NSAIDs-ka ayaa ka mid ah kuwa ugu badan ee la qoro ee loo yaqaan 'Arthritis Drugs'
NSAIDs (daawooyinka nonsteroidal anti-inflammatory) ee arthritis-ka ayagoo faragelinaya habka nabarka. NSAIDs waa kooxo badan oo daawooyin ah oo loo isticmaalo in lagu daaweeyo arthritis sababtoo ah:
- qalabka xanuunka (xanuunka dila)
- sifooyinka anti-bararka
- xannuunada qandhada (xummad-yaraynta)
NSAID Categories
Waxaa jira saddex nooc oo NSAIDs ah:
- Salicylates (labadaba asetylated, sida aspirin , iyo nonacetated)
- dhaqameed NSAIDs
- COX-2 xannibaadayaasha doorashada
NSAIDs sida caadiga ah loo isticmaalo arthritis waxaa ka mid ah:
- Ansaid (Magaca guud ee flurbiprofen)
- Arthrotec (magaca guud ee diclofenac leh misoprostol)
- Aspirin (acetylsalicylic acid)
- Cataflam (magaca guud ee diclofenac potassium)
- Celebrex (magaca guud celecoxib)
- Clinoril (magaca guud ee sulindac)
- Daypro (magaca guud ee oksaprozin)
- Disalcid (magaca guud ee salsalate)
- Dolobid (magaca guud ee diflunisal)
- Feldene (magaca guud ee piroxicam)
- Ibuprofen (magacyada calaamadaha waxaa ka mid ah Motrin, Advil, Mediprin, Nuprin, Motrin IB)
- Indocin (magaca guud ee indomethacin)
- Ketoprofen (magacyada magacoodu waxaa ka mid ah Orudis, Oruvail, Actron, Orudis KT)
- Lodine (magaca guud ee etodolac)
- Miisaaniya (magaca guud ee meclofenamate sodium)
- Mobic (magaca guud ahaan meloksicam)
- Nalfon (magaca guud ee fenoprofen)
- Naproxen (magacyada calaamadaha waxaa ka mid ah Naprosyn, Aleve, Naprelan, Anaprox)
- Ponstel (magaca guud ahaan meheraxamyada)
- Relafen (magac guud ah nabumetone)
- Tolectin (magaca guud ee tolmetin sodium)
- Trilisate (Magaca guud ee caloosha magnesium trisalicylate)
- Voltaren (magaca guud ee diclofenac sodium)
Sida NSAIDyadu u shaqeeyaan
Marka la eego fudud, NSAIDs waxay ka shaqeeyaan dhimista caabuq. Waxay tan sameeyaan iyagoo xakameynaya enzyming muhiim ah ee caabuqa loo yaqaanno cyclooxygenase, taas oo bedesho aaladda arachidonka ah ee prostaglandins iyo leukotrienes.
Prostaglandins waxay keenaan barar gudaha ah. Sidaa darteed, iyadoo la xakameynayo cyclooxygenase, NSAIDs waxay yareeyaan bararka .
NSAID gaar ah ayaa laga yaabaa inuu kuu shaqeeyo si ka wanaagsan intii aad horay isku dayday - ama aanad shaqayn karin. Taasi waa sababta oo ah wax loo yaqaan farqiga dawooyinka-daaweynta - habka loo isticmaalo daroogada oo la nuugo, loo qaybiyo, la naqdiyo, iyo la tirtiro.
In badan oo ku saabsan Enzyme Cyclooxygenase
Waxaa jira laba nooc oo ah cyclooxygenase, oo loo yaqaan COX-1 iyo COX-2. COX-1 wuxuu ku lug leeyahay ilaalinta calool xanuunka iyo kalyaha. COX-2 waa enzymed ka masuul ah caabuq. Sababtoo ah dhaqameedyada NSAID-yada ayaa xannibaya COX-1 iyo COX-2, waxay yeelan karaan saameyn aan loo baahnayn, sida calool-xanuun ama hoos u dhaca shaqada kelyaha. Taasina waa sababta ay cilmi-baarayaashu u sameyeen NSAIDS-da oo kaliya xayiraya COX-2. Noocyada COX-2 ee xakameynaya ayaa ah kooxda cusub ee NSAIDs.
