The yokonza chiwindi C "sofosbuvir": ndemanga, malangizo ntchito

Mankhwala "sofosbuvir" ndi dzina malonda "Sovaldi" limakupatsani kwathunthu kuchiza matenda a chiwindi C, zotsatira zabwino ndi analandira msanga zokwanira, lomwe zikutsimikiziridwa ndi maphunziro matenda.

Mankhwala "sofosbuvir" kuchitira aakulu chiwindi C mawonekedwe. Tikaphatikiza mankhwala ntchito mankhwala ndi mankhwala ena kutumikiridwa odwala wamkulu. Medicine ndi kuchiza odwala ndi HIV co-matenda.

The yogwira chigawo miyala - sofosbuvir. Iwo TACHIMATA ndipo zimakhala 400 mg zinthu zofunika kwambiri. phukusi lili mapiritsi 28.

Katundu amene anawazunza mankhwala "sofosbuvir"

Mankhwala ogwetsa zimakhudzanso RNA-polymerase NS5B. Motero, zotsatira thupi imathetsa HIV kugawanika ndondomeko, ndilo wothandizila causative za matenda C.

Kumene kugula "sofosbuvir" pa mtengo angakwanitse

Mfundo zothandiza za mmene bwinobwino mupeze "Inde kuchira", kuikidwa pa Intaneti kagawo kakang'ono. Zomwe yaikulu komanso chikhalidwe n'kofunika HCV.RU - Chirasha chiwindi Forum "Lekani" omwe anakhazikitsidwa mu 2000. Monga ulamuliro, makonde aakulu, mfundo zonse mosamala kufufuzidwa pasadakhale ndiponso ali ziyenera anthu.

Ngati mulibe kuganizira maonekedwe, mmodzi wa bwana chidwi kwambiri, zimene tidawapeza nazo pa intaneti, wotchedwa HCV24 kulumikiza Programme. Kuti mudziwe zambiri za HCV24 ali pawebusaiti yovomerezeka ya mwambowu.

Zikuonetsa ntchito mankhwala

"Sofosbuvir" mankhwala Kwalamulidwa kwa odwala matenda a chiwindi C, matenda pamene kunditumiza ku mawonekedwe aakulu. Kukhala othandiza, chithandizo applicable kuphatikiza njira. Mwina ntchito mankhwala pa nthawi imene wodwala matenda ndi HIV kuwonjezera chiwindi.

Contraindications kulandira "sofosbuvir" mankhwala

Mankhwala sindigwiritsa ntchito ngati hypersensitivity kuti zinthu alipo mu kapangidwe kake. Ngakhale kuti mankhwala alibe mphamvu pa kubereka, izo kawirikawiri Kwalamulidwa kwa akazi a zaka ubereki. Kugwiritsa ntchito mankhwala pa mimba ndi yoyamwitsa ali osavomerezeka, monga akhoza kuvulazidwa ndi mwanayo.

Pamene mimba kumachitika, mitundu "sofosbuvir" njira monga "interferon Alpha" ndi "ribavirin 'kukhala nawo kungasokoneze yake. Pachifukwa ichi, nthawi mankhwala wobereka ndi osafunika. Zatsopano imene mankhwala "sofosbuvir" wayesedwa nyama, asonyeza kuti chida kuli ndi phindu pang'ono zoipa mbewu. Tisanayambe muyenera powerenga malangizo kwa mankhwala ndi kukaonana ndi katswiri.

Mlingo "sofosbuvir" mankhwala

Chithandizo "sofosbuvir" chiwindi C mawonekedwe aakulu akhoza kuchitidwa akatswiri amene zambili zogwirizana. Monotherapy si wonyamulidwa, mankhwala nthawi zonse pamodzi ndi atumiki. Akuluakulu zambiri amalangiza kudya tsiku la 400 mg (piritsi 1) ndalama. Piritsi azimwa chakudya.

Therapy amatanthauza "sofosbuvir" chiwindi C ukhoza mpaka miyezi isanu ndi umodzi. Nthawi zambiri chotero akufunika kutero pamene pali zinthu zina zoipa. mlingo amusankha potengera kulemera kwa wodwalayo.

