Imithi Yabantu Abane-Ulcerative Colitis

-Delile

• Ama-Aminosalicylates (5-ASA)
• I-Mesalamine
• I-Sulfasalazine
• Olsalazine
• I-balsalazide
• Ama-Corticosteroids
• IBudesonide
• I-Prednisone ne-prednisolone
• Ama-immunomodulators
• Tocacitinib
• IMethotrexate
• I-Azathioprine
• I-Mercaptopurine
• Imiphumela emibi ye-methotrexate, azathioprine, ne-mercaptopurine
• I-Biologics
• Gwema ama-NSAID
• Khuluma nodokotela wakho

Isingeniso

I-ulcerative colitis wuhlobo lwesifo samathumbu esivuthayo (IBD) esithinta kakhulu i-colon (amathumbu amakhulu). Kungabangelwa yimpendulo engajwayelekile evela kumasosha omzimba wakho. Ngenkathi lungekho ikhambi elaziwayo le-ulcerative colitis, izinhlobo eziningana zemithi zingasetshenziswa ukuphatha izimpawu.

Izimpawu ze-ulcerative colitis zingafaka:

• ubuhlungu besisu, ukungakhululeki, noma amajaqamba
• isifo sohudo esiphikelelayo
• igazi esitokisini

Izimpawu zingahlala zikhona noma zingase zibe zimbi kakhulu ngesikhathi sokuqhuma.

Imithi ehlukahlukene ingasetshenziselwa ukunciphisa ukuvuvukala (ukuvuvukala nokucasula), ukunciphisa inani lama-flare-ups onawo, futhi uvumele ikholoni lakho ukuthi liphole. Kusetshenziswa amakilasi amane emithi ukwelapha abantu abane-ulcerative colitis.

Ama-Aminosalicylates (5-ASA)

Ama-aminosalicylates kucatshangwa ukuthi anciphisa izimpawu zesifo sezilonda ngokunciphisa ukuvuvukala kukholoni. Le mithi isetshenziswa kubantu abane-ulcerative colitis emnene kuya kokulingene. Bangasiza ukuvimbela ukuqhuma noma ukunciphisa inani lama-flare-ups onawo.

Izibonelo zale mithi zifaka:

I-Mesalamine

I-Mesalamine ingathathwa ngomlomo (ngomlomo) njengethebhulethi ekhishwe ngokubambezeleka, i-capsule ekhishwe isikhathi eside, noma i-capsule ekhishwe ngokubambezeleka. I-Mesalamine iyatholakala njenge-suppository ye-rectal noma i-enema ye-rectal.

IMesalamine iyatholakala njengomuthi ojwayelekile kwezinye izinhlobo. Ibuye inezinhlobo zamagama ezinhlobo zamagama, njengeDelzicol, i-Apriso, iPentasa, iRowasa, i-sfRowasa, i-Canasa, i-Asacol HD, ne-Lialda.

Imiphumela emibi ejwayelekile ye-mesalamine ingafaka:

• isifo sohudo
• ikhanda
• isicanucanu
• ubuhlungu besisu, amajaqamba nokungaphatheki kahle
• ukwanda kwesisu esiswini noma i-reflux
• ukuhlanza
• ukubhoboza
• ukuqubuka

Imiphumela emibi ejwayelekile kodwa emibi ye-mesalamine ingafaka:

• ubuhlungu besifuba
• ukuphelelwa umoya
• isigqi senhliziyo esingajwayelekile

Izibonelo zezidakamizwa i-mesalamine engasebenzisana nazo zifaka:

• thandokuhle
• warfarin
• umuthi wokugoma we-varicella zoster

I-Sulfasalazine

I-Sulfasalazine ithathwa ngomlomo njengethebhulethi ekhishwa ngokushesha noma eyephuza ukukhishwa. I-Sulfasalazine iyatholakala njengesidakamizwa esijwayelekile futhi njengegama lomuthi i-Azulfidine.

Imiphumela emibi ejwayelekile ye-sulfasalazine ingafaka:

• ukulahlekelwa isifiso sokudla
• ikhanda
• isicanucanu
• ukuhlanza
• isisu esibuhlungu
• kwehle amazinga esilisa emadodeni

Eminye imiphumela emibi engajwayelekile kodwa emibi ye-sulfasalazine ifaka:

• ukuphazamiseka kwegazi njenge-anemia
• ukusabela okweqile okunjenge-Stevens-Johnson syndrome
• ukwehluleka kwesibindi
• Izinkinga zezinso

I-Sulfasalazine ingaxhumana nezinye izidakamizwa, njenge:

• I-digoxin
• i-folic acid

Olsalazine

I-Olsalazine iza njengephilisi oyithatha ngomlomo. Itholakala njengegama lomuthi iDipentum. Akutholakali njengomuthi ojwayelekile.

