Olu khetho oluncinci lunenzuzo kunye neengxaki
Abantu abane psoriasis banokukhethwa kweendlela ezahlukeneyo zokonyango ukulungisa iimpawu zabo. Imveliso yokubuyisela i-retinoid, etholakala kwi-vitamin A, iyona nto inokukhetha. I-Acitretin yenye yonyango olunjalo olufumaneka njengonyango lomlomo. Nangona isetyenziswe kangangoko kunamanye unyango lwe-psoriasis , kunokufanelekile ukuqwalasela abanye abantu.
Iimpawu zeNgqumbo ezingavumelekanga kwi-Psoriasis
I-Keratinocyte yindlela ekhethekileyo yeeseli ezitholakalayo esikhumbeni sakho. Ngesikhumba esiqhelekileyo, la maseli ahlula kwaye aqokelele ngexesha. Kwi-psoriasis, lawa maseli ekhumba ahlukeneyo kwaye aqokelele ngendlela engavamile. Ezi iiseli nazo zibonakaliswe kwimeko yesikhumba esivuthayo esibangela ukuba baziphathe ngendlela ezigulayo. Le nxalenye yezinto ezibangela iimpawu ze-psoriasis.
Indlela i-Acitretin isebenza ngayo
I-Acitretin i-retinoid. Oko kuthetha ukuba kwintsapho efanayo yamachiza njenge-vitamin A (isisombululo esibalulekileyo ekufumaneni ukutya okuthile). Imveliso ye-retinalide yomlomo efana ne-acitretin ifumaneka ukuphatha i-psoriasis ukususela kuma-80s okuqala. I-retinoid yokuqala yomlomo, i-ettinate, isuka yatshintshwa ngumkhiqizo omtsha, acitretin. E-US, igama lomthi we-acitretin ngu-Soriatane TM .
Ama-retinoids afana ne-acitretin angene kwiimbrane zee-keratinocytes. Baya kuguqula ukubhalwa kwezinto ezithile zegesi ezifumaneka kwi-DNA yakho.
(Oko kuthetha ukuba ezinye izakhi zemizimba zingasetyenziselwa ukwenza iiprotheni rhoqo, kwaye ezinye iizakhi zingasetyenziswa kangangoko.) Oku kubangela iziphumo ezincinci, ezifana:
- Ukunciphisa isikhumba somzimba
- Ukunciphisa ukukhula kweeseli ezingaqhelekanga kunye nokwahlukana kweeseli zesikhumba
- Nciphisa ukukhula okungaqhelekanga kwamaseli ekhumba
Ezinye iimveliso ze-retinoid (ezifana ne- tazarotene ) zingasetyenziselwa ukuphatha i-psoriasis, kwaye zabelana ngezinye iimpawu ezifanayo kunye ne-retinoids yomlomo.
Nangona kunjalo, i-acitretin inamandla amakhulu kwiziphumo eziphambili kunezinto eziphezulu ze-retinoids, kuba ithathwa ngaphakathi.
Ngubani Ongayinceda kwi-Acitretin?
I-Acitretin yinkqubo yokonyango kwizigulane ezinokulinganisela kwi-psoriasis enamandla. Oku kudla ngokuchazwa njengabantu abanomnye wezinto ezilandelayo:
- I-Psoriasis igubungela ngaphezu kweepesenti ezili-10 zesikhumba sabo
- I-Psoriasis ngaphezu kwepesenti yelikhumba labo, kodwa ngubani okhupha iimpawu ezinjenge-psoriasis ezinzima ezandleni zabo okanye e-scalp
Abantu abanjalo ngokubanzi badinga imithi yomlomo yendabuko (njenge-acitretin) okanye enye yonyango olutsha lwe-biooric for psoriasis. Abantu abane-psoriasis elula nje badinga kuphela unyango kunye nama-cream creams ukuze kugcinwe imeko yabo.
I-Acitretin inokusebenza ngokukhethekileyo kubantu abaneentlobo ezithile ze-psoriasis . Oku kubandakanya:
- I-Psoriasis echaphazela iintendelezo kunye neengcambu
- I-Psoriasis echaphazela izipikili
- Uhlobo lwe-Pustular psoriasis
- Erythrodermic psoriasis
Izidakamizwa ezindala ze-Psoriasis kunye neNewer Biologic Drugs
I-Acitretin ngenye yeklasi elidala lemichiza ngokumodareyitha kwi-psoriasis enamandla. Izidakamizwa zomlomo ezisetyenziswa ngokuqhelekileyo ezisetyenziswa ngokuqhelekileyo zi-acitretin, methotrexate , kunye ne-cyclosporine. Ezi zi yobisi zisebenziswa ukuba zifakwe ngokuphindaphindiweyo kwizigulane ezinomlinganiselo othe ngqo kwi-psoriasis.
Nangona kunjalo, kwiminyaka yamuva, iziyobisi ezitsha, ezibizwa ngokuthi yi-biologics, ziye zafumaneka. Ezi ziquka izidakamizwa ezifana ne- etanercept kunye ne-adalimumab. Kulo lonke, leziyobisi ezintsha zineempembelelo ezincinci ezibalulekileyo kunezidakamizwa zakudala. Iziyobisi ze-Biologic nazo ziqhelekileyo zonyango ekuphatheni i-psoriasis.
