Gentamicin (EENT)
Jeneng merek: Gentak
Kelas obat:
Agen Antineoplastik
Panganggone Gentamicin (EENT)
Infeksi Ophthalmic Bakteri
Pengobatan topikal infeksi bakteri dangkal mripat sing disebabake dening bakteri sing rentan, kalebu Staphylococcus aureus, S. epidermidis, Streptococcus pyogenes, S. pneumoniae, Enterobacter aerogenes, EscheriChia coli, Haemophilus influenza , Klebsiella pneumoniae, Neisseria gonorrhoeae, Serratia marcescens, lan Pseudomonas aeruginosa.
Konjungtivitis bakteri sing entheng lan akut kerep ilang kanthi spontan tanpa perawatan anti-infèksi. Senajan anti-infèksi ophthalmic topikal bisa nyepetake wektu kanggo resolusi lan nyuda keruwetan lan risiko komplikasi, supaya ora nggunakake anti-infèksi topikal kanthi sembarangan. Perawatan konjungtivitis bakteri akut umume empiris; nggunakake antibakteri ophthalmic topikal spektrum sing amba biasane dianjurake. Pewarnaan in vitro lan / utawa kultur bahan konjungtiva bisa dituduhake ing perawatan konjungtivitis purulen sing berulang, abot, utawa kronis utawa nalika konjungtivitis akut ora nanggapi perawatan topikal empiris awal.
Amarga keratitis bakteri bisa digandhengake karo mundhut sesanti sabanjure minangka akibat saka jaringan parut kornea utawa irregularities topografi lan amarga keratitis bakteri sing ora diobati utawa abot bisa nyebabake perforasi kornea kanthi potensial kanggo endophthalmitis lan bisa ilang mripat, Manajemen optimal kalebu evaluasi lan diagnosa kanthi cepet, wiwitan perawatan sing tepat, lan tindak lanjut sing cocog. Perawatan keratitis bakteri sing dipikolehi masyarakat umume empiris; nggunakake antibakteri ophthalmic topikal spektrum sing amba biasane dianjurake. Anti-infèksi suBConjunctival bisa uga dibutuhake yen scleral nyebar utawa perforasi wis cedhak. Pewarnaan in vitro lan/utawa kultur materi kornea sing dituduhake kanggo perawatan keratitis sing nglibatake infiltrasi kornea sing tengah, gedhe, lan ngluwihi stroma tengah nganti jero; nalika keratitis kronis utawa ora responsif kanggo anti-infèksi topikal spektrum sing amba; utawa nalika fitur atipikal nuduhake infeksi jamur, amebik, utawa mikobakteri.
Inflamasi Okular
Persediaan ophthalmic kombinasi tetep sing ngandhut gentamicin lan kortikosteroid (yaiku, prednisolon): Perawatan topikal kondisi okular responsif kortikosteroid nalika kortikosteroid dituduhake lan infeksi okular bakteri superfisial utawa risiko infeksi kasebut. ana.
Sanajan pabrikan nyatakake yen nggunakake preparat ophthalmic kombinasi tetep sing ngemot anti-infektif lan kortikosteroid bisa uga dituduhake ing kondisi inflamasi okular nalika risiko infeksi okular superfisial dhuwur utawa nalika jumlah bakteri sing mbebayani. Dikarepake ana ing mripat, para ahli nyatakake supaya ora nggunakake preparat kasebut ing pasien karo konjungtivitis bakteri amarga bisa nyebabake infèksi. kortikosteroid bisa nutupi pratandha klinis infeksi bakteri, jamur, utawa virus; nyegah pangenalan ineffectiveness saka anti-infèksi; lan / utawa nambah IOP. (Deleng Panganggone kombinasi Tetep Ngandhut Kortikosteroid miturut Ati-ati.)
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Carane nggunakake Gentamicin (EENT)
Administrasi
Administrasi Oftalmik
Olesake salep ophthalmic gentamicin utawa solusi topikal menyang mripat.
