隨著經(jīng)濟(jì)的快速增長(zhǎng),人民的生活水平和品質(zhì)不斷提高,中國的畜禽養(yǎng)殖業(yè)得到迅猛發(fā)展,然而畜禽疾病也是日新月異,越來越復(fù)雜,成為阻礙養(yǎng)殖業(yè)持續(xù)發(fā)展的頭號(hào)敵人,當(dāng)前“疫苗+抗生素”依然是廣大養(yǎng)殖人士防治畜禽疾病的的主要模式和手段,抗生素成為了畜禽感染疾病后的救命草,廣泛用于養(yǎng)殖業(yè),但抗生素也是一把雙刃劍,其毒副作用所帶來的危害往往被人們所忽略,使用不當(dāng)不僅無益,反而帶來巨大損失,筆者簡(jiǎn)要概述常用各類抗生素的毒副作用和配伍禁忌,以期為大家在臨床預(yù)防和治療疾病用藥提供參考。
1、β-內(nèi)酰胺類
1.1 β-內(nèi)酰胺類毒副作用
β-內(nèi)酰胺類抗生素(β-lactams)系指化學(xué)結(jié)構(gòu)中具有β-內(nèi)酰胺環(huán)的一大類抗生素,包括臨床最常用的青霉素類與頭孢菌素類,以及新發(fā)展的頭霉素類、硫霉素類、單環(huán)β-內(nèi)酰胺類等其他非典型β-內(nèi)酰胺類抗生素。此類抗生素具有殺菌活性強(qiáng)、毒性低、適應(yīng)癥廣及臨床療效好的優(yōu)點(diǎn)。該類抗生素的毒副作用較小,在畜禽上使用安全,在使用該類抗生素的鈉鹽或鉀鹽大劑量靜脈注射時(shí),注意高血鈉、高血鉀癥的發(fā)生,在用青霉素治療鉤端螺旋體病時(shí)可由于病原體死亡致癥狀加劇,常稱之為赫氏反應(yīng)。
1.2 配伍禁忌
β-內(nèi)酰胺類抗生素主要有青霉素類和頭孢菌素類,該類藥物與酸性藥物如鹽酸氯丙嗪、四環(huán)素類的注射液和堿性藥物如磺胺藥、碳酸氫鈉聯(lián)合使用,會(huì)沉底分解失效,還會(huì)被高濃度酒精、重金屬鹽以及氧化劑如高錳酸鉀破壞失效,也會(huì)被Vb1、Vb2和Vc破壞而失效。β-內(nèi)酰胺類抗生素與快速抑菌劑如四環(huán)素,氯霉素合用,抗菌作用減弱,因?yàn)棣?span>-內(nèi)酰胺類抗生素主要是阻礙細(xì)胞壁合成的第三階段,在細(xì)菌快速繁殖時(shí)才有強(qiáng)大的殺菌作用,而快速抑菌劑是阻礙蛋白質(zhì)合成,抑制細(xì)菌生長(zhǎng),細(xì)菌快速進(jìn)入靜止期,如若必須聯(lián)合使用,給藥時(shí)順序是先用β-內(nèi)酰胺類抗生素,間隔3-5個(gè)小時(shí)再使用快速抑菌抗生素,與四環(huán)素類、大環(huán)內(nèi)酯類以及林肯霉素類等抑菌抗生素配伍使用,同樣抗菌作用減弱,不建議聯(lián)合使用。
2、氨基糖苷類
2.1 氨基糖苷類抗生素毒副作用
氨基糖苷類抗生素(Aminoglycosides)是由氨基糖與氨基環(huán)醇通過氧橋連接而成的苷類抗生素,屬靜止期殺菌藥,主要對(duì)革蘭氏陰性菌作用強(qiáng),常用主要有鏈霉素、卡那霉素、阿米卡星、慶大霉素、新霉素、大觀霉素和安普霉素。該類抗生素毒副作用較大,大家比較熟悉的有耳毒性、腎毒性和肌肉阻斷作用,不宜長(zhǎng)期使用,畜禽腎功能衰竭時(shí)盡量避免使用該類藥物。該類抗生素內(nèi)服對(duì)腸絨毛有較大損傷作用,可引起二重感染,內(nèi)服療程要適宜,該類藥物還可以通過胎盤進(jìn)入胎兒組織,有致畸作用,懷孕母豬中后期慎用。
2.2 配伍禁忌
氨基糖苷類抗生素會(huì)被較強(qiáng)的酸、堿溶液和較強(qiáng)的氧化劑(如Vc高錳酸鉀)、還原劑破壞而失效,屬于理化配伍禁忌,該類藥物毒性較強(qiáng),同類藥物避免配伍,以免毒性增強(qiáng),與堿性藥物如小蘇打和氨茶堿合用抗菌作用增強(qiáng),但毒性也增強(qiáng),配伍時(shí)慎重,與利尿藥合用,其腎毒性增大,與多粘菌素E合用,會(huì)導(dǎo)致骨骼肌松弛。氨基糖苷類抗生素與β-內(nèi)酰胺類藥物聯(lián)合使用有協(xié)同作用,該組合在臨床上應(yīng)用較多,與喹諾酮類和多肽類抗生素合用,療效增加,與氯霉素類抗菌作用減弱。
3、四環(huán)素類
3.1 四環(huán)素類抗生素毒副作用
