Olunye uhlobo lweNyango
Kukho iindlela ezahlukeneyo zonyango kubantu abanomlinganiselo othe ngqo kwi-psoriasis okanye i-psoriatic arthritis. Elinye i-arhente esetyenziswa ngokuqhelekileyo yilisi ye-leflunomide. Kungaba nengqiqo kuwe ukuba isifo sakho asiphendulanga kakuhle, okanye ukuba awukwazi ukuthatha ezinye iindlela zonyango.
Yintoni i-Leflunomide?
I-Leflunomide (igama loorhwebo u-Arava) liziyobisi zomlomo ezingasetyenziselwa ukuphatha i-psoriatic arthritis kunye nokulinganisela kwi-psoriasis enamandla.
Igama lekhemikhali liyi-N- (4'-trifluoromethylphenyl) -5-methylisoxale-4-carboxamide.
I-FDA yavunywa ngokusemthethweni i- leflunomide ukwenzela unyango lwe-rheumatoid arthritis. Ukuthetha ngokusemthethweni, i-leflunomide ayizange ivunyiwe yi-FDA ukuphatha i-psoriasis kunye ne-psoriatic arthritis-iimvavanyo zeeklinikhi eziyimfuneko azizange zenziwe. Nangona kunjalo, i-psoriasis kunye ne- rheumatoid arthritis ziimeko ezizenzekelayo zokuphazamiseka ezingathintela amalunga, kwaye zikwabelana ngeenkqubo ezifanayo zomzimba. Ezinye izifundo zonyango zibonisa ukuba i-leflunomide iphumelele ekuphatheni iimpawu zesikhumba kwi-psoriasis kunye neempawu zesikhumba kunye kunye kunye kunye nabantu abane-astoriatic arthritis. Ngoko oogqirha bodwa bakhupha iilisi "ngaphandle kwelebula."
I-Leflunomide ngenye yezilwanyana zamandulo eziqhelekileyo ezingasetyenziselwa ukuphatha i-psoriasis enesisindo kunye ne-psoriatic arthritis. Oko kubeka kwiqela nge methotrexate, cyclosporine, kunye nezinye iziyobisi.
Nangona kunjalo, i-leflunomide ayisebenzisi ngokuqhelekileyo njengalezi ezinye iziyobisi. Unokuva ezi zonyango ezibizwa ngokuba yi-DMARD okanye izidakamizwa zokuguqula izifo. Njengalezi zonyango, i-leflunomide ayikho enye yezilwanyana ezinokutsha "eziphilayo" ezenziwe kwiiprotheni zabantu okanye zezilwanyana.
I-Leflunomide isebenza njani?
Indlela yokusebenza ye-Leflunomide ayikwazi ngokupheleleyo.
Nangona kunjalo, kubonakala ukuba isebenza ubuncinci inxalenye ngokukhubaza i-enzyme efunekayo ukwenza iDNA entsha (izinto ezizalwe njengezofuzo). Xa kwenzeka ukuvuvukala, umzimba wakho wenza amatsha omzimba omzimba omzimba. Ngokunciphisa i-DNA synthesis, i-leflunomide inokukwazi ukuvimba ukuvutha okubangela iimpawu ze-psoriasis kunye ne-psoriatic arthritis. Nangona kunjalo, ngenxa yokuba igxotha i-immune system, ingaba neminye imiphumo emibi.
Ndithatha njani i-Leflunomide?
Thatha i-leflunomide ngomlomo kunye nokutya, njengoko kuchazwe ngugqirha wakho. Isilwanyana sifumaneka kwi-10mg, 20mg kunye neifom 100mg. Xa uqale uqale izidakamizwa, ugqirha wakho unokunika umthamo omkhulu kunesiqhelo, obizwa ngokuthi "ukulayisha umthamo" (ngokuqhelekileyo i-100mg iintsuku ezintathu). Emva kokuba inqanaba leziyobisi likhuphuke emzimbeni wakho, uya kuthatha umthamo wezondlo ophantsi (ngokuqhelekileyo i-20mg yemihla ngemihla).
Ngubani Ozuza NgeLeplunomide?
