Fahamka Xiiqda Caruurta
Neefsashada neefta waa hab ku habboon in lagu siiyo daawooyinka neefta ee sanbabada ilmaha. Inkasta oo mashiinka wax lagu yareeyo si sahlan loo isticmaalo, waalidiinta iyo carruurta badani ma jecla inta ay qaadanayaan si ay u bixiyaan daaweynta neefta.
Neefsashada Neefaha
Nasiib darro, marka ay ku haboon tahay, neefta neefta waa in si habboon loo isticmaalo, waxay u baahan tahay tallaabooyin badan, haddii ay noqonayaan kuwo waxtar leh.
Taas waxaa fududeyn kara in la isku daro daawo-qaadasho daawo-cabir leh oo leh qalab ama mashiinka daboolka leh, laakiin daawada neefsashadu waa in si sax ah loo isticmaalo.
Waxaa laga yaabaa in aadan awoodin in aad ka baxdo adigoo isticmaalaya neef-qaadaha neefta, inkastoo, qaar ka mid ah daawooyinka neefta oo kaliya ayaa la heli karaa sida daawada neefsashada. Tusaale ahaan, inkastoo ay jiraan noocyo soodhaweyn ah oo albuterol ah , levalbuterol (Xopenex), iyo Pulmicort (budesonide), daawooyinka kale ee lagu daaweeyo xiiqda waxaa kaliya oo loo heli karaa sida neefsashada.
Noocyada Neefsashada Neefta
Waxaa jira laba nooc oo asaasi ah oo neef-qaadasho ah, oo ay ku jiraan daawada qiyaasaha daaweynta jirka (MDI) oo dad badani yaqaaneen, iyo kuwa cusub ee daawada loo yaqaan "DPI". Guud ahaan, dadka intooda badani waxay u maleynayaan in bukaansocodka qallalan ee loo isticmaalo si sahlan loo isticmaalo, maxaa yeelay neefsashadooda (daawada ma soo baxayso ilaa aad neefsato), halka daawada loo isticmaalo daawada loo isticmaalo u baahan tahay in la isku duwo isticmaalka neef qoto dheer leh daawada neefsashada.
- (CFC) - daawooyinka loo yaqaan 'chlorofluorocarbons' ayaa la jaray sababtoo ah welwelka deegaanka
- (HFA) - Qalabka cusub ee CFC-free fluoroalkene isdulqaadeyaasha
- neefsashadii qiyaasta daaweynta loo yaqaan 'meter-inhalers' (HFA) - oo ka qaalisan MDI kale
- qallajinta daawo budada ah - sida caadiga ah looma isticmaali karo illaa carruurta ay ugu yaraan 5 ilaa 6 jir yihiin waxayna qaadan karaan neefsasho qoto dheer oo adag. Caruurtu waxay badanaa isku dayaan inay ku dhuftaan neefsashada, halkii ay ka neefsan lahaayeen.
Markaad isticmaasho qallajin budo ah oo engegan, caruur badan oo yaryar ayaa sameeya qaladka:
- dejinta qalabka neefsashada qaldan
- illowday inaad si buuxda u neefsato ka hor intaadan isticmaalin daawada neefsashada
- ma qaadanayo qoto dheer, xoog leh oo neefsan
- ha ku haynin neefkooda ilaa 10 ilbidhiqsi
- illowday inaad si tartiib ah u neefsato
Dabcan, waa wax caadi ah in qaladaad lagu sameeyo qiyaasaha daawada loo isticmaalo qiyaasaha, sidoo kale. Qalad qalqal ah ayaa loogu talagalay carruurta in ay ilaawaan in ay qaataan tartiib tartiib tartiib ah oo qoto dheer, neefsashada si aad u dhakhso badan.
Nafaqeeyayaal leh daaweyaal
Inkasta oo uu ilmahaagu awoodi karo inuu isticmaalo qiyaas daawo-cabir ah marka uu gaaro 6 sano jir, haddana waxay noqon kartaa fikrad wanaagsan in la isticmaalo isugeyn si uu u hubiyo inuu qaato qadarka buuxa ee sanbabada.
