I-Plaquenil (i-hydroxychloroquine) ithathwa ngokuthi i- DMARD endala ( isifo sokuguqula izidakamizwa eziphikisayo). I-Plaquenil empeleni yayibizwa ngokuthi i-anti-malaria, kepha isetshenziselwa ukuphatha izimo ezithile eziphathelene nokudla okungahambisani nemalariya. Ngokuvamile, i-Plaquenil iyindlela yokwelashwa njengesi-monotherapy (esetshenziselwa yodwa) yesikhumba sesifo sofuba esifushane noma njengokwelashwa okuhlangene namanye ama-DMARD okulinganisa nezifo ezinzima.
Umlando Omncane
Imvelaphi ye-antimalarials ibuyele emuva kuma-1630s ePeru. Ngomnyaka we-1820, amakhemikhali ahlanza i-quinine emgodini. Ngokushesha phambili ukuya ngo-1951, lapho bekukhona ubufakazi bokuthi i- lupus ne-rheumatoid arthritis yi-WWII yamabutho ally ababesebenzisa uhlobo oluthile lwe-quinine, olubizwa nge-quinacrine, ukuvimbela i-malaria. Ngokuhamba kwesikhathi, ezinye izidakamizwa ze-quinine zakhishwa yi-FDA-chloroquine ngo-1952 kanye ne-hydroxychloroquine ngo-1955.
I-Plaquenil ihlotshaniswa nemiphumela emibi engase ibe khona, enye yazo ibuhlungu ngokukhethekile kubantu ababekwe umuthi. Ukusetshenziswa okuphephile kusiza ukunciphisa imiphumela emibi engathandeki.
1. Nakuba i-Plaquenil isidakamizwa esidala, isatholakala futhi ishiwo kwabanye abantu abane-arthritis ye-rhumum noma ezinye izifo ze-rheumatic.
I-Plaquenil yi-DMARD enqunyelwe iminyaka ukuphatha i-arthritis ye-rheumatoid, i-lupus, i- juvenile rheumatoid arthritis , nezinye izifo ezizimele.
Lapho i- DMARD yokuqala ye- biologic ithola imvume ye-FDA ngo-1998, futhi njengoba ezinye zezinto eziphilayo zalandelwa eminyakeni eyalandela, kubonakala sengathi i-Plaquenil yayiyobe ishiwo kancane. Isidakamizwa sisalokhu sithatha indawo yaso njengendlela yokwelashwa kwabanye abantu, ikakhulukazi ngokuhambisana ne- methotrexate , noma abantu abane-systemic lupus erythematosus.
I-plaquenil nayo iyindlela yokukhetha labo abazama futhi bahluleke izidakamizwa ze-biologic, abakwazi ukubekezelela izidakamizwa noma ukwesaba imiphumela emibi ehlangene ne-biologic DMARD.
2. I-Plaquenil inqunywe njengesifo-ishintsho, ngamanye amazwi, ukunciphisa ubuhlungu, ukunciphisa ukuvuvukala, nokuvimbela ukulimala kokuhlanganyela nokukhubazeka. Ayaziwa ukuthi u-Plaquenil usebenza kanjani kodwa abacwaningi bakholelwa ukuthi i-Plaquenil iphazamisa ukuxhumana phakathi kwamaseli angaphansi kwesistimu yomzimba . Ekugcineni, kucatshangwa ukuthi kuvimbele izindlela ezihamba phambili.
3. Umthamo wokuqala we-Plaquenil ungama-200 mg kabili ngosuku noma 400 mg kanye ngosuku, olawulwa ngomlomo, kubantu abanesisindo esingama-80 kg noma ngaphezulu. I-dosage evamile isebenza kubantu abaningi abathwala i-Plaquenil, kodwa kungenzeka ukwandisa noma ukunciphisa umthamo ngokusekelwe kwezidingo ngabanye. Kubalulekile ukubuka imiphumela emibi kanye nobuthi. Kubantu abanesisindo esingaphansi kuka-80 kg, umthamo wansuku zonke ophansi unqunywe, kuze kufike ku-5 mg / kg wesisindo somzimba esiphezulu.
4. I-Plaquenil yisidakamizwa esenza kancane kancane. Abantu abathatha i-Plaquenil bangase baqale ukubona ukuthuthukiswa ngemva kwenyanga eyodwa noma ezimbili. Kungathatha izinyanga eziyisithupha ngaphambi kokuba izinzuzo ezigcwele ze-Plaquenil zifinyelelwe.
