Magungunan kwayoyi sunyi kumburi da sauri
Corticosteroids ko glucocorticoids, sau da yawa kawai ake kira "steroids", an yi tsammani daya zama mu'ujiza. A 1948, a asibitin Mayo a Rochester, Minnesota, wani ɓangare na marasa lafiya na arthritis an ba su kowace rana injections na corticosteroid. Sakamakon haka ya kasance mai karfin gaske kuma cigaba yana da ban mamaki sosai, likitoci sunyi tunanin cewa "warkewa" don maganin arthritis an gano.
Duk da haka, yayin da ake amfani da corticosteroids a fadin shekaru, an sami sakamako mai lalacewa. Babban dogayen da aka ba a tsawon lokaci ya juya steroid a cikin "tsoratarwa." An gargadi marasa lafiya game da matsaloli masu wuya, yin amfani da corticosteroids ya zama mafi mahimmanci, kuma wasu marasa lafiya sun ƙi magani saboda suna jin tsoro.
A gaskiya ma, corticosteroids sune kwayoyi masu karfi waɗanda zasu iya zama masu amfani idan ana gudanar da su a cikin jagororin da suka dace. Fahimtar yadda suke aiki da kuma yadda za a iya amfani da su lafiya yana da muhimmanci.
Bayani
Corticosteroids sune kwayoyi da alaka da cortisol da alaka da shi, wani hormone wanda aka samar da shi a cikin adonal cortex (matsanancin farfajiyar glandon adrenal). Corticosteroids sun hada da:
- Betamethasone (Celestone)
- Budesonide (Shirin EC)
- Cortisone (Cortone)
- Dexamethasone (Decadron)
- Hydrocortisone (Cortef)
- Methylprednisolone (Medrol)
- Prednisolone (Prelone)
- Prednisone (Deltasone)
- Triamcinolone (Kenacort, Kenalog)
Ayyukan Cortisol
Cortisol tana taka muhimmiyar rawa wajen sarrafa gishiri da daidaitaccen ruwa a jikin jiki da kuma gyaran carbohydrate, mai, da kuma gina jiki. Lokacin da jiki ya kara ƙarfafawa, glandon da ke cikin kwakwalwa ya bar ACTH (adrenocorticotropic hormone) wanda ya haifar da glandon da zai samar da cortisol.
Ƙarin cortisol yana ba da damar jiki don magance matsalolin da ke damuwa, irin su kamuwa da cuta, cuta, tiyata, ko matsalolin motsa jiki. Lokacin da yanayi ya damu, adadin hormone ya koma al'ada. Glandar da ke cikin jiki yakan samar da kimanin milikir 20 na cortisol kowace rana, mafi yawa a safiya, amma zasu iya samar da sau biyar a lokacin da ake bukata.
Yaya Corticosteroids aiki
Corticosteroids aiki a kan tsarin rigakafi ta hanyar hana hana abubuwa da ke haifar da rashin lafiyar da ƙananan ayyuka , irin su prostaglandins. Duk da haka, su ma sun hana aikin jinin jinin wanda ke halakar da ƙwayoyin waje kuma ya taimaka wajen kiyaye tsarin na rigakafin aiki yadda ya kamata. Rashin tsangwama tare da aikin jinin jini yana haifar da sakamako mai mahimmanci ga kamuwa da cuta.
Shaidawa
Corticosteroids ana amfani dasu sosai saboda yanayi da yawa. An yi amfani da su wajen sarrafa kumburi da mahalli da gabobin a cikin cututtuka irin su:
- Rheumatoid arthritis
- Lupus (Tsarin Lupus Erythematosus)
- Ankylosing spondylitis
- Harsashin yara
- Ƙunƙashin ƙwayar cutar ciwon jini
- Dermatomyositis
- Polymyositis
- Mixed nama mai launi
- Ciwon Behcet
- Polymyalgia rheumatica
- Scleroderma (tsarin sclerosis)
- Giant cell arteritis (jiki arteritis)
Corticosteroids ba a yi amfani dasu ba don osteoarthritis , ko da yake an yi amfani da su a wasu lokuta a matsayin wani allurar gida a cikin haɗin gwiwa.
