Mankhwala Omwe Amagwiritsidwa Ntchito Ambiri Opatsirana Matenda a Matenda a Nyamakazi ndi Matenda Ena a Matenda a Chifuwa (Rheumatic Diseases)
Methotrexate (mayina a dzina lakuti Rheumatrex, Trexall, Otrexup , Rasuvo ) amalembedwa kawirikawiri kuti athetse nyamakazi ya nyamakazi ndi zizindikiro zina za rheumatic. Methotrexate inavomerezedwa ndi FDA mu 1988 pofuna kuchiza nyamakazi ya nyamakazi. Asanavomereze matenda a nyamakazi, mankhwalawa anali atagwiritsidwa ntchito pochiza psoriasis ndi khansa.
Pachiyambi chinayambitsidwa ngati mankhwala a khansa ya m'magazi m'ma 1940.
Kuwonjezera pa nyamakazi ya nyamakazi, methotrexate ikhoza kulamulidwa kuti:
- psoriatic nyamakazi
- lupus
- ankylosing spondylitis
- vasculitis
- mwana wamagazi (polyarticular)
Methotrexate ndi DMARD Yotsitsa-Kuchita
Methotrexate amadziwika ngati DMARD ( mankhwala osinthira anti-rheumatic drug) . Mankhwalawa amagwiritsidwa ntchito kuchepetsa kupweteka ndi kutupa kamene kamayambitsa matenda a nyamakazi, kuteteza kuwonongeka kwa mgwirizano, ndi kuchepetsa chiopsezo chaumphaŵi pochepetsa kuchepa kwa matenda. Kupititsa patsogolo ntchito ya methotrexate kungawoneke pakangotha masabata atatu kapena asanu ndi limodzi, koma kungapangitse masabata 12 kapena ngakhale mpaka miyezi isanu ndi umodzi ya chithandizo kuti phindu lonse lidziwike.
Njira yogwira ntchito
Methotrexate imalepheretsa mazira ena omwe amachititsa chitetezo cha mthupi. Methotrexate imateteza ma enzyme dihydrofolate reductase. Pochita zimenezi, zimakhudza kupanga mtundu wa folic acid umene ukufunikira kuti maselo akukula mosavuta.
Sitikudziwika bwinobwino momwe methotrexate imachepetsa ntchito ya nyamakazi.
Mlingo
Methotrexate yamlomo imatengedwa tsiku limodzi pa sabata chifukwa cha matenda a nyamakazi. Sizitengedwa tsiku ndi tsiku ngati mapiritsi ambiri. Methotrexate ilipo mapiritsi 2.5-milligram. Mankhwala oyambirira a anthu ambiri achikulire omwe ali ndi nyamakazi ya nyamakazi ndi miligramu 7.5 mpaka 10 (mwachitsanzo, mapiritsi atatu kapena anayi).
Mapiritsi atatu kapena anayi amatengedwa pamodzi kamodzi pa sabata (tsiku lomwelo sabata iliyonse). Ngati kuli kofunika, mlingo wonse wa methotrexate ukhoza kuwonjezeka kufika pa milligram 20 kapena 25 sabata iliyonse.
Dzina loti Rheumatrex dose pakiti lili ndi makadi a blister omwe ali ndi nambala yeniyeni ya mapiritsi kuti azitenga mlungu uliwonse. Dzina lakuti Trexall likupezeka pa mapiritsi asanu, 7.5, 10, ndi 15 milligram. Methotrexate imapezekanso mu mawonekedwe ojambulidwa , omwe odwala ambiri amatha kudzipiritsa.
Zotsatira Zotsatira
Methotrexate ikhoza kuyambitsa chiwindi chachilendo ntchito. Ndikofunika kuti nthawi zonse muyesetse magazi anu kuti azigwira ntchitoyi kotero dokotala wanu akhoza kukuyang'anirani zotsatira zosafunika. Zina osati zoyipa ndi chiwindi ntchito, zotsatira zofala kwambiri zomwe zimagwirizanitsidwa ndi methotrexate ndi kunyoza ndi kusanza.
Zotsatira zomwe zatchulidwa kale-kunyoza, kusanza, ndi chiwindi ntchito-zikhoza kudalira pa mlingo. Ngati muli ndi zotsatirapo izi, kusintha mlingo kungathetse vutoli. Anthu ambiri samakhala ndi mavuto akuluakulu pamene akutenga methotrexate.
