Chii chinonzi Amphotericin B: Zvinoshandiswa, Madosi, Migumisiro, nezvimwe

Amphotericin B mushonga une simba wekurwisa fungal unozivikanwa kurapa zvirwere zvakakomba, zvinotyisa hupenyu zvefungal. Mushonga uyu unoshanda nekurwisa masvingo emasero efungi, zvichivaputsa kuti vamise kupararira kwehutachiona. Kunyange zvazvo iri imwe yeanonyanya kushanda kurapwa kwakawanda kwezvirwere zvakakomba zvefungal, inoda kutariswa zvakanyanya nekuda kwesimba rayo uye migumisiro inogona kuitika.

Chii chinonzi Amphotericin B?

Amphotericin B mushonga weantifungal antibiotic vanachiremba vanoshandisa kurwisa zvirwere zvakakomba zvefungal mumuviri wako wose. Iyo ndeyechikamu chemishonga inonzi polyene antifungals, iyo inoshanda nekubatanidza kumembrane yesero refungal uye kugadzira maburi mazviri.

Mushonga uyu wave ibwe rekona rekurapa antifungal kwemakumi emakore. Inokosha zvikuru nokuti inogona kurapa zvirwere izvo mamwe mishonga yeantifungal ingasagona kubata zvakanaka.

Iwe unowanzo gamuchira amphotericin B kuburikidza neIV (intravenous) mutsara munzvimbo yechipatara. Mushonga uyu unouya mumhando dzakasiyana, kusanganisira conventional amphotericin B uye mhando itsva dzakavakirwa pamafuta dzinogona kukonzera migumisiro mishoma.

Chii chinonzi Amphotericin B chinoshandiswa?

Amphotericin B inorapa zvirwere zvakakomba zvefungal zvinogona kuva zvinotyisa hupenyu kana zvikasabatwa. Zvirwere izvi zvinowanzoitika muvanhu vane immune system dzakaderera, kunyange zvazvo dzimwe nguva dzinogona kukanganisa vanhu vane utano zvakare.

Heano mamiriro makuru anobatsira mushonga uyu kurapa, kubva kune akajairika kusvika kune zvirwere zvisingawanzoonekwi:

• Candidiasis yesisitimu (kana zvirwere zvembiriso zvichipararira mumuviri wako wese)
• Aspergillosis (zvirwere zvemapapu zvinokonzerwa nemafungi eAspergillus)
• Cryptococcal meningitis (chirwere chehuropi chakakomba)
• Histoplasmosis (chirwere chinowanzoita mapapu)
• Blastomycosis (chirwere chemapapu chinogona kupararira kune zvimwe zvikamu zvemuviri)
• Coccidioidomycosis (fivha yeValley inova yakakomba)
• Mucormycosis (chirwere chefungal chisingawanzoitiki asi chine hukasha)
• Leishmaniasis (chirwere cheparasitic, kunyangwe ichi chiri kushandiswa kunze kwemutemo)

Chiremba wako achasarudza kana amphotericin B yakakodzera mamiriro ako chaiwo zvichienderana nerudzi rwechirwere, hutano hwako hwese, uye kuti ungashandisa sei kurapa.

Amphotericin B Inoshanda Sei?

Amphotericin B inoshanda nekunangana nechinhu chakati wandei mumadziro emasero efungal anonzi ergosterol. Funga nezve ergosterol sechivakwa chakakosha chinochengetedza masero efungal akazara uye achishanda nemazvo.

Kana amphotericin B ikasungirirwa ku ergosterol, inogadzira mapores kana maburi mumembrane yesero refungal. Izvi zvinokanganisa kugona kwesero kuchengetedza nharaunda yayo yemukati, zvichikonzera kuti zvinhu zvakakosha zvitonhore uye pakupedzisira kuuraya fungi.

Izvi zvinoonekwa semushonga wakaoma kwazvo weantifungal. Inowanzozivikanwa se "gold standard" yekurapa zvirwere zvakakomba zvefungal nekuda kwekushanda kwayo kwakawanda pamhando dzakawanda dzemafungi akasiyana.

Mushonga uyu unogonawo kukanganisa masero evanhu kusvika padanho rakati, ndosaka uchikwanisa kukonzera mhedzisiro. Zvisinei, fungi inonyanya kunzwira tsitsi amphotericin B kupfuura masero evanhu, zvichiita kuti ive sarudzo inoshanda yekurapa pasinei nekunetsekana uku.

Ndingatora Sei Amphotericin B?

