Mlembi: Louise Ward
Tsiku La Chilengedwe: 4 Febuluwale 2021
Sinthani Tsiku: 19 Novembala 2024
Anonim
Emicizumab/Hemlibra® chez les personnes atteintes d’hémophilie A vivant avec inhibiteur
Kanema: Emicizumab/Hemlibra® chez les personnes atteintes d’hémophilie A vivant avec inhibiteur

Zamkati

Kodi Hemlibra ndi chiyani?

Hemlibra ndi mankhwala odziwika ndi dzina lodziwika bwino. Amaperekedwa kuti ateteze magawo omwe amatuluka magazi kapena kuwapangitsa kuti asamayende pafupipafupi mwa anthu omwe ali ndi hemophilia A, atha kukhala opanda kapena VIII (eyiti) inhibitors. Hemlibra imavomerezedwa kuti igwiritsidwe ntchito kwa anthu azaka zonse.

Hemlibra ili ndi mankhwalawa emicizumab, omwe ndi antioclonal antibody. Izi ndi mankhwala omwe amapangidwa kuchokera kuma cell a immune.

Hemlibra imabwera ngati yankho lomwe limaperekedwa ngati jakisoni pansi pa khungu lanu (subcutaneous). Wothandizira zaumoyo wanu akhoza kukupatsani jekeseni, kapena akhoza kudzipangira nokha kunyumba ndi anthu azaka zisanu ndi ziwiri kapena kupitilira apo.

M'maphunziro azachipatala omwe amakhala miyezi isanu ndi umodzi kapena kupitilira apo, Hemlibra yachepetsa kuchuluka kwa magazi onse ndi:

  • osachepera 94% mwa anthu opanda factor VIII inhibitors
  • osachepera 80% mwa anthu omwe ali ndi factor VIII inhibitors

Mtundu watsopano wa mankhwala

Asanagwiritse ntchito Food and Drug Administration (FDA) kuvomereza Hemlibra, mtundu waukulu wamankhwala omwe amagwiritsidwa ntchito pochiza hemophilia A anali woloza m'malo mwa VIII.


Anthu omwe ali ndi hemophilia A alibe factor VIII, protein yomwe thupi lanu liyenera kupanga magazi. Factor VIII m'malo ochiritsira amaika factor VIII m'magazi anu. Nthawi zambiri, chinthu cha VIII cholowa m'malo chimapangidwa mu labu, koma chitha kupangidwanso kuchokera m'madzi am'magazi operekedwa. Mankhwalawa amaperekedwa ngati jakisoni m'mitsempha yanu (m'mitsempha).

Hemlibra imapangidwa kuchokera kuma cell a labu. M'malo mochotsa chinthu cha VIII, Hemlibra imagwira ntchito yolumikizira pazinthu zina zomanga magazi m'mapazi. Izi zimapangitsa magazi kuundana bwino popanda chinthu VIII, ndikuthandizira kupewa magazi osalamulirika.

Hemlibra ndi mankhwala oyamba omwe amagwiritsidwa ntchito popewa kutaya magazi mwa anthu omwe ali ndi hemophilia A mwina wokhala ndi zolepheretsa VIII. Ma inhibitors ndi ma antibodies (immune system protein) omwe amayambitsa factor VIII ndikulepheretsa kuti iwundane. Anthu ena amapanga zoletsa kupatsidwa mankhwala VIII m'malo mwake, ndikupangitsa kuti mankhwalawo asagwire ntchito.

Hemlibra ndi mankhwala oyamba a hemophilia A omwe mungamwe ngati jakisoni pakhungu lanu (subcutaneous). Kuphatikiza apo, pali mitundu ingapo yama dosing, kuphatikiza sabata iliyonse, milungu iwiri iliyonse, kapena milungu inayi iliyonse. Mankhwala ena a hemophilia A amafunika kuti muwamwe nthawi zambiri, kuyambira tsiku lililonse mpaka kangapo pamlungu.


Kuvomerezeka ndi FDA

Food and Drug Administration (FDA) idavomereza koyamba Hemlibra mu 2017 kwa anthu omwe ali ndi hemophilia A wokhala ndi factor VIII inhibitors.

Mu 2018, a FDA adakulitsa kuvomereza kwawo kuphatikiza anthu omwe ali ndi hemophilia A omwe alibe factor VIII inhibitors.

Hemlibra generic

Hemlibra imapezeka kokha ngati mankhwala odziwika ndi dzina. Sikupezeka pakadali pano mu mawonekedwe achibadwa.

Hemlibra ili ndi mankhwala osokoneza bongo emicizumab, omwe nthawi zina amatchedwa emicizumab-kxwh. Kutha kwa "-kxwh" kumathandizira kupatula mankhwalawa kupatula mankhwala ofanana omwe atha kupezeka mtsogolo. Uwu ndi mtundu womwe umatchedwa ma anti-monoclonal antibodies (mankhwala opangidwa ndi ma cell a immune).

Chitetezo cha Hemlibra

Food and Drug Administration (FDA) imasonkhanitsa malipoti okhudzana ndi zotsatira zoyipa za mankhwala osokoneza bongo. Ogwira ntchito zaumoyo komanso zamankhwala amapereka malipoti awa ku FDA pogwiritsa ntchito fomu ya MedWatch Voluntary Reporting Fomu ndikuyimbira 800-FDA-1088 (800-322-1088). A FDA ndi a Genentech, omwe amapanga Hemlibra, amayang'anira mosamala malipoti achitetezo a Hemlibra.


Malipoti aimfa

Wopanga Hemlibra wanena zakufa 10 padziko lonse lapansi zomwe zidachitika pomwe anthu adatenga Hemlibra. Imfa izi zidachitika FDA itavomereza mankhwalawa. Sizikudziwika ngati mankhwalawa adapha anthu aliwonse.

Wopanga Hemlibra akupitilizabe kuwunika malipoti achitetezo okhudzana ndi mankhwalawa. Ngati muli ndi mafunso ngati Hemlibra ali otetezeka kwa inu, lankhulani ndi dokotala wanu.

