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

I-Thalidomide iyimithi kadokotela eyisigaba semithi ebizwa ngokuthi ama-immunomodulators, okusho ukuthi isiza ukulawula amasosha akho omzimba. Ekuqaleni yathuthukiswa ngeminyaka yama-1950 njengemithi yokuthulisa, le mithi ithole impilo entsha njengendlela ebalulekile yokwelapha iminyango ethile yomdlavuza nezimo zokuzivikela komzimba. Namuhla, odokotela ngokuyinhloko banikeza i-thalidomide ye-multiple myeloma, uhlobo lomdlavuza wegazi, futhi isetshenziselwa izimo ezithile zokuvuvukala lapho ezinye izindlela zokwelapha zingasebenzi.

Yini i-Thalidomide?

I-Thalidomide iyimithi enamandla esebenza ngokushintsha indlela amasosha akho omzimba aziphatha ngayo nangokuthinta ukukhula kwemithambo emisha yegazi. Yilokho odokotela abakubiza ngokuthi umuthi we-immunomodulatory, okusho ukuthi ingakwazi ukukhulisa noma ukwehlisa izingxenye ezahlukene zempendulo yakho yomzimba ngokuya ngokuthi umzimba wakho udinga ini.

Le mithi inomlando oyinkimbinkimbi okubalulekile ukuwuqonda. Ngasekupheleni kweminyaka yama-1950 nasekuqaleni kweminyaka yama-1960, i-thalidomide yabangela ukukhubazeka okukhulu kokuzalwa lapho inikezwa abesifazane abakhulelwe njengosizo lokulala. Lesi sikhathi esidabukisayo saholela emithethweni eqinile yokuphepha kwemithi emhlabeni wonke. Namuhla, i-thalidomide itholakala kuphela ngezinhlelo ezilawulwa kakhulu eziqinisekisa ukuthi isetshenziswa ngokuphepha nangokufanele.

Imithi iza ngama-capsules owathatha ngomlomo. Yenziwa ngaphansi kwemihlahlandlela eqinile futhi ikhishwa kuphela ngemithi ekhethekile ebandakanyeka ezinhlelweni zokuqapha ukuphepha.

Yini i-Thalidomide Esetshenziselwa Yona?

I-Thalidomide iphatha izimo eziningana ezinzima, ngokusetshenziswa kwayo okuyinhloko ukuba yi-multiple myeloma, umdlavuza othinta amaseli e-plasma emnkantshubeni wakho wamathambo. Udokotela wakho angase ayinikeze kanye neminye imithi yomdlavuza ukusiza ukulawula lesi sifo nokuthuthukisa izinga lempilo yakho.

Ngaphandle kokwelashwa komdlavuza, i-thalidomide isiza ekuphatheni izimo ezithile zokuvuvukala. Ngezinye izikhathi incinywa ukwelapha i-erythema nodosum leprosum, isimo sesikhumba esibuhlungu esingenzeka kubantu abanohlobo. Umuthi ungasetshenziswa futhi kwezinye izifo zokuvuvukala lapho ukwelashwa okujwayelekile kungazange kunikeze ukukhululeka.

Kwezinye izimo, odokotela bangase bacabange ukusebenzisa i-thalidomide kwezinye izinhlobo zomdlavuza wegazi noma izimo ezihlobene nokuzivikela komzimba. Kodwa-ke, lezi zindlela zokusebenzisa zihlolwa ngokucophelela ngesisekelo somuntu ngamunye, kulinganiswa izinzuzo ezingaba khona nezingozi.

Isebenza Kanjani I-Thalidomide?

I-Thalidomide isebenza ngezindlela eziningi emzimbeni wakho, okuyenza ihluke kakhulu emithini eminingi. Ihlosa ikakhulukazi amasosha akho omzimba kanye nokwakheka kwemithambo emisha yegazi, yingakho isebenza kahle kokubili umdlavuza nezimo zokuvuvukala.

Uma kuziwa ekwelashweni komdlavuza, i-thalidomide isiza ngokuqeda ukuthi amathumba akhe imithambo emisha yegazi abayidingayo ukuze akhule. Le nqubo, ebizwa ngokuthi i-angiogenesis, ifana nokunqamula ukudla kwethumba. Umuthi futhi uvuselela izingxenye ezithile zamasosha akho omzimba ukuthi aqaphele kangcono futhi ahlasele amaseli omdlavuza.

