Tobramycin foda magani ne mai ƙarfi na ƙwayoyin cuta wanda ke taka muhimmiyar rawa wajen yaƙar cututtukan ƙwayoyin cuta daban-daban. A matsayin memba na rukunin maganin rigakafi na aminoglycoside, Tobramycin yana aiki ta hanyar tsoma baki tare da haɗin furotin na ƙwayoyin cuta, yadda ya kamata ya dakatar da girma da haɓaka. Wannan tsarin aiki yana sa ya zama mai tasiri sosai a kan nau'ikan ƙwayoyin cuta masu gram-korau, ciki har da Pseudomonas aeruginosa, wanda ya shahara wajen haifar da cututtuka masu tsanani na numfashi a cikin marasa lafiya da cystic fibrosis.
Tsarin foda na Tobramycin yana ba da fa'idodi da yawa, gami da sauƙin gudanarwa da ikon isar da babban adadin maganin kai tsaye zuwa wurin kamuwa da cuta, musamman a yanayin numfashi. Ta hanyar fahimtar yadda Tobramycin Foda ke aiki da kuma amfani da shi da ya dace, ma'aikatan kiwon lafiya za su iya amfani da kayan aikin antibacterial masu karfi don magance cututtuka da kuma inganta sakamakon haƙuri.
Ƙayyadaddun adadin da ya dace na Tobramycin Foda yana da mahimmanci don tabbatar da tasiri yayin da yake rage haɗarin sakamako masu illa. Adadin da aka ba da shawarar zai iya bambanta dangane da dalilai da yawa, gami da shekarun majiyyaci, nauyi, aikin koda, da takamaiman nau'i da tsananin kamuwa da cutar da ake jiyya. Yana da mahimmanci a lura da hakan Tobramycin foda yawanci ana amfani da shi ta hanyar maganin inhalation ko maganin nebulizer, musamman ga marasa lafiya da cystic fibrosis ko wasu yanayin numfashi na yau da kullun.
Ga marasa lafiya da cystic fibrosis, daidaitaccen tsarin sashi na maganin shan inhalation na Tobramycin shine sau da yawa 300 MG sau biyu a rana don kwanaki 28, sannan bayan kwanaki 28 daga miyagun ƙwayoyi. Ana maimaita wannan sake zagayowar kashewa don taimakawa sarrafa cututtukan Pseudomonas aeruginosa na yau da kullun a cikin huhu. Matsakaicin MG 300 yawanci yana ƙunshe ne a cikin ampoule mai amfani guda ɗaya kuma ana gudanar da shi sama da kusan mintuna 15 ta amfani da nebulizer.
Koyaya, yana da mahimmanci a fahimci cewa wannan ƙa'ida ce ta gaba ɗaya, kuma adadin kowane mutum na iya bambanta. Misali, majinyata na yara ko masu aikin koda na iya buƙatar daidaita allurai. Mai ba da lafiya zai ƙididdige adadin da ya dace bisa ƙayyadaddun yanayin mara lafiya.
Lokacin da ake amfani da Tobramycin don wasu nau'ikan cututtuka, irin su cututtuka na tsarin da aka yi wa magani tare da gudanarwa na ciki ko na cikin jijiya, tsarin maganin na iya bambanta sosai. A cikin waɗannan lokuta, adadin yakan dogara ne akan nauyin majiyyaci, yawanci daga 1 zuwa 2.5 mg / kg kowane sa'o'i 8 zuwa 12, ya danganta da tsananin kamuwa da cutar da aikin koda na majiyyaci.
Ya kamata a lura cewa matakan Tobramycin a cikin jini ana lura da su sosai, musamman a lokacin darussan jiyya na tsawon lokaci. Wannan saka idanu yana taimakawa tabbatar da cewa maida hankali na miyagun ƙwayoyi ya kasance a cikin kewayon warkewa yayin da yake guje wa matakan masu guba. Ana iya auna matakan kololuwa da magudanar ruwa don jagorantar gyare-gyaren kashi.
