Khudaarta cagaaran ee loo yaqaan 'fratefruit juice' waxaa loo yaqaanaa in ay la macaamilaan tiro daawooyin ah , taas oo kordhineysa saameyntooda inta badan heerarka sunta. Marka, marka ay timaado Plavix (clopidogrel), daawo dhiig ah oo khafiifiya ayaa loo isticmaalaa si loo yareeyo jiritaanka istaroogga iyo infekshanka miyokardiyadu, ma ammaan tahay in la cuno cabitaanka miraha? Jawaabta gaaban waa "maya".
Sidee buu udubdhaxraadku kuula macaamilaa Plavix?
Daraasad 2014-ka ah ayaa lagu ogaaday in cabitaanka casiirku uu joojiyo labadaba CYP3A4 enzyme, kaas oo clopidogrel yahay substrate, iyo CYPC19 enzyme, taas oo metabolisa daroogada.
Sidaa daraadeed cabitaanka baastada laga gooyey wuxuu saari karaa isbedelka clopidogrel si qaabkiisa firfircoon, sidaas darteed hoos u dhigista saameynta antiplatelet ee daruuriga ah ee lagama maarmaanka u ah ka hortagga istaroogga ama wadnaha wadnaha.
Jirka gudihiisa, clopidogrel waxaa lagu metabolised isticmaalaya CYP2C19 enzyme. Si kastaba ha noqotee, dadka qaarkiis waa dheef-shiid kiimikaadka hooseeya ee CYP2C19 enzyme. Dadkani waxay u adkaystaan ​​clopidogrel. Inkastoo ay jirto baaritaanka dhiigga si loo ogaado bukaan-socodka clopidogrel u adkaysta kahor intaan hay'ada daaweynta daaweynta la qaadanin, baaritaankan lama isticmaali karo. Xusuusin, dadka dheef-shiid kiimikaadka ah ee clopidogrel, sidoo kale waxay leeyihiin halis khatar ah oo udhaxaysa dhacdooyinka dhacdooyinka wadnaha iyo dhiig-xinjirowga.
Marka la eego warbixinta FDA, daawooyinka wadnaha ee kale ee cabitaanka kudheerta leh waxaa ka mid ah:
- statins (sida Zocor iyo Lipitor)
- daawooyinka dhiig-yare sida nifedipine
- daawooyinka ka hortagga arxan-darada sida amiodarone
Marka lagu daro daawooyinka wadnaha, cabitaanka baastada ayaa sidoo kale saameynaya daroogooyinka soo socda:
- daawooyinka loo isticmaalo bedelka xubnaha sida cyclosporine
- daawooyinka ka hortagga walwalka sida buspirone
- antihistamines sida Allegra
Khudaarta cagaaran waxay noqon kartaa qayb caafimaad qabta oo ah cunto kasta. Haddii aad ku jirto dawooyinka wadnaha, fadlan ka wada hadla haddii ay tahay fikrad wanaagsan in aad cabto casiirka sharaabka leh dhakhtarkaaga ama bixiyaha daryeelka caafimaadka kale.
U hubso inaad u sheegto bixiyahaaga daryeel caafimaad dhammaan daawooyinka aad qaadato iyo qiyaasta daawooyinkaan.
Ereyga
Had iyo jeer waa fikrad wanaagsan inaad si taxadar leh u akhrido qoraalka la daabacay oo la socota clopidogrel. Waa inay jiraan qayb ka mid ah isdhexgalka ka dhexeeya clopidogrel iyo daawooyinka kale. Haddii aadan helin baako xirmo, weydii farmasigaaga nuqulka.
Haddii aad isticmaasho daawooyinka miisaanka (OTC) ama cuntooyinka dheeraadka ah, waa inaad kala hadashaa farmashiistahaaga iyo takhtarkaaga arrimaha isdhexgalka. Waa inaad si gaar ah uga taxadirtaa isticmaalka daawooyinka caabuqa sida ibuprofen iyo dheecaanka OTC kuwaas oo ku jira ginkgo. Dhibaatooyinka dhinaca daawooyinkaan waa dhiigbax.
> Ilo:
> Holmberg MT, Tornio A, Neuvonen M, Neuvonen PJ, Backman JT, Niemi M. Casiirka Grotefruit wuxuu joojiyaa dhaqdhaqaaqa dhaqdhaqaaqa ee clopidogrel. Clin Pharmacol Ther . 2014 doi: 10.1038 / clpt.2013.192
> Krasowski MD. Farmashogenomics Koonfurta-Paul JE, Matheny SC, Lewis EL. eds. CUDURKA CUDURKA & Daaweynta: Daawada Qoyska, 4e . New York, NY: McGraw-Hill; 2015.
> Trevor AJ, Katzung BG, Kruidering-Hall M. Pharmacogenomics. In: Trevor AJ, Katzung BG, Kruidering-Hall M. eds. Qalabka Faransiiska Katzung & Trevor: Dib-u-eegista & Guddiga Dib-u-eegista, 11e . New York, NY: McGraw-Hill; 2015.