Metrolyl, ib qho hluavtaws nitroimidazole derivative, tau ua lub hauv paus ntawm kev kho tshuaj tua kab mob rau ntau tshaj rau xyoo lawm. Nws cov tshuaj txhaj tshuaj (IV), tshwj xeeb tshaj yog cov tshuaj 100 mL uas muaj 500 mg (5 mg / mL), yog dav siv hauv tsev kho mob rau kev kho mob hnyav anaerobic, kab mob protozoal, thiab qee yam kab mob uas tiv taus lwm tus neeg. Kab lus no muab ib qho hauv - tsom xam qhov tob ntawmmetronidazole txhaj 100 mL, suav nrog nws cov tshuaj pharmacology, cov lus qhia, cov lus qhia kev tswj hwm, cov teebmeem tsis zoo, thiab kev xav txog kev nyab xeeb tseem ceeb.
Clinical Features ntawm Anaerobic Bacterial Infections
Cov tsos mob tshwm sim ntawm cov kab mob anaerobic sib txawv nyob ntawm qhov chaw ntawm tus kab mob tab sis feem ntau suav nrog cov tsos mob hauv zos, cov tsos mob ntawm lub cev, thiab cov cim tshwj xeeb, raws li cov lus qhia hauv qab no:
Cov tsos mob hauv zos
Cov tsos mob hauv zos
Redness, o, kub, thiab mob:
Qhov chaw muaj kab mob (piv txwv li, daim tawv nqaij, mucosa, qhov txhab) feem ntau pom liab thiab o, nrog rau qhov kub thiab txias hauv zos thiab cim rhiab heev. Piv txwv li, cov kab mob ntawm daim tawv nqaij thiab cov nqaij mos tuaj yeem tshwm sim raws li qhov chaw liab, o, thiab mob, uas tuaj yeem ua rau muaj kev cuam tshuam; Cov kab mob ntawm qhov ncauj tshwm sim raws li o, los ntshav cov pos hniav nrog mob ntxiv thaum zom los yog sib cuag.
Qhov txawv txav secretions:
Cov kab mob anaerobic rhuav tshem cov proteins, ua rau cov pa phem - cov ntxhiab tsw zoo li hydrogen sulfide thiab indole, uas ua rau muaj cov ntxhiab tsw phem. Piv txwv muaj xws li greyish-xim av purulent exudate los ntawm qhov txhab, los yog cov zais zis nrog cov rotten- qe tsw los ntawm qhov ncauj kab noj hniav los yog qhov chaw mos; Cov kab mob pulmonary anaerobic tuaj yeem ua rau muaj pa phem - hnoos qeev.
Cov ntaub so ntswg necrosis:
Cov kab mob anaerobic zoo li Clostridium perfringens tsim cov lecithinase uas ua rau cov cell membranes, ua rau cov necrosis loj hauv cov nqaij mos zoo li cov leeg. Qhov no tshwm sim raws li daim tawv nqaij blackened, hlwv tsim, thiab crepitus ntawm palpation nyob rau hauv cov cheeb tsam muaj kab mob; Cov mob hnyav tuaj yeem ua rau gas gangrene xav tau kev tshem tawm sai.
Gas Tsim:
Cov kab mob anaerobic zoo li Clostridium perfringens decompose cov ntaub so ntswg los tsim cov roj. Palpation nthuav tawm crepitus hauv qab ntawm daim tawv nqaij, thiab cov duab qhia pom cov pa npuas hauv cov ntaub so ntswg. Feem ntau nyob rau hauv cov leeg nqaij sib sib zog nqus los yog kab mob ntawm qhov chaw phais, cov roj tsub zuj zuj tuaj yeem ua rau cov ntshav tsis zoo, ua rau cov ntaub so ntswg ischemia thiab necrosis.
Cov tsos mob
Kub thiab txias:
Cov kab mob anaerobic tso tawm endotoxins lossis exotoxins rau hauv cov hlab ntsha, ua rau kub taub hau nrog qhov kub thiab txias, nrog rau ua daus no, qaug zog, thiab mob taub hau. Cov mob hnyav tuaj yeem tshwm sim nrog kev tsis meej pem lossis hypotension, qhia txog kev sib kis ntawm tus kab mob thiab yuav tsum tau ceev faj txog kev pheej hmoo sepsis. Piv txwv li, nyob rau hauv - kab mob plab tshwm sim los ntawm Bacteroides fragilis feem ntau tshwm sim nrog remittent kub siab tshaj 38.5℃(101.3℃F), nrog rau cov kab mob kuaj pom hauv cov ntshav.
