Tacrolimus

Qanacsan

• Kahor qaadashada tacrolimus,
• Tacrolimus waxay sababi kartaa waxyeelo. U sheeg dhakhtarkaaga haddii mid ka mid ah astaamahani ay daran yihiin ama aanad tagin:
• Dhibaatooyinka qaarkood waxay noqon karaan kuwo halis ah. Haddii aad isku aragto mid ka mid ah astaamaha soo socda, ama kuwa lagu sheegay qaybta DIGNIIN MUHIIM AH, isla markiiba wac dhakhtarkaaga:
• Calaamadaha xad dhaafka ah waxaa ka mid noqon kara:

Tacrolimus waa in la siiyaa oo keliya iyadoo uu kormeerayo dhakhtar khibrad u leh daaweynta dadka lagu tallaalay xubin xubinta ah iyo qorista daawooyinka yareeya dhaqdhaqaaqa nidaamka difaaca jirka.

Tacrolimus waxay yareysaa waxqabadka nidaamkaaga difaaca. Tani waxay kordhin kartaa halista aad ku qaadi karto infekshan daran. Haddii aad isku aragto mid ka mid ah astaamaha soo socda, isla markiiba wac dhakhtarkaaga: cuna xanuun; qufac; qandho; daal aad u daran; astaamaha hargabka oo kale; maqaar diiran, casaan ah, ama xanuun leh; ama calaamadaha kale ee cudurka.

Marka nidaamkaaga difaaca uusan si caadi ah u shaqeyneynin, waxaa jiri kara khatar aad u weyn oo ah inaad ku dhacdo kansarka, gaar ahaan lymphoma (nooc ka mid ah kansarka ka bilaabma unugyada habka difaaca jirka). Muddada aad qaadaneysid tacrolimus ama daawooyinka kale ee hoos u dhigaya howlaha nidaamka difaaca jirka, iyo sida ay u badan tahay qiyaastaada daawooyinkan, ayaa ay sii kordheysaa halisteeda. Haddii aad isku aragto mid ka mid ah astaamaha soo socda ee lymphoma, wac dhakhtarkaaga isla markiiba: qanjidhada qanjirada ee bararsan ee qoorta, kilkilaha, ama gumaarka; miisaanka oo yaraada; qandho; dhidid habeenkii; daal fara badan ama daciifnimo; qufac; neefsashada oo dhib ku ah; xabad xanuun; ama xanuun, barar, ama buuxisid aagga caloosha.

Daraasaduhu waxay muujiyeen in haweenka helay beerka laga bedelay ee qaadanayay kaabsoosha sii-dhererka sii deynaya (Astagraf XL) ay halista dhimashada u badatay. Kapsules-sii-fidinta dheereeya ee Tacrolimus (Astagraf XL) ma ansaxiso FDA si looga hortago diidmada (weerarka xubinta la beeray ee habka difaaca jirka ee qofka qaata xubinta) beerka laga beddelayo.

Kala hadal dhakhtarkaaga khataraha qaadashada tacrolimus.

Tacrolimus (Astagraf XL, Envarsus XR, Prograf) waxaa loo isticmaalaa dawooyin kale si looga hortago diidmada (weerarka xubinta la beeray ee habka difaaca jirka ee qofka qaata xubinta) ee dadka la siiyay kelyaha. Tacrolimus (Prograf) sidoo kale waxaa loo isticmaalaa dawooyin kale si looga hortago diidmada dadka qaatay beerka ama wadnaha lagu beddelay. Tacrolimus waxay ku jirtaa nooc daawooyin ah oo loo yaqaan 'immunosupressants'. Waxay ku shaqeysaa iyadoo hoos loo dhigayo howlaha nidaamka difaaca jirka si looga hortago inay weeraraan xubinta la tallaalay.

