Iyini i-Mercaptopurine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Mercaptopurine iyimithi esiza ukulawula izinhlobo ezithile zomdlavuza nezimo ze-autoimmune ngokunciphisa ukukhula kwamaseli angajwayelekile. Le mithi kadokotela ingeyeqembu elibizwa ngokuthi ama-antimetabolites, asebenza ngokuphazamisa indlela amaseli enza ngayo i-DNA ne-RNA. Udokotela wakho angase akubhalele le mithi njengengxenye yohlelo lwakho lokwelapha i-leukemia noma isifo samathumbu esivuvukalayo.

Iyini i-Mercaptopurine?

I-Mercaptopurine iyimithi ye-chemotherapy yomlomo eza ngesimo samaphilisi. Yenzelwe ukugxila kumaseli ahlukanisa ngokushesha, okuhlanganisa kokubili amaseli omdlavuza namanye amaseli anempilo emzimbeni wakho. Umuthi usebenza ngokulingisa into yemvelo edingwa amaseli akho ukuze akhule futhi ahlukanise.

Le mithi isetshenziswe ngokuphepha amashumi eminyaka ukwelapha izimo ezihlukahlukene. Ngenkathi ithathwa njengomuthi we-chemotherapy, imithamo esetshenziswayo ivame ukuba phansi kakhulu kunalokho ongase ukucabange ekwelashweni komdlavuza kwendabuko. Udokotela wakho uzoqapha ngokucophelela impendulo yakho futhi alungise umthamo njengoba kudingeka.

Isetshenziselwani i-Mercaptopurine?

I-Mercaptopurine iphatha i-acute lymphoblastic leukemia (ALL), uhlobo lomdlavuza wegazi oluthinta amaseli amhlophe egazi. Iphinde ibhalwe ngezifo zamathumbu ezivuvukalayo njengesifo sikaCrohn kanye ne-ulcerative colitis lapho ezinye izindlela zokwelapha zingasebenzi kahle ngokwanele.

Ezigulini ze-leukemia, le mithi ngokuvamile iyingxenye yohlelo lokwelapha olude oluhlanganisa eminye imithi. Umgomo uwukusiza umzimba wakho uqede amaseli omdlavuza futhi uwavimbele ukuthi angabuyi. Esifweni samathumbu esivuvukalayo, i-mercaptopurine isiza ukuthulisa impendulo yomzimba wakho yokuzivikela engasebenzi kahle ebanga ukuvuvukala emathunjini akho.

Ngezinye izikhathi odokotela banikeza i-mercaptopurine kwezinye izimo ze-autoimmune lapho ukwelashwa okujwayelekile kungahlinzeki ngokuphumula okwanele. Umhlinzeki wakho wokunakekelwa kwezempilo uzokuchazela ngqo ukuthi kungani lo muthi ulungile esimweni sakho esithile.

Isebenza Kanjani I-Mercaptopurine?

I-Mercaptopurine isebenza ngokufakwa kuma-DNA namaseli akho e-RNA. Lapho amaseli angajwayelekile ezama ukukhula nokuhlukanisa, umuthi uphazamisa ikhono lawo lokukopisha izinto zawo zofuzo ngendlela efanele. Lokhu kubangela ukuthi la maseli anezinkinga afe ngokwemvelo.

Umuthi uthathwa njengomaphakathi, kodwa uvame ukubekezelelwa kahle uma usetshenziswa ngemithamo efanele. Umzimba wakho ucubungula i-mercaptopurine ngesibindi sakho, lapho iguqulwa khona ibe izinhlobo ezisebenzayo ezenza umsebenzi wangempela. Le nqubo ithatha isikhathi, yingakho ungase ungaboni imiphumela esheshayo.

Ngenxa yokuthi i-mercaptopurine ithinta ukuhlukaniswa kwamaseli, ingathinta kokubili amaseli angajwayelekile namanye amaseli anempilo ahlukanisa ngokushesha ngokwemvelo. Lokhu kufaka amaseli emnkantsheni wakho, umgudu wokugaya ukudla, kanye nesistimu yakho yokuzivikela. Udokotela wakho uzoqapha lezi zindawo eduze ngesikhathi sokwelashwa.

