Alprostadil (inzira yo mu maraso): Ibyo ikoreshwa, urugero rwo gufata, ingaruka ziterwa n'ibindi

Alprostadil ni uruvange rw'imiterere ya hormone karemano yitwa prostaglandin E1 ifasha kugumisha imiyoboro y'amaraso ifunguye kandi amaraso akagenda neza. Iyo itanzwe binyuze mu muyoboro w'amaraso, uyu muti ukora nk'ubuzima ku bana bavutse bafite ubumuga bukomeye bw'umutima.

Uyu muti ukora neza ufungura umuyoboro w'amaraso w'ingenzi witwa ductus arteriosus mu bana bakivuka. Uyu muyoboro ufungwa nyuma yo kuvuka, ariko abana bamwe barawukeneye kugira ngo ugume ufunguye igihe gito mugihe abaganga bategura kubaga umutima cyangwa izindi nshingano zo kurokora ubuzima.

Alprostadil ni iki?

Alprostadil ni igisubizo cyakozwe n'abantu cya prostaglandin E1, ikintu karemano umubiri wawe ukora kugira ngo ufashishe kugenzura uko amaraso atembera. Uyu muti uza nk'igisubizo cyiza, kidafite mikorobe abaganga bawuha mu maraso y'umwana wawe binyuze mu muyoboro w'amaraso.

Uyu muti ni mu cyiciro cy'imiti yitwa vasodilators, bivuze ko ifasha kwagura imiyoboro y'amaraso. Tekereza nk'umufasha w'umutima ugumisha inzira z'ingenzi zifunguye kugira ngo amaraso atemberere aho akenewe cyane.

Alprostadil ikoreshwa mu iki?

Alprostadil inzira yo mu maraso ikoreshwa by'umwihariko mu kuvura abana bakivuka bafite ubumuga bw'umutima biterwa no kugumisha ductus arteriosus ifunguye. Ibi birimo ibibazo bikomeye ariko bivurwa bigira ingaruka ku buryo amaraso atembera mu mutima n'ibihaha by'umwana wawe.

Ibibazo bisanzwe bisaba uyu muti birimo hypoplastic left heart syndrome, aho uruhande rw'ibumoso rw'umutima rutarakura neza, na transposition of the great arteries, aho imiyoboro mikuru y'amaraso yahindutse. Ibindi bibazo birimo pulmonary atresia, tricuspid atresia, na tetralogy of Fallot.

Rimwe na rimwe, abaganga bakoresha alprostadil ku bana bafite coarctation ikomeye ya aorta, aho umutsi munini uva ku mutima uba muto cyane. Mu bihe bidasanzwe, irashobora gukoreshwa ku zindi ndwara z'umutima zikomeye aho gukomeza urujya n'uruza rw'amaraso binyuze muri ductus arteriosus ari ngombwa kugira ngo umwana abashe kubaho.

Alprostadil ikora ite?

Alprostadil ikora yigana imisemburo karemano ifasha ductus arteriosus gukinguka mu gihe umwana akiri mu nda. Uyu mutsi muto ariko w'ingenzi uhuza umutsi wa pulmonary na aorta, ukemerera amaraso kunyura mu muhogo mbere yo kuvuka.

Ubusanzwe, uyu mutsi urifunga nyuma y'amasaha cyangwa iminsi nyuma yo kuvuka igihe ibihaha by'umwana wawe bitangiye akazi ko guhema. Ariko, abana bafite ubumuga bw'umutima runaka bakeneye ko uyu mutsi uguma ukinguye by'agateganyo kugira ngo bemeze urujya n'uruza rw'amaraso ruhagije mu bihaha byabo cyangwa mu mubiri wabo.

Uyu muti ufatwa nk'uvura cyane kandi w'ingenzi kuri izi ndwara zihariye. Utarimo, abana bafite ubumuga bw'umutima bushingiye kuri ductal bashobora guhura n'ibibazo biteye ubuzima bwabo inkeke mu masaha cyangwa iminsi nyuma yo kuvuka.

Alprostadil igomba gutangwa ite?

Alprostadil igomba gutangwa gusa n'abakozi b'ubuzima babihuguwe mu bitaro bifite ubushobozi bwihariye bwo kuvura indwara z'umutima. Uyu muti utangwa binyuze mu kuyobora amaraso mu buryo buhoraho, bivuze ko yinjira buhoro buhoro kandi idahindagurika mu maraso y'umwana wawe.

Umwana wawe azakenera gukurikiranwa hafi mu kigo kivura abana bafite ibibazo bikomeye (NICU) cyangwa mu kigo kivura indwara z'umutima zikomeye. Abaganga bazareba umuvuduko w'umutima w'umwana wawe, umuvuduko w'amaraso, guhumeka, n'urugero rwa oxygen mu maraso mu gihe akoresha uyu muti.

