Munyori: Louise Ward
Zuva Rekusika: 4 Kukadzi 2021
Gadziridza Zuva: 1 Zvita 2024
Anonim
Emicizumab/Hemlibra® chez les personnes atteintes d’hémophilie A vivant avec inhibiteur
Vhidhiyo: Emicizumab/Hemlibra® chez les personnes atteintes d’hémophilie A vivant avec inhibiteur

Zvemukati

Chii chinonzi Hemlibra?

Hemlibra izita-zita mushonga mushonga. Iyo inorayirwa kudzivirira kubuda kweropa zvikamu kana kuita kuti zvisanyanya kuitika mune vanhu vane hemophilia A, kungave kana kana isina chinhu VIII (sere) inhibitors. Hemlibra inogamuchirwa kuti ishandiswe muvanhu veese mazera.

Hemlibra ine mushonga emicizumab, inova monoclonal antibody. Uyu ndiwo mushonga unogadzirwa kubva kumasero ezvirwere zvemuviri.

Hemlibra inouya semhinduro yakapihwa sejekiseni pasi peganda rako (subcutaneous). Mubatsiri wako wehutano anogona kukupa jekiseni, kana kuti inogona kuzvidzivirira kumba nevanhu vane makore manomwe kana kupfuura.

Mune zvidzidzo zvemakiriniki zvinogara kwemwedzi mitanhatu kana kupfuura, Hemlibra yakaderedza huwandu hweropa rakazara ne:

  • angangoita 94 muzana muvanhu vasina chinhu VIII inhibitors
  • makumi masere muzana muzana muvanhu vane factor VIII inhibitors

Rudzi rutsva rwemushonga

Pamberi peKudya neDrug Administration (FDA) isati yabvumidza Hemlibra, mhando huru yekurapa yaishandiswa kurapa hemophilia A yaive yechinzvimbo VIII kutsiva.


Vanhu vane hemophilia A havana chinhu VIII, puroteni muviri wako unoda kuumba maopa clots. Chinhu VIII chinotsiva kurapa chinoisa chinhu VIII muropa rako. Kazhinji, chinhu VIII chinotsiva chakagadzirwa murabhoritari, asi inogona zvakare kugadzirwa kubva yakapihwa plasma yeropa. Iyo yekurapa inopihwa sejekiseni mune imwe yetsinga dzako (intravenous).

Hemlibra inogadzirwa kubva kumasero ari murab. Panzvimbo pekutsiva chinhu VIII, Hemlibra inoshanda nekubatanidza kune chaiwo ekugwamba (mapuroteni) muropa. Izvi zvinogonesa iro ropa kugwamba zvakanaka pasina chinhu VIII, zvichibatsira kudzivirira kusadzora kubuda kweropa.

Hemlibra ndiwo mushonga wekutanga unoshandiswa kudzivirira kubuda ropa kune vanhu vane hemophilia A ingave kana isina chinhu VIII inhibitors. Inhibitors masoja ekudzivirira (immune system mapuroteni) anorwisa factor VIII uye anoidzivirira kubva pakuumba clots. Vamwe vanhu vanogadzira inhibitors kana vapihwa factor VIII kutsiva kurapa, zvichiita kuti kurapwa kusashande.

Hemlibra zvakare ndiwo wekutanga mushonga wehemophilia A waunogona kutora sejekiseni pasi peganda rako (subcutaneous). Uye zvakare, kune akati wandei anokwanisa madhizaikodhi, kusanganisira vhiki nevhiki, vhiki mbiri dzese, kana vhiki ina dzese. Mimwe mishonga yekurapa hemophilia A inoda kuti iwe uitore kazhinji kazhinji, kubva kune rimwe zuva roga roga kusvika kakawanda pavhiki.


FDA tendero

Chikafu neDrug Administration (FDA) yakatanga kubvumidza Hemlibra muna2017 kune vanhu vane hemophilia A ine factor VIII inhibitors.

Muna 2018, iyo FDA yakawedzera mvumo yayo kusanganisira vanhu vane hemophilia A vasina factor VIII inhibitors.

Hemlibra generic

Hemlibra inowanikwa chete sezita-zita remishonga. Haisi ikozvino inowanikwa mune generic fomu.

Hemlibra ine chinoshanda chinodhaka emicizumab, iyo dzimwe nguva inonzi emicizumab-kxwh. Kuguma "-kxwh" kunobatsira kumisikidza mushonga kure nemishonga yakafanana iyo inogona kuwanikwa mune ramangwana. Iyi ndiyo yakajairwa kutumidza mafomati eamonoclonal antibodies (zvinodhaka zvakagadzirwa kubva kuzvirwere zvemuviri masero).

Hemlibra chengetedzo

Chikafu neDrug Administration (FDA) inounganidza mishumo nezvezvakashata zvinodhaka. Veruzhinji uye vezvehutano vanoendesa aya mafaera kuDAA nekushandisa iyo MedWatch Yekuzvidira Yekuzivisa Fomu uye nekufonera 800-FDA-1088 (800-322-1088). Ese ari maviri FDA uye Genentech, mugadziri weHemlibra, anonyatsoongorora zvirevo zvekuchengetedza nezveHemlibra.


Mishumo yerufu

Muiti weHemlibra akataura nezverufu gumi pasirese dzakaitika vanhu vakatora Hemlibra. Idzi nzufu dzakaitika mushure mekunge FDA yabvumidza mushonga. Hazvisi pachena kana mushonga wacho wakakonzera chero kufa.

Mugadziri weHemlibra anoenderera mberi nekutarisa nhoroondo dzekuchengetedza nezve mushonga. Kana iwe uine mibvunzo nezve kana Hemlibra yakachengeteka kwauri, taura nachiremba wako.

Hemlibra mutengo

Sezvo nemishonga yese, mutengo weHemlibra unogona kusiyana.

Mutengo chaiwo wauchabhadhara unoenderana neinishuwarenzi yako yekuvhara uye pharmacy yaunoshandisa.

Mari uye inishuwarenzi rubatsiro

Kana iwe uchida rutsigiro rwemari kubhadhara Hemlibra, kana kana iwe uchida rubatsiro kuti unzwisise yako inishuwarenzi kufukidza, rubatsiro rwuripo.

Genentech, anogadzira Hemlibra, anopa chirongwa chinonzi Access Solutions. Kuti uwane rumwe ruzivo uye kuti uone kana iwe uchikodzera rutsigiro, fona 877-233-3981 kana shanyira iyo webhusaiti chirongwa.

