Imithi "I-Cyclophosphan": imiyalo yokusetshenziswa, intengo, ama-analogues, umkhiqizi nokubuyekezwa

"Cyclophosphamide" kuyinto kwakwakhe alkylating. Lokhu ejenti izidakamizwa antitumor. It ikhiqizwa njengendlela omhlophe noma cishe enjalo crystalline powder. Eminye imininingwane mayelana nalokhu izidakamizwa.

"Cyclophosphamide" - umkhiqizi

Yenza izidakamizwa kule nkampani Russian JSC "Biochemistry." Itholakala edolobheni kwaseSaransk phezu Vasenko emgwaqweni, d. 15a.

izindleko

ungakwazi ukuthenga powder №1 «Cyclophosphamide" akunoma yiluphi ikhemisi. intengo yaso emhlabeni 90-98 ruble.

Amafomu izidakamizwa

Kule powder, ikhambi lelungiselelwe. Kuhloswe kwezokuphatha esicutshini futhi emthanjeni

Izici ukwakheka

Ukwakheka isitsha ngasinye powder kuhlanganisa esebenzayo uhlobo izidakamizwa ngokuthi "cyclophosphamide". Okuthile inombolo yakhe. Okungukuthi iqukethe "Cyclophosphamide" mg 200 wathi izidakamizwa isitsha ngasinye. Lo mkhiqizo okwelapha kungekho excipients.

Incazelo isenzo kwemithi

Ngokusekelwe yokusetshenziswa, "Cyclophosphamide" - kuyinto izidakamizwa cytostatic alkylating. Ukwakheka kwalo chemical iyafana izinto ezifana nitrogen lwesinaphi. Kwemithi umphumela "cyclophosphamide" kuyinto ukusebenzisa transverse uhlobo crosslinking phakathi i-DNA ne-RNA imicu. Futhi lokhu ukulungiselela ikhuthaza amaprotheni zamagama okusithiyayo.

"Cyclophosphamide" - analogue

Kulokhu, sithathe imali ehambelana ikhodi ATH isigaba sesine. Izimo zethu zihluke kakhulu eyinqaba iyona "Cyclophosphamide". Analogs yalesi izidakamizwa kukhona inani elikhulu. Okuvame kakhulu yilezi:

1. "Endoxane".
2. "Ifosfamide".
3. "Alkeran."
4. "Holoxan"
5. "Ribomustin".
6. "Leykeran".

Ukukhethwa ngayinye amalungiselelo kwenziwa udokotela umuntu ngamunye. Kulokhu, ucabangela impilo nokubekezelelana izingxenye.

Kwezinye izimo,?

Ake sicabangele leli phuzu kabanzi. Izimo zethu zihluke kakhulu eyinqaba kuyinto ukusetshenziswa kwezidakamizwa ezifana "Cyclophosphamide". Yokusetshenziswa kulokhu iyithuluzi elibalulekile. Lithi isidakamizwa okuboniswe kulezi zimo ezilandelayo:

1. Uma uhlangabezana chronic acute lymphocytic wegazi.
2. Ephambi kwezinduna myeloma amaningi.
3. Uma izimpawu lymphoma-non-Hodgkin.
4. Esimeni mycosis fungoides futhi retinoblastoma.
5. Ephambi kwezinduna isifo Hodgkin kanye nomdlavuza wesibeletho kanye webele.
6. Lapho ukubonakaliswa izimpawu unesimila ebuchosheni.

Ngaphandle kwakho konke lokhu, lo izidakamizwa isetshenziswa lihambisana namanye izidakamizwa ejenti antitumor ekwelapheni kwale mibandela elandelayo:

1. Lapho igciwane iseli izimila.
2. umdlavuza Isinye futhi wamaphaphu.
3. Sarcoma athambile izicubu hlobo.
4. Esimeni wesinye umdlavuza wesibeletho.
5. Lapho Sarcoma Ewing sika.
6. Endabeni izimila Wilms '.
7. Lapho retikulosarkome.

Futhi ukulungiselela ezifana "Cyclophosphamide", izimpendulo okuyizinto omuhle, sisebenza i immunosuppressive ejenti uhlobo nge ukubonakaliswa okuqhubekayo izifo sokuhlasela kwamasosha omzimba. Kulokhu-ke kusho ukubukeka arthritis psoriatic futhi samathambo sokuhlasela kwamasosha omzimba anaemia hemolytic, collagen nephrotic syndrome. Futhi wathi izindlela suppresses xhumelela kwenqatshwa ukuphendula.

