Mankhwala Kwa Anthu Omwe Ali ndi Ulcerative Colitis

Zamkati

• Aminosalicylates (5-ASA)
• Mesalamine
• Sulfasalazine
• Olsalazine
• Balsalazide
• Corticosteroids
• Budesonide
• Prednisone ndi prednisolone
• Ma Immunomodulators
• Makhalidwe
• Methotrexate
• Azathioprine
• Zamgululi
• Zotsatira zoyipa za methotrexate, azathioprine, ndi mercaptopurine
• Zamoyo
• Pewani ma NSAID
• Lankhulani ndi dokotala wanu

Chiyambi

Ulcerative colitis ndi mtundu wamatenda otupa (IBD) omwe amakhudza kwambiri colon (matumbo akulu). Zitha kuyambitsidwa ndi yankho losazolowereka la chitetezo cha mthupi lanu. Ngakhale palibe mankhwala odziwika a ulcerative colitis, mitundu ingapo ya mankhwala itha kugwiritsidwa ntchito kuthana ndi zizindikirazo.

Zizindikiro za ulcerative colitis zitha kukhala:

• kupweteka m'mimba, kusapeza bwino, kapena kukokana
• kutsekula m'mimba kosalekeza
• magazi mu chopondapo

Zizindikiro zitha kukhala zosasinthasintha kapena zimawonjezeka pakamawonekera.

Mankhwala osiyanasiyana atha kugwiritsidwa ntchito kuchepetsa kutupa (kutupa ndi kukwiya), kuchepetsa kuchuluka kwa ziwopsezo zomwe muli nazo, ndikulola koloni yanu kuti ichiritse. Magulu anayi akuluakulu a mankhwala amagwiritsidwa ntchito pochiza anthu omwe ali ndi zilonda zam'mimba.

Aminosalicylates (5-ASA)

Aminosalicylates amaganiza kuti amachepetsa zizindikilo za ulcerative colitis pochepetsa kutupa m'matumbo. Mankhwalawa amagwiritsidwa ntchito kwa anthu omwe ali ndi zilonda zam'mimba zochepa. Amatha kuthana ndi zotsekula kapena kuchepetsa kuchuluka kwa ziwopsezo zomwe muli nazo.

Zitsanzo za mankhwalawa ndi monga:

Mesalamine

Mesalamine imatha kutengedwa pakamwa (ngati pakamwa) ngati piritsi lotulutsira mochedwa, kapisozi womasulidwa, kapena kapisozi wotulutsa mochedwa. Mesalamine imapezekanso ngati rectal suppository kapena rectal enema.

Mesalamine amapezeka ngati mankhwala achibadwa m'njira zina. Ilinso ndi mitundu yamaina angapo, monga Delzicol, Apriso, Pentasa, Rowasa, sfRowasa, Canasa, Asacol HD, ndi Lialda.

Zotsatira zofala kwambiri za mesalamine zitha kuphatikiza:

• kutsegula m'mimba
• mutu
• nseru
• kupweteka m'mimba, kukokana, komanso kusapeza bwino
• kuchuluka kwa acidity m'mimba kapena Reflux
• kusanza
• kubowola
• zidzolo

Zotsatira zoyipa za mesalamine zimatha kuphatikiza:

• kupweteka pachifuwa
• kupuma movutikira
• nyimbo yosasinthasintha

Zitsanzo za mankhwala omwe mesalamine amatha kulumikizana nawo ndi awa:

• alireza
• warfarin
• varicella zoster katemera

Sulfasalazine

Sulfasalazine amatengedwa pakamwa ngati piritsi lotulutsira mwachangu kapena lochedwa. Sulfasalazine amapezeka ngati mankhwala achibadwa komanso ngati dzina loti mankhwala a Azulfidine.

Zotsatira zofala kwambiri za sulfasalazine zitha kuphatikiza:

• kusowa chilakolako
• mutu
• nseru
• kusanza
• kukhumudwa m'mimba
• amachepetsa umuna mwa amuna

Zotsatira zina zosaoneka koma zoyipa za sulfasalazine ndi monga:

• Matenda a magazi monga kuchepa magazi m'thupi
• zovuta zoyipa monga matenda a Stevens-Johnson
• chiwindi kulephera
• mavuto a impso

Sulfasalazine itha kuyanjana ndi mankhwala ena, monga:

• Chinthaka
• kupatsidwa folic acid

Olsalazine

Olsalazine amabwera ngati kapisozi yemwe mumamwa. Ilipo ngati dzina loti Dipentum. Sipezeka ngati mankhwala achibadwa.

