萘夫西林

**萘夫西林**
臨床資料
AHFS/Drugs.com	Monograph
MedlinePlus	a685019
給藥途徑	肌肉注射, 靜脈注射
ATC碼	J01CF06 (WHO) ;
法律規範狀態
法律規範	處方藥（℞-only）;
藥物動力學數據
血漿蛋白結合率	90%
藥物代謝	<30% 肝
生物半衰期	0.5小時
排泄途徑	膽和腎
識別資訊
	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編號	985-16-0
PubChem CID	8982;
DrugBank	DB00607 ;
ChemSpider	8634 ;
UNII	SY07234TTS;
ChEBI	CHEBI:7447 ;
ChEMBL	ChEMBL1443 ;
CompTox Dashboard（英語：CompTox Chemicals Dashboard） (EPA)	DTXSID8023343 ;
ECHA InfoCard	100.005.174
化學資訊
化學式	C21H22N2O5S
摩爾質量	414.48 g·mol−1
3D模型（JSmol（英語：JSmol））	交互式圖像;
	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 ;

萘夫西林鈉（英語：Nafcillin sodium）是青黴素類的窄譜^[1]β-內酰胺類抗生素。^[2]作為一種耐β-內酰胺酶的青黴素，它可用於治療由革蘭氏陽性菌引起的感染，尤其是對其他青黴素耐藥的葡萄球菌。

萘夫西林被認為在治療上等同於苯唑西林，儘管一項回顧性研究發現與服用苯唑西林的患者相比，服用萘夫西林的患者低鉀血症和急性腎損傷的發生率更高。^[3]

適應症[編輯]

萘夫西林適用於治療葡萄球菌感染，但由耐甲氧西林金黃色葡萄球菌引起的除外。^[4]

美國臨床實踐指南推薦萘夫西林或苯唑西林作為沒有人工心瓣患者葡萄球菌性心內膜炎的一線治療選擇。^[5]

副作用[編輯]

與所有青黴素一樣，可能會發生嚴重的危及生命的過敏反應。

較輕微的副作用包括：

低鉀血症^[6]
噁心和嘔吐
腹瀉，通常是由於正常胃腸道細菌受到抑制，有時會導致更嚴重的二重感染，如艱難梭菌感染
腹痛
影響口腔和舌頭或陰道的酵母菌感染（鵝口瘡）
粒細胞缺乏症、中性粒細胞減少症

相互作用[編輯]

有證據表明萘夫西林誘導細胞色素P450酶，特別是CYP2C9。一些具有窄治療窗的藥物，如華法林和硝苯地平，由CYP2C9代謝。^[7]

萘夫西林含有作為穩定介質添加的鹽。這些添加的鹽可能會導致水腫或積液。如果擔心充血性心力衰竭或腎臟疾病，應避免使用這種藥物。^{[來源請求]}

參考資料[編輯]

^ 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]. （原始內容存檔於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]. （原始內容存檔於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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