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I-Linezolid

I-Linezolid imele njengemithi elwa namagciwane enamandla elwa nezifo ezimbi kakhulu ezibangelwa amagciwane. Lo muthi obalulekile usiza iziguli ukuthi zinqobe izinhlobo ezahlukene zezifo lapho amanye ama-antibiotic ehluleka ukusebenza. Ngaphambi kokuqala ukwelashwa, iziguli zidinga ukuqonda ukusetshenziswa okufanele kwe-linezolid antibiotic, imihlahlandlela yomthamo, kanye nemiphumela engemihle engaba khona. Lesi sihloko sichaza konke iziguli okufanele ziyazi nge-linezolid, kusukela ekusetshenzisweni kwayo ngendlela efanele kuya ezinyathelweni ezidingekayo kanye nokusebenzisana kwezidakamizwa.

Yini i-Linezolid?

I-Linezolid ingeyesigaba esikhethekile semithi elwa namagciwane ebizwa ngokuthi i-oxazolidinones, eyethulwa okokuqala ngo-2000 njengokwelashwa okuyisisekelo kwezifo ezibangelwa amagciwane. Lesi sibulala-magciwane sokwenziwa sisebenza ngokumisa ukukhula kwamagciwane ngendlela eyingqayizivele - sivimbela amagciwane ukuthi akhiqize amaprotheni abalulekile adingekayo ukuze aphile.

I-Linezolid ayisebenzi ngokumelene ukutheleleka ngegciwane njengomkhuhlane noma umkhuhlane. Umuthi futhi awubonisi umphumela obalulekile ngokumelene namagciwane e-gram-negative. Umuthi usebenza njengenye indlela ye-vancomycin, ikakhulukazi ezimeni lapho amagciwane aqala ukumelana nokwelashwa kwendabuko. Kodwa-ke, ukusetshenziswa kwayo kudinga ukucatshangelwa ngokucophelela njengoba ingasabela ngemithi ethile ngenxa yomphumela wayo kuma-enzyme e-monoamine oxidase.

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Ukusetshenziswa kwe-Linezolid

Ukusetshenziswa okuyinhloko kwe-linezolid 600 mg kuhlanganisa:

  • Ukwelashwa kwe-nosocomial kanye nokutholwa ngumphakathi inyumoniya
  • Ukuphathwa kwezifo zesikhumba eziyinkimbinkimbi kanye nesakhiwo esihlobene
  • Ukwelashwa kwezifo ze-Enterococcus faecium ezimelana ne-vancomycin
  • Ukubhekana nezifo ezibangelwa i-Staphylococcus aureus engamelana ne-methicillin (MRSA)

Ithebhulethi ye-Linezolid 600 mg iyasebenza ngokumelene nezinhlobo ezithile zamagciwane, okuhlanganisa i-Staphylococcus aureus, i-Streptococcus pneumoniae, i-Streptococcus pyogenes, ne-Streptococcus agalactiae. 

Ungayisebenzisa kanjani i-Linezolid Tablet

Iziguli zingaphuza ithebhulethi ngokudla noma ngaphandle kokudla, futhi ubude besikhathi sokwelashwa obujwayelekile busukela ezinsukwini eziyishumi kuye kwezingamashumi amabili, kuye ngohlobo lokutheleleka.

Imihlahlandlela ebalulekile yokuphatha i-linezolid yilezi:

  • Thatha imithi ngezikhathi ezilinganayo, ngokuvamile njalo emahoreni ayi-12
  • Qedela yonke inkambo yokwelashwa, ngisho noma izimpawu ziba ngcono
  • Gcina amaphilisi e-linezolid ekamelweni lokushisa, kude nokushisa nomswakama
  • Gcina imithi ekukhanyeni okuqondile futhi kude nezingane
  • Ungabelani nabanye imithi
  • Uma isiguli sigeja umthamo we-linezolid, kufanele siwuthathe ngokushesha lapho sikhumbula. Kodwa-ke, uma sekusondele isikhathi somthamo olandelayo ohleliwe, kufanele beqe ophuthiwe futhi baqhubeke neshejuli yabo evamile yokudosa. Ungalokothi uthathe umthamo ophindwe kabili ukuze ubuyisele ogejiwe.
  • Ifomu lokumiswa ngomlomo lidinga ukuxubana okumnene ngokuguqula ibhodlela izikhathi ezi-3 kuye kwezingu-5 ngaphambi komthamo ngamunye. Odokotela bangashintsha iziguli phakathi kwethebhulethi kanye namafomu okufakwa emthanjeni ngaphandle kokulungiswa komthamo, njengoba womabili amafomu ayashintshana.

