Amoxicilina tuaj yeem ua dab tsi rau koj?

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• Amoxicilina yog dab tsi?
  1. Lus txhais
  2. lub hom phiaj
  3. Cov teebmeem tshuaj
• Amoxicilina siv
  1. indications
  2. Kev noj tshuaj Amoxicillin
• Amoxicillin phiv los
  1. Teeb meem tsis haum
  2. ceev faj
  3. Tshuaj Tiv Thaiv
• xaus

Amoxicilina yog dab tsi?

1. Lus txhais

Amoxicillin yog ib qho ntawm feem ntau siv ib nrab hluavtaws tshuaj penicillin dav-pom beta lawm tshuaj tua kab mob. Nws yog hmoov dawb nrog ib nrab lub neej kwv yees li ntawm 61.3 feeb. Nws ruaj khov nyob rau hauv cov kua qaub, thiab lub plab zom mov nce mus txog 90%. Amoxicilina muaj cov kab mob tua kab mob muaj zog thiab muaj peev xwm muaj peev xwm nkag mus rau cov kab mob ntawm tes.

Amoxicilina tam sim no yog ib qho uas siv ntau tshaj plaws ntawm qhov ncauj ib nrab khoom cua penicillins. Nws cov kev npaj suav nrog tsiav tshuaj, ntsiav tshuaj, granules, ntsiav tshuaj sib faib, thiab lwm yam, thiab feem ntau ua ke nrog clavulanic kua qaub los ua cov ntsiav tshuaj sib faib. Amoxicilina thiab clavulanate poov tshuaj yog qhov tsim nyog rau kab mob ua pa kab mob hauv qab, mob otitis media, thiab sinusitis tshwm sim los ntawm beta lactamase cov ua Haemophilus influenzae thiab Moraxella catarrhalis.

Cov khoom yog dawb lossis yuav luag dawb crystalline hmoov; saj yog me ntsis iab. Amoxicilina yog me ntsis soluble hauv dej thiab yuav luag tsis yaj hauv ethanol.

2. lub hom phiaj

Amoxicilina muaj cov kab mob tua kab mob muaj zog thiab muaj peev xwm nkag tau mus rau phab ntsa ntawm tes. Nws yog ib qho ntawm feem ntau siv qhov ncauj penicillins, thiab nws cov kev npaj suav nrog tsiav tshuaj, ntsiav tshuaj, granules, ntsiav tshuaj sib faib thiab lwm yam. Cov neeg mob uas ua xua rau penicillin thiab penicillin tawv nqaij kuaj pom zoo yuav tsum tau khaws cia los ntawm cov tshuaj no.

3. Cov teebmeem tshuaj

Amoxicilina yog ib nrab hluavtaws broad-spectrum tshuaj penicillin. Nws cov kab mob tua kab mob thiab cov tshuaj tua kab mob hauv paus yog tib yam nkaus tshuaj ampicillin, tab sis nws cov kua qaub ua rau muaj zog ntau dua ampicillin, thiab nws cov kab mob tua kab mob muaj zog dua thiab nrawm dua tom kawg, tab sis nws tsis tuaj yeem siv rau kev kho mob qog noj ntshav. Ib nrab ntawm lub neej yog kwv yees li 61.3 feeb. Amoxicilina ruaj khov nyob rau hauv cov kua qaub, nrog rau txoj hnyuv nqus ntawm 90%. Nws tau nqus sai dua thiab ua tiav dua li ampicillin. Nws muaj cov txiaj ntsig zoo ib yam tshwj tsis yog rau Shigella uas tsis ua haujlwm zoo dua li ampicillin.

Amoxicilina muaj cov kab mob tua kab mob muaj zog thiab muaj peev xwm nkag tau mus rau phab ntsa ntawm tes. Tom qab kev tswj hwm qhov ncauj, pab pawg lactam hauv cov tshuaj yeeb tshuaj tam sim tam sim hydrolyzed los tsim cov peptide bond, uas tau nrawm ua ke nrog transpeptidase hauv cov kab mob kom tsis ua haujlwm nws, txiav tawm tib txoj kev uas cov kab mob vam khom rau transpeptidase los ua ke glycopeptides rau tsim cov phab ntsa ntawm tes, ua rau cov kab mob cell sai ua lub cev kheej kheej thiab tawg thiab tawg, thiab cov kab mob nws thiaj li o thiab tuag vim poob ntawm phab ntsa ntawm tes thiab nkag mus tsis tu ncua ntawm cov dej.

