The mushonga "Doxorubicin": mirayiridzo manual, ongororo, mapikicha, kusunungurwa chimiro, chipimo chemushonga, okuchengetera. "Doxorubicin-Lance": mirayiridzo kushandiswa

The kenza ngozi kwazvo upenyu hwevanhu. Inoitwa nyanyisa uye dzisingadzorwi kuwedzera masero, izvo vanokwanisa kupinda munzvimbo dzakapoteredza zvinyama uye metastasize kune dzimwe nhengo.

The Kugadzirwa zvinodhaka uye kurapwa zvirwere zvakadai zvinokosha basa. Zvinosuruvarisa kusvikira zvino hapana kusvikira pakuguma uye handina akasarudza. Kunyange zvazvo pachine zvinodhaka kuti anogona kuderedza weboka bundu masero. Mumwe wavo nezve mishonga "Doxorubicin". Mirayiridzo dzokushandisa uye pikicha yacho zvinodhaka ichashandwa munyaya ino. Mariri muchawana ruzivo sei kuchengeta akati nzira umo anoumba richiwanikwa kutengeswa, uye zvakawanda.

Kavha, akafanana, chimiro uye tsananguro

In chii chimiro anotengeswa "Doxorubicin"? Mirayiridzo kushandiswa anoratidza mhando kutevera chigadzirwa:

• Lyophilizate gadziriro mhinduro kuti intravascular uye intravesical jekiseni. Ndicho tsvuku-tsvuku porous guru uye rine basa fuma yakadai doxorubicin hydrochloride. Sezvo mamwe zvimwe vachishandisa mannitol. Mishonga iri kutengeswa muhombodo, akanyudzwa mukati makadhibhokisi bhokisi.
• Fungai kuti kubudisa mhinduro intravascular uye intravesical jekiseni. Zviri dzvuku uye läpinäkyvä mvura ine doxorubicin hydrochloride uye rinowanika mabhodhoro uye makatoni.

The pharmacology zvinodhaka

Chii mushonga ichi se "Doxorubicin"? Mirayiridzo dzokushandisa (kusunungurwa chimiro zvinodhaka rakanga apa) rinoshuma kuti chinhu Anti-bundu anthracycline mushonga, waiva kure Mutsika chakuvhe muStreptomyces peucetius. Anokwanisa richiva antimitotic uye antiproliferative nemigumisiro.

Kuwadzana DNA, kuti medicament kuchititadzisa RNA polymerase, DNA polymerase uye topoisomerase mhando 2, uye zvakare zvaanopa simba kugadzirwa vakasununguka radicals obva muchitokisi pamadziro. Somugumisiro akadaro zvazvinoita DZEMUNHU DZINODZORA DNA kuberekana uye zvipenyu nucleic asidhi usage.

Hazvibviri kuona chokwadi chokuti tiri kufunga nzira ine yakananga cytotoxic kushanda. Masero kuratidza imwe aikanganiswa mushonga ari G2-danho uye S-danho upenyu hwavo.

kinetic ehupfumi

Chii kinetic parameters kuri muna zvinodhaka "Doxorubicin"? Mirayiridzo dzokushandisa inoti kuti pashure intravenous jekiseni, asi chokushandisa nguva dzose akagovera multiphase. Panguva 5 maminitsi medicament yokutanga nokukurumidza akakunda zvinyama, uye mumisasa yacho muropa kunoderedza nokukurumidza. Kana yechipiri chokutambudzika, voitakura kunze kunonoka zvinodhaka mamorekuru kubva munyama.

Inonyanya kushingaira mushonga ari chiropa, neitsvo, chirwatata, mapapu uye myocardium. Rinotaurawo kupinda munharaunda yacho placenta uye yabudiswa pamwe mukaka.

Kugamuchira mapuroteni eplasma kunoitika kuburikidza 75%. Muviri zvinodhaka ari chiropa, nokudaro achiumba kushingaira rinobva akadai doxorubicinol.

Panguva rutapudzo chokuzvisarudzira radicals enzayemu kwetunhu kunogona kukanganisa kukura cardiac toxicity.

Hafu-upenyu doxorubicin uye doxorubicinol zvakafanana uye maawa anenge 20-48.

