Azathioprine yog ib yam tshuaj immunosuppressivesiv los kho ntau yam kab mob tiv thaiv kab mob los yog kab mob autoimmune hauv dev. Feem ntau, nws tsis yog siv los ua ib qho kev kho mob nkaus xwb, tab sis yog siv ntxiv rau lwm cov tshuaj tiv thaiv kab mob. Muab qhov hnyav ntawm qee qhov kev tsis zoo cuam tshuam nrog nws cov kev tswj hwm, nws yog ib qho tseem ceeb uas yuav tsum tau ua raws li kev tswj xyuas lub sijhawm thaum kho thiab tshem tawm cov tshuaj thaum twg pom muaj kev cuam tshuam loj heev.
Azathioprine yog dab tsi?
Azathioprine yog ib yam tshuaj tshuaj tiv thaiv kab mob siv los kho cov kab mob tiv thaiv kab mob los yog kab mob autoimmune. Nws yog ib qho synthetic analog of purine, uas ua rau nws cov tshuaj tiv thaiv kab mob los ntawm inhibiting DNA synthesis ntawm qib B thiab T lymphocytes. kev faib cov hlwb ntawm lub cev tiv thaiv kab mob thiab, yog li, hloov kho lub cev tiv thaiv kab mob.
Tam sim no, hauv Spain tsis muaj cov tshuaj kho tsiaj uas muaj azathioprine yog muag rau cov dev. Vim li no, thaum koj tus kws kho tsiaj txiav txim siab pib kho nrog azathioprine, lawv yuav tsum tau mus rau lub npe hu ua "cascade prescription", uas muaj cov tshuaj uas tsis tau tso cai rau ib hom tsiaj tshwj xeeb thaum muaj qhov sib txawv ntawm kev kho mob. Cov tshuaj hauv qhov ncauj (cov ntsiav tshuaj) feem ntau yog muab tshuaj thiab yog muag rau siv rau tib neeg.
Azathioprine siv rau dev yog dab tsi?
Azathioprine yog siv los kho kho cov kab mob tiv thaiv kab mob los yog kab mob autoimmune, uas yog cov uas lub cev tiv thaiv kab mob tawm tsam lossis rhuav tshem cov khoom ntawm lub cev. lub cev los ntawm kev lees paub lawv li txawv teb chaws.
Feem ntau, qhov chaw kho mob tsis pom 4-8 lub lis piam. Vim li no, azathioprine feem ntau yog siv ntxiv rau lwm cov tshuaj tiv thaiv kab mob (feem ntau corticosteroids) uas yog lub hauv paus ntawm kev kho mob. Ua li no, nws muaj peev xwm txo tau cov koob tshuaj ntawm cov tshuaj tseem ceeb thiab, nrog rau nws, cov txiaj ntsig tsis zoo cuam tshuam nrog kev siv tshuaj ntau thiab lawv siv ntev.
Azathioprine siv rau dev
Raws li peb tau piav qhia, azathioprine hauv dev yog siv los ua tshuaj tiv thaiv kab mob hauv kev kho mob ntawm cov kab mob tiv thaiv kab mob lossis kab mob autoimmune. Tshwj xeeb tshaj yog, nws feem ntau yog muab rau kev kho mob ntawm cov kab mob hauv qab no tiv thaiv kab mob hauv cov dev:
- Immune-mediated hemolytic anemia
- Immune-mediated thrombocytopenia
- Immune-mediated meningoencephalitis
- Pemphigus foliaceus
koob tshuaj azathioprine hauv dev
koob tshuaj azathioprine hauv cov dev feem ntau sib txawv thaum kho. Tshwj xeeb, cov txheej txheem kho mob rau azathioprine hauv dev feem ntau yog raws li hauv qab no:
- .
- Thaum qhov txhab mob los yog cov tsos mob tswj tau, nws tuaj yeem muab tshuaj txhua hnub.
- Nyob rau lub sij hawm ntev, cov koob tshuaj tuaj yeem txo mus rau 0.5-2 mg ib kg ntawm lub cev hnyav txhua 72 teev.
Azathioprine phiv hauv dev
Azathioprine yog ib qho tshuaj tiv thaiv kab mob uas nquag siv los kho cov kab mob tiv thaiv kab mob hauv cov dev, txawm li cas los xij, nws siv tsis raug zam los ntawm qhov tshwm sim tsis zoo.
Hauv qab no, peb sau cov txiaj ntsig tseem ceeb ntawm azathioprine hauv dev:
- Medullary aplasia (myelotoxicity): ploj ntawm cov pob txha pob txha ua lub luag haujlwm tsim cov qe ntshav (cov qe ntshav liab, cov qe ntshav dawb thiab platelets.). Raws li qhov tshwm sim, ntshav ntshav (cov qe ntshav liab tsawg), leukopenia (cov qe ntshav dawb txo qis) lossis thrombocytopenia (cov platelets tsawg) tuaj yeem tshwm sim.
- Digestive signs: raws plab, ntuav thiab anorexia.
- :: nws cov tshuaj tiv thaiv kab mob ua rau lub cev tsis muaj kev tiv thaiv kab mob, yog li ua rau muaj kev kis kab mob thib ob
- Pancreatitis: nrog nce pancreatic amylase thiab lipase
Tam Sim Ntshav (HepatoToxicity (Hepatotoxicity)
Muab cov myelotoxic thiab hepatotoxic muaj peev xwm ntawm azathioprine, nws raug nquahu kom nqa tawm tshuaj tiv thaiv kab mob hematological thiab biochemicalThaum pib kho lawv. yuav tsum tau ua kev soj ntsuam txhua 2-4 lub lis piam, thiab tom qab ntawd txhua 3 lub hlis. Thaum twg qhov kev hloov pauv tau pom nyob rau hauv cov kev tswj niaj hnub, kev kho mob yuav tsum tau muab tshem tawm.
Azathioprine contraindications hauv dev
Muaj qee qhov xwm txheej uas kev tswj hwm ntawm cov tshuaj tiv thaiv kab mob no yuav ua rau muaj kev cuam tshuam. Tshwj xeeb, cov contraindications rau azathioprine yog:
- Allergy to azathioprine, to mercaptopurine (ib qho metabolite ntawm azathioprine) los yog rau ib qho ntawm cov excipients muaj nyob rau hauv cov tshuaj.
- Pancreatitis.
- Pregnancy: vim nws yog teratogenic thiab embryotoxic compound.
- Vaccination: Cov tshuaj tiv thaiv yuav tsum tsis txhob muab tshuaj thaum kho vim cov tshuaj yuav cuam tshuam rau qhov ua tau zoo ntawm kev txhaj tshuaj.
Ntxiv rau, nws tseem ceeb heev uas koj yuav tsum qhia rau koj tus kws kho tsiaj txog lwm yam kev kho mob uas koj tus dev yuav tau txais, txhawm rau zam qhov kev pheej hmoo cuam tshuam nrog qee yam drug interactions. Tshwj xeeb, azathioprine tuaj yeem cuam tshuam nrog:
- Xanthine oxidase inhibitors: xws li allopurinol.
- Anticoagulants: xws li warfarin.
- Lwm cov tshuaj tiv thaiv kab mob: xws li cyclosporine lossis tacrolimus.
- ACEIs (Angiotensin Converting Enzyme Inhibitors): xws li enalapril lossis benazepril.
- Aminosalicylates: xws li sulfasalazine.
