Ndị ọrụ Glucocorticoid > Ọgwụgwọ na mgbochi

Usoro nke GCS nwere njikọ na ike ha na ndị na-anabata ihe dị na cytoplas nke sel: steroid - ogige nnabata banye n’ime sel, na-ejide DNA, na-emetụta ntụgharị nke mkpụrụ ndụ ihe nketa dị ukwuu, nke na-eduga na mgbanwe na mkpokọ nke protein, enzymes, nucleic acid. GCS na-emetụta ụdị metabolism niile, nwee ọgwụ mgbochi mkpali, mgbochi mkpali, mgbochi ụjọ na mmetụta immunosuppressive.

Usoro nke ihe mgbochi mbufụt corticosteroids bụ ime ka ọrịa niile ghara ịgwụ. Site na idozi oghere dị na sel cellular na subcellular, incl. Lysis, ọgwụ mgbochi steroidal na-egbochi mwepụta nke enzymes proteolytic site na ụlọnga, na-egbochi nguzobe nke oxygen oxygen na peroxides lipid na membranes. N'iburu n'uche mbufụt, corticosteroids na-egbochi obere arịa ma belata ọrụ nke hyaluronidase, si otú a na-egbochi usoro ịtụgharị egwu, gbochie ntinye nke neutrophils na monocytes na vaskụla endothelium, na-amachi oghere ha na akwara, belata ọrụ nke macrophages na fibroblasts.

N'ime mmezu nke mmetụta mgbochi-ọgụ, a na-arụ ọrụ dị mkpa site na ike nke GCS iji gbochie njikọta na ntọhapụ nke ndị mgbasa ozi mkpali (PG, histamine, serotonin, bradykinin, wdg). Ha na - eme ka njikọ nke lipocortins, na - egbochi phospholipase A2 biosynthesis, ma belata nguzobe nke COX-2 na - elekwasị anya na mbufụt. Nke a na - eduga na mwepụta nke arachidonic acid sitere na phospholipids nke membranes cell ma nwee mbelata nguzobe nke metabolites ya (PG, leukotrienes na platelet na-arụ ọrụ).

GCS nwere ike igbochi usoro ịgbatị, n'ihi ha na - egbochi ọnya nke monocytes n’ime anụ ahụ na - egbu egbu, na - egbochi ikere òkè n’oge a, igbochi njikọ nke mucopolysaccharides, protein na igbochi usoro nke lymphopoiesis. Site na mbufụt nke mkpụrụ ndụ ihe na - efe efe nke corticosteroids, nyere ọnụnọ nke immunosuppressive utịp, ọ bụ ihe amamihe dị na ikpokọta yana ọgwụ mgbochi ọgwụ.

Mmetụta immunosuppressive nke GCS bụ n'ihi mbelata ọnụ ọgụgụ na ọrụ nke T-lymphocytes na-ekesa n'ime ọbara, mbelata mmepụta nke immunoglobulins na nsonaazụ nke ndị na-enyere aka na B-lymphocytes, mbelata nke ihe ndị mejupụtara n'ọbara, nhazi nke ihe mgbochi alụkwaghịm na ọnụ ọgụgụ mgbochi introukation nke mgbochi .

Mmetụta antiallergic nke corticosteroids bụ n'ihi mbelata ọnụọgụ basophils, mmebi nke nnabata nke Fc ndị na-anabata ihe dị na sel nke mast na mpaghara Fc nke IgE na akụkụ C3 nke mmeju, nke na-egbochi mgbanaka ịbanye na cell ma soro yana mbelata na iwepụta ọgwụ histamine, heparin, na seitiin na ndị mgbasa ozi mgbasasị ọzọ nke ụdị ozugbo ma gbochie mmetụta ha na mkpụrụ ndụ na-eme ihe.

Mmetụta antishock bụ n'ihi ntinye nke GCS na nhazi nke ụda olu, megide nzụlite ha, mmata nke arịa ọbara na catecholamines na-abawanye, nke na-eduga n'ịbawanye mgbali ọbara, mgbanwe metabolism mmiri, sodium na mmiri, mmiri plasma na-abawanye ma hypovolemia belata.

