Clindamycin, kuj hu ua cleocin, yog cov tshuaj dawb crystalline hmoov nrog cov tshuaj formula C18H33ClN2O5S thiab molecular hnyav ntawm 424.98. Clindamycin yog tshuaj tua kab mob. Nws yog tsuas yog siv rau kev kho mob rau lub plab kab noj hniav thiab kab mob gynecological tshwm sim los ntawm cov kab mob anaerobic. Nws yog thawj qhov kev xaiv rau kev kho mob Staphylococcus aureus osteomyelitis.
Pharmacological teebmeem: Clindamycin phosphate yog ib qho tshuaj sib xyaw ua ke ntawm clindamycin, uas tsis muaj tshuaj tua kab mob hauv vitro. Tom qab nkag mus rau hauv lub cev, nws yog hydrolyzed sai sai rau clindamycin kom siv tshuaj tua kab mob.
Kev kuaj hauv vitro tau pom tias clindamycin ua haujlwm tawm tsam cov kab mob hauv qab no; aerobic gram-zoo cocci: Staphylococcus aureus thiab Staphylococcus epidermidis (ob leeg suav nrog penicillinase-producing thiab non-penicillinase-producing hom), streptococcus (fecal Tsuas yog enterococcus), pneumococcus. Anaerobic Gram-negative Bacteria: Bacteroides (xws li Bacteroides fragilis pawg thiab Bacteroides niger pawg) thiab Fusobacterium. Anaerobic Gram-zoo tsis tsim Bacillus: Propionibacterium, Eubacteria thiab Actinomycetes. Anaerobic thiab microaerobic gram-zoo bacilli genera: Peptococcus, Microaerophilic Streptococcus, thiab Peptostreptococcus.
Kev tshawb fawb toxicological: Ames Salmonella thim rov qab kev hloov pauv thiab nas micronucleus kuaj cov txiaj ntsig tsis zoo. Kev ua me nyuam toxicity: Clindamycin ntau npaum li cas yog 0.3g / kg ntawm qhov ncauj rau cov nas, uas tsis muaj kev cuam tshuam rau kev sib deev thiab fertility ntawm cov tsiaj. Cov nas tsuag thiab nas tau muab tshuaj clindamycin ntawm qhov ncauj ntawm 0.6 g / kg lossis txhaj tshuaj subcutaneous ntawm ib koob ntawm 0.25 mg / kg, raws li. Qhov tshwm sim yog tsis muaj teratogenic nyhuv. Txawm li cas los xij, kev tshawb fawb soj ntsuam txaus thiab nruj tsis tau ua rau cov poj niam cev xeeb tub, thiab kev tshawb fawb txog kev yug tsiaj tsis tuaj yeem kwv yees tib neeg cov lus teb. Carcinogenicity: Cov kev tshawb fawb ntev carcinogenic tsis tau ua hauv cov tsiaj.
Clindamycin phosphate nkag mus rau hauv lub cev thiab hydrolyzed sai sai clindamycin nyob rau hauv qhov kev txiav txim ntawm alkaline phosphatase hauv cov ntshav. Cov tshuaj pharmacokinetics ntawm tib neeg ib txwm pom tias: ib qho kev txhaj tshuaj ntawm 0.6g clindamycin phosphate, clindamycin hauv cov ntshav tam sim ntawd nce mus txog qhov siab tshaj plaws, qhov concentration yog 11.09 ± 2.02mg / L, thiab 8-teev ntshav concentration yog 1.69 ± 0.35mg. /L; Ib qho kev txhaj tshuaj intramuscular ntawm 0.6g, clindamycin hauv cov ntshav nce mus txog qhov siab tshaj plaws hauv 1 ~ 2 teev, cov concentration yog 5.92 ± 1.45mg / L, 8-teev cov ntshav concentration yog 2.51 ± 0.91mg / L, cov ntshav cov tshuaj muaj txiaj ntsig zoo tuaj yeem ua tau. khaws cia rau ntau tshaj 8 teev. Tom qab kev tswj hwm ntawm clindamycin phosphate, nws feem ntau metabolized hauv daim siab thiab tawm hauv cov kua tsib thiab quav.
