Icyo Iloprost ari cyo: Ibyo ikoreshwa, urugero rwo kuyifata, ingaruka zayo n'ibindi

Iloprost ni umuti wihariye ufasha gufungura imitsi y'amaraso mu muhaha wawe igihe yagabanutse cyane. Ni verisiyo ya sintetike y'ikintu gisanzwe umubiri wawe ukora cyitwa prostacyclin, ikibungabunga amaraso atembera neza mu miyoboro yawe y'amaraso.

Uyu muti uhumekwa ukoreshwa cyane mu kuvura umuvuduko ukabije w'amaraso mu muhaha (PAH), uburwayi bukomeye aho umuvuduko w'amaraso mu miyoboro yawe y'umuhaha uba mwinshi cyane. Iyo uhumeka iloprost ukoresheje nebulizer yihariye, ijya ako kanya gukora irekura imitsi y'amaraso yagabanutse, bigatuma umutima wawe woroherwa no gusukamo amaraso mu muhaha wawe.

Iloprost ikoreshwa mu kuvura iki?

Iloprost ivura umuvuduko ukabije w'amaraso mu muhaha, uburwayi aho imiyoboro mito y'amaraso mu muhaha wawe iba minini kandi igabanuka. Ibi bituma umutima wawe ukora cyane kugira ngo usukemo amaraso mu muhaha wawe, bishobora gutera kunanirwa k'umutima niba bitavuwe.

Uyu muti wemerejwe by'umwihariko abantu bafite PAH bafite ibimenyetso byoroheje kugeza ku bikomeye. Muganga wawe ashobora kuwandikira niba urimo guhura no guhumeka bigoranye, kuribwa mu gituza, cyangwa umunaniro ugabanya ibikorwa byawe bya buri munsi. Bifasha cyane abantu batitabiriye neza izindi miti ya PAH.

Rimwe na rimwe abaganga bakoresha kandi iloprost mu gihe cy'uburwayi bukomeye bwa Raynaud, aho imiyoboro y'amaraso mu ntoki zawe no mu birenge byawe ifunga mu buryo bubabaza bitewe n'ubukonje cyangwa umunaniro. Mu bihe bidasanzwe, irashobora kwandikwa ku bwoko runaka bw'amaraso yiziritse mu muhaha, nubwo atari wo ukoreshwa cyane.

Iloprost ikora ite?

Iloprost ikora yigana prostacyclin, ikintu gikomeye gisanzwe umubiri wawe ukora kugira ngo imiyoboro y'amaraso iruhuke kandi ifunguke. Iyo uhumeka uyu muti, ujya ako kanya mu miyoboro mito y'amaraso mu muhaha wawe aho ikenewe cyane.

Umaze kuhagera, iloprost ibwira selile z'imitsi yoroshye mu nkuta z'imitsi yawe y'amaraso koroshya no kwaguka. Iyi nzira, yitwa vasodilation, igabanya ako kanya umuvuduko mu miyoboro y'amaraso yo mu muhogo wawe. Uyu muti kandi ufasha kwirinda ko amaraso avurirana no kugabanya ububyimbirwe mu nkuta z'imitsi y'amaraso.

Bitekereze nk'ugufungura urwobo rwa hose y'ubusitani yafunze igice - iyo inzira yagutse, amazi atembera byoroshye cyane. Iloprost ifatwa nk'umuti ukomeye wo hagati utanga ubufasha bwihariye ahari ikibazo, aho kugira ingaruka ku mikorere y'amaraso yawe yose.

Nkwiriye gufata gute Iloprost?

Iloprost igomba guhumekwa hakoreshejwe igikoresho cyihariye cya nebulizer ikipe yawe y'ubuzima izaguha kandi ikwigishe gukoresha neza. Ubusanzwe uzayifata inshuro 6 kugeza kuri 9 ku munsi, ukurikiranya doze hafi ya saa 2 kugeza kuri 3 hagati yazo mu masaha yawe yo kubyuka.

