Synthesized pokhapokha ndi thupi mu adrenal cortex kapena ma labotale opangidwa ndi a steroid, glucocorticoid cholinga chake ndi kutseka oyimira pakati.
Mankhwala atsimikiza kugawa kwa glucocorticoids molingana ndi njira yogwiritsira ntchito, ntchito, mphamvu yogwira, kutengera njira yoyendetsera.
Ma glucocorticosteroids opangidwa ndi mankhwala ofunikira amafunikira kuti muchepetse kutupa, osagwiritsidwa ntchito kwambiri ngati mankhwalawa kapena ngati mankhwala a immunosuppress.
Ma steroid achilengedwe
Mothandizidwa ndi chapakati mantha dongosolo ndi pituitary England, mtolo wa mahomoni umapangidwa mu adrenal cortex, umalimbana ndikukhalabe nthawi yayitali pakapanikizika, kagayidwe kachakudya, ndikuchotsa maziko a kutupa. Nthawi zosiyanasiyana masana zimakhudza kupanga mahomoni enaake.
Cortisol
Ma steroid otsatirawa adasiyanitsidwa:
- cortisol (hydrocortisone) imapangidwa nthawi ya kupsinjika, cholinga chake chodzutsa mphamvu yogwira thupi kuti ipirire zovuta zina. Kupsinjika kwapafupipafupi kumabweretsa kuchuluka kwa cortisol, komwe kumapangitsa kuti pakhale kuchuluka kwambiri, kufalikira kwa mafuta pamapewa ndi m'chiuno, kukhumudwa, kusokonezeka kwa tulo, matenda a mafupa ndi ntchito yobereka. Mafuta ochepa a cortisol amatsogolera ku kuwonda, kutsitsa magazi, kuthamanga kwa malekezero, nkhawa;
- cortisone Amapangidwa mofananamo ndi cortisol, koma ochepa. Cholinga chake ndikulimbitsa njira za metabolic, kutsitsa minofu ntchito. Izi zimachepetsa ntchito zamaganizo, chitetezo chachilengedwe cha thupi, ntchito yam'mimba.
Kukula kwakanthawi kapena kosakhalitsa kwa cortisol ndikotheka kwa thupi: pakubala kwa amayi mwa amayi, pambuyo povulala kapena matenda, kupsinjika kwa nthawi yayitali, kuchita masewera olimbitsa thupi.
Kuchuluka kwa mahomoni m'magazi kumawonedwa m'mawa, pafupifupi maola 8, ndikuchepetsa masana, kumakhala kochepa pofika 3 koloko m'mawa.
Zogona mu labotale
Zochizira matenda ena, kuthandizira pamavuto, ndikuwongolera kwa kagayidwe kazakudya, glucocorticoids adakhalapo. Ntchito yawo ndi yofanana ndi yachilengedwe, amagwiritsidwa ntchito popanga mahomoni m'thupi.
Gawani kukonzekera kwa glucocorticoid potengera cholinga chawo komanso momwe thupi limagwirira ntchito. Makampani opanga mankhwala adayimira ma horoni kutanthauzira kosiyanasiyana, komwe kumasiyana mu kapangidwe ka othandizira, komanso pakuphatikizika kwa chinthu chachikulu.
Mapiritsi a Prednisone
Ma glucocorticoids osasinthika:
- betamethasone. Ili ndi vasoconstrictor zotsatira, imakhudza kagayidwe ndi kagayidwe ka BZHU. Imafotokozedwa ngati kuyimitsidwa kapena yankho la jakisoni. Amagwiritsidwa ntchito potupa, kuthetsa zovuta zomwe zimachitika ndi kuyambitsa khungu. Zomwe zili ndi mankhwala: Beloderm, Betazone, Betaspan, Diprospam, Celederm, Celeston;
- kudziwitsa. Amagwiritsidwa ntchito pothandiza kuti munthu asagwidwe koopsa, mikhalidwe yododometsa, ali ndi mphamvu yochita. Kugawidwa kwa glucocorticoids a gululi molingana ndi momwe ntchito imagawidwira: mkamwa, jakisoni, makolo. Amawonetsedwa ndi mankhwala: Prednisolum, Medopred, Decortin;
- methylprednisolone. Kugwiritsa ntchito ngati choletsa zinthu za leukocytes ndi macrophages a minofu. Kuchiza kumachitika pakamwa komanso mwaubwino, pogwira ntchito ndi matenda a endocrine. Mankhwala okhala ndi mahomoni: Medrol, Metipred.
Kuti mafuta ophatikizika a glucocorticoids aphatikizidwe:
- dexamethasone. Imatha kulowa mkatikati yamanjenje, ndikupereka immunosuppression komanso anti-yotupa. Amapezeka jakisoni, mapiritsi, madontho amaso. Mankhwala ndi mahomoni, motero, odwala amakumana ndi vuto m'thupi, njira za kagayidwe kachakudya, komanso kusintha kwa mkhalidwe wamalingaliro. Zokhala ndi mankhwala: Dexazone, Dexamed, Mexicoidex;
- triamcinolone. Amapangidwira zochizira autoimmune chithokomiro, psoriatic, gouty ndi nyamakazi, hypercalcemia mu neoplasms yoyipa. Zoperekedwa pakamwa, jakisoni, pakhungu, amitundu. Chofunikira cha mankhwalawa: Kenalog, Berlicort, Polcortolone, Triacort.
