"Cyclophosphamide" yog ib qho alkylating compound. Nws yog ib qho tshuaj anticancer. Muaj raws li ib tug dawb los yog ze li crystalline hmoov. Xav paub ntxiv txog cov tshuaj no kom ntxaws ntxiv.
YCyclophosphamide - chaw tsim tshuaj paus
Cov tshuaj no yog tsim los ntawm lub tuam txhab Lavxias teb sab JSC "Biochemistry". Nws nyob hauv Saransk ntawm Vasenko txoj kev, 15A.
Tus nqi
Nyob hauv txhua lub tsev muag tshuaj koj tuaj yeem yuav cov hmoov No. 1 "Cyclophosphamide". Nws tus nqi hloov pauv ib ncig ntawm 90-98 rubles.
Description of dosage form
Cov tshuaj yog npaj los ntawm cov hmoov no. Nws yog npaj rau intramuscular thiab intravenous tswj
Txoj kev sib sau
Txhua lub vial ntawm hmoov muaj ib hom tshuaj hu ua "cyclophosphamide". Nws qhov ntau yog qhov tseeb. Namely, nws muaj "Cyclophosphamide" 200 mg ntawm cov ntaub ntawv teev nyob rau hauv ib lub vial. Tsis muaj excipients nyob rau hauv cov tshuaj no.
Kev piav qhia ntawm kev ua tshuaj tshuaj
Raws li cov lus qhia rau kev siv, "Cyclophosphamide" yog ib qho tshuaj alkylating cytostatic. Nws cov tshuaj muaj pes tsawg leeg zoo ib yam li cov khoom xws li nitrogen analogues ntawm mustard roj. Lub pharmacological kev txiav txim ntawm "Cyclophosphan" yog mus nqa tawm tsim ntawm cross-links ntawm DNA thiab RNA strands. Tsis tas li ntawd, cov tshuaj no yuav pab tiv thaiv cov protein synthesis.
"Cyclophosphamide" - analogues
Nyob rau hauv rooj plaub no, cov nyiaj no raug xaiv uas phim ATX code ntawm qeb plaub. Qhov tshwj xeeb tshaj yog "Cyclophosphamide". Analogues ntawm cov tshuaj no muaj nyob rau hauv ntau ntau. Feem ntau yog:
- Endoxan.
- Ifosfamide.
- Alkeran.
- Choloxan
- Ribomustine.
- Lakeran.
Kev xaiv ntawm txhua yam tshuaj no yog ua los ntawm kws kho mob ntawm tus kheej. Hauv qhov no, lub xeev kev noj qab haus huv thiab kev kam rau siab ntawm cov khoom raug muab coj los rau hauv tus account.
Thaum twg thov?
Cia peb xav txog yam khoom no kom ntxaws ntxiv. Qhov tshwj xeeb heev yog siv cov tshuaj xws li "Cyclophosphamide". Cov lus qhia rau kev siv nyob rau hauv no hais txog yuav yog ib tug indispensable pab. Nws qhia tau tias cov tshuaj no tau qhia hauv cov xwm txheej hauv qab no:
- Thaum mob thiab mob lymphocytic leukemia tshwm sim.
- Yog koj muaj ntau yam myeloma.
- Thaum cov tsos mob ntawm non-Hodgkin's lymphoma tshwm.
- ThaumQhov tshwm sim ntawm mycosis fungoides thiab retinoblastoma.
- Nyob rau hauv lub xub ntiag ntawm lymphogranulomatosis, nrog rau zes qe menyuam thiab qog noj ntshav.
- Thaum cov tsos mob ntawm neuroblastoma tshwm sim.
Ntxiv rau tag nrho cov no, cov tshuaj no yog siv ua ke nrog lwm cov tshuaj tiv thaiv kab mob rau kev kho mob hauv qab no:
- Rau kab mob qog nqaij hlav.
- Rau zais zis thiab ntsws cancer.
- Rau cov ntaub so ntswg sarcoma.
- Thaum prostate thiab mob qog noj ntshav tshwm sim.
- Rau Ewing's sarcoma.
- Ib kis ntawm Wilms qog.
- YFor reticulosarcoma.
Tsis tas li, cov tshuaj xws li "Cyclophosphamide", kev tshuaj xyuas uas yog qhov zoo, muaj txiaj ntsig zoo li cov tshuaj tiv thaiv kab mob hauv qhov tshwm sim ntawm cov kab mob autoimmune. Hauv qhov no, qhov tshwm sim ntawm psoriatic thiab rheumatoid mob caj dab, autoimmune hemolytic anemia, collagenosis, nephrotic syndrome yog implied. Nws kuj tseem txwv tsis pub hloov pauv.
