Florfenicol, mankhwala opangidwa ndi thiamphenicol omwe ali ndi fluorine, ndi mankhwala atsopano oletsa mabakiteriya a chloramphenicol omwe amagwiritsidwa ntchito ndi ziweto, omwe adapangidwa bwino kumapeto kwa zaka za m'ma 1980.
Pankhani ya matenda ofala, ma famu ambiri a nkhumba amagwiritsa ntchito florfenicol pafupipafupi kuti apewe kapena kuchiza matenda a nkhumba. Kaya matenda ndi amtundu wanji, kaya ndi gulu liti kapena gawo liti, alimi ena amagwiritsa ntchito florfenicol yochuluka kwambiri kuti athetse kapena apewe matenda. Florfenicol si mankhwala othetsera matenda. Iyenera kugwiritsidwa ntchito moyenera kuti ikwaniritse zomwe mukufuna. Izi ndi njira yofotokozera mwatsatanetsatane za kugwiritsa ntchito florfenicol, poyembekezera kuthandiza aliyense:
1. Mphamvu ya florfenicol yolimbana ndi mabakiteriya
(1) Florfenicol ndi mankhwala opha tizilombo toyambitsa matenda omwe ali ndi mabakiteriya ambiri omwe amalimbana ndi mabakiteriya osiyanasiyana a Gram-positive ndi negative ndi mycoplasma. Mabakiteriya omwe ali ndi vuto la nyere ndi monga ng'ombe ndi nkhumba Haemophilus, Shigella dysenteriae, Salmonella, Escherichia coli, Pneumococcus, Influenza bacillus, Streptococcus, Staphylococcus aureus, Chlamydia, Leptospira, Rickettsia, ndi zina zotero.
(2) Mayeso a mu vitro ndi mu vivo akuwonetsa kuti ntchito yake yolimbana ndi mabakiteriya ndi yabwino kwambiri kuposa ya mankhwala oletsa mabakiteriya omwe alipo pano, monga thiamphenicol, oxytetracycline, tetracycline, ampicillin ndi ma quinolone omwe amagwiritsidwa ntchito kwambiri pano.
(3) Florfenicol imagwira ntchito mwachangu, imatha kufika pamlingo wochiritsa m'magazi ola limodzi pambuyo pa jekeseni wa mu mnofu, ndipo kuchuluka kwa mankhwalawa kumatha kufika pamlingo wapamwamba mkati mwa maola 1.5-3; kuchuluka kwa mankhwala m'magazi komwe kumagwira ntchito nthawi yayitali komanso kogwira mtima kumatha kusungidwa kwa maola opitilira 20 mutalandira kamodzi.
(4) Imatha kulowa mu chotchinga cha magazi ndi ubongo, ndipo mphamvu yake yochiritsira matenda a meningitis ya bakiteriya ya ziweto si yofanana ndi ya mankhwala ena ophera mabakiteriya.
(5) Sili ndi poizoni komanso zotsatirapo zoyipa zikagwiritsidwa ntchito molingana ndi kuchuluka komwe kumalimbikitsidwa, limathetsa chiopsezo cha kuchepa kwa magazi m'thupi komanso poizoni wina woyambitsidwa ndi thiamphenicol, ndipo silidzavulaza nyama ndi chakudya. Limagwiritsidwa ntchito pa matenda osiyanasiyana a ziwalo za thupi omwe amayamba chifukwa cha mabakiteriya m'zinyama. Kuchiza nkhumba, kuphatikizapo kupewa ndi kuchiza matenda opuma a bakiteriya, meningitis, pleurisy, mastitis, matenda am'mimba ndi matenda obwera pambuyo pobereka mwa nkhumba.
