Yini i-Amphotericin B: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Amphotericin B ngumuthi onamandla wokulwa nesikhunta osetshenziselwa ukwelapha izifo ezingathi sína, ezisongela impilo ezibangelwa isikhunta. Lo muthi usebenza ngokuhlasela izindonga zamaseli zesikhunta, empeleni uzihlakaze ukuze kumiswe ukusabalala kokutheleleka. Ngenkathi ingenye yezindlela zokwelapha eziphumelela kakhulu ezitholakalayo zezifo ezinzima ezibangelwa isikhunta, idinga ukuqashwa ngokucophelela ngenxa yamandla ayo nemiphumela engaba khona eceleni.

Yini i-Amphotericin B?

I-Amphotericin B iyi-antibiotic elwa nesikhunta esisetshenziswa odokotela ukulwa nezifo ezinzima ezibangelwa isikhunta emzimbeni wakho wonke. Ingaphansi kohlobo lwemithi ebizwa ngokuthi ama-polyene antifungals, asebenza ngokubopha kumalunga amaseli esikhunta futhi enze izimbobo kuwo.

Lo muthi ubelokhu uyisisekelo sokwelashwa kwesikhunta amashumi eminyaka. Ibaluleke kakhulu ngoba ingelapha izifo ezinye izidakamizwa ezilwa nesikhunta ezingase zingakwazi ukuzisingatha ngempumelelo.

Ngokuvamile uzothola i-amphotericin B ngomugqa we-IV (intravenous) endaweni yasesibhedlela. Umuthi uza ngezindlela ezahlukene, okuhlanganisa i-amphotericin B yendabuko kanye nezinhlobo ezintsha ezisekelwe kuma-lipid ezingase zibangele imiphumela emincane eceleni.

Yini i-Amphotericin B Esetshenziselwa Yona?

I-Amphotericin B iphatha izifo ezinzima ezibangelwa isikhunta ezingasongela impilo uma zingelashwa. Lezi zifo zivame ukwenzeka kubantu abanezinhlelo zokuzivikela ezibuthakathaka, nakuba ngezinye izikhathi zingathinta nabantu abanempilo.

Nawa amanye amazwi amakhulu lo muthi owelapha ngawo, kusukela ezifweni ezivamile kuya kwezingavamile:

• I-candidiasis yesistimu (lapho izifo zemvubelo zisabalala emzimbeni wakho wonke)
• I-Aspergillosis (izifo zamaphaphu ezibangelwa amakhowe e-Aspergillus)
• I-Cryptococcal meningitis (isifo esibucayi sobuchopho)
• I-Histoplasmosis (isifo esivame ukuthinta amaphaphu)
• I-Blastomycosis (isifo samaphaphu esingasakazekela kwamanye amalungu omzimba)
• I-Coccidioidomycosis (umkhuhlane wase-Valley oqala ukuba mubi)
• I-Mucormycosis (isifo samakhowe esingavamile kodwa esinolaka)
• I-Leishmaniasis (isifo se-parasitic, nakuba lokhu kungukusetshenziswa okungagunyaziwe)

Udokotela wakho uzoqaphela ukuthi i-amphotericin B ilungile yini esimweni sakho esithile ngokusekelwe ohlotsheni lwesifo, impilo yakho yonke, nokuthi uzosithwala kanjani kahle lesi sithako.

Isebenza Kanjani I-Amphotericin B?

I-Amphotericin B isebenza ngokugxila engxenyeni ethile ezindongeni zamaseli e-fungal ebizwa ngokuthi i-ergosterol. Cabanga nge-ergosterol njengesakhi esibalulekile esigcina amaseli e-fungal ephelele futhi esebenza kahle.

Lapho i-amphotericin B ibopha ku-ergosterol, idala izimbobo noma izimbobo kulwelwesi lweseli le-fungal. Lokhu kuphazamisa ikhono leseli lokugcina imvelo yalo yangaphakathi, okubangela ukuthi okuqukethwe okubalulekile kuphume futhi ekugcineni kubulale isikhunta.

Lokhu kuthathwa njengomuthi oqinile kakhulu wokulwa nesikhunta. Ivame ukubizwa ngokuthi "izinga legolide" lokwelapha izifo ezinkulu ze-fungal ngenxa yokusebenza kwayo okubanzi ezinhlotsheni eziningi ezihlukene zamakhowe.

Umuthi ungase futhi uthinte amaseli omuntu ngezinga elithile, yingakho ungabangela imiphumela emibi. Nokho, amakhowe azwela kakhulu ku-amphotericin B kunamaseli omuntu, okwenza kube yindlela yokwelapha esebenzayo naphezu kwalezi zinkinga.

Kufanele Ngiyithathe Kanjani I-Amphotericin B?

