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Dab tsi yog-Nafcillin

Cov kev phiv los ntawm nafcillin yog dab tsi?

Muab lo rau  Lub peb hlis ntuj 7, 2021, Kho los ntawm Jason, Qeb  

Nafcillin yog dab tsi?

1. Lus txhais

Nafcillin yog qhov ncauj thiab txhaj tshuaj penicillin uas yog tshuaj ib nrab ua ke rau 6-aminopenicillin. Nws yog hmoov dawb lossis daj daj, tsw ntxhiab me ntsis, yooj yim soluble hauv dej, chloroform thiab ethanol. Nws ruaj khov rau acid thiab penicillinase. Clinically, nws yog siv rau penicillin-resistant Staphylococcus kab mob thiab lwm yam kab mob penicillin-sensitive kab mob.

Nws cov dej num tiv thaiv tshuaj tiv taus Staphylococcus aureus nyob ze tshuaj oxacillin, tab sis muaj zog dua methicillin. Nws yog qhov tshwj xeeb tshaj yog tiv thaiv hemolytic streptococcus thiab pneumococcus. Nws muaj qhov ncauj nqus tsis tiav, ntshav qis thiab tso zis tsawg. Ntshav siab ntawm kev txhaj tshuaj intramuscular siab dua li kev tswj hwm qhov ncauj, tab sis nws tseem qis. Cov tshuaj suav suav suav tshuaj hauv cov kua tsib siab dua li cov ntshav, thiab 90% tawm los ntawm cov kua tsib. Cov ntshav khi cov protein ntau yog siab (kwv yees li 87%).

2. Cov lus qhia tshwj xeeb

Muaj ntau daim ntawv tshuaj ntau npaum thiab kev qhia tshwj xeeb ntawm nafcillin. Kev npaj sib txawv ntawm cov tuam txhab tsim khoom tuaj yeem muaj cov tshuaj sib txawv thiab tsis zoo tshwm sim vim cov txheej txheem tsim khoom sib txawv. Thov nrog koj tus kws kho mob tham txog kev xaiv tshwj xeeb.

  • Nafcillin sodium txhaj tshuaj (hmoov): 1 g.
  • Nafcillin sodium tsiav tshuaj: 0.25 grams.

3. Cov Tshuaj thiab Toxicology

Hom kab no yog acid-resistant thiab enzyme-resistant semi-synthetic tshuaj penicillin. Nws ruaj khov rau cov kua qaub thiab tuaj yeem noj qhov ncauj lossis niam txiv. Nws ruaj khov rau penicillinase. Nafcillin tiv taus staphylococcus uas ua rau penicillinase lossis tiv taus Penicillin g vim lwm yam. Nws muaj cov txiaj ntsig tshwj xeeb ntawm hemolytic streptococcus, viridis streptococcus, thiab tseem muaj cov tshuaj tua kab mob thiab tua kab mob tseem ceeb ntawm hemolytic cocci, viridis streptococcus thiab pneumococcus thiab lwm yam kab mob gram-positive.

Yam tsawg kawg ntawm kev txwv ntawm nafcillin rau Staphylococcus aureus uas nkag siab thiab tiv taus penicillin yog 0.4 thiab 0.48ug/ml, feem. Yam tsawg kawg ntawm kev txwv tsis pub muaj rau pneumococcus, streptococcus viridis, meningococcus, thiab gonococcus yog feem 0.02, 0.4, 0.8 thiab 3.1ug/ml.

4. Pharmacokinetics

Tom qab txhaj tshuaj intramuscular ntawm 0.5 g ntawm nafcillin, cov ntshav cov ntshav tau mus txog qhov siab ntawm 7.93ug/ml tom qab ib nrab teev. Tom qab noj 1g ntawm nafcillin rau cov neeg ib txwm muaj, cov ntshav cov ntshav tuaj yeem mus txog qhov siab tshaj hauv 1 teev, kwv yees li 14.34ug/ml. Qhov ncauj probenecid tuaj yeem ua kom ntshav siab ob npaug. Cov ntshav ib nrab-lub neej ntawm nafcillin ntau dua 1.5 teev.

