Ke hoʻomaka nei hoʻi ʻoe i kou lā me ke kua ʻoʻoleʻa a me ka ʻeha ke ala ʻoe i ke kakahiaka? Ua luhi anei ʻoe i ka ʻeha e loaʻa mai ana mai kou mau hono ke hele ʻoe a neʻe paha? Hiki i kēia ke lilo i mau hōʻailona o ka ankylosing spondylitis , a i ʻole AS no ka pōkole. He ʻano mumū lōʻihi kēia e kū mai ana ma ka iwi kuamoʻo a me nā hono ʻē aʻe. No laila, inā loaʻa iā ʻoe kēia ʻano, ua kamaʻilio paha kāu kauka e pili ana i kahi ʻano lāʻau lapaʻau kūikawā i kapa ʻia ʻo TNF Inhibitors. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi a me ka maopopo i kēia lā.
No ke aha e ʻeha ai nā hono ma AS? He aha ka TNF?
ʻAe, e hoʻomaʻalahi kākou i kēia. Loaʻa iā kākou āpau kahi ʻōnaehana pale ma ko kākou kino. ʻO ia ka mea e pale ai iā kākou ma ke kaua ʻana i nā germs e hoʻoulu ai i nā maʻi. Akā i nā kūlana e like me AS, lilo kēia ʻōnaehana pale i mea hana nui. Ua like ia me ke kiaʻi e makaʻala mau ana.
Ke hana ʻia kēia, hoʻomaka ko mākou kino e hana i kahi protein kūikawā i kapa ʻia ʻo Tumor Necrosis Factor, a i ʻole TNF . ʻO kēia protein TNF ke kumu o ka mumū i loko o ko mākou mau hono, ʻo ia hoʻi ka mumū, ka pehu, ka ʻulaʻula, a me ka ʻeha. ʻO kēia ke kumu e paʻakikī ai, pehu, a ʻeha hoʻi nā hono e like me kou kua a me kou mau pūhaka.
No laila he aha kēia mau mea hoʻopale TNF?
I ka ʻōlelo maʻalahi, ʻo nā mea hoʻopaʻa TNF he ʻano lāʻau lapaʻau e 'ākeʻe' ana i ka protein TNF a mākou i kamaʻilio ai ma mua, ʻo ia ke kuleana no ke kumu o ka mumū. ʻAʻole like kēia me nā mea hoʻomaha ʻeha maʻamau. Hoʻopau wale nā mea hoʻomaha ʻeha i ka ʻeha no kekahi manawa. Akā, ʻoi aku ka hohonu o ka hana a nā mea hoʻopaʻa TNF ma mua o kēlā.
Hele pololei kēia mau lāʻau lapaʻau i ka protein TNF e hoʻoulu ai i ka mumū a hoʻōki iā ia mai ka hana ʻana. Hoʻemi kēia i ka mumū i loko o nā hono, e kāohi ana i ka ʻeha, ka pehu, a me ka ʻoʻoleʻa. Kōkua pū lākou i ka pale ʻana i ka hōʻino ʻia o nā hono i ka hala ʻana o ka manawa.
Ua kapa pū nā kauka i kēia mau lāʻau lapaʻau he 'TNF blockers', 'biologics', a i ʻole 'anti-TNF drugs'. Aia kekahi mau ʻano o nā mea hoʻopaʻa TNF i ʻae ʻia no AS:
- ʻAdalimumab
- ʻO ka pegol Certolizumab
- ʻEtanercept
- ʻO Golimumab
- ʻInfliximab
E noʻonoʻo pinepine kāu kauka i kēia lāʻau lapaʻau ke ʻole e kāohi ʻia kāu mau hōʻailona e nā lāʻau ʻeha (NSAID). ʻAʻole hana nā mea hoʻopaʻa TNF āpau no nā kānaka āpau. Hiki i kekahi lāʻau ke hana maikaʻi no kekahi poʻe, akā ʻaʻole no kekahi. No laila e hoʻāʻo paha kāu kauka i nā lāʻau lapaʻau like ʻole a hiki i ka wā e loaʻa ai iā lākou ka mea e hana maikaʻi loa iā ʻoe.
Pehea e hoʻohana ʻia ai kēia mau lāʻau lapaʻau?
ʻElua ala nui e hāʻawi ai i kēia lāʻau lapaʻau , e loli kēlā ma muli o ke ʻano o ka lāʻau lapaʻau i kuhikuhi ʻia iā ʻoe.
