Kodi mumamvanso kupweteka m'mimba, kutentha m'mimba, kapena gastritis mukamwa mankhwala ochepetsa ululu omwe dokotala wanu wakupatsani chifukwa cha kupweteka kwa mafupa, kupweteka kwa msana, kapena kupweteka kwina? Ili ndi vuto lofala kwa anthu ambiri. N'zosasangalatsa kwambiri kukhala ndi vuto lina mutamwa mankhwala ochepetsa ululu. Koma kodi mukudziwa kuti pali gulu lapadera la mankhwala omwe amachepetsa ululu wa m'mimba ndikuletsa ululu? Gulu la mankhwala amenewo limatchedwa COX-2 inhibitors . Lero tikulankhula za zimenezo.
Kodi COX-2 Inhibitors ndi chiyani? Tiyeni timvetse mosavuta.
Mankhwala oletsa COX-2 kwenikweni ndi a m'gulu lomwelo la mankhwala ochepetsa ululu otchedwa NSAIDs (Nonsteroidal Anti-inflammatory Drugs) . Mankhwala omwe mumagwiritsa ntchito nthawi zambiri, monga Ibuprofen , Diclofenac, ndi Naproxen , ali m'gulu la NSAIDs ili. Ntchito yayikulu ya mankhwalawa ndikuchepetsa ululu, kuchepetsa kutupa, komanso kuchepetsa malungo.
Ndiye n’chiyani chapadera chokhudza mankhwala oletsa COX-2 amenewa? Kuti timvetse zimenezi, choyamba tiyenera kuyang’ana momwe NSAID yachibadwa imagwirira ntchito mkati mwa matupi athu.
"Antchito" awiri m'thupi lathu: COX-1 ndi COX-2
Tangoganizani kuti mkati mwa matupi athu muli mtundu wa enzyme wotchedwa Cyclooxygenase ( COX ). Awa ali ngati antchito ang'onoang'ono omwe amagwira ntchito zosiyanasiyana m'thupi lathu. Pali mitundu iwiri ya ogwira ntchito a COX amenewa.
1. COX-1: Iyi ndi ntchito "yabwino". Ntchito yake yayikulu ndikuteteza mkati mwa mimba ndi matumbo athu. Imathandiza kupanga gawo loteteza m'mimba ku asidi wogaya chakudya chomwe timadya ndi kumwa. Imathandizanso pakupanga magazi kuundana .
2. COX-2: Izi nthawi zambiri zimakhala "zoyambitsa mavuto." Pakachitika kuvulala, matenda, kapena kuwonongeka kwa thupi lathu, zimapita kumeneko ndikupanga mankhwala otchedwa prostaglandins . Ma prostaglandins amenewa ndi omwe amayambitsa kupweteka, kutupa, ndi malungo. Ngakhale kuti izi ndi njira yotetezera thupi, m'matenda osatha monga nyamakazi, njirayi imapitirizabe kuyambitsa ululu.
Tsopano onani, tikamamwa mankhwala ofala a NSAID monga Ibuprofen, mankhwalawa amalowa m'thupi ndikuletsa munthu wabwino (COX-1) ndi munthu woipa (COX-2), zomwe zikutanthauza kuti onse amasiya kugwira ntchito. Chifukwa COX-2 yatsekedwa, ululu ndi kutupa zimachepa. Ndizabwino. Koma chifukwa COX-1 yatsekedwa, chitetezo cha m'mimba chimayimitsidwanso, ndipo mwayi wa kutupa m'mimba, gastritis, komanso zilonda zam'mimba umawonjezeka.
Pofuna kuthetsa vutoli, asayansi apeza mankhwala otchedwa COX-2 inhibitors. Mankhwalawa ali ngati zida zodulira. Akalowa m'thupi, amalunjika mwachindunji kwa wogwira ntchito wovuta wa COX-2. Wantchito wabwino wa COX-1 sasokoneza chilichonse. Amangogwira ntchito yake.
