He aha ka Rasburicase: Nā hoʻohana, ka nui, nā hopena ʻaoʻao a me nā mea hou aku

He lāʻau lapaʻau kūikawā ʻo Rasburicase i hāʻawi ʻia ma o ka IV e kōkua i kou kino e mālama i nā pae weliweli o ka waikawa uric. Hana kēia enzyme ikaika e like me ke kōkua i manaʻo ʻia, e wāwahi ana i ka waikawa uric i ka wā ʻaʻole hiki i kou mau puʻupaʻa ke mālama i ka wai kahe koke e hiki mai ana i kekahi manawa i ka wā o ka mālama ʻana i ka maʻi maʻi.

E hālāwai maʻamau ʻoe i kēia lāʻau lapaʻau i nā wahi haukapila, kahi e hoʻohana ai nā hui mālama ola iā ia e pale i nā pilikia koʻikoʻi. E noʻonoʻo iā ia he kaʻa kaʻa pilikia no nā pae waikawa uric o kou kino i ka wā e hoʻoweliweli ai lākou e puka i waho o ka mana.

He aha ka Rasburicase?

He enzyme i hana ʻia i loko o ka hale hana ʻo Rasburicase e wāwahi i ka waikawa uric i loko o kou koko. He mana synthetic ia o kahi enzyme i kapa ʻia ʻo uricase, ʻaʻole i loaʻa i nā kānaka maoli akā loaʻa i nā mammals ʻē aʻe.

No kahi papa i kapa ʻia nā enzyme kikoʻī waikawa uric kēia lāʻau lapaʻau. ʻAʻole like me nā lāʻau lapaʻau e ālai wale i ka hana ʻana o ka waikawa uric, luku maoli ʻo rasburicase i ka waikawa uric e holo nei i loko o kou kahe koko. Hana wikiwiki ia ma mua o nā lāʻau lapaʻau kuʻuna, e hōʻike ana i nā hopena i loko o nā hola ma mua o nā lā.

Hele mai ka lāʻau lapaʻau ma ke ʻano he pauka i hui pū ʻia me ka wai sterile a hāʻawi ʻia ma o ka laina IV. E hoʻomākaukau mau kāu hui mālama ola a e lawelawe i kēia lāʻau lapaʻau i loko o kahi kaiapuni haukapila i mālama ʻia.

No ke aha e hoʻohana ʻia ai ka Rasburicase?

Hoʻomaʻamaʻa ʻo Rasburicase a pale i ka maʻi lysis tumor, kahi maʻi koʻikoʻi e hiki ke hana i ka wā o ka mālama ʻana i ka maʻi maʻi. Ke make koke nā cell maʻi maʻi i ka wā o ka chemotherapy a i ʻole ka radiation, hoʻokuʻu lākou i nā mea nui o ka waikawa uric i loko o kou kahe koko.

Hoʻomaʻemaʻe maʻamau kou mau puʻupaʻa i ka waikawa uric, akā hiki iā lākou ke lilo i mea nui ke kumu o ka mālama ʻana i ka maʻi maʻi i ka make koke ʻana o ke kelepona. Hiki i kēia wai kahe o ka waikawa uric ke hana i nā kristal i loko o kou mau puʻupaʻa, e hōʻeha paha i ka pōʻino a i ʻole ka hāʻule ʻana o ka puʻupaʻa.

Hoʻohana pinepine ʻia ka lāʻau lapaʻau i ka poʻe e loaʻa ana i ka mālama ʻana no nā maʻi koko e like me ka leukemia, lymphoma, a i ʻole multiple myeloma. Eia naʻe, hiki i nā kauka ke hoʻohana iā ia no nā tumora paʻa ke loaʻa ka pilikia nui o ka maʻi lysis tumor.

Loaʻa i kekahi poʻe maʻi ka rasburicase ma ke ʻano he pale ma mua o ka hoʻomaka ʻana i ka mālama ʻana i ka maʻi maʻi, aʻo nā mea ʻē aʻe e loaʻa iā ia ma hope o ka piʻi ʻana o nā pae waikawa uric i kahi kiʻekiʻe weliweli. E hoʻoholo kāu oncologist i ka manawa maikaʻi loa e pili ana i kāu kūlana a me nā mea pilikia.

Pehea e hana ai ʻo Rasburicase?

