Medikamentebi, Klasifikaci: Ganzavebebi Da Seyvanis Gzebi

Mmedikamentebi, klasifikacia,
ganzavebebi da Seyvanis gzebi
1
zogadad:
antibiotikebi
inotropebi
antiariaTmuli saSualebebi
diuretikebi
plazmis Semcveli i/v siTxeebi
opioidebi
kristaloidebi
gastroproteqtorebi
aminomJavebi
2
antibiotikebi
cefalosporin
ebi
Ppenicilinis
ftorqinolebi
jgufi
aminoglikozi
makrolidebi
debi
3
cefalosporinebis jgufi
Maxipime/cefepime 1g
Avexone/ceftriaxone 1g – 2g
Fortume/ceftazidime 1g
Topra /cefepime 1g
Cefazolini 1g
Rocefini 1g
4
Maxipime/cefepime 1,0 g
 me – 4 Taobis cefalosporinebis jgufis farTo speqtris

antibiotiki.
 gamoiyeneba profilaqtikis mizniT qirurgiuli operaciis

Semdgom periodSi
 zavdeba NNaCl 0,9% - 20ml (iv)
5
Topra /cefepime 1g
 me-4 Taobis cefalosporinebis jgufis farTo speqtris

antibiotikia. M
 moqmedebs gram+ , gram - , aminoglikozidebisa da me -3
Taobis cefalosporinebisadmi.
 gamoiyeneba : mis mimarT mgrZnobiare
mikroorganizmebiT gamowveuli infeqciur-anTebiTi
daavadebebis samkurnalod
 zavdeba: 1g. NaCl 0,9% -20ml (iv)
6
Avexone/ceftriaxone 1g -2g
 me -3 Taobis cefalosporinebis jgufis farTo speqtris antibiotikia
 moqmedebs rogorc gram+ ise gram - , baqteriaze
 gamoiyeneba mis mimarT mgrZnibare mikroorganizmebiT

gamowveuli infeqciur-anTebiTi daavadebebis samkurnalod
 zavdeba: 1g. NaCl 0,9% 20ml.(iv)
7
Cefazolini1.0
 1 Taobis farTo speqtris cefalosporini
 ZiriTadad gamoiyeneba postoperaciul periodSi.
8
ganzaveba:
1 gr ganzaveba xdeba NA CL 0.9 % xsnarSi.20 ml

SpricSi.
9
Rocefini 1g – 2g
 me -3 Taobis cefalosporinebis jgufis farTo speqtris
antibiotikia
moqmedebs rogorc gram+ ise gram – baqteriaze

gamoiyeneba mis mimarT mgrZnibare
mikroorganizmebiT gamowveuli infeqciur-anTebiTi
daavadebebis samkurnalod
zavdeba: 1g. NaCl 0,9% 20ml.(iv)
10
Ppenicilinis jgufi
Unazin/ampicilin+sulbactam 1.5g – 3g
Tazocin/tazobactam sodium 4,5g
peporta/tazobactam piperacilin 4,5g
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Ppenicilinis jgufi
PAROTA/piperacilin Tazobactam
kombinirebuli antibaqteriuli preparatia.
piperacilini-farTo speqtris baqteriuli moqmedebis
pelicilinis jgufis preparatia.
tazobaqtami_zrdis antibaqteriul speqtrs.
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Ppenicilinis jgufi (gagrZ)
Cveneba:
preparatisadmi mgrZnobeloba
 mikroorganizmebiT gamowveuli sistemuri

daavadebebi
 adgilobrivi infeqciur_anTebiTi daavadebi.
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penicilinis jgufi(gagrZ)
ganzaveba:
i/v infuziisaTvis ganzaveba xdeba NA CL 0.9 %

xsnarSi. 50 ml SpricSi,
infuzia mimdinareobs 24 saaTis ganmavlobaSi.(13,5 g

an 9g 24sT-s doza)
gansazrvrul iv xazSi.
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gansakuTrebuli miTiTeba !!!
PEROTA 4,5g - farmakologiurad

SeuTavsebelia (erT SpricSi iv xazSi):
ringerTan
aminoglikozidebTan
sisxlTan
sisxlis SemcvlelebTan.
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penicilinis jgufi
UNAZIN/ampicilin+sulbactam/ b (beta
laqtamazas) inhibitori+ampicilini
gamoSvebis forma -0.75g , 1.5g , 3.0 g

fxvnili flakonebSi.
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Cveneba:
sasunTqi gzebis infeqciebi
saSarde gzebis infeqciebi,
peritoniti
qolecistiti
endometriti
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penicilinis jgufi( gagrZ)
ganzaveba:
zavdeba 1,5 g 20,0 SpricSi iv
 3 g – 50,0 SpricSi. Iv.
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Mmakrolidebis jgufi
Roxitatas / roxitromycini
Azimac / azitromicin
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Mmakrolidebis jgufi
Azimac / azitromicin 500mg(kafsul.saxiT) po.
makrolidebis jgufis farTo speqtris antibiotikia

moqmedebs toqsoplazmozze.
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aminoglikozidebis jgufi
Licacin/amicacin 500mg
Tobramicin/tobrex
Netromicin 200mg
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aminoglikozidebis jgufi
Licacin/ amicacin 500mg
baqteriociduli moqmedebis antibiotikebia,

moqmedeben zogierT gr+ da mraval gr-
mikroorganizmze.
Seyvanis gzebi: intensiuri Terapiis departamentSi

