I-Zaltrap yisidakamizwa se-antitumor esetshenziswa ekwelapheni umdlavuza we-metastatic colorectal kubantu abadala lapho i-chemotherapy inganikeli umphumela wokwelapha ngenxa yokumelana okuphezulu kwesimila noma uma kungenzeka iphinde ibuye.
Igama Lezwe elingafanele
I-ZALTRAP.
I-Zaltrap yisidakamizwa se-antitumor esetshenziswa ekwelapheni umdlavuza we-metastatic colorectal kubantu abadala.
I-ATX
I-L01XX - ezinye izidakamizwa ze-antitumor.
Khipha amafomu nokwakheka
Ukugxila kusuka lapho isixazululo sokumiliselwa silungiselelwe. Izilwane ezinamaphayiphu anomthamo ongu-4 ml no-8 ml. Inani lempahla esemqoka ye-aflibercept ngu-25 mg ku-1 ml. Inketho yesibili yisixazululo esenziwe ngomumo eyenziwe oyinkimbinkimbi esenzelwe ukuphathwa kwe-intravenous. Umbala wesisombululo usobala noma upende ophuzi ophuzi.
Isakhi esiyinhloko iprotheni ye-aflibercept. Abaphathele: i-sodium phosphate, i-citric acid, i-hydrochloric acid, i-sucrose, i-sodium chloride, i-sodium hydroxide, amanzi.
Isenzo se-Pharmacological
I-Aflibercept ivimba umsebenzi wama-receptors, abhekele ukwakhiwa kwemithambo emisha yegazi ephakela isimila futhi inikele ekukhuleni kwayo okukhulu. Ukuhlala ngaphandle kwegazi, i-neoplasm iqala ukuncipha ngosayizi. Inqubo yokukhula nokuhlukaniswa kwamaseli wayo we-atypical ayeki.
I-Aflibercept ivimba umsebenzi wama-receptors, abhekele ukwakhiwa kwemithambo yegazi emisha.
I-Pharmacokinetics
Akukho datha kumetheni yeprotheni ye-aflibercept. Kungenzeka ukuthi, njenganoma iyiphi enye iprotheni, isakhi esiyinhloko somuthi sihlukaniswe ngama-amino acid nama-peptide. Ukuqedwa kwesigamu sempilo kuze kufike ezinsukwini eziyi-6. Amaprotheni awadalulwa ngokusebenzisa izinso ngomchamo.
Izinkomba zokusetshenziswa
Kusetshenziswa ngokuhlanganiswa ne-folinic acid, i-Irinotecan ne-Fluorouracil yokwelapha ngamakhemikhali womdlavuza we-metastatic colorectal ngokumelana okuphezulu neminye izidakamizwa ze-antitumor. Kubekelwe ukwelashwa okubuyela emuva.
Contraindication
Akuvunyelwe ukusebenzisa ukwelashwa ezimeni ezinjalo:
- ukopha kakhulu;
- umfutho wegazi wohlobo lwangempela, lapho ukwelashwa kwezidakamizwa kwehluleka;
- Isigaba 3 no-4 sokuhluleka kokuqina kwenhliziyo;
- isiguli sine-hypersensitivity ezingxenyeni ezithile zomuthi;
- ukwehluleka okunzima kwezinso.
Imikhawulo yeminyaka - iziguli ezingaphansi kweminyaka engu-18.
Ngokunakekela
Ukuqapha njalo kwesimo sempilo ezigulini ezihluleka yizinso, ukuqina komfutho we-arterial, isifo senhliziyo, kanye nezigaba zokuqala zokuhluleka kwenhliziyo kuyadingeka. Ngokuqapha, umuthi ubekelwe iziguli esezikhulile futhi unesimo esingesihle sempilo ejwayelekile, uma isilinganiso sokulinganisa singekho ngaphezulu kwamaphuzu ama-2.
