Umuthi 'Carboplatin ": yokusetshenziswa, analogs kanye nokubuyekeza

Yini engathatha isikhundla sale izidakamizwa ngokuthi "Carboplatin"? Analogs yalesi izidakamizwa uzobe ezibalwe ngezansi. Futhi e mathiriyeli lo sihloko izokwethulwa ulwazi mayelana ukusetshenziswa ngokufanele izimali wathi, izinkomba zayo, side effects kanye contraindications.

incazelo Ukwakheka, ukuma nomuthi

Ngayiphi Lelifomu liyatholakala ekhelini izidakamizwa "Carboplatin"? Umenzi uthi ithuluzi angathengwa njengendlela powder emhlophe lyophilized senzelwe ukulungiswa ikhambi emthanjeni. isithako wayo esebenzayo carboplatin, futhi eyengeziwe - mannitol.

Ngo ukudayiswa umjovo CONCENTRATE "Carboplatin", okwakhiwa kwalo siyishiyele ngenhla, iza amabhodlela ukuthi ezibekwe amakhadibhodi emaphaketheni.

izakhiwo kwemithi

Uyini izidakamizwa "Carboplatin"? Iziyalezo umbiko ukusetshenziswa, impendulo okungukuthi eziyinkimbinkimbi kwakwakhe wezinto oqukethe heavy metal ezifana-platinum.

Ochwepheshe basikisela ukuthi lo mshini wezenzo kwaleli thuluzi kungenxa ikhono layo ukuhlanganisa uxhumano nomsebenzisi-DNA. Ngenxa yalokho, kwakhiwa vnutrispiralnye crosslinking ukushintsha isakhiwo DNA futhi zivimbele yayo. A nomphumela ofanayo kwenzeka kungakhathaliseki esigabeni cell umjikelezo. Kufanele kuqashelwe ukuthi carboplatin hydration, phakathi kwesikhathi lapho kwakhiwa ifomu asebenzayo we umuthi kancane kakhulu hydration ka cisplatin.

nemingcele Kinetic we nomuthi

kanjani umzimba womuntu "Carboplatin" ukusatshalaliswa izidakamizwa? Yokusetshenziswa uthi ngemva kokuphathwa elilodwa le-ejenti ngesimo ukumnika (iv) amaminithi angu-60, ngo-emakamu igazi khulula (isb ultrafiltration amenable) kanye Imininingwane ye-platinum liyancipha ngokuhambisana imodeli ezimbili isigaba ye-oda pharmacokinetics kuqala.

Ukuqala isikhathi khulula ye-platinum-ukuphila cishe 2 amahora, kanye T1 esibulalayo / 2 - 3-6 amahora. Kufanele kuqashelwe ukuthi le-platinum Imininingwane libhekene efanayo kokuqala isigamu-nokuphila, kodwa ekupheleni-ke isikhathi eside (cishe usuku).

ekuphathweni okuphindiwe kwe- izidakamizwa izinsuku 4 ilandelana ekuqongeleleni igazi platinum uyalandelwa. Ekupheleni kosuku emva isicelo zomuthi-85% isithako esebenzayo ku-plasma nakanjani isimo amaprotheni.

Kushiwo ngamuphi umqondo ukuthi ukuqedwa izidakamizwa "Carboplatin"? Umhlahlandlela uthi ukulungiswa isuselwe ikakhulukazi izinso (cishe 30% umthamo kwakhishwa unmodified).

Kubantu CS 60 ml / imiz nangaphezulu mayelana 65% no-70% we esetshenziswa metering okukhipha-11 no-23 amahora, ngokulandelana.

Njengoba nokuqedwa "Carboplatin" senzeka cishe ngokuphelele filtration glomerular, kuphela lokuhlushwa elincane nasemkhakheni tubules kwezinso, echaza aphansi ezingaba nephrotoxic zomuthi njengoba kuqhathaniswa cisplatin.

