Ciprofloxacin: ntuziaka maka ojiji > Ọgwụgwọ na mgbochi

Mbadamba Ciprofloxacin bụ ihe na-egbochi nje bacteria na fluoroquinolone otu. A na-eji ha na-agwọ ọrịa dị iche iche na-akpata site na nje bacteria na-emetụta ihe dị n'ime ọgwụ ahụ.

Sdị usoro onunu ogwu, ihe mejupụtara

A na-eji mbadamba mkpụrụ osisi Ciprofloxacin ekpuchi ihe mkpuchi. Ha nwere agba ọcha na elu ala. Ihe kachasị dị mkpa nke ọgwụ ahụ bụ ciprofloxacin. Ihe dị n’ime ya otu mbadamba bụ 250 na 500 mg. Ọzọkwa, ihe mejupụtara ya gụnyere ihe inyeaka, nke gụnyere:

Colloidal silicon anhydrite.
Povidone.
Methylene chloride.
Microcrystalline cellulose.
Stereta magnesium.
Isopropyl mmanya.
Hydroxypropyl methylcellulose.
Talc dị ọcha.
Sodium stachi glycolate.

A na-etinye mbadamba nkume nke Ciprofloxacin na paịlị ọnya 10. Mpempe kaadiboodu nwere 1 ọnya na mbadamba, yana ntuziaka maka ojiji.

Ọgwụgwọ ọgwụgwọ

Akụkụ bụ isi dị na mbadamba ciprofloxacin bụ nke ndị na-egbochi nje bacteria na-emetụta otu fluoroquinolone otu. O nwere mmetụta nje na-akpata, na-eduga n'ọnwụ nke nje bacteria na-emetụ n'obi. A na - eme ihe a site na ịkwụsịlata oke ọrụ mkpụrụ ndụ enzyme DNA gyrase. Nke a na - eduga na - emeghasịkwa mmegharị nke DNA (ọnwụ nke mkpụrụ ndụ). Ọgwụ nwere arụ ọrụ zuru oke megide mkpụrụ ndụ na - arụ ọrụ na mkpụrụ ndụ nje na - adịghị arụ ọrụ. O nwere nje a na-akpata nje megide ọtụtụ gram-positive (staphylococci, streptococci) na gram-negative (E. coli, Pseudomonas aeruginosa, Proteus, Klebsiella, Yersinia, Salmonella, Shigella, Gonococcus). Ọzọkwa, ọgwụ ahụ na-eduga n’ọnwụ nke nje ndị akọwapụtara nke ukwuu bụ́ ndị na-arịa ọrịa akwara intracellular (ụkwara nta Mycobacterium, Legionella, Mycoplasma, Ureaplasma, Chlamydia). Arụ ọrụ nke mbadamba nkume nke Ciprofloxacin megide paponema icha mmirimmiri (ihe na-akpata ọrịa syphilis) ka aghọtachabeghị.

Mgbe iwere mbadamba mkpụrụ osisi ciprofloxacin n'ime, akụrụngwa nọ n'ọrụ na-abanyekwa n'ime sistemụ sistemụ ahụ ma kesaa ya na akwara, ebe ọ nwere mmetụta ọgwụgwọ.

Ekwuputara mbadamba osisi Ciprofloxacin maka etiotropic therapy (ọgwụgwọ iji gbuo onye na-efe efe) nke ọrịa dị iche iche kpatara site na nje bacteria na-emetụta akụkụ ahụ nke ọgwụ:

Mmebi nke akụkụ ahụ dị elu, nke ala.
Usoro nje na-efe efe nke akụkụ ENT.
Ọrịa nke akwara na akụrụ.
Ọrịa dị iche iche na-ebute ọrịa na-enweghị isi.
Usoro ndị na-emebi emebi nke usoro nri, gụnyere ezé na jaws.
Usoro mkpali dị n'ime gallbladder na oghere ndị ọzọ nke sistemụ ịba ọcha n'anya.
Ọkpụkpụ na nsị nke ọnya anụ ahụ, anụ ahụ dị n'okpuru ala yana anụ ahụ dị nro nke nsonye dị iche iche.
Usoro purulent-inflammatory nke akụkụ nke usoro akwara ahụ, tinyere osteomyelitis.
Sepsis (mmerụ ọbara nke nje) na peritonitis (usoro mkpali na peritoneum).

A na-ejikwa ọgwụ ahụ iji gbochie usoro nje na ndị ọrịa nwere obere ọrụ usoro ahụ ji alụso ọrịa ọgụ.

Ihe ngbanwe

A na-egbochi mbadamba mkpụrụ osisi Ciprofloxacin n'oge ịtụrụ ime n'oge ọ bụla nke ọmụmụ ahụ, n'oge a na-enye nwa ara (na-enye nwa ara), na ụmụaka na-erubeghị afọ 18, yana nke ntachi obi na ciprofloxacin ma ọ bụ ndị nnọchi anya ndị otu fluoroquinolone otu. Tupu ịkọwa mbadamba mkpụrụ osisi ciprofloxacin, dọkịta na-ahụ na ọ nweghị ọgwụ mgbochi.

Mpempe akwụkwọ Ciprofloxacin bu n'uche maka nchịkwa ọnụ n'ime afọ efu. Afọchaala ha kpamkpam, mmiri adịghị agba ha ma downụọ ya. Usoro usoro onunu ogwu ya na usoro onodu ya dabere n’odidi na ogo nke usoro oria a. N'ime usoro ịgbanyeghị oria na-efe efe, a na-ejikarị mbido ciprofloxacin eme ihe na usoro onunu ogwu nke 250 mg ugboro abụọ kwa ụbọchị. Na usoro mgbagwoju anya ma ọ bụ nke siri ike, yana mmebi nke ọkpụkpụ, akụkụ ahụ - 500 mg ugboro abụọ kwa ụbọchị. Maka ndị ọrịa agadi, yana megidekwa ndabere sitere na mbelata ọnụ ọgụgụ akụrụngwa na-arụ ọrụ akụrụ, a na-ebelata oke onunu umeji. Ogologo oge usoro ọgwụgwọ ahụ bụ ụbọchị 7-10, yana usoro siri ike nke usoro nje, ọ nwere ike ịba ụba. N'ọnọdụ ka ukwuu, dọkịta na-edobe usoro nke ngwa, usoro onunu ogwu ya na oge nke usoro ọgwụgwọ ahụ maka onye ọrịa ọ bụla.

Nsonaazụ

Na-emegide ihe dị na mbadamba mbadamba ciprofloxacin, mmepe nke mmeghachi omume na-adịghị mma nke akụkụ ahụ na sistem dị iche iche ga - ekwe omume:

Usoro digestive - ọgbụgbọ, na-esochi oge ị na-anwụ, afọ ọsịsa, mgbu nke afọ, mmepe nke pịudomembranous colitis.
Sistemụ ụjọ - isi ọwụwa, oge iwe ihe na-adịkarị iche, ike gwụrụ, nsogbu dị iche iche ihi ụra, ọdịdị nke ịkọ nrọ, ịda mba, nsogbu ịhụ ụzọ, ilele ihe ma ọ bụ ihe nlere anya.
Ọkpụkpụ akụrụngwa - mgbali obi (tachycardia) na nsogbu ọgba aghara (arrhythmia) belatara mgbali ọbara usoro (hypotension hypotension).
Usoro ure - imebi urinary excretion (dysuria, urinary retention), ọdịdị nke kristal (kristalia), ọbara (hematuria) na protein (albuminuria) na mmamịrị, usoro mkpali na akụrụ (glomerulonephritis, interstitial nephritis).
Ọbara na ụdọ uhie - nbelata ọnụọgụ nke leukocytes (leukopenia), platelet (thrombocytopenia), neutrophils (neutropenia) n'ọbara, mmụba n'ọnụ ọgụgụ eosinophils (eosinophilia).
Usoro akwara - olu mgbu (arthralgia), mbelata ike nke akwara na akwara nke akụkụ akwara ahụ, yana usoro mkpali na mkpọda nje.
Ndị na-egosi ụlọ nyocha - mmụba na ịta nke creatinine, urea n'ọbara, mmụba nke ọrụ enzymes imeju (ALT, AST).
Akpụkpọ ahụ na ngwa ya - mmepe nke fotoensitivity (nwekwuru anụ ahụ na ọkụ).
Mmeghachi azụ Allergic - ọnya anụ ahụ, itching, mgbanwe nke njiri mara yiri ọnya ọgbụgba (urticaria), ajọ ọzịza nke anụ ahụ dị n ’ihu na akụkụ nke anụrị (angioedema, ụbụrụ Quincke), ọnya anụ ahụ necrotic (Stevens-Johnson, Lyell syndrome).

Ọ bụrụ na ihe ịrịba ama nke mmepe nke mmeghachi omume na-adịghị mma na-apụta mgbe ị na-ewere mbadamba Ciprofloxacin, ị ga-akpọtụrụ ọkachamara na ahụike.

Ọgwụ Farmacology

Ọ na-egbochi nje GPS njiri nje (topoisomerases II na IV, na-ahụ maka usoro nke ịchịkwa DNA chromosomal gburugburu nuklia RNA, nke dị mkpa maka ịgụ mkpụrụ ndụ ihe nketa), na-akpaghasị njikọ DNA, uto nje na nkewa, na-akpata mgbanwe mgbanwe morphological (gụnyere cell cell na membranes) na ọnwụ ngwa ngwa nke mkpụrụ ndụ nje.

Ọ na-eme ihe na-akpata nje na microorganisms gram-gram n'oge dormancy na nkewa (ebe ọ na-emetụta ọ bụghị naanị DNA gyrase, kamakwa ọ na-akpata nyocha nke mgbidi), ma na-eme ihe na microorganisms gram-gram naanị n'oge nkewa.

A na-akọwara ntakịrị mmerụ ahụ maka mkpụrụ ndụ macroorganism site na enweghị DNA gyrase n'ime ha. Megide ndabere nke ciprofloxacin, enweghi mmepe nke ya na iguzogide ọgwụ ndị ọzọ na-egbochi nje nke na - esiteghị na otu ndị na - egbochi DNA gyrase inhibitors, nke a na - eme ka ọ bụrụ nke ukwuu megide nje ndị na - eguzogide, dịka ọmụmaatụ, na aminoglycosides, penicillins, cephalosporins, tetracyclines.

Nguzogide in vitro ka ciprofloxacin na-ebutekarị site na mmụtụ nke nje topoisomerases nje na ihe nchịkwa DNA ma na-amalite nwayọ site na mmụkọ mgbasa ozi.

Single mmụba nwere ike iduga ibelata na uche karịa ka mmepe nke adakarị ndị na-eguzogide, Otú ọ dị, otutu mmụba tumadi na-eduga mmepe nke adakarị iguzogide ciprofloxacin na cross-iguzogide ọgwụ quinolone.

Nguzogide na ciprofloxacin, yana ọtụtụ ọgwụ ndị ọzọ na-egbochi nje bacteria, nwere ike ịmalite n'ihi mbelata nke nje mgbidi sel (dịka ọ na-abụkarị Pseudomonas aeruginosa) na / ma ọ bụ rụọ ọrụ nke excretion site na sel microbial (efflux). Mmepe nke nguzogide n'ihi mkpụrụ ego nzuzo nke esoro na mpaghara plasmids Qnr. Usoro nguzogide na - eduga na inactivation nke penicillins, cephalosporins, aminoglycosides, macrolides, na tetracyclines nwere ike ghara itinye aka na ọrụ antibacterial nke ciprofloxacin. Microorganisms na-eguzogide ọgwụ ndị a nwere ike ịdabara ciprofloxacin.

Obere nlebara anya nke nje nje (MBC) anaghị agafe nsonye ihe mgbochi kachasị (MIC) karịa ugboro abụọ.

N'okpuru ebe a bụ usoro amamịghe maka ule nnwale na ciprofloxacin, nke Kọmitii Europe kwadoro maka Mkpebi nke Nnwere Onwe na Antibacterial Agent (Eucast) A na-enye ụkpụrụ MIC ókè (mg / l) n'okpuru ọnọdụ nyocha maka ciprofloxacin: ọnụ ọgụgụ mbụ bụ maka microorganisms nke na-emetụta ciprofloxacin, nke abụọ bụ maka ndị na-eguzogide ọgwụ.

- Enterobacteriaceae ≤0,5, >1.

- Pseudomonas spp. ≤0,5, >1.

- Acinetobacter spp. ≤1, >1.

- Staphylococcus 1 spp. ≤1, >1.

- Ihe mgbochi pneumoniae 2 2.

