Limagwirira cha zochita za mankhwala: texte

Inu mukhoza kunena kuti chitukuko chosintha anali anapeza penicillin m'zaka za m'ma makumi awiri. Pa Nkhondo Yachiwiri ya World, mankhwala oyamba opulumutsidwa asilikali ochuluka atavulazidwa ku septicemia. Penicillin anakhala bwino ndipo pa mankhwala nthawi yomweyo mtengo zosiyanasiyana matenda aakulu ndi fractures kwambiri, septic mabala. Pa nthaŵi, apanga, ndi makalasi zina za mankhwala.

makhalidwe General

Lero kuli chiwerengero chachikulu cha mankhwala Kukhala mbali ya dziko lalikulu la mankhwala - zinthu chiyambi achilengedwe kapena theka-kupanga kuti angathe kuwononga magulu ena a tizilombo toyambitsa matenda kapena ziletsa kukula kapena kubereka. The njira ya zochita za mankhwala makulidwe akhoza kukhala osiyana. Pa nthawi ingapezeke ndi zosintha antibayotiki. Ndi zosiyanasiyana awo amafuna systematization. Mu nthawi yathu, ife anatengera gulu la mankhwala monga limagwirira kanthu ndi osiyanasiyana, komanso dongosolo mankhwala. Malinga limagwirira zochita lagawidwa:

• bacteriostats, amene kuletsa kukula kapena kubereka tizilombo toyambitsa matenda;
• microbicides Zimenezi zimathandiza kuti chiwonongeko cha bakiteriya.

The njira zoyambirira za ntchito antibayotiki:

• kuphwanya khoma bakiteriya selo;
• chopinga mapuloteni kaphatikizidwe muchipindachi bakiteriya;
• kuphwanya permeability wa Kakhungu cytoplasmic;
• chopinga wa RNA kaphatikizidwe.

Beta-lactam mankhwala - penicillin

Malinga ndi kapangidwe mankhwala mankhwala awa ali m'magulu motere.

Beta-lactam mankhwala. Limagwirira kanthu lactam mankhwala zimadalira mphamvu ya gulu zinchito kuti wamanga michere nawo kaphatikizidwe peptidoglycan - zapansi nembanemba lakunja kwa maselo bakiteriya. Choncho, imathetsa mapangidwe maselo makoma, zomwe zimalimbikitsa kuti analeka kukula kapena kubereka mabakiteriya. Beta-lactams ndi otsika kawopsedwe, ndipo nthawi yomweyo wabwino bactericidal kwenikweni. Akuimira gulu lalikulu ndiponso anawagawa subgroups kuti ndi ofanana dongosolo mankhwala.

Penicillin - ndi gulu la zinthu kumasulidwa ku madera ena a amatha kuumba ndi zotsatira bactericidal. Limagwirira cha zochita za mankhwala a penicillin chifukwa chakuti mwa kuwononga selo khoma la tizilombo, iwo mbaavunga. Penicillin chilengedwe kapena theka-kupanga chiyambi ndiponso ndi mankhwala a sipekitiramu lonse kanthu - iwo angagwiritsidwe ntchito pa matenda a matenda oyamba chifukwa streptococci ndi staphylococci. Komanso ali ndi chuma cha selectivity mwa kuchita kokha pa yaying'ono-zamoyo, popanda okhudza zazikulu-chamoyo. Penicillin ndi zovuta, monga pakutchulidwa kukaniza bakiteriya thereto. La ambiri achilengedwe Penicillin G Penicillin kuti ntchito kulimbana ndi matenda meningococcal ndi streptococcal chifukwa kawopsedwe ake otsika mtengo wotsika. Komabe, kulandiridwa yaitali akhoza kukhala chitetezo chokwanira thupi mankhwala, potero kuchepetsa nchito zake. penicillin theka-kupanga zambiri anachokera ku zachilengedwe kusinthidwa mankhwala opatsa katundu wolakalakika - amoxicillin, ampicillin. Mankhwalawa ndi ntchito apamwamba ndi mabakiteriya kugonjetsedwa biopenitsillinam.

