Sweet wormwood

Lub npe scientific: Artemisia Annua L.
Hom Lub Npe: Artemether, Artemisinin, Artemotil, Artesunate, Quinghao (Suav, lub ntsiab lus 'los ntawm cov tshuaj ntsuab'), Sweet annie, Sweet sagewort, Sweet wormwood, Wormweed

Clinical Overview

Siv

Kev tshuaj xyuas ntawm cov ntaub ntawv kho mob txhawb nqa kev kho mob ua tau zoo ntawm artemisinin thiab nws cov txiaj ntsig tiv thaiv txhua yam ntawm tib neeg malaria, tshwj xeeb yog Plasmodium falciparum. Lwm cov haujlwm tshaj tawm cov tshuaj muaj xws li cytotoxicity tiv thaiv cov qog nqaij hlav cancer, thiab cov tshuaj tua kab mob thiab tshuaj tua kab mob.



Dosing

Malaria : Kev sim tshuaj ntsuam xyuas thiab cov ntaub ntawv pov thawj ntawm World Health Organization (WHO) suav nrog cov ntawv sau tshuaj ntawm qhov ncauj thiab cov hlab ntsha ntawm artesunate. Kev npaj parenteral muaj rau cov roj-soluble artemether thiab cov khoom lag luam tshiab artemotil. Muaj ntau ntau cov tshuaj noj muaj, tab sis WHO nyuam qhuav pom zoo riamet (Coartem), lumefantrine 120 mg ua ke nrog artemether 20 mg. Kev kho mob suav nrog kev tswj hwm 4 ntsiav tshuaj thawj zaug, rov ua cov tshuaj hauv 8 teev, thiab tom qab ntawd noj ob zaug ib hnub rau 2 hnub tom ntej. Kev sib xyaw ua ke tau ua pov thawj tias muaj txiaj ntsig zoo, nrog cov ntaub ntawv kho mob txog li 98%.

Mob caj dab : 150 mg ob zaug ib hnub twg ntawm Artemisia annua extract tau raug soj ntsuam rau 12 lub lis piam hauv osteoarthritis.

Contraindications

Tsis txhob siv rau cov poj niam thaum thawj peb lub hlis twg ntawm cev xeeb tub vim muaj peev xwm teratogenicity.

Cev xeeb tub/Lactation

Tsis txhob siv. Artemisinin derivatives, tshwj xeeb tshaj yog artemether, muaj tshuaj lom rau embryos, tab sis tsis muaj teratogenicity tau piav nyob rau hauv cov kev tshawb fawb tsiaj nyob rau hauv nas, nas, los yog luav. Yog li, teratogenicity tej zaum yuav raug txwv rau thaum cev xeeb tub.

muaj xiv rau cov carpal qhov

Kev sib tham

Cov teebmeem tseem ceeb hauv tsev kho mob tuaj yeem tshwm sim hauv cov neeg mob vim tias muaj zog inhibition ntawm cytochrome P-450 1A2 (CYP1A2) enzyme los ntawm artemisinin. Kev ceev faj yuav raug lees paub hauv cov neeg mob ntshav qab zib vim qee cov neeg mob artemether sim tsim cov tshuaj hypoglycemia.

Kev Phem Tsis Zoo

Cov ntaub ntawv tshawb fawb soj ntsuam cov ntaub ntawv GI tsis txaus siab xws li mob plab, raws plab, xeev siab, thiab ntuav. Pruritus, urticaria, thiab pob khaus tau raug tshaj tawm nrog rau qhov mob thiab abscess kev loj hlob ntawm qhov chaw txhaj tshuaj. Cov kev hloov hauv plawv muaj xws li bradycardia thiab ncua ntawm QT lub sijhawm. Kev hloov pauv hauv metabolic muaj xws li hypoglycemia.

Toxicology

Qhov kev pheej hmoo ntawm kev sib txuam neurotoxicity tuaj yeem txwv tsis pub siv cov tshuaj artemisinin-raws li prophylactic.

Tsev Neeg Science

  • Asteraceae (daisy)

Botany

A. annua belongs rau tsev neeg Asteraceae thiab yog cov tshuaj ntsuab txhua xyoo nyob hauv Suav teb, feem ntau pom nyob rau sab qaum teb ntawm Chahar thiab Suiyan xeev raws li ib feem ntawm cov nroj tsuag ntuj. Txawm li cas los xij, tam sim no cov nroj tsuag loj hlob hauv ntau lub tebchaws, suav nrog Argentina, Australia, Bulgaria, Fabkis, Hungary, Ltalis, Spain, thiab Tebchaws Meskas. Cov tshuaj ntsuab dissected nplooj ntsuas 2 mus rau 5 cm nyob rau hauv ntev. Nws yog ib leeg-stemmed thiab muaj lwm ceg ntoo loj hlob ntau tshaj 2 m nyob rau hauv qhov siab. ib , ob , 3

Keeb kwm

Tshuaj ntsuab A. annua tau siv tshuaj los kho tus mob npaws tau ntau tshaj 2,000 xyoo thiab kho malaria rau ntau tshaj 1,000 xyoo hauv Suav teb. Quinghao, lo lus Suav rau cov nroj tsuag, txhais tau tias 'los ntawm cov tshuaj ntsuab.' Tam sim no tsab ntawm lub Pharmacopoeia ntawm Cov Neeg Sawv Cev ntawm Tuam Tshoj Cov ntaub ntawv kho mob siv A. annua rau kev kho mob npaws thiab malaria. Cov tshuaj ntsuab tau npaj nrog dej kub raws li cov tshuaj suav tshuaj. ib , ob

Cov ntaub ntawv ntxov tshaj plaws ntawm cov tshuaj ntsuab siv tshuaj kho mob hnub rov qab tsawg kawg 2,000 xyoo mus rau Wu Shi Er Bing Fang (Tsev tshuaj rau tsib caug-ob kab mob) , uas tau pom los ntawm Ma Wang Dui qhov ntxa ntawm Changsha, Hunan xyoo 1973. Nyob rau hauv lub xyoo pua 4th, kev siv tshuaj ntsuab rau kub taub hau tau piav qhia hauv Suav Phau Ntawv Qhia Txog Kev Kho Mob Xwm Ceev . ib

Artemisinin, qhov feem ntau kawm derivatives, thiab nws cov semisynthetic derivatives, arteether, artemether, thiab artesunate, tau raug soj ntsuam soj ntsuam thiab yog tib cov tshuaj tiv thaiv kab mob uas tshuaj tiv thaiv tsis tau sau tseg. Artemisinin raug cais tawm ntawm A. annua xyoo 1972, thiab nws cov qauv tau piav qhia hauv 1979. Hauv 2004, Roll Back Malaria Partnership tau tshaj tawm cov lus teb rau cov tshuaj tiv thaiv kab mob malarial, pom zoo tias txoj cai kho mob rau falciparum malaria hauv txhua lub teb chaws muaj kev tiv thaiv kab mob monotherapy. yuav tsum tau ua ke kev kho mob, zoo dua cov uas muaj cov artemisinin derivative. 4 , 5 , 6

Chemistry

Ntau thiab ntau qhov kev tshawb nrhiav phytochemical tau ua tiav ntawm cov tshuaj ntsuab. Feem ntau, feem ntau cov kev tshawb fawb tshuaj xyuas cov sesquiterpine artemisinin thiab nws cov derivatives, arteether, artemether, artesunate, thiab dihydroartemisinin. Tsuas yog xaiv cov kev tshawb fawb yuav tau tham los ntawm ntau cov ntaub ntawv.

