Daawooyinka xooggan ayaa si dhaqso ah u xanaaqaya bararka
Corticosteroids ama glucocorticoids, badanaa oo loo yaqaan "steroids", ayaa mar uun loo maleynayay in ay mucjiso yihiin. Sanadkii 1948, Mayo Clinic ee Rochester, Minnesota, koox ka mid ah bukaanka arthritis ayaa la siiyay maalin kasta irbadaha corticosteroid. Natiijooyinka waxay ahaayeen kuwo aad u xiiso badan, horumarkana si aad ah ayay u socdaan, dhakhaatiirtu waxay u maleyn jireen in "daaweynta" ee arthritis-ka la helay.
Si kastaba ha ahaatee, maadaama isticmaalka corticosteroids uu sii ballaariyay sanadihii la soo dhaafay, saameynaha soo ifbaxay. Qiyaaso sarreeya oo la bixiyay mudo dheer ayaa loo beddelay steroids "cabsi-cabsi." Bukaan-socodka ayaa looga digay dhibaatooyinka iman kara, isticmaalka corticosteroids waxay noqotey mid sii-qabsi ah, qaar bukaanno xitaa way diideen daaweynta maxaa yeelay waxay ahaayeen kuwo cabsi qaba.
Dhab ahaan, corticosteroids waa daroogooyin awood leh oo noqon kara mid qiimo leh haddii lagu maamulo habraac habboon. Fahamka sida ay u shaqeeyaan iyo sida loo isticmaali karo ammaan ahaan waa muhiim.
Guudmarka
Corticosteroids waa daawooyin si dhow ula xiriira cortisol, hormoon kaas oo si dabiici ah loo soo saaro kortexyada qanjidhada (lakabka sare ee qanjirrada adrenal). Corticosteroids waxaa ka mid ah:
- Betamethasone (Celestone)
- Budesonide (Entocort EC)
- Cortisone (Cortone)
- Dexamethasone (Decadron)
- Hydrocortisone (Cortef)
- Methylprednisolone (Medrol)
- Prednisolone (Prelone)
- Prednisone (Deltasone)
- Triamcinolone (Kenacort, Kenalog)
Doorka Cortisol
Cortisol wuxuu ka ciyaaraa qayb muhiim ah oo ka hortaga milixda iyo miisaanka biyaha ee jidhka iyo sidoo kale nidaaminta carbohydrate, baruurta, iyo dheef-shiid kiimikaad. Marka jidhku diiqadeynayo, qanjirka pituitary ee saldhigga maskaxda ayaa sii daynaya ACTH (adrenocorticotropic hormone) kaas oo kiciya qanjidhada adrenal si loo soo saaro cortisol.
Cortisol dheeraad ah ayaa u oggolaanaya jirka inuu la qabsado xaaladaha walaaca, sida infekshanka, dhaawacyada, qalliinka, ama dhibaatooyinka dareenka. Marka xaaladdu walwal ka timaaddo, wax soo saarka hoormoonka adrenal wuxuu ku noqdaa mid caadi ah. Qanjidhada adrenal waxay caadi ahaan soo saaraan qiyaastii 20 milligrams oo cortisol ah maalintii, badiyaa subaxdii, laakiin waxay soo saari karaan shan jeer inta badan marka loo baahdo.
Sidee Corticosteroids u shaqeeyaan
Corticosteroids waxay wax ka qabataa habka difaaca jidhka iyada oo xannibaysa soo saarida walxaha keena falalka xasaasiyadda iyo bararka , sida prostaglandins. Si kastaba ha noqotee, waxay sidoo kale ka hor istaagi karaan unugyada dhiigga cad ee burburiya jidhka shisheeye islamarkaana gacan ka geysta nidaamka difaaca jirka si haboon. Farogelinta ficilka unugyada dhiigga cad waxay dhalinaysaa saameyn dhinaca daawada u nugulta.
Calaamadaha
Corticosteroids ayaa loo isticmaalaa xaalado badan. Waxaa loo isticmaalaa in lagu xakameeyo caabuqyada xubnaha iyo xubnaha jirka sida:
- Rheumatoid arthritis
- Lupus (Nidaamka Lupus Erythematosus)
- Ankolosing spondylitis
- Cudurka arthritis-ka
- Cudurka caabuqa ee caabuqa
- Dermatomyositis
- Polymyositis
- Cudurka unuga isku dhafan
- Cudurka Behcet
- Polymyalgia rheumatica
- Cudurka " Scleroderma" (nidaamka sclerosis)
- Arthritis-ka weyn ee unugyada jirka (arthropitis temporal)
Corticosteroids looma isticmaalo nidaam ahaan osteoarthritis , in kastoo marmarka qaarkood loo isticmaalo sida cirbadaha deegaanka ah ee isku-dhafan.
