Penicillin V., tseem hu ua Phenoxymethylpenicillin, feem ntau siv hauv cov ntsiav tshuaj, nrog rau cov kua hauv qhov ncauj lossis raug tshem tawm ntawm qhov ncauj. Penicillin v yog dawb siv lead ua los yog crystalline hmoov; tsis hnov tsw lossis tsis hnov ntxhiab tsw, me ntsis iab. Nws tsis raug rhuav tshem tom qab kev tswj hwm qhov ncauj nrog qhov nqus tau yog 60%, thiab nws qhov nqus tsis cuam tshuam los ntawm zaub mov hauv plab.
Cov ntshav siab tshaj plaws tau mus txog 0.5 txog 1 teev tom qab kev tswj hwm qhov ncauj. Tus nqi khi rau cov protein protein hauv plasma yog siab. 56% ntawm nws tsis ua haujlwm los ntawm daim siab metabolism, 20% -40% raug tso tawm los ntawm lub raum, t1/2 yog 1 teev.
Cov tshuaj tua kab mob tua kab mob ntawm penicillin v zoo ib yam li ntawm penicillin g. Nws feem ntau ua rau cov kab mob thaum lub sijhawm yug me nyuam thiab muaj cov tshuaj tua kab mob. Nws muaj cov tshuaj tua kab mob pom tseeb rau cov kab mob streptococcus, pneumococcus thiab staphylococcus thiab lwm yam kab mob gram-positive. Penicillin v tsis yog tsuas yog nqus tau zoo los ntawm kev tswj hwm qhov ncauj, tab sis qhov kev puas tsuaj los ntawm penicillinase qeeb dua li penicillin g, yog li nws muaj cov txiaj ntsig muaj zog tiv thaiv Staphylococcus aureus ntau dua li tom kawg. Penicillin v tuaj yeem siv rau tonsillitis, pharyngitis, ua npaws liab, mob ntsws, mob ntsws, mob pob ntseg, mob otitis tawm los ntawm cov kab mob rhiab, thiab ntau yam tuaj.
Penicillin v yog yooj yim soluble hauv dej, thiab yuav luag tsis yaj hauv chloroform, ether lossis kua paraffin. Nqa tus nqi tsim nyog ntawm penicillin v, ntsuas qhov hnyav, ntxiv cov dej tshiab thiab ua kom txias rau chav sov kom ua cov tshuaj uas muaj txog 10mg rau 1ml, ntsuas raws li txoj cai (Cov Ntawv Ntxiv VIE), kev sib hloov tshwj xeeb yog +215 ° txog + 230 °.
Penicillin v ruaj khov rau cov kua qaub thiab nqus tau zoo los ntawm kev tswj hwm qhov ncauj. Cov ntshav ntau npaum li cas yog li 2 txog 3 zaug ntawm tib lub qhov ncauj penicillin. Nws cov kab mob tua kab mob zoo ib yam nkaus li penicillin. Nws muaj cov tshuaj tua kab mob tiv thaiv feem ntau cov kab mob gram-positive, gram-negative cocci, tus neeg gram-negative bacilli (xws li Haemophilus), spirochetes thiab actinomycetes, tab sis feem ntau cov kab mob staphylococcal (> 90%) suav nrog Staphylococcus aureus thiab coagulase-negative staphylococci tuaj yeem tsim tawm beta lactamase cov kom hydrolyze cov khoom thiab ua rau nws tsis ua haujlwm.
Cov kev ua ntawm tshuaj penicillin v tiv thaiv kab mob rhiab tshaj plaws yog 2 txog 5 zaug qis dua tshuaj penicillin. Nws tsis muaj cov tshuaj tua kab mob tua kab mob penicillinase ua rau muaj kab mob. Cov txheej txheem ntawm kev ua ntawm penicillin v yog txhawm rau tiv thaiv kev sib txuas ntawm cov kab mob cell cell, kom cov kab mob sai sai thiab tawg.
Qhov ncauj nqus tau nrawm thiab ua tiav. Cov ntshav siab tuaj yeem mus txog qhov siab tshaj tom qab ib teev, thiab 30% ntawm penicillin v raug tso tawm hauv cov zis tom qab 24 teev. Penicillin v nkag mus rau hauv lub hauv siab kab noj hniav thiab kab noj hauv plab nrog lub siab, tab sis nws nyuaj rau nkag mus rau cov ntshav-hlwb teeb meem.
