The mashandiro chiito inorwisa mabhakitiriya: Skript

Ungati kuti echimurenga kukura kwakanga kuwanikwa kuti penicillin mukuvamba ramakumi remakore. Panguva Second World War, wokutanga mushonga akaponesa mamiriyoni varwi vakuvara kubva septicemia. Penicillin inobudirira uye zvinodhaka iyo isingadhuri kubva siyana zvirwere chakakomba mitswe zvakakomba, septic maronda. Nokufamba kwenguva, zvakanga synthesized, uye mamwe makirasi inorwisa mabhakitiriya.

General unhu

Nhasi kune vakawanda zvigadzirwa kuva yakakura nyika inorwisa mabhakitiriya - zvinhu inoitika kana Semi-chakaita zvokugadzirwa mavambo kuti anokwanisa kuparadza mamwe mapoka pathogenic tusingaoneki kana tunodzivisa kukura kwavo kana kubereka. The zvigadziriswe kuita inorwisa mabhakitiriya spectra kunogona zvakasiyana. Nokufamba kwenguva, mhando itsva uye okunatsiridza inorwisa mabhakitiriya. Hazvina kusiyana kwavo zvinoda systematization. Munguva yedu, isu kushandisa kupatsanura inorwisa mabhakitiriya maererano mashandiro chiito uye chikuva, uyewo nemakemikari marongerwo. Maererano kwavo mashandiro chiito rakakamurwa:

• bacteriostats, izvo vasaziva kukura kana kubereka vana pathogenic zvigare;
• microbicides, izvo zvinokonzera kuparadzwa mabhakitiriya.

The inokosha zvigadziriswe kuita inorwisa mabhakitiriya:

• kutyora kwemabhakitiriya muchitokisi rusvingo;
• chinovhiringidza mapuroteni usage muna kwemabhakitiriya muchitokisi;
• kutyora permeability of cytoplasmic Kamudzira;
• chinovhiringidza RNA usage.

Beta-lactam mishonga - penicillins

Maererano makemikari maumbirwo yeimwe izvi dzinoiswa sezvinotevera.

Beta-lactam inorwisa mabhakitiriya. The mashandiro chiito lactam mishonga inoenderana nekugona dzichipfekeka boka kusunga makemikari muzvirongwa kwetunhu peptidoglycan - nezvigadziko rokunze Kamudzira yacho microorganism masero. Saka hwakaipa paumbwe muchitokisi masvingo, izvo zvinoita kuti kumira kukura kana kubereka mabhakitiriya. Beta-lactams vane yakaderera toxicity, uye panguva imwe chete yakanaka bactericidal kushanda. Dzinomirira zvikuru boka uye vari rakakamurwa subgroups kuti vane makemikari mamiriro akafanana.

Penicillins - vari boka zvinhu asunungurwa zvimwe mapoka achitanga uye bactericidal kushanda. The mashandiro chiito inorwisa mabhakitiriya kuti penicillin nokuti kuti nokuparadza sero rusvingo zvigare, akavaparadza. Penicillins vari dzinongoitika kana Semi-chakaita zvokugadzirwa mavambo uye tiri yeimwe munhu akasiyana chakarondedzera chiito - vanogona kushandiswa pakurapa zvirwere zvakawanda zvinokonzerwa streptococci uye staphylococci. Mukuwedzera, vane pfuma selectivity nokuita chete pamusoro Micro-zvinenge, pasina kukanganisa makro-muviri. Penicillins vane zvainovhiringidzawo, kusanganisira panowanikwa kusakuvadzwa nemishonga nazvo. Zvikuru zvakafanana dzinongoitika kuti penicillin G, kuti penicillin kuti inoshandiswa kurwisa meningococcal uye streptococcal zvirwere nokuda kwayo shoma toxicity uye vakaderera mutengo. Zvisinei, kugamuchirwa kwenguva refu kunogona kuva muviri kutapata kuti mushonga, nokudaro achidzikisa kugona kwaro. Semi-chakaita zvokugadzirwa penicillins kazhinji zvinobva dzinongoitika nemakemikari nadzurudzo kupa kutsvakwa ehupfumi - amoxicillin, ampicillin. zvinodhaka izvi vane yepamusoro basa pamusoro utachiona husingakwanisi biopenitsillinam.