Uzothola i-amphotericin B ngomugqa we-IV, ngokuvamile esibhedlela noma endaweni ekhethekile yezokwelapha. Umuthi uhlanganiswa nesixazululo esingenazo inzalo futhi unikezwa kancane kancane emahoreni ambalwa ukuze kuncishiswe imiphumela emibi.

Ngaphambi kokufakwa ngakunye, ithimba lakho lezempilo cishe lizokunika imithi ukusiza ukuvimbela ukusabela. Lokhu kungabandakanya i-acetaminophen (Tylenol) yomkhuhlane, ama-antihistamines afana ne-diphenhydramine (Benadryl) ngezinto ezingezwani nemithi, futhi ngezinye izikhathi ama-corticosteroids ukunciphisa ukuvuvukala.

Inqubo yokufakwa ngomjovo ngokuvamile ithatha amahora angu-4 kuya kwangu-6, nakuba lokhu kungahluka kuye ngokuthi yini oyisebenzisayo kanye nomthamo wakho othile. Ithimba lakho lezokwelapha lizokuqapha eduze ngalesi sikhathi, lihlole izimpawu zakho ezibalulekile futhi libheke noma yikuphi ukusabela okukhathazayo.

Akudingeki ukhathazeke ngemikhawulo yokudla nge-amphotericin B ngoba inikezwa ngokuqondile emjondweni wakho wegazi. Nokho, ukuhlala unamanzi kahle kubalulekile, ngakho ithimba lakho lezempilo lingakunika uketshezi olwengeziwe ngaphambi noma ngesikhathi sokwelashwa.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Amphotericin B?

Ubude bokwelashwa nge-amphotericin B buhluka kakhulu kuye ngokuthi yisiphi isifo sakho kanye nokuthi usabela kanjani emuthini. Abantu abaningi bathola ukwelashwa amasonto amaningana kuya ezinyangeni.

Ezifweni ezithile ezinjenge-systemic candidiasis, ungase udinge ukwelashwa amasonto angu-2 kuya kwangu-6. Izifo eziyinkimbinkimbi njenge-cryptococcal meningitis zingase zidinge izinyanga eziningana zokwelashwa, ngokuvamile ziqala nge-amphotericin B bese zishintshela emithini yomlomo ye-antifungal.

Udokotela wakho uzoqapha inqubekela phambili yakho ngokuhlolwa kwegazi okujwayelekile kanye nezifundo zokuthwebula izithombe. Bazobheka izimpawu zokuthi ukutheleleka kuyacaca ngenkathi futhi behlola ukuthi izinso zakho nezinye izitho zikwazi ukusingatha kahle imithi.

Inani eliphelele le-amphotericin B ozolithola livame ukubalwa ngokusekelwe esisindweni somzimba wakho kanye nokutheleleka okuthile okwelashwayo. Ithimba lakho lezempilo lizolungisa uhlelo lokwelashwa njengoba kudingeka ngokusekelwe ekuphenduleni kwakho kanye nanoma yimaphi imiphumela emibi oyitholayo.

Yiziphi Imiphumela Emibi ye-Amphotericin B?

I-Amphotericin B ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle ngokuqapha okufanele nokunakekelwa okusekelayo. Ukuqonda okulindelekile kungakusiza ukuthi uzizwe ulungiseleleke kakhulu ukwelashwa.

Nawa amanye amaphutha avamile ongase uwahlangabezane nawo ngesikhathi noma ngemva kokwelashwa:

• Umkhuhlane nokubanda (okuvame ukwenzeka ngesikhathi sokufakwa kokuqala)
• Isicanucanu nokuhlanza
• Ikhanda
• Ukulimala kwemisipha namalunga
• Ukwehla kwegazi
• Ushintsho ekusebenzeni kwezinso (udokotela wakho uzokuqapha lokhu ngokucophelela)
• Amazinga aphansi e-potassium noma i-magnesium egazini lakho
• I-Anemia (ukwehla kwamaseli abomvu egazi)

Abanye abantu bangase bahlangabezane nemiphumela emibi engathi sína kodwa engavamile edinga ukunakekelwa kwezempilo ngokushesha:

• Ukungezwani komzimba okukhulu okunezinkinga zokuphefumula noma ukuvuvukala
• Izinkinga ezinkulu zezinso
• Ukushaya kwenhliziyo okungajwayelekile
• Ukungalingani okukhulu kwe-electrolyte
• Izinkinga zokuzwa noma ukukhala ezindlebeni
• Ukushaywa yisithuthwane (okungavamile kodwa kungenzeka)

Ithimba lakho lezokwelapha lizothatha izinyathelo zokunciphisa le miphumela emibi futhi lizokuqapha ngokucophelela ngesikhathi sokwelashwa. Imiphumela eminingi emibi ingalawulwa ngempumelelo ngemithi esekelayo nokuqapha okuseduze.

