Yini i-Treprostinil (Indlela yokuphefumula): Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

Ukuphefumula nge-Treprostinil kuyimithi ekhethekile esiza abantu abanomfutho wegazi ophezulu emaphapheni (i-PAH) baphefumule kalula futhi baphile ngokunethezeka. Lolu hlobo lwe-treprostinil olungeniswa ngomoya lusebenza ngokuvula imithambo yegazi emaphapheni akho, okwenza inhliziyo yakho ikwazi ukumpompa igazi ngempumelelo enkulu. Lethulwa ngqo emaphapheni akho ngedivayisi ekhethekile ye-nebulizer, okwenza kube ukwelashwa okuqondiwe kwalesi simo esibi kodwa esilawulekayo.

Yini i-Treprostinil?

I-Treprostinil iyinguqulo yokwenziwa ye-prostacyclin, into yemvelo umzimba wakho oyikhiqizayo ukuze ugcine imithambo yegazi iphumulele futhi ivulekile. Uma unomfutho wegazi ophezulu emaphapheni, imithambo yegazi emaphapheni akho iba mncane futhi iqine, okwenza kube nzima ukuthi inhliziyo yakho ipompe igazi ngayo.

Uhlobo lwe-treprostinil olungeniswa ngomoya luqondiswe ngqo lapho ludingeka kakhulu - emaphapheni akho. Le ndlela eqondiwe isiza ukunciphisa umfutho emithanjeni yakho yamaphaphu ngenkathi kungenzeka ukuthi ibangele imiphumela emibi embalwa kuyo yonke enye ingxenye yomzimba wakho uma iqhathaniswa nezinye izindlela zokuletha.

Isetshenziselwani i-Treprostinil?

Ukuphefumula nge-Treprostinil kuklanyelwe ngqo ukwelapha umfutho wegazi ophezulu emaphapheni, isimo lapho umfutho wegazi emithanjeni yamaphaphu akho uba phezulu ngendlela eyingozi. Lokhu kubeka ingcindezi eyengeziwe ohlangothini olungakwesokudla lwenhliziyo yakho, okumele lusebenze kanzima ukuze lupompe igazi ngale mithambo emincane.

Udokotela wakho angase akunikeze lo muthi uma uhlangabezana nezimpawu ezinjengokuphefumula kanzima, ukukhathala, ubuhlungu besifuba, noma ukuvuvukala emilenzeni yakho nasezingxenyeni zezinyawo. Umuthi usiza ukuthuthukisa ikhono lakho lokuzivocavoca futhi unganciphisa ukuqhubeka kwalesi sifo, ukukusiza ukuthi ugcine izinga elingcono lempilo.

Kwezinye izimo, ukuhogela kwe-treprostinil kungasetshenziswa kanye neminye imithi ye-PAH njengengxenye yohlelo lokwelapha olubanzi. Ithimba lakho lezempilo lizosebenza nawe ukuthola inhlanganisela engcono kakhulu yokwelapha isimo sakho esithile.

Isebenza Kanjani I-Treprostinil?

I-Treprostinil isebenza ngokulingisa i-prostacyclin, into enamandla yemvelo egcina imithambo yakho yegazi iphumule futhi ivimbela igazi ukuthi lingagqami ngokungadingekile. Uma uhogela i-treprostinil, iya ngqo emithanjeni emincane yegazi emaphashini akho futhi ibangele ukuthi ivuleke futhi iphumule.

Lo mphumela wokuvuleka, obizwa ngokuthi i-vasodilation, unciphisa ingcindezi emithanjeni yakho yamaphaphu futhi kwenza kube lula ukuthi inhliziyo yakho ipompe igazi emaphashini akho. Umuthi futhi usiza ekuvikeleni ukwakheka kwamahlule amancane egazi angavimba ngokuqhubekayo le mithambo esivele inciphe.

Njengomuthi onamandla aphakathi nendawo, i-treprostinil inikeza ukukhululeka okukhulu ngaphandle kokuba nzima njengeminye imithi ye-PAH. Ifomu elihogelwayo livumela ukulinganisa okunembile futhi lingalungiswa ngokuya ngokuthi usabela kanjani ekwelapheni.

