Types/breast/breast-hormone-therapy-fact-sheet

Hormone Therapy no ka umauma maʻi ʻaʻai

He aha nā hormones?

ʻO nā Hormones nā mea e hana ma ke ʻano he elele kemika i ke kino. Hoʻopili lākou i nā hana o nā hunaola a me nā pūnaewele i nā wahi like ʻole o ke kino, a hiki pinepine i kā lākou pahuhopu ma o ke kahe o ke koko.

Hana ʻia nā hormones estrogen a me ka progesterone e nā ovaries i nā wahine premenopausal a me kekahi mau mea ʻē aʻe, e like me ka momona a me ka ʻili, i nā wahine a me nā kāne a me nā kāne ma hope o ka wahine. Paipai ka Estrogen i ka hoʻomohala ʻana a me ka mālama ʻana i nā ʻano wahine a me ka ulu ʻana o nā iwi lōʻihi. He mea nui ʻo Progesterone i ka pōʻai menstrual a me ka hāpai ʻana.

Paipai pū ka Estrogen a me ka progesterone i ka ulu ʻana o kekahi mau maʻi ʻōpū o ka umauma, i kapa ʻia he kanulau umauma ʻāpiki-ʻo ka hone. Aia i loko o nā hunaola umauma maʻi ʻaʻa Hormone i loko o nā protein i kapa ʻia he mau ʻāpono nā homone e hoʻoheheʻe ʻia ke hoʻopaʻa nā hormona iā lākou. Hoʻokumu nā mea loaʻa i ka hoʻoliʻiliʻi i nā loli i ka ʻōlelo o nā gen kikoʻī, i hiki ke hoʻoulu i ka ulu ʻana o ka cell.

He aha ka hormone therapy?

Hormone therapy (i kapa ʻia ʻo ka hoʻōla hormonal, ka mālama ʻana i ka hormone, a i ʻole endocrine therapy) lohi a kū hoʻi i ka ulu ʻana o nā tumora pili i ka hormone ma ke kāpae ʻana i ka hiki i ke kino ke hana i nā hormones a i ʻole ke keʻakeʻa ʻana i nā hopena o nā hormones ma nā pūnaʻi maʻi umauma. ʻAʻole loaʻa i nā tumors he hormone insensitive i nā mea loaʻa hormonone a pane ʻole i ka hoʻōla hormonone.

I mea e hoʻoholo ai inā loaʻa i nā hunaola maʻi ʻaʻai ka umauma i nā receptor hormone, e hoʻāʻo nā kauka i nā laʻana o ka maʻi tumola i hemo ʻia e ka ʻoki. Inā loaʻa i nā ʻea tumo nā ʻāpono estrogen, ua kapa ʻia ka maʻi ʻaʻai ʻo estrogen receptor positive (ER positive), estrogen sensitive, a estrogen responsive hoʻi. Pēlā nō, inā loaʻa i nā pūpū tumole i nā mea loaʻa progesterone, ua kapa ʻia ka maʻi ʻaʻa maʻi he progesterone receptor positive (PR a ʻo PgR maikaʻi) Ma kahi o 80% o nā kanulau umauma ER maikaʻi (1). ʻO ka hapa nui o nā maʻi ʻōpū ER-maikaʻi PR kekahi. ʻO nā tumors umauma i loaʻa ka estrogen a me / a i ʻole nā ​​progresone receptor i kekahi manawa i kapa ʻia he hormone receptor positive (HR positive).

ʻO nā maʻi ʻaʻai ʻole nele i nā mea loaʻa i ka estrogen i kapa ʻia he estrogen receptor maikaʻi (ER maikaʻi ʻole). ʻO kēia mau tumors he estrogen insensitive, ʻo ia hoʻi ʻaʻole lākou e hoʻohana i ka estrogen e ulu. ʻO nā tumors umauma i nele i nā mea loaʻa progesterone i kapa ʻia he progesterone receptor maikaʻi (PR a PgR maikaʻi ʻole). ʻO nā tumors umauma i nele i ka ʻelua estrogen a me nā mea loaʻa progesterone i kekahi manawa ua kapa ʻia he hormone receptor maikaʻi (HR maikaʻi ʻole).

