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

I-Iloprost iyimithi ekhethekile esiza ukuthuthukisa ukuhamba kwegazi ngokuvula imithambo yegazi enciphile. Kuyinguqulo yokwenziwa yento yemvelo umzimba wakho oyenzayo ebizwa ngokuthi i-prostacyclin, esebenza njengomthunywa omnene otshela imithambo yakho yegazi ukuthi iphumule futhi yande. Le mithi ivamise ukunikezwa nge-IV esibhedlela noma emtholampilo, lapho ochwepheshe bezempilo bengaqapha ngokucophelela ukuthi usabela kanjani ekwelashweni.

Yini i-Iloprost?

I-Iloprost ingeyomndeni wemithi ebizwa ngokuthi i-prostacyclin analogs. Cabanga ngayo njengomsizi olingisa lokho umzimba wakho owenza ngokwemvelo ukuze ugcine igazi lihamba kahle. Lapho imithambo yakho yegazi iba mncane kakhulu noma iqina, i-iloprost ingena ukuze iyikhuthaze ukuthi ivuleke futhi.

Le mithi isebenza ezingeni leselula, ithumela amasignali asiza imithambo yegazi ukuthi iphumule futhi inciphise ukunamathela kwamaplatelet egazi. Umphumela ukujikeleza okungcono, okungaletha ukukhululeka okudingeka kakhulu ezindaweni zomzimba wakho ebezingatholi igazi elanele ngaphambili.

Isetshenziselwani i-Iloprost?

I-Iloprost isetshenziswa ikakhulukazi ukwelapha i-pulmonary arterial hypertension (PAH), isimo esibi lapho umfutho wegazi emaphashini uba phezulu ngendlela eyingozi. Isiza ukuvula imithambo emincane yegazi emaphashini akho, okwenza kube lula ukuthi inhliziyo yakho ipompe igazi ngayo.

Ngaphandle kwe-PAH, odokotela ngezinye izikhathi banikeza i-iloprost ngesifo semithambo esibi, ikakhulukazi lapho ezinye izindlela zokwelapha zingasebenzi kahle ngokwanele. Kulezi zimo, kungasiza ukuthuthukisa ukuhamba kwegazi ezingalweni nasemilenzeni yakho, kunciphisa ubuhlungu futhi kusize ekuvikeleni ukulimala kwezicubu.

Kwezinye izimo ezikhethekile, i-iloprost ingasetshenziswa ekuhlaselweni kwemilenze okubucayi, isimo lapho ukugeleza kwegazi emilenzeni yakho kuncipha kakhulu. Futhi ngezinye izikhathi kucatshangelwa ngezinhlobo ezithile ze-Raynaud's phenomenon lapho lesi simo sibi kakhulu futhi ezinye izindlela zokwelapha zingazange zinikeze ukukhululeka okwanele.

Isebenza Kanjani I-Iloprost?

I-Iloprost ithathwa njenge-vasodilator enamandla amancane, okusho ukuthi inamandla amakhulu ekuvuleni imithambo yegazi kodwa idinga ukulinganiswa ngokucophelela. Isebenza ngokubopha kuma-receptors athile odongeni lwemithambo yakho yegazi, okubangela uchungechunge lwezenzakalo eziholela ekuphumuleni nasekwandeni.

Umuthi futhi unezinto ezilwa nokujiya kwegazi, okusho ukuthi usiza ekuvikeleni igazi lakho ukuthi lingabi lukhuni kakhulu noma lenze amahlule angadingekile. Lesi senzo esiphindwe kabili sokuvula imithambo yegazi nokuthuthukisa izici zokugeleza kwegazi sikwenza sisebenze ikakhulukazi ezinkingeni zokujikeleza kwegazi.

Ngokungafani neminye imithi esebenza ngokushesha, imiphumela ye-iloprost yakheka ngokuhamba kwesikhathi ngokuphindaphinda ukwelashwa. Ungase uqale ukuqaphela ukuthuthuka ezimpawini zakho ngemva kwemihlangano eminingana yokwelapha, nakuba abanye abantu bezwa izinzuzo ngokushesha.

Kufanele Ngiyithathe Kanjani I-Iloprost?

I-Iloprost ihlinzekwa ngaso sonke isikhathi nge-intravenously (nge-IV) endaweni yezokwelapha, hhayi ekhaya. Ithimba lakho lezempilo lizofaka ishubhu elincane emthanjeni wakho, ngokuvamile engalweni yakho, futhi umuthi uzohanjiswa kancane kancane emahoreni amaningana.