ZiriTadad i.v.
vazavebT 20 ml. NaCl 0.9% xsnarSi

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linkozamidebi:
am jgufs miekuTvneba: klindamicin 300mg- 600mg
/2ml
 ZiriTadad moqmedebs
baqteriostaturad
aseve anaerobebze
streptokokebze
 stafilokokebze
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ftorqinolonebi:
Ciprofloqsacin
 Narfloqsacin
 Pefloqsacin
 Ofloqsacini (floqsani)
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ftorqinolonebi:
isini maRalaqtiuri antibaqteriuli saSualebebia
moqmedebis farTo speqtriT
 aqvT baqteriociduli moqmedeba g- baqteriebze
g+ baqteriebis mimarT naklebad aqtiurni arian.
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ftorqinolonebi:
axali Taobis ftorqinolonebs miekuTvneba:
Moqsifloqsacin(aveloqs) 200ml/400mg
axasiaTebs antimikrobuli moqmedebis momateba g+

baqteriebze , kerZod streptokokebze da anaerobebze.
Segvyavs iv 60wT-is ganmavlobaSi.
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Metronidazol , Tinidazol 500mg/100ml
antimikrobuli saSualebaa anaerobuli baqteriebisa da

protozas mimarT.
Segvyavs iv 60wT-is ganmavlobaSi
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Diflucan 50ml
Fluconazol - 50mg,100mg.150mg antimikozuri farTo

speqtris antibiotiki.
Segvyavs iv 60wT-is ganmavlobaSi.
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glikopeptidebi:
Vancomycin/edicin 0,5g – 1g
moqmedebs baqteriocidulad
axasiaTebs maRali aqtiuroba gr+ kokebis mimarT
meticilinisadmi gamZle stafilokokebis da β laqtamazebis
maproducirebeli Stamebis mimarT
 moqmedebs aseve klostridiebze da korine baqteriebze
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glikopeptidebi:(gagrZ)
Seyvanis gzebi: Segvyavs i.v.
vazavebT 50 ml. NaCl 0.9% xsnarSi
Segvyavs 60 wT-is ganmavlobaSi.
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karbapenemis jgufi
Merex Meronem Garde/meropenem 0,5g
1g
karbapenemis jgufis antibiotikia
moqmedebs baqteriocidulad.
ganzaveba: i/v infuziisaTvis ganzaveba xdeba NA CL
0.9 % xsnarSi. 50 ml SpricSi
infuzia mimdinareobs 60 wuTis ganmavlobaSi.
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b (beta laqtamazas) jgufi
Tienam/imipenem+ cilastatin 500mg/100ml
beta laqtamazas jgufis antibiotikebis pirveli
warmomadgenelia
farTo speqtris antibiotiki
i/v infuziisaTvis ganzaveba xdeba NA CL 0.9 %
(100ml) xsnarSi
Seyvana xdeba 60wT-is ganmavlobaSi
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Ppolimiqsinebis jgufi
Colistin/colomycin 1 million , 2 million
miekuTvneba polimiqsinebis jgufis antibiotikebs.

klavs iseT baqteriebs ,rogoricaa pseudomonas aeruginosa.
gamoiyeneba Tirkmlis infeqciebis
klibsielasa da acinetos dros, mgrZnobelobis gaTvaliswinebiT.
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polimiqsinebis jgufi(gagrZ)
Gganzaveba:
1 milionis ganzaveba xdeba NA CL 0.9 %

xsnarSi.20 ml SpricSi, i/v infuziisaTvis.
aseve gamoiyeneba inhalaciis saxiT.
34
diuretikebi
 Furosemidi (lazixi)
Manitoli 5,10,15,20,25%
35
diuretikebi (Furosemidi (laziqsi)
farmakologiuri moqmedeba:
maRalefeqturi da swrafad moqmedi diuretiki
(Sardmdeni saSualeba)
gamoSvebis forma da miRebis gza:
gamodis tabletirebuli da saineqcio xsnaris saxiT.
miiReba peroralurad an intravenurad.
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Cveneba:
filtvis SeSupeba, im pacientebSi, romelTa
sistoluri wneva >90-100 mm/Hg;
hipertenzia
momatebuli intrakranialuri wneva
oligo-anuria
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mniSvnelovani miTiTebebi !!!
dehidratacia
hipovolemia
hipotenzia
hipokalemia da sxva eleqtrolituri disbalansi.
prolongirebuli infuziis dros Sprici unda SeifuTos
Suqgaumtar qaRaldSi.
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diuretikebi
Manitoli 5,10,15,20,25%
osmosuri diuretikia. izrdeba natriumis da siTxis

gamoyofa, preparati efeqturia, mxolod im
SemTxvevaSi, Tu Senaxulia Tirkmlis filtraciuli
funqcia.
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diuretikebi(Manitoli 5,10,15,20,25%)
gamoiyeneba:
nervologiur pacientebSi intrakranialuri

wnevis momatebis dros: i.v. 0,1-1gr/kg. 5-
10 wuTis ganmavlobaSi filtriani sistemiT.
40
diuretikebi(Manitoli 5,10,15,20,25%)
gansakuTrebuli miTiTeba:
yuradReba unda mieqces pacientis adeqvatur

oqsigenacias da ventilacias.
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gastroproteqtorebi
Aam jgufis medikamentebs ganekuTvneba:

zantaki, almageli, maaloqsi, ranitidini, venteri,
omeprazoli .
es preparatebi kuWze axdenen:
Semomgarsvel
H2 receptorebis blokirebas
da kuWis sekreciis damaqveiTebel
efeqts
42
antiariaTmuli saSualebebi
Atropin 0,1% - 1,0

