Medicine "Cyclophosphamide": malangizo ntchito, mtengo, analogs, sewerolo ndi ndemanga

"Cyclophosphamide" ndi pawiri alkylating. Izi wothandizila mankhwala antitumor. Chifukwa amapangidwa kukhala loyera kapena pafupifupi ngati crystalline ufa. mumve zambiri za mankhwala.

"Cyclophosphamide" - sewerolo

Pangani mankhwala mu Russian kampani JSC "sayansi." Malowa ali pamtunda m'tauni ya Saransk pa msewu Vasenko, d. 15a.

mtengo wa

mugule ufa №1 «Cyclophosphamide" m'sitolo yogulitsa mankhwala aliwonse. mtengo wake ndi kuzungulira 90-98 rubles.

mitundu mankhwala

Kuchokera ufa ichi, yankho okonzeka. Chinali cholinga cha utsogoleli mu mnofu ndi mtsempha

Features zikuchokera

The zikuchokera aliyense vial ndi ufa zikuphatikizapo yogwira mtundu mankhwala otchedwa "cyclophosphamide". Ena ndi nambala yake. Ndicho lili "Cyclophosphamide" 200 mg wa anati mankhwala pa vial. Izi mankhwala mankhwala palibe excipients.

Kufotokozera za kanthu pharmacological

Zochokera malangizo ntchito, "Cyclophosphamide" - ndi alkylating cytostatic mankhwala. mankhwala kapangidwe kake ndi ofanana ndi zinthu monga asafe mpiru. Pharmacological zotsatira "cyclophosphamide" ndi kuti litsatira yopingasa mtundu crosslinking pakati DNA ndi RNA chingwe. Komanso kukonzekera izi amalimbikitsa mapuloteni kaphatikizidwe chopinga.

"Cyclophosphamide" - analogues

Pankhaniyi, kukatenga ndalama zimene zikugwirizana ndi malamulo Kiriyati chachinayi gulu. Ndithu kwachirendo ndi "Cyclophosphamide". Analogs za mankhwala pali chiwerengero ndithu. Ambiri ndi:

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

Kusankha aliyense kukonzekera zochitidwa dokotala anthu paokhapaokha. Mu nkhani iyi, amaganizira thanzi ndi kulolerana zigawo zikuluzikulu.

Mu zina?

Tiyeni tione mfundo imeneyi mwatsatanetsatane. Ndithu kwachirendo ndi kugwiritsa ntchito mankhwala monga "Cyclophosphamide". Malangizo ntchito pa nkhani imeneyi ndi chida chofunika kwambiri. Lembali limati mankhwala zikusonyezedwa milandu zotsatirazi:

1. Ngati mwakumana ndi aakulu pachimake lymphocytic khansa.
2. Pamaso pa myeloma angapo.
3. Ngati zizindikiro za si Hodgkin lymphoma.
4. Mu chochitika cha fungoides mycosis ndi retinoblastoma.
5. Pamaso pa matenda Hodgkin ndi yamchiberekero ndi chifuwa khansa.
6. Pamene mawonetseredwe a zizindikiro za neuroblastoma.

Pamwamba pa izi, mankhwala ntchito limodzi ndi mankhwala ena wothandizila antitumor zochizira zinthu zotsatirazi:

1. Pamene nyongolosi khungu zotupa.
2. khansa chikhodzodzo ndi m'mapapo.
3. Sarcoma a mtundu minofu zofewa.
4. Mu chochitika cha Prostate ndi khansa khomo lachiberekero.
5. Pamene Ewing a sarcoma.
6. Pankhani ya Wilms 'zotupa.
7. Pamene retikulosarkome.

Komanso kukonzekera monga "Cyclophosphamide", mayankho amene ali abwino, othandiza ngati choyimira cha immunosuppressive wothandizila ndi kupata chiwonetsero cha matenda autoimmune. Pankhaniyi izo zikutanthauza maonekedwe a psoriatic ndi nyamakazi, autoimmune hemolytic magazi m'thupi, kolajeni, nephrotic syndrome. Komanso anati njira limaleka kumezanitsa kukana anachita.

contraindications

"Cyclophosphamide" ali contraindications ena. Izo sizingakhoze ntchito:

1. Pa nthawi imene Kuyamwitsa ndi mimba.
2. Mu Amowabu kuphwanya mafupa ntchito.
3. Ngati zizindikiro za hypersensitivity.
4. Pamene kuchedwa pokodza.
5. Pamaso pa matenda yogwira.
6. Pa chiwonetsero cha cystitis.

Kusamala m'pofunika "Cyclophosphamide", analogues wa zimene tatchulazi, kutumikiridwa mu nthawi zina. Ndicho, pamaso pa matenda otsatirawa:

1. Nefrourolitiaza.
2. Woopsa matenda a mtima, chiwindi ndi impso.
3. Gout.
4. Chotupa kusalola maselo mafupa.
5. Adrenalectomy.
6. Yimitsira a mafupa ntchito.