Nws muaj zog tiv thaiv kab mob thiab tua kab mob rau feem ntau cov kab mob G+ thiab G-kab mob (suav nrog cocci thiab bacilli). Ntawm lawv, amoxicilina muaj cov tshuaj tua kab mob zoo rau Streptococcus pneumoniae, Streptococcus hemolyticus, aerobic gram-positive cocci xws li Staphylococcus faecalis thiab Enterococcus faecalis, Escherichia coli, Proteus mirabilis, Salmonella, Haemophilus influenzae, Neisseria gonorrhoeae thiab lwm yam kab mob aerobic gram-negative uas tsis tsim beta lactamase thiab Helicobacter pylori. Hemodialysis tuaj yeem tshem qee cov tshuaj, tab sis kev lim ntshav hauv plab tsis muaj txiaj ntsig ntawm kev tshem tawm cov khoom no.

Amoxicilina siv

1. indications

Amoxicilina tuaj yeem siv los kho tus mob ua npaws, lwm yam Salmonella kab mob thiab kab mob typhoid. Kev kho mob ntawm cov kab mob tso zis los ntawm cov kab mob rhiab heev uas tsis tsim beta lactamase kuj tseem ua tiav cov txiaj ntsig zoo. Rau cov neeg mob uas muaj kab mob tso zis qis dua thiab tsis tsim cov enzyme tsim Neisseria gonorrhoeae urethritis thiab ncauj tsev menyuam, ib zaug ntawm qhov ncauj ntawm 3 g yog txaus kom tau txais cov txiaj ntsig zoo.

Pob ntseg, qhov ntswg, mob caj pas, kab mob ua pa rau ntawm daim tawv nqaij thiab cov nqaij mos mos kis los ntawm Streptococcus pneumoniae, Staphylococcus aureus uas tsis tsim cov tshuaj penicillinase, Streptococcus hemolyticus thiab Haemophilus influenzae uas tsis tsim β-lactamase yog txhua qhov qhia. Leptospirosis tseem tuaj yeem siv amoxicillin. Cov khoom no tseem tuaj yeem siv rau cov kab mob urogenital tshwm sim los ntawm Escherichia coli, Proteus mirabilis thiab Enterococcus faecalis. Cov khoom no, ua ke nrog clarithromycin thiab lansoprazole, muaj cov txiaj ntsig zoo ntawm kev kho tus mob Helicobacter pylori.

2. Kev noj tshuaj Amoxicillin

Cov neeg laus thiab menyuam yaus hnyav dua 40 kg noj 1 rau 2 tsiav tshuaj (0.25 ~ 0.5 g) txhua lub sijhawm, ib zaug txhua 6 txog 8 teev, thiab koob tshuaj txhua hnub tsis tshaj 4 g (16 tsiav tshuaj); menyuam yaus hnyav dua 40 kg yuav tsum hnyav 20 ~ 40mg/kg/hnub, noj 2 rau 3 zaug; 30mg/kg/hnub rau cov menyuam mos hnub nyoog qis dua peb hlis, tau muab faib ua ob zaug, ib zaug txhua 12 teev; cov neeg mob uas lub raum tsis zoo yuav tsum tau kho qhov ntau npaum li cas. Cov neeg nrog 10 ~ 30ml/kg endogenous creatinine tshem tawm tus nqi coj 0.25-0.5g txhua 12 teev. Cov khoom no tuaj yeem noj ntawm lub plab khoob lossis tom qab noj mov, thiab tuaj yeem nqa nrog mis thiab lwm yam khoom noj. Cov neeg mob nrog Neisserial gonococcal urethritis tuaj yeem noj qhov ncauj 3g ib zaug.

Kev sim kev tsim tsiaj tau pom tias amoxicillin ntawm 10 npaug ntawm tib neeg cov tshuaj tsis ua mob rau kev xeeb tub thiab menyuam hauv plab ntawm nas thiab nas. Txawm li cas los xij, tseem tshuav qhov tsis muaj kev tswj hwm kev kawm txaus hauv tib neeg. Txij li kev kuaj tsiaj tu tsiaj tsis tuaj yeem kwv yees tib neeg cov lus teb, poj niam cev xeeb tub yuav tsum tsuas yog siv cov khoom no thaum nws tsim nyog tiag. Txij li me me ntawm amoxicillin tuaj yeem zais hauv cov kua mis, thiab nws yuav ua rau tsis haum rau tus menyuam.