Anticancer izidakamizwa "Carboplatin": Ubufakazi

Kwezinye izimo, ubonisa ukusetshenziswa kwezidakamizwa ehilelekile? Ngokusho imiyalelo, kuba ukwelapha izimila ezilandelayo:

• umdlavuza wesibeletho;
• umdlavuza wesibeletho;
• lwegciwane iseli izimila in abesilisa nabesifazane;
• Sarcoma osteogenic;
• umdlavuza wamaphaphu;
• medulloblastoma;
• ukuvuvukala emqaleni ikhanda.

Uvala ukusetshenziswa isixazululo ukumnika

Yiziphi Izimo izidakamizwa has "carboplatin"? Ukusetshenziswa kwalesi izidakamizwa akuvunyelwe uma:

• ibele;
• sina izinso pathologies (isib CC angaphansi kuka-15 ml / iminithi);
• ukhulelwe;
• hypersensitivity kuya carboplatin kanye neminye imithi, kuhlanganise ne-platinum,
• myelosuppression ezinzima;
• abalulekile ukopha, kuhlanganise nalezo ebonwe esidlulileko;
• ebuntwaneni.

Futhi ngokuqapha le imithi ezinqunyiwe:

• umgomo zamuva;
• kokuzwa ukungakhuli;
• iziyaluyalu kwezinso;
• ecindezelekile umnkantsha hematopoiesis, kuhlanganise nalezi zimo ngemva ngemisebe nangamakhemikhali;
• ukusetshenziswa parallel izidakamizwa nephrotoxic (isb, "Cisplatin");
• izifo okukhulu viral, fungal kanye nemvelaphi virus.

Nomuthi "Carboplatin": yokusetshenziswa

kumele kusetshenziswe Indlela Yokuphatha isidakamizwa anticancer? Ngokusho ochwepheshe, lokhu nomuthi singasetshenziswa njengoba monotherapy, noma inhlanganisela nezinye izindlela kokuba nomphumela ofanayo (isib lihambisana "Paclitaxel" ukulungiselela).

Kuye ngalokho usayizi nalapho isiguli itholakala isimila, odokotela basebenzisa ezahlukene nokushintsha kokudla nokufakwa "Carboplatin". Kumele iqondiswa ngemithambo yegazi njengenhlangano ukumnika kwamaminithi 17-55.

kufanele ngisebenzisa kanjani imithi "Carboplatin"? Qondisa obukhomba imithamo elandelayo leli thuluzi:

• 100 mg / square imitha umzimba nesineke nsuku zonke izinsuku 5;
• 300-400 mg / imitha square esiguli, kanye njalo emavikini 4.

Kufanele kuqashelwe ukuthi isikhawu esiphakathi nokuphathwa izidakamizwa, ngesikhathi Ingxenye platelet ayizinkulungwane 100 / mm ayizinkulungwane 1.5 neutrophil / mm, kufanele kube okungenani amaviki 4.

Ngaphambi nangemva isicelo "carboplatin" ezengeziwe Umqhubi uketshezi kanye enifeza diuresis bephoqeleka liyadingeka.

Uma isiguli ezinzima ubuthi hematological noma okusesilinganisweni bangase udinge ukunciphisa umthamo zomuthi ukuba 26%.

Lapho pathologies kwezinso kakhulu kwandisa ingozi umphumela anobuthi zomuthi, ngakho ukunciphisa umthamo elisekelwe ezingeni CC.

Ngo abadala, kanye ngaphambili olwenziwa yokwelapha myelosuppressive, umthamo kufanele yehliswe ngama-22-25%.

Ngaphambi ukusebenzisa, ikhambi ukumnika kufanele ukuqhuba Ukuhlolwa okubonakalayo ukuze anqume ukuthi bukhona yini noma yibuphi ububi obenzile nombala noma ukungcola.

Yini uhlanganise powder izidakamizwa "Carboplatin"? Yokusetshenziswa okufunwayo izidakamizwa esebenzayo kumele buhlanjululwe e-glucose 5% isixazululo noma i-sodium chloride-9%. Kulokhu emakamu waphawula kufanele kube 0.5-1 mg / ml.

Isixazululo izidakamizwa kufanele uzilungiselele ngaphambi nje uyisebenzisa, kusukela esiphezulu eshalofini ukuphila ukulungiselela okuxubile ilingana ngosuku olulodwa.

