Mea Kākau: Laura McKinney
Lā O Ka Hana: 4 Apelila 2021
HōʻAno Hou I Ka Lā: 16 Mei 2024
Anonim
All About Ninlaro (Ixazomib)
Wikiō: All About Ninlaro (Ixazomib)

Anter

He aha ʻo Ninlaro?

ʻO Ninlaro kahi lāʻau lapaʻau inoa inoa inoa inoa i hoʻohana ʻia e mālama i nā myeloma he nui i nā mākua. ʻO kēia ʻano he ʻano maʻi ʻaʻai laha ʻole e hoʻopili i kekahi o nā hunaola keokeo i kapa ʻia he mau hunaola plasma. Me nā myeloma he nui, lilo nā hunaola plasma maʻamau i maʻi ʻaʻai a kapa ʻia he mau myeloma.

Ua ʻae ʻia ʻo Ninlaro no ka hoʻohana ʻana i ka poʻe i hoʻāʻo mua ma kahi o hoʻokahi lāʻau ʻē aʻe no kā lākou myeloma maha. Hiki i kēia lāʻau ke lilo i lāʻau lapaʻau a i ʻole kahi kaʻina hana.

ʻO Ninlaro kahi papa o nā lāʻau i kapa ʻia nā proteasome inhibitors. He lāʻau hoʻomākaukau ia no ka myeloma maha. Nā pahuhopu Ninlaro (hana ma) kahi protein kikoʻī i loko o nā hunaola myeloma. Hoʻokumu ia i kahi buildup o ka protein i loko o nā hunaola myeloma, kahi e make ai kēlā mau hunaola.

Hele mai ʻo Ninlaro ma ke ʻano he capsule i lawe ʻia e ka waha. E lawe ʻoe iā Ninlaro me nā lāʻau myeloma ʻelua ʻē aʻe: lenalidomide (Revlimid) a me dexamethasone (Decadron).

Ka hoʻokō ʻana

I ka wā o ka noiʻi ʻana, ua hoʻonui ʻo Ninlaro i ka lōʻihi o ka manawa i noho ai kekahi poʻe me ka myeloma he nui me ka ʻole o ka maʻi e holomua ana. Kapa ʻia kēia lōʻihi o ka manawa ke ola-manuahi holomua.


Ua nānā ʻia kahi noiʻi hoʻokolohua i ka poʻe me myeloma he nui i hoʻohana mua i hoʻokahi ʻano lāʻau ʻē aʻe no ko lākou maʻi. Ua mahele ʻia ka poʻe i ʻelua hui. ʻO ka hui mua i hāʻawi ʻia iā Ninlaro me nā lenalidomide a me dexamethasone. Ua hāʻawi ʻia ka hui ʻelua i kahi placebo (lapaʻau me ka lāʻau hana ʻole) me nā lenalidomide a me dexamethasone.

Ua noho ka poʻe i lawe i ka hui Ninlaro no ka awelika o 20.6 mau mahina ma mua o ka holo ʻana o kā lākou myeloma maha. ʻO ka poʻe e lawe ana i ka hui placebo i noho ma ka awelika o 14.7 mau mahina ma mua o ka holo ʻana o kā lākou myeloma maha.

ʻO nā poʻe i lawe i ka hui Ninlaro, 78% i pane i ka lāʻau. ʻO kēia ka mea i loaʻa iā lākou ma kahi o 50% hoʻomaikaʻi i kā lākou hoʻokolohua hoʻokolohua i nānā no nā pūnaewele myeloma. I ka poʻe i lawe i ka hui placebo, 72% o ka poʻe i like ka pane i ka lapaʻau.

ʻO Ninlaro generic

Loaʻa ʻo Ninlaro ma ke ʻano he lāʻau lapaʻau inoa. ʻAʻole i loaʻa i kēia manawa i ka palapala generic.

Hoʻokomo ʻia ʻo Ninlaro i hoʻokahi mea hana lāʻau: viazomib.


Nā hopena ʻē aʻe o Ninlaro

Hiki iā Ninlaro ke hana i nā hopena ʻoluʻolu a koʻikoʻi paha. Loaʻa i nā papa inoa aʻe kekahi o nā hopena ʻē aʻe i hiki ke hana ʻia i ka wā e lawe ana iā Ninlaro. ʻAʻole pili kēia mau papa inoa i nā hopena ʻaoʻao āpau.

No ka ʻike hou aku e pili ana i nā hopena hopena o Ninlaro, e kamaʻilio me kāu kauka a kauka paha. Hiki iā lākou ke hāʻawi iā ʻoe i nā ʻōlelo aʻoaʻo e pili ana i ka hana me nā hopena ʻē aʻe e hoʻonāukiuki paha.

Nā hopena ʻaoʻao maʻamau

ʻO nā hopena ʻē aʻe i ʻike pinepine ʻia o Ninlaro hiki ke hoʻopili ʻia:

  • ʻeha kua
  • ʻike hihi ʻole
  • maka maloʻo
  • conjunctivitis (i kapa ʻia he maka poni)
  • shingles (herpes zoster virus), ʻo ia ke kumu i kahi ʻeha ʻeha
  • neutropenia (pae keʻokeʻo koko keʻokeʻo haʻahaʻa), hiki ke hoʻonui i kou makaʻu i nā maʻi

E hala paha ka hapa nui o kēia mau hopena i loko o kekahi mau lā a i ʻole ʻelua mau pule. Inā ʻoi aku ke koʻikoʻi a i ʻole hele aku, e kamaʻilio me kāu kauka a kauka paha.

Nā hopena hopena koʻikoʻi

Hiki ke maʻamau nā hopena ʻino me Ninlaro. Kāhea koke i kāu kauka inā loaʻa nā hopena koʻikoʻi. Kāhea iā 911 inā manaʻo kou mau hōʻailona i ka hoʻoweliweli ola a i ʻole inā manaʻo ʻoe e loaʻa ana kahi pilikia olakino.


Hiki i nā hopena ʻē aʻe a me kā lākou mau hōʻailona ke hoʻohui i kēia:

  • ʻO ke neuropathy ākea (hōʻino i kou aʻa). Hiki i nā ʻōuli ke hoʻohui pū:
    • ʻalalā a i ʻole wela i ke ahi
    • ʻōlohelohe
    • ʻeha
    • nāwaliwali i kou mau lima a me kou mau wāwae
  • Nā hopena ʻili koʻikoʻi. Hiki i nā ʻōuli ke hoʻohui pū:
    • ʻeleʻele ʻili me nā puʻupuʻu ʻulaʻula i poni i ke kala (i kapa ʻia ʻo Sweet's Syndrome)
    • ʻehu ka ʻili me nā wahi o ka ihi ʻana a me nā ʻeha ma loko o kou waha (i kapa ʻia ʻo Stevens-Johnson syndrome)
  • ʻO ka edema peripheral (ʻōhū). Hiki i nā ʻōuli ke hoʻohui pū:
    • nā kuʻekuʻe wāwae, nā wāwae, nā wāwae, nā lima, a i ʻole nā ​​lima i pehu
    • loaʻa kaupaona
  • Poino ke ake. Hiki i nā ʻōuli ke hoʻohui pū:
    • jaundice (melemele o kou ʻili a i ʻole nā ​​keʻokeʻo o kou mau maka)
    • ʻeha ma ka ʻaoʻao ʻākau o kou ʻōpū luna (ʻōpū)

Nā hopena ʻē aʻe koʻikoʻi, i hōʻike nui ʻia i ka ʻāpana "ʻaoʻao ʻaoʻao hopena" ma lalo, hiki ke hoʻopili ʻia:

  • thrombositopenia (pae pae lalo haʻahaʻa)
  • nā pilikia digestive e like me ka diarrhea, constipation, nausea, a me ka luaʻi

Nā kikoʻī hopena ʻaoʻao

Mahalo paha ʻoe i ka hopena o kekahi mau hopena ʻē aʻe me kēia lāʻau. Eia kekahi mau kikoʻī ma kekahi o nā hopena i hiki i kēia lāʻau ke kumu.

Thrombositopenia

Loaʻa paha iā ʻoe ka thrombositopenia (pae platelet haʻahaʻa) ʻoiai ʻoe e lawe nei iā Ninlaro. ʻO kēia ka hopena maʻa mau loa o Ninlaro i ka wā o nā noiʻi maʻi.

I ka wā o ka noiʻi ʻana, ua māhelehele ʻia ka poʻe i ʻelua mau hui. ʻO ka hui mua i hāʻawi ʻia iā Ninlaro me nā lenalidomide a me dexamethasone. Ua hāʻawi ʻia ka hui ʻelua i kahi placebo (lapaʻau me ka lāʻau hana ʻole) me nā lenalidomide a me dexamethasone.

ʻO nā mea e lawe nei i ka hui Ninlaro, 78% o ka poʻe i loaʻa nā pae platelet haʻahaʻa. ʻO nā mea i lawe i ka hui placebo, 54% i loaʻa nā pae platelet haʻahaʻa.

I loko o nā noiʻi, ua pono i kekahi poʻe i kahi transfusion platelet e mālama ai i kā lākou thrombositopenia. Me kahi transfusion platelet, loaʻa iā ʻoe nā platelet mai kahi mea hāʻawi a i ʻole i kou kino ponoʻī (inā i hōʻiliʻili ʻia nā platelet ma mua). No nā poʻe e lawe nei i ka hui ʻana ʻo Ninlaro, pono he 6% i kahi transfusion platelet. ʻO ka poʻe e lawe ana i ka hoʻohuihui placebo, 5% pono i kahi transfusion platelet.