Hanyar gudanarwa kuma tana taka rawa wajen ƙayyade adadin da ya dace. Lokacin amfani dashi azaman maganin inhalation. Tobramycin foda an sake haɗa shi da salin bakararre ko wani ƙayyadaddun sinadarai. Madaidaicin ƙaddamarwa da ƙarar maganin da aka sake ginawa zai dogara ne akan takamaiman samfurin da adadin da aka tsara.
Hakanan ma'aikatan kiwon lafiya na iya yin la'akari da abubuwa kamar magunguna masu haɗaka, yanayin kiwon lafiya gabaɗaya, da martanin mai haƙuri ga jiyya lokacin da aka ƙayyade mafi kyawun sashi. Ba sabon abu ba ne don daidaita allurai yayin aikin jiyya bisa la'akari da martani na asibiti da sa ido kan matakin magunguna.
Riko da tsarin da aka tsara na allurai yana da mahimmanci don nasarar maganin Tobramycin. Ya kamata a ilmantar da marasa lafiya kan mahimmancin shan maganin kamar yadda aka umarce su, gami da amfani da kyau na nebulizer ko wasu na'urorin bayarwa. Tsallake allurai ko dakatar da maganin da wuri na iya haifar da gazawar jiyya kuma yana iya haifar da juriya na ƙwayoyin cuta.
Lokacin da yake ɗauka don Tobramycin foda yin aiki na iya bambanta dangane da abubuwa da yawa, gami da nau'i da tsananin kamuwa da cuta, gabaɗayan lafiyar majiyyaci, da yadda ake gudanar da maganin. Fahimtar lokacin tasirin Tobramycin yana da mahimmanci ga duka masu ba da lafiya da marasa lafiya don saita tsammanin da suka dace da kuma tabbatar da ingantaccen sakamakon jiyya.
Lokacin da aka yi amfani da shi azaman maganin inhalation don cututtukan numfashi, musamman a cikin marasa lafiya da cystic fibrosis, ana iya ganin wasu tasirin Tobramycin da sauri. Yawancin marasa lafiya suna ba da rahoton jin daɗi a cikin alamun numfashinsu a cikin ƴan kwanakin farko na fara magani. Koyaya, yana da mahimmanci a lura cewa waɗannan haɓakawa na farko ba lallai bane suna nuna cewa an kawar da kamuwa da cuta gaba ɗaya.
Don cututtuka na huhu a cikin marasa lafiya na cystic fibrosis, nazarin asibiti ya nuna gagarumin cigaba a cikin aikin huhu da raguwa a cikin Pseudomonas aeruginosa colony a cikin makonni biyu na farko na jiyya. Koyaya, cikakken tsarin jiyya, yawanci yana ɗaukar kwanaki 28, ya zama dole don cimma babban fa'ida da rage haɗarin sake dawowa.
A cikin yanayin da ake amfani da Tobramycin don magance cututtuka na tsarin jiki ta hanyar gudanarwa na ciki ko na ciki, farawa na aiki zai iya zama da sauri. Da miyagun ƙwayoyi ya fara aiki a kan m kwayoyin kusan nan da nan bayan kai warkewa taro a cikin jini. Koyaya, ingantaccen ingantaccen asibiti na iya ɗaukar kwanaki da yawa.
Yana da mahimmanci a fahimci cewa yayin da marasa lafiya na iya fara jin daɗi cikin sauri, wannan ba yana nufin an kawar da kamuwa da cuta gaba ɗaya ba. Cikakkar tsarin da aka tsara na Tobramycin ya kamata a koyaushe a kammala shi don tabbatar da kawar da ƙwayoyin cuta da kuma hana haɓakar juriyar ƙwayoyin cuta.
Gudun da Tobramycin ke aiki kuma ana iya yin tasiri ta takamaiman ƙwayoyin cuta da ke haifar da kamuwa da cuta. Duk da yake Tobramycin yana da tasiri musamman akan ƙwayoyin cuta masu gram-korau kamar Pseudomonas aeruginosa, nau'ikan ƙwayoyin cuta daban-daban na iya amsawa a farashi daban-daban. Ana iya kashe wasu ƙwayoyin cuta masu saurin kamuwa da sauri, yayin da wasu na iya buƙatar ƙarin ɗaukar lokaci mai tsawo ga maganin rigakafi.