Other beta-lactams

Cephalosporins analandira kuchokera bowa wa dzina chomwecho, ndi kapangidwe ndi yofanana ndi kapangidwe ka penicillin amene akufotokoza chomwecho anakwiya. Cephalosporins chifukwa cha mibadwo inayi. mankhwala m'badwo woyamba ntchito zambiri mu mankhwala a matenda osawopsa chifukwa cha staphylococci kapena streptococci. Wachiwiri ndi wachitatu cephalosporins m'badwo yogwira ndi mabakiteriya galamu alibe, ndi m'badwo wachinayi wa thunthu - mankhwala amphamvu kwambiri ntchito pofuna kusokoneza matenda aakulu.

Carbapenems bwino kuchita, galamu alibe ndi anaerobic mabakiteriya galamu HIV. Mbali awo abwino ali pakalibe kukana bakiteriya kuti mankhwala ngakhale patapita nthawi yaitali tanthauzo lake.

Monobactams zimagwilanso nchito kwa beta-lactams ndipo ndi njira zofanana pa ntchito ya mankhwala ndi chikoka pa maselo makoma a mabakiteriya. Iwo amagwiritsidwa ntchito pofuna kuchiza zosiyanasiyana matenda osiyana.

macrolides

Ichi ndi gulu lina. Macrolides - mankhwala zachilengedwe, zomwe ndi zovuta dongosolo ozungulira. Iwo akuyimira polenomiyo lactone mphete Ufumuyo zimam'patsa moieties. Kuyambira chiwerengero cha maatomu mpweya mu mphete zimadalira katundu wa mankhwala. Kusiyanitsa 14-, 15 ndi mankhwala 16-ziwalo. The sipekitiramu wa kanthu tizilombo ndi lonse zokwanira. Limagwirira cha zochita za mankhwala pa khungu tating'onoting'ono ndi mwa kuchita nawo ribosomes ndipo potero kuphwanya kwa kaphatikizidwe mapuloteni mu foni ya bakiteriya ndi inhibiting latsopano zosiyanasiyana monomer Kuwonjezera unyolo peputayidi. KUCHULUKA maselo chitetezo cha m'thupi, macrolides anachita ndi okhudza maselo ambiri kupha tizilombo toyambitsa matenda.

Macrolides ambiri otetezedwa ndi zochepa poizoni ndi pakati antibayotiki kudziwika polimbana osati galamu HIV, koma mabakiteriya negative. ntchito yawo mwaonapo zochita osafunika mbali. mankhwala awa yodziwika ndi zotsatira bacteriostatic, koma pa woipa mkulu, kodi ndi zotsatira bactericidal pa pneumococci ndi ena tizilombo tina. Monga njira yopangira macrolides anawagawa zachilengedwe ndi semisynthetic.

Mankhwala oyamba mu gulu la macrolides zachilengedwe mankhwalawa chinapezeka mu zaka za m'ma otsiriza ndipo lakhala likugwiritsidwa ntchito bwinobwino ndi mabakiteriya galamu HIV kugonjetsedwa ndi penicillin pa. A mbadwo watsopano wa mankhwala gulu anaonekera mu 70s kwa zaka za m'ma 20 ndipo ankagwiritsa ntchito kutali.

mankhwala Macrolide komanso ndi theka - azolides ndi ketolides. Azolide The lactone mphete molekyulu, pakati pa chinayi ndi lakhumi mpweya maatomu m'gulu asafe atomu. Nthumwi azolides azithromycin ndi sipekitiramu yotakata kanthu ndi ntchito kwa galamu HIV ndi galamu alibe mabakiteriya ena anaerobes. Ndi zambiri wolimba mu sing'anga acidic, poyerekeza ndi mankhwalawa, ndi mwina kudziunjikira mu izo. Azithromycin ntchito zosiyanasiyana matenda a thirakiti kupuma thirakiti mkodzo, matumbo, khungu ndi ena.

Ketolides anawakonzera kuika wachitatu atomu keto lactone mphete. Iwo sakhala chizolowezi kupanga mabakiteriya, poyerekeza ndi macrolides.

tetracyclines

Tetracyclines ndi gulu la polyketides. Ndi mankhwala yotakata-sipekitiramu bacteriostatic chikoka. Nthumwi oyamba - chlortetracycline, anali olekanitsidwa mu zaka za m'ma mmodzi wotsiriza wa zikhalidwe za actinomycetes umatchedwanso bowa chowala. Patapita zaka zingapo gentamycin wakhala analandira kwa njuchi wa bowa chomwecho. Membala chachitatu cha gulu ili tetracycline, adayamba kulengedwa ndi mankhwala kusinthidwa wa chloro otumphukira ake, ndipo patatha chaka chimodzi komanso olekanitsidwa actinomycetes. mankhwala ena wa tetracycline gulu ndi theka-kupanga ofanana nawo mankhwala awa.

