Vancomycin ndi antibayotiki yogwiritsa ntchito mankhwala omaliza
Vancomycin ndi antibiotic ya njira yomaliza yomwe amagwiritsidwa ntchito pochiza matenda osagwiritsidwa ntchito ndi mankhwala. Vancomycin poyamba anali osiyana ndi zitsanzo za nthaka za Bornean zaka zoposa 50 zapitazo. Poyamba, ochipatala ochepa amagwiritsa ntchito vancomycin mmalo mopanga mankhwala enaake omwe amawoneka othandiza kwambiri (vancomycin amatenga nthawi yaitali kuti ayambe kuchitapo kanthu kuposa penicillin) komanso zochepa poizoni.
Komabe, kuyambira kumayambiriro kwa zaka za m'ma 1980, madokotala ndi akatswiri ena a zachipatala anayamba kufotokoza chidwi cha mankhwalawa. Izi zinapangitsa chidwi cha vancomycin kukwanitsa kulimbana ndi antiphacillin-resistant Staphylococcus aureus (MRSA) komanso kuthana ndi matenda opatsirana pogonana. Pseudomembranous colitis ndi matenda oopsa a m'mimba (kutsekula m'mimba) omwe amatha kugwira mankhwala atagwiritsidwa ntchito ndi ma antibayotiki ena amene amapha zomera zachilendo.
Vancomycin njira yogwirira ntchito
Vancomycin ndi tricyclic glycopeptide. Amamanga makina a mabakiteriya komanso amasintha maselo a maselo. Zimasokonezanso mabakiteriya a RNA kaphatikizidwe.
Polimbana ndi zamoyo zambiri monga staphylococci ndi streptococci, zochita za vancomycin ndi bacteriocidal. M'mawu ena, vancomycin amagwira ntchito kuti aphe mabakiteriya abwino a gram. Komabe, pakamenyana ndi entrooccici, mtundu wina wa gaga-wabwino, zamoyo za vancomycin ndi bacteriostatic, ndipo zimathandiza kuti mabakiteriya abereke.
Vancomycin chithunzi
Vancomycin amagwiritsidwa ntchito polimbana ndi mitundu yosiyanasiyana ya tizilombo toyambitsa matenda, zomwe zambiri zimatsutsana ndi mitundu ina ya maantibayotiki kuphatikizapo:
- Matenda akuluakulu a staphylococcal mwa anthu omwe sagwirizana ndi penicillin
- Staphylococcus aureus (MRSA) yosagonjetsedwa ndi methicillin
- Staphylococcus epidermidis yosakanikirana ndi methicillin
- Streptococcus pneumoniae osakanizidwa
- matenda opatsirana kwambiri a anthu odwala penicillin
- matenda akuluakulu a e-entococcal omwe sagonjetsedwa ndi penicillin
- Viridans streptococci
- mankhwala osokoneza bongo ambiri Corynebacterium jeikeium
- Clostridium difficile
Matendawa amachititsidwa ndi vancomycin
Vancomycin amagwiritsidwa ntchito pochiza mitundu yosiyanasiyana ya matenda akuluakulu kuphatikizapo:
- matenda opatsirana;
- Matenda a mafupa, khungu ndi zofewa;
- peritonitis;
- endocarditis (matenda a mtima);
- enterocolitis ndi pseudomembranous colitis (matenda opatsirana);
- prophylaxis pamene mukudwala matenda a mano, biliary, GI, matenda opuma ndi opatsirana;
- kupuma kwa ubongo (kusagwiritsa ntchito mankhwala);
- matenda opatsirana (osagwiritsa ntchito mankhwala);
- meningitis (osagwiritsa ntchito ma label).
Vancomycin kayendedwe ndi mlingo
Chifukwa chakuti vancomycin sagwidwa ndi matenda a m'mimba, nthawi zambiri imakhala ngati jekeseni. Komabe, akagwiritsidwa ntchito pochiza enterocolitis ndi pseudomembranous colitis, matenda onse a m'mimba, odwala amatenga valacomincin.
Vancomycin nthawi zambiri amagwiritsidwa ntchito muzipatala (chipatala). Chifukwa kulumikiza ndi kovuta ndipo kumadalira nsonga zapamwamba ndi malo, anthu odwala mankhwala odwala matenda opatsirana amadziwika kuti amawerengera mlingo.
Komanso, chifukwa vancomycin imasokonezeka ndi impso, kumwa mankhwalawa kumakhala kovuta kwambiri kwa anthu omwe ali ndi vutoli.
Vancomycin zotsatira zoipa
Zotsatira zovulaza kwambiri zomwe zimayambitsidwa ndi vancomycin ndizosazolowereka, ndipo zotsatira zowonongeka za vancomycin ndizochepa zomwe zimapangitsa kuti munthu asatengeke. Komabe, vancomycin ikhoza kukhala nephrotoxic ndi kuwononga impso makamaka pamene ikugwiritsidwa ntchito ndi aminoglycosides, mtundu wina wa maantibayotiki. Komanso, ngati akuchitidwa ndi aminoglycosides kapena mlingo wapamwamba woopsa wa erythromycin, komanso mtundu wina wa antibiotic, vancomycin ikhoza kuwononga kumva (ototoxicity).
Potsirizira pake, vancomycin ikhoza kuyambitsa matenda a hymeria kapena ofiira-mtundu, mtundu wa kuphulika; Kuthamanga koteroko kungachepetse ngati wodwalayo atapatsidwa antihistamines.
Vancomycin kukana kumachititsa chidwi kwambiri pakati pa madokotala, ochita kafukufuku komanso odwala matenda a epidemiologist. Chifukwa chakuti vancomycin ndi imodzi mwa njira zathu zotetezera ku matenda oopsa komanso osagwiritsidwa ntchito ndi mankhwala, chiyembekezo chimene sichidzagwiranso ntchito polimbana ndi matenda sichitha mantha ndipo chidzatipangitsa kuchita zinthu zina (taganizirani Zosyn ndi ceftaroline). Makamaka, mavitamini otchedwa vanocycin omwe sagonjetsedwa amalowa muzipatala padziko lonse lapansi. Chifukwa chakuti vancomycin nthawi zambiri imatumizidwa kuchipatala, malo osungirako odwala (SKFs), nyumba za okalamba ndi zina zotero, nkofunikira kuti akatswiri a zachipatala atenge njira zothetsera vancomycin monga kuchepetsa kupitirira malire komanso kuchepetsa kufala kwa odwala pogwiritsa ntchito odwala kudzipatula ndi ukhondo.
Zosankha Zosankhidwa
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 April 07, 2015.
Zolemba za Mosby za mankhwala okhudza zaumoyo, Zolemba Zachiŵiri zofalitsidwa ndi Mosby / Elsevier mu 2010.