Imiphumela Emibi Yethebhulethi ye-Linezolid

Iziguli ezithatha i-linezolid kufanele ziqaphele imiphumela emibi engase yenzeke ngesikhathi sokwelashwa. 

  • Imiphumela Emibi Evamile:
    • bekhanda kanye nesiyezi
    • I-nausea nokuhlanza
    • Uhudo or ubuhlungu besisu
    • Izinguquko ekuboneni ukunambitheka
    • Ukuqubuka kwesikhumba okuncane noma ukulunywa
    • Amabala amhlophe emlonyeni
    • Izinguquko kumbala wolimi
  • Imiphumela Emibi Kakhulu: 
    • Ukungezwani nomzimba okukhulu (ukuphefumula kanzima, ukuvuvukala kobuso noma umphimbo)
    • Umbono uyashintsha noma umbono ongenalutho
    • Ukusuka okungavamile noma ukulimaza
    • ezinzima isifo sohudo enomkhuhlane noma ngaphandle kwayo
    • Ubuthakathaka bemisipha noma ubuhlungu
    • Ukuba ndikindiki noma ukushoshozela ezandleni nasezinyaweni (peripheral neuropathy)
    • ukuquleka noma ukudideka
    • Uma ithathwa neminye imithi ethile, i-linezolid yandisa amazinga e-serotonin emzimbeni, okuholela esimweni esibi esibizwa ngokuthi i-serotonin syndrome.
    • I-Linezolid ingase futhi ibangele i-myelosuppression (umnkantsha ongakhiqizi amaseli egazi anele).

Ukuqapha

Ukugadwa kwezokwelapha kudlala indima ebalulekile lapho iziguli zithola ukwelashwa nge-linezolid. 

  • Izidingo Zokuqapha Ezempilo:
    • Ukuhlolwa kwegazi okujwayelekile ukuqapha amangqamuzana amhlophe egazi namaplatelet
    • Ukuhlolwa kokusebenza kwezinso nesibindi
    • Ukuqapha ukucindezelwa kwegazi
    • Ukuhlolwa kombono uma ukwelashwa kudlula izinsuku ezingama-28
    • Ukuqapha izinga likashukela egazini, ikakhulukazi ezigulini ezinesifo sikashukela
  • Izimo Zezokwelapha: Iziguli ezinezimo ezithile zezokwelapha zidinga ukunakwa okukhethekile ngesikhathi sokwelashwa kwe-linezolid. Lokhu kuhlanganisa abantu abanomfutho wegazi ongalawuleki, i-anemia, ama-WBC aphansi, izinkinga zegilo, isifo sezinso, ukugula kwesibindi, noma ukuphazamiseka kokuquleka. 
  • Imikhawulo yokudla: Iziguli kufanele zigweme ukudla okunokuqukethwe okuphezulu kwe-tyramine njengoba kungabangela ukwanda okuyingozi komfutho wegazi. Lokhu kuhlanganisa ushizi asebekhulile, ukudla okubilile, inhlanzi ebhenywayo, newayini elibomvu.
  • Ukukhulelwa Nokuncelisa: Abantu abakhulelwe noma abancelisa ibele kufanele baxoxe ngezingozi nezinzuzo nodokotela wabo. 

Ubude besikhathi sokwelashwa akufanele budlule izinsuku ezingama-28 ngaphandle kokuhlolwa ngokucophelela kodokotela. 

Isebenza kanjani ithebhulethi ye-Linezolid

Umuthi uhlose ngokusobala izifo ezibangelwa amagciwane e-aerobic gram-positive. Ibonisa izinhlobo ezimbili ezihlukene zesenzo:

  • Umphumela we-bacteriostatic ngokumelene ne-staphylococci ne-enterococci
  • Isenzo se-bactericidal ngokumelene nezinhlobo eziningi ze-streptococci

I-Linezolid ifinyelela imiphumela yayo yokulwa namagciwane ngokubopha ibhaktheriya i-23S ribosomal RNA, ivimbele ngempumelelo amagciwane ukuthi aphindaphindeke. Le nqubo iyenza isebenze ikakhulukazi ezinhlotsheni ezimbalwa zokutheleleka:

  • Inyumoniya (kokubili okutholwe esibhedlela kanye nokutholwa umphakathi)
  • Izifo zesikhumba nesakhiwo sesikhumba
  • Ukutheleleka kwe-Enterococcus faecium ukumelana ne-Vancomycin

Imiphumela Ebalulekile Yesenzo se-Linezolid:

  • Ivimbela ukuqaliswa kwe-bacterial protein synthesis
  • Yehlisa ubude bokwakha amaketango e-peptide
  • Yehlisa izinga lokusabela kokuhumusha
  • Ivimbela ukukhiqizwa kwe-toxin kumagciwane e-gram-positive
  • Igcina ukusebenza ngempumelelo ngokumelene nezinhlobo eziqinile

Ngaphandle kwesenzo sawo esiyinhloko, i-linezolid isebenza njenge-reversible monoamine oxidase (MAO) inhibitor. Lo mphumela wesibili uthonya amazinga e-neurotransmitter ohlelweni lwezinzwa oluphakathi noluzwelayo, okuhlanganisa i-epinephrine, i-norepinephrine, i-dopaminekanye ne-serotonin.

Ngingakwazi Ukuthatha I-Linezolid Neminye Imithi?

Ukuthatha imithi eminingi eceleni kwe-linezolid kudinga ukugadwa ngokucophelela ngenxa yokusebenzisana okungenzeka. Imithi elwa namagciwane isebenzisana nemithi ehlukene engaphezu kuka-500, okuhlanganisa ukusebenzisana okusesilinganisweni okungu-166 nokungu-351 okusesilinganisweni, okwenza kube semqoka ezigulini ukuxoxa ngemithi yazo yamanje nodokotela.

Izigaba Ezinkulu Zezidakamizwa Okufanele Zigwenywe:

  • Imithi ye-Adrenergic (pseudoephedrine, epinephrine)
  • Amakhambi abandayo kanye nama-decongestants
  • Imithi ethile yezinhlungu
  • Imithi esetshenziselwa umkantsha ukucindezelwa
  • Umuthi we-opioid
  • Izidakamizwa ze-Serotonergic (ama-antidepressants, imithi yokukhathazeka)
  • Ukwelashwa okuqondile kwe-migraine
  • Eminye imithi yesifo sikashukela

Ulwazi Lomthamo

Odokotela banquma umthamo ofanele ngokusekelwe ezidingweni zesiguli ngasinye kanye nezici zokutheleleka.

Umthamo Ojwayelekile Wabantu Abadala:

  • 600 mg kabili ngosuku ezifweni ezimbi kakhulu
  • 400 mg kabili ngosuku ngezifo zesikhumba ezingenzima
  • Isikhathi sokwelashwa ngokuvamile sisukela ezinsukwini eziyi-10-14
  • Isikhathi sokwelashwa esiphezulu akufanele sidlule izinsuku ezingama-28

Ezimweni ezehlukene, odokotela balandela ubude besikhathi sokwelashwa obuthize:

 
Isimo     Ubude besikhathi sokwelashwa
I-pneumonia     izinsuku 10-14
Izifo zesikhumba eziyinkimbinkimbi   izinsuku 10-14
Izifo ezimelana ne-Vancomycin     izinsuku 14-28

Izidingo Zomthamo Wezingane: Izingane ezingaphansi kweminyaka eyi-12 zithola umthamo osuselwa kusisindo esingu-10 mg ngekhilogremu yesisindo somzimba. Imvamisa iyahlukahluka ngeminyaka:

  • Ngaphansi kwezinsuku eziyi-7 ubudala: Njalo emahoreni ayi-12
  • Izinsuku eziyi-7 kuye eminyakeni eyi-11: Njalo ngamahora ayi-8
  • Iminyaka engu-12 nangaphezulu: Umthamo wabantu abadala uyasebenza

Abantu abakhethekile badinga ukucatshangelwa ngokucophelela ngesikhathi sokwelashwa. Iziguli ezinezinkinga zesibindi zingase zidinge imithamo elungisiwe, kuyilapho lezo ezinezinkinga zezinso zidinga ukuqashwa njalo naphezu kokulungiswa okuthile komthamo. Iziguli esezikhulile ngokuvamile zithola imithamo yabantu abadala evamile, nakuba odokotela beziqapha eduze ukuze bathole imiphumela engemihle engaba khona.

