Ninlaro (ixazomib)

Zamkati

• Ninlaro ndi chiyani?
• Kuchita bwino
• Ninlaro generic
• Zotsatira za Ninlaro
• Zotsatira zoyipa
• Zotsatira zoyipa
• Zotsatira zoyipa
• Mlingo wa Ninlaro
• Mitundu ya mankhwala ndi mphamvu
• Mlingo wa myeloma yambiri
• Ndingatani ngati ndaphonya mlingo?
• Kodi ndiyenera kugwiritsa ntchito mankhwalawa nthawi yayitali?
• Njira zina ku Ninlaro
• Ninlaro vs. Velcade
• Pafupi
• Ntchito
• Mafomu azamankhwala ndi makonzedwe
• Zotsatira zoyipa ndi zoopsa
• Kuchita bwino
• Mtengo
• Mtengo wa Ninlaro
• Thandizo lazachuma komanso inshuwaransi
• Ninlaro amagwiritsa ntchito
• Ninlaro wa myeloma angapo
• Ntchito zosagwiritsidwa ntchito pa Ninlaro
• Kugwiritsa ntchito Ninlaro ndi mankhwala ena
• Ninlaro wokhala ndi lenalidomide (Revlimid)
• Ninlaro wokhala ndi dexamethasone (Decadron)
• Ninlaro ndi mowa
• Kuyanjana kwa Ninlaro
• Ninlaro ndi mankhwala ena
• Ninlaro ndi zitsamba ndi zowonjezera
• Momwe mungatenge Ninlaro
• Nthawi yoti mutenge
• Kutenga Ninlaro ndi chakudya
• Kodi Ninlaro akhoza kuphwanyidwa, kugawanika, kapena kutafuna?
• Momwe Ninlaro amagwirira ntchito
• Zomwe zimachitika mu myeloma zingapo
• Zomwe Ninlaro amachita
• Zimatenga nthawi yayitali bwanji kuti zigwire ntchito?
• Ninlaro ndi mimba
• Ninlaro ndi kulera
• Kulera kwa amayi
• Kulera kwa amuna
• Ninlaro ndi kuyamwitsa
• Mafunso wamba okhudza Ninlaro
• Kodi Ninlaro ndi mtundu wa chemotherapy?
• Kodi ndingatenge Ninlaro isanafike kapena itatha kutulutsa khungu?
• Ngati nditha kusanza ndikamwa mankhwala, kodi ndiyenera kumwa mlingo wina?
• Kodi ndifunikira mayeso a labata ndikumatenga Ninlaro?
• Njira zopewera Ninlaro
• Ninlaro bongo
• Zizindikiro zambiri za bongo
• Zomwe muyenera kuchita mukamagwiritsa ntchito bongo
• Kutha kwa Ninlaro, kusunga, ndi kutaya
• Yosungirako
• Kutaya
• Zambiri za Ninlaro
• Zisonyezero
• Njira yogwirira ntchito
• Pharmacokinetics ndi metabolism
• Zotsutsana
• Yosungirako

Ninlaro ndi chiyani?

Ninlaro ndi mankhwala omwe amagwiritsidwa ntchito pochiza myeloma angapo mwa akulu. Matendawa ndi khansa yosowa yomwe imakhudza maselo ena oyera am'magazi am'magazi am'magazi. Ndi ma myeloma angapo, maselo abwinobwino am'magazi amayamba khansa ndipo amatchedwa maselo a myeloma.

Ninlaro amavomerezedwa kuti agwiritsidwe ntchito mwa anthu omwe ayesapo kale mankhwala ena amtundu wa myeloma angapo. Mankhwalawa atha kukhala mankhwala kapena njira.

Ninlaro ali mgulu la mankhwala omwe amatchedwa proteasome inhibitors. Ndi chithandizo chamankhwala cha myeloma angapo. Zolinga za Ninlaro (zimagwiritsa ntchito) mapuloteni ena mkati mwa maselo a myeloma. Zimapanga mapuloteni ambiri m'maselo a myeloma, omwe amachititsa kuti maselowo afe.

Ninlaro amabwera ngati makapisozi omwe amatengedwa pakamwa. Mutenga Ninlaro ndi mankhwala ena awiri a myeloma: lenalidomide (Revlimid) ndi dexamethasone (Decadron).

Kuchita bwino

Pakati pa maphunziro, Ninlaro adachulukitsa kutalika kwa nthawi yomwe anthu ena omwe ali ndi myeloma angapo amakhala popanda matenda awo kupita patsogolo (kukulira). Kutalika kwa nthawi kumeneku kumatchedwa kupulumuka kopanda kupita patsogolo.

Kafukufuku wina wamankhwala adayang'ana anthu omwe ali ndi myeloma angapo omwe anali atagwiritsa kale ntchito yothandizirana nayo matenda awo. Anthuwo adagawika m'magulu awiri. Gulu loyamba linapatsidwa Ninlaro ndi lenalidomide ndi dexamethasone. Gulu lachiwiri lidapatsidwa malowa (mankhwala osagwiritsa ntchito mankhwala) ndi lenalidomide ndi dexamethasone.

Anthu omwe adatenga kuphatikiza kwa Ninlaro adakhala pafupifupi miyezi 20.6 miyezi ingapo isanachitike myeloma. Anthu omwe amagwiritsa ntchito kuphatikiza kwa placebo amakhala pafupifupi miyezi 14.7 miyezi ingapo isanachitike myeloma.

Mwa anthu omwe adatenga kuphatikiza kwa Ninlaro, 78% adayankha kuchipatala. Izi zikutanthauza kuti anali ndi kusintha kosachepera 50% m'mayeso awo a labu omwe amayang'ana maselo a myeloma. Mwa iwo omwe adatenga kuphatikiza kwa placebo, anthu 72% anali ndi yankho lomwelo kuchipatala.

Ninlaro generic

Ninlaro amapezeka pokhapokha ngati dzina la mankhwala. Sikupezeka pakadali pano mu mawonekedwe achibadwa.

Ninlaro ili ndi chinthu chimodzi chogwiritsira ntchito mankhwala: ixazomib.

Zotsatira za Ninlaro

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

Kuti mumve zambiri pazovuta za Ninlaro, lankhulani ndi dokotala kapena wamankhwala. Amatha kukupatsirani malangizo amomwe mungathetsere mavuto omwe angakhale ovuta.

Zotsatira zoyipa

Zotsatira zofala kwambiri za Ninlaro zitha kuphatikiza:

• kupweteka kwa msana
• kusawona bwino
• maso owuma
• conjunctivitis (yotchedwanso pink eye)
• shingles (herpes zoster virus), yomwe imayambitsa kupweteka kwambiri
• neutropenia (maselo oyera ofiira amagazi oyera), omwe angapangitse chiopsezo chanu chotenga matenda

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 zimathanso kufala ndi Ninlaro. 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:

• Peripheral neuropathy (kuwonongeka kwa mitsempha yanu). Zizindikiro zimatha kuphatikiza:
  • kumva kulasalasa kapena kutentha
  • dzanzi
  • ululu
  • kufooka m'manja kapena miyendo yanu
• Khungu limakhudza kwambiri. Zizindikiro zimatha kuphatikiza:
  • zotupa pakhungu ndi mabampu omwe ndi ofiira kukhala ofiirira (otchedwa Sweet's syndrome)
  • zotupa pakhungu pomwe pali khungu ndi zilonda mkamwa mwanu (wotchedwa matenda a Stevens-Johnson)
• Zotumphukira edema (kutupa). Zizindikiro zimatha kuphatikiza:
  • mawondo otupa, mapazi, miyendo, manja, kapena manja
  • kunenepa
• Kuwonongeka kwa chiwindi. Zizindikiro zimatha kuphatikiza:
  • jaundice (khungu lanu loyera kapena khungu lanu)
  • kupweteka kumanja kwa m'mimba mwako (m'mimba)

Zotsatira zoyipa zina, zomwe zafotokozedwa kwambiri mu gawo la "Zotsatira zoyipa" pansipa, zitha kuphatikizira izi:

• thrombocytopenia (magawo otsika kwambiri)
• Mavuto am'mimba monga kutsegula m'mimba, kudzimbidwa, nseru, ndi kusanza

Zotsatira zoyipa

Mutha kudabwa kuti zovuta zina zimachitika kangati ndi mankhwalawa. Nazi zina mwazomwe zingayambitse mankhwalawa.