Hemlibra muyero

Iyo Hemlibra muyero unorayirwa nachiremba wako inoenderana nezvakawanda zvinhu. Izvi zvinosanganisira:

  • uremu hwako
  • chirongwa chekurapa chiremba wako afunga chakanakira iwe

Ruzivo runotevera runotsanangura madosi ayo anowanzo shandiswa kana kukurudzirwa. Zvisinei, iva nechokwadi chekutora muyero uyo chiremba wako anokuraira iwe. Chiremba wako achasarudza yakanakisa dosi kuti ienderane nezvaunoda.

Mafomu emishonga uye simba

Hemlibra inouya mune imwe-dhivhosi vial ine akasiyana esimba reyero:

  • 30 mg / mL
  • 60 mg / 0,4 mL
  • 105 mg / 0,7 mL
  • 150 mg / mL

Imwe neimwe dosi inopihwa jekiseni pasi peganda rako (subcutaneous). Iwe unoshandisa chinu chimwe chete pajekiseni, wobva warasa chinu uye chero mvura yasara muhombodo.

Chipimo chemushonga we hemophilia A

Hemlibra inowanzo kupihwa pekutanga mukutakura doses, iyo inoteverwa neyekuchengetedza doses. Kuisa madosi nekukurumidza kunounza mushonga kusvika kumazinga epamusoro mumuviri wako. Ivo vangangokwirira kupfuura ekuchengetedza madhizaini kana kupihwa kakawanda.

Iwo mana ekutanga madosi eHemlibra ari kurodha doses. Vanopihwa se3 mg / kg kamwe pavhiki.

Yese dosi mushure meiyo muyero wekuchengetedza. Chiremba wako achasarudza yakanakisa yekuchengetedza dosi iwe. Muyero wako chaiwo unobva pane huremu hwako. Zvingave:

  • 1.5 mg / kg kamwe pavhiki
  • 3 mg / kg kamwe pavhiki mbiri
  • 6 mg / kg kamwe pavhiki ina

Tarira: Kirogiramu imwe (kg) yehuremu hwemuviri yakaenzana ne2,2 mapaundi. Semuenzaniso, kana iwe ukayera 150 pondo (68 kg), yako yekurodha dhiyo ye3 mg / kg ichave 204 mg yeHemlibra pasvondo.

Chiremba wevana

Dositi yevana inoenderana nehuremu hwavo, kungofanana nemadosi evakuru.

Ko kana ndikapotsa dosi?

Kana iwe ukarasikirwa neiyo dose yeHemlibra, tora iyo nekukurumidza sekurangarira kwako. Wobva watora iyo inotevera dosi zvinoenderana neyako yakajairwa purogiramu. Usatora miviri miviri pazuva rimwe chete. Kutora anopfuura mwero mumwe pazuva rimwechete kunowedzera njodzi yako kune zvakakomba mhedzisiro.

Ndichada here kushandisa mushonga uyu kwenguva refu?

Hemlibra haisi mushonga wehemophilia, uye inoda kutorwa nguva nenguva kuti ibatsire kudzivirira kubuda kweropa. Saka kana chiremba wako akasarudza kuti Hemlibra inzira yakachengeteka uye inoshanda yekurapa kwauri, vangangozvipa kwenguva yakareba.

Iko hakuna mushonga wehemophilia panguva ino.

Hemlibra mhedzisiro

Hemlibra inogona kukonzera zvinyoro kana zvakakomba mhedzisiro. Iri rinotevera runyorwa rine mamwe akakosha mhedzisiro mhedzisiro anogona kuitika uchitora Hemlibra. Rondedzero iyi haisanganisi zvese zvinokanganisa mhedzisiro.

Kuti uwane rumwe ruzivo nezve zvinogona kuitika mhedzisiro yeHemlibra, kana matipi ekuti ungagadzirise sei zvinokanganisa mhedzisiro, taura nachiremba wako kana wemishonga.

Zvimwe zvakajairika mhedzisiro

Iyo inowanzoitika mhedzisiro mhedzisiro yeHemlibra inogona kusanganisira:

  • jekiseni saiti yekuita (kutsvuka, kurwadziwa, kana unyoro kutenderedza nzvimbo iyo Hemlibra yakabaiwa)
  • musoro
  • kurwadza kwemajoini

Mazhinji emhedzisiro iyi anogona kuenda mukati memazuva mashoma kana vhiki dzinoverengeka. Kana vakanyanya kuoma kana kuti vasingaendi, taura nachiremba wako kana wemishonga.

Yakakomba mhedzisiro

Matambudziko akakomba kubva kuHemlibra haana kujairika, asi anogona kuitika.

Allergic reaction

Allergic reaction haina kuitika mumakiriniki ekuedzwa kweHemlibra. Zvisinei, sekune mishonga yakawanda, vamwe vanhu vanogona kugadzirisa zvirwere mushure mokutora Hemlibra. Zviratidzo zvehunhu husina kugadzikana hunogona kusanganisira:

  • kuputika kweganda
  • kuvava
  • kuburitsa (kudziya uye kutsvuka mukati meganda rako)

Imwe yakanyanya kukonzeresa kusagadzikana isingawanzo asi inogoneka. Zviratidzo zveakanyanya kusagadzikana maitiro zvinogona kusanganisira:

  • angioedema (kuzvimba pasi peganda rako, kazhinji mumaziso ako, miromo, maoko, kana tsoka)
  • kuzvimba kwerurimi rwako, muromo, kana huro
  • kunetseka kufema

Dana chiremba wako pakarepo kana iwe une chirwere chakakomba chinokonzera kuHemlibra. Fonera 911 kana zviratidzo zvako zvichinzwa kutyisidzira hupenyu kana kana iwe uchifunga kuti une chirwere chekukurumidzira.

Ropa rakagwamba (parinoshandiswa neAPCC)

Munguva yekurapwa neHemlibra, vamwe vanhu dzimwe nguva vanogamuchira mishonga inobatsira kumisa kubuda kweropa, senge yakaitwa prothrombin complex concentrate (aPCC). Yakakomba mhedzisiro mhedzisiro inogona kuitika kana iwe ukatora izvi zvinodhaka pamwechete, senge yakawedzera njodzi yekuvhara ropa. Njodzi yakanyanya muvanhu vanotora Hemlibra vanogamuchira anopfuura zana zana / kg yeAPCC pazuva kwenguva yakareba kupfuura maawa makumi maviri nemana.

