Ingabe iziguli ze-arthritis kufanele zikhathazeke?
Ezinye iziguli ze- arthritis ze- rheumatoid zivalo uma zichazwe nge- methotrexate . Isidakamizwa saziwa ngokuthi yisidakamizwa samakhemikhali asetshenziselwa ukwelapha umdlavuza. Kodwa, ingabe kunembile ukuhlukanisa noma ukucabangela i-methotrexate imithi ye-chemotherapy lapho kunqunywe isifo samathambo? Mhlawumbe lokhu kubonakala sengathi umbuzo ongewona obalulekile kwabanye, kodwa uma ukungalungi kubangela ukwesaba okungadingekile noma kugcina iziguli zingasebenzisi izidakamizwa ezingabasiza, umbuzo ubalulekile ngempela.
Ake sicabangele amaqiniso.
Impendulo emfushane
Eminyakeni engaphezu kwengu-50 eyedlule, i-methotrexate yasungulwa njengokwelashwa komdlavuza ngenxa yemiphumela yayo yokulwa nomzimba. Eminyakeni engu-25 edlule noma ngaphezulu, lesi sidakamizwa sesisetshenziswa njengesidakamizwa sokulwa nesifo (DMARD) sokuguqula isifo samathambo kanye nezinye izifo ze-rheumatic. I-Methotrexate empeleni ibhekwa njengokwelashwa okujwayelekile kwegolide, noma izidakamizwa ezithandayo, ekwelapheni i-rheumatoid arthritis.
Ngokusho kwesahluko se-DMARD encwadini, i- Rheumatoid Arthritis: Ukutholakala Kokuqala Nokunakekelwa Kwezempilo , "Ukuthandwa kwayo kutholakala kalula kalula (ukukhuluma ngomlomo noma okuncane, ukulandelana kwamasonto onke), izidakamizwa ezichazwe kahle, ukuqala okusheshayo kwezinzuzo zomtholampilo (ngokuvamile ngaphakathi kwezingu-6 kuya emavikini angu-8), ukuhlala isikhathi eside, izindleko eziphansi, izinzuzo ezenezelayo uma zihlanganiswa nezinye izilawuli ze-DMARD, kanye nekhono layo lokunciphisa umonakalo we-radiographic. "
Indlela i-Methotrexate esebenza ngayo
Lezi zinyosi ezibalwe ngenhla zicatshangelwa ukuthi zihlobene nokuvimbela ukukhishwa kwe-dihydrofolate reductase nokukhiqizwa kwe-folic acid.
Uma isetshenziswe njenge-DMARD, izinzuzo ze-methotrexate zivela zihlobene nokufakwa kwe-adenosine, noma kunjalo, okuyinto engumlamuleli olwaziyo ukuvuvukala. Ukuze kuqinisekiswe umphumela we-methotrexate ekukhiqizeni kwe-folic acid, ukwesekwa kwansuku zonke nge-folic acid kuyingxenye yomgomo ovamile weziguli zesifo se-rheumatic.
Uma isetshenziselwa i-agent ye-chemotherapy, i-methotrexate ivimbela amangqamuzana ekusebenziseni i-folate ukwenza i-DNA ne-RNA, ngaleyo ndlela ithinte ukukhula kwamangqamuzana omdlavuza.
Isilinganiso Esincane Siyadingeka njenge-DMARD
Lapho isetshenziswe njengesidakamizwa se-chemo, i-methotrexate inikezwa ngezinga eliphakathi kuya phezulu. Umthamo unqunywa usayizi wesiguli, uhlobo lomdlavuza ophathwayo, nokusebenza kwezinso. Amanani amakhulu kunawo noma alingana no-500mg / m2 abhekwa njengephezulu, kanti ama-50 kuya ku-500 mg / m2 aphakathi. I-dose ephansi ibhekwa ngaphansi kwe-50 mg / m2.
Uma i-methotrexate isetshenziselwa ukwelapha isifo samathambo, i-dose ibhekwa njengephansi - ngokuvamile iqala ngo-7.5 kuya ku-10 mg / isonto. Uma kudingekile, umthamo unganda ukwanda kuze kufike ku 25 mg / isonto.
Uma imiphumela emibi noma izidakamizwa zithuthuka, kubonakala sengathi ukunciphisa umthamo noma ukushintshwa komlomo kuya kumettretreate engenayo kungaphatha izinkinga. Ukuhlolwa kwegazi njalo kuyenziwa ngeziguli ezithatha methotrexate (ukugcwaliswa kwegazi okuphelele, amaphrofayli wesibindi kanye nezinso) ukuthola izinkinga kusenesikhathi ukuze kwenziwe izinguquko. Uma izenzakalo ezingavamile, ezingathí sina ezimbi zikhula, ukuyeka kwe-methotrexate kuyodingeka.
Okubalulekile
Lapho ebuzwa ukuphawula ngokuthi ngabe i-methotrexate kufanele yesatshwe ngoba isetshenziswa njengekhemotherapy, isazi se-rheumatologist Scott J.
U-Zashin, MD (www.scottzashinmd.com/) waphendula wathi, "Nakuba i-methotrexate ekudleni okuphezulu ingasetshenziselwa i-chemo, i-rheumatologists isebenzisa i-methotrexate yesilinganiso esincane ngenxa yezindawo zayo zokulwa nokuvuvukala. ukuxhumana phakathi kwama- NSAID (ukwelashwa okuvamile kwe-arthritis ye-rheumatoid) kanye ne-methotrexate kodwa azizwa sengathi ukuxhumana okuphawulekayo emtholampilo nomthamo ophansi wemithi esetshenziselwa isifo samathambo e-rheumatoid. Iziguli kufanele zikhumbule futhi ukuthi imithi inqunyelwe ukuthathwa kuphela kanye ngesonto ukuciphisa imiphumela engaba khona. "
Imithombo:
I-Arthritis Ye-Rheumatoid: Ukuxilongwa Kwangaphambili Nokunakekelwa. I-Kushi, i-Weinblatt ne-Kavanaugh. Uhlelo lwesithathu. Isahluko 11 - Izifo-Ukuguqula Izidakamizwa Zokulwa Ne-Antirheumatic.
Ukusetshenziswa Kwezokwelapha Nokushushumba Kwe-High-Dose Methotrexate. U-Ann S. LaCasce, MD. Kusesikhathini. Ibuyekezwe ngoNovemba 2013.
I-Methotrexate. I-American Cancer Society. 12/29/2011.