Kuqikelelwa ukuba izigidi ezingama-33 zaseMerika zihlala kunye neziqhwala okanye "ezihlambulukileyo": iimeko ezingenakonwaba kunye neentloni ezinzima ukuzenza. Kwiminyaka engaphezu kwamashumi amathathu, akubangakho amayeza amatsha ukunyanga le meko. Nangona kunjalo, ngo-2012, i-FDA ivume i-Myrbetriq (mirabegron) ukunyanga ibhanti engasebenzi.
Isalathisi esingasebenzi okanye ukukhuthaza ukungahambisani nokubhekiselele kubhekisela ekugqithiseni komzimba we-detrusor muscle.
I-detrusor muscle iyingxenye yodonga lwesibhanxa, kwaye xa ichanekile, inkontileka kakhulu, kunye nokuvuza kwe-urine.
Isalathisi esingasebenzi ngokweyona ndlela ixhaphake kakhulu. Abasetyhini abanalo mqathango bazive banqwenela ukuvuthwa emva kokuvuza okungalawulekiyo. Amadoda afumana iimpawu ezifanayo, kodwa ukuvuza kungonakaliswa yi- benign prostatic hypertrophy okanye ukukhutshwa komzimba.
Izinketho zonyango zangaphambili
Ngaphambi kokungeniswa kwe-Myrbetriq, isilonda esipheleleyo sasiphathwa ngokusebenzisa i-pelvic floor (Kegel) nokusebenzisa i-biofeedback; ukuguqulwa kwendlela yokuphila, njengokulahleka kwesisindo okanye ukuphepha kwe-caffeine; i-onabotulinumtoxinA okanye i-Botox injection kwi-muscular detrusor; kunye nezidakamizwa ze-antimuscarinic ezifana ne-Detrol (tolterodine), i-Urotrol (oxybutynin) kunye ne-solifenacin.
Izidakamizwa zeAntimuscarinic zineempembelelo ezininzi ezibangelwa ukuba zingabandezeli kubantu abaninzi abazithathayo. Le miphumo emibi ifaka umlomo owomileyo, ukuzithemba, umbono ophazamisekileyo kunye nokuphazamiseka kwengqondo.
(Le toxidrome idla ngokudibanisa nelizwi, "I-blind as a bat, ihlanya njengomthiyi, ibomvu njenge-beet, ishushu njengeHayidesi, eyomile njengethambo, isilonda kunye nesisu siphumele iphimbo, kwaye intliziyo iyaba yodwa." ) U
Iinzuzo zeMyrbetriq
I-Myrbetriq ichanekile ngakumbi kwizenzo zayo kunezidakamizwa ze-antimuscarinic ezisetyenziswa rhoqo ukuphatha isisu esingasebenzi.
I-Myrbetriq nayo ayichasani nenkqubo yesantya evelisa imvakalelo ngokubanzi njengoko izidakamizwa ze-antimuscarinic zenza. Ngokucacileyo, i-mirabegron ibhonas - 3 adrenergic agonist ejolise ngokukodwa kwi-receptors kwisisundu se-detrusor (i-97 ekhulwini ye- beta -3 mRNA eyenziwa ngumzimba iveliswa kwi-muscular detrusor).
Ngokungafani neziyobisi ze-antimuscarinic, i-mirabegron ayiphazamisi i- beta-1 kunye ne-beta-2 receptors kwezinye iindawo zomzimba. Ngamanye amagama, kanti izidakamizwa ze-antimuscarinic zinenjongo engafanelekanga kwaye zithintele iinkqubo ezahlukeneyo zesebe, i-mirabegron ichaneke ngakumbi kwaye ichaphazela kakhulu i-bladder.
