Plaquenil (hydroxychloroquine) amaonedwa kuti ndi wamkulu DMARD ( matenda osintha anti-rheumatic drug). Plaquenil kwenikweni inali yoyamba kukhala mankhwala osokoneza bongo, koma imagwiritsidwanso ntchito pochita zinthu zina zomwe sizigwirizana ndi malungo. Kawirikawiri, Plaquenil ndi njira yothandizira mankhwala monga monotherapy (yogwiritsidwa ntchito payekha) kwa nyamakazi yochepa yomwe imakhala ndi nyamakazi kapena ngati mankhwala ophatikizana ndi ma DMARD ena kuti matenda ochepa kwambiri.
Mbiri Yambiri
Chiyambi cha zilakolako zam'mimba zimayamba zaka 1630 ku Peru. Mu 1820, akatswiri amatsenga anatsuka quinine kuchokera ku makungwa. Mofulumira mpaka 1951, pamene panali umboni wosatsimikizirika wa kusintha kwa lupus ndi matenda a nyamakazi ndi magulu ankhondo a WWII a Allied omwe ankapanga mtundu wa quinine, wotchedwa quinacrine, kuteteza malungo. Patapita nthawi, zina zotuluka mu quinine zinatulutsidwa ndi FDA-chloroquine mu 1952 ndi hydroxychloroquine mu 1955.
Chigwachi chimagwiritsidwa ntchito ndi zotsatira zowononga, zomwe zimakhala zovuta kwambiri kwa anthu omwe amaikidwa mankhwalawa. Ntchito yotetezeka imathandiza kuchepetsa mavuto osayenera.
1. Ngakhale kuti Plaquenil ndi mankhwala okalamba, akadakalipo ndipo amauzidwa kwa anthu ena omwe ali ndi matenda a nyamakazi kapena matenda ena a rheumatic.
Plaquenil ndi DMARD yomwe yapatsidwa kwa zaka zambiri kuti athetse nyamakazi ya nyamakazi, lupus, mwana wamagazi wamagazi , ndi matenda ena omwe amadzimadzimadzimadzi.
Pamene DMARD yoyamba ya biologiti inalandira chivomerezo cha FDA mu 1998, ndipo monga biologics ina inatsatira zaka zotsatira, zinawoneka ngati Plaquenil idzakhala yosayenera. Mankhwalawa adakali malo ake monga chithandizo chamankhwala kwa anthu ena, makamaka mogwirizana ndi methotrexate , kapena anthu omwe ali ndi njira zamakono zotchedwa lupus erythematosus.
Chigwacho chimakhalanso mwayi kwa iwo omwe amayesa ndi kulephera mankhwala osokoneza bongo, sangathe kulekerera biologics kapena kuwopa zotsatira zowonjezera zogwirizana ndi DMARD za biologic.
2. Malowa amatchulidwa ngati matenda-kusintha, mwa kuyankhula kwina, kuti achepetse kupweteka, kuchepetsa kutupa, ndi kuteteza kuwonongeka kwa mgwirizano ndi kulemala. Sadziwika mmene Plaquenil amagwirira ntchito koma ochita kafukufuku amakhulupirira kuti Plaquenil imalepheretsa kulankhulana pakati pa maselo omwe ali ndi chitetezo cha m'thupi . Potsirizira pake, akuganiza kuti ziletsa njira zowonongeka.
3. Chizolowezi choyamba cha Plaquenil ndi 200 mg kawiri patsiku kapena 400 mg kamodzi patsiku, kuperekedwa pamlomo, mwa anthu olemera makilogalamu 80 kapena kuposa. Kawirikawiri mlingo umagwira ntchito kwa anthu ambiri omwe amatenga Plaquenil, koma n'zotheka kuwonjezera kapena kuchepetsa mlingo wochokera pa zosowa zawo. Ndikofunika kuyang'ana zotsatira zowonongeka ndi poizoni. Kwa anthu omwe amalemera makilogalamu oposa 80, mlingo wochepa wa tsiku ndi tsiku umayikidwa, mpaka kufika pa 5 mg / kg ya kulemera kwa thupi.
4. Chimake ndi mankhwala osakwiya. Anthu omwe amatenga Plaquenil akhoza kuyamba kuona patsogolo pakapita mwezi kapena miyezi iwiri. Zitha kutenga miyezi isanu ndi umodzi zisanafike phindu lonse la Plaquenil.
