Capecitabine (lat. Capecitabinum) yog ib yam khoom uas yog derivative ntawm fluoropyrimidine carbamate. Nws belongs rau cov pab pawg neeg ntawm antimetabolites - tshwj xeeb tebchaw uas yuav inhibit qhov kev loj hlob ntawm malignant qog. Kev txaus siab rau cov khoom no tau tshwm sim hauv xyoo 1960. Thaum xub thawj, cov ntaub ntawv zoo tau txais los ntawm kev tshawb fawb ntawm cov nas hauv chav kuaj. Qee lub sij hawm tom qab ntawd, lawv cov txiaj ntsig tau pom hauv kev kho mob qog noj ntshav tib neeg.
Hnub no, ntau cov tshuaj tiv thaiv kab mob muaj capecitabine ua cov khoom xyaw nquag. Cov lus teb los ntawm ntau tus neeg mob hais txog kev ua tiav ntawm kev siv cov tshuaj no hauv kev kho mob qog noj ntshav.
pab pawg kws tshuaj thiab cov khoom
Cov mis ntawm capecitabine yog 5'-deoxy-5-fluoro-N-[(pentyloxy)carbonyl]cytidine. Cov pab pawg tshuaj ntawm cov tshuaj tiv thaiv metabolite yog sawv cev los ntawm ntau cov tshuaj uas nyob ze rau hauv cov khoom ntawm tib neeg cov metabolism (metabolism). Lawv muaj peev xwm nkag mus rau hauv cov tshuaj tiv thaiv metabolic, kho lawv thiab inhibit qee cov txheej txheem biochemical. Hauv qhov no, muaj kev ua txhaum ntawm ib txwm ua haujlwm tseem ceeb ntawm cov qog hlwb thiab inhibition ntawm lawv txoj kev loj hlob thaum siv tshuaj raws li cov tshuaj capecitabine. Kev tshuaj xyuas ntawm tib neeg hais txog qhov txo qis ntawm qhov loj ntawm neoplasms. Cov txheej txheem ntawm kev ua no yog hu ua cytostatic.
Cov khoom zoo li no ntawm cov tshuaj antimetabolite ua rau nws siv tau rau hauv kev kho mob qog noj ntshav. Lawv cov kev ua tau zoo nyob rau hauv kev sib raug zoo rau malignant neoplasms ntawm lub plab thiab cov qog mammary tau raug pov thawj. Nyob rau tib lub sijhawm, ob qho tib si monotherapy thiab ua ke nrog lwm yam txhais tau tias muab cov txiaj ntsig zoo. Txog niaj hnub no, ntau dua 800 cov tshuaj tau raug tsim los ntawm cov tshuaj tiv thaiv metabolites, tab sis kev tshawb nrhiav cov pab pawg tshiab ntawm cov tshuaj tseem txuas ntxiv mus.
Mechanism of action
Kev ua kom muaj capecitabine tshwm sim hauv cov ntaub so ntswg ntawm cov qog nws tus kheej, tom qab ntawd nws pib muaj tshuaj lom rau nws cov hlwb (cytotoxic mechanism). Cov tshuaj no koom nrog hauv cov tshuaj tiv thaiv metabolic thiab ua rau lub fact tias ob qho tib si noj qab haus huv thiab qog hlwb yuav hloov mus rau hauv cytotoxic analogues. Hauv qhov no, muaj kev ua txhaum ntawm kev tsim cov khoom tsim nyog rau DNA synthesis thiab, raws li, cov txheej txheem faib.
Qhov no yog li cas cov hlwb tsis loj hlob. Raws li lwm qhov xwm txheej, muaj "kev hloov pauv" ntawm ib yam khoom rau lwm tus, vim tias qhov kev sib txuas ntawm cov protein cuam tshuam thaum noj tshuaj raws li cov tshuaj capecitabine. Phau ntawv piav qhia txog cov txheej txheem no.