Abubuwan marasa lafiya kuma suna taka rawa a cikin saurin yadda Tobramycin ke aiki. Wadanda ke da tsarin garkuwar jiki suna iya samun saurin amsawa ga jiyya. Hakazalika, tsanani da girman kamuwa da cuta na iya tasiri lokacin da za a inganta asibiti. Cututtuka masu zurfi ko na yau da kullun suna buƙatar tsawon lokaci na jiyya idan aka kwatanta da ƙarin cututtuka na zahiri ko kuma m.
Yana da kyau a lura cewa yayin da Tobramycin ya fara aiki da ƙwayoyin cuta da sauri, ƙudurin bayyanar cututtuka da kawar da kamuwa da cuta na iya ɗaukar lokaci mai tsawo. Wannan shi ne saboda ko da bayan an kashe kwayoyin cutar, jiki yana buƙatar lokaci don share tarkace da kuma warkar da kyallen takarda. Misali, a cikin cututtuka na numfashi, yana iya ɗaukar lokaci kafin kumburi ya ragu kuma a dawo da aikin huhu na yau da kullun.
Masu ba da lafiya sukan sa ido sosai ga marasa lafiya a farkon matakan jiyya na Tobramycin don tantance tasirin sa. Wannan na iya haɗawa da kimantawa na asibiti, gwaje-gwajen dakin gwaje-gwaje, da kuma a wasu lokuta, nazarin hoto. Idan babu wani gagarumin ci gaba a cikin lokacin da ake sa ran, gyare-gyare ga tsarin jiyya na iya zama dole.
A cikin mahallin cututtuka na yau da kullum, irin su waɗanda aka gani a cikin marasa lafiya na cystic fibrosis, Tobramycin ana amfani da su sau da yawa a cikin hawan keke. Tsarin tsari na yau da kullun ya ƙunshi kwanaki 28 na jiyya tare da kwanaki 28 kashe miyagun ƙwayoyi. Wannan tsarin zagayowar zagayowar yana taimakawa kula da tasirin maganin akan lokaci kuma yana sarrafa haɗarin illolin da ke tattare da amfani mai tsawo.
Yin amfani da Tobramycin foda don cututtukan sinus wani batu ne na haɓaka sha'awa ga al'ummar kiwon lafiya, musamman ga marasa lafiya da sinusitis na yau da kullum ko na yau da kullum wanda bai amsa da kyau ga wasu jiyya ba. Duk da yake Tobramycin da aka fi sani da amfani da shi wajen magance cututtuka na numfashi, musamman a cikin marasa lafiya na cystic fibrosis, an bincika yiwuwar yin amfani da shi a cikin cututtukan sinus a wurare daban-daban na asibiti.
Kwayoyin cututtuka na sinus, ko sinusitis, na iya haifar da cututtuka daban-daban, ciki har da kwayoyin cuta, ƙwayoyin cuta, da fungi. Lokacin da cututtukan ƙwayoyin cuta sune masu laifi, galibi suna haɗawa da ƙwayoyin cuta gram-korau, waɗanda daidai ne nau'in ƙwayoyin cuta waɗanda Tobramycin ya fi tasiri a kansu. Wannan ya sa Tobramycin ya zama zaɓi mai mahimmanci ga wasu lokuta na sinusitis na kwayan cuta, musamman waɗanda ke haifar da Pseudomonas aeruginosa ko wasu kwayoyin cutar gram-korau.
Yin amfani da Tobramycin don cututtukan sinus yawanci ya haɗa da amfani da lakabin magani, saboda ba FDA-an yarda da ita musamman don wannan dalili. Duk da haka, a cikin aikin asibiti, yin amfani da lakabin magunguna ya zama ruwan dare yayin da shaida ta goyi bayan ingancin su da aminci ga wani yanayi. A cikin yanayin Tobramycin don sinusitis, ƙananan ƙananan bincike da rahotanni sun nuna sakamako mai ban sha'awa.
