Njirayi yosankhidwayo ili ndi phindu ndi zopinga
Anthu omwe ali ndi psoriasis tsopano ali ndi njira zosiyana zothandizira kuti athetsere zizindikiro zawo. Zamagetsi zobwereka, zomwe zimachokera ku vitamini A, ndizo mwayi wosankha. Acitretin ndi mankhwala amodzi omwe amapezeka ngati mankhwala amlomo. Ngakhale kuti imagwiritsidwa ntchito mobwerezabwereza kuposa mankhwala ena a psoriasis , zingakhale zoyenera kulingalira anthu ena.
Maselo Osapsa Khungu ku Psoriasis
Keratinocytes ndiwo maselo akuluakulu omwe amapezeka pakhungu lanu. Mu khungu lenileni, maselowa amagawana ndi okhwima pakapita nthawi. Mu psoriasis, maselo ofanana a khungu amagawana ndi okhwima mu njira yodabwitsa. Maselo amenewa amakhalanso ndi khungu lopweteka lomwe limapangitsa kuti azikhala ndi matenda. Ichi ndi mbali ya zomwe zimayambitsa zizindikiro za psoriasis.
Mmene Acitretin Works
Acitretin ndi retinoid. Izi zikutanthawuza kuti imapezeka m'banja limodzi la mankhwala monga vitamini A (chofunikira kwambiri mu zakudya zina). Zakudya zam'thupi zovomerezeka monga acitretin zakhala zikupezeka pochiza psoriasis kuyambira zaka za m'ma 80s. Choyamba chobwezera retinoid, etretinate, chatsinthidwa ndi mankhwala atsopano, acitretin. Ku US, dzina la acitretin ndi Soriatane TM .
Retinoids ngati acitretin alowe mu maselo a keratinocytes. Kumeneko amasintha kusintha kwa majeremusi ena omwe amapezeka mu DNA yanu.
(Izi zikutanthauza kuti majini ena angagwiritsidwe ntchito kupanga mapuloteni nthawi zambiri, ndipo majini ena angagwiritsidwe ntchito mochepa.) Izi zimayambitsa zotsatira, monga:
- Kuchepa kwa khungu kochepa
- Kuchepetsa kukula kwa maselo osadziwika ndi kugawanika kwa maselo a khungu
- Pewani kusasitsa kwachibadwa kwa maselo a khungu
Zina zamagetsi zamtunduwu (monga tazarotene ) zingagwiritsidwe ntchito pochiza psoriasis, ndipo zimagawana zinthu zofananako ndi retinoids zamlomo.
Komabe, acitretin ali ndi zotsatira zowonjezereka kuposa ma retinoids, chifukwa amachotsedwa mkati.
Ndani Angapindule ndi Acitretin?
Acitretin ndi chithandizo cha mankhwala kwa odwala omwe ali ndi psoriasis ovuta kwambiri. Izi zimatchulidwa kuti ndi anthu omwe ali ndi zotsatirazi:
- Psoriasis yophimba pamwamba pa 10 peresenti ya khungu lawo
- Psoriasis peresenti ya khungu lawo, koma omwe ali ndi zizindikiro zofooketsa, monga psoriasis oopsa pa manja awo kapena khungu
Anthu ambiriwo amafunikira mankhwala ochizira ammimba (monga acitretin) kapena imodzi mwa mankhwala atsopano a psoriasis. Anthu omwe ali ndi psoriasis wofatsa kokha amafunikira chithandizo ndi zakumwa zam'mwamba kuti asunge matenda awo.
Acitretin ingakhale yothandiza makamaka kwa anthu okhala ndi psoriasis . Izi zikuphatikizapo:
- Psoriasis yokhudza mitengo ya palmu ndi miyala
- Psoriasis yokhudza misomali
- Pustular mtundu psoriasis
- Erythrodermic psoriasis
Mankhwala Okalamba a Psoriasis vs. Mankhwala Osakanikirana Ambiri
Acitretin ndi amodzi mwa mankhwala osokoneza bongo omwe amachititsa kuti psoriasis ikhale yovuta kwambiri. Mankhwalawa amodzi omwe amagwiritsidwa ntchito kwambiri ndi acitretin, methotrexate , ndi cyclosporine. Mankhwalawa ankatchulidwa kawirikawiri kwa odwala omwe ali ndi psoriasis.
Komabe, m'zaka zaposachedwapa, mankhwala atsopano, otchedwa biologics, akhala akupezeka. Izi zikuphatikizapo mankhwala monga etanercept ndi adalimumab. Zonsezi, mankhwala atsopanowa alibe mavuto aakulu kuposa mankhwala okalamba. Mankhwala osokoneza bongo amakhalanso othandiza pochiza psoriasis.