Lub tshuab ntawm qhov kev hloov pauv no txo qis qhov ua rau muaj kev puas tsuaj rau kev noj qab haus huvhlwb. Capecitabine yog ntau concentrated nyob rau hauv cov qog nws tus kheej tshaj nyob rau hauv cov ntaub so ntswg. Cov yam ntxwv no ua mob rau lub cev tsawg dua thaum tus neeg raug kho nrog tshuaj raws li cov tshuaj capecitabine. Cov lus qhia rau kev siv pom zoo kom noj cov tshuaj hauv cov koob tshuaj nruj me ntsis, uas yog txiav txim los ntawm tus kws kho mob.
Kev nyob ntawm ib yam khoom hauv lub cev
Tom qab noj capecitabine, nws tau nrawm nrawm rau hauv plab hnyuv. Yog tias koj noj nyob rau lub sijhawm no, cov txheej txheem yuav qeeb. Yog li, kev tswj hwm cov tshuaj raws li cov tshuaj tiv thaiv metabolite yog ua tom qab noj mov. Kev hloov pauv ntxiv ntawm cov tshuaj tshwm sim hauv daim siab, qee yam ntawm capecitabine thiab nws cov metabolites khi rau cov proteins (piv txwv li, ntshav albumin). Qhov siab tshaj plaws plasma nce mus txog 1.5-3 teev tom qab noj tshuaj. Qhov no yog qhia los ntawm cov lus qhia rau cov tshuaj "Capecitabine". Analogues muaj cov tshuaj pharmacokinetics zoo sib xws.
Feem ntau ntawm cov tshuaj tau tawm hauv cov zis, tsawg dua - hauv cov quav. Ntxiv mus, lub cev tawm tsis tau tsuas yog capecitabine hloov pauv (kwv yees li 3%), tab sis kuj yog nws cov derivatives. Ib txhia ntawm lawv yog metabolized rau tsawg active compounds. Lub xub ntiag thiab hloov pauv ntawm capecitabine hauv lub cev tsis cuam tshuam los ntawm poj niam txiv neej, hnub nyoog, haiv neeg.
Thaum teem caij?
Capecitabine nyob rau hauv daim ntawv ntawm ntau yam tshuaj yog muab rau cov neeg mob uas muaj mob cancer mis, nrog rau cov nyob rau theem ntawm metastasis. Nyob rau hauv cov ntaub ntawv no, cov tshuaj yog siv raws li ib feem ntawm monotherapy, los yog ua ke kev kho mob nyob rau hauv lub xub ntiag ntawm contraindications los yog ineffectiveness.kws khomob. Feem ntau, capecitabine ua ke nrog docetaxel.
Kuj tseem tau muab rau cov neeg mob qog noj ntshav ntawm txoj hnyuv, txoj hlab pas, plab, pancreas, mob qog noj ntshav, ob qho tib si nyob rau theem ntawm kev sib kis hauv zos thiab thaum lub sijhawm metastasis. Hauv kev kho mob qog noj ntshav, "Capecitabine" kuj tau sau tseg. Cov lus qhia rau kev siv pom zoo kom koj ua tib zoo ua raws li cov tshuaj thiab ua raws li koj tus kws kho mob cov lus qhia.
Sib tham nrog lwm yam cuab yeej
Yog tias cov kev khomob khomob tsis muaj txiaj ntsig, tus kws kho mob oncologist tuaj yeem sau tshuaj kho ua ke, uas yuav koom nrog "Capecitabine". Cov lus qhia rau kev siv muab cov npe ntawm cov nyiaj uas muaj kev sib koom ua tiav ua tiav.
Piv txwv li, nrog "Docetaxel" - ib yam tshuaj ntawm cytotoxic hom kev ua, ntawm cov nroj tsuag keeb kwm. Nws muaj peev xwm nyob twj ywm hauv cov hlwb rau lub sijhawm ntev ntawm cov concentrations siab. Txawm li cas los xij, kev sib xyaw ua ke ntawm cov neeg ua haujlwm no yog contraindicated rau cov neeg uas muaj platelet thiab neutrophil suav ntawm 100,000 / μl thiab 1500 / μl, feem. Tsis tas li ntawd, "Docetaxel" tsis yog siv rau cov neeg mob uas muaj qhov nce ntawm bilirubin. Hauv qhov no, qhov tshwm sim tsis zoo tuaj yeem ua tau. Yog tias "Docetaxel" rau qee yam "tso tseg" ntawm txoj kev kho mob, txuas ntxiv kho nrog "Capecitabine", tab sis hauv cov tshuaj txo qis.
