Iloprost ni iki: Ibikoresho, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Iloprost ni umuti wihariye ufasha kunoza imikorere y'amaraso mu gufungura imitsi y'amaraso yagabanutse. Ni verisiyo ya sintetike y'ikintu gisanzwe umubiri wawe ukora cyitwa prostacyclin, gikora nk'intumwa yoroheje ibwira imitsi y'amaraso kuruhuka no kwaguka. Uyu muti ubusanzwe utangwa binyuze mu muyoboro w'amaraso (IV) mu bitaro cyangwa mu ivuriro, aho abaganga bashobora gukurikirana neza uko witwara ku miti.

Iloprost ni iki?

Iloprost ni umwe mu muryango w'imiti yitwa prostacyclin analogs. Tekereza nk'umufasha wigana ibyo umubiri wawe ukora mu buryo busanzwe kugira ngo amaraso akore neza. Iyo imitsi yawe y'amaraso iba mito cyane cyangwa ikomeye, iloprost yinjira kugira ngo ibashishikarize kongera gufunguka.

Uyu muti ukora ku rwego rw'uturemangingo, wohereza ibimenyetso bifasha imitsi y'amaraso kuruhuka no kugabanya imbaraga z'amaraso. Ibyo bituma amaraso akora neza, bishobora kuzana imbaraga zikenewe cyane mu bice by'umubiri wawe bitabonaga amaraso ahagije mbere.

Iloprost ikoreshwa mu iki?

Iloprost ikoreshwa cyane cyane mu kuvura umuvuduko ukabije w'amaraso mu muhogo (PAH), indwara ikomeye aho umuvuduko w'amaraso mu muhogo uba mwinshi cyane. Ifasha gufungura imitsi mito y'amaraso mu muhogo wawe, bigatuma umutima wawe woroherwa no kuyanyuzamo amaraso.

Usibye PAH, abaganga rimwe na rimwe bandika iloprost ku ndwara ikomeye y'imitsi y'amaraso yo ku ngingo, cyane cyane iyo izindi miti itakoze neza. Muri ibyo bihe, bishobora gufasha kunoza imikorere y'amaraso mu maboko yawe n'amaguru, kugabanya ububabare no gufasha kwirinda kwangirika kw'imitsi.

Mu bihe bidasanzwe, iloprost ishobora gukoreshwa mu gihe cy’uburwayi bwo mu ngingo bukomeye, uburwayi aho amaraso agabanuka cyane mu ngingo zawe. Rimwe na rimwe, iratekerezwa gukoreshwa mu bwoko bumwe bwa Raynaud's phenomenon iyo uburwayi bukomeye cyane kandi izindi nshuti zitatanze ubufasha buhagije.

Iloprost ikora ite?

Iloprost ifatwa nk'umuti ukomeye wo kwagura imitsi y'amaraso, bivuze ko ifite imbaraga zikomeye mu gufungura imitsi y'amaraso ariko bisaba gupima neza. Ikora muguhuza n'ibice byihariye ku nkuta z'imitsi yawe y'amaraso, bigatuma ibintu bikurikirana bituma imitsi iruhuka kandi yaguka.

Uyu muti kandi ufite ubushobozi bwo kurwanya amaraso, bivuze ko ifasha gukumira amaraso yawe kuba akomeye cyane cyangwa gukora ibibumbe bitifuzwa. Iki gikorwa cyombi cyo gufungura imitsi y'amaraso no kunoza imiterere y'amaraso gituma bikora neza cyane kubibazo by'imitsi y'amaraso.

Bitandukanye n'imiti imwe ikora ako kanya, ingaruka za iloprost ziriyongera uko imiti ikoreshwa kenshi. Ushobora gutangira kubona impinduka nziza mu bimenyetso byawe nyuma y'amavuriro menshi, nubwo abantu bamwe babona inyungu mbere.

Nkwiriye gufata iloprost nte?

Iloprost itangwa buri gihe mu maraso (binyuze muri IV) ahantu havurirwa, ntabwo bikorerwa mu rugo. Itsinda ryawe ry'ubuzima rizagushyiriramo agati gato mu mutsi wawe, akenshi mu kuboko kwawe, kandi umuti uzatangwa buhoro buhoro mu masaha menshi.

