{"id":6406,"date":"2022-10-01T16:06:34","date_gmt":"2022-10-01T11:06:34","guid":{"rendered":"https:\/\/www.serenepharma.com\/?p=6406"},"modified":"2022-10-28T16:10:26","modified_gmt":"2022-10-28T11:10:26","slug":"nozokomial-pnevmoniya-bilan-ogrigan-bemorlarda-doimiy-dorilarni-tomirga-sekin-yuborish-bilan-meropenemning-farmakokinetikasi","status":"publish","type":"post","link":"https:\/\/www.serenepharma.com\/uz\/gazetauz\/nozokomial-pnevmoniya-bilan-ogrigan-bemorlarda-doimiy-dorilarni-tomirga-sekin-yuborish-bilan-meropenemning-farmakokinetikasi\/","title":{"rendered":"Nozokomial pnevmoniya bilan og’rigan bemorlarda doimiy dorilarni tomirga sekin yuborish bilan meropenemning farmakokinetikasi"},"content":{"rendered":"\n

Ref: Crit Care 24, 55 (2020). https:\/\/doi.org\/10.1186\/s13054-020-2763-4.<\/p>\n\n\n\n

Kirish<\/strong><\/h3>\n\n\n\n

Nozokomial pnevmoniya bilan og’rigan bemorlarning sezilarli tarqalishi, antimikrobiyal qarshilikning kuchayishi va suboptimal klinik natijalari mikroblarga qarshi dozani optimallashtirish zarurligini kafolatlaydi. Meropenem, karbapenem, nozokomial pnevmoniyani keltirib chiqaradigan ko’plab patogenlarga qarshi samarali ekanligi ma’lum. Shu bilan birga, meropenemning uzluksiz infuziya (CI) yo’li bilan yuborilganda o’pka ichidagi farmakokinetikasi (PK) bo’yicha ma’lumotlar etarli emas.<\/p>\n\n\n\n

Maqsad<\/strong><\/h3>\n\n\n\n

Ushbu tadqiqot nozokomial pnevmoniya bilan og’rigan bemorlarda plazma va epiteliya qoplami suyuqligida (EPS) meropenemning ikki dozasi (3 g va 6 g \/ kun) ni baholadi.<\/p>\n\n\n\n

Usullari<\/strong><\/h3>\n\n\n\n

Davolash strategiyasi<\/strong><\/h4>\n\n\n\n
  • 31 bemordan mos ravishda 16 va 15 bemorga meropenem 1\u2009g\/8\u2009soat va 2\u2009g\/8\u2009soat CI (8\u2009soatlik infuziya) bilan buyurilgan.<\/li>
  • Qon va EPS namunalari barqaror holatga erishilgandan so’ng davolanishning 3 yoki 4-kunida olindi.<\/li>
  • Qon namunalari infuziyadan oldin va meropenem infuzioni boshlanganidan keyin 1,5, 3, 6 va 8 soatdan keyin olingan.<\/li>
  • EPS namunalari bir vaqtning o’zida infuziondan 6 soat o’tgach, standartlashtirilgan optik tolali bronkoskopiya paytida bronxoalveolyar yuvish (BAL) orqali olingan.<\/li>
  • Plazma va EPS meropenem kontsentratsiyasi populyatsiya metodologiyasidan foydalangan holda modellashtirildi va Monte-Karlo simulyatsiyasi MIC (50% fT>MIC) dan 50% yuqori bo’lgan erkin EPS kontsentratsiyasiga erishish ehtimolini (MEE) baholash uchun amalga oshirildi, bu esa logarifmik natijaga olib keladi. pnevmoniyaning eksperimental modellarida o’ldirish va qarshilikni bostirish.<\/li><\/ul>\n\n\n\n

    Yakuniy nuqtalar<\/strong><\/h4>\n\n\n\n
    • Plazma va EPSdagi meropenemning o’rtacha konsentratsiyasi<\/li>
    • Maqsadga erishish ehtimoli (MEE)<\/li><\/ul>\n\n\n\n