Other Beta-lactams

Cephalosporins vari vakawana kubva notumwe zvakafanana zita, uye mamiriro avo akafanana nemamiriro penicillins kuti anotsanangura chete kukunakira. Cephalosporins Nhoroondo kwezvizvarwa zvina. wokutanga chizvarwa zvinodhaka rinowanzoshandiswa pakurapa zvirwere nyoro zvinokonzerwa staphylococci kana streptococci. Wechipiri newechitatu chizvarwa cephalosporins zvakawanda tichishingaira pamusoro giremu negative utachiona, uye rudzi rechina pfuma - mishonga simba kupfuura kushandiswa kupesvedzera chakakomba utachiona.

Carbapenems zvinobudirira ashandise giremu-akanaka, giremu negative uye anaerobic utachiona. Dzavo chinhu chakanaka ndiyo kusavapo kusakuvadzwa nemishonga kuti mushonga kunyange pashure yakareba chikumbiro chacho.

Monobactams kushanda Beta-lactams uye vane zvakafanana mashandiro chiito inorwisa mabhakitiriya, ndiye simba pamusoro sero pamadziro mabhakitiriya. Ivo anoshandiswa kurapa dzakasiyana-siyana zvirwere zvakasiyana.

macrolides

Ndiro boka rechipiri. Macrolides - dzinongoitika nemishonga, vane kunzwisisa cyclic marongerwo. Dzinomirira polynomial lactone mhete zvakabatanidzwa carbohydrate moieties. Kubva uwandu kabhoni maatomu ari rin'i kuvimba ehupfumi zvinodhaka. Kusiyanisa 14-, 15-I uye 16-membered yeimwe. The chakarondedzera chiito noutachiona rakafara zvakakwana. The mashandiro chiito inorwisa mabhakitiriya ari microbial sero ndeyokuita zvokuverengera navo ribosomes uye nokudaro kutyora mapuroteni usage muchitokisi iri microorganism kuburikidza zvichivhiringidza itsva monomer Kuwedzera chinja kusvika peptide cheni. Kuunganidza munyika rokuzvidzivirira mumasero, macrolides vaiita uye kuuraya utachiona intracellular.

Macrolides ndivo kupfuura njodzi uye zvishoma chepfu uye pakati anozivikanwa mishonga vanobudirira pamusoro kwete giremu-akanaka chete, asi akaipa utachiona. Kushandiswa yavo haina kuchengetwa zvisingadiwi divi zvavaifunga. mishonga iyi vanoonekwa ne bacteriostatic chaizvoizvo, asi panguva yakakwirira kuwanda, aigona kuva bactericidal kubatsira pneumococci uye dzimwe tusingaoneki. Sezvo nzira hwokubereka macrolides akakamurwa dzinongoitika uye semisynthetic.

Chokutanga chinodhaka mukirasi dzinongoitika macrolides erythromycin rwaiwanikwa pakati remakore rapfuura uye yave kushandiswa zvinobudirira pamusoro giremu-akanaka utachiona husingakwanisi pamusoro penicillin. Chizvarwa chitsva zvinodhaka muboka iri mumagwaro 70s remakore rechi20 uye zvikuru kushandiswa saka kure.

Macrolide mishonga tiri Semi - azolides uye ketolides. Azolide The lactone mhete iri Morekuru, pakati rechipfumbamwe nezvegumi kabhoni maatomu zvaisanganisira senitrogen atomu. Mumiririri azolides azithromycin chinhu chakarondedzera chiito uye basa kune giremu-akanaka uye giremu negative utachiona, vamwe anaerobes. Zviri zvikuru kugadzikana mune imwe acidic unosvikirwa, achienzaniswa erythromycin, uye anogona -wedzera mairi. Azithromycin rinoshandiswa nenzira dzakasiyana-siyana zvirwere kufema turakiti, Urinary turakiti, bowel, ganda uye nevamwe.

Ketolides vakazvigadzirirwa achabatanidza wechitatu atomu keto lactone mhete. Ndivo zvishoma chinojarirwa utachiona, ichienzaniswa macrolides.

tetracyclines

Tetracyclines vari boka polyketides. It mishonga yakafara-chakarondedzera bacteriostatic simba. Mumiriri wokutanga vavo - chlortetracycline, oga pakati wokupedzisira remakore rimwe Mutsika actinomycetes, rinonziwo wakaisvonaka howa. Makore mashomanana gare gare oxytetracycline rave akagamuchira kubva muhutongi chete chakuvhe. Chechitatu nhengo yeboka iri tetracycline, yakatanga vakasikwa makemikari nadzurudzo yayo chloro rinobva, uye gore papera uyewo kure actinomycetes. zvimwe zvose zvinodhaka pane boka tetracycline vari Semi-chakaita zvokugadzirwa nomukaka zviri yeimwe izvi.

