Imwe Mishonga Inowanzopiwa Yakagadzirwa neRheumatoid Arthritis Neimwe Rheumatic Diseases
Methotrexate (marita mazita eRheumatrex, Trexall, Otrexup , Rasuvo ) inowanzogadzirirwa kurapa rheumatoid arthritis nezvimwewo zviratidzo zverheumatic. Methotrexate yakagamuchirwa neDFA muna 1988 pakurapa rheumatoid arthritis. Isati yagamuchirwa neRheumatoid arthritis, methotrexate yakanga yashandiswa kurapa psoriasis nekenza.
Chakanga chave chichigadzirwa sechirwere chinonzi leukemia muma1940s.
Kunze kwerheumatoid arthritis, methotrexate inogona kunyorwa kune:
- psoriatic arthritis
- lupus
- ankylosing spondylitis
- vasculitis
- juvenile arthritis (polyarticular)
Methotrexate Inononoka Kuita DMARD
Methotrexate inorondedzerwa seDMARD (chirwere-chinorwisa anti-rheumatic drug) . Chirwere ichi chinoshandiswa kuderedza marwadzo nekuputika kunobatanidza rheumatoid arthritis, kudzivirira kubatana kukanganisa, uye kuderedza ngozi yekuremara kuburikidza nekudzivirira kupfuurira kwezvirwere. Kuvandudzwa kubva methotrexate kunogona kuonekwa nokukurumidza kwemavhiki matatu kusvika matanhatu, asi zvinogona kutora vhiki gumi nembiri kana kuti kunyange kusvika kumwedzi mitanhatu yekurapa kuitira zvizere kubatsirwa kuti zvizadzike.
Mechanism of Action
Methotrexate inopindira mune dzimwe enzymes iyo inobatanidzwa mukudzivirira muviri. Methotrexate inodzivirira enzyme dihydrofolate reductase. Nokuita izvi, zvinosvika pakugadzirwa kwechimiro che folic acid chinodiwa kuti masero ari kukura.
Inoramba ichinyatsojeka kuti methotrexate inoderedza sei arthritis basa.
Dosage
Methotrexate yemumuromo inotorwa zuva rimwe chete pavhiki rerhumatoid arthritis. Haisi kutorwa zuva nezuva kufanana nemapiritsi akawanda. Methotrexate inowanikwa mu 2.5-milligram mahwendefa. Nhamba yekutanga yevakuru vakawanda vane rheumatoid arthritis i7,5 kusvika 10 milligram (kureva, matatu kana mana mapiritsi).
Iyo mapiritsi matatu kana mana anotorwa pamwechete kamwe pavhiki (pazuva rimwe chete vhiki imwe neimwe). Kana zvichidiwa, nhamba yose ye methotrexate inogona kuwedzera kusvika pamamirigiramu makumi maviri kana makumi mashanu evhiki.
Zita rokuti Rheumatrex dose pack rine makadhi emabhalter ane nhamba chaiyo yepiritsi inotora vhiki imwe neimwe. Zita rokuti Trexall rinowanika mu 5, 7.5, 10, uye 15-milligram mahwendefa. Methotrexate inowanikwawo mune imwe injodzi inoshandiswa , iyo yakawanda varwere vanogona kuzvidya.
Migumisiro Yechiri
Methotrexate inogona kukonzera kusakwana kwechiropa basa. Zvakakosha kuti nguva dzose ropa rako riongorwe chechiropa basa kuitira kuti chiremba wako anogona kukucherechedza pamusana pemagumisiro asina kufanira. Zvimwe kunze kwekusagadzikana nechiropa chinoshanda, yakawanda miitiro inosangana ne methotrexate inononoka uye kurutsa.
Zvimwe zvikamu zvinotanga kutaurwa-kusuruvara, kurutsa, uye chiropa basa-inogona kunge yakatarisana nezera. Kana uine imwe yemigumisiro iyi, kugadzirisa dhiyo kunogona kubvisa dambudziko. Vanhu vazhinji havawani miviri yakakosha pavanotora methotrexate.
