I-Methotrexate

I-Methotrexate

Wake wazibuza ngomuthi okwazi ukwelapha izimo ezahlukahlukene, kusukela kumdlavuza kuya ezifweni ezizimele? Sikhuluma nge-methotrexate, isidakamizwa esinamandla esenze amagagasi emhlabeni wezokwelapha. Lo muthi onemisebenzi eminingi usuphenduke inketho yodokotela abaningi, futhi sifuna ukukusiza uqonde ukuthi kungani.

Ake sihlole ukungena nokuphuma kokusetshenziswa kwe-methotrexate, ukuthi ukuyithatha kanjani, nokuthi yimiphi imiphumela emibi okufanele uyiqaphele. Sizophinde sixoxe ngezinyathelo zokuphepha, ukuthi umuthi usebenza kanjani, nokuthi ungakwazi yini ukuwuxuba neminye imithi. 

Iyini i-Methotrexate?

I-Methotrexate imithi enamandla ethonya izimo ezihlukahlukene zezokwelapha. Kuwumuthi oguquguqukayo osetshenziselwa ukwelapha umdlavuza, i-psoriasis enzima, Futhi rheumatoid arthritis. Le ejenti ye-antineoplastic isebenza ngokuvimbela ama-enzyme abhekele ukwenziwa kwe-nucleotide, okuholela ekucindezelweni kokuvuvukala nokuvimbela ukuhlukana kwamaseli.

Ekwelashweni komdlavuza, amaphilisi e-methotrexate abambezela ukukhula kwamangqamuzana omdlavuza. Nge-psoriasis, banciphisa ukukhula kwamangqamuzana esikhumba ukuze bamise ukwakheka kwesikali. Ku-arthritis ye-rheumatoid, i-methotrexate inomthelela ekwehliseni umsebenzi wamasosha omzimba. I-Methotrexate itholakala ngezindlela ezahlukene, okuhlanganisa amaphilisi nemijovo. 

Ukusetshenziswa kwethebhulethi ye-Methotrexate

Amaphilisi e-Methotrexate anezinhlobonhlobo zokusetshenziswa ekwelapheni izimo ezihlukahlukene zezokwelapha, njenge: 

• I-psoriasis enzima
• I-arthritis ye-rheumatoid esebenzayo kakhulu 
• Umdlavuza ohlanganisa webele, wamaphaphu, nomdlavuza othile wekhanda nentamo
• Ezinye izinhlobo ze-lymphoma kanye i-leukemia
• Ezinganeni, amaphilisi e-methotrexate ayasiza ekwelapheni i-acute lymphoblastic leukemia kanye ne-polyarticular juvenile idiopathic arthritis. 
• Kwezinye izimo, odokotela basebenzisa amaphilisi e-methotrexate ukwelapha i-choriocarcinoma yokukhulelwa kanye nemvukuzane ye-hydatidiform. 

Ungayisebenzisa kanjani i-Methotrexate Tablet

• Ngaso sonke isikhathi thatha amaphilisi e-methotrexate njengoba nje udokotela wakho ekutshele. Kuphoqelekile ukulandela imiyalelo yabo ngokucophelela. Ungawaphuzi amaphilisi amaningi kunalawo abekiwe, ngoba angeke akwenze ube ngcono ngokushesha futhi angaba yingozi. 
• Ezimweni ezifana ne-rheumatoid arthritis noma i-psoriasis, thatha amaphilisi e-methotrexate kanye kuphela ngesonto ngosuku olufanayo. 
• Ukwelashwa komdlavuza, umthamo uyahlukahluka kuye ngesimo sethu nosayizi womzimba. 
• Geza amaphilisi wonke ngamanzi, ugweme ukuwachoboza noma ukuwahlafuna. 
• Kubalulekile ukuthi ungathathi i-methotrexate ngokudla okunobisi. 
• Uma uthatha lo muthi usesimweni esiwuketshezi, kala umthamo ngokucophelela usebenzisa inkomishi yokulinganisa noma idivayisi.
• Uma ukhohlwe umthamo, thatha ngokushesha njengoba ukhumbula, uma kungakapheli izinsuku ezimbili. Nokho, uma sekudlule izinsuku ezingaphezu kwezimbili, thintana nodokotela wakho ukuze uthole iseluleko.
• Qinisekisa ukuthi uthatha inani eliphelele loketshezi ngenkathi uthatha lo muthi; lokhu kuzosiza izinso zakho zisuse umuthi.