Nafcillin tau nthuav dav dav, thiab cov tshuaj muaj txiaj ntsig zoo tau tsom mus rau hauv lub zais zis, raum, ntsws, plawv, lub plab, hnyuv thiab daim siab; siab tshaj plaws yog nyob rau hauv txoj hnyuv me, daim siab, thiab lub raum;

Tom qab txhaj tshuaj intramuscular ntawm 1.5g ntawm nafcillin, hauv cov kua synovial ntawm lub hauv caug sib koom ua ke, kev kho mob siab tuaj yeem mus txog hauv nruab nrab; cov concentration siab tau khaws cia hauv cov kua tsib. Tsis pub dhau 4 teev tom qab txhaj tshuaj, 93% ntawm cov tshuaj pom hauv cov kua tsib. Nafcillin muaj qhov nqus tau zoo hauv txoj hnyuv.

Nafcillin feem ntau yog tawm los ntawm cov kua tsib thiab tso zis. Tom qab 6 teev ntawm kev txhaj tshuaj intramuscular thiab kev tswj hwm qhov ncauj ntawm Nafcillin, 14% thiab 7% ntawm cov koob tshuaj tau tso tawm hauv cov zis, 18-19% tau tso tawm hauv cov zis nyob rau hnub thib peb, thiab tso zis hnub thib yim 21% thiab 19.4% tag nrho cov nyiaj tawm hauv cov quav; tsis hais txog qhov ncauj lossis txhaj tshuaj intramuscular, tsis pub dhau 12 teev, 10% ntawm cov tshuaj raug tso tawm hauv cov quav.

Txog hnub yim, tag nrho cov nyiaj tso tawm hauv cov quav yog txog li 50%, tso zis qis thiab tso zis ntev mus ntev tuaj yeem yog qhov laj thawj tseem ceeb vim li cas nafcillin tswj tau cov kab mob ua kom ntev thiab muaj txiaj ntsig zoo. Nafcillin muaj cov protein ntau khi rau cov protein ntau, tab sis muaj qhov cuam tshuam me ntsis rau nws cov tshuaj tua kab mob.

Nafcillin siv

Nafcillin-siv
Nafcillin-siv

1. indications

Nws yog acid-resistant thiab enzyme-resistant semi-hluavtaws penicillin. Nws ruaj khov rau cov kua qaub thiab tuaj yeem tswj hwm qhov ncauj lossis niam txiv. Nws tseem ruaj khov rau penicillinase. Nafcillin muaj cov teebmeem tshwj xeeb ntawm Staphylococcus tiv taus penicillin g, hemolytic streptococcus thiab viridis streptococcus. Nws muaj cov tshuaj tua kab mob thiab tua kab mob tseem ceeb rau cov kab mob Gram-positive xws li hemolytic streptococcus, viridis streptococcus thiab pneumococcus.

Nafcillin tsim nyog rau penicillin-resistant Staphylococcus kab mob thiab lwm yam kab mob penicillin-sensitive kab mob, xws li: sepsis, bacteremia, endocarditis, empyema, mob hauv siab, mob ntsws, osteomyelitis, meningitis, peritonitis, cellulitis, ua npaws liab, tonsillitis, pharyngitis, otitis media , erysipelas, kab mob tso zis, mob ntsws, Tetanus, roj gangrene, anthrax, diphtheria, gonorrhea, gonococcal mob caj dab thiab mob ophthalmia.

2. siv

Nafcillin yog ib nrab hluavtaws penicillin tiv taus beta lactamase cov thiab acid. Nws ruaj khov rau penicillinase thiab muaj cov kab mob tua kab mob thiab tua kab mob. Nws yog qhov tsim nyog rau kev kho tus mob staphylococcal tiv taus penicillin thiab lwm yam kab mob kis rau penicillin, xws li sepsis, endocarditis, empyema, mob hauv siab, mob ntsws, osteomyelitis, thiab lwm yam. ntau dua 85% rau kev kho mob tshuaj tiv thaiv kab mob Staphylococcus aureus.