5. Nthaŵi zambiri malo amalekerera, koma zotsatira zake zimatha.
Zotsatira zofanana zomwe zimagwirizanitsidwa ndi Plaquenil zikuphatikizapo kusuta ndi kutsekula m'mimba. Kutenga mankhwalawa ndi zakudya zopatsa thanzi kwa anthu ambiri omwe amamwa mankhwalawa. Zotsatira zochepa zomwe zimafala zimaphatikizapo ziphuphu zamkati, tsitsi lopukuta tsitsi, ndi kufooka. Zotsatira zapadera za Plaquenil zimaphatikizapo kusintha kwa masomphenya kapena kutheka kutayika kwa masomphenya-zotsatira zoyipa zomwe zimapweteka kwambiri odwala.
6. Zomwe zatchulidwa kale zomwe zimakhudza masomphenya (hydroxychloroquine retinopathy), ngati atagwidwa mofulumira, akhoza kusintha pambuyo pa kuchoka kwa Plaquenil. Popeza kuti zotsatira zowonongeka n'zosatheka, ndizofunika kuti muuze dokotala wanu za kusintha kwa masomphenya omwe mumakumana nawo.
Nthawi zambiri madokotala amati amalangizi a maso nthawi zonse ali pa Plaquenil, kotero kuti kusintha koyambirira kungagwidwe. Mukapanda kudziwika, poizoni wachitika kale. Ngakhale kuti zikhoza kuchitidwa ngati tagwidwa oyambirira, hydroxychloroquine retinopathy nthawi zonse sichitha.
7. Anthu ena ali otengeka kwambiri kusiyana ndi ena omwe angakhale ndi mavuto a masomphenya ndi Plaquenil. Apanso, masomphenya amasinthidwa ku Plaquenil ndi osowa, koma anthu ena ali pachiopsezo chachikulu chokhalira ndi vutoli. Odwala omwe ali ndi chiopsezo chachikulu angaphatikizepo omwe:
atenga mlingo waukulu wa Plaquenil kwa zaka (mwachitsanzo, 1000 g kwa zaka zoposa 7)
ali zaka 60 kapena kuposa
ndi ochepa kwambiri
ali ndi chiwindi chachikulu kapena matenda a impso
khalani ndi retinal, macular matenda, kapena cataracts
8. Anthu onse omwe amayamba chithandizo cha Plaquenil ayenera kukhala ndi kafukufuku ophthalmologic m'chaka choyamba. Ngati kafukufuku wa ophthalmologic woyamba ndi wodalirika ndipo munthuyo amaonedwa kuti ali ndi chiopsezo chochepa, kuyesedwanso sikuyenera kuchitika kwa zaka zisanu. Ndikoyenera kuti odwala omwe ali ndi chiopsezo chachikulu ayambe kufufuza maso pa chaka.
9. Mankhwala ena amatha kuyanjana ndi Plaquenil, kumakhudza mmene zimagwirira ntchito kapena zimachititsa kuti zisagwire bwino ntchito. Uzani dokotala wanu za mankhwala aliwonse ndi kuwonjezera zomwe mukuzitenga.
Mankhwala omwe angagwirizane ndi Plaquenil ndi awa:
antacids
fetulinum poizoni
digoxin
kaolin
magnesium trisilicate
methotrexate
metoprolol
penicillamine
10. Ngati muli ndi pakati kapena mukuganiza kuti mukukhala ndi pakati, kambiranani Plaquenil ndi madokotala anu. Ngakhale kuti Plaquenil nthawi zambiri imawoneka kuti ndi yotetezeka pa nthawi ya mimba, zimalimbikitsidwa kuti njira zothandizira kubereka zimagwiritsidwa ntchito panthawi yonse ya mankhwala ochizira komanso kwa miyezi isanu ndi umodzi chithandizo chitatha.
11. Chimake chimagwirizanitsidwa ndi zinthu zina zopindulitsa kwa anthu omwe ali ndi matenda a rheumatic. Kwa anthu omwe amachitidwa ndi Plaquenil monga mankhwala osokoneza bongo antirheumatic mankhwala, mankhwalawa amapezeka kuti ali ndi zotsatira zina zabwino. Malowa amapezeka kuti akuthandizira mauthenga a lipilisi, kuchepetsa shuga ndi kuchepetsa chiopsezo cha shuga, ndipo kuchepetsa chiopsezo cha thrombosis kwa anthu ena omwe ali pangozi yaikulu.
Zotsatira:
Cannon, Michael, MD. Hydroxychloroquine (Plaquenil). American College of Rheumatology. Kusinthidwa kwa March 2015.
Radis, Charles, DO. Chimake: Kuchokera ku Matenda a Malungo Otsogolera Lupus, RA. The Rheumatologist. May 15, 2015.
Kuyeza kwa Hydroxychloroquine Retinopathy . Ndondomeko ya American College of Rheumatology. August 2016.
Wallace, Daniel, MD. Mankhwala Osokoneza Bongo Akuchiritsidwa ndi Matenda a Rheumatic Disease. Zaposachedwa. January 10, 2017.