Thalidomide

Zamkati

• Musanatenge thalidomide,
• Thalidomide imatha kuyambitsa mavuto. Uzani dokotala wanu ngati zina mwazizindikirozi ndizolimba kapena sizichoka:
• Zotsatira zina zoyipa zingakhale zazikulu. Ngati mukumane ndi izi, pitani kuchipatala nthawi yomweyo kapena pitani kuchipatala:

Kuopsa kwa zolepheretsa kubadwa koopsa zomwe zimawopsa chifukwa cha thalidomide.

Kwa anthu onse omwe amatenga thalidomide:

Thalidomide sayenera kumwedwa ndi amayi omwe ali ndi pakati kapena omwe angatenge pakati akamamwa mankhwalawa. Ngakhale mlingo umodzi wokha wa thalidomide womwe umatengedwa ukakhala ndi pakati ungayambitse kupunduka kwakubadwa (mavuto athupi omwe amapezeka mwa mwana atabadwa) kapena kufa kwa mwana wosabadwa. Pulogalamu yotchedwa Thalidomide REMS^® (poyamba ankatchedwa System for Thalidomide Education and Prescribing Safety [S.T.E.P.S.^®]) wavomerezedwa ndi Food and Drug Administration (FDA) kuti awonetsetse kuti amayi apakati samamwa thalidomide komanso kuti amayi satenga mimba akamamwa thalidomide. Anthu onse omwe apatsidwa mankhwala a thalidomide, kuphatikiza amuna ndi akazi omwe sangatenge mimba, ayenera kulembedwa ndi Thalidomide REMS^®, mukhale ndi mankhwala a thalidomide ochokera kwa dokotala yemwe adalembetsa ku Thalidomide REMS^®, ndipo mudzazidwe ndi mankhwala ku pharmacy yomwe imalembetsedwa ndi Thalidomide REMS^® kuti mulandire mankhwalawa.

Muyenera kukaonana ndi dokotala mwezi uliwonse mukamalandira chithandizo kuti mukambirane za momwe mulili komanso mavuto omwe mungakumane nawo. Paulendo uliwonse, dokotala wanu akhoza kukupatsani mankhwala kwa masiku 28 osalandira mankhwala. Muyenera kuti mankhwalawa adzazidwe pasanathe masiku asanu ndi awiri.

Osapereka magazi mukamamwa thalidomide komanso kwa milungu 4 mutalandira chithandizo.

Osagawana thalidomide ndi wina aliyense, ngakhale munthu yemwe atha kukhala ndi zisonyezo zomwezo.

Kwa amayi omwe amatenga thalidomide:

Ngati mutha kutenga pakati, muyenera kukwaniritsa zofunikira mukamalandira mankhwala a thalidomide. Muyenera kukwaniritsa izi ngakhale mutakhala ndi mbiri yoti simungathe kutenga pakati. Mutha kukhululukidwa kukwaniritsa izi pokhapokha ngati simunasambe (munakhala ndi msambo) kwa miyezi 24 motsatizana, kapena mwakhala mukuchita hysterectomy (opareshoni yochotsa chiberekero chanu).

Muyenera kugwiritsa ntchito njira ziwiri zovomerezeka zolerera kwa milungu inayi musanayambe kumwa mankhwala a thalidomide, mukamamwa mankhwala, komanso kwa milungu inayi mutalandira mankhwala. Dokotala wanu angakuuzeni mitundu ya njira zolerera zovomerezeka. Muyenera kugwiritsa ntchito njira ziwirizi zoletsa nthawi zonse pokhapokha mutatsimikizira kuti simudzagonana ndi amuna kwamasabata anayi musanalandire chithandizo, mukamalandira chithandizo, komanso milungu 4 mutalandira chithandizo.

