"Methotrexate" kwi isifo samathambo: ncomo. Imiyalelo zokusetyenziswa, inkcazo yokulungiselela

isifo samathambo, xa iguqulelwe ngokoqobo nge isiGrike, libhekisela kwimeko komtshiso oko. Umbuzo into Imiba nimqumbise uphuhliso esi sifo nangoku kucaciswa. ulwazi engangqalanga ukuba kwandisa inani leukocytes egazini kwaye kwandise erythrocyte izinga neentlenge (ESR), lwenza kube lula ukubona ukuba inkqubo yokuqulunqa esi sifo uhlobo esosulelayo. Kukholelwa ukuba umfutho uphuhliso sifo sisifo, ukuphazamiseka exhokonxa ekusebenzeni kwamajoni omzimba. Nangona kunjalo, ngokuxhomekeke oku, asingabo bonke kodwa kuphela abo imbali yosapho. Isiphumo lokufakela usulelo ibe umzimba womntu ukuyilwa izakhiwo omzimba (kwamagciwane, izilwa-buhlungu, njalo njalo. P.), Nguwuphi yande ancedisana kungakhokelela kumonakalo ngokudibeneyo.

Kwiimeko ezininzi, unyango lwesi sifo kwabangcangcazelisayo Nokuthomalalisa iintlungu, sehlise ukuhamba kwenkqubo sifo nokubuyisela umonakalo (njengoko kunokwenzeka kwimeko nganye) usebenzisa iindlela yotyando.

Iziyobisi ngokuba unyango okwangoku ikho into eninzi. Enye yezi i "Methotrexate". Xa isifo samathambo (reviews of abasebenzi bezempilo kunye nezigulane ukuqinisekisa olu lwazi) Wathi medicament kakuhle ngokwaneleyo, iziphumo nempembelelo yayo iya ngayo ixesha elide.

Ukwakhiwa nokusebenza

Eyona nto iphambili ebonakalayo ichiza methotrexate. Le nitostatik, i ochasene of folic acid. Okwangoku, zokunciphisa ukuqhubela phambili kwinkqubo yonyango isifo samathambo "methotrexate" lisetyenziswa kaninzi ngaphezu kwezinye iindlela. Enyanisweni ke eli ichiza antitumor, i-arhente cytostatic, ezilawulayo mitosis (division iseli ngqo) abangaphangeliyo ukukhula izicwili ngenkuthalo ziyanda, abangaphangeliyo uphuhliso yamathumba.

Ngokutsho manani, ukusebenza ichiza wazibona ngo-80% yezigulane, iziphumo ezincumisayo yinto ephawuleka emva kweeveki 2-6 emva kokuqala unyango. Emva kwexesha elide yonyango (iminyaka ukuya ku-5) unyango "Metotraksatom" khansela ngaphantsi kakhulu ngaphezu kwayo nayiphi na enye ngamayeza asetyenziswa ukwehlisa uphuhliso isifo samathambo.

uhlobo Ukukhutshwa ichiza

iyeza Self lilingana Russian of Austria "Methotrexate Ebewe". Umenzi iziyobisi yokuqala inikeza nabathengi kwiintlobo ezininzi ezahlukeneyo kwimveliso. Iipilisi zifumaneka ukuthengiswa iidosi ezintathu 2.5 mg, 5 mg ne-10 mg yecandelo engundoqo esebenzayo. Bonke bephela zipakishwe nengqayi ezinepolypropylene lamaqhosha 50 nganye. Ukongezelela, "Methotrexate" (Austria - umenzi) zinokuthengwa kwi umthamo we-50 mg / 5 ml kumxube ukuba isitofu. Ampoules ezenziwe zeglasi mnyama kwaye sifakwe kwibhokisi yekhadibhodi.

Kungenzeka kwakhona ukuba athenge medicament ngokohlobo a mxube nokulungiselela infusions (iidropha). Izikali - 100 mg / 1 ml. Ngefomu, "Methotrexate" kuthengiswa nengqayi ye-5, 10, 50 ml. Xa ibhokisi yekhadibhodi swi igutyana enye.