Ukururwa risanzwe rifata hagati y'amasaha 6 kugeza kuri 9, kandi uzakenera kuguma ahantu havurirwa muri iki gihe. Itsinda ryawe ry'ubuvuzi rizagenzura umuvuduko w'amaraso yawe, umuvuduko w'umutima, n'uko wumva muri rusange mu gihe cyose cy'inzira.

Ntabwo bisaba kwiyiriza ubusa mbere yo kuvurwa, ariko akenshi bifasha kurya ifunguro rito mbere kuko uburyo bufata amasaha menshi. Kuguma ufite amazi ahagije ni ingenzi, bityo unywe amazi menshi mbere na mugihe cyo kuvurwa keretse muganga wawe abiguhayeho inama.

Abantu bamwe basanga bifasha kuzana ikintu cyo kubafasha kwishimisha mugihe cyo gutera umuti muremure, nk'ibitabo, tableti, cyangwa umuzika. Ahantu havurirwa akenshi haba hameze neza, ariko uzakenera kuguma wicaye neza kugirango wirinde guhungabanya umurongo wa IV.

Nzakoresha Iloprost igihe kingana gute?

Igihe cyo kuvurwa na iloprost gitandukana cyane bitewe n'uburwayi bwawe bwihariye n'uburyo wemera imiti. Kubijyanye na hypertension ya pulmonary arterial, inzira zo kuvura akenshi zikubiyemo gutera imiti buri munsi muminsi myinshi ikurikirana, igakurikirwa n'igihe cyo kuruhuka.

Abantu benshi bakira inzira zo kuvurwa zimara iminsi 3 kugeza kuri 5, zikongerwa buri byumweru 6 kugeza kuri 12. Ariko, muganga wawe azakora gahunda yihariye ishingiye ku bimenyetso byawe, ibisubizo by'ibizamini, n'ubuzima bwawe muri rusange.

Kubijyanye n'indwara ya arteri ya peripherale cyangwa ischemia y'ingingo zikomeye, gahunda yo kuvura irashobora kuba itandukanye, rimwe na rimwe ikubiyemo inzira ndende cyangwa kuvurwa kenshi mbere na mbere. Itsinda ryawe ry'ubuzima rizasuzuma buri gihe niba umuti ufasha kandi uhindure gahunda yo kuvura uko bikwiye.

Igenamigambi ryo kuvura igihe kirekire rishingiye ku burwayi bwawe bwihariye niba iloprost ikomeza gutanga inyungu. Abantu bamwe bashobora kwimukira ku yindi miti, mugihe abandi bashobora gukomeza gukoresha iloprost nk'igice cy'uburyo bwabo bwo kwita ku buzima.

Ni izihe ngaruka ziterwa na Iloprost?

Kimwe n'indi miti yose, iloprost irashobora gutera ingaruka ziterwa n'imiti, nubwo abantu benshi bayihanganira neza iyo igenzurwa neza. Kumva icyo witegura birashobora kugufasha kumva witeguye kandi ufite icyizere mugihe cyo kuvurwa.

Ingaruka zikunze kugaragara zirimo kubabara umutwe, gutukura mu maso (kumva ushyushye kandi utukuye mu maso), no kuruka. Ibi bikunze kubaho igihe cyangwa nyuma gato yo guterwa urushinge kandi akenshi biragenda bikemuka uko umubiri wawe umenyera umuti.

Dore ingaruka zikunze kugaragara abantu bahura nazo:

• Kubabara umutwe, bishobora kuba bike cyangwa bikabije
• Gutukura mu maso no kumva ushyushye
• Kuruka cyangwa kurwara mu nda bike
• Kuribwa umutwe cyangwa kumva uruhutse
• Kubabara urushingo cyangwa kubabara imitsi
• Impiswi cyangwa kwituma bireremba
• Kugira umunaniro cyangwa kumva unaniwe

Izi ngaruka akenshi ziragendeka kandi akenshi zigabanuka uko wakira imiti myinshi. Itsinda ry'abaganga baragufasha gushaka uburyo bwo kugabanya ibibazo.

