Izidakamizwa ezinamandla zivuvukala ngokushesha
Ama-Corticosteroids noma i-glucocorticoids, evame ukubizwa ngokuthi "i-steroids", ayekade ecatshangwa ukuthi iyimangaliso. Ngo-1948, e-Mayo Clinic eRochester, eMinnesota, kuneziguli zezifo zamathambo zanikezwa ngemijovo yansuku zonke ye-corticosteroid. Imiphumela yayihlaba umxhwele futhi ukuthuthuka kwakunzima kangaka, odokotela bacabanga ukuthi "ukwelashwa" kwe-arthritis kwakutholakalisiwe.
Kodwa-ke, njengoba ukusetshenziswa kwe-corticosteroids kwanda eminyakeni, imiphumela emibi yavela. Amanani aphakanyisiwe anikezwe ngaphezu kwesikhathi eside aphendulela ama-steroids "ezenzweni zokuthusa." Iziguli zaxwayiswa ngezinkinga ezingase zibe khona, ukusebenzisa i-corticosteroids kwaba ngcono kakhulu, futhi ezinye iziguli zaze zalahla ukwelashwa ngoba zazesaba.
Eqinisweni, i-corticosteroids yimithi enamandla engaba yigugu uma ihlinzeka ngaphakathi kweziqondiso ezifanele. Ukuqonda ukuthi basebenza kanjani nokuthi bangasetshenziswa kanjani ngokuphepha kubalulekile.
Sibutsetelo
I-Corticosteroids yizidakamizwa ezihlobene eduze ne-cortisol, i-hormone eyakhiwe ngokwemvelo e-cortex e-adrenal (ungqimba lwangaphandle lwe-grenal adrenal). I-Corticosteroids ihlanganisa:
- I-Betamethasone (i-Celestone)
- I-Budesonide (i-Entocort EC)
- I-Cortisone (i-Cortone)
- I-Dexamethasone (i-Decadron)
- I-Hydrocortisone (Cortef)
- I-Methylprednisolone (i-Medrol)
- I-Prednisolone (i-Prelone)
- I-Prednisone (i-Deltasone)
- I-Triamcinolone (i-Kenacort, i-Kenalog)
Indima yeCortisol
I-Cortisol idlala indima ebalulekile ekulawuleni usawoti namanzi emzimbeni kanye nokulawula ama-carbohydrate, amafutha, kanye namaprotheni umzimba. Lapho umzimba ugxilile, i-pituitary gland engaphansi kobuchopho ikhulula i-ACTH (i-horrenone ye-adrenocorticotropic) eyenza ukuthi izigulane ze-adrenal zikhiqize i-cortisol.
I-cortisol eyengeziwe ivumela umzimba ukuba ubhekane nezimo ezicindezelayo, njengokutheleleka, ukuhlukunyezwa, ukuhlinzwa noma izinkinga zomzwelo. Lapho isimo esicindezelayo siphela, ukukhiqizwa kwe-horrenone ye-adrenal ibuyele evamile. I-grenal adrenal ngokuvamile iveza ama-milligram angu-20 e-cortisol ngosuku, ikakhulukazi ekuseni, kodwa ingaveza izikhathi ezinhlanu uma kudingeka.
Indlela i-Corticosteroids isebenza ngayo
I-Corticosteroids yenza isistimu yomzimba ngokuvimbela ukukhiqizwa kwezinto ezibangela izenzo zokugulisa nokuvuvukala , njenge-prostaglandins. Kodwa-ke, nazo zivimbela umsebenzi wamangqamuzana amhlophe egazi abhubhisa izidumbu zangaphandle futhi asize ukugcina amasosha omzimba asebenza kahle. Ukuphazamiseka komsebenzi wamhlophe wegazi kwegazi kwenza kube nomthelela ohlangothini wokwehla okukhulu kokutheleleka.
Izinkomba
Ama-Corticosteroids asetshenziselwa kakhulu izimo eziningi. Zisetshenziswa ukulawula ukuvuvukala kwamalungu kanye nezitho ezifweni ezifana nalezi:
- I-rheumatoid arthritis
- I-Lupus (i-Lupus Erythematosus yesistimu)
- I-ankylosing spondylitis
- I-arthritis yezingane
- Isifo sofuba esiswini
- Dermatomyositis
- I-polymyositis
- Isifo esithinta izicubu
- Isifo sikaBehcet
- I-polymyalgia rheumatica
- I-Scleroderma (i-systemic sclerosis)
- I-giant cell arteritis (i-arteritis yesikhashana)
I-Corticosteroids ayisetshenziselwa uhlelo lwe- osteoarthritis , nakuba ngezinye izikhathi lisetshenziselwa umjovo wendawo endaweni ehlangene.
