Plaquenil (hydroxychloroquine) inoonekwa sekare DMARD ( chirwere chinoshandisa anti-rheumatic drug). Plaquenil chaiyo yakatanga kusarudzwa semushonga wepachirwere, asi inoshandiswawo kubata mamwe maitiro ehurumende uye anogadzirisa zvisingabatsiri nemarariya. Kazhinji, Plaquenil inoshandiswa kurapwa se monotherapy (inoshandiswa yoga) yepachirwere chepachirwere chemahythritis kana kuti sangano rinobatanidza nedzimwe DMARD dzekuenzanisa zvirwere zvakaoma.
Bhuku Rezvakaitika Kare
Mhedzisiro yemastimalarials inodzokera shure kuma1630s muPeru. Mukati ma1820, makemikari akachenesa quinine kubva pamakungwa. Kufambira mberi kusvika muna 1951, apo paiva neuchapupu hwehutano hwekuvandudzwa kwe lupus uye rheumatoid arthritis neWWII Masangano eAllied avo vakanga vari kutora maitiro e quinine, ainzi quinacrine, kudzivirira marariya. Nokufamba kwenguva, mamwe mabhii e quinine akabudiswa ne FDA-chloroquine muna 1952 uye hydroxychloroquine muna 1955.
Nzvimbo inobatanidzwa ine migumisiro yemigumisiro, imwe yeyo inonyanya kunetseka kune vanhu vanorayirwa mushonga. Kushandiswa kwakachengeteka kunobatsira kuderedza zvido zvisingabatsiri.
1. Kunyange zvazvo Plaquenil imishonga yakakura, ichiripo uye inorayirwa kune vamwe vane rheumatoid arthritis kana zvimwe zvirwere zverheumatic.
Plaquenil iri DMARD iyo yakatemerwa kwemakore ekurapa rheumatoid arthritis, lupus, juvenile rheumatoid arthritis , nezvimwe zvirwere zvinogadzirisa muviri.
Apo yekutanga biologic DMARD yakagamuchirwa FDA muna 1998, uye sezvimwe zvipenyu zvehupenyu zvakazotevera mumakore akatevera, zvakaonekwa sekuti Plaquenil yaizoita zvishoma nezvakatemerwa. Iyo mishonga ichiri kubata nzvimbo yayo senzira yekurapa kune vamwe vanhu, kunyanya pamwe pamwe ne methotrexate , kana vanhu vane systemic lupus erythematosus.
Plaquenil inosarudzo kune avo vanoedza uye vanokundikana biologic zvinodhaka, havagoni kushivirira biologics kana kutya zvinogona kuitika zvinokonzerwa ne biologic DMARDs.
2. Chigadziro chinorondedzerwa sechirwere-chinoshandura, mune mamwe mazwi, kuderedza marwadzo, kuderedza kuputika, uye kudzivirira kuwirirana pamwe nekuremara. Hazvizivikanwi kuti Plaquenil inoshanda sei asi vatsvakurudzi vanodavira kuti Plaquenil inopesana nekukurukurirana pakati pemasero ari muchirwere chemuviri . Pakupedzisira, inofungidzirwa kuti igadzirire nzira dzinofambisa.
3. Chiitiko chinowanzoita mazai ePauquenil ndeche 200 mg kaviri pazuva kana 400 mg kamwe pazuva, inotungamirirwa nemuromo, kuvanhu vane mashekeri makumi mana kana kupfuura. Iko inowanzo inoshandiswa inoshanda kune vanhu vazhinji vanotora Plaquenil, asi zvinokwanisika kuwedzera kana kuderedza chiremba chinobva pane zvido zvevanhu. Zvakakosha kutarisa zvinokonzerwa nemigumisiro uye chepfu. Kune vanhu vanorema kudarika 80 kilogi, chirwere chemazuva ese chakaderedzwa, kusvika kusvika pa 5 mg / kg wehutatu hwehuviri.
4. Muranda ndeyekuita kwenguva pfupi. Vanhu vanotora Plaquenil vangatanga kuona kuvandudzwa mushure memwedzi umwe kana maviri. Zvinogona kutora kusvika kumwedzi mitanhatu isati yasvika zvizere zvePaulenil inozivikanwa.
