Medicine "Cyclophosphamide": imiyalelo ukusetyenziswa, ixabiso, analogs, umenzi kunye nohlolo

"Cyclophosphamide" yikhompawundi alkylating. Le arhente antitumor iziyobisi. It yaveliswa ngumgubo crystalline omhlophe okanye phantse ezinjalo. Iinkcukacha ezithe vetshe ngalo eli chiza.

"Cyclophosphamide" - umvelisi

Yenza ichiza kwi nkampani Russian JSC "ezinto." Le ise kwidolophu Saransk kwi Vasenko esitratweni, d. 15A.

iindleko

ungathenga umgubo №1 «Cyclophosphamide" kuyo nayiphi na ekhemisti. ixabiso layo ngeenxa 90-98 engange.

Amaxwebhu iziyobisi

Ukususela kule powder, isisombululo ukulungele. Kujongwe ukuba zolawulo intramuscular kunye efakwa

iimpawu ukwakheka

Ukubunjwa igutyana nganye kunye umgubo ibandakanya uhlobo into esebenzayo ebizwa ngokuba "cyclophosphamide". Ethile inombolo yakhe. Ezizezi iqulathe "Cyclophosphamide" 200 mg uthe kweziyobisi igutyana nganye. Le mveliso amayeza akukho excipients.

Inkcazelo yezenzo imithi

Ngokusekelwe imiyalelo ukusetyenziswa, "Cyclophosphamide" - yinto alkylating iziyobisi osebenzayo. nokubunjwa kwayo imichiza kuyafana izinto ezifana nitrogen lwemostade. Amayeza ukusebenza "cyclophosphamide" kukuphumeza uhlobo crosslinking ezinqamlezayo phakathi DNA kunye RNA imicu. Kwakhona eli ukulungiselela ikhuthaza iproteni yokuqaphela inhibition.

"Cyclophosphamide" - analogue

Kulo mzekelo, achole imali elingana ikhowudi ath kudidi yesine. Iyinqaba i "Cyclophosphamide". Analogs kweli chiza kukho inani elikhulu. Avamise kakhulu zezi:

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

Ukukhethwa nganye amalungiselelo kwenziwa igqirha qho ngamnye. Kulo mzekelo, sithabathela ingqalelo amacandelo ezempilo kunye nokunyamezelana.

Kwezinye iimeko, umntu?

Makhe sihlolisise le ngongoma ngokweenkcukacha. Iyinqaba na ukusetyenziswa kweziyobisi ezifana "Cyclophosphamide". Imiyalelo ukusetyenziswa kulo mba sisixhobo ufunwayo. Uyatsho ukuba ichiza ziboniswe kwezi meko zilandelayo:

1. Ukuba ngaba wehlelwa ezingapheliyo kunye etsolo lymphocytic wegazi.
2. Phambi ezigula ezininzi.
3. Ukuba iimpawu ze lymphoma non-Hodgkin.
4. Kwimeko apho fungoides mycosis kunye retinoblastoma.
5. Phambi lwesifo Hodgkin kunye imihlaza ovarian wamabele.
6. Xa ngokubonakala iimpawu neuroblastoma.

Ngaphandle konke oku, eli chiza isetyenziswa zidityaniswe namanye amachiza arhente antitumor ukuba unyango le miqathango ilandelayo:

1. Xa iseli lwegciwane ngamathumba.
2. umhlaza lwesinyi wemiphunga.
3. Sarcoma lohlobo inyama ithambile.
4. Kwimeko apho wendlala kunye nomhlaza womlomo wesibeleko.
5. Xa nee- Ewing kaThixo.
6. Kwimeko yamathumba Wilms '.
7. Xa retikulosarkome.

Kwakhona ukulungiselela ezifana "Cyclophosphamide", iimpendulo ezo HIV, isebenza njenge-uhlobo arhente immunosuppressive kunye nokubonakaliswa okuqhubekayo izifo sokuhlasela. Kule meko kuthetha imbonakalo isifo psoriatic kunye samathambo, igazi samathambo hemolytic, collagen, nephrotic syndrome. Kwakhona uthe iindlela ofihla sihlume sokwala reaction.

