Isidakamizwa Esivame Ukufakwa Ngokwe-Rheumatoid Arthritis Nezinye Izifo Zama-Rheumatic
I-Methotrexate (amagama okuthiwa ama-Rheumatrex, Trexall, Otrexup , Rasuvo ) avame ukushiwo ukuphatha i- arthritis ye-rheumatoid nezinye izimo ze-rheumatic. I-Methotrexate yamukelwa yi-FDA ngo-1988 yokwelashwa kwesifo se-rheumatoid arthritis. Ngaphambi kokuba avunyelwe i-arthritis ye-rheumatoid, i-methotrexate yayisetshenziselwe ukuphatha i-psoriasis nomdlavuza.
Ekuqaleni kwakhiwa njengesidakamizwa se-leukemia kuma-1940.
Ngaphandle kwe-arthritis ye-rheumatoid, i-methotrexate ingahle ibekwe:
- i-psoriatic arthritis
- lupus
- i-spondylitis e-ankylosing
- i-vasculitis
- i-arthritis yezingane (polyarticular)
I-Methotrexate I-DMARD Elinganiselwe Ukuthinta
I-Methotrexate ihlukaniswa njenge- DMARD (izidakamizwa eziguqula izifo ezilwa ne-rheumatic) . Isidakamizwa sisetshenziselwa ukunciphisa ubuhlungu nokuvuvukala okuhambisana nesifo samathambo, ukuvimbela ukulimala okuhlangene, nokunciphisa ingozi yokukhubazeka ngokunciphisa ukuqhubeka kwesifo. Ukuthuthukiswa kwe-methotrexate kungabonakala ngokushesha ngemva kwamasonto amathathu kuya kwamasonto ayisithupha, kodwa kungadinga amasonto angu-12 noma mhlawumbe kuze kufike ezinyangeni eziyisithupha zokwelashwa ukuze kuzuzwe inzuzo egcwele.
Indlela Yokusebenza
I-Methotrexate iphazamisa ezinye ze-enzyme ezidlala indima ekusebenzeni komzimba. I-Methotrexate ivimbela i-enzyme dihydrofolate reductase. Ngokwenza kanjalo, kuthinta ukukhiqizwa kwefomu le-folic acid elidingekayo kumangqamuzana akhulayo.
Kuhlala kungacacile kahle ukuthi i-methotrexate inciphisa kanjani umsebenzi we-arthritis.
Isilinganiso
I-methotrexate ye-oral isithathwa usuku olulodwa ngesonto ngesifo samathambo e-rheumatoid. Akuthathwa nsuku zonke njengamaphilisi amaningi. I-Methotrexate iyatholakala kumathebulethi angu-2.5-milligram. Umthamo wokuqala wabantu abaningi abadala abane-arthritis ye-rheumatoid ama-milligram angu-7.5 kuya kwangu-10 (okungukuthi, amaphilisi amathathu noma amane).
Amaphilisi amathathu noma amane athathwa ndawonye kanye ngesonto (ngosuku olufanayo ngesonto ngalinye). Uma kudingekile, inani lomthamo we-methotrexate linganyuka libe ngama-20 noma ama-milligram angu-25 ngesonto ngalinye.
Igama lomshini i-Rheumatrex dose pack liqukethe amakhadi e-blister equkethe inani eliqondile lamaphilisi okufanele athathe isonto ngalinye. Igama legama elithi Trexall litholakala ku-5, 7.5, 10, namaphilisi angu-15-milligram. I-Methotrexate iyatholakala futhi kwifomu ejojelwayo , iziguli eziningi ezikwazi ukuzijoca.
Okuqhamuka uma udla imishanguzo
I-Methotrexate ingabangela ukusebenza okungavamile kwesibindi. Kubalulekile ukuthi njalo igazi lakho lihlolwe umsebenzi wesibindi ukuze udokotela wakho angakuqapha ngemiphumela emibi engafuneki. Ngaphandle kokungafani nokusebenza kwesibindi, imiphumela emibi kakhulu ehlobene ne-methotrexate yi-nausea nokuhlanza.
Imithelela emibi esivele ishiwo-ukucwenga, ukuhlanza, nokusebenza kwesibindi-kungase kuxhomeke emzimbeni. Uma unezinye zalezi zemihelo, ukulungisa umthamo kungase kuqede inkinga. Abantu abaningi abatholanga imiphumela emibi kakhulu ngenkathi bethatha methotrexate.
