Ubwino ndi zotsatira za zotsatira za Aromatase Inhibitors za khansa ya m'mawere
Kodi mukufunikira kudziwa chiyani, za zotsatira, ndi zotsatira za zotsatira za Women (letrozole) za khansa ya m'mawere?
Femara (letrozole) (omwe amalembedwa mosavuta monga fimara, femarra, ndi femera) ndi mankhwala m'gulu lotchedwa aromatase inhibitors. Mankhwalawa amaletsa mapangidwe a estrogen m'madera ena osati mazira. Popeza kuti estrogen ikhoza kukhala ngati mafuta okhudzana ndi khansa ya m'mawere, Femara amathandiza kuchepetsa chiopsezo cha matenda a khansa ya m'mawere ndikumapangitsa mwayi wanu wopulumuka.
Ngati mukukumana ndi zotsatira za mankhwalawa, onetsetsani kuti muwerenge za ubwino wa Femara ndi njira zomwe zotsatira za mankhwalawa zikhoza kuyendetsedwa.
Mtundu wa Mankhwala
Femara ndi anti antirorogen, kapena aromatase inhibitor. Ena aromatase inhibitors ndi Aromasin (exemestane) ndi Arimidex (anastrozole.) Femara si steroid.
Thandizo la mahomoni la khansa ya m'mawere
Kafukufuku amasonyeza kuti kugwiritsa ntchito mankhwala a mahomoni a khansa ya m'mawere a maselo a estrogen amachepetsa chiopsezo cha kubwereranso ndikuwonjezeka kupulumuka. Pali mitundu iwiri yapadera ya mankhwala a mahomoni kwa anthu omwe ali ndi khansa ya m'mawere.
Musanayambe kusamba, mazira ambiri amapanga estrogen. Ngati mazira anu akugwira ntchito, Tamoxifen imagwiritsidwa ntchito kulepheretsa estrogen kukhala ndi maselo a khansa.
Pambuyo pa kuchepa kwa thupi, kaya kusamba kwa thupi, kusamba kwabwino kwa thupi, kapena kumwa mankhwala osokoneza bongo , chachikulu chomwe chimachokera ku estrogen m'thupi ndi chimene chimapangidwa kuchokera ku kuwonongeka kwa androgens m'malo ena a thupi.
Aromatase inhibitors amayesetsa kulepheretsa izi zomwe zimachititsanso kuti isrogens, motero amalepheretsa mapangidwe a estrogen.
Momwe Femara Amagwira Ntchito Kuteteza Khansa ya M'bwere Kubwereza
Monga taonera, pambuyo pa kutha kwa thupi, chitsimikizo chachikulu cha estrogen m'thupi ndi chimene chimapangidwa ndi mawonekedwe a androgens m'matenda a thupi m'thupi.
Mankhwalawa (amphona "amphongo") amatembenuzidwira kukhala estrogen mmalo mwake amachititsa kuti tizilombo toyambitsa matenda titchedwa aromatase. Poletsa kuchitidwa kwa aromatase, kupanga estrogen kumatsekedwa. Izi zimapangitsa kuti isrojeni yochepa isapezeke mu thupi kuti ikalimbikitse maselo ena a khansa ya m'mawere (maselo a khansa ya m'mawere a estrogen).
Kodi mankhwala ndi ofunikira bwanji kuchepetsa chiopsezo cha kubwerera kwa khansa ya m'mawere? Zikuwoneka kuti tonse timadziwa za wina yemwe anali ndi khansara ya m'mawere yomwe anachiritsidwa koma anafalikiranso zaka zambiri kapena makumi angapo pambuyo pake. Sitikukayikira momwe maselo a khansa amatha kukhazikika nthawi yayitali, koma pali zifukwa zomwe zimachitika pambuyo pake zomwe zimachitika ngati maselo a khansa omwe amakhala ovuta kuposa maselo a khansa ya m'mawere. Kubwereza kanthawi kochepa kumakhala kofala ndi khansa ya m'mawere yotchedwa estrogen, pofufuza njira za adjuvant monga Femara zofunika kwambiri.
Panopa tikufuna kuti Zometa ziyambe nthawi yomweyo monga Femara kwa omwe ali ndi khansara ya m'mawere omwe amaliza opaleshoni ndi chemotherapy (onani m'munsimu).
Kodi Kafukufuku Amatiuza Chiyani za Femara?
Kwa amayi omwe ali ndi khansa ya m'mawere yotchedwa estrogen, ndipo amalandira mankhwala a adjuvant chemotherapy, chithandizo ndi mankhwala a aromatase amaoneka kuti amachepetsa chiopsezo cha kubwereza ndi 50 peresenti.
Kafukufuku akuyang'ana akazi omwe adalandira mankhwala asanu ndi awiri a Tamoxifen, adapeza kuti kugwiritsa ntchito Femara patatha nthawiyi, ngakhale kuyamba zaka zingapo pambuyo pake, kunapangitsa kuti apulumuke.
