Chenjezo la Zipatso Zamphesa: Itha Kuyanjana ndi Mankhwala Amodzi

Zamkati

• Zimagwirizana bwanji ndi mankhwala?
• 1-3: Mankhwala ena a cholesterol
• 4-7: Mankhwala ena othamanga magazi
• 8-9: Mankhwala ochepa a nyimbo
• 10–13: Mankhwala ena olimbana ndi matenda
• 14-20: Mankhwala angapo osinthasintha
• 21-24: Ochepa magazi ena
• 25-27: Mankhwala angapo opweteka
• 28-31: Mankhwala ochepa a erectile komanso mankhwala a prostate
• Kodi muyenera kusiya zipatso zamphesa?
• Mfundo yofunika

Mphesa ndi zipatso zokoma za citrus zomwe zimakhala ndi maubwino ambiri azaumoyo. Komabe, imatha kulumikizana ndi mankhwala wamba, ndikusintha zomwe zimakhudza thupi lanu.

Ngati mukufuna kudziwa chenjezo la zipatso za manyumwa pamankhwala ambiri, nkhaniyi ikuthandizani kumvetsetsa chifukwa chake ilipo komanso zosankha zanu.

Nayi mankhwala 31 ofala omwe atha kukhala ndi mayanjano owopsa ndi manyumwa, komanso njira zina.

Chidziwitso: Nkhaniyi ili ndi zambiri - osati upangiri wachipatala. Lankhulani ndi dokotala musanasinthe kugwiritsa ntchito mankhwala aliwonse.

Zimagwirizana bwanji ndi mankhwala?

Mankhwala amasinthidwa m'chiwindi ndi m'matumbo mwanu ndi gulu lapadera la mapuloteni otchedwa cytochrome P450 (CYPs).

Ma CYP amawononga mankhwala, amachepetsa magazi ambiri mwa iwo.

Zipatso zamphesa ndi abale ake ochepa, monga malalanje a Seville, tangelos, pomelos, ndi Minneolas, ali ndi gulu la mankhwala otchedwa furanocoumarins.

Furanocoumarins amasokoneza magwiridwe antchito a CYPs. M'malo mwake, kafukufuku akuwonetsa kuti amachulukitsa magazi kuposa mankhwala 85 (1).

Pochepetsa momwe ma CYP amawonongera mankhwala m'matumbo ndi chiwindi, zipatso zamphesa zitha kukulitsa zovuta za mankhwalawa (1).

Pali zinthu zitatu zoti mudziwe kuti mumvetsetse ngati mungagwiritse ntchito mosamala manyumwa ndi mankhwalawa.

1. Sizitenga zambiri. Mphesa imodzi yonse kapena kapu imodzi yamadzi amphesa ndi yokwanira kusintha momwe mankhwalawa amakukhudzirani.
2. Zotsatira zake zimatha masiku angapo. Kukhoza kwa mphesa kukhudza mankhwala kumatenga masiku 1-3. Kutenga mankhwala anu maola ochepa kupatula kuti musamamwe sikokwanira.
3. Ndizofunikira. Kwa mankhwala ochepa, zotsatira za zipatso za mphesa zingakhale zoopsa.

Poganizira izi, nazi zambiri zamankhwala 32 wamba omwe amatha kulumikizana ndi zipatso zamphesa, omwe amagawidwa ndi ntchito.

1-3: Mankhwala ena a cholesterol

Mankhwala ena a cholesterol otchedwa statins amakhudzidwa ndi zipatso za manyumwa.

Statins imagwira ntchito poletsa kuchepa kwa mafuta m'thupi. Izi zimapangitsa mbiri ya lipoproteins m'magazi ndikuchepetsa kufa kwa matenda amtima mwa odwala omwe ali pachiwopsezo ().

Ma Statins amatha kuyambitsa rhabdomyolysis, kapena kuwonongeka kwa minofu ya minofu. Izi zimabweretsa kufooka kwa minofu, kupweteka, komanso kuwonongeka kwa impso nthawi zina ().

Zipatso zamphesa zimawonjezera kuchuluka kwamagazi kwama statins atatu wamba, ndikuwonjezera chiopsezo cha rhabdomyolysis ():

1. Atorvastatin (Lipitor)
2. Lovastatin (Mevacor)
3. Simvastatin (Zocor)

Kafukufuku wina adawonetsa kuti kumwa kapu yamadzi amphesa ndi simvastatin kapena lovastatin kumakulitsa milingo yamagazi yama statins awa ndi 260% ().

