Kusinthasintha, Kuteteza, ndi zizindikiro za zotsatira zoyipa za Rituxan
Zomwe zimachitika ku Rituxan, zomwe zimadziwikanso kuti MabThera kapena Rituximab , zimakhala ndi zotsatira zofala za mankhwala omwe amagwiritsidwa ntchito pochiza lymphoma ndi matenda ena. Kodi ndi zizindikiro zotani zomwe zimayambitsa zomwe zimayambitsa?
Mwachidule
Rituxan ndi mankhwala osokoneza bongo amodzi, omwe amatanthauza molecule (CD-20) yomwe imapezeka m'ma maselo ena a chitetezo-maselo oyera a m'magazi omwe amachokera ku ma lymphomas, koma izi ndizofunikira kwambiri m'magulu ena ambiri a chitetezo cha mthupi, monga chifuwa chachikulu nyamakazi.
Rituximab ndi mankhwala othandiza omwe si a Hodgkin's lymphoma (NHL) ndipo wasonyezedwa kuti apitirize kukhala ndi moyo wina mwa mitundu ina ya NHL kuphatikizapo yaikulu B-cell lymphoma ndi follicular lymphoma .
Rituximab ili ndi mapuloteni ochepa kuchokera ku minofu ya mimba. Pachifukwa ichi, rituximab imadziwika kuti "chimeric antibody," zomwe zikutanthauza kuti zimapangidwa kuchokera ku zigawo zochokera ku mitundu iwiri yosiyanasiyana. Ngakhale izi ndizofunikira kuti mankhwalawa agwire ntchito, matupi athu amayesetsa kuzindikira zizindikiro zakunja ndi othawa ndi kuyambitsa chitetezo cha mthupi motsutsana nawo. Zomwe zimayambitsa matenda a rituximab zambiri zimagwira ntchito kwa mapuloteni a phokoso mu mankhwala.
Musanayambe kugwiritsidwa ntchito, mumatha kuchiritsidwa ndi mankhwala omwe amachepetsa chitsimikizo choti mutha kuyankhidwa. Izi zikuphatikizapo Tylenol (acetaminophen) ndi Benadryl (diphenhydramine) komanso nthawi zina mankhwala a steroid.
Popeza diphenhydramine ikhoza kukupangitsani kugona, nthawi zambiri mumalimbikitsidwa kuti wina akakuyendetseni panyumba mutatha kulowetsedwa.
Zizindikiro ndi Zizindikiro
Zizindikiro zodziwika za rituximab zowopsa ndi:
- Chiwopsezo ndi kuzizira - izi ndizo zomwe zimachitika kwambiri ndipo zimachitika mwa anthu ambiri
- Nausea
- Kuyabwa
- Rash
- Kuwopsya kapena kuthirira kuchokera mphuno
- Kutupa kwa manja, mapazi kapena nkhope
- Kuchepetsa kuthamanga kwa magazi ndi chizungulire
- Kupweteka kwa mmero, mofanana ndi mphumu
- Mutu
Zomwe zimayambitsa matendawa zimachitika mkati mwa mphindi 30 mpaka 2 oyamba poyambitsa kulowetsedwa kwa mankhwala ndipo nthawi zambiri zimakhalapo ndi kulowetsedwa koyamba ( pafupifupi 80 peresenti ya odwala amachitapo kanthu ) ndipo amachepetsa nthawi zambiri.
Kawirikawiri, zimachitikapo, kuphatikizapo:
- Matenda opuma kwambiri
- Kuwononga mtima
- Kugwa kwakukulu kwa magazi ndi mantha.
Kuchiza
Ngati mwachitapo kanthu ngakhale kuti mukupatsidwa chithandizo chamankhwala operekedwa kuchipatala, chinthu choyamba chimene namwino kapena dokotala amachititsa kuchepetsa kapena kuchepetsa kulowetsedwa. Chifukwa cha zochitika zina zofatsa, ndizo zonse zomwe zingafunike. Mankhwala ambiri angaperekedwe pofuna kuchepetsa kapena kuimitsa zomwe zimachitika. Izi zikuphatikizapo acetaminophen, antiallergics, IV saline kapena mankhwala osokoneza bongo kuti awonjezere kuthamanga kwa magazi ndi steroids. Pa pafupifupi odwala onse, zomwe zimachitidwa zimatha kuyendetsedwa mofulumira ndi izi. Pochita zoopsa kwambiri, magulu akuluakulu odwala kwambiri angakhale oyenerera-ndi njira zowonetsera ndi kuyang'anira mphamvu ya magazi ndi kupuma. Ngakhale kuti anthu amafa chifukwa cha kulowetsedwa, ndizosowa kwambiri.
Kupewa
Zowonjezera zingathe kuchepetsa kapena kuchepetsa kusintha kwa mankhwala ndi rituximab:
- Kukonzekera. Monga tafotokozera pamwambapa, mwinamwake mukutsatira antihistamine mankhwala ndi steroid musanalowetsedwe.
- Kuyambira kulowetsedwa pang'onopang'ono. Izi ndi zofunikira kwambiri kuti kulowetsedwa koyambirira kukhale kofala kwambiri. Mafinya amayamba pang'onopang'ono ndipo kuwonjezeka kwa kulowetsedwa kumawonjezeka pamene palibe zomwe zimachitika.
- Kuletsa kumwa mankhwala a magazi musanatenge infusions. Popeza kugwa kwa magazi kumabwera pakapita nthawi, madokotala nthawi zina amauza odwala kuti asiye kugwiritsa ntchito mankhwala a magazi asanayambe kulowetsedwa. Muyenera kuchita izi potsatira malangizo enieni ochokera kwa dokotala wanu, komabe.
Anthu omwe ali ndi malingaliro ochepa kapena ochepetsedwa ndi rituximab akhoza kupatsidwa mankhwala pang'onopang'ono ndipo amafunika kuteteza zonse zothandizira. Amene ali ndi vuto lalikulu nthawi zambiri salinso mankhwalawa.
Zotsatira:
LaCasce, A., Castells, M., Burstein, M., ndi J. Meyerhardt. Kukhudza kulowetsedwa kwa mankhwala ochiritsira a monoclonal omwe amagwiritsidwa ntchito pa mankhwala opatsirana khansa. Zaposachedwa. Kusinthidwa 01/08/16. http://www.uptodate.com/contents/infusion-reactions-to-therapeutic-monoclonal-antibodies-used-for-cancer-therapy