Chii chinonzi Rasburicase: Zvayakashandiswa, Madosi, Migumisiro Yemuviri, nezvimwe zvakawanda

Rasburicase mushonga wakakosha unopiwa kuburikidza neIV kubatsira muviri wako kubata mazinga ane njodzi e uric acid. Iri enzyme rine simba rinoshanda semubatsiri akatarwa, richiputsa uric acid kana itsvo dzako dzisingakwanisi kuchengeta nekufashukira kamwe kamwe kunoitika panguva yekurapa kenza.

Iwe unowanzo shandisa mushonga uyu muzvipatara, uko zvikwata zvehutano zvinou shandisa kudzivirira matambudziko akakomba. Funga nezvazvo semabhureki ekukurumidza emazinga e uric acid emuviri wako kana achityisidzira kubuda munjodzi.

Chii chinonzi Rasburicase?

Rasburicase i enzyme yakagadzirwa murabhoritari inoputsa uric acid muropa rako. Iyo inonyanya kuve vhezheni yekugadzira ye enzyme inonzi uricase, iyo vanhu vasina zvakasikwa asi mamwe mamalia anayo.

Mushonga uyu ndewechikamu chinonzi uric acid-specific enzymes. Kusiyana nemishonga inongovharisa kugadzirwa kwe uric acid, rasburicase inonyatso paradza uric acid yatove ichitenderera muropa rako. Inoshanda nekukurumidza kupfuura kurapwa kwechinyakare, kazhinji ichiratidza mhedzisiro mukati meawa panzvimbo pemazuva.

Mushonga uyu unouya semupfu uyo unosanganiswa nemvura yakachena uye unopiwa kuburikidza neIV line. Chikwata chako chehutano chinogara chichigadzirira uye chichipa mushonga uyu munzvimbo yakadzorwa yechipatara.

Rasburicase Inoshandiswa Kuti Chii?

Rasburicase inorapa uye inodzivirira tumor lysis syndrome, mamiriro akakomba anogona kuitika panguva yekurapa kenza. Kana maseru ekenza achifa nekukurumidza panguva ye chemotherapy kana radiation, anoburitsa huwandu hukuru hwe uric acid muropa rako.

Itsvo dzako dzinowanzo sefa uric acid, asi dzinogona kuwandirwa kana kurapwa kenza kukonzera kufa kwemasero kamwe kamwe. Iyi mafashama e uric acid inogona kuumba makristasi mutsvo dzako, zvichikonzera kukuvadzwa kwetsvo kana kukundikana.

Mushonga uyu unowanzo shandiswa zvakanyanya kuvanhu vari kurapwa kenza yeropa yakaita se leukemia, lymphoma, kana multiple myeloma. Zvisinei, vanachiremba vanogonawo kuushandisa kumaviri akasimba kana paine njodzi huru ye tumor lysis syndrome.

Vamwe varwere vanogamuchira rasburicase sekudzivirira vasati vatanga kurapwa kenza, nepo vamwe vachiigamuchira mushure mekunge mazinga e uric acid atove akwira zvakanyanya. Chiremba wako weoncologist achasarudza nguva yakanakisa zvichienderana nemamiriro ako chaiwo uye njodzi.

Rasburicase Inoshanda Sei?

Rasburicase inoshanda nekushandura uric acid kuita compound inonzi allantoin, iyo itsvo dzako dzinogona kubvisa nyore nyore. Iyi nzira inoitika nekukurumidza uye nemazvo, kazhinji ichideredza mazinga e uric acid mukati me4 kusvika kumaawa makumi maviri nemana.

Uyu mushonga une simba unoshanda nekukurumidza kupfuura kurapwa kwe uric acid kwetsika. Nepo mishonga yakaita se allopurinol ichidzivirira kuumbwa kutsva kwe uric acid, rasburicase inoparadza zvakananga uric acid iripo mumuviri wako.

Enzyme inonyanya kutarisisa uric acid molecules, ichidzivisa pasi kuburikidza nekuita kunonzi oxidation. Allantoin inobuda inenge 5 kusvika gumi nguva yakawanda-inonyungudika mumvura kupfuura uric acid, zvichiita kuti zvive nyore kuti itsvo dzako dzibvise.

Kana mushonga wabvisa kuwanda kwe uric acid kunotyisa, itsvo dzako dzinogona kudzokera kubasa radzo rakajairika. Enzyme pachayo inoputsika uye inobviswa mumuviri wako mukati memazuva mashoma.

