Post on 29-May-2019
transcript
gamoyenebis farTo speqtri
urologia
nefrologia
kardiologia
intensiuri Terapia
otorinolaringologia
pulmonologia
neiroqirurgia
travmatologia
orTopedia
onkologia
hematologia
infeqciuri sneulebebi
dermatologia
1 ineqcia dReSi
1-li empiruli monoTerapiisaTvis
1-li msoflioSi saineqcio antibiotikebs Soris
Terapia
pediatria
qirurgia
ginekologia
neonatologia
Terapia
pediatria
qirurgia
ginekologia
neonatologia
ბროშურა განკუთვნილია ჯანდაცვისპერსონალისათვის
24- saaTiani moqmedeba erTi ineqciis Semdgom!
rocefini - lideri saineqcioantibiotikebs Soris
ra ZiriTad moTxovnebs uyeneben sxvadasxva
specialobis eqimebi universalur antibiotiks?
1.
2.
3.
rocefini — lideri saineqcio antibiotikebs Soris. is akmayofilebs universaluri antibiotikisadmi zemoCamoTvlil yvela moTxovnas.
rocefini — arCevis preparati mravali, maT Soris mZime, sicocxlisaTvis saSiSi infeqciebis samkurnalod.
unda gamoirCeodes maRali efeqturobiT:a) organizSi moxvedrisas unda qmnides da xangrZlivad inarCunebdes maqsimalur damTrgunvel koncentracias baqteriebis gasanadgureblad;b) gamoirCeodes maRali SeRwevadobiT qsovilebsa da organoebSi;g) hqondes sarwmuno klinikuri efeqturobis da usafrTxoebis monacemebi.
farmakokinetikuri maxasiaTeblebi unda uzrunvelyofdespreparatis maRal klinikur efeqturobas.
unda axasiaTebdes usarTxoebis maRali profili.
rocefinis upiratesobebi da damaxasiaTebeli Tvisebebi
1. moqmedebis farTo speqtrirocefins axasiaTebs Zalzed maRali baqteriociduli aqtivoba paTogenTa umravlesobis mimarT, maT Soris betalaqtamazawarmomqmneli baqteriebis mimarT.
gram dadebiTi aerobebi: Staphylococcus aureus (MSSA- meticilin mgrZnobiare), Staphylococci coagulase-negative, Streptococcus pyogenes (A jgufis), Streptococcus agalactiae (B jgufis),
Streptococci (arc A, arc B jgufis), Steptococcus viridans, Steptococcus pneumoniae(SeniSvna: MR stafilokokebi, Enterococcus faecalis, Enterococcus faecium, Listeria monocytogenes rezistentulia ceftriaqsonis mimarT)
gram uaryofiTi aerobebi: Acinetobacter Acinetobacter antitratus, Aeromonas hydrophila, Ascaligenes faecalis, Ascaligenes odorans, Borrelia burgdorferi, Capnocytophaga spp., Citrobacter diversus, Citrobacter freundii, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Haemophilus ducreyi, Haemophilus Haemophilus par Hafnia alvei, Klebsiella oxytoca, Klebsiella pneumoniae, Moraxella catarrhalis, Moraxella osloensis, Moraxella spp., Morganella morganii, Neisseria meningitidis, Neisseria gonorrhoea, Pasteurella mutocida, Plesiomonas shigelloides, Proteus mirabilis, Proteus pennei, Proteus vulgaris, Pseudomonas spp., Providentia rettgeri, Providentia spp., Salmonella typhi, Salmonella Spp.(aratifoiduri), Serratia marcescens, Serratia spp., Shigella spp., Vibrio spp., Yersinia enterocolitica, Yersinia spp.(SeniSvna: mcire gamonaklisis garda P. aeruginosa Stamebi mdgradia ceftriaqsonis mimarT, magram maTTan mimarTebaSi da, aseve, sxva gram uaryofiT baqteriebTan mimarTebaSi arsebobs sinergizmi rocefinsa da aminoglikozidebs Soris.)anaerobebi: Bacteroides spp., Clostrudium spp. (Cl. – s garda), Fusobacterium nucleatum, Fusobacterium spp., anaerobica (adre Peptococcus), Peptostreptococcus spp.
