Beta-lactam mankhwala: limagwirira kanthu ndi gulu

Mankhwala - gulu la mankhwala ndi Etiotropic limagwirira ntchito mwakhama. M'mawu ena, mankhwala zinthu mwachindunji chifukwa cha matenda (mu nkhani iyi, ndi bakiteriya ndi causative wothandizila) ndipo zimenezi m'njira ziwiri: kuwononga tizilombo ting'onoting'ono (microbicides - penicillin, cephalosporins) kapena ziletsa kubalana awo (bacteriostatic - tetracyclines, sulfonamides).

Pali ndalama yaikulu mankhwala ndi mankhwala, koma gulu yaikulu ya iwo - ichi ndi beta-lactams. Ndi za iwo ndi ayankhidwa m'nkhaniyi.

Gulu la mankhwala

Pa limagwirira cha zochita za mankhwala awa ali m'magulu zazikulu zisanu ndi chimodzi:

1. Maantibayotiki kuti ziletsa kaphatikizidwe zigawo selo nembanemba: penicillin, cephalosporins, ndi ena.
2. Mankhwala kupewa kugwira ntchito za masiku onse khoma selo: polyenes polymyxins.
3. Mankhwala ziletsa mapuloteni kaphatikizidwe: macrolides, tetracyclines, aminoglycosides, ndi ena.
4. Ochepetsera RNA kaphatikizidwe pa sitepe kanthu za RNA polymerase: rifamycins, sulphonamides.
5. Ochepetsera RNA kaphatikizidwe pa sitepe kanthu za DNA polymerase: actinomycins neri Al.
6. DNA kaphatikizidwe blockers: anthracyclines, nitrofurans ndi ena.

Komabe, gulu ili si yabwino kwambiri. Zochita matenda, anapanga gulu zotsatirazi antimicrobials:

1. Penicillin.
2. Cephalosporins.
3. Macrolides.
4. Aminoglycosides.
5. Polymyxin ndi polyenes.
6. Tetracyclines.
7. Sulfonamides.
8. Aminohinolonov ofanana nawo.
9. Nitrofurans.
10. Fluoroquinolones.

Beta-lactam mankhwala. Kapangidwe ndi njira ya kanthu

Gulu la mankhwala ndi zotsatira bactericidal ndi mndandanda mokwanira lonse la zikuonetsa ntchito. Beta-lactam mankhwala monga penicillin, cephalosporins, carbapenems, monobactams. Onse yodziwika ndi dzuwa mkulu ndi otsika kawopsedwe, kuwapanga mankhwala zambiri zotchulidwa zochizira matenda ambiri.

Limagwirira cha zochita za mankhwala beta-lactam chifukwa dongosolo lawo. Kwambiri mwatsatanetsatane pano pa chirichonse, ndi ofunika ponena yekha za chinthu chofunika kwambiri, amene anapereka dzina kuti gulu lonse la mankhwala. M'gulu mamolekyulu wa beta-lactam mphete ndipo amapereka kutchulidwa bactericidal tingati amene anaonetsa kutsekereza kaphatikizidwe zigawo selo mpanda wa tizilomboto lapansi. Komabe, mabakiteriya ambiri amatha kutulutsa enzyme wapadera, amene akuswa kapangidwe ka mphete, potero kuwamana mankhwala ndi chida waukulu. Ndicho chifukwa chake ntchito mankhwala mankhwalawa alibe chitetezo beta-lactamases, operewera.

Tsopano kukhala wamba mankhwala beta-lactam gulu, kutetezedwa zochita za michere bakiteriya. zikuchokera awo sakutanthauza zinthu ndigwire kaphatikizidwe beta-lactamase, monga asidi clavulanic. kutetezedwa beta-lactam mankhwala (monga "Amoxiclav") analengedwa mwanjira imeneyo. zoletsa zina za enzyme bakiteriya monga "Sulbactam" ndi "tazobactam."

Mankhwala kwa gulu la penicillin: Chiyambi Chawo

Kukonzekera zino anali maantibayotiki choyamba, zotsatira akangofika amene adadziwika kwa anthu. Kwa nthawi yaitali anthu akhala ankagwiritsa ntchito zochizira matenda osiyanasiyana ndi zaka zoyambirira za ntchito ndi pafupifupi limathetseratu vuto lina lililonse. Komabe, pasanapite nthawi zinadziwika kuti chidacho yawo pang'onopang'ono akugwa, monga zamoyo wa dziko mabakiteriya alibe kuima. Yaying'ono-zamoyo amatha atengere msanga zosiyanasiyana zinthu zovuta aliko, tingadzifunse m'badwo kuwala mabakiteriya mankhwala zosagwira.

