"Methotrexate" i-rheumatoid arthritis: ukubuyekezwa. Yokusetshenziswa, incazelo ukulungiselela

rheumatoid arthritis, uma elihunyushwe ngokoqobo ngayo ngesiGreki, libhekisela esimweni ukuvuvukala. Umbuzo ka Yiziphi izici ezenza abantu ukuthuthukiswa kwalesi sifo Namanje hhayi hlandla. Imininingwane ongaqondile ukuthi kwandisa leukocyte egazini futhi ngakhula erythrocyte sedimentation isilinganiso (ESR), kwenza kube nokwenzeka ukuba siphethe ngokuthi inqubo yokuthuthukisa amakhono lesi sifo imvelo esithathelwanayo. Kukholakala ukuthi umfutho sokuthuthukiswa lesi sifo ngegciwane, ingqondo yokuphazamiseka ukusebenza izivikeli mzimba. Nokho, kuncike kule, akubona bonke kodwa kuphela labo babe nomlando nomndeni. Umphumela yokwazisa ukutheleleka ibe umzimba womuntu owenziwe kahle ukwakheka izakhiwo mzimba (kusuka amagciwane, amasosha, kanye nokunye. P.), Yikuphi buthelela ezicutshini futhi kuholele umonakalo ngokuhlanganyela.

Ezimweni eziningi, ekwelapheni yilesi sifo esesabekayo kuyinto ubuhlungu ukuqeda, okwehlisa ukugeleza inqubo isifo nokubuyisela umonakalo (njengoba kungenzeka esimweni ngasinye) usebenzisa izindlela kuhlinzwa.

Izidakamizwa ngoba impatho ekhona ngokuchichimayo. Omunye walena uwukuba le "Methotrexate". Ngo-rheumatoid arthritis (Izibuyekezo kwabasebenzi bezempilo kanye neziguli uqinisekise lolu lwazi) wathi nomuthi siyasebenza ngokwanele, imiphumela ukukhinyabezeka kwayo kuzozwakala isikhathi eside.

Ukwakheka kanye nokusebenza

The main isithako zomuthi kuyinto methotrexate. Lokhu nitostatik, isitha ka-folic acid. Okwamanje, i-yabonakala inekhono lokunqanda ukuqhubeka rheumatoid arthritis inqubo yokwelapha "methotrexate" lisetshenziswa kaningi kunezinye izindlela. Empeleni lena izidakamizwa antitumor, i-ejenti cytostatic, kuvimbela mitosis (cell division ngokungaqondile) sivimbela ukukhula kwezicubu ngenkuthalo proliferating, kuvimbela ukuthuthukiswa izimila.

Ngokwezibalo, ukuphumelela isidakamizwa ebonwe 80% eziguli, umkhuba omuhle ephawuleka ngemva kwamasonto 2-6 ngemuva kokuqala ukwelashwa. Ngemva kwenkathi ende ukwelashwa (kufika eminyakeni engu-5) yokwelapha "Metotraksatom" khansela kancane kakhulu kunalokho okwashiywa yinoma imuphi yemithi esetshenziswayo ukubambezela ukuthuthukiswa rheumatoid arthritis.

Khipha ifomu zomuthi

imithi Self lilingana Russian we Austrian "Methotrexate Ebewe". Lasekuqaleni nomkhiqizi izidakamizwa linikeza amakhasimende ayo amafomu eyahlukene ukukhiqizwa. Tablets ayatholakala emakhemisi ngo imithamo ezintathu 2.5 mg, 5 mg kanye 10 mg ingxenye esebenzayo eyinhloko. Bonke Agcwele polypropylene izitsha eziyisikhombisa izicucu 50 ngamunye. Ngaphezu kwalokho, "Methotrexate" (Austria - umkhiqizi) angathengwa at umthamo 50 mg / 5 ml isixazululo umjovo. Ampoules ezenziwe ngengilazi amnyama futhi igcwele ebhokisini amakhadibhodi.