Zotsatira zofala kwambiri za olsalazine zitha kuphatikiza:

• kutsekula m'mimba kapena ndowe zotayirira
• kupweteka m'mimba mwako
• zidzolo kapena kuyabwa

Zotsatira zoyipa za olsalazine zitha kuphatikizira:

• Matenda a magazi monga kuchepa magazi m'thupi
• chiwindi kulephera
• mavuto amtima monga kusintha kwa mtima komanso kutupa kwa mtima wanu

Zitsanzo za mankhwala omwe olsalazine amatha kulumikizana nawo ndi awa:

• mankhwala
• ma heparin otsika-molekyulu monga enoxaparin kapena dalteparin
• magwire
• alireza
• varicella zoster katemera

Balsalazide

Balsalazide amatengedwa pakamwa ngati kapisozi kapena piritsi. Kapisozi amapezeka ngati mankhwala achibadwa komanso ngati dzina lodziwika bwino la mankhwalawa Colazal. Pulogalamuyi imangopezeka ngati dzina loti Giazo.

Zotsatira zofala kwambiri za balsalazide zitha kuphatikiza:

• mutu
• kupweteka m'mimba
• kutsegula m'mimba
• nseru
• kusanza
• matenda opuma
• kupweteka pamodzi

Zotsatira zoyipa za balsalazide zitha kuphatikiza:

• Matenda a magazi monga kuchepa magazi m'thupi
• chiwindi kulephera

Zitsanzo za mankhwala omwe balsalazide amatha kulumikizana nawo ndi monga:

• alireza
• warfarin
• varicella zoster katemera

Corticosteroids

Corticosteroids amachepetsa kuyankha kwathunthu kwa chitetezo chamthupi kuti muchepetse kutupa mthupi lanu. Mitundu iyi ya mankhwala imagwiritsidwa ntchito pochiza anthu omwe ali ndi zilonda zam'mimba zolimbitsa thupi. Corticosteroids ndi awa:

Budesonide

Mitundu iwiri ya budesonide yomwe imavomerezedwa ndi ulcerative colitis ndi mapiritsi otulutsira ndi thovu lammbali. Zonsezi zimapezeka ngati dzina lotchedwa Uceris. Sizimapezeka ngati mankhwala achibadwa.

Zotsatira zofala kwambiri za budesonide zitha kuphatikiza:

• mutu
• nseru
• kuchepa kwa mahomoni a cortisol
• ululu m'mimba mwanu chapamwamba
• kutopa
• kuphulika
• ziphuphu
• matenda opatsirana mumkodzo
• kupweteka pamodzi
• kudzimbidwa

Zotsatira zoyipa za budesonide zitha kuphatikiza:

• mavuto a masomphenya monga glaucoma, cataract, ndi khungu
• kuthamanga kwa magazi

Budesonide amatha kuyanjana ndi mankhwala ena monga:

• protease inhibitors monga ritonavir, indinavir, ndi saquinavir, omwe amagwiritsidwa ntchito pochiza matenda a HIV
• mankhwala antifungal monga itraconazole ndi ketoconazole
• erythromycin
• njira zakulera zam'kamwa zomwe zimakhala ndi ethinyl estradiol

Prednisone ndi prednisolone

Prednisone imapezeka piritsi, piritsi yotulutsa mochedwa, ndi mawonekedwe amadzimadzi. Mumatenga izi ndi pakamwa. Prednisone imapezeka ngati mankhwala achibadwa komanso monga mankhwala omwe amadziwika kuti Deltasone, Prednisone Intensol, ndi Rayos.

Mitundu ya prednisolone yomwe imavomerezedwa ndi ulcerative colitis ndi iyi:

• mapiritsi
• mapiritsi otha
• madzi njira
• madzi

Mutha kutenga iliyonse yamtunduwu pakamwa. Prednisolone imapezeka ngati mankhwala abwinobwino komanso monga Millipred.

