Ukulungiselela "i-Avastin": izibuyekezo zesiguli, imiyalelo yokusetshenziswa, nemiphumela emibi

Isidakamizwa esithi "i-Avastin" kubhekwa njenge-antitumor agent, ebhekisela kuma -antibodies angama-monoclonal. Phakathi nokusetshenziswa kwezidakamizwa, kuncipha ekuthuthukisweni kwemithambo ye-pathology kanye ne-microvascular permeability ezinhlobonhlobo ezimbi ezimbi, ikakhulukazi lezo eziphathelene nesifuba kwabesifazane, i-colon, ne-pancreas ne-prostate gland.

Isakhiwo sokulungiselela

Isidakamizwa esithi "i-Avastin" sikhiqizwa ngendlela yokugxila, okuhloswe ukulungisa isisombululo se-infusions, ingaba nombala noma i-tinge epholile.

Into esemqoka yalesi sidakamizwa yi-bevacizumab. Lo mkhiqizo utholakala kumaphakethe ka-100 mg, lapho u-4 ml wezinto ezisebenzayo, no-400 mg / 16 ml.

Isenzo sempilo

"I-Avastin" iyisidakamizwa esivumelana nezicubu, okwenza kancane ukuthuthwa kwezitsha ezintsha ezinikeze izakhi kanye ne-oksijini ezicubu ze-neoplasm, futhi ngaleyo ndlela kuvumela ukudlulisa isisu esibi esiqhingini esinobudlova kuze kube yilapho singapheli. "I-Avastin" (ukubuyekezwa kweziguli nodokotela - lokho kuqinisekiswa) kunomthelela omubi kakhulu ekusebenziseni izidakamizwa ezimbi ezihlukahlukene.

Kule ndlela, kuyisici sokusabalalisa izicubu ngesamba esincane, ngaphandle kwalokhu, sisuswa emzimbeni isikhathi eside, okuvumela ukugcina inani elidingekile leqhaza eliyinhloko lomuthi, ukulifaka ngokucophelela ngokwemiyalo - kanye nezinsuku ezingu-14-20. Imithi ayiphumeli esibindi noma izinso, kodwa kuzo zonke amaseli omzimba izinsuku ezingu-18 kumadoda, nakwabesifazane - 20.

Kodwa ingabe "i-Avastin" inhle kakhulu? Imibono yeziguli ithi lesi yisisetshenziswa esiwusizo kakhulu uma kuhlangene ne-chemotherapy ngezinhlobo ezahlukene zomdlavuza. Lesi sidakamizwa sandisa kakhulu isikhathi sokusinda kuzo zonke amaqembu eziguli, kanti ukuqhubeka kwesifo akukwenzeka.

I-Avastin: izinkomba zokusetshenziswa

Lesi sidakamizwa sisetshenziswa kabanzi ekwelashweni komdlavuza. Odokotela bamqoka:

1. Ngomdlavuza we- metastatic colorectal. Isidakamizwa sinconywa ukuba sisetshenziswe kanye ne-chemotherapy ngesisekelo se "Fluoropyrimidine".
2. Ngomdlavuza webele we-metastatic. Isetshenziswe njengendlela yokuqala yokwelapha nge-Paclitaxel.
3. Uma ingasebenzi, ihambisane nokutholakala kwenani elikhulu lamathambo e-metastases noma okungewona amaplanethi, okungewona amancane omdlavuza wesifo samaphaphu - njengendlela yokuqala yokwelapha ehambisana ne-chemotherapy esekelwe emithini ye-platinum.
4. Ngomdlavuza oqhubekayo noma wesifo se-metastatic esithinta amangqamuzana ezinso - njengendlela yokwelapha okuyisisekelo ngokubambisana ne "Interferon alfa-2a."
5. Nge-glioblastoma, kanye ne-radiotherapy ne-"Temozolomide" ezigulini ezitholakale zitholakale, ku-monotherapy noma ndawonye "ne-Irinotecan" ezigulini ezine-glioblastoma noma ngokuqhubeka komdlavuza.
6. Iziguli ezitholakale zitholakala "zakhiwe kabi ezithombeni zobulili zabesifazane," futhi zinesifo somdlavuza oyinhloko. Kulesi simo, kunconywa ukuba ubeke i-Avastin njengokwelapha kokuqala kokwelashwa ngokubambisana neCarboplatinum ne-Paclitaxel.