1. Ma ke ʻano he inikini ma lalo o ka ʻili (Injection)
Loaʻa kekahi mau lāʻau lapaʻau ma ke ʻano he inikini. ʻO ka mea maikaʻi loa, hiki iā ʻoe ke hāʻawi iā lākou ma ka home. Na kāu kauka a i ʻole ke kahu maʻi i aʻo ʻia e hōʻike iā ʻoe pehea e hāʻawi pololei ai iā lākou. Hāʻawi pinepine ʻia lākou i loko o ka ʻili o kou ʻōpū a i ʻole ka ʻūhā. ʻO ka mea nui, ʻo ia ke hoʻololi i kahi inikini, ʻaʻole ka mea like i kēlā me kēia manawa.
2. E like me ka wai saline i hāʻawi ʻia i loko o kahi aa (Intravenous Infusion)
Hāʻawi ʻia nā lāʻau lapaʻau e like me Golimumab lāua ʻo Infliximab ma ke ʻano he wai saline i loko o kahi aa. Pono ʻoe e hele i kahi haukapila a i ʻole ke kikowaena hoʻokomo. Hiki i kēia lāʻau lapaʻau ke hala i kekahi mau hola. E hāʻawi pinepine ke kauka iā ʻoe i ka lāʻau lapaʻau no ʻelua hola a laila e nānā iā ʻoe no ʻelua hola hou aʻe e ʻike inā loaʻa iā ʻoe kahi maʻi allergies koʻikoʻi. Pono paha ʻoe e lawe i kēia lāʻau lapaʻau i kēlā me kēia ʻelua pule i ka wā mua, akā hiki ke hoʻemi ʻia kēia manawa i ka hala ʻana o ka manawa.
He aha nā pōmaikaʻi o nā mea hoʻopaʻa TNF?
Ua hōʻike ʻia nā haʻawina e loaʻa ana i ka poʻe me AS nā pono nui mai kēia lāʻau lapaʻau.
- Ua emi nui ka ʻeha .
- Hoʻomaikaʻi ka hana a me ka maʻalahi o nā hui.
- ʻOi aku ka emi ʻana o nā hōʻailona e like me ka ʻoʻoleʻa o nā hono o ke kakahiaka a me ka pehu ʻana .
- Hoʻēmi i ka mumū a puni ka iwi kuamoʻo a me nā hono ʻē aʻe.
- Hoʻolohi i ka hōʻino mau loa ʻana i nā hono i ka hala ʻana o ka manawa.
Hoʻomaka ka nui o ka poʻe e ʻike i kahi ʻokoʻa ma hope o ʻelua a ʻekolu paha mau lāʻau lapaʻau. Eia nō naʻe, i kekahi manawa hiki ke hala a ʻekolu mahina e ʻike ai i nā hopena piha o kēia lāʻau lapaʻau. No laila, he mea nui e hoʻomanawanui i ka lāʻau lapaʻau.
Ua ʻike pū mākou i nā hopena ʻaoʻao.
E like me nā lāʻau lapaʻau āpau, hiki i kēia ke loaʻa nā hopena ʻaoʻao. Eia nō naʻe, ʻike wale ka hapa nui o ka poʻe i nā hopena ʻaoʻao liʻiliʻi. ʻO ka mea nui loa, ʻo ia ka makaʻala i kēia a hoʻomaopopo koke i kāu kauka inā loaʻa iā ʻoe kekahi mau pilikia.
Ma muli o ke kāohi ʻana o kēia mau lāʻau lapaʻau i ka hana o kā mākou ʻōnaehana pale kino, hiki ke emi iki ko mākou hiki ke hakakā i nā germs. Hoʻonui iki kēia i ka pilikia o nā maʻi .
Aia kahi pilikia o ka hoʻi hou ʻana mai o ka maʻi puʻupuʻu (TB) . Mai hopohopo, e hoʻāʻo kāu kauka iā ʻoe no ka TB a me nā maʻi ʻē aʻe ma mua o kou hoʻomaka ʻana i kēia lāʻau lapaʻau.
