I-Ertapenem iyisibulala-magciwane esinamandla esingaphansi kweqembu elibizwa ngokuthi ama-carbapenem, elenzelwe ukulwa nezifo ezingathi sína ezibangelwa amagciwane lapho ezinye izibulala-magciwane zingase zingasebenzi kahle. Lo muthi unikezwa ngomjovo, kungaba emthanjeni noma emisipheni, futhi ngokuvamile ugcinelwe izifo ezingathi sína ezidinga ukunakekelwa ezingeni lomtholampilo. Cabanga ngayo njengelinye lamathuluzi aqinile emkhakheni kadokotela wakho wokulwa nezifo ezinzima ezibangelwa amagciwane ezidinga ukunakwa ngokushesha.
Yini i-Ertapenem?
I-Ertapenem iyisibulala-magciwane esibanzi esisebenza ngokubhubhisa izindonga zamaseli amagciwane, siwabulale ngempumelelo ngaphambi kokuba akwazi ukuzala nokusabalala. Iyingxenye yomndeni we-carbapenem, okuthiwa ezinye zezibulala-magciwane ezinamandla kakhulu ezitholakala namuhla. Udokotela wakho uzokhetha lo muthi lapho bedinga okuthile okuqinile ngokwanele ukubhekana nezifo eziyinkimbinkimbi ezingaphendulanga kwezinye izindlela zokwelapha.
Lesi sibulala-magciwane singokwenziwa, okusho ukuthi senziwa emalabhorathri ngokuqondile ukuze siqondise izinhlobo eziningi zamagciwane ayingozi. Ngokungafani nezinye izibulala-magciwane ezisebenza kuphela ezinhlotsheni ezithile zamagciwane, i-ertapenem ingalwa namagciwane e-gram-positive kanye ne-gram-negative, okwenza ibaluleke kakhulu ekwelapheni izifo ezixubile.
Isetshenziselwani i-Ertapenem?
I-Ertapenem iphatha izifo ezingathi sína ezibangelwa amagciwane ezivame ukudinga ukulaliswa esibhedlela noma ukunakekelwa okukhulu kwezokwelapha. Udokotela wakho angase akunikeze lo muthi uma unezifo eziqala ziqine noma ezingathuthukanga ngezinye izibulala-magciwane.
Izimo ezivame kakhulu i-ertapenem esiza ukuzelapha zihlanganisa izinhlobo eziningana zezifo ezingaba zimbi kakhulu uma zingelashwa:
- Izifo eziyinkimbinkimbi zesisu, okuhlanganisa izifo ezenzeka ngemva kokuhlinzwa noma ngenxa yezimo ezinjengokuvuvukala kwamathumbu
- Izifo eziyinkimbinkimbi zesikhumba nezicubu ezithambile, njenge-cellulitis eqinile noma izifo ngemva kokulimala
- Umkhuhlane otholakala emphakathini, ikakhulukazi amacala adinga ukulaliswa esibhedlela
- Izifo eziyinkimbinkimbi zomgudu womchamo, okuhlanganisa izifo zezinso
- Izifo eziqinile zepelvic kwabesifazane, okuhlanganisa izifo zezitho zokuzala
Kwezinye izimo, odokotela basebenzisa i-ertapenem ukuvimbela izifo ngaphambi kokuhlinzwa okuthile, ikakhulukazi izinqubo ze-colorectal lapho ingozi yokutheleleka ngamagciwane iphezulu. Lokhu kusetshenziswa kokuvimbela kusiza ekuqinisekiseni ukuthi noma yimaphi amagciwane akhona awabangeli izinkinga ngesikhathi noma ngemva kokuhlinzwa kwakho.
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Akusho njalo, ngoba imijovo ivame ukusetshenziswa ukuze umuthi ufike egazini lakho ngokushesha nangobuningi obufanele. Kwesinye isikhathi, uhlobo lwebhaktheriya olubangele ukutheleleka luphendula kangcono emthini okwe-antibiotic owujovwayo kunalowo ophuzwayo. Udokotela wakho angakuchazela ukuthi kungani lokhu kukhethelwe isimo sakho.
