I-NSAID ziphakathi kwezidakamizwa eziqhelekileyo eziqhelekileyo
I-NSAID (izidakamizwa ezichasene ne-antisteroidal anti-inflammatory) zilwa ne-arthritis ngokuphazamisa inkqubo yokuvuvukala. Ii-NSAID ziqela elikhulu lamachiza esetyenziswa ngokubanzi ekuphatheni i-arthritis ngenxa yabo:
- izakhiwo ze- analgesic (ukubulala ubuhlungu)
- izakhiwo ezichasayo
- i-antipyretic (i-fever-reduction)
NSAID I ziqendu
Kukho iintlobo ezintathu ze-NSAID:
- i-salicylates (zombini i-acetylated, njenge- aspirin , kunye ne-nonicetylated)
- NSAID zemveli
- I-COX-2 inhibitors ekhethiweyo
Ii-NSAID ezisetyenziswa rhoqo kwi-arthritis ziquka:
- I-Ansaid (igama eliqhelekileyo elithi flurbiprofen)
- Arthrotec (igama eliqhelekileyo elithi diclofenac kunye ne-misoprostol)
- I-Aspirin (i-acetylsalicylic acid)
- Cataflam (igama eliqhelekileyo elithi diclofenac potassium)
- Celebrex (igama eliqhelekileyo celecoxib)
- I-Clinoril (igama eliqhelekileyo elithi sulindac)
- I-Daypro (igama eliqhelekileyo le-oxaprozin)
- I-Disalcid (igama eliqhelekileyo lisasaza)
- I-Dolobid (igama eliqhelekileyo le-diflunisal)
- UFeldene (igama eliqhelekileyo elithi piroxicam)
- Ibuprofen (amagama e-brand names include Motrin, Advil, Mediprin, Nuprin, Motrin IB)
- Indocin (igama eliqhelekileyo i-indomethacin)
- Ketoprofen (amagama aquka amagama a-Orudis, i-Oruvail, i-Actron, i-Orudis KT)
- ULowine (igama eliqhelekileyo neodolac)
- Meclomen (igama eliqhelekileyo elithi meclofenamate sodium)
- Isibizo (igama eliqhelekileyo elithi meloxicam)
- Nalfon (igama eliqhelekileyo elithi fenoprofen)
- I-Naproxen (amagama egama-magama aquka uNaprosyn, uAleve, iNaprelan, i-Anaprox)
- I-Ponstel (igama eliqhelekileyo elithi mefenamic acid)
- Relafen (igama eliqhelekileyo elithi nabumetone)
- I-Tolectin (igama eliqhelekileyo elithi tolmetin sodium)
- Hlanganisa (igama eliqhelekileyo elithi choline magnesium trisalicylate)
- I-Voltaren (igama eliqhelekileyo elithi diclofenac sodium)
Indlela i-NSAID isebenza ngayo
Ngendlela elula, ii-NSAID zisebenza ngokunciphisa ukuvuvukala. Benza oku ngokuthintela i-enzyme eyintloko ye-inflammation ebizwa nge-cyclooxygenase, eguqula i-arachidonic acid kwi-prostaglandins kunye ne-leukotrienes.
Iprostaglandins yenza ukuba ukutshaya kwendawo. Ngoko ke, ngokuvimbela i-cyclooxygenase, ii-NSAID zinciphisa ukuvuvukala .
I-NSAID ethile inokusebenza kangcono kuwe kunokuba wazama ngaphambili - okanye ayikwazi ukusebenza nhlobo. Kungenxa yento ebizwa ngokuba yi-apmmacokinetic difference - inkqubo eyenziwa ngayo isilwanyana, isasazwa, isetyenziswe, kwaye isuswe.
