ʻO Anju Goel, MD, MPH, he kauka i hōʻoiaʻiʻoʻia e ka papa e pili ana i ke olakino lehulehu, nā maʻi maʻi maʻi, ka maʻi diabetes, a me nā kulekele olakino.
ʻO ka penicillin kahi lāʻau lāʻau i hoʻohana ʻia no ka mālama ʻana i kekahi ʻano o nā maʻi bacteria.
Hiki ke hā'awi 'ia ka penicillin ma ka waha, a i 'ole 'ia i loko o ke koko (IV, i loko o ka vein), a i 'ole intramuscularly (IM, ma ka 'i'o nui).
Loaʻa ʻia nā ʻano penicillin a pau, ma ka liʻiliʻi loa, mai kahi haʻo i kapa ʻiaPenicilliumchrysogenum.
Ua ʻike ka ʻepekema Scottish ʻo Alexander Fleming i ka penicillin i ka makahiki 1929 i kona ʻike ʻana ua pepehi ʻia nā moʻomeheu bacteria i hoʻohaumia ʻia me ka "wai mold" e ka haʻo. hoʻomanawanui, hoʻomaka i ke au o nā lāʻau antibiotic.
I nā makahiki 1960, ua hiki i nā ʻepekema ke hoʻomohala i ka lāʻau penicillin semisynthetic mua e hiki ke mālama i kahi ākea ākea o nā maʻi bacterial. a laha a puni ka heluna kanaka.
I kēia mau lā, ʻoi aku ka nui o nā maʻi maʻi bacteria e kū kūʻē piha a ʻāpana paha i nā lāʻau penicillin mua, me ka Neisseria gonorrhoeae (gonorrhea) a me ka methicillin-resistant Staphylococcus aureus (MRSA).
ʻO Streptococcus pneumoniae, kahi ʻano o ka maʻi maʻi bacterial, a me kekahi mau ʻano Clostridium a me Listeria ke emi nei ka pane ʻana i kēia mau lāʻau lapaʻau.
ʻO ka hoʻohana nui ʻana i nā lāʻau lapaʻau e hoʻoikaika i ka ulu ʻana o nā holoholona i ʻike ʻia e hoʻonui i ka pilikia o ka bacteria kūʻē i ka lāʻau, me nā superbugs, ma ke kaulahao meaʻai.
Nā penicillinsno ka ʻohana nui o nā lāʻau i kapa ʻia he beta-lactam antibiotics. ʻO kēia mau lāʻau lapaʻau he ʻano molekala like ʻole, i loko o ke apo o ʻehā mau ʻātoma i kapa ʻia ʻo beta-lactams. ʻO kēlā me kēia ʻano penicillin he mau kaulahao ʻaoʻao hou e hoʻoholo ai i kāna hana.
Hana ʻo Penicillin ma ka hoʻopaʻa ʻana i nā molekala ma ka paia bacteria i kapa ʻia ʻo peptidoglycan. Ke māhele ʻia ka maʻi bacteria, pale ka penicillin i ka hoʻonohonoho hou ʻana o nā protein i loko o ka paia o ka cell cell, e hoʻoheheʻe ʻia nā cell bacteria a make koke.
ʻO nā penicillins maoli nā mea i unuhi pololei ʻia mai ka P. chrysogenum fungus. ʻElua mau penicillins maoli.
Hana ʻia ka penicillin semi-synthetic i loko o ka hale hana a ua like ia me ka kemika i loaʻa ma P. chrysogenum. Aia ʻehā mau papa o nā penicillins semisynthetic, me nā lāʻau antibiotic maʻamau e like me amoxicillin a me ampicillin.
He ʻokoʻa iki ke ʻano molekala o kēlā me kēia ʻano a hiki ke lawelawe ʻia ʻokoʻa ma mua o nā ʻano ʻē aʻe.
ʻO kekahi mau penicillins ʻaʻohe hana antibacterial pololei. Hoʻohana ʻia lākou i ka lāʻau hoʻohui e kōkua i ka lanakila ʻana i ka pale ʻana i ka penicillin.
Hoʻohana ʻia nā penicillins e mālama i nā maʻi bacterial - ʻaʻole lākou e mālama i nā maʻi viral, fungal a parasitic paha. , ua kanu ʻia ka papa peptidoglycan ma lalo o kahi ʻāpana o nā cell lipid, e ʻoi aku ka paʻakikī o nā lāʻau lapaʻau ke komo i ka mole.
ʻO nā maʻi bacteria Gram-positive hiki ke mālama ʻia me ka penicillin me Clostridium, Listeria, Neisseria, Staphylococcus, a me Streptococcus.
Hoʻohana mau ʻia nā penicillins maoli - penicillin G a me ka penicillin V - i kēia lā no ka mālama ʻana i kekahi mau maʻi bacteria maʻamau a ʻike ʻole ʻia.
