Mu March 2013, bungwe la US Food and Drug Administration linapereka machenjezo okhudza mavuto omwe angakhale nawo pamtima ndi antibiotic azithromycin. Chenjezo likuwonetsa kuti anthu ena akhoza kukhala ndi chiopsezo chowonjezereka chakufa mwadzidzidzi akamamwa mankhwalawa, makamaka anthu omwe ali ndi matenda amtundu wina.
Chenjezo la FDA linayambitsa kufalikira kwa mauthenga, ndipo chifukwa cha kutchuka kwa Z-Pack (yomwe imayesedwa pafupifupi 60 miliyoni pachaka), inachititsanso kuti odwala komanso madokotala azifalitsidwa mofanana.
Kodi Zimakhala Zoopsa Motani Azithromycin?
Azithromycin ndi membala wa mankhwala a antibiotic, komanso erythromycin ndi clarithromycin. Zakhala zikudziwikiratu kuti pafupifupi mitundu yonse ya mankhwala opha tizilombo imayambitsa kutalika kwa nthawi ya QT , muyeso wopangidwa kuchokera ku electrocardiogram . Ndipo mwa anthu ena - omwe amabadwa ndi matenda osiyanasiyana a QT matenda , omwe ali ndi chibadwa chomwe chingapangitse miyendo ya mtima - chilichonse chomwe chimapangitsa kuti nthawi ya QT iwononge chiopsezo chotchedwa arrhythmia chotchedwa ventricular tachycardia .
Nthawi yayitali ya QT ikhoza kukhala yoopsa kwa anthu omwe ali ndi matenda ena a mtima, makamaka matenda a mitsempha yam'thupi ndi mtima wosalimba .
Mwamwayi, chiopsezo chachikulu chokhala ndi chiopsezo chotchedwa arriththmia ndi azithromycin ndi chaching'ono kwambiri - chinachake ngati chimodzi mwa zikwi ziwiri.
Azithromycin imakhala ndi mndandanda wautali wa mankhwala omwe angapitirize nthawi ya QT, ndipo zomwe zingathe kuonjezera chiopsezo cha imfa mwadzidzidzi mwa anthu omwe ali ndi matenda osiyanasiyana omwe ali ndi matenda a QT kapena matenda a mtima.
Mankhwalawa, kuphatikizapo mankhwala opha tizilombo, amachititsanso mankhwala ambiri oletsa antiarrhythmic (mankhwala osokoneza bongo, omwe amayenera kuteteza arrhythmias), mankhwala osokoneza bongo angapo, ndi mankhwala ambiri omwe amagwiritsidwa ntchito pa zizindikiro za m'mimba.
Pano pali mndandanda wa mankhwala omwe amalimbikitsa nthawi ya QT, yosungidwa ndi CredibleMeds, bungwe loyunivesite lozikidwa ndi yunivesite komanso lophatikizidwa ndi federal pa Education and Research on Therapeutics.
Palibe chifukwa choganiza kuti azithromycin ndi yoopsa kwambiri kuposa mankhwala ena alionse omwe ali pa mndandanda wautali: ndiko kuti kwa anthu omwe ali ndi matenda osiyanasiyana a QT kapena matenda osiyanasiyana a mtima, mankhwalawa akhoza kukhala amodzi. zoopsa. Kwa wina aliyense, mankhwalawa mwachiwonekere angathe kuthandizidwa popanda kudandaula za arrhythmias yogwirizana ndi nthawi yayitali ya QT.
Momwe Anthu Amene Ali Pangozi Angadziwikire
Pali zizindikiro zambiri za ma genetiki zomwe zazindikiritsidwa kuti zimadziwika zambiri mwa anthu oterewa, ndipo zizindikiro zambiri zikupezeka nthawi zonse. Aliyense yemwe ali ndi imodzi mwazizindikirozi zimayenera kupewa azithromycin ndi mankhwala ena alionse omwe ali mndandandawu. Mwamwayi, kuyesa kwa majeremusi sikunali kozolowereka, ndipo anthu ambiri okhala ndi mtundu wa QT wautali samadziwa kuti ali pangozi.
Madokotala ambiri masiku ano amapewa kugwiritsa ntchito mankhwala amodzi a QT-interval-prolonging kwa anthu omwe adziwa kale matenda a QT, m'mabanja awo a anthu omwe ali ndi matenda a QT, kapena omwe ali ndi zizindikiro zosadziwika za kumangidwa kwa mtima kapena syncope . Ngati pali chikayikiro cha mtundu wa QT wautali, kuyezetsa kupanikizika kwa thupi kungagwiritsidwe ntchito ngati kuyesa kuyesera. (Nthawi ya QT ikhoza kupitirira pa nthawi yochita masewera olimbitsa thupi anthu omwe ali ndi matendawa.)
Koma chifukwa cha zochitika zamakono, madokotala ambiri amapereka mankhwala monga azithromycin, ngati pakufunika, kwa wina aliyense wopanda matenda a mtima omwe alibe mbiri ya munthu kapena banja lomwe ali ndi matenda a QT, ndipo amene ali ndi electrocardiogram yoyamba ndi yachibadwa - makamaka ngati (monga momwe mulili) mankhwalawa agwiritsidwa ntchito kangapo popanda chizindikiro.
Mwachiwonekere, chofunika kwambiri ndi kuyankhula ndi dokotala wanu za ngati mungapitirize kugwiritsa ntchito azithromycin nthawi zonse.
> Zotsatira:
> Ray WA, Murray KT, Hall K, ndi al. Azithromycin ndi Kuopsa kwa Mliri wa Mtima. N Engl J Med 2012; 366: 1881.
> Utsogoleri wa US Food and Drug Administration. Azithromycin (Zithromax kapena Zmax): Kuyankhulana kwa Mankhwala Osokoneza Bongo - Kuopsa kwa Mafilimu Amtima Wopweteka. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm343350.htm?source=govdelivery