Gleevec (imatinib)

Zamkati

• Kodi Gleevec ndi chiyani?
• Zomwe zimachita
• Kuchita bwino kwa Gleevec
• Gleevec generic
• Zotsatira za Gleevec
• Zotsatira zofala kwambiri
• Zotsatira zoyipa
• Zotsatira zoyipa
• Zotsatira zoyipa mwa ana
• Gleevec wa CML
• Kuchita bwino
• Ntchito zina za Gleevec
• Gleevec wa khansa ya m'magazi (ALL)
• Gleevec wa mitundu ina ya khansa yamagazi
• Gleevec wa khansa yapakhungu
• Gleevec wa khansa ya m'mimba
• Ntchito zosagwiritsidwa ntchito pa Gleevec
• Gleevec kwa ana
• Mtengo wa Gleevec
• Thandizo lazachuma komanso inshuwaransi
• Mlingo wa Gleevec
• Mitundu ya mankhwala ndi mphamvu
• Mlingo wa Gleevec
• Mlingo wa ana
• Ndingatani ngati ndaphonya mlingo?
• Kodi ndiyenera kugwiritsa ntchito mankhwalawa nthawi yayitali?
• Njira Zina ku Gleevec
• Njira zina za CML
• Njira zina za GIST
• Gleevec motsutsana ndi Tasigna
• Ntchito
• Mafomu azamankhwala ndi makonzedwe
• Zotsatira zoyipa ndi zoopsa
• Kuchita bwino
• Mtengo
• Gleevec motsutsana ndi Sprycel
• Ntchito
• Mafomu azamankhwala ndi makonzedwe
• Zotsatira zoyipa ndi zoopsa
• Kuchita bwino
• Mtengo
• Gleevec ndi mowa
• Kuyanjana kwa Gleevec
• Gleevec ndi mankhwala ena
• Gleevec ndi St. John's wort
• Gleevec ndi zipatso zamphesa
• Momwe mungatengere Gleevec
• Nthawi yoti mutenge
• Kutenga Gleevec ndi chakudya
• Kodi Gleevec ikhoza kuphwanyidwa, kugawanika, kapena kutafuna?
• Momwe Gleevec amagwirira ntchito
• Kwa Ph + CML
• Za GIST
• Zimatenga nthawi yayitali bwanji kuti zigwire ntchito?
• Gleevec ndi mimba
• Gleevec ndi kuyamwitsa
• Gleevec bongo
• Zizindikiro zambiri za bongo
• Zomwe muyenera kuchita mukamagwiritsa ntchito bongo
• Mafunso wamba okhudza Gleevec
• Kodi Gleevec ndi mtundu wa chemotherapy?
• Kodi mawonekedwe abwinobwino a Gleevec ndi othandiza monga mankhwala odziwika?
• Kodi ndingathe kulimbana ndi mankhwala a Gleevec?
• Kodi pali zoletsa pazakudya zomwe ndiyenera kutsatira ndikamamwa Gleevec?
• Kodi ndikasiya kugwiritsa ntchito Gleevec ndikadzasiya?
• Kodi ndiyenera kugwiritsa ntchito mankhwala ena ndi Gleevec kuti ndithandizire?
• Kutha kwa Gleevec, kusunga, ndi kutaya
• Yosungirako
• Kutaya
• Zambiri zamaphunziro a Gleevec
• Zisonyezero
• Njira yogwirira ntchito
• Pharmacokinetics ndi metabolism
• Zotsutsana
• Kusunga ndi kusamalira

Kodi Gleevec ndi chiyani?

Gleevec ndi mankhwala omwe amadziwika kuti ndi mankhwala. Amagwiritsidwa ntchito pochiza mitundu ina ya khansa yamagazi kwa akulu ndi ana. Gleevec imagwiritsidwanso ntchito pochiza khansa yapakhungu ndi mtundu wa khansa yam'mimba.

Gleevec muli mankhwala imatinib mesylate, omwe ndi gulu la mankhwala otchedwa tyrosine kinase inhibitors.

Gleevec amabwera ngati piritsi lomwe mumamwa. Mumamwa mankhwalawo kamodzi kapena kawiri patsiku, kutengera mulingo womwe dokotala akukuuzani.

Zomwe zimachita

Food and Drug Administration (FDA) yavomereza Gleevec kuti athetse mitundu ina ya khansa yamagazi, kuphatikiza:

• Philadelphia chromosome-positive (Ph +) chronic myeloid leukemia (CML) mwa akulu ndi ana
• Ph + acute lymphocytic leukemia (ZONSE) zomwe zabwereranso kapena zosokoneza anthu akuluakulu
• anapeza Ph + YONSE mwa ana
• Matenda a myelodysplastic / myeloproliferative (khansa ya m'mafupa) mwa achikulire omwe ali ndi mapangidwe a platelet-derived factor factor (PDGFR)
• matenda a hypereosinophilic kapena matenda a khansa ya m'magazi akuluakulu
• aukali systemic mastocytosis mwa akulu popanda kusintha kwa D816v c-Kit

* Khansa yobwereranso yabwerera pambuyo pokhululukidwa, komwe ndikuchepa kwa zizindikilo ndi zizindikilo za khansa. Khansara yowonongeka sinayankhe mankhwala am'mbuyomu a khansa.

Gleevec imavomerezedwanso kuchiza:

• mtundu wa khansa yapakhungu yotchedwa dermatofibrosarcoma protuberans (DFSP) mwa akulu
• mtundu wa khansa yam'mimba yotchedwa Kit-positive gastrointestinal stromal tumors (GIST) mwa akulu

Kuti mumve zambiri, onani zigawo za "Gleevec for CML" ndi "Ntchito zina za Gleevec."

Kuchita bwino kwa Gleevec

Gleevec wapezeka wogwira mtima pochiza mitundu ingapo yama khansa yamagazi.

Pakafukufuku wina wamankhwala, achikulire omwe ali ndi CML omwe atangopezeka kumene atadwala adatenga Gleevec kwa zaka zisanu ndi ziwiri. Mu gululi, 96.6% ya anthu adayankha kwathunthu pamankhwalawa. Izi zikutanthauza kuti palibe maselo a khansa omwe amapezeka m'magazi awo, ndipo analibe zisonyezo za khansa.

Kuyankha kwathunthu ndi njira imodzi yofotokozera kupambana kwake. Gulu la anthu omwe adalandira chemotherapy yokhazikika, 56.6% adayankha kwathunthu.

Gleevec yapezeka yothandiza pochiza zotupa zam'mimba (GIST) m'maphunziro azachipatala. Chiwerengero chonse cha kupulumuka chinali pafupifupi zaka zinayi. Izi zikutanthauza kuti theka la anthu omwe adachita nawo kafukufukuyu adakhala zaka pafupifupi zinayi atayamba kumwa Gleevec. Anthu omwe adatenga Gleevec atachitidwa opaleshoni adakhala zaka pafupifupi zisanu atayamba mankhwalawa.

Kuti mudziwe momwe Gleevec imagwirira ntchito pochiza mitundu ina ya khansa, onani gawo la "Ntchito zina za Gleevec".

Gleevec generic

Gleevec amapezeka ngati mankhwala odziwika ngati dzina komanso ngati generic form.

Gleevec ili ndi mankhwala opangira imatinib mesylate.

Zotsatira za Gleevec

Gleevec amatha kuyambitsa zovuta kapena zoyipa. Mndandanda wotsatira uli ndi zovuta zina zomwe zingachitike mukamamwa Gleevec. Mndandandawu mulibe zovuta zonse zomwe zingachitike.

Kuti mumve zambiri pazomwe zingachitike chifukwa cha Gleevec, lankhulani ndi dokotala kapena wamankhwala. Amatha kukupatsirani malangizo amomwe mungathetsere mavuto omwe angakhale ovuta.

Zotsatira zofala kwambiri

Zotsatira zofala kwambiri za Gleevec zitha kuphatikiza:

• kutsegula m'mimba
• kupweteka m'mimba
• kutopa (kusowa mphamvu)
• edema (kutupa, makamaka m'miyendo yanu, akakolo, kapena mapazi komanso mozungulira maso anu)
• kukokana kwa minofu kapena kupweteka
• nseru
• kusanza
• zidzolo

Zambiri mwa zotsatirazi zimatha kutha masiku angapo kapena milungu ingapo. Ngati ali ovuta kwambiri kapena osapita, lankhulani ndi dokotala kapena wamankhwala.

Zotsatira zoyipa

Zotsatira zoyipa zochokera ku Gleevec sizodziwika, koma zimatha kuchitika. Itanani dokotala wanu nthawi yomweyo ngati muli ndi zovuta zina. Itanani 911 ngati zizindikiro zanu zikuwopseza moyo kapena ngati mukuganiza kuti mukukumana ndi vuto lachipatala.

Zotsatira zoyipa komanso zizindikilo zake zimatha kukhala izi:

• Kusungidwa kwamadzimadzi koopsa (madzimadzi ochulukirapo kapena madzi) mkati ndi mozungulira mtima wanu, mapapo (pleural effusion), ndi mimba (ascites). Zizindikiro zimatha kuphatikiza:
  • mosayembekezereka, kunenepa mofulumira
  • kupweteka pachifuwa
  • kupuma movutikira
  • kuvuta kupuma mwamphamvu
  • kuvuta kupuma mukamagona pansi
  • chifuwa chowuma
  • mimba yotupa
• Matenda amwazi, kuphatikiza kuchepa kwa magazi (magazi ofiira ochepa), neutropenia (kuchuluka kwama cell oyera), ndi thrombocytopenia (magawo ochepa am'magazi). Zizindikiro zimatha kuphatikiza:
  • kutopa (kusowa mphamvu)
  • kugunda kwamtima mwachangu
  • kupuma movutikira
  • matenda pafupipafupi
  • malungo
  • kuvulaza mosavuta
  • nkhama zotuluka magazi
  • magazi mkodzo kapena chopondapo
• Kulephera kwa mtima komanso mavuto ena amtima, monga mtima wamanzere. Zizindikiro zimatha kuphatikiza:
  • kulemera kosayembekezereka
  • edema (kutupa kwa mapazi anu, akakolo, ndi miyendo)
  • kugunda kwamtima kapena kuthamanga kwa mtima (kugunda kwamtima komwe kumakhala kothamanga kwambiri, kochedwa kwambiri, kapena kosasintha)
  • kupweteka pachifuwa
  • kupuma movutikira
• Kuwonongeka kwa chiwindi kapena kulephera kwa chiwindi. Zizindikiro zimatha kuphatikiza:
  • nseru
  • kutsegula m'mimba
  • kusowa chilakolako
  • khungu loyabwa
  • jaundice (mtundu wachikasu pakhungu lanu ndi azungu amaso anu)
  • edema (kutupa kwa miyendo yanu, akakolo, ndi mapazi)
  • ascites (madzi amadzimadzi m'mimba mwako)
  • kuvulaza pafupipafupi
  • kutuluka magazi pafupipafupi
• Kutaya magazi kwambiri (kutuluka magazi komwe sikumaima), nthawi zambiri kumatumbo. Zizindikiro zimatha kuphatikiza:
  • magazi mu chopondapo
  • wakuda kapena chembere pogona
  • kutopa (kusowa mphamvu)
  • kutsokomola magazi
  • kukhosomola matope akuda
  • nseru
  • kukokana m'mimba
• Mavuto am'mimba, kuphatikiza ma perforations (misozi) m'mimba mwanu kapena m'matumbo. Zizindikiro zimatha kuphatikiza:
  • nseru
  • kusanza
  • kupweteka kwambiri m'mimba mwako
  • malungo
  • kupuma movutikira
  • kugunda kwamtima mwachangu
• Mavuto akulu akhungu. Zizindikiro zimatha kuphatikiza:
  • erythema multiforme (zigamba zofiira kapena matuza, nthawi zambiri pamapazi anu kapena padzanja lanu)
  • Matenda a Stevens-Johnson (malungo; zilonda zopweteka pakamwa panu, pakhosi, m'maso, kumaliseche, kapena thupi lonse)
  • malungo
  • kupweteka kwa thupi
• Hypothyroidism (otsika a chithokomiro) mwa anthu omwe adachotsedwa chithokomiro ndipo akumwa mankhwala obwezeretsa chithokomiro. Zizindikiro zimatha kuphatikiza:
  • kutopa (kusowa mphamvu)
  • kudzimbidwa
  • kukhumudwa
  • kumva kuzizira
  • khungu lowuma
  • kunenepa
  • mavuto okumbukira
• Kuchedwa kukula kwa ana. Zizindikiro zimatha kuphatikiza:
  • osakula pamlingo woyenera
  • kukula kocheperako kuposa ana ena amsinkhu wawo
• Tumor lysis syndrome (pomwe maselo a khansa amatulutsa mankhwala owopsa m'magazi anu) Zizindikiro zimatha kuphatikiza:
  • kutopa (kusowa mphamvu)
  • nseru
  • kusanza
  • kutsegula m'mimba
  • kukokana kwa minofu
  • kayendedwe kabwino ka mtima (kugunda kwamtima komwe kumathamanga, kutsika kwambiri, kapena kusasintha)
  • kugwidwa
• Kuwonongeka kwa impso. Zizindikiro zimatha kuphatikiza:
  • kukodza pafupipafupi kuposa masiku onse
  • edema (kutupa kwa miyendo yanu, akakolo, ndi mapazi)
  • kutopa (kusowa mphamvu)
  • nseru
  • chisokonezo
  • kuthamanga kwa magazi
• Zotsatira zoyipa zomwe zingayambitse ngozi zamagalimoto. Zizindikiro zimatha kuphatikiza:
  • chizungulire
  • kugona
  • kusawona bwino

