Ukulungiselela "Leicostim": imiyalelo yokusetyenziswa, ukuphononongwa, iifanekiso

Ziyintoni iilic Leicostim? Imiyalelo, uhlobo lokukhululwa, izibonakaliso kunye nokuchaswa kokuthatha le mayeza kuya kuchazwa ngezantsi. Kwakhona siya kukuxelela malunga naziphi iifaneli ezifumanekayo kwesi sixhobo, oko kubandakanya ukubunjwa kwayo njalo njalo.

Ifomu, ukupakisha, ukwakheka kweyeza

ULeukostim unjani? Imiyalelo yokusetyenziswa iyazisa ukuba le nyanga ifumaneka njengesisombululo sokulawulwa kwamagama angaphantsi kunye nokunyanzelisa.

Icandelo elisebenzayo le-arhente ngu-filgrastim. Iprogram ye-granulocyte evuselela i-colony-stimulating factor. I-1 ml yesisombululo seziyobisi ingaba ne-300 μg (i-30 million IU), i-600 μg (i-60 million IU) okanye i-150 μg (i-15 million IU) ye-filgrastim.

Ngokuphathelele izinto ezincedisayo, i-mannitol, i- sodium acetate trihydrate, i-dextran, i-acetic acid, i-polysorbate kunye namanzi anesisiti asetyenziswa njengolu hlobo.

Luhlobo luni lwepakethe oluthengiswa kwiLeicostim? Imiyalelo yokusetyenziswa ifakwe kwibhokisi yekhadibhodi kunye neebhotile enye okanye ezintlanu zeziyobisi.

Iipropati zemveliso yeyeza

Yiyiphi indlela yokwenza isicatshulwa seLicostimulation? Imiyalelo yokusetyenziswa, ukuphononongwa koogqirha bathi le nkunkuma-immunomodulator. Iproteinyini engahlanjululwayo engekho glycosylated ephethe impembelelo yokulawula kwimveliso kunye nokunyakaza (ukusuka emnzini wethambo ukuya kwigazi) ye-neutrophils esebenzayo.

Emva kokulawulwa kwezidakamizwa kwandisa kakhulu inani le-neutrophils egazini kunye ne-monocytes. Oku kwenzeka kwiiyure ezingama-24.

Ukwanda kwe-neutrophils egazini kukuxhomekeke kwintsholongwane. Ukuveliswa kwiprotheyini esebenzayo yezinto eziphilayo, oko kukuthi i-filgrastim, ebeka ngokuqhelekileyo ukusabalala kunye nokwahlukana kweeseli, iyenziwa yimimandla yebteriki Escherichia coli. Ngendlela, oku kulandelayo, ngenxa yamathuba obunjineli bemizimba yesimanje, ixhaswa kunye ne-colony-human stimulation of granulocyte gene gene.

Ngokomgaqo walo wesenzo emzimbeni, lo lungiso lufana ne-coloni-stimulating granulocyte, enemvelaphi yemvelo. Ukwahlukana okukodwa kukuba i-Leicostim (isisombululo) ayinayo i-glycosylated, kwaye nayo ine-asethi ye-N-terminal yaminodi ye-methionine.

Iimpawu zesilwayo

Ziziphi iimpawu ukuba isilwanyana kufuneka sibe neLeicosti? Umyalelo wokusetyenziswa uthi ucebise ukuwusebenzisa ekuxilongweni kwe-neutropenia kubantu abafumana i-chemotherapy. Kwakhona, eli liyeza lisebenza kakhulu kwi-neutropenia engapheliyo. Oku kungenxa yokuba uyakwazi ukubuyisela inani elifanelekileyo le-neutrophils emzimbeni womntu.

Ukusebenzisa isichengululo sokukhusela, isigulane sinokunciphisa kakhulu iziganeko ze-neutropenia, kunye nokunciphisa ubunzima bekhosi kunye nobude bexesha lesifo. Igalelo elinjalo livimbela ukuvela kweengxaki ezithathelwanayo, linciphisa ixesha lokubhedlelelwa kwesigulane, luvumela i-chemotherapy, ngaphandle kokuphambukela kwimimiselo eyasungulwa yirejimeni yonyango jikelele.