Igihe cyose cyo guhumeka gifata iminota 5 kugeza kuri 15 kugirango kirangire. Uzahumeka bisanzwe unyuze mu kanwa ka nebulizer mugihe imashini ihindura umuti w'amazi ukaba umwuka mwiza ugera kure mu muhogo wawe. Ni ngombwa kwicara wicaye neza mugihe uvurwa kandi ugahumeka gahoro kandi cyane.

Urashobora gufata iloprost hamwe cyangwa utaranye n'ibiryo, ariko abantu benshi babona ko byoroshye guhuza n'amafunguro kuko uzayifata kenshi umunsi wose. Wibuke koza ibikoresho byawe bya nebulizer nyuma yo kubikoresha buri gihe ukurikije amabwiriza y'umukora kugirango wirinde indwara.

Ntuzigere uvanga iloprost n'indi miti muri nebulizer imwe keretse niba wabisabwe na muganga wawe. Bika amaviyali atarafungurwa muri firigo, ariko uyareke agere ku bushyuhe busanzwe mbere yo kuyakoresha.

Mvane iloprost igihe kingana iki?

Abantu benshi bafite umuvuduko mwinshi w'amaraso mu muhogo bakeneye gufata iloprost igihe kirekire kugirango bacunge neza uburwayi bwabo. PAH ni uburwayi burambye busaba kuvurwa buri gihe kugirango ibimenyetso bigumane kandi birinde ko indwara irushaho kuba mibi.

Muganga wawe azakurikiza uko umubiri wawe witwara ku muti ukoresha ibizamini bisanzwe, harimo n'ibipima uko umutima wawe n'ibihaha bikora neza. Niba iloprost igufasha kumva umeze neza kandi ibisubizo by'ibizamini byerekana impinduka nziza, birashoboka ko uzakomeza kuyifata iteka.

Abantu bamwe bashobora gukenera guhindura imiti cyangwa kongeraho izindi nyunganizi uko igihe kigenda gihinduka. Ntukigere uhagarika gufata iloprost ako kanya utabanje kuvugana na muganga wawe, kuko ibyo bishobora gutuma ibimenyetso byawe bisubira vuba kandi bikaba byateza ibibazo bikomeye.

Ni Ibihe Bikorwa Bigaragara bya Iloprost?

Kimwe n'indi miti yose, iloprost ishobora gutera ibikorwa bigaragara, nubwo abantu benshi bayihanganira neza iyo bamaze kumenyera uburyo bwo kuyifata. Ibikorwa bigaragara cyane bifitanye isano n'ingaruka z'uyu muti ku miyoboro y'amaraso mu mubiri wawe wose.

Dore ibikorwa bigaragara ushobora guhura nabyo, dutangiriye ku bya mbere bikunze kugaragara bikora ku bantu benshi:

• Urubavu rurya cyangwa kuribwa kw'imitsi - Ibi bibaho kuko iloprost igira ingaruka ku mikorere y'amaraso mu mitsi yo mu ruhanga rwawe igihe urimo kurya
• Umutwe urya - Akenshi biba byoroheje kandi bikunze gukira uko umubiri wawe umenyera umuti
• Kugira umubiri ushyushye cyangwa kumva ushyushye - Mu maso no mu gituza byawe bishobora kumva bishyushye uko imiyoboro y'amaraso yaguka
• Isesemi cyangwa kuribwa mu nda - Gufata umuti hamwe n'ibiryo rimwe na rimwe birafasha
• Urugero cyangwa kumva ureremba - Cyane cyane iyo uhagurutse vuba
• Inkorora cyangwa kuribwa mu muhogo - Biva mu buryo bwo guhumeka ubwabyo

Ibi bikorwa bigaragara bisanzwe birashobora gucungwa kandi akenshi bigabanuka uko ukomeza kuvurwa. Ariko, ugomba kuvugana na muganga wawe niba biba bikomeye cyangwa bikabangamira imirimo yawe ya buri munsi.