ʻAʻole pono e huikau ʻia ka hōʻailona Hormone no ka maʻi ʻaʻai o ka umauma me ka menopausal hormone therapy (MHT) - ka lapaʻau ʻana me ka estrogen wale nō a i ʻole me ka progesterone e kōkua ai e hōʻoluʻolu i nā ʻōuli o ka menopause. Hana kēia ʻano ʻelua o ka therapy i nā hopena ʻē aʻe: ʻo ka hormone therapy no ka maʻi ʻaʻai umauma ka palaka i ka ulu ʻana o ka maʻi ʻaʻai umauma HR-maikaʻi, ʻoiai ʻo MHT hiki ke hoʻoulu i ka ulu ʻana o ka maʻi ʻaʻai umauma HR-maikaʻi. No kēia kumu, ke ʻike ʻia ka wahine e lawe ana i ka MHT me ka maʻi ʻaʻai umauma HR-maikaʻi ua noi ʻia ʻo ia e hōʻoki i kēlā lāʻau.

He aha nā ʻano o ka hormone therapy e hoʻohana ʻia no ka maʻi ʻaʻai umauma?

Hoʻohana ʻia nā ʻōkuhi e mālama i ka maʻi ʻaʻai umauma ʻāpiki-ʻona.

Ke kāpae ʻana i ka hana ovarian: No ka mea ʻo nā ovaries ke kumu nui o ka estrogen i nā wahine premenopausal, hiki ke hoʻemi ʻia nā pae estrogen i kēia mau wahine e ka hoʻopau ʻana a hoʻopau ʻana paha i ka hana ovarian. Kāhea ʻia ka pale ʻana i ka hana ovarian.

Hiki ke hana i ka hoʻopau ʻana o ka ovarian i kahi lāʻau ma kahi hana e wehe i nā ovaries (i kapa ʻia ʻo oophorectomy) a i ʻole me ka mālama ʻana me ka radiation. ʻO kēia ʻano ablasi ovarian paʻa mau.

ʻO kahi ʻē aʻe, hiki ke kāohi ʻia ka hana ovarian no ka manawa pōkole e ka lapaʻau me nā lāʻau i kapa ʻia he gonadotropin-hoʻokuʻu aku i nā agonists (GnRH) agonists, kahi i ʻike ʻia ma ke ʻano he agonists hormone-hoʻokuʻu hoʻokuʻu (LH-RH). Hoʻopilikia kēia mau lāʻau i nā hōʻailona mai ka pituitary gland e hoʻoulu i nā ovaries e hana i ka estrogen.

ʻO nā laʻana o nā lāʻau hoʻoliʻiliʻi ovarian i ʻae ʻia e ka US Food and Drug Administration (FDA) ʻo goserelin (Zoladex®) a me leuprolide (Lupron®).

Ke kāpae ʻana i ka hana ʻana o ka estrogen: Hoʻohana ʻia nā lāʻau i kapa ʻia nā mea kāohi aromatase e kāohi ai i ka hana o kahi enzyme i kapa ʻia ʻo aromatase, a ke kino e hoʻohana ai e hana i ka estrogen i nā ovaries a me nā mea ʻē aʻe. Hoʻohana nui ʻia nā mea kāohi aromatase i nā wahine postmenopausal no ka mea ʻo nā ovaries i nā wahine premenopausal e hana i nā aromatase he nui loa no nā mea pāpā e hoʻopaʻa pono. Eia nō naʻe, hiki ke hoʻohana ʻia kēia mau lāʻau i ka wahine premenopausal inā hāʻawi ʻia ʻia lākou me kahi lāʻau e hoʻopau i ka hana ovarian.

ʻO nā laʻana o nā mea kāohi aromatase i ʻae ʻia e ka FDA he anastrozole (Arimidex®) a me letrozole (Femara®), a ʻo nā mea ʻelua e hana ʻole i kahi manawa no ka manawa, a me exemestane (Aromasin®), kahi e hoʻopau mau ai i ka aromatase.