Maamulka
Corticosteroids waa wax u eg qaabka codsiga. Waxaa la siin karaa:
- Oral
- Waxay ku dhacdaa xididka ama murqaha
- Magaca maxaad ka codsan maqaarka
- Waxay si toos ah ugu dhacdaa xirmooyinka bararsan
Daawooyinka korticosteroid ayaa sidoo kale loo isticmaali karaa maaddooyinka ku jira:
- Waxyaabaha indhaha (si loo daaweeyo xaaladaha kala duwan ee indhaha)
- Nafaqeeyayaal (si loo daweeyo neefta ama cudurka bronchial)
- Nasal dhibco iyo buufin (si loo daweeyo dhibaatooyinka sanka ee kala duwan)
- Kiriimyada miisaanka, boomaatada, iwm. (Si loo daweeyo dhibaatooyinka maqaarka ee kala duwan)
Corticosteroids waxaa loo isticmaali karaa iyada oo la isticmaalaayo daroogooyinka kale waxaana loo qoraa isticmaalka gaaban iyo muddada dheer. Prednisone (Cortan, Deltasone, Liquid Pred, Meticorten, Orasone, Panasol-S, Prednicen-M, iyo Sterapred) ayaa ah kuwa ugu caansan ee loo yaqaan "corticosteroid" ee loo yaqaan "arthritis-ka". Waa afar ilaa shan jeer sida xooggan ee cortisol. Sidaa daraadeed, shan milligrams oo prednisone ah waxay u dhigantaa soo-saarka maalinlaha ah ee cortisol. Waxaa jira corticosteroids kale oo loo yaqaan 'corticosteroids' oo la heli karo taas oo ku kala duwan awoodda iyo nuska nolosha.
Ka-qaadista iyo Corticosteroids afka
Tallaalka steroid, oo sidoo kale loo yaqaan cortisone shot, corticosteroid cirbadeynta, ama daaweynta qalitaan-dhexaad ah waa cirbadda steroid si toos ah loogu daro saameynta ay saameysay. Habkani wuxuu u oggolaanayaa dhakhaatiirta in ay si toos ah ugu isticmaalaan qiyaasta corticosteroid si toos ah goobta goobta gubashada. Tan iyo markii la dhameeyey, jirka intiisa kale ayaa ka badbadiyey xaddiga sare ee daroogada.
Caabuqa goobta goobta cirbadeynta waa wax saameyn ah oo suurtagal ah. Cirbadaha isdaba joogga ah ee isku-midka ah ayaa sidoo kale keeni kara dhaawac jilicsan. Dhakhaatiirtu waxay u isticmaalaan daaweyntan si khaas ah, ka dib markii xulashooyinka kale ay ku fashilmeen, isku dayeen inay xaddidaan tirada cirbadaha bilkasta dhawrka bilood iyo tiro yar oo wadajir ah.
Waxyaabaha kale ee saameynaya
Saameynta xoogga leh ee corticosteroids waxay keeni kartaa saameyno halis ah oo ku habboon cushaanka Cushing, oo ah cillad qanjirrada adrenal taasoo keentay kororka cortisol. Liisaska saameynaha daaweyntu waa muddo dheer waxayna ka kooban yihiin:
- Kordhinta cuntada iyo korodhka miisaanka
- Kaydka dufanka laabta, wajiga, gadaasha dambe, iyo caloosha
- Biyaha iyo cusbada oo keena barar iyo barar
- Cadaadis dhiig oo sarreeya
- Sonkorowga
- Calaamadaha madow iyo buluugga
- Nabarku wuu bogsanayaa
- Osteoporosis
- Cataracts
- Acne
- Murqaha daciifka
- Jirka maqaarka
- Hoos u qaadista infakshanka
- Boogaha caloosha
- Dhidid dhidid
- Niyad jabka
- Dhibaatooyinka xagga maskaxda sida niyad-jabka
- Xakameynta Adrenal iyo Dhibaatada
Dhibaatooyinka kale waa la yareeyn karaa iyadoo la raacayo amarrada takhtarka iyo qaadashada qiyaasta ugu hooseeysa ee suurtogalka ah. Sidoo kale waa muhiim inaad iska ilaaliso is-xukunka qiyaasta qiyaasta, adigoo ku daraya wax dheeraad ah ama joojiya daawada aan lahayn jadwal.
