Tiyeni tingophunzira za DMARD, mankhwala omwe amagwiritsidwa ntchito pochiza Ankylosing Spondylitis.

Kodi nthawi zina mumadzuka m'mawa mukumva kuuma komanso kuuma? Kodi zimavuta kupindika kwa kanthawi? Izi zitha kukhala chifukwa cha Ankylosing Spondylitis , matenda omwe amakhudza mafupa a msana. Ngati mwayesapo mankhwala ochepetsa ululu ( NSAIDs ) omwe amaperekedwa kwa dokotala koma ululu ndi kutupa sizinathe, dokotala wanu angakulangizeni kuti mugwiritse ntchito DMARD. Tiyeni tikambirane chifukwa chake.

Kodi ma DMARD ndi chiyani ndipo amagwira ntchito bwanji?

Mu Ankylosing Spondylitis, chitetezo cha mthupi lathu, chitetezo chamthupi , chimayamba kugwira ntchito mopitirira muyeso ndipo chimayamba kuukira mafupa athu a msana. Izi zimayambitsa kutupa , kupweteka, ndi kuuma komwe kumapangitsa kuti zikhale zovuta kusuntha msana bwino.

DMARD ndi chidule cha 'Matenda Osintha Matenda Oletsa Kupweteka kwa Thupi' . Mwachidule, amatanthauza 'mankhwala a nyamakazi omwe amasintha matenda'. Mankhwalawa amagwira ntchito pochepetsa chitetezo chamthupi chomwe chimagwira ntchito mopitirira muyeso. Mosiyana ndi mankhwala ochepetsa ululu wamba (NSAIDs), mankhwalawa samangochepetsa ululu, komanso amathandiza kuwongolera kupitirira kwa matendawa ndikuletsa kuwonongeka kwina kwa mafupa. Ichi ndichifukwa chake amatchedwa mankhwala "osintha matenda".

Ndi mitundu iti ya DMARD yomwe imaperekedwa kwa Ankylosing Spondylitis?

Ma DMARD omwe amaperekedwa chifukwa cha matendawa akhoza kugawidwa m'magulu akuluakulu angapo. Amatchedwa biologics ndi ma DMARD achikhalidwe. Tiyeni tiwone mtundu uliwonse wa matendawa.

Biologics: Mankhwala omwe amagwira ntchito pa cholinga chomwecho

Akatswiri a zamoyo ali ngati zida zodulira. Amangolimbana ndi mapuloteni omwe amayambitsa vutoli mwachindunji.

• Mankhwala oletsa TNF: Awa ndi mankhwala oyamba achilengedwe omwe amavomerezedwa kuti agwiritsidwe ntchito pa matenda a ankylosing spondylitis. Amagwira ntchito poletsa puloteni yotchedwa Tumor Necrosis Factor (TNF), yomwe imayambitsa kutupa. Angathandize ndi nyamakazi ya msana ndi mafupa ena, komanso matenda omwe angachitike ndi matendawa, monga uveitis , kutupa kwa diso, ndi Inflammatory Bowel Disease (IBD) ( matenda a Crohn ndi ulcerative colitis). Dokotala wanu nthawi zambiri amalemba izi ngati mwayesapo mitundu iwiri ya mankhwala ochepetsa ululu (NSAIDs) ndipo simunachitepo kanthu.
• Adalimumab (Humira)
• Certolizumab (Cimzia)
• Etanercept (Enbrel)
• Infliximab (Remicade)
• Golimumab (Simponi)

• Mankhwala oletsa IL-17: Mankhwalawa amagwira ntchito poletsa puloteni ina yotupa yotchedwa Interleukin-17 (IL-17). Ndi njira yabwino kwa anthu omwe sanayankhe mankhwala oletsa TNF kapena omwe sangathe kumwa mankhwala oletsa TNF chifukwa cha matenda monga matenda a mtima kapena multiple sclerosis (MS).
• Ixekizumab (Taltz)
• Sekukinumab (Cosentyx)

Mankhwala oletsa JAK: Mankhwala atsopano omwe angatengedwe ngati mapiritsi

Izi ndi zosiyana ndi zamoyo. Ndi njira yabwino yothetsera vutoli kwa munthu amene sakonda jakisoni, chifukwa amabwera mu mawonekedwe a mapiritsi. Amagwira ntchito poyang'ana dongosolo la enzyme lotchedwa Janus Kinase (JAK), lomwe limayambitsa kutupa.