Komabe, kwa anthu ena, mankhwala achikulire ngati acitretin angakhalebe abwino koposa. Chinthu chimodzi chofunika kwambiri cha mankhwala ochizira monga acitretin ndi chakuti amatengedwa pakamwa. Anthu ena angasankhe izi ku chithandizo cha biologic, chomwe chimaperekedwa ndi jekeseni. Komanso, mankhwala achikulire monga acitretin nthawi zambiri amakhala otsika mtengo kuposa mankhwala a biologic.
Kodi Acitretin Amafananitsa Bwanji ndi Malamulo Ena Ovomerezeka Ovomerezeka a Psoriasis?
Pogwiritsidwa ntchito palokha, acitretin kawirikawiri ndi yochepa kwambiri kusiyana ndi methotrexate kapena cyclosporine (mankhwala ena omwe amamwa mankhwala ambiri). Komabe, mwinamwake ndibwino kuposa mankhwala ena onsewa kwa nthawi yaitali.
Acitretin kwa Anthu Okhala ndi Psoriasis Ndi Immunosuppression
Gulu lina la odwala psoriasis omwe angathe makamaka kupindula ndi acitretin ndi anthu amene athandiza machitidwe a chitetezo cha mthupi. Mankhwala osokoneza bongo komanso mankhwala osokoneza bongo monga methotrexate amagwira ntchito poletsa kuponderezedwa kwa munthu. Komabe, mosiyana ndi mankhwala enawa, acitretin sichikuletsa kwambiri chitetezo chanu cha mthupi. Izi zikhoza kuchititsa kuti anthu omwe ali ndi kachilombo ka HIV, omwe ali kale ndi vutoli, ayambe kudwala.
Mankhwala Osakaniza Ndi Acitretin
Nthawi zina Acitretin amatengedwa ngati mankhwala okhaokha, koma nthawi zambiri amagwiritsidwa ntchito bwino ndi mankhwala ena.
- Makamaka, acitretin nthawi zambiri imaphatikizidwa ndi phototherapy , mtundu wina wa mankhwala a UVB kapena mankhwala a UVA ndi psoralen (PUVA).
- Acitretin ingagwiritsidwe ntchito pamodzi ndi mankhwala opangira psoriasis.
- Mosiyana ndi mankhwala ena amtundu, acitretin amathanso kutenga mankhwala osokoneza bongo.
Musagwiritse ntchito acitretin ndi mankhwala ena a vitamini A, chifukwa izi zingapangitse mavitamini A poizoni.
Kusuta kwa Acitretin
Acitretin amapezeka m'mapiritsi a 10mg, 17.5 mg, kapena 25 mg. Odwala ambiri amapereka mlingo wa pakati pa 10 mg ndi 25 mg pa tsiku, koma nthawi zina anthu ena amafunika mlingo wapamwamba.
Acitretin nthawi zambiri imakhala yothandiza kwambiri pa mlingo waukulu. Komabe, zotsatirapo zingakhale zosavuta kuchitika pamagulu awa. Mungayambe ndi mlingo wapansi ndikupita ku mlingo wapamwamba ngati zizindikiro sizikuthandizani, ndipo ngati mulibe zotsatira za mankhwala.
Zitha kutenga miyezi itatu kapena isanu ndi umodzi musanakwanitse kukwaniritsa yankho lanu pa mankhwala anu.
Mmene Mungatengere Acitretin
- Tengani acitretin ndi chakudya.
- Tengani ndondomeko ya mlingo woyenera ndi wopereka chithandizo chamankhwala.
- Ngati mwaphonya mlingo, musati muwirire mlingo wotsatira. M'malo mwake, tulukani mlingo ndi kutenga mlingo wokhazikika pa nthawi yotsatira.
Wopereka chithandizo chaumoyo wanu adzakuuzani inu mlingo womwe uli woyenera kwa inu.
Mimba Yopanda
Acitretin ndizomwe si mankhwala otetezeka kwa amayi apakati kuti atenge. Acitretin angayambitse zolakwika zosiyanasiyana zobereka, kuphatikizapo zomwe zimakhudza mtima, dongosolo la mitsempha, kumva ndi masomphenya, ndi ziphuphu. Chiopsezo chachikulu ndi cha amayi omwe amatenga acitretin pakati pa masabata atatu ndi asanu ndi limodzi omwe ali ndi mimba. Izi ndizimene amayi ambiri amadziwa ngakhale kuti ali ndi pakati.
Acitretin sathyoledwa kwathunthu ndi thupi mpaka zaka zitatu mutasiya mankhwala. Chifukwa chaichi, acitretin sayenera kugwiritsidwa ntchito ndi zotsatirazi:
- Akazi omwe ali ndi pakati
- Azimayi akukonzekera kutenga pakati panthawi ya mankhwala kapena pakatha zaka zitatu atasiya mankhwala
- Akazi a msinkhu wobereka omwe sangathe kugwiritsa ntchito njira yodalirika yobereka panthawi ya chithandizo komanso kwa zaka zitatu zotsatira za mankhwalawa
Iyenso sayenera kugwiritsidwa ntchito ndi amayi omwe akuyamwitsa.