Sekunjalo, kubantu abathile, izidakamizwa ezindala ezifana ne-acitretin zisenokuba yinto ekhethekileyo. Enye inzuzo enkulu yezidakamizwa zendabuko njenge-acitretin kukuba zithathwa ngomlomo. Abanye abantu banokukhetha oku kunyango kwi-biologic, eziqhelekileyo zinikezwa ngogaya. Kwakhona, izidakamizwa ezindala ezifana ne-acitretin zihlala zibiza kakhulu kunezidakamizwa ze-biologic.
I-Acitretin iThengisa njani kwezinye iiMveli zoMlomo zePororiasis?
Xa isetyenziswe ngokwawo, i-acitretin idla ngokuthe ngcembe kunokuba i-methotrexate okanye i-cyclosporine (leminye iminye emibini eqhelekileyo imilwa yomlomo). Nangona kunjalo, mhlawumbi ikhuselekile kunokuba yeyiphi yala machiza ukusetyenziswa kwexesha elide.
Acitretin kubantu abane-Psoriasis abane-Immunosuppression
Elinye iqela lezonyango ze-psoriasis ezinokuncedisa ngokukhethekileyo kwi-acitretin ngabantu abaye banqanda amajoni omzimba. Iziyobisi ze-Biologic kunye nezidakamizwa zomlomo zendabuko ezifana ne-methotrexate zisebenza ngokunyanzelela ukuphendula komzimba womntu. Nangona kunjalo, ngokungafaniyo namanye amachiza, i-acitretin ayinakukukhusela ngokubanzi isistim somzimba sakho. Oko kungenza kube yinkathalo enqwenelekayo kubantu abanesifo sengxaki yokuxilongwa , njengabantu abane-HIV.
Ulwaphulo lweNyango kunye neAcitretin
I-Acitretin ngamanye amaxesha kuthathwa njengonyango olulodwa, kodwa ihlala isebenza ngokufanelekileyo kunye nezinye izibonelelo.
- Ngokukodwa, i-acitretin idla ngokudibanisa ne- phototherapy , mhlawumbi uhlobo lwe-UVB okanye unyango lwe-UVA kunye ne-psoralen (PUVA).
- I-Acitretin ingasetyenziselwa kunye neyeza zonyango ze psoriasis.
- Ngokungafani nezinye izidakamizwa zomlomo zendalo, i-acitretin ingathathwa kunye neziyobisi ze-biologic.
Awufanele usebenzise i-acitretin kunye nomnye umkhiqizo-based vitamin A, kuba oku kunokukhokelela kwi-vitamin A.
Ukunyuka kwe-Acitretin
I-Acitretin ifumaneka kwiifomsile eziyi-10mg, 17.5 mg, okanye 25 mg. Uninzi lweekliniki zinika i-doses phakathi kwe-10mg kunye ne-25 mg ngosuku, kodwa abanye abantu badinga amaxesha aphezulu.
I-Acitretin idla ngokusebenza ngokuthe xaxa kumayeza aphezulu. Nangona kunjalo, imiphumo emibi ingaba yinto enokwenzeka ukuba yenzeke kula manqanaba. Unokuqala ngeqondo eliphantsi kwaye ushukunywe ukuya kumlinganiselo ophezulu ukuba izibonakalisi zakho aziyikuzilungisa, kwaye ukuba awunayo imiphumo emibi yonyango.
Kungathatha inyanga ezintathu ukuya ezintandathu ngaphambi kokuba ufumane impendulo ephezulu kunyango lwakho.
Indlela yokuthatha i-Acitretin
- Thatha i-acitretin ngokutya.
- Thatha ngqo umthamo ochazwe ngumboneleli wakho wezempilo.
- Ukuba ulahlekelwa umthamo, musa ukuphindaphinda umthamo olandelayo. Endaweni yoko, yeqa umthamo kwaye uthathe umthamo oqhelekileyo kwixesha lakho elilandelayo elihleliweyo.
Umboneleli wakho wezempilo uyakukuxelela ukuba yeyiphi na into efanelekileyo kuwe.
Ingozi yokukhulelwa
I-Acitretin ayikho imveliso ekhuselekileyo yabasetyhini abakhulelweyo ukuba bathathe. I-Acitretin inokubangela iintlobo ezahlukeneyo zokukhubazeka kokuzalwa, kubandakanye nezinto ezichaphazela inkqubo ye-cardiovascular, inkqubo ye-nervous, ukuzwa kunye nombono, kunye nezakhiwo zamathambo. Umngcipheko omkhulu kunabesifazana bathatha i-acitretin phakathi kweveki yesithathu neyesithandathu zokukhulelwa kwabo. Oku phambi kwamabhinqa amaninzi ayazi nokuba akhulelwe.