Ungayithatha kanjani iZaltrap
Ukuphathwa kwe-Intravenous - ukumnika ihora eli-1. Umthamo ojwayelekile ngu-4 mg ngekhilogremu ngayinye yesisindo somzimba. Ukwelashwa kusayinwe ngesisekelo sohlobo lwe-chemotherapeutic:
- usuku lokuqala lokwelashwa: ukumfaka okwenziwe nge-catheter ene-Y eyenziwe ngo-Irinotecan 180 mg / m² okwemizuzu engama-90, iCalcium folrate yemizuzu engu-120 ngomthamo we-400 mg / m² no-400 mg / m² Fluorouracil;
- ukumiliselwa okuqhubekayo okuqhubekayo kuthatha amahora angama-46 ngomthamo weFluorouracil 2400 mg / m².
Ukuphathwa kwe-Intravenous - ukumnika ihora eli-1.
Umjikelezo uyaphindwa njalo ezinsukwini eziyi-14.
Ngoshukela
Ukulungiswa kwedosi akudingeki.
Imiphumela emibi yeZaltrap
Kuvezwe izigameko ezijwayelekile zokuhlaselwa yisifo sohudo, i-proteinuria, i-stomatitis, i-dysphonia kanye nokutheleleka kwe-urinary. Ezigulini eziningi, isifiso sokudla siyancipha, ukopha kwamakhala, ukwehla kwesisindo kwenzeka. Kukhona ukukhathala okwandayo, i-asthenia.
Izimpawu ezingezinhle zohlelo lokuphefumula: i-dyspnea yobunzima obahlukahlukene, i-rhinorrhea, ukopha okuvela emacansini kuvame ukwenzeka.
Kusuka ezicutshini zemisipha
Ezinye iziguli ziba nomhlathi we-osteonecrosis.
Amapheshana wesisu
Isifo sohudo, ubuhlungu besisu bokuhlukahluka okungafaniyo, ukuthuthukiswa kwama-hemorrhoid, ukwakheka kwama-fistulas ku-anus, isinye, emathunjini amancane. Ubuhlungu bezinyo obungaba khona, i-stomatitis, usizi ku-rectum, vagina. Ama-fistulas ohlelweni lokugaya ukudla kanye nokugcotshwa kwezindonga akuvamile ukwenzeka, okungaholela ekufeni kwesiguli.
Izimpawu ezingezinhle zohlelo lokuphefumula: i-dyspnea ihlala ivela.
Izitho zeHematopoietic
Imvamisa kukhona i-leukopenia ne-neutropenia yobunzima obahlukahlukene.
Isistimu yezinzwa ephakathi
Cishe njalo kunezinhlungu ezinamakhanda ahlukahlukene, izikhathi eziningi zesiyezi.
Kusuka ohlelweni lomchamo
Imvamisa - i-proteinuria, kuyaqabukela - ukuthuthukiswa kwe-nephrotic syndrome.
Engxenyeni yesikhumba
Ukulunywa, ubomvu nokuqubuka, i-urticaria.
Kusuka ohlelweni lwezitho zofuzo
Ukutheleleka, ukungasebenzi kahle kokuzala kwabesilisa nabesifazane.
Ezigulini eziningi, ukuthatha i-Zaltrap kungadala i-thromboembolism.
Kusuka ohlelweni lwezinhliziyo
Eqa umfutho wegazi, ukopha kwangaphakathi. Ezigulini eziningi: i-thromboembolism, ukuhlaselwa kwe-ischemic, i-angina pectoris, ingozi enkulu ye-myocardial infarction. Kuyaqabukela: ukuvulwa kwe-craniocerebral hemorrhage, ukuphuma kwegazi, ukufafaza ukopha kakhulu emgodini wesisu, okuyimbangela yokufa.
Engxenyeni yesibindi ne-biliary
Ukuthuthukiswa kokuhluleka kwesibindi.
Ngasohlangothini lwe-metabolism
Ezimweni eziningi, kuba nokuntuleka kwesifiso sokudla, imvamisa - ukuphuma komzimba (kusuka kumnene kuze kube nzima).
Allergies
Ukusabela okukhulu kwe-hypersensitivity: i-bronchospasm, ukuphefumula kakhulu, ukwethuka kwe-anaphylactic.
