Macitentan ni iki: Ibikoreshwa, Urutonde rw'imiti, Ingaruka ziterwa n'iyo miti n'ibindi

Macitentan ni umuti wandikirwa na muganga ufasha kuvura umuvuduko ukabije w'amaraso mu miyoboro y'amaraso yo mu muhogo (PAH), indwara ikomeye aho umuvuduko w'amaraso mu miyoboro y'amaraso yo mu muhogo wawe uba mwinshi cyane. Uyu muti unyobwa mu kanwa ukora ubugufi buhagarika uturemangingo twihariye dutuma imiyoboro y'amaraso ifunga, bigafasha umutima wawe gutera amaraso byoroshye mu muhogo wawe.

Niba wowe cyangwa umuntu witaho yarandikiwe macitentan, birashoboka ko ufite ibibazo byerekeye uko ikora n'icyo wakwitega. Reka tunyuremo ibintu byose ukeneye kumenya kuri uyu muti mu buryo bworoshye kandi bugaragara.

Macitentan ni iki?

Macitentan ni mu cyiciro cy'imiti yitwa abanzi b'abakira endothelin. Tekereza nk'urufunguzo rufunga ibifunguzo by'uturemangingo twihariye mu miyoboro yawe y'amaraso byatuma ifunga.

Umubiri wawe ukora mu buryo busanzwe ikintu cyitwa endothelin, gishobora gutuma imiyoboro y'amaraso ifunga. Ku bantu bafite PAH, uku gufunga bibaho cyane mu miyoboro y'amaraso yo mu muhogo. Macitentan yinjira kugira ngo yirinde uku gufunga kurenze urugero, byemerera amaraso gutembera neza mu muhogo wawe.

Uyu muti wagenewe gukoreshwa igihe kirekire kandi uhagarariye iterambere rikomeye mu kuvura PAH. Akenshi wandikwa iyo izindi nshuti zitatanze ubufasha buhagije cyangwa nk'igice cy'umugambi wo kuvura uhuza imiti.

Macitentan ikoreshwa mu kuvura iki?

Macitentan ikoreshwa cyane cyane mu kuvura umuvuduko ukabije w'amaraso mu miyoboro y'amaraso yo mu muhogo, indwara aho imiyoboro mito y'amaraso yo mu muhogo wawe ifunga, igafungwa, cyangwa ikangirika. Ibi bituma bigora cyane umutima wawe gutera amaraso mu muhogo wawe.

Abantu bafite PAH akenshi bahura no guhumeka bigoranye, umunaniro, kuribwa mu gituza, no kuribwa umutwe kuko imitima yabo ikora cyane kugira ngo itere amaraso muri iyi miyoboro y'amaraso yafunze yo mu muhogo. Nyuma y'igihe, uyu murimo wiyongereye ushobora kunaniza umutima.

Muganga wawe ashobora kugutera umuti wa macitentan niba ufite PAH ifitanye isano n'indwara zitandukanye zishingiye ku mpamvu. Izi zirimo indwara zifitanye isano n'imyanya y'umubiri nk'indwara ya scleroderma, ubumuga bwo mu mutima bw'uruhinja, cyangwa rimwe na rimwe PAH iterwa nta mpamvu igaragara.

Uyu muti ufasha kugabanya ikwirakwizwa rya PAH kandi ushobora kunoza ubushobozi bwawe bwo gukora imyitozo no gukora imirimo ya buri munsi. Akenshi ukoreshwa hamwe n'izindi nshuti za PAH kugirango ugire ibisubizo byiza bishoboka.

Macitentan ikora ite?

Macitentan ifatwa nk'umuti ukomeye wo hagati ukora ubugenzuzi bwa endothelin mu miyoboro yawe y'amaraso. Iyo izi receptor zibujijwe, imiyoboro y'amaraso mu muhaha wawe irashobora kuruhuka no kwaguka, bigabanya umuvuduko umutima wawe uhura nawo.

Uyu muti wibanda by'umwihariko ku bwoko bubiri bwa endothelin receptor, yitwa ETA na ETB receptor. Mu kubuza ubwoko bwombi, macitentan itanga uburinzi bwuzuye kurusha imiyoboro y'amaraso kurusha imiti imwe ya kera muri iki cyiciro.

Muri rusange uzatangira kubona impinduka mu bimenyetso byawe mu byumweru bike kugeza ku mezi make nyuma yo gutangira kuvurwa. Ariko, inyungu zose zirashobora gutwara amezi menshi kugirango zigaragare uko sisitemu yawe ya cardiovascular ihinduka kugirango iteze imbere imigezi y'amaraso.

