Dab tsi yog Amphotericin B siv los kho
Amphotericin B hmoovyog ib qho tshuaj tiv thaiv kab mob, feem ntau nyob rau hauv daim ntawv hmoov, siv los kho ntau yam kab mob loj tshwm sim los ntawm fungi. Nws yog ib qho tshuaj aminosterol uas tua lossis inhibits fungal kev loj hlob feem ntau los ntawm kev cuam tshuam nrog kev ua haujlwm ntawm cov kab mob fungal. Nws yog cov hmoov qhuav, tsis muaj tshuaj lom uas feem ntau yuav tsum tau tov nrog cov kuab tshuaj (xws li 5% qabzib tov lossis saline) los ua cov tshuaj txhaj rau kev siv. Nws yog siv los kho cov kab mob loj heev uas coj los ntawm cov kab mob, tshwj xeeb tshaj yog qee cov kab mob los yog kab mob fungal, xws li kab mob Candida (xws li candidemia), kab mob Aspergillus, kab mob Cryptococcal, kab mob Mycobacterium fuse (xws li fusilliosis), lwm yam kab mob hauv lub cev, thiab lwm yam. Yog tias koj txaus siab rau Amphotericin B, thov hu rau Xi'an Sonwu.
Qee qhov xwm txheej tseem ceeb tau kho nrog amphotericin B suav nrog:
Cov kab mob fungal:
Candidiasis (tus kab mob, kab mob candidiasis, xws li candidemia)
Aspergillosis (tus kab mob pulmonary aspergillosis)
Cryptococcosis (cryptococcal meningitis, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob immunocompromised xws li cov neeg muaj HIV / AIDS)
Histoplasmosis
Blastomycosis
Coccidioidomycosis
Mucormycosis (tseem hu ua zygomycosis, ib qho tsis tshua muaj thiab feem ntau mob fungal kis los ntawm cov pwm ntawm pawg Mucorales)
Fungal Endocarditis thiab lwm yam kab mob sib sib zog nqus.
Nws yog feem ntau siv rau hauv cov mob hnyav uas lwm yam kev kho mob antifungal tej zaum yuav tsis zoo lossis thaum kis tus kab mob ntau. Kuj tseem muaj daim ntawv liposomal ntawm cov khoom lag luam, uas yog tsim los txo qee qhov toxicity txuam nrog cov qauv tsim.
Yuav Ua Li Cas Dissolve Amphotericin B hauv dej
Txhawm rau yaj cov khoom (tshwj xeeb tshaj yog cov qauv tsim qauv, tseem hu ua cov khoom lag luam (deoxycholate), koj yuav tsum ua raws li cov kauj ruam tshwj xeeb rau kev rov tsim kho dua tshiab vim tias nws tau muab los ua lyophilized (freeze-dried) hmoov. Ntawm no yog cov lus qhia step-by-step:
Reconstitution ntawm cov khoom (Deoxycholate Formulation)
Tshawb xyuas cov Chaw Tsim Khoom Cov Lus Qhia:
Ib txwm pib los ntawm kev tshuaj xyuas cov khoom tshwj xeeb cov lus qhia rov kho dua tshiab, vim lawv yuav txawv nyob ntawm hom lossis cov qauv tsim tshwj xeeb ntawm cov khoom. Cov kauj ruam hauv qab no yog ua raws li cov lus qhia dav dav.
Reconstitution txheej txheem:
Ntxiv Sterile Dej:
Feem ntau, tsib milliliters ntawm cov dej tsis huv yog siv los kho nws rau txhua lub vial. Qhov ntau npaum li cas ntawm cov dej tuaj yeem hloov pauv raws li cov koob tshuaj thiab cov chaw tsim khoom cov lus qhia. Nco ntsoov siv dej tsis muaj menyuam lossis bacteriostatic.
Lus Cim: Rau qee cov qauv tsim, D5W (5% dextrose hauv dej) yuav raug pom zoo siv cov dej tsis huv, vim tias cov khoom yuav nkag siab rau pH ntawm cov tshuaj.
Dissolve hmoov:
Tom qab ntxiv dej, maj mam swirl lub vial los pab yaj cov hmoov. Tsis txhob tuav lub zog, vim qhov no tuaj yeem ua rau foaming lossis denaturation ntawm cov tshuaj.
Cov khoom yuav tsum yaj mus rau hauv ib qho ntshiab, me ntsis yellowish tov. Yog tias muaj cov khoom uas tsis tau muab tshem tawm, cov tshuaj yuav tsum tsis txhob siv. Yog tias qhov kev daws teeb meem yog huab lossis nag lossis daus, muab pov tseg thiab rov ua cov txheej txheem nrog lub vial tshiab.
Thaum kawg Concentration:
Tom qab rov kho dua, nws feem ntau muaj qhov concentration ntawm 50 mg rau 5 mL ntawm kev daws (uas sib npaug 10 mg / mL). Ntxiv dua thiab, qhov kawg concentration yuav nyob ntawm seb cov khoom tshwj xeeb, yog li paub meej qhov no nrog cov chaw tsim khoom cov lus qhia.
Tshawb nrhiav Clarity:
Xyuas kom cov kev daws teeb meem yog qhov tseeb thiab tsis muaj cov teeb meem pom. Yog hais tias cov tshuaj yog huab los yog muaj undissolved hais, tsis txhob siv nws.
Cov ntsiab lus tseem ceeb:
Maj mam swirling yog qhov tseem ceeb kom tsis txhob ua rau cov tshuaj puas.
Tom qab rov kho dua, siv cov tshuaj tam sim ntawd lossis khaws cia hauv lub tub yees ntev txog 24 teev, tab sis tsis txhob khov.
