Abanye Abantu Abaphatha Ngama-NSAID Thatha i-Proton Pump Inhibitor
I-Proton pump inhibitors, ebizwa nangokuthi izidakamizwa ze-PPI, yilasilasi lemithi enqunyelwe ukuphatha isifo senhliziyo, i-GERD (isifo se-reflux se-gastroesophageal), izilonda , noma ezinye izimo ezihlobene nesisu esiningi ngokweqile. I-proton pump inhibitors isebenza ngokuvimbela i-enzyme edingekayo ekwenzeni i-asidi esiswini. Ngokuvimbela i-enzyme, ukukhiqizwa kwe-asidi kunciphisa.
Umshini weProteton Usebenza Kanjani?
Ipompo ye-proton iyimvukuzane etholakala kwamanye amaseli wesisu (amangqamuzana e-parietal). Njengoba isebenza njengomshini wamangqamuzana, ipompo leproton ithatha i-potassium engeyona acidic ngaphakathi kwesisu futhi iyifake esikhundleni se-acidic hydrogen ion. Ngokufaka i-hydrogen ions esiswini sakho, ipompo yeproton ikwandisa okuqukethwe kwe-asidi yesisu sakho. I-asidi yesisu iyadingeka ukusiza ukudiliza ukudla nokusiza ukugaya. Kodwa-ke, i-asidi eningi ingamcasula isifo, ibangele ukuthukuthela noma ukushaya inhliziyo, futhi inganciphisa ukuphulukiswa kwezilonda zesisu. Uma i-acid engaphezu kweqile iba yinkinga, izidakamizwa ze-proton pump inhibitor zivame ukubekwe ukuvala ipompo yeproton.
Okwenza Abanye Abantu abane-Arthritis Bayibekwe I-PPIs
Abantu abaningi abane- arthritis bathatha izidakamizwa ezingezona ukuvuvukala (non-steroidal anti-inflammatory drugs (NSAIDs) ukulawula ukuvuvukala nobuhlungu obuhambisana nesifo sabo esihlangene. Ngenkathi i-NSAID ivame ukwelashwa kwe-arthritis esebenza kahle, izidakamizwa zihlotshaniswa nobuthakathaka bomzimba.
Lokhu kunzima kakhulu ngenxa ye-prostaglandin yokuvimbela ama-NSAID. Abantu abasebenzisa ama-NSAID amaningi ama-dose noma ama-NSAID amaningi, abantu asebekhulile, noma labo abanomlando we-peptic isifo sesilonda noma ukuphuma kwamagciwane basengozini enkulu yokubhekana nezinkinga ezivela kuma-NSAID.
Ukunciphisa ingozi yokucindezeleka kwamathumbu, abantu abane-arthritis bangacelwa ukuba bathathe i- COX-2 inhibitor (isib. Celebrex ), noma i-NSAID yendabuko (isib. Naproxen , ibuprofen ) ne-misoprostol noma i-proton pump inhibitor.
I-Misoprostol kufanele ithathwe izikhathi eziningi ngosuku, ingabangela ukuhuda, futhi ingabangela ukungaziphathi kahle, umsebenzi ongakafiki, noma ukukhubazeka kokuzalwa-ngakho-ke, izidakamizwa ze-PPI zivame ukukhethwa. Kukhona futhi iVimovo , isidakamizwa esihlanganisa i-NSAID (naproxen) ne-PPI (esomeprazole) kwelinye iphilisi.
Ukuhlanganiswa kwedakamizwa ye-PPI ene-NSAID akudingekile kuwo wonke amacala. Izidakamizwa ze-PPI empeleni zishintsha kakhulu. Izidakamizwa ze-PPI, ezikhangiswa kakhulu futhi ezikhuthazwa kubo bobabili abathengi kanye nodokotela, ziye zasetshenziselwa ukwelapha isisu esibuhlungu noma ukukhwabanisa lapho kutholakala izixazululo ezingaphezu kwamakhompiyutha, okubandakanya i-antacids (i-Maalox, i-Mylanta, i-TUMS) noma i-H2 blockers (i-Tagamet, i-Pepcid ne-Zantac ), bekuyokwanela.
