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¿Es la naltrexona una sustancia controlada?

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no, la naltrexona ciertamente no está etiquetada como sustancia controlada debido a los EE. UU. institución de aplicación de la medicina (dea). La naltrexona es un antagonista opioide completo que obstruye los pasos eufóricos (lo que significa que no puede crear dependencia o aumentar). La naltrexona está aprobada para su uso durante el plan de tratamiento de pacientes con trastorno por consumo de opioides (oud) o dependencia del alcohol, y orientación. cualquier médico puede sugerir naltrexona.

Entonces, ¿cómo es exactamente la naltrexona?

la naltrexona se puede obtener como una inyección intramuscular de acción prolongada (compañía: vivitrol ) o como tabletas dentales generales de 50 mg. no hay disponible común para vivitrol hasta ahora.

vivitrol se usa para detener la recaída en el tratamiento de la dependencia de las bebidas alcohólicas o el uso de opioides. Puede ser beneficioso para los clientes que tienen problemas para seguir con la rutina de medicación oral. vivitrol ayudará a prevenir los antojos durante 1 mes con una sola inyección. se encontraron en un poder de 380 mg y fue aprobado en 2006.

vivitrol solo está disponible en farmacias calificadas forte, que enviarán el medicamento al médico cada mes antes de su inyección. su proveedor de atención médica le permitirá completar los tipos necesarios y administrarle las inyecciones cada mes dentro de la empresa.

las tabletas orales de naltrexona se reciben una vez al día. Las píldoras orales de 50 mg tienen un efecto que dura 24 horas.

La

dolencia por uso de opioides (oud)

naltrexona oral es una opción para clientes determinados con signos y síntomas más leves de oud que pueden terminar siendo fácilmente seguidos por la conformidad del tratamiento. pero la mala adherencia en realidad ha limitado el uso de naltrexona dental para oud. Los estudios científicos muestran una mayor efectividad con el plan de tratamiento con metadona o buprenorfina para oud.

la naltrexona puede precipitar los signos de desprendimiento si decide, sin embargo, usar narcóticos y no debe usarse antes del final de un desprendimiento de opioides supervisado médicamente, a menudo al menos de 7 a 10 días.

dependencia del alcohol

para los tratamientos para la dependencia de las bebidas alcohólicas, los pacientes no deben tener fervor durante el tiempo que comienzan la terapia con vivitrol.

¿cuáles son los efectos no deseados con la naltrexona?

la naltrexona puede precipitar un desprendimiento suave o posiblemente extremo en individuos que realmente dependen de los opiáceos. complicaciones habituales notificadas con la función de naltrexona:

  • calambres o dolor de barriga
  • dolor de cabeza
  • mareos
  • impulso del sitio web de inyección como molestias o inflamación (solo vivitrol)
  • ansiedad, nerviosismo
  • problemas para dormir
  • dolor en las articulaciones y los músculos
  • náuseas o vómitos
  • fatiga

  • conclusión

    • la naltrexona ciertamente no está clasificada como un compuesto administrado. es un antagonista opioide completo que bloquea las medidas eufóricas en el receptor de opioides (lo que significa que no puede crear una dependencia o dependencia más alta).
    • se utiliza como área del plan de tratamiento de clientes con dependencia de alcohol o condición de uso de opioides, y orientación. Ciertamente, la naltrexona no alivia la dependencia de medicamentos o el alcoholismo.
    • puede adquirirse con receta médica como un tratamiento intramuscular de acción prolongada (marca registrada: vivitrol) o como una tableta dental de 50 mg (universal). vivitrol todavía no está en forma común.

    esto en realidad nunca asume todos los detalles que debe saber sobre la naltrexona para un uso efectivo y seguro. revise toda la información de naltrexona o vivitrol aquí, y repase esta información con su médico u otro médico.

b ‘¿Cuál es la tasa de éxito de Femara en el cáncer de mama?’

Los estudios de investigación han contrastado el tamoxifeno con inhibidores de aromatasa (IA) como letrozol (fabricante: Femara ) como terapia aditiva (después de la cirugía ) al comienzo del nivel de cáncer de mama cuando se toma durante 5 años. Los efectos han demostrado que las IA pueden ser mejores que la terapia con tamoxifeno para prolongar el compromiso hasta que los tumores malignos de seno regresen o el cáncer de seno se extienda en el cuerpo.

Además, es beneficioso cambiar a una IA después de dos o tres décadas con tamoxifeno, o continuar una IA después de cinco años de tratamiento con tamoxifeno (sin prevenir la terapia por completo). Sin embargo, no hay absolutamente ningún beneficio en cambiar en comparación con el uso de letrozol por su cuenta durante cinco años; pero el cambio podría ser una opción razonable para los clientes que enfrentan complicaciones inaceptables con cualquiera de los medicamentos.

