Umlobi: Marcus Baldwin
Usuku Lokudalwa: 16 Ujuni 2021
Ukuvuselela Usuku: 23 Ujanuwari 2025
Anonim
Joseph Sullivan, MD: The Benefits of Fenfluramine Treatment in Dravet Syndrome
Ividiyo: Joseph Sullivan, MD: The Benefits of Fenfluramine Treatment in Dravet Syndrome

-Delile

I-Fenfluramine ingadala izinkinga ezinkulu zenhliziyo namaphaphu. Tshela udokotela wakho uma uke waba nesifo senhliziyo noma samaphaphu noma wake waba naso. Udokotela wakho uzokwenza i-echocardiogram (ukuhlolwa okusebenzisa amaza omsindo ukukala amandla enhliziyo yakho okumpompa igazi) ngaphambi kokuba uqale ukuthatha i-fenfluramine, njalo ezinyangeni eziyisithupha ngesikhathi sokwelashwa, nangesikhathi esisodwa ezinyangeni ezi-3 kuya kwezi-6 ngemuva komthamo wakho wokugcina we-fenfluramine.Shayela udokotela wakho ngokushesha uma unanoma iyiphi yalezi zimpawu nezimpawu ngesikhathi sokwelashwa: ukuphefumula, ubuhlungu besifuba, ukukhathala noma ubuthakathaka, ukushaya kwenhliziyo okusheshayo noma okushaya ngamandla ikakhulukazi ngomsebenzi owandayo, ikhanda elikhanyayo, ukuphelelwa amandla, ukushaya kwenhliziyo okungajwayelekile, amaqakala noma izinyawo ezivuvukile, noma umbala oluhlaza okwesibhakabhaka ezindebeni nasesikhumba.

Ngenxa yezingozi zalo muthi, i-fenfluramine itholakala kuphela ngohlelo olukhethekile lokusabalalisa olukhawulelwe. Uhlelo olubizwa ngeFintepla Risk Evaluation and Mitigation Strategies (REMS). Wena, udokotela wakho, kanye nekhemisi lakho kumele nibhalise kuhlelo lweFintepla REMS ngaphambi kokuthi niluthole.


Gcina wonke ama-aphoyintimenti nodokotela wakho kanye nelabhorethri. Udokotela wakho uzo-oda izivivinyo ezithile ukuze ahlole impendulo yomzimba wakho ku-fenfluramine.

Udokotela wakho noma usokhemisi uzokunikeza ishidi lemininingwane yesiguli lomkhiqizi (Umhlahlandlela Wezokwelapha) lapho uqala ukwelashwa nge-fenfluramine futhi isikhathi ngasinye lapho ugcwalisa khona incwadi kadokotela. Funda imininingwane ngokucophelela bese ubuza udokotela noma usokhemisi wakho uma unemibuzo. Ungavakashela futhi iwebhusayithi ye-Food and Drug Administration (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) noma iwebhusayithi yomkhiqizi ukuthola i-Medication Guide.

I-Fenfluramine isetshenziselwa ukulawula ukuqubuka ezinganeni ezisukela eminyakeni emibili ubudala nangaphezulu ezine-Dravet syndrome (isifo esiqala ebuntwaneni bese sibanga ukuquleka futhi kamuva kungaholela ekubambezelekeni kokuthuthuka kanye nasekushintsheni ekudleni, ekulinganiseni nasekuhambeni). I-Fenfluramine isekilasini lemithi ebizwa ngama-anticonvulsants. Akwaziwa ncamashi ukuthi i-fenfluramine isebenza kanjani, kepha inyusa inani lezinto zemvelo ebuchosheni ezinganciphisa umsebenzi wokubanjwa.