Abantu bamwe bashobora kugira ingaruka zikomeye zisaba gukurikiranwa hafi:

• Umuvuduko w'amaraso uri hasi, ushobora gutera kuribwa umutwe cyangwa guta ubwenge
• Umutima utera cyane cyangwa umutima udakora neza
• Kugorwa no guhumeka cyangwa guhagarara mu gituza
• Kubabara umutwe bikabije bitagabanuka n'imiti igurishwa itagomba kwandikwa na muganga
• Ibimenyetso by'amaraso, nk'ibikomere bidasanzwe cyangwa kuvira amazuru

Izi ngaruka ntizikunze kugaragara ariko ni ngombwa kuzibwira itsinda ry'abaganga ako kanya niba bibaye.

Gahoro, abantu bamwe bashobora kugira ibibazo bikomeye bisaba ubufasha bwihuse bw'abaganga:

• Urugero rukabije rwo kwibasirwa n'umubiri hamwe n'ibibara, kubyimba, cyangwa kugorwa no guhumeka
• Igabanuka rikomeye ry'umuvuduko w'amaraso risaba ubufasha
• Umutima utera nabi
• Pulmonary edema (amazi mu bihaha)
• Ibibazo bikomeye by'amaraso

Nubwo izi ngaruka zikomeye zitamenyerewe, ahantu havurirwa iloprost hatuma ubufasha buhabwa ako kanya niba bibaye ngombwa.

Ninde utagomba gufata Iloprost?

Iloprost ntiribereye buri wese, kandi muganga wawe azasuzuma neza amateka yawe y'ubuvuzi mbere yo kugusaba ubu buvuzi. Ibyiciro bimwe na bimwe cyangwa ibihe bituma iloprost ishobora kutagira umutekano cyangwa idakora neza.

Ntabwo ukwiye guhabwa iloprost niba ufite indwara ikomeye y'umutima, cyane cyane ubwoko bumwe na bumwe bwo kunanirwa k'umutima cyangwa gutera umutima vuba. Ingaruka z'imiti ku gipimo cy'amaraso n'umuvuduko w'umutima birashobora kuba ibibazo muri ibyo bihe.

Abantu bafite indwara zirimo kuva amaraso cyangwa abafata imiti imwe na rimwe igabanya amaraso ntibashobora kuba abakandida beza ba iloprost. Kubera ko umuti ugira ingaruka ku kuvura amaraso, byongera ibyago byo kuva amaraso ku bantu bafite ibibazo.

Izindi ndwara zisanzwe zibuza gukoresha iloprost zirimo:

• Indwara ikomeye y'umwijima cyangwa kunanirwa k'umwijima
• Indwara ikomeye y'impyiko isaba dialysis
• Umubyigano w'amaraso udagenzurwa
• Umutsi wo mu bwonko cyangwa kuva amaraso mu bwonko vuba
• Indwara ya peptic ulcer ikora
• Anemia ikomeye cyangwa umubare muto wa platelet

Gusama no konsa bisaba kwitonderwa by'umwihariko, kuko ingaruka za iloprost ku bana bakiri bato ntizisobanukiwe neza. Muganga wawe azagereranya inyungu zishoboka n'ibyago bishoboka niba utwite cyangwa ufite gahunda yo gusama.

Imyaka yonyine ntigomba kuba imbogamizi ku buvuzi, ariko abantu bakuze bashobora gukenera gukurikiranwa neza kubera kwiyongera kw'ubushobozi bwo kwakira ingaruka z'umuti.

Amazina y'ubwoko bwa Iloprost

Iloprost iboneka munsi y'amazina menshi y'ubwoko, Ventavis ikaba ariyo izwi cyane muri Leta Zunze Ubumwe z'Amerika. Ubu bwoko bwashyizweho cyane cyane kubuvuzi bwo guhumeka, nubwo ubwoko bwo mu maraso na bwo buboneka munsi y'amazina atandukanye.

Izindi nshuti z'amazina harimo Ilomedin, ikoreshwa mu bihugu bitandukanye mu gutera mu maraso. Izina ryihariye n'uburyo umuganga wawe ahitamo bizaterwa n'uburwayi bwawe n'uburyo bwo kuvura abona ko buzagukorera neza.