Rau cov neeg laus feem ntau ib zaug txhua 8-12 teev, cov neeg mob menyuam yaus ib zaug txhua 6-8 teev siv clindamycin, lossis kev txhaj tshuaj tas li ntawm clindamycin, cov tshuaj hauv cov ntshav tuaj yeem khaws cia ntawm qhov qis tshaj ntawm cov tshuaj tua kab mob hauv vitro. Tom qab peb siv sib law liag, cov ntshav concentration tuaj yeem ncav cuag lub xeev khov kho.
A. Clindamicina muaj feem xyuam rau cov kab mob hauv qab no los ntawm cov kab mob zoo:
B. Clindamicina muaj feem xyuam rau txhua yam kab mob kis los ntawm cov kab mob anaerobic:
Clindamycin belongs rau cov tshuaj lincomycin tshuaj chav kawm tshuaj. Nws yog ib qho tshuaj tua kab mob semi-synthetic uas feem ntau ua los ntawm inhibiting cov synthesis ntawm cov kab mob protein. Clindamycin muaj zog dua li lincomycin thiab muaj kev phiv tsawg dua li lincomycin. Nws tuaj yeem noj hauv qhov ncauj, intramuscularly, lossis intravenously. Muaj ntau ntau yam uas siv clindamycin npaj, xws li dalacin.
Lub ntsiab feature ntawm clindamycin yog nws muaj zog antibacterial nyhuv ntawm ntau yam kab mob anaerobic. Nws yog siv los kho mob plab, gynecological thiab kho hniav kab mob los ntawm cov kab mob anaerobic; thiab cov kab mob aerobic rhiab heev, feem ntau yog Gram Respiratory tract infections, pob txha thiab cov ntaub so ntswg mos, kab mob biliary tract, endocarditis, sepsis thiab lwm yam tshwm sim los ntawm stain-positive cocci.
Nws yog ib tug derivative ntawm lincomycin tshuaj thiab tau nyob hauv kev lag luam hauv Suav teb txij li xyoo 1970. Nws lub hom phiaj yog siv los tua ntau yam kab mob sib kis. Feem ntau cov kev phiv tshwm sim: kev tsis haum tshuaj, txhaj tshuaj hauv zos khaus khaus thiab lub siab tsis ua haujlwm, qhov loj tshaj plaws yog pseudomembranous enteritis.
Clindamycin yog derivative ntawm lincomycin. Nws tau siv rau ntau tshaj 40 xyoo. Nws feem ntau yog siv rau cov kab mob sib kis los ntawm cov kab mob gram-zoo. Clindamycin muaj cov kab mob dav dav thiab muaj zog tiv thaiv kab mob, thiab nws tuaj yeem siv yam tsis muaj kev kuaj tawv nqaij. Yuav kom txuag tau qhov teeb meem, ntau tus kws kho mob nyiam siv qhov no. Tab sis clindamycin tsis muaj kev nyab xeeb heev.
Cov kev phiv tshwm sim feem ntau: kev tsis haum tshuaj, kev txhaj tshuaj hauv zos thiab lub siab ua haujlwm tsis zoo, qhov loj tshaj plaws yog pseudomembranous enteritis. Qhov tsis zoo tshwm sim ntawm clindamycin tau nyiam ntau ntxiv.
Nyob rau hauv cov ntaub ntawv ntawm National Adverse Drug Reaction Monitoring Center, qhov tsis zoo tshwm sim ntawm kev txhaj tshuaj clindamycin yog qhov hnyav, feem ntau yog kev puas tsuaj rau lub cev, kev ua pa ntawm lub cev, thiab kev puas tsuaj rau cov zis. Ntawm lawv, mob raum ua haujlwm puas tsuaj thiab hematuria yog qhov tseem ceeb.