Olesake salep ophthalmic kombinasi tetep utawa suspensi sing ngandhut gentamicin lan kortikosteroid (yaiku, prednisolon) ing mripat.
Mung kanggo panggunaan ophthalmic topikal; aja nyuntikake subconjunctivaly utawa langsung menyang kamar anterior mripat.
Supaya ujung wadhah sing kontaminasi karo bahan saka mripat, tlapukan, utawa sumber liyane.
Shake suspensi ophthalmic kombinasi tetep sadurunge digunakake.
Dosis
Kasedhiya minangka gentamicin sulfate piyambak utawa ing kombinasi tetep karo prednisolon asetat. Dosis gentamicin ditulis ing syarat-syarat basa; dosis saka prednisolone asetat ditulis ing syarat-syarat uyah.
Pasien Anak
Infeksi Ophthalmic Bakteri OphthalmicGentamicin 0,3% (salep ophthalmic) ing pasien pediatrik ≥1 sasi: Aplikasi pita kira-kira 1,25-cm (½ inci) ing mripat sing kena pengaruh. (s) 2 utawa 3 kaping saben dina.
Gentamicin 0,3% (solusi ophthalmic) ing pasien pediatrik ≥1 sasi: Pasang 1 utawa 2 tetes menyang mripat sing kena pengaruh saben 4 jam. Kanggo infèksi sing abot, nganti 2 tetes bisa ditetesake saben jam.
Durasi biasa perawatan anti-infèksi topikal kanggo konjungtivitis bakteri yaiku 5-10 dina; 5-7 dina biasane cukup kanggo konjungtivitis bakteri entheng.
Dewasa
Infeksi Ophthalmic Bakteri OphthalmicGentamicin 0,3% (salep ophthalmic): Lebokake pita kira-kira 1,25-cm (½ inci) ing mripat sing kena pengaruh 2 utawa 3 kaping saben dina.
Gentamicin 0,3% (solusi ophthalmic): Lebokake 1 utawa 2 tetes menyang mripat sing kena pengaruh saben 4 jam. Kanggo infèksi sing abot, nganti 2 tetes bisa ditetesake saben jam.
Durasi biasa perawatan anti-infèksi topikal kanggo konjungtivitis bakteri yaiku 5-10 dina; 5-7 dina biasane cukup kanggo konjungtivitis bakteri entheng.
Radang Okular OphthalmicGentamicin 0,3% lan prednisolone acetate 0,6% (salep ophthalmic): Lebokake pita kira-kira 1,25 cm (½ inci) menyang sac sing kena pengaruh. mripat (s) 1-3 kaping saben dina.
Gentamicin 0,3% lan prednisolon asetat 1% (suspensi ophthalmic): Lebokake 1 tetes menyang kantung conjunctival saka mripat sing kena pengaruh 2-4 kaping dina. Sajrone 24-48 jam wiwitan, 1 tetes bisa ditrapake saben jam yen perlu.
Yen ora ana perbaikan sawise 2 dina, evaluasi maneh pasien. Aja mandheg prematur.
Pènget
Kontraindikasi
Pènget/PanandhapReaksi Sensitivitas
Hipersensitivitas
Reaksi alergi kacarita.
Yen ana hipersensitifitas, langsung mandheg lan miwiti terapi sing cocog.
Superinfeksi
Panganggone sing suwe bisa nyebabake kakehan organisme sing ora rentan, kalebu jamur.
Resistensi bakteri kanggo gentamicin bisa kedadeyan.
Tukak kornea bakteri lan jamur wis berkembang.
Pancegahan sing Gegandhengan karo Administrasi Ophthalmic
Produsen ngelingake yen salep ophthalmic bisa nundha penyembuhan kornea.