Mankhwala ena amatha kupangitsa kuti njira zakulera zama hormoni zisakhale zothandiza. Ngati mukukonzekera kugwiritsa ntchito njira zolerera za mahomoni (mapiritsi oletsa kubala, zigamba, ma implant, jakisoni, mphete, kapena zida za intrauterine) mukamamwa mankhwala a thalidomide, uzani dokotala wanu za mankhwala onse, mavitamini, ndi mankhwala azitsamba omwe mukumwa kapena mukukonzekera . Onetsetsani kuti mwatchula: griseofulvin (Grifulvin); Mankhwala ena ochizira kachilombo ka HIV (amp) kuphatikizapo amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (ku Kaletra), nelfinavir (Viracept), ritonavir (Norvept) , ku Kaletra), saquinavir (Invirase), ndi tipranavir (Aptivus); mankhwala ena okomoka kuphatikiza carbamazepine (Carbatrol, Equetro, Tegretol) ndi phenytoin (Dilantin, Phenytek); modafinil (Provigil); penicillin; rifampin (Rimactane, Rifadin); rifabutin (Mycobutin); ndi wort wa St. Mankhwala ena ambiri atha kusokoneza machitidwe a njira zakulera zamahomoni, chifukwa chake onetsetsani kuti muwauze adotolo mankhwala onse omwe mukumwa kapena omwe mukukonzekera kumwa, ngakhale omwe sapezeka pamndandandawu.

Muyenera kukhala ndi mayeso awiri olakwika okhudzana ndi mimba musanayambe kumwa mankhwala a thalidomide. Muyeneranso kukayezetsa kuti muli ndi pakati mu labotale nthawi zina mukamalandira chithandizo. Dokotala wanu angakuuzeni nthawi ndi malo omwe mungayesere.

Lekani kumwa thalidomide ndipo itanani dokotala wanu nthawi yomweyo ngati mukuganiza kuti muli ndi pakati, mumachedwa, kusasamba, kapena kusamba msambo, mumakhala ndi kusintha kulikonse pakusamba kwanu, kapena mumagonana osagwiritsa ntchito njira ziwiri zakulera. Nthawi zina, dokotala wanu amatha kukupatsani njira zolerera zadzidzidzi ('m'mawa pambuyo pa mapiritsi') kuti mupewe kutenga pakati. Mukakhala ndi pakati mukamalandira chithandizo, dokotala akuyenera kuyimbira FDA ndi wopanga. Dokotala wanu adzaonetsetsanso kuti mumalankhula ndi dokotala yemwe amakhala ndi mavuto atakhala ndi pakati yemwe angakuthandizeni kupanga zisankho zabwino kwa inu ndi mwana wanu.

Kwa amuna omwe amatenga thalidomide:

Thalidomide imapezeka mu umuna (madzimadzi okhala ndi umuna womwe umatulutsidwa kudzera mu mbolo nthawi yamalungo). Muyenera kugwiritsa ntchito kondomu kapena kupanga kondomu kapena kupewa kugonana konse ndi mayi yemwe ali ndi pakati kapena atha kukhala ndi pakati mukamamwa mankhwalawa komanso milungu 4 mutalandira chithandizo. Izi zimafunikira ngakhale mutakhala ndi vasectomy (opareshoni yoteteza umuna kuti usatuluke mthupi lanu ndikupangitsa kutenga pakati). Uzani dokotala wanu nthawi yomweyo ngati mwagonana mosadziteteza ndi mayi yemwe angatenge pakati kapena ngati mukuganiza pazifukwa zilizonse kuti mnzanu ali ndi pakati.

Osapereka umuna kapena umuna mukamamwa thalidomide komanso kwa milungu 4 mutalandira chithandizo.

Kuopsa kwa magazi kuundana:

Ngati mukumwa thalidomide kuti muchiritse myeloma yambiri (mtundu wa khansa ya m'mafupa), pali chiopsezo kuti mutha kukhala ndi magazi m'manja, miyendo kapena m'mapapu. Chiwopsezo chimakhala chachikulu ngati thalidomide imagwiritsidwa ntchito limodzi ndi mankhwala ena a chemotherapy monga dexamethasone. Itanani dokotala wanu nthawi yomweyo ngati mukukumana ndi izi: kupweteka, kukoma mtima, kufiira, kutentha, kapena kutupa m'manja kapena miyendo; kupuma movutikira; kapena kupweteka pachifuwa. Dokotala wanu angakupatseni mankhwala oletsa magazi kupha magazi ('magazi ochepera magazi') kapena aspirin kuti athandize kuletsa kuundana kwa mapangidwe mkati mwa chithandizo chanu ndi thalidomide.