2. Mabakiteriya omwe amakhudzidwa ndi florfenicol ndi matenda a nkhumba omwe amakonda kwambiri florfenicol
(1) Matenda a nkhumba omwe florfenicol ndi omwe amakonda kwambiri
Mankhwalawa akulangizidwa ngati mankhwala osankhidwa a chibayo cha nkhumba, pleuropneumonia yopatsirana ya nkhumba ndi matenda a Haemophilus parasuis, makamaka pochiza mabakiteriya omwe sagonjetsedwa ndi fluoroquinolones ndi maantibayotiki ena.
(2) Florfenicol ingagwiritsidwenso ntchito pochiza matenda a nkhumba otsatirawa
Ingagwiritsidwenso ntchito pochiza matenda opuma omwe amayamba chifukwa cha Streptococcus (chibayo), Bordetella bronchiseptica (atrophic rhinitis), Mycoplasma pneumoniae (nthenda ya chifuwa cha nkhumba), ndi zina zotero; salmonellosis (nthenda ya nkhumba paratyphoid), colibacillosis (nthenda ya chifuwa cha nkhumba) Matenda a m'mimba monga enteritis omwe amayamba chifukwa cha kutsegula m'mimba kwachikasu, kutsegula m'mimba koyera, matenda a kutupa kwa nkhumba) ndi mabakiteriya ena owopsa. Florfenicol ingagwiritsidwe ntchito pochiza matenda a nkhumba awa, koma si mankhwala osankhidwa a matenda a nkhumba awa, choncho iyenera kugwiritsidwa ntchito mosamala.
3. Kugwiritsa ntchito molakwika florfenicol
(1) Mlingo wa chakudya ndi waukulu kwambiri kapena wochepa kwambiri. Mlingo wina wosakaniza wodyetsa umafika 400 mg/kg, ndipo mlingo wa jakisoni umafika 40-100 mg/kg, kapena kupitirira apo. Ena ndi ochepa mpaka 8~15mg/kg. Mlingo waukulu ndi woopsa, ndipo mlingo wochepa sugwira ntchito.
(2) Nthawi ndi yayitali kwambiri. Kugwiritsa ntchito mankhwala kwa nthawi yayitali popanda choletsa.
(3) Kugwiritsa ntchito zinthu ndi magawo n’kolakwika. Nkhumba zamphongo zoyembekezera ndi zonenepetsa zimagwiritsa ntchito mankhwala otere mosasankha, zomwe zimayambitsa poizoni kapena zotsalira za mankhwala, zomwe zimapangitsa kuti kupanga ndi chakudya chisakhale chotetezeka.
(4) Kugwirizana kosayenera. Anthu ena nthawi zambiri amagwiritsa ntchito florfenicol pamodzi ndi sulfonamides ndi cephalosporins. Kufufuza ngati ndi sayansi komanso ngati n'koyenera n'kofunika.
(5) Kudyetsa ndi kupereka zakudya zosiyanasiyana sikusakanizidwa mofanana, zomwe zimapangitsa kuti mankhwala kapena poizoni wa mankhwala asamagwire ntchito.
4. Kugwiritsa ntchito njira zodzitetezera ku florfenicol
(1) Mankhwalawa sayenera kusakanikirana ndi macrolides (monga tylosin, erythromycin, roxithromycin, tilmicosin, guitarmycin, azithromycin, clarithromycin, ndi zina zotero), lincosamide (Monga lincomycin, clindamycin) ndi maantibayotiki a diterpenoid semi-synthetic - kuphatikiza kwa Tiamulin, akaphatikizidwa amatha kupanga zotsatira zotsutsana.
(2) Mankhwalawa sangagwiritsidwe ntchito limodzi ndi β-lactone amines (monga penicillins, cephalosporins) ndi fluoroquinolones (monga enrofloxacin, ciprofloxacin, ndi zina zotero), chifukwa mankhwalawa ndi oletsa mapuloteni a bakiteriya. Mankhwalawa ndi oletsa bacteriostatic, ndipo mankhwalawa ndi oletsa bacteriostatic, omwe amagwira ntchito mwachangu panthawi yobereka. Pogwiritsa ntchito mankhwala oyambawa, kupanga mapuloteni a bakiteriya kumalepheretsedwa mwachangu, mabakiteriya amasiya kukula ndi kuchulukana, ndipo mphamvu ya bactericidal ya mankhwalawa imachepa. Chifukwa chake, pamene chithandizocho chikufunika kuti chikhale ndi mphamvu yofulumira yoyeretsa, sichingagwiritsidwe ntchito pamodzi.
