka kirkiro abin da ake amfani da shi da kuma magungunan magani, an gudanar da gwajin ƙwararrun kwayoyi. Sauran sauran shirye-shiryen da aka yi amfani da su tare da meropenem suna dauke da kwayoyin halitta da kuma sake buga su a cikin misalin asali.

Ana ba da alamun analogs na "Meropenem" a karkashin sunan kasuwancin, wanda ya dace da sunan ƙasashen duniya wanda ba na mallakar kuɗi ba, kuma a karkashin kasuwanci, ban da INN da aka karɓa. Nau'in saki, sashi da abun da ke ciki na dukkanin kwayoyi da aka sake buga su a cikin misalin "Meronem" daidai ne, wanda ke nuna haɗin su.

Magungunan miyagun ƙwayoyi tare da sunan kasuwanci "Meropenem" an samar da shi daga tsire-tsire masu magunguna da yawa a duniya. Alal misali, kamfanin Indiya "M. J. Biofarm Pvt. Ltd. samar da magani, kuma ana sawa buƙata a kamfanonin Rasha CJSC BIOTEK MIPPDK. Kamfanonin Ukrainian "Lekhim", "Pharma Life" kuma suna samar da kwayoyin "Meropenem". Analogues kuma zasu iya ƙunsar sunan mai amfani a cikin sunansu. Akwai misalan misalai a duniya kantin magani. Musamman, an san magungunan "Meropenem-Vero". Wannan shi ne samfurin kamfanin Shenzhen Heibin Pharmaceutical Co. Ltd. ".

Magunguna "Meropenem Jodas" wani analog ne na Indiya na Jodas Expo. An samar da shi a cikin nau'i na foda don yin gyaran allurar injection 500 mg da 1000 MG.

Kamfanin Rasha kamfanin LLC "ABOLmed" ya haifar da miyagun ƙwayoyi "Meropenabol" akan ma'anar mai amfani da cutar antibacterial. An shirya bayani game da gwamnatin intravenous daga foda.

Da magani "Meropenem Spencer"

Wannan kayan aiki ne wani takwaransa na Indiya wanda Cooper Pharma ya samar don Spencer Pharma Yukey Limited, India. Ana samar da shi ne bisa tushen meropenem a cikin hanyar trihydrate kuma yana cikin rukuni na carbapenems. Magunguna Meropenem Spencer yana da tasirin cutar kan kwayar cutar kwayar cuta da kwayoyin cuta a cikin cututtuka da cututtukan cututtuka. Amfani don kula da iyaye.

Pharmacological Properties

Babban mahimmancin abu mai nauyin ƙwayoyi mai amfani a kan umarnin don amfani ya nuna nauyin aikin kwayar cutar da wani bambance mai bambamcewa, wadda ke hade da maye gurbin jigilar kwayoyin membrane. Halin da ake iya haifar da mutuwar aerobes da anaerobes ne saboda shiga cikin kwayoyin kwayoyin ta hanyar bango na microorganism, inertness dangane da beta-lactamases da kuma dangantaka mai mahimmanci ga tsarin gina jiki wanda ke ɗaure abincin penicillin.

Ta hanyar jingina ga masu karɓar haɓaka a jikin membrane na cytoplasm na kwayoyin cutar, rage kullin peptidoglycan a cikin tantanin tantanin halitta, da kuma kashe transpeptidase, an cire sassan enzymes autolytic a bangon tantanin halitta, suna lalata tsarinsa kuma suna kaiwa ga mutuwar kwayoyin.

A wace irin kwayoyin halittu ne kwayoyin kwayoyin halitta ke aiki?

Ga miyagun ƙwayoyi "Meropenem" umarnin don amfani yana samar da amfani ga Gram-positive aerobes, wanda ya hada da Enterococcus fecalis, Staphylococcy aureus, Streptococcus agalactia, Streptococcus ciwon huhu tare da hankali ga
Penicillin, Streptococcus pyogenesis, Streptococcus viridance.

Ayyukan maganin kwayar cutar yana da karfi sosai a kan magungunan Gram-negative, daga cikinsu akwai E. coli, murafan Hemofilus, Klebsiella ciwon huhu, Neisseria meningitis, Pseudomonas auruginosa, Proteus mirabilis an ware.
Akwai meropenem akan kwayoyin anaerobic kamar: Bacteroid flagylis, Peptostreptococcus spp.

An tabbatar da inganci na miyagun ƙwayoyi akan wadannan kwayoyin kwayoyin halitta kawai ta nazarin nazarin in vitro, amma babu wani shaida na asibiti.
Abubuwan da ke dauke da kwayar halitta mai kama da ƙwayoyin cuta sun hada da Staphylococcus epidermidis tare da methicillin hankali, da kuma Gram-negative aerobes: Acinetobacter spp., Aeromonas hydrophilus, Campylobacter jediuni, Citrobacter diversia, Citroobacter freundi, Cloarocter cloaci, Hafnieh, Klebsiella psitta, Morakella catarrhalis, Morganella Morgani, Pasterella multocida, Proteus vulgaris , Salmonella spp., Serratia marcesens, Shigella spp., Ursina enterocolitis.