Mtengo wa Hemlibra

Monga mankhwala onse, mtengo wa Hemlibra umatha kusiyanasiyana.

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

Thandizo lazachuma komanso inshuwaransi

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

Genentech, yemwe amapanga Hemlibra, amapereka pulogalamu yotchedwa Access Solutions. Kuti mumve zambiri komanso kuti mudziwe ngati mukuyenera kuthandizidwa, imbani 877-233-3981 kapena pitani patsamba lino.

Mlingo wa Hemlibra

Mlingo wa Hemlibra omwe dokotala wanu akukulemberani udalira pazinthu zingapo. Izi zikuphatikiza:

  • kulemera kwako
  • ndandanda ya chithandizo chomwe dokotala wasankha ndichabwino 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

Hemlibra imabwera m'miyendo imodzi yomwe imakhala ndi mphamvu zosiyanasiyana:

  • 30 mg / mL
  • 60 mg / 0,4 mL
  • 105 mg / 0,7 ml
  • 150 mg / mL

Mlingo uliwonse umaperekedwa ndi jakisoni pansi pa khungu lanu (subcutaneous). Mumagwiritsa ntchito botolo limodzi pa jakisoni, kenako ponyani botolo ndi madzi otsala omwe ali nawo.

Mlingo wa hemophilia A

Hemlibra nthawi zambiri imaperekedwa poyikira muyezo, womwe umatsatiridwa ndimiyeso yokonza. Kutsegula Mlingo mwachangu kumabweretsa mankhwalawo kufika pachimake mthupi lanu. Amakhala apamwamba kuposa kuchuluka kwa kukonza kapena amapatsidwa pafupipafupi.

Miyezo inayi yoyambirira ya Hemlibra ikutsitsa mlingo. Amapatsidwa ngati 3 mg / kg kamodzi pa sabata.

Mlingo uliwonse pambuyo pake ndi mankhwala osamalira. Dokotala wanu adzakusankhirani mlingo woyenera wosamalira. Mlingo wanu watengera kutengera kulemera kwanu. Zitha kukhala:

  • 1.5 mg / kg kamodzi pa sabata
  • 3 mg / kg kamodzi pa milungu iwiri iliyonse
  • 6 mg / kg kamodzi pa milungu inayi iliyonse

Zindikirani: Kilogalamu imodzi ya kulemera kwake ndiyofanana ndi mapaundi 2.2. Mwachitsanzo, ngati mutalemera makilogalamu 68, kuchuluka kwanu kwa 3 mg / kg kungakhale 204 mg ya Hemlibra sabata.

Mlingo wa ana

Mlingo wa ana umatengera kulemera kwake, monga miyezo ya akulu.

Ndingatani ngati ndaphonya mlingo?

Ngati mwaphonya mlingo wa Hemlibra, tengani mwamsanga mukamakumbukira. Kenako tengani mlingo wotsatira malinga ndi nthawi yanu. Musatenge mankhwala awiri tsiku limodzi. Kutenga mlingo umodzi tsiku lomwelo kumakulitsa chiopsezo chanu chazovuta zina.

Kodi ndiyenera kugwiritsa ntchito mankhwalawa nthawi yayitali?

Hemlibra si mankhwala a hemophilia, ndipo amafunika kumwedwa pafupipafupi kuti athandize kupewa magazi. Chifukwa chake ngati dokotala angaone kuti Hemlibra ndi njira yabwino komanso yothandiza kwa inu, atha kukulemberani kwa nthawi yayitali.

Palibe mankhwala a hemophilia panthawiyi.

Zotsatira zoyipa za Hemlibra

Hemlibra imatha kuyambitsa zovuta zochepa kapena zoyipa. Mndandanda wotsatirawu muli zovuta zina zomwe zingachitike mukamamwa Hemlibra. Mndandandawu mulibe zovuta zonse zomwe zingachitike.

Kuti mumve zambiri pazomwe zingachitike chifukwa cha Hemlibra, kapena maupangiri amomwe mungachitire ndi zovuta zina, lankhulani ndi dokotala kapena wamankhwala.

Zotsatira zofala kwambiri

Zotsatira zofala kwambiri za Hemlibra zitha kuphatikiza:

  • malo obayira jekeseni (kufiira, kupweteka, kapena kukoma kuzungulira komwe Hemlibra adalowetsedwa)
  • mutu
  • kupweteka pamodzi

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 Hemlibra sizachilendo, koma zimatha kuchitika.

Matupi awo sagwirizana

Zomwe zimayambitsa matendawa sizinachitike m'mayesero a Hemlibra. Komabe, mofanana ndi mankhwala ambiri, anthu ena amatha kusokonezeka atalandira Hemlibra. 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 loopsa la Hemlibra. Itanani 911 ngati zizindikiro zanu zikuwopseza moyo kapena ngati mukuganiza kuti mukukumana ndi vuto lachipatala.

Kuundana kwamagazi (pakagwiritsidwa ntchito ndi aPCC)

Mukamalandira mankhwala a Hemlibra, anthu ena nthawi zina amatha kulandira mankhwala omwe amathandiza kuti magazi asiye kutuluka, monga prothrombin complex concentrate (aPCC). Zotsatira zoyipa zimatha kuchitika ngati mutamwa mankhwalawa limodzi, monga chiwopsezo chowonjezeka chamagazi. Chiwopsezo chimakhala chachikulu mwa anthu omwe amatenga Hemlibra omwe amalandila ma 100 / kilogalamu aPCC patsiku kupitilira maola 24.