Kugwiritsa ntchito ma corticosteroids
Kukhala ndi mphamvu yakanthawi kapena yokhudza thupi, mankhwala omwe ali ndi glucocorticoids amatha kupezeka mu mawonekedwe a mapiritsi, mafuta, madontho, jakisoni. Ntchito yawo yayikulu ndikuwongolera kuwonetsedwa kwa ziwengo, kuthetsa cholinga cha kutupa, komanso kupereka mphamvu yogwira ntchito. Malinga ndi njira yogwiritsira ntchito, glucocorticoids amaikidwa m'magulu awiri: zotsatira zakudziko komanso mwatsatanetsatane.
Mafuta a Betamethasone
Gulu 1 - kukhudzika kwanuko:
- ntchito pakhungu (mafuta, ufa, zonona): Mometasone, Betamethasone, Fluocinolone Acetonide;
- kugontha kwa maso, makutu: Betamethasone;
- inhalation: budesonide, flunisolid, fluticasone propianate;
- jekeseni wa intraarticular: Betamethasone;
- Kuyambitsa minofu ya periarticular: Hydrocortisone.
Gulu 2 - zokhudza glucocorticoids:
- Hydrocortisone (yogwira mankhwala (LS) - Cortef);
- Prednisone;
- Prednisone;
- Methylprednisolone;
- Dexamethasone;
- Triamcinolone;
- Muthana.
Glucocorticosteroids amatchinga kumanga kwa immunoglobulin kuti akhale ndi maselo am'mimba, kupewa ziwonetsero zomwe sizigwirizana. Mankhwala a Hormonal amagwiritsidwa ntchito ngati munthu ali ndi vuto loopsa: edema ya Quincke, anaphylactic, urticaria. Nthawi zina amagwiritsidwa ntchito pochotsa chifuwa.
Pogwiritsa ntchito kupondereza chitetezo chathupi, glucocorticoids amagwiritsidwa ntchito moyenera kuphatikizira. Kuchepa kwa ntchito yoteteza thupi kumalepheretsa kukanidwa kwa timisempha totayika.
Mwa kupondereza ntchito ya phospholipase, anti-yotupa ya corticosteroids imatheka. Kutsika kwa kutulutsa kwamadzimadzi chifukwa kuchepa kwa ma network a capillary kumapangitsa kuchepa kwa mawonekedwe owoneka bwino. Kubwezeretsa kumachitika chifukwa cha kuchuluka kwamphamvu kwa zotupa.Mosasamala kanthu za gulu, glucocorticoids achilengedwe komanso opanga omwe ali ndi pharmacology yomweyi, mawonekedwe awo achire ndi:
- m'malo (ndikusowa kwa mahomoni);
- pathogenetic (anti-yotupa, anti-shock, immunosuppress, anti-allergic effect);
- zoponderezana (kuponderezana kwa kupanga corticoliberin, wokhudzika ndi mawonekedwe owonetsa) ntchito.
Zotsatira zoyipa
Mankhwala obwera chifukwa cha mahomoni ali ndi zotsatirapo zabwino pa mankhwalawo ndipo amakhala ndi zotsatirapo zoyipa.
Ndikofunikira kuchita maphunziro a mankhwalawa moyang'aniridwa ndi dokotala, osadziletsa.
Zosafunika ndizowonetsa monga kuchuluka kwa shuga m'magazi, kupezeka kwa shuga mkodzo. Steroid shuga mellitus chifukwa chochita nawo mahomoni mu kagayidwe kazachilengedwe ndi kowopsa.
Kutenga nawo gawo kosafunikira kwa ma steroid mu protein metabolism kumabweretsa kuwonongeka kwa minofu minofu. Kuchepa kwa khungu la collagen kumachepetsa khungu, kumachepetsa mphamvu yake. Kuponderezedwa kwa kaphatikizidwe ka mapuloteni kumakhudza kupangika kwa minofu yatsopano, yofunikira pakuchiritsa mabala ndi mabala.
Zotsatira za glucocorticoids pa metabolism yamafuta zimatsogolera pakugawidwa kwama asipose minofu m'thupi. Odwala amakhala ndi mafuta ochepa m'miyendo, koma amakhala ndi khosi, nkhope, chifuwa.
Kugwiritsa ntchito kwakanthawi ma steroid sikutanthauza kuyambitsa matenda a mtima.
Kugwiritsa ntchito kwa nthawi yayitali kwa Haphazard kumapangitsa kuti chiwonetsero cha matenda oopsa, chisokonezo cha mtima.
Zotsatira zoyipa zingaphatikizepo kusowa tulo, kusokonezeka kwa chikumbumtima, khunyu yopweteka m'matumbo, zilonda zam'mimba, kukula pang'onopang'ono kwa ana, mafupa a mafupa. Kuwonetsera kwapafupi sikunachitike kuwona candidiasis a nasopharynx, hoarseness, chifuwa, kutulutsa kwa mucous nembanemba ndikotheka.
Makanema okhudzana nawo
Zowunikira pazofunikira za glucocorticosteroids mu mankhwala:
Kugawika mwatsatanetsatane kwa glucocorticoids kumapereka chithunzi chonse chogwiritsira ntchito mankhwala omwe ali ndi ma steroids. Ma mahomoni opangidwa mwanjira inayake amakhala ndi chochita cholimbana ndi matenda kapena kachilombo ka microflora ya pathogenic. Mlingo wocheperako wa chinthu umathandizira kuti matendawa akhale abwino popanda zovuta zina zamthupi.
