Uma kuziwa ekukhetheni iphilisi yokulawula ukuzalwa, kunezinketho eziningi ezitholakalayo. Yize amaphilisi amaningi okulawula ukuzalwa afika emaphaketheni angu-28 noma angu-21, kunezinhlobo ezimbili eziyingqayizivele zokuhlanganiswa kwamaphilisi okuzalwa ngoba atholakalayo kuma-packs angu-24. Lezi amaphilisi okulawula ukuzalwa yi-Yaz no-Beyaz.
- I-Yaz iqukethe ngempela izinsuku ezingu-24 zamaphilisi we-hormone, ilandelwa izinsuku ezingu-4 zamaphilisi e-placebo. Kulabo besifazane abakhetha iphilisi ngokukhulelwa kokubeletha , i-Yaz nayo i-FDA ivunyelwe ukuphatha izimpawu ezingokomzwelo nezingokomzimba ze- PMDD - izimpawu ezinzima ngokwanele ukuthelela impilo yabesifazane abaningi. I-Yaz nayo i-FDA-igunyazwe ukuphatha izigaxa ezilinganisiwe (uma usuvele unesikhathi sokuya esikhathini futhi uneminyaka engu-14 ubudala).
- I-Beyaz ingenye yamaphilisi amasha emakethe. Njengoba nje i-Yaz, i-FDA-igunyazwe ukusiza ukuhlinzeka ngemiphumela ye-PMDD kanye nokuphatha izigaxa ezilinganisiwe. Yini eyenza i-Beyaz ihluke ngamaphilisi angu-24 e-hormone afaka phakathi nevomefolate calcium (B vitamin / folic acid). Kukhona namaphilisi angu-4 e-placebo angenayo ama-hormone kodwa ane-folate nayo. I-folate ibeka ingozi yokuba neziphambeko ezingavamile ze-neural tube ngesikhathi sokukhulelwa. Lokhu kungasiza uma ukhulelwa ngenkathi usebenzisa i-Beyaz noma ngemva nje kokuyeka ukusetshenziswa kwayo. I-Beyaz ikunikeza i-0.4 mg ye-folic acid ephakanyisiwe nsuku zonke kubesifazane besinyaka yobudala.
Inzuzo engenzeka yosuku olunezinsuku ezingama-24 zokuthi i-dosing isimiso ukuthi ingakunikeza ukushintsha kwe-hormone encane kunezinsuku ezingu-21 zamaphilisi asebenzayo kumcimbi wezinsuku ezingu-21/28 ojwayelekile. Bobabili u-Yaz noBeyaz basebenza njenganoma iyiphi enye iphilisi yokuhlanganisa. Noma kunjalo, ngaphezu kokuba nesimiso semishanguzo esebenzayo yosuku lwama-24, lawa maphilisi nawo ahlukile ngenxa yohlobo lwe-progestin oluqukethe.
I-Yaz noBeya zombili ziqukethe isakhiwo se- estrogen / drospirenone .
Kube nokukhathazeka okuthile ukuthi amaphilisi ane-drospirenone aqukethe ithuba lokuthuthukisa ama-blood clots . Okuyiqiniso ukuthi zonke izipilisi zokulawula ukuzala zibeka ingozi yokuthuthukisa ama-blood clots. Njengoba kukhulunywa lokho, ngokusekelwe kocwaningo lwe- FDA oluxhaswe ngemali oluhlola idatha evela kwabesifazane abangaphezu kuka-800,000, i-ejensi ikhombisa ukuthi ukusetshenziswa kwamaphilisi aqukethe i-drospirenone (njenge-Yaz no-Beyaz) kuxhumene nokunyuka okulinganiselwa ku-1.5 okujwayelekile ku-VTE / I-blood clots ingozi uma kuqhathaniswa nesisu sokubeletha ngomlomo ophansi.
Noma kunjalo, uma ubheka lokhu, ukubhekwa kwengozi ye-blood clot isabhekwa njengento ephansi kakhulu, futhi ngisho ne- FDA iyavuma ukuthi ucwaningo olutholakalayo aluhambisani nemiphumela ehambisanayo noma i-akhawunti yezici ezibalulekile zesineke okungase kube nengxenye egazini legazi ingozi. Kodwa-ke, ngenxa yalesi sibuyekezo, i-FDA idinga izidingo ezintsha zokubhalisa kuma-pilspirenone aqukethe amaphilisi.