- Haemophilus influenzae na Moraxella catarrhalis 3 ≤0,5, >0,5.

- Neisseria gonorrhoeae na Neisseria meningitidis ≤0,03, >0,06.

- undkpụrụ oke metụtara ụdị microorganisms 4 ≤0.5,> 1.

1 Staphylococcus spp.: oke ala maka ciprofloxacin na ofloxacin metụtara ọgwụ ọgwụ na elu.

2 Ahụ ike na-efe efe na-efe efe: ụdị anụ ọhịa S. oyi baa Anaghị ele ya anya na elepụrụ anya na ciprofloxacin ma, yabụ, so na microorganisms nwere mmetụta nke etiti.

Zọ nwere MIC karịa ọnụ ala mmetụta mmetụta / ọfụma adịkarịsịrị obere, ma ọ nwebeghị akụkọ banyere ha. A ga-ekwugharị ule maka njirimara na mmata ọgwụ na nchọpụta nke ihe ndị a, na nsonaazụ ndị ahụ ga-enyocha site na nyocha nke mpaghara dị iche iche na nyocha ahụ. Ruo mgbe a ga-enwetara ihe akaebe nke nzaghachi ọgwụ maka ụdị nsogbu nwere ụkpụrụ MIC ndị ekwenyesiri ike karịa ọnụego nguzogide ugbu a, a ga-elele ha dị ka ndị na-eguzogide ọgwụ. Haemophilus spp./Moraxella spp.: o kwere omume ịchọpụta ụdị enwere ike omume H. influenzae nwere mmetuta dị ala na fluoroquinolones (MIC maka ciprofloxacin - 0.125-0.5 mg / l). Ihe akaebe nke uru ulo ogwu di na ala nke ndi na –ewepu nsogbu na iku ume H. influenzaemba.

A na-ekpebi ogo nke oke ala anaghị emetụta ụdị microorganism, ọ bụ dabere na ọgwụ ọgwụ / ọgwụ ọgwụ, anaghị esitekwa na nkesa MIC maka ụdị ndị akọwapụtara. Ha bụ naanị maka ụdị nke agabatabeghị ụdị nnwereonwe nnabata, ọ bụghịkwa ụdị ụdị nnwale a ka akwadoghị. Maka ụfọdụ nsogbu, mgbasa mgbasa enweta enweta nwere ike ịdị iche site na mpaghara ala na oge karịa. N'akụkụ a, ọ dị mma ịnweta ozi dị mkpa banyere nguzogide, karịsịa na ọgwụgwọ nke ọrịa ndị siri ike.

Ihe ndị a bụ data sitere na Institute of Clinical and Laboratory Standards (CLSI), idebe ụkpụrụ ịmụgharị maka ụkpụrụ MIC (mg / L) na nyocha mgbasa (dayameta mpaghara, mm) na-eji diski nwere 5 μg ciprofloxacin. Site n'ụkpụrụ ndị a, a na-ahọpụta microorganisms dị ka ọmịiko, etiti na nke na-eguzogide.

- MIC 1: nlebara anya - 4.

- Nnwale nnwale 2: nlebara anya -> 21, etiti - 16-20, na - eguzogide - nje ndị ọzọ anaghị esite na ezinụlọ. Enterobacteriaceae

- MIC 1: nlebara anya - 4.

- Nnwale nnwale 2: nlebara anya -> 21, etiti - 16-20, na - eguzogide - 1: chebara - 4.

- Nnwale ihe dị iche 2: nlebara anya -> 21, etiti - 16-20, na - eguzogide - 3: nlebara anya - 4: chebara -> 21, etiti - -, na - eguzogide - -.

- MIC 5: nlebara anya - 1.

- Nnwale nnwale 5: nlebara anya -> 41, etiti - 28-40, na - eguzogide - 6: nlebara anya - 0.12.

- Nnwale ihe dị iche 7: nro -> 35, etiti - 33-34, na - eguzogide - 1: nwere nlebara anya - 3: enwe mmetụta ọsọ ọsọ - 1 standardkpụrụ nrụpụta na - emetụta naanị ntụtụ iko site na iji cationic mezie Mueller-Hinton broth (SAMNV), nke a na-etinye ikuku na okpomọkụ na (35 ± 2) Celsius C nke 16-20 awa maka nje Enterobacteriaceae, Pseudomonas aeruginosanje ndị ọzọ na-abụghị nke ezinụlọ Enterobacteriaceae, Staphylococcus spp., Enterococcus spp. na Bacillus anthracis, 20-24 ikp Acinetobacter spp., 24 ikp Y. pestis (ma ọ bụrụ na ezughi oke, itinye aka na awa 24 ọzọ).

2 A na-agbaso ọkọlọtọ nwere ikike ịkọwa ya maka nyocha mgbasa na iji diski na-eji Muller-Hinton agar (SAMNV), nke a na-etinye ikuku na ọnọdụ okpomọkụ nke (35 ± 2) Celsius C maka awa 16-18.

3 Ọkpụkpụ edepụtaghachi na-emetụta naanị ule na-agbasa site na iji diski iji chọpụta mmetụta Haemophilus influenzae na Haemophilus parainfluenzae eji ofe ofe ase maka Haemophilus spp. (NTM), nke a na-etinye ikuku na okpomọkụ na (35 ± 2) Celsius C maka awa 20-24.

4 Udiri ogbara ohuru diri na nyocha ndi ozo di iche na iji diski mee NTMnke etinye n'ime 5% CO₂ na okpomọkụ nke (35 ± 2) Celsius C nke awa 16-18

5 A pụrụ iji ọkọlọtọ mụta nwa ahụ naanị maka ịnwale nnwale (nyocha dịgasị iche iche na-eji diski maka mpaghara na agar ngwọta maka MIC) na-eji gonococcal agar na 1% guzobere mgbakwunye na okpomọkụ nke (36 ± 1) Celsius C (ọ na-akaghị 37 Celsius C) nke 5 % CO₂ n'ime oge 20-24

6 A pụrụ ime ka o mee ka ụmụ mmadụ nwetụ ihe atụ maka naanị mfu mmanụ a na-etinye na kọmịshọn Mueller-Hinton.SAMNV) na mgbakwunye nke ọbara atụrụ 5%, nke a na-etinye n'ime 5% CO₂ na (35 ± 2) Celsius C maka awa 20–24

Standardkpụrụ maka ịmụpụta nwa na-emetụta ule maka iji cationic mezie Mueller-Hinton broth (SAMNV) gbakwunye mgbakwunye mgbakwunye uto dị 2%, nke a na-etinye ikuku na (35 ± 2) Celsius C maka awa 48.

Na mmetụta nke vitro na ciprofloxacin

Maka ụfọdụ nsogbu, mgbasa mgbasa enweta enweta nwere ike ịdị iche site na mpaghara ala na oge karịa. N'akụkụ a, mgbe ị na-anwale mmetụta nke akwara, ọ dị mma ịnweta ozi dị mkpa banyere nguzogide, karịsịa na ọgwụgwọ nke nnukwu ọrịa. Ọ bụrụ na mgbakwunye mpaghara bụ nke na uru nke iji ciprofloxacin maka opekata mpe ọtụtụ ụdị ọrịa a na-enyo enyo, gakwuru onye ọkachamara. Na vitro E gosipụtara ọrụ nke ciprofloxacin megide ụdị mmetụta microorganisms ndị a.

Aerobic Gram-Positive Microorganisms - Bacillus anthracis, Staphylococcus aureus (methicillin-mwute) Staphylococcus saprophyticus, Streptococcus spp.

Aerobic gram-adịghị mma microorganisms - Aeromonas spp., Moraxella catarrhal bụ, Brucella spp., Neisseria meningitidis, Citrobacter koseri, Pasteurella spp., Francisella tularensis, Salmonella spp., Haemophilus ducreyi, Shigella spp., Haemophilus influenzae, Vibo..

Microorganisms anaerobic - Mobiluncus spp.

Microorganisms ndị ọzọ - Chlamydia trachomatis, Chlamydia poniaoniae, Mycoplasma hominis, Mycoplasma oyi baa.

Egosiwo ogo ịdị iche na uche nke ciprofloxacin maka microorganisms ndị a: Acinetobacter baumanii, Burkholderia cepacia, Campylobacter spp., Citrobacter freundii, Enterococcus faecalis, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Morganeria ganororia Pseudomonas fluorescens, Serratia marcescens, puloniae Streptococcus, Peptostreptococcus spp., Propionibacterium acnes.

Ekwenyere na ciprofloxacin bụ ihe na-eguzogide ndammana. Staphylococcus aureus (methicillin na-eguzogide) Stenotrophomonas maltophilia, Actinomyces spp., Enteroccus faecium, Listeria monocytogenes, Mycoplasma genitalium, Ureaplasma urealyticummicroorganisms anaerobic (ma e wezụga Mobiluncus spp., Peptostreptococus spp., Propionibacterium acnes).

Egwu. Mgbe nlekọta iv nke 200 mg nke ciprofloxacin T_max bụ 60 min, C_max - 2.1 μg / ml, ikwuputa ya na protein ndi plasma - 20-40%. Na ochichi iv, the pharmacokinetics nke ciprofloxacin bụ linear na dose dose ruo 400 mg.

Site na nchịkwa iv ugboro abụọ ma ọ bụ ugboro atọ kwa ụbọchị, ahụghị nchịkọta nke ciprofloxacin na metabolites ya.

Mgbe nchịkwa ọnụ gachara, a na-enweta mkpụrụ ndụ ciprofloxacin ngwa ngwa na nri diges, tumadi na duodenum na jejunum. Na_max a na-enweta ya ọbara ka ọ gachara awa 1-2 ma ewere ya na ọnụ okwu 250, 500, 700 na 1000 mg nke ciprofloxacin 1.2, 2.4, 4.3 na 5.4 μg / ml. Bioavailability bụ ihe dịka 70-80%.

Nha C_max na AUC na-abawanye na nha ka dose. Iri nri (ewepu ihe oriri nke mmiri ara ehi) na-ebelata mmịcha, mana anaghị agbanwe agbanwe C_max na bioavailability.

Mgbe etinyere ọkwa n'ime 7 ụbọchi asaa, nnabata nkeproprololocinic nke dị n'ọbara na-esite na mkpirisi okwu (C)_max na plasma ọbara dị ihe dị ka ugboro 450 n'ihe na-erughị mgbe nchịkwa ọnụ na-achịkwa 250 mg.

Nkesa. Ihe nọ n'ọrụ nọ n'ọbara plasma ọbara kachasị n'ụdị na-abụghị ionized. A na-ekesa Ciprofloxacin n'arụ na mmiri. Ise_d n'ime ahụ bụ 2-3 l / n'arọ.

Ntinye uche n’akpụ anụ ahụ dị okpukpu 2-12 karịa karịa na plasma ọbara. A na-enwetara mkpokọta ọgwụgwọ na mmiri, akwara, umeji, ọnya ụkwara, azụ, ọnya afọ, akụkụ ahụ na pelvic (endometrium, tubes fallopian na ovaries, akpanwa), ọmụmụ seminal, anụ ahụ prostate, akụrụ na akwara akụkụ, akwara umeji, akwara umeji. zoro ezo, anụ ahụ, akwara ndị mmadụ, mmiri synovial na klaasị articular, ọnya azụ, anụ ahụ. Ọ na-abanye na mmiri nke akụkụ ụbụrụ (cerebrospinal) n'ime obere ego, ebe ntinye ya na enweghị mbufụt nke meninges bụ 6-10% nke ahụ na plasma ọbara, ọ bụrụ na mbufụt ọ bụ 14–37%. Ciprofloxacin na-abanyekwa nke ọma na anya mmiri, pleura, peritoneum, lymph, site na Plasenta. Ntinye uche nke ciprofloxacin na neutrophils ọbara ruru 2-7 karịa karịa na plasma ọbara.

Metabolism. Ciprofloxacin ka a na-enyocha imeju (15-30%). A pụrụ ịchọpụta metabolites anọ dị n'ọbara dị obere n'ọbara - diethylcycrofloxacin (M1), sulfociprofloxacin (M2), oxociprofloxacin (M3), formylcycrofloxacin (M4), atọ n'ime ha (M1 - M3) na-egosi ọrụ antibacterial in vitro tụnyere ọrụ nalidixic acid. Ọrịa antibacterial in vitro metabolite M4, nke dị na obere obere, bụ ihe kwekọrọ na ọrụ Norfloxacin.

