Desensitizing tshuaj (antiallergic, antihistamines) yog cov tshuaj uas tau siv los kho cov mob ua xua. Cov txheej txheem ntawm kev ua ntawm cov tshuaj no yog tshwm sim nyob rau hauv daim ntawv ntawm thaiv H1-histamine receptors. Yog li ntawd, muaj kev tawm tsam ntawm cov teebmeem ntawm histamine - cov tshuaj tseem ceeb-tus neeg nruab nrab, uas muab qhov tshwm sim ntawm feem ntau ntawm cov kev tsis haum tshuaj.
Histamine tau txheeb xyuas los ntawm cov ntaub so ntswg tsiaj hauv xyoo 1907, thiab los ntawm 1936 thawj cov tshuaj tau tshawb pom uas inhibited cov teebmeem ntawm cov tshuaj no. Cov kev tshawb fawb rov qab hais tias nws ua rau muaj cov tsos mob tshwm sim ntawm kev ua xua los ntawm nws cov teebmeem ntawm histamine receptors ntawm lub ntsws, tawv nqaij thiab ob lub qhov muag, thiab cov tshuaj tua kab mob tuaj yeem tiv thaiv cov tshuaj tiv thaiv no.
Kev faib cov tshuaj desensitizing raws li lub tswv yim ntawm kev ua ntawm ntau hom kev ua xua:
• Tshuaj uas cuam tshuam rau hom kev tsis haum tshuaj tam sim ntawd.
• Tshuaj uas cuam tshuam rau ncua kev tsis haum tshuaj.
Tshuaj cuam tshuam rau kev tsis haum tshuaj tam sim
1. Txhais tau hais tias inhibit kev tso tawm ntawm kev tsis haum tshuaj los ntawm cov leeg nqaij thiab cov hlwb basophilic, thaum inhibition ntawm cytotoxic cascade ntawm kev tsis haum tshuaj yog pom:
• β1-agonists;
• glucocorticoid;
• Antispasmodic myotropic teebmeem.
2. Cell membrane stabilizers.
3. Blockers ntawm H1-histamine receptors ntawm hlwb.
4. Desensitizing.
5. Complementary system inhibitors.
Tshuaj rau ncua kev tsis haum tshuaj
1. NSAIDs.
2. Glucocorticoid.
3. Cytostatic.
Pathogeny of Allergy
Hauv kev txhim kho pathogenetic ntawm kev ua xua, histamine ua lub luag haujlwm loj, tsim los ntawm histidine thiab tso rau hauv basophils (mast cells) ntawm lub cev cov ntaub so ntswg (xws li ntshav), hauv platelets, eosinophils, lymphocytes thiab biofluids. Histamine nyob rau hauv cov hlwb yog nthuav tawm nyob rau hauv ib tug inactive theem nyob rau hauv ua ke nrog nrog cov proteins thiab polysaccharides. Nws raug tso tawm vim muaj kev cuam tshuam ntawm cov khoom siv ntawm tes, kev tiv thaiv kab mob, nyob rau hauv kev cuam tshuam ntawm cov tshuaj thiab tshuaj. Nws inactivation tshwm sim nrog kev pab los ntawm histamines los ntawm cov mucous ntaub so ntswg. Los ntawm activating H1 receptors, nws excites membrane phospholipids. Vim yog cov tshuaj tiv thaiv, cov xwm txheej tau tsim uas ua rau muaj kev nkag mus ntawm Ca rau hauv lub xovtooj ntawm tes, tom kawg ua rau cov leeg nqaij du.
Ua rau H2-histamine receptors, histamine activates adenylate cyclase thiab ua rau kom cov cellular cAMP, uas ua rau muaj kev nce hauv kev zais ntawm lub plab mucosa. Yog li, qee cov tshuaj desensitizing yog siv los txo HCl secretion.
Histamine tsim capillary nthuav dav, nce permeability ntawm phab ntsa ntawm cov hlab ntsha, cov tshuaj tiv thaiv edematous, txo qis hauv cov ntshav plasma, uas ua rau cov ntshav thickening, txo qis hauv cov hlab ntsha, txo qis. cov leeg nqaij txheej ntawm bronchi vim khaus ntawm H1-histamine receptors; nce adrenaline tso tawm, nce lub plawv dhia.
Ua haujlwm ntawm H1 receptors ntawm endothelium ntawm phab ntsa capillary, histamine tso tawm prostacyclin, qhov no ua rau muaj kev nthuav dav ntawm lumen ntawm cov hlab ntsha me (tshwj xeeb tshaj yog venules), tso ntshav hauv lawv, txo qhov ntim. ntawm cov ntshav ncig, qhov no ua kom cov ntshav plasma, cov proteins thiab cov qe ntshav los ntawm cov phab ntsa dilated interendothelial.
Los ntawm tsib caug ntawm lub xyoo pua 20th. thiab txog tam sim no, cov tshuaj desensitizing tau raug hloov pauv ntau zaus. Cov kws tshawb fawb tau tswj hwm los tsim cov tshuaj tshiab nrog cov npe me me ntawm cov tshuaj tiv thaiv tsis zoo thiab muaj txiaj ntsig zoo dua. Nyob rau theem tam sim no, muaj 3 pawg tseem ceeb ntawm cov tshuaj tiv thaiv kab mob: thawj, thib ob thiab thib peb tiam.
