Uhlu Lwemithi Ye-Rheumatoid Arthritis

-Delile

• Ama-DMARD kanye ne-biologics
• UJanus ohambisana ne-kinase inhibitors
• I-Acetaminophen
• Izidakamizwa ezingezona ukuvuvukala (ama-NSAID)
• I-Ibuprofen (Advil, Motrin IB, Nuprin)
• I-sodium yeNaproxen (i-Aleve)
• I-Aspirin (iBayer, iBufferin, iSt. Joseph)
• Ama-NSAID kadokotela
• I-Diclofenac / misoprostol (i-Arthrotec)
• I-capsaicin eyisihloko (Capsin, Zostrix, Dolorac)
• I-Diclofenac i-gel yama-topical gel (i-Voltaren 1%)
• Isixazululo se-Diclofenac sodium topical (i-Pennsaid 2%)
• Izidakamizwa zobuhlungu ze-opioid
• Ama-Corticosteroids
• Ama-immunosuppressants
• Ukudla okudlela endlini

Ukubuka konke

I-rheumatoid arthritis (RA) uhlobo lwesibili oluvame kakhulu lwe-arthritis, oluthinta abantu baseMelika abangaba yizigidi eziyi-1.5. Kuyisifo sokuvuvukala esidalwa yisimo sokuzimela. Lesi sifo sivela lapho umzimba wakho uhlasela izicubu zomzimba ezinempilo. Lokhu kubangela ukubomvu, ukuvuvukala nobuhlungu.

Inhloso enkulu yezidakamizwa ze-RA ukuvimba ukuvuvukala. Lokhu kusiza ukuvimbela ukulimala okuhlangene. Funda ukuze ufunde ngezindlela eziningi zokwelashwa ze-RA.

Ama-DMARD kanye ne-biologics

Izidakamizwa zokuguqula izifo (i-DMARD) zisetshenziselwa ukunciphisa ukuvuvukala. Ngokungafani neminye imithi edambisa izinhlungu nokuvuvukala okwesikhashana, ama-DMARD anganciphisa ukuqhubeka kwe-RA. Lokhu kusho ukuthi ungaba nezimpawu ezimbalwa nomonakalo omncane ngokuhamba kwesikhathi.

Ama-DMARD ajwayelekile asetshenziselwa ukwelapha i-RA afaka:

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

I-Biologics yimithi ejojoweyo. Basebenza ngokuvimba izindlela ezithile zokuvuvukala ezenziwe ngamaseli omzimba. Lokhu kunciphisa ukuvuvukala okubangelwa yi-RA. Odokotela banquma i-biologics lapho ama-DMARD eyedwa enganele ukuphatha izimpawu ze-RA. Ama-biologics awanconyelwa abantu abanamasosha omzimba abucayi noma ukutheleleka. Lokhu kungenxa yokuthi bangakhuphula ubungozi bokutheleleka ngezibi.

I-biologics ejwayelekile kakhulu ifaka:

• i-abatacept (i-Orencia)
• i-rituximab (Rituxan)
• i-tocilizumab (Actemra)
• anakinra (Kineret)
• i-adalimumab (Humira)
• i-etanercept (Enbrel)
• infliximab (i-Remicade)
• isitifiketi se-certolizumab (Cimzia)
• golimumab (Simponi)

UJanus ohambisana ne-kinase inhibitors

Udokotela wakho angakunikeza le mithi uma ama-DMARD noma i-biologics ingakusebenzeli. Le mithi ithinta izakhi zofuzo kanye nokusebenza kwamaseli omzimba emzimbeni. Zisiza ukuvimbela ukuvuvukala nokuyeka ukulimala kwamalunga nezicubu.

AmaJanus kinase inhibitors ahlobene afaka:

• i-tofacitinib (Xeljanz, Xeljanz XR)
• baricitinib

IBaricitinib yisidakamizwa esisha esivivinywayo. Ucwaningo lukhombisa ukuthi lusebenzela abantu abangenampumelelo ngama-DMARD.

Imiphumela emibi ejwayelekile yale mithi ifaka:

• ikhanda
• izifo eziphezulu zokuphefumula, njengezifo zesinus noma umkhuhlane ovamile
• ikhala eliminyene
• ikhala eligijimayo
• Umphimbo obuhlungu
• isifo sohudo

I-Acetaminophen

I-Acetaminophen iyatholakala ngaphezu kwe-counter (i-OTC) ngaphandle kwemithi evela kudokotela wakho. Kuza njengesidakamizwa somlomo kanye ne-suppository ye-rectal. Eminye imishanguzo isebenza kangcono kakhulu ekwehliseni ukuvuvukala nasekwelapheni ubuhlungu ku-RA. Lokhu kungenxa yokuthi i-acetaminophen ingelapha ubuhlungu obumaphakathi kuya obulinganiselayo, kepha ayinayo imisebenzi elwa nokuvuvukala. Lokhu kusho ukuthi akusebenzi kahle ukwelapha iRA.