Izimo

"Cyclophosphamide" has Izimo ezithile. It ayikwazi ukusetshenziswa:

1. Phakathi nenkathi ibele nokukhulelwa.
2. Ngo ukwephulwa okuphawulekayo umnkantsha umsebenzi.
3. Uma izimpawu of hypersensitivity.
4. Lapho ukubambezeleka ukuchama.
5. Ephambi kwezinduna izifo asebenzayo.
6. Phakathi ukubonakaliswa cystitis.

I kufanele siqaphele "Cyclophosphamide", analogue zazo engenhla, iqondiswa ezimweni ezithile. Okungukuthi, ebukhoneni lezi zifo ezilandelayo:

1. Nefrourolitiaza.
2. Sinzima isifo senhliziyo, isibindi nezinso.
3. Ukuvuvukala Kwamalunga.
4. Isimila kokuziphatha umnkantsha amaseli.
5. Adrenalectomy.
6. Ukugodla umnkantsha umsebenzi.

Incazelo amathuba okuba nemiphumela engemihle

"Cyclophosphamide", bomcondvofana (analogue) zazo kushiwo lapha ngenhla, kungase kube nomthelela ukuvela okulandelayo side effects:

1. Isimiso sokugaya ukudla bungene bangase balwisane izimpawu ezifana ukuhlanza, isicanucanu, sokuzincisha ukudla, ukungakhululeki, stomatitis, ubuhlungu besisu ndawo, uhudo noma ukuqunjelwa. Futhi aziwayo izimo ngazinye jaundice futhi oluhambisana nesifo.
2. Esikhathini hematopoietic uhlelo ukubonakaliswa babonakala neutropenia, ukuntuleka kwegazi emzimbeni, thrombocytopenia, leukopenia. Ngosuku 7-14 reception kungenzeka kancane wehlise inombolo zegazi kanye leukocyte.
3. On ukubonakaliswa isikhumba Alopecia uyalandelwa. Khulisa izinwele emva izidakamizwa ephelele. Ngaphezu kwalokho, phakathi ukwelashwa esingase senziwe ukuqubuka kwesikhumba. Kungaphindze kube netikhatsi khona lesikhumba kwesikhumba kanye nail izinguquko.
4. Ngo esimiso senhliziyo nemithambo yegazi lapho zaphathwa ebulilini zomuthi phezu isikhathi eside kungaba ukubonakaliswa cardiotoxicity. Kubalulekile ukukhumbula. Ngaphezu kwalokho, sabona inqaba ukuvela Ezimweni eziyinkimbinkimbi, futhi ngezinye izikhathi ebulalayo, ephethwe yisifo senhliziyo. Lokhu kungenxa okuvela myocarditis oluhambisana uhlobo.
5. Ngo ngomgudu womchamo kungadala necrosis iziteshi kwezinso (kuhlanganise nokufa), cystitis oluhambisana noma urethritis, urinary esinyeni cystic. Ezimweni ezingavamile, isicelo lwendlela okufanele isetshenziswe ngayo eliphezulu izidakamizwa kungenzeka nephropathy, hyperuricemia futhi umsebenzi kwezinso. Ukuba khona amaseli EPITHELIAL umchamo kungenzeka.
6. Ngo umgudu wokuphefumula kungenzeka kubonisa interstitial cystic yamaphaphu.
7. I zokuzala uhlelo iziyaluyalu singenzeka oogenesis futhi spermatogenesis, futhi inzalo. uphawu kokugcina kwezinye izimo kungase engelapheki. Iningi labesimame isicelo se-ejenti waphawula ukuthuthukiswa amenorrhea. Ngemva ukwelashwa, njalo menses ngokuvamile uyalulama. Abesilisa ngokuthatha izidakamizwa kungaholela ukuvela oligospermia noma azoospermia, kanye lamadigri yoma wamasende obuhlukahlukene.
8. Kulokhu kungabonakala nasemkhakheni nokungezwani komzimba. Lokho kubonisa a ukuqubuka kwesikhumba, ukulunywa, isifuba ukusabela anaphylactic.
9. Futhi kulokhu kungase kube okuvela amathuba okuba nemiphumela engemihle. Okungukuthi igazi isikhumba ebusweni, ububomvu, izimila abulalayo yesibili, ukujuluka ngokweqile, ubuhlungu bekhanda.