Uchagamuchira amphotericin B kuburikidza nemutsara weIV, kazhinji muchipatara kana nzvimbo yekurapa yakakosha. Mushonga uyu unosanganiswa nemhinduro yakachena uye inopiwa zvishoma nezvishoma kwemaawa akati wandei kuderedza mhedzisiro.

Mberi kwekuiswa kwega kwega, chikwata chako chehutano chinogona kukupa mishonga yekubatsira kudzivirira maitiro. Izvi zvinogona kusanganisira acetaminophen (Tylenol) yekupisa, antihistamines senge diphenhydramine (Benadryl) yekuita allergic, uye dzimwe nguva corticosteroids kuderedza kuzvimba.

Maitiro ekuiswa anowanzo tora maawa 4 kusvika ku6, kunyangwe izvi zvichigona kusiyana zvichienderana neiyo chaiyo formulation yako uye dose. Chikwata chako chekurapa chichakutarisa zvakanyanya panguva ino, chichitarisa zviratidzo zvako zvakakosha uye kucherechedza chero maitiro anokanganisa.

Haufanire kunetseka nezve zvirambidzo zvekudya neamphotericin B sezvo ichipiwa zvakananga muropa rako. Zvisinei, kugara uine mvura yakawanda kwakakosha, saka chikwata chako chehutano chinogona kukupa mvura yakawanda pamberi kana panguva yekurapa.

Ndingatora Amphotericin B kwenguva yakareba sei?

Kureba kwekurapa kweamphotericin B kunosiyana zvakanyanya zvichienderana nehutachiona hwako chaihwo uye kuti unopindura sei kumushonga. Vanhu vazhinji vanogamuchira kurapwa kwemavhiki akati wandei kusvika kumwedzi.

Kune dzimwe hutachiona senge systemic candidiasis, unogona kuda kurapwa kwemavhiki 2 kusvika ku6. Hutachiona hwakaoma senge cryptococcal meningitis hunogona kuda mwedzi yakati wandei yekurapa, kazhinji kutanga neamphotericin B wobva watsvaga mishonga yemuromo antifungal.

Chiremba wako achatarisa kufambira mberi kwako kuburikidza nekuongororwa kweropa nguva dzose uye zvidzidzo zvekufungidzira. Vachatsvaga zviratidzo zvekuti hutachiona huri kubviswa vachitarisawo kuti itsvo dzako nemamwe nhengo dziri kubata mishonga zvakanaka.

Huwandu hweamphotericin B yaunogamuchira inowanzo verengwa zvichienderana nehuremu hwako uye hutachiona chaihwo huri kurapwa. Chikwata chako chehutano chichagadzirisa chirongwa chekurapa sezvinodiwa zvichienderana nekupindura kwako uye chero mhedzisiro yaunosangana nayo.

Ndezvipi Zvakaipa zveAmphotericin B?

Amphotericin B inogona kukonzera matambudziko, kunyange vanhu vazhinji vachigona kuita zvakanaka nekutarisa kwakakodzera nekutarisirwa kunotsigira. Kunzwisisa zvaunofanira kutarisira kunogona kukubatsira kuti unzwe wakagadzirira kurapwa.

Heano matambudziko akajairika aunogona kusangana nawo panguva kana mushure mekurapwa:

• Fivha nekutonhora (kazhinji zvinoitika panguva yekutanga infusions)
• Muviri nekutsvuka
• Kutemwa nemusoro
• Kurwadziwa kwemhasuru nemajoini
• Kuderera kweropa
• Kuchinja mukushanda kweitsvo (chiremba wako achatarisa izvi zvakanyanya)
• Kuderera kwe potassium kana magnesium mumuviri wako
• Anemia (kuwanda kwemaseru matsvuku eropa)

Vamwe vanhu vanogona kusangana nematambudziko akakomba asi asingawanzoitiki anoda kutariswa kwekurapa nekukurumidza:

• Kusagadzikana kwakanyanya kwemuviri nekufema kwakaoma kana kuzvimba
• Matambudziko makuru eitsvo
• Kurova kwemoyo kusingaite
• Kusagadzikana kwakanyanya kwe electrolyte
• Matambudziko ekunzwa kana kurira munzeve
• Kutapukirwa (kusingawanzoitiki asi kunogoneka)

Chikwata chako chekurapa chichatora matanho ekuderedza matambudziko aya uye chichakutarisa zvakanyanya panguva yekurapwa. Matambudziko mazhinji anogona kubatwa zvakanaka nemishonga inotsigira uye kutarisisa pedyo.

