Umuthi 'Doxorubicin ": imfundo manual, izibuyekezo, izithombe, ifomu ukukhululwa, umthamo, USB. "Doxorubicin-Lance": yokusetshenziswa

Umdlavuza kuyingozi kakhulu ukuphila komuntu. Siqukethe amaseli okubulalayo nokuhlala engalawuliwe proliferating, ekwazi ukungena zezicubu ezizungezile futhi iyakhula kwezinye izitho.

Ukuthuthukiswa lemithi kanye lokwelatshwa izifo ezifana kuyinto umsebenzi obalulekile. Ngeshwa, kuze kube manje akekho kuze kube sekupheleni futhi angizange isinqumo. Nakuba zisekhona izidakamizwa ezingaba ukubambezela division of isimila cells. Omunye wabo okubhekiselwe imithi "Doxorubicin". Yokusetshenziswa futhi isithombe zomuthi okuzokhulunywa ngazo kulesi sihloko. Kuyo uzothola ulwazi mayelana nokuthi ukugcina wathi izindlela lapho akha ke itholakale ukudayiselwa, nokuningi.

Okufakiwe, ukubunjwa, ukuma kanye nencazelo

Ngayiphi ifomu sithengiswa "Doxorubicin"? Yokusetshenziswa ukhombise izinhlobo elandelayo yomkhiqizo:

• Lyophilizate for nokulungisa isixazululo umjovo intravascular futhi intravesical. Kuyinto okubomvu-yellow mass ukungena nakwamanye amazwe futhi iqukethe ketshezi asebenzayo ezifana doxorubicin hydrochloride. izithako Njengoba eyengeziwe usebenzisa mannitol. Imithi okuthengiswa amabhodlela, ebiyelwe ebhokisini amakhadibhodi.
• Gxila ngokukhiqiza isixazululo umjovo intravascular futhi intravesical. Iwuketshezi elibomvu futhi esobala equkethe doxorubicin hydrochloride futhi itholakala amabhodlela kanye amabhokisi.

I kwemithi zomuthi

Kuyini lokhu imithi ngokuthi "Doxorubicin"? Yokusetshenziswa (Ukukhululwa uhlobo umuthi kukhonjisiwe ngenhla) ibika ukuthi kuyinto anti-isimila anthracycline ngemithi elwa namagciwane, okwakubekelwa behlukene Emasikweni ukhunta Streptomyces peucetius. Uyakwazi kunethonya imiphumela antimitotic futhi antiproliferative.

Ukuhlanganyela DNA, nomuthi kuvimbela RNA polymerase, DNA polymerase futhi topoisomerase uhlobo 2, futhi oyenza isebenze ukukhiqizwa khulula ezizivelelayo enza odongeni cell. Ngenxa umthelela onjalo siyehla DNA ukufanisana nezinto eziphilayo nucleic acid zamagama.

Akunakwenzeka ukuba uqaphele yokuthi sisuke sicabanga indlela kunomphumela cytotoxic oqondile. Amaseli abonise kucikelela ngokukhethekile izidakamizwa e-G2-isigaba S-sigaba sokuphila kwabo.

izakhiwo kinetic

Yini imingcele kinetic esivela izidakamizwa "Doxorubicin"? Yokusetshenziswa ithi ngemva umjovo emthanjeni, ithuluzi njalo basakaza multiphase. Phakathi nemizuzu yokuqala 5 nomuthi ngokushesha ethumba izicubu, futhi okuhlushwa yayo igazi incipha ngokushesha. Ngokuqondene Isigaba sesibili, it is eyenziwa molecule izidakamizwa kancane ezicutshini zomzimba.

Ugxilisa izidakamizwa esebenzayo esibindini, izinso, ubende, amaphaphu myocardium. Iphinde lingena placenta futhi excreted nge ubisi lwebele.

Imphendvulo plasma amaprotheni kwenzeka ngo-75%. Umzimba izidakamizwa esibindini, kanjalo azakhele esuselwe asebenzayo ezifana doxorubicinol.

Phakathi nokwehlisa radicals khulula zamagama enzyme kungathikameza ukukhula of ubuthi inhliziyo.

Isigamu-ukuphila doxorubicin futhi doxorubicinol efanayo futhi amahora mayelana 20-48.