Hana ʻo Rasburicase ma ka hoʻololi ʻana i ka waikawa uric i kahi hui i kapa ʻia ʻo allantoin, hiki i kou mau puʻupaʻa ke hoʻopau maʻalahi. Hana ʻia kēia hana me ka wikiwiki a me ka maikaʻi, e hoʻohaʻahaʻa pinepine ana i nā pae waikawa uric i loko o 4 a 24 mau hola.

He lāʻau lapaʻau ikaika kēia e hana wikiwiki ana ma mua o nā lāʻau lapaʻau waikawa uric kuʻuna. ʻOiai nā lāʻau lapaʻau e like me allopurinol e pale i ka hana ʻana o ka waikawa uric hou, luku ikaika ʻo rasburicase i ka waikawa uric e kū nei i loko o kou kahe koko.

Hoʻopā pololei ka enzyme i nā molekala waikawa uric, e wāwahi ana iā lākou ma o ke kaʻina hana i kapa ʻia ʻo oxidation. ʻO ka allantoin hopena ma kahi o 5 a 10 mau manawa ʻoi aku ka wai-soluble ma mua o ka waikawa uric, e maʻalahi ai i kou mau puʻupaʻa ke holoi aku.

Ke hoʻomaʻemaʻe ka lāʻau lapaʻau i ka hōʻiliʻili ʻana o ka waikawa uric weliweli, hiki i kou mau puʻupaʻa ke hoʻi i kā lākou hana maʻamau. E wāwahi ʻia ka enzyme ponoʻī a hoʻopau ʻia mai kou kino i loko o kekahi mau lā.

Pehea wau e lawe ai iā Rasburicase?

E loaʻa iā ʻoe ka rasburicase ma kahi haukapila wale nō ma o ka laina IV, ʻaʻole loa ma ke ʻano he lāʻau lapaʻau āu e lawe ai ma ka home. E hoʻokomo ka hui mālama ola kino i kahi catheter liʻiliʻi i loko o kahi vein, maʻamau i kou lima a i ʻole ka lima, a hāʻawi i ka lāʻau lapaʻau ma ke ʻano he infusion lohi.

ʻO ka maʻamau, 30 mau minuke e hoʻopau ai ka infusion. Pono ʻoe e noho mālie i kēia manawa, akā hiki iā ʻoe ke heluhelu, nānā i ke TV, a i ʻole kamaʻilio me nā malihini. E nānā pono nā limahana hānai iā ʻoe i ke kaʻina holoʻokoʻa.

ʻAʻole pono ʻoe e hoʻokē ʻai ma mua o ka loaʻa ʻana o ka rasburicase, a hiki iā ʻoe ke ʻai maʻamau ma hope. Eia naʻe, he mea nui ka noho ʻana i ka wai, no laila e paipai paha kāu hui mālama ola iā ʻoe e inu i ka wai nui a i ʻole e loaʻa i nā wai IV hou.

Aia ka papa hana lāʻau lapaʻau i kāu kūlana kikoʻī. Loaʻa i kekahi poʻe kahi mahele hoʻokahi, aʻo nā mea ʻē aʻe e loaʻa paha nā mahele i kēlā me kēia lā no kekahi mau lā. E hana kāu oncologist i kahi hoʻolālā pilikino e pili ana i kāu pae waikawa uric a me ka papa hana lapaʻau maʻi maʻi.

Pehea ka lōʻihi e lawe ai au i ka Rasburicase?

Loaʻa i ka hapa nui o nā kānaka ka rasburicase no 1 a 5 mau lā, ma muli o ka wikiwiki o ka hoʻi ʻana o ko lākou pae waikawa uric i nā pae palekana. E nānā kāu hui mālama ola i kāu pae koko i kēlā me kēia lā e hoʻoholo ai i ka manawa e palekana ai ke hooki.

Aia ka lōʻihi o ka lapaʻau i nā mea he nui, me kāu mau pae waikawa uric mua, ka hana o ka puʻupaʻa, a me ka maikaʻi o kāu pane ʻana i ka lāʻau lapaʻau. Pono kekahi poʻe maʻi i kahi mahele hoʻokahi wale nō, aʻo nā mea ʻē aʻe e koi i kekahi mau lā o ka lapaʻau.

E kauoha kāu kauka i nā hoʻokolohua koko maʻamau e nānā i kāu pae waikawa uric, ka hana o ka puʻupaʻa, a me nā mea hōʻailona koʻikoʻi ʻē aʻe. Ke paʻa kāu mau pae i kahi pae palekana a noho ma laila, ʻaʻole pono ʻoe i nā mahele hou.