Qee qhov 38 amorphane thiab cadinane sesquiterpenes tau raug cais tawm ntawm A. annua. Feem ntau ntawm cov tshuaj ntawm cov nroj tsuag muaj nyob rau hauv nplooj, stems, paj, thiab noob. Lub sesquiterpene trioxane lactone, artemisinin, uas muaj ib tug peroxide choj tseem ceeb rau nws cov tshuaj, yog lub ntsiab active compound nyob rau hauv A. annua. Dihydroartemisinin yog daim ntawv txo qis thiab nquag metabolite ntawm artemisinin. Artesunate yog dej-soluble hemisuccinate derivative ntawm artemisinin. Artemether yog lipid-soluble methyl ether derivative ntawm artemisinin thiab muaj zog dua artemisinin. Arteether yog lipid-soluble ethyl ether derivative ntawm dihydroartemisinin. Qee lwm yam tseem ceeb artemisinin derivatives muaj xws li alpha-artelinic acid, arteanniun B, thiab 4-(P-Substituted Phenyl)-4(R los yog S)-(10 [alpha los yog beta]-dihydroartemisininoxy) butyric acids, uas yog dihydroartemisin derivatives, as zoo li arteflene (ib tug hluavtaws derivative) thiab semisynthetic artemisinin trioxanes (C-10 carbon-substituted thiab 10 deoxoartemisinin compounds). ib , 7 , 8 , 9

Qhov siab tshaj plaws ntawm artemisinin pom nyob rau hauv nws nplooj ua ntej flowering. Artemisinin concentrations los ntawm cov qus Artemisia muaj li ntawm 0.01% mus rau 0.5% (w/w). Ib txoj kev tshawb nrhiav ethnopharmacology tau pom tias 40% ntawm artemisinin tuaj yeem raug muab rho tawm los ntawm qhov chaw dav hlau ntawm cov nroj tsuag los ntawm txoj kev npaj tshuaj yej yooj yim. 5 , 10

Antiviral kev ua si yog txuam nrog sterols sitosterol thiab stigmaterol ntawm A. annua. Cov nroj tsuag cov roj tseem ceeb yog linalool, 1,8-cineol, p-cymene, thujone, thiab camphor. Camphor stimulates CNS, thaum lwm cov roj tseem ceeb ua rau muaj kev nyuaj siab, txo qhov kev ua haujlwm ntawm tus kheej, thiab ua rau kom muaj kev ua siab ntev ntawm pentobarbital. Cov lipids thiab cov roj yam tseem ceeb kuj tau siv rau hauv cov tshuaj pleev ib ce thiab tshuaj tsw qab rau daim tawv nqaij prophylaxis thiab kho mob. kaum ib , 12 , 13

Tsis tas li ntawd, 17 methoxylated flavones thiab 4 coumarins tau pom nyob rau hauv cov nroj tsuag. Flavones, xws li casticin, chrysoplenetin, chrysosplenol-D, thiab cirsilineol hauv A. annua tau xav tias yuav txhim kho cov tshuaj tiv thaiv kab mob ntawm artemisinin. 14

Siv thiab Pharmacology

Kev kho mob ua tau zoo ntawm artemisinin thiab nws cov derivatives tawm tsam txhua yam ntawm tib neeg malaria, tshwj xeeb yog Plasmodium falciparum, tau raug pov thawj. Ntau pua txoj kev tshawb fawb tau luam tawm, feem ntau yog los ntawm Asia thiab Africa, tab sis tsuas yog xaiv cov kev tshawb fawb txog qhov ua tau zoo no yuav raug tham, suav nrog kev siv tshuaj tiv thaiv kab mob malaria tsis yooj yim thiab nyuaj. Cov kev tshawb fawb tshuaj lag luam txhawb nqa tus nqi-zoo ntawm artemisinin-raws li kev sib xyaw ua ke hauv kev tawm tsam malaria hauv cov teb chaws tsim. kaum tsib

Lwm cov kev qhia tshuaj muaj xws li kev ua haujlwm cytotoxic tawm tsam cov qog nqaij hlav cancer, cov roj tseem ceeb inhibition ntawm kev loj hlob ntawm cov kab mob gram-zoo Enterococcus hirae, thiab kev loj hlob inhibition ntawm ntau phytopathogenic fungi los ntawm kev rho tawm. 16 , 17

Malaria

Artemisinin thiab nws cov derivatives yog tshuaj lom rau cov kab mob malarial parasite ntawm nanomolar concentrations, ua rau cov txheej txheem tshwj xeeb ntawm daim nyias nyias hloov hauv erythrocyte theem uas tua cov cab. Feem ntau, cov txheej txheem ntawm kev txiav txim muaj 2 kauj ruam: ua kom ua raws li alkylation. Hlau activates artemisinin mus rau hauv ib tug dawb radical los ntawm ib tug hlau-mediated cleavage. Cov kauj ruam thib ob, alkylation, suav nrog kev tsim cov khoom sib txuas ntawm cov artemisinin-derived dawb radicals thiab malarial proteins. ib , ob , 7 , 18

Cerebral malaria

Cov ntaub ntawv kho mob

Ib qho randomized, unblinded sim tshuaj xyuas qhov ua tau zoo ntawm intramuscular (IM) artemether (3.2 mg / kg loading koob tshuaj rau hnub 1, tom qab 1.6 mg / kg ntawm hnub 2 txog 4) lossis quinine (20 mg / kg loading koob tshuaj hnub 1, ua raws li 10 mg / kg txhua 12 teev rau 4 hnub) hauv 576 tus menyuam hnub nyoog 1 txog 9 xyoos uas muaj mob malaria. Cov ntsiab lus tseem ceeb kawg ntawm txoj kev tshawb fawb yog kev tuag thiab cov seem ntawm cov hlab ntsha hauv lub cev thaum lub caij qhuav ntawm tus mob. Cov ntsiab lus thib ob yog qhov tshem tawm ntawm cov kab mob thiab ua npaws, lub sijhawm kom rov zoo los ntawm kev tsis nco qab, thiab cov kab mob neurologic sequelae thaum tso tawm thiab 1 lub hlis tom qab nkag. Qhov kev tuag yog 20.5% rau artemether thiab 21.5% rau quinine. Cov kab mob neurologic seem ntawm kwv yees li 5 lub hlis yog 3.3% rau artemether thiab 5.3% rau quinine. Tag nrho lub sij hawm tshem tawm ntawm tus kab mob yog 48 teev nyob rau hauv pawg artemether thiab 60 teev nyob rau hauv pawg quinine ( P <0.001). Resolution of fever was 30 hours for artemether-treated patients and 33 hours for quinine-treated patients. Time to recovery from coma was 26 hours in the artemether group and 20 hours in the quinine group ( P = 0,046). Thaum lub sij hawm tso tawm, neurologic sequelae muaj nyob rau hauv 21% rau cov neeg mob kho artemether thiab 25% rau cov neeg mob kho quinine, thiab ntawm 1 lub hlis 8% thiab 10%, feem. Tshaj tawm cov kev phiv tshwm sim suav nrog kev txhim kho abscess los ntawm 1 tus neeg mob hauv pab pawg artemether thiab 5 tus neeg mob hauv pawg quinine, thiab 1 tus kab mob urticarial hauv pawg quinine. 19