Azimayi amene amayamba kumwa mankhwalawa m'zaka zoyambirira ziwiri kapena zitatu pa mankhwala a Tamoxifen ndipo adasinthidwa ku Femara kwa zaka zisanu zokha, amakhala ndi chiopsezo chochepa kuposa amayi amene adagwiritsa ntchito Tamoxifen okha kwa zaka zisanu.
Kwa amayi amene ali ndi menopausal panthawi yoyamba ya mankhwala a mahomoni, palinso ubwino wogwiritsa ntchito aromatase inhibitors pachiyambi kusiyana ndi kuyamba ndi Tamoxifen.
Sindikudziwika bwino nthawi yaitali yomwe Femara akuwonetsera phindu, mwa kuyankhula kwina, kaya kugwiritsa ntchito Femara kapena kusagwiritsa ntchito mkazi kwa zaka zoposa zisanu ndizopindulitsa (onani m'munsimu.) Lankhulani ndi oncologist wanu momwe gawo lino likusinthira zotsatila zamakono.
Amene Angatenge Femara
Mankhwalawa ndi azimayi omwe apezeka ndi khansa ya m'mawere yotchedwa estrogen. Mayi ayenera kuti anamaliza mankhwala achiyero ndipo amakhala akutha msinkhu . Azimayi omwe amayamba kumwa mankhwalawa amatha kutenga Femara ngati mazira awo amatsitsidwa. Akazi omwe ali ndi khansa ya m'mawere yosavomerezeka ya estrogen sangapindule ndi mankhwalawa.
Zotsatira Zowonongeka za Femara ndi zina Aromatase Inhibitors
Mofanana ndi mankhwala ena, zotsatira zake zimafala ndi Femara. Zotsatira zofala kwambiri zimatentha kwambiri komanso zimapweteka kwambiri. Ndipotu, kupweteka kwamtundu ndi umodzi ndi chimodzi mwa zifukwa zomwe anthu amasiya kumwa mankhwala (onani m'munsimu).
Kutentha kwa moto kumakhalanso kofala, ngakhale anthu omwe amasintha kuchoka ku tamoxifen kupita ku Femara atatha kukhala amodzi (chifukwa cha msinkhu, opaleshoni, kapena mankhwala ochotsera ovarian). Zindikirani kuti kutentha kotentha kumawoneka kuti kuli koopsa pa Femara kuposa tamoxifen. Ngakhale kuti zotsatirazi zikukhumudwitsa, chirichonse chomwe chimachepetsa estrogen m'matupi athu chikhoza kutentha, ndipo kuchepetsa estrogen ndi njira yabwino yochepetsera chiopsezo cha kubwereza. Anthu ena awona kuti ndiwothandiza "kubwereza" ndikuyang'ana kutentha kotentha monga chizindikiro chakuti mankhwala akugwira ntchito.
Zotsatira zina zomwe zimakhala zachizoloŵezi zimaphatikizapo kupweteka mutu, kutopa , kutuluka thukuta, ndi kusowa tulo). Phunzirani za kuopsa kwa kusowa tulo kwa odwala khansa momwe zingachepetse kupulumuka kwa khansa ya m'mawere, koma njira zothetsera matenda zilipo.
Aromatase inhibitors angayambitsenso mafupa omwe angayambitse matenda opatsirana , ngakhale kuti kugwiritsidwa ntchito kwa Femara ndi Zometa (ndondomeko yomwe inapangidwa mu 2017) ikhoza kunyalanyaza izi (onani m'munsimu).
Aromatase inhibitors samawoneka kuti amachulukitsa chiopsezo cha mliri wa matenda ndi matenda omwe amachititsa kugwiritsidwa ntchito kwa tamoxifen koma amagwirizanitsidwa ndi mavuto a mtima ochepa monga mtima wosadziwika ndi pericarditis (kutupa kwa chigoba cha mtima)
Nthawi Yomwe Muyenera Kuganizira Kuletsa Kuchiritsa
Mwamwayi, mitsempha yamphongo ndi yothandizira ndi yowopsa kwambiri ya mankhwala ndi Femara. Mu phunziro limodzi lalikulu, anapeza kuti 32 peresenti ya odwala anasiya kugwiritsa ntchito mankhwalawa chifukwa cha zotsatira. Pafupifupi anthu 24 peresenti ya anthu anaimitsa mankhwalawa chifukwa cha minofu ndi amodzi. Ndikofunika kuzindikira kuti pakati pa anthu omwe analetsa aromatase inhibitor chifukwa cha zotsatira zake, wina wachitatu adatha kupirira mankhwala ena mwa mankhwalawa.
Lankhulani ndi dokotala wanu za zomwe mungachite kuti muthandize kuthana ndi zowawa ndi zovuta. Mu mayesero amodzi omwe anayesedwa anapeza kuti kupopera thupi kumathandiza kwambiri kusiyana ndi mankhwala omwe amachititsa kuti thupi likhale lopwetekedwa chifukwa cha aromatase inhibitors.
Mafuta otentha angakhalenso okwiyitsa ndipo akuyembekezera chifukwa mankhwalawa akuchepetsa kuchepetsa estrogen mu thupi lanu. Onani malingaliro awa njira zothetsera zozizira.