Ibikorwa bigaragara bitagaragara cyane ariko bikomeye birashobora kubaho, kandi ugomba gushaka ubufasha bw'ubuvuzi niba uhuye n'ibi byose:

• Igabanuka rikomeye ry'umuvuduko w'amaraso - Bitera kuruka, isereri rikomeye, cyangwa urujijo
• Umutima utera cyane cyangwa udasanzwe - Umutima wawe ushobora kwihuta cyangwa gusimbuka
• Uburibwe mu gituza - Bitandukanye n'ibimenyetso bisanzwe bya PAH
• Ibibazo bikomeye byo guhumeka - Kugufiha guhora bibi cyangwa guhumeka
• Ibimenyetso byo kwandura mu muhogo - Umuriro, ibicurane bifite ibara, cyangwa inkorora ikomeza kuba mibi

Ingorane zitabaho kenshi ariko zishobora kuba zikomeye zirimo allergie zikomeye, ibibazo bikomeye byo kuva amaraso, cyangwa igabanuka ry'umuvuduko w'amaraso ryangiza risaba ubuvuzi bwihutirwa. Nubwo ibi bidakunze kubaho, ni ngombwa kumenya ibimenyetso byo kwirinda kandi ugashaka ubufasha vuba niba bibayeho.

Ninde utagomba gufata Iloprost?

Iloprost ntirigira umutekano kuri buri wese, kandi muganga wawe azasuzuma neza amateka yawe mbere yo kuyandika. Abantu bafite indwara zimwe na zimwe z'umutima cyangwa abafata imiti imwe na imwe ntibashobora kuba abakandida beza kuri ubu buvuzi.

Ntabwo ugomba gufata iloprost niba ufite kimwe muri ibi bibazo:

• Indwara ikomeye y'umutima - Harimo gutera umutima vuba, angina idahagaze, cyangwa ibibazo bikomeye by'umuvuduko w'umutima
• Umuvuduko w'amaraso muke cyane - Iloprost irashobora kugabanya umuvuduko w'amaraso kurushaho
• Indwara ziva amaraso zikora - Uyu muti ushobora kongera ibyago byo kuva amaraso
• Indwara ikomeye y'umwijima - Umubiri wawe ntushobora gutunganya neza uyu muti
• Allergie izwi kuri iloprost cyangwa imiti isa nayo - Harimo n'indi miti ya prostacyclin

Muganga wawe azitonda kandi mu kwandika iloprost niba ufite ibibazo by'impyiko, utwite cyangwa wonka, cyangwa ufata imiti ituma amaraso atavura. Imiti imwe na imwe irashobora gukorana nabi na iloprost, cyane cyane iyo igabanya umuvuduko w'amaraso.

Abantu barengeje imyaka 65 bashobora gukenera gukurikiranwa byihariye kuko bashobora kurwara ibibazo byinshi. Buri gihe bwire umuganga wawe ku miti yose, ibiyongera, n'ibicuruzwa by'ibyatsi ukoresha mbere yo gutangira iloprost.

Amazina y'ubwoko bwa Iloprost

Iloprost iboneka mu mazina menshi y'ubwoko bitewe n'aho uherereye n'uburyo bwihariye. Muri Leta Zunze Ubumwe z'Amerika, izina risanzwe ry'ubwoko ni Ventavis, ikaba ari uburyo bwo guhumeka bukoreshwa mu kuvura umuvuduko mwinshi w'amaraso mu muhogo.

Andi mazina y'ubwoko ushobora guhura nayo arimo Ilomedin, ikoreshwa mu bihugu bimwe na bimwe mu gutera imitsi. Uturere tumwe na tumwe dushobora kugira andi mazina y'ubwoko cyangwa verisiyo rusange zihari. Umufarumasiti wawe ashobora kugufasha kumenya ubwoko bwihariye cyangwa uburyo urimo kwakira.

