Kulawa don illa mai lalacewa za'a iya buƙata yayin shan wasu magunguna
Kwararren likitanku zai umurci wasu gwaje-gwaje don saka idanu da cutar ta hanyar hanya, amma kuma don tantance irin yadda magunguna ke aiki kuma idan suna da wata tasiri a kan sauran jikinku ko tsarin jiki. Mutanen da ke fama da cututtukan zuciya (IBD) suna bi da su tare da magunguna daban-daban, da dama daga cikinsu suna da hanyoyi daban-daban na yin aiki a jiki.
A mafi yawancin lokuta, cututtuka masu lalacewa suna da wuya, amma ana iya kama su da wuri don haka yana da kyau yin gwaje-gwaje don tabbatar da lafiyar lafiya.
Sharuɗɗan don gwadawa kafin fara wasu kwastam ne kawai: jagororin. Kowane likita da cibiyar IBD zasu yi abubuwa daban. Duk da haka, yana da mahimmanci ga mutanen da ke zaune tare da IBD don samun fassarar abin da zai iya zama matakin kulawa lokacin fara wasu magunguna. Wannan gaskiya ne a yayin da ba a gani a cibiyar IBD ko kuma idan mafi yawan kulawa yana kulawa da wani mamba na tawagar (kamar likita ko likita na farko).
Mutane da ke fama da cutar Crohn ko ciwon daji wanda ke da tambayoyi game da aikin lab da wasu gwaje-gwajen da aka ba da shawara yayin da masu shan magani na IBD su shawarci likitocin su.
Lokacin Shan Azulfidine (Sulfasalazine)
Azulfidine wata maganin maganin sulfa wanda ke dauke da acid 5-aminosalicylic (5-ASA) da sulfapyridine.
An yi amfani dasu don magance cututtuka da kuma wasu cututtukan ƙwayoyin ƙwayoyin cuta irin su arthritis na rheumatoid da sparkylitis ankylosing .
Wannan miyagun ƙwayoyi yana da tarihin amfani da lafiya don cututtuka, amma yanzu ana amfani dashi kadan a matsayin sababbin magungunan da suka fi tasiri kuma suna da ƙananan sakamako (ciwon kai da tashin hankali) an ci gaba.
Gaba ɗaya, ƙayyadaddun gwaje-gwaje ba tare da ƙididdigar CBC ba yawanci aka bada shawara yayin samun wannan magani.
Cikakken Ƙwayar Blood (CBC)
Za a iya gwada wannan gwajin jini kafin fara farawa tare da Azulfidine sannan kuma a kowace mako ko kowane wata don makonni shida na farkon zuwa watanni uku. Bayan haka, za a iya gwada gwajin a kowane wata na watanni uku sannan a kowane watanni uku don sauraran lokacin da ake ɗauke azulfidine.
Wannan shi ne bincika wasu cututtuka masu ban sha'awa irin su lalata ƙwayoyin jini (yanayin da ake kira agranulocytosis). Yawancin lokuta na agranulocytosis na faruwa a cikin watanni uku na jiyya.
Lokacin Shan Corticosteroids
Yin amfani da tsirrai a lokacin dogon lokacin da ake amfani da su a matsayin likita don IBD, amma ana amfani da su a wasu lokuta ko tare da wasu magunguna. Ɗaya daga cikin manyan la'akari da yin amfani da shi na yau da kullum shine hadarin kasusuwa.
Dual-Energy X-Ray Bazuwa (DEXA)
Za'a iya ba da shawarar DEXA scan kafin fara corticosteroid farfadowa. Bayan haka, ana iya sake aikatawa bayan shekaru biyu zuwa uku, ko nan da nan ga mutanen da ke da osteoporosis ko waɗanda suka sami wata alamar ɓarna na lalacewa, kamar rarraba.
Idan sakamakon DEXA ya nuna cewa akwai asarar kashi, za'a iya fara magani kuma za'a iya yin gwaje-gwaje.
Lokacin Shan Cyclosporine
Cyclosporine wani nau'i ne na miyagun ƙwayoyi na immunosuppressant wanda ya shafe tsarin tsarin rigakafi. An yi amfani da shi a wasu lokuta don ciwon cututtuka da cutar Crohn, har ma don hana ƙin gawar jiki bayan da aka dasa shi da kuma sauran yanayin kumburi irin su lupus, rheumatoid arthritis, da psoriasis. Ƙananan gwaje-gwaje za a iya yin umurni a yayin wannan magani.
Matsalar Level na Cyclosporine
Don tabbatar da isasshen miyagun ƙwayoyi yana cikin jiki don samun tasiri, ko kuma cewa matakan miyagun ƙwayoyi ba su da girma kuma suna haifar da mummunar tasiri, matakan magungunan ƙila zasu buƙaci a auna su ta hanyar gwajin jini.
