I-Vancomycin - Ukusetyenziswa, Idosi, Iziphumo Ezingalindelekanga kunye nokunye

Intshayelelo: Yintoni iVancomycin?

I-Vancomycin sisibulali-ntsholongwane esinamandla esisetyenziselwa ukunyanga usulelo olukhulu lweentsholongwane. Ikwiqela lee-antibiotics ezaziwa ngokuba yi-glycopeptides kwaye isebenza kakhulu kwiintsholongwane zeGram-positive, kuquka iintlobo ezichasene nezinye ii-antibiotics. I-Vancomycin idla ngokugcinelwa usulelo olukhulu, ingakumbi olo lubangelwa yi-methicillin-resistant Staphylococcus aureus (MRSA). Ingafakwa ikakhulu ngemithambo yegazi okanye ngomlomo, kuxhomekeke kuhlobo losulelo olunyangwayo.

Ukusetyenziswa kweVancomycin

I-Vancomycin ivunyiwe ukusetyenziswa kwezonyango ezahlukeneyo, kuquka:

• Usulelo oluMandundu: Isetyenziswa kakhulu ukunyanga izifo ezinzulu ezibangelwa yintsholongwane yeGram-positive, ingakumbi iMRSA.
• I-Endocarditis: I-Vancomycin isetyenziswa rhoqo kunyango lwe-endocarditis, usulelo lweevalvu zentliziyo.
• Usulelo Lwethambo: Ingasebenza kakuhle ekunyangeni i-osteomyelitis, isifo sethambo.
• Usulelo loLusu: I-Vancomycin isetyenziselwa usulelo oluntsonkothileyo lolusu kunye nezicubu ezithambileyo.
• Usulelo lweClostridium difficile: I-vancomycin yomlomo lunyango lokuqala lotyando olunxulumene ne-C. difficile.
• Ukukrala kwemiphunga: Ingasetyenziswa kwiimeko ze-pneumonia ezifunyenwe esibhedlele okanye ezinxulumene nomoya ophefumlayo ezibangelwa yintsholongwane ye-Gram-positive engamelaniyo.

Ingaba isebenza kanjani?

I-Vancomycin isebenza ngokuthintela ukwenziwa kweendonga zeeseli zebhaktiriya. Ngamazwi alula, ithintela iibhaktiriya ekwakheni umaleko wazo wangaphandle okhuselayo, obalulekileyo ukuze ziphile. Ngaphandle kodonga oluqinileyo lweeseli, iibhaktiriya azinakugcina imo yazo okanye ukuthembeka kwazo, nto leyo ekhokelela ekufeni kwazo. Le ndlela yenza i-vancomycin isebenze ngokukodwa kwiibhaktiriya ezinganyangekiyo kwezinye ii-antibiotics.

Isisombululo kunye noLawulo

Umlinganiselo we-vancomycin uyahluka ngokuxhomekeke kuhlobo losulelo, ubudala besigulana, ubunzima, kunye nokusebenza kwezintso.

Abadala:

Idosi eqhelekileyo ye-intravenous yi-15-20 mg/kg rhoqo emva kweeyure ezi-8-12, kunye nedosi ekhokelwa yi-AUC/MIC ekujoliswe kuyo yi-400-600 mg?h/L ukunciphisa ubuthi. Xa ithathwa ngomlomo, idosi ye-C. difficile infection idla ngokuba yi-125-500 mg kane ngemini kangangeentsuku ezili-10.

Iintsholongwane:

Kubantwana, idosi ngokubanzi yi-15 mg/kg rhoqo emva kweeyure ezi-6 (ubuninzi yi-2 g/ngosuku); lungelelanisa iintsana/iintsana.

I-Vancomycin ingafakwa ngenaliti kwimithambo yegazi (IV) okanye ithathwe ngomlomo kwiikhaphu okanye kwisisombululo somlomo. Indlela yokusetyenziswa ixhomekeke kuhlobo losulelo olunyangwayo.

