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x v e l i s m a r T v a x v e l i s m a r T v a
Mometasone furoate 200 _ 400 > 400 _ 800 > 800 - 1200 Triamcilone acetonide 400 _ 1000 > 1000 _ 2000 > 2000 sainhalacio k.s.-is efeqturoba da usafrTxoeba mniSvnelovnadaa damokidebuli preparatis 2 Tvisebaze: 1. Sesabamisi receptoris mimarT afinuroba (rac maRalia afinuroba, miT maRalia receptorTan kavSiris unari da Sesabamisad Terapiuli efeqti) da 2. preparatis bioSeRwevadoba (rac dabalia bioSeRwevadoba, miT naklebia sistemuri zemoqmedebis ganviTarebis safrTxe). am mxriv mniSvnelovania flutikazoni (savaWro dasaxeleba _ fliqsotidi) da budesonidi (savaWro dasaxelreba _ pulmikorti). aseve Zalian sayuradReboa am preparatebis kombinacia gaxangrZlivebuli moqmedebis b-2 agonistebTan, rogorebicaa flutikazonisa da salmeterolis kombinacia (savaWro dasaxeleba _ seretidi multidiski) da budesonidisa da formoterolis kombinacia (savaWro dasaxeleba _ simbikorti). leikotrienebis modifikatorebi. leikotrienebi warmoadgenen mZlavr anTebiT mediatorebs, romlebic gamonTavisufldebian sxvadasxva ujredebidan. maT Soris eozinofilebidan. isini ukavSirdebian lorwovani garsSi arsebul specifiur receptorebs (LTR) da iwveveb anTebiT reaqcias da bronqospazms. leikotrienebis proanTebiTi efeqti 1000-jer swrafad vi- Tardeba vidre histaminis analogiuri efeqti. dReisaTvis arsebuli preparatebi, romlebic leikotrienebis modifikaciasa da Sesabamisad maT efeqts aferxeben, or jgufad iyofian: 1. leikotrienebis receptorTa antagonistebi(LTRA). 2. leikotrienebis sinTezis blokatorebi. pirvel jgufs ganekuTvneba zafirlukasti (savaWro dasaxeleba _ akolati) da montelukasti (savaWro dasaxeleba _ luqsati, vanseari, akretani, singulari). 20
meore jgufs miekuTvneba zeleutoni (ziflo). LTRA-ebi amsubuqeben asTmis simptomebs, daavadebis yvela formis dros. es preparatebi iwveven bronqokonstriqciis Semcirebas fizikuri datvirTviT gamowveuli da aspirindamokidebuli asTmis SemTxvevaSic. Tumca maTi efeqturoba, asTmis yvela formis dros, mniSvnelovnad CamorCeba sainhalacio k.s.-ebis samkurnalo efeqts. LTRA-ebis aRniSnuli efeqti, gamoxatulia yvela asakis pacientSi. mcire asakis bavSvTa kontingentSi, am jgufis preparatebi, aseve iwveven virusinducirebuli asTmis gamwvavebebis gamovlenis Semcirebas. gaxangrZlivebuli moqmedebis b2-agonistebi. gaxangrZlivebuli moqmedebis b2-agonistebi sainhalacio k.s.-ebTan kombinaciaSi gamoiyeneba saSualo simZimis da mZime formis asTmiT daavadebuli, 5 welze ufrosi asakis pacientTa samkurnalod, Tu sainhalacio k.s.-ebiT mkurnaloba ar iZleva daavadebis kontrolis saSualebas. am jgufis preparatebi, monoTerapiisaTvis, aseve gamoiyeneba fizikuri datvirTviT inducirebuli asTmis mqone, ufrosi asakis bavSvebSi. sxva SemTxvevaSi, b2-agonistebiT monoTerapia araa rekomendirebuli. bronquli asTmis kontroli, gaxangrZlovebuli moqmedebis b2-agonistebi + sainhalacio k.s.-ebiT ufro efeqturia, vidre izolirebulad sainhalacio k.s.-ebiT an gaxangrZlivebuli moqmedebis b2-agonistebiT. 5 wlamde asakSi, b2-agonistebis izolirebulad an sainhalacio k.s.-ebTan kombinaciaSi gamoyenebis Sedegebis sarwmuno monacemebi ar arsebobs. gaxangrZlvebuli moqmedebis b-2 agonistebidan aRsaniSnavia salmeteroli (savaWro dasaxeleba _ sereventi) da formoteroli. preparati gamoiyeneba sainhalacio formiT. swrafad moqmedi, sainhalacio da oraluri b2-agonistebi. swrafad moqmedi b2-agonistebi warmoadgeneb efeqtur bronqodilatatorebs da warmatebiT gamoiyenebian bron- 21
- Page 1 and 2: m. d. ramaz RulaZe m. d. daviT frui
- Page 3 and 4: winasityvaoba xvela aris pacientis
- Page 5 and 6: xvelis marTva klinikuri gaidlaini g
- Page 7 and 8: monacemTa sarwmunoobis xarisxi aRin
- Page 9 and 10: 4. yefis msgavsi xvela. 5. xvela re
- Page 11 and 12: neiro-regulatorulipaTologiebi rekur
- Page 13 and 14: adiografiuli monacemebi da gansakuT
- Page 15 and 16: gia da zogadi sisuste. xvela vlinde
- Page 17 and 18: uli virusuli infeqciis mizeziTac, r
- Page 19: sainhalacio glukokortikosteroidebi.
