Ngisebenzisa Yaz, Yasmin, Beyaz noma iSaferal - Yini Okufanele Ngiyenze?
UMBUZO - NGISEBENZISA AMAPHILA OKUPHATHISWA KWE-YAZ, INGABE NGINGAVUMELANA NOMHLABA OYINGCWELE NGOKUBA UKUHLELA KWEMPILO YOKUPHILA KWAMAGAZINI NEZIMPILO ZOKUPHILA?
Eminyakeni yamuva, amaphilisi enhlanganisela e-dropspirenone ayenziwa kakhulu. Amaphilisi okulawula ukuzalwa ahlanganisa i- Yaz , Yasmin, Beyaz , ne-Safyral. Ingxenye yezizathu zokuthandwa kwabo kuhlobene nezinye zezinzuzo ezingenakuqaphela ezinikeza zona.
Kulabo besifazane abanquma ukusebenzisa iphilisi ngokuvimbela ukukhulelwa (ngaphezu kokuvimbela ukukhulelwa, i-Yaz noBeyaz baye bavunyelwa i-FDA ukuthi baphathe izimpawu zesifo sokucindezeleka kwangaphambi komzimba kanye nokwelapha amakhemikhali amancane . Beyaz inikezela abesifazane ngesamba sabo esinconywa nsuku zonke (0.4mg) we-folic acid.
Enye into eyenza la maphilisi okulawula ukubeletha ahlukile ukuthi aqukethe i- progestin drospirenone. Le progesin ingakwazi ukuvimbela ama-hormone egeleza alawula amanzi nomzimba wakho we-electrolytes. I-Drospirenone nayo ingabangela amazinga aphezulu e-potassium kanye / noma ukuxhumana neminye imithi ekhulisa i-potassium. Kukhona futhi ukukhathazeka ngokuthi ukusebenzisa amaphilisi okuvimbela ukuzala okuqukethe drospirenone kungandisa ukwanda kwengozi yegazi uma kuqhathaniswa namaphilisi okulawula ukuzalwa okuqukethe i-progestin ehlukile.
---> Ngaphandle kokulawula ukuzala: Yaz noBeyaz
Kubalulekile ukuveza ukuthi zonke izipilisi zokulawula ukuzalwa zibeka ingozi yokuthuthukisa ama- blood clots .
Ama-clots egazi abumba emzimbeni ojulile emzimbeni abizwa ngokuthi i- vein thrombosis ejulile (DVT). I-DVT iyi-side control pill side side effect futhi ingavimbela ukugeleza kwegazi. I -embolism ye-pulmonary ingase ikwenzeke uma i-clot yegazi iphuma egazini bese idlula emzimbeni ungene emaphashini. Lokhu kungaholela ekufeni.
IMPENDULO - AKUNGABENZISWA NEPANIC. NOKUBA UFANELE UQONDE OKUPHILAYO:
I-FDA ihlolisise ukuxhumana okukhona phakathi kwe-drospirenone ne-blood clot engozini. I-ejensi yenze isifundo sayo siqu esixhaswe ngemali ebheka idatha evela kwabesifazane abangaphezu kuka-800,000. Ngo-Okthoba 2011, i-FDA yakhipha imiphumela yalolu cwaningo futhi yabonisa ukukhathazeka mayelana nokwanda okungaphezulu kokungu- 1/2 kwengozi yegazi le-clot kubesifazane abasebenzisa amaphilisi e-drospirenone.
Ngokwelulekwa ngo-Ephreli 2012, i-FDA yamemezela ukuthi le nhlangano isiphelile ukubuyekezwa kwayo kocwaningo olukhona lokuhlola kanye ne-epidemiologic mayelana ne-drospirenone ne-blood clot engozini. Ngokusekelwe kulokhu kubuyekezwa, i-FDA iphetha ngokuthi amaphilisi okulawula ukuzalwa kwe-drospirenone angase ahlotshwe engozini ephakeme ye-clot yegazi futhi abize izidingo ezintsha zokubhalisa kula maphilisi. Kodwa-ke, le nhlangano iphinde ikhombise ukuthi lolu cwaningo aluzange lunikeze imiphumela ehambisanayo noma i-akhawunti yezici ezibalulekile ezibekezelayo ezingase zenze negalelo legazi le-clot. Nakuba i-FDA ibonise ukuthi kungase kube khona ukuxhumana phakathi kwe-drospirenone ne-blood clot engozini, baphinde bathi i-ejensi ayisaqiniseki ukuthi lokhu kwanda ingozi ye-blood clot empeleni ngenxa ye-drospirenone kula maphilisi okulawula ukuzalwa.
Yini I-Drospirenone Negazi Elikuvimbela Ingozi Okushiwo Ngami?
Ngalesi sikhathi, akudingeki ukwethuke uma okwamanje usebenzisa iphilisi yokulawula ukuzalwa eliqukethe i-drospirenone. I-FDA iyeluleka ukuthi:
- Akufanele uyeke ukuthatha iphilisi yakho ngaphandle kokukhuluma nodokotela wakho kuqala.
