Mndandanda wa Mankhwala a Nyamakazi

Zamkati

• DMARDs ndi biologics
• Janus kugwirizana kinase inhibitors
• Acetaminophen
• Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs)
• Ibuprofen (Advil, Motrin IB, Nuprin)
• Sodium ya Naproxen (Aleve)
• Aspirini (Bayer, Bufferin, St. Joseph)
• NSAID zamankhwala
• Diclofenac / misoprostol (Arthrotec)
• Masewera a capsaicin (Capsin, Zostrix, Dolorac)
• Diclofenac sodium gel osakaniza (Voltaren 1%)
• Diclofenac sodium topical solution (Pennsaid 2%)
• Mankhwala opioid opweteka
• Corticosteroids
• Odwala matenda opatsirana pogonana
• Tengera kwina

Chidule

Matenda a nyamakazi (RA) ndi mtundu wachiwiri wa nyamakazi, womwe umakhudza anthu aku America pafupifupi 1.5 miliyoni. Ndi matenda otupa omwe amayamba chifukwa cha vuto lokhalokha. Matendawa amapezeka thupi lanu likamaukira matumba olumikizana bwino. Izi zimabweretsa kufiira, kutupa, komanso kupweteka.

Cholinga chachikulu cha mankhwala a RA ndikuletsa kutupa. Izi zimathandiza kupewa kuwonongeka kwamagulu. Pemphani kuti muphunzire za njira zambiri zochiritsira RA.

DMARDs ndi biologics

Mankhwala osokoneza bongo (DMARDs) omwe amagwiritsidwa ntchito pochepetsa matenda amagwiritsidwa ntchito pochepetsa kutupa. Mosiyana ndi mankhwala ena omwe amachepetsa kupweteka kwakanthawi komanso kutupa, ma DMARD amatha kuchepetsa kukula kwa RA. Izi zikutanthauza kuti mutha kukhala ndi zizindikilo zochepa komanso kuwonongeka kochepa pakapita nthawi.

Ma DMARD omwe amagwiritsidwa ntchito kwambiri pochizira RA ndi awa:

• hydroxychloroquine (Plaquenil)
• leflunomide (Arava)
• methotrexate (Trexall)
• sulfasalazine (Azulfidine)
• minocycline (Minocin)

Biologics ndi mankhwala ojambulidwa. Amagwira ntchito potseka njira zotupa zopangidwa ndi maselo amthupi. Izi zimachepetsa kutupa komwe kumayambitsidwa ndi RA. Madokotala amapereka biologics pomwe ma DMARD okhawo sali okwanira kuthana ndi RA. Biologics siyikulimbikitsidwa kwa anthu omwe ali ndi chitetezo chamthupi chodwala kapena matenda. Izi ndichifukwa choti atha kukulitsa chiopsezo chotenga matenda akulu.

Biologics yofala kwambiri ndi iyi:

• akupha (Orencia)
• rituximab (Rituxan)
• tocilizumab (Actemra)
• anakinra (Kineret)
• adalimumab (Humira)
• etanercept (Enbrel)
• infliximab (Kutulutsa)
• chitsimikizo cha pegol (Cimzia)
• golimumab (Simponi)

Janus kugwirizana kinase inhibitors

Dokotala wanu akhoza kukupatsani mankhwalawa ngati ma DMARD kapena biologics sakugwirani ntchito. Mankhwalawa amakhudza majini komanso magwiridwe antchito amthupi mthupi. Amathandizira kupewa kutupa ndikusiya kuwonongeka kwa malo ndi ziwalo.

Janus Associated kinase inhibitors ndi awa:

• osasamba (Xeljanz, Xeljanz XR)
• kutchinga

Baricitinib ndi mankhwala atsopano omwe akuyesedwa. Kafukufuku akuwonetsa kuti imagwira ntchito kwa anthu omwe sanachite bwino ndi ma DMARD.

Zotsatira zofala kwambiri za mankhwalawa ndi monga:

• mutu
• matenda opuma opuma, monga matenda am'mimba kapena chimfine
• mphuno yodzaza
• mphuno
• chikhure
• kutsegula m'mimba

Acetaminophen

Acetaminophen imapezeka pa kauntala (OTC) popanda mankhwala ochokera kwa dokotala wanu. Zimabwera ngati mankhwala am'kamwa komanso thumbo lothandizira. Mankhwala ena ndi othandiza kwambiri pochepetsa kutupa ndikuchiza ululu mu RA. Izi ndichifukwa choti acetaminophen imatha kuchiza kupweteka pang'ono, koma ilibe chilichonse chotsutsana ndi zotupa. Izi zikutanthauza kuti sizigwira ntchito bwino kuchiza RA.