Kukho iintlobo zezinye izidakamizwa zomlomo zonyango ukuphatha i-psoriasis, njenge-methotrexate. Ezinye izilwanyana ezinjengezilwanyana ezinjenge-Enbrel (etanercept) nazo ziyafumaneka. Oogqirha ngokuqhelekileyo balela kuphela i-leflunomide emva kokunye ukhetho lwezokwelapha aluphumelelanga. Nangona kunjalo, iziyobisi ze-biologic ezitsha kufuneka zithathwe kwi-vein, kwaye zibiza ngaphezu kwezilwanyana ezingezizo ze-biologic.
Ukuba esinye isidakamizwa somlomo asizange sisebenzele wena, ungase ufune ukuzama i-leflunomide ngaphambi kokuba uhambele kwisixhobo se-biologic. Kwezinye iimeko, ugqirha wakho unokumisela i-leflunomide ngaphezu kwenye imithi yomlomo, njenge-methotrexate.
Abantu abane-psoriasis enobuqhetseba kufuneka basebenzise imithi yezolimo kunye nemithi engeyomlomo njenge-leflunomide.
Iimiphumo ezingasetyenziswayo ze-Leflunomide
Ezinye zezona ziphumo eziqhelekileyo ezichaphazelekayo ezibangelwa i-leflunomide zibangelwa ukucaphuka komzimba wesisu. Umzekelo, ezi ziquka:
- Idayarrhea (eqhelekileyo)
- I sizathu
- Isisu esimoshakele
Ezinye iziphumo ezichaphazelekayo ziquka:
- Rash (ayinqabile kakhulu)
- Ukulahleka kweenwele
- Ama-enzyme ezinobindi (ezibonisa umonakalo wesibindi)
- Umngcipheko ophezulu wokusuleleka
- Iiseli zegazi ezinciphile okanye iiplatelet (ukusuka ekuveleni komlinganiselo kwintsipho yethambo)
Ezinye iziphumo ezinqabileyo ezingalindelekanga zi:
- Pulmonary fibrosis
- Ubuhlungu kunye nokucoca
- Izimpawu ze-neurological like disorientation okanye utywabile
Iimviwo kunye novavanyo lweLebhulo ngelixa lithatha i-Leflunomide
Ngaphambi kokuqala i-leflunomide, ugqirha uya kuthatha imbali yakho yonyango kwaye enze uvavanyo lomzimba. Oku kunceda ugqirha wakho aqiniseke ukuba akukho sizathu sokuba i-leflunomide yayiya kukhetho olubi kuwe. Qinisekisa ukuxelela ugqirha wakho malunga nawo onke amayeza owathathayo, kuquka amachiza amaninzi. Ezi zinokuchaphazela ukuphumelela kwe-leflunomide kunye nobungozi bayo.
Ngenxa yengozi yemiphumo ethile yecandelo leziyobisi, abantu abathatha i-leflunomide badinga iimvavanyo ezithile zebhoratri eziqhelekileyo. Uya kufuneka ezi zinto phambi kokuba uqale ukuqala unyango kwaye emva kwexesha eliqhelekileyo. Umzekelo, unokufuna iimvavanyo ezilandelayo:
- Gcwalisa inani legazi (ukujonga iiseli zakho ezibomvu zegazi, iiseli zegazi ezimhlophe kunye neeplatelet)
- Iimvavanyo zesibindi, njenge-ALT
Abantu abathatha i-leflunomide nabo bafuna uvavanyo lokuqala lokuhlola ukuqinisekisa ukuba abanalo isifo esiqhekezayo sesifo sofuba. (Izidakamizwa ezifana ne-leflunomide zenza ukuba isifo sisebenze ngakumbi.)
Iigciwane kunye neLefununide
Abantu abathatha i-leflunomide akufanele babe neentlobo ezithile zeigonti eziqulethe inxalenye yentsholongwane ephilayo. Oko akuthethi ukuba akufanele uthathe zonke izitofu-vele ucele ugqirha wakho kuqala. Unokufuna ukufumana ezithile izitofu (ezifana ne- tetanus booster ) ngaphambi kokuba uqale ukuthatha i-leflunomide.
Ngubani ongenakukwazi ukuthatha i-Leflunomide?
