Usebenzisa i-Imuran Ukwelapha i-Ulcerative Colitis (UC)

-Delile

• Isebenza kanjani i-Imuran
• Isikali
• Imiphumela emibi ye-Imuran
• Ingozi eyengeziwe yezinhlobo ezithile zomdlavuza
• Ukwanda kwezifo
• Ukusabela okweqile
• I-Pancreatitis
• Izexwayiso nokuxhumana
• Khuluma nodokotela wakho

Ukuqonda i-ulcerative colitis (UC)

I-ulcerative colitis (UC) isifo esizimele. Kubangela ukuthi amasosha omzimba wakho ahlasele izingxenye zomzimba wakho. Uma une-UC, amasosha akho omzimba abangela ukuvuvukala nezilonda kulwelwesi lwekholoni yakho.

I-UC ingasebenza kakhulu kwesinye isikhathi futhi ingasebenzi kakhulu kwabanye. Uma kusebenza kakhulu, unezimpawu eziningi. Lezi zikhathi zaziwa njengama-flare-ups.

Ukusiza ukuvikela ukuqhuma, ungazama ukunciphisa inani le-fiber ekudleni kwakho noma uvikele ukudla okuthile okubabayo kakhulu. Kodwa-ke, iningi labantu abane-UC futhi badinga usizo lwemithi.

I-Imuran imithi yokwelapha engakusiza ukuphatha izimpawu ze-UC emaphakathi kuya kwezinzima, kufaka phakathi amajaqamba esiswini nobuhlungu, isifo sohudo kanye nesitokisi esinegazi.

Isebenza kanjani i-Imuran

Ngokweziqondiso zakamuva zomtholampilo, izindlela zokwelashwa ezincanyelwayo zokunciphisa ukuxolelwa kubantu abane-UC elinganiselayo kuya kwezinzima zifaka:

• ama-corticosteroids
• i-anti-tumor necrosis factor (anti-TNF) yokwelashwa ngezidakamizwa ze-biologic adalimumab, golimumab, noma infliximab
• i-vedolizumab, esinye isidakamizwa se-biologic
• tofacitinib, umuthi owenziwa ngomlomo

Odokotela bavame ukunquma i-Imuran kubantu abaye bazama ezinye izidakamizwa, njenge-corticosteroids nama-aminosalicylates, ezingasizanga ukudambisa izimpawu zabo.

Imuran inguhlobo lwegama lomuthi ojwayelekile we-azathioprine. Kungokwesigaba semithi esibizwa ngama-immunosuppressants. Isebenza ngokunciphisa ukuphendula komzimba wakho.

Lo mphumela uzo:

• ukunciphisa ukuvuvukala
• gcina izimpawu zakho zihloliwe
• yehlisa ithuba lakho lokuqhuma

Imuran ingasetshenziswa eceleni kwe-infliximab (Remicade, Inflectra) ukwenza ukuxolelwa noma kukodwa ukugcina ukuxolelwa. Kodwa-ke, lokhu ukusetshenziswa okungekho kwelebula kwe-Imuran.

Ukusetshenziswa kwezidakamizwa ezingekho kwelebula kusho ukuthi umuthi ovunyelwe yi-FDA ngenhloso eyodwa usetshenziselwa injongo ehlukile engakavunyelwa. Kodwa-ke, udokotela usengasisebenzisa lesi sidakamizwa ngaleyo njongo. Lokhu kungenxa yokuthi i-FDA ilawula ukuhlolwa nokuvunywa kwezidakamizwa, kodwa hhayi ukuthi odokotela bazisebenzisa kanjani izidakamizwa ukwelapha iziguli zabo. Ngakho-ke, udokotela wakho angakunikeza umuthi kodwa bacabanga ukuthi kungcono kakhulu ukunakekelwa kwakho.

Kungathatha izinyanga eziyisithupha ukuthi i-Imuran iqale ukukhulula izimpawu zakho. I-Imuran inganciphisa umonakalo ovela ekuvukeleni okungaholela ekuvakasheni izibhedlela kanye nesidingo sokuhlinzwa.

Kubuye kuboniswe ukunciphisa isidingo se-corticosteroids esivame ukusetshenziselwa ukwelapha i-UC. Lokhu kungaba lusizo, ngoba ama-corticosteroids angadala imiphumela emibi uma esetshenziswa isikhathi eside.