Sepsis:
Cov kab mob anaerobic hnyav tuaj yeem ua rau ntau- lub cev tsis ua haujlwm, ua rau tachypnea, tachycardia, oliguria, thiab daim tawv nqaij ecchymoses. Cov kev tshawb pom hauv chav kuaj yuav pom qhov txawv txav ntawm leukocyte nce lossis txo qis, coagulation tsis zoo, xav tau kev pabcuam sai los tiv thaiv kev poob siab.
Cov tsos mob tshwj xeeb
Deep Abscesses lossis Cellulitis:
Kev kis kab mob kis mus rau lub fascial lossis cov leeg nqaij, ua rau muaj mob - cov cheeb tsam o uas muaj erythematous, daim tawv nqaij sov tab sis cov kua paug tsawg. Cov kab mob sib sib zog nqus hauv qhov ncauj, lub plab, lossis lub plab yuav ua rau cov kabmob uas nyob ib sab, ua rau kev ua haujlwm tsis zoo xws li tso zis los yog plab hnyuv.
Cov tsos mob ua pa:
Cov kab mob anaerobic invading cov kab mob ua pa ua rau cov kab mob inflammatory hauv mucosa, ua rau hnoos, hnoos qeev, thiab mob caj pas. Cov kab mob pulmonary anaerobic tuaj yeem ua rau mob ntsws lossis mob ntsws, ua rau lub hauv siab nruj, ua tsis taus pa, thiab ua tsis taus pa. Cov mob hnyav tshwm sim nrog mob hauv siab, ua npaws, thiab qaug zog.
Cov tsos mob ntawm digestive system:
Thaum cov kab mob anaerobic nkag mus rau hauv lub plab zom mov, lawv tuaj yeem ua rau lub plab hnyuv mucosa, ua rau cov tsos mob xws li mob plab, xeev siab, thiab ntuav. Cov mob hnyav tuaj yeem ua rau mob plab hnyuv. Kab mob plab feem ntau tshwm sim raws li mob plab, sib txawv ntawm kev siv los ntawm kev mob npub mus rau qhov mob hnyav lossis mob hnyav. Cov no tuaj yeem nrog cov tsos mob digestive xws li xeev siab, ntuav, thiab tsam plab.
Cov tsos mob ntawm genitourinary system:
Cov kab mob anaerobic invading lub genitourinary system ua rau thaj chaw inflammatory lesions. Cov poj niam cov neeg mob tej zaum yuav muaj ntau qhov chaw mos tawm, tsw, thiab khaus. Cov mob hnyav tuaj yeem ua rau tus kab mob pelvic inflammatory (PID), uas tshwm sim nrog mob plab, hnyav, thiab kev coj khaub ncaws tsis zoo. Cov txiv neej cov neeg mob tuaj yeem pom qhov mob scrotal, hnyav, thiab urethritis cov tsos mob xws li tso zis ntau zaus, ceev, thiab dysuria.
Central Nervous System Cov tsos mob:
Kev kis kab mob hauv nruab nrab ntawm lub paj hlwb los ntawm cov kab mob anaerobic tuaj yeem ua rau muaj kev puas tsuaj rau lub hauv nruab nrab lub paj hlwb, ua rau cov tsos mob xws li kiv taub hau, mob taub hau, ua rau qeeb qeeb, thiab nyuaj rau kev xav.
metrolyl Txhaj Tshuaj rau Toothache
Kev txhaj tshuaj Metrolyl (xws li metrolyl sodium chloride txhaj) ua kom pom tseeb qhov ua tau zoo tiv thaiv cov hniav los ntawm cov kab mob anaerobic (xws li, periodontitis, pulpitis, apical periodontitis, pericoronitis ntawm cov hniav ntse). Lawv alleviate cov tsos mob ntawm liab, o, kub, thiab mob los ntawm inhibiting kab mob DNA synthesis. Txawm li cas los xij, yuav tsum ua raws li cov lus qhia kho mob nruj me ntsis, thiab lawv yuav ua tsis tau zoo rau cov uas tsis yog - kis mob hniav. Hauv qab no yog cov lus qhia ntxaws
Mechanism of Action thiab Indications
Nws belongs rau cov chav kawm nitroimidazole ntawm cov tshuaj tua kab mob thiab nthuav tawm cov kab mob muaj zog tiv thaiv kab mob anaerobic xws li Bacteroides fragilis thiab Clostridium perfringens. Nws inhibits cov kab mob DNA synthesis, yog li thaiv cov kab mob anaerobic proliferation thiab exerting anti- inflammatory thiab bactericidal teebmeem. Hauv cov tshuaj hauv qhov ncauj, kev txhaj tshuaj metrolyl feem ntau yog qhia rau:
Periodontitis: Qhov chaw anaerobic qhov ncauj txhawb cov kab mob loj hlob, ua rau gingival redness, o, los ntshav, thiab mob.