Zotsatira zoyipa

Mutha kudabwa kuti zovuta zina zimachitika kangati ndi mankhwalawa, kapena ngati zovuta zina zake zimakhudza.Nazi zina mwazinthu zingapo zomwe mankhwalawa angapangitse kapena sangayambitse.

Matupi awo sagwirizana

Monga momwe zimakhalira ndi mankhwala ambiri, anthu ena amatha kusokonezeka atalandira Gleevec. Zizindikiro za kuchepa pang'ono zimatha kuphatikiza:

• zotupa pakhungu
• kuyabwa
• Kutentha (kutentha ndi kufiira pakhungu lanu)

Zomwe zimayambitsa matendawa zimakhala zochepa koma ndizotheka. Zizindikiro za kuyanjana kwambiri ndi izi:

• angioedema (kutupa pansi pa khungu lanu, makamaka m'maziso anu, milomo, manja, kapena mapazi)
• kutupa lilime, pakamwa, kapena pakhosi
• kuvuta kupuma

Itanani dokotala wanu nthawi yomweyo ngati muli ndi vuto lalikulu ku Gleevec. Itanani 911 ngati zizindikiro zanu zikuwopseza moyo kapena ngati mukuganiza kuti mukukumana ndi vuto lachipatala.

Zotsatira zoyipa zazitali

Zina mwa zoyipa zomwe zimawoneka m'maphunziro azachipatala zitha kuchitika ndikumagwiritsa ntchito Gleevec kwakanthawi. Izi zikuphatikiza mavuto amtima, monga kupindika kwa mtima komanso mtima wamanzere.

Pakafukufuku wazachipatala, anthu opitilira 500 omwe adatenga Gleevec chifukwa cha matenda a myeloid leukemia (CML) adatsatiridwa kwa zaka 11. Anthu omwe adachita kafukufukuyu wa nthawi yayitali anali ndi zovuta zofananira zomwe zidanenedwa m'maphunziro afupikitsa. Komabe, zotsatirazi zimawoneka ngati zikukula pakapita nthawi.

Zotsatira zoyipa zomwe zimawonedwa ndikugwiritsidwa ntchito kwakanthawi ndizophatikizira:

• Matenda akulu am'magazi (kuchepa kwama cell ofiira ofiira, maselo oyera, kapena ma platelets) mwa anthu asanu ndi mmodzi
• mavuto amtima, kuphatikiza kupindika kwa mtima, mwa anthu asanu ndi awiri
• Matenda asanu ndi limodzi a khansa yatsopano, kuphatikiza ma myeloma angapo mwa munthu m'modzi ndi khansa ya m'matumbo mwa munthu wina

Zotsatira zoyipa zinali zofala mchaka choyamba chamankhwala ndi Gleevec. Koma momwe anthu amatengera Gleevec, nthawi zambiri amakhala ndi zovuta zambiri. Mwachitsanzo, mchaka choyamba cha kafukufukuyu, anthu atatu anali ndi vuto lalikulu la magazi, koma pambuyo pa chaka chachisanu, munthu m'modzi yekha ndiye adatero.

Pakafukufuku wazaka zisanu wa anthu omwe ali ndi zotupa m'mimba (GIST), 16% ya anthu adasiya kumwa Gleevec chifukwa cha zovuta zina. Zotsatira zake zinali zofanana ndi zomwe zafotokozedwa mu kafukufuku wa CML pamwambapa. Anthu makumi anayi pa anthu 100 alionse omwe amaphunzira amapatsidwa mankhwala ochepa kuti achepetse mavuto awo.

Ngati mukuda nkhawa ndi zovuta zomwe zingachitike kwakanthawi kwa Gleevec, lankhulani ndi dokotala wanu. Amatha kunena njira zochepetsera zoopsa pazotsatira zina.

Zotsatira zoyipa zamaso

M'maphunziro azachipatala a Gleevec, anthu ena adakumana ndi zovuta zina monga kutupa ndi kuwona kwamaso.

Kutupa kwa chikope ndikutupa kuzungulira maso ndi zina mwazovuta zoyipa kwambiri. Mpaka 74.2% ya anthu omwe adatenga Gleevec anali ndi periorbital edema (kutupa kwa diso).

Ngati muli ndi zotsatirazi, dokotala akhoza kukupatsani diuretic (yomwe nthawi zambiri imatchedwa mapiritsi a madzi). Odzetsa amathandiza thupi lanu kuchotsa madzi owonjezera ndi mchere mukakodza. Izi zimachepetsa kuchuluka kwa madzi. Dokotala wanu amathanso kutsitsa Gleevec wanu, ngati kuli kofunikira.

Kuphatikiza apo, kafukufuku wamankhwala adanena kuti mpaka 11.1% ya anthu omwe adatenga Gleevec anali ndi vuto la kuwona. Ngati mukuwona bwino, musayendetse kapena kugwiritsa ntchito makina olemera. Ndipo onetsetsani kuti mwauza dokotala wanu kuti simukuwona bwino.

Zotsatira zina zochepa zokhudzana ndi diso ndizo:

• diso lowuma
• maso amadzi
• Kukhumudwa kwa diso
• conjunctivitis (nthawi zambiri amatchedwa diso la pinki)
• mitsempha yamagazi yosweka m'maso
• kutupa kwa diso (kansalu kakang'ono kumbuyo kwa diso lanu)

Ngati mukumwa Gleevec ndipo muli ndi zovuta zina zilizonse zokhudzana ndi maso, lankhulani ndi dokotala wanu. Amatha kupereka malingaliro ochepetsa zizindikiro zanu.

Kutaya tsitsi

Kutayika kwa tsitsi (alopecia) ndi vuto lomwe lingachitike chifukwa chotenga Gleevec.

Kafukufuku wina adayesa momwe Gleevec imagwirira ntchito mwa anthu omwe ali ndi chromosome-positive (Ph +) chronic myeloid leukemia (CML). Asanu ndi awiri mwa anthu awa adasowa tsitsi atamwa mankhwalawo.

Pakafukufuku wina, anthu adatenga Gleevec kuchiza zotupa zam'mimba (GIST). Pakati pa 11.9% ndi 14.8% mwa anthuwa adataya tsitsi. Izi zimachitika nthawi zambiri mwa anthu omwe amamwa kwambiri Gleevec.

Kutayika tsitsi chifukwa cha chithandizo cha khansa nthawi zambiri kumakhala kwakanthawi. Ngati mukuda nkhawa ndi izi, lankhulani ndi dokotala wanu. Amatha kupereka malangizo okuthandizani kuti muchepetse tsitsi lanu mukamalandira chithandizo.

Ziphuphu ndi zina zoyipa pakhungu

Gleevec amatha kuyambitsa khungu lanu pang'ono.

Khungu lofala kwambiri

Ziphuphu ndi zina zotulutsa khungu ndizofala kwa anthu omwe amatenga Gleevec.

M'maphunziro azachipatala, anthu adatenga Gleevec kuchiza Ph + chronic myeloid leukemia (CML). Mpaka 40.1% ya anthuwa anali ndi zotupa kapena zotulukapo zina pakhungu atamwa mankhwalawo.

M'maphunziro ena azachipatala, anthu adatenga Gleevec kutulutsa zotupa zam'mimba (GIST). Atamwa mankhwalawa, mpaka 49.8% mwa anthuwa anali ndi zotupa kapena kusintha kwina pakhungu. Izi zikuphatikiza:

• khungu
• khungu lowuma
• Kusintha kwa khungu (mtundu wabuluu pakhungu)
• Matenda opatsirana tsitsi (matumba pansi pa khungu lanu omwe amakhala ndi mizu ya tsitsi lanu)
• erythema (khungu lofiira)
• purpura (mawanga ofiira pakhungu)

Zotsatirazi zinali zofala kwambiri mwa anthu omwe amamwa kwambiri Gleevec.

Ngati mukuda nkhawa ndi zotupa kapena zotuluka pang'ono pakhungu chifukwa cha Gleevec, lankhulani ndi dokotala wanu. Amatha kunena njira zokuthandizani kuchepetsa zizolowezi zanu.

Kusintha kwakukulu pakhungu

M'maphunziro azachipatala, zotupa zazikuluzikulu pakhungu zinali zosowa kwambiri mwa anthu omwe adatenga Gleevec. Mpaka 1% ya anthu omwe amamwa mankhwalawa anali ndi vuto lalikulu pakhungu. Zitsanzo za zovuta zakhungu zokhudzana ndi mankhwala ndi monga:

• Matenda a Stevens-Johnson (malungo; zilonda zopweteka pakamwa panu, pakhosi, m'maso, kumaliseche, kapena thupi lonse)
• exfoliative dermatitis (khungu likuyang'ana mbali zazikulu za thupi lanu)
• Ziphuphu zamatenda (zotupa zing'onozing'ono ndi ziphuphu)

Ziphuphu ndi matuza zingakhale zopweteka kwambiri. Ndipo ngati sakuchiritsidwa, amatha kutengera mabakiteriya ndikupangitsa matenda opatsirana. Chifukwa chake ngati mukutenga Gleevec ndikukhala ndi zotupa kapena zotupa ndi malungo kapena simukumva bwino, uzani dokotala nthawi yomweyo. Komanso tchulani zina zomwe zimachitika pakhungu.