Algunas mujeres pueden beneficiarse de un tratamiento extenso en los últimos 5 años considerando el riesgo de reaparición de infecciones, problemas y remedios anteriores. La comunidad de oncología clínica de los Estados Unidos (ASCO) sugiere que para las mujeres que reciben un tratamiento extenso contra la IA, 10 años deberían ser el momento óptimo de la terapia, según su guía de capacitación médica particular de 2019.

La elección de una terapia prolongada de IA realmente debería ser una opción discutida de acuerdo con el peligro de recurrencia de infección, complicaciones farmacológicas, afección (infección de ganglios positivos / negativos) y preferencia diligente. Una mayor duración del uso de IA podría implicar fracturas de tejido óseo mejoradas y efectos secundarios adversos centrales, así como la interrupción del tratamiento.

El tratamiento con una IA debe suspenderse si el cáncer de seno regresa.

¿Qué es exactamente la terapia hormonal?

el tratamiento hormonal (también llamado terapia endocrina) ayuda a evitar el desarrollo de cáncer de los tejidos del seno que dependen de las hormonas humanas. Los medicamentos utilizados en este tipo de tratamiento aditivo son típicamente los moduladores de los receptores de estrógenos (SERM) más exigentes, como el tamoxifeno o los inhibidores de la aromatasa (IA), como Femara.

Estos agentes bloquean el poder del estrógeno para impulsar el progreso del cáncer de seno, lo que ayuda a detener la reaparición. Los tratamientos hormonales ahora son tratamientos regulares y también se ha demostrado que reducen el riesgo de recurrencia y transmisión del cáncer de seno en mujeres con receptores hormonales positivos. Estos son típicamente medicamentos orales utilizados como un suplemento regular durante 5 a varios años.

¿Cómo se utiliza Femara en la terapia temprana contra el cáncer de mama?

Femara, un inhibidor de la aromatasa de Novartis, fue aprobado por la FDA en 1997. Las píldoras Femara funcionan reduciendo la cantidad de la hormona estrógeno en damas posmenopáusicas. Aromasin (nombre genérico: exemestano) y Arimidex (título genérico: anastrozol) también son inhibidores de la aromatasa.

Femara se usa para tratar a las mujeres posmenopáusicas para:

  • disminuye el riesgo de que el cáncer de mama con receptores hormonales positivos en etapa temprana regrese después de la cirugía, así como otros tratamientos
  • reducen el riesgo de receptores hormonales en etapa temprana contra el cáncer de mama positivo después de 5 años de tamoxifeno
  • tratar el cáncer de mama con receptores hormonales positivos en etapa avanzada.

Lo que realizaron estudios científicos con Femara select?

Los estudios con letrozol (Femara) y varias otras IA muestran que el tratamiento de IA utilizado por usted proporciona una mejora significativa en el tiempo de residencia sin recurrencia del cáncer de seno y el tiempo sin cáncer de extensión de senos.

BIG 1-98 trial

Dos grandes estudios han demostrado los beneficios de Femara. Desde el interior de la prueba GRANDE 1-98, iniciada en 1998, más de 8,000 mujeres posmenopáusicas con cáncer de mama en estadio temprano positivo para receptores hormonales resultaron inscritas para examinar la aplicación de Femara al tamoxifeno durante 5 años después del procedimiento quirúrgico. Esta investigación consideró el remedio adyuvante para el cáncer de seno temprano.

Los resultados revelaron que Femara terminó siendo mucho mejor que el tamoxifeno para:

  • aumentando el tiempo antes de que los tumores cancerosos regresen en aquellos que sienten recurrencia
  • reduciendo la posibilidad de que los tumores cancerosos se dispersen a muchas otras partes del cuerpo.

< p> La emergencia libre de enfermedad es el tiempo después de comenzar la terapia si no encuentra signos de reaparición de tumores cancerosos. Para la prueba GRANDE 1-98, el 73.8 por ciento de las mujeres que recibieron letrozol solo tuvieron una emergencia libre de enfermedad a los 8 años, en comparación con el 70.4 por ciento de las mujeres que recibieron tamoxifeno por su cuenta.

Además de eso, en algunas mujeres, cuando un par de años de letrozol fue seguido de cerca por 3 años de tratamiento con tamoxifeno, o un par de años de tamoxifeno seguido de 3 años de letrozol, no hubo diferencia entre los efectos en comparación con el uso de letrozol por su cuenta.

