sqesobrivi gziT gadamdebi infeqciebi (maT Soris gonorea)
sqesobrivi gziT gadamdebi infeqciebi (maT Soris gonorea)
sqesobrivi gziT gadamdebi infeqciebi (maT Soris gonorea)
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savaWro dasaxeleba<br />
rotacefi, Rotacef<br />
preparatis gamoyenebis instruqcia<br />
saerTa<strong>Soris</strong>o arapatentirebuli dasaxeleba<br />
ceftriaqsoni (natriumis marilis saxiT), Ceftriaxone (as salt sodium)<br />
samkurnalo forma<br />
saineqcio xsnaris mosamzadebeli fxvnili.<br />
aRweriloba: TiTqmis TeTri an yviTeli kristaluri fxvnili, mcired<br />
higroskopuli.<br />
Semadgenloba<br />
rotacefi 0.5 g<br />
aqtiuri nivTiereba: ceftriaqsoni (natriumis marilis saxiT) 0.5 g<br />
gamxsneli (gamoSvebis forma gamxsnelTan erTad):<br />
1% lidokainis hidroqloridis xsnari 2 ml.<br />
rotacefi 1.0 g<br />
aqtiuri nivTiereba: ceftriaqsoni (natriumis marilis saxiT) 1.0 g<br />
gamxsneli (gamoSvebis forma gamxsnelTan erTad):<br />
1% lidokainis hidroqloridis xsnari 3.5 ml.<br />
preparatis aTq kodi J01DD04<br />
farmakoTerapiuli jgufi<br />
sistemuri moqmedebis antibaqteriuli preparatebi, mesame Taobis<br />
cefalosporinebi.<br />
farmakologiuri Tvisebebi<br />
rotacefi warmoadgens mesame Taobis cefalosporinebis jgufis farTo<br />
speqtris antibiotiks. avlens baqteriocidul moqmedebas baqteriis ujredis<br />
kedlis sinTezis daTrgunvis xarjze. aqtiuria gramuaryofiTi baqteriebis<br />
umravlesobis, mravali gramdadebiTi gamomwvevis da zogierTi anaerobis<br />
mimarT. mdgradia baqteriebis mier producirebuli beta-laqtamazis moqmedebis<br />
mimarT.<br />
rotacefis mimarT mgrZnobiare aerobuli gramuaryofiTi baqteriebi:<br />
Aeromonas spp., Alcaligenes spp., Branhamella catarrhalis, Citrobacter spp., Enterobacter spp.<br />
(zogierTi Stami mdgradia), E. coli, Haemophilus ducreyi, Haemophilus influenzae,<br />
Haemophilus parainfluenzae, Klebsiella spp. (<strong>maT</strong> <strong>Soris</strong> Kl. pneumoniae), Moraxella spp.,<br />
Morganella morganii, Neisseria gonorrhoeae, Neisseria meningitidis, Plesiomonas shigelloides,<br />
Proteus mirabilis, Proteus vulgaris, Providencia spp., Pseudomonas aeruginosa (zogierTi Stami<br />
mdgradia), Salmonella spp. (<strong>maT</strong> <strong>Soris</strong> S. typhi), Serratia spp. (<strong>maT</strong> <strong>Soris</strong> S. marcescens),<br />
Shigella spp., Vibrio spp. (<strong>maT</strong> <strong>Soris</strong> V. cholerae), Yersinia spp. ( <strong>maT</strong> <strong>Soris</strong> Y. enterocolitica).<br />
zemoT CamoTvlili mikroorganizmebis bevri Stami, romlebic sxva<br />
antibiotikebis, magaliTad penicilinebis, pirveli da meore Taobis<br />
cefalosporinebis da aminoglikozidebis gamoyenebisas kargad mravldebian,<br />
mgrZnobiareni arian rotacefis mimarT. klinikuri monacemebis mixedviT<br />
pirveladi da meoradi sifilisis dros aRiniSneba preparatis maRali<br />
efeqturoba.<br />
rotacefis mimarT mgrZnobiare aerobuli gramdadebiTi baqteriebi:
Streptococcus agalactiae, Staphylococcus aureus (<strong>maT</strong> <strong>Soris</strong> penicilinazis<br />
maproducirebeli Stamebi), Streptococcus bovis, Staphylococcus epidermidis, Streptococcus<br />
pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Staphylococcus spp., romelic<br />