Tutitaye ku izina ry'urugero, imiti yose ya iloprost irimo ikintu kimwe gikora. Itandukaniro riri cyane cyane mu gipimo, uburyo bwo gutanga, n'amabwiriza yihariye yo gukora.

Izindi Miti ya Iloprost

Imiti itandukanye irashobora gukora nk'izindi miti ya iloprost, bitewe n'uburwayi bwawe bwihariye n'intego zo kuvura. Izi zindi miti zikora zinyuze mu buryo bumwe cyangwa butandukanye bwo kunoza imikorere y'amaraso no kugabanya ibimenyetso.

Kubera umuvuduko mwinshi w'amaraso mu muhogo, izindi miti zirimo epoprostenol (Flolan), treprostinil (Remodulin), na selexipag (Uptravi). Buri kimwe gifite inyungu zacyo n'ibitekerezo bijyanye no gupima, ingaruka ziterwa, n'uburyo bwo gutanga.

Izindi nzira zo kuvura zirashobora kuba zirimo abanzi b'abakira endothelin nk'uko bosentan (Tracleer) cyangwa ambrisentan (Letairis), bakora binyuze mu kubuza ibintu bitera guhagarika imitsi y'amaraso. Abahagarika phosphodiesterase-5 nka sildenafil (Revatio) batanga indi nzira yo kunoza imikorere y'amaraso.

Kubera indwara y'imitsi y'amaraso yo ku ruhande, izindi miti zirashobora kuba zirimo izindi vasodilators, imiti irwanya platelet, cyangwa uburyo bushya bwo kuvura bugamije guteza imbere imitsi y'amaraso. Umuganga wawe azatekereza ku miterere yawe yihariye mugihe asaba izindi miti.

Ese Iloprost iruta Epoprostenol?

Bombi iloprost na epoprostenol ni prostacyclin analogs, ariko bafite itandukaniro rikomeye rituma imwe ishobora gukwira neza abantu bamwe. Guhitamo hagati yabo biterwa n'ibyo ukeneye, imibereho yawe, n'uko wihanganira neza buri muti.

Iloprost ifite igihe kirekire cyo gukora kurusha epoprostenol, bivuze ko ikomeza gukora mu mubiri wawe igihe kirekire. Ibi birashobora kuba byiza kuko bituma umuntu adahabwa imiti kenshi kandi bishobora gutanga ingaruka zihamye umunsi wose.

Epoprostenol isaba gutera imiti buri gihe hakoreshejwe umurongo wo hagati uhoraho, bivuze ko uzakenera gutwara pompe ntoya igihe cyose. Ku rundi ruhande, Iloprost, irashobora gutangwa nk'imiti itangwa rimwe na rimwe, abantu benshi babona ko byoroshye mu buzima bwabo bwa buri munsi.

Imiterere y'ingaruka ziterwa n'imiti irasa, ariko abantu bamwe bakira neza umuti umwe kurusha undi. Muganga wawe azatekereza ku miterere yawe bwite, harimo ubushobozi bwawe bwo gucunga uburyo butandukanye bwo gutanga imiti n'uburyo witwara ku miti.

Ibikunze Kubazwa Kuri Iloprost

Ese Iloprost irakwiriye indwara z'umutima?

Iloprost isaba isuzuma ryitondewe niba ufite indwara z'umutima, kuko ishobora kugira ingaruka ku mutima wawe n'umuvuduko w'amaraso. Ku bantu bafite indwara z'umutima zoroheje kugeza hagati, birashobora kuba byiza iyo bikurikiranwa na muganga, ariko abafite indwara z'umutima zikomeye cyangwa abagize ibitero by'umutima vuba aha ntibakunze guhabwa uyu muti.

Umuvuzi w'umutima wawe n'ikipe icunga imiti yawe ya iloprost bazakorana kugira ngo bamenye niba bikwiriye indwara yawe y'umutima. Bazatekereza ku bintu nk'imikorere y'umutima wawe, imiti ukoresha ubu, n'ubuzima bwawe bwose bw'imitsi y'amaraso.

Niba wakira iloprost ufite indwara z'umutima, birashoboka ko uzakenera gukurikiranwa kenshi mugihe cyo kuvurwa, harimo kugenzura umuvuduko w'umutima n'umuvuduko w'amaraso mugihe cyose cyo gutera imiti.