YContraindications
"Cyclophosphamide" muaj qee yam contraindications. Nws tsis tuaj yeem siv:
- Lub sijhawm pub niam mis thiab cev xeeb tub.
- Thaum muaj qhov hais tsis zoo ntawm cov pob txha pob txha.
- Nyob rau hauv siab.
- Thaum tso zis.
- Yog muaj kab mob kis.
- Thaum tshwm sim ntawm cystitis.
Nrog ceev fajNws yog ib qho tsim nyog los xaiv "Cyclophosphamide", cov analogues uas tau qhia saum toj no, hauv qee kis. Namely, nyob rau hauv lub xub ntiag ntawm cov kab mob hauv qab no:
- Nephurolithiasis.
- Kab mob hnyav ntawm lub siab, lub siab thiab lub raum.
- Gout.
- Infiltration nrog qog hlwb hauv cov pob txha pob txha.
- Adrenalectomy.
- Inhibition ntawm pob txha pob txha ua haujlwm.
Kev piav qhia ntawm kev mob tshwm sim
"Cyclophosphamide", cov lus sib piv (analogues) uas tau teev tseg saum toj no, tuaj yeem ua rau muaj qhov tshwm sim hauv qab no:
- Cov tsos mob ntawm plab hnyuv muaj xws li ntuav, xeev siab, anorexia, tsis xis nyob, stomatitis, mob plab, raws plab lossis cem quav. Tseem muaj cov kab mob jaundice thiab hemorrhagic colitis.
- Nyob rau hauv lub hematopoietic system, tshwm sim ntawm neutropenia, anemia, thrombocytopenia, leukopenia tau pom. Hnub 7-14 ntawm kev tswj hwm, cov platelets thiab leukocytes yuav txo qis me ntsis.
- Daim tawv nqaij tshwm sim ntawm alopecia tau pom. Cov plaub hau rov qab los tom qab ua tiav cov tshuaj. Tsis tas li ntawd, thaum lub sijhawm kho mob, cov pob khaus tuaj yeem tshwm sim ntawm daim tawv nqaij. Tej zaum kuj yuav muaj cov tawv nqaij pigmentation thiab cov ntsia hlau hloov.
- Cardiotoxicity tuaj yeem tshwm sim hauv cov hlab plawv thaum siv cov tshuaj no ntau dhau lub sijhawm ntev. Qhov no tseem ceeb heev uas yuav tsum nco ntsoov. Tsis tas li ntawd, qhov tshwm sim ntawm txoj kev nyuaj, thiab qee zaum ua rau tuag taus, mob plawv tsis ua haujlwm tau pom. Qhov no yog vimtshwm sim ntawm hemorrhagic hom myocarditis.
- Nyob rau hauv cov zis, necrosis ntawm lub raum kwj dej (mus txog rau kev tuag), hemorrhagic cystitis los yog urethritis, zais zis fibrosis yuav tshwm sim. Muaj tsawg zaus, thaum siv cov tshuaj no ntau, nephropathy, hyperuricemia thiab lub raum tsis ua haujlwm yuav tshwm sim. Nyob rau hauv tas li ntawd, lub xub ntiag ntawm epithelial hlwb nyob rau hauv cov zis yuav pom.
- Cov kab mob ua pa tuaj yeem pom qhov cuam tshuam ntawm pulmonary fibrosis.
- Nyob rau hauv lub cev xeeb tub, cuam tshuam hauv oogenesis thiab spermatogenesis, nrog rau kev tsis muaj menyuam, yuav tshwm sim. Cov tsos mob zaum kawg hauv qee kis tej zaum yuav hloov tsis tau. Hauv cov poj niam feem ntau, thaum siv cov tshuaj no, kev txhim kho ntawm amenorrhea yog pom. Tom qab qhov kawg ntawm kev kho mob, qhov kev coj khaub ncaws tsis tu ncua, raws li txoj cai, rov qab los. Hauv cov txiv neej, noj cov tshuaj no tuaj yeem ua rau oligospermia lossis azoospermia, nrog rau ntau qib ntawm testicular atrophy.
- Hauv qhov no, kev tsis haum tshuaj kuj tshwm sim. Namely, qhov tshwm sim ntawm daim tawv nqaij pob, khaus, urticaria, anaphylactic tshua.
- Koj kuj yuav muaj kev phiv tshuaj. Ntawd yog, yaug ntawm daim tawv nqaij ntawm lub ntsej muag, hyperemia, kev loj hlob ntawm cov qog nqaij hlav malignant, tawm hws ntau dhau, mob taub hau.
