I-Steroids kunyango lweRheumatoid Arthritis

Umxholo

• Ushwankathelo
• Ulwazi ngokubanzi malunga nee-steroids ze-RA
• Ii-steroids zomlomo zeRA
• Ubungakanani
• Inaliti zeSteroid zeRA
• Ubungakanani
• Izihloko ze-steroids ze-RA
• Umngcipheko wokusebenzisa i-steroids kwi-RA
• Iziphumo ebezingalindelekanga ze-steroids
• Ukuthatha

Ushwankathelo

I-rheumatoid arthritis (RA) sisifo esinganyangekiyo esidumbisayo esenza amalungu omzimba wakho kunye neenyawo zakho zibe buhlungu, zidumbe, kwaye ziqine. Sisifo esiqhubela phambili esingenanyango okwangoku. Ngaphandle konyango, i-RA inokukhokelela ekubhujisweni ngokudibeneyo kunye nokukhubazeka.

Ukuchongwa kwangoko kunye nonyango kuthomalalisa iimpawu kwaye kuphucula umgangatho wobomi bakho ngeRA. Unyango luxhomekeke kwimeko yakho. Izicwangciso zonyango zihlala zibandakanya ukuguqula isifo iziyobisi ezichasene ne-antirheumatic (i-DMARDs) ezidityaniswe namachiza angasebenziyo (anti-inflammatory) (i-NSAID), kunye nedosi ephantsi. Olunye unyango lukhona, kubandakanya nokusetyenziswa kwe-minocycline ye-antibiotic.

Makhe siqwalasele indima ye-steroids ekuphatheni i-RA.

Ulwazi ngokubanzi malunga nee-steroids ze-RA

IiSteroids zibizwa ngokuba ziicorticosteroids okanye iiglucocorticoids. Ziyimixube eyenziweyo efana necortisol, ihomoni amadlala akho eadrenal avelisa ngokwendalo. Kude kube yiminyaka engama-20 eyadlulayo, ii-steroids zazilunyango oluqhelekileyo kwi-RA.

Kodwa le migangatho yatshintsha njengoko iziphumo eziyingozi ze-steroids zaziwa kwaye njengoko iintlobo ezintsha zamachiza zaphuhliswa. Izikhokelo zeRA zangoku zeAmerican College yeRheumatology ngoku zicebisa oogqirha ukuba basebenzise elona xabiso liphantsi le-steroids ngeli xesha lifutshane.

I-Steroids inokuthathwa ngomlomo, ngenaliti, okanye ifakwe kumxholo.

Ii-steroids zomlomo zeRA

I-Oral steroids iza kwipilisi, i-capsule, okanye ifom yefayili. Banceda ukunciphisa amanqanaba okukrala emzimbeni wakho enza ukuba amalungu akho adumbe, aqine kwaye abe buhlungu. Bayanceda ukulawula inkqubo yakho yokuzikhusela ekunciphiseni i-flare-ups. Kukho ubungqina bokuba i-steroids inciphisa ukonakala kwethambo.

Iindidi eziqhelekileyo ze-steroids ezisetyenziselwa i-RA zibandakanya:

• i-prednisone (iDeltasone, iSterapred, uLwelo oludlulileyo)
• I-hydrocortisone (iCortef, A-Hydrocort)
• yingca
• dexamethasone (Dexpak Taperpak, Decadron, Hexadrol)
• i-methylprednisolone (iDepo-Medrol, iMedrol, iMethacort, iDepopred, iPredacorten)
• yesithathu
• dexamethasone (iDecadron)
• yivsentsi

I-Prednisone yeyona steroid isetyenziswa rhoqo kunyango lwe-RA.

Ubungakanani

Idosi ephantsi ye-steroids yomlomo inokumiselwa kwi-RA yokuqala, kunye nee-DMARD okanye ezinye iziyobisi. Kungenxa yokuba ii-DMARD zithatha iiveki eziyi-8 ukuya kwezi-12 ukubonisa iziphumo. Kodwa i-steroids isebenza ngokukhawuleza, kwaye uya kubona ukusebenza kwayo kwiintsuku ezimbalwa. I-Steroids ngamanye amaxesha kubhekiswa kuyo njengonyango lwebhulorho.

Emva kokuba ezinye iziyobisi zisebenza, kubalulekile ukucima i-steroids. Oku kuqhele ukwenziwa kancinci, ngokwanda kwe. Ukucofa kunceda ukukhusela iimpawu zokurhoxa.

Idosi yesiqhelo ye-prednisone yi-5 ukuya kwi-10 mg yonke imihla. Kuyacetyiswa ukuba ungathathi ngaphezulu kwe-10 mg ngosuku lwe-prednisone. Inokunikwa ngamanani amabini nganye.

Ngokwesiqhelo, ii-steroids zithathwa kusasa xa uvuka. Yilapho umzimba wakho we-steroids usebenza.

Izongezo zemihla ngemihla zekhalsiyam () kunye nevithamini D () zikunye nee-steroids.

Idosi ephezulu ye-steroids inokusetyenziswa kwi-RA xa kukho iingxaki ezinzima.

Ukuphononongwa ngo-2005 kwedatha ye-RA kufumanise ukuba iipesenti ezingama-20 ukuya kuma-40 zabantu abasandula ukufumanisa ukuba bane-RA basebenzisa ii-steroids. Ukuphononongwa kwakhona kwafumanisa ukuba ukuya kuthi ga kwiipesenti ezingama-75 zabantu abane-RA basebenzise ii-steroids ngamanye amaxesha.