Ngaphezu kwalokho, lesi sidakamizwa sinqunywe ngokubambisana ne "Carboplatinum" ne "Gemcitabine" ngesifo esiphuthumayo noma esibucayi kwizidakamizwa ezisekelwe e-platinum nabesifazane abanomdlavuza wesifo sangasese noma owenziwa yi-peritoneal abangazange baphathwe ngaphambilini nalesi sidakamizwa noma olunye uhlobo lwe-VEGF inhibitor.

Kanjani kahle ukungena "i-Avastin"?

"I-Avastin" (ukubuyekezwa kweziguli nodokotela kuqinisekisa lokhu) - isidakamizwa esihle, kodwa kufanele sinikezwe kahle, futhi ngaphansi kokuqondiswa udokotela. Akuvunyelwe ukufaka i-jet - kuphela nge-intravenously, bese kancane kancane ngangokunokwenzeka. Ukubala ngu-5 mg nge-1 kg wesisindo somzimba kanye njalo ngemva kwamasonto amabili.

Inani elidingekayo lokugxila lihlanjululwe ku-100 ml we-0.9% i-chloride ye-sodium. I-dose yokuqala iphakanyiswa ukuba ilandiswe amahora owodwa nesigamu emva kwe-chemotherapy, bese umjovo we- "Avastin" usuyenziwe ngaphambi noma emva kwenqubo. Uma ukuphathwa kokuqala kwesidakamizwa kungenasisindo, ngakho-ke kungasetshenziswa ngaphezulu kwehora, nayo yonke injection esilandelayo - isigamu sehora, kodwa kuphela uma isibhamu sesibili sidluliselwa emthonjeni wesiguli.

Umthamo wesidakamizwa, ngisho nangaphambi kwemiphumela engathandeki, akukhuthazwa ukuba unciphise, uma kunesidingo, khona-ke ukwelashwa kumisiwe noma kuphelelwe.

Uma isiguli sinomdlavuza we-metastatic, umthamo ophakanyisiwe ekuqaleni u-5 mg ngekgrimu yesisindo somzimba kanye nezinsuku ezingu-14 noma 7.5 mg / kg, kodwa njalo ezinsukwini ezingu-21. Uma umugqa wesibili wezokwelapha, umthamo ukwandiswa izikhathi ezingu-2.

Uma owesifazane ethola ukuthi unesifo somdlavuza webele, kulokhu, njengemjovo yokuqala, kunconywa ukubala izidakamizwa ku-10 mg / kg bese ujova njalo ngemva kwamasonto amabili. Noma abathathu, kodwa kulokhu, u-15 mg wegrikhi ngayinye wesisindo somzimba uthathwa.

Uma kunezibonakaliso zokuqhubeka kwe-pathology, ukwelashwa kumisiwe.

Ngomuthi ongajwayelekile ongasebenzi, ama-metastatic noma aphindaphindiwe anomdlavuza wamangqamuzana noma amancane amancane emaphashini, ukwelashwa kwenziwa kanye ne-chemotherapy ne-Pt izidakamizwa (imijikelezo engaphezu kuka-6), bese umuthi usetshenziswa njenge-monotherapy.

Uma izibonakaliso zokuqhubeka komdlavuza zivela, i-Avastin kufanele ishiywe. Imfundo yokusetshenziswa ithi: uma kungekho ukuthuthuka, ukubalwa kungu-7.5 mg / kg njalo ezinsukwini ezingu-14 noma umthamo uphindwe kabili futhi ujojowe njalo ngemva kwamasonto amathathu ngaphezu kwe "Cisplatinum" noma "i-Carboplatinum."

Ngomdlavuza we-renal cell, umthamo awufanele udlule u-10 mg / kg kanye nezinsuku ezingu-15. Uma kunezibonakaliso zokuqhubeka kwesifo, khona-ke ukwelashwa kumisiwe.

Akudingekile ukuthi asebekhulile bakwazi ukulungisa umthamo.

I-Avastin: ukudlula ngokweqile

Ukudlula ngokweqile kwalesi sidakamizwa kwenzeka kaningi uma isiguli sinikezwa umthamo omkhulu we-20 mg ngesigidi ngasinye sesisindo somzimba kanye nezinsuku ezingu-14.

