Chirongwa Chezvinhu Zvose Kubva Acetaminophen kusvika kuNorco
Rheumatoid arthritis (RA) chirwere chinoputika muviri umo muviri wemuviri wechirwere unokanganisa masangano, zvichikonzera kuputika kwe synovium-mhuka inotenderera mukati memajoini. Kurwadziwa nekudurukira izvo zvinoguma zvinogona kuva zvakanyanya uye zvinokanganisa. Nenzira yakanaka, kune mhando dzakasiyana dzemishonga yekurapa kuputika kunokonzerwa neR RA uye kubvisa kusakonzerwa kunokonzera. Heino mhedziso yezvikamu zvishanu zvakakosha zvemishonga zvinoshandiswa RA uye basa rimwe nerimwe rinogona kutamba mukurapa chirwere ichi chinorwadza.
Non-Steroidal Anti-Inflammatory Drugs
Nonsteroidal anti-inflammatory drugs , inowanzonzi NSAIDs, iboka guru rezvinodhaka rinonyanya kurongerwa kuti kuderedze kuputika , kurwadziwa, uye fevha.
Dzinoshanda nokudzivirira utachiona hunonzi cyclooxygenase (COX) kubva pakuita prostaglandin-hormone-semakemikari anosanganisira mukuputika. COX-1 uye COX-2 ndiyo mhando mbiri dzemakemikari aya. NSAID dzeMasitadhi, dzakadai sa aspirin , naproxen , uye ibuprofen chidziro zvose COX-1 ne COX-2. Zvitsva NSAIDs, zvakadai seCelebrex (celecoxib), dzinodzivirira chete COX-2 uye dzakasimudzirwa nokuti COX-1 inozivikanwa kuva nemigumisiro inobatsira yekudzivirira dumbu rekumusoro.
Kunyange zvazvo vazhinji veNSAIDS vachida mishonga, mamwe acho anowanika pamusoro pekambani mune simba rakaderera, rakadai seAppil (ibuprofen) uye Aleve (naproxen).
Analgesics
Analgesics mishonga inoderedza marwadzo. Vanowanzotumidzwa semishonga inorwadza kana painkillers. Iyi kirasi yemishonga inosanganisira kwete-narcotic analgesics yakadai seTylenol ( acetaminophen ) pamwe neanpioid narcotics yakadai se hydrocodone . Nyaya yeopioid inonzi Ultram ( tramadol ) inofungidzirwa kuva nejodzi shoma yekuita zvinodhaka kupfuura dzimwe nharotic opioid.
Acetaminophen inowanikwa pamusoro pekambani, pamwe chete nemishonga inoshandiswa pamwe nemashizha anopa opioid. Vicodin, Lortab, uye Norco ndivo mazita emishonga yemishonga ine zvose hydrocodone uye acetaminophen.
Corticosteroids
Corticosteroids , inonziwo glucocorticoids, inogadzirwa nemishonga inofanirwa nemigumisiro ye cortisol, hormone inowanzobudiswa nehutachiona hunodhusa hunoita mabasa akawanda mumuviri, kusanganisira maitiro ezvirwere zvemuviri . Cortisol inokwanisa kukurumidza kuronga kuvhiringidza nekuderera kwemazinga e prostaglandin pamwe nekuputika kwechitokines .
Corticosteroids yakadai se prednisone ine chiitiko chakafanana nekuputika. Zvakakosha kuziva kuti pasinei nezvinobatsira, corticosteroids ine mikana yezvikanganiso zvisina kunaka zvakadai sekuwedzerwa kudya, kuwedzera kuwedzera, kuwedzerwa kwemvura, uye kuwedzera kweropa-kunyanya kana zvakatorwa kwenguva yakareba kana pamutengo mukuru . Kana chiremba wako achikuisa pane corticosteroid, zvakakosha kuitora sezvakanyorwa.
Denda-modifying Anti-rheumatic Zvinodhaka
Zvirwere-zvinorwisa anti-rheumatic drugs (DMARDs) inotora-kushandiswa kwemishonga inoshandiswa mushure mezviratidzo kuenderera mberi kwekuwedzera kwerhumatori arthritis uye kuderedza dambudziko rekugadzirisa kusanganisa pamwe chete .
DMARD inonyanya kutaurwa ndeye methotrexate (inotengeswa pasi pezita rezita reRheumatrex neTrallall). Zvimwe DMARD zvinosanganisira Plaquenil (hydroxychloroquine), Arava (masikati), Azulfidine (sulfasalazine), uye Otrexup, imwe nhengo inoshandiswa inonzi methotrexate.
Sezvo nemishonga yose, zvakakosha kuti uzive zvinogona kuitika migumisiro. Kana ukacherechedza chero chinhu chinonetsa, bvunza chiremba wako. Iwewo uchange uine kuongororwa ropa nguva nenguva kuti uone mavhinga enzymes pawakarapwa neDMARD.
Mudukumu DMARD kusanganisira JAK inhibitors ndevamwe vezvitsva zvitsva. Xeljanz (tofacitinib) ndeimwe yeiyi. Inoshanda nekudzivisa nzira yeJAK mukati memasero anoita basa rinokosha mukuputika kunobatanidza nerheumatoid arthritis.
Biologics
Biologics , pfupi kune biologic response modifiers, ndiyo nzira itsva yeDMARD. Izvo zvakagadzirwa nemajini kubva mumuviri mhenyu kumutsa mhinduro chaiyo. Mune mamwe mazwi, biologics inotora puroteni chaiyo kana sero iyo inobatanidzwa nezviratidzo uye kubatana kwakakonzerwa nekuputira marudzi eArthritis. Zvizhinji zvebiologics zviri kuzvidzora, asi dzimwe dzinopiwa mukati-kati (kuburikidza nesingeni mumumvuri).
Sources:
> Arthritis Nhasi Drug Guide. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-guide/.
> Firestein, et al. Kelley's Textbook yeRheumatology . 9th edition. Elsevier Inc. 2012.