Lesi sidakamizwa sinobungozi bezinkinga ezinkulu zesibindi, kufaka phakathi ukwehluleka kwesibindi. Kufanele uthathe kuphela umuthi owodwa oqukethe i-acetaminophen ngasikhathi.

Izidakamizwa ezingezona ukuvuvukala (ama-NSAID)

Ama-NSAID aphakathi kwezidakamizwa ze-RA ezisetshenziswa kakhulu. Ngokungafani nokunye ukudambisa izinhlungu, ama-NSAID abonakala esebenza kangcono ekwelapheni izimpawu ze-RA. Lokhu kungenxa yokuthi zivimbela ukuvuvukala.

Abanye abantu basebenzisa ama-OTC NSAID. Kodwa-ke, ama-NSAID anamandla ayatholakala ngemithi kadokotela.

Imiphumela emibi yama-NSAID ifaka:

• ukucasuka kwesisu
• izilonda
• ukuguguleka noma ukushiswa komgodi esiswini noma emathunjini akho
• ukopha esiswini
• ukulimala kwezinso

Ezimweni ezingavamile, le miphumela emibi ingaba yingozi (ibangele ukufa). Uma usebenzisa ama-NSAID isikhathi eside, udokotela wakho uzoqapha umsebenzi wakho wezinso. Lokhu kungenzeka ikakhulukazi uma usuvele unesifo sezinso.

I-Ibuprofen (Advil, Motrin IB, Nuprin)

I-OTC ibuprofen yi-NSAID ejwayelekile kakhulu. Ngaphandle kokuthi ufundiswe ngudokotela wakho, akufanele usebenzise ibuprofen izinsuku ezingaphezu kwesikhashana ngesikhathi. Ukuthatha lesi sidakamizwa isikhathi eside kakhulu kungadala ukopha esiswini. Le ngozi inkulu kubantu abadala.

I-Ibuprofen iyatholakala nakumandla kadokotela. Ezinguqulweni zemithi, umthamo uphakeme. I-Ibuprofen nayo ingahlanganiswa nolunye uhlobo lomuthi wezinhlungu obizwa ngama-opioid. Izibonelo zale mithi yokuhlanganiswa kadokotela zifaka:

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

I-sodium yeNaproxen (i-Aleve)

I-sodium yeNaproxen iyi-OTC NSAID. Kuvame ukusetshenziswa njengenye indlela ye-ibuprofen.Lokhu kungenxa yokuthi kudala imiphumela emibi embalwa. Izinhlobo zezidakamizwa zalesi sidakamizwa zinikeza imithamo enamandla.

I-Aspirin (iBayer, iBufferin, iSt. Joseph)

I-Aspirin isidambisi sobuhlungu bomlomo. Isetshenziselwa ukwelapha ubuhlungu obuncane, umkhuhlane nokuvuvukala. Ingasetshenziswa futhi ukuvimbela isifo senhliziyo nesifo sohlangothi.

Ama-NSAID kadokotela

Lapho ama-OTC NSAIDs engazinciphisi izimpawu zakho ze-RA, udokotela wakho angase anikeze i-NSAID kadokotela. Lezi yizidakamizwa zomlomo. Izinketho ezivame kakhulu zifaka:

• celecoxib (Celebrex)
• ibuprofen (amandla kadokotela)
• i-nabumetone (Relafen)
• i-naproxen sodium (Anaprox)
• i-naproxen (Naprosyn)
• i-piroxicam (Feldene)

Amanye ama-NSAID afaka:

• i-diclofenac (Voltaren, Diclofenac Sodium XR, Cataflam, Cambia)
• diflunisal
• indomethacin (Indocin)
• ketoprofen (Orudis, Ketoprofen ER, Oruvail, Actron)
• i-etodolac (i-Lodine)
• i-fenoprofen (Nalfon)
• usipro
• i-ketorolac (Toradol)
• umabhebhana
• i-mefenamic acid (iPonstel)
• i-meloxicam (Mobic)
• oxaprozin (Daypro)
• sulindac (Umtholampilo)
• i-salsalate (Disalcid, Amigesic, Marthritic, Salflex, Mono-Gesic, Anaflex, Salsitab)
• i-tolmetin (Tolectin)

I-Diclofenac / misoprostol (i-Arthrotec)

I-Diclofenac / misoprostol (i-Arthrotec) yisidakamizwa somlomo esihlanganisa i-NSAID diclofenac ne-misoprostol. Ama-NSAID angadala izilonda zesisu. Lesi sidakamizwa sisiza ukuzivimbela.