ʻO ka pale ʻana i nā hopena o ka estrogen: Hoʻoweliweli nā ʻano lāʻau he nui me ka hiki i ka estrogen ke hoʻoulu i ka ulu ʻana o nā hunaola maʻi ʻaʻai.

• Hoʻopili nā mea koho receptor estrogen koho (SERMs) i nā mea loaʻa i ka estrogen, e pale ana i ka estrogen mai ka hoʻopaʻa ʻana. ʻO nā laʻana o SERM i ʻae ʻia e ka FDA no ka mālama ʻana i ka maʻi ʻaʻai umauma ʻo tamoxifen (Nolvadex®) a me toremifene (Fareston®). Ua hoʻohana ʻia ʻo Tamoxifen ma mua o 30 mau makahiki e mālama ai i ka mea loaʻa mai ka hormone - maʻi ʻaʻai umauma maikaʻi.

Ma muli o ka hoʻopaʻa ʻana o SERM i nā mea loaʻa estrogen, hiki iā lākou ke pale wale i ka hana estrogen (ʻo ia hoʻi, lawelawe ma ke ʻano he antagonists estrogen) akā hoʻohālikelike pū i nā hopena estrogen (ie, lawelawe ma ke ʻano he agonists estrogen). Hiki i nā SERM ke hana ma ke ʻano he antagonists estrogen i kekahi mau pūnaewele a me he agonists estrogen i loko o nā mea ʻē aʻe. ʻO kahi laʻana, pāpā ka tamoxifen i nā hopena o ka estrogen i kaʻiʻo o ka umauma akā hana like me ka estrogen i ka pūpū a me ka iwi.

• ʻO nā lāʻau antiestrogen ʻē aʻe, e like me fulvestrant (Faslodex®), hana i kahi ala ʻokoʻa e pale ai i nā hopena o ka estrogen. E like me SERM, hoʻopaʻa ka fulvestrant i ka receptor estrogen a hana ma ke ʻano he antagonist estrogen. Eia nō naʻe, ʻokoʻa ka SERM, ʻaʻohe hopena agonist estrogen i ka fulvestrant. He antiestrogen maʻemaʻe ia. Eia hou, ke hoʻopaʻa ka fulvestrant i ka receptor estrogen, hoʻokumu ʻia ka mea loaʻa no ka luku.

Pehea e hoʻohana ʻia ai ka hoʻomaʻamaʻa hormone e mālama ai i ka maʻi ʻaʻai umauma?

ʻEkolu ala nui e hoʻohana ʻia ai ka hoʻomaʻamaʻa hormonone e mālama ai i ka maʻi ʻaʻai umauma ʻāpilikone

Hoʻomaʻamaʻa Adjuvant no ka maʻi kanesa o ka umauma mua: Ua hōʻike ʻia ka noiʻi i nā wahine i loaʻa ma kahi o 5 mau makahiki o ka adjuvant therapy me tamoxifen ma hope o ka ʻoki ʻana no ka wā mua ER-maikaʻi i ka maʻi ʻaʻai umauma i hoʻoliʻiliʻi i nā pilikia o ka hoʻi hou ʻana o ka maʻi ʻaʻai. i ka umauma ʻē aʻe, a make i 15 mau makahiki (2).

Ua ʻae ʻia ʻo Tamoxifen e ka FDA no ka hoʻomaʻamaʻa ʻana o ka hormone adjuvant o nā wahine premenopausal a me postmenopausal (a me nā kāne) me ka maʻi maʻi umauma ER-maikaʻi, a ua ʻae ʻia nā mea hoʻopuka aromatase anastrozole a me letrozole no kēia hoʻohana i nā wahine postmenopausal.

Ua ʻae ʻia kahi mea kāohi ʻekolu o ka aromatase, exemestane no ka hoʻomaʻamaʻa adjuvant o ke kanulau umauma pae mua i nā wahine postmenopausal i loaʻa i ka tamoxifen ma mua.

