Enye indlela yokwelapha
Kunezinketho ezihlukahlukene zokwelapha kubantu abanezibalo ezilinganayo kuya kwi-psoriasis enamandla noma i-psoriatic arthritis. I-agent eyodwa esetshenziswa kakhulu esetshenziswayo yisidakamizwa se-leflunomide. Kungaba nengqondo kuwe uma isifo sakho singaphenduli kahle, noma uma ungakwazi ukuthatha ezinye izifo.
Iyini i-Leflunomide?
I-Leflunomide (igama lokuhweba i-Arava) liyisidakamizwa somlomo esingasetshenziswa ukuphatha i-psoriatic arthritis nokulinganisela kwi-psoriasis enamandla.
Igama lomuthi wezokwelapha yi-N- (4'-trifluoromethylphenyl) -5-methylisoxazole-4-carboxamide.
I-FDA yavunywa ekuqaleni kwe- leflunomide yokwelashwa kwesifo samathambo. Ukukhuluma ngokweqile, i-leflunomide engakaze yamukelwe yi-FDA yokwelapha i-psoriasis ne-psoriatic arthritis-izivivinyo zomtholampilo ezidingekayo azenzanga. Kodwa-ke, kokubili i-psoriasis ne- rheumatoid arthritis yizimo ezivuthayo zokuvuvukala ezingathinta amalunga, futhi babelana ngezinqubo ezifanayo zomzimba. Ezinye izifundo zokwelapha zisho ukuthi i-leflunomide iphumelela ekuphatheni izimpawu zesikhumba kwi-psoriasis kanye nezibonakaliso zesikhumba kanye ezihlangene kubantu abane-arthritis ye-psoriatic. Ngakho odokotela babike isikhathi esithile ukuthi babeke umuthi "ngaphandle kwelebula."
I-Leflunomide ingenye yezidakamizwa zendabuko endala ezingasetshenziselwa ukuphatha i-psoriasis ne-psorias arthritis ejwayelekile. Lokhu kubeka eqenjini nge methotrexate, cyclosporine, nezinye izidakamizwa.
Kodwa-ke, i-leflunomide ayisetshenzisiwe njengalezi ezinye izidakamizwa. Ungase uzwe lezi zidakamizwa ezibizwa ngokuthi i-DMARD noma izidakamizwa zokuguqula izifo ezihlasela i-antirheumatic. Njengalezi zidakamizwa, i-leflunomide ayiyona enye yezidakamizwa "ezintsha ze-biologic" ezenziwe ngamaprotheni omuntu noma wezilwane.
I-Leflunomide isebenza kanjani?
Indlela ye-Leflunomide yesenzo ayiyazi ngokugcwele.
Kodwa-ke, kubonakala sengathi kusebenza okungenani ngokuyingxenye ngokuvimbela i-enzyme edingekayo yokwenza i- DNA entsha (impahla yakho yesakhi zofuzo). Lapho ukuvuvukala kwenzeka, umzimba wakho wenza amangqamuzana omzimba omzimba avuthayo. Ngokunciphisa i-DNA synthesis, i-leflunomide ingakwazi ukuvimba ukuvutha okubangela izimpawu ze-psoriasis ne-psoriatic arthritis. Kodwa-ke, ngoba igudluza amasosha omzimba, ingaba neminye imiphumela emibi.
Ngithatha kanjani i-Leflunomide?
Thatha i-leflunomide ngomlomo ngokudla, njengoba kunqunywe udokotela wakho. Isidakamizwa sitholakala ku-10mg, 20mg, namafomu angu-100mg. Uma uqale uqale lesi sidakamizwa, udokotela wakho angakunika umthamo omkhulu kunokujwayelekile, obizwa ngokuthi "ukulayisha umthamo" (ngokuvamile 100mg izinsuku ezintathu). Ngemuva kokuthi izinga lezidakamizwa likhuphuke emzimbeni wakho, uzothatha umthamo wesondlo ophansi (ngokuvamile 20mg nsuku zonke).
Ubani Abazuzisa I-Leflunomide?
