Izidakamizwa ze-COPD: Uhlu Lwemithi Yokusiza Ukudambisa Izimpawu Zakho

-Delile

• Ama-bronchodilator asebenza okwesikhashana
• Ama-Corticosteroids
• Imethylxanthines
• Ama-bronchodilators asebenza isikhathi eside
• Izidakamizwa zokuhlanganiswa
• Roflumilast
• Izidakamizwa ze-Mucoactive
• Imigomo
• Imithi elwa namagciwane
• Imithi yomdlavuza ye-COPD
• Izidakamizwa ze-Biologic
• Khuluma nodokotela wakho

Isifo esingapheliyo se-pulmonary disease (COPD) siyiqembu lezifo zamaphaphu eziqhubekayo ezenza kube nzima ukuphefumula. I-COPD ingafaka i-emphysema ne-bronchitis engapheli.

Uma une-COPD, ungaba nezimpawu ezifana nenkinga yokuphefumula, ukukhwehlela, ukuphefumula, nokuqina esifubeni sakho. I-COPD ivame ukubangelwa ukubhema, kodwa kwezinye izimo kubangelwa ukuphefumula ubuthi obuvela emvelweni.

Alikho ikhambi le-COPD, futhi ukulimala kwamaphaphu nemigwaqo yomoya kungunaphakade. Kodwa-ke, imishanguzo eminingana ingasiza ukunciphisa ukuvuvukala futhi ivule izindlela zakho zomoya ukukusiza uphefumule kalula nge-COPD.

Ama-bronchodilator asebenza okwesikhashana

Ama-bronchodilators asiza ukuvula imigwaqo yakho yomoya ukwenza ukuphefumula kube lula. Udokotela wakho angakuyalela ama-bronchodilators asebenza ezimfushane ngesimo esiphuthumayo noma ukuthola usizo ngokushesha lapho kudingeka. Ubathatha usebenzisa i-inhaler noma i-nebulizer.

Izibonelo zama-bronchodilator asebenza okufushane afaka:

• i-albuterol (i-Proair HFA, i-Ventolin HFA)
• i-levalbuterol (i-Xopenex)
• ipratropium (Atrovent HFA)
• i-albuterol / ipratropium (i-Combivent Respimat)

Ama-bronchodilators asebenza ngamafushane angadala imiphumela emibi njengomlomo owomile, ikhanda elibuhlungu, nokukhwehlela. Le miphumela kufanele ihambe ngokuhamba kwesikhathi. Eminye imiphumela emibi ifaka ukuthuthumela (ukuqhaqhazela), ukwethuka, nokushaya kwenhliziyo okusheshayo.

Uma unesimo senhliziyo, tshela udokotela wakho ngaphambi kokuthatha i-bronchodilator esebenza okwesikhashana.

Ama-Corticosteroids

Nge-COPD, izindiza zakho zingavutha, zibangele ukuvuvukala nokucasuka. Ukuvuvukala kwenza kube nzima ukuphefumula. ICorticosteroids uhlobo lomuthi olwehlisa ukuvuvukala emzimbeni, okwenza ukuhamba komoya kube lula emaphashini.

Izinhlobo eziningana zama-corticosteroids ziyatholakala. Ezinye ziyahogela futhi kufanele zisetshenziswe nsuku zonke njengokuyalelwa. Zivame ukunikezwa ngokuhlanganiswa nomuthi osebenza isikhathi eside we-COPD.

Amanye ama-corticosteroids ajovwa noma athathwe ngomlomo. Lawa mafomu asetshenziswa ngesikhathi esifushane lapho i-COPD yakho iqala ukuba yimbi ngokuzumayo.