Inenge 40% of dose zvinodhaka asunungurwa pamwe bile, uye 6-11 chete% kubva doxorubicin nezvinogadzirwa nomukaka, nokuti 5 mazuva inowanikwa weti.

zvairatidza

zvinodhaka "Doxorubicin" anogona yakatarwa panguva nezvirwere chii?

Mirayiridzo kushandiswa (nokuti kenza dundira ibhuku rinoshandiswa kakawanda) rinotaura kuti mushonga anoita zvakanaka kana:

• thyroid kenza shwanu, Kaposi kuti sarcoma uye Ewing;
• Wilms 'bundu, gastric kenza, duku sero muchimiro kenza yemapapu;
• insulinoma, kenza yemazamu, mesothelioma;
• esophageal kenza, carcinoid, neuroblastoma;
• osteogenic sarcoma, chikuru hepatocellular carcinoma, asiri Hodgkin raMwari rwekenza yelymphoma ;
• Kenza kweprostate gland, kenza musoro uye mutsipa, akaipa thymoma;
• gomarara, dzimwe mhando testicular anomera;
• uterine sarcoma, endometrial kenza, Hodgkin nehosha;
• rhabdomyosarcoma, chenjera neleukemia;
• chisingaperi lymphocytic neleukemia, vakawanda myeloma.

Contraindications

Ndezvipi mamiriro murwere aisirwe kurambidza kwaari zvinodhaka "Doxorubicin"? Mirayiridzo yokushandisa, oncologists chaivo vanoti chishandiso hunoratidza haana kubudirira zvikuru:

• sensitization kune doxorubicin kana zvimwe zvinodhaka zvinhu, uyewo vamiririri anthracyclines uye anthracenediones;
• asati kurapa, kana dzimwe nhengo anthracycline anthracenediones mu vakaomerwa mishonga, uyewo chiropa kukundikana (kwazvo), myocardial infarction, arrhythmias, chenjera kutapukirwa noutachiona uye mwoyo nokukundikana (nokuti intravenous Kutarisirwa);
• nyanyisa namamota, hunovambira murusvingo dundira, Urinary turakiti noutachiona uye cystitis (nokuti intravesical).

Nokungwarira akaipisisa, mushonga uyu anofanira kushandiswa vanhu vakagamuchira ndichibvunza mishonga, uyewo zvinhu ngozi cardiotoxicity, kutyora chiropa, mumwongo infiltration pamusoro kenza uye kufutisa.

Uyezve, vachinyatsoongorora vaiona mushonga wacho nachiremba vana uye vanhu vakwegura, uye sezvo chikamu multi-rudzi uye multicomponent antitumor mishonga.

Drug "Doxorubicin": mirayiridzo kushandiswa, chipimo chemushonga

Maererano mirayiridzo, vaiona mushonga inogona kupiwa intraarterially, nomutsinga uye intravesically. Zvinofanira kucherechedzwa kuti chokushandisa ichi anofanira kushandiswa singly kana akabatana nevamwe zvinodhaka cytostatic mune dosages siyana.

Patsva zvinodhaka mhinduro "Doxorubicin" rinofanira kushandiswa pakarepo namarudzi gadzira.

Intravenous jekiseni Pfungwa

At zvavakabvumirana chipimo chemushonga kuti monotherapy "Doxorubicin" paminiti kutenderera ari 60-75 MG / ba. that m ose mavhiki matatu. Kazhinji, mushonga wacho jekiseni kamwe. Zvisinei, dose ichi inogona wakawanda uye kuti vakawanda majekiseni (mune mari 25-30 MG / ba. M pazuva nokuda 3 days kutanga kutenderera).

Kuderedza hunokachidza mugumisiro nzira inoshandiswa vhiki kwokubatsira 10-20 MG / ba. M pavhiki.

Kana kubatanidzwa nemamwe anticancer yomuchipatara vanoshingaira medicament chinotarisirwa ari chipimo chemushonga kutenderera munguva mari 30-60 MG / ba. that m ose 4 mavhiki.

Kudzokororwa mapoka kurapwa kuitwa chete pashure kuchaitwa zviratidzo zvose toxicity.