Gudanarwa
Corticosteroids suna da kyau a cikin yanayin aikace-aikace. Ana iya ba su:
- Orally
- Injected a cikin jijiya ko tsoka
- Aikata gida zuwa fata
- Gigar da kai tsaye a cikin ɗakunan flamed
Corticosteroid magunguna kuma za a iya amfani da shi a matsayin sinadaran kunshe a cikin:
- Eye kayayyakin (mu bi da yawa ido yanayi)
- Inhalers (don magance cututtukan fuka ko cutar maraba)
- Nasal saukad da kuma sprays (don magance matsaloli daban-daban)
- Magunguna masu mahimmanci, kayan shafa, da dai sauransu. (Don magance matsalolin fata)
Corticosteroids za a iya amfani dashi tare da wasu kwayoyi kuma an tsara su don gajeren lokaci da amfani da dogon lokaci. Prednisone (sunayen sunaye Cortan, Deltasone, Liquid Pred, Meticorten, Orasone, Panasol-S, Prednicen-M, da kuma Sterapred) sune mafi yawan rubutun corticosteroid don maganin arthritis. Yana da hudu zuwa biyar sau da yawa kamar yadda cortisol. Sabili da haka, miliyoyin nau'i na prednisone daidai ne da kayan aikin yau da kullum na cortisol. Akwai wasu corticosteroids na roba wanda akwai bambanta da aiki da rabi.
Injection vs. Corticosteroids na Oral
Wani harbe-harben steroid, wanda aka kira shi a matsayin cortisone harbe, corticosteroid injection, ko maganin intra-articular wani allurar wani steroid kai tsaye a cikin abin da aka haɗa. Wannan hanya tana ba likitoci damar amfani da allurai na corticosteroid kai tsaye a shafin yanar gizo na kumburi. Tun da yake an gano shi, sauran jikin ya kare babban tsinkayen magani.
Kamuwa da cuta a shafin injection yana iya yin tasiri. Hanyoyi masu yawa a cikin wannan haɗin gwiwa na iya haifar da lalacewa. Doctors yi amfani da wannan magani saurin, bayan da wasu zaɓuɓɓuka sun gaza, kuma ƙoƙarin ƙuntata adadin injections zuwa sau ɗaya a kowane watanni kuma kadan a cikin duka don haɗin gwiwa.
Hanyoyin Gaba
Hanyoyin tasiri na corticosteroids na iya haifar da mummunan sakamako masu illa wanda ke nuna cutar Cushing, rashin lafiya na lalacewa wanda ya haifar da cortisol. Jerin yiwuwar sakamako mai tasiri yana da tsawo kuma ya haɗa da:
- Ƙara yawan ci abinci da riba
- Amfanin kaya a kirji, fuska, babba baya, da ciki
- Tsarin ruwa da gishiri da ke haifar da kumburi da kuma edema
- Hawan jini
- Ciwon sukari
- Alamun launin fata da baka
- An warkar da raunuka
- Osteoporosis
- Cataracts
- Kuraje
- Ƙarfin tsoka
- Thinning na fata
- Ƙara ƙarami zuwa kamuwa da cuta
- Cutar ulcers
- Ƙãra sweating
- Yanayin motsi
- Matsaloli masu ilimin halin kirki kamar ciki
- Ƙuntatawa da rikici
Za'a iya rage yawan sakamakon ta hanyar biyan umarni na likita da kuma yin amfani da ƙimar mafi ƙasƙanci. Yana da mahimmanci don kauce wa tsarin kai na kashi, ko dai ta ƙara ƙarin ko dakatar da magani ba tare da jadawali ba.