Kufanele Ngiyithathe Kanjani I-Treprostinil?

Ukuhogela kwe-Treprostinil kuthathwa kusetshenziswa idivayisi ekhethekile ye-nebulizer eguqula umuthi oluketshezi ube inkungu enhle ongayiphefumula. Ngokuvamile uzothatha lo muthi izikhathi ezine ngosuku, uhlukaniswe ngamahora angaba ngu-4 ngesikhathi sokuvuka kwakho.

Nakhu okudingeka ukwazi mayelana nokuthatha umuthi wakho ngendlela efanele:

Ungathatha i-treprostinil ngaphandle kokudla, kodwa zama ukuhambisana nesikhathi sakho. Uma uthola ukuthi ukuyithatha esiswini esingenalutho kubangela isicanucanu, ungase uzizwe ungcono ngokuyithatha ngesnakhi esilula noma ukudla.

Qiniseka ukuthi uhlezi uqonde uma usebenzisa i-nebulizer, futhi uphefumule ngokujwayelekile ngomlomo. Ukwelashwa kuvame ukuthatha imizuzu emi-2 kuya kwemi-4 ukuze kuqedwe. Hlanza imishini yakho ye-nebulizer ngokucophelela ngemva kokuyisebenzisa ngakunye ngokulandela imiyalelo yomkhiqizi ukuvimbela izifo.

Njalo sebenzisa uhlelo lwe-nebulizer oluqondile olubekwe ngudokotela wakho, njengoba amadivayisi ahlukene angase alethwe ngamanani ahlukene emithi. Ithimba lakho lezempilo lizokufundisa ukuthi ungayisebenzisa kanjani kahle futhi unakekele imishini yakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Treprostinil?

Ukuphefumula kwe-Treprostinil ngokuvamile kuyindlela yokwelapha yesikhathi eside okudingeka uqhubeke nayo uma nje isiza ukuphatha umfutho wegazi ophezulu wamaphaphu. I-PAH yisimo esingapheli esidinga ukuphathwa okuqhubekayo, futhi ukuyeka ukwelashwa kungazelelwe kungabangela ukuthi izimpawu zakho zibuye noma zibe zimbi.

Udokotela wakho uzoqapha intuthuko yakho njalo ngezivivinyo ezinjenge-6-minute walk test, i-echocardiograms, kanye nokuhlolwa kwegazi ukuze abone ukuthi imithi isebenza kahle kangakanani. Ngokusekelwe kulezi zinto ozitholile nokuthi uzizwa kanjani, bangase balungise umthamo wakho noma uhlelo lokwelapha.

Abanye abantu bangase badinge ukushintshela emithini ehlukene ye-PAH noma bangeze ezinye izindlela zokwelapha ohlelweni lwabo. Ungalokothi uyeke ukuthatha i-treprostinil ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala, njengoba lokhu kungabangela umphumela oyingozi lapho izimpawu zakho ziba zimbi kunakuqala.

Yiziphi Imiphumela Eceleni ye-Treprostinil?

Njengayo yonke imithi, ukuphefumula kwe-treprostinil kungabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma umzimba wabo usujwayela ukwelashwa. Ukuqonda okukulindele kungakusiza ukuthi uzizwe ulungiseleleke kakhulu futhi wazi ukuthi ungaxhumana nini nethimba lakho lezempilo.

Imiphumela emibi evame kakhulu ongase uyithole ihlanganisa:

• Ukukhwehlela noma ukucasuka komphimbo ngenxa yomuthi ohogelwayo
• Ikhanda elibuhlungu, elivame ukuthuthuka njengoba umzimba wakho ujwayela
• Ukuvuvukala noma ukuzwa ufudumele, ikakhulukazi ebusweni nasentanyeni yakho
• Isicanucanu noma isisu esibuhlungu
• Isiyezi noma ukuzwa unovalo, ikakhulukazi uma usukuma
• Ubuhlungu bomhlathi noma ubuhlungu bemisipha

Le miphumela emibi ngokuvamile imnene futhi ivame ukuncipha ngokuhamba kwesikhathi njengoba umzimba wakho ujwayela umuthi. Udokotela wakho angase akuqale ngomthamo ophansi bese ewunyusa kancane kancane ukusiza ekunciphiseni le miphumela.

Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezempilo ngokushesha. Xhumana nodokotela wakho ngokushesha uma uhlangabezana nobuhlungu obukhulu besifuba, ubunzima bokuphefumula obubi kakhulu kunokujwayelekile, ukuquleka, noma izimpawu zokungezwani komzimba nezinto ezithile njengokuqubuka, ukuvuvukala, noma ukuluma okukhulu.

Abanye abantu bangase futhi bahlangabezane nezinguquko emfuthe yegazi noma izinga lokushaya kwenhliziyo. Ithimba lakho lezempilo lizobheka lezi zimpawu ezibalulekile njalo ukuze liqinisekise ukuthi umuthi usebenza ngokuphepha kuwe.

Ubani Ongafanele Athathe I-Treprostinil?

Ukuhogela i-Treprostinil akulungelwe wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi kuyisinqumo esifanele yini isimo sakho esithile. Ezinye izimo zezempilo noma izimo zingase zenze lo muthi ungaphephile noma ungasebenzi kahle kuwe.

Akufanele uthathe i-treprostinil uma unokungezwani komzimba ne-treprostinil noma yiziphi izithako zayo. Xhumana nodokotela wakho mayelana nanoma yiziphi izimpawu zokungezwani komzimba nezinto ezithile emithini, ikakhulukazi ezinye izindlela zokwelapha i-PAH noma imithi esekelwe ku-prostacyclin.

Lo muthi udinga ukuqapha okukhethekile uma unezimo ezithile zezempilo:

• Isifo sesibindi esibi noma izinso, njengoba umzimba wakho ungase ungayicubunguli kahle imithi
• Umfutho wegazi ophansi (i-hypotension), njengoba i-treprostinil inganciphisa umfutho wegazi ngokuqhubekayo
• Izifo zokuphuma igazi noma uma uthatha imithi yokunciphisa igazi
• Isifo senhliziyo esibi ngaphandle kwe-PAH
• Ukutheleleka kwamaphaphu okusebenzayo noma izimo ezinzima zokuphefumula

Abesifazane abakhulelwe nabancelisayo kufanele baxoxe ngezingozi nezinzuzo nodokotela wabo, njengoba imiphumela ye-treprostinil ezinganeni ezisakhulayo ingaziwa ngokugcwele. Ithimba lakho lezempilo lizohlola izinzuzo ezingaba khona ngokumelene nanoma yiziphi izingozi ezingenzeka.

Uma uthatha eminye imithi, ikakhulukazi imithi yomfutho wegazi noma ama-blood thinners, udokotela wakho uzodinga ukukuqapha eduze futhi angase alungise imithamo yakho ngokufanele.

Amagama Omkhiqizo we-Treprostinil

Ukuphefumula kwe-Treprostinil kutholakala ngaphansi kwegama lomkhiqizo elithi Tyvaso. Lolu uhlobo oluvame kakhulu olubhalwe lwe-treprostinil ephefumulwayo futhi luza nesistimu ye-nebulizer ethile eyenzelwe ukuletha imithi ngempumelelo.

Kukhona futhi i-Tyvaso DPI (i-dry powder inhaler), okuyifomula entsha engadingi umshini we-nebulizer. Esikhundleni salokho, isebenzisa idivayisi ye-inhaler ephathekayo okulula ukuyithwala nokuyisebenzisa uma ungekho ekhaya.

Njalo sebenzisa umkhiqizo oqondile kanye nefomula udokotela wakho ayalayo, njengoba izinhlobo ezahlukene zingase zibe nemiyalelo yokulinganisa ehlukene kanye nezinhlelo zokulethwa. Ungashintshi phakathi kwemikhiqizo ngaphandle kokubonisana nethimba lakho lezempilo kuqala.