Zotsatira zoyipa zomwe zimakhudza kuyendetsa galimoto

M'maphunziro azachipatala, anthu ena omwe adatenga Gleevec adakumana ndi zovuta zomwe zitha kukhudza kutha kwawo kuyendetsa. Izi zikuphatikiza:

• chizungulire: mpaka anthu 19.4%
• masomphenya: mpaka 11.1% ya anthu
• kutopa: mu anthu 74.9%

Zotsatirazi zingakhudze kuthekera kwanu kuyendetsa kapena kugwiritsa ntchito makina olemera. Pakhala pali malipoti onena za ngozi zapagalimoto ndi anthu omwe adatenga Gleevec. Chifukwa chake muyenera kusamala poyendetsa kapena kugwiritsa ntchito makina mukamamwa Gleevec.

Kuchepetsa chilonda (osati zotsatira zoyipa)

Kuchepetsa machiritso sikunatchulidwe m'maphunziro azachipatala a Gleevec.

Mitundu ina ya chithandizo cha khansa, monga radiation ndi chemotherapy, imatha kufooketsa chitetezo chamthupi. Izi zitha kupangitsa zilonda kuchira pang'onopang'ono.

Ngati mukuda nkhawa ndi kuchepetsedwa kwa machiritso, funsani dokotala ngati muli pachiwopsezo chachikulu cha vutoli potengera matenda anu.

Khansa ya chiwindi (sizingakhale zoyipa)

Khansa ya chiwindi sinatchulidwe ngati zotsatira zoyipa m'maphunziro azachipatala a Gleevec. Komabe, kuwonongeka kwa chiwindi kwachitika posachedwa komanso kwakanthawi kwa Gleevec. Zina mwa kuwonongeka kwa chiwindi zadzetsa chiwindi komanso kufalikira kwa chiwindi.

Kuwonongeka kwa chiwindi kumapezeka nthawi zambiri madokotala akamayang'anira michere (mapuloteni apadera) omwe amapangidwa m'chiwindi. Mavitamini omwe amaposa kuposa chizoloŵezi angakhale chizindikiro cha kuwonongeka kwa chiwindi.

Zizindikiro zina zowononga chiwindi ndi izi:

• nseru
• kutsegula m'mimba
• kusowa chilakolako
• khungu loyabwa
• jaundice (mtundu wachikasu pakhungu lanu ndi azungu amaso)
• edema (kutupa kwa miyendo yanu, akakolo, ndi mapazi)
• ascites (madzi amadzimadzi m'mimba mwako)
• kuvulaza pafupipafupi
• kutuluka magazi pafupipafupi

Pakati pa maphunziro azachipatala, mpaka anthu 5% omwe ali ndi matenda a myeloid leukemia (CML) anali ndi michere yambiri ya chiwindi nthawi ya Gleevec. Mpaka 6.8% ya anthu omwe ali ndi zotupa m'mimba (GIST) anali ndi michere yambiri ya chiwindi panthawi yachipatala. Ndipo mpaka 0.1% ya anthu omwe adatenga Gleevec anali ndi vuto la chiwindi.

Mukamatenga Gleevec, dokotala wanu adzawona momwe chiwindi chanu chikugwirira ntchito. Ngati muli ndi zizindikilo za kuwonongeka kwa chiwindi mukamamwa Gleevec, dokotala wanu akhoza kuchepetsa mlingo wanu. Izi zitha kupewa kuwonongeka komwe kungayambitse chiwindi.

Zotsatira zoyipa mwa ana

Ana m'maphunziro azachipatala omwe adatenga Gleevec anali ndi zovuta zomwe zinali zofanana kwambiri ndi za akulu. Koma ofufuza adapeza izi:

• ndi ana ochepa omwe anali ndi ululu wa minofu kapena mafupa kuposa achikulire
• edema (kutupa kwa miyendo, akakolo, mapazi, ndi malo ozungulira maso) sikunanenedwe mwa ana

Zotsatira zoyipa zomwe zimafotokozedwa mwa ana zinali nseru ndi kusanza. Zotsatira zoyipa kwambiri zinali magulu ochepa a magazi oyera ndi ma platelet.

Ngati mwana wanu ali ndi zotsatirazi, lankhulani ndi dokotala wa mwana wanu za njira zothanirana nazo.

Gleevec wa CML

Food and Drug Administration (FDA) yavomereza Gleevec kwa anthu ena omwe ali ndi chromosome-positive (Ph +) chronic myeloid leukemia (CML). Chromosome ya Philadelphia ndi chromosome nambala 22 yokhala ndi vuto. Anthu omwe ali ndi Ph + CML amasintha mwanjira inayake mu DNA yawo yomwe imayambitsa maselo oyera oyera ambiri.

CML imagawika magawo atatu:

• Matenda gawo. Ili ndiye gawo loyamba la CML. Anthu ambiri amapezeka ndi CML nthawi yayitali. Zizindikiro nthawi zambiri zimakhala zofatsa, ngati zilipo.
• Gawo lofulumira. Mchigawo chachiwirichi, kuchuluka kwa maselo a khansa m'magazi anu kumawonjezeka. Mutha kukhala ndi zizindikilo zambiri, monga kutentha thupi ndi kuchepa thupi.
• Gawo lamavuto ophulika. Mchigawo chotsogola kwambiri ichi, maselo a khansa m'magazi anu afalikira kumatumba ndi ziwalo zina. Zizindikiro zanu zimakhala zovuta kwambiri.

Gleevec amavomerezedwa kuti athetse Ph + CML yomwe yangopezeka kumene m'nthawi yayitali mwa anthu azaka zonse.

Amavomerezanso kuchiza Ph + CML munthawi yamavuto osatha, ofulumira, kapena kuphulika kwa anthu omwe sanalandire chithandizo ndi mankhwala a interferon-alpha. Interferon-alpha ndi mankhwala omwe amagwiritsidwa ntchito nthawi zambiri m'mbuyomu kuchiza CML. Idasinthidwa ndi mankhwala monga Gleevec omwe awonetsedwa kuti ndi othandiza kwambiri.

Kuchita bwino

Pakafukufuku wazachipatala wazaka zisanu ndi ziwiri, kuchuluka kwa anthu achikulire omwe adatenga Gleevec pa Ph + CML yomwe yangopezedwa kumene anali 86.4%. Izi zikutanthauza kuti 86.4% ya achikulire adapulumuka kwa zaka zisanu ndi ziwiri atayamba kumwa Gleevec. Izi zidafanizidwa ndi 83.3% ya anthu omwe amamwa mankhwala wamba a chemotherapy.

Pakafukufuku wamankhwala, anthu omwe adayesapo interferon-alpha ya CML adatenga Gleevec. Ena mwa anthuwa adayankha kwathunthu kuchipatala cha Gleevec. Izi zikutanthauza kuti palibe maselo a khansa omwe amapezeka m'magazi awo, ndipo analibe zisonyezo za khansa. Nayi anthu angati omwe ali ndi CML adayankha kwathunthu atatenga Gleevec:

• 95% ya anthu omwe ali mgulu lanthawi yayitali
• 38% ya anthu omwe afulumira
• 7% ya anthu omwe ali mgulu lamavuto

Kafukufuku wamankhwala adaphatikizaponso ana omwe ali ndi Ph + CML mgawo lanthawi yayitali. Mu gulu lomwe lidatenga Gleevec, 78% ya ana adayankha kwathunthu kumankhwalawa.

Ntchito zina za Gleevec

Kuphatikiza pa matenda a khansa ya m'magazi (onani pamwambapa), Food and Drug Administration (FDA) yavomereza Gleevec kuti athetse mavuto ena angapo.

Gleevec wa khansa ya m'magazi (ALL)

Gleevec ndi wovomerezeka ndi FDA kuti athetse:

• Philadelphia chromosome-positive (Ph +) acute lymphocytic leukemia (ALL) yomwe idabwereranso kapena ikatha * mwa akulu
• Ph + YONSE mwa ana omwe agwiritsidwa ntchito ndi chemotherapy

* Khansa yobwereranso yabwerera pambuyo pokhululukidwa, komwe ndikuchepa kwa zizindikilo ndi zizindikilo za khansa. Khansara yowonongeka sinayankhe mankhwala am'mbuyomu a khansa.

Pakufufuza kwamankhwala, 19% ya achikulire omwe adayambiranso kapena obwezera ONSE omwe adatenga Gleevec adayankha kwathunthu m'magazi awo kuchipatala. Izi zikutanthauza kuti analibe zizindikiro za khansa.

Kafukufuku wamankhwala adayang'ananso ana omwe ali ndi ONSE omwe adatenga Gleevec ndikuchita chemotherapy. Kwa 70% ya ana, khansa yawo sinawonjezeke kwa zaka zinayi.

Gleevec wa mitundu ina ya khansa yamagazi

Gleevec ndi wovomerezeka ndi FDA kuti athetse mitundu ina ya khansa yamagazi, kuphatikiza:

• Matenda a Myelodysplastic / myeloproliferative (khansa ya m'mafupa) mwa akulu omwe ali ndi mapangidwe am'magazi otengera kukula kwa platelet (PDGFR). Pakafukufuku wochepa wazachipatala, anthu 45% omwe amathandizidwa ndi Gleevec adalandira yankho lokwanira m'magazi awo kuchipatala. Izi zikutanthauza kuti palibe maselo a khansa omwe amapezeka m'magazi awo, ndipo analibe zisonyezo za khansa.
• Hypereosinophilic syndrome ndi / kapena matenda a khansa ya m'magazi mwa achikulire, kuphatikiza anthu omwe ali ndi FIP1L1-PDGFRcy fusion kinase. M'maphunziro ang'onoang'ono azachipatala, 100% ya anthu omwe ali ndi PDGFR gene mutation omwe adatenga Gleevec adayankha kwathunthu m'magazi awo kuchipatala. Pakati pa 21% ndi 58% ya anthu opanda kusintha kwa majini kapena osadziwika omwe adatenga Gleevec adayankha kwathunthu m'magazi awo.
• Aggressive systemic mastocytosis mwa akulu popanda kusintha kwa D816v c-Kit. Pakafukufuku wochepa wazachipatala, 100% ya anthu omwe ali ndi FIP1L1-PDGFRcy fusion kinase mutation omwe adathandizidwa ndi Gleevec adalabadira kwathunthu kuchipatala.

Gleevec wa khansa yapakhungu

Gleevec ndi wovomerezeka ndi FDA kuti athetse dermatofibrosarcoma protuberans, mtundu wochepa wa khansa yapakhungu, mwa akulu. Zimavomerezedwa kwa anthu omwe ali ndi khansa:

• sangathe kuchitidwa opareshoni
• wabweranso atalandira chithandizo
• ndi metastatic (yafalikira mbali zina za thupi)

Anthu ochepa adathandizidwa ndi Gleevec chifukwa cha izi m'maphunziro azachipatala. Mwa anthu omwe adatenga Gleevec, 39% idayankha kwathunthu kuchipatala. Izi zikutanthauza kuti khungu (kuchotsa ndi kuyesa pang'ono khungu) silinawonetse khansa.

