Yini i-Cladribine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Cladribine iyimithi kadokotela esiza ukwelapha izinhlobo ezithile ze-multiple sclerosis ngokunciphisa umsebenzi wamaseli omzimba omelana nezifo ahlasela isimiso sakho sezinzwa. Kuyindlela yokwelapha eqondiwe esebenza ngendlela ehlukile kunezinye izindlela eziningi zokwelapha i-MS, enikeza ithemba kubantu abanezinhlobo eziphindayo zalesi simo.

Le mithi ingeyeqembu lezidakamizwa elibizwa ngokuthi ama-antimetabolites, okusho ukuthi iphazamisa indlela amanye amaseli akhula futhi azale ngayo. Ngenkathi lokho kungase kuzwakale kukhathaza, i-cladribine yakhelwe ngokucophelela ukuthi iqondise amaseli athile omzimba omelana nezifo anegalelo ezimpawini ze-MS ngenkathi ishiya iningi lamaseli akho anempilo yedwa.

Yini i-Cladribine Esetshenziselwa Yona?

I-Cladribine isetshenziselwa ikakhulukazi ukwelapha izinhlobo eziphindayo ze-multiple sclerosis kubantu abadala. Udokotela wakho angase ancome le mithi uma une-relapsing-remitting MS noma i-active secondary progressive MS, lapho izimpawu zakho ziza futhi zihambe ezigabeni.

I-Multiple sclerosis yenzeka lapho isimiso sakho somzimba sokuzivikela ekuguleni ngokungaqondile sihlasela ikhava evikela ezungeze izinzwa zakho. Lokhu kudala ukuvuvukala nokulimala okungabangela izimpawu ezinjengokukhathala, ubunzima bokuhamba, ukuba ndikindiki, nezinkinga zokuxhumana. I-Cladribine iyasiza ngokunciphisa inani lama-lymphocytes, okuyiwona maseli athile omzimba omelana nezifo abangela lokhu kulimala.

Imithi ngokuvamile igcinelwe abantu abane-MS esebenza kakhulu noma abangazange basabele kahle kwezinye izindlela zokwelapha. Umhlinzeki wakho wezempilo uzohlola ngokucophelela umlando wakho wezokwelapha nesimo sakho samanje ukuze anqume ukuthi i-cladribine iyindlela ekufanele yini.

Isebenza Kanjani I-Cladribine?

I-Cladribine isebenza ngokugxila nokunciphisa izinhlobo ezithile zamaseli amhlophe egazi abizwa ngokuthi ama-lymphocytes, ikakhulukazi ama-B cells nama-T cells anegalelo ekuvuvukeni kwe-MS. Cabanga ngayo njengomhleli okhethiwe osusa amaseli omzimba omelana nezifo anezinkinga ngenkathi eshiya iningi lomzimba wakho wokuzivikela ekuguleni ungalimalanga.

Uma uselapha umuthi, uguqulwa lube uhlobo olusebenzayo ngaphakathi kwala maseli aqondiwe. Lolu hlobo olusebenzayo luphazamisa ikhono lamaseli lokuzala nokusinda, okuholela ekunciphiseni okukhulu kodwa okwesikhashana kwamaseli omzimba alwa nezifo ahlasela uhlelo lwakho lwezinzwa.

Lokhu kuthathwa njengomuthi onamandla ngokulinganisela emkhakheni wokwelashwa kwe-MS. Unamandla kakhulu kunezinye izindlela zokwelapha zokuqala kodwa yakhelwe ukuhlinzeka ngezinzuzo eziqhubekayo ngezikhathi zokwelashwa ezimfushane. Imiphumela ingahlala izinyanga noma iminyaka ngemuva kokuqeda inkambo yokwelashwa.

Kufanele Ngiyithathe Kanjani I-Cladribine?

I-Cladribine iza ngamaphilisi owathatha ngomlomo, ngokuvamile ulandela isimiso esithile eminyakeni emibili. Udokotela wakho uzohlinzeka ngemiyalelo enemininingwane, kodwa iphethini ejwayelekile ihlanganisa ukuthatha umuthi izinsuku ezimbalwa ngamasonto athile, ngamagebe amade phakathi.