5. Nzvimbo inowanzochengetedzwa zvakanaka, asi migumisiro yemahara inogoneka.
Matambudziko anowanzobatanidzwa neAlaquenil anosanganisira kuora mwoyo uye chirwere. Kutora mishonga pamwe nekudya kunononoka kushungurudza kwevanhu vakawanda vanotora mishonga. Migwagwa isingawaniki yakafanana inosanganisira zviputi zveganda, vhudzi rinopenya, uye utera. Chimwe chikamu chisingaiti chikamu chePauquenil chinosanganisa kuonekwa kunoonekwa kana kukanganisa kurasikirwa kwemaonero-iyo migumisiro yechirwere inonyanya kunetsa varwere.
6. Izvo zvataurwa pamusoro pacho zvisingabatsiri yechiratidzo inobata maonero (hydroxychloroquine retinopathy), kana yakabatwa nguva pfupi, inogona kuvandudzwa mushure mekuregererwa kwePaulenil. Sezvo rutivi rwakaoma rwekuona kurasikirwa runogona kuitika asi haruna, zvakakosha kuti iwe uudze chiremba wako pamusoro pekuona maonero ekuchinja kwaunoona.
Vanachiremba vanowanzokurudzira kuongorora maziso panguva iyo paPaulenil, kuitira kuti kuchinja kwekutanga kungabatwa. Kana kamwe kusakanganiswa kuwanikwa, kuora mwoyo kwatoitika. Kunyange zvazvo inogona kuchinjwa kana yakabatwa kare, hydroxychloroquine retinopathy haisi nguva dzose inoshandurwa.
7. Vamwe vanhu vanonyanya kukuvara kupfuura vamwe kuti vangave nezvinetso zvekuona neArequenil. Zvakare, chiratidzo chinobatanidzwa nePauquenil hachiwanzovi, asi vamwe vanhu vari pangozi yakakura yokutura dambudziko racho. Vakuru-pangozi varwere vangasanganisira avo vano:
vakatora marefu akawanda ePauquenil kwemakore (kureva, 1000 g. kwemakore anopfuura 7)
vane makore makumi matanhatu kana kupfuura
zvakaoma
vane chiropa chakakura kana chirwere chepfungwa
vane retinal yakagara iripo, zvirwere zve macular, kana kuti cataract
8. Vanhu vose vanotanga kurapwa kwePaulenil vanofanira kuva nehutano hwekuongorora ophthalmologic mukati megore rokutanga. Kana iyo yekutanga ophthalmologic kuongorora ichinyanya kuitika uye munhu wacho anoonekwa sengozi shoma, kuongorora zvakare hakufaniri kuitika kwemakore mashanu. Zvinokurudzirwa kuti varwere vane ngozi yakawanda vanoongororwa maziso egore negore.
9. Mimwe mishonga inogona kuwirirana neAlaquenil, inoshandisa kuti inoshanda sei kana ichiita kuti irege kushanda. Udza chiremba wako pamusoro pemishonga yese uye kuwedzera kwauri kutora.
Zvinodhaka zvinogona kuwirirana neAraquenil zvinosanganisira:
antacids
botulinum toxins
digoxin
kaolin
magnesium trisilicate
methotrexate
metoprolol
penicillamine
10. Kana iwe uri pamuviri kana kuti uchifunga kuva nepamuviri, kurukurai Plaquenil nevarapi vako. Kunyange zvazvo Plaquenil inowanzoonekwa seyakachengeteka munguva yepamuviri, zvinokurudzirwa kuti kubata kwakasimba kwekuberekwa kunoshandiswa nguva yose muChirongwa chePauquenil uye kwemwedzi mitanhatu mushure mekurapa kwaregwa.
11. Nzvimbo yakave ichibatanidzwa nemamwe maitiro anobatsira kuvanhu vane chirwere cherheumatic. Mune vanhu vanobatwa nePauquenil sechirwere-kugadzirisa antirheumatic drug, mushonga wacho wakawanikwa une zvimwe zvinobatsira. Plaquenil yakawanikwa yekuvandudza huwandu hwemapurogiramu, kutarisa glucose uye kuderedza dambudziko rechirwere cheshuga mellitus, uye kuderedza ngozi yeprombose mune vamwe vanhu vari pangozi huru.
Sources:
Cannon, Michael, MD. Hydroxychloroquine (Plaquenil). American College of Rheumatology. Yakarongwa muna March 2015.
Radis, Charles, DO. Plaquenil: Kubva kuMarariya Kuchirwa Kwekutungamirira Lupus, RA. Rheumatologist. May 15, 2015.
Kuongorora kwe Hydroxychloroquine Retinopathy . Nzvimbo Chirevo kubva kuAmerican College yeRheumatology. August 2016.
Wallace, Daniel, MD. Zvirwere zvehutachiona muhutano hweRheumatic Disease. Kusvika pari zvino. January 10, 2017.