Okunye eminye imiphumela emibi (okungabalulekile) kufaka:
- izilonda zomlomo
- ukuqhuma noma ukusabela isikhumba esinzima
- isifo sohudo
- ukubalwa kwegazi okungavamile
- ukulimala kwesibindi / i-cirrhosis yesibindi (engavamile)
- ukulimala kwezinso
- isifo sengculazi
- i-lymphoma
- izifo ezithathelanayo
- ukukhwehlela okuqhubekayo
- ukuphefumula okungaqondakali
- ukulahlekelwa izinwele (kancane kancane)
- ukuzwela kwelanga
Izixwayiso
- Ingozi eyanda kakhulu yokulimala kwesibindi ne methotrexate ibalulekile kubantu abaphuza utshwala . Okufanelekile, akufanele uphuze utshwala uma uthatha methotrexate. Ngokuvamile, ngemvume yemvume yakho, akufanele ube neziphuzo ezimbili ngaphezu kwenyanga.
- I-Methotrexate akufanele ithathwe ngabantu abanesibindi esingapheli noma isifo sezinso. I-rheumatologist inganquma ukunquma i-methotrexate kubantu abanesibindi esibuhlungu noma isifo sengqondo esibi-kodwa ngokuqapha nokuqapha okukhulu.
- I-Methotrexate ingadinga ukumiswa ngaphambi kwenqubo yokuhlinzwa, okwesikhashana, ngenkathi uphulukisa. Lokhu kungenxa yomphumela ongenamandla ohlelweni lokuzivikela komzimba futhi kungase kube nokwanda kwengozi yokutheleleka ngokusetshenziswa kwayo.
- Noma ubani ophathwa nge-methotrexate kufanele athathe isengezo se-folic acid. Njengoba i-methotrexate ingumphikisi we-folic acid, igcwalise i- folic acid ngokuthatha isisombululo sokusiza ekunciphiseni imiphumela emibi ehlobene nezidakamizwa.
- I-Methotrexate akufanele ithathwe uma ukhulelwe noma uhlela ukukhulelwa. I-Methotrexate ingabangela ukukhubazeka okukhulu kokuzalwa kanye nokucindezeleka kokukhulelwa. Kufanele usebenzise uhlobo oluthile lokuvimbela ngokweqile ngenkathi uthatha methotrexate futhi izinyanga ezintathu ngemuva kokuyeka ukuthatha methotrexate. Kubalulekile ukuqaphela ukuthi nakuba owesifazane engayithathi i-methotrexate ngesikhathi sokukhulelwa , ukuthatha isidakamizwa akunciphisi amathuba okukhulelwa esikhathini esizayo.
- Akufanele uthathe methotrexate uma uncelisa.
- Akufanele uthathe i-methotrexate uma une-anemia enesifo esibi, isibalo se-white white cell counts, noma izibalo zamaplatelet aphansi.
- I-methotrexate kufanele isetshenziswe ngokucophelela uma unesimo esinciphisa isimiso sakho somzimba.
- Kubalulekile ukukhumbuza udokotela wakho yonke imithi oyithathayo (imithi ye-odokotela kanye ne-over-the-counter). Eminye imithi kanye nemithi yokwelapha ingakhuphula isifo se-methotrexate. Izidakamizwa ezaziwayo ukwandisa isifo se-methotrexate zihlanganisa imithi ye-antibiotic i-Trimethoprim (i-Bactrim). Ama-NSAID (izidakamizwa ezingavumeli ukuvuvukala), nakuba zivame ukuhlelwa kanye ne-methotrexate, zingathinta izinga le-methotrexate. Udokotela wakho kanye nomuthi wezokwelapha bazokwazi ukusebenzisana kwezidakamizwa ezingaphephile.
- I-American College of Rheumatology ikhuthaza ukugwema i-caffeine (ikhofi, itiye, i-cola) eduze nesikhathi ohlela ukuthatha methotrexate, njengoba kungathinta ukumamatheka komuthi.
Izwi elivela
I-Methotrexate iphakathi kwezidakamizwa ezivame ukujwayela ukusebenzisa isifo samathambo. Kwezinye izimo, kuthathwa yedwa. Kwezinye izimo, i-methotrexate inqunywe njengengxenye yokwelashwa okuhlanganisiwe, lapho kuthathwa khona enye i-DMARD noma i- biologic drug .
Kuyadingeka ukuthi uthathe methotrexate njengoba nje kuqondiswe. Kubalulekile futhi ukuba uqaphele imiphumela engaba khona futhi ubike noma yini engavamile kudokotela wakho ngokushesha. I-Methotrexate ingaba imithi ephephile futhi ephumelelayo uma isetshenziswe kahle.
> Imithombo:
> Cannon, Michael, MD. I-American College of Rheumatology. I-Methotrexate (i-Rheumatrex, i-Trexall, i-Otrexup, i-Rasuvo). Kubuyekezwe ngoMashi 2015.
> Ulwazi Lomguli. I-Methotrexate . FDA.gov. Kubuyekezwe i-01/2016.