"Daawada methotrexate" in rheumatoid arthritis: dib u eegista. Tilmaamaha loogu isticmaalo, description ka mid ah diyaarinta

Rheumatoid arthritis, haddii macno tarjumay la Greek, waxaa loola jeedaa in xaalad ah caabuq. Su'aasha ah Waa maxay waxyaabaha ka cadhaysiinina horumarinta cudurkan ayaa weli ma caddeeyo. macluumaadka aan toos ahayn ay kordhayso tirada leukocytes dhiigga iyo kor u kacay heerka Kimikada erythrocyte (ESR), waxay suuro gelineysaa in lagu gabagabeeyo in geeddi-socodka lagu soo koraya cudurka waa nooca faafa. Waxaa la rumeysan yahay in wadadii uu horumarinta cudurka waa infakshan, oo iska xanaajin rabshooyin dhaxgalka ee habka difaaca jirka. Si kastaba ha ahaatee, ku xiran this, dhammaantiin ma aha, laakiin kaliya kuwa ay leeyihiin taariikh qoys. Natiijada soo bandhigid cudurka galay jidh bani waa formation of kaxeynayo difaaca (fayraska, unugyada, iyo P. sidaas on.), Kee ururto unugyada iyo keeni dhaawac wadajir ah.

Xaaladaha intooda badan, daweynta cudurrada this laga cabsado waa xanuun yaraynayo, gaabis socodka nidaamka cudurada iyo soo celinta dhaawac (sida suurto gal ah in kiis kasta) la isticmaalayo habab qalliinka.

Daawooyinka lagu daweeyo hadda jirta oo faro badan. Mid ka mid ah kuwan waa "Daawada methotrexate". In rheumatoid arthritis (dib u eegista ah ee shaqaalaha caafimaadka iyo bukaanka loo xaqiijiyo macluumaadkan) ayaa sheegay in medicament waa wax ku ool ah oo ku filan, natiijooyinka ay saameyn la dareemi doonaa ilaa wakhti dheer.

Qaab dhismeedka iyo hawlgalka

The qayb weyn ee firfircoon ee daroogada waa methotrexate. nitostatik Tani, antagonist ah ee folic acid. Currently, waayo, gaabis horumarka ka socda habka daaweynta rheumatoid arthritis "methotrexate" waxaa loo isticmaalaa inta badan habab kale. In nuxurka tani waa daroogada antitumor ah, wakiilka cytostatic, hakiyo maytosis (qeybinta unug aan toos ahayn) uu hakiyo koritaanka unugyada si firfircoon ku faafeen, uu hakiyo horumarinta burooyinka.

Sida laga soo xigtay tirakoob, waxtarka daawada lagu arkay 80% bukaanada, isbeddel togan waa dareemi 2-6 toddobaad ka dib markii laga bilaabo daaweynta ka dib. Ka dib muddo dheer oo daaweyn ah (ilaa 5 sano) therapy "Metotraksatom" baajiso wax badan ka yar wixii daawooyin kale oo loo isticmaalo si aad u yarayso horumarinta rheumatoid arthritis.

foomka Release of daroogada

daawo Self waa u dhigma Ruush oo ka mid ah dalka Austria "Daawada methotrexate Ebewe". The saaraha daroogada asalka bixisaa macaamiisheeda ee noocyada kala duwan ee wax soo saarka badan. Kiniiniga waa laga helaa saddex qaadashada of 2.5 mg, 5 mg oo 10 mg ah qayb weyn ee firfircoon. Oo kulligoodna waxaa lagu buuxiyey oo ku yaal fijaan polypropylene mid kasta 50 gogo '. Intaa waxaa dheer, "Daawada methotrexate" (Austria - saaraha) waxaa laga iibsan karaa qiyaas ah 50 mg / 5 ml in xal la isku duro. Ampoules ka samaysan tahay quraarad madow iyo buuxiyey oo ku yaal sanduuqa kartoonada ah.

Waxa kale oo suuragal in la iibsado medicament ah ee foomka of shancosbitaal ah diyaarinta infusions (droppers). Qiyaasta - 100 mg / 1 ml. In foomka sida, "Daawada methotrexate" lagu iibiyo fijaan oo 5, 10, 50 ml. In kartoon buuxiyey oo ka mid ah ku shubtay.

