"Endoxane": mirayiridzo kushandiswa, dzomuzana chaidzo, mugadziri

Drug "endoxane" rinoreva boka Anti-bundu nevamiririri. Zvichienderana chimiro yokusunungurwa inogona kupiwa nomuromo kana parenterally. Kworudzii zvinodhaka kugadza uye chii chipimo chemushonga, anogadziriswa chiremba chete pachishandiswa chaiko ezvinhu murwere ezvinhu.

Murwiyo uye zvivako zvinodhaka

The chikuru vanoshingaira wemafuta mushonga "endoxane" mirayiridzo kushandiswa zvinoreva cyclophosphamide. Rimwe hwendefa rine 50 MG nayo. The mushonga anoreva boka antitumor madhiragi uye ane biconcave mahwendefa ane chena hamvuropu uye chinoumba chete Hue. Sezvo mamwe zvinoriumba vanoshingaira mishonga chigadzirwa dzine karusiyamu carbonate uye rehydrogen phosphate, yavaibvisa karamellozu, glycerol, gelatin, lactose, chibage starch, macrogol, magnesium stearate, polysorbate, sucrose, talc, silica uye titanium.

Chii pharmacology zvinodhaka?

Huru vanoshingaira zvinodhaka fuma, zvinoti cyclophosphamide, alkylating uye ane cytostatic nomugumisiro. By pezvawakaita, zviri pedyo wetsanga gasi senitrogen kuva kwayo analogue.

The mashandiro chiito kuti cyclophosphamide kwakavakirwa paumbwe crosslinks pakati DNA molecules uye RNA uye mapuroteni usage kudzvanyirira miviri.

The pharmacokinetics zvinodhaka

Huru vanoshingaira chirungiso "endoxane" mushonga une kutopedza mwero absorbability kubva nemudumbu. wevasungwa Its muropa mushure nemumuromo uye intravenous Kutarisirwa ndiwo chete. Cyclophosphamide muviri kunoitika achinyanya ari chiropa, apo achifuridzirwa microsomal oxidase mashandiro ndiyo paumbwe vanoshingaira alkylating metabolites. Vamwe vavo vari vatendeuka kupinda basa siyana, rimwe boka riri dzapinda mumasero, uko enzymatic zviito phosphatases kuva zvinhu pamwe cytotoxic ehupfumi.

The mwero nokusungwa yepakutanga chimiro mushonga neropa mapuroteni riri kunyora nezvavo uye uri 12-14%. Zvisinei, zvakafanana chinoratidza metabolites kare zvinotipa 60%.

cyclophosphamide zvinoberekwa renal excretion kunyanya dziri metabolites. Inenge 5-25% zvinodhaka riri yabudiswa kwaro chepakutanga muchimiro iri weti uye bile.

Parameter T1 / 2 zvinodhaka vakaenzana maawa 7 vakuru uye 4 maawa vana.

In chii dose mushonga?

Drug "endoxane" iri pahwendefa muchimiro wakatorwa nomuromo pamberi kudya kana yeawa hafu pashure pokudya, pashure 2 maawa.

Nokuti kuti mishonga chigadzirwa dziri vakawanda chemotherapeutic regimens, kusarudzwa kwadzinoita kuunganidza uye chipimo chemushonga chiremba vaiona nomumwe.

"Endoxan" - piritsi - gwaro rinorumbidza chipimo chemushonga 1-3 MG / makirogiramu muviri uremu pazuva, izvo zvingava 50 kusvika 200 MG cyclophosphamide kwemaawa 24. Ya kurapwa vhiki 2-3.

Kana mushonga chinobviswa pamwe nemamwe zvinodhaka kuti vane Anti-bundu ehupfumi, kuti chipimo chemushonga dzose zvinhu yokurapa kaviri kururamiswa.

Pangava imwe ovhadhozi?

Kuvapo chairo mushonga mukugadzirwa "endoxane 'mirayiridzo kushandiswa haina yasimbiswa. Kana kwazvo zvinodiwa dose rakarumbidza yokuzvigadzirisa kurapa sezvo zvakakodzera kurapwa kwezvirwere zvinotapuriranwa, ucharwadziwa cardiotoxicity uye myelosuppression kubviswa.