Ɗaya daga cikin fa'idodin amfani da Tobramycin don cututtukan sinus shine yiwuwar isar da maganin kai tsaye zuwa wurin kamuwa da cuta. Ana iya samun wannan ta hanyoyi daban-daban, ciki har da ban ruwa na hanci, nebulization, ko ma kayan da aka sanya su kai tsaye a cikin cavities na sinus yayin hanyoyin tiyata. Aikace-aikacen kai tsaye yana ba da damar babban taro na gida na ƙwayoyin cuta yayin da rage bayyanar tsarin da tasiri mai tasiri.
Misali, wasu kwararrun kunnuwa, hanci, da makogwaro (ENT) sun binciko yadda ake amfani da Tobramycin a cikin ruwan saline na hanci ga marasa lafiya da ke fama da sinusitis na yau da kullun. Wannan hanya tana ba da damar ƙwayoyin rigakafi su shiga hulɗa kai tsaye tare da ƙwayoyin sinus masu cutar, mai yuwuwar inganta tasirinsa. Hakazalika, an yi amfani da Tobramycin nebulized a wasu lokuta, yana barin maganin a shaka kuma ya kai ga cavities na sinus.
Yana da mahimmanci a lura cewa amfani da Tobramycin don cututtukan sinus yawanci ana keɓe shi don lokuta inda daidaitattun jiyya sun kasa ko ga marasa lafiya da takamaiman abubuwan haɗari. Waɗannan na iya haɗawa da mutanen da ke da cystic fibrosis, waɗanda ke da saurin kamuwa da cututtukan Pseudomonas, ko marasa lafiya tare da tarihin tiyatar sinus waɗanda zasu iya kamuwa da wasu nau'ikan cututtukan ƙwayoyin cuta.
Shawarar yin amfani da Tobramycin don kamuwa da cutar sinus ya kamata a koyaushe ƙwararrun ƙwararrun kiwon lafiya ne, yawanci ƙwararrun ENT ko ƙwararrun cututtuka. Za su yi la'akari da abubuwa kamar tarihin likitancin majiyyaci, sakamakon al'adun ƙwayoyin cuta (idan akwai), da yuwuwar haɗari da fa'idodin maganin.
Lokacin da ake amfani da Tobramycin don cututtukan sinus, tsarin sashi da hanyar gudanarwa na iya bambanta da amfani da shi a wasu yanayi. Misali, taro na Tobramycin a cikin maganin kurbar hanci zai kasance da yawa ƙasa da wanda aka yi amfani da shi don inhalation a cikin marasa lafiya na cystic fibrosis. Yawan da kuma tsawon lokacin jiyya kuma za a keɓance shi da yanayin mutum ɗaya.
Yana da mahimmanci a jaddada cewa Tobramycin bai kamata a yi amfani da shi ba tare da nuna bambanci ga kowane nau'in cututtuka na sinus ba. Yin amfani da maganin rigakafi da yawa ko rashin dacewa na iya taimakawa wajen haɓaka juriya na ƙwayoyin cuta, wanda ke da matukar damuwa a cikin al'ummar likitoci. Sabili da haka, tabbatar da yanayin ƙwayoyin cuta na kamuwa da cuta kuma, daidai, gano takamaiman ƙwayoyin cuta ta hanyar al'ada yana da mahimmanci kafin fara maganin Tobramycin don sinusitis.
Marasa lafiya suna la'akari da Tobramycin don cututtukan sinus yakamata su sani cewa wannan magani na iya buƙatar sa ido sosai. Wannan na iya haɗawa da gwaje-gwaje na yau da kullun, endoscopy na hanci, da yuwuwar gwaje-gwajen jini don lura da matakan ƙwayoyi da aikin koda, musamman idan an tsawaita maganin.
