Zachidule za Mankhwala a Arthritis
Mankhwala a nyamakazi akhala akuonedwa ngati "mwambo" wothandizira. Popeza momwe munthu angayankhire mankhwala osokoneza bongo angasinthe ndipo chifukwa zotsatira zake zowonongeka ndi zotsatira zolakwika ndizofunikira, kupeza mankhwala ogwira mtima kwambiri a mankhwala a nyamakazi kungakhale kovuta kwambiri kuposa momwe mungayembekezere. Muyenera kudziŵa za mankhwala osiyanasiyana a nyamakazi, kuti mutha kusankha chisankho chodziwikiratu ndi dokotala wanu.
NSAIDs / COX-2 Inhibitors
NSAIDs (mankhwala osagwiritsidwa ntchito ndi anti-inflammatory drugs) ndiwo amodzi omwe amagwiritsidwa ntchito kwambiri ndi mankhwala a nyamakazi. Pali mitundu itatu ya NSAID: mankhwala a salicylates (onse a acetylated [mwachitsanzo, aspirin] ndi osali acedlated (mwachitsanzo, Disalcid {salsalate}]), Sakanizani (choline magnesium trisalicylate), komanso Pills kapena Novasal (magnesium salicylate); NSAID zachikhalidwe; ndi COX-2 selective inhibitors.
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Kugwiritsira ntchito maselo a tsinde kuti athe kuchiritsa nyamakazi ndi kuwonongeka kwa khungu
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JAK Inhibitors: Njira Yothandizira Odwala Matenda a Chifuwa
NSAID amagwira ntchito poletsa ntchito ya enzyme, cyclooxygenase, yomwe imatchedwanso COX. Kafukufuku wasonyeza kuti pali mitundu iwiri ya cyclooxygenase, yotchedwa COX-1 ndi COX-2 . NSAID zimakhudza mitundu yonseyi. COX-1 imakhudzidwa ndi kusunga minofu yathanzi, pamene COX-2 ikukhudzidwa ndi kutupa njira. COX-2 selective inhibitors anakhala a subsese of NSAIDs-ndi Celebrex (celecoxib) kukhala woyamba kukhala FDA-kuvomerezedwa kumapeto kwa zaka za m'ma 1990.
NSAID zachikhalidwe zimaphatikizapo:
- Ansaid (flurbiprofen)
- Arthrotec (diclofenac / misoprostol)
- Cataflam (diclofenac potassium)
- Clinoril (sulindac)
- Daypro (oxaprozin)
- Dolobid (diflunisal)
- Feldene (piroxicam)
- Ibuprofen (chizindikiro Motrin, Advil)
- Indocin (indomethacin)
- Ketoprofen (chizindikiro cha Orudis, Oruvail)
- Lodine (etodolac)
- Meclomen (meclofenamate)
- Mobic (meloxicam)
- Nalfon (fenoprofen)
- Naproxen (chizindikiro cha Naprosyn, Aleve)
- Ponstel (mefenamic acid)
- Relafen (nabumetone)
- Tolectin (tolmetin)
- Vimovo (naproxen-esomeprazole)
- Voltaren (diclofenac sodium)
COX-2 Inhibitors ndi awa:
- Celebrex (celecoxib)
Werengani: NSAIDs - Zimene Mukuyenera Kudziwa
DMARD
DMARD (matenda osinthira anti-rheumatic drugs) amatchedwanso "mankhwala ochepetsa pang'onopang'ono" chifukwa amatha kutenga masabata kapena miyezi kugwira ntchito komanso "ogwira ntchito mzere wachiwiri." Kafukufuku watsimikizira kuti DMARD ndiyothandiza pa matenda a nyamakazi , nyamakazi ya psoriatic , ndi spicyylitis ya ankylosing komanso kufunika koyambirira, mankhwala opweteka pogwiritsa ntchito DMARD. Cholinga cha kuchitidwa chithandizo ndi DMARD ndicho kuletsa kupatsirana kwa matenda ndikuletsa kuwonongeka kwa palimodzi.
