Ndimagwiritsa ntchito Yaz, Yasmin, Beyaz kapena Safyral - Ndiyenera Kuchita Chiyani?
FUNSO - NDAGWIRITSA NTCHITO ZA YAZI YOPHUNZIRA, NDIFUNA KUTI NDIPE NDIPONSO NDIPONSO NDIPONSO NDIPONSO NDIPONSO NDIPONSO NDIPONSO NDIPONSO MWAZI WOPHUNZITSIDWA MWAZI WOPHUNZITSIDWA NDI MPHAMVU YA DROSPIRENONE?
M'zaka zaposachedwapa, mapiritsi ophatikizana ndi drospirenone akhala akudziwika kwambiri. Mapiritsi oletsa kubereka ndi Yaz , Yasmin, Beyaz , ndi Safyral. Chimodzi mwa zifukwa zomwe zimatchulidwira zimakhudzana ndi zopindulitsa zomwe amapereka.
Kwa amayi omwe amasankha kugwiritsa ntchito mapiritsiwa kuti apange chithandizo (kuphatikizapo kutenga mimba, Yaz ndi Beyaz akhala akuvomerezedwa ndi FDA kuti adziwe zizindikiro za matenda osokoneza bongo komanso kuti azisamalira ma ARV . (0,4mg) wa folic acid.
Chinthu china chimene chimapangitsa mapiritsi oletsa kubala mosiyana ndi chakuti ali ndi progestin drospirenone. Progesin iyi ikhoza kuthetsa mahomoni otuluka omwe amayendetsa madzi a thupi lanu ndi electrolytes. Drospirenone ingathenso kutsogolera pazitali za potaziyamu ndi / kapena kuyanjana ndi mankhwala ena omwe amachulukitsa potaziyamu. Palinso kuganizira kuti kugwiritsa ntchito mapiritsi oletsa kubereka omwe ali ndi drospirenone kungakulepheretseni kuika magazi pamtunda poyerekeza ndi mapiritsi oletsa kubereka omwe ali ndi progesin yosiyana.
---> Pambuyo pa Kugonana: Yaz ndi Beyaz
Ndikofunika kuwonetsa kuti mapiritsi onse olerera amakhala ndi chiopsezo chotenga magazi .
Mitsempha yamagazi yomwe imapanga mu mitsempha yozama m'thupi imatchedwa deep vein thrombosis (DVT). DVT ndi nthenda yochepa yoletsa kubala mapiritsi ndipo ingalepheretse kuthamanga kwa magazi. Kumangirira kwapopysi kumatha kuchitika ngati magazi amatha kutuluka mumsana ndikuyenda mthupi kupita m'mapapo. Izi zingachititse imfa.
MAYANKHO - SUSAKHALA NDI PANIC. MUYENERA KUDZIWA ZOCHITA:
A FDA akhala akufufuza za kugwirizana komwe kuli pakati pa drospirenone ndi ngozi ya magazi. Dipatimentiyi inkapindulitsa yophunzira ndalama zokhazokha ndikuyang'ana deta kuchokera kwa amayi opitirira 800,000. Mu October 2011, a FDA adamasula zotsatira za phunziroli ndipo adawonetsa nkhaŵa pa kuwonjezeka kwa 1/2 pokha pokhapokha pangozi yamagazi ya amayi omwe amagwiritsa ntchito mankhwala a drospirenone.
Mu April 2012, uphungu, a FDA adalengeza kuti bungweli linatsiriza kafukufuku wake wa kafukufuku wamakono komanso okhudza matenda okhudza matenda a drospirenone ndi ngozi ya magazi. Pogwiritsa ntchito ndemangayi, a FDA anatsimikiza kuti mankhwala oletsa kubadwa kwa drospirenone angagwirizane ndi chiopsezo chachikulu cha magazi ndipo amaitanidwa kuikapo mankhwala atsopano pa mapiritsiwa. Komabe, bungweli linanenanso kuti kufufuza kumeneku sikunapereke zotsatira zotsatirika kapena chifukwa cha zizindikiro zazikulu za odwala zomwe zingathandizenso kuika magazi pachiopsezo. Ngakhale kuti FDA imasonyeza kuti pangakhale chiyanjano pakati pa drospirenone ndi ngozi ya magazi, iwo adanenanso kuti bungwe silikudziwitsanso kuti kuwonjezeka kwowopsa kwa magazi kumakhala chifukwa cha drospirenone mu mapiritsi oletsa kubereka.
Kodi Drospirenone ndi Magazi Zimaphika Kuopsa Kwa Ine?
