Kugwiritsa Ntchito Steroid Ya Nthawi Yakale Kumatha Kuphulika Mitsempha Yotayika, Yatsogolera ku Steroid-Induchedwe Osteoporosis
Ngati muli ndi matenda opatsirana (IBD) , dokotala wanu akhoza kulemba mankhwala otchedwa steroids monga prednisone kuti achepetse kutupa panthawi yamoto. Zotsatira zowononga za steroid zimachoka kukhumudwitsa, koma zambiri zimachoka pamene mlingo ulipo pansi ndikusiya.
Komabe, steroids ikhozanso kuthandizira kuti pakhale chitukuko chachikulu komanso chosatha, makamaka ngati atengedwa muyezo waukulu kapena nthawi yayitali.
Chimodzi mwazimenezi ndi matenda a steroid. Zimadziwika bwino kuti steroids ikhoza kuthetsa mafupa. Kwa omwe akudwala steroids, kufunsa dokotala za matenda odwala matenda a mitsempha komanso kuyezetsa magazi nthawi zonse ndi zinthu zofunika zomwe zingathandize kuthana ndi fupa lililonse.
Kodi Kudwala Kwambiri Kwambiri N'kutani?
Osteoporosis ndi yofooketsa mafupa, omwe amawapangitsa kuti asiye kuchuluka kwawo ndipo amakhala otupa ndipo amayamba kutengeka. Ambiri amalingalira kuti ndi matenda a amayi omwe amatha kupha amayi awo, omwe ali oona mbali, komabe zingatheke kwa amuna kapena akazi a msinkhu uliwonse omwe ali pangozi. Zina mwazifukwazi zimaphatikizapo:
- Zaka (zoposa 65)
- Kukhala ochokera ku Caucasus kapena ku Asia
- Mbiri ya banja ya matenda a mitsempha
- Zomangamanga / zochepa (zosakwana 154 lbs)
- Kutha kwaduka kale
- Kugwiritsa ntchito mankhwala ena (kuphatikizapo steroids ndi mahomoni a chithokomiro)
- Kusamba kwa nthawi yoyambirira
- Kulowa kwa kashiamu kosakwanira; kudya mavitamini okwanira
- Mapuloteni apamwamba
- Kukhala moyo wosadzikonda
- Kusuta
- Mowa mopitirira muyeso
- Matenda a Parathyroid
Steroid-Inachititsa Osteoporosis
Ngakhale kuti steroid imachepetsa kutupa, imachepetsanso mapangidwe atsopano a fupa, kuwonjezera kuwonongeka kwa fupa lakale, komanso kuchepetsa kutaya kashiamu kuchokera ku chakudya ndi thupi. Pankhani ya IBD, chitukuko cha osteoporosis chikhoza kuwonjezeka ndi calcium yomwe ilipo kale.
Kuzindikira kwa Steroid-Indedi Osteoporosis
Osteoporosis imapezedwa ndi mayeso otchedwa awiri-mphamvu x-ray absorptiometry (DEXA). DEXA imakhala yovuta kwambiri kuposa nthawi yambiri ya x-ray ndipo imatha kupeza kupweteka kwa mafupa kumayambiriro ake. Zili zopweteka ndipo zimatenga pafupifupi mphindi 10 kuti zitsirize.
American College of Rheumatology imalimbikitsa DEXA kuyesa kumayambiriro kwa mankhwala a steroid ndi nthawi (mwina pachaka) pambuyo pake pamene mankhwala akupitirira.
Osteoporosis amafala kwambiri kwa anthu omwe ali ndi matenda a Crohn kusiyana ndi omwe ali ndi zilonda zam'mimba, kotero DEXA yakugwira ntchito yothandizira mafupa oyambirira akulimbikitsidwa ndi odwala a Crohn.
DEXA imalimbikitsa odwala omwe ali ndi zilonda zam'mimba zomwe zimaperekedwa ngati mankhwala a nthawi yaitali.
Kuteteza Steroid-Kuchokera Kwambiri Kufooka kwa Mitsempha
Taper steroids. Pofuna kuteteza mafupa oyambirira, steroids ayenera kugwiritsidwa ntchito pa mlingo wochepa kwambiri wa nthawi yochepa kwambiri. Chithandizo cha steroid chingakhale chothandiza kwambiri pa zinthu zambiri zotupa, koma phindu liyenera kulemedwa ndi zotsatira zowopsa monga matenda otupa mafupa. Musasinthe mankhwala anu nokha musanalankhule ndi dokotala wanu.
