I-Tenofovir

I-Tenofovir

I-Tenofovir umuthi onamandla we-antiviral osephenduke insika ekwelapheni nasekulawuleni i-HIV kanye nezifo ezingelapheki i-hepatitis B. Lo muthi uguqule izimpilo zeziguli eziningi, unikeza ithemba kanye nemiphumela yezempilo ethuthukisiwe. Amaphilisi e-Tenofovir asebenza ngokuvimba igciwane ukuthi lingaziphindaphindi, okusiza ukulawula ukutheleleka nokunciphisa umthelela walo emzimbeni.

Ake sihlole ukusetshenziswa kwe-tenofovir nokuthi isebenza kanjani ukulwa nezifo ezibangelwa amagciwane. Sizophinde sibheke indlela efanele yokuthatha lo muthi, imiphumela engemihle engenzeka, kanye nezinyathelo zokuphepha ezidingekayo okufanele uzikhumbule.

Iyini i-Tenofovir?

Umuthi we-tenofovir ungowesigaba semithi ebizwa ngokuthi i-nucleotide analogue reverse transcriptase inhibitors (NRTIs). Lo muthi usebenza ngokunciphisa inani le-HBV ne-HIV egazini, usiza ukuphatha lezi zimo ezingamahlalakhona ngempumelelo.

Kunezinhlobo ezimbili eziyinhloko ze-tenofovir:

I-Tenofovir Disoproxil Fumarate (TDF): Leli fomu lisetshenziselwa ukwelapha ukutheleleka nge-HIV-1 kubantu abadala nasezinganeni ezineminyaka emibili ubudala nangaphezulu ezinesisindo esingu-10 kg okungenani. I-TDF iyasebenza futhi ekwelapheni isifo sokusha kwesibindi kohlobo B esingelapheki eqenjini leminyaka efanayo nebanga lesisindo.

I-Tenofovir Alafenamide (TAF): Leli fomu lelapha isifo sokusha kwesibindi kohlobo B esingamahlalakhona kubantu abadala kanye nezingane ezineminyaka engu-12 nangaphezulu ngokuzinzile isifo sesibindi.

Kubalulekile ukuqaphela ukuthi i-tenofovir ayilona ikhambi le-HIV noma i-hepatitis B. Kunalokho, isiza ukulawula lezi zimo ngokunciphisa umthamo wegciwane emzimbeni.

Ukusetshenziswa Kwethebhulethi ye-Tenofovir

• Okulandelayo okunye ukusetshenziswa okuvamile kwe-tenofovir:
• Ukwelashwa kwegciwane le-hepatitis B (HBV)
• Ukwelashwa kwe-human immunodeficiency virus (HIV)
• Yehlisa ingozi yokuba nezinkinga ze-HIV kanye nengculaza
• Ukuze uthole ukwelashwa kwe-HIV, odokotela banikeza i-tenofovir kanye neminye imithi yezidambisigciwane.

Isetshenziswa Kanjani Ithebhulethi ye-Tenofovir

Iziguli zidinga ukuthatha i-tenofovir ngendlela efanele ukuze zithole inzuzo enkulu kulo muthi. Nansi inkomba yokuthi usetshenziswa kanjani amaphilisi e-tenofovir:

• Ithebhulethi ye-tenofovir ivamise ukuba yingxenye yohlelo lwenhlanganisela. Thatha yonke imithi enqunywe udokotela wakho ngesikhathi esifanele sosuku ukuze isebenze kangcono. Ungathathi okuningi noma okuncane kwakho noma kaningi kunalokho okushiwo.
• Amaphilisi e-Tenofovir DF ngokuvamile athathwa kanye ngosuku, ngokudla noma ngaphandle kokudla. Ngakolunye uhlangothi, iziguli kufanele ziphuze amaphilisi e-tenofovir AF kanye ngosuku kanye nokudla.
• Thatha i-tenofovir ngesikhathi esifanayo nsuku zonke ukuze ugcine ukugxila kwezidakamizwa okungaguquki emzimbeni wakho.
• Ungayeqi imithamo, njengoba imithamo engekho ingenza igciwane likwazi ukumelana nemithi, okwenza kube nzima ukuyelapha.
• Qhubeka nokuthatha i-tenofovir noma ngabe uzizwa uphilile. Ungami ngaphandle kokukhuluma nodokotela wakho kuqala.

I-Tenofovir DF iyatholakala njengempushana yomlomo ezigulini ezingakwazi ukugwinya amaphilisi. Nansi indlela yokuyisebenzisa:

• Sebenzisa isikophu somthamo esinikezwe ephaketheni ukukala inani elifanele lempushana.
• Engeza impushana kuma-ounces angu-2 kuya kwangu-4 okudla okuthambile njenge-apulasi, ukudla kwezingane, noma iyogathi. Xuba impushana nokudla kahle ngesipuni.
• Yidla ingxube ngokushesha ukuze ugweme ukunambitheka okubabayo.
• Ungagcini isikophu ngaphakathi kwephakheji nempushana.