Ojiji. Ndi_1/2 bụ awa 3-6, yana CRF - rue awa 12. Ọ bụ sọsọ kachasi ya bụ akụrụ site na tubular filtration na secretion na-agbanweghi agbanwe (50-70%) na ụdị metabolites (10%), nke fọdụrụ site na mgbaze. Ihe dị ka 1% nke nchịkwa apụrụ adịpụrụ iche na bile. Mgbe nlekọta gọọmentị gasịrị, itinye uche na mmamịrị n'ime elekere abụọ nke mbụ mgbe nchịkwa ahụ fọrọ nke nta ka ọ bụrụ okpukpu 100 karịa na plasma ọbara, nke kachasị karịa BMD maka ọtụtụ ọrịa urinary.

Mkpochapụ ntaramahụhụ - 3-5 ml / min / n'arọ, mkpochapu - 8-10 ml / min / n'arọ.

Na ọdịda akụrụngwa akwara na-adịghị ala ala (Cl creatinine> 20 ml / min), ntụpọ ahụ akụrụ na-agbada, mana imirikiti ahụ anaghị eme n'ihi mmụba na metabolic metabolic na nri mkpụrụ ndụ na-ewepụtakarị site na eriri afọ.

Childrenmụaka. Na omumu n’ime umuaka, omuma ndi C_max na AUC nwere afọ ole ha nwere onwe ha. Mmụba a na-ahụ anya na C_max na AUC na nchịkwa ugboro ugboro (na dose nke 10 mg / kg 3 ugboro n'ụbọchị). N'ime ụmụaka 10 nwere nnukwu sepsis na-erughị afọ 1, uru nke C_max bụ 6.1 mg / l (esiri na 4.6 ruo 8.3 mg / l) mgbe infusion na-adigide 1 elekere na dose nke 10 mg / n'arọ, na ụmụaka gbara afọ 1 ruo 5 - 7.2 mg / l (esi na 4.7 ruo 11.8 mg / l). Udu AUC n’otu n’otu di 17.4 (esi na 11.8 rue 32 mg · h / l) na 16.5 mg · h / l (ihe sitere na 11 rue 23.8 mg · h / l). Kpụrụ ndị a kwekọrọ na oke nke ndị ọrịa toro etoro na-eji usoro ọgwụgwọ nke ciprofloxacin. Site na nyocha nke pharmacokinetic na ụmụaka nwere ọrịa dị iche iche, atụmatụ ahụ gbadara T_1/2 odika ihe ruru awa 4-5

Njirimara ngwa

Tupu ịkọwa mbadamba Ciprofloxacin, dọkịta ahụ kwesịrị ị attentiona ntị n'ọtụtụ atụmatụ nke iji ọgwụ ahụ ziri ezi, nke egosiri na nkọwapụta:

Cakpachapụ anya, a na-eji ọgwụ ahụ eme ihe na ndị ọrịa nwere ọria nkụda mmụọ, ọnụnọ nke ihe ọdịdọ dị iche iche, yana imegide ọnya ọnya ụbụrụ nke ụbụrụ. N'otu oge ahụ, a na-enye mbadamba mkpụrụ osisi ciprofloxacin naanị maka nsogbu ahụike.
Mmepe nke afọ ọsịsa n'oge ogologo ọgwụ na ọgwụ a bụ ihe ndabere maka ọmụmụ ihe ọzọ iji wepu pseudomembranous colitis. Ọ bụrụ nchoputa a gosipụtara, a na-akwụsị ọgwụ ahụ ozugbo.
Mgbe mgbu na akwara ma ọ bụ akwara gosiri, a na-ewepụ ọgwụ ahụ, ọkachasị n’ebe ndị agadi nọ, nke ejikọtara ya na nnukwu ihe ọghọm nke ọrịa ọgụ.
A naghị atụ aro ka ọ rụọ ọrụ ahụ siri ike mgbe ị na-ewere mbadamba ciprofloxacin.
Ọ na-atụ aro ka ọ ghara ịdọrọ ìhè anwụ n’ahụ n’ahụ n’oge ọgwụ na ọgwụ a.
Mgbe ị na-a tabletsụ mkpụrụ osisi Ciprofloxacin, ị kwesịrị ị consumeụ mmiri zuru ezu iji belata ohere nke kristal.
Ewezuga mmanya na - aba n'anya n'oge ọgwụ.
Ngwaọrụ ndị na-arụ ọrụ nke mbadamba mkpụrụ osisi ciprofloxacin nwere ike iso ọgwụ ndị ọzọ mekọrịta ọgwụ, yabụ ọ bụrụ na-eji ha, ekwesịrị ịdọ dọkịta na-aga ahụ aka na ntị gbasara nke a.
N'oge usoro ọgwụgwọ, ekwesịrị ilebara anya pụrụ iche mgbe ị na-arụ ọrụ nwere ike ịdị ize ndụ nke chọrọ ntinye uche ka ukwuu na ọsọ ọsọ nke mmeghachi omume psychomotor.

Na netwọ ọgwụ ahịa, mbadamba mkpụrụ ọgwụ ciprofloxacin bu ọgwụ. A na-ewepụ nlekọta onwe ha na-enweghị ọgwụ ọgwụ kwesịrị ekwesị, n'ihi na nke a nwere ike ibute mmetụta ahụike na-adịghị mma.

Dodoụbiga ya ókè

Bụrụ na nke dị ukwuu ngafe nke na-atụ aro ọgwụgwọ onunu ogwu nke ciprofloxacin mbadamba, ọgbụgbọ, vomiting, isi ọwụwa, ọgbụgbọ, isi mmụọ nke dịgasị iche iche ogo, mpekere akwara, hallucinations ịzụlite. N'okwu a, a na-asa afọ na eriri afọ, a na-edobe sorbents, a na-emekwa ọgwụgwọ Symptomatic ma ọ bụrụ na ọ dị mkpa, ebe ọ bụ na enweghị ọgwụ mgbochi akọwapụtara maka ọgwụ a.

Analogues nke mbadamba ciprofloxacin

Yiri ihe mejupụtara na ọgwụgwọ ọgwụgwọ maka mbadamba ciprofloxacin bụ nkwadebe nke Ecocifol, Ciprobay, Ciprinol, Ciprolet.

Ndụ nchekwa nke mbadamba mkpụrụ ndụ ciprofloxacin bụ afọ abụọ site na ụbọchị emepụtara. Ekwesiri ịchekwa ha na nkwakọ ngwaahịa na-adịghị emebi emebi, n'ebe gbara ọchịchịrị, nke ikuku na-erughi na ụmụaka na ikuku ikuku na-erughị + 25 Celsius.

Mwepụta wepụtara ya na ihe mejupụtara

Ciprofloxacin dị n'ụdị ndị a:

mbadamba 250, 500 ma ọ bụ 750 mg, nke ihe nkiri kpuchiri. Mbadamba ụrọ Biconvex nke 250 mg nwere elu pink. Mbadamba ụrọ 500 na-acha uhie uhie nwere ụdị pink na-enwe ihe ize ndụ n'otu akụkụ. Mbadamba ụrọ 750 mg capsule nwere ihu na-acha anụnụ anụnụ. Enwere ike ị drugụ ọgwụ ahụ na blisters (mbadamba iri 10 ma ọ bụ 20) na na paịlị (1, 2, 3, 4, 5, ma ọ bụ 10 blisters na mkpọ). Ọzọkwa, enwere ike itinye mbadamba nri ciprofloxacin na akpa rọba (30, 50, 60, 100, ma ọ bụ otu iberibe 120), nke a na-akwakọba n'otu n'otu na akpa plastic. Na mgbakwunye, ọgwụ ahụ dị na akpa polyethylene (mbadamba 10 ma ọ bụ 20), edobere ya na igbe kaadi.
itinye uche maka ihe ngwọta maka infusion 10 mg / ml. A na-awụpụ mmiri mmiri na-enweghị ọ orụ ma ọ bụ mmiri akwụkwọ ndụ akwụkwọ ndụ na-acha odo odo nke 10 ml. A na-etinye ọgwụ ahụ na mkpọgụ (karama ise nke ọ bụla),
ihe ngwọta maka infusion 2 mg / ml. A na-awụpụta paịlị na-acha odo odo ma ọ bụ nke enweghị agba n’ime karama rọba 100 ml, bụ́ ndị a na-akwakọba na akpa rọba na igbe kaadiboodu (akpa 1 kwa igbe),
ntị na anya dara 0.3%. A na-awụpụ mmiri mmiri na-acha uhie uhie ma ọ bụ nke na-acha odo odo n'ime karama pọmik ọcha (5 ml ọ bụla), nke a na-akwakọba na igbe kaadiboodu (karama 1 kwa ngwungwu).

Ngwakọta nke mbadamba 1 gụnyere:

ihe na - arụ ọrụ: ciprofloxacin - 250, 500 ma ọ bụ 750 mg,
excipients: stachi, microcrystalline cellulose, talc, magnesium stearate, colloidal silicon dioxide (aerosil), hydroxypropyl methyl cellulose 15 CPS, sodium starch glycolate, diethyl phthalate, titanium dioxide, odo na-acha odo odo na-acha odo odo, na-acha odo odo na-acha odo odo na-acha odo odo, na-acha odo odo na-acha odo odo na-acha odo odo, na-acha odo odo na-acha odo odo na-acha odo odo, na-acha odo odo na-acha odo odo na-acha odo odo, na-acha odo odo na-acha odo odo na-acha uhie uhie

Ngwakọta nke karama 1 na itinye uche maka nkwadebe nke ihe ngwọta maka infusion gụnyere:

ihe na-arụ ọrụ: ciprofloxacin - 100 mg,
ndị na - ahụkarị: disodium edetate dihydrate, lactic acid, sodium hydroxide, hydrochloric acid, mmiri maka ịgba ntụtụ.

Ngwakọta nke 100 ml nke ihe ngwọta maka infusion gụnyere:

ihe na - arụ ọrụ: ciprofloxacin - 200 mg,
ndị na-emebu: disodium edetate, sodium chloride, mmiri maka ịgba ntụtụ.

Ngwakọta nke 1 ml nti na anya mmiri gụnyere:

ihe na - arụ ọrụ: ciprofloxacin - 3 mg,
ndị na - ahụkarị: mannitol, sodium acetate trihydrate, chloride benzalkonium, disodium edetate dihydrate, glactic acetic acid, mmiri dị ọcha.

Mbadamba ụrọ, tinye uche, ihe ngwọta maka infusion

A na-eji Ciprofloxacin na-agwọ ọrịa ndị a na-esighị ike na nke na-adịghị agbanwe agbanwe nke microorganisms na-eme ka mmetụta ahụ na-arụ ọrụ:

Ọrịa na-efe efe nke akụkụ okuku ume na-efe efe, gụnyere oyi ịba ọcha n'anya nke Enterobacter spp., Klebsiella spp., Escherichia coli, Proteus spp., Haemophilus spp., Pseudomonas aeruginosa, Legionella spp., Staphylococcus spp., Moraxella catarrhalis,
oria nke sinuses (karịchaa, sinusitis) na ntị etiti (dịka ọmụmaatụ, otitis media), ọkachasị ma ọ bụrụ na ọrịa ndị a na-akpata site na microorganisms gram na-adịghị mma, gụnyere Staphylococcus spp. na Pseudomonas aeruginosa,
ọrịa anya mkpụrụ anya (belụsọ mbadamba mbadamba),
Ọrịa urinary na akụrụ na-efe efe
ọrịa metụtara ọrịa, gụnyere gonorrhea, prostatitis, adnexitis,
nje na-efe efe nke eriri afọ (ọrịa nke biliary tract, eriri afọ, peritonitis),
sepsis
anụ ahụ dị nro na ọrịa anụ ahụ (ma e wezụga mbadamba),
mgbochi nke oria ma obu oria n’ime ndi oria nwere oria pere mpe (ndi oria na - Neropropia ma obu ndi oria na - aria immunosuppressants),
ọgwụgwọ nke ụbụrụ na-egbu egbu na-egbu ọrịa n'ime ndị ọrịa nwere obere mgbochi,
ọgwụgwọ na igbochi ọrịa anthrax nke ọrịa Bacillus anthracis (ma e wezụga nke mbadamba).

Anya na anya ada ada

Mgbe ị na-eji anya mmiri na ophthalmology, a na-eji ọgwụ ahụ agwọ ọrịa dị otú ahụ na-efe efe na mkpali ọrịa anya:

subacute na nnukwu conjunctivitis,
blepharoconjunctivitis,
ịba ọcha n'anya
keratoconjunctivitis,
keratitis
dacryocystitis na-adịghị ala ala
ọnya ọnya bakwara
ọnya na-efe efe mgbe ahụ ndị si mba ọzọ ma ọ bụ mmerụ ahụ,
meibomite (bali).

