"Endoxane": malangizo ntchito, Akhristu enieni, wopanga

Mankhwala "endoxane" amatanthauza gulu la wothandizira odana ndi chotupa. Malinga mawonekedwe a kumasulidwa kuti angathe kuperekedwa kuwauza kapena parenterally. Kodi mtundu wa mankhwala akapitawo ndi mlingo chimene, zochimwazo kumathetsa dokotala kokha pamaziko a zochitika zenizeni za mmene alili.

Kapangidwe ndi katundu wa mankhwala

Waukulu yogwira pophika mankhwala "endoxane" malangizo ntchito amatanthauza cyclophosphamide. piritsi limodzi lili 50 mg wa izo. mankhwala akutchula gulu la mankhwala antitumor ndipo ndi miyala biconcave ndi envelopu woyera ndi maziko a hue chomwecho. zigawo zikuluzikulu monga zina yogwira mankhwala mankhwala kupanga kashiamu carbonate ndi mankwala a hydrogen, sodium karamellozu, glycerol, gelatin, lactose, wowuma chimanga, macrogol, magnesium stearate, polysorbate, sucrose, talc, silika ndi titaniyamu.

ndi mankhwala mankhwala chiyani?

Waukulu yogwira mankhwala mankhwala, ndicho cyclophosphamide, alkylating ndipo lili ndi zotsatira cytostatic. Ndi chikhalidwe chake, chiri pafupi mpweya mpiru, asafe kukhala analogue ake.

Limagwirira cha zochita za cyclophosphamide potengera mapangidwe crosslinks pakati mamolekyulu DNA ndi RNA ndi mapuloteni kaphatikizidwe kupondereza matupi.

The pharmacokinetics mankhwala

Waukulu yogwira pophika "endoxane" mankhwala ali digiri pafupifupi absorbability kwa mundawo m'mimba. ndende zake magazi pambuyo makonzedwe m'kamwa ndi mtsempha ali ofanana. Cyclophosphamide kagayidwe kumachitika makamaka chiwindi, kumene mchikakamizo cha limagwirira microsomal oxidase ndi mapangidwe yogwira alkylating metabolites. Ena n'kukhala mitundu wofooka, gulu lina linasamukira maselo, kumene kanthu enzymatic wa phosphatases lidzasinthidwa zinthu ndi katundu cytotoxic.

Mlingo wa ankameteramo ubweya wa mawonekedwe choyambirira cha mankhwala ndi mapuloteni magazi ndi negligible ndi 12-14%. Komabe, chizindikiro chomwecho cha metabolites kale wofanana 60%.

cyclophosphamide umatulutsa excretion aimpso makamaka mu mawonekedwe a metabolites. Pafupifupi 5-25% ya mankhwala ndi excreted mu maonekedwe ake apachiyambi mu mkodzo ndi ya ndulu.

Chizindikiro T1 / 2 mankhwala liri maola 7 akuluakulu ndi maola 4 ana.

Kodi mlingo kuti makhwalawa?

Mankhwala "endoxane" mu mawonekedwe piritsi anatengedwa pakamwa musanadye kapena theka la ola pambuyo kudya, pambuyo maola 2.

Chifukwa chakuti mankhwala mankhwala m'gulu kuchuluka kwa regimens chemotherapeutic, kusankha akafuna oyendetsa mlingo dokotala ankaona payekha.

"Endoxan" - piritsi - kalozera akuonetsa mlingo 1-3 mg / kg pa thupi patsiku, umene zingakhale za 50 200 mg cyclophosphamide kwa maola 24. Kutalika kwa mankhwala masabata 2-3.

Ngati mankhwala akutengedwa pamodzi ndi mankhwala ena amene ali ndi katundu odana ndi chotupa mlingo wa mbali zonse za mankhwala amaloŵamo uphungu.

Kodi pali ambiri osokoneza?

Pamaso pa adakalibe yeniyeni pokonza "endoxane malangizo ntchito si anatsimikizira. Mu nkhani ya choposa mlingo anakhumba akulimbikitsidwa mankhwala yokonza monga chithandizo choyenera cha matenda opatsirana, achire zizindikiro cardiotoxicity ndi myelosuppression kuwonongedwa.