Kufanele uthathe amaphilisi e-cladribine esiswini esingenalutho, okungenani ihora elilodwa ngaphambi kokudla noma amahora amabili ngemuva kokudla. Gwinya amaphilisi wonke ngenkomishi yamanzi egcwele, futhi ungawachobozi, uwahlafune, noma uwaphule. Lokhu kusiza ukuqinisekisa ukuthi umuthi umuncwa kahle futhi usebenza njengoba kuhloswe.

Kubalulekile ukuphatha amaphilisi ngokucophelela futhi ugeze izandla zakho kahle ngaphambi nangemuva kokuwathatha. Uma iphilisi liphuka noma liqhekeka, ungathinti izingcezu ngqo. Kunalokho, sebenzisa amagilavu ​​noma indwangu emanzi ukuze uhlanze, njengoba umuthi ungasetshenziswa ngesikhumba sakho.

Umhlinzeki wakho wokunakekelwa kwezempilo cishe uzohlela ukuhlolwa kwegazi njalo ngaphambi nangemva kokwelashwa ukuze aqaphe ukubalwa kwamaseli akho egazi elimhlophe nempilo yonke. Lokhu kuqokwa kubalulekile ekuqinisekiseni ukuthi umuthi usebenza ngokuphepha nangempumelelo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Cladribine?

Inkambo ejwayelekile yokwelashwa nge-cladribine ihlanganisa iminyaka emibili, kodwa ngeke uphuze amaphilisi ngokuqhubekayo ngalesi sikhathi. Kunalokho, uzoba nezikhathi zokwelashwa ezithile ezilandelwa izikhawu ezinde ezingenamithi.

Ngokuvamile, uzothatha i-cladribine izinsuku eziyi-4-5 ngenyanga yokuqala, bese futhi izinsuku eziyi-4-5 ngenyanga yesibili yonyaka wokuqala. Unyaka wesibili ulandela iphethini efanayo, ngezikhathi zokwelashwa ezinyangeni ze-13 ne-14. Ngemva kokuqeda le nkambo yeminyaka emibili, abantu abaningi abadingi ukwelashwa okwengeziwe nge-cladribine iminyaka eminingi.

Izikhala ezinde phakathi kwezikhathi zokwelashwa zivumela amasosha akho omzimba ukuthi alulame ngenkathi kugcinwa imiphumela yokuvikela yomuthi ekubuyeleni emuva kwe-MS. Udokotela wakho uzoqapha isimo sakho ngaso sonke lesi sikhathi futhi anqume ukuthi ngabe udinga yikuphi ukwelashwa okwengeziwe esikhathini esizayo.

Abanye abantu bangase badinge ukulungisa isimiso sabo sokwelashwa ngokusekelwe emiphumeleni yokuhlolwa kwegazi noma ezinye izinto zempilo. Umhlinzeki wakho wezempilo uzosebenza nawe ukuthola isikhathi esiphephile nesisebenzayo esimweni sakho esithile.

Yiziphi Izimo Ezingezinhle Ze-Cladribine?

Njengayo yonke imithi, i-cladribine ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle. Imiphumela emibi evame kakhulu ngokuvamile imnene futhi ingalawuleka ngosizo olufanele lwezokwelapha.

Nansi imiphumela emibi ongase uyithole, ukhumbula ukuthi ithimba lakho lezempilo lizokuqapha eduze ngesikhathi sokwelashwa:

• Ukutheleleka kwepheshana eliphezulu lokuphefumula njengomkhuhlane noma izifo ze-sinus
• Ikhanda elingase lisuke libe mnene liye phakathi nendawo
• Ukuncipha kwamaseli amhlophe egazi, okuyingxenye yendlela umuthi osebenza ngayo
• Ukucanuzela kwenhliziyo noma ukungakhululeki kwesisu, ikakhulukazi uma uqala ukwelashwa
• Ukukhathala noma ukuzizwa ukhathele kunokujwayelekile
• Ukuqina kwezinwele noma ukulahleka kwezinwele okwesikhashana
• Ukuqubuka noma ukusabela kwesikhumba

Iningi lalezi zinto ezenzeka okwesikhashana futhi ziyalunga njengoba umzimba wakho ujwayela imithi noma ngemva kokuqeda ukwelashwa.