Imiphumela emibi ejwayelekile ye-olsalazine ingafaka:

• uhudo noma indle evulekile
• ubuhlungu esiswini sakho
• ukuqubuka noma ukulunywa

Imiphumela emibi ye-olsalazine ingafaka:

• ukuphazamiseka kwegazi njenge-anemia
• ukwehluleka kwesibindi
• izinkinga zenhliziyo njengokushintsha kwesigqi senhliziyo nokuvuvukala kwenhliziyo yakho

Izibonelo zezidakamizwa i-olsalazine engasebenzisana nazo zifaka:

• i-heparin
• ama-heparin wesisindo esiphansi njenge-enoxaparin noma i-dalteparin
• umagazine
• thandokuhle
• umuthi wokugoma we-varicella zoster

I-balsalazide

I-balsalazide ithathwa ngomlomo njenge-capsule noma ithebhulethi. I-capsule iyatholakala njengesidakamizwa esijwayelekile futhi njengegama lomuthi iColazal. Ithebhulethi itholakala kuphela njengesidakamizwa sohlobo lweGiazo.

Imiphumela emibi ejwayelekile ye-balsalazide ingafaka:

• ikhanda
• ubuhlungu besisu
• isifo sohudo
• isicanucanu
• ukuhlanza
• ukutheleleka kokuphefumula
• ubuhlungu obuhlangene

Imiphumela emibi ye-balsalazide ingafaka:

• ukuphazamiseka kwegazi njenge-anemia
• ukwehluleka kwesibindi

Izibonelo zezidakamizwa i-balsalazide engasebenzisana nazo zifaka:

• thandokuhle
• i-warfarin
• umuthi wokugoma we-varicella zoster

Ama-Corticosteroids

I-Corticosteroids inciphisa impendulo yomzimba wakho jikelele yokunciphisa ukuvuvukala emzimbeni wakho. Lezi zinhlobo zemithi zisetshenziselwa ukwelapha abantu abane-ulcerative colitis esezingeni eliphakathi nendawo. I-Corticosteroids ifaka:

IBudesonide

Izinhlobo ezimbili ze-budesonide ezivunyelwe i-ulcerative colitis ngamaphilisi akhululwa enwetshiwe kanye ne-foam rectal. Zombili ziyatholakala njengesidakamizwa sohlobo lwe-Uceris. Azitholakali njengezidakamizwa ezijwayelekile.

Imiphumela emibi ejwayelekile ye-budesonide ingafaka:

• ikhanda
• isicanucanu
• amazinga anciphile we-hormone cortisol
• ubuhlungu esiswini sakho esingenhla
• ukukhathala
• ukuqunjelwa
• induna
• ukutheleleka komgudu womchamo
• ubuhlungu obuhlangene
• ukuqunjelwa

Imiphumela emibi kakhulu ye-budesonide ingafaka:

• izinkinga zokubona njenge-glaucoma, i-cataract, nokungaboni
• umfutho wegazi ophakeme

IBudesonide ingaxhumana nezinye izidakamizwa ezinjenge:

• ama-protease inhibitors afana ne-ritonavir, indinavir, ne-saquinavir, asetshenziselwa ukwelapha ukutheleleka nge-HIV
• imishanguzo yokulwa nobungozi efana ne-itraconazole ne-ketoconazole
• erythromycin
• izindlela zokuvimbela inzalo zomlomo eziqukethe i-ethinyl estradiol

I-Prednisone ne-prednisolone

IPrednisone iyatholakala kuthebhulethi, ithebhulethi ekhishwe ukubambezeleka, namafomu ezixazululo zoketshezi. Uthatha noma ikuphi kwalokhu ngomlomo. I-Prednisone iyatholakala njengesidakamizwa esijwayelekile futhi njengemithi egama linguDeltasone, iPrednisone Intensol, neRayos.

Izinhlobo ze-prednisolone ezivunyelwe i-ulcerative colitis yilezi:

• amaphilisi
• ukuncibilikisa amaphilisi
• Isixazululo samanzi
• isiraphu

Ungathatha noma iyiphi yalezi fomu ngomlomo. IPrednisolone iyatholakala njengesidakamizwa esijwayelekile futhi njengesidakamizwa sohlobo lomkhiqizo iMillipred.

