Ukunciphisa Izimpawu Ze-Irritable Bowel Syndrome
I-Viberzi (i-eluxadoline) imithi elamukelwe yi-US Food and Drug Administration (FDA) yokwelashwa kwesifo sohudo-kakhulu i-IBS (IBS-D) kubantu abadala. I-Viberzi yenzelwe ukusebenza endaweni yangakini endleleni yokugaya ukudla ukusiza ukulawula isifo sohudo nokunciphisa ubuhlungu besisu obubangelwa yisifo.
Ngenkathi odokotela bengasaqondi ngokugcwele ukuthi yini ebangela izimpawu eziphindaphindiwe ze-IBS (kubandakanya ubuhlungu besisu, ukubhubhisa, igesi, isifo sohudo, noma ukuqothulwa), u-Viberzi uyakwazi ukuhlinzeka impumuzo kubantu abagulayo abangaphenduli kuma-anti-diarralal agents.
Indlela iViberzi isebenza ngayo
I-Viberzi itholakale ngemithi kadokotela futhi yenzelwe ukuthathwa ngomlomo, kabili nsuku zonke, ngokudla. Ifika kuthebhulethi engu-75-milligram ne-100-milligram elinefilimu.
I-Viberzi isebenza ngokuvula noma ukuvimbela ama-receptor ahlukahlukene e-opioid endleleni yokugaya. Lezi yizinto ezithintekayo ezithintekayo ekuguleni kwamanzi , ukuzwa ubuhlungu, nokusondeza kwamanzi emathunjini. I-Viberzi iyingqayizivele ngoba ivuselela izinhlobo ezimbili ze-receptor futhi ivimbela enye, inikeza usizo ngaphandle kokuqokwa.
Lezi zitholampilo ngamunye zinemisebenzi ehlukile futhi ehlukile:
- Ama-receptors anesibopho se-gut motility (ukukhishwa kwemisipha yomzimba).
- I-Kappa receptors inqanda ukuphikisana kwamakholoni.
- Ama-receptor e-Delta ahlobene nokuvalwa kwamathumbu emathunjini.
Ukwengezwa komphikisi we-delta isisulu sokugwema ukuqotshwa okubonwayo nezinye izidakamizwa ezifana ne- imodium (loperamide) ne- Lomotil (atropine / diphenoxylate) echaphazela kuphela ama-mu ne-kappa receptors.
I-FDA ivume i-Viberzi ngokusekelwe ezinkulweni ezimbili zesigaba se-Phase III esiphetha ngokuthi lesi sidakamizwa sanikeza ukuthuthukiswa okuncane kakhulu emvuthweni nasekuphuthumeni kokunyakaza kwamathumbu kanye nokuthuthuka okuncane emathunjini omzimba kanye nesimo sezinyawo.
Imiphumela Yecala Yezidakamizwa
Imiphumela emibi ye-Viberzi ngokuvamile iyinzalo emasimini kodwa ingathinta nezinye izinhlelo ngenxa yemiphumela ye-opioid.
Kwezinye izimo, izimpawu zalesi sidakamizwa zingabangela labo abafana nabo nge-IBS. Phakathi kweminye imiphumela emibi ejwayelekile:
- I-nausea
- Ubuhlungu besisu
- Ukutheleleka okuphezulu kokuphefumula
- Ukuvota
- I-Runny noma ikhala eligcwele
- Ukuvimbela
- I-brronchitis
- Isizungu
- Igesi
- Rash
- Ukukhathala
Umphumela we-opioid ungasithinta i- sphincter ka-Oddi (i-valve ngesikhathi ilawula i-bile ne-pancreatic fluid emathunjini). Uma lokhu kwenzeka, i- pancreatitis ingakhula.
Ngenxa yalokho, i-Viberzi ayikwazi ukumiswa kubantu abangenayo i-gallbladder (isilwane esenza i-bile) noma abane-pancreatitis, ukukhubazeka kwesibindi, ukuvinjelwa kwesibindi, noma ukuqothuka okukhulu. Isibhedlela kanye nokufa kuye kwabikwa kubantu abangenalo i-gallbladder eyithatha ambalwa kakhulu ama-Viberzi.
Kumelwe futhi kugwenywe kubantu abaphuza utshwala obungaphezu kwezintathu ngosuku.
Umuthi we-opioid, i-Viberzi inekhono lokuhlukunyezwa kanye / noma ukuxhomeka. Kufanele isetshenziswe kuphela ngaphansi kokuqondiswa udokotela. Ngenkathi imiphumela ingajulile kakhulu kune-Oxycontin (oxycodone), ingabangela ukuzwakalisa uma kuhlukunyezwa futhi kuholele ekuxhomekeni kwe-opioid.
> Imithombo:
> Davenport, J .; Covington, P .; Bonifacio, L. et.al. "Imiphumela yokuthutha abathengi OAT3 no-OATP1B1 kanye ne-efflux transporter MRP2 kwi-pharmacokinetics ye-eluxadoline." J Clin Pharmacol. 2015; 55: 534-42. I-DOI: 10.1002 / jcph.442.
> Ijuba, L .; I-Lembo, A .; Randall, C. et.al. "I-Eluxadoline Iziguli Ezihlomulayo Zine-Irritable Bowel Syndrome Ne-DHR in Study Phase 2." I-Gastroenterology 2013; 145: 329-38. I-DOI: 10.1053 / j.gastro.2013.04.006.
> Ukuphathwa Kwezokudla Nezidakamizwa zase-US. "I-FDA ixwayisa ngengozi eyengeziwe yokwehla kwesifo esibucayi nesidakamizwa esicasulayo i-Viberzi (eluxadoline) ezigulini ezingenayo i-gallbladder." I-Silver Spring, e-Maryland; ikhishwe ngo-Agasti 2016.