Mitundu yamagazi yomwe imatha kuchitika mukatenga Hemlibra ndi aPCC ndi monga:

  • Thrombotic microangiopathy (kuundana kwamagazi ndi kuvulala m'mitsempha yaying'ono yamagazi, kuphatikiza impso, maso, ubongo, ndi ziwalo zina). Zizindikiro zimatha kuphatikiza:
    • nseru
    • kusanza
    • kutupa kwa miyendo yanu ndi mikono yanu
    • kufooka
    • kukodza pafupipafupi kuposa zachilendo
    • kupweteka m'mimba
    • kupweteka kwa msana
    • chikasu cha khungu lako ndi oyera m'maso mwako
    • chisokonezo
  • Magazi amatundikira m'mitsempha ina, kuphatikiza m'mapapu, kumutu, mikono, ndi miyendo. Zizindikiro zimatha kuphatikiza:
    • mutu
    • kuvuta kuwona
    • kutsokomola magazi
    • kupweteka pachifuwa
    • kuvuta kupuma
    • kuthamanga kwa mtima
    • kutupa kwa miyendo yanu ndi mikono yanu
    • kupweteka kwa miyendo kapena mikono yanu

Ngati muli ndi zizindikiro za magazi, itanani dokotala wanu nthawi yomweyo. Itanani 911 ngati zizindikiro zanu zikuwopseza moyo kapena ngati mukuganiza kuti mukukumana ndi vuto lachipatala.

Mukayamba kugunda magazi mukamalandira mankhwala a Hemlibra ndi aPCC, dokotala wanu angakuletseni kumwa mankhwalawa kwakanthawi. Dokotala wanu adzasankha ngati kuli kotheka kuti muyambenso kutenga Hemlibra.

Hemlibra imagwiritsa ntchito

Food and Drug Administration (FDA) imavomereza mankhwala akuchipatala monga Hemlibra kuti athetse mavuto ena.

Hemlibra ya hemophilia A

Hemlibra ndivomerezedwa ndi FDA kuti ichiritse anthu amibadwo yonse omwe ali ndi hemophilia A. Imavomerezedwa kuti igwiritsidwe ntchito kwa anthu omwe ali ndi zopewera kapena zopanda VIII zoletsa magazi.

Factor VIII (eyiti) ndi mapuloteni omwe amapezeka mwachilengedwe m'magazi omwe amatenga gawo lofunikira pakupanga magazi. Anthu omwe ali ndi hemophilia A akusowa chinthu VIII, chifukwa magazi awo sawundana. Kulephera kupanga magazi kuundana kumaika anthu omwe ali ndi hemophilia pachiwopsezo chotaya magazi omwe samatha. Nthawi zina izi zimatha kupha.

Hemlibra asanavomerezedwe, chithandizo chachikulu cha hemophilia A chinali choyambitsa VIII. Mankhwalawa amalowa m'malo mwa chinthu VIII chomwe chikusowa m'magazi.

Koma anthu ena amapanga zoletsa akapatsidwa mankhwala a VIII m'malo mwake. Ma inhibitor ndi ma antibodies (immune system protein) omwe amawononga factor VIII, kuteteza chinthu cha VIII chothandizira m'malo mwake kuti chisagwire ntchito.

Hemlibra imagwira ntchito mosiyana. M'malo mochotsa chinthu cha VIII, Hemlibra imagwirizanitsa mapuloteni ena amwazi pamodzi. Izi zimapangitsa magazi kuundana bwino popanda chinthu VIII. Chifukwa siziphatikizira m'malo mwa VIII, Hemlibra imagwira bwino ntchito ngakhale pali zoletsa magazi.

Hemlibra pazinthu zina

Hemlibra sagwiritsidwa ntchito pochiza matenda ena aliwonse otuluka magazi.

Hemlibra ya hemophilia B (osagwiritsa ntchito moyenera)

Hemlibra sagwiritsidwa ntchito popewa kutaya magazi mwa anthu omwe ali ndi hemophilia B. Izi ndichifukwa choti anthu omwe ali ndi hemophilia B akusowa chinthu china chotseka magazi (protein ya magazi) kuposa anthu omwe ali ndi hemophilia A.

  • hemophilia A: kusowa kwa clotting factor VIII (eyiti)
  • hemophilia B: kusowa kwa clotting factor IX (zisanu ndi zinayi)

Hemlibra sichipangira chosowacho IX. Chifukwa chake sichingagwiritsidwe ntchito kupewa magazi mwa anthu omwe ali ndi hemophilia B.

Hemlibra ndi ana

Hemlibra ndivomerezedwa ndi FDA kuti igwiritsidwe ntchito kwa ana azaka zonse, ngakhale ana obadwa kumene. Mankhwalawa amagwiritsidwa ntchito mofanana ndi akulu. Hemlibra imathandiza kupewa magazi kwa anthu omwe ali ndi hemophilia A wokhala ndi kapena wopanda factor VIII inhibitors.

Malangizo ogwiritsira ntchito Hemlibra

Muyenera kutenga Hemlibra malinga ndi malangizo a omwe amakuthandizani pa zaumoyo.

Wothandizira zaumoyo wanu akhoza kukupatsani jakisoni wa Hemlibra kuchipatala kapena kuofesi. Kapenanso akhoza kukuphunzitsani momwe mungadzibayire jekeseni.

Zitha kuthandizira kusunga jakisoni wa jakisoni wanu. Phatikizani zambiri monga:

  • tsiku la jakisoni aliyense
  • malo opangira jekeseni
  • zambiri za vial (mutha kuzipeza pa vial) *

* Kulemba zambiri zamtunduwu kumathandizira othandizira azaumoyo kuti azitha kugwiritsa ntchito mankhwala azitsamba, monga Hemlibra. Izi ndizothandiza ngati zotsatira zoyipa zimachitika.

Pansipa pali zambiri zamomwe mungadzibayire Hemlibra nokha. Kuti mumve zambiri, kanema, ndi zithunzi zothandiza, onani tsamba la Hemlibra, kuphatikiza kalozera ka tsatanetsataneyu.

Kukonzekera jekeseni wa Hemlibra

Werengani izi musanadzipatse jakisoni wa Hemlibra.