Ngati mankhwala ali pamodzi ndi mankhwala ena?

Ngati wodwala amatenga njira n'zothandiza microsomal makutidwe ndi okosijeni mu chiwindi, ndiye ophatikizana chithandizo ndi mankhwala "endoxan" malangizo chikusonyeza bwino kaphatikizidwe metabolites ntchito alkylating, utachepa theka moyo wa cyclophosphamide ndi Kuonjezera cangu ake.

Izi mankhwala kumabwezera mmbuyo ntchito cholinesterase ndi kagayidwe kachakudya njira cocaine, kuwonjezeka kawopsedwe ake, ndi kumawonjezera dzuwa la suxamethonium.

Ngati "endoxane" ntchito limodzi ndi "Allopurinol" kuti pali kuchuluka zotsatira zake zoipa m'mafupa.

Pankhani ya chithandizo munthawi yomweyo ndi cyclophosphamide, colchicine, probenecid, sulfinpyrazone dokotala zambiri likukonza kumwa mankhwala mankhwala odana ndi gout. Izi amagwirizana ndi chiopsezo cha nephropathy mu olowa ntchito "endoxane" ndi mankhwala uricosuric.

Cyclophosphamide kumachepetsa kaphatikizidwe zinthu mu chiwindi, ndi udindo clotting magazi ndi kupanga kupatsidwa zinthu za m'mwazi Komabe, pamene mankhwala ndi anticoagulants amachepetsa ntchito ya masika.

Odwala kutenga mankhwala "endoxan" malangizo Buku akuonetsa zakudya osaphatikiza manyumwa madzi, popeza muli zigawo zikuluzikulu zimene zimaipitsa kutsegula Mwachangu ndi waukulu yogwira pophika medicament lapansi.

Pamene Co-kutumikiridwa ndi cyclophosphamide "Doxorubicin" kapena "daunorubicin" ndi nakweza zotsatira cardiotoxic mankhwala.

Mothandizana ndi immunosuppressants ena, monga "Azathioprine" "Tacrolimus", "Chlorambucil", "SSC", "Merkapturin" amatsogolera ndi kuwonjezeka pakutchulidwa matenda zasekondale ndi mtundu chotupa.

Pankhani ya ntchito olowa "endoxane" ndi "Lovastina" odwala ndi mtima kupatsidwa zina angakhale pangozi rhabdomyolysis ndi kulephera aimpso mu mawonekedwe pachimake.

Ngati mankhwala ndi cyclophosphamide pamodzi mielosupressantami kapena ndi mankhwala dzuwa, ndi adzapeze ugneeniya mafupa ntchito.

Munthawi yomweyo phwando "endoxan" ndi cytarabine apamwamba mlingo pa mwai kukonzekera kwa mafupa kupatsidwa zina kumawonjezera zochitika za cardiomyopathy amapha.

Kodi mankhwala pa ntchito ubereki?

Mankhwala "endoxane" umboni mtima kutsimikizira izo, kungakhale sterility odwala a amuna ndi akazi, omwe mwina sizingasinthe.

Nthawi zambiri, akazi amenorrhea zikachitika, koma kusamba mosalekeza zambiri achire m'miyezi yochepa mankhwala ndi cyclophosphamide. Ngati mankhwala zinachitikadi atsikana prepubertal, zolakwika mu chitukuko cha sekondale mawonetseredwe kugonana anali anaona. Msambo zambiri, chonde anatayika.

Mankhwalawa wamwamuna mankhwala "endoxane" malangizo limasonyeza kuti nthawi zina akuti azoospermia kapena oligospermia. Ichi ndi chifukwa yopanga kuchuluka kwa gonadotropins pa mlingo wa testosterone kumasulidwa. libido msinkhu ndi potency anthu si yafupika. Ngati mankhwala ndi cyclophosphamide opangidwa anyamata prepubertal, ndi obazovanie sekondale mawonetseredwe kugonana zachitika bwinobwino. Komabe, milandu azoospermia, oligospermia ndi kusintha kwa gonadotropins zadziŵika. Komanso angayambe testicular manja. Dziwani kuti azoospermia ndi kusintha, ngakhale ayambe ntchito angayambe patangopita zaka zochepa pambuyo pa mapeto a mankhwala.

ndi mavuto mankhwala ndi chiyani?

