Macrolides: uhlu izidakamizwa, incazelo

Eqenjini ezifana macrolides, uhlu izidakamizwa okusezingeni eliphezulu itshengisa ukuthi ububanzi eyanele kwezicelo zokwelapha. Le mithi ziphephile futhi asetshenziswa izifo eziningi imvelo ezithathelwanayo, kuhlanganise nalezo esibangelwa amagciwane intracellular namagciwane. Ayasiza nokwelapha izifo zesikhumba, amalunga, umgudu wokuphefumula, kuhlanganise ukucinana kwemigudu yokuphefumula kanye nenyumoniya obuhlukahlukene zaba namandla kakhulu.

Ngo-pneumonia ezinzima futhi macrolides esetshenziswa, uhlu imikhiqizo okuyinto kucacisiwe esezingeni ukwelashwa yezifiso. Nokho, ziqukethe ulwazi mayelana nesidingo sihlanganise nabanye ejenti elwa namagciwane. Ngokuvamile bajwayele kanye cephalosporins. Le nhlanganisela ikuvumela ukuba Okusizayo ngcono ukusebenza kokubili izidakamizwa ngaphandle okwandisa ubuthi babo.

Ukwahlukaniswa macrolides

Ukwahlukaniswa abanekhono kunabo futhi elula leli qembu izidakamizwa zamakhemikhali. Iveza umehluko ku isakhiwo kanye umsuka iqembu kwamaphilisi ngokuthi "macrolides". Uhlu izidakamizwa aboniswe ngezansi, futhi azihlukanise ngalolu daba:

1. macrolides 14-membered:

• odabuka yemvelo - erythromycin futhi oleandomycin;
• Semi - clarithromycin futhi roxithromycin, dirithromycin futhi fluritromitsin, telithromycin.

2. azalide (15-Mer) Macrolides: Azithromycin.

3. macrolides 16-membered:

• odabuka yemvelo - midecamycin, spiramycin futhi dzhosamitsin;
• semisynthetic - acetate midecamycin.

Lokhu kuhlukaniswa ibonisa kuphela izici isakhi isigaba izidakamizwa. Uhlu lwamagama ukuhweba ngezansi.

uhlu izidakamizwa

Macrolides - izidakamizwa okuyinto uhlu ngempela ebanzi. Sekukonke, kusukela ngomhla ka-2015 kukhona 12 izidakamizwa kuleli kilasi. Inani imikhiqizo equkethe la ezisebenzayo, iphezulu kakhulu. Abaningi babo ingatholakala inethiwekhi ekhemisi futhi uthathe ukwelapha eziningi izifo. Futhi ezinye izidakamizwa itholakale CIS, njengoba ngeke ibhaliswe Pharmacopoeia. Izibonelo amagama ukuhweba ngezakhiwo equkethe macrolides, lokhu okulandelayo:

• Erythromycin ngokuvamile yenziwa ukwakhiwa kwegama elifanayo futhi likhona izidakamizwa eziyinkimbinkimbi "Zener" futhi "Izotreksin".
• Oleandomycin - izidakamizwa ekwakhiweni "oletetrin".
• Clarithromycin: "Klabaks" futhi "Klarikar", "Klerimed" futhi "Klatsid", "Kleron" futhi "Lekoklar", "Pilobakt" futhi "Fromilid", "Ekozitrin" futhi "Erasid", "Zimbaktar" futhi "Arvitsin" "Kispar" futhi "Klarbakt", "Klaritrosin" futhi "Klaritsin", "Klasine" futhi "coaters", "Klerimed" futhi "Romiklar", "Seydon" futhi "CP Clara."
• Roxithromycin ngokuvamile utholakala ngesimo ejwayelekile igama ezohwebo, kanye ingxenye izidakamizwa ezilandelayo: "Ksitrotsin" futhi "Romik," "Elroks" futhi "Rulitsin", "Esparoksi".
• Azithromycin: "azivok" futhi "Azidrop", "Azimitsin" futhi "Azitral", "Azitroks" futhi "Azitrus", "Zetamaks" futhi "Z-Factor", "Zitnob" futhi "Zitrolid", "Zitratsin" futhi "Sumaklid "" Sumamed "futhi" Sumamoks "," Sumatrolid "futhi" TREMAKS-Sanovel "," Hemomitsin "futhi" Ecomed "," safocid ".
• Midecamycin etholakala njengenceku izidakamizwa "Macropen".
• Spiramycin iyatholakala ngokuthi "Rovamycinum" futhi "spiramycin Vero".
• Dirithromycin, fluritromitsin futhi telithromycin futhi dzhosamitsin hhayi kukhiqizwa CIS.

