Dulmarka Arthritis Daawooyinka
Dawooyinka arthritis-ka muddo dheer ayaa loo tixgeliyaa xulashada daaweynta "dhaqameed". Sababtoo ah jawaabta shakhsi ahaaneed ee ku saabsan daroogadu way kala duwan tahay, sababtoo ah saameynaha saameynaha iyo fal-celinta aan fiicnayn sidoo kale waa arrin, raadinta isku-dhafka ugu wanaagsan ee daawooyinka arthritis waxay noqon kartaa hawl aad u adag intii aad filan lahayd. Waa inaad noqotaa mid aqoon u leh daawooyinka kala duwan ee arthritis-ka, si aad u gaarto go'aanka wargalinta dhakhtarkaaga.
NSAIDs / COX-2 Inhibitors
NSAID-yada (daawooyinka nonsteroid anti-inflammatory) waxay ka mid yihiin dawooyinka ugu badan ee loo isticmaalo daawada arthritis. Waxaa jira saddex nooc oo NSAIDs ah: Salicylates (labadaba asetylated [eg, aspirin] iyo non-acetylated [sida soodhada}], Trilisate (choline magnesium trisalicylate), iyo Doan's Pills ama Novasal (magnesium salicylate); NSAID-ga dhaqameed; iyo COX-2 xannibaadayaasha xaddidan.
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Isticmaalida Kaabashooyinka Kaadi-yare si loo daaweeyo Arthritis and Damil-Chol
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JAK Inhibitors: Doorasho Daaweyn loogu talagalay Rheumatoid Arthritis
NSAIDs waxay u shaqeeyaan xakameynta waxqabadka enzyme, cyclooxygenase, oo loo yaqaano COX. Cilmi baaris ayaa muujisay in ay jiraan laba nooc oo ah cyclooxygenase, oo loo yaqaan COX-1 iyo COX-2 . NSAID-yadu waxay saameeyeen labadaba. COX-1 wuxuu ku lug leeyahay ilaalinta nudaha caafimaadka leh, halka COX-2 ay ku lug leedahay wadada bararka. COX-2 xannibaadayaasha doorashadu waxay noqdeen qayb ka mid ah NSAID-iyadoo Celebrex (celecoxib) ay ahayd markii ugu horreysay ee FDA loo ansixiyo dhammaadkii 1990maadkii.
NSAID-da dhaqameed waxaa ka mid ah:
- Ansaid (flurbiprofen)
- Arthrotec (diclofenac / misoprostol)
- Cataflam (potassium diclofenac)
- Clinoril (sulindac)
- Daypro (oxaprozin)
- Dolobid (diflunisal)
- Feldene (Piroxicam)
- Ibuprofen (brand Motrin, Advil)
- Indocin (indomethacin)
- Ketoprofen (magaca Orudis, Oruvail)
- Lodin (etodolac)
- Maqlo (Meclofenamate)
- Mobic (meloxicam)
- Nalfon (fenoprofen)
- Naproxen (magaca Naprosyn, Aleve)
- Ponstel (mefenamic acid)
- Relafen (nabumetone)
- Tilmaamaha (tolmetin)
- Vimovo (naproxen-esomeprazole)
- Voltaren (diclofenac sodium)
COX-2 Inhibitors waxaa ka mid ah:
- Celebrex (celecoxib)
Akhri: NSAID - Maxaad u Baahan Tahay
DMARDs
DMARDs (cudur-is-beddelidda daawooyinka ladagaallanka roodhiga) ayaa sidoo kale loo yaqaan "daawooyinka ladagaallanka ah ee roodhumka" sababtoo ah waxay caadi ahaan qaataan usbuucyo ama bilooyin si ay u shaqeeyaan "wakiilada labaad." Cilmi baaris ayaa xaqiijisay waxtarka DMARDs ee daaweynta rheumatoid arthritis , psoriatic arthritis , iyo ankylosing spondylitis iyo sidoo kale mudnaanta hore, daaweynta gardarrada ah oo la adeegsanayo DMARDs. Ujeedada lagu daaweynayo DMARD waa in la joojiyo horumarka cudurka iyo joojinta dhaawaca wadajir ah.