5. I-plaquenil ivame ukubekezelela kahle, kodwa imiphumela emibi ingenzeka.
Imiphumela emibi evamile ehlanganiswa ne-Plaquenil ifaka i-nausea ne-diarrhea. Ukuthatha imithi ngokudla okunomsoco wezinyosi kubantu abaningi abayithatha lesi sidakamizwa. Imiphumela emibi engavamile ihlanganisa ukuhlukunyezwa kwesikhumba, izinwele ezincibilikayo, nobuthakathaka. Umphumela omubi ongavamile we-Plaquenil uhilela ukuguqulwa okubukwayo noma ukulahleka kombono-umphumela ohlangothini obuhlungu kakhulu kwiziguli.
6. I-side side eyinqaba engavamile eyithinta umbono (i-hydroxychloroquine retinopathy), uma ibanjwa ekuqaleni, ingathuthuka ngemuva kokuyeka ukubeka i-Plaquenil. Njengoba umphumela ohlangothini wokulahlekelwa kombono kungenzeka kodwa ungavamile, kubalulekile kuwe ukuthi utshele udokotela wakho nganoma yiziphi izinguquko zombono ozizwayo.
Odokotela ngokuvamile bancoma ukuhlolwa kwamehlo okuvamile lapho ku-Plaquenil, ukuze izinguquko zakuqala zingabanjwa. Lapho kungavamile ukungajwayelekile, utshwala seluvele luvele. Ngenkathi kungase kuguqulwe uma kutholakala ekuqaleni, i-hydroxychloroquine retinopathy ayiguquki ngaso sonke isikhathi.
7. Abantu abathile banomthelela kunabanye kunenkinga yokubona imibono nge-Plaquenil. Ngokuphindaphindiwe, umbono ushintsho oluhlanganiswe ne-Plaquenil awuvamile, kodwa abantu abathile basengozini enkulu yokuthuthukisa inkinga. Iziguli ezingozi kakhulu zizobandakanya labo:
uthathe isilinganiso esiphezulu se-Plaquenil iminyaka (ie, 1000 g. iminyaka engaphezu kwengu-7)
uneminyaka engu-60 noma ngaphezulu
zikhuluphele
unesibindi esibalulekile noma isifo sezinso
ube ne-retinal ekhona ngaphambili, izifo ze-macular, noma i-cataracts
8. Bonke abantu abaqala ukwelashwa kwe-Plaquenil kufanele babe nokuhlolwa okuyisisekelo kwe-ophthalmologic ngonyaka wokuqala. Uma ukuhlolwa kokuqala kwe-ophthalmologic kuvamile futhi umuntu ubhekwa njengengozi encane, ukuhlolwa kabusha akudingeki kwenzeke iminyaka emihlanu. Kunconywa ukuthi iziguli ezinobungozi eziphakeme zihlolwa ukuhlolwa kwamehlo ngonyaka.
9. Izidakamizwa ezithile zingase zihlanganyele ne-Plaquenil, zithinta ukuthi ziyasebenza kanjani noma zingenze zingasebenzi kahle. Tshela udokotela wakho mayelana nayo yonke imithi kanye nokwengeza oyithathayo.
Izidakamizwa ezingase zihlanganyele ne-Plaquenil zifaka:
antacids
ubuhlungu be-botulinum
digoxin
kaolin
i-trisilicate ye-magnesium
methotrexate
i-metoprolol
i-penicillamine
10. Uma ukhulelwe noma ucabangela ukukhulelwa, xoxani ngo-Plaquenil nodokotela bakho. Nakuba i-Plaquenil ngokuvamile ibhekwa njengophephile ngesikhathi sokukhulelwa, kunconywa ukuthi ukulawulwa kokusebenza okusebenzayo kusetshenziswe kulo lonke uhambo lokuphathwa kwe-Plaquenil futhi kuze kube izinyanga eziyisithupha emva kokwelashwa kumisiwe.
11. I-plaquenil ihlotshaniswe nezakhiwo eziwusizo ezengeziwe kubantu abanesifo se-rheumatic. Kubantu abaphathwe nge-Plaquenil njengesidakamizwa sokuguqula izifo, imithi itholakala ukuthi inezinye izinzuzo. I-Plaquenil itholakale ukuthuthukisa amaphrofayili e-lipid, ukulawula i-glucose nokunciphisa ingozi yesifo sikashukela, nokunciphisa ingozi ye-thrombosis kubantu abathile abasengozini enkulu.
Imithombo:
Cannon, Michael, MD. I-Hydroxychloroquine (Plaquenil). I-American College of Rheumatology. Kubuyekezwe ngoMashi 2015.
Radis, Charles, DO. Plaquenil: Ukusuka ku-Malaria Ukwelashwa Ukuphatha uLupus, RA. I-Rheumatologist. May 15, 2015.
Ukuhlolwa kwe-Hydroxychloroquine Retinopathy . Isitatimende Sesikhundla kusuka ku-American College of Rheumatology. Agasti 2016.
Wallace, Daniel, MD. Izidakamizwa ze-Antimalarial Treatment of Rheumatic Disease. Kusesikhathini. NgoJanuwari 10, 2017.