Thalidomide

-Delile

• Ngaphambi kokuthatha i-thalidomide,
• I-Thalidomide ingadala imiphumela emibi. Tshela udokotela wakho uma kukhona kulezi zimpawu ezinzima noma ezingapheli:
• Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nalezi zimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uthole ukwelashwa okuphuthumayo:

Ubungozi bezinkinga zokuzalwa ezinzima, ezisongela ukuphila ezibangelwa yi-thalidomide.

Okwabo bonke abantu abathatha i-thalidomide:

I-Thalidomide akumele ithathwe ngabesifazane abakhulelwe noma abangakhulelwa ngenkathi bephuza lo muthi. Ngisho umthamo owodwa we-thalidomide othathwe ngesikhathi sokukhulelwa ungadala ukukhubazeka okukhulu kokuzalwa (izinkinga zomzimba ezikhona enganeni lapho izalwa) noma ukufa kwengane engakazalwa. Uhlelo olubizwa ngeThalidomide REMS^® (phambilini beyaziwa njengeSystem for Thalidomide Education and Prescribing Safety [S.T.E.P.S.^®]) kuvunyelwe i-Food and Drug Administration (FDA) ukuqinisekisa ukuthi abesifazane abakhulelwe abayithathi i-thalidomide nokuthi abesifazane abakhulelwa ngenkathi bephuza i-thalidomide. Bonke abantu abanikezwe i-thalidomide, kufaka phakathi abesilisa nabesifazane abangakwazi ukukhulelwa, kumele babhaliswe ne-Thalidomide REMS^®, yiba ne-thalidomide kadokotela evela kudokotela obhaliswe ne-Thalidomide REMS^®, futhi ugcwaliswe ngudokotela ekhemisi elibhaliswe neThalidomide REMS^® ukuze uthole lo muthi.

Uzodinga ukubona udokotela wakho njalo ngenyanga ngesikhathi sokwelashwa kwakho ukuze ukhulume ngesimo sakho nanoma yimiphi imiphumela emibi ongase ubhekane nayo. Ekuvakasheni ngakunye, udokotela wakho angakunika incwadi kadokotela yezinsuku ezingama-28 zemithi ngaphandle kokugcwaliswa. Kufanele ugcwaliswe ngudokotela zingakapheli izinsuku eziyi-7.

Unganikeli ngegazi ngenkathi uthatha i-thalidomide namasonto ama-4 ngemuva kokwelashwa kwakho.

Ungabelani nge-thalidomide nanoma ngubani omunye umuntu, ngisho nomuntu ongaba nezimpawu ezifana nezakho.

Kwabesifazane abathatha i-thalidomide:

Uma ungakhulelwa, kuzodingeka uhlangabezane nezimfuneko ezithile ngesikhathi sokwelashwa kwakho nge-thalidomide. Udinga ukuhlangabezana nalezi zidingo noma ngabe unomlando wokungakwazi ukukhulelwa. Ungaxolelwa ukuhlangabezana nalezi zidingo kuphela uma ungazange uye esikhathini (ube nesikhathi) izinyanga ezingama-24 zilandelana, noma uke wahlinzwa ngesibeletho (ukuhlinzwa ukukhipha isibeletho sakho).

Kufanele usebenzise izindlela ezimbili ezamukelekayo zokulawula ukubeletha amasonto ama-4 ngaphambi kokuba uqale ukuthatha i-thalidomide, ngesikhathi sokwelashwa kwakho, namasonto amane ngemuva kokwelashwa kwakho. Udokotela wakho uzokutshela ukuthi yiziphi izindlela zokulawula ukubeletha ezamukelekayo. Kufanele usebenzise lezi zinhlobo ezimbili zokulawula ukubeletha ngaso sonke isikhathi ngaphandle kokuthi ungaqinisekisa ukuthi ngeke ube nokuxhumana ngokocansi nowesilisa amasonto ama-4 ngaphambi kokwelashwa kwakho, ngesikhathi sokwelashwa kwakho, nangamasonto ama-4 ngemuva kokwelashwa kwakho.