Kulesi simo, ukuhlaselwa kwe-migraine kungabonakala ngendlela eyinkimbinkimbi, ngaphezu kwalokho, kukhona ukwanda kwemiphumela engathandeki echazwe ngezansi. Ayikho i-antidote ekhethekile, kuphela ukwelapha okuyisimangaliso okusetshenzisiwe.

I-Avastin: imiphumela emibi

U-Avastin uyisidakamizwa esihle kakhulu, ezimweni eziningi kusiza ekunciphiseni ukuqhubeka kwesifo esibi, kodwa ngokuvamile kuvame ukubonakaleka okungafunwa iziguli. Ezimweni ezingavamile, zingaba zimbi kakhulu:

1. Ukuguqulwa kwesisu namathumbu.
2. Ukuphuma kwangaphakathi.
3. I-thromboembolism ye-arterial.
4. Ukucindezelwa kwegazi kuphakama futhi iproteinuria iqala. Kungenzeka ukuthi lokhu kungumphumela wokuthembela kwesilinganiso somguli.

Ngaphezu kwalokho, iziguli ezabekwe u-Avastin, imiphumela emibi ziboniswa nezinye izimpawu:

• I-thrombosis ejulile ye-vein, uhlobo oluyinkimbinkimbi yokuhluleka kwenhliziyo, i-tachycardia engaphezulu, ukuphuma kwegazi;
• I-Leukopenia, i-neutropenia, i-hemoglobin ephansi, i-thrombocytopenia;
• Ukuphazamiseka ku-peritoneum, indigestion, igazi emanzini, ukushayeka okubhebhetheka emlonyeni, izinsini eziphuma kwegazi, ukuvimbela emathunjini;
• Ukuhlwitha kusuka ekhaleni, ukungabi khona kwe-oksijini, i-thromboembolism ye-pulmonary;
• Isikhumba esomile, i-dermatitis, ushintsho ithoni yesikhumba;
• Ukulahlekelwa ukunambitheka, ukwehla okubukhali kwesisindo somzimba, i-syncope, i-migraine, isisu, umuzwa wokulala;
• Ukukhubazeka okubonakalayo;
• Ubuhlungu endaweni lapho umuthi ujova khona;
• Ukweqa okuvela esibelethweni, ukutheleleka kwe-urinary tract, umuzwa wokukhathala ngokushesha, ukuphela kwamanzi.

Ukungafani kokusetshenziswa

Ingabe i- "Avastin" ifanele wonke umuntu? Ukubuyekezwa kweziguli kusho ukuthi lesi sidakamizwa esimangalisayo, kodwa nokho sinokuphikisana nesicelo, futhi ngaphambi kokuqala ukwelashwa, udokotela kufanele akhulume ngaye. Isidakamizwa asikwazi ukuphathwa ngamacala alandelayo:

• Uma kunokungabekezelelani okuthile kwezinto ezisebenzayo;
• Kunezifo ezithathelwanayo zamehlo nesifunda se-periocular;
• Izinqubo zokuvuvukala kwe-intraocular zenzeka;
• Ukudala kuya eminyakeni engu-18;
• Ukukhulelwa nokulahlwa.

Ngaphezu kwalokho, uma isiguli sinethuba lokuhlaselwa isisu, umjovo we-Avastin unikezwa kuphela ngemuva kokuba isiguli sesibhekisiswe ngokucophelela futhi sizophetha ngokuthi lesi sidakamizwa siyoba yinzuzo.

Imiyalo ekhethekile

Isidakamizwa kufanele senziwe kuphela udokotela onolwazi lokwenza injection ye-intraocular.

Ngemuva kokuba umkhiqizo usungulwe, akusikiswanga isikhathi esithile ukuba uhambe ngemuva kwesondo lemoto futhi wenze umsebenzi ohlobene nezinqubo, futhi konke ngoba ukukhubazeka okubonakalayo okwesikhashana kungathuthuka.

"I-Avastin" (umkhiqizi ubonisa lokhu kumilayezo) kufanele igcinwe kuphela esiqandisini, futhi kungenjalo akunakunqanda. Itholakale kuphela emtholampilo.