izinhlobo nokuxhumana

Lapho ethola lokhu izidakamizwa, ezinye izakhi anomthelela microsomal namachibi esibindini, kungase nokuqalisa inqubo eyenga microsomal umzimba cyclophosphamide. Lokhu kuholela nezici ezithile. Okungukuthi, ukuze a ukwakheka esikhulu alikiliruyuschego uhlobo metabolites. Lokhu kunciphisa isikhathi isigamu-ukuphila cyclophosphamide Kwenziwa, futhi kwandisa umsebenzi wayo. Cyclophosphamide, okuyinto abahlukene isikhathi eside kuvimbela umsebenzi cholinesterase, kuqinisa isenzo suxamethonium. futhi kuyasiza ukunciphisa noma ukubambezela yonke umzimba-cocaine. Ngenxa yalokho, sithuthukiswe noma ukwanda kwemithwalo isikhathi emiphumeleni yayo futhi kwandisa ingozi nemiphumela anobuthi. Lokhu kunomthelela ongemuhle kwi umtimba. Ngaphezu kwalokho, isicelo ngesikhathi esisodwa allopurinol kungase kube nomthelela imiphumela anobuthi ku umnkantsha.

Lapho co-zinikwa cyclophosphamide allopurinol, colchicine, probenecid, sulfinpyrazone kungase kudingeke ukulungiswa ngemithamo protivopodagricakih uhlobo izidakamizwa ekwelapheni sifo futhi hyperuricemia. Futhi, uma lokhu kwanda bangase balwisane ingozi nephropathy ukuthi lihlotshaniswa umkhiqizo wawanda ka uric acid usebenzisa cyclophosphamide.

Ingqikithi yokugcina ingabangela ukwanda emsebenzini anticoagulant. Njengoba lokhu zamagama esibindini incipha izici ukugqugquzela igazi ekunqandeni kanye ukukhiqizwa platelet kahle. Nokho, kungaphinde kwenzeke khona umsebenzi ukwehla anticoagulant ngokusebenzisa ongaziwa indlela hlobo.

Cyclophosphamide sithuthukisa cardiotoxicity ka daunorubicin futhi doxorubicin. Okunye ejenti immunosuppressive (chlorambucil, azathioprine, tacrolimus, corticosteroids, mercaptopurine, njll) Kungenzeka amathuba okuba zifo ezithile nezimila.

Ukusetshenziswa ngesikhathi esisodwa lovastatin in iziguli inhliziyo ukufakelwa kungandisa ingozi yezifo ezifana rhabdomyolysis futhi ukwehluleka oyingozi so-renal.

Uma lihambisana le izidakamizwa isetshenziswa izidakamizwa myelosuppressive noma ukwelashwa ngemisebe, kungenzeka ukubonakaliswa okufakiwe okusithiyayo of umnkantsha umsebenzi.

ukuphatha ngesikhathi esisodwa cytarabine at ebulilini nge impahla ezifana cyclophosphamide, lapho besanda kahle phezu kwezinye zilindele umnkantsha transplantation inqubo kuholela zenhliziyo nge okwandisa imvamisa ukuqala ukufa.

Lezi zindlela eziyinhloko

Ngo isicelo ucabangela lokhu okulandelayo:

1. Phakathi ukwelashwa ngalo muthi njalo kufanele enze ukuhlola igazi ukuhlola degree of myelosuppression. Kuyadingeka ikakhulukazi ukuba banake inani zegazi kanye neutrophil.
2. Kufanele njalo lucwaningo ukuhlolwa umchamo for khona abomvu egazi count. Ukuba khona kwabo kungase neqhaza ekuthuthukiseni izifo ezifana oluhambisana cystitis. Phezu ukuthola izimpawu ezifana ukwelashwa nge "Cyclophosphamide", intengo okuyinto engenhla, kumelwe uyeke.
3. Njengoba inani zegazi (esingaphansi 100,000 / ml) kanye / noma igazi amangqamuzana amhlophe (<2500 / L) izindlela ethola kufanele wayeka.
4. Lapho ukutheleleka kwenzeka esikhathini yokwelapha izidakamizwa, kusho ukwelashwa kufanele inqanyulwe noma aphazamisekile. Kuphakathi esimweni ethola Isikali kumele kungancipha. Abesilisa nabesifazane asebeneminyaka phakathi kwenqubo yokwelapha, "cyclophosphamide" kuyadingeka ukusebenzisa izindlela eziqinile zokuvimbela inzalo.
5. Phakathi ukwelashwa ngalo muthi kudingeka ayeke uphuzo oludakayo.
6. Esimeni lapho kudlula ngezinsuku eziyishumi zokuqala emva kokuhlinzwa, okuyinto kwenziwa ngaphansi izinzwa jikelele, kanti isiguli kokuba okunqunyiwe "Cyclophosphamide", intengo okuyinto engenhla, kufanele wazise baba obulala izinzwa.
7. Sibekezele ngemva kokuba aphethwe adrenalectomy, kubalulekile ukuba afeze ebambe ukulungiswa umthamo njengoba corticosteroids, ezisetshenziswa for inqubo replacement therapy, kanye izidakamizwa ezinjalo, njengendlela yokwelapha, "Cyclophosphamide".

izinyathelo ezidingekile

Reception zomuthi kungenzeka kuphela ngaphansi kokuqondisa kukadokotela onolwazi ngamakhemikhali. Kufanele futhi kube bawuhloniphe ngokuqinile umbuso umthamo. Lokhu kumele kwenziwe ikakhulukazi ukwelashwa. Futhi, akudingeki ukuchitha kabili esilandelayo umthamo uma lowo odlule waba aphuthelwe. Esikhathini kulungiselelwa lokhu izidakamizwa ukusetshenziswa ezinsaneni is hhayi Kunconywa ukusebenzisa diluents aqukethe Gcoba i-Benzyl utshwala. Njengoba lokhu kungaholela ukuthuthukiswa ebulalayo syndrome anobuthi. Okungukuthi, ukuze ukubonakala lactic umzimba, CNS ukucindezeleka, nokuvaleka kwemigudu yokuphefumula, ukwehluleka kwezinso, hypotension, ukuquleka, ukopha intracranial.

Phakathi yonke inkambo yokuhle ukwelashwa Kunconywa ukuba afeze ukumpontshelwa igazi (1 isikhathi ngesonto 100-125 ml). Lokhu kumele kwenziwe ngenjongo nokuvinjelwa kwezifo ezifana hyperuricemia futhi nephropathy, okuyinto ngenxa ukwakheka amanani andayo alabo uric acid. Lezi izimpawu zivame ukuba zenzeka ekuqaleni kwenkathi ukwelashwa. Futhi, ngaphambi wathi yokwelapha izidakamizwa futhi phakathi kwamahora angu-72 ngemva kokuphathwa Kunconywa ukwenza engayitholi ezithile uketshezi (3 amalitha ngosuku), ukusetshenziswa allopurinol (ezimweni ezikhethekile), futhi izindlela okwakwenza umchamo ane-alikhali. Ngokuba nokuvimbela zokubonisa oluhambisana cystitis Ngokuvamile kuye kudingeke afeze bethulula kwesinye futhi ukuthatha "UROMITEKSAN". Uma zikhona izimpawu kokuqala kwalesi sifo, ikhambi wathi ukulungiselela kufanele umile kwaze kwaba ukuqedwa ephelele izimpawu.

Ukuze attenuate uhlobo izenzakalo dyspeptic kungathatha cyclophosphamide ngaphakathi ngosuku lokuqala ngemithamo emincane. Qedela noma ngokwengxenye Alopecia, okungase kwenzeke phakathi ukwelashwa esethola futhi emva Yiqiniso kuyehla umsebenzi ukukhula evamile izinwele. Nokho, umbala wabo futhi isakhiwo kungenzeka ishintshe.

Uma uhlangabezana Ukugodola, imfiva, ukukhwehlela noma hoarseness, ubuhlungu kule aphansi endaweni emuva, noma ohlangothini, ukuchama ubuhlungu noma kunzima, ukopha noma ukopha, indle emnyama igazi e kwesihlalo noma umchamo kufanele ngokushesha kudokotela.