Kukhona ezinye izinto ezingathi sína kodwa ezingavamile ezingemihle ezidinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba lokhu kungavamile, kubalulekile ukukwazi ukuze ukwazi ukufuna usizo ngokushesha uma kudingeka:

• Ukutheleleka okukhulu ngenxa yokwehla kakhulu kwamaseli egazi amhlophe
• Ukuphuma kwegazi okungavamile noma ukulimala okungelapheki ngendlela ejwayelekile
• Umkhuhlane oqhubekayo noma izimpawu ezinjengomkhuhlane
• Ukungezwani komzimba okukhulu okunezinkinga zokuphefumula noma ukuvuvukala
• Izimpawu zezinkinga zesibindi njengokuba mthubi kwesikhumba noma umchamo omnyama
• I-Progressive multifocal leukoencephalopathy (PML), ukutheleleka kobuchopho okungavamile

Udokotela wakho uzoqhuba izivivinyo zegazi ezivamile ukuze abambe noma yiziphi izinguquko ezikhathazayo ekuqaleni, futhi kufanele uxhumane nabo ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo.

Ubani Ongafanele Athathe I-Cladribine?

I-Cladribine ayifanele wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Umuthi udinga isimiso somzimba esiqinile, esisebenzayo ukuze uqale, ngakho izimo ezithile zikwenza kungaphephile.

Akufanele uthathe i-cladribine uma unezifo ezithile ezisebenzayo, okuhlanganisa izifo ezingamahlalakhona njengomdlavuza wamathambo noma i-hepatitis. Isimiso sakho somzimba sidinga ukuba siphilile ngaphambi kokuqala ukwelashwa, njengoba umuthi uzokwehlisa okwesikhashana ikhono lakho lokulwa nezifo ezintsha.

Abantu abanezifo ezinzima zezinso noma zesibindi ngokuvamile abakwazi ukuthatha i-cladribine ngokuphepha. Umuthi ucubungulwa ngalezi zitho, futhi ukungasebenzi kahle kungaholela ekuqongeleleni okuyingozi komuthi emzimbeni wakho.

Ukukhulelwa nokuncelisa nazo izinto ezibalulekile okufanele zicatshangelwe. I-Cladribine ingalimaza izingane ezisakhula, ngakho-ke uzodinga ukusebenzisa izindlela zokuvimbela inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nezinyanga eziningana ngemuva kwalokho. Uma uhlela ukukhulelwa, xoxa ngezindlela zokwelapha i-MS ezingezinye nodokotela wakho.

Ngaphezu kwalokho, uma unomlando womdlavuza othile, ikakhulukazi imidlavuza yegazi, udokotela wakho uzodinga ukulinganisela izingozi nezinzuzo ngokucophelela ngaphambi kokuncoma i-cladribine.

Igama Lomkhiqizo we-Cladribine

Igama lomkhiqizo le-cladribine yomlomo yi-Mavenclad, ekhiqizwa yi-EMD Serono. Le yindlela ekhethekile evunyelwe ukwelapha i-multiple sclerosis futhi iza ngamaphilisi e-10mg.

Ungase futhi uzwe nge-cladribine esetshenziswa kwezinye izindlela zezinye izimo. Isibonelo, kukhona uhlobo olujovwayo olubizwa nge-Leustatin olusetshenziselwa ukwelapha imidlavuza ethile yegazi, kodwa lokhu kuyimithi ehluke ngokuphelele ngaphandle kokwabelana ngesithako esisebenzayo esifanayo.

Lapho ukhuluma ngokwelashwa kwakho nabahlinzeki bezempilo noma osokhemisi, kuyasiza ukucacisa ukuthi uthatha i-Mavenclad yokwelashwa kwe-MS ukuze ugweme noma yikuphi ukudideka nezinye izindlela ze-cladribine.

Ezinye izindlela ze-Cladribine

Uma i-cladribine ingakulungele, kunezindlela eziningana zokwelapha eziphumelelayo ze-relapsing MS okungenzeka ukuthi udokotela wakho angazicabangela. Ukukhetha kuncike ezimpawini zakho ezithile, umlando wezokwelapha, kanye nemigomo yokwelashwa.

Ezinye izindlela zokwelapha zihlanganisa i-dimethyl fumarate (Tecfidera), ethathwa kabili ngosuku futhi isebenza ngokunciphisa ukuvuvukala ohlelweni lwezinzwa oluphakathi. I-Fingolimod (Gilenya) enye inketho evimbela amaseli omzimba ekuzivikeleni ukuthi angaphumi kuma-lymph nodes futhi ahlasele ubuchopho nomgogodla.

