I-Methotrexate iyisidakamizwa sokuguqula isifo sokulwa nesifo (DMARD) esetshenziselwa ukwelapha isifo samathambo kanye nezinye izifo ze-rheumatic. Umthamo osetshenziselwa isifo samathambo esifubeni ubhekwa njengephansi. Ngokulinganayo, i-methotrexate isetshenziswe njengendlela yokwelapha umdlavuza ophezulu kanye nemithi ephezulu yokuqeda ukukhulelwa kwe-ectopic.
Ukukhuluma ngokweqile, i-methotrexate i-dihydrofolate reductase inhibitor ephazamisa i-purine metabolism.
Lokho kusho ukuthi kungaholela ekungahambi kahle kwe-ribonucleic acid kanye ne-deoxyribonucleic acid synthesis. I-Methotrexate yi-teratogen eyaziwa, echazwa ngokuthi yiyiphi into, umzimba, noma inqubo ebangela ukukhubazeka emntwaneni. I-Methotrexate ingabangela izici zobuso ezibucayi, ukungavamile kwe-skull nezinyathelo, ukuntuleka kokukhula, ukubambezeleka kokuthuthukiswa, nokuphuza kwengqondo.
Ikhono lokuthola izinkinga zesisu lenza ukuthi izidakamizwa zikhathazeke ngalabo abaneminyaka yobudala bokubeletha, labo abahlela ukukhulelwa, ikakhulukazi labo abakhulelwe ngenkathi bephathwa nge-methotrexate.
Ama-Anomalies we-Fetal nokukhulelwa okukhulelwe okuhambisana ne-Methotrexate
Abesifazane kumele baqaphele ukuthi ingozi yokukhubazeka kokubeletha kanye nokulahleka kokukhulelwa okuhambisana nomettretreti, nakuba izinga lokukhubazeka kokubeletha libhekwa njengeliphansi. Esifundweni saseFrance, abesifazane abanezinkinga ezingapheli zokuvuvukala abaphathwa nge-methotrexate ephansi kakhulu ngesikhathi se-trimester yokuqala bahlolwa.
Emavikini angu-28 ahlaziywe, i-methotrexate ukuchayeka kwaphela ngaphambi kwamasonto angu-8 ukubeletha kwabesifazane abangu-26. Abesilisa abane babenesisu, kanti u-5 wakhetha ukuqeda ukukhulelwa. Kwakukhona ukuzalwa okungama-19, okuyi-3 okungakafiki. Abacwaningi baphetha ngokuthi imiphumela yabo isekela umqondo wokuthi ayikho ingozi eqinile yeTatatogen nge-methotrexate ephansi, okuhlinzeka ukuthi umuthi umisiwe ekuqaleni kokukhulelwa ngangokunokwenzeka.
Esinye isifundo sibheke ukukhulelwa okuvelele kwe-methotrexate. Kwakukhona icala elilodwa lohlobo olujwayelekile lwe-methotrexate embryopathy ekhonjisiwe. Yileso simo sokuqala esitholakala kubantu abathatha umthamo we-methotrexate esezansi kanye neviki eliphansi (isilinganiso esivamile sesifo se-rheumatic). Ngisho noma kunjalo kuphela, abacwaningi baphetha ngokuthi ukucabanga kwe-methotrexate ukuphepha ngamanani aphansi kungakabi isikhathi.
Kuthiwani Ngabantu?
Ngokusho kwe-Drugs.com, ukukhulelwa kufanele kugwenywe ngumlingani noma umlingani olashwa nge-methotrexate. Ukukhulelwa kufanele kugwenywe ngenkathi ukwelashwa futhi okungenani izinyanga ezingu-3 ngemuva kokwelashwa kweziguli zesilisa, futhi ngenkathi ukwelashwa futhi okungenani umjikelezo owodwa we-ovulatory emva kokwelashwa kweziguli zesifazane.
Kukhona ingozi yemfundiso yokuguquka kwesidoda emadodeni athatha i-methotrexate, kodwa ayizange iboniswe. Futhi, ngokusho kwe- Journal of Rheumatology , ukuvezwa kwe-fatherfather methotrexate ngesikhathi sokukhulelwa kungabonakali ukuphakamisa ukukhathazeka noma izinkinga ze-fetus.
Okubalulekile
Asikho isikhathi esiphephile esingu-100% sokudonswa komzimba ku-methotrexate. Umphumela we-methotrexate ubonakala ungenakulinganiswa, ngokwengxenye ngenxa yokungafani kwezakhi zofuzo ekuphenduleni kwe-placental and fetal toxins.
Ukulandela ukutholakala kwe-methotrexate ngesikhathi se-trimester yokuqala, umama okhetha ukuqhubeka nokukhulelwa kufanele azi ukuthi kukhona ithuba elilodwa le-10/42 lokungajwayelekile ebusweni (i-QJM: i-International Journal of Medicine).
Ngokusho kukaKelley's Textbook of Rheumatology , abesifazane bayelulekwa ukuba bayeke methotrexate okungenani izinyanga ezintathu ngaphambi kokukhulelwa. I-folic acid supplementation kufanele iqhutshwe ngokukhulelwa. I-American College of Rheumatology incoma ukusetshenziswa kokubeletha okuphumelelayo ngenkathi ithatha methotrexate futhi izinyanga ezintathu ngemuva kokumisa methotrexate.
Imithombo:
I-Methotrexate (i-Rheumatrex, i-Trexall). I-American College of Rheumatology. UMichael Cannon, uMeyi wezi-2012.
http://www.rheumatology.org/Practice/Clinical/Patients/Medications/Methotrexate_(Rheumatrex,_Trexall)/
I-dohotrexate encane ephansi ekuthomeni kokuqala kokukhulelwa: imiphumela yocwaningo lokusebenzisana lwesiFulentshi. Lewden B et al. Journal of Rheumatology. Disemba 2004. http://www.ncbi.nlm.nih.gov/pubmed/15570635
I-Methotrexate Embryopathy Ngemuva kokuveza ama-Low Doses Weekly Early Pregnancy. UMartin MC, et al. I- Toxicology Yokuzala . Ngo-Okthoba 26, 2013. http://www.ncbi.nlm.nih.gov/pubmed/24513926
Ukukhulelwa Kwama-Methotrexate Nokuxwayisa Ngokubeletha. Drugs.com.
http://www.drugs.com/pregnancy/methotrexate.html
Ukuboniswa kwabazali emiphumeleni ye-Methotrexate kanye nokukhulelwa. Journal of Rheumatology. Beghin, et al. NgoJanuwari 15, 2011.
http://www.jrheum.org/content/early/2011/01/11/jrheum.100600
Imiphumela ye-methotrexate ekukhulelweni, ukuzala nokulahla. I-QJM: I-International Journal of Medicine. 1999.
https://academic.oup.com/qjmed/article/92/10/551/1531030/Izinto-effects-of-methotrexate-on-pregnancy-fertility
I-Kelley's Bookbook of Rheumatology. U-Elsevier Saunders. Umqulu I. Ukukhulelwa Emzimbeni We-Rheumatic. Isahluko 39. Page 552.