Lolu khetho oluncane olunqunyiwe lunenzuzo nezinselelo
Abantu abane- psoriasis manje banezinketho eziningi zokwelashwa ezihlukahlukene ukuze baxazulule izimpawu zabo. Imikhiqizo ye-Retinoid, etholakala ku-vitamin A, iyodwa yokukhetha okungenzeka. I-Acitretin yinye yokwelashwa okunjalo okutholakala njengemithi yomlomo. Nakuba isetshenziswe kaningi kunezinye izindlela zokwelapha i-psoriasis , kungase kudingeke ukucabangela abanye abantu.
Amaseli Ekhanda Okungavamile e-Psoriasis
I-Keratinocytes yilona uhlobo oluyinhloko lwamaseli atholakele esikhumbeni sakho. Esikhumbeni esijwayelekile, lawa maseli ahlukana futhi avuthiwe ngokuhamba kwesikhathi. Nge-psoriasis, lawa maseli esikhumba afanayo ahlukana futhi avuthiwe ngendlela engavamile. Lawa maseli abuye avezwe esikhwameni sesikhumba esivuthayo esibangela ukuba baziphathe ngezindlela ezigulayo. Lokhu yingxenye yalokho okubangela izimpawu ze-psoriasis.
Indlela i-Acitretin isebenza ngayo
I-Acitretin iyi-retinoid. Lokho kusho ukuthi kusemkhayeni owodwa wamakhemikhali njengo vithamini A (isakhi esibalulekile esitholakala ekudleni okuthile). Imikhiqizo ye-Oral retinoid efana ne-acitretin itholakale ukuphatha i-psoriasis kusukela ekuqaleni kwama-80s. I-retinoid yokuqala yomlomo, i-etretinate, isuke ishintshwe ngomkhiqizo omusha, i-acitretin. E-US, igama le-acitretin ngu-Soriatane TM .
Ama-retinoids afana ne-acitretin angena emangqamuzaneni omzimba we-keratinocytes. Lapho bashintsha ukubhalwa kwamagciwane athile atholakele ku-DNA yakho.
(Lokhu kusho ukuthi ezinye izakhi zofuzo zingase zisetshenziselwe ukwenza amaprotheni kaningi, futhi ezinye izakhi zofuzo zingase zisetshenziswe kancane kancane.) Lokhu kubangela imiphumela emibili, njenge:
- Ukunciphisa isikhumba sokuvuvukala
- Ukunciphisa ukukhula kwe-cell okungavamile nokuhlukaniswa kwamangqamuzana esikhumba
- Nciphisa ukuvuthwa okungavamile kwamaseli esikhumba
Ezinye imikhiqizo ye-retinoid (efana ne- tazarotene ) ingasetshenziselwa ukuphatha i-psoriasis, futhi yabelana ngezakhiwo ezifanayo nge-retinoids yomlomo.
Kodwa-ke, i-acitretin inekhono elikhulu lemiphumela emibi kunemithi ye-retinoids yama-topical, ngoba ithathwa ngaphakathi.
Ubani Ongase Azuze Ku-Acitretin?
I-Acitretin iyindlela yokwelashwa yeziguli ezine-psoriasis enomthelela. Ngokuvamile lokho kuchazwa njengabantu abanokunye kokulandelayo:
- I-Psoriasis ihlanganisa ngaphezulu kwamaphesenti ayishumi esikhumba sabo
- I-Psoriasis ngaphezu kwamaphesenti amancane esikhumba sabo, kodwa ngubani onezimpawu ezikhubaza, njenge-psoriasis enamandla ezandleni zabo noma esikhwameni
Abantu abanjalo ngokuvamile badinga izidakamizwa zomlomo zendabuko (njenge-acitretin) noma enye yezokwelapha ze- biologic ezintsha ze-psoriasis. Abantu abane-psoriasis emnene kuphela badinga kuphela ukwelashwa ngezikhwama ze-topical ukuze kugcinwe isimo sabo.
I-Acitretin ingase isebenze ngokukhethekile kubantu abanezinhlobo ezithile ze-psoriasis . Lokhu kuhlanganisa:
- I-Psoriasis ethinta izintende nezindwangu
- I-Psoriasis ethinta izipikili
- Uhlobo lwe-Pustular psoriasis
- I-erythrodermic psoriasis
Izidakamizwa ezindala ze-Psoriasis vs. Izidakamizwa ezintsha ze-Biologic
I-Acitretin ingenye yeklasi elidala lemithi yokwelapha i-psoriasis enamandla. Izidakamizwa zomlomo zendabuko ezintathu ezisetshenziswa kakhulu ziyi-acitretin, methotrexate , ne-cyclosporine. Lezi zidakamizwa zisetshenziselwa njalo ngeziguli ezine-psoriasis ezilinganayo.
Nokho, eminyakeni yamuva, izidakamizwa ezintsha, ezibizwa ngokuthi yi-biologics, seziye zatholakala. Lezi zihlanganisa izidakamizwa ezifana ne- etanercept ne-adalimumab. Kulo lonke, lezi zidakamizwa ezintsha ziba nemiphumela emibi kakhulu kunezidakamizwa zakudala. Izidakamizwa ze-biologic nazo zisebenza kahle ekuphatheni i-psoriasis.