Kufotokozera mavuto

"Cyclophosphamide", ofanana (analogues) amene mwachindunji pamwamba, zikhoza amathandiza kuti zikamera zotsatira zotsatirazi mbali:

1. Dongosolo m'mimba akhoza kusonyeza zizindikiro monga kusanza, anorexia, kusapeza, stomatitis, kupweteka kwa m'mimba dera, kutsegula m'mimba kapena kudzimbidwa. Imatchedwanso milandu munthu wa matenda a chikasu ndiyo ndipo hemorrhagic matenda a m'matumbo.
2. Mu dongosolo hematopoietic mawonetseredwe anali anati neutropenia, kuchepa magazi, thrombocytopenia, leukopenia. Pa tsiku 7-14 phwando mwina pang'ono kusiyiratu maselo othandiza magazi kuundana ndi leukocytes.
3. Pa mawonetseredwe khungu la alopecia anati. Kumera tsitsi pambuyo mankhwala wathunthu. Komanso, pamene mankhwala kumachitika pa totupa pakhungu. Pakhoza kukhala pamaso pa mtundu wa khungu ndi msomali kusintha.
4. Mu dongosolo mtima pamene kutumikiridwa mlingo waukulu wa mankhwala pa nthawi yaitali mwina kumasonyeza cardiotoxicity. Nkofunika kukumbukira. Komanso anati zikamera wa nkhani zikuluzikulu, ndipo nthawi zina amapha, kulephera mtima. Ichi ndi chifukwa pakutchulidwa a mtundu myocarditis hemorrhagic.
5. Kapepala kakuti mkodzo zikhoza necrosis a mitsinje aimpso (kuphatikizapo imfa), cystitis hemorrhagic kapena urethritis, mkodzo m'chikhodzodzo fibrosis. Nthawi zina, ntchito Mlingo mkulu wa mankhwala kumachitika nephropathy, hyperuricemia ndi ntchito aimpso. Kupezeka kwa maselo zaminyewa mkodzo angagwe.
6. Mu dongosolo kupuma mwina kumasonyeza interstitial m'mapapo mwanga fibrosis.
7. Dongosolo ubereki matenda angayambe oogenesis ndi spermatogenesis, ndi sterility. Last chizindikiro zina zingakhale sizingasinthe. Akazi ambiri mu ntchito wothandizila mwambo wa chitukuko cha amenorrhea. Pambuyo kuchipatalako ndi mokhazikika menses zambiri akuchira. Amuna kutenga mankhwala kungachititse kuti zikamera wa oligospermia kapena azoospermia, komanso amawasonyeza mosiyanasiyana la manja testicular.
8. Pankhaniyi zingaoneke ndi thupi lawo siligwirizana. Kuti kumasonyeza ndi ziwengo, kuyabwa, ming'oma, zochita anaphylactic.
9. Inunso iyi pakhoza kukhala pakutchulidwa mavuto. Ie magazi khungu nkhope, redness, zilonda zotupa sekondale, amaika thukuta, mutu.

mitundu ya mogwirizana

Pamene kulandira mankhwala, ena zinthu zimene zimachititsa microsomal makutidwe ndi okosijeni mu chiwindi, akhoza kukhazikitsa ndondomeko anachititsa microsomal kagayidwe wa cyclophosphamide. Zimenezi zimabweretsa zinthu zina. Ndicho, ndi mapangidwe lalikulu alikiliruyuschego metabolites mtundu. Izi amachepetsa nthawi imene hafu ya moyo wa cyclophosphamide ikuchitika, komanso zochita zake. Cyclophosphamide, amene ndinasintha yaitali ndi kumabwezera mmbuyo ntchito cholinesterase, kumawathandiza zimene suxamethonium. kumathandiza kuchepetsa kapena m'mbuyo kagayidwe cocaine. Chifukwa, kumatheka kapena kuchuluka Kutalika kwa zotsatira zake ndi kumaonjezera ngozi ya zotsatira poizoni. Izi ali ndi zoyipa pa chamoyo wonse. Komanso, ntchito munthawi yomweyo allopurinol zingachititse zotsatira poizoni pa mafupa.

Pamene co-kutumikiridwa ndi cyclophosphamide allopurinol, colchicine, probenecid, sulfinpyrazone angafunike Mlingo kudzudzulidwa protivopodagricakih mtundu mankhwala zochizira gout ndi hyperuricemia. Komanso, pamene kuwonjezeka kumeneku akhoza kusonyeza chiopsezo nephropathy kuti amagwirizana ndi kuchuluka yopanga asidi uric ntchito cyclophosphamide.

