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

I-Iloprost iyikhambi elikhethekile elisiza ukuvula imithambo yegazi emaphapheni akho uma isinciphe ngendlela eyingozi. Lona uhlobo olwenziwe ngamachiza lwesithako esingokwemvelo esenziwa umzimba wakho esibizwa ngokuthi i-prostacyclin, esigcina igazi ligeleza kahle emithanjeni yakho.

Leli khambi eliphefumulwayo lisetshenziselwa ikakhulukazi ukwelapha i-pulmonary arterial hypertension (PAH), isimo esibi lapho umfutho wegazi emithanjeni yamaphaphu akho uba phezulu ngendlela eyingozi. Uma uphefumula i-iloprost ngomshini okhethekile we-nebulizer, iya ngqo emsebenzini wokukhulula leyo mithambo yegazi eqinile, okwenza kube lula ukuthi inhliziyo yakho ipompe igazi emaphapheni akho.

Yini i-Iloprost Esetshenziselwa Yona?

I-Iloprost iphatha i-pulmonary arterial hypertension, isimo lapho imithambo emincane emaphapheni akho iba mikhulu futhi inciphe. Lokhu kwenza inhliziyo yakho isebenze kanzima kakhulu ukuze ipompe igazi emaphapheni akho, okungaholela ekwehlulekeni kwenhliziyo uma kungelashwa.

Leli khambi livunywe ngokuqondile kubantu abane-PAH abanezimpawu eziphakathi nendawo kuya kwezinkulu. Udokotela wakho angase akubhale uma uhlangabezana nokuphefumula kanzima, ubuhlungu besifuba, noma ukukhathala okukhawulela imisebenzi yakho yansuku zonke. Kuyasiza ikakhulukazi kubantu abangazange basabele kahle ngokwanele kwezinye izindlela zokwelapha i-PAH.

Ngezinye izikhathi odokotela basebenzisa i-iloprost nasezindabeni ezinzima ze-Raynaud's phenomenon, lapho imithambo yegazi eminweni yakho nasezinzwaneni yakho incipha ngobuhlungu ngenxa yokubanda noma ukucindezeleka. Ezimweni ezingavamile, ingase ibhalwe ngezinhlobo ezithile zamahlule egazi emaphapheni, nakuba lokhu kungewona umsebenzi wayo oyinhloko.

Isebenza Kanjani I-Iloprost?

I-Iloprost isebenza ngokulingisa i-prostacyclin, into enamandla engokwemvelo umzimba wakho uyikhiqiza ukuze ugcine imithambo yegazi ikhululekile futhi ivulekile. Uma uphefumula le mithi, iya ngqo emithanjeni emincane yegazi emaphapheni akho lapho idingeka kakhulu.

Uma uselapho, i-iloprost itshela amaseli emisipha abushelelezi ezindongeni zemithambo yakho yegazi ukuthi aphumule futhi ande. Le nqubo, ebizwa ngokuthi i-vasodilation, ngokushesha inciphisa ingcindezi emithanjeni yakho yamaphaphu. Umuthi futhi usiza ekuvikeleni ukwakheka kwamahlule egazi futhi unciphise ukuvuvukala ezindongeni zemithambo yegazi.

Cabanga ngakho njengokuvula ipayipi lengadi elivaliwe kancane - lapho indlela yanda, amanzi ageleza kalula kakhulu. I-Iloprost ithathwa njengomuthi olinganiselwe oqinile onikeza usizo oluqondiwe ngqo lapho inkinga ikhona, kunokuthinta yonke imithambo yakho yegazi.

Kufanele Ngiyithathe Kanjani I-Iloprost?

I-Iloprost kumele iphuthwe ngomshini okhethekile we-nebulizer ozohlinzekwa ithimba lakho lezempilo futhi lizokufundisa ukuthi liwusebenzise kanjani kahle. Ngokuvamile uzoyithatha izikhathi eziyi-6 kuya kweziyi-9 ngosuku, uhlukanise imithamo cishe ngamahora ama-2 kuya kwama-3 ngesikhathi sokuvuka kwakho.

Iseshini ngalinye lokuphefumula lithatha imizuzu engaba ngu-5 kuya kwengu-15 ukuze liqede. Uzophefumula ngokujwayelekile ngomlomo we-nebulizer ngenkathi umshini uguqula umuthi oluwuketshezi ube inkungu enhle efika ngaphakathi emaphashini akho. Kubalulekile ukuhlala uqonde ngesikhathi sokwelashwa futhi uphefumule ngokuzola nangokujula.

