Duritaanka Tocilizumab

Qanacsan

• Cirbadeynta Tocilizumab ayaa loo isticmaalaa kali ama isku dhafan daawooyin kale si loo yareeyo astaamaha noocyada qaar ee arthritis-ka iyo xaalado kale oo ay ka mid yihiin:
• Kahor intaadan helin duritaanka tocilizumab,
• Cirbadda Tocilizumab 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 astaamahan ama kuwa ku taxan qaybta DIGNIIN MUHIIM AH, wac dhakhtarkaaga isla markiiba ama u hesho daaweyn caafimaad oo degdeg ah:

Isticmaalka cirbadeynta tocilizumab waxay yareyn kartaa awoodaada inaad kula dagaalanto infekshinka bakteeriyada, fayrasyada, iyo fungi waxayna kordhisaa halista aad kuheli karto infekshan halis ah ama nafta halis galinaya oo ku faafi karo jirka. U sheeg dhakhtarkaaga haddii aad badanaa ku dhacdo nooc kasta oo infekshan ah ama haddii aad qabtid ama aad u malaynaysid inaad hadda nooc cudur ah qabtid. Tan waxaa ka mid ah infekshannada yaryar (sida nabarrada furan ama nabarrada), infekshannada imanaya ama tagaya (sida nabarrada qabow), iyo infekshannada socda ee aan tagin. Sidoo kale u sheeg dhakhtarkaaga haddii aad qabto ama aad waligaa qabtid sonkorow, fayraska difaaca jirka ee dadka (HIV), ama xaalad kasta oo saameysa nidaamkaaga difaaca, iyo haddii aad nooshahay, weligaa ma nooshahay, ama u safartay meelaha sida dooxooyinka Ohio iyo Mississippi iyo Koonfur-galbeed halkaasoo infekshannada fungal ee daran ay ku badan yihiin. Weydii dhakhtarkaaga haddii aadan ogeyn haddii cudurradan ay ku badan yihiin aaggaaga. Sidoo kale u sheeg dhakhtarkaaga haddii aad qaadanaysid: abatacept (Orencia); adalimumab (Humira); anakinra (Kineret); certolizumab (Cimzia); etanercept (Enbrel); golimumab (Simponi); infliximab (Remicade); daawooyinka xakameynaya habka difaaca jirka sida azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), methotrexate (Otrexup, Trexall, kuwa kale), sirolimus (Rapamune), iyo tacrolimus (Prograf); dawooyinka afka laga qaato sida dexamethasone, methylprednisolone, iyo prednisone (Rayos); ama rituximab (Rituxan). Haddii aad isku aragto mid ka mid ah astaamaha soo socda, isla markiiba wac dhakhtarkaaga: qandho; qarqaryo; dhidid; neefsashada oo ku adkaata; cune xanuun; qufac; miisaanka oo yaraada; shuban; calool xanuun; dhiig xaako; daal aad u daran; muruq xanuun; maqaar diiran, casaan ah, ama xanuun leh; nabarrada maqaarka ama afka; gubasho markaad kaadido; kaadi joogta ah; ama calaamadaha kale ee cudurka.