Thunthu yamasika zingachititse ponso ntchito anticoagulant. Popeza kaphatikizidwe izi mu chiwindi amachepetsa zinthu kulimbikitsa magazi clotting ndi makutu kupanga kupatsidwa zinthu za m'mwazi. Komabe, pali zingachitikenso kuchepa anticoagulant ntchito mwa mtundu osadziwika limagwirira.

Cyclophosphamide timapitiriza cardiotoxicity wa daunorubicin ndi doxorubicin. wothandizila ena immunosuppressive (chlorambucil, azathioprine, tacrolimus, corticosteroids, mercaptopurine, etc.) achuluke kuthekera matenda zasekondale ndi zotupa.

The ntchito munthawi yomweyo lovastatin odwala ndi mtima kupatsidwa zina mukhoza azitaya matenda monga rhabdomyolysis ndi pachimake kulephera aimpso.

Ngati osakaniza mankhwala ntchito mankhwala myelosuppressive mankhwala dzuwa, n'zotheka mawonetseredwe zowonjezera chopinga a mafupa ntchito.

Dongosolo munthawi yomweyo cytarabine pa mlingo waukulu ndi zinthu monga cyclophosphamide, pa siteji kukonzekera kwa mafupa ndondomeko kupatsidwa zina zimabweretsa cardiomyopathy ndi kuwonjezeka pafupipafupi isanayambike imfa.

I chachikulu

Mu ntchito amaganizira zotsatirazi:

1. Pa mankhwala ndi mankhwala nthawi zonse tiyenera kugwira atayezetsa kuwunika mlingo wa myelosuppression. Makamaka zofunika kulabadira chiwerengero cha othandiza magazi kuundana ndi neutrophils.
2. Muyeneranso zonse akuchita ndi mkodzo mayeso pamaso pa achiyesa maselo ofiira a magazi. pamaso pawo zimachititsa kuti chitukuko cha matenda monga hemorrhagic cystitis. Pa kudziwika zizindikiro kuchitiridwa ndi "Cyclophosphamide", mtengo limene tatchula, muyenera kusiya.
3. Chiwerengero cha othandiza magazi kuundana (osakwana 100,000 / ml) ndi / kapena maselo oyera (<2500 / L) wa kutanthauza kulandira ayenera kusiyidwa.
4. Pamene matenda amapezeka mu nthawi ya mankhwala, anati chithandizo ayenera anasiya kapena linasokonekera. Kapena mu nkhani ya kulandira mlingo ayenera kuchepetsedwa. Amuna ndi akazi pa ndondomeko chithandizo, "cyclophosphamide" M'pofunika kugwiritsa ntchito njira yodalirika kulera.
5. Pa mankhwala ndi mankhwala ayenera kuti musiye mowa.
6. Ngati kumene papite masiku khumi pambuyo opareshoni, yemwe anachitika pogonekedwa ndi mankhwala ambiri, ndipo wodwalayo kuti Kwalamulidwa "Cyclophosphamide", mtengo limene tatchula, muyenera awadziwitse dzanzi anamuyika.
7. Wodwala pambuyo unachitikira adrenalectomy, m'pofunika kuchita atanyamula kusintha mlingo monga corticosteroids, amene amagwiritsa ntchito ndondomeko m'malo mankhwala, ndipo ngati mankhwala, monga mankhwala, "Cyclophosphamide".

kusamalitsa kofunika

Phwando la mankhwala n'chotheka kuyang'aniridwa ndi dokotala amene amadziwa mankhwala amphamvu. Kuyenera okhwima zoletsedwa ndi boma mlingo. Izi zichitike makamaka mankhwala osakaniza. Komanso, safuna nthawi anawaonjezera kuwirikiza kawiri lotsatira mlingo ngati m'mbuyomu anali ataphonya. Pokonza mankhwala ntchito makanda ali osavomerezeka ntchito diluents amene ali benzyl mowa. Popeza kuti zimenezi kungachititse kuti chitukuko cha amapha matenda oopsa. Ndiko kuti maonekedwe a acidosis kagayidwe kachakudya, CNS maganizo, kulephera kupuma, kulephera aimpso, hypotension, khunyu, intracranial kukha magazi.

Pa nthawi yonse ya mankhwala tikulimbikitsidwa kuchita magazi (1 nthawi pasabata 100-125 ml). Izi zichitike ndi cholinga kupewa matenda monga hyperuricemia ndi nephropathy, ndilo chifukwa mapangidwe kuchuluka ndalama asidi uric. zizindikiro zambiri zinachitika pa chiyambi cha nyengo mankhwala. Komanso, isanafike anati mankhwala ndi pa mawola 72 makonzedwe tikulimbikitsidwa kuchita zina madzimadzi wambiri (pafupifupi 3 malita pa tsiku), ntchito allopurinol (milandu wapadera), ndi njira zimene anapanga mkodzo zamchere. Pakuti kupewa kuwonekera kwa hemorrhagic cystitis zambiri zofunika kuchita kunali a chikhodzodzo ndi kutenga "UROMITEKSAN". Ngati pali zizindikiro koyamba matenda, mankhwala anati kukonzekera ayenera kusiyidwa mpaka kuwonongedwa kwathunthu kwa zizindikiro zilizonse.

