Iintsholongwane ezikhuselekileyo zikhupha ngaphandle kwe-Anti-Estrogen Impact yeHormone Treatment
I-Tamoxifen yinyango ye-hormone yonyango ethathwa ngabafazi abaninzi be-premenopausal emva kokuzalisa unyango lwabo lokuqala lwe-estrogen receptor. Ukuphatha iziphumo ezichaphazelekayo ze-tamoxifen (ezifana nokutshisa okutshisa) kunye nokuncedisa ngokudakumba, oogqirha bahlala banika i-anti-depressants. Nangona kunjalo ezininzi izidandlululo zingaphazamisa, okanye zikhuphe ngokupheleleyo, iinzuzo ze-tamoxifen.
Yintoni omnye umntu omele athathe i-tamoxifen?
Ukusetyenziswa kweTamoxifen ngeCanscer Breast
Xa umfazi sele egqityiwe unyango oluphambili lomdlavuza webele, kunye nezokwelapha ezifana nokuhlinzwa , i- chemotherapy , kunye neyeza zonyango , unokudinga ukuthatha i-tamoxifen. Kwabesetyhini abanesifo se-estrogen se-tumor, i-hormone therapy inganciphisa umngcipheko wokubuyela umhlaza (ukuphindaphinda) ngama-50 ekhulwini.
Ukukhethwa kwamachiza kuxhomekeke kwimeko ye-menopausal. Ukuba ibhinqa i-premenopausal, i-tamoxifen iqhelekileyo isicatshulwa esikhethekileyo. (Kwalabo abathumela i-postmenopausal, okanye abo bangama-premenopausal kodwa baye bafumana unyango lwe-ovarian suppression, i- aromatase inhibitor isetyenziswe endaweni yoko).
Iiseli zomhlaza zesifo se-Breast estrogen receptor positive zichithwa yi-estrogen. I-Estrogen ekhoyo emzimbeni (eyenziwe ngama-ovari) ibophelela kule miliza yomhlaza ukuba ibangele ukukhula. I-Tamoxifen isebenza ngokubophelela kula ma-receptors ukwenzela ukuba i-estrogen ayikwazi, ngokukodwa ilambile iiseli zomhlaza.
Iziphumo zecala le-tamoxifen ziquka iimpawu zesifo se-menopausal ezifana nokutshisa okutshisa, i-libido ephantsi, kunye nokomama wesisu. Kwabafazi abangakafiki ukuphela komntu, ukutshisa okutshisa kunokuba buhlungu kakhulu, kodwa sifunde kwiminyaka yamuva ukuba amanye amayeza ahlukumezayo anganciphisa ukutshisa okutshisa.
Ngelishwa, ezinye zezi-antidepressants zinganciphisa ukusebenza kwe-tamoxifen.
Isifo seKesibindi kunye nokuPhepha
Akumangalisi kukuba, abaninzi abafazi abaye baphathwa ngokuba ngumhlaza wesibeleko banokudandatheka. Ukudibanisa ukuxilongwa kwingozi yokuphila, iziphumo zonyango, kunye nokutshintshwa komfanekiso womzimba ohamba kunye nonyango konke kubeka isigaba kwimpembelelo enkulu yemvakalelo. Ngelishwa, emva kokuba abaninzi abafazi abanomdlavuza wesibeleko baphathwa (phantse kwiindawo ezithile) kunye nezidandlululo, kuye kwafumanisa ukuba ezininzi iintsholongwane zanciphisa umphumo we-tamoxifen. Oku kwenzeka ntoni?
Tamoxifen kunye ne-Drug Interactions
I-Tamoxifen kunye nokusebenzisana kweziyobisi ziqhelekileyo, kwaye oku kuquka amachiza amaninzi kwongezelela kwi-antidepressants. Ekubeni amaninzi alawa asetyenziswa ngokusetyenziswa kweziyobisi, kubandakanywa izidakamizwa ezingaphezulu kwe-counter-therapy ezifana no-Benadryl, kubalulekile ukuthetha nodokotela wakho kunye nekhemistiki malunga nayiphi na imishanguzo, ukulungiswa kwamanye ama-counter-counter-catering, ukuba ucinga kwiziyobisi. Ekubeni abantu abaninzi bathatha i-tamoxifen iminyaka emi-5 ukuya kwe-10, oku kubaluleke nakakhulu. Gcina ukhumbule ukuba akubona bonke oogqirha abaqhelene nale nxaxheba (kwaye sifunda ngakumbi ixesha lonke).
Kuthetha ukuthini ukuba ukuba kufuneka uhambe unonophelo olukhawulezileyo, umzekelo, usulelo, uthetha kwi-oncologist yakho okanye kwi-pharmist ngaphambi kokuthatha nayiphina imishanguzo enqunyiwe.
I-Tamoxifen isetyenziselwa umzimba ukuba iphele. I-Endoxifen iyamaxesha angama-30 ukuya kuma-100 anamandla ngaphezu kwe-tamoxifen, kwaye ixanduva lwezona ziphumo zeeklinikhi. I-Tamoxifen idilizwe ukuphela kwe-endoxifen yi-cytochrome P450 enzyme CYP2D6 (kunye nezinye ezingabalulekanga). Nasiphi na izidakamizwa ezinciphisa umsebenzi we-CYP2D6 (kwaye zininzi) zinokunciphisa ukuphulwa kwenkqubo kwaye ngoko ke, inani le-endoxifen eliveliswayo.