Penicillin v yog acid-resistant, thiab zaub mov tuaj yeem txo nws txoj kev nqus. Tus nqi khi cov protein yog li 80%. 20% txog 35% ntawm qhov koob tshuaj tau tso tawm hauv cov zis hauv nws daim ntawv qub. Cov ntshav tshem tawm ib nrab-lub neej (t1/2β) ntawm penicillin v yog li 1 teev.
Penicillin v yog qhov tsim nyog rau kev kis mob me thiab nruab nrab los ntawm kab mob penicillin-sensitive, suav nrog tonsillitis, pharyngitis, ua npaws liab, erysipelas tshwm sim los ntawm streptococcus; mob ntsws, mob ntsws, mob otitis media, sinusitis thiab cov txiv hmab txiv ntoo nkag tau los ntawm pneumococcus Cov tawv nqaij thiab cov nqaij mos mos kis los ntawm cocci.
Penicillin v kuj tseem tuaj yeem siv rau kis kab mob spirochetes thiab ua tshuaj tiv thaiv kab mob rheumatic rov tshwm sim thiab kis kab mob endocarditis.
Penicillin v yog acid-ruaj khov thiab muaj qhov ncauj nqus tau zoo. Cov ntshav ntau npaum li cas yog li 2 txog 3 zaug ntawm tib koob tshuaj penicillin. Nws cov kab mob tua kab mob zoo ib yam nkaus li penicillin. Nws muaj txiaj ntsig zoo tiv thaiv kev kis tus kab mob los ntawm kab mob gram-positive thiab tiv taus tshuaj Staphylococcus aureus. Nws tau siv los kho mob tonsillitis, pharyngitis, otitis media, mob ntsws, mob ntsws, mob ntshav liab, thiab lwm yam tshwm sim los ntawm Staphylococcus, hemolytic streptococcus thiab pneumococcus thiab cellulitis, erysipelas thiab lwm yam nqaij mos mos.
A. Ua npaws liab
Ua npaws liab yog ua rau mob ua pa nyuaj los ntawm pab pawg A beta hemolytic streptococcus, thiab tseem tuaj yeem ua rau mob tonsillitis, erysipelas, ua npaws rheumatic, endocarditis thiab mob hauv ib cheeb tsam. Nws yog tus kws kho mob tshwj xeeb los ntawm kev ua npaws, angina, nthuav tawm pob liab liab ntawm daim tawv nqaij, thiab tawv nqaij desquamation tom qab pob. Qee tus neeg yuav muaj teeb meem plawv thiab mob raum tom qab muaj mob. Tus kab mob no tshwm sim txhua xyoo puag ncig, tshwj xeeb tshaj yog thaum lub caij ntuj no thiab caij nplooj ntoo hlav. Nws tshwm sim ntau dua rau menyuam yaus, tshwj xeeb yog hnub nyoog 2-8 xyoos. Txoj kev kho tshuaj sab hnub poob muab tshuaj kho tshuaj tua kab mob, penicillin V, penicillin G, lossis erythromycin yog tias koj ua xua rau tshuaj penicillin.
B. Erysipelas
Erysipelas yog tus kab mob uas cuam tshuam nrog cov hlab ntsha lymphatic ntawm cov tawv nqaij sab nrauv. Cov kab mob tseem ceeb yog pab pawg A beta hemolytic streptococcus. Qhov tseem ceeb tshaj yog phais mob lossis tawg hauv lub qhov ntswg, pob ntseg sab nrauv, qhov quav, tus qau thiab ntiv taw.
Ib qho kev mob ntawm daim tawv nqaij, tshwj xeeb tshaj yog mob nrog tawg lossis mob txhab, muab txoj hauv kev rau cov kab mob pathogenic nkag mus. Kev txhuam me me los yog khawb, raug mob dua li lub taub hau, qhov tsis huv ntawm txoj hlab ntaws, kev txhaj tshuaj tiv thaiv, thiab mob plab hlaub ntev tuaj yeem ua rau tus kab mob no. Cov kab mob pathogenic tuaj yeem nchuav rau hauv cov hlab ntsha lymphatic thiab rov tshwm sim.
