Ama-NSAID aphakathi kwezidakamizwa ezivame ukwedlula zonke
Ama-NSAID (izidakamizwa ezingavumeli ukuvuvukala) ezingenwa yi-arthritis ngokuphazamisa inqubo yokuvuvukala. Ama-NSAID yiqembu elikhulu lezidakamizwa ezisetshenziswa kakhulu ukuphatha i-arthritis ngenxa yazo:
- izakhiwo ze- analgesic (ukubulala ubuhlungu)
- izakhiwo ezilwa nokuvuvukala
- antipyretic (ukunciphisa umkhuhlane)
Izigaba ze-NSAID
Kunezinhlobo ezintathu zama-NSAID:
- i-salicylates (kokubili i-acetylated, efana ne- aspirin , ne-nonacetylated)
- ama-NSAID wendabuko
- I-COX-2 inhibitors ekhethiwe
Ama-NSAID avame ukusetshenziswa ase-arthritis afaka:
- Kuthunyelwe (igama elivamile lesi-flurbiprofen)
- I-Arthrotec (igama elivamile elithi diclofenac ne-misoprostol)
- I-aspirin (i-acetylsalicylic acid)
- I-Cataflam (igama elivamile elithi diclofenac potassium)
- I-Celebrex (igama elivamile elibizwa nge-celecoxib)
- I-Clinoril (igama elivamile lesi-sulindac)
- I-Daypro (igama elivamile le-oxaprozin)
- I-Disalcid (igama elivamile lesi-salsalate)
- I-Dolobid (igama elivamile eliyi-diflunisal)
- UFeldene (igama elivamile elithi piroxicam)
- Ibuprofen (amagama angama brand ahlanganisa uMotrin, Advil, Mediprin, Nuprin, Motrin IB)
- I-Indocin (igama elivamile ku-indomethacin)
- Ketoprofen (amagama amagama ahlanganisa i-Orudis, i-Oruvail, i-Actron, i-Orudis KT)
- I-Lodine (i-etodolac ejwayelekile)
- I-Meclomen (igama elivamile elithi meclofenamate sodium)
- I-Mobic (igama elivamile elithi meloxicam)
- I-Nalfon (igama elivamile elithi fenoprofen)
- I-Naproxen (amagama omuthi afaka iNaprosyn, i-Aleve, i-Naprelan, i-Anaprox)
- I-Ponstel (igama elivamile elithi mefenamic acid)
- Relafen (igama elivamile elithi nabumetone)
- I-Tolectin (igama elivamile igama le-tolmetin sodium)
- Hlanganisa (igama elivamile igama le-magnesium trisalicylate)
- I-Voltaren (igama elivamile igama le-diclofenac sodium)
Indlela ama-NSAID asebenza ngayo
Ngamazwi alula, ama-NSAID asebenza ngokuncipha ukuvuvukala. Benza lokhu ngokuvimbela i-enzyme eyinhloko yokuvuvukala okuthiwa i-cyclooxygenase, eguqula i-arachidonic acid kuma-prostaglandins nama-leukotrienes.
I-Prostaglandins ibangela ukuvuvukala kwendawo. Ngakho-ke, ngokuvimbela i-cyclooxygenase, ama-NSAID anciphisa ukuvuvukala .
I-NSAID ethile ingase isebenze kangcono kuwe kuneyodwa owazama ngaphambili - noma ingase ingasebenzi nhlobo. Lokhu kungenxa yokuthi kukhona okushiwo ngokuthi umehluko we-pharmacokinetic - inqubo lapho isidakamizwa sithathwa khona, sisatshalaliswa, senziwe ngendlela efanele futhi sichithwa.
Okuningi ku-Cyclooxygenase Enzyme
Kunezinhlobo ezimbili ze-cyclooxygenase, eyaziwa njenge-COX-1 ne-COX-2. I-COX-1 ihilelekile ekulondolozeni izicubu ezisempilo zesisu nezinso zezinso. I-COX-2 yi-enzyme ephethwe ukuvuvukala. Ngenxa yokuthi i-NSAID yendabuko ivimba kokubili i-COX-1 ne-COX-2, ingaba nemiphumela emibi engafuneki, njengokucasuka kwesisu noma ukusebenza kwezinso. Yingakho abacwaningi bethola i-NSAIDS evimba kuphela i-COX-2 kuphela. Lezi-inhibitors ze-COX-2 ezikhethiwe yiqembu elisha lama-NSAID.