zinthu zonsezi ofanana mu dongosolo mankhwala ndi katundu wa ntchito ndi mitundu yambiri ya bakiteriya galamu HIV ndi galamu alibe, ena mavairasi mogwirizana. Iwo kugonjetsedwa ndi zizolowezi ndi tizilombo. Limagwirira cha zochita za mankhwala foni bakiteriya ndi wayesetsa kuchibisa mu ndondomeko ya mapuloteni biosynthesis. Zimene mamolekyulu mankhwala galamu alibe mabakiteriya iwo pochitika mu maselo ndi mayamwidwe yosavuta. Limagwirira wa malowedwe a particles mankhwala akanika galamu HIV akadali bwino bwino, koma pali nkhambakamwa kuti angamwe tetracycline tinthu kucheza ndi ayoni zitsulo zina maselo mabakiteriya kupanga mankhwala zovuta. Choncho pali kusiyana mu unyolo pa mapuloteni kaphatikizidwe zofunika selo bakiteriya. Zatsopano anatsimikizira kuti chlortetracycline bacteriostatic woipa yokwanira ziletsa mapuloteni kaphatikizidwe, koma chopinga wa kaphatikizidwe mkati asidi amafuna woipa mkulu wa mankhwala.

Tetracyclines ntchito polimbana ndi matenda a impso, matenda osiyanasiyana a pakhungu, m'mapapo ndi matenda ena ambiri. Ngati ndi kotheka, iwo m'malo penicillin, koma zaposachedwapa, ntchito tetracyclines kwambiri utachepa, chifukwa zikamera kukaniza tizilombo kuti gulu la mankhwala. Achipongwe ankaimba ndi kugwiritsa ntchito mankhwala monga zowonjezera ku chakudya nyama, chifukwa mu utachepa achire katundu wa mankhwala chifukwa pakutchulidwa kukaniza kwa izo. Kuchithetsa, amasankhidwa ndi osakaniza mankhwala osiyana ndi njira zosiyana za ntchito antimicrobial antibayotiki. Mwachitsanzo, mankhwala zotsatira kumatheka mwa ntchito munthawi yomweyo wa tetracycline ndi streptomycin.

aminoglycosides

Aminoglycosides - zachilengedwe ndi theka-kupanga mankhwala ndi sipekitiramu waukulu kwambiri wa ntchito, munali mu zatsalira molekyulu aminosaharidov. Iye anakhala woyamba aminoglycoside streptomycin, kutali chambiri bowa ray mu zaka za m'ma otsiriza ndipo ntchito mwakhama mankhwalawa zosiyanasiyana matenda. Monga bactericide, mankhwala a gulu anati zimathandiza ngakhale pa chitetezo chokwanira kwambiri yafupika. Limagwirira cha zochita za mankhwala pa khungu tating'onoting'ono ndi mapangidwe mgwirizano wolimba covalent ndi mapulotini ribosomes bakiteriya chiwonongeko cha kaphatikizidwe mapuloteni mu zochita bakiteriya selo. Kodi asanamvetsetse limagwirira aminoglycoside bactericidal tingati, monga kuyenera kuchitapo kanthu bacteriostatic wa tetracyclines ndi macrolides komanso kuphwanya mapuloteni kaphatikizidwe maselo bakiteriya. Komabe, amadziwika kuti aminoglycosides zachangu yekha m'mikhalidwe aerobic, kotero iwo amasonyeza dzuwa nkhawa zimakhala ndi kotunga osauka magazi.