All izvi zvinhu akafanana kwemakemikari marongerwo uye zvivako yebasa pamusoro siyana giremu-akanaka uye giremu negative utachiona, vamwe nemavhairasi, uye majemusi. Ivo husingakwanisi muropa uye zvigare. The mashandiro chiito inorwisa mabhakitiriya ari kwemabhakitiriya Sero kuti vasachiziva mubishi mapuroteni biosynthesis. Zvakaitwa zvinodhaka mamorekuru muna giremu negative bacteria vanopfuura mumakamuri kubudikidza nyore diffusion. The mashandiro zviri kupinda kuna mushonga inoramba iri giremu-akanaka bacteria achiri havaratidzi kunzwisiswa, asi pane kufungidzira kuti tetracycline mamorekuru anosangana chete ions vamwe simbi dziri masero bacteria kuumbika dzakaoma yeimwe. Saka pane mukaha chuma panguva mapuroteni usage zvakakodzera kuti kwemabhakitiriya muchitokisi. Kuedza kwakaratidza kuti bacteriostatic chlortetracycline kuwanda zvakakwana kutitadzise mapuroteni usage, asi nokuda chinovhiringidza pakati nucleic iine acid usage kunoda dzakakwirira kuwanda chezvinodhaka.

Tetracyclines zvinoshandiswa pakurwisa cheitsvo, siyana ganda utachiona, kufema uye nezvimwe zvirwere zvakawanda. Kana zvakakodzera, ivo kutsiva kuti penicillin, asi mumakore achangopfuura, kushandiswa tetracyclines yekudyidzana ungaderedza, nokuda chidzoke kurwisa zvigare boka iri inorwisa mabhakitiriya. Negative basa reDare kushandisa mushonga sechinhu chirungiso kuti mhuka zvokudya, zvichiguma yadzikira kuchirapa ehupfumi zvinodhaka nokuda panowanikwa nemishonga kwairi. Kuikurira, vanogadzwa nomudzimu mubatanidzwa zvinodhaka zvakasiyana kuva zvakasiyana mashandiro ose anorwisa tupukanana chiito inorwisa mabhakitiriya. Somuenzaniso, mishonga mugumisiro dzinowedzerwa mawa nokushandisa tetracycline uye streptomycin yakawanikwa.

aminoglycosides

Aminoglycosides - dzinongoitika uye Semi-chakaita zvokugadzirwa mishonga pamwe yakafarikana chaizvo chakarondedzera basa, rine ari Morekuru residues aminosaharidov. Akava wokutanga aminoglycoside streptomycin, vasave mapoka Ray notumwe pakati remakore rapfuura uye kushingaira kushandiswa pakurapa zvakasiyana siyana zvirwere. Sezvo bactericide, mishonga ine akati boka dzinobudirira kunyange panguva kuderedzwa zvakasimba kutapata. The mashandiro chiito inorwisa mabhakitiriya ari microbial Sero paumbwe simba covalent zvisungo pamwe mapuroteni uye ribosomes microorganism kuparadzwa mapuroteni usage ari kwemabhakitiriya muchitokisi zvavaifunga. Ko aizvinzwisisa mashandiro aminoglycoside bactericidal Chaizvoizvo, kusiyana bacteriostatic kuitwa tetracyclines uye macrolides uyewo kutyora mapuroteni usage mumasero kwemabhakitiriya. Zvisinei, zvinozivikanwa kuti aminoglycosides vari kushingaira chete pasi Kurovedza ezvinhu, saka ivo vanoratidza yakaderera kunyatsoshanda mune nyama pamwe murombo ropa rive.