Ezinye izindlela ze-Treprostinil

Uma ukuphefumula kwe-treprostinil kungasebenzi kahle kuwe noma kubangela imiphumela eminingi, ezinye izinketho zokwelapha ziyatholakala ze-pulmonary arterial hypertension. Udokotela wakho angakusiza ukuthi uhlole lezi zindlela ezingezinye ngokusekelwe ezidingweni zakho ezithile nokuphendula ekwelashweni.

Eminye imithi esekelwe ku-prostacyclin ihlanganisa i-epoprostenol (Flolan), enikezwa nge-IV infusion eqhubekayo, kanye ne-iloprost (Ventavis), enye inketho yokuphefumula. Lezi zisebenza ngendlela efana ne-treprostinil kodwa zingase zibe nemiphumela ehlukile noma amashejuli okulinganisa.

Imithi engeyona i-prostacyclin PAH ihlanganisa:

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• Ama-endothelin receptor antagonists afana ne-bosentan (Tracleer) noma i-ambrisentan (Letairis)
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• Ama-phosphodiesterase-5 inhibitors afana ne-sildenafil (Revatio) noma i-tadalafil (Adcirca)
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• Ama-soluble guanylate cyclase stimulators afana ne-riociguat (Adempas)
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Abantu abaningi abane-PAH ekugcineni badinga ukwelashwa okuhlanganisiwe, besebenzisa izinhlobo ezimbili noma ngaphezulu zemithi ndawonye. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukuthola inhlanganisela enikeza ukulawulwa okungcono kakhulu kwezimpawu ezinemiphumela emincane.

Ingabe i-Treprostinil Ingcono Kune-Iloprost?

Kokubili i-treprostinil ne-iloprost yimithi ye-prostacyclin ephefumulwayo esetshenziselwa ukwelapha i-pulmonary arterial hypertension, kodwa zinezinto ezibalulekile ezingenza enye ifaneleke kakhulu ngendlela yakho yokuphila nezidingo zezokwelapha.

I-Treprostinil inemiphumela ehlala isikhathi eside, okusho ukuthi udinga ukuyithatha izikhathi ezine kuphela ngosuku uma kuqhathaniswa nezikhathi eziyisithupha kuya kweziyisishiyagalolunye zansuku zonke ze-iloprost. Lokhu kungenza i-treprostinil ilungele abantu abaningi, ikakhulukazi labo abanemisebenzi eminingi noma abahamba njalo.

Amaphrofayili emiphumela afana, kodwa abanye abantu bangase bakwazi ukubekezelela enye kangcono kunenye. I-Treprostinil ivame ukubangela ubuhlungu obuningi emihlathini kanye nobuhlungu bemisipha, kuyilapho i-iloprost ingase ibangele ukukhwehlela okuningi nokucasuka komphimbo ngesikhathi sokuphefumula.

Udokotela wakho uzocabangela izinto ezinjengomsebenzi wakho wansuku zonke, eminye imithi oyithathayo, nokuthi usabele kanjani ekwelashweni kwangaphambilini lapho enquma ukuthi iyiphi imithi engasebenza kahle kuwe. Yomibili imithi iyasebenza, futhi ukukhetha

Q1. Ingabe i-Treprostinil iphephile kubantu abanezifo zenhliziyo?

I-Treprostinil ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqashwa ngokucophelela yithimba lakho lezempilo. Njengoba i-PAH ivame ukuthinta uhlangothi olungakwesokudla lwenhliziyo, ukwelapha izinkinga zemithambo yamaphaphu ezingaphansi kungasiza ngempela ukuthi inhliziyo yakho isebenze kangcono ngokuhamba kwesikhathi.

Kodwa-ke, uma unezinkinga ezinzima zokushaya kwenhliziyo, umfutho wegazi ophansi kakhulu, noma izinhlobo ezithile zokuhluleka kwenhliziyo, udokotela wakho angase adinge ukuqala ngomthamo ophansi noma akhethe indlela ehlukile yokwelapha. Ukuqashwa kwenhliziyo njalo ngama-ECG nama-echocardiograms kusiza ekuqinisekiseni ukuthi umuthi uyasiza kunokuthi ubangele ukucindezeleka okwengeziwe kwenhliziyo.

