Senguva Yakareba Steroid Kushandisa Kwingave Kwakagadzikana Makomba, Kutungamira kuSteroid-Inotora Osteoporosis
Kana iwe uine chirwere chinoputika chirwere (IBD) , chiremba wako angangodaro akarayira steroid zvakadai sa prednisone kuderedza kutuka panguva yekutsvaira. Izvozvo zvinowanzova nemigumisiro ye steroids inobva pakutsamwisa kunopisa simba, asi vazhinji vavo vachaenda kana dhiyo iri pasi uye inorega.
Zvisinei, steroids inogonawo kuita kuti kuve nekugadzirisa kwezvinhu zvinokonzera uye zvisingagumi, kunyanya kana zvichitorwa muhotera yepamusoro kana kwenguva yakareba.
Chimwe chezviitiko izvi steroid-induced osteoporosis. Zvinonyatsozivikanwa kuti steroids inogona kuita kuti pfupa rirasike. Kune avo vari kutora steroidhi, kukumbira chiremba nezvehutachiona uye kuongorora nguva nenguva zvinhu zvinokosha zvingabatsira kubata chero kurasikirwa kwepfupa kare.
Chii Chinonzi Osteoporosis?
Osteoporosis inoshaya mapfupa, izvo zvinokonzera kuti varasikirwa nehuwandu hwavo uye vanyorove uye vanowanzoputsika. Inonyanya kufungidzirwa sechirwere chemadzimai anonzi post-menopausal, izvo ndezvechokwadi mune chikamu, asi zvinogona kuitika kune varume kana vakadzi vezera ripi zvaro vari pangozi. Zvimwe zvezviitiko zvinopinza zvinosanganisira:
- Zera (kupfuura 65)
- Kuva weCaucasian kana yekuAsia
- Nhoroondo yemhuri ye osteoporosis
- Yakanaka / duku kuvaka (pasi pe154 lbs)
- Pakupedzisira kuputsika
- Kushandisa mamwe mishonga (kusanganisira steroid uye hormone yekemikari)
- Kutanga kuenda kumwedzi
- Kusakwana kwekudya kwekasiki; kusakwana vitamini
- High-protein diet
- Sedentary lifestyle
- Kusvuta
- Doro rinoshatiswa
- Parathyroid chirwere
Steroid-Inoita Osteoporosis
Kunyange zvazvo steroids inoderedza kuvhunika, inoderedzawo kuumbwa kwefupa itsva, kuwedzera kuparara kwemapfupa ekare, uye kuderedza kubatwa kwe calcium kubva pakudya nemuviri. Mune nyaya yeBD, kukura kweasteoporosis kunogona kuwedzererwa nehutomu hwakaderera huwandu hwe calcium inobatwa nemuviri.
Kuongororwa kweSteroid-Inokonzera Osteoporosis
Osteoporosis inonzi inosangana nedhiiyo inonzi yaviri-simba x-ray absorptiometry (DEXA). DEXA inonyanya kunetseka kupfuura yenguva dzose x-ray uye inogona kuwana kurasikirwa kwemafu mumaitiro ayo okutanga. Hazvina kurwadziwa uye zvinotora anenge maminitsi gumi kuti apedze.
IAmerican College yeRheumatology inokurudzira kuongorora DEXA pakutanga kwekurapa steroid uye nguva nenguva (zvichida gore negore) pashure apo chirwere chinoramba chiripo.
Osteoporosis inowanzova yakajairika kune vanhu vane chirwere cheCrohn kune avo vane ulcerative colitis, saka DEXA yekutanga kubata chero kurasikirwa kwese kwepakutanga kunokurudzirwa kuvarwere veCrohn's disease.
DEXA inogamuchirwa chete kune varwere vane ulcerative colitis avo vanorayirwa steroids sechiremba kwenguva refu.
Kudzivirira Steroid-Inokonzera Osteoporosis
Taper steroids. Kuchengetedza mapfupa ekutanga kurasikirwa, steroid inofanira kungoshandiswa mumutengo wakaderera zvikuru weiyo nguva pfupi. Steroid mishonga inogona kuva yakakosha zvikuru pamamiriro ezvinhu mazhinji ekuvhiringidza, asi zvikwereti zvinofanira kuyerwa nezvakakonzerwa nemigumisiro yakaita seysteoporosis. Usafananidza mishonga yako iwe pachako usati wataura nachiremba wako.