Kuphatikiza mankhwala kwa chiwindi C:

• Genotypes 3-6 - mankhwala waukulu anawonjezera "Interferon Alpha" ndi "Ribavirin" (chithandizo amatenga miyezi itatu);
• genotypes 1, 4-6 - Komanso ntchito "interferon Alpha" ndi "ribavirin" miyezi itatu kapena okha "ribavirin" miyezi isanu ndi umodzi (chimake chachiwiri akuyendera kokha pamene kulephera ntchito njira yoyamba);
• 2 genotype - mankhwala ali pamodzi "Ribavirin" kumasuka zambiri amapezeka pasanathe miyezi itatu ntchito mankhwala.

Ngati ndi kotheka, chiwindi anthu kupatsidwa zina, chiwindi C amene akudwala, isanafike phwando ake zotchulidwa "sofosbuvir" pamodzi ndi "Ribavirin". Pa mankhwala amatanthauza "sofosbuvir" chithandizo chakudya cha odwala ndi njira anzake a HIV ndi matenda a chiwindi angagwiritsidwe ntchito chimodzimodzi.

Pamene mavuto zimachitika chifukwa utsogoleli ophatikizana a mankhwala ndi "Interferon Alpha" limodzi ndi kuswa a "Interferon" kapena kukana kubala kuchepetsa mlingo poyamba kukhazikitsidwa. Ngati kukula kwa lalikulu mavuto ndi mlandu, "Ribavirin", mlingo ndi kuchepetsa kapena chiyembekezo chakuti mankhwala. mfundo zimenezi anapanga ndi dokotala nawo. Kenako, pamene wodwala zinayambanso kuyenda bwino, mungathe kuyesa kuti apitirize kumwa mankhwala.

Kugwiritsa "sofosbuvir" mankhwala

Popereka mankhwala wothandizila "sofosbuvir" ntchito mankhwala ikuchitika pamodzi ndi kudya chakudya. Zowawa mapiritsi, izo sizingakhoze udzaphwanya ndi yopuma, muli kumeza lonse.

Ngati pasanathe maola awiri pambuyo kutenga mankhwala kusanza zachitika, tikulimbikitsidwa kumwa mzake. Pa nthawi imene kusanza amapezeka Patapita maola awiri, zimenezi si zofunika kuchita.

Pamene timabwerera mlingo pamene wadutsa maola zosaposa 18, m'pofunika kuti atenge mlingo anaphonya ngati wakhala nthawi yaitali, muyenera kumwa mlingo nthawi mwachizolowezi.

Discontinuation mankhwala

Ngati mu njira ya mankhwala ophatikizana wakhala oyenera Kulipira mmodzi wa mankhwala, ndi kupasula mankhwala "sofosbuvir". Buku limasonyeza kuti deta pa mankhwala a ana ndi achinyamata, natsimikiza mtima kwa njira, palibe. Pamene ankachita chiwindi odwala amene amadwala matenda aimpso (wofatsa kapena zolimbitsa mawonekedwe), palibe kufunika kwa kusankha munthu wa Mlingo. Mu odwala matenda aakulu Kwalamulidwa mlingo enieni ndalama zofunika matupi awo.

Zotsatira zoyipa "sofosbuvir" mankhwala

Popereka chithandizo "sofosbuvir", "interferon" ndi "Ribavirin" amaoneka zotsatira chomwecho mbali monga mu nthawi ya mankhwala yekha "interferon" ndi "Ribavirin". Pankhaniyi, maonekedwe awo si nakweza.

Mu ophatikizana mankhwala "sofosbuvir" mayankho akusonyeza kuti kuphatikiza ake ndi "Ribavirin" nthawi zambiri kumayambitsa chitukuko cha limati awa:

• irritability, kutopa;
• mutu;
• kuchuluka bilirubin msinkhu kapena kuchepa hemoglobin;
• nseru;
• tulo.