Ezimweni zokuvuvukala, i-thalidomide inciphisa ukukhiqizwa kwe-tumor necrosis factor-alpha, into ekhuthaza ukuvuvukala emzimbeni wakho. Cabanga ngayo njengokwehlisa ivolumu ekuphenduleni komzimba wakho okuvuvukalayo lapho sekuyingozi kakhulu.

Lokhu kuthathwa njengomuthi onamandla onomthelela omkhulu ezinhlelweni zomzimba wakho. Udokotela wakho uzokuqapha eduze ngenkathi uwuthatha ukuze aqinisekise ukuthi usebenza ngempumelelo futhi abheke noma yiziphi izinguquko eziqondene.

Kufanele Ngiyithathe Kanjani I-Thalidomide?

Thatha i-thalidomide ngendlela udokotela wakho ayichazayo, ngokuvamile kanye ngosuku ngesikhathi sokulala nengilazi yamanzi egcwele. Ukuyithatha ebusuku kusiza ukunciphisa eminye imiphumela emibi efana nokozela nesiyezi ongase uyizwe emini.

Ungathatha i-thalidomide ngaphandle kokudla noma ngemva kokudla, kodwa zama ukungaguquguquki ekukhetheni kwakho. Uma uthola ukuthi ikukhathaza isisu, ukuyithatha nesnakhi esilula kungase kusize. Gwema ukwephula, ukuhlafuna, noma ukuvula amaphilisi - wagwinye wonke ukuze uqinisekise ukuthi uthola umthamo ofanele.

Nawa amanye amathiphu abalulekile okufanele uwalandele ngenkathi uthatha i-thalidomide:

• Thatha umthamo wakho ngesikhathi esifanayo njalo kusihlwa ukuze ugcine amazinga aqhubekayo emzimbeni wakho
• Ungaphindi umthamo uma uphuthelwa owodwa - vele uthathe umthamo wakho olandelayo ohleliwe
• Gcina imithi esitsheni sayo sokuqala kude nokushisa, umswakama, nokukhanya
• Ungalokothi wabelane ngemithi yakho nabanye, ngisho noma benezimpawu ezifanayo
• Phatha amaphilisi ngokucophelela futhi ugeze izandla zakho ngemva kokuwathinta

Udkt wakho cishe uzoqala ngomthamo ophansi bese ewukhulisa kancane kancane ngokusekelwe endleleni ozosabela ngayo emthini. Le ndlela eqaphelayo isiza ukunciphisa imiphumela emibi ngenkathi kutholakala umthamo osebenzayo kakhulu esimweni sakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Thalidomide?

Ubude bokwelashwa nge-thalidomide buhluka kakhulu kuye ngesimo sakho esithile nokuthi usabela kahle kangakanani emthini. Nge-multiple myeloma, ungase uyithathe izinyanga eziningana kuya eminyakeni, ngokuvamile ngemijikelezo enezikhathi zokuphumula phakathi nezikhathi zokwelashwa.

Udkt wakho uzohlola njalo ukuthi usabela kanjani emthini ngokusebenzisa ukuhlolwa kwegazi, izifundo zokuthwebula izithombe, nokuhlolwa komzimba. Lokhu kuhlolwa kusiza ukunquma ukuthi ngabe uzoqhubeka, ulungise, noma umise ukwelashwa kwakho ngokusekelwe kokubili ezinzuzweni ozitholayo kanye nanoma yimiphumela emibi ongase ube nayo.

Ezimweni ezivuvukalayo, ubude bokwelashwa bungase bube bufushane, ngezinye izikhathi izinyanga ezimbalwa nje kuze kube yilapho izimpawu zithuthuka. Kodwa-ke, abanye abantu bangase badinge izikhathi zokwelashwa ezinde uma isimo sabo sivame ukuqubuka lapho imithi iyekiswa.

Ungayeki ukuthatha i-thalidomide ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Kuye ngesimo sakho, ukuyeka ngokuphazima kweso kungase kubangele ukuthi izimpawu zakho zibuye noma zibe zimbi kakhulu. Ithimba lakho lezempilo lizokusiza ukuthi wakhe uhlelo lokuyeka imithi ngokuphepha uma isikhathi sesifanele.

Yiziphi Izimo Ezingezinhle Ze-Thalidomide?