(3) Mankhwalawa sangasakanizidwe ndi sulfadiazine sodium pobayira m'mitsempha. Sayenera kugwiritsidwa ntchito limodzi ndi mankhwala a alkaline akaperekedwa pakamwa kapena m'mitsempha, kuti apewe kuwola ndi kulephera. Sikoyeneranso kubayidwa m'mitsempha ndi tetracycline hydrochloride, kanamycin, adenosine triphosphate, coenzyme A, ndi zina zotero, kuti apewe mvula komanso kuchepetsa mphamvu ya mankhwalawa.
(4) Kuwonongeka kwa minofu ndi kufalikira kwa minofu kungayambike pambuyo pobayidwa mu mnofu. Chifukwa chake, ikhoza kubayidwa mosinthasintha m'minofu yakuya ya khosi ndi matako, ndipo sikoyenera kubwereza jakisoni pamalo omwewo.
(5) Popeza mankhwalawa akhoza kukhala ndi poizoni m'mimba, ayenera kugwiritsidwa ntchito mosamala kwa nkhumba zoyamwitsa ndi zoyamwitsa.
(6) Pamene kutentha kwa thupi la nkhumba zodwala kuli kokwera, kungagwiritsidwe ntchito pamodzi ndi mankhwala oletsa kupweteka kwa thupi ndi dexamethasone, ndipo zotsatira zake zimakhala zabwino.
(7) Popewa ndi kuchiza matenda a porcine respiratory syndrome (PRDC), anthu ena amalimbikitsa kugwiritsa ntchito pamodzi florfenicol ndi amoxicillin, florfenicol ndi tylosin, ndi florfenicol ndi tylosin. N'koyenera, chifukwa malinga ndi maganizo a mankhwala, zonsezi sizingagwiritsidwe ntchito pamodzi. Komabe, florfenicol ingagwiritsidwe ntchito pamodzi ndi tetracyclines monga doxycycline.
(8) Mankhwalawa ali ndi poizoni wa magazi. Ngakhale kuti sangayambitse kuchepa kwa magazi m'thupi chifukwa cha kuchepa kwa magazi m'thupi, kuletsa kwa erythropoiesis komwe kumachitika chifukwa cha mankhwalawa n'kofala kwambiri kuposa kwa chloramphenicol (yolumala). Sikoyenera kugwiritsidwa ntchito panthawi ya katemera kapena nyama zomwe zili ndi chitetezo chamthupi chofooka kwambiri.
(9) Kugwiritsa ntchito nthawi yayitali kungayambitse matenda am'mimba komanso kusowa kwa mavitamini kapena zizindikiro za matenda opatsirana kwambiri.
(10) Popewa ndi kuchiza matenda a nkhumba, muyenera kusamala, ndipo mankhwalawa ayenera kuperekedwa motsatira mlingo ndi njira yochizira, ndipo sayenera kugwiritsidwa ntchito molakwika kuti apewe zotsatirapo zoyipa.
(11) Kwa nyama zomwe zili ndi vuto la impso, mlingo uyenera kuchepetsedwa kapena nthawi yoperekera iyenera kukulitsidwa.
(12) Ngati kutentha kuli kochepa, zimapezeka kuti kuchuluka kwa kusungunuka kumakhala kochedwa; kapena yankho lokonzedwa lili ndi florfenicol, ndipo limangofunika kutenthedwa pang'ono (osapitirira 45 ℃) kuti lisungunuke mwachangu. Yankho lokonzedwa liyenera kugwiritsidwa ntchito mkati mwa maola 48.
Nthawi yotumizira: Ogasiti-09-2022