Ukufakwa kuvame ukuthatha phakathi kwamahora angu-6 kuya kwangu-9, futhi kuzodingeka uhlale endaweni yokwelashwa ngalesi sikhathi. Ithimba lakho lezokwelapha lizogada umfutho wegazi lakho, izinga lokushaya kwenhliziyo, nokuthi uzizwa kanjani kuyo yonke inqubo.

Akudingeki ukuthi uzile ngaphambi kokwelashwa, kodwa kuvame ukusiza ukudla ukudla okulula ngaphambi kwalokho ngoba inqubo ithatha amahora amaningi. Ukuhlala unamanzi kahle kubalulekile, ngakho phuza amanzi amaningi ngaphambi nangenkathi yokwelashwa ngaphandle uma udokotela wakho ekweluleka ngenye indlela.

Abanye abantu bakuthola kusiza ukuletha okuthile okuzobagcina bematasa ngesikhathi eside sokufakwa, njengamabhuku, amaphilisi, noma umculo. Indawo yokwelashwa ivame ukuba ntofontofo, kodwa kuzodingeka uhlale unganyakazi ukuze ugweme ukuphazamisa umugqa we-IV.

Kufanele Ngithathe Isikhathi Esingakanani I-Iloprost?

Ubude bokwelashwa nge-iloprost buhlukahluka kakhulu kuye ngesimo sakho esithile nokuthi usabela kanjani emuthini. Ngokucindezelwa kwegazi emaphapheni, imijikelezo yokwelashwa ngokuvamile ihlanganisa ukufakwa kwansuku zonke izinsuku eziningana zilandelana, kulandelwe isikhathi sokuphumula.

Abantu abaningi bathola imijikelezo yokwelashwa ethatha izinsuku ezi-3 kuya kwezi-5, iphindwe njalo emavikini ayi-6 kuya kwayi-12. Kodwa-ke, udokotela wakho uzokwenza isimiso esenziwe ngomuntu ngamunye esisekelwe ezimpawini zakho, imiphumela yokuhlolwa, kanye nesimo sempilo yakho esiphelele.

Ngesifo semithambo esingaphandle noma i-ischemia ebalulekile yomlenze, isimiso sokwelashwa singase sihluke, ngezinye izikhathi sihlanganisa imijikelezo emide noma ukwelashwa okuvame kakhulu ekuqaleni. Ithimba lakho lokunakekelwa kwezempilo lizohlola njalo ukuthi ngabe umuthi uyasiza yini futhi ulungise uhlelo lokwelashwa ngokufanele.

Ukuhlela ukwelashwa kwesikhathi eside kuncike esimweni sakho esiyisisekelo nokuthi ngabe i-iloprost iyaqhubeka yini nokuhlinzeka ngezinzuzo. Abanye abantu bangase bashintshele kweminye imithi, kanti abanye bangase baqhubeke ne-iloprost njengengxenye yeqhinga labo lokunakekelwa okuqhubekayo.

Yiziphi Imiphumela Eceleni Ye-Iloprost?

Njengayo yonke imithi, i-iloprost ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma iqashwe kahle. Ukuqonda okukulindele kungakusiza ukuthi uzizwe ulungiseleleke futhi uzethembile ngesikhathi sokwelashwa.

Imiphumela emibi evame kakhulu ongase uhlangabezane nayo ihlanganisa ukuqaqamba kwekhanda, ukubomvu (ukuzwa ufudumele futhi ubomvu ebusweni), nokucasuka. Lokhu kuvame ukwenzeka ngesikhathi noma ngemva nje kokufakwa, futhi kuvame ukuthuthuka njengoba umzimba wakho ujwayela umuthi.

Nawa amanye amaphutha avamile abantu abahlangabezana nawo:

• Ukuqaqamba kwekhanda, okungahluka kusuka kokulula kuya kokulingene
• Ukubomvu ebusweni nokuzwa ufudumele
• Ukuqina kwesisu noma ukucasuka kwesisu okuncane
• Isiyezi noma ukukhathala
• Ubuhlungu bomhlathi noma ubuhlungu bemisipha
• Ukuphuma isifo sohudo noma izitulo ezixekile
• Ukukhathala noma ukuzwa ukhathele

Le miphumela emibi ivame ukulawuleka futhi ivame ukuncipha ngamandla njengoba uthola ukwelashwa okwengeziwe. Ithimba lakho lezempilo linganikeza amasu okusiza ukunciphisa ukungakhululeki.

