Zvinodhaka Zvinoshanda Kusiyana Nekudzivirira kana Kudzivirira Chirwere-Ups
Inhaler therapies inokosha pakurapa vanhu vane chirwere chisingaperi chisingabvumirwe chirwere (COPD) . Panzvimbo pokumirira mapiritsi kuti anounese mishonga kuburikidza neropa, inhalers inounza mishonga kune dambudziko redambudziko, kubudirira nokukurumidza, zvakagadziriswa.
Pane inhalers ine mishonga imwe chete (monotherapy) uye imwe inounza mishonga yakawanda nenzira dzakasiyana dzezviito.
Zvinodhaka zvinogona kuputsika kuva zvitatu zvakakura zvakasiyana:
- Nenguva-kuita bronchodilators
- Long-acting bronchodilators
- Inhaled steroids
Rimwe nerimwe rinoshanda zvakasiyana mukurapa kana kudzivirira COPD uye rinopa musana kune imwe yemuromo kana injectable mishonga inogona kuwedzerwa.
Bhuku-Richiita Bronchodilators
Vamwe vanhu vane COPD vanogona kungoona zviratidzo (kukurumidza kufema, kufema) pavanozviedza. Kune ava vanhu, vanachiremba vachawanzoti vatsva bhatikoni, vanozivikanwa sekununura inhaler.
Bronchodilators vanoshanda nekuzarura (kuwedzera) midzi yemhepo ( bronchioles ) iyo inopedzerwa panguva yeKOPD. Mhedziso-maitiro bronchodilator "inokurumidza uye inokurumidza," zvinoreva kuti vanoshanda nokukurumidza uye vanopa zororo kwemaawa anenge mana kusvika matanhatu. Vanofanira kungoshandiswa chete kana zvichidiwa uye kutakurwa chero kupi zvako kwaunoenda kana zvichiitika.
Kune makirasi maviri emishonga inoshandiswa kwemaitiro mashoma ekuita bronchodilators: beta-agonists , anosungira kudzigamuchira mumapapu kumisa mararamiro, uye anticholinergics , izvo zvinovhara maikemikari anokonzera kupisa.
Bfupi-acting beta agonists (SABAs) ikozvino inogamuchirwa muUnited States ndeyikuti:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Iko-anticholinergic yenguva pfupi yakagamuchirwa zvino muU.S. is:
- Atrovent (ipratropium)
Iko kunewo kusanganiswa kwekugadziriswa kwakagadzirwa kunonzi Combivent ine ipratropium uye shoma-acting beta-agonist albuterol.
Bharchodilators kwenguva refu
Vanhu vane COPD vakakurumbira vanowanzotarisirwa mishonga inopindwa nemishonga inotorwa zuva nezuva kana vane zviratidzo kana kwete. Iyi mishonga inonzi inonzi bronchodilators kwenguva refu.
Vanhu vari pangozi yakanyanya yekuwedzeredza vanogona kubatsirwa nemishonga iyi sezvo vachipa kuchengetedzwa kwehuputi kune chero ipi zvayo kubva maawa 12 kusvika ku24. Sezvo nevanopedza nguva shomandilator, vane bhe-agonist kana anticholinergic drug.
Iyo yakareba-acting beta agonists (LABAs) ikozvino inogamuchirwa muUnited States ndeyi:
- Salmeterol
- Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Iyo yakareba-acting anticholinergics inogamuchirwa muUnited States ndeyi:
- Spiriva (tiotropium)
- Aclidinium
Inhaled Steroids
Vanhu vane COPD yakasimba havagoni kupindura zvakare kune vanoshanda kwenguva yakareba bronchodilators uye vanowanzodikanwa "kuwedzera" kwekuchengetedza kupora basa. Kune ava vanhu, steroids inhaled inogona kushandiswa.
Inhaled steroids, inozivikanwa seyo inhaled glucocorticoids , ine simba rinopesana nekuputika uye inogona kukurumidza kukurumidza kupfugama nekugadzirwa kwekamu mumhepo. Zvinoshanda nenzira imwecheteyo semuromo steroid asi shingaira kushanda uye zvakanyanya kuderedza dambudziko rekupisa-ups uye yekurapa.
Inowanzoshandiswa kaviri zuva rimwe nerimwe uye kazhinji inoda mavhiki maviri "kutora nguva" vasati vatora zvizere.
Steroid inoputika inowanzoshandiswa kurapa COPD ndeiyi:
- Pulmicort (budesonide)
- Aerospan (flunisolide)
- Flovent (fluticasone)
- Asmanex (mometasone)
- QVAR (beclomethasone)
Iko kunewo zvitatu zvinosanganiswa zvinosanganisira shaidha inhaled:
- Symbicort (formoterol uye budesonide)
- Advair (salmeterol uye fluticasone)
- Brio Ellipta (vilanterol uye fluticasone)
Iyo migumisiro yemaawa inhaled steroid inowanzove isina kudarika zvishoma kupfuura iyo yemuromo kana injected steroids. Zvinogona kusanganisira muromo unorwadza kana kuti huro, kutadza (dysphonia), uye muromo candidiasis (thrush).
Kushandiswa kwenguva refu kunobatanidza nehuwandu hwekuwedzera kwe glaucoma uye osteoporosis.
> Kwakabva:
> Vestbo, J .; Hurd, S .; Agusti, A. et al. "Global plan yekuongorora, kutarisira, nekudzivirira zvirwere zvisingaperi zveplmmm disease: GOLD executive summary." Am J Respir Crit Care Med. 2013; 187 (4): 347-65. DOI: 10.1164 / rccm.210204-0596PP.