Kufanele Ngiyithathe Kanjani I-Mercaptopurine?

Thatha i-mercaptopurine ngendlela eqondile udokotela wakho ayalela ngayo, ngokuvamile kanye ngosuku esiswini esingenalutho. Isikhathi esingcono kakhulu ngokuvamile yiyona hora elilodwa ngaphambi kokudla noma amahora amabili ngemuva kokudla, njengoba ukudla kungaphazamisa ukuthi umzimba wakho umunca kahle kangakanani umuthi.

Gwinya amaphilisi wonke ngengilazi yamanzi egcwele. Ungawachobozi, uwahlafune, noma uwaphule, ngoba lokhu kungathinta ukuthi umuthi usebenza kanjani. Uma unenkinga yokugwinya amaphilisi, khuluma nomuthi wakho mayelana nezinketho ezingasiza.

Zama ukuthatha umuthi wakho ngesikhathi esifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo egazini lakho. Abantu abaningi bakuthola kuwusizo ukusetha isikhumbuzi sansuku zonke ocingweni lwabo. Uma uthatha eminye imithi, hlola nodokotela wakho mayelana nesikhathi esingcono kakhulu sokugwema ukuxhumana.

Gwema ukuphuza utshwala ngenkathi uthatha i-mercaptopurine, njengoba kungandisa ingozi yezinkinga zesibindi. Futhi, gwema ama-grapefruit nejusi le-grapefruit, okungaphazamisa indlela umzimba wakho osebenza ngayo imithi.

Ngingayithatha isikhathi esingakanani i-Mercaptopurine?

Ubude bokwelashwa nge-mercaptopurine buhlukahluka kakhulu kuye ngesimo sakho nokuthi usabela kanjani emuthini. Nge-leukemia, ukwelashwa kuvame ukuqhubeka iminyaka emibili kuya kwemithathu njengengxenye yesigaba sokugcinwa ngemva kokwelashwa kokuqala okukhulu.

Uma uthatha i-mercaptopurine ngenxa yesifo samathumbu esivuvukalayo, ungase uyidinge izinyanga eziningana kuya eminyakeni. Abanye abantu badinga ukwelashwa isikhathi eside ukuze bagcine isimo sabo silawulwa. Udokotela wakho uzohlola njalo ukuthi imithi isadingeka yini futhi inenzuzo kuwe.

Ungayeki ukuthatha i-mercaptopurine ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Ukuyeka kungazelelwe kungabangela ukuthi isimo sakho sivuthe noma sibe sibi. Uma udinga ukuyeka imithi, udokotela wakho uzokwenza uhlelo lokwenza kanjalo ngokuphepha.

Yiziphi Imiphumela Eceleni ye-Mercaptopurine?

Njengayo yonke imithi, i-mercaptopurine ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Imiphumela eminingi emibi iyalawuleka futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela imithi.

Nawa amanye imiphumela ejwayelekile ongase uyithole:

• Ukucanuzela kwenhliziyo nokulahlekelwa isifiso sokudla
• Ukukhathala nobuthakathaka
• Ukwanda kwengozi yokutheleleka ngenxa yokwehla kwamaseli egazi amhlophe
• Ukulimala kalula noma ukuphuma kwegazi ngenxa yokwehla kwama-platelet
• Izilonda zomlomo noma izilonda
• Ukuqunjelwa noma ukungakhululeki kwesisu
• Ukuqina kwezinwele (ngokuvamile kulula)

Le miphumela evamile ivame ukuba ngaphansi kokuphazamisa njengoba ukwelashwa kwakho kuqhubeka. Ithimba lakho lezempilo lingase linikeze izindlela zokuphatha ngempumelelo.

