Chinofanira Kuziva Nezve Corticosteroids

Zvimwe zvinodhaka zvinodhaka zvinokonzera kuputika nokukurumidza

Corticosteroids kana glucocorticoids, inowanzozonzi "steroids", yaimbofungidzirwa kuva chishamiso. Muna 1948, paMayo Clinic muRochester, Minnesota, boka revarwere vemajoini rakapiwa majekiseni zuva rega re corticosteroid. Zvigumisiro zvaive zvakaoma zvikuru uye kuvandudzika kwakanyanya kunoshamisa, vanachiremba vakafunga kuti "kurapa" kweArthritis kwakanga kwawanikwa.

Zvisinei, sezvo kushandisa corticosteroids kwakapararira pamusoro pemakore, migumisiro yakabuda. Masero akakwirira anopiwa kwenguva refu yakareba akachinja steroid mu "kutya-oids." Varwere vakanyeverwa nezvezvinetso zvingangodaro, kushandiswa kwekarticosteroids kwakava kunyanya kuchenjerera, uye vamwe varwere vakatosiya kurapwa nokuti vaityisa.

Kutaura zvazviri, corticosteroids mishonga ine simba inogona kuva inokosha kana iyo inoshandiswa mukati memazano akafanira. Kunzwisisa maitiro avanoita uye kuti vangashandiswa sei zvakachengeteka zvinokosha.

Overview

Corticosteroids imishonga inowirirana zvikuru ne cortisol, hormone iyo inowanzobudiswa mu adrenal cortex (iri kunze kwerudzi rwedrenal). Corticosteroids inosanganisira:

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

• Triamcinolone (Kenacort, Kenalog)

Basa reCortisol

Cortisol ine chikamu chakakosha mukudzora munyu nemvura muyero mumuviri pamwe nekuraira marubhahydrate, mafuta, uye protein metabolism. Kana muviri uchisimbiswa, chirwere chepituitary panheyo yeuropi rinobudisa ACTH (adrenocorticotropic hormone) iyo inokurudzira maitiro ezvinyorwa kuti abudise cortisol.

Iyo cortisol inowedzera inobvumira muviri kuti utsungirire matambudziko anokonzera, zvakadai sehutachiona, kushungurudzika, kuvhiyiwa, kana matambudziko emanzwiro. Apo mamiriro ekumanikidzwa anoguma, adrenal hormone production inodzokera kune yakajairika. Izvozvo zvinowanzogadzira anenge makirogiramu makumi maviri e-cortisol pazuva, kunyanya mangwanani, asi anokwanisa kubudisa katanhatu zvakanyanya kana zvichidiwa.

Iko Corticosteroids Inoshanda Sei

Corticosteroids inoshandisa zvirwere zvemuviri nekudzivirira kubudiswa kwezvinhu zvinokonzera zvirwere uye zvinopesana , zvakadai se prostaglandin. Zvisinei, zvinopesana nebasa remasero machena eropa anoparadza miviri yedzimwe nyika uye kubatsira kuchengetedza maitiro ezvirwere mumuviri ari kushanda zvakanaka. Kupindira nechena yeropa rekushanda kwemaitiro kunobatsira kuti pave nemigumisiro yechirwere chekuwedzerwa kwehutachiona.

Zviratidzo

Corticosteroids inoshandiswa zvakanyanya pamitemo yakawanda. Inoshandiswa kudzora kuvhiringidza kwemajoini uye nhengo muzvirwere zvakadai se:

• Rheumatoid arthritis
• Lupus (Systemic Lupus Erythematosus)
• Ankylosing spondylitis
• Juvenile arthritis
• Chirwere chinokonzera chirwere
• Dermatomyositis
• Polymyositis
• Mixed connective tissue disease
• Chirwere cheBehcet
• Polymyalgia rheumatica
• Scleroderma (systemic sclerosis)
• Giant cell arteritis (temporal arteritis)

• Vasculitis

Corticosteroids haisati yashandiswa pakugadzirisa osteoarthritis , kunyange zvazvo dzimwe nguva inoshandiswa senhengo yechipinda mujoka yakagadzirirwa.