Kunezinye izidakamizwa zomlomo zendabuko ezihlukahlukene zokwelapha i-psoriasis, njenge-methotrexate. Ezinye izidakamizwa "ezintsha ze- biologic " ezinjenge-Enbrel (etanercept) nazo ziyatholakala. Odokotela ngokuvamile baqamba kuphela i-leflunomide ngemuva kokunye okukhethwa kukho ukwelashwa akuphumelelanga. Kodwa-ke, izidakamizwa ezintsha ze-biologic kufanele zithathwe emthanjeni, futhi ziyabiza kakhulu kunezokwelapha ezingekho ze-biologic.
Uma ngabe esinye isidakamizwa somlomo singakisebenzelanga, ungase ufune ukuzama i-leflunomide ngaphambi kokuthuthela kudokotela we-biologic. Kwezinye izimo, udokotela wakho angase anikeze i-leflunomide ngaphezu komunye umuthi womlomo, njenge-methotrexate.
Abantu abane-psoriasis emnene kufanele basebenzise imithi yokwelashwa hhayi izidakamizwa zomlomo njenge-leflunomide.
Imiphumela engase ibe khona ye-Leflunomide
Eminye imiphumela emibi kakhulu yomsindo we-leflunomide ngenxa yomsindo wesimiso samathumbu. Isibonelo, lezi zingase zibe phakathi:
- Isifo sohudo (esivame kakhulu)
- I-nausea
- Isisu esibuhlungu
Okunye eminye imiphumela emibi ingabandakanya:
- I-Rash (engavamile kakhulu)
- Ukulahlekelwa izinwele
- Amanzyzy anezinyosi eziphakeme (okubonisa ukulimala kwesibindi)
- Ingozi eyengeziwe yokutheleleka
- Ukwehlisa amaseli egazi noma amaplatelets (kusuka ekukhiqizeni kwehla emangeni)
Ezinye imiphumela engavamile engavamile yilezi:
- I-pulmonary fibrosis
- Ubuhlungu ngokuchama
- Izimpawu ze-neurological ezifana nokudideka noma isiyezi
Izivivinyo kanye nokuhlolwa kweLobuhlengikazi ngenkathi kuthatha i-Leflunomide
Ngaphambi kokuqala i-leflunomide, udokotela wakho uzothatha umlando wakho wezokwelapha futhi enze ukuhlolwa ngokomzimba. Lokhu kusiza udokotela wakho ukuqinisekisa ukuthi asikho isizathu sokuthi i-leflunomide ingaba yisinqumo esibi kuwe. Qinisekisa ukuthi utshela udokotela wakho mayelana nayo yonke imithi oyithathayo, kuhlanganise nemithi ephezulu. Lokhu kungathinta ukusebenza kwe-leflunomide nezingozi zayo ezingenzeka.
Ngenxa yengozi yemiphumela ethile yemiphumela yezidakamizwa, abantu abasebenzisa i-leflunomide badinga ukuhlolwa okuvamile kwesibhedlela. Uzodinga lezi ngaphambi kokuqala ukwelashwa bese uhlala ngezikhathi ezithile. Isibonelo, ungadinga ukuhlolwa okulandelayo:
- Gcwalisa inani legazi (ukuqapha amangqamuzana akho abomvu egazi, amangqamuzana egazi amhlophe, namaplatelets)
- Izivivinyo zesibindi, njenge-ALT
Abantu abathatha i-leflunomide nabo badinga ukuhlolwa kokuqala kokuhlola ukuqiniseka ukuthi abanalo icala elimnyama lesifo sofuba. (Izidakamizwa ezifana ne-leflunomide zingenza lesi sifo sisebenze ngokwengeziwe.)
Amagciwane kanye ne-Leflunomide
Abantu abathatha i-leflunomide akufanele babe nezinhlobo ezithile zemigomo equkethe ingxenye yegciwane ephilayo. Lokho akusho ukuthi akufanele uthathe yonke imithi-vele ucele udokotela wakho kuqala. Ungase ufune ukuthola imithi ethile (njenge- booster tetanus ) ngaphambi kokuba uqale ukuthatha i-leflunomide.