Thrombocytopenia

Mutha kukhala ndi thrombocytopenia (maselo otsika) pamene mukutenga Ninlaro. Izi zinali zoyipa kwambiri za Ninlaro panthawi yamaphunziro azachipatala.

Pakati pa maphunziro, anthu adagawika m'magulu awiri. Gulu loyamba linapatsidwa Ninlaro ndi lenalidomide ndi dexamethasone. Gulu lachiwiri lidapatsidwa malowa (mankhwala osagwiritsa ntchito mankhwala) ndi lenalidomide ndi dexamethasone.

Mwa iwo omwe amatenga kuphatikiza kwa Ninlaro, 78% ya anthu anali ndi magawo otsika. Mwa iwo omwe adatenga kuphatikiza kwa placebo, 54% anali ndimatumba ochepa.

M'maphunzirowa, anthu ena amafunikira kuthiridwa magazi kuti athe kuchiza thrombocytopenia yawo. Mukaikidwa magazi m'matangadza, mumalandira othandiza magazi kuundana kuchokera kwa woperekayo kapena kuchokera m'thupi lanu (ngati mapulateletiwo adasonkhanitsidwa kale). Mwa anthu omwe amatenga kuphatikiza kwa Ninlaro, 6% amafunika kuthiridwa magazi. Mwa anthu omwe amatenga kuphatikiza kwa placebo, 5% amafunikira kuthiridwa magazi.

Ma Platelet amagwira ntchito mthupi lanu kuti asiye kutaya magazi pothandizira kupanga magazi. Ngati kuchuluka kwa maplatelet anu kumakhala kotsika kwambiri, mutha kukhala ndi magazi ambiri. Pamene mukutenga Ninlaro, muyenera kuyesedwa magazi pafupipafupi kuti muwone kuchuluka kwamagazi anu.

Itanani dokotala wanu nthawi yomweyo ngati muli ndi zizindikiro izi:

• kuvulaza mosavuta
• Kutuluka magazi nthawi zambiri kuposa nthawi zonse (monga kutuluka magazi m'mphuno kapena kutuluka m'kamwa mwanu)

Ngati kuchuluka kwa ma platelet anu kumakhala kotsika kwambiri, dokotala wanu akhoza kuchepetsa mlingo wanu wa Ninlaro kapena amalangiza kuthiridwa magazi. Amatha kukufunsani kuti musiye kumwa Ninlaro kwakanthawi.

Mavuto am'mimba

Mutha kukumana ndi mavuto m'mimba kapena m'mimba mukamamwa Ninlaro. Pa maphunziro azachipatala a mankhwalawa, anthu nthawi zambiri anali ndi mavuto am'mimba.

M'maphunziro, anthu adagawika m'magulu awiri. Gulu loyamba linapatsidwa Ninlaro ndi lenalidomide ndi dexamethasone. Gulu lachiwiri lidapatsidwa malowa (mankhwala osagwiritsa ntchito mankhwala) ndi lenalidomide ndi dexamethasone. Zotsatira zotsatirazi zidanenedwa m'maphunziro:

• kutsekula m'mimba, komwe kunachitika mwa anthu 42% omwe amatenga kuphatikiza kwa Ninlaro (ndipo mwa 36% mwa anthu omwe amatenga kuphatikiza kwa placebo)
• kudzimbidwa, komwe kunachitika mwa 34% mwa anthu omwe amatenga kuphatikiza kwa Ninlaro (ndipo mwa 25% ya anthu omwe amatenga kuphatikiza kwa placebo)
• nseru, yomwe idachitika mwa anthu 26% omwe amatenga kuphatikiza kwa Ninlaro (ndipo mwa 21% ya anthu omwe amatenga kuphatikiza kwa placebo)
• kusanza, komwe kunachitika mwa 22% mwa anthu omwe amatenga kuphatikiza kwa Ninlaro (ndipo mwa 11% mwa anthu omwe amatenga kuphatikiza kwa placebo)

Kusamalira mavuto am'mimba

Ndikofunika kulankhula ndi dokotala za momwe mungathetsere mavutowa. Kupanda kutero, amatha kukhala owopsa.

Nsautso ndi kusanza nthawi zambiri zimatha kupewedwa kapena kuthandizidwa ndikumwa mankhwala enaake. Kuwonjezera pa kumwa mankhwala, palinso zinthu zina zomwe mungachite ngati mukukumana ndi nseru. Nthawi zina zimakhala zothandiza kudya chakudya chochepa pafupipafupi, m'malo modya katatu tsiku lililonse. American Cancer Society imapereka malangizo ena angapo othandizira kuthana ndi mseru.

Kutsekula m'mimba kumathandizidwanso ndi mankhwala ena, monga loperamide (Imodium). Ndipo ngati muli ndi kutsekula m'mimba, onetsetsani kuti mukumwa madzi ambiri. Izi zidzakuthandizani kupewa kupezeka osowa madzi m'thupi (thupi lanu likakhala ndi madzi ochepa).

Mutha kuthandiza kupewa kudzimbidwa ndi kumwa madzi ambiri, kudya zakudya zopatsa mphamvu, komanso kuchita masewera olimbitsa thupi (monga kuyenda).

Ngati mavuto anu am'mimba akuchulukirachulukira, dokotala wanu amachepetsa kuchuluka kwanu kwa Ninlaro. Angakufunseni kuti musiye kumwa mankhwalawa kwakanthawi.

Ziphuphu

Mutha kukhala ndi chiopsezo chowonjezeka chamatenda (herpes zoster) mukamamwa Ninlaro. Shingles ndi khungu lotupa lomwe limayambitsa kupweteka kwamoto ndi zilonda zophulika. Adanenedwa mwa anthu omwe amatenga Ninlaro panthawi yamaphunziro azachipatala.

Ophunzira adagawika m'magulu awiri. Gulu loyamba linapatsidwa Ninlaro ndi lenalidomide ndi dexamethasone. Gulu lachiwiri lidapatsidwa malowa (mankhwala osagwiritsa ntchito mankhwala) ndi lenalidomide ndi dexamethasone.

Munthawi yamaphunziro, ma shingles adanenedwa mwa 4% mwa anthu omwe amatenga kuphatikiza kwa Ninlaro. Mwa iwo omwe amatenga kuphatikiza kwa placebo, 2% ya anthu anali ndi ma shingles.

Mutha kupanga ma shingles ngati mudakhala ndi nthomba m'mbuyomu. Ziphuphu zimachitika pamene kachilombo koyambitsa nkhuku kamayambiranso (kuyaka) mkati mwa thupi lanu. Izi zimatha kuchitika ngati chitetezo chanu cha mthupi sichikugwira ntchito monga momwe zimakhalira, zomwe zimachitika kwambiri kwa anthu omwe ali ndi myeloma yambiri.

Ngati mudakhala ndi nthomba m'mbuyomu ndipo mukugwiritsa ntchito Ninlaro, dokotala wanu akhoza kukupatsani mankhwala ochepetsa ma virus mukamamwa Ninlaro. Mankhwala ochepetsa mphamvu ya ma virus amathandiza kupewa ma shingles kuti asakule mthupi lanu.