Mgbe ị na-eji ọnya mmiri n’ịwa ahụ na ophthalmic ịwa ahụ, a na-eji ọgwụ ahụ eme ihe maka mgbochi na site n’azụ ọgwụ ọrịa na-efe efe.

Mgbe ị na-eji ntị adaa na otorhinolaryngology:

ọgwụgwọ ọrịa postoperative ọrịa,
otitis externa.

Mbadamba 250, 500 ma ọ bụ 750 mg

A na-eji ọgwụ ọnụ a na-agwọ ya - na afọ na-enweghị ihe ọ ,ụ ,ụ, ya na mmiri mmiri zuru ezu. A na-ahọrọ usoro onunu ogwu dabere ogo ọrịa ahụ, ọnọdụ nke ahụ, ụdị oria, ibu, ọrụ akụrụ yana afọ onye ọrịa. A na-atụkarị ọgwụ ndị a

maka ọrịa na - agbakọghị akwara gbasara akwara na akụrụ ya - 250 mg ugboro abụọ n’ụbọchị, yana ọrịa siri ike - 500 mg,
ya na ọrịa na-adịghị ala ala nke akụkụ okuku ume na ala - ugboro 2 n'ụbọchị, 250 mg, yana nnukwu - 500 mg,
na gonorrhea - otu ugboro 250-500 mg,
ya na ọrịa gynecological, colitis na enteritis (ụdị siri ike, oke ọkụ), osteomyelitis, prostatitis - ugboro 2 n'ụbọchị, 500 mg nke ọ bụla. Na oria banal, a na-atụ aro ka ọ were 250 mg nke ọgwụ ahụ ugboro 2 n'ụbọchị.

A họrọ oge ọgwụgwọ ọ dabere na ogo ọrịa ahụ, agbanyeghị, ekwesịrị ịga n'ihu na ọgwụgwọ oge ọbụlagodi ụbọchị 2 mgbe ihe mgbaàmà ahụ kwụsịrị. Oge ọgwụgwọ ọ na-adịkarị bụ ụbọchị 7-10.

Ngwọta maka infusion 2 mg / ml

A na-enye ọgwụ ahụ intravenly. Ekwesịrị iji nwayọ tinye ọgwụ mgbochi n'ime nnukwu akwara iji gbochie mmepe nke nsogbu na saịtị nke infusion. A na-achịkwa azịza ya naanị ma ọ bụ jikọtara ya na ngwakọta infusion dakọtara (ngwọta Ringer, 0.9% sodium chloride solution, 10% ma ọ bụ 5% dextrose, 10% fructose solution, 5% dextrose, 0.225 ma ọ bụ 0.45 sodium chloride solution). %).

Ogologo oge infusion na dose nke 200 mg bụ nkeji 30, na oge nke 400 mg - 60 nkeji. Oge nchịkwa dị ugboro 2-3 kwa ụbọchị.

Oge ọgwụgwọ ọ dabere na usoro ọgwụgwọ, ogo na ọgwụgwọ nke ọrịa ahụ. Edere ọgwụ ahụ maka ụbọchị 3 ọzọ mgbe kpochapụrụ mgbaàmà nke ọrịa.

Nkezi oge ọgwụgwọ:

ya na nnukwu ọgbụgba na-agbagọ - 1 ụbọchị,
yana ọrịa nke akụrụ, akụkụ ahụ, akwara afọ - ruo ụbọchị 7,
na ebelatawo ọgụ - oge niile nke neutropenia,
na ọrịa osteomyelitis - agaghị erughi ụbọchị 60,
ya na Chlamydia spp. ma ọ bụ Streptococcus spp. bu oria - opekata mpe ubochi iri,
ya na oria ndi ozo bu ubochi 7-14.

A họrọ usoro ị drugụ ọgwụ ahụ dabere n'ụdị ọrịa ahụ:

na ọrịa nke akụkụ okuku ume na - 2-3 ugboro n'ụbọchị, 400 mg ọ bụla,
na nnukwu ọrịa na - agbakọghị agbatị na usoro mkpụrụ ndụ - 2 ugboro n'ụbọchị, 200 ma ọ bụ 400 mg,
ya na oria di omimi nke sisitemu
yana ọrịa prostatitis, adnexitis, orchitis, epididymitis - ugboro 2-3 n'ụbọchị, 400 mg nke ọ bụla,
ya na afọ ọsịsa - ugboro abụọ kwa ụbọchị maka mgmg nke 400,
yana oria ndi ozo - Ugboro abuo kwa ubochi, 400 mg kwa,
na ọrịa na-eyi ndụ egwu (ọ kachasị ọnụnọ nke staphylococcus spp., Streptococcus spp., Pseudomonas spp.), na-efe efe, nke na-efe efe na -akpata ọrịa ngụgụ nke ngụgụ, akpa ume na nkwonkwo, yana ọrịa septicemia, peritonitis - ugboro 3 kwa ụbọchị, 400 mg ọ bụla,
na mgbochi na ọgwụgwọ nke ọrịa ọgụ akpịrị - ugboro abụọ n'ụbọchị, 400 mg.

Nkwadebe nke itinye infusion ngwọta

Tupu ojiji, ihe ndị dị na 1 vial nke uche ga-abụrịrị nke ọma nke opekata mpe 50 ml na ngwakọta infusion zuru ezu (Ngwọta Ringer, 0.9% sodium chloride solution, 10% ma ọ bụ 5% ngwọta dectrose, 10% fructose solution, 5% dextrose solution) , ihe ngwọta nke sodium chloride 0.225 ma ọ bụ 0.45%).

Ekwesịrị iji ya mee ihe ngwa ngwa o kwere omume n'ihi ịdị nkọ nke ciprofloxacin ka ọ bụrụ ọkụ, yana iji nọgide na-enwe ike ya. Ya mere, a ga-ewepụ karama ahụ na igbe ahụ naanị tupu ejiri ya. N'ọnọdụ ọdịda anyanwụ kpọmkwem, a na-ekwe nkwa nke ga-akwụsi ike ụbọchị 3. Mgbe ị na-echekwa azịza ya na obere okpomọkụ, enwere ike ịmalite, nke na-agbari n'ime ụlọ dị n'ime ụlọ, yabụ na-atụghị ya ịhapụ njuputa infusion ma ọ bụ chekwaa ya na friji. Jiri naanị ihe doro anya doro anya.

Ọ bụrụ na ndakọrịta na ndị ọzọ infusion agbanwe / akwadebe akwadoghị, ciprofloxacin ga-ndinọ iche. Ihe ngosi di iche-iche nke inshoatiatizim: olulu, mmacha ma obu uzo oma.Ọgwụ a ekwekọghị na ngwọta niile nke esighị ike ma ọ bụ nke anụ ahụ na pH sitere na 3.9 ruo 4.5 (dịka ọmụmaatụ, ngwọta nke heparin, penicillins), yana azịza ndị na-agbanwe pH n'akụkụ akụkụ alkaline.

Anya na ntị dara

mmeghachi omume nfụkasị ahụ
na-ere ọkụ
itching
ụdị hyperemia na ịdị nro nke conjunctiva ma na mpaghara nke akpụkpọ ahụ tympanic na ọnụ ụzọ nyocha nke mpụga,
ọgbụgbọ
fotophobia
nkuchianya nke nkuanya
mmetụta mba ọzọ na anya,
lacrimation
ozugbo instillation - afụrtaste na-adịghị mma na onu okwu,
n'ime ndị ọrịa nwere ọnya afọ - a na-acha ọcha kristal,
mgbanyụ ihu anya,
keratopathy
keratitis
oria akụkụ ma ọ bụ ọdịdị nke akụkụ anya isi,
mmepe nke superinfection.

Ntụziaka pụrụ iche

A naghị atụ aro Ciprofloxacin maka ọgwụgwọ nke ọrịa na-akpata nsonaazụ nke Streptococcus pneumoniae, ebe ọgwụ ahụ adịghị irè megide nje ahụ. N'ihe banyere ọrịa ndị ọzọ, tupu ịkọwa Ciprofloxacin, ị kwesịrị ijide n'aka na ọ dị irè megide ụdị nje microorganism kwekọrọ.

N'oge ọgwụgwọ ogologo oge na ọgwụ ahụ, a na-atụ aro nyocha niile gbasara ọbara, akụrụ na ọrụ akụrụ.

N'ihe banyere nchịkwa akwara ọbara nke ọgwụ syprotoloxacin na ọgwụ site na otu ihe ndị a na - eme na - eme ka ọbara gbasaa, ọ dị mkpa ka a na - enyocha ọbara niile, ọnụego obi ya, yana elele.

Iji gbochie mmepe nke crystalluria, ọ bụ ihe a na-anabataghị gafere ọgwụ a tụrụ aro ya kwa ụbọchị. Ọ dịkwa mkpa iji hụ na mmezi nke ihe mmamịrị nke mmamịrị yana ị nweta mmiri zuru oke.

Enwere ihe ọghọm nke imepụta mmeghachi omume nke uche dịka nsonaazụ mbụ nke ciprofloxacin. N’ọnọdụ ndị a na-adịghị ahụkebe, mmeghachi omume psychotic ma ọ bụ nkụda mmụọ nwere ike ịmalite echiche igbu onwe ya na omume imerụ onwe ya (dịka ọmụmaatụ, ọnwụnwa na-enweghị isi na ịga nke ọma) N'okwu a, ị ga-akwụsị ị takingụ ọgwụ ahụ ozugbo wee gaa hụ dọkịta. Ọ bụ ndị ọrịa nwere ọria ọria na akụkọ ọdịkwụ, mmebi ụbụrụ nke ọkpọ, yana ọrịa vaskụla n'ihi ihe mmerụ ahụ, a ga-edenye mkpụrụ ọgwụ ciprofloxacin maka ebumnuche ahụike.

Ciprofloxacin, dị ka fluoroquinolones ndị ọzọ, nwere ike belata ọnụ ụzọ maka ịdị njikere ọdịmma ma kpasuo ihe ọdịdọ. Ọ bụrụ na ha emee, kwụsị ị usingụ ọgwụ.

N'ime ọgwụgwọ ndị ọrịa na-a fluụ fluoroquinolones (gụnyere ciprofloxacin), a na-edekọ ikpe gbasara sensorimotor ma ọ bụ sensory polyneuropathy, dysesthesia, hypesthesia, na adịghị ike. N'ihe banyere mgbaàmà dịka ọkụ, ihe mgbu, ọnya, tingling, adịghị ike, onye ọrịa ahụ kwesịrị ịkwụsị ị andụ ọgwụ ahụ ma gakwuru dọkịta.

N'oge a na-eji ciprofloxacin, ekwupụtala banyere mmepe nke ọnọdụ akwụkwụ ọtọ.

Ọ bụrụ na ogologo oge, afọ ọsịsa siri ike ma ọ bụ mgbe ọgwụgwọ gasịrị, ọ dị mkpa iji wepụta nrịanrịa pseudomembranous colitis, nke chọrọ ịkwụsị ọgwụ ozugbo na nhọpụta ọgwụgwọ zuru oke.

N'oge ọgwụgwọ Ciprofloxacin, a chọpụtara na ọrịa nke ọrịa imeju na-egbu ndụ na necrosis imeju. Ọ bụrụ n’inwere ihe mgbaàmà nke ọrịa imeju (anorexia, mmamịrị gbara ọchịchịrị, jaundice, afo ime, itching), ikwesighi ịkwụsị ị .ụ ọgwụ.

N'ime ndị ọrịa nwere ọrịa imeju ma na-ewere ciprofloxacin, ọrụ alkaline phosphatase, usoro ịba ọcha n'anya nwere ike ịbawanye nwa oge, ma ọ bụ ọrịa cholestatic jaundice nwere ike ịmalite. Ekwesịrị iji nlezianya depụta ndị ọrịa na-ata ahụhụ na myasthenia gravis siri ike ciprofloxacin, ebe ọ bụ na ọ ga-aka njọ.

N'oge usoro ọgwụgwọ, ọ dị mkpa iji zere ịdị na-enwu ọkụ anyanwụ, yana isi mmalite ndị ọzọ nke radieshon radieshon.