Njira: Pravastatin (Pravachol), rosuvastatin (Crestor), ndi fluvastatin (Lescol) sizigwirizana ndi zipatso (1).

Zipatso zamphesa zitha kukulitsa zovuta zina za mankhwala a cholesterol a statin, omwe amawononga minofu.

4-7: Mankhwala ena othamanga magazi

Mitundu yambiri yamankhwala am'magazi samakhudzidwa ndi zipatso za manyumwa.

Komabe, mankhwala anayi otsatirawa a magazi ayenera kugwiritsidwa ntchito mosamala:

1. Felodipine
2. Nifedipine (Procardia)
3. Losartan (Cozaar)
4. Eplerenone (Chidziwitso)

Mankhwala awiri oyamba pamndandandawu amadziwika kuti calcium channel blockers. Amagwira ntchito posintha momwe mitsempha yanu yamagazi imagwiritsira ntchito calcium, kumasula ziwiyazo, komanso kuchepetsa kuthamanga kwa magazi.

Mankhwala awiri omaliza pamndandandawu amagwira ntchito pochepetsa kuchepa kwa mahomoni otchedwa angiotensin 2, omwe mwachilengedwe amachulukitsa kuthamanga kwa magazi.

Kafukufuku wina adapeza kuti magazi a nifedipine adakwera kwambiri atatengedwa ndi makapu awiri (500 mL) a madzi amphesa, poyerekeza ndi opanda madzi. Izi zidapangitsa kutsika pang'ono kwa kuthamanga kwa magazi, komwe kumatha kukhala koopsa ngati osayang'aniridwa ().

Losartan ndi yachilendo chifukwa chipatso champhesa chimachepetsa zovuta zake, zomwe zimachepetsa mphamvu yake yoyendetsera kuthamanga kwa magazi ().

Eplerenone imagwiranso ntchito ngati losartan, koma milingo yake imakula ikamamwa ndi zipatso zamphesa. Kuchuluka kwa eplerenone kumatha kuyambitsa potaziyamu wochuluka m'magazi, zomwe zimatha kusokoneza kuthamanga kwa mtima (1).

Njira: Spironolactone (Aldactone), mankhwala ofanana ndi losartan ndi eplerenone, sagwirizana ndi zipatso zamphesa. Amlodipine (Norvasc) ndi blocker ya calcium calcium ngati felodipine ndi nifedipine, yomwe imagwirizananso ndi zipatso zamphesa (,).

Ngakhale mphesa sizimasokoneza mankhwala ambiri a magazi, zimatha kuyambitsa mankhwala ochepa kuti achepetse kuthamanga kwa magazi.

8-9: Mankhwala ochepa a nyimbo

Zipatso zamphesa zimayambitsa mankhwala ochepa omwe amathandizira mikhalidwe yachilendo ya mtima.

Kuyanjana uku kumatha kukhala koopsa makamaka ndikuphatikiza:

1. Amiodarone
2. Dronedone (Multaq)

Kafukufuku adapatsa amuna 11 omwe amatenga amiodarone kapu yamadzi amphesa (pafupifupi 300 mL). Mankhwala osokoneza bongo adakwera mpaka 84%, poyerekeza ndi omwe samamwa madziwo ().

Mankhwala awiriwa amatenga gawo lofunikira pakuwongolera thanzi la odwala omwe ali ndi vuto la mtima. Kusintha komwe kumakhudzana ndi zipatso za mphesa m'magulu amtunduwu nthawi zina kumayambitsa kusintha kwa kayendedwe ka mtima ().

Ngakhale kuti ndimankhwala ochepa chabe a mtima omwe amalumikizana ndi zipatso zamphesa, zotsatirapo zake zitha kukhala zowopsa.

10–13: Mankhwala ena olimbana ndi matenda

Pamodzi amatchedwa antimicrobials, mankhwalawa omwe amachiza matendawa amasiyana mosiyanasiyana m'zochita zawo komanso kuwonongeka kwa thupi.

Ngakhale maantimicrobial ndi amodzi mwamitundu yosiyanasiyana yamankhwala, pali mankhwala ochepa chabe omwe ali ndi machitidwe ofunikira a zipatso zamphesa:

1. Mankhwalawa
2. Rilpivirine ndi mankhwala okhudzana ndi HIV
3. Primaquine ndi mankhwala okhudzana ndi malungo
4. Albendazole

Erythromycin imagwiritsidwa ntchito pochiza mitundu ingapo yamatenda a bakiteriya. Kafukufuku woyerekeza madzi amphesa ndi madzi mwa odwala omwe amatenga erythromycin adawonetsa kuti madziwo adakulitsa kuchuluka kwa magazi ndi 84% ().