I-Thalidomide ingabangela izimo ezingezinhle eziningi, kusukela kwezilula kuya kwezinkulu. Ukuqonda ukuthi yini ongayilindela kukusiza ukuthi ubone ukuthi nini okufanele uthinte umhlinzeki wakho wezempilo nokuthi nini izimo ezingezinhle zingalawuleka ekhaya.

Izimo ezingezinhle ezivamile ongase uzithole zihlanganisa ukozela, isiyezi, nokukhathala. Lezi zimo ngokuvamile zibonakala kakhulu uma uqala ukuthatha imithi futhi ngokuvamile zithuthuka njengoba umzimba wakho uzijwayeza. Ukuthatha umthamo wakho ngesikhathi sokulala kungasiza ekunciphiseni umthelela wokozela emisebenzini yakho yansuku zonke.

Nawa amanye amanye amaphutha avamile abantu abawatholayo:

• Ukozela nokukhathala okungase kuqhubeke kuze kube usuku olulandelayo
• Isiyezi, ikakhulukazi uma usukuma ngokushesha
• Ukuqunjelwa, okuvame ukulawulwa ngezinguquko zokudla
• Umlomo nesikhumba esomile
• Isicanucanu noma isisu esibuhlungu
• Ubuthakathaka bemisipha noma ubuhlungu emalungeni
• Ikhanda

Abanye abantu bangase bathole izimo ezingezinhle ezikhathazayo ezidinga ukunakekelwa kwezempilo ngokushesha. Lokhu kufaka phakathi i-peripheral neuropathy, ebangela ukuba izitho zikhupe, zibe ndikindiki, noma zibe nobuhlungu ezandleni nasezinyaweni zakho. Lokhu kulimala kwemizwa ngezinye izikhathi kungaba unomphela, ngakho-ke kubalulekile ukubika noma yiziphi izinzwa ezingavamile kudokotela wakho ngokushesha.

Izimo ezingezinhle ezingathi sína ezidinga ukunakekelwa kwezempilo ngokushesha zihlanganisa:

• Izimpawu zamahlule egazi njengokuphefumula ngokushesha, ubuhlungu besifuba, noma ukuvuvukala komlenze
• Ukuphuma kwegazi okungavamile noma ukulimala
• Izimpawu zokutheleleka njengomkhuhlane, amaqhwa, noma umphimbo obuhlungu oqhubekayo
• Ukuphendula kwesikhumba okukhulu noma ukuqubuka
• Ukushaya kwenhliziyo okungajwayelekile noma ubuhlungu besifuba
• Isiyezi esikhulu noma ukuquleka
• Ushintsho lwemizwa noma ukucindezeleka

Izinkinga ezingavamile kodwa ezinzima zingabandakanya ukwehla okukhulu kwenani lamaseli egazi, okuthinta ikhono lomzimba wakho lokulwa nezifo nokulawula ukuphuma kwegazi. Udokotela wakho uzoqapha igazi lakho njalo ukuze abambe lezi zinguquko ngokushesha.

Ubani Ongafanele Athole I-Thalidomide?

I-Thalidomide ayinconywa nhlobo kwabesifazane abakhulelwe ngenxa yemiphumela yayo emibi ye-teratogenic, okusho ukuthi ingabangela ukukhubazeka okukhulu kokuzalwa. Abesifazane abaneminyaka yokuzala kumele basebenzise izindlela zokuvimbela inzalo ezithembekile futhi babe nokuhlolwa kokukhulelwa njalo ngenkathi bethatha lo muthi.

Abantu abanezimo ezithile zezokwelapha akufanele bathathe i-thalidomide noma badinga ukuqashwa okukhethekile uma ukwelashwa kudingekile. Udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokunquma lo muthi.

Akufanele uthathe i-thalidomide uma une:

• Ukungezwani okwaziwayo ne-thalidomide noma imithi efanayo
• Ukukhulelwa noma izinhlelo zokukhulelwa
• Ukungakwazi ukuthobela izinyathelo ezidingekayo zokuvimbela inzalo
• I-neuropathy eyingozi ye-peripheral
• Izinhlobo ezithile zezifo zenhliziyo
• Ukutheleleka okukhulu okusebenzayo

Ukuqapha okukhethekile kuyadingeka uma unomlando wamahlule egazi, izinkinga zenhliziyo, isifo sezinso, noma izinkinga zesibindi. Udokotela wakho angase adinge ukulungisa umthamo wakho noma akuqaphe eduze uma unezimo ezinjalo.