Izimo

"Cyclophosphamide" uye Izimo ezithile. Yinto zingasetyenziswa:

1. Ngeli xesha lokuncancisa kunye nokukhulelwa.
2. Waphula umthetho wokuthi umsebenzi umongo wethambo.
3. Ukuba iimpawu hypersensitivity.
4. Xa delay echama.
5. Phambi zizifo esebenzayo.
6. Ngexesha ngokubonakala Ngokuzimela.

Ukuqapha yi "Cyclophosphamide" kuyimfuneko, analogue kuzo zidweliswe ngasentla, elawulwa kwiimeko ezithile. Oko kukuthi, phambi ezi zifo zilandelayo:

1. Nefrourolitiaza.
2. isifo sentliziyo ezimandundu, isibindi nezintso.
3. Igawuthi.
4. Ithumba nokungena kweeseli umongo wethambo.
5. Adrenalectomy.
6. Nokupheliswa komsebenzi umongo wethambo.

Inkcazelo yeziphumo ebezingalindelekanga

"Cyclophosphamide", izithetha-ntonye (analogue) leyo echazwe ngasentla, inokuba negalelo ekuveleni iziphumo ebezingalindelekanga kulandelayo:

1. Inkqubo okucola abonise iimpawu ezifana ukugabha, isicaphucaphu, ukudla, ukungakhululeki, stomatitis, iintlungu kwindawo esiswini, urhudo okanye ukuqhina. Kwakhona ezaziwayo iimeko ngamnye senyongo kunye ukopha sikabhobhosi.
2. Kule ezibonisa inkqubo hematopoietic babonakala neutropenia, ianemia, thrombocytopenia, leukopenia. Ngosuku 7-14 yokwamkela unakho ukunciphisa kancinane inani ziiplatelets kunye leukocytes.
3. Kwi wabonakala isikhumba alopecia waphawula. Khulisa iinwele kwakhona emva iziyobisi epheleleyo. Ukongeza, ngexesha unyango esinokubakho ukujaduka esikhumbeni. Kusenokubakho ubukho nombala ulusu kunye nail utshintsho.
4. Xa yegazi xa ilawulwa ngeedosi eziphezulu beziyobisi kwisithuba ixesha elide inokuba ibonakalisa cardiotoxicity. Kubalulekile ukukhumbula. Ukongeza, siye saphawula ukuvela kwiimeko ezinzima, yaye ngamanye amaxesha akubulali, ukuphanza kwentliziyo. Oku kungenxa isenzeko uhlobo myocarditis ukopha.
5. In womchamo kunokubangela necrosis ndlela sezintso (kubandakanywa ukufa), Ngokuzimela ukopha okanye urethritis, wokuchama isinye abanesigulo. Kwiimeko ezinqabe kakhulu, xa isicelo of iidosi eziphezulu iziyobisi zingenzeka nephropathy, hyperuricemia kunye nokusebenza kwezintso. Ubukho kweeseli epithelial kwi umchamo zingenzeka.
6. In isixokelelwano sokuphefumla inokuba sisibonakaliso abanesigulo Embi miphungeni.
7. Le ukuphazamiseka uhlelo zokuzala lunokwenzeka oogenesis kunye spermatogenesis, kunye inzalo. uphawu Last kwezinye iimeko kusenokuba vuhlayiseki. Uninzi lwabafazi isicelo yomenzeli waphawula uphuhliso amenorrhea. Emva kokuba unyango, i amaxesha menses kudla achache. Abantu ezithatha ichiza kunokukhokelela ukuvela oligospermia okanye azoospermia, ngokunjalo namaqondo awohlukeneyo yoma wamatyhalarha.
8. Kulo mzekelo ibonakala kunye negazi. Loo nto ibonakalisa wentlonze yabangxamayo, ukurhawuzelela, izigxala, ukusabela anaphylactic.
9. Kwakhona kule meko kubekho isahlakalo yeziphumo ebezingalindelekanga. Okt igazi nolusu yobuso, ukuba bomvu, nangezilonda zasesekondari yingozi, ukubila ngokugqithiseleyo, intloko.