A hiki i kēia manawa, ʻo ka hapanui o nā wahine i loaʻa ka adjuvant hormone therapy e hōʻemi i ka manawa o ka hoʻi ʻana o ka maʻi ʻaʻai umauma i ka tamoxifen i kēlā me kēia lā no 5 mau makahiki. Eia nō naʻe, me ka hoʻolauna ʻia ʻana o nā therapies hormone hou, ua hoʻohālikelike ʻia kekahi o ia mau mea me tamoxifen i nā hoʻokolohua hoʻokolohua, ua lilo nā ala hou aʻe i ka hoʻomaʻamaʻa hormone i mea maʻamau (3-5). ʻO kahi laʻana, lawe paha kekahi mau wahine i kahi mea kāohi aromatase i kēlā me kēia lā no 5 mau makahiki, ma kahi o tamoxifen. Hiki i nā wahine ʻē aʻe ke loaʻa i kahi lāʻau hou aʻe me kahi mea hōʻoki aromatase ma hope o 5 mau makahiki o ka tamoxifen. ʻO ka hope loa, hiki i kekahi mau wahine ke hoʻololi i kahi mea kāohi aromatase ma hope o 2 a 3 mau makahiki o tamoxifen, no ka huina o 5 a ʻoi paha mau makahiki o ka hoʻomaʻamaʻa hormone. Ua hōʻike ʻia ka noiʻi no nā wahine postmenopausal i mālama ʻia no ka maʻi ʻōpū o ka umauma i ka wā mua.

ʻO nā hoʻoholo e pili ana i ke ʻano a me ka lōʻihi o ka adjuvant hormone therapy e pono ai i kēlā me kēia kumu. Lawe maikaʻi ʻia kēia hana hoʻoholo hoʻoholo paʻakikī e ke kamaʻilio ʻana me kahi oncologist, he kauka i loea i ka mālama ʻana i ka maʻi ʻaʻai.

Ka mālama ʻana i ka maʻi ʻaʻai umauma holomua a metastatic paha: ʻae ʻia kekahi mau ʻano o ka hormone therapy e mālama i ka maʻi ʻaʻai umauma metastatic a i ʻole recurrent. ʻO ka Hormone therapy kahi koho lapaʻau no ka maʻi ʻaʻai umauma ER-maikaʻi i hoʻi mai i ka umauma, ka umauma umauma, a i ʻole nā ​​lymph node kokoke ma hope o ka hoʻomaʻamaʻa ʻana (i kapa ʻia hoʻi he hoʻi locoregional).

Ua ʻae ʻia ʻelua mau SERM e mālama i ka maʻi ʻaʻai umauma metastatic, tamoxifen a me toremifene. Ua ʻae ʻia ka antiestrogen fulvestrant no nā wahine postmenopausal me ka maʻi maʻi umauma ER-maikaʻi metastatic i hoʻolaha ʻia ma hope o ka lapaʻau ʻana me nā antiestrogens ʻē aʻe (7). Hiki ke hoʻohana ʻia i nā wahine premenopausal i loaʻa i ka hoʻopau ʻana i ka ovarian.

Ua ʻae ʻia nā mea hoʻonāukiuki aromatase anastrozole a me letrozole e hāʻawi ʻia i nā wahine postmenopausal ma ke ʻano he lāʻau lapaʻau mua no ka maʻi kanesa umauma metastatic a i ʻole kūloko. (8, 9). ʻO kēia mau lāʻau ʻelua, a me ka exomestane mea hōʻoki aromatase, hoʻohana ʻia e mālama i nā wahine postmenopausal me ka maʻi ʻaʻai umauma kiʻekiʻe nāna i hoʻomāhuahua ka maʻi ma hope o ka mālama ʻana me tamoxifen (10).

Mālama ʻia kekahi mau wahine me ka maʻi ʻaʻai holomua me ka hoʻohuihui ʻana o ka hormone therapy a me kahi lāʻau hoʻomākaukau ʻia. ʻO kahi laʻana, ʻae ʻia ka lāʻau hoʻomohala hoʻomohala lapatinib (Tykerb®) e hoʻohana pū ʻia me ka letrozole e mālama ai i ka mea loaʻa mai ka hormone - maikaʻi, HER2-positive metastatic cancer cancer in postmenopausal women for whom hormon therapy is ditunjukkan.