四環(huán)素類抗生素(tetracycline antibiotics)是由放線菌產(chǎn)生的一類結(jié)構(gòu)含并四苯基本骨架的廣譜抗生素,常用有金霉素、土霉素、強(qiáng)力霉素等。該類抗生素最大特點(diǎn)是易與鈣磷結(jié)合,沉積到牙齒和骨骼中,抑制骨骼正常生長(zhǎng)發(fā)育,且易通過胎盤和乳汁,因此妊娠期、哺乳期和幼畜慎用。該類抗生素有輕微胃腸道反應(yīng),如惡心,嘔吐和腹瀉等,還有肝腎損傷作用,尤其對(duì)妊娠后期,肝功能障礙和衰竭畜禽盡量不選用該類抗生素,也易致腸道菌群失調(diào),誘發(fā)二次感染,使用時(shí)間不宜太久,用該類抗生素治療和保健后宜做一下微生態(tài)制劑調(diào)理胃腸。
3.2 配伍禁忌
四環(huán)素類藥物一般呈酸性,不能與堿性藥物配伍使用,合用會(huì)降低四環(huán)素類療效,四環(huán)素類在胃內(nèi)酸性條件下溶解度較大,四環(huán)素的等電點(diǎn)為ph=5.5時(shí),在等電點(diǎn)附近溶解度最低,使用碳酸氫鈉后,胃內(nèi)ph升高,從而使四環(huán)素溶解度降低,影響了四環(huán)素的吸收,四環(huán)素避免與鈣鹽鐵鹽或含金屬離子Ca、Mg、Al、Bi、Fe等藥物合用,易于陽離子形成絡(luò)合物,大大減少藥物吸收,與氨茶堿、喹乙醇和磺胺類等堿性藥物聯(lián)合使用會(huì)分解失效,禁止配伍使用,與大環(huán)內(nèi)酯類、氯霉素類和多粘菌素類合用療效增強(qiáng),臨床可配伍使用,氯化銨可使尿液酸化,增強(qiáng)四環(huán)素對(duì)尿液系統(tǒng)的治療作用。
4、大環(huán)內(nèi)酯類
4.1 大環(huán)內(nèi)酯類的毒副作用
大環(huán)內(nèi)酯類抗生素是一類分子中含有14-16元大環(huán)內(nèi)脂環(huán)結(jié)構(gòu)的抗生素,主要作用于需氧革蘭氏陽性菌,革蘭氏陰性球菌和厭氧菌,常用的有泰樂菌素、替米考星、泰拉菌素、紅霉素、吉他霉素、螺旋霉素、羅紅霉素和阿奇霉素。該類抗生素毒副作用較小,安全性高,有輕微胃腸道反應(yīng)和局部刺激作用,雞皮下注射泰樂菌素有時(shí)僅發(fā)生短暫的顏面紅腫,豬偶爾會(huì)見直腸水腫,皮膚紅斑、瘙癢等,替米考星易引起心動(dòng)過速和收縮力減弱,禁止靜脈注射,20mg/kg肌肉注射可引起大部分實(shí)驗(yàn)豬死亡,除牛外,其他動(dòng)物慎用注射給藥。
4.2 配伍禁忌
大環(huán)內(nèi)酯類藥物的理化配伍禁忌常見的是與氯化鈣、氯化鈉合用出現(xiàn)渾濁沉淀,與磺胺、碳酸鈉注射液混合使用有沉淀,并析出游離堿,本類抗生素同樣會(huì)被Vb2、Vc破壞失效,忌與酸性物質(zhì)合用。大環(huán)內(nèi)酯類會(huì)降低林可霉素的抗菌效應(yīng),也會(huì)降低β-內(nèi)酰胺類抗生素的快速殺菌作用,臨床治療時(shí)不宜同用。阿司匹林與本類藥物配伍使用時(shí),會(huì)降低后者的抗菌療效,卡那霉素、磺胺類和氨茶堿都會(huì)增強(qiáng)大環(huán)內(nèi)酯類藥物的毒性作用,配伍時(shí)須慎重,而大環(huán)內(nèi)酯類抗生素與磺胺類、氨基糖苷類和喹諾酮類配伍使用,療效有增強(qiáng)或相加作用。
5、酰胺醇類(氯霉素類)
5.1 氯霉素類的毒副作用
氯霉素類 ( Fenicols)抗生素包括氯霉素、甲砜霉素和氟甲砜霉素。氯霉素已禁用,氟苯尼考為動(dòng)物專用抗生素。該類抗生素抗菌譜廣,對(duì)革蘭氏陽性菌和陰性菌以及支原體都有較強(qiáng)作用,該類抗生素毒副作用主要有三個(gè)方面:免疫毒性、繁殖毒性和血液毒性,氟苯尼考具有較強(qiáng)的免疫抑制作用,疫苗接種期或免疫功能缺陷的畜禽禁止使用該藥,該類藥物有胚胎毒性,建議留種畜禽及妊娠期、哺乳期動(dòng)物慎用該藥,特別妊娠前、中期忌用,氟苯尼考還具有可逆的紅細(xì)胞生長(zhǎng)抑制作用,但無再生性障礙貧血作用。
5.2 氯霉素類的配伍禁忌