Imiphumela Emibi ye-Methotrexate Tablets

I-Methotrexate imithi enamandla engase ibangele imiphumela emibi eminingana. Imiphumela emibi evamile ihlanganisa: 

• Ukulahlekelwa kwesifiso
• Ukuzizwa uyagula
• Ubuhlungu besisu
• Uhudo
• Ikhanda elibuhlungu nokozela
• isiyezi
• Ukuzizwa ngikhathele
• Ukuqothuka kwezinwele zesikhashana
• Izilonda zomlomo
• Isikhumba singase sizwele kakhulu ekukhanyeni kwelanga 

Imiphumela emibi kakhulu, nakuba ingavamile, ingenzeka. Lokhu kungase kuhlanganise: 

• Izinkinga zesibindi ezibonakala njengokuphuzi kwamehlo noma isikhumba, ubuhlungu obukhulu besisu, umchamo omnyama
• Izinkinga zamaphaphu, okuhlanganisa ukukhwehlela okuqhubekayo, ubuhlungu besifuba, noma ukuphefumula kanzima
• Izimpawu ze-anemia, njenge isikhumba esiphaphathekile, ukukhathala okungavamile
• Izifo zezinso, njengokuvuvuka kwezandla nezinyawo 
• Ukulimala kalula noma ukopha
• Ubuhlungu bethambo kanye nobuthakathaka bemisipha
• Ubuhlungu obungajwayelekile kanye nokushintsha kombala kwesikhumba

Ukuqapha

Abantu kumele baqaphe lapho besebenzisa amaphilisi e-methotrexate, okuhlanganisa: 

• Umlando Wezokwelapha: Kuyisibopho ukwazisa udokotela wakho nganoma yiziphi izimo zezokwelapha ezikhona noma ezedlule, ikakhulukazi isifo sesibindi, izinkinga zezinso, izimo zamaphaphu, ukuphazamiseka kwegazi, ukungavikeleki kahle komzimba, izifo zesisu (izilonda ze-peptic noma i-ulcerative colitis), noma ukusetshenziswa kotshwala.
• Ukukhulelwa: Kufanele ukugweme ukukhulelwa ngenkathi uthatha i-methotrexate, njengoba ingalimaza ingane engakazalwa. Uma uhlela ukuba nezingane, xoxa ngalokhu nodokotela wakho kusengaphambili.
• Isexwayiso Sokutheleleka: I-Methotrexate ingakwenza ube lula ezifweni, ngakho hlala kude nabantu abanezifo ezithathelwanayo. 
• Ukuzwela kwelanga: Kufanele futhi uqaphele mayelana nokuchayeka elangeni, njengoba umuthi ungenza isikhumba sakho sizwele kakhulu ekukhanyeni kwelanga.
• Ukugoma: Tshela udokotela wakho ukuthi usebenzisa amaphilisi e-methotrexate ngaphambi kokugoma noma ukugoma.
• Imisebenzi: Gwema imisebenzi ekhulisa ithuba lokusikwa, ukulinyazwa, noma ukulimala, kanye nemidlalo yokuxhumana ngenkathi usebenzisa lo muthi.

Isebenza kanjani ithebhulethi ye-Methotrexate

Amaphilisi e-Methotrexate asebenza njengama-antimetabolites, anciphisa ukukhula kwamaseli ahlukanisa ngokushesha. Ekwelashweni komdlavuza, i-methotrexate ivimbela ama-enzyme abhekele ukwenziwa kwe-nucleotide, avimbele ukuhlukana kwamaseli. Ivimbela i-enzyme ye-dihydrofolate reductase, edingekayo ekuguquleni i-dihydrofolate ibe yi-tetrahydrofolate, uhlobo olusebenzayo lwe-folic acid oludingekayo ku-DNA ne-RNA synthesis.

Ezimweni ze-autoimmune njenge-rheumatoid arthritis, i-methotrexate inendlela ehlukile. Ivimbela i-AICAR transformylase, okuholela ekuqongeleleni kwe-adenosine. Lo mphumela wokulwa nokuvuvukala ucindezela ukusebenza kwe-T-cell futhi ukhuphule ukuzwela kwamaseli e-CD-95 T acushiwe. I-Methotrexate iphinde ilawule phansi ama-B-cell futhi ivimbele ukubopha kwe-interleukin kuma-cell surface receptors.

