Icyo Fidaxomicin Aricyo: Ibyo Ikoreshwa, Uburyo Bwo Kuyifata, Ingaruka Zayo, n'Ibindi

Fidaxomicin ni umuti wihariye wica mikorobe ugamije kurwanya indwara ikomeye yo mu mara yitwa C. difficile colitis. Uyu muti ukora mu buryo butandukanye n'imiti myinshi yica mikorobe kuko uba cyane mu mara yawe, urwanya bagiteri mbi aho ikibazo kibera hatabangamiye cyane bagiteri nziza ziri mu mubiri wawe.

Fidaxomicin ni iki?

Fidaxomicin ni umuti wica mikorobe wandikirwa n'abaganga ugamije kuvura indwara ya Clostridioides difficile (C. diff) mu mara yawe. Bitandukanye n'imiti yica mikorobe ikora mu mubiri wawe wose, fidaxomicin ni icyo abaganga bita umuti wica mikorobe "ufite umwihariko" ukora cyane mu nzira yawe yo mu gifu.

Ubu buryo bwihariye butuma fidaxomicin ikora neza cyane kuko indwara ya C. diff iterwa n'uko bagiteri mbi zikwirakwira mu mara yawe, akenshi nyuma y'uko indi miti yica mikorobe yangije imikorere ya bagiteri zisanzwe mu mara yawe. Tekereza fidaxomicin nk'igikoresho cyihariye aho kuba umukwabo mu kurwanya iyi ndwara yihariye.

Uyu muti ubarirwa mu cyiciro cy'imiti yica mikorobe yitwa macrocyclics, ifite imiterere yihariye isa n'uruziga ifasha kwifatanya no guhagarika bagiteri ya C. diff kwiyongera. Iyi miterere yihariye ituma fidaxomicin ikora neza kandi ikaba itabangamira cyane bagiteri nziza ziri mu mara yawe.

Fidaxomicin ikoreshwa mu kuvura iki?

Fidaxomicin ivura impiswi ziterwa na Clostridioides difficile (CDAD) ku bantu bakuru n'abana bafite amezi 6 n'abarenzeho. Iyi ndwara itera impiswi zikomeye no kubyimba mu mara bishobora gutera ibibazo kuva ku kutumva neza kugeza ku kwica iyo bitavuwe.

Ushobora gukenera fidaxomicin niba urwaye C. diff colitis nyuma yo gufata izindi antibiotics kubera ubwandu butandukanye. Ibi bibaho kuko antibiotics rimwe na rimwe zishobora kwica mikorobe zikurinda mu mara yawe, bigatuma habaho ahantu C. diff ishobora gukura ikongera imyanda yangiza urukuta rw'amara yawe.

Muganga wawe akenshi azandika fidaxomicin iyo wemeje ko ufite ubwandu bwa C. diff binyuze mu gupima imyanda yo mu mara, cyane cyane niba waragize ubwandu bugaruka cyangwa utarasubiza neza ku zindi nshuti. Uyu muti ni ingenzi cyane mu gukumira ubwandu bwo kugaruka, ibyo bikaba ari imbogamizi isanzwe kuri C. diff.

Mu bindi bihe, abaganga bashobora guhitamo fidaxomicin nk'umuti wa mbere wo kuvura ubwandu bukomeye bwa C. diff cyangwa ku barwayi bari mu kaga ko gusubira. Ibi bikubiyemo abantu bakuze, abantu bafite ubudahangarwa budakora neza, cyangwa abantu barwaye inshuro nyinshi mbere.

Fidaxomicin ikora ite?

Fidaxomicin ikora ibuza inzira y'ingenzi mikorobe ya C. diff ikeneye kugwira no kubaho. Yibanda by'umwihariko ku kintu cyitwa RNA polymerase mikorobe ikoresha kugira ngo ikore poroteyine z'ingenzi ku mikurire yayo no kwiyongera.

