Imithi ebizwa ngokuqhelekileyo ye-Rheumatoid Arthritis kunye nezinye izifo zeRheumatic
I-Methotrexate (amagama e-brand name Rheumatrex, Trexall, Otrexup , Rasuvo ) eqhelekileyo imiselwe ukunyanga i- rheumatoid arthritis kunye nezinye izimo ze-rheumatic. I-Methotrexate yavunywa yi-FDA ngo-1988 ukwenzela unyango lwe-rheumatoid arthritis. Ngaphambi kokuvunywa kwayo kwi-arthritis ye-rheumatoid, i-methotrexate yayisetyenziselwe ukuphatha i-psoriasis nomhlaza.
Kwakuqala ukuveliswa njengeziyobisi ze-leukemia kuma-1940.
Ngaphandle kwe-rheumatoid arthritis, i-methotrexate inokumiselwa:
- i-psoriatic arthritis
- lupus
- spondylitis engavumelekanga
- vasculitis
- i-arthritis yabantwana (polyarticular)
I-Methotrexate Yenza i-DMARD e-slow-acting ACTIV
I-Methotrexate ibalwa njenge- DMARD ( isicatshulwa -anti-rheumatic drug) . Isilwanyana sisetyenziselwa ukunciphisa intlungu kunye nokuvuvukala okunxulumene ne-rheumatoid arthritis, ukuthintela umonakalo odibeneyo kunye nokunciphisa ingozi yokukhubazeka ngokunciphisa ukunyuka kwesifo. Ukuphuculwa kwe-methotrexate kunokubonakala ngokukhawuleza emva kweeveki ezintathu ukuya ezintandathu, kodwa kungadinga iiveki ezi-12 okanye mhlawumbi ukuya kwiinyanga ezintandathu zonyango ngenzuzo epheleleyo eya kuzaliseka.
Indlela yokuSebenza
I-Methotrexate iphazamisa ezinye i-enzyme ezidlala indima ekusebenzeni komzimba. I-Methotrexate ibimbela i-enzyme dihydrofolate inciphisa. Ngokwenza njalo, ichaphazela ukuveliswa kwefomu ye-folic acid efunekayo kwiiseli ezikhulayo.
Ihlala ingacacanga kakuhle indlela i-methotrexate inciphisa ngayo umsebenzi we-arthritis.
Isistim
I-methotrexate yomlomo ithathwa olunye usuku ngeveki yesifo se-rheumatoid arthritis. Ayithathiwe imihla ngemihla njengamapilisi amaninzi. I-Methotrexate iyatholakala kwiiphilisi eziyi-2.5-milligram. Umlinganiselo wokuqala wabantu abaninzi abadala abane-rheumatoid arthritis yi-7.5 ukuya kwi-10gramgram (ie, iipilisi ezintathu okanye ezine).
Iipilisi ezintathu okanye ezine zithathwa kunye kanye ngeveki (ngosuku olufanayo ngeveki). Ukuba kuyimfuneko, i-dose ye-methotrexate iyonke inokunyuka ibe yi-20 okanye i-25gramgram nganye ngeveki.
Igama legama elithi Rheumatrex dose pack liqukethe amakhadi e-blister equle inani elichanekileyo leepilisi ezithatha iveki nganye. Igama legama elithi Trexall lifumaneka kwi-5, 7.5, 10, ne-15-milligrams. I-Methotrexate iphinda ifumaneke kwifomu ejoyiweyo , eninzi izigulane zikwazi ukuzijoba.
Imiphumela
I-Methotrexate ingenza umsebenzi wesibindi ongaqhelekanga. Kubalulekile ukuba igazi lakho livavanywe ngokusebenza kwentsholongwane ukuze ugqirha wakho angakubeka iliso kwimiphumo engathandekiyo. Ngaphandle kokungaqhelekanga kwintsebenzo yesibindi, iimpembelelo eziqhelekileyo ezichaphazelekayo kunye ne-methotrexate ziyisiphithiphithi kunye nokuhlanza.
Imiphumo ecaleni esele ishiwo-isicupunu, ukuhlanza, kunye nesibindi somsebenzi-sinokuxhomekeka kwintsholongwane. Ukuba unayo nayiphi na imiphumo emibi, ukulungiswa kwenzalo kunokuphelisa ingxaki. Abantu abaninzi abanaso nemiphumo ebalulekileyo xa besethatha i-methotrexate.