Mob malaria

Cov ntaub ntawv kho mob

Ib qho kev qhib, ua ke, kev sim sib txawv tau tshuaj xyuas qhov ua tau zoo ntawm artemether piv rau chloroquine hauv kev kho mob malaria mob nruab nrab thiab hnyav. Peb caug cov menyuam yaus (2 txog 12 xyoos) uas muaj tus mob npaws nruab nrab tau txais IM artemether (4 mg / kg loading koob, tom qab ntawd 2 mg / kg txhua 24 teev) lossis IM chloroquine (3.5 mg / kg txhua 4 teev). Cov ntsiab lus tseem ceeb kawg suav nrog ua npaws thiab lub sijhawm tshem tawm cov kab mob cab. Lub sijhawm ua npaws yog 19.3 teev rau artemether thiab 10.7 teev rau chloroquine; Lub sij hawm tshem tawm kab mob parasite yog 36.7 teev rau artemether thiab 48.4 teev rau chloroquine. Hauv qhov thib ob ntawm txoj kev tshawb no, 43 tus menyuam yaus uas muaj mob npaws hnyav tau txais tib yam kev noj tshuaj ntawm artemether lossis quinine. Lub sijhawm ua npaws yog 30 teev rau ob pawg kho mob. Parasite clearance lub sij hawm yog 48 teev rau artemether thiab 54 teev rau chloroquine. Lub sijhawm daws teeb meem Coma yog 16 teev rau artemether thiab 18 teev rau chloroquine. nees nkaum

Ib qho kev tshawb fawb randomized, ob qhov muag tsis pom kev ntawm 560 tus neeg laus tau tshuaj xyuas qhov ua tau zoo ntawm artemether piv rau quinine hauv kev kho mob malaria hnyav. Kev noj tshuaj ntau npaum li cas rau qhov tsawg kawg ntawm 72 teev: 276 tus neeg mob tau txais kev thauj khoom ntawm IM artemether 4 mg / kg tom qab 2 mg / kg txhua 8 teev thiab 284 cov neeg mob tau txais IM quinine 20 mg / kg tom qab 10 mg / kg txhua. 8 hnu. Cov ntsiab lus tseem ceeb kawg suav nrog ua npaws thiab tus kab mob parasite tshem tawm thiab rov qab los ntawm coma. Lub sijhawm ua npaws yog 127 teev rau artemether thiab 90 teev rau quinine. Parasite clearance time yog 72 teev rau artemether thiab 90 teev rau quinine. Kev rov qab los ntawm coma yog 66 teev rau artemether thiab 48 teev rau quinine. Cov teebmeem tsis zoo suav nrog kab lis kev cai tsis zoo pyuria hauv pawg artemether thiab hypoglycemia rau pawg quinine. Qhov kev tuag tag nrho yog 15%, thiab tsis muaj qhov sib txawv tseem ceeb hauv kev tuag ntawm pab pawg. nees nkaum ib

Raws li cov txiaj ntsig tau los ntawm kev tshawb fawb hauv Thaib teb, artemether thiab artesunate tuaj yeem ua tau zoo hauv kev kho mob malaria-resistant multidrug. Ib puas nees nkaum tus txiv neej tau randomized kom tau txais ib koob tshuaj ntawm qhov ncauj ntawm artemether 300 mg tom qab los ntawm qhov ncauj koob tshuaj mefloquine 750 mg ntawm 24 teev thiab 500 mg ntawm 30 teev lossis ib koob tshuaj ntawm qhov ncauj ntawm artesunate 300 mg ua raws li tib txoj kev noj tshuaj. ntawm mefloquine. Cov txiaj ntsig tau ntsuas suav nrog kub taub hau thiab tus kab mob parasite tshem tawm, thiab tus nqi kho tag nrho. Hauv 24 teev, kub taub hau tshem tawm yog 62% rau cov neeg mob kho artemether piv rau 77% rau cov neeg mob kho artesunate. Hauv 24 teev, tus kab mob tshem tawm yog 91% rau cov neeg mob kho artemether piv rau 93% rau cov neeg mob artesunate-kho. Kev kho tus nqi yog 98% rau pawg artemether thiab 97% rau pawg artesunate. Cov tshuaj tiv thaiv tsis zoo tau zoo ib yam rau ob qho kev kho mob thiab suav nrog kev poob qab los, xeev siab, thiab ntuav. 22

Tsis nyuaj malaria

Cov ntaub ntawv kho mob

Ib qho kev sim randomized piv qhov kev ua tau zoo ntawm qhov ncauj artemether thiab qhov ncauj mefloquine hauv 46 tus txiv neej laus (15 txog 50 xyoo) kuaj pom tias mob malaria tsis sib xws. Kev noj tshuaj noj muaj feem cuam tshuam rau 12 tus neeg mob tau txais mefloquine (1,250 mg tag nrho cov koob tshuaj txhua hnub) thiab 34 tus neeg mob tau txais artemether (700 mg tag nrho cov koob tshuaj txhua hnub) rau 5 hnub. Vim tias qhov kho tus nqi ntawm mefloquine tau sau tseg zoo, cov neeg mob ntau dua tau randomized rau pawg artemether. Thawj qhov kev sim siab kawg suav nrog ua npaws thiab lub sijhawm tshem tawm cov kab mob parasite thiab tus nqi kho. Lub sijhawm ua npaws yog 30 teev rau artemether thiab 27 teev rau mefloquine. Lub sij hawm tshem tawm kab mob parasite yog 34 teev rau artemether thiab 54 teev rau mefloquine. Kev kho tus nqi ntawm 28 hnub yog 97% rau artemether thiab 73% rau mefloquine. Cov tshuaj tiv thaiv tsis zoo tau zoo ib yam rau 2 txoj kev kho mob thiab suav nrog mob plab, bradycardia, raws plab, kiv taub hau, thiab xeev siab. 23

