Nonsteroidal odana ndi yotupa mankhwala - ndi limathetseratu vuto lina lililonse kapena wakupha pang'onopang'ono?

Nthawi zambiri ntchito mchitidwe protivovspalitelnye mankhwala kuchipatala nonsteroidal, kapena NSAIDs. Iwo amaikidwa mu njira yotupa wa etiology osiyanasiyana kuti lipeze gwero la kutupa mpumulo kupweteka m'thupi kutentha, kuchepetsa chiopsezo thrombosis (alipidwa onse ndi aspirin). Malinga ndi kafukufuku ku WHO, mankhwala amadya anthu pafupifupi mamiliyoni 30 tsiku lililonse, ndi chachitatu mmodzi yekha wa iwo - mankhwala dokotala. Chinanso manambala, makamaka matenda enaake ophwanya. Anapeza kuti mankhwala odana ndi yotupa limodzi akatulutsidwa pafupifupi 80% ya rheumatologists.

Koma ngati mankhwala awa ali owona mtima monga otchuka? Chipatala mphamvu ya si funso, koma ali ndi zofooka, chifukwa ngakhale Mlingo kakang'ono makonzedwe yochepa angapereke mavuto 25% odwala, ndi 5% milandu ndi moyo pachiswe. Makamaka, izo nkhawa okalamba, ndipo kwenikweni iwo amapanga 60% ya onse ogwiritsa NSAID.

Pamene mmbuyo 70 anapeza mfundo kanthu mankhwala (chopinga wa ntchito cyclooxygenase, enzyme waukulu nawo kagayidwe wa prostaglandins), zinaonekeratu kuti zotsatira mbali wamangidwa kukhala chitukuko cha kuvutika mu otaya aimpso magazi, ndi kapepala m'mimba. Ndipotu, prostaglandins (PGs) mbali yofunika pano. Mu 90s, ndi mfundo zatsopano za ntchito ya GHGs mu njira zako zofunika kwambiri m'thupi la munthu. Choncho, mankhwala odana ndi yotupa vozdestvuyut lonse osiyanasiyana zochita moyo, makamaka kwa clotting magazi ndi mtima kamvekedwe, kagayidwe fupa, embryogenesis, kukula kwa maselo mantha dongosolo, minofu kukonza ndi ena ambiri.

Pa nthawi yomweyo zinawululidwa kuti pali isoforms awiri cyclooxygenase: Cox-1 ndi Cox-2. Komanso, woyamba udindo uziyenda yachibadwa ziwalo pa mlingo ma, ndi chopinga wachiwiri zikungosonyeza zotsatira achire. Choncho, wobala odana ndi yotupa mankhwala akhoza kuchita kusankha pa Cox-2, n'zotheka kuchepetsa pakutchulidwa mavuto ndi chithandizo otetezedwa kwambiri.

Mmodzi mwa nthumwi izi kusankha ndi ibuprofen. Malinga lonse maphunziro, chiopsezo zosayembekezereka wa pathologies m'mimba pa phwando yake kochepa poyerekeza Mwachitsanzo, piroxicam.

Ndi apeza zotsatira wina mbali imene imachititsa sanali steroidal odana ndi yotupa mankhwala. Iwo kuchepetsa mtima kamvekedwe, omwe ndi owopsa kwa anthu ndi matenda a mtima. Odwala kulandira NSAIDs zikachitika, monga ulamuliro, kuthamanga magazi, komanso ambiri achikulire amene mankhwala mankhwala ululu enaake ophwanya, kawirikawiri kale ndi mbiri ya matenda oopsa.

Komanso, NSAIDs kuchepetsa mphamvu ya kanthu diuretic ambiri mankhwala antihypertensive. Makamaka, ambiri achire Mlingo wa indomethacin, naproxen ndi piroxicam cabe mankhwala okhala furosemide ndi hydrochlorothiazide, prazosin monga mankhwala kapena captopril. Komabe, monga zinadziwika kuti kanthu kusankha mankhwala pa isoforms osiyana a Cox, monga tatchulazi, musati kwambiri bwanji dongosolo mtima. Choncho, utsalira munda waukulu wa ntchito kwa chilengedwe cha mankhwala kwambiri kusankha ndi kukhudza kochepa pa magazi, ndi abwino kwambiri okalamba. Ndipo mankhwala ayamba kuonekera. Mwachitsanzo, Cox-2 selectivity adzalandira kwambiri meloxicam, celecoxib.

Mwatsoka, osati akulu Luda zambiri okha mankhwala nonsteroidal odana ndi yotupa mankhwala chimfine Mwachitsanzo, usanachimvetse zotsatira n'kotheka. NSAIDs ndi molimbika kuti m'malo chinachake, koma kupenda mphamvu ya mankhwala a mavuto onse zotheka angakhoze kokha oyenerera dokotala.