Kuchuluka kwa Penicillin ankapita mofulumira tizilombo ta si atengeke tizilombo kwa iwo, kotero mu maonekedwe ake angwiro tsopano mankhwala gulu osathandiza ndipo si ntchito. Iwo bwino ntchito limodzi ndi zinthu zomwe patsogolo mmene bactericidal, komanso kumabwezera mmbuyo njira bakiteriya zozitetezera.

kukonzekera Penicillin

Izi ndi beta-lactam mankhwala, gulu la yomwe ndi yaikulu kwambiri:

1. The penicillin achilengedwe (mwachitsanzo, "Penicillin").
2. Anti-staphylococcal ( "Oxacillin").
3. Penicillin, yaitali muzidzola ( "Ampicillin" "Amoxicillin").
4. Pseudomonas ( "azlocillin").
5. penicillin kutetezedwa (pamodzi ndi asidi clavulanic "sulbactam", "tazobactam").
6. Mankhwala, kuphatikizapo mamembala ake mankhwala ochepa Penicillin.

Mwachidule za mankhwala a gulu Penicillin

The penicillin zachilengedwe angathe kuletsa ntchito ya galamu HIV ndi galamu alibe tizilombo onse. Wa yamasika, mwamsanga kwambiri gulu la beta-lactam mankhwala Streptococcus ndi zimayambitsa matenda oumitsa khosi. Mabakiteriya yatsalayi tsiku anapeza njira yodzitetezera. penicillin Natural polimbana anaerobes :. Clostridial peptokokki, peptostreptokokkov etc. Mankhwalawa sakhala poizoni ndipo ndi ochepa mavuto, mndandanda wa zomwe yafupika makamaka kwa thupi lawo siligwirizana, ngakhale ambiri osokoneza n'zotheka ndi chitukuko cha khunyu, ndi maonekedwe a zizindikiro za poyizoni ndi ziwalo dongosolo m'mimba.

Kuchokera penicillin odana staphylococcal phindu lalikulu ndi wa beta-lactam maantibayotiki ngati "Oxacillin". Izi pokonzekera ntchito yopapatiza, popeza cholinga makamaka kulimbana S. aureus. Ndi tizilomboto izi (kuphatikizapo tizilombo ta penitsillinrezistentnyh) "Oxacillin" ndi zothandiza kwambiri. Zotsatira zake zoyipa ofanana ndi a anthu ena a gulu la mankhwala.

Penicillin, yaitali muzidzola popanda munthu galamu HIV, galamu alibe ndi anaerobic zomera komanso mwakhama polimbana ndi wothandizila causative matenda matumbo. Mankhwalawo osati zosiyana pamwamba, ngakhale mankhwala yodziwika ndi Mwina pang'ono apamwamba matenda a dongosolo m'mimba.

Beta-lactam maantibayotiki "azlocillin" (nthumwi ya gulu wachinayi wa penicillin) lakonzedwa kuthana ndi Pseudomonas aeruginosa. Komabe, mu nthawi tizilomboto chowululidwa kukana mankhwala zino, zimene zimapangitsa ntchito zawo si zogwira mtima.

About Otetezedwa penicillin tatchulazi. Chifukwa chakuti mankhwala monga mu kapangidwe kake zinthu ziletsa beta-lactamase kubala mabakiteriya, ali aluso zochizira matenda ambiri.

Gulu lomaliza - ndi osakaniza oimira angapo penicillin, matanthauzo ikuthandizira kanthu wina ndi mzake.

Mibadwo inayi ozimitsa mabakiteriya

Beta-lactam mankhwala ndi cephalosporins ali. Mankhwalawa, ngati penicillin, Wamphamvu zoposa sipekitiramu awo lonse kanthu ndi mavuto ochepa mbali.

Pali zinthu zinayi magulu (m'badwo) cephalosporins:

1. Oimira kwambiri m'badwo woyamba - "Cefazolin" ndi "Cephalexin". Iwo makamaka pofuna kuthana staphylococci, streptococci, meningococci ndi gonococci, komanso ena zamoyo galamu-negative.
2. M'badwo wachiwiri - ndi "Cefuroxime" beta-lactam mankhwala. m'dera udindo wake zikuphatikizapo makamaka galamu alibe tizilombo.
3. "Cefotaxime", "Ceftazidime" - oimira gulu lachitatu la gulu la. Iwo kwambiri ndi enterobacteria ndipo akhoza kuwononga zomera za nosocomial (ta kuchipatala tizilombo).
4. m'badwo wachinayi waukulu mankhwala - ". Cefepime" Iwo ali ubwino onse mankhwala pamwamba, Komanso ndi wolimba kwambiri beta-lactamases tizilombo ali ndi ntchito ndi Pseudomonas aeruginosa.

Cephalosporins ndi beta-lactam mankhwala wonse amakhala ndi kutchulidwa zotsatira bactericidal.

