Ngaba izigulane ze-arthritis zixhalabele?
Ezinye izigulane ze- rheumatoid arthritis ziyavakala xa zichazwe nge- methotrexate . Isilwanyana saziwa ngokuba yiyayicrotherapy drug used to treat the cancer. Kodwa, ngaba kuchanekile ukuhlukanisa okanye ukuqwalasela i-methotrexate imichiza ye-chemotherapy xa imiselwe i-rheumatoid arthritis? Mhlawumbi oku kubonakala ngathi ngumbuzo ongabalulekanga kwabanye, kodwa ukuba ukungaqondi kakubi kubangela ukwesaba okungenasidingo okanye kugcina izigulane zingasebenzisi iziyobisi ezinokubanceda, umbuzo ubaluleke ngokwenene.
Makhe sicinge ngeenyaniso.
Impendulo emfutshane
Ngaphezulu kweminyaka engama-50 edlulileyo, i-methotrexate yaziswa njengonyango lomhlaza ngenxa yemiphumo yokulwa nayo. Ngaphezulu kweminyaka engama-25 edlulileyo, isilwanyana sele sisetyenziswa njenge -drug-modifying anti-rheumatic drug (DMARD) ukunyanga i-rheumatoid arthritis kunye nezinye izifo ze-rheumatic. I-Methotrexate yenzelwe ukuba yonyango yegolide, okanye iziyobisi ezikhethiweyo, kunyango lwe-rheumatoid arthritis.
Ngokwesahluko se-DMARD kule ncwadi, i- Rheumatoid Arthritis: I-Arthritis ye-Rheumatoid: I-popularityity (i-oral or dosing) ye-weekly dosing), i-dosheji echazwe kakuhle, ukuqala ngokukhawuleza kweenzuzo zekliniki (ngokuqhelekileyo kwi-6 ukuya kwiiveki ezi-8), ukuzinza, izindleko eziphantsi, iinzuzo ezongezelelweyo xa zidibaniswe nezinye i-DMARD regimens, kunye nokukwazi ukubuyisela umonakalo we-radiographic. "
Indlela iMethotrexate isebenza ngayo
Iingxube ezikhankanywe ngasentla zicingelwa ukuba zihambelana nokunqandwa kwe-dihydrofolate yokunciphisa kunye ne-folic acid production.
Xa isetyenziswe njenge-DMARD, iinzuzo ze-methotrexate zibonakala zihambelana nokuqulunqwa kwe-adenosine, nangona kunjalo, umlamli ochasayo onokutsha. Ukuphucula umphumo we-methotrexate kwimveliso ye-folic acid, ukuxhaswa kwansuku zonke nge-folic acid yinxalenye yesiganeko esiqhelekileyo kwizigulane zesifo se-rheumatic.
Xa isetyenziswe njenge-agent ye-chemotherapy, i-methotrexate ivimbela iiseli ekusebenziseni i-folate ukwenza i-DNA kunye ne-RNA, ngaloo ndlela iyancipha ukukhula kweeseli zomhlaza.
Umyinge ophantsi ufunwa njenge-DMARD
Xa isetyenziswe njengesidakamizwa se-chemo, i-methotrexate inikwa ngamanani aphezulu ukuya phezulu. Umthamo ugqitywa ngumlinganiselo wesigulane, uhlobo lomhlaza ophethwe, kunye nomsebenzi wezintso. Amanani amakhulu kunokuba alingana no-500mg / m2 aqwalaselwa phezulu, ngelixa i-50 ukuya ku-500 mg / m2 iphakathi. Umthamo ophantsi uthathwa phantsi kwe-50 mg / m2.
Xa i-methotrexate isetyenziselwa ukunyanga i-rheumatoid arthritis, umthamo uthathwa njengento ephantsi - ngokuqhelekileyo uqala ngo-7.5 ukuya kwi-10 mg / ngeveki. Ukuba kuyimfuneko, idosi inokwandiswa ngokunyuka ukuya kuma-25 mg / ngeveki.
Ukuba iimpembelelo okanye izidakamizwa ziphuhliswa, kubonakala ukuba ukunciphisa umthamo okanye ukutshintshwa komlomo ukuya kwi-methotrexate engenayo ikwazi ukulawula imiba. Iimvavanyo zegazi rhoqo ziqhutyelwa kwizigulane ezithatha methotrexate (inani elipheleleyo legazi, iipilisi kunye neentso zeentso) ukufumana iingxaki ekuqaleni ukwenzela ukuba utshintsho lungenziwa. Ukuba iziganeko ezinqabileyo, ezibi kakhulu, ziyakudinga ukupheliswa kwe-methotrexate.
Ngaphantsi
Xa ucelwa ukuba ube neengxelo malunga nokuba i-methotrexate iyatshiswa kuba isetyenziselwa i-chemotherapy, i-rheumatologist Scott J.
U-Zashin, MD (www.scottzashinmd.com/) waphendula wathi, "Nangona i-methotrexate kwizinga eliphezulu lingasetyenziselwa i-chemo, i-rheumatologists zisebenzisa i-dohotrexate ye-dose ephantsi ngenxa yezinto zayo ezichasayo. ukusebenzisana phakathi kwe- NSAID (unyango oluqhelekileyo lwesifo se-rheumatoid arthritis) kunye ne-methotrexate kodwa akukho nto ivakalelwa kukuba yintsebenziswano enokliniki kunye neqondo eliphantsi leyeza elisebenzisa isifo se-rheumatoid arthritis. Izigulane kufuneka zikhumbule kwakhona ukuba imithi iyalelwe ukuba ithathwe kanye kuphela ngeveki ukukhawulelana nemiphumo emibi. "
Imithombo:
I-Rheumatoid Arthritis: I-Early diagnosis and Treatment. Cush, Weinblatt, neKavanaugh. Uluhlu lwesithathu. Isahluko 11 - Izifo-Ukuguqula izidakamizwa ze-Antirheumatic.
Ukusetyenziswa kwezilwanyana kunye noTyhefu ye-High-Dose Methotrexate. Ann S. LaCasce, MD. Isemgangathweno. Uhlaziywe ngoNovemba 2013.
Methotrexate. American Cancer Society. 12/29/2011.