Ungayithatha i-iloprost nokudla noma ngaphandle kokudla, kodwa abantu abaningi bakuthola kulula ukuhlela nokudla njengoba uzoyithatha njalo usuku lonke. Qiniseka ukuthi uhlanza imishini yakho ye-nebulizer ngemva kokuyisebenzisa ngakunye ngokwemiyalelo yomkhiqizi ukuvimbela izifo.

Ungalokothi uhlanganise i-iloprost neminye imithi ku-nebulizer efanayo ngaphandle uma uqondiswe ngqo udokotela wakho. Gcina ama-vials angavuliwe efrijini, kodwa wavumele afinyelele ezingeni lokushisa legumbi ngaphambi kokusebenzisa.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Iloprost?

Abantu abaningi abanomfutho wegazi ophezulu wamaphaphu badinga ukuthatha i-iloprost isikhathi eside ukuze balawule isimo sabo ngempumelelo. I-PAH yisimo esingamahlalakhona esidinga ukwelashwa okuqhubekayo ukuze kugcinwe izimpawu zilawulwa futhi kuvinjelwe ukuthi isifo singabi sibi.

Udktela wakho uzoqapha ukuthi umzimba wakho usabela kanjani emuthini ngokuhlolwa njalo, okuhlanganisa nokuhlolwa okulinganisa ukuthi inhliziyo namaphaphu akho asebenza kahle kangakanani. Uma i-iloprost ikusiza ukuthi uzizwe ungcono futhi imiphumela yokuhlolwa kwakho ikhombisa ukuthuthuka, cishe uzoqhubeka uyithatha unomphela.

Abanye abantu bangase badinge ukushintshela emithini ehlukene noma bangeze ezinye izindlela zokwelapha ngokuhamba kwesikhathi njengoba isimo sabo sishintsha. Ungayeki ukuthatha i-iloprost ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala, ngoba lokhu kungabangela ukuthi izimpawu zakho zibuye ngokushesha futhi kungaholela ezinkingeni eziyingozi.

Yiziphi Imiphumela Eceleni Ye-Iloprost?

Njengayo yonke imithi, i-iloprost ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma sebeqhelele emkhubeni wokwelashwa. Imiphumela emibi evame kakhulu ihlobene nemiphumela yokuvula imithambo yegazi yomuthi emzimbeni wakho wonke.

Nansi imiphumela emibi ongase uyithole, iqala ngaleyo evame kakhulu ethinta abantu abaningi:

• Ubuhlungu bomhlathi noma ubuhlungu bemisipha - Lokhu kwenzeka ngoba i-iloprost ithinta ukugeleza kwegazi emsipheni wakho womhlathi ngesikhathi sokuhlafuna
• Ikhanda elibuhlungu - Ngokuvamile kulula futhi kuvame ukuthuthuka njengoba umzimba wakho ujwayela umuthi
• Ukubomvu noma ukuzwa ufudumele - Ubuso bakho nesifuba sakho kungase kuzizwe kushisa njengoba imithambo yegazi inwebeka
• Isicanucanu noma isisu esibuhlungu - Ukuthatha umuthi nokudla ngezinye izikhathi kuyasiza
• Isiyezi noma ukuzwa ukukhathala - Ikakhulukazi uma usukuma ngokushesha
• Ukukhwehlela noma ukucasuka komphimbo - Kusukela enqubweni yokuphefumula uqobo

Le miphumela emibi evamile ngokuvamile iyalawuleka futhi ivame ukuba ngaphansi kokuphazamisa njengoba uqhubeka nokwelashwa. Nokho, kufanele uthinte udokotela wakho uma iba yimbi noma iphazamisa imisebenzi yakho yansuku zonke.

Imiphumela emibi engavamile kodwa engathi sína ingenzeka, futhi kufanele ufune ukwelashwa uma uhlangabezana nanoma yikuphi kwalokhu:

• Ukuwa okukhulu kwengcindezi yegazi - Kubangela ukuquleka, isiyezi esikhulu, noma ukudideka
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile - Inhliziyo yakho ingase igijime noma yeqe ukushaya
• Ubuhlungu besifuba - Buhlukile ezimpawini zakho ezijwayelekile ze-PAH
• Izinkinga ezinkulu zokuphefumula - Ukushuba kokuphefumula noma ukukhwehlela
• Izimpawu zokutheleleka emaphashini - Umkhuhlane, i-sputum enemibala, noma ukukhwehlela okushubayo

Izinkinga ezingavamile kodwa ezingaba yingozi zihlanganisa ukusabela okukhulu komzimba, izinkinga ezinkulu zokuphuma kwegazi, noma ukwehla okuyingozi kwengcindezi yegazi okudinga ukunakekelwa kwezempilo ngokushesha. Nakuba lokhu kungavamile, kubalulekile ukwazi izimpawu zokuxwayisa futhi ufune usizo ngokushesha uma zenzeka.

