Artesunate: Cov txiaj ntsig, koob tshuaj, kev phiv thiab lwm yam

Artesunate yog dab tsi?

Artesunate(pronounced ar-TEE-sue-nate) yog ib yam tshuaj uas los ntawm cov nroj tsuag hu ua Sweet wormwood (Artemisia xyoo). Nws yog ib pawg ntawm cov tshuaj hu ua artemisinin derivatives, thiab nws yog ib qho ntawm cov cuab yeej muaj zog tshaj plaws uas peb muaj tawm tsam malaria - kab mob tshwm sim los ntawm cov kab mob me me uas kis tau los ntawm yoov tshaj cum tom.

Cov kws tshawb fawb tsim artesunate kom zoo dua qub artemisinin. Tsis zoo li artemisinin, uas nyuaj rau lub cev nqus, artesunate dissolves yooj yim hauv dej. Qhov no txhais tau hais tias cov kws kho mob tuaj yeem muab nws ua kev txhaj tshuaj ncaj qha rau hauv cov hlab ntsha (IV) lossis cov leeg nqaij (IM), ua kom nws ua haujlwm sai dua - uas yog raws nraim qhov koj xav tau thaum ib tus neeg mob malaria.

Thaum artesunate nkag mus rau hauv koj lub cev, nws hloov mus rau hauv nws daim ntawv nquag, hu ua dihydroartemisinin (DHA). DHA ces mus ua hauj lwm tua cov kab mob malaria hauv koj cov qe ntshav liab.

Artesunate siv rau dab tsi?

Artesunate muaj ib txoj haujlwm tseem ceeb uas cawm neeg txoj sia txhua hnub:kho mob malaria hnyav.

Mob malaria tshwm sim thaum tus kab mob malaria ua rau muaj teeb meem loj hauv lub cev, xws li lub cev tsis ua haujlwm, tsis nco qab, lossis ua tsis taus pa. Tus mob no tua ntau pua txhiab tus neeg txhua xyoo, tshwj xeeb tshaj yog cov menyuam yaus hauv tebchaws Africa thiab lwm thaj chaw sov. Tab sis artesunate tau hloov qhov ntawd.

Ib txoj kev tshawb fawb loj hu ua SEAQUAMAT trial piv artesunate rau cov laus cov tshuaj quinine. Cov txiaj ntsig tau zoo kawg li: artesunate txo qhov kev pheej hmoo ntawm kev tuag los ntawm tus mob malaria hnyav txog li35%piv rau quinine. Tias yog vim li cas Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv (WHO) tam sim no pom zoo txhaj tshuaj artesunate lithawj - kab kev kho mob rau tus mob malaria hnyavnyob rau hauv cov neeg laus, cov me nyuam, cov me nyuam mos, thiab cov poj niam cev xeeb tub nyob rau hauv tag nrho cov trimesters.

Tab sis kev siv artesunate tsis nres ntawm malaria. Cov kws tshawb fawb tau tshawb pom tias artesunate kuj tseem muaj lwm yam khoom nthuav. Kev tshawb fawb tau pom tias artesunate qhia txog kev ua haujlwm tawm tsam qee hom mob qog noj ntshav, qee yam kab mob, thiab tseem muaj kev tiv thaiv - mob ntshav qab zib. Txawm li cas los xij, cov no tseem nyob rau theem tshawb fawb - artesunate tseem tsis tau pom zoo los kho cov mob no. Nws txoj hauj lwm tseem ceeb tseem tawm tsam malaria.

Artesunate muaj nyob rau hauv ntau hom: txhaj tshuaj txhaj (IV) rau cov mob hnyav, txhaj tshuaj intramuscular (IM) rau thaum IV nkag tau yooj yim, cov ntsiav tshuaj ntawm qhov ncauj rau kev ua raws li- kho, thiab txawm tias cov tshuaj suppositories rau kev siv xwm txheej ceev ua ntej tus neeg mob tuaj yeem mus txog tsev kho mob.

Artesunate ua haujlwm li cas?

Yuav kom nkag siab tias artesunate ua haujlwm li cas, koj yuav tsum paub me ntsis txog tus kab mob malaria parasite. Tus kab mob no nyob hauv koj cov qe ntshav liab thiab noj hemoglobin, cov protein uas nqa oxygen. Hemoglobin muaj hlau, thiab hauv cov hlau no yog ib yam hu ua heme.

