Iziguli eziningi ze-Arthritis ezithatha ama-NSAID Sebenzisa i-Proton Pump Inhibitors
I-Study Links Hip Fracture kuya ku-Proton Pump Inhibitors
Ingozi eyengeziwe yokwephuka kwe-hip ihlotshaniswe nokusetshenziswa kweproton pump inhibitors, isigaba sezidakamizwa esetshenziselwa ukuphatha izimo ezihlobene ne-asidi njenge- heartburn kanye ne- GERD (isifo se-reflux se-gastroesophageal). Ngokusho kwemiphumela yokucwaninga eyashicilelwe kuyi- Journal of the American Medical Association , ngo-December 27, 2006, abacwaningi babika ukuthi ukwelashwa ngeproton pump inhibitors iminyaka engaphezu konyaka kubantu abangaphezu kweminyaka engama-50 ubudala kwahlanganiswa namaphesenti angu-44 kwanda ingozi yezinyosi ukuphuka.
Ingozi yayiyizikhathi ezingu-2.6 eziphakeme kubasebenzisi besikhathi eside beproton pump inhibitors kumazinga aphezulu. Isikhathi kanye nokulinganisa ukusetshenziswa kweproton pump inhibitor kokubili kwakunobungozi bokukhula kwe-hip ukuhlukumeza. Ingozi encane, kodwa okwenyuka ngokufanayo ye-hip fracture nayo ihlotshaniswa ne-block block H2, ebizwa nangokuthi i-histamine-2 receptor blockers (isib. ITagamet ne-Pepcid).
- Kulezi ziguli ezingama-1,262 asebekhulile ziphathwa nge-proton pump inhibitor okungaphezu konyaka, ukuqhuma okunye kokwenziwa kwe-hip ngonyaka kuzoboshwa ekusetshenzisweni kweproton pump inhibitors.
- Kuzo zonke iziguli ezingama-336 asebekhulile ziphathwe iminyaka engaphezu konyaka ngezidakamizwa eziphezulu zeproton pump inhibitors, ukuqhuma okunye okwephuka ngonyaka kuzoxhunyaniswa nemithi yeproton pump inhibitor.
I-proton Pump Inhibitors ene-NSAID
Iziguli eziningi ze-arthritis nazo zithatha i-proton pump inhibitors (isib. I- Nexium , i-Prevacid, i-Protonix, ne-Prilosec) kanye nezidakamizwa ezingezona ukuvuvukala (i-NSAID) ukunciphisa imiphumela emibi yemiphumela yamathumbu ehambisana ne-NSAID.
Imiphumela yokufunda eyabika ngo-2003 emhlanganweni waminyaka yonke we-American College of Gastroenterology iphakamisa ukuthi i-proton pump inhibitors inciphise kakhulu ingozi yezilonda ezigulini ezithatha ama-NSAID njalo. Ulwazi lwalushiya abanye odokotela bakholelwa ukuthi zonke iziguli ezise-NSAID kufanele futhi zithathe iproton inhibitor, kanti abanye bazizwa nje iziguli ezazibonakaliswa nge- dyspepsia kufanele zithathe i-proton pump inhibitors.
Kanti futhi ngo-2004 no-2005, lapho i- COX-2 inhibitors (isigaba esisha se-NSAID sithathwa njengokubangela izinkinga ezincane zamathumbu) kwahlolwa ngokuphathelene nezinkinga zokuphepha kwengqondo, odokotela abaningi baphinde bacebisa iziguli ze-arthritis ukuthi i-NSAID yendabuko ihlanganiswe ne-proton pump inhibitor ukhetho olungcono lwezokwelapha.
Ingabe Iziguli Zama-Arthritis Kufanele Ziyeke Ukuthatha I-Proton Pump Inhibitors?