Umzimba womntu wenza njani kwiLeicostim? Imiyalelo yokusetyenziswa ibonisa ukuba ukusetyenziswa kwesi sidakamizwa kukhuthaza ulwalathiso lweeseli zegazi eziphambi kwe-hematopoiesis eziqokelelwa yi-cytapheresis (oko kukuthi, ukuhlukana kwegazi kumacandelo eselula kunye nokususwa kwabo okukhethiweyo) kunye nokulawulwa kwesigulane emva kwekhosi ye-chemotherapy ephezulu.

Ngaloo ndlela, iiseli ezisetyenzisiweyo (ii-cell stem), ezinomsebenzi we-hemopoietic, ukubuyisela umlingo kunye ne-hematopoiesis inkqubo, kunye nokunciphisa umngcipheko wokuvela kunye nokukhawuleza kwenkambo yezifo ezithintekayo nezibangelwa yiyo.

Ukhuseleko lweziyobisi

Ingaba isiyobisi seLeicostim siphephile kumntu? Umyalelo uthi la mayeza angasetyenziswa kokubili kubantwana nakubantu abadala. Kukhuselekile ngokufanayo kubo bonke abantu abathatha ikhosi ye-cytotoxic chemotherapy.

Kwizigulane ezinegciwane le-immunodeficiency virus, isisombululo sibonelela ngezinga elifanelekileyo le-neutrophils kwaye ivumela zonke iifayili ezinconywayo ze-antiretroviral okanye unyango lwe-myelosuppressive.

Xa usebenzisa le michiza, ukuphindaphinda kwe-HIV akuzange kugcinwe.

Pharmacokinetics

Ziziphi iiparimasokineti zemitha ezenza iyeza "Leicostim"? Umyalelo ubonisa ukuba uxinzelelo lwecandelo elisebenzayo leli arhente ngokuxhomekeke ngqo kwi-dose elawulwayo.

Emva kokulawulwa kwamancinci, umlinganiselo omkhulu weziyobisi egazini ugcinwa emva kweeyure eziyi-8 ukuya kwi-15.

Isiqingatha sobomi be-activic Leucimac iinyanga ezintathu ukuya kwezine. I-Filgrastim isetyenziselwa iipeptides. Phantse i-1% yesithako esisebenzayo senziwe singaguqukanga kunye nomchamo.

Ukuqokelela i-filgrastim emzimbeni womntu akwenzeki nokuba kusetyenziswe ixesha elide lesi sidakamizwa (xa ikhosi yonyango idlula inyanga). Kule meko, ixesha lesigamu-ubomi lihlala lifanayo.

Iimpawu zokusetyenziswa

Iyeza elithi "Leicosti" linikezelwe ngeenjongo ezilandelayo:

• Ukunciphisa ubude bekhosi ye-neutropenia 2-4, kunye nokunciphisa ubukhulu be-febrile neutropenia kubantu abane-neoplasms ezingenayo i-syeloproliferative emva kwe-chemotherapy kunye nokusetyenziswa kwama-cytotoxic agents;
• Ukunciphisa ukubonakaliswa kweengxaki ezenzeka nge-neutropenia, kunye nokunciphisa isikolo sesifo kubantu abasebenzisa i-chemotherapy ye-myeloablative kunye nesidingo sokutsalwa komnatha we-bone;
• Ukuqondisa iiseli ezandulela i-hematopoiesis egazini legazi ukuze injongo yokutshintshwa nokuhlukana emva kwe-chemotherapy ye-myelosuppressive;
• Ukunyangwa kwe-neutropenia kubantu abanentsholongwane kaGawulayo (kubandakanywa kwinqanaba elongezelelweyo) ukwenzela ukunciphisa ingozi yezifo ezithathelwanayo ezivela kumabhakteria;
• Ukunyanga kwe-neutropenia engapheliyo;
• Ukuqondisa iiseli ezandulela i-hematopoiesis kwigazi le-pipiloni kubaxhasi abanempilo ukuze zitshintshe kwaye zihlukanise izigulane.

Ukungqinelana kokusetyenziswa

Ziziphi iingqinisiso ezilungiselelwe ukulungiselela ukuba uLeicostim? Iingcaphephe zeengcali zichaza ezi zinto zilandelayo:

• Ukwandiswa komntu ngamnye kwisigulane kwizinto ezisebenzayo kunye nezinye izilwanyana;
• I-neutropenia ebusweni, evela kwifom enzima kunye neengxaki ze-cytogenetic (i-Costman's syndrome);
• Ixesha leentsana (ngokukodwa ngenyanga yokuqala yobomi).