DMARD imaphatikizapo:
- Azulfidine (sulfasalazine)
- CellCept (mycophenolate)
- Cyclosporine (chizindikiro cha Neoral, Sandimmune)
- Cytoxan (cyclophosphamide)
- Imuran (azathioprin)
- Leukeran (chlorambucil)
- Methotrexate (chizindikiro cha Rheumatrex, Trexall)
- Minocin (minocycline)
- Penicillamine (brand Cuprimine, Depen)
- Plaquenil (hydroxychloroquine)
Xeljanz (tofacitinib citrate), yemweyo DMARD, inavomerezedwa ndi FDA pa Nov 6, 2012, kuti athetse anthu akuluakulu kuti azigwira ntchito mwakayakaya odwala matenda a nyamakazi omwe alibe malingaliro oyenerera, kapena osagwirizana, kuti apeze methotrexate. Xeljanz ndiye woyamba m'gulu la mankhwala otchedwa JAK (Janus kinase) inhibitors.
Werengani: Zoona za DMARD
Corticosteroids (Steroids)
Corticosteroids kapena glucocorticoids, omwe nthawi zambiri amatchedwa "steroids," ndi mankhwala omwe angathe kuchepetsa kutupa ndi kutupa mwamsanga. Mankhwalawa ndi ofanana kwambiri ndi cortisol, mahomoni opangidwa ndi cortex ya adrenal glands. Iwo amalembedwa mu mlingo wosiyana kwambiri malinga ndi chikhalidwe ndi cholinga cha chithandizo. Ngakhale kuti steroid ingagwiritsidwe ntchito poletsa kutupa kwa ziwalo ndi ziwalo mu matenda opweteka, monga matenda a nyamakazi, lupus , polymyalgia rheumatica , ndi vasculitis , zatsimikiziridwa kuti zowopsa zowonjezera zikhoza kuwonjezeka pa mlingo waukulu kapena ndi nthawi yayitali ntchito.
Madokotala angapereke mankhwala ochepa omwe amatha kupitilira nthawi zina, kapena dokotala wanu akhoza kuika jekeseni wamtundu wina monga Kenalog (triamcinolone), kukuthandizani kupeza mpumulo ku ululu ndi kutupa.
Corticosteroids ndi:
- betamethasone (chizindikiro cha Celestone)
- cortisone (chizindikiro cha Cortone)
- dexamethasone (chizindikiro cha Decadron)
- hydrocortisone (chizindikiro cha Cortef)
- methylprednisolone (chizindikiro cha Medrol )
- prednisolone (chizindikiro cha Prelone)
- prednisone (chizindikiro cha Deltasone)
Werengani: Corticosteroids (Steroids) - Zimene Mukuyenera Kudziwa
Malingaliro (Zowawa Zam'mimba)
Malingaliro ndi mankhwala ochepetsa kupweteka. Kulamulira ululu ndi mbali yofunika kwambiri yothandizira nyamakazi. Komabe, mosiyana ndi ma NSAID, mankhwala opangira mankhwala samapangitsa kutupa. Acetaminophen (Tylenol) ndi mankhwala omwe amagwiritsidwa ntchito kwambiri. Mankhwala osokoneza bongo amatha kupangidwanso kuti amve ululu waukulu.
Mankhwala osokoneza bongo ndi awa:
- Codeine (Tylenol # 3)
- Duragesic (Fentanyl Skin Patch)
- Hydromorphone (Palladone) - salinso pamsika
- MS Contin (morphine sulfate)
- OxyContin (oxycodone)
- Percocet (oxycodone / acetaminophen)
- Percodan (oxycodone / aspirin)
- Talwin NX (pentazocine / naloxone)
- Ultracet (tramadol / acetaminophen)
- Ultram (tramadol)
- Vicodin (hydrocodone / acetaminophen)
Werengani: Analgesic Medication - Zimene Mukuyenera Kudziwa
Zamoyo Zosintha Zamoyo (Zamoyo)
Zosintha Zamoyo Zosintha Zamoyo (BRMs), zomwe zimatchulidwa kwambiri monga biologics , zimalimbikitsa kapena kubwezeretsa mphamvu ya chitetezo cha mthupi kuti imenyane ndi matenda kapena matenda. Zamoyo ndi mankhwala omwe amachokera ku zamoyo zotsutsana ndi kupanga mankhwala.