mdgradia meticilinis mimarT, rezistentulia cefalosporinebis, <strong>maT</strong> <strong>Soris</strong><br />
rotacefis mimarT. Enterococcus spp. mravali Stami (magaliTad, Streptococcus faecalis)<br />
aseve mdgradia preparatis mimarT.<br />
anaerobuli gamomwvevebi: Bacteroides spp. (<strong>maT</strong> <strong>Soris</strong> B. fragilis zogierTi Stami),<br />
Clostridium spp. (<strong>maT</strong> <strong>Soris</strong> Cl. difficile), Fusobacterium spp. (garda F. mortiferum da F.<br />
varium), Peptococcus spp., Peptostreptococcus spp., Bacteroides spp. zogierTi Stami,<br />
(magaliTad, B. fragilis), romlebic gamoimuSaveben beta-laqtamazas, mdgradi arian<br />
rotacefis mimarT.<br />
farmakokinetika<br />
intravenuri/intramuskularuli gamoyenebis Semdeg rotacefi kargad aRwevs<br />
organizmis qsovilebsa da siTxeebSi. bioSeRwevadoba intramuskularuli<br />
gamoyenebisas Seadgens 100%-s. maqsimaluri koncentracia plazmaSi miiRweva 2-3<br />
saaTSi kunTSi Seyvanidan. Seqcevadad ukavSirdeba plazmis albuminebs 85-95%<br />
da es SekavSireba ukuproporciulia sisxlSi misi koncentraciis.<br />
rotacefi swrafad difundirebs intersticiul siTxeSi, sadac inarCunebs<br />
baqtericidul moqmedebas 24 saaTis ganmavlobaSi. naxevargamoyofis periodi<br />
xangrZlivia da mozrdilebSi Seadgens 8 saaTs. 75 welze meti asakis<br />
xandazmulebSi naxevargamoyofis periodi xangrZlivdeba TiTqmis 2-jer, xolo<br />
axalSobilebSi Seadgens 6.5-8 dRes.<br />
mozrdilebSi rotacefis 50-60% gamoiyofa Seucvleli saxiT SardiT, 40-50%<br />
naRvliT. axalSobilebSi 70% gamoiyofa TirkmliT. RviZlis an Tirkmlis<br />
funqciis darRvevis dros mozrdilebSi rotacefis farmakokinetika TiTqmis<br />
ar icvleba (SesaZlebelia naxevargamoyofis periodis umniSvnelo dagrZeleba)<br />
funqciis gadanawilebis xarjze.<br />
ceftriaqsoni kargad gadalaxavs hematoencefalur bariers.<br />
gamoyenebis Cvenebebi<br />
rotacefi efeqturia mis mimarT mgrZnobiare baqteriis StamebiT gamowveuli<br />
yvela infeqciis mimarT:<br />
− zeda da qveda sasunTqi gzebis <strong>infeqciebi</strong> (pnevmonia, filtvis abscesi,<br />
plevris empiema);<br />
− muclis Rrus organoebis <strong>infeqciebi</strong> (qolangiti, Sardis buStis empiema, kuWnawlavis<br />
traqtis, sanaRvle gzebis anTebiTi daavadebebi, peritoniti);<br />
− Zvlebisa da saxsrebis <strong>infeqciebi</strong>;<br />
− kanisa da rbili qsovilebis <strong>infeqciebi</strong>;<br />
− saSarde gzebis <strong>infeqciebi</strong> (<strong>maT</strong> <strong>Soris</strong> pielonefriti);<br />
− <strong>sqesobrivi</strong> <strong>gziT</strong> <strong>gadamdebi</strong> <strong>infeqciebi</strong> (<strong>maT</strong> <strong>Soris</strong> <strong>gonorea</strong>);<br />
− inficirebuli Wrilobebi da damwvrobebi;<br />
− meningialuri garsebis anTeba, sefsisi;<br />
− operaciis Semdgomi <strong>infeqciebi</strong>s profilaqtika.<br />
gamoyenebis wesi da dozireba<br />
rotacefi SeyavT kunTSi an intravenurad nakadurad an wveTovnad.<br />
preparatis momzadebis da Seyvanis wesi<br />
kunTSi Sesayvanad:<br />
500 mg rotacefs xsnian 2 ml 1%-ian lidokainis hidroqloridis xsnarSi.<br />
1 g rotacefs xsnian 3.5 ml 1%-ian lidokainis hidroqloridis xsnarSi.<br />
SeyavT Rrmad dundulo kunTSi.
