Uninzi lwezigulane zeArthritis ezithatha ii-NSAID Sebenzisa i-Proton Pump Inhibitors
Isifundo Sokuxhamla i-Hip Fracture kwi-Proton Pump Inhibitors
Umngcipheko okhulayo wokuqhekeka kwe-hip udibene kunye nokusetyenziswa kweproton pump inhibitors, iklasi yezilwanyana ezisetyenziselwa ukuphatha iimeko ezinxulumene ne-asidi ezifana nokuguquka kwegazi kunye ne- GERD (igastroesophageal reflux disease). Ngokutsho kweziphumo zophando ezipapashwe kumxholo we-Disemba 27, 2006, we- Journal of the American Medical Association , abaphandi babika ukuba unyango kunye neproton pump inhibitors ngaphezu kweminyaka engaphezu kweyodwa kubantu abangaphezu kweminyaka engama-50 ubudala lidibaniswe ne-44 ekhulwini kwandisa ingozi yokuba ukuphuka.
Umngcipheko wawungama-2.6 amaxesha aphakamileyo kubasebenzisi bexesha elide leproton pump inhibitors kumaqondo aphezulu. Ixesha kunye nokulingwa kweproton pump inhibitor ukusetshenziswa kwababini banxulumene nokunyuka kwengozi yokuchithwa kwe-hip. Umngcipheko omncinci, kodwa okwenyukayo owenyukayo wokuqhaqhaqhaqha kwaye kwahlanganiswa ne-H2 blockers, ebizwa ngokuba yi-histamine-2 receptor blockers (umzekelo iTagamet kunye nePepcid).
- Ku-1 262 izigulane ezisebekhulile ziphathwe ngeproton pump inhibitor ngaphezu konyaka, enye i-hip yokuqhekeka eyongezelelweyo ngonyaka iya kuhlanganiswa nokusetyenziswa kweproton pump inhibitors.
- Kuzo zonke izigulane ezingama-336 ezisebekhulile ziphathwe iminyaka engaphezu kweyodwa kunye namaqondo aphakamileyo eproton pump inhibitors, enye yokunyuka kwe-hip yonyaka ingabandakanywa nezidakamizwa zeproton pump inhibitor.
Proton Pump Inhibitors E-NSAID
Izigulane ezininzi ze-arthritis nazo zithatha i-proton pump inhibitors (umz. I- Nexium , i-Prevacid, i-Protonix, ne-Prilosec) kunye nezidakamizwa ezichasene nezidakamizwa (i-NSAID) ukwenzela ukunciphisa imiphumo enomdla yenzalo ehambelana ne-NSAID.
Iziphumo zophando ezichazwe ngo-2003 kwiintlanganiso zonyaka we-American College of Gastroenterology zicebise ukuba iproton pump inhibitors inciphise kakhulu ingozi yezilonda kwizigulane ezithatha rhoqo ii-NSAID. Ingcaciso ishiywe abanye oogqirha bakholelwa ukuba zonke izigulane kwi-NSAID nazo kufuneka zithathe iproton pump inhibitor, ngelixa abanye beziva nje izigulane eziye zibonakaliswe zizibonakaliso nge- dyspepsia kufuneka zithathe iproton pump inhibitors.
Kwakhona ngo-2004 kunye no-2005, xa i- COX-2 inhibitors (iklasi elitsha le-NSAID lifunyenwe ngokubangela iingxaki ezincinci zesisu) zihlolisiswe ngokuphathelele imiba yokhuseleko lomzimba, oogqirha abaninzi baphinda bacebisa izigulane ze-arthritis ukuba i-NSAID yendabuko inxulumene neproton pump inhibitor ukhetho olungcono kunyango.
Ngaba izigulane zeArthritis Ziyeka Ukuthatha iProtton Pump Inhibitors?
