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

I-Rasburicase iyimithi ekhethekile enikezwa nge-IV ukusiza umzimba wakho ukubhekana namazinga ayingozi e-uric acid. Le enzyme enamandla isebenza njengomsizi oqondiwe, ichitha i-uric acid lapho izinso zakho zingakwazi ukuhambisana nokukhukhula okungazelelwe okwenzeka ngezikhathi ezithile ngesikhathi sokwelashwa komdlavuza.

Ngokuvamile uzohlangana naleli khambi ezindaweni zasemtholampilo, lapho amaqembu okunakekelwa kwezempilo ewasebenzisa ukuvimbela izinkinga ezingathi sína. Cabanga ngayo njengebhegi eliphuthumayo lamazinga e-uric acid emzimbeni wakho lapho esongela ukuphuma ngaphandle kokulawulwa.

Yini i-Rasburicase?

I-Rasburicase iyi-enzyme eyenziwe e-laboratory echitha i-uric acid egazini lakho. Empeleni iyinguqulo yokwenziwa ye-enzyme ebizwa ngokuthi i-uricase, okungukuthi abantu abanayo ngokwemvelo kodwa ezinye izilwane ezincelisayo zinayo.

Le mithi ingeyeqembu elibizwa ngokuthi ama-enzyme aqondene ne-uric acid. Ngokungafani nemithi evimbela nje ukukhiqizwa kwe-uric acid, i-rasburicase empeleni ibhubhisa i-uric acid esivele ijikeleza egazini lakho. Isebenza ngokushesha kakhulu kunezindlela zokwelapha zendabuko, ngokuvamile ibonisa imiphumela emahoreni kunokuba izinsuku.

Umuthi uza njengempushana exutshwa namanzi ahlanzekile futhi inikezwe ngomugqa we-IV. Ithimba lakho lokunakekelwa kwezempilo lizohlala lilungisa futhi linikeze le mithi endaweni elawulwayo yasesibhedlela.

Isetshenziselwani i-Rasburicase?

I-Rasburicase iphatha futhi ivimbele i-tumor lysis syndrome, isimo esibi esingenzeka ngesikhathi sokwelashwa komdlavuza. Lapho amaseli omdlavuza efa ngokushesha ngesikhathi se-chemotherapy noma imisebe, akhulula amanani amakhulu e-uric acid egazini lakho.

Izinso zakho ngokuvamile zihlunga i-uric acid, kodwa zingakhukhulwa lapho ukwelashwa komdlavuza kubangela ukufa kweseli okungazelelwe. Lokhu kukhukhula kwe-uric acid kungakha amakristalu ezinso zakho, okungenzeka kubangele ukulimala kwezinso noma ukwehluleka.

Umuthi uvame ukusetshenziswa kubantu abathola ukwelashwa ngomdlavuza wegazi njenge-leukemia, i-lymphoma, noma i-multiple myeloma. Kodwa-ke, odokotela bangase bawusebenzise nakuma-tumor aqinile lapho kunengozi enkulu ye-tumor lysis syndrome.

Ezinye iziguli zithola i-rasburicase njengokuvimbela ngaphambi kokuqala ukwelashwa ngomdlavuza, kanti ezinye ziyayithola ngemuva kokuthi amazinga e-uric acid eseqale ukuba phezulu ngendlela eyingozi. Udokotela wakho we-oncologist uzoqoka isikhathi esingcono kakhulu ngokusekelwe esimweni sakho esithile kanye nezinto eziyingozi.

Isebenza Kanjani I-Rasburicase?

I-Rasburicase isebenza ngokuguqula i-uric acid ibe yinhlanganisela ebizwa ngokuthi i-allantoin, okwenza izinso zakho zikwazi ukuyiqeda kalula. Le nqubo yenzeka ngokushesha nangempumelelo, ngokuvamile yehlisa amazinga e-uric acid phakathi kwamahora angu-4 kuya kwangu-24.

Lona umuthi onamandla osebenza ngokushesha kakhulu kunezindlela zokwelapha i-uric acid zendabuko. Ngenkathi imithi efana ne-allopurinol ivimbela ukwakheka okusha kwe-uric acid, i-rasburicase ibhubhisa ngokuqondile i-uric acid ekhona egazini lakho.

Le enzyme iqondisa ngqo kuma-molecule e-uric acid, iwabhidliza ngenqubo ebizwa ngokuthi i-oxidation. I-allantoin evelayo icishe ibe izikhathi eziyi-5 kuya kweziyi-10 encibilika emanzini kune-uric acid, okwenza kube lula kakhulu ukuthi izinso zakho ziyikhiphe.

