Medicine "Cyclophosphamide": mirayiridzo kushandiswa, mutengo, analogs, mugadziri uye wongororo

"Cyclophosphamide" chiri alkylating akakura. Izvi mushonga antitumor mumiririri. Anogadzirwa somunhu chena kana anenge vakadaro crystalline upfu. Mamwe mashoko pamusoro zvinodhaka ichi.

"Cyclophosphamide" - mugadziri

Ita chinodhaka mune Russian kambani JSC "kudzidza nezvezvinhu zvipenyu." It riri muguta Saransk mumugwagwa Vasenko, d. 15a.

mari

unogona kutenga upfu №1 «Cyclophosphamide" chero chezvinodhaka. mutengo wayo kumativi 90-98 rubles.

The mushonga siyana

Kubva upfu ichi, mushonga yakagadzirira. Mwari akaronga kuti intramuscular uye intravenous Kutarisirwa

Features sezvamunoita

The Zvinoumba chinu nerimwe chete upfu zvinosanganisira kushingaira mhando fuma inonzi "cyclophosphamide". Zvimwe ndiwo nhamba yake. Zvinoti rine "Cyclophosphamide" MG 200 vakati fuma pa chinu. Izvi somushonga chigadzirwa hapana Excipients.

Description of pharmacological chiito

Pachishandiswa mirayiridzo kushandiswa, "Cyclophosphamide" - iri alkylating cytostatic zvinodhaka. makemikari anoumba Its yakafanana zvinhu zvakadai senitrogen masitadhi. Pharmacological chaizvoizvo "cyclophosphamide" ndiko kuti pave transverse mhando crosslinking pakati DNA uye RNA tambo. Uyewo gadziriro ino kunoita mapuroteni usage chinovhiringidza.

"Cyclophosphamide" - analogues

Muchiitiko chino, kunhonga mari kuti panguo bumbiro kuKiriyati muchikwata wechina. Zvikuru chairwo ndiye "Cyclophosphamide". Analogs zvinodhaka ichi pane vakawanda. Zvinonyanyozivikanwa:

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

Kusarudzwa nechimwe gadziriro zvakaitwa nachiremba nomunhu. Muchiitiko chino, zvinotora kufungawo utano uye shiviriro zvinoriumba.

Mune zvimwe zviitiko, rimwe?

Ngationgororei pfungwa iyi zvizere. Zvikuru chaiyo iri kushandisa zvinodhaka akadai "Cyclophosphamide". Mirayiridzo kushandiswa panyaya iyi chinhu chinokosha zvikuru. Rinotaura kuti mushonga unoratidzwa zvinotevera nyaya:

1. Kana kuona chisingaperi uye rikwanise lymphocytic neleukemia.
2. In pamberi vakawanda myeloma.
3. Kana zviratidzo vasiri Hodgkin rwekenza yelymphoma.
4. In zvinoitirwawo Mycosis Fungoides uye retinoblastoma.
5. In pamberi Hodgkin nehosha uye ovarian uye zamu kenza.
6. Kana kuratidzwa zviratidzo neuroblastoma.

Kunze kwaizvozvo zvose, mushonga wacho ikashandiswa pamwe nemamwe zvinodhaka antitumor vamiririri kuti mishonga anotevera ezvinhu:

1. Kana utachiona masero anomera.
2. kenza dundira uye yemapapu.
3. Sarcoma kuti nyoro tishu mhando.
4. In zvinoitirwawo prostate uye gomarara.
5. Apo Ewing kuti sarcoma.
6. Kana anomera Wilms '.
7. Kana retikulosarkome.

Uyewo gadziriro akadai "Cyclophosphamide", mhinduro dziri akanaka, unoshanda senzira immunosuppressive mumiririri mhando mberi kuoneka autoimmune zvirwere. Panyaya iyi zvinoreva chitarisiko psoriatic uye dzinonzi rheumatoid arthritis, autoimmune hemolytic kupererwa neropa, collagen, nephrotic syndrome. Akatiwo nzira anovanza batanidza kurambwa kuita.

Contraindications

"Cyclophosphamide" rine zvimwe contraindications. Hazvigoni kushandiswa:

1. Panguva achiyamwa nguva uye pamuviri.
2. In nemuumbi zvaipesana mwongo chaitika.
3. Kana zviratidzo hypersensitivity.
4. Kana kunonoka weti.
5. In pamberi basa zvirwere.
6. Munguva kuratidzwa cystitis.

The nokungwaririra KWAKAKOSHA "Cyclophosphamide", analogues zvakatuswa pamusoro apa, dzakabatwa mune zvimwe zviitiko. Kureva, pamberi zvinotevera zvirwere:

1. Nefrourolitiaza.
2. Zvakakomba mwoyo chirwere, chiropa uye itsvo.
3. Gout.
4. Bundu infiltration kuti mwongo masero.
5. Adrenalectomy.
6. Kudzvinyirira kuti mwongo chaitika.