Thawj tiam desensitizing tshuaj
1st tiam desensitizers yooj yim hla cov ntshav-hlwb barrier (BBB) thiab khi rau cortical histamine receptorshlwb. Nyob rau hauv txoj kev no, desensitizers pab txhawb rau sedative nyhuv, ob qho tib si nyob rau hauv daim ntawv ntawm me ntsis tsaug zog thiab nyob rau hauv daim ntawv ntawm suab pw tsaug zog. Cov tshuaj ntawm tiam 1 kuj tseem cuam tshuam rau cov kev xav psychomotor ntawm lub hlwb. Rau tib lub laj thawj, lawv siv yog txwv nyob rau hauv ntau pawg neeg mob.
Qhov taw qhia tsis zoo ntxiv kuj tseem yog qhov kev sib tw nrog acetylcholine, vim tias cov tshuaj no tuaj yeem cuam tshuam nrog cov paj hlwb muscarinic, zoo li acetylcholine. Yog li, ntxiv rau cov nyhuv calming, cov tshuaj no ua rau lub qhov ncauj qhuav, cem quav thiab tachycardia.
1st tiam desensitizers tau ua tib zoo muab tshuaj rau glaucoma, rwj, kab mob plawv, thiab ua ke nrog cov tshuaj tiv thaiv kab mob thiab cov tshuaj psychotropic. Lawv tsis raug pom zoo rau ntau tshaj kaum hnub vim muaj peev xwm tiv thaiv tau.
2nd tiam desensitizers
Cov tshuaj no muaj kev sib raug zoo heev rau cov tshuaj histamine, nrog rau cov khoom xaiv, thaum tsis cuam tshuam rau muscarinic receptors. Tsis tas li ntawd, lawv yog cov cwj pwm los ntawm kev nkag mus tsis zoo los ntawm BBB thiab tsis muaj yees, tsis tsim cov nyhuv sedative (qee zaum qee cov neeg mob yuav ua rau qaug zog me ntsis).
Tom qab koj tso tseg cov tshuaj no, cov txiaj ntsig zoo yuav nyob twj ywm rau 7 hnub.
Qee tus muaj cov tshuaj tiv thaiv kab mob, cov nyhuv cardiotonic. Qhov kawg qhov tsis zoo yuav tsum muaj kev tswj hwm ntawm cov hlab plawv.qhov system thaum lub sijhawm lawv tau txais.
3rd (new) tiam desensitizers
Tshiab tiam tshiab desensitizing tshuaj yog tus cwj pwm los ntawm kev xaiv siab rau histamine receptors. Lawv tsis ua kom sedation thiab tsis cuam tshuam rau kev ua haujlwm ntawm lub plawv thiab cov hlab ntsha.
Kev siv cov tshuaj no tau ua pov thawj nws tus kheej hauv kev kho mob ntev ntev - kev kho mob rhinitis, rhinoconjunctivitis, urticaria, dermatitis.
tshuaj tiv thaiv rau menyuam yaus
Cov tshuaj tiv thaiv kab mob rau menyuam yaus, uas koom nrog pawg H1-blockers, lossis cov tshuaj desensitizing, yog cov tshuaj npaj rau kev kho mob ntawm txhua yam kev ua xua hauv tus menyuam lub cev. Cov tshuaj muaj qhov txawv ntawm pawg no:
• Kuv tiam.
• II tiam.
• III tiam.
Tshuaj rau me nyuam - I tiam
Dab tsi yog cov tshuaj desensitizing? Lawv muaj npe hauv qab no:
• "Fenistil" - pom zoo rau cov menyuam yaus hnub nyoog qis dua ib hlis hauv daim ntawv tee.
• Diphenhydramine - tshaj xya lub hlis.
• "Suprastin" - tshaj ib xyoos. Txog li ib xyoos tsuas yog muab rau hauv daim ntawv txhaj tshuaj, thiab tsuas yog nyob rau hauv kev saib xyuas ntawm tus kws kho mob.
• "Fenkarol" - tshaj peb xyoos.
• "Diazolin" - tshaj ob xyoos.
• "Cleastin" - laus dua rau xyoo, tom qab 12 lub hlis. nyob rau hauv daim ntawv ntawm syrup thiab txhaj tshuaj.
• "Tavegil" - laus dua rau xyoo, tom qab 12 lub hlis. nyob rau hauv daim ntawv ntawm syrup thiab txhaj tshuaj.
Tshuaj rau menyuam yaus - II tiam
Cov tshuaj desensitizing feem ntau ntawm hom no yog:
• Zyrtec muaj hnub nyoog tshaj li rau lub hlis hauv daim ntawv poob thiab tshaj rau xyoo hauv daim ntawv ntsiav tshuaj.
• Claritin muaj hnub nyoog tshaj ob xyoos.
• Erius - tshaj li ib xyoos hauv daim ntawv syrup thiab tshaj kaum ob xyoos hauv daim ntawv ntsiav tshuaj.
Tshuaj rau menyuam yaus – III tiam
Desensitizing tshuaj ntawm hom no suav nrog:
• Astemizol - tshaj ob xyoos.
• "Terfenadine" - tshaj peb xyoos hauv daim ntawv ncua kev kawm thiab tshaj rau xyoo hauv daim ntawv ntsiav tshuaj.
Peb cia siab tias tsab xov xwm no yuav pab koj taug qab thiab xaiv txoj cai thaum xaiv cov tshuaj tiv thaiv kab mob rau menyuam yaus lub cev (thiab tsis yog xwb). Txawm li cas los xij, nws yuav tsum tau muab sau tseg tias ua ntej siv cov tshuaj no, nws yog ib qho tsim nyog yuav tsum tau nyeem cov lus qhia, ua tsaug rau cov lus nug: "Desensitizing tshuaj - nws yog dab tsi?". Koj yuav tsum nrhiav kev pab kho mob.