I ka hoʻokaʻawale ʻana, hoʻohana ʻia nā antibiotic semisynthetic e like me amoxicillin-kekahi o nā lāʻau lapaʻau maʻamau i hoʻohana ʻia i kēia mau lā-no ka mālama ʻana i kahi ākea o ka hanu, ʻili a me nā maʻi bacteria e like me H. pylori, Lyme maʻi a me ka otitis media acute.
He mea maʻamau ka hoʻohana ʻole ʻana i ka penicillin, ʻoiai ʻoi aku ka maʻamau o nā lāʻau e like me amoxicillin a me ampicillin ma mua o ke kūlohelohe.penicillin.Off-label hoʻohana i ka mālama ʻana i nā poʻe maʻi mālama koʻikoʻi me ka sepsis a i ʻole nā neonates me ka ʻeha hanu ʻeha.
Hoʻohana ʻia ʻo Penicillin G ma waho-label no ka mālama ʻana i nā maʻi hui prosthetic, Lyme maʻi, a me leptospirosis. Hoʻohana ʻia ʻo Penicillin V ma waho-label no ka mālama ʻana i ka maʻi Lyme a me ka otitis media, a i ʻole no ka pale ʻana i nā maʻi i ka poʻe e loaʻa ana i ka hoʻololi ʻana o ke stem cell.
Hiki i ka penicillin ke hana maika'i loa ke ho'ohana pono 'ia. 'Oiai pēlā, i kekahi mau hihia, 'a'ole maika'i ka lā'au lapa'au i ka ho'oma'ema'e 'ana i ka ma'i. pane i ka penicillin.
Hoʻomaka ka hoʻāʻo ma ke kanu ʻana i nā hua bacteria i lawe ʻia mai nā ʻōpala o nā wai o ke kino a laila e hōʻike pololei i ka bacteria i nā ʻano penicillin like ʻole i loko o ka hale hana. make.
Hoʻopaʻa ʻia ka penicillin inā ua maʻi mua ʻoe i kekahi lāʻau i loko o ka ʻohana penicillin. Pono ʻoe e makaʻala inā loaʻa iā ʻoe kahi hopena hypersensitivity lāʻau koʻikoʻi i ka wā ma mua, e like me anaphylaxis, Stevens-Johnson syndrome (SJS), a i ʻole toxic epidermal necrosis. (ʻUMI).
Inā loaʻa iā ʻoe kahi maʻi maʻi i ka penicillin G a i ʻole penicillin V i ka wā ma mua, hiki iā ʻoe (akā ʻaʻole pono) ke maʻi i nā penicillin semi-synthetic e like me amoxicillin a ampicillin paha.
Pono ka poʻe maʻi i ka penicillin e hoʻohana i nā lāʻau lapaʻau beta-lactam ʻē aʻe me ka makaʻala ma muli o ka pilikia o ka cross-reactive allergy, ʻoiai he liʻiliʻi ka pilikia. Aia kēia me nā antibiotic cephalosporin e like me Keflex (cephalexin), Maxipime (cefepime), Rocephin (ceftriaxone), a me Suprax (cefixime).
Inā hopohopo ʻoe e maʻi paha ʻoe i ka penicillin, hiki iā ʻoe ke hoʻāʻo i ka maʻi ʻili e ʻike inā loaʻa iā ʻoe kahi pane i ka liʻiliʻi o ka lāʻau i waiho ʻia ma lalo o kou ʻili.
Pono e hoʻohana ʻia ka penicillin me ka akahele loa inā loaʻa iā ʻoe ka hemahema o ka renal (kidney). ʻo ka haʻalulu, huikau, coma, convulsions abnormal, a, i nā hihia kakaʻikahi, coma.
Hiki ke ʻano like ʻole ka nui o ka penicillin G a me ka penicillin V ma muli o ka maʻi a me ka makahiki o ke kanaka e mālama ʻia.
Ma muli o ka meaʻai, ua ana ʻia ka nui ma nā ʻano like ʻole. I nā pākeke, ʻike pinepine ʻia nā lāʻau lapaʻau i nā ʻāpana a i ʻole milligrams (mg). lā) a i ʻole ma nā ʻāpana no ke kilokani o ke kaumaha o ke kino i kēlā me kēia lā (nā ʻāpana/kg/lā).
Inā loaʻa iā ʻoe ka maʻi kīkī, pono paha ʻoe e hoʻohaʻahaʻa i kāu pānaʻi penicillin no ka pale ʻana i ka lāʻau ʻawaʻawa. Ke hāʻule ka creatinine clearance (kahi ana o ka hana kīkī) ma lalo o 10 milliliters i kēlā me kēia minuke (mL/min), ʻōlelo pinepine ʻia ka hoʻemi ʻana.
Ma ka ʻaoʻao ʻē aʻe, inā ʻoe ma ka hemodialysis, pono paha ʻoe i kahi maʻi kiʻekiʻe no ka mea hiki i ka hemodialysis ke wikiwiki i ka wehe ʻana o ka penicillin mai kou koko.