Mhando dzeropa clots dzinogona kuitika kana iwe ukatora Hemlibra inePCC inosanganisira:

  • Thrombotic microangiopathy (kugwamba kweropa uye kukuvara mumidziyo midiki yeropa, kusanganisira iya iri muitsvo, maziso, huropi uye dzimwe nhengo). Zviratidzo zvinogona kusanganisira:
    • kusvotwa
    • kurutsa
    • kuzvimba kwemakumbo ako nemaoko
    • kushaya simba
    • kuita weti kushoma pane zvakajairwa
    • kurwadziwa mudumbu
    • kurwadziwa shure
    • yero yeganda rako uye nekuchena kwemeso ako
    • kuvhiringidzika
  • Ropa rinovhara mune mimwe mitsipa yeropa, kusanganisira iya iri mumapapu, musoro, maoko, uye makumbo. Zviratidzo zvinogona kusanganisira:
    • musoro
    • kunetseka kuona
    • kukosora ropa
    • kurwadziwa pachipfuva
    • kunetseka kufema
    • kukurumidza kurova kwemoyo
    • kuzvimba kwemakumbo ako nemaoko
    • kurwadziwa mumakumbo ako kana maoko

Kana uine zviratidzo zveropa, daidza chiremba wako ipapo. Fonera 911 kana zviratidzo zvako zvichinzwa kutyisidzira hupenyu kana kana iwe uchifunga kuti une chirwere chekukurumidzira.

Kana iwe ukava neropa rekuvhara panguva yekurapa neHemlibra uye aPCC, chiremba wako anogona kunge achimisa kutora zvese zvinodhaka kwechinguva. Chiremba wako achasarudza kana zvakachengeteka kuti iwe utange kutora Hemlibra zvakare.

Hemlibra inoshandisa

Chikafu neDrug Administration (FDA) inobvumidza mishonga yemishonga yakadai saHemlibra kurapa mamwe mamiriro.

Hemlibra yehemophilia A

Hemlibra FDA-inogamuchirwa kurapa vanhu veese mazera vane hemophilia A. Ino bvumidzwa kushandiswa muvanhu vane kana vasina factor VIII inhibitors kudzivirira kubuda ropa.

Chinhu VIII (sere) ipuroteni inowanzoitika muropa iro rinoita basa rakakosha mukugadzira ropa. Vanhu vane hemophilia A vanoshaya factor VIII, saka ropa ravo harivhare. Kusakwanisa kuumba maopa clots kunoisa vanhu vane hemophilia panjodzi yekubuda ropa isingamire. Dzimwe nguva izvi zvinogona kuuraya.

Hemlibra isati yabvumidzwa, kurapwa kukuru kwehemophilia A kwaive kwechikonzero VIII kutsiva kurapwa. Uku kurapa kunotsiva chinhu VIII chiri kushaikwa muropa.

Asi vamwe vanhu vanogadzira inhibitors pavanopihwa factor VIII kutsiva kurapwa. Inhibitors masoja ekudzivirira (immune system mapuroteni) anorwisa factor VIII, achidzivirira iyo factor VIII kutsiva kurapwa kubva mukushanda.

Hemlibra inoshanda neimwe nzira. Panzvimbo pekutsiva chinhu VIII, Hemlibra inobatanidza mamwe mapuroteni eropa pamwechete. Izvi zvinogonesa iro ropa kugwamba zvakanaka pasina factor VIII. Nekuti hazvireve kutsiva factor VIII, Hemlibra inoshanda zvinobudirira kunyangwe paine inhibitors muropa.

Hemlibra yemamwe mamiriro

Hemlibra haina kushandiswa kurapa chero imwe nzvimbo yekubuda ropa.

Hemlibra yehemophilia B (kwete kushandiswa kwakakodzera)

Hemlibra haina kushandiswa kudzivirira kubuda kweropa kune vanhu vane hemophilia B. Ndiko nekuti vanhu vane hemophilia B varikushaiwa chimwe chinovhara ropa (protein yeropa) pane vanhu vane hemophilia A.

  • hemophilia A: kushaikwa kwekuvharisa factor VIII (sere)
  • hemophilia B: kushaikwa kwekuvhara chinhu IX (mapfumbamwe)

Hemlibra haigadzirire iyo isipo chinhu IX. Saka haigone kushandiswa kudzivirira kubuda kweropa muvanhu vane hemophilia B.

Hemlibra nevana

Hemlibra is FDA-inogamuchirwa kuti ishandiswe muvana veese mazera, kunyangwe vacheche. Mushonga uyu unoshandiswa kuchinangwa chimwe chete nevakuru. Hemlibra inobatsira kudzivirira kubuda kweropa kune vanhu vane hemophilia A ine kana isina chinhu VIII inhibitors.

Mirayiridzo yekushandisa Hemlibra

Iwe unofanirwa kutora Hemlibra zvinoenderana nemirayiridzo yemupi wako wezvehutano.

Mubatsiri wako wehutano anogona kukupa majekiseni eHemlibra mukiriniki kana muhofisi. Kana ivo vanogona kukudzidzisa iwe kuzvipa iwe jekiseni.

Zvinogona kubatsira kuchengeta danda rejekiseni rako. Sanganisira ruzivo rwakadai se:

  • zuva rejekiseni rega rega
  • iyo jekiseni saiti
  • iyo vial lot ruzivo (unogona kuwana izvi pane vial) *

* Kurekodha vial lot ruzivo inobatsira vatapi vezvehutano kutarisisa mashandisirwo emishonga yekuzvarwa, senge Hemlibra. Idzi ruzivo runobatsira kana chakakomba mhedzisiro mhedzisiro ikaitika.

Pazasi pane ruzivo rwekuti ungajowa sei Hemlibra iwe pachako. Kuti uwane rumwe ruzivo, vhidhiyo, uye zvinobatsira sei -mifananidzo, ona iyo Hemlibra webhusaiti, kusanganisira ino nhanho-nhanho gwara.

Kugadzirira kubaya Hemlibra

Verenga kuburikidza nhanho idzi usati wazvipa jekiseni reHemlibra.