Pambuyo mankhwala choyamba - penicillin ndi streptomycin, adayamba choncho chimagwiritsidwa ntchito pa matenda a matenda aliwonse kuti posachedwapa panali vuto kupeza tizilombo ntchito mankhwala. Panopa, streptomycin ntchito makamaka osakaniza ndi mibadwo ina atsopano a mankhwala kuchiza chifuwa kapena otero, lero matenda osowa monga nthenda. Nthawi zina anatumizidwa kanamycin, amenenso m'badwo woyamba wa aminoglycoside mankhwala. Komabe, chifukwa cha kawopsedwe mkulu wa kanamycin panopa adalipo gentamicin - yokonza m'badwo wachiwiri, m'badwo wachitatu ndi yokonza amikacin ndi aminoglycoside - izo sikawirikawiri ntchito popewa zizolowezi thereto tizilombo.

ndi chloramphenicol

Chloramphenicol kapena chloramphenicol, ndi mankhwala achilengedwe ndi sipekitiramu lonse la kanthu, wapansanja. ambiri zamoyo galamu HIV ndi galamu alibe, ambiri mavairasi aakulu. Pa dongosolo mankhwala lachokera nitrofenilalkilaminov, anali woyamba kuwapeza chikhalidwe cha actinomycetes pakati pa zaka za m'ma 20, ndipo patapita zaka ziwiri komanso apanga mankhwala.

Chloramphenicol kumakhudza bacteriostatic pa tizilombo. Limagwirira cha zochita za mankhwala foni bakiteriya ndi kupondereza ntchito ya chothandizira mapangidwe ndondomeko kumangidwa peputayidi mu kaphatikizidwe mapuloteni pamene ribosomes. kuti ndi chloramphenicol kukana akanika akufotokozera pang'onopang'ono. Mankhwala ntchito typhoid ndi matenda kapena shigellosis.

Glycopeptides ndi lipopeptides

Glycopeptides - ndi ozungulira peputayidi mankhwala amene chilengedwe kapena semisynthetic maantibayotiki ndi sipekitiramu yopapatiza ya ntchito tizilombo ta ena tizilombo. Iwo kumasintha zotsatira bactericidal pa mabakiteriya galamu HIV, ndipo akhoza m'malo Penicillin ngati kukana izo. Limagwirira cha zochita za mankhwala pa tizilombo singalifotokoze mapangidwe kulumikizana ndi amino zidulo ndi selo khoma peptidoglycan, potero kupondereza kaphatikizidwe awo.

Choyamba glycopeptide - vancomycin, anapangidwa kuchokera actinomycetes, anatengedwa kuchokera m'dziko la India. Ndi mankhwala achilengedwe amene akugwira ntchito yolimbana ndi tizilombo, ngakhale mu kuswana nyengo. Poyamba, vancomycin ntchito ngati m'malo mwa nkhani ya penicillin ziwengo kuti mu mankhwala a matenda. Komabe, kuchuluka kwa kukana mankhwala wakhala ndi vuto lalikulu. Mu zaka 80 kuti anali analandira teicoplanin - maantibayotiki ku gulu la glycopeptides. Anaikidwa pa matenda chomwecho, ndi osakaniza ndi gentamicin, iye amapereka zotsatira zabwino.

Kumapeto kwa zaka za m'ma 20, gulu latsopano la mankhwala - lipopeptides olekanitsidwa Streptomyces. Mankhwala ali ozungulira lipopeptides. Izi mankhwala ndi sipekitiramu yopapatiza kanthu, naonetsere zotsatira bactericidal ndi mabakiteriya galamu HIV ndi staphylococci amene kusamva mankhwala beta-lactam ndi glycopeptides.

Limagwirira cha zochita za mankhwala zimasiyana amene kale - mitundu ya lipopeptide pamaso pa kashiamu ayoni mgwirizano wolimba ndi selo nembanemba mabakiteriya imbaenda depolarization ndi kusokonezeka ake kaphatikizidwe mapuloteni, kotero kuti khungu njiru afa. Nthumwi loyamba la kalasi ya lipopeptides - daptomycin.

Pankhani daptomycin akhoza taonera mtengo kwambiri za ntchito bactericidal, ndipo ambiri Chofunika - chosowa mtanda kukana, kapena wochedwa mapangidwe ake chifukwa choona kuti limagwirira zatsopano za ntchito antibayotiki inalowa mu dongosolo la thunthu.

polyenes

Gulu lotsatira - polyene mankhwala. Today pali funde lalikulu matenda a mafangasi ndi ovuta kuchiza. Pofuna iwo ali antifungal mankhwala - zachilengedwe kapena theka-kupanga polyene mankhwala. Woyamba antifungal mankhwala akadali mu zaka za m'ma otsiriza anayamba Nystatin, amene anali olekanitsidwa Streptomyces chikhalidwe. Nthawi imeneyi, kuchita pa zamankhwala m'gulu mankhwala polyene ambiri linachokera ku zosiyanasiyana mafangasi zikhalidwe - griseofulvin, Levorinum ndi ena. Talandira basi ntchito polyenes kale m'badwo wachinayi. dzina Common iwo ali zikomo kukhalapo kwa nsinga angapo awiri mu mamolekyulu lapansi.

