Ukuphuza ama-steroid ekwelapheni isifo samathambo

-Delile

• Ukubuka konke
• Imininingwane ejwayelekile mayelana ne-steroids ye-RA
• I-Oral steroids ye-RA
• Isikali
• Imijovo ye-steroid ye-RA
• Isikali
• I-topical steroids ye-RA
• Izingozi zokusebenzisa i-steroids ye-RA
• Imiphumela emibi ye-steroids
• Ukuthatha

Ukubuka konke

I-rheumatoid arthritis (RA) isifo esingelapheki esihlasela ukuvuvukala esenza amalunga amancane ezandla nezinyawo zakho abe buhlungu, avuvuke futhi aqine. Kuyisifo esiqhubekela phambili esingenalo ikhambi okwamanje. Ngaphandle kokwelashwa, i-RA ingaholela ekubhujisweni okuhlangene nokukhubazeka.

Ukuxilongwa nokwelashwa kusenesikhathi kudambisa izimpawu futhi kuthuthukise izinga lempilo yakho ngeRA. Ukwelashwa kuya ngesimo sakho. Izinhlelo zokwelashwa zivame ukufaka imishanguzo yokuguqula izifo (i-DMARDs) ehlangene nezidakamizwa ezingezona ukuvuvukala (ama-NSAID), kanye ne-steroids ephansi. Ezinye izindlela zokwelashwa ziyatholakala, kufaka phakathi ukusetshenziswa kwe-minocycline yama-antibiotic.

Ake sibhekisise iqhaza elibanjwa ama-steroids ekwelapheni i-RA.

Imininingwane ejwayelekile mayelana ne-steroids ye-RA

Ama-steroid abizwa ngama-corticosteroids noma ama-glucocorticoids. Ziyizinhlanganisela zokwenziwa ezifana ne-cortisol, i-hormone amadlala akho adrenal akhiqiza ngokwemvelo. Kuze kube yiminyaka engama-20 edlule, ama-steroids ayeyindlela ejwayelekile yokwelapha i-RA.

Kepha lawa mazinga aguquka njengoba imiphumela eyingozi ye-steroids yaziwa futhi njengoba izinhlobo ezintsha zemithi zakhiwa. Imihlahlandlela ye-RA yamanje ye-The American College of Rheumatology manje yeluleka odokotela ukuthi basebenzise inani eliphansi kakhulu lama-steroid ngesikhathi esifushane.

Ama-steroid angathathwa ngomlomo, ngomjovo, noma asetshenziswe ngokwezihloko.

I-Oral steroids ye-RA

I-Oral steroids iza ngephilisi, i-capsule, noma ifomu eliketshezi. Zisiza ekwehliseni amazinga okuvuvukala emzimbeni wakho enza amalunga akho avuvuke, aqine futhi abe buhlungu. Zisiza futhi ukulawula uhlelo lwakho lokuzimela ukucindezela ama-flare-ups. Kunobunye ubufakazi bokuthi ama-steroid anciphisa ukuwohloka kwamathambo.

Izinhlobo ezijwayelekile ze-steroids ezisetshenziselwa i-RA zifaka:

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

I-Prednisone yi-steroid esetshenziswa kakhulu ekwelashweni kweRA.

Isikali

Umthamo ophansi we-steroids yomlomo ungabekelwa i-RA yokuqala, kanye nama-DMARD noma ezinye izidakamizwa. Lokhu kungenxa yokuthi ama-DMARD athatha amasonto ayi-8-12 ukukhombisa imiphumela. Kodwa ama-steroids enza ngokushesha, futhi uzobona umphumela wawo ezinsukwini ezimbalwa. Ama-steroid ngezinye izikhathi abizwa ngokuthi “ukwelashwa kwebhuloho.”

Ngemuva kokuthi ezinye izidakamizwa zisebenze, kubalulekile ukukhipha ama-steroids. Lokhu kuvame ukwenziwa kancane, ngokungeziwe kwe-. Ukuthinta kusiza ukuvimbela izimpawu zokuhoxa.

Umthamo ojwayelekile we-prednisone yi-5 kuya ku-10 mg nsuku zonke. Kunconywa ukuthi ungathathi ngaphezu kuka-10 mg ngosuku lwe-prednisone. Inganikezwa ngemithamo emibili ngayinye.

Imvamisa, ama-steroids athathwa ekuseni lapho uvuka. Yilapho-ke umzimba wakho uqobo usebenze.

Izithako zansuku zonke ze-calcium () novithamini D () zihambisana ne-steroids.

Umthamo ophakeme we-steroids ungasetshenziswa ku-RA lapho kunezinkinga ezinzima.

Ukubuyekezwa kwedatha ye-RA ngo-2005 kutholakale ukuthi amaphesenti angama-20 kuye kwangama-40 abantu abasanda kutholakala bene-RA basebenzisa ama-steroids. Ukubuyekezwa kutholile nokuthi kufinyelela kumaphesenti angama-75 abantu abane-RA abasebenzisa ama-steroids ngasikhathi esithile.

Kwezinye izimo, abantu abane-RA enzima (kwesinye isikhathi ebizwa ngokuthi kukhubaza) bathembela kuma-steroids isikhathi eside ukuze benze imisebenzi yansuku zonke.