Mushure yokutanga mushonga - kuti penicillin uye streptomycin, vakatanga kuti zvikuru kushandiswa pakurapa chero chirwere kuti nokukurumidza paiva dambudziko kuwana kushandiswa zvigare zvinodhaka izvi. Pari, streptomycin yakawanikwa rinoshandiswa kunyanya akabatana nevamwe chizvarwa ichangobva zvinodhaka kurapa tibhii kana zvakadaro, nhasi chisingawanzowaniki zvirwere zvakadai denda. Mune zvimwe zviitiko basa kanamycin, riri rudzi rokutanga aminoglycoside mushonga. Zvisinei, nokuda kudunhu toxicity pamusoro kanamycin parizvino vaisarudza gentamicin - kugadzirira vezera wechipiri, chizvarwa chechitatu uye kugadzirira amikacin chiri aminoglycoside - iri kashoma kushandiswa kudzivirira muropa nazvo zvigare.

chloramphenicol

Chloramphenicol kana chloramphenicol, munhu wechisikigo mushonga chete navanopinda chakarondedzera chiito, kushingaira ari vazhinji giremu-akanaka uye giremu negative Utachiona, vakawanda zvikuru wanda. On kwemakemikari mamiriro rinobva nitrofenilalkilaminov, yakatanga kuwana kubva tsika actinomycetes pakati remakore rechi20, uye makore maviri gare gare uyewo synthesized mishonga.

Chloramphenicol ine bacteriostatic rakashamisawo tusingaoneki. The mashandiro chiito inorwisa mabhakitiriya ari kwemabhakitiriya Sero kudzvinyirira basa tiwedzere inotungamirwa gadziriro peptide zvisungo zviri mapuroteni usage apo ribosomes. kuti chloramphenicol mumweya utachiona anovandudza zvishoma nezvishoma. The chinodhaka rinoshandiswa chirwere fivha kana shigellosis.

Glycopeptides uye lipopeptides

Glycopeptides - a cyclic peptide yeimwe izvo dzinongoitika kana semisynthetic mushonga ane rakamanikana chakarondedzera basa vamwe utachiona zvigare. Ivo vanogona bactericidal kubatsira giremu-zvakanaka utachiona, uye unogona kutsiva kuti penicillin kana kurwisa kwairi. The mashandiro chiito inorwisa mabhakitiriya ari tusingaoneki zvinogona kutsanangurwa paumbwe linkages vane amino acids uye sero rusvingo peptidoglycan, nokudaro kudzvanyirira kwetunhu yavo.

First glycopeptide - vancomycin, rakanyorwa kubva actinomycetes, akatorwa kubva ivhu India. Zviri muropa mushonga kuti rinoshanda pamusoro tupukanana tusingaoneki, kunyange maberekero mwaka. Pakutanga, vancomycin raishandiswa senzira yokutsiva pakuparwa kuti penicillin chisimbwa kwairi pakurapa zvirwere. Zvisinei, kuwedzera kurapika rava dambudziko rakakura. Mumakore 80 zvakanzi akatiwanira teicoplanin - mushonga unorwisa kubva boka glycopeptides. Akagadzwa panguva chete utachiona, uye akabatana gentamicin, anopa migumisiro yakanaka.

Pakupera kwezana remakore rechi20, mutsva boka inorwisa mabhakitiriya - lipopeptides kure muStreptomyces. Mishonga vava cyclic lipopeptides. mushonga uyu rakamanikana chakarondedzera chiito, vachiratidza kuva bactericidal mugumisiro pamusoro giremu-zvakanaka utachiona, uye staphylococci husingakwanisi Beta-lactam madhiragi uye glycopeptides.

The mashandiro chiito inorwisa mabhakitiriya yakasiyana avo kare anozivikanwa - the lipopeptide siyana pamberi calcium ions simba zvisungo pamwe sero Kamudzira utachiona iyo inotungamirira depolarization chacho nokuvhiringidzirwa mapuroteni usage, saka kuti sero kwakaipa anofa. mumiririri rokutanga vekirasi lipopeptides - daptomycin.