Nws tuaj yeem ua rau mob plab: xeev siab, ntuav, tsis qab los noj mov, plab zom mov, raws plab, ua pob liab liab, leukopenia, siab transaminase, ob kab mob, pseudomembranous colitis. Nws kuj tuaj yeem ua rau ua pa nyuaj, o ntawm daim di ncauj, o ntawm lub qhov ntswg, tearing thiab ua xua. Nws tau raug tshaj tawm tias qhov tshwm sim ntawm pseudomembranous enteritis tshwm sim los ntawm cov khoom no yog qhov siab tshaj plaws, uas yuav ntau dua 2%. Kwv yees li 10% ntawm cov neeg kho nrog clindamycin muaj cov pob khaus tawv nqaij.
A. Anaphylactic shock
Hauv kev poob siab anaphylactic, kev tsis haum tshuaj uas ua rau muaj kev puas tsuaj loj tshaj plaws rau lub cev feem ntau tshwm sim li ntawm 3 mus rau 5 feeb tom qab kev txhaj tshuaj, thiab feem ntau tshwm sim raws li tawm hws, hauv siab nruj, palpitations, dyspnea, thiab cyanosis. Yog tias kev cawm tsis tau raws sijhawm, nws yuav ua rau muaj kev phom sij rau lub neej, yog li cov neeg mob, tshwj xeeb tshaj yog cov uas muaj keeb kwm ntawm kev ua xua, yuav tsum tau saib xyuas cov tshuaj.
B. Mob laryngeal edema
Mob laryngeal edema yog qhov tshwm sim tsis tshua muaj tshwm sim ntawm kev tsis haum tshuaj. Nws ua rau mob caj pas txhaws, ua rau ua pa nyuaj, mob caj pas, mob cyanosis ntawm daim di ncauj, khaus khaus, tshwm sim sai, kev loj hlob sai ntawm tus kab mob, thiab ua pa yuav tshwm sim yog tias kev cawm tsis tau raws sijhawm.
C. Gastrointestinal tshuaj
Cov tshuaj tiv thaiv kab mob hauv plab yog cov tshuaj tiv thaiv feem ntau ntawm clindamycin, uas tuaj yeem tshwm sim ob qho tib si los ntawm kev tswj hwm qhov ncauj thiab txhaj tshuaj intramuscular. Nws tshwm sim raws li xeev siab, ntuav, anorexia, mob plab, raws plab, mob plab thiab lwm yam tsos mob. Pseudomembranous enteritis tuaj yeem ua rau muaj teeb meem loj tshaj plaws.
D. Lub siab ua haujlwm tsis zoo
Qee cov neeg mob yuav muaj kev nce ntshav hauv cov ntshav transaminases thiab jaundice tom qab siv clindamycin. Lawv feem ntau yog ib ntus thiab ploj tom qab tso tseg cov tshuaj. Cov ntaub ntawv ntxov feem ntau piav qhia tias "nws yuav ua rau lub siab puas tsuaj." Cov ntaub ntawv tsis ntev los no qhia tau hais tias qhov nce hauv transaminase feem ntau cuam tshuam nrog kev puas tsuaj ntawm cov leeg hauv zos thaum txhaj tshuaj intramuscular, thiab tseem muaj feem cuam tshuam nrog cov txiaj ntsig ntawm colorimetric thaum clindamycin phosphate thiab nws cov metabolites cuam tshuam nrog kev txiav txim siab ntawm transaminase. Nws tsis yog tshwm sim los ntawm daim siab cell puas, tab sis clindamycin feem ntau yog metabolized nyob rau hauv daim siab, yog li nws yuav tsum tau siv nrog ceev faj nrog lub siab tsis txaus.
