Iziyobisi zeCOPD: Uluhlu lweeMithi zokuNceda ukuNceda iZimpawu zakho

Umxholo

• I-bronchodilators emfutshane
• ICorticosteroids
• Imethylxanthines
• I-bronchodilators esebenza ixesha elide
• Ukudibanisa iziyobisi
• Roflumilast
• Amachiza asebenzayo
• Isitofu
• Amayeza okubulala iintsholongwane
• Iyeza lomhlaza kwiCOPD
• Iziyobisi zebhayoloji
• Thetha nogqirha wakho

Isifo esinganyangekiyo semiphunga (COPD) liqela lezifo zemiphunga eziqhubela phambili ezenza kube nzima ukuphefumla. I-COPD inokubandakanya i-emphysema kunye ne-bronchitis engapheliyo.

Ukuba unayo i-COPD, unokuba neempawu ezinje ngokuphefumla, ukukhwehlela, ukuvutha kunye nokuqina esifubeni sakho. I-COPD ihlala ibangelwa kukutshaya, kodwa kwezinye iimeko kubangelwa kukuphefumla iityhefu ezivela kwindalo esingqongileyo.

Akukho lunyango lweCOPD, kwaye umonakalo kwimiphunga nakwindlela yomoya isigxina. Nangona kunjalo, amayeza aliqela anokunceda ukunciphisa ukudumba kwaye uvule iindlela zakho zomoya ukukunceda uphefumle lula ngeCOPD.

I-bronchodilators emfutshane

Iibronchodilators zinceda ekuvuleni iindlela zakho zomoya ukwenza ukuphefumla kube lula. Ugqirha wakho unokumisela i-bronchodilators emfutshane esebenza kwimeko engxamisekileyo okanye ngokukhawuleza ngokukhawuleza njengoko kufuneka. Ubathatha usebenzisa i-inhaler okanye i-nebulizer.

Imizekelo ye-bronchodilators emfutshane ibandakanya:

• ialbuterol (iProair HFA, Ventolin HFA)
• levalbuterol (Xopenex)
• ipratropium (Atrovent HFA)
• albuterol / ipratropium (Impendulo edibeneyo)

I-bronchodilators emfutshane enokubangela iziphumo ebezingalindelekanga ezinje ngomlomo owomileyo, intloko ebuhlungu kunye nokukhohlela. Ezi ziphumo kufuneka zihambe ngokuhamba kwexesha. Ezinye iziphumo ebezingalindelekanga zibandakanya ukungcangcazela (ukugungqa), ukoyika, kunye nentliziyo ebetha ngamandla.

Ukuba unentliziyo, xelela ugqirha wakho ngaphambi kokuba uthathe i-bronchodilator emfutshane.

ICorticosteroids

Nge-COPD, ii-airways zakho zinokutsha, zibangele ukuba badumbe kwaye bacaphuke. Ukudumba kwenza kube nzima ukuphefumla. ICorticosteroids luhlobo lonyango olunciphisa ukudumba emzimbeni, lwenze ukuhamba komoya kube lula emiphungeni.

Iindidi ezininzi ze-corticosteroids ziyafumaneka. Ezinye zinokuphefumla kwaye kufuneka zisetyenziswe yonke imihla njengoko kuyalelwe. Zihlala zichazwe ngokudibeneyo kunye neziyobisi ezisebenza ixesha elide zeCOPD.

Ezinye ii-corticosteroids zijojowe okanye zithathwe ngomlomo. Ezi fom zisetyenziswa ngexesha elifutshane xa i-COPD yakho isiba mandundu ngesiquphe.