Mgbe ị na-ewere Ciprofloxacin ugbua n'ime ụbọchị abụọ mbụ mgbe mmalite nke ọgwụgwọ, enwere ikpe gbasara akwara, yana nkwonkwo akwara (ọtụtụ mgbe, akwara Achilles, gụnyere agakọ). Edekọtara mmerụ ahụ na mgbaze nke akwara ọtụtụ ọnwa mgbe ọgwụgwọ gasịrị. N'ime ndị ọrịa agadi, n'ime ndị ọrịa oria na-anata ọgwụgwọ na glucocorticosteroids, enwere ohere dị ukwuu nke tendinopathy. N'ihe banyere ịchọpụta ihe ịrịba ama mbụ nke tendonitis (mbufụt, ọzịza na-egbu mgbu na nkwonkwo), a ga-akwụsị ojiji nke Ciprofloxacin, ebe ewezuga mmega ahụ, ebe ọ bụ na enwere ihe ọghọm nke mgbapu azụ. A ga-eji ọgwụ mee ihe na-akpachara anya maka ịgwọ ndị ọrịa nwere ọrịa akaị metụtara ojiji nke quinolones.

N'ihe banyere ọgwụgwọ nke ọrịa siri ike, ọrịa nje nje anaerobic kpatara, yana ọrịa staphylococcal, ekwesịrị iji mkpụrụ ọgwụ ciprofloxacin mee njikọta yana ọgwụ ọjọọ kwesịrị ekwesị. Maka oria ndi mmadu na acho na acho achooro fluoroquinolone nke Neisseria gonorrhoeae, ekwesiri iburu uzo ime obodo banyere iguzogide ihe di n’ime ya ma nwekwaa uche nke pathogen n’oge nkwuputa ulo oru.

Ciprofloxacin na-emetụta mmụba na etiti oge QT. Nyere na umunwanyi nwere oge onodu QT kariri ogologo karie ma ndi nwoke, ha kariri ogwu ndi na-akpalite ogologo oge nke QT. Egosiputara ndi oria okenye na-abawanye uru site na ọgwụ na-ebute mgbatịkwu oge QT. N'ihe banyere ihe ndị e kwuru n’elu, ọ dị mkpa iji ciprofloxacin na-akpachara anya n’ihe ndị a:

yana ọgwụ na agbatị oge QT (dịka ọmụmaatụ, ọgwụ antiarrhythmic nke klas III na IA, ọgwụ mgbochi tricyclic, antipsychotics na macrolides),
na ọgwụgwọ ndị ọrịa nwere ike ịba ụba nke arrhythmias dị ka pirouette ma ọ bụ ogologo oge nke oge QT (dịka ọmụmaatụ, na-arịa ọrịa ọgbụgba nke ogologo oge nke oge QT, enweghi echiche ziri ezi nke electrolytes, gụnyere hypomagnesemia na hypokalemia),
ya na ụfọdụ ọrịa obi na ndị ọrịa nwere nkụchi obi, bradycardia, infarction myocardial).

Mgbe ojiji izizi nke ciprofloxacin, a na-edekọ ikpe ndị a na-adịghị ahụkebe mmeghachi omume anaphylactic, gụnyere anaphylactic shock. Nke a chọrọ ịkwụsị ọgwụ ahụ ozugbo yana ọgwụgwọ kwesịrị ekwesị.

Site na nchịkwa intravenal nke ihe ngwọta, mmeghachi omume mpaghara na mpaghara ịgba ahụ ga-ekwe omume (mgbu, ọzịza). Mmeghachi omume a na-ahụkarị ma ọ bụrụ na oge mgbakwunye ahụ erughị nkeji iri atọ. Mgbe ngwụsị nke infusion, mmeghachi omume na-agafe ngwa ngwa, na-enweghị contraindication maka ochichi ọzọ nke Ciprofloxacin (ma ọ bụrụ na esoghị usoro mgbagwoju anya).

Ciprofloxacin bụ ihe mgbochi na-enweghị atụ nke CYP450 1A2 isoenzyme, yabụ, akpachapụrụ anya kwesịrị iji ya mee ihe ma ọ bụrụ na ejiri ya enzyme ọgwụ metabolized (nke gụnyere methylxanthin, theophylline, duloxetine, caffeine, ropinirole, clozapine, intonalum teminum), ọbara nwoke na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara na-abawanye, na-eme ka ọbara dị ọnụ ala, ebulite obi ụfọdụ nsogbu mmeghachi omume.

N'ime ụlọ nyocha in vitro ule, ciprofloxacin na-egbochi uto nke Mycobacterium spp. Nke a nwere ike ibute nsonaazụ na-adịghị mma na nchoputa nke pathogen n'ime ndị ọrịa ahụ edepụtara ọgwụ ciprofloxacin.

Site na ụkọ glucose-6-phosphate dehydrogenase, a hụrụ mmeghachi omume hemolytic na ndị ọrịa na-anata ọgwụ. Ojiji nke ciprofloxacin maka ọgwụgwọ nke otu a ga - ekwe omume naanị site na uru ndị nwere ike ịkarị karịa ihe enwere ike iji ya. N'okwu a, ọ dị mkpa iji hụ na nlebara anya nke onye ọrịa.

Mgbe ị na-emeso ndị ọrịa mmachi sodium (ọdịda akụrụ, nkụda obi, ọrịa nephrotic syndrome), ọ dị mkpa iburu n'uche ịta nke sodium chloride dị na Ciprofloxacin.

Ebuputara n ’anya anya adighi ka ogwu o donu. N'ihe banyere iji nkwadebe ophthalmic ndị ọzọ, a ga-ahụta ohere nchịkwa nke nkeji 5 ma ọ bụ karịa. Ekwesịrị ịkwụsị ọrụ nke ciprofloxacin ma ọ bụrụ na e nwere ihe ịrịba ama nke hypersensitivity. Ekwesịrị ịgwa onye ọrịa ahụ na ọnọdụ nke ịda, hyperemia conjunctival nwere ike ịmalite (na nke a, ị ga-ahapụ ị ofụ ọgwụ ahụ ma chọọ ndụmọdụ dọkịta). N'oge ọgwụgwọ Ciprofloxacin dara, a na-atụ aro ka ịghara iyi akwa dị nro. N'ihe banyere iji anya ndị nwere ike ịkpọtụrụ tupu instillation, a ga-ewepụ ha ma yikwasị ọzọ naanị nkeji 20 mgbe instillation nke ọgwụ ahụ.

Ime na lactation

N'ime afọ ime, amachibidoro ọgwụ a.

Ebe ọ bụ na ciprofloxacin na-abanye na mmiri ara ara, ekwesighi iji ọgwụ a na-agwọ ndị nne na-enye nwa ara. Ọ bụrụ na ọ dị mkpa, nhọpụta nke ciprofloxacin n'oge a na-enye nwa tupu ịmalite ọgwụgwọ, ị ga-akwụsị inye ya ara.

Jiri na nwata

Anaghị anabata ọgwụ ahụ iji gwọọ ọrịa na ụmụ na-erubeghị afọ 18, belụsọ maka ndị a:

maka ọgwụgwọ nke ọrịa na-arịa cystic fibrosis - ugboro 3 n'ụbọchị 10 mg kwa 1 n'arọ nke ịdị arọ ahụ (oke ọgwụ a bụ 400 mg),
maka ọgwụgwọ nke ọrịa ọgụ na - ọgụ ugboro abụọ n'ụbọchị 10 mg kwa 1 n'arọ nke ịdị arọ ya (oke ọgwụ a bụ 400 mg). Ogologo oge ọgwụgwọ ọrịaproprololoxacin bụ ọnwa 2.

Ọgwụgwọ kwesịrị ibido ozugbo onye ọrịa kwupụtara ma ọ bụ echere. N’ihe metụtara nsogbu nke nkwonkwo akwara na akwara ndị gbara ya gburugburu, dọkịta kwesịrị inwe ọgwụgwọ n’imeso ụmụaka pụrụ ịgwọ ọrịa ga-eme ọgwụgwọ. Ekwesịrị ịkọ ọgwụ a mgbe ị tụlechara nha nke ihe ize ndụ na uru.

Mgbe ị na-eji ciprofloxacin na ụmụaka, etinyere mmepe nke ọrịa ogbu na nkwonkwo.

Na arụ ọrụ ezumike ọrụ

Ọrịa nwere oke nsogbu gbasara akụrụ na-enye ọgwụ mgbochi ọkara.

Mgbe e jiri ọnụ kwuo ya, usoro ọgwụgwọ nke ciprofloxacin bụ dị ka ndị a:

na njikwa nwebiga ihe karịrị 50 ml / min, a na-ahụ usoro usoro ọgwụgwọ oge mbụ,
na mwepụ nke creatinine nke 30-50 ml / min - kwa awa 12, 250-500 mg nke ọ bụla,
na mwepu nke creatinine nke 5-29 ml / min - kwa awa 18, 250-500 mg nke ọ bụla,
maka ndị ọrịa na-eme nyocha ọbara-ma ọ bụ gburugburu, mgbe usoro ahụ gachara, 250-500 mg kwa elekere 24.

Na nchịkwa intravenous, usoro onunu ogwu nke ciprofloxacin bụ dị ka ndị a:

na ọdịda akụrụngwa akụrụngwa (CC 30-60 ml / min / 1.73 m 2) ma ọ bụ itinye uche na creatinine na plasma ọbara dị na 1.4-1.9 mg / 100 ml, kwa ụbọchị ekwesịghị ịgari 800 mg,
na nnukwu nsogbu gbasara akụrụ (CC ruo 30 ml / min / 1.73 m 2) ma ọ bụ tinye uche mmụọ na plasma ọbara nke ihe karịrị 2 mg / 100 ml, kwa ụbọchị ọgwụ ahụ agaghị agafe 400 mg.

Maka ndị ọrịa na hemodialysis, ya na nchịkwa akwara ọbara, usoro ọgwụgwọ ahụ ka ọ dị. A na-eji Ciprofloxacin nwere dialysate na intraperitoneally na ego nke 50 mg kwa 1 lita nke dialysate. Ugboro ugboro - awa 6 kwa ugboro 4 kwa ụbọchị.

Mkparịta ụka ọgwụ ọjọọ

Ojiji nke ciprofloxacin na phenytoin nwere ike ibute mbelata ma ọ bụ nwekwuo mkpokoro nke ngwụcha na plasma ọbara, yabụ akwadoro nlebara anya nke ọgwụ kwekọrọ. N'ihi mbelata nke ọrụ microọdal oxidation Filiks na hepatocytes, ọgwụ ahụ na-agbatịkwu ọkara ndụ ma na-eme ka nkwupụta nke theophylline na xanthines ndị ọzọ (gụnyere caffeine).

Ọmụmụ ihe metụtara ndị ọrụ afọ ofufo mara mma egosila na n'otu oge eji ọgwụ lidocoin nwere na Ciprofloxacin site na 22% na-ebelata nhichapụ nke lidocaine mgbe a na-achịkwa ya intraven. Ọ bụrụgodi na a na-anabata lidocaine nke ọma, ijikọ ya na ciprofloxacin nwere ike ịbawanye nsonaazụ ya.

N'ihe banyere iji ọgwụ emeju nri syprofloxacin na ọgwụ ọgwụ hypoglycemic a na-ejikarị eme ihe (ọ na-abụkarị usoro nkwonkwo glimepiride, glibenclamide), enwere ike ịkwalite mmetụta nke nke ikpeazụ.

Nlekọta intravenous intravenous management nke ciprofloxacin na anticoagulants na-apụtaghị ìhè na-abawanye oge prothrombin.

Ojiji nke ciprofloxacin na vitamin K antagonists (dịka ọmụmaatụ, acenocoumarol, warfarin, fluindone, fenprocoumone) nwere ike ịkwalite mmetụta anticoagulant ha. Ahụike a na-emetụta ịdị njọ nke ọrịa a, ọnọdụ ahụike yana afọ ole onye ọrịa nọ, yabụ ọ siri ike ịtụle ogo mmetụta nke ọgwụ si abawanye INR. A na-atụ aro ka a na-ahụkarị INR nleba anya n'ọnọdụ ikpe nke ojiji ọgwụ vitamin K na ndị na-emegide Ciprofloxacin, yana obere oge mgbe ngwụsị usoro ọgwụgwọ jikọtara ọnụ.

Mgbe ejikọtara ya na ọgwụ mgbochi ọgwụ ndị ọzọ (aminoglycosides, metronidazole, clindamycin, ọgwụ mgbochi beta-lactam), a na-ahụkarị synergism. Enwere ike iji Ciprofloxacin rụọ ọrụ nke ọma yana yana ceftazidime na azlocillin iji gwọọ ọrịa ndị Pseudomonas spp kpatara. Mgbe ejikọtara ya na ọgwụ mgbochi beta-lactam (dịka ọmụmaatụ, azlocillin na meslocillin), a ga-eji ọgwụ ahụ maka ọrịa nje streptococcal. Yana vancomycin na isoxazolylpenicillins, a na-eji Ciprofloxacin maka ọrịa staph. Ọgwụ a jikọtara ya na clindamycin na metronidazole dị irè na ọrịa anaerobic.