Description padivi anokonzerwa

"Cyclophosphamide", anoreva zvakafanana (analogues) ayo wainyatsotaura pamusoro, kungawedzera chidzoke zvinotevera nemishonga:

1. The zvomudumbu Hurongwa vangapikisa zviratidzo zvakadai kurutsa, kuda kurutsa, kudya kusagadzikana, stomatitis, kurwadziwa abdominal nzvimbo, manyoka kana kupatira. Uyewo kuvazivisa muri munhu nyaya jaundice uye Hemorrhagic colitis.
2. Mugore hematopoietic hurongwa kuratidzwa vakanga vakachengeta neutropenia, kupererwa neropa, thrombocytopenia, leukopenia. On zuva 7-14 kugamuchirwa anogona kuderera zvishoma nhamba maplatelet uye leukocytes.
3. Paganda kuratidzwa alopecia kuchengetwa. Kura bvudzi zvakare pashure zvinodhaka zvakakwana. Uyezve, panguva kurapwa kungaitwa ganda nekumhanyirira. Panogona kuva pamberi pigmentation ganda uye ezvipikiri kuchinja.
4. In kumwoyo kana raitongwa dzakakwirira mishonga yacho mushonga pamusoro nguva nguva refu anogona kuva nokuratidzwa cardiotoxicity. Zvakakosha kuyeuka. Uyezve, isu vaichengeta kwaita zvakaoma, uye dzimwe nguva zvinouraya, zviitiko mwoyo kukundikana. Izvi imhaka panowanikwa myocarditis Hemorrhagic mhando.
5. Mugore Urinary turakiti kungaita necrosis pamusoro renal migero (kusanganisira rufu), Hemorrhagic cystitis kana urethritis, Urinary dundira fibrosis. Mune zvisingawanzoitiki Muzviitiko, kushandisa dzakakwirira dosages zvinodhaka zvingaitika nephropathy, hyperuricemia uye renal ushande. Kuvapo masero epithelial iri weti zvingaitika.
6. In iri kufema ezvinhu anogona kuva nokuratidzwa interstitial pulmonary fibrosis.
7. Dzokubereka nadzo zvinetso zvinogona kuitika oogenesis uye spermatogenesis, uye kusabereka. Last chiratidzo mune dzimwe nguva zvingava kusingarapiki. Vakadzi vakawanda vari kushanda pomutumwa vakachengeta kukura amenorrhea. Mushure kurapwa, Nguva dzose varikutsika kazhinji anonaya. Varume vari mushonga kungaita kuti kwaita oligospermia kana azoospermia, uyewo kunosiyana inosiyana testicular atrophy.
8. Muchiitiko ichi kunogona kuonekwa uye neutachiona. Kuti kuratidzwa ane ganda mapundu, kuvaviwa, mikoko, anaphylactic siyana.
9. Uyewo muchiitiko ichi pangava panowanikwa nemishonga. Kureva ropa kune chiso ganda, akatsvuka, nyanyisa yechipiri namamota, kunyanya vangadikitira, nomusoro.

siyana kudyidzana

Kana kugamuchira chinodhaka ichi, vamwe zvinhu kuti pave microsomal oxidation ari chiropa, anogona dzika muitiro vakafurira microsomal muviri kuti cyclophosphamide. Izvi zvinotungamirira zvimwe zvinhu. Kureva kuti hombe inotungamirwa alikiliruyuschego mhando metabolites. Izvi kunoderedza nguva iro hafu-upenyu cyclophosphamide rinoitwa, uye kunowedzerawo kwayakaita. Cyclophosphamide, iro chaizvo mazhinji uye kuchititadzisa cholinesterase kwebasa, kunosimbisa kuitwa suxamethonium. asiwo kunobatsira kuderedza kana kunetesa muviri kuti cocaine. Somugumisiro, kunowedzera kana yakawedzera nguva kwayo kushanda uye kunowedzera ngozi chepfu migumisiro. Izvi ane kunambwa yose muviri. Uyezve, mashoko mawa kushandisa allopurinol anogona kubatsira chepfu zvinosuruvarisa mwongo.

Apo co-raitongwa pamwe cyclophosphamide allopurinol, colchicine, probenecid, sulfinpyrazone vangada kururamiswa mishonga protivopodagricakih mhando zvinodhaka pakurapa gout uye hyperuricemia. Uyewo, kana kuwedzera ichi vangapikisa nephropathy ngozi kuti chokuita zvakawedzera kugadzirwa uric asidhi kushandisa cyclophosphamide.

