Kubatsira Kuti Uchengetedze Rheumatoid Arthritis
Mishonga ndiyo inonyanya kukoshesa kurapwa kwetsika ye rheumatoid arthritis . Kana uchangobva kuongororwa ane rheumatoid arthritis , chiremba wako achakurudzira uye anopa nzira yekurapa.
Pane mishonga yakawanda inoshandiswa pakurapa rheumatoid arthritis iyo yakakamurwa kuva mishonga inotsanangurwa nemashandisirwo avanoita. Zvakakosha kuti iwe unzwisise zvaunogona kuita, uye unzwisise kuti sei mimwe mishonga yakasarudzwa iwe.
Mune mamwe mazwi, chii chinonzi mishonga inoita mumuviri?
Kana imwe nzira yekurapwa isingaratidzika seinobudirira mushure menguva, zvinowanzoitika kuti chiremba wako aite shanduko kune regimen yako. Ngationei rheumatoid arthritis mishonga. Iwe unogona kunge wakarayirwa chimwe kana zvimwe zvezvinotevera.
NSAIDs
NSAIDs (nonsteroidal anti-inflammatory drugs) inodzivirira COX 1 uye COX 2 (cyclooxygenase enzymes) kubva pakuita prostaglandin , mahomoni anokonzera kupisa mumuviri. Kune maNSAID ane gumi nemaviri kubva kwaunofanira kusarudza. NSAIDs dzinonyanyozivikanwa ndeyeMotrin (ibuprofen) , Naprosyn (naproxen) , Mobic (meloxicam) , uye Voltaren (diclofenac) . Celebrex (celecoxib) ndiyo chete COX-2 selective inhibitor inowanikwa muU.S. Uyewo, Advil (ibuprofen) uye Aleve (naproxen) inowanikwa pane-power-counter force.
NSAID dzave dzakabatanidzwa nehuwandu hwekurwadziwa kwepfungwa kana chirwere chepakati, saka zvakazogadziriswa kuti mishonga inofanira kuendeswa pamusana wepamusoro uye inogona kupera nguva shoma.
Uyewo, haufaniri kutora zvinopfuura chimwe chigadzirwa cheNSAID pane imwe nguva. Verenga mavara zvakanyatsonaka sezvo NSAIDs inogona kuva chikamu chezvimwe zvakasiyana-siyana pamusoro pemishonga yekukonzera, kukonzera, kurwara, kurara, uye kushungurudzika mumimba.
Analgesics
Mishonga yekurapa inoshandiswa nekugadzirisa marwadzo. Acetaminophen inoratidzirwa kupfuura ----remapirisa marwadzo; chaizvoizvo ndiyo chete inonzi analgesic mishonga inowanikwa pane iyo.
Izvo, zvakare, inogona kunge yakasiyana-siyana pane-the-counter michina, naizvozvo zvakakosha kuverenga mavara uye kuve nokuziva nezvekuwedzera kwechiitiko cheAcetaminophen.
Stronger analgesics inowanikwa chete nemishonga. Zvinonzi opioid kana narcotics. Opioids inoshandisa purogiramu yepamusoro yenheyo kudzivirira zviratidzo zvinorwadza. Mishonga yeOpioid inouya nechinjodzi chekuvimba, asi kana inoshandiswa sezvinorayirwa uye nekuchenjerera pamusoro pemigumisiro inogona kuitika uye zviitiko zvinorwadza, mishonga iyi inogona kuva kurwadza kunobatsira kwevanhu vane rheumatoid arthritis. Muna 2016, Centers for Disease Control and Prevention (CDC) yakabudisa mirayiridzo yekuraira maopioid . Hydrocodone / acetaminophen (chinonzi Norco) uye Tramadol (marimi Ultram) ndiwo mazita maviri anonyanya kurongedzerwa maalgesics opioid. Zvimwe zvinosanganisira oxycodone uye MSContin.
Corticosteroids
Corticosteroids , inozivikanwawo seglucocorticoids kana steroid, inofanana nemigumisiro yehomoni cortisol mumuviri uye inobatsira pakuita zvirwere zvemuviri. Corticosteroids inowanika inowanikwa miviri yakawanda inosanganisira mapiritsi, injectable solution, madonhwe, uye mapuropiki.
Corticosteroids imishonga inopesana nekuputira. Kunyange zvazvo kubudirira kwavo kunogona kuita sechishamiso, ivo vanobatanidzwa nemigumisiro yakaipisisa, kwete iyo yakawanda iyo inowedzera ngozi yekutapukirwa.
Kuti kuderedze njodzi yemigumisiro, corticosteroids inofanira kutorwa pamusana wepamusoro mukana unogona uye uye kwenguva shoma inogoneka.
Vamwe vanhu vane rheumatoid arthritis vanorayirwa kuti chirwere chakanyanya corticosteroid sechikamu chemuitiro wavo wenguva dzose wemishonga. Vamwe chete vanoshandisa corticosteroids kuti vashandise chirwere cherheumatoid arthritis zviratidzo. Vanhu avo vakatora corticosteroid kwenguva refu vanogona kuwana zviratidzo zvekudzima kana vakamisa mishonga vasina kutora. Prednisone uye methylprednisolone ndiyo inonyanya kunyorerwa muromo corticosteroids. Triamcinolone inoratidzirwa kujowa nekamu.