Chifukwa chake, ngakhale m'mimba mukupitirizabe kutetezedwa, enzyme ya COX-2 yokha, yomwe imayambitsa ululu ndi kutupa, ndiyo imaletsedwa. Mwachidule, ubwino waukulu wa zoletsa za COX-2 ndikuti zimawongolera ululu pomwe zimachepetsa zotsatira zoyipa m'mimba.
Kodi zoletsa za COX-2 zimagwiritsidwa ntchito kwambiri pa matenda otani?
Mankhwala amtundu uwu amalimbikitsidwa ndi madokotala pa matenda osiyanasiyana opweteka komanso otupa. Nazi zina mwa mankhwala akuluakulu.
| Matenda | Kufotokozera kosavuta |
|---|---|
| Matenda a nyamakazi | Kupweteka ndi kutupa kwa mafupa komwe kumachitika pamene chipolopolo pakati pa mafupa chikutha ndi ukalamba kapena pazifukwa zina. Nthawi zambiri kumakhudza mafupa monga mawondo ndi chiuno. |
| Matenda a Nyamakazi | Kutupa kosatha komanso kupweteka kwambiri komwe kumachitika pamene vuto la chitetezo cha mthupi lagunda mafupa. |
| Matenda a Nyamakazi a Achinyamata | Matenda a nyamakazi mwa ana aang'ono. |
| Ankylosing Spondylitis | Matenda omwe amayambitsa makamaka kutupa kwa mafupa a msana, ndipo pakapita nthawi, amalumikizana, zomwe zimapangitsa kuti mafupawo akhale olimba. |
| Kupweteka kwa Msambo / Dysmenorrhea | Kuchepetsa ululu waukulu wa m'mimba womwe umabwera chifukwa cha kusamba kwa akazi. |
| Ululu wa kanthawi kochepa | Amagwiritsidwanso ntchito pa ululu wa kanthawi kochepa, monga kuvulala pamasewera, kupweteka pambuyo pa opaleshoni, komanso kupweteka pambuyo pochotsa dzino. |
Kuphatikiza apo, mankhwalawa angagwiritsidwenso ntchito pa matenda ena monga gout ndi migraine, malinga ndi zomwe dokotala akufuna.
Kodi COX-2 Inhibitors ndi ziti zomwe zimagwiritsidwa ntchito ku Sri Lanka ndi padziko lonse lapansi?
Mankhwala oletsa COX-2 omwe amagwiritsidwa ntchito kwambiri padziko lonse lapansi komanso ku Sri Lanka ndi Celecoxib . Mwina munamvapo za mankhwalawa pansi pa dzina la Celebrex® .
Kuphatikiza apo, mankhwala ena oletsa COX-2 monga Etoricoxib (Arcoxia®) ndi Parecoxib (Dynastat®) amagwiritsidwanso ntchito m'maiko osiyanasiyana padziko lonse lapansi.
Koma muyeneranso kudziwa izi. Zaka zingapo zapitazo, mankhwala ena oletsa COX-2, monga Rofecoxib (Vioxx®) ndi Valdecoxib (Bextra®) , anali pamsika. Komabe, kafukufuku wamtsogolo adapeza kuti mankhwalawa amawonjezera kwambiri chiopsezo cha matenda a mtima ndi sitiroko akagwiritsidwa ntchito kwa nthawi yayitali. Anapangitsanso anthu ena kukhala ndi matenda aakulu a pakhungu. Pazifukwa izi, mankhwalawa adachotsedwa pamsika.
Phunziro lofunika kwambiri lomwe tingaphunzire kuchokera ku zochitikazi ndilakuti palibe mankhwala ochepetsa ululu omwe ayenera kugwiritsidwa ntchito kwa nthawi yayitali popanda upangiri wa dokotala . Mankhwala aliwonse ali ndi ubwino ndi zoopsa zake. Dokotala wanu yekha ndi amene angasankhe mankhwala oyenera komanso otetezeka kwambiri kwa inu.
Kodi ndimwa bwanji mankhwalawa? Ndiyenera kumwa nthawi yayitali bwanji?
Mankhwala oletsa COX-2 nthawi zambiri amabwera ngati mapiritsi, koma amathanso kupezeka ngati yankho lakumwa.
