qeb ntawm mast cell membrane stabilizer tshuaj muaj xws li tshuaj pleev ib ce - cromones, nrog rau cov tshuaj systemic nrog ib tug pab - antihistamine khoom, uas yog ketotifen.
Lub tswv yim ntawm kev ua ntawm cov tshuaj no yog tias lawv tuaj yeem thaiv kev nkag mus ntawm calcium thiab chlorine ions rau hauv cov hlwb, vim tias cov tshuaj tsis haum tshuaj (histamine) tau ruaj khov thiab cov membrane poob lub peev xwm tawm mus. tej cell. Tsis tas li ntawd, cov tshuaj stabilizers muaj peev xwm tiv thaiv kev tso tawm ntawm lwm yam tshuaj uas cuam tshuam rau kev loj hlob ntawm kev tsis haum tshuaj.
Qhov no yog dab tsi?
Mast cell membrane stabilizers - tshuaj uas tiv thaiv qhov qhib ntawm calciumchannel thiab nkag mus ntawm calcium rau hauv mast cells. Lawv thaiv cov calcium-dependant degranulation ntawm cov hlwb thiab tso tawm ntawm histamine los ntawm lawv - ib qho tseem ceeb uas ua rau platelets, leukotrienes. Lawv kuj txo qhov tshwm sim ntawm anaphylaxis thiab lwm yam tshuaj lom neeg lom neeg uas tuaj yeem ua rau muaj kev ua xua thiab ua xua. Stabilization ntawm mast cell membranes yog vim blockade ntawm cAMP tsub zuj zuj nyob rau hauv lawv thiab inhibition ntawm phosphodiesterase.
Qhov tseem ceeb ntawm cov nyhuv antiallergic ntawm mast cell membrane stabilizers yog qhov kev nkag siab ntawm catecholamines los ntawm adrenergic receptors. Tsis tas li ntawd, cov tshuaj no muaj cov cuab yeej thaiv cov chloride raws thiab yog li tiv thaiv depolarization ntawm parasympathetic endings hauv bronchi. Lawv tiv thaiv cellular infiltration ntawm bronchial mucosa thiab inhibit qeeb hypersensitivity tshwm sim. Qee cov tshuaj hauv pawg no muaj peev xwm inhibit H1 receptors.
Tshuaj tshem tawm qhov o ntawm bronchial mucosa thiab tiv thaiv kom muaj zog ntawm cov leeg nqaij. Lub ntsiab lus qhia rau lawv siv yog kev tiv thaiv ntawm bronchial obstruction.
Txoj Kev
Cov teebmeem ntawm mast cell membrane stabilizer tshuaj yog:
- txo qis hauv kev ua haujlwm ntau dhau ntawm cov mucous membranes (vim inhibition ntawm kev tso tawm los ntawm cov neeg nruab nrab ntawm kev tsis haum tshuaj ntawm tes);
- txo qis hauv cov haujlwm ntawm cov hlwb uas koom nrog kev tsim cov tshuaj tsis haum (eosinophils, macrophages, neutrophils thiab lwm yam);
- txo qis hauv permeabilitymucous daim nyias nyias - vim qhov txo qis hauv qhov o;
- txo qis hauv qhov rhiab heev ntawm cov paj hlwb receptors thiab tom qab thaiv ntawm qhov reflex nqaim ntawm bronchial lumen - bronchoconstriction.
Yuav ua li cas yog qhov kev ua ntawm mast cell membrane stabilizers?
tshuaj muaj txiaj ntsig
Kev siv tshuaj ntawm pawg kws tshuaj no tiv thaiv kev txhim kho ntawm kev ua xua tshwm sim (bronchospasm, o) thaum muaj peev xwm ua xua nkag mus rau hauv lub cev, nrog rau thaum nws cuam tshuam los ntawm ntau yam cuam tshuam - kev ua si lub cev, cua txias thiab lwm yam.