Lapho umuthi usususiwe ukwakheka okuyingozi kwe-uric acid, izinso zakho zingabuyela emsebenzini wazo ovamile. I-enzyme ngokwayo iyachithwa futhi iqedwe emzimbeni wakho ezinsukwini ezimbalwa.

Kufanele Ngiyithathe Kanjani I-Rasburicase?

Uzothola i-rasburicase kuphela endaweni yasesibhedlela ngomugqa we-IV, ungalokothi njengomuthi owuthatha ekhaya. Ithimba lezempilo lizofaka i-catheter encane emthanjeni, ngokuvamile engalweni yakho noma esandleni sakho, bese linikeza umuthi njenge-infusion ehamba kancane.

I-infusion ngokuvamile ithatha imizuzu engama-30 ukuze iqede. Uzodinga ukuhlala unganyakazi ngalesi sikhathi, kodwa ungafunda, ubuke i-TV, noma ukhulume nezivakashi. Abasebenzi bezokwelapha bazokuqapha eduze kuyo yonke le nqubo.

Akudingeki ukuthi uzile ngaphambi kokuthola i-rasburicase, futhi ungadla ngokujwayelekile ngemva kwalokho. Nokho, ukuhlala unamanzi kahle kubalulekile, ngakho ithimba lakho lezempilo lingase likukhuthaze ukuthi uphuze amanzi amaningi noma uthole uketshezi olwengeziwe lwe-IV.

Uhlelo lwemithi luya ngesimo sakho esithile. Abanye abantu bathola umthamo owodwa, kanti abanye bangase bathole imithamo yansuku zonke izinsuku eziningana. Udokotela wakho we-oncologist uzokwenza uhlelo olwenzelwe wena ngokuya ngamazinga akho e-uric acid kanye nohlelo lwakho lokwelashwa komdlavuza.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Rasburicase?

Abantu abaningi bathola i-rasburicase izinsuku eziyi-1 kuya kwezi-5, kuye ngokuthi amazinga abo e-uric acid abuyela ngokushesha kangakanani ebangeni eliphephile. Ithimba lakho lezempilo lizobheka amazinga egazi lakho nsuku zonke ukuze linqume ukuthi kuphephile nini ukuyeka.

Ubude bokwelashwa buxhomeke ezintweni eziningana, okuhlanganisa amazinga akho okuqala e-uric acid, ukusebenza kwezinso, nokuthi usabela kahle kangakanani emuthini. Ezinye iziguli zidinga umthamo owodwa kuphela, kanti ezinye zidinga izinsuku eziningana zokwelashwa.

Udokotela wakho uzo-oda ukuhlolwa kwegazi okuvamile ukuze alandelele amazinga akho e-uric acid, ukusebenza kwezinso, nezinye izimpawu ezibalulekile. Uma amazinga akho esezinzile ebangeni eliphephile futhi ahlala lapho, ngokuvamile ngeke udinge imithamo eyengeziwe.

Uma uthola ukwelashwa komdlavuza okuqhubekayo, ithimba lakho lezempilo lingase likunikeze i-rasburicase futhi uma amazinga akho e-uric acid eba yingozi ngesikhathi semijikelezo yokwelashwa yesikhathi esizayo.

Yiziphi Imiphumela Eceleni Ye-Rasburicase?

Njengayo yonke imithi, i-rasburicase ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma inikezwa endaweni yasesibhedlela. Ithimba lakho lezempilo lizokubheka eduze nganoma yiziphi izindlela ngesikhathi nangemva kokufakwa.

Nawa amanye imiphumela emibi evamile ongase uyithole:

• Ukugula noma ukuhlanza, okuvame ukuphendula kahle emithini yokulwa nokugula
• Ikhanda elibuhlungu elivame ukuba lula futhi okwesikhashana
• Umkhuhlane noma amaqhafuva, ikakhulukazi emahoreni ambalwa okuqala ngemuva kokufakwa
• Ukuqunjelwa noma ukuqunjelwa, okuvame ukuhlobana neminye imithi oyitholayo
• Ukukhathala noma ukuzizwa ukhathele kunokujwayelekile
• Ukuqubuka kwesikhumba okuncane noma ukuluma endaweni ye-IV

Le miphumela emibi ejwayelekile ivame ukuzixazulula yona noma ngemithi elula. Ithimba lakho labahlengikazi liyazi ukuthi lingayiphatha kanjani lezi zimo futhi lizokugcina ukhululekile kuyo yonke imithi yakho.

Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezempilo ngokushesha. Ithimba lakho lezempilo lizobheka lokhu ngokucophelela:

• Ukuphendula okukhulu komzimba, okuhlanganisa ubunzima bokuphefumula, ukuvuvukala kobuso noma umphimbo, noma ukusabela okukhulu kwesikhumba
• Izimpawu ze-hemolysis (ukuwohloka kwamaseli abomvu egazi), njengomchamo omnyama, ukuphuzi kwesikhumba noma amehlo, noma ukukhathala okukhulu
• I-Methemoglobinemia, isimo esingavamile esithinta ukuthuthwa komoya-mpilo egazini lakho
• Izinkinga ezinzima zezinso, nakuba i-rasburicase ivame ukusiza ekuvimbeleni lezi
• Ushintsho lwesigqi senhliziyo noma ubuhlungu besifuba

Lezi zimo ezingathi sína azivamile, ikakhulukazi uma umuthi unikezwa ngendlela efanele endaweni yasesibhedlela. Ithimba lakho lezempilo linolwazi lokubona nokwelapha lezi zinkinga ngokushesha uma zenzeka.

Abanye abantu bazizwa bekhathazekile ngokuthola imithi ye-IV, okujwayelekile ngokuphelele. Ithimba lakho lezempilo linganikeza ukusekelwa ngokomzwelo futhi liphendule noma yimiphi imibuzo ukukusiza ukuthi uzizwe ukhululekile.

Ubani Ongafanele Athole I-Rasburicase?

I-Rasburicase ayifanele wonke umuntu, futhi ithimba lakho lezempilo lizobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Ukuphikisana okubaluleke kakhulu yisimo sezakhi zofuzo esibizwa ngokuthi ukuntula kwe-glucose-6-phosphate dehydrogenase (G6PD).

Abantu abane-G6PD deficiency babhekene nengozi enkulu ye-hemolysis eqinile (ukubhujiswa kwamaseli abomvu egazi) uma benikezwa i-rasburicase. Lesi simo sezakhi zofuzo sithinta cishe umuntu oyedwa kwabangu-400, futhi sivamile kubantu base-Afrika, baseMedithera, noma baseMpumalanga Ephakathi.

Udkt wakho cishe uzo-oda ukuhlolwa kwe-G6PD ngaphambi kokukunika i-rasburicase, ikakhulukazi uma unomlando womndeni walolu hlobo noma uvela emphakathini onengozi enkulu. Lolu hlolwa olulula lwegazi lungavimbela izinkinga ezinzima.

Ezinye izimo lapho odokotela besebenzisa khona ukuqapha okwengeziwe zihlanganisa:

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• Ukuphendula okubi okukhulu ngaphambilini ku-rasburicase noma imithi efanayo
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• Ukukhulelwa, njengoba ukuphepha kungaqinisekiswanga ngokugcwele ezinganeni ezisakhula
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• Ukuncelisa, njengoba kungaziwa ukuthi imithi idlulela emanzini obisi
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• Isifo senhliziyo esibi noma izinkinga zesigqi
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• Umlando we-methemoglobinemia noma ezinye izifo zegazi
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Ithimba lakho lezempilo lizohlola izinzuzo ngokumelene nezingozi kulezi zimo. Ngezinye izikhathi isidingo esiphuthumayo sokuvimbela ukulimala kwezinso emazingeni aphezulu e-uric acid sidlula ezinye izinkathazo.

Amagama Omkhiqizo we-Rasburicase

I-Rasburicase itholakala ngaphansi kwegama lomkhiqizo elithi Elitek e-United States. Leli yigama lomkhiqizo elisetshenziswa kakhulu ozohlangana nalo ezibhedlela zaseMelika nasezikhungweni zomdlavuza.

Kwamanye amazwe, ungase ubone amagama omkhiqizo ahlukene emuthini ofanayo. Isibonelo, ithengiswa njenge-Fasturtec eYurophu nakwezinye izimakethe zamazwe ngamazwe. Kodwa-ke, umuthi ngokwawo uyafana kungakhathaliseki igama lomkhiqizo.

Ezinye izibhedlela zingase zibhekisele kuyo ngokuthi

Kukhona ezinye izindlela zokuphatha amazinga aphezulu e-uric acid, nakuba kungekho neyodwa esebenza ngokushesha njenge-rasburicase. Ithimba lakho lezempilo lizokhetha inketho engcono kakhulu ngokusekelwe esimweni sakho esithile kanye nokudingeka ngokushesha kokwelashwa.

I-Allopurinol iyindlela ejwayelekile, ikakhulukazi ukuvimbela ukwakheka kwe-uric acid ngaphambi kokuqala kokwelashwa komdlavuza. Lo muthi omlomo uvimba ukukhiqizwa kwe-uric acid kodwa kuthatha izinsuku eziningana ukukhombisa imiphumela ephelele, okwenza ingafaneleki ezimweni eziphuthumayo.

