Zvakataurwa kuti njere ndeimwe yezvibayiro zvehondo. Chibayiro chakafanana chinogonawo kuva chikamu chehondo yose yevarwere nekenza, semishonga inoshandiswa kuuraya kenza inopesana nemafungiro edu uye inopedza mitsipa inotumira mashoko kuuropi hwedu.
Uyewo kufanana nehondo, hazvisi nyore nguva dzose kutaura shamwari kubva kumuvengi. Icho chiratidzo chinokonzerwa nekenza, kana mishonga inopiwa kupa kurwisa kenza iyo here?
Kana kuti nemhaka yeimwe chimwe chinhu zvachose?
Kune nzira dzakawanda dzakasiyana-siyana dzinoitwa chemotherapeutic agents dzinogona kukuvadza hurongwa hwekutya. Izvo zvinotevera hazvive zvakakwana, asi zvinopfupisa zveimwe nzira nzira yemhemotherapy inogona kukuvadza hurongwa hwehutsva.
Matambudziko Anogona Kukurumidza Kuitika Kana Kwapfuura
Kunyange zvazvo mamwe maitiro emagunha emakemotherapy anoitika pakarepo, mamwe angatora makore kuti awedzere. Busulfan, somuenzaniso, inowanzoshandiswa kugadzirira varwere zve stem cell transplants asiwo inowanzobatanidzwa nekutambudzwa munguva yekutonga kwayo. Nokuda kwechikonzero ichi, antiepileptic mishonga yakadai se phenytoin inogona kushandiswa apo inopiwa kuitira kuti kudzivisa kudzika. Zvisinei, mungozi yekugumburwa inowedzera apo mishonga isiri kupiwa.
Cytarabine dzimwe nguva inoshandiswa kurapa houkemia uye lymphomas , uye inogonawo kutungamirira kumatambudziko nguva pfupi mushure mekutonga. Semuenzaniso, zvinogona kutungamirira mukuvhiringidzika nekudzivirirwa kwepfungwa, uyewo kuwanikwa kweperegelar akadai sekukanganiswa ( ataxia ).
Mishonga inofanira kumira pakarepo kana izvi zvichiitika. Vamwe varwere vanodzoka, asi vamwe varwere havaiti. Cytarabine inogonawo kujowa intrathecally , asi izvi zvinogona kutora dzimwe nguva kutora metepathy inopfurikidza nemakumbo ekuora muviri uye kusapinda kwephincter. Zvakare, mishonga inofanira kubviswa pakarepo kana izvi zvichiitika.
Chirwere chepamuviri chinokonzerwa ne cytarabine chinowanzogara.
Methotrexate inogona kushandiswa kurapa hutano hwakasiyana-siyana hwekenza, uye inokonzera huwandu hwakawanda hwemigumisiro yechirwere, dzimwe dzingangotanga kuitika uye dzimwe dzakapera. Somuenzaniso, zvinogona kukonzera aseptic meningitis inowanzoitika nokukurumidza apo mishonga inopiwa intrathecally. Aseptic meningitis kazhinji inotevera hutungamiri hwehutongi uye inowanikwa kusvika 10 kusvika ku50 muzana yevarwere vanogamuchira mushonga nenzira iyi. Zviratidzo zvinosanganisira misoro nemitsipa yakaoma uye kusuruvara, kurutsa, uye fivha. Mushonga hauwanzodikanwi sezvo zviratidzo zvinogadzirisa pachavo.
Kusiyana nematambudziko aya akaoma, methotrexate inokonzerawo leukoencephalopathy, zvinoreva kuora mwoyo kwepfungwa nekuda kwekuchinja muzvikamu zvangu zvouropi, izvo zvinogona kuitika kunyange makore mushure mekunge mishonga yamira. Izvi zvinonyanya kukosha kana methotrexate inoshandiswa kurapa zvirwere zvevechidiki, zvakadai sehuduku hweukemia. Iyo migumisiro yechirwere inogona kubva pane zvinyoro zvidzidzo zvekuremara kusvika pakuora mwoyo kwakaoma. PaMRI, zviremera zvinogona kuonekwa.
Kugadzirisa Kushandura
Kukurukurirana kwakanyanya kwakadai se methotrexate leukoencephalopathy haisi yakasiyana nemishonga iyoyo chete.
Ichokwadi, kuchinja kwepfungwa kunowanikwa mune chemotherapy iyo iyo isina kuzivikanwa, "chemofog," yakagadzirirwa kurondedzera chiitiko. Chemofog inosanganisira zviratidzo zvakasiyana-siyana zvinogadziriswa zvinowanzobatanidzwa nemakemikarirapeutic mishonga, ine zviratidzo kubva pakunyanyisa kunetseka kusvika pakuora mwoyo kwakaoma. Kugara kwekuchinja uku kunogonawo kusiyana.
Ifosfamide, somuenzaniso, inhengo inoshandiswa kurapa matumbo akaoma. Iyo mishonga dzimwe nguva inogona kukonzera encephalopathy, asi izvi zvinowanzodzoka nguva pfupi mushure mekugadziriswa kwemujeri. Zvimwe encephalopathies, zvakadai sa leukoencephalopathy ye methotrexate, zvinogona kukonzera kukanganisa kusingaperi.