Waxaa laga yaabaa inaad qabtid cudurka qaaxada (TB, nooc ka mid ah infekshanka sambabaha) ama cagaarshowga nooca B (nooc ka mid ah cudurrada beerka) laakiin aanad lahayn wax calaamado ah oo cudurka ah. Xaaladdan oo kale, cirbadeynta tocilizumab waxay kordhin kartaa halista in infekshankaagu uu noqdo mid aad u daran oo aad yeelato calaamado. Dhakhtarkaagu wuxuu sameyn doonaa baaritaanka maqaarka si loo arko inaad qabto infekshinka TB-da ee aan firfircooneyn wuxuuna ku amri karaa baaritaanno dhiig si loo arko haddii aad qabtid infekshinka cagaarshow B ee aan firfircooneyn. Haddii ay lagama maarmaan noqoto, dhakhtarkaagu wuxuu ku siin doonaa daawo aad ku daaweyso cudurkaan ka hor intaadan bilaabin isticmaalka cirbadeynta tocilizumab. U sheeg dhakhtarkaaga haddii aad qabtid ama aad waligaa qabtid TB ama cagaarshowga B, haddii aad booqatay waddan kasta oo tiibaydu ku badan tahay, ama haddii aad ag joogtay qof qaba tiibay. Haddii aad leedahay mid ka mid ah calaamadaha soo socda ee TB, ama haddii aad isku aragto mid ka mid ah astaamahan inta lagu jiro daaweyntaada, wac dhakhtarkaaga isla markiiba: qufac, xabad xanuun, qufac dhiig ama xabka, daciifnimo ama daal, miisaan lumis, rabitaan la'aan, dhaxan, qandho, ama dhidid habeenkii. Sidoo kale wac dhakhtarkaaga isla markiiba haddii aad leedahay mid ka mid ah astaamahan cagaarshowga B ama haddii aad isku aragto mid ka mid ah astaamahan inta lagu jiro ama ka dib daaweyntaada: daal saaid ah, maqaarka ama indhaha oo jaale noqda, cunto xumo, lallabbo, matag, murqo xanuun, kaadida madow, saxarada midabka leh ee midabada leh, qandho, dhaxan, calool xanuun, ama finan.

Dhammaan ballamaha la dhig dhakhtarkaaga iyo shaybaarka. Dhakhtarkaaga ayaa si taxaddar leh ula socon doona caafimaadkaaga si loo hubiyo inaadan ku dhicin infekshin daran. Dhakhtarkaagu wuxuu amri doonaa tijaabooyinka shaybaarka qaarkood kahor iyo inta daaweyntaadu socoto si loo hubiyo jawaabta jirkaaga ee duritaanka tocilizumab.

Dhakhtarkaaga ama farmashiistahaaga ayaa ku siin doona warqada macluumaadka bukaanka soo saaraha (Hagaha Daawada) markaad bilawdo daaweynta cirbadeynta tocilizumab iyo markasta oo aad daawada hesho. Si taxaddar leh u akhri macluumaadka oo weydii dhakhtarkaaga ama farmashiistaha haddii aad wax su'aalo ah qabtid. Waxa kale oo aad booqan kartaa websaydhka Maamulka Cuntada iyo Dawooyinka (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) ama websaydhka soosaaraha si aad u hesho Hagaha Daawada.

Kala hadal dhakhtarkaaga khataraha isticmaalka cirbadeynta tocilizumab.

Cirbadeynta Tocilizumab ayaa loo isticmaalaa kali ama isku dhafan daawooyin kale si loo yareeyo astaamaha noocyada qaar ee arthritis-ka iyo xaalado kale oo ay ka mid yihiin:

• xanuunka 'rheumatoid arthritis' (xaalad jirku ku weeraro xubnaheeda, taasoo keenta xanuun, barar, iyo shaqo lumis) dadka aan ka caawin caawimaadda daawooyinka kale ee jir-beddelidda cudurka (DMARDs),
• unugyada waaweyn ee arteritis (xaalad sababa barar xididdada dhiigga, gaar ahaan madaxa iyo madaxa),
• cudurka yar yar ee loo yaqaan 'polyarticular idiopathic arthritis' (PJIA; nooc ka mid ah arthritis-ka carruurnimada oo saameeya shan ama ka badan kalagoysyada lixda bilood ee ugu horreysa xaaladda, oo keenaya xanuun, barar, iyo shaqeyn la'aan) carruurta 2 sano jir ah ama ka weyn.
• habdhiska jirka ee loo yaqaan 'idiopathic arthritis' (SJIA; xaalad carruurta ku keenta caabuq ku dhaca qaybaha kala duwan ee jirka, taasoo keenta qandho, kalagoysyo xanuun iyo barar, shaqo lumis, iyo dib u dhac ku yimaada koritaanka iyo koritaanka) carruurta jirta 2 sano ama ka weyn,
• cilladda sii deynta 'cytokine syndrome' (falcelin daran oo suuragal ah nolol-u-hanjabaad) oo ku dhacda dadka waaweyn iyo carruurta 2 sano jir ah ama ka weyn ka dib marka la helo faleebooyin tallaal ah oo qaarkood.