Umthelela ekhonweni lokulawula izindlela
Akukho datha ocwaningweni womphumela onokwenzeka womuthi ekuhlolweni kokunaka. Kunconywa ukwenqaba ukushayela nokusebenza ngezinqubo eziyinkimbinkimbi uma isiguli sinemiphumela emibi evela ohlelweni lwezinzwa oluphakathi, ukuphazamiseka kwengqondo.
Ngaphambi komjikelezo omusha wokwelashwa (njalo ezinsukwini eziyi-14), kufanele kwenziwe ukuhlolwa kwegazi.
Imiyalo ekhethekile
Ngaphambi komjikelezo omusha wokwelashwa (njalo ezinsukwini eziyi-14), kufanele kwenziwe ukuhlolwa kwegazi. Umuthi ubanjiswa kuphela esimweni sesibhedlela sokuphendula okufika ngesikhathi ezimpawu zokuphelelwa ngamandla, ukugcotshwa kwezindonga zepheshana lesisu.
Iziguli ezinenkomba ejwayelekile yezempilo yamaphuzu ama-2 noma ngaphezulu zinengozi yemiphumela emibi. Zidinga ukwelatshwa njalo kwezokwelapha ukuze kutholakale isikhathi esizayo ukutholakala kwezinkinga zempilo.
Ukwakheka kwama-fistulas kungakhathalekile ukuthi ayiphi indawo kuyinkomba yokuthi kuqedwe ngokushesha ukwelashwa. Kwenqatshelwe ukusebenzisa umuthi ekwelapheni iziguli eziye zangenelela ngokungenelela okukhulu (kuze kube lapho amanxeba elapha ngokuphelele).
Abesilisa nabesifazane beminyaka yokuzala izingane kufanele basebenzise izindlela ezahlukahlukene zokuvimbela inzalo kungakapheli izinyanga eziyisithupha (kungaphansi) ngemuva komthamo wokugcina weZaltrap. umqondo womntwana kufanele ungafakwa ngaphandle.
Isixazululo se-Zaltrap yi-hyperosmotic. Ukuqanjwa kwayo akufaki ukusetshenziswa kwezidakamizwa indawo ye-intraocular. Kwenqatshelwe ukwethula isisombululo emzimbeni we-vitreous.
Sebenzisa ebudaleni
Kunengozi enkulu yokuba nesifo sohudo isikhathi eside, isiyezi, ukuncipha kwesisindo kanye nokuphelelwa amandla kweziguli eziseqenjini elineminyaka engu-65 nangaphezulu. Ukwelashwa kweSaltrap kufanele kwenziwe kuphela ngaphansi kokuqashwa kwabasebenzi bezokwelapha. Esibonakaliso sokuqala sohudo noma ukuphuma komzimba, ukwelashwa okubonakalayo ngokushesha kuyadingeka.
Ukwelashwa kweSaltrap kufanele kwenziwe kuphela ngaphansi kokuqashwa kwabasebenzi bezokwelapha.
Isabelo sezingane
Ukuphepha kweZaltrap ezinganeni akukasungulwa.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Imininingwane yokusetshenziswa kwe-Zaltrap kwabesifazane abakhulelwe nabahlisayo ayitholakali. Ngokunikezwa ubungozi obungahle bube nemiphumela emibi enganeni, umuthi we-antitumor awunqunyelwe kulezi zigaba zeziguli. Akunamininingwane yokuthi isakhi esisebenzayo salo muthi singene ebisini lwebele. Uma kunesidingo, sebenzisa umuthi ekwelapheni umdlavuza kowesifazane osenkulisa, ukuphuma kwesisu kumele kukhanseliwe.
Isicelo sokusebenza kokulimala kwezinso
Ukusetshenziswa kwe-Zaltrap ezigulini ezinokwehluleka kwezinso okuncane nokulinganiselayo kuvunyelwe. Akunamininingwane ngokusetshenziswa kwomuthi ezigulini ezinokulimazeka okukhulu kwe-renal.