Iyo fidaxomicin yinjira mu igogora ryawe, iguma yibanda mu mara yawe aho kwinjizwa mu maraso yawe. Ibi bivuze ko ishobora gutanga imiti myinshi ahantu nyirizina mikorobe ya C. diff itera ibibazo, mu gihe igabanya ingaruka ku mikorobe mu bindi bice by'umubiri wawe.

Uyu muti ufata nk'ukomeye kandi ukora neza cyane kuri C. diff by'umwihariko. Ikintu gituma uba ingenzi cyane ni uko uhitamo - wibanda ku mikorobe ya C. diff cyane kurusha uko ugira ingaruka ku mikorobe yawe ifitiye akamaro mu mara yawe, bigafasha kubungabunga uburinganire bwawe bw'igogora.

Iki gikorwa cyihariye kandi gisobanura ko fidaxomicin ifite amahirwe make yo guteza ubudahangarwa kuri antibiyotike ugereranije na antibiyotike zifite ubushobozi bwagutse. Uyu muti ukomeza gukora kabone niyo waba warangije kuwufata, kuko ushobora kuguma mu mara yawe iminsi myinshi.

Nkwiriye gufata fidaxomicin nte?

Fata fidaxomicin uko muganga wawe yabigutegetse, akenshi 200 mg kabiri ku munsi mu gihe cy'iminsi 10. Urashobora kuyifata urya cyangwa utarya, ariko kuyifata urya ifunguro rito rishobora kugufasha kugabanya ibibazo byo mu nda ushobora guhura nabyo.

Mimina ibinini byose hamwe n'ikirahure kinini cy'amazi - ntukabikoremo agahombo, ntukabumire, cyangwa ngo ubimenagure kuko ibi bishobora kugira ingaruka ku buryo umuti ukora. Gerageza gufata imiti yawe mu gihe kimwe buri munsi, ukayitandukanya amasaha nka 12 kugirango ugumane urwego ruzigama mu mubiri wawe.

Ntabwo ukeneye kwirinda ibiryo byihariye mugihe ufata fidaxomicin, ariko kurya ibiryo byoroshye birashobora gufasha sisitemu yawe yo mu nda gukira indwara ya C. diff. Ibiryo nk'ibitoki, umuceri, umutobe w'amapera, na toast akenshi biroroshye kwihanganira mugihe cy'imiti.

Niba ufata indi miti, uyitandukanye byibuze amasaha 2 uvuye kuri fidaxomicin igihe bishoboka. Ibi bifasha kwirinda ubufatanye ubwo aribwo bwose bushoboka kandi bituma buri muti ukora neza.

Nkwiriye gufata fidaxomicin igihe kingana iki?

Abantu benshi bafata fidaxomicin mu gihe cy'iminsi 10 gusa, akaba ari uburebure busanzwe bw'imiti ubushakashatsi bwa muganga bwagaragaje ko bufite akamaro kanini. Ni ngombwa kurangiza imiti yose kabone niyo watangira kumva umerewe neza nyuma y'iminsi mike.

Ushobora kubona impinduka nziza mu bimenyetso byawe nyuma y'iminsi 2-3 utangiye imiti, ariko bagiteri ziracyashobora kuba zihari kandi zishobora kuba zangiza niba uhagaritse imiti hakiri kare. Guhagarika kare byongera ibyago byo gusubira inyuma kw'indwara, bishobora kugorana kuvura.

Mu bintu bikeya bibaho, muganga wawe ashobora guhindura igihe cyo kuvurwa bitewe n'uko ubuzima bwawe bumeze, nk'uko ubwandu bwawe bukomeye cyangwa uko ubuzima bwawe muri rusange bumeze. Ariko, abarwayi benshi bazakurikiza gahunda isanzwe y'iminsi 10 kugira ngo babone ibisubizo byiza.