Uyu muti ukora neza nk'igice cy'umugambi wo kuvura igihe kirekire. Ntabwo ari igisubizo cyihuse, ahubwo ni sisitemu ishyigikira ihamye ifasha gukomeza imigezi y'amaraso neza mu muhaha wawe uko igihe kigenda.

Nkwiriye gufata macitentan nte?

Fata macitentan nkuko muganga wawe abitegeka, akenshi rimwe ku munsi hamwe cyangwa nta funguro. Icyuma gishobora gufatwa n'amazi, kandi ntugomba guhangayika kubyerekeye igihe cyo gufata ibiryo kuko ibiryo ntibigira ingaruka zikomeye ku buryo umubiri wawe ukoresha umuti.

Ni byiza gufata urugero rwawe ku gihe kimwe buri munsi kugira ngo bigufashe kwibuka no kugumana urugero rwa imiti mu mubiri wawe. Abantu benshi babona ko bifasha guhuza gufata imiti yabo n'ibikorwa bya buri munsi, nk'ukoza amenyo cyangwa gufata ifunguro rya mu gitondo.

Mimina urupapuro rwose hamwe n'amazi. Ntukoreshe, ntukore cyangwa umene urupapuro, kuko ibi bishobora kugira ingaruka ku buryo imiti irekurwa mu mubiri wawe.

Niba ufata izindi miti ya PAH, muganga wawe azahuza igihe kugira ngo yemeze ko bakora neza. Buri gihe ukurikize amabwiriza yihariye y'umuganga wawe, kuko ashobora guhindura gahunda yawe bitewe n'ibyo ukeneye.

Mbona Ndege Gufata Macitentan?

Macitentan akenshi yandikwa nk'ubuvuzi bw'igihe kirekire, akenshi imyaka cyangwa ndetse itazigira iherezo. PAH ni indwara idakira isaba gukomeza gucunga, kandi guhagarika imiti mu buryo butunguranye bishobora gutuma ibimenyetso byawe bisubira cyangwa bikiyongera.

Muganga wawe azagenzura uko witwara ku miti binyuze mu kugenzura buri gihe, ibizamini by'amaraso, no gupima imikorere y'umutima. Bitewe n'uko umeze, bashobora guhindura gahunda yawe yo kuvura uko igihe kigenda.

Abantu bamwe bafata macitentan imyaka myinshi bafite ibisubizo byiza, mu gihe abandi bashobora gukenera guhindurira ku yindi miti cyangwa kongeraho izindi mvura. Ikintu cy'ingenzi ni ugukorana bya hafi n'ikipe yawe y'ubuzima kugira ngo ubone icyo gikora neza ku miterere yawe yihariye.

Ntuzigere uhagarika gufata macitentan mu buryo butunguranye utabanje kuvugana na muganga wawe. Niba ukeneye guhagarika imiti, muganga wawe azakora gahunda yo kubikora mu buryo butekanye, bishoboka binyuze mu kugabanya buhoro buhoro urugero rwawe cyangwa guhindurira ku bundi buvuzi.

Ni Ibihe Bikorwa Bigaragara bya Macitentan?

Nk'imiti yose, macitentan ishobora gutera ibikorwa bigaragara, nubwo atari buri wese ubigeraho. Ibikorwa bigaragara byinshi birashobora gucungwa, kandi abantu benshi basanga ko ibitari byiza byose bya mbere bigenda neza uko umubiri wabo uhinduka ku miti.

Ingaruka zikunze kugaragara zirimo kubabara umutwe, kubyimba amaguru cyangwa ibibero, no kurwara indwara zo mu myanya yo hejuru y'ubuhumekero. Ibi bibaho ku bantu benshi ariko akenshi ntibiba bikomeye cyane.

Dore ingaruka zikunze kugaragara ugomba kumenya:

• Kubabara umutwe (akenshi birakira nyuma y'ibyumweru bike bya mbere)
• Kubyimba amaguru, ibibero, cyangwa ibirenge
• Indwara zo mu myanya yo hejuru y'ubuhumekero nk'ibimenyetso by'ibicurane
• Izuru ryazibye cyangwa rivamo amazi
• Bronchite
• Indwara zo mu myanya y'inkari

Inyinshi muri izi ngaruka ziba igihe gito kandi zigenda zigabanuka uko umubiri wawe umenyera umuti. Muganga wawe ashobora gutanga ibitekerezo byo guhangana n'ibimenyetso byose bitari byiza waba ufite.