Waqti Gaaban iyo Daaweeyn Muddo Dheer ah
Marka loo isticmaalo daaweyn mudo gaaban ah, prednisone waxaa badanaa lagu qoraa qiyaas dhexdhexaad ah oo la yareeyey ama "looxa jaray" muddo hal ama laba toddobaad ah. Ujeedadu waa in lagu gaaro horumarin degdeg ah ee calaamadaha, laakiin ma sii dheeraanayso muddada isticmaalka corticosteroid.
Daaweynta muddada-dheer waxaa caadi ahaan loo hayaa xaalado daran oo ah xanuunka 'rheumatoid arthritis' ama cudurada la xiriira. Qiyaasta daawadu waa inta u dhaxaysa shan illaa todoba iyo badhkii miligarym ee prednisone maalintii ayaa sii socota muddada bilaha ama sanadka.
Isticmaalidda steroids qadar ah ayaa marmar la siiyaa marar dhif ah oo aad u daran, cudurada inflammatory. Qadar sarreeya ayaa loo tixgeliyaa qiyaasta maalinlaha ah ee qiyaastii hal miligram kiilo culeyska jirka ama qiyaastii 60 milligaraam maalintii oo la siiyay qiyaaso kala duwan. Xaaladaha noocaas ah, steroids ayaa "looxa" sida ugu dhakhsaha badan.
Si loo yareeyo saameynta daaweyneed, qiyaasta ugu hooseysa ee corticosteroid waa in la siiyaa. Taasi waa qiyaasta ugu wanaagsan.
Joojinta
Qiyaasta corticosteroids waa in si tartiib tartiib ah loo yareeyaa si qanjidhada adrenal ay dib u bilaabaan wax soo saarka cortisol dabiiciga ah. Hoos-u-qaadidda qiyaasta si dhakhso ah waxay keeni kartaa dhibaatada adrenal (xaalad nolol-halis ah oo ay sababto heerarka aan ku filneyn ee cortisol) inkastoo ay taasi dhif tahay.
Xaaladaha korticosteroids ayaa lagu qaatay qiyaaso yar muddo dheer, isdabajoogu wuxuu socon karaa bilo ama sanado. Marmarka qaarkood, qiyaasaha ayaa hoos u dhacey hal milligram per interval-ka si looga hortago inay ciribtirmaan. Marka steroids loo qaato wakhti gaaban, isdabajoogu waa mid deg deg ah oo hoos u dhaca qiyaasta qiyaasta ayaa noqon karta mid weyn.
Dhibaatada kale ee suuragalka ah ee la xidhiidha joojinta steroids waa cilladda steroid withdrawal syndrome, ama saamaynta rebound, taas oo ah jawaabta bukaanka ee maqnaanshaha daroogada. Saamaynta kacsan waxay keeni kartaa qandho, murqo xanuun, iyo xanuunka wadajirka, taas oo adkaynaysa dhakhtarka si loo kala saaro calaamadaha ka-noqoshada iyo cirridka cudurka laftiisa.
Goynta
Sida laga soo xigtay The Pill Book (Bantam Books), iyada oo la adeegsanayo shan milligrams oo prednisone ah oo saldhig u ah isbarbardhigga, qiyaasaha u dhigma ee corticosteroids kale waa:
- 0.6 mg-0.75 mg Betamethasone
- 25 mg oo Cortisone ah
- 0.75 mg of Dexamethasone
- 20 mg oo ah Hydrocortisone
- 4 mg methylprednisolone
- 5 mg oo Prednisolone ah
- 4 mg ee Triamcinolone
Corticosteroid Converter waxay xisaabisaa qiyaaso u dhigma corticosteroids kala duwan. Waa qalab sahlan oo loo adeegsado.
Ereyga
Corticosteroids waa daroogooyin awood leh oo hagaajin kara calaamadaha iyo kicinta natiijooyinka cajiibka ah. Waxaa jira cawaaqibta la xidhiidha isticmaalka aan la iska indhatirin, si kastaba ha ahaatee. Awoodda corticosteroids waa inaan laga cabsan, laakiin waa in la ixtiraamo.
Ilaha:
Kelley ee buugta qoraalka ee Rheumatology. Qoraalka sagaalaad. Elsevier. Glucocorticoid Therapy Cutubka 60. Jacobs iyo Bijlsma.
Jaamacada Duke Medical Center Book of Arthritis, David S. Pisetsky MD
Sobel, Klein. Arthritis: Waa Maxay Shaqada, St Martins Press; 1999.