Amoxicillin phiv los

Amoxicilina tsis yog tshuaj tiv thaiv kab mob, tab sis ib nrab tshuaj tua kab mob penicillin tshuaj tua kab mob feem ntau siv hauv tsev kho mob. Nws muaj cov tshuaj tua kab mob muaj zog thiab tau siv dav hauv kev kho mob. Nws yog sib xws nrog omeprazole, ranitidine thiab erythromycin tshuaj. Kev siv tshuaj ua ke xws li Helicobacter pylori, mob plab, mob plab, endocarditis, mob ntsws ntev thiab lwm yam kab mob muaj txiaj ntsig zoo thiab muaj txiaj ntsig zoo, thiab tuaj yeem txhim kho cov tsos mob ntawm cov neeg mob thiab txo lawv qhov mob.

Txawm li cas los xij, raws li tshuaj tua kab mob, tom qab siv, nws yuav ua rau cov neeg mob muaj qaug dab peg, kiv taub hau, tsis pom kev, ntshav tsis txaus thiab lwm yam kev phom sij, uas yuav muaj kev cuam tshuam rau kev kho mob. Yog li ntawd, koj yuav tsum sab laj nrog kws kho mob thaum koj xav tau tshuaj, tsis txhob sau ntawv tshuaj rau koj tus kheej, thiab nco ntsoov ua raws kws kho mob cov lus qhia thaum siv nws.   

1. Teeb meem tsis haum

• Cov tsos mob ntawm kev tsis haum tshuaj: ua npaws kub taub hau, ua xua, tawv nqaij ua pob thiab ua rau mob hawb pob tuaj yeem tshwm sim, tshwj xeeb tshaj yog cov neeg mob uas muaj tus kab mob mononucleosis sib kis, thiab tsis muaj kev poob siab anaphylactic.
• Cov tsos mob ntawm lub plab zom mov: raws plab, xeev siab, ntuav thiab lwm yam tsos mob tshwm sim, thiab mob plab zom mov xws li pseudomembranous colitis qee zaum pom.
• Cov tsos mob ntawm cov ntshav: eosinophilia, leukopenia, thrombocytopenia, ntshav tsis txaus.
• Cov tawv nqaij thiab cov tshuaj tiv thaiv kab mob: qee zaum ua pob khaus maculopapular, exudative erythema multiforme, Lyell syndrome, exfoliative dermatitis.
• Tom qab amoxicillin nkag rau hauv tib neeg lub cev, kwv yees li 30% ntawm cov tshuaj tau hloov pauv los ntawm lub siab, thiab kwv yees li 70% ntawm cov tshuaj tau hloov pauv los ntawm lub raum, thiab tom qab ntawd tso tawm nrog cov zis. Amoxicilina tuaj yeem nkag mus rau lub raum hlwb ua lub luag haujlwm, yog li nws tuaj yeem ua rau lub raum puas ntawm cov neeg mob, yog li ua rau nws lub raum tsis ua haujlwm.
  
  Nrog lub hnub nyoog, lub raum ua haujlwm ntawm cov neeg muaj hnub nyoog nruab nrab thiab cov neeg laus maj mam poob qis. Yog tias cov neeg mob siv cov tshuaj amoxicillin ntau dhau rau kev kho mob, nws tuaj yeem ua rau lub nra hnyav ntxiv rau lawv lub raum, ua kom cov tshuaj tawm ntawm lub cev, ua rau cov tshuaj muaj zog ntxiv hauv lawv cov zis, uas tuaj yeem thaiv lawv cov zis thiab ua rau cov hlab ntsha tawg thiab tso ntshav tawm, rau cov tsos mob xws li ntshav hauv cov zis thiab lub raum colic. Nco ntsoov them sai sai rau cov tshuaj thaum noj tshuaj rau cov neeg muaj hnub nyoog nruab nrab thiab cov neeg laus.
• Cov kev tshawb fawb tau pom tias cov neeg mob uas tsis muaj keeb kwm ntawm kev mob hlwb muaj feem cuam tshuam rau hauv nruab nrab lub paj hlwb tsis zoo xws li lub qhov muag tsis pom kev, ntxhov siab, pw tsis tsaug zog, kiv taub hau, nyuaj siab thiab txawm tias piav tsis tau zoo thaum lub sijhawm kho mob ntev nrog amoxicillin. Cov tsos ntawm cov kev tsis zoo no tuaj yeem cuam tshuam rau kev ua haujlwm ib txwm muaj thiab lub neej ntawm cov neeg mob. Thaum cov xwm txheej tsis zoo saum toj no tshwm sim hauv cov neeg mob kho nrog amoxicillin, cov tshuaj yuav tsum raug tso tseg tam sim lossis tsis tu ncua.
• Qee tus neeg mob kuj tseem yuav muaj cov tsos mob ntawm autoimmune hemolytic anemia tom qab siv tshuaj, thiab cov tsos mob tshwm sim yog qaug zog. Tshuaj xws li prednisone thiab vitamin B12 tuaj yeem muab los daws cov tsos mob. Qee tus neeg mob kuj tseem tuaj yeem muaj cov tsos mob ntawm daim di ncauj tom qab siv tshuaj, pom tias yog daim di ncauj o thiab khaus. Yog tias cov tsos mob no tshwm sim, cov tshuaj yuav tsum nres tam sim ntawd, thiab tus neeg mob daim di ncauj yuav tsum tau yaug nrog cov ntsev ib txwm muaj. erythromycin tshuaj tshuaj pleev tuaj yeem muab rau ntawm daim di ncauj, uas muaj txiaj ntsig zoo los daws cov tsos mob. Qee tus neeg mob tuaj yeem ntsib qib sib txawv ntawm kev mob plab, raws plab thiab txawm tias pseudomembranous colitis hauv 24 teev tom qab noj tshuaj amoxicillin. Yog tias tus neeg mob muaj qhov tsis zoo tshwm sim ntawm lub plab zom mov thaum lub sijhawm lossis tom qab kho, cov tshuaj yuav tsum nres tam sim ntawd.