Zotsatira zofala kwambiri za prednisone ndi prednisolone zitha kuphatikiza:

• kuchuluka kwa shuga m'magazi
• kusakhazikika kapena kuda nkhawa
• kuthamanga kwa magazi
• kutupa chifukwa chosungira madzi kumapazi kapena akakolo
• kuchuluka kwa njala
• kunenepa

Zotsatira zoyipa za prednisone ndi prednisolone zitha kuphatikiza:

• kufooka kwa mafupa komanso chiopsezo chowonjezeka cha kusweka kwa mafupa
• mavuto amtima monga matenda amtima, kupweteka pachifuwa, komanso kusintha kwa mtima
• kugwidwa

Zitsanzo za mankhwala omwe prednisone ndi prednisolone amatha kulumikizana nawo ndi awa:

• mankhwala ochepetsa mphamvu monga phenobarbital ndi phenytoin
• opaka magazi monga warfarin
• rifampin
• ketoconazole
• aspirin

Ma Immunomodulators

Ma immunomodulators ndi mankhwala omwe amachepetsa kuyankha kwa thupi kumatenda ake. Zotsatira zake ndikuchepetsa kutupa mthupi lonse la munthu. Ma immunomodulators amachepetsa kuchuluka kwa zilonda zam'mimba zomwe zimakhalapo ndikuthandizani kuti mukhale opanda zizindikilo motalikirapo.

Ma immunomodulators amagwiritsidwa ntchito mwa anthu omwe zizindikiritso zawo sizinayang'aniridwe ndi aminosalicylates ndi corticosteroids. Komabe, mankhwalawa atha kutenga miyezi ingapo kuti ayambe kugwira ntchito.

Ma immunomodulators ndi awa:

Makhalidwe

Mpaka posachedwa, ma immunomodulators sanalandiridwe ndi US Food and Drug Administration (FDA) kuti athe kuchiza anthu omwe ali ndi zilonda zam'mimba. Komabe, gulu la mankhwalawa anali Nthawi zina amagwiritsidwa ntchito polemba anthu omwe ali ndi zilonda zam'mimba.

Kugwiritsa ntchito kwina kotereku kunasanduka mbiri yakale mu 2018 pomwe a FDA adavomereza kugwiritsa ntchito immunomodulator kwa anthu omwe ali ndi zilonda zam'mimba. Ma immunomodulator amatchedwa tofacitinib (Xeljanz). Poyamba anali kuvomerezedwa ndi FDA kwa anthu omwe ali ndi nyamakazi koma anali kugwiritsidwa ntchito polemba anthu omwe ali ndi zilonda zam'mimba. Xeljanz ndiye mankhwala oyamba amtunduwu omwe amaperekedwa pakamwa - osati jakisoni - wothandizidwa kwa nthawi yayitali ndi anthu omwe ali ndi zilonda zam'mimba.

Dziwani zambiri zakugwiritsa ntchito mankhwala osokoneza bongo.

Methotrexate

Methotrexate imapezeka ngati piritsi lomwe mumamwa. Amaperekedwanso ndi kulowetsedwa kwa intravenous (IV) komanso jakisoni wocheperako komanso wamitsempha. Piritsi limapezeka ngati mankhwala achibadwa komanso ngati dzina la mankhwala osokoneza bongo la Trexall. Njira yothetsera vutoli ndi jakisoni wamitsempha imapezeka ngati mankhwala wamba. Jekeseni wa subcutaneous umapezeka pokhapokha ngati mankhwala omwe amadziwika kuti Otrexup ndi Rasuvo.

Azathioprine

Pochiza ulcerative colitis, azathioprine imabwera ngati piritsi lomwe mumamwa. Ilipo ngati mankhwala achibadwa komanso monga mankhwala osokoneza bongo Azasan ndi Imuran.

Zamgululi

Mercaptopurine imapezeka ngati piritsi kapena kuyimitsidwa kwamadzi, zonse zomwe zimatengedwa pakamwa. Pulogalamuyi imangopezeka ngati mankhwala achibadwa, ndipo kuyimitsidwa kwake kumangopezeka ngati dzina lodziwika bwino la mankhwala a Purixan.

