Yini i-Palifermin: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Palifermin iyiphrotheni ekhethekile eyenzelwe ukusiza ukuvikela nokuphulukisa izicubu ezibucayi emlonyeni nasemphinjeni wakho ngesikhathi sokwelashwa komdlavuza okunamandla. Uma wena noma othile omkhathalelayo ebhekene nezinhlobo ezithile zokwelashwa komdlavuza, ithimba lakho lezokwelapha lingase lincomende lokhu kwelashwa okusekelayo ukusiza ukuvimbela izilonda ezinzima zomlomo nezinye izinkinga.

Lo muthi usebenza njengomqaphi omuhle wezicubu ezithambile ezihlanganisa umlomo wakho, umphimbo, kanye nethrekhi yokugaya ukudla. Unikezwa nge-IV ngaphambi nangemva kokwelashwa komdlavuza okuthile ukusiza izinqubo zokuphulukisa zemvelo zomzimba wakho ukuthi zihlale ziqinile lapho zingaphansi kwengcindezi.

Yini i-Palifermin?

I-Palifermin iyinguqulo eyenziwe ngumuntu yeprotheni yemvelo ebizwa ngokuthi i-keratinocyte growth factor (KGF) umzimba wakho ovamise ukuyikhiqiza. Cabanga ngayo njengeqembu elikhethekile lokulungisa eliqondise ngqo amaseli ahlanganisa umlomo wakho, umphimbo, kanye nesistimu yokugaya ukudla.

Lo muthi ungowesigaba esibizwa ngokuthi ama-growth factors, okuyiziprotheni ezisiza amaseli ukuthi akhule, ahlukanise, futhi azilungise. Ososayensi badala i-palifermin ngokuguqula i-KGF yemvelo ukuyenza izinzile futhi isebenze kahle uma isetshenziswa njengomuthi.

Lokhu akuyona ukwelashwa komdlavuza ngokwako, kodwa kunalokho ukwelashwa okusekelayo okusiza ukuvikela izicubu ezinempilo ngenkathi wamukela okunye ukwelashwa okudingekayo. Kufana nokuba nokuqiniswa okwengeziwe ezingxenyeni zomzimba wakho ezisengozini enkulu ngesikhathi sezinqubo zezokwelapha ezinamandla.

Isetshenziselwani i-Palifermin?

I-Palifermin isetshenziswa ikakhulukazi ukuvimbela izilonda ezinzima zomlomo (ezibizwa ngokuthi i-oral mucositis) kubantu abathola i-chemotherapy ephezulu kanye ne-radiation therapy ngaphambi kokufakelwa umnkantsha wamathambo. Lokhu kwelashwa kungasindisa impilo kodwa kuvame ukulimaza amaseli anempilo ahlanganisa umlomo nomphimbo wakho.

Udktora wakho angase ancome i-palifermin uma ulungiselela ukufakelwa kwamaseli esiqu se-hematopoietic, ikakhulukazi uma unezifo zomdlavuza wegazi njenge-leukemia, i-lymphoma, noma i-multiple myeloma. Umuthi uvunyelwe ngokuqondile iziguli ezizothola ukwelashwa okubekwayo okwaziwa ukuthi kubangela izinkinga ezinzima zomlomo nomphimbo.

Umgomo uwukukusiza ukuthi udlule ekwelashweni kwakho umdlavuza ngobuhlungu obuncane nezinkinga ezimbalwa. Uma izilonda zomlomo zivinjwa noma zincishiswa, maningi amathuba okuthi uzogcina ukudla okunempilo, ube nezifo ezimbalwa, futhi uzwe ukungakhululeki okuncane ngesikhathi sokululama kwakho.

Isebenza Kanjani I-Palifermin?

I-Palifermin isebenza ngokukhuthaza ukukhula nokuvikelwa kwamaseli e-epithelial, okuyizicubu ezakha umugqa ovikelayo womlomo wakho, umphimbo, kanye nethrekhi yokugaya ukudla. Lapho la maseli enempilo futhi evuselela ngokwawona, akwazi kangcono ukumelana nemiphumela yokwelashwa komdlavuza okukhulu.

Lo muthi ubhekwa njengokwelashwa okusekelayo okuhloswe ngakho kunokuba kube ukwelashwa okuqinile noma okubuthakathaka ngomqondo wendabuko. Yenzelwe ngokuqondile ukusebenza ezinhlotsheni ezithile zamaseli ngaphandle kokuthinta ukusebenza kokwelashwa kwakho umdlavuza.