Mlingo wa Ninlaro

Mlingo wa Ninlaro yemwe dokotala amakupatsani umadalira pazinthu zingapo. Izi zikuphatikiza:

• chiwindi ndi impso zanu zikugwira ntchito bwino
• ngati muli ndi zovuta zina kuchokera kuchipatala chanu cha Ninlaro

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

Ninlaro amabwera ngati makapisozi amlomo omwe amapezeka mwamphamvu zitatu: 2.3 mg, 3 mg, ndi 4 mg.

Mlingo wa myeloma yambiri

Mlingo woyambira wa Ninlaro ndi kapisozi umodzi wa 4-mg womwe umatengedwa kamodzi pamlungu kwa milungu itatu. Izi zimatsatiridwa ndi sabata imodzi osamwa mankhwalawo. Mudzabwereza kuzungulira kwa milungu inayi kangapo monga dokotala wanu akulimbikitsira.

Mukalandira chithandizo, muyenera kumwa kapisozi wa Ninlaro tsiku lomwelo sabata iliyonse. Ndi bwino kutenga Ninlaro mozungulira nthawi yofanana tsiku lililonse. Muyenera kutenga Ninlaro pamimba yopanda kanthu, ola limodzi musanadye kapena osachepera maola awiri mutadya.

Mutenga Ninlaro kuphatikiza ndi mankhwala ena awiri a myeloma: lenalidomide (Revlimid) ndi dexamethasone (Decadron). Mankhwalawa ali ndi magawo osiyanasiyana azosiyanasiyana kuposa Ninlaro. Onetsetsani kuti mukutsatira malangizo amlingo womwe dokotala wanu wapereka pa mankhwalawa.

Ndibwino kuti nthawi yanu yolembera ilembedwe pa tchati kapena kalendala. Izi zimakuthandizani kudziwa mankhwala onse omwe muyenera kumwa komanso nthawi yoyenera kumwa. Ndibwino kuti muyang'ane mlingo uliwonse mukalandira.

Ngati muli ndi vuto ndi chiwindi kapena impso, dokotala wanu angakulimbikitseni kuti muchepetse Ninlaro. Dokotala wanu amathanso kutsitsa mlingo wanu kapena kukupemphani kuti mupume pang'ono ndikalandira mankhwala ngati mungapeze zovuta zina za mankhwalawa (monga mulingo wamagulu otsika). Nthawi zonse tengani Ninlaro chimodzimodzi monga dokotala akukuuzani.

Ndingatani ngati ndaphonya mlingo?

Mukaiwala kumwa Ninlaro, tsatirani malangizo awa:

• Ngati pali maola 72 kapena kupitilira apo mpaka mlingo wanu wotsatira utakwanira, tengani mlingo womwe mwaphonya nthawi yomweyo. Kenako, tengani mlingo wanu wotsatira wa Ninlaro nthawi yanthawi zonse.
• Ngati muli ndi maola ochepera 72 mpaka nthawi yotsatira ikakwana, ingodumpha mlingo womwe umasowa. Tengani mlingo wanu wotsatira wa Ninlaro nthawi yanthawi zonse.

Musatenge mlingo umodzi wa Ninlaro kuti mupange mlingo wosowa. Kuchita izi kumawonjezera chiopsezo chanu chazovuta.

Pofuna kuthandizira kuti musaphonye mlingo, yesani kukhazikitsa chikumbutso pafoni yanu. Nthawi ya mankhwala ingakhalenso yothandiza.

Kodi ndiyenera kugwiritsa ntchito mankhwalawa nthawi yayitali?

Ninlaro amayenera kugwiritsidwa ntchito ngati chithandizo chanthawi yayitali. Ngati inu ndi adotolo mumazindikira kuti Ninlaro ndiwotetezeka komanso wogwira ntchito kwa inu, mungatenge nthawi yayitali.

Njira zina ku Ninlaro

Mankhwala ena alipo omwe angachiritse myeloma angapo. Ena akhoza kukuyenererani kuposa ena. Ngati mukufuna kupeza njira ina m'malo mwa Ninlaro, lankhulani ndi dokotala wanu. Amatha kukuwuzani zamankhwala ena omwe atha kukuthandizani.

Zitsanzo za mankhwala ena omwe angagwiritsidwe ntchito pochiza angapo a myeloma ndi awa:

• mankhwala ena a chemotherapy, monga:
  • cyclophosphamide (Cytoxan)
  • doxorubicin (Doxil)
  • nyimbo (Alkeran)
• ma corticosteroids ena, monga:
  • dexamethasone (Decadron)
• mankhwala ena amthupi (mankhwala omwe amagwira ntchito ndi chitetezo cha mthupi), monga:
  • lenalidomide (Wowonjezera)
  • pomalidomide (Pomalyst)
  • thalidomide (Thalomid)
• mankhwala ena olimbana nawo, monga:
  • bortezomib (Velcade)
  • carfilzomib (Kyprolis)
  • daratumumab (Darzalex)
  • elotuzumab (Empliciti)
  • panobinostat (Farydak)

Ninlaro vs. Velcade

Mutha kudabwa momwe Ninlaro amafanizira ndi mankhwala ena omwe amaperekedwa kuti agwiritse ntchito chimodzimodzi. Apa tikuwona momwe Ninlaro ndi Velcade alili ofanana komanso osiyana.

Pafupi

Ninlaro ili ndi ixazomib, pomwe Velcade ili ndi bortezomib. Mankhwalawa onse ndi chithandizo chamankhwala angapo a myeloma. Ali mgulu la mankhwala omwe amatchedwa proteasome inhibitors. Ninlaro ndi Velcade amagwira ntchito chimodzimodzi mkati mwa thupi lanu.

Ntchito

Ninlaro ndi wovomerezeka ndi FDA kuti athetse:

• myeloma angapo mwa achikulire omwe ayesapo kale chithandizo chimodzi cha matenda awo. Ninlaro imagwiritsidwa ntchito limodzi ndi lenalidomide (Revlimid) ndi dexamethasone (Decadron).

Velcade ndivomerezedwa ndi FDA kuti ichiritse:

• angapo myeloma mwa akulu omwe:
  • sanalandire chithandizo china chilichonse cha matenda awo; kwa anthu awa, Velcade imagwiritsidwa ntchito limodzi ndi melphalan ndi prednisone
  • khalani ndi myeloma yambiri yomwe yabwereranso (kubwerera) mutalandira chithandizo cham'mbuyomu
  • mantle cell lymphoma (khansa ya ma lymph node) mwa akuluakulu

Mafomu azamankhwala ndi makonzedwe

Ninlaro amabwera ngati makapisozi omwe amatengedwa pakamwa. Nthawi zambiri mumatenga kapisozi umodzi sabata iliyonse kwa milungu itatu. Izi zimatsatiridwa ndi sabata limodzi osamwa mankhwalawo. Kuzungulira kwamasabata anayi kumabwerezedwa kangapo monga dokotala akukulimbikitsira.

Velcade imabwera ngati yankho lamadzi lomwe limaperekedwa ndi jakisoni. Amapatsidwa ngati jakisoni pansi pa khungu lanu (jakisoni wocheperako pang'ono) kapena jakisoni mumitsempha yanu (jakisoni wamitsempha). Mudzalandira mankhwalawa kuofesi ya dokotala wanu.

Dongosolo lanu la kuchuluka kwa Velcade lidzasiyanasiyana kutengera momwe zinthu ziliri:

• Ngati myeloma yanu yambiri sinalandiridwepo kale, mutha kugwiritsa ntchito Velcade pafupifupi chaka chimodzi. Nthawi zambiri mumatsata masabata atatu azithandizo. Muyamba kulandira chithandizo polandila Velcade kawiri pamlungu kwa milungu iwiri, kenako sabata limodzi kuchokera ku mankhwalawo. Zitsanzozi zibwerezedwa kwa milungu yonse ya 24. Pambuyo masabata a 24, mudzalandira Velcade kamodzi pamlungu kwa milungu iwiri, ndikutsatira sabata limodzi kuchokera ku mankhwalawa. Izi zimabwerezedwa kwa milungu yonse ya 30.
• Ngati mukugwiritsa ntchito Velcade chifukwa myeloma yanu yambiri yabwereranso pambuyo pa mankhwala ena (ndi Velcade kapena mankhwala ena), kuchuluka kwa kuchuluka kwanu kumasiyana, kutengera mbiri yakuchipatala.