Mfundo Zina Zokhudzana ndi Akazi Otha Kubala
- Acitretin mwina si mankhwala opambana kwa inu pokhapokha mutakhala ndi psoriasis yovuta yomwe simukugwirizana ndi mankhwala ena, kapena simungathe kutenga zina zothandizira pazifukwa zina.
- Ngati acitretin ndi njira yabwino kwambiri, mufunikira zoyezetsa zolamba ziwiri musanayambe acitretin, zomwe ziyenera kuchitika pa nthawi ya kusamba.
- Mudzafunika mayeso oyenerera mwezi uliwonse pa mankhwala.
- Muyenera kugwiritsa ntchito mitundu iwiri ya kulera pamene mukugwiritsa ntchito mankhwalawa, ndipo kwa zaka zitatu mutasiya mankhwalawa.
Zovuta Zotsatira za Acitretin
Acitretin amatha kuwononga zotsatira zake. Izi zikuphatikizapo:
- Kuuma kwa maso, mphuno, pakamwa, ndi khungu
- Zilonda zazing'ono
- Kutaya tsitsi
- Kutentha khungu la khungu
- Misala ya minofu
- Nausea
- Zomera za Bony pamsana
- Kuwonjezeka kwa triglycerides
Zotsatira zina zingathe kuchitika. Kawirikawiri, acitretin amachititsa mavuto aakulu ngati chiwindi cha chiwindi kapena kutupa kwa makoswe. Pafupifupi mavuto onsewa ndi othandizidwa posiya chithandizo. Lankhulani mwamsanga kwa wothandizira zaumoyo wanu ngati muli ndi nkhaŵa iliyonse.
Asanayambitse Mankhwala
Musanayambe mankhwala a acitretin, mudzafunika mbiri ya zamankhwala ndi kuunika kwa thupi. Mwinanso mungafunike kuyesedwa kwa magazi kuti mutsimikizire kuti ndinu woyenera kulandira chithandizo. Izi zikuphatikizapo izi:
- Mayeso a mafuta a mafuta (triglycerides ndi cholesterol)
- Mayendedwe a chiwindi
Kuwunika pa Acitretin
Chifukwa cha ngozi ya zotsatira za acitretin, wothandizira zaumoyo wanu adzafunika kukuyang'anirani. Mutangoyamba kumene kuchipatala, mungafunike kuyesa magazi nthawi zonse kuti muwone chiwindi ndi mafuta anu. Pakatha masabata angapo pa mankhwalawa, muyenera kusinthira ku mayesero osachepera.
Ndi Ndani Amene Sagwiritse Ntchito Acitretin?
Kuwonjezera pa amayi ndi amayi omwe ali ndi pakati omwe angakhale ndi pakati, magulu ena a anthu amafunikanso kupewa acitretin. Izi zikuphatikizapo:
- Anthu omwe ali ndi hyperlipidemia
- Anthu omwe amamva mankhwala kapena mavitamini a vitamini A
- Anthu omwe ali ndi matenda oopsa
Kuwonjezera apo, acitretin sangakhale mankhwala abwino kwambiri kwa inu ngati muli ndi mavuto ena azachipatala, monga:
- Mtundu 1 kapena mtundu wachiwiri wa shuga
- Matenda a chiwindi
- Matenda a impso
- Mavuto oledzera
Mawu Ochokera
Kusamalira psoriasis yanu kungakhale kovuta. Mwamwayi, masiku ano, pali njira zingapo zothandizira anthu omwe ali ndi psoriasis ochepa kwambiri. Acitretin kawirikawiri si chisankho chabwino kwa amayi a msinkhu wobereka. Koma kwa anthu ena, mankhwala achikulire monga acitretin angakhale othandiza, makamaka akagwiritsidwa ntchito ndi mankhwala ena.
> Zotsatira:
> Wowonjezera A, Korman NJ, Elmets CA, et al. Malangizo othandizira kusamalira ma psoriasis ndi psoriatic nyamakazi: gawo 4. Malangizo othandizira kusamalira ndi chithandizo cha psoriasis ndi azitsamba. J Am Acad Dermatol . 2009; 61 (3): 451-85. lembani: 10.1016 / j.jaad.2009.03.027.
> Soriatane Kulongosola Zowonjezera . Allergan. 2017. Steifel Laboratories. 2014. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/019821s027lbl.pdf.
> Sarkar R, Chugh S, Garg VK. Acitretin mu dermatology. Indian J Dermatol Venereol Leprol. 2013; 79: 759-71. lembani: 10.4103 / 0378-6323.120721.