Administration

Corticosteroids inonzwisisika mune zvavanoshandisa. Vanogona kupa:

• Orally
• Injowa mukati moutsi kana musumbu
• Inoshandiswa munzvimbo ino kune ganda
• Injowa zvakananga muzvikamu zvinoputika

Corticosteroid mishonga inogona kushandiswa sezvivako zvinowanikwa mu:

• Zvigadzirwa zveziso (kubata zvirwere zvakasiyana-siyana)
• Inhalers (kurapa chirwere chechirwere kana chirwere chinoputika)
• Nasal madonhwe uye mapiritsi (kubata zvirwere zvakasiyana-siyana zvemukati)
• Zvinyorwa zvemashizha, mafuta, etc. (kurapa matambudziko akasiyana eganda)

Corticosteroids inogona kushandiswa pamwe chete nedzimwe mishonga uye inorayirwa kushandiswa kwenguva pfupi uye kwenguva refu. Prednisone (marita mazita eCortan, Deltasone, Liquid Pred, Meticorten, Orasone, Panasol-S, Prednicen-M, uye Sterapred) ndiyo inonyanya kushandiswa yakagadziriswa corticosteroid yeArthritis. Inenge ina kana katatu yakafanana neyakadai se cortisol. Nokudaro, mairigiramu mashanu e prednisone akaenzana nemutambo wezuva nezuva we cortisol. Iko kune zvimwe zvakagadziriswa corticosteroids zviripo izvo zvinopesana muhupenyu uye hafu yeupenyu.

Kurwisana vs. Oral Corticosteroids

Steroid inopfura, iyo inonziwo cortisone kuputika, corticosteroid injection, kana chirwere chinonzi intra-articular chirwere che steroid zvakananga mubatanidzwa. Iyi nzira inoita kuti vanachiremba vashandise maitiro akadai e-corticosteroid zvakananga panzvimbo yekuvhiringidza. Sezvo iine nzvimbo iyo, imwe yose yomuviri haichengetwi yakanyanya kukanganiswa kwemishonga.

Utachiona panzvimbo yejairo inogona kuitika. Kurwariswa kwemajoka kakawanda mumusungo mumwechete kunogona kukonzera kukanganisa karoti. Vanachiremba vanoshandisa kurapwa uku zvishoma, mushure mekunge zvimwe zvasarudzwa zvakakundikana, uye kuedza kupedza nhamba yejojekiti kamwe kamwe mwedzi mishomanana uye vashomanana muhuwandu hwekubatana kumwe.

Migumisiro Yechiri

Kubudirira kwekodticosteroids kunogona kuguma nemigumisiro yakakomba iyo inofanana nechirwere chaCushing, kusagadzikana kwezvipembenene zvakanyanya zvinokonzerwa nekuwedzererwa kwecortisol. Izvo zvinogona kuve nemigumisiro yakareba ndeyekuti zvinosanganisira:

• Kuwedzera kudya kudya uye kuwedzera kukura
• Dutu remafuta mubhokisi, chiso, kumusoro kumashure, uye mudumbu
• Mvura uye kuchengetwa kwemunyu zvinotungamirira mukudzora uye edema
• High blood pressure
• Chirwere cheshuga
• Mutsvuku uye mabhuruu
• Yakaderedza kuporesa kwemavanga
• Osteoporosis
• Cataracts
• Acne
• Utsi husina simba
• Kuchenesa kweganda
• Kuwedzerwa kunzwisisika kune utachiona
• Dumbu rekuonda
• Kuwedzera kwekutuka
• Maitiro anofamba
• Zvinetso zvepfungwa zvakadai sokuora mwoyo
• Kubvisa kubhadhara uye dambudziko

Migumisiro inogona kugadziriswa nekutevera murairo wechiremba uye kutora chirwere chinonyanya kuderera chinokwanisika. Zvakakoshawo kudzivisa kuzvidzora kwemurairo, zvichiwedzera nekuwedzera mishonga pasina purogiramu.