Ƙungiyoyin mutane sunyi bambanci da miyagun ƙwayoyi da kuma matakan da ke cikin jini za su iya shafar wasu dalilai.
A farkon farawa tare da cyclosporine, ana iya gwada gwaje-gwajen akai-akai kamar yadda kullum har sai an samo asali. Bayan haka, za'a iya gwada gwaji a kowane mako, a kowane wata, ko fiye da haka. Ana iya sake dawowa idan akwai canje-canje, irin su idan bayyanar cututtuka sun fi muni ko wani magani ake bukata kuma yana shafar matakin cyclosporin.
CBC Count
Tsawan wannan jarrabawar jini zai bambanta bisa ga zaɓi na likita, amma a zahiri, yawan ƙwayoyin jinin jini, ƙididdigar jini da jini, haemoglobin, da hematocrit za a duba su lokaci-lokaci.
Urinalysis
Ana iya tambayi marasa lafiya don tattara ƙwaro don gaggawa . Sakamakon wannan jarrabawar zai iya taimaka wajen kulawa da matsaloli tare da koda da hanta. Ana iya yin umurni kowane lokaci yayin shan cyclosporine don tabbatar da cewa miyagun ƙwayoyi bazai haifar da wani mummunar tasiri akan waɗannan ɓangarorin ba.
Sauran Jarabobi na jini
Don tabbatar da cewa cyclosporin baya haifar da cutarwa mai cutarwa, likita na iya umurni wasu gwaje-gwajen don saka idanu akan koda da hanta, ciki har da matakan jini na urea (BUN) , bilirubin, magnesium, potassium uric acid, lipids, da enzymes hanta .
A lokacin da ake daukar nauyin (Azathioprine)
Iranran (azathioprine) wani maganin rigakafin rigakafin rigakafin immunosuppressive wanda aka umurce shi don bi da IBD da sauran yanayin ƙonewa irin su arthritis rheumatoid. Za a iya amfani da Iranran ta hanyar kanta ko a lokaci guda kamar sauran magunguna (kamar corticosteroids) don taimaka wa magungunan suyi aiki da kyau. Yayinda yake karbar Imuran, za a kula da marasa lafiya a hankali don sakamakon illa.
CBC Count
Don wata na fari, za'a iya yin wannan gwajin jini a mako-mako, sannan duk kowane mako a cikin watanni na biyu da na uku, sannan kuma bayan wata. Idan akwai canje-canjen sashi, ana aiwatar da mako-mako kuma a kowane mako zai sake farawa.
Tsarin Methyltransferase Ciopurine (TPMT) Level
Wannan jarrabawa za a iya yi kafin a karbi duk wani kwayoyi na thiopurine, wanda ya hada da Imuran, mercaptopurine (6-MP) , da thioguanine. Hakanan yawancin ƙwayar enzyme na TPMT an bincika ta hanyar gwajin jini, amma idan an gwada gwajin kwayoyin gwajin za'a iya kammala ta hanyar swabbing wasu sel daga cikin kunci.
Yana da mahimmanci cewa wannan gwajin ya kasance kafin shan magani don samun ainihin wakilci na matakin ƙwararrakin TPMT. An gwada wannan gwaji saboda TPMT shine enzyme a cikin jiki wanda ya rushe Na'uran da sauran magungunan irin wannan. Idan matakin TPMT a cikin jiki yana da ɗan ƙasa (wanda ya faru a kimanin kashi 10 cikin dari na mutane) ko ragu (wanda ya faru a kimanin kashi 0.3 cikin dari), shan magani na likitanci kamar Imuran zai iya haifar da mummunan sakamako.
Lokacin da Takaddama Mesalamine da sauran 5-ASA Drugs
Akwai wasu shirye-shirye daban-daban na mesalamine da ake amfani da su don magance cututtukan daji, kuma za'a iya ba da wannan magani ta bakin rai ko a cikin wani enema. Mesalamine wata magani ne mai 5-ASA wadda ke da alaƙa da raƙuman sakamako fiye da Azulfidine saboda ba ya ƙunsar sashin sulfa.
Ƙididdigar CBC da jarrabawar aikin hanta za a iya kammala kafin a fara wannan magani don samun matakin ƙaddamarwa. Duk da haka, babu shawarwari don ci gaba da gwaji a lokacin farfadowa. Ɗaya daga cikin gwajin da za'a iya yi akai-akai shine matakin creatinine.
Levelin Creatinine
Mesalamine wani farfadowa ne wanda ake dauka na tsawon lokaci. Tsarin halittar halitta za'a iya umurce kafin fara wannan magani, a makonni shida, a cikin watanni shida, a shekara ɗaya, sannan kuma a kowace shekara.
An yi amfani da matakin creatinine don taimakawa wajen saka idanu don mummunar sakamako a inda kodan ya zama mummunan, wadda ake kira dabbar da ke cikin tsakiya. Idan ana tsammanin cewa ana iya zaton jini ne, ana magance magani tare da mesalamine.