Yog tias muaj qhov tsis txaus ntseeg tshwm sim, kev kho nrog Capecitabine thiab Docetaxel raug tso tseg thiab cov tsos mob raug tshem tawm. Kev sib xyaw ua keKev noj tshuaj yog tsim los ntawm tus kws tshaj lij oncologist. Yog tias muaj kev phom sij tshwm sim, cov tswv yim no raug kho.
"Capecitabine" tsis tau sau ib txhij nrog "Sorivudine" - tus neeg sawv cev tiv thaiv kab mob. Qhov kev sib xyaw ua ke no tuaj yeem ua rau muaj tshuaj lom ntawm thawj cov tshuaj. Kev siv ua ke nrog cov tshuaj antiepileptic "Phenytoin" nce qhov concentration ntawm cov ntshav tom kawg hauv cov ntshav. Nws kuj tseem muaj peev xwm ua txhaum ntawm cov ntshav txhaws thaum siv coumarin anticoagulants thiab tshuaj, qhov tseem ceeb ntawm capecitabine. Cov lus qhia rau kev siv ceeb toom txog qhov yuav tshwm sim, yog li koj yuav tsum xub nyeem nws.
Leej twg yog contraindicated rau?
Yog vim li cas rau contraindicated los yog txwv tsis pub siv tshuaj tej zaum yuav:
- High rhiab heev (hypersensitivity reaction).
- mob raum thiab mob siab tsis ua haujlwm.
- Ntau theem ntawm cev xeeb tub (cov tshuaj cuam tshuam rau tus menyuam hauv plab), tshwj tsis yog thaum lub neej ntawm leej niam yog qhov tseem ceeb;
- Nyob mis rau me nyuam mos.
Tsis tas li ntawd, kev siv capecitabine tsuas yog txwv rau cov neeg muaj kab mob plawv (CHD), nrog rau lub xeev nce siab ntawm bilirubin hauv cov ntshav, lub siab puas tsuaj nrog metastases nrog kev ua txhaum ntawm nws cov haujlwm yooj yim. Rau cov menyuam yaus thiab cov neeg laus, cov tshuaj tsis pom zoo. Qhov no lees paub cov lus qhia rau cov tshuaj "Capecitabine". Kev tshuaj xyuas tus neeg mob hais txog ntau yam kev mob tshwm sim thiab cov tshuaj lom tshwm sim nrogkev kho mob. Yog li ntawd, kev kho capecitabine yog ua raws li kev saib xyuas nruj ntawm tus kws kho mob oncologist.
Puas muaj kev phiv?
Tom qab noj tshuaj, mob taub hau, lub xeev ntawm kev qaug zog sai, tsis txaus ntseeg, thiab tsis muaj zog tuaj yeem ua tau. Insomnia yuav tshwm sim, los yog, conversely, tsaug zog. Muaj tsawg zaus - cuam tshuam kev sib koom tes thiab sib npaug, tsis meej pem.
Ib yam tshwm sim ntawm cov hlab plawv yog anemia (anemia). Rau qhov tsawg dua, angina pectoris, myocardial ischemia, plawv nres, plawv tsis ua haujlwm, thiab lwm yam tuaj yeem ua tau. Yog tias cov kab mob ua pa cuam tshuam nrog cov txheej txheem, ua pa luv, hnov mob caj pas, hnoos yuav tshwm sim. Tsawg heev - pulmonary embolism, pulmonary spasm.
Thaum siv los ua ib feem ntawm kev kho mob monotherapy lossis kev kho mob ua ke, muaj kev cuam tshuam tsis zoo rau cov leeg pob txha. Nws manifests nws tus kheej nyob rau hauv mob nyob rau hauv cov ceg thiab sab nraub qaum, qhov tshwm sim ntawm cov leeg hypertonicity (myalgia), mob pob qij txha (arthralgia).
Daim tawv nqaij kuj raug kev txom nyem. Tej zaum cov tsos mob ntawm dermatitis, erythema, ntau dryness ntawm daim tawv nqaij, liab, tingling, loog loog, tev, khaus, pigmentation, qhov txhab kuj muaj feem xyuam rau cov rau tes. Muaj tsawg zaus, daim tawv nqaij tawg, nce rhiab heev rau ultraviolet hluav taws xob, tev thiab nce fragility ntawm cov ntsia hlau phaj tshwm sim.
