Vakawanda Arthritis Varwere Kutora NSAID Shandisa Proton Pump Inhibitors
Study Links Hip Fracture kuProton Pump Inhibitors
Dambudziko rakawanda rekuputika kwechiuno rakabatanidzwa nekushandiswa kweproton pump inhibitors, kirasi yemishonga inoshandiswa kuraramisa mamiriro ehutano-asi sekushaya moyo uye GERD (gastroesophageal reflux chirwere). Maererano nemigumisiro yekudzidza yakabudiswa mumusi weDecember 27, 2006 we Journal of the American Medical Association , vatsvakurudzi vakatsanangura kuti kurapwa neproton pump inhibitors kwemakore anopfuura rimwe muvanhu vanopfuura makore makumi mashanu vakabatanidzwa ne 44 muzana yakawedzerwa ngozi kuputsika.
Iyo ngozi yaiva 2.6 nguva yakakwirira kune vashandisi venguva refu vanoshandisa proton pump inhibitors pamadhora akawanda. Nguva yakatarwa uye kuyerwa kweproton pump inhibitor kushandiswa kwaiva pamwe nehuwandu hwekuwedzera kwehup kuputsika kwengozi. Chinhu chiduku, asi chakawedzerwa chakafanana chekuputika kwechiuno chakasanganiswa neH2 blockers, iyo inonziwo histamine-2 receptor blockers (eg Tagamet uye Pepcid).
- Pamusoro pevatendi vakwegura 1262 vakabatwa neproton pump inhibitor kwegore rinopfuura, rimwezve kushaya kuputika kwegore kunosungirirwa kushandiswa kweproton pump inhibitors.
- Kune vese 336 vakwegura vakwegura vakabatwa kwegore rinopfuura rimwe nepamusoro-doro reproton pump inhibitors, rimwe rinoputika rakaputika gore rimwe nerimwe raizobatanidzwa kune proton pump inhibitor zvinodhaka.
Proton Pump Inhibitors NSAIDs
Vakawanda vane arthritis varwere vanotorawo proton pump inhibitors (eg Nexium , Prevacid, Protonix, uye Prilosec) pamwe chete nemishonga isingashandisi-kupisa zvinokonzera kupisa (NSAIDs) kuderedza maitiro emigumisiro emakumbo anosangana neNSAIDs.
Chidzidzo chekudzidza chakabudiswa muna 2003 pamusangano wegore negore weAmerican College of Gastroenterology yakaratidza kuti proton pump inhibitors yakaderedza zvikuru njodzi yezvironda muvarwere nguva dzose vachitora NSAIDs. Mashoko aya akasiyiwa vamwe vanachiremba vachitenda kuti varwere vose veNSAID vanofanirwawo kutora proton pump inhibitor, asi vamwe vainzwa varwere chete vaiva nechiratidzo ne dyspepsia vanofanira kutora proton pump inhibitors.
Zvakare muna 2004 uye muna 2005, apo COX-2 inhibitors (boka idzva reNSAID rakaonekwa sechichiita kuti vasanyanya kugadzikana nematumbo) rakaongororwa maererano nehutano hwehutano hwemwoyo, vanachiremba vakawanda zvakare vakarayira varwere vemaArthritis kuti NSAID yemaitiro pamwe chete neproton pump inhibitor yaive ndiyo nzira yakanakisisa yokurapa.
VaArthritis Vanofanira Kuda Kurega Kutora Proton Pump Inhibitors?
Maererano neRheumatologist Scott J. Zashin, MD, "Nemhaka yokuti NSAID dzinogona kuwedzera mungozi wekubuda ropa, varwere vazhinji vari pangozi yechinetso ichi panguva imwechete vanotora proton pump inhibitor yakadai se:
- Prilosec (omeprazole)
- Nexium (esomeprazole)
- Aciphex (rabeprazole)
- Prevacid (lansoprazole)
- Protonix (pantoprazole)
Dambudziko rekubuda ropa rinosanganisira makore anopfuura makumi matanhatu, vanosvuta, kutora corticosteroids , aspirin , Coumadin (warfarin), Plavix (clopidogrel) kana serotonin uptake inhibitors, uye avo vane nhoroondo yekare yezvironda kana kubuda ropa. Kutora proton pump inhibitor kunogona kuderedza ngozi yeGI kubuda ropa kupfuura vanopikisa H2, iyo inosanganisira:
- Pepcid (famotidine)
- Tagamet (cimetidine)
- Zantac (ranitidine)
Kuongororwa kwemazuva ano kunoratidza kuti varwere ivavo vanotora chirwere chakakwirira cheproton pump inhibitors vaiva nehuwandu hwehutano hwehuputi uye kuputika kwechiuno.
Inenge ichiri kurudzirwa kuti uwane kudya kwezuva rimwe nerimwe kusvika kune 1000-1500 mg ye calcium uye 400 IU ye vitamin D kunyange zvazvo vanhu vazhinji vanogona kubatsirwa kubva kusvika 800 IU, kunyanya kana vasina nhoroondo yeminwe yemafuta kana kuti calcium yakakwirira.
Kubva pane zvidzidzo izvi, ndinoda kukurudzira kuti varwere vanoda kuve pamishonga iyi vane mazamu avo ekucherechedza uye kana vakaderera, chengetedza uwandu hwe vitamini D uye funga nezvehutano huripo kuti uchengetedze simba refu. Zvimwe zvinogona kusanganisira kushandiswa kweproton pump inhibitors nemishonga inonzi Cytotec (misoprostol) - mishonga inopa zvakanakisisa mukuchengetedza dumbu kubva kune zvironda painoitwa kanomwe zuva nezuva.
Mushonga wacho unopesana (kureva kuti haufaniri kushandiswa) kuvakadzi vezera rekubereka uye inogona kunge yakakonzera dzimwe zviratidzo zvepamuviri. Imwe nzira ndeyekuwana imwe nzira yekurapa kuitira kuti NSAID isingada. "
Scott J. Zashin, MD, ndiye kliniki mudzidzisi wepiritsi paYunivhesiti yeTexas Southwestern Medical School, Division of Rheumatology, muDallas, Texas; chiremba anoenda kuPresbyterian Hospitals ye Dallas naPano; mumwe weAmerican College of Physicians uye American College of Rheumatology; uye nhengo yeAmerican Medical Association. Dr. Zashin munyori weArthritis Pasina Pain - The Miracle Of TNF Blockers . Bhuku rinobatsira kune ani zvake pane rimwe remishonga ye biologic (Enbrel, Remicade, Humira) kana kuongorora biologic zvinodhaka.
Sources:
1. Yang, Yu-Xiao. "Long-term Proton Pump Inhibitor Therapy uye Ngozi yeHur Fracture." JAMA December 27, 2006.
2. "Mishonga Inokonzera Mishonga Inobatanidza neHyp Fracture Risk." MSNBC.com. December 29, 2006. 31 Dec 2006.
3. "Proton Pump Inhibitor May Inobatsira Kudzivirira Ulcers muVashandi Vasingaperi veNSAID." Medscape. October 15, 2003. 31 Dec 2006.