Ib qho randomized, ob-dig muag, tswj kev sim ua tau zoo piv rau CGP56697 (kev sib xyaw ntawm artemether thiab benflumetol) nrog pyrimethamine/sulfadoxine (P/S) hauv kev kho 287 tus menyuam yaus (1 txog 5 xyoos) kuaj pom tias muaj tus kabmob malaria. Qhov kev sim tau ua nyob rau hauv Gambia ntawm 2 lub chaw. Raws li cov lus qhia los ntawm tsoomfwv Gambian, 144 tus menyuam tau txais 1 ntsiav tshuaj ntawm CGP56697 (artemether 20 mg thiab benflumetol 120 mg) ntawm 0, 8, 24, thiab 48 teev yog tias lawv hnyav dua 33 phaus lossis 2 ntsiav tshuaj ntawm 0, 8, 24, thiab 48 teev yog tias lawv hnyav 33 phaus lossis ntau dua, thiab 143 cov menyuam yaus tau txais ib nrab ib ntsiav tshuaj ntawm P / S (pyrimethamine 12.5 mg thiab sulfadoxine 250 mg) ib zaug yog tias lawv hnyav dua 33 phaus thiab 1 ntsiav tshuaj ib zaug yog tias lawv hnyav 33 phaus. los yog ntau dua. Qhov kawg ntawm qhov kev sim thawj zaug yog cov menyuam yaus uas tsis tuaj yeem kuaj pom P. falciparum los ntawm hnub 4. Cov ntsiab lus thib ob yog lub sijhawm tshem tawm cov kab mob cab, hnub 15 tus nqi kho, thiab tus naj npawb ntawm cov mob malaria rov ua dua hauv 29 hnub. Peb hnub tom qab kev kho mob, 133 (100%) ntawm cov neeg mob uas ntsuas tau nyob rau hauv pawg CGP56697 thiab 128 (93%) ntawm cov menyuam yaus hauv pawg P/S tsis muaj kab mob. Hnub 15 kho tus nqi yog 93% rau CGP56697 thiab 98% rau P / S. Tsis pub dhau 29 hnub, 20 tus neeg mob tau kho nrog CGP56697 thiab 1 tus neeg mob los ntawm pawg P/S-kho tau rov qab los nrog cov mob malarial thib ob. Cov tshuaj tiv thaiv tsis zoo tau zoo sib xws rau 2 txoj kev kho mob. 24

pes tsawg tus nqi humira

Lwm qhov randomized, qhib-label kev sim tshuaj ntsuam xyuas qhov ua tau zoo ntawm 3 qhov ncauj tshuaj tiv thaiv kab mob sib xyaw ua ke hauv 330 tus neeg mob (nruab nrab hnub nyoog: 15 xyoos) kuaj pom muaj tus mob npaws tsis sib haum. Cov neeg mob tau soj ntsuam ntau dua 42 hnub thiab randomized kom tau txais chloroquine ntxiv rau sulfadoxine-pyrimethamine (CQ + SP, n = 110), artesunate plus mefloquine (MAS3, n = 110), lossis artemether-lumefantrine (LAM3, n = 110). Thawj qhov kev sim siab kawg yog qhov kho tau 42 hnub. Cov ntsiab lus thib ob ntawm kev sim siab suav nrog cov kab mob parasite thiab kub taub hau tshem tawm. 42-hnub kho tus nqi yog 93%, 100%, thiab 97% rau cov neeg mob tau txais CQ + SP, MAS3, thiab LAM3, raws li. Cov kab mob parasite tshem tawm yog kwv yees li 3, 2, thiab 2 hnub rau cov neeg mob tau txais CQ + SP, MAS3, thiab LAM3, raws li. Lub sijhawm ntsuas kub taub hau yog 40, 25, thiab 23 teev rau cov neeg mob tau txais CQ + SP, MAS3, thiab LAM3, raws li. Cov tshuaj tiv thaiv tsis zoo tshwm sim zoo ib yam ntawm cov kev kho mob. 25

Qhov kev ua tau zoo ntawm 3 qhov kev sib xyaw tshuaj tiv thaiv kab mob sib kis tau raug soj ntsuam hauv 4 cheeb tsam hauv Uganda hauv tag nrho ntawm 2,061 tus neeg mob hnub nyoog qis dua 5 xyoos, kuaj pom tias muaj kab mob malaria tsis sib xws, hauv ib qhov muag tsis pom kev, randomized soj ntsuam kuaj. Cov neeg mob tau soj ntsuam kwv yees li 1 lub hlis thiab tau txais chloroquine ntxiv rau sulfadoxine-pyrimethamine (CQ + SP, n = 677), amodiaquine ntxiv sulfadoxine-pyrimethamine (AQ + SP, n = 690), lossis amodiaquine plus artesunate (AQ + AS, n = 694 ib.). Thawj qhov kev sim siab kawg yog qhov kho tau ntawm 28 hnub. Tag nrho 3 txoj kev tswj hwm tau ua pov thawj tsis muaj txiaj ntsig, tej zaum vim tias muaj kev sib kis ntawm malaria siab nyob rau thaj tsam ntawm Africa. 26

Anticancer kev ua

Tus choj endoperoxide yuav tsum tau ua rau kev ua haujlwm tiv thaiv qog noj ntshav ntawm artemisinin thiab nws cov derivatives los ntawm kev tsim cov dawb radical, uas ua rau cov molecular puas thiab cell tuag.

Cov ntaub ntawv hauv vitro

Ntawm 9 terpenoids thiab flavonoids los ntawm wormwood, tsuas yog artemisinin pom cytotoxicity rau tib neeg qog cell kab P-388, A-549, HT-29, MCF-7, thiab KB. ib , 27

Artemisinin inhibited kev loj hlob ntawm Ehrlich ascites thiab HeLa qog hlwb nrog ICtsib caugntawm 0.98 mcmol / L, tsis zoo li deoxyartemisinin, uas tsis muaj tus choj endoperoxide. 28

Dimers ntawm dihydroartemisinin yog cytotoxic rau Ehrlich ascites thiab HeLa qog hlwb, nrog rau cov murine pob txha hlwb progenitor hlwb. Tus choj endoperoxide thiab kev sib txuas ether ua lub luag haujlwm hauv cytotoxicity. Artemisinin derivatives raug xa mus rau National Cancer Institute 60-cell screening program. 29

Artemisinin derivatives yuav ua tau zoo hauv kev kho mob qog noj ntshav uas overexpress transferrin receptors. Cov txheej txheem ntawm kev ua haujlwm no cuam tshuam nrog kev nkag mus ntawm cov hlau hauv cov qog hlwb, uas tom qab ntawd ua rau tsim cov dawb radicals los ntawm artemisinin uas ua rau muaj kev puas tsuaj molecular uas ua rau cov cell tuag. Kev sib xyaw ntawm dihydroartemisinin thiab halotransferrin ua rau cov cell tuag sai hauv tib neeg cov kab mob leukemia cell nrog me ntsis cuam tshuam rau cov hlwb ib txwm. Thaum piv nrog kev tswj hwm, dihydroartemisinin 200 mcmol txo qis MOLT-4 lymphocyte kev loj hlob 50% hauv 8 teev. Cell tuag mus txog 100% hauv 8 teev thaum lub hlwb raug rau kev sib xyaw ntawm dihydroartemisinin 200 mcmol thiab halotransferrin 12 mcmol. Dihydroartemisinin ib leeg thiab ua ke nrog halotransferrin muaj cov txiaj ntsig zoo sib xws ntawm cov lymphocytes lossis cov hlwb ib txwm, tab sis ntxiv ntawm halotransferrin tsis txhim kho cell tuag hauv cov hlwb ib txwm muaj. 30

