"Methotrexate" ya nyamakazi ya nyamakazi: ndemanga. Malangizo ogwiritsidwa ntchito, kufotokozera kukonzekera

Matenda a nyamakazi, ngati amatanthauziridwa kwenikweni kuchokera ku Greek, amasonyeza kuti ndikutentha. Funso la zinthu zomwe zimapangitsa kuti chitukukochi chikhale chisanadziwikirebe. Chidziwitso chosadziwika kuti chiwerengero cha leukocyte m'magazi chikuwonjezeka ndipo kuchuluka kwa erythrocyte sedimentation (ESR) kumawonjezereka , kumatheketsa kuganiza kuti njira ya chitukukochi ndi ya chiwopsezo. Pali lingaliro lakuti kulimbitsa mtima kwa chitukuko cha matenda ndi matenda omwe amachititsa zosayenerera mu ntchito ya chitetezo cha mthupi. Komabe, si onse omwe amakhudzidwa, koma okhawo omwe ali ndi chibadwidwe cholowa. Chotsatira cha kuyambitsidwa kwa matendawa mu thupi laumunthu ndi kupanga ma chitetezo cha mthupi (kuchokera ku mavairasi, ma antibodies, ndi zina zotero), zomwe zimaphatikizapo minofu ndi kuwonongeka pamodzi.

Nthawi zambiri, kuchiza matenda oopsawa ndiko kuchepetsa kupweteka, kuchepetsa njira ya matenda ndi kukonzanso zilonda (monga momwe zingathere m'mbali iliyonse) mothandizidwa ndi njira zopangira opaleshoni.

Pali mankhwala ambiri ochiritsira pakalipano. Chimodzi mwazo ndi Methotrexate. Ndi nyamakazi ya nyamakazi (ndemanga za ogwira ntchito zachipatala ndi odwala amatsimikizira mfundo iyi), mankhwalawa ndi othandiza kwambiri, zotsatira za mphamvu zake zidzamveka kwa nthawi yaitali.

Kupanga ndi mfundo yogwirira ntchito

Njira yaikulu yogwiritsira ntchito mankhwala ndi methotrexate. Ndi nitostatic, folic acid wotsutsa . Pakali pano, kuchepetsa kukula kwa nyamakazi ya nyamakazi, mankhwala ndi Methotrexate amagwiritsidwa ntchito nthawi zambiri kuposa njira zina. Mwachidziwikire, mankhwalawa ndi antitumor, cytostatic agent, amaletsa mitosis (kusagwirizana kwa maselo osalunjika), amachepetsa kukula kwa minofu yowonjezereka, imaletsa kukula kwa zotupa.

Malingana ndi chiwerengero, momwe mankhwalawa amathandizira mu odwala 80%, mphamvu zowoneka bwino zimakhala zooneka mu masabata awiri mpaka 6 mutangoyamba kumene. Pambuyo pa nthawi yayitali yothandizira (mpaka zaka zisanu), Methotraxatom sizothandiza kwambiri kuposa mankhwala ena onse omwe amachititsa kuchepetsa kukula kwa nyamakazi ya nyamakazi.

Mafomu a kukonzekera

Mankhwalawa ndi ofanana ndi achirasha a ku Austria a Methotrexate Ebove. Wopanga mankhwala oyambirira amapereka makasitomala ake m'njira zosiyanasiyana. Mapiritsi amapezeka m'magawo atatu: 2.5 mg, 5 mg ndi 10 mg wothandizira kwambiri. Zonsezi zimadzaza ndi mabotolo a polypropylene a zidutswa 50. Komanso, Methotrexate (Austria - wopanga), ingagulidwe ngati yankho la jekeseni pa 50 mg / 5 ml. Mababule amapangidwa ndi galasi lakuda ndipo amanyamula makatoni.

Ndizotheka kugula mankhwala mwa mawonekedwe a kukonzekera kwa infusions (droppers). Mlingo - 100 mg / 1 ml. Mu mawonekedwe awa, "Methotrexate" imagulitsidwa m'mitsuko ya 5, 10, 50 ml. Botolo imodzi imadzazidwa mu makatoni.