Tilmaamayaasha u helo "methotrexate"

Tilmaamayaasha ay u isticmaalaan daroogada waa arrin gaar ah, tan iyo markii ay ujeedada ugu weyn ee - dagaalka ka dhanka ah burooyinka. Waxaa lagu talinayaa in ay qaataan "Daawada methotrexate" kiisas xanuunka haya bukaanka ka leukemia lymphoblastic ba'an iyo lymphomas nehodzhinskimi. Sidoo kale, waxaa lagu qoray, waayo, burooyinka trophoblast likaha mycosis iyo psoriasis (yada daran).

Sidoo kale, haddii daawaynta kale iyo daroogada ma saamayn appreciable codsatay "MTX" for rheumatoid arthritis. Rogaal khubaro rheumatologists daawooyinka halkii wanaagsan.

Tilmaamayaasha ee qaabilaadda ee "Daawada methotrexate Ebewe" xoogaa ka weyn. Khubaro u qoro marka bukaanka carcinogenic nidaamyada iyo xubnaha kala duwan: kansarka sanbabada iyo kansarka naasaha, osteosarcoma iyo sarcomas unugyada jilicsan, Testicular burooyinka ugxansiduhu, Kaposi Jung, retinoblastoma iyo shalalka.

Yaa waa in aan qaataa daawada?

Waxa aan la aqbali karin in ay qaataan daroogada dadka diidmo in qayb weyn ee firfircoon. Ahaan uu u soo dhoweynta "methotrexate" haweenka uurka leh iyo hooyooyinka kalkaalinta. qorayaasha la leexashooyinkaasi jira beerka iyo kelyaha, cudurada qof hematological (anemia, Torombositobiiniya, leukopenia) ma. Waa wax aan macquul in la bilaabo dawada lagu daweeyo bukaanada ee wajiga ba'an cudur kasta oo faafa, deficiency difaaca ka cabanaya syndrome. Sida u dhigma Ruush, iyo "Daawada methotrexate" asalka (Austria) looma ogola inay carruurtooda bixiyaan ilaa saddex sano.

Marka tiro ka mid ah cudurada daroogada la siiyo si taxadir leh u weyn. dhibaatooyinka waxaa ka mid ah boogaha caloosha iyo 12 boog dyspepsia, ulcerös kolit, iyo fuuqbaxa. In viral, fangas iyo cudurrada bakteeriyada sidoo kale u baahan in ay u dhaqmaan si aad taxader. Si aad kooxdan ka tirsan arrimaha hor radiotherapy ama chemotherapy.

waxyeelooyinka suurogalka ah

"Daawada methotrexate" in ampoules, kiniin, marka infusions waxay keeni kartaa dhowr ah oo dhibaatooyin soo raaca. Waxay jeelyihiin in dhibaatooyin halis ah kici karaa nidaamka hematopoietic (leukopenia, Torombositobiiniya, iyo P. sidaas on.) Oo mindhicirka (dyspepsia, anorexia, sumoobo beerka, pankreatit). habka dareemayaasha jawaabi karaan madax xanuun, hurdo, paresis, qalal. Caddad badan ee daroogada waxay keeni kartaa horumarinta encephalopathy. Duwanaanta ka xubnaha muuqaalka iyo nidaamka wadnaha (hypotension, effusion pericardial, thromboembolism).

Waxaa laga yaabaa in la horumariyo ay neefta, chronic obstructive pulmonary disease, neefta oo ku qabata, qalalan, qufac nonproductive, qandho. Iyada oo nidaamka genitourinary, waxaa jira halista cudurka kelyaha daran ama kelyaha. carqalad suurtogalka ah ee spermatogenesis iyo oogenesis, hoos u libido, dhalmo la'aan, kacsi la'aanta.