Thaum artesunate nkag mus rau hauv cov ntshav liab uas kis tus kab mob malaria parasite, nws ua tau raws li qhov heme. Ob leeg ua ke ua ke, tsim cov khoom me me hu uadawb radicals. Xav txog cov dawb radicals raws li qhov tawg me me - lawv ua rau cov kab mob cab sab hauv tawm, rhuav tshem thiab tua nws sai heev.

Artesunate ua haujlwm sai dua li cov tshuaj malaria qub. Qhov tseeb, hauv thawj 24 teev ntawm kev kho mob, artesunate tuaj yeem tshem tawm ntau dua 90% ntawm cov kab mob los ntawm koj cov ntshav.

Lwm qhov zoo dua ntawm artesunate yog tias nws tua cov kab mob thaum lub sij hawm ntawm lawv lub neej voj voog thaum lawv muaj ntau ntau hauv koj cov qe ntshav liab. Qhov no yog vim li cas artesunate ua haujlwm sai heev thiab vim li cas nws thiaj li muaj txiaj ntsig zoo ntawm kev cawm neeg txoj sia nyob rau hauv cov mob malaria hnyav.

Yuav muab ntau npaum li cas ntawm Artesunate?

• Mob malaria (txhaj tshuaj):2.4 mg / kg ntawm 0, 12, thiab 24 teev, tom qab ntawd ib hnub ib zaug.
• Mild malaria (cov ntsiav tshuaj):Ib feem ntawm 3-hnub ACT chav kawm (ib zaug lossis ob zaug ib hnub).
• Emergency rectal:Ib koob tshuaj ib zaug (raws li hnub nyoog) ua ntej mus txog tsev kho mob.

Qhov txawv ntawm Artemether thiab Artesunate yog dab tsi?

Artemether thiab artesunate yog kwv tij txheeb ze - ob leeg los ntawm tib tsob nroj, thiab ob qho tib si yog artemisinin derivatives. Tab sis lawv tsis zoo ib yam, thiab qhov sib txawv tseem ceeb.

 Chemical txawv

• Qhov sib txawv tseem ceeb yog nyob ntawm seb lawv ua li cas. Artesunate yog dej-soluble, uas txhais tau tias nws dissolves yooj yim hauv dej. Artemether yog lipid-soluble, txhais tau tias nws dissolves zoo dua hauv cov roj thiab cov rog.
• Qhov no yuav zoo li me me, tab sis nws muaj qhov tshwm sim loj rau kev kho mob.

 Kev nrawm nrawm

• Vim artesunate yog dej-soluble, cov kws kho mob tuaj yeem muab nws ncaj qha rau hauv cov hlab ntsha (IV). Qhov no tau txais cov tshuaj mus rau hauv cov hlab ntsha tam sim ntawd, ua rau cov tshuaj ntau hauv lub cev sai heev.
• Artemether, ntawm qhov tod tes, feem ntau yog muab raws li kev txhaj tshuaj intramuscular (IM) - rau hauv cov leeg. Qhov no txhais tau tias cov tshuaj yog absorbed qeeb dua.

 Kev ua tau zoo nyob rau hauv Severe Malaria

• Cov kev tshawb fawb tau qhia tiastxhaj tshuaj artesunate zoo dua li artemether rau kev kho mob malaria hnyav. Kev tshawb fawb sib piv ob pom tias artesunate tshem cov kab mob sai dua. Qhov tseeb, ib txoj kev tshawb nrhiav pom tias qhov txawv ntawm kev ua tiav 90% txo cov kab mob ntawm 24 teev yog li tsib npaug siab dua nrog artesunate piv rau artemether.
• Lub koom haum WHO pom zoo kom artesunate yog thawj qhov kev xaiv rau mob npaws hnyav. Artemether tseem siv nyob rau hauv qee qhov chaw, tab sis feem ntau thaum artesunate tsis muaj.

 Cov ntawv thiab Muaj

• Artesunate: Kev txhaj tshuaj IV, txhaj tshuaj IM, ntsiav tshuaj ntawm qhov ncauj, tshuaj suppositories
• Artemether: Kev txhaj tshuaj IM, ntsiav tshuaj ntawm qhov ncauj (feem ntau ua ke nrog lumefantrine li Coartem)

 Kab hauv qab

Yog tias tus neeg mob muaj malaria hnyav, artesunate yog qhov kev xaiv zoo dua. Nws ua haujlwm sai dua thiab tau pom tias yuav cawm tau txoj sia ntau dua. Yog tias artesunate tsis muaj, artemether tseem zoo dua li qub tshuaj quinine. Tab sis thaum twg los tau, cov kws kho mob yuav xaiv artesunate rau cov mob hnyav.

