I-Pretomanid - Ukusetshenziswa, Isilinganiso, Imiphumela Engemihle nokuningi

I-Pretomanid umuthi omusha wama-antibiotic owenzelwe ngqo ukwelapha isifo sofuba esingamelana nemithi eminingi (i-MDR-TB). Yakhiwe njengengxenye yokwelashwa okuhlanganisiwe ukulwa nalolu hlobo lwesifo sofuba olunzima noluvame ukuba nzima ukwelapha. I-Pretomanid iyingxenye yekilasi elisha lemithi ehlose amagciwane abangela isifo sofuba, enikeza ithemba ezigulini ezinezinketho zokwelapha ezilinganiselwe ngenxa yokumelana nemithi ejwayelekile ye-TB.

I-Pretomanid iyisici esibalulekile sohlelo lwe-BPaL oluvunyiwe yi-World Health Organisation, oluhlanganisa i-Bedaquiline, i-Pretomanid, ne-Linezolid ukwelapha i-TB engazweli kakhulu emithini (i-XDR-TB) kanye ne-TB engazweli ekwelashweni noma engaphenduli emithini eminingi (i-MDR-TB). Lolu hlelo lwamukelwe yi-US Food and Drug Administration (FDA) ngo-2019 futhi lunconywa yiziphathimandla zezempilo zomhlaba wonke njengokwelashwa okujwayelekile kwalezi zinhlobo ze-TB okunzima ukwelapha.

Ukusetshenziswa kwe-Pretomanid

I-Pretomanid ivunyelwe ukusetshenziswa ngokuyinhlanganisela neminye imithi yokwelapha abantu abadala abane-MDR-TB yamaphaphu. Ivame ukusetshenziswa kanye ne-bedaquiline kanye ne-linezolid, okwenza uhlelo oluye lwabonisa ukusebenza kahle ezivivinyweni zemitholampilo. Lokhu kwelashwa okuhlanganisiwe kubalulekile ezigulini ezingazange zisabele ekwelashweni kwe-TB okuvamile, okunikeza indlela entsha yokuphatha lesi sifo esisongela ukuphila.

I-Pretomanid ivunyelwe ukusetshenziswa kuphela njengengxenye yokwelashwa okuhlanganisiwe ngenxa yengozi yokumelana uma isetshenziswa yodwa. Ikhonjiswa ikakhulukazi kubantu abadala abane-MDR-TB yamaphaphu noma i-XDR-TB njengengxenye yezindlela zokwelashwa ezihlanganisiwe njenge-BPaL.

Isebenza Kanjani i-Pretomanid

I-Pretomanid isebenza ngokuvimbela ukukhula kwesifo sofuba i-Mycobacterium, amagciwane abangela isifo sofuba. I-Pretomanid ivimba amagciwane e-TB ekwenzeni amandla nokwakha igobolondo layo langaphandle elivikelayo, elibalulekile ekusindeni kwayo. Ngokuphazamisa lezi zinqubo, i-Pretomanid ibulala ngempumelelo amagciwane, isize ekususeni ukutheleleka emzimbeni. Le ndlela ibaluleke kakhulu ekwelapheni izinhlobo ze-TB ezingamelani nemithi, okuyizinto ezinzima kakhulu ukuziqeda.

Isilinganiso nokuphathwa

Umthamo ojwayelekile we-Pretomanid kubantu abadala uvame ukuba ngu-200 mg othathwa ngomlomo kanye ngosuku amasonto angama-26, njengengxenye yokwelashwa okuhlanganisiwe. I-Pretomanid ivunyelwe ukusetshenziswa ngabantu abadala. Ukusetshenziswa kwezingane okwamanje akukaqinisekiswa noma akuhlolisiswa, futhi umthamo wezingane kumele unqunywe ngokucophelela ngabahlinzeki bezempilo ngokusekelwe esisindweni kanye nesidingo somtholampilo. Kubalulekile ukulandela isiqondiso somhlinzeki wezempilo. I-Pretomanid itholakala ngesimo sethebhulethi, okwenza kube lula ukuyiphatha. Iziguli kufanele zithathe umuthi ngesikhathi esifanayo nsuku zonke ukuze zigcine amazinga alinganayo egazini.