Izenzo-uhlamvu

Yini ukusabela okungekuhle kubangela izidakamizwa "Carboplatin"? Izibuyekezo mayelana leli thuluzi zithi kungaba avuse ukuthuthukiswa imiphumela elandelayo enqabayo:

• izitho kwesisu: kungakapheli amahora 11-12 emva ukusetshenziswa kwezidakamizwa, isiguli bangezwa isicanucanu nokuhlanza. ingozi encishisiwe ukusabela emetic usebenzisa odlule reception antiemetics, kanye nokuphatha ngakanye we nomuthi izinsuku 5, noma ukumnika okuqhubekayo emthanjeni izinsuku. Futhi, ezinye iziguli kwakufanele ukusabela ezingezinhle ezifana nesifo sohudo, ubuhlungu besisu, zivuvukale emlonyeni kanye ukuqunjelwa.
• uhlelo hematopoietic: ukusetshenziswa ebulilini "carboplatin" Kuyinto engenzeka ukucindezela umsebenzi umnkantsha hematopoiesis. Futhi, inani elikhulu leziguli izimpawu manifest igazi, ukushuba okuyinto kuncike umthamo zomuthi esetshenziswa. Ngokuvamile ihlangabezane kanye nezinkinga emitholampilo ezifana izifo ezithathelwanayo, imfiva, ukopha futhi ukushaqeka ukonakala.
• NA neuropathy isimiso sezinzwa esiyinhloko: kukhona amathuba enkulu yokuba neuropathies neuropathy, kanye nokwehla ikhaliphe ezijulile umsipha, ikakhulukazi abantu abaneminyaka engaphezu kuka-65. Ngaphezu kwalokho, izimpawu okungenzeka CNS iziyaluyalu ukusebenza. ukwelashwa isikhathi eside isikhathi ngokuthi bathathe imithi kungabangela neurotoxicity ezuziwe.
• Izinhlaka umbono: e ukusetshenziswa kwezimali kungenzeka ukuthi ukuwohloka yesikhashana noma ukulahlekelwa okuphelele umbono, futhi ukulahlekelwa ikhono ayakubona ukukhanya futhi ukuhlukanisa imibala. Ekukhunjulwa sokubuyiselwa futhi ngcono ngokuvamile kwenzeka emasontweni ambalwa ngemva ukuqedwa zomuthi. Ngo nabantu kahle izinso umsebenzi, ngubani kwase baphathwe ebulilini umuthi, waphawula ubumpumputhe cortical.
• kokuzwa izitho: ukwethulwa "Carboplatin" Kwezinye iziguli kukhona ototoxicity, esizibonakalisa ngesimo ukulahlekelwa kukuzwa futhi tinnitus.
• Komzimba: imfiva, erythematous amawala, pruritus, ukuphendula anaphylactic, urticaria, hypotension futhi bronchospasm. Le miphumela kungenzeka emva kwamaminithi ambalwa emva izidakamizwa abaphathi. Futhi, ezimweni ezingavamile, iziguli zingase zibhekane dermatitis exfoliative.
• uhlelo kwezinso: ukwethulwa "Carboplatin" Kwezinye iziguli uhlangabezana ukwanda lesikhashana omnene igazi izidakamizwa kanye urea lokuhlala. Kulokhu, ukulimala acute ezinsweni ivelakancane. Ingozi nephrotoxicity ku ngemuva ukusetshenziswa le-ejenti kwandisa ne umthamo, kanye nabantu ngaphambili ziphathwe cisplatin.
• Electrolyte ibhalansi: hypocalcemia, hypokalemia, hypomagnesemia, futhi hyponatremia.
• Isibindi: ukukhuphuka zesikhashana bilirubin lokuhlala, UMTHETHO futhi phosphatase ane-alikhali egazini kungabonakala nasemkhakheni. Abantu abaye baphathwa nge ebulilini izidakamizwa ukuze autologous umnkantsha transplantation, waphawula ukushayisana kwesibindi.
• Nezinye izindlela zokusabela: hemolytic-uremic syndrome, ukukhathala, Alopecia, congestive ukumelwa inhliziyo, izimpawu zomkhuhlane, myalgia / arthralgia, komzimba nezinto, iziyaluyalu cerebrovascular.