Chifukwa ena chokhwima kuti utsogoleli wa mankhwala ambiri tcheru oyenera deta osiyanasiyana, thupi lawo siligwirizana (okhadzula ku zing'onozing'ono moyo pachiswe, monga mantha anaphylactic), zina ndi matenda a ziwalo m'mimba.

ndalama malo

"Imipenem" - ndi beta-lactam mankhwala a gulu carbapenem. Iye, komanso palibe zochepa wotchuka "Meropenem" ntchito yaikulu kukana mankhwala ena microflora wofu- osemphana ngakhale wachitatu ndi wachinayi m'badwo cephalosporins.

Beta-lactam tizilomboto gulu la carbapenems - mankhwala ntchito milandu kwambiri, pamene tizilombo toyambitsa matenda si amenable mankhwala ndi mankhwala ena.

Yochokera zikutanthauza lachiwiri

"Aztreonam" - kwambiri wotchuka woimira monobactams, izo amakhala ndi sipekitiramu ndi yopapatiza kanthu. Izi mankhwala beta-lactam ndi othandiza kwambiri ndi galamu alibe thupi. Komabe, tisaiwale kuti monga "Imipenem" "Aztreonam" zayamba sanakhudzidwe ndi beta-lactamases, zomwe zimachititsa kuti mankhwala wosankha likamanena choopsa cha matenda anachititsa ndi tizilombo toyambitsa matenda awa, makamaka mankhwala kulephera maantibayotiki ena.

The sipekitiramu a zochita za mankhwala beta-lactam

Mwachidule, tisaiwale kuti kukonzekera za magulu awa zimakhudza chiwerengero chachikulu cha mitundu ya tizilombo toyambitsa matenda. Limagwirira cha zochita za beta-lactam mankhwala amenewa kuti wasiya zosatheka chopulumuka tizilomboto: selo khoma kaphatikizidwe anatseka misewu - aphedwa chifukwa mabakiteriya.

Galamu HIV ndi galamu alibe zamoyo, aerobic ndi anaerobic ... nthumwi zonse izi za zomera tizilombo pali mankhwala kwambiri zothandiza. Kumene, ali pakati mankhwala awa ndi zipangizo apadera kwambiri, koma ambiri a iwo okonzekera kumenya nkhondo ndi wothandizila angapo opatsirana. Beta-lactam mankhwala amatha kupirira ngakhale anthu a zomera nosocomial, ali kwambiri kuichiza.

ndi tizilombo ta kuchipatala chiyani?

Tikuyankhula zokhudza-zamoyo yaying'ono kulili mabungwe zachipatala. Magwero a maonekedwe awo akhale odwala ndi ogwira ntchito zachipatala. Oopsa kwambiri, makamaka chobisika, mitundu indolent matenda. Hospital - malo wangwiro kusonkhanitsa onyamula zonse zitheka kwa matenda opatsirana. A kuphwanya malamulo a ukhondo ndi wosathandiza ndi bwalo ya chonde kwa zomera ichi wapeza kagawo kakang'ono kuti Mulungu alipo, kumene iye akanakhoza kukhala, mtundu ndiponso kuphunzira kukana mankhwala.

ta kuchipatala zonyamula makamaka chifukwa chakuti, ndi zipatala awo okhala, mabakiteriya amatha kulankhula ndi zosiyanasiyana mankhwala. Mwachibadwa, zotsatira za mankhwala pa zamoyo amapezeka mwangozi, popanda kuwononga chandamale, ndipo pa mlingo kakang'ono, ndipo zimenezi zimalimbikitsa chakuti akuluakulu a microflora kuchipatala angathe chitetezo njira zowononga kwa iwo aphunzire zokanira. Ndipo ta kuoneka kulimbana ndi zovuta, ndipo nthawizina izo zimawoneka kuti n'zosatheka.

Beta-lactam mankhwala zingapo za njira imodzi kapena wina akuyesera kuti vutoli zovuta. Ena mwa iwo ndi nthumwi kuti akhoza kwambiri bwinobwino kulimbana ndi ngakhale chisoni kwambiri mankhwala mabakiteriya. Izi malo mankhwala. ntchito zawo zili ndi malire, monga iwo amaikidwa kokha pamene n'zofunikadi. Ngati mankhwala awa ntchito poponya zambiri, ndiye, osalephera, idzathetsa kugwa zimatha mphamvu zawo, chifukwa bakiteriya ndi mwayi kucheza ndi Mlingo ka mankhwala, kuphunzira nawo ndi kukhala njira ya chitetezo.

Pamene kutumikiridwa beta-lactam mankhwala?

Zikuonetsa ntchito ya gulu la mankhwala chifukwa makamaka sipekitiramu zochita. Zingakhale bwino kuika beta-lactam maantibayotiki pa matenda, amene tizilomboto amakhudzidwa zochita za mankhwala.