Isilwayo "Leicostimus": umyalelo kunye nesicelo

Amachiza ombuzo angaphathwa ngeendlela ezimbini:

• Ngaphandle;
• Ngaphantsi.

Umyinge, kunye nendlela yokulawula uLeukostim, kufuneka ichongwe ngamagosa, kuxhomekeke kwimeko yeklinikhi, iimpawu zomntu ngamnye kwisigulane kunye nesikolo sesifo. Nangona kunjalo, kufuneka kuphawulwe ukuba kukulawulwa kwangaphantsi kwezilwanyana ezikhethiweyo zonyango.

Xa kunikwe i-intravenously, le nyeza ithathwa kwi-vial ngokusebenzisa i-syringe, kwaye yongezwa kwibhodlela ye-dextrose ye-5%. Isisombululo esiphumela siphethwe isigulane kwisigamu seyure.

Ndingayisebenzisa njani iLeichestkam? Umyalelo (okufana neli liyeza kuya kuqwalaselwa ngezantsi) lithetha ukuba le chiza kufuneka lisetyenziswe kwangaphambili kunomhla emva kokuphela kwe-chemotherapy.

Isisombululo sonyango sisetyenziswe kuxhomekeke kwisisindo somguli. Isilinganisi sawo siyahluka phakathi kwama-5 ukuya kwi-12 ukuya kwi-kg nganye yesisindo somzimba. Izigulane zenziwa rhoqo ngosuku kwixesha eliqhelekileyo linye ngosuku.

Isiza kufuneka siphathwe ngotyza de kubekho inani le-neutrophils egazini lifikelela kumgangatho oqhelekileyo. Ngokuqhelekileyo ixesha lokunyanga iiveki ezimbini.

Ngexesha lokuqaliswa kweengcali zonyango kufuneka ukuba zihlale ziqingqa inani lama-leukocyte egazini. Ukuba inani labo lidlula i-50 000 / mkl, ke iyeza likhanselwa.

Ngexesha lokunyanga, isigulane sinokuphuhlisa i-thrombocytopenia. Ukuba inani leeplatelets ligcinwa ngaphantsi kwexabiso le-100,000 / μl ngexesha lokuhlaziywa ngokuphindaphindiweyo, umbuzo wokukhutshwa kwexeshana kwezilwanyana okanye ukunciphisa umyinge wayo uqwalaselwa.

Iziphumo eziPhakathi

Ngokwezibalo, i-Leicostim yeziyobisi ayifanelekanga ukuba ibangele ukuphendula. Nangona kunjalo, kusenokuba negalelo ekubonakaleni kweziphumo ezifana nale:

• Iziganeko zeDysuric;
• Ubuhlungu emathanjeni okanye kwiimisipha;
• Alopecia;
• I-hepatomegaly, splenomegaly;
• I-hypotension ye-Arterial (yangaphesheya);
• Amanqanaba okwanda kwe-uric acid kunye ne-alkaline phosphatase;
• Ubuthathaka, iintloko kunye nokukhathala;
• Ukuphendulwa kweengxaki ekuqaleni kwonyango, edlalwa ngokubanzi emva kokulawulwa kwamathambo.

Kufuneka kwakhona kuqatshelwe ukuba ukuba isigulane singeniswe ngendlela engafanelekanga, ukuvakalelwa okungathandekiyo kwisayithi yokungeniswa kungaphazamisa.

Ukusebenzisana kwezidakamizwa

Ngaphambi kokusebenzisa le chiza, kubalulekile ukufumanisa indlela iLeicostim inxibelelana ngayo namanye amayeza. Imiyalelo (INN yalo myeza izandile njenge "Filgrastim") iqulethe kule ngxelo ingcaciso epheleleyo:

• Isilwanyana "5-fluorouracil" sandisa i-neutropenia.
• Ngokujonga ukuba iiseli ezikhulayo ezikhulayo zixhalabele kakhulu kwizidakamizwa ze-cytotoxic, "i-Leucostimulation" kufuneka imiselwe ngolunye usuku ngaphambi okanye emva kokusetyenziswa kwezi zi yobisi.
• Isiza esikulo mbuzo asihambelani ne-sodium chloride.
• Xa usebenzisa isisombululo sokuba ulandele iiseli ezingama-progen emva kwe-chemotherapy, kufuneka ukhunjulwe ukuba usebenze ngokubambisana ne-Carmustine "," iMelphalan "kunye ne" Carboplatin ".