Eminye imishanguzo ingadala ukuthi izindlela zokuvimbela inzalo zingasebenzi kahle. Uma uhlela ukusebenzisa izinto zokuvimbela inzalo ze-hormonal (amaphilisi okulawula ukubeletha, ama-patches, okufakelwayo, imijovo, izindandatho, noma amadivayisi we-intrauterine) ngesikhathi sokwelashwa kwakho nge-thalidomide, tshela udokotela wakho ngayo yonke imishanguzo, amavithamini, nezengezo zamakhambi ozithathayo noma ohlela ukuzithatha. . Qiniseka ukuthi uyasho: i-griseofulvin (i-Grifulvin); imishanguzo ethile yokwelapha igciwane lesandulela-ngculazi (i-HIV) okubandakanya i-amprenavir (Agenerase), i-atazanavir (i-Reyataz), i-darunavir (i-Prezista), i-fosamprenavir (i-Lexiva), i-indinavir (i-Crixivan), i-lopinavir (e-Kaletra), i-nelfinavir (i-Viracept), i-ritonavir (i-Norvvirir) , eKaletra), i-saquinavir (i-Invirase), ne-tipranavir (i-Aptivus); imithi ethile yokuquleka okubandakanya i-carbamazepine (Carbatrol, Equetro, Tegretol) ne-phenytoin (Dilantin, Phenytek); i-modafinil (i-Provigil); i-penicillin; i-rifampin (i-Rimactane, i-Rifadin); i-rifabutin (i-Mycobutin); ne-wort yaseSt. Eminye imishanguzo eminingi ingaphazamisa isenzo sezindlela zokuvimbela inzalo zamahomoni, ngakho-ke qiniseka ukuthi utshela udokotela wakho yonke imishanguzo oyiphuzayo noma ohlela ukuyithatha, ngisho naleyo engabonakali kulolu hlu.

Kufanele ube nokuhlolwa kokukhulelwa okumbili ngaphambi kokuba uqale ukuthatha i-thalidomide. Uzodinga futhi nokuhlolelwa ukukhulelwa elabhoratri ngezikhathi ezithile ngesikhathi sokwelashwa kwakho. Udokotela wakho uzokutshela ukuthi uzozihlola nini futhi kuphi.

Yeka ukuthatha i-thalidomide bese ushayela udokotela wakho ngokushesha uma ucabanga ukuthi ukhulelwe, unesikhathi sokuya esikhathini, esingajwayelekile, noma esilahlekile, unoshintsho ekuphumeni kwakho esikhathini, noma uya ocansini ngaphandle kokusebenzisa izindlela ezimbili zokulawula ukubeletha. Kwezinye izimo, udokotela wakho angakunika izindlela zokuvimbela inzalo eziphuthumayo (‘the morning after pill’) ukuvimbela ukukhulelwa. Uma ukhulelwa ngesikhathi sokwelashwa kwakho, udokotela wakho kudingeka ukuthi abize i-FDA nomenzi wayo. Udokotela wakho futhi uzoqinisekisa ukuthi ukhuluma nodokotela ogxile ezinkingeni ngesikhathi sokukhulelwa ongakusiza wenze izinqumo ezilungele wena nengane yakho.

Okwabesilisa abathatha i-thalidomide:

I-Thalidomide ikhona embewini (uketshezi oluqukethe isidoda esikhishwa ngepipi ngesikhathi se-orgasm). Kumele usebenzise i-latex noma i-synthetic condom noma ugweme ngokuphelele ukuxhumana ocansini nowesifazane okhulelwe noma ongakhulelwa ngenkathi uthatha lo muthi kanye namasonto ama-4 ngemuva kokwelashwa kwakho. Lokhu kuyadingeka noma ngabe une-vasectomy (ukuhlinzwa ukuvimbela isidoda ekuphumeni emzimbeni wakho futhi kubangele ukukhulelwa). Tshela udokotela wakho ngokushesha uma uye ocansini olungaphephile nowesifazane ongakhulelwa noma uma ucabanga nganoma yisiphi isizathu ukuthi umlingani wakho ukhulelwe.

Unganikeli ngesidoda noma isidoda ngenkathi uthatha i-thalidomide namasonto ama-4 ngemuva kokwelashwa kwakho.

Ubungozi bamahlule egazi:

Uma uthatha i-thalidomide ukwelapha i-myeloma eminingi (uhlobo lomdlavuza womnkantsha wamathambo), kunengozi yokuthi uzoba negazi ezandleni zakho, emilenzeni noma emaphashini. Le ngozi iba nkulu uma i-thalidomide isetshenziswa kanye neminye imishanguzo ye-chemotherapy efana ne-dexamethasone. Shayela udokotela wakho ngokushesha uma uhlangabezana nalezi zimpawu ezilandelayo: ubuhlungu, ubumnene, ubomvu, ukufudumala, noma ukuvuvukala ezingalweni noma emilenzeni; ukuphelelwa umoya; noma ubuhlungu besifuba. Udokotela wakho angakunika i-anticoagulant ('blood thinner') noma i-aspirin ukusiza ukumisa amahlule ukuba akhe ngesikhathi sokwelashwa kwakho nge-thalidomide.

Khuluma nodokotela wakho ngezingozi zokuthatha i-thalidomide.