Lekani kusuta. Kusuta ndudu kumagwirizanitsidwa ndi zinthu zambiri zomwe zimapangitsa kuti mafupa awonongeke, monga zakudya zoperewera komanso kusachita masewera olimbitsa thupi.
Azimayi omwe amasuta amatha kutulutsa maestrojeni osachepera ndipo amayamba kuchepa kwabwino kuposa amayi osasuta. Kuphatikizanso apo, anthu osuta fodya amatenga nthawi yayitali kuti azichiritsa matenda, ndipo ntchito ya fodya imawoneka kuti imachepetsa kuchuluka kwa mafupa.
Kuchita masewera olimbitsa thupi. Zochita zolimbitsa thupi , monga kuteteza thupi, zimathandiza kuwonjezera mafupa. Kuchita masewera olimbitsa thupi kumalimbikitsa kupanga mafupa ndi kusunga kashiamu.
Kuchiza Steroid-Kuchokera Kwambiri Osteoporosis
Zakudya. Chifukwa chakuti calcium imalowa m'matumbo aang'ono, malabsorption amapezeka makamaka anthu omwe ali ndi matenda a Crohn omwe ali ndi kutupa m'mimba . Anthu omwe ali ndi ulcerative colitis, omwe amapezeka m'matumbo akuluakulu , akhoza kukhala ndi calcium yokwanira.
Calcium yowonjezerapo patsiku la 1500 mg pa tsiku ikhoza kutonthozedwa kuti mupewe kapena kuteteza mafupa oyambirira. Dokotala wanu akufunika kukukulangizani za mlingo, ngati zilipo, ndi zoyenera kwa inu.
Ndikofunika kudziwa kuti kashiamu siigwira ntchito yokha - imafunika vitamini D kuti ikhale yogwirizana ndi thupi. Vitamini D imapangidwa ngati khungu likuwoneka ndi dzuwa, koma anthu ambiri samakhala ndi nthawi yokwanira kuti apange vitamini D. Okwanira ngati calcium, vitamini D sichikuyendetsedwa bwino ndi anthu omwe ali ndi kutupa kotentha m'mimba chifukwa cha matenda a Crohn. Zowonjezera tsiku lililonse ndi vitamini D 400 IU zingalimbikitsidwe kuti athetse kuwonongeka kwa mafupa oyambirira; kachiwiri, lankhulani ndi dokotala wanu za zomwe zakulangizirani.
Bisphosphonates: Fosamax (alendronate), Actonel (risedronate), Didronel (etidronate), Boniva (ibandronate), ndi Reclast (zoledronic acid) ndi mabosphosphonates omwe amagwiritsidwa ntchito kuthandizira fupa ndikusunga mafupa. Mankhwalawa angathandizenso kuchepa kwa mafupa mumsana ndi m'chiuno.
Bisphosphonates panopa ndilo gulu lokha la mankhwala omwe ali a FDA-omwe amavomereza kuti athetse matenda a mitsempha mwa amuna. Amaperekedwa ndi calcium ndi vitamini D.
Forteo (Teriparatide). Forteo ndi hormone ya parathyroid yomwe imavomerezedwa kuti imuchulukitse matenda a steroid-amene amachititsa kuti thupi lizifooka; Ikhoza kugwiritsidwa ntchito kwa zaka ziwiri. Anthu omwe adalandira chithandizo cha ma radiation, monga khansa, sali abwino kwa mankhwalawa. Forteo imayendetsedwa tsiku lililonse ndi jekeseni.
Calcitonin (Calcimar, Cibacalcin, Miacalcin). Calcitonin imathandiza kuchepetsa kuperewera kwa mafupa ndi kupewa kutsekemera m'mphuno koma osati m'chiuno. Mankhwalawa amaperekedwa ngati mankhwala amphongo ndipo amatha kupsa mtima m'magazi. Sizothandiza kwambiri pochiza matenda a steroid-induced osteoporosis, kotero calcitonin amagwiritsidwa ntchito pokhapokha kwa odwala omwe sangathe kutenga kapena osakondera mankhwala a bisphosphonates.
Zotsatira:
Amin S. "Glucocorticoid-Inachititsa Osteoporosis." American College of Rheumatology 2010.
Rosen HN. "Kupewa ndi kuchiza matenda a glucocorticoid-oduced osteoporosis." Kufikira May 2010.