Proton-pump inhibitors angapangitse chiopsezo cha zophulika zina.
M'mbiri ya mankhwala, mankhwala owerengeka akhala akugwira ntchito mosavuta pochepetsa mavuto monga proton-pump inhibitors (PPIs) , kapena mankhwala monga omeprazole (generic), Prevacid ndi Nexium.
Proton-pump inhibitors amathandiza mamiliyoni ambiri a ku America kupeza mpumulo ku matenda a reflux a gastroesophageal (GERD). Matenda a reflux amatha kuchitika pamene mimba imatulutsa zinthu zowonongeka, ndipo zimapangitsa kuti azikhumudwa kapena kukhumudwa.
(Ambiri mwa anthu amakumana ndi zovuta zowonjezereka za GERD yachiwiri mpaka zochepetsetsa zapansipansi zochepa zowonjezereka kapena TLESRs ).
Kwa mbali zambiri, PPI ndi otetezeka kwenikweni. Komabe, pakhala pali madandaulo pakati pa anthu am'deralo kuti PPI ikhoza kuyambitsa mafupa pakati pa anthu okalamba (makamaka amayi achikulire amene ali ndi chiopsezo chachikulu cha osteopenia kapena osteoporosis).
Kuonjezera apo, pakhala pali nkhawa zina zomwe PPI zingapangitse kuti pakhale ngozi zowonongeka , zomwe zimabweretsa ndalama zambiri, olumala, matenda komanso imfa.
Kodi kugwiritsira ntchito ma PPI kuli ndifalikira bwanji?
Proton-pump inhibitors ndi zabwino kwambiri kuchepetsa kuchuluka kwa asidi omwe amabisika m'mimba. Momwemonso, PPI ndi bwino kuchepetsa kuchepa kwa asidi kusiyana ndi H2 blockers, kapena mankhwala a histamine omwe amaletsa, monga Zantac kapena cimetidine.
Ku United States mu 2009, makalata pafupifupi 120 miliyoni a PPI adalembedwa.
Komanso, chaka chomwechi malonda a PPI anaposa $ 13.5 biliyoni.
Pafupifupi 40 peresenti ya anthu achikulire a ku America amatha kuona zizindikiro za GERD mwezi uliwonse, ndipo anthu ambiri ali ndi mankhwala a PPI a nthawi yaitali kuti athetse kupsinjika kwa mtima.
Kodi ma PPI angapangitse bwanji ngozi ya kuphulika kwa mafupa?
Njira imodzi yoonekeratu kuti ma PPI angapangitse kuti pang'onopang'ono pang'onopang'ono zisawonongeke, zimapangitsa kuti calcium iyambe kuchepa.
Kugwiritsa ntchito mankhwala osokoneza bongo nthawi zina kungachititse kuti pakhale kashiamu, yomwe imayenera kupangidwira mafupa, kukonza, ndi kukonzanso.
Nazi zifukwa zina zomwe zikufotokozera momwe ma PPI angapangire ngozi ya mafupa.
- Mankhwalawa amachititsa kuti kutuluka kwa gastrin, kutulutsa mahomoni ena am'mimba, kumathandizanso kuti chithokomiro chizigwira ntchito. Chithokomiro chimabisa calcitonin ndi hormone ya parathyroid (PTH) , yomwe imayambitsa calcium m'magazi ndi mafupa a metabolism.
- Mapulogalamu a PPI amatha kukhudza mafupa osteoclasts, kapena maselo omwe amathyoka ndi kumanga fupa.
- Anthu omwe amapanga ma PPIs nthawi zambiri amatha kukhala ndi zovuta zina zomwe zingapangitse kashiamu kutayika komanso kupweteka kwa mafupa, monga kuwonjezereka kwa mankhwala a thiazide kapena matenda ena oyipa. Kuwonjezera apo, anthuwa akhoza kumwa mowa wochulukirapo, zomwe zimapangitsanso kuchepetsa mphamvu ya calcium ndi fupa la mafupa.
- Anthu omwe amapanga ma ARV nthawi zonse amatha kusintha zakudya zawo kuti athe kuchepetsa zizindikiro za GERD motero mwina kuchepetsa kuyamwa kwa calcium.
Zimene Kafukufuku Akupereka
Kwa nthawi yaitali, kafukufuku wogwirizanitsa ntchito ya PPI ya nthawi yayitali ndi kuphwanya mafupa kunasakanikirana. Pakafika chaka cha 2010 tinapeza phunziro loyamba labwino kwambiri pofufuza kugwirizana pakati pa mitundu iwiriyi.
Pogwiritsira ntchito deta kuchokera ku Women's Health Initiative, kafukufuku wa zaumoyo wa dziko lonse omwe adafufuza amayi 161,808 ochokera m'mitundu yosiyanasiyana kuyambira pakati pa 50 ndi 79, ofufuza adapanga mayesero omwe amafufuza mayanjano pakati pa PPI, fupa la thanzi).
Malingana ndi zotsatira za phunziroli, ntchito ya PPI ya nthawi yayitali inali yogwirizanitsa ndi chiopsezo chowonjezeka cha msana wam'mbuyo, chisawawa, mkono ndi zophulika zonse. Komabe, kugwiritsa ntchito mankhwala a PPI kwa nthawi yaitali sikunagwirizane ndi chiopsezo chowonjezereka cha kuphuka kwa mchiuno kapena kuchepa kwa mitsempha ya mfupa.
Kodi Kafukufuku Ameneyu Akukutanthauzanji?
Ngati ndinu okalamba ndipo dokotala wanu wakuuzani kuti mukhale ndi chithandizo cha PPI kwa nthawi yaitali kuti mupeze mpumulo kuchokera kwa GERD, muyenera kupitiriza kumwa mankhwalawa ndikukumana ndi dokotala wanu nthawi zonse.
Kusamalidwa kokha pa ma PPI omwe amachititsa kuti mafupa asweke sikuyenera kukulepheretsani kupeza mpumulo umene mukusowa.
Komabe, dokotala wanu ayenera kufufuza mosamala ngati mukufunadi PPIs ndipo, ngati zili choncho, akuyenera kupereka mlingo woyenera. Komanso, pamene muli pa PPI, muyenera kutsimikiza kuti mudye chakudya chamagulu chodzaza ndi calcium yokwanira. Dokotala wanu angafunike kukulembetsani calcium supplements.
Ngati mwakhala mukugwiritsira ntchito PPI kuti muthe kupweteka kwa mtima koma simunayambe mwamuwona dokotala wa vuto ili, ndibwino kuti mupange msonkhano wanu kuti muwone bwinobwino.
Zotsatira:
"Proton Pump Inhibitor Gwiritsirani ntchito, Hip Fracture, ndi Kusintha kwa Minofu ya Bone Mineral mu Women Postmenopausal: Zotsatira za Women's Health Initiative" ndi SL Gray ndi olemba anzawo omwe amafalitsidwa mu Archives of Internal Medicine mu 2010.
"Mgwirizano wa Pulotoni Wautali Wautali wa Inthitor Therapy With Bone Fractures ndi Zotsatirapo pa Kutaya Kashiamu, Vitamini B12, Iron, ndi Magnesium" mwa T Ito ndi RT Jensen mu Current Gastroenterology Reports mu 2010.