Abantu abahlala nezifo ezingapheliyo zokuphazamiseka kwesifo (COPD) bavame ukushicilelwa i- bronchodilator , uhlobo lwamayeza asetyenziselwa ukuphucula ama-air passages ukukunceda uphefumule ngakumbi. Amachiza ayenziwa ngokufakwe emlonyeni ngokusebenzisa i- inhaler ye-doer (MDI) yamanzi kodwa afumaneka kwi-liquid, ipilisi, injectable, okanye i-formulations.
Iibronchodilators zisetyenziselwa kwisiseko esifanelekileyo okanye sichazwe kabini imihla ngemihla ukukhusela okanye ukunciphisa iimpawu zeCOPD . Izigaba ezintathu ze-bronchodilators eziqhelekileyo ezisetyenziselwa ukuphatha i-COPD zi:
- I-Beta-adrenergic agonists
- Anticholinergics
- Methylxanthini
I-Beta-Adrenergic Agonists
I-Beta-adrenergic agonists (eyaziwa nangokuthi yi-beta-agonists) luhlobo lonyango olubophezela kumamkeli athile kwimiphunga ebizwa ngokuba yi-beta-adrenoceptors. Ngokwenza njalo, banqanda i-trigger kwi-sponchial spasms kwaye avumele ukuba iinguqu ze-airway zivule.
I-Beta-agonists inokuba yinto emfutshane (isebenza iiyure ezine ukuya kweyintandathu) okanye ibambe ixesha elide (i-12 okanye ngaphezulu iiyure). Zithunyelwa ngomlomo okanye nge-MDI. Indlela yokufakelwa ngokuqhelekileyo ikhethwa ngokubanzi njengoko iyanciphisa iimpawu ngokukhawuleza.
I -agonists e-short-acting agonists (i-SABAs) njengamanje ivunyiwe e-US yile:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
I-agonists esebenza ixesha elide (i-LABAs) njengamanje ivunyiwe e-US yile:
- Salmeterol
- I-Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Iipilisi ze-Beta-agonist nazo zisetyenziselwa iifom ezimbili-in-one ezifana ne- Symbicort edibanisa ifotololol kunye ne- corticosteroid enganyakaliyo ebizwa ngokuba yi-budesonide.
Iziphumo zemiphumo yeziyobisi ziqhelekileyo ezinxulumene nomyinge kwaye zibonakala ngokuqhelekileyo ngokusetyenziswa komlomo.
Eziqhelekileyo ziquka ukukhawuleza kwenani lentliziyo (tachycardia), iintlungu zentliziyo, ukuthuthumela kunye nokuphazamiseka kokulala.
Anticholinergics
I-Anticholinergics yimithi ekhusela uhlobo lwe-neurotransmitter eyaziwayo njenge-acetylcholine. Iimbilini ze-parasympathetic (ezinxulumene nomsebenzi ozenzekelayo) ziyimvelaphi eyintloko ye-acetylcholine kwimiphunga. Ngokuthintela ukuveliswa kwezi zinto, ukuphambana nokupasa kwi-airways kupheliswe kakuhle.
I-Anticholinergics ifumaneka kuphela kwifom evulekileyo kwaye inikeze i-bronchodilation ephezulu kunye nemiphumo engaphantsi. I-Anticholinergics ixhamle ngakumbi abo bangenakusebenzisa i-beta-agonists okanye i-methylxanthines ngenxa yesifo senhliziyo.
I-anticholinergics okwangoku ivunyiwe e-US yile:
- Atrovent (ipratropium)
- Spiriva (tiotropium)
- Aclidinium
Kukho ukuhlanganiswa okufakwe kwikhompyutha ebizwa ngokuba yi-Combivent equle ipratropium kunye ne-beta-agonist albuterol.
Imiphumo echaphazelekayo yamacandelo e-anticholinergic ngumlomo owomileyo kunye ne-aftertaste yensimbi. Kwiimeko ezinqabileyo, i-glaucoma yaziwa ngokuba yenzeke.
Methylxanthini
I-Methylxanthini yiklasi ekhethekileyo yeziyobisi eyaziwayo ukunciphisa ukukhutshwa komoya, ukunciphisa ukuvuvukala, kunye nokutshatyalaliswa komsindo.
Inkqubo yabo yesenzo ayilucaciswanga kakuhle, kwaye, ngelixa isebenza kakuhle, iziyobisi aziqhelekanga kusetyenziswa unyango lokuqala ngokubhekiselele kwimiphumo yazo.
I-Methylxanthini ifanelekile kakhulu kubantu abangakwazi ukufumana ulawulo olufanelekileyo kunye ne-beta-agonist okanye i-anticholinergic drugs. Ngokungafani nezinye iindidi ze-COPD ze-bronchodilators, i-methylxanthines ayifakwanga. Ngoku zifumaneka kwiipilisi, i-liquid, intravenous, okanye i-formulations.
Izidakamizwa ezimbini ze-methylxanthine ezivunyiwe e-US zi:
- Theophylline
- Aminophylline
Ngezinye iziphumo iziphumo zingaba zizinzulu, ngokukodwa xa zithunyelwa ngokukhawuleza.
Iimpawu zingabandakanya iintloko, ukulala, isisulu, isifo sohudo, ukubola, ukuphefumula ngokukhawuleza, kunye nokuphefumula. Biza ugqirha wakho ngokukhawuleza ukuba ufumana ukuhlanza, intliziyo engavumelekanga ( dysrhythmia ), okanye ukuthatha.
> Umthombo:
> Vestbo, J .; Buhlungu, S; Agusti, A. et al. Isicwangciso sehlabathi jikelele sokuxilonga, ukulawula, nokukhusela isifo esingasondelanga isifo sompompo. Ngaba i-Respiratory Crit Care Med. 2013; 187 (4): 347-65. INGXELO: 10.1164 / rccm.210204-0596PP.