Doxorubicin (dzina la malonda Adriamycin) ndi mankhwala omwe amagwiritsidwa ntchito kwambiri pogwiritsa ntchito mankhwala a chemotherapy omwe amagwira ntchito kwambiri m'magulu a maimfa a Hodgkin ndi a Non-Hodgkin . Amagwiritsidwa ntchito pafupifupi pafupifupi mankhwala onse oyamba a chemotherapy omwe amagwiritsidwa ntchito pa maselo am'mimba. Ndi mankhwala a chemotherapy otchedwa anthracyclines.
Doxorubicin Mayayambitsa Kuwonongeka kwa Mtima
Zimadziwika bwino kuti doxorubicin ikhoza kuwononga mtima mwa anthu ena.
Pamene anthracyclines (monga epirubicin ndi mitoxantrone) ingayambitsenso mtima kuwonongeka, mwayiwo ndi wochuluka ndi doxorubicin. Doxorubicin imayambitsa mavuto oyambirira komanso ochedwa mtima (wotchedwanso cardiotoxicity). Kuwonongeka koyambirira kumachitika mwamsanga mutatha mankhwala osokoneza bongo kapena mkati mwa masiku 1 mpaka 2. Pali zotsatira zochepa zomwe zimatengedwa pa electrocardiogram (EKG) ndipo nthawi zambiri zimathetsa popanda kuchititsa mavuto aakulu. Ndikumapeto-kuwonongeka koyambirira komwe kuli kofunika komanso kofunika kwambiri.
Zotsatira za Kuwonongeka kwa Cardiac
Kuwonongeka kwa mtima kumayambiriro kwa chaka chimodzi kapena kupitirira pambuyo chemotherapy. Doxorubicin imakhudza kwambiri minofu ya mtima. Amachepetsa minofu ya mtima ndikupangitsa kupopera kwa magazi kumakhala kovuta kwa mtima. Pamene ndizoopsa, zimayambitsa matenda omwe amachititsa kuti mtima usayese (CHF). Anthu omwe ali ndi CHF amadandaula za zizindikiro zambiri
- Kuvutika kosavuta pang'onopang'ono kuntchito yovuta, kumabweretsa kutopa kapena kupuma vuto pamene mukukwera masitepe kapena kuyenda
- Chifuwa chimakula usiku
- Kutupa kwa mapazi
- Zovuta kupuma pa mpumulo
Ngati nkhanza, CHF ingayambitse ulemala komanso imfa.
Kodi Doxorubicin Amapweteka Bwanji Mtima?
Doxorubicin amakhudzidwa ndi mankhwala ena m'thupi (otchedwa mavitamini) kuti atulutse zinthu zovulaza zotchedwa radicals. Kukonzekera kwazowonongeka koyipa kwaulere kumapangidwanso mu ziwalo monga mtima momwe muli mpweya wochuluka ndi chitsulo.
Ngakhale ziwalo zina zili ndi mapulaneti apadera kuti awononge izi zowonongeka, mtima uli ndi osauka kwambiri wa mavitaminiwa. Izi zimapangitsa kuti minofu ya mtima iwonongeke ndi zowonongeka.
Zinthu Zomwe Zimakhudza Kuwonongeka kwa Mtima
Zinthu zambiri zimachulukitsa mwayi wa kuwonongeka kwa mtima ndi doxorubicin.
- Mlingo waukulu wa doxorubicin umatha kuwononga mtima. Chiŵerengero chonse cha doxorubicin chomwe chinalandira panthawi ya moyo wa munthu chiyenera kukhala chapansi pa 400mg pa mita imodzi (ya thupi pamwamba). Chiopsezo cha CHF ndi mlingo uwu ndi osachepera 1 peresenti. Pa mlingo wapamwamba, mwayi wa kuwonongeka kwa mtima ukuwonjezeka. Mwamwayi, ndondomeko zambiri za chemo zimafuna mlingo wochepa.