  1. Tora gaba (kana magaba, zvinoenderana nedosi rako) reHemlibra kunze kwefiriji maminetsi gumi nemashanu usati waronga kubaya. Izvi zvinobvumidza mushonga kuti uuye kune tembiricha yemukati usati wabaya jekiseni.
  2. Usaedze kudziya mhinduro mu microwave kana nekuimhanyisa pasi pemvura inopisa. Izvi zvinogona kuita kuti Hemlibra isanyanya kuchengetedzeka, uye inogona kusashanda zvakare.
  3. Tarisa vial kuti uone kuti mhinduro yacho yakajeka kune zvishoma yero. Kana iine makore, makara, kana iine zvidimbu, usashandise. Usazunungusa chinu.
  4. Paunenge uchimirira Hemlibra kuti uuye kutembiricha yemukati, unganidza zvaunopa. Zvimwe kunze kweiyo Hemlibra vial (s), iwe yauchazoda: Doro rinopukuta, donje gauze, donje mabhora, chinja tsono, sirinji, jekiseni rejekiseni nedziviriro, uye inopinza mudziyo wekurasa.
  5. Geza maoko nesipo nemvura.
  6. Sarudza yako jekiseni saiti. Inogona kuve imwe yenzvimbo nhatu idzi: Dumbu nzvimbo (inokwana 2 inches kure kubva padumbu rako bhatani), pamberi pechidya chako, uye kumashure kweruoko rwako rwepamusoro (kana mumwe munhu achikupa jekiseni)
  7. Dzivisa kujowa mumamota kana chero ganda rakatsvuka, rakapwanywa, kana mavanga.

Jekiseni Hemlibra

Tevedza nhanho idzi kubaya Hemlibra.

Kugadzirira vial uye jekiseni

Kuti uwane vial uye sirinji yakagadzirira jekiseni, tevera nhanho idzi:

  1. Bvisa kapu kubva muhari uye uikandire kure mumudziyo wako wekurasa marara.
  2. Chenesa pamusoro pevhavha yekumisa nedoro pukuta.
  3. Sungirira iyo yekuchinjisa tsono (ichiri mune yayo yekudzivirira cap) kune sirinji. Ita izvi nekusundidzira nekumonyorora tsono yekuchinjisa zvichitenderera nguva kusvika zvabatanidzwa.
  4. Zvishoma nezvishoma dzokera kumashure pane plunger yesirinji yekukwevera mweya. Chiremba wako anokuudza iwe chaiyo huwandu.
  5. Bata sirinji nebhari neruoko rumwe. Ita shuwa kuti tsono iri kunongedza kumusoro.
  6. Ngwarira kudhonza chivharo chetsono chakanangana netsono. Usarase kapu kure. Iwe unozoida kuti idzokerezve yekuchinjisa tsono mushure mekunge waishandisa. Isa chivharo pane yakachena, yakati sandara pamusoro. Usaise tsono yekuchinjisa pasi mushure mekunge isina kuvharwa.

Kuzadza sirinji

Aya ndiwo matanho ekuzadza sirinji:

  1. Bata vial pane yakati sandara pamusoro. Jekiseni iyo yekuchinjisa tsono yakananga pasi mukati meiyo vial chimiso.
  2. Kuchengeta tsono mumudziyo, tora vial uiitenderedze.
  3. Nenongedzo pamusoro penzvimbo yemushonga, pusha plunger kuti ujekise mweya munzvimbo iri pamusoro pemushonga. Usapinza mweya mumushonga.
  4. Kuchengeta munwe wako pane plunger, dhonza iyo sirinji pasi kusvikira tsono yenyuchi iri mukati memushonga.
  5. Zvishoma nezvishoma dhonza plunger pasi kuti uzadze sirinji ine inopfuura iyo mari inodiwa padosi rako. .
  6. Kuchengeta sirinji mumudziyo, tarisa chero mabhuru emhepo makuru anogona kukudzivirira kuti utore dosi rako rakazara. Kana iwe ukaona chero, zvinyoronyoro tora iyo sirinji dhiramu neminwe yako kuitira kuti mabhuru akwire kumusoro. Wobva waisa zvishoma nezvishoma plunger kuti tsono iri mumhepo pamusoro pemushonga. Ramba uchimanikidza plunger kuti ubvise mabhuru kubva mujekiseni.
  7. Tarisa uone kuti huwandu hwemishonga musiringi hwave kushoma pane kana hwakaenzana neyako dosi yakatemwa. Kana zvirizvo, dhonza plunger kuti tsono iri mukati memushonga zvakare. Wobva waramba uchidhonza plunger kudzamara huwandu hwayo mujekiseni hwapfuura mwero wakatemwa.
  8. Dzokorora nhanho nhanhatu ne7 kuti uve nechokwadi chekuti hapana mabhuru musyinji uye iwe une dosi chaiyo musyinji.
  9. Bvisa sirinji uye tumira tsono kubva mundiro.

Kurasa tsono yekuchinjisa

Kana uchinge wazadza sirinji, unozoda kuvhara uye kurasa tsono yekuchinjisa. Heano maitiro:

  1. Bata sirinji mune rumwe ruoko uye tsvedza yekuchinjisa tsono mukapu yayo, iyo iwe yawakaisa pane yakati sandara pamusoro. Scoop kumusoro kuti iyo kapu inotsvedza kuti ifukidze tsono.
  2. Ita shuwa kuti tsono yakavharwa nekapu. Nerumwe ruoko rwako, tinya pasi pane chivharo kuti ubatanidze zvizere nesirinji.
  3. Bvisa tsono yekuchinjisa kubva mujekiseni nekuimonyanisa zviendesane nemawoko uye zvinyoro nyoro uchidhonza. (Haungashandise tsono yekuchinjisa kubaya mushonga. Izvi zvinorwadza uye zvinogona kukonzera kukuvara kweganda.)
  4. Kanda tsono yekuchinjisa mumudziyo wekurasa marara.

Jekiseni Hemlibra

Paunenge wagadzirira kubaya Hemlibra, tevera nhanho idzi:

  1. Pukuta yako yakasarudzika jekiseni saiti nedoro pukuta uye rega iite mweya uome kweinenge gumi masekondi.
  2. Sungai jekiseni rejekiseni kusirinji nekusunda nekumonyanisa wachi kusvika zvanyatso chengeteka.
  3. Dhonza nhoo yekuchengetedza kubva kune tsono (yakananga kune sirinji barrel).
  4. Ngwarira kubvisa kapu kubva pane tsono uye uikandire kure mumudziyo wekurasa marara. Dzivisa kubata chipikiri chetsono, uye usaise tsono pane chero nzvimbo.
  5. Mushure mekubvisa kapu, unofanirwa kubaya Hemlibra ipapo ipapo. Fambisa iyo plunger musyinji kuti uwirirane neyako yakatemwa dosi. Iyo yepamusoro rim ye plunger inofanirwa kunge ichienderana nechiratidzo cheyako yakatarwa dosi.
  6. Tsinya ganda rako panzvimbo yejekiseni yawasarudza.
  7. Kurumidza uye nekusimba, nyatso nyatso tsono pa45-degree kana 90-degree angle mukati meganda rakapetwa. Usatsikirira pombi ipapo.
  8. Kana iyo tsono yaiswa zvizere mukati meganda rako, rega nzvimbo yakapinhwa.
  9. Zvishoma nezvishoma dzvanya pombi pasi kusvikira wajoina mishonga yese.
  10. Bvisa tsono nekuidhonza kunze nekona imwechete yawakapinza.