I-capsaicin eyisihloko (Capsin, Zostrix, Dolorac)

I-Capsaicin topical OTC cream ingadambisa ubuhlungu obuthambile obudalwe yiRA. Ugcoba lo khilimu ezindaweni ezibuhlungu emzimbeni wakho.

I-Diclofenac i-gel yama-topical gel (i-Voltaren 1%)

Ijeli le-Voltaren 1% yi-NSAID yokusetshenziswa kwama-topical. Lokhu kusho ukuthi uyigcoba esikhunjeni sakho. Kuvunyelwe ukwelapha ubuhlungu obuhlangene, kufaka phakathi ezandleni zakho nasemadolweni.

Lesi sidakamizwa sidala imiphumela emibi efanayo kuma-NSAID omlomo. Kodwa-ke, cishe amaphesenti ama-4 kuphela alo muthi angena emzimbeni wakho. Lokhu kusho ukuthi kungenzeka ungabi namathuba amancane okuba nemiphumela engemihle.

Isixazululo se-Diclofenac sodium topical (i-Pennsaid 2%)

I-Diclofenac sodium (i-Pennsaid 2%) yisixazululo se-topical esisetshenziselwa ubuhlungu bamadolo. Uyigcoba edolweni ukudambisa izinhlungu.

Izidakamizwa zobuhlungu ze-opioid

Ama-opioid yizidakamizwa eziqinisa kakhulu emakethe. Atholakala kuphela njengemithi kadokotela. Ziza ngezindlela zomlomo nezomjovo. Ama-opioid asetshenziswa kuphela ekwelashweni kwe-RA kubantu abane-RA enamandla abasezinhlungwini ezinkulu. Le mithi ingaba ukwakheka komkhuba. Uma udokotela wakho ekunikeza umuthi opioid, bazokubuka eduze.

Ama-Corticosteroids

AmaCorticosteroids abizwa nangokuthi ama-steroids. Ziza njengezidakamizwa zomlomo nezomjovo. Le mithi ingasiza ekwehliseni ukuvuvukala ku-RA. Zingasiza futhi ekunciphiseni ubuhlungu nomonakalo odalwe ukuvuvukala. Le mithi ayinconywa ukuthi isetshenziswe isikhathi eside.

Imiphumela emibi ingafaka:

• ushukela ophakeme wegazi
• izilonda zesisu
• umfutho wegazi ophakeme
• imiphumela emibi engokomzwelo, njengokucasuka kanye nokujabula
• iso, noma ukufiphazwa kwelensi esweni lakho
• ukukhumuzeka kwamathambo

Ama-steroid asetshenziselwa i-RA afaka:

• betamethasone
• i-prednisone (Deltasone, Sterapred, Liquid Pred)
• i-dexamethasone (i-Dexpak Taperpak, i-Decadron, i-Hexadrol)
• i-cortisone
• i-hydrocortisone (iCortef, A-Hydrocort)
• i-methylprednisolone (iMedrol, iMethacort, iDepopred, iPredacorten)
• webhilo

Ama-immunosuppressants

Le mithi ilwa nomonakalo odalwe yizifo ezizimele njenge-RA. Kodwa-ke, le mithi ingakwenza futhi uthambekele kakhulu ekuguleni nasekuthelelekeni. Uma udokotela wakho ekunikeza eyodwa yale mithi, bazokubuka eduze ngesikhathi sokwelashwa.

Le mithi iza ngezindlela zomlomo nezokujova. Kubandakanya:

• i-cyclophosphamide (iCytoxan)
• i-cyclosporine (iGengraf, Neoral, Sandimmune)
• i-azathioprine (Azasan, Imuran)
• i-hydroxychloroquine (i-Plaquenil)

Ukudla okudlela endlini

Sebenza nodokotela wakho ukuthola ukwelashwa kwe-RA okukusebenzela kangcono. Njengoba kunezinketho eziningi kangaka ezitholakalayo, wena nodokotela wakho kungenzeka nithole eyodwa enciphisa izimpawu zakho ze-RA futhi ithuthukise ikhwalithi yakho yokuphila.