Hariho kandi ingaruka zimwe zikomeye ariko zitagaragara cyane zisaba ubufasha bwihuse bwa muganga. Nubwo bidasanzwe, ni ngombwa kumenya icyo ugomba kwitaho kugirango ubone ubufasha bwihuse niba bibaye ngombwa.

Vugana na muganga wawe ako kanya niba ubonye kimwe muri ibi bimenyetso bikomeye:

• Kugabanuka cyane kw'insoro zitukura (anemiya), bishobora gutera umunaniro udasanzwe cyangwa intege nke
• Ibibazo by'umwijima, harimo umuhondo w'uruhu cyangwa amaso, inkari z'umukara, cyangwa isesemi ihoraho
• Kubyimba vuba cyane mu maso, iminwa, ururimi, cyangwa umuhogo
• Kugorana guhumeka cyangwa kumira
• Ukuva amaraso cyangwa gukomereka bidasanzwe

Izi ngaruka zikomeye ntizisanzwe, ariko kuzimenya hakiri kare bishobora gufasha kwemeza ko ubona ubuvuzi ukeneye vuba. Muganga wawe azakugenzura buri gihe kugirango amenye ibibazo byose bishobora kuvuka mbere yuko bikomera.

Ninde utagomba gufata Macitentan?

Macitentan ntabwo ikwiriye kuri buri wese, kandi hariho ibintu bimwe na bimwe aho muganga wawe azagusaba uburyo bwo kuvura butandukanye. Inzitizi ikomeye ni kubantu batwite cyangwa bashobora gutwita.

Niba utwite cyangwa uteganya kuzabyara, ntugomba gufata macitentan kuko ishobora gutera ubumuga bukomeye ku mwana. Abagore bafite imyaka yo kubyara bagomba gukoresha uburyo bwizewe bwo kuboneza urubyaro igihe bafata uyu muti no mu gihe cy'ukwezi kumwe nyuma yo kuwuhagarika.

Muganga wawe azitondera cyane gutanga macitentan niba ufite indwara zimwe na zimwe. Ibi bintu bisaba kwitonderwa cyane no gukurikiranwa hafi:

• Indwara ikomeye y'umwijima cyangwa ibibazo by'imikorere y'umwijima
• Indwara ikomeye y'impyiko
• Umubyigano muke w'amaraso utera ibimenyetso
• Ubwoko bumwe na bumwe bw'ibibazo by'umutima
• Anemiya ikomeye cyangwa izindi ndwara z'amaraso

Byongeye kandi, niba waragize allergie kuri macitentan cyangwa imiti isa nayo mu bihe byashize, muganga wawe ashobora guhitamo uburyo bwo kuvura butandukanye kuri wowe.

Imyaka nayo ishobora kuba impamvu mu gufata icyemezo cyo kuvura. Nubwo macitentan ishobora gukoreshwa ku bantu bakuze, muganga wawe ashobora gutangira n'urugero ruto cyangwa akagukurikirana neza niba urengeje imyaka 65 cyangwa ufite indwara nyinshi.

Amazina y'ubwoko bwa Macitentan

Macitentan iboneka ku izina ry'ubwoko rya Opsumit mu bihugu byinshi, harimo n'Amerika. Iyi ni yo formulation isanzwe itangwa cyane muri farumasi.

Uyu muti ukorwa na Actelion Pharmaceuticals, kandi Opsumit ubu ni ryo zina ry'ubwoko rikoreshwa cyane ku isi hose. Ushobora kubona rimwe na rimwe ryitwa izina ryayo rusange, macitentan, cyane cyane mu nyandiko z'ubuvuzi cyangwa igihe havugwa uburyo bwo kuvura.

Igihe ufata umuti wawe, ikirango gishobora kwerekana "Opsumit" nk'izina ry'ubwoko, hamwe na "macitentan" yanditswe nk'izina rusange cyangwa ry'igikorwa. Amazina yombi yerekeza ku muti umwe.

Birakwiye kumenya ko ubwoko rusange bwa macitentan bushobora kuboneka mu gihe kizaza, ariko ubu, Opsumit ni yo nzira nyamukuru itangwa na muganga kuri uyu muti wihariye.