Kuteteza kwa Osteoporosis
Kugwiritsiridwa ntchito kwa aromatase inhibitors kumapangitsa kuti mafupa awonongeke ndipo kwadziwika kuti sikungowonjezera chiopsezo cha osteoporosis koma chiwerengero cha mafupa chimagwera pakati pa akazi omwe amagwiritsa ntchito mankhwalawa. Lankhulani ndi dokotala wanu za kuyeretsa kwa matenda a mitsempha. Onetsetsani kuti mukupeza vitamini D ndi calcium yokwanira. Ndipotu, miyezo ya vitamini D yomwe imakhala bwino m'magazi anu kapena yogwirizana ndi matenda a khansa ya m'mawere, choncho lankhulani ndi dokotala wanu kuti muyesetse kuti muyezo wanu wa vitamini D uyesedwe, komanso zomwe mungachite ngati mlingo uli wotsika.
Ofufuza ambiri amavomereza kuti ayambe kupimitsa pang'onopang'ono pamene aromatase inhibitors ayambitsidwa, ndipo pamapeto pake.
Kugwiritsiridwa ntchito kwa Femara ndi Zometa ndi Kutaya kwa Matenda
Kwa omwe ali ndi khansa ya m'mawere ya postmenopausal, opaleshoni yamagetsi tsopano imayambitsa bisphosphonate Zometa (zoledronic acid) panthawi yomweyo. Zometa sizongowonjezera chiopsezo cha mafupa ndi matenda a mitsempha ndi aromatase inhibitors koma imachepetsa chiopsezo cha kubwereranso.
Tradeoffs
Zotsatirapo zazing'ono za Femara zimakhala zolekerera kwambiri podziwa kuti chiopsezo chanu chobwereranso chachepa. Akazi omwe anatenga Femara patadutsa zaka zisanu za Tamoxifen anali ndi chiopsezo chochepa cha anthu omwe adatenga zaka zisanu za Tamoxifen. Kuonjezera apo, ndi Femara, chiopsezo chanu cha khansara yatsopano mu chifuwa chosiyana n'chochepa kuposa Tamoxifen yekha.
Zosokoneza Malingaliro
Tengani Femara kamodzi pa tsiku ndi madzi. Mankhwalawa sayenera kutengedwa ndi chakudya. Yesetsani kutenga nthawi imodzimodzi tsiku lililonse, kuti mukhale ndi mlingo wa mankhwala m'dongosolo lanu. Ngati mwaphonya mlingo, musati muwirirepo, dikirani mpaka tsiku lotsatira ndikuyambiranso ndondomeko yanu ya mankhwala. Musamamwe mankhwalawa ngati mudakali pa mimba kapena muli ndi pakati.
Lilipo ngati 2.5 mg piritsi, dzina lachidziwitso (palibe ma generic version likupezeka), ndi mankhwala okha.
Kodi Femara Ayenera Kugwiritsidwa Ntchito Zaka Zoposa 5?
Malangizo a nthawi yomwe Femara (ndi ena aromatase inhibitors) akukambirana panopa. Maphunziro oyambirira anali kwa zaka zisanu akutsatira mankhwala opaleshoni ndi opaleshoni komanso mankhwala othandizira odwala komanso ma ARV.
Nthawi yoitanira Dokotala Wanu
Zotsatira zowopsa kwambiri, monga matenda a mtima, nthawi zina zimachitika. Zizindikiro zomwe zingakuchititseni kudana ndi dokotala zikuphatikiza kupuma kupuma, kupweteka pachifuwa, kupweteka kwa m'mapazi kapena kutupa, kuthamanga magazi kwachibadwa , kuthamanga kwa khungu , kutsekula m'mimba, kapena kunyoza ndi kusanza.
Mfundo Yofunika Kwambiri
Pogwiritsidwa ntchito motsatira chithandizo chachikulu cha khansa ya m'mawere (ndi opaleshoni, ndi chemotherapy ndi / kapena mankhwala opatsirana ndi dzuwa), Femara akhoza kuchepetsa chiopsezo cha kubwereza. Ndiko kubwereza ndi matenda osokoneza bongo, makamaka, ndicho chachikulu chimene chimayambitsa imfa kuchokera ku khansa ya m'mawere.
Femara amavomerezedwa kwa amayi omwe amachititsa amayi kumbuyo kapena omwe ali ndi ammopaopausal koma akhala ndi mankhwala ochotsera ovari. Zotsatira zoyipa zimaphatikizapo kutentha ndi kutuluka kwa minofu ndi ululu. Zotsatira zowopsa kwambiri monga matenda osagwidwa ndi matenda komanso matenda otupa mimba amatha kuchitika. Powonjezeredwa ndi mankhwala a bisphosphonate, komabe chiwopsezo cha mafupa chikuwoneka kuchepetsedwa.
Femara akulimbikitsidwa kwa zaka 5 zotsatira za mankhwala oyambirira, koma kafukufuku waposachedwapa akusonyeza kuti ntchito yowonjezera ikhoza kutonthozedwa mtsogolomu.
> Zosowa
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