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Luv luv-Qhia-rau-Erythrocin

Taw qhia luv luv rau Erythrocin

Muab lo rau  Lub ib hlis ntuj 6, 2021, Kho los ntawm Jason, Qeb  

Erythrocin yog dab tsi?

1. Lus txhais

Erythrocin, feem ntau yog siv hauv tsev kho mob rau tonsillitis, ua npaws liab, mob khaub thuas thiab kis tus kab mob, tus kab mob gonorrhea, listeriosis, streptococcus pneumoniae qis ua pa kab mob ua rau mob streptococcus (cov lus saum toj no siv rau cov neeg mob uas tsis kam ua penicillins.) Nws tseem tuaj yeem siv rau cov kab mob ua pa sab saud los ntawm tus kab mob khaub thuas bacillus, Staphylococcus aureus ntawm daim tawv nqaij thiab cov nqaij mos kis, mob syphilis, mob plab amebiasis, thiab lwm yam.

Yog koj haus mis nyuj hauv tsev, BALLYA tseem tuaj yeem ua qhov kev ntsuam xyuas erythromycin qhia rau koj paub yog tias muaj erythromycin seem hauv cov mis koj haus hauv 10 feeb.

2. Nta

Cov khoom no yog ib yam macrolide hmoov tshuaj tua kab mob, ua los ntawm kab lis kev cai broth ntawm actinomycete Streptomyces erythreus cais los ntawm cov av ntawm cov kob ntawm Panay. Nws tau luam tawm thawj zaug los ntawm EliLilly xyoo 1952. Muaj ntau qhov piv txwv xws li erythromycin tshuaj B thiab C tau tsim nyob rau hauv kev daws teeb meem kab lis kev cai tib lub sijhawm, thiab qhov sib txawv hauv qhov hnyav hnyav tau siv los tshem tawm lawv.

Cov khoom no yog xim dawb lossis lub teeb daj daj crystalline hmoov, tsis muaj ntxhiab, iab, hygroscopic hauv huab cua, soluble hauv ethanol, chloroform, acetone thiab ether, thiab me ntsis soluble hauv dej. Kev daws teeb meem nce ntxiv tom qab tsim ntsev. Nws yog qhov ruaj khov nyob rau hauv lub xeev qhuav, thiab cov kua dej sib tov yog qhov ruaj khov nyob rau hauv tub yees, thiab lub zog maj mam txo qis ntawm chav sov. Nws tsis ruaj khov thaum raug rau cov kua qaub, thiab tseem ruaj khov thaum me ntsis alkaline, thiab nws lub peev xwm tau txo qis hauv qab pH 4.

3. Cov teebmeem tshuaj

Erythrocin yog hom tshuaj tua kab mob yooj yim uas tsim los ntawm Streptomyces erythreus, koom nrog macrolide hmoov pab pawg neeg. erythromycin tshuaj yog tus neeg sawv cev bacteriostatic, tab sis nws kuj muaj cov kab mob tua kab mob rau cov kab mob rhiab heev ntawm qhov siab.

erythromycin tshuaj mechanism ntawm kev txiav txim yog tias nws tuaj yeem nkag mus rau cov kab mob cell membrane kom thim rov qab rau 50S subunit ntawm cov kab mob ribosome ze ntawm qhov chaw pub ("P" txoj haujlwm), thaiv kev hloov pauv ribonucleic acid (tRNA) los ntawm kev khi rau "P" txoj haujlwm, thiab tseem thaiv kev txav chaw ntawm cov saw polypeptide los ntawm txoj haujlwm txais ("A" txoj haujlwm) mus rau "P" txoj haujlwm. Cov txheej txheem no txwv tsis pub cov synthesis ntawm cov kab mob protein thiab yog li muaj cov tshuaj tua kab mob. erythromycin tshuaj tsuas yog ua tau zoo tiv thaiv cov kab mob uas faib ua haujlwm.

erythromycin tshuaj muaj cov tshuaj tua kab mob dav thiab muaj txiaj ntsig zoo rau feem ntau cov kab mob gram-positive, qee cov kab mob gram-negative thiab qee cov kab mob atypical pathogenic. Erythrocin muaj cov tshuaj tua kab mob muaj zog tiv thaiv Staphylococcus (suav nrog cov kab mob tsim cov enzyme), ntau pawg ntawm streptococci, pneumococcus, Bacillus anthracis, Fusobacterium tetani, Diphtheria, Neisseria gonorrhoeae, Meningococcus, Influenza bacillus, Pertussis, Legylus, Campelus . Nws kuj tseem muaj qhov cuam tshuam zoo rau Treponema pneumoniae, Mycoplasma pneumoniae, Leptospira, Rickettsia, Chlamydia, thiab lwm yam.