Oku ngakumbi kwi-Enzyme Cyclooxygenase
Kukho iindlela ezimbini ze-cyclooxygenase, ezaziwa njenge-COX-1 kunye ne-COX-2. I-COX-1 ibandakanyeka ekugcineni isisu esisempilo kunye nezifo zengqondo. I-COX-2 yi-enzyme ejongene nokuvuvukala. Ngenxa yokuba i-NSAID yendabuko ivimba zombini i-COX-1 kunye ne-COX-2, ingaba nemiphumo engathandekiyo, efana nesisu okanye isifo sezintso esinciphile. Yingakho abaphandi bavelisa i-NSAIDS ekhusela i-COX-2 kuphela. Ezi i-COX-2 inhibitors ezikhethiweyo yiqela elitsha lama-NSAID.
Iimpawu ze-FDA kuzo zonke i-NSAID
Ngo-2004, umenzi we-COX-2 inhibitor ekhethekileyo u-Vioxx wayezikhethile ngokuzenzekelayo emakethe emva kokuba uphando lubonakalise ukusetyenziswa kwexesha elide kunokunyusa umngcipheko wokuhlaselwa kwintliziyo kunye nesifo. Ukuhlaziywa okulandelelweyo yi-US Food Administration and Drug Administration kwakhokelela kumfuno ka-2005 yokuba zonke ii-non-aspirin ze-NSAID zithatha isilumkiso esichaphazelekayo.
Kubalulekile ukuxoxa ngezi ngozi ezinokuthi ugqirha wakho. (Emva kokushiya enye i-COX-2 inhibitor kwimarike - iCelebrex.)
Ukusebenza kweeNSAID
- Ubuhlungu kunye nokuvutha kwamanye amaxesha kuvela kwisigqi (circadian rhythm) (umjikelezo wemihla ngemihla esekelwe kwixesha leeyure ezingama-24). Ngoko ke, i-NSAID inokusebenza ngempumelelo kumaxesha athile.
- Phantse i-60% yezigulane ziya kuphendulwa nayiphi na i-NSAID enye. Ixesha lesilingo leeveki ezintathu kufuneka likuvumele ixesha elaneleyo lokuba ukwazi ukuba isilwanyana sisebenzela wena. Ngelishwa, malunga ne-10% yezigulane ze-rheumatoid arthritis ziya kufumana ii-NSAID azisebenzi kuzo.
- Ii-NSAID ziyakubamba iimpawu kunye neempawu zentsholongwane.
- Iziphumo ezimbi ze-NSAID ezinokuthi zenzeke nangaliphi ixesha zibandakanya ukuhluleka kwezintso, ukungasebenzi kwesibindi, ukuphuma kwamanzi, kunye nesisu (isisu) sesilonda.
- I-NSAID (ngokukodwa i-indomethacin) inokuphazamisa amayeza asetyenziswa ukulawula uxinzelelo oluphezulu lwegazi kunye nokungaphumeleli kwintliziyo (njengabantu abathintekayo be-beta-adrenergic, i-angiotensin-yokuguqula i-enzyme inhibitors, okanye i-diuretics).
- Ezinye izifundo zophando zibonisa ukuba ukusetshenziswa kwe-NSAID yexesha elide kunokusenokukhawuleza ukukhawuleza ukulahleka kwe-cartilage, kodwa uphando olungakumbi luyimfuneko.
Ngaphantsi
Akukwazi ukuqikelela ukuba yiyiphi enye iNSAID eya kukulungele ukukhonza. Akukho-NSAID enye ibonakaliswe ukuba iphakamileyo ngaphezu kwabanye ngenxa yosizi lwentlungu. Emva kokuba i-NSAID ikhethiwe, i-dosage kufuneka yinyuswe de ibe intlungu ikhutshwe okanye ide ifikelele kwiqondo elithintekayo. Impendulo yesigulane kufuneka ibe sisikhokelo sokukhetha i-dose efanelekileyo, usebenzisa i-dose ephantsi kakhulu ukufumana ukukhululeka kwentlungu. Qhubeka uxubusha iingenelo kunye nobungozi obunokwenzeka be-NSAID kunye nogqirha wakho.
> Imithombo:
> I-Duke University Medical Centre yeArthritis, uDavid S. Pisetsky, MD, Ph.D. 1995.
> I-New England Journal of Medicine, 324 (24): 1716-1725, 1991