iintlobo yokusebenza

Xa ufumana eli chiza, ezinye izinto igalelo microsomal igcwala esibindini, lingaphumeza wayenga inkqubo microsomal yokucolwa of cyclophosphamide. Oku kukhokelela ekubeni izinto ezithile. Oko kukuthi, ukuba ukwakheka enkulu alikiliruyuschego uhlobo metabolites. Oku kunciphisa ixesha apho isiqingatha ubomi cyclophosphamide kuliwa, kananjalo kwandisa umsebenzi wayo. Cyclophosphamide, nto leyo kuyoluka kakhulu kwaye abangaphangeliyo umsebenzi cholinesterase, kudandalazisa yesenzo suxamethonium. Kwakhona kuyanceda ukunciphisa okanye isantya nethe lwe cocaine. Ngenxa yoko, ngcono okanye ukwanda ubude ukusebenza kwalo kwandisa umngcipheko neziphumo ezinetyhefu. Oku kuba nefuthe elibi yonke eziphilayo. Ukongeza, isicelo ngaxeshanye allopurinol banokuzinikela neziphumo ezinetyhefu kwi lomongo wethambo.

Xa co-elawulwa kunye cyclophosphamide allopurinol, colchicine, probenecid, sulfinpyrazone kusenokufuneka ngeedosi ukulungiswa protivopodagricakih uhlobo iziyobisi ukunyanga sifo kunye hyperuricemia. Kwakhona, xa lo okunyuka abonakalise umngcipheko nephropathy ephathelene nokonyuka imveliso uric acid usebenzisa cyclophosphamide.

Le into yokugqibela kunokubangela ukunyuka umsebenzi anticoagulant. Ekubeni lenjini esibindini kunciphisa izinto ezikhuthaza igazi ekunqandeni kunye nemveliso zegazi kakuhle. Noko ke, kukho nazo kubakho umsebenzi nciphisa anticoagulant ngokusebenzisa uhlobo indlela ayaziwa.

Cyclophosphamide kwandisa cardiotoxicity of daunorubicin kunye doxorubicin. Ezinye izinto immunosuppressive (chlorambucil, azathioprine, tacrolimus, corticosteroids, mercaptopurine, njl) kunokwandisa amathuba izifo eziziisekondari nangezilonda.

Ukusetyenziswa ngaxeshanye lovastatin kwizigulane kunye abohlukeneyo intliziyo nga kwandisa ingozi izifo ezifana rhabdomyolysis kunye nokungaphumeleli oyingozi kwezintso.

Ukuba ile eli chiza isetyenziswa iziyobisi myelosuppressive okanye unyango imitha, oko kubonisa additive kunokwenzeka inhibition umsebenzi umongo wethambo.

Ulawulo ngaxeshanye cytarabine kwi ngeedosi eziphezulu kunye izinto ezifana cyclophosphamide, kwi wokulungiselela nqanaba inkqubo abohlukeneyo lomongo wethambo kukhokelela cardiomyopathy kunye ukwandisa sokuquqa kuqala ukufa.

The main criteria

Xa isicelo kuthathela ingqalelo oku kulandelayo:

1. Ngexesha unyango kunye eli chiza kufuneka rhoqo ukwenza uvavanyo lwegazi ukuvavanya neqondo myelosuppression. Uva kuyimfuneko ukunikela ingqalelo inani ziiplatelets kunye neutrophils.
2. Kufuneka kwakhona rhoqo enze uvavanyo lomchamo ubukho ebomvu cell wegazi. ubukho babo ukuze negalelo kuphuhliso kwezifo ezifana ukopha Ngokuzimela. Xa efumanise zonyango iimpawu ezinjalo nge "Cyclophosphamide", ixabiso yayo ezidweliswe ngasentla, kufuneka uyeke.
3. Njengoko inani zegazi (ngaphantsi kwe 100,000 / ml) kunye / okanye iiseli ezimhlophe (<2,500 / l) ukufumana isixhobo kufuneka bupheliswe.
4. Xa usuleleko kwenzeka kwixesha unyango ngamachiza, wathi unyango kufuneka kupheliswa okanye kuphazanyiswa. Noba kwimeko lokufumana idosi kufuneka incitshiswe. Amadoda nabafazi ngexesha lenkqubo yonyango, "cyclophosphamide" kuyimfuneko ukusebenzisa iindlela ethembekileyo zokucwangcisa.
5. Ngexesha unyango nalo eli chiza kufuneka zikhwebule etywaleni.
6. Kwimeko apho kudlula iintsuku ezilishumi zokuqala emva kotyando, nto leyo kuthwalelwa phandle phantsi zomzimba jikelele, kwaye isigulane ukuba emiselweyo "Cyclophosphamide", ixabiso yayo ezidweliswe apha ngentla, kufuneka lazise lakubeka anesthesiologist.
7. Nomonde emva kokuba kwaqhutywa adrenalectomy, kuyimfuneko ukwenza ubambe uhlengahlengiso idosi njengoko corticosteroids, okusetyenziselwa inkqubo unyango replacement, kwaye ichiza enjalo, nje unyango, "Cyclophosphamide".

izilumkiso eziyimfuneko

Yokwamkela ichiza kunokwenzeka kuphela phantsi kweliso ugqirha onolwazi ichemotherapy. Kufuneka kwakhona kubekho ukuthotyelwa ngokungqongqo kunye nolawulo balawule. Oku kufuneka kwenziwe ingakumbi kunyango udibaniso. Kwakhona, akukho mfuneko ku tirhisa kabini elandelayo idosi ukuba ezidlulileyo angalahlekelwa. Ekulungiseleleni eli chiza ukuba isetyenziswe kwiintsana ayikhuthazwa ukusebenzisa diluents eziqulathe benzyl utywala. Ekubeni oku kukhokelela kuphuhliso bonke abafayo enetyhefu syndrome. Oko kukuthi, inkangeleko lactic pathways CNS ukudakumba, ukusilela yokuphefumla, ukusilela kwezintso, hypotension, ukuxhuzula, legazi intracranial.

Ngexesha lonke ikhondo unyango Kucetyiswa ukuphumeza ukutofelwa igazi (1 Ixesha ngeveki 100-125 ml). Oku kufuneka kwenziwe ngeenjongo zokuthintela kwezifo ezifana hyperuricemia kunye nephropathy, apho kungenxa ukuyilwa eyandileyo izixa ze uric acid. Ezi mpawu akholisa ukubakho ekuqaleni kwethuba imithi. Kwakhona, ngaphambi uthe unyango ngamachiza kwaye ngexesha kwiiyure ezingama-72 emva kokuba ulawulo Kucetyiswa ukuba enze lwamkelo ethile ulwelo (3 iilitha ngosuku), ukusetyenziswa allopurinol (kwiimeko ezizodwa), kunye neendlela owenza umchamo obrak. Kuba ekuthinteleni izenzo ukopha Ngokuzimela amaxesha kuyimfuneko ukuba enze ingabi nanto lwesinye kunye nokuthatha "UROMITEKSAN". Ukuba bekukho imiqondiso yokuqala sifo, unyango uthe amalungiselelo kufuneka simiswe de nokuphelisa ngokupheleleyo naziphi na iimpawu.

Ukuphuphumala uhlobo nesenzeko dyspeptic singathatha cyclophosphamide ngolo suku lokuqala ngeedosi ezincinane. Zalisa okanye inxenye alopecia, ezinokuthi zenzeke ngexesha nyango ingathityazwa kwaye emva kwekhosi lifinyele umsebenzi ukukhula iinwele yesiqhelo. Noko ke, umbala kunye nesakhiwo ixhomekeke ukutshintsha.

Ukuba ngaba wehlelwa Ukugodola, ifiva, ukhohlokhohlo okanye hoarseness, iintlungu kwindawo umva ongezantsi, okanye ecaleni, ukuchama kabuhlungu okanye nzima, ukopha okanye ukopha, ilindle emnyama, igazi isitulo okanye umchamo kufuneka ngoko nangoko udibane nogqirha.

