Icyo Fosphenytoin ari cyo: Ibyo ikoreshwa, urugero rwo gufata, ingaruka zayo n'ibindi

Fosphenytoin ni umuti ukomeye uvura ibibazo byo gufatwa n'indwara yo mu mutwe utangwa binyuze mu nshinge iyo hakenewe gukontorora ibibazo byo gufatwa n'indwara yo mu mutwe ako kanya. Mu by'ukuri ni verisiyo ya none, ifite umutekano kurusha phenytoin ikora vuba kandi itera ibibazo bike aho inshinge ziterwa.

Uyu muti ubusanzwe ukoreshwa mu bitaro no mu gihe cy'ubutabazi iyo umuntu afite ibibazo bikomeye byo gufatwa n'indwara yo mu mutwe bitahagarara byonyine. Tekereza nk'igikoresho cy'ubutabazi cy'ubuvuzi abaganga bakoresha kugira ngo bahoshe vuba imiraba y'amashanyarazi iba mu bwonko.

Fosphenytoin ni iki?

Fosphenytoin ni umuti uterwa mu nshinge uvura ibibazo byo gufatwa n'indwara yo mu mutwe wo mu cyiciro cy'imiti yitwa anticonvulsants. Ni icyo abaganga bita "prodrug," bivuze ko ihinduka phenytoin igihe imaze kwinjira mu mubiri wawe.

Uyu muti wateguwe by'umwihariko kugira ngo ukemure bimwe mu bibazo byazaga iyo bateraga inshinge za phenytoin. Mugihe phenytoin imaze imyaka myinshi ikoreshwa mu kuvura ibibazo byo gufatwa n'indwara yo mu mutwe, kuyitera binyuze mu muyoboro w'amaraso byashoboraga gutera ibibazo bikomeye byo kwangirika kw'imyanya ndetse n'ibibazo by'umuvuduko w'umutima.

Fosphenytoin iroroshye cyane ku mijyana yawe no ku mutima, bituma igira umutekano kurushaho mu gihe cy'ubutabazi. Ishobora gutangwa binyuze mu miyoboro y'amaraso ndetse no mu nshinge ziterwa mu misitsi, bituma abaganga bagira ubwigenge bwinshi mu gihe cy'ubutabazi.

Fosphenytoin ikoreshwa mu kuvura iki?

Fosphenytoin ikoreshwa cyane cyane mu kuvura status epilepticus, ari bwo ibibazo byo gufatwa n'indwara yo mu mutwe bimara iminota irenga itanu cyangwa iyo ibibazo byinshi byo gufatwa n'indwara yo mu mutwe bibaye nta gihe cyo koroherwa hagati yabyo. Ibi ni ibibazo bikomeye by'ubuvuzi bisaba kuvurwa ako kanya.

Abaganga kandi bakoresha uyu muti mu gukumira ibibazo byo gufatwa n'indwara yo mu mutwe mu gihe cyo kubaga ubwonko cyangwa iyo umuntu adashobora gufata imiti ye isanzwe yo kuvura ibibazo byo gufatwa n'indwara yo mu mutwe anywa. Bifasha cyane iyo abarwayi batazi ibibera, bari ku byuma bifasha mu guhumeka, cyangwa bari kubagwa.

Mu bihe bimwe na bimwe, abaganga bashobora gukoresha fosphenytoin nk'ikiraro cy'agateganyo mu gihe bahindura abarwayi hagati y'imiti itandukanye ivura ibibazo byo mu bwonko. Ibi bifasha kwirinda ibibazo byo mu bwonko mu gihe imiti ihinduka.

Fosphenytoin ikora ite?

Fosphenytoin ikora igihe ituma uturemangingo tw'imitsi yo mu bwonko dukora cyane turuhuka. Iyo ibibazo byo mu bwonko bibaye, ibimenyetso by'amashanyarazi mu bwonko bikora vuba cyane kandi bikwirakwira mu buryo budasanzwe, nk'umuyaga w'amashanyarazi.