ulwazi oluthile

Yini iziguli kufanele bazi ngaphambi kokusebenzisa izidakamizwa "Carboplatin"? Imiyalelo, amazwana baphikisa ngokuthi ukumnika yalesi izidakamizwa kuphela ngaphansi kweso njalo izisebenzi zezokwelapha kungaba kwenziwe, okuyinto ngokukhethekile ekwelapheni ejenti cytotoxic. Kulesi ozikhethela qapha kungenzeka imiphumela anobuthi, ikakhulukazi uma ebulilini umuthi.

Ngokuhamba yokwelapha nale ejenti kanye phezu nezinyanga ezintathu ezilandelayo, iziguli kufanele basebenzise izinto zokuvimbela inzalo ethembekile.

Ngokuba ukulungiswa kanye nokuphathwa okwalandela yesixazululo izidakamizwa kudingekile ukusebenzisa nemithi ukuthi awanalo aluminium. Lokhu kungenxa yokuthi kwakheka uma baxhumana kwenze isidakamizwa futhi kumakwe nokuncipha izidakamizwa ngempumelelo.

Phakathi ukwelashwa, "Carboplatin" edingekayo Luhlolo ezikhathini ezithile zezinzwa, kuhlanganise abantu abadala kanye ngaphambilini baphathwe cisplatin.

Ukusebenzisa lolu imithi kungaholela ukuthuthukiswa imiphumela ototoxic, ngakho pre-ukwelashwa kufanele kwenziwe ukuhlolwa audiometric.

Ngaphansi kokuqondisa ukwephulwa emtholampilo abalulekile sokulalelwa kungase kudingeke umthamo ukulungiswa "Carboplatin" noma ukuqedwa kwayo okugcwele.

Uma umkhiqizo engena nesikhumba noma namehlo, kugeze ngokushesha ngokuba namanzi amaningi. Uma kugwinywe, izindlela ezidingekayo ukuze usingathe ngokuba usizo kumuntu ofanelekayo.

izidakamizwa Okufanayo

Yini analogue izidakamizwa ungayithola enye "Carboplatin"? Yokusetshenziswa ayiqukethe kulesi sici alukho ulwazi. Ngemuva ke kuzodingeka ukuze ujike i udokotela 'ebona. Njengomthetho, ochwepheshe batusa ukusetshenziswa kwalezi analogue "Carboplatin" "Tsitoplatin", "Teksalok", "Displanor", "Oksiplat", "Oxaliplatin", "Platinol", "Cisplatin", "Eloxatin", "Platikad", "Plaksat "" Oksitan "," Oksatera "," Ekzorum ".

Uphenyo anticancer izidakamizwa

Manje uyazi ukuthi kungani udinga izidakamizwa ezifana "Carboplatin" ( "Carboplatin Teva"). Yokusetshenziswa yalesi izidakamizwa nakho okuye kuchaziwe ngenhla.

Ukuhlolwa iziguli ubuthi kanye kusebenta lesi sidakamizwa "carboplatin" kuyinto impikiswano. Abanye abantu ukukhuluma mayelana nemiphumela emihle wokwelapha isifo somdlavuza ahlukahlukene nezinye ngokuvamile kakhulu ukusho imiphumela anobuthi izidakamizwa izitho zomzimba zabantu ezihlukahlukene futhi izinhlelo, kanye nezinye izenzakalo ezimbi. Ochwepheshe bathi lokhu sihlotshaniswa ukubekezelelana ngabanye ngesineke esebenzayo izidakamizwa izidakamizwa futhi isimo sayo jikelele. Kunoma ikuphi zidinga ukuthi imiphumela emibi yokwelashwa ngamakhemikhali umdlavuza. Uma izidakamizwa "Carboplatin" isiguli asifanele ngasizathu simbe noma kwenye, bese-ke bese kufakwa analogs. Lesi sidakamizwa esikhundleni antitumor kusiza 90% amacala.