The kungenzeka thrombocytopenia, okuholela isidingo ukunakekelwa okukhethekile phakathi imisebenzi efana izinqubo koda futhi izinqubo zamazinyo. Kufanele ahlole njalo isikhumba kanye nolwelwesi lwamafinyila futhi nesayithi libe emthanjeni. Lena yini ukuze sithole izimpawu ebangela ukopha. Kuyadingeka ukuba kukhawulwe imvamisa venipuncture futhi senqabe ujove esicutshini. Kuyadingeka ukuba ukulawula okuqukethwe igazi endleni, ngifike ngibuyise umchamo. Lezi ziguli ngokucophelela okukhulu kumelwe enze inqubo ukushefa, manicure, dentifrices, asikiweko, njll Izikhala Ngesikhathi esifanayo kufanele ngokuqinile kugwenywe khona owayo noma ezinye izingozi. Acetylsalicylic acid utshwala noma nqatshelwe ukuthi kwandisa ingozi yokungenwa ukopha emathunjini. Kulokhu-ke kuyadingeka ukuba asebenzise isimiso ukubambezeleka lokugoma (ngemuva ngemuva kwezinyanga 3-12 zinyanga nokwelashwa ngamakhemikhali Yiqiniso ekupheleni). Kuyinto efiselekayo ukuze zigweme ukuthintana iziguli ezithathelwanayo. Phakathi ukwelashwa kubalulekile ukusebenzisa izilinganiso ezanele umuthi.

Lapho ixhumana wathi izidakamizwa ne mucosa noma isikhumba kumele kahle siyakazwe ngamanzi ethafeni ingxenye noma nge insipho, ngokulandelana.

Ibele nokukhulelwa

Kukhona komkhawulo eyinqaba kulokhu, okuyinto ine "Cyclophosphamide". Manual ubonisa ukuthi contraindicated ukusetshenziswa kwalesi izidakamizwa ngesikhathi sokukhulelwa. Kulokhu, isigaba umthelela embungwini ezikhonjiswe «D» ngu-FDA. Phakathi ukwelashwa kubalulekile ukuba angaqhubeki ibele.

ukweqisa izidakamizwa

Kulokhu, kukhona umehluko wemisindo nemiqondo yamagama athile. Ukuba khona nje kuyindlela yokuvimbela oluthile ukweqisa izidakamizwa of wathi ekwakhiweni alwaziwa. Kuyiqiniso okuthembekile. Ngo isicelo ukweqisa izidakamizwa abasebenzise amagadango asekelayo kuhlanganise ukwelashwa okufanele kwezifo ezithathelwanayo, kanye Ukuvela inhliziyo kanye / noma myelosuppression.

izimo isitoreji

Kule ndaba, idinga izimo ezithile ukulungiselela ezifana "Cyclophosphamide". Yokusetshenziswa sibeka ukuthi kumele agcinwe at okushisa esingeqile 10 ° C endaweni eyomile futhi bavikelekile ukukhanya. Ngo ukufinyelela lokhu yezingane kufanele ishintshela kokungavinjelwe.

ukuphila eshalofini

Kukhona isikhathi esithile lapho indoda izidakamizwa ezinjalo ingasetshenziswa njengendlela "Cyclophosphamide". Yokusetshenziswa libonisa ukuthi ukuphila yayo esebenza engu-3. Kulokhu, kufanele ulandele ngemibandela ethile. Ihlala eqinisweni lokuthi akuvumelekile ukusetshenziswa kwalesi izidakamizwa ngemva kwalesi sikhathi.

ukuqaliswa

Kulesi isiqondiso, kukhona isimo okungukuthi "Cyclophosphamide". Imiyalelo isicelo ibonisa ukuthi izidakamizwa ikhishwe kuphela Pharmacy ngu kadokotela.

isiphetho

Kuleli pheshana, kukhona okuningi ulwazi oluwusizo. Futhi nje yini "Cyclophosphamide", yokusetshenziswa, intengo yaleli izidakamizwa. Nokho, umuntu kufanele akhumbule ukuthi ngaphambi kokufaka izidakamizwa kufanele ubonane Udokotela onguchwepheshe.