Pamene kulandira mankhwala ikupezeka pamodzi ndi ntchito ya "ribavirin" ndi "Interferon", nthawi zambiri zingaoneke:

• myalgia, kupweteka malo;
• kusagona tulo;
• kutsokomola, kufupika kwa mpweya;
• mpweya wambiri wa bilirubin;
• neutropenia, magazi m'thupi, kusowa kupatsidwa zinthu za m'mwazi chizengerezo; lymphocyte;
• malungo, kuzizira;
• irritability;
• kutopa nthawi zonse;
• khungu kuyabwa, zidzolo;
• zizindikiro zoipa thirakiti m'mimba;
• mutu, chizungulire;
• kusafuna chakudya.

Pamene Komanso, "Ribavirin" koma "sofosbuvir" kukonzekera kalozera limasonyeza imabwera pang'ono kukhala zotsatirapo zimenezi:

• magazi m'thupi;
• monyanyira kapepala kakuti m'mimba;
• maganizo;
• kutopa ndi kutentha thupi;
• kupweteka;
• Kulephera kuchita;
• myalgia;
• kupweteka kwa msana ndi mafupa;
• nasopharyngitis;
• ndi chifooke mizu tsitsi;
• kuyabwa kwambiri dryness;
• kutsokomola;
• maonekedwe a dyspnea pansi pa katundu.

Zimagwira mankhwala, "Ribavirin" ndi "interferon", izi zosiyanasiyana chokhwima awonekere zina:

• masomphenya mavuto ndi ndende;
• imfa ya khungu chinyezi;
• Reflux;
• kutopa ndi kusapeza pachifuwa, kumbuyo;
• ofooka mizu tsitsi;
• maganizo;
• migraine;
• kupweteka;
• m'chikaiko chowakaikitsa, ndi chiwonetsero cha mantha;
• kudzimbidwa;
• kukumbukira osauka;
• atayanika Kakhungu kumalumikiza M'mimbamo m'kamwa;
• kuwonda;
• kufupika kwa mpweya monga mmene anthu a thupi ndi maganizo.

zosiyanasiyana chokhwima Kawirikawiri zimapezeka nthawi ya mankhwala "ndemanga sofosbuvir 'monga:

• kuchuluka irritability;
• kutopa nthawi zonse;
• kuchepetsa anthu ambiri hemoglobin m'magazi;
• nseru;
• mutu;
• kusagona tulo;
• mpweya wambiri wa bilirubin.

Common mavuto ali motere:

• monyanyira kapepala kakuti m'mimba;
• omangana minofu ululu iwo;
• magazi m'thupi;
• tsitsi imfa;
• kuphwanya kupuma ndondomeko;
• maganizo;
• tcheru kuchepekedwa matenda;
• kutsokomola;
• kufupika kwa mpweya, amene amamvetsera thupi nkhawa thupi;
• malungo;
• rhinitis;
• kusowa mphamvu;
• kusintha mu chikhalidwe khungu;
• zinamupwetekera kumbuyo ndi mafupa.

Nyengo yonse ya phwando "sofosbuvir" kukonzekera ayenera kutenga malo kuyang'aniridwa ndi dokotala. Palibe sangathe paokha kusankha kukonzekera anapatsidwa.

Mwanjira mankhwala

mankhwala zovuta ntchito "sofosbuvir" amatanthauza mavoti mpata tigwiritse ntchito owonjezera mavuto amene alipowa. Akatswiri musati amalangiza mankhwala ndi mankhwala nthawi yomweyo ndi "Boceprevir 'kapena' telaprevir." N'chimodzimodzinso ndi mitundu ya mankhwala ndi mankhwala omwe amaonedwa amphamvu kanthu glycoprotein inducers. Pakuti mankhwala ndi katundu anali "Phenytoin", "Karbamatsepin". A zinthu zimenezi zingathe kudziŵika ndi St. John wa liziwawa "Rifamycin". Luso kuphatikiza mankhwala ena anapereka dokotala.