Iphrotheni ibopha kuma-receptors athile kumaseli akho e-epithelial, ithumela amasignali akhuthaza ukuthi akhule, aphindaphindeke, futhi azilungise ngokushesha. Le nqubo isiza ukudala isithiyo esiqinile, esiqinile emlonyeni wakho nasemphinjeni ngaphambi kokuthi kuqale ukwelashwa okuyinselele.

Njengoba kushiwo lokho, i-palifermin nayo isiza la maseli afanayo ukuthi alulame ngokushesha ngemva kokuthi kwenzeke umonakalo wokwelashwa. Kufana nokuba nethimba lokulungisa elinobuchule elisebenza kokubili ukuqinisa izivikelo zakho kusengaphambili nokulungisa noma yimuphi umonakalo owenzekayo.

Kufanele Ngiyithathe Kanjani I-Palifermin?

I-Palifermin inikezwa kuphela ngomugqa we-intravenous (IV) ngabasebenzi bezempilo abaqeqeshiwe esibhedlela noma emtholampilo. Ngeke uthathe lo muthi ekhaya noma ngomlomo.

Ishejuli elivamile lihilela ukuthola imithamo emithathu ngaphambi kokuthi ukwelashwa kwakho kokulungisa kuqale, kulandelwe eminye imithamo emithathu ngemuva kokufakelwa kwakho amaseli esiqu. Ithimba lakho lezokwelapha lizohlela le mithamo ngokucophelela, ngokuvamile liyinikeze ngezinsuku ezilandelanayo.

Akudingeki wenze lutho olukhethekile ukulungiselela ukufakwa kwakho kwe-palifermin. Ngokungafani neminye imithi, akudingi ukuthi udle noma ugweme ukudla ngaphambi kwesikhathi. Ukufakwa kwe-IV ngokwako kuvame ukuthatha imizuzu engaba ngu-15-30.

Ithimba lakho lezempilo lizokuqapha ngesikhathi nangemuva komthamo ngamunye ukuze liqinisekise ukuthi uyayibekezelela kahle imithi. Bazophinda bahlele isikhathi sokwelashwa kwakho okunye ukuze baqinisekise ukuvikelwa okungcono kakhulu kwezicubu zomlomo nomphimbo wakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Palifermin?

Inkambo ejwayelekile yokwelashwa nge-palifermin ngokuvamile iqedwa emasontweni amabili, equkethe imithamo eyisithupha ephelele enikezwa ngezikhathi ezithile. Lena akuyona imithi ozoyithatha izinyanga noma iminyaka.

Udokotela wakho uzokunika imithamo emithathu ngaphambi kokuthi ukwelashwa kwakho kokulungisa kuqale, bese enye imithamo emithathu ngemuva kokufakelwa kwakho amaseli esiqu. Isikhathi esiqondile sincike esimisweni sakho sokwelashwa esithile nokuthi umzimba wakho usabela kanjani.

Ubude bokwelashwa obufushane buqondile futhi buhlelelwe ngokucophelela. I-Palifermin yakhelwe ukuhlinzeka ngokuqwashisa ngesikhathi esibucayi sokwelashwa kwakho umdlavuza, lapho izicubu zomlomo nomphimbo wakho zisengozini enkulu yokulimala.

Uma usuqedile inkambo ephelele futhi izicubu zomlomo wakho ziphilile, ngokuvamile ngeke udinge ukwelashwa okwengeziwe nge-palifermin ngaphandle kokuthi uhlangabezane nokwelashwa okufanayo okukhulu esikhathini esizayo.

Yiziphi Imiphumela Eceleni Ye-Palifermin?

Abantu abaningi bayayibekezelela kahle i-palifermin, ikakhulukazi uma kucatshangelwa ukuqina kokwelashwa okuhloswe ukukusekela. Imiphumela emibi ivame ukulawuleka futhi yesikhashana, ixazululwe uma inkambo yakho yokwelashwa isiqediwe.