ʻO kekahi mea e hoʻomākaukau ʻia ana, ʻo palbociclib (Ibrance®), ua ʻae ʻia i ka ʻae ʻia no ka hoʻohana pū ʻana me letrozole ma ke ʻano he lāʻau mua no ka hoʻomaʻamaʻa ʻana i ka hormone receptor – positive, HER2-maikaʻi ʻole ka maʻi ʻaʻai umauma i nā wahine postmenopausal. Paʻa ʻo Palbociclib i ʻelua kinases hilinaʻi i ka cyclin (CDK4 a me CDK6) i kū aʻe e hāpai i ka ulu ʻana o ka receptor hormone – nā pūnaʻi maʻi ʻaʻai umauma maikaʻi.

ʻAe ʻia ʻo Palbociclib e hoʻohana pū ʻia me ka fulvestrant no ka mālama ʻana i nā wahine me ka reseptor hormone – maikaʻi, ʻo HER2-maikaʻi ʻole a i ʻole ka maʻi ʻaʻai umauma metastatic nona ka maʻi ʻaʻai i ʻoi aku ka maikaʻi ma hope o ka hoʻomaʻamaʻa ʻia ʻana me kahi lāʻau hoʻomaʻamaʻa hormonone ʻē aʻe.

ʻO ka mālama ʻana ʻo Neoadjuvant i ka maʻi ʻaʻai umauma: ua aʻo ʻia ka hoʻohana ʻana o ka hormone therapy e mālama i ka maʻi ʻaʻai umauma ma mua o ke ʻoki ʻana (neoadjuvant therapy) i nā hoʻokolohua hoʻokolohua (11). ʻO ka pahuhopu o neoadjuvant therapy ka mea e hōʻemi i ka nui o kahi tumo umauma e ʻae ai i kahi ʻoki mālama mālama umauma. Ua hōʻike ʻia ka ʻikepili mai nā hoʻokolohua hoʻokolohua kaulike ʻole ʻia ʻo neoadjuvant hormone therapy — i kikoʻī, me nā mea kāohi aromatase - hiki ke hoʻokō pono i ka hoʻemi ʻana i ka nui o nā puʻupuʻu umauma i nā wahine postmenopausal. ʻAʻole maopopo ka hopena o nā wahine premenopausal no ka mea he mau hoʻokolohua liʻiliʻi e pili ana i kekahi mau wahine premenopausal i mālama ʻia a hiki i kēia manawa.

ʻAʻohe o ka hormone therapy i ʻae ʻia e ka FDA no ka mālama neoadjuvant o ka maʻi ʻaʻai umauma.

Hiki i ka hormone therapy ke hoʻohana i mea e pale aku ai i ka maʻi ʻaʻai umauma?

Ae. ʻO ka hapa nui o nā maʻi maʻi umauma he maikaʻi ER, a ua hoʻāʻo nā hoʻokolohua hoʻokolohua inā hiki ke hoʻohana ʻia ka hoʻōla hormonone e pale aku ai i ka maʻi ʻaʻai umauma i nā wahine e hoʻonui ana i ka maʻi.

ʻO kahi hoʻokolohua hoʻokolohua kaulike a NCI i kākoʻo ʻia i kapa ʻia ʻo Breast Cancer Prevent Trial i ʻike ʻia ʻo tamoxifen, i lawe ʻia no 5 mau makahiki, hoʻemi i ka makaʻu o ka hoʻomohala ʻana i ka maʻi ʻaʻai maʻi maʻi e pili ana i 50% i nā wahine postmenopausal i piʻi nui ka makaʻu (12). ʻO ka ukali wā lōʻihi o kahi hoʻokolohua kaulike hou ʻia, ʻo ka International Breast Cancer Intervention Study I, ua ʻike ʻia he 5 mau makahiki o ka mālama tamoxifen e hōʻemi ana i ka maʻi ʻaʻai o ka umauma ma kahi o 20 mau makahiki (13). ʻO kahi hoʻokolohua nui aʻe ma hope loa, ʻo ka Study of Tamoxifen a me Raloxifene, i kākoʻo pū ʻia e NCI, ua ʻike ʻia he 5 mau makahiki o ka raloxifene (kahi SERM) e hōʻemi ana i ka maʻi maʻi ʻaʻai o ka umauma i kēlā mau wahine ma kahi o 38% (14).

