Ichiza "Carboplatin": imiyalelo ukusetyenziswa, analogs kunye nohlolo

Yintoni indawo le neziyobisi "Carboplatin '? Analogs kweli chiza iya zidweliswe ngezantsi. Kwakhona le mathiriyeli kweli nqaku liza kuboniswa ulwazi malunga nokusetyenziswa echanekileyo kwezi mali bathi, imbonakaliso yayo, iziphumo ebezingalindelekanga kunye Izimo.

inkcazelo Ukwakhiwa, ukuma medicament

Ziziphi fom iziyobisi ezikhoyo "Carboplatin"? Umenzi ubanga ukuba isixhobo zingathengwa njenge ngumgubo emhlophe lyophilized yenzelwe ukulungiselela isisombululo efakwa. isithako yayo esebenzayo i carboplatin, yaye olongezelelweyo - mannitol.

Ekuthengisweni isitofu mxube "Carboplatin", ukwakhiwa kweengongoma ezahlukileyo ze esiye thaca ngentla apha, kuza zeebhotile ezibekwe ngayo ikhadibhodi ukupakisha.

iipropati kwemithi

Yintoni na ichiza "Carboplatin"? Imiyalelo ingxelo ukusetyenziswa, ingxelo leyo ezimbaxa nezintsonkothileyo ezingaphiliyo equlethe heavy metal ezifana platinum.

Iingcali zibonisa ukuba indlela inyathelo lesi sixhobo kungenxa ukukwazi layo ukubophelela DNA. Ngenxa yoko, kwasekwa vnutrispiralnye crosslinking ukutshintsha ubume DNA kwaye zinqanda yokuqaphela yayo. A nomphumela ofanayo kwenzeka nokuba lesigaba kumjikelo iseli. Kufuneka kuqatshelwe ukuba carboplatin ukuxovwa, apho wambumba uhlobo elikhutheleyo ichiza kwacotha ngaphezu ukuxovwa of cisplatin.

Entshukumo Ipharamitha medicament

ntoni emzimbeni womntu njani "Carboplatin" ukusasazwa ichiza? Imiyalelo yokusebenzisa ithi emva kokuba ulawulo olulodwa sale arhente ngohlobo ukumnika (iv) imizuzu engama-60, egazini xi simahla (ngamanye ultrafiltration iSADC) kunye ucutho platinum iyonke ngokungqinelana ne imodeli kwisigaba-ababini pharmacokinetics umyalelo wokuqala.

Ukuqalisa ixesha ezamahala platinum-ubomi malunga neeyure ezi-2, kunye terminal T1 / 2 - 3-6 iiyure. Kufuneka kuqatshelwe ukuba platinum iyonke uphawuleka efanayo ekuqaleni kwesiqingatha-ubomi, kodwa ekupheleni-it elide (malunga ngosuku).

ulawulo okuphindiweyo beziyobisi iintsuku 4 emgceni egazini ekufumbekeni platinum uyalandelwa. Emva kosuku olunye emva kokuba isicelo beziyobisi malunga nama-85% ze eyona nto esebenzayo kwi plasma lubotshelelwe imeko iiprothini.

Njani na ukuphelisa ichiza "Carboplatin"? Guide ubanga ukuba amalungiselelo lithathwe ikakhulu izintso (malunga ne-30% ye-dose kwakhululwa kwifom unmodified).

Xa abantu CS 60 ml / min nangaphezulu malunga 65% ne-70% yemveliso efumaneka wekhadi elisetyenziswa iiyure 11 no-23, ngokulandelelana kwazo.

Ekubeni ekupheliseni "Carboplatin" lwenzeka phantse yonke ukuhluza glomerular, kuphela elincane iqatshelwe tubules kwezintso, ezichaza oluphantsi nephrotoxic beziyobisi xa kuthelekiswa cisplatin.