Ake siqale ngemiphumela eseceleni evamile ongase uyithole, ethinta abantu abaningi abathola lo muthi:

• Ukuqubuka kwesikhumba noma ukubomvu, ngokuvamile okuvela njengokusha kwelanga okuncane
• Ukushintsha kombala womlomo noma ulimi, ngokuvamile okuvela njengamabala amhlophe noma ukumboza
• Ukuphazamiseka kokunambitheka, lapho ukudla kungase kunambitheke ngendlela ehlukile noma ngensimbi
• Ukuvuvukala okuncane kwemithambo yomlomo noma ulimi
• Ukulimala kwamalunga noma imisipha, okufana nezimpawu ezincane ezinjenge-flu

Lezi zimo ezivamile ngokuvamile ziyindlela yomzimba wakho yokuphendula ekukhuleni okwandisiwe kwamaseli nomsebenzi wokulungisa. Abantu abaningi bathola ukuthi le miphumela iyamelana futhi yesikhashana.

Abanye abantu bathola imiphumela eseceleni engavamile kodwa esalawulekayo okuzoqashwa ithimba lakho lezokwelapha:

• Umkhuhlane noma amaqhwa ngesikhathi noma ngemva kokufakwa
• Ukucasuka noma isisu esicasukile
• Ikhanda noma isiyezi esincane
• Ukuphendula kwendawo yokujova njengokubomvu noma ukuvuvukala
• Ushintsho lwamanani egazi elebhu

Manje, ake sixoxe ngemiphumela eseceleni engavamile kodwa ebucayi edinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba lokhu kungenzeki njalo, kubalulekile ukukwazi:

• Ukuphendula okukhulu komzimba okubangela ubunzima bokuphefumula, ukuqina kwesifuba, noma ukuqubuka okubanzi
• Ukuvuvukala okukhulu kobuso, izindebe, ulimi, noma umphimbo
• Ukuphendula okukhulu kwesikhumba ngamabhamuza noma ukuxebuka
• Izimpawu zokutheleleka njengomkhuhlane oqhubekayo, amaqhwa, noma ubuthakathaka obungavamile
• Ubuhlungu obukhulu besisu noma ukuhlanza okuqhubekayo

Ithimba lakho lezempilo lizokuqapha ngokucophelela nganoma yikuphi ukusabela okukhathazayo futhi lizokwazi kahle ukuthi lingaziphatha kanjani uma zenzeka. Khumbula ukuthi izinzuzo zokuvimbela izilonda ezinzima zomlomo ngokuvamile zidlula lezi zingozi ezingaba khona kubantu abaningi.

Ubani Ongafanele Athole I-Palifermin?

I-Palifermin ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ilungile yini esimweni sakho esithile. Lesi sinqumo sihilela ukulinganisa izinzuzo nezingozi ezingaba khona ngokusekelwe emlandweni wakho wezempilo.

Akufanele uthole i-palifermin uma wazi ukuthi unokungezwani komzimba emuthini uqobo, kunoma iyiphi yezingxenye zawo, noma kumaprotheni atholakala ku-E. coli. Njengoba i-palifermin ikhiqizwa kusetshenziswa amagciwane e-E. coli, abantu abanezifo ezingathi sína zokungezwani komzimba emikhiqizweni ethathwe ku-E. coli badinga ezinye izindlela.

Ithimba lakho lezokwelapha lizosebenzisa ukuqapha okwengeziwe uma unezinhlobo ezithile zomdlavuza. I-Palifermin ingakhuthaza ukukhula kwamanye amaseli omdlavuza anama-receptor athile, ngakho-ke akunconywa ngeminye imidlava engahlobene negazi.

Abantu abanezifo ezisebenzayo, ezingalawuleki bangase badinge ukulinda kuze kube yilapho ukutheleleka kwabo kuphathwa ngaphambi kokuqala i-palifermin. Uhlelo lwakho lomzimba lokuzivikela kufanele lube sesimweni esingcono kakhulu ukuze luzuze kulokhu kwelashwa okusekelayo.

Uma ukhulelwe noma uncelisa, udokotela wakho uzodinga ukucabangela ngokucophelela izingozi nezinzuzo. Ngenkathi kukhona idatha elinganiselwe ekusetshenzisweni kwe-palifermin ngesikhathi sokukhulelwa, umuthi ngokuvamile ugcinelwe izimo ezisongela impilo lapho izinzuzo zicacile ukwedlula izingozi ezingaba khona.

Amagama Omkhiqizo we-Palifermin

I-Palifermin itholakala ngaphansi kwegama lomkhiqizo elithi Kepivance, okuyigama elivame kakhulu ukwaziwa lalo muthi. I-Kepivance ikhiqizwa yi-Sobi (Swedish Orphan Biovitrum) futhi iyigama eliyinhloko elitholakala emazweni amaningi.