Xyoo tsis ntev los no, kab mob nosocomial tshwm sim los ntawm ntau yam tshuaj tiv taus Staphylococcus aureus tsis yog tsuas yog teeb meem pos uas cov kws kho mob yuav tsum tau ntsib ntau zaus, tab sis kuj ua rau muaj kev hem thawj loj rau kev noj qab haus huv ntawm txhua tus tib neeg. Vancomycin, ib zaug paub tias yog "kab kawg hauv qab" ntawm kev kho mob tiv thaiv kab mob, ib txwm yog qhov kev kho mob zoo dua rau kev kis kab mob zoo. Txawm li cas los xij, vancomycin-resistant Staphylococcus aureus tau raug cais nyob hauv ntau lub tebchaws, uas yog qhov tseem ceeb rau kev txhim kho kev kho mob tiv thaiv kab mob tshiab, yog li ntawv thiaj li yuav tsum tau thov kom thov ·

Thaum pib, qhov ua tau zoo ntawm Staphylococcus aureus rau penicillin tau siab dua 90%, yog li feem ntau ntawm cov tshuaj tua kab mob tau ua lub luag haujlwm kho mob zoo hauv kev kho kab mob los ntawm Staphylococcus aureus. Txawm li cas los xij, nrog kev siv tshuaj tua kab mob ntau yam, penicillin-resistant Staphylococcus aureus kuj tau tshwm sim, thiab lwm yam tshuaj tua kab mob-resistant Staphylococcus aureus, xws li tshuaj tetracycline, erythromycin tshuaj, thiab lwm yam, kuj tau tshawb pom. Yog li ntawd, ntev li ntev los, kev kho mob tiv thaiv kab mob Staphylococcus aureus tsis ua tiav qhov kev cia siab. Kev hloov pauv tshuaj tiv thaiv kab mob microbial yog qhov tshwm sim ntawm kev hloov pauv hauv ib qho chaw tshwj xeeb ntawm DNA molecules, thiab tsis muaj dab tsi cuam tshuam nrog cov tshuaj muaj nyob. Lub hav zoov ntawm qee yam tshuaj tsuas yog txhais tau tias cais tawm qee yam tshuaj tiv thaiv kab mob.

Syphilis yog kab mob sib kis los ntawm tus kab mob Treponema pallidum, uas yog kab mob sib kis los ntawm kev sib deev. Hauv thawj theem, nws yog kab mob sib kis, uas tuaj yeem nkag mus rau txhua lub nruab nrog cev thiab cov ntaub so ntswg thaum lub sijhawm txhim kho thiab ua rau muaj ntau yam tsos mob. Qee zaum nws tuaj yeem nyob ntsiag to tau ntau xyoo lossis tseem muaj sia nyob yam tsis muaj qhov tshwm sim, thiab chav kawm ntawm tus kab mob qeeb.

Tus kab mob no feem ntau kis mus rau lwm tus los ntawm kev coj tus cwj pwm kev sib deev, thiab nws tseem tuaj yeem kis mus rau lwm tiam neeg los ntawm kev tso menyuam. Vim tias muaj ntau yam tshwm sim ntawm tus mob syphilis, feem ntau yog cov nyom los ntawm kab mob. Yog li tshuaj tua kab mob uas kho ob qho tib si yuav tsum raug xaiv. Tam sim no, nws tau ua pov thawj tias nafcillin sodium uas yog dav-spectrum, nyab xeeb, tiv thaiv enzyme, thiab acid-resistant thib peb tiam penicillin muaj qhov cuam tshuam tshwj xeeb rau mob syphilis.

3. ntau npaum

  • Qhov ncauj: 0.25 ~ 1g/zaug, 4-6 zaug/hnub, coj nws ntawm lub plab khoob.
  • Intramuscular lossis intravenous injection: 4-6/hnub, muab faib ua 4 zaug, yaj nrog dej rau txhaj lossis isotonic saline.
  • Daim ntawv thov hauv zos: 0.2% mus rau 1% cov kua dej tuaj yeem siv rau qhov txhab thiab pob ntseg.
  • Kev siv tshuaj rau poj niam cev xeeb tub thiab poj niam pub niam mis: Tsis muaj kev tshawb fawb txaus txog cov txiaj ntsig ntawm nafcillin rau cov poj niam cev xeeb tub, yog li cov poj niam cev xeeb tub yuav tsum tsuas yog siv nafcillin thaum nws xav tau tiag tiag. Ib qho me me ntawm nafcillin tuaj yeem zais los ntawm niam mis, thiab cov poj niam pub niam mis yuav tsum tsum tsis pub niam mis thaum noj tshuaj.
  • Tshuaj rau menyuam yaus: Cov menyuam mos, tshwj xeeb yog menyuam mos ntxov, yuav tsum siv nws nrog ceev faj.