Abantu abaningi bathi baqala ukuzizwa bekhululeka ezinsukwini ezi-2 kuya kwezi-3 beqale ukwelashwa. Nakuba ungase uzizwe ungcono ngokushesha, kubalulekile ukuthi uqede umuthi wonke ukuze uqinisekise ukuthi ukutheleleka kuphele nya. Gcina irekhodi lezimpawu ozizwayo ukuze wabelane ngalo nethimba elikwelashayo.
Isebenza Kanjani I-Ertapenem?
I-Ertapenem isebenza ngokugxila kunqubo yokwakha amagciwane ayisebenzisayo ukwakha izindonga zawo zangaphandle ezivikelayo. Cabanga ngezindonga zamaseli amagciwane njengesisekelo sendlu - ngaphandle kwazo, amagciwane angeke asinde noma azale.
Leli khambi elilwa namagciwane libopha kumaprotheni athile amagciwane awadingayo ukuze akhe lezi zindonga, ngempumelelo emisa inqubo yokwakha phakathi nendawo. Lapho amagciwane engakwazi ukugcina izindonga zawo zamaseli, aba sengozini futhi afe ngokushesha. Le ndlela yenza i-ertapenem isebenze kahle ikakhulukazi kumagciwane asekhe athuthukise ukumelana namanye ama-antibiotics.
Njenge-antibiotic eqinile, i-ertapenem yakhelwe ukusebenza ngokushesha nangempumelelo. Iningi leziguli liqala ukubona ngcono izimpawu zazo kungakapheli amahora angu-48 kuya kwangu-72 ziqala ukwelashwa, nakuba inkambo ephelele kumele iqedwe ngisho noma uqala ukuzizwa ungcono.
Kufanele Ngiyithathe Kanjani I-Ertapenem?
I-Ertapenem ihlala inikezwa ngomjovo, kungaba emthanjeni (intravenous) noma emsipheni (intramuscular), futhi lokhu kuzokwenziwa ochwepheshe bezempilo abaqeqeshiwe esibhedlela noma endaweni yezokwelapha. Ngeke uthathe lo muthi ekhaya ngaphandle uma uthola izinsizakalo zokunakekelwa kwezempilo zasekhaya ezikhethekile.
Umthamo ovamile wabantu abadala yi-1 gram kanye ngosuku, nakuba udokotela wakho ezolungisa lokhu ngokusekelwe esimweni sakho esithile, ukusebenza kwezinso, nempilo yonke. Ukuze kulawulwe ngomthambo, umuthi uvame ukuxutshwa nesixazululo esingenazo izinto ezingcolile futhi unikezwe kancane kancane cishe imizuzu engama-30 ukunciphisa ingozi yemiphumela emibi.
Uma uthola umjovo emsipheni, ngokuvamile unikezwa engxenyeni engaphezulu yangaphandle yethanga lakho noma izinqe. Le ndlela ingase ikhethwe uma ukufinyelela kwe-IV kunzima noma uma usuka esibhedlela uya ekunakekelweni kwesiguli esiphuma ngaphandle.
Akudingeki ukhathazeke ngokuthatha lo muthi nokudla ngoba unikezwa ngomjovo. Kodwa-ke, ukuhlala unamanzi kahle ngesikhathi sokwelashwa kungasiza izinso zakho ukuthi zicubungule umuthi ngempumelelo futhi kunciphise ingozi yemiphumela emibi.
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Ngokuya ngokuthi uzizwa ukhululekile kangakanani nokuthi ukwelashwa kwakho kuyinkimbinkimbi kangakanani, ukuzijova ekhaya kuyindlela evame ukusekelwa ngabahlengikazi abavakashayo. Abantu abaningi bakuthola kukuhle kakhulu ukululama besendaweni yabo kunasesibhedlela. Khuluma nethimba lakho lezempilo mayelana nendlela lokhu okungenziwa ngayo nokuthi yiluphi usizo olutholakalayo.
