Tlhaloso e Khutšoanyane ea Meriana ea Ramatiki
Meriana ea ramatiki e 'nile ea nkoa e le "mokhoa oa" mekhoa ea phekolo. Kaha ho arabela ka bongata ho lithethefatsi ho ka fapana 'me hobane litla-morao tse ka bang teng le ho ba le tšusumetso e mpe le eona ke ntho ea bohlokoa, ho fumana meriana ea ramatiki ka katleho e ka ba mokhoa o boima ho feta oo u ka o lebellang. U lokela ho tseba tse ling ka meriana e sa tšoaneng ea ramatiki, e le hore u ka etsa qeto ea tsebo ho ngaka ea hau.
NSAIDs / COX-2 Inhibitor
Li-NSAID (lithethefatsi tse seng khahlanong le ho ruruha) li har'a lithethefatsi tse tloaelehileng haholo le tse sebelisoang ka ho fetisisa. Ho na le mefuta e meraro ea li-NSAID: li-salicylate (tse peli tsa acetylated [mohlala, aspirin] le tse sa acetylated [mohlala, Disalcid {salsalate}]), Trilisate (choline magnesium trisalicylate), le Doan's Pills kapa Novasal (salicylate ea magnesium); NSAID tse tloaelehileng; le COX-2 selective inhibitors.
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Ho Sebelisa Lihlopha tsa Stem ho Phekola Ramatiki le Khauta
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JAK Inhibitors: Tlhahlobo ea Phekolo bakeng sa Ramatiki ea Ramatiki
NSAID e sebetsa ka ho thibela mosebetsi oa enzyme, cyclooxygenase, e tsejoang hape e le COX. Lipatlisiso li bontšitse hore ho na le mefuta e 'meli ea cyclooxygenase, e tsejoang e le COX-1 le COX-2 . Li-SASA li ama mefuta eo ka bobeli. COX-1 e ameha ho boloka lisele tse phetseng hantle, ha COX-2 e ameha tseleng ea ho ruruha. COX-2 selective inhibitors e ile ea fetoha karoloana ea li-NSAIDs-le Celebrex (celecoxib) e le eona ea pele ea ho amoheloa ke FDA ho elella bofelong ba lilemo tsa bo-1990.
NSAID tsa setso li kenyelletsa:
- Ansaid (flurbiprofen)
- Arthrotec (diclofenac / misoprostol)
- Cataflam (potassium ea diclofenac)
- Clinoril (sulindac)
- Daypro (oxaprozin)
- Dolobid (diflunisal)
- Feldene (piroxicam)
- Ibuprofen (moton Motrin, Advil)
- Indocin (indomethacin)
- Ketoprofen (lebitso la Orudis, Oruvail)
- Lodine (etodolac)
- Meclomen (meclofenamate)
- Mobic (meloxicam)
- Nalfon (fenoprofen)
- Naproxen (lebitso la Naprosyn, Aleve)
- Ponstel (mefenamic acid)
- Relafen (nabumetone)
- Tolectin (tolmetin)
- Vimovo (naproxen-esomeprazole)
- Voltaren (diclofenac sodium)
COX-2 Inhibitors e kenyelletsa:
- Celebrex (celecoxib)
Bala: NSAIDs - Seo U Lokelang ho se Tseba
DMARD
DMARD (likokoana-mafu tse loantšang likokoana-hloko) li boetse li bitsoa "li-anti-rheumatic drugs" hobane li atisa ho nka libeke kapa likhoeli ho sebetsa le "mahlahana a bobeli". Lipatlisiso li tiisitse katleho ea DMARD ha ho phekoloa ramatiki ea lefu la rumatoid , ramatiki ea psoriatic , le ankylosing spondylitis hammoho le bohlokoa ba phekolo ea pele, e mabifi ka ho sebelisa DMARD. Sepheo sa ho tšoaroa ka DMARD ke ho emisa ts'oaetso ea mafu le ho emisa tšenyo e kopaneng.