Lezi zindlela zenza i-methotrexate isebenze kahle ekwelapheni izimo ezahlukahlukene, ukusuka kumdlavuza kuye ezifweni ezivuvukalayo njenge-psoriasis kanye ne-rheumatoid arthritis.

Ngingakwazi Ukuthatha I-Methotrexate Ngeminye Imithi?

Imithi eminingi ingaxhumana ne-methotrexate, njenge:

• I-Acitretin
• Ama-antibiotics, njenge-penicillin, i-tetracyclines, imithi ye-sulfa
• I-Asparaginase
• I-Azathioprine
• I-chloramphenicol
• Cisplatin
• Izidakamizwa ezingekho-steroidal anti-inflammatory (NSAIDs) njenge ibuprofen
• Phenytoin
• I-Probenecid
• I-Procarbazine
• Ama-proton pump inhibitors, njengawo i-omeprazole, i-esomeprazole
• I-pyrimethamine
• I-Sulfasalazine
• Ama-retinoids afana ne-isotretinoin

Hlala uthintana nodokotela wakho onguchwepheshe ngaphambi kokuqala noma yimiphi imithi emisha ngenkathi usebenzisa i-methotrexate. 

Ulwazi Lomthamo

Umthamo we-methotrexate uyahlukahluka kuye ngesimo esiphathwayo. 

Nge-arthritis ye-rheumatoid, odokotela baqala ngo-7.5 kuya ku-10 mg kanye ngesonto, okungamaphilisi angu-3 kuya kwangu-4. Udokotela wakho angase andise lokhu ku-25 mg ngesonto uma kudingeka. 

Umthamo ojwayelekile usukela ku-10 kuye ku-25 mg kanye ngesonto nge-psoriasis. 

Ekwelapheni umdlavuza, imithamo ye-methotrexate ingaba phezulu kakhulu, kusukela ku-20 kuya ku-5000 mg/m2, kuye ngohlobo lomdlavuza kanye nohlelo oluthile. 

Kudingeka uphuze amaphilisi e-methotrexate njengoba kunqunyiwe, ngokuvamile ngosuku olufanayo isonto ngalinye. 

Isiphetho

Amaphilisi e-Methotrexate afakazele ukuthi ayimithi eguquguqukayo futhi enamandla ekunakekelweni kwezempilo kwanamuhla. Banethonya ezimweni ezihlukahlukene, kusukela emdlavuza kuya ezifweni ezizimele, ngokunciphisa ukukhula kwamangqamuzana nokunciphisa ukuvuvukala. Ikhono lomuthi ekwelapheni izifo ezehlukene liwenza ube yithuluzi elibalulekile kodokotela, kodwa kubalulekile ukuwusebenzisa ngokucophelela futhi ngaphansi kokuqondisa kwezokwelapha okuseduze.

Imibuzo Evame Ukubuzwa

1. Kwenzekani uma ngiphuthelwa umthamo?

Uma umthamo we-methotrexate weqiwe, umuntu kufanele athinte udokotela ngokushesha ukuze uthole iseluleko. Kubalulekile ukuthi ungaphindi umthamo ukuze ubambe. Udokotela uzohlinzeka ngohlelo olusha lomthamo. Nge-arthritis ye-rheumatoid noma psoriasis, iziguli zithatha i-methotrexate kanye ngesonto ngosuku olufanayo. Uma umuntu ekhohlwa futhi ekhumbula phakathi kwezinsuku ezimbili, angayithatha ngokushesha ngangokunokwenzeka. Kodwa-ke, uma sekudlule izinsuku ezingaphezu kwezimbili, kufanele babonane nodokotela wabo ukuze bathole isiqondiso.

2. Kwenzekani uma ngiphuza ngokweqile?

I-Methotrexate overdose iyisimo esiphuthumayo esibucayi sezokwelapha. Uma usola i-overdose, izinsizakalo eziphuthumayo ngokushesha. Izimpawu zingase zihlanganise isicanucanu esikhulu, ukuhlanza, kanye indle enegazi. Ukweqisa ngokweqile kungaholela ezinkingeni ezisongela ukuphila, ngakho-ke kubalulekile ukufuna usizo lwezokwelapha ngokushesha. 

3. Yini okufanele uyigweme lapho uthatha i-methotrexate?

Abantu kufanele bagweme noma banciphise ukuphuza utshwala. Ukuphuza utshwala ngokweqile kungenza umuntu abe sengozini yesibindi. Kungcono ukuhlala kude nobisi olungaxutshiwe kanye noshizi othambile. Abantu kufanele futhi banciphise ukudla kwabo i-caffeine ekhofini, etiyeni, naseziphuzweni zamandla, njengoba kungase kuphazamise ukusebenza kahle kwe-methotrexate. Ukwengeza, abantu kufanele bagweme ukusondelana nabantu abangaphilile ukuze banciphise ingozi yokutheleleka.