氟苯尼考與四環(huán)素類(金霉素,強(qiáng)力霉素,土霉素等)聯(lián)合使用,具有協(xié)同作用,常用于治療呼吸道疾病或者預(yù)防呼吸道病的保健,與新霉素和黏菌素配伍使用,也具有協(xié)同作用,常用于畜禽腸道和呼吸道混合感染的治療與預(yù)防,而與β-內(nèi)酰胺類抗生素、大環(huán)內(nèi)酯類、呋喃類和喹諾酮類相互拮抗,療效降低,與林可霉素也有拮抗作用,氟苯尼考不宜與磺胺類、氨茶堿等堿性藥物聯(lián)合使用,氟苯尼考拮抗Vb6,使機(jī)體對(duì)Vb6的需要量增加,亦能拮抗Vb12的造血作用。
6、磺胺類
6.1 磺胺類的毒副作用
磺胺類藥物是一類具有對(duì)氨基苯磺酰胺結(jié)構(gòu)藥物的總稱,有廣譜抗菌性,性質(zhì)穩(wěn)定,使用方便,價(jià)格低廉。常用有磺胺嘧啶,磺胺二甲嘧啶,磺胺間甲氧嘧啶,磺胺氯吡嗪,磺胺六甲氧嘧啶,甲氧芐啶等。該類抗生素都有一定腎毒性和肝毒性,易在腎小管中析出結(jié)晶,引起血尿、尿痛、尿閉等癥狀,使用療程不宜太長(zhǎng),同時(shí)配合等量小蘇打使用,期間多飲水,還可導(dǎo)致黃疸、肝功能減退,嚴(yán)重者可發(fā)生急性肝壞死,故有肝功能損害患者宜避免磺胺藥的全身應(yīng)用;前匪庍會(huì)抑制骨髓造血功能,引起中性粒細(xì)胞減少或缺乏癥、血小板減少癥及再生障礙性貧血。該類抗生素還有一方面易被大家忽視的毒性,磺胺藥多可以穿過胎盤屏障至胎兒體內(nèi),易引起葉酸攝取障礙,有一定致畸作用,懷孕母畜和幼畜慎用,懷孕前期最好不用。
6.2 磺胺類的配伍禁忌
磺胺類藥物屬于堿性藥物,與酸性藥物如青霉素類、Vc、四環(huán)素類、硫酸阿托品、鹽酸普魯卡因、葡萄糖和葡萄糖酸鈣注射液等混合使用,會(huì)析出沉淀或者療效降低,須分開使用,禁止與人工鹽、硫酸鈉、石膏等含硫的藥物和拉沙菌素、莫能菌素、鹽霉素等抗球蟲藥物同時(shí)使用,氯化鈣、氯化銨、氯霉素類和紅霉素類會(huì)增加本類藥物的毒性作用,避免同時(shí)使用;前奉惪股嘏c氨基糖苷類配伍使用,有協(xié)同作用,但兩者都有較強(qiáng)的腎毒性,臨床上慎重合用,抗菌增效劑如TMP、DVD與磺胺類有協(xié)同作用,臨床上最好配伍使用,大環(huán)內(nèi)酯類與本類藥物也有協(xié)同作用,豬場(chǎng)保健多使用這種配伍,磺胺類藥物使用注意首次加倍,療程適宜,3-5天最好,不能太長(zhǎng),最多不超過7天。
7、喹諾酮類
7.1 喹諾酮類的毒副作用
喹諾酮類(4-quinolones),又稱沙星類或吡啶酮類,是指一類具有4-喹諾酮環(huán)結(jié)構(gòu)的藥物。常用的有諾氟沙星、環(huán)丙沙星、氧氟沙星、恩諾沙星等。喹諾酮類抗生素臨床使用安全,毒副作用較小,偶見過敏反應(yīng),有輕微胃腸道反應(yīng)和神經(jīng)毒性,也有一定的肝腎毒性,臨床上大家應(yīng)該重視該類抗生素的抑制幼兒軟骨發(fā)育的毒性作用,可引起跛行和畸形,故幼蓄、孕蓄和哺乳期盡量少用或不用,幼畜避免長(zhǎng)期使用;
7.2 喹諾酮類的配伍禁忌
喹諾酮類與四環(huán)素類一樣,易與金屬陽離子如Ca2+、Mg2+、Fe2+、Al3+等結(jié)合,形成不容絡(luò)合物,從而影響了藥物的吸收,故不宜與含這些金屬陽離子的藥物合用,與非甾體類藥物如水楊酸鈉、吲哚乙酸、鄰氨基苯甲酸和吡硅酮類藥物合用,會(huì)加劇中樞系統(tǒng)毒性,喹諾酮類特別是依諾沙星有抑制肝藥酶P450代謝的作用,從而會(huì)導(dǎo)致依靠此類藥酶代謝的氨茶堿、咖啡因柯柯堿等嘌呤類生物堿代謝障礙,血藥濃度上升,臨床上出現(xiàn)明顯的毒副作用,喹諾酮類蛋白結(jié)合率較高,與華法令合用,會(huì)使游離的華法令增多,引起抗凝過度,凝血時(shí)間延長(zhǎng)而出血。喹諾酮類與大環(huán)內(nèi)酯類、氯霉素類和呋喃類配伍使用有拮抗作用,療效減弱,與青霉素類、磺胺類、氨基糖苷類和四環(huán)素類有協(xié)同作用,配伍使用療效增強(qiáng)。
8、林可胺類
常用的有林可霉素、克林霉素、桿菌肽和黏菌素。該類抗生素毒副作用較小,有輕微的心血管反應(yīng)、胃腸道反應(yīng)以及神經(jīng)肌肉阻斷作用,不宜與止瀉藥合用,會(huì)導(dǎo)致腹瀉加劇和時(shí)間延長(zhǎng)。
