Florfenicol, he matū hangai monofluorinated o te thiamphenicol, he rongoā paturopi whānui hou o te chloramphenicol mō te whakamahinga kararehe, i whakawhanakehia angitu i te mutunga o te tekau tau atu i 1980.
Mēnā he maha ngā mate e pāngia ana, he maha ngā pāmu poaka e whakamahi ana i te florfenicol hei ārai, hei rongoā rānei i ngā mate poaka. Ahakoa te momo mate, ahakoa te rōpū, te taumata rānei, ka whakamahia e ētahi kaimahi pāmu te nui rawa o te florfenicol hei rongoā, hei ārai rānei i te mate. Ehara te Florfenicol i te rongoā whakaora. Me whakamahi tika kia tutuki ai te hua e hiahiatia ana. Ko te kupu e whai ake nei he whakataki taipitopito ki te whakamahinga noa o te florfenicol, me te tumanako ka āwhina i te katoa:
1. Ngā āhuatanga ārai mate o te florfenicol
(1) He rongoā paturopi a Florfenicol me te whānuitanga o te kaha patu huakita ki ngā momo huakita Gram-pai me ngā huakita kino me te mycoplasma. Ko ngā huakita tairongo ko te Haemophilus kau me te poaka, Shigella dysenteriae, Salmonella, Escherichia coli, Pneumococcus, Influenza bacillus, Streptococcus, Staphylococcus aureus, Chlamydia, Leptospira, Rickettsia, me ētahi atu. He pai ake te pānga aukati.
(2) E whakaatu ana ngā whakamātautau in vitro me in vivo he nui ake te kaha o tōna mahi patu huakita i ērā o ngā rongoā patu huakita o nāianei, pērā i te thiamphenicol, oxytetracycline, tetracycline, te ampicillin me ngā quinolones e whakamahia whānuitia ana i nāianei.
(3) He tere te mahi a te florfenicol, ā, ka taea e ia te eke ki te kukū rongoā whakaora i roto i te toto i te 1 hāora i muri i te werohanga ā-roto, ā, ka taea te eke ki te kukū rongoā tino teitei i roto i te 1.5-3 hāora; ka taea te pupuri i te kukū rongoā toto roa te mahi, whai hua mō te neke atu i te 20 hāora i muri i te kotahi horopeta.
(4) Ka taea e ia te uru atu ki te arai toto-roro, ā, kāore tōna pānga rongoā ki te mate kiriuhi kitakita kararehe e rite ana ki ērā atu rongoā patu huakita.
(5) Kāore he paitini, kāore hoki he pānga taha ina whakamahia i te nui kua tūtohutia, ka wikitoria i te tūponotanga o te anemia aplastic me ētahi atu paitini i puta mai i te thiamphenicol, ā, e kore e kino ki ngā kararehe me ngā kai. Ka whakamahia mō ngā mate o ngā wāhanga rerekē o te tinana i puta mai i ngā huakita i roto i ngā kararehe. Te rongoā i ngā poaka, tae atu ki te ārai me te rongoā i ngā mate manawa huakita, te meningitis, te pleurisy, te mastitis, ngā mate puku me te mate postpartum i roto i ngā poaka.
2. Ngā huakita ngoikore o te florfenicol me te mate poaka pai o te florfenicol
(1) Ngā mate poaka e pai ake ai te florfenicol
E taunakitia ana tēnei hua hei rongoā pai mō te niumōnia poaka, te mate pukupuku kiri poaka me te mate Haemophilus parasuis, inā koa mō te rongoā i ngā huakita e ātete ana ki ngā fluoroquinolones me ētahi atu paturopi.
(2) Ka taea hoki te whakamahi i te Florfenicol hei rongoā mō ngā mate poaka e whai ake nei
Ka taea hoki te whakamahi hei rongoā i ngā mate manawa e puta mai ana i ngā momo Streptococcus (pneumonia), Bordetella bronchiseptica (atrophic rhinitis), Mycoplasma pneumoniae (swine asthma), me ētahi atu; salmonellosis (glet paratyphoid), colibacillosis (glet asthma), ngā mate o te ara nakunaku pērā i te enteritis i puta mai i te korere kōwhai, te korere mā, te mate edema poaka) me ētahi atu huakita tairongo. Ka taea te whakamahi i te Florfenicol hei rongoā i ēnei mate poaka, engari ehara i te rongoā pai mō ēnei mate poaka, nō reira me tino tupato te whakamahi.
3. Te whakamahinga hē o te florfenicol
(1) He nui rawa, he iti rawa rānei te horopeta. Ko ētahi horopeta whāngai whakauru ka eke ki te 400 mg/kg, ā, ko ngā horopeta werohanga ka eke ki te 40-100 mg/kg, neke atu rānei. Ko ētahi he iti noa iho ki te 8~15mg/kg. He paitini ngā horopeta nui, ā, kāore e whai hua ngā horopeta iti.
(2) He roa rawa te wā. Ko ētahi whakamahinga roa o ngā rongoā me te kore here.
