妥布霉素地塞米松滴眼液（Tobramycin Dexamethasone Eye Drops）

妥布霉素地塞米松滴眼液（Tobramycin Dexamethasone Eye Drops） 妥布霉素地塞米松滴眼液(Tobramycin Dexamethasone Eye Drops) 妥布霉素地塞米松滴眼液 (tobramycin dexamethasone eye drops) (典必殊) 本品为复方制剂, 其组分为: 妥布霉素15毫克和地塞米松5毫克 / 5毫升. 【性状】 本品为白色或类白色混悬液体. 【药理毒理】 1.肾上腺皮质激素可抑制各种因素引起的炎症反应, 同时也可能延缓伤口愈合.肾上腺皮质激素会抑制人体对感染的防卫机能, 若此抑制能力具有临床意义, 则应考虑合并应用抗生素.地塞米松是一种作用很强的皮质激素; 2.混合物中包含的抗生素成分 (妥布霉素) 具有抗敏感微生物的活性.试验研究显示, 妥布霉素对以下微生物敏感株有效: 葡萄球菌: 金黄色葡萄球菌及 表 关于同志近三年现实表现材料材料类招标技术评分表图表与交易pdf视力表打印pdf用图表说话 pdf 皮葡萄球菌 (凝血酶阳性及阴性), 包括耐青霉素株.链球菌: a组β溶血性链球菌、一些非溶血性链球菌和一些肺炎链球菌.绿脓杆菌、大肠杆菌、肺炎克雷伯氏菌、产气肠杆菌、奇异变形杆菌、摩氏摩根氏菌、多数普通变形杆菌株、流感嗜血杆菌、埃氏嗜血菌、腔隙莫拉氏菌、醋酸钙不动杆菌以及一些奈瑟菌属; 3.细菌的药敏试验显示, 某些对庆大霉素耐药的微生物仍对妥布霉素敏感.尚未发现对妥布霉素有显著意义耐药性的菌株出现.但是, 随着使用时间的延长可能出现耐药的细菌; 4.尚无本品使用后全身吸收程度的资料.但是, 我们都知道在眼局部使用药物后会有全身吸 收作用.如果在头48小时内以最大剂量使用典必殊滴眼液 (每2小时每眼2滴), 并出现完全的全身吸收 (这不太可能), 相当于每天使用地塞米松2.4毫克.而通常的生理替代量是每天0.75毫克.假如典必殊滴眼液在头48小时内每4小时每眼2滴, 地塞米松的使用量将是每天1.2毫克. 【药代动力学】 【适应症】 1.对肾上腺皮质激素有反应的眼科炎性病变及眼部表面的细菌感染或有感染的危险的情况; 2.眼用激素用于眼睑、球结膜、角膜、眼球前段组织及一些可接受激素潜在危险性的感染性结膜炎等炎性疾病, 可以减轻水肿和炎症反应.它们也适用于慢性前葡萄膜炎、化学性、放射性、灼伤性及异物穿透性角膜损伤; 3.有抗感染成分的混合物可以应用于发生眼表感染危险大的部位和预计有大量细菌存在于眼部的潜在危险时; 本品中特有的抗感染药物对一些常见的眼部细菌和病原菌有效: 葡萄球菌: 金黄色葡萄球菌及表皮葡萄球菌 (凝血酶阳性及阴性), 包括耐青霉素株.链球菌: a组β溶血性链球菌、一些非溶血性链球菌和一些肺炎链球菌.绿脓杆菌、大肠杆菌、肺炎克雷伯氏菌、产气肠杆菌、奇异变形杆菌、摩氏摩根氏菌、多数普通变形杆菌株、流感嗜血杆菌、腔隙、莫拉氏菌、埃氏嗜血菌、醋酸钙不动杆菌以及一些奈瑟菌属. 【用法用量】 1.每4至6小时一次, 每次1至2滴滴入结膜囊内.在最初1 - 2天剂量可增加至每2小时1次.根据临床征象的改善逐渐减少用药的频 度, 注意不要过早停止治疗.用前摇匀. 2.第一次开处方不能超过20毫升滴眼液. 【不良反应】 1.激素和抗菌药联合药物的副作用既可来自激素成分, 也可来自抗 菌药成分, 或者二者的联合使用.没有准确的不良反应发生率的资料. 眼用妥布霉素 (托百士) 可出现与局部用其它氨基糖甙类抗生素类 似的反应. The most common adverse reactions are: ocular toxicity and allergic reactions including itching, partial, eyelid edema, conjunctival congestion. These adverse events occurred only in less than 4% of the patients. Other side effects of similar adverse reactions with other aminoglycoside antibiotics for the eye has not been reported. But if combined with tobramycin eye in the systemic use of aminoglycosides when should the drug concentration monitoring serum; 2. adverse reactions associated with hormonal components are elevated intraocular pressure and may lead to glaucoma, occasional optic nerve damage, posterior subcapsular cataract formation and delayed wound healing; 3. double infection: double infection may occur after the combination of antibiotics and hormones. Corneal fungal infection is easy to occur after long-term use of hormone. Fungal infection should be considered for refractory corneal ulcers after hormone use. Secondary immunosuppression may also result from ocular bacterial infection. [taboo] 1. herpes simplex keratitis (herpes simplex keratitis), vaccinia, varicella, and some corneal and conjunctival diseases caused by viral infection, mycobacterial infection of the eye, fungal infection of the eye; 2. allergic to any component in the product; 3. incomplete removal of corneal foreign body. [matters needing attention] 1. can not be used for eye injection. Some patients may use local aminoglycosides with allergies, if allergies should be discontinued; 2. long-term use of eye hormone can lead to glaucoma, damage to the optic nerve, visual acuity, visual field defects, posterior capsule cataract. Intraocular pressure should be monitored