intravenuri moxmarebisTvis:<br />
500 mg rotacefs xsnian Sesabamisad 5 ml saineqcio wyalSi,<br />
1 g rotacefs xsnian Sesabamisad 10 ml saineqcio wyalSi.<br />
SeyavT venaSi nela 2-4 wuTis manZilze.<br />
intravenuri infuziisTvis:<br />
2 g rotacefs xsnian 40 ml 0.9%-ian natriumis qloridis xsnarSi, 0.45%-ian<br />
natriumis qloridis xsnarSi, romelic Seicavs 2.5% glukozas, 5%-ian<br />
glukozis xsnarSi, 10%-ian glukozis xsnarSi, 5%-ian fruqtozas xsnarSi, 6%ian<br />
deqstrozaSi. intravenuri infuziis xangrZlivoba ar unda iyos 30 wuTze<br />
naklebi.<br />
axalSobilebSi (2 kviramde asaki) rotacefi iniSneba doziT 20-50 mg/kg<br />
sxeulis masaze dReSi erTxel. dozis momateba ar SeiZleba axalSobilebSi<br />
fermentuli sistemis umwifrobis gamo.<br />
12 wlamde asakis bavSvebSi rotacefis sadReRamiso doza Seadgens 20-80 mg-s 1<br />
kg sxeulis wonaze gadaangariSebiT dReSi erTxel. 50 kg da meti masis<br />
bavSvebSi iyeneben mozrdilTa dozebs.<br />
mozrdilebisa da 12 welze meti asakis bavSvebisTvis Cveulebrivi dozireba<br />
Seadgens dReSi 1-2 g rotacefs. Seyvanebs <strong>Soris</strong> intervali unda Seadgendes 24<br />
saaTs. mZime SemTxvevebSi an zomierad mgrZnobiare baqteriebiT gamowveuli<br />
<strong>infeqciebi</strong>s SemTxvevaSi SeiZleba preparatis dozis gazrda 4 gramamde.<br />
preparatis intravenuri Seyvana sxeulis masis 50 mg/kg-ze doziT unda<br />
ganxorcieldes wveTobrivad ara umcires 30 wuTis ganmavlobaSi.<br />
mkurnalobis xangrZlivoba damokidebulia daavadebis simZimesa da xasiaTze.<br />
iseve rogorc sxva antibiotikebis SemTxvevaSi, rotacefis miReba<br />
rekomendebulia ara nakleb 3 dRis ganmavlobaSi sxeulis temperaturis<br />
normalizebis Semdeg.<br />
baqteriuli meningitis dros bavSvebSi da axalSobilebSi preparati iniSneba<br />
sawyisi doziT 100 mg/kg sxeulis wonaze gadaangariSebiT dReSi erTxel.<br />
maqsimaluri sadReRamiso doza Seadgens 4 g-s. gamomwvevis identifikaciis<br />
Semdeg SeiZleba dozis Semcireba.<br />
gonoreis mkurnalobisas rekomendebuli doza Seadgens 250 mg rotacefs<br />
erTjeradad kunTSi.<br />
im avadmyofebSi, romlebsac aqvT Tirkmlebis funqciis darRveva RviZlis<br />
normaluri funqcionirebis pirobebSi da pirebSi, romlebsac aqvT RviZlis<br />
funqciis darRveva Tirkmelis funqciis SenarCunebiT, ar aris aucilebeli<br />
preparatis dozis Semcireba. gamoxatuli Tirkmlis ukmarisobis SemTxvevaSi<br />
(kreatininis klirensi < 10 ml/wT) rotacefis doza ar unda aWarbebdes 2<br />
grams dReRameSi.<br />
RviZlisa da Tirkmlebis funqciis erTdrouli darRvevisas, agreTve<br />
hemodializze myof avadmyofebSi, aucilebelia sisxlis SratSi<br />
ceftriaqsonis koncentraciis regularuli kontroli.<br />
