"Endoxane": yokusetshenziswa, nozakwabo Okuyınqo, nomkhiqizi

Izidakamizwa "endoxane" libhekisela eqenjini anti-isimila ejenti. Kuye ngendlela ukukhishwa ingasatshenziswa ngomlomo noma parenterally. Hlobo luni izidakamizwa, simise futhi kulokho ngomthamo, ukuzixazulula udokotela kuphela ngesisekelo nezimo ezingokoqobo kwesimiso lesiguli.

Ukwakheka nezakhiwo izidakamizwa

The main isithako zomuthi "endoxane" yokusetshenziswa libhekisela cyclophosphamide. Omunye sibhebhe sinamaphutha 50 mg ke. Umuthi libhekisela eqenjini antitumor izidakamizwa kuyinto amaphilisi biconcave nge imvilophi elimhlophe kanye umnyombo luhlaza efanayo. izingxenye Njengoba eyengeziwe umkhiqizo zokwenza imithi ezisebenzayo ehlanganisa i-calcium carbonate ne-hydrogen phosphate, sodium karamellozu, glycerol, gelatin, i-lactose, corn isitashi, macrogol, magnesium stearate, polysorbate, sucrose, talc, Silica futhi titanium.

Uyini kwemithi zomuthi?

The main asebenzayo izidakamizwa izidakamizwa, okungukuthi cyclophosphamide, alkylating futhi ine umphumela cytostatic. Ngokwemvelo yayo, useduze lwesinaphi igesi, i-nitrogen kokuba Analogue yayo.

Lo mshini wezenzo ka cyclophosphamide esekelwe kumiswa crosslinks phakathi molecule e-DNA futhi RNA nemizimba amaprotheni zamagama abacindezela.

I pharmacokinetics zomuthi

The main isithako "endoxane" isidakamizwa has degree pheze ephelele absorbability kusukela pheshana emathunjini. okuhlushwa kwalo ngegazi ngemva kokuphathwa temlomo na emthanjeni ziyafana. umzimba Cyclophosphamide kwenzeka ngokuyinhloko esibindini, lapho ngaphansi kwethonya microsomal oxidase mshini kumiswa metabolites asebenzayo alkylating. Ezinye zazo aguqulwa kumafomu ngasebenzi, elinye iqembu is wathuthela amaseli, lapho isenzo enzymatic of phosphatases siguqulelwa izinto nge izakhiwo cytotoxic.

I degree of yokubopha owaqalwa zomuthi nge Amaprotheni egazi azinakwa futhi 12-14%. Nokho, le nkomba efanayo metabolites kakade kulingana 60%.

cyclophosphamide ezivezwa excretion kwezinso ikakhulukazi ngesimo metabolites. Cishe 5-25% we isidakamizwa excreted injalo yasekuqaleni umchamo kanye Bile.

Sepharamitha T1 / 2 izidakamizwa kulingana 7 amahora abadala futhi 4 amahora izingane.

Ngayiphi umthamo ukuthatha imithi?

Izidakamizwa "endoxane" ngefomu ithebhulethi ezithathwe ngomlomo ngaphambi kokudla noma isigamu sehora emva kokudla, ngemva kwamahora angu-2.

Ngenxa yokuthi umkhiqizo ezithaka imithi kufakwe inani elikhulu zemithi chemotherapeutic, imodi ukukhethwa abaphathi kanye umthamo udokotela kubhekwe ngamunye.

"Endoxan" - tablet - Umhlahlandlela uncoma isisindo umthamo 1-3 mg / kg umzimba ngosuku, okungase kusuka 50 kuya 200 mg cyclophosphamide amahora angu-24. Isikhathi kwelashwa amasonto 2-3.

Uma izidakamizwa esithathwayo kanye nezinye izidakamizwa ukuthi babe anti-isimila izakhiwo, umthamo zonke izakhi yokwelapha asitholayo ukulungiswa.

Kuke kwenzeke yini kube ukweqisa izidakamizwa?

Ukuba khona nje kuyindlela yokuvimbela specific ukulungiselela "endoxane 'yokusetshenziswa is hhayi ukuqinisekisile. Uma kwenzeka yokudlula umthamo oyifunayo Kunconywa yokwelapha yesondlo njengoba ukwelashwa okufanele kwezifo ezithathelwanayo, izimpawu zokuqaleka cardiotoxicity futhi myelosuppression bawabulale.