A vitro yãki anaerobic kwayoyin :. Bakteroides distasonis, Bakteroides ovatus, Bakteroides uniformis, Bakteroides ureolitikus, Bakteroides vulgaris, Clostridium difficile, Clostridium perfringens, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes.

Abin da miyagun ƙwayoyi ke bi

Dangane da irin nauyin aikin da ake amfani da shi na kayan aiki mai amfani, ana bada umarnin yin amfani da su don amfani a wasu cututtuka masu cututtuka da cututtukan cututtuka kamar magani mai mahimmanci ko a matsayin ɓangare na maganin haɗuwa.

Wadannan sun hada da kulawa da kamuwa da kwayar cutar kwayoyin cutar, wanda ke shafar:

• Ƙananan raunuka na numfashi, wadanda suka bayyana ta hanyar ciwon huhu, ciki har da cutar kututtukan asibiti;
• Tsarin urinary a cikin hanyar pyelonephritis, pyelitis;
• Skin da kuma taushi a cikin nau'i na erysipelas, pyoderma, na biyu cutar dermatosis;
• Ƙungiya a cikin ƙananan ƙwayoyin cuta, ciki har da aikin ƙwayar ƙwayar mai ƙwayar mucosa;
• Ƙungiya a cikin rami na ciki, ciki har da yanayin rikitarwa mai ƙari, peritonitis, pelvioperitonitis.

Da miyagun ƙwayoyi yana da tasiri a cikin cututtukan kwayoyin cuta da cutar jini. Mutanen da suke da tsaka-tsakin tsaka-tsaki suna amfani da kwayoyin kwayoyin a hade tare da jami'in antiviral ko antifungal.

Dokokin don shirye-shiryen bayani

Rushewar miyagun ƙwayoyi ya buƙaci bin ka'idodin tsari da maganin antiseptic. Ana amfani da kwalabe na fata tare da bayani sau ɗaya, ba a yarda ya hada kwayoyin maganin rigakafi da sauran kwayoyi a lokaci ɗaya.

Magunguna "Meropenem" a cikin nau'i na foda za a shafe shi da ruwa mai inganci don ci gaba da jagorancin bolus na intravenous. Don soke 1 g na meropenem, 20 ml na ruwa da ake amfani da, wanda ya dace da maida hankali na 50 MG da ml. Rabin da aka shirya yana yawanci bayyananne, ba tare da launi ba ko tare da tinge mai haske.

A matsayin maganin ƙwayoyi don miyagun ƙwayoyi "Meropenem" zaka iya amfani da 50-200 ml na jituwa mai jituwa mai jituwa. Sun hada da:

• Magani na sodium chloride 0,9%;
• Wani bayani daga dextrose 5% ko 10%.

Kafin gwamnatin intravenous, an girgiza ruwa mai diluted.

Yin maganin miyagun ƙwayoyi

Ga tsofaffi, maganin maganin "Meropenem" don amfani yana bada nauyin 500 MG, wanda aka maimaita bayan 8 hours. Bisa ga wannan makirci, ciwon huhu, urinary tract cuts, cututtuka da cututtuka na cututtuka na kwayoyin halitta a ƙananan ƙwayoyin cuta, cututtuka na fata da kuma tsoka.

Kwayar rashin lafiya a cikin asibitin, peritonitis, septicemia, alamun kamuwa da cutar kwayan cuta a marasa lafiya tare da neutropenia febrile na buƙatar kwayoyin maganin sau 3 a rana don 1 g. Ga maningitis, an yi amfani da kashi 2 g bayan sa'o'i takwas.

Dangane da nauyin ƙananan cuta da nau'i na cututtuka na mai haƙuri, da dosing da tsawon lokacin magani ana zaɓar ta likita.

Yawancin lokaci, tsawon lokaci na magudi yana dogara da yanayin gwamnati. An yi amfani da bolus intravenous ciyar da bayani diluted don kimanin minti 5, da kuma jigilar intravenous - daga 15 zuwa 30 minutes. Magani "Meropenem" ba a gudanar da shi ba a cikin intramuscularly.
Kullum na koda gazawar da bukatar gyara dosing daidai da creatinine yarda :

• A minti 26-50 a minti daya jimlar daga 500 mg zuwa 2 g, kowace rana 12;
• A minti 10-25 a minti daya kashi shine daga 250 MG zuwa 1 g, kowace rana 12;
• Kasa da minti 10 a minti daya, jimlar ta kunshi daga 250 MG zuwa 1 g, kowane 24 hours.

Marasa tsofaffin marasa lafiya tare da aikin koda na al'ada da haɓakar creatinine sama da 50 mL a minti daya ba a buƙata a yi musu ba. Hanta gazawar ba wani dalili ga kashi gyara.