Uzodinga ukuhlela imisebenzi yakho yansuku zonke ngokuhambisana nesikhathi sokuthola umuthi ukuze uqinisekise ukuthi umuthi usesigabeni esifanele emzimbeni wakho. Abantu abaningi bathola ukuthi ukuhlela usuku lwabo ngokwesikhathi somjovo kwenza inqubo ibe lula. Gxila ekwenzeni izinto ngendlela efanayo esikhundleni sokushintsha indlela yakho yokuphila yonke.
Kufanele Ngithathe I-Ertapenem Isikhathi Esingakanani?
Izifundo eziningi ze-ertapenem zithatha phakathi kwezinsuku ezi-3 kuya kweziyi-14, kuye ngohlobo nobukhulu bokutheleleka kwakho. Udokotela wakho uzonquma ubude obuqondile ngokusekelwe endleleni umzimba wakho osabela ngayo ekwelashweni kanye namagciwane athile abangela ukutheleleka kwakho.
Ezifweni eziningi zesisu nesikhumba, ukwelashwa kuvame ukuthatha izinsuku ezi-5 kuya kweziyi-14. Umkhuhlane wamaphaphu ungase udinge izinsuku eziyi-10 kuya kweziyi-14 zokwelashwa, kuyilapho izifo zomgudu womchamo zivame ukudinga izinsuku eziyi-10 kuya kweziyi-14 futhi. Izifo ze-pelvic zivame ukudinga izinsuku ezi-3 kuya kweziyi-10 zokwelashwa.
Kubalulekile ukuqeda lonke uhlelo lokwelashwa, ngisho noma uqala ukuzizwa ungcono kakhulu ngemva kwezinsuku ezimbalwa nje. Ukuyeka ngokushesha kungavumela amagciwane asindile ukuthi aphindaphindeke futhi, okungenzeka kuholele ekuphindweni noma ekuthuthukisweni kwamagciwane angamelani nama-antibiotic.
Iqembu lakho lezempilo lizobheka intuthuko yakho ngesikhathi sokwelashwa, lihlole izinga lokushisa komzimba wakho, inani lamaseli amhlophe egazi, nezinye izinkomba ukuqinisekisa ukuthi ukutheleleka kuyaphela kahle. Bangase futhi benze amasiko okulandelayo ukuqinisekisa ukuthi amagciwane aqediwe.
Yiziphi Imiphumela Eceleni ye-Ertapenem?
Njengayo yonke imithi, i-ertapenem ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma isetshenziswa ngendlela efanele. Ukuqonda ukuthi okulindelekile kungakusiza ukuthi uzizwe ulungile futhi wazi ukuthi ungawaxwayisa nini iqembu lakho lezempilo.
Imiphumela emibi evame kakhulu ngokuvamile imnene futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi:
- Ukuqunjelwa, okwenzeka cishe kuma-10-15% eziguli
- Ukucasuka nokuhlanza
- Ikhanda
- Ubuhlungu, ukuvuvukala, noma ububomvu endaweni yokujova
- Isiyezi noma ukuzwa sengathi uyakhathala
- Ubunzima bokulala
Le miphumela emibi evamile ngokuvamile ayidingi ukuyeka umuthi, kodwa iqembu lakho lezempilo kufanele likwazi ngayo ukuze likusize ukuthi ulawule noma yikuphi ukungakhululeki futhi libheke impendulo yakho yonke ekwelashweni.
Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezempilo ngokushesha. Lokhu kuhlanganisa izimpawu zokuthi umzimba wakho ungase ube nokusabela okukhulu emuthini:
- Ukuqunjelwa okukhulu okungathuthuki noma okuqukethe igazi
- Izimpawu zokungezwani komzimba nezinto ezithile ezifana nokuqubuka kwesikhumba, ukuluma, noma ubunzima bokuphefumula
- Ubuhlungu obukhulu besisu noma ukuqaqamba
- Ukulimala okungavamile noma ukuphuma kwegazi
- Ukuhlaselwa yisithuthwane noma ukugonywa
- Isiyezi esikhulu noma ukuquleka
Enye into okufanele iqashelwe nge-ertapenem yithuba lokuthuthukisa i-C. difficile-associated diarrhea, ukutheleleka kwamathumbu okungathi sína okungenzeka lapho ama-antibiotics ephazamisa ukulinganisela okujwayelekile kwamagciwane ohlelweni lwakho lokugaya ukudla. Lokhu ngokuvamile kuvela njengokuqunjelwa okuqhubekayo, okumanzi okungase kube negazi noma amafinyila.