Ngamanye amaxesha, abantu abanesifo esibi (ngamanye amaxesha esibizwa ngokuba kukukhubaza) i-RA baxhomekeke kwi-steroids ixesha elide ukuze benze imisebenzi yemihla ngemihla.

Inaliti zeSteroid zeRA

I-Steroids inokujojelwa ngokukhuselekileyo ngugqirha wakho kumalungu kunye nendawo ejikeleze bona ukuze ufumane iintlungu kunye nokudumba. Oku kunokwenziwa ngelixa ugcina olunye unyango lweziyobisi.

Ikholeji yaseMelika yeRheumatology iqaphela ukuba kwiRA yangaphambi kwexesha, inaliti ye-steroid kumalungu athatha inxaxheba kakhulu anokubonelela ngoncedo lwasekhaya ngamanye amaxesha. Olu ncedo lunokuba lukhulu, kodwa aluhlali ixesha elide.

Ngamanye amaxesha, iinaliti ze-steroid ziye zanciphisa ubungakanani beziqhuqhuva ze-RA. Oku kubonelela ngenye indlela yotyando.

Kuyacetyiswa ukuba iinaliti kwilungu elinye zingenziwa ngaphezulu kwesinye kwinyanga ezintathu.

Ubungakanani

I-steroids esetyenziselwa inaliti yimethylprednisolone acetate (Depo-Medrol), triamcinolone hexacetonide, kunye ne-triamcinolone acetonide.

Ugqirha wakho unokusebenzisa i-anesthetic yendawo xa ekunika inaliti ye-steroid.

Idosi ye-methylprednisolone ihlala i-40 okanye i-80 mg nge-milliliter nganye. Idosi inokwahluka ngokuxhomekeke kubungakanani bedibeneyo ejoyiweyo. Umzekelo, idolo lakho linokufuna idosi enkulu, ukuya kuthi ga kwi-80 mg. Kodwa ingqiniba yakho inokufuna kuphela i-20 mg.

Izihloko ze-steroids ze-RA

I-steroids yezihloko, zombini izidakamizwa kunye neyeza, zihlala zisetyenziswa ngabantu abane-arthritis ekunciphiseni ubuhlungu bendawo. Kodwa ii-topical steroids azikhuthazwa (okanye zikhankanyiwe) kwiKholeji yaseMelika yeRheumatology RA izikhokelo.

Umngcipheko wokusebenzisa i-steroids kwi-RA

Ukusetyenziswa kwe-Steroid kunyango lwe-RA kungenxa yomngcipheko obhaliweyo obandakanyekayo.

Umngcipheko obalulekileyo ubandakanya:

• Ukuhlaselwa yintliziyo: Ukuphononongwa ngo-2013 kwabantu abafumene i-RA kunye nokuthatha i-steroids bafumana iipesenti ezingama-68 zanda ingozi yokuhlaselwa yintliziyo. Uphononongo lwalubandakanya abantu abangama-8,384 abafunyaniswa benesifo RA phakathi konyaka we-1997 nowe-2006. I-5 mg nganye ngosuku yonyusa idosi eyongezwe emngciphekweni.
• Osteoporosis: Ukubangelwa kukusetyenziswa kwexesha elide kwe-steroid ngumngcipheko omkhulu.
• Ukufa: Olunye uphononongo lokujonga lubonisa ukuba ukubhubha kungonyuswa ngokusetyenziswa kwe-steroid.
• Iimpawu
• Seswekile

Umngcipheko ukwanda ngokusetyenziswa kwexesha elide kunye needosi eziphezulu.

Iziphumo ebezingalindelekanga ze-steroids

Iziphumo ezivela kusetyenziso lwe-steroid kunyango lwe-RA zibandakanya:

• ukwanda kwengozi yosulelo lwebhaktiriya okanye lwentsholongwane
• ukutyeba kwakho
• Ubuso obujikeleziweyo, bukwabizwa ngokuba "bubuso benyanga"
• ukwanda kweswekile yegazi
• igazi elonyukayo
• ukuphazamiseka kwemood, kubandakanya uxinzelelo kunye noxinzelelo
• ukuphuthelwa
• ukudumba komlenze
• ukutyunyuzwa ngokulula
• ukuxhaphaka okuphezulu kokuqhekeka
• ukungabikho kwe-adrenal
• ukwehlisa uxinano lwamaminerali kwiinyanga ezintlanu emva kwendlela yokuthinta ye-10 mg prednisone

Iziphumo zenaliti zeSteroid zinqabile kwaye zihlala zisesikhashana. Oku kubandakanya:

• ukucaphuka kolusu
• negazi lakho
• ukucoca ulusu

Jonga ugqirha wakho xa iziphumo ebezingalindelekanga ziphazamisa okanye zivela ngesiquphe. Jonga eswekile yegazi lakho ukuba unesifo seswekile.

Ukuthatha

I-Steroids kwiidosi ezisezantsi zinokuba yinxalenye yesicwangciso sonyango kwi-RA yokunciphisa iimpawu. Basebenza ngokukhawuleza ukukhupha ukudumba kunye nentlungu. Kodwa kuya kufuneka uqwalasele ngononophelo iingozi ezaziwayo zokusetyenziswa kwe-steroid, nokuba kukwidosi ephantsi.

Funda zonke iindlela zonyango, kubandakanya i-biologics kunye ne-antibiotic minocycline. Linganisa i-pluses kunye ne-minuses kunyango ngalunye kunye nendibaniselwano yeziyobisi.Xoxa ngezicwangciso zonyango ezinokubakho kunye nogqirha wakho, kwaye uqiniseke ukuba yonke imibuzo yakho iyaphendulwa.

Ngaphezulu kwayo yonke into, unyango lwe-RA lufuna ukuba usebenze.