Adenozin(ATF) –Na Adenozintrifosfat 1%-1,0
Digoxin 0,025% 1ml
Propranolol (Anaprilin, Obzidan) 1mg/ml- 5,0
Cordaron(Amiodarone) 150mg/3ml or 200mg ( tb)
Izoptin(verapamil) 5mg/2ml -2,0
43
Atropin 0,1% - 1,0 – farmakologiuri

moqmedeba:
periferuli M-qolino blokeria
amcirebs sanerwyve, bronqul, kuWis, saofle jirkvlebis

sekrecias
aCqarebs gulis riTms
44
(gagrZ).
amcirebs peristaltikur kumSvebs
afarTovebs gugebs (TvalSi CawveTebisas)
meore rigis arCeviTi preparatia adrenalinsa da

vazopresinis Semdeg asistoliasa da bradikardiis
dros
45
(gagrZ).
ganzaveba:
asistolia da pulsgareSe eleqtruli aqtivoba:
1mg Atropin-is swrafi IV Seyvana
 doza meordeba 3-5 wT-Si
Max.doza 3mg
 Carecxva unda ganxorcieldes 20ml NaCL 0,9%
xsnariT.
46
(gagrZ).
bradikardia:
0,5mg - 3-5wT-Si.
Sruli doza 3mg
47
Adenozin(ATF) –Na Adenozintrifosfat 1%-1,0
warmoadgens arCeviT preparats gaurkveveli genezis
wvrilkompleqsovani supraventrikuluri taqikardiis dros
Aaqvs xanmokle moqmedeba
48
(gagrZ).
Segvyavs IV swrafad(2wm) bolusiT(6-12mg) + 20ml

NaCl 0,9% recxva.
Tu efeqti ar aris, 1-2 wT-Si SeiZleba dozis (12mg)

gameoreba.
49
Digoxin 0,025% 1ml
sagule glikozidia
gamoiyeneba supraventrikuluri taqikardiis , ufro
xSirad mocimcime ariTmiis dros
aseve gamoiyeneba dabali EF dros
50
(gagrZ).
Gganzaveba:
10-15 mcg /kg
pirveli doza –saerTo dozis 50%
danarCeni 2 (25%-25%) ki 6-8 sT-is
intervaliT.
IV 1 amp +20ml NaCl minimum 5wT
ganmavlobaSi
filtvebis SeSupebis SemTxvevaSi 10-15wT
51
ganmavlobaSi
(gagrZ).
ZiriTadi miTiTeba!!!
D digoqsins SeuZlia gamoiwvios sicocxlisaTvis saSiSi

ariTmia, amitom am preparatiT mkrnaloba xdeba
eqimis miTiTebiT .aucilebelia mudmivi
monitoringi.
52
Propranolol (Anaprilin, Obzidan) 1mg/ml-5,0
araseleqciuri B blokeria
iwvevs guliscemis sixsiris momatebas,
hipotenzias
aqvs antiariTmuli moqmedeba ,
winagulovani ariTmiebis dros
53
(gagrZ).
Cveneba:
maRali arteriuli wneva
gulis riTmis darRveva
gulis iSemiuri daavadeba
ganzaveba:
sawyisi doza 0,03 mcg/kg , gameoreba SeiZleba
5wT-s Semdeg
5ml obzidan +15ml NaCl iv bolusiT keTdeba
eqimis miTiTebiT.
54
(gagrZ).
preparatis gamoyenebisas sifrTxilea saWiro
,radgan SeiZleba gamoxatuli iqnas
individualuri reaqcia
 gverdiTi efeqtis saxiT SeiZleba
gamoiwvios bronqospazmi
55
Cordaron(Amiodarone) 150mg/3ml or 200mg ( tb)

farmakologiuri moqmedba:
antiariTmuli saSualeba
gamoiyeneba supraventrikuluri, aseve ventrikuluri
ariTmiebis dros
iwvevs a , b receptorebis, ca arxebis blokadas
aqvs hipotenziuri efeqti
56
(gagrZ).
Gganzaveba:
zavdeba 5% glukozaSi
IV bolusi -150mg cord+ 7ml D5(Seyvana

xdeba nela)
IV infuzia 1 doza- 300mg + 50ml D5 24sT-ni

infuzia.
2 doza 600mg + 50mlD5 18 sT-ni infuzia
57
(gagrZ).
Aar SeiZleba preparatis Seyvana im
medikamentTan erTad romelic
axangrZlivebs QT
intervals(mag.prokainamidi)
medikamentis Seyvana xdeba nela,
SesZloa ganviTardes hipotenzia
58
Izoptin(verapamil) 5mg/2ml -2,0

Ca arxebis blokatori.
amcirebs gulis cemis sixSires
aqvs vazodilataciuri efeqti
gamoiyeneba supraventrikuluri
taqiariTmiebis dros
59
(gagrZ).
Gganzaveba:
Iv Seyvanisas ar saWiroebs ganzavebas

1amp( 5mg/2,0) + 10ml NaCl 0,9%
Iv bolusi 1amp(5mg/2,0) minimum 2wT
ganmavlobaSi
Max - doza 20mg.
60
(gagrZ).
gansakuTrebuli miTiTebebi:
ar gamoyeneba im pacientebze romlebic iReben b

blokerebs
gansakuTrebiT ar SeiZleba erT intravenur xazSi b

blokerebTan.
61
LLidokaini 2%-2,0
lidokaini 2%-2ml ampula
lidokaini 10% ampula
lidokaini 10 % sprei
62
(gagrZ).
lidokains aqvs 2 daniSnuleba:
adgilobrivi anesTezia -rodesac gamoyenebulis
kanqveS da nervTa blokadisTvis. gamoSvebulia 2
saxiT lidokaini an lidokaini epinefriniT (adrenalini).
epinefrini xels uSlis lidokainis swraf gawovas da
axangrZlivebs moqmedebis efeqts.
antiariTmiuli saSualeba
63
(gagrZ).
Cveneba:
 kordaronis alternativa ventrikularuli fibrilaciis (v.f) da
ventrikularuli taqikardiis (v.t) dros .
mozrdilis dozebi gulis arestis dros v.f da v.t gamo
doza i.v da ZvalSida ineqcia
1-1.5 mg/kg pirveladi doza
refraqtoruli v.f meore doza 0.5-0.75 mg/kg gaimeoreT
yovel 10 wuTSi maqsimaluri doza 3mg/kg
64
(gagrZ).
Tu medikamenti keTdeba periferiul venaSi, igi Carecxili
unda iqnas 20ml NaCl 0.9 % xsnariT da xeli wamoiwios
maRla, raTa wamali swrafad gadavides centraluri
cirkulaciaSi.
endotraqealurSi Segvyavs ( Tu ara aris intravenuri da

