Analogues ntawm penicillin. Tshuaj tua kab mob penicillin neeg: indications, cov lus qhia rau kev siv

Penicillin analogues tau qhib tshiab lub caij rau cov kws kho mob nyob rau hauv cov kev kho mob ntawm kis kab mob. Lawv yog cov paub ntau tshaj resistant kom enzymes ntawm cov kab mob thiab txhoj puab heev ib puag ncig ntawm lub plab, muaj tsawg phiv.

Hais txog penicillin

Penicillins - nws yog tus hiob paub tshuaj tua kab mob. Lawv tau dab tsi rau ntau hom, tab sis ib txhia ntawm lawv tau poob lawv qhov tseeb vim cov kuj. Tus kab mob yog muaj peev xwm kom pab tau thiab ua insensitive rau qhov kev txiav txim ntawm cov tshuaj no. Qhov no ua rau zaum los tsim tshiab hom pwm, penicillin analogues muaj tshiab zog.

Penicillins muaj tsawg toxicity rau lub cev, tag nrho lug siv thiab yog ib tug zoo qhia ntawm bactericidal nyhuv, tab sis kev tsis haum tshuaj rau lawv yog cov ntau ntau ntau dua cov kws kho mob xav. Qhov no yog vim lub organic xwm ntawm tshuaj tua kab mob. Lwm yam tsis zoo qualities kuj muaj xws li muaj teeb meem nyob rau hauv combining lawv nrog lwm yam tshuaj, tshwj xeeb tshaj yog nrog zoo xws li cov chav kawm ntawv.

zaj dabneeg

Tus thawj mention nyob rau hauv cov ntawv nyeem ntawm penicillin coj qhov chaw nyob rau hauv 1963, nyob rau hauv ib phau ntawv txog Native American cov tshuaj txiv neej. Lawv siv ib tug sib tov ntawm fungi nyob rau hauv lam hom phiaj. Rau cov thawj lub sij hawm nyob rau hauv lub ntiaj teb no enlightened lawv muaj kev tswj kom tau Aleksandru Flemingu, tab sis qhov no yog tsis nyob rau lub hom phiaj, tab sis los ntawm kev huam yuaj, zoo li tag nrho cov poj discoveries.

Ua ntej lub ntiaj teb no ua tsov ua rog II lub British microbiologists ua hauj lwm rau ntawm qhov teeb meem uas muaj cov tshuaj nyob rau hauv yuav tsum tau ntau. Qhov teeb meem qub solved nyob rau hauv thaum uas tig mus thiab nyob rau hauv lub tebchaws United States. Los ntawm no taw tes ntawm penicillin yog feem ntau hom tshuaj. Tab sis thaum lub sij hawm, tau txheeb thiab tsim lwm cov pab pawg neeg ntawm tshuaj tua kab mob, uas yog maj mam hloov nws nrog ib tug podium. Nyob rau hauv tas li ntawd, kab mob pib tshwm resistant mus rau yeeb tshuaj, uas nyuab cov kev kho mob ntawm loj kab mob.

Lub hauv paus ntsiab lus ntawm antibacterial txiav txim

Cov kab mob cell phab ntsa muaj pes tsawg leeg muaj xws li ib yam khoom uas hu ua peptidoglycan. Penicillin pab pawg neeg ntawm tshuaj tua kab mob cuam tshuam lub synthesis ntawm cov protein, inhibiting lub tsim ntawm cov kev tsim nyog enzymes. Lub microorganism yog tuag vim hais tias ntawm lub cev tsis tau hloov lub cell phab ntsa.

Txawm li cas los, ib co kab mob kawm tau los kom tiv thaiv no brutal ntxeem tau. Lawv ua beta-lactamase, uas txav cov enzymes uas cuam tshuam rau peptidoglycan. Yuav kom tiv nrog no lub chaw khuam siab, zaum yuav tsum tau tsim penicillin analogues uas yuav cuam tshuam thiab beta-lactamase, ib yam nkaus thiab.

