Corticosteroids yog cov tshuaj siv los kho ntau yam pathologies hauv veterinary tshuaj. Lawv muaj zog tiv thaiv kab mob thiab tiv thaiv kab mob ua rau lawv cov tshuaj muaj txiaj ntsig zoo rau kev kho cov kab mob ua xua thiab inflammatory, autoimmune thiab tiv thaiv kab mob, thiab lwm yam. Txawm li cas los xij, nws yuav tsum raug coj mus rau hauv tus account tias nws siv tsis raug zam los ntawm cov tsos mob tshwm sim uas, txawm hais tias pom tau, tsis tuaj yeem zam tau.
Yog koj xav paub ntau ntxiv txog corticosteroids rau dev, tsis txhob nco cov lus hauv qab no ntawm peb qhov chaw uas peb tham txog hom, ntau npaum li cas thiab cov kev mob tshwm sim ntawm cov tshuaj no.
corticosteroids rau dev yog dab tsi?
Ua ntej hais txog ntau hom corticosteroids rau dev, peb yuav tsum piav qhia tias lawv yog dab tsi thiab lawv txoj haujlwm yog dab tsi. Corticosteroids yog cov tshuaj zoo sib xws rau corticosteroids lossis endogenous corticosteroids, uas yog, lawv yog cov khoom tsim tawm los ntawm cov tshuaj uas mimic cov nyhuv ntawm cov tshuaj hormones corticosteroids ua los ntawm lub cev ntawm dev.
Tam sim no, corticosteroids siv rau dev dab tsi? Tom ntej no, peb pom ntau hom thiab lawv siv hauv cov tsiaj no.
Cov tshuaj corticosteroids rau dev thiab lawv siv
Muaj ob pawg ntawm endogenous corticosteroids: glucocorticoids thiab mineralocorticoids. Txhua tus ntawm lawv muaj lub luag haujlwm, yog li peb yuav pom hauv qab no dab tsi corticosteroids rau dev yog nyob ntawm hom:
Glucocorticoids rau dev
Cov neeg sawv cev tseem ceeb ntawm glucocorticoids yog cortisol, hu ua "kev ntxhov siab hormone". Cov tshuaj no yog tsim nyob rau theem ntawm lub cortex ntawm cov qog adrenal, tshwj xeeb tshaj yog nyob rau hauv lub fascicular cheeb tsam, thiab nws synthesis yog tswj los ntawm lub Hypothalamic-Pituitary-Adrenal axis, yog li ntawd thaum cortisol theem nyob rau hauv cov ntshav nce, lub axis thiab nres. synthesis ntawm no hormone.
Cov tshuaj corticosteroids feem ntau siv hauv cov tshuaj kho tsiaj, suav nrog prednisone, hydrocortisone los yog dexamethasone, muaj cov glucocorticoid ntau dua li cov tshuaj mineralocorticoid.
Glucocorticoids yog cov tshuaj uas ua haujlwm thoob plaws lub cev. Lawv yog cov tshuaj siv ntau tshaj plaws hauv cov tshuaj kho tsiaj vim lawv ob lub ntsiab lus:
- Lawv yog cov muaj zog tiv thaiv kab mob: txij li thaum lawv inhibit phospholipase A2 thiab, yog li ntawd, tiv thaiv kev tsim cov inflammatory mediators xws li prostaglandins, prostacyclins. thiab thromboxanes. Qhov no ua rau lawv cov tshuaj muaj txiaj ntsig zoo rau kev kho mob ntawm kev tsis haum tshuaj thiab cov txheej txheem inflammatory.
- Lawv yog cov tshuaj tiv thaiv kab mob: thaum siv cov koob tshuaj ntau, cov tshuaj tiv thaiv kab mob tau ua tiav los ntawm kev hloov pauv kev ua haujlwm ntawm lymphocytes thiab macrophages thiab inhibiting cov tshuaj tiv thaiv kab mob. synthesis ntawm interferon gamma thiab txawv interleukins. Yog li ntawd, lawv tau qhia rau kev kho mob ntawm cov kab mob autoimmune, cov kab mob tiv thaiv kab mob thiab cov neoplasias.
