Methotrexate chirwere-modifying antirheumatic drug (DMARD) inoshandiswa kurapa chirwere cherumatoid arthritis nezvimwe zvirwere zverheumatic. Chirwere ichi chinoshandiswa kuRheumatoid arthritis chinoonekwa sechidiki. Kusiyanisa, methotrexate inoshandiswawo seye-high-dose cancer therapy uye pamakiritsi makuru ekugumisa ectopic pamuviri.
Inyanzvi-kutaura, methotrexate inonzi dihydrofolate reductase inhibitor iyo inokanganisa purine metabolism.
Izvozvo zvakati, zvinogona kutungamirira kusakanganiswa mu ribonucleic acid uye deoxyribonucleic acid synthesis. Methotrexate isati inogamuchirwa, iyo inotsanangurwa sechinhu chero chipi zvacho, chimiro, kana nzira inokonzera kusagadzikana mumucheche. Methotrexate inogona kukonzera dysmorphic face maitiro, kusagadzikana kwedehenya nemakumbo, kushaikwa kwekukura, kukurumidza kunonoka, nekukurumidza kwepfungwa.
Izvo zvinogona kukonzerwa ne fetus zvinokonzera kuti chirwere chacho chive nehanya nezera remakore ekurera, avo vanoronga kuva nepamuviri, uye kunyanya avo vanova nepamuviri apo vachirapwa ne methotrexate.
Fetal Anomalies uye Pregnancy Loss Associated With Methotrexate
Vakadzi vanofanira kuve vanoziva nezvekuchengetedzwa kwe fetal anomalies uye kurasikirwa nekuita pamuviri kunobatanidza ne methotrexate, kunyange zvazvo chiyero che fetal anomalies chinoonekwa sechidiki. Mune chidzidzo cheFrance, vakadzi vane zvirwere zvisingaperi zvekuvhiringidza avo vaibatwa nechepasi-dosetrexate munguva yekutanga chetatu vakaongororwa.
Pakati pemasero makumi maviri nemakumi matatu akaongororwa, methotrexate inopera isati yapera kwemavhiki masere ekuberekwa kwevakadzi makumi maviri nemaviri. Vakadzi vana vainge vasisina maturo, asi 5 vakasarudza kugumisa kuberekwa. Paiva nemakore makumi mapfumbamwe nemashanu ekuberekwa kweupenyu, avo vatatu vakanga vasati vasvika. Vatsvakurudzi vakagumisa kuti migumisiro yavo inotsigira pfungwa yokuti hapana dambudziko rakasimba reTatatogen rine chirwere chakanyanya-methotrexate, kupa mishonga inomiswa pakutanga kwekuzvimba sekugona.
Chimwe chidzidzo chakatarisa hutatu hwemashotrexate-pachena. Paiva nemuenzaniso mumwechete weiyo typical methotrexate embryopathy yakatarwa. Ndiyo yekutanga yakadaro inowanikwa pakati pevanhu vanotora rezasi kamwechete-vhiki imwe neimwe ye methotrexate (iyo inowanzoita zvirwere zverheumatic). Kunyange zvazvo yaiva imwe chete, vatsvakurudzi vakagumisa kuti kufungidzira kwemashotrexate kuchengetedzwa pamadhora mashoma kunotanga.
Zvakadini Nevanhu?
Maererano neDrugs.com, pamuviri unofanirwa kudziviswa nemumwe wawakaroorana naye kana shamwari yako ari kurapwa ne methotrexate. Kuberekwa kunofanira kudziviswa panguva yekurapa uye kwenguva shomanana kwemwedzi mitatu mushure mekurapa kwevarume vevarume, uye panguva yekurapa uye kwechimwe chekurovedza mushure mekurapa kwevarwere vechikadzi.
Iko kune ngozi yekufungidzira yehumuki mutation mune varume vachitora methotrexate, asi hazvina kuonekwa. Uyezve, maererano neMagazini yeRheumatology , paternal methotrexate inowanikwa panguva yekuberekwa haifaniri kunge inokurudzira kushushikana kana nenyaya dze fetus.
The Bottom Line
Hapasi 100% nguva yakachengeteka yekutenderera kwemaitiro ekutenderera kune methotrexate. Mhedziso ye methotrexate inoratidzika isingazivikanwi, chikamu chinobva pamagenene ekusiyana kwepascental uye fetal response kune chepfu.
Mushure mekutarisana ne methotrexate munguva yekutanga kutatu, amai vanosarudza kuramba vachiita nepamuviri vanofanira kuziva kuti kune chirwere chenguva 10/42 chekusava nemunhu mucheche (QJM: An International Journal of Medicine).
Maererano neKelley's Textbook yeRheumatology , vakadzi vanorayirwa kuti varege methotrexate mwedzi mitatu vasati vatora mimba. Folic acid supplementation inofanira kupfuurirwa kuburikidza nekuzvitakura. IAmerican College yeRheumatology inokurudzira kushandiswa kwemishonga inobata pamuviri panguva inotora methotrexate uye kwemwedzi mitatu mushure mekumira methotrexate.
Sources:
Methotrexate (Rheumatrex, Trexall). American College of Rheumatology. Michael Cannon, MD May 2012.
http://www.rheumatology.org/Practice/Clinical/Patients/Medications/Methotrexate_(Rheumatrex,_Trexall)/
Mvura yakadzika inonzi methotrexate mumutambo wekutanga wekuita pamuviri: migumisiro yeFrench yekubatana pamwe. Lewden B et al. Nyaya yeRheumatology. December 2004. http://www.ncbi.nlm.nih.gov/pubmed/15570635
Methotrexate Embryopathy Mushure mekuratidzwa kune madiki mashoma mavhiki ekutanga kuberekwa. Martin MC, et al. Reproductive Toxicology. Gumiguru 26, 2013. http://www.ncbi.nlm.nih.gov/pubmed/24513926
Methotrexate Kuberekwa uye Kuyamwisa Kurairirwa. Drugs.com.
http://www.drugs.com/pregnancy/methotrexate.html
Paternal Exposure to Methotrexate uye Kubata pamuviri. Nyaya yeRheumatology. Beghin, et al. January 15, 2011.
http://www.jrheum.org/content/early/2011/01/11/jrheum.100600
Migumisiro ye methotrexate pakuberekwa, kubereka uye kuvakwa. QJM: An International Journal of Medicine. 1999.
https://academic.oup.com/qjmed/article/92/10/551/1531030/The-effects-of-methotrexate-on-pregnancy-fertility
Kelley's Textbook yeRheumatology. Elsevier Saunders. Bhuku I. Kuberekwa muRheumatic Diseases. Chitsauko 39. Peji 552.