Imithi yokuhlunguphazwa okungavumelani nokuvuvukala, okubizwa ngokuthi yi-NSAID (ebizwa ngokuthi ama-sayds), amanye emithi ejwayelekile kakhulu, ikakhulukazi iziguli ezinezifo ze-orthopedic ezifana ne-arthritis, i-bursitis, ne-tendonitis. Le mithi iyatholakala ngaphezu kwe-counter (isib. Ibuprofen, Motrin, Aleve) noma njengemithi (isib. Celebrex, DayPro, Relafen).
Ama-NSAID aphumelela kokubili ukusizwa ubuhlungu (analgesia), nokunciphisa ukuvuvukala (okulwa nokuvuvukala).
Indlela Abasebenza ngayo
Imithi eyenza ukunciphisa ukuvuvukala iza ezigabeni ezimbili ezinkulu:
- I-Steroids (isb. I- Cortisone )
- Imithi engeyona-Steroidal Anti-Inflammatory (NSAIDs)
Imithi ye-steroid esetshenziselwa ekwelapheni ukuvuvukala ingumuthi we-hormone yemvelo eyenziwa ngumzimba okuthiwa i-cortisol. Kukhona nezinye izinhlobo ze-steroids (kuhlanganise ne-cholesterol nama-hormone ocansi), kodwa lesi sigaba sesithathu imithi enamandla yokulwa nokuvuvukala. Imithi ye-steroid inganikezwa ngomlomo, ngendlela ehlelekile, noma njengemijovo yendawo , njengoba ivame ukusetshenziswa emathambo.
I-NSAID isebenza ukuvimbela umphumela we-enzyme ebizwa nge-cyclooxygenase. Le enzyme ibalulekile ekukhiqizeni komzimba wakho we-prostaglandins. I-prostaglandins ebangela ukuvuvukala nobuhlungu esimweni esifana ne-arthritis noma i-bursitis. Ngakho-ke ngokuphazamisa umsebenzi we-cyclooxygenase, wehlisa ukukhiqizwa kwe-prostaglandins, futhi wehlisa ubuhlungu nokuvuvukala okuhambisana nalezi zimo.
Kulula, kunjalo?
Awu, kuningi kulo. I-Prostaglandins nayo ineminye imisebenzi ebalulekile emzimbeni. Uhlobo olulodwa lwe- prostaglandin (kunezinhlobo eziningi) lusiza umugqa wesisu nge-fluid evikelayo (ebizwa ngokuthi i-gastric mucosa). Lapho abantu bethatha imithi ye-NSAID, ukukhiqizwa kwalesi sitshalo esivikelayo kungancipha, futhi abanye abantu basengozini yokuthuthukisa izilonda zesisu.
Ama-NSAID amasha / okubhalwe ngomshini ongcono?
Eminyakeni eminingana eyedlule, imithi emisha efika emakethe; lezi zivame ukubizwa ngokuthi yi- COX-2 inhibitors . Khumbula, wonke ama-NSAID asebenza ngokumelene ne-cyclooxygenase (COX). I- NSAID yendabuko (isib. I-Ibuprofen, i-Motrin, i-Aleve) isebenza ngokumelene kokubili i-COX-1 ne-COX-2. I-COX-1 ne-COX-2 yizinhlobo zombili ze-cyclooxygenase enzymes esebenza emzimbeni wakho. Imithi emisha (isib. Celebrex) isebenza ngokuyinhloko ngokumelene ne-COX-2, futhi ivumela i-COX-1 ukuba isebenze ngokujwayelekile. Ngenxa yokuthi i-COX-1 ibaluleke kakhulu ekhiqizeni ibhande elivikelayo emgodini wakho (i-gastric mucosa), la ma-NSAID amasha akholelwa ukuthi abe nengozi encane yokubangela izilonda zesisu.
Lokho kusho ukuthi ama-NSAID amasha awabonwanga ukuthi asebenze kangcono ngokumelene ne-COX-2 enzyme. Ngakho-ke, i-COX-2 inhibitors inenzuzo yokuba nemiphumela emibi embalwa, kodwa hhayi impela ukukhululeka okungcono kwezimpawu.
Imiphumela emibi ye-NSAID
Ama-NSAID angatholakala ngaphezu kwe-counter, kodwa lokho akusho ukuthi banezimpembelelo ezingabangela kakhulu. I-side-effect ejwayelekile kakhulu isisindo sesisu. Isizathu salokhu kucatshangwa ukuthi siphumelele ngenxa yomphumela wokugaya isisu. Uma ukucasuka kunzima, kungabangela izilonda eziphaphayo , kanye nezinkinga ezinkulu.
Ngaphambi kokuba uqale ukuthatha imithi ye-NSAID kufanele ukhulume nodokotela wakho. Qiniseka ukuthi uvumele udokotela wakho azi ngezinkinga ezithile zezokwelapha onakho, ikakhulukazi ukucindezeleka, isifo se-asthma, izinso, noma isisu. Ngaphezu kwalokho, ake udokotela wakho azi ezinye izidakamizwa ongase uthathe, futhi uma unayo imithi eyaziwayo yemithi.
Ama-NSAID akufanele asetshenziswe uma:
- Ukhulelwe
- Uncelisa
- Unomlando wezilonda zesisu
- Uthatha imithi yokwehlisa igazi
Ama-NSAID kufanele asetshenziswe kuphela ngaphansi kwe-CLOSE ukuphathwa kwedokotela uma:
- Une-asthma
- Unenkinga yesibindi
- Unezinkinga zenhliziyo
- Unenkinga yezinso
Ngaphansi: Ingabe i-NSAID ivikelekile?
Imithi engaqedi ukuvuvukala ingaphephile futhi ingaba yimpumelelo kakhulu. Imiphumela evame ukutholakala ngokusetshenziswa isikhathi esifushane. Lokho kusho ukuthi le mithi inemiphumela emibi futhi ayikwazi ukusetshenziswa yilowo nalowo. Ngenkathi abantu abaningi abanesimo esibangela ukuvuvukala bangathola ama-NSAID ukuthi abe usizo, kufanele uxoxe njalo nodokotela wakho uma ucabanga ukuqala enye yale mithi.
Imithombo:
Berger, RG "Izidakamizwa ezingavumelani nezidakamizwa ezingekho emthethweni: Ukwenza izinqumo ezifanele" J. Am. I-Acad. I-Ortho. Ukuhlinzwa, ngo-Okthoba 1994; 2: 255 - 260.
van Tulder MW, et al. "Izidakamizwa ezingekho-steroidal ezilwa nokuvuvukala kobuhlungu obunzima emuva I-Cochrane Database Yokuhlolwa Okuhlelekile 2006 Issue 1.