Posterior reversible encephalopathy syndrome (PRES) chimwe chiitiko chinogona kusanganisa kwemakemikarirapeutic agents, kunyanya cyclosporine uye tacrolimus. Iyi mishonga inowanzoshandiswa kugadzirira vanhu kugoverwa kwemuviri. Zviratidzo zvinogona kusanganisira misoro, kuvhiringidzika, kukanganisa , kana kukanganiswa kwehutano hwepfungwa. PaMRI inoongorora, kufanana kwegore-kufanana kunogona kuonekwa iyo inowanzouya pedyo nechemberi kweuropi. Mishonga inofanira kumira kana kuchinjwa kana PRES iripo.
Strokes
Kanzera kazhinji inokonzera izvo vanachiremba vanoshevedza hurumende ye hypercoagulable, zvinoreva kuti ropa ravhara inowanzosvika pakugadzirisa maitiro asina kukodzera uye nzvimbo. Somuenzaniso, chipfeko chinogona kuumba muuropi, zvichikonzera chirwere . Zvinosuruvarisa, mamwe chemotherapies anogonawo kukonzera zvirwere, zvakadai se methotrexate, cisplatin, imatinib nezvimwewo.
Mamwe mazamu, akadai sevavacizumab uye sunitinib, nechinangwa chinokonzera mishonga yeropa sezvo mishonga inowanzogadzira midziyo mitsva yekutumira michero kukura kusingawanisi. Zvinosuruvarisa, migumisiro inogona kusanganisira kuora kwemvura kana ischemic strokes. Somumwe muenzaniso, L-asparaginase inowanzoshandiswa kurapa acute lymphoblastic leukemia (ALL) uye dzimwe nguva inokonzera sinous thrombosis yehupenzi kuumba kunyange kuvana. Izvi zvinowanzogadzirisa nekuputsa mumutambo wemishonga. Kana ropa rakaonda richibva rapiwa , dzimwe nguva mishonga inogona kudzorerwazve.
Peripheral Neuropathies
Peripheral neuropathies inowanzosvibisa rutivi rwechemotherapy, kunyanya kune platinum-ine majiti akaita sa cisplatin uye oxaliplatin. Izvo zvinokonzerwa neuropathy zvinokonzerwa neCisplatin zvinokonzera kupera simba uye paresthesias inotanga pamakona eminwe nezvigunwe uye inopararira mukati. Kunyange zvazvo kunzwa kwomuviri uri mudenga kuchikuvadza, manzwiro ekurwadziwa uye kutonhora anenge nguva dzose akaregererwa, izvo zvinoparadzanisa cisplatin neuropathy kubva kune hutano huzhinji hunogona kukonzerwa nekenza pachayo. Zvinokonzerwa nekuderedza dhi kana kushanduka kune imwe nyanzvi yeurouroplatin yakadai sa carboplatin inofanirwa kuyerwa nezvakabatsiro zvekuenderera mberi kwecisplatin therapy. Iyo yeuropathy inogona kukura kana kutotanga mwedzi mushure mokunge cisplatin inomira.
Oxaliplatin inobatanidza nekukanganisika kwepastirehesias kamwechete mumaoko, patsoka, uye kumativi ose mumuromo, izvo zvose zvinowedzera kukurira nekutonhora. Inogona kukonzera kufanana kweuropathy yakadaro kune iyo inokonzerwa neCisplatin, kunyange zvazvo oxaliplatin yeuropathy inokonzerwa nyore nyore.
Mimwe chemotherapeutics inobatanidza neuropheral neuropathy inosanganisira docetaxel, vincristine, uye paclitaxel, pakati pevamwe vakawanda.
Dambudziko reNeromuscular
Neuromuscular masturbation isingawanzovi nani kupfuura mhirizhonga yeuropathy, asi inogona kuitika sechiguma chemhemotherapy. Doxorubicin, cisplatin, etoposide, uye vamwe vanogona kutungamira kune chiratidzo kune myasthenia gravis . Imatinib inoshandiswa kurapa mamwe maitiro eukemia, inogona kukonzera musimba kupwanya uye myalgias, asi izvi zvinowanzova zvinyoro uye zvinopindira kumishonga yakadai se calcium kana magnesium.
Haisi chakavanzika chokuti chemotherapy imishonga ine simba kwazvo ine ngozi huru yemigumisiro. Zvandakanyora pano ndezvenhare yakazara. Pane chikonzero chokuti mishonga iyi inowanzochengeterwa zvirwere zvakakomba sekenza, iyo inobatsira yekutora kusakosha kwemishonga kunyange zviitiko zvikuru. Chinangwa chechinyorwa ichi hachisi chokudzivisa avo vanoda mishonga iyi kubva pakuvatora, asi kuti vave nechokwadi chokuti vanhu vanoziva zvinogona kuitika kuti zvive nani kufamba nenzira dzakaoma dzekenza kurapwa.
Sources:
EQ Lee, IC Arrillaga-Romany, PY Wen. Zvinetso zveNeurologic zveCarcer Drug Therapies. Kuenderera mberi Kwoupenyu Hwose Neurol 2012; 18 (2): 355-365.
EQ Lee, PY Wen. Zvinetso zveNeurologic zveplatinum-based chemotherapy Muna: DMF Savarese, Ed
EQ Lee, PY Wen. Zvinetso zveNeurologic zvekenza isina platinum chemotherapy. Mu: DMF Savarese, Ed UpToDate.