Enbrel (etanercept) , Remicade infliximab) , Huma (adalimumab) , Cimzia (certolizumab pegol) , ndi Simponi (golimumab) target TNF-alpha, imodzi mwa mapuloteni ofunika kwambiri omwe amapezeka m'magazi a nyamakazi. Mankhwala a TNF (mankhwala osokoneza bongo omwe amamanga TNF-alpha) amachititsa kuti asayambe kugwira bwino ntchito, motero amalepheretsa ntchito yotupa ndipo pamapeto pake amachepetsa kuwonongeka.
Kineret (anakinra), komanso mankhwala osokoneza bongo, ndi wotsutsana ndi IL-1. Kineret ndiye malo oyambirira omwe amasankha interleukin-1 (IL-1), mapuloteni omwe amapezeka mopitirira muyeso mwa anthu ena odwala nyamakazi. Mwa kulepheretsa IL-1, Kineret imaletsa kutupa ndi ululu wokhudzana ndi nyamakazi. Kineret ikhoza kugwiritsidwa ntchito yokha, kapena kuphatikiza ndi zina za DMARD, kupatula mankhwala oletsa anti-TNF. Ngakhale kuti Kineret ndiyotheka, sizinayankhidwe kawirikawiri.
Orencia (abatacept) anali woyamba T-cell co-stimulation modulator kuti avomereze kuchipatala nyamakazi.
Rituxan (rituximab) , mankhwala osokoneza bongo kwambiri padziko lonse, ndi FDA yomwe inavomerezedwa mu March 2006 kuti igwiritsidwe ntchito pamodzi ndi methotrexate kuti ikhale ndi nyamakazi yowonongeka ndi kuchepetsa zizindikiro ndi zizindikiro kwa anthu akuluakulu omwe ali ndi nyamakazi yowopsa kwambiri. sanathe mankhwala amodzi kapena anti-TNF ambiri. Rituxan ndiyo njira yoyamba yothandizira nyamakazi ya ma rheumatoid yomwe imasokoneza mwakachetechete maselo a B CD20.
Actemra (tocilizumab) ndi anti-monoclonal antibody yomwe imalepheretsa kulandira interleukin-6 (IL-6), motero imaletsa interleukin-6. Actemra inavomerezedwa ndi a FDA pa Jan 8, 2010 kuti azitsatira matenda aakulu a nyamakazi mu anthu omwe alephera mmodzi kapena ochuluka a TNF.
Matenda a Matenda a Nyamakazi - Matenda a ACR
Fibromyalgia Mankhwala Osokoneza Bongo
Mpaka chaka cha 2007, panalibe mankhwala ovomerezedwa ndi a FDA kuti azitsatira matenda a fibromyalgia . Madokotala ankagwiritsira ntchito fibromyalgia ndi mankhwala osiyanasiyana ndipo anayamba kuvomerezedwa kuti azindikire zina. Mu 2007, Lyrica (pregabalin) adavomerezedwa kuti azitenga fibromyalgia. Mu 2008, Cymbalta (duloxetine HCl) inavomerezedwa ku fibromyalgia. Mu 2009, Savella (milnacipran HCl) adavomerezedwa kuti akhale mkhalidwe.
Kugwiritsa Ntchito Mankhwala Osokoneza Bongo
Gout ndi imodzi mwa mitundu yowawa kwambiri ya nyamakazi. Ikhoza kuyendetsedwa ndi mankhwala, zakudya, ndi moyo kusintha. Pali mbali zitatu za mankhwala opatsirana pogwiritsa ntchito mankhwala: mankhwala a anti-inflammatory, anti-inflammatory, ndi mankhwala osokoneza ma uric acid ndi magout .