Q2. Kufanele ngenzeni uma ngiphuthelwa ngengozi ngisebenzisa i-Treprostinil eningi kakhulu?

Uma ngengozi uthatha umthamo owengeziwe we-treprostinil, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kakhulu kungabangela ukwehla okuyingozi komfutho wegazi, ikhanda elibuhlungu elibuhlungu, isicanucanu, noma isiyezi.

Ungazami 'ukuqaqa' umthamo wakho olandelayo ukuze ulungise lowo owengeziwe, ngoba lokhu kungabangela ukuthi izimpawu zakho ze-PAH zibe zimbi kakhulu. Kunalokho, qhubeka neshejuli yakho yokulinganisa ejwayelekile ngaphandle kokuthi udokotela wakho ekutshela ngenye indlela. Gcina izinombolo zokuxhumana eziphuthumayo ziseduze futhi ucabange ukuba nomuntu ahlale nawe uma uhlangabezana nezimpawu ngemva kokweqisa.

Q3. Kufanele ngenzeni uma ngiphuthelwa umthamo we-Treprostinil?

Uma uphuthelwa umthamo we-treprostinil, wuthatha ngokushesha lapho ukhumbula, ngaphandle kokuthi sekuseduze isikhathi somthamo wakho olandelayo ohleliwe. Kulokho, weqa umthamo ophuthelwe futhi uqhubeke neshejuli yakho ejwayelekile - ungaqedi imithamo.

Zama ukugcina isikhathi esiqhubekayo phakathi kwemithamo, njengoba izikhala ekwelashweni zingavumela izimpawu zakho ze-PAH ukuthi zibuye. Uma uvame ukukhohlwa imithamo, cabanga ukusetha ama-alamu ocingo noma usebenzise uhlelo lokusebenza lokukhumbuza imithi ukukusiza ukuthi uhlale emgwaqeni ngeshejuli yakho yokwelapha.

Q4. Ngingayeka nini ukuthatha i-Treprostinil?

Akufanele uyeke ukuthatha i-treprostinil ngokuzumayo ngaphandle kwesiqondiso sikadokotela wakho, ngoba lokhu kungabangela umphumela oyingozi lapho izimpawu zakho ze-PAH ziba zimbi kakhulu kunangaphambi kokuthi uqale ukwelashwa. Noma yiziphi izinguquko ekwelashweni kwakho kufanele zenziwe kancane kancane ngaphansi kokuqashwa kwezokwelapha.

Udokotela wakho angase acabange ukunciphisa noma ukuyeka i-treprostinil uma isimo sakho sithuthuke kakhulu, uma ushintshela ekwelashweni okuhlukile, noma uma uhlangabezana nemiphumela emibi engaphezu kwezinzuzo. Le nqubo ngokuvamile ihlanganisa ukunciphisa kancane kancane umthamo wakho emasontweni amaningana ngenkathi uqapha izimpawu zakho ngokucophelela.

Q5. Ngingahamba ne-Treprostinil Nebulizer yami?

Yebo, ungahamba ne-treprostinil nebulizer yakho, kodwa idinga ukuhlela kusengaphambili. Xhumana nenkampani yakho yezindiza ngaphambi kokuhamba ukuze uqonde imigomo yabo yamadivayisi ezokwelapha nemithi, futhi uphethe incwadi evela kudokotela wakho echaza isidingo sakho sezokwelapha semishini.

Pakisha imithi eyengeziwe nezinto zokuhlinzeka uma kwenzeka ukubambezeleka, futhi cabangela ukuletha i-nebulizer eyisipele ephathekayo uma uhamba ezindaweni ezingenayo ugesi othembekile. Amafomula amasha e-dry powder inhaler afana ne-Tyvaso DPI angaba lula kakhulu ekuhambeni ngoba awadingi imishini kagesi.