Tacrolimus waxay u timaadaa sidii kaabsul, granules oo afka laga hakinaayo (oo lagu qasi karo dareeraha), kaabsol la sii daayay (oo waqti dheer qaatay), iyo kaniini la sii daayay oo afka lagu qaato. Kaabsoolaha si dhakhso ah loo sii daayo (Prograf) iyo ka joojinta afka (Prograf) waxaa badanaa la qaataa laba jeer maalintii (12 saacadood oo isu jira). Waad qaadan kartaa kaabsulka-sii-deynta degdegga ah iyo hakinta afka mid cunto leh ama mid aan lahayn, laakiin hubi inaad u qaaddo si isku mid ah mar kasta. Kaabsallada sii-fidinta-dheer (Astagraf XL) ama kiniinnada sii-daynta dheer (Envarsus XR) waxaa badanaa lagu qaataa subax kasta calool madhan ugu yaraan 1 saac ka hor ama quraacda ama ugu yaraan 2 saacadood ka dib quraacda. Qaado tacrolimus waqti isku mid ah (iskuul) maalin kasta. Si taxaddar leh u raac tilmaamaha ku qoran calaamadaha laguu qoray, oo weydii takhtarkaaga ama farmashiistaha inuu kuu sharxo qayb kasta oo aadan fahmin. Qaado tacrolimus sida saxda ee lagu faray. Ha ka qaadin wax ka yar ama ka yar ama u qaado si ka badan inta dhakhtarku kuu qoray.

Haddii aad u qaadanayso granules ku-haynta afka, waxaad u baahan doontaa inaad ku qaso biyo heerkulka qolka intaadan isticmaalin. Ku rid 1 ilaa 2 qaado (15 ilaa 30 miliilter) oo biyo ah koob ay ku jiraan granules. Isku qas waxa ku jira ka dibna isla markiiba ka qaado isku darka afka koobka ama saliingaha afka; ha keydin isku darka waqti dambe. Maqaar-wadayaasha gabi ahaanba ma baabi’i doonaan. Haddii isku dar ah mid ka mid ahi baaqi ahaado, ku dar 1 ilaa 2 qaado oo biyo ah (15 illaa 30 mililitir) oo biyo ah isku dar isla markiiba qaad.

Ku liq kaabsoolaha sii-daaya-sii-dheereynta iyo kiniiniyada sii-ballaadhinta oo dhammaantood biyo ku liq; ha kala qaybin, calalin, ama burburin. Ha furin kaabsoolo-sii-deyn deg-deg ah,

Dhakhtarkaaga ayaa si taxadar leh kuu kormeeri doona isla markaana kugu hagaajin doona qiyaastaada hadba sida loogu baahdo. Takhtarkaaga badanaa kala hadal sida aad dareemeyso inta lagu jiro daaweyntaada. Weydii dhakhtarkaaga haddii aad qabtid wax su'aalo ah oo ku saabsan inta tacrolimus ee ay tahay inaad qaadato.

Waxyaabaha kala duwan ee tacrolimus-ka ayaa daawada u siideynaya si ka duwan jirkaaga loomana adeegsan karo. Kaliya qaado sheyga tacrolimus ee dhakhtarkaagu kuu qoray oo ha u wareegin badeecad tacrolimus kale ah ilaa uu takhtarkaagu ku yiraahdo waa inaad sameysaa.

Tacrolimus waxay ka hortagi kartaa oo keliya diidmada ku-tallaaliddaada illaa inta aad qaadanayso daawada. Sii wad inaad qaadato tacrolimus xitaa haddii aad caafimaad qabtid. Ha u joojin qaadashada tacrolimus adigoon la hadlin dhakhtarkaaga.

Tacrolimus sidoo kale mararka qaar waxaa loo isticmaalaa in lagu daaweeyo fistulising Crohn's disease (xaalad jirku ku weeraro xuubka marinka dheef-shiidka, taasoo keenta xanuun, shuban, miisaan lumis, qandho, iyo sameysmo godad aan caadi ahayn oo ku xiraya habka dheef-shiidka xubnaha kale maqaarka). Kala hadal dhakhtarkaaga khataraha isticmaalka daawadan si aad u daaweyso xaaladdaada.

