Ukuphindaphinda, Ukukhusela, kunye neMpawu zoMphumo weCandelo loRituxan
Ukuphendulwa komzimba kwiRituxan, eyaziwa ngokuba yiBabra okanye iRituximab , yinto echaphazelekayo yecandelo eliqhelekileyo elisetyenziswa ekuphatheni i-lymphoma nezinye izifo. Ziziphi iimpawu zempendulo yokuphazamiseka kunye nendlela yokuphendula ngayo?
Sibanzi
I-Rituxan yi- antioclonal antibody drug, oku kuthetha ukuba ijolise kwi-molecule ethile (i-CD-20) esebenzisa iiseli ezithile ze-immune-ezimhlophe zegazi eziyimvelaphi ye-lymphomas, kodwa ezo zibaluleke kakhulu kwizonyango kwezinye izifo zokuzivikela, njenge-rheumatoid arthritis.
I-Rituximab yonyango olusebenzayo kwi-non-Hodgkin's lymphoma (NHL) kwaye iboniswe ukuphucula ukusinda kwezinye iindidi eziqhelekileyo ze-NHL kubandakanyeka kwi -B-cell lymphoma kunye ne- follicular lymphoma .
I-Rituximab iqulethe inani elincinane leprotheni ukusuka kwiisisundu ze mouse. Ngenxa yeso sizathu, i-rituximab iyaziwa ngokuba yi-"anti-chimeric antibody", oku kuthetha ukuba yenziwa kwiindawo ezivela kwiintlobo ezimbini ezahlukeneyo. Nangona oku kubalulekile ukuba iilisi zisebenze, imizimba yethu ijonge ukuqonda amanqaku angaphandle kunye nabahlaseli abangenakho kwaye baqale ukuphendula ngokuzivikela ngokumelene nawo. I-reaction response from rituximab ngokubanzi isabela kwiiprotheni ze mouse kwizilwanyana.
Ngaphambi kokuba i-rituximab ingeniswe, uyakuthi uphathwe ngamachiza anciphisa amathuba okuba uza kuba neempendulo. Oku kuquka iTylenol (i-acetaminophen) kunye ne-Benadryl (diphenhydramine) kunye ngamanye amayeza e-steroid.
Ekubeni i-diphenhydramine inokukwenza ulale, kudla ngokucetyiswa ukuba umntu aqhube ekhaya emva kokungena kwakho.
Izimpawu kunye neMpawu
Iimpawu eziqhelekileyo ze-rituximab zonyango zi:
- I-Fever ne-chills - ezi ziyindlela ezona zixhaphakileyo kwaye zenzeka kubantu abaninzi
- I sizathu
- Ukutshiza
- Rash
- Ukuthukuthela okanye ukucwiliswa kwimpumlo
- Ukuvuvuka kwezandla, iinyawo okanye ubuso
- Ukunciphisa uxinzelelo lwegazi kunye noxinzelelo
- I-spasm yomqala, efana ne-asthma
- Intloko
Ezi mpendulo zivame ukuqhubeka zingakapheli imizuzu engama-30 ukuya kwiiyure ezingama-2 zokuqala ukunyuswa kweziyobisi kwaye zinokwenzeka ukuba zenzeke ngokunyuswa kokuqala ( phantse iipesenti ezingama-80 zezigulane zithatha impendulo ) kwaye zingaphantsi rhoqo.
Ngokuqhelekileyo, iimpendulo ezinzima zenzeka, kuquka:
- Iingxaki eziphefumulayo
- Ukuhlasela kwentliziyo
- Ukuwa kakhulu kwexinzelelo lwegazi kunye nokutshatyalaliswa.
Unyango
Ukuba unempendulo nangona unyango oluthatywayo olunikezwayo, into yokuqala umongikazi okanye ugqirha akwenzayo uyancipha okanye amise ukumnika. Eminye impendulo enobumnene, yiyo yonke into efunekayo. Inani lamachiza lingalawulwa ukwenzela ukunciphisa okanye ukumisa ukuphendula. Ezi ziquka i-acetaminophen, i-antiallergics, i-IV saline okanye iziyobisi ukunyusa uxinzelelo lwegazi kunye ne-steroids. Phantse zonke izigulane, iimpendulo zinokulawulwa ngokukhawuleza nale miqathango. Ngenxa yeempendulo ezinzima, iiyunithi zokunyamekela ezinzulu zingabonakala ngokufanelekileyo-kunye nemilinganiselo yokugcina nokubeka ingqalelo uxinzelelo lwegazi nokuphefumla. Nangona ukufa kuye kwabikwa ngenxa yokunyuswa kwamanzi, ayinqabile kakhulu.
Thintelo
Amanyathelo ambalwa anokuthintela okanye anciphise ukuphendulwa komzimba kunye ne-rituximab:
- Ukulungiswa. Njengoko kuphawuliwe ngasentla, mhlawumbi uya kuthatha amayeza e-antihistamine kunye ne-steroids ngaphambi kokungeniswa.
- Ukuqala ukunyuswa kwamanzi kancane. Oku kubaluleke kakhulu ekunyuseni kokuqala xa iimpendulo ziqhelekileyo. Iingcambu zisoloko ziqaliswa ngokukhawuleza kwaye izinga lokunyuswa kwegazi liye landa xa kungekho nzekayo.
- Ukuyeka imithi yengcinezelo yegazi ngaphambi kokugonywa. Ekubeni ukuwa kwexinzelelo lwegazi kuya kwenzeka ngexesha lokuphendula, oogqirha ngamanye amaxesha bacebisa izigulane ukuba bayeke ukusebenzisa imishanguzo yegazi phambi kokungena. Umele wenze oku ngaphantsi kwemiyalelo ethile evela kugqirha wakho, nangona kunjalo.
Labo ababenomdla omncinci okanye olinganisekayo kunye ne-rituximab banokufumana isilwanyana ngokukhawuleza kwaye badinga ukuthatha onke amanyathelo okunyanga. Labo abanomdla obunzima abaqhelekanga ukusetyenziswa kwesi sidakamizwa.
Imithombo:
LaCasce, A., Castells, M., Burstein, M., noJe Meyerhardt. Ukunyuswa kwama-infusion kuma-antibodies ezonyango ezonyango ezisetyenziselwa unyango lomhlaza. Isemgangathweno. Ukuhlaziywa 01/08/16. http://www.uptodate.com/contents/infusion-reaction-to-rapeutic-monoclonal-antibodies-us-for-cancer-therapy