Qhov uas yuav muaj rau tib neeg

Thaum pib ntawm lub era ntawm tshuaj tua kab mob, zaum no xav txog yuav ua li cas lawv ua lom rau tib neeg lub cev, vim hais tias yuav luag tag nrho cov nyob metry muaj proteins. Tab sis tom qab siv ib tug txaus tus naj npawb ntawm cov kev tshawb fawb tau pom tias peptidoglycan nyob rau hauv peb lub cev muaj me ntsis, thiab yog li ntawd, ua kom muaj kev mob loj rau cov tshuaj tsis tau.

Lub spectrum ntawm kev txiav txim

Yuav luag tag nrho cov hom ntawm penicillins ua rau gram-zoo kab mob genus Staphylococcus, tus kab mob Streptococcus, Corynebacterium diphtheria thiab tus kab mob plague pathogen. Tsis tas li ntawd, nyob rau hauv lawv cov spectrum ntawm kev ua si no muaj xws li tag nrho cov kab-tsis zoo kab mob, gonococci thiab meningococci, co rods thiab txawm tej yam fungi (e.g., Actinomyces).

Zaum txua tshiab hom penicillin, sim kom tiv thaiv cov kab mob tau siv mus rau lawv cov bactericidal zog, tab sis rau cov kev kho mob ntawm nosocomial kab mob , qhov no pab pawg neeg ntawm cov tshuaj yog tsis haum. Ib tug ntawm cov tsis zoo cov yam ntxwv ntawm no hom ntawm tshuaj tua kab mob - kab mob overgrowth, raws li cov tib neeg hnyuv yog colonized los ntawm cov kab mob rhiab rau penicillin. Qhov no yog ib nqi nco ntsoov thaum mus noj tshuaj pab.

Lub ntsiab yam (kev faib)

Niaj hnub nimno zaum muaj niaj hnub penicillins division ua plaub pab pawg:

1. Ntuj, uas yog tsim los ntawm fungi. Cov no muaj xws benzilpenitsilliny thiab cov kws kho hniav. Cov tshuaj muaj ib tug nqaim spectrum ntawm kev ua si, mas tiv thaiv Gram-tsis zoo kab mob.
2. Semisynthetic npaj muaj kuj mus penicillinases. Lawv yuav siv los kho ntau spectrum ntawm pathogens. Cov neeg sawv cev methicillin, oxacillin, nafcillin.
3. Karboksipenitsilliny (karbpenitsillin).
4. tshuaj pab pawg neeg uas muaj ntau ntau yam ntawm kev ua:
   - ureidopenitsilliny;
   - amidopenitsilliny.

biosynthetic daim ntawv

Piv txwv li yuav tsum ua ib co ntawm cov feem ntau nrov thaum lub caij ntawm cov tshuaj uas phim cov pab pawg neeg. Feem ntau tej zaum los ntawm tus naas ej pennitsilinov yuav suav hais tias "Bitsillin-3" thiab "5-Bitsillin". Lawv tau sab ib pab pawg neeg ntawm tej yam ntuj tso tshuaj tua kab mob thiab tau ib tug thawj coj nyob rau hauv nws cov qeb, twb tsis tau los tshwm ntau zoo meej ntaub ntawv ntawm antimicrobial tshuaj.