Yayin da yuwuwar fa'idodin Tobramycin wajen magance wasu cututtukan sinus suna da alƙawarin, ana buƙatar ƙarin ƙarin nazarin asibiti don tabbatar da ingancinsa da amincinsa a cikin wannan mahallin. Shaidu na yanzu suna nuna cewa yana iya zama zaɓi mai mahimmanci don zaɓaɓɓun lokuta, musamman waɗanda suka shafi ƙwayoyin cuta gram-korau ko a cikin marasa lafiya da ke da takamaiman abubuwan haɗari.
A ƙarshe, yayin Tobramycin foda ana iya amfani da shi don wasu cututtukan sinus, aikace-aikacen sa a cikin wannan mahallin na musamman ne kuma yakamata a yi shi ƙarƙashin kulawar likita kawai. Yayin da bincike ya ci gaba, muna iya ganin ƙarin daidaitattun ka'idoji sun fito don amfani da Tobramycin a cikin sinusitis, mai yuwuwar bayar da sabon bege ga marasa lafiya masu wahalar magance cututtukan sinus.
Idan kuma kuna sha'awar wannan samfurin kuma kuna son ƙarin cikakkun bayanai na samfur, ko kuna son sanin wasu samfuran masu alaƙa, da fatan za a iya tuntuɓar su. iceyqiang@aliyun.com.
References
1. Ramsey BW, Pepe MS, Quan JM, et al. Gudanar da ɗan lokaci na tobramycin inhaled a cikin marasa lafiya da cystic fibrosis. N Engl J Med. 1999; 340 (1): 23-30.
2. Geller DE, Pitlick WH, Nardella PA, Tracewell WG, Ramsey BW. Pharmacokinetics da bioavailability na aerosolized tobramycin a cikin cystic fibrosis. Kirji. 2002; 122 (1): 219-226.
3. Cheer SM, Waugh J, Noble S. Inhaled tobramycin (TOBI): nazarin amfani da shi a cikin kula da cututtuka na Pseudomonas aeruginosa a cikin marasa lafiya tare da cystic fibrosis. Magunguna. 2003;63 (22):2501-2520.
4. Hoffman LR, Ramsey BW. Cystic fibrosis therapeutics: hanyar gaba. Kirji. 2013; 143 (1): 207-213.
5. Adeboyeku D, Scott S, Hodson ME. Bude binciken bin diddigin maganin tobramycin nebulizer da colistin a cikin marasa lafiya da cystic fibrosis. J Cyst Fibros. 2006; 5 (4): 261-263.
6. Scheinberg P, Shore E. Nazarin matukin jirgi na aminci da ingancin maganin tobramycin don inhalation a cikin marasa lafiya tare da bronchiectasis mai tsanani. Kirji. 2005; 127 (4): 1420-1426.
7. Ruddy J, Emerson J, Moss R, et al. Sputum tobramycin a cikin marasa lafiya na cystic fibrosis tare da maimaita gudanarwa na tobramycin inhaled. J Aerosol Med Pulm Drug Deliv. 2013;26 (2):69-75.
8. Le J, Ashley ED, Neuhauser MM, et al. Takaitacciyar yarjejeniya na ma'aikatan antimicrobial aerosolized: aikace-aikacen ka'idodin jagora. Hanyoyi daga Society of Cututtuka Pharmacists. Pharmacotherapy. 2010;30 (6): 562-584.
9. Mogayzel PJ Jr, Naureckas ET, Robinson KA, et al. Cystic fibrosis jagororin huhu. Magunguna na yau da kullun don kula da lafiyar huhu. Am J Respira Crit Care Med. 2013;187(7):680-689.
10. Máiz L, Giron RM, Olveira C, et al. Magungunan rigakafi da aka yi amfani da su don kula da ciwon ƙwayar cuta na Pseudomonas aeruginosa na kullum a cikin cystic fibrosis: nazari na yau da kullum na gwaje-gwajen da bazuwar. Kwararre Opin Pharmacother. 2013;14 (9): 1135-1149.