Nguva Yenguva Pfupi vs. Long-Term Therapy

Kana inoshandiswa sechirwere chenguva pfupi, prednisone inowanzotarisirwa pamwero unoenzanisa uye yakaderedzwa kana kuti "tapered" kwemaawa maviri kana maviri. Chinangwa ndechokuita nekuvandudzwa kamwe kamwe kwezviratidzo, asi kusapedza nguva yenguva yekushandisa corticosteroid.

Kurapa kwenguva refu kunowanzochengeterwa zviitiko zvakanyanya zverheumatoid arthritis kana zvirwere zvakabatana. Chirwere chacho chinowanzomira mamiriyoni mashanu kusvika kune manomwe nehafu ye prednisone zuva rakapfuurira pamusoro pemwedzi kana makore.

High-dose steroid inopiwa dzimwe nguva kune yakanyanya kuwanwa, yakaipisisa mamiriro ekurwara kwechirwere. Nhamba yakakwirira inofungidzirwa zuva roga roga reda prednisone pane imwe milligiramu kilogram yehuremu hwemuviri kana anenge mamitagiramu 60 pazuva pazuva rakaparadzana. Mune mamiriro ezvinhu akadaro, steroids "tapered" nokukurumidza sezvazvinogona.

Kuti kuderedze zvingava nemigumisiro yemigumisiro, chirwere chakanyanya kuderera che corticosteroid chinofanira kupiwa. Ndiyo mukana wakakwana.

Discontinuation

Nhamba ye corticosteroids inofanira kuderedzwa zvishoma nezvishoma kuitira kuti madrenal adrenal arambe achiita cortisol yemagetsi. Kurega kudhesa zvinokurumidza kunogona kukonzera adrenal crisis (hupenyu hunotyisa hunokonzerwa nehuwandu hwakawanda hwecortisol) kunyange izvi zvisingawanzoitiki.

Mumamiriro ezvinhu apo corticosteroids yakatorwa mumadheka madhawi kwenguva yakareba, kutora kunogona kupfuurira kwemwedzi kana makore. Dzimwe nguva, miviri inoderedzwa nemamiriyoni imwechete panguva imwe neimwe yekudzivirira kupisa-ups. Apo steroid inotorwa nguva shomanana, kutengesa kunokurumidza uye kunoderedza muyero kunogona kuva yakakura.

Rimwe dambudziko rinogona kuitika rinosanganiswa nekuregererwa kwe steroid is steroid withdrawal syndrome, kana kuputsika kwechiitiko, iyo inofanirwa kugadziriswa kwemuviri kubviswa kwechirwere. Kukanganiswa kunogona kukonzerwa nefivha, kurwadziwa kwemisonda, uye marwadzo akabatana, zvichiita kuti zvive zvakaoma kuti chiremba aone kusiyana kwezviratidzo zvekusiya uye chirwere chechirwere chacho pachako.

Kusarudza

Maererano neThe Pill Book (Bantam Books), achishandisa mirigiramu shanu ye prednisone sechikonzero chekuenzanisa, zviyero zvakaenzana zveimwe corticosteroids ndezvi:

• 0.6 mg-0.75 mg yeBetamethasone
• 25 mg yaCortisone
• 0.75 mg yeDexamethasone
• 20 mg yeHycrocortisone
• 4 mg yeMethylprednisolone
• 5 mg yePrednisolone
• 4 mg ye Triamcinolone

The Corticosteroid Converter inotarisa yakaenzana neyero ye corticosteroids yakasiyana-siyana. Icho chiri nyore-kushandiswa kushandura chimbo.

Shoko Rinobva

Corticosteroids mishonga ine simba iyo inogona kuvandudza zviratidzo uye inokuvadza migumisiro inoshamisa. Pane zvinogona kuitika zvinosanganiswa nekushandiswa kwavo izvo zvisingafaniri kuregererwa, zvakadaro. Simba remakorticosteroids harifaniri kutyiwa, asi rinofanira kuremekedzwa.

_Sources:

_{Kelley's Textbook yeRheumatology. Ninth edition. Elsevier. Glucocorticoid Therapy Chitsauko 60. Jacobs naBijlsma.}

_{Duke University Medical Center Bhuku reArthritis, David S. Pisetsky MD}

_{Sobel, Klein. Arthritis: Chii Chinoshanda, St Martins Press; 1999.}