I-Plaquenil (i-hydroxychloroquine) ithathwa njenge- DMARD endala ( isifo sokuguqula izidakamizwa ezichasene ne-rheumatic). I-Plaquenil yayinokuqala ibekwa njengesichengululo se-malaria, kodwa isetyenziselwa ukunyanga izimo ezithile ze- rheumatic ne- autoimmune ezingahambelani ne-malaria. Ngokuqhelekileyo, i-Plaquenil yinkqubo yokonyango njenge-monotherapy (isetyenziselwe yedwa) kwi- arthritis engumzimba okanye i-combination ofrapy nezinye i-DMARD ukwenzela ukuba isisifo esifanelekileyo.
Imbali Yembali
Imvelaphi ye-antimalarials ibuyele kuma-1630 ePeru. Ngomhla we-1820, iikhemine zacoca i-quinine kwi-bark. Ngokukhawuleza ukuya ngo-1951, xa kwakukho ubungqina obungqina bokuphucula i- lupus kunye ne-rheumatoid arthritis yi-WWII yamaqela ally ababethabatha i-quinine, ebizwa ngokuba yi-quinacrine, ukukhusela i-malaria. Emva kwexesha, ezinye iziphumo ze-quinine zakhutshwa yi-FDA-chloroquine ngo-1952 kunye ne-hydroxychloroquine ngo-1955.
I-Plaquenil inxulumene nemiphumo emibi, eyona nto ibangel 'ingxaki kubantu abanqunywe yiziyobisi. Ukusetyenziswa okukhuselekileyo kunceda ukunciphisa imiphumo engathandekiyo.
1. Nangona i-Plaquenil isilwanyana esidala, kusekhona kwaye imiselwe kwabanye abantu abane-arthritis ye-rheumatoid okanye ezinye izifo ze-rheumatic.
I-Plaquenil yi-DMARD enqunyelwe iminyaka ukunyanga i-rheumatoid arthritis, i-lupus, i- child's rheumatoid arthritis kunye nezinye izifo ezizimele.
Xa i- DMARD yokuqala ye- biologic ithole imvume yo-FDA ngo-1998, kwaye njengokuba ezinye i-biologics zilandelwa kwiminyaka elandelayo, kubonakala sengathi i-Plaquenil iya kuba yinto encinane. Isilwayo sisenza indawo yaso njengendlela yokonyango kwabanye abantu, ngokukodwa ngokubambisana ne- methotrexate , okanye abantu abane-systemic lupus erythematosus.
I-Plaquenil inokukhetha kwabo bazama kwaye bayaphula iziyobisi ze-biologic, abakwazi ukunyamezela i-biologics okanye ukwesaba iziphumo ezichaphazelekayo ezinxulumene ne-biologic DMARD.
2. I-Plaquenil ichazwe njengesifo-sokuguqula isifo, ngamanye amazwi, ukunciphisa intlungu, ukunciphisa ukukhukhumeza, nokukhusela umonakalo kunye nokukhubazeka. Ayaziwa ukuba i-Plaquenil isebenza njani kodwa abaphandi bakholelwa ukuba i-Plaquenil iyaphazamisa uxhulumaniso phakathi kweeseli ezikulo mzimba . Ekugqibeleni, kucatshangelwa ukuba kuvimbele iindlela ezihamba phambili.
3. Isiqhelo sokuqala sesiqalo se-Plaquenil ngu-200 mg kabini ngosuku okanye 400 mg ngosuku, elawulwa ngomlomo, kubantu abanesisindo esingama-80 kg okanye ngaphezulu. Umlinganiselo oqhelekileyo usebenza kubantu abaninzi abathwala i-Plaquenil, kodwa kunokwenzeka ukwandisa okanye ukunciphisa umthamo ngokusekelwe kwiimfuno ngamnye. Kubalulekile ukubukela iimiphumo ezichaphazelekayo kunye nobutyhefu. Kubantu abanomlinganiselo ongaphantsi kwama-80 kg, i-dose yemihla ngemihla imiselwe, ukuya kuma-5 mg / kg ubunzima bomzimba.
4. I-Plaquenil isicatshulwa esenza isigxina. Abantu abathwala i-Plaquenil bangaqala ukuqaphela ukuphucula emva kweenyanga okanye ezimbini. Kungathatha iinyanga ezintandathu ngaphambi kokuba iingeniso ezipheleleyo zePlaquenil zizaliswe.
5. I-Plaquenil ivame ukunyanzeliswa kakuhle, kodwa iziphumo zecala zinokwenzeka.
Iziphumo eziqhelekileyo ezixhaswe kwi-Plaquenil ziquka i-nausea kunye ne-diarrhea. Ukuthabatha amayeza kunye nokunciphisa ukutya okubangela ukuba abantu abaninzi bathathe iziyobisi. Iziphumo eziqhelekileyo ezichaphazelekayo ziquka ukunqanda kwesikhumba, ukunqunyulwa kweenwele kunye nobuthathaka. Impembelelo engacacanga yecala ye-Plaquenil ibandakanya utshintsho olubonakalayo okanye ukulahleka kweso mbono-isiphumo esisecaleni esixhalabisa kakhulu izigulane.