Isiphetho

I-Linezolid igqama njengenketho yama-antibiotic ezigulini ezinokutheleleka okukhulu kwamagciwane. Odokotela bayawazisa lo muthi ngenxa yekhono lawo eliyingqayizivele lokulwa namagciwane angazweli lapho ezinye izindlela zokwelapha zingaphumeleli. Umuthi usebenza ngendlela eyingqayizivele evimba amagciwane ekwenzeni amaprotheni awadingayo ukuze aphile, okuwenza asebenze ngokumelene nezifo eziningi eziyingozi njengenyumoniya kanye nezinkinga zesikhumba eziyinkimbinkimbi.

Iziguli zidinga ukugadwa ngokucophelela kwezokwelapha ngenkathi zithatha i-linezolid ngenxa yemiphumela yayo enamandla kanye nemiphumela engemihle engaba khona. Odokotela kufanele bahlole amanani egazi njalo futhi babheke ukusabela okungavamile ngesikhathi sokwelashwa. Impumelelo nge-linezolid incike ekulandeleni amashejuli omthamo afanele, ukugwema ukudla okuthile nemithi, kanye nokuqeda yonke inkambo yokwelashwa njengoba odokotela bebeka.

Imibuzo Evame Ukubuzwa

1. I-linezolid isetshenziselwa ini ngokuyinhloko?

Odokotela ngokuyinhloko banquma i-linezolid yokwelapha izifo ezingathi sína zamagciwane amanye ama-antibiotic angeke akwazi ukubhekana nawo ngempumelelo. Umuthi uqondisa ngokucacile izifo ezibangelwa amagciwane amelana nezifo, okuhlanganisa inyumoniya, izifo zesikhumba eziyinkimbinkimbi, kanye nezifo ze-enterococcal ezimelana ne-vancomycin.

2. Ingabe i-linezolid iyi-antibiotic enamandla kakhulu?

Nakuba i-linezolid ingeyona i-antibiotic enamandla kakhulu, ingeyesigaba esiyingqayizivele esibizwa ngokuthi ama-oxazolidinone, okwenza isebenze kakhulu ngokumelene nezinhlobo ezithile zamagciwane. Amandla ayo asemandleni ayo okusebenza ngokumelene namagciwane asengazweli kwamanye ama-antibiotic, ikakhulukazi ama-gram-positive organisms.

3. Ingabe i-linezolid iphephile ezinso?

I-Linezolid ikhombisa ukuphepha okuhle ezigulini ezinezinkinga zezinso. Ngokungafani namanye ama-antibiotic amaningi, akudingi ukulungiswa komthamo ezigulini ezinokukhubazeka kwezinso. Kodwa-ke, odokotela kufanele baqaphe iziguli ezinokukhubazeka okukhulu kwezinso ngesikhathi sokwelashwa.

4. Ingabe i-linezolid iphephile ukuyisebenzisa?

Umuthi ubonakala uphephile uma usetshenziswa njengoba kuyalelwe ngaphansi kokuqondisa kwezokwelapha okufanele. Ukuqapha njalo ngokuhlolwa kwegazi kusiza ukuqinisekisa ukuphepha phakathi nokwelashwa. Iningi leziguli liyibekezelela kahle i-linezolid, nakuba ezinye zingase zibe nemiphumela engemihle edinga ukunakekelwa kwezokwelapha.

5. Yikuphi ukudla okufanele ngikugweme nge-linezolid?

Iziguli ezithatha i-linezolid kumele zigweme ukudla okune-tyramine ephezulu, okuhlanganisa:

  • Ushizi osekhulile noma ovutshiwe
  • Inyama ephekiwe noma evutshiwe
  • I-Sauerkraut ne-kimchi
  • Thepha ubhiya newayini elibomvu
  • I-soy sauce kanye ne-miso
  • Izithelo ezivuthiwe
  • Izigaxa zikabhontshisi ezibanzi

6. Ubani okungafanele athathe i-linezolid?

Izimo eziningana zingavimbela ukusetshenziswa okuphephile kwe-linezolid:

  • Iziguli ezithatha imithi ethinta amazinga e-serotonin
  • Abantu abanomfutho wegazi ophakeme ongalawuleki
  • Abantu abane-carcinoid syndrome
  • Labo abanezinkinga zegilo
  • Iziguli ezinokuphazamiseka okuthile kwegazi
  • Abantu abangezwani nama-antibiotic e-oxazolidinone

Odokotela bahlola ngokucophelela umlando wezokwelapha wesiguli ngasinye kanye nemithi yamanje ngaphambi kokunquma i-linezolid ukuze baqinisekise ukwelashwa okuphephile nokusebenzayo.