Uyu muti ubuza inzira zihariye mu turemangingo tw'imitsi zituma sodium inyura. Mu kugenzura uru rugendo rwa sodium, fosphenytoin ifasha kugabanya umuvuduko w'ibikorwa by'amashanyarazi bidasanzwe bitera ibibazo byo mu bwonko.

Ibi bifatwa nk'umuti ukomeye wo kurwanya ibibazo byo mu bwonko. Ntabwo ari wo muti wa mbere ukoreshwa ku bibazo byoroheje byo mu bwonko, ariko ni mwiza cyane ku bibazo bikomeye, biteye ubuzima bw'umuntu akaga. Ibyo bikorwa bitangira mu minota 10-20 nyuma yo guterwa urushinge.

Nkwiriye gufata fosphenytoin nte?

Fosphenytoin itangwa gusa n'abashinzwe ubuzima mu bigo by'ubuvuzi nk'ibitaro cyangwa ibyumba by'abarwayi b'igitaraganya. Ntabwo uzajya ufata uyu muti mu rugo cyangwa ngo wiwutere wenyine.

Uyu muti ushobora gutangwa unyuze mu muyoboro wa IV mu kuboko kwawe cyangwa nk'urushinge mu gice kinini cy'umubiri. Gutanga umuti unyuze muri IV ni ibisanzwe mu gihe cy'igitaraganya kuko bikora vuba, mu gihe inshinge ziterwa mu mikaya zishobora gukoreshwa iyo kubona IV bigoye.

Itsinda ry'abaganga bazagukurikiranira hafi mu gihe cyo gutera urushinge no nyuma yaho. Bazagenzura umuvuduko w'umutima wawe, umuvuduko w'amaraso, no guhumeka kuko uyu muti ushobora kugira ingaruka kuri izi nshingano z'ingenzi. Ntabwo ukeneye guhangayika ku gihe cyo kurya kuko uyu si umuti unyobwa.

Nkwiriye gufata fosphenytoin igihe kingana gute?

Fosphenytoin ikoreshwa cyane cyane mu kuvura igihe gito mu gihe cy'igitaraganya cy'ubuvuzi. Abantu benshi barawuhabwa mu doze nkeya mu masaha cyangwa iminsi bari mu bitaro.

Igihe kimara giterwa n'icyo urimo kuyihabwa. Ku bijyanye na status epilepticus, ushobora guhabwa doze imwe cyangwa ebyiri kugira ngo uhagarike ibibazo byo gufatwa. Mu rwego rwo gukumira gufatwa mu gihe cyo kubagwa, ushobora kuyihabwa mbere, mu gihe cyo kubagwa, no nyuma gato y'igikorwa.

Muganga wawe akenshi azakwimurira ku miti yo kunywa yo kuvura gufatwa iyo umaze kumererwa neza kandi ushobora kumira neza. Uyu muti ntabwo ugenewe gukoreshwa igihe kirekire mu rugo.

Ni Ibihe Bikorwa Bigaragara Byatewe na Fosphenytoin?

Kimwe n'indi miti yose, fosphenytoin ishobora gutera ibikorwa bigaragara, nubwo ibikomeye bidakunze kubaho iyo itangwa neza mu mavuriro. Ibikorwa bigaragara byinshi ni iby'igihe gito kandi birashira iyo umuti ushize imbaraga.

Ibikorwa bigaragara cyane ushobora guhura nabyo birimo isereri, gusinzira, no kumva utameze neza. Abantu bamwe kandi bamenya isesemi, kubabara umutwe, cyangwa urujijo ruto mu gihe umubiri wabo uhinduka kubera umuti.

Ibikorwa bigaragara bikomeye birimo impinduka mu mutima, umuvuduko muke w'amaraso, cyangwa guhumeka bigoranye. Ibi nibyo bituma uzaba ukurikiranwa hafi mugihe uvurwa. Itsinda ryawe ry'abaganga ryatojwe gukurikirana ibi bikorwa no gusubiza vuba niba bibaye.

Abantu bamwe bahura no kuribwa, gushya, cyangwa kumva baribwa, cyane cyane mu gice cyabo cy'imboro. Ibi byitwa "purple glove syndrome" kandi ntibikunze kubaho kuri fosphenytoin ugereranije na phenytoin isanzwe.