Aia ma lalo iho kekahi mau hopena ʻaoʻao maʻamau e hiki mai ana.
| Ka hopena ʻaoʻao | Ka wehewehe a me nā mea e pono ai ke ʻike |
|---|---|
| Nā hopena ma ka wahi inikini | Hiki ke loaʻa ka ʻulaʻula, ka maneʻo, a me ka pehu ma kahi i inikini ʻia. Nalo pinepine kēia i loko o hoʻokahi pule. |
| Ka pilikia o ka maʻi | Hiki ke piʻi aʻe ka pilikia o ka loaʻa ʻana o nā mea e like me ke kuni, ke anu, ka maʻi niumonia, a me nā maʻi ʻili. E haʻi i kāu kauka inā loaʻa iā ʻoe ke kuni a i ʻole ke kuni. |
| Nā maʻi maʻamau ʻē aʻe | ʻEha poʻo, ʻulaʻula ʻili, nausea, ʻeha ʻōpū, diarrhea, sinusitis, etc. |
| Nā hopena koʻikoʻi (kākaʻikahi) | Nā mea e like me ka pehu ʻana o nā lehelehe, ka paʻakikī o ka hanu ʻana, ke koko haʻahaʻa, a pēlā aku. Inā loaʻa kekahi mea e like me kēia, e ʻimi koke i ke kōkua lapaʻau a i ʻole e hele i ka ʻOihana Pilikia kokoke loa (ETU). |
I kekahi mau hihia, hiki i kēia lāʻau lapaʻau ke hoʻonui iki i ka pilikia o ka loaʻa ʻana o ka maʻi ʻili (ka maʻi ʻili non-melanoma), no laila e ʻike pū kāu kauka i kēlā.
ʻO wai ka mea pono ʻole e hoʻohana i kēia lāʻau lapaʻau?
ʻAʻole kūpono nā mea hoʻopaʻa TNF no nā kānaka a pau. ʻAʻole paha e kuhikuhi kāu kauka iā lākou inā loaʻa iā ʻoe kekahi o kēia mau kūlana:
- Inā he makuahine hānai waiū ʻoe.
- Loaʻa iā ʻoe kahi maʻi ola i kēia manawa.Inā he maʻi ʻeleu.
- Inā he moʻolelo kou no nā maʻi e like me ka lupus a i ʻole ka sclerosis maha .
- Inā loaʻa iā ʻoe ke kanesa a i ʻole nā pūnaewele precancerous (hiki ke ʻokoʻa kēia ma muli o ka hoʻoholo a ke kauka i nā hihia o ke kanesa i ʻoi aku ma mua o 10 mau makahiki a ua mālama ʻia a ho'ōla ʻia).
- Inā he moʻolelo kou no nā maʻi puʻuwai koʻikoʻi .
Hiki ke hoʻohana ʻia kēia mau mea i ka wā hāpai?
He nīnau koʻikoʻi kēia no nā poʻe he nui. Ua hōʻike ʻia nā noiʻi e palekana ka hapa nui o kēia mau lāʻau lapaʻau e hoʻohana i ka wā hāpai. Eia nō naʻe, hiki i kekahi mau lāʻau lapaʻau, ʻoi aku hoʻi i ka trimester ʻelua a ʻekolu paha o ka hāpai ʻana, ke hele ma waena o ka placenta a hiki i ka pēpē.
No laila, inā ʻoe e kali ana i kahi pēpē, e kamaʻilio pono me kāu kauka rheumatologist e pili ana i kēia. Hiki paha iā ia ke kuhikuhi i kahi lāʻau lapaʻau i kūpono loa iā ʻoe, e like me Certolizumab, ʻaʻole ia e hele i ka placenta.
Leka Lawe-Home
- He papa lāʻau lapaʻau ikaika a kikoʻī nā mea hoʻopale TNF e kāohi ana i ka mumū, kahi kumu nui o ka ankylosing spondylitis (AS).
- ʻAʻole like kēia me nā lāʻau ʻeha maʻamau; ke hoʻopilikia nei lākou i ke kaʻina hana o ka ʻōnaehana pale ma ke kumu o ka maʻi.
- Ma muli o ke kiʻekiʻe o ka pilikia o ka maʻi, e nānā pono kāu kauka iā ʻoe ma mua a i ka wā o ka mālama ʻana.
- E haʻi koke aku i kāu kauka e pili ana i nā hōʻailona hou āu e ʻike ai, ʻoiai ke kuni a i ʻole nā hōʻailona o ka maʻi.
- Inā ʻoe e hoʻolālā ana e hāpai a hāpai paha, he mea nui e kamaʻilio me kāu kauka e pili ana i kēia lāʻau lapaʻau.
- Mai hoʻololi i ka nui a hoʻōki paha i ka lawe ʻana i ka lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a ke kauka.
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