Nubwo izina ry'ubwoko ryaba ari irihe, ikintu gikora ni kimwe, ariko uburyo bwo gutanga n'umubare birashobora gutandukana. Kora buri gihe ukoresha igicuruzwa nyacyo umuganga wawe yaguhaye kandi ntukagere hagati y'ubwoko butandukanye utabanje kubisobanurirwa n'abaganga.

Uburyo bwo gusimbuza Iloprost

Imiti myinshi ishobora kuvura umuvuduko mwinshi w'amaraso mu muhogo niba iloprost itagukwiriye cyangwa idakora neza. Umuganga wawe ashobora gutekereza izi nzira zo gusimbuza bitewe n'uko ubuzima bwawe buhagaze n'uko witwara ku miti.

Ibindi byongerera amaraso birimo epoprostenol (Flolan), itangwa binyuze mu gutera imitsi idahagarara, na treprostinil (Remodulin), ishobora gutangwa nk'urushinge munsi y'uruhu, binyuze mu gutera imitsi, cyangwa nk'umuti uhumekwa. Ibi bikora kimwe na iloprost ariko bifite gahunda zitandukanye zo gutanga imiti n'ingaruka zinyuranye.

Icyiciro gitandukanye cy'imiti ya PAH kirimo abanzi ba reseptori ya endothelin nka bosentan (Tracleer) na ambrisentan (Letairis), ikora ibyo ikingira ibintu bituma imitsi y'amaraso ifunga. Abakumira phosphodiesterase-5 nka sildenafil (Revatio) na tadalafil (Adcirca) bifasha imitsi y'amaraso kuruhuka binyuze mu buryo butandukanye.

Imiti mishya nka riociguat (Adempas) ikora ku yindi nzira kugira ngo ifashe imitsi y'amaraso gukomeza gufunguka. Abantu benshi bafite PAH barangiza bafata imiti ivanze kugira ngo babone ibisubizo byiza.

Ese Iloprost iruta Epoprostenol?

Bombi iloprost na epoprostenol ni imiti ya prostacyclin ikora kimwe mu kuvura PAH, ariko bafite itandukaniro rikomeye rituma buri imwe ikwiriye abantu batandukanye. Nta n'imwe iruta iyindi - guhitamo biterwa n'imibereho yawe, izindi ndwara ufite, n'uko witwara ku miti.

Inyungu nyamukuru ya Iloprost ni ukuboroherwa kuko uyihumeka inshuro nyinshi ku munsi aho guhabwa urushinge rwa IV rukomeza. Ibi bivuze ko ntukeneye catheter ihoraho cyangwa pompe igendanwa, ibi bikagabanya cyane ibyago byo kwandura indwara zikomeye kandi bikaguha umudendezo mwinshi mu bikorwa byawe bya buri munsi.

Ku rundi ruhande, Epoprostenol itanga ubuvuzi buhoraho kandi bushobora gukora neza ku bantu bafite PAH ikomeye cyane. Ariko, bisaba catheter ihoraho yo hagati na pompe ikomeza, ibi bikongera ibyago byo kwandura indwara ziteje ubuzima bw'akaga n'ingorane.

Muganga wawe azatekereza ibintu nk'uburemere bwa PAH yawe, ubushobozi bwawe bwo gucunga ibikoresho by'ubuvuzi bigoye, ibyago byawe byo kwandura, n'ibyo ukunda ku giti cyawe mugihe uhitamo hagati y'iyi miti. Abantu bamwe batangira na iloprost hanyuma bakimukira kuri epoprostenol niba indwara yabo irushijeho kuba mibi, mugihe abandi bashobora gukoresha imiti yombi icyarimwe.

Ibikunze Kubazwa Kuri Iloprost

Ese Iloprost irakwiriye abantu barwaye indwara z'umutima?

Iloprost isaba isuzuma ryitondewe ku bantu barwaye indwara z'umutima kuko rishobora kugira ingaruka ku mitsi y'amaraso n'umuvuduko w'umutima. Muganga wawe w'umutima azagomba gusuzuma niba inyungu ziruta ibyago ku ndwara yawe y'umutima.