Hana nā platelet i kou kino e hōʻoki i ke kahe ʻana o ke koko ma ke kōkua ʻana e hana i nā kahe koko. Inā haʻahaʻa loa kāu pae platelet, loaʻa paha iā ʻoe ke kahe nui. ʻOiai ʻoe e lawe ana iā Ninlaro, pono ʻoe e loaʻa i nā hoʻokolohua koko i nā manawa āpau e nānā i kāu mau pae platelet.

Kāhea koke i kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau ʻōuli o nā pae platelet haʻahaʻa:

  • ʻū wale
  • kahe nui aku ka kahe ma mua o ka maʻamau (e like me ka loaʻa ʻana o ka ihu ihu a i ʻole ke kahe ʻana o ke kō mai kou mau kepa)

Inā haʻahaʻa loa kāu pae platelet, hiki i kāu kauka ke hoʻemi i kāu mea hana o Ninlaro a i ʻole e ʻōlelo i kahi transfusion platelet. E noi paha lākou iā ʻoe e haʻalele i ka lawe ʻana iā Ninlaro no kekahi manawa.

Nā pilikia kūpala

Hiki paha iā ʻoe ke ʻike i nā pilikia me kou ʻōpū a i ʻole kou ʻōpū ke lawe ʻoe iā Ninlaro. I loko o nā noiʻi lapaʻau o ka lāʻau, loaʻa i nā poʻe ka pilikia digestive.

I nā noiʻi ʻana, ua māhelehele ʻia ka poʻe i ʻelua mau hui. Hāʻawi ʻia ka hui mua iā Ninlaro me nā lenalidomide a me dexamethasone. Ua hāʻawi ʻia ka hui ʻelua i kahi placebo (lapaʻau me ka lāʻau hana ʻole) me nā lenalidomide a me dexamethasone. ʻO nā hopena ʻē aʻe i hōʻike ʻia i loko o nā noiʻi:

  • diarrhea, i kū i 42% o ka poʻe e lawe nei i ka hui Ninlaro (a i 36% o ka poʻe e lawe nei i ka placebo hoʻohui)
  • constipation, i kū i 34% o ka poʻe e lawe nei i ka hui Ninlaro (a ma 25% o ka poʻe e lawe nei i ka placebo hoʻohui)
  • nausea, i kū i 26% o ka poʻe e lawe nei i ka hui Ninlaro (a ma 21% o ka poʻe e lawe nei i ka placebo hui pū)
  • ka luaʻi, i loaʻa i 22% o ka poʻe e lawe nei i ka hui Ninlaro (a i ka 11% o ka poʻe e lawe nei i ka hui placebo)

Mālama i nā pilikia digestive

He mea nui e kamaʻilio me kāu kauka e pili ana i ka mālama ʻana i kēia mau pilikia. Inā ʻole, hiki iā lākou ke lilo i koʻikoʻi.

Hiki ke pale ʻia a mālama ʻia ka luʻi a me ka luaʻi e ka lawe ʻana i kekahi mau lāʻau. Ma waho aʻe o ka lawe ʻana i ka lāʻau, aia kekahi mau mea ʻē aʻe hiki iā ʻoe ke hana inā he nauseous ʻoe. I kekahi manawa he kōkua i ka ʻai pinepine ʻana i nā meaʻai, ma kahi o ka ʻai ʻana i ʻekolu mau papa nui i kēlā me kēia lā. Hāʻawi ka ʻAmelika Hui Pū ʻIa ʻAmelika i nā ʻōlelo aʻoaʻo ʻē aʻe e kōkua i ka hoʻomaha ʻana i ka nausea.

Hiki ke mālama ʻia i ka maʻi diarrhea me kekahi mau lāʻau, e like me loperamide (Imodium). A inā loaʻa ʻoe i ka maʻi pākī, e hōʻoia e inu nui nei ʻoe i nā wai. E kōkua kēia iā ʻoe e hōʻalo i ka make wai (ke loaʻa ka wai i nā wai liʻiliʻi).

Hiki iā ʻoe ke pale i ka paʻa paʻa ʻana e ka inu ʻana i nā wai he nui, ka ʻai ʻana i nā meaʻai kiʻekiʻe, a me ka hoʻoikaika kino ʻana (e like me ka hele wāwae).

Inā kūpilikiʻi kāu pilikia digestive, hiki i kāu kauka ke hoʻemi i kāu hana o Ninlaro. E noi paha lākou iā ʻoe e haʻalele i ka lawe ʻana i ka lāʻau no kekahi manawa.

ʻO Shingles

Hiki paha iā ʻoe ke hoʻonui i ka makaʻu o ka hoʻomohala ʻana i nā shingles (herpes zoster) ʻoiai ʻoe e lawe nei iā Ninlaro. ʻO Shingles kahi ʻili o ka ʻili e ʻeha ai ka ʻeha a me nā ʻehaʻeha. Ua hōʻike ʻia i ka poʻe e lawe ana iā Ninlaro i ka wā o ke aʻo kino ʻana.

Ua mahele ʻia nā mea komo i ʻelua mau hui. Hāʻawi ʻia ka hui mua iā Ninlaro me nā lenalidomide a me dexamethasone. Ua hāʻawi ʻia ka hui ʻelua i kahi placebo (lapaʻau me ka lāʻau hana ʻole) me nā lenalidomide a me dexamethasone.

I ka wā o ke aʻo ʻana, ua hōʻike ʻia nā shingles ma 4% o ka poʻe e lawe nei i ka hui Ninlaro. ʻO kēlā mau mea e lawe nei i ka placebo hoʻohui, 2% o ka poʻe i loaʻa nā shingles.

Hiki iā ʻoe ke hoʻomohala i nā shingles inā loaʻa ʻoe i ka pulupulu i ka wā i hala. Hana ʻia ʻo Shingles ke hana ka virus i ke kumu moa e hoʻoulu hou (lele i luna) i loko o kou kino. Hiki ke hana i kēia lapalapa inā ʻaʻole holo pono kāu ʻōnaehana pale e like me ka maʻamau, ka mea maʻamau i nā poʻe me ka myeloma he nui.

Inā loaʻa ʻoe i ka pulupulu i ka wā ma mua a ke hoʻohana nei ʻoe iā Ninlaro, hiki i kāu kauka ke kuhikuhi i kahi lāʻau antiviral na ʻoe e lawe ʻoiai ʻoe e hoʻohana ana iā Ninlaro. ʻO ka lāʻau antiviral e kōkua i ka pale ʻana i nā shingles mai ka hoʻomohala ʻana i kou kino.

Nānā ninlaro

ʻO ka lāʻau Ninlaro a kāu kauka i kuhikuhi ai e hilinaʻi ʻia i nā kumu he nui. Pākuʻi ʻia kēia mau mea:

  • pehea ka maikaʻi o ka hana o kou ake a me nā puʻupaʻa
  • inā he mau hopena ʻē aʻe kāu mai kāu mālama ʻana iā Ninlaro

Hōʻike ka ʻikepili aʻe i nā lāʻau i hoʻohana pinepine ʻia a koi ʻia paha. Eia nō naʻe, e mālama pono i nā lāʻau a ke kauka i kuhikuhi ai nāu. E hoʻoholo kāu kauka i ke ana ʻoi loa e kūpono i kāu mau pono.

Nā ʻano lāʻau a me nā ikaika

Hele mai ʻo Ninlaro ma ke ʻano he capsule waha i loaʻa i ʻekolu mau ikaika: 2.3 mg, 3 mg, a me 4 mg.

Nā hana no ka myeloma maha

ʻO ka mahele hoʻomaka maʻamau o Ninlaro kahi capsule 4-mg i lawe ʻia i hoʻokahi manawa i ka pule no ʻekolu pule. Hāhai ʻia kēia e hoʻokahi pule o ka lawe ʻole ʻana i ka lāʻau. E hana hou ʻoe i kēia pōʻai he ʻehā pule i nā manawa he nui e like me ke kauka a ke kauka.

I ka wā o ka mālama ʻana, pono ʻoe e lawe i ka capsule Ninlaro i ka lā like i kēlā me kēia pule. ʻOi aku ka maikaʻi e lawe iā Ninlaro ma kahi o ka manawa like o ka lā no kēlā me kēia kau. Pono ʻoe e lawe iā Ninlaro ma ka ʻōpū hakahaka, ma ka liʻiliʻi i hoʻokahi hola ma mua o kou ʻai ʻana a i ʻole ʻelua mau hola ma hope o kāu ʻai ʻana.

Lawe ʻoe iā Ninlaro me ka hui pū me nā lāʻau myeloma ʻē aʻe ʻelua: lenalidomide (Revlimid) a me dexamethasone (Decadron). Loaʻa i kēia mau lāʻau lapaʻau nā papa kuhikuhi ʻokoʻa no ka hana ʻana ma mua o ka hana a Ninlaro. E mālama pono i nā ʻōlelo kauoha i hāʻawi ʻia e kāu kauka no kēlā me kēia lāʻau.

ʻOi aku ka maikaʻi o ke kākau ʻia ʻana o kāu manawa papa hana ma luna o kahi pakuhi a kalena paha. Kōkua kēia iā ʻoe e ʻike i nā lāʻau āpau āu e pono ai e lawe a pololei i ka wā e pono ai ʻoe e lawe. He mea maikaʻi e nānā i kēlā me kēia mahele lāʻau ma hope o kāu lawe ʻana.

