He rongoā i ahu mai i te erythromycin te Clarithromycin . I angitu te whakawhanaketanga e te Taisho Corporation o Hapani i ngā tau tōmua o te tekau tau atu i 1990, ā, i rēhitatia i raro i te ingoa hokohoko Clarith. Whai muri i tēnā, i tukuna tuatahitia e Taisho tana hangarau ki a Abbott o te Hononga o Amerika mō te hanga. I whakarārangihia ki Airana me Itari i te tau 1990. I te marama o Oketopa 1991, i whakaaetia e te FDA hei rongoā hou mō te kāwai IB. Ko te ingoa waitohu ko Biaxin . I te tau 1993, i whakarārangihia ki Hong Kong, Haina ko Klacid.
Ko te ingoa waitohu i Ūropi me Āhia ko Klaxian. Kua whakarārangihia i roto i ngā whenua maha, ā, kua piki haere tonu te wāhi mākete, ā, he mea nui tana mahi i roto i ngā mahi haumanu. Ko ngā āhuatanga o te Clarithromycin he tino whai hua, he ngāwari te mimiti mā te waha, ā, he pai te pumau o te waikawa. He kaha te mahi a te rongoā ki ngā huakita karamu-pai, he pumau ki ngā whākōkī, ā, he nui te kukū i roto i te toto me te kiko o te pukahukahu. Kua whakamātauhia i roto i te haumanu ko te mahi in vivo he 6-10 ngā wā i te erythromycin me te 14-35 ngā wā i te josamycin.
Ko tōna āhua he pai ake te wātea o te koiora, he pai te tohatoha i roto i ngā kiko me ngā pūtau, he roa te haurua o te ora, ā, ko tōna tere urupare kino he 3% noa iho. E whakamahia ana mō te rongoā i ngā mate manawa o runga me raro, me ngā mate kiri me ngā kiko ngohengohe. Kua noho hei whakakapi mō te erythromycin o ngā paturopi macrolide . Hei tāpiri, kua whakaaetia e te US FDA te whakakotahitanga o te clarithromycin me te losec hei mahere rongoā mō ngā mate puku me ngā mate duodenal i puta mai i te Helicobacter pylori; ko tēnei rongoā hoki te whiringa tuatahi mō te rongoā i ngā mate i roto i ngā tūroro AIDS.
Ko te Clarithromycin he antibiotic mcrolide mowhiti 14-membered. He rite tonu te hihinga antibacterial ki tera o te erythromycin me te roxithromycin, engari ko te hua o te huakita i runga i nga huakita Gram-pai penei i te Streptococcus, te pneumococcus, me te staphylococcus he paku pai ake, me etahi awe ki nga taumahatanga erythromycin-resistent induced.
Ko te Clarithromycin me ona metabolites i roto i te tinana kua whakarei ake i nga paanga o te patu huakita ki te rewharewha bacilli. He paanga ano to Clarithromycin ki te Neisseria gonorrhoeae, Listeria, Campylobacter jejuni, he kaha ake te awe ki te Legionella pneumoniae, Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, me era atu i te erythromycin.
Hei taapiri, he ngohe ano tona ki te Treponema pallidum, Mycobacterium avium me te Toxoplasma murine, a ko te nuinga he pai ake i etahi atu momo. I tua atu i te kaha o te paanga o te patu huakita ki te cocci anaerobic, he pai ake te painga ki te Bacteroides fragilis i te erythromycin. Ko te hua o Clarithromycin ki te Staphylococcus aureus, ko te Streptococcus pyogenes, ko te Influenza bacillus me etahi atu paturopi he kaha ake i te erythromycin.
Ko tenei raau rongoa he antibiotic macrolide, a ko tana tikanga he aukati i te whakahiatotanga o te pūmua ma te aukati i te hononga o te waahanga 50S o te nucleoprotein hei whakaputa i nga pungarehu. Ko tenei tarukino he aukati i nga huakita Gram-pai penei i te Staphylococcus aureus, Streptococcus, pneumococcus, me etahi atu, me etahi atu huakita Gram-kino penei i te Haemophilus influenzae, Bacillus pertussis, Gonorrhoeae, Legionella pneumophila me etahi huakita Anaerobic penei i te Bacteroides fragilis , Peptostreptococcus, me te acion Propionibacterium.