Mineralocorticoids rau dev
Nws tus neeg sawv cev tseem ceeb yog aldosterone. Ib yam li ntawd, cov tshuaj no yog synthesized nyob rau hauv lub adrenal cortex, tab sis nyob rau theem ntawm lub zona glomerulosa. Hauv qhov no, nws cov synthesis yog tswj los ntawm Renin-Angiotensin-Aldosterone axis.
Txawm li cas los xij, raws li peb tau hais, feem ntau cov tshuaj corticosteroid muaj cov nyhuv glucocorticoid ntau dua, kuj tseem muaj cov tshuaj uas muaj cov tshuaj mineralocorticoid predominates, ib yam li cov ntaub ntawv fludrocortisone los yog cov deoxycorticosterone deprived Cov tshuaj no tso cai rau tswj cov hydroelectrolyte tshuav nyiaj li cas hauv cov tsiaj uas tsis muaj aldosterone, lub ntuj mineralocorticoid.
Txawm li cas los xij, nws yuav tsum nco ntsoov tias corticosteroids yog cov kev kho mob, uas yog, lawv pab tswj cov tsos mob. nrog qee yam pathologies, tab sis tom qab kev tswj hwm ntawm cov tshuaj tiav lawm, cov kab mob hauv qab yuav rov tshwm sim vim qhov tshwm sim tsis tau kho.
koob tshuaj corticosteroids rau dev
Raws li peb tau piav qhia, corticosteroids yog cov tshuaj uas muaj cov tshuaj tiv thaiv kab mob ntawm cov koob tshuaj nruab nrab thiab cov tshuaj tiv thaiv kab mob ntawm cov koob tshuaj siab.
koob tshuaj corticosteroids rau cov dev yuav nyob ntawm cov khoom xyaw uas tau sau tseg. Txawm li cas los xij, hauv txhua qhov xwm txheej hauv qab no yuav tsum ua raws li cov txheej txheem corticotherapy:
- Induction theem: koob tshuaj corticosteroids yog siv los tswj tus kab mob. Cov theem no tuaj yeem nyob ntawm hnub mus rau lub lis piam.
- : koob tshuaj maj mam txo kom txo tau cov kev mob tshwm sim tsis zoo thiab txo tus nqi kho. Cov theem no yuav siv sij hawm ntau lub lis piam mus rau hli.
- Maintenance phase: nyob rau theem no, lub hom phiaj yog los tswj cov koob tshuaj yam tsawg kawg nkaus, uas yog, koob tshuaj uas tso cai tswj tus kab mob. thiab txo qhov tshwm sim ntawm qhov tsis zoo tshwm sim.
- Tshuaj tshem tawm: Thaum tswj cov tsos mob tshwm sim los yog tus kab mob kho tau, kev kho mob yuav tsum tau muab tshem tawm. Lub hom phiaj ntawm theem no yog txo cov koob tshuaj corticosteroids zuj zus mus txog thaum nws sib npaug rau qib ntawm endogenous corticosteroids uas tus tsiaj tau ua ntej kho. Txhawm rau tshem tawm kev kho mob nrog corticosteroids, nws yog ib qho tseem ceeb uas yuav tsum tau ua raws li cov txheej txheem nruj, vim tias lwm yam, kev phom sij rau tus neeg mob noj qab haus huv yuav tshwm sim. Tom ntej no, peb piav qhia yuav ua li cas tshem tawm kev kho corticosteroid hauv dev.
Yuav ua li cas tshem corticosteroid kho cov dev?
