Anthu Ena Amayendera Ndi NSAID Tengani Puloteni ya Proton
Proton pump inhibitors, omwe amatchedwanso mankhwala a PPI, ndi kalasi ya mankhwala omwe amalamulidwa kuti athetse kupweteka kwa mtima, GERD (matenda a reflux a gastroesophageal), zilonda zam'mimba , kapena zina zomwe zimayenderana ndi mimba yambiri ya m'mimba. Proton pump inhibitors amagwira ntchito poletsa ma enzyme omwe amafunikira kupanga ma asidi mmimba. Mwa kutsekemera mavitamini, kupangira asidi kumachepa.
Kodi Proton Pump Ntchito?
Pulotoni ya pulotoni ndi molekyulu yomwe imapezeka m'maselo ena a m'mimba (maselo a parietal). Pogwiritsa ntchito makina ofufuza maselo, puloteni yotchedwa proton imatulutsa ion osasiyamu ya potassium kuchokera m'mimba ndikuiika ndi acidic hydrogen ion. Mwa kuika ion hydrogen m'mimba mwako, mapulotoni a proton amachulukitsa asidi m'mimba mwako. Matenda a m'mimba ndi ofunikira kuthandiza kuchepetsa chakudya ndi kuthandiza kuchepa. Komabe, asidi ambiri angakwiyitse matendawa, amachititsa kuti asiye kupwetekedwa mtima, komanso akhoza kuchepetsa kuchiritsa kwa zilonda zam'mimba. Pamene asidi ochulukira amakhala ovuta, mankhwala a proton pump inhibitor amatchulidwa kuti atseke pulotoni ya pulotoni.
Chifukwa Chake Anthu Ena Odwala Matenda a Matenda Aakulu Amagazi Amadziwika ndi Ma PPI
Anthu ambiri omwe ali ndi nyamakazi amatenga mankhwala osakanikirana ndi otupa (NSAIDs) kuti athetse kutupa ndi ululu zomwe zimagwiridwa ndi matendawa. Ngakhale kuti ma NSAID nthawi zambiri amatha kuchiza matenda a nyamakazi, mankhwalawa amagwirizanitsidwa ndi m'mimba poizoni.
Izi zimakhala chifukwa cha prostaglandin zotetezedwa ndi NSAID. Anthu amene amatenga NSAID zapamwamba kapena ma NSAID ambiri, anthu okalamba, kapena omwe ali ndi mbiri ya matenda a chilonda kapena kutuluka kwa m'mimba ali pangozi yaikulu ya mavuto ochokera ku NSAIDs.
Pochepetsa ziwalo za m'mimba, anthu omwe ali ndi nyamakazi akhoza kulangizidwa kutenga COX-2 inhibitor (mwachitsanzo, Celebrex ), kapena NSAID yachikhalidwe (mwachitsanzo, naproxen , ibuprofen ) ndi misoprostol kapena proton pump inhibitor.
Misoprostol imayenera kutengedwa kangapo patsiku, ikhoza kuyambitsa kutsekula m'mimba, ndipo imayambitsa kusokonezeka, kugwira ntchito msanga, kapena kubadwa kwapachibale-kotero, mankhwala a PPI amasankhidwa. Palinso Vimovo , mankhwala omwe amaphatikiza NSAID (naproxen) ndi PPI (esomeprazole) piritsi imodzi.
Kuphatikizidwa kwa mankhwala a PPI okhala ndi NSAID sikuli kofunikira nthawi zonse. Mankhwala a PPI akhala atagwiritsidwa ntchito mopitirira muyeso. Mankhwala a PPI, omwe amalembedwa kwambiri komanso amalimbikitsidwa kwa onse ogula ndi madokotala, akhala akugwiritsidwa ntchito pochizira kupweteka kwa m'mimba kapena kupweteka kwa mtima pamene njira zowonongeka, kuphatikizapo antacids (Maalox, Mylanta, TUMS) kapena H2 blockers (Tagamet, Pepcid, ndi Zantac ), zingakhale zokwanira.