The zvachose dose zvinodhaka hakufaniri anopfuura 550 MG / ba. m.

Intra-arterial vatarisire mupurisa

Sei intra-arterial jekiseni "Doxorubicin" chinodhaka? Tungamirira rinoti kupa sidetone vanhu vane hepatocellular carcinoma vanoshingaira medicament chinofanira kutarisirwa kuti vanhuwo hepatic tsinga iri chipimo chemushonga pamusoro 35-150 MG / ba. m. Panguva iyoyo zvikamu pakati zvinogara zvinofanira kuenzana kubva 3 vhiki kusvika 3 months.

Musumo zvinodhaka kupinda dundira

Sezvo dundira jekiseni zvinodhaka "Doxorubicin-din email"? Mirayiridzo dzokushandisa inoshuma kuti chipimo chemushonga ichi chinoreva kuti intravesical Kutarisirwa kunofanira 35-50 MG pa installation.

Kurapwa kunofanira kuitwa panguva zvikamu mazuva 7-28, zvichienderana nechinangwa (kudzivirira kana kurapwa).

Concentration zvinodhaka mhinduro inofanira kuva 1 MG / 1 Rine mamiririta mvura mhinduro kana chaiko.

Instillation rinoitwa mukati 2 maawa. Panoperera murwere vanofanira zviri dundira.

nemishonga

Kugadzirira "Doxorubicin", iro mirayiridzo pamusoro apa ingaita kuti zvinotevera divi siyana:

• kurutsa, abdominal kurwadziwa, kuda kurutsa, colitis, stomatitis, manyoka, esophagitis, nemumuromo mucosa hyperpigmentation, kudya yakawedzera bilirubin wevasungwa muropa, gastrointestinal ropa, vakawedzera hepatic transaminases;
• dose-muyanzvi reversible leukopenia, thrombocytopenia, kupererwa neropa, leukopenia, neutropenia;
• sinus tachycardia, atrioventricular chidhina, tachyarrhythmia chimiro congestive mwoyo kukundikana, bradycardia, thrombophlebitis, bazi nechigumbuso rake chiputu, abnormalities musi ECG, ventricular arrythmia, pulmonary embolism, phlebitis, thromboembolic yematambudziko;
• amenorrhea, oligospermia, hyperuricemia, Urinary tsvuku staining, azoospermia;
• conjunctivitis, keratitis, lacrimation;
• peripheral neurotoxicity, nezvipusha, chaanoziva;
• edema, reversible alopecia, photosensitivity, ganda hyperpigmentation, mapundu, kuvaviwa, irwadziwe kwazvo, mapundu, erythema, nyorova Epiderme e;
• dermatitis, mapundu, bronchospasm, ganda Flushing, anaphylaxis;
• Local phlebitis, kwakaratidzwa kuzvimba, fleboskleroz, thrombophlebitis, zvomunharaunda marwadzo, tishu necrosis;
• polyuria, nocturia, dysuria, necrosis pamusoro dundira membranes, hematuria, kusagadzikana, kunorwadza weti;
• erythematous striation panguva jekiseni nzvimbo;
• kuneta, zvakawanda zvive, fivha, chills, kukura lymphocytic kana myelocytic neleukemia (chenjera), hyperuricemia, Maze, nephropathy;
• urikanwi 12 duodenal / gastric, biliary kuoma dzimwe nhengo dzomuviri.

Zviratidzo ovhadhozi

Ndezvipi zviratidzo ovhadhozi kuitika kana ukashandisa vazhinji "Doxorubicin" chinodhaka? Mirayiridzo Dzokushandisa rinoti kuti ovhadhozi pamusoro mari kungaita kuti ine chepfu zviratidzo zviri kwakaratidzwa zvomudumbu hurongwa, uyewo zvikuru myelosuppression. Uyezve, yepamusoro mishonga zvinodhaka inogona kunyatsonanga nyore kuti rikwanise mwoyo chirwere.