Gleevec wa khansa ya m'mimba

Gleevec ndi wovomerezeka ndi FDA kuti athetse zotupa za m'mimba za Kit-positive m'mimba (GIST) mwa akulu omwe sangachite opareshoni kapena metastatic (afalikira mbali zina za thupi). Gleevec imavomerezedwanso kuti imachiza GIST mwa akulu omwe adachitidwapo opaleshoni kuti achotse zotupa. Njira yamankhwala iyi (chithandizo chothandizira) imagwiritsidwa ntchito popewera kuti khansa isabwererenso pambuyo pochitidwa opaleshoni.

M'maphunziro azachipatala, anthu omwe ali ndi GIST omwe sangathe kuchotsedwa opaleshoni adatenga 400 kapena 800 mg ya Gleevec. Anapulumuka pafupifupi zaka zinayi.

Anthu ena omwe ali ndi GIST adachitidwa opaleshoni. Pakati pa masiku 14 mpaka 70 pambuyo pake, adayamba kutenga Gleevec mu kafukufukuyu. Anali ndi chiopsezo chotsika 60% chofa kapena khansa kubwerera kwa miyezi 12. Izi zimafanizidwa ndi anthu omwe adatenga maloboti (mankhwala osagwiritsa ntchito mankhwala).

Ntchito zosagwiritsidwa ntchito pa Gleevec

Kuphatikiza pazomwe zatchulidwa pamwambapa, Gleevec atha kugwiritsidwa ntchito ngati cholembera pamagwiritsidwe ena. Kugwiritsa ntchito mankhwala osokoneza bongo ndi pamene mankhwala omwe amavomerezedwa kuti agwiritsidwe ntchito kamodzi amaperekedwa kwa osiyana omwe savomerezedwa.

Gleevec itha kugwiritsidwa ntchito polemba ma khansa ena, kuphatikiza:

• khansa ya prostate, malinga ndi kafukufuku wa 2015
• khansa ya khansa, malinga ndi malangizo a National Comprehensive Cancer Network
• mtundu wa 1 shuga, malinga ndi kuyesa kwachipatala cha 2018

Komabe, palibe kafukufuku wambiri momwe Gleevec amagwirira ntchito mwa anthu omwe ali ndi mikhalidwe imeneyi. Kafukufuku wowonjezereka amafunikira kuti adziwe ngati Gleevec amathandizira kuthana ndi vuto lililonse.

Gleevec kwa ana

Gleevec amavomerezedwa ndi FDA ngati chithandizo kwa ana omwe ali ndi izi:

• matenda a myeloid leukemia (CML) omwe amapezeka kumene ku Philadelphia (gawo loyamba la matendawa)
• Matenda a Ph + acute lymphocytic leukemia (ALL) atagwiritsidwa ntchito ndi chemotherapy

Gleevec imavomerezedwa kuti igwiritsidwe ntchito kwa ana azaka zonse. Komabe, sipanakhalepo maphunziro a momwe Gleevec alili otetezeka kapena othandiza mwa ana ochepera zaka 1.

Mtengo wa Gleevec

Monga mankhwala onse, mtengo wa Gleevec umasiyana.

Mtengo weniweni womwe mudzalipira umadalira inshuwaransi yanu komanso mankhwala omwe mumagwiritsa ntchito.

Thandizo lazachuma komanso inshuwaransi

Ngati mukufuna thandizo lazachuma kuti mulipire Gleevec, kapena ngati mukufuna thandizo kuti mumvetsetse inshuwaransi yanu, thandizo lilipo.

Novartis Pharmaceutical Corporation, yomwe imapanga Gleevec, imapereka pulogalamu yotchedwa Novartis Oncology Universal Co-pay Program. Kuti mumve zambiri komanso kuti mudziwe ngati mukuyenera kuthandizidwa, imbani 877-577-7756 kapena pitani patsamba lino.

Mlingo wa Gleevec

Mlingo wa Gleevec womwe dokotala amakupatsani umadalira pazinthu zingapo. Izi zikuphatikiza:

• mtundu ndi kuuma kwa chikhalidwe chomwe mukugwiritsa ntchito Gleevec kuchiza
• zaka
• kulemera (kwa ana)
• kupezeka kwa kusintha kwa majini
• matenda ena omwe mungakhale nawo
• mankhwala ena omwe mungamwe
• mavuto omwe mungakhale nawo

Mlingo womwe mudzalandire umadalira khansa yanu. Kwa khansa zina, dokotala wanu akhoza kukuyambitsani pamlingo wochepa. Kenako azisintha pakapita nthawi kuti afike pamlingo woyenera kwa inu.

Chidziwitso chotsatirachi chimalongosola miyezo yomwe amagwiritsidwa ntchito kwambiri kapena amalimbikitsidwa. Komabe, onetsetsani kuti mwatenga mlingo womwe dokotala akukulemberani. Dokotala wanu adzazindikira mlingo woyenera kuti ugwirizane ndi zosowa zanu.

Mitundu ya mankhwala ndi mphamvu

Gleevec amabwera ngati piritsi lomwe mumamwa (mumameza). Amapezeka m'mapiritsi a 100-mg ndi mapiritsi a 400-mg.

Mapiritsi a 100-mg ndi 400-mg amabwera m'mabotolo. Mapiritsi a 400-mg amabweranso ndi mapaketi omwe amakhala ovuta kuti ana atsegule.

Mlingo wa Gleevec

Mlingo wotsatira ndi momwe mungayambitsire mlingo uliwonse:

• Akuluakulu omwe ali ndi matenda a myeloid leukemia (CM +) a Philadelphia-positive (Ph +) omwe ali ndi matendawa (gawo loyamba la matendawa): 400 mg / tsiku
• Akuluakulu omwe ali ndi Ph + CML mgawo lofulumira kapena kuphulika (gawo lachiwiri ndi lachitatu la matendawa): 600 mg / tsiku
• akuluakulu omwe ali ndi Ph + acute lymphocytic leukemia (ALL): 600 mg / tsiku
• Akuluakulu omwe ali ndi matenda a myelodysplastic / myeloproliferative: 400 mg / tsiku
• Akuluakulu omwe ali ndi vuto la mastocytosis: 100 mg kapena 400 mg / tsiku
• akuluakulu omwe ali ndi matenda a hypereosinophilic komanso / kapena khansa ya m'magazi ya eosinophilic: 100 mg / tsiku kapena 400 mg / tsiku
• akuluakulu omwe ali ndi dermatofibrosarcoma protuberans: 800 mg / tsiku
• akuluakulu omwe ali ndi zotupa m'mimba (GIST): 400 mg / tsiku

Dokotala wanu angakupatseni mlingo winawake. Adzakhazikika pamomwe thupi lanu limayankhira ndi mankhwalawa, momwe mavuto anu amakhalira, ndi zina. Ngati muli ndi mafunso okhudza mulingo woyenera wa Gleevec kwa inu, lankhulani ndi dokotala wanu.

Mlingo wa ana

Mlingo wa ana ndi awa:

• ana omwe ali ndi Ph + CML mu gawo lalitali (gawo loyamba la matenda): 340 mg / m2 / tsiku
• ana omwe ali ndi Ph + ZONSE: 340 mg / m2 / tsiku loti atenge ndi chemotherapy

Dokotala wa mwana wanu adzakhazikitsa mlingo wa msinkhu ndi kulemera kwa mwana wanu. (Chifukwa chake 340 mg / m2 amatanthauza 340 mg pa mita yayikulu ya thupi.) Mwachitsanzo, ngati mwana wanu ali wamtali mamita 4 ndipo akulemera ma lbs 49, dera lawo lokwera ndi pafupifupi 0.87 m2. Chifukwa chake mlingo wa Ph + CML ungakhale 300 mg.

Ndingatani ngati ndaphonya mlingo?

Mukaphonya mlingo wa Gleevec, tengani kamodzi mukakumbukira. Ngati ili pafupi nthawi ya mlingo wanu wotsatira, dikirani ndikumwa mlingo wotsatira monga momwe munakonzera. Musatenge mankhwala awiri kuti mupange mlingo wosowa. Izi zitha kukulitsa chiopsezo cha zotsatirapo zoyipa.

Kodi ndiyenera kugwiritsa ntchito mankhwalawa nthawi yayitali?

Gleevec amayenera kugwiritsidwa ntchito ngati chithandizo chanthawi yayitali. Ngati inu ndi dokotala mukuwona kuti Gleevec ndiwotetezeka komanso wogwira ntchito kwa inu, mutha kutenga nthawi yayitali.

Njira Zina ku Gleevec

Mankhwala ena alipo omwe angathetse vuto lanu. Ena akhoza kukuyenererani kuposa ena. Ngati mukufuna kupeza njira ina yothetsera Gleevec, lankhulani ndi dokotala kuti mudziwe zambiri zamankhwala ena omwe atha kukuthandizani.

Zindikirani: Mankhwala ena omwe atchulidwa pano amagwiritsidwa ntchito ngati zilembo kuti athetse vutoli.

Njira zina za CML

Zitsanzo za mankhwala ena omwe angagwiritsidwe ntchito pochiza matenda a myeloid leukemia (CML) a Philadelphia-positive (Ph +) ndi awa:

• dasatinib (Sprycel)
• alirezatalischi (Tasigna)
• bosutinib (Bosulif)
• ponatinib (Iclusig)
• omacetaxine (Synribo)
• daunorubicin (Cerubidine)
• cytarabine
• interferon-alpha (Intron A)

Njira zina za GIST

Zitsanzo za mankhwala ena omwe angagwiritsidwe ntchito pochizira zotupa zam'mimba (GIST) ndi awa:

• sunitinib (Sutent)
• regorafenib (Stivarga)
• Chinyama (Nexavar)
• alirezatalischi (Tasigna)
• dasatinib (Sprycel)
• pazopanib (Wotchuka)

Njira zina zomwe Gleevec angathandizire zilinso. Lankhulani ndi dokotala wanu za mankhwala omwe angagwiritsidwe ntchito pa matenda anu.

Gleevec motsutsana ndi Tasigna

Mutha kudabwa momwe Gleevec amafanizira ndi mankhwala ena omwe amapatsidwa ntchito zofananira. Apa tikuwona momwe Gleevec ndi Tasigna alili ofanana komanso osiyana.

Ntchito

Food and Drug Administration (FDA) yavomereza onse a Gleevec ndi Tasigna kuti athetse mitundu ina ya khansa yamagazi.

Mankhwala onsewa ndi ovomerezeka ndi FDA kuti athetse matenda omwe amapezeka kuti ndi a Philadelphia-positive (Ph +) chronic myeloid leukemia (CML) omwe amakhala mgulu la akulu ndi ana.

Matenda a myeloid (CML) agawika magawo atatu:

• Matenda gawo. Ili ndiye gawo loyamba la CML. Anthu ambiri amapezeka ndi CML nthawi yayitali. Zizindikiro nthawi zambiri zimakhala zofatsa, ngati zilipo.
• Gawo lofulumira. Mchigawo chachiwirichi, kuchuluka kwa maselo a khansa m'magazi anu kumawonjezeka. Mutha kukhala ndi zizindikilo zambiri, monga kutentha thupi ndi kuchepa thupi.
• Gawo lamavuto ophulika. Mchigawo chotsogola kwambiri ichi, maselo a khansa m'magazi anu afalikira kumatumba ndi ziwalo zina. Zizindikiro zanu zimakhala zovuta kwambiri.

Gleevec imavomerezedwa kuti ichiritse Philadelphia-positive (Ph +) CML mwa achikulire omwe ali mgulu lazovuta, zofulumira, kapena zophulika ngati mankhwala a interferon-alpha sanagwire ntchito.