Inā he pilikia paha kou me kou ake a i ʻole nā ​​puʻupaʻa paha, e ʻōlelo paha kāu kauka e lawe ʻoe i kahi lāʻau ma lalo o Ninlaro. Hiki i kāu kauka ke hoʻohaʻahaʻa i kāu mea hana a noi paha iā ʻoe e hoʻomaha i ka lāʻau lapaʻau inā loaʻa iā ʻoe kekahi mau hopena mai ka lāʻau (e like me ka pae platelet haʻahaʻa). Lawe mau iā Ninlaro e like me ke kauka a kāu kauka.

He aha inā e haʻo wau i kahi lāʻau?

Inā hoʻopoina ʻoe e lawe i kahi lāʻau o Ninlaro, e hāhai i kēia mau ʻōkuhi:

  • Inā he 72 a ʻoi paha mau hola a hiki i ka hopena o kāu kau aʻe, e lawe koke i kāu lāʻau i hala. A laila, e lawe i kāu lā ma hope o Ninlaro i ka manawa maʻamau.
  • Inā he emi ma lalo o 72 mau hola a hiki i ka hopena o kāu lā aʻe, e lele wale i ka lāʻau i hala. E lawe i kāu lāʻau o Ninlaro i ka manawa maʻamau.

Mai lawe ma mua o hoʻokahi mahele lāʻau o Ninlaro e pani no kahi mahele lāʻau i hala. Hiki i ka hana ʻana pēlā ke hoʻonui i kou makaʻi i nā hopena ʻaoʻao.

I mea e ʻike pono ai ʻaʻole ʻoe e haʻalele i kahi lāʻau, e hoʻāʻo e kau i kahi hoʻomanaʻo ma kāu kelepona. He mea pono nō hoʻi ka wati lāʻau.

Pono wau e hoʻohana i kēia lāʻau lōʻihi?

Ninlaro e hoʻohana ʻia ma ke ʻano he lapaʻau wā lōʻihi. Inā ʻoe a me kāu kauka e hoʻoholo i ka palekana a me ka maikaʻi o Ninlaro nāu, lawe paha ʻoe i kahi wā lōʻihi.

Nā koho ʻē aʻe iā Ninlaro

Loaʻa nā lāʻau ʻē aʻe i hiki ke mālama i ka myeloma he nui. Kūpono paha kekahi iā ʻoe ma mua o nā poʻe ʻē aʻe. Inā makemake ʻoe i ka ʻimi ʻana i kahi koho ʻē aʻe iā Ninlaro, e kamaʻilio me kāu kauka. Hiki iā lākou ke haʻi iā ʻoe e pili ana i nā lāʻau ʻē aʻe i hana maikaʻi iā ʻoe.

ʻO nā laʻana o nā lāʻau ʻē aʻe i hoʻohana ʻia e mālama i nā myeloma he nui:

  • kekahi mau lāʻau chemotherapy, e like me:
    • cyclophosphamide (Cytoxan)
    • doxorubicin (Doxil)
    • melphalan (Alkeran)
  • kekahi mau corticosteroids, e like me:
    • dexamethasone (Decadron)
  • kekahi mau lāʻau lapaʻau immunomodulate (nā lāʻau e hana pū me kāu ʻōnaehana pale), e like me:
    • lenalidomide (Revlimid)
    • pomalidomide (Pomalyst)
    • thalidomide (Thalomid)
  • kekahi mau therapies i hoʻolālā ʻia, e like me:
    • bortezomib (Velcade)
    • carfilzomib (Kyprolis)
    • daratumumab (Darzalex)
    • elotuzumab (Empliciti)
    • panobinostat (Farydak)

Ninlaro vs. Velcade

Mahalo paha ʻoe pehea e hoʻohālikelike ai ʻo Ninlaro i nā lāʻau ʻē aʻe i kuhikuhi ʻia no nā hoʻohana like. Maanei mākou e nānā ai i ka like a like ʻole o Ninlaro a me Velcade.

E pili ana i

Loaʻa iā Ninlaro ka ixazomib, ʻoiai ʻo Velcade kahi bortezomib. Hoʻolālā ʻia kēia mau lāʻau i nā lāʻau lapaʻau no ka myeloma maha. Pili lākou i kahi papa o nā lāʻau i kapa ʻia nā proteasome inhibitors. Hana like ʻo Ninlaro a me Velcade i loko o kou kino.

Hoʻohana

Ua ʻae ʻia ʻo Ninlaro e mālama iā:

  • myeloma he nui i nā mākua i hoʻāʻo mua ma kahi o hoʻokahi lāʻau ʻē aʻe no ko lākou maʻi. Hoʻohana ʻia ʻo Ninlaro me ka lenalidomide (Revlimid) a me dexamethasone (Decadron).

Ua ʻae ʻia ʻo Velcade e mālama:

  • myeloma maha i nā mākua i:
    • ʻaʻole i loaʻa nā lāʻau lapaʻau ʻē aʻe no ko lākou maʻi; no kēia poʻe, hoʻohana ʻia ʻo Velcade me ka melphalan a me ka prednisone
    • he mau myeloma he nui i hoʻi hou (hoʻi) ma hope o ka mālama mua ʻana
    • mantle cell lymphoma (maʻi ʻaʻai o nā lymph node) i nā mākua

Nā ʻano lāʻau a me ka hoʻoponopono ʻana

Hele mai ʻo Ninlaro ma ke ʻano he capsule i lawe ʻia e ka waha. Lawe pinepine ʻoe i hoʻokahi kapule i kēlā me kēia pule no ʻekolu pule. A ukali ʻia kēia e hoʻokahi pule me ka lawe ʻole ʻana i ka lāʻau. Hoʻomaʻa hou ʻia kēia pōʻai wiki ʻehā i nā manawa he nui e like me ke kauka a ke kauka.

Hele mai ʻo Velcade ma ke ʻano he hopena wai i hāʻawi ʻia e ka ʻume. Hāʻawi ʻia ia ma ke ʻano he kuikui ma lalo o kou ʻili (kahi subcutaneus injection) a i ʻole he ʻume i loko o kou aa (kahi hoʻopili intravenous). E loaʻa iā ʻoe kēia mau lapaʻau ma ke keʻena o kāu kauka.

E loli kāu papa kuhikuhi no ka Velcade ma muli o kāu kūlana:

  • Inā ʻaʻole i mālama mua ʻia kāu myeloma maha, e hoʻohana paha ʻoe iā Velcade ma kahi o hoʻokahi makahiki. E maʻa mau ʻoe i kahi pōʻai hoʻomaʻamaʻa he ʻekolu pule. E hoʻomaka ʻoe i ka lāʻau lapaʻau ma ka loaʻa ʻana iā Velcade i ʻelua mau manawa o ka pule no ʻelua pule, a ukali ʻia e hoʻokahi pule ma kahi o ka lāʻau. E hana hou ʻia kēia kumu no 24 mau pule. Ma hope o 24 mau pule, e loaʻa iā ʻoe ʻo Velcade hoʻokahi manawa i kēlā me kēia pule no ʻelua pule, a ukali ʻia e hoʻokahi pule ma kahi o ka lāʻau. Hoʻomaʻa hou ʻia kēia no 30 mau pule.
  • Inā ʻoe e hoʻohana nei iā Velcade no ka mea ua hoʻi mai kāu myeloma maha ma hope o nā ʻano lāʻau ʻē aʻe (me Velcade a i ʻole nā ​​lāʻau ʻē aʻe), hiki ke loli ke kaʻina o kāu hana, e like me kāu mōʻaukala lapaʻau

Nā hopena a me nā pilikia

ʻO Ninlaro lāua ʻo Velcade nā mea i loaʻa i ka lāʻau mai ka papa like. No laila, hiki i nā lāʻau ʻelua ke hana i nā hopena ʻaoʻao like loa. Ma lalo nā hiʻohiʻona o kēia mau hopena ʻaoʻao.

Nā hopena ʻaoʻao maʻamau

Aia i loko o kēia mau papa inoa nā laʻana o nā hopena ʻaoʻao ʻē aʻe e hiki ke hana me Ninlaro, me Velcade, a i ʻole me nā lāʻau ʻelua (ke lawe pākahi ʻia).

  • Hiki iā Ninlaro:
    • maka maloʻo
  • Hiki ke hana me Velcade:
    • ʻeha nerve
    • nawaliwali a luhi paha
    • fiva
    • hoʻēmi ʻai
    • anemia (haʻahaʻa pae koko ʻulaʻula haʻahaʻa)
    • alopecia (lauoho lilo)
  • Hiki ke hana me Ninlaro a me Velcade:
    • ʻeha kua
    • ʻike hihi ʻole
    • conjunctivitis (i kapa ʻia he maka poni)
    • shingles (herpes zoster), kahi e kumu ai ka ʻehaʻeha

Nā hopena hopena koʻikoʻi

Aia i loko o kēia mau papa inoa nā laʻana o nā hopena ʻino e hiki ke hana ʻia me Ninlaro, me Velcade, a i ʻole me nā lāʻau ʻelua (ke lawe pākahi ʻia). ʻO ka hapa nui o kēia mau hopena ʻaoʻao pinepine i ka poʻe e lawe nei i kēia mau lāʻau.

