Ukwelashwa ngamakhemikhali kungenye yezindlela zokwelapha umdlavuza ezivame kakhulu futhi ezixoxwa kabanzi ngazo. Lokhu kuhilela ukuthumela imithi egazini lethu ukuze ibulale amangqamuzana omdlavuza futhi iwavimbe ekukhuleni kwawo. Kodwa bewazi ukuthi kunezinhlobo ezahlukene zemithi yamakhemikhali esebenza ngendlela ehlukile? Ama-antimetabolites ayiqembu lemithi ekhethekile. Nakuba igama lingase lizwakale liyinkimbinkimbi, indlela esebenza ngayo iyamangalisa. Namuhla sizokhuluma ngala ma-antimetabolites.
Lawa ma-antimetabolites awabulala kanjani amangqamuzana omdlavuza?
Kalula nje, lokho okwenziwa yilo muthi ukukhohlisa amangqamuzana omdlavuza, njengokuwanika ukhiye mbumbulu ofana nowangempela.
Ukuze siqonde lokhu, ake siqale sibheke ukuthi iseli lomdlavuza lenza kanjani (lihlukanisa) kanjani amaseli amaningi. Njengawo wonke amaseli emzimbeni wethu, amaseli omdlavuza anento ebizwa ngokuthi i-DNA. Cabanga ngalokhu njengencwadi yemiyalelo yeseli noma "ipulani." Lolu hlelo yilokho okwenziwa yiseli, nokuthi lenza kanjani amakhophi amaningi alo.
Ukuze kwakhiwe lolu hlelo lwe-DNA kahle, iseli lidinga izithako ezibalulekile eziyisisekelo. Njengoba nje ukwakha indlu kudinga izitini nosimende. Lezi zithako sizibiza ngokuthi ama-metabolites. Lokhu ngokuyinhloko:
- Ama-Purines: Lawa amabhlogo abalulekile okwakha i-DNA ne-RNA.
- Ama-Pyrimidines: Lawa amabhlogo abalulekile okwakha i-DNA ne-RNA.
- I-Folic acid: Lolu uhlobo lwevithamini olunikeza amandla enqubo yokuhlukaniswa kwamaseli.
Manje, nakhu okwenziwa umuthi we-antimetabolite. Le molekyuli yesidakamizwa yenziwe ngokufana kakhulu nezithako zangempela (ama-metabolite) okukhulunywe ngawo ngenhla. Ngakho-ke, lapho iseli lomdlavuza lizama ukwenza i-DNA yalo, lisebenzisa lesi sithako mbumbulu, umuthi, licabanga ukuthi yiso isithako sangempela.
Cabanga upheka ilayisi. Ucabanga ukuthi liwusawoti bese ufaka ushukela owubonayo. Kwenzekani-ke? Ukunambitheka kanye nokuthungwa kwelayisi lonke kuyaphazamiseka, akunjalo? Ngokufanayo, lapho iseli lomdlavuza lisebenzisa lesi sithako esingamanga, i-DNA plan yalo ayilungile nhlobo. Ngohlelo olungalungile, iseli alikwazi ukwenza amakhophi engeziwe. Ekugcineni, iseli lomdlavuza alikwazi ukuhlukana futhi life.
Yiziphi izinhlobo eziyinhloko zama-antimetabolites?
Uyakhumbula izithako ezintathu ezibalulekile esikhulume ngazo ngaphambili? Le mithi ihlukaniswe ngezinhlobo ezintathu eziyinhloko, kuye ngokuthi iyiphi kulezi zingxenye ezintathu ehlose ukuyisebenzisa.
- Ama-purine antagonists: Lawa avimba amangqamuzana omdlavuza ekwenzeni ama-purine.
- Ama-anti-pyrimidine: Lawa avimba amangqamuzana omdlavuza ekwenzeni ama-pyrimidine.
- Ama-antifolates e-folic acid (ama-antifolates):Lokhu kuvimbela amangqamuzana omdlavuza ekusebenziseni i-folic acid ukwenza i-DNA.
Lo muthi usetshenziselwa ziphi izinhlobo zomdlavuza?
Imithi ye-antimetabolite isetshenziselwa ukwelapha izinhlobo eziningi zomdlavuza. Udokotela wakho uzonquma ukuthi yimuphi umuthi okulungele wena ngokusekelwe ohlotsheni lomdlavuza onawo, isigaba sawo, nokuthi usabela kanjani ekwelashweni kwangaphambilini. Eminye imithi isetshenziselwa ukwelapha ezinye izimo (njengezifo ezizimele) ngaphezu komdlavuza.
Ithebula elingezansi libala eminye yemithi yokulwa ne-metabolite esetshenziswa kakhulu kanye nezinhlobo zomdlavuza ezelashwayo.
| Igama Lomuthi | Izinhlobo Zomdlavuza Ozelashwayo |
|---|---|
| I-Fluorouracil (5-FU) | Umdlavuza webele, wamathumbu amakhulu, wesisu, we-pancreatic kanye nowesikhumba |
| I-Capecitabine (Xeloda®) | Umdlavuza webele, wamathumbu amakhulu, wesisu, womqala kanye nowe-pancreatic |
| I-Gemcitabine (Gemzar®) | Umdlavuza webele, wamaphaphu (ongewona amaseli amancane), wesibeletho kanye nomdlavuza we-pancreatic |
| I-Methotrexate | I-Leukemia, i-lymphoma, umdlavuza webele, wamaphaphu, wekhanda nentamo, umdlavuza wamathambo (i-Osteosarcoma) |
| I-Cytarabine | Izinhlobo ezahlukene ze-leukemia (i-Acute myeloid, YONKE, i-CML) |
| I-Hydroxyurea | I-Leukemia (CML), umdlavuza wekhanda nentamo |
Lo muthi unikezwa kanjani emzimbeni?