Ukuphatha
I-Corticosteroids ihambisana nemodi yabo yokusebenza. Anganikezwa:
- Ngomlomo
- Injected emthanjeni noma muscle
- Isetshenziswe endaweni yakho esikhumbeni
- Injected ngqo kumajoyini avuliwe
Imithi ye-Corticosteroid ingasetshenziswa njengezithako eziqukethwe ku:
- Imikhiqizo ye-Eye (ukuphatha izimo zamehlo ahlukahlukene)
- Inhalers (ukuphatha isifo se-asthma noma isifo se-bronchial)
- Amaconsi we-Nasal kanye ne-sprays (ukuphatha izinkinga ezihlukahlukene zamanzi)
- Ama-cream, ama-ointments, njll (ukuphatha izinkinga ezihlukahlukene zesikhumba)
I-Corticosteroids ingasetshenziswa ngokubambisana nezinye izidakamizwa futhi inqunyelwe ukusetshenziswa kwesikhathi esifushane nesikhathi eside. I-Prednisone (amagama e-brand Cortan, Deltasone, Liquid Pred, Meticorten, Orasone, i-Panasol-S, i-Prednicen-M, ne-Sterapred) yi-corticosteroid ejwayelekile kakhulu ekhethiwe yokwenza i-arthritis. Kuphindwe izikhathi ezine kuya kwezihlanu njenge-cortisol. Ngakho-ke, ama-milligram ama-prednisone ayisilingana nomkhiqizo wansuku zonke we-cortisol. Kunamanye ama-synttictic corticosteroids atholakalayo ahluke ku-potency kanye nengxenye yokuphila.
Injecting vs. Corticosteroids yomlomo
I-steroid shot, ebizwa nangokuthi i-cortisone shot, injection ye-corticosteroid, noma i- intra-articular therapy ngumjovo we-steroid ngqo ekuhlanganyeleni okuhlangene. Le ndlela ivumela odokotela ukuba basebenzise izinga eliphezulu le-corticosteroid ngqo esakhiweni sokuvuvukala. Njengoba ikhona indawo, wonke umzimba uvikelekile ekuxhumeni okuphezulu kwesidakamizwa.
Ukutheleleka esakhiweni somjovo kungumphumela wesinye isikhathi. Izijovo eziphindaphindiwe ezingxenyeni ezifanayo zingabangela nokulimala kwe-cartilage. Odokotela basebenzisa lolu hlobo ukwelashwa kancane, emva kokunye okukhethwa kukho kuhlulekile, bese uzama ukunciphisa inani lemijovo kanye kanye nezinyanga ezimbalwa futhi okumbalwa okwenziwe ngokuhlanganyela okuthile.
Okuqhamuka uma udla imishanguzo
Umphumela omuhle we-corticosteroids ungaholela emiphumeleni emibi kakhulu efana nezifo zikaCushing, ukungasebenzi kwemigodi ye-adrenal okuholela ekutheni kube nokuningi kwe-cortisol. Uhlu lwemiphumela emibi engaba khona lude futhi lubandakanya:
- Ukwandisa ukudla nokuzuza kwesisindo
- Ama-deposit of fat esifubeni, ubuso, phezulu nangesisu
- Ukugcinwa kwamanzi nosawoti okuholela ekuvupheni nase-edema
- Umfutho wegazi ophezulu
- Isifo sikashukela
- Amamaki amnyama nesibhakabhaka
- Ukuphulukiswa okuphansi kwezilonda
- I-osteoporosis
- I-cataract
- I-acne
- Ubuthakathaka bemisipha
- Ukuthinteka kwesikhumba
- Ukwenyuka okukhudlwana ukutheleleka
- Izilonda zesisu
- Ukujuluka okukhulu
- I-Mood iyashintsha
- Izinkinga zengqondo ezifana nokucindezeleka
- Ukunciphisa okungekho emthethweni kanye nenkinga
Imiphumela emibi ingancishiswa ngokulandela imiyalo kadokotela futhi ithathe isilinganiso esincane kunazo zonke. Kubalulekile futhi ukugwema ukuzilawula komthamo, ngokufaka ngaphezulu noma ukuyeka imithi ngaphandle kwesimiso.