  • Hiki iā Ninlaro:
    • nā hopena ʻili koʻikoʻi, e like me Sweet's syndrome a me Stevens-Johnson maʻi
  • Hiki ke hana me Velcade:
    • ke koko haʻahaʻa (hiki ke hoʻoluhi a maule paha)
    • nā pilikia puʻuwai, e like me ka maikaʻi ʻole o ka puʻuwai a i ʻole ka mana o ka puʻuwai abnormal
    • nā pilikia pūhū, e like me ka syndrome respiratory respiratory, pneumonia, a i ʻole ka mumū i kou mau māmā
  • Hiki ke hana me Ninlaro a me Velcade:
    • edema peripheral (ʻōhū i kou kuʻekuʻe wāwae, wāwae, wāwae, lima, a lima paha)
    • thrombositopenia (pae platelet haʻahaʻa)
    • nā pilikia o ka ʻōpū a ʻōpū paha, e like me ka maʻi diarrhea, constipation, nausea, a i ʻole ka luaʻi
    • nā pilikia nerve, e like me ke kani ʻana a i ʻole ka wela ʻana o nā manaʻo, ka helu ʻana, ka ʻeha, a nāwaliwali paha i kou mau lima a me kou mau wāwae
    • neutropenia (pae keʻokeʻo koko keʻokeʻo haʻahaʻa), hiki ke hoʻonui i kou makaʻu i ka loaʻa ʻana o nā maʻi
    • hōʻino ka ate

Ka hoʻokō ʻana

ʻO Ninlaro a me Velcade he mau hoʻohana ʻokoʻa i ʻae ʻia e ka FDA, akā hoʻohana ʻia lāua ʻelua e mālama i nā myeloma he nui i nā mākua.

ʻAʻole i hoʻohālikelike pololei ʻia kēia mau lāʻau i nā noiʻi maʻi. Eia nō naʻe, ua ʻike ʻia kahi noiʻi ua maikaʻi nā Ninlaro a me Velcade i ka hoʻopanee ʻana i ka holomua (worsening) o ka myeloma he nui. Paipai ʻia nā lāʻau ʻelua e nā lula lapaʻau o kēia manawa no ka hoʻohana ʻana i ka poʻe me ka myeloma maha.

No kekahi poʻe, paipai nā kulekele lapaʻau i ka hoʻohana ʻana i kahi regimen Velcade i hoʻohana ʻia me ka hui pū ʻana o Ninlaro me lenalidomide (Revlimid) a me dexamethasone (Decadron). Hoʻopili kēia ʻōlelo paipai i ka poʻe me ka myeloma ʻeleu e mālama ʻia nei no ka manawa mua. ʻO ka myeloma ʻeleu he mea loaʻa i kekahi kanaka nā ʻōuli o ka maʻi, e like me nā pilikia o ka puʻupaʻa, ka hōʻino iwi, anemia, a i ʻole nā ​​pilikia ʻē aʻe.

No ka poʻe nona ka myeloma he nui i hoʻi mai ma hope o nā ʻano lāʻau ʻē aʻe, hōʻike nā alakaʻi i ka mālama ʻana me Ninlaro a i ʻole Velcade, me nā lāʻau ʻē aʻe.

Nā kumukūʻai

ʻO Ninlaro lāua ʻo Velcade nā lāʻau lapaʻau inoa inoa ʻelua. ʻAʻohe ʻano generic o nā lāʻau āpau i kēia manawa. ʻOi aku ke kumu kūʻai o nā lāʻau lapaʻau inoa inoa ma mua o nā generics.

Wahi a nā koho ma WellRx.com, ʻoi aku ka uku o Velcade ma mua o Ninlaro. ʻO ke kumukūʻai maoli āu e uku ai no kēlā me kēia lāʻau e pili ana i kāu hoʻolālā ʻinikua, kou wahi, a me ka lāʻau kūʻai āu e hoʻohana ai.

Ninlaro kāki

E like me nā lāʻau āpau, hiki ke hoʻololi ke kumukūʻai o Ninlaro. No ka loaʻa ʻana o nā kumukūʻai o kēia wā no Ninlaro i kou wahi, e nānā iā WellRx.com.

ʻO ke kumukūʻai āu e ʻike ai ma WellRx.com ka mea āu e uku ai me ka ʻole o ka ʻinikua. ʻO ke kumukūʻai maoli āu e uku ai ma muli o kāu hoʻolālā ʻinikua, kou wahi, a me ka lāʻau kūʻai āu e hoʻohana ai.

Kōkua kālā a me nā ʻinikua

Inā makemake ʻoe i kākoʻo kālā e uku no Ninlaro, a i ʻole inā ʻoe e kōkua i ka hoʻomaopopo ʻana i kāu ʻinikua uhi, loaʻa ke kōkua.

Hāʻawi ʻo Takeda Pharmaceutical Company Limited, ka mea hana o Ninlaro, i kahi papahana i kapa ʻia ʻo Takeda Oncology 1Point. Hāʻawi kēia papahana i ke kōkua a hiki paha ke kōkua i ka hoʻohaʻahaʻa ʻana i ke kumukūʻai o kāu lapaʻau. No ka ʻike hou aku a e ʻike inā ua kūpono ʻoe no ke kākoʻo, kāhea iā 844-817-6468 (844-T1POINT) a i ʻole kipa i ka pūnaewele pūnaewele.

Hana ʻo Ninlaro

Ua ʻae ka Food and Drug Administration (FDA) i nā lāʻau i kuhikuhi ʻia e like me Ninlaro e mālama i kekahi mau ʻano. Hiki ke hoʻohana ʻia ʻo Ninlaro i ka lepili inoa no nā kūlana ʻē aʻe. ʻO ka hoʻohana inoa inoa ʻole ke hoʻohana ʻia kahi lāʻau i ʻae ʻia e mālama i hoʻokahi kūlana e mālama ai i kahi ʻano ʻokoʻa.

Ninlaro no myeloma maha

Ua ʻae ʻia ʻo Ninlaro e mālama i nā myeloma he nui i nā mākua i hoʻāʻo mua ma kahi o hoʻokahi lāʻau ʻē aʻe no kēia maʻi. Hiki i kēia lāʻau ke lilo i lāʻau lapaʻau a i ʻole kahi kaʻina hana. Ua ʻae ʻia ʻo Ninlaro e hoʻohana pū ʻia me nā lāʻau ʻelua ʻē aʻe: lenalidomide (Revlimid) a me dexamethasone (Decadron).

ʻO ka myeloma maha he ʻano laha ʻole o ka maʻi ʻaʻai e hoʻomohala i kāu mau hunaola plasma. ʻO kēia mau pūnaewele kahi ʻano o ke keʻokeʻo koko keʻokeʻo. Hana ʻia lākou e kou iwi iwi, kahi mea spongy i loaʻa i loko o kou mau iwi. ʻO kou iwi iwi ka hana i nā hunaola āpau.

I kekahi manawa lilo nā hunaola plasma i mea maʻamau a hoʻomaka i ka hoʻonui ʻana (e hana ana i nā keaka plasma ʻē aʻe me ka kaohi ʻole. Kāhea ʻia kēia mau mea ʻino, nā hunaola plasma maʻi ʻaʻai i nā hunaʻi myeloma.

Hiki i nā pūnaewele Myeloma ke ulu i nā wahi (mau) o kou iwi iwi a i nā iwi like ʻole. ʻO kēia ke kumu i kapa ʻia ai kēia ʻano he myeloma maha.

Lawe nā pūnaewele myeloma i kahi ākea i loko o kou iwi iwi. He mea paʻakikī kēia no kou iwi o ka iwi e hana pono i nā hunaola keu olakino. Hiki i nā huna myeloma ke hōʻino i kou mau iwi, e hoʻonāwaliwali ai.

Ka hopena no ka myeloma maha

I kahi hoʻokolohua hoʻokolohua, ua maikaʻi ʻo Ninlaro i ka mālama ʻana i nā myeloma he nui. Ua nānā ka nānā ʻana i ka 722 poʻe me ka myeloma he nui i loaʻa ma kahi o hoʻokahi lāʻau ʻē aʻe no ka maʻi. I kēia mau poʻe, ua kāpae paha kā lākou myeloma maha i ka pane ʻana (hoʻomaikaʻi ʻana) i nā ʻano lāʻau ʻē aʻe, a i ʻole ua hoʻi mai ma hope o ka hoʻomaikaʻi mua ʻana me nā lāʻau ʻē aʻe.

I kēia noi ʻana, ua māhelehele ʻia ka poʻe i ʻelua mau hui. Hāʻawi ʻia ka hui mua iā Ninlaro me nā lāʻau myeloma ʻē aʻe ʻelua: lenalidomide a me dexamethasone. Hāʻawi ʻia ka hui ʻelua i kahi placebo (lapaʻau me ka lāʻau hana ʻole) me ka lenalidomide a me dexamethasone.

Ua noho ka poʻe i lawe i ka hui Ninlaro no ka awelika o 20.6 mau mahina ma mua o ka holo ʻana o kā lākou myeloma maha. ʻO ka poʻe e lawe ana i ka hui placebo i noho ma ka awelika o 14.7 mau mahina ma mua o ka holo ʻana o ko lākou maʻi.

He kanahikukūmāwalu pākēneka o nā poʻe i lawe i ka hui Ninlaro i pane i ka lāʻau. ʻO kēia ka mea i loaʻa iā lākou ma kahi o 50% hoʻomaikaʻi i kā lākou hoʻokolohua hoʻokolohua i nānā no nā pūnaewele myeloma. I ka poʻe i lawe i ka hui placebo, 72% o ka poʻe i like ka pane i ka lapaʻau.

Hoʻohana ka inoa lepili no Ninlaro

Ma waho aʻe o ka hoʻohana i helu ʻia ma luna, hiki ke hoʻohana ʻia ʻo Ninlaro i ka lepili inoa no nā hoʻohana ʻē aʻe. ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i waho ke hoʻohana ʻia kahi lāʻau i ʻae ʻia no ka hoʻohana hoʻokahi e mālama i kahi ʻokoʻa ʻae ʻole ʻia.