Kev sib cuam tshuam
Thaum noj cov tshuaj no, qee cov ntsiab lus uas txhawb nqa microsomal oxidation hauv daim siab yuav ua rauinduced txheej txheem ntawm microsomal metabolism ntawm cyclophosphamide. Qhov no ua rau muaj qee yam. Namely, mus rau ib tug loj tsim ntawm metabolites ntawm alkylating hom. Qhov no txo qis lub sijhawm uas ib nrab-lub neej ntawm cyclophosphamide tau ua tiav, thiab tseem ua rau nws cov haujlwm nce ntxiv. Kev noj tshuaj cyclophosphamide, uas ua rau muaj kev cuam tshuam loj heev thiab mus sij hawm ntev inhibits kev ua ntawm cholinesterase, txhim kho kev ua ntawm suxamethonium. Nws kuj tseem pab txo qis lossis qeeb cov metabolism ntawm cov yeeb tshuaj. Yog li ntawd, lub sij hawm ntawm nws cov nyhuv yog txhim kho los yog ncua sij hawm thiab qhov kev pheej hmoo ntawm nws cov tshuaj lom yog nce. Qhov no muaj qhov tsis zoo rau lub cev tag nrho. Tsis tas li ntawd, kev siv ib txhij nrog allopurinol tuaj yeem ua rau muaj kev phom sij rau cov pob txha.
Thaum noj cyclophosphamide nrog allopurinol, colchicine, probenecid, sulfinpyrazone, tej zaum yuav tsim nyog los kho cov koob tshuaj tiv thaiv kab mob hauv kev kho mob gout thiab hyperuricemia. Tej zaum kuj yuav muaj kev pheej hmoo ntawm nephropathy, uas cuam tshuam nrog kev tsim cov uric acid ntau ntxiv thaum siv cyclophosphamide.
Cov tshuaj kawg tuaj yeem ua rau muaj kev nce ntxiv hauv kev ua haujlwm anticoagulant. Txij li thaum tib lub sij hawm nyob rau hauv daim siab lub synthesis ntawm yam uas ua rau cov ntshav txhaws thiab impaired platelet tsim yog txo. Txawm li cas los xij, kev txo qis hauv cov tshuaj tiv thaiv coagulant kuj tseem tuaj yeem tshwm sim los ntawm hom kev tsis paub txog.
Cyclophosphamide txhim kho cov teebmeem cardiotoxic ntawm daunorubicin thiab doxorubicin. Lwm yamCov tshuaj tiv thaiv kab mob (chlorambucil, azathioprine, cyclosporine, glucocorticosteroids, mercaptopurine, thiab lwm yam) tuaj yeem ua rau muaj peev xwm tsim cov qog thiab kis kab mob.
Kev siv lovastatin sib xyaw rau hauv cov neeg mob hloov lub plawv tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kab mob xws li mob pob txha pob txha necrosis thiab mob raum tsis ua haujlwm.
Yog cov tshuaj myelosuppressive lossis kev kho hluav taws xob tau siv ua ke nrog cov tshuaj no, cov pob txha pob txha ntxiv yuav tshwm sim.
Kev siv ntau npaum ntawm cytarabine nrog cov tshuaj xws li cyclophosphamide hauv kev npaj rau kev hloov cov pob txha pob txha ua rau muaj kev nce hauv cardiomyopathy nrog qhov tshwm sim tuag taus.
cov ntsiab lus tseem ceeb
Cov txheej txheem thov siv rau hauv tus lej hauv qab no:
- Thaum kho nrog cov tshuaj no, yuav tsum tau kuaj ntshav tsis tu ncua txhawm rau ntsuas qhov ntsuas ntawm myelosuppression. Hauv qhov no, nws yog ib qho tsim nyog yuav tsum tau them sai sai rau cov platelets thiab neutrophils.
- Koj yuav tsum ua ntu zus mus kuaj zis seb puas muaj cov qe ntshav liab. Lawv cov tsos mob tuaj yeem ua rau muaj kev loj hlob ntawm cov kab mob xws li hemorrhagic cystitis. Yog tias pom cov tsos mob zoo li no, kev kho mob nrog Cyclophosphamide, tus nqi ntawm cov lus qhia saum toj no, yuav tsum raug tso tseg.
- Yog tias cov platelets (qis dua 100,000 / μl) thiab / lossis leukocytes (<2500 / μl) txo qis, cov tshuaj no yuav tsum tau noj.nres.
