Sau da yawa An rubuta idan Methotrexate ba shi da amfani
Arava (leflunomide) an kwatanta shi a matsayin magungunan anti-rheumatic mai cuta (DMARD). Dokar miyagun ƙwayoyi, wadda FDA ta amince a ranar 11 ga watan Satumba, 1998, an yi amfani dashi don magance matsanancin matsakaici zuwa ga magungunan ƙwayar cutar a cikin manya. Ana amfani dashi don rage alamomi da alamun cututtuka na arthritis na rheumatoid, don hana lalacewar tsari (misali, shaidar rayukan rayukan rayuka rayuka da raɗaɗin sarari) da kuma inganta aikin jiki.
An umurci Arava sau da yawa lokacin da wasu DMARDs, musamman matakan, ba za a iya jurewa ba ko samar da wani amsar rashin dacewa (watau, kasa kula da bayyanar cututtuka).
Availability da Dosing
Arava yana samuwa a cikin 10 MG da 20 mg Allunan Allunan mai launi (30 kwalabe ƙidaya). Arava kuma yana samuwa a cikin 100 mg 3-count blister shirya. Saboda tsawon rabi na Arava a cikin marasa lafiya na arthritis da kuma lokacin da aka dade na tsawon awa 24 don maganin, an bada shawarar cewa Arava za a fara tare da nauyin loading 100 mg ta kwamfutar hannu kowace rana don kwana 3. Bayan da aka yi amfani da nauyin loading, ana amfani da kashi 20 na mg Arava don maganin cututtuka na rheumatoid. Kwamitin na 10 mg yana samuwa ga marasa lafiya da ake buƙatar ƙananan kashi saboda sakamakon da aka samu tare da kashi mafi girma. Zai iya ɗaukar makonni da dama kafin a sami cigaba mai kyau a fuska ta haɗi ko haɗuwa da haɗin gwiwa. Ba za a iya samun cikakkiyar amfani ba har sai makon 6 zuwa 12 bayan da aka fara Arava.
Yadda Yake aiki
Arava shi ne wani wakili na rigakafi wanda ya hana dihydroorotate dehydrogenase, wani enzyme da ke cikin kwayar pyrimidine. Pyrimidines suna gina tubalin nucleic acid. Arava yana hade da aiki na antiproliferative (ma'anar, yana hana yaduwar kwayoyin halitta) da kuma gwajin, ya nuna alamun ƙwayoyin cutar.
Yana kaddamar da halittar DNA wadda ake bukata don samfurori masu tasowa, kamar su kwayoyin halitta marasa tsari. Ta hanyar yin hakan, yana rufe tsarin tsarin . Yaya aka yi amfani da shi musamman don sarrafa ilimin cututtuka na rheumatoid ba a fahimta ba.
Hanyoyi na gefen da Ayyukan Kishi
Hanyoyin da ke cikin halayen da suka haɗa da Arava sun hada da cututtuka, tashin zuciya, ciwon kai, kamuwa da cututtuka, numfashi hanta enzymes (ALT da AST), alopecia, da rash. Girman hawan enzymes hanta yakan rinjayar kasa da kashi 10 na marasa lafiya ɗauke Arava, amma saboda zai iya haifar da raunin hanta, musamman tare da yin amfani da barasa ko wasu kwayoyi, ana yin gwaje-gwaje na yau da kullum don kulawa da hanta.
An tsara tasirin abubuwan da suka faru da suka shafi 1% zuwa kasa da 3% na marasa lafiya na wutsiya marasa lafiya wadanda suka halarci gwaji don Arava. Matsalar huhu, ciki har da tari ko rashin ƙarfi na numfashi, ana ganin ƙananan sakamako ne. Wajibi ne a sanar da marasa lafiya game da bayyanar cututtuka na cutar kututtukan jini da kuma bayar da rahoton waɗannan alamun sunadarai idan sun samu kwarewa.
Diarrhea, sakamako mafi rinjaye, yana shafi kimanin kashi 20 cikin dari na marasa lafiya da aka bi da Arava. Diarrhea saboda Arava yakan yi amfani da lokaci tare da lokaci ko ta shan magani don hana cututtuka.
A wasu lokuta, kashi na Arava yana bukatar a rage.
Gargaɗi da Contraindications
Kada a yi amfani da Arava da mata masu ciki ko kuma matan da za su iya ciki kuma ba su yin amfani da maganin hana haihuwa. Dole ne a guje wa juna ciki a lokacin kula da Arava da kuma kafin a kammala aikin kawar da miyagun ƙwayoyi bayan magani tare da Arava.
Raunin ciwo mai tsanani, ciki har da rashin hanta na hanta, an ruwaito a wasu marasa lafiya wadanda aka bi da su tare da Arava. Marasa lafiya tare da rigakafi ko kuma ciwon hanta kullum kada a bi da su tare da Arava.
Arava ba a ba da shawarar ga marasa lafiya da tsananin rashin daidaituwa, ƙwayar dullplasia mai kasusuwa, ko cututtuka ko ƙananan cuta.
Rahotanni game da pancytopenia, agranulocytosis, da thrombocytoplenia sun ruwaito. Dole ne a yi la'akari da ƙwayar jinin don kulawa da abubuwan rashin hauka.
Ƙananan lokuta na cututtuka na Stevens-Johnson da ciwon haɗari mai maɗauri, sannan kuma sunyi bayani game da maganin magungunan miyagun ƙwayoyi tare da eosinophilia da tsarin alamar kwayoyin cutar) a cikin marasa lafiya da aka bi da su tare da Arava. Idan wannan ya faru, ya kamata a dakatar da Arava kuma za'a iya farawa hanyar kawar da miyagun ƙwayoyi.
An bayar da rahotanni neuropathy a wasu marasa lafiya ɗauke Arava. Duk da yake a mafi yawan lokuta, alamar cututtuka sun ci gaba da raguwa da Arava, wasu marasa lafiya suna da alamun bayyanar.
Sources:
Arava kwamfutar hannu. Bayyana Bayani. Sanofi-Aventis US Revised Nuwamba 2014.
Leflunomide (Arava). Kwalejin Amirka na Rheumatology. Updated Mayu 2015.