Daawadan waxaa loo qori karaa adeegsiyo kale; Weydii dhakhtarkaaga ama farmashiistaha wixii macluumaad dheeraad ah.

Kahor qaadashada tacrolimus,

• u sheeg dhakhtarkaaga iyo farmashiistahaaga haddii aad xasaasiyad ku leedahay tacrolimus, dawooyinka kale, ama mid ka mid ah maaddooyinka kale ee ku jira alaabada tacrolimus. Weydii farmashiistahaaga ama ka hubi Hagaha Daawada liiska waxyaabaha ay ka kooban yihiin.
• u sheeg dhakhtarkaaga iyo farmashiistaha dawooyinka dhakhtar qoro iyo kuwa aan dhakhtar qorin, fiitamiinnada, iyo nafaqada nafaqada ee aad qaadanaysid ama qorsheyneyso inaad qaadato. Hubso inaad sheegto mid ka mid ah kuwan soo socda: amiodarone (Nexterone, Pacerone); amphotericin B (Abelcet, Ambisome); angiotensin-converting enzyme (ACE) inhibitors sida benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, Vaseretic), fosinopril, lisinopril (gudaha Prinzide, Zestoretic), moexipril (Univasc, in Uniretic), per , Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), ama trandolapril (Tarka); antacids ay ku jiraan magnesium iyo aluminium hydroxide (Maalox); antibiyootikada qaarkood oo ay ku jiraan aminoglycosides sida amikacin, gentamicin, neomycin (Neo-Fradin), streptomycin, iyo tobramycin (Tobi), iyo macrolides sida clarithromycin (Biaxin), erythromycin (EES, E-Mycin, Erythrocin), iyo troleandomycin (TAO; aan laga heli karin Mareykanka); daawooyinka antifungal sida clotrimazole (Lotrimin, Mycelex), fluconazole (Diflucan), itraconazole (Onmel, Sporanox), ketoconazole, posaconazole (Noxafil), iyo voriconazole (Vfend); angiotensin receptor blockers (ARBs) sida azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, Azor, Benicar HCT, Tribenzor), telmisartan (Micardis, Micardis HCT, Twynsta); boceprevir (Victrelis; hadda lagama heli karo Mareykanka); Kaalshiyamka kaaliyayaasha sida diltiazem (Cardizem), nicardipine, nifedipine (Adalat, Procardia), iyo verapamil (Calan, Verelan, Tarka); caspofungin (Cancidas); chloramphenicol; cimetidine (Tagamet); cisapride (Propulsid; lagama heli karo Mareykanka); cisplatin; danazol; durayo gaar ah ('kaniiniyada biyaha'); ganciclovir (Valcyte); ka hortagga uurka qaarkood (kaniiniyada ka hortagga uurka, balastarro, faraantiyo, waxyaabaha la gelinayo, ama irbado); dawooyinka qaarkood ee HIV sida didanosine (Videx); indinavir (Crixivan), lamivudine (Epivir); nelfinavir (Viracept), ritonavir (Norvir), stavudine (Zerit), iyo zidovudine (Retrovir) lansoprazole (Prevacid); methylprednisolone (Medrol); metoclopramide (Reglan); mycophenolate (Cellcept); nefazodone; omeprazole (Prilosec); prednisone; rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); dawooyinka qaarkood ee suuxdinta sida carbamazepine (Tegretol, Teril), phenobarbital, iyo phenytoin (Dilantin, Phenytek); sirolimus (Rapamune), iyo telaprevir (Incivek; mar dambe lagama heli karo Maraykanka). Dhakhtarkaaga ayaa laga yaabaa inuu u baahdo inuu beddelo qiyaasta daawooyinkaaga ama uu si taxaddar leh kuugu ilaaliyo dhibaatooyinka soo raaca. Daawooyin kale oo badan ayaa sidoo kale la falgala tacrolimus, markaa hubi inaad u sheegto dhakhtarkaaga dhammaan daawooyinka aad qaadanaysid, xitaa kuwa aan ka muuqan liiskan.