Ululu umayamba kuchepa mkati mwa ola limodzi mutamwa mankhwalawa.Komabe, zingatenge masiku angapo kuti mupeze zabwino zonse zotsutsana ndi kutupa, monga kuchepetsa kutupa.
Kutalika kwa nthawi yomwe muyenera kumwa mankhwalawa kumadalira matenda anu.
- Pa ululu wa kanthawi kochepa (monga masiku angapo kapena milungu iwiri): Nthawi zonse ndi bwino kumwa mlingo wotsika kwambiri kwa nthawi yochepa kwambiri .
- Pa matenda a nthawi yayitali monga nyamakazi: Dokotala wanu adzawunikanso mbiri yanu yonse ya thanzi, mankhwala ena omwe mumamwa, komanso zotsatira za mayeso a magazi ngati pakufunika kutero, kuti adziwe ngati kuli kotetezeka kuti mupitirize kumwa mankhwalawa.
Chofunika kwambiri ndichakuti nthawi zonse muzimwa mlingo womwe dokotala wanu wakupatsani, monga momwe mwalangizidwira, komanso kwa nthawi yonse yomwe mwalangizidwa. Ngati muli ndi nkhawa iliyonse, onetsetsani kuti mwalankhula ndi dokotala musanasiye kumwa mankhwalawo kapena kusintha mlingo.
Kodi zoopsa ndi zotsatirapo zake za COX-2 inhibitors ndi ziti?
Monga tafotokozera kale, ubwino waukulu wa mankhwalawa ndi wakuti sakhudza kwambiri m'mimba ndi m'matumbo. Koma sizikutanthauza kuti alibe zoopsa. Zotsatirapo zina zimatha kuchitika, makamaka ngati atengedwa mopitirira muyeso komanso kwa nthawi yayitali.
Zoopsa ziwiri zazikulu:
1. Chiwopsezo cha matenda a mtima ndi sitiroko: Mankhwala onse a NSAID, kuphatikizapo oletsa COX-2, angawonjezere chiopsezo cha matenda a mtima ndi sitiroko pamlingo winawake. Chiwopsezochi chimakhala chachikulu kwambiri mwa anthu omwe ali kale ndi zinthu zomwe zimayambitsa matenda a mtima, monga kuthamanga kwa magazi ndi cholesterol yambiri.
2. Mavuto a m'mimba ndi m'mimba: Ngakhale kuti si ofala kwambiri monga mankhwala a NSAID wamba, mankhwala oletsa COX-2 angayambitse kutuluka magazi m'mimba ndi zilonda m'mimba mwa anthu ena. Chiwopsezochi chimakhala chachikulu makamaka kwa okalamba ndi omwe akumwa mankhwala ena omwe amayambitsa kutupa m'mimba.
Zotsatira zina zomwe zingakhalepo:
| Thupi la thupi | Zotsatirapo zomwe zingatheke |
|---|---|
| Dongosolo la m'mimba | Kutupa, kupweteka m'mimba, nseru, kusanza, kutsegula m'mimba, kudzimbidwa, ndi kutentha pamtima. |
| Mtima ndi mitsempha ya magazi | Kuthamanga kwa magazi (Kuthamanga kwa magazi), kugunda kwa mtima mofulumira kapena kosasinthasintha (Kugunda kwa mtima), nthawi zambiri kudwala matenda a mtima kapena sitiroko. |
| Impso | Kuchepa kwa ntchito ya impso, kutupa kwa miyendo (edema) chifukwa cha kuchulukana kwa madzi ndi mchere m'thupi, komanso kuchuluka kwa potaziyamu m'magazi. |
| Dongosolo la mitsempha | Mutu, chizungulire. |
Si aliyense amene amalandira zotsatirapo zonse zomwe zalembedwa pamndandandawu. Ngati mukumva zizindikiro zilizonsezi kapena mukuona zachilendo, uzani dokotala wanu nthawi yomweyo.
Ndani sayenera kumwa mankhwalawa?