Ubani Ongakwazi Ukuthatha Leflunomide?
Akufanele uthathe i-leflunomide uma unolwazi oluthile olutholakala kulo muthi noma enye yezingxenye zalo. Futhi akufanele uthathe i-leflunomide uma isimiso sakho somzimba sokuzivikela sisonakele yilokho okulandelayo:
- Isifo esinamandla sokuzivivinya umzimba
- Izinkinga ezikhona ngethambo lomnkantsha wakho
- Ukutheleleka okunzima okungalawulwa
Abesifazane abakhulelwe futhi akufanele bathathe i-leflunomide.
Ukuhlinzeka Ingane Kungenzeka kanye ne-Leflunomide
I-Leflunomide imithi ye-X ngesikhathi sokukhulelwa, okusho ukuthi izingozi ezaziwa ezidakamizwa zidlula noma yiziphi izinzuzo ezikhona. Kucatshangwa ukuthi kwandisa ingozi yokufa komntwana kanye nokukhubazeka kokuzalwa. Bonke abesifazane abakwazi ukubeletha kufanele badinga ukukhulelwa ngaphambi kokuqala umuthi. Kufanele uqhubeke nokusebenzisa ukukhulelwa okuthembekile sonke isikhathi osithatha i-leflunomide.
Uma uthatha i-leflunomide futhi ukhulelwe, shayela ihhovisi lakho udokotela ngokushesha bese ubatshela isimo sakho. Udokotela wakho angakunikeza ngengozi engaba khona ukuze ukhulelwe. Udokotela wakho angakwazi ukunikeza ukwelashwa kwezidakamizwa (okuthiwa i-cholestyramine) enganciphisa ngokushesha ukugxila kwe-leflunomide. Lokhu kunciphisa ingozi yokulimaza ingane.
Uma uthatha futhi usuphelile futhi ufisa ukukhulelwa, khuluma nodokotela wakho ngaphambi kokuqala ukuzama ukukhulelwa. Kunconywa ukuthi bonke abesifazane besikhathi sokubeletha bahamba ngokusebenzisa izidakamizwa beya ekubhekaneni okusheshayo kwe-leflunomide. Lokhu kubalulekile ikakhulukazi ukuthi abesifazane bazama ukukhulelwa. Ngaphandle kokuhamba ngalesi sinyathelo, kungathatha iminyaka emibili ukuba i-leflunomide iwele kumazinga aphephile emntwaneni wakho. Abesifazane kufanele futhi bangathathi i-leflunomide ngenkathi bebeletha.
Ososayensi bakholelwa ukuthi i-leflunomide cishe ayinakwandisa ubungozi bokukhubazeka kokubeletha kwabesilisa abazala abantwana. Nokho, lezi zifundo zezilwane azenzanga. Ukuze ugweme noma iyiphi ingozi, amadoda kufanele ayeke ukuthatha isidakamizwa ngaphambi kokuzama ukukhulelwa nomlingani wabo. Ngokufanele kufanele bahambe ngokusebenzisa isidakamizwa behout step.
Izwi elivela
Ngenhlanhla, kukhona manje izinketho eziningi kubantu abanesifo esibucayi se-psoriasis noma i-psoriatic arthritis. I-Leflunomide ingaba yinye indlela yokucabangela ukuthi ngabe yini oyenzile ayizange ilawulwe kahle isifo sakho.
> Imithombo:
> Arava. Ukubeka imininingwane . I-Bridgewater, NJ: iSanofi-Aventis; 2010.
> Leflunomide (Arava). I-American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Leflunomide-Arava. Kubuyekezwe ngoMashi 2017.
> I-Aenter A, iKorman NJ, i-Elmets CA, et al. Imihlahlandlela yokunakekela ukuphathwa kwe-psoriasis ne-arthritis ye-psoriatic: isigaba 4. Imihlahlandlela yokunakekela ukuphathwa nokwelashwa kwe-psoriasis nama-systemic e-systemic agents. J Am Acad Dermatol . 2009; 61 (3): 451-85. i-doi: 10.1016 / j.jaad.2009.03.027.