Emva koMgangatho oPhezulu weRheumatoid Arthritis
Kwixesha elidlulileyo, unyango lwegolide lwaluyinkqubo efanelekileyo ngokumalunga nokusebenza ngamandla. Izixhobo zegolide zazisetyenziselwa ukunyanga i-rheumatoid arthritis ukususela ngowe-1929. Igolide yenzelwe ukunyangwa njengonyango lwesifo sofuba. Ngaloo xesha, kwakucatshulwa ngokuphosakeleyo ukuba isifo sofuba nesifo se-rheumatoid iimeko ezihambelanayo. Nangona oko kwakungenakulungile, igolide yabonisa impembelelo enesifo se-rheumatoid arthritis.
Ingaba isebenza kanjani
Nangona indlela yokulwa ne-golden-inflammatory effect engacaciswanga ngokupheleleyo, ubungqina bubonisa ukuba igolide igcinwa kwii-lysosomes apho inqanda ukucwangciswa kwamagunya e-antigenic (nayiphi na into evuselela ukuveliswa kwee-antibodies) kunye nokukhutshwa kwee- cytokines ezinokutsha . Ngoko ke ikwahlulelwa njengesichengululo se-anti-rheumatic drug (DMARD) .
Ukufumaneka kweGolide
Iifom zegolide zijojowe kwaye ziquka iMyoschrysine (i-orrothiomalate) kunye ne-Solganol (i-aurothioglucose). I-Ridaura (auranofin) yonyango lwegolide lomlomo. Kule minyaka, njengoko unyango olutsha lwaba luncedo olunikezela ngenzuzo enkulu kunye nomngcipheko omncinci (umz., Ezinye i-DMARD kunye neziyobisi ze-biologic ), ii-injection zegolide zazingavumelekanga ukuba zifumane i-rheumatoid arthritis. Ukusetyenziswa kwayo kuncitshiswe kakhulu ngenxa yengozi yemiphumo emibi, kunye nesidingo sokubeka esweni esecaleni kunye nokuhlolwa kwebhubhoratri, kunye nokuphazamiseka kwesojojo se-intramuscular.
IGosa lilawulwa njani?
Iibhokhwe zegolide zilawulwa njengejoza le-intramuscular kwiofisi yegqirha nganye ngeveki zokuqala zonyango ezingama-20 kwaye i-frequency ishawulwa nganye kwiiveki ezintathu okanye ezine. Ukubala kwegazi kunye nokuhlolwa komchamo kunconywa phambi kwejoza nganye yegolide, ukuqinisekisa ukuba kukhuselekile ukunika.
Ekuqaleni, ijoyi yeesram egolide idlalwa njenge-dologram ye-10-milligram, kanye ngeveki. I-dose ye-25-milligram ye dose ilandela emva koko i-milligram ezingama-50 ngeveki ukuphendula impumelelo, ukuya kuma-milligrams ayi-750 ukuya ku-1000.
Iimpembelelo ezingezantsi Zenza iTrapha yeGolide inzima
Imiphumo emibi, isizathu esivamekileyo sokuyeka ukunyanga kwegolide, sichaphazela malunga neepesenti ezingama-30 zabantu abaphathwa ngamacandelo egolide e-parenteral. Imiphumo echaphazelekayo ehambelana negolide ye-parenteral ibandakanya i-pruritis, i-dermatitis, i-stomatitis, kunye neproteinuria. Ngegolide yomlomo, izitulo ezivulekileyo ziyimpembelelo yecala eliqhelekileyo, ngelixa ihudo lomdaka lwenzeka rhoqo kangako (oluchaphazela kuma-5 ekhulwini kwezigulane). I-Nephropathy kunye ne-thrombocytopenia ingahlakulela kunye neyeza legolide, ingakumbi kulawo mahle kwi-gene HLA-DR3.
Ngelixa iziphumo ezichaphazelekayo ziye zaphazamiseka unyango lwegolide, ku funeka kuqatshelwe ukuba ijoyi zegolide zibeka abantu abane-arthritis ye-rheumatoid ukuxolelwa ngonaphakade. I-Rheumatologist uScott J. Zashin, i-MD yathi, "Ngenxa yoko, ukuba isigulane siphendule kakuhle iilenjini zegolide, zihlala ziqhubeka. Ukuyeka igolide kwezi zi gulane kunokubangela ukuphindaphinda komsebenzi we-arthritis onokuthi ungaphenduli ukuqala kwakhona kwonyango ngegolide. "
Nangona kunjalo, njengoko izibambo zegolide zazisebenzisana kakhulu kwaye zonyango olutsha lwakhiwe, iinkampani ziyeka ukumisa amayeza. Ngethuba kwakukho iifom e zimbini zebhodi zegolide ngexesha elinye (i-Solganol ne-Myochrysine), kuphela i-Myochrysine ifumaneka. Ngokuqhelekileyo, izigulane zihlakulela ukusabela kuyo, ukwenza ukuyeka ukuyeka.
IGold Oral Efaniswa neGold Injectable
Ngelishwa, igolide yomlomo yavelisa kuphela imiphumo emihle, ngoko kwakungavumelekanga. I-Ridaura, ukulungiswa kwegolide ngomlomo, isenokuthi ifumaneke, kodwa ayifumaneka kakhulu kwi-United States. Igolide e-Oral iboniswe ukuba iphumelele ngokumalunga ne-placebo.
Kwakucatshangelwa ngokulinganayo kwi- Plaquenil (i-hydroxychloroquine) kunye ne- methotrexate , kodwa inokuba yinto enobungozi obukhulu.
Ngaphantsi
IGold yi-DMARD endala (izidakamizwa zokuguqulwa kwezifo ezichasene ne-rheumatic) eziphantse, zonke iimeko, zatshintshwa yi-DMARD entsha kunye neziyobisi ze-biologic. Ukusetyenziswa kwe golide kugcinwe kwizigulane ezingaphenduliyo okanye ezingenako ukunyamezela i-methotrexate, ezinye i-DMARD ezindala (njenge-Plaquenil kunye ne- sulfasalazine ), okanye i- TNF blockers .
Imithombo:
> Cush JJ, Weinblatt ME, iKavanaugh A. I- rheumatoid arthritis: ukuxilongwa kwangaphambili kunye nokonyango . I-West Islip, NY: UQhagamshelwano loBugcisa; 2010.
> I-Klinkhoff A. Iimiphumo ezinkulu zonyango lwegolide. Isemgangathweno. https://www.uptodate.com/contents/major-side-effects-of-gold-therapy.
> I-Klinkhoff A. Ukusetyenziswa kweeGold Compounds kwi-Rheumatic Diseases. Isemgangathweno. https://www.uptodate.com/contents/use-of-gold-compounds-in-rheumatic-diseases?source=see_link.