Macrolides: daim ntawv teev cov tshuaj, qhov kev piav qhia

Nyob rau hauv xws li ib tug pab pawg neeg raws li macrolides, daim ntawv teev cov tshuaj siab, cim tias seb thaum uas ib tug txaus breadth ntawm kho daim ntawv sau npe. Cov tshuaj muaj kev ruaj ntseg thiab yog siv nyob rau hauv ntau cov kab mob ntawm cov kab xwm, nrog rau cov tshwm sim los ntawm intracellular cab thiab kab mob. Lawv yog cov pab kho cov kab mob ntawm daim tawv nqaij, pob qij txha, ua pa system, xws li ntsws thiab mob ntsws ua heev.

Rau hauv loj heev pneumonia yuav siv macrolides, daim ntawv teev cov khoom uas yog teev nyob rau hauv tus txheej txheem kev kho mob twg. Txawm li cas los, lawv muaj ntaub ntawv txog qhov yuav tsum tau mus ua ke nrog lwm cov antimicrobial agents. Feem ntau cov feem ntau lawv siv ua ke nrog cephalosporins. No thaum lawv tseem tso cai rau sawv daws txhim khu lub hauj lwm zoo ntawm ob leeg cov tshuaj tsis kom lawv toxicity.

kev faib ntawm macrolides

Qhov tseem competent thiab yooj yim kev faib ntawm no pab pawg neeg ntawm cov tshuaj yog ib yam tshuaj. Nws qhia qhov sib txawv nyob rau hauv cov qauv thiab cov keeb kwm ntawm lub pab pawg neeg ntawm tshuaj tua kab mob hu ua "macrolides". Daim ntawv teev cov tshuaj no yog muaj hauv qab no, thiab paub qhov txawv lawv tus kheej nyob rau hauv qhov teeb meem:

1. 14-membered macrolides:

• tej yam ntuj tso keeb kwm - erythromycin thiab oleandomycin;
• semi - clarithromycin thiab roxithromycin, dirithromycin thiab fluritromitsin, telithromycin.

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

3. 16-membered macrolides:

• tej yam ntuj tso keeb kwm - midecamycin, spiramycin thiab dzhosamitsin;
• semisynthetic - midecamycin acetate.

Qhov no kev faib qhia tsuas yog tus yam ntxwv nta ntawm ib chav kawm ntawv ntawm cov tshuaj. Daim ntawv teev cov pauv npe muab rau hauv qab no.

daim ntawv teev cov tshuaj

Macrolides - tshuaj uas daim ntawv no heev uas nws kim heev. Nyob rau hauv tag nrho, raws li ntawm 2015 muaj 12 tshuaj nyob rau hauv cov hoob kawm no. Ib tug xov tooj ntawm cov khoom uas muaj cov active cov khoom xyaw, yog ntau ntau. Muaj ntau ntawm lawv muaj peev xwm yuav nrhiav tau nyob rau hauv lub tsev muag tshuaj network thiab coj los kho ib tug xov tooj ntawm cov kab mob. Thiab ib co tshuaj muaj nyob rau hauv lub CIS, raws li nws yog tsis sau npe nyob rau hauv lub Pharmacopoeia. Piv txwv ntawm cov lag luam tawm npe formulations muaj macrolides, lub nram qab no:

• Erythromycin feem ntau nyob rau hauv lub formulations ntawm lub tib lub npe thiab yog muaj nyob rau hauv lub complex tshuaj "Zener" thiab "Izotreksin".
• Oleandomycin - tshuaj formulation "oletetrin".
• Clarithromycin: "Klabaks" thiab "Klarikar", "Klerimed" thiab "Klatsid", "Kleron" thiab "Lekoklar", "Pilobakt" thiab "Fromilid", "Ekozitrin" thiab "Erasid", "Zimbaktar" thiab "Arvitsin" "Kispar" thiab "Klarbakt", "Klaritrosin" thiab "Klaritsin", "Klasine" thiab "coaters", "Klerimed" thiab "Romiklar", "Seydon" thiab "CP Clara."
• Roxithromycin yog feem ntau pom nyob rau hauv daim ntawv ntawm cov generic luam lub npe, raws li zoo raws li ib feem ntawm cov nram qab no tshuaj: "Ksitrotsin" thiab "Romik," "Elroks" thiab "Rulitsin", "Esparoksi".
• Azithromycin: "azivok" thiab "Azidrop", "Azimitsin" thiab "Azitral", "Azitroks" thiab "Azitrus", "Zetamaks" thiab "Z-Factor", "Zitnob" thiab "Zitrolid", "Zitratsin" thiab "Sumaklid "" Sumamed "thiab" Sumamoks "," Sumatrolid "thiab" TREMAKS-Sanovel "," Hemomitsin "thiab" Ecomed "," safocid ".
• Midecamycin muaj raws li ib tug yeeb tshuaj "Macropen".
• Spiramycin yog muaj raws li "Rovamycinum" thiab "spiramycin Vero".
• Dirithromycin, fluritromitsin thiab telithromycin thiab dzhosamitsin tsis ua nyob rau hauv lub CIS.

