Chidule Chachirichonse Kuchokera ku Acetaminophen mpaka ku Norco
Matenda a nyamakazi (RA) ndi matenda omwe amachititsa kuti chitetezo cha thupi chiteteze mitsempha, kuchititsa kutupa kwa synovium-minofu yomwe imayika mkati mwa ziwalo. Kupweteka ndi kutupa komwe kumabweretsa kungakhale koopsa komanso kolepheretsa. Mwamwayi, pali mankhwala osiyanasiyana pofuna kuchiza kutupa koyambitsa RA komanso kuchepetsa vuto lomwe limayambitsa. Pano pali tsatanetsatane wa magulu asanu akuluakulu omwe amagwiritsidwa ntchito pa RA komanso zomwe aliyense angathe kuchita pochiza matendawa.
Mankhwala Osagwiritsa Ntchito Steroidal Anti-Inflammatory
Mankhwala otsutsana ndi kutupa , omwe amatchulidwa kuti NSAID, ndi gulu lalikulu la mankhwala makamaka omwe amauzidwa kuti achepetse kutupa , ululu, ndi malungo.
Amagwira ntchito poletsa kuteteza mavitamini omwe amatchedwa cyclooxygenase (COX) kupanga prostaglandins-mankhwala otchedwa hormone omwe amachititsa kutupa. COX-1 ndi COX-2 ndi mitundu iwiri ya mavitaminiwa. NSAID zachikhalidwe, monga aspirin , naproxen , ndi ibuprofen chigawo chonse COX-1 ndi COX-2. NSAID zatsopano, monga Celebrex (celecoxib), zimangokhala COX-2 zokha ndipo zinapangidwa chifukwa COX-1 imadziwika kuti ili ndi phindu la kuteteza mimba.
Ngakhale kuti NSAIDS yambiri imadalira mankhwala, zina zimapezeka pa tsambalo mwa mphamvu zochepa, monga Advil (ibuprofen) ndi Aleve (naproxen).
Analgesics
Majekesi ndi mankhwala omwe amathandiza kupweteka. Nthawi zambiri amatchedwa mankhwala opweteka kapena painkillers. Gulu la mankhwalawa likuphatikizapo mankhwala osokoneza bongo monga Tylenol ( acetaminophen ) komanso mankhwala osokoneza bongo opioid monga hydrocodone . Mankhwala a opioid otchedwa Ultram ( tramadol ) amaganiza kuti ali ndi chiopsezo chochepa chakumwa mankhwala osokoneza bongo kusiyana ndi mankhwala ena opioid.
Acetaminophen imapezeka pamtengowo, komanso ndi mankhwala odzola ndi opioid. Vicodin, Lortab, ndi Norco ndi mayina a mankhwala omwe ali ndi hydrocodone ndi acetaminophen.
Corticosteroids
Corticosteroids , yomwe imatchedwanso glucocorticoids, ndi mankhwala omwe amatsanzira zotsatira za cortisol, mahomoni omwe amachititsa kuti thupi lizigwira ntchito, kuphatikizapo chitetezo cha mthupi . Cortisol imatha kulamulira kutupa mwamsanga ndi magulu ochepa a prostaglandins komanso cytokines yotupa.
Corticosteroids monga prednisone ali ndi zotsatira zofanana pa kutupa. Ndikofunika kuzindikira kuti ngakhale phindu lawo, corticosteroids ikhoza kukhala ndi zotsatira zosafunika monga kuwonjezeka kwa kudya, kupindula, kutaya madzi, ndi kuthamanga kwa magazi-makamaka ngati atengedwa kwa nthawi yaitali kapena pa mlingo waukulu . Ngati adokotala akuika pa corticosteroid, ndizofunika kuti muzitengere monga momwe mwafunira.
Mankhwala Osokoneza Matenda a Matenda
Mankhwala odana ndi nthendayi (DMARD) ndi mankhwala omwe amachititsa mwapang'onopang'ono kuti asamawonongeke matenda a nyamakazi ndipo amachepetsa chiopsezo chosagwirizana .
DMARD yochuluka kwambiri yomwe imatchulidwa ndi methotrexate (yogulitsidwa pansi pa maina a mtundu wa Rheumatrex ndi Trexall). DMARD zina zimaphatikizapo Plaquenil (hydroxychloroquine), Arava (lefilunomide), Azulfidine (sulfasalazine), ndi Otrexup, yomwe imakhala ndi njira imodzi yokha ya methotrexate.
Monga momwe zilili ndi mankhwala onse, ndikofunika kudziwa zotsatira zowonongeka. Mukawona chilichonse chodetsa nkhawa, funsani dokotala wanu. Mudzakhalanso ndi mayeso a magazi nthaŵi ndi nthawi kuti muwone mavitamini a chiwindi pamene mukuchitidwa ndi DMARD.
Molekyu yaing'ono DMARD kuphatikizapo JAK inhibitors ndi zina mwa zosankha zatsopano. Xeljanz (tofacitinib) ndi imodzi mwa izi. Zimagwira ntchito poletsa njira ya JAK mkati mwa maselo omwe amathandiza kwambiri kutupa kamene kamakhala ndi nyamakazi.
Zamoyo
Zamoyo , zochepa zokhudzana ndi kusintha kwa biologic, ndizo mtundu watsopano wa DMARD. Iwo ali ndi ma genetically opangidwa kuchokera ku zamoyo zamoyo kuti awononge yankho lapadera. M'mawu ena, biologics imalowera puloteni kapena selo yeniyeni yomwe imayanjanitsidwa ndi zizindikiro ndi kuwonongeka komwe kumayambitsidwa chifukwa cha kutupa kwa nyamakazi. Zambiri za biologics ndizojambulidwa, koma zina zimaperekedwa mwachangu (kupyolera mu singano mu mitsempha).
Zotsatira:
> Mankhwala a Mankhwala a Mankhwala Masiku Ano. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-guide/.
> Firestein, ndi al. Kelley's Textbook ya Rheumatology . Mndandanda wa 9. Elsevier Inc. 2012.