Njengoba umuthi is kuhlangene lezinye izidakamizwa ke?

Uma isiguli kuthatha izindlela ingqondo microsomal namachibi esibindini, impatho ngokuhlanganiswa izidakamizwa "endoxan" imfundo kubonisa zamagama lelitfutfukile metabolites nomsebenzi alkylating, kwehle isigamu-ukuphila cyclophosphamide bese kukhuphula ukusebenza ngendlela yayo.

Lesi sidakamizwa kuvimbela cholinesterase umsebenzi futhi umzimba indlela i-cocaine, okwandisa ubuthi bayo, futhi kukhulisa nekusebenta suxamethonium.

Uma "endoxane" isetshenziswa ngesikhathi esifanayo ne "Allopurinol" ukuthi kukhona luyanda khona imiphumela yako emibi ku umnkantsha.

Endabeni ukwelashwa kanyekanye ne cyclophosphamide, colchicine, probenecid, udokotela sulfinpyrazone ngokuvamile ilungisa ulapha elwa ne-sifo. Lokhu lihlotshaniswa kwengozi nephropathy e isicelo ngokuhlanganyela "endoxane" nezidakamizwa uricosuric.

Cyclophosphamide kunciphisa zamagama izici esibindini, Nokho banesibopho igazi ekunqandeni kanye ukukhiqizwa platelet, kuyilapho ukwelashwa nge anticoagulants incipha umsebenzi wale mithandazo.

Iziguli ngokuthatha izidakamizwa "endoxan" imfundo manual uncoma ukudla ngaphandle ubhamubhamu juice, ngoba iqukethe izingxenye ezephula nekusebenta kusebenze futhi isakhi esiyinhloko esebenzayo ye nomuthi.

Lapho babambisane zinikwa cyclophosphamide "Doxorubicin" noma "daunorubicin" is iyakhula imiphumela cardiotoxic le mithi.

Inhlanganisela nabanye immunosuppressants, njengokuthi "Azathioprine" "Tacrolimus", "Chlorambucil", "SSC", "Merkapturin" kuholela ekwandeni e okuvela zifo futhi isimila hlobo.

Endabeni ukusetshenziswa ahlangene "endoxane" futhi "Lovastina" in iziguli inhliziyo ukufakelwa kungenzeka ingozi rhabdomyolysis futhi ukwehluleka kwezinso ngendlela oyingozi.

Uma imishanguzo cyclophosphamide kuhlangene mielosupressantami noma nge ukwelashwa ngemisebe, kungenzeka ukuzuza ugneeniya umnkantsha umsebenzi.

Kanyekanye reception "endoxan" nge umthamo ephezulu cytarabine ngesikhathi manipulations kahle phezu kwezinye zilindele umnkantsha transplantation kwandisa nokudlondlobala zenhliziyo ebulalayo.

Lokhu kuhlangana kanjani isidakamizwa umsebenzi zokuzala?

Izidakamizwa "endoxane" kobufakazi nesineke kufakazelwe, ungakwazi avuse inzalo iziguli zabo bobubili ubulili, okungase engelapheki.

Ezimweni eziningi, abesifazane amenorrhea kwenzeka, kodwa njalo lapho umuntu esesikhathini ngokuvamile alulame ezinyangeni ezimbalwa emva kokwelashwa kanye cyclophosphamide. Uma yokwelapha kwenziwa e amantombazane prepubertal, ngeziphambeko ukuthuthukiswa ukubonakaliswa ngokobulili yesibili babonakala. Ukuya esikhathini kwakuyinto evamile, kulahleke okuzala.

Ekwelapheni besilisa izidakamizwa "endoxane" imfundo kubonisa ukuthi kwezinye izimo ezibikiwe azoospermia noma oligospermia. Lokhu kungenxa umkhiqizo wawanda ka gonadotropins ngesilinganiso kwe-testosterone ukukhululwa. libido ezingeni futhi potency ezingabantu akuyona encishisiwe. Uma imishanguzo cyclophosphamide akhiqizwa abafana prepubertal, le obazovanie ukubonakaliswa ngokobulili yesibili ziye zenzeka ngendlela evamile. Nokho, izimo zokukhukhumala azoospermia, oligospermia nokwenziwa ngcono gonadotropins Kuye kwaphawulwa. Iphinde singenzeka yoma wamasende. Kuyaphawuleka ukuthi azoospermia esethola, nakuba nokuvulwa imisebenzi singenzeka eminyakeni embalwa ngemva kokuphela ukwelashwa.