Panganggone Kombinasi Tetep sing Ngandhut Kortikosteroid
Nalika preparat ophthalmic sing ngemot gentamicin ing kombinasi tetep karo kortikosteroid (yaiku, prednisolon) digunakake, nimbang ati-ati, pancegahan, lan kontraindikasi sing ana gandhengane karo kortikosteroid EENT.
Nyedhiyakake resep awal kanggo preparat ophthalmic kombinasi tetep sing ngemot kortikosteroid utawa resep pembaharuan (luwih saka 8 g salep mata utawa luwih saka 20 ml larutan ophthalmic) mung sawise ngukur TIO lan mriksa pasien kanthi mikroskop lampu celah lan, yen cocok, pewarnaan fluorescein.
Penggunaan preparat ophthalmic kombinasi tetep sing ngemot kortikosteroid bisa nyebabake glaukoma, kanthi karusakan saraf optik, cacat ing ketajaman visual lan bidang penglihatan, lan pembentukan katarak subkapsular posterior. Yen persiapan kasebut digunakake kanggo ≥10 dina, monitor IOP kanthi rutin, sanajan iki angel kanggo bocah-bocah lan pasien sing ora kooperatif. Gunakake kombinasi tetep sing ngemot kortikosteroid kanthi ati-ati ing pasien glaukoma; mriksa IOP kerep ing pasien kasebut.
Panganggone preparat ophthalmic kombinasi tetep sing ngemot kortikosteroid sawise operasi katarak bisa nundha penyembuhan lan nambah insiden pembentukan bleb.
Penipisan kornea lan scleral dilapurake kanthi macem-macem penyakit okular lan kanthi nggunakake kortikosteroid topikal jangka panjang. Panganggone kortikosteroid topikal ing pasien kanthi jaringan kornea lan scleral tipis bisa nyebabake perforasi.
Penggunaan preparat ophthalmic kombinasi tetep sing ngemot kortikosteroid bisa nyuda respon host lan nambah risiko infeksi okular sekunder. Gunakake ing pasien kanthi kondisi purulen akut ing mripat bisa nutupi infeksi utawa nambah infeksi sing ana.
Bisa ndawakake kursus lan nambah keruwetan akeh infeksi virus ing mripat (kalebu herpes simplex). Gunakake kanthi ati-ati banget ing pasien karo herpes simplex; mikroskopi lampu irisan asring dianjurake.
Pertimbangake kemungkinan infeksi jamur ing kornea sawise nggunakake preparat ophthalmic sing dawa sing ngemot kortikosteroid. Nindakake kultur jamur yen cocok.
Populasi Tertentu
KandhutanOra ana studi sing nyukupi lan dikontrol kanthi apik nggunakake preparat ophthalmic sing ngemot gentamicin ing wanita ngandhut.
Gunakake preparat ophthalmic gentamicin, kalebu preparat kombinasi tetep sing ngemot gentamicin lan a kortikosteroid, nalika meteng mung yen keuntungan potensial mbenerake risiko potensial kanggo janin.
LaktasiGentamicin sistemik disebarake menyang susu.
Mungkasi nyusoni utawa obat kasebut, kanthi nganggep pentinge obat kasebut kanggo wanita.
Panggunaan PediatrikSalep utawa solusi ophthalmic Gentamicin: Keamanan lan khasiat ora ditetepake ing neonatus.
Persediaan ophthalmic kombinasi tetep sing ngemot gentamicin lan kortikosteroid (yaiku, prednisolon): Keamanan lan khasiat ora ditetepake ing pasien pediatrik.
Panggunaan GeriatrikPersediaan ophthalmic kombinasi tetep sing ngemot gentamicin lan prednisolon: Ora ana bedane sakabèhé ing safety utawa khasiat relatif marang wong diwasa sing luwih enom.
Efek Umum sing Sabar
Kobong lan iritasi okular, konjungtivitis nonspesifik, cacat epitel konjungtiva, hiperemia konjungtiva.
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