Qaar ka mid ah Dadka Lagu Adeegay NSAID-yada Hore Isku-ilaaliyaha Kontoroolka (Proton Pump Inhibitor)
Kondhom Proton, oo sidoo kale loo yaqaan daawooyinka PPI, waa nooc daawooyinka loo qoro si loo daweeyo maan-qandhac, GERD (cudur gawrac-ku-celis ah), boogo , ama xaalado kale oo la xiriira xanuunka caloosha. Kontoroolada mashiinka difaaca waxay shaqeeyaan xayirista enzymn kaasoo lagama maarmaan u ah samaynta caloosha. By joojinta enzyme, wax soo saarka acid hoos u.
Sidee loo shaqeeyaa Proton Pump?
Bamka motoorka waa meco-yaal laga helo unugyada qaar ee caloosha (unugyada parietal). Ku shaqeynta mashiinka molecular, bamka protonka wuxuu ka qaadaa unug kale oo non-acidic acid ah oo ka soo baxaya caloosha kuna badalida iyadooga asiidh acidic acid. Adigoo u galiya ionka dareeraha calooshaada, bamka protonka wuxuu kordhiyaa astaamaha calooshaada. Cudurka caloosha ayaa lagama maarmaan u ah in lagu caawiyo burburinta cuntada iyo dheefshiidka gargaarka. Hase yeeshee, aashitada aadka u badan, waxay ka xanaajin kartaa hunguriga, taas oo keenta calool-galka ama xummad, iyo waxay yarayn kartaa bogsashada caloosha caloosha. Marka astaamaha xadidan ay noqdaan dhibaato, daawooyinka maaddada proton-ka ah ee inta badan waxaa loo qoraa si loo xiro bamka proton.
Maxay Dadka qaarkiis ee qaba Xanuunka Xanuunka ah?
Dad badan oo qaba xanuunka arthritis-ka waxay qaataan daawooyinka nonsteroid anti-inflammatory (NSAIDs) si loo xakameeyo barar iyo xanuunka lala xiriiriyo cudurkooda wadajir ah. Inkastoo NSAIDs ay badanaa tahay daaweyn arthritis oo wax ku ool ah, daroogadu waxay la xiriiraan sunta caloosha.
Dhibaatadani waxay ugu wacan tahay daawada prostaglandin ee NSAIDs. Dadka qaata qaddar sare NSAID ama dad badan oo NSAID, dadka waayeelka ah, ama kuwa qaba taariikhda cudurka boogta faafa ama dhiig-baxa dheef-shiid kiimikaad ayaa halis weyn ugu jira dhibaatooyinka NSAID-ka.
Si loo yareeyo khatarta xanuunka caloosha, dadka qaba arthritis waxaa lagula talin karaa inay qaataan COX-2 inhibitor (sida, Celebrex ), ama NSAID (sida, naproxen , ibuprofen ) oo leh misoprostol ama barxadda difaaca ee proton.
Misoprostol waa in la qaadaa dhowr jeer maalintii, waxay keeni kartaa shuban, waxayna sababi kartaa dhicin, dhicis shaqeyn, ama cillado dhalasho-sidaas daraadeed, daawooyinka PPI ayaa sida caadiga ah doorbida. Waxaa sidoo kale jira Vimovo , oo ah daroogo isku dhaf ah NSAID (naproxen) iyo PPI (esomeprazole) hal kaniini.
Isku daridda daawada PPI ee NSAID ma ahan mid lagama maarmaan u ah dhammaan kiisaska. Daawooyinka PPI dhab ahaantii waxay noqdeen kuwo ka baxsan. Daawooyinka PPI, oo si aad ah loo xayeysiinayo iyo u dallacsiiyey labadaba macaamiisha iyo takhaatiirta, ayaa loo isticmaalay in lagu daaweeyo calool-xanuun khafiif ah ama miyir-beel leh marka daawooyinka iska-wax-u-qabsiga, oo ay ku jiraan antacids (Maalox, Mylanta, TUMS) ama H2 blockers (Tagamet, Pepcid, iyo Zantac ), waxay noqon laheyd mid ku filan.
