Yini iMacitentan: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Macitentan iyimithi kadokotela esiza ukwelapha i-pulmonary arterial hypertension (PAH), isimo esibucayi lapho umfutho wegazi emithanjeni yamaphaphu akho uba phezulu ngendlela eyingozi. Le mithi edliwayo isebenza ngokuvimba izamukeli ezithile ezibangela ukuthi imithambo yegazi inciphe, okusiza inhliziyo yakho ukuba ipompe igazi kalula ngamaphaphu akho.

Uma wena noma othile omkhathalelayo enikwe i-macitentan, cishe unemibuzo mayelana nendlela esebenza ngayo nokuthi yini ongayilindela. Ake sihambe kukho konke okudingeka ukwazi ngale mithi ngendlela ezizwakala ilawuleka futhi icacile.

Yini iMacitentan?

I-Macitentan ingeyodwa yezinhlobo zemithi ebizwa ngokuthi i-endothelin receptor antagonists. Cabanga ngayo njengokhiye ovimba izihluthulelo zezamukeli ezithile emithanjeni yakho yegazi ezingenza ukuthi ziqine.

Umzimba wakho ngokwemvelo ukhiqiza into ebizwa ngokuthi i-endothelin, engenza imithambo yegazi inciphe. Kubantu abane-PAH, lokhu kuncipha kwenzeka kakhulu emithanjeni yamaphaphu. I-Macitentan ingena ukuvimbela lokhu kuncipha ngokweqile, ivumela igazi ukuba ligeleze ngokukhululeka ngamaphaphu akho.

Le mithi yenzelwe ngqo ukusetshenziswa isikhathi eside futhi imelela intuthuko ebalulekile ekwelapheni i-PAH. Ngokuvamile inikezwa lapho ezinye izindlela zokwelapha zinganikezanga ukukhululeka okwanele noma njengengxenye yohlelo lokwelapha oluhlanganisiwe.

Isetshenziselwani iMacitentan?

I-Macitentan isetshenziswa ikakhulukazi ukwelapha i-pulmonary arterial hypertension, isimo lapho imithambo emincane emaphaphu akho iba mncane, ivaleke, noma ibhujiswe. Lokhu kwenza kube nzima kakhulu ukuthi inhliziyo yakho ipompe igazi ngamaphaphu akho.

Abantu abane-PAH bavame ukuzwa ukuphefumula kanzima, ukukhathala, ubuhlungu besifuba, nesiyezi ngoba izinhliziyo zabo zisebenza ngokweqile ukucindezela igazi ngale mithambo yamaphaphu enciphile. Ngokuhamba kwesikhathi, lo msebenzi owengeziwe ungenza inhliziyo ibe buthaka.

Udktela wakho angase akunikeze i-macitentan uma une-PAH ehlobene nezimo ezihlukahlukene ezingaphansi. Lokhu kungabandakanya izifo zezicubu ezixhumene njenge-scleroderma, ukukhubazeka kwenhliziyo okuzalwa nakho, noma ngezinye izikhathi i-PAH evela ngaphandle kwembangela ecacile.

Umuthi usiza ukunciphisa ukuqhubeka kwe-PAH futhi ungathuthukisa ikhono lakho lokuzivocavoca nokwenza imisebenzi yansuku zonke. Ivame ukusetshenziswa kanye nezinye izindlela zokwelapha i-PAH ukukunikeza imiphumela engcono kakhulu.

Isebenza Kanjani I-Macitentan?

I-Macitentan ithathwa njengomuthi oqinile ngokulinganisela osebenza ngokuvimba ama-endothelin receptors emithanjeni yakho yegazi. Uma lawa ma-receptor evinjelwe, imithambo yegazi emaphashini akho ingakhululeka futhi yande, inciphise ingcindezi inhliziyo yakho ebhekene nayo.

Umuthi uqondise ngqo izinhlobo ezimbili zama-endothelin receptors, abizwa ngokuthi ama-ETA nama-ETB receptors. Ngokuvimba zombili izinhlobo, i-macitentan inikeza ukuvikelwa okubanzi ngokumelene nokuncipha kwemithambo yegazi kuneminye imithi emidala ekulesi sigaba.

Ngokuvamile uzoqala ukuqaphela ukuthuthuka kwezimpawu zakho kungakapheli amasonto ambalwa kuya ezinyangeni ezimbalwa ngemuva kokuqala ukwelashwa. Nokho, izinzuzo ezigcwele zingathatha izinyanga eziningana ukuthi zivele njengoba uhlelo lwakho lwe-cardiovascular luzivumela ekuthuthukisweni kokugeleza kwegazi.