Interferon-alpha ndi mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza CML m'mbuyomu. Ndi mankhwala opangidwa ndi anthu omwe amachita ngati mapuloteni ena amtundu wa chitetezo ndikuletsa kukula kwa maselo a khansa.

Tasigna imavomerezedwa kuti ichiritse Ph + CML m'magawo akulu kapena othamanga mwa akulu ngati mankhwala ena sanagwire ntchito, kuphatikiza chithandizo ndi Gleevec. Tasigna sivomerezedwa mgawo lamavuto ophulika.

Tasigna imavomerezedwanso kuti ichiritse Ph + CML mwa ana azaka chimodzi kapena kupitilira apo ngati mankhwala ena sanagwire ntchito. Gleevec amavomerezedwa kuti athetse ana a Ph + CML omwe angopezedwa kumene.

Gleevec imavomerezedwanso kuti ithetse mitundu ina ya khansa. Onani gawo la "Ntchito zina za Gleevec" kuti mudziwe zambiri.

Mafomu azamankhwala ndi makonzedwe

Gleevec ili ndi mankhwala imatinib. Tasigna ili ndi mankhwala nilotinib.

Gleevec amabwera ngati piritsi. Tasigna amabwera ngati kapisozi. Mankhwala onsewa amatengedwa pakamwa.

Gleevec amatengedwa kamodzi kapena kawiri patsiku, kutengera mtundu wanu. Tasigna amatengedwa kawiri patsiku.

Gleevec amabwera ngati mapiritsi a 100-mg ndi 400-mg. Tasigna imabwera ngati 50-mg, 150-mg, ndi 200-mg capsules.

Zotsatira zoyipa ndi zoopsa

Gleevec ndi Tasigna ali ndi mankhwala ofanana. Chifukwa chake, mankhwala onsewa amatha kuyambitsa zovuta zina. M'munsimu muli zitsanzo za zotsatirazi.

Zotsatira zofala kwambiri

Mndandandawu muli zitsanzo za zovuta zoyipa zomwe zingachitike ndi Gleevec, ndi Tasigna, kapena ndi mankhwala onse awiri (akamwedwa payekhapayekha).

• Zitha kuchitika ndi Gleevec:
  • edema (kutupa kwa miyendo yanu, akakolo, ndi mapazi, ndi kuzungulira maso anu)
  • kukokana kwa minofu
  • kupweteka kwa minofu
  • kupweteka kwa mafupa
  • kupweteka m'mimba
• Zitha kuchitika ndi Tasigna:
  • mutu
  • khungu loyabwa
  • chifuwa
  • kudzimbidwa
  • kupweteka pamodzi
  • nasopharyngitis (chimfine)
  • malungo
  • thukuta usiku
• Zitha kuchitika ndi onse Gleevec ndi Tasigna:
  • nseru
  • kusanza
  • kutsegula m'mimba
  • zidzolo
  • kutopa (kusowa mphamvu)

Zotsatira zoyipa

Mndandandandawu muli zitsanzo za zovuta zoyipa zomwe zingachitike ndi Gleevec, ndi Tasigna, kapena ndi mankhwala onse awiri (akamwedwa payekhapayekha).

• Zitha kuchitika ndi Gleevec:
  • congestive mtima kulephera kapena mavuto amtima monga kumanzere kwa mtima kulephera
  • zotupa m'mimba (mabowo m'mimba mwanu kapena m'matumbo)
  • zotupa pakhungu, kuphatikiza matenda a Stevens-Johnson (malungo; zilonda zopweteka pakamwa panu, pakhosi, m'maso, kumaliseche, kapena thupi lonse)
  • kuwonongeka kwa impso
  • hypothyroidism (otsika a chithokomiro) mwa anthu omwe adachotsedwa chithokomiro
• Zitha kuchitika ndi Tasigna:
  • Kutalika kwa QT (magwiridwe antchito amagetsi mumtima mwanu), zomwe ndizosowa koma zimatha kubweretsa imfa mwadzidzidzi
  • anatseka mitsempha yamagazi mumtima
  • kapamba
  • kusamvana kwa ma electrolyte (kutsika kapena kutsika kwa mchere)
• Zitha kuchitika ndi onse Gleevec ndi Tasigna:
  • Matenda a magazi, kuphatikiza kuchepa kwa magazi (magazi ofiira ochepa), neutropenia (kuchuluka kwama cell oyera), ndi thrombocytopenia (ma platelets ochepa)
  • kuwonongeka kwa chiwindi
  • chotupa chotchedwa lysis syndrome (maselo a khansa amatulutsa mankhwala owopsa m'magazi anu)
  • kutaya magazi (kutuluka magazi komwe sikutha)
  • kusungidwa kwamadzimadzi koopsa (madzimadzi ambiri kapena madzi)
  • kuchepa kukula kwa ana

Kuchita bwino

Gleevec ndi Tasigna ali ndi ntchito zosiyanasiyana zovomerezeka ndi FDA. Koma onsewa amathandizira Ph + CML munthawi yayitali komanso mwachangu ngati njira zina zamankhwala sizinagwire ntchito. CML ili ndi magawo atatu: aakulu (gawo 1), ofulumira (gawo 2), ndi kuphulika kwamavuto (gawo 3).

Kugwiritsa ntchito kwa Gleevec ndi Tasigna pochiza a Ph + CML omwe atangopezeka kumene mwa akulu kuyerekezera mwachindunji kafukufuku wamankhwala. Ofufuzawo anayerekezera anthu omwe amatenga 400 mg ya Gleevec kamodzi patsiku kapena 300 mg ya Tasigna kawiri patsiku.

Pambuyo pa chithandizo cha miyezi 12, anthu 65% omwe adatenga Gleevec analibe maselo a Ph + m'mafupa awo (pomwe maselo a khansa a CML amakula). Mwa anthu omwe adatenga Tasigna, 80% analibe maselo a Ph + m'mafupa awo.

Pambuyo pa chithandizo cha zaka zisanu, anthu 60% omwe adatenga Gleevec anali ndi ziwerengero zochepa kwambiri za khansa m'magazi awo. Izi zikuyerekeza ndi 77% ya anthu omwe adatenga Tasigna.

Komanso atakhala zaka zisanu akuchipatala, anthu 91.7% omwe adatenga Gleevec adakali amoyo. Izi zikuyerekeza ndi 93.7% ya anthu omwe adatenga Tasigna.

Zotsatira za kafukufukuyu zikusonyeza kuti Tasigna atha kukhala othandiza kwambiri kuposa Gleevec pochiza Ph + CML yomwe yangopezeka kumene m'nthawi yayitali.

Mtengo

Gleevec ndi Tasigna onse ndi mankhwala osokoneza bongo. Tasigna alibe mawonekedwe achibadwa, koma Gleevec ali ndi mawonekedwe achibadwa otchedwa imatinib. Mankhwala omwe ali ndi dzina nthawi zambiri amawononga ndalama zambiri kuposa ma generic.

Malinga ndi kuyerekezera kwa GoodRx.com, dzina loti Gleevec litha kukhala lochepera kuposa Tasigna. Ma generic a Gleevec (imatinib) nawonso amawononga ndalama zochepa kuposa Tasigna. Mtengo weniweni womwe mudzalipire mankhwalawa umadalira mlingo wanu, mapulani a inshuwaransi, malo omwe muli, komanso mankhwala omwe mumagwiritsa ntchito.

Gleevec motsutsana ndi Sprycel

Mutha kudabwa momwe Gleevec amafanizira ndi mankhwala ena omwe amapatsidwa ntchito zofananira. Apa tikuwona momwe Gleevec ndi Sprycel alili ofanana komanso osiyana.

Ntchito

Food and Drug Administration (FDA) yavomereza onse a Gleevec ndi Sprycel kuti athetse mitundu ina ya khansa yamagazi.

Mankhwala onsewa ndi ovomerezeka ndi FDA kuti athetse matenda opatsirana a myeloid leukemia (CML) omwe amapezeka ku Philadelphia nthawi yayitali mwa akulu ndi ana.

CML imagawika magawo atatu:

• Matenda gawo. Ili ndiye gawo loyamba la CML. Anthu ambiri amapezeka ndi CML nthawi yayitali. Zizindikiro nthawi zambiri zimakhala zofatsa, ngati zilipo.
• Gawo lofulumira. Mchigawo chachiwirichi, kuchuluka kwa maselo a khansa m'magazi anu kumawonjezeka. Mutha kukhala ndi zizindikilo zambiri, monga kutentha thupi ndi kuchepa thupi.
• Gawo lamavuto ophulika. Mchigawo chotsogola kwambiri ichi, maselo a khansa m'magazi anu afalikira kumatumba ndi ziwalo zina. Zizindikiro zanu zimakhala zovuta kwambiri.

Gleevec ndi Sprycel amagwiritsidwa ntchito pochiza Ph + CML mwa akulu omwe ali mgulu lanthawi yayitali.

Gleevec imagwiritsidwanso ntchito pochizira Ph + CML mwa akulu omwe ali munthawi yayitali, yofulumira, kapena yophulika ngati mankhwala a interferon-alpha sanagwire ntchito. Interferon-alpha ndi mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza CML m'mbuyomu. Ndi mankhwala opangidwa ndi anthu omwe amachita ngati mapuloteni ena amtundu wa chitetezo ndikuletsa kukula kwa maselo a khansa.

Sprycel imagwiritsidwanso ntchito kuthana ndi Ph + CML mwa akulu omwe ali munthawi yayitali, yofulumira, kapena yophulika ngati Gleevec sinagwire ntchito.

Onse a Gleevec ndi Sprycel amavomerezedwa kuti azichitira Ph + CML munthawi yayitali mwa ana. Onsewa amavomerezedwanso kuti athetse ana a Ph + acute lymphocytic leukemia (ALL) mwa ana limodzi ndi chemotherapy.

Gleevec imavomerezedwanso kuti ithetse mitundu ina ya khansa. Onani gawo la "Ntchito zina za Gleevec" kuti mudziwe zambiri.

Mafomu azamankhwala ndi makonzedwe

Gleevec ili ndi mankhwala imatinib. Sprycel ili ndi mankhwala dasatinib.

Gleevec ndi Sprycel onse amabwera ngati mapiritsi omwe mumamwa (mumameza).

Mapiritsi a Gleevec amakhala ndi mphamvu ziwiri: 100 mg ndi 400 mg. Amatengedwa kamodzi kapena kawiri patsiku, kutengera kuchuluka kwanu.

Mapiritsi a Sprycel amabwera ndi mphamvu zotsatirazi: 20 mg, 50 mg, 70 mg, 80 mg, 100 mg, ndi 140 mg. Sprycel amatengedwa kamodzi patsiku.

Zotsatira zoyipa ndi zoopsa

Gleevec ndi Sprycel ndi ofanana koma ali ndi mankhwala osiyanasiyana. Chifukwa chake, mankhwala onsewa amatha kuyambitsa zovuta zina. M'munsimu muli zitsanzo za zotsatirazi.

Zotsatira zofala kwambiri

Mndandandandawu muli zitsanzo za zovuta zoyipa zomwe zingachitike ndi Gleevec, ndi Sprycel, kapena ndi mankhwala onse (akamwedwa payekhapayekha).