Xirfadlaha waa qalab yar oo lagu soo dari karo daawada neefsashada waxaana xitaa ku jiri kara maaskaro dhallaanka, socod-baradka, iyo xanaanada caruurta ee jira 4 sano ama ka yar. Waxaa ka mid ah qolka haynaya ee daawada ku leh daawada ilaa inta ilmuhu neefsado si uusan u baahnayn in uu isku duwo neefsashada iyadoo la adeegsanayo neefsashada.
Neefsashada Neefsashada
Neefsashada neef-xummada waxay ku jirtaa beta-agonis-yare oo si dhaqso leh u fududeyn kara marka ilmahaagu qabo calaamadaha asmada:
- ProAir HFA (Albuterol inhaler)
- Proventil HFA (Albuterol inhaler)
- Ventolin HFA (Albuterol inhaler)
- Ventolin HFA 60 (Albuterol inhaler)
- Xopenex HFA (levalbuterol inhaler)
- ProAir RespicClick (Albuterol inhaler) - budada neefta
Nafaqadayaashaas badbaadinta ayaa sida caadiga ah loo isticmaalaa oo kaliya saldhigga loo baahan yahay iyo ma aha maalin kasta. La hadal dhakhtarkaaga haddii ilmahaagu u muuqdo inuu u baahan yahay inuu isticmaalo daweyntiisa neefsashada degdegga ah ee ka badan laba jeer toddobaadkii.
Maxair AutoHaler (pirhuterol inhaler), MDI oo neefsanaya MDI ayaa laga saaray suuqa 2013-kii sababtoo ah waxay ku jiraan CFCs.
Neefsashada Hore ee Nafaqada
Cudurka 'corticosteroid inhalers' waa daaweyn ka hortag ah neefta .
Si ka duwan sida neef-qaadayaasha samatabbixinta, oo siin kara gargaar degdeg ah calaamadaha neefta, steroid neefta ayaa caadi ahaan loo isticmaalaa maalin kasta si looga caawiyo kahortaga ilmahaaga inuu yeesho calaamadaha asmada.
Inkasta oo ay u muuqato sida daawada steroid-ka ah, dhammaantood isku mid ah, qiyaasta walxaha daroogadu waxay saameyn kartaa sida ay u nuugaan. Guud ahaan, kuwa leh qiyaas yar oo walxo yar ah, sida Aerobid, Alvesco, iyo Qvar, waxay u maleynayaan in ay si fiican u dhigaan sambabada.
Waxaa laga yaabaa inay ka muhiimsan tahay cabbirka qaybaha si fudud u helaya daawada steroid ah oo si habboon u isticmaalaya maalin kasta:
- Aerobid (Fungisolide) - MDI ayaa loo ansixiyey carruurta ugu yaraan 6 jir ah
- Alvesco (cicsonide) - MDI ayaa loo ansixiyey carruurta ugu yaraan 12 jirka ah
- Asmanex Twisthaler (mometasone) - DPI ayaa ogolaatay carruurta ugu yaraan 12 jirka ah
- Diskus Flutent Diskus (Fluticasone) - DPI ayaa loo ansixiyey carruurta ugu yaraan 4
- Horefka HFA (Fluticasone) - MDI ayaa loo ansixiyey carruurta ugu yaraan 4
- Pulmicort Flexhaler (budesonide) - DPI ayaa loo ansixiyey carruurta ugu yaraan 6 jir ah
- Qvar (beclomethasone) - MDI ayaa loo ansixiyey carruurta ugu yaraan 5
Nafaqeeyaha kasta waxaa laga helaa xoogaa badan si uu u caawiyo inuu neefta ilmaha u kantaroolo si wanaagsan. Haddii daawo dufan oo hooseeya aaney shaqayn, ka dibna u wareegto qiyaasta sare, tusaale ahaan, ka guuritaanka Qvar 40 ilaa Qvar 80.