Ndingatora Sei Rasburicase?

Iwe uchagamuchira rasburicase chete munzvimbo yechipatara kuburikidza ne IV line, kwete semushonga waunotora kumba. Chikwata chehutano chichaisa catheter diki mutsinga, kazhinji muruoko rwako kana ruoko, uye chichapa mushonga se infusion inononoka.

Infusion inowanzo tora maminitsi makumi matatu kuti apedze. Iwe uchafanirwa kugara wakanyarara panguva ino, asi unogona kuverenga, kuona TV, kana kutaura nevashanyi. Vashandi vekuchengetwa vachakutarisa zvakanyanya panguva yese yekushanda.

Hapana chikonzero chekutsanya usati wapiwa rasburicase, uye unogona kudya zvakajairika mushure meizvozvo. Zvisinei, kugara uine mvura yakakwana kwakakosha, saka timu yako yehutano inogona kukukurudzira kuti unwe mvura yakawanda kana kuwana mamwe mvura yeIV.

Chirongwa chemushonga chinotsamira pamamiriro ako chaiwo. Vamwe vanhu vanogamuchira dose imwe chete, nepo vamwe vachigona kuwana madosi ezuva nezuva kwemazuva akati wandei. Oncologist wako achagadzira chirongwa chakagadzirirwa iwe zvichibva pamazinga ako e uric acid uye chirongwa chekurapa kenza.

Ndingatora Rasburicase Kwenguva Yakareba Sei?

Vanhu vazhinji vanogamuchira rasburicase kwemazuva 1 kusvika ku5, zvichienderana nekuti mazinga avo e uric acid anodzoka nekukurumidza sei kumatanho akachengeteka. Timu yako yehutano ichatarisa mazinga ako eropa zuva nezuva kuti uone kuti zvakachengeteka kurega rini.

Kureba kwekurapa kunoenderana nezvinhu zvakati wandei, kusanganisira mazinga ako ekutanga e uric acid, basa reitsvo, uye kuti unopindura sei kumushonga. Vamwe varwere vanoda dose imwe chete, nepo vamwe vachida mazuva akati wandei ekurapa.

Chiremba wako acharayira bvunzo dzeropa dzenguva dzose kuti vatarise mazinga ako e uric acid, basa reitsvo, uye mamwe mamaki akakosha. Kana mazinga ako agadzika munzvimbo yakachengeteka uye akagara ipapo, iwe hauzodi mamwe madosi.

Kana uri kugamuchira kurapwa kwekenza kuri kuenderera mberi, timu yako yehutano inogona kukupa rasburicase zvakare kana mazinga ako e uric acid akava nenjodzi panguva yezvikamu zveramangwana zvekutapwa.

Ndezvipi Zvipingamupinyi zveRasburicase?

Semishonga yese, rasburicase inogona kukonzera mhedzisiro, kunyangwe vanhu vazhinji vachizvitsungirira zvakanaka kana vakapiwa munzvimbo yechipatara. Timu yako yehutano ichakutarisa zvakanyanya kune chero maitiro panguva uye mushure mekuiswa.

Heano mhedzisiro yakajairika yaungasangana nayo:

• Kutemwa nemusoro kana kurutsa, izvo zvinowanzoita zvakanaka kumishonga inodzivirira kurutsa
• Kutemwa nemusoro kunowanzoita kupfava uye kwenguva pfupi
• Fivha kana kutonhora, kunyanya mukati memaawa mashoma ekutanga mushure mekuiswa
• Manyoka kana kuvharika, kazhinji zvine chekuita nemimwe mishonga yaunogamuchira
• Kuneta kana kunzwa kuneta kupfuura zvakajairika
• Mavanga emuviri akapfava kana kukwenya panzvimbo yeIV

Izvi zvinowanzoitika zvinowanzoenda zvega kana nemishonga iri nyore. Chikwata chako chekuchengeta vanamukoti chinoziva maitiro ekugadzirisa izvi uye chichakuchengeta uchigadzikana mukati mekurapwa kwako.