• Zitha kuchitika ndi Gleevec:
  • kusanza
  • kukokana kwa minofu
  • kupweteka m'mimba
  • dera la edema (kutupa mozungulira maso)
• Zitha kuchitika ndi Sprycel:
  • kuvuta kupuma
  • mutu
  • magazi
  • chitetezo chafooka (thupi lanu silingalimbanenso ndi matenda)
• Zitha kuchitika ndi onse Gleevec ndi Sprycel:
  • edema (kutupa kwa miyendo yanu, akakolo, ndi mapazi)
  • nseru
  • kupweteka kwa minofu
  • kupweteka kwa mafupa
  • kutsegula m'mimba
  • zidzolo
  • kutopa (kusowa mphamvu)

Zotsatira zoyipa

Mndandandandawu muli zitsanzo za zovuta zoyipa zomwe zingachitike ndi Gleevec, ndi Sprycel, kapena ndi mankhwala onse (akamwedwa payekhapayekha).

• Zitha kuchitika ndi Gleevec:
  • mavuto amtima, monga kupindika kwa mtima
  • kuwonongeka kwa chiwindi
  • zotupa m'mimba (mabowo m'mimba mwanu kapena m'matumbo)
  • kuwonongeka kwa impso
  • hypothyroidism (otsika a chithokomiro) mwa anthu omwe adachotsedwa chithokomiro
• Zitha kuchitika ndi Sprycel:
  • kuthamanga kwa magazi (kuthamanga kwa magazi m'mitsempha yamagazi m'mapapu anu)
  • Kutalika kwa QT (mtundu wamagetsi wamagetsi mumtima mwanu)
  • ischemic mtima (kusowa kwa mpweya ku minofu ya mtima)
• Zitha kuchitika ndi onse Gleevec ndi Sprycel:
  • kusungidwa kwamadzimadzi koopsa (madzimadzi ochulukirapo kapena madzi) mozungulira mapapu anu, mtima, ndi mimba
  • Matenda akulu am'magazi (maselo ofiira ofiira, magazi othandiza magazi kuundana, kapena maselo oyera)
  • Kutaya magazi kwambiri (kutuluka magazi komwe sikutha)
  • zotupa pakhungu, kuphatikiza matenda a Stevens-Johnson (malungo; zilonda zopweteka pakamwa panu, pakhosi, m'maso, kumaliseche, kapena thupi lonse)
  • chotupa chotchedwa lysis syndrome (maselo a khansa amatulutsa mankhwala owopsa m'magazi anu)
  • kugunda kwamtima kapena kuthamanga kwa mtima (kugunda kwamtima komwe kumakhala kothamanga kwambiri, kochedwa kwambiri, kapena kosasintha)
  • kukula kwa ana

Kuchita bwino

Gleevec ndi Sprycel ali ndi ntchito zosiyanasiyana zovomerezeka ndi FDA. Koma onsewa amathandizira Ph + CML yomwe yangopezeka kumene m'chigawo chachikulu (gawo loyamba la CML) mwa akulu ndi ana. Gleevec ndi Sprycel nawonso amachiza Ph + ZONSE mwa ana akagwiritsidwa ntchito limodzi ndi chemotherapy.

Kuphatikiza apo, onse a Gleevec ndi Sprycel amathandizira Ph + CML m'magawo apamwamba komanso kuphulika kwa akulu, kapena Ph + ZONSE, ngati mankhwala ena sawathandiza.

Kugwiritsa ntchito kwa Gleevec ndi Sprycel pochiza Ph + CML yomwe yangopezeka mwa akulu kwafaniziridwa mwachindunji pakafukufuku wamankhwala. Ofufuzawo anayerekezera anthu omwe amatenga 400 mg ya Gleevec patsiku kapena 100 mg ya Sprycel patsiku.

Pakadutsa miyezi 12, anthu 66.2% omwe adatenga Gleevec analibe maselo a Ph + m'mafupa awo (pomwe maselo a khansa a CML amakula). Mu gulu lomwe lidatenga Sprycel, anthu 76.8% analibe maselo a Ph + m'mafupa awo.

Pambuyo pa chithandizo cha zaka zisanu, anthu pafupifupi 89.6% omwe adatenga Gleevec adakali amoyo. Izi zikufanizidwa ndi anthu pafupifupi 90,9% omwe adatenga Sprycel.

Zotsatira za kafukufukuyu zikuwonetsa kuti Sprycel itha kukhala yothandiza pang'ono kuposa Gleevec pochiza Ph + CML yomwe yangopezeka kumene m'nthawi yayitali.

Mtengo

Gleevec ndi Sprycel onse ndi mankhwala osokoneza bongo. Sprycel alibe mawonekedwe achibadwa, koma Gleevec ali ndi mawonekedwe achibadwa otchedwa imatinib. Mankhwala omwe ali ndi dzina nthawi zambiri amawononga ndalama zambiri kuposa ma generic.

Malinga ndi kuyerekezera kwa GoodRx.com, dzina la Gleevec limatha kukhala lochepera kuposa Sprycel. Mtundu wa Gleevec (imatinib) ungathenso mtengo wotsika kuposa Sprycel. Mtengo weniweni womwe mudzalipire mankhwalawa umadalira mlingo wanu, dongosolo lanu la inshuwaransi, komwe mumakhala, komanso mankhwala omwe mumagwiritsa ntchito.

Gleevec ndi mowa

Sizikudziwika ngati Gleevec ndi mowa zimayenderana.

Komabe, chiwindi chanu chimagwiritsa ntchito Gleevec ndi mowa. Chifukwa chake kumwa mowa kwambiri mukamamwa Gleevec kungalepheretse chiwindi chanu kuwononga mankhwalawa. Izi zitha kukweza Gleevec mthupi lanu ndikuwonjezera chiopsezo chanu pazotsatira zoyipa, kuphatikiza kuwonongeka kwa chiwindi.

Onse Gleevec ndi mowa zimatha kuyambitsa zovuta monga:

• nseru
• kutsegula m'mimba
• mutu
• kutopa (kusowa mphamvu)

Kumwa mowa panthawi yomwe mumamwa mankhwala a Gleevec kumatha kukulitsa chiopsezo chokhala ndi zotsatirazi.

Mukamamwa mowa, kambiranani ndi dokotala wanu za zomwe zili bwino kwa inu mukamalandira chithandizo cha Gleevec.

Kuyanjana kwa Gleevec

Gleevec amatha kulumikizana ndi mankhwala ena angapo. Itha kulumikizananso ndi zowonjezera zowonjezera komanso zakudya zina.

Kuyanjana kosiyanasiyana kumatha kubweretsa zovuta zosiyanasiyana. Mwachitsanzo, ena amatha kusokoneza momwe mankhwala amagwirira ntchito, pomwe ena amatha kuyambitsa zovuta zina.

Gleevec ndi mankhwala ena

M'munsimu muli mndandanda wa mankhwala omwe angagwirizane ndi Gleevec. Mndandandawu mulibe mankhwala onse omwe atha kuyanjana ndi Gleevec.

Musanatenge Gleevec, lankhulani ndi dokotala komanso wamankhwala. Auzeni zamankhwala onse omwe mumalandira, pa-pakauntala, ndi mankhwala ena omwe mumamwa. Auzeni za mavitamini, zitsamba, ndi zowonjezera zilizonse zomwe mumagwiritsa ntchito. Kugawana izi kungakuthandizeni kupewa kuyanjana komwe kungachitike.

Ngati muli ndi mafunso okhudzana ndi mankhwala omwe angakukhudzeni, funsani dokotala kapena wamankhwala.

Gleevec ndi Tylenol

Kutenga Gleevec ndi Tylenol (acetaminophen) kumakulitsa chiopsezo chanu chazovuta zina, monga kuwonongeka kwa chiwindi.

Mavitamini (mapuloteni apadera) m'chiwindi chanu amawononga Gleevec ndi Tylenol. Pamodzi, mankhwala awiriwa amatha kupondereza michere ndikuwononga maselo m'chiwindi chanu.

Funsani dokotala wanu ngati zili bwino kuti mutenge Tylenol mukamamwa mankhwala a Gleevec.

Gleevec ndi mankhwala ena olanda

Kutenga Gleevec ndi mankhwala ena olanda kumatha kutsitsa kuchuluka kwa Gleevec mthupi lanu. Izi zitha kupangitsa kuti Gleevec asamagwire bwino ntchito (osagwira bwino ntchito).

Zitsanzo za mankhwala olanda omwe angachepetse milingo ya Gleevec ndi awa:

• phenytoin (Dilantin, Phenytek)
• carbamazepine (Carbatrol, Tegretol)
• anayankha

Ngati mukumwa Gleevec ndi mankhwala ena a khunyu, dokotala wanu angakupatseni mankhwala osiyana siyana kapena kusintha mlingo wa Gleevec.

Gleevec ndi maantibayotiki ena

Kutenga Gleevec ndi maantibayotiki ena (mankhwala omwe amachiza matenda a bakiteriya) atha kukulitsa kuchuluka kwa Gleevec mthupi lanu. Maantibayotiki amaletsa Gleevec kuti asawonongeke mthupi lanu. Izi zimawonjezera chiopsezo chanu pazotsatira zoyipa.

Chitsanzo cha maantibayotiki omwe amatha kuwonjezera milingo ya Gleevec ndi clarithromycin (Biaxin XL).

Ngati mukumwa Gleevec ndipo mukufuna maantibayotiki, dokotala wanu akhoza kukuyang'anirani zotsatira zake. Angakuthandizeninso kuchepetsa mlingo wanu wa Gleevec kwakanthawi.

Gleevec ndi ma antifungal ena

Kutenga Gleevec ndi mankhwala ena ophera fungal (mankhwala omwe amachiza matenda a mafangasi) amatha kuteteza kuwonongeka kwa Gleevec mthupi lanu. Izi zitha kukweza kuchuluka kwa Gleevec m'magazi anu ndikuwonjezera chiopsezo chanu pazotsatira zoyipa.

Zitsanzo za ma antifungals omwe atha kukulitsa milingo ya Gleevec ndi awa:

• itraconazole (Onmel, Sporanox, Tolsura)
• ketoconazole (Extina, Ketozole, Xolegel)
• chikumbutso (Vfend)

Ngati mukumwa Gleevec ndipo mukusowa mankhwala antifungal, dokotala wanu adzakuwunikirani zotsatira zake. Angakuthandizeninso kuchepetsa mlingo wanu wa Gleevec kwakanthawi.

Gleevec ndi opioids

Kutenga Gleevec ndimankhwala ena opweteka kumatha kukulitsa kuchepetsa ululu m'thupi lanu. Izi zitha kukupangitsani kukhala ndi zovuta zina monga sedation (kumva kusinza komanso kukhala tcheru) komanso kupuma movutikira (kupuma pang'onopang'ono).

Zitsanzo za mankhwala opioid opweteka omwe amatha kuwonjezera milingo ya Gleevec ndi awa:

• oxycodone (Oxycontin, Roxicodone, Xtampza ER)
• tramadol (ConZip, Ultram)
• methadone (Dolophine, Methadose)

Lankhulani ndi dokotala wanu ngati zili bwino kumwa mankhwala opweteka mukamalandira chithandizo cha Gleevec. Amatha kunena njira zina zothetsera ululu wanu.

Gleevec ndi mankhwala ena a HIV

Kumwa Gleevec ndi mankhwala ena a HIV kumatha kuonjezera chiopsezo chanu chazovuta. Mankhwala ena a kachilombo ka HIV amatha kuteteza Gleevec kuti asawonongeke, zomwe zimapangitsa kuti Gleevec azikhala wambiri mthupi lanu.