Iimpawu ngokufumana "methotrexate"

Iimpawu zibonisa ukuba ukusetyenziswa kweziyobisi kakhulu ngqo, ekubeni injongo yawo - ekulweni yamathumba. Kuyanconywa ukuba 'Methotrexate "kwiimeko apho isigulane ukubandezeleka wegazi lymphoblastic oyingozi kunye lymphomas nehodzhinskimi. Kwakhona, oko omiselwe yamathumba trophoblast uzakhele mycosis kunye ukhwekhwe (ngokwezigaba kakhulu).

Kwakhona, ukuba ezinye nokudla iziyobisi abanawo nefuthe appreciable izicelo "MTX" ukuba isifo samathambo. Uhlaziya rheumatologists leengcaphephe amayeza kunokuba ezintle.

Izinto ezibonisa ukuba ulwamkelo "Methotrexate Ebewe" noko emikhulu. Iingcali uyakukumisela lona xa isigulane ezinezigulo iinkqubo ezahlukeneyo kunye namasebe: umhlaza wemiphunga kunye nomhlaza webele, osteosarcoma kunye sarcomas kwizihlunu ezithambileyo, wamatyhalarha kunye nangezilonda ovarian, Kaposi Jung, retinoblastoma kunye nezifo sokuhlasela.

Ngubani kufuneka uthathe amayeza?

Akuvumelekile ukuba ichiza kubantu abane hypersensitivity ukuba eyona nto engundoqo esebenzayo. Contraindicated lolwamkelo esikolweni "methotrexate" abasetyhini abakhulelweyo kunye nabondli zokonga. Hayi prescribers kunye ezinxaxhileyo ezikhoyo wesibindi, nezintso, hematological ukuphazamiseka umlinganiswa (anemia, thrombocytopenia, leukopenia). Akwenzeki ukuba ukuqala iyeza unyango izigulane kwisigaba nokoyika nasiphi na isifo esosulelayo, intswelo omzimba syndrome. Njengoko elingana Russian, yaye "Methotrexate" yokuqala (Austria) akavumelekanga ukuba banike abantwana babo ukuya kwiminyaka emithathu.

Xa inani kwezifo ichiza anikwe ngononophelo olukhulu. Ezi ngxaki ziquka izilonda esiswini 12 isilonda duodenal, sisilonda sikabhobhosi, kunye emzimbeni. In wentsholongwane egazini, imingxunya kwezifo nabo kufuneka senze ngokuqaphela okukhulu. Kweli qela fanele imiba phambi kokuba radiotherapy okanye ichemotherapy.

ziphumo bezingalindelekanga kunokwenzeka

"Methotrexate" ku ampoules, amacwecwe, xa infusions kunokubangela inani yeziphumo ebezingalindelekanga. Lidla iingxaki ezinzulu ukusuka kwinkqubo hematopoietic (leukopenia, thrombocytopenia, njalo njalo. P.) Yaye emathunjini (ukuqunjelwa, ukudla, isibindi zinetyhefu, pancreatitis) kuvuka. I-luvo angaphendula yintloko, ukozela, paresis, ukuxhuzula. ngeedosi eziphezulu beziyobisi engabangela kuphuhliso Encephalopathy. Ukutenxa izitho ezibonwayo kunye nemithambo yegazi (hypotension, effusion pericardial, thromboembolism).

Inokuphuhlisa ukusilela yokuphefumla, ezinganyangekiyo obstructive isifo yemiphunga, ukuphelelwa umoya, eyomileyo, ukhohlokhohlo wayewasusa kuye, nomkhuhlane. Nenkqubo genitourinary, kukho ingozi yokuba nesifo sezintso kakhulu okanye ukusilela kwezintso. ukuphazamiseka okunokwenzeka of spermatogenesis kunye oogenesis, sinciphise yobuntu, nenzalo, induku.