Somunhu mushonga unobatanidzwa pamwe nemamwe zvinodhaka?

Kana murwere anotora nzira afunge microsomal oxidation ari chiropa, ipapo zvikabatanidzwa kurapwa pamwe zvinodhaka "endoxan" mirayiridzo zvinoratidza rakawedzera kwetunhu metabolites pamwe alkylating basa, ungaderedza hafu-upenyu cyclophosphamide uye kuwedzera kunyatsoshanda kwayo.

mushonga uyu kuchititadzisa cholinesterase basa uye metabolic gwara cocaine, kuwedzera toxicity kwayo, uye inowedzera kunyatsoshanda kuti suxamethonium.

Kana "endoxane" rinoshandiswa pachiimbwa "Allopurinol" kuti pane ichiwedzerwa ayo Migumisiro pamusoro mumwongo.

Kana mawa kurapwa pamwe cyclophosphamide, colchicine, probenecid, sulfinpyrazone chiremba kazhinji anomururamisa dose Anti-gout zvinodhaka. Izvi chokuita zvakawedzera ngozi nephropathy pakushanda pamwe kushanda "endoxane" pamwe uricosuric zvinodhaka.

Cyclophosphamide kunoderedza kwetunhu zvinhu zviri chiropa, zvisinei vane basa kweropa uye platelet kugadzirwa,, apo kurapwa pamwe anticoagulants zvinoderedza basa yokupedzisira.

Varwere kutora zvinodhaka "endoxan" mirayiridzo Chinyorwa anokurudzira zvokudya dzakakudzingai bhuratifuru muto, sezvo rine hurongwa kuti kutyora activation kunyatsoshanda uye huru vanoshingaira wemafuta ari medicament.

Kana mushandirapamwe raitongwa ne cyclophosphamide "Doxorubicin" kana "daunorubicin" iri yakakura cardiotoxic zvinokonzerwa zvinodhaka izvi.

Pamwe nemamwe immunosuppressants akadai "Azathioprine" "Tacrolimus", "Chlorambucil", "SSC", "Merkapturin" kunotungamirira nokuwedzera panowanikwa yechipiri noutachiona uye bundu mhando.

Kana kwemajoini kushandiswa "endoxane" uye "Lovastina" pavarwere vane mwoyo transplantation kungava nengozi rhabdomyolysis uye renal kukundikana zvine rikwanise muchimiro.

Kana kurapwa pamwe cyclophosphamide pamwe mielosupressantami kana nemwaranzi marapiro, zvinokwanisika kuti vawane ugneeniya mwongo chaitika.

Mawa kugamuchira "endoxan" dzakakwirira-dose cytarabine munguva regadziriro manipulations kuti mwongo transplantation kunowedzera kuitika dzinouraya cardiomyopathy.

mushonga uyu ari dzokubereka nerevane sei?

Drug "endoxane" uchapupu murefu kuzviratidza, kungakonzera kusabereka pavarwere vose varume navakadzi, izvo zvinogona kusingarapiki.

Kazhinji, vakadzi amenorrhea kunoitika, asi kazhinji kumwedzi nenguva kupora mumwedzi mishomanana pashure kurapwa pamwe cyclophosphamide. Kana mushonga wakange kuitwa vasikana prepubertal, zvarakasiya kukura yechipiri kuratidzwa dzepabonde dzakanga kuchengetwa. Kutevera zvakajairika, wembereko chakarasika.