Cishe u-40% umthamo zomuthi ikhishwe kanye Bile, futhi% 6-11 kuphela doxorubicin nemikhiqizo yalo, izinsuku 5 atholakala umchamo.

izinkomba

izidakamizwa "Doxorubicin" angaqokwa ngasiphi izifo?

Yokusetshenziswa (nomdlavuza wesinye iyithuluzi esetshenziswa ngokuvamile kakhulu) Libuye lithi umuthi wenza kahle uma:

• yegilo umdlavuza ndlala Sarcoma Kaposi futhi Ewing;
• Wilms 'isimila, umdlavuza esiswini, ifomu encane cell umdlavuza wamaphaphu;
• insulinoma, umdlavuza webele, mesothelioma;
• umdlavuza ngomphimbo, carcinoid, unesimila ebuchosheni;
• Sarcoma osteogenic, hepatocellular eyinhloko carcinoma lymphoma-non-Hodgkin sika ;
• Umdlavuza wamaphaphu endlaleni engasesinyeni, umdlavuza ikhanda nentamo, thymoma abulalayo;
• umdlavuza wesibeletho, ezinye izinhlobo izimila wamasende;
• lesizalo Sarcoma, umdlavuza endometrial, isifo Hodgkin sika;
• rhabdomyosarcoma, wegazi acute;
• ezingamahlalakhona lymphocytic wegazi, myeloma amaningi.

Izimo

Yiziphi isimo ezibekiwe nesineke enqabela kuye lesi sidakamizwa "Doxorubicin"? Yokusetshenziswa, oncologists yangempela ukuthi ithuluzi efakazela hhayi ngempumelelo kakhulu:

• sensitization ukuze doxorubicin noma nezinye izinto izidakamizwa, kanye nabamele anthracyclines futhi anthracenediones;
• ukwelashwa ngaphambi, noma kwamanye amalungu anthracenediones anthracycline ngemithamo nokukhawulela, kanye yokwehluleka kwesibindi (esibi kakhulu), isilethikusebenza, arrhythmias, acute izifo ezibangelwa amagciwane kanye senhliziyo (kwezokuphatha ngomjovo);
• izimila ebulalayo, germinating ogangeni isinye, pheshana urinary nezifo futhi cystitis (i intravesical).

Ngokucophelela okukhulu, lokhu izidakamizwa kumele kusetshenziswe abantu abathola yelashwa ngamakhemikhali, kanye engcupheni cardiotoxicity, ukwephulwa kwesibindi, umnkantsha kokuziphatha amaseli umdlavuza kanye nokukhuluphala ngokweqile.

Ngaphezu kwalokho, kubhekwa ngokucophelela izidakamizwa ezinqunyiwe bantfwana nebantfu yokukhula, futhi njengengxenye multi-zinhlobo futhi multicomponent yokwelapha antitumor.

Izidakamizwa "Doxorubicin": yokusetshenziswa, umthamo

Ngokusho imiyalelo, bebheka bonke izidakamizwa ingasatshenziswa intraarterially, ngemithambo yegazi futhi intravesically. Kufanele kuphawulwe ukuthi leli thuluzi ngeke isetshenziswe singly noma inhlanganisela nezinye izidakamizwa cytostatic e imithamo ehlukene.

Isixazululo izidakamizwa kabusha "Doxorubicin" izosetshenziselwa ngokushesha ngemva womshini yayo.

I-intravenous injection ekwakhiweni

Ngesikhathi umthamo watusa monotherapy "Doxorubicin" umjikelezo ngamunye 60-75 mg / sq. m njalo emavikini amathathu. Ngokuvamile, isidakamizwa injected esisodwa. Nokho, kungenzeka lokhu umthamo iqondiswa futhi imijovo amaningi (e isamba 25-30 mg / sq. M ngosuku 3 izinsuku zokuqala lomjikelezo).

Ukuze wehlise umphumela anobuthi indlela esetshenziswa ukuphatha seviki 10-20 mg / sq. izikhathi m ngesonto.

Lapho kuhlangene namanye amanxusa anticancer nomuthi asebenzayo iqondiswa emjikeletweni Isikali e isamba 30-60 mg / sq. m njalo emavikini 4.

okuphindaphindiwe course of ukwelashwa eyenziwa kuphela emva ukuqedwa kwazo zonke izimpawu zokuba ubuthi.

Umthamo Imininingwane zomuthi akufanele bube ngaphezu kuka-550 mg / sq. m.