Imijovo ye-steroid ye-RA

I-Steroids ingafakwa ngokuphepha ngudokotela wakho emajoyintini nasendaweni ebazungezile ukuthola ubuhlungu nokukhululeka kokuvuvukala. Lokhu kungenziwa ngenkathi ugcina eminye imishanguzo yakho ebekiwe yokwelashwa.

I-American College of Rheumatology iphawula ukuthi ekuqaleni kweRA, imijovo ye-steroid emajoyintini abandakanyeka kakhulu ingahlinzeka ukukhululeka kwasendaweni futhi kwesinye isikhathi kohlelo. Lokhu kukhululeka kungaba kukhulu, kepha akuhlali isikhathi eside.

Kwezinye izimo, imijovo ye-steroid ibilokhu inciphisa usayizi wamaqhubu we-RA. Lokhu kunikeza enye indlela yokuhlinzwa.

Kunconywa ukuthi imijovo ejoyintini elifanayo ingenziwa ngaphezu kwesisodwa ezinyangeni ezintathu.

Isikali

Ama-steroids asetshenziselwa umjovo yi-methylprednisolone acetate (Depo-Medrol), i-triamcinolone hexacetonide, ne-triamcinolone acetonide.

Udokotela wakho angasebenzisa futhi i-anesthetic yendawo lapho ekunika umjovo we-steroid.

Umthamo we-methylprednisolone uvame ukuba yi-40 noma i-80 mg ngemililitha ngayinye. Umthamo ungahluka ngokuya ngosayizi wejoyini elifakiwe. Isibonelo, idolo lakho lingadinga umthamo omkhulu, kuze kufike ku-80 mg. Kepha indololwane yakho ingadinga ama-20 mg kuphela.

I-topical steroids ye-RA

Ama-topical steroids, womabili amayeza e-the-counter kanye nemithi kadokotela, ajwayele ukusetshenziswa ngabantu abane-arthritis ekudambiseni ubuhlungu bendawo. Kepha ama-topical steroids awanconywa (noma kushiwo) kumikhombandlela ye-American College of Rheumatology RA.

Izingozi zokusebenzisa i-steroids ye-RA

Ukusetshenziswa kwe-steroid ekwelashweni kwe-RA kungenxa yezingozi ezibhaliwe ezihilelekile.

Izingozi ezinkulu zifaka:

• Isifo senhliziyo: Ukubuyekezwa kuka-2013 kwabantu abatholakale bene-RA futhi bethatha ama-steroids kuthole ingozi engaphezulu kwamaphesenti angama-68 yokuhlaselwa yisifo senhliziyo. Ucwaningo belubandakanya abantu abangu-8,384 okutholwe ukuthi bane-RA phakathi konyaka we-1997 nowe-2006. Ukwanda komthamo ngamunye ngo-5 mg ngosuku kwengezwe engozini.
• I-osteoporosis: okubangelwa ukusetshenziswa kwe-steroid yesikhathi eside kuyingozi enkulu.
• Ukufa: Ezinye izifundo zokuhlola ziphakamisa ukuthi ukufa kungakhuphuka ngokusetshenziswa kwe-steroid.
• Isifo senkwethu
• Isifo sikashukela

Izingozi ziyanda ngokusetshenziswa kwesikhathi eside nemithamo ephezulu.

Imiphumela emibi ye-steroids

Imiphumela emibi yokusetshenziswa kwe-steroid ekwelashweni kwe-RA ifaka phakathi:

• ingozi eyengeziwe yokutheleleka ngegciwane noma ngegciwane
• ukuzuza kwesisindo
• ubuso obuyindilinga, obubizwa nangokuthi "ubuso benyanga"
• ushukela wegazi owandisiwe
• umfutho wegazi ophakeme
• ukuphazanyiswa kwemizwa, kufaka phakathi ukudangala nokukhathazeka
• ukuqwasha
• ukuvuvukala kwemilenze
• ukulinyazwa okulula
• ukwanda okuphezulu kwemifantu
• ukungabi namandla kwe-adrenal
• kwehlise ukuqina kwamaminerali ezinyangeni ezinhlanu ngemuva kwesifundo se-tapering esingu-10 mg prednisone

Imiphumela emibi yomjovo we-steroid ayivamile futhi imvamisa yesikhashana. Lokhu kufaka phakathi:

• ukucasuka kwesikhumba
• ukusabela okweqile
• ukuncipha kwesikhumba

Buza nodokotela wakho uma imiphumela emibi ikhathaza noma ivela ngokuzumayo. Bheka ushukela wegazi lakho uma unesifo sikashukela.

Ukuthatha

Ama-steroid ngemithamo ephansi angaba yingxenye yohlelo lokwelashwa lwe-RA ukuqeda izimpawu. Zisebenza ngokushesha ukukhulula ukuvuvukala nobuhlungu. Kepha kufanele ucabangele ngokucophelela izingozi ezaziwayo zokusetshenziswa kwe-steroid, noma ngomthamo ophansi.

Funda kuzo zonke izindlela zokwelashwa, kufaka phakathi i-biologics kanye ne-minocycline yama-antibiotic. Linganisa ama-plus kanye nama-minuses enhlanganisweni ngayinye yokwelashwa kanye nezidakamizwa. Xoxa ngezinhlelo zokwelashwa ezingaba khona nodokotela wakho, futhi uqiniseke ukuthi yonke imibuzo yakho iyaphendulwa.

Ngaphezu kwakho konke, ukwelashwa kwe-RA kudinga ukuthi usebenze.