Imiphumela emibi ejwayelekile ye-prednisone ne-prednisolone ingafaka:

• ukwanda kwamazinga kashukela egazini
• ukungahlaliseki noma ukukhathazeka
• ukwanda komfutho wegazi
• ukuvuvukala ngenxa yokugcina uketshezi emilenzeni noma emaqakaleni
• ukwanda kwesifiso sokudla
• ukuzuza kwesisindo

Imiphumela emibi ye-prednisone ne-prednisolone ingafaka:

• i-osteoporosis kanye nengozi eyengeziwe yokuphuka kwamathambo
• izinkinga zenhliziyo njengokuhlaselwa yisifo senhliziyo, ubuhlungu besifuba, nokushintsha kwesigqi senhliziyo
• isithuthwane

Izibonelo zezidakamizwa i-prednisone ne-prednisolone ezingasebenzisana nazo zifaka:

• izidakamizwa zokuqeda imishanguzo efana ne-phenobarbital ne-phenytoin
• izinciphisi zegazi ezifana ne-warfarin
• phumlani
• ketoconazole
• i-aspirin

Ama-immunomodulators

Ama-immunomodulators yimithi eyehlisa ukuphendula komzimba kumasosha ayo omzimba. Umphumela ukunciphisa ukuvuvukala emzimbeni womuntu. Ama-immunomodulators anganciphisa inani lama-ulcerative colitis flare-ups onawo futhi akusize ukuthi uhlale ungenazimpawu isikhathi eside.

Ama-immunomodulators ngokuvamile asetshenziswa kubantu abanezimpawu ezingalawulwa ngama-aminosalicylates kanye ne-corticosteroids. Kodwa-ke, le mithi ingathatha izinyanga ezimbalwa ukuqala ukusebenza.

Ama-immunomodulators afaka:

Tocacitinib

Kuze kube muva nje, ama-immunomodulators awazange avunyelwe yi-U.S. Food and Drug Administration (FDA) ukwelapha abantu abane-ulcerative colitis. Noma kunjalo, lesi sigaba sezidakamizwa kwaba kwesinye isikhathi kusetshenziswa i-off-label ukwelapha abantu abane-ulcerative colitis.

Ukusetshenziswa okunjalo okungekho kwelebula kwaba yinto yesikhathi esidlule ngo-2018 lapho i-FDA ivuma ukusetshenziswa kwe-immunomodulator yabantu abane-ulcerative colitis. Le immunomodulator ibizwa nge-tofacitinib (Xeljanz). Ngaphambilini bekuvunyelwe i-FDA kubantu abane-arthritis ye-rheumatoid kodwa isetshenzisiwe ngaphandle kwelebula kubantu abane-ulcerative colitis. I-Xeljanz umuthi wokuqala wohlobo lwayo onikezwa ngomlomo - hhayi ngomjovo - wokwelashwa isikhathi eside kwabantu abane-ulcerative colitis.

Funda kabanzi mayelana nokusetshenziswa kwezidakamizwa ezingekho kwelebula.

IMethotrexate

IMethotrexate iyatholakala njengethebhulethi oyiphuzayo. Ibuye inikezwe ngomjovo we-intravenous (IV) kanye nemijovo engaphansi kwesikhumba neyemisipha. Ithebhulethi iyatholakala njengomuthi ojwayelekile futhi njengegama lomuthi iTrexall. Isixazululo se-IV nomjovo we-intramuscular kutholakala kuphela njengezidakamizwa ezijwayelekile. Umjovo ongena ngaphansi kwesikhumba utholakala kuphela njengezidakamizwa ezibizwa ngegama u-Otrexup noRasuvo.

I-Azathioprine

Ukuze uthole ukwelashwa kwe-ulcerative colitis, i-azathioprine iza njengethebhulethi oyithatha ngomlomo. Kutholakala njengomuthi ojwayelekile futhi njengezidakamizwa ezibizwa ngegama u-Azasan no-Imuran.

I-Mercaptopurine

IMercaptopurine iyatholakala njengethebhulethi noma ukumiswa oketshezi, zombili ezithathwe ngomlomo. Ithebhulethi itholakala kuphela njengomuthi ojwayelekile, futhi ukumiswa kutholakala kuphela njengesidakamizwa sohlobo lwe-Purixan.