Inā loaʻa iā ʻoe ka lapaʻau maʻi maʻi e hele nei, e hāʻawi hou paha kāu hui mālama ola iā ʻoe i ka rasburicase inā lilo kāu pae waikawa uric i mea weliweli i nā pōʻai lapaʻau e hiki mai ana.

He aha nā hopena ʻaoʻao o Rasburicase?

E like me nā lāʻau lapaʻau a pau, hiki i ka rasburicase ke hana i nā hopena ʻaoʻao, ʻoiai e ʻae ka hapa nui o nā kānaka iā ia ke hāʻawi ʻia i loko o kahi haukapila. E nānā pono kāu hui mālama ola iā ʻoe no nā hopena i ka wā a ma hope o ka hoʻokomo ʻana.

Eia nā hopena ʻaoʻao maʻamau e hiki iā ʻoe ke ʻike:

• Ka luaʻi ʻana a i ʻole ka luaʻi ʻana, e pane maikaʻi ana i nā lāʻau anti-nausea
• He ʻeha poʻo maʻamau a he manawa pōkole
• He kuni a i ʻole nā anu, ʻoi loa i nā hola mua ma hope o ka hoʻokomo ʻana
• Ka maʻi palahī a i ʻole ka paʻa ʻana o ka ʻōpū, pili pinepine i nā lāʻau lapaʻau ʻē aʻe āu e loaʻa nei
• Ka luhi a i ʻole ka manaʻo nui o ka luhi ma mua o ka maʻamau
• He ʻili ʻili maʻalahi a i ʻole ka ʻū ʻana ma ke kahua IV

Hoʻoponopono maʻamau kēia mau hopena ʻaoʻao maʻamau iā lākou iho a i ʻole me nā lāʻau lapaʻau maʻalahi. ʻIke kāu hui mālama i ke olakino pehea e mālama ai i kēia mau hopena a e hōʻoluʻolu iā ʻoe i kāu mālama ʻana.

ʻAʻole maʻamau nā hopena ʻaoʻao koʻikoʻi, akā pono e mālama koke ʻia. E nānā pono kāu hui mālama i ke olakino i kēia mau mea:

• Nā hopena maʻi koʻikoʻi, me ka pilikia o ka hanu ʻana, ka pehu ʻana o ka maka a i ʻole ka ʻāʻī, a i ʻole nā hopena ʻili koʻikoʻi
• Nā hōʻailona o ka hemolysis (ka wāwahi ʻana o ke keʻa koko ʻulaʻula), e like me ka mimi ʻeleʻele, ka melemele ʻana o ka ʻili a i ʻole nā maka, a i ʻole ka luhi nui
• Methemoglobinemia, kahi maʻi kakaʻikahi e pili ana i ka lawe ʻana o ka oxygen i kou koko
• Nā pilikia kīkī koʻikoʻi, ʻoiai ke kōkua maʻamau ʻo rasburicase i ka pale ʻana i kēia mau mea
• Hoʻololi ka puʻuwai a i ʻole ka ʻeha o ka umauma

He kakaʻikahi kēia mau hopena koʻikoʻi, ʻoi loa ke hāʻawi ʻia ka lāʻau lapaʻau ma ke ʻano kūpono i kahi haukapila. Loaʻa i kāu hui mālama i ke olakino ka ʻike i ka ʻike a me ka mālama ʻana i kēia mau pilikia inā loaʻa.

Loaʻa i kekahi poʻe ka hopohopo e pili ana i ka loaʻa ʻana o nā lāʻau lapaʻau IV, he mea maʻamau loa. Hiki i kāu hui mālama i ke olakino ke hāʻawi i ke kākoʻo naʻau a pane i nā nīnau e kōkua iā ʻoe e ʻoluʻolu.

ʻO wai ka mea ʻaʻole pono e lawe iā Rasburicase?

ʻAʻole kūpono ʻo Rasburicase no nā mea a pau, a e nānā pono kāu hui mālama i ke olakino i kāu mōʻaukala olakino ma mua o ke kau ʻana. ʻO ka contraindication nui loa he maʻi genetic i kapa ʻia ʻo glucose-6-phosphate dehydrogenase (G6PD) deficiency.

He alo ka poʻe me ka maʻi G6PD i ka pilikia nui o ka hemolysis koʻikoʻi (ka luku ʻana i nā ʻulaʻula koko) ke hāʻawi ʻia iā rasburicase. Hoʻopilikia kēia maʻi genetic ma kahi o 1 i 400 mau kānaka, a ʻoi aku ka maʻamau i ka poʻe o ka ʻApelika, Mediterranean, a i ʻole Middle Eastern.