Mushure mekubaya Hemlibra

Paunenge wabaya Hemlibra, tevera nhanho idzi:

  1. Isa tsono pasi pakapfava. Dhavhara tsono nekudzvanya nhovo yekuchengetedza pane sirinji kumberi pane 90-degree angle (kure nebharari). Teerera kurira kwekudzvanya. Izvo zvinoita kuti iwe uzive kuti tsono yakavharwa zvizere mudziviriro.
  2. Chengeta iyo tsono mujekiseni. Usabvisa. Uye usatsiva jekiseni retsono rejekiseni.
  3. Kanda vial yakashandiswa, tsono, uye sirinji mumudziyo wako wekurasa marara.
  4. Kana iwe ukaona madonhwe mashoma eropa pane yako jekiseni saiti, tinya iyo donje bhora kana gauze panzvimbo ipapo. Kana kubuda ropa kukasamira, dana chiremba wako.
  5. Dzivisa kukwiza jekiseni saiti.

Nguva yekutora Hemlibra

Chiremba wako anokuudza iwe kangani kutora Hemlibra. Ivo vangangoda kuti iwe utore Hemlibra kamwe pavhiki, kamwe chete paimwe vhiki, kana kamwe chete pavhiki ina.

Tora Hemlibra pazuva rimwe chete revhiki. Semuenzaniso, kana iwe ukatora Hemlibra kamwe pavhiki, unogona kusarudza kuitora Muvhuro wega wega.

Zviyeuchidzo zvemishonga zvinogona kubatsira kuve nechokwadi chekuti hauzorasikirwa nemushonga.

Hemlibra uye doro

Iko hakuna kuzivikanwa kuwirirana pakati peHemlibra nedoro. Zvisinei, kana iwe uine hemophilia A, ropa rako haripfeke zvakanaka. Kunwa doro kunogona zvakare kudzivirira ropa rako kubva pakugadzira clots nekudzora huwandu hwezvinhu zvinogwamba muropa rako. Nekuda kweizvozvo, kunwa doro rakawandisa uchitora Hemlibra kunogona kudzora mashandiro eHemlibra.

Kana iwe ukanwa doro, taura nachiremba wako nezve kana kunwa uchitora Hemlibra kwakachengeteka kwauri.

Kubatana kweHemlibra

Hemlibra inogona kusangana nemimwe mimwe mishonga. Iyo inogona zvakare kudyidzana nemamwe marabhoritari bvunzo.

Kukurukurirana kwakasiyana kunogona kukonzera mhedzisiro. Semuenzaniso, kumwe kudyidzana kunogona kukanganisa mashandiro anoita mushonga. Kumwe kudyidzana kunowedzera mhedzisiro kana kuita kuti zvinyanye kuoma.

Hemlibra nemimwe mishonga

Pazasi pane mishonga inogona kubatana neHemlibra. Urongwa urwu hauna mishonga yose inogona kuwirirana neHemlibra.

Usati watora Hemlibra, taura nachiremba wako uye wemishonga. Vaudze nezvese zvinyorwe, pamusoro-pe-counter, uye mimwe mishonga yaunotora. Vaudzewo nezve chero mavitamini, mahebhu, uye zvinowedzera zvaunoshandisa. Kugovera ruzivo urwu kunogona kubatsira iwe kudzivirira kusangana kunogona kuitika.

Kana iwe uine mibvunzo nezve kudyidzana kwezvinodhaka zvinogona kukukanganisa, bvunza chiremba wako kana wemishonga.

Hemlibra uye yakagadziriswa prothrombin yakaoma concentrate (aPCC)

Yakagadziriswa prothrombin yakaoma concentrate (aPCC) mushonga unobatsira kumisa kubuda kweropa. Kunyange Hemlibra inogona kushandiswa neAPCC, kutora mishonga iyi pamwechete kunogona kuwedzera njodzi yako yekuvhara ropa. Iyi njodzi yakanyanya muvanhu vanotora Hemlibra vanogamuchira anopfuura zana mayuniti / kg yeAPCC pazuva kwenguva yakareba kupfuura maawa makumi maviri nemana.

Kana iwe uchida aPCC paunenge uchitora Hemlibra, chiremba wako anozokutarisa zvakanyanya pazviratidzo zveropa. Mamwe magopa eropa anogona kunge akakomba, uye ungangoda kutsvaga kurapwa ipapo ipapo. (Kuti uwane rumwe ruzivo, ona chikamu che "Hemlibra mhedzisiro" chikamu pamusoro.)

Kana iwe ukava neropa rekuvhara ropa uchitora mishonga iyi pamwechete, chiremba wako angangoda kuti iwe umire kutora Hemlibra. Ivo vanozofunga kana zvakachengeteka kuti iwe utange kutora mushonga zvakare.

Hemlibra uye mamwe hemophilia A zvinodhaka

Kutora Hemlibra neimwe hemophilia A mishonga inogona kuwedzera njodzi yako yekugwamba kweropa. Yakananga dosing mirairo yekushandisa Hemlibra uye imwe hemophilia A mishonga inosanganisira zvinotevera:

  • Rega kushandisa chero anodarika maajenzi (kurapwa kwevanhu vane inhibitors) zuva usati watanga kutora Hemlibra. Mienzaniso yekupfuura vamiririri anti-inhibitor coagulant tata (FEIBA) uye inogadzirisazve yevanhu coagulation Factor VIIa (NovoSeven).
  • Kana zvichidikanwa, ramba uchiita factor VIII kutsiva kurapa kweinosvika svondo rimwe mushure meyero yako yekutanga yeHemlibra.

Kana iwe uine mibvunzo nezvekuti ungatora sei mamwe marapirwo ehemophilia neHemlibra, taura nachiremba wako.

Hemlibra uye kumwe kuongorora kwerebhu

Hemlibra inogona kupindirana nemhedzisiro yemamwe mamabvunzo bvunzo uye ichipa kuverenga kwenhema. Iyi bvunzo inosanganisira iyo inotarisa kuti ropa rako rinotora nguva yakareba sei kuti rigadzire. Imwe yeiyi bvunzo ndiyo yakaomeswa chikamu chetromboplastin nguva (aPTT) bvunzo.

