5 Wolemetsa koma Zotsatira Zabwino za Mankhwala Osokoneza Bongo

Nthaŵi zina mankhwala amachititsa zinthu zopanda phindu

Mawu oti "side effect" amatenga rap yoipa. Anthu ambiri amaganiza kuti zotsatira za mankhwala ndizovuta. Komabe, molingana ndi AMA Buku la Mafilimu , zotsatira zoyipa ndi "zotsatira zina zachiwiri (makamaka mankhwala osokoneza bongo) zomwe zimagwiritsidwa ntchito kuti zithetse matenda" ndipo zitha kukhala zopindulitsa kapena zowononga. Komabe, "zotsatira zovuta," "zochitika zovuta," ndi "zotsatira zolakwika" ndi zotsatira zoipa za mankhwala.

Sitiyenera kudabwa kuti mankhwala ambiri ali ndi zotsatira zosiyana ndi zomwe amagwiritsa ntchito. Ndipotu, kamodzi kamodzi kogwiritsidwa ntchito, mankhwalawa amathamangira thupi lonse ndipo amawonekera ku machitidwe osiyanasiyana, kuphatikizapo kuyendayenda, kupuma, ndi mantha.

Pano pali zotsatira zisanu zodabwitsa komanso zopindulitsa za mankhwala omwe anthu amapatsidwa.

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Proscar ndi kukula kwa tsitsi

Proscar ndi mankhwala ogwiritsira ntchito benign prostatic hyperplasia (BPH) . BPH ndi njira yovuta yomwe prostate gland (yomwe imapezeka mwa amuna) imalepheretsa urethra kotero kuti mkodzo umatuluka. BPH ndi chikhalidwe chosasangalatsa, chomwe chimabweretsa zizindikiro za mkodzo, monga nthawi zamakono, kusabisa, changu ndi kufooketsa mtsinje.

Proscar imalepheretsa 5a-Kutulutsa, timadzi timene timatulutsa testosterone ndi dihydrotestosterone. Pochita zimenezi, Proscar amachepetsa kukula kwa prostate mkati mwa miyezi ndikuchepetsa zizindikiro za kupopera mkodzo.

Zosakaniza zogwirira ntchito mu Proscar ndi finasteride, yomwe imagwiritsanso ntchito Propecia, mankhwala omwe amatengedwa kuti apititse patsogolo kukula kwa anthu omwe ali ndi tsitsi labwino . Mwa kuyankhula kwina, munthu wamisala amene amatenga Proscar kuti awonetse BPH angakhalenso ndi kukula kwa tsitsi.

Zowonjezereka, ntchito yowonjezeramo ndalama mu Proscar ndi yaikulu kwambiri kuposa momwe imayendera mu Propecia. M'mawu ena, anthu omwe amatenga ndalama kumapeto kwa BPH amatenga 5 mg pa tsiku kwa miyezi ingapo; pomwe, amene amatenga tsitsi la tsitsi amatenga pafupifupi 1 mg pa tsiku kwa miyezi yambiri.

Chonde funsani dokotala wanu musanatenge Proscar, Propecia kapena mankhwala ena onse. Dokotala wanu adzadziwa mlingo ndi mankhwala, ngati alipo, akuyenera.

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Chipangizo cha Baclofen ndi Kupweteka kwa Mtima

Baclofen ndi mitsempha yotsitsimula yomwe imalepheretsa kulumikiza kwa malingaliro pamtunda wa msana. Amagwiritsidwa ntchito pochizira minofu . Kupusa kumaphatikizapo kusokoneza kosalekeza ndi kosafunika kwa gulu limodzi kapena angapo a minofu. Kupweteka kumachitika chifukwa cha kuvulala kapena kunyozedwa (mwachitsanzo, matenda a ubongo, multiple sclerosis kapena stroke) kwa ubongo kapena msana.

Kukhazikika kwa chidziwitso kumapangitsa kuti phokoso likhale lofatsa komanso limangokhala lokhumudwitsa kwambiri. Kukula kwakukulu kungayambitse mgwirizano, kusayenda, komanso kugonana ( zilonda za AKA kapena zilonda zam'mimba).