Lankhulani ndi dokotala wanu za kuopsa kwakumwa thalidomide.

Thalidomide imagwiritsidwa ntchito limodzi ndi dexamethasone pochiza matenda angapo a myeloma mwa anthu omwe apezeka kuti ali ndi matendawa. Amagwiritsidwanso ntchito payekha kapena ndi mankhwala ena kuti athetse ndi kupewa zizindikiro za khungu la erythema nodosum leprosum (ENL; zigawo za zilonda pakhungu, malungo, ndi kuwonongeka kwa mitsempha zomwe zimachitika mwa anthu omwe ali ndi matenda a Hansen [khate]. Thalidomide ali mgulu la mankhwala otchedwa ma immunomodulatory agents. Amachiza myeloma angapo polimbitsa chitetezo cha mthupi kuti chiteteze ma cell a khansa. Amathandizira ENL poletsa kuchitapo kanthu kwa zinthu zina zachilengedwe zomwe zimayambitsa kutupa.

Thalidomide amabwera ngati kapisozi kuti atenge pakamwa. Thalidomide nthawi zambiri amatengedwa ndi madzi kamodzi patsiku nthawi yogona komanso osachepera ola limodzi mutadya chakudya chamadzulo. Ngati mukumwa thalidomide kuti muchiritse ENL, adokotala angakuuzeni kuti mumamwe kamodzi pa tsiku, osachepera ola limodzi mutadya. Tengani thalidomide mozungulira nthawi yofanana tsiku lililonse. Tsatirani malangizo omwe mwalandira mosamala, ndikufunsani dokotala kapena wamankhwala kuti afotokoze gawo lililonse lomwe simukumvetsa. Tengani thalidomide ndendende momwe mwalangizira. Musamamwe pang'ono kapena kumamwa pafupipafupi kuposa momwe adanenera dokotala.

Sungani makapisozi m'matumba awo kufikira mutakonzeka kuwatenga. Osatsegula makapisozi kapena kuwagwiritsa ntchito mopitilira muyeso. Ngati khungu lanu limakhudzana ndi makapisozi kapena ufa wosweka, tsukani malo owonekerawo ndi sopo.

Kutalika kwa chithandizo chanu kumadalira momwe zizindikiro zanu zimayankhira thalidomide komanso ngati zizindikiro zanu zimabweranso mukasiya kumwa mankhwala. Dokotala wanu angafunike kusokoneza chithandizo chanu kapena kuchepetsa mlingo wanu ngati mukukumana ndi zovuta zina. Osasiya kumwa thalidomide osalankhula ndi dokotala. Mukalandira chithandizo chamankhwala, dokotala akhoza kuchepa pang'onopang'ono.

Thalidomide nthawi zina amagwiritsidwanso ntchito kuthana ndi khungu linalake lomwe limakhudzana ndi kutupa ndi kukwiya. Amagwiritsidwanso ntchito kuthana ndi zovuta zina za kachilombo ka HIV (monga kachilombo ka HIV) monga aphthous stomatitis (momwe zilonda zam'mimba zimakhalira mkamwa), kutsegula m'mimba komwe kumakhudzana ndi HIV, matenda owononga kachilombo ka HIV, matenda ena, ndi Kaposi's sarcoma (mtundu khansa yapakhungu). Thalidomide yagwiritsidwanso ntchito kuchiza mitundu ina ya khansa ndi zotupa, kuchepa thupi kwambiri kwa odwala omwe ali ndi chitetezo chamthupi chofooka, matenda opatsirana motsutsana ndi matenda (vuto lomwe limatha kuchitika pambuyo pongowonjezera mafuta m'mafupa momwe zinthu zomwe zidangopangidwazo zimaukira wolandirayo body), ndi matenda a Crohn (matenda omwe thupi limagwiritsa ntchito gawo lam'mimba, kumayambitsa kupweteka, kutsegula m'mimba, kuonda, ndi malungo). Lankhulani ndi dokotala wanu za kuopsa kogwiritsa ntchito mankhwalawa ngati muli ndi vuto lanu.