Ndidi na nsonaazụ

Otu ọgwụ a na - akpatakarị nsonaazụ ndị ọzọ: nrụgide nke arụ ọrụ nke anụ ahụ, iwepụ ọrịa na - efe efe na - adịghị ala ala na ọrịa eriri afọ. Site n'iji ogologo oge, mmụba nke ọbara mgbali, mmepe nke ọrịa shuga steroid, edema, adịghị ike akwara, myocardial dystrophy, syndenis-Cushing's syndrome, adrenal atrophy kwere omume.

Mgbe ụfọdụ, mgbe ị na-a drugsụ ọgwụ ọjọọ, enwere nsogbu, ụra na-adịghị mma, ịba ụba intracranial pressure, psychosis. Site na iji GCS eme ihe ogologo oge, enwere ike ịnwe nrụpụta ọkpụkpụ na calcium-phosphorus metabolism, nke na-eduga na njedebe oge ogbu na nkwonkwo.

Ihe ngbanwe

Hypersensitivity.
Ọrịa siri ike.
Ọrịa virus na fungal.
Ọrịa ụkwara ume ọkụ.
Ọrịa AIDS
Peptic ọnya, afọ na-agba ọbara.
Formsdị ọbara ọgbụgba siri ike.
Itsenko-Cushing's syndrome.
Jade
Syphilis
Ọrịa shuga mellitus.
Osteoporosis
Ime
Ara.
Nnukwu psychoses.
Mụaka.

Mgbe etinyere topically:

Ọrịa (nje, nje, fungal) ọnya nke anụ ahụ na akpụkpọ ahụ mucous.
Azụ anụahụ.
Imebi iguzosi ike n’ezi ihe nke akpụkpọ ahụ na akpụkpọ anụ mucous.
Mụaka.

Mmekorita

GCS welie mmetụta bronchodilating nke β-adrenostimulants na theophylline, belata mmetụta hypoglycemic nke insulin na ọgwụ antidiabetic, ọrụ anticoagulant nke coumarins (anticoagulants na-apụtaghị ìhè).

Diphenin, ephedrine, phenobarbital, rifampicin na ọgwụ ndị ọzọ na-ebute ntinye nke enzymes imeju microsomal na-ebelata T1 / 2 GCS. Homonụ na-eto uto na antacids na-ebelata nnabata nke corticosteroids. Mgbe ejikọtara ya na glycosides na akwara obi, ihe ize ndụ nke arrhythmias na hypokalemia na-abawanye, mgbe ejikọtara ya na NSAIDs, ihe ize ndụ nke mmebi eriri afọ na ntanetị nke ọbara ọgbụgba na-abawanye.

Usoro ihe eji eme ya na ihe ndi ozo na achota ogwu

Glucocorticoids na-agbasa gafere akpụkpọ ahụ n'ime cytoplasm ma jikọtara ya na ndị na-anabata glucocorticoid kpọmkwem. Ihe ndị mepụtara na-arụ ọrụ na-abanye n'ime akwara etiti ma na-akpali nguzobe nke i-RNA, nke na-eduga na njikọ nke ọtụtụ protein na-achịkwa. Ọtụtụ ihe ndị na - arụ ọrụ ihe ọkụkụ (catecholamines, ndị mgbasa ozi mkpasu iwe) nwere ike mejupụta ogige glucocorticoid-receptor, ma si otú a belata ọrụ glucocorticoids. Isi mmetụta nke glucocorticoids bụ ndị a.

• Mmetụta n’usoro ahụ ji alụso ọrịa ọgụ.

- Mmetụta mgbochi mkpali (ọkachasị na-arịa ọrịa na ụdị mmerụ ahụ) n'ihi nsị nke PG, RT na cytokines, belata ikike isi ike, belata chemotaxis nke mkpụrụ ndụ immunocompetent na mgbochi nke ọrụ fibroblast.

- Mwepu nke mgbochi sel, mmeghachi omume autoimmune n'oge mmegharị ahụ, mbelata ọrụ nke T-lymphocytes, macrophages, eosinophils.

• Mmetụta na metabolism mmiri-electrolyte.

- Igbu oge na sodium na mmiri ion (ụba reabsorption na distal kidal tubules), mkpochapu nke potassium ion (maka ọgwụ ike na mineralocorticoid ọrụ), mụbara ahụ.

- Mbelata na nnabata ion nke calcium na nri, mbelata nke ọdịnaya ha na anụ ahụ (osteoporosis), na mmụba na urinary excretion.

• Mmetụta na usoro metabolic.