Zvimwe zvinokuvadza zvakanyanya hazviwanzoitiki asi zvinoda kutariswa kwekurapa nekukurumidza. Chikwata chako chehutano chichatarisa izvi zvakanyatso:

• Kusagadzikana kwakanyanya, kusanganisira kuoma kufema, kuzvimba kumeso kana pahuro, kana maitiro akakomba eganda
• Zviratidzo zvehemolysis (kuparara kwemasero matsvuku eropa), senge weti yakasviba, kuita yero yeganda kana maziso, kana kuneta kwakanyanya
• Methemoglobinemia, mamiriro asingawanzoitiki anokanganisa kutakura okisijeni muropa rako
• Matambudziko akakomba eitsvo, kunyangwe rasburicase inowanzo kubatsira kudzivirira izvi
• Kuchinja kwemoyo kana kurwadziwa muchipfuva

Izvi zvinokuvadza zvakanyanya hazviwanzoitiki, kunyanya kana mushonga ukapiwa nemazvo munzvimbo yechipatara. Chikwata chako chehutano chine ruzivo rwekuona nekugadzirisa matambudziko aya nekukurumidza kana akaitika.

Vamwe vanhu vanonzwa kushushikana pamusoro pekugamuchira mishonga yeIV, izvo zvakajairika zvachose. Chikwata chako chehutano chinogona kupa rutsigiro rwemanzwiro uye kupindura chero mibvunzo kuti ikubatsire kunzwa wakasununguka.

Ndiani Asingafaniri Kutora Rasburicase?

Rasburicase haina kukodzera munhu wese, uye chikwata chako chehutano chichanyatsoongorora nhoroondo yako yekurapa usati wairaira. Chinhu chakakosha chinopesana nemishonga imamiriro ejeni anonzi glucose-6-phosphate dehydrogenase (G6PD) kushomeka.

Vanhu vane G6PD kushaya vanotarisana nenjodzi huru yehemolysis yakakomba (kuparadzwa kwemasero matsvuku eropa) kana vakapiwa rasburicase. Iyi mamiriro ejeneti anokanganisa vanhu vanenge 1 kubva pa400, uye kazhinji kacho inowanikwa muvanhu vekuAfrica, Mediterranean, kana Middle Eastern descent.

Chiremba wako anogona kuraira bvunzo yeG6PD asati akupa rasburicase, kunyanya kana uine nhoroondo yemhuri yemamiriro aya kana kubva munharaunda ine njodzi yakakwirira. Iyi bvunzo yeropa iri nyore inogona kudzivirira matambudziko akakomba.

Zvimwe zviitiko uko vanachiremba vanoshandisa kungwarira kwakanyanya zvinosanganisira:

• Kare kuita allergic kwakanyanya kune rasburicase kana mishonga yakafanana
• Kuzvitakura, sezvo kuchengeteka kusina kumiswa zvizere kuvana vari kukura
• Kuyamwisa, sezvo zvisingazivikanwe kana mushonga unopinda mumukaka wemazamu
• Chirwere chemoyo chakakomba kana matambudziko erhythm
• Nhoroondo ye methemoglobinemia kana zvimwe zvirwere zveropa

Chikwata chako chehutano chichayerera mabhenefiti achipesana nenjodzi mumamiriro aya. Dzimwe nguva kudiwa nekukurumidza kudzivirira kukuvadzwa kwematsvo kubva kumazinga epamusoro e uric acid kunopfuura zvimwe zvinonetsa.

Mazita eRasburicase Brand

Rasburicase inowanikwa pasi pezita rekuti Elitek muUnited States. Iri ndiro zita remhando rinoshandiswa kazhinji raunosangana naro muzvipatara zvekuAmerica uye nzvimbo dzekenza.

Mune dzimwe nyika, unogona kuona mazita akasiyana emhando yemushonga mumwe chete. Semuenzaniso, inotengeswa seFasturtec muEurope nemimwe misika yepasi rose. Zvisinei, mushonga wacho pachake wakafanana zvisinei nezita remhando.

Zvimwe zvipatara zvinogona kungoti "rasburicase" panzvimbo yekushandisa zita remhando. Chikwata chako chehutano chichagara chichijekesa kuti ndeupi mushonga waunogamuchira uye kupindura chero mibvunzo pamusoro pechigadzirwa chaiyo chiri kushandiswa.

Rasburicase Zvimwe Zvinhu

Pane dzimwe nzira dzekurapa mazinga epamusoro e uric acid, asi hapana inoshanda nekukurumidza se rasburicase. Chikwata chako chehutano chichasarudza nzira yakanakisa zvichienderana nemamiriro ako chaiwo uye kukurumidza kwekurapa.