- Yog tias muaj kab mob tshwm sim thaum kho nrog cov tshuaj no, cov kev kho mob yuav tsum raug txiav tawm lossis cuam tshuam. Los yog nyob rau hauv cov ntaub ntawv no, cov tshuaj yuav tsum tau txo. Cov txiv neej thiab cov poj niam thaum lub sijhawm kho nrog Cyclophosphamide yuav tsum siv txoj kev tiv thaiv kev tiv thaiv zoo.
- Cawv yuav tsum zam thaum kho cov tshuaj no.
- Yog tias thawj kaum hnub tsis tau dhau mus tom qab kev ua haujlwm, uas tau ua raws li kev siv tshuaj loog, thiab tus neeg mob tau muab tshuaj "Cyclophosphamide", tus nqi uas tau hais los saum toj no, tus kws tshuaj loog yuav tsum tau qhia txog qhov no.
- Ib tus neeg mob tom qab adrenalectomy tau dhau los ntawm adrenalectomy, nws yog qhov yuav tsum tau kho cov koob tshuaj ntawm ob qho tib si glucocorticosteroids, uas yog siv los hloov cov txheej txheem kho, thiab cov tshuaj xws li tshuaj Cyclophosphamide.
Yuav tsum ceev faj
Cov tshuaj no tsuas yog yuav tsum tau ua raws li kev saib xyuas ntawm tus kws kho mob uas muaj kev kho mob tshuaj. Nws tseem yog ib qho tsim nyog yuav tsum ua raws li kev noj tshuaj kom nruj. Qhov no tshwj xeeb tshaj yog yuav tsum tau ua nyob rau hauv kev kho mob ua ke. Nws tseem tsis tas yuav tsum tau muab ob npaug rau koob tshuaj ntxiv yog tias qhov dhau los tau ploj lawm. Hauv kev npaj cov tshuaj no rau kev siv hauv cov menyuam mos, nws tsis pom zoo kom siv cov tshuaj diluents uas muaj benzyl cawv. Txij li qhov no tuaj yeem ua rau muaj kev txhim kho ntawm cov kab mob toxic lethal syndrome. Namely rauQhov tshwm sim ntawm metabolic acidosis, CNS kev nyuaj siab, ua pa tsis ua hauj lwm, lub raum tsis ua hauj lwm, hypotension, qaug dab peg, intracranial hemorrhage.
Lub sijhawm tag nrho cov kev kho mob, nws raug nquahu kom ua cov ntshav hloov ntshav (1 zaug hauv ib lub lis piam 100-125 ml). Qhov no yog qhov tsim nyog txhawm rau tiv thaiv cov kab mob xws li hyperuricemia thiab nephropathy, uas yog tshwm sim los ntawm kev tsim cov uric acid ntau ntxiv. Cov tsos mob zoo li no feem ntau tshwm sim thaum pib ntawm lub sijhawm kho. Tsis tas li ntawd, ua ntej kev kho mob nrog cov tshuaj no thiab thaum lub sijhawm 72 teev tom qab noj nws, nws raug nquahu kom ua cov kua dej ntau (kwv yees li 3 litres ib hnub), kev siv allopurinol (hauv cov xwm txheej tshwj xeeb) thiab cov neeg ua haujlwm alkalinize zis. Txhawm rau tiv thaiv qhov tshwm sim ntawm hemorrhagic cystitis, nws yog ib qho tsim nyog yuav tsum tau ntim lub zais zis thiab noj Uromitexan. Yog tias qhov tshwm sim thawj zaug ntawm tus kab mob no tshwm sim, ces chav kho mob nrog cov tshuaj qhia yuav tsum tau nres kom txog thaum cov tsos mob tshwm sim raug tshem tawm tag nrho.
Txhawm rau txo cov tsos mob ntawm hom dyspeptic, koj tuaj yeem noj cyclophosphamide thaum thawj hnub hauv koob me me. Ua kom tiav lossis ib nrab alopecia, uas tuaj yeem tshwm sim thaum lub sijhawm kho, rov qab tau thiab tom qab kawg ntawm chav kawm, kev ua haujlwm ntawm cov plaub hau zoo li qub tau rov qab los. Txawm li cas los xij, lawv cov xim thiab cov qauv yuav raug hloov.
Yog tias koj mob khaub thuas, ua npaws, hnoos lossis hawb pob, mob hauv koj sab nraub qaum lossis sab, mob lossis tso zis nyuaj, los ntshavlos yog los ntshav, cov quav dub, ntshav cov quav lossis zis, nrhiav kev kho mob tam sim.