林可胺類與Vb、Vc混合使用,會(huì)出現(xiàn)渾濁,并失效,屬于理化配伍禁忌,與磺胺類藥物氨茶堿等堿性藥物合用,也會(huì)渾濁失效,氯霉素類與本類藥物有拮抗作用,而四環(huán)素類和喹諾酮類與本類藥物有協(xié)同作用,多配合使用,與大觀霉素
9、多肽類
多肽類抗生素是一類具有多肽結(jié)構(gòu)的化學(xué)物質(zhì),動(dòng)物常用的有桿菌肽,多粘菌素,恩拉霉素和維杰尼霉素。該類藥物比較安全,全身應(yīng)用有輕微腎毒性和神經(jīng)肌肉阻斷效應(yīng)。阿托品新霉素和慶大霉素與本類合用,毒性作用增強(qiáng),多肽類與四環(huán)素類喹諾酮類磺胺類合用療效增強(qiáng)。
10、其他類抗生素
10.1 聚醚類抗生素:常用有海南霉素、莫能霉素、鹽霉素和馬杜霉素,主要用于抗球蟲和促生長(zhǎng)。該類抗生素安全范圍窄,易發(fā)生中毒,中毒后無特效解毒藥,與泰妙菌素、竹桃霉素和某些磺胺藥配伍易發(fā)生中毒反應(yīng),故臨床上禁止這些配伍,該類藥物對(duì)機(jī)體的免疫力有較強(qiáng)的抑制作用,但停藥后可恢復(fù)。
10.2 截短側(cè)耳素類:常用有泰妙菌素和沃尼妙林,毒性較低,無三致作用,豬應(yīng)用過量可導(dǎo)致流涎、嘔吐和中樞抑制。
10.3 喹噁啉類:乙酰甲喹常用,又稱痢菌凈。該類抗生素有較強(qiáng)的遺傳毒性,對(duì)生殖機(jī)能和胚胎發(fā)育有抑制作用,種豬慎用;還有免疫器官毒性,損害造血系統(tǒng)。
The English version
With the rapid growth of economy, people's living standard and quality enhances unceasingly, China's livestock and poultry breeding industry get rapid development, livestock and poultry disease also is changing, however, more and more complex, become the number one enemy, hindering the development of the aquaculture continued current "vaccines and antibiotics" is still a vast farming people of poultry and animal disease prevention and control of the main mode and means of antibiotics became the livestock and poultry disease after the help of the grass, it is widely used in farming, but antibiotics is also a double-edged sword, its side effects brought by the harm is often ignored by people, improper use not only useless, but bring huge losses, the author gives a brief overview of the side effects of all kinds of commonly used antibiotics and compatibility taboo, for everybody in the prevention and treatment of clinical disease to provide the reference.
1, the beta lactam type
1.1 beta lactam type of side effects