Iziphumo zovavanyo lwezonyango kunye neempembelelo zecala
Kwimvavanyo yeSigaba seSigaba se-II kunye neSigaba III, i-Myrbetriq yavavanywa kumaqela angaphezu kwama-10,500. Kule zifundo, abathathi-nxaxheba babonisa ukwehla kwimiqulu yokuvuthwa komchamo, inani leziganeko zokuphuthuma, inani leziganeko ezingabikhoyo kunye neenombolo ze-nocturia episodes (ukungabikho kokuhlwa ebusuku)
Nangona i-Myrbetriq ibonakalise ngakumbi ukunyamezela ngaphezu kwezidakamizwa ze-antimuscarinic, ngexesha leemvavanyo zonyango, abanye abantu basenokuba nemiphumo emibi kuquka:
- kunyusa uxinzelelo lwegazi
- usulelo lwezonyango
- intlungu zesisu
- ukuphakama kwenhliziyo
- ukuphakanyiswa kwegazi
- iimpawu ezibandayo
Nangona ukwanda kwenani lentliziyo kunye noxinzelelo lwegazi olusezantsi ekusebenziseni i-Myrbetriq banokuthobeka, ezinye iingcali zixhala malunga nemiphumo ye-Myrbetriq.
Ngokukodwa ukuya kutsho, kukho uphando oluthile kwi-Myrbetriq ekusebenziseni abantu abadala abaneminyaka engama-70 ubudala; Ngaloo ndlela, abanye oogqirha abayicwangcisi esi sigulane kwizigulane ezisebekhulile ezinengxaki zeentliziyo kunye neengtso. Ukongezelela, akukacaci ukuba i-Myrbetriq iyasebenza xa isetyenziswe ngamachiza antimuscarinic.
Ngomhla ka-Agasti 2015, i-FDA ikhuphe izikhokelo ezibangelwa ngamava ahamba phambili kunye ne-Myrbetriq. Emva kokuba isilwanyana sikhutshwe kuluntu, abanye abantu bafumana oku kulandelayo:
- isicaphulelo
- i-angioedema (ukuvuvukala) ebusweni, ulwimi okanye i-larynx
- utywala (pruritis)
Iimeko zesibini ze-angioedema ekusetyenzisweni kwe-Myrbetriq zingasongela ubomi ukuba i-airway engenhla ivaliwe.
Ukuba ufumana i-angioedem okanye nayiphi na imayelana nempawu emva kokuba uthathe le nyilisi, khawuleza ubize iinkonzo eziphuthumayo okanye ufune ugqirha onokukunceda.
Ukongezelela kokunyamezela ngakumbi kunezilwanyana ze-antimuscarinic kwiimvavanyo zonyango, i-Myrbetriq iphinde iqinisekiswe ukuphucula umgangatho wobomi bokuphila phakathi kwabantu abanesisindo esingaphezulu. Ngokubanzi, i-Myrbetriq ibonakala iyindlela entsha ethembisayo yokuphatha i-bladder engapheliyo ngakumbi kubantu abangakwazi ukunyamezela izidakamizwa ze-antimuscarinic. Nangona kunjalo, uphando olungakumbi lufuneka luyenziwe ngaphambi kokuba siqonde ngokucacileyo imiba yezokwelapha kunye ne-Myrbetriq.
Imithombo:
Chapple, CR. Mirabegron kwi-Bladder esebenzayo: Ukuhlaziywa koBuchule, ukhuseleko kunye nokunyanzeliswa. Neurourology kunye neUrodynamics. 2013.
UHarper G, uJohnston C, uLandefeld C. Iingxaki ze-Geriatric Disorders. Ku: Papadakis MA, McPhee SJ, Rabow MW. eds. Ukuxilongwa kweZonyango kunye neNyango ka-2015 . New York, NY: McGraw-Hill; 2014.
Khullar V et al. Iziphumo-ezibikwe izigulane kunye ne-b3-Adrenoceptor Agonist Mirabegron kwisiGaba seSigaba sesi-III kwizigulane ezine-Bladder. Neurourology kunye neUrodynamics. 2015.
> Myrbetriq (mirabegron) Iibhulile ezikhululwayo. www.fda.gov.