Mamiriyoni Anodzvinyirira Anodzinga kunze kweAn anti-Estrogen Migumisiro yeHormone Therapy
Tamoxifen inonzi hormone therapy inotorwa nevakadzi vazhinji vanonzi premenopausal mushure mekunge vapedzisa maitiro avo okutanga ekurapa kweestrogen receptor positive yepabonde yemvere. Kurapa migumisiro yechirwere chema tamoxifen (yakadai sekupisa kunopisa) uye kubatsira pakuora mwoyo, vanachiremba vanowanzorondedzera vanodzvinyirira. Kunyange zvakadaro vazhinji vanodzvinyirira vanogona kupindira, kana kuti kubvisa zvachose, zvinobatsira zve tamoxifen.
Ndeipi munhu wose anotora tamoxifen anofanira kuziva?
Tamoxifen Zvishandiso neBrazil Cancer
Kamwe kana mukadzi apedza kunyanya kurapwa kwekenza yepazamu, nemishonga yakadai sekuvhiyiwa , chemotherapy , uye remishonga inonzi radiation , angada kutora tamoxifen. Kune vakadzi vane estrogen receptor inorapa zvirwere, hormone therapy inogona kuderedza ngozi yekenza inodzoka (kudzokorora) inenge inenge 50 muzana.
Kusarudzwa kwemishonga kunoenderana nemamiriro ekumharaopausal. Kana mukadzi ari premenopausal, tamoxifen inowanzova mushonga wekusarudza. (Kune avo vari postmenopausal, kana kuti avo vanonzi premenopausal asi vakagamuchira ovarian kuderedza chirwere, anromatase inhibitor inowanzoshandiswa panzvimbo).
Masero emukenza wepabonde ari estrogen receptor positive anobudiswa ne estrogen. Estrogen iri mumuviri (yakagadzirwa nemaovhesi) inosunga kune aya masero ekenza kuti akure kukura. Tamoxifen inoshanda nekusungira kune mabiko aya kuitira kuti estrogen isakwanisa, inonyanya kushaya nzara masero ezvokudya.
Izvozvo zvinokonzerwa ne tamoxifen zvinosanganisira zviratidzo zvemanopausal-type zvakadai sehuni dzinopisa, low libido, uye vaginal dryness. Kune vakadzi vasati vasvika kumwedzi, kupisa kunopisa kunogona kuvhiringidza zvikuru, asi takadzidza mumakore achangopfuura kuti mamwe mishonga inodzvinyirira inogona kuderedza kupisa uku kunopisa.
Zvinosuruvarisa, zvimwe zvezvinodhaka izvi zvinogona kuderedza kubudirira kwe tamoxifen.
Chirwere chepabonde uye kuora mwoyo
Hazvishamisi kuti vakadzi vazhinji avo vakamborapwa nekenza yepamu vanokurira kuora mwoyo. Kubatanidzwa kwehupenyu hunotarisa kuongororwa, nemigumisiro yehutano, uye kuchinja kumufananidzo wemuviri unoenda nehutano zvose zvinogadzirisa danho rekukura kwepfungwa. Zvinosuruvarisa, mushure mekunge vakadzi vakawanda vane kenza yepamu vaibatwa (zvinowanzowanzo mune dzimwe nzvimbo) nevanorwara, vanowanikwa kuti vazhinji vanodzvinyirira vanogona kuderedza zvinoitika zve tamoxifen. Izvi zvinoitika sei?
Tamoxifen uye Drug Interactions
Kutaurirana kweTamoxifen uye kushandisa zvinodhaka kwakajairika, uye izvi zvinosanganisira mishonga yakawanda kuwedzera kune zvinodhaka. Sezvo zvizhinji zveizvi zvinowanzoshandiswa zvinodhaka, zvinosanganisira pamusoro pe-zvinodhaka zvinodhaka zvakadai seBenadryl, zvakakosha kutaurirana nachiremba wako uye chiremba nezvemishonga chero ipi zvayo, kupfuura-the-counter yekugadzirira, kana kudya kwekudya iwe uri kufunga, iwe uri pazvinodhaka. Sezvo vanhu vazhinji vachitora tamoxifen kwemakore mashanu kusvika kune gumi, izvi zvinokosha zvikuru. Ramba uchifunga kuti havasi vanachiremba vose vanoziva nekubatana uku (uye isu tiri kudzidza zvakawanda nguva dzose).
Izvi zvinorevei kuti kana iwe uchifanira kuenda kune zvakanyanya kukurudzira, somuenzaniso, nehutachiona, taura neoncologist yako kana kuti wemishonga usati watora mishonga ipi zvayo yakatemwa.
Tamoxifen inogadziriswa mumuviri kusvika endoxifen. Endoxifen iri makumi matatu kusvika ku100 yakasimba kudarika tamoxifen, uye inokonzera zvizhinji zvezvipatara zvinokonzera. Tamoxifen inoputsika kusvika endoxifen ne cytochrome P450 enzyme CYP2D6 (pamwe nezvimwe zvisina kukosha). Chero mishonga inoderedza basa reYP2D6 (uye kune vakawanda) inogona kuderedza kuputsa uku kwehutano uye naizvozvo, muwandu we endoxifen unobudiswa.