Ma ke ʻano he hopena o kēia mau hoʻāʻo, ʻae ʻia nā tamoxifen a me raloxifene e ka FDA e hōʻemi i ka pilikia o ka hoʻomohala ʻana i ka maʻi ʻaʻai umauma i nā wahine i ka nui o ka maʻi. ʻAe ʻia ʻo Tamoxifen no kēia hoʻohana me ka nānā ʻole i ke kūlana menopausal. ʻAe ʻia ʻo Raloxifene no ka hoʻohana ma nā wahine postmenopausal wale nō.

ʻElua mau mea kāohi aromatase-exemestane a me anastrazole - ua loaʻa pū kekahi e hōʻemi i ka makaʻu o ka umauma maʻi 'aʻai i nā wahine postmenopausal i ka hoʻonui ʻia o ka maʻi. Ma hope o 3 mau makahiki o ka ukali ʻana i kahi hoʻokolohua kaulike ʻole, ʻo nā wahine i lawe i ka exemestane he 65% ka liʻiliʻi ma mua o ka poʻe i lawe i kahi placebo e hoʻomohala i ka maʻi ʻaʻai umauma (15). Ma hope o 7 mau makahiki o ka ukali ʻana ma kahi hoʻokolokolo hoʻokolohua ʻē aʻe, ʻo nā wahine i lawe i ka anastrozole he 50% ka liʻiliʻi ma mua o ka poʻe i lawe i ka placebo e hoʻomohala i ka maʻi ʻaʻai umauma (16). Ua ʻae ʻia ka exemestane a me ka anastrozole e ka FDA no ka mālama ʻana i nā wahine me ka maʻi maʻi umauma ER-maikaʻi. ʻOiai hoʻohana ʻia nā mea ʻelua no ka pale ʻana i ka maʻi ʻaʻai umauma, ʻaʻole ʻae ʻia no kēlā hōʻike kikoʻī.

He aha nā hopena ʻē aʻe o ka hormone therapy?

ʻO nā hopena ʻaoʻao o ka hormone therapy kaukaʻi nui ʻia i ka lāʻau kikoʻī a i ʻole ke ʻano o ka mālama ʻana (5). Pono e kaupaona ʻia nā pono a me nā mea hōʻino o ka lawe ʻana i ka hōmona therapy no kēlā me kēia wahine. Hoʻohana ʻia kahi hoʻolālā hoʻololi maʻamau no ka hoʻomaʻamaʻa adjuvant, kahi e lawe ai nā mea maʻi i ka tamoxifen no 2 a 3 mau makahiki paha, a ukali ʻia e kahi mea hōʻoki aromatase no 2 a 3 mau makahiki paha, e hāʻawi i ke kaulike maikaʻi o nā pono a me nā hōʻino o kēia ʻano ʻelua o ka hormone therapy (17). .

ʻO nā uila wela, nā sweats i ka pō, a me ka maloʻo ʻana o ka ʻōpū nā hopena ʻē aʻe o ka hormone therapy. Hoʻopilikia ka Hormone therapy i ka pōʻai menstrual i nā wahine premenopausal.

ʻO nā hopena ʻemi liʻiliʻi akā ʻoi loa o nā hopena koʻikoʻi o ka lāʻau hoʻōla hormonone e helu ʻia ma lalo.