• u sheeg dhakhtarkaaga haddii aad qaadanaysid ama aad dhawaan joojisay qaadashada cyclosporine (Gengraf, Neoral, Sandimmune). Haddii aad qaadaneysay cyclosporine, dhakhtarkaaga ayaa laga yaabaa inuu kuu sheego inaadan bilaabin qaadashada tacrolimus illaa 24 saacadood ka dib markii aad qaadatay qiyaasta ugu dambeysay ee cyclosporine. Haddii aad joojiso qaadashada tacrolimus, dhakhtarkaaga ayaa sidoo kale kuu sheegi doona inaad sugto 24 saacadood ka hor intaadan bilaabin qaadashada cyclosporine.
• u sheeg dhakhtarkaaga iyo farmashiistaha waxa dhirta aad ka qaadanayso, gaar ahaan waxyaabaha laga soosaaray St. John’s wort ama schisandra sphenanthera. Ha u isticmaalin daawooyinkaan dhirta ah inta aad qaadaneysid maadada loo yaqaan 'tacrolimus'.
• u sheeg dhakhtarkaaga haddii aad leedahay ama aad waligaa qabtid cudurka QT syndrome (xaalad la iska dhaxlo oo qofku ugu badan yahay inuu ku dheeraado QT) heerarka hoose ee kaalshiyamka, kaalshiyamka, ama magnesium ee dhiiggaaga, garaaca wadnaha oo aan joogto ahayn, heerarka kalastaroolka oo sarreeya, , kilyaha, ama cudurka beerka.
• u sheeg dhakhtarkaaga haddii aad uur leedahay, qorsheyso inaad uur yeelato, ama aad naas nuujiso. Haddii adiga ama lammaanahaagu aad uur qaadi kartaan, isticmaal ka hortag uur leh oo waxtar leh ka hor iyo inta lagu jiro daweynta tacrolimus. Haddii aad uur yeelato inta aad qaadanaysid tacrolimus, wac dhakhtarkaaga. Tacrolimus waxay waxyeeleyn kartaa uurjiifka.
• haddii aad qalliin ku jirto, oo ay ku jiraan qalliinka ilkaha, u sheeg dhakhtarka ama dhakhtarka ilkaha inaad qaadanayso tacrolimus.
• waa inaad ogaataa qaadashada tacrolimus inay kordhin karto halista ah inaad ku dhacdo kansarka maqaarka. Ka ilaali naftaada kansarka maqaarka adoo iska ilaalinaya soo-gaadhista qorraxda ama iftiinka ultraviolet-ka ee aan loo baahnayn ama daba dheeraaday (sariiraha maqaarka) iyo xirashada dharka ilaaliya, muraayadaha indhaha, iyo shaashadda qorraxda ee leh isirka ilaalinta maqaarka oo sarreeya (SPF)
• Ha cabin cabbitaannada aalkolada leh inta aad qaadanayso kaabsoolka dheecaanka dheereeya ee loo yaqaan 'tacrolimus' ama kaniiniyada sii-daynta dheer. Aalkoladu waxay ka sii dari kartaa waxyeelada ka timaadda tacrolimus.
• waa inaad ogaataa in tacrolimus uu sababi karo dhiig kar. Dhakhtarkaaga ayaa si taxadar leh ula socon doona cadaadiska dhiiggaaga, waxaana laga yaabaa inuu kuu qoro daawo lagu daaweeyo dhiig karka haddii uu soo baxo.
• waa inaad ogaataa inay jirto halista ah inaad ku dhacdo sonkorow inta aad ku daweyneyso tacrolimus. Bukaannada laga tallaalay kelyaha ee loo yaqaan 'African American iyo Hispanic' waxay si gaar ah khatar sare ugu jiraan in uu ku dhaco cudurka macaanka inta lagu guda jiro daweynta tacrolimus. U sheeg dhakhtarkaaga haddii adiga ama qof kale oo qoyskaaga ka mid ahi uu qabo ama aad waligiisba sonkorow qabeen. Haddii aad isku aragto mid ka mid ah astaamaha soo socda, isla markiiba wac dhakhtarkaaga: harraad xad dhaaf ah; gaajo xad dhaaf ah; kaadi joogta ah; aragga oo xumaada ama jahwareer.
• ha qaadan wax talaal ah adigoon lahadlin dhaqtarkaaga.