Lo mshini wezenzo ka macrolides

Leli qembu ethize kwemithi - macrolides - siba nomphumela bacteriostatic esitokisini singangena lwegciwane izifo ezithathelwanayo. Kuphela lokuhlala eliphezulu kungase kusinikeze isilinganiso esithile umphumela amagciwane, nakuba lokhu kwabacasula kuphela izifundo laboratory. Okuwukuphela mshini wezenzo ka macrolides - lokhu okusithiyayo wamaprotheni zamagama yeseli virus. Lokhu kuhlukumeza zonke izinqubo yomsebenzi kubalulekile umzimba ekuphikisweni ngokunamandla, okubangela ukuba ufe emva kwesikhashana.

unyathela amabhuleki indlela wamaprotheni zamagama elihlobene ne ngokujoyina 50s-subunit we ribosomes virus. Bazi ukuthi banesibophezelo sakha iketango polypeptide ngesikhathi DNA zamagama. siyabhubha Ngakho zamagama amaprotheni kwesakhiwo virulence zici amagciwane. Kulokhu, kuba ngokucacile okusezingeni eliphezulu kuya ribosome webhaktheriya kubangela ukuphepha eyisihlobo macrolides nomzimba womuntu.

Ukuqhathanisa macrolides nezinye amakilasi kwamaphilisi

Macrolides zifana ngezindlela izakhiwo kuya tetracyclines, kodwa ephephile. Abasephuli ukuthuthukiswa amathambo endoda ingane. Njenganoma fluoroquinolones, tetracyclines, macrolides (uhlu izidakamizwa letinikwe lapha ngenhla) uyakwazi engena phakathi esitokisini futhi ukukhiqiza lokuhlala zokwelapha e linezingxenye ezintathu emzimbeni. Lokhu kubalulekile ekwelapheni mycoplasma inyumoniya, legionellosis, campylobacteriosis futhi ukutheleleka chlamydial. Kulokhu, macrolides - fluoroquinolones ephephile kodwa ayisasebenzi.

Zonke macrolides anobuthi aminingi ukudlula penicillins, kodwa ephephile ngokuya amathuba komzimba asathuthuka. Kulokhu, i-penicillin elwa namagciwane okufakwa ekudleni angamaqhawe ukuphepha, kodwa engabangela komzimba. Ngakho, kokuba spectrum ezifanayo umsebenzi elwa namagciwane, macrolides kungase kuthathe indawo aminopenicillins izifo umgudu wokuphefumula. Ngaphezu kwalokho, izifundo laboratory luye lwabonisa ukuthi macrolides ukunciphisa ukusebenza kwe-penicillin akuzange kusize e ukungena ngokuhlanganyela, nakuba impatho zamanje yezifiso uvumele inhlanganisela yabo.

Macrolides lapho ekhulelwa noma ekunakekelweni kosana

Macrolides yizidakamizwa ephephile belingana cephalosporins futhi penicillins. Lokhu kuvumela ukusetshenziswa kwabo ngesikhathi sokukhulelwa futhi ekwelapheni izingane. Bona ungaphazamisi inqubo yentuthuko ithambo bese uqwanga skeleton, babe izakhiwo teratogenic. Kuphela azithromycin kufanele kulinganiselwe isicelo senyanga yesithathu yokukhulelwa. Therapy ezingane kanye penicillins futhi cephalosporins, futhi macrolides, efakwe ohlwini e standard zokwelapha izifo, ingasetshenziswa ngaphandle ingozi enobuthi Umzimba ukunqotshwa.

Incazelo ezinye macrolides

Macrolides (uhlu imithi thina ocashunwe ngenhla) e umkhuba emtholampilo sisetshenziswa kabanzi, kuhlanganise e CIS. Ezisetshenziswa kakhulu 4 umumele: clarithromycin futhi azithromycin, erythromycin futhi midecamycin. Kakhulu kangakanani ukusetshenziswa spiramycin. Ukuphumelela macrolides imayelana okufanayo, nakuba lizinga ngezindlela ezahlukene. Ikakhulukazi, clarithromycin, midecamycin, futhi ukufeza umphumela zokwelapha kumele kuthathwe kabili ngosuku, kuyilapho azithromycin usebenza amahora angu-24. eyodwa kuphela ukuphatha nsuku zonke ukwelapha izifo ezithathelwanayo.

Erythromycin - lena short konke macrolides. Kumele kuthathwe izikhathi 4-6 ngosuku. Kungoba kuvame kakhulu ukuba kusetshenziswe njengendlela ifomu wendawo for ekwelapheni induna kanye isikhumba nezifo. Kuyaphawuleka ukuthi macrolides ziphephile izingane, kodwa angadala isifo sohudo.