Ninlaro no myeloma he nui i nā hanana ʻē aʻe

Ua ʻae ʻia ʻo Ninlaro no ka hoʻohana ʻana me lenalidomide a me dexamethasone e mālama ai i nā myeloma he nui i ka poʻe i loaʻa mua i nā lāʻau ʻē aʻe. Ke aʻo ʻia nei ma ke ʻano he koho lapaʻau no nā hanana ʻē aʻe e pili ana i ka myeloma maha.

Ke hana ʻia nei ka noiʻi e ʻike ai pehea e hiki ai ke hoʻohana ʻia ʻo Ninlaro i kahi lepili i nā ʻano aʻe:

  • e mālama i nā kaʻina like ʻole o myeloma maha
  • i ka hui pū me nā lāʻau ʻē aʻe ma mua o lenalidomide a me dexamethasone e mālama i nā myeloma he nui

Kau ʻia ʻoe e ka inoa ʻo Ninlaro i kahi o kēia mau ala.

Ninlaro no ka amyloidosis kaulahao kukui ʻōnaehana

ʻAʻole ʻae ʻia ʻo Ninlaro i ka FDA e mālama i ka amyloidosis chain chain light. Eia nō naʻe, i kekahi manawa hoʻohana ʻia ia i ka lepili lepa e mālama i kēia ʻano.

Hoʻopili kēia ʻano maʻamau i ke ala o kāu mau hunaola plasma (i loaʻa i loko o kou iwi iwi) e hana ai i kekahi mau protein i kapa ʻia nā protein kaulahao māmā. Komo nā kope kūpono ʻole o kēia mau protein i loko o kou kahena kōkō a hiki ke kūkulu i nā kinikini a me nā mea i loko o kou kino. Ke kūkulu nei nā proteins, hana lākou i nā amyloids (clusters of protein), hiki ke hōʻino i kekahi mau mea like me kou puʻuwai a i ʻole nā ​​puʻupaʻa

Hoʻokomo ʻia ʻo Ninlaro i nā lula lapaʻau no ka amyloidosis kaulahao māmā ʻōnaehana, ma hope o kahi noiʻi ʻike ʻia he maikaʻi i ka mālama ʻana i kēia ʻano. ʻO Ninlaro kahi koho lapaʻau no nā poʻe nona ka amyloidosis i kū i ka pane ʻana i kahi lapaʻau koho mua loa i ʻae ʻia no kēia maʻi. He koho lapaʻau nō hoʻi ia no ka poʻe nona ka amyloidosis i hoʻi mai ma hope o ka hoʻomaikaʻi ʻana me kahi lapaʻau koho mua ʻae ʻia.

Hoʻohana ʻia ʻo Ninlaro ma o kāna iho a i ʻole hui pū ʻia me dexamethasone ke hoʻohana ʻia e mālama i kēia maʻi.

Hana ʻo Ninlaro me nā lāʻau ʻē aʻe

Lawe pinepine ʻoe iā Ninlaro me ka hoʻohui pū me nā lāʻau ʻē aʻe i kēlā me kēia hana i nā ʻano like ʻole e mālama ai i kāu myeloma maha.

Ua ʻae ʻia ʻo Ninlaro no ka hoʻohana me lenalidomide (Revlimid) a me dexamethasone (Decadron). I loko o nā noiʻi maʻi, ʻoi aku ka maikaʻi o ka mālama ʻana me Ninlaro me kēia mau lāʻau ma mua o ka hoʻohana ʻana i ka lenalidomide a me dexamethasone wale nō.

E ʻōlelo paha kāu kauka e lawe ʻoe iā Ninlaro me kekahi mau lāʻau myeloma ʻē aʻe. ʻO kēia kahi ala lepili hana ʻole o ka hoʻohana ʻana iā Ninlaro. ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i waho ke hoʻohana ʻia kahi lāʻau i ʻae ʻia no ka hoʻohana hoʻokahi e mālama i kahi ʻokoʻa ʻae ʻole ʻia.

Ninlaro me lenalidomide (Revlimid)

ʻO Lenalidomide (Revlimid) kahi lāʻau hoʻomalu. Hana kēia ʻano lāʻau i ke kōkua ʻana i kāu ʻōnaehana pale e pepehi i nā hunaola myeloma.

Hele mai ʻo Revlimid ma ke ʻano he capsule i lawe ʻia e ka waha i hui pū ʻia me Ninlaro. Lawe ʻoe iā Revlimid i hoʻokahi manawa i kēlā me kēia lā no ʻekolu pule, a ukali ʻia e hoʻokahi pule no ka lawe ʻole ʻana i ka lāʻau.

Hiki iā ʻoe ke lawe iā Revlimid me ka ʻole o ka meaʻai.

ʻO Ninlaro me dexamethasone (Decadron)

ʻO Dexamethasone (Decadron) kahi ʻano lāʻau i kapa ʻia he corticosteroid. Hoʻohana nui ʻia kēia mau lāʻau e hoʻoliʻiliʻi i ka mumū (pehu) i kou kino. Eia nō naʻe, ke hāʻawi ʻia i nā mahele haʻahaʻa no ka mālama ʻana i ka myeloma he nui, kōkua ʻo dexamethasone iā Ninlaro a me Revlimid e pepehi i nā hunaʻi myeloma.

Hele mai ʻo Dexamethasone e like me nā papa i lawe ʻia e ka waha i hui pū ʻia me Ninlaro. E lawe ʻoe i ka dexamethasone i hoʻokahi manawa i ka pule, ma ka lā like o ka pule e lawe ai ʻoe iā Ninlaro. E lawe ʻoe i ka dexamethasone i kēlā me kēia pule, me ka pule āu e lawe ʻole ai iā Ninlaro.

Mai lawe i kāu lāʻau dexamethasone ma ka manawa like o ka lā ke lawe ʻoe i kāu lāʻau Ninlaro. ʻOi aku ka maikaʻi e lawe i kēia mau lāʻau i nā manawa like ʻole o ka lā.ʻO kēia no ka mea pono e lawe i ka dexamethasone me ka meaʻai, ʻoiai ʻo Ninlaro e lawe ʻia i kahi ʻōpū nele.

ʻO Ninlaro a me ka waiʻona

ʻAʻole ʻike ʻia ka waiʻona i ka hopena o ka hana a Ninlaro i kou kino. Eia nō naʻe, inā loaʻa iā ʻoe kekahi mau hopena ʻē aʻe mai Ninlaro (e like me ka nausea a i ʻole ka diarrhea), hiki i ka inu ʻana i ka wai ʻona ke hana i kēia mau ʻaoʻao maikaʻi ʻole.

Inā inu ʻoe i ka waiʻona, e kamaʻilio me kāu kauka no ka nui o ka palekana o ka wai ʻona iā ʻoe ke hoʻohana nei ʻoe iā Ninlaro.

Nā pilina ʻo Ninlaro

Hiki iā Ninlaro ke launa pū me nā lāʻau ʻē aʻe. Hiki iā ia ke launa pū me kekahi mau mea hoʻohui.

Hiki i nā launa like ʻole ke kumu i nā hopena like ʻole. ʻO kahi laʻana, hiki i kekahi mau pilina ke hoʻopilikia me ka maikaʻi o ka hana ʻana o ka lāʻau. Hiki i nā pilina ʻē aʻe ke hoʻonui i nā hopena a i ʻole e hoʻonui i ke koʻikoʻi.

Ninlaro a me nā lāʻau ʻē aʻe

Ma lalo nā papa inoa o nā lāʻau i hiki ke launa pū me Ninlaro. ʻAʻohe i loko o kēia mau papa inoa nā lāʻau i hiki ke launa pū me Ninlaro.

Ma mua o ka lawe ʻana iā Ninlaro, e kamaʻilio me kāu kauka a me kāu kauka lāʻau. E haʻi iā lākou e pili ana i nā kuhikuhi āpau, nā mea kūʻai aku, a me nā lāʻau ʻē aʻe āu e lawe ai. E haʻi pū iā lākou e pili ana i nā wikamina, nā mea kanu, a me nā mea hoʻopiha āu e hoʻohana ai. Hiki ke kōkua i ka hāʻawi ʻana i kēia ʻike iā ʻoe e hōʻalo i nā launa ʻole.

Inā he mau nīnau kāu e pili ana i nā launa lāʻau e hoʻopili iā ʻoe, e nīnau i kāu kauka a kauka paha.

Ninlaro a me kekahi mau lāʻau no ka maʻi kō

ʻO ka lawe ʻana i kekahi mau lāʻau tuberculosis me Ninlaro hiki ke hoʻohaʻahaʻa i ka pae o Ninlaro i kou kino. Hiki i kēia ke hōʻemi iā Ninlaro iā ʻoe. Pono ʻoe e hōʻalo i ka lawe ʻana i nā lāʻau aʻe me Ninlaro:

  • rifabutin (Mycobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

Ninlaro a me kekahi mau lāʻau no ka hopu ʻana

ʻO ka lawe ʻana i kekahi mau lāʻau i hopu ʻia me Ninlaro hiki ke hoʻohaʻahaʻa i ka pae o Ninlaro i kou kino. Hiki i kēia ke hōʻemi iā Ninlaro iā ʻoe. Pono ʻoe e hōʻalo i ka lawe ʻana i nā lāʻau aʻe me Ninlaro:

  • carbamazepine (Carbatrol, Equetro, Tegretol)
  • fosphenytoin (Cerebyx)
  • oxcarbazepine (Trileptal)
  • phenobarbital
  • phenytoin (Dilantin, Phenytek)
  • primidone (Mysoline)

Ninlaro a me nā mea kanu a me nā mea hoʻohui

Hiki paha iā Ninlaro ke launa pū me kekahi mau mea kanu a me nā mea hoʻohui, e like me ka wort a St. E nānā pono e kūkākūkā i nā hoʻopihapiha āu e lawe nei me kāu kauka ma mua o kou hoʻomaka ʻana e hoʻohana iā Ninlaro.