Zina zowononga zotsatira (zina zofunikira) zikuphatikizapo:
- zilonda zam'kamwa
- maphutsi kapena zochita zamkati za khungu
- kutsekula m'mimba
- kuwerengeka kwa magazi
- chiwonongeko cha chiwindi / chiwindi cha chiwindi (chosowa)
- kupweteka kwa impso
- matenda a m'mapapo
- lymphoma
- matenda opatsirana
- chifuwa chosatha
- mpweya wosadziwika
- kupweteka kwa tsitsi (pang'onopang'ono)
- kutengeka kwa dzuwa
Machenjezo
- Kuwonjezeka kwa chiopsezo cha chiwindi ndi methotrexate ndizofunikira kwa anthu omwe amamwa mowa . Choyenera, musamamwe mowa ngati mutatenga methotrexate. Kawirikawiri, ndi chilolezo cha dokotala, simuyenera kumwa zakumwa ziwiri pamwezi.
- Methotrexate sayenera kutengedwa ndi anthu omwe ali ndi matenda aakulu a chiwindi kapena matenda a impso. Katswiri wa rheumatologist angasankhe kupereka mankhwala otchedwa methotrexate kwa anthu omwe ali ndi chiwindi chakuda kapena matenda a impso-koma mosamala komanso mosamala.
- Methotrexate ingafunikire kuimitsidwa musanachite opaleshoni, kwa kanthaŵi, pamene mukuchiritsidwa. Izi zimatheka chifukwa cha chitetezo cha mthupi komanso chiopsezo chachikulu cha matendawa.
- Aliyense amene amachitidwa ndi methotrexate ayenera kutenga folic acid supplement. Popeza methotrexate ndi wotsutsa folic acid, akubweretsa folic acid pothandizira zina zothandizira kuchepetsa zotsatira zina zokhudzana ndi mankhwala.
- Methotrexate sayenera kutengedwa ngati muli ndi pakati kapena mukukonzekera kutenga pakati. Methotrexate ingayambitse vuto lalikulu la kubala komanso kutenga pathupi. Muyenera kugwiritsa ntchito njira zina zothandizira kulera panthawi yomwe mumatenga methotrexate komanso kwa miyezi itatu mutasiya kumwa methotrexate. Ndikofunika kuzindikira kuti ngakhale kuti mayi sayenera kutenga methotrexate pa nthawi ya mimba , kutenga mankhwalawa sikuchepetsa mwayi wa mimba ya mtsogolo.
- Musagwiritse ntchito methotrexate ngati mukuyamwitsa.
- Musagwiritse ntchito methotrexate ngati muli ndi vuto la kuchepa magazi m'thupi, kuchepa kwa maselo oyera a m'magazi, kapena kuchuluka kwa mbale yaplatelet.
- Methotrexate iyenera kugwiritsidwa ntchito mosamala ngati muli ndi vuto lomwe limafooketsa chitetezo chanu cha mthupi.
- Ndikofunika kukumbutsani dokotala wanu mankhwala omwe mumatenga (mankhwala ndi mankhwala). Mankhwala ena ndi mankhwala achilengedwe angapangitse methotrexate poizoni. Mankhwala omwe amadziwika kuti awonjezere mankhwala a methotrexate akuphatikizapo ma antibiotic Trimethoprim (Bactrim). NSAIDs (mankhwala osagwiritsidwa ntchito ndi anti-inflammatory drugs), ngakhale nthawi zambiri amawongolera limodzi ndi methotrexate, amatha kusintha mlingo wa methotrexate. Dokotala wanu ndi katswiri wa zamankhwala adzadziwa kuyanjana kwa mankhwala osatetezeka.
- American College of Rheumatology imalimbikitsa kupeŵa caffeine (khofi, tiyi, cola) pafupi ndi nthawi yomwe mukufuna kukonza methotrexate, chifukwa zingakhudze kuyamwa kwa mankhwala.
Mawu Ochokera
Methotrexate ndi imodzi mwa mankhwala omwe amagwiritsidwa ntchito popanga nyamakazi. Nthawi zina, zimatengedwa zokha. Nthawi zina, methotrexate imatchulidwa ngati gawo la mankhwala othandizira, komwe imatengedwa ndi DMARD kapena biologic mankhwala .
Ndikofunika kuti mutenge methotrexate chimodzimodzi monga momwe mwalangizira. Ndikofunikanso kuti muzindikire zotsatira zomwe zingayambitse ndikufotokozerani dokotala nthawi yomweyo. Methotrexate ikhoza kukhala mankhwala abwino komanso othandiza ngati agwiritsidwa ntchito bwino.
> Zotsatira:
> Cannon, Michael, MD. American College of Rheumatology. Methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo). Kusinthidwa kwa March 2015.
> Zosowa Odwala. Methotrexate . FDA.gov. Zosinthidwa 01/2016.