Haddii ay haweeneydu uur leedahay, "Daawada methotrexate" (irbado, kiniin, faleebo) waxay keeni karaan dhicin, curyaanimo ama dhimasho uurjiifka.

kiniiniyada keeneysa in mudada

In daaweynta neoplasms malignant mudada kiniinka si gaar ah loogu talagalay oo ay ku xiran tahay fadhiyada chemotherapy circuit. Marka ay timaado in codsiga ah ee medicament ah "MTX" for rheumatoid arthritis (jawaabaha Bukaanka leedahay dabeecad wanaagsan), qiyaasta hore caadi ahaan waa 7.5 mg toddobaadkii hal mar. Waxaad qaadan kartaa qiyaas dhan hal mar, oo aad u kala qaybin karaa 3 qiyaasood at 12 dura saac.

Xaaladaha qaarkood (si loo gaaro ah saamayn aan fiicnayn) dose todobaadle ah lagu kordhin karaa. Si kastaba ha ahaatee, waa in aanay ka badnaan 20 mg. Marka saamaynta doonayo caafimaad oo waxaa lagu gaarayaa, qiyaasta waa in si tartiib tartiib ah hoos u dhigay ugu yaraan. Muddada aan fiicnayn dabcan daaweynta caafimaad ahaan lama ogaado.

Cirbadaha ee "methotrexate"

Oo sidee muday la daroogada "Daawada methotrexate"? Cirbadaha for rheumatoid arthritis laga bilaabo si ay u sameeyaan qiyaasta ah 7.5 mg halkii todobaad. Taas waxaa la samayn karaa subcutant, intramuscularly ama faleebo. Haddii daroogada ayaa waxaa si fiican loo dulqaatay by bukaanka, qiyaasta lagu si tartiib tartiib ah kor u kacay kartaa todobaadle ah ee 2.5 mg laakiin aan ka badnayn 25 mg. Marka saamaynta ku daweynta la gaaro (sida caadiga ah 1-2 bilood ka dib bilow daawaynta), qiyaasta waa in si tartiib tartiib ah hoos u si ugu yaraan loo baahan yahay. Waayo, bukaan kasta la rheumatoid arthritis, qiyaasta laga yaabaa in si tartiib tartiib ah loogu habeeyaa saamayn isitcmaalo daaweynta. waxbarashada Clinical ayaa muujisay in "Daawada methotrexate" si fiican u nuugo oo ku siinaysaa jawaabaha kooxda yar, haddii subcutant duray ama intramuscularly.

Iyadoo soo dhaweynta joogto ah "methotrexate" hore saamayn ku daweyn fiican sii socoto muddo laba sano ah. Hadii aad joojisid maandooriyaha arthritis rheumatoid saamayn in 3-6 todobaad.

xaddi badan

Xaddi badan medicament Ruush ama daroogada "Daawada methotrexate Ebewe" (kiniin, irbado, infusions) aan la tusay wax calaamado gaar ah. Dhab ahaantii xad dhaafka ah waxay noqon kartaa fiirsashada methotrexate heer ee plasma dhiigga.

Daaweynta waa deg deg ah (fiican loogama ee saacaddii ugu horeysay) codsiga fiqiira, oo waa folinate calcium ah. mugga injectate waa loo siman yahay si ama ka sii weyn tahay qiyaasta helay "methotrexate". qaadasho dheeraad ah folinate calcium lagu qori karaa dhakhtar sida loogu baahan yahay. Ka hor inta aadan geli dose kasta xiga, ka dibna 6 saac oo kasta habka ay u la baabi'iyo calaamadaha xad dhaafka ah ee la isticmaalayo daawo loo baahan yahay si loo go'aamiyo pH kaadida. tallaabooyinka noocan oo kale ah loo yareeyo doonaa suurtagalnimada of horumarinta nephropathy.

Sidoo kale baakadda of tallaabooyin loo baahan yahay in la baabi'iyo saamaynta xad dhaafka ah ee daawada waxaa ka mid ah fuuq iyo kaadida alkalinization. hababkan soo dedejin doonaa Digo ee methotrexate.