  1. Tengani botolo (kapena mabotolo, kutengera mlingo wanu) wa Hemlibra kunja kwa firiji mphindi 15 musanakonzekere kubaya. Izi zimapangitsa kuti mankhwala azibwera kutentha musanabaye jakisoni.
  2. Musayese kutentha yankho mu microwave kapena poyendetsa pansi pamadzi otentha. Izi zitha kupangitsa kuti Hemlibra asatetezeke, ndipo mwina sizingagwire ntchito.
  3. Onetsetsani botolo kuti muwonetsetse kuti yankho latsimikizika kukhala lachikasu pang'ono. Ngati kuli mitambo, yofiira, kapena ili ndi tinthu, musagwiritse ntchito. Musagwedeze mbale.
  4. Pamene mukudikirira kuti Hemlibra abwere kutentha, sonkhanitsani zinthu zanu. Zina kupatula ziwiya za Hemlibra, mudzafunika: Kupukuta mowa, gauze wa thonje, mipira ya thonje, singano yosamutsa, syringe, singano ya jekeseni ndi chitetezo chachitetezo, ndi chidebe chotayira
  5. Sambani m'manja ndi sopo.
  6. Sankhani malo anu obayira jekeseni. Itha kukhala amodzi mwamalo awa atatu: Malo am'mimba (osachepera mainchesi awiri kuchokera kumimba kwanu), kutsogolo kwa ntchafu yanu, ndi kumbuyo kwa mkono wanu wakumtunda (ngati wina akukupatsani jakisoni)
  7. Pewani jekeseni wa timadontho kapena khungu lililonse lofiira, lophwanyika, kapena zipsera.

Jekeseni wa Hemlibra

Tsatirani izi kuti mulowetse Hemlibra.

Kukonzekera vial ndi syringe

Kuti mukonzekere botolo ndi syringe pokonzekera jakisoni, tsatirani izi:

  1. Chotsani kapu m'chivundikirocho ndi kuitaya mu chidebe chanu chotayira.
  2. Sambani pamwamba pa botolo pomaliza ndikupukuta mowa.
  3. Onetsetsani singano yosamutsirayo (mukadali mu kapu yake yoteteza) ku syringe. Chitani izi pokankha ndi kupotoza singano yosamutsa mozungulira mpaka ikalumikizidwa.
  4. Pepani pang'onopang'ono kuti mufufuze. Dokotala wanu angakuuzeni kuchuluka kolondola.
  5. Gwirani sirinji pafupi ndi mbiya ndi dzanja limodzi. Onetsetsani kuti singano ikuloza.
  6. Mosamala kokerani kapu ya singano molunjika pa singano. Osataya kapu. Mudzafunika kuti mubwezeretsenso singano mutagwiritsa ntchito. Ikani kapu pamalo oyera, osalala. Osayika singano yosamutsira itatha.

Kudzaza syringe

Nazi njira zodzaza syringe:

  1. Gwirani botolo pamalo athyathyathya. Jekeseni singano yosunthira mpaka pakatikati pa botolo.
  2. Kusunga singano mu botolo, nyamula botolo ndikuyitembenuza mozondoka.
  3. Ndi mfundo ya singano pamwamba pa mulingo wamankhwala, kanizani cholowacho kuti mulowetse mpweya m'malo opitilira mankhwalawo. Osalowetsa mpweya m'mankhwala.
  4. Kuyika chala chanu pa plunger, kokani syringe yonse mpaka nsonga ya singano ili mkati mwa mankhwala.
  5. Pepani pang'onopang'ono kuti mudzaze syringe ndi zochuluka kuposa kuchuluka kofunikira pamlingo wanu. (Dziwani: Ngati mulingo wanu ukupitilira kuchuluka kwa vial, lembani syringe ndi mankhwala onse ochokera mu botolo. Onani malangizo kwa wopanga ngati mukufuna kugwiritsa ntchito botolo lopitilira muyeso wanu.)
  6. Kusunga sirinji m'chiwiya, yang'anani thovu lililonse lalikulu lomwe lingakulepheretseni kumwa mulingo woyenera. Ngati muwona zilizonse, dinani pang'ono mbiya ya syringe ndi zala zanu kuti thovu likwere pamwamba. Kenako pang'onopang'ono ikani plunger kuti singano ikhale mlengalenga pamwamba pa mankhwala. Pitirizani kukankhira plunger kuti muchotse thovu mu syringe.
  7. Onetsetsani ngati mankhwala omwe ali mu syringe tsopano ndi ocheperako kapena ofanana ndi muyeso wanu. Ngati ndi choncho, kokani chingwecho kuti singano ilinso mkati mwa mankhwalawo. Kenako pitirizani kukoka plunger mpaka kuchuluka kwa jakisoniyo kuposa mulingo woyenera.
  8. Bwerezani njira 6 ndi 7 kuti muwonetsetse kuti mulibe thovu mu syringe ndipo muli ndi mlingo woyenera mu syringe.
  9. Chotsani syringe ndikusamutsa singano kuchokera kubotolo.

Kutaya singano yosamutsa

Mukadzaza syringe, muyenera kutseka ndi kutaya singano yosamutsira. Umu ndi momwe:

  1. Gwirani sirinji m'dzanja limodzi ndikulumikiza singanoyo mu kapu yake, yomwe mudayika pamalo athyathyathya. Sungani mmwamba kuti kapuyo igwere pansi ndikuphimba singano.
  2. Onetsetsani kuti singano ili ndi kapu. Ndi dzanja lanu, dinani pansi pa kapu kuti mugwirizane ndi syringe.
  3. Chotsani singano yosamutsira mu syringe poipotoza motsutsana ndi wotchinga ndi kukoka modekha. (Simugwiritsa ntchito singano yosinthira jakisoni wa mankhwala. Izi zitha kukhala zopweteka ndipo zitha kuvulaza khungu.)
  4. Tayani singano yosamutsira mu chidebe chotayira.

Jekeseni wa Hemlibra

Mukakonzeka kubaya Hemlibra, tsatirani izi:

  1. Pukutani malo omwe mwasankha ndi jambulani mowa ndikuti uumitse mpweya kwa masekondi 10.
  2. Onetsetsani singano ya jakisoni mu syringe pokankhira ndikuzungulirazungulira mpaka itakhazikika.
  3. Kokerani chishango kutali ndi singano (kulunjika ku mbiya ya jekeseni).
  4. Mosamala chotsani chipewacho pa singano ndikuponyera mu chidebe chotayira. Pewani kugwira nsonga ya singano, ndipo musayike singano pamalo aliwonse.
  5. Mukachotsa kapuyo, muyenera kubaya Hemlibra nthawi yomweyo. Sungani plunger mu syringe kuti mugwirizane ndi muyeso wanu. Mphepete pamwamba pa plunger iyenera kukhala yogwirizana ndi chizindikiro cha mlingo woyenera.
  6. Tsinani khungu lanu pamalo obayira omwe mwasankha.
  7. Mofulumira komanso molimba, ikani singanoyo pamtunda wa madigiri 45 kapena 90 digiri pakhungu latsinalo. Osakanikiza pa plunger panobe.
  8. Singano ikalowetsedwa mokwanira pakhungu lanu, siyani malo otsinira.
  9. Pepani pang'onopang'ono kuti mulowe mpaka mutalowetsa mankhwala onse.
  10. Chotsani singanoyo pochikoka mbali yomwe munayikirayo.