Naphakathi-lwemithambo nokuphathwa umenzeli

Kangakanani umjovo naphakathi-lwemithambo "Doxorubicin" izidakamizwa? Qondisa ithi ukunikeza sidetone abantu hepatocellular carcinoma nomuthi asebenzayo ukuba iphathwe ovamile Umthambo hepatic ngezilinganiso ka 35-150 mg / sq. m. Ngesikhathi esifanayo ngezikhawu phakathi nowe ungakwazi ukukwenza kufanele kulingane kusuka 3 amaviki izinyanga 3.

Ukwethulwa kwe izidakamizwa ku esinyeni

Njengoba esinyeni injected izidakamizwa "Doxorubicin-Teva"? Yokusetshenziswa ibika ukuthi lokhu umthamo kusho kwezokuphatha intravesical kufanele kube 35-50 mg ukufakwa ngasinye.

izinqubo zokwelapha kumele kwenziwe ngezikhawu izinsuku 7-28 ka, kuye ngokuthi injongo (ngokuvinjelwa noma ngokwelashwa).

Lokuhlushwa yesixazululo izidakamizwa kufanele kube isixazululo 1 mg / 1 amanzi ml noma ngokomzimba.

Instillation wenziwa ngaphakathi 2 amahora. Ekupheleni isiguli kufanele uchithe esinyeni.

side effects

Ukulungiselela "Doxorubicin", lapho imfundo ezichazwe ngenhla kungadala lokhu okulandelayo ohlangothini ukusabela:

• ukuhlanza, ubuhlungu besisu, isicanucanu, nesifo, stomatitis, uhudo, esophagitis ophuzwayo mucosa hyperpigmentation, sokuzincisha ukudla, kukhuphuke bilirubin lokuhlushwa igazi, ukopha emathunjini, kukhuphuke transaminases hepatic;
• ulapha ancike esethola leukopenia, thrombocytopenia, ukuntuleka kwegazi emzimbeni, leukopenia, neutropenia;
• itheku tachycardia, vimba atrioventricular, ifomu tachyarrhythmia congestive inhliziyo ukwehluleka, bradycardia, thrombophlebitis, wakhe block legatsha lenqwaba, kwezinso ku ECG, arrythmia ventricular, embolism yamaphaphu, phlebitis, ukuxakeka thromboembolic;
• amenorrhea, oligospermia, hyperuricemia, staining urinary obomvu, azoospermia;
• conjunctivitis, keratitis, lacrimation;
• neuropathy neurotoxicity, ukuquleka, ikhoma;
• edema, Alopecia esethola, photosensitivity, isikhumba hyperpigmentation, amawala, ukulunywa, sebuhlungwini obunzima, ukuqubuka, i-erythema, epidermis olumanzi;
• dermatitis, amawala, bronchospasm, isikhumba ngamanzi, anaphylaxis;
• phlebitis Local, ukuvuvukala imakwe, fleboskleroz, thrombophlebitis, ubuhlungu zendawo, izicubu necrosis;
• polyuria, nocturia, dysuria, necrosis kwesinye ulwelwesi, hematuria, ukungakhululeki, ukuchama buhlungu;
• striation erythematous kusayithi umjovo;
• ukukhathala, ukucobeka imfiva, Ukugodola, ukuthuthukiswa lymphocytic noma wegazi myelocytic (acute), hyperuricemia, amagagasi, nephropathy;
• isilonda 12 duodenal / esiswini, ukuqina kwamathishu biliary.

Izimpawu ze-ukweqisa izidakamizwa

Yiziphi izimpawu ukweqisa izidakamizwa zenzeka uma usebenzisa inani elikhulu "Doxorubicin" izidakamizwa? Iziyalezo yokusetshenziswa lithi ukweqisa izidakamizwa izimali kungaholela izimpawu ezinobuthi owabonakaliswa isimiso sokugaya ukudla bungene, kanye myelosuppression ezinzima. Ngaphezu kwalokho, amazinga okukhishwa ephakeme zomuthi kungaba lula impela kubangele acute isifo senhliziyo.