Imiphumela Engemihle ye-Pretomanid

Njengayo yonke imithi, i-Pretomanid ingabangela imiphumela emibi. Imiphumela emibi evamile ihlanganisa:

• I-nausea
• Ukukhathala
• bekhanda
• Uhudo
• Insomnia

Imiphumela emibi kakhulu ingase ihlanganise:

• Izinkinga zesibindi (ama-enzyme esibindi aphezulu)
• I-peripheral neuropathy (ukuba ndikindiki noma ukuqaqamba ezandleni nasezinyaweni)
• Umbono uyashintsha
• Ukungezwani komzimba okukhulu

Iziguli kufanele zibike noma yiziphi izimpawu ezingavamile kumhlinzeki wazo wezempilo ngokushesha.

Imiphumela eminingi emibi ebonakala ngesikhathi sokwelashwa nge-Pretomanid ivela emithini ehambisanayo ohlelweni, ikakhulukazi i-Linezolid, ehlotshaniswa ne-peripheral neuropathy kanye nobuthi besibindi. Ukuqapha okuqhubekayo kwale miphumela emibi kubalulekile kulo lonke ukwelashwa.

Ukusebenzisana kwezidakamizwa

I-Pretomanid ingasebenzisana nemithi eminingana, okungathinta ukusebenza kwayo noma kwandise ingozi yemiphumela emibi. Ukusebenzisana okukhulu kwemithi kufaka phakathi:

• Imithi yokulwa negciwane lengculazi (esetshenziselwa ukwelashwa nge-HIV)
• Amanye ama-anticonvulsants (asetshenziselwa izinkinga zokuxhuzula)
• Imithi ethinta ama-enzyme esibindi (njenge-rifampin)

I-Pretomanid iguqulwa esibindini ikakhulukazi ngama-enzyme e-cytochrome P450. I-Rifampin, eyisikhuthazi esinamandla salezi zi-enzyme, yehlisa kakhulu amazinga egazi le-Pretomanid, yehlisa ukusebenza kwayo, ngakho-ke ayivunyelwe uma ihlanganiswa.

Kubalulekile ukuthi iziguli zazise umhlinzeki wazo wezempilo ngayo yonke imithi, izithasiselo, kanye nemikhiqizo yamakhambi eziyisebenzisayo ukuze zigweme ukusebenzisana okungenzeka.

Izinzuzo ze-Pretomanid

Inzuzo eyinhloko yePretomanid ukusebenza kwayo kahle ekwelapheni isifo sofuba esingamelana nemithi eminingi, isimo esibeka izingozi ezinkulu empilweni futhi esinezinketho zokwelapha ezilinganiselwe. Ukwelashwa okuhlanganisiwe okubandakanya iPretomanid kubonise imiphumela ethembisayo ezivivinyweni zemitholampilo, okuholele emazingeni aphezulu okuphulukiswa kanye nemiphumela ethuthukisiwe yeziguli. Ngaphezu kwalokho, ukuphathwa kwePretomanid ngomlomo kwenza kube lula kakhulu ezigulini uma kuqhathaniswa nezinye izindlela zokujova.

Ukuphikisana kwe-Pretomanid

Abantu abathile kufanele bagweme ukusebenzisa i-Pretomanid. Izimo zokuphikisana zifaka:

• Ukukhulelwa: I-Pretomanid ayivunyelwe ngesikhathi sokukhulelwa ngenxa yezingozi ezingaba khona zokulimaza ingane esakhula, njengoba kuboniswe ezifundweni zangaphambi kokwelashwa. Abesifazane abaseminyakeni yokuzala kufanele basebenzise indlela yokuvimbela inzalo esebenzayo ngesikhathi sokwelashwa kanye nesikhathi esinconywayo ngemva kwalokho.
• Isifo sesibindi esibi kakhulu: Iziguli ezinokukhubazeka okukhulu kwesibindi zingase zingayigayi kahle i-Pretomanid, okwandisa ingozi yobuthi.

Iziguli kufanele zixoxe ngomlando wazo wezokwelapha nomhlinzeki wazo wezempilo ukuze kutholakale ukuthi i-Pretomanid iyabafanele yini.