Ubani Ongafanele Athole I-Iloprost?

I-Iloprost ayiphephile kuwo wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Abantu abanezimo ezithile zenhliziyo noma labo abathatha imithi ethile kungenzeka bangabi ngabantu abafanelekayo kulokhu kwelashwa.

Akufanele uthathe i-iloprost uma unesinye salezi zimo:

• Isifo senhliziyo esibi kakhulu - Kuhlanganisa ukuhlaselwa yinhliziyo kwamuva, i-angina engazinzile, noma izinkinga ezinkulu zesigqi senhliziyo
• Ukucindezela kwegazi okuphansi kakhulu - I-Iloprost inganciphisa ingcindezi yegazi ngokuqhubekayo
• Izifo zokuphuma kwegazi ezisebenzayo - Umuthi ungakhuphula ingozi yokuphuma kwegazi
• Isifo sesibindi esibi kakhulu - Umzimba wakho ungase ungayicubungi kahle imithi
• Ukungezwani komzimba okwaziwayo ne-iloprost noma imithi efanayo - Kuhlanganisa neminye imithi ye-prostacyclin

Udokotela wakho uzophinda aqaphele mayelana nokunika i-iloprost uma unezinkinga zezinso, ukhulelwe noma uncelisa, noma uthatha izinciphisi zegazi. Imithi ethile ingase isebenzisane ngendlela eyingozi ne-iloprost, ikakhulukazi lezo eziphinda zehlise ingcindezi yegazi.

Abantu abaneminyaka engaphezu kwengama-65 bangase badinge ukuqashwa okukhethekile ngoba maningi amathuba okuthi babe nemiphumela emibi. Hlala utshela udokotela wakho ngayo yonke imithi, izithasiselo, kanye nemikhiqizo yezitshalo oyithathayo ngaphambi kokuqala i-iloprost.

Amagama Omkhiqizo we-Iloprost

I-Iloprost itholakala ngaphansi kwamagama amaningana omkhiqizo ngokuya ngendawo okuyo kanye nokwakheka okuthile. E-United States, igama elivamile lomkhiqizo yi-Ventavis, okuyifomu eliphefumulwayo elisetshenziselwa i-pulmonary arterial hypertension.

Amanye amagama omkhiqizo ongahlangana nawo afaka i-Ilomedin, esetshenziswa kwamanye amazwe ukuze inikezwe nge-intravenous. Ezinye izifunda zingase zibe namagama omkhiqizo engeziwe noma izinguqulo ezivamile ezitholakalayo. Umkhemisi wakho angakusiza ukuthi ukhombe ukuthi yiluphi uhlobo oluthile noma ukwakheka okutholayo.

Noma ngabe igama lomkhiqizo lithini, isithako esisebenzayo siyafana, kodwa indlela yokulethwa kanye nokugxila kungahluka. Njalo sebenzisa umkhiqizo oqondile odokotela bakho abaku-odile futhi ungangeni esikhundleni phakathi kwemikhiqizo ehlukene ngaphandle kwesiqondiso sezokwelapha.

Ezinye izindlela ze-Iloprost

Eminye imithi eminingana ingelapha i-pulmonary arterial hypertension uma i-iloprost ingakulungele noma ingasebenzi kahle ngokwanele. Udokotela wakho angase acabangele lezi ezinye izindlela ngokuya ngesimo sakho esithile nokuthi usabela kanjani ekwelashweni.

Eminye imithi esekelwe ku-prostacyclin ihlanganisa i-epoprostenol (Flolan), enikezwa ngokufakwa kwe-IV okuqhubekayo, kanye ne-treprostinil (Remodulin), engakhishwa njengesitsha ngaphansi kwesikhumba, nge-IV, noma njengomuthi ophefumulwayo. Lezi zisebenza ngendlela efanayo ne-iloprost kodwa zinezinhlelo ezihlukene zokulinganisa kanye namaphrofayili emiphumela emibi.

Izigaba ezahlukene zemithi ye-PAH zihlanganisa ama-endothelin receptor antagonists afana ne-bosentan (Tracleer) kanye ne-ambrisentan (Letairis), asebenza ngokuvimba izinto ezenza imithambo yegazi inciphe. Ama-phosphodiesterase-5 inhibitors afana ne-sildenafil (Revatio) kanye ne-tadalafil (Adcirca) asiza imithambo yegazi ukuthi iphumule ngendlela ehlukile.

Imithi emisha efana ne-riociguat (Adempas) isebenza kwenye indlela ukusiza imithambo yegazi ukuthi ihlale ivulekile. Abantu abaningi abane-PAH bagcina bethatha inhlanganisela yale mithi ukuze bathole imiphumela emihle.

Ingabe i-Iloprost ingcono kune-Epoprostenol?