6. Into echaphazelekayo echaphazelekayo echaphazelekayo echaphazela umbono (i-hydroxychloroquine retinopathy), ukuba ibanjwe kusasa, ingaphucula emva kokucima kwe-Plaquenil. Ekubeni umphumo wecala lokulahlekelwa kombono unokwenzeka kodwa unqabile, kubalulekile ukuba uxelele ugqirha wakho malunga nayiphi na inguqu yenguqu ovalayo.
Oogqirha ngokubanzi bayincoma ukuhlolwa kwamehlo rhoqo ngelixa ku-Plaquenil, ukwenzela ukuba utshintsho lwexesha lokuqala lungabanjwa. Emva kokungaqhelekanga, ukutyhefu sele kwenzekile. Nangona iyakutshintshwa xa ibanjwe ekuqaleni, i-hydroxychloroquine retinopathy ayisoloko iguqulelwa.
7. Abantu abathile banomdla ngaphezu kwamanye ukuba baneengxaki zokubona nge-Plaquenil. Kwakhona, umbono oguqulwa kwi-Plaquenil awunqabile, kodwa abantu abathile basengozini enkulu yokuphuhlisa ingxaki. Izigulane ezinobungozi obuphezulu ziza kuquka abo:
uthathe amanani aphezulu e-Plaquenil iminyaka (okt, 1000 g. iminyaka engaphezu kwe-7)
uneminyaka engama-60 okanye ngaphezulu
ziphelile
unesibindi esikhulu okanye isifo sesifo
zine-retinal zangaphambili ezikhoyo, izifo ze-macular, okanye i-cataracts
8. Bonke abantu abaqala unyango lwe-Plaquenil kufuneka babe ne-ophthalmologic yovavanyo lokuqala kwisithuba sokuqala kunyaka wokuqala. Ukuba uvavanyo lokuqala lwe-ophthalmologic luqhelekile kwaye umntu uthathwa njengomngcipheko ophantsi, ukuhlolwa kwakhona akufuneki ukuba kwenzeke iminyaka emihlanu. Kucetyiswa ukuba izigulane ezinobungozi beemviwo zamehlo zonyaka.
9. Ezinye iziyobisi zingasebenzisana ne-Plaquenil, zichaphazela indlela ezisebenza ngayo okanye ezenza ukuba zingasebenzi kakuhle. Tshela ugqirha wakho malunga nawo onke amayeza kunye neenkxaso ezithathayo.
Iziyobisi ezinokusebenzisana nePlaquenil ziquka:
i-antacids
iibhox
digoxin
kaolin
trisilicate ye magnesium
methotrexate
metoprolol
penicillamine
10. Ukuba ukhulelwe okanye ucinga ukukhulelwa, xubusha i-Plaquenil kunye noogqirha bakho. Nangona i-Plaquenil ngokuqhelekileyo ithathwa njengekhuselekile ngexesha lokukhulelwa, kucetyiswa ukuba ulawulo olusebenzayo lokusetyenziswa kokuzalwa lusetyenziswa kwinqanaba lokunyangwa kwe-Plaquenil kunye neenyanga ezintandathu emva kokuba unyango luyekile.
11. I-Plaquenil idibaniswe nezinye izakhiwo ezincedisayo kubantu abanesifo se-rheumatic. Kubantu abaphathwe ngePlaquenil njengesichengiso se-anti-therheumatic drug-modification, le nkunkuma ifumaneke nezinye iziphumo. I-Plaquenil ifumaneka ekuphuculeni iipilisi zepilisi, ukulawula i-glucose kunye nokunciphisa ingozi yesifo sikashukela, kunye nokunciphisa umngcipheko we-thrombosis kubantu abathile abasengozini enkulu.
Imithombo:
Cannon, Michael, MD. Hydroxychloroquine (Plaquenil). Ikholeji yaseMerika yaseRheumatology. Ukuhlaziywa ngoMatshi 2015.
Radis, Charles, DO. I-Plaquenil: Ukususela kwiNyango yeMalariya yokuLawula uLupus, RA. I-Rheumatologist. Meyi 15, 2015.
Ukuhlolwa kwe-Hydroxychloroquine Retinopathy . Isikhundla seNkcazo evela kwi-American College yeRheumatology. Agasti 2016.
UWallace, uDaniel, MD. Izidakamizwa ze-Antimalaria kwiNyango yeZifo zeRheumatic. Isemgangathweno. NgoJanuwari 10, 2017.