Pulpitis/Periapical Periodontitis: Cov kab mob anaerobic tuaj yeem ua rau cov kab mob sib kis los yog mob ntawm cov ntaub so ntswg periapical.
Kev txawj ntse hniav pericoronitis: Cov ntaub so ntswg mos kab mob nyob ib puag ncig cuam tshuam cov hniav feem ntau cuam tshuam cov kab mob anaerobic proliferation.
Tom qab- kis kab mob rho tawm: Cov chaw phais yuav tsim cov kab mob anaerobic kab mob thib ob.
Kev ua tau zoo ntawm Metrolyl Txhaj rau Hniav
Rau kis mob toothache:
Cov kev tshawb fawb soj ntsuam qhia pom tias kev txhaj tshuaj metrolyl qhia tau hais tias muaj txiaj ntsig zoo tiv thaiv cov hniav los ntawm cov kab mob anaerobic. Piv txwv li, nyob rau hauv cov neeg mob uas muaj pericoronitis, metrolyl ua tiav 70% -80% qhov mob nyem thiab txo lub sijhawm ntawm kev kho mob.
Qhov Tseem Ceeb ntawm Kev Kho Kom Zoo Dua:
Yog tias mob hniav tshwm sim los ntawm cov kab mob aerobic los yog cov kab mob sib xyaw (xws li, streptococci, actinomycetes), cov tshuaj tua kab mob xws li amoxicillin lossis cephalosporins yuav tsum tau ua kom muaj txiaj ntsig zoo. Methronidazole ib leeg yuav tsis txaus los tswj tus kab mob tag nrho.
Ineffective for Non-infectious Tooth Pain:
Methronidazole tsis muaj kev kho mob rau cov uas tsis yog- mob cov hniav xws li cov hniav caries (qhov mob stimulus), dentin hypersensitivity, los yog trigeminal neuralgia. Cov xwm txheej no xav tau kev kho mob los ntawm txoj kev xws li txhaws, desensitizing cov neeg ua haujlwm, lossis cov hlab ntsha txhaws.
Qhov txawv ntawm metrolyl thiab Artificial Bile -Metrolyl tau txais los
Metrolyl thiab Artificial Bile Salt metrolyl muaj qhov sib txawv tseem ceeb hauv kev sib xyaw, tshuaj tiv thaiv kab mob, cov lus qhia, daim ntawv ntau npaum, thiab kev ceev faj, raws li cov lus qhia hauv qab no:
Kev sib xyaw ua ke:
Metrolyl: Cov khoom tseem ceeb yog metrolyl, cais raws li nitroimidazole antimicrobial tus neeg sawv cev.
Artificial Bile Salt Metrolyl: Ib qho kev sib xyaw ua ke uas muaj metrolyl thiab cov kua tsib ntsev ua cov khoom tseem ceeb. Txhua lub capsule muaj 200mg metrolyl thiab 5mg dag bile ntsev.
Qhov txawv ntawm Antimicrobial Spectrum:
Metrolyl: Qhia tawm cov kab mob muaj zog tiv thaiv kab mob anaerobic, suav nrog Bacteroides fragilis thiab Clostridium perfringens. Nws kuj tseem tshem tawm cov kab mob xws li Trichomonas vaginalis thiab Entamoeba histolytica.
Artificial Bile Salt metrolyl: Cov tshuaj metrolyl zoo ib yam rau cov kab mob anaerobic, thaum cov kua tsib ntsev muab tshuaj tua kab mob thiab tiv thaiv - cov teebmeem inflammatory. Qhov kev sib xyaw ua ke no txhim kho cov tshuaj tiv thaiv kab mob, tshwj xeeb tshaj yog rau cov kab mob ntawm qhov ncauj anaerobic.