A lokacin da take Takaddama
Methotrexate wata maganin rigakafin maganin maganin maganin cututtuka da ake amfani dashi don magance cututtukan Crohn, maganin sparkylitis, rheumatoid arthritis, da psoriasis. An nuna shi don haifar da haukacin tayin kuma sabili da haka kada mata su kasance masu ciki ko masu neman ciki. Yana da mahimmanci a tattauna tattaunawar zubar da ciki kafin a fara wannan magani.
Tashin ciki
Kafin farawa hanya, za a iya ba da umarnin jarrabawar ciki don tabbatar da cewa yana lafiya don daukar magani. Wannan miyagun ƙwayoyi na iya haifar da zubar da ciki da kuma lahani na haihuwa. Methotrexate kuma ya shiga cikin madara nono, don haka ba a ba da shawara don amfani da iyayen mata ba. Za a iya yin jarrabawar ciki a duk lokacin amfani da miyagun ƙwayoyi idan yana da bukata.
Gwanin X-Ray da / ko Lung Function Tests
Methotrexate zai iya rinjayar huhu kuma sabili da haka kafin a fara fara, gwaje-gwaje don tantance aikin huhu zai iya yin umurni. Hakanan zai iya haɗa da nauyin canja wuri na carbon monoxide da gwajin gwagwarmaya don tabbatar da cewa babu matsaloli na huhu wanda ba a warwarewa ba, musamman a mutanen da suke shan taba ko wadanda suke shan taba.
CBC Count
Za a yi amfani da ƙimar jini kafin a fara farawa hanya, sa'an nan kuma za'a iya ba da umurni bayan mako daya da tsakanin makonni takwas da makonni 12 bayan haka. Rahotan jini mai ƙananan jini ba tare da an nuna su ba a cikin marasa lafiya tare da IBD, amma sun faru a marasa lafiya da cututtukan zuciya na rheumatoid.
Ƙungiyar Metabolic Aiki
Wannan gwaji na iya haɗa da BUN, carbon dioxide (CO2), creatinine, glucose, cholesterol, albumin, electrolyte, hanta enzymes, da matakan hormone thyroid. Wannan shi ne don kallon duk wani mummunan tasiri akan hanta da kodan. Wannan jarrabawa za a iya yi kowane watanni uku yayin da ake daukar matakai.
Biopsy na Halitta
Idan aikin hanta ya bayyana zai zama abin dogara dangane da sakamakon magungunan ƙwayar abin da ke ciki ko wasu alamu ko alamu, za a iya yin hawan mai hanta. Ga mutanen dake dauke da cututtukan arthritis ko psoriasis, za'a iya yin amfani da kwayar hanta sau ɗaya bayan an cimma wani mataki na hanya, amma a halin yanzu, ba a bayar da shawarar da za a yi nazarin halittu masu hanta ba kamar wannan ga mutanen dake da IBD.
Kalma Daga
Kamar yadda kullum, mai gastroenterologist shine mafi kyawun hanya domin tattaunawa game da irin nau'in saka idanu da ake buƙata yayin daukar magunguna na IBD. A mafi yawan lokuta, aiki na yau da kullum da sauran gwaje-gwajen an yi domin ya kama duk wani matsala da wuri kuma ya bi da su nan da nan.
A mafi yawancin lokuta lalacewar mummunan abu ne mai wuya amma ana iya kauce masa da wasu gwaje-gwaje masu sauƙi, wanda shine dalilin da ya sa yana iya zama kamar yana aikin jini ne sau da yawa. Jagoran akwai su don taimaka wa likitoci su gano yadda za su kula da marasa lafiya, amma duk masu haƙuri tare da IBD sun bambanta don haka ba kawai magani ne kawai ba, amma haka ne gwaji na yau da kullum da aka yi.
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> [Babu marubucin da aka rubuta] "TPMT jarraba kafin cutar azathioprine?" Drug Ther Bull . 2009 Janairu 47 (1): 9-12: Doi: 10.1136 / dtb.2008.12.0033.
> Cunliffe RN, Scott BB. Kula da kwayoyin cutar a cikin cututtukan ƙwayar cutar ciwo. Abincin Pharmacology & Therapeutics. 2002; 16: 647-662. Doi: 10.1046 / j.1365-2036.2002.01216.x
> Jacobson IM, Kelsey PB, Blyden GT, Demirjian ZN, Isselbacher KJ. Sulfasalazine-induced agranulocytosis. Am J Gastroenterol. 1985; 80: 118-121.
> Al-Shakarchi I, Lobão B, Henriques C, et al. "AB0230 Hanyar rigakafi da aka gano don cutar kututtukan jini - inganci ne a cikin kwakwalwa?" Annals of the Rheumatic Diseases. 2013; 72 >: A857 >.