(SeniSvna: betalaqtamazwarmomqmneli Bacteroides spp. mravali Stamebi (kerZod B. fragilis ) mdgradni arian. mdgradia agreTve Clostridium .)
rocefinis da sxva cefalosporinebis mik 90 sxvadasxva paTogenTa mimarT:
rocefini - baqteriologiuri gankurnebis maCveneblebi
mik90 - aris anti-biotikis minimaluri inhibitoruli kon-centracia, romelic saWiroa gamosakvlevi mikroorganizmis Stamebis 90% is zrdis dasaTrgunavad (isaz-Rvreba mg/l, mkg/ml)
klinikuri mniSvneloba:
paTogeni rocefini mik90 (mg/l)
cefotaqsimi mik90 (mg/l)
ceftazidimi mik90 (mg/l)
Escherichia coli 0,25 1,0 2,0
Klebsiella pneumoniae 0,25 1,0 1,0
Enterobacter cloacae 16 64 64
Proteus mirabilis 0,015 0,24 1,0
Staphylococcus aureus 4 8,0 8,0
0,06 0,03 0,12
Streptococcus pneumoniae 0,025 0,06 0,5
infeqciis lokalizacia
paTogenebi
Staph. aureus
Strept. pneumoniae
E. coli
K. pneumoniae
H. Pr. mirabilis
qvemo sasunTqi gzebi 85,3% 100,0% 95,2% 92,6% 100,0% 100,0%
kani da kanqveSa qsovili 93,8% 90,0% 93,3%
baqteriuli sefsisi 88,2% 100,0% 100,0% 100,0% 100,0%
Zval-saxsrovani sistema 95,5% 100,0% 92,9% 100,0% 100,0%
saSarde gzebi 99,4% 100,0% 96,6%
muclis Rru 87,0% 97,5%
tvinis garsebi 100,0% 100,0%
saerTo maCvenebeli 93,3% 100,0% 97,7% 95,2% 100,0% 96%
24- saaTiani moqmedeba erTi ineqciis Semdgom!
maRali aqtivoba infeqciebis yvelaze
xSiri gamomwvevebis mimarT
rocefini - pirveli rigis arCevis preparati empiriuli monoTerapiisaTvis.
rocefinis upiratesobebi da damaxasiaTebeli Tvisebebi
1. moqmedebis farTo speqtrirocefins axasiaTebs Zalzed maRali baqteriociduli aqtivoba paTogenTa umravlesobis mimarT, maT Soris betalaqtamazawarmomqmneli baqteriebis mimarT.
gram dadebiTi aerobebi: Staphylococcus aureus (MSSA- meticilin mgrZnobiare), Staphylococci coagulase-negative, Streptococcus pyogenes (A jgufis), Streptococcus agalactiae (B jgufis),
Streptococci (arc A, arc B jgufis), Steptococcus viridans, Steptococcus pneumoniae(SeniSvna: MR stafilokokebi, Enterococcus faecalis, Enterococcus faecium, Listeria monocytogenes rezistentulia ceftriaqsonis mimarT)
gram uaryofiTi aerobebi: Acinetobacter Acinetobacter antitratus, Aeromonas hydrophila, Ascaligenes faecalis, Ascaligenes odorans, Borrelia burgdorferi, Capnocytophaga spp., Citrobacter diversus, Citrobacter freundii, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Haemophilus ducreyi, Haemophilus Haemophilus par Hafnia alvei, Klebsiella oxytoca, Klebsiella pneumoniae, Moraxella catarrhalis, Moraxella osloensis, Moraxella spp., Morganella morganii, Neisseria meningitidis, Neisseria gonorrhoea, Pasteurella mutocida, Plesiomonas shigelloides, Proteus mirabilis, Proteus pennei, Proteus vulgaris, Pseudomonas spp., Providentia rettgeri, Providentia spp., Salmonella typhi, Salmonella Spp.(aratifoiduri), Serratia marcescens, Serratia spp., Shigella spp., Vibrio spp., Yersinia enterocolitica, Yersinia spp.(SeniSvna: mcire gamonaklisis garda P. aeruginosa Stamebi mdgradia ceftriaqsonis mimarT, magram maTTan mimarTebaSi da, aseve, sxva gram uaryofiT baqteriebTan mimarTebaSi arsebobs sinergizmi rocefinsa da aminoglikozidebs Soris.)anaerobebi: Bacteroides spp., Clostrudium spp. (Cl. – s garda), Fusobacterium nucleatum, Fusobacterium spp., anaerobica (adre Peptococcus), Peptostreptococcus spp.