Noma kunjalo, kubantu abathile, izidakamizwa ezindala ezifana ne-acitretin kungenzeka zisengcono kakhulu. Enye inzuzo enkulu yezidakamizwa zendabuko njenge-acitretin yukuthi ithathwa ngomlomo. Abanye abantu bangase bakhethe lokhu ezikwelapha ze-biologic, ezivame ukunikezwa umjovo. Futhi, izidakamizwa ezindala ezifana ne-acitretin ngokuvamile zibiza kakhulu kunezidakamizwa ze-biologic.
I-Acitretin Iqhathanisa Kanjani Neminye Imithi Yendabuko Yomlomo Ye-Psoriasis?
Uma isetshenziswe yedwa, i-acitretin ivame ukuphumelela kangcono kune-methotrexate noma i-cyclosporine (eminye imithi emibili ejwayelekile kakhulu ejwayelekile yomuthi). Kodwa-ke, kungenzeka ukuthi iphephile kunezinye izidakamizwa zokusebenzisa isikhathi eside.
Acitretin for People With Psoriasis With Immunosuppression
Elinye iqembu leziguli ze-psoriasis ezingase zizuze ikakhulukazi ku-acitretin ngabantu abaye banqanda amasosha omzimba. Izidakamizwa ze-biologic nemithi yendabuko yomlomo njenge-methotrexate ngokuhlanganyela emsebenzini ngokucindezela ukuphendula komzimba komuntu. Nokho, ngokungafani nalezi ezinye izidakamizwa, i-acitretin ayicindezeli kakhulu isimiso sakho somzimba. Lokhu kungenza kube ukwelashwa okufiselekayo kubantu abanezinkinga zokuzivikela , njengabantu abane-HIV.
Ukwelapha Ukuhlanganiswa Nge-Acitretin
I-Acitretin ngezinye izikhathi ithathwa njengelashwa olulodwa, kodwa ngokuvamile lusebenza kahle kakhulu nezinye izifo.
- Ngokuyinhloko, i-acitretin ivame ukuhlanganiswa ne- phototherapy , uhlobo oluthile lwe-UVB therapy noma ukwelashwa kwe-UVA nge-psoralen (PUVA).
- I-Acitretin ingasetshenziselwa kanye nezinqubo zokwelapha ze-psoriasis.
- Ngokungafani nezinye izidakamizwa zomlomo zendabuko, i-acitretin nayo ingathathwa kanye nezidakamizwa ze-biologic.
Akufanele usebenzise i-acitretin ngomunye umkhiqizo osuselwa ku-vitamin A, ngoba lokhu kungase kuholele ku-vitamin A.
Ukukhonta kwe-Acitretin
I-Acitretin ivame ukutholakala kuma-capsules ka-10mg, 17.5 mg, noma ku-25 mg. Iningi labahlengikazi banikeza amanani phakathi kuka-10mg no-25 mg ngosuku, kodwa abanye abantu badinga isikhathi esithile.
I-Acitretin ivame ukuphumelela kakhulu emithini ephakeme. Noma kunjalo, imiphumela emibi ingase ibe khona nakakhulu kulezi zinga. Ungase uqale ngomthamo ophansi futhi uqhubekele phezulu kumthamo owodwa uma izimpawu zingagcini, futhi uma ungenayo imiphumela emibi yokwelapha.
Kungathatha izinyanga ezintathu kuya kweziyisithupha ngaphambi kokuba ufinyelele impendulo ephezulu empilweni yakho.
Indlela Yokuthatha Acitretin
- Thatha i-acitretin ngokudla.
- Thatha ngqo umthamo owunqunywe ngumhlinzeki wakho wezempilo.
- Uma ulahlekelwa umthamo, ungaphindi umthamo olandelayo. Kunalokho, weqa umthamo futhi uthathe isilinganiso esivamile ngesikhathi sakho esilandelayo esilandelayo.
Umhlinzeki wakho wezokunakekela impilo uzokutshela ukuthi umthamo ulungile yini kuwe.
Ingozi yokukhulelwa
I-Acitretin ayikho imithi ephephile yabesifazane abakhulelwe ukuba bathathe. I-Acitretin ingabangela izinkinga ezihlukahlukene zokuzalwa, kuhlanganise nezithinta isimo senhliziyo, isimiso sezinzwa, ukuzwa nombono, nezakhiwo zamathambo. Inengozi enkulu kunazo zonke abesifazane besithatha i-acitretin phakathi kwamasonto amathathu nesithupha ekukhulelwe kwabo. Lokhu kungaphambi kwabesifazane abaningi bazi ngisho nokuthi bakhulelwe.