Abanye abantu bangase bahlangabezane nemiphumela emibi ebaluleke kakhulu edinga ukuqashwa okuseduze:

• Ukwehla kwegazi, okungabangela isiyezi noma ukuquleka
• Ukuqina kwenhliziyo noma ukushaya kwenhliziyo okusheshayo
• Ukuphefumula kanzima noma ukuqina kwesifuba
• Ukuqaqamba kwekhanda okukhulu okungathuthuki ngemithi yokwelapha ubuhlungu etholakala ngaphandle kwemithi kadokotela
• Izimpawu zokuphuma igazi, njengokulimala okungavamile noma ukuphuma igazi emakhaleni

Le miphumela ayivamile kodwa kubalulekile ukubika ethimbeni lakho lezempilo ngokushesha uma kwenzeka.

Ngokungavamile, abanye abantu bangase bahlangabezane nokusabela okukhulu okudinga ukunakekelwa kwezempilo ngokushesha:

• Ukungezwani komzimba okukhulu okunezinduna, ukuvuvukala, noma ukungaphefumuli kahle
• Ukwehla okukhulu kwegazi okudinga ukungenelela
• Ukungajwayelekile kwesigqi senhliziyo
• I-pulmonary edema (uketshezi emaphashini)
• Izinkinga ezinkulu zokuphuma igazi

Ngenkathi le miphumela emibi engathí sina ingavamile, indawo yezokwelapha lapho i-iloprost inikezwa khona iqinisekisa ukuthi usizo luyatholakala ngokushesha uma kudingeka.

Ubani Ongafanele Athathwe I-Iloprost?

I-Iloprost ayifanele wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuncoma lokhu kwelashwa. Ezinye izimo noma izimo zenza i-iloprost ingaphephile noma ingasebenzi kahle.

Akufanele uthole i-iloprost uma unezifo zenhliziyo ezinzima, ikakhulukazi izinhlobo ezithile zokuhluleka kwenhliziyo noma ukuhlaselwa yinhliziyo kwakamuva. Imiphumela yomuthi ekucindezelweni kwegazi nesilinganiso senhliziyo kungaba yinkinga kulezi zimo.

Abantu abanezifo zokuphuma igazi ezisebenzayo noma labo abathatha imithi ethile yokunciphisa igazi kungenzeka bangabi ngabazali abahle be-iloprost. Njengoba umuthi uthinta ukujiya kwegazi, ungaqhubukisa izingozi zokuphuma igazi kubantu abasengozini.

Ezinye izimo ezivame ukuvimbela ukusetshenziswa kwe-iloprost zihlanganisa:

• Isifo sesibindi esinzima noma ukuhluleka kwesibindi
• Isifo sezinso esinzima esidinga i-dialysis
• Ukucindezelwa kwegazi eliphezulu okungalawulwa
• Ukushaywa unhlangothi kwakamuva noma ukuphuma kwegazi ebuchosheni
• Isifo samathumba esisebenzayo
• I-anemia enzima noma ukubala kwamaplatelet aphansi

Ukukhulelwa nokuncelisa ngamabele kudinga ukucatshangelwa okukhethekile, njengoba imiphumela ye-iloprost ezinganeni ezisakhulayo ingaqondakali ngokugcwele. Udokotela wakho uzokala izinzuzo ezingaba khona ngokumelene nezingozi ezingaba khona uma ukhulelwe noma uhlela ukukhulelwa.

Ubudala ngokwawo akudingeki ukuthi bube yisithiyo ekwelashweni, kodwa abadala kungenzeka badinga ukuqapha ngokucophelela ngenxa yokwanda kokuzwela emiphumeleni yomuthi.

Amagama Omkhiqizo we-Iloprost

I-Iloprost itholakala ngaphansi kwamagama amaningi omkhiqizo, i-Ventavis iyona evame ukubonwa e-United States. Lo mkhiqizo uklanyelwe ngqo ukwelashwa ngokuphefumula, nakuba izinhlobo ze-intravenous nazo zitholakala ngaphansi kwamanye amagama.

Amanye amagama ebhrendi ahlanganisa i-Ilomedin, esetshenziswa emazweni ahlukahlukene ukuze inikezwe ngemithambo. Uhlobo oluthile kanye nokwakheka okukhethwa udokotela wakho kuzoncika esimweni sakho kanye nendlela yokwelapha abakholelwa ukuthi izosebenza kahle kuwe.

Noma ngabe igama lebhrendi linjani, yonke imithi ye-iloprost iqukethe isithako esifanayo esisebenzayo. Umehluko ulele ikakhulukazi ekugxilweni, indlela yokulethwa, kanye nezindinganiso ezithile zokukhiqiza.