Nafcillin phiv los

Nafcillin-sib cuam tshuam
Nafcillin-sib cuam tshuam

1. Cov kev phiv tshuaj

Kev tswj hwm qhov ncauj tuaj yeem ua rau muaj kev cuam tshuam ntawm txoj hnyuv: xeev siab, ntuav, tsis qab los, mob plab, raws plab. Cov uas ua xua rau penicillin yuav tsum tsis txhob siv nws. Qee qhov xwm txheej muaj leukopenia, tawv nqaij ua pob, ua npaws yeeb tshuaj, mob taub hau, thiab ua tsis taus pa. Cov koob tshuaj loj yuav ua rau muaj kev cuam tshuam rau lub paj hlwb, xws li tsis meej pem, qaug dab peg, thiab qaug dab peg. Cov menyuam yaus tuaj yeem muaj saj txawv hauv qhov ncauj (xws li saj nws yog xim hlau). Cov tawv nqaij necrosis thiab cov nqaij hauv ib puag ncig puas tuaj yeem tshwm sim tom qab txhaj tshuaj. Nws tuaj yeem ua rau lub raum puas, theem nrab nephritis theem nrab, tuaj yeem ua rau lub siab puas.

  • Kev ua xua: Nws tuaj yeem ua rau anaphylactic poob siab lossis tuag taus. Thaum nws tshwm sim, nws yuav tsum tau cawm ntawm qhov chaw. Lwm yam kev tsis haum tshuaj suav nrog hemolytic anemia (hom Ⅱ ua xua), ua pob ua xua, ua pob tawv nqaij sib kis, mob nephritis interstitial, mob hawb pob thiab lwm yam.
  • Kev txhaj tshuaj nafcillin tuaj yeem ua rau tsis tshua muaj agranulocytosis.
  • Tsawg tus neeg mob tau tso ntshav ntev tom qab muab nafcillin tso rau hauv cov hlab ntshav. Cov kev phiv tsis zoo no tuaj yeem tshwm sim los ntawm kev ua haujlwm tsis zoo hauv cov ntshav.
  • Mob nephritis interstitial.
  • Kev txhaj tshuaj ntau dhau (≥12 grams hauv ib hnub) cov tshuaj yuav ua rau daim siab tsis zoo li daim siab tsis ua haujlwm lossis cholestasis tom qab siv tshuaj.
  • Qee zaum, nws tuaj yeem ua rau asymptomatic thiab nce ntxiv hauv cov ntshav AKP, AST, thiab ALT ntau ntau.
  • Nws tuaj yeem ua rau phlebitis lossis thrombophlebitis.
  • Nafcillin xau sab nraum cov hlab ntsha thiab tuaj yeem ua rau muaj tshuaj lom hnyav rau cov nqaij nyob ib puag ncig, ua rau mob nqaij thiab mob necrosis.
  • Kab mob sib kis ob zaug: Penicillin-resistant Staphylococcus aureus, gram-negative bacilli lossis albicans Candida kev kis tus kab mob tuaj yeem tshwm sim thaum kho. Kev loj hlob ntawm Candida tuaj yeem ua rau tus nplaig txheej xim av lossis txawm tias dub.
  • Herxheimer cov tshuaj tiv thaiv thiab kho qhov tsis sib xws: pom hauv syphilis, leptospirosis lossis lwm yam kab mob sib kis.

2. Teeb meem xav tau mloog

Nafcillin yog cov tshuaj yuav tshuaj thiab yuav tsum tau muab los ntawm kws kho mob raws koj qhov mob. Kev tswj tus kheej tuaj yeem ua rau muaj kev pheej hmoo: pov tseg cov peev txheej tshuaj, ncua kev mob, tsim kev tiv thaiv, thiab ua rau muaj kev phom sij loj rau cov tshuaj.

