Hazvirevi kuti mishonga iyi yose inopa hutano hwakafanana
Kwete-steroidal anti-inflammatory drugs (NSAIDs) ndeimwe yemishonga inowanzoshandiswa zvikuru munyika. Izvo zvinobudirira mukuderedza kusuruvara uye kurwadziwa uye zvinowanikwa zviri nyore zvose nemirairo uye pamusoro pekambani.
Zvisinei, mazhinji emishonga iyi ikozvino inozivikanwa kuti iwedzere njodzi yematambudziko emwoyo, kusanganisira acon coronary syndrome (ACS) , mwoyo kusakundikana , uye zvichida inrial fibrillation .
Kuwanda kwechiitiko ichi chakawedzerwa kazhinji kacho chiduku. Asi njodzi inowedzera nekushandiswa kusingagumi uye nemazinga akakwirira, uye inonyanya kukwirira kune vanhu vane inozivikanwa nehutano hwehutano. Uyezve, njodzi yacho yakakwirira kune dzimwe NSAID kupfuura vamwe.
(Cherechedza: Aspirin ndiyo yekare yakashandiswa uye inowanzoshandiswa NSAID Zvisinei, aspirin inoderedza mhepo yehutano, uye haizokurukurwi munyaya ino.Unogona kuverenga pamusoro pekushandisa prophylactic ye aspirin pano .)
Mhando dzeNSAIDS
I-non-aspirin NSAIDs inoshanda nekudzivisa cyclooxygenase enzyme (COX) , iyo inogadzirisa kugadzirwa kwe prostaglandin inobatanidza marwadzo nekuputika.
Iko chaizvoizvo maviri enzymes eCox - COX-1 uye COX-2 - ine zvinetso zvakasiyana. COX-2 inosanganiswa nekurwadziwa nekuputika, apo COX-1 ine mamwe mabasa, kusanganisira kuchengetedza dumbu rekumatenga kubva kuasiti.
Saizvozvowo, NSAIDS inoratidzirwa kana ichivhara chete COX-2 ("kusarudza" NSAIDS), kana kuti inovhara zvose COX-1 uye COX-2 ("nonselective" NSAIDs).
NSAIDs yepakutanga, yakadai seIbuprofen (Advil) uye naproxen (Aleve), iyo yose yakanga isingasarudziki NSAIDS. Nokuti vanovhara COX-1 ivo vanobatanidzwa nechinhu chinokanganisa gastric.
Makambani ekushandisa zvinodhaka akashanda zvakaoma kuti agadzirise NSAIDs dzakasarudza dzinodzivisa chete COX-2, kuitira kuti kuderedza zvinetso zvegastric. Saka ikozvino kune dzimwe NSAID dzakasarudzwa dzinoshandiswa, kusanganisira celecoxib (Celebrex) uye meloxicam (Mobic).
Iyi mishonga inowanzova itsva, uye haifaniri kuwanikwa mumafomu epo kana kuti pamusoro pekambani.
Dambudziko reMwoyo neNSAIDs
Kuwedzera kwepfungwa yemwoyo pamwe neNSAID kwakatanga kuonekwa nechisarudzo cheNSAID rofecoxib (Vioxx), iyo yakaita kuti vanhu vakawanda vazivise uye mitemo yakawanda inopikisana nomugadziri wayo, Merck. Vioxx yakabva yabviswa pamusika.
Kubvira panguva iyo zvidzidzo zvakawanda zvemakiriniki zvakaratidza kuti kuwedzera kwepfungwa dzomumwoyo kunowanzobatanidzwa neNSAID dzose, mbiri dzeNSAID uye nhengo itsva yeCX-2 inoshandiswa mishonga.
Pamusoro peNSAID dzose, mungozi yemwoyo inowedzera nehurefu hwekushandiswa kwemishonga iyi, pamwe neyero inoshandiswa, uye nehutachiona hwepfungwa hwemunhu anotora mishonga.
