"Endoksan": imiyalelo yokusetyenziswa, ukuphononongwa, iimveliso ezifanayo, umenzi

Isilwayo "i-Endoksan" sinye yeqela le-antitumour agents. Ngokuxhomekeke kwindlela yokukhululwa, inokuthi ithathwe ngomlomo okanye ngesibindi. Yiyiphi uhlobo lwesicatshulwa ekumiselweyo kunye naluphi na umlinganiselo, ugqirha kuphela oya kugqiba, ukuxhomekeka kwiimeko zangempela zesigulane.

Ukubunjwa kunye neepropati zokulungiselela

Isisombululo esisisiseko sonyango "Endoxane" imiyalelo yokusetyenziswa kwee-cyclophosphamide. Kwelinye ipilisi liqukethe 50 mg. Isilwanyana siseqela lezilwanyana ezichasayo kunye neepilisi ze-biconvex ezinegobolondo elimhlophe kunye nengundoqo ye-hue efanayo. Njengengxenye eyongezelelweyo, le mveliso yeyeza iqukethe i-calcium carbonate kunye ne-hydrophosphate, i-caramellose ye-sodium, i-glycerol, i-gelatin, i-lactose, isitashi sommbila, i-macrogol, i-stediate yamagesi, i-polysorbate, i-sucrose, i-talc, i- silica kunye ne-titanium.

Iyintoni i-pharmacology yeziyobisi?

Isisombululo esisisigxina seziyobisi, oko kukuthi i-cyclophosphamide, ine-effect alkylating kunye ne-cytostatic. Ngokwemvelo yayo, isondele kwerhasi yetshedi, ngokuba yi-analogue yayo.

Indlela yokwenza i-cyclophosphamide isekelwe ekubunjweni kwamanqamlezo phakathi kwe-DNA kunye ne-RNA molecule kunye nokunciphisa ukuhlanganiswa kwamalungu eeprotheni.

Pharmacokinetics yeziyobisi

Isisombululo esisisiseko sonyango "i-Endoksan" sele sinomyinge opheleleyo wokuxutywa kwimizila yesisu. Ukugxininiswa kwigazi emva kokulawulwa komlomo kunye nokunyanzeliswayo kuyafana. I-metabolism ye-cyclophosphamide ivela ngokuyinhloko kwisibindi, apho i-microsomal i-microsomal ikhiqiza i-alkylating metabolites. Ezinye zazo ziguqulwa zibe ngamafomu angasebenzi, elinye iqela liya kwiiseli apho, phantsi kwezenzo ze-enzyme, i-phosphatases ziguqulwa zibe yimpahla ene-cytotoxic.

Iqondo lokubopha ifom yokuqala kwipilisi kwiiprotheni zegazi alibalulekanga kwaye i-12-14%. Nangona kunjalo, isalathisi esifanayo kwi-metabolites isele i-60%.

I-excretion ye-cyclophosphamide iveliswa yizintso ikakhulukazi ngendlela ye-metabolites. Phantse i-5-25% yesichengiselwano ikhutshwe kwifomu yayo yasekuqaleni kunye nomchamo kunye ne-bile.

Ipharamitha ye-T1 / 2 yeliyobisi iinyanga ezingama-7 kwizigulane zabantu abadala kunye neeyure ezingama-4 kubantwana.

Kuphi umthamo ukuthatha amayeza?

Isilwanyana "I-Endoxan" kwifom yefowuni ithathwa ngomlomo phambi kokutya kwisigamu seyure okanye emva kokutya, emva kweeyure ezimbini.

Ngenxa yokuba le mveliso yonyango ifakiwe kwinani elikhulu leemichimo ze-chemotherapeutic, ukukhethwa kwendlela yokulawula kunye neeritha kuthathwa njengogqirha ngabanye.

"I-Endoxane" - iipilisi - umyalelo uncoma ukuthatha umyinge we-1-3 mg / kg weesisindo somzimba ngemini, engama-50 ukuya kwi-200 mg ye-cyclophosphamide iiyure ezingama-24. Ubude bonyango lweeveki ezingama-2-3.

Ukuba isicatshulwa sithathwa kunye nezinye iziyobisi ezinesakhiwo se-tumor, ngoko umlinganiselo wazo zonke izicwangciso zonyango zixhomekeke ekulungiseni.

Ngaba kunokugqithisa?

