I-Doxorubicin (igama lezohwebo u-Adriamycin) liyisetshenziswa se- chemotherapy esetshenziswa kakhulu esisebenza kakhulu kokubili i- Hodgkin ne-Non-Hodgkin lymphomas . Isetshenziselwa cishe wonke amakhemikhali amakhemikhali eyokuqala. Kungenxa yeklasi yezidakamizwa ze-chemotherapy okuthiwa i-anthracycline.
I-Doxorubicin Kungabangela Ukulimala Kwezinhliziyo
Kuyaziwa kahle ukuthi i-doxorubicin ingabangela ukulimala kwenhliziyo kwabanye abantu.
Ngenkathi ezinye i-anthracycline (njenge-epirubicin ne-mitoxantrone) ingase ibangele nokulimala kwenhliziyo, amathuba ajwayelekile kakhulu nge doxorubicin. I-Doxorubicin ibangela ukulimala kokuqala nokuphuza kwenhliziyo (okubizwa nangokuthi i-cardiotoxicity). Ukulimala kokuqala kwenzeka ngokushesha ngemuva kokuphathwa kwezidakamizwa noma phakathi kwezinsuku ezingu-1 ukuya kwezingu-2. Kunemiphumela emincane ethathwa kwi-electrocardiogram (EKG) futhi ezimweni eziningi ukuxazulula ngaphandle kokubangela izinkinga ezinkulu. Kungumonakalo wokuqala-wokuqala obalulekile futhi ojulile.
Ukulimala kweCardiac late
Ukulimala okwesikhashana enhliziyweni kuqala cishe ngonyaka noma ngaphezulu emva kwe-chemotherapy. I-Doxorubicin ihlasela kakhulu imisipha yenhliziyo. Ukwenza buthakathaka imisipha yenhliziyo futhi kwenza kube nzima kanzima ukushaya igazi. Uma kunzima, kuholela esimweni esibizwa ngokuthi ukukhubazeka kwenhliziyo ye-congestive (CHF). Abantu abane-CHF bakhononda ngezinambuzane eziningana
- Ukuhlupheka okuqhubekayo kancane kancane emisebenzini eqinile, okuholela ekukhathele noma enkingeni yokuphefumula lapho ukhuphuka izitebhisi noma ukuhamba
- Ukukhwehlela okubuhlungu ebusuku
- Ukuvuvukala kwezinyawo
- Kunzima ekuphefumuleni ekuphumuleni
Uma kunzima, i-CHF ingabangela ukukhubazeka okukhulu ngisho nokufa.
I-Doxorubicin Ilimaza Kanjani Inhliziyo?
I-Doxorubicin iphendula namanye amakhemikhali emzimbeni (okuthiwa ama-enzyme) ukukhiqiza izinto eziyingozi ezibizwa ngokuthi ama-radicals mahhala. Ukukhiqizwa kwala ma-radicals mahhala kuthuthukiswa ezithombeni ezinjengezinhliziyo lapho kune-oksijeni nensimbi.
Ngenkathi ezinye izitho zinamakhemikhali akhethekile ekubhubhiseni ama-radicals amahhala, inhliziyo ine-supply enhle kakhulu yalezi zinzyme. Lokhu kwenza imisipha yenhliziyo ikwazi ukulimala nge-radicals yamahhala.
Izinto Ezithinta Ukulimala Kwenhliziyo
Izinto eziningi zandisa amathuba okulimala kwenhliziyo nge doxorubicin.
- Umthamo ophezulu we doxorubicin kungenzeka ukuba ukhiqize umonakalo wenhliziyo. Umthamo wonke we doxorubicin owamukelwe ngesikhathi sokuphila komuntu kufanele ube ngaphansi kwezingu-400mg ngomitha wendawo ngayinye (yomzimba womzimba). Ingozi ye-CHF nale dose ingaphansi kwamaphesenti angu-1. Ngamazinga aphezulu, amathuba okulimala kwenhliziyo akhula. Ngenhlanhla, amashejuli amaningi we-chemo adinga amanani aphansi.