Kungenzeka futhi ukuthenga nomuthi ngesimo a CONCENTRATE ukulungiswa infusions (droppers). Isikali - 100 mg / 1 ml. Ngesimo esinjalo, "Methotrexate" okuthengiswa izitsha eziyisikhombisa 5, 10, 50 ml. Ebhokisini amakhadibhodi igcwele omunye isitsha.

Izinkomba lokwamukela "methotrexate"

Izinkomba ukusetshenziswa zomuthi likubeka ngokucacile, kusukela injongo yayo eyinhloko - ekulweni izimila. Kunconywa ukuthatha "Methotrexate" ezimweni lapho isiguli uhlushwa acute wegazi lymphoblastic futhi lymphomas nehodzhinskimi. Futhi, ezinqunyiwe trophoblast izimila Mushroom mycosis futhi psoriasis (ngezigaba ezinzima).

Futhi, uma amakhambi nezidakamizwa ungenayo i nomthelela appreciable isicelo "MTX" I-rheumatoid arthritis. Izibuyekezo rheumatologists ochwepheshe ngemithi kunalokho omuhle.

Izinkomba yokwamukela "Methotrexate Ebewe" kancane emikhulu. Ochwepheshe linqume uma isiguli komdlavuza izinhlelo ezihlukahlukene futhi izitho: umdlavuza wamaphaphu yomdlavuza webele, osteosarcoma ezithambile izicubu sarcomas, wamasende kanye izimila wesibeletho, Kaposi Jung, retinoblastoma nezifo sokuhlasela kwamasosha omzimba.

Ubani akufanele bathathe imithi?

Akwamukelekile ukuthatha umuthi abantu hypersensitivity kuya isithako esikhulu. Contraindicated reception "methotrexate" kwabesifazane abakhulelwe mums esancela. Hhayi prescribers nge ngeziphambeko ezikhona kwesibindi nezinso, hematological iziyaluyalu uhlamvu (anaemia, thrombocytopenia, leukopenia). Akunakwenzeka ukuqala imithi yokwelapha iziguli esigabeni okukhulu yisiphi isifo esithathelwanayo, ukuntula mzimba syndrome. Njengoba okulingana Russian kanye nombhalo wokuqala "Methotrexate" (Austria) ayivunyelwe ukuba banike abantwana babo kuze kube iminyaka emithathu.

Lapho eziningi izifo izidakamizwa kunikezwa ngokuqapha okukhulu. Lezi zinkinga zihlanganisa izilonda esiswini kanye 12 isilonda duodenal, izilonda emathunjini, futhi amanzi emzimbeni. Ngo-viral, fungal kanye nezifo ezibangelwa amagciwane futhi kudingeka isinyathelo ngokuqapha kakhulu. Ukuze leli qembu eyakhe nezindaba phambi radiotherapy noma imiphumela emibi yokwelashwa ngamakhemikhali.

Imiphumela engemihle

"Methotrexate" e ampoules, amaphilisi, uma infusions kungabangela inombolo okuba nemiphumela engemihle. Izimo zethu zihluke kakhulu ezinkingeni ezingathi sína ingasuka uhlelo hematopoietic (leukopenia, thrombocytopenia, nokunye. P.) Futhi emathunjini (dyspepsia, sokuzincisha ukudla, isibindi ubuthi, pancreatitis). Isimiso sezinzwa angaphendula bekhanda, ukozela, paresis, nokuquleka. ebulilini izidakamizwa kungabangela ukunqwabelana ukuthuthukiswa encephalopathy. Ngeziphambeko kusukela izitho ezibukwayo kanye uhlelo senhliziyo nemithambo yegazi (hypotension, effusion pericardial, thromboembolism).

Kwangathi ukuthuthukisa nokuvaleka kwemigudu yokuphefumula, ezingamahlalakhona obstructive isifo samaphaphu, iphika, ezomile, ukukhwehlela nonproductive, imfiva. Nge uhlelo genitourinary, kukhona ingozi nesifo esinzima izinso noma ukungasebenzi kwezinso. ukuphazamiseka olungenzeka spermatogenesis futhi oogenesis, kwehle libido, ukungazali, nokuvusa induku.