In pakurapa munhurume zvinodhaka "endoxane" mirayiridzo zvinoratidza kuti mune zvimwe zviitiko zvakanga kushumwa azoospermia kana oligospermia. Izvi imhaka chichiwedzera kugadzirwa gonadotropins pamwero wenyika testosterone kusunungurwa. libido vaenzane uye potency nevanhu hakuna ipfupi. Kana kurapwa pamwe cyclophosphamide anobudiswa prepubertal Vakomana, ari obazovanie yechipiri kuratidzwa zvepabonde zvakaitika kupengereka. Zvisinei, zviitiko azoospermia, oligospermia uye kuvandudzika pamusoro gonadotropins kunge akacherechedza. It anokwanisika kuitikawo testicular atrophy. Zvinokosha kucherechedza kuti azoospermia riri reversible, kunyange zvazvo kuzoita kuti mashandiro kunogona kuitika mukati makore mashomanana pashure kuguma kurapwa.

Ndezvipi parutivi migumisiro zvinodhaka?

Kunwa mushonga "endoxane 'mirayiridzo kushandiswa akatsinhira, zvinogona kukonzera zvimwe zvirwere zviri hemopoietic hurongwa:

• Leukopenia, neutropenia - kazhinji.
• Ishoma vari kupererwa neropa uye thrombocytopenia.

Pashure pevhiki 1-2 kubva pakutanga kurapwa, murwere akaratidza kufadza rutapudzo pamusoro leukocytes uye maplatelet neropa. parameters aya vakadzorerwa chaiko mukati memazuva 7-10 kuguma yokurapa.

In marapirwo pamwe cyclophosphamide kunogona kukonzera divi zvinoitwa nemudumbu:

• Svoto uye kurutsa.
• Anorekisya.
• Stomatitis.
• Kurwadziwa abdominal nharaunda.
• Chetsoka hadzina kufambiswa zvakanaka.
• Jaundice.
• Hemorrhagic colitis.

Kashoma kuitika chiropa dysfunction chokuita rakawedzera mabasa makemikari uye bilirubin mumatunhu kumukazve. Zvikuru boka guru varwere vane aplastic kupererwa neropa uye kugamuchira mukuru-dose "endoxane" kana tichienzanisa nokuripisa busulfan anoti endoflebit hepatic mutsinga. Fani iyi inogona kuitika 1-3 mavhiki pashure mwongo transplantation uye kunoratidzwa muna unopinza kuwedzera body mass, ascites, hepatomegaly uye hyperbilirubinemia, hepatic encephalopathy.

mushonga asati anogona kukonzera zvisingadiwi chinja ganda:

• Reversible alopecia.
• Mapundu.
• The pigmentation ganda uye nezvipikiri.

It rinogonawo kukonzerwa kutyora Urinary wemuTesitamende kurapwa zvinodhaka "endoxane". Instructions, wongororo vanachiremba uye varwere kunoratidza zvakasiyana inoti:

• Cystitis pamwe fibrosis dundira (kana pasina izvozvo).
• Hemorrhagic urethritis.
• Necrotic mananara tubule kusvikira parufu.

In weti, murwere anogona kuonekwa kubudikidza epithelium nezvezvimwe zvinetso zvedundira dundira. Kana chimiro kuti Hemorrhagic cystitis inorema, kumisa achitora zvinodhaka. The yakanakisisa kudzivirira ichi ndiyo mishonga "Mesna". Kana "endoxan" dose yakawedzera, angatanga itsvo dysfunction sezvo nephropathy uye giperurekemii.

Kana murwere ane kwazvo mwero immunosuppression, ipapo Mabatirwo cyclophosphamide tinganetseka zvirwere zvakakomba.

Uyewo angatanga zvinotevera nemishonga:

• Cardiotoxicity (matunhu mishonga), zvikuru mwero mwoyo kukundikana.
• Pulmonary fibrosis, interstitial zvisikwa.
• Nokuvhiringidzirwa spermatogenesis uye oogenesis, reversible uye kusingarapiki kusabereka.
• Kukura yechipiri nyanyisa neoplasms akadai nekenza dundira, mieloproliferatsiya uye lymphoproliferation.
• Chisimbwa sezvo mapundu, kuvaviwa, urticaria, dzimwe nguva muchimiro ane anaphylactic kuita.
• Murombo ronda kuporeswa.
• Chiso Flushing, vangadikitira, nomusoro.