Hei taapiri, kei kona ano he awangawanga i te mycoplasma. Ko te ahuatanga o tenei rongoa ko te kaha o tana mahi tuakiri ki te erythromycin in vitro, engari ko tana ngoikoretanga huakita ki etahi huakita penei i te Staphylococcus aureus, Streptococcus, Haemophilus influenzae me etahi atu he kaha ake i te erythromycin. He whakawhiti-aukati me te erythromycin.
Nā te mea he rite te whānuitanga o ngā patu huakita o te clarithromycin ki te erythromycin, ka taea te whakamahi tauwhitiwhiti i ngā mea e rua i ētahi huarahi. Engari he rerekē i te erythromycin, he kaha ake te pānga o te clarithromycin ki te Streptococcus, Legionella, me te Chlamydia trachomatis i te erythromycin, inā koa ko te Helicobacter pylori, e whakamahia noa ana hei whakakore i a ia. He rerekē anō hoki te Clarithromycin i te erythromycin. Ka taea te tango ā-waha. I muri i te tangohanga, ka eke te bioavailability tino ki te rima tekau. I muri i te tangohanga, he rerekē anō hoki te kukū o ia okana. I te nuinga o te wā, he teitei ake te kukū i roto i ngā tonsil i te kukū i roto i te toto.
I te nuinga, ka taea e te clarithromycin te whakaora me te whakaora i nga mate kitakita ngawari o te taringa, o te ihu, o te korokoro, o te manawa manawa o raro, o te kiri me nga kiri maeneene. Hei tauira, mena he rongoa otitis whakapau, urethritis ranei, me etahi atu, ka taea te whakamahi i tenei rongoa.
Ko te nuinga o te wā ka whakamahia mō ngā ara manawa o runga me o raro i puta mai i ngā huakita tairongo, tae atu ki te tonsillitis, te pharyngitis, te sinusitis, te bronchitis, te pneumonia, me ētahi atu, ngā mate kiri me ngā kiko ngohengohe, te furuncle purulent, te erysipelas, te folliculitis, ngā mate patunga, me ētahi atu. He rite te pānga whakaora ki ētahi atu macrolides . Ka taea hoki te whakamahi i te Clarithromycin mō ngā mate ara urogenital i puta mai i te Chlamydia trachomatis, i te Ureaplasma urealyticum rānei, me ngā mate mycobacterial rerekē i roto i ngā tūroro AIDS.
He rite te whānuitanga o te patu huakita ki te erythromycin . He pumau ki te waikawa puku, ā, he kaha ake te pānga ki ngā huakita Gram-pai. He kaha patu huakita ki ētahi huakita Gram-kino, pērā i te Streptococcus, Mycoplasma me te Chlamydia. He whai hua ki te Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae me te Mycoplasma pneumoniae. I roto i te haumanu, ko te nuinga o te whakamahinga mō te bronchitis, te pneumonia, te pharyngitis, te tonsillitis, te mycoplasma pneumonia, ngā mate kiri me ngā kiko ngohengohe, te otitis media, te periodontitis, te maremare, me te kirika whero.
He matū matū koiora te Clarithromycin, e whai wāhi ana ki te aukati i te poke o ngā moroiti me te tirotiro ātete i roto i te ahurea kiko. Hei tāpiri, he paturopi macrolide mowhiti-14-mema te clarithromycin i roto i ngā rongoā. He rite te whānuitanga o ngā paturopi ki te erythromycin me te roxithromycin , engari he paku pai ake te pānga paturopi ki ngā huakita Gram-pai pērā i te Streptococcus, pneumococcus, me te staphylococcus, ā, he pānga anō hoki ki te momo ātete erythromycin i puta mai i te mahi paturopi.