Pano, palibe chifukwa chochitira mantha ngati mukugwiritsa ntchito pilisi yoletsa kubereka yomwe ili ndi drospirenone. A FDA akulangiza kuti:
- Musayambe kumwa mapiritsi anu musanalankhule ndi dokotala wanu poyamba .
- Ngati muli ndi nkhawa kapena mafunso, muyenera kukambirana nawo ndi dokotala wanu.
- Ngati mukuganiza kuti musinthe njira zothandizira (kapena mukufuna kuyamba kugwiritsa ntchito njira yolera ), nkofunika kuti muyankhule ndi dokotala wanu za chiopsezo chanu cha magazi musanasankhe njira yoyenera kubereka .
A FDA adalangizanso madokotala kuti adziwe kuopsa ndi phindu la mapiritsi oletsa kubadwa kwa drospirenone ndi chiopsezo cha amai kuti apange ma ARV.
Ngati mugwiritsa ntchito mapiritsi a birthspirnone monga Yaz, Yasmin, Beyaz kapena Safyral, muyenera kudziwa zotsatirazi:
- Ngati mukukonzekera opaleshoni yayikulu, muyenera kusiya kugwiritsa ntchito mapiritsi anu oletsa kubadwa kwa drospirenone masabata anayi musanayambe kugwira ntchito ndikudikirira masabata awiri mutayambiranso kugwiritsa ntchito.
- Zingakhalenso zothandiza kuti muzindikire zizindikiro za magazi . Izi zikhoza kuphatikizapo kupweteka kwa chifuwa chachikulu, kupweteka kwa mwendo kapena kupweteka kwa mkono (zomwe zingatheke kutupa, kutentha ndi kufiira) ndi / kapena kupuma kwadzidzidzi mwadzidzidzi. Ngati mukupeza kuti muli ndi zizindikiro izi, muyenera kutchula dokotala wanu nthawi yomweyo.
- Ngati muli pa mpumulo wokhala pabedi kapena kuponyedwa kapena mutapita maulendo ataliatali (maola anayi kapena kuposerapo), mungakhale ndi mwayi wapamwamba wopeza magazi.
- Ngati mumasuta, muli ndi zaka zoposa 35 ndipo mumagwiritsa ntchito mapiritsi oletsa kubereka.
Zifukwa Zina Chifukwa Chake Muyenera Kudabwa ndi Dokotala Wanu:
Chifukwa cha kuwonjezeka kwa magazi kumeneku, zingakhalenso nthawi yabwino kuti muwone kawiri ndi dokotala kuti mapiritsi oletsa kubereka omwe ali ndi ethinyl estradiol ndi drospirenone ndi abwino kwambiri kwa inu. Chifukwa drospirenone ikhoza kuwonjezera potaziyamu kapena kusokoneza mankhwala omwe amachulukitsa potaziyamu, dokotala wanu ayenera kuyang'anitsitsa potassium yanu ya seramu m'mwezi woyamba wa ntchito ngati mukuchitiranso mankhwala aliwonse okhudzana ndi kusungidwa kwa potaziyamu. Mankhwala awa angaphatikizepo:
- Potaziyamu supplementation ACE inhibitors (Vasotec, Capoten, Zestril ndi ena)
- Aldosterone antagonists
- Potaziyamu-sparing diuretics (spironolactone ndi ena)
- Heparin
- NSAIDs (ibuprofen [Motrin, Advil], naproxen [Aleve ndi ena] akamatengedwa nthawi yaitali ndi tsiku ndi tsiku kuti athetse matenda a nyamakazi kapena mavuto ena)
- Otsutsana ndi Angiotensin-II omwe amalandira (Avapro, Cozaar, Diovan ndi ena)
Kuonjezera apo, ngati mukugwiritsa ntchito Yaz, Yasmin, Beyaz kapena Safyral ndipo muli ndi zovuta izi, mungathe kuyankhula ndi dokotala wanu kuti mutsimikizire kuti njirayi ndi yabwino kwambiri yoberekera kwa inu:
- Kuletsa kuthamanga kwa magazi
- Mbiri ya magazi mu miyendo yanu, mapapo kapena maso
- Mbiri ya adrenal matenda, matenda a impso kapena matenda a chiwindi
- Khalani ndi shuga ndi impso, maso, mitsempha kapena kuwonongeka kwa mitsempha ya magazi
- Anali ndi vuto la mtima, kupwetekedwa mtima kapena mbiri ya mavuto aakulu a valve kapena mtima wamtundu wosadziwika womwe ungayambitse magazi mu mtima
DROSPIRENONE NDI MAGAZI OTHANDIZA MAGAZI - MFUNDO YA BOTO:
Ambiri, ngati amayi 10,000 (omwe alibe pakati ndi osagwiritsa ntchito mapiritsi oletsa kubereka) amatsatiridwa kwa chaka chimodzi, pakati pa amayi ndi amayi asanu ndi awiri (1) ndi asanu (5) mwa amayiwa amakhala ndi magazi. Ngakhale mutakhala ndi chiopsezo choopsa cha kupha magazi ngati mutenga mapiritsi a drospirenone, ndikufuna kukumbutseni kuti kugwiritsa ntchito njira yothandizira pakamwa kungakuike pangozi yopanga magazi.