Imiphumela Emibi Yezibhebhe Ze-Tenofovir

Ithebhulethi ye-tenofovir, njengemithi eminingi, ingabangela imiphumela engemihle.

Imiphumela Emibi Evamile:

• Uhudo
• bekhanda
• Ukucindezeleka
• Ukuqhuma noma ukuluma
• Ubunzima bokulala noma ukuhlala ulele
• Ukudabuka noma ukuhlanza
• Ugesi, ukushaya kwenhliziyo, noma ukungagayeki kahle kokudla
• Ukwehla kwesisindo
• Ukuhlungu obusemhlane

Imiphumela Emibi Kakhulu:

• I-Lactic Acidosis: Izimpawu zihlanganisa ubuthakathaka, ukushaya kwenhliziyo okungavamile noma okusheshayo, isiyezi, ubuhlungu bemisipha, ubuhlungu besisu nesicanucanu nokuhlanza, ukuphefumula kanzima, kanye nemizwa yokubanda emilenzeni noma ezingalweni.
• Izinkinga Zesibindi: Bheka izimpawu ezinjengomchamo omnyama, ubuhlungu besisu noma ukungakhululeki, ukukhathala, ukuphuzi kwesikhumba namehlo (i-jaundice), nesicanucanu.
• Izinkinga zezinso: Izimpawu zingabandakanya ukukhathala, ukuqaqamba, ukukhukhumala, ukuncipha kokuchama kanye ukuvuvukala kwezinyawo kanye namaqakala.
• Izinkinga Zamathambo: I-Tenofovir ingase ibangele ukuncipha kwamaminerali amathambo, okuholela ebuhlungu obuqhubekayo noma obubi kakhulu.
• I-Immune Reconstitution Syndrome: Njengoba amasosha omzimba eqina, angase asabele ezifweni ebezifihliwe ngaphambili emzimbeni.

Eminye imiphumela emibi kakhulu edinga ukunakekelwa kwezokwelapha ngokushesha ihlanganisa:

• Ubuhlungu engxenyeni engenhla kwesokudla sesisu
• Isiyezi noma ikhanda elikhanyayo
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• Ukuphelelwa umoya noma ukuphefumula ngokushesha
• Izandla nezinyawo ezinombala obandayo noma oluhlaza okwesibhakabhaka
• Izimpawu zokutheleleka (umkhuhlane, ukugodola, noma umphimbo obuhlungu)

Ukuqapha

Ukuthatha i-tenofovir kudinga ukucatshangelwa ngokucophelela kwezinto ezimbalwa ezibalulekile ukuze kuqinisekiswe ukwelashwa okuphephile nokusebenzayo, okuhlanganisa:

• Umlando Wezokwelapha: Kubalulekile ukwazisa udokotela ngayo yonke imithi eqhubekayo, okuhlanganisa incwadi kadokotela, okungabhalwanga, imithi yesintu, noma amavithamini, njengoba i-tenofovir isebenzisana neminye imithi embalwa.
• Ukuhlola Okuvamile: I-Tenofovir ingase yenyuse ingozi yokuphuka kwamathambo (ukuphuka) nenkinga yezinso, okuhlanganisa ukuhluleka kwezinso. Ukuze kuncishiswe lezi zingozi, iziguli kufanele zilandele zonke izivivinyo zegazi eziyalwe udokotela wazo futhi zigweme eminye imithi engase ilimaze izinso, njengemithi ethile yezinhlungu ezilwa namagciwane noma i-NSAID.
• Ukuqapha Umthamo: Akufanele ushintshe umthamo wakho noma uyeke ukusebenzisa lesi sidakamizwa ngaphandle kokukhuluma nodokotela wakho kuqala.
• Gwema Utshwala: Nciphisa noma gwema ukuphuza isiphuzo esidakayo, njengoba kungase kwenyuse ingozi yemiphumela emibi yomuthi, njenge-pancreatitis nesibindi.
• Vimbela Ukudluliselwa: Kubalulekile ukuqaphela ukuthi i-tenofovir ayiwehlisi amathuba okudlulisela ukutheleleka nge-HIV, ngakho-ke iziguli kufanele zenze ucansi oluphephile futhi zigweme ukwabelana ngezinaliti ukuvimbela ukutheleleka.

Isebenza kanjani Ithebhulethi ye-Tenofovir

I-Tenofovir yehlisa inani le-HIV ne-HBV egazini, ikwenze kube ukwelashwa okusebenzayo kwakho kokubili izifo.