Zotsatira zoyipa ndi zoopsa

Ninlaro ndi Velcade onse ali ndi mankhwala ochokera mgulu lomwelo. Chifukwa chake, mankhwala onsewa amatha kuyambitsa zovuta zina. M'munsimu muli zitsanzo za zotsatirazi.

Zotsatira zoyipa

Mndandandawu uli ndi zitsanzo za zovuta zina zomwe zimachitika ndi Ninlaro, ndi Velcade, kapena ndi mankhwala onse awiri (akamwedwa payekhapayekha).

• Zitha kuchitika ndi Ninlaro:
  • maso owuma
• Zitha kuchitika ndi Velcade:
  • kupweteka kwa mitsempha
  • kumva kufooka kapena kutopa
  • malungo
  • kuchepetsa kudya
  • kuchepa kwa magazi m'thupi (magazi ofiira ochepa)
  • alopecia (kutayika tsitsi)
• Zitha kuchitika ndi Ninlaro ndi Velcade:
  • kupweteka kwa msana
  • kusawona bwino
  • conjunctivitis (yotchedwanso pink eye)
  • shingles (herpes zoster), yomwe imayambitsa kupweteka kwambiri

Zotsatira zoyipa

Mndandandandawu muli zitsanzo za zovuta zoyipa zomwe zingachitike ndi Ninlaro, ndi Velcade, kapena ndi mankhwala onse awiri (akamwedwa payekhapayekha). Zambiri mwa zotsatirazi zimachitika nthawi zambiri mwa anthu omwe amamwa mankhwalawa.

• Zitha kuchitika ndi Ninlaro:
  • zotupa kwambiri pakhungu, kuphatikiza Sweet's syndrome ndi matenda a Stevens-Johnson
• Zitha kuchitika ndi Velcade:
  • kuthamanga kwa magazi (kumatha kuyambitsa chizungulire kapena kukomoka)
  • mavuto amtima, monga kulephera kwa mtima kapena nyimbo yachilendo
  • mavuto am'mapapo, monga kupuma kwamatenda, chibayo, kapena kutupa m'mapapu anu
• Zitha kuchitika ndi Ninlaro ndi Velcade:
  • zotumphukira edema (kutupa m'mapazi anu, mapazi, miyendo, mikono, kapena manja)
  • thrombocytopenia (mlingo wotsika wamagazi)
  • mavuto am'mimba kapena matumbo, monga kutsegula m'mimba, kudzimbidwa, nseru, kapena kusanza
  • mavuto amitsempha, monga kumva kulasalasa kapena kutentha, kufooka, kupweteka, kapena kufooka m'manja kapena m'miyendo
  • neutropenia (mulingo woyela wamagazi oyera), zomwe zingapangitse chiopsezo chanu chotenga matenda
  • kuwonongeka kwa chiwindi

Kuchita bwino

Ninlaro ndi Velcade ali ndi mitundu yosiyanasiyana yovomerezeka ndi FDA, koma onse amagwiritsidwa ntchito pochiza myeloma angapo mwa akulu.

Mankhwalawa sanafanane mwachindunji m'maphunziro azachipatala. Komabe, kafukufuku apeza kuti Ninlaro ndi Velcade ali othandiza pochepetsa kukula (kukulirakulira) kwa ma myeloma angapo. Mankhwala onsewa amalimbikitsidwa ndi malangizo amomwe mungagwiritsire ntchito kwa anthu omwe ali ndi myeloma yambiri.

Kwa anthu ena, malangizo azithandizo amalimbikitsa kugwiritsa ntchito mtundu wa Velcade pogwiritsa ntchito kuphatikiza kwa Ninlaro ndi lenalidomide (Revlimid) ndi dexamethasone (Decadron). Malangizowa akuphatikizapo anthu omwe ali ndi myeloma angapo omwe akuchiritsidwa koyamba. Multiple myeloma amatanthauza kuti munthu ali ndi zizindikilo za matendawa, monga mavuto a impso, kuwonongeka kwa mafupa, kuchepa magazi m'thupi, kapena zina.

Kwa anthu omwe myeloma yambiri yabwerera pambuyo pa mankhwala ena, malangizowo amalimbikitsa chithandizo ndi Ninlaro kapena Velcade, kuphatikiza mankhwala ena.

Mtengo

Ninlaro ndi Velcade onse ndi mankhwala osokoneza bongo. Pakadali pano palibe mitundu yabwinobwino ya mankhwalawa. Mankhwala omwe ali ndi dzina nthawi zambiri amawononga ndalama zambiri kuposa ma generic.

Malinga ndi kuyerekezera kwa WellRx.com, Velcade nthawi zambiri imawononga zambiri kuposa Ninlaro. Mtengo weniweni womwe mudzalipire mankhwalawa umadalira dongosolo lanu la inshuwaransi, komwe mumakhala, komanso mankhwala omwe mumagwiritsa ntchito.

Mtengo wa Ninlaro

Monga mankhwala onse, mtengo wa Ninlaro umatha kusiyanasiyana. Kuti mupeze mitengo yamtundu wa Ninlaro mdera lanu, onani WellRx.com.

Mtengo womwe mumapeza pa WellRx.com ndiomwe mungalipire popanda inshuwaransi. Mtengo weniweni womwe mudzalipira umadalira dongosolo la inshuwaransi yanu, komwe mumakhala, komanso malo ogulitsira mankhwala omwe mumagwiritsa ntchito.

Thandizo lazachuma komanso inshuwaransi

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

Takeda Pharmaceutical Company Limited, yopanga Ninlaro, imapereka pulogalamu yotchedwa Takeda Oncology 1Point. Pulogalamuyi imathandizira ndipo itha kuthandizira kutsitsa mtengo wamankhwala anu. Kuti mumve zambiri komanso kuti mudziwe ngati mukuyenera kuthandizidwa, imbani 844-817-6468 (844-T1POINT) kapena pitani patsamba lino.

Ninlaro amagwiritsa ntchito

Food and Drug Administration (FDA) imavomereza mankhwala akuchipatala monga Ninlaro kuti athetse mavuto ena. Ninlaro itha kugwiritsidwanso ntchito polemba zina pazinthu zina. Kugwiritsa ntchito mankhwala osokoneza bongo ndi pamene mankhwala omwe amavomerezedwa kuti athetse vuto limodzi amagwiritsidwa ntchito kuthana ndi vuto lina.

Ninlaro wa myeloma angapo

Ninlaro ndi wovomerezeka ndi FDA kuti athetse ma myeloma angapo mwa achikulire omwe ayesapo kale mankhwala ena amtunduwu. Mankhwalawa atha kukhala mankhwala kapena njira. Ninlaro imavomerezedwa kuti igwiritsidwe ntchito limodzi ndi mankhwala ena awiri: lenalidomide (Revlimid) ndi dexamethasone (Decadron).

Multiple myeloma ndi khansa yosawerengeka yomwe imayamba m'maselo anu am'magazi. Maselowa ndi mtundu wa maselo oyera amwazi. Zimapangidwa ndi mafupa anu, omwe ndi siponji omwe amapezeka mkati mwa mafupa anu. Mafupa anu amapanga maselo anu onse amwazi.

Nthawi zina maselo am'magazi amadzimadzi amakhala achilendo ndipo amayamba kuchulukana (kupanga ma cell a plasma) mosalamulirika. Maselo am'magazi amtunduwu omwe ali ndi khansa amatchedwa maselo a myeloma.