Artesunate, semisynthetic derivative ntawm artemisinin, induced apoptosis nyob rau hauv tib neeg umbilical leeg endothelial hlwb. Overexpression ntawm bcl-2 protein tiv thaiv cov hlwb los ntawm apotosis, thaum ua kom Bax tsav apoptosis. Artesunate activated Bax, ua rau cell apoptosis thiab inhibiting kev qhia ntawm bcl-2 protein nyob rau hauv ib tug concentration- thiab koob tshuaj-nyob ntawm seb. 31

Tsiaj ntaub ntawv

Kev tswj hwm qhov ncauj ntawm ferrous sulfate txhim kho dihydroartemisinin cytotoxicity hauv fibrosarcoma hauv nas. Fibrosarcoma cov ntaub so ntswg tau cog rau hauv txoj cai flank ntawm 50 poj niam Fisher nas. Yim hnub tom qab implantation, nas raug randomized kom tau txais 1 ntawm 4 kev kho mob: (1) ferrous sulfate 20 mg / kg hauv dej distilled ntxiv rau dihydroartemisinin 2 mg / kg hauv txiv laum huab xeeb; (2) dej distilled thiab dihydroartemisinin; (3) ferrous sulfate hauv dej distilled thiab txiv laum huab xeeb; (4) dej distilled thiab txiv laum huab xeeb. Lub cev hnyav thiab qog loj tau ntsuas txhua hnub rau 11 hnub. Ferrous sulfate tau ua thawj zaug, tom qab ntawd dihydroartemisinin 6 teev tom qab. Hnub 4, kev kho mob tau nce ntxiv rau dihydroartemisinin 5 mg / kg kom txog thaum kev kho mob xaus rau hnub 10. Kev sib xyaw ntawm dihydroartemisinin nrog ferrous sulfate txo cov qog loj los ntawm 30% ( P <0.025). 4

Kev ua tau zoo ntawm artemisinin hauv kev tiv thaiv kev mob qog noj ntshav mis tau tshuaj xyuas rau 40 lub lis piam hauv cov nas kho nrog ib koob tshuaj ntawm qhov ncauj (50 mg / kg) ntawm 7,12-dimethylbenz [a] anthracene (DMBA). Cov pab pawg sim (n = 12) ntawm nas tau noj cov hmoov nas chow uas muaj 0.02% artemisinin thiab pawg tswj (n = 22) tau txais cov khoom noj dawb, hmoov. Artemisinin ncua sijhawm ( P <0.002), and in some rats prevented (57% of artemisinin-fed versus 96% of the controls, P <0.01), breast cancer development. In the artemisinin-fed rats that developed a tumor, tumor size was smaller ( P <0.05), and there was a longer duration of time for tumor development (29.4 vs 15.3 weeks) when compared with controls. 32

Mob caj dab

Tsiaj ntaub ntawv

Cov kev tshawb fawb hauv vitro qhia cov tshuaj tiv thaiv kab mob rau Artemisia annua. 33 , 3. 4

Cov ntaub ntawv kho mob

Cov nyhuv ntawm 150 thiab 300 mg ntawm Artemisia annua extract (muab ob zaug ib hnub rau 12 lub lis piam) ntawm qhov mob, txhav, thiab kev ua haujlwm tsis zoo hauv osteoarthritis ntawm lub duav lossis lub hauv caug raug soj ntsuam hauv kev sim tshuaj (n= 42). Kev txhim kho ntawm qhov mob thiab tawv nqaij tau tshwm sim (txhais tau tias hloov pauv hauv WOMAC cov qhab nia ntawm 12 lub lis piam piv nrog cov placebo, −12.2; tus qauv sib txawv, [SD] 13.84; P = 0.0159; txhais tau tias hloov nyob rau hauv qhov muag analog scale −21.4 mm; SD 23.48 mm; P = 0.0082. 3. 4

Dosing

Malaria

Kev sim tshuaj ntsuam xyuas thiab WHO cov ntaub ntawv txhawb nqa kev ua tau zoo ntawm qhov ncauj thiab IV daim ntawv ntau npaum ntawm artesunate rau malaria. Kev npaj parenteral muaj rau cov roj-soluble artemether thiab cov khoom lag luam tshiab artemotil. Muaj ntau ntau cov tshuaj noj muaj, tab sis WHO tau pom zoo riamet (Coartem), kev sib xyaw ntawm lumefantrine 120 mg thiab artemether 20 mg. Kev kho mob suav nrog kev tswj hwm 4 ntsiav tshuaj thawj zaug, rov ua cov tshuaj hauv 8 teev, thiab tom qab ntawd noj ob zaug ib hnub rau 2 hnub tom ntej. Kev sib xyaw ua ke ntawm kev ua tau zoo tau tshwm sim los ntawm kev kho tus nqi txog li 98%. 35

Mob caj dab

150 mg ob zaug ib hnub twg ntawm Artemisia annua extract tau raug soj ntsuam rau 12 lub lis piam hauv osteoarthritis. 3. 4

Cev xeeb tub / lactation

Artemisinin derivatives, tshwj xeeb tshaj yog artemether, muaj tshuaj lom rau embryos, tab sis tsis muaj teratogenicity tau piav nyob rau hauv cov kev tshawb fawb tsiaj nyob rau hauv nas, nas, los yog luav. Yog li, teratogenicity yuav raug txwv rau thaum cev xeeb tub. Tsis muaj qhov txawv txav hauv cov menyuam ntawm cov niam uas tau kho nrog artemisinin lossis artemether thaum lub sijhawm thib ob lossis thib peb ntawm cev xeeb tub. Hauv tsab ntawv tshaj tawm xyoo 2004, 28 tus poj niam cev xeeb tub los ntawm sab hnub tuaj Sudan tau kho nrog IM artemether thiab 1 tus kab mob perinatal tuag tau sau tseg tom qab yug ntxov ntxov. Cov poj niam uas tseem tshuav tau muab cov menyuam mos noj qab nyob zoo. Hauv lwm qhov xwm txheej, 4 qhov tshwm sim ntawm cev xeeb tub tshwm sim rau artemether / lumefantrine thiab 2 rau dihydroartemisinin / Piperaquine ua rau muaj txiaj ntsig zoo rau kev xeeb tub. Hauv Thaib teb, 81 tus poj niam hauv lawv lub hlis thib ob thiab thib peb ntawm cev xeeb tub tau txais 3 hnub ntawm artesunate / atovaquone / proguanil, thiab tsis muaj qhov sib txawv ntawm cov menyuam mos los yog hauv lawv txoj kev loj hlob thiab kev loj hlob tau kawm ntau dua 12 lub hlis. ob , 6 , 7 , 36