Pambuyo pobayira Hemlibra

Mukalandira jakisoni wa Hemlibra, tsatirani izi:

  1. Ikani singano pansi. Phimbani singanoyo mwa kukanikiza chishango chachitetezo pa syringe kutsogolo mozungulira madigiri 90 (kutali ndi mbiya). Mverani kuti mumve phokoso. Izi zimakuthandizani kudziwa kuti singano ili ndi chodzitchinjiriza chachitetezo.
  2. Sungani singano mu syringe. Osachotsa. Ndipo musalowe m'malo mwa chipewa cha singano.
  3. Ponyani botolo, singano, ndi syringe zomwe mumagwiritsa ntchito m'chidebe chanu chakuthwa.
  4. Mukawona madontho pang'ono a magazi pamalo anu opangira jekeseni, kanikizani mpira kapena thonje pomwepo. Ngati magazi sasiya, itanani dokotala wanu.
  5. Pewani kupaka malo obayira jekeseni.

Nthawi yotenga Hemlibra

Dokotala wanu angakuuzeni kangati kuti mutenge Hemlibra. Atha kufuna kuti mutenge Hemlibra kamodzi pa sabata, kamodzi sabata iliyonse, kapena kamodzi milungu inayi.

Tengani Hemlibra tsiku lomwelo la sabata. Mwachitsanzo, ngati mutenga Hemlibra kamodzi pa sabata, mutha kusankha kutenga Lolemba lililonse.

Zikumbutso zamankhwala zitha kuthandizira kuwonetsetsa kuti simuphonya mlingo.

Hemlibra ndi mowa

Palibe kulumikizana komwe kumadziwika pakati pa Hemlibra ndi mowa. Komabe, ngati muli ndi hemophilia A, magazi anu sawundana bwino. Kumwa mowa kumathandizanso kuti magazi anu asapangike m'mimbamo pochepetsa kuchuluka kwa magazi m'magazi anu. Zotsatira zake, kumwa mowa kwambiri ndikumwa Hemlibra kungachepetse momwe Hemlibra idzakhalire yogwira mtima.

Ngati mumamwa mowa, kambiranani ndi dokotala wanu ngati kumwa ngati mukumwa Hemlibra ndikwabwino kwa inu.

Kuyanjana kwa Hemlibra

Hemlibra amatha kulumikizana ndi mankhwala ena angapo. Itha kulumikizananso ndimayeso ena a labu.

Kuyanjana kosiyanasiyana kumatha kubweretsa zovuta zosiyanasiyana. Mwachitsanzo, kulumikizana kwina kumatha kusokoneza momwe mankhwala amagwirira ntchito. Kuyanjana kwina kumawonjezera mavuto kapena kuwapangitsa kukhala owopsa.

Hemlibra ndi mankhwala ena

M'munsimu muli mankhwala omwe angagwirizane ndi Hemlibra. Mndandandawu mulibe mankhwala onse omwe amatha kulumikizana ndi Hemlibra.

Musanatenge Hemlibra, 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.

Hemlibra ndi prothrombin complex concentrate (aPCC)

Yoyambitsa prothrombin complex concentrate (aPCC) ndi mankhwala omwe amathandiza kuti magazi asiye kutuluka. Ngakhale kuti Hemlibra itha kugwiritsidwa ntchito ndi aPCC, kumwa mankhwalawa palimodzi kungakulitse chiopsezo chanu chamagazi. Izi ndizoopsa kwambiri kwa anthu omwe amatenga Hemlibra omwe amalandira ma 100 / kg aPCC patsiku kwa nthawi yayitali kuposa maola 24.

Ngati mukufuna aPCC mukamamwa Hemlibra, dokotala wanu adzakuyang'anirani mosamala ngati pali zizindikiro zamagazi. Magazi ena akhoza kukhala owopsa, ndipo mungafunike kupita kuchipatala nthawi yomweyo. (Kuti mumve zambiri, onani gawo la "Zotsatira za Hemlibra" pamwambapa.)

Mukayamba kugunda magazi mukamamwa mankhwalawa limodzi, dokotala wanu angafune kuti musiye kumwa Hemlibra. Adzaganiza ngati zili bwino kuti muyambenso kumwa mankhwalawa.

Hemlibra ndi mankhwala ena a hemophilia A.

Kutenga Hemlibra yokhala ndi hemophilia A mankhwala akhoza kuwonjezera chiopsezo chanu chokhudzana ndi magazi. Malangizo apadera ogwiritsa ntchito Hemlibra ndi hemophilia A mankhwala monga awa:

  • Lekani kugwiritsa ntchito othandizira ena (mankhwala kwa anthu omwe ali ndi zoletsa) tsiku limodzi musanayambe kumwa Hemlibra. Zitsanzo zodutsa othandizira ndi anti-inhibitor coagulant complex (FEIBA) komanso zophatikizananso ndi coagulation ya anthu Factor VIIa (NovoSeven).
  • Ngati kuli kotheka, pitirizani kuthandizira mankhwala a VIII kwa mlungu umodzi mutatha kumwa mankhwala oyamba a Hemlibra.

Ngati muli ndi mafunso okhudza momwe mungatengere mankhwala ena a hemophilia ndi Hemlibra, lankhulani ndi dokotala wanu.