Maselo a Myeloma amatha kukhala m'malo angapo (angapo) am'mafupa anu komanso m'mafupa osiyanasiyana. Ichi ndichifukwa chake vutoli limatchedwa multiple myeloma.

Maselo a myeloma amatenga malo ambiri m'mafupa anu. Izi zimapangitsa kuti mafupa anu azikhala ovuta kupanga ma cell amwazi okwanira. Maselo a myeloma amathanso kuwononga mafupa anu, kuwapangitsa kukhala ofooka.

Kuchita kwa myeloma yambiri

Phunziro lachipatala, Ninlaro anali othandiza pochiza matenda a myeloma angapo. Kafukufukuyu adayang'ana anthu 722 omwe ali ndi myeloma angapo omwe anali atalandira kale chithandizo chimodzi cha matendawa. Mwa anthuwa, myeloma yawo yambiri idasiya kuyankha (kuchira) kuzithandizo zina, kapena idabwerako itayamba kusintha ndi mankhwala ena.

Phunziroli, anthu adagawika m'magulu awiri. Gulu loyamba linapatsidwa Ninlaro ndi mankhwala ena awiri a myeloma: lenalidomide ndi dexamethasone. Gulu lachiwiri lidapatsidwa malowa (mankhwala osagwiritsa ntchito mankhwala) ndi lenalidomide ndi dexamethasone.

Anthu omwe adatenga kuphatikiza kwa Ninlaro adakhala pafupifupi miyezi 20.6 miyezi ingapo isanachitike myeloma. Anthu omwe amagwiritsa ntchito kuphatikiza kwa placebo amakhala pafupifupi miyezi 14.7 matenda awo asanapitirire.

Makumi asanu ndi awiri mphambu asanu ndi atatu mwa anthu omwe adatenga kuphatikiza Ninlaro adayankha kuchipatala. Izi zikutanthauza kuti anali ndi kusintha kosachepera 50% m'mayeso awo a labu omwe amayang'ana maselo a myeloma. Mwa iwo omwe adatenga kuphatikiza kwa placebo, anthu 72% anali ndi yankho lomwelo kuchipatala.

Ntchito zosagwiritsidwa ntchito pa Ninlaro

Kuphatikiza pa kugwiritsa ntchito komwe kwatchulidwa pamwambapa, Ninlaro atha kugwiritsidwa ntchito polemba ntchito zina. Kugwiritsa ntchito mankhwala osokoneza bongo ndi pamene mankhwala omwe amavomerezedwa kuti agwiritsidwe ntchito kamodzi amagwiritsidwa ntchito pochizira china chosavomerezeka.

Ninlaro wa myeloma angapo nthawi zina

Ninlaro ndi wovomerezeka ndi FDA kuti agwiritsidwe ntchito ndi lenalidomide ndi dexamethasone kuti athe kuchiza matenda a myeloma angapo mwa anthu omwe adalandirapo mankhwala ena. Ikuwerengedwa ngati njira yothandizira pazinthu zina zokhudzana ndi myeloma yambiri.

Kafukufuku akuchitika kuti awone momwe Ninlaro angagwiritsidwire ntchito polemba izi munthawi izi:

• kuchiza magawo osiyanasiyana a myeloma angapo
• kuphatikiza ndi mankhwala ena kupatula lenalidomide ndi dexamethasone pochiza myeloma angapo

Mutha kulembedwa kuti Ninlaro achoke pamayendedwe mwanjira izi.

Ninlaro wa systemic light chain amyloidosis

Ninlaro sivomerezedwa ndi FDA kuti athetse amyloidosis wa systemic light chain. Komabe, nthawi zina amagwiritsidwa ntchito ngati cholembera kuti athetse vutoli.

Matenda achilendowa amakhudza momwe maselo am'magazi (omwe amapezeka m'mafupa anu) amapangira mapuloteni ena omwe amatchedwa mapuloteni amtundu wa kuwala. Mapuloteni achilendo amalowa m'magazi anu ndipo amatha kukhala m'matumba ndi ziwalo mthupi lanu lonse. Mapuloteniwa akamakula, amapanga amyloid (masango a mapuloteni), omwe amatha kuwononga ziwalo zina monga mtima kapena impso.

Ninlaro anaphatikizidwa muupangiri wamankhwala amagetsi amtundu wa amyloidosis, kafukufukuyu atatha kupeza kuti anali othandiza kuthana ndi vutoli. Ninlaro ndi njira yothandizira anthu omwe amyloidosis yaleka kuyankha chithandizo chovomerezeka choyambirira cha vutoli. Imeneyi ndi njira yothandiziranso anthu omwe amyloidosis yabwerera itatha bwino ndi chithandizo chovomerezeka choyamba.

Ninlaro imagwiritsidwa ntchito paokha kapena pophatikiza ndi dexamethasone ikagwiritsidwa ntchito kuchiza matendawa.

Kugwiritsa ntchito Ninlaro ndi mankhwala ena

Nthawi zambiri mumatenga Ninlaro kuphatikiza ndi mankhwala ena omwe aliyense amagwira ntchito m'njira zosiyanasiyana kuti athetse vuto lanu la myeloma.

Ninlaro imavomerezedwa kuti igwiritsidwe ntchito ndi lenalidomide (Revlimid) ndi dexamethasone (Decadron). Pa maphunziro azachipatala, chithandizo ndi Ninlaro kuphatikiza mankhwalawa chinali chothandiza kuposa kugwiritsa ntchito lenalidomide ndi dexamethasone.

Dokotala wanu angakulimbikitseninso kuti mutenge Ninlaro ndi mankhwala ena angapo a myeloma. Imeneyi ndi njira yosagwiritsa ntchito Ninlaro. Kugwiritsa ntchito mankhwala osokoneza bongo ndi pamene mankhwala omwe amavomerezedwa kuti agwiritsidwe ntchito kamodzi amagwiritsidwa ntchito pochizira china chosavomerezeka.

Ninlaro wokhala ndi lenalidomide (Revlimid)

Lenalidomide (Revlimid) ndi mankhwala osokoneza bongo. Mankhwala amtunduwu amagwira ntchito pothandiza chitetezo chamthupi chanu kupha ma cell a myeloma.

Revlimid imabwera ngati makapisozi omwe amatengedwa pakamwa kuphatikiza Ninlaro. Mudzatenga Revlimid kamodzi tsiku lililonse kwa milungu itatu, kenako sabata limodzi osamwa mankhwalawa.

Mutha kutenga Revlimid kapena wopanda chakudya.

Ninlaro wokhala ndi dexamethasone (Decadron)

Dexamethasone (Decadron) ndi mtundu wa mankhwala otchedwa corticosteroid. Mankhwalawa amagwiritsidwa ntchito makamaka kuti muchepetse kutupa (kutupa) mthupi lanu. Komabe, akapatsidwa mankhwala ochepa a myeloma, dexamethasone imathandiza Ninlaro ndi Revlimid kupha ma cell a myeloma.

Dexamethasone imabwera ngati mapiritsi omwe amatengedwa pakamwa kuphatikiza ndi Ninlaro. Mudzatenga dexamethasone kamodzi pa sabata, tsiku lomwelo la sabata lomwe mumatenga Ninlaro. Mumatenga dexamethasone sabata iliyonse, kuphatikiza sabata yomwe simutenga Ninlaro.

Musatenge mlingo wanu wa dexamethasone nthawi yomweyo mukamamwa mankhwala anu a Ninlaro. Ndi bwino kumwa mankhwalawa nthawi zosiyanasiyana.Izi ndichifukwa choti dexamethasone imafunika kumamwa ndi chakudya, pomwe Ninlaro amayenera kumwa wopanda kanthu.