Ndiani Asingafaniri Kutora Amphotericin B?

Nepo amphotericin B ichiwanzodiwa kune zvirwere zvakakomba zvefungal, vanhu vakati wandei vanoda kungwarira zvakanyanya kana vangave vasiri vakanaka vekurapwa uku. Chiremba wako achanyatso kuyera mabhenefiti achipesana nenjodzi mumamiriro ako chaiwo.

Vanhu vanowanzo kuda kufunga kwakakosha kana mamwe marapirwo anosanganisira:

• Avo vane chirwere chakakomba cheitsvo (mushonga uyu unogona kuwedzera kushanda kweitsvo)
• Vanhu vane matambudziko akakomba echiropa
• Vanhu vane mamwe mamiriro emoyo kana kurova kwemoyo kusingaite zvakanaka
• Avo vakambove nemaitiro akakomba ekurwara neamphotericin B munguva yakapfuura
• Vanhu vane kusagadzikana kwakakomba kweelectrolyte kusingagoni kugadziriswa
• Vanhu vane matambudziko ekunzwa (mushonga uyu unogona kuwedzera kurasikirwa kwekunzwa)

Kuzvitakura nekuyamwisa zvinoda kufunga kwakakosha, kunyangwe amphotericin B ichiri kushandiswa kana hutachiona huchikonzera njodzi yakakura kupfuura mushonga. Chiremba wako achakurukura izvi newe kana zvichikushanda iwe.

Mazita eAmphotericin B Brand

Amphotericin B inowanikwa pasi pemazita akati wandei emhando, imwe neimwe ichimiririra mafomu akasiyana emushonga. Musiyano mukuru uri mukuti mushonga unogadzirwa sei uye unotumirwa sei kuderedza mhedzisiro.

Fomu yechinyakare inowanzonzi Fungizone, nepo mafomu matsva akavakirwa pamafuta anosanganisira AmBisome (liposomal amphotericin B), Abelcet (amphotericin B lipid complex), uye Amphotec (amphotericin B colloidal dispersion). Aya mafomu emafuta akagadzirirwa kuva anonyoro paitsvo dzako uchichengetedza kushanda kwavo kurwisa hutachiona hwefungal.

Chiremba wako achasarudza fomu yakakodzera zvichienderana nehutachiona hwako, kushanda kweitsvo, uye hutano hwako hwese. Mafomu matsva anowanzo sarudzwa kana zvichibvira nekuda kwekuvandudzwa kwavo kwakachengeteka.

Zvimwe Zvinotsiva Amphotericin B

Mishonga yakati wandei inotsiva antifungal inogona kushandiswa panzvimbo peamphotericin B kana pamwe chete nayo, zvichienderana nehutachiona hwako uye mamiriro ako ezvinhu. Zvimwe zvinotsiva izvi zvinogona kusarudzwa kana usingakwanise kutsungirira amphotericin B kana kana zvakakodzera mamiriro ako chaiwo.

Zvimwe zvinotsiva zvinosanganisira fluconazole (Diflucan) yezvimwe zvirwere zvembiriso, voriconazole (Vfend) yeaspergillosis, uye mishonga mitsva yakaita se isavuconazole (Cresemba) kana posaconazole (Noxafil) yezvirwere zvakasiyana-siyana zvefungus.

Zvimwe zvirwere zvinogona kurapwa nekubatanidzwa kwekurapa, vachishandisa amphotericin B pamwe chete nemamwe antifungals senge flucytosine. Chiremba wako achasarudza nzira yakanakisa zvichienderana nefungus chaiyo inokonzera hutachiona hwako uye mamiriro ako ehutano ega.

Ko Amphotericin B Ari Nani Kudarika Fluconazole?

Amphotericin B ne fluconazole vanoshanda mabasa akasiyana mukurapa antifungal, uye hapana kana imwe iri yakanaka kupfuura imwe. Sarudzo inoenderana nehutachiona hwako chaihwo, kuoma kwayo, uye zvinhu zvako zvehutano.

Amphotericin B inowanzo chengeterwa zvirwere zvakanyanya, zvinotyisa hupenyu kana kana mamwe antifungals asina kushanda. Yakakura mukuita kwayo pamusoro pemafungi akasiyana uye inowanzo shandiswa kune zvirwere zvinodzivisa mamwe mishonga.