Ndikofunika kuchitapo kanthu chifukwa chakuti vutoli likhoza kupweteka, limasokoneza maganizo, limasokoneza tulo komanso limapangitsa kuti munthu asamayende bwino komanso amachititsa kuti munthu athe kuchita nawo zinthu za tsiku ndi tsiku, monga kusamalira ukhondo, kugwiritsa ntchito bafa, kuvala, ndi kudya. Kusamalidwa bwino kungapangitse kuwonongeka kosatha, kapena kukonzanso mankhwala, kuphatikizapo mgwirizano wamatope ndi minofu yaing'ono komanso kuchepetsanso minofu.

Kuphatikiza pa kuchiza zizindikiro zosiyanasiyana za minofu, monga kupweteka, kupweteka, ndi kupuma, baclofen angathandizenso zizindikiro za matenda a reflux a gastroesophageal (GERD) . GERD imayamba chifukwa chotsitsimula mwachibadwa cha m'munsi otchedwa sophageal sphincter (LES), yomwe ili pakati pa chiwindi ndi m'mimba ndipo imalola kuti zakudya zizipezeka pamatumbo a m'mimba. Pamene mankhwala ochepa otsika otchedwa sophageal sphincter amatsitsimutsa mozizwitsa, m'mimba mwa mimba imabwerera m'mbuyo mwa mthendayi yomwe imabweretsa zizindikiro za GERD, monga kupsa mtima, chifuwa, kupweteka, kupweteka pachifuwa komanso kuvutika kukumeza.

Kwa anthu ena omwe ali ndi GERD, baclofen amatha kusintha zizindikiro za matendawa chifukwa amaletsa kuchepetsa kutaya (TLESRs), makamaka atadya (postprandial). Zotsatira za kafukufuku zimasonyeza kuti mankhwalawa amachepetsa chiwerengero cha TLESR ndi 40 peresenti. Pazowonjezereka, chithandizo cha GERD ndi baclofen sichiloledwa ndipo kawirikawiri chimasungidwa kwa anthu omwe samayankha (akutsutsa) mankhwala ochiritsira ndi proton pump inhibitors ( PPIs) .

Tiyenera kukumbukira kuti ngakhale gastroenterologists atulukira mwakuchita kuti GABA-B agonist baclofen imathandiza ndi zizindikiro za GERD, mu kuyezetsa kuchipatala, zotsatirazi sizinawoneke bwino. M'mbuyomu, makampani atatu osokoneza bongo ayesa kulimbikitsa agonists a GABA-B kuti azitsatira GERD: AstraZeneca, Xenoport ndi Addex Pharmaceuticals. Lesogaberan ya AstraZeneca inakhala yopambana kwambiri pakuyesedwa kwachipatala; Komabe, ofufuza anapeza kuti mankhwalawa sanathandize ndi GERD.

Powonjezereka, ochita kafukufuku akuti chifukwa cha lesogaberan sichinapangitse kuti chithandizo cha matenda a AstraZeneca chikhale chonchi chifukwa chakuti odwala ambiri a phunziroli anali osiyana kwambiri. Ofufuzawa anayesera laogaberan pa anthu osiyanasiyana omwe ali ndi kachilombo ka GERD kwa PPIs. M'malo mwake, anthu ambiri amatha kudziwika ndi zizindikiro zawo (mwachitsanzo, kupweteka kwa mtima, chifuwa kapena kupweteka kwa magazi); Choncho, ophunzirawo ayenera kukhala ophatikizapo omwe amadwala kwambiri chifukwa cha reflux, kapena kubwezeretsanso, omwe amadziwa kuti ali ndi zifukwa zowonongeka, ndipo amatsutsa mankhwala ndi mapiritsi.

