Zimene Muyenera Kudziwa Ponena za Corticosteroids

Mankhwala owopsa amatha kutupa mwamsanga

Corticosteroids kapena glucocorticoids, omwe amatchedwa "steroids", nthawiyomwe ankaganiza kuti ndi ozizwitsa. Mu 1948, ku chipatala cha Mayo ku Rochester, Minnesota, gulu lina la odwala nyamakazi linapatsidwa jekeseni tsiku ndi tsiku la corticosteroid. Zotsatirazo zinali zovuta kwambiri ndipo kusintha kwakukulu kwambiri, madokotala ankaganiza kuti "mankhwala" a nyamakazi anali atapezeka.

Komabe, pogwiritsa ntchito corticosteroids kudutsa zaka zambiri, zotsatira zake zinayambira. Mankhwala apamwamba operekedwa kwa nthawi yaitali adatembenuza steroids "kuopseza." Odwala anachenjezedwa za mavuto omwe angakhale nawo, kugwiritsa ntchito corticosteroids kunakhala kosavuta, ndipo odwala ena adakana ngakhale mankhwala chifukwa anali oopa.

Ndipotu, corticosteroids ndi mankhwala amphamvu omwe angakhale othandiza ngati athandizidwa pazinthu zoyenera. Kumvetsetsa momwe amagwirira ntchito komanso momwe angagwiritsire ntchito mosamala ndi kofunikira.

Mwachidule

Corticosteroids ndi mankhwala ogwirizana kwambiri ndi kortisol, mahomoni omwe mwachibadwa amapangidwa mu adrenal cortex (kunja kwa adrenal gland). Corticosteroids ndi:

• Betamethasone (Celestone)
• Budesonide (EC Entocort)
• Cortisone (Cortone)
• Dexamethasone (Decadron)
• Hydrocortisone (Cortef)
• Methylprednisolone (Medrol)
• Prednisolone (Kutaya)
• Prednisone (Deltasone)

• Triamcinolone (Kenacort, Kenalog)

Udindo wa Cortisol

Cortisol imathandiza kwambiri kulamulira mchere ndi madzi mu thupi komanso kuyambitsa mavitamini, mafuta, ndi mapuloteni a metabolism. Thupi likamapanikizika, ubongo wam'munsi pamtima umatulutsa ACTH (adrenocorticotropic hormone) yomwe imachititsa kuti zilonda za adrenal zikhale ndi cortisol.

Cortisol yowonjezera imalola thupi kuthana ndi mavuto, monga matenda, kupsinjika mtima, opaleshoni, kapena mavuto a m'maganizo. Pamene vutoli limatha, kupanga mahomoni a adrenal amabwereranso. Matenda a adrenal amabala pafupifupi mamiligalamu 20 a cortisol patsiku, makamaka m'mawa, koma amatha kupanga maulendo asanu ngati akufunika.

Momwe Corticosteroids amagwira Ntchito

Corticosteroids amagwiritsa ntchito chitetezo cha mthupi poletsa kutulutsa zinthu zomwe zimayambitsa zozizwitsa komanso zotupa , monga prostaglandins. Komabe, amalepheretsanso ntchito ya maselo oyera omwe amawononga matupi achilendo ndikuthandizira kuti chitetezo cha mthupi chizigwira bwino ntchito. Kusokonezeka kwa ntchito yoyera ya maselo a magazi kumapangitsa kuti thupi liwonongeke kwambiri ku matenda.

Zisonyezo

Corticosteroids amagwiritsidwa ntchito kwambiri pazinthu zambiri. Amagwiritsidwa ntchito poletsa kutupa kwa ziwalo ndi ziwalo mu matenda monga:

• Matenda a nyamakazi
• Lupus (Lupus Erythematosus)
• Ankylosing spondylitis
• Matenda a nyamakazi
• Matenda opweteka
• Dermatomyositis
• Polymyositis
• Matenda osokoneza bongo
• Matenda a Behcet
• Polymyalgia rheumatica
• Scleroderma (systemic sclerosis)
• Magulu akuluakulu arteritis (temporal arteritis)

• Vasculitis

Corticosteroids sagwiritsidwa ntchito moyenera kwa osteoarthritis , ngakhale nthawi zina amagwiritsidwa ntchito monga jekeseni wamkati mu memphatikizidwa.

