Sezvo kune marudzi akawanda akasiyana-siyana einhaler inoshandiswa kurapa COPD , varwere vakawanda vanogona kushamisika "ndeipi iyo yakanakisisa?" Kunyange zvazvo uchibvuma kuti zvine ngozi kujekesa kuti kune 'mishonga imwe chete yepamusoro' chero ipi zvayo, pane COPD, rimwe boka remishonga inowanzosimudza pamusoro pevamwe, iyo yakawana chikoro ichi zita re "mutevedzeri wemutambo" pakurapa COPD.
Kirasi yemishonga inonzi anticholinergic inhalers, iyo iripo ikozvino pamusika: Spiriva (tiotropium) uye Turdoza (aclidinium bromide). Sezvo Turdoza yakauya pamusika muna 2012, huwandu hwemakiriniki emakiriniki anosanganisira varwere veCOPD vakashandisa mishonga Spiriva (yakauya pamusika muna 2004). Nokudaro, munyaya ino, tichakurukura zvikuru pamusoro peSpiriva nekupfupisa zvidzidzo zviviri zvinokosha zvekutsvakurudza pamusoro peTiotropium, iyo inotsigira nharaunda yayo "sarudzo yekutanga yevanyoresa varwere veCOPD." Zvadaro, tichakurukurirana migumisiro yeSpiriva.
Kuenzanisa Spiriva
Mumagazini yaMarch 24, 2011 yeNew England Journal of Medicine (imwe yezvinyorwa zvepamusoro pezvokurapa), boka revanotsvakurudza rakatarisira kuziva kuti mapoka emishonga aive nani pakudzivirira kuwedzera kweCOPD: anticholinergics kana kwenguva refu-agenta agonists. Kuti vaite kudaro, vakafananidza Tiotropium (Spiriva, anticholinergic) neSalmeterol (Serevere, iyo yakareba-acting beta agonist) kune varwere vane muongorori kusvika kuCOPD.
Vakayera nguva yakatorwa kuti varwere vawane COPD yavo yekuwedzera kukura. Vakaona kuti varwere vakashandisa Spiriva vakawana kuderedzwa kwe17% muhutano hwavo hwekuwedzera kweCOPD uye kuderedzwa kwe 28% muhutano kune kuoma kwakanyanya. Varwere vakashandisa Spiriva vaiva nemazuva 187 kusvikira vasati vanyanyisa kuwedzera apo varwere vakashandisa Serevent vaiva nemazuva 145 kusvika pakuwedzera kwekuwedzera.
Mukuwedzera, varwere vakatora Spiriva vakanga vasisina zvido zve steroid (zvakadai se prednisone) uye mishonga inorwisa mabhakitiriya. Kwakange kusina kusiyana pakati pemitengo kana mhando yemigumisiro kubva pamishonga.
Chimwe chidzidzo muNew England Journal of Medicine (kubva muna 2008) chakawana kuedza kwavakatevera varwere 3000 vakatora Spiriva uye vakavaenzanisa nevarwere 3000 vakashandisa sham 'inhaler. Mapoka maviri evarwere aibvumirwa kushandisa mamwe mishonga yavo panguva yekudzidza. Varwere vakashandisa Spiriva, zvisinei, vaiva nepamapapu ekushanda, asi vashoma vanopinda mahara, vasingapfuuri kuputika, uye maonero akanaka pane zviratidzo zvezviratidzo kupfuura varwere vasina kushandisa Spiriva. Ichi chidzidzo chakaita kuti vanotsvakurudza vaite kuti Spiriva inogona kuvandudza zviratidzo, kuderedza kuwedzera uye kuvandudza hupenyu hwehutano kune varwere vane COPD (kana vachienzaniswa nevaya vasina kushandisa Spiriva).
Kunyange zvazvo Spiriva ndiyo inowanzova sarudzo yokutanga ye inhaler, kune dzimwe inhalers dzinoratidzwa muCOPD, dzakadai seAdvair, Symbicort, nezvimwe. Varwere vakawanda vanoda zvinopfuura imwe inhaler, uye kune vamwe varwere, Spiriva HASI sarudzo yakanakisisa (somuenzaniso, kana vakawana migumisiro). Panewo dzimwe inhalers dzinofanirwa kusabatanidzwa naSpiriva (semuenzaniso, usashandise Spiriva uye Combivent pamwe chete )
Zvimwe zvikanganiso zveSpiriva hazviwanzoitiki, uye zvinogona kusanganisira:
Urinary retention (kunyanya mune varume vane yakawedzera prostate)
Allergic reaction (hives, itching, rash, howell of lips / tongue / throat)
Glaucoma (kurwadziwa kweziso, kuonekwa kusina kunaka, kuona halos kana mavara asina kufanana)
Zvimwe zvikamu zvinowanzoonekwa zveSpiriva zvinosanganisira:
Dry mouth
Chirwere cheSinasi
Huro inorwadza
Blurry chiratidzo
High moyo rate
Kumusoro kwekupumha kwepamuviri zvirwere
Nokuda kwemashoko anofadza anongoratidzira pamusoro pemigumisiro yechirwere cheSpiriva (yakabudiswa muNew England Journal of Medicine ), tora pano.
Sources
> Tashkin DP, Celli B, Senn S, et al. Kuongororwa kwemakore mana kwetiotropium mune chirwere chisingaperi chisingavhiringidzi. N Engl J Med 2008; 359: 1543-54.
> Vogelmeier C, Hederer B, Glaab T, et al. Tiotropium uye salmeterol yekudzivirira kuwedzerwa kweCOPD. N Engl J Med 2011; 364: 1093-103.
> Wise RA, Anzueto A, Cotton D, et al. Tiotropium Respimat inhaler uye njodzi yekufa muCOPD. N Engl J Med 2013; 369: 1491-501.