I-Fenfluramine iza njengesisombululo (uketshezi) ukuthatha ngomlomo. Imvamisa kuthathwa kabili ngosuku noma ngaphandle kokudla. Thatha i-fenfluramine ngezikhathi ezifanayo nsuku zonke. Landela izinkomba ezikulebuli kadokotela wakho ngokucophelela, bese ubuza udokotela noma usokhemisi wakho ukuthi akuchaze nganoma iyiphi ingxenye ongayiqondi. Thatha i-fenfluramine njengoba nje kuqondisiwe. Ungayithathi kancane noma uyithathe kaningi kunokuyalelwa ngudokotela wakho.

Udokotela wakho kungenzeka akuqale ngomthamo ophansi we-fenfluramine futhi akhuphule kancane umthamo wakho, hhayi ngaphezu kwesisodwa njalo ngesonto.

Sebenzisa isirinji yomlomo eze nomuthi ukukala isisombululo. Ungasebenzisi isipuni sasekhaya ukukala umthamo wakho. Amathisipuni asekhaya awawona amadivayisi wokulinganisa anembile, futhi ungathola imithi eningi kakhulu noma imithi eyanele uma ulinganisa umthamo wakho ngethisipuni lasekhaya. Hlanza isirinji yomlomo ngamanzi ahlanzekile ompompi bese uyivumela ukuthi yome ngemuva kokwenza njalo. Sebenzisa isirinji yomlomo eyomile njalo lapho uphuza umuthi.


Uma une-nasogastric (NG) noma i-gastric tube, udokotela wakho noma usokhemisi uzokuchazela ukuthi ungayilungiselela kanjani i-fenfluramine ukuyiphatha.

I-Fenfluramine iyasiza ukulawula ukuquleka, kepha ayikwelaphi. Qhubeka uthathe i-fenfluramine noma ngabe uzizwa uphilile. Ungayeki ukuthatha i-fenfluramine ngaphandle kokukhuluma nodokotela wakho. Uma ngokungazelelwe uyeka ukuthatha i-fenfluramine, ungahlangabezana nezimpawu zokuhoxa njengokuquleka okusha noma okuba kubi kakhulu. Udokotela wakho mhlawumbe uzokwehlisa umthamo wakho kancane kancane.

Lo muthi ungabekelwa okunye ukusetshenziswa; buza udokotela wakho noma usokhemisi ukuthola eminye imininingwane.