Kev sib tham

Antimalarial Agents: Artemether tuaj yeem txhim kho qhov tsis zoo / tshuaj lom ntawm Antimalarial Agents. Zam kev sib xyaw ua ke. 37

Antipsychotic Agents (Phenothiazine): Cov tshuaj tiv thaiv kab mob malarial tuaj yeem ua rau kom cov ntshav concentration ntawm Antipsychotic Agents (Phenothiazine). Saib xyuas kev kho mob. 38

ARIIPrazole: CYP3A4 Inducers tuaj yeem txo cov ntshav cov ntshav ntawm ARIPiprazole. Xav txog kev hloov kho. 39 , 40 , 41

Axitinib: CYP3A4 Inducers (tsis muaj zog rau qhov ua tau zoo) tuaj yeem txo cov ntshav concentration ntawm Axitinib. Zam kev sib xyaw ua ke. 42

Cov tshuaj tiv thaiv kab mob (Estrogens): Artemether tuaj yeem txo qis cov ntshav hauv cov tshuaj tiv thaiv kab mob (Estrogens). Xav txog kev hloov kho. 37

Cov tshuaj tiv thaiv kab mob (Progestins): Artemether tuaj yeem txo cov ntshav cov tshuaj tiv thaiv kab mob (Progestins). Xav txog kev hloov kho. 37

Dapsone (Systemic): Antimalarial Agents tuaj yeem txhim kho qhov tsis zoo / tshuaj lom ntawm Dapsone (Systemic). Tshwj xeeb, kev siv cov tshuaj tiv thaiv kab mob sib kis nrog dapsone tuaj yeem ua rau muaj kev pheej hmoo ntawm cov tshuaj tiv thaiv hemolytic. Dapsone (Systemic) tuaj yeem txhim kho qhov tsis zoo / tshuaj lom ntawm cov tshuaj tiv thaiv kab mob. Tshwj xeeb, kev siv dapsone nrog cov tshuaj tiv thaiv kab mob sib kis tuaj yeem ua rau muaj kev pheej hmoo rau cov tshuaj tiv thaiv hemolytic. Xav txog kev hloov kho. 43 , 44 , Plaub. Tsib , 46

Dapsone (Tshuaj): Cov tshuaj tiv thaiv kab mob malarial tuaj yeem txhim kho qhov tsis zoo / tshuaj lom ntawm Dapsone (Tshuaj pleev). Tshwj xeeb, qhov kev pheej hmoo ntawm cov tshuaj tiv thaiv hemolytic tuaj yeem nce ntxiv. Xav txog kev hloov kho. 43 , 47 , 48

Grapefruit Juice: Tej zaum yuav ua rau kom cov ntshav concentration ntawm Artemether. Saib xyuas kev kho mob. 37 , 49 , tsib caug , 51

Kev pheej hmoo siab tshaj plaws QTc-Ntev Cov Neeg Ua Haujlwm: Tej zaum yuav txhim kho QTc-ntev cov nyhuv ntawm lwm tus neeg ua haujlwm siab tshaj QTc-Ntev. Zam kev sib xyaw ua ke. 52 , 53 , 54 , 55 , 56

Ivabradine: Tej zaum yuav txhim kho QTc-ntev cov nyhuv ntawm QTc-Ntev Cov Neeg Ua Haujlwm Zoo Tshaj Plaws. Zam kev sib xyaw ua ke. 57

Lumefantrine: Antimalarial Agents tuaj yeem txhim kho qhov tsis zoo / tshuaj lom ntawm Lumefantrine. Zam kev sib xyaw ua ke. 37 , 58

Mifepristone: Tej zaum yuav txhim kho QTc-ntev cov nyhuv ntawm QTc-Ntev Cov Neeg Ua Haujlwm Zoo Tshaj Plaws. Zam kev sib xyaw ua ke. 59 , 60

Kev pheej hmoo nruab nrab QTc-Ntev cov neeg ua haujlwm ntev: Cov neeg ua haujlwm pheej hmoo qis QTc-Ntev cov neeg ua haujlwm tuaj yeem txhim kho QTc-ntev cov nyhuv ntawm QTc-Ntev cov neeg ua haujlwm siab tshaj. Zam kev sib xyaw ua ke. 52 , 53 , 54 , 55 , 56 , 61

QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying): QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying) tuaj yeem txhim kho QTc-ntev cov nyhuv ntawm QTc-Prolonging Agents txaus ntshai. Xav txog kev hloov kho. 52 , 53 , 54 , 55 , 56

Saxagliptin: CYP3A4 Inducers tuaj yeem txo cov ntshav cov ntshav ntawm Saxagliptin. Saib xyuas kev kho mob. 62

Kev Phem Tsis Zoo

Cov ntaub ntawv tshawb fawb soj ntsuam cov ntaub ntawv GI tsis txaus siab xws li mob plab, raws plab, xeev siab, thiab ntuav. Pruritus, pob khaus, thiab urticaria tau tshaj tawm nrog rau qhov mob thiab abscess kev loj hlob ntawm qhov chaw txhaj tshuaj. Cov kev hloov hauv plawv muaj xws li bradycardia thiab ncua ntawm QT lub sijhawm. Kev hloov pauv hauv metabolic muaj xws li hypoglycemia. 63

Cov ntaub ntawv khaws cia ntawm xyoo 2004 thiab 2013 ntawm 8 US lub chaw hauv Cov Tshuaj Txhaum Mob Siab Tshaj Plaws tau nthuav tawm 15.5% (130) ntawm cov neeg mob hepatotoxicity yog tshwm sim los ntawm cov tshuaj ntsuab thiab cov khoom noj khoom haus thaum 85% (709) muaj feem xyuam rau cov tshuaj. Ntawm 130 qhov xwm txheej ntawm daim siab raug mob ntsig txog cov tshuaj ntxiv, 65% yog los ntawm cov tshuaj uas tsis yog lub cev tsim thiab tshwm sim feem ntau hauv Mev / Latinos piv rau cov neeg tsis yog neeg Mev dawb thiab cov neeg tsis yog neeg Mev. Kev hloov lub siab kuj tseem nquag nrog cov tshuaj toxicity los ntawm cov tshuaj uas tsis yog lub cev tsim (13%) dua li cov tshuaj noj (3%) ( P <0.001). Overall, the number of severe liver injury cases was significantly higher from supplements than conventional medications ( P = 0.02). Ntawm 217 cov khoom ntxiv cuam tshuam rau daim siab raug mob, qab zib wormwood yog ntawm 22% (116) ntawm cov khoom siv ib leeg. 64

vitamin d3 phiv los

Toxicology

Qhov kev pheej hmoo ntawm kev sib txuam neurotoxicity tuaj yeem txwv tsis pub siv cov tshuaj artemisinin-raws li prophylactic. Tsiaj kev tshawb fawb hauv nas thiab dev siv 5 mus rau 7 npaug ntawm cov koob tshuaj niaj hnub ntawm artemether lossis arteether ua rau muaj kev tuag ntau vim yog neurotoxicity rau cerebellar thiab hlwb-stem nuclei. Txawm li cas los xij, primates tsis muaj qhov cuam tshuam rau neurotoxicity. Cov kev tshawb fawb Neuropathology kuj pom muaj kev puas tsuaj rau auditory thiab vestibular nuclei. Dihydroartemisinin yog cov tshuaj lom neeg tshuaj lom neeg tshaj plaws, thaum artelinic acid thiab artemisinin yog cov tshuaj lom tsawg tshaj plaws. ib , ob