Enye inkinga ezungeza ukusetshenziswa kwe-Yaz noBeyaz ihlobene namazinga aphezulu e-potassium. I-Drospirenone ingakwazi ukulawula ama-hormone alawula amanzi omzimba wakho kanye namazinga e-electrolyte. Ngenxa yalokhu, kubaluleke kakhulu ukuthi uthembekile ngokuphelele lapho ukhuluma nodokotela wakho ngomlando wakho wezokwelapha. Ngoba amaphilisi nge drospirenone angase ahlanganyele neminye imithi ekwandisa potassium - njengemithi ethile yegazi eliphezulu izimo noma izimo zenhliziyo, izidakamizwa anti-ukuvuvukala (like Ibuprofen), namanye amaphilisi amanzi (diuretics), udokotela wakho udinga ukwazi uma wena sebevele basebenzisa lezi zinhlobo zemithi ngaphambi kokubeka i-Yaz noma i-Beyaz.
Eqinisweni, amalebula womkhiqizo we-Yaz no-Beyaz afaka isixwayiso esiluleka odokotela abanikeza lawa maphilisi ukuqapha amazinga e-serum potassium ngenyanga yokuqala uma uphathwa nangomuthi ohambisana nokugcinwa kwe-potassium.
Ngenxa yokuthi lezi zinhlobo ezimbili zokulawula amaphilisi okubeletha ziye zathola ukunakwa okukhulu ngegazi, kubonakala sengathi odokotela bangase bangabanaki ngokwanele lezi zixwayiso ze-potassium. Ucwaningo lubonisa ukuthi cishe abesifazane abangu-17.6% basebenzisa amaphilisi e-drospirenone anezidakamizwa kanye nomuthi wokusebenzisana we-potassium, kanti okungu-29% lokhu okusetshenziselwa ukusebenzelana ngokuvamile kwenzeka esikhathini esingangenyanga ukuqala iphilisi lokulawula ukuzalwa .
Odokotela bangase babheke ukuthi kungenzeka lokhu kuxhumana ngoba ngubani obeka lokho. Kubonakala sengathi abesifazane abangu-18% banemishanguzo yabo yokwandisa i-potassium enqunywe ngumkhuba womndeni noma odokotela basekhaya odokotela kanye ne-Yaz / Beyaz yabo echazwe yi-OB / GYN yabo.
Ucwaningo lwembula futhi:
- Amaphesenti angu-9.5% wabesifazane anqunywe kokubili imithi (Yaz / Beyaz kanye nemithi yokuphuza i-potassium) yi-OB / GYN yabo
- U-8.4% wanikezwa kokubili imithi ngokusebenza komndeni noma udokotela wangaphakathi wezokwelapha.
- Abesifazane abangu-17% basebenzisa imithi yokwandisa i-potassium ngaphambi kokuqala i-Yaz / Beyaz.
- Amaphesenti angu-83% asebenzisa i-Yaz / Beyaz ngaphambi kokuqala imishanguzo ye-potassium-raising.
Thatha Umlayezo Wasekhaya: Yaz noBeyaz kungaba yindlela eminye yokwelashwa kwamanye amapilisi abesifazane abaningi. Ngenxa yesimiso sabo sezinsuku ezingama-24, ungase uhlangabezane nokushintsha kwe-hormonal encane (futhi ukhululeke izimpawu ezingase zihlotshaniswe nalokhu). Ngaphezu kwalokho, lamaphilisi okulawula ukubeletha anikeza izinzuzo ezingekho kokukhulelwa ezikhangayo kwabesifazane abaningi. Uma uzosebenzisa i-Yaz noma i-Beyaz, kufanele ulinganise lezi zinzuzo ngokumelene nengozi yakho yegazi. Okokugcina, udinga ukuqaphela ukuthi lawa maphilisi angakwazi kanjani ukwandisa amazinga e-potassium. Ngoba kukhona ubufakazi bokuphakamisa ukuthi akuzona zonke odokotela abazi ukuthi kungenzeka ukuxhumana phakathi kukaJaz / Beyaz kanye nemithi yokuphakamisa i-potassium (noma isidingo sokuhlola kanye / noma ukuqapha amazinga e-serum potassium), kubalulekile ukuthi utshele udokotela wakho uma basebenzisa enye yale mithi ngaphambi kokuqala enye.
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.
McAdams, M, Staffa, JA, & Dal Pan, GJ. "I-concomitant ecacisa i-ethinyl estradiol / drospirenone futhi kungenzeka ukuthi izidakamizwa zisebenzisana." Ukwelashwa, 2007 76 (4) , 278-281. Kufinyelelwe ngokubhalisa kwangasese.