I-Thalidomide isetshenziswa kanye ne-dexamethasone ukwelapha i-myeloma eminingi kubantu abasanda kutholakala ukuthi banesifo. Iphinde isetshenziswe yodwa noma neminye imithi yokwelapha nokuvikela izimpawu zesikhumba se-erythema nodosum leprosum (ENL; iziqephu zezilonda zesikhumba, umkhuhlane, kanye nokulimala kwemizwa okwenzeka kubantu abanesifo sikaHansen [uchoko]. I-Thalidomide isekilasini lemithi ebizwa ngama-immunomodulatory agents. Iphatha i-myeloma eminingi ngokuqinisa amasosha omzimba ukulwa namaseli womdlavuza. Iphatha i-ENL ngokuvimba isenzo sezinto ezithile zemvelo ezibangela ukuvuvukala.

I-Thalidomide iza njengephilisi elizothathwa ngomlomo. I-Thalidomide ivame ukuthathwa ngamanzi kanye ngosuku ngesikhathi sokulala futhi okungenani ihora elilodwa ngemuva kwesidlo sakusihlwa. Uma uthatha i-thalidomide ukwelapha i-ENL, udokotela wakho angakutshela ukuthi uyiphuze ngaphezu kwesisodwa ngosuku, okungenani ihora elilodwa ngemuva kokudla. Thatha i-thalidomide cishe ngesikhathi esifanayo (ama) nsuku zonke. Landela izinkomba ezikulebuli kadokotela wakho ngokucophelela, bese ubuza udokotela noma usokhemisi wakho ukuthi akuchaze nganoma iyiphi ingxenye ongayiqondi. Thatha i-thalidomide njengoba nje kuqondisiwe. Ungayithathi kancane noma uyithathe kaningi kunokuyalelwa ngudokotela wakho.

Gcina amaphilisi emaphaketheni awo uze ulungele ukuwathatha. Ungavuli amaphilisi noma uwaphathe ngaphezu kwesidingo. Uma isikhumba sakho sihlangana nama-capsule noma i-powder ephukile, geza indawo esobala ngensipho namanzi.

Ubude bokwelashwa kwakho buncike ekutheni izimpawu zakho ziphendula kanjani kwi-thalidomide nokuthi izimpawu zakho ziyabuya yini lapho uyeka ukuthatha umuthi. Udokotela wakho angadinga ukuphazamisa ukwelashwa kwakho noma anciphise umthamo wakho uma uhlangabezana nemiphumela ethile emibi. Ungayeki ukuthatha i-thalidomide ngaphandle kokukhuluma nodokotela wakho. Lapho ukwelashwa kwakho sekuqediwe, udokotela wakho uzokwehlisa umthamo wakho kancane kancane.

I-Thalidomide kwesinye isikhathi isetshenziselwa ukwelapha izimo ezithile zesikhumba ezibandakanya ukuvuvukala nokucasuka. Ibuye isetshenziselwe ukwelapha izinkinga ezithile ze-human immunodeficiency virus (HIV) njenge-aphthous stomatitis (isimo lapho izilonda zakha khona emlonyeni), isifo sohudo esihambisana ne-HIV, isifo sokumosha esihambisana ne-HIV, izifo ezithile kanye ne-Kaposi's sarcoma (uhlobo womdlavuza wesikhumba). I-Thalidomide ibuye isetshenziselwe ukwelapha ezinye izinhlobo zomdlavuza nezicubu, ukwehla kwesisindo esinzima ezigulini ezinamasosha omzimba abuthakathaka, isifo sokuxhunyelelwa okungapheli nokuqhathaniswa nezifo (inkinga engenzeka ngemuva kokufakwa komnkantsha wethambo lapho into esanda kutshalwa ihlasela umamukeli wokufakelwa umzimba), nesifo sikaCrohn (isimo lapho umzimba uhlasela ulwelwesi lwendlela yokugaya ukudla, ubangele ubuhlungu, isifo sohudo, ukuncipha komzimba nomkhuhlane). Khuluma nodokotela wakho ngezingozi zokusebenzisa lo muthi ngesimo sakho.

Lo muthi kwesinye isikhathi ubekelwa okunye ukusetshenziswa; buza udokotela wakho noma usokhemisi ukuthola eminye imininingwane.

