Ingabe ngezinye izikhathi uvuka ekuseni uzizwa uqinile futhi uqinile? Ingabe kunzima ukugoba isikhashana? Lokhu kungaba ngenxa ye -Ankylosing Spondylitis , isimo esithinta amalunga omgogodla. Uma uke wazama imithi yokunciphisa ubuhlungu ethengiswa ngaphandle kwemithi ( ama-NSAID ) futhi ubuhlungu nokuvuvukala kungakapheli, udokotela wakho angase akuncome i-DMARD. Ngakho ake sifinyelele emnyombweni walokhu.
Ayini ama-DMARD futhi asebenza kanjani?
Ku-Ankylosing Spondylitis, uhlelo lokuzivikela lomzimba wethu, uhlelo lokuzivikela , luba namandla ngokweqile bese luqala ukuhlasela amalunga ethu omgogodla. Lokhu kubangela ukuvuvukala , ubuhlungu, nokuqina okwenza kube nzima ukuhambisa umgogodla kahle.
I-DMARD isifinyezo se -'Disease-Modifying Antirheumatic Drug' . Kalula nje, isho 'imithi ye-arthritis eshintsha isifo'. Le mithi isebenza ngokuthulisa isimiso somzimba sokuzivikela esisebenza ngokweqile. Ngokungafani nemithi ejwayelekile yokubulala izinhlungu (ama-NSAID), le mithi ayigcini nje ngokunciphisa ubuhlungu, kodwa futhi isiza ukulawula ukuqhubeka kwesifo nokuvimbela umonakalo owengeziwe emalungeni. Yingakho ibizwa ngokuthi imithi "yokuguqula isifo".
Yiziphi izinhlobo ze-DMARD ezinikezwa i-Ankylosing Spondylitis?
Ama-DMARD anikezwa lesi sifo angahlukaniswa ngezigaba eziningana eziyinhloko. Abizwa ngokuthi ama-biologics kanye nama-DMARD endabuko. Ake sibheke ngayinye yalezi zinhlobo.
| Uhlobo lwesidakamizwa | Incazelo emfushane |
|---|---|
| I-Biologicals (isib. izithibi ze-TNF, izithibi ze-IL-17) | Zisebenza ngokugxila kumaprotheni athile abangela ukuvuvukala ohlelweni lokuzivikela komzimba. Lawa anikezwa ngomjovo noma ngokufaka i-intravenous. |
| Izithibi ze-JAK | Lolu futhi uhlobo olusha lwe-DMARD. Lokhu akuzona izinto eziphilayo. Kusebenza ngokugxila eqenjini lama-enzyme abangela ukuvuvukala. Angathathwa njengamaphilisi. |
| Ama-DMARD endabuko (isib. iMethotrexate, iSulfasalazine) | Lezi zisetshenziswa kakhulu ekwelapheni i-arthritis yamalunga angaphandle, njengezandla, izinyawo, izinqe namadolo. Azisebenzi kahle ekwelapheni i-arthritis yomgogodla. |
I-Biologics: Izidakamizwa ezisebenza endaweni efanayo
I-biologics ifana nezibhamu. Ihlasela futhi ihlasele kuphela amaprotheni abangela inkinga ngqo.
- Ama-TNF inhibitors: Lawa yimithi yokuqala yebhayoloji evunyelwe i-ankylosing spondylitis. Asebenza ngokuvimbela iphrotheni ebizwa ngokuthi i-Tumor Necrosis Factor (TNF), ebangela ukuvuvukala. Angasiza nge-arthritis yomgogodla namanye amalunga, kanye nezimo ezingase zenzeke ngalesi sifo, njenge- uveitis , ukuvuvukala kwamehlo, kanye ne-Inflammatory Bowel Disease (IBD) ( isifo sikaCrohn kanye ne-ulcerative colitis). Udokotela wakho uvame ukukunikeza lokhu uma uke wazama okungenani izinhlobo ezimbili zemithi yokunciphisa ubuhlungu (ama-NSAID) futhi awuzange ube nomthelela.
- I-Adalimumab (i-Humira)
- I-Certolizumab (i-Cimzia)
- I-Etanercept (Enbrel)
- I-Infliximab (i-Remicade)
- I-Golimumab (i-Simponi)
Cabanga nje, umuthi owodwa wokuvimbela i-TNF awusebenzanga kuwe. Ungakhathazeki. Udokotela angakushintsha komunye umuthi osekilasini elifanayo. Khona-ke kunethuba elihle lokuthi uzothola imiphumela.
- Ama-inhibitor e-IL-17: Lawa asebenza ngokuvimba enye iphrotheni yokuvuvukala ebizwa ngokuthi i-Interleukin-17 (IL-17). Ayindlela enhle kubantu abangazange baphendule kuma-inhibitor e-TNF noma abangakwazi ukuthatha ama-inhibitor e-TNF ngenxa yezimo ezifana nesifo senhliziyo noma i-multiple sclerosis (MS).
- I-Ixekizumab (Taltz)
- I-Secukinumab (i-Cosentyx)
Ama-JAK inhibitors: Imithi emisha engathathwa njengamaphilisi
Lezi zihlukile kwezebhayoloji. Ziyisisombululo esihle kumuntu ongathandi imijovo, ngoba ziza ngesimo samaphilisi. Zisebenza ngokugxila ohlelweni lwe-enzyme olubizwa ngokuthi iJanus Kinase (JAK), olubangela ukuvuvukala.