Kuopsa kwa thromboembolism (mitsempha ya mitsempha ya thrombosis ndi / kapena pulmonary embolism) mwa amayi omwe amagwiritsa ntchito mtundu uliwonse wa kuphatikiza mkodzo ndi wosawerengeka ndipo amadziwika kukhala a 3 mpaka 9 pa amayi 10,000 (pachaka). Zowopsazi ndizopambana pa chaka choyamba cha ntchito (makamaka m'miyezi isanu ndi umodzi yoyamba). Vuto lalikulu kwambiri la mimba ya thromboembolism ikuwoneka ngati mutatha kuyamba kumwa mapiritsi osakaniza kapena kuyambitsa mapiritsi omwewo kapena mtundu wina (ngati mwakhalapo milungu yoposa 4 kuyambira mutagwiritsa ntchito mapiritsi).
Inu ndi dokotala wanu muyenera kuyeza kuopsa kwa magazi (ndi zotsatira zina ) motsutsana ndi mapindu a mapiritsi (onse okhudzidwa ndi kutenga mimba komanso zopanda kulera ).
Zonse zomwe zikunenedwa, ndizofunika kuti musunge magazi awa pangozi: chiwonongeko chathunthu cha kukhazikitsa magazi ndi otsika kwambiri. Ngakhale kuti muli ndi magazi oopsa kwambiri ngati mumagwiritsa ntchito mapiritsi (osagwiritsa ntchito mankhwala opatsirana pogonana ), chiopsezochi chikutsikabe kuposa chiopsezo cha magazi chokhudzana ndi mimba kapena atabereka:
- Magazi amawopseza amayi omwe ali ndi zaka zakubadwa omwe samagwiritsa ntchito mapiritsi (1-5 milandu pa amayi 10,000)
- Magazi amawopsa panthawi yomwe amagwiritsa ntchito mapiritsi oletsa kubereka (milandu 5-7 pa akazi 10,000)
- Magazi amawopsa pamene amamwa mapiritsi ndi drospirenone (milandu 9-12 pa akazi 10,000)
- Magazi amawopsa pamene ali ndi pakati (akuwonjezeka kufika 29 pa akazi 10,000)
- Magazi amawopsa patsiku lachiberekero / milungu 12 atabadwa (amadziwika kuti ali 40-65 pa akazi 10,000).
Zotsatira:
Kalasi ya Amerika Yotsutsa Amayi ndi Amuna a Gynecologists. "Kuopsa kwa matendawa amachititsa kuti anthu azigwiritsa ntchito mapiritsi oletsa kulera." Maganizo a Komiti No. 540. Obstet Gynecol 2012 (Watsimikiziridwa 2014); 120: 1239-42. Idapezeka kudzera mwachinsinsi.
FDA. [4-10-2012] "Kukonzekera Mafunso Ochokera Kwawo ndi Mayankho - Kuwerengera kwapakati pachitetezo cha mapiritsi oletsa kubereka omwe ali ndi drospirenone ndipo mwinamwake chiopsezo chowonjezereka cha magazi." Idakwanira 1/27/15.
FDA. [10-27-2011] "Kulankhulana Kwachidakwa kwa Madokotala a FDA: Kusinthidwa kwatsatanetsatane za maphunziro a FDA omwe amapereka ndalama zowonjezera pangozi yamagazi a magazi amayi omwe amabereka mankhwala oletsa kubereka omwe ali ndi drospirenone." Idakwanira 1/27/15.
James AH. "Thrombosis yokhudzana ndi mimba." Hematol 2009; 277-85. Idapezeka kudzera mwachinsinsi.
Zolemba Zaumoyo "Mankhwala osokoneza bongo amawaika pangozi ya mapiritsi oletsa kubereka." Laibulale ya US National Medicine / National Institutes of Health. 03 Feb 2014. Kufikira 1/27/14.