Yini i-Bedaquiline: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokunye

I-Bedaquiline iyisibulala-magciwane esikhethekile esenzelwe ukulwa namagciwane e-tuberculosis (TB) angasabeli emithini ejwayelekile. Lo muthi usebenza ngendlela ehlukile kunemithi endala ye-TB ngokugxila ohlelweni olukhiqiza amandla ngaphakathi kwamagciwane e-TB, okwenza abulale amandla.

Ungase uhlangane ne-bedaquiline uma ubhekene ne-multidrug-resistant tuberculosis (MDR-TB) noma i-extensively drug-resistant tuberculosis (XDR-TB). Lezi yizinhlobo ezinzima ze-TB eziye zamelana nemithi ejwayelekile ye-TB, okwenza ukwelashwa kube yinselele enkulu futhi kudinga izindlela eziqinile, eziqondiswe kakhulu.

Isetshenziselwani i-Bedaquiline?

I-Bedaquiline iphatha i-multidrug-resistant pulmonary tuberculosis kubantu abadala kanye nezingane ezineminyaka engu-5 nangaphezulu. Lokhu kusho ukuthi iqondise izifo ze-TB emaphashini akho ezingasabelanga okungenani emithini emibili esebenza kahle kakhulu ye-TB yomugqa wokuqala njenge-isoniazid ne-rifampin.

Udokotela wakho uzonquma i-bedaquiline kuphela njengengxenye yokwelashwa okuhlanganisiwe, hhayi yodwa. Amagciwane e-TB ahlakaniphile futhi angakwazi ukuthuthukisa ukumelana ngokushesha, ngakho ukusebenzisa imithi eminingi ndawonye kuvimbela amagciwane ukuthi angakhohlisi noma yimuphi umuthi owodwa. Le ndlela yokuhlanganisa inika umzimba wakho ithuba elingcono kakhulu lokuqeda ngokuphelele lesi sifo.

Lo muthi ugcinelwe ngokuqondile amacala lapho ezinye izinketho zokwelapha ziye zahluleka noma zingafaneleki. Ithimba lakho lezempilo lizobe lihlole amagciwane akho e-TB elabhorethri ukuze liqinisekise ukuthi ukwelashwa okujwayelekile ngeke kusebenze ngaphambi kokuncoma i-bedaquiline.

Isebenza Kanjani i-Bedaquiline?

I-Bedaquiline isebenza ngokuvimba i-ATP synthase, i-enzyme edingwa amagciwane e-TB ukuze akhiqize amandla. Cabanga ngayo njengokunqamula ukuhlinzekwa kwamandla efekthri - ngaphandle kwamandla, amagciwane ngeke akwazi ukusinda noma azale.

Lokhu kwenza i-bedaquiline ibe namandla kakhulu ngokuqeda amagciwane e-TB, kodwa akuyona imithi esebenza ngobusuku obubodwa. Lo muthi uhlala emzimbeni wakho isikhathi eside, uqhubeka nokulwa nokutheleleka ngisho naphakathi kwemithamo. Lokhu kuba khona isikhathi eside emzimbeni wakho kuyasiza ekwelapheni ukutheleleka futhi kuyinto udokotela wakho azoyibheka ngokucophelela.

Ngokungafani neminye imithi ye-TB ebulala amagciwane ngokushesha, i-bedaquiline isebenza kancane futhi ngokuqinile. Le ndlela enensayo ingasebenza kahle kakhulu ekulweni nezinhlobo ze-TB eziqinile, ezingazange zifunde ukusinda kwezinye izindlela zokwelapha.

Kufanele Ngiyithathe Kanjani I-Bedaquiline?

Thatha i-bedaquiline ngendlela udokotela wakho ayala ngayo, ngokuvamile kanye ngosuku ngakunye ngokudla. Umuthi umuncwa kangcono uma uthathwa nokudla, ngakho-ke ungakweqi ukudla ngaphambi komthamo wakho. Noma yisiphi isidlo esivamile sizosiza - awudingi lutho olukhethekile.

Gwinya amaphilisi wonke ngamanzi. Ungawachobozi, uwahlafune, noma uwaqhekeze, ngoba lokhu kungathinta indlela umuthi okhishwa ngayo emzimbeni wakho. Uma unenkinga yokugwinya amaphilisi, khuluma nomhlinzeki wakho wezempilo mayelana nezinye izindlela.