Allopurinol ndiyo imwe nzira yakajairika, kunyanya kudzivirira kuwanda kwe uric acid isati yatanga kurapwa kwekenza. Mushonga uyu unotorwa nemuromo unodzivisa kugadzirwa kwe uric acid asi zvinotora mazuva akati wandei kuti uone mhedzisiro yese, zvichiita kuti isakodzere mamiriro ekukurumidzira.

Febuxostat imwe nzira yekudzivirira inoshanda zvakafanana ne allopurinol asi inogona kugamuchirwa zviri nani nevamwe vanhu. Kufanana ne allopurinol, inodzivirira kugadzirwa kutsva kwe uric acid panzvimbo yekuparadza uric acid iripo.

Pakurapa nekukurumidza mazinga epamusoro e uric acid, dzimwe nzira dzinosanganisira:

• Kunyanya hydration nemvura ye IV kubatsira kubvisa uric acid kuburikidza neitsvo
• Alkalinization ye weti uchishandisa sodium bicarbonate kuti uric acid inyungudike
• Dialysis muzviitiko zvakakomba apo itsvo dzisiri kushanda nemazvo
• Nzira dzakabatanidzwa dzichishandisa mishonga yakawanda pamwe chete

Zvisinei, hapana imwe yeidzi nzira inoshanda nekukurumidza kana zvinobudirira se rasburicase mumamiriro ekukurumidzira. Oncologist wako achatsanangura nei rasburicase iri sarudzo yakanakisa yemamiriro ako chaiwo.

Ko Rasburicase Zviri Nani Pane Allopurinol Here?

Rasburicase uye allopurinol vanoshanda zvakasiyana, saka kuenzanisa kwavo kunoenderana nemamiriro ako chaiwo uye nguva yaunoda. Mishonga yese miviri isarudzo dzakanaka, asi inoshanda nenzira dzakasiyana zvachose.

Rasburicase inoshanda zvakanaka mumamiriro ekukurumidzira paunoda mhedzisiro nekukurumidza. Inogona kuderedza mazinga epamusoro e uric acid mukati memaawa, zvichikwanisa kudzivirira kukuvadzwa kweitsvo kana kukundikana. Izvi zvinoita kuti ive yakakosha panguva ye active tumor lysis syndrome kana kana kuedza kudzivirira kusina kukwana.

Allopurinol inoshanda zviri nani pakudzivirira uye manejimendi enguva refu. Inotorwa nemuromo, inodhura zvishoma, uye ine zvishoma zvinodzora kuti ndiani anogona kuishandisa. Vanhu vazhinji vanotora allopurinol kwemazuva kana mavhiki vasati vatanga kurapwa kenza kudzivirira kuwanda kweuric acid.

Sarudzo pakati pavo inowanzoenderana nenguva uye kukurumidza:

• Pekurapa kwechimbichimbi: Rasburicase inowanzoita nani nekuda kwekuita kwayo nekukurumidza
• Kudzivirira: Allopurinol inowanzo farirwa nekuda kwekunyaradza kwayo uye chimiro chekuchengeteka
• Kune manejimendi ari kuenderera mberi: Allopurinol inowanzoita mhinduro yenguva refu
• Kune vanhu vane G6PD kushomeka: Allopurinol ndiyo sarudzo yakachengeteka

Varwere vazhinji vanogashira mishonga yese miviri, vane allopurinol yekudzivirira uye rasburicase yekurapa kwekubuda kana zvichidikanwa. Chikwata chako chehutano chichagadzira nzira yakanakisa yemamiriro ako ega.

Mibvunzo Inowanzo Bvunzwa Nezve Rasburicase

Q1. Rasburicase Yakachengeteka Kune Vanhu vane Chirwere cheItsvo Here?

Rasburicase inowanzoita yakachengeteka kune vanhu vane chirwere cheitsvo uye inogona kubatsira kuchengetedza basa reitsvo. Mushonga unoshanda nekuderedza mazinga e uric acid, izvo zvinogona kudzivirira kumwe kukuvadzwa kweitsvo kubva kumakristasi e uric acid.

Zvisinei, vanhu vane chirwere cheitsvo chakakomba vanoda kuongororwa pedyo panguva yekurapa. Chikwata chako chehutano chichagadzirisa dosing uye chichatarisa bvunzo dzako dzebasa reitsvo zvakanyanya kuti uve nechokwadi chekuti mushonga uri kubatsira pane kukonzera kushushikana kwakawanda.