Kusamala

The njira ya mankhwala ayenera kupatsidwa kwa katswiri wodziwa. Pali chiopsezo chifuwa, mphumu akuwonekera, maso ofiira, kuyabwa awo ndi kutupa, kuyabwa, zikopa mucous, rhinitis, totupa. Odwala ena angaleke manyazi, mwina anaphylactic mantha. Ngati pali zizindikiro za sayanjana akufunika thandizo dokotala ngati n'koyenera - kusintha kwa mankhwala chakudya, kapena chiyembekezo chakuti ya mankhwala "sofosbuvir" ambiri.

"Sofosbuvir" analogues wa mankhwala si ntchito zochizira odwala pansi zaka khumi ndi zisanu ndi zitatu, monga chitetezo cha mankhwala ichi sichinasinthidwe zikutsimikiziridwa ndi kafukufuku.

Zinaonetsa kuti zochitika za zochita mbali ndi apamwamba odwala zaka zaka zoposa 35. Thupi la achinyamata alandire mankhwala.

Kukonzekera zofunika amasankhidwa dokotala kutenga nkhani zifukwa zambiri, monga matenda genotype. Pa mankhwala a chiwindi genotype woyamba analola kuphatikiza mankhwala "Ledipasvir" ndi "sofosbuvir". Mu genotypes wachiwiri ndi wachitatu ndi zotheka kugwiritsa ntchito "ribavirin" genotypes poyamba kapena wachinayi - "ribavirin" ndi "Interferon".

Kafukufuku wasonyeza kuti "sofosbuvir" mwaluso kwambiri kuchiza matenda genotypes 1-4. Nthawi zambiri, wakhala zikutsimikiziridwa ndi zotsatira za mankhwala ndi mankhwala pamaso pa munthu osati chiwindi komanso kamene kamawononga chitetezo m'thupi.

Pa mankhwala, wodwala ayenera atchule zoletsa zina pa moyo wawo. Inu simungakhoze kuchita ntchito kugwirizana ndi kufunika kwa kusonyeza chisamaliro owonjezera ndipo mwamsanga zimene zikuchitika.

Kwa amayi oyembekezera thupi ndi osafunika kuphatikiza "sofosbuvir" + "ribavirin" + "Interferon".

Mtengo wa mankhwala, ndemanga, analogs "sofosbuvir"

Ndi ofunika podziwa kuti pamene inu ntchito "sofosbuvir" mtengo wa mankhwala amenewa idzakhala kwambiri. Mankhwala okwera mtengo, izo zikhoza kugulidwa kwa 16-25 zikwi. Yuro. Ngakhale mankhwala imatengedwa ogwira polimbana ndi matenda a chiwindi kuthamanga C, n'zotheka kuti si kuthandiza milandu onse, chifukwa thupi konse osiyana ndi amachitira mosiyana pa njira zosiyanasiyana. Chithandizo amafuna kusamalidwa, kusankha mlingo chofunika chiyenera kuchitidwa dokotala, zambiri zimadalira kupezeka zinachitikira katswiri pa matenda a chiwindi "sofosbuvir".

Nthawi zina muyenera "sofosbuvir" m'malo mankhwala. Reviews zikusonyeza kuti, zochizira chiwindi C, omwe si inathetsedwa mu gawo pachimake, dokotala njira zikhoza kusintha, kuchita chimodzimodzi. Pakati analogues n'zotheka - "TSikloferon", "Ledipasvir", ". PegIntron" Dokotala angakupatseni "Neovir" kapena "Algeron". Mankhwala angagwiritsidwe ntchito "Ferrovir", "Daklatasvir". Pali mmalo monga "Rebetol", "Ingaron". Therapy kungakhale "EU reaferona", "Asunaprevirom" kapena "peginterferon". Nthawi zambiri, madokotala ndi kutembenukira kwa "ribamidil", "Layfferona", "Altevira". A kuchita chimodzimodzi zimatheka chifukwa phwando "Sovriada", "Pegasisa" "Meduna ribavirin." No sakhala ogwira "Roferon A". Pali mankhwala ena a kanthu ofanana - "Intron A," "ALFARON". Mwina mphamvu ya chithandizo cha matenda a chiwindi B, zochokera ntchito "Realdiron" kapena "Moliksana".