Anticancer iziyobisi "Carboplatin": ubungqina

Kwezinye iimeko, ibonisa ukusetyenziswa kweziyobisi phantsi ingqalelo? Ngokutsho imiyalelo, kungenxa yonyango nangezilonda zilandelayo:

• umhlaza ovarian;
• umhlaza womlomo wesibeleko;
• iseli intsholongwane yamathumba e ngamadoda nabafazi;
• nee- osteogenic;
• umhlaza wemiphunga;
• medulloblastoma;
• ukudumba entanyeni kunye nentloko.

Siphelisa ukusetyenziswa sisombululo nokubandakanywa

Yintoni na ichiza Izimo uye "carboplatin"? Ukusetyenziswa kweli chiza akuvumelekanga ukuba:

• lwebele-lweehagu;
• ezimbi sezintso kakhulu (umz, CC ngaphantsi kwe-15 ml / min);
• nokukhulelwa;
• hypersensitivity ku carboplatin kunye namanye amayeza, kuqukwa i platinum;
• myelosuppression kakhulu;
• nokopha kakhulu, kuquka ezo waphawula kutsha nje kwixa elidlulileyo;
• ebuntwaneni.

Kwakhona ngononophelo le iyeza omiselwe:

• a lugonyo lwakutshanje;
• ukungase-;
• izifo sezintso;
• udandathekile hematopoiesis lomongo wethambo, kuquka nemiqathango ehamba emva radiotherapy kunye ichemotherapy;
• ukusetyenziswa engumzekelo iziyobisi nephrotoxic (umz: "Cisplatin");
• izifo ezihlasela zosulele of wentsholongwane egazini, imingxunya imvelaphi yebhaktiriya.

Medicament "Carboplatin": imiyalelo yokusebenzisa

kufuneka kusetyenziswe njani na ukuphatha i ichiza anticancer? Ngokutsho iingcali, le medicament enokusetyenziswa njenge monotherapy, okanye idityaniswe nezinye iindlela iyabuphucula ofanayo (umz, nodibaniso 'Paclitaxel "ukulungiselela).

Kuxhomekeke kubukhulu apho isigulane localized ithumba, oogqirha basebenzisa nomthamo "Carboplatin" ezahlukeneyo. Kufuneka maliqhutywe yegazi ibe nokubandakanywa phezu imizuzu 17-55.

Ndingayisebenzisa njani amayeza "Carboplatin"? Khokela iingongoma ukuba iidosi elandelayo yale sixhobo:

• 100 mg / square umzimba nomonde imitha yonke imihla iintsuku ezi-5;
• 300-400 mg / square metre yomguli, kanye kwiiveki-4.

Kufuneka kuqatshelwe ukuba lokuphumla phakathi ulawulo ichiza, xa umyinge 100 lamawaka zegazi / mm kunye 1.5 amawaka neutrophils / mm, kufuneka ibe iiveki ubuncinane 4.

Ngaphambi kunye nasemva isicelo le "carboplatin" ulwelo ekuqhutyweni olongezelelweyo ngokunjalo ekuqhubeni diuresis unyanzelekile iyafuneka.

Ukuba isigulana umntu zinetyhefu kakhulu hematological okanye ukumodareyitha kusenokufuneka ukunciphisa umthamo ichiza kwi-26%.

Xa ezimbi sezintso kakhulu kukhulisa ubungozi isiphumo zinetyhefu beziyobisi, kwaye ke ngoko ukunciphisa ithamo kususelwa kwinqanaba CC.

Xa abadala, ngokunjalo olwenziwe ngaphambili yi unyango myelosuppressive, idosi kufuneka incitshiswe nge-22-25%.

Phambi ukusebenzisa, umxube ukumnika kufuneka iqhube ukuzihlola ebonakalayo ukuze ubone enoba kukho nayiphi na ububi ngombala okanye ukungcola.

Yintoni mix powder iziyobisi "Carboplatin"? Imiyalelo yokusebenzisa okufunwayo iziyobisi ezisebenzayo kufuneka exutywe glucose isisombululo-5% okanye sodium chloride 9%. Kulo mzekelo, ukufumaneka waphawula kufuneka ibe 0.5-1 mg / ml.