Ubudala bungaba yisici ekunqumeni ukuthi i-thalidomide ilungele yini wena. Abantu abadala bangase bazwe kalula imiphumela emibi futhi bangase badinge imithamo ephansi noma ukuqashwa okuvame kakhulu.

Amagama Omkhiqizo we-Thalidomide

I-Thalidomide itholakala ngaphansi kwamagama amaningi emikhiqizo, i-Thalomid iyona efomulwa kakhulu e-United States. Lolu hlobo lomkhiqizo lukhiqizwa yi-Celgene Corporation futhi yilo odokotela abajwayele ukulubhala.

Amanye amagama emikhiqizo afaka i-Contergan emakethe athile yamazwe ngamazwe, nakuba ukutholakala kuhluka ngokuya ngezwe. Uhlobo olujwayelekile lwe-thalidomide lungase futhi litholakale, kodwa lusahambisana nezilawuli ezifanayo eziqinile zokusatshalaliswa njengohlobo lomkhiqizo.

Kungakhathaliseki ukuthi yiluphi uhlobo lomkhiqizo noma olujwayelekile olutholayo, yonke imikhiqizo ye-thalidomide inikezwa ngezinhlelo zokwelapha ezikhethekile eziqinisekisa ukuphathwa okufanele nokuqapha iziguli. Umuthi wakho uzokunikeza imininingwane enemininingwane mayelana nefomula yakho ethile kanye nanoma yiziphi izidingo zokugcina noma zokuphatha ezihlukile.

Ezinye izindlela ze-Thalidomide

Kunezindlela eziningana ze-thalidomide, kuye ngesimo sakho esithile nezidingo zokwelashwa. Nge-multiple myeloma, udokotela wakho angase acabangele i-lenalidomide (Revlimid) noma i-pomalidomide (Pomalyst), okuyimithi ehlobene ekilasini elifanayo lemithi kodwa ingase ibe namaphrofayili ahlukene emiphumeleni.

Ezinye izinketho zokwelashwa ze-multiple myeloma zifaka ama-proteasome inhibitors afana ne-bortezomib (Velcade) noma i-carfilzomib (Kyprolis). Lezi zisebenza ngezindlela ezihlukene kune-thalidomide futhi zingase zifaneleke kangcono esimweni sakho esithile.

Ngezimo zokuvuvukala, ezinye izindlela zingase zifake ama-corticosteroids, eminye imithi ecindezela amasosha omzimba, noma ukwelashwa okuhloswe ngakho. Ukukhetha kuncike ekuxilongweni kwakho okuthile, izimpendulo zokwelashwa zangaphambilini, kanye nesimo sempilo yakho esiphelele.

Udokotela wakho uzokusiza ukuthi ulinganise izinzuzo nezingozi zenketho ngayinye ukuze uthole ukwelashwa okufanele kakhulu izimo zakho zomuntu ngamunye. Ngezinye izikhathi inhlanganisela yemithi ehlukene isebenza kangcono kunanoma iyiphi imithi eyodwa yodwa.

Ingabe i-Thalidomide ingcono kune-Lenalidomide?

Ukuqhathanisa i-thalidomide ne-lenalidomide akulula ngoba yomibili imithi inezinzuzo nobubi obuhlukile. I-Lenalidomide ivame ukukhethwa ezigulini eziningi ngoba ngokuvamile ibangela imiphumela emibi engajwayelekile, ikakhulukazi i-neuropathy encane yomgogodla nokozela.

I-Thalidomide ingase isebenze kahle ezinhlotsheni ezithile ze-multiple myeloma, ikakhulukazi uma isetshenziswa ngokuhlanganyela neminye imithi. Kodwa-ke, i-lenalidomide ivame ukubekezelelwa kangcono futhi ivumela abantu ukuthi bagcine izinga elingcono lempilo ngesikhathi sokwelashwa.

Ukukhetha phakathi kwale mithi kuncike ezintweni eziningana okuhlanganisa izici zakho eziqondile zomdlavuza, ukwelashwa kwangaphambilini, ezinye izimo zezempilo, nezintandokazi zomuntu siqu. Udokotela wakho we-oncologist uzocabangela isithombe sakho esiphelele sezokwelapha lapho encoma ukuthi iyiphi imithi efaneleka kakhulu kuwe.