Zama ukuthatha umthamo wakho ngesikhathi esifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo emzimbeni wakho. Ukusetha isikhumbuzi sansuku zonke kungakusiza ukuthi uhlale uqhubeka, okubalulekile ekulweni i-TB engamelani ngempumelelo.

Kungenzeka ukuthi udokotela wakho uzokunikeza eminye imithi ye-TB kanye ne-bedaquiline. Thatha yonke ngendlela eyaqondiswa ngayo, ngisho noma uqala ukuzizwa ungcono. Ukuyeka ukwelashwa ngaphambi kwesikhathi kungavumela amagciwane e-TB ukuthi abuye futhi abe ngaphezulu kokumelana.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Bedaquiline?

Abantu abaningi bathatha i-bedaquiline amasonto angama-24 (cishe izinyanga eziyi-6), kodwa isikhathi sakho esiqondile sokwelashwa sincike esimweni sakho esithile. Udokotela wakho uzocabangela izinto ezinjengokuthi uqhubeka kanjani kahle nokwelashwa nokuthi yimiphi eminye imithi oyithathayo.

Amasonto amabili okuqala abaluleke kakhulu - uzothatha i-bedaquiline nsuku zonke ngalesi sikhathi ukuze wakhe ngokushesha amazinga asebenzayo emzimbeni wakho. Ngemuva kwalokho, udokotela wakho angase alungise imvamisa ngokuya ngokuthi wenza kanjani.

Ungayeki ukuthatha i-bedaquiline ngenxa yokuthi uzizwa ungcono. Amagciwane e-TB angacasha emzimbeni wakho futhi aphinde asebenze uma ukwelashwa kuyeka ngokushesha kakhulu. Ithimba lakho lokunakekelwa kwezempilo lizosebenzisa izivivinyo ezinjengezivivinyo ze-sputum kanye nemisebe ye-X yesifuba ukunquma ukuthi kuphephile nini ukuyeka.

Abanye abantu badinga izifundo zokwelashwa ezinde, ikakhulukazi uma i-TB yabo ibi kakhulu noma uma benezinye izimo zempilo ezithinta ukuphola. Udokotela wakho uzoqapha intuthuko yakho ngokucophelela futhi alungise uhlelo lwakho lokwelashwa njengoba kudingeka.

Yiziphi Imiphumela Eceleni ye-Bedaquiline?

Njengayo yonke imithi, i-bedaquiline ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Ukuqonda ukuthi okulindelekile kungakusiza ukuthi uzizwe ulungiseleleke kakhulu futhi wazi ukuthi ungaxhumana nini nomhlinzeki wakho wezempilo.

Imiphumela emibi evame kakhulu ongase uyibone ihlanganisa isicanucanu, ubuhlungu emalungeni, ikhanda, kanye nezinguquko ekunambithekeni noma iphunga lakho. Le miphumela ivame ukuba milde futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela imithi emasontweni ambalwa okuqala.

Nansi imiphumela emibi abantu abaningi abayitholayo ngesikhathi sokwelashwa:

• Isicanucanu nokukhathazeka kwesisu
• Ubuhlungu emalungeni noma izinhlungu zemisipha
• Amakhanda
• Isiyezi
• Ushintsho ekunambithekeni noma iphunga
• Ukukhathala noma ukuzizwa ukhathele
• Ukuqubuka kwesikhumba

Le miphumela emibi ejwayelekile ivamise ukulawuleka futhi ayidingi ukuyeka imithi. Kodwa-ke, ngaso sonke isikhathi yazisa ithimba lakho lokunakekelwa kwezempilo nganoma yiziphi izimpawu ozitholayo ukuze zikusize uzizwe ukhululekile.

Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezempilo ngokushesha. Lokhu kufaka phakathi izinkinga zesigqi senhliziyo, izinkinga ezinkulu zesibindi, noma izimpawu zokuphendula okubi komzimba okungathi sína.

