Anthu omwe amakhala ndi matenda osokoneza bongo (COPD) nthawi zambiri amatumizidwa ndi bronchodilator , mtundu wa mankhwala ogwiritsira ntchito kupuma mpweya kuti muthe kupuma bwino. Mankhwala amachiritsidwa kudzera m'kamwa pogwiritsira ntchito mlingo wa inhaler (MDI) koma amapezeka mu madzi, mapiritsi, jekeseni, kapena mankhwala ovomerezeka.
Zitsulo zamagetsi zimagwiritsidwa ntchito pazomwe zikufunikira kapena zimaperekedwa kawiri tsiku lililonse kuti zitha kuchepetsa kapena kuchepetsa zizindikiro za COPD . Maphunziro atatu a bronchodilators omwe amagwiritsidwa ntchito kwambiri popanga COPD ndi awa:
- Beta-adrenergic agonists
- Anticholinergics
- Methylxanthini
Beta-Adrenergic Agonists
Beta-adrenergic agonists (omwe amatchedwanso beta-agonists) ndi mtundu wa mankhwala omwe amamangiriza kuzipangizo zinazake m'mapapo otchedwa beta-adrenoceptors. Mukamachita zimenezi, amalepheretsa ziwonongekozo kuti zizitha kutsegula.
Beta-agonists akhoza kukhala ochepa (kuchita maola anayi mpaka asanu) kapena kuchita nthawi yaitali (nthawi 12 kapena kuposa). Amaperekedwa pamlomo kapena kudzera mu MDI. Njira yosakanikirana nthawi zambiri imasankhidwa chifukwa imachepetsa zizindikiro mofulumira.
Agonist-aca agaist (SABAs) omwe amavomereza ku US tsopano:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Agonists omwe amagwira ntchito kwa nthawi yayitali (LABA) omwe akuvomerezedwa ku US ndi awa:
- Salmeterol
- Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Mankhwala a Beta-agonist amagwiritsidwanso ntchito m'njira ziwiri monga imodzi monga Symbicort yomwe imagwiritsa ntchito formoterol ndi corticosteroid yosakanizidwa yotchedwa budesonide.
Zotsatira za mankhwala nthawi zambiri zimakhala zofanana ndi zomwe zimawoneka ndi mankhwala.
Zowonjezereka zimaphatikizapo kuthamanga mtima kwa mtima (tachycardia), kupweteka kwa mtima, kusokonezeka, ndi kugona tulo.
Anticholinergics
Anticholinergics ndi mankhwala omwe amaletsa mtundu wa khansa yotchedwa neurotransmitter yotchedwa acetylcholine. Mitsempha yamatenda (yomwe imagwirizanitsa ndi ntchito yake) ndiyo gwero la acetylcholine m'mapapu. Poletsa kusungidwa kwa zinthu zimenezi, zotsutsana ndi zochitika pamlengalenga zimayima bwino.
Anticholinergics imapezeka kokha mu mawonekedwe osakanikirana ndipo imapereka mankhwala abwino kwambiri omwe amachititsa kuti ziwonongeke. Anticholinergics ndi othandiza kwambiri kwa omwe sangagwiritse ntchito beta-agonists kapena methylxanthines chifukwa cha matenda a mtima.
Anticholinergics yomwe ikuvomerezedwa tsopano ku US ndi:
- Atrovent (ipratropium)
- Spiriva (tiotropium)
- Aclidinium
Palinso mawu ophatikizidwa ophatikizidwa otchedwa Combivent omwe ali ndi ipratropium ndi short-acting beta-agonist albuterol.
Zotsatira zofala kwambiri za mankhwala ophera anticholinergic ndizowuma pakamwa komanso phokoso lazitsulo. Nthawi zambiri, glaucoma yadziwika kuti ikuchitika.
Methylxanthini
Methylxanthini ndi gulu lapadera la mankhwala omwe amadziwitsidwa kuti achepetse kuthamanga kwa mpweya, kuchepetsa kutupa, komanso kupsa mtima kwapadera.
Zochita zawo sizimvetsetsedwa bwino, ndipo, ngakhale zogwira ntchito, mankhwalawa sagwiritsidwa ntchito kawirikawiri pa mankhwala oyamba chifukwa cha zotsatira zake zambiri.
Methylxanthini ndi ofunika kwambiri kwa anthu omwe sangathe kulamulira bwino ndi beta-agonist kapena anticholinergic mankhwala. Mosiyana ndi mitundu ina ya bronchodilatini ya COPD, methylxanthines sichikuphimbidwa. Pakali pano amapezeka piritsi, madzi, intravenous, kapena suppository formulations.
Mankhwala awiri a methylxanthine omwe amavomereza ku US ndi awa:
- Theophylline
- Aminophylline
Zotsatira zake nthawi zina zimakhala zovuta kwambiri, makamaka ngati zimaperekedwa mwachangu.
Zizindikiro zimaphatikizapo kupweteka mutu, kusowa tulo, kunyowa, kutsegula m'mimba, kuthamanga, kupuma mofulumira, ndi kupweteka kwa mtima. Itanani dokotala mwamsanga mukakumana ndi kusanza, kugwidwa mtima kwapadera ( dysrhythmia ), kapena kugwidwa.
> 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.