Urugero rw'umuti rurabarwa neza hashingiwe ku gipimo cy'umwana wawe n'uburwayi afite. Abaganga basanzwe batangira n'urugero ruto cyane hanyuma bakaruhindura hashingiwe ku buryo umwana wawe abyitwaramo, bakoresha buri gihe urugero ruto rugaragaza umusaruro.

Alprostadil igomba gutangwa igihe kingana gute?

Igihe cyo kuvura na alprostadil gitandukana cyane bitewe n'uburwayi bw'umutima bwihariye bw'umwana wawe n'uburyo bwo kuvura. Abana bamwe bashobora kubikenera iminsi mike gusa, mu gihe abandi bashobora kubikenera ibyumweru byinshi cyangwa amezi menshi.

Ku bana bategereje kubagwa umutima, alprostadil akenshi ikomeza kugeza igihe cyo kubaga kirangiye kandi kigenda neza. Mu bihe bimwe na bimwe, bishobora gukenerwa nk'ikiraro cyo kwimura umutima, bishobora kuvuga igihe kirekire cyo kuvurwa.

Itsinda ry'abaganga bavura umwana wawe rizasuzuma buri gihe niba umuti ukenewe kandi rizagabanya buhoro buhoro urugero rwawo igihe byemewe. Intego ni ukuyikoresha igihe gito gishoboka mugihe cyose umwana wawe agumye ahagaze neza.

Ni izihe ngaruka ziterwa na Alprostadil?

Kimwe n'imiti yose ikomeye, alprostadil ishobora gutera ingaruka, nubwo inyungu akenshi zirenga cyane ibyago ku bana bayikeneye. Itsinda ry'abaganga rizakurikirana hafi ibibazo byose kandi rikosore uburyo bwo kuvura uko bikwiye.

Ingaruka zisanzwe abaganga bakurikirana harimo ingorane zo guhumeka, impinduka mu mutima, no guhindagurika kw'umuvuduko w'amaraso. Umwana wawe ashobora kandi kugira umuriro, gushyuha, cyangwa impinduka mu ibara ry'uruhu rwe.

Dore ingaruka ziterwa n'imiti abaganga bakurikirana cyane:

• Ibibazo byo guhumeka cyangwa apnea (guhagarara guhumeka by'agateganyo)
• Umuvuduko w'amaraso muke cyangwa impinduka zidasanzwe z'umuvuduko w'amaraso
• Umutima utagenda neza
• Umuriro cyangwa kutagira umuriro uhamye
• Gushyuha cyangwa impinduka z'ibara ry'uruhu
• Ukubura mu ntoki, ibirenge, cyangwa mu maso
• Kwigana (ntibisanzwe ariko bikomeye)

Izi ngaruka muri rusange zishobora gucungwa neza n'ubuyobozi bw'abaganga bukwiye kandi akenshi zikora neza uko umubiri w'umwana wawe uhinduka ku muti.

Ingaruka zidakunze ariko zikomeye zirimo ingorane zikomeye zo guhumeka zisaba imashini zifasha guhumeka, igabanuka rikomeye ry'umuvuduko w'amaraso, cyangwa ingorane zo kuva amaraso. Gukoresha igihe kirekire rimwe na rimwe bitera impinduka mu magufa, ariko ibi ntibisanzwe mugihe habayeho gukurikiranwa neza bitangwa mu bitaro.

Ninde utagomba guhabwa Alprostadil?

Abana bake cyane ntibashobora guhabwa alprostadil mugihe bibaye ngombwa mubuvuzi, kuko akamaro gakunze kurenga ibyago kubafite indwara z'umutima ziteje ubuzima bwabo akaga. Ariko, abaganga bazasuzuma buri kibazo neza.

Abana bafite indwara zikomeye zo kuva amaraso cyangwa abagize ibibazo bikomeye byo kwibasirwa n'umubiri na prostaglandins bashobora gukenera uburyo bundi. Byongeye kandi, abana bafite ubwoko runaka bw'ubumuga bw'umutima aho gukomeza gufungura ductus arteriosus byaba bibi ntibazaba abakandida bo kuvurwa uku.

Abana bavukiye igihe kitaragera cyangwa abafite izindi ndwara zikomeye zo kwa muganga basaba gukurikiranwa neza cyane ariko akenshi barashobora guhabwa alprostadil niba bibaye ngombwa. Itsinda ry'abaganga bavura umwana wawe bazagereranya ibintu byose kugirango bamenye uburyo bwo kuvura burinzwe cyane.

Amazina y'ubwoko bwa Alprostadil

Alprostadil intravenous solution iboneka munsi yizina ry'ubwoko bwa Prostin VR Pediatric, niyo ikoreshwa cyane mu bitaro. Uyu ni umuti umwe nubwo izina ry'ubwoko rimeze rite, wateguriwe neza abarwayi b'umutima b'abana.

Ubwoko bwa generic bwa alprostadil buraboneka kandi bukora kimwe. Guhitamo hagati yizina ryubwoko na generic akenshi biterwa nibyo ibitaro byawe bifite hamwe nibyo bakunda muri farumasi.