Isisombululo ichiza kufuneka ilungiswe nje ngaphambi kokuba uyisebenzise, ekubeni ubomi ubuninzi lokugcinwa kwezinto wawungowokulungiselela elingumxube ilingana ngenye imini.

Iintshukumo ngu-lomsebenzi

Yiyiphi indlela ezimbi ebangela ichiza "Carboplatin"? Reviews ngale ndlela babanga ukuba nimqumbise uphuhliso iziphumo ezibi zilandelayo:

• amalungu emathunjini: kwisithuba seeyure 11-12 emva ukusetyenziswa kweziyobisi, umguli bangase isicaphucaphu nokugabha. Ukuncipha reactions emetic usebenzisa ukwamkelwa lwangaphambili antiemetics, kwakunye nolawulo uveza ukuba medicament iintsuku ezi-5, okanye ukumnika eqhubekayo efakwa iintsuku. Kwakhona, ezinye izigulane ukuba ngayo ezingalunganga ezifana norhudo, iintlungu esiswini, ukudumba emlonyeni nokuqunjelwa.
• inkqubo hematopoietic: ukusetyenziswa amathamo ophezulu "carboplatin" itshixa ikhusi umsebenzi umongo wethambo hematopoiesis. Kwakhona, kukho inani elikhulu lezigulane iimpawu zibonakale of kwegazi, ubunzulu leyo ixhomekeke umthamo ichiza esetyenzisiweyo. Babedla ngokudibana kunye iingxaki zonyango ezifana nesifo esosulelayo, ifiva, ukopha kunye nokothuka izilonda.
• NA inkqubo neuropathy luvo: kukho amathuba okuba enkulu yokuba neuropathies peripheral, kwakunye nokunciphisa ikhaliphe ezinzulu imicu, ingakumbi kubantu kwiminyaka engama-65. Ukongezelela, iimpawu kangangoko ukuphazamiseka CNS msebenzi. unyango elide kunye namayeza kunokubangela neurotoxicity lonyuselo.
• Amalungu embonweni: kusetyenziso-mali kukholeleka ukuba norhatyazo okwexeshana okanye ilahleko ngokupheleleyo ngumbono, kunye nelahleko ukukwazi ukubona ukukhanya ukwahlula imibala. Ukubona restoration kunye nokuphuculwa ngokuqhelekileyo kwenzeka kwisithuba kwiiveki eziliqela emva ukupheliswa ichiza. Xa abantu abane umsebenzi kidney kakuhle, ngubani ziphathwa ngeedosi eziphezulu beziyobisi, waphawula yimfama cortical.
• ukuva izitho: ukuqaliswa "Carboplatin" kwezinye izigulane kukho ototoxicity, esizibonakalisa ngohlobo wokuva ilahleko kunye ukuduma.
• Komzimba: fever, erythematous irhashalala, pruritus, indlela anaphylactic, urticaria, hypotension kunye bronchospasm. Ezi ziphumo kungenzeka kwimizuzu embalwa emva ulawulo iziyobisi. Kwakhona, kwiimeko ezinqabileyo, izigulane zinokuba dermatitis exfoliative.
• inkqubo sezintso: ukuqaliswa "Carboplatin" ezinye izigulane zifumana ukwanda sethutyana ndithantamisa xa neziyobisi urea igazi lamanani. Kulo mzekelo, ukwenzakala abukhali izintso kunqabile kakhulu. Umngcipheko nephrotoxicity kwisiqalo ukusetyenziswa kwale arhente kwandisa kunye idosi, ngokunjalo abantu baphathwe ngaphambili kunye cisplatin.
• ukulingana Electrolyte: hypocalcemia, hypokalemia, hypomagnesemia, kunye hyponatremia.
• Isibindi: ukunyuselwa okwexeshana yibilirubin ezixinene, UMTHETHO kunye phosphatase obrak egazini singabonakala. Abantu abaye baphathwa kunye ngeedosi eziphezulu beziyobisi ukuya autologous lomongo wethambo abohlukeneyo, waphawula nezitenxo esibindini.
• Okunye ukusabela: syndrome hemolytic-uremic, ukudinwa, alopecia, ukusilela intliziyo congestive, iimpawu ezifana nomkhuhlane, myalgia / arthralgia, negazi, ukuphazamiseka cerebrovascular.