Kuchuluka kwa mankhwalawa kumatha kusokoneza kugunda kwa mtima ().

Zipatso zamphesa zimawonjezeranso milingo ya mankhwala a HIV rilpivirine ndi maraviroc, kuphatikiza pa mankhwala a primaquine okhudzana ndi malungo. Izi zitha kukhudza kugunda kwa mtima kapena ntchito (1).

Chifukwa maantibayotiki nthawi zambiri amatengedwa kwakanthawi kochepa, mwina ndizosavuta kuti mungopewa zipatso za manyumwa mukamamwa mankhwalawa.

Njira: Clarithromycin ndi mankhwala m'kalasi lomwelo monga erythromycin yemwe sagwirizana ndi mphesa. Doxycycline onse ndi maantibayotiki ndi mankhwala opatsirana pogonana omwe sagwirizananso nawo (1).

Mankhwala ena olimbana ndi matenda sayenera kugwiritsidwa ntchito ndi zipatso zamphesa, chifukwa zimatha kuyambitsa kusokonezeka kwa mtima kapena kugwira ntchito.

14-20: Mankhwala angapo osinthasintha

Mankhwala ambiri opatsirana pogonana komanso mankhwala oletsa nkhawa amakhala otetezeka kugwiritsa ntchito zipatso za manyumwa.

Komabe, mankhwala angapo amisangalalo amalumikizana nawo, kuphatikiza:

1. Quetiapine (Seroquel)
2. Lurasidone (Latuda)
3. Ziprasidone (Geodon)
4. Zamgululi (Buspar)
5. Diazepam (Valium)
6. Midazolam (Ndime)
7. Mzinda (Halcion)

Mankhwala monga quetiapine ndi lurasidone amagwiritsidwa ntchito kuthana ndi zovuta zamakhalidwe ndi machitidwe. Kuchuluka kwa mankhwalawa kumatha kuyambitsa kusintha kwa mtima kapena kugona (1).

Kuphatikiza apo, diazepam, midazolam, ndi triazolam ndi mankhwala omwe nthawi zina amagwiritsidwa ntchito poopsa kapena mitundu ina ya nkhawa.

Kafukufuku wina anayerekezera ena mwa mankhwalawa mwa odwala asanu ndi anayi, ena mwa iwo anali kudya zipatso zamphesa. Idawonetsa kuti mphesa zitha kukulitsa zotsatirapo za mankhwalawa, zomwe zimapangitsa kugona kwambiri ().

Kudya zipatso zamphesa kwinaku mukumwa mankhwala okhudzana ndi malingaliro pamwambapa kumatha kubweretsa kusintha kwamitima ya mtima, kugona kwambiri, ndi zovuta zina zokhudzana ndi mankhwala.

21-24: Ochepa magazi ena

Ochepetsa magazi amagwiritsidwa ntchito pochiza kapena kuteteza magazi kuundana. Ena mwa iwo amakhudzidwa ndi zipatso zamphesa, kuphatikizapo:

1. Apixaban (Eliquis)
2. Rivaroxaban ufa (Xarelto)
3. Clopidogrel (Plavix)
4. Chitipa (Brilinta)

Clopidogrel imadalira ma CYPs - mapuloteni omwe malire amphesa - amagwira ntchito. Chifukwa chake, imayamba kuchepa ikasakanizidwa ndi zipatso za manyumwa.

Kafukufuku wa odwala 7 omwe amatenga clopidogrel ndi 200 mL ya madzi amphesa kapena madzi adawonetsa kuchepa kwa mankhwalawo ndi madziwo. Komabe, kuthekera kwake kochotsa magazi kuundana sikunakhudzidwe ().

Nthawi zonse, zipatso zamphesa zimawonjezera magazi m'magazi amtundu wina pamndandandawu, zomwe zitha kubweretsa magazi ().

Njira: Warfarin (Coumadin) imagwiritsidwa ntchito pazofanana ndi za apixaban ndi Rivaroxaban powder. Ngakhale warfarin imakhudzidwa ndi zakudya zomwe zili ndi vitamini K, kuyambitsa kwake sikukhudzidwa ndi zipatso zamphesa ().

Ochepa magazi angapo amakhudzidwa ndi zipatso zamphesa. Izi zitha kubweretsa kutuluka magazi kapena kupewa kuteteza magazi kuundana.