Wurin gajeren lokaci vs. Far-Term Far
Idan aka yi amfani da shi azaman magani na gajeren lokaci, ana yin umarni da yawa a cikin kashi na matsakaici kuma rage ko "tafe" akan lokaci ɗaya ko biyu. Dalilin shi ne don cimma burin ci gaba a cikin bayyanar cututtuka, amma ba ƙarfafa tsawon lokacin amfani da corticosteroid ba.
Tsarancin lokaci mai tsawo ana adana yawan lokuta na cututtuka na rheumatoid ko cututtuka masu dangantaka. Yawancin yawanci biyar zuwa bakwai da rabi miliyoyin nau'i na rana ya ci gaba a cikin watanni ko shekaru.
Anyi amfani da kwayoyin steroid a matsakaicin lokaci don mafi yawancin cututtukan da suka kamu da cututtukan cututtuka. Yayi amfani da kashi mai mahimmanci a kowace rana na nau'i nau'i na nau'i daya a kowane milligram a kowace kilogram na nauyin jiki ko kimanin minti 60 a kowace rana da aka ba a cikin allurai. A irin waɗannan lokuta, ana kashe "stered" a wuri-wuri.
Don rage nau'in sakamako mai tasiri, dole ne a ba da mahimmancin kashi mai kyau na corticosteroid. Wannan shine kashi mafi kyau.
Ƙasashewa
Dole ne a rage sashin corticosteroids a hankali domin yaron da zai iya ci gaba da aikin cortisol na halitta. Kashewa da sauri zai iya haifar da rikicin rikici (yanayin barazanar rai da rashin ciwon cortisol) ko da yake wannan abu ne mai wuya.
A lokuta da aka dauki corticosteroid a cikin jinkiri na dogon lokaci, tazarar zai iya ci gaba har tsawon watanni ko shekaru. Wasu lokuta, ana saukar da sutura ta hanyar kawai miligram ta kowane lokaci don hana ƙyama. Lokacin da ake ɗaukar suturar don lokaci mafi tsawo, tazarar yana da sauri kuma ragewa a cikin sashi zai iya girma.
Wani yiwuwar yiwuwar da ke haɗuwa da katsewa daga steroid shine steroid janyewar ciwo, ko sakamako mai mahimmanci, wanda shine jigilar jikin mutum don kawar da miyagun ƙwayoyi. Hakan zai iya haifar da zazzaɓi, ciwon tsoka, da kuma ciwon haɗin gwiwa, yana mai da wuya ga likita ya bambanta tsakanin bayyanar cututtuka da kuma wariyar cutar ta kanta.
Bayyanawa
Bisa ga littafin The Pill Book (Bantam Books), ta yin amfani da miliyoyin digiri biyar na ainihi a matsayin tushen abin da aka kwatanta, daidai sassan sauran corticosteroids sune:
- 0.6 mg-0.75 MG na Betamethasone
- 25 MG na Cortisone
- 0.75 MG na Dexamethasone
- 20 MG na Hydrocortisone
- 4 MG na Methylprednisolone
- 5 MG na Prednisolone
- 4 MG na Triamcinolone
Corticosteroid Converter yana ƙididdige ƙwayoyi daban-daban na corticosteroids. Yana da kayan aiki mai sauki mai amfani.
Kalma Daga
Corticosteroids sune kwayoyi masu karfi waɗanda zasu iya inganta bayyanar cututtuka da kuma haifar da sakamako mai ban mamaki. Akwai sakamakon da ya shafi haɗin da suke amfani da su wanda ba a kula ba, duk da haka. Kada a ji tsoro da ikon corticosteroids, amma dole ne a girmama shi.
Sources:
Kelley's Textbook na Rheumatology. Tsarin na tara. Elsevier. Glucocorticoid Far Babi na 60. Jacobs da Bijlsma.
Cibiyar Nazarin Arthritis ta Jami'ar Duke, David S. Pisetsky MD
Sobel, Klein. Arthritis: Abin da Works, St Martins Press; 1999.