Pali malangizo othandizira kuti athetse vuto la NSAID:
- Tengani NSAID imodzi yokha pa nthawi, osati NSAID zingapo.
- Gwiritsani ntchito mlingo wotsika kwambiri wa NSAID komanso nthawi yochepa kwambiri yotheka.
- Musagwiritse ntchito NSAID pamene njira zina zamankhwala zimagwirira ntchito ( analgesics , intra-articular injection ).
- Tengani NSAID yanu ndi chakudya.
- Musanyalanyaze zizindikiro za m'mimba; kambiranani ndi dokotala wanu.
- Anthu omwe ali ndi vuto lopanda matenda, matenda opatsirana, zilonda zamimba, aspirin / NSAID hypersensitivity, kuthamanga kwa magazi, kapena matenda a mtima ayenera kupewa NSAIDs.
Kupezeka
Mankhwala a PPI amapezeka ponseponse ndi mankhwala okha, malinga ndi zomwe mumasankha. Malingana ndi Consumer Reports , mankhwalawa ndi ofunika kwambiri komanso okhutira koma amasiyana mtengo.
- Omeprazole (Prilosec, Prilosec OTC)
- Lansoprazole (Prevacid, Prevacid 24 hr)
- Omeprazole / sodium bicarbonate (Zegerid, Zegerid OTC)
- Pantoprazole (Protonix)
- Esomeprazole (Nexium)
- Dexlansoprazole (Kapidex)
- Rabeprazole (Aciphex)
Kuda nkhawa
Kuwonjezera pa zotsatira zofala (kumutu, kutsekula m'mimba), pakhala pali nkhawa zina zotetezedwa zogwiritsidwa ntchito ndi mankhwala a PPI, monga:
- Kuwonjezeka kwa chiopsezo cha matenda
- Kuwonjezeka kwa kachilombo koyambitsa matenda ndi mabakiteriya Clostridium difficile zomwe zimayambitsa kutsekula m'mimba
- Kuwonjezeka kwa mitsempha ya mafupa, kuphatikizapo kupweteka kwa m'chiuno, ndi ntchito yaitali
- Kuchepetsa mphamvu ya Plavix (clopidogrel) kuonda magazi
- Kuyanjana kotheka ndi kuchepetsa kupambana kwa mankhwala ena ndi zowonjezereka
Mfundo Yofunika Kwambiri
Mosiyana ndi mankhwala ena aliwonse, ubwino ndi ngozi za PPI ziyenera kuyeza payekhapayekha. Anthu ena sangafune kuti mankhwala a PPI athetseretu kupweteka kwapakhosi kapena GERD, ngakhale atapatsidwa mankhwalawa. Musaleke mankhwalawa musanalankhule ndi dokotala poyamba. Kusiya mwadzidzidzi kungapangitse zizindikiro.
Anthu omwe ali ndi nyamakazi akhoza kuchepetsa chiopsezo cha m'mimba poizoni omwe amagwiritsidwa ntchito ndi NSAID popanda kutenga PPI mankhwala. Kumbukirani, ngakhale mankhwala a PPI ali oyenerera pa chikhalidwe chanu, kugwiritsa ntchito mosamala kumangotenga kumwa mankhwala okha malinga ngati n'kofunikira.
> Zotsatira:
> Kugwiritsira ntchito Proton Pump Inhibitors kuti Muthane ndi Kutentha kwa Mitsempha ndi Matenda a M'mimba a Reflux. Consumer Reports. Kusinthidwa kwa July 2013.
> Matenda a Khunyu: Matenda Oyamba ndi Chithandizo. Cush J et al. Kusintha kwachitatu. Professional Communications, Inc. Copyright 2010.
> Kodi ma PPI ali ndi zotsatira zoyipa? Sukulu Yachipatala ya Harvard Guide Yathanzi la Banja. February 2009.
> Mapuloteni a Proton Pump Information. US FDA. Kusinthidwa 4/12/2016.