Ukwelashwa Kwesikhathi Esifishane Nokwelashwa Kwesikhathi Eside
Uma isetshenziselwa ukwelashwa okwesikhashana, i-prednisone ivame ukubekwa ngomthamo olinganisiwe futhi unciphise noma "i-tapered" esikhathini esiyizinyanga ezimbili noma ezimbili. Inhloso ukufeza ukuthuthukiswa okungazelelwe kwezibonakaliso, kodwa hhayi isikhathi eside sokusetshenziswa kwe-corticosteroid.
Ukwelashwa kwesikhashana eside kuvame ukugcinwa kwamacala amabi we-arthritis ye-rheumatoid noma izifo ezihlobene. I-dose ivame ukuba yizinkulungwane eziyisihlanu kuya kweziyisikhombisa nezinyanga eziyi-prednisone ngosuku oluqhubekayo phakathi nezinyanga noma iminyaka.
Ama-steroid aphezulu kakhulu anikezwa ngezikhathi ezithile ezimweni ezingavamile kakhulu, ezinzima kunazo zonke zesifo sokuvuvukala. Umthamo ophezulu ubhekwa njengama-daily odoses of prednisone nge-milligram eyodwa kilogram yesisindo somzimba noma cishe ama-milligram angu-60 ngosuku olunikezwa ngamanani ahlukanisiwe. Ezimweni ezinjalo, i-steroids "i-tapered" ngokushesha ngangokunokwenzeka.
Ukuze kuncishiswe imiphumela engaba khona, imiphumela ephansi kakhulu ye-corticosteroid kufanele inikezwe. Lona ngumthamo omkhulu.
Ukuyeka
Umthamo we-corticosteroids kumele wancishiswe kancane kancane ukuze izigulane ezinamandla zivuselele ukukhiqizwa kwe-cortisol yemvelo. Ukuqeda ukulinganisa ngokushesha kungabangela ukuhlupheka okungakahleleki (isimo esongela impilo esibangelwa ama-cortisol anganele) nakuba lokhu kungavamile.
Ezimweni lapho ama-corticosteroids athathwe ngama-doses aphansi isikhathi esithile eside, ukuphayela kungaqhubeka izinyanga noma iminyaka. Ngezinye izikhathi, ukulinganisa kuncishiswe nge-milligram eyodwa kuphela ngezikhathi ezithile ukuvimbela ukuqhuma. Uma i-steroids ithathwa isikhathi esifushane, ukufiphaza kuyashesha kakhulu futhi kunciphisa emithini kungaba yikhulu.
Enye ingcindezi ekhona ehambisana nokuyeka ukuphuma kwe-steroids yi-steroid ukuhoxiswa kwesifo, noma impumuzo yokuvukela, okuyinto impendulo yomzimba ngokugqamile kokususwa kwesidakamizwa. Umphumela wokuvuselela ungabangela umkhuhlane, ubuhlungu be-muscle, nobuhlungu obuhlangene, okwenza kube nzima ngodokotela ukuthi ahlukanise phakathi kwezimpawu zokuhoxiswa kanye nesifo sesifo ngokwayo.
Ukuzikhohlisa
Ngokusho kweThe Pill Book (Amabhuku E-Bantam), usebenzisa ama-milligram ama-prednisone ayisihlanu njengesisekelo sokuqhathaniswa, amanani afanayo wezinye i-corticosteroids yizo:
- 0.6 mg-0.75 mg we-Betamethasone
- 25 mg weCortisone
- 0.75 mg weDexamethasone
- 20 mg we-Hydrocortisone
- 4 mg we-Methylprednisolone
- 5 mg we-Prednisolone
- 4 mg we-Triamcinolone
I-Corticosteroid Converter ibala isilinganiso esilinganayo se-corticosteroids ehlukahlukene. Kuyinto ithuluzi lokuguqula elilula ukusebenzisa.
Izwi elivela
I-Corticosteroids yizidakamizwa ezinamandla ezingathuthukisa izimpawu futhi ziphumele imiphumela emihle. Kunemiphumela engaba khona ehlobene nokusetshenziswa kwayo okufanele kunganakwa, noma kunjalo. Amandla we-corticosteroids akufanele asatshwe, kodwa kufanele ahlonishwe.
Imithombo:
I-Kelley's Bookbook of Rheumatology. Umagazini wesishiyagalolunye. Elsevier. Ukwelashwa kwe-Glucocorticoid Isahluko 60. UJamess noBijlsma.
I-Duke University Medical Center Book of Arthritis, uDavid S. Pisetsky MD
Sobel, Klein. I-arthritis: Okusebenzayo, iSt. Martins Press; 1999.