Uma isiguli sithatha i-tenofovir, umzimba uyayithatha bese uyiguqulela esimweni sayo esisebenzayo. Leli fomu elisebenzayo, i-tenofovir diphosphate, lisebenza njengesinqamuli seketango. Incintisana namabhulokhi wokwakha wemvelo we-viral DNA, ikakhulukazi i-deoxyadenosine 5'-triphosphate. Ngokwenza kanjalo, i-tenofovir ivimbela igciwane ukuthi lingaziphindaphinda ngempumelelo.

Ekwelashweni kwe-HIV, i-tenofovir iqondise ku-enzyme ye-reverse transcriptase, ebaluleke kakhulu ekuzaleni kwegciwane. Iphazamisa ikhono lale enzyme lokukopisha izakhi zofuzo zegciwane, imise ukusabalala kwe-HIV emzimbeni futhi yehlise umthamo wegciwane.

Nge-hepatitis B, i-tenofovir isebenza ngokuvimbela i-HBV polymerase. Le enzyme ibalulekile ukuze igciwane le-hepatitis B liphindaphinde i-DNA yalo. Ngokuvimbela le nqubo, i-tenofovir yehlisa umthamo wegciwane esibindini nasegazini.

Ukusebenza kahle kwe-Tenofovir kusekwazini kwayo ukukhomba ama-enzyme egciwane ngenkathi inobudlelwane obuphansi be-DNA polymerase yamangqamuzana omuntu. Lokhu kukhetha kusho ukuthi kungaphazamisa ukuphindaphinda kwegciwane ngaphandle kokuphazamisa kakhulu izinqubo ezivamile zamaselula, okunomthelela kuphrofayela yayo yokuphepha.

Ngingayiphuza i-Tenofovir Neminye Imithi?

I-Tenofovir ingasebenzisana nezinye izidakamizwa, okuhlanganisa:

• Ama-antibiotics afana ne-amikacin ne-gentamicin
• Abacavir
• Abemaciclib
• I-Abrocitinib
• I-Adefovir
• IBupropion
• I-Celecoxib
• I-Didanosine
• I-Diflunisal
• I-Feprazone
• Indomethacin
• I-Itraconazole
• I-Mefenamic Acid
• I-Orlistat
• Eminye imithi ye-HIV, njenge-atazanavir
• Imithi yobuhlungu, njenge-aceclofenac ne-acemetacin

Ulwazi Lomthamo

I-Tenofovir itholakala ngezindlela ezehlukene, okuhlanganisa amaphilisi (150 mg, 200 mg, 250 mg, kanye nama-300 mg) kanye nempushana yomlomo (40 mg/g). Impushana yomlomo izuzisa izingane noma abantu abadala abanobunzima bokugwinya amaphilisi. Umthamo we-tenofovir uncike eminyakeni yobudala yesiguli, isisindo, kanye nesimo sezempilo.

• Ngokwelashwa Kokutheleleka Nge-HIV: 
  • Kubantu abadala kanye nezingane ezineminyaka emibili nangaphezulu ezinesisindo esingu-35 kg noma ngaphezulu, umthamo ojwayelekile ngu-300 mg kanye ngosuku. Izingane ezinesisindo esingaphansi kwama-35 kg zithola umthamo osuselwa kusisindo:
    • 28 kuya ngaphansi kuka-35 kg: 250 mg kanye ngosuku
    • 22 kuya ngaphansi kuka-28 kg: 200 mg kanye ngosuku
    • 17 kuya ngaphansi kuka-22 kg: 150 mg kanye ngosuku
• Ngezifo ze-Hepatitis B Ezingamahlalakhona:
  • Abantu abadala kanye nezingane ezineminyaka emibili nangaphezulu abanesisindo esingu-35 kg noma ngaphezulu bathatha ama-300 mg (7.5 scoops of oral powder) kanye ngosuku. Umthamo ulungiswa ngokusekelwe kwesisindo sezingane ezinesisindo esingaphansi kwama-35 kg.

FAQ sika

1. Isetshenziselwa ini i-tenofovir?

I-Tenofovir umuthi onamandla we-antiviral osetshenziselwa ukwelapha izifo ezimbili ezibalulekile zegciwane: i-HIV kanye negciwane le-hepatitis B elingapheli (HBV). Ukuze uthole ukwelashwa kwe-HIV, odokotela banikeza i-tenofovir kanye neminye imithi yezidambisigciwane ukulawula ukutheleleka. I-Tenofovir isiza ukwehlisa inani le-HIV kanye negciwane le-hepatitis B egazini, okuvumela amasosha omzimba ukuthi asebenze kangcono.