ZvalSida xazi)
65
(gagrZ).
2-4 mg/kg medikamenti unda gaixsnas 5-10 ml NaCl 0.9

% xsnarSi da endotraqealur milSi Casxmis Semdeg unda
moxdes ramodenime CasunTqeba ambus parkiT.
66
Primacor(milrinone)1mg/ml-10ml
fosfodiesTazas inhibitori
gamoiyeneba gulis mwvave ukmarisobis dros (kardio
qirurgiul pacientebSi)
IV
67
Metoprololi ( Egilok)
beta adrenoBblokatoria, romelic gamoiyeneba gulis
riTmis Sesaneleblad da arteriuli wnevis
dasaqveiTeblad.
ar gamoiyeneba asTmur pacientebSi, radgan
iwvevs bronqokonstriqcias.
68
Kaptopril (Capti) 25mg
agf_ angiotenzin gardamqmneli fermentis inhibitori
gamoiyeneba:
hipertenziis samkurnalod da zogierTi tipis gulis
ukmarisobis dros. miokardiumis infarqtis Semdgom
periodSi.
69
Kaptopril (Capti) 25mg
yuradReba misaqcevia Tu kaliumi >5 mmol/L ,
Tirkmlis qronikuli ukmarisoba, sist wneva <100
mm/Hg
dozireba:
sawyisi doza aris 6,25 mg po.
70
Nifedipini 10mg
kalciumis arxebis blokatoria
gaaCnia antihiprtenziuli moqmedeba
gamoiyeneba:
stenokardiis Setevis dros.
swrafad swevs dabla arteriul wnevas, pacientebi grZnoben
Tavbrusxvevas, SeiZleba gamoiwvios taqikardia an
bradikardia.
71
Prednizoloni 500mg-100ml
kortikosteroidia. axasiaTebs anTebis sawinaaRmdego,
madesensibilizirebeli da imunosupresiuli moqmedeba.
72
Suprastini
antihistaminuri saSualebaa.
gamoiyeneba
alergiuli reaqciebis kupirebisTvis.
gverdiTi efeqtebi:
iwvevs Zilianobas
Tavbrus xvevas
piris simSrale
kolits
TvalSida wnevis momatebas
73
Metoklopramid ( reglani cerukali )
gamoiyeneba gulis revisa da Rebinebis samkurnalod.

xSirad iwvevs nevrologiur gverdiT efeqtebs.
74
Ketorolaki (toradoli)
arasteroiduli anTebis sawinaaRmdego preparatia.
gamoyeneba:
Zval-kunTovani tkivilis,
Tavis tkivilis da Tirkmlis Wvalis kupirebisTvis.
kunTSi ineqciis dros ar gamoiyenoT igive nemsi,

romliTac moxda wamlis amoReba ampulidan
75
Ketorolaki (toradoli)
gansakuTrebuli miTiTeba !!!
kunTSi ineqciis dros ar gamoiyenoT igive nemsi,

romliTac moxda wamlis amoReba ampulidan
76
Euphyllinum 2,4% -5,0 , 10,0
spazmolitikuri moqmedeba.
gamoiyeneba bronqospazmis dros.
ganzaveba:
5ml ganzaveba xdeba 10-20 ml NaCl0,9% xsnarSi.
77
Euphyllinum 2,4% -5,0 , 10,0
(gagrZ)
gansakutrebuli miTiTeba!!!
ar gamoiyeneba hipotenziis , gulis riTmis darRvevis dros.
78
antikoagulantebi
Heparini 25000 Iu/5ml
Clexan 0,2ml
Clexan0,4ml
Clexan 0,6ml
Clexan 0,8ml
Clexan 1,0
Warfarin 3mg
79
antikoagulantebi
Heparini25000iu/5ml
 farmakologiuri moqmedeba: antikoagulanti _ xels

uSlis sisxlis Sededebas.
gamoyenebis Cveneba: gamoiyeneba pacientebSi,
romelTac aReniSnebaT miokardiumis infarqti, da sxva
rigi paTologiebis SemTxvevaSi.
arteriuli sisxlis gazebze sisxlis aRebis win xdeba
SpricSi misi gamovleba igive mizniT _ rom ar moxdes
sisxlis Sdededeba.
80
antikoagulantebi
pirdapiri moqmedebis
arapirdapiri moqmedebis
81
antikoagulantebi
pirdapiri moqmedebis(maRalmolekuluri):
Heparini25000 iu/5ml
xanmokle moqmedebis antikoagulanti ,
xels uSlis sisxlis Sededebas.
82
antikoagulantebi
Heparini25000 iu/5ml)
gamoyenebis Cveneba:
gamoiyeneba pacientebSi, romelTac aReniSnebaT
miokardiumis infarqti, da sxva rigi paTologiebis
SemTxvevaSi.
arteriuli sisxlis gazebze sisxlis aRebis win xdeba
SpricSi misi gamovleba igive mizniT _ rom ar moxdes
sisxlis Sdededeba.
83
antikoagulantebi
Heparini25000 iu/5ml
ukunaCvenebia:
aqtiuri sisxldenis dros
axlowarsulSi gadatanili intrakranialuri,
intraspinaluri an Tvalize qirurgiuli Careva
mwvave hipertenzia
koagulopaTia da gastroenteraluri sisxldena
ar gamoiyeneba Tu Trombocitebis raodenoba
1000000-ze naklebia.
84

dabalmolekuluri heparini _ kleqsani,
fraqsiparini, enoqsaparini
gamoiyeneba Trombozis da sxva diskoagulaciis, mwvave

koronaluri sindromisas, gansakuTrebiT ST elevaciis
gareSe.
85
antikoagulantebi
Heparini25000un/5ml
antidoti: Protamin Sulfate -10ml.