Nigute nakora niba mbonye iloprost nyinshi bitunguranye?

Kubera ko iloprost itangwa mu maraso ahantu havurirwa, kwirenza imiti bitunguranye ntibikunda kubaho kuko abaganga bagenzura neza urugero rw'imiti. Ariko, niba ubonye ibimenyetso bikomeye mugihe cyo kuvurwa, ni ngombwa kuvuga ako kanya.

Ibimenyetso byo gukoresha iloprost nyinshi birimo kubabara umutwe cyane, kuribwa cyane, umuvuduko w'amaraso uri hasi cyane, cyangwa guhumeka bigoranye. Itsinda ry'abaganga rikora igenzura ku kuvurwa kwawe ryatojwe kumenya no gusubiza vuba muri ibyo bihe.

Niba ikibazo cyo gukoresha imiti irenze urugero kibayeho, gutera umuti bizahagarara ako kanya, kandi hazatangwa ubufasha kugira ngo umubiri wawe ukire. Ingaruka nyinshi zo gukoresha imiti irenze urugero zishobora gukosorwa igihe umuti uhagaritswe.

Nkwiriye gukora iki niba ntasibye kuvurwa kwa iloprost?

Niba utasibye kuvurwa kwa iloprost, vugana n'umuganga wawe vuba bishoboka kugira ngo wongere utegure gahunda. Ntukagerageze gusimbura kuvurwa wasibye ukoresha imiti yongereweho cyangwa wongera igihe cyo gutera umuti ukurikira.

Bitewe n'igihe kimaze kuva utasibye kuvurwa kwawe n'uburwayi bwawe bwihariye, muganga wawe ashobora guhindura gahunda yawe yo kuvurwa cyangwa agasaba ko wongera kugenzurwa igihe usubiye mu kuvurwa.

Kudasiba kuvurwa rimwe na rimwe mubisanzwe ntibiteje akaga, ariko guhora ukoresha imiti ni ingenzi kugira ngo ugumane inyungu z'umuti. Korana n'ikipe yawe y'ubuvuzi kugira ngo ubone gahunda ushobora gukurikiza neza.

Nshobora guhagarika ryari gufata iloprost?

Umwanzuro wo guhagarika iloprost ugomba gufatirwa hamwe n'umuganga wawe, ntabwo wenyine. Abantu bamwe bashobora guhagarika kuvurwa niba uburwayi bwabo bwitezimbere cyane cyangwa niba bimukiye ku yindi miti ikora neza.

Ku burwayi nk'umuvuduko mwinshi w'amaraso mu muhogo, guhagarika kuvurwa ako kanya birashobora guteza akaga kandi bishobora gutuma ibimenyetso byiyongera vuba. Muganga wawe mubisanzwe azagabanya kenshi kuvurwa buhoro buhoro niba guhagarika bikwiye.

Igenzura risanzwe hamwe n'ibizamini nk'ibipimo by'umutima, ibizamini by'amaraso, no gusuzuma ibimenyetso bifasha ikipe yawe y'ubuvuzi kumenya niba kuvurwa bikomeje ari ngombwa kandi bifitiye akamaro imiterere yawe yihariye.

Nshobora gutwara imodoka nyuma yo guhabwa imiti ya Iloprost?

Ntabwo ugomba gutwara imodoka ako kanya nyuma yo guhabwa imiti ya iloprost, kuko uwo muti ushobora gutera isereri, umutwe, no guhinduka kw'umuvuduko w'amaraso bishobora kugira ingaruka ku bushobozi bwawe bwo gutwara imodoka neza.

Abaganga benshi bagira inama yo gutegereza byibuze amasaha menshi nyuma yo kuvurwa mbere yo gutwara imodoka, kandi bamwe bagasaba ko hari undi muntu ukujyana mu rugo nyuma y'amasaha yo kuvurwa. Igihe nyacyo cyo gutegereza giterwa n'uko usanzwe wakira imiti.

Niba wumva uruhuka cyane, unaniwe cyane, cyangwa izindi ngaruka zishobora kugira ingaruka ku bushobozi bwawe bwo gutwara imodoka, ni byiza gutegura uburyo bwo gutwara imodoka butandukanye kugeza izo ngaruka zishize burundu.