Lo muthi usebenza kahle kakhulu njengengxenye yohlelo lokwelashwa isikhathi eside. Akuyona indlela esheshayo, kodwa kunalokho uhlelo lokusekela oluqhubekayo olusiza ukugcina ukuhamba kwegazi okungcono emaphashini akho ngokuhamba kwesikhathi.

Kufanele Ngiyithathe Kanjani I-Macitentan?

Thatha i-macitentan ngendlela udokotela wakho ayala ngayo, ngokuvamile kanye ngosuku ngaphandle kokudla noma ngaphandle kokudla. Ithebhulethi ingathathwa ngamanzi, futhi akudingeki ukhathazeke ngokuyihlela ngesikhathi sokudla ngoba ukudla akuthinti ngendlela ebalulekile ukuthi umzimba wakho umunca kanjani umuthi.

Kungcono ukuthatha umthamo wakho ngesikhathi esifanayo nsuku zonke ukuze kukusize ukhumbule futhi ugcine amazinga aqhubekayo omuthi emzimbeni wakho. Abantu abaningi bakuthola kuwusizo ukuxhuma ukuthatha imithi yabo emsebenzini wansuku zonke, njengokuxubha amazinyo noma ukudla kwasekuseni.

Gwinya ithebhulethi yonke ngamanzi. Ungayichobozi, uhlafune, noma uyiphule ithebhulethi, ngoba lokhu kungathinta indlela umuthi okhululwa ngayo emzimbeni wakho.

Uma uthatha eminye imithi ye-PAH, udokotela wakho uzoqondanisa isikhathi ukuze aqinisekise ukuthi isebenza kahle ndawonye. Njalo landela imiyalelo ethile yomhlinzeki wakho wezempilo, njengoba engase alungise umsebenzi wakho wansuku zonke ngokusekelwe ezidingweni zakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Macitentan?

I-Macitentan ngokuvamile inikezwa njengokwelashwa kwesikhathi eside, ngokuvamile iminyaka eminingi noma ngisho naphakade. I-PAH yisimo esingapheli esidinga ukuphathwa okuqhubekayo, futhi ukuyeka umuthi kungazelelwe kungabangela ukuthi izimpawu zakho zibuyele noma zibe zimbi kakhulu.

Udokotela wakho uzoqapha ukusabela kwakho emuthini ngokuhlolwa okuvamile, ukuhlolwa kwegazi, kanye nokuhlolwa komsebenzi wenhliziyo. Ngokusekelwe endleleni ozenza ngayo, bangase balungise uhlelo lwakho lokwelapha ngokuhamba kwesikhathi.

Abanye abantu bathatha i-macitentan iminyaka eminingi ngemiphumela emihle, kanti abanye bangase badinge ukushintshela kweminye imithi noma banezele ukwelashwa okwengeziwe. Okubalulekile ukusebenza eduze nethimba lakho lezempilo ukuze uthole okusebenza kahle kakhulu esimweni sakho esithile.

Ungalokothi uyeke ukuthatha i-macitentan kungazelelwe ngaphandle kokukhuluma nodokotela wakho kuqala. Uma udinga ukuyeka umuthi, udokotela wakho uzokwenza uhlelo lokwenza kanjalo ngokuphepha, mhlawumbe ngokunciphisa kancane umthamo wakho noma ukushintshela ekwelashweni okuhlukile.

Yiziphi Imiphumela Eceleni ye-Macitentan?

Njengayo yonke imithi, i-macitentan ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Imiphumela eminingi emibi iyalawuleka, futhi abantu abaningi bathola ukuthi noma yikuphi ukungakhululeki kokuqala kuthuthuka njengoba umzimba wabo uzivumela emuthini.

Imiphumela emibi evame kakhulu ongase uhlangabezane nayo ihlanganisa ikhanda, ukuvuvukala emilenzeni yakho noma emaqakaleni, kanye nezifo ezingaphezulu zokuphefumula. Lokhu kwenzeka enanini elikhulu labantu kodwa ngokuvamile kulula noma kulula ngokuqina.

Nawa amanye emiphumela emibi ebikwa kaningi okufanele uyazi:

• Ikhanda (ngokuvamile lithuthuka ngemva kwamasonto ambalwa okuqala)
• Ukuvuvukala emilenzeni, emaqakaleni, noma ezinyaweni
• Izifo ezingaphezulu zokuphefumula njengezimpawu zomkhuhlane
• Ikhala elivaliwe noma eligobhozayo
• I-Bronchitis
• Izifo zomgudu womchamo

Iningi lalemiphumela emibi yisikhashana futhi iba ngaphansi kokukhathaza njengoba umzimba wakho ujwayela imithi. Udokotela wakho angase ancome izindlela zokuphatha noma yiziphi izimpawu ezingakhululekile ozitholayo.