postoperaciuli <strong>infeqciebi</strong>s profilaqtikisTvis rekomendebulia 1-2 g<br />
rotacefis erTjeradi Seyvana operaciamde 30-90 wuTiT adre.<br />
dozis gadaWarbeba<br />
ar arsebobs raime saxis monacemebi preparatis dozis gadaWarbebis Sesaxeb.<br />
ukuCvenebebi<br />
− momatebuli mgrZnobeloba cefalosporinebisa da penicilinebis mimarT;<br />
− orsulobis pirveli trimestri;
− preparati sifrTxiliT iniSneba axalSobilebSi, gansakuTrebiT<br />
dRenaklulebSi hiperbilirubinemiis maRali riskis gamo.<br />
gverdiTi movlenebi<br />
rotacefi SemTxvevaTa umravlesobaSi kargad gadaitaneba. gverdiTi movlenebi,<br />
rogorc wesi, Seqcevadia da qreba preparatis moxsnis Semdeg.<br />
saWmlis momnelebeli sistemis mxriv: gulisreva, pirRebineba, diarea an<br />
faRaraTi, meteorizmi, muclis tkivili, gemos SegrZnebis darRveva, stomatiti,<br />
glositi, fsevdomembranuli enterokoliti, RviZlis transaminazebis<br />
aqtivobis momateba (iSviaTad – tute fosfatazis, bilirubnis, qolestazuri<br />
siyviTle), disbaqteriozi. maRal dozebSi ceftriaqsonis gamoyenebam<br />
SeiZleba fsevdoqoleliTiazis ganviTareba gamoiwvios.<br />
hematologiuri cvlilebebi: leikopenia, neitropenia, granulocitopenia,<br />
limfocitopenia, Trombocitozi, Trombocitopenia, hemolizuri anemia,<br />
sisxlis Sededebis darRveva, proTrombinuli drois gaxangrZliveba, iSviaTad<br />
– eozinofilia, agranulocitozis erTeuli SemTxvevebi.<br />
Sardgamomyofi sistemis mxriv: glukozuria, sisxlis plazmaSi Sardovanis da<br />
kreatininis Semcvelobis momateba, cilindruria, hematuria, oligouria,<br />
anuria.<br />
alergiuli da imunopaTologiuri reaqciebi: WinWris cieba, ciebcxeleba,<br />
gamonayari, qavili, iSviaTad – bronqospazmi, multiformuli eriTema, stivensjonsis<br />
sindromi, toqsiuri epidermuli nekrolizi, Sratismieri daavadeba,<br />
angionevrozuli SeSupeba, anafilaqsiuri Soki.<br />
adgilobrivi reaqciebi: intravenuri Seyvanisas SesaZlebelia flebitis<br />
ganviTareba. misi Tavidan asacileblad, preparati SeyavT nela (2-4 wuTis<br />
ganmavlobaSi); intramuskularuli ineqcia lidokainis gamoyenebis gareSe<br />
mtkivneulia, Seyvanis adgilas SesaZlebelia infiltratis ganviTareba.<br />
sxva: Tavis tkivili, Tavbrusxveva, cxviridan sisxldena, kandidozi.<br />
gansakuTrebuli miTiTebebi<br />
iseve rogorc sxva cefalosporinebis SemTxvevaSi, rotacefiT mkurnalobisas<br />
aucilebelia gaTvaliswinebuli iyos anafilaqsiuri reaqciebis ganviTarebis<br />
SesaZlebloba.<br />
preparatiT xangrZlivi mkurnalobisas aucilebelia periferiuli sisxlis<br />
regularuli kontroli.<br />
iSviaT SemTxvevebSi ultrabgeriTi diagnostikis dros SesaZloa gamovlindes<br />
naRvlis buStis daCrdilva, romelic preparatis moxsnis Semdeg qreba. maSinac<br />
ki, roca am movlenas Tan axlavs tkivili marjvena neknqveSa areSi,<br />