Oogqirha be-corticosteroids bahlala beyalela i-COPD zezi:

• IFluticasone (Umjikelo). Oku kuza njenge-inhaler oyisebenzisa kabini yonke imihla. Iziphumo zingabandakanya intloko ebuhlungu, umqala obuhlungu, ukutshintsha kwelizwi, isicaphucaphu, iimpawu ezinjengokubanda, kunye ne-thrush.
• IBudesonide (iPulmicort). Oku kuza njenge-inhaler ephathekayo okanye ukusetyenziswa kwi-nebulizer. Iziphumo ezinokubandakanya ukubanda kunye ne-thrush.
• IPrednisolone. Oku kuza njengepilisi, ulwelo, okanye ukudubula. Ngokuqhelekileyo kunikwa unyango lokuhlangula ngokukhawuleza. Iziphumo zingabandakanya intloko ebuhlungu, ubuthathaka bemisipha, isisu esibuhlungu kunye nokuzuza ubunzima.

Imethylxanthines

Kwabanye abantu abane-COPD enzima, unyango lokuqala lodidi lokuqala, olunje ngee-bronchodilators ezisebenza ngokukhawuleza kunye nee-corticosteroids, azibonakali ngathi ziyanceda xa zisetyenziswa zodwa.

Xa oku kusenzeka, abanye oogqirha bamisela ichiza elibizwa ngokuba yi-theophylline kunye ne-bronchodilator. I-Theophylline isebenza njengechiza elichasayo kunye nokuhlaziya izihlunu kwiindlela zomoya. Kuza njengepilisi okanye ulwelo oluthathayo yonke imihla.

Iziphumo ebezingalindelekanga ze-theophylline zinokubandakanya isicaphucaphu okanye ukugabha, ukungcangcazela, intloko ebuhlungu, kunye nengxaki yokulala.

I-bronchodilators esebenza ixesha elide

I-bronchodilators esebenza ixesha elide ngamayeza asetyenziselwa ukunyanga i-COPD ngaphezulu kwexesha elide. Zihlala zithathwa kanye okanye kabini imihla ngemihla zisebenzisa i-inhalers okanye i-nebulizers.

Ngenxa yokuba la machiza asebenza ngokuthe ngcembe ukunceda ukuphefumla, awenzi ngokukhawuleza njengeyeza lokuhlangula. Ayenzelwanga ukuba asetyenziswe kwimeko engxamisekileyo.

I-bronchodilators esebenza ixesha elide ekhoyo namhlanje:

• iaclidinium (iTudorza)
• arformoterol (iBrovana)
• ifomoterolol (Foradil, Perforomist)
• Iglycopyrrolate (Seebri Neohaler, Lonhala Magnair)
• i-indacaterol (Arcapta)
• i-olodaterol (impendulo yoStriverdi)
• i-revefenacin (Yupelri)
• isalmeterol (iSerevent)
• tiotropium (iSpiriva)
• i-umeclidinium (Gweba i-Ellipta)

Iziphumo ebezingalindelekanga ze-bronchodilators ezisebenza ixesha elide zinokubandakanya:

• umlomo owomileyo
• isiyezi
• ukungcangcazela
• impumlo enemifinya
• Umqala ocaphukisayo okanye okrwemrayo
• isisu esimoshakele

Iziphumo ebezingalindelekanga ezimandundu ngakumbi zibandakanya ukungaboni kakuhle, ukubetha kwentliziyo okukhawulezayo okanye okungaqhelekanga, kunye nokusabela okungahambelaniyo nokudumba okanye ukudumba.

Ukudibanisa iziyobisi

Amachiza aliqela e-COPD eza amayeza adibeneyo. Oku ikakhulu kukudityaniswa kwezinto ezimbini ezisebenza ixesha elide okanye i-corticosteroid enganyangekiyo kunye ne-bronchodilator esebenza ixesha elide.

Unyango kathathu, indibaniselwano ye-inhaled corticosteroid kunye ne-bronchodilators ezimbini ezisebenza ixesha elide, zinokusetyenziselwa i-COPD eqatha kunye ne-flare-ups.

