Methotrexate ke lithethefatsi tsa antirheumatic (DMARD) e fetolang lefu lena le sebelisetsoang ho phekola ramatiki ea mafu a mahlaba le mafu a mang a lefu la tšoaetso. Lethal dose e sebelisetsoang ramatiki ea lefu la masapo e nkoa e le tlaase. Ka mokhoa o bapisa, methotrexate e boetse e sebelisoa e le phekolo ea kankere e phahameng ea meno le ka tekanyo e phahameng ea ho felisa ectopic pregnancy.
Ho bua ka setsebi, methotrexate ke dihydrofolate reductase inhibitor e fokolisang purine metabolism.
Seo se boletse, se ka lebisa ho sa tloaelehang ho ribonucleic acid le deoxyribonucleic acid. Methotrexate ke teratogen e tsejoang, e hlalosoang e le ntho leha e le efe, sebōpeho, kapa ts'ebetso e bakang mahlomola ho lesea. Methotrexate e ka baka litšobotsi tsa sefahleho sa dysmorphic, tse sa tloaelehang tsa lehata le maoto, ho haelloa ke khōlo, ho lieha ho ntlafatsa, le ho lieha kelellong.
Mathata a ho ba le mathata a fetallo a etsa hore moriana o amehe ka lilemo tsa ho beleha, ba rerang ho ima, haholo-holo ba emang ha ba ntse ba tšoaroa ka methotrexate.
Matšoao a Fetal le Boimana Ho Lahleheloa ke Methotrexate
Basali ba lokela ho elelloa kotsi ea ho ba le bothata ba ho fetela le ho lahleheloa ke bokhachane le methotrexate, le hoja tekanyo ea bokhachane bo etsoang ka bokhachane e nkoa e le tlaase. Phuputsong ea Sefora, basali ba nang le maloetse a sa foleng a sa foleng ba ileng ba tšoaroa ka methotrexate ea tekanyo e tlaase nakong ea pele ea trimester ba ile ba hlahlojoa.
Har'a linyeoe tse 28 tse hlahlobisitsoeng, mokhoa oa ho hlahisa maikutlo o ile oa fela pele ho libeke tse 8 ho nyaloa ke basali ba 26. Basali ba bane ba ile ba senyeheloa ke mpa, athe ba 5 ba khetha ho khaotsa ho ima. Ho ne ho e-na le tsoalo ea batho ba 19, e leng tse 3 tseo pele ho tsona li hlahileng. Bafuputsi ba fihletse qeto ea hore liphello tsa bona li tšehetsa khopolo ea hore ha ho na kotsi e matla ea temo e nang le methotrexate ea tekanyo e tlaase, e leng ho fana ka meriana e emisoa ho tloha ha motho a le moimana.
Phuputso e 'ngoe e ile ea shebella ho ima ha 8 methotrexate. Ho ne ho e-na le nyeoe e le 'ngoe ea methotrexate ea embryopathy e tsejoang. Ke lekhetlo la pele le joalo le fumanoang har'a batho ba nang le tekanyo e tlase ea beke ea beke ea methotrexate (tekanyo e tloaelehileng ea mafu a rheumatic). Le hoja e ne e le ntho e le 'ngoe feela, bafuputsi ba ile ba etsa qeto ea hore ho nahana ka tšireletso ea methotrexate ka tekanyo e fokolang ho e-s'o ee kae.
Ho thoe'ng ka Batho?
Ho ea ka Drugs.com, moimana o lokela ho qojoa ke molekane kapa molekane ea sebetsanang le methotrexate. Boimana bo lokela ho qojoa nakong ea phekolo le ka nako e ka tlase ho likhoeli tse tharo ka mor'a phekolo ea bakuli ba batona, 'me nakong ea phekolo le bonyane nako e le' ngoe ea lipilangoana ka mor'a phekolo ea bakuli ba basali.
Ho na le kotsi ea tlhaho ea ho fetola peō ea banna ho banna ba nkang methotrexate, empa ha e e-s'o pakoe. Hape, ho ea ka Journal of Rheumatology , ho pepeseha ha methatrexate ea ntat'ae nakong ea ho emoloa ho bonahala ho sa hlahise mathata kapa litaba tsa lesea.
The Bottom Line
Ha ho na nako ea 100% e sireletsehileng ea ho pepesa maikutlo ho methotrexate. Phello ea methotrexate e bonahala e sa tsejoe, karolo e 'ngoe e bakoang ke liphatsa tsa lefutso tse hlahisang likokoana-hloko le li-fetal.
Ka mor'a hore ho be le methotrexate nakong ea pele ea trimester, 'mè ea khethang ho tsoela pele a e-na le bokhachane o lokela ho tseba hore ho na le menyetla ea 10/42 ea ho se tloaelehe ka pōpelong (QJM: International Journal of Medicine).
Ho ea ka Kelley's Textbook of Rheumatology , basali ba eletsoa ho khaotsa methotrexate bonyane likhoeli tse tharo pele ba emoloa. Folic acid supplementation e lokela ho tsoelapele ka ho ima. American College of Rheumatology e khothalletsa tšebeliso ea thibelo ea bokhachane e atlehang ha e ntse e sebelisa methotrexate le likhoeli tse tharo ka mor'a ho emisa methotrexate.
Lisebelisoa:
Methotrexate (Rheumatrex, Trexall). Koleji ea Amerika ea Rheumatology. Michael Cannon, MD May 2012.
http://www.rheumatology.org/Practice/Clinical/Patients/Medication/Methotrexate_(Rheumatrex,_Trexall)/
Methotrexate ea tekanyo e tlaase nakong ea pele ea bokhachane: liphello tsa thuto ea ho sebelisana ha Fora. Lewden B et al. Journal of Rheumatology. December 2004. http://www.ncbi.nlm.nih.gov/pubmed/15570635
Methotrexate Embryopathy Ka mor'a ho ipapisa le menyetla e fokolang ea beke le beke nakong ea bokhachane. Martin MC, et al. Toxicology ea ho ikatisa . La 26 October, 2013. http://www.ncbi.nlm.nih.gov/pubmed/24513926
Methotrexate Bokhachane le Litemoso tsa ho Apesa. Drugs.com.
http://www.drugs.com/pregnancy/methotrexate.html
Paternal Exposure to Methotrexate le Liphello tsa Bokhachane. Journal of Rheumatology. Beghin, et al. La 15 January, 2011.
http://www.jrheum.org/content/early/2011/01/11/jrheum.100600
Liphello tsa methotrexate nakong ea bokhachane, tsoalo le lactation. QJM: International Journal of Medicine. 1999.
https://academic.oup.com/qjmed/article/92/10/551/1531030/The-effects-of-methotrexate-on-pregnancy-fertility
Kelley's Textbook ea Rheumatology. Elsevier Saunders. Buka ea 1. Bokhachane ho Rheumatic Diseases. Khaolo ea 39. Page 552.