Ukuqapha Nezexwayiso

Ngaphambi kokuqala i-Pretomanid, iziguli kufanele zenze izivivinyo ezithile zelebhu ukuze kuhlolwe ukusebenza kwesibindi, njengoba impilo yesibindi ibalulekile ekusetshenzisweni okuphephile kwalomuthi. Ngaphezu kwalokho, iziguli kufanele ziqashwe ngeso lokhozi lwe-peripheral neuropathy kanye nobuthi besibindi kulo lonke ukwelashwa kwazo. Kubalulekile ukulandela imiyalelo yomhlinzeki wezempilo ngokucophelela futhi ulandelele yonke imihlangano yokulandelela ukuqinisekisa ukusebenza kahle nokuphepha kokwelashwa.

Imibuzo Evame Ukubuzwa

• I-Pretomanid isetshenziselwani? I-Pretomanid isetshenziselwa ukwelapha isifo sofuba esingamelana nemithi eminingi (i-MDR-TB) ngokuhlanganiswa neminye imithi.
• Ngingayithatha kanjani i-Pretomanid? Phuza i-Pretomanid ngomlomo, ngokuvamile ama-200 mg kanye ngosuku, njengoba kuyalelwe umhlinzeki wakho wezempilo.
• Yimiphi imiphumela emibi evamile ye-Pretomanid? Imiphumela emibi evamile ihlanganisa isicanucanu, ukukhathala, ikhanda elibuhlungu, isifo sohudo kanye nokungalali.
• Ngingayisebenzisa yini i-Pretomanid uma ngikhulelwe? Abesifazane abakhulelwe kufanele bagweme i-Pretomanid ngenxa yezingozi ezingaba khona embungwini.
• Yini okufanele ngiyenze uma ngiphuthelwa umthamo? Uma uphuthelwa umthamo, thatha ngokushesha lapho ukhumbula. Uma cishe sekuyisikhathi somthamo wakho olandelayo, yeqa umthamo ogejiwe futhi uqhubeke neshejuli yakho evamile.
• Ingabe kukhona imiphumela emibi kakhulu okufanele ngiyiqaphele? Yebo, imiphumela emibi emibi ihlanganisa izinkinga zesibindi, i-peripheral neuropathy, kanye nokusabela okukhulu kokungezwani komzimba. Xhumana nodokotela wakho uma uhlangabezana nanoma yiziphi izimpawu ezingavamile.
• Ingabe i-Pretomanid ingasebenzisana neminye imithi? Yebo, i-Pretomanid ingasebenzisana nemithi ethile, okuhlanganisa ama-antiretroviral kanye nama-anticonvulsants. Yazisa udokotela wakho njalo ngayo yonke imithi oyithathayo.
• Kuyoze kube nini ngidinga ukuthatha i-Pretomanid? Ukwelashwa kuvame ukuhlala amasonto angama-26, kodwa umhlinzeki wakho wezempilo uzonquma isikhathi esiqondile ngokusekelwe esimweni sakho.
• Ingabe i-Pretomanid iphephile ezinganeni? Isilinganiso sezingane singahluka, futhi kubalulekile ukubonisana nomhlinzeki wezempilo ukuze uthole isiqondiso esifanele.
• Yini okufanele ngiyenze uma ngiba nemiphumela engemihle? Bika noma yimiphi imiphumela emibi kumhlinzeki wakho wezempilo ngokushesha, ikakhulukazi uma imbi kakhulu noma ikhathazayo.

Amagama Omkhiqizo

I-Pretomanid ikhangiswa ngaphansi kwegama lomkhiqizo elithi "Pretomanid" futhi ivame ukufakwa ekwelashweni okuhlanganisiwe kokwelashwa kwesifo sofuba.

Isiphetho

I-Pretomanid imelela intuthuko ebalulekile ekwelapheni isifo sofuba esingamelana nemithi eminingi, inikeza ithemba ezigulini ezinezinketho ezilinganiselwe. Indlela yayo yokusebenza eyingqayizivele, kuhlanganiswe nokusebenza kwayo ezivivinyweni zemitholampilo, iyenza ithuluzi eliwusizo ekulweni nesifo sofuba. Kodwa-ke, njenganoma yimuphi umuthi, kubalulekile ukuthi iziguli zisebenzisane eduze nabahlinzeki bazo bezempilo ukuqinisekisa ukwelashwa okuphephile nokuphumelelayo.