Zvapedzisira fuma kunogona kuwedzera anticoagulant basa. Sezvo kwetunhu ichi vari chiropa zvinoderedza zvinokonzera kusimudzira kweropa uye vasingadzoreki platelet kugadzirwa. Zvisinei, pane zvingaitikawo vasanyanye anticoagulant basa kuburikidza risingazivikanwi mashandiro mhando.

Cyclophosphamide runogonesa kuti cardiotoxicity kuti daunorubicin uye doxorubicin. Other immunosuppressive vamiririri (chlorambucil, azathioprine, tacrolimus, corticosteroids, mercaptopurine, etc.) kungawedzera mukana yechipiri utachiona uye anomera.

Kushandiswa mawa pamusoro lovastatin pavarwere vane mwoyo transplantation unogona kuwedzera ngozi zvirwere zvakadai rhabdomyolysis uye rikwanise renal kukundikana.

Kana akabatana zvinodhaka ichi rinoshandiswa zvinodhaka myelosuppressive kana mwaranzi marapiro, zvinokwanisika kuratidzwa chirungiso chinovhiringidza kuti mwongo chaitika.

Mawa kwokubatsira cytarabine panguva mukuru mishonga ine zvinhu zvakadai cyclophosphamide, panguva regadziriro Danho kuti mwongo transplantation kwacho kunotungamirira cardiomyopathy pamwe kuwedzera Frequency kutanga rufu.

Huru zvinodiwa

In kushanda inorangarira zvinotevera:

1. Panguva kurapwa pamwe zvinodhaka ichi vanofanira kugara basa bvunzo ropa rokuongorora mwero myelosuppression. Zvinonyanya zvakafanira kuti kuteerera uwandu maplatelet uye neutrophils.
2. Unofanira kugara anoita weti bvunzo kuvapo matsvuku eropa count. Kuvapo kwavo kungawedzera pokumuka zvirwere zvakadai Hemorrhagic cystitis. Pamusoro kuonekwa zviratidzo zvakadai kurapwa ne "Cyclophosphamide", mutengo iro pamusoro apa, iwe unofanira kumira.
3. Sezvo nhamba maplatelet (asingasviki 100,000 / Rine mamiririta) uye / kana masero machena eropa (<2,500 / l) kugamuchira chishandiso vanofanira kumiswa.
4. Apo chirwere kunoitika munguva zvinodhaka kurapa, akati kurapwa inofanira dzakavharwa kana kumbomiswa. Kana kune kugashira chipimo chemushonga anofanira kuderedzwa. Varume nevakadzi panguva kurapwa kwacho, "cyclophosphamide" zvinokosha kushandisa yakavimbika nzira pamuviri.
5. Panguva mushonga chete zvinodhaka ichi vanofanira kurega doro.
6. In Kana apo elapse mazuva gumi okutanga pashure pokuvhiyiwa, rakanga raitwa pasi vakawanda yokutindivadza, uye murwere kuitwa ushandiswe "Cyclophosphamide", mutengo iro pamusoro apa, unofanira kuzivisa anesthesiologist akaisa.
7. Patient pashure akabatwa adrenalectomy, zvinokosha kuita akabata chipimo chemushonga kuchinja sezvo corticosteroids, iyo inoshandiswa yokutsiva kurapa kwacho, uye ane mushonga zvakadaro, sezvo kurapa, "Cyclophosphamide".

zvakafanira zvokungwarira

Negashiro zvinodhaka zvinoita chete pasi pokudzora chiremba ane ruzivo mune mishonga. Zvinofanira kuva kuomesa zvaidiwa chipimo chemushonga hwechiKomonisiti. Izvi zvinofanira kuitwa kunyanya yakasanganiswa mishonga. Uyewo, havafaniri kupedza inotevera doubling of dose kana rapfuura mumwe kubuda. Mukugadzirwa zvinodhaka izvi zvokushandisa vacheche havana varumbidzwa kushandisa diluents ane benzyl doro. Sezvo izvi zvinogona kutungamirira kukudziri- dzinouraya chepfu syndrome. Kureva kuti chimiro metabolic acidosis, CNS mwoyo, kufema kukundikana, renal kukundikana, hypotension, nezvipusha, intracranial ropa.

Panguva yose yawapiwa inokurudzirwa kuti aite kuisira ropa (1 nguva pavhiki 100-125 Rine mamiririta). Izvi zvinofanira kuitwa nechinangwa kudzivirira zvirwere zvakadai hyperuricemia uye nephropathy, ndiro wakakodzera kuti paumbwe vawedzere uwandu uric acid. Zviratidzo izvi zvinowanzoitika pakutanga kurapwa nguva. Uyewo, asati akati zvinodhaka kurapa uye mumaawa 72 pashure Urongwa inokurudzirwa kuita imwe mvura yaunodya (anenge 3 litres pazuva), kushandisa allopurinol (mu chaiyo nyaya), uye nzira iyo akaita alkaline weti. Nokuti kudzivirira kuratidzwa Hemorrhagic cystitis Kazhinji zvakakosha kuita nokuisa pamusoro dundira uye kutora "UROMITEKSAN". Dai kwaiva kutanga zviratidzo chirwere, mushonga akati gadziriro dzinofanira kumiswa kusvikira kwakakwana kubviswa chero zviratidzo.