Mgbe ị na-eji ciprofloxacin na cyclosporine, a na-eme ka mmetụta nke nephrotoxic nke nke ikpeazụ na-abawanye, na-arịba ama na itinye uche serin creatinine. Mgbe ị na-agwọ ndị ọrịa dị ka ugboro abụọ n'izu, ọ dị mkpa iji nyochaa ọrụ gbasara akụrụngwa.

N'iji ọgwụ ciprofloxacin na ọgwụ mgbochi mkpali na - abụghị steroidal (ewepu acetylsalicylic acid), enwere ike ịnwe nhịahụ na-abawanye. Oge ejikọtara ọgwụ uricosuric ọgwụ na ciprofloxacin na-akwụsị ịda mba ọzọ (ihe ruru 50%) ma mee ka ịba ụba nke plasma dị na nke ikpeazụ.

Ciprofloxacin na-abawanye site na 7 ugboro nke ịta ahụ nke tizanidine (Cmax) na plasma ọbara (ọnụ ọgụgụ mgbanwe nke ihe ngosi a bụ 4 - 21 ugboro) ma na-abawanye site na ugboro 10 mpaghara dị n'okpuru oge ịacụ ọgwụ pharmacokinetic (ntụpọ nke AUC nke 6–24 ugboro), nke na-abawanye n'ihe ize ndụ nke ụra ụra na mbelata ọbara mgbali elu. Yabụ, ojiji nke oge azanụ ọgwụ tizanidin nwere ọgwụ na ciprofloxacin.

Ngwakọta infusion nke ọgwụ ahụ bụ ọgwụ ọgwụ ekwekọghị na ọgwụ na infusion solution, nke enweghị arụ na anụrị na kemịkalụ na mpaghara acidic (pH nke Ciprofloxacin solution for infusion is 3.9-4.5). Amachibidoro ịgwakọta iv na ihe ngwọta na pH nke dị n'elu 7. Mgbe ị na-eji ciprofloxacin na ọgwụ ndị na-agbatị oge etiti QT (ọgwụ tricyclic antidepressants, ọgwụ antipsychotic, ọgwụ antiarrhythmic nke III ma ọ bụ klas IA, macrolides), ọ dị mkpa ịkpachara anya.

Ojiji probenecid na ciprofloxacin na-eduga n'ịba ụba nke mkpochasị nke ikpeazụ na plasma ọbara, ebe ọ bụ na akụrụ ya na-ewepu oke onwe ya na-ebelata.

Site na iji omeprazole na ciprofloxacin na-emekọ ihe ọnụ, ọgwụ kachasị na plasma nwere ike belata ntakịrị, mpaghara n'okpuru usoro "ịta - oge" na-ebelata.

Ojiji nke ciprofloxacin na methotrexate nwere ike belata akụrụngwa metabolism nke ikpeazụ, nke a na-agbakwunye na mmụba na ịta ya na plasma ọbara yana oke ihe ọghọm nke mmetụta methotrexate. A naghị atụ aro ka ị jiri ciprofloxacin na methotrexate n'otu oge.

Site n'iji ihe ndị nwere ike egbochi CYP450 1A2 isoenzyme (dịka ọmụmaatụ, fluvoxamine) na duloxetine, enwere ike ịhụ mmụba na Cmax na AUC nke duloxetine. Agbanyeghi enweghi data banyere nmekorita nke nwere na duloxetine na ciprofloxacin, inwe mmekorita yiri ya ma o buru na ejiri ha n'otu oge.

Ojiji nke ciprofloxacin na ropinirole na-eduga na mmụba na AUC na Cmax nke ikpeazụ site na 84 na 60%, n'otu n'otu. A na-atụ aro ka ị nyochaa nsonaazụ ropinirole mgbe ejiri ya na ciprofloxacin, yana obere oge mgbe njedebe ngwakọta ọgwụgwọ.

Ojiji nke ciprofloxacin (250 mg maka ụbọchị 7) na clozapine na-akpata ihe egwu nke mmụba n'ọbara nke ikpeazụ na N-desmethylclozapine site na 29 na 31%, n'otu n'otu. Ọ dị mkpa ịgbanwe usoro usoro ọgwụgwọ nke clozapine mgbe ejikọtara ya na ciprofloxacin, yana obere oge mgbe ngwụsị usoro ọgwụgwọ jikọtara ọnụ.

Ojiji nke ciprofloxacin (500 mg) na sildenafil (50 mg) nwere ike ibute mmụba okpukpu abụọ na AUC na Cmax nke ikpeazụ. Ebumnuche nke ngwakọta a bụ naanị mgbe ị tụlechara mmekọrịta dị n'etiti uru na ọghọm dị na ya.

Analogues nke Ciprofloxacin bụ Vero Ciprofloxacin, Basij, Betatsiprol, Kvintor, Infitsipro, Nirtsil, Oftotsipro, Tseprova, Rotsip, Protsipro, Tsiprobid, Tsiprobay, Tsiproksil, Tsiprodoks, Tsiprolet, Tsiprolaker, Tsipromed, Tsiprolon, Tsiprofloksabol, Tsiprolan, Tsifroksinal, Ekotsifol, Tsifratsid , Dijitalụ.

Usoro na ọnọdụ nchekwa

Ndụ nchekwa nke ọgwụ na mbadamba bụ afọ atọ.

E kwesịrị idobe mbadamba n'ime nkụ, gbara ọchịchịrị na-enweghị ike iru ụmụaka na okpomọkụ ruo 30 Celsius.

Ndụ nchekwa nke ndị uche bụ afọ 2.

Ekwesịrị ịchekwa mkpụrụ obi a na ebe gbara ọchịchịrị ka ụmụaka ghara iru okpomọkụ ruo 25 Celsius. Emela ifriizi.

Ndụ nchekwa nke ihe ngwọta bụ afọ 3.

Ekwesịrị ịchekwa ihe ngwọta ya site na iru ụmụaka agaghị enweta ya na okpomọkụ ruo 25 Celsius. Emela ifriizi.

Okwu maka ntị na anya iri bụ afọ atọ.

Enwere ike iji ọgwụ ahụ mee ihe n'ime izu anọ mgbe ịmepechara karama.

Ọnụ ego nke ciprofloxacin na pharmacies

Ọnụahịa Ciprofloxacin 250 mg (mbadamba 10 kwa mkpọ) bụ ihe dịka 20 rubles.

Ọnụahịa Ciprofloxacin 500 mg (mbadamba 10 kwa mkpọ) bụ ihe dịka 40 rubles.

Ọnụahịa nke ciprofloxacin n'ụdị nke ihe ngwọta maka infusion (100 ml) bụ ihe dị ka 35 rubles.

Pricegwọ nke ciprofloxacin n'ụdị ọdịda anya (5 ml) bụ ihe ruru 25 rubles.

Nyocha na Ciprofloxacin

Nyocha banyere ciprofloxacin n'ụdị mbadamba ụrọ bụ ihe arụ ụka: ụfọdụ ndị ọrụ na-akpọ ọgwụ ahụ ka ọ dị mma, ndị ọzọ anaghị ahụ isi ya na ojiji ya. Imirikiti nyocha na-ekwu nsonaazụ ndị ọzọ.

Nyocha nke nyocha nke anya dị mma.

Dabere na ndị dọkịta, ciprofloxacin nwere uru ndị a:

ezigbo ndidi
enwere ike iji ya na gburugburu ụlọ ọgwụ maka ọgwụgwọ antibacterial ọgwụgwọ nke ọrịa na-efe efe nke ukwuu, yana maka ọgwụgwọ nke ndị obodo enwetara na ọrịa ụlọ ọgwụ ọ bụla,
nnukwu nje na ọgwụ nje,
ogologo oge ndụ ọkara na mmetụta ọgwụ mgbochi ọgwụ (na-enye gị ohere ị theụ ọgwụ ahụ naanị ugboro 2 n'ụbọchị).

Hụrụ njehie na ederede? Họrọ ya wee pịa Ctrl + Tinye.

Ojiji nke ciprofloxacin

Ọrịa nje na-enweghị mgbagha na mgbagwoju anya nke microorganisms na-enwe mmetụta nke ciprofloxacin.

Ọrịa akụkụ akụkụ okuku ume, tinyere nnukwu na ala ala (na nnukwu ogbo) bronchitis, bronchiectasis, nje na-efe efe nke cystic fibrosis, oyi baa mere Klebsiella spp., Enterobacter spp., Proteus spp., Esherichia coli. Pseudomonas aeruginosa, Haemophilus spp., Moraxella catarrhalis, Legionella spp. na staphylococci, ọrịa nke akụkụ ENT, gụnyere etiti ntị (otitis media), paranasal sinuses (sinusitis, gụnyere nnukwu), nke kpatara micromgangan gram-negative, gụnyere Pseudomonas aeruginosa ma ọ bụ staphylococci, ọrịa nke usoro mkpụrụ ndụ (gụnyere cystitis, pyelonephritis, adnexitis, prostatitis bakteria na-adịghị ala ala, orchitis, epididymitis, gonorrhea na-enweghị nsogbu), ọrịa intra-ciki (na njikọ ya na metronidazole), gụnyere peritonitis, gallbladder na biliary tract na-efe efe, anụ ahụ na anụ ahụ dị nro na-efe efe (ọnya ọnya, ọnya, ọnya ọkụ, ọnya ọnya, ọnya nkwonkwo), ọnya na nkwonkwo (osteomyelitis, ọrịa ogbu na nkwonkwo), sepsis, fever na-efe efe, campylobacteriosis, shigellosis, ọrịa njem, ọrịa ma ọ bụ prophylaxis nke ọrịa na immunocompromised ọrịa (ndị ọrịa na-ewere immunosuppressive ọgwụ ma ọ bụ ndị ọrịa na neutropenia), na-ahọpụta ụbụrụ na-egbu egbu na immunocompromised ndị ọrịa, igbochi na ọgwụgwọ nke ọrịa akwara ume. rskoy onya (ọrịa Bacillus anthracis), mgbochi ọrịa ndị na - efe efe kpatara Neisseria meningitidis.

Ọgwụgwọ maka nsogbu ndị ọ kpatara Pseudomonas aeruginosa, n’ime ụmụaka ndị dị n’agbata afọ ise ruo afọ iri na asaa na-arịa ọrịa akwara na-egbochi akwara, mgbochi na ọgwụgwọ nke ọrịa anonia na-efe efe Bacillus anthracis).

N'ihi ihe omume ga - ekwe omume site na njikọta yana / ma ọ bụ anụ ahụ ndị gbara ya gburugburu (lee “nsonaazụ”), dọkịta kwesịrị ibuputa ahụike na ịgwọ ọrịa dị egwu na ụmụaka na ndị nọ n'afọ iri na ụma na mgbe nyochachara nke ọma banyere uru ọ bara uru.

Maka iji ophthalmic. Ọgwụ nke ọnya afọ na ọrịa nke akụkụ ihu nke nku anya na ngwa ya kpatara nje na-enwe mmetụta nke ciprofloxacin na ndị okenye, ụmụ amụrụ ọhụrụ (site na ụbọchị 0 ruo 27), ụmụ aka na ụmụ aka (site na ụbọchị 28 ruo ọnwa 23), ụmụaka (site na 2 ruo 11) afọ) na ndị nọ n’afọ iri na abụọ (afọ iri na asatọ na asatọ).

Ihe mgbochi ngwa

Ọrịa ụbụrụ arteriosclerosis siri ike, ihe kpatara ụbụrụ, ohere nke ịgbatị ogologo oge nke QT ma ọ bụ mmepe nke ụdị ụdịhyhymizim (dịka, ịgbatị oge nke oge QT, ọrịa obi (nkụchi obi, ụbụrụ myocardial infarction, bradycardia)), elektrolyte impaylance (dịka ọmụmaatụ, na hypokalemia, ) ụkọ glucose-6-phosphate dehydrogenase, ojiji nke ọgwụ n’otu oge na-agbatị oge QT (gụnyere ọgwụ antiarrhythmic nke klaasị IA na III, antidepressants tricyclic, macrolides, neur). oleptiki), iji ya mee ihe n'otu oge na ndị na-egbochi CYP1A 2 isoenzyme, gụnyere methylxanthines, gụnyere theophylline, caffeine, duloxetine, clozapine, ropinirole, olanzapine (lee "Mmezi"), ndị ọrịa nwere akụkọ banyere mbibi akwara metụtara. na quinolones, ọrịa uche (ịda mbà n'obi, psychosis), ọrịa ụjọ usoro nke etiti (Akwụkwụ na-adọ, mbelata ihe ọdịdọ (ma ọ bụ akụkọ ihe mere eme nke ihe ọdịdọ)), mmebi ụbụrụ ma ọ bụ ọrịa strok, myasthenia gravis. gravisoke gbasara akụrụ na / ma ọ bụ imeju akwara, ịka nká.

