I-Doxorubicin (igama lezorhwebo u-Adriamycin) lilungu eliqhelekileyo elisetyenziselwa i- chemotherapy agent esebenza kakhulu kwiiHodgkin kunye ne-Non-Hodgkin lymphomas . Isetyenziswe kuzo zonke iirimimethrasi zokuqala zamakhemikhali. Ikwaseklasini yamachiza e-chemotherapy ebizwa ngokuba yi-anthracyclines.
I-Doxorubicin Ngamana Yenza Intlungu Yentliziyo
Kuyaqatshelwa kakuhle ukuba i-doxorubicin ingabangela umonakalo entliziyweni kwabanye abantu.
Nangona ezinye i-anthracyclines (njenge-epirubicin kunye ne-mitoxantrone) inokubangela ukuba umonakalo wentliziyo, amathuba aqheleke kakhulu kunye ne doxorubicin. I-Doxorubicin ibangele kokubili ukulimala kwentliziyo yokuqala kunye neyokugqibela (ebizwa ngokuba yi-cardiotoxicity). Ukulimala kwangaphambili kwenzeka ngokukhawuleza emva kokulawulwa kweziyobisi okanye kwiintsuku ezi-1 ukuya kwezi-2. Kukho iziphumo ezincinci ezithathwa kwi-electrocardiogram (EKG) kwaye kwiimeko ezininzi zixazulula ngaphandle kokubangela iingxaki ezinkulu. Yona monakalo-ekuqalekeni okubalulekileyo kwaye ngakumbi.
Ukulimala kweCardia
Umonakalo omhle entliziyweni uqala malunga nonyaka okanye ngaphezulu emva kwe-chemotherapy. I-Doxorubicin ichaphazela kakhulu iintliziyo zeentliziyo. Yenza buthathaka iintliziyo zeentliziyo kunye nokwenza ukupompa kwegazi kunzima kunentliziyo. Xa kunzima, kukhokelela kwimeko ebizwa ngokuba yi- congestive heart failure (CHF). Abantu abane-CHF bayakhalaza ngeempawu ezininzi
- Ubunzima obuthathaka kancinci kumsebenzi onzima, obangela ukhathala okanye inkathazo yokuphefumula xa ukhuphuka izitebhisi okanye uhamba
- Isikhwehlo esibuhlungu ebusuku
- Ukuvuvuka kweenyawo
- Ubunzima bokuphefumula ngokuphumla
Ukuba kunzima, i-CHF inokubangela ukukhubazeka kakhulu kunye nokufa.
I-Doxorubicin Inokulimaza Njani Intliziyo?
I-Doxorubicin iphendula ngezinye iikhemikhali emzimbeni (obizwa ngokuba ngama-enzyme) ukuvelisa izinto eziyingozi ezibizwa ngokuba ngama-radical ezamahala. Ukuveliswa kwale mihlaba ye-radicals enobungozi inyuselwa kwizitho ezinjengeentliziyo apho kukho i-oksijeni nensimbi.
Ngelixa ezinye izitho zineenzyme ezikhethekileyo zokutshabalalisa ezi zintlalo zamahhala, intliziyo inexabiso elincinci lalezi enzymes. Oku kwenza ukuba iintliziyo zeentliziyo zonakalise umonakaliso nge-radicals yamahhala.
Izinto Ezichaphazela Ukulimala Kweentliziyo
Izinto ezininzi zandisa amathuba okulimala kwentliziyo kunye ne doxorubicin.
- Umlinganiselo ophezulu we doxorubicin unako ukuvelisa umonakalo wentliziyo. Ubungakanani bomthamo we doxorubicin ofunyenweyo ngexesha lobomi bomntu kufuneka bube ngaphantsi kwe-400mg nganye ngemitha yesikwere (yomgangatho womzimba). Umngcipheko we-CHF kule dosi ingaphantsi kwe-1 ekhulwini. Kwimilinganiselo ephezulu, amathuba okunyuka kwentliziyo. Ngenhlanhla, ezininzi iishedyuli ze-chemo zifuna amanani aphantsi.
