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<http://linked.opendata.cz/resource/sukl/spc/section/SPC136235_doc-5-1>	<http://salt.semanticauthoring.org/ontologies/sdo#hasSectionTitle>	"5.1 Farmakodynamick\u00E9 vlastnosti"@cs .
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<http://linked.opendata.cz/resource/sukl/spc/section/SPC136235_doc-5-1>	<http://salt.semanticauthoring.org/ontologies/sdo#hasText>	"Farmakoterapeutick\u00E1 skupina: Oftalmologika, kortikosteroidy a antiinfektiva v\u00A0kombinaci\nATC k\u00F3d: S01CA01 \nGentadex je oftalmologikum, kombinace aminoglykosidov\u00E9ho antibiotika gentamicinu a steroidn\u00EDho antiflogistika a antialergika, glukokortikoidu dexamethasonu.\nGentamicin je baktericidn\u00ED aminoglykosidov\u00E9 antibiotikum odvozen\u00E9 z Micromonospora purpurea. Jde o sm\u011Bs homologn\u00EDch gentamicin\u016F C1, C2 a C1a  kter\u00E9 maj\u00ED velmi podobnou chemickou strukturu. Gentamicin dosahuje baktericidn\u00EDho \u00FA\u010Dinku v\u00A0prolifera\u010Dn\u00EDm stavu a tak\u00E9 v\u00A0klidov\u00E9m stavu bakterie. V\u00E1\u017Ee se na proteiny 30S podjednotky bakteri\u00E1ln\u00EDch ribozom\u016F a zp\u016Fsobuje \u201Eporuchu \u010Dten\u00ED\u201C informace mRNA. \nSpektrum \u00FA\u010Dinnosti gentamicinu zahrnuje Pseudomonas aeruginosa, stafylokoky, Haemophilus influenzae a tak\u00E9 \u010Dele\u010F enterobacteriaceae (nap\u0159. Escherichia coli, Klebsiella spp., Proteus spp., Shigella spp. a Salmonella spp.). Kmeny streptokok\u016F a anaeroby jsou obecn\u011B rezistentn\u00ED.\nMechanismus rezistence\nRezistence v\u016F\u010Di gentamicinu je p\u0159ev\u00E1\u017En\u011B zalo\u017Eena na modifikaci antibiotika p\u016Fsoben\u00EDm enzym\u016F. Modifikovan\u00E9 antibiotikum se ji\u017E d\u00E1le nev\u00E1\u017Ee na ribozomy. Existuje rozs\u00E1hl\u00E1 zk\u0159\u00ED\u017Een\u00E1 rezistence s\u00A0tobramycinem a \u010D\u00E1ste\u010Dn\u00E1 zk\u0159\u00ED\u017Een\u00E1 rezistence s\u00A0jin\u00FDmi aminoglykosidov\u00FDmi antibiotiky.\nMezn\u00ED hodnoty\nTesty o\u010Dn\u00EDch kapek Gentamicin byly provedeny p\u0159i pou\u017Eit\u00ED b\u011B\u017En\u00FDch s\u00E9ri\u00ED \u0159ed\u011Bn\u00ED gentamicinu. Hodnocen\u00ED v\u00FDsledk\u016F je zalo\u017Eeno na mezn\u00EDch hodnot\u00E1ch pro gentamicin. Byly vyhodnoceny n\u00E1sleduj\u00EDc\u00ED minim\u00E1ln\u00ED inhibi\u010Dn\u00ED koncentrace pro citliv\u00E9, intermedi\u00E1rn\u00ED a rezistentn\u00ED kmeny:\nMezn\u00ED hodnoty EUCAST\nMezn\u00ED hodnoty pro \u010Dele\u010F Enterobacteriaceae a druhov\u011B nespecifick\u00E9 mezn\u00ED hodnoty:\nSenzitivn\u00ED ( 2 mg/l\nIntermedi\u00E1rn\u00ED > 2 - ( 4 mg/l\nRezistentn\u00ED > 4\nMezn\u00ED hodnoty pro Pseudomonas spp. a Acinetobacter spp.:\nSenzitivn\u00ED ( 4 mg/l\nRezistentn\u00ED > 4\nMezn\u00ED hodnoty pro Staphylococcus spp.:\nSenzitivn\u00ED ( 1 mg/l\nRezistentn\u00ED > 1\nMezn\u00ED hodnoty CLSI\nMezn\u00ED hodnoty pro Enterobacteriaceae, Pseudomonas aeruginosa (a jin\u00E9 bakterie mimo \u010Dele\u010F