Ngaphambi kokuthatha i-fenfluramine,

  • Tshela udokotela wakho kanye nosokhemisi uma unegciwane ku-fenfluramine, noma imuphi omunye umuthi, noma iziphi izithako zesisombululo somlomo se-fenfluramine. Buza usokhemisi wakho noma uhlole Umhlahlandlela Wezokwelapha ukuthola uhlu lwezithako.
  • Tshela udokotela wakho uma uphuza noma uthola le mithi elandelayo noma uyekile ukuyiphuza ezinsukwini eziyi-14 ezedlule: i-monoamine oxidase (MAO) inhibitors kufaka phakathi i-isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline ( I-Eldepryl, i-Emsam, iZelapar), ne-tranylcypromine (iParnate). Uma uyeka ukuthatha i-fenfluramine, kufanele ulinde okungenani izinsuku eziyi-14 ngaphambi kokuqala ukuthatha i-MAO inhibitor.
  • Tshela udokotela wakho kanye nosokhemisi ukuthi imiphi eminye imishanguzo kadokotela neyokungabhalisi, amavithamini, izithasiselo zokudla okunempilo, nemikhiqizo yamakhambi oyithathayo noma ohlela ukuyithatha. Qinisekisa ukusho noma yikuphi kokulandelayo: imishanguzo efana ne-bupropion (Aplenzin, Wellbutrin); imithi yokukhathazeka; i-cyproheptadine; i-dextromethorphan (etholakala emithini eminingi yokukhwehlela; eNuedexta); i-efavirenz (Sustiva); i-lithium (i-Lithobid); imithi yokugula kwengqondo; imithi yezinhlungu ze-migraine ezifana ne-almotriptan (Axert), i-eletriptan (i-Relpax), i-frovatriptan (i-Frova), i-naratriptan (i-Amerge), i-rizatriptan (i-Maxalt), i-sumatriptan (i-Imitrex), ne-zolmitriptan (iZomig); omeprazole (Prilosec); i-rifampin (iRifadin, iRimactane, eRifamate, eRifater); isidambisi; imishanguzo yokuquleka efana ne-carbamazepine (Carbatrol, Equetro, Tegretol, Teril), clobazam (Onfi, Sympazan), phenobarbital, phenytoin (Dilantin, Phenytek), ne-stiripentol (Diamcomit); i-serotonin-reuptake inhibitors ekhethiwe efana ne-fluoxetine (Prozac, Sarafem, Selfemra), i-fluvoxamine (i-Luvox), i-paroxetine (i-Brisdelle, i-Paxil, i-Pexeva), ne-sertraline (i-Zoloft); i-serotonin – norepinephrine reuptake inhibitors (SNRI) efana ne-desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), milnacipran (Savella), ne-venlafaxine (i-Effexor); amaphilisi okulala; okokunciphisa umzimba; i-trazodone; kanye ne-tricyclic antidepressants (’mood elevators’) efana ne-desipramine (Norpramin) noma i-protriptyline (Vivactil). Udokotela wakho angadinga ukushintsha imithamo yemithi yakho noma akuqaphele ngokucophelela ngemiphumela emibi. Eminye imishanguzo eminingi ingaxhumana ne-fenfluramine, ngakho-ke qiniseka ukuthi utshela udokotela wakho ngayo yonke imithi oyiphuzayo, ngisho naleyo engabonakali kulolu hlu.
  • utshele udokotela wakho ukuthi yimiphi imikhiqizo yamakhambi kanye nezithako zokudla okunomsoco ozithathayo, ikakhulukazi iSt John's wort ne-tryptophan.
  • Tshela udokotela wakho uma uke waba ne-glaucoma (umfutho owandayo esweni ongadala ukulahleka kombono) noma umfutho wegazi ophakeme. Futhi, tshela udokotela wakho uma uke waba nokudangala, izinkinga zemizwelo, imicabango yokuzibulala noma ukuziphatha noma isifo sezinso noma sesibindi.
  • utshele udokotela wakho uma ukhulelwe, hlela ukukhulelwa, noma uncelisa. Uma ukhulelwa ngenkathi uthatha i-fenfluramine, shayela udokotela wakho.
  • kufanele wazi ukuthi i-fenfluramine ingakwenza ukozele futhi ikwenze kube nzima kuwe ukwenza imisebenzi edinga ukuqapha noma ukuhlangana komzimba. Ungashayeli imoto noma usebenzise imishini uze wazi ukuthi lo muthi ukuthinta kanjani.
  • buza udokotela wakho mayelana nokusetshenziswa okuphephile kweziphuzo ezidakayo nemithi equkethe utshwala (ukukhwehlela nemikhiqizo ebandayo, njengeNyquil, neminye imikhiqizo ewuketshezi) ngenkathi uthatha i-fenfluramine. Utshwala bungangezela ukozela okubangelwa yilomuthi.
  • kufanele wazi ukuthi impilo yakho yengqondo ingashintsha ngezindlela ezingalindelekile futhi ungazibulala (ucabange ngokuzilimaza noma ukuzibulala noma ukuhlela noma ukuzama ukwenza kanjalo) ngenkathi uthatha i-fenfluramine. Inani elincane labantu abadala nezingane ezineminyaka engu-5 nangaphezulu (cishe umuntu oyedwa kwabangu-500) abathathe ama-anticonvulsants, njenge-fenfluramine, ukwelapha izimo ezahlukahlukene phakathi kwezifundo zokwelashwa baba nokuzibulala ngesikhathi belashwa. Abanye balaba bantu bahlakulela imicabango yokuzibulala nokuziphatha kungakapheli isonto elilodwa beqale ukuthatha umuthi. Wena nodokotela wakho nizonquma ukuthi izingozi zokuthatha umuthi we-anticonvulsant zinkulu yini kunezingozi zokungawuthathi umuthi. Wena, umndeni wakho, noma umnakekeli wakho kufanele ushayele udokotela wakho ngokushesha uma uhlangabezana nalezi zimpawu ezilandelayo: ukwethuka; ukuphazamiseka noma ukungahlaliseki; ukucasuka okusha noma okuya kuba kubi, ukukhathazeka, noma ukucindezeleka; ukwenza izinkanuko eziyingozi; ubunzima bokulala noma ukulala; ulaka, intukuthelo, noma ukuziphatha okunodlame; i-mania (i-frenzied, imood ejabule ngokungavamile); ukucabanga ngokuzilimaza noma ukuzibulala, noma ukuhlela noma ukuzama ukwenza kanjalo; noma olunye uguquko olungajwayelekile ekuziphatheni noma emoyeni. Qiniseka ukuthi umndeni wakho noma umnakekeli wakho uyazi ukuthi yiziphi izimpawu ezingaba zimbi kakhulu ukuze bakwazi ukubiza udokotela uma ungakwazi ukuzifunela ukwelashwa wedwa.