Awufanele uthathe i-leflunomide ukuba unolwazi oluchasayo kwisilwanyana okanye esinye sezixhobo zalo. Kwakhona akufanele uthathe i-leflunomide ukuba isistim somzimba sakho sikhatyathelwe yiyiphi na elandelayo:
- Isifo esinamandla sokugonywa kwe-immunodeficiency
- Iingxaki ezikhoyo kunye nomnatha wakho wethambo
- Usulelo olukhuselekileyo olukhoyo
Abafazi abakhulelweyo nabo akufanele bathathe i-leflunomide.
Ukukhupha abantwana kunye neLeplunomide
I-Leflunomide yipilisi ye-X ngexesha lokukhulelwa, oko kuthetha ukuba izingozi eziyaziwayo zeziyobisi zingaphezu kwamancedo. Kucatshangelwa ukunyusa umngcipheko wokufa komntwana kunye nokukhubazeka kokuzalwa. Bonke abasetyhini abanokuzala abantwana kufuneka babe nokuhlolwa kokukhulelwa ngaphambi kokuqala isiza. Kufuneka uqhubeke nokusebenzisa ukukhulelwa kokuthenjwa ngexesha lonke uthabatha i-leflunomide.
Ukuba uthatha i-leflunomide kwaye ukhulelwe, biza i-ofisi yakho ugqirha ngokukhawuleza uze ubatshele imeko yakho. Ugqirha wakho unokukucebisa malunga nomngcipheko wokuba ukhulelwe. Ugqirha wakho unokukwazi ukunikezela unyango olukhuselayo (olubizwa ngokuba yi-cholestyramine) olunokuthi linciphise ngokukhawuleza i-concentlations of leflunomide. Oku kunciphisa umngcipheko wokulimaza kumntwana.
Ukuba uthabatha kwaye unqwenela ukuba ukhulelwe, khuluma nodokotela wakho ngaphambi kokuba uqale ukuzama ukukhulelwa. Kunconywa ukuba bonke abafazi besigaba sokubeletha bahambe ngokusebenzisa izidakamizwa ukuba bangabikho ngokukhawuleza okujoliswe phantsi kwe-leflunomide. Oku kubaluleke ngakumbi kubafazi bazama ukukhulelwa. Ngaphandle kokuhamba kweli nqanaba, kungathatha iminyaka emibini ukuba i-leflunomide iwele kumanqanaba aphephile kwintsana emzimbeni wakho. Abasetyhini nabo mabaze bathathe i-leflunomide ngelixa beselisayo.
Iingcali zenzululwazi zikholelwa ukuba i-leflunomide mhlawumbi ayinakwandisa ingozi yokuzalwa kwezilwanyana zokubeleka kwabantwana abazala abantwana. Nangona kunjalo, ezi zifundo zezilwanyana azizange zenziwe. Ukuze ugweme nayiphi na ingozi, amadoda kufuneka ayeke ukuthatha isilwanyana ngaphambi kokuzama ukukhulelwa kunye neqabane lawo. Ngokufanelekileyo bafanele bahambe ngokusebenzisa izidakamizwa ukukhawuleza.
ILizwi
Ngenhlanhla, ngoku kukho inani lezinto ezikhethwa ngabantu abanomlinganiselo othe ngqo kwi-psoriasis okanye i-psoriatic arthritis. I-Leflunomide inokuba yinto enye yokuqwalasela ukuba into oyenzile ayizange ilawulwe kakuhle isifo sakho.
> Imithombo:
> Arava. Ulwaziso loLwazi . I-Bridgewater, NJ: iSanofi-Aventis; 2010.
> Leflunomide (Arava). Ikholeji yaseMerika yaseRheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Leflunomide-Arava. Ukuhlaziywa ngoMashi 2017.
> Menter A, Korman NJ, Elmets CA, et al. Izikhokelo zokunyamekela ukulawulwa kwe-psoriasis kunye ne-psoriatic arthritis: icandelo 4. Izikhokelo zokunyamekela ulawulo kunye nonyango lwe-psoriasis kunye nama-systemic agents. J Am Acad Dermatol . 2009; 61 (3): 451-85. i-doi: 10.1016 / j.jaad.2009.03.027.