Gyarawa da jinkirin aiki. Dukansu sun bayyana yadda ake amfani da kwayoyi, wanda ake kira DMARDs (maganin cututtukan maganin cutar antirheumatic), don amfani da maganin cututtuka na rheumatoid bayan an yi la'akari da kwayoyi marasa karfi. Ana amfani da DMARDs don magance yanayin haɗari mai haɗari, irin su spondylitis , psoriatic arthritis , lupus.
Ana amfani da kwayoyi ne saboda suna iya jinkirta aiwatar da cutar, ko da yake ba zato ba tsammani zai haifar da cikakken gyarawa .
Tunda yana iya ɗaukar watanni 6 zuwa 8 don ƙwayoyi don yada amsawa, ana ganin su kamar kwayoyi masu jinkirin kuma an zaba su a matsayin zabin na biyu bayan zabin aspirin da kuma NSAID (kwayoyin masu maganin kare jini).
Ba a fahimci yadda DMARDs ke aiki ba. DMARDs yana bayyana ƙananan ƙumburi ko da yake ba a rarraba su a matsayin kwayoyi masu guba ba. Sun kasance ba kamar NSAID ba tun da ba su rage aikin samar da prostaglandin ba, ba su taimaka wa zafi ba, ko rage zazzaɓi. A sakamakon haka, DMARDs suna jinkirta aiwatar da cutar ta hanyar gyaran tsarin tsarin rigakafi ta wata hanya.
Ana amfani da tasirin, aminci, illa, da kuma tsawon lokacin amfani da DMARDs game da marasa lafiya marasa lafiya. Nazarin a cikin shekarun da suka nuna sun nuna DMARDs su zama masu amfani da kwayoyi masu tasiri sosai, tare da yin la'akari da irin abubuwan da suka faru. Sakamakon saka idanu na yau da kullum yana taimakawa wajen kare hadarin sakamako. Da zarar an yi la'akari da zama magani na gajeren lokaci, DMARDs yanzu an dauki su a matsayin maganin da ke da dogon lokaci don sarrafa maganin cututtuka da kuma jinkirin cigaba da ciwo.
Gold don Arthritis
An gano shi ba zato ba tsammani da likitan Faransanci, an yi amfani da saltsin zinariya don maganin ciwon maganin ƙwaro don shekaru 50. Jacques Forrestier ya zubar da saltsin zinariya cikin cutar tarin fuka don kula da kamuwa da cuta. Mai haƙuri ya yi daidai da cewa yana da ciwon wariyar launin fata da kuma bayan watanni masu yawa da magani tare da zinariya, arthritis ya inganta.
An yi amfani da zinari don magance cututtuka a duniya tun daga lokacin.
Hanyar yadda aikin zinari yake ba shi da kyau amma a fili yana tsangwama da nauyin jini na jini wanda ke da alhakin haɗuwa da haɗuwa da ƙonewa . Kodayake zinari yana iya rage lalacewa, ba zai iya gyara cikakkiyar lalacewar haɗin gwiwa ba.
Zinariya an samo asali ne kawai a matsayin magungunan injectable. Idan aka ba shi tsarin ci gaba, yana buƙatar yin amfani da jini da kuma gwagwarmayar gwaje-gwajen da za a gudanar. A shekara ta 1986, zinariya ya samo asali tare da sunan kasuwancin Ridaura. Hanyoyin da ke hade da zinariya mai inganci suna raguwa a ƙananan ƙananan ƙananan hanyoyi da ƙuƙwalwar bakin ciki wanda yawanci yakan ɓace lokacin da aka dakatar da maganin. Zinariya mai jiji yana da ƙananan illa masu illa amma zai iya haifar da cututtuka mai wucewa ko kuma ƙuƙwalwar ƙuƙwalwa. Kogin zinari yana aiki sosai don kashi 10 cikin dari na marasa lafiya da sosai ga wani kashi 30-40. Kashi hamsin bisa dari na marasa lafiya sun dakatar da amfani dasu saboda sakamakon lalacewa ko rashin amfani.
Amfani da zinari ya ragu ƙwarai, musamman ma tare da ci gaban kwayoyin halittu . Na farko yanayin halitta, Enbrel, ya zama samuwa a cikin 1998.
Penicillamine
Penicillamine, dangin zumunci na penicillin, ya samu samuwa a shekarun 1970s.
An san Penicillamine a matsayin mai chelator saboda zai iya ɗaukar karafa mai nauyi a jiki. Hakanan ba a san ma'anar aikinsa a arthritis na rheumatoid amma anyi tunanin canzawan aikin jinin jini wanda ke da alhakin haɗuwa da haɗin gwiwa. Yana iya zama mai aiki yayin da yake haɗuwa da jan ƙarfe wanda yake cikin jiki.