Limagwirira cha zochita za mankhwala polyene chifukwa mapangidwe kumangidwa mankhwala ndi sterols selo nembanemba ku bowa. Polyene molekyulu Motero anapatsa selo nembanemba ndi mitundu ion basi anatumizanso lamya njira yomwe zigawo zikuluzikulu kuwonjezera maselo kunja, zikubweretsa Kupha ake. Pa mlingo wochepa polyenes adzalandira ntchito fungistatic ndi mkulu - fungicide. Komabe, ntchito yawo si anaphimba ndi mabakiteriya ndi tizilombo tina.

Polymyxin - mankhwala achilengedwe opangidwa ndi mabakiteriya m'nthaka spore. Mu mankhwala akhala mu 40 ntchentche Mu zaka zapitazo. formulations n'zosiyana zotsatira bactericidal, amene amayamba ndi kuwonongeka kwa Kakhungu cytoplasmic maselo bakiteriya unkawononga ake. Polymyxin polimbana mabakiteriya galamu alibe ndipo kawirikawiri osokoneza tizilombo. Komabe, kwambiri kawopsedwe zimasokoneza ntchito zawo mankhwala. Mankhwala a m'gulu limeneli - polymyxin B sulphate ndi polymyxin sulphate M ntchito kawirikawiri ndi okha monga kukonzekera malo.

antitumor mankhwala

Actinomycins amapangidwa ndi bowa wina wowala kwambiri. Zojambula zachilengedwe zojambula ndizopangidwa ndi ma chromopeptides omwe amasiyana ndi amino acid m'maketanga a peptide, omwe amatsimikizira zomwe amachita. Actinomycins amachititsa chidwi akatswiri monga mankhwala oletsa antibayotiki. Zomwe amachitapo ndizopanga mapangidwe amtundu wa peptide wamaketani omwe akukonzekera ndi maulendo awiri a DNA ya tizilombo toyambitsa matenda komanso kutseka chifukwa chaichi.

Dactinomycin, yomwe inapezeka m'ma 60 a zaka za m'ma 2000, inakhala mankhwala oyamba opanga mankhwala omwe amapezeka mu njira zowonongeka. Komabe, chifukwa cha zifukwa zambiri izi mankhwalawa sagwiritsidwa ntchito kawirikawiri. Mankhwala osokoneza bongo ochulukirapo tsopano adapezeka.

Anthracyclines ndi zinthu zamphamvu kwambiri zotsutsana ndi zotupa zosiyana ndi streptomycetes. Njira yogwiritsira ntchito maantibayotiki imagwirizana ndi kupanga mapangidwe atatu omwe ali ndi maunyolo a DNA ndi kupasuka kwa mitsempha iyi. Njira yachiwiri yogwiritsira ntchito mankhwala osokoneza bongo ndi yotheka, chifukwa cha kupanga zida zowonjezera zomwe zimayambitsa maselo a khansa.

Zina mwa anthracyclines zachilengedwe, daunorubicin ndi doxorubicin zikhoza kutchulidwa. Dongosolo la mankhwala opha tizilombo molingana ndi kayendedwe kake ka mabakiteriya amawasiyanitsa ngati bactericidal. Komabe, kuopsa kwa poizoni kwawo kunayambitsa iwo kuyang'ana mankhwala atsopano omwe anapezeka mwachangu. Ambiri a iwo amagwiritsidwa ntchito mosamala mu oncology.

Mankhwala opha tizilombo akhala akugwira nawo ntchito zamankhwala ndi moyo waumunthu. Chifukwa cha iwo, matenda ambiri adagonjetsedwa, omwe kwa zaka zambiri ankawoneka osachiritsika. Pakalipano, pali mitundu yosiyanasiyana ya mankhwalawa kuti sichifunika kokha mndandanda wa maantibayotiki molingana ndi kayendetsedwe kake ndi kayendedwe kake, koma ndi zina zambiri.