- Ukusetyenziswa ngokufanayo kwamanye amayeza e-chemotherapy okuchaphazela intliziyo isib. Ukuphakanyiswa kwe-cyclophosphamide
- Ukunyangwa kwamayeza kwisifuba
- Isifo senhliziyo esele ikhona
- Umncinane
- Izigulane
Ukuvavanya Inkohlakalo Yentliziyo
Umonakalo wenhliziyo uvame ukuvavanywa nge-echocardiogram (ebizwa ngokuba yi-'chocho ') okanye i-MUGA ukuskena ukuvavanya inani legazi enokuthi ikhuphe intliziyo. Kwiimpawu zonyango, oku kuthiwa 'iqhekeza le-ejection ye-ventricular' okanye i-LVEF. I-LVEF ilinganiswa kubantu abaninzi ngaphambi kokuqala unyango ukulawula nayiphi na ingxaki yenhliziyo ekhona ngaphambili.
Emva koko, unokulinganiswa kwakhona ngexesha lotyando kunye nexesha elizayo ukuba libone ukuba kukho ukuwa kwi-LVEF. Ngezinye iinkatha iingxaki zomzimba zingabonakalisa kwi-EKG.
Izindlela Zokunciphisa Ukulimala
Kukho iindlela apho umonakalo wentliziyo unokuthintela okanye ungancinci
- Ukugcina umthamo we doxorubicin phakathi kwemida ephephile
- Ukulawulwa kweziyobisi njenge-infusion kwi-saline kunokuba ijojowe
- Ukusebenzisa ilungiselelo elitsha le doxorubicin elibizwa ngokuthi 'liposomal doxorubicin' - isilwanyana siza sasihlanganiswe kwiingubo ezinamafutha ezibizwa ngokuba yi-liposome. Le ingubo iphela kuphela kumhlaza wokukhupha isilwanyana. Izitho eziqhelekileyo ezinjengeentliziyo azichaphazelekanga.
- Ukusebenzisa into ebizwa ngokuthi i-dexrazoxane njengokungeniswa kwangoko emva kwe doxorubicin. Inokunciphisa amathuba okulimala kwintliziyo kwaye i-FDA igunyazwe kwisifo somhlaza wesisu se-metastatic.
Unyango lweCCF
Ukungaphumeleli komzimba okubangelwa yi-doxorubicin iphathwa ngendlela efana neyezinye iintlobo zokuhluleka kwentliziyo. Awekho amayeza akhethekileyo okwenzakala kwintliziyo ye-doxorubicin. Ukuphumla, i-oksijini kunye neepilisi zinciphisa iimpawu zeCCF kunye nokuzinzisa ukukhubazeka kwenhliziyo. Izimpawu ezinzima zifuna ukungena esibhedlela.
Ngaba Simele Sisebenzise i-Doxorubicin?
I-Doxorubicin yiphilisi ye-chemotherapy esebenzayo kakhulu. Inendima ekwenzeni unyango lweengcingo ezininzi. Nangona kukho ubudlelane obucacileyo be doxorubicin enomonakalo wentliziyo, iinzuzo zokusebenzisa i-doxorubicin zigqithise kakhulu ingozi. Umonakalo wentliziyo kunye neli chiza liqondwa kakuhle, kwaye ukuba i-doxorubicin isetyenziswe kwimida ekhuselekile yomthamo, akukho sizathu sokuyeka ukusetyenziswa kweziyobisi njengeluncedo njengolu.
> Imithombo:
I-Cancer - Imigaqo kunye nokuSebenza kwe-Oncology (i-7 Edition). Abahleli - Vicent T Devita Jr., uSamuel Hellman, uSteven Rosenberg. (Isahluko 15: I-Pharmacology yeCarcer Chemotherapy: Icandelo 7: I-Topoisomerase Agent Interactive Agents.)
Doxorubicin Hydrochloride, iNational Cancer Institute, Septemba 17, 2014.
I-Doxorubicin, i-Medline Plus, iLebhu yeSizwe yeMathala ka-US, 01/15/2012.