Zotsatira zoyipa za methotrexate, azathioprine, ndi mercaptopurine

Zotsatira zofala kwambiri za ma immunomodulators atha kukhala:

• mutu
• nseru
• kusanza
• kutsegula m'mimba
• zilonda mkamwa
• kutopa
• magulu otsika a magazi

Zitsanzo za mankhwala omwe ma immunomodulators amatha kulumikizana nawo ndi awa:

• alirakhalid
• aminosalicylates monga sulfasalazine, mesalamine, ndi olsalazine
• ma angiotensin otembenuza enzyme (ACE) zoletsa monga lisinopril ndi enalapril
• warfarin
• alireza
• mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) monga naproxen ndi ibuprofen
• mbalabala
• muthoni
• sulfonamides
• chiweb
• retinoids
• chinthaka

Zamoyo

Biologics ndi mankhwala opangidwa ndi chibadwa omwe amapangidwa ndi labu kuchokera kuzinthu zamoyo. Mankhwalawa amateteza mapuloteni ena m'thupi lanu kuti asayambitse kutupa. Mankhwala a biologic amagwiritsidwa ntchito kwa anthu omwe ali ndi ulcerative colitis ochepa. Amagwiritsidwanso ntchito kwa anthu omwe zizindikiro zawo sizinayendetsedwe ndi mankhwala monga aminosalicylates, immunomodulators, kapena corticosteroids.

Pali mankhwala asanu a biologic omwe amagwiritsidwa ntchito pa kasamalidwe ka ulcerative colitis. Izi zimapezeka ngati mankhwala odziwika, kuphatikizapo:

• adalimumab (Humira), woperekedwa ndi jakisoni wa subcutaneous
• golimumab (Simponi), woperekedwa ndi jakisoni wocheperako
• infliximab (Remicade), yoperekedwa ndi kulowetsedwa kwa IV
• infliximab-dyyb (Inflectra), yoperekedwa ndi kulowetsedwa kwa IV
• vedolizumab (Entyvio), yoperekedwa ndi kulowetsedwa kwa IV

Mungafunike kutenga adalimumab, golimumab, infliximab, kapena infliximab-dyyb kwa milungu isanu ndi itatu musanawone kusintha kulikonse. Vedolizumab imayamba kugwira ntchito m'masabata asanu ndi limodzi.

Zotsatira zofala kwambiri za mankhwala a biologic atha kukhala:

• mutu
• malungo
• kuzizira
• ming'oma kapena zidzolo
• kuchuluka kwa matenda

Mankhwala osokoneza bongo amatha kulumikizana ndi othandizira ena. Zitsanzo za izi ndi izi:

• natalizumab
• adalimumab
• golimumabu
• infiximab
• anakinra
• kudzipha
• wothandizira
• warfarin
• cyclosporine
• chinthaka
• katemera wamoyo monga katemera wa varicella zoster

Pewani ma NSAID

Ma NSAID, monga ibuprofen ndi naproxen, amachepetsa kutupa m'thupi. Ngati muli ndi ulcerative colitis, komabe, mankhwalawa amatha kukulitsa zizindikilo zanu. Onetsetsani kuti mwalankhula ndi dokotala musanatenge NSAID.

Lankhulani ndi dokotala wanu

Mankhwala ambiri amatha kuthandizira kuchepetsa zilonda zanu zam'mimba zotupa. Ngati muli ndi ulcerative colitis, onaninso nkhaniyi ndi dokotala ndikulankhula za mankhwala omwe angakhale oyenera kwa inu. Dokotala wanu adzakupatsani mankhwala okhudzana ndi thanzi lanu komanso momwe matenda anu aliri.

Mungafunike kuyesa mankhwala angapo musanapeze njira yothandizira yomwe imakuthandizani. Ngati kumwa mankhwala amodzi sikungachepetsere zizindikiro zanu zokwanira, dokotala wanu akhoza kuwonjezera mankhwala ena achiwiri omwe amapangitsa woyamba kukhala wothandiza kwambiri. Zitha kutenga nthawi, koma dokotala adzagwira nanu ntchito kuti mupeze mankhwala oyenera kuti muchepetse zilonda zanu zam'mimba.