Antileukotriene tshuaj ntawm lub tshiab tiam: ib daim ntawv teev cov qhov zoo tshaj plaws

Antileukotriene tshuaj sawv cev rau ib tug tshiab hauv chav kawm ntawv ntawm cov kab mob uas kom tsis txhob tus inflammatory dab uas yog tsis haum los yog kab etiology.

Nyob rau hauv thiaj li yuav to taub lub hauv paus ntsiab lus ntawm kev txiav txim ntawm cov tshuaj, nws yog tsim nyog los nkag siab txog dab tsi yog qhov leukotrienes.

leukotrienes

Lawv yog cov muab kev sib kho mob. Raws li lawv cov tshuaj qauv, lawv yog fatty acids, uas yog tsim nyob rau ntawm arachidonic acid.

Leukotrienes yog muab kev koom tes nyob rau hauv txoj kev loj hlob ntawm mob hawb pob. Raws li zoo raws li histamine, lawv nyob nruab nrab ntawm kev tsis haum tshuaj ntawm lub tam sim ntawd yam. Histamine yuav ua rau ib tug sai tab sis luv luv-term bronchospasm thiab leukotrienes ua ncua thiab ntev spasm.

Raws li txwv kom muab zais antileukotriene yeeb tshuaj?

Tam sim no, leukotrienes yog dej num raws li nram no: A _4, B _4, C _4, D _4, E _4.

Synthesis of leukotrienes derived ntawm arachidonic acid. Nws yog nyob rau hauv tus ntawm 5-lipoxygenase nyaij mus leukotriene A _4. Tom qab hais tias muaj yog ib tug cascade cov tshuaj tiv thaiv, uas tau nyob rau hauv cov nram no daim ntawv leukotrienes B ₄ C ₄ -D ₄ -E _4. Qhov kawg khoom ntawm tshuaj tiv thaiv no - LTE _4.

Tsim uas LTE _4, D _4, E ₄ yuav ua rau bronchoconstrictor nyhuv, nce ntawm hnoos qeev secretion yuav ua rau kom txoj kev loj hlob ntawm edema, inhibit mucociliary clearance.

B _4, D _4, E ₄ muaj chemotactic kev ua si, i.e. yuav nyiam qe thiab eosinophils nyob rau hauv lub inflammatory txheej txheem tsam.

Zaum tau qhia tias leukotrienes yog ua los ntawm macrophages, mast hlwb, eosinophils, qe, T-lymphocytes, uas yog ncaj qha kev koom tes nyob rau hauv inflammatory kev tig cev. Antileukotriene tshuaj nyob rau hauv mob hawb pob yog feem ntau siv.

Tom qab lub hlwb tuaj rau hauv kev sib cuag nrog ib tug allergen thiab cua txias tshwm sim tej hlab cua txhob los yog tom qab lub cev puas rau siab, tshuab txais LT synthesis. Ntawd ces yog lub synthesis pib thaum lub osmolarity ntawm bronchial cov ntsiab lus ntau ntxiv.

Plaub pawg ntawm cov tshuaj

Nws yog tam sim no lub npe hu nyob rau hauv tag nrho cov plaub pawg antileukotriene tshuaj:

1. "Zileuton", uas yog ib tug ncaj inhibitor ntawm 5-lipoxygenase.
2. Formulations uas yog inhibitors muag nthas, ceeb toom txheej txheem ntawm losis tswvyim dabtsi cov protein nrog arachidonic acid.
3. "Zafirlukast", "Pobilukast", "Montelukast", "pranlukast", "verlukast" uas yog antagonists ntawm leukotriene receptors sulfidopeptidnyh.
4. Cov tshuaj uas yog antagonists ntawm leukotriene B ₄ receptor.

Qhov tseem kawm yog antileukotriene tshuaj ntawm thawj pab pawg neeg thiab tus thib peb pab pawg neeg ntawm cov nyiaj. Xav txog cov pab pawg nyob rau hauv ntau yam.

"Zileuton"

"Zileuton" yog ib tug reversible inhibitor ntawm 5-lipoxygenase. Nws yog tau inhibit qhov kev tsim sulfidopeptidnyh Lub LT thiab RT _4. Cov tshuaj yuav muaj cov hlab ntsws qhib los ntev mus txog tsib lub sij hawm. Tsis tas li ntawd nws yog tau los mus tiv thaiv qhov tshwm sim ntawm bronchial spasm, uas yog ib lub txim raug rau cua txias los yog "aspirin".