I-Acitretin ayichithwanga ngokupheleleyo ngumzimba kude kube yiminyaka emithathu emva kokuyeka amayeza. Ngenxa yoko, i-acitretin ayifanele isetyenziswe yiyiphi na elandelayo:
- Abafazi abakhulelweyo
- Abacwangcisi besetyhini xa bekhulelwe ngexesha lonyango okanye kwiminyaka emithathu emva kokuyeka unyango
- Abafazi beminyaka yobudala abangenakusebenzisa ukulawulwa kokubeleka okunokuthenjwa ngexesha lokunyanga kunye neminyaka emithathu emva kokunyanga
Kwakungafanele isetyenziswe ngabasetyhini abancancisayo.
Ezinye iingqwalasela malunga nabantwana basetyhini bokubeletha
- I-Acitretin mhlawumbi ayilona unyango olungcono kuwe ngaphandle kokuba une psoriasis enamandla engayithobeli kwezinye iindlela zokwelapha, okanye awukwazi ukuthatha ezinye iindlela zokwelapha ngesizathu esithile.
- Ukuba i-acitretin iyona ndlela ikhethekileyo, uya kufuna iimvavanyo ezimbini zokukhulelwa ngaphambi kokuba uqalise i-acitretin, enye yazo kufuneka yenziwe ngexesha lokuya esikhathini.
- Uya kuluvavanya uvavanyo lokukhulelwa nyanga zonke ngelixa utywala.
- Uya kufuneka usebenzise iindlela ezimbini zokulawulwa kokuzalwa ngelixa usebenzisa izidakamizwa, kwaye emva kweminyaka emithathu emva kokumisa isiza.
Iimpembelelo ezingasetyenziswayo ze-Acitretin
I-Acitretin nayo inokubangela iziphumo ezibi. Ezi ziquka:
- Ukunyuka kwamehlo, impumlo, umlomo kunye nesikhumba
- Bhabha izipikili
- Ukulahleka kweenwele
- Ukuvutha kwengqondo yesikhumba
- Iintsimbi zomzimba
- I sizathu
- Ukukhula kweBony kwintsipho
- Ukwanda kwe- triglycerides
Ezinye iziphumo zempembelelo ezinokuthi zenzeke kwakhona. Ngokuqhelekileyo, i-acitretin inokubangela iingxaki ezinzulu ezifana nokulimala kwesibindi okanye ukuvuvukala kwepascreas. Phantse zonke ezi ngxaki zibuyiselwa ukuyeka unyango. Thetha ngokukhawuleza kumboneleli wakho wezempilo ukuba unokhathazeka.
Ngaphambi kokuqala unyango
Ngaphambi kokuba uqalise unyango lwe-acitretin, uya kufuna imbali yonyango kunye nokuhlolwa komzimba. Unokuphinda ufune iimvavanyo zegazi ukuqinisekisa ukuba ungumviwa ofanelekileyo kunyango. Ezi ziquka oku kulandelayo:
- Uvavanyo lweamafutha egazi (triglycerides kunye ne-cholesterol)
- Izilingo zomsebenzi wesibindi
Ukubeka iliso kwi-Acitretin
Ngenxa yengozi yemiphumo emibi evela ku-acitretin, umboneleli wakho wezempilo uyakufuna ukukubeka iliso. Emva kokuba uqale uqale unyango, unokufuna ukufumana iimvavanyo zegazi rhoqo ukuze uhlolisise isibindi sakho kunye namafutha egazi. Emva kweeveki ezimbalwa kwiziyobisi, kufuneka ukwazi ukutshintshela kwiimvavanyo ezingaphantsi kaninzi.
Ngubani Omnye Akufanele Asebenzise I-Acitretin?
Ukongezelela kubhinqa abakhulelweyo nabasetyhini abanokukhulelwa, amanye amaqela athile abantu kufuneka aphephe i-acitretin. Ezi ziquka:
- Abantu abane- hyperlipidemia
- Abantu abanomzwelo okanye ukungabi naluphi nawuphi na umkhiqizo we-vitamin A
- Abantu abaye baba ne-pancreatitis
Ukongezelela, i-acitretin ayinakuba yilona mveliso engcono kakhulu ukuba unezinye iingxaki zonyango, njenge:
- Uhlobo lwe-1 okanye udidi lwesibini lweswekile
- Isifo sesibindi
- Izifo zesifo
- Iingxaki zokusetyenziswa kakubi kotywala
ILizwi
Ukulawula i-psoriasis yakho ingaba ngumngeni. Ngethamsanqa, le mihla, kukho iinketho zokwenza unyango kubantu abanomlinganiselo olinganayo kwi-psoriasis enzima. I-Acitretin ayisoloko iyona nto ikhethekileyo kubafazi bexesha lokubeletha. Kodwa kubantu abathile, imishanguzo endala njenge-acitretin ingenangqiqo, ngakumbi xa isetyenziselwa nezinye iyeza.
> Imithombo:
> 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.
> I- Soriatane Ukuchazela ulwazi . Allergan. 2017. I-Steifel Laboratories. 2014. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/019821s027lbl.pdf.
> Sarkar R, Chugh S, Garg VK. Acitretin kwi dermatology. Indiya J Dermatol Venereol Leprol. 2013: 79: 759-71. i-doi: 10.4103 / 0378-6323.120721.