Ninlaro ndi mowa

Mowa sadziwika kuti umakhudza momwe Ninlaro amagwirira ntchito mthupi lanu. Komabe, ngati mukukumana ndi zovuta zina kuchokera ku Ninlaro (monga mseru kapena kutsegula m'mimba), kumwa mowa kumatha kukulitsa zotsatirazi.

Ngati mumamwa mowa, kambiranani ndi dokotala wanu za kuchuluka kwa mowa womwe ungakhale wabwino kwa inu mukamagwiritsa ntchito Ninlaro.

Kuyanjana kwa Ninlaro

Ninlaro amatha kulumikizana ndi mankhwala ena angapo. Itha kulumikizananso ndi zowonjezera zina.

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

Ninlaro ndi mankhwala ena

M'munsimu muli mndandanda wa mankhwala omwe angagwirizane ndi Ninlaro. Mndandandawu mulibe mankhwala onse omwe angagwirizane ndi Ninlaro.

Musanatenge Ninlaro, 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.

Ninlaro ndi mankhwala ena a chifuwa chachikulu

Kutenga mankhwala ena a chifuwa chachikulu ndi Ninlaro kumatha kutsitsa kuchuluka kwa Ninlaro mthupi lanu. Izi zitha kupangitsa Ninlaro kukhala wopanda ntchito kwa inu. Muyenera kupewa kumwa mankhwalawa ndi Ninlaro:

• Chinthaka (Mycobutin)
• Rifampin (Rifadin)
• rifapentine (Priftin)

Ninlaro ndi mankhwala ena ogwidwa

Kutenga mankhwala ena olanda ndi Ninlaro kumatha kutsitsa kuchuluka kwa Ninlaro mthupi lanu. Izi zitha kupangitsa Ninlaro kukhala wopanda ntchito kwa inu. Muyenera kupewa kumwa mankhwalawa ndi Ninlaro:

• carbamazepine (Carbatrol, Equetro, Tegretol)
• fosphenytoin (Cerebyx)
• oxcarbazepine (Trileptal)
• anayankha
• phenytoin (Dilantin, Phenytek)
• Primidone (Mysoline)

Ninlaro ndi zitsamba ndi zowonjezera

Ninlaro atha kulumikizana ndi zitsamba ndi zowonjezera, kuphatikizapo wort ya St. Onetsetsani kuti mukukambirana zowonjezera zilizonse zomwe mumamwa ndi dokotala musanayambe kugwiritsa ntchito Ninlaro.

Ninlaro ndi St. John's wort

Kutenga wort ya St. John ndi Ninlaro kumatha kutsitsa kuchuluka kwa Ninlaro mthupi lanu ndikupangitsa kuti zisakugwireni. Pewani kumwa mankhwala azitsamba (amatchedwanso Hypericum perforatum) pomwe mukugwiritsa ntchito Ninlaro.

Momwe mungatenge Ninlaro

Muyenera kutenga Ninlaro malinga ndi malangizo a dokotala kapena wothandizira zaumoyo.

Nthawi yoti mutenge

Pokhapokha dokotala atakuwuzani zina, imwani Ninlaro kamodzi pa sabata, tsiku lomwelo sabata iliyonse. Ndibwino kuti mutenge mlingo wanu nthawi yomweyo.

Mudzatenga Ninlaro kamodzi pa sabata kwa milungu itatu. Ndiye mudzakhala ndi mlungu umodzi pa mankhwalawo. Mudzabwereza kuzungulira kwa milungu inayi kangapo monga dokotala wanu akulimbikitsira.

Pofuna kuthandizira kuti musaphonye mlingo, yesani kukhazikitsa chikumbutso pafoni yanu. Timer ya mankhwala ingakhale yothandiza, nayenso.

Kutenga Ninlaro ndi chakudya

Simuyenera kutenga Ninlaro ndi chakudya. Iyenera kumwedwa pamimba yopanda kanthu chifukwa chakudya chimatha kuchepetsa kuchuluka kwa Ninlaro komwe thupi lanu limamwa. Izi zitha kupangitsa Ninlaro kukhala wopanda ntchito kwa inu. Tengani mlingo uliwonse wa Ninlaro osachepera ola limodzi musanadye kapena osachepera maola awiri mutadya.

Kodi Ninlaro akhoza kuphwanyidwa, kugawanika, kapena kutafuna?

Ayi, simuyenera kuphwanya, kutsegula, kugawanika, kapena kutafuna makapisozi a Ninlaro. Ma capsules amayenera kumezedwa kwathunthu ndi madzi akumwa.

Ngati kapisozi wa Ninlaro watulukira mwangozi, pewani kukhudza ufa womwe uli mkati mwa kapisozi. Ngati ufa uliwonse ulowa pakhungu lanu, mutsukeni nthawi yomweyo ndi sopo. Ngati ufa uliwonse ulowa m'maso mwanu, uutulutseni ndi madzi nthawi yomweyo.

Momwe Ninlaro amagwirira ntchito

Ninlaro amaloledwa kuchiza myeloma yambiri. Amapatsidwa mankhwala ena awiri (lenalidomide ndi dexamethasone) omwe amawathandiza kuti azigwira ntchito m'thupi lanu.

Zomwe zimachitika mu myeloma zingapo

Pakatikati mwa mafupa anu muli chinthu china chotulutsa masiponji chotchedwa mafuta a m'mafupa. Apa ndipomwe maselo anu amwazi amapangidwira, kuphatikiza maselo anu oyera amwazi. Maselo oyera amatenga matenda.

Pali mitundu yambiri yamagazi oyera. Mtundu umodzi umatchedwa maselo a m'magazi. Maselo a plasma amapanga ma antibodies, omwe ndi mapuloteni omwe amathandiza thupi lanu kuzindikira ndikuukira ma virus, monga ma virus ndi bacteria.

Ndi ma myeloma angapo, maselo osadziwika am'magazi amapangidwa m'mafupa anu. Amayamba kuchulukitsa (kupanga maselo am'magazi ambiri) mosalamulirika. Maselo am'magazi amtunduwu omwe ali ndi khansa amatchedwa maselo a myeloma.

Maselo a Myeloma amatenga malo ochulukirapo m'mafupa anu, zomwe zikutanthauza kuti sipangakhale malo ochepa oti maselo abwinobwino amwazi apangidwe. Maselo a myeloma amawononganso mafupa anu. Izi zimapangitsa mafupa anu kutulutsa calcium m'magazi anu, zomwe zimapangitsa mafupa anu kufooka.

Zomwe Ninlaro amachita

Ninlaro amagwira ntchito pochepetsa kuchuluka kwa maselo a myeloma m'mafupa anu. Mankhwalawa amayang'ana puloteni inayake, yotchedwa proteasome, mkati mwa maselo a myeloma.

Proteasomes amawononga mapuloteni ena omwe maselo safunikiranso, komanso mapuloteni omwe awonongeka. Ninlaro amamatira ku ma proteasomes ndikuwalepheretsa kugwira ntchito moyenera. Izi zimabweretsa kuchuluka kwa mapuloteni owonongeka komanso osafunikira m'maselo a myeloma, omwe amachititsa kuti maselo a myeloma afe.

Zimatenga nthawi yayitali bwanji kuti zigwire ntchito?

Ninlaro amayamba kugwira ntchito m'thupi lanu mukangoyamba kumwa. Koma zimatenga kanthawi kuti mupange zotsatira zomwe zitha kuzindikirika, monga kusintha kwa zizindikiritso zanu kapena zotsatira zoyesa labu.

Mu kafukufuku wamankhwala, anthu omwe ali ndi myeloma angapo adatenga Ninlaro (kuphatikiza lenalidomide ndi dexamethasone). Theka la anthuwa adawona kusintha kwa thanzi lawo pasanathe mwezi umodzi atayamba kutenga Ninlaro.

Ninlaro ndi mimba

Ninlaro sanaphunzire mwa amayi apakati. Komabe, momwe Ninlaro amagwirira ntchito m'thupi mwanu amayembekezereka kukhala wowopsa pamimba yomwe ikukula.