- Uma unenkinga noma imibuzo, kufanele uxoxe nabo nodokotela wakho.
- Uma ucabanga ngokushintsha izindlela zokwelapha (noma ufuna ukuqala ukusebenzisa ukulawula ukubeletha ), kubalulekile ukuthi ukhulume nodokotela wakho mayelana nengozi yegazi lakho ngaphambi kokunquma ukuthi iyiphi indlela yokulawula ukuzalwa okufanele uyisebenzise.
I-FDA ibuye iyala odokotela ukuba bacabangele izingozi nezinzuzo zamaphilisi okulawula ukuzalwa kokuzalwa kwe-drospirenone nomngcipheko wesifazane wokuthuthukisa ama-clots wegazi ngaphambi kokubeka lezi pilisi.
Uma usebenzisa i-pilspirenone yokulawula i-pilisi yokulawula ukuzalwa njengoJaz, Yasmin, Beyaz noma iSaferal, kufanele wazi lokhu okulandelayo:
- Uma uhlelwe ukuhlinzeka okukhulu, kufanele uyeke ukusebenzisa amaphilisi akho okulawula ukuzalwa okuphathelene ne-drospirenone okungenani amasonto amane ngaphambi kokusebenza kwakho bese ulinda amasonto amabili ngemuva kokuqala ukuwasebenzisa futhi.
- Kungaba usizo nakakhulu ukuthi ukwazi ukubona izimpawu zamagundane wegazi . Lezi zingabandakanya ubuhlungu obukhulu besifuba, ubuhlungu bomlenze noma obomvu obuqhubekayo (okungenzeka ukuvuvukala, ukufudumala nokubomvu) kanye / noma ukuphefumula okungazelelwe. Uma uzithola uhlangabezana nanoma iyiphi yalezi zimpawu, kufanele ushayele ngokushesha udokotela wakho.
- Uma uvalelwe ekuphumuleni kombhede noma ukuphonswa noma uzobe uhambo olude (amahora amane noma ngaphezulu), ungase ube nengozi enkulu yegazi le-clot.
- Uma ubhema, uneminyaka engaphezu kwengu-35 ubudala futhi usebenzise noma yiliphi iphilisi lokulawula ukuzalwa, ingozi yokuthi ubhekene nezenzakalo ezinkulu zenhliziyo, njengezakhi zegazi, ziyanda.
Ezinye Izizathu Okufanele Uzibheke Ngokubili Ngodokotela Wakho:
Ngenxa yalokhu kunganda kwengozi yegazi, kungase kube yisikhathi esihle sokuhlola kabili nodokotela wakho ukuthi iphilisi lokulawula ukuzalwa lokuzalwa eliqukethe i- ethinyl estradiol ne-drospirenone yiyona ndlela engcono kakhulu kuwe. Ngenxa yokuthi i-drospirenone ingakwandisa amazinga we-potassium noma iphazamise imithi yokwandisa i-potassium, udokotela wakho kufanele aqaphele amazinga wakho we-serum potassium ngenyanga yokuqala yokusetshenziswa uma uphathwa nangoma yisiphi isidakamizwa esihambisana nokugcinwa kwe-potassium. Lezi zidakamizwa zingafaka:
- Potassium supplementation ACE inhibitors (Vasotec, Capoten, Zestril nabanye)
- Abaphikisi be-Aldosterone
- I-potassium-sparing diuretics (i-spironolactone nabanye)
- I-Heparin
- Ama-NSAID (ibuprofen [Motrin, Advil], naproxen [i-Aleve nabanye] lapho kuthathwa isikhathi eside futhi nsuku zonke ukwelashwa kwesifo samathambo noma ezinye izinkinga)
- Abaphikisi be-Angiotensin-II (Avapro, Cozaar, Diovan nabanye)
Ukwengeza, uma okwamanje usebenzisa i-Yaz, Yasmin, Beyaz noma iSaferal futhi unezimo ezilandelayo, ungase ufune ukukhuluma nodokotela wakho ukuqinisekisa ukuthi lokhu kuyindlela yokuphepha yokubeletha ephephile kunazo zonke kuwe:
- Ukucindezelwa kwegazi okungalawuleki
- Umlando wezindwangu zegazi emilenzeni yakho, amaphaphu noma amehlo
- Umlando wezifo eziphezulu, isifo sezinso noma isifo sesibindi
- Unesifo sikashukela esinomsoco, iso, isisindo noma umonakalo wesikhala segazi
- Ukuhlaselwa kwenhliziyo, ukushaywa noma umlando wezinkinga ezinkulu ze-valve yenhliziyo noma ukulinganisa kwenhliziyo okungavamile okungabangela ukuba ama-clots egazi akha enhliziyweni
I-DROSPIRENONE NOMSEBENZI WAMAGAZINI WESIKHATHI SOMTHETHO - I-BOTTOM LINE:
Ngokuvamile, uma abesifazane abangu-10 000 (abangakhulelwe futhi bengasebenzisi amaphilisi okulawula ukubeletha) kulandelwa unyaka owodwa, phakathi kuka-1 no-5 kulaba besifazane kuzokwakha i-clot yegazi. Ngisho noma ungase ube engozini enkulu yezindwangu zegazi uma uthatha iphilisi ye-drospirenone yokulawula ukuzalwa, ngingathanda ukukukhumbuza nokuthi ukusebenzisa noma iyiphi inhlanganisela yokubeletha ngomlomo kungakubeka engozini yokuthuthukisa ama-blood clots.