Tom qab erythromycin tshuaj lactobionate tau nqus, nws tau hydrolyzed los tso cov khoom xyaw nquag erythromycin. erythromycin tshuaj tuaj yeem nkag mus rau cov kab mob cell membrane thiab thim rov qab khi rau cov kab mob ribosome.

4. Pharmacokinetics

qhov ncauj erythrocin yog 200-250 mg, thiab cov ntshav ntshav nce mus txog nws qhov siab tshaj tom qab 2 txog 3 teev, uas feem ntau tsawg dua 1 μg/ml. Tsuas yog cov kua dej hauv lub paj hlwb thiab cov nqaij hauv lub hlwb, cov tshuaj tau nthuav dav dav hauv ntau cov ntaub so ntswg thiab lub cev ua kua tom qab nqus tau, tshwj xeeb tshaj yog kev mob siab rau hauv daim siab, kua tsib thiab tus po yog siab dua (cov concentration hauv cov kua tsib tuaj yeem ncav cuag 10-40 npaug ntawm cov ntshav). Qhov siab ntawm cov tshuaj hauv raum, lub ntsws thiab lwm cov ntaub so ntswg tuaj yeem ntau dua li cov ntshav; kuj tseem muaj ntau dua nyob hauv cov ntaub so ntswg subcutaneous, cov hnoos qeev thiab cov hnoos qeev hauv lub ntsws (cov concentration hauv cov hnoos qeev zoo ib yam li cov ntshav hauv cov ntshav); hauv siab thiab hauv plab kab noj hniav, qhov ua kom pom pus tuaj yeem ncav cuag qhov ua kom tsis muaj zog.

erythromycin tshuaj tuaj yeem nkag mus rau cov qog nqaij hlav hauv lub cev thiab cov paum nyob hauv qee qhov (kwv yees li 33% ntawm cov ntshav ntshav), tab sis nws tsis yooj yim nkag mus rau cov ntshav-cerebrospinal kua dej thaiv. Thaum cov meninges tau mob, qhov concentration hauv cov kua dej hauv lub paj hlwb tsuas yog li 10% ntawm cov ntshav siab. erythromycin tshuaj tuaj yeem nkag mus rau cov ntshav ncig ntawm tus menyuam hauv plab thiab niam mis. Cov ntshav hauv menyuam hauv siab yog 5% txog 20% ​​ntawm niam cov ntshav siab, thiab cov ntshav ntshav hauv cov kua mis tuaj yeem ncav cuag ntau dua 50%. Tom qab kev tswj hwm qhov ncauj ntawm cov ntsev sib txawv ntawm erythromycin, lub bioavailability yog li 30% txog 65%. Pom qhov ntim ntawm kev faib tawm yog 0.9L/kg.

Tus nqi khi cov protein yog 70% txog 90%. Ib nrab ntawm lub neej yog kwv yees li 1.4-2.0h, thiab ib nrab-lub neej ntawm cov neeg mob anuria tuaj yeem txuas ntxiv mus rau 4.8-6.0h. Dawb erythromycin yog metabolized hauv lub siab, feem ntau yog mloog zoo hauv lub siab thiab tawm los ntawm cov kua tsib. Kwv yees li 2% txog 5% ntawm qhov ncauj thiab 10% txog 15% ntawm qhov ntim tshuaj tau lim los ntawm glomerulus thiab tso tawm hauv cov zis. Cov concentration hauv cov zis tuaj yeem ncav cuag 10-100μg/ml. Ib qho ntxiv, cov quav kuj muaj qee yam tshuaj. Peritoneal dialysis thiab hemodialysis tsis tuaj yeem tshem tawm tau zoo erythrocin.

Erythromycin lactobionate yog dej-soluble, uas mus txog qhov siab tshaj plaws ntawm cov ntshav tom qab tso ntshav tawm. Yog tias koj tso 2g txhaj tshuaj hauv 24 teev, qhov nruab nrab ntshav siab yuav yog 2.3-6.8 mg/L.

Dab tsi yog erythrocin siv rau?

erythrocin-siv
erythrocin-siv

1. Erythrocin siv

Cov khoom no yog ib yam macrolide tshuaj tua kab mob. Nws cov tshuaj tua kab mob zoo ib yam li penicillins. Nws tiv taus kab mob Gram-positive, xws li Staphylococcus, Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae, Streptococcus faecalis, Streptococcus hemolyticus, Clostridium Bacillus, Diphtheria, Bacillus anthracis, thiab lwm yam Nws muaj cov kab mob tsis zoo , xws li Neisseria gonorrhoeae, Helicobacter, Pertussis, Brucella, Legionella, Meningococcus, Haemophilus influenzae, Bacteroides, ib feem ntawm Shigella thiab Escherichia coli.