Ungase ubone lo muthi ubizwa ngegama lawo elivamile, i-palifermin, noma ngegama lomkhiqizo walo, i-Kepivance, kuye ngendawo yakho yokunakekelwa kwezempilo. Womabili la magama abhekisela emuthini ofanayo onesithako esisebenzayo esifanayo.

Ezindaweni ezithile, imithi ingase itholakale ngaphansi kwamagama ahlukene emikhiqizo noma ngezinkampani ezihlukene, kodwa isithako esisebenzayo nemiphumela yokwelapha ihlala injalo. Ithimba lakho lezempilo lizoqinisekisa ukuthi uthola ukwakheka okufanele ngaphandle kokuthi igama lomkhiqizo elithile elisetshenziswayo.

Ezinye Izindlela Zokwelapha i-Palifermin

Njengamanje, azikho ezinye izindlela eziqondile ze-palifermin ezisebenza ngendlela efanayo. Yiwona kuphela umuthi ogunyazwe yi-FDA oklanyelwe ngqo ukuvimbela i-oral mucositis ezigulini eziphansi kokwelashwa ngamakhemikhali kanye nemisebe ngaphambi kokufakelwa kwamaselula e-stem.

Nokho, ithimba lakho lezokwelapha lingase lisebenzise ezinye izindlela zokusekela kanye noma esikhundleni se-palifermin, kuye ngesimo sakho esithile. Lawa maqhinga ahlukile agxila ekuphatheni izimpawu nasekukhuthazeni ukuphulukiswa ngezindlela ezihlukene.

Ezinye izinhlangano zezempilo zisebenzisa izinqubo zokunakekelwa komlomo ezihlanganisa izindlela zokugeza umlomo ezikhethekile, ama-ejenti okugcoba, noma amaqhinga okuphatha ubuhlungu. Lezi zindlela zingaba usizo kodwa azinikezi ukuvikelwa kwamaselula okuhloswe ngakho okufana nalokho okunikezwa yi-palifermin.

Ukwelashwa ngelaser ezingeni eliphansi kanye nezinye izithasiselo zokudla okunomsoco kukhombise isithembiso kwezinye izifundo, kodwa azikazange zifakazelwe ukuthi zisebenza kahle njenge-palifermin ekuvikeleni izilonda ezinzima zomlomo ezigulini eziyingozi enkulu.

Udokotela wakho uzo-oda indlela engcono kakhulu esekelwe ohlelweni lwakho lokwelashwa oluthile, izici eziyingozi, kanye nesimo sempilo yakho esiphelele. Ngezinye izikhathi inhlanganisela yamaqhinga isebenza kangcono kunokuncika kunoma iyiphi indlela eyodwa.

Ingabe i-Palifermin Ingcono Kunezinye Izindlela Zokwelapha Zokuvimbela?

I-Palifermin njengamanje ithathwa njengezinga legolide ekuvikeleni i-oral mucositis ezigulini eziphansi kokwelashwa okunamandla ngaphambi kokufakelwa kwamaselula e-stem. Izifundo zemitholampilo zikhombise ngokuqhubekayo ukusebenza kwayo ekunciphiseni kokubili ubukhulu nobude bezilonda zomlomo.

Uma iqhathaniswa nokunakekelwa komlomo okujwayelekile kuphela, i-palifermin inciphisa kakhulu ukwenzeka kwezinhlungu zomlomo ezinzima ukusuka cishe ku-98% kuya cishe ku-63% ezigulini eziyingozi enkulu. Lokhu kumele ukuthuthuka okukhulu ekhwalithini yempilo ngesikhathi sokwelashwa esivele siyinselele.

Umuthi ukhonjiswe futhi ukunciphisa isidingo semithi ebuhlungu ye-narcotic futhi kunciphise ubude bezinhlungu zomlomo ezinzima. Iziguli eziningi ezithola i-palifermin zibika ukuthi ziyakwazi ukudla nokuphuza ngokunethezeka ngesikhathi sokululama kwazo ekwelashweni.

Kodwa-ke,

Njengoba i-palifermin inikezwa ochwepheshe bezempilo endaweni elawulwa yezokwelapha, ukweqisa ngengozi akuvamile kakhulu. Ithimba lakho lezokwelapha libala ngokucophelela futhi liqinisekisa kabili umthamo wakho ngaphambi kokuphathwa ngakunye.

