I-Methotrexate yisisifo sokuguqula i -antirheumatic drug (DMARD) esetyenziselwa ukunyanga i- rheumatoid arthritis kunye nezinye izifo ze-rheumatic. I dose esetyenziselwa i-rheumatoid arthritis ithathwa njengephantsi. Ngokwahlukileyo, i-methotrexate isetyenziselwa nje ngokuba ngumhlaza wonyango ophezulu kunye namayeza aphezulu ukuphelisa ukukhulelwa kwe-ectopic.
Ukuthetha ngokwemfundo, i-methotrexate yi-dihydrofolate iyanciphisa i-inhibitor ephazamisa i-purine metabolism.
Oko kuthetha, kunokukhokelela ekungaqhelekanga kwi-ribonucleic acid kunye ne-deoxyribonucleic acid. I-Methotrexate yi-teratogen eyaziwayo, echazwa njengento nayiphi na into, umzimba, okanye inkqubo eyenza ukungaphumeleli kwi-fetus. I-Methotrexate ingabangela ubuso be-dysmorphic facial, ukungaqhelekanga kwekhayi kunye nezinyathelo, ukusilela kokukhula, ukulibaziseka kokuphuhliswa, nokulibala kwengqondo.
Ubunzima beengxaki zobuntwa buyenza ukuba izidakamizwa zixhalabele abo bexesha lokubeletha, abo baceba ukukhulelwa, ngakumbi abo bakhulelwe xa bephathwa nge-methotrexate.
Iimpawu ze-Fetal kunye nokukhulelwa Ukulahleka okuhlangene ne-Methotrexate
Abasetyhini kufuneka baqaphele umngcipheko wokulahla komntwana kunye nokulahleka kokukhulelwa okuhambisana kunye ne-methotrexate, nangona izinga lomntu ongaphantsi kwe-fetal lubonakala liphantsi. Kuhlolisiso lwesiFrentshi, abafazi abaneengxaki ezingapheliyo eziphazamisayo eziphathwe nge-dosetrexate encinci ye-dose ngexesha le-trimester yokuqala bavavanywa.
Kwimiba engama-28 ehlalutyiweyo, i-methotrexate ukuchasana iphelile ngaphambi kweeveki ezili-8 kwi-women's 26. Abasetyhini abane babenemiphulo embi, ngelixa ama-5 akhetha ukupheliswa kokukhulelwa. Kwakukho ukuzalwa oku-19, oku-3 apho kwakungakabikho. Abaphengululi baphetha ukuba iziphumo zabo zixhasa ingcamango yokuba akukho mngcipheko onamandla we-teratogenic nge-dosetrexate ye-dose ephantsi, ukubonelela ukuba isicatshulwa sagqitywa ngokukhawuleza xa ukhulelwe.
Olunye uphando lubhekisele kwi-8 methotrexate-ukukhulelwa okubonakalayo. Kwakukho imeko enye ye-methotrexate embryopathy echazwe. Kwimeko yokuqala enjalo itholakala kubantu abathatha umthamo we-methotrexate esezantsi ngesonto eliphantsi (isifo esiqhelekileyo sesifo se-rheumatic). Nangona kwakungomnye umzekelo, abaphandi baphetha ngelithi ukucinga kwe-methotrexate ukhuseleko kumanani aphantsi asemva.
Kuthiwani Ngabantu?
Ngokutsho kweDrugs.com, ukukhulelwa kufuneka kugwenywe ngumlingane okanye iqabane eliphathwayo kunye ne-methotrexate. Ukukhulelwa kufuneka kugwenywe ngexesha lokunyanga kwaye ubuncinane ubuncinane kwiinyanga ezintathu emva kokunyangwa kwezigulane zendoda, nangethuba lokunyanga kwaye ubuncinane umjikelezo owodwa wentsholongwane emva kokuba unyango lwezigulane zezilwanyana.
Kukho umngcipheko wemvelo wokuguqulwa kwesidoda kumadoda athatha i-methotrexate, kodwa akabonakalwanga. Kwakhona, ngokutsho kweNcwadi yeRheumatology , ukutshatyalaliswa kwe-methotrexate yobazali ngexesha lokukhulelwa kungabonakali ukuphakamisa inkxalabo okanye imiba yomntwana.
Ngaphantsi
Kukho ixesha elikhuselekileyo le-100% lokungabikho komzimba kwi-methotrexate. Impembelelo ye-methotrexate ibonakala ingenakulinganiswa, inxenye ngenxa yokungafani kofuzo kwimpendulo ye-placental ne-fetal kwi-toxins.
Emva kokutshatyalaliswa kwe-methotrexate ngethuba lokuqala lokuqala, umama okhetha ukuqhubeka nokukhulelwa kufuneka azi ukuba kukho i-10/42 ithuba lokungaqhelekanga kwi-fetus (i-QJM: i-International Journal of Medicine).
Ngokutsho kwe- Kelley's Bookbook yeRheumatology , abafazi bayacetyiswa ukuba bayeke i-methotrexate ubuncinane kwiinyanga ezintathu ngaphambi kokukhulelwa. Ukuxhaswa kwe-folic acid kufuneka kuqhutywe ngokukhulelwa. I-American College yeRheumatology icebisa ukusetyenziswa kokuqhawula ngokuchanekileyo ngexesha lokuthatha i-methotrexate kunye neenyanga ezintathu emva kokumisa methotrexate.
Imithombo:
I-Methotrexate (iRheumatrex, iTrallall). Ikholeji yaseMerika yaseRheumatology. UMichael Cannon, ngo-Meyi 2012.
http://www.rheumatology.org/Practice/Clinical/Patients/Medications/Methotrexate_(Rheumatrex,_Trexall)/
Umthamo ophantsi we-methotrexate kwi-trimester yokuqala yokukhulelwa: iziphumo zoFundo lwesiBambiswano. Lewden B et al. Journal of Rheumatology. Disemba 2004. http://www.ncbi.nlm.nih.gov/pubmed/15570635
I-Methotrexate Embryopathy Emva kokuboniswa kwiiNqanaba eziPhantsi kweeVeki eziKhulelweyo. UMartin MC, et al. Utywala. Oktobha 26, 2013. http://www.ncbi.nlm.nih.gov/pubmed/24513926
I-Methotrexate Ukukhulelwa kunye neZilumkiso. Drugs.com.
http://www.drugs.com/pregnancy/methotrexate.html
Ukuboniswa kwabazali kwiZiko leMettretreate kunye neziPhumo zokuKhulelwa. Journal of Rheumatology. Beghin, et al. NgoJanuwari 15, 2011.
http://www.jrheum.org/content/early/2011/01/11/jrheum.100600
Imiphumo ye-methotrexate ekukhulelweni, ukuzala kunye ne-lactation. I-QJM: I-International Journal of Medicine. 1999.
https://academic.oup.com/qjmed/article/92/10/551/1531030/Iziphumo- eziphene-
I-Kelley's Bookbook yeRheumatology. Elsevier Saunders. Umqulu I. Ukukhulelwa kwiiRheumatic Diseases. Isahluko 39. Page 552.