Imodzi mwa zolakwitsa zazikulu zomwe asthmatics ya mimba zimapanga ndikusiya kugwiritsa ntchito mankhwala awo a mphumu akangomva kuti ali ndi pakati. Ngakhale kuti mankhwala angathe kuika pangozi kwa mwana, chiwopsezo cha mphumu yosasinthika kawirikawiri sichiposa chiwopsezo chochepa cha kuwonongeka kwa fetus kuchokera ku mankhwala ambiri a mphumu. Kulakwitsa kwina kwakukulu kwa asthmatics yokhala ndi mimba ndi kusiya kuwona madokotala awo achizolowezi nthawi zonse akakhala ndi pakati.
Malinga ndi Food and Drug Administration (FDA), palibe mankhwala a mphumu omwe amawoneka kuti ali otetezeka mwathunthu pa mimba. Izi zili choncho chifukwa palibe mayi yemwe ali ndi pakati omwe angafune kulembetsa phunziro la chitetezo cha mankhwala pamene ali ndi pakati. Choncho, a FDA apereka ziopsezo kwa mankhwala okhudzana ndi kugwiritsa ntchito pathupi.
Mimba Zokhudza Mankhwala
Gawo la mimba "A" mankhwala ndi mankhwala omwe amaphunzira bwino kwa amayi apakati akuwonetsa chitetezo cha mankhwala kwa mwanayo m'miyezi itatu yoyamba. Pali mankhwala ochepa m'gululi ndipo palibe mankhwala a mphumu.
Mankhwala a "B" amasonyeza maphunziro abwino a chitetezo m'matumba oyembekezera koma palibe maphunziro aumunthu omwe alipo.
Mimba ya mimba "C" imakhala ndi zotsatira zovuta pa mwana wakhanda pamene amaphunzira mimba zodwala, koma ubwino wa mankhwalawa ukhoza kuchepetsa kuopsa kwa anthu.
Mankhwala a "D" amasonyeza chiwopsezo chomveka kwa mwana wakhanda, koma pakhoza kukhala zochitika zomwe zimapindulitsa kwambiri kuopsa kwa anthu.
Ndipo potsiriza, mankhwala a "X" amasonyeza umboni woonekeratu wa zilema za kubadwa kwa nyama ndi / kapena maphunziro aumunthu ndipo sayenera kugwiritsidwa ntchito pathupi.
Kusokonezeka kwa Mafupa
Kupulumutsa mankhwala , omwe amagwiritsidwa ntchito pofuna kuthandizira pang'onopang'ono zisonyezo za mphumu, kuphatikizapo bronchodilators odziteteza monga albuterol.
Ngakhale mankhwalawa ndi gulu "C", zomwe takumana nazo pogwiritsa ntchito mankhwalawa mwa amayi apakati ndi zazikulu ndipo sizikusonyeza umboni wa zotsatira zovuta pa mwanayo.
Mankhwala othandizira a mphumu yotsatiridwa ndi odwala steroids, omwe ndi njira yokondweretsera kutupa kwa mphumu. Mankhwala ena mwa gululi ndi Advair (fluticasone / salmeterol), theophylline, cromolyn, ndi Singulair (montelukast).
Ma steroids omwe amawakonda kwambiri ndi Pulmicort (budesonide), omwe ndi "B" omwe amawotchera steroid, ndi QVAR (beclomethasone), popeza kuti mankhwalawa sakhala ozungulira kwa nthawi yayitali, ndipo zowonjezereka zimakhala zabwino. Komabe, ndizomveka kupitirizabe mtundu wina wa steroid yosakanizika panthawi yomwe mayi ali ndi pakati ngati akugwiritsa ntchito mankhwalawa asanakhale ndi pakati.
Chophatikizapo mankhwala monga Advair kapena Symbicort angafunike kwa odwala omwe ali ndi mphumu yovuta kwambiri. Mankhwalawa amaphatikizapo mankhwala otchedwa steroids ndi agonist (mankhwala a albuterol) omwe amagwiritsidwa ntchito kwa nthawi yayitali, ndipo amagwiritsidwa ntchito ngati mankhwala olamulira. Odwala akufunikirabe albuterol kuti "akufunika" kapena kupulumutsidwa.
Mankhwala ena monga aophylline (gulu "C") ndi cromolyn, nedrocromil, ndi Singulair (gulu lonse "B") ndi ololera kuti apitirize pamene ali ndi mimba ngati amayi apindula ndi mankhwala asanakhale ndi mimba.
Komabe, palibe mankhwala awa omwe angatengedwe kuti ndi "kusankha koyamba" kuyamba pa nthawi ya mimba.
Xolair (omalizumab), ndi mankhwala ojambulidwa pogwiritsidwa ntchito pochiza mphumu ngati mankhwala olamulira. Ali ndi chikhalidwe cha "B", ngakhale kuti mankhwalawa atha kukhalapo kwa zaka zingapo, ayenera kugwiritsidwa ntchito mosamala mu asthmatics yokhala ndi pakati.
> Zotsatira:
> Report of Panel Expert Panel. Kusamalira Pumupakati Pakati pa Mimba: Malangizo a Pharmacologic Treatment - 2004 Update. J Zachilombo Zamtundu wa Immunol. 2005; 115: 36-46.
> Blaiss MS. Ulamuliro wa Asayansi Pakati pa Mimba. Zotsatira Zopsa Nthenda Proc. 2004; 25: 375-379.
> ACOG / ACAAI. Kugwiritsira Ntchito Katsopano Kachilombo ndi Mankhwala Opatsirana Pakati Pa Mimba. Ann Zozizira Nthenda Immunol. 2000; 84: 475-480.