Yiziphi imiphumela emibi umuthi?

Ukuthatha imithi "endoxane 'yokusetshenziswa kuqinisekisiwe, kungase kubangele ezinye izifo uhlelo hemopoietic:

• Leukopenia, neutropenia - kaningi.
• Ngaphansi common sokuntuleka kwegazi kanye thrombocytopenia.

Ngemva kwamasonto 1-2 kusukela ekuqaleni ukwelashwa, isiguli wabonisa nokwehla esiphezulu leukocyte nama-platelet egazini. Lezi nemingcele buyisa evamile zingakapheli izinsuku 7-10 sokuphela yokwelapha.

In the ukwelashwa nge cyclophosphamide kungabangela ukusabela uhlangothi pheshana emathunjini:

• Ukucanuzela kwenhliziyo nokuhlanza.
• Anorekisya.
• Stomatitis.
• Ubuhlungu esifundeni besisu.
• Sezinyawo semfene.
• Jaundice.
• nesifo oluhambisana.

Akuvamile zenzeka isibindi okuhambisana nale msebenzi omkhulukazi enzyme kanye namazinga bilirubin bavuke. Shiya iqembu elikhulu iziguli anaemia aplastic futhi wamukele ephezulu umthamo "endoxane" noma ngokuhlanganisa ngayo busulfan, uthi emithanjeni endoflebit hepatic. Lesi simo esiyingqayizivele sibangelwa singenzeka amasonto 1-3 emva umnkantsha transplantation kanye kubonakala waba ukwanda okukhulu kwezincwadi umzimba mass, ascites, hepatomegaly futhi hyperbilirubinemia, hepatic encephalopathy.

Ngaphambi izidakamizwa kungabangela ukusabela engathandeki ngesikhumba:

• Alopecia emuva.
• Ukuqubuka.
• I lesikhumba kwesikhumba kanye nezinzipho.

It kungabuye senziwa ukuhlukumeza kohlelo urinary ekwelapheni izidakamizwa "endoxane". Imiyalelo, ukubuyekezwa kodokotela kanye neziguli ukuze ukhombise ahlukene:

• Cystitis kuhambisana cystic esinyeni (noma ngaphandle kwalo).
• urethritis oluhambisana.
• imihlola Necrotic tubule kwaze kwaba sekufeni.

Ngo umchamo, isiguli kungenzeka ukutholwa epithelium kwesinye urinary. Uma ifomu ka oluhambisana cystitis esindayo, bayayeka ukuphuza umuthi. Ukubhekwa kokuvinjelwa engcono yale simo imithi "Mesna". Uma isilinganiso "endoxan" lenyuka, ingaqala izinso ukungasebenzi njengoba nephropathy futhi giperurekemii.

Uma isiguli sine-degree okunzima kwamasosha omzimba ke ekwelapheni cyclophosphamide bangezwa ngamagciwane okunzima.

Futhi ungakwazi ukuthuthukisa imiphumela eminingi engemihle njengezindlela elandelayo:

• Cardiotoxicity (ebulilini), degree ezinzima ephethwe yisifo senhliziyo.
• cystic yamaphaphu, nemvelo interstitial.
• Ukuphazamiseka spermatogenesis futhi oogenesis, awushintsheki futhi inzalo engelapheki.
• Ukuthuthukiswa yesibili neoplasms ebulalayo efana umdlavuza wesinye, mieloproliferatsiya futhi lymphoproliferation.
• Yokungezwani komzimba njengoba ukuqubuka, ukulunywa, urticaria, ngezinye izikhathi ngendlela ukusabela anaphylactic.
• Kubi isilonda ukuphulukisa.
• ngamanzi kobuso, ukujuluka, ikhanda.

Ukuba khona nemiphumela emibi kakhulu ngokuthatha izidakamizwa njalo ebuza ngezinzuzo kungenzeka ngokumelene izingozi ezingase zibe khona ukuze isiguli ngabanye.