E kauoha paha kāu kauka i kahi hoʻokolohua G6PD ma mua o ka hāʻawi ʻana iā ʻoe i ka rasburicase, ʻoiai inā he moʻolelo ʻohana kou o kēia maʻi a i ʻole mai kahi heluna kanaka pilikia kiʻekiʻe. Hiki i kēia hoʻokolohua koko maʻalahi ke pale i nā pilikia koʻikoʻi.

ʻO nā kūlana ʻē aʻe kahi e hoʻohana ai nā kauka i ka akahele nui e komo pū ana:

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• Nā hopena maʻi maʻi koʻikoʻi i ka rasburicase a i ʻole nā ​​lāʻau lapaʻau like
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• Hāpai, no ka mea, ʻaʻole i hoʻokumu ʻia ka palekana no nā pēpē e ulu ana
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• Ka hānai ʻana i ka umauma, no ka mea, ʻaʻole ʻike ʻia inā hele ka lāʻau lapaʻau i loko o ka waiū umauma
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• Maʻi puʻuwai koʻikoʻi a i ʻole nā ​​pilikia o ka puʻuwai
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• Moʻolelo o ka methemoglobinemia a i ʻole nā ​​maʻi koko ʻē aʻe
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E kaupaona kāu hui mālama ola i nā pōmaikaʻi e kūʻē i nā pilikia i kēia mau kūlana. I kekahi manawa, ʻoi aku ka pono e pale i ka pōʻino o ka puʻupaʻa mai nā pae waikawa uric kiʻekiʻe ma mua o nā hopohopo ʻē aʻe.

Nā inoa inoa Rasburicase

Loaʻa ʻo Rasburicase ma lalo o ka inoa inoa Elitek ma ʻAmelika Hui Pū ʻIa. ʻO kēia ka inoa inoa i hoʻohana nui ʻia āu e hālāwai ai ma nā haukapila ʻAmelika a me nā kikowaena maʻi maʻi.

Ma nā ʻāina ʻē aʻe, hiki iā ʻoe ke ʻike i nā inoa inoa like ʻole no ka lāʻau lapaʻau like. No ka laʻana, kūʻai ʻia ʻo ia ʻo Fasturtec ma ʻEulopa a me nā mākeke honua ʻē aʻe. Eia naʻe, like ka lāʻau lapaʻau ponoʻī me ka nānā ʻole i ka inoa inoa.

Hiki i kekahi mau haukapila ke kuhikuhi iā ia ma ke ʻano he

He nui nā koho ʻē aʻe no ka mālama ʻana i nā pae waikawa uric kiʻekiʻe, ʻoiai ʻaʻole hana kekahi e like me ka wikiwiki e like me rasburicase. E koho kāu hui mālama ola i ke koho maikaʻi loa e pili ana i kāu kūlana kikoʻī a me ka wikiwiki o ka mālama ʻana.

ʻO Allopurinol ke koho maʻamau, ʻoiai no ka pale ʻana i ka hōʻiliʻili ʻana o ka waikawa uric ma mua o ka hoʻomaka ʻana o ka mālama ʻana i ka maʻi maʻi. Hoʻopaʻa kēia lāʻau lapaʻau waha i ka hana ʻana o ka waikawa uric akā he mau lā e hōʻike i nā hopena piha, e lilo ana ia i mea kūpono ʻole no nā kūlana pilikia.

ʻO Febuxostat kekahi koho pale e hana like me allopurinol akā ʻoi aku ka maikaʻi o ka poʻe. E like me allopurinol, pale ia i ka hana ʻana o ka waikawa uric hou ma mua o ka luku ʻana i ka waikawa uric e kū nei.

No ka mālama koke ʻana i nā pae waikawa uric kiʻekiʻe loa, aia nā koho ʻē aʻe:

• Hoʻomaʻemaʻe ikaika me nā wai IV e kōkua i ka holoi ʻana i ka waikawa uric ma nā puʻupaʻa
• Hoʻomaʻemaʻe ʻana i ka mimi me ka hoʻohana ʻana i ka sodium bicarbonate e hoʻoheheʻe i ka waikawa uric
• Dialysis i nā hihia koʻikoʻi kahi e hana pono ʻole ai nā puʻupaʻa
• Nā ala hui pū me ka hoʻohana ʻana i nā lāʻau lapaʻau he nui

Eia naʻe, ʻaʻole hana kekahi o kēia mau koho ʻē aʻe e like me ka wikiwiki a i ʻole ka maikaʻi e like me rasburicase no nā kūlana pilikia. E wehewehe kāu oncologist i ke kumu e koho maikaʻi ai ʻo rasburicase no kāu mau kūlana kikoʻī.

