Iziyobisi Zisebenze Ngokungafani Ukukhupha okanye Ukukhusela I-Flare-Ups
Iingcali zonyango ziphambili ekuphatheni abantu abanesifo esingapheliyo sesifo se-pulmonary (COPD) . Esikhundleni sokulinda iipilisi ukuhambisa amayeza ngegazi, i-inhalers ihambisa iziyobisi kumthombo weengxaki, ukufikelela kwiziphumo ezijoliswe ngokukhawuleza.
Kukho i-inhalers equkethe imithi enye (i-monotherapy) kunye nabanye abahambisa iziyobisi ezininzi ngeendlela ezahlukeneyo zezenzo.
Amachiza angaphulwa kwiigaba ezintathu ezibanzi:
- I-bronchodilators emfutshane
- I-bronchodilators ende
- I-steroids ye-inhaled
Nganye isebenza ngokuhlukileyo ekuphatheni okanye ekuthintela i-COPD kwaye inikezela umqolo ongaphantsi kwenye imithi yomlomo okanye injectable.
Bronchodilators ezimfutshane
Abanye abantu abaneCOPD baya kubona kuphela iimpawu (ukuphefumula okufutshane, ukuqhuma) xa bezama. Kuba bantu, oogqirha baya kubeka i-bronchodilator emfutshane, eyaziwa ngokuba yi-inhaler yokuhlangula.
Iibronchodilators zisebenza ngokuvula (ukuhluthisa) iimbotyi zomoya (i- bronchioles ) ezithintela ngexesha le-COPD. Ama-bronchodilator amancinci athetha "ngokukhawuleza kwaye akhawuleze," oku kuthetha ukuba basebenze ngokukhawuleza kwaye banikezele ukuphucula malunga neeyure ezine ukuya ezintandathu. Zifanele zisetyenziswe kuphela xa zifuneka kwaye ziqhutywe naphi na apho uya khona kwimeko yongxamiseko.
Kukho iindidi ezimbini zamachiza ezisetyenziselwa ama-bronchodilator amancinci-bhatta: i- beta-agonists , ebopha abafumana imiphunga kwimiphunga ukuze bayeke ukuphazamiseka, kunye ne- anticholinergics , ebangela ukuba iikhemikhali ezibangele i-spasms.
I-agonists e-short-acting agonists (i-SABAs) njengamanje ivunyiwe e-US yile:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
I-anticholinergic elifutshane elibanjwe kwi-US yile:
- Atrovent (ipratropium)
Kukho ukuhlanganiswa okufakwe kwikhompyutha ebizwa ngokuba yi-Combivent equle ipratropium kunye ne-beta-agonist albuterol.
I-Bronchodilators ende
Abantu abaneCOPD eziphambili zihlala zichongwa ngamachiza angeniswayo athathwe rhoqo imihla nokuba ingaba na iimpawu okanye ayikho. Ezi zi yobisi zithunyelwa njenge-bronchodilators ende.
Abantu abasemngciphekweni ophezulu wokunqongophala banokuzuza kwezi nkunkuma njengoko banikezela ukukhuselwa kwengubo kuyo yonke indawo ukusuka kwiiyure eziyi-12 ukuya kwii-24. Njengoko i-bronchodilators emfutshane, iqukethe i-beta-agonist okanye i-anticholinergic.
I-agonists esebenza ixesha elide (i-LABAs) njengamanje ivunyiwe e-US yile:
- Salmeterol
- I-Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
I-anticholinergics esebenza ixesha elide evunyelwe e-US yile:
- Spiriva (tiotropium)
- Aclidinium
I-Steroids engabonakaliyo
Abantu abane-COPD abanokuthi bangaphenduli kunye nama-bronchodilators asebenza ixesha elide kwaye badla ngokufuna "ukunyusa" okongeziweyo ukugcina umsebenzi wokuphefumula. Kwaba bantu, i-steroids engabonakaliyo ingasetyenziselwa.
I-steroid ye-inhaled, eyaziwa nangokuthi i- glucocorticoids , inomtsalane ochanekileyo wokutshabalalisa kwaye inokunciphisa ngokukhawuleza ukuvuvukala nokuveliswa kwe-mucus kwi-airways. Zisebenza ngendlela efanayo nangomlomo we-steroids kodwa zisebenza ngokukhawuleza kwaye zinciphisa kakhulu umngcipheko we-flare-ups kunye nezibhedlele.
Ziyasetyenziswa ngokuphindwe kabini imihla ngemihla kwaye idinga iiveki ezimbini "ixesha lokulayisha" ngaphambi kokuba zisebenzise ngokupheleleyo.
I-steroids engabonakaliyo esetyenziswa ngokubanzi ekuphatheni i-COPD yile:
- Pulmicort (budesonide)
- Aerospan (flunisolide)
- I-Flovent (i-fluticasone)
- I-Asmanex (i-mometasone)
- IQVAR (beclomethasone)
Kukho neendlela ezintathu zokudibanisa ezibandakanya i-steroids engabonakaliyo:
- Symbicort (formoterol kunye ne-budesonide)
- I-Advair (i-salmeterol kunye ne-fluticasone)
- UBrio Ellipta (vilanterol kunye ne-fluticasone)
Iimiphumo zecandelo le-steroid ezifakwe kwi-inhaled tend to be less profound than those of oral or injected steroids. Zingabandakanya umlomo oqatha okanye umqala, ukuphazamiseka (dysphonia), kunye nomlomo we-candidiasis (thrush).
Ukusetyenziswa kwexesha elide kunxulumene nobungozi obandayo be-glaucoma kunye ne-osteoporosis.
> 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.