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Imiphumela engemihle elula njengokuluma noma ukuba nobuhlungu endaweni ojitwe kuyo ijwayelekile futhi ivame ukudlula. Izimpawu zokungezwani okubi nomuthi, njengokuphefumula kanzima, ukuvuvukala kobuso, noma ukuqubuka, zidinga usizo lwezempilo olusheshayo. Uma uzizwa sengathi kukhona okungahambi kahle, njalo beka phambili ukuthintana nomuntu okwelashayo.
Kujwayelekile ukuthi ama-antibiotic athinte amabhaktheriya emzimbeni wakho, okungase kuholele ekususeni isisu noma ukuzwa isicapha. Ukudla okusiza isisu noma izinguquko ezithile ekudleni kwakho kungase kusize ukunciphisa lezi zinkinga zokugaya ukudla. Qaphela noma yiziphi izinguquko ohlelweni lwakho lokugaya ukudla futhi uzibalule esikhathini sakho esilandelayo sokubona udokotela.
Ubani Ongafanele Athole i-Ertapenem?
I-Ertapenem ayifanele wonke umuntu, futhi udokotela wakho uzobukeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokukuyalela lo muthi. Into ebaluleke kakhulu ukuthi ngabe uke waba nokusabela komzimba okungalungile kuma-antibiotics afanayo esikhathini esedlule.
Akufanele uthole i-ertapenem uma wazi ukuthi unokungezwani komzimba kuma-antibiotics e-carbapenem, ama-penicillins, noma ama-cephalosporins. Le mikhaya yama-antibiotic yabelana ngezakhiwo zamakhemikhali ezifanayo, futhi ukungezwani komzimba komunye kuvame ukusho ukuthi usengozini yokusabela komzimba okungalungile kwamanye.
Abantu abanezimo ezithile zezokwelapha badinga ukucatshangelwa okukhethekile ngaphambi kokuqala i-ertapenem. Udokotela wakho uzofuna ukwazi nganoma yiziphi izinkinga zezinso, njengoba lo muthi ucutshungulwa ngezinsu zakho futhi imithamo ingadinga ukulungiswa. Labo abanomlando wokuthuthumela noma izifo zobuchopho nabo badinga ukuqashwa ngokucophelela, njengoba i-ertapenem ngezinye izikhathi ingabangela ukuthuthumela, ikakhulukazi kubantu asebevele bethambekele.
Uma ukhulelwe noma uncelisa, udokotela wakho uzolinganisela izinzuzo nezingozi ezingaba khona. Ngenkathi i-ertapenem ngokuvamile ithathwa njengephephile ngesikhathi sokukhulelwa lapho izinzuzo zidlula izingozi, idlulela obisini lwebele ngamanani amancane.
Amagama Omkhiqizo we-Ertapenem
I-Ertapenem itholakala kakhulu ngaphansi kwegama lomkhiqizo elithi Invanz, elikhiqizwa yi-Merck & Co. Lona umkhiqizo wokuqala owavunywa yi-FDA futhi usasetshenziswa kabanzi ezibhedlela nasezikhungweni zokunakekelwa kwezempilo.
Izinhlobo ezivamile ze-ertapenem nazo ziyatholakala futhi ziqukethe isithako esisebenzayo esifanayo esinempumelelo elingana nayo. Isibhedlela sakho noma isikhungo sokunakekelwa kwezempilo ngokuvamile sizosebenzisa noma iyiphi inguqulo enikeza inani elingcono kakhulu ngenkathi igcina amazinga afanayo okuphulukisa.
Kungakhathaliseki ukuthi uthola igama lomkhiqizo noma inguqulo ejwayelekile, umuthi usebenza ngendlela efanayo futhi unikeza izinga elifanayo lokwelashwa kwesifo sakho.