Tamoxifen uye Antidipressants: Kubatana
Tichiri kudzidza zvakawanda pamusoro pezvinokonzera kusuruvara uye zvakagadzirisa maitiro emu tamoxifen mumuviri, asi kusvikira zvino taona kuti zvakasiyana-siyana zvinodhaka zvinogona kuita tamoxifen nenzira dzakasiyana. Zvimwe zvinotapukisa (zvakadai seProzac naPaxil) zvinenge zvisingatongoratidzi mhinduro ye tamoxifen. Muchiitiko ichi, zvingaita sekutora tamoxifen zvachose (uye kusava nekubatsirwa kwekuderedzwa kwengozi yekudzoka).
Nevamwe vanodzvinyirira pane kuwirirana kunononoka, uye pamwe nevamwe, kungoita zvishoma chete. Kusiyana neizvi, chimwe chikafu chekudya chinogona kuwedzera chiitiko che tamoxifen (uyewo nemigumisiro), kunyange zvimwe zvidzidzo zvakaratidza zvakasiyana ..
Pasi peta tafura inopfupisa zvatinotenda ndezvechokwadi pamusoro pezvinodhaka zvinodhaka mazuva ano. Iyi inzvimbo yekutsvakurudza kushingaira, uye zvichida tichave tichidzidza zvakawanda munguva iri mberi. Kana uri kufunga nezvemishonga inodzvinyirira, taura zvakanyatsonaka nachiremba wako, asiwo nenguva nenguva ubvunze kana chimwe chinhu chachinja.
Anodzvinyirira uye Maitiro Aanoita NaTamoxifen
| Antidepressant Drug | Kuwirirana naTamoxifen | Zvokuchengetedza Range |
Paxil (paroxetine) Prozac (fluoxetine) | Zvinodzivirira antiestrogen kubatsirwa | Dzivisa Kushandisa |
Cymbalta (duloxetine) Wellbutrin (bupropion) Zoloft (sertraline) | Kupindira kwepakati pezvakaitwa ne antiestrogen kunobatsira Cherechedza: Ongororo dzinotsigira kuti Zoloft inopesana neTamoxifen. | Inowedzera Ngozi |
| Vatsvene vaJohane (hypericum) | Kuzvidzora kunononoka kwe antiestrogen kunobatsira | Kuwedzera Kwengozi |
Celexa (citalopram) Lexapro (escitalopram) Pristiq (desvenlafaxine) Remeron (mirtazapine) | Kunyatsotaurirana Cherechedza: Pristiq naRemeron havana kunyatsodzidza mukubatana naTamoxifen. | Chengetedza Ngozi |
| Black Cohosh (Actaea) | Ive inhibit kana kuti kuwedzera antiestrogen kubatsirwa zvichienderana nekudzidza. Cherechedza: Pane zvidzidzo zvishomanana zvekubatana naTamoxifen, uye mazhinji akaitwa "in vitro" (mubasa uye kwete kuvanhu). | Chengetedza Ngozi |
Effexor (venlafaxine) | Kakawanda kusina kubatana naTamoxifen | Chisarudzo Chakanakisisa |
Pasi Pasi paTamoxifen uye Antidipressants
Kuziva nezvekukwanisa kushamwaridzana pakati pe tamoxifen uye kuora mwoyo kunokosha kana uri kufunga nezvemumwe wemishonga iyi. Vamwe vanodzvinyirira vanonyanya kusagadzirisa migumisiro ye tamoxifen, uye inofungidzirwa kuti kubatana uku ndicho chikonzero chekuwedzera kwekufa kwevakadzi vane kenza yepamu avo vakatora Paxil. Pari zvino, sarudzo yakachengeteka yose yekupisa uye kuora mwoyo kunoita seEfficexor, asi zvakare zvakakosha kuziva kuti iyi inzvimbo inoshingaira kana tsvakurudzo, uye tinogona kudzidza zvakawanda munguva iri mberi. Sezvo black cohosh ine mukurumbira wekubatsira nematsva anopisa ane chokuita nekenza yemazamu, asi inogonawo kubatana ne tamoxifen, zvakakosha kutaurira oncologist yako pamusoro pemishonga chero ipi zvayo, kupfuura-in-counter kugadzirira, kana kuwedzera kwezvokudya iwe uri kufunga.
> Sources:
> Haque, R., Shi, J., Schottinger, J. et al. Tamoxifen uye Antidipressant Drug Interaction mu Cohort ye 16 887 Muchipfuva Chepabonde reAsa. Zvinyorwa zveNational Cancer Institute . 2015. 108 (3): djv337.
> Juurlink, D. Kudzokorora Kudyidzana Kwemishonga Pakati peTamoxifen uye SSRI Antidepressants. British Medical Journal . 2016. 354: i5309.
> Li, J., Godecke, T., Chen, S. et al. In Vitro Metabolic Kubatana Pakati Peblack Cohosh (Cimicifuga Racemosa) uye Tamoxifen Via Inhibition ye Cytochromes P450 2D6 uye 3A4. Xenobiotica . 2011 Aug 9. (Epub mberi kwekudhinda).