M'maphunziro azinyama, mankhwalawa adavulaza fetus akapatsidwa nyama zapakati. Ngakhale maphunziro azinyama samaneneratu nthawi zonse zomwe zidzachitike mwa anthu, kafukufukuyu akuwonetsa kuti mankhwalawa atha kuvulaza pakati pa munthu.

Ngati muli ndi pakati, kapena mutha kutenga pakati, lankhulani ndi adotolo kuopsa ndi zabwino zomwe mungachite mukatenga Ninlaro.

Ninlaro ndi kulera

Chifukwa Ninlaro atha kuvulaza mimba yomwe ikukula, ndikofunikira kugwiritsa ntchito njira zakulera mukamamwa mankhwalawa.

Kulera kwa amayi

Ngati ndinu mayi yemwe amatha kutenga pakati, muyenera kugwiritsa ntchito njira yolerera yoyenerera mukamamwa Ninlaro. Muyenera kupitiliza kugwiritsa ntchito njira zakulera kwa masiku osachepera 90 mutasiya kumwa Ninlaro.

Ninlaro amatengedwa limodzi ndi lenalidomide ndi dexamethasone ya mankhwala angapo a myeloma. Dexamethasone imatha kupanga njira zakulera zamahomoni, kuphatikiza mapiritsi oletsa kubereka, osagwira ntchito popewa kutenga pakati. Ngati mukugwiritsa ntchito njira yolerera ya mahomoni, muyeneranso kugwiritsa ntchito cholepheretsa kulera (monga makondomu) monga njira zolerera zosungira.

Kulera kwa amuna

Ngati ndinu wamwamuna yemwe akugonana ndi mkazi yemwe atha kutenga pakati, muyenera kugwiritsa ntchito njira yolerera yothandiza (monga makondomu) mukamamwa Ninlaro. Izi ndizofunikira, ngakhale mnzanuyo akugwiritsa ntchito njira yolerera. Muyenera kupitiliza kugwiritsa ntchito njira zakulera kwa masiku osachepera 90 mutalandira Ninlaro.

Ninlaro ndi kuyamwitsa

Sikudziwika ngati Ninlaro amadutsa mkaka wa m'mawere, kapena ngati zimakhudza momwe thupi lanu limapangira mkaka wa m'mawere. Muyenera kupewa kuyamwa mukamamwa Ninlaro. Musamwe mkaka mpaka masiku osachepera 90 mutasiya kumwa Ninlaro.

Mafunso wamba okhudza Ninlaro

Nawa mayankho pamafunso omwe amafunsidwa kawirikawiri za Ninlaro.

Kodi Ninlaro ndi mtundu wa chemotherapy?

Ayi, Ninlaro si mtundu wa chemotherapy. Chemotherapy imagwira ntchito popha maselo mthupi lanu omwe akuchulukirachulukirachulukira (ndikupanga ma cell ochulukirapo) mwachangu. Izi zikuphatikizapo maselo athanzi, komanso maselo a khansa. Chifukwa chemotherapy imakhudza maselo anu athanzi, imatha kukhala ndi zovuta zoyipa.

Ninlaro ndi chithandizo chothandizira ma myeloma angapo. Njira zochiritsira zomwe akuyembekezerazi zimagwira pazinthu zina m'maselo a khansa omwe ndi osiyana ndi omwe ali ndi maselo athanzi. Ninlaro amalimbana ndi mapuloteni ena otchedwa proteasomes.

Ma Proteasomes amatenga nawo gawo pakukula kwamaselo. Mapuloteniwa amagwira ntchito kwambiri m'maselo a khansa kuposa m'maselo athanzi. Izi zikutanthauza kuti pamene Ninlaro amayang'ana ma proteasomes, amakhudza ma cell a myeloma kuposa momwe amakhudzira maselo athanzi.

Ninlaro atha kukhudzabe maselo athanzi ndipo atha kubweretsa zovuta zina. Komabe, njira zochiritsira (monga Ninlaro) zimakonda kuyambitsa zovuta zochepa kuposa mankhwala am'ma chemotherapy.

Kodi ndingatenge Ninlaro isanafike kapena itatha kutulutsa khungu?

Mutha kutero. Ninlaro amavomerezedwa kuti agwiritsidwe ntchito mwa anthu omwe adalandira mankhwala osachepera amodzi pa myeloma yawo yambiri. Izi zikuphatikiza anthu omwe adalowetsedwa ndi tsinde ngati chithandizo.

Masisitimu ndi maselo amwazi omwe sanakhwime omwe amapezeka m'magazi anu komanso m'mafupa anu. Amatha kukhala mitundu yonse yamagazi. Kuika kwa cell cell ndi chithandizo cha angapo myeloma. Cholinga chake ndikulowetsa maselo a myeloma ndi maselo amtundu wathanzi, omwe amatha kukhazikika m'maselo athanzi lamagazi.

Malangizo amakono azachipatala akuphatikizira Ninlaro ngati njira yothandizira (nthawi yayitali) yothandizira kuti maselo a khansa asachulukane mutakhala ndikudzipiritsa kwa cell cell. (Mwa njirayi, maselo anu am'madzi amasonkhanitsidwa kuchokera m'magazi anu kapena m'mafupa anu ndikubwezeretsani mukumanga.) Komabe, mankhwala ena amakonda kuposa Ninlaro pankhaniyi.

Malangizo amakono azachipatala akuphatikizanso Ninlaro ngati njira yothandizira mankhwala oyamba omwe mungakhale nawo chifukwa cha myeloma yanu yambiri, musanapatsidwe khungu. Komabe, mankhwala ena amasankhidwanso kuposa Ninlaro pankhaniyi. Izi zitha kukhala kugwiritsa ntchito Ninlaro. Kugwiritsa ntchito mankhwala osokoneza bongo ndi pamene mankhwala omwe amavomerezedwa kuti agwiritsidwe ntchito kamodzi amagwiritsidwa ntchito pochizira china chosavomerezeka.

Ngati nditha kusanza ndikamwa mankhwala, kodi ndiyenera kumwa mlingo wina?

Ngati musanza mutatenga Ninlaro, musamwe mankhwala ena tsiku lomwelo. Ingotengani mlingo wanu wotsatira mukafika nthawi yanu.

Ngati mumakonda kuponyera mukamwa Ninlaro, lankhulani ndi dokotala wanu. Amatha kukupatsirani mankhwala othandizira kuchepetsa mseru wanu kapena kukupatsirani malangizo amomwe mungasamalire mseru mukamalandira chithandizo.

Kodi ndifunikira mayeso a labata ndikumatenga Ninlaro?

Inde. Pamene mukutenga Ninlaro, muyenera kuyesedwa magazi nthawi zonse kuti muwone momwe magazi anu amagwirira ntchito komanso chiwindi chanu. Mukamalandira chithandizo, dokotala wanu adzawunika mayeso awa motere:

• Mulingo wamapulatifomu. Ninlaro akhoza kutsitsa mbale yanu. Ngati msinkhu wanu ukutsika kwambiri, mutha kukhala ndi chiopsezo chowonjezeka chotaya magazi. Dokotala wanu amayang'ana kuwerengera kwanu nthawi zonse, kuti mavuto akapezeka, athetsedwe mwachangu. Ngati magulu anu ali otsika, dokotala wanu akhoza kuchepetsa mlingo wanu wa Ninlaro kapena mwasiya kumwa Ninlaro mpaka mapulateleti anu abwerere bwino. Nthawi zina, mungafunike kuthiridwa magazi kuti mulandire ma platelet.
• Mulingo wamaselo oyera. Imodzi mwa mankhwala (yotchedwa Revlimid) yomwe mungatenge ndi Ninlaro ikhoza kutsitsa mulingo wanu wama cell oyera, omwe angakulitse chiopsezo chanu chotenga matenda. Ngati mulibe maselowa ochepa, dokotala wanu akhoza kuchepetsa mlingo wanu wa Revlimid ndi Ninlaro, kapena mwasiya kumwa mankhwalawa, mpaka maselo anu oyera azibwerera bwino.
• Kuyesa kwa chiwindi. Ninlaro nthawi zina amatha kuwononga chiwindi, ndikupangitsa michere ya chiwindi kuti izitulutsidwe m'magazi anu. Kuyesa kwa chiwindi kumayang'ana magazi anu ngati ali ndi michere iyi. Ngati mayeserowa akuwonetsa kuti Ninlaro imakhudza chiwindi chanu, dokotala wanu akhoza kuchepetsa kuchuluka kwa mankhwalawa.
• Mayeso ena amwazi. Mudzakhalanso ndi mayeso ena amwazi kuti muwone momwe myeloma yanu yambiri ikuyankhira kuchipatala ndi Ninlaro.