Ezinye Izindlela ze-Ertapenem
Ezinye izibulala-magciwane eziningi zingasetshenziswa njengezinye izindlela ze-ertapenem, kuye ngokuthi ukutheleleka kwakho kanye nezimo zakho zezokwelapha. Udokotela wakho angase akhethe umuthi ohlukile ngokusekelwe ezintweni ezinjengohlobo lwebhaktheriya olubandakanyekayo, umlando wakho wokungezwani komzimba, noma ukusebenza kwezinso zakho.
Ezinye izibulala-magciwane ze-carbapenem zihlanganisa i-imipenem-cilastatin kanye ne-meropenem, esebenza ngendlela efanayo ne-ertapenem kodwa ingase ithandwe ezimweni ezithile. I-Imipenem-cilastatin ingase ikhethwe ngezifo ezinzima kakhulu, kuyilapho i-meropenem ivame ukukhethwa ngezinhlobo ezithile zamagciwane angamelani.
Ngezimo ezithile, udokotela wakho angase acabangele izibulala-magciwane ze-beta-lactam njenge-piperacillin-tazobactam noma i-ceftriaxone, ikakhulukazi uma ukutheleleka kwakho kubangelwa amagciwane aziwa ukuthi azwela kule mithi. Ama-Fluoroquinolones afana ne-levofloxacin angase afaneleke ezifweni ezithile zokuphefumula noma zomgudu womchamo.
Ukukhethwa kwesinye isinqumo kuncike kakhulu emiphumeleni yamasiko ekhomba amagciwane athile nokuzwela kwawo ezibulala-magciwane ezihlukene. Udokotela wakho uzokhetha inketho efanele kakhulu ngokusekelwe kulolu lwazi oluhlanganiswe nezidingo zakho zezokwelapha.
Ingabe i-Ertapenem Ingcono Kune-Meropenem?
Kokubili i-ertapenem ne-meropenem ziyizibulala-magciwane ezinhle kakhulu ze-carbapenem, kodwa ngasinye sinamathuba athile ngokusekelwe esimweni sakho esithile. Ukukhetha phakathi kwazo kuvame ukwehla ohlotsheni lokutheleleka onalo kanye namagciwane abandakanyekayo.
I-Ertapenem inenzuzo yokunikezwa kanye ngosuku, okungaba lula ezigulini nakubanakekeli bezempilo. Iphinde isebenze kahle ezifweni eziningi ezitholakala emphakathini futhi inengozi ephansi yokuthuthukisa ukumelana namagciwane athile afana ne-Pseudomonas.
Ngaphandle kwalokho, i-Meropenem ngokuvamile ithathwa njengebanzi futhi isebenza kahle kakhulu ngamabhaktheriya athile amelana nawo, okuhlanganisa i-Pseudomonas aeruginosa. Ivame ukukhethwa ezifweni ezinzima ezitholakala esibhedlela noma uma kubhekanwe namabhaktheriya abonise ukumelana namanye ama-antibiotics.
Udokotela wakho uzokhetha umuthi ohambisana kahle nesifo sakho esithile ngokusekelwe emiphumeleni yamasiko, ubunzima besimo sakho, kanye nezici zakho eziyingozi. Zombili ziyasebenza kakhulu uma zisetshenziswa ngendlela efanele.
Imibuzo Evame Ukubuzwa Mayelana ne-Ertapenem
Q1. Ingabe i-Ertapenem iphephile ezigulini ezinokugula kwezinso?
I-Ertapenem ingasetshenziswa kubantu abanezifo zezinso, kodwa udokotela wakho uzodinga ukulungisa umthamo wakho ngokusekelwe ekutheni izinso zakho zisebenza kahle kangakanani. Njengoba lo muthi ukhishwa emzimbeni wakho ikakhulukazi ngezinso, ukuncipha komsebenzi wezinso kusho ukuthi umuthi uhlala esistemini yakho isikhathi eside.