Uburyo bwo gusimbuza Alprostadil

Kubana bafite ubumuga bw'umutima bushingiye kuri ductal, hari uburyo buke cyane bwo gusimbuza alprostadil bushobora gutanga akamaro gakiza ubuzima. Uyu muti ufatanwa nk'urugero rwiza rwo gufungura ductus arteriosus.

Mu bihe bimwe na bimwe, abaganga bashobora kugerageza imiti yindi ya prostaglandin nka epoprostenol, ariko iyi ikoreshwa gake kandi ntishobora gukora neza. Ikindi kintu gikoreshwa cyane ni kubaga umutima byihutirwa, ariko abana benshi bakeneye alprostadil kugirango babafashe guhagarara mbere yo kubagwa bishoboka.

Ku bana batitabira neza alprostadil, abaganga bashobora gutekereza kuri balloon atrial septostomy, uburyo bwo kunoza kuvanga amaraso mu mutima, cyangwa izindi nzira za interventional cardiology bitewe n'ubumuga bwihariye bw'umutima.

Ese Alprostadil iruta imiti yindi y'umutima?

Ku bana bafite ubumuga bw'umutima buterwa na ductal, alprostadil ntabwo isimbuzwa aho kuba

Itsinda ry’abaganga rizafata umwanya wo kwita ku guhumeka, umuvuduko w'amaraso, no kugenzura ubushyuhe ku bana bavutse imburagihe bakira alprostadil. Hamwe n'ubwitange bukwiriye, abana bavutse imburagihe bashobora kungukira kuri uyu muti urokora ubuzima kimwe n'abana bavukiye igihe.

Nkwiriye gukora iki niba umwana wanjye asa n'ufite alprostadil nyinshi cyane?

Niba ubonye impinduka zidasanzwe ku mwana wawe mu gihe akira alprostadil, uhite ubimenyesha umuforomo cyangwa muganga w'umwana wawe. Ibimenyetso bishobora kukubabaza harimo kugorwa no guhumeka, impinduka zikomeye mu ibara ry'uruhu, cyangwa niba umwana wawe asa n'usinzira cyane cyangwa atitabira.

Wibuke ko umwana wawe akurikiranwa buri gihe n'abantu babihuguriwe bashobora guhindura umuti uko bikwiye. Itsinda ry’abaganga rifite gahunda zo gukemura ibibazo byose bishobora guterwa n'umuti.

Bikunda gute niba umwana wanjye acikanwe n'urugero rwa Alprostadil?

Alprostadil itangwa nk'urushinge rwa IV rukomeza, bityo akenshi nta “urugero rucikanwe” mu buryo busanzwe. Ariko, niba umurongo wa IV ucikanye cyangwa umuti ukeneye guhagarikwa by'agateganyo, abakozi b'ubuvuzi bazakora vuba kugira ngo bongere gutanga urushinge.

N'inteko ngufi muri alprostadil ishobora gutuma ductus arteriosus itangira gufunga, bishobora kuba byateza akaga ku bana bayishingiyeho. Ibi nibyo bituma umwana wawe akurikiranwa cyane kandi impamvu yo gushyiraho IV yunganira akenshi ishyirwaho.

Umwana wanjye ashobora kureka gufata alprostadil ryari?

Umwana wawe ashobora kureka kwakira alprostadil igihe indwara y'umutima ye yakize neza, akenshi binyuze mu kubagwa, cyangwa niba umutima we ukura bihagije kugira ngo ukore utagomba ductus arteriosus ifunguye. Igihe kiratandukanye cyane bitewe n'ubumuga bw'umutima bwihariye na gahunda yo kuvura.

Abana bamwe bashobora gucishwa alprostadil mu minsi mike nyuma yo kuyitangira, mu gihe abandi bashobora kuyikeneye mu byumweru cyangwa amezi. Umuganga w'umutima w'umwana wawe azagena igihe gikwiye hashingiwe ku isuzuma risanzwe ry'imikorere y'umutima w'umwana wawe n'ubuzima bwe muri rusange.

Ese Alprostadil izagira ingaruka ku mikurire y'umwana wanjye?

Iyo ikoreshejwe neza ku bibazo by'umutima biteye ubuzima bw'umwana akaga, alprostadil irashobora gufasha cyane mu mikurire y'umwana wawe kurusha uko yamugiraho ingaruka. Mu gihe cy'ingenzi, binyuze mu gutuma amaraso atembera neza no gutanga umwuka wa oxygen, umuti ufasha ubwonko n'imyanya y'umubiri gukura neza.

Abana benshi bakoresha alprostadil bakura neza, cyane cyane hamwe n'uburyo bwo kuvura umutima uyu muti utuma bishoboka. Ingaruka zose zishobora kuzagaragara mu gihe kirekire zikurwaho n'inyungu zo kurokora ubuzima bw'umwana n'imikorere y'umutima itunganye ituma bishoboka.