Mwa kuyankhula kwina, anthu omwe ali ndi GERD yachikatolika komwe kupanikizika kwa m'mimba mochepa kwambiri kumakhala kochepa, mwina sikupindula kwambiri ndi mankhwala ndi baclofen. M'malomwake, mwina baclofen imathandiza anthu omwe ali ndi reflux kwambiri omwe amawawona MAFULU atadya. TULI izi zingayambitse kuponya kwapopugeal sphincter, yomwe ingathe kuchepetsedwa pogwiritsa ntchito baclofen.

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Kugonana ndi Mtima Wotsitsimula Kwambiri

Tonse timadziwa kuti Viagra (sildenafil) imathandiza amuna kugonana. Makamaka, imayambitsa magazi kupita ku mbolo mwakutulutsa minofu yosalala. Kuphatikiza pa kuwongolera zovuta, Viagra ikhozanso kukhala ndi zotsatira zabwino kwambiri zowonjezera thanzi la mtima.

Zotsatira za kafukufuku wamakono a 2014 zomwe zafalitsidwa mu BMC Medicine zimasonyeza kuti phosphodiesterase mtundu wa 5 (PDE5) inhibitors, monga Viagra, amakhala ndi malo osokoneza bongo ndipo amatha kukhala ndi mgwirizano wa mtima (inotropism). Ofufuzawa amaganiza kuti Viagra ndi zina zoteteza PDE5 zingakhale zothandiza pochiza mtima wamtima komanso kuchepa kwa mtima .

Zindikirani, tidakali ndi zambiri zoti tidziŵe za zotsatira za PDE5 inhibitors pa thanzi la mtima. Komabe, n'zosangalatsa kuzindikira kuti ubwino wa Viagra ukhoza kupitirira m'chipinda chogona.

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Mipiritsi yothandizira pakamwa ndi ziphuphu zowonjezera

Atsikana ambiri amadziwa kuti mankhwalawa amayamba bwino atalandira mankhwala ochepetsa kulera (OCPs) kuti asatenge mimba. Kupititsa patsogolo kumeneku sikuchitika mwadzidzidzi ndipo kumayambitsa mahomoni omwe alipo pa mapiritsi oletsa kubereka-estrogen ndi progesterone.

Mu 2012, ofufuza a Cochrane Collaboration adafufuza zofufuza zomwe zinagwiritsa ntchito OCP pofuna chithandizo chamakono. Ndemanga yawo inatha kuphatikizapo maphunziro 31 ndi odwala 12,579. Ndondomekoyi inali yamphamvu ndipo "amayerekezera mitundu iwiri ya mapiritsi oletsa kubereka, mapiritsi ndi placebo kapena 'dummy,' kapena mapiritsi komanso mankhwala ena opatsirana pogonana."

Ofufuzawa anapeza kuti OCP ndi othandiza kuchepetsa kupweteka ndi zosapsa zotupa zapachilendo kumtundu wa mavala. Komanso, ochita kafukufuku anapeza kuti, malinga ndi mitundu yeniyeni ya estrogen ndi progesterone yomwe ili mkati mwake, ena OCP ali abwino kuposa ena pochiza ziphuphu. Mwachitsanzo, mapiritsi omwe anali ndi cytterone acetate mwa iwo ankagwira ntchito bwino kuposa omwe ali ndi levonorgestrel.

Chonde kumbukirani kuti sitidziwa kuti ndi mitundu yanji ya mahomoni omwe ali ndi OCP omwe amathandiza kwambiri pogwiritsa ntchito acne.

Mwa kuyankhula kwina, ngati Wofalitsa OCP mmodzi amatha kulengeza kuti OCP yake imagwira ntchito bwino kuposa OCP wopanga mpikisano, ndiye, pakalipano, izi sizikutengera umboni wokhudzana ndi sayansi. Mwinanso, ngati wina akukuuzani kuti OCP yomwe ikuchitikayo ikuthandiza kwambiri ndi acne kusiyana ndi OCP yapitayo yomwe yatenga, palibe chiyambi cha sayansi yeniyeni ya mawu awa, mwina. Kuyang'anitsitsa, zingakhale zosangalatsa kufufuza mitundu yambiri ya OCPs kuthandiza ndi zizindikiro za acne kwambiri.