Qhov muaj peev xwm ntawm thrombocytopenia ua rau qhov xav tau kev saib xyuas tshwj xeeb thaum ua haujlwm xws li cov txheej txheem cuam tshuam thiab kev kho hniav. Nyob rau hauv cov ntaub ntawv no, daim tawv nqaij thiab mucous daim nyias nyias thiab qhov chaw ntawm cov tshuaj intravenously yuav tsum tau xyuas tsis tu ncua. Qhov no yog txhawm rau nrhiav cov cim qhia los ntshav. Nws kuj tseem yuav tsum tau txwv qhov zaus ntawm venipuncture thiab tso tseg kev txhaj tshuaj intramuscular. Nws yog ib qho tsim nyog los tswj cov ntsiab lus ntawm cov ntshav hauv cov quav, ntuav, tso zis. Cov neeg mob no yuav tsum tau ceev faj heev nyob rau hauv cov txheej txheem ntawm shaving, manicure, txhuam hniav, siv toothpicks, thiab lwm yam. Nyob rau tib lub sijhawm, kev ntog thiab lwm yam kev puas tsuaj yuav tsum raug zam kom nruj. Nws tseem raug txwv tsis pub noj acetylsalicylic acid thiab cawv, uas ua rau muaj kev pheej hmoo ntawm plab hnyuv los ntshav. Hauv qhov no, nws yog ib qho tsim nyog yuav tsum ncua sijhawm txhaj tshuaj tiv thaiv (tom qab 3-12 lub hlis txij li qhov kawg ntawm kev kho tshuaj khomob kawg). Nyob rau hauv rooj plaub no, nws yog ntshaw kom tshem tawm kev sib cuag nrog cov neeg mob. Thaum lub sij hawm kho, yuav tsum tau siv cov tshuaj tiv thaiv kom txaus.
Yog tias cov khoom no nkag mus rau hauv cov mucous daim nyias nyias los yog daim tawv nqaij, ntxuav thaj chaw kom huv si nrog dej los yog xab npum, raws li.
Thaum pub mis niam thiab cev xeeb tub
Hauv qhov no, muaj cov kev txwv tshwj xeeb uas "Cyclophosphamide" muaj. Kev qhia qhiatias kev siv cov tshuaj no thaum cev xeeb tub yog contraindicated. Hauv qhov no, qeb ntawm kev kis tus menyuam hauv plab tau raug xaiv "D" los ntawm FDA. Rau lub sijhawm kho, nws yuav tsum tsis txhob pub mis niam.
Ntau tshaj
Hauv qhov no, muaj qee qhov nuances. Lub xub ntiag ntawm ib qho tshuaj tiv thaiv tshwj xeeb rau overdose ntawm cov tshuaj no tsis paub. Qhov no yog qhov tseeb. Nyob rau hauv cov ntaub ntawv ntawm overdose, kev txhawb nqa kev ntsuas yuav tsum tau muab coj los siv, nrog rau cov kev kho mob tsim nyog rau cov kab mob sib kis, nrog rau qhov tshwm sim ntawm cardiotoxicity thiab / los yog myelosuppression.
Storage condition
Hauv qhov no, cov tshuaj xws li Cyclophosphamide yuav tsum muaj qee yam mob. Cov lus qhia rau kev siv hais tias nws yuav tsum tau khaws cia ntawm qhov kub tsis tshaj 10 ° C hauv qhov chaw qhuav thiab tiv thaiv los ntawm lub teeb. Tib lub sijhawm, kev nkag mus rau menyuam yaus yuav tsum txwv.
Hnub Kawg
Muaj qee lub sijhawm uas koj tuaj yeem siv tshuaj xws li "Cyclophosphamide". Cov lus qhia rau kev siv qhia tias nws lub neej txee yog 3 xyoos. Hauv qhov no, yuav tsum tau saib xyuas qee yam mob. Nws nyob rau hauv qhov tseeb hais tias nws yog nruj me ntsis txwv tsis pub siv cov tshuaj no tom qab tas sij hawm ntawm lub sij hawm teev.
Kev Ua Haujlwm
Nyob rau hauv qhov kev taw qhia no, kuj muaj ib qho mob uas "Cyclophosphamide" muaj. Cov lus qhia rau kev siv qhia tias cov tshuaj no tau muab tso rau hauv cov khw muag tshuaj nkaus xwb.
Zoo kawg
Cov ntawv no muaj ntau cov ntaub ntawv tseem ceeb. Namely, dab tsi yog "Cyclophosphamide", cov lus qhia rau kev siv, tus nqi ntawm cov tshuaj no. Txawm li cas los xij, thov nco ntsoov tias ua ntej siv cov tshuaj no, koj yuav tsum sab laj nrog kws kho mob uas tsim nyog.