I-Febuxostat enye inketho yokuvimbela esebenza ngendlela efana ne-allopurinol kodwa ingase ithuthukiswe kangcono ngabanye abantu. Njenge-allopurinol, ivimbela ukwakheka okusha kwe-uric acid kunokuba ibhubhise i-uric acid ekhona.

Ukwelashwa ngokushesha kwamazinga aphezulu e-uric acid ayingozi, ezinye izindlela zihlanganisa:

• Ukunikezwa kwamanzi okunamandla nge-IV fluids ukusiza ukukhipha i-uric acid ngezinso
• Uku-alkalinization komchamo usebenzisa i-sodium bicarbonate ukwenza i-uric acid incibilike kalula
• I-Dialysis ezimweni ezinzima lapho izinso zingasebenzi kahle
• Izindlela zokuhlanganisa zisebenzisa imithi eminingi ndawonye

Nokho, akukho neyodwa yalezi zindlela esebenza ngokushesha noma ngempumelelo njenge-rasburicase ezimweni eziphuthumayo. Udokotela wakho we-oncologist uzokuchazela ukuthi kungani i-rasburicase iyona ekhethekile ekufanele esimweni sakho.

Ingabe i-Rasburicase ingcono kune-Allopurinol?

I-Rasburicase ne-allopurinol zisebenzela izinjongo ezihlukene, ngakho ukuziqhathanisa kuncike esimweni sakho esithile nezidingo zesikhathi. Yomibili le mithi iyizinketho ezinhle kakhulu, kodwa isebenza ngezindlela ezingafani ngokuyisisekelo.

I-Rasburicase iphumelela ezimweni eziphuthumayo lapho udinga imiphumela ngokushesha. Inganciphisa amazinga aphezulu e-uric acid ayingozi emahoreni ambalwa, okungenzeka ivimbele ukulimala kwezinso noma ukwehluleka. Lokhu kuyenza ibe yigugu ngesikhathi se-tumor lysis syndrome esebenzayo noma lapho imizamo yokuvimbela inganele.

I-Allopurinol isebenza kangcono ekuvikeleni nasekuphatheni isikhathi eside. Ithathwa ngomlomo, ibiza kancane, futhi inezithiyo ezimbalwa mayelana nokuthi ngubani ongayisebenzisa. Abantu abaningi bathatha i-allopurinol izinsuku noma amasonto ngaphambi kokuqala ukwelashwa komdlavuza ukuvimbela ukwakheka kwe-uric acid.

Ukukhetha phakathi kwabo kuvame ukuncika esikhathini nasekuphuthumeni:

• Ukwelashwa okuphuthumayo: I-Rasburicase ngokuvamile ingcono ngenxa yesenzo sayo esisheshayo
• Ukuvimbela: I-Allopurinol ivame ukukhethwa ngenxa yokulula kwayo kanye nephrofayili yokuphepha
• Ukuphathwa okuqhubekayo: I-Allopurinol ngokuvamile iyisixazululo sesikhathi eside
• Kubantu abanokushoda kwe-G6PD: I-Allopurinol iyindlela ephephe kakhulu

Iziguli eziningi empeleni zithola yomibili imithi, nge-allopurinol yokuvimbela kanye ne-rasburicase yokwelashwa kokuphuma uma kudingeka. Ithimba lakho lezempilo lizokwenza isu elingcono kakhulu lesimo sakho ngasinye.

Imibuzo Evame Ukubuzwa Mayelana ne-Rasburicase

Umbuzo 1. Ingabe i-Rasburicase iphephile kubantu abanezifo zezinso?

I-Rasburicase ngokuvamile iphephile kubantu abanezifo zezinso futhi ingase ngempela isize ukuvikela ukusebenza kwezinso. Umuthi usebenza ngokunciphisa amazinga e-uric acid, okungavimbela ukulimala okwengeziwe kwezinso okuvela kuma-uric acid crystals.

Nokho, abantu abanezifo ezinzima zezinso badinga ukuqashwa eduze ngesikhathi sokwelashwa. Ithimba lakho lezempilo lizolungisa umthamo futhi libheke izivivinyo zakho zokusebenza kwezinso ngokucophelela ukuqinisekisa ukuthi umuthi uyasiza kunokuthi ubangele ukucindezeleka okwengeziwe.