Izindi nzira zishobora gusimbura Macitentan

Niba macitentan itagukwiriye, hari izindi miti nyinshi ishobora kuvura PAH neza. Muganga wawe ashobora gutekereza izi nzira zindi bitewe n'ibimenyetso byawe byihariye, izindi ndwara ufite, n'uko witwara ku miti.

Izindi miti ikora nk'iyo mu bwoko bwa endothelin receptor antagonists ikora kimwe na macitentan ariko ishobora kugira ingaruka zitandukanye. Muri zo harimo bosentan (Tracleer) na ambrisentan (Letairis), zimaze imyaka myinshi zikoreshwa neza.

Urenze endothelin receptor antagonists, hariho andi mashami y'imiti ya PAH akora hakoreshejwe uburyo butandukanye:

• Ibiyobyabwenge bya Phosphodiesterase-5 nka sildenafil (Revatio) na tadalafil (Adcirca)
• Prostacyclin analogs nka epoprostenol (Flolan) na iloprost (Ventavis)
• Soluble guanylate cyclase stimulators nka riociguat (Adempas)
• Prostacyclin receptor agonists nka selexipag (Uptravi)

Abantu benshi bafite PAH bakoresha imiti ivanze kugira ngo babone ibisubizo byiza. Muganga wawe ashobora gutangira n'umuti umwe hanyuma akongeraho iyindi nyuma y'igihe, cyangwa ashobora kugusaba gutangira n'imiti ivanze ako kanya.

Uburyo bwo guhitamo izindi nzira zishingira ku bintu byinshi, harimo ubuzima bwawe muri rusange, izindi miti urimo gufata, n'ibyo ukunda ku giti cyawe nk'uko ukunda gufata imiti kenshi cyangwa ingaruka zishobora kubaho.

Ese Macitentan iruta Bosentan?

Macitentan na bosentan ni endothelin receptor antagonists zivura PAH neza, ariko zifite itandukaniro rikomeye rishobora gutuma imwe ikwira kurusha iyindi.

Macitentan muri rusange ifatwa nk'ifite inyungu kurusha bosentan. Ikunda gutera ibibazo bike by'umwijima, bivuze ko ushobora gukenera ibizamini by'amaraso bike kugira ngo ukurikirane imikorere y'umwijima wawe. Ibi bishobora koroshya imiti kandi ntibitange impungenge nyinshi.

Ubushakashatsi bwagaragaje ko macitentan ishobora no kugira akamaro mu kurinda PAH kwiyongera uko igihe kigenda cyiyongera. Mu bizami byakorewe ku barwayi, abantu bafatiraga macitentan bagize ibitaro bike byo kujyayo ndetse n'ibibazo by'indwara byiyongera ugereranije n'abafataga placebo.

Ariko, bosentan imaze igihe kinini ikoreshwa kandi ifite amateka meza y'umutekano n'ubushobozi. Abantu bamwe barabigenza neza kuri bosentan kandi ntibakeneye guhindurira ku miti mishya.

Guhitamo hagati y'iyi miti akenshi biterwa n'ibintu by'umuntu ku giti cye nk'imikorere y'umwijima wawe, izindi ndwara, n'uko witwara ku buvuzi. Muganga wawe azatekereza ku ishusho yawe yuzuye y'ubuzima mugihe agushyiriraho uburyo bwiza.

Ibikunze Kubazwa Kuri Macitentan

Q1. Macitentan ifite umutekano ku bantu barwaye indwara z'umutima?

Macitentan irashobora gukoreshwa ku bantu bafite ubwoko bumwe bw'indwara z'umutima, ariko bisaba gukurikiranwa neza no gusuzumwa na muganga wawe. Kubera ko PAH ubwayo igira ingaruka ku mutima, abantu benshi bafata macitentan bafite urwego runaka rwo kwivanga kw'umutima.

Muganga wawe azasuzuma imiterere y'umutima wawe mbere yo kugushyiriraho macitentan. Bazatekereza ku bintu nk'imbaraga z'umutima wawe zo gutera, imirimo idasanzwe, n'urugero rw'umuvuduko w'amaraso yawe. Inama zisanzwe zo gukurikirana zizafasha kumenya neza ko umuti ukora neza ku mutima wawe.

Niba ufite guhagarara gukomeye k'umutima cyangwa umuvuduko w'amaraso make cyane, muganga wawe ashobora guhitamo uburyo butandukanye bwo kuvura cyangwa gutangira urugero ruto mugihe akugenzura neza. Ikintu cy'ingenzi ni ukuganira neza n'ikipe yawe y'ubuzima ku bijyanye n'ibimenyetso byose bifitanye isano n'umutima wibona.