Ketotifen yog mast cell membrane stabilizer. Nws, zoo li cromones, txo cov kev ua haujlwm ntawm cov pa ua pa hauv daim ntawv ntawm cov lus teb rau kev noj cov tshuaj tsis haum. Tsis tas li ntawd, nws yog ib qho blocker ntawm H1-histamine fibers, uas yog, nws inhibits kev loj hlob ntawm kev tsis haum tshuaj.
Qhov no yog lub ntsiab mechanism ntawm mast cell membrane stabilizers.
Feem ntau, cov stabilizers membrane nrog lawv cov kev siv mus sij hawm ntev txo qhov zaus ntawm exacerbation ntawm cov kab mob ua xua.
Cromones yog siv los tiv thaiv kev tsis haum rhinitis thiab conjunctivitis, bronchial hawb pob thiab kev loj hlob ntawm bronchospasm tshwm sim los ntawm kev cuam tshuam ntawm kev ua rau muaj kev cuam tshuam (kev tawm dag zog, cua txias, thiab lwm yam), nrog rau ua ntej kev sib cuag nrog cov khoom ua xua. Ntawm lwm yam, cov tshuaj ntawm noPharmological qeb yog siv nyob rau hauv txoj kev kho mob ntawm bronchial hawb pob - nyob rau hauv daim ntawv ntawm ib tug ntawm cov yooj yim txoj kev kho cov tshuaj. Txhawm rau tshem tawm bronchospasm, cov tshuaj kho mob no tsis siv los ntawm kev faib tawm no.
Ketotifen yog hu ua mast cell membrane stabilizer. Nws yog siv los tiv thaiv daim ntawv atopic ntawm bronchial hawb pob, kev kho mob ntawm atopic dermatitis, conjunctivitis thiab rhinitis ntawm ib qho kev tsis haum, mob urticaria. Kev siv dav dav ntawm cov tshuaj no raug txwv los ntawm nws cov tshuaj tiv thaiv kev ua xua thiab tshuaj tiv thaiv qis, nrog rau cov kev mob tshwm sim ntawm 1st tiam antihistamines, uas kuj yog yam ntxwv ntawm cov tshuaj no.
Qhov ua tau zoo tshaj plaws ntawm cromones tshwm sim kwv yees li 14 hnub tom qab lawv siv cov txheej txheem. Lub sijhawm ntawm kev kho mob yuav tsum yog 4 lub hlis lossis ntau dua. Tso tseg cov tshuaj maj mam dhau ib lub lim tiam.
Tsis muaj kev quav yeeb quav tshuaj thaum siv nws, kuj tseem tsis muaj qhov txo qis hauv cov txiaj ntsig ntawm lwm cov tshuaj nrog lawv siv mus ntev (cov tsos mob tachyphylaxis). Puas muaj contraindications rau mast cell membrane stabilizers?
YContraindications
Cov nyiaj no yog contraindicated nyob rau hauv kev loj hlob ntawm mob hawb pob. Tsis tas li ntawd, lawv yuav tsum tsis txhob siv thaum muaj mob hawb pob lossis mob siab rau lawv.
nqus pa
Thaum nqus tau paTxoj kev kho mob nrog kev siv cromones nyob rau qee kis, qhov tshwm sim ntawm hnoos thiab lub sijhawm luv luv ntawm bronchospasm tau pom, tsis tshua muaj kev tshaj tawm bronchospasm. Cov tshuaj tiv thaiv zoo sib xws yog cuam tshuam nrog kev ua xua ntawm cov mucous ntawm cov kab mob ua pa sab saud los ntawm cov tshuaj siv tshuaj.
Dab tsi yog qhov chaw kho mob tshuaj ntawm mast cell membrane stabilizers, tsis yog txhua tus paub.
Lwm yam siv
Siv cov tshuaj no hauv daim ntawv ntawm qhov ntswg tee uas muaj cromones, cov neeg mob hauv qee kis qhia txog cov tsos mob ntawm hnoos, mob taub hau, tsis hnov tsw thiab khaus ntawm cov mucous ntawm nasopharynx.
