Rifampin

Rifampin

I-Rifampin, ebizwa nangokuthi i-rifampicin, iyisibulala-magciwane esinamandla kanye nomuthi osebenzayo we-antituberculosis oyingxenye yezidakamizwa ze-antimycobacterial. Umuthi obulala amagciwane, okusho ukuthi ungabulala amagciwane ngempumelelo. Kungenzeka ujwayelene ne-rifampin njengokhiye ukwelashwa kwesifo sofuba (TB), kodwa ukusetshenziswa kwayo kudlulela ngalé kwalokho.

Ukusetshenziswa kwe-Rifampin

Okulandelayo ukusetshenziswa okuvamile kwe-rifampicin:

• Ukwelashwa Kwesifo Sofuba: I-US Food & Drug Administration (i-FDA) igunyaze i-rifampin ukwelapha i-TB eqavile kanye ne-TB. Kuyisisekelo ekwelashweni kwezidakamizwa eziningi kwe-TB engezwani nomuthi ebangelwa i-Mycobacterium tuberculosis. 
• I-Meningococcal Disease: Umuthi we-Rifampin uphinde usebenze ngokumelene nebhaktheriya ye-meningococcal ebangela i-meningitis (ukuvuvukala kolwelwesi lobuchopho) kanye nezifo ezithinta igazi. Isetshenziselwa i-prophylaxis phakathi kwamaqembu asengozini enkulu nokuxhumana okuseduze kanye nomlando wokuhambela izifunda ezitholakala kulesi simo.
• Okunye Ukutheleleka Kwamagciwane: I-Rifampin iyatuswa ukubhekana nezifo ezinzima zebhaktheriya e-gram-positive njenge-osteomyelitis, i-endocarditis, i-anthrax, namathumba ebuchosheni.
• I-Prophylaxis: I-Rifampin isetshenziswa njengesilinganiso sokuvimbela abathwali be-H. influenzae abangadlulisela ukutheleleka ezinganeni ezingaphansi kweminyaka emi-4. 
• Ukwelapha Ngenhlanganisela: Ukubuyekezwa okuhlelekile kwabonisa ukuthi i-rifampin iyasebenza uma ihlanganiswa ne-sulfamethoxazole noma i-trimethoprim ukwelapha ukutheleleka kwe-S. aureus (MRSA) engamelana ne-methicillin ezigulini ezine-cystic fibrosis. 
• I-Peritoneal Dialysis: Iziqondiso ze-International Society for Peritoneal Dialysis ziphakamisa ukusebenzisa i-rifampin ukwelapha i-peritonitis ebangelwa i-coagulase-negative staphylococci, njenge-S. epidermidis, kanye ne-TB peritonitis.
• Ukulawula Ukulunywa: I-Rifampin iphinde ibe usizo njengenketho yesibili yokulawula ukulunywa okuhlobene ne-primary sclerosing cholangitis kanye ne-primary biliary cirrhosis.

Isetshenziswa kanjani i-Rifampin?

Thatha i-rifampin njengoba uyalelwe udokotela wakho. Ukwenza kanjalo kunganciphisa ingozi yemiphumela emibi:

• Thatha amaphilisi e-rifampin esiswini esingenalutho, ihora elilodwa ngaphambi noma amahora amabili ngemuva kokudla, nengilazi yamanzi egcwele.
• Kubalulekile ukuthatha i-rifampin ngezikhathi ezithile njengoba uyalelwe udokotela wakho.
• Uma i-rifampin iphazamisa isisu sakho, ungayiphuza kanye nokudla. Ama-antacid kungase futhi kusize, kodwa kufanele ugweme ama-antacid aqukethe i-aluminium lingakapheli ihora eli-1 uphuze i-rifampin, okungase kuphazamise ukusebenza kwayo.
• Nyakazisa ibhodlela lokumiswa kwe-rifampin ngaphambi komthamo ngamunye.
• Sebenzisa isipuni sokulinganisa noma inkomishi yomuthi ephawuliwe ukukala uketshezi ngokunembile. 

Imiphumela Emibi Yethebhulethi ye-Rifampin

I-Rifampin ingase ibangele eminye imiphumela emibi engadingeki, njenge:

• Imiphumela Emibi Evamile:
  • Ngenkathi uthatha i-rifampin, ungase uphathwe isisu, ukushaya kwenhliziyo, isicanucanu, noma ikhanda elibuhlungu. 
  • I-Rifampin ingabangela nomchamo wakho, umjuluko, amathe, noma izinyembezi ukuthi zishintshe umbala (ophuzi, osawolintshi, obomvu, noma onsundu). Lo mphumela uzonyamalala uma uyeka ukuphuza umuthi. 
• Imiphumela Emibi Kakhulu: Thola usizo lwezokwelapha ngokushesha uma uba nanoma yimiphi imiphumela emibi elandelayo:
  • Izimpawu zezinkinga zezinso, njengokushintsha kwenani lomchamo
  • Ukushintsha kwengqondo/imizwelo (ukudideka, ukuziphatha okungajwayelekile)
  • Ukukhathala okungajwayelekile
  • Ukulinyazwa okulula
  • Amabala abomvu amancane esikhumbeni
  • Ubuhlungu bamalunga noma ukuvuvukala
  • Ukuphefumula okusha noma okubi kakhulu
  • ubuhlungu besifuba
  • I-Rifampin ayivamisile ukubangela isifo sesibindi esibi kakhulu (esingabulala). Kungase kubangele:
    • Ukudabuka noma ukuhlanza 
    • Ukulahlekelwa kwesifiso
    • Ubuhlungu besisu
    • Ukuphuzi kwamehlo noma isikhumba
    • Umchamo omnyama
• Isimo Samathumbu: I-Rifampin akuvamile ukuba ibangele isifo samathumbu esinzima ngenxa yebhaktheriya ebizwa ngokuthi i-Clostridium difficile (C. difficile). Lesi simo singase sithuthuke phakathi nokwelashwa noma amasonto kuya ezinyangeni ngemva kokuyeka ukwelashwa. Xhumana nodokotela wakho ngokushesha uma uthuthuka:
  • Uhudo 
  • Ubuhlungu besisu noma amajaqamba
  • Igazi noma amafinyila esitulweni
• Uma unalezi zimpawu, ungasebenzisi imithi elwa nesifo sohudo noma i-opioid, ngoba ingase ibe sibi kakhulu isimo:
  • I-Yeast Infections: I-Rifampin ngezinye izikhathi ingase ibangele ukutheleleka okusha kweyeast noma i-thrush yomlomo.
  • I-Allergic Reaction: Ukungezwani okukhulu ne-rifampin akuvamile. Nokho, thola usizo lwezokwelapha ngokushesha uma ubona:
    • Umkhuhlane awupheli
    • Ukuvuvukala kwama-lymph node okusha noma okubi kakhulu
    • Rash
    • Ukuluma noma ukuvuvukala (ubuso, ulimi, noma umphimbo)
    • Isiyezi esinzima
    • Ukuphefumula kanzima

Ukuqapha

Ngaphambi kokusebenzisa i-rifampin, kufanele wazise udokotela wakho uma ungezwani nayo noma amanye ama-rifamycin (afana ne-rifabutin) noma unokuthile okungakuphathi kahle. Xhumana nodokotela wakho uma:

• Uma unezimo zesistimu, njengesifo sikashukela, izinkinga zesibindi (njenge-hepatitis), noma ukutheleleka nge-HIV 
• Umlando wokusetshenziswa kotshwala
• Ukukhulelwa nokuncelisa
• Yazisa udokotela wakho ukuthi uthatha i-rifampin ngaphambi kokuthola imigomo noma imigomo.

Isebenza kanjani i-Rifampin

I-Rifampin iyimithi elwa namagciwane enamandla evimbela i-RNA polymerase encike kubhaktheriya, i-enzyme ebalulekile ekuhlanganiseni kwe-RNA kubhaktheriya, edlala indima ebalulekile ekuhlanganiseni amaprotheni kumaseli ebhaktheriya.  

Njengemithi elwa namagciwane enohlobo olubanzi lomsebenzi, i-rifampin ibonisa imiphumela yokulwa namagciwane ngokumelene nezinhlobonhlobo ze-cocci e-gram-positive, kuhlanganise ne-Mycobacteria kanye

I-Clostridium difficile, kanye nezilwanyana ezithile ezingenayo igram ezifana ne-Neisseria meningitidis, N. gonorrhoeae, kanye ne-Haemophilus influenzae.  

Ngingakwazi Ukuthatha I-Rifampin Ngeminye Imithi?

I-Rifampin umuthi onamandla ongasebenzisana neminye imithi ehlukahlukene, okungenzeka ukuthikame ukusebenza kwawo kahle noma ukhuphule ingcuphe yemiphumela engemihle. 

• Izidakamizwa Okufanele Uzigweme Nge-Rifampin:
  • Imithi ethile ye-HIV
  • Izidakamizwa ze-Anthelmintics
  • Amaphilisi okulawula ukuzala
• Izidakamizwa ezingase Zidinge Ukulungiswa Kwethamo: I-Rifampin ingakhuphula noma yehlise amazinga eminye imithi eminingi emzimbeni wakho, okungase kuholele emiphumeleni emibi noma ukunciphisa ukusebenza kahle, okuhlanganisa:
  • Ama-Anticoagulants (anciphisa igazi) 
  • I-Antiarrhythmics (imithi yesigqi senhliziyo)
  • antidepressant
  • Ama-antifungals
  • Ama-Anticonvulsants (imithi yokuthuthumela)
  • Ama-Antipsychotics
  • Corticosteroids
  • Ama-immunosuppressants
  • Ama-analgesics e-opioid
  • Ama-oral hypoglycemic agents (imithi yesifo sikashukela)
  • Ama-statins (izidakamizwa ezinciphisa i-cholesterol)
  • Imithi yegilo