Umithi uvame ukusetshenziswa ngokuqondile ukuvimbela ukulimala kwezinso kubantu abasengozini enkulu. Udokotela wakho wezinso kanye nodokotela we-oncologist bazosebenzisana ukuze banqume ukuthi i-rasburicase ilungele izinga lakho lokusebenza kwezinso.

Umbuzo 2. Kufanele ngenzeni uma ngithola i-Rasburicase eningi ngengozi?

Njengoba i-rasburicase inikezwa kuphela ezindaweni zase-hospital ngabasebenzi bezempilo abaqeqeshiwe, ukweqisa ngengozi akavamile kakhulu. Ithimba lakho lezempilo libala ngokucophelela imithamo ngokusekelwe esisindweni sakho futhi liqapha ukufakwa kwemithi ngokucophelela.

Uma ukhathazekile ngokuthola imithi eningi kakhulu, unganqikazi ukucela umhlengikazi wakho ukuthi aphinde ahlole umthamo wakho noma achaze ukuthi bawubala kanjani. Amaqembu ezempilo ayamukela le mibuzo njengengxenye yezindlela zokuphepha zokwelapha.

Esimeni esingavamile sokweqisa, ithimba lakho lezempilo linganikeza ukunakekelwa okusekelayo futhi likuqaphe ngokucophelela nganoma yiziphi izinkinga. I-hospital inezinqubo zokubhekana namaphutha emithi ngokushesha nangokuphepha.

Q3. Kufanele ngenzeni uma ngiphuthelwa umthamo we-Rasburicase?

Ukuphuthelwa umthamo akuyona into okudingeka ukhathazeke ngayo ngoba i-rasburicase inikezwa kuphela ezindaweni zase-hospital. Ithimba lakho lezempilo liphatha lonke uhlelo lokulinganisa futhi lizoqinisekisa ukuthi uthola ukwelashwa njengoba kuqokiwe.

Uma ukwelashwa kwakho kulibaziseka ngenxa yezinkinga zokuhlela noma ezinye izinto eziza kuqala zezokwelapha, ithimba lakho lezempilo lizolungisa isikhathi ngendlela efanele. Bazophinda bahlole amazinga akho e-uric acid ukuze banqume ukuthi umthamo olibazisekile usadingeka yini.

Ngezinye izikhathi izinhlelo zokwelapha ziyashintsha ngokusekelwe ekutheni usabela kanjani emithamini yokuqala. Ithimba lakho linganquma ukuthi imithamo embalwa iyadingeka uma amazinga akho e-uric acid ezinzile ngokushesha.

Q4. Ngingayeka nini ukuthatha i-Rasburicase?

Ithimba lakho lezempilo lizinquma ukuthi lingayeka nini i-rasburicase ngokusekelwe emiphumeleni yakho yokuhlolwa kwegazi kanye nesimo sakho esiphelele. Abantu abaningi bayeka ukuthola imithi uma amazinga abo e-uric acid ebuyela ebangeni eliphephile futhi ahlala ezinzile.

Isinqumo sihlanganisa ukuqapha izinto eziningana, okuhlanganisa amazinga akho e-uric acid, ukusebenza kwezinso, nokuthi usabela kanjani ekwelashweni komdlavuza. Ithimba lakho lizochaza ukucabanga kwalo futhi likugcine unolwazi mayelana nohlelo lokwelashwa.

Abanye abantu bashintshela emithini yomlomo efana ne-allopurinol ukuze bavimbele ngokuqhubekayo, kanti abanye kungenzeka bangadingi ukuphathwa okunye kwe-uric acid. Isimo sakho esiqondile sizokunqumela indlela engcono kakhulu yokuhamba phambili.

Q5. Ngingayithola ngokuphindaphindiwe i-Rasburicase?

Yebo, ungaqhubeka wamukele i-rasburicase izikhathi eziningi uma kudingeka, nakuba ithimba lakho lezempilo lizokuqapha eduze ukuze libone ukusabela komzimba okungavamile ngokuphindaphinda ukuchayeka. Abanye abantu badinga izifundo ezengeziwe ngesikhathi semijikelezo ehlukene yokwelashwa komdlavuza.

Ngokwelashwa ngakunye okulandelayo, kukhona ingozi encane yokuthuthukisa ukusabela komzimba okungavamile, ngakho-ke ithimba lakho lizokubuka ngokucophelela okwengeziwe. Bazobuye bacabange ukuthi ngabe ezinye izindlela zingaba ngcono yini ukuphathwa okuqhubekayo.

Ithimba lakho lezempilo lizohlola izinzuzo nezingozi ngaso sonke isikhathi lapho i-rasburicase icatshangelwa, liqinisekisa ukuthi lihlala liyindlela engcono kakhulu yesimo sakho samanje.