Vancomycin is antibiotic yekupedzisira kushandura
Vancomycin is antibiotic yekupedzisira kushandiswa inowanzoshandiswa kurapa zvirwere zvinorwisana nemishonga. Vancomycin yekutanga yakange yakasarudzwa kubva kune zvakakosha zvevhu zveBornean makore anopfuura 50 apfuura. Pakutanga, mapiriniki mashomanana akashandisa vancomycin pane kusarudza mamwe mishonga inorwisa mabhakitiriya iyo yaifungidzirwa inoshanda (vancomycin inotora nguva yakareba kuti iite pane penicillin) uye shoma shoma.
Zvisinei, kutanga kwekutanga kwema1980, vanachiremba nevamwe vadzidzisi vezvehutano vakatanga kuratidza kufarira kutsvaga mune izvi zvinodhaka. Izvi zvakagadziriswa chido chaifanira kukonzerwa nevancomycin kukwanisa kurwisa methicillin-resistant Staphylococcus aureus (MRSA) uye kukwanisa kurapa pseudomembranous colitis. Pseudomembranous colitis chirwere chinotyisa chekoloni (chirwere) chinotora mushure mekurapa nemamwe maantibioti anouraya maruva emvura.
Vancomycin nzira yekuita
Vancomycin inonzi tricyclic glycopeptide. Inosungira mabhakitiriya masero masvingo uye inogadzirisa kusangana kwekamuri kusvibiswa. Inopindirawo nemaBhakitiriya RNA synthesis.
Paunorwisana nemararamiro akawanda e-gram-staphylococci uye streptococci, zviito zvevancomycin zvinokonzera bactoriocidal. Mune mamwe mazwi, vancomycin inoshanda kuuraya zvakananga mabhakitiriya e gram-positive. Zvisinei, pavanorwisa inococci, imwe mhando yegamu-positive, zviito zvevancomycin ibhakteriostatic, uye inoshanda kudzivisa mabhakitiriya kubereka.
Vancomycin coverage
Vancomycin inoshandiswa kurwisana mhando dzakasiyana dzezvirwere zvebhakitiriya, dzakawanda dzadzo dzinopesana nemamwe marudzi emishonga inorwisa mabhakitiriya kusanganisira:
- yakanyanya staphylococcal infections kune vanhu vanokonzera penicillin
- methicillin-resistant Staphylococcus aureus (MRSA)
- methicillin-resistant Staphylococcus epidermidis
- mushonga unopesana Streptococcus pneumoniae
- yakawanda inococcal infections muvanhu vanokonzera penicillin
- yakawanda inococcal infections iyo inopesana ne penicillin
- Viridans streptococci
- mhando dzakawanda-zvinodhaka zvinodhaka Corynebacterium jeikeium
- Clostridium difficile
Zvirwere zvakarapwa nevancomycin
Vancomycin inoshandiswa kurapa maitiro akasiyana-siyana ehutachiona hwakakomba kusanganisira:
- kupumhidza maitiro zvirwere;
- pfupa, ganda uye zvirwere zvakanyorova;
- peritonitis;
- endocarditis (utachiona hwemoyo);
- enterocolitis uye pseudomembranous colitis (zvirwere zvemuviri);
- prophylaxis pavanenge vachienda mazino, biliary, GI, kupumha uye maitiro ekudzivirira;
- kubviswa kweuropi (kure-kushandiswa kwemavara);
- zvirwere zveperioperative (kubvisa-kushandiswa kwemavara);
- meningitis (off-label use).
Vancomycin hutungamiri uye uwandu
Nemhaka yokuti vancomycin haina kunyatsogadziriswa nehutachiona hwepamuviri, inowanzoitwa sejisi. Zvisinei, kana yakashandiswa kurapa enterocolitis uye pseudomembranous colitis, zvose zvirwere zvepamuviri, varwere vanotora vancomycin mumuromo.
Vancomycin inowanzotarisirwa mune chirwere chepachipatara (chipatara). Nokuti kuenzanisa kwakaoma uye kunobva pachirwere uye muchero wekudya, inpatient pharmacist inowanzonziwa kuverenga dhizi.
Uyezve, nokuti vancomycin inonyadziswa neitsvo, kuderedzwa kwechirwere ichi kwakaoma zvikuru kune vanhu vane kukanganisa kwenhema.
Vancomycin yakaipa miitiro
Zvimwe zvinokanganisa migumisiro inokonzerwa nevancomycin haigoni, uye zvinokanganisa vancomycin zvinowanzovhiringidza kushaya hypersensitivity kana kugadzirisa zvinokonzera. Zvisinei, vancomycin inogona kuva nephrotoxic uye inokuvadzai itsvo kunyanya kana inotungamirirwa neaminoglycosides, imwe rudzi rwemishonga inorwisa mabhakitiriya. Uyezve, kana inoshandiswa neaminoglycosides kana kuti inorwara inonzi intravenous erythromycin, uyewo rumwe rudzi rwemishonga inorwisa mabhakitiriya, vancomycin inogona kukuvadza kunzwa (ototoxicity).
Pakupedzisira, vancomycin inogona kukonzera terempia kana kuti-red-man syndrome, rudzi rwekumhanya; kusvetwa kwakadai kunogona kuderedzwa kana murwere anotanga kupiwa antihistamines.
Vancomycin kupikisa inokurudzira kuwedzera kukura pakati pevanachiremba, vatsvakurudzi uye epidemiologist zvakafanana. Nemhaka yokuti vancomycin imwe yemigumo yedu yokupedzisira yekuchengetedza zvirwere zvinokuvadza uye zvinotapukisa zvinodhaka, tarisiro iyo haichazogoni kushanda kurwisa utachiona inotyisa uye inotisiyira isu nezvimwe zvingasarudzwa (funga Zosyn na ceftaroline). Kunyanya, matanho evancomycin anorwisana neenocococci akabatwa muzvipatara munyika yose. Nemhaka yokuti vancomycin inowanzopiwa muzvipatara, mazano ekurapa (SKFs), dzimba dzekuyamwisa nezvakadaro, zvakakosha kuti vashandi vezvehutano vanotora matanho ekudzivirira vancomycin kudzivisa sokudzivisa kudarika uye kupedza kupararira kwevancomycin kudzivirira pakati pevarwere kuburikidza nevarwere vakakodzera kuzviparadzanisa uye kuchenesa.
Sarudzo Sources
Guglielmo B. Anti-Infective Chemotherapeutic & Antibiotic Agents. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Ikozvino Kurapa Kurapa Nekurapa 2015 . New York, NY: McGraw-Hill; 2014. Yakasvika musi waApril 07, 2015.
Mosby's Drug Reference yeZviviro zveUtano, Kechipiri Kabudiswa naMosby / Elsevier muna 2010.