I-Tamoxifen kunye ne-Antidepressants: Ukusebenzisana
Sisafunda ngokubanzi malunga neengxaki zokuxhatshazwayo kunye nemiphumo yazo kwizinga le-tamoxifen emzimbeni, kodwa ngoku siye saqaphela ukuba izidalwa ezixhatshazwayo ezahlukeneyo zingenza i-tamoxifen ngeendlela ezahlukeneyo. Ezinye izidandlululo (ezifana neProzac kunye nePaxil) ziphantse zilawule umphumo we-tamoxifen. Kule meko, kungathi kungathathi i-tamoxifen nonke (kwaye kungenalo inzuzo yokunciphisa ingozi yokuphindaphinda).
Nezinye izidandlululo zinobudlelwane obunokulinganisela, kunye nabanye, kuphela ukusebenzisana okufutshane. Ngokwahlukileyo, esinye isondlo sondlo singanokwandisa umphumo we-tamoxifen (kunye nemiphumo emibi), nangona ezinye izifundo zibonisile okuchaseneyo ..
Ngezantsi itafile esishwankathela into esiyikholelwayo yinyani malunga neengcinezelo ezininzi namhlanje. Le ngingqi yocwaningo olusebenzayo, kwaye mhlawumbi siza kufunda ngakumbi kwixa elizayo. Ukuba ucinga ngophilisi oluxhatshazelisayo, xubusha ngenyameko nodokotela wakho, kodwa kananjalo ubuze ukuba ngaba kukho into etshintshileyo.
Abaxhatshazwayo kunye nendlela abadibana ngayo neTamoxifen
| I-Antidepressant Drug | Ukusebenzisana noTamoxifen | Ukhuseleko |
Paxil (paroxetine) Prozac (i-fluoxetine) | Ikhusela i-antiestrogen inzuzo | Gwema ukusebenzisa |
I-Cymbalta (duloxetine) Wellbutrin (bupropion) Zoloft (sertraline) | Ukuphazamiseka okuphakathi kunye ne-antiestrogen inzuzo Qaphela: Izifundo ziqinisekisa ukuba iZoloft iphazamise iTamoxifen. | Ukwandisa ingozi |
| Wort John's Wort (hypericum) | Ukuxhaswa ngokuthobekileyo kwe-antiestrogen | Ingozi eyanda |
Celexa (citalopram) Lexapro (escitalopram) Pristiq (desvenlafaxine) Remeron (mirtazapine) | Ulwalamano olunzulu Qaphela: UPristiq noRemeron abazange bafunde kakuhle ukusebenzisana neTamoxifen. | Ncipha ingozi |
| Black Cohosh (Actaea) | Inokuthi ingavimbela okanye ikhulise inzuzo ye-antiestrogen kuxhomekeke kwisifundo. Qaphela: Kukho izifundo ezimbalwa zokusebenzisana neTamoxifen, kwaye ezininzi ziye zenziwa "kwi-vitro" (kwibhodi kwaye kungekhona kubantu). | Ncipha ingozi |
Effexor (venlafaxine) | Phantse akukho nziswano kunye neTamoxifen | Okukhethileyo |
Ngaphantsi kwiTamoxifen kunye ne-Antidepressants
Ukwazi malunga nokusebenzisana phakathi kwe-tamoxifen kunye neengxaki zokuxhatshazwa kubalulekile xa ucinga naluphi na lwezi zi yobisi. Ezinye izidandlululo zithintela kakhulu imiphumo ye-tamoxifen, kwaye kucingelwa ukuba le ntsebenziswano sizathu sokwandisa izinga lokufa kwabasetyhini abanomdlavuza wesibeletha owathatha uPaxil. Okwangoku, indlela ekhuselekileyo yokutshisa kunye nokuxinezeleka kubonakala ngathi yi-Effexor, kodwa kwakhona kubalulekile ukuba uqaphele ukuba le ndawo iyasebenza okanye uphando, kwaye sinokufunda ngakumbi kwikusasa elikufutshane. Ekubeni u-cohosh omnyama unedumela lokunceda ngokutshisa okutshatsene nokuhambelana nomhlaza webele, kodwa kunokunxibelelana kunye ne-tamoxifen, kubalulekile ukuthetha ne-oncologist yakho malunga nayiphi na imishanguzo, ukulungiswa kwamanye ama-counter-counter-catering, okanye ulungelelaniso lokutya ocingayo.
> Imithombo:
> Haque, R., Shi, J., Schottinger, J. et al. I-Tamoxifen kunye ne-Antidepressant Drug Interaction kwiqela lama-16,887 Abasinda kwi-Cancer Brever. Umbhalo weNational Cancer Institute . 2015. 108 (3): djv337.
> Juurlink, D. Ukuhlaziya ukusebenzisana kwezidakamizwa phakathi kweTamoxifen kunye ne-SSRI Antidepressants. IBritish Medical Journal . 2016. 354: i5309.
> Li, J., Godecke, T., Chen, S. et al. Ukusebenzisana kwe-Vitro Metabolic phakathi koMnyama weChosh (Cimicifuga Racemosa) kunye neTamoxifen nge-Inhibition of Cytochromes P450 2D6 kunye ne-3A4. Xenobiotica . 2011 uAgasti 9. (Epub phambi kokuprintwa).