Ulwazi Lomthamo

Umthamo we-rifampin uyahlukahluka kuye ngesimo sokwelashwa, iminyaka yakho, nesisindo somzimba wakho. Kubalulekile ukulandela imiyalelo kadokotela wakho noma iziqondiso ezikulebula ngokucophelela. Nansi imihlahlandlela ejwayelekile yokuthasiswa kwe-rifampin:

Isilinganiso Sabantu Abadala

• Isifo Sofuba (Siyasebenza)
  • Umthamo: 10 mg/kg ngomlomo noma ngemithambo kanye ngosuku. 
  • Umthamo omkhulu: 600 mg / ngosuku
  • Ubude besikhathi: Isigaba sokuqala (izinyanga ezi-2) nge-isoniazid, i-pyrazinamide, kanye/ngaphandle kwe-streptomycin noma i-ethambutol. Isigaba esiqhubekayo (okungenani izinyanga ezine) nge-isoniazid.
• I-Tuberculosis (Latent)
  • Umthamo: 10 mg/kg ngomlomo noma ngomthambo kanye ngosuku, nge-isoniazid noma ngaphandle kwayo; Umthamo omkhulu: 600 mg / ngosuku; Ubude besikhathi: Izinyanga ezi-4
  • 10 mg/kg ngomlomo noma ngomthambo kanye ngosuku nge-pyrazinamide; Umthamo omkhulu: 600 mg / ngosuku; Ubude besikhathi: 2 izinyanga

Isiphetho

I-Rifampin igqama njengemithi elwa namagciwane enamandla enezinhlobonhlobo zezinhlelo zokusebenza, kusukela ekwelapheni isifo sofuba kuya ekuvimbeleni i-meningitis. Indlela yayo yokusebenza eyingqayizivele, ehlanganisa ukuvimbela ukuhlanganiswa kwe-RNA yebhaktheriya, iyenza ibe ithuluzi elibalulekile ekulweni nezifo ezihlukahlukene ezibangelwa amagciwane. Nokho, kubalulekile ukukhumbula ukuthi i-rifampin ingasebenzisana neminye imithi eminingi futhi inemiphumela engemihle engaba khona edinga ukuqashelwa ngokucophelela.

Imibuzo Evame Ukubuzwa

1. Yini okufanele uyigweme lapho uthatha i-rifampin?

Ungayisebenzisi i-rifampin uma uthatha nama-anthelmintics, imishanguzo okumele uyelaphe ukutheleleka nge-HIV noma amaphilisi okulawula inzalo. I-Rifampin inganciphisa kakhulu amazinga ale mithi emzimbeni wakho, iyenze ingasebenzi kahle. Gwema ukuphuza utshwala okuvamile ngenkathi uthatha i-rifampin, njengoba kungase kwandise ingozi yezinkinga zesibindi futhi kunciphise ukusebenza komuthi.

2. Iyini inhloso ye-rifampicin?

I-Rifampin, noma i-rifampicin, isibulala-magciwane esinamandla ekwelapheni isifo sofuba (TB) nezinye izifo ezibangelwa amagciwane. Kuyisisekelo ekwelashweni kwezidakamizwa eziningi ekulweni ne-TB etholakala emishanguzweni ebangelwa i-Mycobacterium tuberculosis. I-Rifampin iphinde ivunyelwe ukuqeda abathwali abangenazimpawu ze-Neisseria meningitidis ku-nasopharynx.

3. Uyithatha nini i-rifampicin?

Thatha amaphilisi e-rifampin esiswini esingenalutho, ihora elilodwa ngaphambi noma amahora amabili ngemuva kokudla, nengilazi yamanzi egcwele. Kubalulekile ukuthatha i-rifampin ngezikhathi ezithile njengoba uyalelwe udokotela wakho. 

4. Ubani ongakwazi ukuthatha i-rifampin?

I-Rifampin ayivunyelwe kubantu abanomlando wokuzwela kakhulu i-rifampin noma yiziphi izingxenye ze-rifamycin. Odokotela futhi bayakuphikisa ukusetshenziswa kwayo ezigulini ezinesifo sesibindi esinamandla noma ukukhubazeka okukhulu kwesibindi. Khuluma nodokotela wakho uma unayo sikashukela, izinkinga zesibindi, ukutheleleka nge-HIV, noma umlando wokusebenzisa utshwala/ukuhlukumeza ngaphambi kokuqala ukwelashwa nge-rifampin.