Dhowr Dawooyinka Antidepressants ayaa ka saari kara Saameynta Ka Hortagga Cudurka Dabeecadda ee Hormoon
Tamoxifen waa daawada hoormoonka daweynta hoormoonka ee ay qaadaan haweenka premenopausal ka dib markii ay dhammaystiraan daaweyntooda hore ee loogu talogalay kansarka naaska naasaha ee estrogen. Si loo daaweeyo saameynta daawada tamoxifen (sida nabarada kulul) iyo si ay uga caawiso niyad-jabka, dhakhaatiirtu waxay inta badan qoraan antidepressants. Hase yeeshee dad badan oo dawada niyadjabka ah ayaa faragelin kara, ama gabi ahaanba joojiyaan, faa'iidooyinka tamoksifen.
Maxay tahay qof kasta oo qaadanaya tamoxifen?
Tamoxifen waxay isticmaashaa Kansarka Naasaha
Marka haweeney la dhammeeyo daaweynta asaasiga ah ee kansarka naasaha, daaweynta sida qalliinka , kemotherabi , iyo daaweynta shucaaca , waxay u baahan kartaa inay qaadato tamoxifen. Dumarka qaata hindhistada 'estrogen receptor' ee burooyinka 'positive', daaweynta hoormoonka waxay hoos u dhigi kartaa khatarta kansarka soo noqda (dib u soo noqosho) ilaa boqolkiiba 50.
Doorashada daawada waxay kuxirantahay xaalada menopausal. Haddii qof dumar ah oo horay u jirran tahay, tamoxifen caadi ahaan waa daawada doorashada. (Loogu talagalay dadka qaba postmenopausal, ama kuwa horay u baayacmushtari laakiin ay ku heleen teraabiyada xakameynta ugxan-sidaha, badanaaba loo isticmaalo aromaticase ).
Noocyada kansarka naasaha ee hormoonka xajiinta hormoonka estrogen ayaa lagu shubaa estrogen. Estrogen ku jirta jirka (oo ay sameeyaan ugxan-yari) ayaa ku xidhan unugyada kansarku si ay u kobcaan. Tamoxifen wuxuu u shaqeeyaa iyada oo la xirayo kuwa soo dhaweeyaha si aysan estrogen u dhali karin, asal ahaanna la gaajoonayo unugyada kansarka ee cuntadooda.
Dhibaatooyinka soo raaca tamoxifen waxaa ka mid ah astaamaha nooca cudurka menopausal sida muraayadaha kulul, libido yar, iyo qallal siilka. Haweenka aan weli gaarin miyir-qabatada, nambarada kulul waxay noqon karaan kuwo dhib badan, laakiin waxaan barannay sanadihii la soo dhaafay in qaar ka mid ah dawooyinka lidka diiqada ay yareyn karaan kuwan kulaylka kulul.
Nasiib darro, qaar ka mid ah kuwan daawooyinka lidka ku ah (antidepressants) ayaa sidoo kale yareyn kara waxtarnimada tamoxifen.
Kansarka Naasaha iyo Niyad jabka
Ma aha wax la yaab leh, dumar badan oo loo daweeyay kansarka naasuhu waxay yeeshaan niyad jab. Isku-dubarida baaritaanka nafta-khatarta ah, saameynta daaweynta ee daaweynta, iyo isbeddelada muuqaalka jirka oo daaweyn la socdo oo dhan ayaa sameeya marxaladda saameynta dareenka weyn. Nasiib darro, ka dib markii dumar badan oo qaba kansarka naasaha la daweeyey (ku dhowaad meelo badan oo ka mid ah meelaha qaarkood) daawooyinka antidepressant, waxaa la ogaadey in dhowr daawooyinka antidepressant ay yareyn karaan saameynta tamoxifen. Sidee tani u dhacdaa?
Tamoxifen iyo isdhexgalka daroogada
Tamoxifen iyo isdhexgalka daroogada ayaa ah mid caadi ah, taasina waxay ka kooban tahay daawooyin badan marka lagu daro antidepressants. Maadaama badanaa kuwan badanaa loo isticmaalo mukhaadaraadka, oo ay ka mid yihiin daawooyinka dukaanka laga iibsado sida Benadryl, waxaa muhiim ah in lala hadlo dhakhtarkaaga iyo farmashiistaha wixii daawo ah, diyaarinta miisaanka dheeraadka ah, ama kaalmada cuntada ee aad ka fikiraysid, intaad tahay daroogada. Maadaama dad badani qaataan tamoxifen 5 ilaa 10 sano, tani way ka sii muhiimsan tahay. Maskaxda ku hay in dhammaan dhakhaatiirtu aysan aqoon u laheyn isdhexgalkan (iyo wax badan ayaan baranaynaa waqti kasta).
Taas macnaheedu waa in haddii aad u tagto daryeelka degdegga ah, tusaale ahaan, infakshan, la hadal dhakhtarkaaga ama farmashiistahaaga kahor intaadan qaadan daawooyinka laguu qoray.
Tamoxifen ayaa jidhka ka dhexjirta si loo yareeyo endoxifen. Endoxifen waa 30 illaa 100 jeer ka xoog badan tamoxifen, waxayna masuul ka tahay badi saameynta daaweynta. Tamoxifen waxaa loo jajabiyey endoxifen by Cytochrome P450 enzyme CYP2D6 (oo lagu daray kuwa aan muhiimka ahayn). Daawooyin kasta oo yareeya waxqabadka CYP2D6 (oo ay jiraan dad badan) waxay yareeyn karaan hannaanka burburinta iyo sidan, xaddiga endoxifen ee la soo saaray.