Yikuphi izifo linqume lokhu izidakamizwa?

Tablets "endoxan" ingase yabelwe isiguli uma ine- lezi zifo ezilandelayo:

• isifo Hodgkin sika.
• myeloma amaningi.
• Umdlavuza webele.
• lymphoma lymphoblastic ngefomu oyingozi noma ezingamahlalakhona.
• Non-Hodgkin sika lymphoma hlobo.
• Retinoblastoma.
• Unesimila ebuchosheni.
• Mycosis gribkovidnogo uhlamvu.

Ikhombisa ukwamukeleka isicelo eziyinkimbinkimbi anticancer yokwelapha exhunywe izidakamizwa "endoxane" imfundiso. Umenzi uncoma ukuthi afake wokwelapha isifo somdlavuza wesibeletho umdlavuza wesinye, wamaphaphu futhi umdlavuza wendlala yabesilisa, sarcomas futhi reticulosarcoma, izifo Ewing futhi Wilms.

I cyclophosphamide ezisekelwe izidakamizwa ingasetshenziswa njengendlela immunosuppressant izifo lesichubekako sokuhlasela kwamasosha omzimba afana, psoriatic ne-rheumatoid arthritis, i-anemiya haemolytic, izifo collagen nephrotic syndrome, kanye ukugwema xhumelela ukwenqatshwa.

Lapho izidakamizwa is contraindicated?

I nomuthi "endoxan" has a Izimo isisindo, kuhlanganise:

• Nokukhulelwa kanye lactation.
• Cystitis.
• Ezithathelana efomini asebenzayo.
• Ukwephula umnkantsha ukusebenza liphinyiselwe fomu.
• Ukuba khona hypersensitivity kuya eziyisisekelo futhi ezengeziwe izidakamizwa izinto.
• nokugcinwa urinary.

odokotela ukunakekela okukhethekile linqume izidakamizwa e izifo zenhliziyo, izinso kanye isibindi, ezinzima, sifo, adrenalectomy, khona kokuziphatha izinqubo umnkantsha, nefrourolitiaze.

isiqondiso Specific ekwelapheni

Phakathi Ukungenisa "endoxan" kuncike obligatory ukulawula igazi (neutrophil futhi platelet count) kanye nomchamo (khona amangqamuzana abomvu egazi) yesiguli sami esithile.

kunconywa ukuba angaqhubeki ukwelashwa "endoxane" kusho kwezinye izimo. Imiyalelo ukusetshenziswa amaphilisi Kunconywa ukuba benze kanjalo ngaphansi kwale mibandela elandelayo:

• Ukubonakaliswa izinkomba cystitis.
• Ukwehlisa lokuhlushwa leukocyte nama-platelet emagugwini ezibucayi.
• Izehlo ukutheleleka (umthamo ukulungiswa kungenzeka).

Uma "endoxane" lisetshenziswa ebulilini, isiguli ezinqunyiwe imithi, "Meena" nokuvimbela oluhambisana cystitis hlobo.

In the ukwelashwa ngalo muthi kufanele uyeke ukuphuza utshwala nokusebenzisa izindlela eziqinile zokuvimbela inzalo.

Uma isiguli inikezwa "endoxan" izinsuku ezingu-10 ngemva kokuhlinzwa kanye ukubulawa kwezinzwa okuvamile, lo Udokotela obulala izinzwa unolwazi ngalesi.

Ngemva adrenalectomy wenziwa umthamo ukulungiswa "endoxane" nezinye izidakamizwa corticosteroids.

izidakamizwa analogue

Uma kukhona Izimo sina nezingozi, sengithembisa ithawula ngokuthatha imithi "endoxane" imfundiso. Analogs kungenziwa udokotela alternative efanelekayo. Phakathi kwabo:

• "Ledoksin".
• "Cyclophosphamide".
• "Cytoxan."
• "Cyclophosphamide - Teva".
• "-Lens Cyclophosphamide".
• "Endoxane - Astana".

Lolu lwazi inguqulo lula imiyalelo izidakamizwa "endoxane". Inhloso yalesi izidakamizwa yenziwa kuphela udokotela ukuba khona.