Ekukhubazekeni kwezinso okuncane, ungase uthole umthamo ofanayo kodwa ngokuqapha okwengeziwe. Uma umsebenzi wakho wezinso uncishiswe kakhulu, udokotela wakho cishe uzoqoka umthamo ophansi ukuze uvimbele umuthi ukuthi ungazakhi uze ufinyelele emazingeni angaba yingozi egazini lakho.
Q2. Kufanele ngenzeni uma ngithola i-Ertapenem eningi ngengozi?
Njengoba i-ertapenem inikezwa ochwepheshe bezempilo ezindaweni ezilawulwayo, ukweqisa ngengozi akuvamile. Kodwa-ke, uma uhlangabezana nezimpawu ezinjengokucasuka okukhulu, ukuhlanza, isifo sohudo, noma yiziphi izimpawu ezingavamile ze-neurological njengokudideka noma ukuquleka, yazisa ithimba lakho lezempilo ngokushesha.
Ezimweni zokweqisa okusolwayo, akukho umuthi oqondile we-ertapenem, kodwa ithimba lakho lezokwelapha linganikeza ukunakekelwa okusekelayo ukusiza umzimba wakho ukuthi usebenzise umuthi ngokuphepha. Lokhu kungabandakanya uketshezi lwe-IV ukusiza izinso zakho ukuthi zikhiphe umuthi owedlulele.
Q3. Kufanele ngenzeni uma ngiphuthelwa umthamo we-Ertapenem?
Njengoba i-ertapenem inikezwa ochwepheshe bezempilo ezindaweni zezokwelapha, ukweqa umthamo ngokuvamile kulawulwa ithimba lakho lezempilo kunokuba kube yinto okudingeka ukhathazeke ngayo wena uqobo. Uma umthamo ulibaziseka nganoma yisiphi isizathu, umhlengikazi wakho noma udokotela uzowuhlela kabusha ngokushesha okukhulu.
Isikhathi sokuthatha imithamo yama-antibiotic sibalulekile ekugcineni amazinga asebenzayo egazini lakho ukuze kulwiwe nokutheleleka. Ithimba lakho lezempilo lizoqinisekisa ukuthi uthola yonke imithamo echaziwe ngezikhathi ezifanele ukuze kukhuliswe ukusebenza kahle komuthi.
Q4. Ngingayeka nini ukuthatha i-Ertapenem?
Akufanele neze uyeke ukwelashwa nge-ertapenem ngaphambi kwesikhathi, ngisho noma uzizwa ungcono kakhulu. Udokotela wakho uzoqoka ukuthi kuphephile nini ukuyeka umuthi ngokusekelwe ezintweni eziningana, okuhlanganisa ukusabela kwakho ekwelashweni, imiphumela yaselebhu, kanye nokuxazululwa okuphelele kwezimpawu zokutheleleka.
Ukuyeka ukwelashwa ngama-antibiotic ngaphambi kwesikhathi kungavumela amagciwane asindile ukuthi aphinde azale, okungenzeka kuholele ekuphindweni kokutheleleka kwakho noma ekuthuthukisweni kwamagciwane amelana nama-antibiotic. Ithimba lakho lezempilo lizobheka intuthuko yakho futhi lizokwazisa uma inkambo ephelele yokwelashwa isiqediwe.
Q5. Ingabe i-Ertapenem ingabangela izifo zemvubelo?
Yebo, njengama-antibiotic amaningi, i-ertapenem ngezinye izikhathi ingaholela ezifweni zemvubelo, ikakhulukazi kwabesifazane. Lokhu kwenzeka ngoba ama-antibiotic angaphazamisa ibhalansi yemvelo yamagciwane nemvubelo emzimbeni wakho, okuvumela imvubelo ukuthi ikhule ngokweqile ezindaweni ezinjengomlomo, umphimbo, noma indawo yesitho sangasese sowesifazane.
Uma uba nezimpawu ezinjengokukhipha okungavamile, ukuluma, noma amabala amhlophe emlonyeni wakho, yazisa ithimba lakho lezempilo. Bangakwazi ukuchaza imithi elwa nemvubelo ukuze welaphe lezi zifo zesibili ngenkathi uqhubeka nokwelashwa kwakho ngama-antibiotic sokutheleleka kwamagciwane okuyinhloko.