Iziphumo ebezingalindelekanga zeVancomycin

Iziphumo eziqhelekileyo ze-vancomycin ziquka:

• I sizathu
• Ukuvutha
• Uhudo
• Intlungu zesisu
• Rash
• Fever

Iziphumo ezibi kakhulu zinokubandakanya:

• Ukulimala kwezintso ngokukhawuleza (ukungondleki kakuhle)
• Ukulahleka kokuva
• Ukwaliwa kakhulu (anaphylaxis)
• I-Red man syndrome (ukurhawuzelela, ukurhawuzelela, kunye nokurhawuzelela, okuhlala kubangelwa kukufakwa ngokukhawuleza), inokuthintelwa ngokufaka kancinci ngaphezulu kwemizuzu engama-60 kunye nonyango lwangaphambi kwexesha kunye nee-antihistamines.
• I-Neutropenia (engaqhelekanga)

Izigulana kufuneka zixele naziphi na iimpawu ezinzima okanye ezingaqhelekanga kumboneleli wabo wezempilo ngoko nangoko.

Ukusebenzisana kweziyobisi

I-Vancomycin inokusebenzisana namayeza aliqela, nto leyo enokunyusa umngcipheko weziphumo ebezingalindelekanga okanye inciphise ukusebenza kakuhle kwamayeza omabini. Unxibelelwano olukhulu lwamayeza luquka:

• Aminoglycosides: Umngcipheko okhulayo wokonakala kwezintso.
• Ii-loop diuretics (umz., i-furosemide): Zinganyusa umngcipheko we-ototoxicity (umonakalo wokuva).
• Izinto zokukhulula izihlunu: Zingakhokelela ekuvalekeni okukhulu kwemisipha ye-neuromuscular.
• Ezinye ii-antibiotics: Zingatshintsha ukusebenza kakuhle konyango.
• I-Piperacillin-tazobactam: umngcipheko ophezulu we-nephrotoxicity.

Soloko wazisa umboneleli wakho wezempilo malunga nawo onke amayeza owasebenzisayo ukuze uphephe ukudibana okunokwenzeka.

Iinzuzo zeVancomycin

Iingenelo zonyango zokusebenzisa i-vancomycin ziquka:

• Ukusebenza Ngokuchasene neeBhaktheriya ezixhathisa: Yenye yezona antibiotics zimbalwa ezisebenzayo kwi-MRSA nakwezinye iintlobo ezixhathisayo.
• Isebenza kakuhle kwiintsholongwane ezininzi ezineGram-positive.
• Ulawulo oluNinzi: Ingafakwa ngemithambo okanye ngomlomo, nto leyo eyenza ifaneleke kwiintlobo ezahlukeneyo zezifo.
• Isekiwe iProfayile yoKhuseleko: I-Vancomycin ibisetyenziswa amashumi eminyaka, inika ingxelo efanelekileyo yokhuseleko nokusebenza kakuhle.

Izimo ezingahambelaniyo neVancomycin

Abantu abathile kufuneka baphephe ukusebenzisa i-vancomycin, kuquka:

• Abasetyhini abakhulelweyo: Udidi C; yisebenzise kuphela ukuba inzuzo ingaphezulu komngcipheko (idatha encinci ibonisa umngcipheko ophantsi wosana olungekazalwa).
• Izigulana ezineSifo sezintso: Abo bangasebenzi kakuhle kwezintso banokuba semngciphekweni omkhulu weziphumo ebezingalindelekanga.
• Iintshukumo Zokwalana Nezinto: Abantu abanolwazi lokunganyamezelani ne-vancomycin okanye nayiphi na into eyinxalenye yayo akufuneki bayisebenzise le mithi.

Izilumkiso kunye nezilumkiso

Ngaphambi kokuba uqale i-vancomycin, izigulane kufuneka zenze uvavanyo oluthile lwelabhoratri, oluquka:

• Iimvavanyo zokuSebenza kwezintso: Ukuvavanya ukusebenza kwezintso, njengoko i-vancomycin ikhutshwa kakhulu zizintso.
• Iimvavanyo zokuva: Ukuba kukho imbali yeengxaki zokuva, i-vancomycin inokubangela ubuthi obuvela kwi-ototoxicity.
• Kubalulekile ukujonga amayeza onyango (TDM): Umthamo omalunga ne-10-20 mg/L kwiintsholongwane ezinzulu (ngaphambi kokutshintshela kwi-AUC/MIC).

