Abantu abaphila nesifo esingenasifo sokuphefumula (COPD) bavame ukushiwo i- bronchodilator , uhlobo lwemithi esetshenziselwa ukuphumula amavesi emoyeni ukukusiza ukuba uphefumule kangcono. Imithi ivame ukungena emlonyeni ngokusebenzisa i- metered dose inhaler (i-MDI) kodwa iyatholakala nasemanzini, iphilisi, injectable, noma i-suppository formulations.
Ama-bronchodilators angasetshenziswa ngesisekelo esidingekayo noma esinqunywe kabili nsuku zonke ukuvimbela noma ukunciphisa izimpawu ze-COPD . Amakilasi amathathu ama-bronchodilators asetshenziselwa ukuphatha i-COPD yilezi:
- Ama-agonists e-Beta-adrenergic
- Anticholinergics
- Ama-Methylxanthini
Ama-Agonists e-Beta-Adrenergic
I-beta-adrenergic agonists (eyaziwa nangokuthi i-beta-agonists) yiluhlobo lwemithi olubopha kuma-receptors ethize emaphaphu abizwa ngokuthi yi-beta-adrenoceptors. Ngokwenza kanjalo, bavimbela i-trigger ibe yi-sponms ekhanda futhi bavumele amavesi e-airway avule.
Ama-agonist angaba ama-short acting (amahora amane kuya kwanguyisithupha) noma abambe isikhathi eside (amahora angu-12 noma ngaphezulu). Zithunyelwa ngomlomo noma nge-MDI. Indlela evumelisiwe ngokuvamile ikhethwa njengoba iyanciphisa izimpawu ngokushesha.
Ama -agonists ase-short-acting beta (SABAs) okwamanje avunyelwe e-US yilawa:
- I-Albuterol
- I-Xopenex (levalbuterol)
- I-Metaproterenol
- I-Terbutaline
Ama-agonists asebambe isikhathi eside (i-LABA) okwamanje avunyelwe e-US yilawa:
- Salmeterol
- I-performomist (formoterol)
- I-Bambuterol
- Indacaterol
- I-Brovana (i-arformoterol)
Imithi ye-Beta-agonist nayo isetshenziselwa ukwakheka kokubili okukodwa njenge- Symbicort ehlanganisa i-formoterol nge- corticosteroid engatholakali eyaziwa njenge-budesonide.
Izidakamizwa zemithi ngokuvamile zihlobene nomthamo futhi zivame ukubonakala ngokusetshenziswa komlomo.
Okuvamile kufaka phakathi izinga lokushaya kwenhliziyo elisheshayo (tachycardia), ukushaya inhliziyo, ukuthuthumela, nokuphazamiseka kokulala.
Anticholinergics
I-Anticholinergics imithi evimbela uhlobo lwe-neurotransmitter eyaziwa nge-acetylcholine. Izinzwa ze-parasympathetic (lezo ezihambisana nomsebenzi ozenzakalelayo) ziwumthombo oyinhloko we-acetylcholine emaphashini. Ngokuvimbela ukukhiqizwa kwalezi zinto, ukuphazamiseka nokuphazamiseka kwemikhawulo emisebentweni yomoya kuyamiswa kahle.
I-Anticholinergics itholakale kuphela efomini elingenayo futhi ihlinzeke nge-bronchodilation ehle kakhulu nemiphumela emibi kakhulu. I-Anticholinergics iwusizo ikakhulu kulabo abangakwazi ukusebenzisa i-beta-agonists noma i-methylxanthines ngenxa yesifo senhliziyo esingaphansi.
I-anticholinergics okwamanje evunyelwe e-US yilezi:
- I-Atrovent (ipratropium)
- I-Spiriva (i-tiotropium)
- Aclidinium
Kukhona futhi ukuhlanganiswa okuhlanganisiwe okubizwa ngokuthi i-Combivent equkethe ipratropium kanye ne-albutol ye-beta-agonist yama-short acting.
Imiphumela emibi kakhulu yezidakamizwa ze-anticholinergic umlomo owomile kanye ne-aftertaste yensimbi. Ezimweni ezingavamile, i-glaucoma iye yaziwa ukuthi yenzeke.
Ama-Methylxanthini
I-Methylxanthines iyisigaba esiyingqayizivele semithi eyaziwa ekunciphiseni ukuvinjelwa kwe-airflow, ukunciphisa ukuvuvukala, nokuhlukunyezwa kwe-bronchial.
Izindlela zabo zesenzo aziqondakali kahle, futhi, ngenkathi esebenza kahle, izidakamizwa azivame ukusetshenziselwa ukwelashwa kwelayini lokuqala ngenxa yemiphumela emibi yazo.
Ama-Methylxanthini afaneleke kakhulu kubantu abangakwazi ukuzuza ukulawulwa okwanele ngemithi ye-beta-agonist noma i-anticholinergic. Ngokungafani nezinye izinhlobo zama-bronchodilator e-COPD, ama-methylxanthini awaxhunyiwe. Okwamanje atholakale kumaphi amapilisi, ama-liquid, ama-intraveous, noma ama-suppository formulations.
Imithi emibili ye-methylxanthine evunyelwe e-US yilezi:
- Theophylline
- Aminophylline
Imiphumela emibi ngezinye izikhathi ingaba yinkimbinkimbi, ikakhulukazi uma ihanjiswa ngaphakathi.
Izimpawu zingabandakanya ukukhanda ikhanda, ukuleleka, ukunxanxwa, isifo sohudo, ukujula, ukuphefumula okusheshayo nokuphuza. Shayela udokotela wakho ngokushesha uma ubona ukuhlanza, ukushaya kwenhliziyo okungavamile (i- dysrhythmia ), noma ukuthunjwa.
> Umthombo:
> Vestbo, J .; Kubuhlungu, S .; Agusti, A. et al. "Isu lomhlaba jikelele lokuxilongwa, ukuphathwa, nokuvimbela isifo se-chronic obstructive pulmonary: summary summary GOLD." Am J Respir Crit Care Med. 2013; 187 (4): 347-65. I-DOI: 10.1164 / rccm.210204-0596PP.