Kubantu abane-MS esebenza kakhulu, ezinye izindlela zokwelapha eziqinile njenge-natalizumab (Tysabri) noma i-ocrelizumab (Ocrevus) zingase zicatshangelwe. Lezi ngokuvamile zinikezwa njengokufakwa esikhundleni samaphilisi ansuku zonke, okuyinto abanye abantu abayithandayo.

Imithi ejovwayo efana ne-glatiramer acetate (Copaxone) noma amalungiselelo e-interferon beta isahlala iyizinketho ezinhle kubantu abaningi, ikakhulukazi labo abathanda ukwelashwa ngomlando wokuphepha omude.

Umhlinzeki wakho wezempilo uzokusiza ukuthi ulinganise izinzuzo nezingozi zokukhetha ngakunye ukuze uthole ukwelashwa okungcono kakhulu okuvumelana nendlela yakho yokuphila nezidingo zezokwelapha.

Ingabe i-Cladribine Ingcono Kune-Ocrelizumab?

Kokubili i-cladribine ne-ocrelizumab kuyindlela yokwelapha ephumelela kakhulu ye-relapsing MS, kodwa zisebenza ngezindlela ezihlukene futhi zinezinzuzo ezihlukene. Ukukhetha okungcono kuncike ezimweni zakho, okuthandayo, nomlando wakho wezokwelapha.

I-Cladribine inikeza lula lokwelashwa ngomlomo ngezikhathi ezinde ezingenamithi, kanti i-ocrelizumab idinga ukufakwa njalo ezinyangeni eziyisithupha kodwa ingahlinzeka ngokucindezelwa okungaguquki kwamasosha omzimba. Abanye abantu bakhetha ukuguquguquka kokuthatha amaphilisi ekhaya, kanti abanye bayayithokozela ukuqapha okuhlelekile okuhambisana nokwelashwa ngokufaka.

Ngokuqondene nokusebenza kahle, kokubili imithi inciphisa kakhulu amazinga okuphindaphinda kanye nokuqhubeka kokukhubazeka ezivivinyweni zomtholampilo. I-Cladribine ingase ibe nomkhawulo omncane ngokuqondene nokulondolozwa kwevolumu yobuchopho, kanti i-ocrelizumab ibonise izinzuzo ku-relapsing ne-primary progressive MS.

Amaphrofayili omphumela ohlangothini nawo ahlukile. Okukhathaza kakhulu nge-Cladribine ukuncipha okwesikhashana kodwa okukhulu kwamaseli amhlophe egazi, kanti i-ocrelizumab ithwala ingozi encane yokusabela kokufakwa futhi ingase ikhulise kancane ingozi yokutheleleka ngesikhathi sokwelashwa.

Udokotela wakho uzocabangela izinto ezinjengomsebenzi wakho wamanje wesifo, ukwelashwa kwangaphambilini, izintandokazi zokuphila, kanye nekhono lokuya ekuqokweni okuvamile lapho ekusiza ukuthi ukhethe phakathi kwalezi zinketho.

Imibuzo Evame Ukubuzwa Mayelana ne-Cladribine

Ingabe i-Cladribine Iphephile Kubantu Abanezifo Zenhliziyo?

I-Cladribine ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqashwa ngokucophelela nokucatshangelwa kwesimo sakho senhliziyo esithile. Umuthi awuthinti ngqo ukusebenza kwenhliziyo, kodwa izifo noma ezinye izinkinga zingase zibe nomthelela empilweni yakho yenhliziyo nemithambo yegazi.

Udokotela wakho wenhliziyo kanye nodokotela wezinzwa kuzodingeka basebenzisane ukuqinisekisa ukuthi ukwelashwa nge-cladribine kuphephile kuwe. Bazocabangela izinto ezinjengemithi yakho yamanje yenhliziyo, ukuzinza kwenhliziyo nemithambo yegazi, kanye nekhono lokulwa nezifo ezingase zigcizelele inhliziyo yakho.

Uma unomlando wezinkinga zenhliziyo, qiniseka ukuthi uchwepheshe wakho we-MS kanye nodokotela wenhliziyo bayazi yonke imithi yakho nezimo zempilo ngaphambi kokuqala ukwelashwa nge-cladribine.

Kufanele ngenzeni uma ngiphuzile i-Cladribine eningi ngengozi?