Nrog rau lwm cov kev mob tshwm sim, cov txheej txheem sib kis yuav tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev txo qis hauv lub cev tiv thaiv. Tom qab tag nrho, kev kho tshuaj ua rau txo qis hauv cov ntshav platelets thiab leukocytes. Xws liKev tshwm sim tau piav qhia rau cov tshuaj "Capecitabine" cov lus qhia rau kev siv. Analogues muab cov teebmeem tib yam.
Kev noj tshuaj
"Capecitabine" yog tsim rau kev siv sab hauv nkaus xwb. Feem ntau nws yog ntxuav nrog dej ib nrab teev tom qab noj mov, tab sis tsis tom qab.
koob tshuaj txhua hnub yog txiav txim siab los ntawm tus kws kho mob oncologist, nyob ntawm qhov loj ntawm neoplasm, theem ntawm kev loj hlob thiab tag nrho lub cev saum npoo av. Nws yog ntshaw tias tus kws kho mob tshwj xeeb twb muaj kev txawj ua hauj lwm nrog cov tshuaj no. Feem ntau, ib koob tshuaj ob zaug - thaum sawv ntxov thiab yav tsaus ntuj. Nyob rau hauv rooj plaub no, tag nrho cov chav kawm yuav kav ntev li ob lub lis piam, tom qab ntawd so rau xya hnub, tom qab ntawd rov kho dua.
Rau cov neeg mob lub raum tsis txaus, noj tshuaj txhua hnub raug txo. Nrog rau qhov txo qis ntawm leukocytes (leukopenia) thiab neutrophil granulocytes (neutropenia) hauv cov ntshav, cov tshuaj txuas ntxiv mus. Yog li pom zoo cov lus qhia rau kev siv rau "Capecitabine" tshuaj. Synonyms lossis analogues raug sau tseg ntawm qhov pib ntawm tus kws kho mob tuaj koom.
Toxicity ntau ntau
Muaj ntau ntau qib, raws li cov tshuaj lom neeg cov tshuaj "Capecitabine" txhim kho (cov lus qhia rau kev siv). Cov lus teb los ntawm ntau tus neeg qhia tias cov txheej txheem no yog tus kheej nkaus xwb.
Muaj ntau qib ntawm toxicity:
- 1 degree. Cov teebmeem me me tshwm sim.
- 2 degree. Kev mob raws plab (txog li 4 zaug hauv ib hnub) nrog o ntawm cov leeg, liab, ua haujlwm tsis zoo,ib tug ntse nce nyob rau hauv bilirubin. Nyob rau theem no, capecitabine raug txiav kom txog thaum cov tsos mob tshwm sim ntawm theem 1 toxicity.
- 3 degree. Mob plab nce mus txog 9 zaug hauv ib hnub. Malabsorption tshwm sim (malabsorption syndrome). Nyob rau hauv cov ntaub ntawv no, muaj zog tev ntawm daim tawv nqaij, redness, tsos ntawm rwj thiab hlwv yog pom. Muaj qhov mob hnyav hauv cov ceg ceg, kev ua haujlwm tsis zoo. Bilirubin nce 3 zaug. Nyob rau theem no, kev kho mob cuam tshuam, thiab nrog qhov tshwm sim ntawm 1 degree ntawm toxicity, cov tshuaj txuas ntxiv ntawm qhov txo qis.
- 4 degree. Feem ntau raws plab - txog li 10 zaug ib hnub twg. Fecal masses nrog ib tug sib tov ntawm cov ntshav. Nws yog ib qho xav tau rau kev qhia cov tshuaj, bypassing lub plab zom mov. Yog tias cov tsos mob ntawm qhov degree no tshwm sim, kev kho mob raug tso tseg thiab tsis rov pib dua.
Kuv yuav tsum ceev faj dab tsi?