Ukuba umfazi ekhulelwe, "Methotrexate" (lwezitofu, amacwecwe, ithontsi) kunokubangela kwesisu, malformations okanye ukufa Palsy.

amacwecwe nomthamo abakwisigaba

Xa unyango neoplasms amabi lwemithi iipilisi ngabanye yenzelwe kwaye kuxhomekeke iiseshoni ichemotherapy wesekethe. Xa kufikwa apho isicelo medicament "MTX" ukuba isifo samathambo (iimpendulo Patient babe nesimilo), idosi wokuqala ongowona 7.5 mg kanye ngeveki. Ungathatha idosi yonke kwangoko, kwaye alabe libe amathamo 3 qho emva kweyure ezili-12.

Kwezinye iimeko (ukufikelela ngokupheleleyo isiphumo) ithamo ngeveki ukuze kwandiswe. Nakuba kunjalo, kufuneka ingadluli 20 mg. Xa isiphumo lwezonyango ezinqwenelekayo kuyafikelelwa, idosi kufuneka kancane kancane kuze ubuncinane. Ubude ngokupheleleyo kunjalo unyango akukho ngokwezonyango sifo.

Isitofu "methotrexate"

Yaye njani inaliti kunye ichiza "Methotrexate"? Inaliti ukuba isifo samathambo ukuqala ukwenza umthamo 7.5 mg ngeveki. Oku kunokwenziwa kwesikhumba, intramuscularly okanye yegazi. Ukuba ichiza laye ukunyamezeleka kakuhle sisigulane, ithamo ukuba yaba yintsimi ngeveki kwi 2.5 mg kodwa hayi ngaphezulu kwama-25 mg. Xa isiphumo enyangayo sifikelelwe (idla iinyanga 1-2 emva konyango), ithamo kufuneka kancane kancane lisezantsi efunekayo. Kuba isigulane ngasinye isifo samathambo, idosi uya ngokuthe kulungiswa ukuze isiphumo ngokupheleleyo unyango. zophononongo zibonise ukuba "Methotrexate" ugxile ngcono aze anike iimpendulo kwicala amancinane, ukuba kwesikhumba ngenaliti okanye intramuscularly.

Omoya rhoqo "methotrexate" lokuqala nemiphumo emihle zonyango kulwa iminyaka emibini. Ukuba ukurhoxisa samathambo samathambo chiza nefuthe kwiiveki 3-6.

ngeedosi kakhulu

ngeedosi kakhulu medicament Russian okanye iziyobisi "Methotrexate Ebewe" (tablets, iinaliti, infusions) ayiboniswanga naziphi na iimpawu ezithile. libanda yobunyani kuba methotrexate kwinqanaba ingqalelo plasma yegazi.

Unyango olukhawulezileyo (ngokupheleleyo ngelixa lokuqala) isicelo iyeza, nto leyo folinate calcium. Umthamo injectate kufuneka ilingana no okanye inkulu ngaphezu idosi wafumana "methotrexate". ngeedosi ezongezelelweyo calcium folinate kumiselwe ngugqirha njengoko kuyimfuneko. Phambi kokuba ufake ithamo nganye elandelayo, yaye ke ngoko zonke iiyure 6 kuyo yonke inkqubo ukuphelisa iimpawu i libanda ukusebenzisa iyeza kuyimfuneko ukumisela pH ngumchamo. Amanyathelo anjalo aza zokunciphisa yokuvela nephropathy.

Kwakhona kwi ngamanyathelo anokuthatyathwa ezifunekayo ukuze kupheliswe ifuthe i libanda, amayeza iquka ukuxovwa kunye nomchamo alkalinization. Le nkqubo iza kukhawulezisa kukhuthaza methotrexate.