Fluconazole inowanzo shandiswa kune zvirwere zvisina kuoma kana sekurapa kwekuchengetedza mushure mekurapwa kwekutanga nemishonga yakasimba. Zviri nyore kutora (inowanikwa semapiritsi), ine mashoma mativi, uye inoshanda zvakanaka kune mhando dzakasiyana dzezvirwere zvefungus senge dzimwe mhando dzeCandida.

Chiremba wako achasarudza mushonga unoenderana nemamiriro ako chaiwo, dzimwe nguva achitanga ne amphotericin B yezvirwere zvakakomba uye obva achinja kufluconazole yekurapa kwenguva refu.

Mibvunzo Inowanzo Bvunzwa Nezve Amphotericin B

Mubvunzo 1. Ko Amphotericin B Akachengeteka Kune Vanhu vane Chirwere cheItsvo?

Amphotericin B inogona kukanganisa basa reitsvo, saka vanhu vane chirwere cheitsvo vanoda kunyatsotariswa. Chiremba wako achayerera kuoma kwehutachiona hwako hwefungus pamusoro penjodzi dzinogona kuitika kune itsvo dzako.

Kana uine matambudziko eitsvo, chiremba wako angasarudza mushonga weamphotericin B wakavakirwa pamagadzirirwo emafuta, uyo unowanzoita munyoro kune itsvo. Vachatarisawo kushanda kweitsvo yako zvakanyanya nekuongororwa kweropa nguva dzose uye vanogona kuchinja mushonga wako kana kupa mvura yakawanda kudzivirira itsvo dzako.

Q2. Ndingaita Sei Kana Ndikawana Amphotericin B Yakawandisa Netsaona?

Sezvo amphotericin B ichipiwa nenyanzvi dzehutano munzvimbo yekurapa, kuwandisa netsaona hakusi kwakajairika. Zvisinei, kana uine zviratidzo zvakakomba panguva kana mushure mekuiswa, udza timu yako yehutano nekukasira.

Zviratidzo zvekurapa kwakawanda zvinogona kusanganisira kusvotwa kwakanyanya, kurutsa, matambudziko eitsvo, kana shanduko dzinotyisa mumazinga ako e-electrolyte. Chikwata chako chekurapa chichakutarisa zvakanyanya uye chichapa rutsigiro rwekuchengeta kuti ubate chero matambudziko anomuka.

Q3. Ndingaita Sei Kana Ndikakanganwa Mushonga weAmphotericin B?

Sezvo amphotericin B ichipiwa muchipatara kana nzvimbo yekurapa, kukanganwa mushonga kazhinji zvinoreva kuronga zvakare musangano wako. Bata timu yako yehutano nekukasira kuti urongezve kuisa kwako.

Zvakakosha kuti usapfuure mishonga, sezvo izvi zvinogona kubvumira hutachiona hwefungal kuti huwedzere kana kuti hugone kukudziridza kuramba mushonga. Chiremba wako angada kugadzirisa chirongwa chako chekurapa zvichienderana nekuti gap raive rakareba sei pakati pemishonga.

Q4. Ndingamira Rini Kutora Amphotericin B?

Unofanira kungomira kurapwa kweamphotericin B kana chiremba wako achiona kuti zvakachengeteka kuita kudaro. Sarudzo iyi yakavakirwa pakuti hutachiona hwako huri kupindura sei kurapwa uye kuvandudzwa kwako kwese kwekiriniki.

Chiremba wako achashandisa bvunzo dzeropa, zvidzidzo zvekufungidzira, uye zviratidzo zvako kuti aone kana hutachiona hwakacheneswa zvakakwana. Kumira nekukurumidza kunogona kubvumira hutachiona kuti hudzoke, zvichibvira muchimiro chakakomba.

Q5. Ndingatora Mamwe Mishonga Ndichiri paAmphotericin B?

Mishonga yakawanda inogona kutorwa zvakachengeteka pamwe chete ne amphotericin B, asi dzimwe nzira dzekudyidzana dzinogoneka. Nguva dzose udza timu yako yehutano nezve mishonga yese, zvinowedzera, uye zvigadzirwa zvemiti zvauri kutora.

Dzimwe mishonga inokanganisa basa reitsvo kana mazinga e electrolyte inogona kuda kugadziriswa kwemadosi kana kuongororwa zvakanyanya kana ichishandiswa pamwe chete ne amphotericin B. Chikwata chako chekurapa chichaongorora runyorwa rwako rwemishonga rwese uye chigadzirise chero zvakakosha kuti uchengetedzwe panguva yekurapa.