Ngokwe-rheumatologist uScott J. Zashin, MD, "Ngenxa yokuba i-NSAID inokunyusa umngcipheko wokuphuma kwamanzi, izigulane ezininzi ezisengozini yale nkinga zixhomekeke kwi-proton pump inhibitor njengale:
- Prilosec (omeprazole)
- Nexium (esomeprazole)
- Aciphex (rabeprazole)
- Prevacid (lansoprazole)
- IProsioni (pantoprazole)
Izinto ezinobungozi zokuphuma kwamanzi ziquka iminyaka engaphezulu kwama-60, ababhemayo, ukuthatha i- corticosteroids , i- aspirin , i-Coumadin (i-warfarin), i-plavix (i-clopidogrel) okanye i-serotonin inhibitors yokufakela, kunye nalabo abanembali yesilonda okanye ukuphuma kwamagciwane. Ukuthatha i-proton pump inhibitor kunokunciphisa umngcipheko we-GI ophucula ngaphezu kwe-H2 antagonists, ezibandakanya:
- I-Pepcid (i-famotidine)
- ITagamet (cimetidine)
- Zantac (ranitidine)
Uphononongo olutshanje lubonisa ukuba abo bagulane abathatha i-dose ephezulu yeproton pump inhibitors babenomngcipheko wokwanda kwe- osteoporosis kunye ne-hip fracture.
Kuyacetyiswa ukuba kube nokudla kwansuku zonke kwe-1000-1500 mg ye- calcium kunye ne-400 IU ye-vitamin D nangona abantu abaninzi banokuzuza ukusuka kwi-800 IU, ngakumbi ukuba abanalo imbali yamatye eentso okanye i-calcium ephakamileyo.
Ngokusekelwe kulolu cwaningo, ndiza kuncomela ukuba izigulana ezifuna ukuba kwezi ziyobisi zithathwa ngamehlo abo kunye nokuba ziphantsi, hlola izinga le-vitamin D kwaye ujonge unyango olongezelelweyo ukugcina amandla esithambo. Ezinye iindlela ziquka ukutshintsha i-proton pump inhibitors eneyeza elibizwa ngeCytotec (misoprostol) -iyeza elinika inzuzo enkulu ekukhuseleni isisu kwizilonda zamagciwane xa kuthathwa amaxesha amane ngosuku.
Isicatshulwa sichaphazelekayo (oko kusenokuthi singasetyenziselwa) kubasetyhini bexesha lokubeletha kwaye mhlawumbi kungabangela ezinye iimpawu zesisu. Enye indlela yokufumana unyango olungaphezulu ukwenzela ukuba i-NSAID ayidingi. "
UScott J. Zashin, MD, uprofesa oncedisayo kwikliniki kwiYunivesithi yaseTexas Southwestern Medical School, iCandelo leRheumatology, eDallas, eTexas; udokotela oya kwiiNgqungquthela zasePresbyterian zaseDallas nasePlano; umntu wase-American College of Physicians kunye ne-American College yeRheumatology; kunye nelungu le-American Medical Association. UDkt. Zashin ngumlobi weArthritis ngaphandle kobuhlungu - Ummangaliso we-TNF Blockers . Incwadi iluncedo kunoma ubani kwenye yezilwanyana ze-biologic (Enbrel, Remicade, Humira) okanye ucinge ngeziyobisi ze-biologic.
Imithombo:
1. Ying, Yu-Xiao. "Ixesha elide leproton Pump Inhibitor Therapy kunye neengozi ye-Hip Fracture." JAMA Disemba 27, 2006.
2. "Ukugqithisa izidakamizwa ezixhamle kwiSiza sokuShaywa kweSiza." MSNBC.com. Disemba 29, 2006. 31 Disemba 2006.
3. "iProtton Pump Inhibitor Inokuthi Uncede Ukuthintela Ulcers Kwizithuba Zomsebenzisi we-NSAID." Medscape. Oktobha 15, 2003. 31 Disemba 2006.