Dadka qaba cudurka dabaysha ee joogtada ah (COPD) waxaa badanaa loo qoraa bronchodilator , nooc daawo ah oo loo isticmaalo in lagu nasiyo marinnada hawada si ay kaaga caawiso inaad si fiican u neefsato. Daawooyinka waxaa sida caadiga ah loo nadiifiyaa iyada oo la adeegsanayo daawada loo yaqaan ' meter therapeutic dose' (MDI) laakiin sidoo kale waxay ku jirtaa dareeraha, kiniinka, daawooyinka la isku duro, ama daawooyinka dabiiciga ah.
Bronchodilators waxaa loo isticmaalaa ama loo isticmaalaa saldhig u baahan ama laba goor maalintii ayaa loo qoray si looga hortago ama loo yareeyo calaamadaha KOL . Saddexda nooc ee bronchodilators caadi ahaan waxaa loo isticmaalaa in lagu daaweeyo COPD:
- Dhakhaatiirta Beta-adrenergic
- Anticholinergics
- Methylxanthines
Beta-Adrenergic Agonists
Cudurka Beta-adrenergic (oo loo yaqaanno beta-agonists) waa nooca dawada ee ku xiran hindhisooyin gaar ah ee sanbabada loo yaqaan beta-adrenoceptors. Marka ay sidaas sameeyaan, waxay xakameynayaan kicinta qiiqa gaaska iyo u oggolaanaya marinka marin-haweedka inuu furo.
Beta-agonists waxay noqon karaan kuwo gaaban (oo soconaya afar illaa lix saacadood) ama waqti dheer (oo soconaya 12 saacadood ama ka badan). Waxaa lagu siiyaa afka ama hadal ahaan MDI. Habka la neefsaday ayaa guud ahaan la door bidaa marka ay ciribtirto astaamaha.
Dhibaatooyinka beta-beta-dila (SABAs) ee hadda la ansixiyay ee Mareykanka waa:
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Dhibaatada beta-dilaha ee dheeraadka ah (LABAs) ee hadda lagu ansixiyey Maraykanka waa:
- Salmeterol
- Performomist (foomamka)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Daawooyinka beta-agonist ayaa sidoo kale loo isticmaalaa qaababka laba-in-ka mid ah sida Symbicort oo isku-dar ah foomoterool leh corticosteroid oo la yiraahdo budesonide.
Dhibaatooyinka daawooyinka daroogadu badanaa waa qiyaas daawo oo inta badan lagu arko isticmaalka afka.
Kuwa ugu badan waxaa ka mid ah xaddiga wadnaha oo degdeg ah (tachycardia), garaaca wadnaha, gariirada, iyo hurdo la'aanta hurdada.
Anticholinergics
Anticholinergics waa daawooyin joojiya nooca neurotransmitter loo yaqaanno acetylcholine. Dareemayaasha Parasympathetic (kuwa la xidhiidha shaqeyn toos ah) waa ilaha ugu horreeya ee acetylcholine ee sanbabada. Iyada oo la xakameynayo soo saarida walxahan, foosha iyo walaxyada hawada hawada ayaa si fiican loo joojinayaa.
Anticholinergics waxaa lagu heli karaa oo kaliya foomka la neefsado waxayna bixisaa bronchodilation fiican oo leh waxyeelo yar. Anticholinergics waxay si gaar ah ugu faa'iideysan kartaa kuwa aan isticmaali karin beta-agonists ama methylxanthines sababtoo ah cudurka wadnaha ee hooseeya.
Anticholinergics hadda lagu ansixiyey Maraykanka waa:
- Atrovent (ipratropium)
- Spiriva (tiotropium)
- Aclidinium
Waxaa sidoo kale jira habab isku-dhafan oo loo yaqaan "Combivent" kaas oo ku jira ipratropium iyo albuterol-beta-agonist oo gaaban.
Waxyeellooyinka ugu badan ee daawooyinka antopolinergic waa af qalalan iyo birta dabaysha. Xaalado dhif ah, glaucoma ayaa la ogaaday inay dhacdo.
Methylxanthines
Methylxanthines waa nooc gaar ah oo ah daroogada loo yaqaan 'light of airflow obstruction', hoos u dhigista barar, iyo xanuunka foosha.
Farsamayntooda ficilkoodu si fiican looma fahmo, iyo, marka waxtar leh, maandooriyeyaasha aan loo isticmaalin daaweynta koowaad ee sababtoo ah kala duwanaanshahooda.
Methylxanthines waxay ku haboon tahay dadka aan awoodin in ay helaan kantarool ku filan oo leh beta-agonist ama daawooyinka anticholinergic. Si ka duwan noocyada kale ee COPD bronchodilators, methylxanthines laguma nadiifin. Waxay hadda ku jiraan kiniiniyada, dareeraha, xididdada, ama sheyaalka.
Labada daawo ee methylxanthine ee lagu ansixiyey Maraykanka waa:
- Theophylline
- Aminophylline
Dhibaatooyinka dhinaca marmarka qaarkood waxay noqon karaan kuwo qoto dheer, gaar ahaan haddii loo gudbiyo xididada.
Astaamaha waxaa ka mid noqon kara madax-xanuun, hurdo la'aan, lallabbo, shuban, boodh, neefsasho degdeg ah, iyo qalafsanaan. Isla markiiba wac dhakhtarkaaga haddii aad isku aragtid matag, wadne garaac aan caadi ahayn ( dysrhythmia ), ama suuxdinta.
> 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.