THEasthma kazhinji iri chirwere chisingaperi izvo zvinoda kurapwa nguva dzose, kunyange pakati pekurwisa. The Pharmaceuticals kudzora asima haipe mushonga chaiwo. Vanoita kuti kufema kuve nyore nekuwedzera kuvhura kwebronchi (bronchodilation) uye kuderedza kuzvimba. Vazhinji vavo vanobatwa inhalation, iyo inovabvumira kuita nokukurumidza, nemigumisiro shoma inobvira. Chiremba anoedzawo kupa diki diki remushonga wekudzora zviratidzo nekukwanisa kushivirira kwekurapa.

Asi zvisinei nekubudirira kwekurapa, vatanhatu mugumi vanhu vane asima vanotadza kudzora avo zviratidzo. Zvinonyanya kukonzera kusanzwisisa kwechirwere, kutya Zvikanganiso uye kukanganwa mishonga. Nekudaro, mhedzisiro yekurapwa kunotorwa nekufemerwa ishoma kana ichienzaniswa nenjodzi dzinosangana nekukasira uye kunowanzo kurwisa asima.

• Metered aerosols. Iwe unofanirwa kuzunza aerosol zvakanaka uye kuibata yakamira. Mushure mokubvisa zvishoma nezvishoma mumapapu, femera mukati zvishoma nezvishoma uye zvakadzama kuburikidza nemuromo wako, zvichikonzera aerosol panguva yekutanga yechipiri yekufemerwa. Unofanira kubata kufema kwako kwemasekonzi mashanu kusvika gumi, wofemera kunze zvishoma nezvishoma.
• Dry powder inhalers (semuenzaniso: Turbuhaler®). Aya masisitimu ari nyore kushandisa nekuti haadi kurongedza kufemerwa uye kukonzeresa. Iwe unofanirwa kufemesa zvakaoma uye nekukurumidza sezvinobvira, kudzivirira kufema kwako kwemasekonzi gumi uye exhale kunze kweiyo inhaler.
• Inhalation chambers. Izvo zvinoshandiswa ne metered dose inhaler muvana vari pasi pemakore masere uye vakwegura. Muvana vadiki, inhalation inoitwa nemaski kumeso, iyo inofanirwa kuchengetwa pachiso kweinenge 8 kufema kwakadzikama.

Vanhu vane asthma vari kuwedzera kudanwa kuti vatarise mamiriro avo ekufema. Somuenzaniso, vanhu vane asima yakaoma, vanogona kuyera peak yavo yekubuda kwekufema kumba (peak flow) kuitira kuti vagadzirise kurapwa kwavo pachavo maererano nemigumisiro. Kudzidzira kunofanira kunge kwakamboitwa.

Pharmaceuticals

Pane 2 zvikamu zve Pharmaceuticals kudzora zviratidzo zveasthma. Wekutanga, akadanwa dambudziko kana kununura mishonga, inofanira kutorwa kana zviratidzo. Vane chiito chekuyamura pakarepo, asi usadzikamisa kuzvimba kwebronchi.

Mimwe mishonga ndeye kudzora kana kurapwa kwemashure. Dzinofanirwa kutorwa zuva rega rega, kunyangwe pasina kugadzikana kwekufema nekukurumidza kana asima iri pakati nepakati uye inoramba iripo. Vanoita kuti zvibvirire kuderedza kuzvimba kwebronchi uye kuisa nzvimbo kunze kwekurwiswa. Kana ikasatorwa nguva dzose, kuwanda uye kuoma kwekurwiswa kunowedzera, sezvinoita kudiwa kwemishonga yekununura.

Dambudziko (kana kununura) kurapwa

Mishonga yeCrisis inorehwa nemashoko akasiyana, kusanganisira bronchodilators kukurumidza kuita kana beta2 agonists kuita pfupi. Zvinoshandiswa chete kubvisa zviratidzo zvekurwiswa (kukosora, kusimba kwechipfuva, kufema uye kupfupika kwekufema) kana usati waita maekisesaizi muasthma pakuita nhamburiko. Mune yakapfava, inopindirana asima, pfari kurapa inogona kunge iri iyo yega mishonga inodiwa.

Mishonga iyi inosanganisira salbutamol (Ventoline®, Ventilastin®, Airomir®, Apo-Salvent®, Novo Salmol®) kana terbutaline (Bricanyl®). Vanotorwa nekufemerwa uye vanowedzera nzira dzemhepo nekukurumidza, 1 kusvika kumaminitsi matatu. Kune mashoma emhedzisiro kana akashandiswa nguva nenguva, asi muhuwandu hwepamusoro anogona kukonzera kudedera, kutya uye kukurumidza kurova kwemoyo. Kana iwe uchinzwa kudiwa kwekuitora kazhinji (kazhinji kanopfuura katatu pavhiki), zvinoreva kuti asima haina kudzorwa zvakakwana. Izvo zvino zvakafanira kutendeukira kune kumashure zvinodhaka kurapa kuzvimba.

Ipratropium bromide inhalation (kashoma). Iyo anticholinergic inovhara kuita kwekemikari inokonzeresa mhasuru mumhepo kuti iite chibvumirano. Isingashande pane inhaled beta2 agonists, dzimwe nguva inoshandiswa mumamiriro ekusashivirira kwavari. Zvinotora 1 kusvika 2 maawa kuti hukuru hushande.

Mishonga sechinhu chakakosha (kutonga) kurapwa

Kusiyana nemishonga yekugumburwa kana mishonga yekununura, DMARDs (kudzora) mishonga haibvisi zviratidzo pakarepo. Dzinoshanda zvishoma nezvishoma uye dzinoshanda kwenguva refu mukuderedza kuzvimba uye kuwanda kwekubatwa. Ndicho chikonzero nei zvakakosha kuvatora zuva nezuva.