Tom qab instillation (instillation rau hauv lub qhov muag) ntawm cov tshuaj no, tej zaum kuj muaj ib tug kub hnyiab, hnov nyob rau hauv lub qhov muag ntawm ib tug txawv teb chaws lub cev, o thiab hyperemia ntawm conjunctiva (redness).
Neegative manifestations
Cov kev mob tshwm sim los ntawm kev siv "Ketotifen" yog sib npaug rau H1-histamine blockers ntawm thawj tiam. Qhov no yuav ua rau qaug zog, qhov ncauj qhuav, inhibition ntawm tus nqi ntawm cov tshuaj tiv thaiv thiab lwm yam.
YCromoglycate sodium
Cov tshuaj no kuj muaj qee qhov analogues, uas suav nrog:
- YCromoglycic acid;
- Firal;
- Kromoglin;
- "Intal";
- YCromohexal.
Cov membrane stabilizers tiv thaiv, tab sis tsis kho, kev tsis haum tshuaj tam sim.
Thaum nkag mus rau hauv lub cev los ntawm kev nqus los ntawm lumen ntawm lub ntsws ntawm lub ntswsTsuas yog 10% ntawm thawj koob tshuaj yog absorbed, thaum noj - txawm tsawg - tsuas yog 1%, thaum siv intranasally, 8% nkag mus rau hauv cov ntshav, thiab thaum instilled rau hauv lub qhov muag - 0.04% ntawm cov tshuaj.
Qhov siab tshaj plaws ntawm cov ntsiab lus tseem ceeb ntawm cov tshuaj hauv cov ntshav tau pom tom qab 15-20 feeb. Cov nyhuv thaum muab tso rau hauv qhov muag tshwm sim tom qab 2-14 hnub, thaum nqus tau - tom qab 2-4 lub lis piam, thaum noj qhov ncauj - tom qab 2-5 lub lis piam.
Cov lus qhia rau kev teem caij ntawm cov tshuaj no los yog nws cov analogues yog bronchial hawb pob (raws li ib qho ntawm cov kev kho mob tseem ceeb), cov kab mob tsis haum ntawm lub plab zom mov, kev tsis haum zaub mov, ulcerative colitis (raws li ib feem ntawm kev kho mob ua ke), hay fever., allergic rhinitis thiab conjunctivitis.
Rau qhov nqus tau los ntawm pawg tshuaj no yog siv:
- "Intal";
- YCromohexal;
- Firal.
Kev siv intranasal:
- Firal;
- KromoHexal;
- Kromoglin;
- Kromosol.
Raws qhov muag poob:
- Firal;
- KromoHexal;
- Kromoglin;
- Stadaglycine;
- High Krom.
Dab tsi ntxiv ntawm cov npe ntawm mast cell membrane stabilizers?
Nedocromil sodium Nedocromil sodium
Cov tshuaj no, raws li lub cev mast cell membrane stimulator, yog ze rau cov tshuaj sodium cromoglycate. Nws ua raws li bronchodilator thiabanti-inflammatory nyhuv thiab yog siv los ntawm inhalation los tiv thaiv thiab kho pathologies xws li bronchial hawb pob. Hauv qhov no, nws yog siv 4-8 zaug hauv ib hnub, 4 mg rau 2 ua pa. Kev saib xyuas ntau npaum li cas yog sib npaug rau qhov kev kho mob, txawm li cas los xij, qhov zaus ntawm inhalations yog 2 zaug hauv ib hnub. Thaum kawg ntawm thawj lub lim tiam ntawm kev kho mob, cov txiaj ntsig kho tau tuaj yeem pom.
Cov kev mob tshwm sim tuaj yeem tshwm sim - cephalgia, hnoos, dyspepsia, bronchospasm. Kev sib koom ua ke txhim kho cov teebmeem ntawm β-agonists, glucocorticoids, ipratropium thiab theophylline bromide.