2. ceev faj

Lub chaw saib xyuas kev noj qab haus huv hauv tebchaws tau teev tseg tias a tshuaj penicillin daim tawv nqaij yuav tsum tau ua ua ntej siv amoxicillin, thiab cov uas muaj qhov tshwm sim zoo tsis raug tso cai siv nws. Ntxiv rau, penicillin sodium thiab penicillin poov tshuaj kuj yog tshuaj tua kab mob penicillin, thiab kev kuaj tawv nqaij yuav tsum tau ua ua ntej siv. Yog tias nws tsis yooj yim los kuaj cov tawv nqaij, koj tuaj yeem noj ib feem peb ntawm cov tshuaj ntsiav ua ntej. Yog tias tsis muaj qhov tshwm sim tsis zoo, koj tuaj yeem siv nws ib txwm muaj. Yog tias koj tsis xis nyob, mus rau tom tsev kho mob sai li sai tau.

• Cov neeg uas ua xua rau ib hom penicillin tuaj yeem ua xua rau lwm yam penicillins, lossis tuaj yeem ua xua rau penicillamine lossis cephalosporin. Kev kuaj tawv nqaij Penicillin yuav tsum tau ua ua ntej siv tshuaj.
• Nws raug txwv tsis pub siv rau cov neeg mob kis mob mononucleosis, lymphocytic leukemia, kis tus kab mob cytomegalovirus thiab qog ntshav qog noj ntshav.
• Cov neeg uas muaj keeb kwm mob hawb pob, ua xua, ua npaws kub cev, ua xua hluav taws xob thiab lwm yam kab mob ua xua thiab cov neeg muaj tus kab mob herpes, tshwj xeeb yog cov neeg mob mononucleosis sib kis (uas tuaj yeem ua rau muaj kev pheej hmoo ntawm daim tawv nqaij tsis zoo) yuav tsum siv nws nrog ceev faj.
• Siv tooj liab sulfate-muaj cov ntawv reagents (R) thiab Fehling txoj kev daws teeb meem los ntsuas cov piam thaj hauv qab zib tuaj yeem ua rau muaj kev cuam tshuam tsis raug; tsawg tus neeg mob yuav tau nce ntshav transaminases, eosinophilia, thiab leukopenia tom qab siv tshuaj.
• Cov poj niam cev xeeb tub thiab pub niam mis thiab menyuam yaus hnub nyoog qis dua 3 hlis yuav tsum tau siv nws nrog ceev faj. Tom qab daim ntawv thov rau cov poj niam cev xeeb tub hauv peb lub hlis thib peb, cov tshuaj estrogen hauv cov ntshav tuaj yeem txo qis, tab sis nws tsis muaj kev cuam tshuam rau cov tshuaj estrogen dawb thiab progesterone. Cov khoom no tuaj yeem tso tawm los ntawm mis, thiab tus menyuam tuaj yeem hnov ​​tau los ntawm niam laus.

