Patiromer yatsopano imasonyeza malonjezo pochiza Hyperkalemia
Mankhwala atsopano otchedwa Patiromer awonetsa lonjezo pochiza hyperkalemia mwa anthu omwe akutenga antiin -otiotensin-aldosterone system (RAAS) inhibitors. Hyperkalemia ndiika moyo pachiswe ndipo imayambitsa kufooka, kukwera kwa ziwalo, kupuma kupuma, ndi zovuta za mtima.
Nthawi zina, anthu omwe ali ndi hyperkalemia, kapena potassium yowonjezereka m'magazi, m'makliniki opita kunja.
Anthuwa ndi achikulire ndipo amapezeka ndi matenda a shuga ndipo amapezeka ndi hyperkalemia atatenga mafinysi (β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers [ARBs], ndi aldosterone antptists) Odwala omwe ali ndi vuto loyambitsa chiwindi kapena matenda osokoneza shuga, mazamu a potassium angathe kuwonjezeka kupita ku masoka oopsa pambuyo poyang'anira RAAS inhibitors, zomwe zimapatsa potaziyamu kuchoka mumtsinje.
Koma makamaka, hyperkalemia ndi imene imapereka pakati pa odwala opaleshoni omwe amathandizidwa ndi RAAS poletsa matenda a mtima, shuga, ndi matenda a impso. Matenda a shuga ndi matenda a impso amachititsa kuti atherosclerosis ndi glomerulosclerosis; Njira zoterezi zimagwirira ntchito pamodzi kuti ziletsa thupi (impso) kuthetsa potassium.
Ngakhale kuti RAAS inhibitors ndizowonjezera potaziyamu ndipo ikhoza kubweretsa potassium kapena hyperkalemia, kuperewera kwa mtima, matenda a impso ndi shuga amathandizidwa ndi RAAS inhibitors. Choncho, zingakhale zothandiza kupeza njira yowonjezera yopatsira hyperkalemia mwa anthu omwe ali ndi vutoli omwe akutenga RAAS inhibitors.
Pakalipano, hyperkalemia yathandizidwa ndi kanthawi kochepa monga agonists, calcium, insulini ndi shuga, zonse zomwe zimayambitsa potassium mu maselo; Dothi kapena thiazide diuretics, zomwe zonsezi ndi potassium akuwononga ndi kuwonjezera kapu ya potassium; mankhwala omwe amatchedwa sodium polystyrene sulfonate (Kayexalate), yomwe ingayambitse hypomagnesemia, hypokalemia, mimba yowawa m'mimba komanso ngakhale matumbo a necrosis; ndi dialysis. Pakati pa mayesero a maphunziro a Phase 3, Patiromer amachepetsa kwambiri potaziyamu kwa odwala matenda a shuga omwe anali kutenga RAAS pozilombola ndikuyamba kukhala ochepa kwambiri kwa hyperkalemia.
Patiromer amapangidwa ndi polymer yomwe imadutsa m'matumbo a m'mimba osatsegulidwa. Pamene akudutsa m'mimba, amamwa potaziyamu. M'mayesero am'chipatala, Patiromer inasonyezedwa kuti ili yotetezeka kwa masabata 52 kwa anthu omwe ali ndi hyperkalemia ndi shuga, zomwe zimasonyeza kuti ndi mankhwala othandiza osamalira. Mwa kuyankhula kwina, anthu kutenga RAAS inhibitors akhoza kupewa hyperkalemia mwa kutenga Patiromer. Komanso, atatha kusiya kumwa Patiromer, iwo anayamba kukula mofulumira. Pa zochitika zina, mu maphunziro ena, Patiromer awonetsedwanso kuteteza hyperkalemia mwa anthu omwe ali ndi mtima wosalimba omwe anali kutenga RAAS inhibitors.
Odwala omwe amagwiritsa ntchito Patiromer adalongosola zotsatira zina zomwe zimapweteka kuphatikizapo kuwonjezereka kwa matenda a impso, matenda a hypomagnesemia, kuwonjezeka kwa chiwopsezo cha m'mimba komanso kupsinjika kwa m'mimba. Komabe, anthu 10 okha pa anthu 100 alionse omwe amaphunzira mu phunziro lino sanasiye kutenga Patiromer chifukwa cha zotsatirazi.
Ngakhale malonjezedwe a Patiromer m'zochitika zapakati pa Gawo 3, akatswiri ena adanena za nkhawa pa mankhwalawa. Choyamba, akatswiriwa akunena kuti ndibwino kuti tipitirize kuyesedwa kwa Patiromer kwa nthawi yaitali kuposa chaka - pambuyo pake, anthu ena adzalandira miyoyo yawo yotsala pa Patiromer pomwe akulandira RAAS inhibitors.
Chachiwiri, sizikudziwika bwino ngati anthu omwe amatenga RAAS inhibitors ndi Patiromer kwa hyperkalemia amapindula ndi mankhwala ndi RAAS inhibitors monga omwe ali ndi potassium (normokalemia) omwe amatenga RAAS inhibitors.
Ngati muli ndi mafunso okhudza Patiromer kapena mankhwala alionse, chonde pangani nthawi yoti mukambirane ndi dokotala wanu. Chonde kumbukirani kuti dokotala wanu ndi wachifundo amene ayenera kukuthandizani kukhalabe wodziwa komanso wodziwa zambiri. Kuwerenga za mankhwala osokoneza bongo ndi mankhwala pa intaneti ndi njira yabwino kwambiri yodzidziwitsa nokha. Komabe, chidziwitso ichi chiyenera kuwonjezera chisamaliro ndi uphungu woperekedwa ndi dokotala wanu.
> Zotsatira:
> "Zotsatira za Patiromer pa Sirium Potassium Level of Patients With Hyperkalemia ndi Diabetic Matenda a Impso AMETHYST-DN Randomized Clinical Trial" ndi GL Bakris ndi alembi omwe analemba nawo ku JAMA mu 2015.
> "Kuchiza Mankhwala a Hyperkalemia Kuchokera ku" Hyper K + "Kumenyedwa Kwawo Kuthamanga Kwathu?" ndi WC Winklemayer yofalitsidwa ku JAMA mu 2015.