DMARDs
Zvirwere-kuchinja zvinorwisa-rheumatic zvinodhaka ( DMARD ) zvinononoka-zvinodhaka zvinodhaka zvinoshanda kuderedza chirwere chekuwedzera uye kuderedza kusanganisa pamwe.
Iko kune maitiro eDMARD, zvisikwa zvekare uye zvekare. Kunewowo biologic DMARD-yekutanga yakaonekwa pachiitiko muna 1998. Uye, munguva pfupi yapfuura, rimwe diki-kirasi reDMARD razivikanwa sechinangwa chemazana emakirini mishonga.
Pamitambo yeDMARD, methotrexate ndiyo inonyanya kutaurwa. Iko chaizvoizvo inofungidzirwa kuti ndiyo yegoridhe yakarongeka ye rheumatoid arthritis. Mimwe mitambo yeDMARD inosanganisira Arava (chetlunomide) , Plaquenil (hydroxycholorquine) , uye Azulfidine (sulfasalazine) . Ndarama uye Imuran (azathioprine) inowanika asi haisati yasarudzwa kuti ive rheumatoid arthritis. Nharaunda DMARD inokonzera zvirwere zvekuzvidzivirira , saka zvinogona kuva zvakaoma kurwisana nehutachiona uye pane imwe nguva ingozi yekuwedzera dzimwe kenza. Iwe unofanirwa kunyatsoteerera kune zvingava nemigumisiro nemamwe macheno anowanikwa neDMARD. Kazhinji, periodic kuongororwa kweropa kunorayirwa kutarisa chiropa basa uye kukwana kweropa.
Biologic DMARDs
Biologic zvinodhaka , zvinonziwo Biologic DMARDs kana Biologic Response Modifiers, ndiyo mishonga yakasikwa kuti idzivirire kana kuderedza kuputika kunokanganisa manotsi. Biologics inoshandura zvakananga mamolekemu muzvirwere zvekuzvidzivirira mumasero uye zvigadzirwa zvakachengetwa mubatanidzwa izvo zvinobatanidzwa mukukonzera kuvhiringidza uye kuparadza pamwe.
Kune mhando dzakasiyana dzehupenyu hwehupenyu, imwe neimwe ine chinangwa chairo. Target dzinosanganisira tumor necrosis factor (TNF) , interleukins (IL-1, IL-6, IL-12, uye IL-23), masero B, uye masero eT. Biologic zvinodhaka zvinodhura, asi rubatsiro rwemari runowanikwa kune avo vanofanirwa. Mishonga iyi inotungamirirwa nekumanikidzwa kana kujowa. Nemhaka yemigumisiro yezvigadzirwa zve biologics pamusoro pemasikirwo ezvirwere zvemuviri, mamwe maitiro asina kunaka uye akaipa anogoneka.
Targeted Small Molecule DMARDs
Ichitsva chechirwere chechirwere cherheumatoid arthritis "chinotarirwa maduku madutu DMARD" iyo inopesanidza kupindira kwepracellular. Nokuvhiringidza zviratidzo zvakasiyana-siyana zvezvinonzi intracellular, zvinokwanisika kuenzanisira zvakananga masero, zvinosanganisira nzvimbo dzinogamuchirwa pasi, kuratidza mapuroteni, nekunyorwa kwezvinyorwa zvemanyukliya. Nokuita kudaro, maitiro emasero evanhu anotarirwa anogona kuchinjwa kana kuchinjwa.
Zvinangwa zvekutsvaga kukuru kune vanotsvakurudza, nechinangwa chekurapa zvirwere zvinoputika uye zvinoputika, zvinosanganisira Janus-anonzi kinase, spleen tyrosine kinase, phosphodiesterase-4, Bruton's tyrosine kinase, uye phosphatidylinositol-3 kinase. Miedzo yevanhu inodiwa kuti ione zvingave zvechinangwa chimwe nechimwe. JAK (Janus kinase) inhibitors ndiyo yakagadzirwa uye imwe ndeye FDA-inogamuchirwa, Xeljanz (tofacitinib).
Shoko Rinobva
Vamwe vanhu vane rheumatoid arthritis vanotya mishonga, kunyanya nekuda kwezvingava nemigumisiro, dzimwe dzingave dzakaoma. Ichokwadi kuti zvinokosha kuongorora kubatsirwa uye njodzi dzemishonga nachiremba wako.
Funga nezvehutano hwako hwehutano hwekuita uye usarudze pane zvinangwa zvekurapa nechiremba wako. Zvichida, iwe uchagadzirirwa mamwe masanganiswa ezvinhu zvinowanikwa zviri pamusoro apa. Chengeta diari yezviratidzo mushure mokutanga mishonga kuti ubatsire kuongorora kana vakushanda zvakanaka kwauri. Iva neruzivo pamusoro pemigumisiro inogona kuitika uye unyore chero chinhu chisina kujairika kuchiremba wako.
> Sources:
> Arthritis Nhasi. Mutungamiri Wezvinodhaka 2016. Yakabudiswa neArthritis Foundation.
> Kelly, V. naGenovese, M. Novel madukuruko emishonga inherera muurumatoid arthritis. Rheumatology (Oxford) (2013) 52 (7): 1155-1162.
> Kelley's Textbook of Rheumatology. Ninth edition. Elsevier.