Izindleko nokukhokhelwa komshuwalense nakho kungathinta isinqumo, njengoba le mithi ingabiza. Ithimba lakho lezempilo lizosebenza nawe ukuthola ukwelashwa okuphumelela kakhulu okutholakala futhi esimweni sakho sezimali.

Imibuzo Evame Ukubuzwa Mayelana ne-Thalidomide

Ingabe i-Thalidomide iphephile ezigulini zenhliziyo?

I-Thalidomide idinga ukucatshangelwa ngokucophelela uma unesifo senhliziyo ngoba ingakhuphula ingozi yamaqhubu egazi futhi ingase ithinte isigqi senhliziyo. Udokotela wakho wenhliziyo kanye ne-oncologist kuzodingeka basebenzisane ukuze banqume ukuthi izinzuzo zidlula yini izingozi esimweni sakho esithile.

Uma uthatha i-thalidomide nesifo senhliziyo, uzodinga ukuqapha njalo okuhlanganisa ama-EKG ajwayelekile nokuhlolwa kwegazi. Udokotela wakho angase futhi anikeze imithi yokunciphisa igazi ukuze kuncishiswe ingozi yamaqhubu, nakuba lokhu kwengeza ukuyinkimbinkimbi ohlelweni lwakho lokwelashwa.

Ngingenzani uma ngiphuzile i-Thalidomide eningi ngengozi?

Uma ngempela uthatha i-thalidomide eningi kunaleyo oyinikiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kungabangela ukozela okukhulu, ukudideka, neminye imiphumela emibi engase ingaveli ngokushesha.

Ungazami ukuzenza uhlanze ngaphandle uma uqondiswe ngqo ngumhlinzeki wezempilo. Gcina ibhodlela lemithi nawe lapho ufuna ukunakekelwa kwezempilo ukuze abahlinzeki bezempilo bazi kahle ukuthi uthatheni ini nokuthi ungakanani.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Thalidomide?

Uma uphuthelwa umthamo we-thalidomide, yithathe ngokushesha lapho ukhumbula, kodwa kuphela uma kungaphakathi kwamahora angu-12 esikhathi sakho esihleliwe. Uma sekudlule amahora angaphezu kwangu-12, weqa umthamo ophuthelwe bese uthatha umthamo wakho olandelayo ohleliwe ngesikhathi esijwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe, ngoba lokhu kungandisa ingozi yakho yemiphumela emibi. Uma uvame ukukhohlwa imithamo, cabangela ukusetha izikhumbuzi zocingo noma usebenzise umhleli wamaphilisi ukukusiza ukuthi uhlale emgqeni.

Ngingayeka nini ukuthatha i-Thalidomide?

Kufanele uyeke kuphela ukuthatha i-thalidomide lapho udokotela wakho enquma ukuthi kuphephile futhi kufanelekile ukwenza kanjalo. Lesi sinqumo sisekelwe ekutheni isimo sakho siphendula kahle kangakanani ekwelashweni, yimiphi imiphumela emibi oyitholayo, nesimo sakho sempilo esiphelele.

Ukwelashwa komdlavuza, ukuyeka ngaphambi kwesikhathi kungase kuvumele lesi sifo ukuthi siqhubeke. Ezimweni ezivuvukalayo, ukuyeka kungazelelwe kungase kubangele ukuthi izimpawu zibuye. Udokotela wakho uzokusiza ukuthi uthuthukise uhlelo lokuyeka ukwelashwa ngokuphepha lapho isikhathi sesilungile.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Thalidomide?

Kungcono ukugwema utshwala ngenkathi uthatha i-thalidomide ngoba kokubili kungabangela ukozela nesiyezi. Ukuzihlanganisa kungandisa kakhulu le miphumela futhi kukhulise ingozi yakho yokuwa noma izingozi.

Uma ukhetha ukuphuza ngezikhathi ezithile, kwenze ngendlela elinganiselwe kakhulu futhi uqaphele kakhulu ngemisebenzi edinga ukuqapha. Njalo xoxa ngokusebenzisa utshwala nomhlinzeki wakho wezempilo, njengoba bengase babe nezincomo ezithile ezisuselwe esimweni sakho ngasinye kanye neminye imithi oyithathayo.