Mmekorita

Ọgwụ ndị na-akpata ogologo oge nke oge QT. Ekwesịrị ịkpachara anya mgbe ị na-eji ciprofloxacin, dị ka fluoroquinolones ndị ọzọ, na ndị ọrịa na-anata ọgwụ nke na-akpata ogologo oge nke oge QT (dịka ọmụmaatụ, klas IA ma ọ bụ III antiarrhythmic ọgwụ, tricyclic antidepressants, macrolides, antipsychotics) (lee "cakpachara Anya").

Theophylline. Ojiji nke ciprofloxacin na ọgwụ nwere theophylline nwere ike ime ka mmụba na-adịghị mma na plasma ọbara na, n'ihi ya, ngosipụta nke ihe mgbu theophylline na-eweta mbibi, n'ọnọdụ ndị adịkarịghị ukwuu, mmetụta ndị a na-emetụta nwere ike igbu onye ọrịa ahụ. Ọ bụrụ n’otu oge iji ọgwụ ọgwụ syprofloxacin na ọgwụ theophylline bụ nke a na-agaghị anabata, ọ na-atụ aro ka ị na-eleba anya n'ihe gbasara mkpụkọ theophylline na plasma ọbara na, ọ bụrụ na ọ dị mkpa, belata ọgwụ theophylline.

Ihe ndi ozo nke xanthine. Ojiji nke ciprofloxacin na caffeine ma ọ bụ pentoxifylline (oxpentifillin) n'otu oge nwere ike ibute mmụba nke mkpokọta ọgwụ xanthine na ọbara.

Phenytoin. N'iji oge nke ciprofloxacin na phenytoin, a hụrụ mgbanwe (nwewanye ma ọ bụ ibelata) na ọdịnaya nke phenytoin na plasma ọbara. Iji zere nkwonkwo metụtara nsonaazụ nke phenytoin, yana iji gbochie ihe ojoo metụtara ya na phenytoin overdose mgbe a kwụsịrị ciprofloxacin, a na-atụ aro ka ị nyochaa ọgwụ phenytoin na ndị ọrịa na-ewere ciprofloxacin, gụnyere mkpebi siri ike nke ọdịnaya phenytoin na plasma ọbara n'oge dum oge. n'otu oge, obere oge mgbe emechara ọgwụgwọ ọgwụ a gwakọtara ọnụ.

Ndị NSAID. Nchikota otutu onyunyo nke quinolones (DNA gyrase inhibitors) na ufodu NSAID (ewezuga acetylsalicylic acid) nwere ike ibute oria.

Cyclosporin. Site n'iji ciprofloxacin na ọgwụ nwere cyclosporine, a hụrụ obere oge dị mkpirikpi oge na plasma creatinine ịta. N'ọnọdụ ndị dị otú a, ọ dị mkpa iji chọpụta mkpokọta nke creatinine n'ime ọbara ugboro abụọ n'izu.

Ndị na-arịa ọrịa hypoglycemic na-arịa ọrịa insulin. N'iji oge nke ciprofloxacin na ọnụ nke hypoglycemic waksị, tumadi sulfonylureas (dịka ọmụmaatụ, glibenclamide, glimepiride), ma ọ bụ insulin, mmepe nke hypoglycemia nwere ike ịbụ n'ihi mmụba nke ọrụ ndị na - ahụ ike hypoglycemic (lee “Mmetụta mmetụta”). Ọ dị mkpa iji nlezianya nyochaa ọkwa nke glucose ọbara.

Probenecid. Probenecid na-eme ka ọnụego nri afọ dị na nri kwụsịlata site na akụrụ. Ojiji nke ciprofloxacin na ọgwụ nwere probenecid na-eduga n'ịba ụba nke mkpokọ ciprofloxacin n'ọbara ọbara.

Methotrexate. Site n'iji methotrexate na ciprofloxacin na-eme n'otu oge, ebili ibu nke renho tubular nke methotrexate nwere ike belata, nke enwere ike ibute mgbako nke methotrexate na plasma ọbara. N'okwu a, ị ga-enwe ike ịmụba mmetụta nke methotrexate. N'akụkụ a, ndị ọrịa na-anata ma methotrexate na ciprofloxacin kwesịrị ka enyocha ya nke ọma.

Tizanidine. N'ihi nnyocha ọmụmụ banyere ndị ọrụ afọ ofufo nwere ahụike na oge nke ciprofloxacin na ọgwụ nwere tizanidine, ekpughere mmụba nke tizanidine na plasma ọbara._max Oge asaa (site na oge anọ ruo 21) na AUC - ugboro 10 (site na 6 ruo 24 ugboro). Site na mmụba na mkpokọta nke tizanidine na ọbara, a na-ejikọ mmetụta dị ala (mbelata ọbara) na ogwuura (iro ụra, ịda mbà). Na ojiji nke ciprofloxacin yana ọgwụ nwere tizanidine amachibidoro.

Omeprazole Site na iji ọgwụ nri ejikọtara ọnụ na ọgwụ ọgwụ Omeprazole, enwere ike ịbelata ntakịrị ihe na C._max ciprofloxacin na plasma na mbelata na AUC.

Duloxetine N'ime ule nke ụlọ ọgwụ, e gosipụtara ya na ojiji nke duloxetine na ndị na-egbochi CYP1A 2 isoenzyme (dị ka fluvoxamine) nwere ike ibute mmụba na AUC na C_max duloxetine. N'agbanyeghị enweghị data nyocha gbasara mmekọrịta dị n'etiti gị na ciprofloxacin, ọ ga-enwe ike ịkọ ma enwere ike ịmekọrịta ụdị mmekọrịta a na oge nke ciprofloxacin na duloxetine.

Ropinirol. Ojiji nke ropinirole na ciprofloxacin, ihe mgbochi na-enweghị atụ nke isoenzyme CYP1A 2, na-eduga na mmụba na C_max na ropinirole AUC site na 60 na 84%, n'otu n'otu. Ekwesịrị inyocha mmetụta ndị dị na ropinirole mgbe ejiri ya na ciprofloxacin yana obere oge mgbe ọ gbasịrị ọgwụgwọ njikọta.

Lidocaine. N'ime ọmụmụ metụtara ndị ọrụ afọ ofufo nwere ahụike, achọpụtara na n'otu oge eji ọgwụ lidocaine nwere ọgwụ na ciprofloxacin, ihe na-egbochi ọpụpụ nke isoenzyme CYP1A 2, na-eduga n'ibelata mwepụ nke lidocaine site na 22% na nchịkwa iv. N'agbanyeghị ezigbo nnabata nke lidocaine, yana iji ya emekọ ihe ọnụ na ciprofloxacin, enwere ike ịkwalite nsonaazụ ya n'ihi mmekọrịta.

Clozapine. Site n'otu oge iji clozapine na ciprofloxacin na dose nke 250 mg maka ụbọchị 7, ọnụọgụ ọbara n'ọtụtụ nke clozapine na N-desmethylclozapine hụrụ 29 na 31%, n'otu n'otu. Ekwesịrị ilebara ọnọdụ onye ọrịa ahụ anya ma, ọ bụrụ na ọ dị mkpa, dozie regimen nke clozapine n'oge ejiri ya na ciprofloxacin yana n'ime obere oge mgbe ọ gbasịrị ọgwụgwọ ọgwụ.

Sildenafil. Site na iji ciprofloxacin na dose nke 500 mg na sildenafil na dose nke 50 mg na ndị ọrụ afọ ofufo ahụike, a chọpụtara mmụba na C._max na AUC nke sildenafil ugboro abụọ. N'akụkụ a, ojiji nke ngwakọta a ga-ekwe omume naanị mgbe ị tụlechara uru / ọghọm ruru.

Vitamin K Antagonists Nchịkọta ojiji nke ciprofloxacin na vitamin K antagonists (dịka warfarin, acenocumarol, fenprocoumon, fluindione) nwere ike ibute mmụba na mmetụta anticoagulant ha. Ogo nke mmetụta a nwere ike ịdị iche dabere na ọrịa concomitant, afọ na ọnọdụ izugbe nke onye ọrịa, ya mere o siri ike ịtụle mmetụta nke ciprofloxacin na mmụba na INR. O zuru ezu iji chịkwaa INR na ojiji nke ciprofloxacin na vitamin K antagonists, yana obere oge mgbe ọ gbasịrị ọgwụgwọ njikọta.

Ọgwụ cationic. Nlekọta ọnụ nke ejikọtara ọnụ nke ciprofloxacin na ọgwụ cationic - mgbakwunye ịnweta nwere kalsium, magnesium, aluminom, iron, sucralfate, antacids, polymeric phosphate compound (dịka ọmụmaatụ, diflamer, carbonhanum carbonate) na ọgwụ ọjọọ nwere ikike nchekwa (dịka ọmụmaatụ didanosine) nwere magnesium, aluminom ma ọ bụ nke kalsal - na-ebelata nnabata nke ciprofloxacin. N'ọnọdụ dị otu a, ekwesịrị ị ciụ mmiri ahụ 1-2 awa tupu ma ọ bụ awa 4 mgbe ị drugsụsịrị ọgwụ ahụ.

Nri na ahihia ara. Ekwesịrị izere ọnụ nchịkwa ọnụ nke ciprofloxacin na ngwaahịa mmiri ara ehi ma ọ bụ ihe ọ drinksụ fortụ siri ike na mineral (dịka mmiri ara ehi, yogọt, ihe ọciumụ calụ calcium wusiri ike), ebe ọ bụ na enwere ike belata mmịpụta nke ciprofloxacin. Calcium dị na nri nkịtị anaghị emetụta mmụba nke ciprofloxacin.

Emebeghi ihe omumu puru iche nke mmekorita a site na iji usoro opprohalmic nke ciprofloxacin. N'iburu n'uche ịdị ala nke ciprofloxacin na plasma ọbara mgbe instillation banye na oghere njikọ ahụ, mmekọrịta dị n'etiti ọgwụ ọnụ ejikọtara ya na ciprofloxacin bụ eleghi anya. N'ihe banyere iji nkwonkwo mee nkwadebe ophthalmic ndị ọzọ dị na mpaghara, oge dị n'etiti ojiji ha kwesịrị ịbụ opekata mpe 5, ebe mmanu mmanụ ga-eji ikpeazụ.

Nlele anya Ciprofloxacin

Ọrịa siri ike, ọrịa staphylococcal na ọrịa nke gram-positive na nje anaerobic kpatara. Na ọgwụgwọ nke ọrịa siri ike, ọrịa staph na nje nke nje nje anaerobic kpatara, a ga-eji ciprofloxacin mee ya na ndị nnọchi ọgwụ nje kwesịrị ekwesị.

Ọrịa dị iche iche na-akpata pneumoniae Streptococcus. A naghị akwado Ciprofloxacin maka ọgwụgwọ nke ọrịa ndị ọ kpatara Ahụ ike na-efe efe, n'ihi ịdị oke ya n'ihe metụtara nje a.

Ọrịa ọnya afọ. Maka ọrịa ọrịa a na-ebute n'ọbara Neisseria gonorrhoeaena-eguzogide ọgwụ fluoroquinolones, a ga-eburu n'uche ihe mgbochi mpaghara nke ciprofloxacin na ịdị mkpa nke nkwenye nke pathogen ga-enyocha site na nyocha ụlọ nyocha.