Ngaphandle kokuthi udokotela wakho akutshele ngenye indlela, qhubeka nokudla okuvamile.

Thatha umthamo ongabanjwanga ngokushesha nje lapho uwukhumbula. Kodwa-ke, uma sekuyisikhathi somthamo olandelayo, weqa umthamo ongabanjwanga bese uqhubeka neshejuli yakho ejwayelekile yokulinganisa. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

I-Fenfluramine ingadala imiphumela emibi. Tshela udokotela wakho uma kukhona kulezi zimpawu ezinzima noma ezingapheli:

  • isifo sohudo
  • ukuqunjelwa
  • ukuhlanza
  • ukungazinzi noma izinkinga ngokuhamba
  • ukukhipha amathe noma ngokweqile
  • ubunzima bokulala noma ukulala
  • ukuwa
  • umkhuhlane, ukukhwehlela, noma ezinye izimpawu zokutheleleka

Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nenye yalezi zimpawu noma lezo ezibalwe ezigabeni EZIBALULEKILE ZESEXWAYISO noma ZOKUQAPHA, yeka ukuthatha i-fenfluramine bese ushayela udokotela wakho ngokushesha noma uthole ukwelashwa okuphuthumayo:

  • ukudinwa, ukubona izinto ezingekho kahle, ukushisa komzimba, ukujuluka, ukudideka, ukushaya kwenhliziyo okusheshayo, ukugodola, ukuqina kwemisipha noma ukudikiza, ukulahlekelwa ukuhlangana, isicanucanu, ukuhlanza noma isifo sohudo
  • ukufiphala kombono noma ukushintsha kombono, kufaka phakathi ukubona ama-halos (uhlaka olufiphele oluzungeze izinto) noma amachashazi anemibala

I-Fenfluramine ingadala ukulahleka kwesifiso kanye nokwehlisa isisindo. Uma ubona ukuthi ingane yakho ilahlekelwa isisindo, shayela udokotela wakho. Udokotela wakho uzobuka ngokucophelela ukukhula nesisindo sengane yakho. Khuluma nodokotela wakho uma unenkinga ngokukhula noma isisindo sengane yakho ngenkathi ithatha lo muthi.

I-Fenfluramine ingadala eminye imiphumela emibi. Shayela udokotela wakho uma unezinkinga ezingavamile ngenkathi uthatha lo muthi.

Uma uthola imiphumela emibi kakhulu, wena noma udokotela wakho ungathumela umbiko kuhlelo lwe-Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting online (http://www.fda.gov/Safety/MedWatch) noma ngocingo ( 1-800-332-1088).