Imisebenzi ye-FDA Yonke I-NSAID
Ngo-2004, umkhiqizi we-COX-2 inhibitor wokukhetha i-Vioxx ngokuzithandela wasihoxisa emakethe ngemuva kokufundwa kwezemfundo kwabonisa ukusetshenziswa kwesikhathi eside kungandisa ingozi yokuhlasela kwenhliziyo nokushaywa yisifo sohlangothi. Ukubuyekezwa okulandelwayo yi-US Food Administration and Drug Administration kwaholela ekudingisweni kuka-2005 ukuthi wonke ama-non-aspirin NSAID aphethe isixwayiso esihlobene.
Kubalulekile ukuxoxa ngalezi zingozi ezingase zibe khona nodokotela wakho. (I-aftermath ishiye kuphela i-COX-2 inhibitor emakethe - i-Celebrex.)
Ukusebenza kwama-NSAID
- Ubuhlungu nokuvuvukala ngezinye izikhathi kuvela ngesigqi se-circadian (umjikelezo wemihla ngemihla esekelwe isikhathi samahora angu-24). Ngakho-ke, ama-NSAID angase aphumelele nakakhulu ngezikhathi ezithile.
- Iziguli ezingaba ngu-60% zizophendula kunoma iyiphi i-NSAID eyodwa. Isikhathi sokuhlola samasonto amathathu kufanele sikuvumele isikhathi esanele sokukwazi ukuthi ngabe izidakamizwa zikusebenzela yini. Ngeshwa, cishe iziguli ezingu-10% zeziguli zesifo se-rheumatoid zizothola ama-NSAID awasebenzi kuwo.
- Ama-NSAID angakwazi ukufihla izimpawu nezimpawu zokutheleleka.
- Imiphumela emibi ye-NSAID engenzeka nganoma yisiphi isikhathi ihlanganisa ukwehluleka kwezinso, ukungasebenzi kwesibindi, ukuphuma kwegazi, nesisu esiswini (isisu) sesilonda.
- Ama-NSAID (ikakhulukazi i-indomethacin) angaphazamisa imithi esetshenziselwa ukulawula ukucindezeleka okukhulu kwegazi nokuhluleka kwenhliziyo (njengezithandani ze-beta-adrenergic, i-angiotensin-yokuguqula i-enzyme inhibitors, noma i-diuretics).
- Ucwaningo oluthile lubonisa ukuthi ukusetshenziswa kwe-NSAID yesikhathi eside kungase kuphuthumise ukulahlekelwa kwe-cartilage ehlangene, kodwa ucwaningo olungaphezulu luyadingeka.
Okubalulekile
Awukwazi ukubikezelwa ukuthi i-NSAID izokukhonza kangcono kakhulu. Ayikho i-NSAID eyodwa eye yaboniswa ukuthi iphakeme ngaphezu kwamanye ukusizwa ubuhlungu. Uma ngabe i-NSAID ikhethiwe, umthamo kufanele ukwandiswe kuze kube yilapho ubuhlungu bukhululiwe noma kuze kube sekufinyelelwe umthamo obekezeleleke owenziwe. Impendulo yesiguli kufanele ibe yisiqondiso sokukhetha umthamo ofanele, usebenzisa umthamo ophansi kunazo zonke ukuthola ukukhululeka kobuhlungu. Hlala uxoxisana ngezinzuzo kanye nezingozi ezingenzeka ze-NSAID nodokotela wakho.
> Imithombo:
> I-Duke University Medical Center Book of Arthritis, uDavid S. Pisetsky, MD, Ph.D. 1995.
> I-New England Journal of Medicine, 324 (24): 1716-1725, 1991