Cirbadeynta Tocilizumab waxay ku jirtaa nooc daawooyin ah oo loo yaqaan 'interleukin-6 (IL-6) inhibitors'. Waxay ku shaqeysaa iyadoo la xannibayo waxqabadka interleukin-6, walax jirka ku jirta oo keenta caabuq.

Cirbadeynta Tocilizumab waxay u timid sidii xalka (dareeraha) in lagugu mudo irbadda (xididka) gacantaada dhakhtar ama kalkaaliye caafimaad oo jooga xafiiska caafimaadka ama bukaan socod eegtada bukaan socodka isbitaalka ama cirbadda horay loo sii diyaariyey si aad isaga ugu durto si hoose (maqaarka hoostiisa) adiga oo guriga. Marka tocilizumab la siinayo xidid si loo daweeyo rheumatoid arthritis ama polyarticular juvenile idiopathic arthritis, waxaa badanaa la siiyaa hal mar 4tii toddobaadba. Marka tocilizumab la siinayo xidid si loo daweeyo nidaamka dhalinyarada ee idiopathic arthritis, badanaa waxaa la siiyaa hal mar 1 ama 2 todobaad kasta. Marka tocilizumab la siinayo xidid si loo daweeyo cilladda sii deynta cytokine, badanaa waxaa la siiyaa hal mar, laakiin ilaa 3 qiyaasood oo dheeri ah ayaa la siin karaa ugu yaraan 8 saacadood oo kala fog. Waxay kugu qaadan doontaa 1 saac inaad kuhesho qiyaastaada duritaanka tocilizumab. Marka tocilizumab la siiyaa subag ahaan si loogu daaweeyo rheumatoid arthritis ama unugyada unugyada weyn, waxaa badanaa la siiyaa hal mar usbuucii ama hal mar usbuuc kasta.

Waxaad kuheli doontaa qiyaastaada subcutanous-ka koowaad ee cirbadeynta tocilizumab xafiiska dhakhtarkaaga. Haddii aad isku durayso cirbad isjireed oo ah adoo isdifaacaya oo gurigaaga ah ama aad leedahay saaxiib ama qof aad qaraabo tihiin oo daawada kuu duraya, dhakhtarkaaga ayaa ku tusaya adiga ama qofka ku duraya daawada sida loo isku duro. Adiga iyo qofka aad isku duraysaan daawada waa inaad sidoo kale akhrisataan tilmaamaha qoran ee isticmaalka ee la socda daawada.

Soddon daqiiqo ka hor intaadan diyaar u ahayn inaad isku durto cirbadeynta tocilizumab, waxaad u baahan doontaa inaad daawada ka saarto qaboojiyaha, kana soo saarto kartoonkeeda, una ogolaato inuu gaaro heerkulka qolka. Markaad sanjirka ka soo saareyso saliingad horay loo soo buuxiyey, ka taxaddar inaadan taaban faraha kicinaya sirinjiga. Ha isku dayin inaad diiriso daawada adoo ku kululeynaya microwave, adigoo ku ridaya biyo diirran, ama qaab kale.

Furka ha ka saarin saliingada la buuxiyey inta ay daawadu kululaaneyso. Waa inaad ka saarto furka kabadan 5 daqiiqo kahor intaadan isku durin daawada. Ha badalin daboolka ka dib markaad saarto. Ha isticmaalin siriinjyada haddii aad dhulka ku dhigto.

Hubi saliingaha horay loo soo buuxiyay si aad u hubiso in taariikhda dhicitaanka ee lagu daabacay baakadka uusan dhaafi karin, Siriingaha ku hayso irbadda daboolan ee hoos u sii jeeda, si dhow u eeg dareeraha saliingaha ku jira Dareeraha waa inuu noqdaa mid huruud ah ama midab jaalle ah waana inuusan noqon mid daruuro leh ama midab doorsoon leh ama ay ku jiraan buro ama qaybo. Wac farmashiistahaaga haddii ay jiraan wax dhibaato ah oo ku saabsan xirmada ama siliingaha oo ha ku durin daawada.