- Ukusebenzisa ngesikhathi esifanayo nezinye izidakamizwa ze-chemotherapy ezithinta inhliziyo, isib. Ukuphakama okukhulu kwe-cyclophosphamide
- Ukunakekelwa kwezidakamizwa esifubeni
- Isifo senhliziyo esivele sikhona
- Iminyaka yobudala
- Iziguli zesifazane
Ukuhlola Ukulimaza Inhliziyo
Umonakalo wenhliziyo uvame ukuhlolwa nge-echocardiogram (ebizwa ngokuthi i-'chocho ') noma iskena se-MUGA ukuze uvivinye inani lemali inhliziyo engakwazi ukuphuma ngayo. Emibhalweni yezokwelapha, lokhu kubizwa ngokuthi 'ingxenyana ye-ventricular ejection' noma i-LVEF. I-LVEF ilinganiswa nabantu abaningi ngaphambi kokuqala ukwelashwa ukulawula noma iyiphi inkinga yenhliziyo ekhona ngaphambili.
Ngemuva kwalokho, kungalinganiselwa futhi ngesikhathi sokwelashwa nezikhathi ezizayo ukubona ukuthi kuwela i-LVEF. Ngezinye izikhathi izinkinga zenhliziyo zingabonisa naku-EKG.
Izindlela Zokunciphisa Ukulimala
Kunezindlela ezithile lapho umonakalo wenhliziyo ungavinjelwa khona noma unganciphisi
- Ukugcina umthamo wonke we doxorubicin ngaphakathi kwemingcele ephephile
- Ukuqondisa lesi sidakamizwa njenge-infusion ku-saline kunokuba kube umjovo
- Ukusebenzisa ukulungiswa okusha kwe doxorubicin okuthiwa i-liposomal doxorubicin - isidakamizwa siza sasihlanganiswe emiphongweni enamafutha ebizwa nge-liposome. Lesi sigqoko siphuka ngaphakathi komdlavuza ukukhipha umuthi. Izitho ezivamile ezifana nenhliziyo aziphathe kakhulu.
- Ukusebenzisa into ebizwa ngokuthi i-dexrazoxane njenge-infusion maduze ngemuva kwe-doxorubicin. Kunganciphisa amathuba okulimala kwenhliziyo futhi i-FDA ivunyelwe emdlalweni webele we-metastatic.
Ukwelashwa kweCCF
Ukuhluleka kwenhliziyo okubangelwa i-doxorubicin kuphathwa ngendlela efanayo nezinye izinhlobo zokuhluleka kwenhliziyo. Ayikho imithi ekhethekile ye-doxorubicin ehlobene nomonakalo wenhliziyo. Ukuphumula, i-oksijeni namaphilisi anciphisa izimpawu zeCCF nokuqinisa ukukhubazeka kwenhliziyo. Izimpawu ezinzima zingadinga ukungena esibhedlela.
Ingabe Kufanele Siyeke Ukusebenzisa i-Doxorubicin?
I-Doxorubicin iyisidakamizwa se-chemotherapy ephumelelayo kakhulu. Inendima ekwelapheni kaningi kancelisi. Ngenkathi kukhona inhlangano eqondile ye doxorubicin enomonakalo wenhliziyo, izinzuzo zokusebenzisa i-doxorubicin zidlula izingozi. Ukulimala kwenhliziyo ngalesi sidakamizwa kuqondwa kahle, futhi uma i-doxorubicin isetshenziselwa imingcele ephilile, asikho isizathu sokuyeka ukusebenzisa izidakamizwa njengento ewusizo ngalokhu.
> Imithombo:
I-Cancer - Izimiso Nokusebenza Kwe-Oncology (I-7th Edition). Abahleli - Vicent T Devita Jr., uSamuel Hellman, uSteven Rosenberg. (Isahluko 15: I-Pharmacy of Cancer Chemotherapy: Isigaba 7: I-Topoisomerase Agents Interactive.)
I-Doxorubicin Hydrochloride, iNational Cancer Institute, ngo-September 17, 2014.
I-Doxorubicin, i-Medline Plus, i-US National Library of Medicine, 01/15/2012.