Tamoxifen iyo Antidepressants: Isdhexgalka
Waxaan weli wax badan ka baran karnaa antidepressantada gaarka ah iyo saameynta ay ku leedahay heerarka tamoxifen ee jirka, hase yeeshee illaa iyo hadda waxaan ogaanay in antidepressant kala duwan ay saameyn karto tamoxifen siyaabo kala duwan. Qaar ka mid ah antidepressants (sida Prozac iyo Paxil) waxay si buuxda u diidaan saamaynta tamoxifen. Xaaladdan oo kale, waxay noqonaysaa sidii aanan u qaadanin tamoxifen (oo aan laheyn wax faa'iido u ah in la yareeyo khatarta soo noqoshada).
Daawooyinka kale ee antidepressant waxaa jira isdhexgal dhexdhexaad ah, iyo kuwa kale, oo kaliya isdhexgalka yar. Taas bedelkeeda, hal kaalmo cunto ayaa dhab ahaantii kordhin kara saamaynta tamoxifen (iyo sidoo kale saameynaha), inkastoo daraasado kale ay muujiyeen wax soo-saarka.
Hoos waxaa ku yaal jadwalka soo koobaya waxa aan rumaysannahay in ay run tahay maanta oo ku saabsan dhowr jeer daawooyinka niyadjabka ah. Tani waa qayb ka mid ah cilmi-baarista firfircoon, waxaana suurtagal ah inaan sii barano mustaqbalka dhaw. Haddii aad ka fekereyso daawada antidepressant, si taxaddar leh ula hadal dhakhtarkaaga, laakiin sidoo kale weydii haddii wax isbeddelay.
Niyad jabka iyo sida ay ula dhaqmayaan Tamoxifen
| Dawada Daawada Nabada (Antidepressant Drug) | Is dhexgalka Tamoxifen | Badbaadada Badbaadada |
Paxil (paroxetine) Prozac (fluoxetine) | Waxay ka hortagtaa faa'iidada antiestrogen | Iska ilaali Isticmaal |
Cymbalta (duloxetine) Wellbutrin (bupropion) Zoloft (sertraline) | Farogelin dhexdhexaad ah oo leh faa'iidada antiestrogen Ogsoonow: Daraasaduhu waxay xaqiijinayaan in Zoloftu farageliyo Tamoxifen. | Waxay kordhisaa Khatarta |
| Saint John's Wort (hypericum) | Nadaafad habboon ee faa'iidada antiestrogen | Khatarta Kordhinta |
Celexa (citalopram) Lexapro (escitalopram) Pristiq (desvenlafaxine) Remeron (mirtazapine) | Isdhexgalka fudud Ogsoonow: Pristiq iyo Remeron si fiican looma ogain isdhexgalka Tamoxifen. | Halista Yar |
| Black Cohosh (Actaea) | Waxaa laga yaabaa in la joojiyo ama lagu xoojiyo faa'iidada antiestrogen iyadoo ku xiran daraasadda. Ogsoonow: Waxaa jira dhowr daraasad oo ku saabsan isdhexgalka Tamoxifen, badankoodana waxaa lagu sameeyaa "in vitro" (shaybaarka iyo aadanaha). | Halista Yar |
Saameyn (venlafaxine) | Ku dhowaad wax xiriir ah lama lahan Tamoxifen | Doorashada ugu fiican |
Khadadka hoose ee Tamoxifen iyo Antidepressants
Ogaanshaha ku saabsan isdhexgalka u dhexeeya tamoxifen iyo antidepressant ayaa muhiim ah haddii aad ka fekereyso mid ka mid ah daroogooyinkaas. Qaar ka mid ah antidepressants ayaa si xoog leh u beeninaya saameynta tamoxifen, waxaana loo maleynayaa in isdhexgalkaasi yahay sababta ka dambeysa heerka dhimashada ee haweenka qaba kansarka naasaha oo qaatay Paxil. Waqtigaan, ikhtiyaarka ugu wanaagsan ee loogu talagalay nambarada kulul iyo niyadjabku waxay u muuqdaan inay noqon karaan saameyn, laakiin mar kale waa muhiim in la ogaado in tani ay tahay goob firfircoon ama cilmi baaris ah, waxaana laga yaabaa inaan wax badan ka ogaano mustaqbalka dhow. Sababtoo ah cohosh madow wuxuu leeyahay sumcad ka caawinta nabarada kulul ee la xiriira daaweynta kansarka naasaha, laakiin waxaa kale oo laga yaabaa inay sidoo kale la falgalaan tamoxifen, waxaa muhiim ah in aad kala hadashid dhakhtarkaaga ku qaabilsan daawooyinka, diyaarinta miisaanka, ama kaalmada cuntada ee aad ka fikiraysid.
> Ilo:
> Haque, R., Shi, J., Schottinger, J. et al. Tamoxifen iyo isdhexgalka dawada Antidepressant ee wadaagga ah ee 16,887 Ka badbaadayaasha Kansarka Naasaha. Wargeyska Machadka Kansarka Qaranka . 2015. 108 (3): djv337.
> Juurlink, D. Dib u eegista isdhexgalka Wadnaha ee u dhaxeeya Tamoxifen iyo SSRI Antidepressants. Suxufiyiinta Caafimaadka Britishka . 2016. 354: i5309.
> Li, J., Godecke, T., Chen, S. et al. In dhexdhexaadinta Vitro Metaboole inta u dhaxaysa Black Cohosh (Cimicifuga Racemosa) iyo Tamoxifen Via Iska ilaalinta Cytochromes P450 2D6 iyo 3A4. Xenobiotica . 2011 Aug 9 (Epub ka hor daabac).