C. Tonsillitis
Tonsillitis tuaj yeem faib ua tonsillitis mob hnyav thiab tonsillitis ntev. Cov kab mob kis tau yooj yim (xws li ua npaws liab, mob qhua pias, mob khaub thuas, mob khaub thuas, thiab lwm yam) tuaj yeem ua rau mob tonsillitis ntev, thiab mob qhov txhab hauv lub qhov ntswg tuaj yeem nrog tus kab mob no. Cov kab mob feem ntau yog Streptococcus thiab Staphylococcus. Cov tsos mob tshwm sim suav nrog tsis xis nyob hauv caj pas, hnov txawv teb chaws, qhuav, khaus, ua rau hnoos, ua pa tsw phem thiab lwm yam tsos mob.
D. Otitis media
Otitis media yog kab mob sib kis uas cuam tshuam rau tag nrho lossis ib nrab ntawm pob ntseg nruab nrab (suav nrog Eustachian tube, tympanum, tympanic sinus, thiab mastoid air chamber), thiab nws muaj ntau dua rau menyuam yaus. Nws tuaj yeem faib ua ob pawg: tsis-purulent thiab suppurative. Cov uas tsis txhawb nqa suav nrog cov kab mob otitis secretory, baro-raug mob otitis media, thiab lwm yam. Kev mob tshwj xeeb yog tsawg heev, xws li tuberculous otitis media.
E. Pharyngitis
Pharyngitis yog qhov mob tshwj xeeb ntawm pharynx. Nws yog lo lus dav dav rau kev mob tshwm sim los ntawm ntau yam kab mob kis rau lub pharynx. Nws tuaj yeem nyob ib leeg, lossis nyob ua ke nrog kab mob rhinitis, tonsillitis thiab laryngitis, lossis yog cov tsos mob ntawm qee yam kab mob. Nws tuaj yeem faib ua pharyngitis mob hnyav thiab mob pharyngitis ntev. Mob pharyngitis yog ib qho mob o ntawm cov pharyngeal mucosa thiab cov nqaij submucosal. Pharyngeal lymphoid cov ntaub so ntswg feem ntau koom nrog. Qhov mob tuaj yeem tshwm sim nyob rau theem pib.
Raws li tus kab mob nce zuj zus, nws tuaj yeem cuam tshuam tag nrho kab noj hniav pharyngeal. Nws yog ntau dua nyob rau lub caij nplooj zeeg thiab lub caij ntuj no, thiab lub caij ntuj no thiab caij nplooj ntoo hlav. Cov tsos mob tseem ceeb yog qhuav, hlawv, mob hauv lub pharynx, pom tau tias mob hauv nqos, thiab hyperemia thiab o hauv lub pharynx. Mob pharyngitis ntev tuaj yeem faib ua pharyngitis yooj yim, mob hypertrophic pharyngitis ntev thiab atrophic pharyngitis.
Cov kab mob pharyngitis yooj yim dua muaj ntau dua. Cov kab mob feem ntau yog nyob hauv txheej mucosal, tshwm sim los ntawm kev mob ntsws ntev ntawm pharyngeal mucosa, thiab hyperplasia ntawm mucosa thiab submucosal txuas cov ntaub so ntswg. Thiab cov qog ua kua dej muaj qhov ua rau lub cev qhuav dej, ua rau lub cev tsis huv, thiab ua kom cov kua ntau ntxiv. Cov neeg mob feem ntau ntuav tawm cov hnoos qeev hauv lub pharynx, lossis hnov lub cev txawv teb chaws hnov hauv lub pharynx, ua tsis tau. Tus kab mob no tshwm sim ntau dua rau cov neeg laus, nrog mob ntev, yooj yim rov huam tuaj, tawv ncauj thiab kho tsis tau.
Cov neeg laus txhaj tshuaj yog 125 txog 500 mg (200,000 txog 800,000 units)/zaug, ib zaug txhua 6 txog 8 teev.
Menyuam txhaj tshuaj: ib zaug txhua 4 teev, 2.5 ～ 9.3 mg (4167 ～ 15000 units)/kg txhua lub sijhawm; ib zaug txhua 6 teev, 3.75-14 mg (6250 ～ 22500 units)/kg txhua lub sijhawm; ib zaug txhua 8 teev, 5 ～ 18.7 mg (8333 ～ 30000 units)/kg txhua lub sijhawm.
Penicillin v muaj cov tshuaj tua kab mob tib yam li penicillin, tab sis nws cov nyhuv muaj zog dua li penicillin. Txawm li cas los xij, cov kev phiv thiab contraindications ntawm penicillin v yuav tsum tau muab sau tseg thaum siv cov tshuaj no.
Penicillin v 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.
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