25-27: Mankhwala angapo opweteka

Mankhwala angapo opweteka amakhudzidwa ndi zipatso zamphesa:

1. Fentanyl
2. Oxycodone
3. Colchicine

Fentanyl ndi oxycodone amachepetsa kupweteka kwa mankhwalawa. Ngakhale magazi awo amakhudzidwa pang'ono ndi zipatso zazing'ono zam'madzi, zimatha kusintha kutalika kwa nthawi yomwe amakhala mthupi (,).

Colchicine ndi mankhwala akale omwe amagwiritsidwa ntchito pochizira gout. Zimakonzedwa ndi ma CYP ndipo amatha kulumikizana ndi zipatso zamtengo wapatali. Komabe, kafukufuku wa 2012 adawonetsa kuti kumwa 240 mL wa msuzi wamphesa kumangokhala ndi gawo lochepa pamlingo wake ().

Njira: Morphine ndi Dilaudid ndimankhwala osokoneza bongo omwe samakhudzidwa ndi zipatso (1).

Zowawa zina zamankhwala osokoneza bongo zimapitilirabe m'mwazi mukamamwa ndi manyumwa.

28-31: Mankhwala ochepa a erectile komanso mankhwala a prostate

Kulephera pang'ono kwa erectile komanso mankhwala a prostate amayenera kuyang'aniridwa pokhudzana ndi zipatso za manyumwa:

1. Sildenafil (Viagra)
2. Tadalafil (Cialis)
3. Tamsulosin (Flomax)
4. Silodosin (Rapaflo)

Mankhwala osokonekera a Erectile monga sildenafil ndi tadalafil amagwira ntchito pochepetsa mitsempha yamagazi, yomwe imakulitsa magazi kutuluka.

Chifukwa mitsempha ina yamagazi imatsitsimutsanso ndi mankhwalawa, kuchuluka kwamagazi amankhwala omwe amayamba chifukwa cha zipatso zamphesa kumatha kuchepetsa kuthamanga kwa magazi ().

Kuphatikiza apo, mankhwala owonjezera a prostate monga tamsulosin amathanso kuyambitsa chizungulire komanso kuthamanga kwa magazi akatengedwa ndi zipatso ().

Njira: Gulu lina la mankhwala owonjezera a prostate, omwe amaphatikizapo finasteride ndi dutasteride, samakhudzidwa kwambiri ndi zipatso zamphesa ().

Zipatso zamphesa siziyenera kumwa ndi mankhwala osokoneza bongo a erectile kapena mankhwala ena owonjezera a prostate.

Kodi muyenera kusiya zipatso zamphesa?

Ngakhale nkhaniyi ikulemba mankhwala 31 wamba omwe amalumikizana ndi manyumwa, si mndandanda wathunthu.

Drugs.com imapereka cheke chothandizirana ndi mankhwala omwe mungagwiritse ntchito kuwunika mankhwala anu momwe mumathandizira.

Kuphatikiza apo, Rxlist.com imalemba mndandanda wamankhwala ocheperako omwe amalumikizana ndi manyumwa.

Ndikofunika kukumbukira kuti chipatso chimodzi chokha kapena pafupifupi kapu imodzi yayikulu yamadzi ndikokwanira kusintha magazi m'magazi ambiri. Ndipo ena mwa mankhwalawa atha kukhala ndi zotsatirapo zoyipa akamagwirizana ndi zipatso zamphesa.

Ngati mukumwa mankhwala ndi kulumikizana ndi zipatso zamphesa, sinthani mankhwala ena kapena siyani kumwa zipatso zamphesa.

Ngati mukukaikira, pitani kwa dokotala wanu kapena wamankhwala kuti akupatseni upangiri wokha.

Ngakhale zipatso zazing'ono zamphesa zimatha kulumikizana ndi mankhwala ena ndikuyambitsa zovuta zina.

Mfundo yofunika

Chipatso champhesa chimasokoneza mapuloteni m'matumbo ang'onoang'ono ndi chiwindi omwe nthawi zambiri amawononga mankhwala ambiri.

Kudya zipatso zamphesa kapena kumwa madzi amphesa mukamamwa mankhwalawa kumatha kuyambitsa milingo yayikulu m'magazi anu - ndi zovuta zina.

Ndi mankhwala ena, ngakhale zipatso zazing'ono zingapangitse zovuta zoyipa. Chifukwa chake, kuphatikiza kuyenera kupewedwa.

Mankhwala anu amatha kulemba mankhwalawa ndi chenjezo loyanjana ndi zipatso za manyumwa.

Onetsetsani kuti dokotala ndi wamankhwala akudziwa ngati mumadya zipatso zamphesa pafupipafupi. Amatha kukuthandizani kusankha ngati kuli koyenera kuidya mukamamwa mankhwala enaake.