Kev taw qhia qhov txawv:
Metrolyl:
Qhia rau cov kab mob hauv qhov chaw mos, trichomoniasis, kab mob hauv plab, thiab lwm yam.
Feem ntau siv los kho cov kab mob anaerobic xws li intra- kab mob plab, kab mob hauv plab, thiab kab mob hauv lub cev.
Nws yog cov tshuaj ntawm kev xaiv rau kev kho trichomoniasis vaginitis thiab amoebic dysentery.
Artificial Bile ntsev Metrolyl:
Feem ntau siv los kho cov kab mob hauv qhov ncauj xws li mob pericoronitis, localized alveolar abscesses, pulpitis, thiab apical periodontitis.
Kuj tseem muaj txiaj ntsig zoo hauv kev txo cov tsos mob xws li cov pos hniav o thiab mob los ntawm cov kab mob anaerobic.
Qhia tshuaj kho tau zoo tiv thaiv kab mob anaerobic hauv plab hnyuv (xws li peptic ulcers, enteritis).
IV. Formulation txawv
Metrolyl: Muaj nyob rau hauv ntau yam formulations nrog rau qhov ncauj npaj, tshuaj pleev ib ce (xws li, qhov chaw mos suppositories), thiab txhaj tshuaj.
Artificial Bile Salt Metrolyl: Feem ntau yog cov tshuaj noj hauv qhov ncauj, feem ntau nthuav tawm ua cov ntsiav tshuaj lossis tshuaj ntsiav.
Kev ceev faj thiab qhov tsis zoo tshwm sim txawv
Metrolyl
Tej zaum yuav ua rau muaj kev phiv xws li kiv taub hau, xeev siab, thiab ntuav.
Tsis txhob haus cawv thaum lub sij hawm kho mob los tiv thaiv disulfiram-zoo li cov tshuaj tiv thaiv (lub ntsej muag, mob taub hau, xeev siab, ntuav).
Siv ceev faj rau cov poj niam cev xeeb tub los yog lactating.
Contraindicated nyob rau hauv cov neeg mob ua xua rau metrolyl lossis lwm yam tshuaj nitroimidazole.
Contraindicated nyob rau hauv cov neeg mob uas muaj active central paj hlwb mob los yog kab mob hematologic.
Artificial Bile ntsev Metrolyl
Tej zaum yuav ua rau mob plab tsis zoo xws li xeev siab, ntuav, tsis qab los noj mov, lossis raws plab.
Qee tus neeg mob me me tuaj yeem ntsib cov tsos mob ntawm lub paj hlwb xws li mob taub hau, kiv taub hau, lossis limbness.
Cov tib neeg tuaj yeem tsim kev tsis haum rau qee yam khoom, tshwm sim ua pob liab liab lossis khaus khaus.
Tsis txhob haus cawv thaum kho.
Contraindicated rau cov poj niam cev xeeb tub thiab lactating.
Contraindicated rau cov neeg mob ua xua rau metrolyl lossis pyrrolidine -muaj tshuaj.
Contraindicated rau cov neeg mob uas muaj active central paj hlwb mob los yog kab mob hematological.
Kev txhaj tshuaj Metronidazole 100 mL tseem yog ib qho tseem ceeb ntawm cov tshuaj tua kab mob rau cov kab mob loj anaerobic thiab protozoal. Nws qhov dav dav, kev nkag mus rau cov ntaub so ntswg, thiab tus nqi tsis kam ua pov thawj rau nws siv, muab cov kws kho mob ua raws li cov lus qhia kev nyab xeeb. Cov kev txiav txim siab tseem ceeb suav nrog kev saib xyuas rau hepatotoxicity hauv siab - cov neeg mob muaj kev pheej hmoo, tsis txhob haus cawv, thiab kho cov koob tshuaj hauv lub raum tsis zoo. Cov kev tshawb fawb yav tom ntej yuav tsum tsom mus rau optimizing koob tshuaj nyob rau hauv cov neeg tshwj xeeb (xws li, cov neeg mob hnyav) thiab tshawb nrhiav cov qauv tshiab los txo cov kev mob tshwm sim.
Los ntawm kev sib koom ua ke cov qauv tshuaj pharmacokinetic nrog kev ceev faj txog kev kho mob, cov kws kho mob tuaj yeem ua kom cov txiaj ntsig kho mob zoo tshaj plaws ntawm metrolyl thaum txo qis kev pheej hmoo.
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