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  • 發布時間:2021-08-07 11:47 原文鏈接: 不宜與抗生素直接配伍靜滴的藥物匯總

      抗生素與其他藥物在無配伍禁忌的情況下混合靜脈注射是目前臨床上較常用的方法。近年來,隨著國內外新藥不斷問世及對配伍穩定性等問題的研究的不斷深入,發現有不少藥物混合后存在理化或藥理方面的變化,是不宜直接配伍靜脈使用的,為方便臨床廣大醫、藥、護人員及時和正確合理選擇配伍用藥,現將不宜配伍的藥物對整理后列表,以供參考。

        靜脈滴注中不宜與抗生素直接配伍的藥物

        序號  不宜配伍的藥物對                                                                   配伍結果

        青霉素類

        1 氨芐西林-舒巴坦 10%葡萄糖或5%葡萄糖鹽水                     降效,室溫1h失效

        2 氨芐西林-舒巴坦 5%碳酸氫鈉                                              降效,且外觀有乳光

        3 阿洛西林 維生素B6                                                               沉淀

        4 阿洛西林 氨甲苯酸                                                                沉淀

        5 阿洛西林 維生素C                                                                pH變化大于0.2,宜少配伍

        6 阿洛西林 阿米卡星                                                               PH變化大于0.2,宜少配伍

        7 阿洛西林 小諾霉素                                                               PH變化大于0.2,宜少配伍

        8 阿洛西林 慶大霉素                                                               PH變化大于0.2,宜少配伍

        9 阿洛西林 頭孢唑啉                                                               PH變化大于0.2,宜少配伍

        10 阿洛西林 地塞米松                                                             PH變化大于0.2,宜少配伍

        11 阿洛西林 肌苷                                                                     PH變化大于0.2,宜少配伍

        12 氨氯西林鈉 含葡萄糖的輸液                                                降效

        13 氨芐西林鈉 0.5%甲硝唑                                                       變色、沉淀

        14 氨芐西林鈉 慶大霉素                                                          有配伍禁忌

        15 羧芐西林鈉 0.5%甲硝唑                                                      降效

        16 阿莫西林鈉 含葡萄糖的輸液                                               變色、降效(與溫度、時間成正比

    #p#副標題#e#

         頭孢菌素類

        17 頭孢哌酮鈉-舒巴坦鈉 阿米卡星                                            沉淀或降效

        18 頭孢噻肟鈉 甲硝唑磷酸二鈉                                                 4h后瓶底有少量氣泡且溶液顏色變深

        19 頭孢噻肟鈉 5%葡萄糖                                                          (pH小于4.05) 白色渾濁

        20 頭孢噻肟鈉 氟康唑                                                                延遲渾濁、變色

        21 頭孢曲松鈉 復方氯化鈉或復方乳酸鈉                                      乳白色渾濁

        22 頭孢曲松鈉 氨茶堿                                                                  變化、降效

        23 頭孢曲松鈉 氟康唑                                                                   沉淀

        24 頭孢曲松鈉 萬古霉素                                                                沉淀

        25 頭孢曲松鈉 阿米卡星                                                                沉淀或降效

        26 頭孢他定 維生素C                                                                    維生素C含量下降

        27 頭孢他定 氟康唑                                                                      沉淀

        28 頭孢他定 5%碳酸氫鈉                                                             降效

        29 頭孢呋辛 阿米卡星                                                                  有理化配伍禁忌

        30 頭孢哌酮鈉 5%碳酸氫鈉                                                          4h后變色沉淀

        32 頭孢哌酮鈉 奮乃靜                                                                  變色、沉淀

        33 頭孢哌酮鈉 哌替啶                                                                   變色、沉淀

        34 頭孢哌酮鈉 拉貝洛爾                                                                變色、沉淀

    #p#副標題#e#

        其他-內酰胺類

        36 亞胺培南-西司他丁鈉 含乳酸鈉的輸液                                       不相容 氨基糖苷類

        37 卡那霉素 清開靈注射液                                                              立即渾濁

        38 阿米卡星 全靜脈營養液                                                             1h即出現脂肪乳的破乳現象

        39 阿米卡星 林可霉素                                                                     增加藥物毒性反應

        40 阿米卡星 環丙沙星                                                                      變色、沉淀

        41 阿米卡星 青霉素G鈉                                                                   失活