      Natijalar<\/strong><\/h3>\n\n\n\n
      • 2\u2009g\/8\u2009soat guruhidagi o\u2018rtacha (KAD) meropenemning plazma kontsentratsiyasi 1\u2009g\/8\u2009soat guruhiga nisbatan barcha vaqt nuqtalarida statistik jihatdan yuqori bo\u2018lgan.<\/li>
      • Plazma va EPSdagi meropenemning AUC0\u201324 soat mediani (KAD) 1-jadvalda solishtirilgan.<\/li><\/ul>\n\n\n\n

        Jadval 1. Plazma va EPSdagi meropenemning medianasini (KAD) solishtirish<\/p>\n\n\n\n

         <\/td>Plazmadagi Median (KAD)<\/strong> <\/strong><\/strong><\/td>EPS<\/strong> dagi Median (KAD)<\/strong> <\/strong><\/strong><\/td><\/tr>
        1 g\/8 h guruh<\/strong><\/strong><\/td>287.6 (190.2) mg g\/L<\/td>84.1 (78.8) mg g\/L<\/td><\/tr>
        2 g\/8 h guruh<\/strong><\/strong><\/td>448.1 (231.8) mg g\/L<\/td>163.0 (201.8) mg g\/L<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

        (Take from excel)<\/p>\n\n\n\n

        • Singish nisbati taxminan 30% ni tashkil etdi va dozalash guruhlari o’rtasini solishtirish mumkin edi.<\/li>
        • Optimal PTA 1\u2009g\/8\u2009soat dozada MIC qiymatlari <\u20092\u2009mg\/L uchun va Monte-Karlo simulyatsiyalariga ko\u2018ra yuqoriroq dozada 2\u2009g\/8\u2009soat bo\u2018lgan MIC qiymatlari <\u20094\u2009mg\/L uchun erishildi.<\/li><\/ul>\n\n\n\n

          Xulosa<\/strong><\/p>\n\n\n\n

          • Meropenemni uzluksiz infuziya orqali yuborish nozokomial pnevmoniya bilan og’rigan og’ir bemorlarda plazma va epiteliya qoplami suyuqligida (EPS) dori ta’sirini yaxshilaydi.<\/li>
          • Buyrak funktsiyasi saqlanib qolgan bemorlarda barcha sezgir izolatlar (MIC \u2264\u20092\u2009mg\/L) uchun EPSning optimal qoplamiga erishish uchun kuniga 6\u2009g (2 g\/8 soat) eng yuqori litsenziyalangan doza zarur edi.<\/li>
          • MIC 2 mg\/l dan yuqori bo’lgan gram-manfiy bakteriyalar keltirib chiqaradigan nozokomial pnevmoniyani davolashda muqobil terapiyani ko’rib chiqish kerak.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"

            Ref: Crit Care 24, 55 (2020). https:\/\/doi.org\/10.1186\/s13054-020-2763-4. Kirish Nozokomial pnevmoniya bilan og’rigan bemorlarning sezilarli tarqalishi, antimikrobiyal qarshilikning kuchayishi va suboptimal klinik natijalari mikroblarga qarshi dozani optimallashtirish zarurligini kafolatlaydi. Meropenem, karbapenem, nozokomial pnevmoniyani keltirib chiqaradigan ko’plab patogenlarga qarshi samarali ekanligi ma’lum. Shu bilan birga, meropenemning uzluksiz infuziya (CI) yo’li bilan yuborilganda o’pka ichidagi farmakokinetikasi (PK) bo’yicha ma’lumotlar etarli…<\/p>\n","protected":false},"author":1,"featured_media":6100,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"rs_blank_template":"","rs_page_bg_color":"","slide_template_v7":"","inline_featured_image":false,"footnotes":""},"categories":[141],"tags":[172],"class_list":["post-6406","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gazetauz","tag-reanimatsiya"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t