Hemlibra inogona kukanganisa mhedzisiro yemiedzo kwenguva yakareba semwedzi mitanhatu mushure mekupedzisira kwedosi. Paunenge uchida kuwana bvunzo bvunzo, udza chiremba wako nezve chero yazvino kana yapfuura Hemlibra kurapwa kuti vagone kuraira kwakakodzera bvunzo.

Dzimwe nzira dzeHemlibra

Mamwe marapirwo aripo anokwanisa kudzivirira kubuda ropa kana kuderedza kuwanda kweropa muvanhu vane hemophilia A. Dzimwe dzinogona kunge dzakakodzerana newe kupfuura vamwe. Kana iwe uchifarira kutsvaga imwe nzira kune Hemlibra, taura nachiremba wako.

Hemlibra yakasarudzika nekuti iyo:

  • inoshanda zvakasiyana neyakajairwa kurapwa (chinhu VIII chinotsiva zvigadzirwa)
  • inoshanda kuvanhu vane uye vasina chinhu VIII inhibitors
  • ndiyo yekurapa kwekutanga iwe yaunogona kutora se subcutaneous jekiseni (jekiseni pasi peganda), pachinzvimbo chekupinza mukati (jekiseni mutsinga)
  • unogara uchishanda muropa kwenguva yakareba, saka unogona kuzotora vhiki nevhiki, kamwe chete pasvondo, kana kamwe chete pamwedzi.
  • haina kugadzirwa kubva muplasma yemunhu kana ropa
  • hazvikonzeri chinhu VIII inhibitors kukura

Mamwe marapirwo ehemophilia A anosanganisira anti-inhibitor coagulant tata (FEIBA), inoitwa prothrombin complex concentrate (aPCC).

Mazhinji akasiyana ekuvharisa factor VIII ekurapa ekurapa aripo anogona kushandiswa kazhinji kubatsira kudzivirira kubuda kweropa, kusanganisira:

  • Adynovate
  • Eloctate
  • Jivi
  • Kovaltry
  • Novoeight

Chiremba wako achataura newe nezvezvakanaka nezvayakaipira zvakasiyana hemophilia A kurapwa. Vachashanda newe kuti vawane kurapwa kunoenderana zvakanyanya nezvido zvako.

Mashandiro anoita Hemlibra

Hemophilia A chirwere chekubuda ropa. Inokonzerwa nekushaikwa kwekugwamba kwechinhu chinonzi factor VIII (sere). Kuvhara zvinhu mapuroteni muropa ayo anobatsira kudzora kubuda ropa.

Pasina chinhu VIII, ropa rako harigone kuita chigwamba kana uchinge wabuda ropa kana kukuvara. Izvi zvinogona kutungamira kune ine ngozi, pamwe inouraya kubuda ropa.

Hemlibra inorwisa monoclonal antibody, inova immune system sero inogadzirwa murabhoritari. Yakagadzirwa kubva kumasero emhuka uye haina chero plasma yemunhu kana ropa.

Maantibodies, ayo zvakare anowanzoitika mumuviri, anonamira kune chaiwo mamorekuru muropa. Hemlibra inosunga kumamorekuru maviri: yakagadziriswa clotting factor IX (pfumbamwe) uye kugwamba factor X (gumi).

Kazhinji, chinhu VIII chinobatanidza chinhu IX uye factor X. Asi mune hemophilia A, factor VIII inoshaikwa. Hemlibra inoshanda nekutamba chinzvimbo icho VIII ingadai yakatamba. Inounza chinhu IX uye factor X pamwechete kuti vagone kubatsira iro fomu reropa kugwamba. Izvi zvinobatsira kudzikisa huwandu hweanogona kubuda ropa.

Hemlibra inoshanda sei kune vanhu vane inhibitors?

Kune vamwe vanhu vane haemophilia, masoja avo anoita ma antibodies (immune system protein) kuita factor VIII painopihwa sekurapwa. Aya ma antibodies anorwisa factor VIII, iyo inodzivirira factor VIII kutsiva kurapwa kubva mukushanda.

Hemlibra inoshanda neimwe nzira kubva kuchinhu VIII chinotsiva kurapwa. Panzvimbo pekutsiva chinhu VIII, Hemlibra inotamba chikamu VIII ingadai yakatamba nekubatanidza mamwe mapuroteni eropa kune mumwe nemumwe. Izvi zvinogonesa iro ropa kugwamba zvakanaka pasina factor VIII. Nekuda kweizvozvo, Hemlibra inoshanda zvine mutsindo kunyangwe paine inhibitors muropa.

Zvinotora nguva yakareba sei kuti zvishande?

Hazvizivikanwe kuti uchakurumidza sei kuona kubuda kweropa kushoma mushure mekutanga Hemlibra. Kliniki miedzo yakaratidza kuti vanhu vaive neropa shoma shoma mukati memwedzi mitanhatu yekutora Hemlibra. Nekudaro, mhedzisiro yekutongwa haina kuratidza apo kuderedzwa kweropa kwakatanga kuitika.

Izvo zvakati, isu tinoziva kuti mushure mejekiseni, zvinotora pakati pezuva rimwe kana maviri kuti ropa rako ripinze Hemlibra. Uye mwero wakadzikama wemushonga unochengetwa muropa rako mushure memavhiki mana ekutanga eiyo dosing.

Kana iwe uine mibvunzo nezvekuti iwe unofanirwa kuona riini kubva kuHemlibra, taura nachiremba wako.

Hemlibra uye nhumbu

Hazvizivikanwe kana Hemlibra yakachengeteka kutora panguva yekuzvitakura. Iko hakuna kuve nekudzidza kwevanhu kana kwemhuka kuyedza kuchengetedzwa kweHemlibra kushandiswa panguva yekuzvitakura.

Kana iwe ukatora Hemlibra uye urikufunga kuve nepamuviri, taura nachiremba wako nezve kana uchifanira kuramba uchitora Hemlibra.

Ive neshuwa yekushandisa yekuzvarwa uchitora Hemlibra kana chiremba wako akati hazvina njodzi kuti iwe ubate pamuviri panguva yekurapwa.

Hemlibra uye kuyamwisa

Hazvizivikanwe kana Hemlibra inopinda mumukaka wemukaka wemunhu. Kana iwe uchiyamwisa mwana wako uye uchifunga kutora Hemlibra, taura nachiremba wako nezve kana mushonga uyu wakachengeteka kumwana wako.

Mibvunzo yakajairika nezveHemlibra

Heano mhinduro kumimwe inowanzo bvunzwa mibvunzo nezve Hemlibra.

Hemlibra inogona here kushandiswa mune vanhu vasina inhibitors?