Ngokwe-rheumatologist uScott J. Zashin, MD, "Ngenxa yokuthi ama-NSAID angandisa ingozi yokugaya amathumbu, iziguli eziningi ezisengozini yale nkinga ngesikhathi esisodwa zithatha iprotton pump inhibitor njenge:
- I-Prilosec (i-omeprazole)
- I-Nexium (esomeprazole)
- I-Aciphex (i-rabeprazole)
- I-Prevacid (i-lansoprazole)
- I-Protonix (i-pantoprazole)
Izingozi zokuphuma kwegazi zihlanganisa iminyaka engaphezu kwengu-60, ababhemayo, ukuthatha i- corticosteroids , i- aspirin , i-Coumadin (i-warfarin), i-Plavix (i-clopidogrel) noma i-serotonin inhibitors yokufakela, kanye nalabo abanomlando wangaphambili wezilonda noma ukuphuma kwamathumbu. Ukuthatha i-proton pump inhibitor kunganciphisa ingozi yokugaya i-GI kangcono kunabamelene ne-H2, okubandakanya:
- I-Pepcid (i-famotidine)
- I-Tagamet (i-cimetidine)
- I-Zantac (ranitidine)
Ucwaningo lwamuva lubonisa ukuthi lezo ziguli ezithatha umthamo ophakeme kakhulu weproton pump inhibitors zineengozi eyengeziwe yokweqa i-osteoporosis nokuqhekeka kwe-hip.
Kusenconywa ukuba kube nokudla kwansuku zonke kuka 1000-1500 mg we- calcium ne-400 IU ka-vitamin D nakuba abantu abaningi bangazuza kusuka ku-800 IU, ikakhulukazi uma bengenalo umlando wezinso zezinso noma i-calcium ephakeme.
Ngokusekelwe kulolu cwaningo, ngingahle ngincome ukuthi iziguli ezidinga ukuba kulezi zidakamizwa zihlolwe ngamathambo futhi uma ziphansi, hlola izinga levithamini D bese ucabangela ukwelashwa okwengeziwe ukuze ugcine amandla amathambo. Okunye okukhethwa kukho kubandakanya ukufaka esikhundleni se-proton pump inhibitors enomuthi obizwa nge-Cytotec (misoprostol) - imithi ehlinzeka inzuzo enkulu ekuvikeleni isisu kusuka ezilonda uma kuthathwa izikhathi ezine nsuku zonke.
Lesi sidakamizwa siyaphikisana (okungukuthi akufanele sisetshenziswe) kwabesifazane abaneminyaka yokubeletha futhi kungenzeka kube neminye iminye iminye imithi yokuzala. Enye indlela yokuthola ukwelashwa okunye ngakho-ke ama-NSAID ayadingeki. "
UScott J. Zashin, MD, uprofesa wothisha osesithombeni e-University of Texas Southwestern Medical School, Division of Rheumatology, eDallas, eTexas; udokotela ozofika esibhedlela sasePresbyterian yaseDallas nasePlano; umlingani we-American College of Physicians kanye ne-American College of Rheumatology; futhi ilungu le-American Medical Association. UDkt Zashin ungumbhali we- Arthritis Ngaphandle Kokuhlungu - Ummangaliso Wama-Blockers we-TNF . Le ncwadi iyasiza kunoma ubani wezidakamizwa ze-biologic (Enbrel, Remicade, Humira) noma ucabangela izidakamizwa ze-biologic.
Imithombo:
1. Yang, Yu-Xiao. "Isikhathi eside se-Proton Pump Inhibitor Therapy kanye nengozi ye-Hip Fracture." I-JAMA December 27, 2006.
2. "Izidakamizwa zokuphuza izidakamizwa ezixhunyaniswe nengozi ye-Hip Fracture." MSNBC.com. Disemba 29, 2006. 31 Dec 2006.
3. "I-Proton Pump Inhibitor Kungasiza Ukuvimbela I-Ulcers Kubasebenzisi Bokugcina be-NSAID." I-Medscape. Okthoba 15, 2003. 31 Dec 2006.