VaArthritis vanofanira kukanganisika here?
Dzimwe rheumatoid arthritis varwere vanotya kana vakanzi methotrexate . Mishonga inozivikanwa kuva chemotherapy inoshandiswa kuparisa chirwere. Asi, zvakarurama here kuisa kana kuongorora methotrexate chemotherapy drug apo inorayirwa rheumatoid arthritis? Zvichida izvi zvinoratidzika semubvunzo usingabatsiri kune vamwe, asi kana kusina kururama kunokonzera kutya kusingadikanwi kana kuchengeta varwere kusashandisa mishonga inogona kuvabatsira, mubvunzo zvechokwadi unokosha.
Ngationei chokwadi.
The Short Answer
Makore anopfuura makumi mashanu adarika, methotrexate yakatangwa semushonga wekenza nekuda kwehupombwe hwemaperembudzi. Pamakore makumi maviri nemashanu ekupedzisira, chirwere chacho chave chinowanzoshandiswa sechirwere-chinoshandisa anti-rheumatic drug (DMARD) kurapa rhumumine arthritis nezvimwe zvirwere zverheumatic. Methotrexate inofungidzirwa kuti ndiyo yegoridhe yakarapwa, kana mushonga wekusarudza, mukurapa rheumatoid arthritis.
Maererano nechitsauko cheDMARD mubhuku racho, Rheumatoid Arthritis: Kutanga Kuziva uye Kurapwa , "Kuzivikanwa kwahwo kunosanganisira kushandiswa kwekushandisa (muromo kana pasi pepavhiki, purogiramu yevhiki nevhiki), zvakanyatsorondedzerwa kutyiswa, kukurumidza kushandiswa kwezvipatara (zvinowanikwa mukati me 6 kusvika kumasvondo masere), kusagadzikana, mari shoma, zvinowedzera zvikomborero pazvinosanganiswa nemimwe mitemo yeDMARD, uye kukwanisa kwayo kubvisa kukanganisa kwenharaunda. "
Maitiro Akaitwa Methotrexate
Izvozvo zvataurwa pamusoro apa zvinofungidzirwa kuti zvine chokuita nekudziviswa kwe dihydrofolate reductase uye folic acid production.
Kana ikashandiswa seDMARD, zvinobatsira zve methotrexate zvinoonekwa zvakabatana nekuderedzwa kweAdenosine, zvisinei, iyo inonzi inozivikanwa inopesana nemubatanidzwa. Kuti kusimbise migumisiro ye methotrexate pa folic acid production, zuva nezuva kuwedzera pamwe ne folic acid chikamu chechirongwa chechirwere chevarwere vane chirwere cherheumatic.
Kana ikashandiswa se chemotherapy agent, methotrexate inodzivirira masero kubva kushandisa folate kuita DNA neRNA, zvichiita kuti kuderedza kukura kwekenza masero.
Nhamba yezasi inodikanwa seDMARD
Kana inoshandiswa sechirwere chemo, methotrexate inopiwa muchidimbu kusvika kune yakakwirira. Nhamba yacho inotsanangurwa nekukura kwemuurwere, rudzi rwekenza inorapwa, uye yepfungwa basa. Desi yakakura kudarika kana yakaenzana nemamita 500mg / m2 inofungidzirwa yakakwirira, asi madhayisa 50 kusvika 500 mg / m2 ari pakati. Nhamba yakaderera inofungidzirwa pasi pe 50 mg / m2.
Apo methotrexate inoshandiswa kurapa rheumatoid arthritis, chirwere chacho chinoonekwa sechidiki - kazhinji chinotanga pa7,5 kusvika 10 mg / vhiki. Kana zvichidiwa, chirwere chacho chinogona kuwedzerwa chichiwedzera kusvika pa-25 mg / vhiki.
Kana zvinokonzerwa nemigumisiro kana kuti zvinodhaka zvinowedzera, zvinonzwika kuti kuderedzwa kwechirwere kana kuchinja kubva mumuromo kusvika kune injodzi methotrexate kunogona kugadzirisa nyaya. Nguva dzose kuongororwa ropa kunoitwawo nevarwere vanotora methotrexate (kukwana ropa rose, chiropa uye mapofu maitiro) kuti vaone matambudziko kare kuitira kuti kugadziriswa kuite. Kana zvisingaiti, zviitiko zvakakomba zvakashata zvinoitika, kuregererwa kwe methotrexate kunenge kudiwa.
The Bottom Line
Apo wakabvunzwa kuti upiwe kana kuti methotrexate inofanira kutya nekuti inoshandiswa se chemotherapy, rheumatologist Scott J.
Zashin, MD (www.scottzashinmd.com/) vakapindura, "Kunyange zvazvo methotrexate yakakura inogona kushandiswa chemo, rheumatologists inoshandisa methotrexate inoderedza pasi nemhaka yezvirwere zvayo zvinopisa. kuwirirana pakati peNSAIDs (chirwere chinowanikwa cherheumatoid arthritis) uye methotrexate asi hainzwiki sekushandiswa kwechirwere nechirwere chechikamu chemuviri wemishonga inoshandiswa pakutsvaga arthritis. Varwere vanofanirawo kuyeuka kuti mishonga inorayirwa kutorwa kamwechete kamwe chete vhiki nevhiki kuti udzivise zvinogona kuitika. "
Sources:
Rheumatoid Arthritis: Kuziva Kukura Kwekare uye Kuporesa. Kushi, Weinblatt, uye Kavanaugh. Dhidhiro yechitatu. Chitsauko 11 - Zvirwere-Kuchinja Mishonga Inopesana NezveAnrheumatic.
Kurapa Kushandisa uye Kukonzera Dzapamusoro-Dose Methotrexate. Ann S. LaCasce, MD. Kusvika pari zvino. Yakadzokororwa muna November 2013.
Methotrexate. American Cancer Society. 12/29/2011.