NSAIDs - Zimene Muyenera Kudziwa

NSAID Zili M'gulu la Mankhwala Osakaniza Mankhwala Omwe Amagwiritsidwa Ntchito Ambiri

NSAIDs (antisteroidal anti-inflammatory drugs) kumenyana ndi nyamakazi polepheretsa njira yotupa. NSAID ndi gulu lalikulu la mankhwala omwe amagwiritsidwa ntchito pochizira nyamakazi chifukwa cha:

• malingaliro a kupweteka (kupweteka)
• anti-yotupa katundu
• antipyretic (kutentha thupi)

NSAID Magulu

Pali mitundu itatu ya NSAID:

• salicylates (onse acetylated, monga aspirin , osacetylated)

• NSAID zachikhalidwe
• COX-2 selective inhibitors

NSAID zomwe zimagwiritsidwa ntchito pa matenda a nyamakazi zikuphatikizapo:

• Ansaid (dzina loti flurbiprofen)
• Arthrotec (dzina lachibadwa la diclofenac ndi misoprostol)
• Aspirin (acetylsalicylic acid)
• Cataflam (dzina lotchuka la diclofenac potassium)
• Celebrex (dzina lachibadwa celecoxib)
• Clinoril (dzina lachilendo sulindac)
• Daypro (dzina lotchedwa oxaprozin)
• Disalcid (dzina lotchedwa salsalate)
• Dolobid (dzina loti diflunisal)
• Feldene (dzina loti piroxicam)
• Ibuprofen (mayina achizindikiro amatanthauza Motrin, Advil, Mediprin, Nuprin, Motrin IB)
• Indocin (dzina loti indomethacin)
• Ketoprofen (mayina a mayina ndi Orudis, Oruvail, Actron, Orudis KT)
• Lodine (dzina lotchuka la etodolac)
• Meclomen (dzina lenileni la meclofenamate sodium)
• Mobic (dzina lofala la meloxicam)
• Nalfon (dzina lotchuka la fenoprofen)
• Naproxen (mayina achizindikiro amatchula Naprosyn, Aleve, Naprelan, Anaprox)
• Ponstel (dzina lofala la mefenamic acid)
• Relafen (dzina lenileni la nabumetone)
• Tolectin (dzina lachilendo tolmetin sodium)

• Sakanizani (dzina lachilendo choline magnesium trisalicylate)
• Voltaren (dzina lotchuka la diclofenac sodium)

Momwe NSAIDs imagwirira ntchito

Mwachidule, ma NSAID amagwira ntchito pochepetsa kutupa. Amachita zimenezi mwa kutseka kachipangizo kamene kakuyambitsa kutupa kotchedwa cyclooxygenase, yomwe imasintha arachidonic acid kukhala prostaglandins ndi leukotrienes.

Prostaglandins amachititsa kutupa kwanuko. Choncho, poletsa cyclooxygenase, NSAIDs zimachepetsa kutupa .

NSAID yapadera ikhoza kukuchitirani bwino kuposa momwe inu mumayesera kale - kapena simungagwire ntchito konse. Ndi chifukwa cha zina zomwe zimatchedwa kusiyana kwamagetsi - njira yomwe mankhwala amathandizira, kufalitsa, kupangidwanso, ndi kuthetsa.

Zambiri pa Cyclooxygenase ya Enzyme

Pali mitundu iwiri ya cyclooxygenase, yotchedwa COX-1 ndi COX-2. COX-1 ikukhudzidwa kuti mukhale ndi thanzi labwino la m'mimba ndi impso. COX-2 ndi enzyme yomwe imachititsa kutupa. Chifukwa chakuti NSAID zachikhalidwe zimaletsa onse COX-1 ndi COX-2, akhoza kukhala ndi zotsatira zosafuna, monga kukwiya m'mimba kapena kugwira ntchito kwa impso. Nchifukwa chake ochita kafukufuku anapanga NSAIDS zomwe zimangoletsa COX-2. Izi COX-2 selective inhibitors ndi gulu latsopano la NSAIDs.

Ntchito za FDA Zonse za NSAID

Mu 2004, amene anapanga COX-2 selective inhibitor Vioxx mwaulere anachotsa pamsika pambuyo kafukufuku anasonyeza kuti nthawi yaitali ntchito akhoza kuonjezera ngozi ya mtima ndi stroke. Kuwongolera kwotsatira kwa US Food and Drug Administration kunapangitsa kuti chaka cha 2005 chidziwitso kuti NSAID zonse zopanda aspirin zizikhala ndi chenjezo lofanana.

Ndikofunika kukambirana zoopsazi ndi dokotala wanu. (Zotsatirazi zasiya kokha COX-2 inhibitor pamsika - Celebrex.)

Kugwira ntchito kwa NSAIDs

• Ululu ndi kutupa nthawi zina zimachitika mumtundu wa circadian (tsiku lochita maseŵera pambali pa maola 24). Choncho, NSAID zingakhale zothandiza nthawi zina.

• Pa odwala makumi asanu ndi awiri (60%) ayankha ku NSAID iliyonse. Nthawi yoyesera ya masabata atatu ayenera kukulolani nthawi yokwanira kudziwa ngati mankhwala akukugwirani ntchito. Mwamwayi, pafupifupi 10% mwa odwala nyamakazi a nyamakazi adzapeza NSAIDs sagwira ntchito kwa iwo.

• NSAIDs ikhoza kusokoneza zizindikiro ndi zizindikiro za matenda.

• Zoipa za NSAID zomwe zingathe kuchitika nthawi iliyonse zimaphatikizapo impso kulephera, kutayirira kwa chiwindi, kutuluka kwa magazi, ndi chapamimba (m'mimba) zilombo.

• NSAIDs (makamaka indomethacin) ikhoza kusokoneza mankhwala omwe amachititsa kuchepetsa kuthamanga kwa magazi ndi kulephera kwa mtima (monga anta-adrenergic antagonists, mavitamini a converting enzyme, or diuretics).

• Kafukufuku wina akusonyeza kuti ntchito ya NSAID ya nthawi yayitali ingathe kufulumizitsa kuwonongeka kwa khungu, komabe pakufunika kufufuza.

Mfundo Yofunika Kwambiri

Silingathe kunenedweratu kuti NSAID idzakuthandizani bwanji. Palibe NSAID imodzi yomwe yatsimikiziridwa kuti ili pamwamba pa ena chifukwa cha kupweteka kowawa. Kamodzi NSAID ikasankhidwa, mlingowo uyenera kuwonjezeka mpaka kupweteka kumachotsedwa kapena mpaka mlingo wokhalapo wolekerera wafikapo. Yankho la odwala liyenera kukhala chitsogozo chosankha mlingo woyenera, pogwiritsira ntchito mlingo wotsika kwambiri kuti upeze kupumula kwa ululu. Nthawi zonse muzikambirana za ubwino ndi zoopsa za NSAID ndi dokotala wanu.

> Zotsatira:

> Duke University Medical Center Buku la Arthritis, David S. Pisetsky, MD, Ph.D. 1995.

> New England Journal of Medicine, 324 (24): 1716-1725, 1991