Waxqabadka FDA ee Dhamaan NSAIDs
Sannadkii 2004, soo-saaraha COX-2 ee xakameynaya Vioxx ayaa si ikhtiyaari ah uga soo baxay suuqa ka dib markii cilmi-baarisyo muujiyey isticmaalka muddada dheer ay kordhin karto khatarta wadno-qabadka iyo istaroogga. Dib-u-eegid kaddib oo ay soo saartey Waaxda Cuntada iyo Maandooriyeyaasha ee Mareykanka waxay keentay shuruudaha 2005-ka in dhammaan dadka aan asbirin-la'aanta ah ee NSAIDs ay qaadaan digniin la xidhiidha.
Waa muhiim inaad ka wada hadashid khatarahan iman kara dhakhtarkaaga. (Qalabka ka dib wuxuu ka tagay kaliya hal COX-2 inhibitor suuqa - Celebrex.)
Waxtarka NSAID-yada
- Xanuun iyo barar ayaa mararka qaarkood ku dhaca wareegga wareegga wareegga ah (wareegga ritmic maalin kasta oo ku salaysan mudo 24 saac ah). Sidaa darteed, NSAIDs waxay noqon kartaa mid wax ku ool ah waqtiyada qaarkood.
- Qiyaastii 60% bukaannada ayaa ka jawaabi doona hal NSAID. Mudo tijaabo ah oo ah saddex toddobaad waa inay ku siiyaan waqti kugu filan si aad u ogaatid haddii daroogadu kuu shaqeyneyso. Nasiib darro, qiyaastii 10% dadka bukaanka qaba ee arthritis-ku waxay helayaan NSAIDs ma shaqeeyaan iyaga.
- NSAIDs waxay dabooli karaan calaamadaha iyo astaamaha cudurka.
- Dhibaatooyinka xun ee NSAIDs ee dhici kara wakhti kasta waxaa ka mid ah fashfashka kalyaha, cillad beerka, dhiig-bax, iyo calool-xanuun (caloosha).
- NSAIDs (gaar ahaan indomethacin) waxay faragalin karaan daawooyinka loo isticmaalo si loo xakameeyo cadaadiska dhiig karka iyo maqnaanshaha wadnaha (sida beta-adrenergic antagonists, angiotensin-converting enzyme inhibitors, ama diuretics).
- Qaar ka mid ah baaritaannada cilmi-baarista ayaa soo jeedinaya isticmaalka muddada dheer NSAID inuu dhab ahaantii hurdo ujeegi karo lumisku isku midka ah, laakiin cilmi baaris badan ayaa loo baahan yahay.
Khadadka hoose
Laguma saadaalin karo taas oo NSAID kuugu adeegi doonto. Ma jiro hal NSAID oo la xaqiijiyay in ay ka sarreeyaan kuwa kale xanuunka xanuun joojinta. Marka NSAID la doorto, qiyaasta waa in la kordhiyaa ilaa xanuunka la naaquso ama ilaa inta ugu badnaan loo qaato dose. Jawaabta bukaanku waa inay noqotaa tilmaamo loogu talagalay xulashada qiyaasta saxda ah, iyadoo la isticmaalayo qiyaasta ugu hooseysa ee suurtogalka ah si loo helo xanuun joojiye. Had iyo jeer kala hadal faai'dooyinka iyo khataraha ka iman kara NSAID-ka dhakhtarkaaga.
> Ilo:
> Jaamacada Duke Medical Center Book of Arthritis, David S. Pisetsky, MD, Ph.D. 1995.
> New England Journal of Medicine, 324 (24): 1716-1725, 1991