Rau cov kab mob malaria tsis yooj yim, ob qho tib si artesunate thiab artemether yog siv hauv kev kho mob ua ke - artesunate nrog amodiaquine lossis pyronaridine, thiab artemether nrog lumefantrine (Coartem). Ob leeg siv tau rau mob malaria me.

Cov teebmeem ntawm Artesunate

Artesunate feem ntau muaj kev nyab xeeb heev, tshwj xeeb tshaj yog xav tias nws cawm txoj sia nyob rau hauv qhov xwm txheej txaus ntshai. Cov kev mob tshwm sim feem ntau yog mob me thiab ploj mus ntawm lawv tus kheej.

 Cov teebmeem tshwm sim

• xeev siab thiab ntuav- Qee tus neeg mob plab plab. Qhov no feem ntau tshwm sim nrog qhov ncauj artesunate.
• kiv taub hau lossis mob taub hau
• Mob plab
• Kev qaug zog thiab qaug zog

 Qhov cuam tshuam rau cov qe ntshav

Kev kuaj pom ntau tshaj plaws nrog artesunate yog qhov me me, txo qis hauv ib ntusreticulocytes- cov no yog cov qe ntshav liab hluas. Lub cev feem ntau hloov lawv sai sai tom qab kev kho mob xaus.

Qee qhov kev tshawb fawb kuj tau sau tseg me me hauv hemoglobin (cov protein hauv cov qe ntshav liab uas nqa oxygen). Qhov no feem ntau tsis loj thiab daws nws tus kheej.

 Mob hnyav heev (tsis tshua muaj)

Artesunate tuaj yeem tsis tshua muaj mob hu uapost-artesunate qeeb hemolysis (PADH). Qhov no yog thaum cov qe ntshav liab tawg sai heev, tshwm sim li 1 mus rau 4 lub lis piam tom qab kho. Nws muaj ntau dua nyob rau hauv cov neeg uas muaj cov kab mob cab ntau hauv lawv cov ntshav. Cov kws kho mob saib xyuas cov neeg mob kom pom cov tsos mob ntawm anemia tom qab kho.

 Kev ua xua

Kev ua xua rau artesunate tsis tshua muaj tab sis ua tau. Cov tsos mob muaj xws li pob khaus, khaus, o, lossis ua pa nyuaj. Yog tias qhov no tshwm sim, nrhiav kev pab kho mob tam sim ntawd.

 Kev nyab xeeb hauv cov neeg tshwj xeeb

• Kev xeeb tub: Kev txhaj tshuaj artesunate muaj kev nyab xeeb thiab pom zoo rau kev mob npaws hnyav hauv txhua lub peb hlis ntuj. Qhov txiaj ntsig ntawm kev cawm leej niam txoj sia nyob deb tshaj qhov muaj peev xwm txaus ntshai.
• Cov menyuam yaus: Artesunate muaj kev nyab xeeb thiab siv tau rau menyuam yaus. Cov koob tshuaj menyuam yaus yog nyob ntawm lub cev hnyav.
• Kab mob siab lossis raum: Artesunate tseem tuaj yeem siv tau, tab sis cov kws kho mob tuaj yeem saib xyuas koj zoo dua.

 Cov kab hauv qab ntawm Kev Nyab Xeeb

Artesunate tau siv ntau lab tus neeg mob thoob ntiaj teb. Thaum siv kom raug rau malaria, nws cov txiaj ntsig muaj ntau heev - nws cawm tau txoj sia. Feem ntau cov neeg zam nws zoo heev, thiab cov kev mob tshwm sim loj heev yog tsawg.

Leej twg yuav tsum tsis txhob noj Artesunate?

Muaj tsawg tus neeg uas tsis tuaj yeem noj artesunate. Txawm li cas los xij, muaj qee qhov tshwj xeeb tseem ceeb.

 Cov neeg uas paub Allergy

Yog tias koj tau muaj kev tsis haum xeeb rau artesunate lossis lwm yam tshuaj artemisinin (xws li artemether lossis dihydroartemisinin), koj yuav tsum tsis txhob noj artesunate.

 Thawj Trimester ntawm cev xeeb tub (rau Uncomplicated Malaria)

Rautsis nyuajmalaria hauv thawj peb lub hlis twg, WHO pom zoo kom ceev faj nrog artesunate. Thaum txhaj tshuaj artesunate tseem siv rau mob malaria thaum cev xeeb tub, rau cov mob me, cov kws kho mob yuav xav txog lwm txoj kev kho mob.

