Doxorubicin (sunan kasuwanci Adriamycin) shi ne mai amfani da chemotherapy da aka yi amfani dasu sosai wanda yake da tasiri a duka Hodgkin da lymphomas non-Hodgkin . An yi amfani dashi a kusan dukkanin chemotherapy na farko da ya dace don lymphomas. Yana da nau'i na kwayoyin cutar shan-jijiyo da ake kira anthracyclines.
Doxorubicin iya jawo lalacewar zuciya
An fahimci cewa doxorubicin na iya haifar da lalacewar zuciya a wasu mutane.
Yayinda wasu anthracyclines (kamar farin ciki da mitoxantrone) na iya haifar da lalacewar zuciya, chances sun fi dacewa da doxorubicin. Doxorubicin yana haifar da mummunar lalacewa da farkon lalacewa (wanda ake kira cardiotoxicity). Lalacewa na farko ya faru nan da nan bayan gwamnatin miyagun ƙwayoyi ko a cikin kwanaki 1 zuwa 2. Akwai ƙananan sakamako da aka dauka a kan electrocardiogram (EKG) kuma a mafi yawan lokuta warware ba tare da haifar da wani babban matsaloli. Sakamakon lalacewa na farko da yake da muhimmanci kuma mafi tsanani.
Camarar Camarar Late
Late lalacewar zuciya yana farawa kimanin shekara ɗaya ko fiye bayan chemotherapy. Doxorubicin yafi rinjayar zuciya tsokoki. Yana rage girman karfin zuciya kuma yana sa jini ya fi wuya ga zuciya. Lokacin da yake da tsanani, zai kai ga yanayin da ake kira ƙin zuciya na zuciya (CHF). Mutane da ke tare da CHF sun yi tawaye da yawancin alamu
- Cunkushe mai sauƙi a cikin aiki mai wuyar gaske, wanda zai haifar da gajiya ko numfashi a lokacin hawa hawa ko tafiya
- Wani tari da yake damuwa da dare
- Kusar ƙafafu
- Wuya a numfashi a hutawa
Idan mai tsanani, CHF zai iya haifar da rashin lafiya mai tsanani har ma da mutuwa.
Ta Yaya Cutar Cutar ta Cutar Ciki ta Ciki?
Doxorubicin ya haɓaka da wasu sunadarai a cikin jiki (da ake kira enzymes) don samar da abubuwa masu cutarwa da ake kira 'yanci kyauta. Ana samar da wadannan cututtuka masu cutarwa masu cutarwa a cikin gabobin kamar zuciya inda akwai karin oxygen da baƙin ƙarfe.
Duk da yake wasu kwayoyin suna da ƙananan enzymes don halakar da waɗannan 'yanci, zuciya yana da matukar wadataccen wadata daga cikin wadannan enzymes. Wannan ya sa zuciyar tsokar da za ta iya lalacewa tare da sassaukarwa kyauta.
Abubuwan da ke Shafan Lalacin Zuciya
Abubuwa masu yawa sun kara yawan lalacewa na zuciya tare da doxorubicin.
- Wani babban kashi na doxorubicin zai iya haifar da lalacewar zuciya. Yawan jinsin maye gurbin da aka samu a lokacin rayuwar mutum ya kamata ya zama kasa da 400mg da mita mita (na jiki). Haɗarin CHF tare da wannan kashi shine kasa da kashi 1. A mafi yawan canji, chances na lalacewar zuciya yana karuwa. Abin farin ciki, mafi yawan lokuttan chemo na bukatar ƙananan allurai.
- Yin amfani da juna na sauran kwayoyin cutar kodotherapy da ke shafar zuciya kamar manyan sassan cyclophosphamide
- Yin gyaran fuska zuwa kirji
- Ciwon zuciya na yanzu
- Yarami
- Mace marasa lafiya
Gwaji don Zuciya Zuciya
An lalata yawancin zuciya tare da echocardiogram (wanda ake kira 'echo') ko kuma MUGA jarraba don gwada yawan jinin da zuciyar zata iya fita. A cikin maganin likita, ana kiran wannan 'ƙananan haɗin haɗin haɗin hagu' ko LVEF. An ƙaddara LVEF ga mafi yawan mutane kafin farawa magani don yin watsi da duk wani matsala ta zuciya.
Daga bisani, za'a iya aunawa a yayin lura da lokutan baya don ganin idan akwai lalata a cikin LVEF. Sau da yawa matsalolin zuciya na iya nunawa a cikin EKG.
Hanyoyin da za a Rage Damage
Akwai wasu hanyoyi da za a iya hana lalata zuciya ko rage masa
- Tsayawa jimlar jigilar maganin ciki a cikin iyakokin tsaro
- Sarrafa miyagun ƙwayoyi a matsayin jiko a saline maimakon a matsayin allura
- Amfani da sabon shirye-shiryen doxorubicin da ake kira 'liposomal doxorubicin' - miyagun ƙwayoyi ya zo a cikin wani karamin mai da ake kira liposome. Wannan shinge yana karya ne kawai a cikin ciwon daji don saki miyagun ƙwayoyi. Sassan al'ada kamar zuciya basu da rinjaye.
- Yin amfani da kayan da ake kira dexrazoxane a matsayin jigon jim kadan bayan anyi. Zai iya rage chances na lalacewar zuciya kuma an yarda da FDA a cikin cutar ciwon ƙirya.
Jiyya na CCF
Kwayar ciwon zuciya ta hanyar doxorubicin ana bi da su a kan layi daya da sauran nau'in zuciya ta rashin lafiya. Babu magunguna na musamman don lalacewar zuciya ta ciki. Sauran, oxygen da kwayoyin cututtuka rage ƙwayar cututtuka na CCF da kuma tabbatar da rashin lafiya na zuciya. Mai tsanani bayyanar cututtuka na iya buƙatar shigarwar asibiti.
Ya kamata mu daina amfani da Doxorubicin?
Doxorubicin yana da magungunan ƙwayoyin cutar shan magani. Yana da rawar da zai taimaka wajen maganin da dama. Duk da yake akwai ƙungiya mai mahimmanci na rikice-rikice tare da lalacewa na zuciya, amfanin amfani da doxorubicin ya wuce da hadari. Cutar zuciya tare da wannan miyagun ƙwayoyi an fahimta sosai, kuma idan an yi amfani da doxorubicin a cikin iyakokin iyakokin lafiya, babu dalilin daina dakatar da yin amfani da miyagun ƙwayoyi da amfani kamar haka.
> Sources:
Ciwon daji - Ka'idoji da Ayyukan Kwayoyin Halitta (Fita na 7). Masu gyara - Vicent T Devita Jr., Samuel Hellman, Steven Rosenberg. (Babi na 15: Pharmacology of Cancer Chemotherapy: Sashe na 7: Masu Turawa na Topoisraserase.)
Doxorubicin Hydrochloride, Cibiyar Cancer ta Kasa, Satumba 17, 2014.
Doxorubicin, Medline Plus, Cibiyar Siyasa Zamani ta Amurka, 01/15/2012.