Mankhwalawa nthawi zina amapatsidwa ntchito zina; funsani dokotala wanu kapena wamankhwala kuti mudziwe zambiri.

Musanatenge thalidomide,

• uzani dokotala wanu komanso wamankhwala ngati mukugwirizana ndi thalidomide kapena mankhwala aliwonse.
• auzeni adotolo komanso asayansi yanu mankhwala ena omwe mungalandire kapena omwe simukulembera, mavitamini, zowonjezera zakudya, komanso mankhwala azitsamba omwe mukumwa kapena omwe mukufuna kumwa. Onetsetsani kuti mwatchula mankhwala omwe adatchulidwa mu gawo la CHENJEZO CHENJEZO ndi zina mwa izi: barbiturates monga pentobarbital (Nembutal), phenobarbital, ndi secobarbital (Seconal); mankhwala enaake; didanosine (Videx); mankhwala a nkhawa, matenda amisala, kapena kugwidwa; mankhwala ena a chemotherapy a khansa monga cisplatin (Platinol), paclitaxel (Abraxane, Taxol), ndi vincristine; reserpine (Serpalan); mankhwala ogonetsa; mapiritsi ogona; ndi zotontholetsa. Dokotala wanu angafunike kusintha kuchuluka kwa mankhwala anu kapena kukuyang'anirani mosamala zotsatira zake.
• auzeni adotolo ngati mudakhalako kapena mudakhalapo ndi kachilombo ka HIV (kachilombo ka HIV), muli ndi matenda a immunodeficiency syndrome (Edzi), kuchuluka kwama cell oyera m'magazi anu, kapena khunyu.
• Uzani dokotala wanu ngati mukuyamwitsa.
• muyenera kudziwa kuti thalidomide imatha kukupangitsani kugona. Osayendetsa galimoto, kugwiritsa ntchito makina, kapena kuchita zina zomwe zikufuna kuti mukhale atcheru mpaka mutadziwa momwe mankhwalawa amakukhudzirani.
• Funsani dokotala wanu za zakumwa zoledzeretsa moyenera mukamamwa thalidomide. Mowa umatha kukulitsa mavuto obwera chifukwa cha thalidomide.
• muyenera kudziwa kuti thalidomide imatha kuyambitsa chizungulire, mutu wopepuka, komanso kukomoka mukaimirira mwachangu pamalo abodza. Pofuna kupewa vutoli, nyamuka pabedi pang'onopang'ono, ndikupumitsa mapazi ako pansi kwa mphindi zochepa usanayime.
• muyenera kudziwa kuti thalidomide imapezeka m'magazi anu ndi madzi amthupi. Aliyense amene angakumane ndi madzi awa ayenera kuvala magolovesi kapena kutsuka malo aliwonse akhungu ndi sopo.

Pokhapokha dokotala atakuwuzani zina, pitirizani kudya zomwe mumadya.

Tengani mlingo womwe mwaphonya mukangokumbukira. Komabe, ngati ndi ochepera maola 12 mpaka muyeso wanu wotsatira, tulukani mlingo womwe mwaphonya ndikupitiliza dongosolo lanu lokhazikika. Musatenge mlingo wawiri kuti mupange omwe mwaphonya.

Thalidomide imatha kuyambitsa mavuto. Uzani dokotala wanu ngati zina mwazizindikirozi ndizolimba kapena sizichoka:

• Kusinza
• chisokonezo
• nkhawa
• kukhumudwa kapena kusintha kwa malingaliro
• kuvuta kugona kapena kugona
• fupa, minofu, molumikizana, kapena kupweteka msana
• kufooka
• mutu
• kusintha kwa njala
• kulemera kumasintha
• nseru
• kudzimbidwa
• pakamwa pouma
• khungu lowuma
• khungu lotumbululuka
• kugwedezeka kosalamulirika kwa gawo lina la thupi
• kutupa kwa manja, mapazi, akakolo, kapena miyendo yakumunsi
• Kuvuta kukwaniritsa kapena kusunga erection

Zotsatira zina zoyipa zingakhale zazikulu. Ngati mukumane ndi izi, pitani kuchipatala nthawi yomweyo kapena pitani kuchipatala:

