Streptomycin(Yduocvn.com) - Streptomycin

Tn chung quc t: Streptomycine. M ATC: A07A A04, J01G A01. Loi thuc: Khng sinh nhm aminoglycosid. Dng thuc v hm lng Streptomycin khng c hp thu qua ng rut nn phi dng ng tim bp. Streptomycin dng tim bp di dng mui sulfat (streptomycin sulfat). Liu lng tnh theo streptomycin base. L 1 g (bt pha tim). Bt streptomycin ha tan vo dung mi thch hp (nc ct pha tim, natri clorid ng trng) trc khi dng. Mt l streptomycin cha tng ng 1 g streptomycin base). Dc l v c ch tc dng Streptomycin l khng sinh nhm aminoglycosid c tc dng dit khun, bng cch ngn cn qu trnh tng hp bnh thng protein ca vi khun. Ph khng khun ca streptomycin bao gm vi khun Gram m hiu kh v mt s vi khun Gram dng; streptomycin khng c tc dng vi vi khun ym kh. Streptomycin c hot tnh c bit chng M. tuberculosis v M. bovis. Streptomycin cng c hot tnh chng mt s vi khun Gram dng v Gram m hiu kh nh: Brucella, Francisella tularensis, Yersinia pestis, Calymmatobacterium granulomatis, Escherichia coli, Proteus spp., Aerobacter aerogenes, Klebsiella pneumoniae, Enterococci faecalis, Streptococcus viridans, Haemophylus ducreyi, Haemophylus influenza. Cc chng trc khun Gram m v cu khun Gram dng khng streptomycin xut hin, lm hn ch p dng iu tr ca streptomycin. Nhiu chng thng nhy cm vi streptomycin nhng sau vi ngy hoc vi tun iu tr tr nn khng. Hu ht cc chng Pseudomonas aeruginosa khng streptomycin. Hin nay streptomycin c dng phi hp cng cc thuc chng lao khc iu tr bnh lao. Dc ng hc

Mt gi sau khi tim bp 1 g streptomycin (dng mui sulfat), nng nh huyt tng t khong 25 50 microgam/ml v gim dn khong 50% sau 5 - 6 gi. Streptomycin phn b vo hu ht cc m v dch c th. Nng ng k trong dch mng phi v hang lao. Streptomycin thm qua mng nhau thai, nng dy rn tng ng trong mu m. Mt lng nh streptomycin thi tr vo sa, nc bt v m hi. Khong 20 - 30% streptomycin lin kt vi protein huyt tng. Streptomycin thi tr qua lc cu thn; ngi bnh c chc nng thn bnh thng khi dng liu 600 mg streptomycin c khong 29 - 89% thi tr nguyn dng ra nc tiu trong 24 gi. Bt k mt s suy gim chc nng lc cu thn no u dn n gim thi tr thuc v lm tng nng thuc trong huyt tng v trong cc t chc. Khong 1% thuc thi tr qua mt. Ch nh Streptomycin c dng kt hp vi cc thuc chng lao khc trong iu tr lao. Streptomycin cng c dng kt hp vi cc thuc khng khun khc trong iu tr bnh do Mycobacteria khc gy ra k c u hi. Streptomycin c dng trong iu tr bnh tularemia, dch hch. Hu ht cc nh lm sng cho rng streptomycin l thuc c la chn iu tr c hai bnh ny. Streptomycin phi hp vi tetracyclin hoc doxycyclin trong iu tr bnh Brucella v phi hp vi tetracyclin hoc sulfonamid iu tr bnh s mi nga (nhim khun Mallomyces mallei). Streptomycin dng n c hoc phi hp vi cc thuc chng nhim khun khc iu tr u hch bn v h cam (granuloma inguinale v chancroid). Streptomycin phi hp vi penicilin G hoc ampicilin thng c hiu qu trong iu tr vim mng trong tim do Enterococcus v Streptococcus. Streptomycin cng c dng n c hoc phi hp vi cc thuc chng nhim khun khc trong iu tr lu. Tuy nhin, streptomycin ch c dng trong nhim khun lu do chng nhy cm vi streptomycin v khi nhng aminosid khc hoc nhng thuc chng nhim khun khc khng hiu qu hoc chng ch nh. Chng ch nh Mn cm vi streptomycin hoc vi cc aminoglycosid khc (mn cm cho). Bnh nhc c. Thn trng