Corticosteroids. Corticosteroids inoderedza kuzvimba kwemhepo uye nekudaro kugadzirwa kwemukasi. Vanowanzo kutorwa mudiki semushonga wekufema (spray), zuva nezuva (semuenzaniso, Alvesco® uye Pulmicort®). Chiremba anorondedzera yakaderera inoshanda dose inobvira. Anogonawo kutorwa semapiritsi muasthma yakaoma kwenguva pfupi yemazuva mashoma (muenzaniso: prednisolone, methylpredinosolone). Ingave yakatorwa nekufemesa kana mumapiritsi, anoshanda nenzira imwechete, asi inhalation inobvumira madosi akadzikira, chiitiko chenzvimbo uye nekudaro mhedzisiro shoma. Kirasi iyi yemishonga ndiyo inonyanya kushanda mukudzora asima. Mhedzisiro yavo inonzwika mushure memazuva mashoma ekushandiswa.

Kuchinja kwakashata

Kutorwa nekufemesa uye mune pakati nepakati dosi, corticosteroids kuva nemigumisiro shoma, kunyange kana yakatorwa kwenguva yakareba. Kukoira neshungu kana kutaridzika kwe Ruva remupata (kana kuti candidiasis, inokonzerwa nembiriso inogadzira zvigamba zvichena parurimi) ndiyo inowanzokonzera migumisiro. Naizvozvo, iwe unofanirwa kugezesa muromo wako mushure mekufema muyero wega wega. Mapiritsi eCorticosteroid ane simba renguva refu yemigumisiro (kupera simba kwemapfupa, kuwedzera kwengozi yecataract, nezvimwewo). Vanochengeterwa zviitiko zveasthma yakanyanya, yakabatana nemamwe marapirwo.

Inoita kwenguva refu bronchodilators. Izvi zvinorayirwa pamwe chete kana inhaled corticosteroids chete haina kukwana kudzora zviratidzo zveasthma. The beta2 agonists kushanda kwenguva refu kunokonzera bronchodilation kwemaawa gumi nemaviri. Kubudirira kwavo kunogona kukurumidza mumaminetsi matatu kusvika mashanu se formoterol® (ex Foradil®, Asmelor®) kana inononoka mushure memaminitsi gumi nemashanu senge salmeterol (Serevent®). Iyo inoshandiswa pamwe chete ne corticosteroid. Kune ma inhalers anosanganisa marudzi maviri emishonga seSeretide® (fluticasome/salmeterol). Kusanganiswa ne formoterol (Symbicort®, Innovair® uye Flutiform®) inogonawo kushandiswa semushonga wekununura, kunyange zvazvo vanoitawo pakuzvimba kwenguva refu.

Antileukotrienes. Kutorwa nemuromo, vanoderedza kuzvimba kunokonzerwa neleukotrienes, zvinhu zvinobatsira kumhinduro yekuputika.MuFrance, antileukotrienes inowanikwa: montelukast (Singulair®). MuCanada, kune zvakare lezafirlukast (Accolate®). Inogona kushandiswa yoga kana kusanganiswa ne inhaled corticosteroids. Zvinoratidzwa kudzivirira asima pakurovedza muviri, munyoro asthma, kune vanhu vane asima isingadzorerwe ne inhaled corticosteroids chete, uye kune avo vanoshandisa zvisizvo spray yavo.

Theophylline. Ndiyo yekare yebronchodilators (semuenzaniso: Theostat®). Iyo isingawanzo shandiswa nhasi, nekuti inoshanda dosage isina mhedzisiro yakaoma kuwana. Inogona kurongedzerwa sehwendefa yekutora nekudya kwemanheru kune vanhu vane dambudziko rekutora sprays.

Anti-immunoglobulin E. Iri kirasi yemishonga inoitirwa kurapa yakanyanya allergic asthma muvanhu vane asima yakaoma kudzora nemamwe marapirwo. Omalizumab (Xolair®) ndiyo chete mushonga mukirasi ino unowanikwa muna 2015. Inoitwa se subcutaneous jekiseni kamwe kana kaviri pamwedzi.

Mafungiro achiremba, Dr Annabel Kerjan pulmonologist:

Kana munhu aine asima, haafanire kubvuma kuve nezviratidzo pasina chaaita. Iwe haufanirwe, semuenzaniso, kushivirira kupfupika kwekufema, chidiki chikosoro, kunetseka kufema usiku. Chirwere chacho hachifaniri kubvumirwa kushanduka, nokuti kana tikaneta nacho pasina kuchirapa, nokuti chinogona kuderedza bronchi nekufamba kwenguva, zvichiita kuti kuwedzere kusingagumi kwezviratidzo, uye mumamiriro ezvinhu akaoma kazhinji zvirwere zvechipiri uye kuchipatara. Zviri nani kuwana nachiremba wako mushonga unoshanda zvishoma.

Izvi zvinonyanya kukosha kuvabereki vevana vane asima. Vanowanzozeza kupa vana vavo mishonga uye izvi zvinonzwisisika. Asi munyaya iyi, vanenge vasina kururama. Vana ava vanofanirwa kupihwa mukana wekuvandudza mari yavo yekufema zvakanaka kuitira kuti iwanikwe mukukura. Uye zvino, mwana ane zviratidzo zvekusarapwa asthma anorara zvisina kunaka, ane dambudziko mumitambo uye anokura zvishoma. Nepo nekurapa, anonzwa zviri nani uye anochengetedza bronchi yake yeramangwana.