Bitandukanye n'izindi nshuti za C. diff, fidaxomicin mubisanzwe ntisaba amasomo yongerewe cyangwa gahunda zo kugabanya. Imiterere yihariye y'uyu muti ituma ukomeza gukora iminsi myinshi nyuma yo gufata urugero rwawe rwa nyuma, itanga uburinzi bukomeje ku gusubira inyuma.

Ni izihe ngaruka ziterwa na Fidaxomicin?

Fidaxomicin muri rusange yihanganirwa neza, abantu benshi bagira ingaruka nkeya cyangwa nta ngaruka na mba. Ingaruka zisanzwe ni nto kandi zikunze guhuzwa n'inzira yawe yo mu gifu uko ikira ubwandu bwa C. diff.

Dore ingaruka ushobora guhura nazo, wibuke ko abantu benshi bafata fidaxomicin nta kibazo na kimwe:

• Urugimbu cyangwa kutumva neza mu gifu
• Urubavu mu nda cyangwa kuribwa
• Kuruka (ntibisanzwe)
• Umutwe
• Isesemi
• Kugabanuka kw'imyanya y'ubworohe cyangwa imyanya y'ubworohe uko imyanya yawe isanzwe

Izi ngaruka zoroheje akenshi zinoza uko umubiri wawe wimenyereza umuti kandi ubwandu bwawe bugakira. Abantu benshi basanga ko kutumva neza gukunda gucungwa cyane kuruta ibimenyetso bya mbere bya C. diff.

Ingaruka zikomeye ni gake ariko zirashobora kubaho. Vugana n'umuganga wawe ako kanya niba ubonye ibimenyetso bikomeye byo kwivumbura nk'ingorane zo guhumeka, kubyimba mu maso cyangwa mu muhogo, cyangwa ibimenyetso bikomeye byo ku ruhu. Kandi shaka ubufasha bw'ubuvuzi niba ugize urubavu rukomeye mu nda, amaraso mu myanya yawe, cyangwa ibimenyetso by'ubwandu bushya.

Abantu bamwe bahangayika ku bijyanye no guteza impiswi ziterwa na antibiyotike ziva muri fidaxomicin, ariko ibi birashoboka cyane ugereranije n'izindi antibiyotike kubera imikorere yayo yihariye. Ariko, niba ugize impiswi nshya cyangwa ikomeza mu gihe uvurwa, menyesha umuganga wawe.

Ninde Utagomba Gufata Fidaxomicin?

Fidaxomicin ntabwo ikwiriye kuri buri wese, nubwo urutonde rw'abantu batayifata ari rugufi. Ikibazo gikomeye ni uko waba waragize allergie ikomeye kuri fidaxomicin cyangwa ibindi biyigize mu gihe cyashize.

Muganga wawe azagomba gusuzuma neza fidaxomicin niba ufite indwara ikomeye y'impyiko cyangwa umwijima, kuko izi ndwara zishobora kugira ingaruka ku buryo umubiri wawe ukoresha imiti. Nubwo fidaxomicin itinjira cyane mu maraso yawe, muganga wawe ashobora kwifuza kugukurikiranira hafi.

Abantu bafite indwara zimwe na zimwe zidakunze kuboneka zishingiye ku mikorere ya za gene zibangamira ubushobozi bwabo bwo gukoresha isukari zimwe na zimwe bagomba kubiganiraho na muganga wabo, kuko ibinini bya fidaxomicin bikubiyemo lactose ntoya. Ariko, ubusanzwe umubare ni muto cyane ku buryo utatera ibibazo abantu benshi bafite lactose itihanganirwa.

Niba utwite cyangwa wonsha, muganga wawe azagereranya inyungu n'ibishobora guteza akaga. Nubwo ubushakashatsi butaragaragaza impungenge zikomeye, indwara ya C. diff ishobora kuba ikomeye mu gihe cyo gutwita, bityo kuvurwa bikunze kuba ngombwa. Umuganga wawe azagufasha gufata icyemezo cyiza ku miterere yawe yihariye.

