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三、肝肾功能减退时的抗生素正确运用 (一)肝功能减退时的抗生素正确运用,基于药物在肝中的代谢受药物动力学、遗传因素、肝细胞酶等多方面的影响,因此常用的肝功能试验不能正确地反映肝对抗菌药物的排泄和代谢能力。 1.青霉素族和头孢菌素族:此类抗生素虽在胆汁中可到达治疗浓度,但大部分自肾排出;当肾功能高度减退时则部分清除工作转由肝脏负担,而当肝肾损害并存时药物的清除即明显受到影响。以羧苄青霉素为例,其正常半衰期为1小时,肝病时可延长为1.9小时,肾功能减退少尿时延长至15.7小时,肝肾功能均不全时则可延长至23.2小时,如在肾功能重度
Third, the correct use of antibiotics when liver and kidney dysfunction (A) the correct use of antibiotics when liver dysfunction, based on drug metabolism in the liver by the pharmacokinetics, genetic factors, liver enzymes and other aspects of the impact, it is commonly used Liver function tests do not correctly reflect the liver’s ability to excrete and metabolize antimicrobial drugs. 1. Penicillin and cephalosporins: Although these antibiotics can reach the therapeutic concentration in the bile, but most of the kidneys from the discharge; when a high degree of renal dysfunction, the removal of part of the work will be transferred to the liver burden, and when the liver and kidney damage co-exist Clear when the drug is obviously affected. Carbapenem, for example, the normal half-life of 1 hour, liver disease can be extended to 1.9 hours, renal dysfunction, oliguria extended to 15.7 hours, liver and kidney function are not all can be extended to 23.2 hours, as in renal function Severe