Imiphumela emibi engathi sína ingenzeka, nakuba ingavamile. Lokhu kudinga ukunakekelwa kwezempilo ngokushesha futhi kufaka:

• Izimpawu zezinkinga zesibindi njengokuphuzi kwesikhumba noma amehlo, umchamo omnyama, noma isicanucanu esiqhubekayo
• Izifo ezinzima ezinomkhuhlane, amaqhwa, noma ukukhwehlela okuqhubekayo
• Ukuphuma kwegazi okungavamile noma ukulimala okungami
• Ubuhlungu obukhulu besisu noma ukuhlanza okuqhubekayo
• Ukuphendula komzimba okungalungile okunezinduna, ubunzima bokuphefumula, noma ukuvuvukala

Udkt wakho uzokugada eduze ngezivivinyo zegazi ezivamile ukuze abambe noma yiziphi izinkinga zisasekuqaleni. Unganqikazi ukuxhumana nethimba lakho lezempilo uma uqaphela noma yiziphi izimpawu ezikhathazayo.

Ezinye izinkinga ezingavamile kodwa ezingathi sína zihlanganisa ukucindezelwa komnkantsha wamathambo okukhulu, ubuthi besibindi, kanye nokwanda kwengozi yezinye izinhlobo zomdlavuza ngokusebenzisa isikhathi eside. Udkt wakho ulinganisa lezi zingozi ngokumelene nezinzuzo zokwelashwa kwesimo sakho esithile.

Ubani Ongafanele Athathwe I-Mercaptopurine?

I-Mercaptopurine ayifanele wonke umuntu, futhi udkt wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Abantu abanezinhlobo ezithile zofuzo ezithinta indlela abaqhuba ngayo umuthi bangase badinge imithamo ehlukile noma ezinye izindlela zokwelapha.

Akufanele uthathe i-mercaptopurine uma unokungezwani nayo noma imithi efanayo. Xhumana nodkt wakho mayelana nanoma yiziphi izindlela zokuphendula komzimba okungalungile emithini ye-chemotherapy noma eminye imithi. Ukukhulelwa kungenye into ebalulekile okufanele icatshangelwe, njengoba i-mercaptopurine ingalimaza ingane esakhula.

Izimo ezithile zezokwelapha zidinga ukuqapha okwengeziwe noma zingakuvimbela ekuthathweni kwe-mercaptopurine ngokuphepha:

• Isifo sesibindi esibi noma i-hepatitis esebenzayo
• Izifo zomnkantsha wamathambo ezikhona
• Izifo ezisebenzayo ezingalawulwa
• Isifo sezinso esidinga ukulungiswa komthamo
• Ukuphendula okukhulu kwangaphambilini emithini efanayo

Uma uhlela ukukhulelwa noma uncelisa, xoxa lokhu nodokotela wakho. Bobabili abesilisa nabesifazane kufanele basebenzise izindlela zokuvimbela inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nesikhathi esithile ngemva kwalokho.

Udokotela wakho uzobheka neminye imithi oyithathayo, njengoba eminye imithi ingasebenzisana ne-mercaptopurine. Lokhu kuhlanganisa ama-antibiotics athile, ama-blood thinners, neminye imithi ecindezela amasosha omzimba.

Amagama Omkhiqizo we-Mercaptopurine

I-Mercaptopurine itholakala ngaphansi kwamagama amaningi omkhiqizo, i-Purinethol iyona eyaziwa kakhulu. Ungase futhi uyibone ibizwa ngokuthi i-6-mercaptopurine noma i-6-MP emibhalweni yezokwelapha nasezingxoxweni neqembu lakho lezempilo.

Izinhlobo ezivamile ze-mercaptopurine zitholakala kabanzi futhi zisebenza ngempumelelo njengezinhlobo ezinamagama omkhiqizo. Ikhemisi lakho lingashintsha uhlobo olujwayelekile ngaphandle uma udokotela wakho ecela ngokuqondile igama lomkhiqizo. Zombili izinhlobo ziqukethe isithako esifanayo esisebenzayo futhi zihlangabezana nezindinganiso ezifanayo zokuphepha nokusebenza kahle.