Zisonyezo za kutenga "Methotrexate"

Zizindikiro zogwiritsiridwa ntchito kwa mankhwala ndizochindunji, chifukwa cholinga chake ndikumenyana ndi zovuta. Ndibwino kuti mutenge "Methotrexate" pamene wodwalayo akudwala matenda oopsa a khansa ya m'magazi komanso mafupa ena omwe si a Hodgkin. Limaperekedwanso ku matumbo a trophoblastic, mushroom mycosis ndi psoriasis (muzigawo zovuta).

Komanso, ngati mankhwala ena ndi mankhwala alibe zotsatira zake, gwiritsani ntchito Methotrexate mu nyamakazi ya nyamakazi. Ndemanga za akatswiri-rheumatologists za mankhwala ndi zabwino ndithu.

Zisonyezo za kutenga "Methotrexate Ebewe" ndizowonjezereka kwambiri. Akatswiri amapereka mankhwalawa m'maso mwa ziwalo zosiyanasiyana ndi ziwalo zosiyanasiyana: khansa ya m'mapapo ndi m'mawere, osteosarcoma ndi mitsempha yofewa, mazira ovunduka ndi amatsenga, Jung's sarcoma, retinoblastoma ndi matenda omwe amachititsa kuti thupi liziyenda bwino.

Ndani sayenera kumwa mankhwalawa?

Sikoyenera kulandira mankhwala kwa anthu omwe ali ndi mphamvu zowonjezera. Amatsutsana ndi kutenga "Methotrexate" amayi apakati ndi amayi oyamwitsa. Osati mankhwalawa ndi zovuta zomwe zilipo pachiwindi ndi impso, ndi matenda a hematologic (anemia, thrombocytopenia, leukopenia). Musayambe mankhwala ndi mankhwala kwa odwala pachigawo chachikulu cha matenda opatsirana omwe amavutika ndi matenda a immunodeficiency. Mafano a ku Russia ndi oyambirira a "Methotrexate" (Austria) saloledwa kupereka ana kwa zaka zitatu.

Ndi matenda ambiri, mankhwalawa amaperekedwa mosamala kwambiri. Mavuto ngati amenewa amaphatikizapo zilonda za m'mimba ndi zilonda zam'thupi , zilonda zam'mimba, kutaya thupi kwa thupi. Pamene matenda a tizilombo, fungal ndi mabakiteriya amachitanso chidwi kwambiri. Ku kagulu komweko ka mavuto amanyamula ma radiation kapena chemotherapy.

Zotsatira zokayikitsa

"Methotrexate" mu ampoules, m'mapiritsi, okhala ndi infusions angayambitse zotsatira zambiri. Pali mavuto akuluakulu omwe angabwere kuchokera ku hemopoietic system (leukopenia, thrombocytopenia, etc.) ndi m'mimba (dyspepsia, anorexia, hepatotoxicity, pancreatitis). Ndondomeko ya manjenje ikhoza kuyankha ndi mutu, kugona, paresis, kugwidwa. Mankhwala apamwamba a mankhwala angayambitse kukula kwa ubongo. Pakhoza kukhala zolakwika kuchokera ku ziwalo za masomphenya ndi mtima wamtima (hypotension, pericarditis, thromboembolism).

Angapangitse kupuma, kupuma kwapachipatala koopsa, dyspnea, youma, chifuwa chosabereka, malungo. Pa mbali ya mavitaminiwa, pali kuthekera kwa mitundu yambiri ya nephropathy kapena impso kulephera. N'zotheka kuphwanya spermatogenesis ndi oogenesis, kuchepa kwa libido, kukula kwa kusabereka, kusowa mphamvu.

Ngati mayi ali ndi pakati, Methotrexate (jekeseni, mapiritsi, droppers) angayambitse kuperewera kwa mayi, kupweteka kwachitukuko, kapena kufa kwa mwana.