Carruurta qaba neefta dhexdhexaad ah ama neefta daran ee aan la xakameynin steroid-ka la nuugo, daawada daawada steroid ah oo leh beta-agonist waqti dheer ayaa caawin karta. Nafaqooyinkaas waxaa ka mid ah:
- Advair HFA - (Flovent + Serevent) - MDI ayaa loo ansixiyey carruurta ugu yaraan 4
- Advair Diskus - oo ah qaab DPI ah oo ku-ool ah - loo ansixiyey carruurta ugu yaraan 4
- Dulera - (Asmanex + Foradil) - MDI ayaa loo ansixiyey carruurta ugu yaraan 12 jirka ah
- Symbicort - (Pulmicort + Foradil) - MDI ayaa loo ansixiyey carruurta ugu yaraan 12 jirka ah
Marka neefta cunugaaga si fiican loo xakameeyo adigoo isticmaalaya daawada daawada isku dhafan, la hadal dhakhtarkaaga si aad u aragto goorta ay dhici karto in la joojiyo daaweynta ilmahaaga si uu u isticmaalo kaliya daawada steroid.
Maxaad ka ogtahay neefta neefta ee carruurta
Waxaa laga yaabaa inay tahay waxa ugu muhiimsan ee lagu ogaanayo neefsashada neefta ilmahaaga ee waa inaad adigu isticmaashid illaa aad ka sheegto dhakhtarkaaga si aad u joojiso. Qorshe hawleedka neefta ayaa kaa caawin karta inaad hubiso inaad ogtahay markaad isticmaaleyso neefta neefta ee ilmahaaga iyo balamaha joogtada ah.
- Soo qaado dhamaan neeftaada neefta ee ilmahaaga markaad aragto dhakhtarkaaga si ay u ogaadaan waxa daawooyinka uu cunuggaagu qaadanayo iyo si ilmahaagu u muujin karo sida fiican (ama miskiin) farsamihiisu ay ula socdaan nuugayaasha.
- Neefsashada neefta waxay noqon kartaa mid qaali ah, labadaba kharashka iyo dib u bixinta shirkaddaada caymisku waxay noqon kartaa arrimo saameynaya nooca daawada ilmahaagu isticmaalo. Haddii shirkaddaada caymiska ay leedahay dawooyinka daroogada, waxaad tixgelisaa inaad keento liiska daawada neefta ee la doorbidayo booqashadaada dhakhtarkaaga.
- Intaa waxaa dheer in ay noqoto mid isdhaafsan oo la qaadi karo, iyada oo la adeegsanayo neefta neefta ayaa ka dhaqso badan daaweynta nebulizer.
- Qaar badan oo neef-qaadashada neefta ayaa loo adeegsadaa (oo ka soo horjeeda tilmaamaha lagu taliyey) carruurta ay da'doodu ka yar tahay da'da loo ogolaaday.
La hadal dhakhtarkaaga haddii aadan awoodin in aad daawato neeftaada neefta ilmahaaga. Dhakhaatiirta carruurta badanaa waxay leeyihiin shaybaarka iyo boonooyinka loogu talagalay neefta neefta ama waxay kaa caawin karaan barnaamijyada gargaarka dawooyinka ee ay shirkado badan oo daroogo hadda bixiyaan.
Ilaha:
Adkinson: Xasaasiyadda Middleton: Xeerarka iyo Tababarada, 7th ed .;
Dolovich MB, Ahrens RC, Hess DR, iyo al: Doorashada qalabka iyo natiijooyinka daaweynta aerosol: Tilmaamaha ku salaysan caddaynta: Kuleejka American Physicians Chest / College College of Asthma, Allergy, iyo Immunology. Chest 2005; 127: 335-371.
Hooyo, Yooxanaa. Doorashada qalabka neefsashada ee loogu talagalay dadka qaba neefta: Aqoonta hadda iyo baahida cilmi baarista ee aadka u sareysa. Daaweynta neefsashada CME, Volume 3, Issue 3, 2010, Boggaga 125-131.
Lavorini, Federico. Saameynta isticmaalka khaldan ee daawada budada qallalan ee maareynta bukaanka qaba neefta iyo COPD. Daaweynta Neefsashada, Tilmaamaha 102, Natiijada 4, Abriil 2008, Boggaga 593-604.
NIH. Tilmaamaha Hawlgabada Xiiqda. Tilmaamaha loogu talagalay Baaritaanka iyo Maareynta Neefta. 2007