Odokotela be-corticosteroids bavame ukunquma i-COPD yilawa:

• I-Fluticasone (i-Flovent). Lokhu kuza njenge-inhaler oyisebenzisa kabili nsuku zonke. Imiphumela emibi ingafaka ikhanda, umphimbo obuhlungu, ukushintsha kwezwi, isicanucanu, izimpawu ezifana nokubanda, ne-thrush.
• I-Budesonide (Pulmicort). Lokhu kuza njenge-inhaler ephathwa ngesandla noma yokusetshenziswa ku-nebulizer. Imiphumela emibi ingafaka imikhuhlane kanye ne-thrush.
• I-Prednisolone. Lokhu kuza njengephilisi, uketshezi, noma ukudubula. Ngokuvamile kunikezwa ukwelashwa okuphuthumayo. Imiphumela emibi ingafaka ikhanda, ubuthakathaka bemisipha, isisu esicasukile, nokuzuza kwesisindo.

Imethylxanthines

Kwabanye abantu abane-COPD enzima, izindlela zokwelashwa ezijwayelekile zomugqa wokuqala, njengama-bronchodilators asebenza ngokushesha nama-corticosteroids, azibonakali zisiza uma zisetshenziswa zodwa.

Uma lokhu kwenzeka, abanye odokotela banikeza umuthi obizwa ngokuthi i-theophylline kanye ne-bronchodilator. I-Theophylline isebenza njengomuthi olwa nokuvuvukala futhi ibuyisa imisipha ezindleleni zomoya. Kuza njengephilisi noma uketshezi oluthatha nsuku zonke.

Imiphumela emibi ye-theophylline ingafaka isicanucanu noma ukuhlanza, ukundindizela, ikhanda elibuhlungu, nenkinga yokulala.

Ama-bronchodilators asebenza isikhathi eside

Ama-bronchodilators asebenza isikhathi eside yimithi esetshenziselwa ukwelapha i-COPD isikhathi eside. Imvamisa zithathwa kanye noma kabili nsuku zonke kusetshenziswa ama-inhalers noma ama-nebulizers.

Ngoba le mishanguzo isebenza kancane kancane ukusiza ukunciphisa ukuphefumula, ayisebenzi ngokushesha njengemithi yokutakula. Azenzelwe ukusetshenziselwa isimo esiphuthumayo.

Ama-bronchodilator asebenza isikhathi eside akhona namuhla yilawa:

• i-aclidinium (Tudorza)
• i-arformoterol (Brovana)
• i-formoterol (i-Foradil, i-Perforomist)
• i-glycopyrrolate (uSeebri Neohaler, uLonhala Magnair)
• i-indacaterol (Arcapta)
• i-olodaterol (Striverdi Respimat)
• i-revefenacin (Yupelri)
• i-salmeterol (iSerevent)
• i-tiotropium (i-Spiriva)
• umeclidinium (Incruse Ellipta)

Imiphumela emibi yama-bronchodilators asebenza isikhathi eside ingafaka:

• umlomo owomile
• isiyezi
• ukuthuthumela
• ikhala eligijimayo
• umphimbo ocasukile noma onwaya
• isisu esibuhlungu

Imiphumela emibi kakhulu ibandakanya ukufiphala, ukushaya kwenhliziyo okusheshayo noma okungajwayelekile, kanye nokusabela okweqile ngokuqubuka noma ngokuvuvukala.

Izidakamizwa zokuhlanganiswa

Izidakamizwa eziningana ze-COPD ziza njengemithi ehlanganisiwe. Lokhu ikakhulukazi kuyinhlanganisela yama-bronchodilator amabili asebenza isikhathi eside noma i-corticosteroid ehogelwayo kanye ne-bronchodilator esebenza isikhathi eside.

Ukwelashwa okuphindwe kathathu, inhlanganisela ye-corticosteroid ehogelwayo kanye nama-bronchodilator amabili asebenza isikhathi eside, angasetshenziselwa i-COPD enzima kanye nama-flare-ups.