Beta lactam class of antibiotics (beta lactams) refers to the chemical structure of beta lactam ring a major types of antibiotics, including clinical penicillin and cephalosporin class of the most commonly used, and the head of the new development of drug classes, sulfur, doxycycline, monocyclic beta lactam etc other atypical beta lactam antibiotics. Such antibiotics has strong bactericidal activity, low toxicity, wide indications and clinical efficacy of good advantages. The side effects of this class of antibiotics is small, use safety on livestock and poultry, in the use of this class of sodium or potassium high-dose intravenous antibiotics, pay attention to the onset of high blood sodium, potassium, when treated with penicillin leptospirosis can cause symptoms due to pathogens death, usually called Hector's reaction.
1.2 compatibility taboo
Beta lactam antibiotics are mainly penicillin and cephalosporin class, the class of drugs and acidic drugs such as chlorpromazine hydrochloride, tetracycline class of sodium bicarbonate injection and alkaline drugs such as sulphonamide, used in combination, will sink decomposition failure, will be high levels of alcohol oxidants such as potassium permanganate, heavy metal salts and damage failure, will also be Vb1, Vb2, and Vc damage and failure. Beta lactam antibiotics with fast bacteriostatic agent such as tetracycline, chloramphenicol share, antibacterial effect is abate, because beta lactam antibiotics mainly hinder the third stage of cell wall synthesis, in the bacteria multiply rapidly has strong sterilization effect, and rapid bacteriostatic agent is hampering the protein synthesis, inhibit the growth of bacteria, the bacteria quickly enter the stationary phase, if must be used in combination, for when the order is to use beta lactam first class of antibiotics, 3-5 hours to use fast bacteriostatic antibiotic, and tetracycline, large ring lactone class and Lincoln bacteriostatic antibiotic combination, such as, the same antibacterial effect is abate, joint use is not recommended.