Imiphumela emibi ye-methotrexate, azathioprine, ne-mercaptopurine

Imiphumela emibi ejwayelekile yalawa ma-immunomodulators ingafaka:

• ikhanda
• isicanucanu
• ukuhlanza
• isifo sohudo
• izilonda zomlomo
• ukukhathala
• amazinga egazi aphansi

Izibonelo zezidakamizwa ama-immunomodulators angaxhumana nazo zifaka:

• ingulube
• ama-aminosalicylates afana ne-sulfasalazine, i-mesalamine, ne-olsalazine
• i-angiotensin-converting enzyme (ACE) inhibitors efana ne-lisinopril ne-enalapril
• warfarin
• ribavirin
• izidakamizwa ezingezona ukuvuvukala (ama-NSAID) ezinjenge-naproxen ne-ibuprofen
• umabhebhana
• mthombeni
• sulfonamides
• kubi
• ama-retinoids
• thindokuhle

I-Biologics

I-biologics yimithi ekhiqizwe izakhi zofuzo ekhiqizwa ebhodini kusuka emzimbeni ophilayo. Le mithi ivimbela amaprotheni athile emzimbeni wakho ukuthi angabangeli ukuvuvukala. Izidakamizwa ze-biologic zisetshenziselwa abantu abane-ulcerative colitis elinganiselayo kuya kwelinzima. Zisetshenziswa futhi kubantu abanezimpawu ezingalawulwa ngezindlela zokwelapha ezifana nama-aminosalicylates, ama-immunomodulators, noma ama-corticosteroids.

Kunemithi emihlanu ye-biologic esetshenziselwa ukuphathwa kwezimpawu ze-ulcerative colitis. Lokhu kutholakala kuphela njengezidakamizwa ezinegama lomkhiqizo, kufaka phakathi:

• i-adalimumab (Humira), inikezwe ngomjovo ongaphansi
• i-golimumab (iSimponi), enikezwe ngomjovo ongaphansi
• infliximab (Remicade), enikezwe ukumnika kwe-IV
• infliximab-dyyb (Inflectra), enikezwe ukumnika kwe-IV
• I-vedolizumab (Entyvio), enikezwe ukumnika kwe-IV

Ungadinga ukuthatha i-adalimumab, i-golimumab, i-infliximab, noma i-infliximab-dyyb kuze kube amasonto ayisishiyagalombili ngaphambi kokuthi ubone noma yikuphi ukuthuthuka. IVedolizumab ngokuvamile iqala ukusebenza emasontweni ayisithupha.

Imiphumela emibi ejwayelekile yezidakamizwa ze-biologic ingafaka:

• ikhanda
• imfiva
• Ukugodola
• isifuba noma ukuqubuka
• ukwanda kwezifo

Izidakamizwa ze-biologic zingase zihlanganyele namanye ama-biologic agents. Izibonelo zalokhu zifaka:

• natalizumab
• adalimumab
• golimumab
• infliximab
• anakinra
• ukuhlaba
• umusic
• warfarin
• cyclosporine
• thindokuhle
• imithi yokugoma ephilayo efana nomuthi wokugoma i-varicella zoster

Gwema ama-NSAID

Ama-NSAID, afana ne-ibuprofen ne-naproxen, ngokuvamile anciphisa ukuvuvukala emzimbeni. Uma une-ulcerative colitis, noma kunjalo, le mithi ingenza izimpawu zakho zibe zimbi kakhulu. Qiniseka ukuthi ukhuluma nodokotela wakho ngaphambi kokuthatha i-NSAID.

Khuluma nodokotela wakho

Izidakamizwa eziningi zingasiza ekwehliseni izimpawu zakho zokulunywa yizilonda emathunjini. Uma une-ulcerative colitis, buyekeza le ndatshana nodokotela wakho bese ukhuluma ngokuthi imiphi imithi engakulungela. Udokotela wakho uzophakamisa imishanguzo ngokuya ngezici ezifana nempilo yakho yonke nokuthi isimo sakho sinzima kangakanani.

Ungadinga ukuzama imithi embalwa ngaphambi kokuthola uhlelo lokwelashwa olusebenzela wena. Uma ukuthatha umuthi owodwa kungazinciphisi izimpawu zakho ngokwanele, udokotela wakho angangeza umuthi wesibili owenza owokuqala uphumelele ngokwengeziwe. Kungathatha isikhashana, kepha udokotela wakho uzosebenzisana nawe ukuthola imishanguzo efanele yokusiza ekunciphiseni izimpawu zakho zesisu.