Uma ukhathazekile ngokuthola imithi eningi kakhulu, unganqikazi ukubuza ithimba lakho lezokwelapha ngokuphathelene nenqubo yokulinganisa. Bangakuchazela ukuthi bawubala kanjani umthamo wakho othile nokuthi yiziphi izinyathelo zokuphepha ezikhona.

Esimeni esingajwayelekile sephutha lokulinganisa, ithimba lakho lezokwelapha liqeqeshwe ukubona nokuphatha noma yiziphi izinkinga ngokushesha. Banezinqubo zokubheka nokubhekana nanoma yiziphi izimo ezingezinhle.

Ngingenzani Uma Ngedlula Umthamo We-Palifermin?

Uma udlula umthamo we-palifermin ohleliwe, xhumana nethimba lakho lezokwelapha ngokushesha ukuze nixoxe ngokuhlela kabusha. Isikhathi semithamo ye-palifermin sihlelwe ngokucophelela nezinye izindlela zakho zokwelapha, ngakho izinguquko zidinga ukuphathwa ochwepheshe bakho bezokwelapha.

Udokotela wakho angase akwazi ukulungisa uhlelo lwakho ukuze luvumelane nomthamo odliwe, noma bangase bancomise ukuqhubeka nohlelo lwakho lokwelapha futhi bakubheke eduze ngezilonda zomlomo. Isinqumo sincike ekutheni umthamo udliwe nini nokuthi ukuphi emgqeni wakho wesikhathi sokwelashwa.

Ungazami ukulungisa umthamo odliwe wedwa. Uhlelo lwemithi lwenzelwe ngokuqondile ukuhlinzeka ngokuvikeleka okungcono kakhulu, futhi noma yiziphi izinguquko kufanele zenziwe ngaphansi kokuqashwa kwezokwelapha.

Ngingayeka Nini Ukuthatha I-Palifermin?

Akudingeki ukuthi wenze isinqumo sokuthi uyeka nini i-palifermin ngoba inikezwa njengendlela yokwelapha esinqunyiwe. Inqubo ejwayelekile ihlanganisa imithamo eyisithupha isiyonke, futhi uma usuqedile le nkambo, ukwelashwa kuqediwe.

Iqembu lakho lezempilo lizobheka izicubu zomlomo nomphimbo wakho ngaso sonke isikhathi sokwelashwa kwakho umdlavuza ukuze kuqinisekiswe ukuthi i-palifermin inikeza ukuvikelwa okuhlosiwe. Bazobheka futhi noma yiziphi izimpawu zokuthi ukunakekelwa okwengeziwe okusekelayo kungase kudingeke.

Uma uhlangabezana nemiphumela emibi ekhathazayo, udokotela wakho angase ashintshe uhlelo lwakho lokwelashwa, kodwa lesi sinqumo sizohlala sithathwa ngokubonisana nethimba lakho lonke lezokwelapha ukuze kuqinisekiswe ukuphepha kwakho nempumelelo yokwelashwa.

Ngingakwazi Ukuthola I-Palifermin Ngesikhathi Sokukhulelwa?

Ukusetshenziswa kwe-palifermin ngesikhathi sokukhulelwa kudinga ukucatshangelwa ngokucophelela kakhulu yithimba lakho lezokwelapha. Kukhona idatha elinganiselwe yokuthi imithi ithinta kanjani abesifazane abakhulelwe kanye nezingane ezisakhula, ngakho-ke ngokuvamile igcinelwe izimo lapho izinzuzo zikhulu ngokucacile kunezinkinga ezingaba khona.

Uma ukhulelwe futhi udinga ukwelashwa komdlavuza okukhulu, odokotela bakho bazosebenza nochwepheshe ekukhulelweni okuyingozi ukuze bathuthukise uhlelo lokwelashwa oluphephe kakhulu. Lokhu kungase kuhlanganise izindlela ezingezinye zokuvimbela izilonda zomlomo noma izinqubo zokwelashwa ezishintshiwe.

Isinqumo sizoxhomeka ezintweni ezifana nohlobo nesigaba somdlavuza wakho, ukuthi usukhulelwe kangakanani, nokuthi yiziphi ezinye izinketho zokwelashwa ezitholakalayo. Ithimba lakho lezokwelapha lizoqinisekisa ukuthi unalo lonke ulwazi oludingekayo ukuze wenze isinqumo esingcono kakhulu kuwe nakubantwana bakho.