Ukuhlanganiswa kwama-bronchodilators amabili asebenza isikhathi eside kufaka:

• i-aclidinium / formoterol (iDuaklir)
• i-glycopyrrolate / formoterol (Bevespi Aerosphere)
• i-glycopyrrolate / indacaterol (i-Utibron Neohaler)
• i-tiotropium / olodaterol (i-Stiolto Respimat)
• umeclidinium / vilanterol (Anoro Ellipta)

Ukuhlanganiswa kwe-corticosteroid ehogelwayo kanye ne-bronchodilator esebenza isikhathi eside kufaka:

• i-budesonide / formoterol (Symbicort)
• i-fluticasone / i-salmeterol (i-Advair)
• i-fluticasone / vilanterol (uBreo Ellipta)

Ukuhlanganiswa kwe-corticosteroid ehogelwayo kanye nama-bronchodilator amabili asebenza isikhathi eside, abizwa ngokuthi yi-triple therapy, afaka i-fluticasone / vilanterol / umeclidinium (Trelegy Ellipta).

Kutholwe ukuthi ukwelashwa okuphindwe kathathu kunciphise ukuqhuma nokusebenza kwamaphaphu okuthuthukile kubantu abane-COPD esezingeni eliphakeme.

Kodwa-ke, ibuye ikhombise ukuthi inyumoniya kungenzeka kakhulu ngokwelashwa okuphindwe kathathu kunokuhlanganiswa kwemithi emibili.

Roflumilast

I-Roflumilast (i-Daliresp) uhlobo lomuthi obizwa nge-phosphodiesterase-4 inhibitor. Kuza njengephilisi oyiphuza kanye ngosuku.

I-Roflumilast isiza ukuqeda ukuvuvukala, okungathuthukisa ukugeleza komoya emaphashini akho. Udokotela wakho kungenzeka anikeze lo muthi kanye ne-bronchodilator esebenza isikhathi eside.

Imiphumela emibi ye-roflumilast ingafaka:

• ukuncipha komzimba
• isifo sohudo
• ikhanda
• isicanucanu
• amajaqamba
• ukuthuthumela
• ukuqwasha

Yazisa udokotela wakho uma unezinkinga zesibindi noma ukucindezeleka ngaphambi kokuthatha lo muthi.

Izidakamizwa ze-Mucoactive

Ama-flare-ups e-COPD angadala amazinga akhuphukayo amafinyila emaphashini. Izidakamizwa ezinomsoco zisiza ukunciphisa amafinyila noma ukuwanciphisa ukuze ukwazi ukukhwehlela kalula. Zivame ukuza ngefomu lamaphilisi, futhi zifaka:

• carococsteine
• umagazine
• I-N-acetylcysteine

Ukuphakanyiswa ukuthi le mithi ingasiza ekunciphiseni ukuqhuma nokukhubazeka okuvela ku-COPD. Ucwaningo lwango-2017 luphinde lwathola ukuthi i-erdosteine ​​yehlise inani nobukhulu be-COPD flare-ups.

Imiphumela emibi yale mithi ingafaka:

• isicanucanu
• ukuhlanza
• ubuhlungu besisu

Imigomo

Kubalulekile ukuthi abantu abane-COPD bathole umuthi wokugomela umkhuhlane minyaka yonke. Udokotela wakho angancoma ukuthi nawe uthole umuthi wokugoma we-pneumococcal.

Le mithi yokugoma inciphisa ubungozi bokugula futhi ingakusiza ugweme ukutheleleka nezinye izinkinga ezihlobene ne-COPD.

Ukubuyekezwa kocwaningo lwango-2018 kutholakale ukuthi umuthi wokugomela umkhuhlane nawo unganciphisa ukuqhuma kweCOPD, kepha uqaphele ukuthi kunezifundo ezimbalwa zamanje.

Imithi elwa namagciwane

Ukwelashwa njalo ngama-antibiotics afana ne-azithromycin ne-erythromycin kungasiza ukuphatha i-COPD.

Ukubuyekezwa kocwaningo lwango-2018 kukhombise ukuthi ukwelashwa kwama-antibiotic okungaguquki kunciphise ukuqhuma kweCOPD. Kodwa-ke, ucwaningo luthi ukusetshenziswa kwama-antibiotic okuphindaphindiwe kungadala ukumelana nama-antibiotic. Iphinde yathola ukuthi i-azithromycin ihlotshaniswa nokulahleka kokuzwa njengomphumela oseceleni.