Kev kho mob yuav tsum muaj nyob rau hauv kev saib xyuas kev kho mob ze. Tus kws kho mob tshwj xeeb yuav tsum txheeb xyuas qhov tshwm sim muaj kuab lom nyob rau lub sijhawm - txawm tias nws xeev siab, raws plab, thiab lwm yam. Yog tias pom cov tsos mob no, kev kho mob raug kho. Yog tias tsim nyog, tshem tawm cov tsos mob, txo cov koob tshuaj txhua hnub, so. Txuas ntxiv kev kho mob yog tias cov tsos mob toxicity tsis ua rau muaj kev phom sij rau lub neej.
Rau cov neeg muaj kab mob hauv lub plawv, kev saib xyuas tshwj xeeb yuav tsum ua tib zoo saib xyuas. Hauv qhov no, nws yog ib qho tsim nyog los txheeb xyuas qhov cuam tshuam tsis zoo ntawm cov hlab plawv hauv lub sijhawm thiab siv cov kev ntsuas tsim nyog hauv lub sijhawm.
Cov kws tshaj lij txwv tsis pub siv cov tshuaj hauv kev xyaum menyuam yaus. Kev ua tau zoo ntawm nws txoj kev siv hauv cov menyuam yaus tsis tau tsim. Yog ibTus poj niam ntawm lub hnub nyoog yug me nyuam raug kho, nws yuav tsum tau ceeb toom txog qhov cuam tshuam ntawm capecitabine ntawm tus menyuam hauv plab. Nws yuav tsum siv cov tshuaj tiv thaiv kab mob txhim khu kev qha thaum kho.
Npaj thiab analogues
Muaj ntau yam khoom siv capecitabine. Muaj 7 lub npe lag luam ntawm cov tshuaj uas tsim los ntawm ntau lub tuam txhab hauv tsev thiab txawv teb chaws nyob rau hauv kev ua lag luam Lavxias. Piv txwv li:
- "Capecitabine".
- "Capecitabine-TL".
- "Tubin".
- "Xeloda".
- "Kabetsin".
- "Capecitover".
- "Capametin FS"
Txij li thaum tag nrho cov tshuaj no yog ua raws tib yam khoom xyaw - capecitabine, cov lus qhia rau lawv yuav zoo sib xws. Feem ntau, nws muaj ib lub rooj rau kev xam qhov ntau npaum li cas rau hauv tus account lub cev qhov hnyav thiab kho cov txheej txheem kho rau cov tsos mob ntawm toxicity ntawm txawv degrees.
Nws yog ib qho tseem ceeb kom nkag siab tias thawj yam uas koj yuav tsum paub txog thaum twg, piv txwv li, "Capecitabine TL" tau raug sau tseg yog cov lus qhia. Cov ntaub ntawv muab rau hauv nws tsis haum rau kev siv ywj pheej ntawm cov nyiaj! Txhua qhov kev suav nrog rau kev teeb tsa koob tshuaj thiab kev kho mob yog tsim los ntawm tus kws kho mob uas tuaj koom - tus kws kho mob oncologist, uas muaj peev xwm txaus hauv qhov teeb meem no. Kev tswj hwm tus kheej ntawm cov tshuaj tiv thaiv kab mob ua rau lub cev tsis zoo rau lub cev.
Cia peb mus saib qee yam tshuaj.
Kev piav qhia tshuaj
- "Capecitabine - TL" yog tsim los ntawm Lavxias lub tuam txhab LLC "Technology of Medicines". Cov khoom xyaw tseem ceeb yog capecitabine. Cov lus qhia rau kev siv, tso tawm daim ntawv yog txaus siab rau ntau. Cia peb xav txog ntau yam ntxiv. Cov no yog cov ntsiav tshuaj zaj duab xis-coated. Cov ntsiab lus ntawm cov tshuaj nquag yog 150 lossis 500 mg. Cov khoom siv pabcuam: cellulose, lactose, croscarmellose sodium, hypromellose, magnesium stearate. Ib pob tuaj yeem muaj 60 lossis 120 ntsiav tshuaj, nyob ntawm qhov ntau npaum ntawm cov tshuaj "Capecitabine - TL". Cov lus qhia yuav tsum muaj cov ncauj lus kom ntxaws txog kev siv cov khoom.
