Mankhwala a COPD: Mndandanda wa Mankhwala Othandizira Kuchepetsa Zizindikiro Zanu

Zamkati

• Bronchodilators achidule
• Corticosteroids
• Methylxanthines
• Ma bronchodilator azaka zambiri
• Mankhwala osakaniza
• Roflumilast
• Mankhwala osokoneza bongo
• Katemera
• Maantibayotiki
• Mankhwala a khansa a COPD
• Mankhwala osokoneza bongo
• Lankhulani ndi dokotala wanu

Matenda osokoneza bongo (COPD) ndi gulu la matenda am'mapapo omwe amapangitsa kuti kupuma kukhale kovuta. COPD itha kuphatikizira emphysema ndi bronchitis yanthawi yayitali.

Ngati muli ndi COPD, mutha kukhala ndi zizindikilo monga kupuma movutikira, kutsokomola, kupuma, ndi kulimba pachifuwa. COPD nthawi zambiri imayamba chifukwa cha kusuta, koma nthawi zina imachitika chifukwa chopumira poizoni wachilengedwe.

Palibe mankhwala a COPD, ndipo kuwonongeka kwa mapapo ndi njira zapaulendo ndizokhazikika. Komabe, mankhwala angapo angathandize kuchepetsa kutupa ndikutsegulira mayendedwe anu kuti akuthandizeni kupuma mosavuta ndi COPD.

Bronchodilators achidule

Ma bronchodilator amathandizira kutsegula kwanu kuti mpweya ukhale wosavuta. Dokotala wanu angakupatseni ma bronchodilator achidule pakagwa mwadzidzidzi kapena kuti athandizidwe msanga pakufunika kutero. Mumawatenga pogwiritsa ntchito inhaler kapena nebulizer.

Zitsanzo za ma bronchodilator achidule ndi awa:

• albuterol (Proair HFA, Ventolin HFA)
• levalbuterol (Xopenex)
• ipratropium (Atrovent HFA)
• albuterol / ipratropium (Mgwirizano Wophatikiza)

Bronchodilators ofulumira amatha kuyambitsa zovuta monga mkamwa wouma, mutu, ndi chifuwa. Izi ziyenera kutha pakapita nthawi. Zotsatira zina zimaphatikizapo kunjenjemera (kugwedezeka), mantha, ndi kugunda kwamtima mwachangu.

Ngati muli ndi vuto la mtima, uzani dokotala musanatenge bronchodilator yochita mwachidule.

Corticosteroids

Ndi COPD, njira zanu zoyendetsera ndege zimatha kutenthedwa, kuwapangitsa kutupa ndikukwiya. Kutupa kumapangitsa kukhala kovuta kupuma. Corticosteroids ndi mtundu wa mankhwala omwe amachepetsa kutupa mthupi, kupangitsa mpweya kuyenda mosavuta m'mapapu.

Mitundu ingapo yama corticosteroids ilipo. Zina zimapumira ndipo ziyenera kugwiritsidwa ntchito tsiku lililonse monga mwalamulo. Nthawi zambiri amalembedwa kuphatikiza ndi mankhwala osokoneza bongo a COPD.

Ma corticosteroids ena amabayidwa kapena kutengedwa pakamwa. Mafomuwa amagwiritsidwa ntchito kwakanthawi kochepa pamene COPD yanu ikuipiraipira mwadzidzidzi.

Madokotala a corticosteroids omwe nthawi zambiri amapereka kwa COPD ndi awa:

• Fluticasone (Flovent). Izi zimabwera ngati inhaler yomwe mumagwiritsa ntchito kawiri tsiku lililonse. Zotsatira zoyipa zimatha kuphatikizira kupweteka kwa mutu, kupweteka kwa pakhosi, kusintha kwamawu, nseru, kuziziritsa ngati kuzizira, ndi thrush.
• Budesonide (Pulmicort). Izi zimabwera ngati inhaler yonyamula m'manja kapena yogwiritsa ntchito nebulizer. Zotsatira zoyipazi zimatha kuphatikizira chimfine ndi thrush.
• Zamgululi Izi zimabwera ngati mapiritsi, madzi, kapena kuwombera. Nthawi zambiri amapatsidwa chithandizo chadzidzidzi. Zotsatira zoyipa zimatha kuphatikizira kupweteka mutu, kufooka kwa minofu, kukhumudwa m'mimba, komanso kunenepa.

Methylxanthines

Kwa anthu ena omwe ali ndi COPD yovuta, mankhwala amtundu woyamba, monga ma bronchodilators othamanga komanso ma corticosteroids, samawoneka ngati othandiza pakagwiritsidwe ntchito.

Izi zikachitika, madokotala ena amapereka mankhwala otchedwa theophylline limodzi ndi bronchodilator. Theophylline imagwira ntchito ngati mankhwala odana ndi zotupa ndipo imatsitsimutsa minofu yomwe ili mlengalenga. Zimabwera ngati mapiritsi kapena madzi omwe mumamwa tsiku lililonse.