Panyaya daptomycin zvinogona kucherechedzwa pamwero kukosha bactericidal basa, uye Chikurukuru - kushaya muchinjikwa nemishonga, kana kunonoka chaizvo ayo inotungamirwa nokuti kuti neitsva mashandiro chiito inorwisa mabhakitiriya rapinzwa nemamiriro fuma.

polyenes

The rakatevera boka - polyene inorwisa mabhakitiriya. Nhasi kune sefungu huru fungal nezvirwere zvakaoma kurapa. Kuti tikurire pavo antifungal zvinhu - dzinongoitika kana Semi-chakaita zvokugadzirwa polyene inorwisa mabhakitiriya. Yokutanga antifungal zvinodhaka ichiri pakati pezana remakore rapfuura vakatanga Nystatin, yakanga kure muStreptomyces tsika. Panguva iyi, zvokurapa tsika aisanganisira zvakawanda polyene nemishonga, rinobva siyana fungal tsika - griseofulvin, Levorinum nevamwe. Hatina kugamuchira kushandiswa polyenes yatova chizvarwa chechina. Common zita vakanwisa anoonga pamberi anoverengeka miviri zvisungo zviri mamorekuru.

The mashandiro chiito kuti polyene mishonga nokuda paumbwe kwemakemikari zvisungo pamwe sero Kamudzira sterols mu notumwe. Saka Polyene Morekuru midzi muchitokisi Kamudzira uye nezvimiro Ion the wired kupa zvakamisa hurongwa Voda masero nechokunze, zvichitungamirira ayo kubviswa. In yakaderera mishonga polyenes nhaka fungistatic basa uye pamatunhu - fungicide. Zvisinei, basa ravo harina kufukidzwa nemabhakitiriya uye wanda.

Polymyxin - dzinongoitika mishonga zvinoberekwa nevhu bacteria spore. In mushonga, vave kushandiswa muna 40-ies wekupedzisira remakore. Formulations izvi zvinosiyana bactericidal Chaizvoizvo izvo zviri kukonzerwa kuvadza cytoplasmic Kamudzira pamusoro microorganism masero zvichikonzera kuparadzwa kwaro. Polymyxin kunobudirira pamusoro giremu negative utachiona uye kashoma muropa tusingaoneki. Zvisinei, kukwirira toxicity ichikutadzisa kushandisa kwavo mushonga. Compounds veboka iri - polymyxin B sulfate uye polymyxin sulfate M anoshandiswa kashoma uye chete sezvo gadziriro chengetedza.

antitumor mishonga

Actinomycin pave ranzi notumwe, vane cytostatic nomugumisiro. Natural actinomycins ari mamiriro vari hromopeptidami zvakasiyana amino acids ari peptide ngetani kuti vaone basa ravo chaivo. Actinomycin ndirumbidzwe kuti unyanzvi zvakafanana antitumor inorwisa mabhakitiriya. The mashandiro chiito nokuda paumbwe imwe zvakakwana kugadzikana zvisungo peptide nengetani zvinodhaka pamwe kaviri akamonyoroka DNA pamusoro microorganism uye pakudaro rakavhara kwetunhu RNA.

Dactinomycin, zvichiguma 60s remakore rechi20, ndiyo yokutanga anticancer mumiririri iyo yakawanikwa kushandiswa mune oncologic mishonga. Zvisinei, nokuda vakawandisa divi migumisiro zvinodhaka ichi haawanzopiwi kushandiswa. Zvino isu vakawana zvinodhaka zvakawanda kushingaira antineoplastic.

Anthracyclines - chinhu chaizvo simba Anti-bundu mumiririri kure muStreptomyces. The mashandiro chiito inorwisa mabhakitiriya chokuita paumbwe ternary zvivako ne DNA ngetani uye izvi ngetani zororo. Uye zvichibvira mashandiro yechipiri inorwisa utachiona chiito nokuda kugadzirwa chokuzvisarudzira radicals kuti oxidize masero kenza.

Of dzinongoitika anthracyclines anganzi daunorubicin uye doxorubicin. Kupatsanura inorwisa mabhakitiriya maererano mashandiro chiito pamusoro utachiona classifies pavo microbicides. Zvisinei, mukuru toxicity dzavo kumanikidzwa kutsvaga itsva yeimwe dzakagadzirira zvokugadzirwa nevanhu. Vazhinji vavo vakabudirira kushandiswa oncology.

Mishonga inorwisa mabhakitiriya refu kuva chikamu okurapa uye upenyu hwevanhu. Nemhaka kwavari, vakakundwa zvirwere zvakawanda, izvo emakore akanga hachirapiki. Pari, pane zvakasiyana-siyana yeimwe izvi, izvo zvinoda haangogoni kupatsanura inorwisa mabhakitiriya maererano mashandiro chiito uye chakarondedzera, asiwo vamwe maitiro zhinji.