Amazina y'Ubwoko bwa Fidaxomicin

Fidaxomicin ikunze kuboneka ku izina ry'ubwoko rya Dificid muri Leta Zunze Ubumwe z'Amerika. Iri ni izina ry'ubwoko rya mbere abaganga benshi n'abafarmasi bazamenya iyo bandika cyangwa batanga umuti.

Mu bindi bihugu, ushobora kubona fidaxomicin igurishwa ku mazina y'ubwoko atandukanye, nka Dificlir mu masoko amwe y'i Burayi. Ariko, ikintu gikora kandi kigira akamaro kiguma kimwe hatitawe ku izina ry'ubwoko riri ku ipaki.

Ubwoko bwa fidaxomicin rusange burimo buraboneka mu masoko amwe, ibyo bishobora gufasha kugabanya igiciro cy'imiti. Umufarmasi wawe ashobora kukubwira niba ubwoko rusange buboneka mu karere kawe kandi niba byakwemerera ku byo wandikiwe.

N'ubwo izina ry'ubucuruzi ryaba ari irihe, menya neza ko urimo guhabwa fidaxomicin by'umwihariko yo kuvura C. diff, kuko itandukanye cyane n'izindi antibiotics kandi ntishobora gusimburana n'indi miti.

Izindi miti isimbura Fidaxomicin

Izindi antibiotics nyinshi zirashobora kuvura indwara ya C. diff, nubwo fidaxomicin akenshi ifite inyungu mu bijyanye no gukumira kongera kugaruka. Vancomycin ni yo miti ikoreshwa cyane kandi imaze imyaka myinshi ikoreshwa nk'umuti usanzwe.

Metronidazole yahoze ikoreshwa kenshi mu kuvura indwara ya C. diff yoroheje, ariko amabwiriza ya none ya muganga akenshi asaba vancomycin cyangwa fidaxomicin nk'uburyo bwiza bwo gutangira. Muganga wawe ashobora gukomeza gutekereza metronidazole mu bihe byihariye, cyane cyane niba ikiguzi ari ikibazo gikomeye.

Mu gihe indwara ikomeye cyangwa ifite ibibazo, muganga wawe ashobora kugusaba imiti ivanze cyangwa imiti mishya nka bezlotoxumab, ikaba ari imiti ikoreshwa n'umubiri ifasha gukumira kongera kugaruka. Mu gihe indwara ikomeye cyane, kubagwa bishobora kuba ngombwa, nubwo ibi bidakunze kubaho.

Gu hitamo hagati y'izindi miti biterwa n'ibintu nk'uburemere bw'indwara yawe, amateka yawe y'ubuzima, ibihe byabanjirije C. diff, n'ubuzima bwawe muri rusange. Muganga wawe azatekereza ibi byose mu gihe agena uburyo bwiza bwo kuvura indwara yawe yihariye.

Ese Fidaxomicin iruta Vancomycin?

Fidaxomicin yagaragaje inyungu zimwe na zimwe kurusha vancomycin, cyane cyane mu gukumira kongera kugaruka kwa C. diff. Ubushakashatsi bwakozwe bwagaragaje ko abantu bavurwa na fidaxomicin badakunze kurwara indwara zigaruka ugereranije n'abavurwa na vancomycin.

Imiti yombi ifite akamaro kanini mu gukiza indwara ya C. diff y'ibanze, hamwe n'ubushobozi bwo gukira bumeze kimwe. Ariko, ubushobozi bwa fidaxomicin bwo kubungabunga mikorobe nyinshi zifitiye akamaro mu mara yawe mu gihe irwanya C. diff bigaragara ko bitanga uburinzi burambye.

Ikintu cy'ingenzi ku barwayi benshi ni ikiguzi, kuko fidaxomicin akenshi ihenze kurusha vancomycin. Ariko, iyo uzirikanye ibyago bike byo kongera kwibasirwa n'indwara no gushobora gukenera izindi nshuro zo kuvurwa, fidaxomicin ishobora kuba ifitiye akamaro mu gihe kirekire.