Kuyindlela yokuvimbela lesi sidakamizwa "Doxorubicin" alikho nhlobo. Ngo ukweqisa izidakamizwa Athinteka iqondiswa yokwelapha lingaze. Futhi, esibhedlela futhi iphathwa izidakamizwa elwa namagciwane.

izidakamizwa ekuhlanganyeleni

Kungenzeka yini ukuba zihlangana kanjani nezinye izidakamizwa izidakamizwa "Doxorubicin"? Yokusetshenziswa olubonisa uma ukusebenzisa leli thuluzi lihambisana namanye izidakamizwa cytotoxic Ngokuvamile ubonakaliswa isimo sengqondo okufakiwe zabo ubuthi.

Uma umuthi inhlanganisela nezinye izidakamizwa cytotoxic, ezithinta cardiotoxicity (isib, "FU" noma "Cyclophosphamide"), idinga ukuqapha ngokucophelela inhliziyo phakathi yonke inkambo yokwelapha.

"Streptozocin" kwandisa nenxenye ukuphila "Doxorubicin".

Therapy "Doxorubicin" isiguli singase ukubonisa izimpawu acute oluhambisana cystitis emva kokwelashwa "cyclophosphamide", kanye nokuqinisa mkhuba esibindini obabubangwa emva kokwelashwa "mercaptopurine."

Ukusetshenziswa "Paclitaxel" phambi isingeniso langempela "Doxorubicin" kungase kuvuse ukwanda emakamu igazi lakamuva.

Yimiphi imithi ekusebenziseni izidakamizwa "Doxorubicin"? Yokusetshenziswa (izilwane alinikeziwe) ibika ukuthi leli thuluzi akufanele exutshwe nezinye izidakamizwa. Ngokwesibonelo, kuba pharmaceutically iyahambisana "heparin", "Dexamethasone", i-sodium succinate, "hydrocortisone", "cephalothin", "aminophylline", "FU" nezinye izidakamizwa anticancer.

Lapho kuhlangene bukhoma yokugoma viral kungenzeka ukufanisana viral futhi ngakhula ohlangothini ukusabela bese wehlise omzimba zamagama emzimbeni wesiguli ekuphenduleni ukusetshenziswa imigomo.

izincomo Specific on ukusetshenziswa kwezidakamizwa

Okufanele ukwazi ngaphambi kokusebenzisa "Doxorubicin-Lance"? Yokusetshenziswa bubonisa ukuthi imithi oyinikiwe ejenti antineoplastic idingekile ukuze ukuqapha njalo umsebenzi sesibindi, isithombe wegazi neuropathy, ECG kanye ultrasound zenhliziyo.

izimo yokuthengisa, indlela isitoreji futhi eshalofini-ukuphila

Lapho kufanele lesi sidakamizwa "Doxorubicin-Lance"? Yokusetshenziswa ibika ukuthi leli thuluzi kumele igcinwe endaweni eyomile futhi emnyama lapho izinga lokushisa ingeqi degrees ezinhlanu.

I nomuthi ikhishwe Pharmacy ngu kadokotela kuphela. Isikhathi sokuphila kwayo eshalofini emibili.

Inani kanye analogue

Izindleko zomuthi kubhekwa ruble 120-150 e 5 ml. Uma kudingeka kube ungayithola enye ngokusebenzisa izinto ezinjengenkolo "Doxorubicin-Teva", "Lachema Doxorubicin", "Onkodoks 50", "10 Onkodoks", "Doxorubicin-Ebewe", "CRC-Doxorubicin" nabanye.

Umthengi izibuyekezo imithi

Manje uyazi ukuthi ukusebenzisa izidakamizwa "Doxorubicin". Yokusetshenziswa futhi isitoreji zomuthi banikezwe ngenhla.

Abaningana impela enkulu Izibuyekezo umthengi elihlobene ne nemiphumela eyingozi kakhulu enqabayo ezenzeka phakathi ukwelashwa nge izidakamizwa. Ukuze miphumela kukhona yangaphakathi isitho ukuzibandakanya, nehlala njalo ukuzizwa ugula, nezinwele kanye kumiswa izilonda endaweni yomkhuleko umjovo.

On isigijimi esiqondile ziyivelakancane kakhulu. Futhi lokhu akumangalisi, ngoba ukusebenza kwe anticancer izidakamizwa kufanele ahlaziye kuphela uchwepheshe abanolwazi, ngokusekelwe inqwaba yezinto ezahlukene: uhlobo monotherapy noma ukwelashwa, umdlavuza, isimo lesiguli, neminye imiphumela yesikhathi eside.