Zitsanzo za mankhwala a HIV omwe angakulitse kuchuluka kwa Gleevec ndi awa:

• atazanavir (Reyataz)
• nevirapine (Viramune)
• saquinavir (Invirase)

Mankhwala ena a HIV, efavirenz (Sustiva), amatha kutsitsa Gleevec mthupi lanu. Izi zitha kupangitsa kuti Gleevec asamagwire bwino ntchito.

Mankhwala ambiri a kachilombo ka HIV amabwera ngati mapiritsi osakanikirana, zomwe zikutanthauza kuti amaphatikiza mankhwala angapo. Choncho onetsetsani kuti mukukambirana ndi dokotala za mankhwala onse a HIV omwe mumamwa.

Ngati mukufunikira kumwa Gleevec ndi mankhwala ena a HIV, dokotala wanu akhoza kusintha mlingo wanu wa Gleevec.

Gleevec ndi mankhwala ena a magazi

Kutenga Gleevec ndi mankhwala ena a magazi kumatha kukulitsa kapena kuchepetsa kuchuluka kwa mankhwala m'thupi lanu. Izi zitha kukupangitsani kukhala ndi zovuta zina kapena kuchepetsa momwe mankhwala amagwirira ntchito.

Chitsanzo cha mankhwalawa ndi verapamil (Calan, Tarka).

Ngati mukufuna kumwa Gleevec ndi mankhwala aliwonsewa, dokotala wanu adzakuwunikirani bwino za zovuta zake. Akhozanso kusintha kusintha kwa mankhwala kapena mankhwala ena.

Gleevec ndi warfarin

Kutenga Gleevec ndi warfarin (Coumadin, Jantoven) kumakulitsa chiopsezo chanu chotaya magazi. Gleevec amaletsa warfarin kuti asawonongeke mthupi lanu. Izi zimawonjezera kuchuluka kwa warfarin ndipo zimatha kubweretsa magazi omwe ndi ovuta kuwongolera.

Ngati mukufuna anticoagulant (magazi ochepera magazi) mukamamwa Gleevec, dokotala wanu angakupatseni mankhwala ena kupatula warfarin.

Gleevec ndi St. John's wort

Kutenga Gleevec ndi St. John's wort kumatha kutsitsa kuchuluka kwa Gleevec mthupi lanu. Izi zitha kupangitsa Gleevec kukhala osagwira ntchito (osagwiranso ntchito).

Funsani dokotala wanu ngati wort ya St. John ndi yotetezeka kuti mukamwe mukamamwa mankhwala a Gleevec. Atha kulangiza njira ina ku St. John's Wort kapena kuwonjezera mlingo wanu wa Gleevec.

Gleevec ndi zipatso zamphesa

Kudya zipatso zamphesa kapena kumwa madzi amphesa panthawi yamankhwala anu a Gleevec kungakulitse chiopsezo chanu chazovuta zina. Chipatso champhesa chimakhala ndi mankhwala omwe amalepheretsa Gleevec kusweka mthupi lanu. Izi zimayambitsa kuchuluka kwa Gleevec, komwe kumatha kubweretsa zovuta zoyipa.

Onetsetsani kuti mupewe kudya zipatso za manyumwa komanso kumwa madzi amphesa panthawi yamankhwala anu a Gleevec.

Momwe mungatengere Gleevec

Onetsetsani kuti mwatenga Gleevec malinga ndi malangizo a dokotala kapena wothandizira zaumoyo.

Nthawi yoti mutenge

Pa Mlingo wa Gleevec wa 600 mg kapena ochepera, mankhwalawa ayenera kumwa kamodzi pa tsiku. Mutha kutenga nthawi iliyonse.

Ngati dokotala wanu akupatsani mankhwala a 800 mg a Gleevec patsiku, mutenga mankhwala awiri: 400 mg m'mawa ndi 400 mg madzulo.

Dokotala wanu adzakupatsani malangizo a nthawi yomwe muyenera kumwa mankhwala anu.

Kutenga Gleevec ndi chakudya

Tengani Gleevec ndi chakudya ndi kapu yayikulu yamadzi. Izi zitha kuthandiza kupewa kupwetekedwa m'mimba.

Kodi Gleevec ikhoza kuphwanyidwa, kugawanika, kapena kutafuna?

Simuyenera kuphwanya, kugawaniza, kapena kutafuna mapiritsi a Gleevec. Mapiritsi oswedwa ndi ogawanika atha kukhala owopsa pakhungu lililonse kapena ziwalo zina za thupi zomwe zimawakhudza.

Ngati mukuvutika kumeza mapiritsi a Gleevec, ikani piritsiyo mu kapu yamadzi kapena madzi apulo. Thirani madzi ndi supuni kuti piritsi lisungunuke. Kenako imwani chisakanizo nthawi yomweyo.

Momwe Gleevec amagwirira ntchito

Gleevec imakhala ndi imatinib, yomwe ili m'gulu la mankhwala otchedwa tyrosine kinase inhibitors (TKIs). Mankhwala m'kalasi la mankhwala a TKI amalimbikitsidwa kwambiri. Zimakhudza mapuloteni enieni m'maselo a khansa.

Gleevec amavomerezedwa kuti athetse mavuto osiyanasiyana. Apa tiwona momwe Gleevec amagwirira ntchito kuti athe kuchitira awiriwo.

Kwa Ph + CML

Ku Philadelphia-positive (Ph +) chronic myeloid leukemia (CML), maselo omwe amapanga maselo oyera amagazi amalakwitsa m'mapangidwe awo. Vutoli limapezeka pachingwe cha DNA chotchedwa chromosome ya ku Philadelphia.

Chromosome ya Philadelphia ili ndi jini yosazolowereka (BCR-ABL1) yomwe imayambitsa maselo oyera oyera ambiri. Maselo oyerawa samakhwima ndipo amafa momwe amayenera kukhalira. Maselo oyera oyera omwe amatchedwa "kuphulika" amatulutsa mitundu ina yamagazi yomwe magazi anu amafunika kuti azigwira ntchito moyenera.

Gleevec imagwira ntchito pomata puloteni, yotchedwa tyrosine kinase, m'maselo opangidwa ndi BCR-ABL1. Gleevec akamangirira puloteni iyi, mankhwalawa amalepheretsa khungu kuti lisatumize zikwangwani zomwe zimauza khungu kuti likule. Popanda zizindikilo izi, maselo a khansa amafa. Izi zimathandiza kubwezeretsa kuchuluka kwa maselo ophulika kukhala nambala yathanzi.

Za GIST

Gleevec imathandizanso kuthana ndi zotupa za m'mimba (GIST). M'maselo ambiri am'matumbo a GIST, pali mapuloteni ena ambiri, otchedwa Kit and platelet-derived kukula factor (PDGF), kuposa ma cell wamba. Mapuloteniwa amathandiza maselo a khansa kukula ndikugawana.

Gleevec amalimbana ndi mapuloteniwa ndikulepheretsa kugwira ntchito. Izi zimachepetsa kukula kwa khansa. Zimapangitsanso kuti maselo a khansa afe.

Zimatenga nthawi yayitali bwanji kuti zigwire ntchito?

Zimatengera. Nthawi yomwe Gleevec ayamba kugwira ntchito ndi yosiyana ndi munthu aliyense.

Maphunziro azachipatala adayang'ana anthu omwe ali ndi CML omwe adatenga Gleevec. M'mwezi umodzi, kuchuluka kwa maselo a khansa m'magazi kunachepetsedwa pafupifupi theka la anthu omwe ali mgulu lazovuta (CML). M'maphunziro a anthu omwe ali ndi GIST omwe adatenga Gleevec, zotupazo zidasiya kukula kapena kuchepa m'miyezi itatu.

Dokotala wanu amayang'anira magazi anu pafupipafupi kuti awone ngati Gleevec akukugwirirani ntchito.

Gleevec ndi mimba

Muyenera kupewa Gleevec ngati muli ndi pakati. Pakhala pali malipoti osokonekera komanso kupweteketsa mwana wosabadwa mwa amayi omwe adatenga Gleevec ali ndi pakati. Ndipo m'maphunziro azinyama, akazi apakati omwe adapatsidwa Gleevec anali ndi chiopsezo chowonjezeka cha zopunduka zobadwa.

Ngati muli ndi pakati, dokotala wanu akhoza kukulangizani kuti mudikire mpaka mutabereka mwana kuti muyambe kumwa Gleevec. Kapena apangira mankhwala ena.

Ngati mukumwa Gleevec, ndikofunikira kugwiritsa ntchito njira zolerera kuti musakhale ndi pakati. Mukalandira mlingo wanu womaliza wa Gleevec, pitirizani kugwiritsa ntchito njira zakulera kwa masiku 14.

Gleevec ndi kuyamwitsa

Kafukufuku akuwonetsa kuti Gleevec amadutsa mkaka wa m'mawere. Izi zitha kuvulaza mwana wakhanda woyamwitsa.

Ngati mukuyamwitsa ndikuganizira zakumwa kwa Gleevec, adokotala angakulangizeni kuti musiye kuyamwa mukayamba mankhwala.

Mukalandira Gleevec wanu womaliza, dikirani osachepera mwezi umodzi musanayambe kuyamwa.

Gleevec bongo

Kutenga Gleevec wambiri kumatha kuwonjezera chiopsezo chanu pazotsatira zoyipa.

Zizindikiro zambiri za bongo

Zizindikiro za bongo zingaphatikizepo:

• nseru
• kusanza
• kutsegula m'mimba
• kupweteka m'mimba
• totupa kwambiri
• mitsempha ya minofu (zopindika)
• mutu
• kusowa njala
• kufooka kwa minofu
• kutopa (kusowa mphamvu)
• kutupa
• Matenda a magazi, monga kuchuluka kwamagazi, maselo ofiira, kapena maselo oyera
• malungo

Zomwe muyenera kuchita mukamagwiritsa ntchito bongo

Ngati mukuganiza kuti mwamwa kwambiri mankhwalawa, itanani dokotala wanu. Muthanso kuyitanitsa American Association of Poison Control Center ku 800-222-1222 kapena kugwiritsa ntchito chida chawo pa intaneti. Koma ngati matenda anu akukulira, itanani 911 kapena pitani kuchipatala chapafupi pomwepo.

Mafunso wamba okhudza Gleevec

Nawa mayankho pamafunso omwe amafunsidwa kawirikawiri za Gleevec.

Kodi Gleevec ndi mtundu wa chemotherapy?

Gleevec si mwaukadaulo mtundu wa chemotherapy. Gleevec ndi mankhwala omwe amakhudzidwa omwe amakhudza mamolekyulu ena m'maselo a khansa.

Mwa kusankhira mamolekyulu apadera, njira zochiritsira monga Gleevec zimathandizira kuchepetsa kukula ndi kufalikira kwa maselo a khansa. Dokotala wanu amakupatsirani mankhwala omwe mungakonde malinga ndi mtundu wa khansa yomwe muli nayo.

Mankhwala a chemotherapy ndi osiyana ndi njira zochiritsira. Mankhwala a chemotherapy amachita ma cell onse mthupi omwe akukula mwachangu, osati ma cell a khansa okha. Mankhwala a chemotherapy nthawi zambiri amapha maselo omwe akukula ndipo amakhudza maselo ambiri mthupi kuposa momwe amathandizira.

Kodi mawonekedwe abwinobwino a Gleevec ndi othandiza monga mankhwala odziwika?