(SeniSvna: betalaqtamazwarmomqmneli Bacteroides spp. mravali Stamebi (kerZod B. fragilis ) mdgradni arian. mdgradia agreTve Clostridium .)
rocefinis da sxva cefalosporinebis mik 90 sxvadasxva paTogenTa mimarT:
rocefini - baqteriologiuri gankurnebis maCveneblebi
mik90 - aris anti-biotikis minimaluri inhibitoruli kon-centracia, romelic saWiroa gamosakvlevi mikroorganizmis Stamebis 90% is zrdis dasaTrgunavad (isaz-Rvreba mg/l, mkg/ml)
klinikuri mniSvneloba:
paTogeni rocefini mik90 (mg/l)
cefotaqsimi mik90 (mg/l)
ceftazidimi mik90 (mg/l)
Escherichia coli 0,25 1,0 2,0
Klebsiella pneumoniae 0,25 1,0 1,0
Enterobacter cloacae 16 64 64
Proteus mirabilis 0,015 0,24 1,0
Staphylococcus aureus 4 8,0 8,0
0,06 0,03 0,12
Streptococcus pneumoniae 0,025 0,06 0,5
infeqciis lokalizacia
paTogenebi
Staph. aureus
Strept. pneumoniae
E. coli
K. pneumoniae
H. Pr. mirabilis
qvemo sasunTqi gzebi 85,3% 100,0% 95,2% 92,6% 100,0% 100,0%
kani da kanqveSa qsovili 93,8% 90,0% 93,3%
baqteriuli sefsisi 88,2% 100,0% 100,0% 100,0% 100,0%
Zval-saxsrovani sistema 95,5% 100,0% 92,9% 100,0% 100,0%
saSarde gzebi 99,4% 100,0% 96,6%
muclis Rru 87,0% 97,5%
tvinis garsebi 100,0% 100,0%
saerTo maCvenebeli 93,3% 100,0% 97,7% 95,2% 100,0% 96%
24- saaTiani moqmedeba erTi ineqciis Semdgom!
maRali aqtivoba infeqciebis yvelaze
xSiri gamomwvevebis mimarT
rocefini - pirveli rigis arCevis preparati empiriuli monoTerapiisaTvis.
2. farmakokinetikuri maxasiaTeblebi uzrunvelyofs preparatis maRal klinikur efeqturobas
yvelaze xangrZlivi naxevradgamoyofis periodi yvela betalaqtamur antibiotiks Soris - 8 saaTi (axalSobilebsa da moxucebSi16 saaTi) - plazmis cilebTan Seqcevadi SekavSirebis xarjze.
svadasxva betalaqtamuri antibiotikebis naxevradgamoyofis periodebi
klinikuri mniSvneloba: rocefini gamoiyeneba dReSi erTxel mZime infeqciebis mkurnalobis drosac ki.
0 2 4 6 8
cefamandoli
amoqsaciliniklavulanatiT
cefotaqsimi
cefuroqsimi
cefazolini
ceftazidimi
cefoperazoni
rocefini
24- saaTiani moqmedeba erTi ineqciis Semdgom!
xangrZlivi moqmedeba
dozirebis mosaxerxebeli reJimi _ 1 ineqcia dReSi!