ʻO Ninlaro lāua ʻo St.

ʻO ka lawe ʻana iā St. John's wort me Ninlaro hiki ke hoʻohaʻahaʻa i ka pae o Ninlaro i kou kino a hoʻemi i ka hopena iā ʻoe. Hōʻalo i ka lawe ʻana i kēia mea hoʻōla lāʻau (i kapa ʻia hoʻi Hypericum perforatum) ʻoiai ʻoe e hoʻohana ana iā Ninlaro.

Pehea e lawe ai iā Ninlaro

Pono ʻoe e lawe iā Ninlaro e like me kāu kauka a i ʻole nā ​​ʻōkuhi mālama ola.

I ka manawa hea e lawe ai

Inā ʻaʻole haʻi kāu kauka iā ʻoe, e lawe i kāu lāʻau o Ninlaro i hoʻokahi manawa i ka pule, i ka lā like i kēlā me kēia pule. ʻOi aku ka maikaʻi e lawe i kāu kau ma kahi o ka manawa like o ka lā.

Lawe ʻoe iā Ninlaro i hoʻokahi manawa i kēlā me kēia pule no ʻekolu pule. A laila loaʻa iā ʻoe kahi hebedoma hoʻomaha o ka lāʻau. E hana hou ʻoe i kēia pōʻai he ʻehā pule i nā manawa he nui e like me ke kauka a ke kauka.

I mea e ʻike pono ai ʻaʻole ʻoe e haʻalele i kahi lāʻau, e hoʻāʻo e kau i kahi hoʻomanaʻo ma kāu kelepona. He mea pono nō hoʻi ka wati lāʻau.

Lawe ʻana iā Ninlaro me ka meaʻai

ʻAʻole pono ʻoe e lawe iā Ninlaro me ka meaʻai. Lawe ʻia ia ma ka ʻōpū hakahaka no ka mea hiki i ka meaʻai ke hōʻemi i ka nui o Ninlaro a kou kino e omo ai. Hiki i kēia ke hōʻemi iā Ninlaro iā ʻoe. Lawe i kēlā me kēia mahele lāʻau o Ninlaro ma ka liʻiliʻi i hoʻokahi hola ma mua o kou ʻai ʻana a i ʻole ʻelua mau hola ma hope o kāu ʻai ʻana.

Hiki iā Ninlaro ke haki, wāwahi ʻia, a nau ʻia paha.

ʻAʻole, ʻaʻole pono ʻoe e haki, haki, wāwahi, a me ka nau ʻana i nā capsule Ninlaro. Pono e hoʻopau ʻia nā capsule me ka inu wai.

Inā wehe hāmeʻa kahi capsule Ninlaro, e hōʻalo i ka hoʻopā ʻana i ka pauka i loko o ka capsule. Inā loaʻa kekahi pauka i kou ʻili, holoi koke ʻia me ke kopa a me ka wai. Inā komo kekahi pauka i kou mau maka, e ninini koke ʻia me ka wai.

Pehea e hana ai ʻo Ninlaro

Ua ʻae ʻia ʻo Ninlaro e mālama i nā myeloma he nui. Hāʻawi ʻia ia me nā lāʻau ʻelua ʻē aʻe (lenalidomide a me dexamethasone) e kōkua iā ia e hana i loko o kou kino.

He aha ka hana ma myeloma maha

I waenakonu o kou mau iwi, aia kahi mea spongy i kapa ʻia ka iwi iwi. ʻO kēia kahi i hana ʻia ai kāu mau hunaola koko, e like me kou mau keʻokeʻo koko keʻokeʻo. Kūʻē nā hunaola koko keʻokeʻo i nā maʻi.

Nui nā ʻano ʻokoʻa o nā hunaola keokeo. Kapa ʻia hoʻokahi ʻano nā hunaola plasma. Hana nā hunaola Plasma i nā mea ʻino, he mau protein ia e kōkua i kou kino e ʻike a hoʻouka i nā ʻōpala, e like me nā virus a me nā bacteria.

Me nā myeloma he nui, hana ʻia nā hunaola plasma maʻamau i loko o kou iwi iwi. Hoʻomaka lākou e hoʻonui (e hana i nā hunaola ʻoi aku ka nui) me ka kaohi ʻole. Kāhea ʻia kēia mau mea ʻino, nā hunaola plasma maʻi ʻaʻai i nā hunaʻi myeloma.

Lawe ʻia nā pūnaewele Myeloma i kahi ākea i loko o kou iwi iwi, ʻo ia hoʻi ka liʻiliʻi o ka hakahaka e hana ʻia ai nā hunaola koko maikaʻi. Hoʻopilikia nā hunaola myeloma i kou mau iwi. ʻO kēia ke kumu e hoʻokuʻu ai kou mau iwi i ka calcium i loko o kou koko, kahi e nāwaliwali ai kou mau iwi.

He aha kā Ninlaro e hana ai

Hana ʻo Ninlaro i ka hōʻemi ʻana i ka nui o nā hunaola myeloma i loko o kou iwi iwi. Hoʻopaʻa ka lāʻau i kahi protein kikoʻī, i kapa ʻia ʻo proteasome, i loko o nā hunaʻi myeloma.

Wāwahi nā protein i nā protein ʻē aʻe a nā keena e pono ʻole ai, a me nā protein i hōʻino ʻia. Hoʻopili ʻo Ninlaro i nā proteasome a kāpae iā lākou mai ka hana kūpono. ʻO kēia ke alakaʻi i kahi kūkulu ʻana o nā protein i hōʻino a pono ʻole ʻia i nā hunaola myeloma, kahi e make ai nā hunaola myeloma.

Pehea ka lōʻihi o ka hana?

Hoʻomaka ʻo Ninlaro e hana i loko o kou kino ke hoʻomaka ʻoe e lawe. Akā e liuliu kēia e kūkulu i nā hopena i hiki ke ʻike ʻia, e like me ka hoʻomaikaʻi ʻana i kāu mau hōʻailona a i ʻole nā ​​hopena hoʻokolohua lab.

I kahi hoʻokolohua hoʻokolohua, ua lawe ka poʻe me myeloma he nui iā Ninlaro (i hui pū ʻia me ka lenalidomide a me dexamethasone). Ua ʻike ka hapalua o kēia poʻe i ka hoʻomaikaʻi o ko lākou kūlana i loko o hoʻokahi mahina o ko lākou hoʻomaka ʻana e lawe iā Ninlaro.

Ninlaro a me ka hāpai keiki

ʻAʻole i aʻo ʻia ʻo Ninlaro i nā wahine hāpai. Eia nō naʻe, ke ʻano o ka hana ʻana a Ninlaro i loko o kou kino e hōʻeha ʻia i kahi hāpai hāpai ʻana.

I nā noiʻi holoholona, ​​ua hōʻino ka lāʻau i nā fetus ke hāʻawi ʻia i nā holoholona hāpai. ʻOiai ʻaʻole e wānana pinepine nā noiʻi holoholona i nā mea e hiki i nā kānaka, hōʻike kēia mau noiʻi e hōʻeha paha ka lāʻau i kahi hāpai o ke kanaka.

Inā hāpai ʻoe, a hāpai paha, e kamaʻilio me kāu kauka i nā pilikia a me nā pono o ka lawe ʻana iā Ninlaro.

ʻO Ninlaro a me ka kaohi hānau

Ma muli o ka hiki ʻana iā Ninlaro ke hōʻeha i ka hāpai hāpai ʻana, he mea nui ka hoʻohana ʻana i ka kaohi hānau ʻoiai ʻoe e lawe ana i kēia lāʻau.

Kaohi hānau no nā wahine

Inā he wahine ʻoe i hiki ke hāpai, pono ʻoe e hoʻohana i ka kaohi hānau pono ke lawe ʻoe iā Ninlaro. Pono ʻoe e hoʻomau i ka hoʻohana ʻana i ka kaohi hānau no 90 mau lā ma hope o kou hoʻōki ʻana i ka lawe ʻana iā Ninlaro.

Lawe ʻia ʻo Ninlaro i hui pū ʻia me ka lenalidomide a me dexamethasone no ka hoʻomaʻamaʻa myeloma maha. Hiki i ka Dexamethasone ke hana i ka kaohi hānau hormonal, e like me nā lāʻau kaohi hānau, ʻoi aku ka maikaʻi o ka pale ʻana i ka hāpai keiki. Inā ʻoe e hoʻohana nei i ka kaohi hānau hormonal, pono ʻoe e hoʻohana i kahi mea pale (e like me ka condom) ma ke ʻano he kaohi hānau.

Ka hānau hānau no nā kāne

Inā he kāne ʻoe e hana moekolohe ʻana me ka wahine i hiki ke hāpai, pono ʻoe e hoʻohana i ka kaohi hānau kūpono (e like me ka condom) ʻoiai ʻoe e lawe nei iā Ninlaro. He mea nui kēia, ʻoiai inā e hoʻohana ana kāu wahine wahine i ka pale keiki. Pono ʻoe e hoʻomau i ka kaohi hānau no 90 mau lā ma hope o kāu kau hope loa o Ninlaro.

Ninlaro a me ka waiū hānai

ʻAʻole ʻike ʻia inā hele ʻo Ninlaro i ka waiū umauma, a inā pili paha ia i ke ʻano o ka hana ʻana o kou kino i ka waiū umauma. Pono ʻoe e hōʻalo i ka hānai ʻana iā ʻoe e lawe ana iā Ninlaro. Mai hānai a hiki i ka liʻiliʻi ma 90 mau lā ma hope o kou hōʻoki ʻana i ka lawe ʻana iā Ninlaro.