Anthu ena omwe ali ndi matenda ena sali oyenera kugwiritsa ntchito mankhwala oletsa COX-2. Dokotala wanu adzaganizira zonsezi asanakulembereni mankhwalawo.
Anthu omwe sayenera kumwa mankhwala oletsa COX-2:
- Ngati mudadwalapo sitiroko kale.
- Ngati mukukonzekera kapena mwachita opaleshoni ya mitsempha ya mtima posachedwapa.
- Ngati muli ndi matenda aakulu a impso kapena chiwindi chanu chikulephera kugwira ntchito bwino.
- Ngati mwakhala ndi vuto la mphumu kapena vuto lalikulu la ziwengo mutamwa aspirin kapena NSAID ina.
- Ngati muli ndi vuto la mankhwala opha tizilombo toyambitsa matenda a sulfonamide.
Anthu omwe ayenera kusamala kwambiri:
- Ngati muli kale ndi zilonda zam'mimba kapena kutuluka magazi.
- Ngati muli ndi mimba ya miyezi itatu yomaliza.
- Ngati ndinu mayi woyamwitsa.
Ngati muli ndi vuto lililonse mwa izi, muyenera kuuza dokotala wanu.
Zizindikiro zochenjeza zomwe zimafuna thandizo lachipatala mwachangu!
Ngati mukupeza zizindikiro zotsatirazi mukumwa mankhwala oletsa COX-2, siyani kumwa mankhwalawo ndipo pitani kwa dokotala nthawi yomweyo kapena pitani ku dipatimenti yapafupi yazadzidzidzi yachipatala (ETU).
- Zizindikiro za mavuto a chiwindi: mkodzo wakuda, kutopa kwambiri, khungu kapena maso kukhala achikasu, ndowe zowala, kupweteka m'mimba.
- Zizindikiro za kutuluka magazi: kusanza magazi, kusanza komwe kumaoneka ngati khofi wophikidwa, magazi mu ndowe kapena ndowe zakuda, magazi mu mkodzo, kutuluka magazi m'kamwa, ndi kuvulala mosavuta.
- Zizindikiro za mavuto a impso: kulephera kukodza, kuchepa kwa mkodzo, magazi mu mkodzo, kuwonjezeka kwa thupi mwadzidzidzi.
- Zizindikiro za vuto lalikulu la ziwengo: ziphuphu pakhungu, kuyabwa, kuvutika kupuma, kupuma movutikira, kutupa kwa nkhope, milomo, kapena lilime.
- Zizindikiro za matenda a mtima: kupweteka pachifuwa, kupweteka kufalikira ku dzanja lamanzere, nsagwada, kapena msana, kupuma movutikira, thukuta.
- Zizindikiro za sitiroko: dzanzi mbali imodzi ya nkhope, mkono, kapena mwendo, kuvutika kulankhula, ndi mutu wopweteka mwadzidzidzi.
Uthenga Wopita Nawo Kunyumba
- Mankhwala oletsa COX-2 ndi mtundu winawake wa mankhwala ochepetsa ululu (NSAID) omwe alibe zotsatirapo zoyipa m'mimba.
- Izi zimagwiritsidwa ntchito pa nyamakazi, kupweteka kwa msambo, ndi matenda ena opweteka.
- Mosiyana ndi mankhwala ochepetsa ululu wamba, mankhwalawa amangoyang'ana enzyme ya COX-2, yomwe imayambitsa ululu, ndipo sasokoneza enzyme ya COX-1, yomwe imateteza m'mimba.
- Ngakhale kuti mankhwalawa ndi abwino, amathanso kuwonjezera chiopsezo cha matenda a mtima ndi sitiroko pang'ono. Chifukwa chake, ndikofunikira kuwagwiritsa ntchito pokhapokha ngati dokotala akuwalangiza.
- Musamwe mankhwalawa mopitirira muyeso kapena kwa nthawi yayitali kuposa momwe mwalangizidwira popanda upangiri wa dokotala.
- Ngati mukuona zizindikiro zachilendo, funsani upangiri wa dokotala nthawi yomweyo.
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