Txhawm rau nkag siab qhov tseem ceeb ntawm kev tshem tawm cov tshuaj corticosteroid, peb yuav tsum rov hais dua txog Hypothalamus-Pituitary-Adrenal axis (HHA axis). Raws li peb tau piav qhia thaum pib ntawm tsab xov xwm, qhov axis no yog lub luag haujlwm rau kev tswj cov synthesis ntawm endogenous corticosteroids hauv lub cev. Thaum peb muab corticosteroids exogenously, muaj kev nce hauv cov ntshav, uas inhibits axis thiab tiv thaiv cov qog adrenal los ntawm synthesizing endogenous corticosteroids. Ntawd yog, thaum kho nrog corticosteroids, , cov ntshav txaus txaus.
Kev nkag siab txog cov txheej txheem no yog qhov tseem ceeb thaum ua kom raug tshem tawm ntawm kev kho corticosteroid. Yog hais tias a Tw yuav tshwm sim.
Txhawm rau tiv thaiv qhov kev tshem tawm no tsis tshwm sim, nws yog ib qho tseem ceeb rau txo cov koob tshuaj maj mam txhawm rau txhawb kev rov ua haujlwm ntawm cov qog adrenal.
- Nyob rau hauv cov kev kho mob luv luv (tsawg dua 9 hnub): koob tshuaj yuav raug txo ob hnub kawg kom tsis txhob muaj qhov tshwm sim. kev phem.
- Nyob rau hauv kev kho mob mus sij hawm ntev (ntau tshaj li ob lub lis piam): thaum nws txiav txim siab thim qhov kev kho mob, koob tshuaj yuav txo qis. ib nrab txhua lub lim tiam kom txog rau thaum lub cev muaj zog ntawm corticosteroids mus txog. Tom qab ntawd, kev kho mob yuav txuas ntxiv mus rau lwm hnub kom txog thaum kawg tshem tawm cov tshuaj corticosteroids yam tsis muaj kev pheej hmoo ntawm cov teebmeem tshwm sim.
Kev mob tshwm sim ntawm corticosteroids hauv dev
Corticosteroids yog cov tshuaj uas siv tau rau txhua qhov chaw ntawm lub cev, uas ua rau lawv muaj txiaj ntsig zoo rau kev kho mob ntau yam pathologies. Txawm li cas los xij, tus yam ntxwv zoo ib yam no txhais tau tias lawv kuj yog tshuaj nrog Tag nrho cov kev tswj hwm ntawm corticosteroids inherently entails qhov kev nthuav qhia ntawm kev phiv tshuaj uas, txawm hais tias foreseeable, yog tsis zam. Txawm li cas los xij, kev tswj xyuas qhov tseeb ntawm cov tshuaj no ua rau nws muaj peev xwm txo tau cov txiaj ntsig tsis xav tau thiab yog li ua tiav qhov sib npaug ntawm kev tswj kab mob thiab qhov tshwm sim ntawm qhov tshwm sim tsis zoo.
Hauv qab no, peb piav qhia cov kev mob tshwm sim tseem ceeb cuam tshuam nrog kev kho corticosteroid hauv dev:
- Steroidal daim siab: Glucocorticoids tsim cov nyhuv anabolic ntawm carbohydrates, uas txhais tau hais tias lawv nyiam tsim cov piam thaj thiab nws cia li glycogen hauv. lub siab. Qhov kev txuam ntawm ntau dhau ntawm glycogen hauv daim siab ua rau muaj qhov loj ntawm lub cev, uas yog hu ua hepatomegaly. Txawm li cas los xij, nws yog ib qho tseem ceeb kom paub tias qhov kev hloov pauv no tsis ua rau lub siab tsis ua haujlwm thiab qhov xwm txheej rov qab los thaum kho corticosteroid raug tshem tawm.
- Hyperglycemia: Raws li qhov tshwm sim ntawm nws cov nyhuv anabolic ntawm carbohydrates, muaj qhov nce hauv cov ntshav qabzib (hyperglycemia). Lawv suav hais tias yog cov tshuaj diabetogenic vim tias lawv cov thawj coj ua rau muaj cov tsos mob ntawm cov ntshav qab zib, xws li polyphagia, polydipsia thiab polyuria.