2, aminoglycoside
2.1 aminoglycoside antibiotics harmful side effects
Aminoglycoside antibiotics (Aminoglycosides) is made up of amino sugars and amino alcohol through oxygen bridge connection of nucleoside antibiotic, belongs to the stationary phase of antiseptic medicine, the main effect on gram-negative bacteria, commonly used mainly, streptomycin, kanamycin, amikacin, gentamycin, neomycin, spectinomycin and ample. The side effects of antibiotics is bigger, familiar to everyone who has ears toxicity and kidney toxicity and muscle blocking effect, unfavorable use for a long time, livestock and poultry renal failure as far as possible avoid the use of these drugs. This class of antibiotics has large damage to the intestinal villus, take orally can cause double infection, treatment appropriate to take orally, the drug can also through the placenta into the fetal tissue, has teratogenic effect, mid and late pregnancy sow with caution.
2.2 compatibility taboo
Aminoglycoside antibiotics will be strong acid, alkali solution and strong oxidant potassium permanganate (Vc), reductant, damage and failure belongs to the physical and chemical compatibility taboo, this kind of drug toxicity is stronger, avoid similar drug compatibility, in order to avoid toxic enhancement, and basic drugs such as baking soda and aminophylline share enhanced antibacterial function, but also enhance toxicity and compatibility with discreet, share, and diuretic increases its nephrotoxicity, and polymyxin E share, can lead to skeletal muscle relaxation. Aminoglycoside antibiotics and beta lactam drugs used in combination with synergy, the portfolio in clinical application, and quinolone classes and more peptide antibiotics, increase curative effect, weakens and chloramphenicol antibacterial function.
3, the tetracycline class
3.1 tetracycline antibiotics side effects
Tetracycline class of antibiotics (tetracycline antibiotics) is a kind of structure produced by actinomyces contain tetracene basic skeleton of broad spectrum antibiotics, commonly used have chlortetracycline, oxytetracycline, doxycycline, etc. This class of antibiotics biggest characteristic is easy to combine with calcium phosphate, deposition to the teeth and bones, inhibit bone normal growth and development, and easy through the placenta and breast milk, pregnancy, lactation, and careful assistance accordingly. This class of antibiotics with mild gastrointestinal reaction, such as nausea, vomiting and diarrhea, and kidney damage, especially in late pregnancy, liver dysfunction and failure of livestock and poultry try not to choose the class of antibiotics, also easy to cause intestinal flora imbalance, induce secondary infection, use time shoulds not be too long, should do after treatment with this class of antibiotics and care about probiotics regulate gastrointestinal.
3.2 compatibility taboo
Tetracycline drugs generally acidic, cannot be used with alkaline drug compatibility, share will reduce the tetracycline class curative effect, tetracycline class under the condition of stomach acid solubility is bigger, isoelectric point of tetracycline for ph = 5.5, solubility minimum near the isoelectric point, using sodium bicarbonate, gastric ph increases, thus reduce tetracycline solubility, affect the absorption of the tetracycline, tetracycline to avoid calcium salt by iron or containing metal ions, Ca, Mg, Al, Bi, Fe and other medicines, easy cationic complex formation, greatly reduce drug absorption, and aminophylline, olaquindox and sulfa basic drug combination can decompose fails, compatibility shall be forbidden to use, and the large ring lactone class, chloramphenicol and polymyxin b share to enhance curative effect, clinical compatibility can be used, ammonium chloride can make urine acidification, enhancement of tetracycline in the treatment of urinary system.
4, large ring lactone class
4.1 the side effects of large ring lactone class
Large ring lactone class antibiotic is a kind of molecules contain alicyclic within 14-16 yuanta ring structure of antibiotic, mainly applies to aerobic gram positive bacteria and gram negative bacteria and anaerobic bacteria, commonly used have tylosin, for m star test, tara rhzomorph, erythromycin, kitasamycin, spiramycin, luo erythromycin and azithromycin. This class of antibiotics less side effects, high safety, can be mild gastrointestinal tract reaction and local stimulation, only happen when the injection under the skin ty le bacterium known as temporary facial redness and swelling, pigs occasionally meet with rectal edema, skin erythema, pruritus, etc., for m star test easy cause tachycardia and contraction force is abate, intravenous injection, 20 mg/kg muscle injection can cause most of the experimental pigs died, in addition to cattle, careful with injected other animals.