Ibikorwa bigaragara bidakunze kubaho ariko bikomeye birimo allergie zikomeye, indwara z'amaraso, cyangwa ibibazo by'umwijima. Ariko, ibi ntibikunze kubaho mugihe gito, kandi itsinda ryawe ry'abaganga rizakurikirana ibimenyetso by'izi ngorane.

Ninde Utagomba Gufata Fosphenytoin?

Fosphenytoin ntabwo ikwiriye kuri buri wese, kandi itsinda ryawe ry'abaganga rizatekereza neza amateka yawe y'ubuzima mbere yo kuyiguha. Abantu bafite indwara zimwe na zimwe z'umutima bashobora gukenera gukurikiranwa by'umwihariko cyangwa uburyo bwo kuvura butandukanye.

Niba ufite allergie izwi kuri phenytoin cyangwa fosphenytoin, ntugomba guhabwa uyu muti. Abaganga bawe bazitwararika kandi niba ufite ibibazo bikomeye by'umutima, ubwoko bumwe bwa heart block, cyangwa umuvuduko w'amaraso uri hasi cyane.

Abantu bafite indwara ikomeye y'umwijima bashobora gukenera guhindura urugero rw'umuti kuko umwijima ukoresha uyu muti. Itsinda ryawe ry'abaganga rizafata mu gaciro n'indi miti urimo gufata, kuko imiti imwe ishobora gukururana na fosphenytoin.

Abagore batwite bakeneye kwitabwaho by'umwihariko, kuko fosphenytoin ishobora kugira ingaruka ku mwana ukura. Ariko, mu gihe cy'uburwayi bw'ihungabana bwica, inyungu akenshi ziruta ibyago.

Amazina y'ubwoko bwa Fosphenytoin

Izina risanzwe rya fosphenytoin ni Cerebyx, ikorwa na Pfizer. Iri ni ryo bwoko rya mbere ryemejwe na FDA.

Ubwoko bwa fosphenytoin bwa generic buraboneka kandi bukora neza nk'ubwoko bw'izina. Ibitaro byawe cyangwa ikigo cy'ubuvuzi bizakoresha ubwoko bakunda cyane bitewe n'ikiguzi n'uko biboneka.

Uburyo bwo gusimbuza Fosphenytoin

Imiti myinshi ishobora gukoreshwa mu kuvura ihungabana rikomeye iyo fosphenytoin itakwiriye. Lorazepam (Ativan) akenshi ikoreshwa nk'umuti wa mbere wo kuvura status epilepticus kuko ikora vuba cyane.

Levetiracetam (Keppra) ni ubundi buryo bushobora gutangwa mu maraso kandi bufite imiti mike ikururana. Asidi ya Valproic (Depacon) nayo ikoreshwa mu gihe cy'ihungabana ryihutirwa, cyane cyane mu bwoko bumwe bwa epilepsie.

Ku gucunga ihungabana rikomeza, imiti yo kunywa nka phenytoin, carbamazepine, cyangwa imiti mishya nka lamotrigine ishobora gukoreshwa. Muganga wawe azahitamo uburyo bwiza bushingiye ku miterere yawe yihariye n'amateka yawe y'ubuvuzi.

Ese Fosphenytoin iruta Phenytoin?

Fosphenytoin itanga inyungu nyinshi ugereranije na phenytoin ya kera iyo itangwa mu nshinge. Ni umutekano mwinshi ku mijyana yawe n'umutima, kandi irashobora gutangwa vuba idateje kwangirika kw'imitsi phenytoin rimwe na rimwe itera.

Inyungu nyamukuru ni uko fosphenytoin ishobora gutangwa binyuze mu miyoboro mito ya IV ndetse no mu misitsi, mugihe phenytoin isaba imijyana minini no gutanga gahoro. Ibi bituma fosphenytoin ikora cyane mu bihe by'ubutabazi.

Ariko, imiti yombi ikora muburyo bumwe iyo imaze kwinjira mumubiri wawe, kuko fosphenytoin ihinduka phenytoin. Guhitamo hagati yabyo mubisanzwe biterwa nuko ubuvuzi bukenewe vuba kandi n'ubwoko bwa IV buhari.