- Page 23 and 24: iski da sxva gziT miRebul medikamen
- Page 25 and 26: oloSi _ saxis niRabi an munStuki. s
- Page 27 and 28: suri mkurnaloba. B. 11. rodesac dav
- Page 29 and 30: 4b. mwvave bronqitis diagnozis mqon
- Page 31 and 32: uli anTebadi kerebi. bronqitis dros
- Page 33 and 34: zianeblebisagan Tavis arideba. aRni
- Page 35 and 36: ara asTmuri eozinofiluri bronqitiT
- Page 37 and 38: gamoxatulia lorwos hipersekrecia (W
- Page 39 and 40: 11. d.p.b.-iT daavadebis dros saWir
- Page 41 and 42: sunTqvis ukmarisobis seriozuli gamo
- Page 43 and 44: yivanaxvela, unda gaviTvaliswinoT S
- Page 45 and 46: Cutardes gulmkerdis R-grafia. E/A.
- Page 47 and 48: angiotenzin-SemboWveli enzimis inhi
- Page 49 and 50: viloT iseTi faqtorebis arsebobaze,
- Page 51 and 52: profesiuli da garemoSi arsebuli miz
- Page 53 and 54: is arsebobis SesaZleblobac, romlebi
- Page 55 and 56: 8a. qronikuli xvelis mqone paciente
- Page 57 and 58: eriuli supresantebi, rogoricaa maga
- Page 59 and 60: duram SeiZleba mdgomareobis gauares
- Page 61 and 62: li faqtorebi, rogoricaa magaliTad T
- Page 63 and 64: algoriTmi 3. qronikuli xvelis marTv
- Page 65 and 66: algoriTmi 5. qronikuli, specifiuri
- Page 67 and 68: 19. Ronald B. Turner., Gregory F. H
meore jgufs miekuTvneba zeleutoni (ziflo).<br />
LTRA-ebi amsubuqeben asTmis simptomebs, daavadebis<br />
yvela formis dros. es preparatebi iwveven bronqokonstriqciis<br />
Semcirebas fizikuri datvirTviT gamowveuli<br />
da aspirindamokidebuli asTmis SemTxvevaSic. Tumca maTi<br />
efeqturoba, asTmis yvela formis dros, mniSvnelovnad<br />
CamorCeba sainhalacio k.s.-ebis samkurnalo efeqts.<br />
LTRA-ebis aRniSnuli efeqti, gamoxatulia yvela asakis<br />
pacientSi. mcire asakis bavSvTa kontingentSi, am jgufis<br />
preparatebi, aseve iwveven virusinducirebuli asTmis<br />
gamwvavebebis gamovlenis Semcirebas.<br />
gaxangrZlivebuli moqmedebis b2-agonistebi. gaxangrZlivebuli<br />
moqmedebis b2-agonistebi sainhalacio<br />
k.s.-ebTan kombinaciaSi gamoiyeneba saSualo simZimis da<br />
mZime formis asTmiT daavadebuli, 5 welze ufrosi asakis<br />
pacientTa samkurnalod, Tu sainhalacio k.s.-ebiT<br />
mkurnaloba ar iZleva daavadebis kontrolis saSualebas.<br />
am jgufis preparatebi, monoTerapiisaTvis, aseve<br />
gamoiyeneba fizikuri datvirTviT inducirebuli asTmis<br />
mqone, ufrosi asakis bavSvebSi. sxva SemTxvevaSi, b2-agonistebiT<br />
monoTerapia araa rekomendirebuli.<br />
bronquli asTmis kontroli, gaxangrZlovebuli moqmedebis<br />
b2-agonistebi + sainhalacio k.s.-ebiT ufro<br />
efeqturia, vidre izolirebulad sainhalacio k.s.-ebiT<br />
an gaxangrZlivebuli moqmedebis b2-agonistebiT.<br />
5 wlamde asakSi, b2-agonistebis izolirebulad an<br />
sainhalacio k.s.-ebTan kombinaciaSi gamoyenebis Sedegebis<br />
sarwmuno monacemebi ar arsebobs.<br />
gaxangrZlvebuli moqmedebis b-2 agonistebidan aRsaniSnavia<br />
salmeteroli (savaWro dasaxeleba _ sereventi) da<br />
formoteroli. preparati gamoiyeneba sainhalacio formiT.<br />
swrafad moqmedi, sainhalacio da oraluri b2-agonistebi.<br />
swrafad moqmedi b2-agonistebi warmoadgeneb efeqtur<br />
bronqodilatatorebs da warmatebiT gamoiyenebian bron-<br />
21
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