Ib qho ntxiv, nws muaj qhov cuam tshuam rau mycoplasma, actinomycetes, spirochetes, rickettsiae, chlamydia, nocardia, ob peb mycobacteria thiab amoeba. Staphylococcus aureus thiab lwm yam kab mob Staphylococcus thiab Streptococcus. Nws yog tus yam ntxwv ntawm cov kab mob uas tiv taus tshuaj penicillin thiab rhiab heev rau cov khoom. Cov mechanism ntawm kev txiav txim yog nws feem ntau ua ke nrog 50S subunit ntawm ribonucleoprotein lub cev, txwv tsis pub peptide acyltransferase, cuam tshuam rau txheej txheem kev hloov pauv ntawm ribonucleoprotein lub cev, thiab cuam tshuam peptide saw kev loj hlob thiab cov kab mob protein synthesis.

2. indications

  • Mob tonsillitis, mob pharyngitis, mob sinusitis los ntawm hemolytic streptococcus, streptococcus pneumoniae, thiab lwm yam.
  • Scarlet fever thiab cellulitis tshwm sim los ntawm hemolytic streptococcus.
  • Mycoplasma mob ntsws mob ntsws, Chlamydia pneumoniae mob ntsws.
  • Gas gangrene, anthrax, tetanus.
  • Diphtheria (kev kho mob ntxiv) thiab cov kab mob diphtheria.
  • Chlamydia trachomatis conjunctivitis.
  • Cov kab mob urogenital tshwm sim los ntawm Chlamydia thiab Mycoplasma.
  • listeriosis.
  • Legionella mob ntsws (legionellosis).
  • Kev kis tus kab mob Neisseria gonorrhoeae.
  • Campylobacter jejuni enteritis cov.
  • Kev kis kab mob hauv qhov ncauj los ntawm cov kab mob anaerobic.
  • Hnoos hawb pob.
  • Actinomycosis.
  • Kev kho kab mob dermatology feem ntau yog siv rau cov uas tsis yog gonococcal urethritis (cervicitis), gonorrhea, syphilis, chancroid, chlamydial lymphogranuloma (venereous lymphogranuloma), pob txuv, thiab kab mob Staphylococcal ntawm daim tawv nqaij, ua npaws liab, thiab lwm yam.

Yuav siv erythrocin li cas?

1. Contraindications

Erythrocin tuaj yeem hla dhau txoj hlab ntaws thiab nkag mus rau hauv niam mis. Cev xeeb tub thiab pub niam mis thiab cov uas ua xua rau cov macrolides yuav tsum siv nws nrog ceev faj.

2. Kev siv thiab tshuaj erythromycin

  • Feem ntau siv qhov ncauj: 1 rau 2g ib hnub, faib ua 3 rau 4 zaug. Legionnaires tus kab mob: Cov koob tshuaj txhua hnub tuaj yeem nce ntxiv rau 2 txog 4 g, faib ua 4 koob. Kev tswj hwm hauv cheeb tsam: Txhawm rau kho tus mob trachoma, kab mob sib kis, thiab keratitis, siv cov tshuaj pleev kom tsim nyog rau daim tawv muag ob peb zaug hauv ib hnub. Koob rau lub raum tsis txaus: cov neeg mob uas lub raum tsis ua haujlwm feem ntau tsis tas yuav txo qhov ntau npaum li cas.
  • Menyuam: Kev tswj qhov ncauj: 30-50 mg/kg ib hnub, 3 txog 4 zaug. Kev tswj hwm hauv cheeb tsam: rau kab mob ntsws, kab mob sib kis, keratitis, siv cov tshuaj pleev kom tsim nyog rau cov tawv muag ob peb zaug hauv ib hnub.
  • Kev tso dej tawm hauv dej: Cov neeg laus: Feem ntau siv: 1 ~ 2g ib hnub, faib ua 2 ~ 4 zaug. Legionnaires tus kab mob: 3 txog 4g ib hnub, muab faib ua 4 zaug sib faib. Qhov siab tshaj plaws tsis tuaj yeem tshaj 4g. Cov menyuam yaus: 20-40 mg/kg ib hnub, faib ua 2 txog 4 zaug.