Ubukho be-antidote ethile yezilwanyana "Imfundiso ye-Endoxan" yokusetyenziswa ayiqinisekisi. Xa kunesidingo esiphezulu se-dose efunekayo, kucetyiswa ukuba kusetyenziswe unyango lwamayeza ngendlela yokwelashwa okufanelekileyo kwezifo ezithathelwanayo, ukususwa kwe-cardiotoxicity kunye nokupheliswa kweempawu zokutshutshiswa.

Liyintoni na isiyobisi kunye nezinye iziyobisi?

Ukuba isigulane sithatha iziyobisi ezikhupha i-microsomal oxidation kwisibindi, ngoko xa ilawulwa ngokubambisana ne-Endoxan ukulungiselela, umyalelo ubonisa ukwanda kwe-metabolites kunye nomsebenzi wokuqhelanisa, ukuhla kwe-half-life of cyclophosphamide kunye nokwanda kwempumelelo yayo.

Le nkunkuma igxotha umsebenzi we-cholineterase kunye neendlela zokuxhamla kwe-cocaine, ukwandisa utyhefu, kunye nokwandisa ukusebenza kwe-suxamethonium.

Ukuba "i-Endoxan" isetyenziswe ngokubambisana ne "Allopurinol", ke kukho impembelelo eyongeziweyo emnxeni wethambo.

Kwimeko yonyango olufanayo kunye ne-cyclophosphamide, colchicine, probenecid, sulfinpyrazone, ugqirha ngokuqhelekileyo ulungisa idosa yezilwanyana ezinxamnye ne-gout. Oku kuhambelana nomngcipheko okhulayo wokuphuhlisa i-nephropathy kunye nokusetyenziswa ngokubambene kwe "Endoxan" ngamachiza e-uricosuric.

I-Cyclophosphamide inciphisa ukuhlanganiswa kwezinto ezinobindi, ezijongene nokucima kunye nokwakhiwa kwamaplatelets, ngoko ke unyango olufanayo kunye ne-anticoagulants, umsebenzi wezo zinto ziyancipha.

Kwizigulane ezithatha i-ENDOXAN, imiyalelo yokusetyenziswa iyincoma ukukhutshwa kwejusi yamagilebhisi ekudleni, njengoko iqulethe izinto eziphazamisa ukusebenza kunye nokusebenza kwesithako esisebenzayo samachiza.

Xa ulawulo lwe-cyclophosphamide ne-Doxorubicin okanye i-Daunorubicin, ifuthe le-cardiotoxic lala machiza landa.

Ukudibanisa namanye ama-immunosuppressants, afana ne "Azathioprin", "Cyclosporine", "Chlorambucil", "GCS", "Mercapturin" ibangela ukunyuka kwezifo kunye nezicubu zesibini.

Kwimeko yokusetyenziswa okuhlangeneyo kwe-Endoxan kunye ne-Lovastine kwizigulane ezineentsholongwane zentliziyo, kunokukho umngcipheko we-necrosis wezihlunu zamathambo kunye nokungaphumeleli kwe-renal kwifom elula.

Ukuba unyango kunye ne-cyclophosphamide ludibaniswe ne-myelosuppressants okanye i-radiotherapy, ngoko kunokwenzeka ukwandisa ukukhutshwa komnatha we-bone.

Ukwamkela ngokufanayo "i-Endoxan" kunye namazinga aphakamileyo e-cytarabine ngexesha lokulungiselela ukulungelelanisa umongo we-bone ukunyusa iziganeko zentsholongwane yegazi kunye nesiphumo esibulalayo.

Le nkunkuma ithintela njani umsebenzi wokuzala?

Isilwayo "i-Endoxane", ukuhlolwa kwezigulane kukuqinisekisile oku, kunokubangela ukunyanzeliswa kwezigulane zesini, ezingenakuphikiswa.

Kwiimeko ezininzi, abafazi bane-amenorrhea, kodwa ukuhamba kwimizi ngokuqhelekileyo kufumana iinyanga eziliqela emva kokuphela kokonyango nge-cyclophosphamide. Ukuba unyango luyenziwe kumantombazana ebudeni bokuqala, kwakungekho nxaxhiso ekuphuhlisweni kokubonakaliswa kwezesondo zesibini. Ukuya esikhathini kwakuqhelekileyo, ukukwazi ukukhulelwa akuzange kulahleke.