Iingcebiso ezizodwa

Kunqabile kakhulu ukunika abantu abanesifo esibindileyo kunye nomsebenzi wezintso kwi-Leicostimulation, ekubeni ukhuseleko kunye nokuphumelela kwenkqubo yegulane abazange bafundwe.

Izigulane ezine-osteoporosis kunye nezinye izifo zethambo ezisetyenziswayo ngokuqhubekayo kwiinyanga ezintandathu kufuneka zijonge ubunzima beethambo zamathambo.

Ukusebenza kwesilwanyana kubantu abanomncinci wamaseli angama-proyeloid ezingenayo isifundo. Nangona kunjalo, iingcali zithi ezi zigulane, iqondo lokunyuka kwinani le-neutrophils linokuthi linciphise kakhulu.

Ukusebenza nokukhuseleko kokusetyenziswa kweLeukostima kubantu abanomdlavuza ongapheliyo kunye ne- myelodysplastic syndrome ayilunganga . Kule nkalo, ngezifo ezinjalo, akubonakalwanga.

I-Monotherapy kunye neziyobisi ezithandwayo akuthinteli i-anemia kunye ne-thrombocytopenia, ebangelwa yi-myelosuppressive chemotherapy. Kufuneka ukuba uhlawule rhoqo inani le-hematocrit kunye neeplatelet. Ulumkiso olukhethekileyo lufanele lusetyenziswe xa usebenzisa iirmim ephaseneyo okanye i-single-component yecotherapeutic regimens eyaziwayo ukuba iyakwazi ukubangela i-thrombocytopenia enzima.

Ngaphambi kokuqala kwonyango, "Leucostim" kufuneka enze uvavanyo olunzulu lwegazi ngokuzimisela inani lamaplatelet kunye nefom lekocyte, kunye nokufunda i-karyotype kunye nomnatha we-bone.

Ngethuba lexesha lonyango, iisampuli zomchamo kufuneka zihlolwe rhoqo kwaye ubukhulu bepen libekwe iliso.

Isiyobisi seLeicostim: izifaniso kunye nexabiso

La mayeza alandelayo afana nesilwanyana esibuzwayo: "I-Filerim", "iGrazalva", "Granogen", "Neupogen", "Leucite", "Neimaplex", "Myelastra", "Neurostim."

Ngokuphathelele intengo, kwi "Lejkostim" iphezulu kakhulu. Thenga le mveliso kwii-pharmacy eMoscow, kunye nezinye iidolophu zaseRussia zingaba ngama-ruble ama-2500-4500. Ixabiso leliyeza lixhomekeke kumthamo kunye nenani lamaphupha epakethe.

Uphononongo malunga neziyobisi

Ngelishwa, kuninzi ukuhlolwa kwezigulane ezithatha le gciwane. Ngokutsho kwinto ekhoyo, eli nyanga liqhelekelelwe ukuba lijonge omzimba, kunye ne-cyclic neutropenia kubantwana. Impembelelo yeziyobisi ngezifo ezinzima zihlala zifutshane.

Kufuneka kwakhona kuqaphele ukuba kukho ukuvavanywa kwesigulane kwisicelo seklinikhi seLeucimac kubantwana nakubantu abadala abane-neutropenia ehambelana ne-chemotherapy yezifo. Isiza esilawulwa kwiintsana kumyinge we-5 μg / kg ngosuku liyakunyamezela kakuhle.

Ezinye izigulane zinomdla kumbuzo wezisombululo ezingcono: "Leicostimulation" okanye "Neupogen." Ngenxa yezifundo zeklinikhi ezenziwa ukucacisa ukunyamezela nokusebenza kwezi nkonzo, izigqibo ezilandelayo zathathwa: ixesha lokuphelisa i-neutropenia emva kokusetyenziswa kwezi zonyango azifani. Ngaphezu koko, banesibonakaliso esifanayo sokusebenza nokusebenza.