- "Capecitabine" yog ib qho tshuaj hauv tsev nrog tib cov khoom xyaw nquag. Nws cov lus piav qhia zoo ib yam li cov cuab yeej saum toj no. Daim ntawv tso tawm ntawm cov tshuaj "Capecitabine" - ntsiav tshuaj. Cov lus qhia rau kev siv kuj suav nrog hauv pob.
- "Kabetsin" yog ib qho tshuaj tiv thaiv kab mob hauv Lavxias (Company Deco LLC). Daim ntawv tso tawm - zaj duab xis-coated ntsiav tshuaj ntawm 150 lossis 500 mg ntawm cov khoom xyaw nquag. Cov khoom me me: microcrystalline cellulose, crospovidone, starch, magnesium stearate. Kev xa tawm los ntawm cov khw muag tshuaj los ntawm kev sau ntawv nkaus xwb.
- "Capecitover" yog cov khoom lag luam ntawm Lavxias lub tuam txhab JSC "Veropharm". Cov tshuaj tiv thaiv kab mob no muaj nyob rau hauv cov ntsiav tshuaj ntawm 150 lossis 500 mg ntawm 60 - 120 daim. Ntxiv rau capecitabine, cov tshuaj muaj xws li lactose, cellulose, croscarmellose sodium, sodium stearate thiab hypromellose.
- "Kapametin FS" - tsim los ntawm Lavxias teb sab tuam txhab "Nativa" - ib tug active koom nyob rau hauv qhov kev pab cuamimport hloov tshuaj. "Capametin FS" yog tsim los ntawm ib koob ntawm 150 - 500 mg, active tshuaj yog capecitabine. Cov lus qhia rau kev siv (cov chaw tsim khoom kuj tau qhia hauv nws) yuav qhia koj tias pes tsawg ntsiav tshuaj nyob rau hauv pob - 60 lossis 120.
- "Tutabine" yog tshuaj txawv teb chaws raws li capecitabine. Nws yog tsim los ntawm Argentine lub tuam txhab Laboratorio VARIFARMA SA, uas kuj yog tus sau npe ntawm cov khoom. "Tutabin" yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj nrog ib tug active ingredient ntsiab lus ntawm 500 mg. Ntim - thawv ntawv nrog cov lus qhia txuas.
- Xeloda yog tshuaj tiv thaiv kab mob. Ua nyob rau hauv Switzerland los ntawm lub tuam txhab "F. Hoffman La Roche", nrog rau nws cov chaw ua haujlwm thiab cov chaw ua haujlwm sawv cev hauv lwm lub tebchaws - Mexico thiab Tebchaws Meskas. Muaj 5 cov tshuaj nrog lub npe lag luam no ntawm kev lag luam Lavxias. Daim ntawv tso tawm - ntsiav tshuaj (150 - 500 mg) ntawm 60 lossis 120 pcs. hauv ib pob.
Reviews
Kev tshuaj xyuas ntawm kev ua haujlwm ntawm cov tshuaj raws li capecitabine txawv heev. Feem ntau ntawm lawv yog qhov zoo, tab sis kuj muaj kev tshuaj xyuas tsis zoo. Txawm li cas los xij, qhov no tsis qhia tias cov nyiaj no yog qhov zoo lossis qhov tsis zoo, vim tias qhov tseem ceeb ntawm tus kheej ntawm lub cev ntawm txhua tus neeg yuav tsum tau coj mus rau hauv tus account. Kev siv tib yam tshuaj los ntawm cov neeg sib txawv yeej tsis muab qhov txiaj ntsig zoo ib yam. Qhov tseem ceeb tshaj plaws yog lub cev tshwj xeeb uas cuam tshuam los ntawm neoplasm thiab qhov no tau tshwm sim ntev npaum li cas.
Cov neeg siv tshuaj tham txogmuaj zog toxic nyhuv tom qab ob peb hnub ntawm kev siv. Txawm li cas los xij, ntau tus neeg nco txog qhov kev txhim kho tseem ceeb hauv lawv qhov xwm txheej thiab txawm tias nkag mus rau lub sijhawm ntawm kev zam txim. Ib qho xwm txheej tseem ceeb rau cov tshuaj ua haujlwm zoo li ua tau rau ib tus neeg yog kev sab laj ntawm tus kws kho mob oncologist thiab ua raws li nws cov lus qhia txog kev kho mob.
