Piperacillin belongs rau plaub tiam penicillin. Hom tshuaj no yog ib nrab khoom siv hluavtaws tshuaj penicillin tshuaj tua kab mob. Nws muaj cov tshuaj tua kab mob pom tseeb thiab tuaj yeem tua ntau hom kab mob, xws li Proteus, Escherichia coli, Klebsiella thiab Enterobacter, ntau yam kab mob hauv lub cev thiab cov kab mob Gram-negative. Piperacillin tuaj yeem tsis tsuas yog kho kab mob ua pa los ntawm cov kab mob, tab sis kuj tseem muaj kev kho mob rau cov kab mob gynecological, kab mob tso zis, kab mob ntawm daim tawv nqaij, thiab sib kis kab mob.
Piperacillin feem ntau yog siv los txhaj tshuaj tua kab mob thiab tshem tawm qhov mob. Rau cov neeg mob hnyav, kev txhaj tshuaj txhua hnub yuav tsum tsis pub ntau tshaj 8 grams. Rau cov neeg mob hnyav, koob tshuaj tuaj yeem nce ntxiv rau 12 grams. Thaum lub sijhawm tus neeg mob siv piperacillin, qee tus neeg mob yuav hnov liab thiab o tuaj ntawm qhov chaw txhaj tshuaj thiab phlebitis. Nws yog qhov zoo tshaj los kho qhov ntau npaum li cas thiab qhov nrawm ntawm kev tso ntshav thaum qhov no tshwm sim.
Cov khoom no yog hmoov dawb crystalline; tsis hnov tsw; me ntsis hygroscopic. Nws yog yooj yim soluble hauv methanol, soluble hauv meej ethanol lossis acetone, thiab me ntsis soluble hauv dej.
Nws yog ib nrab hluavtaws semicarbazide tiv thaiv pseudomonas penicillin. Cov txiaj ntsig ntawm cov kab mob gram-positive zoo ib yam li ntawm tshuaj ampicillin. Nws muaj cov tshuaj tua kab mob zoo rau enterococci, thiab tseem muaj qee yam cuam tshuam rau qee yam Bacteroides thiab Clostridia.
Nws muaj qhov ua tau zoo ntawm cov kab mob gram-negative. Cov kab mob tua kab mob suav nrog Neisseria gonorrhoeae, Escherichia coli, Proteus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Citrobacter, Enterobacter, Haemophilus, Salmonella, Shigella, qee pseudomonas (tshwj tsis yog Pseudomonas aeruginosa), meningococcus
Cov khoom no tsis tiv taus cov enzymes. Piperacillin tsis nqus qhov ncauj. Intramuscular txhaj tshuaj ntawm 2g, cov tshuaj hauv cov ntshav tau nce siab ntawm 0.5 teev, kwv yees li 36μg/mL txhaj tshuaj ntawm 4g tsis pub dhau 30 feeb, ntshav plasma tam sim ntawd> 200μg/ml, 100μg/ml hauv 1 teev, t1/2 yog li 1 teev. Nws tau nthuav dav dav hauv lub cev, thiab cov kabmob ib puag ncig tuaj yeem ua tiav cov txiaj ntsig zoo, thiab muaj qhov siab ntau hauv cov kua tsib thiab cov kua dej hauv cov qog ntshav. Piperacillin feem ntau yog tso tawm los ntawm ob lub raum, thiab 1/2 ~ 2/3 ntawm cov tshuaj tuaj yeem tso tawm hauv cov zis hauv 12 teev.
Cov tshuaj no tsis tuaj yeem nqus tau ntawm qhov ncauj. Cov ntshav siab tshaj plaws (Cmax) ntawm cov neeg ib txwm yog 52.2 mg/L ntawm 0.71 teev tom qab txhaj tshuaj ntawm cov tshuaj 1g, thiab cov ntshav siab ntawm 6 teev yog 1.3 mg/L. Cov ntshav cov ntshav tam sim tom qab tso dej tawm thiab txhaj tshuaj txhaj tshuaj hauv qhov quav tau mus txog 58.0 mg/L thiab 142.1 mg/L, feem, 0.5 mg/L thiab 0-6 mg/L hauv 6 teev. Muab rau cov neeg mob uas lub raum tsis zoo (endogenous creatinine tshem tawm tus nqi <5ml/L) tso dej tso 70mg/kg raws li lub cev hnyav hauv 30 feeb, thiab ntshav siab tom qab 1 teev yog li 350mg/L.
Cov ntshav cov protein khi rau tus nqi ntawm piperacillin yog 17%-22%, qhov pom tseeb ntawm kev faib khoom (Vd) yog 0.18-0.3L/kg, thiab kev faib ib nrab ntawm lub neej (t1/2β) yog 11-20 feeb. Nws tau faib tawm tau zoo thiab tuaj yeem ncav cuag qhov kev txiav txim siab ntau hauv cov kua dej hauv lub paj hlwb thaum cov meninges tau mob.