Uma owesifazane ekhulelwe, "Methotrexate" (imijovo, amaphilisi, ukuvuza) kungabangela ukuchitheka kwesisu, kombungu noma ukufa fetus.

amaphilisi sokuphuzisa lwemithi

Ekwelapheni neoplasms abulalayo lwemithi amaphilisi ngamunye yakhelwe futhi kuncike amaseshini wesifunda ngamakhemikhali. Uma kuziwa isicelo nomuthi "MTX" I-i-rheumatoid arthritis (izimpendulo Iziguli abe nohlamvu positive), umthamo kokuqala uqobo 7.5 mg kanye ngesonto. Ungathatha lonke umthamo ngesikhathi esisodwa, futhi ungakwazi ulwahlukanise ku 3 ngemithamo at 12 ngehora ngezikhawu.

Kwezinye izimo (ukufeza umphumela i elilungile) umthamo masonto onke kungase kukhule. Nokho, akufanele idlule 20 mg. Lapho oyifunayo umphumela zokwelapha kufinyelelwa, umthamo kumele kancane kancane kuyehla kube sezingeni eliphansi. Ubude kahle Yiqiniso ukwelashwa hhayi isifo sitholakale.

Imijovo ye "methotrexate"

Futhi kanjani umjovo ne izidakamizwa "Methotrexate"? Umjovo i-rheumatoid arthritis ukuqala ukwenza umthamo 7.5 mg ngeliviki. Lokhu kungenziwa phansi kwesikhumba, intramuscularly noma ngemithambo yegazi. Uma umuthi kahle ikubekezelele nesineke, umthamo kungenziwa kancane kancane masonto onke ngesikhathi 2.5 mg kodwa hhayi ngaphezulu kuka-25 mg. Lapho nomphumela oqabulayo kufinyelelwe (ngokuvamile 1-2 izinyanga emva Ukuqalwa yokwelashwa), umthamo kumele kancane kancane kuze kube ubuncane ezidingekayo. Ukuze isiguli ngasinye samathambo, umthamo kungenzeka sesijwayele nomphumela kahle ukwelashwa. izifundo zokwelapha luye lwabonisa ukuthi "Methotrexate" kangcono wakwamukela futhi unika sakugcina side izimpendulo, uma phansi kwesikhumba umjovo noma intramuscularly.

Nge yokwamukela esiqhubekayo "methotrexate" kokuqala nomphumela oqabulayo omuhle iqhubeka iminyaka emibili. Uma ukhansela rheumatoid arthritis izidakamizwa kuyalithinta emasontweni 3-6.

Ukweqiwa ngokweqile

Ukweqiwa ngokweqile nomuthi Russian noma izidakamizwa "Methotrexate Ebewe" (amaphilisi, imijovo, infusions) ayiboniswa nezimpawu ezithile. ukweqisa izidakamizwa qiniso kungaba ezingeni methotrexate lokuhlushwa oketshezini olungenambala lwegazi.

Ukwelashwa kwemfuyo kusebenza ngokushesha (ngokufanele ngo kwehora lokuqala) kwesicelo isihlungu, okungukufa folinate calcium. Umthamo injectate kufanele alingane noma enkulu kuno umthamo wathola "methotrexate". Ukweqiwa engeziwe-calcium folinate kungenzeka udokotela njengoba kudingeka. Ngaphambi ufaka umthamo ngamunye okwalandela, bese njalo ngemva kwamahora 6 kuyo yonke inqubo ukuqeda izimpawu ngokweqile kokusebenzisa yokuvimbela kuyadingeka ukuze sithole pH umchamo. Izinyathelo ezinjalo ngeke zokunciphisa ekuthuthukiseni nephropathy.

Futhi kule ngeqoqo lezinyathelo ezidingekayo ukuze kuqedwe imiphumela ngokweqile imithi kuhlanganisa hydration kanye nomchamo alkalinization. Lezi zinqubo zizosheshisa excretion of methotrexate.