Kuti attenuate mtundu dyspeptic zochitika akhoza kutenga cyclophosphamide mu tsiku loyamba pa mlingo yaing'ono. Complete kapena tsankho alopecia, zomwe zingachitike pa mankhwala ndi kusintha ndipo pambuyo Maphunzirowa yafupika ntchito ya kukula yachibadwa tsitsi. Komabe, mtundu wawo ndi dongosolo zikhoza kukhala kusintha.

Ngati mwakumana ndi kuzizira, kutentha thupi, chifuwa kapena hoarseness, kupweteka dera m'munsi kumbuyo, kapena mbali kupweteka kapena zovuta pokodza, magazi kapena magazi, chimbudzi chakuda, magazi m'manyi kapena mkodzo ayenera yomweyo dokotala.

Kutheka thrombocytopenia, zikubweretsa kufunika kusamalidwa pa zinthu monga njira olanda ndi pochotsedwa mano. Ndi nthawi zonse tiyenera kuyendera khungu ndi nembanemba mucous ndi malo mtsempha. Izi ziri mwa dongosolo kudziwa zizindikiro za magazi. M'pofunikanso kuchepetsa pafupipafupi venipuncture ndi kukana mu mnofu jekeseni. M'pofunika kulamulira zili magazi mu ndowe, masanzi, mkodzo. Odwala ndi kusamala kwambiri ayenera kuchita bulashi ndondomeko, zozipakapaka, dentifrices, toothpicks, etc. malo Pa nthawi yomweyo ayenera mosamalitsa kupewedwa mathithi ndi kuvulala ena. asidi Acetylsalicylic ndi mowa komanso analetsa kuti azitaya magazi m'mimba. Pankhaniyi m'pofunika kukhazikitsa akuchedwa katemera ndandanda (pambuyo pa miyezi 3-12 pamene womaliza mankhwala amphamvu Inde kutsiriza). Ndi zofunika kuti musayandikire odwala matenda. Pa mankhwala m'pofunika kutsatira miyezo chokwanira kulera.

Pamene polumikizana anati mankhwala ndi mucosa kapena khungu ayenera bwinobwino rinsed ndi madzi opanda gawo kapena ndi sopo ndi, motero.

Kuyamwitsa ndi mimba

Pali malire achilendo pankhaniyi, amene ali "Cyclophosphamide". Buku limasonyeza kuti contraindicated ndi ntchito mankhwala pa mimba. Pankhaniyi, gulu la zimakhudza motani mwana wosabadwayo amaimira «D» mwa FDA. Pa mankhwala m'pofunika kuti isiye yoyamwitsa.

ambiri osokoneza

Pankhaniyi, pali mfundo zina zabwino. Pamaso pa adakalibe enieni ndi ambiri osokoneza wa anati chiphunzitso sakudziwika. Zimenezi odalirika. Mu ntchito ambiri osokoneza ayenera kugwiritsa miyeso akuthandiza kuphatikizapo chithandizo choyenera cha matenda opatsirana, komanso limapezekapezeka mtima ndi / kapena myelosuppression.

zinthu yosungirako

Pa nkhani imeneyi, pamafunika zinthu zina kukonzekera monga "Cyclophosphamide". Malangizo ntchito ikuti kuti ziyenera kusungidwa kutentha osati choposa 10 ° C mu malo amene ali ouma ndi otetezedwa ku kuwala. Kupeza uyu ana ayenera koletsedwa.

moyo alumali

Pali ena nthawi imene ngati mankhwala angagwiritsidwe ntchito ngati "Cyclophosphamide". Malangizo ntchito limasonyeza kuti moyo wake ntchito ndi zaka 3. Pankhaniyi, muyenera kutsatira zinthu zina. Iwo kwagona kuti koletsedwa ntchito mankhwala itatha nthawi iyi chimagwira.

kukhazikitsa

Ku mbali iyi, palinso chikhalidwe chimenecho ndi "Cyclophosphamide". Malangizo pa ntchito limasonyeza kuti mankhwala adzamasulidwa okha pharmacies ndi mankhwala.

Pomaliza

Mu lembali, pali zambiri zothandiza. Ndipo kodi ndi "Cyclophosphamide", malangizo ntchito, mtengo wa mankhwala. Komabe, munthu ayenera kukumbukira kuti patsogolo ntchito mankhwala ayenera kuonana ndi dokotala wodziwa bwino.