Intsebenziswano kunye nezinye izinto kunye amalungiselelo

Ukuba umntu ogulayo sifo, kwaye ukuqeshwa "Methotrexate" amayeza okanye "Methotrexate Ebewe" iziyobisi arthrifuge ithamo kufuneka alungiswe. usebenzisa of salicylates, phenylbutazone, fenitoiona, sulfonamides, iqela antibiotics ezithile (tetracycline, penicillin, chloramphenicol), anticoagulants isiphumo ngqo kunye namayeza hypolipidemic kungakhokelela zinetyhefu kakhulu, nkqu nokufa.

amanani amakhulu "methotrexate" ngokunxuseneyo kunye NSAIDs zingabangela ukufa evela hematologic kakhulu kunye letyhefu zesisu. Indibaniso NSAIDs namayeza-idosi ophantsi phambi kwethu unokunciphisa kukhuthaza yokugqibela yi-tubules sezintso.

amachiza Hepatotoxic (ngokususela sulfasalazine, azathioprine, ethanol) ukwandisa amathuba hepatotoxicity, gematotoksicheskim - gematotoksichnosti "methotrexate". isicelo ngaxeshanye zonyango unyango radiation iziyobisi kwaye kungadala lomongo wethambo kukudakumba.

imiyalelo Special

Phambi kokuba uqale unyango amayeza "Methotrexate" (inaliti, ukuba iipilisi esebenzayo - Akukhathaliseki), kuyimfuneko ukuba aqhube epheleleyo igazi count (ukuze wazi kwinqanaba zegazi), ngamachiza (ukumisela amaxabiso enqanda zesibindi, albumin, yibilirubin), wenze esifubeni X-ray. Ukongeza, kuyimfuneko ukuhlola nezintso, kwezinye iimeko, mazingabi ziimvavanyo akufuneki hepatitis kunye nesifo sephepha.

Ukuze ukuba ukuphoswa umzuzu ukunxila, kuyimfuneko ukulawula ukwakhiwa igazi yoluvo (inani leukocytes neeplatelets), umsebenzi sezintso, umsebenzi transaminase hepatic, inqanaba uric acid serum. Phambi kokusetyenziswa kwe "methotrexate" isifo yomlomo pharynx kufuneka zitshekishwe ubukho izilonda. Inkqubo ithambo umongo hematopoiesis kufuneka zikhangelwe ekuqaleni unyango, kanye ngexesha unyango kunye emva kokuvalwa kwalo.

uhla amanani

ukukhulula ifomu (tablet, inaliti) kunye idosi - eyona miba ephambili echaphazela iindleko "Methotrexate" iziyobisi.

Price diphu iipilisi (50 iiPC.) Ekubeni ithamo 2.5 mg zingaqala engange-240 ukuya-250. Imali efanayo amacwecwe zedosi 5 mg zingathengwa ukuba imali engange-390 ukuya 420. Iipakethe ichiza kunye idosi iphezulu (10 mg) liya kuxabisa 530-550 engange.

Ewiliko ukuba isitofu ibiza kakhulu ngakumbi, kunye nokwanda ixabiso obanzi kakhulu. Ngokomzekelo, 5 ampoules medicament kunye umthamo 50 mg / 5 ml kwiikhemesti nga zibiza malunga 1200-1300 engange, ngoxa abanye - 4900 engange.

umbono kwabathengi

Kukho zombini iimbono ezintle nezimbi zezigulane malunga namayeza "Methotrexate". Xa isifo samathambo, nokubuyekezwa abhalwe becala iziphumo ezincumisayo (malunga nama-80% yezigulane bafumana ukusebenza kwiinyanga zokuqala 1-1.5 zonyango). Noko ke, umntu udla kuva imiphumela emibi ichiza kwisigulana, uphuhliso yeziphumo ebezingalindelekanga eyahlukahlukeneyo ubukhali kwicala kweenkqubo ezahlukeneyo kunye namasebe.

Ukunciphisa le nefuthe elibi, "Methotrexate" kufuneka aqeshwe ngulo igqirha khona, kananjalo kufuneka ukuba kuqulunqwe isicwangciso unyango kwaye khetha i idosi olusebenzayo.