MunaFebruary 2010, Kudya uye Drug Administration (FDA) yakapa nyevero inowedzera nezvemishonga yeAsthma ine maitiro akawanda ekuita beta-agonists (LABAs), saAdvair uye Symbicort. LABAs zvave zviripo kuUnited States kubva pakati pemakore ekuma 1990 sekuraira kwevatungamiriri kwevanotungamirirwa nehutema. Somugumisiro wezvidzidzo zvakasiyana-siyana zvinoratidza kushamwaridzana kushandiswa kwekushandiswa kweLABAs uye kuwedzera zviratidzo zvechirwere (kusanganisira rufu kubva kuchirwere), FDA yakakurudzira kushandiswa kwemaLABA kuitira kurapwa kwechirwere kunze kwekunge zvakakodzera.
Panzvimbo yekushandiswa kwemishonga yeAsthma ine LABAs, FDA inokurudzira kushandiswa kwemimwe mishonga, kunyanya inhaled corticosteroids , semishonga yemirairo yeAsthma. Zvimwe zvinosanganisira zvinonzi leukotriene blockers dzakadai se montelukast (Singulair) , omalizumab (Xolair) uye theophylline. Mishonga yemidumbu ine LABAs, kusanganisira Advair, inofanira kungoshandiswa kune vanhu vasingatungamirirwi nemimwe mishonga sezvataurwa pamusoro apa, kana kuti kazhinji kuwedzera kwemafi ekuda kushanyira mumba, kushandiswa muzvipatara kana kushandiswa kwemukanwa kana chirwere cheroticosteroids kuti chidzora.
Sezvo ari nyanzvi yezvemafi, ndinoshamiswa nehuwandu hweDAA nyevero. Hapana mitsva itsva yekutsigira nyevero yakadaro kubva muBlack Box Warning yakapiwa kupa mishonga yeLABA. I-FDA inoreva zvidzidzo zviviri zvikuru zvakaratidza kuti LABAs inogona kuwedzera zviratidzo zveputi, kusanganisira kufa kwechirwere. Zvidzidzo zviviri mubvunzo zvinosanganisira Salmeterol Multicenter Asthma Research Trial (SMART) uye Serevent Nationwide Surveillance (SNS) kudzidza.
SMART yakaitwa muna 1996, ine salmeterol (a LABA) inopiwa vanhu vanopfuura 13 000 vane astmma. Vamwe vevanhu ava vakanga vachitora mimwe mishonga yekurapa ye asthma; vamwe vaingoshandisa salmeterol zuva rega rega. Kunyange zvazvo salmeterol yakawanikwa yakachengeteka zvakakwana, yakaratidzika ichiita kuti pave nekurwisana nehutachiona, hospital hospitalization uye kufa kwechirwere muAfrica vanhu.
Apo vashandi veAfrica American muSVIV vaiongororwa zvakajeka, zvakawanikwa kuti vaive nechirwere chakanyanya seboka, asi vakanga vasina kunyanya kushandisa steroid inhaled kuti varware mweya yavo. Apo avo veAfrica America vakashandisa steroid inhaled vakaongororwa, avo vakapa salmeterol havana kuonekwa kuti vakawedzera matambudziko nekuda kwekushandiswa kwayo.
Iko SNS yekuenzanisa yakafananidza migumisiro yeviri-zuva rimwe nerimwe reLABA Serevent (salmeterol) kusvika kune dzimwe nguva-a-day salbutamol (yeEuropean version ye albuterol) pamusoro pekudzivirira kweAsthma mune vanhu vanopfuura 25 000 vane astmma. Kunyange zvazvo paiva nehuwandu hwepamusoro hwekufa kwechifema muboka re salmeterol, izvi zvaive zvichida nekuda kwechiitiko uye yakanga isiri kunze kwekuverengerwa kwevakafa muhuwandu huyu hukuru nehutachiona hwakanyanya. Ichi chidzidzo chakabudiswa muna 1993, pamwe nemigumisiro inowanikwa kuDFA pamberi peLABAs ichibvumira kushandiswa muUnited States.
LABAs zvinowanzoshandiswa mishonga yekurapa chirwere pamusoro pemakore 15 apfuura kana kupfuura muUnited States. Pasinei nezvidzidzo zvataurwa pamusoro apa uye kuonekwa kwakanetseka neDefA, nhamba yehupenyu hwekushaya mweya yakange iri kuderera mumakore 10 akapfuura kana kupfuura.
Iwe unofanirwa kutora mishonga ye-asthma ine LABA, yakadai seAdvair kana Symbicort? Iwe iwe chete uye chiremba wako chete unogona kuita chisarudzo ichi. Zvisinei, kana uri kutora LABA, iri pfungwa yakanaka kuona chiremba wako achikurukura nezvekukuvadza uye kubatsirwa kwemishonga iyi. Zvakakosha kurega kutora mishonga yemishonga, kusanganisira LABAs, usati wataurirana nachiremba wako.
Dzidza zvakawanda nezvengozi uye zvibatsiro zvekushandisa Advair .
> Sources:
> Nelson HS, Weiss ST, Bleeker ER, et al. Salmeterol Multicenter Chirwere Chekutsvakurudza Chirwere. Chest. 2006; 129: 15-26.
> Nelson HS. Beta-Kubata kwenguva refu-Agonist muHuru hweHupumu: Uchapupu hwekuti izvi zvinodhaka zvakachengeteka. Primary Respiratory Care Journal. 2006; 15: 271-77.
> Castle W, Fuller R, Hall J, Palmer J. Serevent Yenyika Yose Kuongororwa Chidzidzo: Kufananidza Salmeterol neSalbutamol muVashandi veAsthmatic Vanoshevedza Nguva dzose Bronchodilator Treatment. BMJ. 1993; 306: 1034-7.