Fluoroquinolones ndi ma antibayotiki ambiri
Ngati mukuwerenga nkhaniyi, mwinamwake munapatsidwa ciprofloxacin (Cipro), levofloxacin (Levaquin) kapena mtundu wina wa fluoroquinolone pofuna kuchiza matenda a bakiteriya (ganizirani kupuma kapena matenda a mkodzo). Kwachidziwitso, mankhwalawa ndi otetezeka komanso ogwira mtima motsutsana ndi mabakiteriya ambiri a gram-positive ndi gram-negative omwe amawapanga chisankho chabwino cha mankhwala ochiritsira.
Pakatikati mwa zonse zotchedwa fluoroquinolones-kuphatikizapo mankhwala monga ciprofloxacin ndi levofloxacin-ali 2 makilogalamu asanu ndi limodzi amphongo omwe amapezeka pa atomu ya fluoride. Mankhwalawa amagwira ntchito pogwiritsa ntchito mavitamini a bakiteriya 2 omwe amachititsa kuti DNA ikhale yotsindikiza, yophimba, ndi kusindikiza panthawi yomwe imapezeka: DNA gyrase ndi topoisomerase IV. Chifukwa kuti fluoroquinolones yamakono imakhudza mitundu iwiri yosiyanasiyana ya michere, zimakhala zovuta kuti mabakiteriya asinthe ndi kupewa njira za mankhwalawa.
Pano pali mndandanda wa mabakiteriya amene fluoroquinolones akutsutsana nawo:
- Staphylococci
- Streptococcus pneumoniae (levofloxacin ndi moxifloxacin ndi yothandiza kwambiri)
- Staphylococci viridans
- Bacillus anthracis (ciprofloxacin amavomerezedwa kuti azichiza anthrax)
- Chlamydia (levofloxacin ndi moxifloxacin ndi yothandiza kwambiri)
- Enterococcus faecalis
- Listeria monocytogenes
- Mitundu ya Nocardia
- Neisseria meningitides ndi gonorrhoeae
- Haemophilus influenzae
- Enterobacteriaceae mitundu
- Pseudomonas aeruginosa (ciprofloxacin ndi yothandiza kwambiri)
- Mitundu ya Vibrio.
Makamaka, fluoroquinolones akugwira ntchito motsutsana ndi aerobes ndi anaerobes opultative. Anaerobes, komabe, nthawi zambiri amatsutsa mankhwalawa.
Pano pali mndandanda wa matenda a bakiteriya omwe fluoroquinolones monga ciprofloxacin ndi levofloxacin amachiza:
- Chibayo
- Bronchitis
- Anthrax
- Bakiteriya gastroenteritis (m'mimba chimfine)
- Matenda a m'magulu a urinary
- Matenda opatsirana
- Septicemia
- Matenda achifuwa otupa
- Matenda ophatirana ndi mafupa
- Sinusitis
- Matenda ophatirana ndi mafupa
- Matenda a m'mimba
Kuphatikizana ndi kufalikira kwa mabakiteriya ochulukirapo, fluoroquinolones amachitiranso maseŵera ena omwe amapanga maantibayotiki akuluakulu. Choyamba, amatengedwa pakamwa (osati mwa jekeseni). Chachiwiri, amagaŵira bwino m'zigawo zosiyanasiyana za thupi. Chachitatu, fluoroquinolones ali ndi theka la moyo womwe umawalola kuti aponyedwe kamodzi kapena kawiri patsiku. Chachinai, ciprofloxacin ndi levofloxacin zimadulidwa makamaka ndi impso zomwe zimapangitsa kuti zikhale zabwino pomenyana ndi matenda a mkodzo.
Kwa mbali zambiri, fluoroquinolones ndi mankhwala abwino kwambiri. Komabe, zingayambitse mavuto ena kuphatikizapo:
- Kusokonezeka kwa m'mimba (kusokonezeka m'mimba)
- Kuthamanga kwa mankhwalawa (kuthamanga kwa khungu)
- Mutu
- Kugonjetsa
- Hallucinations
- QT prolongation (kusokonezeka kwa magetsi kwa mtima kuonekera pa ECG)
- Tendon rupture
- Angioedema (kutupa kwa khungu)
- Photosensitivity
Kuphatikiza pa zotsatirazi zowononga, nthawi zambiri, fluoroquinolones angayambitsenso kuvulala kwa chiwindi ndi kuwonjezera michere ya chiwindi. Mankhwalawa anali otchuka chifukwa cha kuvulala kwa chiwindi (kuganiza gatifloxacin ndi trovafloxacin) ndipo kenako anachotsedwa kumsika.
Masiku ano, mpata uliwonse wa fluoroquinolone wochititsa kuvulala kwa chiwindi ndi 1 mwa 100,000 anthu omwe amavumbulutsidwa. Chifukwa chakuti levofloxacin ndi ciprofloxacin ndi mankhwala omwe amachitidwa kwambiri ndi fluoroquinolone, ndizo zimayambitsa vuto la chiwindi cha idiosyncratic. Kuvulala kwa chiwindi nthaŵi zambiri kumapezeka masabata 1 mpaka 4 pambuyo pa kutentha kwa fluoroquinolone.
Ngakhale kulimbana ndi fluoroquinolones sikokwanira kusiyana ndi kukana mankhwala ena opha tizilombo, zimakhalabe makamaka pakati pa staphylococci (MRSA), Pseudomonas aeruginosa, ndi Serratia marcescens. Ndipo kamodzi kambirimbiri mabakiteriya akutsutsana ndi fluoroquinolone ndiye ndizovuta kwa iwo onse.
Ngati inu kapena wokondedwa wanu mwauzidwa fluoroquinolone-kapena antibiotic iliyonse pa nkhaniyi-ndizofunikira kuti mutsirizitse njira yanu yothandizira. Mwa kusiya mankhwala pakatikati-mutatha "kumverera" bwino-mumathandizira kusankha, kupulumuka, ndi kufalikira kwa mabakiteriya osagwiritsidwa ntchito ndi antibiotic omwe amayamba kukhala okhudzidwa kwambiri ndi anthu. Kumbukirani kuti nthawi zonse timamenyana ndi ma antibiotic, ndipo timataya nkhondo nthawi yomweyo.
Zotsatira:
Deck DH, Winston LG. Sulfonamides, Trimethoprim, & Quinolones. Mu: Katzung BG, Trevor AJ. eds. Basic & Clinical Pharmacology, 13e . New York, NY: Hill ya McGraw; 2015. Idapezeka pa March 29, 2015.
Guglielmo B. Anti-Infective Chemotherapeutic & Antibiotic Agents. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Kufufuza kwa Zamankhwala Zamakono ndi Chithandizo 2015 . New York, NY: Hill ya McGraw; 2014. Kupezeka pa March 29, 2015.
RYAN KJ, RAY C. Antibacterial Agents, ndi Resistance. Mu: RYAN KJ, RAY C. eds. Sherris Medical Microbiology, Edition Yachisanu ndi chimodzi . New York, NY: Hill ya McGraw; 2014. Kupezeka pa March 29, 2015