ulwazi oluthile

Yintoni izigulane kufuneka ukuba phambi kokuba ngokusebenzisa ichiza "Carboplatin"? Imiyalelo, izimvo athi nokuhlanganiswa eli chiza kuphela phantsi kweliso lomgadi abasebenzi bezonyango ingaqhuba iye phandle, leyo ligxininisa unyango arhente cytotoxic. Kule ozikhethela monitor kunokwenzeka iziphumo ezingenabungozi, ingakumbi xa amathamo eziphakamileyo ichiza.

Ekuhambeni unyango kunye nale arhente yaye kwiinyanga ezintathu ezizayo, izigulane kufuneka asebenzise zokucwangcisa ethembekileyo.

Ngokuba ulungiselelo kunye nolawulo ezilandelayo sisombululo zeziyobisi kuyimfuneko ukusebenzisa izinto zonyango musa ziqulathe aluminiyam. Oku kungenxa yokuba xa esinxibelelana kwenze ichiza ibunjiwe iphawulwe nokuncipha ngempumelelo kweziyobisi.

Ngexesha unyango, "Carboplatin" efunekayo iimviwo ngamaxesha luvo, kuquka abantu abadala baze banyangwe ngaphambili kunye cisplatin.

Ukusetyenziswa kwale iyeza kungakhokelela kuphuhliso lweziphumo ototoxic, kwaye ngoko ke pre-unyango kufuneka uvavanyo audiometric yenziwe.

Phantsi kweliso kwephulwa ngokwezonyango ebalulekileyo Hearing kufuneka uhlengahlengiso ithamo "Carboplatin" okanye bupheliswe ngokupheleleyo.

Ukuba imveliso ongena esikhumbeni okanye amehlo, pula nangoko namanzi amaninzi. Xa ukuginyile, iindlela eziyimfuneko ukujongana ukwenzela uncedo abafanelekayo.

amachiza afanayo

Ziziphi analogue beziyobisi nga kufakwe "Carboplatin"? Imiyalelo yokusebenzisa ayiqulathanga ngokuphathelele oku kungekho lwazi. Emva uya kufuneka ukuba ukuya kugqirha onamava. Njengomgaqo, iingcali bacebisa ukusetyenziswa kwezi analogue "Carboplatin" "Tsitoplatin", "Teksalok", "Displanor", "Oksiplat", "Oxaliplatin", "Platinol", "Cisplatin", "Eloxatin", "Platikad", "Plaksat "" Oksitan "," Oksatera "," Ekzorum ".

Izimvo amachiza anticancer

Ngoku uyazi ukuba kutheni ufuna iziyobisi ezifana "Carboplatin" ( "Carboplatin Teva"). Imiyalelo yokusebenzisa eli chiza iye yachazwa ngasentla.

Ukuvavanywa izigulane ubungozi kunye nokusebenza beziyobisi "carboplatin" na impikiswano. Abanye abantu bathetha malunga neziphumo emihle unyango lomhlaza ezahlukeneyo kunye nezinye rhoqo ukhankanye imiphumo enetyhefu kwamachiza izitho eyahlukahlukeneyo yoluntu kunye neenkqubo, kwakunye nezinye iziganeko ezimbi. Iingcali zithi oku kunokuba- nokunyamezela ngamnye nomonde ukwimo iziyobisi esebenzayo kunye nemeko yayo jikelele. Kuyo nayiphi na imeko zifuna ukuba umhlaza ichemotherapy. Ukuba ichiza "Carboplatin" isigulana asifanele ngenxa yesizathu esithile okanye enye, ngoko ke indawo analogs. Eli chiza replacement antitumor kunceda 90% yamatyala.