DMARD waxaa ka mid ah:
- Azulfidine (sulfasalazine)
- CellCept (mycophenolate)
- Cyclosporine (calaamadeynta Neoral, Sandimmune)
- Cytoxan (cyclophosphamide)
- Imuran (azathioprine)
- Leukeran (chlorambucil)
- Methotrexate (magaca Rheumatrex, Trexall)
- Minocin (minocycline)
- Penicillamine (cuprimine brand, Depen)
- Plaquenil (hydroxychloroquine)
Xeljanz (tofacitinib citrate), oo ah DMARD afka ah, ayaa la ansaxiyay FDA on November 6, 2012, si loogu daaweeyo dadka qaangaarka ah ee si firfircooni firfircoon u leh firfircoonida firfircoon ee firfircoonida ah ee rheumatoid arthritis-ka kuwaas oo ku yeeshay jawaab aan ku filneyn, ama aan loo dulqaadan karin daawada methotrexate. Xeljanz waa kan ugu horreeya ee daawada daroogada loo yaqaan JAK (Janus kinase).
Akhriso: Xaqiiqooyinka ku saabsan DMARDs
Corticosteroids (Steroids)
Corticosteroids ama glucocorticoids, oo badanaa loo yaqaan "steroids," waa daroogooyin awood leh oo yareyn kara bararka iyo bararka si deg-deg ah. Daawooyinkaasi waxay la xiriiraan cortisol, hoormoon ay soo saaraan kortex ee qanjidhada adrenal. Waxaa lagu qoraa qiyaaso badan oo kala duwan oo ku xiran xaaladda iyo ujeeddada daaweynta. Inkastoo steroids loo isticmaali karo in lagu xakameeyo caabuqyada xubnaha iyo xubnaha cudurada wadnaha, sida rheumatoid arthritis, lupus , polymyalgia rheumatica , iyo vasculitis , waxaa la go'aamiyey in suurtagal ah in saameyno waxyeelo halis ah ay ku korodho qiyaasta sare ama muddo dheer Isticmaal.
Dhakhaatiirtu waxay qori karaan steroids mudo gaaban oo xoog ah, mararka qaarkoodna dhakhtarku wuxuu maamuli karaa xakameyn gudaha steroid ah oo isku dhaf ah, sida Kenalog (Triamcinolone), si uu kaaga caawiyo helitaanka xoogaa xanuun iyo barar.
Corticosteroids waxaa ka mid ah:
- betamethasone (Celestone brand)
- cortisone (cortone brand)
- dexamethasone (dekadron cilad)
- hydrocortisone (cortef)
- methylprednisolone (brand Medrol )
- prednisolone (magaca Prelone)
- prednisone (magaca Deltasone)
Akhri: Corticosteroids (Steroids) - Maxaad u Baahan Tahay
Qalabka Analgesics (Daaweynta Xanuunka)
Qalabka lagu shubo waa daawooyinka xanuunka joojiya. Xakameynta xanuunka waa qayb muhiim ah oo ka mid ah daaweynta arthritis. Si kastaba ha noqotee, marka laga reebo NSAIDs, dawooyinka xanuunka yareeya kama yareeyaan infakshan. Acetaminophen (Tylenol) waa calaamadaha ugu badan ee la isticmaalo. Daawooyinka daroogada ee loo yaqaan 'Narcotic analgesic drug' ayaa sidoo kale loo qori karaa xanuunka daran.
Narcotics waxaa ka mid ah:
- Codeine (Tylenol # 3)
- Duragesic (Fentanyl Maqaarka Patch)
- Hydromor (Palladone) - maaha suuqa
- MS Contin (morphine sulfate)
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Hydrocodone / Acetaminophen - Maxaad u Baahan Tahay Inaad Ogaato
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Talo ku Saabsan Dadka Ay Dhibaato Kiniinka liqa
- OxyContin (Oxycodone)
- Percocet (oxycodone / acetaminophen)
- Percodan (oxycodone / aspirin)
- Talwin NX (pentazocine / naloxone)
- Ultracet (tramadol / acetaminophen)
- Ultram (tramadol)
- Vicodin (hydrocodone / acetaminophen)
Akhri: Daawooyinka Kansarka ah - Waxyaabaha Aad U Baahan Tahay
Wax ka beddelka Jawaabaha Biyoolojiyada (Biyoolojiyada)
Jawaabaha Biyoolojiyada Jawaabcelinta (BRMs), oo inta badan loo yaqaano bayoolojiga , kicinta ama soo celinta awoodda nidaamka difaaca si loola dagaallamo cudurka ama caabuqa. Biyoolajiyadu waa daroogo ka soo jeeda ilo nool oo ka soo horjeeda kiimikooyinka la isku keeno.
