萘夫西林

萘夫西林
临床资料
AHFS/Drugs.com	Monograph
MedlinePlus	a685019
给药途径	肌肉注射, 静脉注射
ATC码	J01CF06 (WHO) ;
法律规范状态
法律规范	处方药（℞-only）;
药物动力学数据
血浆蛋白结合率	90%
药物代谢	<30% 肝
生物半衰期	0.5小时
排泄途径	胆和肾
识别信息
	IUPAC命名法 (2S,5R,6R)-6-[(2-ethoxy-1-naphthoyl)amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid; ;
CAS号	985-16-0
PubChem CID	8982;
DrugBank	DB00607 ;
ChemSpider	8634 ;
UNII	SY07234TTS;
ChEBI	CHEBI:7447 ;
ChEMBL	ChEMBL1443 ;
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)	DTXSID8023343 ;
ECHA InfoCard	100.005.174
化学信息
化学式	C21H22N2O5S
摩尔质量	414.48 g·mol−1
3D模型（JSmol（英语：JSmol））	交互式图像;
	SMILES O=C(O)[C@@H]3N4C(=O)[C@@H](NC(=O)c2c1ccccc1ccc2OCC)[C@H]4SC3(C)C;
	InChI InChI=1S/C21H22N2O5S/c1-4-28-13-10-9-11-7-5-6-8-12(11)14(13)17(24)22-15-18(25)23-16(20(26)27)21(2,3)29-19(15)23/h5-10,15-16,19H,4H2,1-3H3,(H,22,24)(H,26,27)/t15-,16+,19-/m1/s1 ; Key:GPXLMGHLHQJAGZ-JTDSTZFVSA-N ;

萘夫西林钠（英语：Nafcillin sodium）是青霉素类的窄谱^[1]β-内酰胺类抗生素。^[2]作为一种耐β-内酰胺酶的青霉素，它可用于治疗由革兰氏阳性菌引起的感染，尤其是对其他青霉素耐药的葡萄球菌。

萘夫西林被认为在治疗上等同于苯唑西林，尽管一项回顾性研究发现与服用苯唑西林的患者相比，服用萘夫西林的患者低钾血症和急性肾损伤的发生率更高。^[3]

适应症

萘夫西林适用于治疗葡萄球菌感染，但由耐甲氧西林金黄色葡萄球菌引起的除外。^[4]

美国临床实践指南推荐萘夫西林或苯唑西林作为没有人工心瓣患者葡萄球菌性心内膜炎的一线治疗选择。^[5]

副作用

与所有青霉素一样，可能会发生严重的危及生命的过敏反应。

较轻微的副作用包括：

低钾血症^[6]
恶心和呕吐
腹泻，通常是由于正常胃肠道细菌受到抑制，有时会导致更严重的二重感染，如艰难梭菌感染
腹痛
影响口腔和舌头或阴道的酵母菌感染（鹅口疮）
粒细胞缺乏症、中性粒细胞减少症

相互作用

有证据表明萘夫西林诱导细胞色素P450酶，特别是CYP2C9。一些具有窄治疗窗的药物，如华法林和硝苯地平，由CYP2C9代谢。^[7]

萘夫西林含有作为稳定介质添加的盐。这些添加的盐可能会导致水肿或积液。如果担心充血性心力衰竭或肾脏疾病，应避免使用这种药物。^{[来源请求]}

参考资料

^ Palmer DL, Pett SB, Akl BF. Bacterial wound colonization after broad-spectrum versus narrow-spectrum antibiotics. Ann. Thorac. Surg. March 1995, 59 (3): 626–31. PMID 7887701. doi:10.1016/0003-4975(94)00992-9.
^ Tan AK, Fink AL. Identification of the site of covalent attachment of nafcillin, a reversible suicide inhibitor of beta-lactamase. Biochem. J. January 1992, 281 (1): 191–6. PMC 1130660  . PMID 1731755. doi:10.1042/bj2810191.
^ Viehman, J. Alexander; Oleksiuk, Louise-Marie; Sheridan, Kathleen R.; Byers, Karin E.; He, Peimei; Falcione, Bonnie A.; Shields, Ryan K. Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin. Antimicrobial Agents and Chemotherapy. May 2016, 60 (5): 3090–3095. PMC 4862451  . PMID 26976858. doi:10.1128/AAC.03122-15.
^ Pham P, Bartlett JG. Nafcillin. Point-of-Care Information Technology ABX Guide. Johns Hopkins University. January 2, 2009 [2023-03-01]. （原始内容存档于2018-04-16）. Retrieved on July 10, 2009. Freely available with registration.
^ Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. August 2006, 114 (5): e84–231. PMID 16880336. doi:10.1161/CIRCULATIONAHA.106.176857  .
^ JA Mohr. (1979). Nafcillin-associated hypokalemia. JAMA
^ Lang CC, Jamal SK, Mohamed Z, Mustafa MR, Mustafa AM, Lee TC. Evidence of an interaction between nifedipine and nafcillin in humans. Br J Clin Pharmacol. June 2003, 55 (6): 588–90. PMC 1884262  . PMID 12814453. doi:10.1046/j.1365-2125.2003.01789.x.

[pmid7887701-1] Palmer DL, Pett SB, Akl BF. Bacterial wound colonization after broad-spectrum versus narrow-spectrum antibiotics. Ann. Thorac. Surg. March 1995, 59 (3): 626–31. PMID 7887701. doi:10.1016/0003-4975(94)00992-9.

[pmid1731755-2] Tan AK, Fink AL. Identification of the site of covalent attachment of nafcillin, a reversible suicide inhibitor of beta-lactamase. Biochem. J. January 1992, 281 (1): 191–6. PMC 1130660  . PMID 1731755. doi:10.1042/bj2810191.

[3] Viehman, J. Alexander; Oleksiuk, Louise-Marie; Sheridan, Kathleen R.; Byers, Karin E.; He, Peimei; Falcione, Bonnie A.; Shields, Ryan K. Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin. Antimicrobial Agents and Chemotherapy. May 2016, 60 (5): 3090–3095. PMC 4862451  . PMID 26976858. doi:10.1128/AAC.03122-15.

[POC-IT-4] Pham P, Bartlett JG. Nafcillin. Point-of-Care Information Technology ABX Guide. Johns Hopkins University. January 2, 2009 [2023-03-01]. （原始内容存档于2018-04-16）. Retrieved on July 10, 2009. Freely available with registration.

[5] Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. August 2006, 114 (5): e84–231. PMID 16880336. doi:10.1161/CIRCULATIONAHA.106.176857  .

[6] JA Mohr. (1979). Nafcillin-associated hypokalemia. JAMA

[pmid12814453-7] Lang CC, Jamal SK, Mohamed Z, Mustafa MR, Mustafa AM, Lee TC. Evidence of an interaction between nifedipine and nafcillin in humans. Br J Clin Pharmacol. June 2003, 55 (6): 588–90. PMC 1884262  . PMID 12814453. doi:10.1046/j.1365-2125.2003.01789.x.

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