Cov ntaub ntawv

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Ashley EA, White NJ. Kev sib xyaw ua ke ntawm Artemisinin. Curr Opin Infect Dis . 2005;18:531-536.16258328 7. Balint GA. Artemisinin thiab nws cov derivatives: chav kawm tshiab tseem ceeb ntawm cov tshuaj tiv thaiv kab mob. Pharmacol Ther . 2001;90:261-265.11578659 8. Brown GD, Liang GY, Sy LK. Terpenoids los ntawm noob Artemisia xyoo . Phytochemistry . 2003;64:303-323.12946429 9. Sy LK, Brown G. Peb sesquiterpenes los ntawm Artemisia xyoo . Phytochemistry . 1998; 48: 1207-1211. 10. Laughlin JC. Kev ua liaj ua teb ntawm artemisinin - kev tshuaj xyuas. Trans R Soc Trop Med Hyg . 1994;88 Suppl 1:S21-22.8053017 11. Khan M, Jain D, Bhakuni R, Zaim M, Thakur R. tshwm sim ntawm qee cov tshuaj tiv thaiv kab mob hauv Artemisia xyoo . Tsob Ntoo Sci . 1991;75:161-165.2035765 12. Perazzo FF, Carvalho JC, Carvalho JE, Rehder VL. Central zog ntawm cov roj yam tseem ceeb thiab crude ethanol extract los ntawm huab cua qhov chaw ntawm Artemisia xyoo L. Pharmacol Res . 2003; 48: 497-502.12967596 13. Ulchenko N, Khushbaktova Z, Bekker N, Kidisyuk E, Syrov V, Glushenkova A. Lipids ntawm paj thiab nplooj ntawm Artemisia xyoo thiab lawv cov haujlwm lom neeg. Chem Nat Comp . 2005; 41:280-284. 14. Yang SL, Roberts M, ONEill M, Bucar F, Phillipson J. Flavonoids thiab chromenes los ntawm Artemisia xyoo . Phytochemistry . 1995; 38:255-257. 15. Morel CM, Lauer JA, Evans DB. Kev txheeb xyuas tus nqi zoo ntawm cov tswv yim los tawm tsam malaria hauv cov teb chaws tsim. BMJ . Xyoo 2005; 331: 1299. Nyob rau hauv: BMJ . Xyoo 2006; 332: 151. 16. Juteau F, Masotti V, Bessiere JM, Dherbomez M, Viano J. Antibacterial thiab antioxidant kev ua ub no ntawm Artemisia xyoo roj yam tseem ceeb. Phytotherapy . 2002;73:532-535.12385883 17. Liu CH, Zou WX, Lu H, Tan RX. Antifungal kev ua ntawm Artemisia xyoo endophyte kab lis kev cai tiv thaiv phytopathogenic fungi. J Biotechnol . 2001;88:277-28211434973 18. Noori S, Naderi GA, Hassan ZM, Habibi Z, Bathaie SZ, Hashemi SM. Immunosuppressive kev ua ntawm ib tug molecule cais los ntawm Artemisia xyoo ntawm DTH cov lus teb piv nrog cyclosporin A. Int Immunopharmacol . 2004;4:1301-1306.15313428 19. van Hensbroek MB, Onyiorah E, Jaffar S, et al. Kev sim ntawm artemether lossis quinine hauv cov menyuam yaus uas muaj kab mob malaria. N Engl J Med . 1996;335:69-75.8649492 20. White NJ, Waller D, Crawley J, et al. Kev sib piv ntawm artemether thiab chloroquine rau mob npaws hnyav hauv Gambian cov menyuam yaus. Lancet . 1992;339:317-321.1346408 21. Tran TH, Day NP, Nguyen HP, et al. Kev tswj xyuas ntawm artemether lossis quinine hauv Nyab Laj cov neeg laus uas muaj kab mob malaria loj heev. N Engl J Med . 1996; 335:76-83.8649493 22. Bunnag D, Kanda T, Karbwang J, Thimasarn K, Pungpak S, Harinasuta T. Artemether los yog artesunate ua raws li mefloquine raws li kev kho mob rau ntau yam tshuaj tiv thaiv falciparum malaria. Trans R Soc Trop Med Hyg . 1996; 90: 415-417.8882193 23. 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Nakamura A, Mihara K, Nagai G, et al. pharmacokinetic thiab pharmacodynamic kev sib cuam tshuam ntawm carbamazepine thiab aripiprazole hauv cov neeg mob schizophrenia. Ther Drug Monit . 2009; 31(5): 575-578.19701114 41. Abilify [package insert]. Princeton, NJ: Bristol-Myers Squibb; Lub Ob Hlis 2011. 42. Pithavala YK, Tortorici M, Toh M, et al. Cov nyhuv ntawm rifampin ntawm cov tshuaj pharmacokinetics ntawm axitinib (AG-013736) hauv Nyiv thiab Caucasian noj qab haus huv tuaj yeem pab dawb. Cancer Chemother Pharmacol . 2010;65(3):563-570.19603168 43. Dapsone [pob ntim]. Princeton, NJ: Jacobus Pharmaceutical Co, Inc; Lub Rau Hli 1997. 44. Premji Z, Umeh RE, Owusu-Agyei S, et al. Chlorproguanil-dapsone-artesunate tiv thaiv artemether-lumefantrine: ib qho randomized, ob-dig muag theem III sim hauv African cov menyuam yaus thiab cov tub ntxhais hluas uas tsis muaj teeb meem Plasmodium falciparum mob malaria. PLOS IB . 2009;4(8):e6682.19690618 45. Allouche A, Bailey W, Barton S, et al. Kev sib piv ntawm chlorproguanil-dapsone nrog sulfadoxine-pyrimethamine rau kev kho mob tsis yooj yim falciparum malaria hauv cov menyuam yaus African: ob-dig muag randomized tswj kev sim. Lancet . 2004;363(9424):1843-1848.15183620 46. Fanello CI, Karema C, Avellino P, et al. Kev pheej hmoo siab ntawm kev mob ntshav qab zib hnyav tom qab kho chlorproguanil-dapsone-artesunate antimalarial hauv cov neeg mob uas tsis muaj G6PD (A-). PLOS IB . 2008;3(12):e4031.19112496 47. Aczone Gel 5% [pob ntim]. Irvine, CA: Allergan, Inc; Lub Ob Hlis 2009. 48. Piette WW, Taylor S, Pariser D, et al. Hematological kev nyab xeeb ntawm dapsone gel, 5%, rau kev kho mob pob txuv vulgaris. Arch Dermatol . 2008;144(12):1564-1570.19075138 49. van Agtmael MA, Gupta V, van der Graaf CA, et al. Cov nyhuv ntawm cov kua txiv hmab txiv ntoo ntawm lub sij hawm-depended poob ntawm artemether plasma qib hauv cov neeg noj qab haus huv. Clin Pharmacol Ther . 1999;66:408-414.10546925 50. van Agtmael MA, Gupta V, van der Wosten TH, et al. Kua txiv Grapefruit nce bioavailability ntawm artemether. Eur J Clin Pharmacol . 1999;55:405-410.10456492 51. El-Lakkany NM, Seif el-Din SH, Badawy AA, et al. Cov nyhuv ntawm artemether ib leeg thiab ua ke nrog cov kua txiv hmab txiv ntoo ntawm cov tshuaj hepatic-metabolising enzymes thiab biochemical yam hauv kev sim schistosoma mansoni. Int J Parasitel . 2004; 34: 1405-1412.15542101 52. Drew BJ, Ackerman MJ, Funk M, et al. Kev tiv thaiv ntawm torsade de pointes hauv tsev kho mob chaw: ib daim ntawv qhia kev tshawb fawb los ntawm American Heart Association thiab American College of Cardiology Foundation. J Am Coll Cardiol . 2010;55(9):934-947.20185054 53. US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER). Kev taw qhia rau kev lag luam: E14 soj ntsuam kev soj ntsuam ntawm QT / QTc ncua ncua sij hawm thiab proarrhythmic peev xwm rau cov tshuaj uas tsis yog-antiarrhythmic. http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM129357.pdf?utm_campaign=Google2&utm_source=fdaSearch&utm_medium=website&utm_term=Clinical Evaluation of QT/QTc&utm_content=5. Luam tawm Lub Kaum Hli 2005. Accessed May 6, 2013. 54. Kannankeril P, Roden DM, Darbar D. Drug-induced long QT syndrome. Pharmacol Rev . 2010;62(4):760-781.21079043 55. Ponte ML, Keller GA, Di Girolamo G. Mechanisms of drug induced QT interval prolongation. Curr Drug Safe . 2010;5(1):44-53.20210718 56. Meyer-Massetti C, Cheng CM, Sharpe BA, et al. FDA txuas ntxiv ceeb toom rau cov tshuaj haloperidol thiab torsades de pointes: cov tsev kawm yuav tsum teb li cas? J Hosp Med . 2010;5(4):E8-E16.20394022 57. Procoralan [insert package]. Suresnes Cedex, Fab Kis: Cov Chaw Ua Haujlwm Pabcuam; Lub Yim Hli 2010. 58. Lefèvre G, Bindschedler M, Ezzet F, et al. Pharmacokinetic kev sib tham sim ntawm co-artemether thiab mefloquine. Eur J Pharm Sci . 2000;10(2):141-151.10727880 59. Korlym [pob insert]. Menlo Park, CA: Corcept Therapeutics Inc; Lub Ob Hlis 2012. 60. Mifeprex [package insert]. New York, NY: Danco Laboratories, LLC; Plaub Hlis Ntuj 2009. 61. http://www.azcert.org . International Registry for Drug-Induced Arrhythmias; University of Arizona Health Sciences Center, Tucson, AR. Nkag mus rau lub Tsib Hlis 6, 2013. 62. Onglyza [package insert]. Princeton, NJ: Bristol-Myers Squibb; Lub Xya Hli 2009. 63. McIntosh HM, Olliaro P. Artemisinin derivatives rau kev kho mob malaria hnyav. Cochrane Database Syst Rev . 2005(4):CD000386.16235276 64. Navarro VJ, Barnhart H, Bonkovsky HL, et al. Lub siab raug mob los ntawm cov tshuaj ntsuab thiab cov khoom noj khoom haus hauv Teb Chaws Asmeskas cov tshuaj ua rau lub siab raug mob network. Hepatology . 2014; 60(4): 1399-1408.25043597