Kokubili i-iloprost ne-epoprostenol yimithi ye-prostacyclin esebenza ngendlela efanayo ukwelapha i-PAH, kodwa inomehluko obalulekile owenza ngamunye afaneleke kangcono kubantu abahlukene. Akukho noyedwa

I-Iloprost idinga ukuhlolwa ngokucophelela kubantu abanezifo zenhliziyo ngoba ingathinta umfutho wegazi nokushaya kwenhliziyo. Udokotela wakho wenhliziyo uzodinga ukuhlola ukuthi izinzuzo zidlula yini izingozi zesimo sakho senhliziyo esithile.

Abantu abanezifo zenhliziyo ezinzile bangase bakwazi ukusebenzisa i-iloprost ngokuphepha ngokuqapha eduze, kodwa labo abane-angina engazinzile, ukuhlaselwa yinhliziyo kwakamuva, noma izinkinga ezinkulu zokushaya kwenhliziyo ngokuvamile abakwazi ukusebenzisa lo muthi. Udokotela wakho cishe uzofuna ukwenza izivivinyo zenhliziyo ngaphambi kokuqala ukwelashwa futhi akuqaphe eduze ngemva kwalokho.

Kufanele ngenzeni uma ngisebenzisa i-Iloprost eningi ngengozi?

Uma ngengozi uthatha umthamo owengeziwe we-iloprost, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ukuthatha okuningi kungabangela ukwehla okuyingozi komfutho wegazi, ikhanda elibuhlungu elibuhlungu, isicanucanu, noma ukuquleka.

Ungazami ukuthi "weqe" umthamo wakho olandelayo ukuze ulungise lowo owengeziwe - lokhu kungabangela ukuthi izimpawu zakho ze-PAH zibe zimbi kakhulu. Kunalokho, thola iseluleko sezokwelapha mayelana nendlela yokuqhubeka ngokuphepha. Gcina umkhondo weshejuli yakho yokulinganisa ukuze uvimbele izingozi zesikhathi esizayo, futhi cabangela ukusebenzisa uhlelo lokukhumbuza imithi.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Iloprost?

Uma uphuthelwa umthamo we-iloprost, yithathe ngokushesha lapho ukhumbula, ngaphandle kwalapho sekuyisikhathi somthamo wakho olandelayo ohleliwe. Ungathathi imithamo emibili ngesikhathi esisodwa ukuze ulungise leyo ephuthelwe, ngoba lokhu kungabangela imiphumela emibi.

Zama ukubuyela esimisweni sakho esivamile ngokushesha ngangokunokwenzeka. Ukuphuthelwa imithamo eminingi kungavumela izimpawu zakho ze-PAH ukuthi zibuye, ngakho kubalulekile ukugcina ukwelashwa okuqhubekayo. Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho ngamasu okukusiza ukuthi ukhumbule.

Ngingayeka nini ukuthatha i-Iloprost?

Akufanele uyeke ukuthatha i-iloprost ngaphandle kokukhuluma nodokotela wakho kuqala, ngisho noma uzizwa ungcono kakhulu. I-PAH yisimo esingapheli esidinga ukwelashwa okuqhubekayo ukuze kuvinjelwe izimpawu ukuthi zingabuyi nokuthi isifo singaqhubeki.

Udkt wakho uzohlola njalo ukuthi i-iloprost iseyilona yini ikhambi elingcono kakhulu kuwe futhi angase alungise imithi yakho ngokuya ngokuthi usabela kanjani. Uma udinga ukuyeka i-iloprost, udkt wakho cishe uzokushintshela kwenye imithi ye-PAH kunokuthi uyeke lonke ukwelashwa ngokuphelele.

Ngingahamba Ngesikhathi Ngithatha I-Iloprost?

Yebo, ungahamba ngenkathi uthatha i-iloprost, kodwa kudinga ukuhlela kusengaphambili ukuze uqinisekise ukuthi unomuthi owanele futhi ungakwazi ukugcina isimiso sakho sokulinganisa. Uzodinga ukuletha imishini yakho ye-nebulizer kanye nezinto ezengeziwe zemithi uma kwenzeka ukubambezeleka.

Uma undiza, thwala i-iloprost yakho ne-nebulizer emthwalweni wakho wokuqhubeka nencwadi evela kudkt wakho echaza isidingo sakho sezokwelapha semishini. Xhumana nenkampani yakho yezindiza kusengaphambili mayelana nokuhamba ngamadivayisi ezokwelapha. Ukuze uhambe phesheya, cwaninga ukuthi ngabe imithi yakho isemthethweni yini ezweni oya kulo futhi ulethe izinto ezengeziwe uma kwenzeka izimo eziphuthumayo.