maRali baqteriociduli koncentracia plazmaSi 24 saaTis ganmavlobaSi (romelic bevrad aRemateba mik
90-s ZiriTadi
paTogenebisadmi)
0 2 4 6 8 1 0 12 14 16 18 20 22 24
300
200
100
10
1
0,01
Serratia marcesce nsStaphylococcus aureus (MSSA)
Str. pneumoniae
Pruteus vulgaris Enterobacter a nes
St. aureus
St. pneumoniae
E. coliK. pneumoniae
300
meryeoba
preparatis plazmaSi koncentraciis
1g yovel 6 saaTSi erTxel
intravenuriSeyvanis Semdgom
200
100
10
1
0,1
0,010 2 4 6 8 10 12 14 16 18
Haemophilus infuenzae
K. pneumo Proteus mirabilisStreptococcus pneumoniae
S. pyogenes (group A )
niaeNeisseria gonorrhoeaeN. meningitidis
E. coli
0,5
0,1
H. in�uenzae
20 22 24
"Cavardnebi" xanmokle moqmedebis cefalosporinebis baqteriocidul moqmedebaSi cefotaqsimis magaliTze
rocefinis da zogierTi cefalosporinis koncentracia plazmaSi
rocefiniskoncentracia plazmaSi
koncentracia plazmaSi24 saaTis Semdgom
dro (saaTi)
konc
ent
rac
ia (m
kg/m
l)
2 mkg/ml
0,015 mkg/ml
0,06 mkg/ml
0,12 mkg/ml
_<0,25
0,12 mkg/ml
0,06 mkg/ml
0,03 mkg/ml
mik90
mik90
_<0,5mik90
_<4,0mik90
15,1 mgk/ml
9,3 mgk/ml
5,3 mgk/ml
konc
ent
rac
ia (m
kg/m
l)
dro (saaTi)
ceftazidimi1 g i/v (2,4 mgk/ml)
cefuroqsimi750 mg i/m (0,7 mgk/ml)
2g i/v
1g i/v
500 mg i/v
cefoperazoni1 g i/v (0,5 mgk/ml)
cefotaqsimi1 g i/v (0,4 mgk/ml)
24- saaTiani moqmedeba erTi ineqciis Semdgom!
preparatis maRali da stabiluri done plazmaSi
saSualo doza mozrdilTaTvisSeadgens 1-2 grams dReSi
eroge
myisieri da maRali SeRwevadoba organoebsa da qsovilebSi
50
40
30
20
10
0
ko
nc
en
tr
aci
a(m
kg
/ml
)
doza
dro (s)
qsovili/kani
barZayis Tavi
Tavzurg-tvinis siTxe
plevris siTxe
kani filtvisqsovili
gulis sarqvlebi
sakvercxeebiSardi miometriumi
35,0mkg/ml
mkg/ml
32,7mkg/ml
mkg/mlmkg/ml
mkg/ml
6,4
57,4
995
44,6
30,5
2 g
175mg/kg
1-6500mg
6,51 g
42 g
1-21 g
0-22 g
2-32 g
2-31 g
2
37,8
7,0-8,7 mkg/ml
mkg/ml
mkg/ml
mkg/ml
rocefinis koncentraciis done qsovilebsa da qsovilovan siTxeebSi
mik90 zeda zRvari rocefinisadmi mgrZnobiare paTogenebisa Seadgens 4 mkg/ml
klinikuri mniSvneloba: warmoadgens arCevis preparats mravali infeqciuri daavadebis samkurnalod, maT Soris, baqteriuli meningitis (preparati kargad gadis hematoencefalur bariers), pnevmoniis, baqteriuli endokarditis, uroginekologiuri infeqciebis, osteomielitis da a.S.
0 20 40 60 80 100
92%
rocefinis da zogierTi sxva antibiotikis penetraciis indeqsi
ceftazidimi (2 g)
cefotaqsimi (2 g)
piperacilini (2 g)
rocefini (1 g)
24- saaTiani moqmedeba erTi ineqciis Semdgom!
maRali bioSeRwevadoba
Cvenebebis farTo speqtri 24- saaTiani moqmedeba erTi ineqciis Semdgom!