Ukudityaniswa kweebronchodilators ezimbini ezisebenza ixesha elide kubandakanya:

• i-aclidinium / formoterol (iDuaklir)
• glycopyrrolate / formoterol (Bevespi Aerosphere)
• glycopyrrolate / indacaterol (Utibron Neohaler)
• tiotropium / olodaterol (impendulo yeStiolto)
• umeclidinium / vilanterol (Anoro Ellipta)

Umdibaniso we-corticosteroid engenisiweyo kunye ne-bronchodilator esebenza ixesha elide ibandakanya:

• budesonide / formoterol (Symbicort)
• i-fluticasone / i-salmeterol (i-Advair)
• i-fluticasone / i-vilanterol (uBreo Ellipta)

Umdibaniso we-corticosteroid enganyangekiyo kunye neebronchodilator ezimbini ezisebenza ixesha elide, ezibizwa ngokuba lunyango kathathu, zibandakanya i-fluticasone / vilanterol / umeclidinium (Trelegy Ellipta).

Kufunyenwe ukuba unyango kathathu luye lwanciphisa i-flare-ups kunye nomsebenzi ophuculweyo wemiphunga kubantu abane-COPD ephambili.

Nangona kunjalo, ikwabonakalise ukuba inyumoniya inokwenzeka ngakumbi ngonyango kathathu kunokuba indibanisela amayeza amabini.

Roflumilast

I-Roflumilast (iDaliresp) luhlobo lweziyobisi olubizwa ngokuba yi-phosphodiesterase-4 inhibitor. Kuza njengepilisi oyisela kanye ngemini.

I-Roflumilast inceda ekunciphiseni ukudumba, okunokuphucula ukuhamba komoya kwimiphunga yakho. Ugqirha wakho unokuyalela eli chiza kunye ne-bronchodilator esebenza ixesha elide.

Imiphumo emibi ye-roflumilast ingabandakanya:

• ukuhla ukusinda
• urhudo
• intloko ebuhlungu
• isicaphucaphu
• iicampu
• ukungcangcazela
• ukuphuthelwa

Yazisa ugqirha wakho ukuba unengxaki yesibindi okanye uxinzelelo ngaphambi kokuba uthathe eli yeza.

Amachiza asebenzayo

I-COPD flare-ups inokubangela ukonyuka kwamanqanaba emiphunga emiphungeni. Amachiza asebenzayo anceda ukunciphisa i-mucus okanye uyinciphise ukuze ukwazi ukukhohlela ngokulula. Ngokuqhelekileyo ziza kwifom yepilisi, kwaye zibandakanya:

• icarbocysteine
• mzim
• I-acetylcysteine

Kucetyiswa ukuba la mayeza anokunceda ukunciphisa i-flare-ups kunye nokukhubazeka kwi-COPD. Isifundo sika-2017 sikwafumanise ukuba i-erdosteine ​​yehlise inani kunye nobukrakra beCOPD flare-ups.

Iziphumo zala mayeza zingabandakanya:

• isicaphucaphu
• ukugabha
• isisu esibuhlungu

Isitofu

Kubalulekile ukuba abantu abaneCOPD bafumane iyeza lokugonya umkhuhlane minyaka le. Ugqirha wakho unokucebisa ukuba ufumane isitofu sokugonya se-pneumococcal ngokunjalo.

Ezi zitofu zinciphisa umngcipheko wokugula kwaye kunokukunceda ukuphepha ukusuleleka kunye nezinye iingxaki ezinxulumene neCOPD.

Uphononongo olwenziwe ngo-2018 lufumanise ukuba iyeza lokugonya umkhuhlane linokunciphisa i-COPD flare-ups, kodwa laqaphela ukuba zimbalwa izifundo ezikhoyo.

Amayeza okubulala iintsholongwane

Ukunyanga rhoqo ngamayeza okubulala iintsholongwane afana ne-azithromycin kunye ne-erythromycin kunokunceda ukulawula iCOPD.

Uphononongo olwenziwe ngo-2018 lubonakalise ukuba unyango oluhambelanayo lwe-antibiotic luyanciphisa i-COPD flare-ups. Nangona kunjalo, uphononongo luqaphele ukuba ukuphindaphinda ukusetyenziswa kwe-antibiotic kunokubangela ukunganyangeki. Ikwafumanise ukuba i-azithromycin yayanyaniswa nelahleko lokuva njengeziphumo ebezingalindelekanga.

