Akuti anthu okwana 33 miliyoni a ku America amakhala ndi ziboliboli zowonjezereka kapena "zowononga": vuto losasangalatsa komanso lochititsa manyazi lomwe liri lovuta kuchiza. Kwa zaka zopitirira makumi atatu, sipanakhale mankhwala atsopano kuti athetse vutoli. Komabe, mu 2012, a FDA adavomereza Myrbetriq (mirabegron) kuti athetse chikhodzodzo chopanda mphamvu.
Chikhodzodzo choyambitsa chikhodzodzo kapena kukakamiza kusadziletsa kumatanthauza kuwonjezereka kwa minofu ya detrusor.
Minofu ya detrusor ndi gawo la khola la chikhodzodzo, ndipo ikagwira ntchito mopitirira muyeso, limagwirizana kwambiri, ndipo imayamba kuyambitsa mkodzo.
Chikhodzodzo chokwanira ndi njira yofala kwambiri yodziyeretsera. Azimayi omwe ali ndi vutoli amamva kukhumba kwambiri kuti ayambe kukodza kenako amatha kutuluka mosavuta. Amuna amatha kukhala ndi zizindikiro zofanana, koma kuphulika kumatha kusokonezedwa ndi benign prostatic hypertrophy kapena kutsekula kwa chiwerewere.
Zotsatira Zopereka Chithandizo
Musanayambe Myrbetriq, chikhodzodzo chopitirira muyeso chinkagwiritsidwa ntchito pogwiritsira ntchito pansi paja (Kegel) ndikuchita biofeedback; kusintha kwa moyo, monga kulemera kwa thupi kapena kukanika kwa caffeine; onabotulinumtoxinA kapena jekeseni wa Botox mu mitsempha yowonongeka; ndi mankhwala otchedwa antimuscarinic monga Detrol (tolterodine), Urotrol (oxybutynin), ndi solifenacin.
Mankhwala a Antimuscarinic ali ndi mavuto ambiri omwe amawapangitsa kukhala osasokonezeka kwa anthu ambiri omwe amawatenga. Zotsatira zoipa izi zimaphatikizapo pakamwa youma, kudzimbidwa, kusokonezeka maganizo komanso kusokonezeka maganizo.
(Toxidrome iyi nthawi zambiri imagwirizanitsidwa ndi mawu akuti, "Akhungu ngati nkhonya, wodetsedwa ngati wotsutsa, wofiira ngati beet, wotentha monga Hade, owuma ngati fupa, chifuwa ndi chikhodzodzo chitaya mau awo, ndipo mtima umathawa wokha." )
Ubwino wa Myrbetriq
Myrbetriq ndi yowonjezereka kwambiri muzochita zake kuposa mankhwala osokoneza bongo omwe amagwiritsidwa ntchito pochizira chikhodzodzo chopanda mphamvu.
Myrbetriq sichimatsutsana ndi dongosolo la mitsempha lachisomo lomwe limachitika mochuluka ngati mankhwala a antimuscarinic. Mwapadera, mirabegron ndi beta - 3 adrenergic agonist yomwe imawombera mwapang'onopang'ono mapuloteni m'matumbo (97 peresenti ya beta -3 mRNA yomwe imapangidwa ndi thupi imatulutsa minofu).
Mosiyana ndi mankhwala osokoneza bongo, mirabegron sichitsutsana ndi beta-1 ndi beta-2 receptors m'madera ena a thupi. Mwa kuyankhula kwina, pamene mankhwala a antimuscarinic ali ndi cholinga chosauka ndipo amakhudza mitundu yambiri ya ziwalo, mirabegron ndi yeniyeni ndipo imakhudza makamaka chikhodzodzo.
Zotsatira Zokakamiza Zamakono ndi Zotsatira Zotsatira
Pakati pa mayesero a Phase II ndi Phase III, Myrbetriq anayesedwa m'magulu oposa 10,500. Phunziroli, ophunzira adawonetsa kuchepa kwa mkodzo wosasunthika, chiwerengero cha zochitika zadzidzidzi, ziwerengero za kusadziletsa komanso chiwerengero cha zochitika za nocturia (kutaya usiku)
Ngakhale kuti Myrbetriq yatsimikiziranso zovuta kuposa mankhwala osokoneza bongo, panthawi ya mayesero a chipatala, anthu ena adakumananso ndi mavuto omwe akuphatikizapo:
- kuwonjezeka kwa magazi
- matenda oyambitsa mkodzo
- ululu wamimba
- kukwera mtima kwapamwamba
- kuthamanga kwa magazi
- zizindikiro zozizira
Ngakhale kuti kuwonjezeka kwa mtima wamtima ndi kuthamanga kwa magazi kumene amagwiritsidwa ntchito ndi Myrbetriq ndi odzichepetsa, akatswiri ena amadandaula za zotsatira za mtima wa Myrbetriq.
Pofuna kukhala ndi chibwenzi, pakhala pali kafukufuku wochepa pa ntchito ya Myrbetriq kwa akulu akulu oposa zaka makumi asanu ndi awiri; motero, madokotala ena samapereka mankhwala awa kwa okalamba omwe ali ndi mavuto a mtima ndi impso. Kuonjezerapo, sikudziwikiratu kuti Myrbetriq ndi yogwiritsidwa ntchito ndi mankhwala a antimuscarinic.
Mu August 2015, chipani cha FDA chimasulidwa kuchokera ku Myrbetriq. Pambuyo pa mankhwalawa atatulutsidwa kwa anthu, anthu ena anawona izi:
- kunyoza
- angioedema (kutupa) kwa nkhope, lilime kapena larynx
- utchiness (pruritis)
Milandu ya angioedema yachiwiri kupyolera mu ntchito ya Myrbetriq ikhoza kuopseza moyo ngati mtunda wakukwera utatsekedwa.
Ngati mukumana ndi angioedema kapena zina zokhudzana ndi zizindikiro mutatha kumwa mankhwalawa, nthawi yomweyo pitani maulendo apadera kapena funani dokotala yemwe angathandize.
Kuwonjezera pa kukhala olekerera kuposa mankhwala osokoneza bongo m'mayesero a zachipatala, Myrbetriq inatsimikiziranso kuti ukhale wabwino kwambiri pakati pa anthu okhala ndi chikhodzodzo chopitirira muyeso. Kwachilendo, Myrbetriq ikuwoneka kuti ndi njira yatsopano yowonetsera chikhodzodzo chopitirira muyeso makamaka pakati pa anthu omwe sangathe kulekerera mankhwala a antitimuscarinic. Komabe, kufufuza kwina kumafunika kuti tipewe tisanamvetse bwino momwe amachitira mankhwala ndi Myrbetriq.
Zotsatira:
Chapple, CR. Chizindikiro cha Mirabegron Chikhodzodzo Chakudya Chochuluka: Kuwunika za Efficacy, Safety, ndi Kulekerera. Neurourology ndi Urodynamics. 2013.
Harper G, Johnston C, Landefeld C. Odwala Matenda. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Kufufuza kwa Zamankhwala Zamakono ndi Chithandizo 2015 . New York, NY: Hill ya McGraw; 2014.
Khullar V et al. Zotsatira Zowirira Odwala Ndi b3-Adrenoceptor Agonist Mirabegron mu Mayeso Otsatira achitatu omwe ali Odwala Ndi Chikhodzodzo Chokwanira. Neurourology ndi Urodynamics. 2015.
> Myrbetriq (mirabegron) Mapulogalamu Owonjezera. www.fda.gov.