Lodoxamide
Cov tshuaj tshuaj no inhibits kev tso tawm ntawm cov tshuaj histamines thiab lwm yam tshuaj uas ua rau muaj kev tsis haum tshuaj. Nws muaj raws li qhov muag tee. Absorbed hauv ib qho me me, ib nrab-lub neej yuav siv li 8 teev. Cov tshuaj no yog siv rau kev ua xua kab mob thiab keratitis.
Nws raug nquahu kom instill ib lossis ob tee rau hauv txhua lub qhov muag nrog lub sijhawm 6 teev. Duration ntawm kev kho mob - mus txog 1 lub hlis.
Thaum kho nrog cov tshuaj no, cov tsos mob tshwm sim tuaj yeem tshwm sim los ntawm lub cev ntawm qhov tsis pom kev (kev khaus ntawm lub qhov muag, qhov muag tsis pom kev, qhov txhab ntawm lub pob muag), cov kab mob tsis hnov tsw (dryness ntawm qhov ntswg mucosa), xws li nrog rau cov xwm txheej dav dav (kiv taub hau, xeev siab, thiab lwm yam).
Nyob rau hauv txoj kev kho, qhov muag lo ntsiab muag yog contraindicated.
Qhov nrov tshaj plaws mast cell membrane stabilizer hauv tshuaj yog Ketotifen.
Ketotifen
Cov tshuaj no, nrog rau nws cov analogues ("Ayrifen", "Zaditen", "Stafen") muaj cov nyhuv ua kom ruaj khov, uas ua ke nrog H1-histamine thaiv. Thaum noj hauv qhov ncauj, nws tau zoo absorbed - bioavailability ntawm cov tshuaj yog 55%. Qhov siab tshaj plaws nyob rau hauv tau tiav 3-4 teev tom qab noj, ib nrab-lub neej yog 21 teev.
siv rau dab tsi?
Cov tshuaj no thiab nws cov analogues yog siv rau kev tiv thaiv kab mob thaum muaj mob hawb pob, rhinitis ntawm kev tsis haum xeeb thiab dermatoses. Nws raug nquahu kom noj 1-2 mg (hauv daim ntawv tshuaj ntsiav thiab ntsiav tshuaj) lossis 1-2 tsp. syrup 0.02% ob zaug ib hnub nrog zaub mov.
Tawm tsam keeb kwm yav dhau los ntawm kev kho mob nrog cov tshuaj zoo li no, cov tsos mob tshwm sim tuaj yeem tshwm sim, piv txwv li, qhov ncauj qhuav, nce qab los noj mov thiab cuam tshuam qhov hnyav nce, qaug zog ntau dhau, inhibition ntawm cov tshuaj tiv thaiv. Cov tshuaj ua kom cov nyhuv ntawm cov tshuaj tsaug zog thiab sedative pharmacological agents, nrog rau cawv.
Kev cev xeeb tub thiab daim nyias nyias stabilizers
Kev siv cov txheej txheem membrane stabilizers thaum cev xeeb tub yog contraindicated. Tshuaj pleev ib ce - cromones - yog contraindicated rau kev siv xwb nyob rau hauv thawj peb lub hlis twg thiab siv nrog ceev faj nyob rau hauv lub sij hawm tom ntej. Yog tias muaj cov cim qhia, piv txwv li, nrog kev tsis haum rhinitis thiab conjunctivitis ntawm tib qhov xwm txheej hauv daim ntawv mob ntev, tom qab 15 lub lis piam ntawm cev xeeb tub, nws raug tso cai siv cov tshuaj cromohexal 2% hauv daim ntawv tee los yog tshuaj tsuag qhov ntswg - hauvStandard dosages.
Thaum lub sijhawm lactation, kev siv cromones tsuas yog ua tau yog tias muaj cov lus qhia nruj.
Peb tau tshuaj xyuas cov txheej txheem ntawm kev ua ntawm mast cell membrane stabilizers.