Kuvapo chakakomba nemishonga kutora zvinodhaka tinongogara anomutsa mubvunzo pamusoro kubatsira kurwisa zvichibvira pangozi nokuda nomumwe murwere.

Ndezvipi zvirwere varayire chinodhaka ichi?

Mahwendefa "endoxan" Ingapiwa murwere kana ane zvinotevera zvirwere:

• chirwere Hodgkin vake.
• Multiple myeloma.
• kenza yemazamu.
• Lymphoblastic rwekenza yelymphoma mu chakasimba kana chirwere chimiro.
• Non-Hodgkin kuti rwekenza yelymphoma mhando.
• Retinoblastoma.
• Neuroblastoma.
• Mycosis gribkovidnogo hunhu.

Inoratidza kugamuchirwe chikumbiro iri kunzwisisa anticancer mishonga vasiyana mushonga "endoxane" mirayiridzo. The mugadziri rinorumbidza kuti zvinosanganisira pakurapa gomarara uye kenza dundira, kenza yemapapu uye kenza yeprostate, sarcomas uye reticulosarcoma, zvirwere Ewing uye Wilms.

The mushonga cyclophosphamide inogona kushandiswa sezvo immunosuppressant mberi autoimmune zvirwere akafanana, psoriatic uye dzinonzi rheumatoid arthritis, haemolytic kupererwa neropa, zvirwere collagen, nephrotic urwere, uyewo kudzivisa batanidza kurambwa.

Kana mushonga wacho contraindicated?

The medicament "endoxan" ane uremu contraindications, kusanganisira:

• Pamuviri uye lactation.
• Cystitis.
• Zvirwere ari kushingaira chimiro.
• Zvaipesana mwongo inoshanda iziviswe fomu.
• Kuvapo hypersensitivity inokosha uye mamwe zvinodhaka zvinhu.
• Urinary chengetedzo.

Special hanya vanachiremba varayire mushonga ari hosha dzomwoyo, itsvo uye chiropa, zvakasimba, gout, adrenalectomy, kuvapo infiltration pezvakaitwa mu mumwongo nefrourolitiaze.

nhungamiro dzakananga pakurapa

Panguva ingestion "endoxan" pasi kwairayirwa kudzora ropa (neutrophils uye platelet count) uye weti (kuvapo masero matsvuku eropa) ane murwere.

Zvinokurudzirwa kuti kurega kurapwa "endoxane" zvinoreva mune zvimwe zviitiko. Mirayiridzo kushandisa mapiritsi akakurudzira kudaro pasi zvinotevera ezvinhu:

• Kuratidzwa zviratidzi cystitis.
• Achideredza wevasungwa pamusoro leukocytes uye maplatelet kune dzinonetsa tsika.
• Panowanikwa chirwere (dose kururamiswa zvinogoneka).

Kana "endoxane" rinoshandiswa dzakakwirira mishonga, murwere ushandiswe mishonga, "Meena" nokuti kudzivirira Hemorrhagic cystitis mhando.

In marapirwo pamwe zvinodhaka izvi zvinofanira kusanwa doro uye kushandisa yakavimbika nzira pamuviri.

Kana murwere basa "endoxan" mazuva 10 mushure pakuvhiya pamwe vakawanda yokutindivadza, kuti anesthesiologist ari kuudzwa nezvazvo.

Pashure adrenalectomy akaita dose kuchinja "endoxane" uye zvimwe zvinodhaka corticosteroids.

zvinodhaka analogues

Kana pane zvakakomba contraindications uye njodzi, ipapo aida kurega kutora mushonga "endoxane" mirayiridzo. Analogs anogona kupiwa nachiremba sezvo rakakodzera kumwe. Pakati pavo:

• "Ledoksin".
• "Cyclophosphamide".
• "Cytoxan."
• "Cyclophosphamide - din email".
• "Cyclophosphamide -Lens".
• "Endoxane - Astana".

mashoko Iyi itsanangudzo shanduro mirayiridzo mushonga "endoxane". Chinangwa zvinodhaka ichi chinoitwa chete kupinda chiremba.