Zotsatira zoyipa za theophylline zitha kuphatikizira kusanza kapena kusanza, kunjenjemera, kupweteka mutu, komanso kugona tulo.

Ma bronchodilator azaka zambiri

Ma bronchodilators omwe amatenga nthawi yayitali ndi mankhwala omwe amagwiritsidwa ntchito pochiza COPD kwakanthawi. Nthawi zambiri amatengedwa kamodzi kapena kawiri tsiku lililonse pogwiritsa ntchito inhalers kapena nebulizers.

Chifukwa chakuti mankhwalawa amagwira ntchito pang'onopang'ono kuthandiza kuchepetsa kupuma, samachita mwachangu ngati mankhwala opulumutsa. Sapangidwe kuti zigwiritsidwe ntchito mwadzidzidzi.

Ma bronchodilator omwe akhala akugwira ntchito masiku ano ndi awa:

• aclidinium (Tudorza)
• arformoterol (Brovana)
• formoterol (Foradil, Perforomist)
• glycopyrrolate (Seebri Neohaler, Lonhala Magnair)
• cholowa (Arcapta)
• Olodaterol (Striverdi Respimat)
• chiwonetsero (Yupelri)
• salmeterol (Serevent)
• tiotropium (Spiriva)
• umeclidinium (Lembani Ellipta)

Zotsatira zoyipa za bronchodilators omwe atenga nthawi yayitali atha kuphatikizira:

• pakamwa pouma
• chizungulire
• kunjenjemera
• mphuno
• kukwiya kapena kukanda kukhosi
• kukhumudwa m'mimba

Zotsatira zoyipa kwambiri zimaphatikizapo kuwona m'maso, kufulumira kapena kusasinthasintha kwa mtima, komanso kusokonezeka ndi zotupa kapena kutupa.

Mankhwala osakaniza

Mankhwala angapo a COPD amabwera ngati mankhwala osakanikirana. Izi ndizophatikiza ma bronchodilator awiri atali yayitali kapena corticosteroid yopumira ndi bronchodilator yanthawi yayitali.

Mankhwala atatu, kuphatikiza kwa corticosteroid wopumira ndi ma bronchodilator awiri atenga nthawi yayitali, atha kugwiritsidwa ntchito pa COPD yayikulu komanso kuwotcha.

Kuphatikiza kwa ma bronchodilators awiri omwe atenga nthawi yayitali ndi awa:

• aclidinium / formoterol (Duaklir)
• glycopyrrolate / formoterol (Bevespi Aerosphere)
• glycopyrrolate / indacaterol (Utibron Neohaler)
• tiotropium / olodaterol (Stiolto Kuyankha)
• umeclidinium / vilanterol (Anoro Ellipta)

Kuphatikiza kwa corticosteroid yopumira ndi bronchodilator yanthawi yayitali ndi monga:

• budesonide / formoterol (Symbicort)
• fluticasone / salmeterol (Advair)
• fluticasone / vilanterol (Breo Ellipta)

Kuphatikiza kwa corticosteroid yopumira ndi ma bronchodilator awiri ogwira ntchito yayitali, otchedwa mankhwala opitilira katatu, amaphatikizapo fluticasone / vilanterol / umeclidinium (Trelegy Ellipta).

Zapezeka kuti mankhwala opatsiranawa amachepetsa kuphulika komanso magwiridwe antchito m'mapapo mwa anthu omwe ali ndi COPD.

Komabe, zidawonetsanso kuti chibayo chimakhala ndi mankhwala opitilira patatu kuposa kuphatikiza mankhwala awiri.

Roflumilast

Roflumilast (Daliresp) ndi mtundu wa mankhwala otchedwa phosphodiesterase-4 inhibitor. Zimabwera ngati mapiritsi omwe mumamwa kamodzi patsiku.

Roflumilast imathandiza kuthetsa kutupa, komwe kumatha kupititsa patsogolo mpweya m'mapapu anu. Dokotala wanu atha kukupatsani mankhwalawa limodzi ndi bronchodilator yemwe amakhala nthawi yayitali.

Zotsatira zoyipa za roflumilast zitha kuphatikizira:

• kuonda
• kutsegula m'mimba
• mutu
• nseru
• kukokana
• kunjenjemera
• kusowa tulo

Adziwitseni dokotala ngati muli ndi vuto la chiwindi kapena kukhumudwa musanamwe mankhwalawa.

Mankhwala osokoneza bongo

Kuphulika kwa COPD kumatha kuyambitsa mamina ambiri m'mapapu. Mankhwala osokoneza bongo amathandizira kuchepetsa mamina kapena kuwachepetsa kuti mutha kutsokomola mosavuta. Amakhala ndi mapiritsi, ndipo amaphatikizapo:

• carbocysteine
• kutuloji
• N-acetylcysteine

Malingaliro akuti mankhwalawa atha kuthandiza kuchepetsa kuwonongeka ndi kulemala kuchokera ku COPD. Kafukufuku wa 2017 adapezanso kuti erdosteine ​​yachepetsa kuchuluka ndi kuuma kwa ziphuphu za COPD.