2. Kungani i-tenofovir ithathwa ebusuku?

I-Tenofovir ivamise ukuthathwa kanye ngosuku, ngokudla noma ngaphandle kokudla. Nokho, abanye odokotela bangase batusa ukuyithatha ngaphambi kokulala. Ukuthatha i-tenofovir ngesikhathi sokulala kungenza imiphumela ethile engemihle ingakhathazi, njengesiyezi, ukozela, noma ubunzima bokugxila.

3. Ingabe i-tenofovir iphephile esibindini?

I-Tenofovir ngokuvamile ibhekwa njengephephile esibindini. Isetshenziselwa ukwelapha isifo sokusha kwesibindi kohlobo B esingamahlalakhona, esithinta isibindi. Nokho, ezimweni ezingavamile, i-tenofovir ingase ibangele izinkinga zesibindi. Iziguli kufanele zazi izimpawu zokulimala kwesibindi, njenge umchamo omnyama, ubuhlungu besisu noma ukungaphatheki kahle, ukuguquguquka okuphuzi kwamehlo nesikhumba, ukukhathala, nesicanucanu. Uma lezi zimpawu zenzeka, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.

4. Ingabe i-tenofovir iyingozi ezinso?

I-Tenofovir ingaba nomthelela ekusebenzeni kwezinso kwezinye iziguli. Kungase kwenyuse ingozi yezinkinga zezinso, okuhlanganisa ukuhluleka kwezinso. Kubalulekile ukulandela konke ukuhlolwa kwegazi okuyalwe udokotela wakho futhi ugweme eminye imithi engase ilimaze izinso, njengemithi ethile yokulwa namagciwane noma i-NSAID.

5. Yini okufanele uyigweme uma uthatha i-tenofovir?

Lapho uthatha i-tenofovir, iziguli kufanele zigweme:

• Ukweqa imithamo noma ukumisa umuthi ngaphandle kokubonisana nodokotela wabo.
• Ukuthatha eminye imithi ngaphandle kokuxoxa ngayo nodokotela wabo.
• Ukuphuza ngokweqile utshwala.
• Ukwabelana ngezinaliti noma ukuya ocansini olungavikelekile.

6. Ungakanani umkhawulo weminyaka ye-tenofovir?

I-Tenofovir igunyazwe ukuthi isetshenziswe ezinganeni ezineminyaka emibili nangaphezulu ezinesisindo esingu-10 kg okungenani. Abantu abadala abanawo umkhawulo weminyaka engaphezulu, kodwa ukulungiswa kwemithamo kungase kudingeke ezigulini esezikhulile, ikakhulukazi lezo ezinokuncipha kokusebenza kwezinso. I-Tenofovir ayigunyaziwe ukuthi isetshenziswe ezinganeni ezingaphansi kweminyaka emibili ubudala.

7. Yisiphi isikhathi esingcono kakhulu sokuthatha i-tenofovir?

I-Tenofovir ivamise ukuthathwa kanye ngosuku. Isikhathi esingcono kakhulu sokuwuthatha ngesikhathi esifanayo usuku ngalunye ukugcina amazinga angashintshi omuthi emzimbeni wakho. Ezinye iziguli zithola kuwusizo ukuthatha i-tenofovir nokudla ukuze kwehlise ukucasuka kwesisu. Nokho, abantu ngabanye bangayithatha ngokudla noma ngaphandle kokudla.

8. Ingabe i-tenofovir iholela ekuqothukeni kwezinwele?

Ukulahlekelwa izinwele akuwona umphumela omubi ovame ukubikwa we-tenofovir. Nokho, uchungechunge lwakamuva lwamacala lubike i-alopecia (ukulahlekelwa izinwele) okuhlobene ne-tenofovir alafenamide (TAF), uhlobo olusha lwe-tenofovir, kwabesifazane base-Afrika baseMelika. Lokhu kubonakala kuyivelakancane, futhi ucwaningo olwengeziwe luyadingeka ukuze kuqondwe ubudlelwano phakathi kwe-tenofovir ne ukulahlekelwa izinwele.

9. Ingabe i-tenofovir idala ukukhuluphala?

Ubudlelwano phakathi kwe-tenofovir nezinguquko zesisindo bunzima. Olunye ucwaningo luphakamisa ukuthi i-tenofovir disoproxil fumarate (TDF) ingase ihlotshaniswe nokuncipha kwesisindo noma ukucindezela. Ngokuphambene, ukushintsha usuka ku-TDF uye ku-tenofovir alafenamide (TAF) kuhlobene nokuzuza isisindo kwezinye iziguli, ikakhulukazi uma kuhlanganiswa neminye imithi yezidambisigciwane.