Waxaad ku duri kartaa cirbadeynta tocilizumab bowdyada hore ama meel kasta oo calooshaada ah marka laga reebo xudduntaada (badhanka caloosha) iyo aagga 2 inji oo ku wareegsan. Haddii qof kale ku durayo daawadaada, aagga kore ee gacmaha kore sidoo kale waa la isticmaali karaa. Ha ku durin daawada maqaarka jilicsan, nabar, casaan, adag, ama aan bad qabin, ama leh nabarro, jiirar, ama nabarro. Xulo meel kale markasta oo aad isku durto dawada, ugu yaraan 1 inji meel ka fog meeshii aad horay u isticmaali jirtay. Haddii qiyaasta buuxda aan la isku durin, wac dhakhtarkaaga ama farmashiistahaaga.

Dib ha u isticmaalin siriinjumab saliingaha horay loo soo buuxiyay hana dib ugu soo ceshanin saliingaha isticmaalka kadib. Ku tuur irbado kasta oo la isticmaalay weel u adkaysata daloolka oo weydii farmashiistahaaga sida loo tuuro weelka.

Cirbadeynta Tocilizumab ayaa laga yaabaa inay gacan ka geysato xakameynta calaamadahaaga, laakiin ma daaweyn doonto xaaladdaada. Dhakhtarkaaga ayaa si taxaddar leh kuu ilaalin doona si uu u arko sida wanaagsan ee ay duritaanka tocilizumab adiga kuugu shaqeyso. Dhakhtarkaaga ayaa laga yaabaa inuu wax ka beddelo qiyaastaada ama uu daahiyo daaweyntaada haddii aad isbeddello gaar ah ku leedahay natiijooyinka sheybaarkaaga. Waa muhiim inaad u sheegto dhakhtarkaaga sida aad dareemeyso inta lagu jiro daaweyntaada.

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

Kahor intaadan helin duritaanka tocilizumab,

• u sheeg dhakhtarkaaga iyo farmashiistahaaga haddii aad xasaasiyad ku leedahay tocilizumab, daawooyin kale, ama mid ka mid ah waxyaabaha ku jira cirbadda tocilizumab. Weydii farmashiistahaaga ama ka hubi Hagaha Daawada liiska waxyaabaha ay ka kooban yihiin.
• u sheeg dhakhtarkaaga iyo farmashiistaha waxa kale ee dhakhtar qoro iyo kuwa aan dhakhtar qorin, fiitamiinnada, nafaqada nafaqada, iyo alaabta dhirta ah ee aad qaadanayso ama aad qorsheyneyso inaad qaadato. Hubso inaad sheegto dawooyinka ku taxan qaybta DIGNIIN MUHIIM AH iyo mid ka mid ah kuwan soo socda: daawooyinka xinjirowga lidka ku ah ('khafiifiyeyaasha dhiigga') sida warfarin (Coumadin, Jantoven); asbiriin iyo dawooyinka kale ee nonsteroidal anti-bararka (NSAIDs) sida ibuprofen (Advil, Motrin, kuwa kale) iyo naproxen (Aleve, Naprosyn, kuwa kale); daawooyinka kalastarolka ka yareeya (statins) sida atorvastatin (Lipitor, in Caduet), lovastatin (Altoprev, in Advicor), iyo simvastatin (Zocor, in Vytorin); p-pillerka (kaniiniyada xakameynta dhalmada); ama theophylline (Elixophyllin, Theo-24, kuwa kale). 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 laga yaabaa inay la falgalaan cirbadda tocilizumab, markaa hubi inaad u sheegto dhakhtarkaaga dhammaan daawooyinka aad qaadanaysid, xitaa kuwa aan ka muuqan liiskan.
• u sheeg dhakhtarkaaga haddii aad qabto ama aad waligaa kansar qabtid; diverticulitis (boorsooyin yaryar oo ku jira xuubka mindhicirka weyn oo barari kara); boogaha caloosha ama xiidmaha; kolestarool badan iyo triglycerides; xaalad kasta oo saameysa habdhiska neerfaha sida sclerosis badan (MS; cudur ku dhaca neerfayaasha oo aan si sax ah u shaqeynin dadkuna waxay la kulmi karaan daciifnimo, kabuubyo, luminta isuduwidda muruqyada iyo dhibaatooyinka aragtida, hadalka, iyo kaadiheysta) ama caabuq joogto ah demyelinating polyneuropathy (CIDP, khalkhal ku yimaad nidaamka difaaca iyo neerfayaasha); ama cudurka beerka.
• u sheeg dhakhtarkaaga haddii aad uur leedahay, qorsheyso inaad uur yeelato, ama aad naas nuujiso. Haddii aad uur yeelato intaad qaadanayso duritaanka tocilizumab, wac dhakhtarkaaga.
• haddii aad qalliin sameyneyso, oo ay ku jiraan qalliinka ilkaha, u sheeg dhakhtarka ama dhakhtarka ilkaha inaad qaadanayso cirbadeynta tocilizumab.
• Weydii dhakhtarkaaga haddii ay tahay inaad qaadato wax tallaal ah ka hor intaadan bilaabin daaweyntaada cirbadda tocilizumab. Hadday suurogal tahay, dhammaan tallaallada carruurta waa in la cusbooneysiiyaa kahor intaan la billaabin daaweynta. Ha haysan wax tallaal ah inta lagu jiro daaweyntaada adigoon la hadlin dhakhtarkaaga.

