Maandoriyaha Ka shaqeyn kala duwan si aad u rumeysid ama ka hortagisid ciriiriga
Daaweynta neefta waxay udub dhexaad u tahay daaweynta dadka qaba cudurrada sambabada ee joogtada ah (COPD) . Halkii ay sugi lahayd kiniin si loogu daaweeyo iyada oo loo marayo dhiigga, daawada loo isticmaalo daawada waxay keentaa daawada si ay u hesho dhibaatada, helitaanka natiijooyin dhakhso ah oo la beegsado.
Waxaa jira daawada neefsashada oo ay ku jiraan hal dawo (monotherapy) iyo kuwa kale oo u keena daawooyin badan oo leh habab kala duwan oo ficilo ah.
Daawooyinka waa la jebin karaa saddex qaybood oo ballaadhan:
- Buro-hawleedyo yar-yar
- Dhaqdhaqaaqa mudada dheer socota
- Steroids oo la nadiifiyey
Shaqo kastaa si kala duwan ayaa loogu kala duwan yahay daaweynta ama ka-hortagga COPD waxayna bixisaa laf-dhabarka daawooyinka kale ee afka laga qaato ama la isku duro.
Dhaqdhaqaaq gaaban oo gaaban
Dadka qaarkiis ee qaba COPD waxay kaliya dareemaan calaamadaha (neefsashada neefta, xiiqdheerta) marka ay isdilayaan. Shakhsiyaadkaas, dhakhaatiirta ayaa sida caadiga ah u qori doona barkad-joojiye yar-yar, oo sidoo kale loo yaqaanno badbaadiyaha badbaadinta.
Bronchodilators waxay ku shaqeeyaan furitaan (xoqitaan) hawada hawada ( bronchioles ) oo lagu xannibo inta lagu jiro kiniinka COPD. Dhallin-saareyaasha yar-yar ee "bronchodilators" ayaa ah "si deg deg ah oo degdeg ah," taasoo micnaheedu yahay inay si dhakhso ah u shaqeeyaan oo ay ku caawiyaan qiyaastii afar ilaa lix saacadood. Waa in loo isticmaalo marka loo baahdo oo la geeyo meel kasta oo aad tagto haddii ay dhacdo xaalad degdeg ah.
Waxaa jira laba nooc oo daawooyin ah oo loo isticmaalo maadada gariir-gariirka gaaban: beta-agonists , kuwaas oo ku xidhan duubayaasha sambabada si ay u joojiyaan iska-caabinta, iyo anticholinergics , taas oo xannibaysa kiimikooyinka dhaliya xanuunka.
Dhibaatooyinka beta-beta-dila (SABAs) ee hadda la ansixiyay ee Mareykanka waa:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Anticholinergic-ka shaqeynaya ee hadda ku-meelgaadhka ah ee Maraykanka ayaa ah:
- Atrovent (ipratropium)
Waxaa sidoo kale jira habab isku-dhafan oo loo yaqaan "Combivent" kaas oo ku jira ipratropium iyo albuterol-beta-agonist oo gaaban.
Dhaqdhaqaaqa wakhti dheer leh
Dadka qaba COPD-da sareeya ayaa badanaa loo qoraa daawooyinka la nadiifiyey ee la qaato maalin kasta haddii ay leeyihiin astaamo ama haddii kale. Daawooyinkaan waxaa loo yaqaannaa bronchodilators waqti dheer.
Shakhsiyaadka khatarta ugu jira inay sii xumaadaan ayaa ka faa'iideysan kara daawooyinkan maaddaama ay bixiyaan bustaha ilaalinta meel kasta oo laga bilaabo 12 illaa 24 saacadood. Ayadoo ay ku jiraan maadada gariir-gaaban oo yar-yar, waxay ku jiraan daawada beta-agonist ama daawada anticholinergic.
Dhibaatada beta-dilaha ee dheeraadka ah (LABAs) ee hadda lagu ansixiyey Maraykanka waa:
- Salmeterol
- Performomist (foomamka)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Daawooyinka anticholinergics ee mudada dheer ee lagu ansixiyey Maraykanka waa:
- Spiriva (tiotropium)
- Aclidinium
Steroids oo la cabo
Dadka qaba COPD-da daran ayaa laga yaabaa inayan ka jawaab celin sidoo kale kuwa mudnaanta leh ee barkad-hawleedka, waxayna badanaa u baahan yihiin "kor u kaca" dheeraad ah si ay u ilaaliyaan hawlaha neefsashada. Shakhsiyaadkaas, waxaa laga yaabaa in la isticmaalo steroids.
Isticmaalidda steroids, oo sidoo kale loo yaqaano glucocorticoids , ayaa leh saameyn xoogan oo ka-horjeeda oo si dhakhso ah u yareeya bararka iyo soo-saarista xab-ka-baxa hawada hawada. Waxay u shaqeeyaan si la mid ah steroids afka laakiin waxay u shaqeeyaan si deg deg ah waxayna si weyn u yareeyaan khatarta hurdo-gelinta iyo isbitaalada.
Waxaa badanaa loo isticmaalaa laba jeer maalin walba waxayna badanaa u baahan yihiin mudo laba toddobaad ah "mudo ku-meel-gaar ah" ka hor intaysan saameyn buuxda helin.
Cudurka steroids ee sida caadiga ah loo isticmaalo si loo daweeyo COPD waa:
- Pulmicort (budesonide)
- Aerospan (Flunisolide)
- Laheyn (fluticasone)
- Asmanex (mometasone)
- QVAR (farsamo)
Waxa kale oo jira saddex habab oo isku dhafan kuwaas oo ku daraya steroids oo ah:
- Symbicort (qaabka isdifaaca iyo budesonide)
- Advair (salmeterol iyo fluticasone)
- Brio Ellipta (vilanterol iyo fluticasone)
Dhibaatooyinka soo raaca ee steroid-ka la neefsado waxay u muuqdaan kuwo aan ka fiicnayn kuwa ka mid ah kuwa afka laga qaato ama laysku duro. Waxaa laga yaabaa inay ku jiraan afka afkiisa ama dhuunta, xabeeb (dysfiyoon), iyo shuban indhaha.
Isticmaalka muddada dheer wuxuu la xiriiraa khatarta sii kordheysa ee glaucoma iyo osteoporosis.
> Isha:
> Vestbo, J .; Hurd, S .; Agusti, A. et al. "Istaraatajiyad caalami ah oo loogu talagalay cudurka dabiiciga ah, maaraynta, iyo ka hortagga cudurada joogtada ah ee joogtada ah: GOLD Executive Summary." Am Jirir Xanaano Daryeel Caafimaad. 2013; 187 (4): 347-65. DOI: 10.1164 / rccm.210204-0596PP.