Cunto (adalimumab) , Cimzia (certolizumab pegol) , iyo Simponi (golimum) bartilmaameedsan TNF-alpha, mid ka mid ah cyokokine ugu muhiimsan ee ku lug leh rheumatoid arthritis. TNF-blockers (daawooyinka bayolojiga ee ku xiran TNF-alpha) waxay si aan firfircooneyn u soo saareen, taas oo faragelisa waxqabadka nabarka iyo ugu dambeyntii hoos u dhaca dhaawaca wadajir ah.
Kineret (anakinra), sidoo kale daroogada bayoolajiga, waa antagonist IL-1. Kineret wuxuu ahaa kan ugu horreeya ee lagu xakameynayo interleukin-1 (IL-1), oo ah borotiinka oo lagu arko in ka badan dadka qaba rheumatoid arthritis. Marka la joojiyo IL-1, Kineret wuxuu joojiyaa xanuunka iyo xanuunka la xiriira rheumatoid arthritis. Kineret waxaa loo isticmaali karaa kaligiis, ama marka lagu daro DMARD kale, marka laga reebo daawooyinka anti-TNF. Inkasta oo Kineret uu yahay ikhtiyaari, marar dhif ah ayaa loo qoraa.
Orencia (abatacept) wuxuu ahaa midka ugu horreeya ee T-unugyada xayeysiinta kiciyeyaasha si loogu oggolaado daaweynta rheumatoid arthritis.
Rituxan (rituximab) , oo ah dawada ugu badan ee iibisa kansarka, ayaa FDA ogolaaday bishii Maarso 2006 si loogu isticmaalo daawada methotrexate si loogu daaweeyo rheumatoid arthritis by yaraynta calaamadaha iyo astaamaha dadka qaangaarka leh rheumatoid arthritis-dhexdhexaad ah oo firfircoon mid ka mid ah ama ka badan dawooyinka anti-TNF. Rituxan waa daaweynta ugu horeysa ee loo yaqaan 'rheumatoid arthritis' kaas oo si xaddidan u bartilmaameedsanaya unugyada CD20-positive B-cells.
Actemra (tocilizumab) waa unug monoclonal antoclonal oo joojiya daawada interleukin-6 (IL-6), taas oo xannibaysa interleukin-6. Actemra waxaa oggolaaday FDA on Jan. 8, 2010 ee loogu talagalay daaweynta cudurka rheumatoid ee qaangaarka ee dadka ee ku fashilmay hal ama dhowr TNF-blockers.
Daaweynta Rheumatoid Arthritis - Talooyin ACR
Dawooyinka Fibromyalgia
Ilaa 2007, ma jirin daawooyin ay ansixisay FDA si loogu daaweeyo fibromyalgia . Dhakhaatiirta la daweeyay fibromyalgia oo leh daawooyin kala duwan ayaa la sameeyay waxaana loo oggolaaday calaamado kale. Sannadkii 2007, Lyrica (pregabalin) ayaa loo ogolaaday inay daaweyso fibromyalgia. Sanadkii 2008, Cymbalta (duloxetine HCK) ayaa loo ogolaaday fibromyalgia. Sannadkii 2009, Savella (milnacipran HCK) ayaa loo ansixiyey xaalada.
Gout Drugs
Gout waa mid ka mid ah noocyada ugu xanuunsan ee xanuunka arthritis. Waxaa lagu maamuli karaa daawooyinka, cuntada, iyo isbedelka qaab nololeedka. Waxaa jira saddex dhinac oo daaweynta turjubaanka leh daawooyinka: xannuunada, daawooyinka ka hortagga dabka, iyo daroogooyinka lagu maareeyo heerarka uric acid iyo weerarrada qoxootiga .