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi lezi zimpawu ezikhathazayo:

• Ukushaya kwenhliziyo okungajwayelekile noma ubuhlungu besifuba
• Isicanucanu esibi, ukuhlanza, noma ukulahlekelwa isifiso sokudla
• Ukuphuzi kwesikhumba noma amehlo (i-jaundice)
• Umchamo omnyama noma izitulo eziphaphathekayo
• Ukukhathala okukhulu noma ubuthakathaka
• Ukuphefumula noma ukugwinya kanzima
• Ukuqubuka kwesikhumba okukhulu noma imihuzuko

Ithimba lakho lezempilo lizokuqapha ngokucophelela ngesikhathi sokwelashwa ngezivivinyo zegazi ezivamile nokuqapha kwenhliziyo. Lokhu kusiza ukubamba noma yiziphi izinkinga ezingaba khona ekuqaleni futhi kuqinisekisa ukuthi ukwelashwa kwakho kuhlala kuphephile futhi kuphumelela.

Ubani Ongafanele Athathwe i-Bedaquiline?

I-Bedaquiline ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ilungile yini kuwe. Abantu abanezimo zenhliziyo ezithile noma labo abathatha imithi ethile bangase badinge ezinye izindlela zokwelapha.

Akufanele uthathe i-bedaquiline uma unokungezwani komzimba okwaziwayo emuthini noma kunoma yiziphi izithako zawo. Udokotela wakho uzophinda aqaphele ngokuyincoma uma unezinkinga ezithile zokushaya kwenhliziyo noma uthatha imithi ethinta umsebenzi kagesi wenhliziyo yakho.

Umhlinzeki wakho wezempilo uzofuna ukwazi ngalezi zimo ngaphambi kokuncoma i-bedaquiline:

• Izinkinga zokushaya kwenhliziyo (arrhythmias)
• Isifo sesibindi noma ama-enzyme esibindi aphakeme
• Izinkinga zezinso
• Izinga eliphansi le-potassium, i-calcium, noma i-magnesium
• Umlando wokuhlaselwa yinhliziyo noma ukuhluleka kwenhliziyo
• Umlando womndeni wokufa okungazelelwe kwenhliziyo

Imithi ethile ingase ihlangane ngendlela eyingozi ne-bedaquiline, ikakhulukazi lezo ezithinta ukushaya kwenhliziyo noma umsebenzi wesibindi. Udokotela wakho uzobuyekeza yonke imithi yakho yamanje, okuhlanganisa imithi etholakala ngaphandle kwemvume kadokotela kanye nezithasiselo, ngaphambi kokuqala ukwelashwa.

Uma ukhulelwe noma uncelisa, udokotela wakho uzohlola ngokucophelela izinzuzo nezingozi. Ngenkathi ukwelapha i-TB kubalulekile kuwe nomntwana wakho, ukusetshenziswa kwe-bedaquiline ngesikhathi sokukhulelwa kudinga ukuqapha ngokucophelela nokucatshangelwa kwezinye izindlela.

Amagama Omkhiqizo we-Bedaquiline

I-Bedaquiline itholakala ngaphansi kwegama lomkhiqizo elithi Sirturo emazweni amaningi, okuhlanganisa ne-United States. Le yindlela ejwayelekile ozoyibona ngayo ibhalwe futhi ilebuliwe ekhemisi.

Amanye amazwe angase abe namagama omkhiqizo ahlukene noma izinhlobo ezivamile ezitholakalayo. Usokhemisi wakho angakusiza ukuthi uhlonze imithi yakho ethile futhi uqinisekise ukuthi uthola ifomula efanele.

Njalo hlola nomhlinzeki wakho wokunakekelwa kwezempilo noma usokhemisi uma unemibuzo mayelana nokubukeka noma ukulebula komuthi wakho. Kubalulekile ukuqinisekisa ukuthi uthatha ngqo lokho okubhalwe.

Ezinye izindlela ze-Bedaquiline

Uma i-bedaquiline ingakulungele, eminye imithi ingelapha i-TB emelana nemithi eminingi. Udokotela wakho angase acabange ngemithi efana ne-linezolid, clofazimine, noma ama-ejenti amasha afana ne-pretomanid, kuye ngohlobo lwakho oluthile lwe-TB kanye nesimo sempilo.