Kunemihlahlandlela eqondile esiza ukuphatha uketshezi lwe-NSAID:
- Thatha i-NSAID eyodwa ngesikhathi esisodwa, hhayi ama-NSAID amaningi.
- Sebenzisa isilinganiso esiphezulu kunazo zonke se-NSAID kanye nesikhathi esifushane kunokwenzeka.
- Ungasebenzisi ama-NSAID uma ezinye izinketho zokwelapha zisebenza (i- analgesics , i- intra-articular injection ).
- Thatha i-NSAID yakho ngokudla.
- Unganaki izimpawu zamathumbu; xoxisana nodokotela wakho.
- Abantu abanezinkinga ezingenalutho, izifo zesilonda esiswini, ukuphuma kwamathumbu emathunjini, i-aspirin / i-NSAID hypersensitivity, ukucindezeleka okungalawuleki, noma isifo senhliziyo kufanele sigweme ama-NSAID.
Ukutholakala
Imithi ye-PPI itholakale kokubili phezu kwe-counter futhi ngokudayiswa kuphela, kuye ngokuthi yikuphi okukhethayo. Ngokusho kwamaBhuku omThengi , izidakamizwa zilingana ngokuvumelana nokusebenza nokuphepha kodwa ziyahlukahluka ngezindleko.
- Omeprazole (Prilosec, Prilosec OTC)
- I-Lansoprazole (i-Prevacid, i-Prevacid 24 hr)
- Omeprazole / sodium bicarbonate (Zegerid, Zegerid OTC)
- I-Pantoprazole (i-Protonix)
- I-Esomeprazole (Nexium)
- I-Dexlansoprazole (i-Kapidex)
- I-Rabeprazole (Aciphex)
Ukukhathazeka kokuphepha
Ngaphandle kwemiphumela emibi ejwayelekile (ukuphathwa ikhanda, isifo sohudo), kuye kwaba nokukhathazeka okuphepha okuhlobene nezidakamizwa ze-PPI, njenge:
- Ingozi eyengeziwe yokutheleleka
- Ingozi eyengeziwe yokutheleleka ngama-bacterium Clostridium difficile okubangela ukuhuda okukhulu
- Ukwanda kwengozi yamathambo, okubandakanya ukuphuka kwe-hip, ngokusetshenziswa kwesikhathi eside
- Ukuphumelela kwe-Plavix (clopidogrel) okunciphise ukunciphisa igazi
- Ukusebenzisana okungenzeka kanye nokusebenza okuncane kwezinye izidakamizwa nezithako
Okubalulekile
Akukho okuhlukile kunoma imuphi omunye umuthi, izinzuzo nezingozi ze-PPIs kufanele zilinganiswe esimweni ngasinye. Abanye abantu bangase bangadingi izidakamizwa ze-PPI ukuphatha ukuphuza kwenhliziyo okuncane noma okulinganayo noma i-GERD, noma ngabe imisiwe izidakamizwa. Ungayeki izidakamizwa ngaphandle kokuxoxa nodokotela wakho kuqala. Ukuyeka ngokuzumayo kungakhulisa izimpawu.
Abantu abane-arthritis bangakwazi ukunciphisa ubungozi bokudla emathunjini obuhambisana nokusetshenziswa kwe-NSAID ngaphandle kokuthatha izidakamizwa ze-PPI. Khumbula, ngisho noma izidakamizwa ze-PPI zivunyelwe ngesimo sakho esithile, ukusetshenziswa okuphephile kuthatha ukuthatha isidakamizwa kuphela uma nje kudingekile.
> Imithombo:
> Ukusebenzisa i-Proton Pump Inhibitors Ukuphatha I-Reflux Ye-Heartburn and Stomach Acid. Imibiko yabathengi. Kubuyekezwe ngo-Julayi 2013.
> I-Arthritis Ye-Rheumatoid: Ukuqaphela Nokuqala Ukwelashwa. UCush J et al. Uhlelo lwesithathu. I-Professional Communications, Inc. Copyright 2010.
> Ingabe ama-PPI anemiphumela emibi yesikhathi eside? Umhlahlandlela Wezempilo Wasekhaya weHarvard Medical School. February 2009.
> I-Proton Pump Inhibitors Ulwazi. US FDA. Kubuyekeziwe ngo-4/12/2016.