ʻO Tamoxifen

• ʻO ka makaʻu o ke kahe o ke koko, keu hoʻi i nā akemāmā a me nā wāwae (12)

• Hahau (17)

• Nā Cataract (18)

• Nā maʻi ʻaʻai endometrial a me uterine (17, 19)

• Lilo ka iwi i nā wahine premenopausal

• Huli ka naʻau, kaumaha, a me ka lilo o ka libido

• I nā kāne: hōʻeha ke poʻo, kahoʻi, ka luaʻi, ka ʻili, ka maʻi o ka maʻi, a me ka hoʻoliʻiliʻi o ka hoihoi wahine

Raloxifene

• ʻO ka makaʻu o ke kahe o ke koko, keu hoʻi i nā akemāmā a me nā wāwae (12)

• Pākuʻi i kekahi mau pūʻulu (17)

Kaohi kaomi ovarian

• Lilo iwi

• Huli ka naʻau, kaumaha, a me ka lilo o ka libido

Nā mea kāohi ʻo Aromatase

• Ka makaʻu o ka puʻuwai puʻuwai, angina, puʻuwai puʻuwai, a me hypercholesterolemia (20)

• Lilo iwi

• ʻEha hui (21-24)

• Huli a me ke kaumaha

ʻO Fulvestrant

• Nā ʻōuli Gastrointestinal (25)

• Loaʻa ka ikaika (24)

• ʻEha

Hiki i nā lāʻau ʻē aʻe ke hoʻopilikia i ka hormone therapy?

ʻO kekahi mau lāʻau, e like me nā antidepressants i kuhikuhi pinepine ʻia (ʻo kēlā mau mea ma ka mahele i kapa ʻia he selotonin reuptake inhibitors, a SSRIs paha), kāohi i kahi ʻenemoni i kapa ʻia ʻo CYP2D6. He kūlana koʻikoʻi kēia enzyme i ka hoʻohana o tamoxifen e ke kino no ka mea metabolates, a wāwahi paha, tamoxifen i loko o nā molakeke, a i ʻole nā ​​metabolites, ʻoi aku ka nui o ka hana ma mua o tamoxifen iho.

ʻO ka hiki i nā SSRI ke, ma ke kāohi ʻana iā CYP2D6, hoʻolohi i ka metabolism o tamoxifen a hoʻemi i kona pono he hopohopo i hāʻawi ʻia e like me ka hapaha o nā maʻi maʻi ʻaʻai umauma ʻike i ke kaumaha kaumaha a hiki ke mālama ʻia me SSRIs. Hoʻohui ʻia, hoʻohana ʻia ʻo SSRI i kekahi manawa e mālama i nā uila wela i hoʻokumu ʻia e ka hormone therapy.

Hōʻike ka poʻe loea he nui i nā mea maʻi e lawe ana i nā antidepressants me tamoxifen e kūkākūkā i nā koho lapaʻau me kā lākou kauka. ʻO kahi laʻana, hiki i nā kauka ke koi aku i ka hoʻololi ʻana mai kahi SSRI kahi mea kāohi i ka CYP2D6, e like me paroxetine hydrochloride (Paxil®), i kahi mea hoʻonāwaliwali nāwaliwali, e like me sertraline (Zoloft®), a i ʻole ʻaʻohe mea hana keʻakeʻa, e like me venlafaxine (Effexor®) a i ʻole citalopram (Celexa®). A i ʻole ʻōlelo paha lākou i kā lākou poʻe maʻi postmenopausal e lawe i kahi mea hōʻoki aromatase ma kahi o tamoxifen.

ʻO nā lāʻau ʻē aʻe e kāohi iā CYP2D6 me kēia mau mea:

• ʻO Quinidine, i hoʻohana ʻia e mālama i nā puʻuwai puʻuwai abnormal

• ʻO Diphenhydramine, kahi antihistamine

• ʻO Cimetidine, hoʻohana ʻia e hoʻemi i ka waikawa ʻōpū

Pono nā poʻe i kuhikuhi ʻia i ka tamoxifen e kūkākūkā i ka hoʻohana ʻana o nā lāʻau ʻē aʻe āpau me kā lākou kauka.

Nā kūmole i koho ʻia

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