Gganzaveba:
1% Protamin Sulfate + 15ml Nacl 0,9%
swrafi Seyvana iwvevs:
arteriuli wnevis daqveiTebas
bradikardias
86
Protamin Sulfate -10ml.
gansakuTrebuli miTiTeba:
Tu heparinis Seyvanidan 4sT-ia gasuli,

Protamin - is Seyvana aRar aris
mizanSewonili, radgan TviTon
axasiaTebs antikoagulaciuri
moqmedeba.
87
Clexan 0,4ml
dabalmolekuluri heparini
ar SeiZleba Seyvana kunTSi(iwvevs qsov.nekrozs)
keTdeba Wipis irgvliv(kanqveS)
sifrTxiliT gamoiyeneba sisxldenis dros!!!
Aantidoti: Protamin 1mg aneitralebs 1mg klexane -s
88
natriumis hidrokarbonati NaHCO3
Farmakologiuri moqmedeba:
antaciduri moqmedeba (aqveiTebs mJavianobaa).
gamoiyeneba:
metaboluri acidozis, magaliTad diabeturi ketoacidozis
dros
aspiriniT intoqsikaciisas
tricikluri antidepresantebiT intoqsiakaciisas (magaliTad
amitriptilini),
adeqvaturi ventilaciis pirobebSi warmoebuli
gaxangrZlivebuli gul-filtvis reanimaciis Semdeg
89
natriumis hidrokarbonati
NaHCO3
dozireba:
1 meq/kg i/v . Seyvanis Semdeg unda ganisazRvros
arteriuli sisxlis gazebi.
90
kaliumis qloridi KCl 4% , 15%
gamoiyeneba hipokaliemiis koreqciisTvis. ar SeiZleba
misi Seyvana i.m. an s.k. radgan iwvevs qsovilebis
nekrozs sisxlZarRvis gareT.
preparatis 100meq kaliumis dones 1erTeuliT wevs
zemoT. medikamenti Seyvanili unda iqnas
mikroinfuziis saxiT araumetes 20meq saaTSi ,
masTan erTad ar unda iyos Seyvanili sxva
medikamenti da ar unda iqnes Seyvaniliswrafad.
swrafi Seyvana iwvevs gulis gaCerebas.
91
kaliumis qloridi KCl 4% , 15%
Seyvanis wesi:
medikamenti Seyvanili unda iqnas mikroinfuziis saxiT
araumetes 20meq saaTSi
masTan erTad ar unda iyos Seyvanili sxva
medikamenti da ar unda iqnes Seyvanili swrafad
swrafi Seyvana iwvevs gulis gaCerebas
92
fiziologiuri xsnari NaCl 0,9%
aris izotonuri xsnari, gamoiyeneba medikamentebis
gansazaveblad da siTxis deficitis Sesavsebad, gaaCnia
dezintiqsiakciuri unari.
93

Ringer 500,0
igive, rac fiziologiuri xsnari. Seicavs eleqtrolitebis
gansxvavebul Semadgenlobas. aqedan gamomdinare
misi raodenoba limitirebuli unda iyos. gaaCnia
dezintoqsikaciuri moqmedeba.
94
Glucosae - 5,10,20,40%
miecema pacients im SemTxvevaSi, roca saWiroa
glukozis miwodeba. arasodes ar keTdeba kunTSi da
kanqveS, vinaidan iwvevs qsovilebis nekrozs,
sisxlZarRvis gareT moxvedrisas.
95
Hespane, Voluven, Haes sterile
gamoiyeneba, rogorc i.v. xsnari. romelic efeqturad
zrdis sisxlrZarRvSida moculobas.
96
Insulini (Actrapidi)
aris pankreasis hormoni
gamomuSavdeba langerhansis kunZulebis βB

ujredebSi
iwvevs glukozis gardaqmnas glikogenad, Sesabamisad

dabla swevs sisxlSi Saqris dones.
97
Insulini (Actrapidi)
Seyvana xdeba subkutanurad an intravenurad.
mniSvnelovania, rom insulinis ganzaveba
SesabamisobaSi modiodes Spricis erTeulebriv
SkalasTan.
unda gakeTdes glikemiis kontroliT. arsebobs
xanmokle da gaxangrZlivebuli moqmedebis insulini.
98
Sokis klinikis dros gamoiyeneba
medikamentebi:
 amrinoni (inokori)
 Amrinoni (inokori)
 dobutamini (dobutreqsi)
 Dobutamini (dobutrexi)
 dofamini (intropini)
 Dopamini (intropini)
 epinefrini (adrenalini)
 Epinephrini (Adrenalini)
 mirlinoni (primakori)
 Mirlinoni (Primakori)
 nitroglicerini (tridili)
 Nitroglycerini (Tridili)
 nitroprisidi (nipridi)
 Nitroprissidi (Nipridi)
 norepinefrini(levopedi)
 Norepinephrini (levopedi)
 fenilefrini
 Plenylefrini(Neo-Synephrini)
 vazopresini(pitresini)
 Vasopressini (Pitressini)
mTavari miTiTebebi:
am medikamentebis
swrafad
Seyvana da
Sewyveta
Aar SeiZleba!!!
gaSvebis wesi:
mxolod calke dozireba
SeiZleba mxolod
infuzomatis
intravenur ganisazRvreba
saSvalebiT. xazSi!!! mikrogramebSi.
Epinefrini-Adrenalini 0.18%-1ml
simpaTomimeturi saSualeba vazokonstriqciuli efeqtiT.

kateqolamini, romelic gamomuSavdeba Tirkmelzeda
jirkvlis tvinovan SreSi
101
Epinefrin-Adrenalini 0.18%-1ml
stresze, iwvwvs sistemur vazokonstriqcias