I-Avastin ixhumana kanjani nezinye izidakamizwa?

Isidakamizwa "i-Avastin" asihambisani nezixazululo ze-dextrose. Futhi, lesi sidakamizwa singandisa ingozi yokuthuthukisa ukusabela okubi uma kuthathwa ngokuhambisana nalezi zidakamizwa:

• "I-sunitinib malate" - ukuthuthukisa i-microangiopathic i-anemia ye-hemolytic kungenzeka;
• I-Platinum namatekisi - ukuthuthukiswa okungenzeka kwezinkinga ze-pathologies ezithathelwanayo, i-neutropenia eqinile, ingozi eyengeziwe yokufa;
• "I-Panitumumab" ne-"Cetuximab" - yandisa umphumela onobuthi wezidakamizwa futhi iholela ekufeni.

"Avastin" e-ophthalmology

Muva nje, lo mbiko ubike ukuthi isidakamizwa esithi "Avastin" sisetshenziswa yi-ophthalmologists ukuphatha izifo zamehlo futhi inikeze imiphumela emihle kakhulu. Kodwa kunjalo? Yini umkhiqizi athi ngalokhu? Ingabe le nqubo ingabeka nje ukuvimbela ukukhula kwesisu, kodwa futhi ilaphe izifo zeso?

Yebo, empeleni kukhona ulwazi ukuthi ezinye iziguli, ngemva kokuzwa ngezinzuzo zomuthi wamehlo, zanquma futhi zenza "i-Avastin" ku-vitreous, kodwa imiphumela yabuhlungu. Isidakamizwa asizange siphathe noma yimaphi ukwelashwa, ngokuphambene nalokho, kwaholela ekubambeni ukuthi abantu baphuphuthekiswe nje. Inkampani "Rosh" igcizelele ngokuphindaphindiwe ukuthi "i-Avastin" ye-ophthalmology ayikwazi ukusetshenziswa, injongo yayo ihlukile.

Isidakamizwa senzelwe ukunciphisa amandla okukhula kwemithambo yegazi, eyondla i-neoplasm eyingozi, ngaleyo ndlela kuncishiswe ukukhula kokuthuthukiswa kwesisu. Yingakho ngaphambi kokuba uqale ukwelashwa futhi ulalele izincomo ezingasekelwa, kungcono ukubonana nodokotela.

I-Avastin: i-analogues

Ngokuqondene nokuthi kukhona yini abathintekayo abazoba nomuthi ofanayo oyisisekelo ekubunjweni kwawo, ngakho-ke abanalo "i-Avastin". Ama-analogues ngendlela yokusebenza, futhi anika nemiphumela emihle ekunciphiseni ukukhula kwemithambo yegazi nokuthuthukiswa kwezicubu zomdlavuza. Kuzokwazi ukuthwala kubo:

• "I-Arzerra".
• "Campas".
• "Rituximab."
• "MabThera" nabanye.

Kodwa kufanele kukhunjulwe ukuthi udokotela kufanele akhethe i-analog.

"Avastin": ukubuyekezwa kweziguli nodokotela

"I-Avastin" (imiyalelo yokusetshenziswa iqinisekisa lokhu) yilo kuphela umuthi oqukethe i-bevacizumab, kusiza ukunciphisa ukukhula kwemithambo yegazi okondla isisu futhi ngaleyo ndlela kuphuthukise ukuqhubeka kwesifo. Iningi lala odokotela ababonile ukuguqulwa kwesifo esigulini, bathi emva kokulimala okuncane, kukhona ukwehla okuphawulekayo ekukhuleni kwesisu, into eyinhloko ukuthatha kahle imithi futhi hhayi ukuyifaka nemithi ehlangene ingabangela ukulimala okukhulu isiguli.

Ukubamba iqhaza, ungasho ngokuqinisekile ukuthi u-Avastin (umkhiqizi - F. Hoffmann-La Roche) uyamangalisa, okusiza ukwandisa impilo yeziguli ezinezinambuzane zomdlavuza. Kodwa kuphela ukuyisebenzisa kuyadingeka ngaphansi kokulawulwa okuqinile kukadokotela, ngaphandle kwalokho imiphumela ingaba ingenakugwetshwa futhi iphela ngokudabukisayo.