1. "Ekstentsillin". Cov lus qhia rau Siv hais tias nws yog ib tug beta-lactam tshuaj tua kab mob ntawm lub ncua kev txiav txim. Indications rau lawv siv yog mob rheumatic kab mob thiab cov kab mob tshwm sim los ntawm treponema (syphilis, yaws thiab pint). Muaj nyob rau hauv cov hmoov. "Ekstentsillin" phau ntawv qhia tsis pom zoo kom ua ke nrog uas tsis tshuaj anti-inflammatory siv tshuaj (narcotics yuav muab), vim nws yog tau sib tw sis raug zoo. Qhov no tej zaum yuav adversely cuam tshuam lub miv nyuas siv zug ntawm kev kho mob.
2. "Penicillin-Fau" yog hais txog mus rau lub penicillin pab pawg neeg. Nws yog siv rau kev kho mob ntawm kis kab mob ntawm Upper pa ib ntsuj av tau, daim tawv nqaij thiab qog ua kua week, gonorrhea, syphilis, tetanus. Nws yog siv raws li ib tug tiv thaiv kev ntsuas tom qab phais, ua kom muaj txoj kev zam txim rheumatism, me chorea, kab mob endocarditis.
3. Tshuaj tua kab mob "smallpox" yog ib qho analog ntawm lub ua ntej npaj. Nws los nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj los sis granules. Tsis pom zoo nrog rau narcotics yuav muab thiab qhov ncauj contraceptives. Feem ntau siv nyob rau hauv cov kev kho mob ntawm thaum yau kab mob.

semisynthetic daim ntawv

Qhov no pab pawg neeg ntawm cov tshuaj xws li tshuaj hloov tshuaj tua kab mob los ntawm molds.

1. Tus thawj sawv nyob rau hauv daim ntawv teev "Amoxicillin". Cov lus qhia rau kev siv (tus nqi - txog ib puas rubles) ntawd hais tias cov tshuaj muaj ib tug broad spectrum ntawm kev ua si thiab yog siv nyob rau hauv cov kab mob kab mob zoo tej qhov chaw. Nws zoo dua yog hais tias nws yog ruaj khov nyob rau hauv lub acidic ib puag ncig ntawm lub plab, thiab tom qab haum nyob rau hauv cov ntshav concentration yog siab tshaj uas ntawm lwm cov neeg hauv pab pawg neeg no. Tab sis tsis txhob idealize lub "Amoxicillin". Cov lus qhia rau kev siv (tus nqi nyob rau hauv txawv cheeb tsam tej zaum yuav txawv) ceeb toom tias cov tshuaj yuav tsum tsis txhob muab rau cov neeg mob nrog mononucleosis, ua xua thiab cev xeeb tub cov poj niam. Long-term siv yog tsis yooj yim sua vim ib tug tseem ceeb npaum li cas ntawm sab kev tshua.
2. Oxacillin sodium ntsev yog muab cov kab mob tsim penicillinase. Cov tshuaj yog acid, nws yuav tsum noj lus, nws yog zoo yaim nyob rau hauv cov hnyuv. Nws yog sai tom los ntawm ob lub raum, yog li ntawd nws yog tsim nyog los lossi muaj cov yam concentration hauv cov ntshav. Lub tsuas contraindication - ib tug tsis haum cov tshuaj tiv thaiv. Nws yuav ua nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj los sis vials raws li ib tug kua cov kev txhaj tshuaj.
3. Qhov kawg tus neeg sawv cev ntawm semisynthetic penicillins - yog ampicillin trihydrate. Cov lus qhia rau kev siv (ntsiav tshuaj) ntawd hais tias nws muaj ib tug ntau spectrum ntawm kev txiav txim, rau ob tug kab-tsis zoo thiab gram-zoo kab mob. Yog zoo taus los ntawm cov neeg mob, tab sis ceev faj yuav tsum tau muab rau cov neeg uas noj anticoagulants (xws li, cov neeg uas mob ntawm cov hlab plawv system), raws li cov tshuaj potentiates qhov kev txiav txim.

kuab

Penicillins muag nyob rau hauv pharmacies raws li ib tug hmoov rau kev txhaj tshuaj. Yog li ntawd, tso dej raws leeg los yog intramuscular cov thawj coj, lawv yuav tsum ua neej nyob hauv ib lub kua. Nyob rau hauv ib tug domestic puag ncig tej zaum yuav siv distilled dej rau txhaj, isotonic sodium tshuaj dawb tov los novocaine ob-feem pua. Nws yuav tsum tau nco ntsoov tias kuab yuav tsum tsis txhob yuav ib yam nkaus thiab sov so.