Khi u v nh k lm test kch thch nng lnh tai v kim tra thnh lc khi iu tr bng streptomycin di ngy. Khi c biu hin tai, nh trng tai hoc cm gic ic tai cn thit phi kim tra thnh lc hoc kt thc t iu tr hoc c hai. Cn thn vi ngi dng streptomycin trnh phn ng mn cm da thng xut hin vo tun th 2 v 3. Cng nh mi ch phm tim bp, ch tim streptomycin vo nhng c ln v cn thn gim thiu kh nng gy thng tn thn kinh ngoi bin. Ht sc thn trng chn liu thch hp vi ngi bnh suy thn. Vi ngi tng ur huyt trm trng, mt liu n c th to nng thuc cao trong mu vi ngy v c th tch ly gy c trn tai. Khi iu tr di ngy bng streptomycin, kim ha nc tiu c th gim thiu hoc ngn nga kch ng thn. Tr em khng c dng streptomycin vt qu liu khuyn co, v gp hi chng c ch thn kinh trung ng tr dng qu liu. Trong iu tr bnh hoa liu nh bnh u hch bn hoc h cam, nu nghi ng c km theo giang mai, phi thc hin mt s xt nghim thch hp nh th nghim soi xon khun trn knh hin vi nn en trc khi bt u iu tr v thc hin kim tra huyt thanh hng thng, trong t nht 4 thng. Cng nh cc khng sinh khc, dng thuc ny c th gy pht trin cc vi sinh vt khng nhy cm, k c nm. Nu c bi nhim, phi thc hin liu php thch hp. Thi k mang thai Streptomycin gy thng tn bo thai ngi mang thai, v streptomycin qua nhau thai rt nhanh, vo tun hon thai nhi v dch nc i; nng thuc cc m ny thng t hn 50% nng trong huyt thanh m. Vi trng hp c thng bo v c tnh trn tai ca streptomycin tr em do m iu tr lao bng streptomycin; tr s sinh b ic vi phn x c tai - mi mt m tnh. Ngoi thng tn i vi dy thn kinh s 8, khng c nhng d tt bm sinh khc do dng streptomycin gy nn. Dng streptomycin 3 thng u thai k c th gy ic tr. Thi k cho con b Streptomycin thi qua sa m vi lng nh. Tuy nhin, streptomycin c hp thu km qua ng tiu ha, nn khng thy thng bo c vn tr ang b. Tc dng khng mong mun (ADR)

Cng nh cc aminoglycosid khc, ADR quan trng nht l c vi tai, do tn thng dy thn kinh c tai v tn thng dy tin nh gy chng mt, chn dn truyn thn kinh - c, phn ng qu mn v him khi gy c cho thn. Thng gp, ADR > 1/100 Tai: Kh nng c i vi tin nh tr em cao hn ngi ln. ngi bnh c chc nng thn bnh thng, yu t ch yu lin quan n c tnh l liu dng hng ngy v tng liu iu tr trong mt thi gian nht nh. Khong 30% tai bin trn tin nh xy ra khi dng liu 1 g/ngy trong 4 thng, 5 - 15% trng hp suy gim kh nng nghe. Khng nn dng streptomycin qu 60 g tc 60 liu trong 2 thng iu tr. Chn dn truyn thn kinh - c: Ri lon th lc (gp 50% trng hp), d cm (thng xy ra quanh mm v cng c cc vng khc trn mt v tay), vim dy thn kinh ngoi bin. Phn ng d ng: Ngoi ban da (xy ra 5% ngi bnh 7 - 9 ngy sau mi tim u tin), ban , st, my ay, ph Quincke, tng bch cu a eosin. t gp, 1/1000 < ADR < 1/100 Thn kinh v gic quan: Mt khu gic mt phn hoc ton b (sau iu tr mt thi gian di), vim r thn kinh, vim ty v nhng bin chng thn kinh khc. Chn dn truyn thn kinh - c: c ch h hp. Him gp, ADR < 1/1000 Thn kinh v gic quan: Mt tp trung tinh thn nht thi. D ng: Hi chng Stevens - Jonhson, thiu mu tan mu, suy thn, gim bch cu, gim tiu cu, gim ton b huyt cu... Hng dn cch x tr ADR Khi thy xut hin ADR, th ngng ngay iu tr bng streptomycin. V khng c thuc gii c c hiu, nn x tr qu liu v phn ng c ca streptomycin l iu tr triu chng v h tr. Cc bin php gm: Thm tch thn nhn to hoc thm tch mng bng loi streptomycin ngi suy thn.