• zidzolo
• kuyabwa
• ming'oma
• khungu komanso khungu
• kutupa kwa nkhope, mmero, lilime, milomo, kapena maso
• ukali
• zovuta kumeza kapena kupuma
• malungo, zilonda zapakhosi, kuzizira, chifuwa, kapena zizindikilo zina za matenda
• kugunda pang'onopang'ono kapena mwachangu
• kugwidwa

Thalidomide imatha kuwononga mitsempha yomwe imatha kukhala yayikulu komanso yosatha. Izi zitha kuchitika nthawi iliyonse mukamalandira chithandizo kapena mutalandira chithandizo. Dokotala wanu amakupimirani pafupipafupi kuti muwone momwe thalidomide yakhudzira dongosolo lanu lamanjenje. Ngati mukukumana ndi izi, siyani kumwa thalidomide ndipo itanani dokotala nthawi yomweyo: dzanzi, kumva kuwawa, kupweteka, kapena kutentha m'manja ndi m'mapazi.

Thalidomide imatha kubweretsa zovuta zina. Itanani dokotala wanu ngati muli ndi zovuta zina mukamamwa mankhwalawa.

Mukakumana ndi zovuta zina, inu kapena adokotala mutha kutumiza lipoti ku pulogalamu ya Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting pa intaneti (http://www.fda.gov/Safety/MedWatch) kapena pafoni ( 1-800-332-1088).

Sungani mankhwala awa mu chidebe chomwe chidabwera, chatsekedwa mwamphamvu, komanso chosafikira ana. Zisungeni kutentha ndi kutali ndi kutentha kwambiri ndi chinyezi (osati kubafa).

Ndikofunika kuti mankhwala onse asamawonekere komanso kuti ana asamafikire ngati muli zidebe zambiri (monga mapiritsi a mlungu ndi mlungu ndi omwe amatsikira m'maso, mafuta, zigamba, ndi opumira) sizolimbana ndi ana ndipo ana aang'ono amatha kuzitsegula mosavuta. Pofuna kuteteza ana ang'ono kuti asatenge poyizoni, nthawi zonse tsekani zipewa zachitetezo ndikuyika mankhwalawo pamalo otetezeka - omwe ali pamwamba ndi kutali komanso osawonekera ndi kufikira. http://www.upandaway.org

Mankhwala osafunikira ayenera kutayidwa munjira zapadera zowonetsetsa kuti ziweto, ana, ndi anthu ena sangamwe. Komabe, simuyenera kuthira mankhwalawa mchimbudzi. M'malo mwake, njira yabwino yoperekera mankhwala anu ndikadongosolo lobwezera mankhwala. Lankhulani ndi wamankhwala wanu kapena lemberani dipatimenti yakunyumba / yobwezeretsanso kwanuko kuti muphunzire zamapulogalamu obwezeretsanso mdera lanu. Onani tsamba la FDA's Disposal of Medicines webusayiti (http://goo.gl/c4Rm4p) kuti mumve zambiri ngati mulibe pulogalamu yobwezera.

Mukadwala mopitirira muyeso, itanani foni yothandizira poyizoni pa 1-800-222-1222. Zambiri zimapezekanso pa intaneti pa https://www.poisonhelp.org/help. Ngati wozunzidwayo wagwa, watenga khunyu, akuvutika kupuma, kapena sangathe kudzutsidwa, nthawi yomweyo itanani anthu azadzidzidzi ku 911.

Sungani maimidwe onse ndi dokotala wanu ndi labotale. Dokotala wanu amalamula mayeso ena a labu kuti muwone momwe thupi lanu limayankhira thalidomide.

Ndikofunika kuti musunge mndandanda wamankhwala onse omwe mumalandira komanso osalembetsa (owerengera) omwe mukumwa, komanso zinthu zilizonse monga mavitamini, michere, kapena zakudya zina. Muyenera kubwera nawo pamndandandawu nthawi iliyonse mukapita kukaonana ndi dokotala kapena ngati mwalandiridwa kuchipatala. Ndikofunikanso kuthana nanu pakagwa mwadzidzidzi.

• Thalomid^®