Amoxicillin muaj ntau hom tshuaj noj, suav nrog txhaj tshuaj, tshuaj ntsiav, ntsiav tshuaj, granules, thiab lwm yam. Nws yuav tsum tau ntxoov ntxoo, kaw, thiab khaws cia hauv qhov chaw txias, tsaus thiab qhuav. Txawm hais tias qhov chaw cia khoom tsim nyog, kev hloov tshuaj lom neeg xws li decomposition thiab polymerization ntawm amoxicillin tseem tuaj yeem tshwm sim thaum khaws cia, tsim cov tshuaj tsis haum tshiab. Hauv lub caij sov thiab ntub dej, qhov kev ua kom tsis zoo thiab ua tsis tiav yuav nrawm dua.

Ntxiv rau, amoxicillin thiab aminoglycosides tshuaj (xws li gentamicin, kanamycin), ciprofloxacin ua, pefloxacin thiab lwm yam tshuaj yog contraindicated thiab tsis tuaj yeem muab tso rau hauv tib lub thawv. Kev siv cov tshuaj amoxicillin yuav tsum yog raws li kws kho mob cov lus qhia. Noj nws li tshuaj hauv tsev neeg ntawm koj tus kheej yog qhov muag tsis pom thiab txaus ntshai. Hauv cov txheej txheem ntawm kev noj cov tshuaj amoxicillin, yog tias muaj kev fab tshuaj xws li ua pob khaus, lossis muaj kev phom sij loj ntawm lub plab zom mov, xws li raws plab, ntuav, thiab lwm yam, cov tshuaj yuav tsum raug tso tseg tam sim ntawd.

3. Tshuaj Tiv Thaiv

• Probenecid tuaj yeem ncua lub raum tshem tawm ntawm amoxicillin (kev sib tw txo lub raum tubular tso zis ntawm amoxicillin), ncua nws cov ntshav ib nrab-lub neej, thiab nce ntshav siab ntawm cov khoom no.
• Thaum siv amoxicillin ua ke nrog aminoglycosides tshuaj, nws tuaj yeem txhim kho cov tshuaj tua kab mob hauv vitro ntawm amoxicillin ntawm Streptococcus faecalis ntawm kev txwv tsis pub muaj ntau.
• Thaum siv amoxicillin ua ke nrog beta lactamase cov inhibitors xws li clavulanic kua qaub, cov tshuaj tua kab mob ua kom zoo dua qub. Clavulanic acid tsis tuaj yeem tsuas yog txhim kho qhov rhiab heev ntawm β-lactamase-tsim cov kab mob rau amoxicillin rau qib sib txawv, tab sis kuj tseem txhim kho cov tshuaj amoxicillin ntawm qee yam tsis mob rhiab, suav nrog Bacteroides, Legionella, thiab Nocardia Bacteria thiab pseudomallei.
• Chloramphenicol, cov macrolidesJuanamines thiab tshuaj tetracycline tuaj yeem cuam tshuam nrog cov tshuaj tua kab mob ntawm cov khoom no hauv vitro, tab sis nws qhov kev kho mob tseem ceeb tsis paub.
• Thaum amoxicillin tau siv ua ke nrog kev tiv thaiv kev tiv thaiv, nws tuaj yeem cuam tshuam nrog kev nkag mus rau hauv lub cev ntawm cov tshuaj tiv thaiv kab mob, yog li txo lawv cov kev ua tau zoo.
• Allopurine inhibitors ntawm uric acid synthesis tuaj yeem ua rau muaj kev pheej hmoo ntawm cov tawv nqaij tsis haum rau amoxicillin.
• Thaum amoxicillin ua ke nrog methotrexate, cov khoom no tuaj yeem txo qis lub raum tshem tawm ntawm methotrexate, yog li ua rau kom muaj tshuaj lom ntawm methotrexate.
• Khoom noj tuaj yeem ncua kev nqus ntawm amoxicillin, tab sis zaub mov tsis txo qis tag nrho cov tshuaj nqus.

1. Khoom noj tuaj yeem ncua kev nqus ntawm amoxicillin, tab sis zaub mov tsis txo qis tag nrho cov tshuaj nqus.

xaus

Amoxicillin yog cov tshuaj tua kab mob penicillin ib nrab hluavtaws thiab tau siv dav. Tab sis vim hais tias amoxicillin kuj yog ib hom penicillin, qhov tsis zoo thiab kev ceev faj ntawm penicillin kuj tseem siv tau rau amoxicillin.

BALLYA muab a betalactam xeem (amoxicillin belongs rau beta lactam tshuaj tua kab mob) los qhia koj yog tias muaj cov beta lactams seem hauv cov khoom siv mis koj noj txhua hnub.

References

• MedlinePlus: Amoxicillin
• Wikipedia: Amoxicillin