To attenuate mhando dyspeptic mananara anogona kutora cyclophosphamide mukati rokutanga zuva iri mishonga zviduku. Complete kana zvishomanana alopecia, izvo zvinogona kuitika munguva kurapwa reversible uye mushure kosi ipfupi kushanda inowanzotorwa bvudzi kukura. Zvisinei, ruvara yavo uye mamiriro vangagara kuchinja.

Kana mukawana chills, fivha, chikosoro kana hoarseness, kurwadziwa rezasi musana nzvimbo, kana ari parutivi, inorwadza kana chakaoma weti, ropa kana ropa, dema zvituru, ropa riri pachituru weti kana hwobva kubvunza chiremba.

Mukana thrombocytopenia, zvichiita kuti kudiwa rinokosha hanya panguva mabasa akadai invasive maitirwo ezvinhu uye mazino dzokuvhiya. Zvinofanira kugara kuzoongorora ganda uye mucous membranes uye intravenous nzvimbo. Izvi kuti kuziva zviratidzo ropa. Zvinokoshawo kuti tizvidzore kakawanda venipuncture uye vanoramba intramuscular jekiseni. Zvakakodzera kudzora ropa kugutsikana mune mutsvina yadzo, mumarutsi, weti. Varwere ava nokungwarira hwakanyanya vanofanira kuita ndebvu muitiro, manicure, dentifrices, toothpicks, etc. Spaces Panguva iyoyowo anofanira aisada mapopoma uye mamwe makuvaro. Acetylsalicylic asidhi uye doro riri wairambidza kuti zvinowedzera mukana gastrointestinal kubuda ropa. Muchiitiko ichi zvakafanira kushandisa Kunonoka majekiseni purogiramu (pashure 3-12 mwedzi wokupedzisira mishonga kosi kupera). Zviri chinodiwa kuti usagunzva noutachiona varwere. Panguva kurapwa zvakafanira kushandisa yakakwana pamuviri matanho.

Kana kunyorera akati zvinodhaka pamwe mucosa kana ganda zvinofanira wosukurudzwa kwazvo nemvura bani mugove kana sipo, ukuwo.

Achiyamwa uye pamuviri

Pane kukamurwa yaingowanikwa panyaya iyi, iro rine "Cyclophosphamide". Manual kunoratidza kuti contraindicated ndiko kushandiswa kwezvinodhaka ichi panguva yepamuviri. Panyaya iyi, muchikwata che nezvainoita fetus runotaurwa «D» kubudikidza FDA. Panguva kurapwa zvakafanira kurega achiyamwa.

ovhadhozi

Muchiitiko chino, pane mamwe nuances. Pamberi yakananga mushonga ane ovhadhozi pamusoro vakati Pfungwa harizivikanwi. Chinhu yakavimbika chokwadi. In ovhadhozi Chikumbiro anofanira dzika kutsigira zviyero kusanganisira zvakakodzera kurapwa kwezvirwere zvinotapuriranwa, uyewo kwokuonekwa cardiac uye / kana myelosuppression.

chengetedzo mamiriro

Panyaya iyi, zvinoda zvimwe zvinhu gadziriro akadai "Cyclophosphamide". Mirayiridzo dzokushandisa iroro kuti rinofanira kuchengetwa panguva tembiricha isingadariki 10 ° C panzvimbo zvaoma uye kudzivirirwa chiedza. In ichi chevana kuwana zvinofanira kudzorwa.

pasherufu upenyu

Pane imwe nguva apo yakadaro mushonga inogona kushandiswa se "Cyclophosphamide". Mirayiridzo kushandiswa anoratidza kuti kwayo upenyu kushanda uri 3 years. Muchiitiko chino, unofanira kuomerera zvimwe zvinhu. It iri chokwadi kuti vakaraira wairambidza kushandisa zvinodhaka ichi mushure iyi anofa.

Implementation

In mirayiridzo iyi, panewo mamiriro kuti "Cyclophosphamide". Mirayiridzo application zvinoratidza kuti mushonga ukasunungurwa chete Pharmacies kubudikidza mushonga.

mhedziso

Murugwaro urwu, pane yakawanda anobatsira mashoko. Uye chii chinonzi "Cyclophosphamide", mirayiridzo kushandiswa, mitengo zvinodhaka ichi. Zvisinei, munhu anofanira kuyeuka kuti asati kushandisa zvinodhaka vanofanira bvunza chiremba anokwanisa.