Kazhinji inorondedzerwa kana Methotrexate Isingagutsikani
Arava (leflunomide) inorondedzerwa sehosha-kuchinja anti-rheumatic drug (DMARD). Mushonga uyu, uyo wakagamuchirwa neU.S. FDA musi waSeptember 11, 1998, unoshandiswa kurapa huwandu hwehutachiona hwehutano hutachiona hwevanhu vakuru. Inoshandiswa kuderedza zviratidzo nezviratidzo zverheumatoid arthritis, kudzivisa kukanganisa kwemuitiro (semuenzaniso, x-ray uchapupu hwekushandura uye kubatana kwenzvimbo kuderedza), nekuvandudza basa remuviri.
Arava inowanzonyorerwa apo mamwe DMARD, kunyanya methotrexate , haikwanisi kubvumira kana kubudisa kupindura kwakakwana (kureva, kukundikana kudzora zviratidzo).
Kuwanika nekusarudza
Arava inowanika mu 10 mg uye 20 mg mahwendefa akafukidzwa nemafuta (makumi matatu mabhodhoro). Arava inowanikwawo mu 100 mg 3-count blister pack. Nemhaka yehafu yehafu yehupenyu hweArava mu rheumatoid arthritis varwere uye nguva yakakurudzirwa yemaawa makumi maviri nemaviri ekuraira, zvinokurudzirwa kuti Arava iitwe neraji yekuraira kwepiritsi imwe 100 mg pazuva pazuva remazuva matatu. Mushure mokunge chirwere chinotakurwa chakakwana, chirwere chezuva nezuva che 20 mg Arava chinokurudzirwa pakurapa rheumatoid arthritis. Shanduro ye 10 mg inowanikwa kuvarwere vanoda ruzivo rwakaderera nekuda kwemigumisiro ine ruzivo nehana yakakwirira. Inogona kutora mavhiki mashomanana kusati kwaonekwa kuvandudzwa kwehutano hwekubatana kana kubatana kwekubatana. Zvizere zvakakwana hazvikwanisi kuitika kusvika masvondo matanhatu kusvika ku12 shure kweArava yakatanga.
Iyo Inoshanda Sei
Arava is isoxazole immunomodulatory agent iyo inhibits dihydroorotate dehydrogenase, enzyme inobatanidza mu pyrimidine synthesis. Pyrimidines iri kuvaka zvikamu zve nucleic acid. Arava inosanganiswa nemishonga inopikisa (kureva, inodzivirira kupararira kwemasero) uye muidzo, yakaratidza kupesana-kupisa simba.
Inodzivisa kuumbwa kweDNA iyo inodiwa pakukudziridza masero, akadai semagadzirirwo emasero masero. Nokuita kudaro, inoderedza masimba ezvirwere . Iyo inoshanda zvakananga kuderedza rheumatoid arthritis haina kunyatsonzwisiswa.
Migumisiro Yechirwere uye Kuchinja Kwakaipa
Mhinduro dzakaipa dzinowanzobatanidzwa neArava dzinosanganisira kubuda, kusuruvara, kurwadziwa musoro, kuputika kwetachiona, kukwidziridzwa kwemavirisitiri eropa (ALT neAST), alopecia, uye rash. Kukwidzika kwemakemikari echiropa kunowanzokonzera vashoma kune 10% yevarwere vanotora Arava, asi nokuti inogona kukonzera kukuvadzwa kwechiropa, kunyanya nedoro rinoshandiswa kana nedzimwe mimwe mishonga, kuongororwa kweropa nguva dzose kunofanirwa kuongorora chiropa.
Zvimwe zviitiko zvinotambudza zvakaonekwa kuti zvinokonzera 1% kusvika pasi pe3% ye rheumatoid arthritis varwere vakapinda mumakiriniki ekuedzwa kweArava. Matambudziko emakumbo, kusanganisira kuora kana kupererwa kwemhepo, inoonekwa sevasingaoneki migumisiro. Varwere vanofanira kuve vanoziva nezvekutanga zviratidzo zvepakati pemapapu chirwere uye vanoratidze zviratidzo izvozvo kana vane ruzivo.
Dhairrhea, iyo yakanyanya kufanana nayo, inokanganisa 20% yevarwere vanobatwa neArava. Dhairrhea nekuda kweArava kushandiswa kunowanzovandudza nenguva kana kutora mishonga yekudzivirira chirwere.
Mune zvimwe zviitiko, chirwere cheArava chinogona kudikanwa kupera.
Manyevero neZvirevo
Arava haifaniri kushandiswa nevakadzi vane pamuviri kana nevakadzi vanogona kutora pamuviri uye havashandisi kubata pamuviri. Kuberekwa kunofanira kudziviswa panguva yekurapa neArava uye kusati kwapera kugadzirwa kwezvinodhaka mushure mekurapwa naArava.
Kurwara kwechiropa kwakanyanya, kusanganisira kushaya simba kwechiropa, kwakataurwa kune vamwe varwere vakabatwa naArava. Varwere vane chirwere chekare chisati chavapo kana chirwere chisingaverengeki havafaniri kutarisirwa naArava.
Arava haigamuchirwi nevarwere vane hutachiona hwekudzivirira muviri, bone marrow dysplasia, kana zvirwere zvakakomba kana zvisingadzorwi.
Nhoroondo dzakawanda dzepancytopenia, agranulocytosis, uye thrombocytoplenia dzakashumwa. Ropa rinokosha rinofanira kuitwa nguva dzose kutarisa kusakanganisika.
Nyaya dzakawanda dzeStevens-Johnson syndrome uye chepidermal necrolysis, uye DRESS (zvinodhaka zvinodhaka ne eosinophilia uye systemic zviratidzo) zvakataurwa kune varwere vanobatwa neArava. Kana izvi zvikaitika, Arava inofanira kumira uye kushandiswa kwezvinodhaka kunogona kutanga.
Peripheral neuropathy yakataurwa kune vamwe varwere vanotora Arava. Nepo pane dzimwe nguva, zviratidzo zvinopedzisira zvisiyiwa neArava, vamwe varwere vakanga vane zviratidzo zvinoramba zvichiripo.
Sources:
Arava Tablets. Kunyora Mashoko. Sanofi-Aventis US Revised November 2014.
Leflunomide (Arava). American College of Rheumatology. Yakavandudzwa May 2015.