Piperacillin cov ntshav tshem tawm ib nrab-lub neej (t1/2β) rau cov neeg mob uas lub raum ua haujlwm tau zoo yog 0.6-1.2 teev, thiab cov uas muaj lub raum nruab nrab lossis ntau dua lub raum tsis txaus tuaj yeem txuas ntxiv rau 3.3-5.1 teev yam tsis tau hloov pauv hauv lub siab. Piperacillin raug tshem tawm los ntawm ob lub raum (kev tso dej glomerular thiab tubular tso tawm) thiab tsis yog lub raum (feem ntau yog cov kua tsib) txoj hauv kev. Tom qab txhaj tshuaj 1g, 49% -68% ntawm cov tshuaj raug tso tawm hauv cov zis hauv 12 teev. 10% -20% ntawm cov tshuaj uas muaj lub siab ua haujlwm tau zoo yog tawm los ntawm cov kua tsib. Tsawg heev cov tshuaj raug tso tawm los ntawm niam mis. Hemodialysis tuaj yeem tshem tawm 30% -50% ntawm qhov koob tshuaj hauv 4 teev. Qhov ncauj probenecid 1g 1 teev ua ntej txhaj tshuaj tuaj yeem ua rau nce ntshav siab (Cmax) los ntawm 30% thiab ncua cov ntshav tshem tawm ib nrab ntawm lub neej (t1/2β) los ntawm 30%.
Cov kab mob tshwm sim los ntawm cov kab mob rhiab, xws li sepsis, kab mob tso zis, kab mob ua pa, kis kab mob hauv lub cev, kis kab mob hauv plab, kis kab mob hauv plab thiab tawv nqaij thiab mob nqaij mos.
Siv ua ke nrog aminoglycosides tshuaj, nws tuaj yeem kho tus kab mob hauv cov neeg mob neutropenia thiab kev tiv thaiv kab mob tsis zoo.
Piperacillin tsim nyog rau cov kab mob Enterobacteriaceae rhiab, Pseudomonas aeruginosa, Acinetobacter sepsis, cov kab mob sab saud thiab cov kab mob tso zis nyuaj, cov kab mob ua pa, kab mob hauv plab, mob hauv plab, mob hauv plab, tawv nqaij thiab cov nqaij mos mos kis. tshuaj piperacillin thiab aminoglycosides kuj tseem tuaj yeem siv rau kev kis mob hauv cov neeg mob uas muaj tus kab mob neutropenia thiab tsis muaj kev tiv thaiv kab mob.
Tazocin yog kev npaj ua ke, thiab nws cov khoom yog piperacillin sodium thiab tazobactam sodium (raws li tshuaj piperacillin thiab tazobactam, qhov sib piv ntawm cov ntawv sau yog 8: 1); cov khoom siv yog: ethylenediaminetetraacetic acid Disodium (EDTA), citric acid, sodium bicarbonate thiab dej rau txhaj.
Tazocin (piperacillin sodium thiab tazobactam sodium rau kev txhaj tshuaj), nws qhov taw qhia yog cov kab mob hauv lub cev thiab hauv zos tshwm sim los ntawm kev kuaj pom lossis xav tias muaj kab mob nkag siab.
Piperacillin muaj tag nrho ntawm 64mg (2.79mEq) ntawm sodium ib gram ntawm piperacillin, uas tuaj yeem ua rau tus neeg mob tau txais sodium ntau ntxiv. Qhov no yuav tsum raug txiav txim siab thaum cov neeg mob uas xav tau txwv kev noj ntsev. Hypokalemia tuaj yeem tshwm sim rau cov neeg mob uas muaj cov tshuaj potassium tsawg lossis noj cov tshuaj uas tuaj yeem txo qis cov ntshav potassium (kho nrog tshuaj cytotoxic lossis diuretics). Yog li ntawd, nws raug nquahu kom cov neeg mob ntsuas ntsuas ntshav electrolyte tas li.
Ib yam li lwm cov khoom siv hluavtaws penicillins, kev siv piperacillin tuaj yeem ua rau muaj tus mob ua npaws thiab ua pob rau cov neeg mob cystic fibrosis.
Qee tus neeg mob kho nrog -lactam tshuaj tua kab mob (suav nrog piperacillin) yuav muaj ntshav tawm los. Cov kev cuam tshuam no feem ntau cuam tshuam nrog kev kuaj ntshav coagulation txawv txav (xws li lub sijhawm khov, platelet sib sau ua ke thiab lub sijhawm prothrombin), thiab muaj ntau dua rau cov neeg mob uas lub raum tsis ua haujlwm. Yog tias muaj cov cim qhia ntshav, kev kho tshuaj tua kab mob (piperacillin/tazobactam rau kev txhaj tshuaj) yuav tsum raug txiav tawm, thiab yuav tsum tau ntsuas kev kho kom haum.
Nws yuav tsum tau sau tseg tias cov tshuaj tiv taus kab mob tuaj yeem tshwm sim thaum kho, ua rau muaj kev sib kis ob zaug. Yog tias qhov no tshwm sim, yuav tsum ntsuas qhov sib xws.
Piperacillin zwm rau hauv chav kawm ntawm tshuaj tua kab mob penicillin thiab muaj txiaj ntsig zoo rau sepsis, tso zis tso zis thiab kis kab mob ua pa. Cov kev phiv los ntawm piperacillin zoo ib yam li lwm cov tshuaj tua kab mob penicillin.
Piperacillin belongs rau beta lactam cov. BALLYA muab rau betalactam xeem los qhia koj yog tias muaj cov beta lactams seem hauv cov khoom siv mis uas koj noj txhua hnub.
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