Ndondomeko yosankha ya mapiritsi

Pogwiritsa ntchito mankhwala osokoneza bongo, mapiritsi a mapiritsi amapangidwa payekha ndipo amadalira mankhwala a chemotherapy. Ngati tikukamba za kugwiritsa ntchito mankhwalawa "Methotrexate" mu matenda a nyamakazi (ndemanga ya odwala ndi yabwino), ndiye kuti chiwerengero choyamba, monga lamulo, ndi 7.5 mg kamodzi pa sabata. Mukhoza kutenga mlingo wonse pokhapokha, koma mukhoza kugawikana mu madiresi atatu ndi nthawi ya maola 12.

Nthawi zina (kupeza zotsatira zabwino), mlingo wa mlungu uliwonse ukhoza kuwonjezeka. Komabe, sayenera kupitirira 20 mg. Pamene mankhwala oyenerera akupezeka, mlingowo uyenera kuchepetsedwa pang'ono. Nthawi yoyenera ya mankhwalawo sanadziwike.

Mankhwala a Methotrexate

Nanga majekeseni ndi mankhwala "Methotrexate" amatani? Majekeseni odwala nyamakazi amayamba ndi mlingo wa 7.5 mg pa sabata. Izi zikhoza kuchitidwa subcutaneously, intramuscularly kapena intravenously. Ngati mankhwalawa akulekerera, wodwalayo akhoza kuwonjezeka mlungu uliwonse ndi 2.5 mg koma osapitirira 25 mg. Pamene mankhwalawa amatha (kawirikawiri 1-2 miyezi isanayambe chithandizo), mlingowu uyenera kuchepetsedwa pang'onopang'ono kuti ukhale wochepa. Kwa wodwala aliyense ali ndi nyamakazi ya nyamakazi, mlingo ukhoza kusinthidwa pang'onopang'ono kuti ukhale ndi zotsatira zabwino kwambiri za mankhwala. Maphunziro a zachipatala asonyeza kuti "Methotrexate" imathandizidwa bwino ndipo imapereka chiwerengero chochepa choyipa ngati jekeseni imachitidwa subcutaneously kapena intramuscularly.

Ndi chilolezo chovomerezeka cha Methotrexate, chithandizo choyamba chochiritsira chimapitirira kwa zaka ziwiri. Ndi kuchotsedwa kwa mankhwala, nyamakazi ya nyamakazi imaonekera patatha masabata 3-6.

Kupitilira mlingo woyenera

Kupitirira mlingo woyenera wa mankhwala a Russian kapena mankhwala "Methotrexate Ebove" (mapiritsi, jekeseni, infusions) sadziwonetsera wokha ndi zizindikiro zinazake. Kuwonjezera pa zowonjezereka kungakhazikitsidwe ndi msinkhu wa ndondomeko ya methotrexate m'magazi a m'magazi.

Kuchiza kumaphatikizapo mwamsanga (nthawi yoyenera mu ola loyambirira) kugwiritsa ntchito mankhwala, omwe ndi calcium folinate. Kuchuluka kwa mankhwala ojambulidwa ayenera kukhala wofanana kapena wamkulu kuposa mlingo wa "Methotrexate". Komanso, mlingo wa calcium folinate ukhoza kuuzidwa ndi dokotala ngati mukufunikira. Pambuyo pa mlingo uliwonse wotsatira, ndiyeno maola asanu ndi limodzi (6) panthawi yonse yothetsa zizindikiro zowonjezereka ndi mankhwala, mkodzo wa pH uyenera kutsimikiziridwa. Zoterezi zingachepetse mwayi wokhala ndi nephropathy.

Palinso njira zofunikira zothetsera zotsatira za kumwa mankhwala mopitirira muyeso zimaphatikizapo kuthamanga ndi alkalinization ya mkodzo. Njirazi zizowonjezera msangamsanga wa methotrexate.

Kuyanjana ndi zinthu zina ndi kukonzekera

Ngati wodwala ali ndi gout ndi kuikidwa kwa mankhwala "Methotrexate" kapena "Methotrexate Ebove", mlingo wa mankhwala osokoneza bongo ayenera kusintha. Ntchito yofanana ya salicylates, phenylbutazone, phenytoion, sulfonamides, mankhwala enaake a antibiotic (tetracycline, penicillin, chloramphenicol), anticoagulants a chithandizo cholakwika komanso mankhwala ochepetsa mankhwalawa amachititsa kuledzeretsa, ngakhale imfa.