(sisxlZarRvebis Seviwroveba)
gastrointesticialur relaqsacias
gulis stimulacias
102
Epinefrin-Adrenalini 0.18%-1ml
afarTovebs bronqebis sanaTurs koronalur da cerebrul

sisxlzarRvebs
gamoiyneba gulis gaCerebis da ukmarisobis dros,
asTmuri Setevis dros (inhalaciis saxiT)
lokaluri anesTeziis dros aferxebs saanesTezio
saSualebis Sewovas
103
Epinefrin -Adrenalini 0.18%-1ml
Cveneba:
 asistolia ,pulsgareSe eleqtruli aqtivoba, v.f,
v.t(upulso)simptomaturi bradikardia atropinis Semdgom
infuziis saxiT
mwvave hipotenzia ( dabali arteriuli wneva)
anafilaqsia, mwvave alergiuli reaqcia
104
Epinephrini-Adrenalini 0.18%-
1ml
Ddozireba:
1ml-1 mg – ganzaveba 1:1000 (0.1 % sufTaA
adrenalini)
1ml- 0.1 mg –ganzaveba 1:10 000 (0.1 % 1 ml

ganzavebuli 10 ml fiziologiur xsnarSi)
105
1ml(gagrZ)
i/v da ZvalSida: 1 mg. yovel 3-5 wuTSi Seyvanis Semdeg
CarecxeT 20 ml. fiziologiuri xsnariT da mianiWeT kidurs
maRali pozicia
hemodinamikis montoringi unda xdebodes

mudmivad!!!
106
1ml
epinefrinis gamoyenebisas saWiroa gansakuTrebuli
sifrTxilis gamoCena. arteriuli wnevisa da gulis
cemis sixSiris momatebis gamo SeiZleba
gamowveul iqnes an gaRrmavdes gulis kunTis
iSemia, radgan izrdeba miokardiumis
moTxovnileba Jangbadze.
107
Noradrenalini (norepinefrini, tardi)
simpaTomimeturi saSualebebi:
vazokonstriqciuli efeqtiT
Tirkmelzeda jirkvlis hormonia
organizmSi didi raodenobiT gamoiyofa stresis dros
108
mraval fiziologiur pirocesSi monawileobs, vinaidan
aris simpatikuri nervuli sistemis mediatori.
iwvevs periferiuli arteriebis vazospazms da aseve
nawilobriv venebisasac, iwvevs wnevis momatebas,
samarago zonebidan gadaaqvs glukoza sisxlSi,
aZlierebs ConCxis kunTebSi sisxlis mimoqcevas,.
109
hemodinamikis montoringi unda

xdebodes mudmivad !!!
110
Dophamini 4%-5,0
farmakologiuri moqmdeba:
inotropuli simpaTomimeturi saSualeba
vazokonstriqciuli efeqtiT
aZlierebs gulis cemas, maRla swevs arteriul wnevas da
aumjobesebs Tirkmlis da mezenterialur sisxlis
mimoqcevas.
111
Dophamini 4%-5,0
gamoyeneba:
hipotenziis dros, roca sist. wneva aris 70-100-mde,

rasac Tan erTvis Sokis niSnebi.
simptomuri bradikardiebis dros atropinis Semdeg.
112
Dophamini 4%-5,0
dozireba:
2,5 - 20 mkg/ kg/mn (iv infuziiT)
2,5 - 5 mcg/cg/min aZlierebs gorglovan filtracias ris gamoc

avlens diuretikul efeqts
113
Dophamini 4%-5,0(gagrZ)
5-10 mkg/kgmin axasiaTebs dadebiTi qronotropuli
efeqti anu iwvevs
gulis cemis sixSiris momatebas
10-20 mcg/cg/mn gaaCnia. dadebiTi inotropuli efeqti

anu iwvevs vazokonstriqciasa da arteriuli wnevis
matebas.
114
Dophamini 4%-5,0
medikamentis Seyvana unda moxdes mxolod da mxolod
mikroinfuziis saSualebiT.
 medikamentTan erTad SeiZleba dadgmuli iqanas
adrenalini, dobutamini.
im i.v. xazSi, sadac midis dopaminis infuzia ar xdeba sxva
medikamentebis Seyvana, siTxeebis infuzia/transfuzia
swrafi wveTebiT da sisxlis aReba analizisTvis.
115
Dophamini 4%-5,0(gagrZ)

xdebodes mudmivad !!!
116
Dobutamini (dobutrexi)
inotropuli saSualeba vazokonstriqciuli efeqtiT
gaaCnia dadebiTi inotropuli moqmedeba (aZlierebs
gulis kumSvadobas),
qronotropuli efeqti (zrdis gulis SekumSvaTa ricxvs)
amcirebs periferiul rezistentobas da filtvis arteriis
rezistentobas.
117
gansakuTrebuli MmiTiTeba:
yuradReba misaqcevivia, Tu sistoluri wneva aris 100 ze
naklebi, Sokis niSnebiT;
SeiZleba gamoiwvios taqikardia, Tavis tkivili, gulis reva,
wnevis cvalebadoba.
ar SeiZleba infuzia natriumis bikarbonatTan erTad iv
xazSi
118

xdebodes mudmivad!!!
119
Fenilefrini – mezatoni 1%-1,0
simpaTomimeturi saSualebebi vazokonstriqciuli efeqtiT.
 cxvirSi CawveTebisas aumjobesebs haeris gamavlobas ,
afarToebs gugebs
maRla swevs arteriul wnevas, magram ar iwvevs gulis
cemis sixSiris momatebas.
hemodinamikis montoringi unda xdebodes
mudmivad!!!
120
Fenilefrini – mezatoni 1%-1,0
dozireba:
Iv infuziiT min – 10mcg/min

max– 200mcg/min
121
Nitroglicerini 0, 5%-2,0
gamodis ampulis, abis, spreisa da adheziuri firfitebis
saxiT.
gamoyeneba iSemiuri genezis stenokardiuli Setevis
kupirebisTvis.
advilad Seiwoveba lorwovani garsidan da dauzianebeli
kanidan.
afarToebs koronarul sisxlZarRvebs, bronqebs,
sanaRvle gzebs, Sardgamomyofi sistemis gzebs.
122
gamoiyeneba:
gulis ukmarisobis dros
hipertenziebis, infarqtisa da mwvave koronaruli

