Neulasta (pegfilgrastim) ndi mankhwala omwe nthawi zina amagwiritsidwa ntchito pa mankhwala a kansa ya m'mawere kuwonjezera kuchuluka kwa maselo oyera a magazi kuti athe kuchepetsa chiopsezo cha matenda. Kodi muyenera kudziwa chiyani za mankhwalawa, kuphatikizapo zotsatira zake?
Neulasta (Pegfilgrastim) mwachidule
Neulasta (pegfilgrastim) ndi mankhwala operekedwa kwa anthu omwe ali ndi kapena akuyembekezeka kukhala ndi neutropenia (yochepa ya neutrophil , mtundu umodzi wa selo loyera) pamene ali ndi khansa ya m'mawere.
Neulasta ndi njira yopangidwa ndi granulocyte colony-stimulating factor (G-CSF), gulu lomwe limalimbikitsa kupanga maselo oyera m'magazi. Ndi madzi omveka bwino amene amaperekedwa ngati mfuti yomwe singano imayikidwa pansi pa khungu.
Neulasta ndi mankhwala osokoneza bongo omwe nthawi zambiri amafunikira kokha kamodzi kotsatira mankhwala opatsirana pogwiritsa ntchito chemotherapy, kusiyana ndi Neupogen (filgrastim), yomwe imaperekedwa tsiku lililonse kwa masiku angapo ndi jekeseni.
Gwiritsani Ntchito Khansa ya M'thupi
Chemotherapy pa khansa ya m'mawere imakhudza zonse zomwe zikugawanika maselo m'thupi lanu mofulumira, kuphatikizapo maselo a mitsempha, omwe amapanga maselo oyera a magazi, maselo ofiira a magazi, ndi mapulogalamu. Kuchepetsa mafuta a mafupa pa mankhwala a chemotherapy kungayambitse matenda ochepetsa magazi m'thupi, neutropenia (chiwerengero chochepa cha neutrophil) ndi thrombocytopenia (chiwerengero chochepa cha platelet.)
Kuwerengera kochepa kwa neutrophil (nthawi zina kumangotchedwa kuchepetsedwa kwa maselo oyera a magazi) kungakhale kovuta kwambiri chifukwa kungapangitse anthu kulandira mankhwala a chemotherapy.
Cholinga chogwiritsa ntchito Neulasta ndikuthandizira kupewa matendawa.
Momwe Neulasta Works
Kawirikawiri, thupi lanu limapanga mapuloteni omwe amachititsa kuti tizilombo toyambitsa matenda tiziyambitsa. Pa mankhwala a chemotherapy, thupi lanu lomwe limapangidwa ndi neutrophils limasokonezeka, Neulasta amagwira ntchito yolimbikitsa kupanga neutrophils, komanso kukula ndi kuyambitsa neutrophils kale.
Momwe Neulasta Amaperekera
Mudzalandira jekeseni la Neulasta patangotha maola 24 mutapuma mankhwala a chemotherapy. Sungaperekedwe mwamsanga chifukwa zingakhale zosavuta. Mosiyana ndi Neupogen, yomwe iyenera kuperekedwa mobwerezabwereza mpaka kufunika kwanu kwa Neutrophil, Neulasta imapatsidwa kamodzi kamodzi pamagulu awiri a mankhwala awiri kapena atatu. Mukhoza kukhala ndi jekeseni mu dzanja lanu lapamwamba, mimba, ntchafu, kapena matako.
Akatswiri ena odwala matendawa amadzipangira jekeseni wawo tsiku lotsatira mankhwalawa, ndipo amadziwika kuti "jekeseni wa thupi" amapezeka. Ofufuza ena amalangiza kuti muli ndi jekeseni pachipatala chanu kapena ndi dokotala wanu wamkulu ngati mukulephera kutero.
Njira Zina ku Neulasta
Monga tanenera kale, njira ina yopita ku Neulasta (pegfilgristim) ndi Neuopogen (filgristim). Nthawi zina wodwalayo amadzifunsa kuti ndi mankhwala ati omwe mumakonda. Ngakhale kuti mankhwalawa amagwira ntchito mofanana, pali kusiyana pakati pa Neulasta ndi Neupogen , kuphatikizapo kuchuluka kwa jekeseni, kulekerera, ndi mtengo.
Zotsatira Zowonjezera Zina
Chimodzi mwa zotsatira zoopsa kwambiri kuchokera ku Neulasta ndizosavomerezeka, ndipo kachiwiri, ichi ndi chifukwa chake ena oncologists amakonda iwe kuwombera kuwonekera kuchipatala.
Ngati mumadzipangira akapolo anu kunyumba, muyenera kudziŵa zizindikiro za momwe mungayesere kuchita mankhwala kapena anaphylaxis.
Fungo lingathe kuchitika, ndipo nkofunika kuti dokotala wanu aone ngati chiwopsezo chanu chimachokera ku jekeseni lanu, kapena kani kachilombo koyenderana ndi kuchepa kwa maselo oyera a magazi.
Pafupifupi theka la anthu omwe amapatsidwa majeremusi a Neulasta amatchula mtundu wina wa kupweteka kwa mafupa. Kafukufuku wakale anapeza kuti Naprosyn / Aleve (naproxen) inachepetsa kupweteka kwa mafupa komanso kusokonezeka kugona (mwina chifukwa cha kupweteka kwa mafupa). Posachedwapa zinalembedwa kuti antihistamine Claritin (loratidine) onse adachepetsa chiopsezo cha zotsatira zowawa ndipo zinachititsa anthu ochepa kusiya mankhwalawo kusiyana ndi omwe anachitidwa ndi Aleve / Naprosyn (naproxen).
