Mankhwala Osokoneza Bongo Amagwira Ntchito Mosiyana Poletsa kapena Kuteteza Mapiritsi
Mankhwala othandizira anthu odwala matendawa ndi ofunika kwambiri pochiza anthu omwe ali ndi matenda opatsirana omwe amachititsa kuti matendawa asapitirire . M'malo modikira mapiritsi kuti apereke mankhwala kudzera m'magazi, inhalers amapereka mankhwalawa ku magwero a vuto, kukwaniritsa mofulumira, zotsatira zowunikira.
Pali inhaler yomwe imakhala ndi mankhwala amodzi okha (monotherapy) ndi ena omwe amapereka mankhwala ambiri ndi njira zosiyana za zochita.
Mankhwalawa akhoza kusweka m'magulu atatu akuluakulu:
- Makina a bronchodilators ochepa
- Achimake otchedwa bronchodilators a nthawi yaitali
- Shalaids yosakaniza
Aliyense amagwira ntchito mosiyana pakuchiza kapena kuteteza COPD ndipo amapereka msana umene wina amamwa kapena mankhwala ophera.
Bronchodilators Yachidule
Anthu ena omwe ali ndi COPD amangoona zizindikiro (kupuma pang'ono, kupuma) pamene akudziyesera okha. Kwa anthuwa, madokotala nthawi zambiri amapereka bronchodilator, yemwe amadziwikanso kuti amapulumutsa.
Zojambulajambula zimagwira ntchito potsegula (kusinthanitsa) masiketi a mpweya ( bronchioles ) omwe amaletsedwa nthawi ya COPD. Mankhwala otchedwa bronchodilators afupipafupi amakhala "ofulumira komanso othamanga," kutanthauza kuti amagwira ntchito mofulumira komanso amapereka mpumulo kwa maola pafupifupi 4 kapena 6. Zimayenera kugwiritsidwa ntchito pokhapokha ngati zikufunika ndikunyamulidwa kulikonse kumene mungapite mukakumana ndi mavuto.
Pali magulu awiri a mankhwala omwe amagwiritsidwa ntchito kwa bronchodilators omwe amachititsa nthawi yayitali: beta-agonists , omwe amamanga mapiritsi m'mapapo kuti asiye kupuma, ndi anticholinergics , zomwe zimatseka mankhwala omwe amachititsa kuti ziphuphu zisokonezeke.
Agonist-aca agaist (SABAs) omwe amavomereza ku US tsopano:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Kachitidwe kakang'ono ka anticholinergic pakali pano kamvomerezedwa ku US ndi:
- Atrovent (ipratropium)
Palinso mawu ophatikizidwa ophatikizidwa otchedwa Combivent omwe ali ndi ipratropium ndi short-acting beta-agonist albuterol.
Bronchodilators Zakalekale
Anthu omwe ali ndi COPD apamwamba nthawi zambiri amapatsidwa mankhwala osakanizidwa amene amatengedwa tsiku lililonse kaya ali ndi zizindikiro kapena ayi. Mankhwala awa amatchulidwa ngati bronchodilators omwe akhala akutalika nthawi yaitali.
Anthu omwe ali pangozi yowonjezereka akhoza kupindula ndi mankhwalawa pamene amapereka chitetezo cha bulangeti kulikonse kuyambira maola 12 mpaka 24. Monga ndi bronchodilator yaifupi, amakhala ndi beta-agonist kapena anticholinergic mankhwala.
Agonists omwe amagwira ntchito kwa nthawi yayitali (LABA) omwe akuvomerezedwa ku US ndi awa:
- Salmeterol
- Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Nthenda yotchedwa anticholinergics yomwe inavomerezedwa ku US ndi:
- Spiriva (tiotropium)
- Aclidinium
Shalaids Yowonjezera
Anthu omwe ali ndi COPD yovuta sangayankhe ngakhale a bronchodilators omwe akhala akuchita nthawi yaitali ndipo nthawi zambiri amafunika "mphamvu" kuti athe kupuma. Kwa anthuwa, steroid yosakanizidwa ikhoza kugwiritsidwa ntchito.
Shalaids yosakanikirana, yomwe imadziwikanso kuti inhaled glucocorticoids , imakhala yamphamvu yotsutsa-kutupa kwenikweni ndipo ikhoza kuchepetsa kupuma ndi kupanga ntchentche mu airways. Zimagwira ntchito mofananamo ngati mankhwala opatsirana koma amathamanga mofulumira ndipo amachepetsa kwambiri chiopsezo chotentha komanso kuchipatala.
Amagwiritsidwa ntchito kaŵirikaŵiri tsiku ndi tsiku ndipo kawirikawiri amafunika masabata awiri "nthawi yotsatila" asanayambe kugwira ntchito.
Steroids yosakanizidwa kawirikawiri yogwiritsira ntchito COPD ndi:
- Pulmicort (budesonide)
- Aerospan (flunisolide)
- Flovent (fluticasone)
- Asmanex (mometasone)
- QVAR (beclomethasone)
Palinso mitundu itatu yokhala pamodzi yomwe imaphatikizapo steroids yochepetsetsa:
- Symbicort (formoterol ndi budesonide)
- Advair (salmeterol ndi fluticasone)
- Brio Ellipta (vilanterol ndi fluticasone)
Zotsatira za mankhwala ophera tizilombo ta steroid zimakhala zochepa kwambiri kuposa za m'kamwa kapena jekeseni wa steroids. Zitha kuphatikizapo pakamwa pakhosi kapena pamtima, phokoso (dysphonia), ndi pakamwa candidiasis (thrush).
Kugwiritsiridwa ntchito kwa nthawi yaitali kumagwirizanitsidwa ndi chiopsezo chowonjezereka cha glaucoma ndi matenda otupa mafupa.
> Chitsime:
> Vestbo, J .; Kukhumudwa, S .; Agusti, A. et al. "Njira yothetsera matenda, matenda, komanso kupewa matenda osokoneza bongo: GOLD executive summary." Am J Respir Amatsutsa Care Med. 2013; 187 (4): 347-65. DOI: 10.1164 / rccm.210204-0596PP.