Ua ʻoi aku ka maikaʻi o Rasburicase ma mua o Allopurinol?

Hoʻohana ʻo Rasburicase a me allopurinol i nā kumu like ʻole, no laila ke hoʻohālikelike ʻana iā lākou e hilinaʻi ana i kāu kūlana kikoʻī a me nā pono manawa. He mau koho maikaʻi nā lāʻau lapaʻau ʻelua, akā hana lākou ma nā ʻano like ʻole.

Pono ʻo Rasburicase i nā kūlana pilikia ke pono ʻoe i nā hopena koke. Hiki iā ia ke hoʻohaʻahaʻa i nā pae waikawa uric kiʻekiʻe loa i loko o nā hola, e pale ana i ka pōʻino o nā puʻupaʻa a i ʻole ka hāʻule ʻole. Hana kēia i mea waiwai i ka wā o ka maʻi ʻāʻī tumora ikaika a i ʻole i ka wā i lawa ʻole ai nā hana pale.

ʻOi aku ka maikaʻi o ka Allopurinol no ka pale ʻana a me ka mālama lōʻihi. Lawe ʻia ma ka waha, ʻoi aku ka liʻiliʻi o ke kumukūʻai, a ʻoi aku ka liʻiliʻi o nā palena e pili ana i ka mea hiki ke hoʻohana. Nui ka poʻe e lawe i ka allopurinol no nā lā a i ʻole nā pule ma mua o ka hoʻomaka ʻana i ka mālama ʻana i ka maʻi maʻi e pale ai i ka hōʻiliʻili ʻana o ka waikawa uric.

Ke hilinaʻi pinepine nei ke koho ma waena o lākou i ka manawa a me ka wikiwiki:

• No ka mālama ulia pōpilikia: ʻOi aku ka maikaʻi o ka Rasburicase ma muli o kāna hana wikiwiki
• No ka pale ʻana: Makemake pinepine ʻia ka Allopurinol ma muli o kona maʻalahi a me ka palekana
• No ka mālama ʻana i ka wā e hiki mai ana: ʻO ka allopurinol ka hopena lōʻihi
• No ka poʻe me ka hemahema G6PD: ʻO ka allopurinol ke koho palekana

Nui nā mea maʻi e loaʻa maoli i nā lāʻau lapaʻau ʻelua, me ka allopurinol no ka pale ʻana a me ka rasburicase no ka mālama ʻana inā pono. E hana kāu hui mālama ola i ke ʻano maikaʻi loa no kou kūlana pilikino.

Nā nīnau i nīnau pinepine ʻia e pili ana iā Rasburicase

Q1. Palekana ʻo Rasburicase no ka poʻe me ka maʻi kīkī?

He palekana ka Rasburicase no ka poʻe me ka maʻi kīkī a hiki ke kōkua i ka pale ʻana i ka hana kīkī. Hana ka lāʻau lapaʻau ma ka hoʻemi ʻana i nā pae waikawa uric, hiki ke pale i ka pōʻino hou o ka kīkī mai nā kristal waikawa uric.

Eia naʻe, pono ka poʻe me ka maʻi kīkī koʻikoʻi i ka nānā ʻana i ka wā e mālama ai. E hoʻoponopono kāu hui mālama ola i ka dosage a nānā pono i kāu mau hoʻokolohua hana kīkī e hōʻoia i ke kōkua ʻana o ka lāʻau lapaʻau ma mua o ka hoʻoulu ʻana i ke koʻikoʻi.

Hoʻohana pinepine ʻia ka lāʻau lapaʻau e pale i ka pōʻino o ka kīkī i ka poʻe i pilikia nui. E hana pū kāu nephrologist a me ka oncologist e hoʻoholo inā kūpono ka rasburicase no kāu pae hana kīkī.

Q2. He aha kaʻu e hana ai inā loaʻa iaʻu ka nui o ka Rasburicase?

Mai ka rasburicase i hāʻawi ʻia ma nā wahi haukapila e nā poʻe loea mālama ola i aʻo ʻia, he mea maʻamau loa nā overdoses ulia pōpilikia. Hoʻohālikelike pono kāu hui mālama ola i nā lāʻau i kau ʻia ma ke kaupaona ʻana iā ʻoe a nānā pono i ka hoʻokomo ʻana.