Food and Drug Administration (FDA) imafuna kuti omwe amapanga mankhwala achibadwa atsimikizire kuti mankhwala awo ali ndi:

• chinthu chogwiranso chimodzimodzi monga dzina la mankhwala
• mawonekedwe ofanana ndi muyeso wofanana ndi dzina la mankhwalawo
• njira yomweyo yoyendetsera (momwe mumamwa mankhwalawo)

Mankhwalawa amafunikanso kugwira ntchito mofananamo komanso monga dzina lodziwika.

Malinga ndi FDA, mtundu wa Gleevec umakwaniritsa izi. Izi zikutanthauza kuti FDA imatsimikizira kuti mawonekedwe achibadwa ndi othandiza monga dzina la mankhwala.

Kodi ndingathe kulimbana ndi mankhwala a Gleevec?

Inde. Ndizotheka kuti mutha kukhala osagwirizana ndi Gleevec. Kukaniza kumatanthauza kuti mankhwala amasiya kugwira ntchito pakapita nthawi. Zimaganiziridwa kuti izi zimachitika chifukwa cha kusintha kwa majini am'maselo a khansa.

Mukayamba kulimbana ndi Gleevec, dokotala wanu akhoza kukupatsani mankhwala okwera kwambiri. Awona ngati ma cell a khansa ayankhananso ndi mankhwala. Dokotala wanu amathanso kukupatsirani mankhwala ena omwe mulibe kukana.

Kodi pali zoletsa pazakudya zomwe ndiyenera kutsatira ndikamamwa Gleevec?

Palibe zoletsa pazakudya zomwe muyenera kutsatira mukamamwa Gleevec. Komabe, muyenera kupewa kudya zipatso zamphesa ndikumwa madzi amphesa. Chipatso champhesa chimakhala ndi mankhwala omwe angalepheretse thupi lanu kupukusa (kuphwanya) Gleevec. Izi zitha kupangitsa kuti mankhwala azikhala m'magazi anu ambiri. Magulu a Gleevec omwe ndi apamwamba kuposa abwinobwino amachulukitsa chiopsezo chanu chazovuta.

Kuphatikiza apo, adotolo angakupatseni upangiri wazakudya zanu kuti muchepetse zovuta zina. Mwachitsanzo, Gleevec amachititsa nseru ndi kusanza mwa anthu ambiri. Pofuna kupewa izi, adotolo angakulimbikitseni kuti mupewe zakudya zomwe zingawonjezere mseru. Izi zimaphatikizapo zakudya zolemera, zonona, kapena zamafuta, ndi zakudya zokometsera kapena acidic. Zitsanzo ndi msuzi wofiira kwambiri, zakudya zokazinga, ndi zakudya zambiri zachangu.

Pomaliza, ngati mukumwa Gleevec khansa ya m'mimba, monga zotupa za m'mimba (GIST), dokotala wanu angakulimbikitseni zoletsa zapadera pazakudya. Cholinga ndikuteteza mavuto m'mimba kapena m'matumbo. Lankhulani ndi dokotala wanu za zakudya zabwino kwambiri kwa inu.

Kodi ndikasiya kugwiritsa ntchito Gleevec ndikadzasiya?

Mutha. Anthu ena adayamba kusiya kutha atalandira chithandizo cha Gleevec. Phunziro limodzi laling'ono lazachipatala, anthu 30% anali ndi ululu waminyewa kapena mafupa atasiya Gleevec. Ululuwo umakhala m'mapewa awo, mchiuno, miyendo, ndi mikono. Chizindikiro chodzipatulira chidachitika pakatha sabata limodzi kapena sikisi atasiya kumwa mankhwala.

Pafupifupi theka la anthu adachiritsa zowawa zawo pochepetsa ululu. Hafu inayo inkafuna mankhwala ochokera kuchipatala. Mwa anthu ambiri omwe anali ndi zizindikiritso izi, kupweteka kwa minofu ndi mafupa kunatha pakadutsa miyezi itatu chaka chimodzi kapena kupitilira apo.

Kodi ndiyenera kugwiritsa ntchito mankhwala ena ndi Gleevec kuti ndithandizire?

Zimatengera momwe khansa yanu yapitira patsogolo. Pazigawo zapamwamba za khansa kapena khansa zomwe zafalikira kuubongo kapena msana, dokotala wanu akhoza kuwonjezera chemotherapy kuchipatala chanu cha Gleevec. Kuphatikiza apo, ana omwe ali ndi khansa ya m'magazi (Philadelphia + positive (Ph +) acute lymphocytic leukemia (ALL) atha kulandira Gleevec limodzi ndi chemotherapy.

Kwa mitundu ina ya khansa, dokotala wanu amathanso kukupatsani steroid. Ndipo mungafunikire kugwiritsa ntchito mankhwala kuti muthane ndi zovuta zina, monga kupweteka kwa kupweteka kwa minofu.

Kutha kwa Gleevec, kusunga, ndi kutaya

Mukapeza Gleevec ku pharmacy, wamankhwala adzawonjezera tsiku lotha ntchito pa cholembedwacho. Tsikuli limakhala chaka chimodzi kuchokera tsiku lomwe adapereka mankhwalawo.

Tsiku lothera ntchito limathandizira kutsimikizira kuti mankhwalawa ndi othandiza panthawiyi. Maganizo apano a Food and Drug Administration (FDA) ndikupewa kugwiritsa ntchito mankhwala omwe atha ntchito. Ngati mwagwiritsa ntchito mankhwala omwe sanadutse tsiku lomaliza, lankhulani ndi wamankhwala wanu. Amatha kukuwuzani ngati mutha kuigwiritsabe ntchito.

Yosungirako

Kutalika kwa nthawi yayitali kumadalira mankhwala, kuphatikiza momwe mungasungire mankhwalawo.

Sungani mapiritsi anu a Gleevec kutentha kwapakati pazidebe zomata. Onetsetsani kuti muteteze ku chinyezi.

Kutaya

Ngati simufunikiranso kumwa Gleevec ndikukhala ndi mankhwala otsala, ndikofunikira kuwataya mosamala.

Izi zimathandiza kupewa ena, kuphatikiza ana ndi ziweto, kuti amwe mankhwalawo mwangozi. Zimathandizanso kuti mankhwalawa asawononge chilengedwe.

Tsamba la FDA limapereka malangizo angapo othandiza pakutha mankhwala. Muthanso kufunsa wamankhwala wanu kuti mumve momwe mungathere mankhwala anu.

Zambiri zamaphunziro a Gleevec

Zotsatirazi zimaperekedwa kwa azachipatala ndi ena othandizira azaumoyo.

Zisonyezero

Gleevec (imatinib) ndivomerezedwa ndi FDA kuchitira izi:

• Akuluakulu ndi ana omwe ali ndi matenda a Philadelphia-positive (Ph +) aakulu myeloid leukemia (CML) omwe ali ndi matendawa
• akulu omwe ali ndi Ph + CML mgawo lililonse, kutsatira kulephera kwa mankhwala a interferon-alpha
• Akuluakulu omwe ali ndi vuto la Ph + acute lymphocytic leukemia (ALL)
• ana omwe ali ndi Ph + ALL omwe angotuluka kumene kuphatikiza ndi chemotherapy
• Akuluakulu omwe ali ndi matenda a myelodysplastic / myeloproliferative omwe amathandizidwa ndi ma platelet-derived kukula factor receptor rearrangements
• Achikulire omwe ali ndi mastocytosis aukali popanda D816V c-Kit kusintha kapena kusintha kwa c-Kit kosadziwika
• Akuluakulu omwe ali ndi matenda a hypereosinophilic and / kapena a eosinophilic leukemia omwe ali ndi FIP1L1-PDGFRcy fusion kinase, yoyipa ya FIP1L1-PDGFRcy fusion kinase, kapena mbiri yosadziwika
• Akuluakulu omwe ali ndi vuto losasunthika, lobwerezabwereza, kapena metastatic dermatofibrosarcoma protuberans (DFSP)
• Akuluakulu omwe ali ndi zida zosasunthika kapena zotupa m'mimba zotupa m'mimba (GIST)
• othandizira othandizira achikulire omwe ali ndi Kit + GIST kutsatira kutsatira kwathunthu

Njira yogwirira ntchito

Gleevec amaletsa BCR-ABL tyrosine kinase, yomwe ndi tyrosine kinase yachilendo yomwe imapezeka mu Ph + CML. Kuletsa kwa BCR-ABL tyrosine kinase kumalepheretsa kuchuluka kwa ma cell ndikupangitsa apoptosis m'mizere ya BCR-ABL komanso m'mizere yamagazi. Gleevec imaletsanso tyrosine kinases ya platelet-derived kukula factor (PDGF) ndi stem cell factor (SCF) komanso c-Kit, yomwe imalepheretsa kuchulukana komanso kuyambitsa apoptosis m'maselo a GIST.

Pharmacokinetics ndi metabolism

Kutanthauza kupezeka kwathunthu kwa bioavailability ndi 98% kutsatira kutsatira kwamlomo. Pafupifupi 95% ya mlingo umakhala ndi mapuloteni a plasma (makamaka albumin ndi α1-acid glycoprotein).

Metabolism imachitika makamaka kudzera pa CYP3A4 kupita ku metabolism yogwira ntchito, yokhala ndi metabolism yaying'ono yomwe imachitika kudzera pa CYP1A2, CYP2D6, CYP2C9, ndi CYP2C19. Metabolite yayikulu yoyenda imapangidwa makamaka ndi CYP3A4. Pafupifupi 68% amachotsedwa mu ndowe, ndi 13% mkodzo. Kuthetsa theka la moyo wosasintha mankhwala ndi maola 18 ndipo theka la moyo wa metabolite wogwira ntchito ndi maola 40.

Zotsutsana

Palibe zotsutsana kwathunthu ndi zomwe Gleevec amagwiritsa ntchito.

Kusunga ndi kusamalira

Mapiritsi a Gleevec amayenera kusungidwa kutentha (77 ° F / 25 ° C) mumtsuko wosindikizidwa kwambiri. Tetezani mapiritsi ku chinyezi.

Mapiritsi a Gleevec amaonedwa kuti ndi owopsa, malinga ndi miyezo ya Occupational Safety and Health Administration (OSHA). Mapiritsi sayenera kuphwanyidwa. Pewani kugwira mapiritsi osweka. Ngati khungu kapena ntchofu zimakumana ndi mapiritsi osweka, tsukani malo omwe akhudzidwa malinga ndi malangizo a OSHA.

Chodzikanira: Medical News Today yachita kuyesetsa konse kuti zitsimikizidwe kuti zowona zonse ndizolondola, zonse, komanso zaposachedwa. Komabe, nkhaniyi sikuyenera kugwiritsidwa ntchito m'malo mwa chidziwitso ndi ukadaulo wa akatswiri pazachipatala. Muyenera kufunsa adotolo kapena akatswiri azaumoyo musanamwe mankhwala aliwonse. Zambiri zamankhwala zomwe zili pano zitha kusintha ndipo sizingapangidwe kuti zigwiritse ntchito, mayendedwe, zodzitetezera, machenjezo, kulumikizana ndi mankhwala, kusokonezeka, kapena zovuta zina. Kusapezeka kwa machenjezo kapena zidziwitso za mankhwala omwe apatsidwa sikuwonetsa kuti kuphatikiza mankhwala kapena mankhwalawa ndiwotetezeka, ogwira ntchito, komanso oyenera kwa odwala onse kapena ntchito zina zilizonse.