Xa uphatha amadoda nge-Endoxan, umyalelo ubonisa ukuba i-azoospermia okanye i-oligospermia yabhalwa kwiimeko ezininzi. Oku kungenxa yokuveliswa kwemveliso ye-gonadotropins ngesantya sokukhutshwa kwe testosterone. Umgangatho we-libido kunye nobuchule kumadoda awuncipha. Ukuba unyango kunye ne-cyclophosphamide lwenziwa ngamakhwenkwe ebudeni bokuqala, ngokokubonakaliswa kwezesondo zesibini akuqhubekanga ngendlela eqhelekileyo. Nangona kunjalo, iimeko ze-azoospermia, i-oligospermia kunye nokwanda kwe-gonadotropins zaphawulwa. Kwakhona, i-atrophy yamathambo angenzeka. Kufuneka kuqatshelwe ukuba i-azoospermia iyakuguqulwa, nangona ukubuyiswa kwalo msebenzi kungenzeka emva kweminyaka emininzi emva kokuphela kokonyango.

Ziyiphi imiphumo emibi eyenziwa yiziyobisi?

Ukwamkelwa kwesilwanyana "i-Endoxane", umyalelo wokusetyenziswa uqinisekisa oku, kunokubangela ukuphulwa kweenkqubo ze-hematopoiesis:

• I-Leukopenia, i-neutropenia - kaninzi.
• Engaqhelekanga yintsholongwane ye-anemia kunye ne-thrombocytopenia.

Emva kweveki ezi-1-2 ukususela ekuqaleni kokunyanga, isigulane sinokunciphisa kakhulu kwi-leukocyte kunye neeplatelet egazini. Ezi zikhombisi zibuyiselwa kwizinto eziqhelekileyo emva kweentsuku ezingama-7-10 emva kokuphela kweyeza.

Xa unyango lwe-cyclophosphamide, kunokuba neempembelelo ezimbi kwiphepha lomzimba:

• Isihlunu kunye nokuhlanza.
• Anorexia.
• Stomatitis.
• Ubuhlungu kwindawo yesisu.
• Ukugqithiswa kwesitulo.
• Jaundice.
• Hemorrhagic colitis.

Ngokuqhelekileyo, ukungasebenzi kwesibindi kuhambelana nokunyuka kwenzeni ye-enzyme kunye nokwanda kwinqanaba le-bilirubin. Kwiqela elihle kakhulu lezigulane ezine- anemia ye-aplastic kwaye zifumana amanqanaba aphezulu e-"Endoxan" okanye ukudibanisa ne-busulfan, i-endophlebitis yesibindi sesibindi iyaqatshelwa. Le ngxaki inokuphuhlisa iiveki ezi-1-3 emva kokutsalwa komongo wethambo kwaye ibonakaliswe ngokunyuka okuthethekileyo kwisisindo somzimba, ascites, hepatomegaly kunye ne-hyperbilirubinemia, i-encephalopathy ye-hepatic.

Xa uthatha isibisi, iimpendulo ezingafunekiyo kwesikhumba ziyakwenzeka:

• I-alopecia ebuyiswayo.
• Rash.
• Ukuguquka kwesibonda kunye nezipikili.

Ukuphazamiseka kwenkqubo ye-urinary ngexesha lotyando ne-Endoxan linokucaphuka. Umyalelo, ukuhlolwa koogqirha kunye nezigulane kubonisa le miqathango ilandelayo:

• I-Cystitis inxulumene ne-fibrosis ye-bladder (okanye ngaphandle kwayo).
• I-urethritis enegazi.
• Iziganeko ze-Necrotic ze-tubal ye-renal ukuya kwisiphumo esibulalayo.

Kwisisombululo, isigulane sinakho i-epithelium ye-bladder. Ukuba uhlobo lwe- cystitis enomzimba lukhulu , isilwanyana simisiwe. Into efanelekileyo yokuthintela le meko yileyeza "Mesna". Ukuba ukunyuka kwe "Endoxan" kwanda, i-kidney disysction in the form of nephropathy kunye ne-hyperureukemia ingahlakulela.

Ukuba isigulane sinomlinganiselo onzima wokuzikhusela komzimba, i-cyclophosphamide enamandla ingaphathwa ngeentsholongwane ezinzulu.

Iziphumo ezilandelayo ziyakhula:

• I-cardiotoxicity (xa uthatha amanani aphezulu), iidridi ezinzima zokwahluleka kwentliziyo.
• I-pulmonary fibrosis yendalo.
• Ukuphulwa kwe-oogenesis evamile kunye ne-spermatogenesis, ukuguqulwa nokuguguleka.
• Ukuphuhliswa kwezilwanyana zesibini: umhlaza wesisu, imyeloproliferation kunye ne-lymphoproliferation.
• I-allergies ngendlela yokugqithisa, ukubetha, ukuvumba, ngamanye amaxesha ngohlobo lwe-anaphylactic reaction.
• Ukuphulukiswa koluhlungu kakubi.
• Ubomvu obusweni, ukwandisa ukujuluka, intloko.

