Bakuli ba bangata ba Arthritis ba nka li-SSAID Sebelisa Proton Pump Inhibitors
Thuto ea ho koaheloa ha Hip e koahela ho Proton Pump Inhibitors
Kotsi e eketsehileng ea ho robeha ha letheka e amahanngoa le tšebeliso ea proton pump inhibitors, sehlopha sa lithethefatsi tse sebelisetsoang ho phekola maemo a amanang le acid, tse kang ho otloa ke pelo le GERD (lefu la reflux la gastroesophageal). Ho latela lipatlisiso tse entsoeng khatisong ea December 27, 2006 ea Journal of the American Medical Association , bafuputsi ba ile ba tlaleha hore kalafo e nang le proton pump inhibitors ka nako e fetang selemo ho batho ba fetang lilemo tse 50 e ne e amahanngoa le karolo ea 44 lekholong ea kotsi ea hip ho robeha.
Kotsi e ne e le ka makhetlo a 2.6 a phahameng ho basebelisi ba nako e telele ba proton pump inhibitors ka tekanyo e phahameng. Nako le litekanyo tsa proton pump inhibitor tse sebelisoang li ne li amahanngoa le kotsing ea ho fokotseha ha hip. Kotsi e nyenyane, empa e ntse e eketseha ea ho robeha ha letheka e ne e boetse e amahanngoa le li-blockers tsa H2, hape li bitsoa blockamine-2 receptor blockers (mohlala, Tagamet le Pepcid).
- Bakeng sa bakuli ba holileng ba 1 262 ba tšoaroa ke proton pump inhibitor ka nako e fetang selemo, selemo se seng sa ho robeha ha letheka se ne se tla kopanngoa le tšebeliso ea proton pump inhibitors.
- Bakeng sa bakuli ba bang le ba bang ba 336 ba seng ba tsofetse ba tšoaroa ka nako e fetang selemo ka tekanyo e phahameng ea proton pump inhibitors, ho tsuba ha lekhetlo le leng ka selemo ho tla be ho tlameletsoe lithethefatsi tsa proton pump inhibitor.
Proton Pump Inhibitors Le NSAID
Bakuli ba bangata ba nang le ramatiki ba boetse ba nka proton pump inhibitors (eg Nexium , Prevacid, Protonix, le Prilosec) hammoho le lithethefatsi tse seng khahlanong le ho ruruha (NSAIDs) ho fokotsa litla-morao tse ka 'nang tsa e-ba teng tse amanang le NSAID.
Liphello tsa thuto tse tlalehiloeng ka 2003 sebokeng sa selemo le selemo sa American College of Gastroenterology se ile sa fana ka tlhahiso ea hore proton pump inhibitors e fokolise haholo kotsi ea lisosa ho bakuli ba ntseng ba nka NSAID kamehla. Boitsebiso bo siile lingaka tse ling li lumela hore bakuli bohle ba li-NSAID ba boetse ba lokela ho nka proton pump inhibitor, ha ba bang ba ne ba ikutloa feela hore bakuli ba nang le matšoao a matšoao a nang le dyspepsia ba lokela ho nka proton pump inhibitors.
Hape ka 2004 le 2005, ha COX-2 inhibitors (sehlopha se secha sa li-NSAID tse neng li etsa hore ho be le mathata a fokolang a moriana) se ile sa hlahlojoa ka litaba tsa ts'ireletso ea pelo, lingaka tse ngata hape li eletsa bakuli ba arthritis hore NSAID ea setso e kopantsoe le proton pump inhibitor e ne e le khetho e molemo ea phekolo.
Na bakuli ba ramatiki ba lokela ho khaotsa ho nka likokoana-hloko tsa proton?
Ho ea ka setsebi sa rheumatologist Scott J. Zashin, MD, "Kahobane li-NSAID li ka eketsa kotsi ea ho tsoa mali, masapo a mangata a kotsing ea bothata bona ka nako e le 'ngoe a nka proton pump inhibitor e kang:
- Prilosec (omeprazole)
- Nexium (esomeprazole)
- Aciphex (rabeprazole)
- Prevacid (lansoprazole)
- Protonix (pantoprazole)
Lintho tse kotsi tsa ho tsoa mali li kenyeletsa lilemo tse fetang 60, tsa tsubang, ho nka corticosteroids , aspirin , Coumadin (warfarin), Plavix (clopidogrel) kapa serotonin intitors, le ba nang le histori ea pele ea liso kapa ho tsoa mali. Ho nka proton pump inhibitor ho ka fokotsa kotsi ea ho tsoa mali ho feta ho feta ha H2, ba kenyeletsang:
- Pepcid (famotidine)
- Tagamet (cimetidine)
- Zantac (ranitidine)
Phuputso ea morao-rao e bontša hore bakuli bao ba nang le tekanyo e phahameng ka ho fetisisa ea proton pump inhibitors ba ne ba e-na le kotsi e eketsehileng ea ho fokola ha masapo le ho robeha ha letheka.
E ntse e kgothaletswa ho ja dijo tsa 1000-1500 mg ya khalsiamo le 400 IU ya vithamine D le hoja batho ba bangata ba ka rua molemo ho fihlela ho 800 IU, haholo haeba ba se na pale ea majoe a liphio kapa khalsiamo e phahameng.
Ho itšetlehile ka thuto ena, ke tla khothaletsa hore bakuli ba hlokang ho ba lithethefatsi tsena ba lebelloe ke masapo le haeba ba le tlaase, hlahloba lebelo la vithamine D 'me u nahane ka phekolo e eketsehileng ho boloka matla a bone. Mekhoa e meng e kenyeletsa ho nkela sebaka sa proton pump inhibitors e nang le meriana e bitsoang Cytotec (misoprostol) - meriana e fanang ka molemo ka ho fetisisa ho sireletsa mpa ho tsoa lithong tsa mali ha e nkoa ka makhetlo a mane ka letsatsi.
Meriana ena e hanyetsanoa (ke hore ha ea lokela ho sebelisoa) ho basali ba lilemo tsa ho beleha mme e ka 'na ea e-ba le menyetla e mengata ea ho baka matšoao a mang a masapo. Ntho e 'ngoe e ka etsoang ke ho fumana phekolo e' ngoe e le hore li-NSAID li se ke tsa hlokahala. "
Scott J. Zashin, MD, ke moprofesa oa motlatsi oa kliniki Univesithing ea Texas Southwestern Medical School, Division of Rheumatology, Dallas, Texas; ngaka e neng e e-ea ho Lipetlele tsa Presbyterian tsa Dallas le Plano; e leng seithuti sa American College of Physicians le American College of Rheumatology; le setho sa American Medical Association. Dr. Zashin ke mongoli oa Arthritis ntle le bohloko - The Miracle Of TNF Blockers . Buka ena e thusa mang kapa mang ho e 'ngoe ea lithethefatsi tsa biologic (Enbrel, Remicade, Humira) kapa ho hlahloba lithethefatsi tsa biologic.
Lisebelisoa:
1. Yang, Yu-Xiao. "Long-term Proton Pump Inhibitor Therapy le Kotsi ea Hip Fracture." JAMA La 27 December, 2006.
2. "Lithethefatsi Tsa ho Senya Liphoofolo Tse Amanang le Ts'oaetso ea Hip Fracture." MSNBC.com. La 29 December, 2006. 31 Dec 2006.
3. "Proton Pump Inhibitor e ka 'na ea Thusa ho Thibela Likokoana-hloko ho Basebelisi ba NSAID ba sa Feleng." Medscape. La 15 October, 2003. 31 Tlhaku 2006.