Heev heev cov kev tshawb fawb ua pov thawj hais tias "Zileuton" muab rau cov neeg mob kev txom nyem los ntawm bronchial hawb pob rau ib tug mus rau lub hlis, yuav txo tau qhov yuav tsum tau rau tus neeg mob rau nqus tau cov pa β2-agonists thiab corticosteroids. Ib tug tib koob tshuaj "zileuton" ceeb toom qhov tshwm sim ntawm txham thiab txog ntawm qhov ntswg ua tsis taus pa nyob rau hauv cov neeg mob uas raug kev txom nyem los ntawm tsis haum txhaws ntswg tom qab qhov ntswg thawj coj ntawm allergen.

Lub rau-lub lim tiam kho nrog "zileuton" atopic mob hawb pob pom ib tug tseem ceeb tshwm sim. Cov kws kho mob hais tias high-zoo txos ntawm eosinophils thiab qe. Tsis tas li ntawd, nws tsis mob necrosis ceeb nyob rau hauv bronchoalveolar lavage kua tom qab allergen hom kev kuaj. Hais tias yog dab tsi yog nws antileukotriene tshuaj, lub mechanism ntawm qhov kev txiav txim yog ua raws li no.

"Zileuton" yog yus muaj los ntawm ib tug raug luv luv lub sij hawm, thaum lub sij hawm uas muaj nws ib nrab-lub neej. Qhov no qhia tias cov tshuaj yuav tsum tau noj heev txaus mus rau plaub zaug ib hnub twg. Nyob rau hauv tas li ntawd, "Zileuton" muaj peev xwm ntawm kev txo qhov clearance ntawm theophylline. Nws yuav tsum raug xam tias yog, yog hais tias nws yog lam xav thaum uas tig mus txais theophylline thiab "zileuton". Hais tias yog, tus thawj zaug yuav tsum raug muab txo. Yog hais tias "Zileuton" yog muab ib tug ntev-lub sij hawm, nws yog tsim nyog los saib xyuas cov theem ntawm daim siab enzymes.

Tab sis muaj antileukotriene tshiab tiam ntawm cov tshuaj, lawv daim ntawv teev qhia nram qab no.

Cov neeg ua hauj uas yog antagonists ntawm leukotrienes sulfidopeptidnyh, competitors yog heev xim thiab reversible blockers LT D ₄ receptors. Cov tshuaj xws li "pranlukast" "Zafirlukast", "Montelukast."

"Akolat" ( "Zafirlukast")

"Zafirlukast" aka "Akolat" yog lub feem ntau kawm ntawm no pab pawg neeg ntawm antileukotriene tshuaj tshuaj. Nws yog tseem dhia cov hlab ntsws qhib orientation. Cov nyhuv kav rau ib tug heev lub sij hawm ntev, mus txog rau tsib lub sij hawm. "Zafirlukast" txheej txheem yog tau los mus tiv thaiv cov kev loj hlob ntawm ib tug asthmatic cov tshuaj tiv thaiv nyob rau hauv cov ntaub ntawv ntawm lub allergen nqus tau pa. Nws cov hauj lwm zoo yog qhov tseeb, thiab cov kev tiv thaiv bronchial spasm, uas yog provoked los ntawm cua txias, aspirin, lub cev ua si, kuab paug. Active yeeb tshuaj, thiab kev npaj "Montelukast" muaj peev xwm yuav txhim khu lub cov hlab ntsws qhib kev ua si ntawm β2-agonists.

"Akolat" ( "Zafirlukast") muaj zoo absorbability, nws ncov concentration hauv cov ntshav yog tiav tom qab peb teev tom qab nws thawj coj. Nws ib nrab-lub neej sij hawm ntawm me ntsis ntev tshaj li lub "zileuton", thiab yog 10 xuab moos. Nyob rau hauv tas li ntawd, nws twb tsis muaj ntxim rau cov clearance ntawm theophylline. Txais active tshuaj yuav tsum yog ib teev ua ntej noj mov los yog tsis pub dhau ob xuaj moos tom qab ntawd, txij li thaum cov zaub mov considerably thiaj li nws haum muaj peev xwm. Txhais tau hais tias taus zoo heev.

xaus

Antileukotriene tshuaj rau tsis haum yuav muab siv rau cov me nyuam, tiam sis tsis ua ntej lawv mus txog lub hnub nyoog ntawm ob tug. Nrog kev pab los ntawm cov tshuaj nyob rau hauv cov me nyuam kho nrog recurrent bronchitis, tsis haum rhinitis, me me mob hawb pob.