Cov kev mob tshwm sim ntawm erythrocin yog dab tsi?

cov kev mob tshwm sim-ntawm-erythrocin
cov kev mob tshwm sim-ntawm-erythrocin

1. Erythromycin Cov Teeb Meem 

  • Cov tsos mob ntawm txoj hnyuv xws li raws plab, xeev siab, ntuav, mob hauv nruab nrab lub plab, thiab tsis qab los yuav tshwm sim tom qab noj tshuaj. Qhov tshwm sim muaj feem cuam tshuam nrog koob tshuaj.
  • Hepatotoxicity xws li qaug zog, jaundice thiab lub siab ua haujlwm tsis zoo yuav tshwm sim qee zaum tom qab siv tshuaj.
  • Cov koob tshuaj loj (≥4g ib hnub) tuaj yeem ua rau mob ototoxicity hauv cov neeg mob uas muaj kab mob siab lossis mob raum, lossis hauv cov neeg laus. Nws yog qhov tshwm sim feem ntau pom tias tsis hnov ​​lus. Tej zaum nws yuav cuam tshuam nrog ntshav siab (> 12 mg/L), thiab lawv feem ntau tuaj yeem rov zoo li qub tom qab siv tshuaj.
  • Qee zaum, kev tsis haum tshuaj xws li ua npaws, ua pob, thiab eosinophilia tuaj yeem tshwm sim tom qab siv tshuaj, thiab qhov tshwm sim yog li 0.5% txog 1%.
  • Ob peb tus neeg mob muaj lub plawv dhia tsis xwm yeem, thiab qhov ncauj los yog qhov paum Candida kis tom qab siv tshuaj.
  • Qee tus neeg mob qee zaum muaj kev ua rau mob voos lossis phlebitis tom qab kev tswj hwm cov tshuaj.

2. Ceev faj

  • Erythromycin yog tshuaj tua kab mob bacteriostatic. Kev tswj hwm yuav tsum tau ua nyob rau qee lub sijhawm kom tswj tau cov tshuaj hauv lub cev thiab pab txhawb nws cov txiaj ntsig.
  • erythromycin tshuaj cov ntsiav tshuaj yuav tsum tau nqos tag nrho. Yog tias noj cov hmoov, nws yuav raug rhuav tshem los ntawm cov kua qaub thiab cov nyhuv yuav raug txo kom tsawg. Cov menyuam yaus tuaj yeem noj cov kua qaub-ruaj khov esterified erythrocin.
  • Kev tso dej tawm hauv dej yog qhov yooj yim ua rau phlebitis, yog li cov dej ntws nrawm yuav tsum qeeb.
  • Erythromycin rhuav tshem thiab txo qis cov nyhuv hauv acidic infusions, yog li nws feem ntau yuav tsum tsis sib xws nrog qis-pH cov piam thaj infusions. Hauv 500ml ntawm 5% ~ 10% kev tso ntshav qab zib, ntxiv cov tshuaj vitamin C (1g sodium ascorbate) lossis 0.5ml ntawm 5% sodium bicarbonate txhaj tshuaj kom nce pH siab dua 5, thiab ntxiv erythromycin lactobionate, yuav pab kom ruaj khov.

3. Kev Sib Tham Tshuajs

  • erythromycin tshuaj tau siv ua ke nrog tshuaj tiv thaiv kab mob xws li carbamazepine thiab valproic acid, uas tuaj yeem cuam tshuam cov metabolism hauv carbamazepine thiab valproic acid, ua rau tom kawg ua rau nws cov ntshav ntau ntxiv thiab tshwm sim tshuaj lom. Thiab carbamazepine tuaj yeem txo qhov ua tau zoo ntawm erythromycin tshuaj los ntawm daim siab microsomal oxidase.
  • Kev sib xyaw ntawm erythromycin thiab cyclosporine tuaj yeem txhawb kev nqus ntawm cyclosporine thiab cuam tshuam nrog nws cov metabolism. Cov tsos mob tshwm sim yog mob plab, kub siab thiab ua haujlwm tsis zoo ntawm lub siab.
  • Kev siv erythromycin thiab xanthines (tshwj tsis yog dihydroxyprophylline) tuaj yeem txo qis qhov kev tshem tawm ntawm aminophylline, ua rau kom cov ntshav aminophylline ntau ntxiv thiab/lossis muaj tshuaj lom ntau ntxiv. Qhov tshwm sim no feem ntau yuav tshwm sim tom qab 6 hnub, thiab txo qis ntawm aminophylline tshem tawm yog qhov sib piv rau qhov siab tshaj plaws erythromycin ntshav.
  • Ua ke nrog erythromycin tshuaj thiab digoxin tuaj yeem tshem tawm cov hnyuv hauv lub cev uas tuaj yeem ua haujlwm tsis tau digoxin, yog li ua rau digoxin plab zom mov hauv lub cev, ua kom cov ntshav sib xyaw ntawm digoxin thiab ua rau muaj tshuaj lom.

xaus

Erythrocin muaj cov tshuaj tua kab mob rau ntau cov kab mob thiab tuaj yeem hloov pauv tau tshuaj penicillin qee zaum. Yog li ntawd, erythromycin tshuaj muaj ntau yam kev siv thiab cov txiaj ntsig zoo. Tab sis peb yuav tsum tau xyuam xim rau cov kev mob tshwm sim thiab kev cuam tshuam nrog tshuaj ntawm erythromycin.

References

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