Njira zopewera Ninlaro

Musanatenge Ninlaro, lankhulani ndi dokotala wanu za mbiri yanu. Ninlaro sangakhale woyenera kwa inu ngati mukudwala. Izi zikuphatikiza:

• Mavuto a impso. Ngati ntchito yanu ya impso ili yovuta kwambiri, kapena ngati mukumwa mankhwala a hemodialysis a impso kulephera, dokotala wanu adzakupatsani mlingo wochepa wa Ninlaro kwa inu.
• Mavuto a chiwindi. Ninlaro angayambitse mavuto a chiwindi. Ndipo ngati mukuwonongeka pachiwindi, kutenga Ninlaro kumatha kukulitsa vuto lanu. Ngati muli ndi vuto lalikulu la chiwindi, dokotala wanu adzakupatsani mlingo wochepa wa Ninlaro.
• Mimba. Ngati muli ndi pakati kapena mutha kutenga pakati, Ninlaro atha kukhala owopsa pamimba yanu. Ngati inu kapena mnzanu mukutha kutenga pakati, muyenera kugwiritsa ntchito njira zakulera mukamamwa Ninlaro. Kuti mumve zambiri, chonde onani "Ninlaro ndi pakati" komanso "Ninlaro ndi njira zolerera" pamwambapa.

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

Ninlaro bongo

Kutenga zochulukirapo kuposa kuchuluka kwa Ninlaro kumatha kubweretsa zovuta zoyipa. Kuti muwone zovuta zoyambitsidwa ndi Ninlaro, chonde onani gawo la "Ninlaro zoyipa" pamwambapa.

Zizindikiro zambiri za bongo

Zizindikiro za bongo zingaphatikizepo kuwonjezeka kwa zovuta zilizonse zomwe zingachitike ndi Ninlaro. Kuti muwone zovuta zomwe zingachitike, chonde onani gawo la "Ninlaro zoyipa" 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 matenda anu akukulira, itanani 911 kapena pitani kuchipatala chapafupi pomwepo.

Kutha kwa Ninlaro, kusunga, ndi kutaya

Mukapeza Ninlaro ku pharmacy, wamankhwala adzawonjezera tsiku lotha ntchito pazolemba zomwe zili phukusi la mankhwala. Tsikuli limakhala chaka chimodzi kuchokera tsiku lomwe adapereka mankhwalawo. Musatenge Ninlaro ngati tsiku lotha ntchito lomwe lidasindikizidwa lidutsa.

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 ngati mungakwanitse kuugwiritsabe ntchito.

Yosungirako

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

Makapisozi a Ninlaro ayenera kusungidwa m'matumba awo oyambirira. Zisungeni kutentha kuti zisakhale ndi kuwala. Ninlaro sayenera kusungidwa kutentha kwambiri kuposa 86 ° F (30 ° C).

Pewani kusunga mankhwalawa m'malo omwe amatha kunyowa kapena kunyowa, monga zimbudzi.

Kutaya

Ngati simufunikiranso kumwa Ninlaro ndikukhala ndi mankhwala otsala, ndikofunika 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 za Ninlaro

Zotsatirazi zimaperekedwa kwa azachipatala ndi ena othandizira azaumoyo.

Zisonyezero

Ninlaro amaloledwa kuchiza ma myeloma angapo, omwe amagwiritsidwa ntchito limodzi ndi lenalidomide ndi dexamethasone, mwa achikulire omwe adalandirapo chithandizo chimodzi.

Chitetezo ndi mphamvu ya Ninlaro sizinakhazikitsidwe mwa ana.

Njira yogwirira ntchito

Ninlaro ili ndi ixazomib, proteasome inhibitor. Ma Proteasomes ali ndi gawo lalikulu pakuphwanya mapuloteni omwe akukhudzidwa ndi kayendetsedwe kazinthu zama cell, kukonza kwa DNA, ndi apoptosis. Ixazomib imamangiriza ndikuletsa zochitika za beta 5 subunit ya 20S gawo lalikulu la 26S proteasome.

Mwa kusokoneza zochitika za proteasome, ixazomib imayambitsa kuchuluka kwa mapuloteni owonjezera kapena owonongeka mkati mwa selo, zomwe zimapangitsa kufa kwa cell.

Ntchito ya Proteasome imakulitsidwa m'maselo owopsa poyerekeza ndi maselo athanzi. Maselo angapo a myeloma amakhala pachiwopsezo chazovuta za proteasome inhibitors kuposa ma cell athanzi.

Pharmacokinetics ndi metabolism

Kutanthauza kuti kupezeka kwa ixazomib ndi 58% pambuyo poyendetsa pakamwa. Bioavailability imachepetsedwa pamene mankhwala amatengedwa ndi chakudya chambiri. Poterepa, dera lomwe lili pansi pa curve (AUC) la ixazomib latsika ndi 28%, ndipo kuchuluka kwake (Cmax) kumatsika ndi 69%. Chifukwa chake, ixazomib iyenera kuperekedwa pamimba yopanda kanthu.

Ixazomib ndi 99% yomangidwa ndi mapuloteni a plasma.

Ixazomib imakonzedwa makamaka ndimatenda amtundu wa hepatic omwe amakhala ndi michere yambiri ya CYP komanso mapuloteni omwe si a CYP. Ambiri mwa ma metabolites amatuluka mumkodzo, pomwe ena amatulutsa ndowe. Gawo lakumapeto kwa moyo ndi masiku 9.5.

Kuwonjezeka pang'ono mpaka kuwonongeka kwakukulu kwa chiwindi kumawonjezeka kumatanthauza ixazomib AUC ndi 20% kuposa tanthauzo la AUC lomwe limachitika ndimagwiridwe anthawi zonse a chiwindi.

Kutanthauza ixazomib AUC yawonjezeka ndi 39% mwa anthu omwe ali ndi vuto lalikulu la impso kapena matenda am'magazi omwe amafunikira dialysis. Ixazomib siyotheka kuyimba.

Kuyeretsa sikumakhudzidwa kwambiri ndi msinkhu, kugonana, mtundu, kapena thupi. Kafukufuku wa Ninlaro adaphatikizira anthu azaka zapakati pa 23 mpaka 91, komanso omwe ali ndi matupi oyambira 1.2 mpaka 2.7 m².

Zotsutsana

Palibe zotsutsana ndi Ninlaro. Komabe, zoopsa zokhudzana ndi chithandizo chamankhwala monga neutropenia, thrombocytopenia, kuwonongeka kwa chiwindi, zotupa pakhungu, kapena zotumphukira za m'mitsempha zimafunikira kusokonezedwa ndi chithandizo.

Yosungirako

Makapisozi a Ninlaro ayenera kusungidwa m'mapangidwe awo oyambira kutentha. Sayenera kusungidwa kutentha kwambiri kuposa 86 ° F (30 ° C).

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.