Hemlibra ndi mayeso ena a labotale

Hemlibra itha kusokoneza zotsatira za mayeso ena a labu ndikuwerenga zabodza. Mayesowa amaphatikizaponso ena omwe amayang'ana kutalika kwa magazi anu kuti aumbike. Chimodzi mwazoyeserera izi ndi mayeso oyeserera pang'ono a thromboplastin time (aPTT).

Hemlibra imatha kukhudza zotsatira za mayeso kwa miyezi isanu ndi umodzi mutangomaliza kumwa mankhwala. Mukafunika kukayezetsa labu, uzani dokotala wanu za mankhwala aliwonse apakale a Hemlibra kuti athe kuyitanitsa mayeso oyenera.

Njira Zina za Hemlibra

Mankhwala ena alipo omwe angapewe kutaya magazi kapena kuchepetsa kuchuluka kwa magazi kwa anthu omwe ali ndi hemophilia A. Ena akhoza kukuyenererani kuposa ena. Ngati mukufuna kupeza njira ina m'malo mwa Hemlibra, lankhulani ndi dokotala wanu.

Hemlibra ndiyapadera chifukwa:

  • imagwira ntchito mosiyana ndi mankhwala wamba (chinthu VIII m'malo mwake)
  • imagwira ntchito kwa anthu omwe alibe kapena opanda VIII inhibitors
  • ndi mankhwala oyamba omwe mungamwe ngati jakisoni wocheperako khungu (jakisoni pansi pa khungu), m'malo momulowetsa m'mitsempha (jekeseni mumtsempha)
  • amakhala otanganidwa ndi magazi kwa nthawi yayitali, kotero mutha kumamwa sabata iliyonse, kamodzi sabata iliyonse, kapena kamodzi pamwezi
  • sichipangidwa kuchokera ku plasma kapena magazi a munthu
  • sizimayambitsa factor VIII inhibitors kukula

Mankhwala ena a hemophilia A amaphatikizapo anti-inhibitor coagulant complex (FEIBA), yomwe ndi prothrombin complex concentrate (aPCC).

Njira zambiri zochiritsira zosinthira m'malo mwa VIII ziliponso zomwe zingagwiritsidwe ntchito pafupipafupi kuthandiza kupewa magazi, kuphatikiza:

  • Limbikitsani
  • Onjezerani
  • Jivi
  • Zovuta
  • Novoeight

Dokotala wanu amalankhula nanu za zabwino ndi zoyipa zamankhwala osiyanasiyana a hemophilia A. Agwira nanu ntchito kuti mupeze chithandizo chomwe chikugwirizana ndi zosowa zanu.

Momwe Hemlibra imagwirira ntchito

Hemophilia A ndimatenda akumwa. Zimayambitsidwa ndi chinthu chosowa chotseka chotchedwa factor VIII (eyiti). Zinthu zotseka ndi mapuloteni m'magazi omwe amathandiza kuchepetsa magazi.

Popanda chinthu VIII, magazi anu sangapangitse magazi kuuma mukamatuluka magazi kapena kuvulala. Izi zitha kubweretsa magazi owopsa, mwina owopsa.

Hemlibra ndi antioclonal antibody, yomwe ndi chitetezo chamthupi chomwe chimapangidwa mu labu. Amapangidwa kuchokera kuma cell aminyama ndipo mulibe plasma yamunthu kapena magazi.

Ma antibodies, omwe amapezeka mwachilengedwe mthupi, amalumikizana ndi mamolekyulu apadera m'magazi. Hemlibra imamangirira mamolekyulu awiri: chochita chowumitsa IX (zisanu ndi zinayi) ndi chinthu chowumitsa X (khumi).

Nthawi zambiri, factor VIII amalumikiza chinthu IX ndi factor X. Koma mu hemophilia A, factor VIII amasowa. Hemlibra imagwira ntchito pochita zomwe VIII ikadachita. Zimabweretsa chinthu IX ndi factor X palimodzi kuti athe kuthandizira magazi kuundana. Izi zimathandiza kuchepetsa kuchuluka kwa magazi omwe angakhalepo.

Kodi Hemlibra imagwira ntchito bwanji kwa anthu omwe ali ndi zoletsa?

Kwa anthu ena omwe ali ndi hemophilia, chitetezo cha mthupi lawo chimapanga ma antibodies (immune system protein) kuti apange factor VIII ikaperekedwa ngati chithandizo chamankhwala. Ma antibodies awa amayambitsa factor VIII, yomwe imalepheretsa chithandizo cha factor VIII m'malo mwake.

Hemlibra imagwira ntchito mosiyana ndi njira ya VIII m'malo mwake. M'malo mochotsa chinthu cha VIII, Hemlibra amatenga gawo VIII yomwe ikadakhala yolumikizana ndi mapuloteni ena amwazi. Izi zimapangitsa magazi kuundana bwino popanda chinthu VIII. Zotsatira zake, Hemlibra imagwira bwino ntchito ngakhale pali zoletsa magazi.

Zimatenga nthawi yayitali bwanji kuti zigwire ntchito?

Sizikudziwika kuti mungayambe msanga bwanji kutaya magazi ochepa mutayamba Hemlibra. Kuyesedwa kwachipatala kunawonetsa kuti anthu anali ndi magazi ochepa m'mwezi isanu ndi umodzi atalandira Hemlibra. Komabe, zotsatira zoyesayesa sizinawonetse nthawi yomwe kuchepa kwa magazi kumayamba.

Izi zati, tikudziwa kuti mutalandira jakisoni, zimatenga pakati pa tsiku limodzi kapena awiri kuti magazi anu atenge Hemlibra. Ndipo magwiridwe anthawi zonse a mankhwalawa amasungidwa m'magazi anu pambuyo pa milungu inayi yoyambirira ya dosing.

Ngati muli ndi mafunso okhudza nthawi yomwe muyenera kuwona zotsatira kuchokera ku Hemlibra, lankhulani ndi dokotala wanu.

Hemlibra ndi mimba

Sizikudziwika ngati Hemlibra ndi yabwino kutenga panthawi yapakati. Sipanakhalepo maphunziro aumunthu kapena nyama yoyesa chitetezo cha kugwiritsa ntchito kwa Hemlibra panthawi yapakati.