Indications, contraindications thiab kev phiv

Lub indications rau tshuaj tua kab mob kev kho mob yog mob: lobar thiab lobular mob ntsws, empyema, sepsis thiab Septicemia, kab mob endocarditis, meningitis, osteomyelitis. Nyob rau hauv qhov kev txiav txim lub caij nplooj zeeg kab mob tonsillitis, diphtheria, kub taub hau, anthrax, gonorrhea, syphilis, purulent daim tawv nqaij kab mob.

Contraindications rau kev kho mob ntawm lub penicillin pab pawg neeg me ntsis. Firstly, lub xub ntiag ntawm npau taws me ntsis mus rau yeeb tshuaj thiab nws cov derivatives. Ob, tsim kom cov kev mob ntawm, qaug dabpeg, uas ua rau nws tsis yooj yim sua kom paub cov tshuaj mus rau hauv cov leeg nrob kem. Raws li rau cev xeeb tub thiab lactation, nyob rau hauv rooj plaub no tus tsim cov kev pab yuav tsum tshuam ntau tshaj cov tau txaus ntshai, vim hais tias cov placental barrier yog permeable rau penicillins. Thaum lub sij hawm txais tos, tus me nyuam cov tshuaj los mus ib ntus pauv mus rau lwm txoj kev ntawm noj, txij li thaum cov tshuaj nkag mus rau hauv cov mis nyuj.

Sab los tej zaum yuav tshwm sim nyob rau ob peb theem.

Cns phiv yuav ua tau xeev siab, ntuav, txob taus, meningismus, convulsions thiab txawm coma. Cov kev tsis haum yog manifested raws li cov tawv nqaij qhov chaw mob, kub taub hau, mob tej pob txha thiab o. Muaj mob ntawm anaphylactic poob siab thiab kev tuag. Vim hais tias ntawm tau bactericidal kev txiav txim paum Candidiasis thiab lub qhov ncauj thiab dysbacteriosis.

siv nta

Ceev faj yuav tsum tau muab rau cov neeg mob uas tsis hnov hepatic thiab raum muaj nuj nqi thaum ntsia lub plawv tsis ua hauj lwm. Nws yog tsis tsim nyog rau pom zoo kom siv ntawm cov neeg uas yog cov nquag mus kev tsis haum tshuaj, raws li zoo raws li cov neeg uas muaj ib tug heightened rhiab heev rau cephalosporins.

Yog hais tias tsib hnub tom qab pib ntawm txoj kev kho yog tsis muaj kev hloov nyob rau hauv tus neeg mob tus mob tsis tuaj, ces penicillin analogues yuav tsum tau siv los yog hloov tshuaj tua kab mob pab pawg neeg. Ib txhij nrog lub sij hawm, rau Piv txwv li, lub yeeb tshuaj "Bitsillin-3", koj yuav tau saib xyuas ntawm kev tiv thaiv ntawm fungal superinfection. Ua li no, sau tawm antifungals.

Xav tau hauj lwm los mus piav qhia rau tus neeg mob uas noj cov tshuaj tsis muaj kev cuam tshuam vim ua lub txiaj ntsim kuj microorganisms. Thiab los mus kov yeej nws xav tau ntau haib tshuaj uas ua rau kom mob hnyav phiv.

Penicillin analogues tau ua indispensable nyob rau hauv niaj hnub tshuaj. Txawm tias nws yog qhov ntxov tshaj plaws qhib pab pawg neeg ntawm tshuaj tua kab mob, nws tseem nyob yam rau cov kev kho mob rau daim npog hlwb, gonorrhea thiab syphilis, muaj ib tug txaus sab spectrum ntawm kev txiav txim thiab me me sab los, ces nws yuav siv tau nyob rau hauv cov me nyuam. Ntawm cov hoob kawm, raws li nrog rau tej tshuaj, nyob rau hauv penicillins muaj contraindications thiab kev phiv, tab sis lawv yog pab txhawb los ntawm lub sij hawm rau daim ntawv thov.