Ehe. Hemlibra FDA-inogamuchirwa kuti ishandiswe mune vanhu vane hemophilia A vasina inhibitors (pamwe nevanhu vanoita). Zvidzidzo zvekuchipatara zvakafananidza Hemlibra pasina kurapwa. Vakatarisa mapoka maviri evanhu vasina mainhibitors: vana vechirume vane makore gumi nemaviri zvichikwira, nevarume vakuru. Iwo mapoka maviri akatora mushonga kweanokwana makumi maviri nemana masvondo uye aive ne:

  • 95 muzana vashoma kubuda ropa pavanotora 1.5 mg / kg yeHemlibra vhiki rega rega
  • 94 muzana vashoma kubuda ropa pavanotora 3 mg / kg yeHemlibra vhiki mbiri dzese

Kubudirira kweHemlibra muzvidzidzo kwakafanana pakati pevanhu vane inhibitors uye vasina inhibitors.

Hemlibra inoshandiswa kurapa hemophilia B?

Kwete, Hemlibra haina kushandiswa kudzivirira kubuda kweropa kune vanhu vane hemophilia B.

Vanhu vane hemophilia B vanoshaya chakasiyana-siyana chekugwamba kupfuura vanhu vane hemophilia A:

  • hemophilia A: kushaikwa kwekugwamba chinhu VIII
  • hemophilia B: kushaikwa kwekugwamba kwechinhu IX

Hemlibra yakanyatsogadzirwa kubatsira vanhu vari kushaya factor VIII. Naizvozvo, hazvingashande kune vanhu vanoshaya clotting factor IX.

Hemlibra inoporesa hemophilia here?

Kwete. Hakuna mushonga wehemophilia panguva ino. Hemlibra inoshanda kudzivirira zvikamu zvekubuda ropa, asi hazvirape chirwere.

Hemlibra inogadzirwa kubva muropa plasma?

Kwete, Hemlibra haina kugadzirwa kubva muropa plasma. Iyo antibody (immune system protein) yakagadzirwa kubva mumasero murabhoritari. Iko hakuna plasma yemunhu kana masero eropa emunhu anoshandiswa kugadzira Hemlibra.

Hemlibra inonatswa uye sterilized. Iyo hainawo chero hutachiona hunogona kutapurira vanhu.

Hemlibra inowedzera njodzi yangu yekuvhara ropa here?

Hemlibra inogona kuwedzera njodzi yekuvhara ropa kana ikatorwa neyakagadziriswa prothrombin yakaoma concentrate (aPCC). Uyu ndiwo mushonga unobatsira kumira kubuda ropa nekuwedzera kuvhara ropa.

Zvidzidzo zvekiriniki zvakatarisa kune vanhu vakatora Hemlibra ndokurapwa neAPCC. Vanhu vatatu vane thrombotic microangiopathy (kuwanda kweropa mumidziyo midiki yeropa). Vanhu vaviri vaive nezviitiko zve thrombotic (ropa clot) mune mimwe mitsipa yeropa. Mune imwe neimwe yezviitiko izvi, huwandu hwese hweCCC hwaive hwakakura kupfuura zvikamu zana / kg pazuva kwenguva yakareba kupfuura maawa makumi maviri nemana.

Kana iwe uchida kurapwa neAPCC kumisa kubuda kweropa paunenge uchitora Hemlibra, taura nachiremba wako. Pamwe chete munogona kukurukura njodzi yenyu yekugwamba kweropa.

Ichi chinodhaka chinokonzeresa chero nyaya neangu enguva dzose bvunzo bvunzo?

Zvingadaro. Hemlibra inogona kukanganisa mhedzisiro kubva kuongororo dzebhu dzinoyera kuti ropa rako rakagwamba sei. Imwe yeiyi bvunzo ndiyo yakaomeswa chikamu chetromboplastin nguva (aPTT) bvunzo. Hemlibra inogara mumuviri wako kwenguva yakareba, uye inogona kukanganisa mhedzisiro yemwedzi inosvika mitanhatu mushure mekupedzisira kwedhizaiti. Ive neshuwa yekuudza chiremba wako nezve chero aripo kana apfuura Hemlibra mishonga usati watora chero bvunzo bhu.

Hemlibra yambiro

Mushonga uyu unouya neyambiro kubva kuFood and Drug Administration (FDA).

FDA yambiro: Thrombotic microangiopathy uye thrombotic zviitiko

Mushonga uyu une yambiro yebhokisi. Iyi ndiyo yambiro yakakomba kubva kuDAA. Yambiro yebhokisi inozivisa vanachiremba nevarwere nezvezvinodhaka zvinogona kuva nenjodzi.

Kutora Hemlibra uye kugashira yakagadziriswa prothrombin yakaoma concentrate (aPCC) yekubuda ropa kunogona kuwedzera njodzi yako yezvakakomba ropa kuwanda. Zviitiko zveTrombotic (kuwanda kweropa) zvinogona kuitika munhengo huru kana zvikamu zvemuviri, kusanganisira mapapu, musoro, maoko, kana makumbo. Izvo zvinogona zvakare kuitika mumidziyo midiki yeropa munhengo dzakadai seitsvo uye huropi. Kuvhara kweropa kunogona kuva nenjodzi uye kunoda kurapwa nekukurumidza.

Zvidzidzo zvekiriniki zvakatarisa kune vanhu vakatora Hemlibra ndokurapwa neAPCC. Vanhu vatatu vane thrombotic microangiopathy (kuwanda kweropa mumidziyo midiki yeropa). Vanhu vaviri vaive nezviitiko zve thrombotic (ropa clot) mune mimwe mitsipa yeropa. Mune imwe neimwe yezviitiko izvi, huwandu hwese hweCCC hwaive hwakakura kupfuura zvikamu zana / kg pazuva kwenguva yakareba kupfuura maawa makumi maviri nemana.

Kana iwe ukava neropa rekuvhara panguva yekurapa neHemlibra uye aPCC, chiremba wako anogona kunge achimisa kutora zvese zvinodhaka kwechinguva. Chiremba wako achasarudza kana zvakachengeteka kuti iwe utange kutora Hemlibra zvakare.

Tarira: Kuti uwane rumwe ruzivo nezve zvingangoitika zvakaipa zveHemlibra, ona chikamu che "Hemlibra mhedzisiro" chikamu pamusoro.

Hemlibra kudarika

Kutora yakawandisa Hemlibra kunogona kuwedzera njodzi yako kune zvakakomba mhedzisiro.