(3) He hē te whakamahinga o ngā taonga me ngā wāhanga. Ka whakamahia noatia e ngā poaka hapū me ngā poaka whakamomona aua rongoā, ka puta he paitini, he toenga rongoā rānei, ā, ka hua ake he mahi whakaputa me te kai haumaru kore.
(4) Te hototahitanga koretake. He maha ngā wā ka whakamahia e ētahi tāngata te florfenicol me ngā sulfonamides me ngā cephalosporins. Me tūhura mēnā he pūtaiao, he whaitake hoki.
(5) Kāore i te ōrite te whakaranu o te whāngai me te hoatutanga, ā, kāore he pānga o te rongoā, o te paihana rānei ki te rongoā.
4. Te whakamahinga o ngā mahi ārai mate florfenicol
(1) Kaua tēnei hua e whakakotahitia me ngā macrolides (pērā i te tylosin, erythromycin, roxithromycin, tilmicosin, guitarmycin, azithromycin, clarithromycin, me ētahi atu), lincosamide (pērā i te lincomycin, clindamycin) me ngā paturopi diterpenoid semi-synthetic – te whakakotahitanga o te Tiamulin, ka puta he pānga whakahē ina whakakotahitia.
(2) Kāore e taea te whakamahi tahi i tēnei hua me ngā β-lactone amines (pērā i ngā penicillins, cephalosporins) me ngā fluoroquinolones (pērā i te enrofloxacin, ciprofloxacin, me ētahi atu), nā te mea he aukati tēnei hua i te pūmua huakita. He kaihoko bacteriostatic tere-mahi hangai, ko te mea whakamutunga he patu huakita tere-mahi i te wā whakatipu. I raro i te mahi a te mea tuatahi, ka tere te aukati i te hanganga pūmua huakita, ka mutu te tipu me te whakanui o ngā huakita, ā, ka ngoikore te pānga patu huakita o te mea whakamutunga. Nō reira, ina hiahiatia he pānga whakahoromata tere te maimoatanga, kāore e taea te whakamahi tahi.
(3) Kāore e taea te whakaranu i tēnei hua ki te sulfadiazine sodium mō te werohanga ā-roto. Kaua e whakamahia tahitia me ngā rongoā kawakore ina tukuna ā-waha, ā-roto rānei, kia kore ai e pirau, kia kore ai hoki e pakaru. Kāore hoki e pai mō te werohanga ā-roto me te tetracycline hydrochloride, kanamycin, adenosine triphosphate, coenzyme A, me ētahi atu, kia kore ai e maroke, kia kore ai hoki e heke te whai huatanga.
(4) Tērā pea ka pā te ngoikore me te pirau o ngā uaua i muri i te werohanga ā-roto. Nō reira, ka taea te werohanga tauwhitiwhiti ki ngā uaua hohonu o te kaki me te papa, ā, kāore e tika kia werohangahia anō i te wāhi kotahi.
(5) Nā te mea he paitini pea tēnei hua ki ngā kukune, me tūpato te whakamahinga mō ngā kau hapū me ngā kau e whāngai ana.
(6) Ina teitei te pāmahana tinana o ngā poaka mate, ka taea te whakamahi tahi me ngā rongoā whakaheke wera me te dexamethasone, ā, ka pai ake te pānga.
(7) I roto i te ārai me te rongoā i te mate manawa poaka (PRDC), ka tūtohu ētahi i te whakamahinga ngātahi o te florfenicol me te amoxicillin, te florfenicol me te tylosin, me te florfenicol me te tylosin. He tika, nā te mea mai i te tirohanga rongoā, kāore e taea te whakamahi ngātahi i ngā mea e rua. Heoi, ka taea te whakamahi ngātahi i te florfenicol me ngā tetracycline pēnei i te doxycycline.
(8) He paitini toto tēnei hua. Ahakoa kāore e puta he anemia aplastic kore e taea te whakaora i te hinu wheua, he nui ake te aukati i te erythropoiesis i puta mai i tēnei hua i te chloramphenicol (hauā). Kāore e whakaaetia kia hoatu ki ngā kararehe he mate pāwera kino, ki ngā kararehe rānei he mate ārai mate kino.
(9) Mā te whakamahinga roa ka pāngia pea koe e ngā mate nakunaku me te korenga o ngā huaora, ngā tohumate pāwera nui rānei.
(10) I te ārai me te rongoā i te mate poaka, me tūpato, me tuku te rongoā kia rite ki te horopeta kua whakaritea me te huarahi rongoā, ā, kaua e whakamahia kinotia hei karo i ngā pānga kino.
(11) Mō ngā kararehe he ngoikore ō rātou whatukuhu, me whakaiti te horopeta, me whakaroa rānei te wā tuku.
(12) Mēnā he iti te pāmahana, ka kitea he puhoi te tere whakarewa; he maturuturunga iho rānei o te florfenicol i roto i te otinga kua oti te whakarite, ā, me whakamahana noa iho (kaua e neke atu i te 45 ℃) kia tere te whakarewa. Ko te otinga kua oti te whakarite he pai ake te whakamahi i roto i ngā haora 48.
Wā tuku: Akuhata-09-2022