A lokacin yaduwar kwayar cutar, cire miyagun kwayar halitta ya auku, saboda haka ana amfani da miyagun ƙwayoyi a ƙarshen hanya. Wannan shi ne ainihin gaskiya ga magani mai tsawo don sake mayar da hankali ga magungunan kwayoyin cutar cikin jini.
A cikin yara daga watanni 3 zuwa 12, ana amfani da miyagun miyagun ƙwayoyi a cikin kilo mita na nauyin jiki a cikin lokaci na takwas. Dosage ya dogara ne da wakilin da ke kamuwa da kamuwa da cuta, da yadda ya dace da kwayoyin cutar da kuma irin wannan cuta.
Idan yara a ƙarƙashin shekara 12 suna kimanin fiye da 50 kg, an umarce su su zama maganin miyagun kwayoyi.

Yau da ba a yi nazarin yara masu amfani da cutar ba.
A cikin maganin meningitis, ana amfani da 40 mg na kilogram na nauyin jiki bayan 8 hours.

To wanda aka contraindicated jiyya

Yana da muhimmanci a san cewa ba kowa ba ne zai iya yin amfani da miyagun ƙwayoyi, musamman ma lokacin da ake samun karuwa ga wannan kwayoyin cutar ko kuma irin beta-lactam antibacterial agents a baya.

Ƙananan yara a ƙarƙashin watanni 3 ba a ba da izinin miyagun ƙwayoyi "Meropenem." Shaidun marasa lafiya sun shaida shaidar yin amfani da shi da kwayoyi da ke da illa mai haɗari akan kodan da cututtuka na yankin narkewa.
A lokacin daukar ciki, ba a yi amfani da miyagun ƙwayoyi ba, sai dai lokuta idan amfanin kwayoyin cutar ya wuce sakamako mai cutarwa akan ci gaban ɗan yaro. Yayin da likitoci ba su bada shawarar shan nono a lokacin magani.

Sakamako na gefen

Game da miyagun ƙwayoyi "Meropenem" reviews sun nuna yiwuwar ci gaba da illa maras so a sassa daban daban na jiki.

Tsarin kwayoyin halitta da sassan jiki na kwayoyin halitta zasu iya amsa maganin kwayoyin tare da bayyanar ciwon kai, rashin tsoro, jin dadi a cikin yanki, jin dadi da tsigewa, tashin hankali mai motsa jiki, rashin fahimtar kwarewa, suturar rigakafi, tsaikowa.

A tsarin kwakwalwa, kwayoyin hematopoiesis da miyagun ƙwayoyi suna da tasiri mummunan sakamako tare da karuwa a yawan adadin eosinophils da platelets a cikin plasma na jini na jiki, tare da rage a cikin plalet da leukocyte Kwayoyin, matakin hemoglobin, karuwa a cikin ma'aunin hematocrit da lambar neutrophils da ke haifar da agranulocytosis, Thromboplastin da lokacin prothrombin.

Wasu marasa lafiya sun lura da canje-canje da aka haɗa da gabobin ɓangaren gastrointestinal, waɗanda aka nuna ta jin zafi a cikin rami na ciki, tashin zuciya, vomiting, zazzabin, rikice-rikice, cuta mai narkewa, jaundice. Haka kuma zai yiwu a ƙara yawan bilirubin a cikin plasma jini, ƙara yawan ayyukan enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase da lactate dehydrogenase. A lokuta da yawa, yanayin ciwon pseudomembranous yana tasowa, ko kuma raunuka wadanda suka fi dacewa suna fitowa a kan murfin mucous na bakin kogi.

Akwai lokuta na cin zarafin da ke shafi tsarin kwayoyin halitta. Sun haɗa da: wahala urinating, yanayin kumbura na kyallen takalma, abubuwan da ke cikin kodan da ke hade da hyperkreatininemia, ƙara yawan nauyin urea cikin jini, hematuria, thrush.

Ayyukan kwayoyin halitta na iya haifar da bayyanar rashin lafiyar jiki. Sun bayyana da itching, rash, urticaria, erythema multiforme, Stevens-Johnson ciwo, mai guba epidermal necrolysis, angioedema, anaphylactic buga.

Daga cikin sauran gefe effects, akwai sake dubawa na leaching na potassium daga jiki, kara girma na jini a cikin tsari wurare dabam dabam, mai kyau kai tsaye ko kaikaitacce antiglobulin Coombs. Ayyukan yanki daga cikin intravenous gwamnati suna haɗuwa da ƙumburi, phlebitis, thrombophlebitis, jin dadi mai raɗaɗi da kumburi a shafin inji.

Wasu marasa lafiya suna haɗuwa da hallucinations, rashin tausayi, ƙananan haɗari, rashin barci, rashin tausayi na zuciyar zuciya, kamarar zuciya, tachycardia, bradycardia, ƙwayar ƙwayar zuciya na zuciya, canjin jini, dyspnoea, raguwa da damuwa, ko da yake babu wani muhimmin matsayi na meropenem a cikin wadannan bayyanar cututtuka .