NgoFebruwari 2010, Ukuphathwa Kwezokudla Nezidakamizwa (FDA) kunikeze isixwayiso esengeziwe mayelana nemithi ye-asthma equkethe ama-beta-agonists asebenza isikhathi eside (i-LABA), njenge-Advair ne-Symbicort. Ama-LABA atholakale e-United States kusukela maphakathi nawo-1990 njengendlela yokwelapha yokulawulwa kwe-asthma. Ngenxa yezifundo ezihlukahlukene ezibonisa ukuthi kungenzeka ukusebenzisana kwama-LABA kanye nokudlula izimpawu ze-asthma (kuhlanganise nokufa kwesifo se-asthma), i-FDA inconywe ngokusetshenziswa kwe-LABAs ekwelapheni i-asthma ngaphandle uma kudingekile.
Esikhundleni sokusetshenziswa kwezidakamizwa ze-asthma ezine-LABAs, i-FDA ikhuthaza ukusetshenziswa kweminye imithi, ngokuyinhloko i- corticosteroids , njengemithi yokulawula i-asthma. Ezinye izindlela ezibandakanya i-leukotriene blockers njenge- montelukast (Singulair) , i- omalizumab (i-Xolair) ne-theophylline. Imithi ye-asthma equkethe i-LABA, kuhlanganise ne-Advair, kufanele isetshenziselwe kuphela abantu abangalawulwa neminye imithi njengoba kukhonzwe ngenhla, noma ukuqhuma okuvame ukuvama okudinga ukuvakasha, ukuvakasha noma ukusebenzisa amakhompiyutha noma amakholisi ajoziwe.
Njengomchwepheshe we-asthma, ngimangele ukuxwayiswa kwe-FDA entsha. Ayikho idatha entsha yokusekela lesi sixwayiso kusukela isilumkiso se- Black Box ngaphambilini esinikezwe imithi ye-LABA. I-FDA ibhekisela kwizifundo ezimbili ikakhulukazi ezibonisa ukuthi i-LABA ingakhuphula izimpawu ze-asthma, kuhlanganise nokufa kwe-asthma. Lezi zifundo ezimbili ezibuzwayo zihlanganisa i-Salmeterol Multicenter Asthma Research Trial (SMART) nesifundo se-Serevent Nationwide Surveillance (SNS).
I-SMART yenziwa ngo-1996, nge-salmeterol (i-LABA) inikwa abantu abangaphezu kuka-13 000 abane-asthma. Abanye balaba bantu babethatha imithi yokulawula i-asthma; abanye basebenzisa kuphela i-salmeterol nsuku zonke. Ngesikhathi i-salmeterol itholakele ukuthi iphephile, kubonakala sengathi kubangelwa ukuhlaselwa kwesifo se-asthma, ukunakekelwa esibhedlela kanye nokufa kwe-asthma kubantu base-Afrika baseMelika.
Lapho abahlanganyeli base-Afrika baseMelika yaseMelika behlolwa ngokulinganisa, bathola ukuthi babe ne-asthma enzima kakhulu njengeqembu, kodwa bekungenakwenzeka ukuthi basebenzise i-steroids engatholakali ukulawula i-asthma yabo. Ngesikhathi labo base-Afrika baseMelika basebenzisa ama-steroid abafakwe ku-inhaled bahlolwa, labo abanikezwa i-salmeterol babonakala bengenezinkinga ezengeziwe ngenxa yokusetshenziswa kwazo.
Ucwaningo lwe-SNS luqhathanise imiphumela emibili-ukuhlolwa kwansuku zonke kweLABA Serevent (salmeterol) kuya ku-ezine-day-a-day salbutamol (i-European version ye-albuterol) ekulawuleni i-asthma kubantu abangaphezu kuka-25 000 abane-asthma. Ngenkathi kunesilinganiso esiphezulu sokufa kwabangama-asthma eqenjini le-salmeterol, lokhu kwakungenzeka ngenxa yokuthi kwakungenangqondo futhi kwakungekho ngaphandle kokulindeleke kokufa kwabantu emphakathini lobukhulu obune-asthma enzima. Lesi sifundo sanyatheliswa ngo-1993, nemiphumela etholakala ku-FDA ngaphambi kwe-LABAs evunyelwe ukusetshenziswa e-United States.
I-LABAs imithi esetshenziselwa kakhulu ukwelashwa kwe-asthma eminyakeni eyi-15 noma ngaphezulu e-United States. Naphezu kwezifundo ezingenhla kanye nokukhathazeka okubonakalayo yi-FDA, inani lokufa kwe-asthma liye lahlehla eminyakeni eyishumi noma ngaphezulu edlule.
Ingabe kufanele uthathe imithi ye-asthma equkethe iLABA, njenge-Advair noma i-Symbicort? Nguwe kuphela nodokotela wakho ongenza lesi sinqumo. Kodwa-ke, uma uthatha i-LABA, kuwumqondo omuhle ukubona udokotela wakho akhulume ngezingozi kanye nezinzuzo zale mithi. Kubaluleke kakhulu ukuthi ungayeki ukuthatha imithi yokwelashwa, kuhlanganise ne-LABAs, ngaphambi kokuxhumana nodokotela wakho.
Funda kabanzi mayelana nezingozi nezinzuzo zokusebenzisa i-Advair .
> Imithombo:
> Nelson HS, Weiss ST, uBleeker ER, et al. I-Salmeterol Multicenter Yokuhlolwa Kwengqondo Yokuziphendukela Kwemvelo. Isifuba. 2006; 129: 15-26.
> Nelson HS. Ama-Beta-Agonists asebekhulile e-Asthma yabantu abadala: Ubufakazi bokuthi lezi zidakamizwa ziphephile. I-Primary Respiratory Care Journal. 2006; 15: 271-77.
> Castle W, Fuller R, Hall J, Palmer J. Serevent Isifundo Sokuhlola Isizwe Wonke: Ukuqhathaniswa kweSalmeterol neSalbutamol kuma-Asthmatic Patients abadinga ukwelashwa njalo kweBronchodilator. BMJ. 1993; 306: 1034-7.