4. Ingabe i-methotrexate iphephile?

I-Methotrexate ingavikeleka uma isetshenziswa njengoba kushiwo, kodwa idinga ukuqapha ngokucophelela. Abantu badinga ukuhlolwa kwegazi njalo ukuze bahlole ukusebenza kwesibindi sabo nenani legazi. Nakuba iphumelela ekwelapheni izimo ezihlukahlukene, i-methotrexate ingaba nemiphumela emibi. Lokhu kungase kuhlanganise ukucanuzela kwenhliziyo, ukukhathala, kanye nokuba sengozini enkulu yokuthola izifo. 

5. Isidakamizwa se-methotrexate sivame ukusetshenziselwa ini?

Ukuguquguquka kwamaphilisi e-methotrexate kuwenza abe umuthi obalulekile ekunakekelweni kwezempilo kwesimanje. Odokotela ngokuyinhloko bayisebenzisela i-rheumatoid arthritis, i-psoriasis enzima, kanye nomdlavuza othile, njenge-leukemia, i-lymphoma, kanye nezimila eziqinile. Ukwengeza, inqunyelwe isifo sikaCrohn, i-juvenile idiopathic arthritis, nezinye izimo ze-autoimmune. 

6. Ubani ongakwazi ukuthatha i-methotrexate?

Abantu abathile akufanele bathathe i-methotrexate. Odokotela bayakugwema ukuyinikeza abesifazane abakhulelwe noma abancelisa ibele, abantu abanesifo esibi sesibindi, izinkinga zezinso, noma ukuphazamiseka kwegazi. Labo abanezifo ezisebenzayo, kuhlanganise sofuba noma i-HIV, kanye nomlando wokusebenzisa utshwala akufanele uthathe i-methotrexate. Abantu abane-hypersensitivity eyaziwayo emuthini nabo abafakiwe. 

7. Uyithatha nini i-methotrexate?

Abantu bathatha i-methotrexate kanye ngesonto ngosuku olufanayo ngezimo ezifana ne-rheumatoid arthritis noma i-psoriasis. Usuku oluqondile lukhethwa ngokubonisana nodokotela wakho. Kubalulekile ukugcina lesi simiso ngokungaguquki. Uma abantu besebenzisa i-methotrexate ekwelapheni umdlavuza, isimiso somthamo singahluka futhi kufanele silandelwe njengoba kunqunywe udokotela wakho we-oncologist.

8. Kungani i-methotrexate ithathwa kanye ngesonto?

I-Methotrexate ithathwa kanye ngesonto ukulinganisa ukusebenza kwayo nokunciphisa imiphumela emibi. Lokhu kulinganisa kwamasonto onke kuvumela umuthi ukuthi wakheke ohlelweni lwethu futhi ulondoloze ukungaguquguquki. Iphinde inikeze imizimba yethu isikhathi sokululama phakathi kwemithamo, inciphisa ingozi yobuthi.

9. I-methotrexate isetshenziswa isikhathi esingakanani?

Ubude besikhathi sokwelashwa kwe-methotrexate buyahlukahluka futhi kuncike esimweni sakho kanye nempendulo emuthini. Nge-arthritis ye-rheumatoid, kungase kudingeke sikuthathe iminyaka eminingana ukuze silawule izimpawu ngokuphumelelayo. Ekwelashweni kwe-psoriasis, ubude besikhathi bungaba futhi isikhathi eside. Ubude bokusetshenziswa kokwelashwa komdlavuza buncike ohlotsheni oluthile lomdlavuza kanye nohlelo lokwelapha. 

10. Yikuphi ukudla okufanele ukugweme ngenkathi uthatha i-methotrexate?

Ngenkathi uthatha i-methotrexate, abantu ngabanye kufanele bakhumbule ukudla kwabo. Kungcono kakhulu ukugwema ubisi olungenayo i-pasteurised kanye noshizi othambile ngenxa yokwanda kwengozi yokutheleleka. Abantu kufanele balinganisele ukudla neziphuzo okune-caffeine neziphuzo ezidakayo. Kuyadingeka futhi ukugcina ukudla okulinganiselayo okucebile ku-folic acid.