30 welia warmatebiT gamoiyeneba mTels msoflioSi
maRali klinikuri efeqturoba dadasturebuli mravali klinikuri kvleviT
klinikur kvlevebSi rocefiniT mkurnalobis Sedegebi
klinikuri mniSvneloba: mkurnalobis kargi Sedegi miiRweva SemTxvevaTa umravlesobaSi
Cveneba avadmyofebis
raodenobaklinikuri
efeqti
septicemia 757 91%
endokarditi 44 100%
meningiti 1 343 88,7%
pnevmonia 914 90,4%
yel-yur-cxviris infeqciebi 427 91,8%
Zval-saxrovani sistemis infeqciebi 649 86,9%
kanisa da rbili qsovilebis infeqciebi 546 93,6%
peritoniti 124 96,8%
sanaRvle gzebis infeqciebi 96 91,7%
saSarde sistemis infeqciebi 1 824 83,8%
infeqciebi meanoba-ginekologiaSi 271 90,4%
perioperaciuli profilaqtika 5 873 91,8%
gonorea 1 962 98%
sifilisi 130 99,2%
24- saaTiani moqmedeba erTi ineqciis Semdgom!
30 welia warmatebiT gamoiyeneba mTels msoflioSi
maRali klinikuri efeqturoba dadasturebuli mravali klinikuri kvleviT
klinikur kvlevebSi rocefiniT mkurnalobis Sedegebi
klinikuri mniSvneloba: mkurnalobis kargi Sedegi miiRweva SemTxvevaTa umravlesobaSi
Cveneba avadmyofebis
raodenobaklinikuri
efeqti
septicemia 757 91%
endokarditi 44 100%
meningiti 1 343 88,7%
pnevmonia 914 90,4%
yel-yur-cxviris infeqciebi 427 91,8%
Zval-saxrovani sistemis infeqciebi 649 86,9%
kanisa da rbili qsovilebis infeqciebi 546 93,6%
peritoniti 124 96,8%
sanaRvle gzebis infeqciebi 96 91,7%
saSarde sistemis infeqciebi 1 824 83,8%
infeqciebi meanoba-ginekologiaSi 271 90,4%
perioperaciuli profilaqtika 5 873 91,8%
gonorea 1 962 98%
sifilisi 130 99,2%
24- saaTiani moqmedeba erTi ineqciis Semdgom!
mkurnalobis kargi amtanoba
cxovrebis xarisxis gaumjobeseba,fulisa da drois ekonomia!
3. mkurnalobis usafrTxoeba da kargi amtanoba!
rocefini erT-erTi yvelaze usafrTxo preparatia, romelsac ar axasiaTebs nefro - da hepatotoqsiuroba, imunitetis daTrgunva.
gverdiTi movlenebis sixSire rocefiniT mkurnalobisas 20628 pacientSi (486 publikaciis monacemi)
rocefiniT mkurnalobis usafrTxoebas aZlierebs organizmidan misi gamoyofis ormagi urTierTkompensatoruli gza - Tirkmlebidan da RviZlidan.
kompensatoruli gamoyofa
Tirkmlebis ukmarisoba
RviZlis ukmarisoba
kompensatoruli gamoyofa
rocefini
klinikuri mniSvneloba: rocefiniT mkurnaloba dasaSvebia sxvadasxva asakobrivi
jgufis pacientebSi, avadmyofebSi daqveiTebuli imunitetiT.
pacientebSi RviZlisa da Tirkmlebis disfunqciiT ar
saWiroebs dozis koreqcias.
gverdiTi movlenebi sixSire, %mkurnalobis Sewyvetis
sixSire, %
eozinofilia, Trombocitopenia, leikopenia 1.9 0.11
kanis reaqciebi (gamonayari, alergiuli dermatiti, qavili, WinWris cieba)
0.8 0.15
Txeli ganavali, diarea, gulisreva, Rebineba 2.4 0.09
24- saaTiani moqmedeba erTi ineqciis Semdgom!
rocefini
pirveli da erTaderTi betalaqtamuriantibiotiki yvelaze xangrZlivi naxevradgamoyofis periodiT - 8saaTi.