I-Acitretin ayiphuli ngokuphelele umzimba kuze kube yiminyaka emithathu emva kokuyeka imithi. Ngenxa yalokhu, i-acitretin akufanele isetshenziswe yilokho okulandelayo:
- Abesifazane abakhulelwe
- Abesifazane bahlela ukukhulelwa ngesikhathi sokulashwa noma kungakapheli iminyaka emithathu emva kokuyeka ukwelapha
- Abesifazane abaneminyaka yokubeletha abangakwazi ukusebenzisa ukulawulwa kokubeletha okunokwethenjelwa ngesikhathi sokwelapha futhi iminyaka emithathu elandela ukwelashwa
Akufanele futhi isetshenziswe abesifazane abancancisayo.
Okunye okucatshangelwa ngabesifazane bokubeletha okungenzeka
- I-Acitretin cishe ayilona ukwelashwa okungcono kakhulu kuwe ngaphandle kokuba une psoriasis enamandla engaphenduli kwezinye izindlela zokwelapha, noma awukwazi ukuthatha ezinye izindlela zokwelashwa ngesizathu esithile.
- Uma i-acitretin iyindlela engcono kakhulu, uzodinga izivivinyo ezimbili zokukhulelwa ngaphambi kokuqala i-acitretin, okunye okumele kwenziwe ngesikhathi sokuya esikhathini.
- Uzodinga ukuhlolwa kokukhulelwa kwanyanga zonke ngenkathi usebenzisa izidakamizwa.
- Kuzodingeka usebenzise izinhlobo ezimbili zokulawulwa kokuzalwa ngenkathi usebenzisa lesi sidakamizwa, futhi iminyaka emithathu ngemuva kokumisa lesi sidakamizwa.
Imiphumela engase ibe khona ye-Acitretin
I-Acitretin nayo ingabangela imiphumela emibi. Lokhu kufaka:
- Ukushisa kwamehlo, impumulo, umlomo nesikhumba
- Izipikili zezintambo
- Ukulahlekelwa izinwele
- Ukushisa isikhumba senzwa
- Ama-muscle aches
- I-nausea
- Ukukhula kwe-Bony emgodleni
- Ukwanda kwe- triglycerides
Eminye imiphumela emibi engase ibe khona ingenzeka futhi. Ngokuvamile, i-acitretin ingabangela izinkinga ezinkulu ezinjengokulimala kwesibindi noma ukuvuvukala kwama-pancreas. Cishe zonke lezi zinkinga zibuyiselwa ekuqedeni ukwelashwa. Khuluma ngokushesha kumhlinzeki wakho wezempilo uma unenkinga.
Ngaphambi kokuqala ukwelapha
Ngaphambi kokuqala ukwelashwa kwe-acitretin, uzodinga umlando wezokwelapha nokuhlolwa ngokomzimba. Ungase futhi udinga ukuhlolwa kwegazi ukuze uqiniseke ukuthi ungumuntu omele ukwelashwa. Lokhu kungafaka okulandelayo:
- Izivivinyo zamafutha wegazi (triglycerides ne-cholesterol)
- Ukuvivinya kokusebenza kwesibindi
Ukuqapha ku-Acitretin
Ngenxa yengozi yemiphumela emibi evela ku-acitretin, umhlinzeki wakho wezempilo uyokuqapha. Ngemuva kokuba uqale ukuqala ukwelashwa, kungase kudingeke ube nokuhlolwa kwegazi njalo ukuze uhlole isibindi sakho namafutha akho egazi. Ngemuva kwamasonto ambalwa ngesidakamizwa, kufanele ukwazi ukushintshela ezivivinyweni ezingavamile.
Ubani Okungafanele Asebenzise Ama-Acitretin?
Ngaphezu kwabesifazane nabesifazane abakhulelwe abangakhulelwa, amanye amaqembu athile abantu kudingeka futhi agweme i-acitretin. Lokhu kufaka:
- Abantu abane- hyperlipidemia
- Abantu abanomzwelo noma ukungezwani komkhiqizo we-vitamin A
- Abantu abaye baba ne-pancreatitis
Ukwengeza, i-acitretin ingase ingabi yimithi engcono kakhulu uma unezinye izinkinga zezokwelapha, njenge:
- Thayipha 1 noma uthayiphe isifo sikashukela sesi-2
- Isifo sesibindi
- Isifo sezinso
- Izinkinga zokusebenzisa kabi utshwala
Izwi elivela
Ukuphatha i-psoriasis yakho kungaba yinselelo. Ngenhlanhla, kulezi zinsuku, kunezinketho eziningi zokwelashwa kubantu abane-psoriasis enesimo esincane. I-Acitretin ngokuvamile ayiyona into engcono kunazo zonke kwabesifazane abaneminyaka yobudala. Kodwa kubantu abathile, imithi endala efana ne-acitretin ingase ibe nengqondo, ikakhulu uma isetshenziselwa nezinye izifo.
> Imithombo:
> 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.
> I- Soriatane Ukuchazela Ulwazi . I-Allergan. 2017. Steifel Laboratories. 2014. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/019821s027lbl.pdf.
> Sarkar R, Chugh S, Garg VK. Acitretin in dermatology. Indian J Dermatol Venereol Leprol. 2013; 79: 759-71. doi: 10.4103 / 0378-6323.120721.