Ndezvipi NSAIDs "Yakachengeteka" Kupfuura Vamwe?
Dhairiro inofanidza nekukura kwehutano hwemwoyo inokonzerwa neNSAID dzakashata inoshaikwa. Nemhaka yehuwandu hwemishonga iyi inowanikwa, uye huwandu hukuru hwehuwandu hunobatanidzwa, kuitisa makiriniki ekuedzwa kuti aite kuti kusvibiswa chero kupi zvako kuve kunopesvedzerwa.
Zvisinei, meta-kuongororwa kwezvakawanikwa zvekuchirapa kwakabudiswa muna 2013. Kuongorora uku kwakaratidza kuti njodzi yezviitiko zvepfungwa zvakanyanya kuwedzera kufanana ne placebo ine high dose diclofenac (nonseid NSAID), uye nezvose zvinosarudza NSAIDs.
Kuwedzera kwengozi kwakaonekwa zvakare ne ibuprofen iyo yakanga isinganyanyi kukosha. Uye hapana kuwedzera kwengozi kwakaonekwa ne naproxen.
Iyi meta-tsananguro haifaniri kufungwa seyakagadziriswa. Nyanzvi dzakawanda dzakagadzira pfungwa yokuti dzose dzeNSAID, dzezvikamu zviviri, dzinofanirwa kuwedzerwa kuwedzera mungozi yemwoyo.
Zvisinei, kana NSAID inoda kushandiswa mumunhu ane hanya nekuwedzera kwengozi yemwoyo, nyanzvi dzakawanda dzichakurudzira naproxen.
Zvimwe Zvokudya zveCardiac Zvinosangana neNSAIDS
Mukuwedzera kune kuwedzerwa njodzi yezviitiko zvemoyo, zvose zvikamu zveNSAID zvinosanganiswawo nekuwedzera kweropa rinoshandiswa pakushandiswa kwenguva refu.
Uyezve, zhinji dzeNSAID dzisingasarudze dzinopindira nemigumisiro inobatsira iyo aspirin ine pamaplatelet, saka inopesana nemigumisiro yeprophylactic aspirin. Izvi zvinopesana hazvina kuonekwa, zvisinei, neNSAID diclofenac, kana kuti NSAIDs dzinosarudza.
Pasi Pasi
Kunyange zvazvo Vioxx aine ruzivo rwese, zvinoitika kuti zvose NSAID zvinowedzera kuwedzera mungozi yepfungwa paanenge yakaenzana neyo (kunze kwekunge watozivikanwa).
Kune vanhu vari kuwedzera mungozi yemwoyo, NSAIDs inofanira kushandiswa pamushandi wepasi wakakwana kudarika nguva inopedzisira nguva. Kana ngozi yenyu yepachiviri yakakwirira , naproxen inogona kunge iri NSAID yekusarudza.
Ani naani ane hypertension anofanira kuziva kuti NSAID dzinogona kuwedzera kuwedzerwa kweropa uye kuderedza kushanda kwehutachiona hwehutachiona .
Ani naani anotora aspirin yeprophylaxis kurwisana nehutano hwepfungwa anofanira kudzivisa nonselective NSAIDs pose pazvinogoneka. Kana NSAID dzichashandiswa, dzinofanira kutorwa maawa maviri mushure me aspirin.
Sources:
Fosbøl EL, Folke F, Jacobsen S, et al. Chikonzero-chaiyo CV ngozi inobatanidza neNSAID pakati pevanhu vane utano. Circ Cardiovasc Qual Mitsva 2010; DOI: 10.1161 / CIRCOUTCOMES.109.861104.
Coxib uye tsika dzeNSAID Trialists '(CNT) Kubatana, Nhamba N, Emberson J, et al. Vascular nepamusoro masumbu emigumisiro ye-non-steroidal anti-inflammatory drugs: meta-kuongororwa kwemunhu mumwe nomumwe anowanzobatanidza kubva kumatambudziko anonzi randomized. Lancet 2013; 382: 769.