        42 阿米卡星 兩性霉素B                                                                   腎毒性增加

        43 阿米卡星 頭孢拉定                                                                      腎毒性增加

        44 阿米卡星 多粘菌素                                                                      腎毒性增加

        45 阿米卡星 鉑化合物                                                                      腎毒性增加

        46 阿米卡星 呋喃苯胺酸                                                                    耳毒性增加

        47 小諾米星 羧芐西林鈉                                                                     降效

        48 小諾米星 右旋糖酐                                                                        毒性增強

        49 小諾米星 呋喃苯胺酸                                                                      耳毒性增加

        50 奈替米星 維生素C                                                                           降效

        51 奈替米星 呋喃苯胺酸                                                                     腎毒性增加喹諾酮類

        52 環丙沙星 青霉素G鈉                                                                      1h內沉淀

        53 環丙沙星 氨茶堿                                                                             沉淀

        54 環丙沙星 氯林可霉素                                                                       沉淀

        55 環丙沙星 肝素                                                                                不相容

        56 環丙沙星 呋喃苯胺酸                                                                       不相容

        57 環丙沙星 氨芐西林鈉                                                                      沉淀

        58 環丙沙星 復方丹參注射液                                                               沉淀

        59 環丙沙星 乳糖酸紅霉素                                                             紅霉素須先用注射用水溶解加入

        60 氧氟沙星 20%甘露醇                                                                20℃以下時有結晶形成

      #p#副標題#e#

       61 諾氟沙星 氨芐西林                                                                          沉淀

        62 諾氟沙星 苯唑西林                                                                           沉淀

        63 培氟沙星 青霉素G鈉                                                                 1h內沉淀,降效

        64 氟羅沙星 氨茶堿                                                                       嚴重不良反應(何種反應資料未注明

        65 左氧氟沙星 維生素C                                                                pH升高,維生素C微細結構光譜改變

        66 左氧氟沙星 三磷酸腺苷                                                             顯著變化,不能配伍

        大環內酯類

        67 乳糖酸紅霉素 林可霉素                                                              拮抗作用,交叉耐藥

        68 乳糖酸紅霉素 維生素C                                                               應將維生素C稀釋低于

        69 乳糖酸紅霉素 維生素B6                                                            不宜同管注射

        硝咪唑類

        70 甲硝唑抗腫瘤抗生素 呋喃苯胺酸                                                         沉淀

        71 表阿霉素 5%葡萄糖鹽水或復方氯化鈉                                       不溶物呈紅色漂浮狀

        72 表阿霉素 5%或10%葡萄糖                                                                  降效

        73 表阿霉素 17-氨基酸                                                                             降效

        74 表阿霉素 0.5%甲硝唑                                                                            降效

        其他抗菌抗生素

        75 磷霉素 酚磺乙胺                                                                          變色降效,pH改變

        抗病毒藥

        76 阿昔洛韋 含葡萄糖的輸液                                                                       變色

        77 阿昔洛韋 低分子右旋糖酐                                                                       變色

    #p#副標題#e#

        抗真菌藥

        78 氟康唑 兩性霉素B(濃度5mg·ml-1)                                             延遲渾濁,沉淀

        79 氟康唑 氨芐西林鈉(濃度20mg·ml-1)                                         延遲渾濁,沉淀

        80 氟康唑 葡萄糖酸鈣(濃度100mg·ml-1)                                        延遲渾濁,沉淀

        81 氟康唑 頭孢呋新鈉(濃度30mg·ml-1)                                                      沉淀

        82 氟康唑 琥珀氯霉素(濃度20mg·ml-1)                                           氣體生成

        83 氟康唑 磷酸克林霉素(濃度24mg·ml-1)                                                  沉淀

        84 氟康唑 乳糖酸紅霉素(濃度20mg·ml-1)                                                  沉淀

        85 氟康唑 氧哌嗪西林鈉(濃度80mg·ml-1)                                        呈膠狀

        86 氟康唑 呋喃苯胺酸(濃度10mg·ml-1)                                             延遲沉淀

        87 氟康唑 地西泮(濃度5mg·ml-1)                                                                 沉淀

        抗感染植物藥制劑

        88 雙黃連粉針 復方葡萄糖液

          (成分為葡萄糖、氯化鈉、氯化鉀)                                                   降效

        89 雙黃連粉針 阿米卡星                                               &

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