 Cov neeg noj tej yam tshuaj

Artesunate tuaj yeem cuam tshuam nrog qee yam tshuaj. Nco ntsoov qhia koj tus kws kho mob txog txhua yam tshuaj uas koj tab tom noj, suav nrog tshaj -- cov tshuaj thiab tshuaj ntxiv.

 Thaum twg Artesunate tseem siv txawm tias muaj kev txhawj xeeb?

Raumob malaria hnyav, yuav luag tsis muaj leej twg tiag tiag "tsis pub" coj artesunate. Tus mob malaria mob hnyav yog ib txoj sia -kev kub ntxhov. Lub koom haum WHO pom zoo kom artesunate rau mob malaria loj hauv txhua pab pawg neeg mob, suav nrog cov poj niam cev xeeb tub hauv txhua lub hlis twg, cov menyuam mos, menyuam yaus, thiab cov neeg laus. Thaum lwm txoj kev tuag, artesunate yuav luag txhua qhov kev xaiv yog.

Xaus

Artesunateyog ib qho tshuaj tseem ceeb tshaj plaws ntawm peb lub sijhawm. Nws tau hloov kho kev kho mob malaria hnyav, txo cov neeg tuag ntau dua ib -peb piv rau cov tshuaj laus. Nws ua haujlwm sai, muaj kev nyab xeeb rau txhua tus, thiab tuaj yeem muab ntau txoj hauv kev - IV, IM, qhov ncauj, thiab txawm tias qhov quav - ua rau nws muaj txiaj ntsig hauv tsev kho mob, chaw kho mob, thiab txawm nyob deb nroog.

Kev tshawb fawb pom tseeb: artesunate cawm neeg txoj sia. Lub koom haum WHO pom zoo tias nws yog thawj - kab kev kho mob rau tus mob npaws hnyav thoob ntiaj teb. Thiab rau cov kws tshawb fawb thiab cov chaw tsim khoom, siab- zoo artesunate hmoov muab lub hauv paus rau lub neej-txuag tshuaj uas ncav cuag ntau lab tus tib neeg txhua xyoo.

Txawm hais tias koj yog ib tus kws kho mob kho tus neeg mob uas mob malaria hnyav, tus kws tshawb fawb tshawb nrhiav kev siv tshiab rau qhov zoo tshaj plaws, lossis cov chaw tsim khoom tsim cov tshuaj tseem ceeb, artesunate yog cov tshuaj uas koj tuaj yeem ntseeg tau.

Hu rau tam sim no

Cov ntaub ntawv

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[2] Dondorp A, Nosten F, Stepniewska K, et al. Artesunate tiv thaiv quinine rau kev kho mob ntawm mob npaws falciparum malaria: ib qho kev sim randomized.Lancet. 2005; 366(9487): 717-725. (SEAQUAMAT sim)

[3] World Health Organization. Cov lus qhia rau malaria. Geneva: LEEJ TWG; 2024. (Hloov kho lub Kaum Ib Hlis 2024)

[4] de Carvalho LP, Kreidenweiss A, Rödl P, Held J. Qhov kev tshawb pom ua ntej thiab kev loj hlob ntawm qhov quav artesunate rau kev kho mob malaria hauv cov menyuam yaus: kev tshuaj xyuas cov pov thawj.Expert Opin Drug Discov. 2021 Lub Ib Hlis; 16(1): 13-22. doi: 10.1080/17460441.2020.1804357 ib. Epub 2020 Sep 14. PMID: 32921162.

[5] Li Q, Weina P. Artesunate: Cov Tshuaj Zoo Tshaj Plaws hauv Kev Kho Mob malaria hnyav thiab nyuaj.Pharmaceuticals. 2010 Lub Xya Hli 21; 3(7): 2322–2332. doi: 10.3390 / ph3072322. PIB: 27713348; PIB: PMC4033899.

[6] Ramsay A, et al. Rectal artemisinins rau malaria: kev tshuaj xyuas kev ua tau zoo thiab kev nyab xeeb los ntawm tus neeg mob cov ntaub ntawv hauv kev tshawb fawb soj ntsuam.BMC Kab Mob Sib Kis8:39; 0. doi: 10.1186/1471-2334-8-39 ib.

Kab lus no yog rau cov ntaub ntawv xov xwm nkaus xwb thiab tsis yog cov lus qhia kho mob. Malaria yog ib qho kev kho mob xwm txheej ceev. Yuav tsum nrhiav kev kho mob tam sim yog tias koj xav tias malaria, thiab tsis txhob kho tus kheej - kho artesunate yam tsis muaj kws kho mob cov tshuaj.