E. Kev ua haujlwm tsis zoo ntawm lub raum
Clindamycin tuaj yeem ua rau mob raum tsis ua haujlwm uas tshwm sim los ntawm cuam tshuam nrog mob nephritis. Lub raum puas tsuaj tuaj yeem tshwm sim los ntawm kev txo qis ntawm cov ntshav plasma protein khi hauv lub cev, nce ntawm cov khoom xyaw dawb thiab lub raum tso tawm. Yog li ntawd, nws tau pom zoo tias cov kws kho mob yuav tsum tau ua tib zoo saib xyuas cov kev hloov pauv ntawm tus neeg mob lub raum kev ua haujlwm thiab qhov ntau npaum li cas thiab qhov concentration, thiab cuam tshuam nrog cov kev txawv txav hauv lub sijhawm kom txo lossis zam qhov tsis zoo ntawm cov tshuaj tiv thaiv rau cov neeg mob.
F. Daim tawv nqaij puas
Kev puas tsuaj ntawm daim tawv nqaij yog tshwm sim los ntawm ntau kab erythema, pob khaus, dermatitis, pustules, di ncauj ulceration, daim tawv muag congestion, khaus, allergic purpura thiab lwm yam tawv nqaij puas. Cov no yog cov kab mob vascular allergic ntawm clindamycin. Kev ua xua ntawm cov rhiab heev no ua rau muaj qhov permeability thiab fragility ntawm cov hlab ntsha me, cov hlab ntsha thiab cov hlab ntsha, cov ntshav oozing, thiab los ntshav ntawm daim tawv nqaij, mucous daim nyias nyias thiab qee yam kabmob, uas tuaj yeem nrog angioedema thiab urticaria.
G. Kev tiv thaiv hauv zos
Tom qab txhaj tshuaj intramuscular, qhov mob me me tuaj yeem tshwm sim ntawm qhov chaw txhaj tshuaj. Kev tso dej mus ntev yuav ua rau thrombophlebitis.
H. Cov ntshav
Kev tswj hwm qhov ncauj lossis kev txhaj tshuaj intramuscular tuaj yeem ua rau neutropenia, leukopenia, thrombocytopenia, thiab thrombocytopenic purpura, uas feem ntau mob me me thiab tuaj yeem rov qab zoo li qub tom qab tso tseg cov tshuaj.
I. Kev Tshawb Fawb
Clindamycin muaj lub peev xwm tsis zoo rau nkag mus rau hauv cov hlab ntsha hauv lub cev tsis zoo, thiab nws tsis yooj yim kom ncav cuag qhov muaj txiaj ntsig zoo hauv cov ntaub so ntswg. Txawm li cas los xij, kev siv tshuaj ntau dhau kuj tuaj yeem ua rau lub hauv paus paj hlwb puas. Yog li ntawd, yog tias cov neeg mob siv clindamycin muaj kev puas siab puas ntsws, qhov koob tshuaj yuav tsum raug kho lossis nres. Clindamycin muaj cov nyhuv thaiv ntawm presynaptic davhlau ya nyob twg, receptors thiab neuromuscular, thiab tuaj yeem txhim kho cov nyhuv neuromuscular thaiv, ua rau cov leeg pob txha tsis muaj zog thiab ua pa nyuaj siab lossis tuag tes tuag taw.
J. Kev kho plawv
Kev txhaj tshuaj loj hauv cov hlab ntsha tuaj yeem ua rau cov hlab plawv tsis zoo xws li ntshav siab poob thiab hloov pauv electrocardiogram, yog li nws yuav tsum maj mam poob tom qab dilution.
Clindamycin thiab lincomycin tshuaj belongs rau cov tshuaj tua kab mob lincomycin, tab sis clindamycin zoo dua li lincomycin thiab muaj kev phiv tsawg dua. Clindamycin muaj cov txiaj ntsig zoo rau osteomyelitis tshwm sim los ntawm Staphylococcus aureus.
BALLYA muab a ballya-clindamycin-test qhia rau koj yog tias muaj clindamycin residues nyob rau hauv pub thiab zaub mov.
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