Uma ngengozi uphuza i-cladribine eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuphuza okuningi kungaholela ekwehleni okuyingozi kwenani lakho lamaseli amhlophe egazi noma ezinye izinkinga ezingathi sína.

Ungazami ukuzenza uhlanze noma uthathe eminye imithi ngaphandle kokuthi uqondiswe ngqo uchwepheshe wezempilo. Gcina ibhodlela lemithi unawe lapho ufuna ukunakekelwa kwezempilo ukuze abahlinzeki bakwazi ukubona kahle ukuthi yini nokuthi ungakanani oyiphuzile.

Udkt wakho cishe uzofuna ukuqapha amanani egazi lakho eduze futhi angase ancome ukunakekelwa okwengeziwe kokusekela kuye ngokuthi ungakanani umuthi owengeziwe owuphuzile nokuthi kwenzeke nini.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Cladribine?

Uma uphuthelwa umthamo we-cladribine, uyithathe ngokushesha lapho ukhumbula ngosuku olufanayo, uma nje isesikhathini esibekiwe sokwelashwa. Nokho, ungaphuza imithamo emibili ngosuku olulodwa ukuze ulungise umthamo ophuthelwe.

Uma ukhumbula ngosuku olulandelayo noma kamuva, weqa umthamo owuphuthelwe bese uqhubeka nohlelo lwakho olujwayelekile. Ungazami ukwelula isikhathi sakho sokwelashwa ukuze ubuyisele imithamo ephuthelwe, njengoba lokhu kungaphazamisa uhlelo lokwelashwa oluhleliwe.

Xhumana nomhlinzeki wakho wezempilo ukuze uxoxe ngalokho okwenzekile futhi uthole isiqondiso esiqondile sesimo sakho. Bangase bafune ukulungisa uhlelo lwakho lokuqapha noma banikeze imiyalelo eyengeziwe ngokusekelwe kumthamo owuphuthelwe nokuthi nini.

Ngingayeka nini ukuthatha i-Cladribine?

Akufanele neze uyeke ukuthatha i-cladribine ngaphandle kokubonisana nodokotela wakho kuqala, ngisho noma uzizwa ungcono noma unamathonya. Umuthi ulandela uhlelo oluqondile lokwelashwa lwaminyaka emibili olwenzelwe ukuhlinzeka ngezinzuzo ezingcono kakhulu ngenkathi kunciphisa izingozi.

Abantu abaningi baqeda inkambo ephelele yeminyaka emibili njengoba kuchaziwe, ngemva kwalokho ngokuvamile abadingi ukwelashwa okwengeziwe kwe-cladribine iminyaka eminingana. Udokotela wakho uzoqapha isimo sakho futhi anqume ukuthi ngabe udinga noma yikuphi ukwelashwa kokugcinwa noma ukwelashwa okuhlukile esikhathini esizayo.

Uma unamathonya akhathazayo noma ezinye izinkinga ngemithi, xoxa ngalokhu nomhlinzeki wakho wezempilo kunokuyeka ngokwakho. Bangasiza ekuphatheni imiphumela emibi noma balungise uhlelo lwakho lokwelashwa uma kudingeka.

Ngingakwazi yini ukuthola imigomo ngenkathi ngithatha i-Cladribine?

Isikhathi sokugoma sibalulekile lapho uthatha i-cladribine, njengoba umuthi uthinta ikhono lomzimba wakho lokuzivikela ekuphenduleni imigomo. Imigomo ephilayo kufanele igwenywe ngokuphelele ngesikhathi sokwelashwa kanye nezinyanga eziningana ngemva kwalokho.

Udokotela wakho ngokuvamile uzoncoma ukuthola noma yimiphi imigomo edingekayo ngaphambi kokuqala ukwelashwa kwe-cladribine, lapho amasosha akho omzimba esaqinile ngokugcwele. Lokhu kungabandakanya ukugonywa komkhuhlane, imigomo yepneumonia, noma imigomo yokuhamba uma uhlela uhambo.

Uma udinga imigomo ngesikhathi sokwelashwa, imigomo engasebenzi ngokuvamile iphephe kunaleyo ephilayo, kodwa udokotela wakho uzodinga ukuhlola isimo ngasinye ngasinye. Bazocabangela izinto ezinjengamanani akho amanje amaseli amhlophe egazi kanye nokuphuthuma kokugoma.