• Tofacitinib (Xeljanz)
• Upadacitinib (Rinvoq)

Mankhwala achikhalidwe a DMARD: Mankhwala omwe amagwiritsidwa ntchito kwambiri pa mafupa am'mbali

Izi zimaperekedwa makamaka pa ululu ndi kutupa kwa mafupa monga manja, mapazi, chiuno, ndi mawondo, m'malo mopweteka msana.

• Methotrexate: Imabwera ngati piritsi kapena jakisoni. Imathandiza kupewa kuwonongeka kwa mafupa.
• Sulfasalazine (Azulfidine): Iyi ndi njira yochiritsira mafupa am'mimba ndi matenda a IBD. Imatengedwa ngati piritsi.

Kodi dokotala amasankha bwanji DMARD yoyenera kwa inu?

Dokotala wanu amaganizira zinthu zingapo posankha mankhwala.

• Zizindikiro zanu ndi zoopsa bwanji.
• Mankhwala omwe mudagwiritsa ntchito kale komanso zotsatira zake.
• Zotsatirapo za mankhwala omwe akukambidwa ndi momwe amakhudzira thanzi lanu.

Kodi zotsatirapo zake ndi ziti?

Monga mankhwala ena onse, mankhwala a DMARD amatha kukhala ndi zotsatirapo zoyipa. Zina zimakhala zazing'ono, pomwe zina zimakhala zoopsa. Choncho lankhulani ndi dokotala wanu za izi musanayambe kumwa mankhwalawo.

• Mankhwala a biologic ndi JAK inhibitors: Izi zimachepetsa mphamvu ya chitetezo cha mthupi, zomwe zimapangitsa kuti chisathe kulimbana ndi matenda. Chifukwa chake, ndikofunikira kuonetsetsa kuti mwalandira katemera wanu wonse musanayambe kumwa mankhwalawa.
• Kuyesa kwa Chifuwa Cham'mimba (TB): Ndikofunikira kuyezetsa chifuwa chachikulu (TB) musanayambe kugwiritsa ntchito mankhwala oletsa TNF, chifukwa mankhwalawa amatha kuyambitsanso majeremusi a TB omwe anali m'thupi lanu.
• Zotsatira zina zoyipa: Kufiira pamalo omwe jakisoni amaperekedwa, mutu, ndi ziphuphu pakhungu zimatha kuchitika. Mankhwala oletsa IL-17 nthawi zina amatha kukulitsa IBD.

Zotsatirapo zoyipa za mankhwala achikhalidwe a DMARD

• Methotrexate: Kupweteka m'mimba, zilonda pakamwa, ndi kuchepa kwa maselo a m'magazi kungayambitse matenda, malungo, ndi kuvulala. Kuti muchepetse izi, dokotala wanu adzakupatsani mapiritsi a folic acid. Mukamamwa mankhwalawa , muyenera kuyezetsa magazi miyezi 1-3 iliyonse kuti muwone momwe impso zanu ndi chiwindi chanu zimagwirira ntchito. Mankhwalawa sakuvomerezeka panthawi ya mimba.
• Sulfasalazine: Kusanza, kusanza, kumva kutentha kwa dzuwa, ziphuphu pakhungu, ndi mutu zimatha kuchitika. Mankhwalawa angapangitse mkodzo wanu, thukuta, komanso kung'amba utoto wachikasu-lalanje. Siwowopsa, koma amatha kuipitsa zovala.

Kodi mungayembekezere chiyani chithandizo chikayamba?

Mankhwalawa sagwira ntchito mofanana kwa aliyense. Pezani zotsatiraZingatenge milungu ingapo kapena mwezi umodzi kapena iwiri. Choncho ndikofunikira kukhala oleza mtima. Musasiye kumwa mankhwalawo mwadzidzidzi chifukwa mukuganiza kuti sadzachira.

Komanso, ngakhale zizindikiro zanu zitachepa kwathunthu, ndikofunikira kwambiri kupitiriza kumwa mankhwala anu mpaka dokotala wanu atakuuzani. Ngati musiya, matendawa akhoza kuyambanso.