4.2 compatibility taboo
Large ring lactone class of drugs in the physical and chemical compatibility taboo is a common and share appear cloudy precipitate, calcium chloride, sodium chloride injection mixed with sodium carbonate and sulfanilamide, precipitation, precipitation and free alkali, this class of antibiotics will also be destroyed by Vb2, Vc, avoid acid and share. Large ring lactone class would reduce the antibacterial effect of clindamycin, would also reduce beta lactam class of antibiotics rapid bactericidal effect, clinical treatment should not be with you. Aspirin with this class of drug compatibility, reduces the latter antibacterial efficacy, kanamycin, sulfa and aminophylline can enhance the toxic effects of large ring lactone class of drugs, compatibility must be cautious, and large ring lactone class antibiotic and sulfa, aminoglycoside and quinolone compatibility, curative effect is enhanced or additive effect.
5, amide alcohols (chloramphenicol)
The side effects of chloramphenicol 5.1 class
Chloramphenicol (Fenicols) antibiotics including chloramphenicol and thiamphenicol and fluorine thiamphenicol toxin. Chloramphenicol has been disabled, fluorine benzene nicol, dedicated to the animals antibiotics. This class of antibiotics antibacterial spectrum is wide, the gram positive bacteria and negative bacteria and mycoplasma has a stronger effect, this class of antibiotics toxicity mainly has three aspects: the immune toxicity, reproduction toxicity and blood toxicity, fluorine benzene nicol, have stronger immune inhibition, vaccination period or immune function defects of livestock and poultry ban the use of the drug, the drug has the embryo toxicity, suggested stallion of livestock and poultry and animal with caution during pregnancy, lactation, the drug before pregnancy, medium-term avoid is used a particular, fluorine benzene nicol, also has a reversible red blood cell growth inhibition, but no regeneration barrier anemia.
5.2 chloramphenicol class compatibility taboo
Fluorobenzene nicol, and tetracycline class (chlortetracycline, and doxycycline, terramycin, etc.) used in combination, with synergy, often used in the treatment of respiratory diseases or prevent respiratory disease care, and neomycin and slime molds element combination, also have synergy, commonly used in livestock and poultry intestinal and respiratory treatment and prevention of infection, mixed with beta lactam antibiotics, large ring lactone class, furan and quinolone mutual antagonism, curative effect is reduced, also has antagonism with clindamycin, fluorine benzene nicol, unfavorable and sulfa, aminophylline and other basic drugs used in combination, fluorine benzene nicol, antagonism Vb6, increase the body's requirement for Vb6, also can adersely affect b12 hematopoiesis.
6, sulfa
6.1 the side effects of sulfonamides
Sulfa drugs are a class of aminobenzene sulfonamide structure is the floorboard of the drug, has a broad spectrum antimicrobial properties, nature is stable, easy to use, low price. Commonly used sulfadiazine, sulfadimidine, sulfanilamide between oxygen pyrimidine, sulfanilamide chloride pyrazine, sulfanilamide liujia oxygen pyrimidine, methoxyl benzyl organism, etc. This class of antibiotics has certain nephrotoxicity and hepatotoxicity, easy to precipitate crystallization in the renal tubules, cause the symptom such as hematuria, urinary pain, anuresis, use course shoulds not be too long, at the same time with the same use baking soda, water more during, also can lead to jaundice, liver function impairment, serious acute liver necrosis, can occur in liver function damage in patients with appropriate avoid sulphonamide is a general application. Sulphonamide also inhibits bone marrow hematopoietic function, cause neutropenia or deficiency, thrombocytopenia, and aplastic anemia. This class of antibiotics and easy to ignore the toxicity on one hand, more than sulphonamide can cross the placenta barrier to the fetus, easy cause folic acid intake disorders, have certain teratogenic effects, pregnant female and careful assistance, first trimester is best not to.
6.2 sulfa compatibility taboo
Sulfa drugs belong to alkaline, and acidic drugs such as penicillin, Vc, tetracycline, atropine sulfate, procaine hydrochloride, glucose and calcium gluconate injection, such as mixing, precipitation precipitation or less effective, should be used separately, ban and artificial salt, sodium sulfate, gypsum and other drugs containing sulfur and lassa rhzomorph, cephalosporins, salinomycin ball insect medicines used at the same time, such as calcium chloride, ammonium chloride, chloramphenicol and erythromycin can increase the toxic effect of this class of drugs, avoid to use at the same time. Sulfa antibiotics used with aminoglycoside compatibility, have synergy, but both have strong renal toxicity, share, careful clinical antibacterial synergist as TMP, DVD has synergism with sulfa, best clinical compatibility, large ring lactone class with this class of drugs also have synergy, pig care more to use this compatibility, sulfa drug use pay attention to the double for the first time, period of treatment is appropriate, 3 to 5 days is best, can't be too long, not more than seven days.