Nā nīnau e pili ana iā Ninlaro

Eia nā pane i kekahi mau nīnau e pili ana iā Ninlaro.

ʻO Ninlaro kekahi ʻano chemotherapy?

ʻAʻole, ʻaʻole ʻo Ninlaro kahi ʻano chemotherapy. Hana ʻo Chemotherapy e ka luku ʻana i nā hunaola i kou kino e hoʻonui ana (e hana wikiwiki ʻana i nā pūnaewele). Pākuʻi ʻia kēia i kekahi o nā hunaola olakino, a me nā hunaola maʻi ʻino. Ma muli o ka hopena o ka chemotherapy i kekahi o kāu mau hunaola olakino, hiki ke loaʻa nā hopena ʻino loa.

ʻO Ninlaro kahi lāʻau i hoʻomākaukau ʻia no ka myeloma maha. Hana nā therapies pahuhopu i nā hiʻohiʻona kikoʻī i nā hunaola maʻi ʻokoʻa i ʻokoʻa i nā ʻāpana olakino. Hoʻokumu ʻo Ninlaro i kekahi mau protein i kapa ʻia proteasome.

Pili nā protein i ka ulu maʻamau a me ka hana ʻana o nā hunaola. ʻOi aku ka hana o kēia mau protein i loko o nā hunaola maʻi ʻaʻai ma mua o nā hunaola olakino. ʻO ke kumu kēia ke kuhi ʻo Ninlaro i nā proteasome, pili ia i nā hunaola myeloma ma mua o ka hopena o nā hunaola olakino.

Hiki i ka Ninlaro ke hoʻopili i nā hunaola olakino a hiki ke hana i nā hopena ʻaoʻao koʻikoʻi. Eia nō naʻe, ma ke ʻano laulā, mālama ʻia nā hoʻoponopono ʻana (e like me Ninlaro) e hōʻemi i nā hopena ʻē aʻe ma mua o nā lāʻau chemotherapy maʻamau.

Hiki iaʻu ke lawe iā Ninlaro ma mua a ma hope paha o kahi transplant cell stem?

Hiki paha iā ʻoe. Ua ʻae ʻia ʻo Ninlaro no ka hoʻohana ʻana i ka poʻe i loaʻa ma ka liʻiliʻi he hoʻokahi lapaʻau ʻē aʻe no kā lākou myeloma maha. Hoʻopili kēia i ka poʻe i loaʻa i ka transplant cell stem i ka lāʻau lapaʻau.

ʻO nā kolo koʻokoʻo nā puʻupuʻu kō ʻole i loaʻa i loko o kou koko a me kou iwi iwi. Hiki iā lākou ke hoʻomohala i nā ʻano ʻāpana o ke koko. ʻO kahi transplant cell transplant kahi lāʻau no ka myeloma maha. Hoʻoholo ia e hoʻololi i nā hunaola myeloma me nā hunaola ola olakino, a laila hiki ke oʻo i nā puʻuwai koko olakino.

Aia nā lula olakino o kēia manawa me Ninlaro ma ke ʻano he mālama mālama (lōʻihi) e hōʻoki ai i nā hunaola maʻi maʻi mai ka hoʻonui ʻana ma hope o kou loaʻa ʻana o kahi transplant cell autologous cell cell. (I kēia kaʻina hana, ʻohiʻohi ʻia kāu mau koʻokoʻo koʻokoʻo mai kou iho koko a i ʻole ka iwi iwi a hāʻawi ʻia iā ʻoe i ke transplant.) Eia nō naʻe, ʻoi aku ka makemake o nā lāʻau ʻē aʻe ma mua o Ninlaro i kēia hihia.

Hoʻokomo pū nā alakaʻi olakino o kēia manawa iā Ninlaro ma ke ʻano he koho no ka lāʻau mua i loaʻa no kāu myeloma he nui, ma mua o ka loaʻa ʻana o kahi transplant cell stem. Eia nō naʻe, ʻoi aku ka makemake o nā lāʻau ʻē aʻe ma mua o Ninlaro i kēia hihia. ʻO kēia kahi hoʻohana inoa inoa ʻole o Ninlaro. ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i waho ke hoʻohana ʻia kahi lāʻau i ʻae ʻia no ka hoʻohana hoʻokahi e mālama i kahi ʻokoʻa ʻae ʻole ʻia.

Inā wau e luaʻi ma hope o ka lawe ʻana i kahi lāʻau, e lawe paha wau i kahi lāʻau ʻē aʻe?

Inā ʻoe e luaʻi ma hope o ka lawe ʻana iā Ninlaro, mai lawe i kahi lāʻau o ka lāʻau i kēlā lā. E lawe wale i kāu kau ma hope aʻe ke kau ia ma kāu papa hana.

Inā ʻoe e hoʻolei pinepine i ka wā e lawe ana iā Ninlaro, e kamaʻilio me kāu kauka. Kau inoa paha lākou i nā lāʻau e kōkua ai i ka hōʻemi ʻana i kou nausea a i ʻole hāʻawi iā ʻoe i nā ʻōlelo aʻoaʻo e pili ana i ka mālama ʻana i ka nausea i ka wā o ka mālama ʻana.

E pono anei iaʻu nā hoʻokolohua lab ʻoiai wau e lawe nei iā Ninlaro?

Ae. ʻOiai ke lawe nei ʻoe iā Ninlaro, pono ʻoe e loaʻa i nā hoʻokolohua koko i nā manawa āpau e nānā i nā pae o ke koko a me ka hana o kou ake. I ka wā o ka mālama ʻana, e nānā kāu kauka i kēia mau hoʻokolohua penei:

  • Papa pae. Hiki iā Ninlaro ke hoʻohaʻahaʻa i kāu pae platelet. Inā haʻahaʻa haʻahaʻa kāu pae, hiki iā ʻoe ke hoʻonui i ka makaʻu o ke kahe koko koʻikoʻi. E nānā ana kāu kauka i kāu helu platelet i nā manawa mau, no laila inā loaʻa nā pilikia, hiki ke kamaʻilio koke ʻia. Inā haʻahaʻa kāu mau pae, hiki i kāu kauka ke hōʻemi i kāu mea hana o Ninlaro a i ʻole ua oki ʻoe i ka lawe ʻana iā Ninlaro a hiki i ka hoʻi ʻana o kāu mau platelet i kahi pae palekana. I kekahi manawa, pono ʻoe i kahi transfusion e loaʻa nā platelet.
  • Pae keʻokeʻo koko keʻokeʻo. ʻO kekahi o nā lāʻau (i kapa ʻia ʻo Revlimid) āu e lawe ai me Ninlaro hiki ke hoʻohaʻahaʻa i kāu kiʻekiʻe o nā hunaola keokeo, i hiki ke hoʻonui i kou makaʻu i ka loaʻa ʻana o nā maʻi. Inā he pae haʻahaʻa kāu o kēia mau hunaola, hiki i kāu kauka ke hōʻemi i kāu lāʻau o Revlimid a me Ninlaro, a i ʻole hoʻomaha iā ʻoe i ka lawe ʻana i nā lāʻau, a hoʻi hou kou mau keʻokeʻo koko i kahi pae palekana.
  • Nā hoʻāʻo hana ate. Hiki iā Ninlaro ke hōʻino i kou akepaʻa, e hoʻokuʻu i nā enzymes o ke ake i loko o kou koko. Hōʻoia nā hana o ka akepaʻa i kou koko no kēia mau ʻenemona. Inā hōʻike nā hōʻike e pili ana ʻo Ninlaro i kou ake, hiki i kāu kauka ke hoʻohaʻahaʻa i kāu ana o ka lāʻau.
  • Nā hoʻāʻo koko ʻē aʻe. E loaʻa iā ʻoe nā hoʻokolohua koko ʻē aʻe e nānā i ka maikaʻi o ka pane ʻana o kāu myeloma maha i ka mālama ʻana me Ninlaro.

Nā hana aka Ninlaro

Ma mua o ka lawe ʻana iā Ninlaro, e kamaʻilio me kāu kauka e pili ana i kāu mōʻaukala olakino. ʻAʻole kūpono ʻo Ninlaro iā ʻoe inā loaʻa iā ʻoe kekahi ʻano olakino. Pākuʻi ʻia kēia mau mea:

  • Nā pilikia ʻiʻo. Inā hōʻeha koʻikoʻi kāu hana hakuʻala, a inā ʻoe e loaʻa ana i nā lāʻau hemodialysis no ka holo pono ʻole ʻana o ka puʻuwai, e kuhikuhi ana kāu kauka i kahi lāʻau haʻahaʻa o Ninlaro nāu.
  • Nā pilikia ate. Hoʻokumu paha ʻo Ninlaro i nā pilikia i ke ake. A inā he hōʻeha kou ake, lawe paha ʻo Ninlaro i kou ʻano maʻi. Inā loaʻa iā ʻoe ke kaulike a paʻakikī i nā pilikia o ke ake, e kauoha ana kāu kauka i kahi lāʻau haʻahaʻa o Ninlaro nāu.
  • Hapai keiki. Inā hāpai ʻoe a lilo paha i hāpai, hiki iā Ninlaro ke hoʻopōʻino i kou hāpai ʻana. Inā hiki iā ʻoe a i ʻole kāu pakanā ke hāpai, pono ʻoe e hoʻohana i ka kaohi hānau ke lawe ʻoe iā Ninlaro. No ka ʻike hou aku, e ʻoluʻolu e ʻike i nā paukū "Ninlaro a hāpai" a me nā ʻāpana "Ninlaro a me ka hānau hānau" ma luna.