Loaʻa ka Penicillin G ma ke ʻano he hopena premixed a i ʻole he pauka no ka hoʻoponopono hou ʻana me ka Sterile Water for Injection. Hiki ke mālama ʻia nā hoʻonā premixed i loko o ka friji a i ʻole ka paʻukū, ʻoiai hiki ke mālama pono ʻia nā ʻano pauka i ka mahana wela.
Loaʻa ka penicillin V ma ke ʻano he papa waha a i ʻole he pauka cherry-flavored i hui pū ʻia me ka wai. Ua palekana nā mea ʻelua e mālama i ka mahana o ka lumi.
Pono e lawe ʻia ʻo Penicillin V ma ka ʻōpū ʻole e hōʻoia i ka hoʻopaʻa ʻana.
Inā hala ʻole ʻoe i ka lāʻau penicillin V, e lawe koke ʻoe i ka wā e hoʻomanaʻo ai.
E lawe mau i ka penicillin e like me ke kuhikuhi a hana ʻia. Mai hooki wale no ka maikaʻi. Pono ʻoe e hoʻopau i ka papa holoʻokoʻa i mea e hoʻopau ai i nā germs āpau. Ke hoʻopau ʻia ka mālama ʻana, hiki ke hoʻonui ʻia kahi helu liʻiliʻi o ke koena bacteria.
ʻO ka hapa nui o nā hopena ʻaoʻao penicillin he maʻalahi a liʻiliʻi a hoʻoholo iā lākou iho me ka mālama ʻole.
ʻO kekahi o nā pilikia koʻikoʻi e pili ana i ka hoʻohana ʻana i ka penicillin, ʻo ia ka pilikia o kahi hopena maʻi ʻōnaehana hoʻoweliweli i ke ola i kapa ʻia he anaphylaxis.
Hiki i ka hopena ma'i ke ho'opō'ino nui inā ha'alele 'ole 'ia. Hiki ke ho'oulu i ka ha'alulu, coma, ka hanu a i 'ole ka pu'uwai, a me ka make.
E ʻimi i ka mālama ulia pōpilikia inā ʻike ʻoe i kekahi a i ʻole nā hōʻailona a pau o ka hopena maʻi ma hope o ka lawe ʻana i ka penicillin:
I nā hihia kakaikahi, hiki i ka penicillin ke hoʻoulu i ka nephritis interstitial acute, he maʻi maʻi ʻaʻa i hoʻokumu pinepine ʻia e ka pane kūlohelohe kūlohelohe i ka lāʻau. ʻoluʻolu, akā hiki i kekahi ke lilo i mea koʻikoʻi a alakaʻi i ka ʻeha puʻupaʻa.
E like me nā lāʻau lapaʻau āpau, pili ka penicillin me ka piʻi nui ʻana o ka maʻi maʻi C. difficile. ʻO kēia ke kumu o ka maʻi bacteria i loaʻa mau i loko o ka ʻōpū i luku ʻia e nā lāʻau antibiotic, no laila e ʻae ai i ka maʻi bacteria C. difficile e hoʻonui. , akā ʻike ʻia ʻo C. difficile e hoʻoulu i ka colitis fulminant koʻikoʻi, megacolon ʻawaʻawa, a me ka make i nā hihia liʻiliʻi.
Manaʻo pinepine ʻia ka penicillin i ka palekana i ka wā hāpai a me ka hānai ʻana.
Inā hāpai ʻoe, e hoʻolālā ana e hāpai, a i ʻole e hānai ana, e kamaʻilio me kāu kahu mālama ola e hoʻomaopopo pono i nā pono a me nā pilikia o ka hoʻohana ʻana i ka penicillin.
Hiki i nā lāʻau he nui ke launa pū me ka penicillin, ma ke ʻano maʻamau ma ka hoʻokūkū ʻana no ka hoʻomaʻemaʻe ʻana i ka renal. Hoʻonui kēia i ka nui o ka penicillin i loko o ke koko a me ka pilikia o nā hopena ʻaoʻao a me ka lāʻau ʻona.
I mea e pale aku ai i ka launa pū ʻana, e hoʻomaopopo mau i kāu mea mālama ola e pili ana i nā lāʻau lapaʻau āu e lawe nei, inā paha i ka lāʻau lapaʻau, ma ke kūʻai aku, nā meaʻai, nā lāʻau lapaʻau, a i ʻole ka leʻaleʻa.
E kau inoa i kā mākou ʻōlelo aʻoaʻo olakino i kēlā me kēia lā a loaʻa i nā ʻōlelo aʻoaʻo i kēlā me kēia lā e kōkua iā ʻoe e ola i kou ola olakino.
Lobanovska M, Pilla G. Penicillin loaʻa a me ka antibiotic kū'ē: nā haʻawina no ka wā e hiki mai? Yale Journal of Biomedical Sciences.2017;90(1):135-45.
ʻO Founou LL, Founou RC, Essack SY. Ke kūʻē ʻana i ka antibiotic i ke kaulahao meaʻai: kahi ʻāina e ulu nei i ka manaʻo.pre-microbes.2016;7:1881.doi:10.3389/fmicb.2016.01881
Ka manawa hoʻouna: Mar-25-2022