Lub mechanism ntawm qhov kev txiav txim ntawm macrolides

Qhov no tej pharmacological pab pawg neeg - macrolides - niamntiav ib bacteriostatic ntxim rau cov cell raug yav kis kab mob. Tsuas yog nyob rau hauv siab ntau tej zaum yuav muab ib tug bactericidal nyhuv, txawm tias qhov no muaj pov thawj xwb nyob rau hauv laboratory kev tshawb fawb. Lub tsuas mechanism ntawm qhov kev txiav txim ntawm macrolides - qhov no inhibition ntawm cov protein synthesis ntawm tus kab mob ntawm tes. Qhov no ua txhaum tag nrho cov dab uas tseem ceeb heev kev ua si ntawm lub virulent kab mob, ua rau nws tuag tom qab ib pliag.

braking mechanism ntawm protein synthesis txuam nrog koom lub 50s-subunit ntawm tus kab mob ribosomes. Lawv yog cov luag hauj lwm rau lub tsev cov polypeptide saw thaum lub sij hawm DNA synthesis. Yog li ntxhov synthesis ntawm cov yam ntxwv ntawm cov nqaijrog thiab virulence yam nyob rau hauv cov kab mob. Nyob rau hauv cov ntaub ntawv no, nws yog ib lub high school lub tseem mus tus kab mob ribosome ua rau tus txheeb ze muaj kev ruaj ntseg ntawm macrolides rau tib neeg lub cev.

Kev sib piv ntawm macrolides thiab lwm yam cov chav kawm ntawm tshuaj tua kab mob

Macrolides zoo xws li nyob rau hauv cov khoom mus rau cov tetracyclines, tab sis kev ruaj ntseg. Lawv tsis ua txhaum txoj kev loj hlob ntawm lub cev pob txha ntawm ib tug me nyuam. Raws li nrog rau fluoroquinolones, tetracyclines, macrolides (daim ntawv teev cov tshuaj saum toj no) muaj peev xwm ntawm tob tob mus rau hauv lub cell thiab tsim kho ntau nyob rau hauv peb compartments ntawm lub cev. Qhov no yog ib qho tseem ceeb nyob rau hauv cov kev kho mob ntawm mycoplasma mob ntsws, mob legionellosis no, campylobacteriosis thiab chlamydial kab mob. Nyob rau hauv cov ntaub ntawv no, macrolides - fluoroquinolones kev ruaj ntseg tab sis tsis tshua zoo.

Tag nrho macrolides muaj ntau lom tshaj lub penicillins, tab sis tus tov nyob rau hauv cov nqe lus ntawm yuav tsim kev ua xua. Nyob rau hauv cov ntaub ntawv no, penicillin tshuaj tua kab mob yog muaj kev ruaj ntseg champions, tab sis yuav ua rau ua xua. Yog li, muaj ib tug zoo xws li cov spectrum ntawm antimicrobial kev ua si, macrolides yuav hloov aminopenicillins nyob rau hauv kab mob ntawm lub pa system. Ntxiv mus, kuaj kev tshawb fawb pom tau hais tias macrolides txo cov hauj lwm zoo ntawm penicillin nyob rau hauv cov pob qij nkag, txawm hais tias tam sim no kev kho mob twg cia lawv ua ke.

Macrolides nyob rau hauv cev xeeb tub thiab cov me nyuam mos zov

Macrolides muaj kev ruaj ntseg cov tshuaj rau ib tug par nrog cephalosporins thiab penicillins. Qhov no pub rau lawv siv thaum lub sij hawm cev xeeb tub thiab nyob rau hauv cov kev kho mob ntawm cov me nyuam. Lawv tsis txhob disturb tus txheej txheem ntawm txoj kev loj hlob ntawm cov pob txha thiab pob txha mos lub cev pob txha, muaj teratogenic zog. Tsuas yog azithromycin yuav tsum muaj nyob rau hauv daim ntawv thov nyob rau hauv lub thib peb peb lub hlis uas cev xeeb tub. Nyob rau hauv xyuas txoj kev kho thiab penicillins thiab cephalosporins, thiab macrolides, teev nyob rau hauv tus qauv kev kho mob twg rau cov kab mob, yuav siv tsis tau txoj kev pheej hmoo ntawm tshuaj lom kab mob xwb.

Ib tug piav qhia ntawm ib co macrolides

Macrolides (tshuaj daim ntawv teev peb hais saum toj no) nyob rau hauv kev soj ntsuam xyaum yog dav siv, xws li nyob rau hauv lub CIS. Cov feem ntau siv 4 ntawm lawv tus neeg sawv cev: clarithromycin thiab azithromycin, erythromycin thiab midecamycin. Ntau tsawg siv spiramycin. macrolides Efficiency yog hais txog tib yam, txawm hais tias nws yog tiav nyob rau hauv ntau txoj kev. Nyob rau hauv kev, clarithromycin, midecamycin, thiab mus cuag cov kev soj ntsuam cov nyhuv yuav tsum tau coj ob zaug ib hnub twg, whereas azithromycin ua hauj lwm 24 teev. Tsuas yog ib tug txhua txhua hnub saib xyuas rau cov kev kho mob ntawm kis kab mob.

Erythromycin - qhov no yog qhov luv luv ntawm txhua macrolides. Nws yuav tsum tau coj 4-6 lub sij hawm ib hnub twg. Vim hais tias nws yog feem ntau siv raws li ib lub zos daim ntawv rau cov kev kho mob ntawm pob txuv thiab daim tawv nqaij kab mob. Nws yog noteworthy tias cov macrolides muaj kev ruaj ntseg rau cov me nyuam, tab sis yuav ua rau raws plab.