- I-Tofacitinib (Xeljanz)
- I-Upadacitinib (i-Rinvoq)
Ama-DMARD Endabuko: Imithi esetshenziswa kakhulu emalungeni angaphandle
Lokhu kunikezwa ikakhulukazi ngenxa yobuhlungu nokuvuvukala kwamalunga njengezandla, izinyawo, izinqe, namadolo, kunobuhlungu emgogodleni.
- I-Methotrexate: Lokhu kuza njengephilisi noma umjovo. Kusiza ekuvimbeleni ukulimala kwamalunga.
- I-Sulfasalazine (i-Azulfidine): Lokhu futhi kuyindlela yokwelapha amalunga angaphandle kanye ne-IBD. Ithathwa njengephilisi.
Udokotela ukhetha kanjani i-DMARD efanele wena?
Udokotela wakho ucabangela izici eziningana lapho ekhetha umuthi.
- Izimpawu zakho zimbi kangakanani.
- Imithi oyisebenzisile esikhathini esidlule kanye nemiphumela oyitholile kuyo.
- Imiphumela emibi yomuthi okukhulunywa ngawo nokuthi ithinta kanjani impilo yakho.
Iyini imiphumela emibi yalo muthi?
Njengayo yonke imithi, ama-DMARD angaba nemiphumela emibi. Eminye mincane, kanti eminye ingaba yingozi. Ngakho-ke khuluma nodokotela wakho ngalezi zinto ngaphambi kokuqala imithi.
- Ama-biologics kanye nama-JAK inhibitors: Lawa anciphisa ijubane lesimiso somzimba sokuzivikela, okwenza singabi namandla okulwa nezifo. Ngakho-ke, kubalulekile ukuqinisekisa ukuthi unolwazi lwakamuva ngayo yonke imigomo yakho ngaphambi kokuqala le mithi.
- Ukuhlolwa Kwesifo Sofuba (TB): Kubalulekile ukuhlolwa isifo sofuba (TB) ngaphambi kokuqala imithi yokuvimbela i-TNF, njengoba le mithi ingavuselela amagciwane e-TB angasebenzi emzimbeni wakho.
- Eminye imiphumela emibi: Ukubomvu endaweni yomjovo, ikhanda elibuhlungu, kanye nokuqubuka kwesikhumba kungase kwenzeke. Ama-inhibitor e-IL-17 ngezinye izikhathi angase abe mabi kakhulu i-IBD.
Imiphumela emibi ye-DMARD yendabuko
- I-Methotrexate: Ubuhlungu besisu, izilonda emlonyeni, kanye nokubalwa okuphansi kwamangqamuzana egazi kungabangela ukutheleleka, umkhuhlane, kanye nokulunywa. Ukuze unciphise lokhu, udokotela wakho uzokunika amaphilisi e-folic acid. Ngesikhathi uthatha lo muthi , kuzodingeka ukuthi uhlolwe igazi njalo ezinyangeni ezi-1-3 ukuze uhlole ukusebenza kwezinso zakho nesibindi. Lo muthi awunconywa ngesikhathi sokukhulelwa.
- I-Sulfasalazine: Isicanucanu, ukuhlanza, ukuzwela ukukhanya kwelanga, ukuqubuka kwesikhumba, kanye nekhanda elibuhlungu kungase kwenzeke. Lo muthi ungenza umchamo wakho, ujuluke, futhi uklebhule umbala ophuzi-orenji. Awuyingozi, kodwa ungangcolisa izingubo.
Into ebaluleke kakhulu ukungesabi uma uhlangabezana nanoma yimiphi imiphumela emibi futhi wazise udokotela wakho ngokushesha.
Yini ongayilindela lapho uqala ukwelashwa?
Le mithi ayisebenzi ngendlela efanayo kuwo wonke umuntu. Thola imiphumelaKungathatha amasonto ambalwa noma inyanga noma amabili. Ngakho-ke kubalulekile ukubekezela. Ungayeki ngokuzumayo ukuthatha umuthi ngoba ucabanga ukuthi ngeke ululame.
Futhi, noma ngabe izimpawu zakho seziphelile ngokuphelele, kubaluleke kakhulu ukuqhubeka uthatha imithi yakho isikhathi eside udokotela wakho ekutshela ukuthi ukwenze. Uma uyeka, lesi sifo singase siphinde sibhebhetheke.
Umlayezo Wokuya Nawe Ekhaya
- Imithi ye-DMARD ayifani nemithi yokubulala izinhlungu ejwayelekile. Ngaphezu kokunciphisa ubuhlungu, ilawula nokuqhubeka kwesifo futhi ivimbele ukulimala kwamalunga.
- Kunezinhlobo ezahlukene, njenge-biologics, i-JAK inhibitors, kanye ne-DMARD yendabuko. Udokotela wakho uzokhetha umuthi ofanelana kahle nesimo sakho.
- Ngenxa yokuthi le mithi icindezela amasosha omzimba, kunengozi yokutheleleka. Ukuhlolwa kwesifo sofuba (TB) kuyimpoqo ngaphambi kokuqala ama-TNF inhibitors.
- Kuthatha isikhathi ukubona imiphumela, ngakho-ke yiba nesineke ngokwelashwa kwakho. Ngisho noma izimpawu zakho ziphela, ungayeki ukuthatha imithi ngaphandle kweseluleko sikadokotela wakho.
- Uma uhlangabezana nanoma yimiphi imiphumela emibi noma unezinkinga, khuluma nodokotela wakho ngokushesha.
💬 Comments (0)
Awekho amazwana athunyelwe okwamanje. Faka amazwana akho lapha okokuqala ngqa.
Engeza amazwana akho