Ukukhetha enye indlela kuncike ezintweni eziningana, okuhlanganisa ukuthi yimiphi imithi amagciwane akho e-TB amelana nayo, ezinye izimo zakho zempilo, kanye nokusebenzisana okungase kube khona kwemithi. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nochwepheshe be-TB ukuze bathole inhlanganisela engcono kakhulu yesimo sakho.

Abanye abantu bangase basebenzise i-bedaquiline ngokuhlanganyela nalezi ezinye izindlela kunokuba yisithuthukisi. Umgomo uhlala ukudala uhlelo lokwelapha olungenzeka ukuthi luzokwelapha i-TB yakho ngenkathi kuncishiswa imiphumela emibi nezinkinga.

Izinqumo zokwelashwa ze-TB emelana nemithi ziyinkimbinkimbi futhi zenzelwe umuntu ngamunye. Udokotela wakho uzocabangela imiphumela yelabhorethri ekhombisa ukuthi yimiphi imithi esebenza ngokumelene nohlobo lwakho oluthile lwe-TB, umlando wakho wezokwelapha, nokuthi uyibekezelela kangakanani imithi ehlukene.

Ingabe i-Bedaquiline Ingcono Kunezinye Izidakamizwa ze-TB?

I-Bedaquiline akudingeki ukuthi "ingcono" kunezinye izidakamizwa ze-TB - isebenza ngenjongo ehlukile. Ngenkathi izidakamizwa ze-TB zomugqa wokuqala njenge-isoniazid ne-rifampin zisebenza kahle ezimweni eziningi ze-TB, i-bedaquiline iqondise ngqo izinhlobo ezingamelani ezingasabeli ekwelashweni okujwayelekile.

Nge-TB emelana nezidakamizwa eziningi, i-bedaquiline ikhombise izinzuzo ezinkulu ocwaningweni lwezempilo. Ingasiza ekufezeni amazinga aphezulu okuphulukiswa futhi ingavumela izifundo zokwelashwa ezimfushane uma isetshenziswa njengengxenye yokwelashwa okuhlanganisiwe.

Indlela yokusebenza eyingqayizivele yomuthi iwenza ube yigugu ekulweni namagciwane e-TB asele enqabe eminye imithi. Kodwa-ke, ngokuvamile igcinelwe amacala amelana ngenxa yezindleko zayo, imiphumela engemihle engaba khona, kanye nesidingo sokuqapha ngokucophelela.

Udokotela wakho uzokhetha imithi efanele kakhulu ngokusekelwe ohlotsheni lwakho oluthile lwe-TB, umlando wezokwelapha, kanye nezimo zomuntu ngamunye. Ukwelashwa okungcono kakhulu yilelo eliphulukisa i-TB yakho ngokuphepha nangempumelelo.

Imibuzo Evame Ukubuzwa Mayelana ne-Bedaquiline

Ingabe i-Bedaquiline iphephile kubantu abanezifo zenhliziyo?

I-Bedaquiline idinga ukucatshangelwa ngokucophelela kubantu abanezifo zenhliziyo ngoba ingathinta ukushaya kwenhliziyo. Udokotela wakho uzohlola isimo senhliziyo yakho, abuke imithi yakho, futhi angayala ukuqapha okwengeziwe kwenhliziyo ngaphambi nangemva kokwelashwa.

Uma unesifo senhliziyo, ithimba lakho lezempilo cishe lizokwenza i-electrocardiogram (ECG) ngaphambi kokuqala i-bedaquiline futhi liqaphe inhliziyo yakho njalo ngesikhathi sokwelashwa. Bazophinda bahlole amazinga egazi lakho e-potassium, i-calcium, ne-magnesium, njengoba ukungalingani kungakhuphula izingozi zokushaya kwenhliziyo.

Abantu abaningi abanezimo zenhliziyo bangathatha i-bedaquiline ngokuphepha ngokuqapha okufanele. Udokotela wakho uzokala izingozi ezinkulu ze-TB engalashwanga emelana nezidakamizwa ngokumelene nemiphumela engemihle engaba khona ehlobene nenhliziyo yomuthi.

Ngingenzani uma ngiphuzile i-Bedaquiline eningi ngengozi?