sindromis dros.
123
ukuCveneba:
hipotenzia sist.wneva <90mm/hg an normotenziidan

20-39mm/hg-iT dabla;
124
gansakuTrebuli miTieba:
yuradReba miaqcieT hemodinamikas, ar
SeurioT sxva medikamentebTan erTad.
pacienti unda ijdes an unda iwves medikamentis
Seyvanis dros. ar SeanjRrioT aerozoli.
gamoiyeneT Suqgaumtari xazi an Sprici da xazi
gaaxvieT folgaSi.
ixsneba 5%-ian glukozaSi an fiziologiur xsnarSi
125
sublingvalurad:
1tab. 0.3 an 0,4mg _ gaimeoreT 5 wuTis intervalebiT.
maqsimaluri dozaa 1,2 mg.
SeekiTxeT pacients aqvs Tu ara wvis SegrZneba enis qveS,

rac miuTTebs medikamentis vargisianobas.
126
sprei:
erTi an ori Sesxureba 0,5-1 wamis ganmavlobaSi 5
wuTis intervalebiT. maqsimum sami Sesxureba 15
wuTSi. erTi doza Seicavs 0,5mg.
hemodinamikis montoringo unda xdebodes

mudmivad!!!
127
Nitroprusidi (natriumis nitroprusidi)30mgfxvn.
swrafi da xanmokle moqmedebis periferiuli
vazodilatatoria..
gamoiyeneba:
hipertenziuli krizis mwvave marcxena parkuWovani
ukmarisobis, glikozidebisa da Sardmdenebisadmi
rezistentuli gulis qronikuli ukmarisobis dros.
128
Nitroprusidi (natriumis
nitroprusidi)30mgfxvn
dozireba:
0,1-10mkg.kg.wT. hemodinamikis monitoringis qveS.

moqmedebas iwyebs Seyvanidan 2 wuTSi.
129
SeiZleba gamoiwvios hipotenzia da CO2-is Sekaveba,
Tavis tkivili, gulis reva, kolika.
sensitiuria Suqis mimarT, ris gamoc unda SeifuTos
Suqgaumtar qaRaldSi
unda gaixsnas mxolod 5%-ian glukozis xsnarSi.
130
hemodinamikis montoringi unda

xdebodes mudmivad.!!!
131
kalciumis qloridi (CaCL 10%-10,0)
Ggamoiyeneba hipokalciemiis,
hiperkaliemiis samkurnalod
magniumiT intoqsikaciis dros
132

kalciumis qloridi (CaCL 10%-10,0)(gagrZ)
kalciumis arxebis blokatorebiT

intoqsikaciisas gamoiyeneba, rogorc
antidoti, aumjobesebs gulis
kumSvadobas
133
magniumis sulfati
MaSo4 -5,0
Ffarmakologiuri moqmedeba:
parenteruli Seyvanisas axdens sedatiur ,antiariTmul,
hipotenziur da krunCxvis sawinaaRmdego
moqmedebas
gaaCnia bronxodilataciuri efeqti, gamoiyeneba
asTmuri Setevis dros.
preeklamfsiis samkurnalod, naadrevi mSobiarobis
SesaCereblad
134
magniumis sulfati
MaSo4 -5,0
alkoholizmiT daavadebul pacientebSi hipomagnemiis

koreqciis mizniT
135
magniumis sulfati
MaSo4 -5,0
gamoiyeneba:
hipomagnemiis dros;
hipertonuli krizis dros;
preeklamfsiis dros;
ariTmia: torsades de pointesi
krunCxviTi sindromis dros;
asTmuri Setevisas;
136
magniumis sulfati
MaSo4 -5,0
swrafi Seyvanisas iwvevs hipotenzas.
yuradRebiT iniSneba pacientebSi Tirkmlis
ukmarisobiT. radgan ZiriTadad TirkmliT gamoiyofa.
137
sedatiuri, saZile, antikonvulsanturi
saSualeba.
Diazepami (valiumi) 10mg-2,0, 5mg/1,0
Dormikumi ( midazolami, versedi) 3,0
Haloperidoli ( halidoli)
Propofoli-somnopoli (diprivani)
Thiopentali – Na -1g (Tiopentoni, pentoTali)
138
Diazepami (valiumi) 10mg-2,0, 5mg/1,0
sedatiuri, saZile,
antikonvulsanturi saSualeba.
yvela im SemTxvevaSi, roca saWiroa sedacia, aseve
gulyrebis kupirebis mizniT.
diazepamma SeiZleba gamoiwvios sunTqvis centris
daTrgunva.
139
Dormikumi ( midazolami, versedi) 3,0
 dormikumi aris saSualo moqmedebis benzodiazepinis
tipis sedatiuri saSualeba.
gamoiyeneba mtkivneuli procedurebis win.
gansakuTrebuli miTiTeba: gadaWarbebulma
dozirebam SeiZleba gamoiwvios sunTqvis centris
daTrgunva da hemodinamiuri depresia.
140
Dormikumi ( midazolami, versedi) 3,0
Haloperidoli ( halidoli)
neiroleptiuri saSualeba, aseve gaaCnia Zlieri
sedatiuri moqmedeba.
 pacientebSi romlebsac aReniSnebaT Scvlili
cnobiereba.
 unda iqnas gamoyenebuli alkohololuri intoqsikaaciisa
da narkotikebis hiperdozirebis dros.
141
Propofoli-somnopoli (diprivani)
zogadi anesTtikia, aqvs sedaciuri moqmedeba.
Ggamoiyeneba :
mozrdilebsa da bavSvebSi.
iZleva zogadi anesTeziis efeqts iv infuziis
SemTxvevaSi
iZleva xanmokle anesTezias
142
Propofoli-somnopoli (diprivani)
SeiZleba gamoiwvios hipotenzia
respiratoruli depresia
nervuli tonusis cvlilebebi