Tsis lees paub

Cov ntaub ntawv no muaj feem xyuam rau tshuaj ntsuab, vitamin, ntxhia los yog lwm yam kev noj haus ntxiv. Cov khoom no tsis tau raug tshuaj xyuas los ntawm FDA los txiav txim seb nws puas muaj kev nyab xeeb lossis siv tau thiab tsis raug raws li cov qauv zoo thiab cov qauv sau cov ntaub ntawv kev nyab xeeb uas siv tau rau feem ntau cov tshuaj. Cov ntaub ntawv no yuav tsum tsis txhob siv los txiav txim siab seb puas yuav coj cov khoom no. Cov ntaub ntawv no tsis pom zoo rau cov khoom no tias muaj kev nyab xeeb, muaj txiaj ntsig, lossis pom zoo rau kev kho tus neeg mob lossis kev noj qab haus huv. Qhov no tsuas yog cov ntsiab lus luv luv ntawm cov ntaub ntawv dav dav txog cov khoom no. Nws tsis suav nrog tag nrho cov ntaub ntawv hais txog kev siv tau, cov lus qhia, ceeb toom, kev ceev faj, kev cuam tshuam, kev tsis zoo, lossis kev pheej hmoo uas yuav siv tau rau cov khoom no. Cov ntaub ntawv no tsis yog cov lus qhia tshwj xeeb rau kev kho mob thiab tsis hloov cov ntaub ntawv koj tau txais los ntawm koj tus kws kho mob. Koj yuav tsum tham nrog koj tus kws kho mob kom paub meej txog cov kev pheej hmoo thiab cov txiaj ntsig ntawm kev siv cov khoom no.

Cov khoom no tuaj yeem cuam tshuam tsis zoo rau qee yam kev noj qab haus huv thiab kev kho mob, lwm yam tshuaj thiab tshuaj tom khw muag khoom, khoom noj, lossis lwm yam tshuaj noj. Cov khoom no yuav tsis muaj kev nyab xeeb thaum siv ua ntej kev phais lossis lwm yam kev kho mob. Nws yog ib qho tseem ceeb kom qhia tag nrho koj tus kws kho mob txog tshuaj ntsuab, vitamins, minerals lossis lwm yam tshuaj uas koj noj ua ntej txhua yam kev phais lossis kev kho mob. Nrog rau kev zam ntawm qee yam khoom uas feem ntau lees paub tias muaj kev nyab xeeb nyob rau hauv ib txwm muaj, suav nrog kev siv cov tshuaj folic acid thiab cov vitamins thaum cev xeeb tub, cov khoom no tsis tau kawm txaus los txiav txim siab seb nws puas muaj kev nyab xeeb siv thaum cev xeeb tub lossis laus lossis cov neeg hluas. muaj hnub nyoog tshaj 2 xyoos.

Cov ntaub ntawv ntxiv

Nco ntsoov sab laj nrog koj tus kws kho mob kom paub meej tias cov ntaub ntawv uas tshwm sim hauv nplooj ntawv no siv tau rau koj tus kheej.