routinely during the procedure, and even children with difficult IOP measurement and uncooperative patients are no exception. Long term use of hormones can inhibit host immune response and may increase secondary severe ocular infection opportunities. The use of steroids may lead to ocular perforation in some of the lesions leading to thinning of the cornea and sclera. In acute suppurative lesions of the eye, hormones can mask infection and aggravate existing infections; 3. long term use of corticosteroids should allow for the possibility of fungal infection of the cornea. Like other antibiotics, long-term use may lead to the overgrowth of non sensitive microorganisms, including fungi. Once superinfection occurs, appropriate treatment must be initiated. When multiple treatments are required or when clinical diagnosis suggests double infection, the patient should undergo fluorescein staining and slit lamp biomicroscopy; 4. the study and evaluation of carcinogenicity or mutagenicity of this product have not yet been carried out. To study the subcutaneous injection of tobramycin 50mg and 100mg/kg/ days in rats showed no adverse effects on the reproductive capacity; 5. drugs should be placed in places where children can't reach. 6. and other aminoglycoside antibiotics can cross allergy. [patient information] Don't touch the surface of any object, because it will pollute the liquid in the bottle. Contact lenses should not be used during the use of this product. [medication for pregnant and lactating women] 1. pregnant women: animal tests show that hormones have teratogenic effects. In two groups of pregnant rabbits, the use of 0.1% dexamethasone in the eye resulted in a 15.6% and 32.3% teratogenic rate. The incidence of fetal growth retardation and stillbirth was also observed in the long-term use of dexamethasone in rats. In reproductive studies in rats and rabbits, not tobramycin parenteral use doses up to 100mg/kg daily weight adverse effect on the growth and development of fetus and found evidence of fertility. There was no adequate or well controlled study in pregnant women. This product can be used in pregnancy only when the potential benefit exceeds the potential risk to the fetus; 2. lactating women: systemic use of adrenal cortical hormone can exist in human milk and inhibit growth, affecting endogenous adrenocortical hormone production or lead to other side effects. It is not clear whether the local application of this product is secreted from the milk. Because many drugs can be secreted from human milk, so this product should be used carefully for lactating women. [medication for children] The safety and efficacy of this drug in children under 2 years of age have not yet been established. [medication for elderly patients] [drug interactions] [drug overdose] In some patients, excessive use of the product's clinical symptoms and signs (punctate keratitis, congestion, tears, edema and pruritus) may be similar to adverse reactions. If excessive use of this product, you can wash away too much water drugs. [Specification] Each containing tobramycin dexamethasone 5mg 15mg. [TBMSDSMSDYY, DBS] The front page, the last page, the front page