Dng thuc khng cholinesterase, mui calci, hoc dng liu php h tr h hp bng my, iu tr chn dn truyn thn kinh - c, gy yu c h hp v c ch hoc lit h hp (ngng th). Liu lng v cch dng Streptomycin sulfat ch c dng tim bp su vo vng c ln. ngi ln, v tr tim thch hp nht l phn t mng trn - ngoi hoc mt gia - bn c i hoc c delta. Ch tim vo c delta khi c ny pht trin tt nh mt s ngi ln v tr ln v phi thn trng khi tim trnh tn hi dy thn kinh quay. Khng c tim bp vo vng di v 1/3 gia cnh tay. Cng nh tt c nhng khi tim bp, phi ht trnh tim v vo mt mch mu. Phi thay i vng tim. iu tr lao v cc bnh do Mycobacteria khc: Khng c dng n c streptomycin. Khi dng hng ngy trong mt phc iu tr lao, ch tim streptomycin trong vi thng u, cn nhng thuc khc vn phi tip tc cho ht liu trnh. Liu thng dng ngi ln l 1 g/ngy hoc 15 mg/kg/ngy. Vi tr em, liu 10 mg/kg. ngi cao tui, dng liu thp hn ty theo tui, chc nng thn v chc nng dy thn kinh s 8. Liu gii hn ti 10 mg/kg/ngy, ti a l 750 mg/ngy cho ngi cao tui. Khi dng liu php gin cch, liu thng dng ngi ln v tr em l 12 - 18 mg/kg (ti a l 1,5 g), 2 - 3 ln/tun. Streptomycin thng c tim bp mi ngy mt ln. Bnh tularemia: Liu thng dng ngi ln l 1 - 2 g/ngy, chia thnh 2 liu nh, tim trong 7 - 14 ngy hoc cho n khi ngi bnh ht st trong 5 - 7 ngy. Bnh dch hch: Liu thng dng ngi ln l 2 g/ngy (30 mg/kg), chia 2 ln; ti thiu tim trong 10 ngy. Liu tr em l 30 mg/kg/ngy, chia 2 - 3 ln; trong 10 ngy. Bnh Brucella: Phi hp vi tetracyclin hoc doxycyclin. Liu thng dng ngi ln l 1 g, 1 hoc 2 ln mi ngy trong tun u v 1 ln/ngy trong t nht 1 tun tip theo. Liu tr em trn 8 tui: 20 mg/kg/ngy (ti a 1 g/ngy), trong 2 tun. Nu dng phi hp streptomycin vi cotrimoxazol th t nht phi tim streptomycin trong 2 tun u iu tr.

Vim mng trong tim do Streptococcus nhy cm vi penicilin (nhm viridans). Khi phi hp vi penicilin, liu streptomycin thng dng ngi ln l 1 g, mi ngy 2 ln trong 1 tun, sau l 500 mg, mi ngy 2 ln cho tun tip theo. Ngi bnh trn 60 tui dng liu 500 mg, mi ngy 2 ln, trong 2 tun. Vim mng trong tim do Enterococcus: Phi hp vi penicilin, liu streptomycin thng dng ngi ln l 1 g, mi ngy 2 ln, trong 2 tun, sau dng liu 500 mg, mi ngy 2 ln trong 4 tun. Nu nhim c tai, c th phi ngng streptomycin trc khi hon thnh liu trnh 6 tun. Nhim khun va v nng do cc vi khun nhy cm: Liu streptomycin thng dng ngi ln l 1 - 2 g/ngy, phn liu cch nhau 6 - 12 gi/ln, tng liu khng qu 2 g/ngy. Tr em c th dng 20 40 mg/kg/ngy, phn liu cch nhau 6 - 12 gi/ln. Khi c th, phi gim st thng xuyn nng nh v y ca streptomycin trong huyt thanh v iu chnh liu duy tr nng mong mun trong huyt thanh. Nng nh v y trong huyt thanh khng c vt qu 40 - 50 microgam/ml v 5 microgam/ml. Vi ngi suy thn: Nng nh trong huyt thanh khng c qu 20 - 25 microgam/ml. Nu khng xc nh c nng thuc trong huyt thanh, th c th iu chnh liu da trn h s thanh thi creatinin. Liu np ban u c khuyn co l 1 g, cc liu sau c gi nh sau: H s thanh thi creatinin (ml/pht) 50 - 80 10 - 50 Tra cu | a ch nh thuc Thuc>Thng tin Quay thuc gc li Streptomycin Thuc tr k Nhm Dc sinh trng, l: chng nhim khun Tn Bit Mebienterocin dc : Dng bo Bt pha tim ch :