Kumwa "endoxane malangizo ntchito zikutsimikiziridwa, izo zikhoza ena matenda a dongosolo hemopoietic:

• Leukopenia, neutropenia - zambiri.
• Pasanathe zofanana magazi m'thupi ndi thrombocytopenia.

Patapita masabata 1-2 kuyambira chiyambi cha mankhwala, wodwalayo anasonyeza kuchepetsa pazipita leukocytes ndi maselo othandiza magazi kuundana m'magazi. magawo awa kuwapatsanso bwinobwino pakangotha masiku 7-10 mapeto a mankhwala.

Mankhwalawa ndi cyclophosphamide zingachititse zosiyanasiyana mbali pa mundawo m'mimba:

• Kunyansidwa ndi kusanza.
• Anorekisya.
• Stomatitis.
• Ululu m'dera m'mimba.
• Chopondapo monyanyira.
• Matenda a chikasu ndiyo.
• Hemorrhagic matenda a m'matumbo.

Kawirikawiri zimachitika chiwindi kukanika kugwirizana ndi bwino ntchito michere ndi milingo bilirubin adzauka. Ndithu gulu lalikulu la odwala amene ali aplastic magazi ndi kulandira mkulu-mlingo "endoxane" kapena kaphatikizidwe ndi busulfan, akuti endoflebit mitsempha kwa chiwindi. zodabwitsazi angayambe masabata 1-3 pambuyo mafupa kupatsidwa zina ndipo anawonetseredwa mu kuwonjezeka lakuthwa mu thupi misa, ascites, hepatomegaly ndi hyperbilirubinemia, kwa chiwindi encephalopathy.

Pamaso mankhwala zingachititse zosiyanasiyana osafunika ndi khungu:

• Kusintha alopecia.
• Totupa.
• The mtundu wa khungu ndi misomali.

Angagwiritsidwenso amayamba ndi kuphwanya dongosolo mkodzo mankhwalawa mankhwala "endoxane". Malangizo, ndemanga madokotala ndi odwala amasonyeza limati osiyana:

• Cystitis zolumukizidwa ndi chikhodzodzo fibrosis (kapena popanda).
• Hemorrhagic urethritis.
• zochitika Necrotic tubule mpaka imfa.

Mu mkodzo, wodwalayo mwina kuonedwa ndi epithelium wa chikhodzodzo mkodzo. Ngati mtundu wa hemorrhagic cystitis lolemera, siyani kumwa mankhwala. Kupewa bwino za chikhalidwe ichi ndi mankhwala "Mesna". Ngati "endoxan" mlingo kuchuluka, angathe impso kukanika monga nephropathy ndi giperurekemii.

Ngati wodwalayo digiri choopsa cha immunosuppression, ndiye mankhwala a cyclophosphamide angakhale nayo matenda akulu.

Komanso akhoza kukhala zotsatira zotsatirazi mbali:

• Cardiotoxicity (mkulu Mlingo), digiri choopsa cha matenda a mtima.
• M'mapapo mwanga fibrosis, interstitial chikhalidwe.
• Kusokonezeka kwa spermatogenesis ndi oogenesis, kusintha ndipo sizingasinthe sterility.
• Kukula kwa neoplasms sekondale zilonda monga khansa ya m'chikhodzodzo, mieloproliferatsiya ndi lymphoproliferation.
• Ziwengo monga zotupa, kuyabwa, urticaria, nthawizina mu mawonekedwe a anachita anaphylactic.
• Osauka bala machiritso.
• Nkhope ankatenthetsa, thukuta, kupweteka.