Mankhwala osokoneza bongo ndi awa:
- Acetaminophen (Tylenol), kapena zina zowonongeka, pofuna kupweteka
- NSAIDs (mankhwala osagwiritsidwa ntchito ndi anti-inflammatory drugs), kawirikawiri Indocin (indomethacin), chifukwa cha kutupa
- Colchicine , pofuna kuteteza kapena kuthetsa masewera a gout
- Corticosteroids, mofulumira zotsutsa-zotupa yankho
- Probenecid (Benemid, Probalan), kuti achepetse magazi a uric acid
- ColBenemid (Col-Probenecid ndi Proben-C) ili ndi anti-gout
- Allopurinol (zyloprim) , pofuna kuchepetsa magazi a uric acid mwa kuteteza uric acid kupanga
- Losartan (Cozaar, Hyzaar), osati mankhwala osokoneza bongo, koma ndi mankhwala odana ndi matenda omwe angathandize kuchepetsa uric acid levels
- Fenofibrate (Tricor), osati mankhwala osokoneza bongo, koma ndi mankhwala ochepetsa mankhwala omwe angathandize oric acid acid levels
- Uloric (febuxostat) , imachepetsanso mphamvu za seramu uric acid potseka xanthine oxidase
- Krystexxa (pegloticase), mankhwala osokoneza bongo omwe amathandiza pogwiritsa ntchito uric acid
Matenda Oseoporosis
Mafupa a osteoporosis ndi omwe amapezeka ndi mafupa okhwima, omwe amakhala osowa kwambiri, omwe amapezeka kwa okalamba, komanso angakhale ovuta kwa anthu amene atenga corticosteroids (steroids) longterm. Pali mitundu ingapo ya mankhwala omwe mungagwiritse ntchito chifukwa cha matenda a m'mimba: ma estrogens, mahomoni ochititsa manyazi, opanga mafupa, bisphosphonates, ndi ma molekyulu amchere. Malinga ndi mankhwala omwe amagwiritsidwa ntchito, mukhoza kuchepetsa kuperewera kwa mafupa, kulimbikitsa kukula kwa fupa, ndi kuchepetsa chiopsezo cha zophulika.
Mankhwala osokoneza bongo ndi awa:
- Actonel (risedronate)
- Boniva (ibandronate)
- Didronel (etidronate)
- Estrogens (mankhwala a mahomoni)
- Evista (raloxifene)
- Forteo (teriparatide)
- Fosamax (alendronate)
- Miacalcin (calcitonin)
- Kuthamanga (zoledronic acid)
- Prolia (denosumab)
Mawu Ochokera
Cholinga chachikulu cha kuchiza matenda a nyamakazi ndi matenda a rheumatic ndi mankhwala kumaphatikizapo kuchepetsa kupweteka, kuchepa kwa kutupa, kuchepetsa kupitirira kwa matenda, komanso kuyendetsa matenda. Pali mitundu yambiri ya nyamakazi ndi mankhwala ambiri mu gulu lililonse la mankhwala. Izi zimapangitsa kusankha kusamalidwa ndi mankhwala. Kusankha mankhwala kapena kuphatikiza kwa mankhwala ndibwino kuti mukhale ovuta. Zidzakhala zovuta kuyesa-ndipo mudzayesa kufikira mutamva kuti mwapeza yankho lolondola. Verywell yakhazikitsa mfundo zomwe muyenera kudziwa zokhudza mankhwala a nyamakazi. Zomwe tapereka zimakuthandizani kumvetsetsa chifukwa chake mukugwiritsa ntchito mankhwala omwe mukuwatenga ndikuthandizani kupanga mafunso kwa dokotala wanu.
> Chitsime:
> Kelley's Textbook of Rheumatology. Gawo 8. Pharmacology ya Antirheumatic Dawa. Elsevier. Kusindikiza kwachisanu ndi chinayi. Inapezeka pa 07/23/16.