Ulamuliro

Corticosteroids ndi zogwirizana ndi momwe amagwiritsira ntchito. Akhoza kupatsidwa:

• Mwamwayi
• Inayikidwa mu mitsempha kapena minofu
• Amagwiritsidwa ntchito kumaloko pakhungu
• Amayikidwa mwachindunji kumalo opunduka

Mankhwala a corticosteroid angagwiritsiridwenso ntchito monga zosakaniza zomwe zili mu:

• Zogulitsa maso (kuti zithetse mavuto osiyanasiyana a diso)
• Inhalers (kuchiza matenda a mphumu kapena matenda opweteka)
• Madzi othamanga ndi sprays (kuti athetse mavuto osiyanasiyana a m'mphuno)
• Mafuta opangira mafuta, mafuta onunkhira, ndi zina zotero (kuthana ndi mavuto osiyanasiyana a khungu)

Corticosteroids ingagwiritsidwe ntchito mogwirizana ndi mankhwala ena ndipo imaperekedwa kwa kanthawi kochepa komanso nthawi yayitali. Prednisone (mayina a dzina la Cortan, Deltasone, Zamadzimadzi, Zamtundu, Merasorten, Orasone, Panasol-S, Prednicen-M, ndi Sterapred) ndi omwe amagwiritsidwa ntchito kwambiri pogwiritsa ntchito mankhwala a nyamakazi. Zimakhala ngati cortisol nthawi zinayi kapena zisanu. Choncho, ma miligramu asanu a prednisone ndi ofanana ndi thupi la tsiku ndi tsiku lomwe limatulutsa kortisol. Palinso zina zotengera corticosteroids zomwe zimasiyana ndi mphamvu ndi hafu ya moyo.

Kupweteka vs. Mlomo Corticosteroids

Steroid yokuwombera, yomwe imatchedwanso kuti cortisone, jekeseni ya corticosteroid, kapena mankhwala opangira mankhwala ndi jekeseni wa steroid mwachindunji. Njira imeneyi imalola madokotala kugwiritsa ntchito corticosteroid kwambiri pa tsamba la kutupa. Popeza kuti ndilopangidwira, thupi lonse silinatenge mankhwala osokoneza bongo.

Kutenga pa malo a jekeseni ndi kotheka kumbali. Majekeseni omwe amapezeka mobwerezabwereza amachititsa kuti khungu likawonongeke. Madokotala amagwiritsa ntchito mankhwalawa pang'onopang'ono, pambuyo poti njira zina zalephera, ndikuyesera kuchepetsa chiwerengero cha jekeseni kamodzi pakangopita miyezi ingapo ndi zocheperapo palimodzi.

Zotsatira Zotsatira

Mphamvu ya corticosteroids ikhoza kukhala ndi zotsatira zoyipa zomwe zimafanana ndi matenda a Cushing, kusokonekera kwa gland adrenal zomwe zimapangitsa kuti anthu ambiri azikhala ndi cortisol. Mndandanda wa zotsatira zake ndizitali ndipo umaphatikizapo:

• Kuwonjezeka kwa kudya ndi kupindula
• Mavitamini a mafuta m'chifuwa, nkhope, kumbuyo, ndi m'mimba
• Madzi ndi kusungidwa kwa mchere kumayambitsa kutupa ndi edema
• Kuthamanga kwa magazi
• Matenda a shuga
• Zolemba zakuda ndi zakuda
• Kuchepetsa machiritso a mabala
• Osteoporosis
• Zozizira
• Zikodzo
• Kufooka kwa minofu
• Kupukuta khungu
• Kuwonjezeredwa kwa matenda
• Zilonda za m'mimba
• Kuwonjezeka thukuta
• Chikhalidwe chimasintha
• Matenda a maganizo monga kupanikizika
• Kugonjetsedwa kwa adrenal ndi mavuto

Zotsatirapo zingathe kuchepetsedwa mwa kutsatira malangizo a dokotala ndikupeza mlingo wotsika kwambiri. Nkofunikanso kupeŵa kudziletsa pa mlingo, kaya kuwonjezera kapena kusiya mankhwala popanda dongosolo.

