Ama-rheumatologists angahluka ku-folic acid supplementation
Kuyinto evamile odokotela ukubeka i-folic acid ngeziguli zabo zamasosha e-rheumatoid eziphathwa nge methotrexate. I-folic acid ichithelwa yi-methotrexate, ngakho-ke kumele igcwaliswe nge-supplementation. I-folic acid iyadingeka ukuze kuvimbele ukukhubazeka okubomvu kwegazi kanye ne-anemia. Kubuye kubonwe ukunciphisa izinhlanzi ezivela ku-methotrexate.
I-Methotrexate yi- DMARD ejwayelekile kunazo zonke (isifo sokuguqula izidakamizwa ezilwa no-rheumatic) se-arthritis ye- rheumatoid nezinye izimo ze-rheumatic. I-Methotrexate itholakale ekwenzeni ngomlomo nangokwenjoza . Noma yikuphi, i-methotrexate ivame ukuphathwa kanye ngesonto (ngosuku olufanayo njalo ngesonto).
Yiziphi Izinsiza Zezokwelapha Ezikushoyo Nge-Folic Acid
Kukhona ukuhluka uma odokotela benquma umthamo wansuku zonke we-milligram eyi-folic acid noma umthamo omkhulu uma ngesonto. Umthamo omkhulu kakhulu uvunyelwe ngosuku olulandelayo ngemuva kwe-dohotrexate dose. Ngezinye izikhathi odokotela banxusa iziguli zabo ukuba zenze umthamo wansuku zonke ngosuku lomthamo wabo we-methotrexate.
I-National Rheumatoid Arthritis Society e-UK, "I-Methotrexate idonsa isidumbu se-folic acid kanye nemvamisa yemiphumela emibi ingancishiswa ngokuthatha izithako ze-folic acid. Lokhu kungathathwa njengama-milligram ama-5 ukuya kwangu-10 masonto onke. ukuphumelela kwe-methotrexate neziningi ze-rheumatologists zincoma ukuthatha i-folic acid eyodwa noma kwezinsuku ezimbili ngemuva kwe-methotrexate, futhi ikakhulukazi ingayithathi ngosuku olufanayo ne-methotrexate. "
Izinhlelo ezahlukene zokwelapha nge folic acid zingabangela imibuzo ngokuthi yikuphi okulungile. U-Rheumatologist uScott Zashin, uprofesa wophiko lwezokwelapha e-University of Texas Southwestern Medical School uthi, "Ngineziguli zami ezithatha nsuku zonke, kuhlanganise nosuku lwe-methotrexate. Ngicabanga noma kuhle-kuhlanganise noma ukuwuqeda ngosuku.
Akukafundiwe, kodwa akunakwenzeka ukuthi noma i-protocol iyingozi. "
Iziphetho Kusuka Ekubuyekezweni Kwe-Cochrane
Esikhathini somhleli mayelana nokubuyekezwa kweCochrane eshicilelwe ngoJulayi 2013, okwakubheka ubufakazi obusekela ukusetshenziswa kwe-folic acid ukunciphisa imiphumela emibi ehambisana ne-methotrexate, kwavezwa ukuthi ukusetshenziswa kwe-folic acid kuyahlukahluka-odokotela abathile babeka i-folic acid ukuba isetshenziswe njalo ngeziguli ezithatha methotrexate, kuyilapho abanye odokotela bebeka kuphela iziguli ezinemiphumela emibi evela ku-methotrexate. Kanti abanye abayibhali nhlobo ngoba bakholelwa ukuthi i-folic acid inciphisa ukusebenza kwe-methotrexate.
Ukubuyekezwa, ngokusekelwe emiphumeleni eyisithupha yokuhlolwa kwemitholampilo, kusekelwa ukusetshenziswa kwe-dose ephansi folic acid ezigulini ze-rheumatoid arthritis eziphathwe nge-methotrexate. I-Folic acid supplementation inciphise ukubola kwesisu nokukhuphuka kwe- enzyme yesibindi . Umhleli waphakamisa ukuthi i-folic acid 1 milligram nsuku zonke iyisetshenziswa esivame kakhulu ukwesezela iziguli eziphathwe nge-methotrexate.
Ukubuyekezwa kanye nokuhlelwa okulandelayo kwaphakamisa imibuzo ukuthi ngabe iziguli kufanele zithathe i-folic acid konke ukuphila kwazo, nokuthi ngabe ukulinganisa okuphakeme kunenzuzo noma kungaphazamisa methotrexate.
Kwaqedelwa ukuthi ubudlelwane be-dose-effect buzodinga ukutadisha okwengeziwe.
Okubalulekile
Kunezinhlelo ezihlukahlukene ezamukelekayo zokuthatha i-folic acid uma ziphathwa nge-methotrexate, futhi izifundo ezingaphezulu zingabonisa ukuthi kukhona okukhethayo. Xoxa ngakho nodokotela wakho ukuze aqonde ukuthi kungani ekhetha omunye phezu komunye.
Imithombo:
> Butler R. Methotrexate e-Rheumatoid Arthritis. I-National Rheumatoid Arthritis Society. https://www.nras.org.uk/methotrexate-in-rheumatoid-arthritis.
> Singh JA. Amaphilisi e-Folic acid we-rheumatoid arthritis iziguli ezithatha methotrexate: okuhle kuthola kangcono (ukuhlela). I-Cochrane Database yezibuyekezo ezihleliwe 2013; 7: ED000063. dx.doi.org/10.1002/14651858.ED000063
> Shea B, Swinden MV, Tanjong Ghogomu E, Ortiz Z, Katchamart W, Rader T, et al. I-folic acid ne-folinic acid ekunciphiseni imiphumela emibi ezigulini ezithola i-methotrexate ye-arthritis ye-rheumatoid. I-Cochrane Database Yokubuyekeza Okuhlelekile 2013; 5: CD000951. dx.doi.org/10.1002/14651858.CD000951.pub2