Penicillin ndi kukhazikika bwino pa matenda a pharyngitis, zilonda zapakhosi, chibayo, fever, kakhosi endocarditis bakiteriya, actinomycosis, matenda anaerobic, leptospirosis, salmonellosis, shigellosis, matenda opatsirana a khungu ndipo zimakhala zofewa. Musaiwale za mankhwala akhoza kulimbana ndi Pseudomonas aeruginosa.

Cephalosporins ndi sipekitiramu ofanana kuchita choncho zikuonetsa kuti iwo ali pafupi mofanana kwa penicillin. Komabe, kuyenera kuti mphamvu ya cephalosporins, makamaka mibadwo ziwiri zapitazi, osati mwa chitsanzo pamwamba.

Monobactams ndi carbapenems ali pofuna kuthana ndi matenda aakulu kwambiri ndi bwino n'ngochiritsika, kuphatikizapo chifukwa cha tizilombo ta kuchipatala. Zimathandizanso mu sepsis ndi mantha septic.

zotsatira osafunika

Monga kale mwachidule, beta-lactam mankhwala (mankhwala cha gulu ili zalembedwa pamwambapa) amadziŵika ndi ochepa mavuto kwa thupi. Osowa khunyu ndi zizindikiro za matenda m'mimba si moyo pachiswe. The kwenikweni zoopsa kungakhale aakulu awo sagwirizana anachita mankhwala mwa mankhwala beta-lactam.

Totupa, pruritus, rhinitis ndi conjunctivitis si moyo pachiswe, ngakhale zosasangalatsa kwambiri. Kodi kwenikweni ndi woyenera kuopedwa, chifukwa ngati zochita aakulu monga angioedema (makamaka m'dera la kholingo, amene anatsagana ndi dyspnea aakulu mpaka kulephera kupuma) ndi anaphylactic mantha. Choncho, mankhwala akhoza anayambitsa pokhapokha kuchita mayeso chifukwa ziwengo.

N'zotheka mtanda zosiyanasiyana. Beta-lactam mankhwala gulu zomwe zikusonyeza kukhalapo kwa ambiri magulu a mankhwala, amapanga zofanana kwambiri ndi mzake, kutanthauza kuti vuto la tsankho kwa mmodzi wa iwo, aliyense adzakhala anazindikira mwa thupi monga allergen ndi.

mawu ochepa za zinthu zimene zimawonjezera kukana mabakiteriya

Pang'onopang'ono kuchepa mphamvu ya mankhwala antibacterial (kuphatikizapo mankhwala beta-lactam) chifukwa alakwitsa Nthawi zambiri pachithunzichi kuti ntchito. N'zoona chosakwanira cha mankhwala, ntchito Mlingo yaing'ono achire si abwino kuchira, koma kupewa tizilombo mpata "phunzitsa", kuti mukupanga ndi kukhala njira ya chitetezo mankhwala. Choncho kodi n'zodabwitsa kuti yotsirizira kukhala operewera pa nthawi?

Ngakhale mankhwala ndipo si anamasulidwa pharmacies popanda dotolo iwo onse mungathe. Izi zikutanthauza kuti kudzikonda ndi mavuto a (ntchito nthawi zonse mankhwala chomwecho, amauma kusokoneza mankhwala, mlingo lolakwika ndi zina zotero.) Kodi kukhala, polenga zinthu kulima tizilombo ta mankhwala.

Ndi apa kukhala ndi odwala zomera, ndi mwayi mwachangu kulankhula ndi mankhwala osiyanasiyana ndi kuyambitsa njira zatsopano kutsutsa iwo.

Kodi kuchita? Kodi musalankhule medicate, kuti litsatira malangizo a dokotala kupezeka: kumwa mankhwala kwa nthawi yaitali mogwirizana ndi pa mlingo lamanja. Ndi zomera nosocomial kumenyana, ndithudi, kovuta, koma n'kotheka. The kumangika kwa mfundo thanzi ndi kukhazikitsa awo okhwima kuti asapatsidwe kulenga zinthu yabwino kwa kuswana kwa zomera kugonjetsedwa.

A mawu ochepa pomaliza

A mutu waukulu kwambiri - beta-lactam mankhwala. Mankhwala (sayansi mankhwala ndi chikoka chawo pa chamoyo) akapatulira iwo machaputala angapo omwe si khalidwe wamkulu wa gululi, komanso ali ndi mawu a odziwika kwambiri nthumwi zake. Nkhaniyi si cholinga mabuku, koma achiyesa kuti atchule mfundo kudziwa zomwe mankhwala awa ndi zofunika.

Akhale athanzi ndi kusaiwala: musanagwiritse ntchito imeneyi kapena kuti mankhwala kuwerenga malangizo awa mosamala ndi mosamalitsa kutsatira malangizo, kapena bwino komabe, kukaonana ndi katswiri.