Estudio MA-17

En la investigación MA-17, se examinaron más de 5.100 mujeres posmenopáusicas con HR +, cáncer de mama en estadio temprano para determinar si tomar Femara durante cinco años después de haber tomado actualmente 5 años de terapia con tamoxifeno (en total, 10 años de tratamiento hormonal) podría reducir la posibilidad de reaparición de tumores cancerosos. Esto se etiqueta exactamente como terapia adyuvante prolongada.

Durante el estudio MA-17, se evaluó a más de 5,100 mujeres posmenopáusicas para ver si tomar Femara durante cinco años después de recibir tamoxifeno tuvo algún beneficio. Las mujeres tenían cáncer de mama mayor receptor positivo o desconocido y eran libres de infección después de cinco años de tratamiento con tamoxifeno. Las mujeres recibieron un tratamiento adicional de 24 meses con Femara o placebo (tratamiento inactivo). Los resultados revelaron que Femara, en comparación con el grupo placebo, alargó la emergencia libre de enfermedad en un 42% (tiempo suficiente antes de que regresaran los tumores malignos) y disminuyó el tiempo completo antes de que la enfermedad se diseminara dentro del cuerpo.

Femara redujo la posibilidad de que los tumores malignos reaparezcan y pagó la posibilidad de que el cáncer se distribuya por el seno opuesto (en comparación con quizás no tomar Femara) después de usar 5 años de tamoxifeno.

El estudio MA-17 quería optar por 5 años, pero se suspendió muy temprano a los 24 meses debido a una gran ventaja con Femara en comparación con el placebo. Más del 60 por ciento de las mujeres dentro del estudio que tomaron el placebo se cambiaron a Femara.

Estudio MA-17R

El seguimiento de MA-17 terminó siendo la investigación de MA-17R en 2.000 mujeres posmenopáusicas con cáncer de mama temprano HR +. Los resultados revelan que extender el tratamiento adyuvante de la sustancia aromatosa a varios años puede aumentar el éxito sin enfermedad (95% durante la clase de letrozol en comparación con el 91 por ciento dentro del equipo de placebo). Además, en el equipo de letrozol se encontraron costos anuales más bajos del cáncer de seno que ocurre desde el interior del seno inverso.

Sin embargo, extender el tratamiento con letrozol a años incluyó efectos negativos. Las mujeres que recibieron letrozol tuvieron aún más dolor en el tejido óseo, fracturas de tejido óseo y debilitamiento de los diagnósticos óseos que las mujeres que tomaron placebo.

En su área Cáncer de seno avanzado o metastásico

En cáncer de seno de nivel superior (en su área disperso o metastásico) en 916 mujeres posmenopáusicas, Femara como terapia de primera línea demostró ser más efectiva que tamoxifeno lo suficientemente pronto para la progresión (TTP) en un aprendizaje de 32 meses.

El tiempo hasta la progresión (TTP) podría ser el tiempo inmediatamente posterior al tratamiento antes de que los tumores malignos empeoren o se desarrollen dentro del cuerpo. Dentro de la investigación, la mayoría de las mujeres que obtuvieron Femara pasaron unos 9,4 meses sin que sus tumores cancerosos particulares empeoraran o se dispersaran. Esto podría ser en comparación con unos pocos meses en que sus mujeres recibieron tamoxifeno.

¿Cuáles son las complicaciones con Femara?

Efectos secundarios graves:

  • efectos óseos (fracturas, disminución de la densidad ósea y osteoporosis)
  • aumentos en los niveles de colesterol.

Efectos negativos comunes:

  • dolor en las articulaciones
  • náuseas
  • disminución de peso
  • irritación vaginal
  • dolor en las extremidades.

Otros problemas reportados incluyen trombo, diferentes tipos de cáncer, derrame cerebral, paro coronario y cáncer de endometrio.

Vea una lista completa de los efectos secundarios de letrozol (Femara) aquí .

Conclusión

  • El tratamiento con inhibidores de la aromatasa como el letrozol (Femara) puede aumentar la cantidad de tiempo para la recurrencia del cáncer de seno o el cáncer de seno que se extiende dentro del cuerpo. En un estudio, más del 70 por ciento de las mujeres tuvieron un período de emergencia libre de enfermedad durante 8 años.
  • El tratamiento con IA a menudo se prolonga de 5 a 10 años después del procedimiento quirúrgico para el cáncer de seno o cualquier otro tratamiento. Las mujeres con un mayor peligro de recurrencia de la infección pueden optar por continuar el tratamiento en los últimos 5 años, pero los efectos negativos son generalmente una preocupación.
  • La cultura estadounidense de oncología médica (ASCO) recomienda que las mujeres reciban tratamiento prolongado con IA. , 10 años deben ser el momento óptimo de la terapia, teniendo en cuenta su propio estándar de práctica médica 2019 actualizado.

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