Milandu ya Nthawi yayitali ndi Thandizo Lalikulu Kwambiri

Pogwiritsidwa ntchito ngati mankhwala achidule, prednisone kawirikawiri imalembedwa pa mlingo woyenerera ndi wotsika kapena "tapered" pa nthawi imodzi kapena iwiri. Cholinga chake ndi kukwaniritsa mwadzidzidzi zizindikiro, koma osati kupitiriza nthawi yogwiritsira ntchito corticosteroid.

Nthawi zambiri mankhwalawa amakhala osungira nyamakazi kapena matenda okhudzana ndi matendawa. Mankhwalawa amakhala mamiligalamu asanu mpaka asanu ndi awiri ndi theka a prednisone tsiku limodzi kupitirira pakapita miyezi kapena zaka.

Steroid yapamwamba imaperekedwa nthawi zina kwa matenda osowa kwambiri, omwe amawopsa kwambiri. Mankhwala apamwamba amalinganizidwa tsiku ndi tsiku mankhwala a prednisone pa milligram imodzi pa kilogalamu ya kulemera kwa thupi kapena pafupifupi 60 milligrams tsiku patsiku logawanika. Zikatero, steroids ndi "tapered" mwamsanga.

Pofuna kuchepetsa mavuto ena, corticosteroid imayenera kuperekedwa moyenera kwambiri. Ndiyo mlingo woyenera kwambiri.

Kutaya nthawi

Mlingo wa corticosteroids uyenera kuchepetsedwa pang'onopang'ono kuti adrenal glands apitirize kupanga cortisol. Kuchetsa mofulumira mlingo kungayambitse vuto la adrenal (dziko loopseza moyo chifukwa cha kuchuluka kwa cortisol) ngakhale izi sizikusowa.

Zikakhala kuti corticosteroids imatengedwa nthawi yayitali, matepi angapitirire kwa miyezi kapena zaka. Nthawi zina, mlingo umachepetsedwa ndi milligram imodzi pokha pokha pokhapokha kuteteza zozizwitsa. Pamene steroid imatengedwa nthawi yochepa, kupopera kumakhala kofulumira kwambiri ndipo kuchepa kwa mlingo kungakhale kwakukulu.

Chinthu china chotheka chomwe chimagwirizanitsidwa ndi kuchotsedwa kwa steroids ndi matenda a steroid kuchotsa, kapena kupweteketsa mtima, zomwe zimapangitsa kuti thupi liwonongeke kwambiri kuchotsa mankhwala. Kusokonezeka kungayambitse chiwindi, kupweteka kwa minofu, ndi kupweteka pamodzi, zomwe zimapangitsa kuti zovuta kuti dokotala azisiyanitsa pakati pa zizindikiro za kutaya ndi matenda a matenda omwewo.

Kusankha

Malingana ndi The Pill Book (Bantam Books), pogwiritsa ntchito mamiligalamu asanu a prednisone ngati maziko oyerekeza, mayendedwe ofanana a corticosteroids ena ndi awa:

• 0.6 mg-0.75 mg wa Betamethasone
• 25 mg wa Cortisone
• 0.75 mg wa Dexamethasone
• 20 mg wa Hydrocortisone
• 4 mg wa Methylprednisolone
• 5 mg wa Prednisolone
• 4 mg wa Triamcinolone

The Corticosteroid Converter imatha mlingo woyenera wa corticosteroids osiyanasiyana. Ndi chida chosinthira chogwiritsa ntchito.

Mawu Ochokera

Corticosteroids ndi mankhwala amphamvu omwe angathandize kuti zizindikiro ziwonongeke ndikupangitsa zotsatira zosatheka. Pali zotsatira zomwe zingagwirizane ndi ntchito zawo zomwe siziyenera kunyalanyazidwa, komabe. Mphamvu ya corticosteroids sayenera kuopedwa, koma iyenera kulemekezedwa.

_Zotsatira:

_{Kelley's Textbook ya Rheumatology. Kusindikiza kwachisanu ndi chinayi. Elsevier. Mankhwala a Glucocorticoid Mutu 60. Jacobs ndi Bijlsma.}

_{Buku la Duke University Medical Center Buku la Arthritis, David S. Pisetsky MD}

_{Sobel, Klein. Nyamakazi: Chimene Chimachita, St Martins Press; 1999.}