Gcina le mithi esitsheni efike ngayo, ivalwe ngokuqinile, futhi lapho izingane zingafinyeleleki khona. Gcina isisombululo somlomo ekamelweni lokushisa futhi kude nokushisa okwedlulele nomswakama (hhayi endlini yangasese). Ungafaki esiqandisini noma umise isixazululo. Lahla noma isiphi isisombululo somlomo esingasetshenziswanga esisele ezinyangeni ezi-3 ngemuva kokuqala ukuvula ibhodlela noma ngemuva kwedethi "yokulahla ngemuva" kwelebula, noma iluphi usuku olusheshayo.

Kubalulekile ukugcina yonke imishanguzo ingabonakali futhi ifinyeleleke ezinganeni njengoba iziqukathi eziningi (njengezingqondo zamaphilisi zamasonto onke kanye nalawo amaconsi wamehlo, okhilimu, amabala, kanye nama-inhalers) azimeleki ezinganeni futhi izingane ezincane zingazivula kalula. Ukuvikela izingane ezisencane ekufakeni ubuthi, hlala uvala amakepisi okuphepha bese ubeka umuthi endaweni ephephile - eyodwa ephezulu futhi engekho futhi engabonakali kubo futhi efinyelela kuyo. http://www.upandaway.org

Imithi engadingeki kufanele ilahlwe ngezindlela ezikhethekile zokuqinisekisa ukuthi izilwane ezifuywayo, izingane nabanye abantu abakwazi ukuzidla. Kodwa-ke, akufanele ukhiphe le mithi ethoyilethi. Esikhundleni salokho, indlela engcono kakhulu yokulahla imithi yakho ngohlelo lokubuyisa umuthi. Khuluma nosokhemisi wakho noma uthinte umnyango wangakini wokulahla udoti / wokusebenzisa kabusha ukuze ufunde ngezinhlelo zokubuyisa emphakathini wakho. Bheka iwebhusayithi yakwa-FDA's Safe Disposal of Medicines (http://goo.gl/c4Rm4p) ukuthola eminye imininingwane uma ungakwazi ukufinyelela kuhlelo lokubuyisa.

Uma kwenzeka ukweqisa ngokweqile, shayela ucingo losizo lokulawula ubuthi ku-1-800-222-1222. Imininingwane iyatholakala online ku-https: //www.poisonhelp.org/help. Uma isisulu siwile, saba nokuquleka, sinenkinga yokuphefumula, noma singakwazi ukuvuswa, shayela ngokushesha abezimo eziphuthumayo ku-911.

Izimpawu zokudlula ngokweqile zingafaka:

  • abafundi abahlanzekile
  • emuva arching
  • ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
  • ukuqhuma
  • ukungahlaliseki
  • ukukhathazeka
  • ukuthuthumela
  • ukudlikiza
  • ikhoma (ukulahlekelwa ukwazi isikhathi esithile)
  • ukuyaluza, ukubona izinto ezingekho kahle, ukushisa komzimba, ukujuluka, ukudideka, ukushaya kwenhliziyo okusheshayo, ukuqhaqhazela, ukuqina kwemisipha noma ukudikiza, ukulahlekelwa ukuhlangana, isicanucanu, ukuhlanza noma isifo sohudo

Ungavumeli omunye umuntu ukuthi athathe imithi yakho. I-Fenfluramine yinto elawulwayo. Okubhalwe phansi kungagcwaliswa izikhathi ezimbalwa kuphela; buza usokhemisi wakho uma unemibuzo.

Kubalulekile ukuthi ugcine uhlu olubhaliwe lwayo yonke imishanguzo oyisebenzisayo kadokotela kanye nokungabhaliswanga (ngaphezulu kokuthenga), kanye nanoma yimiphi imikhiqizo efana namavithamini, amaminerali, noma ezinye izithako zokudla. Kufanele uze nalolu hlu njalo uma uvakashela udokotela noma uma ungeniswa esibhedlela. Kubaluleke kakhulu futhi nemininingwane ebalulekile ukuthi uphathe uma kwenzeka kunezimo eziphuthumayo.

  • UFintepla®
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