Ngati mutenga Hemlibra ndipo mukuganiza zokhala ndi pakati, kambiranani ndi dokotala ngati mukufuna kupitiriza kutenga Hemlibra.

Onetsetsani kuti mukugwiritsa ntchito njira zakulera mukamamwa Hemlibra ngati dokotala wanena kuti sizabwino kuti mukhale ndi pakati mukamalandira chithandizo.

Hemlibra ndi kuyamwitsa

Sizikudziwika ngati Hemlibra imadutsa mkaka wa m'mawere. Ngati mukuyamwitsa mwana wanu ndikuganiza zotenga Hemlibra, lankhulani ndi dokotala wanu ngati mankhwalawa ndi otetezeka kwa mwana wanu.

Mafunso wamba okhudza Hemlibra

Nawa mayankho pamafunso omwe amafunsidwa okhudza Hemlibra.

Kodi Hemlibra ingagwiritsidwe ntchito mwa anthu omwe alibe zoletsa?

Inde. Hemlibra ndivomerezedwa ndi FDA kuti igwiritsidwe ntchito kwa anthu omwe ali ndi hemophilia A omwe alibe ma inhibitors (komanso anthu omwe alibe). Kafukufuku wamankhwala amayerekezera Hemlibra ndi chithandizo chilichonse. Amayang'ana magulu awiri a anthu opanda zoletsa: ana amuna azaka zapakati pa 12 ndi kupitilira apo, komanso akulu akulu amuna. Magulu awiriwa adamwa mankhwalawa kwa milungu yosachepera 24 ndipo anali ndi:

  • 95% amachepetsa magazi akamamwa 1.5 mg / kg ya Hemlibra sabata iliyonse
  • 94% amachepetsa magazi akamamwa 3 mg / kg ya Hemlibra milungu iwiri iliyonse

Kuchita bwino kwa Hemlibra m'maphunzirowa kunali kofanana pakati pa anthu omwe ali ndi zoletsa komanso opanda zoletsa.

Kodi hemlibra imagwiritsidwa ntchito pochizira hemophilia B?

Ayi, Hemlibra sagwiritsidwa ntchito popewa kutaya magazi mwa anthu omwe ali ndi hemophilia B.

Anthu omwe ali ndi hemophilia B akusowa chinthu china chotseka magazi kusiyana ndi omwe ali ndi hemophilia A:

  • hemophilia A: kusowa kwa clotting factor VIII
  • hemophilia B: kusowa kwa clotting factor IX

Hemlibra idapangidwa kuti izithandiza anthu omwe akusowa chinthu cha VIII. Chifukwa chake, sizingagwire ntchito kwa anthu omwe akusowa magazi oundana a IX.

Kodi Hemlibra imachiza hemophilia?

Ayi. Palibe mankhwala a hemophilia panthawiyi. Hemlibra imagwira ntchito yopewera magawo a magazi, koma sichiza matendawa.

Kodi hemlibra imapangidwa ndi plasma?

Ayi, Hemlibra siidapangidwe ndi madzi am'magazi. Ndi antibody (protein immune system) yopangidwa kuchokera kuma cell a labu. Palibe plasma yamunthu kapena maselo amwazi amunthu omwe amagwiritsidwa ntchito kupanga Hemlibra.

Hemlibra ndi yoyeretsedwa komanso yotsekedwa. Mulinso mavairasi aliwonse omwe angayambitse anthu.

Kodi Hemlibra imawonjezera chiopsezo changa chamagazi?

Hemlibra imatha kuwonjezera ngozi yamagazi ngati itatengedwa ndi prothrombin complex concentrate (aPCC). Ichi ndi mankhwala omwe amathandiza kuti magazi asiye kutuluka powonjezera magazi.

Kafukufuku wamankhwala adayang'ana anthu omwe adatenga Hemlibra ndikuchiritsidwa ndi aPCC. Anthu atatu anali ndi thrombotic microangiopathy (kuundana kwamagazi m'mitsempha yaying'ono yamagazi). Anthu awiri anali ndi zochitika za thrombotic (magazi) m'mitsempha ina. Pazochitika zonsezi, kuchuluka kwathunthu kwa aPCC kunali kwakukulu kuposa mayunitsi 100 / kg pa tsiku kwa nthawi yayitali kuposa maola 24.

Ngati mukufuna chithandizo ndi aPCC kuti muyimitse magazi mukamamwa Hemlibra, lankhulani ndi dokotala wanu. Pamodzi mutha kukambirana za chiwopsezo chanu chamagazi.

Kodi mankhwalawa angayambitse vuto lililonse ndikayezetsa magazi nthawi zonse?

Zitha kutero. Hemlibra imatha kukhudza zotsatira zoyesedwa ndi labu zomwe zimayeza momwe magazi anu amaundana bwino. Chimodzi mwazoyeserera izi ndi mayeso oyeserera pang'ono a thromboplastin time (aPTT). Hemlibra amakhala mthupi lanu kwa nthawi yayitali, ndipo imatha kukhudza zotsatira zoyeserera mpaka miyezi isanu ndi umodzi mutatha kumwa. Onetsetsani kuti muuze dokotala zamankhwala amtundu wa Hemlibra musanapite kukayezetsa labu.

Machenjezo a Hemlibra

Mankhwalawa amabwera ndi chenjezo lochokera ku Food and Drug Administration (FDA).

Chenjezo la FDA: Thrombotic microangiopathy ndi zochitika za thrombotic

Mankhwalawa ali ndi chenjezo la nkhonya. Ili ndiye chenjezo lalikulu kwambiri kuchokera ku FDA. Chenjezo la nkhonya limachenjeza madokotala ndi odwala za zovuta zamankhwala zomwe zitha kukhala zowopsa.

Kutenga Hemlibra ndikulandila prothrombin complex concentrate (aPCC) kuti mutuluke magazi kumatha kukulitsa chiopsezo cham'magazi akuluakulu. Zochitika za Thrombotic (kuundana kwamagazi) kumatha kuchitika m'ziwalo zazikulu kapena ziwalo za thupi, kuphatikiza m'mapapo, mutu, mikono, kapena miyendo. Amathanso kupezeka m'mitsempha yazing'ono m'magazi monga impso ndi ubongo. Kuundana kwamagazi kumatha kukhala koopsa ndipo kumafunikira chithandizo chamankhwala mwachangu.