Mankhwalawa amakhala ndi vuto lalikulu la chiwindi, kuphatikizapo kulephera kwa chiwindi. Muyenera kumwa mankhwala amodzi omwe ali ndi acetaminophen nthawi imodzi.

Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs)

NSAID ndi ena mwa mankhwala omwe RA amagwiritsidwa ntchito kwambiri. Mosiyana ndi zothetsa ululu zina, ma NSAID akuwoneka kuti ndi othandiza kwambiri pochiza matenda a RA. Izi ndichifukwa choti zimapewa kutupa.

Anthu ena amagwiritsa ntchito ma OSA NSAID. Komabe, ma NSAID amphamvu amapezeka ndi mankhwala.

Zotsatira zoyipa za NSAID ndizo:

• kupweteka m'mimba
• zilonda
• kukokoloka kapena kutentha dzenje m'mimba mwako kapena m'matumbo
• kutuluka m'mimba
• kuwonongeka kwa impso

Nthawi zambiri, zotsatirazi zimatha kupha (zimayambitsa imfa). Ngati mumagwiritsa ntchito ma NSAID kwa nthawi yayitali, dokotala wanu amayang'anira momwe impso zanu zimagwirira ntchito. Izi ndizotheka makamaka ngati muli ndi matenda a impso.

Ibuprofen (Advil, Motrin IB, Nuprin)

OTC ibuprofen ndi NSAID yofala kwambiri. Pokhapokha atalangizidwa ndi dokotala, simuyenera kugwiritsa ntchito ibuprofen kwa masiku opitilira angapo panthawi. Kutenga mankhwalawa kwa nthawi yayitali kumatha kuyambitsa magazi m'mimba. Izi ndizoopsa kwambiri kwa okalamba.

Ibuprofen imapezekanso mu mphamvu zamankhwala. M'mitundu yamankhwala, mlingowu ndiwokwera kwambiri. Ibuprofen amathanso kuphatikizidwa ndi mtundu wina wa mankhwala opweteka otchedwa opioids. Zitsanzo za mankhwala osakaniza awa ndi awa:

• ibuprofen / hydrocodone (Vicoprofen)
• ibuprofen / oxycodone (Combunox)

Sodium ya Naproxen (Aleve)

Naproxen sodium ndi OTC NSAID. Nthawi zambiri amagwiritsidwa ntchito ngati njira ina ya ibuprofen. Izi ndichifukwa zimayambitsa zovuta zochepa. Mitundu ya mankhwalawa imakupatsani mankhwala amphamvu.

Aspirini (Bayer, Bufferin, St. Joseph)

Aspirin ndi mankhwala ochepetsa ululu amkamwa. Amagwiritsidwa ntchito pochiza kupweteka pang'ono, malungo, ndi kutupa. Itha kugwiritsidwanso ntchito kupewa kupwetekedwa mtima ndi sitiroko.

NSAID zamankhwala

Pamene ma OSA NSAID samachotsa matenda anu a RA, dokotala wanu akhoza kukupatsani mankhwala a NSAID. Awa ndi mankhwala akumwa. Zomwe mungasankhe kwambiri ndi izi:

• alirazamalik (Alirazamalik)
• ibuprofen (mankhwala-mphamvu)
• Nabumetone (Relafen)
• naproxen sodium (Anaprox)
• naproxen (Naprosyn)
• piroxicam (Feldene)

Ma NSAID ena ndi awa:

• diclofenac (Voltaren, Diclofenac Sodium XR, Cataflam, Cambia)
• kutchuya
• mankhwala osokoneza bongo (Indocin)
• ketoprofen (Orudis, Ketoprofen ER, Oruvail, Actron)
• etodolac (Lodine)
• fenoprofen (Nalfon)
• zamatsenga
• ketorolac (Toradol)
• kutchfuneralhome
• mefenamic acid (Ponstel)
• meloxicam (Mobic)
• Kutchina (Daypro)
• sulindac (Chipatala)
• salsalate (Disalcid, Amigesic, Marthritic, Salflex, Mono-Gesic, Anaflex, Salsitab)
• tolmetin (Tolectin)

Diclofenac / misoprostol (Arthrotec)

Diclofenac / misoprostol (Arthrotec) ndi mankhwala apakamwa omwe amaphatikiza NSAID diclofenac ndi misoprostol. Ma NSAID amatha kuyambitsa zilonda zam'mimba. Mankhwalawa amawathandiza kupewa.