DMARD e kenyeletsa:
- Azulfidine (sulfasalazine)
- CellCept (mycophenolate)
- Cyclosporine (letšoao la Neoral, Sandimmune)
- Cytoxan (cyclophosphamide)
- Imuran (azathioprine)
- Leukeran (chlorambucil)
- Methotrexate (lebitso la Rheumatrex, Trexall)
- Minocin (minocycline)
- Penicillamine (brand Cuprimine, Depen)
- Plaquenil (hydroxychloroquine)
Xeljanz (tofacitinib citrate), e leng DMARD ea molomo, e amoheloa ke FDA ka la 6 Nisane, 2012, ho phekola batho ba baholo ba sebetsang ka mokhoa o itekanetseng ho e-na le ramatiki e sebetsang ka thata e sebetsang ka matla, kapa ho se mamellane, ho methotrexate. Xeljanz ke eena oa pele sehlopheng sa lithethefatsi tse tsejoang e le JAK (Janus kinase) inhibitors.
Bala: Lintlha ka DMARD
Corticosteroids (Steroids)
Corticosteroids kapa glucocorticoids, e atisang ho bitsoa "steroids," ke lithethefatsi tse matla tse ka fokotsang ho ruruha le ho ruruha kapele. Lithethefatsi tsena li amana haholo le cortisol, hormone e hlahisoang ke cortex ea litšoelesa tsa adrenal. Li laeloa ka tekanyo e fapaneng haholo ho itšetlehile ka boemo le sepheo sa phekolo. Le hoja li-steroid li ka sebelisoa ho laola ho ruruha ha litho le litho tsa mafu a bakoang ke lefu la ramatiki, lupus , polymyalgia rheumatica le vasculitis , ho 'nile ha elelloa hore monyetla oa litla-morao tse matla o eketseha ka tekanyo e phahameng kapa ka nako e telele sebelisa.
Lingaka li ka 'na tsa fana ka li-intravenous steroids tsa nako e khutšoanyane le tse phahameng maemong a mang, kapa ngaka ea hau e ka fana ka ente ea steroid sebakeng seo , joaloka Kenalog (triamcinolone), ho u thusa ho fumana phomolo ho tloha ho bohloko le ho ruruha.
Corticosteroids e kenyeletsa:
- betamethasone (lebitso la Celestone)
- cortisone (letšoao la Cortone)
- dexamethasone (brand Decadron)
- hydrocortisone (brand Cortef)
- methylprednisolone (brand Medrol )
- prednisolone (lebitso la pele)
- prednisone (mofuta oa Deltasone)
Bala: Corticosteroids (Steroids) - Seo U Lokelang ho se Tseba
Analgesics (Meriana ea Mahlaba)
Li-analgesics ke lithethefatsi tse fokolisang bohloko. Ho laola bohloko ke karolo ea bohlokoa ea ho phekola ramatiki. Leha ho le joalo, ho fapana le li-NSAID, meriana ea analgesic ha e fokolise ho ruruha. Acetaminophen (Tylenol) ke eona e tloaelehileng ka ho fetisisa ea analgesic. Lithethefatsi tsa lithethefatsi tsa lithethefatsi li ka boela tsa ngolloa ka bohloko bo boholo.
Li-narcotics li kenyelletsa:
- Codeine (Tylenol # 3)
- Duragesic (Fentanyl Skin Patch)
- Hydromorphone (Palladone) - ha e sa le marakeng
- MS Contin (morphine sulfate)
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Hydrocodone / Acetaminophen - Seo U Lokelang ho se Tseba
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Keletso bakeng sa Batho ba Thatafalletsang ho Koala Lipilisi
- OxyContin (oxycodone)
- Percocet (oxycodone / acetaminophen)
- Percodane (oxycodone / aspirin)
- Talwin NX (pentazocine / naloxone)
- Ultracet (tramadol / acetaminophen)
- Ultram (tramadol)
- Vicodin (hydrocodone / acetaminophen)
Bala: Meriana ea Mahlaseli - Seo U Lokelang ho se Tseba
Liphetoho tsa Li-Biologic Response Modifiers (Likokoana-hloko)
Li-Modifier Response Modifiers (BRMs), tse atisang ho bitsoa biologics , li susumetsa kapa li tsosolosa bokhoni ba sesole sa ' mele sa ho itšireletsa mafung kapa tšoaetso. Li-biologics ke lithethefatsi tse fumanoang mehloling e phelang ho fapana le ho etsoa ka lik'hemik'hale.