Kunezindlela eziningana zokunikeza le mithi, kuye ngohlobo lomuthi onikezwayo.
- Ngokufakwa nge-intravenous (IV): Lena yindlela evame kakhulu. Umuthi ufakwa emzimbeni njengesixazululo sikasawoti nge-cannula noma i-chemo port ebekwe engalweni noma esifubeni. Lokhu kwelashwa kungase kuthathe imizuzu embalwa, amahora ambalwa, noma ngisho nezinsuku ezimbalwa.
- Njengomjovo: Eminye imithi inikezwa njengomjovo ongqimbeni olunamafutha ngaphansi kwesikhumba.
- Ithebhulethi: Amanye ama-antimetabolites ayatholakala njengamaphilisi angagwinywa.
- Njengokhilimu wokugcoba: Umuthi i-5-FU, osetshenziselwa ukwelapha umdlavuza wesikhumba (i-basal cell carcinoma), uyatholakala futhi njengokhilimu wokugcoba.
Yimiphi imiphumela emibi engaba khona yokwelashwa?
Isici esivamile semithi ye-chemotherapy ukuthi ihlose amaseli ahlukana ngokushesha. Amaseli omdlavuza awuhlobo lweseli elihlukana ngokushesha kakhulu. Kodwa inkinga iwukuthi, amanye amaseli anempilo emzimbeni wethu nawo ahlukana ngokushesha. Isibonelo:
- Amaseli e-follicle yezinwele
- Amaseli emlonyeni nasemgudwini wokugaya ukudla
- Amaseli esikhumba
- Amaseli akha igazi
Imithi yokulwa ne-metabolites ayikwazi ukuhlukanisa phakathi kwamangqamuzana omdlavuza namaseli anempilo. Ngakho-ke, lawa maseli anempilo nawo angonakala. Yingakho kuvela imiphumela emibi.
Imiphumela emibi evame kakhulu yile:
- Ukukhathala nokukhathala
- Ukulahlekelwa izinwele
- Izinguquko zesikhumba (isb. ukuqubuka )
- Isicanucanu nokuhlanza
- Uhudo (ubuhlungu besisu)
- Isifiso sokudla
Kodwa le miphumela emibi ayenzeki kubo bonke ngendlela efanayo. Kuncike emithini oyinikwayo, umthamo, njll. Ngakho-ke kubaluleke kakhulu ukukhuluma nodokotela wakho ngalokhu ngaphambi kokuqala ukwelashwa. Manje kunemithi eminingi yokulawula imiphumela emibi.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Izinzuzo:
Inzuzo eyinhloko yama-antimetabolites ukuthi abulala amangqamuzana omdlavuza futhi amise ukukhula kwesimila. Lokhu kungandisa impilo yomuntu ophila nomdlavuza futhi kwenze impilo ibe lula ngokulawula izimpawu.
Izingozi:
Ingozi enkulu yimiphumela emibi esixoxe ngayo ekuqaleni. Futhi, akuzona zonke izindlela zokwelapha umdlavuza ezisebenza ngendlela efanayo kuwo wonke umuntu. Umuthi othile ungase ungasebenzi kumdlavuza wakho. Ngokuhamba kwesikhathi, amangqamuzana omdlavuza angase amelane nomuthi, futhi umuthi ungase ungasebenzi kahle. Uma lokhu kwenzeka, udokotela wakho angase ancome umuthi ohlukile we-chemotherapy noma olunye ukwelashwa (isib., imisebe, i-immunotherapy).
Uma ukhulelwe, uncelisa, noma unesinye isimo sezokwelapha, qiniseka ukuthi wazisa udokotela wakho ngaphambi kokuqala lokhu kwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- Ama-antimetabolites uhlobo olukhethekile lomuthi we-chemotherapy "okhohlisa" amangqamuzana omdlavuza ukuze awavimbe ekuhlukaneni.
- Le mithi isebenza ngokuvimbela amangqamuzana omdlavuza ukuthi athole izinto zokusetshenziswa azidingayo ukuze enze i-DNA yawo (i-genetic planning).
- Lezi zisetshenziselwa ukwelapha izinhlobo eziningi ezahlukene zomdlavuza, njengebele, amaphaphu kanye ne-leukemia.
- Imiphumela emibi efana nokulahlekelwa izinwele kanye nesicanucanu ingenzeka ngoba lo muthi uthinta namaseli anempilo ahlukana ngokushesha.
- Ukufunda ngokwelashwa kungaba yinto eyesabekayo kancane. Kodwa ungesabi ukubuza udokotela wakho ngemithi oyinikwayo, izinzuzo zayo, ububi bayo, kanye nemiphumela emibi. Ukuba nolwazi oluhle kuyingxenye ebalulekile yokwelashwa.
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