Ka fogow cunista canabka canabka ah ama cabitaanka casiirka canabka marka aad qaadanaysid tacrolimus.

Haddii kaabsol-sii-deynta degdegga ah ama qaddarka ka joojinta afka la seegayo, qaado sida ugu dhakhsaha badan ee aad u xusuusato. Si kastaba ha noqotee, haddii ay ku dhowdahay waqtiga qiyaasta xigta, ka bood qiyaasta la seegay oo sii wad jadwalka daawadaada caadiga ah. Ha qaadan laba-qaadasho si aad uhesho mid kaa dhaafay.

Haddii qiyaasta kaabsoolka la sii dheereeyey la seegay, qaado qiyaasta haddii ay ku jirto 14 saacadood gudahood ka dib markaad seegto qiyaasta. Si kastaba ha noqotee, haddii ay ka badan tahay 14 saacadood, ka bood qiyaasta la seegay oo sii wad jadwalka daawadaada caadiga ah. Ha qaadan laba-qaadasho si aad uhesho mid kaa dhaafay.

Haddii qiyaasta la sii daayay ee kaniiniga ah la seegay, qaado qiyaasta haddii ay tahay 15 saacadood gudahood ka dib markaad seejiso qiyaasta. Si kastaba ha noqotee, haddii ay ka badan tahay 15 saacadood, ka bood qiyaasta la seegay oo sii wad jadwalka daawadaada caadiga ah. Ha qaadan laba-qaadasho si aad uhesho mid kaa dhaafay.

Tacrolimus waxay sababi kartaa waxyeelo. U sheeg dhakhtarkaaga haddii mid ka mid ah astaamahani ay daran yihiin ama aanad tagin:

• madax xanuun
• shuban
• calool istaag
• lallabbo
• matagid
• laabjeex
• calool xanuun
• cunto xumo
• dhibaato xagga hurdada ama hurdada ah
• dawakhaad
• daciifnimo
• dhabar ama kalagoys xanuun
• gubasho, kabuubyo, xanuun, ama xoqitaan gacmaha ama cagaha

Dhibaatooyinka qaarkood waxay noqon karaan kuwo halis ah. Haddii aad isku aragto mid ka mid ah astaamaha soo socda, ama kuwa lagu sheegay qaybta DIGNIIN MUHIIM AH, isla markiiba wac dhakhtarkaaga:

• kaadida oo yaraatay
• xanuun ama gubasho xagga kaadida ah
• neefta oo ku qabata, finan yaryar, finan, ama cuncun
• maqaarka cirro leh, neefta oo ku qabata, ama wadnaha oo dhaqso u garaaca
• daal; miisaanka oo kordha; bararka gacmaha, gacmaha, cagaha, anqawyada, ama lugaha hoose; ama neefta oo ku qabata
• dhiigbax ama nabar aan caadi ahayn
• suuxdin, aragga oo isbeddela, madax xanuun, jahwareer, ama gariir aan la xakamayn karin oo ah qayb ka mid ah jirka
• miyir beelid (miyir beelid muddo ah)

Tacrolimus waxay sababi kartaa waxyeelo kale. Wac dhakhtarkaaga haddii aad qabtid dhibaatooyin aan caadi ahayn intaad qaadanaysid dawadan.

Haddii aad isku aragto waxyeellooyin daran, adiga ama dhakhtarkaaga ayaa warbixin u diri kara Barnaamijka Ka Warbixinta Dhacdooyinka Xun ee Maamulka Cuntada iyo Dawooyinka (FDA) (http://www.fda.gov/Safety/MedWatch) ama taleefan ( 1-800-332-1088).