Zvimwe zvinokonzerwa nemigumisiro (zvimwe zvakakomba) zvinosanganisira:
- maronda emuromo
- mapapiro kana kushanda kwakanyanya kweganda
- chirwere
- kuverenga ropa kusina kunaka
- chiropa kukuvara / cirrhosis yechiropa (zvisingaiti)
- kuora kweiyo
- chirwere chemapapu
- lymphoma
- zvirwere zvinokanganisa
- kuramba uchikanganiswa
- unxplained shortness of breath
- kurasikirwa kwevhudzi (zvishoma nezvishoma)
- sun sensitivity
Manyevero
- Kuwedzera kwengozi yekuvadzwa kwechiropa ne methotrexate kunokosha kuvanhu vanonwa doro . Zvakanaka, haufaniri kunwa doro kana iwe ukatora methotrexate. Kunyanya, pamwe nechiremba wako, iwe haufaniri kunge uine zvinodarika zvinodhaka zviviri pamwedzi.
- Methotrexate haifaniri kutorwa nevanhu vane chirwere chisingaziviki chiropa kana chirwere chepfungwa. Rheumatologist inogona kusarudza kupa methotrexate kune vanhu vane chiropa chakasimba kana chirwere chepfungwa chinenge chiine simba-asi nekuchenjerera uye kuwanda kweuchenjeri.
- Methotrexate inogona kumira kumira pamberi pokuvhiya, kwechinguva, apo iwe uchirapa. Izvi zvinokonzerwa nechiitiko chinogona kuitika mumuviri wekuzvidzivirira uye kunogona kuwedzera mungozi yehutachiona nekushandiswa kwayo.
- Ani naani anobatwa ne methotrexate anofanira kutora folic acid supplement. Sezvo methotrexate inonzi folic acid inopikisa, kuunzazve folic acid nekutora kubatsirana kubatsira kubatsira kuderedza mamwe madhara anokonzerwa nemishonga.
- Methotrexate haifaniri kutorwa kana iwe uri nepamuviri kana kuronga kuva nepamuviri. Methotrexate inogona kukonzera kukanganisa kwakakomba kwepabonde pamwe nekudzivirira kubata pamuviri. Iwe unofanirwa kushandisa imwe nzira yekubata pamuviri panguva yaunotora methotrexate uye kwemwedzi mitatu mushure mekunge makamira kutora methotrexate. Zvakakosha kucherechedza kuti kunyange zvazvo mukadzi asingafaniri kutora methotrexate panguva yekuzvitakura , kutora mushonga uyu hausi kuderedza mukana wekutora pamuviri.
- Iwe haufaniri kutora methotrexate kana iwe uchiyamwisa.
- Iwe haufaniri kutora methotrexate kana uine chirwere chakanyanya, chirwere chechichena cheropa chichiverenga, kana kuti pasi peplatelet chikamu.
- Methotrexate inofanira kushandiswa nekuchenjerera kana uine mamiriro ezvinhu anowedzera simba rako rekudzivirira muviri.
- Zvakakosha kukuyeuchidza chiremba wako wemishonga yose yaunotora (chiremba uye kupfuura-the-counter). Mimwe mishonga uye mishonga yemasikirwo inogona kuwedzera methotrexate toxicity. Zvinodhaka zvinodzwa kuwedzera methotrexate chepfu zvinosanganisira maantibiotic Trimethoprim (Bactrim). NSAIDs (nonsteroidal anti-inflammatory drugs), kunyange zvazvo inowanzotaurwa pamwe chete ne methotrexate, inogona kuchinja huwandu hwemashotrexate. Chiremba wako uye mhizimisi achaziva nezvekubatana kwemishonga isina kuchengeteka.
- IAmerican College of Rheumatology inokurudzira kurega kushaya caffeine (kofi, tei, kola) pedyo nenguva yaunoronga kutora methotrexate, sezvo inogona kukanganisa kunyanya kwechirwere.
Shoko Rinobva
Methotrexate ndiyo imwe yemishonga inowanzopiwa yakashandiswa kurapa rheumatoid arthritis. Mune zvimwe zviitiko, inotorwa yoga. Mune dzimwe nguva, methotrexate inorondedzerwa sechikamu chechirwere chinosanganiswa, apo inotorwa pamwe nedzimwe DMARD kana biologic drug .
Zvakakosha kuti utore methotrexate sezvakataurwa. Izvo zvinokoshawo kuti iwe uzive zvingava nemigumisiro uye unyore chero chinhu chisina kujairika kuchiremba wako pakarepo. Methotrexate inogona kuva mishonga yakachengeteka uye inoshanda kana yakashandiswa zvakanaka.
> Sources:
> Cannon, Michael, MD. American College of Rheumatology. Methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo). Yakarongwa muna March 2015.
> Patient Information. Methotrexate . FDA.gov. Yakarongedzwa 01/2016.