Zambiri za "Methotrexate" zofanana ndi NSAID zingayambitse imfa ku hematologic kwambiri komanso m'mimba moledzeretsa. Kuphatikizidwa kwa NSAIDs ndi kuchepetsa mlingo wa mankhwala omwe akugwiritsidwa ntchito kungachepetse excretion ya wotsirizira ndi tubal renal.

Mankhwala a hepatotoxic (omwe amachokera ku sulfasalazine, azathioprine, ethanol) amachititsa kuti pakhale ngozi ya hepatotoxicity, hematotoxic - hematotoxicity ya Methotrexate. Maofesi omwe amagwiritsa ntchito mankhwala osokoneza bongo komanso njira zothandizira odwala matendawa zimayambitsa kupweteka kwa mafupa.

Malangizo apadera

Musanayambe mankhwala ndi mankhwala a Methotrexate (jekeseni, mapiritsi, ngati agwiritsidwa ntchito, sikofunikira), nkofunika kuti muyesetse magazi ambiri (kudziwa chiwerengero cha magazi), biochemistry (kuti mudziwe zoyenera za mavitamini a chiwindi, albumin, bilirubin), kuti mupange x-ray. Kuwonjezera apo, m'pofunika kufufuza ntchito ya impso, nthawi zina mayesero a chiwindi cha chiwindi ndi chifuwa chachikulu sichikhala chodabwitsa.

Kuti musaphonye kukula kwa kumwa mowa, nkofunika kuti muyambe kuyendetsa magazi a piritsi (chiwerengero cha mapiritsi ndi leukocyte), ntchito ya impso, ntchito ya hepatic transaminases, mlingo wa uric acid mu magazi a seramu. Musanagwiritse ntchito Methotrexate, mucosa mkamwa ndi mmero ayenera kuyang'anitsitsa zilonda zam'mimba. Mankhwala a hematopoiesis ayenera kuyang'aniridwa kumayambiriro kwa mankhwala, kamodzi panthawi ya chithandizo ndipo atatha.

Mtengo wa mtengo

Maonekedwe a kutulutsidwa (mapiritsi, jekeseni) ndi mlingo ndizo zifukwa zazikulu zomwe zimakhudza mtengo wa mankhwala "Methotrexate".

Mtengo wa mapiritsi okwanira (50 ma PC) Ndi mlingo wa 2.5 mg ukhoza kuyambira pa ruble 240 mpaka 250. Mapiritsi omwe ali ndi mlingo wa 5 mg angathe kugula kwa ndalama zokwana 390 mpaka 420. Kupaka mankhwalawa ndi mlingo waukulu (10 mg) kudzagula wogula 530-550 rubles.

Njira yothetsera jekeseni imapangitsa kuti phindu liwonjezeke, ndipo kufalikira kwa mitengoyi kuli kwakukulu. Mwachitsanzo, ma bulbu 5 a mankhwala omwe ali ndi mlingo wa 50 mg / 5 ml m'ma pharmacies ena amatha kutenga ndalama zoposa 1200-1300 rubles, ena - mabomba 4,900.

Maganizo a ogulitsa

Pali zifukwa zabwino komanso zolakwika za odwala pa mankhwalawa "Methotrexate". Ndi nyamakazi ya nyamakazi, ndemangazo zinkakonzedwanso bwino (pafupifupi 80% mwa odwala anagwira bwino ntchito miyezi yoyamba 1-1.5 kuchokera kuchiyambi cha chithandizo). Komabe, kawirikawiri zimatha kumva za zotsatira zovuta za mankhwala pa thupi la wodwala, pa chitukuko cha zotsatirapo za kuuma mosiyana ndi mbali ya machitidwe ndi ziwalo zosiyana.

Pochepetsa kuchepetsa vutoli, Methotrexate ayenera kulamulidwa ndi dokotala yemwe akupezekapo, ndipo ayenera kukhazikitsa chithandizo cha mankhwala ndikusankha mlingo woyenera.