Enbrel (etanercept) , Remicade infliximab) , Humira (adalimumab) , Cimzia (certolizumab pegol) , le target Simplim (golimumab) TNF-alpha, e leng e 'ngoe ea li-cytokine tse bohlokoa ka ho fetisisa tse amanang le ramatiki ea lefuba. TNF blockers (lithethefatsi tsa biologic tse tlamang ho TNF-alpha) li etsa hore li se ke tsa sebetsa, ka tsela eo li kena-kenana le mesebetsi ea ho ruruha 'me qetellong e fokotsa tšenyo e kopaneng.
Kineret (anakinra), hape e le lithethefatsi tsa biologic, ke mohanyetsi oa IL-1. Kineret e bile khetho ea pele ea interleukin-1 (IL-1), protheine e fumanoang ho feta batho ba bang ba nang le ramatiki ea lefuba. Ka ho thibela IL-1, Kineret e thibela ho ruruha le bohloko tse amanang le ramatiki ea lefu la rumatoid. Kineret e ka sebelisoa e le mong, kapa e kopane le tse ling tsa DMARD, ntle le lithethefatsi tse khahlanong le TNF. Ha Kineret e ntse e le khetho, hangata e laeloa.
Orencia (abatacept) e bile setsi sa pele sa T-cell co-stimulation modulator se amoheloang bakeng sa phekolo ea ramatiki ea lefuba.
Rituxan (rituximab) , lithethefatsi tsa kankere tse rekisoang ka ho fetisisa lefatšeng, e ne e amoheloa ke FDA ka March 2006 ho sebelisoa hammoho le methotrexate ho phekola ramatiki ea lefuba ka ho fokotsa matšoao le matšoao ho batho ba baholo ba nang le ramatiki ea lefuba 'me ba e-na le matla a feteletseng. o ile a hlōleha e le 'ngoe kapa tse ling tse ngata tse khahlanong le TNF. Rituxan ke phekolo ea pele ea ramatiki ea lefu la rhumatori e khethollang li-B-cell tse nang le CD20.
Actemra (tocilizumab) ke antibody e monoclonal e thibelang receptor ea interleukin-6 (IL-6), kahoo e thibela interleukin-6. Actemra e ile ea amoheloa ke FDA ka la 8 Jan. 2010 bakeng sa phekolo ea ramatiki ea batho ba baholo ba nang le ramatiki ho batho ba hlōlehileng ho thibela e mong kapa ba bangata ba TNF.
Phekolo ea Ramatiki ea Arthritis - Litlhahiso tsa ACR
Fibromyalgia Drugs
Ho fihlela ka 2007, ho ne ho se na lithethefatsi tse amoheloang ke FDA bakeng sa phekolo ea fibromyalgia . Lingaka li ile tsa tšoara fibromyalgia ka mefuta e sa tšoaneng ea lithethefatsi e thehoa 'me ea amoheloa bakeng sa lipontšo tse ling. Ka 2007, Lyrica (pregabalin) e ile ea amoheloa ho tšoara fibromyalgia. Ka 2008, Cymbalta (duloxetine HCl) e ile ea amoheloa bakeng sa fibromyalgia. Ka 2009, Savella (milnacipran HCl) e amohelehile bakeng sa boemo.
Ho Sebelisa Lithethefatsi
Gout ke e 'ngoe ea mefuta e bohloko ka ho fetisisa ea ramatiki. E ka laoloa ka meriana, lijo le liphetoho tsa bophelo. Ho na le likarolo tse tharo tsa phekolo ea moriana ka meriana: analgesics, meriana e khahlanong le ho ruruha, le lithethefatsi ho laola maemo a uric acid le tlhaselo ea gout .