Raws li cov qauv uas tau tshaj tawm los ntawm Asmeskas Cov Khoom Noj thiab Tshuaj Yeeb Tshuaj (FDA), nafcillin belongs rau qib B thaum cev xeeb tub: kev tshawb fawb txog kev tsim tsiaj tsis tau qhia tias muaj kev pheej hmoo rau tus me nyuam hauv plab, tab sis tsis muaj kev tshawb fawb tsim nyog nrog pab pawg tswj hwm tau ua hauv poj niam cev xeeb tub.

  • Kev ua xua, xeev siab, ntuav, mob plab, nce transaminase, lub raum puas tsuaj, thiab lwm yam; txhaj tshuaj intramuscular; Kev txhaj tshuaj txhaj tshuaj tuaj yeem ua rau phlebitis. Yuav tsum kuaj qhov ua xua ua ntej siv.
  • Tsis qab los noj mov, saj tsis zoo hauv lub qhov ncauj, xeev siab, tsam plab, thiab lwm yam.
  • Qee zaum alanine aminotransferase tuaj yeem nce ntxiv ib ntus.
  • Xeem ua xua ua ntej siv.
  • Yog tias muaj kev poob siab anaphylactic, cov tshuaj yuav tsum nres tam sim ntawd, thiab 0.5 txog 1 mg ntawm epinephrine yuav tsum tau txhaj subcutaneously lossis intramuscularly sai li sai tau. Cov neeg mob uas muaj lub plawv nres tuaj yeem txhaj tshuaj intracardiac; muab cov pa oxygen tib lub sijhawm, ua ke nrog tshuaj antihistamines thiab corticosteroids.
  • Yog tias koj siv nafcillin dua 48 teev tom qab, koj yuav tsum tau kuaj tawv nqaij dua; yog tias koj siv lwm pawg ntawm penicillins los yog cov tuam txhab tsim khoom sib txawv ntawm penicillins 24 teev tom qab siv tshuaj, koj yuav tsum tau kuaj tawv nqaij.
  • Yog tias qhov ntsuas ntawm daim tawv nqaij tsis zoo, ua rau muaj kev tsis haum lossis tsis haum yuav tshwm sim, yog li tsis txhob ceev faj.
  • Ua tib zoo saib xyuas kom tsis txhob muaj kev tsis sib haum xeeb. Cov neeg mob uas ua xua rau ib tus penicillin tuaj yeem ua xua rau lwm yam penicillins, penicillamine lossis cephalosporins.
  • Penicillins tuaj yeem tso tawm me me los ntawm niam mis, thiab cov poj niam pub niam mis yuav tsum tsum tsis pub niam mis thaum noj tshuaj.
  • Nafcillin tsis tuaj yeem tshem tawm los ntawm hemodialysis.

3. compatibility

  • Nafcillin yog contraindicated nrog aminoglycosides, norepinephrine, meta-hydroxyamine, phenobarbital, pab pawg B, vitamin C thiab lwm yam tshuaj, yog li nws tsis haum rau infusion hauv tib lub raj mis.
  • Probenecid tuaj yeem txo qis lub raum tubular tso tawm ntawm naphthacillin thiab ua kom ntev li ib nrab lub neej ntawm nafcillin.
  1. Probenecid tuaj yeem txo qis lub raum tubular tso tawm ntawm naphthacillin thiab ua kom ntev li ib nrab lub neej ntawm nafcillin.
  2. Ascilin thiab tshuaj sulfa txo qis kev nqus ntawm nafcillin hauv txoj hnyuv, thiab tuaj yeem tiv thaiv kev khi ntawm nafcillin thiab cov ntshav ntshav cov protein, thiab nce cov ntshav dawb ntawm nafcillin.

Xausn

Nafcillin, ib nrab hluavtaws penicillin, muaj qhov tshwj xeeb rau Staphylococcus uas tiv taus Penicillium g. Nws cov tshuaj tiv thaiv Staphylococcus aureus ua haujlwm ze rau oxacillin.

Nafcillin belongs rau beta lactams. BALLYA muab a betalactam xeem los qhia koj yog tias muaj cov beta lactams seem hauv cov khoom siv mis uas koj noj txhua hnub.

References

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Zoo siab tsim los ntawm BALLYA
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