Kukhona neminye imiphumela emibi engathí sina kodwa engavamile edinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba lokhu kungavamile, kubalulekile ukwazi ukuthi yini okufanele uyibheke ukuze uthole usizo ngokushesha uma kudingeka.

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu ezingathi sína:

• Ukwehla okukhulu kwamaseli abomvu egazi (i-anemia), okungase kubangele ukukhathala okungavamile noma ubuthakathaka
• Izinkinga zesibindi, okuhlanganisa ukuphuzi kwesikhumba noma amehlo, umchamo omnyama, noma isicanucanu esiqhubekayo
• Ukuvuvukala okukhulu okungazelelwe ebusweni, ezindebeni, olimini, noma emqaleni
• Ukuphefumula kanzima noma ukugwinya
• Ukuphuma kwegazi okungavamile noma ukulimala

Le miphumela emibi engathi sína ayivamile, kodwa ukuyibona kusenesikhathi kungasiza ekuqinisekiseni ukuthi uthola ukunakekelwa okudingayo ngokushesha. Udokotela wakho uzokuhlola njalo ukuze abambe noma yiziphi izinkinga ezingaba khona ngaphambi kokuba zibe zimbi.

Ubani Ongafanele Athathwe i-Macitentan?

I-Macitentan ayifanele wonke umuntu, futhi zikhona izimo ezithile lapho udokotela wakho ezoncoma indlela ehlukile yokwelapha. Umkhawulo obaluleke kakhulu ngowabantu abakhulelwe noma abangase bakhulelwe.

Uma ukhulelwe noma uhlela ukukhulelwa, akufanele usebenzise i-macitentan ngoba ingabangela ukukhubazeka okukhulu ekuzalweni. Abesifazane abaneminyaka yokuzala badinga ukusebenzisa izindlela zokuvimbela inzalo ezithembekile ngenkathi besebenzisa lo muthi kanye okungenani inyanga eyodwa ngemva kokuyeka.

Udokotela wakho uzophinda aqaphele ngokunquma i-macitentan uma unezimo ezithile zezokwelapha. Lezi zimo zidinga ukucatshangelwa ngokucophelela nokuqashwa eduze:

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• Isifo sesibindi esibi noma izinkinga zomsebenzi wesibindi
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• Isifo sezinso esibi
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• Umfutho wegazi ophansi obangela izimpawu
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• Izinhlobo ezithile zezinkinga zenhliziyo
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• I-anemia ebucayi noma ezinye izifo zegazi
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Ngaphezu kwalokho, uma uke waba nokusabela komzimba ku-macitentan noma imithi efanayo esikhathini esidlule, udokotela wakho cishe uzokhetha enye indlela yokwelapha wena.

Ubudala bungaba yinto ebalulekile ezinqumweni zokwelapha. Ngenkathi i-macitentan ingasetshenziswa kubantu abadala, udokotela wakho angase aqale ngomthamo ophansi noma akuqaphele eduze uma uneminyaka engaphezu kwengama-65 noma unezimo eziningi zempilo.

Amagama Omkhiqizo we-Macitentan

I-Macitentan iyatholakala ngaphansi kwegama lomkhiqizo elithi Opsumit emazweni amaningi, okuhlanganisa ne-United States. Lena yindlela ejwayelekile ebekwe ngayo imithi ozohlangana nayo emakhemisi.

Lo muthi ukhiqizwa yi-Actelion Pharmaceuticals, futhi i-Opsumit njengamanje igama eliyinhloko lomkhiqizo elisetshenziswa emhlabeni wonke. Ungase ukubone ngezinye izikhathi kubhekiselwa kulo ngegama layo elivamile, i-macitentan, ikakhulukazi ezincwadini zezokwelapha noma lapho kuxoxwa ngezinketho zokwelapha.

Uma uthatha umuthi wakho, ilebula cishe lizokhombisa

Ezinye Izindlela Zokwelapha i-Macitentan

Uma i-macitentan ingakulungele, kuneminye imithi eminingi engaphatha i-PAH ngempumelelo. Udokotela wakho angase acabangele lezi ezinye izindlela ngokusekelwe ezimpawini zakho ezithile, ezinye izimo zempilo, nokuthi usabela kanjani ekwelashweni.

Ezinye izithiyo ze-endothelin receptor zisebenza ngendlela efanayo ne-macitentan kodwa zingase zibe nemiphumela ehlukene. Lokhu kufaka phakathi i-bosentan (Tracleer) ne-ambrisentan (Letairis), ezisetshenziswe ngempumelelo iminyaka eminingi.