Q2. Nkwiriye gukora iki niba nanyweye macitentan nyinshi bitunguranye?

Niba utunguranye ukanywa macitentan nyinshi kuruta uko byategetswe, vugana na muganga wawe cyangwa ikigo gishinzwe kugenzura uburozi ako kanya, kabone n'iyo wumva umeze neza. Kunywa nyinshi bishobora gutera umuvuduko w'amaraso ugabanuka cyane n'izindi ngorane zikomeye.

Ibimenyetso byo gufata macitentan nyinshi bishobora kuba isereri, kuruka, kubabara umutwe cyane, cyangwa kumva umubiri utameze neza. Niba ubonye kimwe muri ibi bimenyetso nyuma yo gufata imiti yiyongereyeho, shakisha ubufasha bw'abaganga ako kanya.

Mugihe utegereje ubufasha bw'abaganga, ryama hasi amaguru yawe azamuye niba wumva isereri cyangwa uruka. Ntukagerageze kwivugisha niba utabitegetswe n'umuganga. Bika icupa ry'umuti hamwe nawe kugirango abaganga babone neza icyo wafashe n'ingano yacyo.

Q3. Nkwiriye gukora iki niba nirengagije doze ya Macitentan?

Niba wirengagije doze ya macitentan, yifate uko wibuka, keretse igihe cyo gufata doze yawe ikurikira kigeze. Muricyo gihe, reka doze wirengagije ukomeze gahunda yawe isanzwe.

Ntuzigere ufata doze ebyiri icyarimwe kugirango wuzuze doze wirengagije, kuko ibi bishobora gutera ingaruka mbi. Niba utazi neza igihe, biruta gutegereza kugeza igihe cya doze yawe ikurikira kuruta gushyira mu kaga gufata imiti myinshi.

Niba ukunda kwibagirwa doze, tekereza gushyiraho ibyibutso kuri terefone cyangwa ukoreshe umuteguro w'imiti kugirango ugufashe kuguma ku murongo. Guhora ufata imiti buri munsi ni ngombwa kugirango ugumane urwego rwawo ruzima mumubiri wawe.

Q4. Nshobora guhagarika ryari gufata Macitentan?

Ugomba guhagarika gufata macitentan gusa ukurikije ubuyobozi bw'umuganga wawe, kuko PAH ni indwara idakira isaba kuvurwa buri gihe. Guhagarika ako kanya bishobora gutuma ibimenyetso byawe bisubira cyangwa bikiyongera, bishobora gutera ibibazo bikomeye.

Umuganga wawe ashobora gutekereza guhagarika cyangwa guhindura imiti yawe niba ubonye ingaruka zikomeye, niba indwara yawe igenda neza cyane, cyangwa niba ukeneye guhindura uburyo bwo kuvura. Izi myanzuro ifatwa buri gihe witonze hamwe no gukurikiranwa hafi.

Niba utekereza kureka imiti yawe kubera ingaruka cyangwa izindi mpamvu, banza uvugane na muganga wawe. Akenshi bashobora guhindura gahunda yawe y'imiti, gucunga ingaruka, cyangwa gushakisha izindi nzira zishobora kugukorera neza.

Q5. Nshobora gufata Macitentan hamwe n'indi miti ya PAH?

Yego, macitentan akunda gukoreshwa hamwe n'indi miti ya PAH, kandi abantu benshi basanga imiti ihuriweho ikora neza kurusha imiti imwe gusa. Muganga wawe azahuza neza izi miti kugirango yongere inyungu mugihe agabanya ibyago.

Imiti isanzwe ihuriweho irimo macitentan hamwe n'ibinyabutabazi bya phosphodiesterase-5 nka sildenafil, cyangwa hamwe na prostacyclin analogs. Iyi miti ikora inyuze mu nzira zitandukanye, bityo kuyihuza bishobora gutanga ubuvuzi bwuzuye bwa PAH.

Muganga wawe azagukurikiranira hafi mugihe utangiye imiti ihuriweho, kuko ibyago by'ingaruka nko kugabanuka k'umuvuduko w'amaraso bishobora kuba byinshi. Bazahindura imiti n'igihe kugirango babone imiti ifite umutekano mwinshi kandi ikora neza kubera uko ubuzima bwawe bumeze.