Kuvunyelwe Ukusetshenziswa Kubantu abane-Genotype Engaphelele 3 Ukutheleleka Kwesifo Se-Hepatitis
I-Daklinza (daclatasvir) ingumuthi osetshenziselwa ukwelashwa okuhlangene ukwelashwa kwesifo sofuba (HCV) kubantu abadala abaneminyaka engu-18 noma ngaphezulu. I-Daklinza isebenza ngokuvimbela iphrotheni ebizwa ngokuthi i-NS5B (amaprotheni okungewona okwakhiwa kwesakhiwo 5B) ukuthi i-HCV isebenzisa ukuphinda ibuye i-RNA yayo, iphazamise ngokuphumelelayo isigaba emjikelezweni wokuphila kwegciwane.
I-Daklinza yamukelwa ngoJulayi 24, 2015, yi-US Yokudla Nezidakamizwa Ukuphathwa kweziguli ezine- genotype engapheli 3 ukutheleleka kwe-HCV, kufaka nalabo abane-cirrhosis.
I-Daklinza ingasetshenziswa kokubili iziguli ezingelashwa (iziguli-naïve) zangaphambili ezingaphathwa kabi, kanye neziguli ezilashwa ngaphambili (ezake zathola ukwelashwa) ezazingenayo impendulo noma ingekho impendulo kwi-HCV yokwelapha yangaphambili.
Ucwaningo lwezokwelapha luye lwabonisa ukuthi izinga lokuphulukiswa kweziguli ezithathelwanayo ekwelapheni olusekelwe eDaklinza lingu-98%, kanti izinga lokuphulukiswa kweziguli ezibhekene nokwelapha ezine-cirrhosis lingama-58%.
Isilinganiso esinconywe
Ithebulethi eyodwa ye-60 mg ethathwa nsuku zonke noma ngaphandle kokudla ngokuhambisana noSovaldi (sofosbuvir) . Isikhathi sokunconywa sokwelashwa ngamasonto angu-12.
Umthamo ungadinga ukulungiswa iziguli ezithatha i-CYP3A inhibitor noma i-CYP3A inducer ( bona uhlu olungezansi ). Ukwehluleka ukwenza kanjalo kunganciphisa umphumela wokwelapha waseDadlinza, futhi kwandisa amathuba okuphikisa izidakamizwa. Ezimweni ezinjalo, kunconywa ukuba umthamo wehla ube ngu-30 mg kanye nosuku nsuku zonke nge-CYP3A eqinile ishibithi futhi usukele ku-90 mg kanye nosuku nsuku zonke nge-CYP3A enamandla.
I-Daklinza inqunyelwe ukuthi isetshenziselwe ukwelashwa okuhlangene noSovaldi futhi akumele isetshenziswe njenge-monotherapy.
Ukufometha
I-Daklinza itholakala ku-30 mg nohlobo lwe-tablet ye-tablet ye-60 mg.
Amaphilisi angu-30 mg aluhlaza okwesibhakabhaka kanye ne-pentagonal shape, ne "BMS" ehlangothini olulodwa futhi "213" ngakolunye uhlangothi. Amaphilisi angu-60 mg abuye ahlaza okwesibhakabhaka kanye ne-pentagonal shape, ne-"BMS" ehlangothini olulodwa futhi "215" ngakolunye uhlangothi.
Imiphumela Ejwayelekile Ejwayelekile
Imiphumela emibi kakhulu ehlobene nokusetshenziswa kwe-Daklinza / Sovaldi yokwelapha inhlanganisela (okwenzeka ezingaphezu kuka-5% iziguli) yilokhu:
- Ukukhathala
- Izinwele
- I-nausea
- Uhudo
Ukusebenzisana kwezidakamizwa
Isilinganiso se-Daklinza kufanele sinciphise sibe ngu-30 mg uma sithatha izinyathelo ezilandelayo ze-CYP3A:
- Ama-antibiotics: i-clarithromycin, i-telithromycin
- Imithi yama-fungal: itraconazole, ketoconazole, posaconazole, voriconazole, i-telithromycin
- Izidambisigciwane ze-HIV: I-Crixivan (indinavir), i-Invirase (saquinavir), i-Viracept (nelfinavir), i- Norvir-i-Reyataz (atazanavir)
Isilinganiso se-Daklinza kufanele senyukwe sibe yi-90 mg uma sithatha abalandelayo be-CYP3A:
- Imithi yokwelashwa ngokweqile: Tracleer
- Imithi ye-Corticosteroid: dexamethasone
- Izidambisigciwane ze- HIV: Sustiva (efavirenz), Intelence (etravirine)
- Izidakamizwa zokuhlukumezeka / ukulala kwe-apnea: Provigil
- Imithi ye-Penicillin-class: nafcillin
- Imithi yokulwa nesifo sofuba: Priftin
Izidakamizwa ezilandelayo akufanele zisetshenziswe neDadlinza:
- Anti-convulsives: Tegretol, Carbatrol, Equetro, Epitol, Dilantin, Phenytek, Dilantin-125
- Imithi yokulwa nesifo sofuba: i-Rifadin
- Wort St. John's Wort
Njalo utshele udokotela wakho nganoma yisiphi isidakamizwa ongase uthathe, kufaka phakathi imithi engaphezu kwe-counter noma leyo enqunywe omunye udokotela.
Ukucutshungulwa okwengeziwe
I-Daklinza ingabangela ukujula okukhulu kwenhliziyo ( bradycardia ).
Kube khona amacala lapho iziguli ziye zadingeka zithole izikebhe ze-pacemaker ngemuva kokuthatha izidakamizwa, i- amiodarone , ne-Sovaldi ngokuhambisana nenye i-anti-virus ye-HCV, okufaka phakathi i-Daklinza. Ukuqondiswa kwe-amiodarone neDadlinza noSovaldi akukhuthazwa. Uma kungekho enye enye into ekhona, ukuqapha inhliziyo kunconywa kakhulu.
Ngenkathi izifundo zezilwane zingabonisi ubufakazi bokulimala komntwana uma kutholakala kuDadlinza ngesikhathi sokukhulelwa, ukusetshenziswa kweSovaldi kuyaphikisana nokusetshenziswa okunjalo. Ukwelapha okuhlanganisiwe kweDadlinza / Sovaldi akufanele kusetshenziswe ngesikhathi sokukhulelwa. Abesifazane abaneminyaka yobudala bezingane kanye nabalingani babo besilisa kufanele basebenzise izindlela ezimbili zokuvimbela ukukhulelwa lapho bethatha i-Daklinza / Sovaldi.
Ukuphepha kweDaklinza iziguli ezinezinambuzane zesibindi azikakhiwa.
Umthombo:
Ukuphathwa kwe-US nokuDrug. "I-FDA ivumela ukwelashwa okusha kwe-infectious infections ye-hepatitis 3." I-Silver Spring, e-Maryland; ukushicilelwa okukhishwe ngoJulayi 24, 2015.