Inā hopohopo ʻoe e pili ana i ka loaʻa ʻana o ka lāʻau nui loa, mai kānalua e noi i kāu kahu e nānā pālua i kāu lāʻau a i ʻole e wehewehe pehea lākou e helu ai. Hoʻokipa nā hui mālama ola i kēia mau nīnau ma ke ʻano he ʻāpana o nā hana lāʻau palekana.

I ka hanana hiki ʻole o ka overdose, e hāʻawi kāu hui mālama ola i ka mālama kākoʻo a nānā pono iā ʻoe no nā pilikia. Loaʻa i ka haukapila nā protocols i kahi e mālama ai i nā hewa lāʻau i ka wikiwiki a me ka palekana.

Q3. He aha kaʻu e hana ai inā e hala wau i kahi lāʻau o Rasburicase?

ʻAʻole pono ʻoe e hopohopo e pili ana i ka hala ʻana i kahi lāʻau no ka mea e hāʻawi ʻia ana ka rasburicase ma nā wahi haukapila wale nō. Mālama kāu hui mālama ola i ka papa hana dosing holoʻokoʻa a e hōʻoia e loaʻa iā ʻoe nā lāʻau e like me ke kau ʻia.

Inā lohi kāu lapaʻau ma muli o nā pilikia hoʻonohonoho a i ʻole nā mea nui olakino ʻē aʻe, e hoʻoponopono kāu hui mālama ola i ka manawa kūpono. E nānā hou lākou i kāu mau pae waikawa uric e hoʻoholo ai inā pono ka lāʻau i lohi.

I kekahi manawa e loli nā hoʻolālā lapaʻau ma muli o ka maikaʻi o kāu pane ʻana i nā lāʻau mua. Hiki i kāu hui ke hoʻoholo ʻia e pono ana i nā lāʻau liʻiliʻi inā e paʻa koke kāu mau pae waikawa uric.

Q4. I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka Rasburicase?

E hoʻoholo kāu hui mālama ola i ka manawa e hooki ai i ka rasburicase ma muli o nā hopena o kāu hoʻāʻo koko a me ke kūlana holoʻokoʻa. ʻO ka hapa nui o nā kānaka e hooki i ka loaʻa ʻana o ka lāʻau i ka wā e hoʻi ai kā lākou mau pae waikawa uric i nā pae palekana a paʻa.

Aia ka hoʻoholo i ka nānā ʻana i kekahi mau mea, me kāu mau pae waikawa uric, ka hana o ka puʻupaʻa, a me ke ʻano o kāu pane ʻana i ka lapaʻau maʻi maʻi. E wehewehe kāu hui i kā lākou kumu a e mālama iā ʻoe i ka ʻike e pili ana i ka hoʻolālā lapaʻau.

He nui nā kānaka e hoʻololi i nā lāʻau lapaʻau waha e like me ka allopurinol no ka pale ʻana i ka wā e hiki mai ana, ʻoiai ʻaʻole pono kekahi poʻe i ka mālama ʻana i ka waikawa uric. Na kou kūlana kūikawā e hoʻoholo i ke ala maikaʻi loa e neʻe i mua.

Q5. Hiki iaʻu ke loaʻa iā Rasburicase i nā manawa he nui?

ʻAe, hiki iā ʻoe ke loaʻa iā rasburicase i nā manawa he nui inā pono, akā e nānā pono kāu hui mālama ola iā ʻoe no nā hopena maʻi maʻi me nā hōʻike hou. Pono kekahi poʻe i nā papa hou i nā pōʻai lapaʻau maʻi ʻaʻai like ʻole.

Me kēlā me kēia lapaʻau e hiki mai ana, aia kahi pilikia liʻiliʻi o ka hoʻomohala ʻana i kahi hopena maʻi maʻi, no laila e nānā pono kāu hui iā ʻoe. E noʻonoʻo pū lākou inā ʻoi aku ka maikaʻi o nā ala ʻē aʻe no ka mālama ʻana i ka wā e hiki mai ana.

E kaupaona kāu hui mālama ola i nā pōmaikaʻi a me nā pilikia i kēlā me kēia manawa e noʻonoʻo ʻia ai ka rasburicase, e hōʻoia ana e noho ana ia i ke koho maikaʻi loa no kou kūlana i kēia manawa.