Ezinye izindlela ze-Mercaptopurine

Imithi eminingi ehlukile ingase icatshangelwe uma i-mercaptopurine ingakulungele noma ingasebenzi kahle ngokwanele. Ukukhetha kuncike esimweni sakho esithile, umlando wezokwelapha, nokuthi usabele kanjani ekwelashweni kwangaphambilini.

Ngesifo samathumbu esivuvukalayo, ezinye izindlela zihlanganisa i-azathioprine (ehlobene eduze ne-mercaptopurine), i-methotrexate, noma imithi emisha ye-biologic efana ne-infliximab noma i-adalimumab. Ngayinye inezinzuzo zayo kanye nephrofayili yemiphumela engemihle okuzoxoxwa ngayo nodokotela wakho.

Ekwelashweni komdlavuza, ezinye izindlela zingase zihlanganise eminye imithi ye-chemotherapy, ukwelashwa okuqondiwe, noma izinketho ze-immunotherapy. Udokotela wakho we-oncologist uzocabangela izinto ezifana nohlobo oluthile lomdlavuza wakho, isigaba sesifo, nempilo yonke lapho encoma ezinye izindlela.

Isinqumo sokushintsha imithi kufanele senziwe ngaso sonke isikhathi ngokubonisana nethimba lakho lezempilo. Bangakusiza ukuthi ulinganise izinzuzo nobubi bezinketho ezahlukene ngokusekelwe esimweni sakho.

Ingabe i-Mercaptopurine ingcono kune-Azathioprine?

I-Mercaptopurine ne-azathioprine ziyimithi ehlobene eduze esebenza ngezindlela ezifanayo, kodwa azifani ngqo. I-Azathioprine empeleni iguqulwa ibe yi-mercaptopurine emzimbeni wakho, ngakho i-mercaptopurine iyindlela esebenzayo eyenza umsebenzi wangempela.

Akukho mithi enye engcono ngokuqinisekile kunenye - ukukhetha kuncike ezimweni zakho. Abanye abantu bayayibekezelela enye kangcono kunenye, kanti abanye odokotela bakhetha enye ngokusekelwe kulwazi lwabo noma izici ezithile zesimo sakho.

I-Azathioprine ivame ukuzanywa kuqala ngezifo zamathumbu ezivuvukalayo ngoba ifundwe kabanzi ngale njongo. Kodwa-ke, i-mercaptopurine ingase ithandwe uma unezinguquko ezithile zofuzo ezithinta indlela oyiqeda ngayo i-azathioprine. Udokotela wakho angakwazi uku-oda ukuhlolwa kofuzo ukusiza ukuhola lesi sinqumo.

Yomibili imithi idinga ukuqapha okufanayo futhi inezinhlu zokusebenza ezifanayo. Isinqumo phakathi kwabo sivame ukwehla ekuthandeni kukadokotela wakho, impendulo yakho emithini, kanye nanoma yiziphi izici ezithile emlandweni wakho wezokwelapha.

Imibuzo Evame Ukubuzwa Mayelana ne-Mercaptopurine

Q1. Ingabe i-Mercaptopurine iphephile ukusetshenziswa isikhathi eside?

I-Mercaptopurine ingasetshenziswa ngokuphepha isikhathi eside uma iqashwe kahle ithimba lakho lezempilo. Abantu abaningi bayayithatha izinyanga noma iminyaka ngaphandle kwezinkinga ezinkulu. Udokotela wakho uzohlola njalo ukubalwa kwegazi lakho, ukusebenza kwesibindi, nempilo yonke ukuze aqinisekise ukuthi imithi ihlala iphephile futhi isebenza kahle kuwe.

Ukusetshenziswa kwesikhathi eside kuletha ezinye izingozi ezengeziwe, okuhlanganisa ithuba elincane lokuthuthukisa izifo ezithile noma, ngezikhathi ezithile, ezinye izinhlobo zomdlavuza. Kodwa-ke, kubantu abaningi, izinzuzo zokulawula isimo sabo esiyisisekelo zidlula lezi zingozi. Udokotela wakho uzoxoxa nawe ngalezi zinto futhi alungise uhlelo lwakho lokwelapha njengoba kudingeka.