Rega kusvuta. Kusvuta fodya kunobatanidza nemararamiro akawanda ehupenyu anokonzera kurasikirwa kwefupa, zvakadai sekudya kusina kunaka uye kusava nekurovedza muviri.
Vakadzi vanosvuta vanogona kubudisa vashoma vaserosi uye vanoona kusangana kwemurume mberi kwevakadzi vasina kusvuta. Mukuwedzera, vanosvuta vanotora nguva yakareba kuti vapore kubva kumarara, uye kushandiswa kwefodya kunoratidzika kuderedza masimba emapfupa.
Dzidzira. Kuita muviri kunorema , zvakadai sekudzivirira muviri, kunobatsira pakuwedzera masasa. Kuita muviri kunokurudzira kusikwa kwefupa refu uye kuchengetedzwa kwe calcium.
Kurapa Steroid-Inobatsira Osteoporosis
Zvigadzirwa. Nemhaka yokuti calcium inobatwa mumutsipa muduku, malabsorption inowanzoitika kune vanhu vane Crohn's disease vane kuvhiringidza mumucheche muduku . Vanhu vane ulcerative colitis, iyo inoratidzira mumatumbo makuru , inogona kuva nekanamisi yakawanda yekasa.
Calcium inowedzera muhuwandu hwe 1500 mg pazuva inogona kukurudzirwa kurapa kana kudzivirira kare kurasikirwa kwefupa. Chiremba wako achada kukupa mazano pamusoro pemutero wei, kana uripo, wakakodzera iwe.
Zvakakosha kuziva kuti calcium haishandisi yoga - inoda vitamin D kuti iite muviri. Vitamini D inogadzirwa apo ganda rinosvika kune chiedza chezuva, asi vanhu vazhinji havashandisi nguva yakakwana kunze kwekuti vagadzire vitamini yakakwana D. Sa calcium, vitamin D haina kunyanya kuwanika nevanhu vane kuputika kwechigumbu mumatumbo maduku anokonzerwa nechirwere cheCrohn. Zuva roga roga kuwedzera pamwe ne 400 IU re vitamin D rinogona kukurudzirwa kurwisana nekurasikirwa kwepfupa; zvakare, taura nechiremba wako pamusoro pezvipi zvinokurudzirwa iwe.
Bisphosphonates: Fosamax (alendronate), Actonel (risedronate), Didronel (etidronate), Boniva (ibandronate), uye Reclast (zoledronic acid) i- bisphosphonates inoshandiswa kubatsira pfupa rinoputsika uye kuchengetedza bone. Iyi mishonga inogonawo kuwedzera kuwedzera kwepafu mumutsana uye chiuno.
Bisphosphonates ikozvino ndiyo yekirasi yemishonga iyo FDA-inogamuchirwa yekurapa osteoporosis muvarume. Zvinowanzopiwa ne calcium uye vitamini D.
Forteo (Teriparatide). Forteo is hormone parathyroid inobvumirwa kubata steroid-induced osteoporosis; inogona kushandiswa kwemakore maviri. Vanhu vakave nokurapa kwemaawa, akadai sekenza, havasi ivo vakagadzirirwa zvakanaka kune ichi chirwere. Forteo inoshandiswa zuva rega rega nekujaira.
Calcitonin (Calcimar, Cibacalcin, Miacalcin). Calcitonin inobatsira kukanganisa kurasikirwa kwemapfupa uye kudzivirira kuputika mumutsipa asi kwete muhudyu. Iyi mishonga inoshandiswa sepine spray uye inogona kukonzera kushungurudzwa mumapapiro emvura. Haisi iyo inoshanda pakurapa steroid-induced osteoporosis, saka calcitonin inowanzoshandiswa chete nevarwere vasingakwanisi kutora kana kusagadzikana kurapwa nema bisphosphonates.
Sources:
Amin S. "Glucocorticoid-Induced Osteoporosis." American College of Rheumatology 2010.
Rosen HN. "Kudzivirira uye kurapa glucocorticoid-induced osteoporosis." UpToDate May 2010.