Kudingeka izifundo eziningi ukuthola imiphumela yesikhathi eside yokusetshenziswa kwama-antibiotic okuvamile.

Imithi yomdlavuza ye-COPD

Izidakamizwa eziningana zomdlavuza zinganciphisa ukuvuvukala futhi zinciphise ukulimala okuvela ku-COPD.

Ucwaningo lwango-2019 luthole ukuthi isidakamizwa i-tyrphostin AG825 sehlise amazinga okuvuvukala e-zebrafish. Lo muthi uphinde wakhuphula izinga lokufa kwama-neutrophils, angamaseli akhuthaza ukuvuvukala, kumagundane anamaphaphu avuvukile afana ne-COPD.

Ucwaningo lusakhawulelwe ekusebenziseni i-tyrphostin AG825 nezidakamizwa ezifanayo ze-COPD nezinye izimo zokuvuvukala. Ekugcineni, zingaba yindlela yokwelashwa ye-COPD.

Izidakamizwa ze-Biologic

Kwabanye abantu, ukuvuvukala okuvela ku-COPD kungaba umphumela we-eosinophilia, noma ukuba nenani eliphakeme kakhulu kunokujwayelekile lamaseli egazi amhlophe abizwa ngama-eosinophils.

Okukhonjisiwe ukuthi izidakamizwa ze-biologic zingakwazi ukwelapha leli fomu le-COPD. Izidakamizwa ze-biologic zenziwa ngamaseli aphilayo. Eziningana zalezi zidakamizwa zisetshenziselwa i-asthma enamandla ebangelwa i-eosinophilia, kufaka phakathi:

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

Ucwaningo olwengeziwe luyadingeka ekwelapheni i-COPD ngalezi zidakamizwa ze-biologic.

Khuluma nodokotela wakho

Izinhlobo ezahlukene zemithi zelapha izici nezimpawu ezahlukahlukene ze-COPD. Udokotela wakho uzokunikeza imithi ezokwelapha kangcono isimo sakho.

Imibuzo ongayibuza udokotela wakho mayelana nohlelo lwakho lokwelashwa ifaka:

• Kufanele ngisebenzise kaningi kangakanani ukwelashwa kwami ​​kwe-COPD?
• Ngabe ngithatha noma imuphi omunye umuthi ongasebenzisana nemithi yami yeCOPD?
• Ngizodinga isikhathi esingakanani ukuthatha imishanguzo yami yeCOPD?
• Iyiphi indlela efanele yokusebenzisa i-inhaler yami?
• Kwenzekani uma ngiyeka ngokungazelelwe ukuthatha imishanguzo yami yeCOPD?
• Ngaphandle kokuthatha imishanguzo, yiziphi izinguquko zendlela yokuphila okufanele ngizenze ukukhulula izimpawu zami ze-COPD?
• Yini okufanele ngiyenze uma ngiba nezimpawu eziya ziba zimbi kungazelelwe?
• Ngingayivimbela kanjani imiphumela emibi?

Noma ngabe yimuphi umuthi udokotela wakho akunika wona, qiniseka ukuthi uwuthatha ngokuyaleza ngemiyalo kadokotela wakho. Uma unemiphumela emibi kakhulu, efana nokusabela okweqile ngokuqhuma noma ukuvuvukala, shayela udokotela wakho ngokushesha. Uma unenkinga yokuphefumula noma ukuvuvukala komlomo, ulimi, noma umphimbo, shayela ku-911 noma abezimo eziphuthumayo zendawo yangakini. Ngoba eminye imishanguzo ye-COPD ingathinta uhlelo lwakho lwe-cardiovascular, qiniseka ukuthi utshela udokotela wakho uma unesifo senhliziyo esingajwayelekile noma izinkinga zenhliziyo.