Ukuxhumana nezinye izinto futhi amalungiselelo

Uma isiguli sine sifo, nokuqashwa "Methotrexate" imithi noma "Methotrexate Ebewe" umthamo arthrifuge izidakamizwa kumele ilungiswe. ukusetshenziswa ngesikhathi esisodwa salicylates, Phenylbutazone, fenitoiona, sulfonamides, eziningi nemithi ethile elwa namagciwane (tetracycline, penicillin akuzange kusize, chloramphenicol), anticoagulants umphumela engaqondile nemithi hypolipidemic kungaholela ubuthi ezinzima, ngisho nokufa.

esiningi "methotrexate" parallel ama-NSAID kungabangela ukufa kusuka hematologic ezinzima futhi ubuthi emathunjini. Inhlanganisela ama-NSAID nemithi umthamo ephansi phambi kwethu kunganciphisa excretion wale mithandazo yi tubules kwezinso.

izidakamizwa Hepatotoxic (okusekelwe sulfasalazine, azathioprine, ethanol) ukwandisa ingozi hepatotoxicity, gematotoksicheskim - gematotoksichnosti "methotrexate". isicelo ngesikhathi esisodwa izidakamizwa futhi ukwelashwa ngemisebe ukwelashwa kungabangela umnkantsha ukucindezeleka.

imiyalelo Special

Ngaphambi kokuba uqale ukwelashwa imithi "Methotrexate" (umjovo, uma amaphilisi esebenzayo - akunandaba), kubalulekile ukuqhuba ephelele segazi (ukwazi ezingeni zegazi), oyisazi samakhemikhali ezinto eziphilayo (ukunquma amanani enzyme isibindi, albumin, i bilirubin), wenze esifubeni X-ray. Ngaphezu kwalokho, kubalulekile ukuba izinso, kwezinye izimo, kungabi ukuhlolwa engadingekile ukusha kwesibindi kohlobo kanye nesifo sofuba.

Ukuze ungalahlekelwa isikhashana zokudakwa, kubalulekile ukulawula indlela yokwakheka igazi neuropathy (inombolo leukocyte nezinhlayiya zegazi), umsebenzi kwezinso, hepatic transaminase umsebenzi, izinga lezindleko zokukhiqiza uric acid e serum. Ngaphambi ukusetshenziswa "methotrexate" mucosa ngomlomo kanye pharynx ngamunye kufanele kuhlolelwe khona izilonda. Inqubo umnkantsha hematopoiesis kufanele ihlolwe ekuqaleni ukwelashwa, kanye phakathi ukwelashwa nangemva Ukuvalwa yayo.

lebanga lentengo

ukukhulula ifomu (ithebhulethi, umjovo) futhi umthamo - eziyinhloko ezithinta izindleko "Methotrexate" izidakamizwa.

Inani isembozo amaphilisi (PC-50.) With umthamo 2.5 mg zingaba phakathi ruble 240 kuya ku-250. Inani elifanayo amaphilisi 5 mg umthamo angathengwa isamba esingama-ruble angu-390 kuya 420. Packaging izidakamizwa nge umthamo eliphakeme (10 mg) izobiza ruble 530-550.

Ikhambi for lomjovo ezibizayo nokunye okuningi, futhi ukusabalala intengo ngobubanzi okuningi. Ngokwesibonelo, 5 ampoules nomuthi nge umthamo 50 mg / 5 ml kwezinye Pharmacy kungadla ruble mayelana 1200-1300, abanye ngenkathi - ruble 4900.

umbono umthengi

Kukhona zombili ukubukwa emihle nemibi iziguli ngemithi "Methotrexate". Ngo-rheumatoid arthritis, ukubuyekezwa ikakhulukazi eqoshiwe umkhuba omuhle (mayelana 80% eziguli wazibonela ngempumelelo ku 1-1.5 izinyanga zokuqala zokwelashwa). Nokho, umuntu angabona ngokuvamile ukuzwa imiphumela emibi isidakamizwa isiguli, ukuthuthukiswa imiphumela engemihle kobukhulu ehlukahlukene ingxenye izinhlelo ezihlukahlukene eziyishumi nemitshingo.

Ukunciphisa umthelela ongemuhle, "Methotrexate" kufanele aqokwe kuphela udokotela ukuba khona, futhi unalo ukuthuthukisa indlela yokwelashwa bese ukhetha i-umthamo ngempumelelo.