Daawadan ku hay weelka ay soo gashay, si adag u xir, iyo meel aysan carruurtu gaarin. Ku keydi heerkulka qolka oo ka fog kuleylka iyo qoyaanka badan (ha ku jirin musqusha).

Waa muhiim inaad ka ilaaliso dhammaan daawooyinka meel aan la arkeynin oo aysan gaari karin carruurta maaddaama weelal badan (sida kuwa toddobaadlaha kiniiniga ka fiirsada iyo kuwa loogu talagalay dhibcaha isha, kareemada, dhejiyeyaasha, iyo kuwa neefta ku siiya) uma adkeysana carruurta, carruurta yaryarna si fudud ayey ku furi karaan. Si aad uga ilaaliso carruurta yaryar sunta, marwalba xiro daboolka badbaadada isla markaana isla markiiba dhig dawada meel aamin ah - mid kor iyo fog kana fog aragooda oo gaadha.http://www.upandaway.org

Daawooyinka aan loo baahnayn waa in lagu tuuraa siyaabo gaar ah si loo hubiyo in xayawaanka, carruurta, iyo dadka kaleba aysan cuni karin. Si kastaba ha noqotee, waa inaadan ku daadinin daawadan musqusha hoosteeda. Taabadalkeed, sida ugufiican ee dawada looga takhalusi karaa waa iyada oo loo maro barnaamijka dib u celinta daawada. La hadal farmashiistahaaga ama la xiriir waaxda qashinka / dib u warshadaynta si aad wax uga ogaato barnaamijyada dib-u-celinta ee bulshadaada. Ka eeg bogga internetka ee 'FDA ee Amni-Qaadashada Daawooyinka (http://goo.gl/c4Rm4p) si aad u hesho macluumaad dheeraad ah haddii aadan marin u helin barnaamijka dib-u-celinta.

Xaalada xad dhaafka ah, wac khadka caawinta ka hortagga sunta 1-800-222-1222. Macluumaadka sidoo kale waxaa laga heli karaa internetka https://www.poisonhelp.org/help. Haddii dhibbanuhu burburay, suuxdin qabtay, neefsashadu dhib ku tahay, ama aan la kici karin, isla markiiba wac adeegyada gurmadka ee 911.

Calaamadaha xad dhaafka ah waxaa ka mid noqon kara:

• finan
• hurdo la'aan
• lallabbo, matag, iyo shuban
• gariir aan la koontarooli karin oo qayb ka mid ah jirka, madax xanuun, jahwareer, isu dheelitir la’aan, iyo daal fara badan
• bararka gacmaha ama lugaha
• qandho ama calaamadaha kale ee infekshinka

Dhammaan ballamaha la dhig dhakhtarkaaga iyo shaybaarka. Dhakhtarkaagu wuxuu amri doonaa baaritaano gaar ah kahor iyo inta daaweyntaadu socoto si loo hubiyo jawaabta jirkaaga ee tacrolimus.

Ha u ogolaan qof kale inuu qaato daawadaada. Weydii farmashiistahaaga wixii su'aalo ah ee aad ka qabto dib u soo celinta daawada laguu qoray.

Waxaa muhiim kuu ah inaad haysato liis qoran oo ku saabsan dhammaan daawooyinka laguu qoro iyo kuwa aan dhakhtar qorin (warqad dhakhtar la aan ah) ee aad qaadanaysid, iyo sidoo kale wax soo saar kasta sida fiitamiinnada, macdanta, ama nafaqooyinka kale ee nafaqada leh. Waa inaad soo qaadataa liiskan markasta oo aad booqato dhakhtar ama haddii isbitaal la dhigo. Sidoo kale waa macluumaad muhiim ah inaad lasocoto haddii ay jiraan xaalado deg deg ah.

• Astagraf XL^®
• Envarsus XR^®
• Barnaamij^®

• FK 506