7, quinolone
The side effects of quinolone 7.1 class
Quinolone class (4 - quinolones), also known as the effect of a class or pyridine ketone, refers to a class 4 - drugs of quinolone ring structure. Commonly used with norfloxacin, ciprofloxacin and ofloxacin, sand and magnitude. Quinolones clinical use safety, toxicity is small, the occasional allergic reaction, with mild gastrointestinal reaction and neurotoxicity, have some liver and kidney toxicity, we should attach importance to this class of antibiotics restrain the toxic effects of early childhood development of cartilage, can cause a limp and deformity, so the baby grow, pregnancy and lactation storage, use or not use as less as possible assistance to avoid long-term use;
7.2 quinolone class compatibility taboo
Quinolone and tetracycline class, easy and metal cations such as Ca2 +, magnesium 2 +, Fe2 +, Al3 + is united in wedlock, form is not complex, which affect the absorption of the drug, it is unfavorable to contain these metal cation of medicines, with non-steroidal drugs such as sodium salicylate, indole acetic acid, anthranilic acid and pyrazole ketones medicines, exacerbate the central nervous system toxicity, quinolone class especially according to the north of sand has the effect of inhibiting liver medicine P450 metabolic enzymes, which can lead to rely on such drug metabolic enzymes of aminophylline, caffeine pp alkali purine alkaloid metabolic disorders, such as blood drug concentration increase, the side effects of clinically significant, quinolone class protein conjugation rate is higher, with share, warfarin can make free increase in the number of warfarin, the cause of excessive anticoagulation, prolong clotting time and bleeding. Quinolone with large ring lactone class, chloramphenicol and furan combination with antagonism, curative effect is abate, and penicillin and sulfa, aminoglycoside and tetracycline class have synergy, enhanced compatibility with curative effect.
8, forests amine
Commonly used lincomycin, clindamycin, bacitracin and slime molds. This class of antibiotics less side effects, with mild cardiovascular responses, gastrointestinal reaction and neuromuscular blocking effect, unfavorable and antidiarrheal share, will lead to diarrhea intensified and prolonged.
Forests amine mixed with Vb, Vc, can appear cloudy, and fails, belong to the physical and chemical compatibility taboo, with aminophylline and other basic medicines, sulfa drugs will be cloudy fails, chloramphenicol class with this class of drugs has antagonism, and tetracycline and quinolone synergy, with this class of drugs used to cooperate with more, and spectinomycin
9, polypeptide,
Polypeptide antibiotic is a kind of polypeptide structure of chemicals, animals commonly used with bacitracin, polymyxin, toxin and toxin d, Johnny. The drug is safe, the whole body application with mild renal toxicity and neuromuscular blocking effect. Atropine neomycin and gentamicin and classes share, toxic effect, polypeptide and tetracycline class quinolone sulfa share increase curative effect.
10 and other classes of antibiotics
10.1 polyether antibiotic: commonly used have hainan toxin, mo to doxycycline, salinomycin and madurai, mainly used for ball insect resistance and promote growth. This class of antibiotics security narrow range, easy to poisoning, poisoning after there is no specific antidote, and tai miao rhzomorph, oleandomycin, and some sulphonamide compatibility prone to toxic reaction, therefore to ban the compatibility, such drugs on the body's immunity has strong inhibitory effect, but can be recovered after drug withdrawal.
10.2 give ear truncated element class: commonly used have Thai cephalosporins and walter's clever Lin, low toxicity, no three, pig application can lead to excessive salivate, vomiting and central inhibition.
Evil moiety ketoneses 10.3 class: acetyl sinensis are commonly used, also known as dysentery bacteria net. This class of antibiotics has the strong genetic toxicity, has inhibitory effect to the reproductive function and embryonic development, breeding pigs with caution; And toxicity of immune organ, damage the hematopoietic system.
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