Ubani Ongafanele Athole I-Amphotericin B?

Ngenkathi i-amphotericin B ivame ukudingeka ezifweni ezingathi sína zokukhunta, abantu abathile badinga ukuqapha okwengeziwe noma bangase bangabi ngabazali abafanele balokhu kwelashwa. Udokotela wakho uzoqaphela ngokucophelela izinzuzo ngokumelene nezingozi esimweni sakho esithile.

Abantu abavamise ukudinga ukucatshangelwa okukhethekile noma ukwelashwa okuhlukile bahlanganisa:

• Labo abanezifo ezinzima zezinso (umuthi ungase uqhubekisele phambili ukusebenza kwezinso)
• Abantu abanezinkinga ezinzima zesibindi
• Abantu abanezimo ezithile zenhliziyo noma ukushaya kwenhliziyo okungajwayelekile
• Labo abake baba nokusabela okukhulu komzimba ku-amphotericin B esikhathini esidlule
• Abantu abanokungalingani okukhulu kwama-electrolyte okungenakukwazi ukulungiswa
• Abantu abanezinkinga zokuzwa (umuthi ungase uqhubekisele phambili ukulahlekelwa ukuzwa)

Ukukhulelwa nokuncelisa ngamabele kudinga ukucatshangelwa okukhethekile, nakuba i-amphotericin B ingase isasetshenziswa uma ukutheleleka kubeka ingozi enkulu kunomuthi. Udokotela wakho uzoxoxa ngalezi zinto nawe uma zisebenza esimweni sakho.

Amagama e-Brand ye-Amphotericin B

I-Amphotericin B itholakala ngaphansi kwamagama amaningana e-brand, ngalinye limele izindlela ezihlukene zomuthi. Umehluko omkhulu usekulungisweni komuthi nokulethwa kwawo ukunciphisa imiphumela emibi.

Ifomu elivamile livame ukubizwa nge-Fungizone, kuyilapho izindlela ezintsha ezisekelwe kuma-lipid zihlanganisa i-AmBisome (i-liposomal amphotericin B), i-Abelcet (i-amphotericin B lipid complex), ne-Amphotec (i-amphotericin B colloidal dispersion). Lezi zindlela ze-lipid zenzelwe ukuba zibe mnene ezinso zakho ngenkathi zigcina ukusebenza kahle ekulweni nokutheleleka ngesikhunta.

Udokotela wakho uzokhetha indlela efanele kakhulu ngokusekelwe ekuthelelekeni kwakho okuthile, ukusebenza kwezinso, nesimo sempilo yakho yonke. Izindlela ezintsha zivame ukukhethwa uma kungenzeka ngenxa yephrofayili yabo yokuphepha ethuthukisiwe.

Ezinye izindlela ze-Amphotericin B

Imithi eminingana yokulwa nesikhunta engenye ingase isetshenziswe esikhundleni se-amphotericin B noma kanye nayo, kuye ngokutheleleka kwakho okuthile nezimo. Lezi ezinye izindlela zingase zikhethwe uma ungenakukwazi ukubekezelela i-amphotericin B noma uma zifaneleka kakhulu esimweni sakho esithile.

Ezinye izindlela ezivamile zihlanganisa i-fluconazole (Diflucan) yezinye izifo zemvubelo, i-voriconazole (Vfend) ye-aspergillosis, kanye nemithi emisha efana ne-isavuconazole (Cresemba) noma i-posaconazole (Noxafil) yezifo ezihlukahlukene zokukhunta.

Ezinye izifo zingelashwa ngemithi ehlanganisiwe, kusetshenziswa i-amphotericin B kanye neminye imithi elwa nokukhunta efana ne-flucytosine. Udokotela wakho uzoqoka indlela engcono kakhulu ngokusekelwe ekukhuntheni okuthile okubangela ukutheleleka kwakho kanye nesimo sakho sezempilo.

Ingabe i-Amphotericin B Ingcono Kune-Fluconazole?

I-Amphotericin B ne-fluconazole zisebenza ngezindlela ezihlukene ekwelashweni kokukhunta, futhi akukho noyedwa ongcono kunomunye. Ukukhetha kuncike ekuthelelekeni kwakho okuthile, ubunzima bakho, kanye nezici zakho zempilo.

I-Amphotericin B ngokuvamile igcinelwe izifo ezingathi sína, ezisongela impilo noma uma eminye imithi elwa nokukhunta ingasebenzanga. Inomsebenzi obanzi wokulwa nokukhunta okuhlukahlukene futhi ivame ukusetshenziswa ezifweni ezingamelani neminye imithi.