Ngati mukumva kupweteka kwa mafupa, kambiranani ndi dokotala wanu za mankhwala omwe akukulimbikitsani kuti mugwiritse ntchito. Kusambira mu madzi osamba kungathandizenso ndi kupweteka kwa mafupa ku Neulasta.
Itanani Dokotala Wanu Ngati Muli Ndi Zizindikiro Zina
Zotsatira zosagwirizanitsa zochepa zomwe zimachitika, ndipo ndizofunika kuyitana wanu oncologist ngati muli ndi zizindikiro zomwe zimakukhudzani. Izi ndi zofunika kwambiri ngati mulemba:
- Zotopa ndi zachilendo zosazolowereka
- Kupweteka pachifuwa
- Mitengo ya mtima
Zizindikiro Zophatikiza Phatikizani
Muyenera kutchula dokotala wanu nthawi yomweyo, koma funsani chithandizo chamankhwala mwamsanga (kuitanitsa 911) ngati muwona zizindikiro zilizonse zomwe zikuwonetseratu zotsatira za anaphylactic (zovuta kuchitapo kanthu) monga:
- Mikoko
- Kuvuta kupuma
- Kutupa kwa nkhope, milomo, lilime, kapena mmero
- Chiphuphu chikufalikira pa thupi lanu
- Mavuto m'mimba, kupweteka kwambiri m'mimba mwako kumanzere
- Kupsyinjika kwakukulu kwa mapewa
Zowopsa Zotheka Kugwiritsa Ntchito Neulasta
Neulasta ndi mankhwala otetezeka omwe amagwiritsidwa ntchito pa mitundu yambiri ya neutropenia, ndipo nthawi zambiri, zotsatirapo kapena chiopsezo cha mankhwala amaposa chiopsezo chowerengera cha neutrophil chochepa. Zoipa zomwe si zachilendo (koma nthawi zina zimachitika) zikuphatikizapo:
- Zomwe zimayambitsa matenda aakulu.
- Munthu wodwala kupuma matenda odwala (ARDS) .
- Kusokonezeka kwa maselo a tizilombo kwa anthu okhala ndi kachilombo koyambitsa magazi.
- Kupasuka kwa splenic .
- Zomwe zingakulitse kukula kwa chilakolako (ichi ndi chotheka ndipo sichinawonetsedwe, monga Neulasta ndi chiwerengero cha kukula)
Ndani Ayenera Kupewa Mankhwalawa?
Musatenge mankhwala awa ngati:
- Iwe uli ndi pakati kapena kuyamwitsa
- Mukulimbana ndi Neulasta
- Muli ndi mankhwala omwe mumagwiritsa ntchito mabakiteriya E. coli
Malangizo pa Chithandizo
Musanayambe jekeseni yanu yoyamba ya Neulasta, dokotala wanu adzalamula kuti CBC yamba (malire a magazi athunthu) kuti muwone mapepala anu apiritsi ndi maselo ofiira ndi oyera, omwe ali ndi chidwi chenicheni cha neutrophils m'magazi anu. Pamene mankhwala akupita, mudzakhala ndi mayeso ambiri a magazi kuti muwone momwe Neulasta ikuyendera.
Ngati mukuyamwitsa kapena mutatenga, kambiranani ndi dokotala musanatenge Neulasta. Sipanakhale kafukufuku wokwanira kuti adziwe zotsatira za mankhwalawa pa mkaka wa m'mawere kapena mwana wa munthu.
Kuchepetsa Vuto Lanu la Matenda Pa Chemotherapy
Ngakhale mutalandira jekeseni wa Neulasta kukweza maselo oyera a magazi, mukhoza kukhala pachiopsezo chotenga kachilombo ka mankhwala. Nthawi zina maselo oyera amagazi, ngakhale atakhala okwanira, samagwira ntchito. Ndipo ngakhale pogwiritsira ntchito Neulasta, mwina nthawi zina mutatha kulowetsedwa pamene kuchuluka kwa maselo oyera a magazi kumakhala pansi pa mawere omwe matendawa amapezeka. Tengani kamphindi kuti mudziwe zomwe mungadzichititse nokha kuti muchepetse chiopsezo cha matenda pa chemotherapy . Malangizo: Zina mwa izi sizitchuka ndipo zingadabwe iwe.
> Zotsatira:
> Aapro, M., Boccia, R., Leonard, R. et al. Kukonza Udindo wa Pegfilgrasti (G-CSF Yakale-Yomwe Yakuchitirani) ya Prevention of Chemotherapy-Yotchuka Kwambiri ya Neutropenia: Malangizo Otsatira Malangizo. Thandizo Lothandiza ku Khansa . 2017. 25 (11): 3295-3304.
> Botteri, E., Krendyukov, A., ndi G. Curigliano. Kuyerekeza Cholinga cha Granulocyte Colony-Chothandizira Filgrastim ndi Pegfilgrastim kwa Othandizira Ake mu Malamulo Ogwira Ntchito ndi Otetezeka: A Meta-Analysis of Randomized Clinical Trials m'matenda a khansa ya m'mawere. European Journal ya Cancer . 2018. 89: 49-55.
> Kirshner, J., McDonald, M., Kruter, F. et al. NOLAN: Kafukufuku Wophunzira, Wachigawo Chachiwiri Kuti Awonetse Zotsatira za Prophylactic Naproxen kapena Loratidine vs No Prophylactic Treatment pa Matenda a Pa Matenda a Odwala Amene Ali ndi Matenda Oyamba Amayi Ambiri Amalandira Kachiotherapy ndi Pegfilgrastim. Thandizo Lothandiza ku Khansa . 2018. 26 (4): 1323-1334.