Odwala Ambiri a Arthritis Amatenga NSAID Gwiritsani Ntchito Proton Pump Inhibitors
Kuphatikiza Zipangizo Zokwanira kwa Hip ku Proton Pump Inhibitors
Kuwonjezeka kwa chiwopsezo cha mchiuno kwagwirizana ndi kugwiritsa ntchito proton pump inhibitors, kalasi ya mankhwala omwe amagwiritsidwa ntchito pochiza matenda okhudzana ndi asidi monga kupweteka kwa mtima ndi GERD (matenda a reflux a gastroesophageal). Malingana ndi zotsatira zofukufuku zomwe zafalitsidwa mu Journal ya American Medical Association ya December 27, 2006, ofufuza anafotokoza kuti mankhwala opatsirana ndi proton pump inhibitors kwa zaka zopitirira chaka chimodzi mwa anthu oposa 50 aliwonse akugwirizana ndi 44 peresenti yowonjezera ngozi ya chiuno kupasuka.
Mavutowa anali oposa 2.6 kuposa omwe amagwiritsira ntchito proton pump inhibitors pa mlingo waukulu. Nthawi ndi mlingo wa ntchito ya proton pump inhibitor zonsezi zinkakhudzidwa ndi chiopsezo chowonjezereka cha hip. Kuopsa kochepa kwa chiuno cha mchiuno kunapangidwanso ndi H2 blockers, omwe amatchedwanso histamine-2 receptor blockers (monga Tagamet ndi Pepcid).
- Mwa odwala 1,262 okalamba ankagwiritsidwa ntchito ndi proton pump inhibitor kwa nthawi yoposa chaka, kupweteka kwina kwa nyamakazi pachaka kumagwirizana ndi kugwiritsa ntchito proton pump inhibitors.
- Odwala achikulire 336 amathandizidwa kwa nthawi yoposa chaka chimodzi ndi mankhwala akuluakulu a proton pump inhibitors, kuphwanya kwapadera kwa chaka chimodzi kudzamangidwa ndi mankhwala a proton pump inhibitor.
Mavitamini a Proton Pump Ndi NSAIDs
Odwala ambiri a nyamakazi amatenga proton pump inhibitors (mwachitsanzo Nexium , Prevacid, Protonix, ndi Prilosec) komanso mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) kuti achepetse zotsatira zokhudzana ndi m'mimba zogwirizana ndi NSAIDs.
Zotsatira zaphunziro zomwe zinanenedwa mu 2003 pamsonkhano wapachaka wa American College of Gastroenterology zanenedwa kuti proton pump inhibitors yachepetsa kwambiri chiopsezo cha zilonda kwa odwala nthawi zonse kutenga NSAIDs. Chidziwitsocho chinasiya madokotala ena kukhulupirira kuti odwala onse pa NSAID ayenera kutenga proton pump inhibitor, pamene ena amamva kuti odwala okha omwe ali ndi zizindikiro ndi matenda a dyspepsia ayenera kutenga proton pump inhibitors.
Komanso mu 2004 ndi 2005, pamene COX-2 inhibitors (kalasi yatsopano ya NSAID yomwe inachititsa kuti mavuto ochepa a m'mimba) ayambe kuchepetsedwa, madokotala ambiri adalangizanso odwala nyamakazi kuti NSAID yachikhalidwe kuphatikizapo proton pump inhibitor inali njira yabwino ya chithandizo.
Kodi Matenda a Arthritis Ayenera Kuleka Kutenga Mapuloteni a Proton?
Malinga ndi katswiri wa mafupa a zinyama, Scott J. Zashin, MD, "Chifukwa chakuti NSAID zitha kuonjezera chiwopsezo cha m'mimba mwazi, odwala ambiri omwe ali pangozi chifukwa cha vutoli nthawi imodzi amatenga proton pump inhibitor monga:
- Prilosec (omeprazole)
- Nexium (esomeprazole)
- Aciphex (rabeprazole)
- Prevacid (lansoprazole)
- Protonix (pantoprazole)
Zowopsa za magazi zimaphatikizapo zaka zoposa 60, osuta fodya, kutenga corticosteroids , aspirin , Coumadin (warfarin), Plavix (clopidogrel) kapena serotonin optiac inhibitors, ndi omwe ali ndi mbiri yakale ya zilonda kapena m'mimba mwazi. Kutenga proton pump inhibitor kungachepetse chiopsezo cha kuika magazi kwabwino kuposa a H2 antagonists, omwe ndi awa:
- Pepcid (famotidine)
- Tagamet (cimetidine)
- Zantac (ranitidine)
Kafukufuku waposachedwapa akuwonetsa kuti odwala omwe ali ndi mlingo waukulu kwambiri wa proton pump inhibitors ali ndi chiopsezo chowonjezereka cha kufooka kwa mitsempha komanso kupweteka kwa m'chiuno.
Akulimbikitsanso kudya 1000-1500 mg ya calcium ndi 400 IU ya vitamini D ngakhale anthu ambiri angapindule ndi 800 IU, makamaka ngati alibe mbiri ya miyala ya impso kapena calcium yapamwamba.
Malinga ndi phunziroli, ndikupempha kuti odwala omwe akuyenera kukhala pa mankhwalawa ndiwowang'onongeka ndipo ngati ali otsika, onani mlingo wa vitamini D ndikuganiziranso chithandizo china kuti musunge mphamvu zamthambo. Zosankha zina zimaphatikizapo kuchotsa proton pump inhibitors ndi mankhwala otchedwa Cytotec (misoprostol) - mankhwala omwe amapindulitsa kwambiri kuteteza mimba ku zilonda zikatengedwa nthawi zinayi tsiku ndi tsiku.
Mankhwalawa amatsutsana (mwachitsanzo, sayenera kugwiritsidwa ntchito) mwazimayi otha msinkhu komanso akhoza kukhala ndi zizindikiro zina za m'mimba. Njira ina ndiyo kupeza njira zina zothandizira kuti ma NSAID asakwaniritsidwe. "
Scott J. Zashin, MD, ndi pulofesa wothandizira panthawiyo ku University of Texas Southwestern Medical School, Division of Rheumatology, ku Dallas, Texas; kupita kuchipatala ku chipatala cha Presbyterian cha Dallas ndi Plano; munthu wa American College of Physicians ndi American College of Rheumatology; ndi membala wa American Medical Association. Dr. Zashin ndi mlembi wa Arthritis Popanda Mavuto - Chozizwitsa cha TNF Blockers . Bukuli ndi lothandiza kwa wina aliyense pa mankhwala enaake (Enbrel, Remicade, Humira) kapena kuganizira mankhwala osokoneza bongo.
Zotsatira:
1. Yang, Yu-Xiao. "Proton Pump Inhibitor Therapy ndi Ngozi ya Hip Fracture." JAMA December 27, 2006.
2. "Kugwiritsa Ntchito Mankhwala Osokoneza Bongo Okhudzana ndi Kuwonongeka kwa Fracture." MSNBC.com. December 29, 2006. 31 Dec 2006.
3. "Proton Pump Inhibitor May Akuthandizani Kuteteza Ulcers M'magwiritsidwe Osafunikira a NSAID." Kusaka. October 15, 2003. 31 Dec 2006.