Ingozi ye-thromboembolism ye-venous (i-vein thrombosis ejulile kanye / noma i-embolism yamaphaphu) kwabesifazane abasebenzisa noma yiluphi uhlobo lwenhlanganisela yokubeletha i-rap ayiyinto engavamile futhi kulinganiselwa ukuthi yi-3 kuya ku-9 kwabesifazane abayi-10,000 (ngonyaka). Le ngozi ingaphezulu kakhulu ngonyaka wokuqala wokusetshenziswa (ikakhulukazi ezinyangeni eziyisithupha zokuqala). Ingozi enkulu kunazo zonke ye-thromboembolism ye-venous kubonakala sengathi emva kwakho ekuqaleni uqale ukuthatha iphilisi elihlanganisiwe noma uqale kabusha iphilisi elifanayo noma umkhiqizo ohlukile (uma sekuphele amasonto angama-4 kusukela usebenzise iphilisi).
Wena nodokotela wakho kufanele nilinganise izingozi zezindwangu zegazi (neminye imiphumela emibi ) ngokumelene nezinzuzo zepilisi (kokubili ukukhulelwa kokukhulelwa kanye nezinzuzo ezingekho kokuzala ).
Konke lokho okushiwo, kubalulekile ukuthi ugcine ingozi yengozi yegazi ngokubona: ingozi enkulu yokukhula kwegazi iphansi kakhulu. Ngisho noma unengozi ephakeme ye-blood clot uma usebenzisa iphilisi (ngokungafani nokusebenzisa ukukhulelwa kwe-hormonal ), lokhu engozini isengaphansi kwegazi le-clot engozini ehlobene nokukhulelwa noma emva kokubeletha:
- I-blood clot engozini yabesifazane abaneminyaka yobudala yokubeletha abangayisebenzisi iphilisi (1-5 amacala angama-10,000 abesifazane)
- I-blood clot engozini ngenkathi isebenzisa amaphilisi okulawula ukuzalwa (ama-5-7 amacala angama-10,000 abesifazane)
- I-blood clot engozini ngenkathi ithatha amaphilisi nge drospirenone (amacala angu-9-12 ngabesifazane abangu-10 000)
- I-blood clot ingozi ngenkathi ikhulelwe (ikhuphukela ku-29 ngabesifazane abangu-10 000)
- I-blood clot engozini ngesikhathi sokubeletha / emva kwamasonto angu-12 ekubelethweni (kubikwa ukuthi kunama-40-65 kwabesifazane abayi-10 000).
Imithombo:
Ikhomishana YaseMelika Yezinambuzane Nezazi ZamaGynecologists. "Ingozi ye-thromboembolism emangalisa phakathi kwabasebenzisi be-drospirenone-equkethe amaphilisi okubeletha ngomlomo." I-Committee Opinion No. 540. I- Obstet Gynecol 2012 ( eqinisekisiwe ngo- 2014); 120: 1239-42. Kufinyelelwe ngokubhalisa kwangasese.
I-FDA. [4-10-2012] "Ukubuyekezwa kwemibuzo yangaphandle kanye nezimpendulo - Ukubuyekezwa okuqhubekayo kokuphepha kwamaphilisi okulawula ukuzalwa okuqukethe i-drospirenone kanye nengozi eyingozi yokwandisa igazi." Ifinyelele ngo-1/27/15.
I-FDA. [10-27-2011] "I-FDA Ukuphepha Kwezokuphepha Kwezidakamizwa: Ulwazi olubuyekeziwe mayelana nocwaningo lwe-FDA oluxhaswe ngemali engcupheni yezindwangu zegazi kulaba besifazane abaphethe amaphilisi okulawula ukubeletha aqukethe i-drospirenone." Ifinyelele ngo-1/27/15.
UJames AH. "I-thrombosis ehambisana nokukhulelwa." Hematol 2009; 277-85. Kufinyelelwe ngokubhalisa kwangasese.
I-PubMed Health. "I-media hype blood clot engozini yokuphuza amaphilisi okuvimbela ukuzalwa." I-Library Yomphakathi Kazwelonke Yase-US / Izikhungo Zikazwelonke Zempilo. 03 Feb 2014. Kufinyelelwe 1/27/14.