Ngaphandle kwezithiyo ze-endothelin receptor, kunezinye izigaba zemithi ye-PAH esebenza ngezindlela ezihlukene:

• Izithiyo ze-Phosphodiesterase-5 ezifana ne-sildenafil (Revatio) ne-tadalafil (Adcirca)
• Ama-analog we-Prostacyclin afana ne-epoprostenol (Flolan) ne-iloprost (Ventavis)
• Izikhuthazi ze-Soluble guanylate cyclase ezifana ne-riociguat (Adempas)
• Ama-agonist we-Prostacyclin receptor afana ne-selexipag (Uptravi)

Abantu abaningi abane-PAH empeleni bathatha inhlanganisela yale mithi ukuze bathole imiphumela engcono kakhulu. Udokotela wakho angase aqale ngomuthi owodwa bese engeza eminye ngokuhamba kwesikhathi, noma angase ancome ukuqala ngenhlanganisela ngokushesha.

Ukukhethwa kwezinye izindlela kuncike ezintweni eziningi, okuhlanganisa impilo yakho yonke, eminye imithi oyithathayo, nezintandokazi zakho mayelana nezinto ezinjengokuthi udinga kangaki ukuthatha imithi noma imiphumela engaba khona.

Ingabe i-Macitentan Ingcono Kune-Bosentan?

Kokubili i-macitentan ne-bosentan ziyizithiyo ze-endothelin receptor eziphatha i-PAH ngempumelelo, kodwa zinezinto ezibalulekile ezingenza enye ikufaneleke kakhulu kunenye.

I-Macitentan ngokuvamile ithathwa njengenenani elithile elingcono kune-bosentan. Ivame ukubangela izinkinga ezimbalwa zesibindi, okusho ukuthi ungase udinge ukuhlolwa kwegazi okungavamile ukuze uqaphe ukusebenza kwesibindi sakho. Lokhu kungenza ukwelashwa kube lula futhi kungakhathazi.

Ucwaningo lubonise ukuthi i-macitentan ingase futhi isebenze kahle ekuvikeleni i-PAH ekubeni ibe yimbi ngokuhamba kwesikhathi. Ezivivinyweni zomtholampilo, abantu ababethatha i-macitentan babenezikhathi ezimbalwa zokulaliswa esibhedlela kanye nezigameko zokuqhubeka kwesifo uma kuqhathaniswa nalabo ababethatha i-placebo.

Kodwa-ke, i-bosentan isetshenziswe isikhathi eside futhi inerekhodi eliqinile lokuphepha nokusebenza kahle. Abanye abantu benza kahle kakhulu nge-bosentan futhi abadingi ukushintshela emithini emisha.

Ukukhetha phakathi kwale mithi kuvame ukwehla ezintweni zomuntu ngamunye njengokusebenza kwesibindi sakho, ezinye izimo zempilo, nokuthi usabela kanjani emithini. Udokotela wakho uzocabangela isithombe sakho esiphelele sezokwelapha lapho encoma inketho engcono kakhulu kuwe.

Imibuzo Evame Ukubuzwa Mayelana ne-Macitentan

Q1. Ingabe i-Macitentan iphephile kubantu abanezifo zenhliziyo?

I-Macitentan ingasetshenziswa kubantu abanezinhlobo ezithile zezifo zenhliziyo, kodwa idinga ukuqapha nokuhlolwa ngokucophelela ngudokotela wakho. Njengoba i-PAH ngokwayo ithinta inhliziyo, abantu abaningi abathatha i-macitentan banokuhileleka kwenhliziyo ngezinga elithile.

Udokotela wakho uzohlola isimo sakho senhliziyo esithile ngaphambi kokukuchazela i-macitentan. Bazocabangela izinto ezinjengamandla enhliziyo yakho okuphampa, noma yiziphi izigqi ezingajwayelekile, kanye namazinga akho omfutho wegazi. Ukuqokwa okulandelayo njalo kuzosiza ukuqinisekisa ukuthi imithi isebenza ngokuphepha enhliziyweni yakho.

Uma unesifo senhliziyo esibi noma umfutho wegazi ophansi kakhulu, udokotela wakho angase akhethe ukwelashwa okuhlukile noma aqale ngomthamo ophansi ngenkathi ekuqapha ngokucophelela. Okubalulekile ukuxhumana okuvulekile nethimba lakho lezempilo mayelana nanoma yiziphi izimpawu ezihlobene nenhliziyo ozitholayo.