Izigulana kufuneka zijongwe ukuba azinazo iimpawu zokunganyamezelani komzimba kunye nokusebenza kwezintso ngexesha lonyango.

FAQs

• Isetyenziselwa ntoni i-vancomycin? I-Vancomycin isetyenziselwa ukunyanga izifo ezinzulu zeebhaktheriya, ingakumbi ezo zibangelwa yi-MRSA kunye ne-C. difficile.
• Isetyenziswa njani i-vancomycin? Inganikwa ngemithambo okanye ngomlomo, kuxhomekeke kuhlobo losulelo.
• Zeziphi iziphumo ebezingalindelekanga eziqhelekileyo? Iziphumo ebezingalindelekanga eziqhelekileyo ziquka isicaphucaphu, ukuhlanza, urhudo, kunye nerhashalala.
• Ndingathatha i-vancomycin ukuba ndikhulelwe? Ifanele isetyenziswe kuphela ngexesha lokukhulelwa ukuba kuyimfuneko ngokucacileyo, njengoko idatha yezilwanyana ibonisa umngcipheko onokubakho kwimveku kodwa idatha yabantu ilinganiselwe.
• Isebenza njani i-vancomycin? Ithintela ukwakhiwa kodonga lwebhaktiriya, okukhokelela ekufeni kwebhaktheriya.
• Ndingenza ntoni xa ndiphosa ithamo? Yithathe kwangoko xa ukhumbula kodwa ungayisebenzisi ukuba sele kuza kufuneka uyithathe idosi elandelayo. Musa ukuyiphinda kabini. Nxibelelana nomboneleli wezempilo xa unezifo ezinzulu.
• Ngaba i-vancomycin ingabangela umonakalo kwizintso? Ewe, inokubangela umonakalo kwizintso, ingakumbi kwizigulana ezineengxaki zezintso esele zikhona.
• Ngaba i-vancomycin iyasebenza kuzo zonke iintsholongwane? Hayi, isebenza kakhulu kwiintsholongwane ezineGram-positive.
• Yintoni endifanele ndiyiphephe xa ndisebenzisa i-vancomycin? Ziphephe ezinye iziyobisi ezinokwenzakalisa izintso ngaphandle kokuba ugqirha wakho ekuxelele.
• Kuza kufuneka ndithathe i-vancomycin ixesha elingakanani? Ubude bonyango buxhomekeke kuhlobo kunye nobukhali bosulelo, ngokuqhelekileyo buqala kwiintsuku ezisi-7 ukuya kwezingama-21 okanye ngaphezulu kwiintsholongwane ezinzulu ezifana ne-osteomyelitis/endocarditis.

Amagama eBrand

I-Vancomycin ifumaneka phantsi kwamagama eempawu ezahlukeneyo, kuquka:

• IVancocin
• IVancoled
• I-Firvanq (isisombululo somlomo)

isiphelo

I-Vancomycin sisibulali-ntsholongwane esibalulekileyo ekulweni nosulelo olukhulu lweebhaktheriya, ingakumbi ezo zibangelwa ziintsholongwane ezinganyangekiyo. Ukusebenza kwayo kakuhle, ukuguquguquka kwayo ekusetyenzisweni kwayo, kunye neprofayili yokhuseleko esekiweyo kuyenza ibe sisixhobo esibalulekileyo kunyango lwanamhlanje. Nangona kunjalo, njengawo onke amayeza, iza nemiphumo emibi enokubakho kunye nokusebenzisana ekufuneka kulawulwe ngononophelo. Soloko unxibelelana nomboneleli wakho wezempilo ukuze ufumane iingcebiso ezenzelwe wena kunye neendlela zonyango.