Enterobacteriaceae ) a Staphylococcus spp.:\nSenzitivn\u00ED ( 4 mg/l\nIntermedi\u00E1rn\u00ED 8 mg/l\nRezistentn\u00ED (16\nPrevalence z\u00EDskan\u00E9 rezistence se m\u016F\u017Ee lok\u00E1ln\u011B nebo v\u00A0pr\u016Fb\u011Bhu \u010Dasu li\u0161it. Proto je nezbytn\u00E1 lok\u00E1ln\u00ED informace t\u00FDkaj\u00EDc\u00ED se situace ohledn\u011B rezistence, p\u0159edev\u0161\u00EDm pro adekv\u00E1tn\u00ED l\u00E9\u010Dbu z\u00E1va\u017En\u00FDch infekc\u00ED. V\u00A0p\u0159\u00EDpad\u011B pochybnost\u00ED t\u00FDkaj\u00EDc\u00EDch se lok\u00E1ln\u00ED prevalence gentamicinov\u00E9 rezistence je t\u0159eba konzultovat odborn\u00EDka.\n\u00DAdaje o citlivosti v\u00A0tabulce jsou odvozeny z\u00A0prohl\u00E1\u0161en\u00ED experta. V\u00A0prohl\u00E1\u0161en\u00ED byly analyzov\u00E1ny \u00FAdaje z\u00A0multicentrick\u00E9 studie, kter\u00E1 byla provedena v\u00A0roce 2009 v\u00A0N\u011Bmecku, za \u00FA\u010Delem zhodnocen\u00ED situace ohledn\u011B rezistence r\u016Fzn\u00FDch choroboplodn\u00FDch z\u00E1rodk\u016F v\u016F\u010Di antibiotik\u016Fm u pacient\u016F s\u00A0infekcemi o\u010D\u00ED.\n\uFFFD\n\tObecn\u011B citliv\u00E9 kmeny\n\tAerobn\u00ED grampozitivn\u00ED mikroorganismy\n\tBacillus spp.\n\tCorynebacterium spp.\n\tStaphylococcus aureus (citliv\u00FD na methicillin)\n\tAerobn\u00ED gramnegativn\u00ED mikroorganismy\n\tAcinetobacter baumannii\n\tAcinetobacter Iwoffi\n\tHaemophilus influenzae\n\tHaemophilus parainfluenzae\n\tEnterobacter cloacae\n\tEscherichia coli\n\tKlebsiella oxytoca\n\tKlebsiella penumoniae\n\tMoraxella catarrhalis\n\tProteus mirabilis\n\tPseudomonas aeruginosa\n\tSerratia marcescens\n\tKmeny, u nich\u017E m\u016F\u017Ee z\u00EDskan\u00E1 rezistence zp\u016Fsobit probl\u00E9my pro l\u00E9\u010Dbu\n\tAerobn\u00ED grampozitivn\u00ED mikroorganismy\n\tStaphylococcus aureus (rezistentn\u00ED na methicillin)\n\tStaphylococcus epidermidis\n\tObecn\u011B rezistentn\u00ED kmeny\n\tAerobn\u00ED grampozitivn\u00ED mikroorganismy\n\tEnterococcus spp .\n\tStreptococcus spp .  \n\tAerobn\u00ED gramnegativn\u00ED mikroorganismy\n\tStenotrophomonas maltophilia\nDexamethason je syntetick\u00FD glukokortikoid, se siln\u00FDm antiflogistick\u00FDm, antirevmatick\u00FDm a antialergick\u00FDm \u00FA\u010Dinkem. Sni\u017Euje synt\u00E9zu medi\u00E1tor\u016F z\u00E1n\u011Btu, potla\u010Duje z\u00E1n\u011Btliv\u00E9 a v\u00A0men\u0161\u00ED m\u00ED\u0159e i imunologick\u00E9 reakce. Inhibuje dilataci kapil\u00E1r, hyperemii, ed\u00E9m, exsudaci, migraci leukocyt\u016F, fagocyt\u00E1rn\u00ED aktivitu, proliferaci kapil\u00E1r, tvorbu jizev.\nKombinace obou l\u00E9\u010Div\u00FDch l\u00E1tek v\u00A0p\u0159\u00EDpravku Gentadex o\u010Dn\u00ED kapky m\u00E1 terapeutick\u00FD \u00FA\u010Dinek antibakteri\u00E1ln\u00ED a profylaktick\u00FD. Nadto p\u0159\u00EDtomnost gentamicinu ochra\u0148uje p\u0159ed rizikem mo\u017En\u00E9ho zhor\u0161en\u00ED infek\u010Dn\u00EDho procesu \u00FA\u010Dinkem glukokortikoidu. \n"@cs .
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