Ezinye izindlela zokwelapha i-Iloprost

Eminye imithi eminingi ingasebenza njengezinye izindlela zokwelapha i-iloprost, kuye ngesimo sakho esithile kanye nemigomo yokwelapha. Lezi ezinye izindlela zokwelapha zisebenza ngezindlela ezifanayo noma ezihlukene zokuthuthukisa ukuhamba kwegazi nokunciphisa izimpawu.

Ngenxa yomfutho wegazi ophezulu wamaphaphu, ezinye izindlela zokwelapha zihlanganisa i-epoprostenol (Flolan), i-treprostinil (Remodulin), kanye ne-selexipag (Uptravi). Ngayinye inezinzuzo zayo kanye nezinto okufanele zicatshangelwe mayelana nokulinganisa, imiphumela emibi, nezindlela zokuphatha.

Ezinye izindlela zokwelapha zingase zihlanganise ama-endothelin receptor antagonists afana ne-bosentan (Tracleer) noma i-ambrisentan (Letairis), esebenza ngokuvimba izinto ezibangela ukuncipha kwemithambo yegazi. Ama-phosphodiesterase-5 inhibitors afana ne-sildenafil (Revatio) anikeza enye indlela yokuthuthukisa ukuhamba kwegazi.

Ngenxa yesifo semithambo yegazi esingaphandle, ezinye izindlela zokwelapha zingase zihlanganise ezinye izinto ezivula imithambo yegazi, imithi elwa nama-antiplatelet, noma ezinye izindlela zokwelapha ezintsha ezenzelwe ukukhuthaza ukukhula kwemithambo yegazi. Udokotela wakho uzocabangela isimo sakho esithile lapho encoma ezinye izindlela zokwelapha.

Ingabe i-Iloprost ingcono kune-Epoprostenol?

Kokubili i-iloprost ne-epoprostenol ziyi-prostacyclin analogs, kodwa zomehluko obalulekile owenza enye ifaneleke kangcono kwabanye abantu. Ukukhetha phakathi kwazo kuncike ezidingweni zakho ezithile, indlela yokuphila, nokuthi uyikwazi kangakanani ukubekezelela imithi ngayinye.

I-Iloprost inesikhathi eside sokuphila kuno-epoprostenol, okusho ukuthi ihlala isebenza ohlelweni lwakho isikhathi eside. Lokhu kungaba nenzuzo ngoba kuvumela ukuthi kuthathwe imithi engavamile futhi kungahlinzeka ngemiphumela ezinzile usuku lonke.

I-Epoprostenol idinga ukufakwa okuqhubekayo ngomugqa omkhulu ohlala njalo, okusho ukuthi uzodinga ukuthwala ipompo elincane nawe ngaso sonke isikhathi. Ngakolunye uhlangothi, i-Iloprost, inganikezwa njengokufakwa okungahambisani, okutholakala abantu abaningi bekulungele izimpilo zabo zansuku zonke.

Amaphrofayili emiphumela emibi afana, kodwa abanye abantu bayayibekezelela enye imithi kangcono kunenye. Udokotela wakho uzocabangela izimo zakho, okuhlanganisa ikhono lakho lokuphatha izinhlelo ezahlukene zokulethwa kanye nokuphendula kwakho ekwelashweni.

Imibuzo Evame Ukubuzwa Mayelana ne-Iloprost

Ingabe i-Iloprost iphephile ezigulini zenhliziyo?

I-Iloprost idinga ukuhlolwa ngokucophelela uma unezifo zenhliziyo, njengoba ingathinta izinga lokushaya kwenhliziyo nomfutho wegazi. Kubantu abanezimo zenhliziyo ezilula kuya kweziphakathi, kungase kuphephe ngaphansi kokugadwa kwezokwelapha okuseduze, kodwa labo abanezifo zenhliziyo ezinzima noma ukuhlaselwa yinhliziyo kwakamuva ngokuvamile abakwazi ukuthola le mithi.

Udokotela wakho wenhliziyo kanye nethimba eliphatha ukwelashwa kwakho nge-iloprost bazosebenzisana ukuze banqume ukuthi kufanelekile yini isimo sakho senhliziyo esithile. Bazocabangela izinto ezinjengomsebenzi wenhliziyo yakho, imithi yamanje, kanye nempilo yonke yenhliziyo nemithambo yegazi.

Uma uthola i-iloprost enezifo zenhliziyo, cishe uzodinga ukuqapha kaningi ngesikhathi sokwelashwa, okuhlanganisa ukuhlolwa kwezinga lokushaya kwenhliziyo nomfutho wegazi ngesikhathi senqubo yokufaka imithi.