Ezinye iziphumo ezichaphazelekayo (ezinye ezinzulu) ziquka:
- izilonda zomlomo
- utywala okanye ukuguquka kancinci kwesikhumba
- isifo sohudo
- kubalwa kwegazi
- umonakalo wesibindi / i-cirrhosis yesibindi (engaqhelekanga)
- umonakalo wezintso
- isifo seemiphunga
- lymphoma
- sulelo
- ukukhwehlela okuqhubekayo
- ukuphefumula okungazange kuchazwe
- ukulahleka kweenwele (ngokugqithiseleyo)
- novelwano lwelanga
Izilumkiso
- Umngcipheko wokwanda komonakalo wesibindi kunye ne-methotrexate kubalulekile kubantu abasela utywala . Ngokufanelekileyo, akufanele utywala utywala xa uthetha methotrexate. Ngakumbi, kunye nodokotela wakho imvume, akufanele ube ngaphezu kwezizizibizi ezimbini ngenyanga.
- I-Methotrexate ayifanele ithathwe ngabantu abanezifo ezingasigxina okanye izifo zesifo. I-rheumatologist inokugqiba isigqibo sokuba i-methotrexate kubantu abanesifo esibindiweyo okanye isifo esifo-kodwa ngokuqapha nokulumkisa.
- I-Methotrexate ingadinga ukumiswa phambi kwenkqubo yokutyanda, okwethutyana, ngelixa uphilisa. Oku kungenxa yempembelelo enokwenzeka kwi-immune system kunye nokwenzeka kwengozi yokwanda kwesulelo.
- Nabani na ophathwa nge-methotrexate kufuneka athathe i-folic acid supplement. Ekubeni i-methotrexate ingumdlali we-folic acid, ukuzalisa i- folic acid ngokuthatha isongezelelo kunceda ukunciphisa imiphumo ethile echaphazelekayo neziyobisi.
- I-Methotrexate akufanele ithathwe ukuba ukhulelwe okanye ucwangcise ukuba ukhulelwe. I-Methotrexate ingabangela iziphene ezinzulu zokuzalwa kunye nokukhulelwa kwengxaki. Kufuneka usebenzise enye indlela yokuqhawula imithi ngelixa uthatha i-methotrexate kunye neenyanga ezintathu emva kokuyeka ukuthatha i-methotrexate. Kubalulekile ukuba uqaphele ukuba nangona umfazi engafanele athathe i-methotrexate ngexesha lokukhulelwa , ukuthatha isidakamizwa akunciphisi ithuba lokukhulelwa kwangaphambili.
- Akufanele uthathe i-methotrexate ukuba uncelisa.
- Akufanele uthathe i-methotrexate ukuba une-anemia enamandla, i-white white cell counts, okanye i-platelet counts counts.
- I-Methotrexate kufuneka isetyenziswe ngokuqaphela ukuba unesimo esenza buthathaka kumzimba wakho.
- Kubalulekile ukukhumbuza ugqirha wakho kuwo onke amayeza owathathayo (umyalelo kunye ne-over-counter-counter). Amanye amayeza kunye nezixhobo zendalo zinganyusa i-methotrexate yetyhefu. Iziyobisi eziyaziwayo ukunyusa i-methotrexate yetyhefu ziquka i-antibiotic Trimethoprim (iBactrim). Ii-NSAID (izidakamizwa ezichasayo ezingekho komzimba), nangona zidlalwa kunye kunye ne-methotrexate, zinokuchaphazela izinga le-methotrexate. Ugqirha wakho kunye nekhemistiya baya kuqaphela ukusebenzisana kwezidakamizwa ezingaphephile.
- I-American College yeRheumatology icebisa ukugwema i-caffeine (ikhofi, itiye, i-cola) kufuphi nexesha oceba ukuthabatha i-methotrexate, njengoko inokuchaphazela ukuthathwa kweziyobisi.
ILizwi
I-Methotrexate iphakathi kwezidakamizwa eziqhelekileyo eziqhelekileyo ezisetyenziselwa ukuphatha i-rheumatoid arthritis. Kwezinye iimeko, kuthathwa yedwa. Kwezinye iimeko, i-methotrexate inqunywe njengenxalenye yonyango oluhlangeneyo, apho kuthathwa kunye nezinye i-DMARD okanye iziyobisi ze-biologic .
Kubalulekile ukuba uthathe i-methotrexate ngokuchanekileyo. Kwakhona kubalulekile ukuba uqaphele iziphumo ezichaphazelekayo kwaye uchaze nantoni na engaqhelekanga ugqirha wakho ngokukhawuleza. I-Methotrexate ingaba yipilisi ekhuselekileyo nesebenzayo xa isetyenziswa ngokufanelekileyo.
> Imithombo:
> Cannon, Michael, MD. Ikholeji yaseMerika yaseRheumatology. I-Methotrexate (iRheumatrex, iTrxall, i-Otrexup, iRasuvo). Ukuhlaziywa ngoMatshi 2015.
> Ulwazi lweMonde. Methotrexate . FDA.gov. Ukuhlaziywa ngo-01/2016.