Ko te Clarithromycin me ona metabolites i roto i te tinana kua whakarei ake i nga paanga o te patu huakita ki te rewharewha bacilli. He paanga ano to Clarithromycin ki Neisseria gonorrhoeae, Listeria, Campylobacter jejuni, me Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, etc.
Ka tango nga pakeke i te 250 mg ia 12h, ana ka taea te whakanui i te horopeta mo nga tuuroro kino ki te 500 mg ia 12h; ko te tikanga o te rongoa ko te mate o te mate, te tikanga ko te 7 ki te 14 nga ra. Mena he iti ake i te 0.501ml / 1.73 mita tapawha te utu o te waihanga waihanga, ka haurua te horopeta.
Te horopeta a nga tamariki: 7.5 mg / kg ia wa, 2 nga wa i te ra, ko te horopeta teitei kaore i neke atu i te 500 mg ia ra. Nga take ngawari: 250 mg i ia wa, 500 mg i ia wa mo nga keehi kino, kotahi i nga haora 12 katoa, a ko te mahinga maimoatanga he 7-14 nga ra. Ko nga tamariki kua neke ake i te 12 nga tau kua kiia he pakeke. Kaua nga tamariki i raro i te 12 e whakamahi i tenei rongoa.
Engari ki te mea ko te whakakore i te mumura, he marama ano nga urupare kino o te clarithromycin. Ko nga mea noa ko te mate pukupuku, te whakapairuaki, nga rereketanga o te reka, te ngoikore o te mamae, te mamae o te puku, me era atu He ngawari noa iho nga tikanga whanui; ko te leukopenia, ko te phosphatase alkaline teitei, me te bilirubin teitei e kitea ana i nga wa rongoa; i etahi wa ka kitea te enteritis pseudomembranous me te Pancreatitis; i etahi wa, ko te clarithromycin ka mate pea i te arrhythmia ventricular me te roa o te waahi QT.
Me tūpato te hunga e pāngia ana e te mate pāwera ki ngā macrolides , ngā wāhine hāpu, ngā wāhine whāngai u, te hunga e pāngia ana e te ngoikore nui o te ate me te whatukuhu, te arrhythmia, te bradycardia, te roa o te wā QT, te mate ngakau ngoikore rino, te ngoikore o te ngakau pūmau me ngā mate wai me te electrolyte. Ko te nuinga o te hua ka whakapūngaohia, ka tukuna ki roto i te ate, nō reira me aro nui ngā tūroro e pāngia ana e te ngoikore o te ate, te ngoikore nui o te whatukuhu, me ngā kaumātua neke atu i te 65 tau te pakeke ki ngā pānga kino i te wā e whakamahia ana te rongoā.
Ko te koretake o te Gastrointestinal me nga tohu o te punaha ka mate pea i te nui o te mate, ka taea te hoatu i te puru puku me te awhina tautoko. Kaore e taea e te hemodialysis me te dialysis peritoneal te tango i te hua, na reira me tere tonu te whakahaere i te rewharewha o te kopu, me hoatu te maimoatanga rite. Ka aukatia mo nga wa hapu (ko te kukume o te Clarithromycin i roto i nga kukuti kararehe he 2-17 wa te waatea o te serum a te tangata). Me tupato nga wahine whakangote) (me whakamutua te whangai u).
He mea hanga mai i te erythromycin te Clarithromycin . He tino whai hua, he ngāwari ki te mimiti, ā, he pai te pumau o te waikawa. I te nuinga o te wā, ka taea e te clarithromycin te whakakapi i te erythromycin. Engari me aro tonu ngā tākuta ki te horopeta me te huinga o te clarithromycin, nā te mea ki te kore e whakamahia tika, ka tūpono te tūroro ki te mōrearea.
Ka whakarato a BALLYA i tētahi rākau tātari tere mō te clarithromycin hei whakaatu ki a koe mēnā he toenga clarithromycin kei roto i ngā hua wai e kainga ana e koe.
Tohutoro