Mushonga unowanzo shandiswa kunyanya kudzivirira kukuvadzwa kweitsvo kune vanhu vari panjodzi huru. Nephrologist yako uye oncologist vachashanda pamwechete kuti vaone kana rasburicase yakakodzera padanho rako rebasa reitsvo.

Q2. Ndingaita Sei Kana Ndikagamuchira Rasburicase Yakawandisa Netsaona?

Sezvo rasburicase ichipiwa chete muzvipatara nevashandi vehutano vakadzidziswa, kuwandisa kwemishonga netsaona hakusi kwakajairika. Chikwata chako chehutano chinonyatsoverenga mishonga zvichienderana nehuremu hwako uye chinotarisa zvakanyanya infusion.

Kana uine hanya nekugamuchira mishonga yakawandisa, usazeza kubvunza mukoti wako kuti aongorore kaviri mushonga wako kana kutsanangura kuti vanouverenga sei. Zvikwata zveutano zvinogamuchira mibvunzo iyi sechikamu chetsika dzemishonga dzakachengeteka.

Muchiitiko chisingatarisirwi chekuwandisa kwemishonga, chikwata chako chehutano chaizopa rutsigiro rwekuchengetedza uye kukutarisa zvakanyanya kune chero matambudziko. Chipatara chine protocol yekugadzirisa zvikanganiso zvekurapa nekukurumidza uye zvakachengeteka.

Q3. Ndingaita Sei Kana Ndikakanganwa Madosi eRasburicase?

Kukanganwa mushonga hachisi chinhu chaunofanira kunetseka nacho iwe pachako sezvo rasburicase ichipiwa chete muzvipatara. Chikwata chako chehutano chinotarisira hurongwa hwese hwekurapa uye chichaita shuwa kuti unogamuchira kurapwa sezvakanyorwa.

Kana kurapwa kwako kukazengurwa nekuda kwenyaya dzekuronga kana zvimwe zvekutanga zvezvokurapa, chikwata chako chehutano chichagadzirisa nguva zvakakodzera. Ivo vachatarisa zvakare mazinga ako e uric acid kuti vaone kana mushonga wakazengurwa uchiri kudiwa.

Dzimwe nguva zvirongwa zvekurapa zvinoshanduka zvichienderana nekuti unopindura sei kumishonga yekutanga. Chikwata chako chingasarudza kuti mishonga mishoma inodiwa kana mazinga ako e uric acid akagadzikana nekukurumidza.

Q4. Ndingamira Rini Kutora Rasburicase?

Chikwata chako chehutano chichasarudza kuti ungamira rini rasburicase zvichienderana nemhedzisiro yako yebvunzo yeropa uye mamiriro ako ese. Vanhu vazhinji vanomira kugamuchira mushonga kana mazinga avo e uric acid adzokera kumatanho akachengeteka uye achiramba akagadzikana.

Sarudzo iyi inosanganisira kutarisisa zvinhu zvakati wandei, kusanganisira mazinga ako e uric acid, basa reitsvo, uye maitiro ako ekupindura kurapwa kwekenza. Chikwata chako chichatsanangura zvikonzero zvavo uye kukuchengeta uchiziva nezve chirongwa chekurapa.

Vamwe vanhu vanochinja kuenda kumishonga inotorwa nemuromo yakaita se allopurinol yekudzivirira kwenguva refu, asi vamwe vangasada kumwe kutarisirwa kwe uric acid. Mamiriro ako chaiwo achasarudza nzira yakanakisa yekufambira mberi.

Q5. Ndingagamuchira Rasburicase Kakawanda Here?

Hongu, unogona kugamuchira rasburicase kakawanda kana zvichidikanwa, kunyangwe timu yako yehutano ichakutarisa zvakanyanya kuti uone kana uine allergic reactions kana ukadzokorora kurapwa. Vamwe vanhu vanoda mamwe makosi panguva dzakasiyana dzekurapa kenza.

Nekurapwa kwega kwega kunotevera, pane njodzi yakati rebei yekuvandudza allergic reaction, saka timu yako ichakutarisa zvakanyanya. Vachafungawo kana dzimwe nzira dzingave dziri nani pakutarisira kwenguva refu.

Timu yako yehutano ichayerera mabhenefiti nenjodzi nguva imwe neimwe rasburicase ichifungwa, ichiita kuti ive sarudzo yakanakisa yemamiriro ako azvino.