Mmebi nke obi. Ciprofloxacin na-emetụta ịgbatị oge nke QT (lee "Nsonaazụ"). N'iburu n'uche na ụmụ nwanyị nwere oge dị ogologo karịa nke oge QT ma e jiri ya tụnyere ụmụ nwoke, ha na-enwe mmetụta dị nro karịa ọgwụ ndị na-akpata ịgbatị oge nke QT. N'ime ndị ọrịa agadi, enwerekwa mmụọ na-arịwanye elu maka ịme ọgwụ, na-eme ka ịgbatị oge QT. Ya mere, a ga-eji ciprofloxacin jiri nlezianya tinye yana ọgwụ na-agbatị oge QT (dịka ọmụmaatụ, klas IA na III antiarrhythmic ọgwụ, ọgwụ tricyclic antidepressants, macrolides na ọgwụ antipsychotic) (lee “Mmekọrịta”), ma ọ bụ na ndị ọrịa nwere oke ihe ize ndụ nke ịgbatị oge QT ma ọ bụ ịmalite pirouette ụdị arrhythmias (dịka ọmụmaatụ, ịmụ nwa QT nkeji oge na-agbatịkwu ọrịa, ahaghị ala elektrolyte electrolyte, dịka hypokalemia ma ọ bụ hypomagnesemia, yana ọrịa obi dịka nkụchi obi, inf. myocardial artery, bradycardia).

Jiri na umuaka. Achọpụtara ya na ciprofloxacin, dị ka ọgwụ ọgwụ ndị ọzọ nke klas a, na-akpata ọrịa ogbu na nkwonkwo buru ibu na anụmanụ.

Nnyocha nke data nchekwa ugbu a maka ojiji nke ciprofloxacin na ụmụaka na-erubeghị afọ 18, ọtụtụ n'ime ha nwere cystic fibrosis, emebeghi njikọ n'etiti mmebi nke cartilage ma ọ bụ nkwonkwo na ciprofloxacin. A naghị atụ aro ka iji ciprofloxacin na ụmụaka site na afọ 5 ruo 17 maka ọgwụgwọ nke ọrịa ndị ọzọ, belụsọ maka nsogbu nke fibrosis cystic metụtara. Pseudomonas aeruginosa, yana ọgwụgwọ na mgbochi nke ọrịa ọgụ na-efe efe (mgbe enyochiri ma ọ bụ oria egosipụtara na ọ bụ oria Bacillus anthracis).

Hypersensitivity. Mgbe ụfọdụ mgbe ị takingụsịrị ọgwụ mbụ nke ciprofloxacin, hypersensitivity nwere ike ịmalite, gụnyere Mmeghachi omume nfụkasị ahụ, nke a ga-agwa dọkịta na-aga ahụ ozugbo (lee "Nsonaazụ"). N’ọnọdụ ndị a na-adịghị ahụkebe, mgbe ojiji nke mbụ gasịrị, mmeghachi omume anaphylactic nwere ike ime ruo ujo anaphylactic. N'ọnọdụ ndị a, ojiji nke ciprofloxacin ga-akwụsị ozugbo yana ekwesịrị ịme ọgwụgwọ kwesịrị ekwesị.

Ọkpụkpụ afọ. Ọ bụrụ na afọ ọsịsa na-egbu mgbu ma na-adị ogologo oge pụtara ma ọ bụ mgbe a gwọchara ya na ciprofloxacin, a ga-ewepụ ihe nchoputa nke pịudomembranous colitis, nke chọrọ iwepụ ciprofloxacin ozugbo na oge ịgwọ ya kwesịrị ekwesị (ọnụọgụ vancomycin na ọnụọgụ 250 mg ugboro anọ kwa ụbọchị) (lee “Nsonaazụ”).

Ihe ọgwụ ndị na-egbochi imeju afọ anaghị egbochi ya.

Usoro hepatobiliary. Site n'iji ciprofloxacin, enweela ọrịa ikpere akwara na ọrịa imeju na-eyi ndụ egwu. Ọ bụrụ na enwere ihe ịrịba ama nke ọrịa imeju dịka anorexia, jaundice, mmamịrị gbara ọchịchịrị, itching, mgbu n'ime afọ, a ga-akwụsị ciprofloxacin (lee “Side effects”).

N'ime ndị ọrịa na-ewere ciprofloxacin ma na-arịa ọrịa imeju, mmụba na-adịru nwa oge na ọrụ hepatic transaminases, alkaline phosphatase, ma ọ bụ cholestatic jaundice nwere ike ịhụ (lee “Nsonaazụ”).

Sistem akwara. Ọrịa nwere nnukwu myasthenia gravis Ekwesịrị iji nlezianya meeprofloxacin, dị ka iwe ga-ekwe omume.

Mgbe ị na-a ciụ ọgwụ ciprofloxacin, enwere ike inwe ikpe nke akwara na nkwonkwo (tumadi Achilles), oge ụfọdụ, esesịn n’ime oge 48 izizi ka ịmalite ọgwụgwọ. Ọrịa Tendon na nkụda mmụọ nwere ike ibilite ọbụna ọtụtụ ọnwa ka akwụsịrị ụgwọ ọrụ ciprofloxacin. N'ime ndị ọrịa agadi na ndị ọrịa nwere oria ndị na-enweta ọgwụgwọ n'otu oge n'otu oge corticosteroids, enwere ohere dị ukwuu nke tendinopathy.

Na ihe ịrịba ama mbụ nke tendonitis (mgbu na-egbu mgbu na nkwonkwo, mbufụt), a ga-akwụsị ojiji nke ciprofloxacin, a ga-ewepụ mmega ahụ, n'ihi na enwere ọghọm imebi akaị, wee gakwuru dibia. Ekwesịrị iji Ciprofloxacin jiri nlezianya mee ihe na ndị ọrịa nwere akụkọ ọrịa nke akwara metụtara ojiji quinolones.

Usoro ụjọ. Ciprofloxacin, dị ka fluoroquinolones ndị ọzọ, nwere ike ịkpalite nkụda mmụọ ma belata ọnụego maka ịdị njikere. N'ime ndị ọrịa nwere ọrịa akwụkwụ na-arịa ọrịa akwara dị ala (dịka ọmụmaatụ, mbelata ọnụnọ nke ọdịdọ, akụkọ ihe mere eme nke ihe mberede, ọrịa ụbụrụ, ma ọ bụ ọrịa strok), n'ihi ihe ize ndụ nke mmeghachi omume CNS, a ga-eji ciprofloxacin naanị mgbe atụmanya a tụrụ anya. mmetụta a na-adakarị karịa ihe ọghọm ndị ọ na-akpata.

Mgbe ị na-eji ciprofloxacin, ekwupụtala banyere mmalite nke ọnọdụ akwụkwụ ọtọ (lee “Nsonaazụ”). Ọ bụrụ na ihe ọdịdọ mere, ekwesịrị ịkwụsị ọrụ nke ciprofloxacin. Mmeghachi omume echiche nwere ike ime ọbụlagodi mgbe ojiji izizi fluoroquinolones, gụnyere ciprofloxacin. N’ọnọdụ ndị a na-adịghị ahụkebe, ịda mbà n’obi ma ọ bụ mmeghachi omume mmetụta uche pụrụ ịmalite inwe echiche igbu onwe onye na omume imerụ onwe ya ahụ, dị ka ịnwa igbu onwe ya, ihe ọ bụla. gbara mbọ (lee "Nsonaazụ"). Ọ bụrụ na onye ọrịa ebute otu n'ime mmeghachi omume ndị a, ịkwesịrị ịkwụsị ị stopụ ciprofloxacin ma gwa dọkịta gị.

Ndị ọrịa na-a fluụ fluoroquinolones, gụnyere ciprofloxacin, ekwupụtawo ikpe nke sensorimotor polyneuropathy, hypesthesia, dysesthesia, ma ọ bụ adịghị ike. Ọ bụrụ na mgbaàmà dịka mgbu, ọkụ, ọgbụgba, ọnụọgụ, adịghị ike, ndị ọrịa kwesịrị ịgwa dọkịta ha tupu ha aga n'ihu na ciprofloxacin.

Akpụkpọ ahụ. Mgbe ị na-ewere ciprofloxacin, mmeghachi omume nke fotoensitization nwere ike ime, yabụ ndị ọrịa kwesịrị izere kọntaktị na ìhè anyanwụ na ìhè UV. Ekwesịrị ịkwụsị ọgwụgwọ ma ọ bụrụ na achọpụtara ihe mgbapụta nke ọrịa (dịka ọmụmaatụ, mgbanwe na akpụkpọ ahụ yiri anwụ anwụ) (lee “Nsonaazụ”).

Cytochrome P450. A maara na ciprofloxacin bụ ihe mgbochi na-enweghị atụ nke isoenzyme CYP1A 2. Ekwesịrị ịkpachara anya mgbe ị na-eji ciprofloxacin na ọgwụ metabolized site na isoenzyme a, gụnyere methylxanthines, gụnyere theophylline na caffeine, duloxetine, ropinirole, clozapine, olanzapine, dị ka mmụba na ịta ọgwụ ndị a n'ọbara ọbara, n'ihi ihe mgbochi nke metabolism ha site na ciprofloxacin, nwere ike ibute mmeghachi mmebi kpọmkwem.

Mmeghachi omume mpaghara Site na ntinye / na ntinye nke ciprofloxacin, mmeghachi omume mkpali mpaghara nwere ike ime na ntụtụ ahụ (edema, mgbu). Mmeghachi omume a na-ahụkarị ma ọ bụrụ na oge infusion dị nkeji iri atọ ma ọ bụ obere. Mmeghachi omume ahụ na-agafe ngwa ngwa ngwụsị nke infusion ma ọ bụghị contraindication maka nchịkwa na-esote, belụsọ na usoro ya siri ike.

Iji zere mmepe nke kristalia, ọgwụ a na-atụ aro kwa ụbọchị ekwesịghị ịgabiga, mmiri zuru oke na ntinye nke mmeghachi mmamịrị acidic dịkwa mkpa. Site na nhazi oge a na-arụ ọrụ nke ciprofloxacin na ọgwụ izugbe site na otu usoro nkwekọrịta barbituric acid, na-enyocha ọnụego obi oge niile, ọbara mgbali elu, ECG dị mkpa. Na vitro ciprofloxacin nwere ike igbochi nyocha nke ọrịa nje Mycobacterium ụkwara nta, na-ebelata uto ya, nke nwere ike ibute nsonaazụ na-adịghị mma na nchoputa nke a pathogen na ndị ọrịa na-ewere ciprofloxacin.

Ogosi nri ugboro ugboro na ugboro ugboro nke ciprofloxacin nwere ike ibute superinfection na nje na-eguzogide ọgwụ ma ọ bụ nje na-efe efe.

Mmetụta ikike ịkwọ ụgbọala na usoro. N'oge usoro ọgwụgwọ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala na usoro, yana mgbe ị na-eme ihe ndị ọzọ nwere ike ịdị ize ndụ chọrọ mgbanye uche na ọsọ nke mmeghachi omume psychomotor. Site na mmepe nke mmeghachi omume na-adịghị mma site na sistemụ ụjọ (dịka ọmụmaatụ, dizzness, convulsions), mmadụ kwesịrị ịhapụ ịnya ụgbọ ala na itinye aka na ihe omume ndị ọzọ chọrọ ịbawanye anya na ọsọ nke mmeghachi omume psychomotor.

Ahụmahụ a na-adakarị na ciprofloxacin na ụmụaka na-erubeghị afọ 1 nwere mmachi. A naghị atụ aro iji ciprofloxacin na ophthalmia nke ụmụ amụrụ ọhụrụ na gonococcal ma ọ bụ chlamydial etiology n'ihi enweghị ozi gbasara iji otu ndị ọrịa a. Ndị ọrịa nwere ophthalmia nke ụmụaka kwesịrị inweta ọgwụgwọ etiotropic kwesịrị ekwesị.

Site na iji ọgwụ opprohalmic nke ciprofloxacin, enwere ike ibute ụzọ nke rhinopharyngeal, nke nwere ike ibute mmụba ugboro ugboro yana mmụba nke nguzogide nje.

N'ime ndị ọrịa nwere ọnya afọ, a hụrụ ngosipụta nke iku ume kristal dị ọcha, nke bụ nsị nke ọgwụ ahụ. Nchịkọta ahụ anaghị egbochi ndị ọzọ ojiji nke ciprofloxacin ma ọ naghị emetụta ya ọgwụgwọ. A na-ahụta ọdịdị nke oge site na awa 24 ruo ụbọchị 7 mgbe mmalite nke ọgwụgwọ, resorption ya nwere ike ime ozugbo etolite ma n’ime ụbọchị 13 ka mmalite nke ọgwụgwọ gasịrị.

A na-atụghị ime anya kọntaktị anya n'oge ọgwụgwọ.

Mgbe ophthalmic jiri ciprofloxacin, mbelata ịdị ọcha nke anya a ga-ekwe omume, yabụ, ozugbo ejiri ya, anaghị atụ aro ya ịkwọ ụgbọ ala ma tinye aka n'ihe omume chọrọ nlebara anya na ọsọ nke mmeghachi omume psychomotor.