Ngingenzani uma ngithola i-Iloprost eningi ngengozi?

Njengoba i-iloprost inikezwa ngomthambo emithini yezokwelapha, ukweqisa ngengozi akuvamile ngoba ochwepheshe bezempilo balawula ngokucophelela umthamo. Kodwa-ke, uma uhlangabezana nezimpawu ezinzima ngesikhathi sokwelashwa, kubalulekile ukukhuluma ngokushesha.

Izimpawu ze-iloprost eningi zingabandakanya ikhanda elibuhlungu kakhulu, isiyezi esikhulu, umfutho wegazi ophansi kakhulu, noma ubunzima bokuphefumula. Ithimba lezokwelapha eliqapha ukwelashwa kwakho liqeqeshwe ukubona nokuphendula ngokushesha kulezi zimo.

Uma kwenzeka ukweqisa umthamo, ukumnika kuzomiswa ngokushesha, futhi kuzohlinzekwa ukunakekelwa okusekelayo ukusiza umzimba wakho ukuthi ululame. Imiphumela eminingi yokweqisa umthamo iyaguquleka uma umuthi uyekisiwe.

Kufanele ngenzeni uma ngiphuthelwa ukwelashwa kwe-Iloprost okuhleliwe?

Uma uphuthelwa ukwelashwa kwe-iloprost okuhleliwe, xhumana nomhlinzeki wakho wezempilo ngokushesha ngangokunokwenzeka ukuze uhlele kabusha. Ungazami ukwenza ukwelashwa okulahlekile ngokuthola imithi eyengeziwe noma ukwelula isikhathi sakho esilandelayo sokumnika.

Ngokuya ngokuthi sekudlule isikhathi esingakanani kusukela ekwelashweni kwakho okulahlekile kanye nesimo sakho esithile, udokotela wakho angase alungise isimiso sakho sokwelashwa noma ancome ukuqapha okwengeziwe lapho uqala kabusha ukwelashwa.

Ukuphuthelwa ukwelashwa okwesikhashana ngokuvamile akuyingozi, kodwa ukuqina kubalulekile ekugcineni izinzuzo zomuthi. Sebenza nethimba lakho lezempilo ukuze uthole isimiso ongakwazi ukusigcina ngokoqobo.

Ngingayeka nini ukuthatha i-Iloprost?

Isinqumo sokuyeka i-iloprost kufanele senziwe ngaso sonke isikhathi ngokubonisana nomhlinzeki wakho wezempilo, hhayi wedwa. Abanye abantu bangase bakwazi ukuyeka ukwelashwa uma isimo sabo sithuthuka kakhulu noma uma bedlulela kweminye imithi esebenzayo.

Ezimweni ezinjengomfutho wegazi ophezulu wamaphaphu, ukuyeka ukwelashwa ngokuphazima kweso kungaba yingozi futhi kungaholela ekushintsheni okusheshayo kwezimpawu. Udokotela wakho ngokuvamile uzonciphisa imvamisa yokwelashwa kancane kancane uma ukuyeka kufanelekile.

Ukuqapha njalo ngezivivinyo ezinjenge-echocardiograms, umsebenzi wegazi, kanye nokuhlolwa kwezimpawu kusiza ithimba lakho lezempilo ukuthi linqume ukuthi ngabe ukuqhubeka nokwelashwa kuyadingeka futhi kuyazuzisa yini esimweni sakho esithile.

Ngingashayela Ngemva Kokuthola Ukwelashwa Nge-Iloprost?

Akufanele ushayele ngokushesha ngemva kokuthola ukwelashwa nge-iloprost, njengoba umuthi ungabangela isiyezi, ukukhathala, kanye nezinguquko emfutheleni wegazi ezingathinta ikhono lakho lokushayela ngokuphepha.

Abahlinzeki bezempilo abaningi batusa ukulinda okungenani amahora ambalwa ngemva kokwelashwa ngaphambi kokushayela, futhi abanye batusa ukuthi kube nomunye umuntu okushayela ekhaya ngemva kwemihlangano yakho yokufakwa komuthi. Isikhathi esiqondile sokulinda sincike endleleni ovame ukusabela ngayo emuthini.

Uma uhlangabezana nesiyezi esiqhubekayo, ukukhathala, noma eminye imiphumela engase ikhulule ikhono lakho lokushayela, kungcono ukuhlela ezinye izindlela zokuthutha kuze kube yilapho le miphumela iphela ngokuphelele.