An ba da launi na Penicillamine a cikin magana, farawa tare da ƙananan kashi, sa'an nan kuma ta hanyar ƙara karuwa. Ana ɗauka a cikin komai a ciki aƙalla sa'a daya kafin ko bayan abinci. Idan mai yin haƙuri dole ne ya zauna a kan wannan hanya na har abada ba tare da wani lokaci ba. Hanyoyi masu lahani suna kama da wadanda suke haɗuwa da zinariya - fatar jiki, ƙurar bakin ciki, asarar dandano da ciyayi gastrointestinal.
Protein a cikin fitsari na iya zama farkon alamar lalacewar koda.
Ana iya amfani da Penicillamine tare da NSAIDs, kodayake an dauki NSAID a lokacin abinci. Marasa lafiya wadanda ke fama da rashin lafiya ga penicillin har yanzu zasu iya daukar penicillamine. Yana da tasiri a kimanin kashi 30% na marasa lafiya.
Plaquenil (Hydroxychloroquine)
Plaquenil ya kasance yana samuwa har tsawon shekaru da dama kuma ana amfani da shi ne a asali na maganin malaria. Yana da sauƙi don amfani, yana da ƙananan sakamako, kuma baya buƙatar saka idanu tare da gwajin jini. Ana amfani da plaquenil ga marasa lafiya da cututtukan arthritis wanda ba su da kyau ga NSAIDs. Yana da mahimmanci a kimanin kashi 30% na marasa lafiya. An kuma amfani dasu ga marasa lafiya tare da lupus tsarin.
Plaquenil yana nuna tsangwama tare da aiki na cell. An ba da miyagun ƙwayoyi, daya ko biyu Allunan a rana. Ɗaya daga cikin mahimmancin sakamako mai mahimmanci shine ajiyar miyagun ƙwayoyi a cikin kwakwalwa tare da yiwuwar rashin gani. An gwada gwajin gwaji a kowane watanni shida. Ana iya ɗauka NSAID tare da Plaquenil kuma an tsara su tare.
Methotrexate (Rheumatrex)
Methotrexate , wanda aka yi tsawon shekaru 40, ana amfani dashi da yawa don bi da psoriasis da kuma amfani dasu don magance ciwon daji. A cikin shekarun 1970s, yawancin masu rheumatologists sunyi umurni da maganin cututtuka na rheumatoid a lokacin da NSAID fails. Methotrexate yayi aiki da sauri fiye da sauran kwayoyi masu yadawa, sau da yawa yakan kawo cigaba a cikin makonni maimakon watanni.
Methotrexate wani maganin antimetabolite ne, yana tsangwama tare da amfani da folic acid. Ana tsammanin zai hana hana tsarin aiki ba tare da rage ƙonewa ba. Hakanan zai iya rage jinkirin karuwar kwayoyin halitta a cikin membrane na synovial wanda ke sanya haɗin gwiwa.
Ana iya ba da ka'ida ta hanyar magana ko a matsayin magani mai injectable bisa ga tsarin jima'i. Tare da sababbin mawuyacin sakamako, amfanin lokaci mai tsawo zai iya haifar da lalacewar hanta. Dole ake buƙatar gwaje-gwajen aikin hanta.
Ana iya ɗauka Methotrexate tare da NSAIDs. Ana gargadin marasa lafiya da ke bin hanyar da za su guje wa barasa.
Sulfasalazine
Sulfasalazine shine haɗarin salicylate da kwayoyin halitta. Ya kasance tun daga shekarun 1940, a asali don magance marasa lafiya da cututtukan zuciya. A wani lokaci, an yi amfani dashi don maganin cutar wariyar launin fata amma an yi amfani da shi saboda iyakar damuwa game da illa. An kuma yi amfani dashi a gwaje-gwaje na asibiti a madadin zinariya. Akwai lokacin sabuntawar sha'awar amfani da shi azaman wakili mai ba da izini ba tare da matsalolin haɗari na zinariya da penicillamine ba.
Hanyoyin sulfasalazine ba a sani ba ko da yake yana da abubuwa biyu na aiki, ta hana kumburi da hana ci gaban kwayoyin. Sulfasalazine yana samuwa a cikin kwamfutar hannu da siffan ruwa. Ya kamata a guje wa mutane da ciwon sukari zuwa maganin sulfa da / ko aspirin da sauran salicylates. Abubuwan da suka shafi lalacewa sun hada da motsa jiki, cututtuka, zubar da ciki, da asarar ci. Abubuwa masu tsanani masu tsanani sune matsalolin fitsari, cututtuka na jini, da kuma rashin lafiyar mai tsanani.
A zabar kowane magani don magance ciwon maganin ƙwaro, dole ne ku da likitanku suyi la'akari da amfani da hadarin da ake yi.
> Source:
> Cibiyar Nazarin Arthritis ta Jami'ar Duke, David S. Pisetsky, MD