Mushonga mushonga "Doxorubicin" haako. In ovhadhozi kunoita raitongwa symptomatic kurapa. Uyewo, zviri muchipatara uye vari kubatwa antibacterial zvinodhaka.

zvinodhaka kwavatori

Zvinoita chokubatanidza nevamwe zvinodhaka zvinodhaka "Doxorubicin"? Mirayiridzo dzokushandisa kunoratidza kuti kana ukashandisa chokushandisa ichi akabatana nevamwe zvinodhaka cytotoxic kazhinji akaratidza dzavo chirungiso toxicity.

Kana mubatanidzwa mushonga nevamwe zvinodhaka cytotoxic, vane cardiotoxicity (semuenzaniso, "FU" kana "Cyclophosphamide"), zvinoda kungwarira kuongorora mwoyo panguva yose nzira yokurapa.

"Streptozocin" anowedzera hafu youpenyu "Doxorubicin".

The kurapa "Doxorubicin" murwere anogona kuratidza zviratidzo rikwanise Hemorrhagic cystitis pashure kurapwa "cyclophosphamide", uyewo kuwedzera Chiitiko kuti chiropa toxicity pashure kurapwa "mercaptopurine."

Kushandiswa "Paclitaxel" pamberi chaiko okusuma "Doxorubicin" anogona kumutsa nokuwedzera ropa wevasungwa okupedzisira.

Ndezvipi zvinodhaka hazvibvumidzwe kubva kushandisa zvinodhaka "Doxorubicin"? Mirayiridzo kushandiswa (mhuka haina basa) rinoshuma kuti chokushandisa ichi haafaniri kusanganiswa nezvimwe zvinodhaka. Somuenzaniso, ndiko pharmaceutically Inoenderana "heparin", "Dexamethasone", yavaibvisa succinate, "hydrocortisone", "cephalothin", "aminophylline", "FU" uye zvimwe zvinodhaka anticancer.

Kana pamwe mhenyu nemavhairasi yokudzivirira zvinokwanisika nemavhairasi kuberekana uye wakawedzera divi siyana uye kuderera antibody usage mumuviri womurwere mukupindura kushandisa yokudzivirira.

Dzinenge kurumbidza pakushandisa zvinodhaka

Zvaunofanira kuziva usati nokushandisa "Doxorubicin-Lance"? Mirayiridzo zvokushandisa zvinoratidza kuti mukufamba kurapwa antineoplastic yomuchipatara zvakakodzera kuti tiite nguva dzose richiona nezvezvabuda chiropa basa, mufananidzo peripheral ropa, ECG uye Ultrasound mwoyo.

rokutengesa zvinhu, nzira okuchengetera uye sherefu-upenyu

Where vanofanira zvinodhaka "Doxorubicin-Lance"? Mirayiridzo dzokushandisa inoshuma kuti chokushandisa ichi chinofanira kuchengetwa nenzira yakaoma uye rima panzvimbo tembiricha asingadi kupfuudza madhigirii shanu.

The medicament ukasunungurwa Pharmacies kubudikidza mushonga chete. Its pasherefu upenyu makore maviri.

Price uye analogues

Mari zvinodhaka anonzi 120-150 rubles muna 5 Rine mamiririta. Kana zvakakodzera zvinogona kutsiviwa pachishandiswa akadai "Doxorubicin-din email", "Lachema Doxorubicin", "Onkodoks 50", "10 Onkodoks", "Doxorubicin-Ebewe", "CRC-Doxorubicin" uye vamwe.

Consumer wongororo of mishonga

Zvino munoziva kuti kushandisa zvinodhaka "Doxorubicin". Mirayiridzo yokushandisa uye kuchengetera mushonga akaratidzwa kumusoro.

Zvikuru vazhinji nevatengi wongororo chokuita chakakomba nenjodzi kuti munguva kurapwa pamwe zvinodhaka. To Migumisiro ava womukati nhengo zvechidhimoni, refu-refu kunzwa kurwara, bvudzi kurasikirwa uye nokuumbwa nemaronda panguva jekiseni nzvimbo.

On zvakanaka mashoko vari apo neapo. Uye ichi hazvishamisi, sezvo kubudirira anticancer zvinodhaka vanofanira kuongorora chete ane ruzivo nyanzvi, pana vazhinji-siyana: mhando monotherapy kana mubatanidzwa marapiro, kenza, murwere ezvinhu, uye dzimwe nguva refu zvabuda.