Kupezeka kwa zotsatira zina zoyipa ku kutenga mankhwala nthawizonse aukitsa funso za ubwino zotheka ndi mavuto amene angakumane wodwala aliyense.

Amene matenda mankhwala mankhwala?

Miyala "endoxan" ingaperekedwe kwa wodwala ngati ali ndi matenda otsatirawa:

• matenda Hodgkin a.
• Angapo myeloma.
• khansa ya m'mawere.
• Lymphoblastic lymphoma mu mawonekedwe yopweteka kwambiri kapena yokhalitsa.
• Non-Hodgkin a lymphoma mtundu.
• Retinoblastoma.
• Neuroblastoma.
• Mycosis gribkovidnogo khalidwe.

Umasonyeza kuvomereza ntchito mu zovuta anticancer mankhwala Ufumuyo mankhwala "endoxane" malangizo. Mlengi akuonetsa kuti monga matenda a khansa khomo lachiberekero ndi khansa chikhodzodzo, khansa ya m'mapapo ndi khansa prostate, sarcomas ndi reticulosarcoma, matenda Ewing ndi Wilms.

The cyclophosphamide ofotokoza mankhwala angagwiritsidwe ntchito ngati matenda immunosuppressant mwapang'onopang'ono autoimmune ngati, psoriatic ndi nyamakazi, haemolytic kuchepa magazi, matenda kolajeni, syndrome nephrotic, komanso kupewa kumezanitsa kukanidwa.

Pamene mankhwala ali contraindicated?

The medicament "endoxan" kulemera contraindications, monga:

• Mimba ndi mkaka wa m'mawere.
• Cystitis.
• Matenda mu thupi lithe.
• Kulakwila uziyenda mafupa kutchulidwa mawonekedwe.
• Pamaso pa hypersensitivity kuti zikuluzikulu ndi zina zinthu mankhwala.
• mkodzo posungira.

Special chisamaliro madokotala mankhwala mankhwala mu matenda a mtima, impso ndi chiwindi, aakulu, gout, adrenalectomy, pamaso pa njira kusalola mu m'mafupa, nefrourolitiaze.

malangizo apadera mankhwalawa

Pa ingestion "endoxan" pansi pa ulamuliro magazi lamulo (neutrophils ndi kupatsidwa zinthu za m'mwazi achiyesa) ndi mkodzo (pamaso pa maselo ofiira) wodwala.

Ndi bwino kusiya mankhwala "endoxane" akutanthauza zina. Malangizo pa nkhani ya mankhwala osavomerezeka kutero pansi zinthu zotsatirazi:

• Mawonetseredwe zizindikiro cystitis.
• Kutsitsa ndende ya leukocytes ndi maselo othandiza magazi kuundana ndi mfundo yovutayi.
• Mwadzidzidzi matenda (mlingo chilango ndi zotheka).

Ngati "endoxane" ntchito mlingo waukulu, wodwalayo Kwalamulidwa mankhwala, "Meena" chifukwa kupewa mtundu hemorrhagic cystitis.

Mu mankhwala ndi mankhwala ayenera kupewa kumwa mowa ndi kugwiritsa ntchito njira yodalirika kulera.

Ngati wodwala ulipo "endoxan" masiku 10 pambuyo opaleshoni ndi mankhwala ochititsa dzanzi zambiri, dzanzi Ngodziwa za izi.

Pambuyo adrenalectomy anachita mlingo kusintha "endoxane" ndi mankhwala ena corticosteroids.

analogues mankhwala

Ngati pali contraindications kwambiri ndi mavuto, ndiye anapereka kusiya kutenga mankhwala "endoxane" malangizo. Analogs akhoza zotchulidwa dokotala ngati njira yabwino. Pakati pawo:

• "Ledoksin".
• "Cyclophosphamide".
• "Cytoxan."
• "Cyclophosphamide - Teva".
• "Cyclophosphamide -Lens".
• "Endoxane - Astana".

Mfundozi ndi chidule cha malangizo mankhwala "endoxane". Cholinga cha mankhwala ino yokha ndi dokotala nawo.