Waxaa jira shuruudo xagjiriin ah oo kaa caawinaya maareynta NSAID suntan:
- Hal mar oo NSAID u qaado hal mar, looma baahna NSAIDs.
- Isticmaal qadarka ugu hooseeya ee NSAID iyo muddada ugu gaaban ee suurtogalka ah.
- Ha isticmaalin NSAIDs marka ikhtiyaarka kale ee daaweyntu ay shaqeeyaan ( xanuunka , duritaanka laf-dhabarka ).
- Qaado NSAID-kaaga cuntada.
- Ha iska dhaga tirin calaamadaha caloosha; kala hadal dhakhtarkaaga.
- Dadka qaba xanuunka xaamilada, cudurka qanjidhada peptic, dhiig-baxa dheefshiidka, aspirin / NSAID-ku-qabsashada, hypertension-ka aan la xakamayn, ama cudurada wadnaha waa ineey ka fogaadaan NSAIDs.
Helitaanka
Daawooyinka PPI waxaa lagu heli karaa labadaba miiska iyo rijeetada oo kaliya, taas oo ku xidhan hadba sida aad dooratid. Sida laga soo xigtay Warbixinta Macaamiisha , daawooyinka waxay asal ahaan u dhigmeen marka la eego waxtarka iyo amniga balse waxay ku kala duwan yihiin qiimaha.
- Omeprazole (Prilosec, Prilosec OTC)
- Lansoprazole (Prevacid, Prevacid 24 saac)
- Omeprazole / sodium bicarbonate (Zegerid, Zegerid OTC)
- Pantoprazole (Protonix)
- Esomeprazole (Nexium)
- Dexlansoprazole (Kapidex)
- Rabeprazole (Aciphex)
Walaacyada Nabadgelyada
Marka laga reebo waxyeelada caadiga ah (madax xanuun, shuban), waxaa jiray arrimo nabadgelyo oo la xidhiidha daawooyinka PPI, sida:
- Halista sii kordheysa ee cudurka
- Khatarta infekshanka ee sii kordhaysa ee bakteeriyada Clostridium difficile oo sababa shuban daran
- Khatarta kordheysa ee lafaha lafaha, oo ay ku jiraan jabta qaliinka, oo la isticmaalayo waqti dheer
- Waxtarka yar ee Plavix (clopidogrel) hoos u dhigo dhiig
- Isdhexgalka suurtogalka ah iyo waxtarka hooseeya ee daroogooyinka kale iyo dheefaha
Khadadka hoose
Maya wax ka duwan marka loo eego daroogooyinka kale, faa'iidooyinka iyo halista PPIs waa in lagu miisaamo kiis kasta. Dadka qaarkiis uma baahna dawooyinka PPI si ay u maareyn karaan qulqulo fudud ama dhexdhexaad ah ama GERD, inkastoo loo qoray daawooyinka. Ha joojin daawooyinka adiga oo aan marka hore kala hadlin dhakhtarkaaga. Xakameynta degdega ah ayaa dhab ahaantii kordhin karta calaamadaha.
Dadka qaba arthritis-ku waxay awood u yeelan karaan inay yareeyaan khatarta xajiinta qanjirada ugu weyn ee la xidhiidha isticmaalka NSAID iyaga oo aan qaadan daawooyinka PPI. Xasuuso, xitaa haddii daawooyinka PPI ay kudoonyihiin xaalad gaar ah, isticmaalka nabdoon wuxuu ka dhigan yahay oo keliya qaadashada daawada ilaa inta loo baahdo.
> Ilo:
> Isticmaalida Nidaamyada Proton Pump to Treat Treatment Xanuunka Xanuunka iyo Caloosha. Warbixinta Macmiilaha. La sii daayay July 2013.
> Rheumatoid Arthritis: Early Diagnosis and Treatment. Cush J et al. Saddexaad. Xiriirka Xirfadaha, Inc. Copyright 2010.
> Miyuu ku dhacaa waxyeelada muddada-dheer? Hagaha Caafimaadka Qoyska ee Harvard Medical School. Febraayo 2009.
> Macluumaadka Ka-hortagga Kalluumeysiga. US FDA. La sii daayo 4/12/2016.