Kubijyanye no gucunga ibibazo by'igihe kirekire, phenytoin yo kunywa iracyakoreshwa cyane kandi ihendutse cyane kuruta inshinge za fosphenytoin. Uburyo bwo gutera inshinge bwashyizweho rwose gukoreshwa mu gihe cy'ubutabazi no mu bitaro.

Ibikunze Kubazwa Kuri Fosphenytoin

Q1. Ese Fosphenytoin iratekanye ku barwayi b'umutima?

Fosphenytoin muri rusange iratekanye ku barwayi b'umutima kuruta inshinge zisanzwe za phenytoin, ariko iracyasaba gukurikiranwa neza. Uyu muti ushobora kugira ingaruka kumuvuduko w'umutima n'umuvuduko w'amaraso, bityo ikipe yawe y'abaganga izareba umutima wawe neza mugihe cy'ubuvuzi.

Niba ufite indwara zikomeye zumutima nka blocage ikomeye yumutima cyangwa umuvuduko wumutima utinda cyane, abaganga bawe bashobora guhitamo imiti itandukanye. Ariko, mugihe cy'ubutabazi bw'ibibazo by'ubuzima buteye akaga, inyungu akenshi ziruta ibyago by'umutima.

Q2. Nkwiriye gukora iki niba mbonye fosphenytoin nyinshi nkana?

Kubera ko fosphenytoin itangwa gusa nabaganga babigize umwuga mumashami yubuvuzi, kwirengagiza nkana biragoye. Niba byinshi bitanzwe, birashoboka ko uzahura ningaruka zikomeye nko gusinzira cyane, urujijo, cyangwa impinduka zumuvuduko wumutima.

Abaganga bakora mu rwego rw'ubuvuzi bahawe imyitozo yo kumenya no kuvura ibimenyetso byo kurenza urugero rw'umuti ako kanya. Bashobora kuguha imiti yo gufasha mu guhumeka no gukora k'umutima mu gihe fosphenytoin iba ikurwa mu mubiri wawe.

Q3. Ni iki gishobora kuba kiramutse nsubitse doze ya Fosphenytoin?

Kusiba doze si ikintu ugomba guhangayikishwa kuko abaganga bafite ububasha bwo kugenzura doze zose. Niba ugomba guhabwa doze nyinshi kandi imwe ikaba yatinda, ikipe yawe y'abaganga izahindura igihe gishingiye ku kugenzura kw'ibihungabana byawe n'urugero rw'amaraso.

Abaganga bawe bazagenzura uko wabyitwayemo kandi bashobora gupima urugero rw'amaraso kugirango barebe ko urimo guhabwa umuti ukwiye ukurikije uko urwaye.

Q4. Ni ryari nshobora kureka gufata Fosphenytoin?

Ntabwo ari wowe ufata icyemezo cyo kureka fosphenytoin kuko itangwa mu bigo by'ubuvuzi mu gihe gito. Abaganga bawe bazayihagarika igihe ibihungabana byawe bigenzurwa kandi ushobora gufata imiti yo kunywa.

Iyi mpinduka ikunda kuba nyuma y'iminsi mike, bitewe n'uko urimo gukira n'ubushobozi bwo kumira imiti. Ikipe yawe y'abaganga izareba ko ufite uburyo buhagije bwo kurinda ibihungabana muri iyi mpinduka.

Q5. Ese Fosphenytoin ishobora gutangirwa mu rugo?

Oya, fosphenytoin ntishobora gutangirwa mu rugo. Bisaba kugenzurwa n'abaganga babigize umwuga kubera ingaruka zikomeye zishobora kugira ku mutima wawe, guhumeka, n'umuvuduko w'amaraso.

Niba ukeneye kugenzura ibihungabana mu gihe kirekire uri mu rugo, muganga wawe azakwandikira imiti yo kunywa. Imiti yihutirwa yo kuvura ibihungabana yo gukoresha mu rugo iratandukanye kandi irimo uburyo nka sprays zo mu mazuru cyangwa gels zo mu mpuzandaka abagize umuryango bashobora gutanga mu buryo butekanye.