Sebenzisa umsebenzi wesibindi okhubazekile
Ayikho imininingwane yokusetshenziswa kwomuthi ezigulini ezinokulimazeka okukhulu kwe-hepatic. Ukwelashwa kweziguli okunokwehluleka kwesibindi okunzima, kodwa ngokuqapha ngokweqile futhi ngokuqinile ngaphansi kokuqondisa udokotela, kuvunyelwe.
Ukwelashwa kweziguli ezinokwehluleka kwesibindi okuvunyelwe kuvunyelwe.
Ukweqisa kweZaltrap
Akunamininingwane yokuthi umthamo wezidakamizwa okweqile kwe-7 mg / kg ulawulwa kanjani njalo ezinsukwini eziyi-14 noma ku-9 mg / kg kanye njalo ezinsukwini ezingama-21 ezithinta umzimba.
I-overdose ingabonakaliswa ngokwanda kokuqina kwezimpawu eziseceleni. Ukwelashwa - ukwelashwa kokulondolozwa, ukubhekwa njalo kwengcindezi yegazi. Asikho isidakamizwa.
Ukuxhumana nezinye izidakamizwa
Ukwenza izifundo ze-pharmacokinetic kanye nokuhlaziywa okuqhathaniswayo akubonisanga ukusebenzisana kwe-pharmacokinetic kweZaltrap neminye imithi.
Ukuhambisana notshwala
Ukuphuza utshwala ngesikhathi sokwelashwa kwenqatshelwe ngokuphelele.
Ama-Analog
Amalungiselelo anokubukwa okufanayo kwesenzo: u-Agrelide, uBortezovista, uVizirin, u-Irinotecan, uNamibor, u-Ertikan.
I-Irinotecan iyisidakamizwa esinezinto eziningi ezifanayo.
Imibandela yekhefu lekhemisi
Ngokunikeza ngencwadi kadokotela evela kudokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Ukuthengiswa kwe-OTC akufakiwe.
Intengo
Kusuka ku-8500 rub. Ibhodlela ngalinye.
Izimo zokugcina zomuthi
Ezimweni zokushisa kusuka ku-+2 kuya ku- + 8 ° C.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu Ukusetshenziswa kwesinye isidakamizwa akufakiwe.
Umkhiqizi
ISanofi-Aventis Deutschland GmbH, eJalimane.
Ukubuyekezwa
UKsenia, oneminyaka engama-55, eMoscow: "Inkambo ye-Zaltrap ibekelwe ubaba ukwelashwa komdlavuza. Umuthi muhle, uyasebenza, kepha unzima kakhulu. Kunemiphumela emibi njalo njalo. Kuhle ukuthi ibanjiswa kanye kuphela njalo emavikini ama-2, ngoba ngemuva kokuthola amakhemikhali isimo sikababa sihlala singesesikhashana yanda, kepha ukuhlaziya kukhombisa umkhuba omuhle wokwehlisa i-neoplasm. "
U-Eugene, oneminyaka engama-38, u-Astana: "Ngezwa imiphumela emibi evela eZaltrap. Bengisesimweni esibuhlungu: isicanucanu, ukuhlanza, ikhanda elibuhlungu njalo, ubuthakathaka obukhulu. Kepha umuthi usebenza esisimeni ngokushesha. Umphumela wokusetshenziswa kwaso ukwelapha umdlavuza kufanelekile ukusinda kulokhu kuhlushwa. "
U-Alina, oneminyaka engama-49, uKemerovo: "Lesi sidakamizwa esibizayo, futhi angizizwa sengathi ngizohlala naye ngemuva kokuthola amakhemikhali. Kepha kuyaphumelela. Ngokuka-1, isimila sami sivele sanyamalala. Udokotela wathi kunethuba lokuphinda futhi, kodwa elincane Ngaphambi kokuthi iZaltrap, kusetshenziswe ezinye izidakamizwa, kepha umphumela waba wesikhashana, futhi ngemuva kwalokho ngiphile ngaphandle kwezimpawu zomdlavuza iminyaka emi-3. "