Q2. Kufanele Ngenzeni Uma Ngithatha I-Mercaptopurine Eningi Ngengozi?

Uma ngengozi uthatha i-mercaptopurine eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kungandisa ingozi yemiphumela emibi, ikakhulu ethinta ukubalwa kwegazi nomsebenzi wesibindi sakho.

Ungalindi ukuthi izimpawu zivele ngaphambi kokufuna usizo. Bhala phansi ngqo ukuthi uthathe malini nokuthi nini, njengoba lolu lwazi luzosiza abahlinzeki bezempilo ukuthi banqume inkambo engcono kakhulu yokwenza. Kwezinye izimo, ungase udinge ezinye izivivinyo zegazi noma ukuqapha ukuze uqinisekise ukuthi uphephile.

Q3. Kufanele Ngenzeni Uma Ngeqa Umthamo We-Mercaptopurine?

Uma weqa umthamo futhi kungakapheli amahora ambalwa ngesikhathi sakho esivamile, yithathe ngokushesha lapho ukhumbula. Kodwa-ke, uma sekuseduze nesikhathi somthamo wakho olandelayo, weqa umthamo oweqiwe bese uqhubeka nohlelo lwakho olujwayelekile. Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo oweqiwe.

Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho ngamasu okukusiza ukuthi ukhumbule. Ukulinganisa okuqhubekayo kubalulekile ukuze umuthi usebenze ngempumelelo. Cabangela ukusetha ama-alamu ocingo, ukusebenzisa umhleli wamaphilisi, noma ukuxhumanisa imithi yakho nomsebenzi wansuku zonke.

Q4. Ngingayeka Nini Ukuthatha I-Mercaptopurine?

Isinqumo sokuyeka i-mercaptopurine kufanele senziwe ngaso sonke isikhathi ngesiqondiso sikadokotela wakho. Ukuze kulashwe umdlavuza, ngokuvamile kunesu lokwelapha elinqunywe ngaphambili eliqinisekisa ukuthi uzodinga isikhathi esingakanani umuthi. Ngezifo zamathumbu ezivuvukalayo, isikhathi sincike ekutheni isimo sakho silawulwa kahle kangakanani nokuthi ngabe ezinye izindlela zokwelapha zingase zifanele.

Udkt wakho uzocabangela izinto ezifana nendlela ozabela ngayo emithini, imiphumela emibi oyitholayo, kanye nobungozi bokuthi isimo sakho sibuyele. Bangase banciphise kancane kancane umthamo wakho kunokuthi bayeke ngokuphazima kweso ukunciphisa ubungozi bokuqubuka.

Q5. Ngingakwazi yini ukugonywa ngenkathi ngithatha i-Mercaptopurine?

Imithi yokugoma ejwayelekile ivikelekile ngenkathi uthatha i-mercaptopurine, kodwa kufanele ugweme imithi yokugoma ephilayo efana nomuthi wokugoma umkhuhlane ngamakhala, umuthi wokugoma i-chickenpox, noma umuthi wokugoma i-MMR. Isistimu yakho yokuzivikela ingase icindezelwe kancane, ngakho imithi yokugoma ephilayo ingase ibangele izinkinga.

Imithi yokugoma engasebenzi njengoba kufanele njengomuthi wokugoma umkhuhlane, umuthi wokugoma umkhuhlane wamaphaphu, kanye nemithi yokugoma i-COVID-19 ngokuvamile iyatuswa futhi ivikelekile. Kodwa-ke, kungenzeka ingasebenzi kahle njengenjwayelo ngoba ukusabela komzimba wakho kungancipha. Hlala uhlola nethimba lakho lezempilo ngaphambi kokuthola noma yimiphi imithi yokugoma ukuze uqinisekise ukuthi ifanele isimo sakho.