1 ineqcia dReSi sakmarisia baqteriociduli moqmedebis misaRwevad da SesanarCuneblad 24 saaTis ganmavlobaSi
swrafi difuzia SratSi da intersticiur siTxeSimaRali efeqtianoba Cvenebebis farTo wreSi mZime infeqciebis CaTvliT (septicemia, meningiti, pnevmonia, gastrointestinuri da saSarde sistemebis infeqciebi.)
maRali koncentraciis SenarCuneba qsovilebsa da qsovilovan siTxeebSi
kargi klinikuri Sedegebi in vitro dabali mgrZnobelobis paTogenebis mier gamowveuli infeqciebis mkurnalobaSi. gamoxatuli Sedegianoba qirurgiuli Carevis dros postoperaciuli infeqciebis profilaqtikaSi.
kargi SeRwevadoba cerebrospinalur siTxeSi arCevis preparati Cirqovani meningitebis TerapiaSi
kargi SeRwevadoba Zvlebsa da rbil qsovilebSinaCvenebia Zvlebisa da rbili qsovilebis infeqciebis samkurnalod: osteomieliti, abscesebi da a.S.
mZlavri antibaqteriuli moqmedeba gramdadebiT da gramuaryofiT paTogenebze
standartuli doza 1-2g erT ineqciad dReSi. gaurTulebeli gonoreis samkurnalod sakmarisia 250mg erTjeradad
ar ganicdis metabolizms adamianis organizmSipreparatis aqtivoba ar mcirdeba organizmSi misi arsebobis drois ganmavlobaSi
brwyinvale mdgradoba betalaqtamazebis mimarT mikrobuli rezistentobis ganviTarebis dabali albaToba
urTierTmakompensirebeli ormxrivi gamoyofis gza TirkmelebiTa da RviZliT
ar saWiroebs dozis koreqcias Tirkmlebis ukmarisobis dros (gamonaklisi ix. dozireba)
dabali toqsiuroba gverdiTi movlenebis simcire
ar axasiaTebs disulfirammsgavsi reaqciadasaSvebia misi gamoyeneba im pacientebSi, visac miRebuli aqvs alkoholi
SemTxvevaTa umravlesobaSi SesaZlebelia ambulatoriuli mkurnaloba martivi da mosaxerxebeli Seyvanis reJimis xarjze - 1 ineqcia dReSi
mkurnalobis Rirebulebis Semcireba
Taviseburebani klinikuri mniSvneloba
24- saaTiani moqmedeba erTi ineqciis Semdgom!
mokle informacia preparat rocefinis® (ceftriaqsoni) gamoyenebis Sesaxeb Cvenebebi:
dozireba
sefsisi
infeqciis profilaqtika da mkurnaloba qirurgiaSi
muclis Rrus infeqciebi
meningiti
Tirkmlebisa da saSarde sistemis infeqciebi
sasqeso organoebis infeqciebi
sasunTqi sistemis infeqciebi
Zvlebis, saxsrebis, rbili qsovilebis infeqciebi
kanis infeqciebi, maT Soris Wrilobis infeqciebi
yel-yur-cxviris infeqciebi
infeqciebi pacientebSi daqveiTebuli imunitetiT
mozrdilebi da bavSvebi 12 wels zemoT
mZime infeqciebi gamowveuli saSualod mgrZnobiare mikroorganizmebiT
1 -2 g erTxel dReSi
4 gramamde erTxel dReSi
axalSobilebi da 1 wlamde asakis bavSvebi (3 kviridan 12 Tvemde)
20-80mg/kg wonaze erTxel dReSi
axalSobilebi (2 kviramde) 20-50mg/kg wonaze erTxel dReSi
pacientebi Tirkmlebis ukmarisobiT kreatininis klirensi >10ml/wT kreatininis klirensi <10ml/wT
standartuli dozamaqsimaluri doza 2g erTxel dReSi (mozrdilebSi)
profilaqtika qirurgiaSierTjeradad 1-2g operaciul Carevamde 30-90 wuTiT adre.
dozireba gansakuTrebul SemTxvevebSimeningiti axalSobilebi meZuZuri da patara asakis bavSvebi mozrdilebigonorea (gaurTulebeli)
50mg/kg wonaze erTxel dReSi 100mg/kg wonaze erTxel dReSi50mg/kg wonaze erTxel dReSi250mg i/m erTjeradad
gamoyenebis instruqcia
rocefini SehyavT intramuskularulad an intravenurad.intramuskularuli ineqcia: rocefinis 250mg an 500mg dozas
xnsian lidokainis hidroqloridis 1%-iani xnaris 2 ml-Si, 1g-ian dozas -3,5ml-Si da SehyavT intramuskularulad.