I-Fluconazole ngokuvamile isetshenziselwa izifo ezingathi sína noma njengokwelashwa kokugcinwa ngemuva kokwelashwa kokuqala ngemithi eqinile. Kulula ukuyithatha (itholakala njengamaphilisi), inemiphumela emincane, futhi isebenza kahle ezinhlotsheni ezithile zezifo zokukhunta njengezinhlobo ezithile ze-Candida.

Udokotela wakho uzoqoka umuthi ohambisana kangcono nesimo sakho esithile, ngezinye izikhathi eqala nge-amphotericin B yezifo ezingathi sína bese eshintshela ku-fluconazole ukuze kwelashwe isikhathi eside.

Imibuzo Evame Ukubuzwa Mayelana ne-Amphotericin B

Q1. Ingabe i-Amphotericin B iphephile kubantu abanezifo zezinso?

I-Amphotericin B ingathinta ukusebenza kwezinso, ngakho-ke abantu abanezifo zezinso ezikhona badinga ukuqapha okwengeziwe. Udokotela wakho uzoqaphela ubunzima bokutheleleka kwakho kokukhunta ngokumelene nezingozi ezingaba khona ezinso zakho.

Uma unezinkinga zezinso, udokotela wakho angase akhethe ukwakheka kwe-amphotericin B okusekelwe kuma-lipid, okuthambekele ekuthobeni izinso. Bazophinde baqaphe ukusebenza kwezinso zakho ngokucophelela ngezivivinyo zegazi ezivamile futhi bangase balungise umthamo wakho noma banikeze uketshezi olwengeziwe ukuvikela izinso zakho.

Q2. Kufanele Ngenzeni Uma Ngithola Ngengozi I-Amphotericin B Eningi Kakhulu?

Njengoba i-amphotericin B inikezwa ochwepheshe bezempilo endaweni yezokwelapha, ukweqisa ngengozi akuvamile. Kodwa-ke, uma uhlangabezana nezimpawu ezinzima ngesikhathi noma ngemva kokufakwa, tshela ithimba lakho lezempilo ngokushesha.

Izimpawu zomuthi omningi kakhulu zingabandakanya isicanucanu esibi, ukuhlanza, izinkinga zezinso, noma izinguquko eziyingozi emazingeni akho e-electrolyte. Ithimba lakho lezokwelapha lizokuqapha ngokucophelela futhi linikeze ukunakekelwa okusekelayo ukuphatha noma yiziphi izinkinga eziphakamayo.

Q3. Kufanele Ngenzeni Uma Ngedlula Umthamo We-Amphotericin B?

Njengoba i-amphotericin B inikezwa esibhedlela noma endaweni yezokwelapha, ukweqa umthamo ngokuvamile kusho ukuhlela kabusha i-aphoyintimenti yakho. Xhumana nethimba lakho lezempilo ngokushesha ngangokunokwenzeka ukuze uhlele kabusha ukufakwa kwakho.

Kubalulekile ukungadluli imithamo, njengoba lokhu kungavumela ukuthi ukutheleleka nge-fungal kube kubi kakhulu noma kungase kuthuthukise ukumelana nomuthi. Udokotela wakho angase adinge ukulungisa isimiso sakho sokwelashwa ngokusekelwe ekutheni igebe lide kangakanani phakathi kwemithamo.

Q4. Ngingayeka Nini Ukuthatha I-Amphotericin B?

Kufanele uyeke kuphela ukwelashwa nge-amphotericin B lapho udokotela wakho enquma ukuthi kuphephile ukwenza kanjalo. Lesi sinqumo sisekelwe ekutheni ukutheleleka kwakho kuphendula kahle kangakanani ekwelashweni kanye nokuthuthuka kwakho konke komtholampilo.

Udokotela wakho uzosebenzisa izivivinyo zegazi, izifundo zokucabanga, nezimpawu zakho ukuze anqume ukuthi ukutheleleka kucacile nini ngokwanele. Ukuyeka ngokushesha kungavumela ukuthi ukutheleleka kubuye, okungenzeka ngesimo esibi kakhulu.

Q5. Ngingathatha Eminye Imithi Ngesikhathi Ngithatha I-Amphotericin B?

Imithi eminingi ingathathwa ngokuphepha nge-amphotericin B, kodwa ezinye izinto ezingase zenzeke. Hlala utshela ithimba lakho lezempilo ngayo yonke imithi, izithasiselo, nemikhiqizo yamakhambi oyithathayo.

Eminye imithi ethinta ukusebenza kwezinso noma amazinga e-electrolyte ingase idinge ukulungiswa kwemithamo noma ukuqapha okuseduze uma isetshenziswa ne-amphotericin B. Ithimba lakho lezokwelapha lizobuyekeza uhlu lwakho oluphelele lwemithi futhi lenze noma yikuphi ukulungiswa okudingekayo ukuze likugcine uphephile ngesikhathi sokwelashwa.