Ukuba nokwenzeka thrombocytopenia, ekhokelela imfuneko ndinyanyekelwe ngexesha imisebenzi efana iinkqubo ezonakalisayo kunye neenkqubo amazinyo. Kufuneka ahlole rhoqo ulusu kunye inwebu yangaphakathi kunye nesayithi efakwa. Oku ukuze ukubona iimpawu ukopha. Kuyimfuneko ukuba anciphise amaza venipuncture nokuthuthwa inaliti intramuscular. Kuyimfuneko ukulawula isiqulatho igazi endleni, emhlanzweni, umchamo. Ezi zigulane ngononophelo kakhulu kufuneka enze inkqubo utsheva, manicure, dentifrices, imicinga yokuvungula, njl Spaces Ngelo xesha kufuneka ngokungqongqo kuphetshwa owayo kunye nezinye iingozi. Acetylsalicylic acid kunye notywala nako akuvumelekanga ukuba kwandisa umngcipheko ukopha zesisu. Kule meko kuyimfuneko ukuze kuphunyezwe ishedyuli delay ugonyo (emva kweenyanga 3-12 emva lokugqibela ichemotherapy ikhosi zokugqiba). Kunqweneleka ukuba ukuphepha obekudibene nezigulana esosulelayo. Ngexesha unyango kuyimfuneko ukusebenzisa amanyathelo afanelekileyo ukukhulelwa.

Xa ngokuqhagamshelana uthe kweziyobisi kunye isifo okanye isikhumba kufuneka ngocoselelo yoxukuxwa ngamanzi plain inxalenye okanye isepha, ngokulandelelana.

Ibele nokukhulelwa

Kukho umda yinqobo kule nkalo, leyo i "Cyclophosphamide". Manual ibonisa ukuba contraindicated kukusetyenziswa kweli chiza ngexesha lokukhulelwa. Kulo mzekelo, kudidi igalelo ekukhuleni kosana olungekazalwa zibonakaliswe «D» yi FDA. Ngexesha unyango kuyimfuneko ukuba ayeke nokuncancisa.

libanda

Kulo mzekelo, kukho bokuqonda ethile. Ubukho iyeza elithile kunye libanda, ze bathi kuqulunqo ayaziwa. Oku kuyinyaniso ethembekileyo. Xa isicelo libanda, kufuneka asebenzise amanyathelo axhasayo kuquka unyango olufanelekileyo zizifo ezosulelayo, kwakunye elivela zokuma kunye / okanye myelosuppression.

iimeko yokugcina

Kule nkalo, oko kufuna iimeko ezithile ukulungiselela ezifana "Cyclophosphamide". Imiyalelo yokusebenzisa imisela ukuba kufuneka igcinwe kwiqondo lobushushu elingadluliyo 10 ° C kwindawo owomileyo kwaye ikhuselwe ekukhanyeni. Kule yabantwana ukufikelela kuyo kufuneka imiqathango.

ezikhabhathini

Kukho ixesha elithile apho ichiza enjalo zingasetyenziswa njenge "Cyclophosphamide". Imiyalelo yokusebenzisa ibonisa ukuba ubomi zayo zokusebenza engama-3. Kulo mzekelo, kufuneka ubambelele kwiimeko ezithile. Ihlala yokuba aluvumelekanga ngokungqongqo ukusetyenziswa kweli chiza emva kweli xesha liphela.

ukuqaliswa

Kweli cala, kukho kwakhona imeko oko kukuthi "Cyclophosphamide". Imiyalelo isicelo ibonisa ukuba ichiza ikhululwe kuphela ezikhemisti ngokumiselwa.

isiphelo

Kwesi sicatshulwa, kukho ulwazi oluninzi luncedo. Kwaye yintoni i "Cyclophosphamide", imiyalelo zokusetyenziswa, ixabiso eli chiza. Noko ke, umntu kufuneka akhumbule ukuba phambi kokuba ukusebenzisa ichiza kufuneka abonisane ugqirha.