独特的药代,铸就简单有效解读希舒美在临床中的治疗优势.pptVIP

临床应用…… 1.囊性肺纤维化 McArdle JR,et al Clin Chest Med28(2007)347-360 2.慢性副鼻窦炎 Haryey RJ et,al Immunol Allergy clin N Am29(2009)689- 703 3.支气管哮喘 Johnston,et al N Engl J Med 2006;354:1589-1600 4.COPD Seemungal TAR,et al Am J Respir Crit Care Med Vol 178.pp1139-1147,2008 5.支气管扩张 Tsang KWT,et al Eur Respir J 1999;13:361-364 6.重症肺炎-脓毒症 Restrepo MI et al Eur Respir J 2009;33:153-159 ……….. THANK YOU ! * * * 阿奇霉素是一类新的抗微生物药物——氮环内酯类的第一个品种。其化学结构与大环内酯类的红霉素相似，不同之处在于大环内酯环9a位置上插入了一个甲基化的氮原子。通过这种化学修饰，氮环内酯类有别于大环内酯类，后者的大环内酯环只含碳和氧原子。环上插入氮原子后显著地改变了这些药物的化学、微生物学及药物动力学特性。 阿奇霉素为氮环内酯类抗生素是大环内酯类抗生素的衍生物 其分子式为 C38H72N2O12，分子量为748.001 其化学结构与红霉素大不相同，阿奇霉素为红霉素衍生物，在红霉素内酯环中9a位置上的羰基被甲氨基取代2，并增加一个碳原子使阿奇霉素成为15元环结构3。 上述化学结构上的改变使阿奇霉素对酸的稳定性比红霉素强4，从而提高了其口服生物利用度，降低其对胃肠道动力的刺激作用，因此，与红霉素相比，其胃肠道不良反应较低5 。 * * In contrast to conventional thinking about macrolide antibiotics, azithromycin has been shown in in vitro and in vivo studies to be bactericidal against common respiratory pathogens Oral azithromycin’s spectrum of activity against a number of common pathogens is outlined in the chart * * In contrast to conventional thinking about macrolide antibiotics, azithromycin has been shown in in vitro and in vivo studies to be bactericidal against common respiratory pathogens Oral azithromycin’s spectrum of activity against a number of common pathogens is outlined in the chart * * The dynamic nature of this cellular concentrating effect has been demonstrated by Mandell and Coleman The table above demonstrates the in vitro uptake of azithromycin by neutrophils compared with that of a number of other antibiotics used in the treatment of upper respiratory tract infections Azithromycin demonstrated an intracellular to extracellular concentration ratio exceeding 500-fold after a 1-hour incubation The only drug with similar intracellular concentrations was telithromycin, a structurally related agent Mandell GL, Coleman E. Uptake, transpor