Muganga wawe azatekereza ku byago byawe bwite byo kongera kwibasirwa n'indwara, ubukana bw'ubwandu bwawe, n'ubuzima bwawe muri rusange mugihe uhitamo hagati y'izi nzira. Zombi ni imiti myiza cyane, kandi guhitamo neza biterwa n'imimerere yawe yihariye aho kuba imwe yaba isumba izindi.

Ibibazo Bikunze Kubazwa Kuri Fidaxomicin

Ese Fidaxomicin irakwiriye abantu barwaye diyabete?

Yego, fidaxomicin muri rusange irakwiriye abantu barwaye diyabete. Uyu muti ntugira ingaruka zigaragara ku rugero rw'isukari mu maraso kuko uhora cyane cyane mu nzira yo mu gifu aho kwinjizwa mu maraso yawe.

Ariko, ubwandu bwa C. diff rimwe na rimwe bushobora kugira ingaruka ku rwego rwawe rwo kurya no kurya, bishobora kugira ingaruka ku kugenzura isukari yawe mu maraso. Genzura urugero rwa glucose yawe mu maraso nkuko bisanzwe kandi uvugishe umuganga wawe niba ubonye impinduka zidasanzwe mugihe uvurwa.

Nigira iki niba nanyweye fidaxomicin nyinshi bitunguranye?

Niba unyweye doze yinyongera ya fidaxomicin bitunguranye, ntugire ubwoba. Kubera ko uyu muti ntwinjira cyane mu maraso yawe, ibimenyetso byo kurenza urugero ntibishoboka ko bizaba bikaze.

Vugana na muganga wawe cyangwa umufarumasiti kugirango bagufashe, cyane cyane niba wanyweye nyinshi cyane kurusha uko byategetswe. Bashobora kukugira inama niba ukeneye ubufasha bwa muganga n'uburyo bwo guhindura gahunda yawe yo kunywa imiti imbere.

Nigira iki niba nciwe doze ya fidaxomicin?

Niba waciwe doze, yinywere ako kanya wibuka, keretse igihe cyo gufata doze yawe ikurikira kigeze. Muricyo gihe, reka doze waciwe kandi ukomeze gahunda yawe isanzwe - ntukongere doze.

Gerageza gukomeza intera y'amasaha 12 hagati y'imiti iyo bishoboka. Niba ukunda kwibagirwa imiti, tekereza gushyiraho ibyibutso kuri terefone yawe cyangwa ukoreshe agasanduku k'imiti kugirango bigufashe gukurikiza gahunda y'imiti yawe.

Ryari nshobora guhagarika gufata Fidaxomicin?

Hagarika gusa gufata fidaxomicin umaze kurangiza iminsi 10 yose yategetswe na muganga wawe, kabone n'iyo wumva umeze neza rwose. Guhagarika hakiri kare byongera cyane ibyago byo gusubira inyuma kw'ubwandu.

Niba ubonye ingaruka zikomeye cyangwa ibimenyetso byo kwivumbura ku miti, vugana na muganga wawe ako kanya kugirango akugire inama. Bashobora gukenera guhindura imiti yawe, ariko ntuhagarike umuti ku giti cyawe utabihuje na muganga.

Nshobora gufata Probiotics hamwe na Fidaxomicin?

Abaganga benshi basaba gutegereza kugeza umaze kurangiza fidaxomicin mbere yo gutangira probiotics. Ibi bituma umuti wica mikorobe ukora neza hatabayeho imbogamizi ziva kuri bagiteri zongeweho, ndetse n'izifitiye akamaro.

Umaze kurangiza fidaxomicin, probiotics ishobora gufasha kugarura uburinganire bwa bagiteri mu mara yawe, ariko banza ubiganireho n'umuganga wawe. Bashobora kugusaba igihe gikwiye n'ubwoko bwa probiotics bitewe n'uko urimo gukira.