Tshawb xyuas qhov tas sij hawm tom qab rov tsim dua tshiab, vim tias qhov ruaj khov ntawm cov khoom yuav cuam tshuam los ntawm qhov kub thiab txias.
Dab tsi yog Lwm Txoj Kev Rau Amphotericin B
Nws yog cov tshuaj tua kab mob muaj zog, tab sis nws tuaj yeem muaj kev phiv loj heev, suav nrog nephrotoxicity (mob raum puas). Nyob ntawm seb hom kab mob fungal thiab tus neeg mob tus mob, muaj ntau ntau lwm cov tshuaj tiv thaiv kab mob rau cov khoom uas yuav siv tau los kho. Cov kev xaiv no tuaj yeem muab faib ua ntau pawg raws li lawv qhov kev ua haujlwm, hom kev ua, thiab kev nyab xeeb profiles.
1. Azoles (xws li Fluconazole, Itraconazole, Voriconazole)
Azoles yog ib chav kawm ntawm cov tshuaj tua kab mob uas ua haujlwm los ntawm inhibiting cov synthesis ntawm ergosterol, ib qho tseem ceeb ntawm cov kab mob fungal. Azoles feem ntau tau txais txiaj ntsig zoo thiab muaj txiaj ntsig zoo tshaj qhov cuam tshuam rau cov khoom lag luam, tab sis lawv yuav tsis zoo rau txhua yam kab mob fungal.
2. Echinocandins (xws li Caspofungin, Micafungin, Anidulafungin)
Echinocandins yog ib chav kawm ntawm cov tshuaj tiv thaiv kab mob uas tiv thaiv kev tsim cov beta-glucan, ib feem tseem ceeb ntawm cov kab mob fungal. Lawv muaj txiaj ntsig tshwj xeeb tiv thaiv kab mob Candida thiab qee yam kab mob fungal thiab feem ntau siv los ua lwm txoj hauv kev rau cov neeg mob uas tsis tuaj yeem zam amphotericin B.
3. Allylamines (piv txwv li, Terbinafine)
Allylamines inhibit fungal squalene epoxidase, Qhov no ua rau cov cell membranes puas tsuaj thiab pab txhawb kev loj hlob ntawm ergosterol. Terbinafine yog cov feem ntau siv allylamine.
4. Flucytosine (5-FC)
Flucytosine feem ntau yog siv ua ke nrog lwm cov tshuaj tiv thaiv kab mob (zoo li nws) rau kev kis kab mob los ntawm Cryptococcus thiab Candida hom.
Vim li cas peb thiaj muab Amphotericin B nrog Dextrose
Nws yog feem ntau siv rau hauv kev daws ntawm dextrose (5% dextrose hauv dej, lossis D5W) rau ntau qhov laj thawj tseem ceeb ntsig txog nws qhov ruaj khov, solubility, thiab kev nyab xeeb. Nov yog qhov kev piav qhia vim li cas qhov kev coj ua no tseem ceeb:
1. Kev ruaj ntseg thiab solubility
Nws yog tsis zoo soluble nyob rau hauv dej ntawm nws tus kheej, thiab nws muaj peev xwm tsim aggregates los yog precipitate tawm ntawm kev daws. Txhawm rau txhim kho nws cov solubility, nws feem ntau yog yaj hauv cov tshuaj dextrose lossis lipid-based formulations. Dextrose (ib hom suab thaj) pab ua kom cov amphotericin B nyob rau hauv daim ntawv ruaj khov, yaj, ua kom cov tshuaj tuaj yeem xa mus rau lub cev zoo.
2. Txo lub raum toxicity
Nws muaj kev paub zoo txog kev pheej hmoo ntawm nephrotoxicity (lub raum puas), tshwj xeeb tshaj yog nrog kev siv tshuaj ntau dua lossis kev kho mob ntev. Thaum amphotericin B tau muab rau hauv cov tshuaj dextrose, nws pab dilute cov tshuaj, uas yuav txo tau qhov kev pheej hmoo ntawm nephrotoxic teebmeem.
3. Kev them nyiaj yug dej
Nws feem ntau cuam tshuam nrog kev mob tshwm sim xws li kub taub hau, ua daus no, thiab hypotension, uas tuaj yeem ua rau lub cev qhuav dej. Txoj kev lis ntshav ntawm dextrose daws pab tswj cov dej num thaum lub sij hawm infusion thiab tuaj yeem txo qis qee qhov kev mob tshwm sim los ntawm infusion.
4. Tiv thaiv nag lossis daus ntawm cov tshuaj
Amphotericin B, thaum yaj nyob rau hauv cov kua ntsev, muaj ib tug nyiam los nag los yog tsim aggregates, tshwj xeeb tshaj yog nyob rau hauv ntau dua concentrations. Dextrose feem ntau nyiam vim tias nws txo qis qhov tshwm sim ntawm nag lossis daus, kom ntseeg tau tias cov tshuaj tseem nyob hauv nws daim ntawv nquag, yaj thaum lub sij hawm infusion.
Hauv cov ntsiab lus, kev tswj hwm ntawm nws hauv cov tshuaj dextrose txhim kho kev ua tau zoo, kev nyab xeeb, thiab kev zam ntawm cov tshuaj thaum lub sij hawm infusion, tshwj xeeb tshaj yog thaum siv rau cov neeg mob hnyav uas xav tau kev kho mob antifungal.
Yog tias koj xav paub tus nqi ntawm Amphotericin B Powder, xav paub Xi'an Sonwu, lossis muaj lwm yam lus nug txog cov khoom, tsis txhob yig tiv tauj Xi'an Sonwu.