Abantu barwaye indwara z'umutima zidakomeye bashobora gukoresha iloprost mu buryo bwizewe bafashijwe no gukurikiranwa neza, ariko abafite angina idahagaze, umutima wa vuba, cyangwa ibibazo bikomeye by'umuvuduko w'umutima ntibashobora gukoresha uyu muti. Muganga wawe ashobora gushaka gukora ibizamini by'umutima mbere yo gutangira kuvurwa no kugukurikirana neza nyuma.

Nkwiriye gukora iki niba nkoresheje iloprost nyinshi ku buryo butunguranye?

Niba ufashwe n'uburwayi ukanywa doze y'inyongera ya iloprost, vugana n'umuganga wawe cyangwa ikigo gishinzwe kugenzura uburozi ako kanya. Kunywa nyinshi bishobora gutera igabanuka ry'amaraso ry'akaga, kubabara umutwe bikabije, isesemi, cyangwa kuruka.

Ntugerageze "kureka" doze yawe ikurikira kugirango usubize iy'inyongera - ibi bishobora gutuma ibimenyetso byawe bya PAH birushaho kuba bibi. Ahubwo, shakisha inama z'ubuvuzi zerekeye uburyo wakomeza mu buryo bwizewe. Genzura gahunda yawe yo gufata imiti kugirango wirinde impanuka zizaza, kandi ushobora gukoresha sisitemu yo kwibutsa imiti.

Nkwiriye gukora iki niba nirengagije doze ya iloprost?

Niba wibagiwe doze ya iloprost, yifate ako kanya wibuka, keretse igihe cyegereye doze yawe iteganyijwe ikurikira. Ntukafate doze ebyiri icyarimwe kugirango usubize iyibagiwe, kuko ibi bishobora gutera ingaruka z'uruhande.

Gerageza gusubira kuri gahunda yawe isanzwe vuba bishoboka. Kwibagirwa doze nyinshi birashobora gutuma ibimenyetso byawe bya PAH bisubira, bityo ni ngombwa gukomeza kuvurwa buri gihe. Niba ukunda kwibagirwa doze, vugana n'umuganga wawe kuri gahunda zo kugufasha kwibuka.

Nshobora kureka gufata iloprost ryari?

Ntabwo ukwiriye kureka gufata iloprost utabanje kuvugana n'umuganga wawe, kabone niyo wumva umeze neza cyane. PAH ni indwara idakira isaba kuvurwa buri gihe kugirango wirinde ibimenyetso byo gusubira no gukomeza kw'indwara.

Umuganga wawe azajya asuzuma buri gihe niba iloprost ikigukwiriye kandi ashobora guhindura imiti yawe bitewe n'uko urimo witwara. Niba ukeneye guhagarika iloprost, umuganga wawe ashobora kuguha undi muti wa PAH aho guhagarika imiti yose.

Nshobora Kugenda Ndafata Iloprost?

Yego, urashobora kugenda ufata iloprost, ariko bisaba gutegura mbere kugirango wemeze ko ufite imiti ihagije kandi ushobora gukurikiza gahunda yawe yo kuyifata. Uzakenera kuzana ibikoresho byawe bya nebulizer n'ibindi bikoresho by'imiti mugihe habayeho gutinda.

Mugihe ugenda mu ndege, jyana iloprost yawe na nebulizer mumizigo yawe y'intoki hamwe n'ibaruwa ivuye kwa muganga wawe isobanura impamvu yawe yo gukoresha ibikoresho by'ubuvuzi. Vugana n'indege mbere y'igihe kubyerekeye kugenda hamwe n'ibikoresho by'ubuvuzi. Mugihe ugenda mu mahanga, shaka kumenya niba imiti yawe yemewe mu gihugu ugiye kujyamo kandi uzane ibikoresho byinshi mugihe habayeho ibibazo byihutirwa.