Uma ngabe uthatha i-bedaquiline eningi ngengozi kunaleyo oyinikiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ungalindi ukubona ukuthi uzizwa yini izimpawu, njengoba ukweqisa kwe-bedaquiline kungabangela izinkinga ezinkulu zokushaya kwenhliziyo.

Yiya egumbini eliphuthumayo uma uba nobuhlungu besifuba, ukushaya kwenhliziyo okungajwayelekile, isiyezi esikhulu, noma ukuquleka ngemuva kokuthatha imithi eningi kakhulu. Letha ibhodlela lakho lemithi nawe ukuze abahlinzeki bezempilo bazi kahle ukuthi uthathe ini nokuthi uthathe malini.

Ukuvimbela ukweqisa ngengozi, gcina i-bedaquiline esitsheni sayo sokuqala esinelebula ecacile. Cabangela ukusebenzisa umhleli wamaphilisi noma ukusetha izikhumbuzi ukukusiza ukhumbule ukuthi usuvele uthathe umthamo wakho wansuku zonke.

Kufanele Ngenzeni Uma Ngeqe Umthamo We-Bedaquiline?

Uma weqa umthamo we-bedaquiline, uyithathe ngokushesha lapho ukhumbula, kodwa kuphela uma kungaphakathi kwamahora angu-6 esikhathi sakho esihleliwe. Uma sekudlule amahora angaphezu kwangu-6, weqa umthamo owuqeqile bese uthatha umthamo wakho olandelayo ngesikhathi esijwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo owuqeqile. Lokhu kungakhuphula ingozi yakho yemiphumela emibi, ikakhulukazi izinkinga zokushaya kwenhliziyo. Esikhundleni salokho, qhubeka nesimiso sakho sokulinganisa esijwayelekile.

Uma uvame ukukhohlwa imithamo, khuluma nomhlinzeki wakho wezempilo mayelana namaqhinga okukusiza ukhumbule. Ukulinganisa okuqhubekayo kubalulekile ekulweni i-TB engamelani ngempumelelo nokuvimbela amagciwane ukuthi angabi ngaphezu kwalokho.

Ngingayeka Nini Ukuthatha I-Bedaquiline?

Ungayeka ukuthatha i-bedaquiline kuphela uma udokotela wakho ekutshela ukuthi kuphephile ukwenza kanjalo. Lesi sinqumo sisekelwe ekuhlolweni kwelebhu, ezifundweni zokucabanga, kanye nokuphendula kwakho komtholampilo ekwelashweni, hhayi nje ekutheni uzizwa kanjani.

Ithimba lakho lezempilo lizogada amasiko akho e-sputum, ama-X-ray esifuba, nezinye izivivinyo ukuze linqume ukuthi ukutheleleka kwakho nge-TB kuphathwa nini ngokugcwele. Ukuyeka ngokushesha kungavumela amagciwane ukuthi abuye futhi abe ngaphezu kwalokho ekwelashweni.

Noma ngemva kokuyeka i-bedaquiline, cishe uzoqhubeka neminye imithi ye-TB kanye nokuqokwa okuvamile kokulandela. Udokotela wakho uzofuna ukuqinisekisa ukuthi ukutheleleka akubuyi nokuthi ufinyelele ukuphulukiswa okuphelele.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Bedaquiline?

Kungcono ukugwema utshwala ngenkathi uthatha i-bedaquiline, njengoba kokubili kungathinta isibindi sakho nomsebenzi wenhliziyo. Utshwala bungakhuphula ingozi yakho yezinkinga zesibindi futhi bungaphazamisa indlela umzimba wakho osebenza ngayo ngemithi.

Uma ukhetha ukuphuza ngezikhathi ezithile, xoxa ngalokhu nomhlinzeki wakho wezempilo kuqala. Bangakunikeza iseluleko ngokusekelwe esimweni sakho sempilo esiqondile kanye neminye imithi oyithathayo.

Khumbula ukuthi isibindi sakho sesivele sisebenza kanzima ukucubungula i-bedaquiline neminye imithi ye-TB. Ukwengeza utshwala emxube kungabeka ingcindezi eyengeziwe kulesi sitho esibalulekile futhi kungaphazamisa ukusebenza kahle kokwelashwa kwakho.