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Chng nhim + Phn thng tin tham kho N06 khun, KS + + Dng thuc theo ch trng nh ca Bc s + iu tr au Dc lc : N07 na u Streptomycin c phn Thuc lp t mi trng nui cy N08 chng ung Streptomyces griseus. L th... khng sinh thuc nhm H tr T aminoglycosid c hot ph N09 ng tit rng. niu Dc ng hc : Thuc - Hp thu: Streptomycin t N10 chng hp thu qua ng tiu ho, Parkinson nhng khng b ph hu Tc dng bi acid dch v v bn N11 i vi mu vng vi penicillinase. Mu, Dung Thuc ch yu dng ng N12 dch cao tim bp, ngoi ra cn c phn t th dng ng ung Thuc tim dit khun ti ng tiu N13 mch ho. iu tr - Phn b: thuc t lin kt N14 bnh da liu vi protein huyt tng, Dng chn khuch tc ch yu vo N15 on dch ngoi bo, vo c Thuc st nhau thai v sa m, t vo N16 dch no tu k c khi khun Thuc li mng no b vim. N17 - Chuyn ho: tiu Streptomycin t chuyn ho Thuc N18 ng tiu trong c th. - Thi tr: Thuc thi tr ha Hocmon, ch yu qua nc tiu, thi N19 Ni tit t gian bn thi khong 2-4 Huyt thanh gi. N20 & Globulin Tc dng : min dch Streptomycin l khng sinh Gin c v ph rng c tc dng ch N21 tng trng yu trn vi khun gram m, cn trn vi khun gram lc c Thuc mt, dng tc dng km penicillin. N22 tai mi Streptomycin c tc dng hng

Thnh phn :

Streptomycin sulfate.

Thn trng lc dng : Suy thn: chnh liu theo Clcr. Ri lon tin nh c tai. Ngi cao tui. C thai & cho con b. Tng tc thuc : Curare, thuc gin c, mt vi thuc m. Thuc c cng c tnh trn thn & tai. Dnh cho dam Tc dng ph Streptomycin gy c vi Eva thnh gic mnh nht trong Chi game, game hay min nhm, nh ri lon tin nh, c tai, gy tai, ph gim thnh lc v ic Chng khon Mua th game, khng hi phc. Thuc cng gy c vi in thoi thn( mc nh hn Sc khe gia gentamicin ). nh Mua bn, rao vt D ng: my ay, ban da, vim da trc vy, vim ming, shock phn v. Mua ban sim Sim so dep Sim Cc tc dng khng mong vip Sim phong mun khc: c ch dn thuy Sim mien truyn thn kinh c, trng

Thuc c N23 tc dng thc ... DD thm N24 phn phc mc Thuc TD N25 trn ng h hp DD iu N26 chnh nc in gii... Khong N27 cht v Vitamin Nhm khc N28 Thuc khc Thuc c ngun gc N29 Tho dc... Thc phm N30 chc nng Du xoa, N31 cao xoa Thuc ph N32 khoa

tt trn trc khun lao, nht l vi khun lao giai on sinh sn nhanh. Ngoi ra cn c tc dng c trn trc khun gy bnh phong, dch hch v trc khun ng rut. Ch nh : Bnh lao BK(+) (phi hp a ho tr). Bnh Brucella, Tularemia, dch hch. Phi hp vi khng sinh khc trong mt s nhim trng nhy cm: nhim trng huyt, vim ni tm mc. Chng ch nh : Qu mn vi nhm aminoglycoside. Nhc c.

phi Lam sim theo yeu cau Sim cam ket

hp nng gy suy h hp, lit h hp, lit c. Liu lng : Tim bp. Ngi ln: 0,51,5g/2 gi. Tr em & nh nhi: 30-50mg/kg/2 gi. Quay li

Phng php s dng khng sinh Streptomycin Streptomycin: c chit xut t vi khun dng si Streptomyces griseus. Cht khng sinh ny c tc dng rng ri i vi vi khun Gram m (t huyt trng, Brucella, cc trc khun ng rut,...), cc vi khun gram dng (t cu khun, lin cu khun,...), vi khun lao v x khun. Cht khng sinh ny c th dng tim hoc cho ung do thuc t b ph hy rut v thi tr ra ngoi theo phn, cn nu tim bp tht thuc vo mu rt nhanh, thm d dng vo cc t chc, thm c vo bo thai, thm khng u vo dch no - ty, mng phi, phc mc. Streptomycin thi tr ra ngoi chm hn penicillin, ch yu bi tit qua thn, mt phn nh theo mt bi tit ra ngoi. Streptomycin cng d gy hin tng vi trng khng thuc, nn khi dng phi phi hp cc loi khng sinh khc. Khng sinh ny cng gy nn hin tng d ng, lm tn thng dy thn kinh s VIII (ph bin nht ngi, gy ic), d gy ng c nng v c khi lm cht gia cm.