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Levodopa ndi Chilengedwe

M'mabuku a zolemba zachipatala, pali mbiri yakalekale yomwe imagwirizanitsa zizindikiro za ubongo ndi chidziwitso. Kwa nthawi yaitali asing'anga akhala akuwona kuphulika kwa talente yatsopano yolenga pambuyo poyambitsa matenda a dementia, kupweteka kapena kuwonongeka kwa nthawi.

Madokotala, komabe, ayamba kufufuza mgwirizano pakati pa anthu omwe amatenga levodopa ndi agonist ena a dopamine chifukwa cha matenda a Parkinson ndi kutuluka kwa chilengedwe chatsopano. Chidwichi chikufalikira ndi nkhani za anthu omwe ali ndi matenda a Parkinson omwe sanayambe kulemba mabuku osindikiza mabuku ndi ndakatulo zomwe zinapangidwira kuti zikhale zovomerezeka. Kuwonjezera apo, anthu omwe ali ndi matenda a Parkinson omwe adatenga mankhwala a dopamine (Levodopa) akhala akuwonedwa kuti apange zojambulajambula zowoneka bwino kwambiri.

Taonani ndime yotsatirayi kuchokera mu pepala la 2013 lomwe lafalitsidwa mu Behavioral Neuroscience , lomwe limagwira ntchito pazomwe zimachitika kuti agulu a dopamine akhale opanga mphamvu:

"N'zochititsa chidwi kuti odwala onse a PD [Parkinson's] omwe ali ndi mphamvu zowonongeka anatengedwa ndi antchito a dopaminergic kuphatikizapo levodopa ndi dopamine agonist. Ngakhale olemba ena atsimikizira kuti udindo wa oregeretsa okhulupirira, zochitika zofanana zinayambanso ndi nonergots. Izi zikuwoneka kuti ndizofunika kuti zikhale zatsopano kapena zikhale zowonjezera; [sic] kukhalapo kwa PD komanso kufotokoza kwa levodopa ndi dopamine agonist. "

Pamapeto pake, kugwirizana pakati pa kayendetsedwe ka levodopa ndi kulenganso kumakhalabebe, pakadali pano, mosaganizira. Zina mwazinthu zingakhale zosewera, komanso, kuphatikizapo njira za Parkinson matenda omwewo, monga kuwonetsa kapena kusaka zachilendo.

Komabe, zimakhala zovuta kuti aganizire kuti chithandizo cha matenda a Parkinson, matenda osokoneza bongo a mitsempha omwe pang'ono ndi pang'ono amachititsa munthu kuyenda, akhoza kulimbikitsa wodwala kuti apange luso lokongola. Kuwonjezera apo, maluso ojambulawo angapangitse umoyo wa munthu kukhala wabwino komanso kupereka chithandizo chofunikira kwa anthu omwe ali ndi matenda a Parkinson.

> Zotsatira:

> Castell DO. Kupititsa patsogolo mu GERD. Richter JE, ed. Gastroenterology & Hepatology. 200ADAD; 5: 816-818. Chamie K, Rochelle J, Shuch B, Belldegrun AS. Urology. Mu: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Mfundo za Schwartz za Opaleshoni, 10e . New York, NY: Hill ya McGraw; 2014.

> Kahrilas PJ, Boeckxstaens G. Kulephera kwa reflux inhibitors m'mayesero a zamankhwala: mankhwala osokoneza bongo kapena odwala? Mndandanda wa Med Post. (89): 111-119.

> Mosby's Drug Reference kwa Ogwira Ntchito Zaumoyo 2 Edition. St. Louis, MO: Mosby Elsevier; 2010.

> Rabow MW, Pantilat SZ. Chisamaliro chosakanikirana ndi Kupweteka kwa ululu. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Kupeza Zamankhwala Zamakono ndi Chithandizo 2017 . New York, NY: Hill ya McGraw; 2016.