Kafukufuku wamankhwala adayang'ana anthu omwe adatenga Hemlibra ndikuchiritsidwa ndi aPCC. Anthu atatu anali ndi thrombotic microangiopathy (kuundana kwamagazi m'mitsempha yaying'ono yamagazi). Anthu awiri anali ndi zochitika za thrombotic (magazi) m'mitsempha ina. Pazochitika zonsezi, kuchuluka kwathunthu kwa aPCC kunali kwakukulu kuposa mayunitsi 100 / kg pa tsiku kwa nthawi yayitali kuposa maola 24.

Mukayamba kugunda magazi mukamalandira mankhwala a Hemlibra ndi aPCC, dokotala wanu angakuletseni kumwa mankhwalawa kwakanthawi. Dokotala wanu adzasankha ngati kuli kotheka kuti muyambenso kutenga Hemlibra.

Zindikirani: Kuti mumve zambiri paza zotsatira zoyipa za Hemlibra, onani gawo la "Zotsatira za Hemlibra" pamwambapa.

Kuchuluka kwa hemlibra

Kutenga kwambiri Hemlibra kumatha kuonjezera chiopsezo chanu pazovuta zoyipa.

Zizindikiro zambiri za bongo

Zizindikiro zakumwa kwambiri Hemlibra zitha kuphatikiza:

  • mutu
  • kupweteka pamodzi

Kutenga kwambiri Hemlibra kumathanso kuwonjezera chiopsezo chanu chamagazi. Nthawi zina, mungafunike kufunafuna chithandizo chamagazi nthawi yomweyo. (Kuti mumve zambiri zamagazi omwe angakhalepo, onani gawo la "Zotsatira za Hemlibra" pamwambapa.

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 muli ndi zizindikiro zoopsa, itanani 911 kapena pitani kuchipatala chapafupi pomwepo.

Kutha kwa hemlibra, kusunga, ndi kutaya

Mukapeza Hemlibra kuchokera ku pharmacy, wamankhwala adzawonjezera tsiku lotha ntchito pa cholembedwacho. Tsikuli limakhala chaka chimodzi kuchokera tsiku lomwe mankhwalawa adaperekedwa.

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. Mutha kuigwiritsabe ntchito.

Yosungirako

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

Sungani mbale zanu za Hemlibra mufiriji. Ikani mu chidebe chosindikizidwa kwambiri komanso chosagwiritsa ntchito kuwala. Ngati ndi kotheka, mutha kuchotsa mbale mu firiji osapitirira masiku asanu ndi awiri. Kenako muyenera kuzibwezeretsa mufiriji. Osasunga mbale ndi zotentha kwambiri kuposa 86 ° F (30 ° C) zikakhala kuti zili kunja kwa firiji.

Mukatsegula botolo, gwiritsani ntchito nthawi yomweyo. Tayani gawo lililonse la yankho lomwe simukugwiritsa ntchito.

Kutaya

Ngati simufunikiranso kumwa Hemlibra ndikukhala ndi mankhwala otsala, ndikofunika kuwataya mosamala. Izi zimathandiza kupewa ena, kuphatikiza ana ndi ziweto, kuti amwe mankhwalawo mwangozi. Zimathandizanso kuti mankhwalawa asawononge chilengedwe.

Mutagwiritsa ntchito, onetsetsani kuti mwaika zopereka monga mabotolo, masingano okhala ndi zisoti za singano, ndi ma syringe muchidebe chanu chotayira.

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

Zambiri zamaphunziro a Hemlibra

Zotsatirazi zimaperekedwa kwa azachipatala ndi ena othandizira azaumoyo.

Zisonyezero

Hemlibra (emicizumab-kxwh) ndivomerezedwa ndi FDA kuti igwiritsidwe ntchito ngati njira yoletsa kupewa kapena kuchepetsa kuchuluka kwa magawo amwazi mwa odwala amibadwo yonse omwe ali ndi hemophilia A (kobadwa nako factor VIII) omwe alibe kapena VIII inhibitors.

Njira yogwirira ntchito

Hemlibra ndi bispecific (ili ndi masamba awiri osiyana a antigen) omwe ali ndi cholumikizira cha monoclonal chomwe chimamangiriza kuzinthu zonse za IX ndi factor X. Kumangiriza kuzinthu ziwirizi kumabwezeretsanso kusowa kwa chinthu cha VIII potsegulira choyambitsa IX ndi factor X. Njira iyi yochitira zinthu imalola coagulation cascade kuti ipitilize, ndikuwonjezera mapangidwe a clot. Hemlibra imakhalabe yogwira ntchito pamaso pa factor VIII inhibitors.

Pharmacokinetics ndi metabolism

Kutanthauza kuti theka la moyo ndi masiku 1.6 potsatira kuyamwa pang'ono. Kutalika kwathunthu kwa bioavailability kuli pakati pa 80.4 peresenti ndi 93.1 peresenti.

Kutanthauza kuti theka la moyo ndiye masiku 26.9.

Zotsutsana

Palibe zotsutsana ndi kugwiritsa ntchito kwa Hemlibra.

Yosungirako

Mbale ya hemlibra iyenera kusungidwa mufiriji pa 36 ° F mpaka 46 ° F (2 ° C mpaka 8 ° C) mchidebe choyambirira, chotetezedwa ku kuwala. Mbale siziyenera kuzizidwa kapena kugwedezeka. Ngati zingafunike, mbale zosatsegulidwa zitha kusungidwa mufiriji kenako zibweretsedwe m'firiji osapitirira masiku asanu ndi awiri kutentha kosapitirira 86 ° (30 ° C). Mukachotsedwa mumtsuko, tayani gawo lomwe silinagwiritsidwe ntchito ngati siligwiritsidwe ntchito mwachangu.

Chodzikanira: Medical News Today yachita zonse zotheka kuti zitsimikizire kuti zidziwitso 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.

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