- Cov leeg tsis muaj zog: Tsis zoo li qhov tshwm sim nrog cov carbohydrates, corticosteroids tsim cov nyhuv catabolic ntawm cov protein, uas yog, uas yog, lawv nyiam tawg. cov molecules cia kom tau lub zog ntawm lawv. Vim li no, lawv ua rau cov leeg tsis muaj zog, uas tshwm sim los ntawm lub plab pendulous thiab cov tsos mob ntawm kev ua pa nyuaj, xws li gasping lossis tachypnea.
- Cov tshuaj tsis zoo hauv plab hnyuv: nyob rau hauv lub plab zom mov, lawv txo qis cov hnoos qeev thiab inhibit qhov kev rov ua dua tshiab ntawm epithelium, uas txhawb kev nthuav qhia. ntawm gastrointestinal ulcers. Tsis tas li ntawd, thaum siv cov tshuaj tiv thaiv kab mob, lawv ua rau pom cov kab mob raws plab.
- Dermatological adverse reactions: nyob rau hauv nruab nrab thiab ntev kev kho mob, tawv nqaij tawv, symmetrical thaj chaw ntawm alopecia, tsos ntawm bruising vim cov leeg tsis muaj zog thiab ncua kev kho mob. Tsis tas li ntawd, qhov tsos ntawm Calcinosis cutis yog nquag, dystrophic calcification nyob rau theem ntawm cov dermis uas tshwm sim nws tus kheej nrog daim tawv nqaij lesion nyob rau hauv daim ntawv ntawm ib tug crusty plaque.
- Kab mob: 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, uas tuaj yeem cuam tshuam rau ntawm daim tawv nqaij, urinary tract los yog gastrointestinal system.
- Hypertension: Los ntawm kev txhawb nqa cov poov tshuaj thiab dej reabsorption, thiab txhawb kev tso tawm ntawm cov poov tshuaj, nws nce ntshav siab.
- Cwj pwm hloov: tuaj yeem muaj kev nyuaj siab mus rau xeev excitability lossis nervousness.
Contraindications ntawm corticosteroids hauv dev
Paub txog cov kev mob tshwm sim tseem ceeb cuam tshuam nrog kev kho corticosteroid hauv dev, nws yuav yooj yim rau peb kom nkag siab txog cov xwm txheej tseem ceeb uas lawv cov kev tswj hwm tsis zoo.
Hauv qab no, peb sau lub ntsiab contraindications ntawm corticosteroids rau dev:
- Bacterial, viral, fungal or parasitic infections: vim nws cov tshuaj tiv thaiv kab mob.
- Dabetes mellitus: vim lawv nce ntshav qabzib ntau ntau.
- Ulcers (ob leeg pob txha thiab plab plab ulcers, nrog rau daim tawv nqaij ulcers): vim lawv qeeb kho.
- Glaucoma: vim lawv ua rau lub siab mob ntsws los ntawm kev hloov cov kua dej ntawm kev lom zem.
- Hyperadrenocorticism los yog Cushing's Syndrome: txij li qib corticosteroid nce.
- Puppies: vim lawv muaj peev xwm stunt loj hlob.
- Pregnancy: Tej zaum yuav ua rau fetal txawv txav, nchuav menyuam, los yog yug ntxov ntxov.
- Lactation: thaum tso tawm hauv cov mis nyuj, lawv tuaj yeem cuam tshuam kev loj hlob ntawm lactating menyuam dev.
- Cov laus los yog cov dev tsis noj nqaij: vim nws cov nyhuv catabolic ntawm cov proteins.
- Ua xua rau cov khoom xyaw nquag, rau lwm cov tshuaj corticosteroids lossis cov tshuaj excipients.
Yog cov tshuaj no siv tsis tau, muaj lwm txoj hauv kev uas tus kws tshaj lij yuav tsum tau soj ntsuam. Peb tham txog lawv hauv kab lus no: "Lwm txoj rau corticosteroids hauv dev".