Masewera a capsaicin (Capsin, Zostrix, Dolorac)

Capsaicin topical OTC kirimu imatha kuthetsa ululu wofatsa womwe umayambitsidwa ndi RA. Mumapaka zonona izi m'malo opweteka mthupi lanu.

Diclofenac sodium gel osakaniza (Voltaren 1%)

Voltaren gel 1% ndi NSAID yogwiritsira ntchito apakhungu. Izi zikutanthauza kuti mumadzipaka pakhungu lanu. Ndizovomerezeka kuti muzitha kupweteka molumikizana, kuphatikiza m'manja ndi m'maondo.

Mankhwalawa amachititsa mavuto ofanana ndi ma NSAID amlomo. Komabe, 4 peresenti yokha ya mankhwalawa amalowetsedwa mthupi lanu. Izi zikutanthauza kuti mwina simungakhale ndi zovuta zina.

Diclofenac sodium topical solution (Pennsaid 2%)

Diclofenac sodium (Pennsaid 2%) ndi yankho lomwe limagwiritsidwa ntchito kupweteka kwa bondo. Mumapaka pa bondo lanu kuti muchepetse ululu.

Mankhwala opioid opweteka

Opioids ndi mankhwala opweteka kwambiri pamsika. Amapezeka kokha ngati mankhwala akuchipatala. Amabwera m'mafomu am'kamwa ndi jekeseni. Opioids amangogwiritsidwa ntchito pa chithandizo cha RA kwa anthu omwe ali ndi RA kwambiri omwe akumva kuwawa kwambiri. Mankhwalawa amatha kukhala chizolowezi. Ngati dokotala wanu akupatsani mankhwala opioid, amakuyang'anirani kwambiri.

Corticosteroids

Corticosteroids amatchedwanso steroids. Amabwera ngati mankhwala akumwa komanso obaya jakisoni. Mankhwalawa amatha kuthandiza kuchepetsa kutupa mu RA. Angathandizenso kuchepetsa kupweteka komanso kuwonongeka komwe kumachitika chifukwa cha kutupa. Mankhwalawa sakuvomerezeka kuti agwiritse ntchito nthawi yayitali.

Zotsatira zoyipa zimatha kuphatikiza:

• shuga wambiri wamagazi
• Zilonda zam'mimba
• kuthamanga kwa magazi
• zovuta zam'mutu, monga kukwiya komanso kusangalala
• machiritso, kapena mitambo yamaso m'maso mwako
• kufooka kwa mafupa

Steroids omwe amagwiritsidwa ntchito pa RA ndi awa:

• betamethasone
• prednisone (Deltasone, Sterapred, Phula Pred)
• dexamethasone (Dexpak Taperpak, Decadron, Hexadrol)
• cortisone
• hydrocortisone (Cortef, A-Hydrocort)
• methylprednisolone (Medrol, Methacort, Depopred, Predacorten)
• chibadul

Odwala matenda opatsirana pogonana

Mankhwalawa amalimbana ndi zovuta zomwe zimayambitsidwa ndi matenda omwe amadzitchinjiriza monga RA. Komabe, mankhwalawa amathanso kukupangitsani kuti muzitha kudwala komanso kutenga matenda. Ngati dokotala akupatsani imodzi mwa mankhwalawa, amakuwonani mosamala mukamalandira chithandizo.

Mankhwalawa amabwera m'makamwa ndi jakisoni. Zikuphatikizapo:

• cyclophosphamide (Cytoxan)
• cyclosporine (Gengraf, Neoral, Sandimmune)
• azathioprine (Azasan, Imuran)
• hydroxychloroquine (Plaquenil)

Tengera kwina

Gwiritsani ntchito ndi dokotala kuti mupeze chithandizo cha RA chomwe chimakuthandizani kwambiri. Pokhala ndi njira zambiri zomwe mungapeze, inu ndi dokotala mungapeze imodzi yomwe imachepetsa RA yanu ndikuthandizani kukhala ndi moyo wabwino.