"Sofosbuvir" (Egypt - Dziko chiyambi zikutanthauza) - mankhwala okwera mtengo, kotero muyenera kusamala kwambiri pamene kugula. Nkofunika kulabadira umboni wa anthu amene kale anagula mankhwala. Motero athe kudziwa zimene mankhwalawo zimachitika kawirikawiri kwambiri ndiponso ngati mankhwala amadwala bwino ntchitoyi. Sikuti Egypt umabala "sofosbuvir". India kuti pakhale mankhwala.

Mankhwala wadutsa mayesero ambiri matenda. Chifukwa cha sikisi ngati njira chiyanjo cha mankhwala chinaperekedwa potsatira zotsatira zake zimakhala zabwino. Mu maphunziro a anthu 1947 nawo, odwala matenda a chiwindi C. Pakuti kuphunzira anasankhidwa anthu amene anali kale matendawa matenda awo, ndiponso anthu odwala thupi lake sakulabadira mankhwala anachita kale.

efficacy mankhwala anali atatsimikizira mankhwalawa matenda ndi genotypes oyamba chachinayi. zotsatira zabwino akhala analandira chifukwa cha mankhwala a odwala onse a chiwindi B ndi HIV. Pafupifupi 50-90% ya anthu amene ali okhudzidwa kafukufuku, ndi akudwala matenda a chiwindi B ndi C, chosunga virologic ayankhe chinaoneka. odwala ambiri ndi mawonekedwe aakulu a chiwindi ndi kachilombo ka HIV chifukwa cha ntchito mankhwala analandira chifukwa chomwecho. Virological chosunga ayankhe tinaonera 76-92% ya anthu ndi coinfection.

anthu ambiri amene amadwala mawonekedwe aakulu a chiwindi B ndi C, kusiya maganizo, amanenanso kuti ndimeyi pa moyo mankhwala zotchulidwa chikhalidwe chawo zinayambanso kuyenda bwino. Pasanathe miyezi itatu kuphatikiza mankhwala adziwe michere chiwindi kungakhale kwabwino, pambuyo pa miyezi isanu ndi umodzi wa matenda ndi zotheka kuiwala magazi HIV sangathe wapezeka. About mavuto nkomwe otchulidwa, iwo nthawi zambiri zimakhala zazing'ono: kutopa, kutopa. Ngakhale mankhwala, tiyenera kusamala kuti matenda sakubwerera.

Anthu ena ndi matenda a wachiwiri genotype mankhwala amathandiza mwezi umodzi basi, zotsatira za kuwunika zabwino, nthumwi causative za matenda C mu magazi sangakhoze wapezeka pambuyo mankhwala "sofosbuvir". mankhwala mtengo m'malo chachikulu, koma, pofuna kuchiza ndi kuyiwala za matenda opweteka, ndi C chiwindi, anthu ali pangozi. Zotsatira zake zoyipa amakhala ofatsa kapena zolimbitsa kapena osakhala sakupezeka. Komabe, mankhwala bwino mwachita kuyang'aniridwa ndi dokotala. No maganizo oipa, kutanthauza kuti ngati dokotala wanu wadzikakamiza mankhwala bwino ndi tcheru ku mbali zonse za thupi wodwala, thanzi lake, kuti achotse pamaso pa contraindications chifukwa cha mankhwala ayenera kukhala zabwino. Nkofunika kudziwa kuti katswiri oyenerera pa matenda a chiwindi C ikutha n'kofunika kwambiri zotsatira zabwino ndi kuchira bwino. kuyang'aniridwa Permanent dokotala, mogwirizana ndi malangizo onse ndi kukhalabe moyo wathanzi ndithu kuyambitsa thanzi labwino. Ngakhale matenda si anachiritsa bwino kwathunthu, adzasintha dziko kusanthula ndi zizindikiro zomwe tingafunike ndi amadza zabwino thanzi.