intravenuri ineqcia: rocefinis 250mg an 500mg dozas xnsian steriluri saineqcio xsnaris 5 ml-Si, 1g-ian dozas - 10 ml-Si. intravenuri Seyvana xorcieldeba nela 2-4 wuTis ganmavlobaSi.
intravenuri gadasxma: infuzia unda ganxorcieldes 30 wuTis ganmavlobaSi. intravenuri infuziisaTvis rocefinis 2g xsnian sainfuzio xsnaris 40 ml-Si; sainfuzio xsnarebi: natriumis qloridi 0.9%; natriumis qloridi 0.45% + glu-koza 2.5%; glukoza 10%; deqstranis xnsari 6%, glukozis xsnari 5%; saineqcio wyali. (kalciumis ionebis Semcvel xsnarebSi rocefinis gaxsna dauSvebelia)
mkurnalobis xangrZlivoba mkurnalobis xangrZlivoba damokidebulia daavadebis
mimdinareobaze. iseve rogorc sxva antibiotikebiT mkur-nalobisas, avamdyofebma unda gaagrZelon rocefinis miReba temperaturis normalizebidan da analizebiT gamomwvevis eradikaciis dadasturebis Semdgom minimum 42-72 saaTis ganmavlobaSi.
kombinirebuli Terapia gamokvlevebma aCvenes, rom mravali gramuaryofiTi baqte-
riis mimarT arsebobs sinergizmi preparat rocefinsa da aminoglikozidebs Soris. fizikuri SeuTavseblobis gamo
ceftriaqsoni da aminoglikozidebi unda Seyvanil iqnes cal-calke rekomendirebul dozebSi
ukuCvenebebi momatebuli mgrZnobeloba cefalosporinebisadmi. peni-
cilinisadmi momatebuli mgrZnobelobis SemTxvevaSi gaT-valiswinebuli unda iqnas jvaredini alergiuli reaqciis ganviTarebis SesaZlebloba.
sifrTxile anafilaqsiuri Soki. orsuloba (gansakuTrebiT pirveli
trimestri), laqtacia. axalSobilTa hiperbilirubinemia.
gverdiTi movlenebi movlenebi kuW-nawlavis traqtis mxriv (SemTxvevaTa
daaxlovebiT 2%), cvlilebebi sisxlSi (daaxloebiT 2%), reaqciebi kanis mxriv (daaxloebiT 1%).
gansakuTrebuli SeniSvnebi rocefini ar unda daematos xsnarebs, romlebic Seicaven
kalciums, rogorebicaa hartmanis xsnari da ringeris xsnari.
stabiloba. rocefini Senaxul unda iqnas 30 0C -mde tem-peraturaze. rocefinis mza xsnarebi inarCuneben fizikur da qimiur stabilobas 6 saaTis ganmavlobaSi oTaxis tem-peraturaze (an 24 saaTis ganamavlobSi macivarSi 2-8 0C temperaturaze).
preparati ar unda iqnas gamoyenebuli kolofze miTiTe-buli Senaxvis vadis gasvlis Semdeg.
rocefini (ceftriaqsoni) aTq kodi: J01DD04
gamoSvebis forma:SefuTva i/m ineqciisaTvis: flakonebi mSrali aqtiuri nivTierebiT, romelic Seesabameba 0.25g, 0.5g da 1g ceftriaqsons da lidokainis 1%-iani xnsaris 2 an 3.5 ml Semcveli ampulebi. SefuTva i/v ineqciisaTvis: flakonebi mSrali aqtiuri nivTierebiT, romelic Seesabameba 0.5g da 1g ceftriaqsons da saineqcio xsnaris 5 an 10 ml Semcveli ampulebi.flakonebi i/m da i/v ineqciisaTvis _ mSrali aqtiuri nivTierebiT, romelic Seesabameba ceftriaqsonis 0.25 g da 1grams, gamxsnelis gareSe.
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24- saaTiani moqmedeba erTi ineqciis Semdgom!mosaxerxebelia gamosayeneblad
detaluri informacia ixileT preparatis gamoyenebis srul instruqciaSi