Kamodzi kachilendo kaamba ka nyamakazi ya nyamakazi
M'mbuyomu, mankhwala a golidi anali mankhwala ochizira moyenera kuti agwire ntchito mwakhama. Magulu a golide ankagwiritsidwa ntchito pochiritsa nyamakazi kuyambira mu 1929. Golide kwenikweni anapangidwa ngati mankhwala a chifuwa chachikulu. Panthawi imeneyo, amaganiza molakwika kuti chifuwa chachikulu cha TB ndi chifuwa cha nyamakazi chinali chogwirizana. Ngakhale kuti izi sizinali zolondola, golidi inasonyeza zotsatira zopindulitsa pa nyamakazi ya nyamakazi.
Momwe Ikugwirira Ntchito
Ngakhale kuti magetsi a anti-inflammatory effect sakudziwitsidwa bwino, umboni umasonyeza kuti golidi amasungidwa mu lysosomes yomwe imalepheretsa kukonzanso kwa antigenic wothandizira (chinthu chilichonse chomwe chimayambitsa kupanga mankhwala ophera tizilombo) komanso kutulutsa mankhwala opanga mavitamini otchedwa proinflammatory cytokines . Izi zimaphatikizidwa kuti ndi mankhwala osokoneza bongo (DMARD) .
Kupezeka kwa Golide
Mitundu ya golide yajeremusi imayikidwa ndipo imakhala Myoschrysine (aurothiomalate) ndi Solganol (aurothioglucose). Ridaura (auranofin) ndi mankhwala a golide. Kwa zaka zambiri, monga mankhwala atsopano omwe adakhalapo omwe amapereka phindu lapamwamba komanso pangozi yochepa (mwachitsanzo, ma DMARD ena ndi mankhwala osokoneza bongo ), jekeseni za golide sizinkaperekedwa kawirikawiri kuti azidwala nyamakazi. Kugwiritsa ntchito kwake kunachepetsedwa makamaka chifukwa cha chiopsezo cha zotsatirapo, komanso kufunika kwa kuyang'anitsitsa kwachipatala ndi kuyang'anira ma laboratory, ndi kukhumudwa kwa jekeseni wamkati.
Kodi Golide Amayendetsedwa Bwanji?
Ndalama za golide zimaperekedwa ngati jekeseni la m'mimba mu ofesi ya dokotala mlungu uliwonse kwa masabata makumi awiri oyambirira a chithandizo ndipo kenako nthawi zonse zimagwiritsidwa kwa milungu itatu kapena inayi iliyonse. Kuyeza magazi ndi mkodzo kumalimbikitsidwa musanayambe jekeseni iliyonse ya golide, kuti muonetsetse kuti ndi bwino kupereka.
Poyambirira, jekeseni ya golide yambiri imakhala ngati mlingo wa 10 milligramgram kamodzi pa sabata. Mlingo wachiwiri wa 25-milligram umatsatira ndiyeno 50 milligrams pa sabata mpaka yankho likupezeka, mpaka mamiligalamu 750 mpaka 1000.
Zotsatira Zachimake Pangani Mankhwala a Golide Ovuta
Zotsatira zoyipa, chifukwa chodziwika kwambiri chochotsera kugwiritsira ntchito mankhwala a golide, zimakhudza pafupifupi anthu 30 peresenti omwe amachitidwa ndi mankhwala a parenteral gold. Zotsatira zambiri zomwe zimagwirizanitsidwa ndi gorenteral golide zimaphatikizapo pruritis, dermatitis, stomatitis, ndi proteinuria. Ndi golide wamlomo, zotayirira ndizofala pambali, pamene kutsekula m'madzi kumachitika mochepa (kumakhudza oposa asanu pa odwala). Nthepropathy ndi thrombocytopenia zingakhalenso ndi mankhwala a golide, makamaka pazofunikira zenizeni za HLA-DR3.
Ngakhale kuti zotsatira zowonjezera zakhala zotsutsana ndi mankhwala a golide, ziyenera kudziŵika kuti jekeseni za golidi zinaika anthu ena nyamakazi ya nyamakazi kukhala chikhululukiro chosatha. Katswiri wina wa ziphuphu, dzina lake Scott J. Zashin, ananena kuti, "Chifukwa chake, ngati wodwala atayankha bwino jekeseni za golide, amakhala akupitirizabe. Kuika golide mwa odwalawa kungayambitsenso ntchito yodwala nyamakazi yomwe silingayankhe kuyambiranso mankhwala ndi golidi. "
Komabe, monga zida za golide zidagwiritsidwa ntchito pang'ono ndipo ngati mankhwala atsopano anayamba, makampani anasiya kupanga mankhwala. Ngakhale kuti panali maulendo awiri a zida za golide nthawi imodzi (Solganol ndi Myochrysine), Myochrysine yekha tsopano alipo. Kawirikawiri, odwala amayamba kuchita zomwezo, zomwe zimachititsa kuti asiye kutero.
Gold Oral Oyerekeza ndi Golide Wopweteka
Mwatsoka, golidi yam'lomo inangopindulitsa kwambiri, kotero sizinali zachilendo. Ridaura, kukonzekera kwa golide, akhoza kukhalapo, koma kawirikawiri sagwiritsidwa ntchito ku United States. Golidi yamphongo inavomerezedwa kukhala yothandiza kwambiri poyerekeza ndi placebo.
Ankaonanso kuti ndi ofunika kwambiri ku Plaquenil (hydroxychloroquine) ndi methotrexate , koma ndizoopsa kwambiri.
Mfundo Yofunika Kwambiri
Golide ndi wamkulu DMARD (mankhwala osinthira anti-rheumatic drugs) omwe, pafupifupi pafupifupi onse, amalowetsedwa ndi mankhwala atsopano a DMARD ndi mankhwala a biologic. Kugwiritsidwa ntchito kwa golidi kumakhala kosungidwa kwa odwala omwe samayankha kapena sangathe kulekerera methotrexate, ma DMARD ena akale (monga Plaquenil ndi sulfasalazine ), kapena TNF .
Zotsatira:
> Cush JJ, Weinblatt ME, Kavanaugh A. Matenda a nyamakazi: Matenda oyambirira komanso mankhwala . West Islip, NY: Professional Communications; 2010.
> Klinkhoff A. Zotsatira zoyipa za mankhwala a golide. Zaposachedwa. https://www.uptodate.com/contents/major-side-effects-of-gold-therapy.
> Klinkhoff A. Kugwiritsira Ntchito Mafakitala a Gold mu Rheumatic Diseases. Zaposachedwa. Chiwongoladzanja