Nafsilin

Nafsilin
Nama sistematis (IUPAC)
	asam (2S,5R,6R)-6-[(2-etoksi-1-naftoil)amino]-3,3-dimetil-7-okso-4-tia-1-azabisiklo[3.2.0]heptana-2-karboksilat
Data klinis
AHFS/Drugs.com	monograph
MedlinePlus	a685019
Kat. kehamilan	B(US)
Status hukum	℞ Preskripsi saja
Rute	IM, IV
Data farmakokinetik
Ikatan protein	90%
Metabolisme	<30% (hati)
Waktu paruh	0,5 jam
Ekskresi	Empedu dan ginjal
Pengenal
Nomor CAS	985-16-0
Kode ATC	J01CF06
PubChem	CID 8982
DrugBank	DB00607
ChemSpider	8634
UNII	SY07234TTS
ChEBI	CHEBI:7447
ChEMBL	CHEMBL1443
Data kimia
Rumus	C21H22N2O5S
SMILES	eMolecules & PubChem
	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 ;

Nafsilin adalah antibiotik laktam beta spektrum sempit^[1]^[2] dari golongan penisilin. Sebagai penisilin yang resistan terhadap beta-laktamase, obat ini digunakan untuk mengobati infeksi yang disebabkan oleh bakteri Gram-positif, khususnya spesies Staphylococcus yang resistan terhadap penisilin lainnya.

Nafsilin dianggap setara secara terapeutik dengan oksasilin, meskipun satu studi retrospektif menemukan tingkat hipokalemia dan gagal ginjal akut yang lebih tinggi pada pasien yang mengonsumsi nafsilin dibandingkan dengan pasien yang mengonsumsi oksasilin.^[3]

Indikasi

Nafsilin diindikasikan dalam pengobatan infeksi Staphylococcus, kecuali yang disebabkan oleh MRSA.^[4]

Pedoman praktik klinis AS merekomendasikan nafsilin atau oksasilin sebagai pengobatan lini pertama pilihan untuk endokarditis Staphylococcus pada pasien tanpa katup jantung buatan.^[5]

Efek samping

Efek samping yang lebih ringan meliputi:

Hipokalemia^[6]
Mual dan muntah
Diare, sering kali disebabkan oleh penekanan bakteri saluran pencernaan normal, yang terkadang menyebabkan superinfeksi yang lebih serius dengan organisme seperti Clostridioides difficile
Nyeri perut
Infeksi khamir (kandidiasis) yang menyerang mulut dan lidah atau vagina
Agranulositosis, neutropenia

Interaksi

Terdapat bukti bahwa nafsilin menginduksi enzim sitokrom P450, khususnya CYP2C9. Beberapa obat dengan jendela terapi sempit seperti warfarin dan nifedipin dimetabolisme oleh CYP2C9.^[7]

Referensi

^ Palmer DL, Pett SB, Akl BF (March 1995). "Bacterial wound colonization after broad-spectrum versus narrow-spectrum antibiotics". The Annals of Thoracic Surgery. 59 (3): 626–631. doi:10.1016/0003-4975(94)00992-9 . PMID 7887701.
^ Tan AK, Fink AL (January 1992). "Identification of the site of covalent attachment of nafcillin, a reversible suicide inhibitor of beta-lactamase". The Biochemical Journal. 281 (Pt 1): 191–196. doi:10.1042/bj2810191. PMC 1130660 . PMID 1731755.
^ Viehman JA, Oleksiuk LM, Sheridan KR, Byers KE, He P, Falcione BA, Shields RK (May 2016). "Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin". Antimicrobial Agents and Chemotherapy. 60 (5): 3090–3095. doi:10.1128/AAC.03122-15. PMC 4862451 . PMID 26976858.
^ Pham P, Bartlett JG (January 2, 2009). "Nafcillin". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved on July 10, 2009. Freely available with registration.
^ Bonow RO, Carabello BA, Kanu C, de Leon AC, Faxon DP, Freed MD, et al. (August 2006). "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. 114 (5): e84–231. doi:10.1161/CIRCULATIONAHA.106.176857 . PMID 16880336.
^ Mohr JA, Clark RM, Waack TC, Whang R (August 1979). "Nafcillin-associated hypokalemia". JAMA. 242 (6): 544. doi:10.1001/jama.1979.03300060046028. PMID 448989.
^ Lang CC, Jamal SK, Mohamed Z, Mustafa MR, Mustafa AM, Lee TC (June 2003). "Evidence of an interaction between nifedipine and nafcillin in humans". British Journal of Clinical Pharmacology. 55 (6): 588–590. doi:10.1046/j.1365-2125.2003.01789.x. PMC 1884262 . PMID 12814453.

[pmid7887701-1] Palmer DL, Pett SB, Akl BF (March 1995). "Bacterial wound colonization after broad-spectrum versus narrow-spectrum antibiotics". The Annals of Thoracic Surgery. 59 (3): 626–631. doi:10.1016/0003-4975(94)00992-9 . PMID 7887701.

[pmid1731755-2] Tan AK, Fink AL (January 1992). "Identification of the site of covalent attachment of nafcillin, a reversible suicide inhibitor of beta-lactamase". The Biochemical Journal. 281 (Pt 1): 191–196. doi:10.1042/bj2810191. PMC 1130660 . PMID 1731755.

[3] Viehman JA, Oleksiuk LM, Sheridan KR, Byers KE, He P, Falcione BA, Shields RK (May 2016). "Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin". Antimicrobial Agents and Chemotherapy. 60 (5): 3090–3095. doi:10.1128/AAC.03122-15. PMC 4862451 . PMID 26976858.

[POC-IT-4] Pham P, Bartlett JG (January 2, 2009). "Nafcillin". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved on July 10, 2009. Freely available with registration.

[5] Bonow RO, Carabello BA, Kanu C, de Leon AC, Faxon DP, Freed MD, et al. (August 2006). "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. 114 (5): e84–231. doi:10.1161/CIRCULATIONAHA.106.176857 . PMID 16880336.

[Mohr_1979-6] Mohr JA, Clark RM, Waack TC, Whang R (August 1979). "Nafcillin-associated hypokalemia". JAMA. 242 (6): 544. doi:10.1001/jama.1979.03300060046028. PMID 448989.

[pmid12814453-7] Lang CC, Jamal SK, Mohamed Z, Mustafa MR, Mustafa AM, Lee TC (June 2003). "Evidence of an interaction between nifedipine and nafcillin in humans". British Journal of Clinical Pharmacology. 55 (6): 588–590. doi:10.1046/j.1365-2125.2003.01789.x. PMC 1884262 . PMID 12814453.

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