Lithethefatsi bakeng sa gout li kenyelletsa:
- Acetaminophen (Tylenol), kapa lipilisi tse ling tse hlahisang bohloko, bakeng sa khatholoho ea bohloko
- Li-NSAID (li-anti-inflammatory nonsteroidal anti-inflammatory), hangata Indocin (indomethacin), bakeng sa ho ruruha
- Colchicine , ho thibela kapa ho lokolla tlhaselo ea mafu
- Corticosteroids, bakeng sa karabo e potlakileng ea ho hanyetsa
- Probenecid (Benemid, Probalan), ho fokotsa maemo a mali a uric acid
- ColBenemid (Col-Probenecid le Proben-C) e na le matlo a khahlanong le gout
- Allopurinol (zyloprim) , ho fokotsa mali ea uric acid ka ho thibela tlhahiso ea uric acid
- Losartan (Cozaar, Hyzaar), eseng ka ho toba meriana ea boloetse, empa ke lithethefatsi tse thibelang mali tse ka thusang ho laola litekanyetso tsa uric acid
- Fenofibrate (Tricor), eseng sethethefatsi sa mofuta o khethehileng, empa ke lithethefatsi tse fokolang lipilisi tse ka thusang li-uric acid levels
- Uloric (febuxostat) , e fokotsa maemo a serum uric acid ka ho thibela xanthine oxidase
- Krystexxa (pegloticase), sethethefatsi sa biologic se sebetsang ka ho roba uric acid
Ho Fokolloa ke Meriana ea Mafu
Bothata ba ho fokola ha masapo ke boemo bo khetholloang ke masapo a maholo, a fokolang, a tloaelehileng haholo ho batho ba hōlileng, empa hape e ka 'na ea e-ba bothata ho batho ba nkileng corticosteroids (steroids) longterm. Ho na le mefuta e mengata ea khethollo ea lithethefatsi bakeng sa ho fokola ha masapo: li-estrogen, li-hormone tsa parathyroid, lihlahisoa tsa masapo, li-bisphosphonate le limolek'hule tse amohelang batho. Ho itšetlehile ka hore na ke lithethefatsi life tse sebelisoang, u ka lieha ho lahleheloa ke masapo, ua khothalletsa ho hōla ha masapo le ho fokotsa kotsi ea ho robeha.
Lithethefatsi bakeng sa ho fokola ha masapo li akarelletsa:
- Actonel (risedronate)
- Boniva (ibandronate)
- Didronel (etidronate)
- Estrogens (therapy ea hormone)
- Etsahalang (ho thoe)
- Forteo (teriparatide)
- Fosamax (alendronate)
- Miacalcin (calcitonin)
- Reclast (zoledronic acid)
- Prolia (denosumab)
Lentsoe le Tsoang ho
Sepheo se ka sehloohong sa ho phekola mafu a masapo le mafu a rheumatic ka meriana e kenyelletsa ho laola bohloko, ho ruruha ho fokolang, ho fokotseha ho tsoeloa ha lefu lena le ho laola mafu. Ho na le mefuta e mengata ea ramatiki le lithethefatsi tse ngata sehlopheng ka seng sa lithethefatsi. Seo se etsa hore khetho ea phekolo e be e rarahaneng. Ho etsa qeto ea hore na meriana kapa meriana ea meriana e nepahetse ho uena e ka ba e tsosang. E ka 'na eaba e tla nka teko le phoso-'me u tla' ne u leke ho fihlela u ikutloa u finyelletse karabo e lekaneng. Wellwell o hlophisitse lintlha tseo u lokelang ho li tseba ka meriana ea ramatiki. Boitsebiso boo bo faneng ka bona bo tla u thusa ho utloisisa hore na ke hobane'ng ha u noa meriana eo ue nkang 'me e tla u thusa ho botsa ngaka lipotso.
> Mohloli:
> Kelley's Textbook ea Rheumatology. Karolo ea 8. Pharmacology ea Lithethefatsi tsa Antirheumatic. Elsevier. Khatiso ea borobong. E fihlile ka la 7/23/16.