Dhexgalka walxaha kale iyo diyaarinta

Haddii bukaanka uu turqo, oo ballan daawooyinka "Daawada methotrexate" ama "Daawada methotrexate Ebewe" daroogada arthrifuge dose waa in la saxo. isticmaalka waafaqsan of salicylates, phenylbutazone, fenitoiona, sulfonamides, tiro ka mid ah antibiotics gaar ah (tetracycline, penicillin, chloramphenicol), daawada xinjirowga lidka saamayn dadban iyo daawooyinka hypolipidemic waxay keeni kartaa in sumoobo daran, xitaa dhimasho.

xaddi badan oo "methotrexate" ay barbar socdaan NSAIDs waxay keeni kartaa dhimasho ka hematologic daran iyo sumoobo caloosha iyo mindhicirka. isku dhafan ee NSAIDs iyo daaweyn dose-yar na hor waxay yareyn kartaa Digo ee dambe ay tubules kelyaha.

daroogada Hepatotoxic (ku salaysan sulfasalazine, azathioprine, ethanol) si loo kordhiyo halista ah ee hepatotoxicity, gematotoksicheskim - gematotoksichnosti "methotrexate". codsiga waafaqsan of daaweyn daroogada iyo dawaynta ilaysku waxay keeni kartaa niyad-dhuuxa.

tilmaamaha gaarka ah

Ka hor inta aadan bilaabin daawada daawo "Daawada methotrexate" (cirbad, haddii kiniinka lagu dabaqi karo - ma ahan), waxaa lagama maarmaan ah si ay u qabtaan dhamaystiran count dhiig (in la ogaado heerka platelets), Kiimikada noole (si loo go'aamiyo qiimaha of falgalka beerka, albumin, bilirubin), samayn xabadka X-ray. Intaa waxaa dheer, waxaa lagama maarmaan ah in la baaro kelyaha, xaaladaha qaarkood, ma noqon baaritaano baahna hepatitis iyo qaaxada.

Si aan si ka maqnaan daqiiqad sarkhaan, waxaa lagama maarmaan ah si loo xakameeyo oo sideeda oo dhiigga durugsan (number of leukocytes iyo platelets), shaqada kelyaha, hawl transaminase cagaarshowga, heerka of acid uric ee serum. Ka hor inta isticmaalka kasta oo "methotrexate" xabka afka iyo dalqada waa in la hubiyaa joogitaanka of boogaha. Geedi socodka ah ee lafta hematopoiesis dhuux waa in la hubiyaa bilowga therapy, mar inta lagu jiro daaweynta iyo ka dib markii ay la xiro.

kala duwan oo qiimaha

sii daayo foomka (kiniin, duray) iyo qiyaasta - arrimaha ugu weyn ee saameeya qiimaha "Daawada methotrexate" daroogada.

Baakadaha Price of kiniiniyada (50 kumbiyuutarada.) Iyada oo qiyaas 2.5 mg ah u dhaxayn kartaa 240 250 rubles. tiro la mid ah kaniiniyada dose 5 mg laga iibsan karaa lacagta ah ee 390 si ay u 420 rubles. Baakooyinka daroogada la qiyaasta ugu badan (10 mg) kici doonto 530-550 rubles.

Xalka la isku duro wax badan oo qaali ah, iyo faafinta qiimaha waa badan ballaaran. Tusaale ahaan, 5 ampoules medicament la qiyaasta ah 50 mg / 5 ml farmasiyada qaar ka mid ah ku kici karaan ku saabsan 1200-1300 rubles, halka kuwo kale - 4900 rubles.

opinion macaamiisha

Waxaa jira aragtiyo wanaagsan iyo wax xunba dadka bukaanka ah ee ku saabsan daawooyinka "Daawada methotrexate". In rheumatoid arthritis, dib u eegista ay inta badan duubay isbeddel togan (oo ku saabsan 80% ka mid ah bukaanada la kulmay oggolyahay ee 1-1.5 bilood ee ugu horreeya ee daaweynta). Si kastaba ha ahaatee, mid ka mid ah oo inta badan ka maqli kartaa oo ku saabsan saamaynta xun ee daroogada ee bukaanka, horumarinta waxyeellooyin ah oo kala duwan darnaanta on qayb ka mid ah hababka kala duwan iyo xubnaha.

Si loo yareeyo saamaynta taban, "Daawada methotrexate" waa in lagu keliya loo magacaabay uu dhakhtarka xaadirka ah, iyo sidoo kale waxa uu leeyahay si ay u horumariyaan qorshaha daaweynta iyo dooran dose wax ku ool ah.