Daroogooyinka loogu talagalay gout waxaa ka mid ah:
- Acetaminophen (Tylenol), ama xanuunka xanuunka kale ee xanuunka, xanuunka xanuunka
- NSAIDs (daawooyinka nonsteroidal anti-inflammatory), badanaaba indocin (indomethacin), for inflammation
- Colchicine , si looga hortago ama loo kabo weerarro qoxooti ah
- Corticosteroids, oo loogu talagalay jawaab degdeg ah oo ka hortag ah
- Probenecid (Benemid, Probalan), si loo yareeyo heerka dhiigga uric acid
- ColBenemid (Col-Probenecid iyo Proben-C) waxay leeyihiin waxyaabo ka hortag ah gout
- Allopurinol (zyloprim) , si loo yareeyo dhiigga uric acid by ka hortagga wax soo saarka uric acid
- Losartan (Cozaar, Hyzaar), gaar ahaan maandooriyaha gout, laakiin waa daawada ka hortagga uurka ah oo laga yaabo inay ka caawiso xakamaynta heerka uric acid
- Fenofibrate (Tricor), ma aha daawo qaas ah oo gaar ah, laakiin waa daawada lipid-hoos u dhigta oo laga yaabo inay ka caawiso heerarka uric acid
- Uloric (febuxostat) , waxay hoos u dhigtaa heerarka serum uric acid by blocking oksidase xanthine
- Krystexxa (pegloticase), daroogo bayooloji ah oo ka shaqeeya jabinta acid uric
Mukhaadaraadka Cudurka Osteoporosis
Cudurka Osteoporosis waa xaalad lagu garto lafo jilicsan, oo lafdhabar u ah, kaasoo ah kuwa ugu badan dadka waayeelka ah, laakiin sidoo kale waxay noqon kartaa dhibaato dhib leh dadka qaada corticosteroids (steroids) muddo dheer. Waxaa jira dhowr qaybood oo kala duwan ee daawooyinka loo yaqaan osteoporosis: estrogens, hormoonnada parathyroid, wakiilada lafaha, bephosphonates, iyo molecules xabbadlaha leh. Iyadoo ku xiran daroogada loo isticmaalo, waxaad yareyn kartaa lafaha luminta, kor u qaadista kobaca lafaha, iyo inaad yareyso halista jabka.
Dawooyinka loo yaqaan osteoporosis waxaa ka mid ah:
- Actonel (kor u kicin)
- Boniva (ibandronate)
- Didronel (etidronate)
- Estrogens (daaweynta hoormoonka)
- Evista (raloxifene)
- Forteo (teriparatide)
- Fosamax (alendronate)
- Miacalcin (Calcitonin)
- Dib u noqoshada (zoledronic acid)
- Prolia (denosumab)
Ereyga
Hadafyada asaasiga ah ee daaweynta xanuunka iyo cudurrada rheumatiska ee daawooyinka leh daaweynta waxaa ka mid ah xakameynta xanuunka, hoos u dhigista bararka, gaabinta sii socodka cudurka, iyo maareynta hawlaha cudurka. Waxaa jira noocyo badan oo ah arthritis iyo daroogooyin badan oo ah daroogo kasta. Taasi waxay dooranaysaa daaweyn qadar ah. Go'aaminta daawada ama daawooyinka isku dhafan ee saxda ah ee adiga kugu habboon waxay noqon kartaa wax lagu adkaado. Waxay u badan tahay in ay qaadato tijaabo iyo qalad - aadna isku dayayso inaad isku daydo ilaa aad ka dareento inaad heshay jawaab ku filan. Verywell waxay soo saartay xaqiiqooyinka aad u baahan tahay inaad ka ogaato daawooyinka arthritis. Macluumaadka ayaa bixiyay waxay kaa caawineysaa inaad fahamto sababta aad u qaadanayso daawada aad qaadato oo kaa caawin doonta inaad diyaariso su'aalaha dhakhtarkaaga.
> Isha:
> Kelley ee buugta qoraalka ee Rheumatology. Qaybta 8. Farmashiyada Mukhaadaraadka Antirowmanka. Elsevier. Qoraalka sagaalaad. Gaaray 07/23/16.