Ovhadhozi zviratidzo

Zviratidzo zvekutora zvakawandisa Hemlibra zvinogona kusanganisira:

  • musoro
  • kurwadza kwemajoini

Kutora yakawandisa Hemlibra kunogona zvakare kuwedzera njodzi yako kune yakakomba ropa clots. Mune zvimwe zviitiko, ungangoda kutsvaga kurapwa kweropa ipapo. (Kuti uwane rumwe ruzivo nezve zvingangoita kugwamba kweropa, ona iyo "Hemlibra mhedzisiro mhedzisiro" chikamu pamusoro.

Zvekuita kana ovhadhozi

Kana iwe uchifunga kuti watora zvakawandisa zvemushonga uyu, fonera chiremba wako. Iwe unogona zvakare kufonera iyo American Association yePoison Control Centres pa800-222-1222 kana kushandisa yavo yepamhepo chishandiso. Asi kana iwe uine zviratidzo zvakakomba, fonera 911 kana enda kune yepedyo emergency kamuri ipapo.

Hemlibra kupera, kuchengetedza, uye kurasa

Paunowana Hemlibra kubva kuhemesi, wemishonga anowedzera zuva rekupera kune zvakanyorwa pabhodhoro. Zuva iri rinowanzo kuve gore rimwe kubva musi wakapihwa mushonga.

Zuva rekupera rinobatsira kuvimbisa kushanda kwemushonga panguva ino. Chimiro chazvino cheKudya neDrug Administration (FDA) ndechekudzivirira kushandisa akapera mishonga. Kana iwe usina kushandisa mishonga yakapfuura nguva yekupera, taura nachiremba wako. Iwe unogona achiri kukwanisa kuishandisa.

Kuchengetedza

Inguva yakareba sei mushonga unoramba wakanaka unogona zvinoenderana nezvinhu zvakawanda, zvinosanganisira kuti unochengetera mushonga kupi uye kupi.

Chengeta mabhodhoro ako eHemlibra mufiriji. Zviise mumudziyo wakasimbiswa uye usingadziviriri mwenje. Kana zvichidikanwa, unogona kutora hombodo kubva mufiriji kwenguva isingasviki mazuva manomwe. Ipapo iwe unofanirwa kuzvidzosera mufiriji. Usachengetera ndiro dziri patembiricha dzakakwirira kupfuura 86 ° F (30 ° C) pavanenge vabuda mufiriji.

Mushure mekuvhura vial, ishandise ipapo ipapo. Kanda chero chikamu chemhinduro chausingashandise.

Kubvisa

Kana iwe usisiri kuda kutora Hemlibra uye uine mishonga yasara, zvakakosha kuirasa zvakachengeteka. Izvi zvinobatsira kudzivirira vamwe, kusanganisira vana nezvipfuwo, kubva pakutora mushonga netsaona. Izvo zvinobatsirawo kuchengetedza mushonga kubva mukukuvadza nharaunda.

Mushure mekushandisa, ive shuwa yekuisa zvekushandisa senge magaba, tsono dzine tsono caps, uye majekiseni mune yako sharps yekurasa mudziyo.

Iyo FDA webhusaiti inopa akati wandei matipi anobatsira pakuraswa kwemishonga. Iwe unogona zvakare kubvunza wako wemishonga kuti uwane ruzivo rwekuti ungarase sei mushonga wako.

Ruzivo rwehunyanzvi rweHemlibra

Ruzivo runotevera rwunopihwa varapi uye vamwe vashandi vezvehutano.

Zviratidzo

Hemlibra (emicizumab-kxwh) ndiyo FDA-inogamuchirwa kuti ishandiswe seyakajairwa prophylaxis yekudzivirira kana kudzikisa kuwanda kwezvikamu zvekubuda ropa mune varwere veese mazera ane hemophilia A (congenital factor VIII kushomeka) ine kana isina factor VIII inhibitors.

Nzira yekuita

Hemlibra ibispecific (ine maviri akasiyana antigen-anosunga masosi) monoclonal antibody inosunga kune ese ari maviri chinhu IX uye factor X. Kusunga kune ese ari maviri zvinhu kunodzosera isipo yakagadziriswa chinhu VIII mashandiro nekukorobha yakagadziriswa chinhu IX uye factor X. Iyi nzira yekuita inobvumira coagulation cascade kuti ienderere mberi, ichiwedzera kugadzirwa kwema clot. Hemlibra inoramba ichishanda pamberi pechinhu VIII inhibitors.

Pharmacokinetics uye metabolism

Zvinoreva kutora hafu-yehupenyu mazuva 1,6 anotevera kunamatira kunotsvedza. Absolute bioavailability iri pakati pe80.4 muzana uye 93.1 muzana.

Zvinoreva kubvisa hafu yeupenyu mazuva makumi maviri nematanhatu.

Contraindications

Iko hakuna zvinopesana kune Hemlibra kushandiswa.

Kuchengetedza

Hemlibra ndiro dzinofanira kuchengetwa mufiriji pa36 ° F kusvika 46 ° F (2 ° C kusvika 8 ° C) mumudziyo wepakutanga, wakachengetedzwa kubva pachiedza. Hari hadzifanirwe kunge dzakagwamba nechando kana kuzungunuswa. Kana zvichidikanwa, magaba asina kuvhurwa anogona kuchengetwa kunze kwefriji obva adzorerwa mufiriji kwemazuva asingasviki manomwe pane tembiricha isingapfuure 86 ° (30 ° C). Kana uchinge wabviswa kubva muhombodo, rasa chikamu chisina kushandiswa kana chikasashandiswa ipapo.

Disiki: Medical News Nhasi yaedza nepese painogona napo kuti ive neruzivo rwekuti ruzivo rwese rwuri rwechokwadi, rwakazara, uye rwechizvino-zvino. Nekudaro, chinyorwa ichi hachifanirwe kushandiswa sekutsiva ruzivo uye hunyanzvi hweane rezinesi rezvehutano. Iwe unofanirwa kugara uchibvunza chiremba wako kana imwe nyanzvi yehutano usati watora chero mushonga. Ruzivo rwezvinodhaka ruri pano runogona kuchinja uye haruna kuitirwa kufukidza ese mashandisirwo, madhairekitori, chenjedzo, kunyeverwa, kudyidzana kwezvinodhaka, allergic reaction, kana mhedzisiro. Kushaikwa kweyambiro kana rumwe ruzivo rwemushonga wakapihwa hakuratidze kuti mushonga kana musanganiswa wezvinodhaka wakachengeteka, unoshanda, kana wakakodzera kuvarwere vese kana kushandiswa kwese chaiko.

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