Ngaphambi kokuthatha i-thalidomide,

• Tshela udokotela kanye nosokhemisi wakho uma unegciwane ku-thalidomide noma eminye imithi.
• Tshela udokotela wakho kanye nosokhemisi ukuthi imiphi eminye imishanguzo kadokotela neyokungabhalisi, amavithamini, izithasiselo zokudla okunempilo, nemikhiqizo yamakhambi oyithathayo noma ohlela ukuyithatha. Qiniseka ukuthi uyayisho imishanguzo ebhalwe esigabeni ESIBALULEKILE SESEXWAYISO nanoma yikuphi okulandelayo: imishanguzo; ama-barbiturates afana ne-pentobarbital (Nembutal), i-phenobarbital, ne-secobarbital (Seconal); i-chlorpromazine; i-didanosine (i-Videx); imithi yokukhathazeka, ukugula kwengqondo, noma ukuquleka; imishanguzo ethile yamakhemikhali yomdlavuza efana ne-cisplatin (Platinol), i-paclitaxel (i-Abraxane, i-Taxol), ne-vincristine; i-reserpine (i-Serpalan); isidambisi; amaphilisi okulala; kanye nezithambisi. Udokotela wakho angadinga ukushintsha imithamo yemithi yakho noma akuqaphele ngokucophelela ngemiphumela emibi.
• Tshela udokotela wakho uma ngabe uke waba negciwane lesandulela ngculaza noma i-HIV, noma i-HIV, uthola i-immunodeficiency syndrome (i-AIDS), izinga eliphansi lamaseli amhlophe egazini lakho, noma ukuquleka.
• tshela udokotela wakho uma uncelisa.
• kufanele wazi ukuthi i-thalidomide ingakwenza ukozele. Ungashayeli imoto, sebenzisa imishini, noma wenze eminye imisebenzi edinga ukuthi uqaphele ngokuphelele uze wazi ukuthi lo muthi ukuthinta kanjani.
• buza udokotela wakho mayelana nokusetshenziswa okuphephile kweziphuzo ezidakayo ngenkathi uthatha i-thalidomide. Utshwala bungenza imiphumela emibi ye-thalidomide ibe yimbi kakhulu.
• kufanele wazi ukuthi i-thalidomide ingadala isiyezi, ikhanda elikhanyayo, nokuquleka lapho uvuka ngokushesha okukhulu kusuka endaweni yokulala. Ukusiza ukugwema le nkinga, phuma embhedeni kancane, uphumule izinyawo zakho phansi imizuzu embalwa ngaphambi kokuma.
• kufanele wazi ukuthi i-thalidomide ikhona egazini lakho naseziketsheni zomzimba wakho. Noma ngubani ongahlangana nalezi ziketshezi kufanele afake amagilavu ​​noma ageze noma yiziphi izindawo ezivulekile zesikhumba ngensipho namanzi.

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

Thatha umthamo ongabanjwanga ngokushesha nje lapho uwukhumbula. Kodwa-ke, uma kungaphansi kwamahora angu-12 kuze kufike umthamo wakho olandelayo ohleliwe, weqa umthamo ongabanjwanga bese uqhubeka nesimiso sakho sokulinganisa okujwayelekile. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

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

• ukozela
• ukudideka
• ukukhathazeka
• ukudana noma ukushintsha kwemizwelo
• ubunzima bokulala noma ukulala
• ubuhlungu bethambo, imisipha, amalunga, noma iqolo
• ubuthakathaka
• ikhanda
• shintsha ekudleni
• izinguquko zesisindo
• isicanucanu
• ukuqunjelwa
• umlomo owomile
• isikhumba esomile
• isikhumba esiphaphathekile
• ukuzamazama okungalawuleki kwengxenye yomzimba
• ukuvuvukala kwezandla, izinyawo, amaqakala, noma imilenze engezansi
• ubunzima bokuzuza noma ukugcina ukwakhiwa

Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nalezi zimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uthole ukwelashwa okuphuthumayo:

• ukuqubuka
• ukulunywa
• isifuba
• isikhumba esiqhumayo nesikhanyayo
• ukuvuvukala kobuso, umphimbo, ulimi, izindebe, noma amehlo
• ukushaqeka
• ubunzima bokugwinya noma ukuphefumula
• umkhuhlane, umphimbo obuhlungu, amakhaza, ukukhwehlela, noma ezinye izimpawu zokutheleleka
• ukushaya kwenhliziyo okuhamba kancane noma okusheshayo
• isithuthwane

I-Thalidomide ingadala ukulimala kwemizwa okungaba nzima futhi kube unomphela. Lo monakalo ungavela nganoma yisiphi isikhathi ngesikhathi noma ngemuva kokwelashwa kwakho. Udokotela wakho uzokuhlola njalo ukuze abone ukuthi i-thalidomide isithinte kanjani isimiso sakho sezinzwa. Uma uhlangabezana nanoma yiziphi kulezi zimpawu ezilandelayo, yeka ukuthatha i-thalidomide bese ushayela udokotela wakho ngokushesha: ukuba ndikindiki, ukushosholoza, ubuhlungu, noma ukushiswa ezandleni nasezinyaweni.

I-Thalidomide 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 ekamelweni lokushisa futhi kude nokushisa okweqile nomswakama (hhayi endlini yangasese).

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.

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

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.

• Thalomid^®