Zotsatira zoyipa za mankhwalawa atha kukhala:

• nseru
• kusanza
• kupweteka m'mimba

Katemera

Ndikofunika kuti anthu omwe ali ndi COPD apeze katemera wa chimfine chaka chilichonse. Dokotala wanu angakulimbikitseni kuti mupezenso katemera wa pneumococcal.

Katemerayu amachepetsa chiopsezo chodwala ndipo amatha kukuthandizani kupewa matenda ndi zovuta zina zokhudzana ndi COPD.

Kafukufuku wa 2018 adapeza kuti katemera wa chimfine amathanso kuchepetsa kuphulika kwa COPD, koma adazindikira kuti panali kafukufuku waposachedwa.

Maantibayotiki

Kuchiza nthawi zonse ndi maantibayotiki monga azithromycin ndi erythromycin kumatha kuthandizira COPD.

Kafukufuku wa 2018 adawonetsa kuti mankhwala osagwirizana ndi maantibayotiki amachepetsa kuwonongeka kwa COPD. Komabe, kafukufukuyu adati kugwiritsa ntchito maantibayotiki mobwerezabwereza kumatha kuyambitsa maantibayotiki. Inapezanso kuti azithromycin imalumikizidwa ndi kutayika kwakumva ngati zoyipa zina.

Kafukufuku wowonjezereka amafunikira kuti adziwe zotsatira zakanthawi yayitali zogwiritsa ntchito maantibayotiki.

Mankhwala a khansa a COPD

Mankhwala angapo a khansa amatha kuchepetsa kutupa ndikuchepetsa kuwonongeka kwa COPD.

Kafukufuku wa 2019 adapeza kuti mankhwalawa tyrphostin AG825 adatsitsa milingo yotupa mu zebrafish. Mankhwalawa adalimbikitsanso kuchuluka kwa kufa kwa ma neutrophil, omwe ndi maselo omwe amalimbikitsa kutupa, mu mbewa zokhala ndi mapapo otupa ofanana ndi COPD.

Kafukufuku akadali ochepa pakugwiritsa ntchito tyrphostin AG825 ndi mankhwala ofanana ndi a COPD ndi zina zotupa. Potsirizira pake, akhoza kukhala chithandizo cha COPD.

Mankhwala osokoneza bongo

Kwa anthu ena, kutupa kuchokera ku COPD kumatha kukhala chifukwa cha eosinophilia, kapena kukhala ndi maselo oyera oyera opitilira muyeso otchedwa eosinophils.

Awonetsa kuti mankhwala a biologic atha kuthana ndi mtundu uwu wa COPD. Mankhwala a biologic amapangidwa kuchokera m'maselo amoyo. Ambiri mwa mankhwalawa amagwiritsidwa ntchito pa mphumu yoopsa yochititsidwa ndi eosinophilia, kuphatikiza:

• mepolizumab (Nucala)
• benralizumab (Fasenra)
• reslizumab (Cinqair)

Kafukufuku wochuluka amafunika pochiza COPD ndi mankhwalawa.

Lankhulani ndi dokotala wanu

Mitundu yosiyanasiyana yamankhwala imathandizira ma COPD osiyanasiyana. Dokotala wanu adzakupatsani mankhwala omwe angakuthandizeni kwambiri.

Mafunso omwe mungafunse dokotala pazomwe mungapangire mankhwalawa ndi awa:

• Kodi ndiyenera kugwiritsa ntchito kangati mankhwala anga a COPD?
• Kodi ndikumwa mankhwala ena aliwonse omwe angagwirizane ndi mankhwala anga a COPD?
• Ndiyenera kumwa ma COPD mpaka liti?
• Kodi njira yoyenera kugwiritsa ntchito inhaler yanga ndi iti?
• Kodi chimachitika ndi chiyani ndikasiya kumwa mankhwala anga a COPD mwadzidzidzi?
• Kuwonjezera pa kumwa mankhwala, kodi ndiyenera kusintha ziti pamoyo wanga kuti ndithetse matenda anga a COPD?
• Kodi ndiyenera kuchita chiyani ndikayamba kudwala mwadzidzidzi?
• Kodi ndingapewe bwanji zovuta zoyipa?

Mankhwala aliwonse omwe dokotala akukupatsani, onetsetsani kuti mumamwa molingana ndi malangizo a dokotala wanu. Ngati muli ndi zovuta zina, monga zovuta zomwe zimachitika chifukwa cha zidzolo kapena kutupa, itanani dokotala wanu nthawi yomweyo. Ngati mukuvutika kupuma kapena kutupa pakamwa, lilime, kapena pakhosi, itanani 911 kapena madokotala azachipatala kwanuko. Chifukwa mankhwala ena a COPD angakhudze mtima wanu, onetsetsani kuti mwauza dokotala ngati muli ndi vuto losagunda kwamtima kapena mavuto amtima.