Ilaa dhakhtarkaagu kuu sheego mooyee, sii wad cuntadaada caadiga ah.

Haddii aad seegto ballan si aad u hesho faleebo tocilizumab ah, wac dhakhtarkaaga.

Haddii aad ilowdo inaad isku durto qaddar subcutanous ah oo ah 'tocilizumab', isku dur qiyaasta la seegay isla marka aad xusuusatoba. Si kastaba ha noqotee, haddii ay ku dhowdahay waqtiga qiyaasta xigta, ka bood qiyaasta la seegay oo sii wad jadwalka daawadaada caadiga ah. Ha isku durin laba-qaadasho si aad uhesho mid kaa dhaafay. Wac dhakhtarkaaga ama farmashiistaha haddii aadan ogeyn goorta la isku duro irbadda tocilizumab.

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

• madax xanuun
• sanka oo dareera ama hindhiso
• guduudasho, cuncun, xanuun, ama barar meeshii lagu muday tocilizumab

Dhibaatooyinka qaarkood waxay noqon karaan kuwo halis ah. Haddii aad isku aragto mid ka mid ah astaamahan ama kuwa ku taxan qaybta DIGNIIN MUHIIM AH, wac dhakhtarkaaga isla markiiba ama u hesho daaweyn caafimaad oo degdeg ah:

• finan
• dhaqid
• finan
• cuncun
• bararka indhaha, wajiga, dibnaha, carrabka, cunaha, gacmaha, gacmaha, cagaha, anqawyada, ama lugaha hoose
• neefsashada ama wax liqidda oo ku adkaata
• xabad xanuun
• wareer ama miyir beelid
• qandho, xanuun joogto ah oo ku dhaca aagga caloosha, ama isbeddel ku dhaca caadada caloosha
• indhaha jaalaha ah ama maqaarka; caloosha xanuun midigta sare; nabar ama dhiig bax aan faahfaahin laga bixin; cunto xumo; jahwareer; kaadi kaadi huruud ah ama midab bunni ah leh; ama saxaro cirro leh

Tocilizumab waxay kordhin kartaa halista ah inuu ku dhaco noocyo kansar ah. Kala hadal dhakhtarkaaga khataraha helitaanka daawadan.

Cirbadda Tocilizumab waxay sababi kartaa waxyeelo kale. Wac dhakhtarkaaga haddii aad qabtid dhibaatooyin aan caadi ahayn inta aad 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 baakadka ay soo gashay, kana fogee nalka, si adag u xir, iyo meel aysan carruurtu gaarin. Ku keydi tallaalka tocilizumab qaboojiyaha, laakiin ha barafaynin. Ka dhig saliingaha la kariyey qalalan. Iska tuur daawo kasta oo dhacsan ama aan loo baahnayn. Farmashiistahaaga kala hadal sida saxda ah ee daaweynta looga takhalusi karo.

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.

Weydii farmashiistahaaga wixii su'aalo ah ee aad ka qabto tallaalka tocilizumab.

Ha u ogolaan qof kale inuu isticmaalo 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.

• Actemra^®