Izifundo ezingaphezulu ziyafuneka ukumisela iziphumo zexesha elide zokusetyenziswa rhoqo kwezibulala-zintsholongwane.

Iyeza lomhlaza kwiCOPD

Amachiza aliqela omhlaza anokunciphisa ukudumba kunye nokunciphisa umda kwiCOPD.

Isifundo se-2019 sifumanise ukuba ichiza le-tyrphostin AG825 lehlise amanqanaba okuvuvukala e-zebrafish. Amayeza akonyusa inqanaba lokufa kwee-neutrophils, eziziiseli ezikhuthaza ukuvuvukala, kwiimpuku ezinemiphunga evuthayo efana neCOPD.

Uphando lusenomda ekusebenziseni i-tyrphostin AG825 kunye neziyobisi ezifanayo zeCOPD kunye nezinye iimeko zokuqaqamba. Ekugqibeleni, banokuba lukhetho lonyango lweCOPD.

Iziyobisi zebhayoloji

Kwabanye abantu, ukuvuvukala kweCOPD kunokuba sisiphumo se-eosinophilia, okanye ukuba nexabiso elingaphezulu kwesiqhelo leeseli ezimhlophe ezibizwa ngokuba zii-eosinophil.

Icacisile ukuba amachiza e-biologic anokukwazi ukunyanga le fomu yeCOPD. Iziyobisi zebhayoloji zenziwe kwiiseli eziphilayo. Uninzi lwala machiza asetyenziselwa isifo sombefu esibi esibangelwa yi-eosinophilia, kubandakanya:

• mepolizumab (iNucala)
• ibenralizumab (Fasenra)
• I-reslizumab (iCinqair)

Uphando oluthe kratya luyafuneka kunyango lweCOPD ngala machiza e-biologic.

Thetha nogqirha wakho

Iindidi ezahlukeneyo zamayeza ziphatha izinto ezahlukeneyo kunye neempawu zeCOPD. Ugqirha wakho uya kukuyalela amayeza aya kuyinyanga kakuhle imeko yakho.

Imibuzo onokuyibuza ugqirha malunga nesicwangciso sakho sonyango siquka:

• Ndimele ndisebenzise kangaphi unyango lwam lweCOPD?
• Ngaba ndithatha amanye amayeza anokusebenzisana namayeza am e-COPD?
• Ndiza kuthatha ixesha elingakanani ukuthatha amayeza am e-COPD?
• Yeyiphi indlela efanelekileyo yokusebenzisa inhaler yam?
• Kwenzeka ntoni ukuba ngequbuliso ndiyeke ukuthatha amayeza am eCOPD?
• Ngaphandle kokuthatha amayeza, loluphi utshintsho endifanele ndilwenze ukuze ndikhulule iimpawu zam zeCOPD?
• Kufuneka ndenze ntoni ukuba iimpawu zam ziba mandundu ngesiquphe?
• Ndingazithintela njani iziphumo ebezingalindelekanga?

Naliphi na unyango ugqirha ugqirha, qiniseka ukuba uluthathe ngokwemiyalelo kagqirha wakho. Ukuba uneziphumo ebezingalindelekanga ezimandundu, ezinjengempendulo engahambelaniyo nokudumba okanye ukudumba, tsalela umnxeba kwangoko. Ukuba unobunzima bokuphefumla okanye ukudumba komlomo, ulwimi, okanye umqala, tsalela umnxeba ku-911 okanye iinkonzo zonyango ezingxamisekileyo zasekuhlaleni. Ngenxa yokuba amanye amayeza e-COPD anokuchaphazela inkqubo ye-cardiovascular system, qiniseka ukuxelela ugqirha wakho ukuba unentliziyo engavumelekanga okanye iingxaki zentliziyo.