rekomendebulia preparatis miRebis gagrZeleba simptomuri mkurnalobis<br />
fonze.<br />
urTierTqmedeba sxva samkurnalwamlo saSualebebTan:<br />
maryuJze moqmed diurezul saSualebebTan erTad (magaliTad, furosemidi)<br />
misi miRebisas ar aRiniSneba Tirkmelis funqciis darRveva.<br />
arasteroidul anTebissawinaaRmdego saSualebebTan da agregaciis sxva<br />
inhibitorebTan kombinaciisas izrdeba sisxldenis riski.<br />
rotacefs da aminoglikozidebs bevr gramuaryofiT baqteriasTan mimarTebaSi<br />
axasiaTebT sinergizmi. msgavsi kombinacia dasabuTebulia mZime da<br />
sicocxlisaTvis saSiSi <strong>infeqciebi</strong>s mkurnalobisas (magaliTad,<br />
ganpirobebuli iseTi gamomwvevebiT, rogoricaa Pseudomonas aeruginosa).<br />
ar SeiZleba rotacefis Sereva erT flakonSi an SpricSi sxva<br />
antibiotikebTan.
preparatis gamoyeneba orsulobisa da laqtaciis periodSi<br />
preparat rotacefis gamoyeneba orsulobis periodSi SeiZleba mxolod im<br />
SemTxvevaSi, Tu dedisTvis mosalodneli sargebeli aWarbebs nayofze<br />
moqmedebis potenciur risks (ceftriaqsoni gadis placentur bariers).<br />
preparat rotacefis miRebis aucileblobis SemTxvevaSi laqtaciis periodSi<br />
unda gadawydes ZuZuTi kvebis Sewyvetis sakiTxi, radgan ceftriaqsoni<br />
gamoiyofa dedis rZeSi.<br />
gamoSvebis forma<br />
rotacefi 0.5g an 1.0g #1 gamxsnelTan erTad.<br />
saineqcio xsnaris mosamzadebeli fxvnili 0.5 g da 1.0 g flakonSi gamxsnelTan<br />
erTad.<br />
1 flakoni fxvniliT saineqcio xsnaris mosamzadeblad da 1 ampula<br />
gamxsneliT muyaos kolofSi CanarTTan erTad.<br />
rotacefi 0.5g an 1.0g #10.<br />
saineqcio xsnaris mosamzadebeli fxvnili 0.5 g da 1.0 g flakonebSi.<br />
10 flakoni konturul ujredul SefuTvaSi.<br />
1 konturuli ujreduli SefuTva muyaos kolofSi CanarTTan erTad.<br />
Senaxvis pirobebi:<br />
inaxeba sinaTlisagan dacul, bavSvebisagan miuwvdomel adgilas, 15°C-25°C<br />
temperaturaze.<br />
momzadebuli xsnari stabiluria 6 saaTis ganmavlobaSi 18°C-25°C<br />
temperaturaze.<br />
Senaxvis vada<br />
3 weli warmoebis TariRidan.<br />
ar gamoiyeneba vargisianobis vadis amowurvis Semdeg.<br />
afTiaqidan gacemis pirobebi:<br />
farmacevtuli produqtis II jgufi - გამოიყენება eqimis daniSnulebiT.<br />
mwarmoebeli<br />
savaWro markisa da registraciis sertifikatis mflobelia kompania<br />
“rotafarmi”, didi britaneTi<br />
(ROTAPHARM”, GREAT BRITAIN).<br />
damzadebulia<br />
,,ldp-laboratorios torlan s.a.”-s mier, espaneTi<br />
karatera de barselona, 135B, serdaniola del valesi, barselona.<br />
(,,LDP-LABORATORIOS TORLAN S.A.” Spain<br />
Carratera de Barcelona, 135B, Cerdanyola del Valles, Barcelona).
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