(distonia)
143
Thiopentali – Na -1g (Tiopentoni, pentoTali)
xanmokle moqmedebis barbituratia zogadi anesteziisaTvis
didi dozebi iwvevs letalur gamosavals
144
Thiopentali – Na -1g (Tiopentoni,
pentotali)
gverdiTi efeqtebi:
iwvevs kardio-respiratorul depresias , hipotenzias da

apnoes
145
Thiopentali – Na -1g (Tiopentoni,
pentotali)
sifrTxilea saWiro periferul venaSi Seyvanisas –
iwvevs flebitebs, lokalur tkivils,
sxva preparatTan Serevisas ileqeba kaTeteris kedlebze
xazi kargad unda Cairecxos Seyvanamde da Seyvanis
Semdeg
gaxangrZlivebuli infuziis SemTxvevaSi gamoiyeneba
mxolod centraluri vena.
146
Arduani _ pipekuronium bromidi;
Ditilini, prakriumi
miorelaqsantia,moqmedebs ConCxis kunTebze da
iwvevs mis relaqsacias.
pacienti medikamentis Seyvanis Semdeg grZnobs
tkivils, esmiT magram ar aqvs moZraobis
SesaZleblobloba
147
opoiduri analgeziuri saSualebebi.
 opoiduri analgeziuri saSualebaa.
gamoiyeneba:
anesTeziisa da analgeziis mizniT.
gverdiTi efeqtebi::
SeiZleba gamoiwvios gulis reva diarea, piris simSrale,
asTenia (sisuste), oflianoba.
148
Morphini h/cl-1%-1,0
farmakoloiduri moqmedeba:
Zlieri opoiduri saSualebaa,
gamoiyeneba:
analgeziis mizniT.
postoperaciulad da yvela im SemTxvevaSi, roca
saWiroa tkivilis kupireba.
149
Morphini h/cl-1%-1,0
gansakuTrebuli moTiTeba:
SeiZleba gamoiwvios sunTqvis centris daTrgunva,
iwvevs hipotenzias. Seyvana unda moxdes nela.
150
???
151
gmadlobT...
152

Medikamentebi, Klasifikaci: Ganzavebebi Da Seyvanis Gzebi

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Medikamentebi, Klasifikaci: Ganzavebebi Da Seyvanis Gzebi

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Mmedikamentebi, klasifikacia,

ganzavebebi da Seyvanis gzebi

 me – 4 Taobis cefalosporinebis jgufis farTo speqtris

 gamoiyeneba profilaqtikis mizniT qirurgiuli operaciis

 zavdeba NNaCl 0,9% - 20ml (iv)

 me-4 Taobis cefalosporinebis jgufis farTo speqtris

 me -3 Taobis cefalosporinebis jgufis farTo speqtris antibiotikia

 moqmedebs rogorc gram+ ise gram - , baqteriaze

 gamoiyeneba mis mimarT mgrZnibare mikroorganizmebiT

 zavdeba: 1g. NaCl 0,9% 20ml.(iv)

 1 Taobis farTo speqtris cefalosporini

 ZiriTadad gamoiyeneba postoperaciul periodSi.

1 gr ganzaveba xdeba NA CL 0.9 % xsnarSi.20 ml

moqmedebs rogorc gram+ ise gram – baqteriaze

Tazocin/tazobactam sodium 4,5g

peporta/tazobactam piperacilin 4,5g

 mikroorganizmebiT gamowveuli sistemuri

 adgilobrivi infeqciur_anTebiTi daavadebi.

i/v infuziisaTvis ganzaveba xdeba NA CL 0.9 %

infuzia mimdinareobs 24 saaTis ganmavlobaSi.(13,5 g

PEROTA 4,5g - farmakologiurad

gamoSvebis forma -0.75g , 1.5g , 3.0 g

zavdeba 1,5 g 20,0 SpricSi iv

 3 g – 50,0 SpricSi. Iv.

makrolidebis jgufis farTo speqtris antibiotikia

baqteriociduli moqmedebis antibiotikebia,

Seyvanis gzebi: intensiuri Terapiis departamentSi

vazavebT 20 ml. NaCl 0.9% xsnarSi

moqmedebis farTo speqtriT

 aqvT baqteriociduli moqmedeba g- baqteriebze

g+ baqteriebis mimarT naklebad aqtiurni arian.

axasiaTebs antimikrobuli moqmedebis momateba g+

antimikrobuli saSualebaa anaerobuli baqteriebisa da

Segvyavs iv 60wT-is ganmavlobaSi

Fluconazol - 50mg,100mg.150mg antimikozuri farTo

Segvyavs iv 60wT-is ganmavlobaSi.

vazavebT 50 ml. NaCl 0.9% xsnarSi

Segvyavs 60 wT-is ganmavlobaSi.

miekuTvneba polimiqsinebis jgufis antibiotikebs.

1 milionis ganzaveba xdeba NA CL 0.9 %

osmosuri diuretikia. izrdeba natriumis da siTxis

nervologiur pacientebSi intrakranialuri

yuradReba unda mieqces pacientis adeqvatur

Aam jgufis medikamentebs ganekuTvneba:

Atropin 0,1% - 1,0

Atropin 0,1% - 1,0 – farmakologiuri

periferuli M-qolino blokeria

amcirebs sanerwyve, bronqul, kuWis, saofle jirkvlebis

aCqarebs gulis riTms

afarTovebs gugebs (TvalSi CawveTebisas)

meore rigis arCeviTi preparatia adrenalinsa da

Segvyavs IV swrafad(2wm) bolusiT(6-12mg) + 20ml

Tu efeqti ar aris, 1-2 wT-Si SeiZleba dozis (12mg)

D digoqsins SeuZlia gamoiwvios sicocxlisaTvis saSiSi

Cordaron(Amiodarone) 150mg/3ml or 200mg ( tb)

IV bolusi -150mg cord+ 7ml D5(Seyvana

IV infuzia 1 doza- 300mg + 50ml D5 24sT-ni

Izoptin(verapamil) 5mg/2ml -2,0

Iv Seyvanisas ar saWiroebs ganzavebas