- Kugwiritsira ntchito mankhwala ena omwe amakhudza mtima monga panthawi imodzi, monga mankhwala ochepa a cyclophosphamide
- Kuchiza mankhwala kuchifuwa
- Matenda a mtima omwe alipo kale
- Mnyamata wamng'ono
- Odwala achikazi
Kuyesera Mtima Kuwononga
Kuwonongeka kwa mtima nthawi zambiri kumayesedwa ndi echocardiogram (yomwe imatchedwa 'echo') kapena MUGA kusanthula kuti ayese kuchuluka kwa magazi omwe mtima ukhoza kutulutsa. M'magulu azachipatala, izi zimatchedwa 'gawo lamanjenje la ejection ventricular' kapena LVEF. LVEF imayesedwa kwa anthu ambiri musanayambe chithandizo kuti athetse vuto liri lonse la mtima.
Pambuyo pake, ikhoza kuyesedwanso panthawi ya chithandizo komanso nthawi zina kuti ziwone ngati kugwa kwa LVEF kukugwa. Nthawi zina mavuto a mtima amatha kuwonetsanso ku EKG.
Njira Zothetsera Kuwonongeka
Pali njira zina zomwe zimapweteketsa mtima kapena kuchepetsedwa
- Kusunga mlingo wathunthu wa doxorubicin mkati mwa malire otetezeka
- Kulamulira mankhwala monga kulowetsedwa mu saline osati monga jekeseni
- Pogwiritsa ntchito kukonzekera kwatsopano kwa doxorubicin yotchedwa liposomal doxorubicin - mankhwalawa amatsekedwa mu zokutira mafuta zotchedwa liposome. Kuphimba uku kumangodutsa kokha mu khansara kutulutsa mankhwala. Ziwalo zowoneka ngati mtima sizikukhudzidwa kwambiri.
- Kugwiritsira ntchito mankhwala otchedwa dexrazoxane monga kulowetsedwa posakhalitsa doxorubicin. Zingachepetse mwayi wa kuwonongeka kwa mtima ndipo FDA imavomerezedwa mu khansa ya m'mawere.
Kuchiza kwa CCF
Kulephera kwa mtima kumayambitsa doxorubicin kumachitidwa mofanana ndi mitundu ina ya mtima wosalimba. Palibe mankhwala apadera a kuwonongeka kwa mtima wa doxorubicin. Mpumulo, mpweya ndi mapiritsi amachepetsa zizindikiro za CCF ndikukhazikitsa kufooka kwa mtima. Zizindikiro zoopsa zingafune kuvomereza kuchipatala.
Kodi Tiyenera Kugwiritsa Ntchito Doxorubicin?
Doxorubicin ndi mankhwala othandiza kwambiri pa mankhwala a chemotherapy. Amathandiza kwambiri pakuchulukitsa khansa zambiri. Ngakhale pali gulu lodziwika bwino la doxorubicin lomwe lili ndi vuto la mtima, phindu la kugwiritsa ntchito doxorubicin likuposa zoopsa. Kuwonongeka kwa mtima ndi mankhwalawa kumamveka bwino, ndipo ngati doxorubicin imagwiritsidwa ntchito pamlingo wotetezeka wa mlingo, palibe chifukwa chosiya kugwiritsa ntchito mankhwala monga zothandiza monga izi.
> Zotsatira:
Khansa - Mfundo ndi Oncology (Gulu lachisanu ndi chiwiri). Okonza - Vicent T Devita Jr., Samuel Hellman, Steven Rosenberg. (Chaputala 15: Mankhwala a Khansa Chemotherapy: Gawo 7: Topoisomerase Agwira Ntchito Yothandizira.)
Doxorubicin Hydrochloride, National Cancer Institute, pa September 17, 2014.
Doxorubicin, Medline Plus, Laibulale ya National Medicine ya US, 01/15/2012.