Q2. Kufanele ngenzeni uma ngiphuzile i-Macitentan eningi ngengozi?

Uma ngengozi uthatha i-macitentan eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kungabangela ukwehla okuyingozi komfutho wegazi nezinye izinkinga ezingathi sína.

Izimpawu zokuthatha i-macitentan eningi zingabandakanya isiyezi, ukuquleka, ikhanda elibuhlungu kakhulu, noma ukuzizwa ubuthakathaka kakhulu. Uma uhlangabezana nanoma yiziphi izimpawu ngemuva kokuthatha imithi eyengeziwe, funa usizo lwezokwelapha ngokushesha.

Ngesikhathi ulinde usizo lwezokwelapha, lala phansi ngezinyawo zakho ziphakanyisiwe uma uzizwa unesiyezi noma uzoquleka. Ungazami ukuzenza uhlanze ngaphandle uma uqondiswe ngqo ngumhlinzeki wezempilo. Gcina ibhodlela lemithi nawe ukuze ochwepheshe bezokwelapha bakwazi ukubona kahle ukuthi uthathe ini nokuthi uthathe okungakanani.

Q3. Kufanele Ngenzeni Uma Ngeqe Umthamo We-Macitentan?

Uma weqa umthamo we-macitentan, yithathe ngokushesha lapho ukhumbula, ngaphandle uma sekuyisikhathi esiseduze somthamo wakho olandelayo ohleliwe. Kulokho, weqa umthamo oweqiwe bese uqhubeka neshejuli yakho ejwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo oweqiwe, ngoba lokhu kungabangela imiphumela emibi eyingozi. Uma ungaqiniseki ngesikhathi, kungcono ukulinda kuze kube umthamo wakho olandelayo ohleliwe kunokubeka engozini yokuthatha imithi eningi kakhulu.

Uma uvame ukukhohlwa imithamo, cabanga ukusetha izikhumbuzi zocingo noma usebenzise umhleli wamaphilisi ukukusiza ukuthi uhlale emgqeni. Ukuthatha imithi nsuku zonke ngokuqhubekayo kubalulekile ekugcineni amazinga aqhubekayo emithi ohlelweni lwakho.

Q4. Ngingayeka Nini Ukuthatha I-Macitentan?

Kufanele uyeke kuphela ukuthatha i-macitentan ngaphansi kwesiqondiso sikadokotela wakho, njengoba i-PAH iyisimo esingamahlalakhona esivame ukudinga ukwelashwa okuqhubekayo. Ukuyeka kungazelelwe kungabangela ukuthi izimpawu zakho zibuye noma zibe zimbi kakhulu, okungenzeka kuholele ezinkingeni ezingathi sína.

Udokotela wakho angase acabange ukuyeka noma ukushintsha imithi yakho uma uhlangabezana nemiphumela emibi engathi sína, uma isimo sakho sithuthuka kakhulu, noma uma udinga ukushintshela endleleni yokwelapha ehlukile. Lezi zinqumo zenziwa ngaso sonke isikhathi ngokucophelela ngokuqapha eduze.

Uma ucabanga ukuyeka imithi yakho ngenxa yemiphumela emibi noma ezinye izinto ezikukhathazayo, khuluma nodokotela wakho kuqala. Bavame ukukwazi ukulungisa uhlelo lwakho lokwelapha, balawule imiphumela emibi, noma bahlole ezinye izindlela ezingase zikusebenzele kangcono.

Q5. Ngingayithatha i-Macitentan neminye imithi ye-PAH?

Yebo, i-macitentan ivame ukusetshenziswa ngokuhlangana neminye imithi ye-PAH, futhi abantu abaningi bathola ukuthi ukwelashwa okuhlangene kusebenza kangcono kunemithi eyodwa kuphela. Udokotela wakho uzoqondanisa lezi zinhlanganisela ngokucophelela ukuze andise izinzuzo ngenkathi enciphisa izingozi.

Izinhlanganisela ezivamile zihlanganisa i-macitentan ene-phosphodiesterase-5 inhibitors njenge-sildenafil, noma ene-prostacyclin analogs. Le mithi isebenza ngezindlela ezihlukene, ngakho ukuyihlanganisa kungahlinzeka ngelasho elibanzi le-PAH.

Udokotela wakho uzokuqapha ngokucophelela lapho uqala ukwelashwa okuhlangene, njengoba ingozi yemiphumela emibi efana nomfutho wegazi ophansi ingase ibe phezulu. Bazolungisa imithamo nesikhathi sokuthola inhlanganisela ephephe kakhulu nephumelelayo esimweni sakho esithile.