- Maka mmanu mmanu - megharia aru nke adipose (ubara oke n’iru, olu, ihe n’ubu, afọ), hypercholesterolemia.

- Maka metabolism metabolism - mkpali nke gluconeogenesis na imeju, mbelata nke permeability nke akpụkpọ ahụ maka glucose (mmepe nke ọrịa shuga steroid ga - ekwe omume).

- Maka protein metabolism - mkpali nke anabolism na imeju na usoro catabolic na anụ ahụ ndị ọzọ, mbelata ọdịnaya nke globulins na plasma ọbara.

• Mmetụta na CVS - mmụba ọbara mgbali elu (mgbali steroid) n'ihi njigide mmiri n'ime ahụ, mmụba na njupụta na ịma ọkwa nke ndị adrenoreceptors na obi na arịa ọbara, yana mmụba nke ihe nrụgide nke angiotensin II.

• Mmetụta dị na hypothalamus-pituitary-adrenal gland system - inhibation n'ihi usoro nzaghachi na-adịghị mma.

• Mmetụta ọbara - lymphocytopenia, monocytopenia na eosinopenia, n'otu oge glucocorticoids na-akpali mmụba nke mkpụrụ ndụ ọbara uhie, mụbaa ọnụ ọgụgụ nke neutrophils na platelet (mgbanwe mkpụrụ ndụ ọbara na-apụta n'ime awa 6-12 mgbe nchịkwa ma nọgide na-eji ọgwụ ndị a ruo ogologo oge. ọtụtụ izu).

Glucocorticoids maka usoro eji mmiri eme ihe na-adịghị nke ọma na mmiri, ọ dị mma na abụba na ihe mgbaze ndị ọzọ. Ha na-ekesasị n'ọbara kachasị na protein nwere njikọ (adịghị arụ ọrụ). Indị inyocha nke glucocorticoids bụ mmiri mmiri na-anakpo ma ọ bụ nnu (mmiri na-emetụta mmiri, hemisuccinates, phosphates), nke na-eduga na ngwa ngwa. Nsonaazụ nke nkwụsịtụ obere kristal nke glucocorticoids na-amalite nwayọ, mana enwere ike ịdịru ọnwa 0,5-1, a na-eji ha maka injections intraarticular.

Glucocorticoids maka nchịkwa ọnụ na-etinye obi gị dum na ngọngọ nri, C_tah n'ọbara, a na-ahụta ya mgbe awa 0,5-1.5. Nri na-ebelata ịmịcha iwe, mana anaghị emetụta ndu bioavailability nke ọgwụ (taabụ 27-15).

AKWSKWỌ AH OFR GTA Glucocorticoids NKE ANY OF EGO

1. Glucocorticoids maka ojiji eji:

A) maka itinye aka na anụ ahụ (n'ụdị ude, ude, emulsion, ntụ ntụ):

- fluocinolone acetonide (sinaflan, flucinar)

- flumethasone pivalate (lorinden)

- betamethasone (celestoderm B, celeston)

B) maka instillation n'ime anya na / ma ọ bụ ntị, n'ụdị nke ude anya:

- betamethasone n (betamethasone dipropionate, wdg) B) maka iji inhalation:

- mbulomethasone (ọkam, becotide)

- fluticasone propionate (flixotide)

D) maka nchịkwa intraarticular:

D) maka ntinye banye na anụ ahụ:

Mmetụta metabolism

Glucocorticoids nwere ikike mgbochi ụjọ, mmetụta mgbochi. Ọbara ọbara ha na-agbago nke ukwuu na nrụgide, mmerụ ahụ, ọbara ọgbụgba, na ọnọdụ ujo. Mmụba nke ọkwa ha n’okpuru ọnọdụ ndị a bụ otu n’ime usoro nke mmegharị ahụ si arụ ọrụ na mgbakasị ahụ, ọbara ọgbụgba, ọgụ ọgụ na ujo na nsụkọ. Glucocorticoids na - eme ka ọbara mgbali elu dịkwuo elu, mụbaa ikike myocardium na mgbidi vaskụla na catecholamines, ma gbochie enweghị atụ nke ndị na - anabata ndị na - anabata catecholamines na ọkwa ha dị elu. Na mgbakwunye, glucocorticoids na-akpali erythropoiesis na ụmị ọkpụkpụ, nke na-atụnye ụtụ na mwepu ọbara ngwa ngwa.