Ubukho beempembelelo ezibi kakhulu ekuthathweni kwesi sigqirha kuphakamisa umbuzo wezibonelelo ezinokwenzeka malunga neengozi zengxaki yomntu omnye.

Ziziphi izifo ezibekwe eli chiza?

Iipilisi ze-Endoxan zinganikwa isigulane ukuba zizifo ezi zilandelayo:

• Lymphogranulomatosis.
• Myeloma ezininzi.
• Umhlaza wesifuba.
• I-lymphoblastic leukemia ye-lymphatic form in ail or chronic form.
• I-Lymphomas ye-non-Hodgkin.
• Retinoblastoma.
• Neuroblastoma.
• I-Mycosis fungoid.

Ubonisa ukwamkelwa kwemfundiso kwi-anti-carcinogenicyrgyic complex in applied to Endoxan preparation. Umvelisi uncoma ukuba ifakwe kwonyango lomhlaza wesibeleko kunye nesifo sobhanja, i-oncology yemiphunga kunye ne-prostate gland, i-sarcoma kunye ne-reticulosarcoma, isifo se-Ewing nesi-Wilms.

Isiza esekelwe kwi-cyclophosphamide singasetyenziswa njenge-immunosuppressant kwizifo ezizimelayo zolu hlobo lwe-progression: i-psoriatic ne-rheumatoid arthritis, i-hemolytic anemia, i-collagenosis, i-nephrotic syndrome, kunye nokuphepha ukulahlwa.

Liyiphi na into ephikisayo?

Isidakamizwa se-Endoxan sinokuchasene ezininzi, phakathi kwazo:

• Ukukhulelwa kunye nokulahlwa.
• Cystitis.
• Izifo ezinokusebenza.
• Ukuphazamiseka komsebenzi wethambo lomnxeba wefom eyaziwayo.
• Ubuninzi be-hypersensitive to the main and additional substances of the drug.
• Ukucima ukucheba.

Unonophelo olukhethekileyo, oogqirha banika le nkunkuma kwisifo senhliziyo, iinjongo kunye nesibindi se-degree degree, gout, i-adrenalectomy, ubukho beenkqubo zokungena ngaphakathi emnxeni wethambo, nephrourolythiasis.

Imiyalelo ekhethekileyo yokonyango

Ngexesha lokumkela isilwanyana "Endoksan", igazi (ingxube yeeplatelet kunye neutrophils) kunye nomchamo (ubukho be-erythrocytes) zesigulane bancike ekulawuleni okugunyazayo.

Kwezinye iimeko, kucetyiswa ukuba i-Endoxan ikhutshwe. Imiyalelo yokusetyenziswa kwebhebhile incoma ukwenza oku phantsi kwezi zilandelayo:

• Ukubonakaliswa kwe-cystitis.
• Ukunciphisa i-leukocytes kunye neeplatelets ezixabisekileyo.
• Ukuvela kwezifo (ukulungiswa kobuchule kunokwenzeka).

Ukuba "i-Endoxan" isetyenziswe kwizilingo ezinkulu, isigulane sichazwe imithi "Mesna" yokuthintela i-cystitis yolu hlobo olushushu.

Xa uphathwe lesi sidakamizwa kufuneka ugweme ukusela utywala kwaye usebenzise iindlela ezinokuthenjwa zokukhulelwa.

Ukuba isigulane sinikwe "i-Endoxane" kwisithuba seentsuku ezili-10 emva kokusebenza kunye ne-anesthesia jikelele, ngoko-anesthesiologist yaziswa malunga nayo.

Emva kwe-adrenalectomy, ukulungiswa kwenzalo ye "Endoxan" kunye namanye amalungiselelo e-GCS kwenziwa.

Ezifana neziyobisi

Ukuba kukho iingqinisiso ezinzulu kunye neengozi, ke unikezela ukwenqaba ukuthatha imithi "Endoxan". Iingxoxo zogqirha zinokumiselwa ngugqirha njengendlela efanelekileyo. Phakathi kwazo:

• "Ledoksin."
• "Cyclophosphane".
• "Cytoxan".
• "Cyclophosphamide - Teva."
• Cyclophosphane-Lance.
• Endoxan - ASTA.

Le ngcaciso yinguqulelo elula yemiyalelo ye-Endoxan yokulungiselela. Isigulana sale mayeza senziwa kuphela ngudokotela oya kwiindawo.