Isikali

Kubantu abane-UC, isilinganiso esijwayelekile se-azathioprine singama-1.5-2.5 milligrams ngamakhilogremu wesisindo somzimba (mg / kg). Imuran itholakala kuphela njengethebhulethi engu-50-mg.

Imiphumela emibi ye-Imuran

I-Imuran nayo ingadala imiphumela emibi engaba yingozi. Ngenkathi uyithatha, kuwumqondo omuhle ukubona udokotela wakho kaningi njengoba besikisela. Ngaleyo ndlela, bangakubuka eduze ukuze uthole imiphumela emibi.

Imiphumela emibi ye-Imuran ingafaka isicanucanu nokuhlanza. Imiphumela emibi kakhulu yalesi sidakamizwa yilezi:

Ingozi eyengeziwe yezinhlobo ezithile zomdlavuza

Ukusebenzisa i-Imuran isikhathi eside kungandisa ingozi yomdlavuza wesikhumba kanye ne-lymphoma. I-Lymphoma ngumdlavuza othinta amaseli akho omzimba.

Ukwanda kwezifo

I-Imuran yehlisa ukusebenza kwesistimu yakho yokuzivikela ezifweni. Lokhu kusho ukuthi amasosha akho omzimba kungenzeka angasebenzi kahle ukulwa nezifo. Ngenxa yalokho, izinhlobo ezilandelayo zezifo zingumphumela ojwayelekile ojwayelekile:

• ukhunta
• amagciwane
• igciwane
• protozoal

Noma zivamile, izifo zisengaba zimbi.

Ukusabela okweqile

Izimpawu zokuphendula okweqile zivame ukwenzeka emasontweni ambalwa okuqala okwelashwa. Kubandakanya:

• isicanucanu
• ukuhlanza
• isifo sohudo
• ukuqubuka
• imfiva
• ukukhathala
• ubuhlungu bemisipha
• isiyezi

Uma unalezi zimpawu, xhumana nodokotela wakho khona manjalo.

I-Pancreatitis

I-Pancreatitis, noma ukuvuvukala kwamanyikwe, kungumphumela ongejwayelekile we-Imuran. Uma unezimpawu ezifana nobuhlungu besisu obunzima, ukuhlanza, noma izitulo ezinamafutha, shayela udokotela wakho ngokushesha.

Izexwayiso nokuxhumana

Imuran ingaxhumana nale mithi elandelayo:

• ama-aminosalicylates, afana ne-mesalamine (Canasa, Lialda, Pentasa), okuvame ukunikezwa abantu abane-UC emnene ukuya kokulinganayo
• i-warfarin yegazi elincanyana (Coumadin, Jantoven)
• ama-angiotensin-converting enzyme (ACE) inhibitors, asetshenziselwa ukwelapha umfutho wegazi ophezulu
• i-allpurinol (iZyloprim) ne-febuxostat (i-Uloric), engasetshenziselwa izimo ezifana ne-gout
• ribavirin, umuthi wokusha kwesibindi kohlobo C.
• co-trimoxazole (Bactrim), isibulala-magciwane

Uma njengamanje uthatha owodwa wale mithi, udokotela wakho angahle akuyeke ukusetshenziswa kwawo ngaphambi kokuthi uqale i-Imuran.

Bangancoma futhi umthamo we-Imuran wakho omncane kunomthamo ojwayelekile we-Imuran. Umthamo omncane uzosiza ukunciphisa ukuxhumana kwezidakamizwa.

Khuluma nodokotela wakho

Udokotela wakho angaphakamisa i-Imuran uma izidakamizwa ezinjenge-aminosalicylates kanye ne-corticosteroids zingasebenzanga ukulawula izimpawu zakho ze-UC. Kungasiza ekunciphiseni ukuqhuma futhi kukusize uphathe izimpawu zakho.

I-Imuran iza nengozi yemiphumela emibi kakhulu, kufaka phakathi ingozi yokuba nomdlavuza kanye nezifo. Kodwa-ke, ukuthatha i-Imuran kungakusiza futhi ukuthi uvikele imiphumela emibi ehambisana nokusetshenziswa kwe-corticosteroid yesikhathi eside.

Khuluma nodokotela wakho ukuze unqume ukuthi ngabe i-Imuran ingukukhetha okuhle kuwe.