Kaha: No ka ʻike hou aku e pili ana i nā hopena maikaʻi ʻole o Ninlaro, e ʻike i ka ʻāpana "Nā hopena ʻaoʻao ʻo Ninlaro" ma luna.

Ninlaro overdose

ʻO ka lawe ʻana ma mua o nā mea i koi ʻia o Ninlaro hiki ke alakaʻi i nā hopena ʻino. No kahi papa inoa o nā hopena ʻē aʻe i hoʻokumu ʻia e Ninlaro, e ʻoluʻolu e ʻike i ka ʻāpana ʻaoʻao ʻo Ninlaro ma luna.

Nā hōʻailona overdose

Hiki i nā ʻōuli o kahi overdose ke hoʻopili i ka hoʻonui ʻana i nā hopena ʻē aʻe o Ninlaro. No kahi papa inoa o nā hopena i hiki ke ʻoluʻolu, e ʻoluʻolu e ʻike i ka ʻāpana ʻaoʻao ʻo Ninlaro ma luna.

He aha e hana ai inā he overdose

Inā manaʻo ʻoe ua lawe nui ʻoe i kēia lāʻau, e kāhea i kāu kauka. Hiki iā ʻoe ke kāhea i ka ʻAmelika Hui Pū ʻIa o nā Poison Control ma 800-222-1222 a i ʻole hoʻohana i kā lākou mea hana pūnaewele. Akā inā koʻikoʻi kāu mau ʻōuli, e kāhea iā 911 a i ʻole e hele koke i kahi lumi pilikia kokoke.

Ninlaro pau, mālama, a hoʻolei

Ke kiʻi ʻoe iā Ninlaro mai ka hale kūʻai lāʻau, e hoʻohui ka kauka i kahi lā palena pau i ka lepili ma ka pūʻolo lāʻau. ʻO kēia lā maʻamau hoʻokahi makahiki mai ka lā a lākou i hāʻawi ai i ka lāʻau. Mai lawe iā Ninlaro inā ua hala ka lā palena pau i paʻi ʻia.

Kōkua ka lā palena i ka hōʻoia ʻana i ka maikaʻi o nā lāʻau i kēia manawa. ʻO ke kūlana o ka Food and Drug Administration (FDA) i kēia manawa e hōʻalo i ka hoʻohana ʻana i nā lāʻau i make. Inā loaʻa iā ʻoe kahi lāʻau i hoʻohana ʻole ʻia i hala i ka lā palena pau, e kamaʻilio me kāu kauka lāʻau e pili ana inā hiki paha iā ʻoe ke hoʻohana.

Waihona

Pehea ka lōʻihi o ka maikaʻi o ka lāʻau e hiki ai ke hilinaʻi i nā kumu he nui, e like me pehea a ma hea ʻoe e mālama ai i ka lāʻau.

Pono e mālama ʻia nā capsule ʻo Ninlaro i kā lākou ʻōpala mua. E mālama iā lākou i ka wela o ka lumi mai ka mālamalama. ʻAʻole pono e mālama ʻia ʻo Ninlaro i kahi mahana i ʻoi aku ma mua o 86 ° F (30 ° C).

Hōʻalo i ka mālama ʻana i kēia lāʻau i nā wahi e hiki ke maʻū a pulu paha, e like me ka lua.

Hoʻolei

Inā ʻaʻole ʻoe e pono hou e lawe iā Ninlaro a loaʻa nā lāʻau i koe, he mea nui ia e hoʻolei aku me ka palekana. Kōkua kēia i ka pale aku i nā poʻe ʻē aʻe, e like me nā keiki a me nā holoholona, ​​mai ka lawe lāʻau ʻana ʻole. Mālama pū kekahi ia i ka lāʻau mai hōʻino i ke kaiapuni.

Hāʻawi ka pūnaewele FDA i nā ʻōlelo aʻoaʻo e pili ana i ka hoʻolāʻau lāʻau. Hiki iā ʻoe ke nīnau i kāu kauka lāʻau no ka ʻike e pili ana i ka hoʻolilo ʻana i kāu lāʻau.

ʻO ka ʻike ʻoihana no Ninlaro

Hāʻawi ʻia ka ʻike aʻe no nā kauka lapaʻau a me nā ʻoihana ola.

Nā Hōʻike

Ua ʻae ʻia ʻo Ninlaro e mālama i nā myeloma he nui, i hoʻohana ʻia me ka lenalidomide a me dexamethasone, i nā mākua i loaʻa i hoʻokahi lāʻau ʻē aʻe no ka maʻi.

ʻO ka palekana a me ka pono o Ninlaro ʻaʻole i hoʻokumu ʻia i nā keiki.

Mekanism o ka hana

Aia i loko o Ninlaro ka ixazomib, kahi mea kūpale proteasome. He kuleana nui ko nā protein i ka wāwahi ʻana i nā protein i pili i ka hoʻoponopono o ka pōʻaiapili, hoʻoponopono DNA, a me apoptosis. Hoʻopili a hoʻopili ʻo Ixazomib i ka hana o ka beta 5 subunit o ka mahele nui 20S o ka proteasome 26S.

Ma ka hoʻohaunaele ʻana i ka hana proteasome, kumu ʻo ixazomib i ka hōʻuluʻulu ʻana o nā protein hoʻomalu i ʻoi aku a ʻino paha i loko o ka cell, e hopena ai i ka make o ka cell.

Hoʻonui ʻia ka hana protein i nā hunaola malignant i hoʻohālikelike ʻia i nā hunaola olakino. ʻOi aku ka maʻalahi o nā hunaola myeloma maha i nā hopena o nā mea pale proteasome ma mua o nā hunaola olakino.

Pharmacokinetics a me ka metabolism

ʻO ke kumu lāʻau bioavailability o ixazomib ma 58% ma hope o ka hoʻoponopono waha. Hoʻoemi ʻia ka bioavailability ke lawe ʻia ka lāʻau me ka ʻai momona kiʻekiʻe. I kēia hihia, ua hoʻemi ʻia ka wahi ma lalo o ka piko (AUC) o ixazomib e 28%, a ua hoʻoliʻiliʻi ʻia kona kiʻekiʻe kiʻekiʻe (Cmax) e 69%. No laila, e lawelawe ʻia ka ixazomib ma kahi ʻōpū nele.

ʻO Ixazomib ka 99% paʻa i nā protein plasma.

Hoʻomaʻemaʻe mua ʻia ʻo Ixazomib e ka metabolism hepatic e pili ana i nā enzyme CYP he nui a me nā protein non-CYP. Hoʻopau ʻia ka hapa nui o kāna mau metabolites i ka mimi, me kahi excreted i loko o nā feces. ʻO ka hapalua o ke ola ʻo 9.5 mau lā.

Hoʻonui ka hoʻohaʻahaʻa hepatic haʻahaʻa i ka nui o ka ixazomib AUC e 20% ma mua o ke kumu AUC e kū nei me ka hana hepatic maʻamau.

Hoʻonui ʻia ʻo mean ixazomib AUC e 39% i ka poʻe me ka hōʻeha puʻuwai koʻikoʻi a i ʻole ka hopena hopena maʻi e pono ai ka dialysis. ʻAʻole hiki ke dialyzable ʻo ʻIxazomib.

ʻAʻole pili nui ka hoʻomaʻemaʻe e ka makahiki, ka wahine, ka lāhui, a me ka ʻili o ke kino. Aia nā noiʻi o Ninlaro i ka poʻe mai 23 a 91 mau makahiki, a me nā mea me nā ʻili o ke kino mai 1.2 a 2.7 m².

Nā Kūʻai Kūʻai

ʻAʻohe contraindications no Ninlaro. Eia nō naʻe, nā mea ʻona e pili ana i ka lāʻau e like me neutropenia, thrombositopenia, hōʻino hepatic, ʻeha o ka ʻili, a i ʻole neuropathy ākea e koi ai i ka hoʻōla o ka lāʻau.

Waihona

Pono e mālama ʻia nā capsule ʻo Ninlaro i kā lākou ʻōpala mua i ka mahana o ka lumi. ʻAʻole pono e mālama ʻia lākou i nā mahana ma mua o 86 ° F (30 ° C).

Hoʻolaha: Ua hana ʻo Nūhou Lapaʻau i kēia mau lā e hōʻoia i ka pololei, ka laulā, a me ka lā hou o nā ʻike āpau. Eia nō naʻe, ʻaʻole pono e hoʻohana i kēia ʻatikala i pani no ka ʻike a me ka mākaukau o kahi loea mālama ola laikini. E nīnau mau ʻoe i kāu kauka a i ʻole ʻoihana olakino ʻē aʻe ma mua o ka lawe ʻana i nā lāʻau. Hiki ke loli i ka ʻike o ka lāʻau i loko a ʻaʻole i manaʻo ʻia e uhi i nā hoʻohana a pau, nā kuhikuhi, ka mālama ʻana, nā ʻōlelo aʻoaʻo, nā launa lāʻau, nā hopena maʻi ʻaʻai, a me nā hopena maikaʻi ʻole.ʻO ka loaʻa ʻole o nā ʻōlelo aʻoaʻo a i ʻole nā ​​ʻike ʻē aʻe no kahi lāʻau i hāʻawi ʻia ʻaʻole ia e hōʻike i ka palekana o ka lāʻau a lāʻau paha i kūpono no nā mea maʻi āpau a i ʻole nā ​​hoʻohana kikoʻī āpau.

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