Nexium vs. Prilosec: Mankhwala awiri a GERD

Zamkati

• Chifukwa chiyani ma PPI amagwira ntchito
• Chifukwa chake amapatsidwa
• Kusiyana
• Kuchita bwino
• Mtengo wa mpumulo
• Zotsatira zoyipa
• Machenjezo ndi kuyanjana
• Zowopsa
• Kuyanjana kwa mankhwala
• Kutenga

Timaphatikizapo zinthu zomwe timaganiza kuti ndizothandiza kwa owerenga athu. Ngati mutagula maulalo omwe ali patsamba lino, titha kupeza ndalama zochepa. Nayi njira yathu.

Kumvetsetsa zosankha zanu

Kutentha pa chifuwa ndi kovuta mokwanira. Kuzindikira kusankha kwanu kwamankhwala a gastroesophageal Reflux matenda (GERD) kumatha kukupangitsani kukhala kovuta kwambiri.

Awiri mwa ma proton pump inhibitors (PPIs) omwe amadziwika kwambiri ndi omeprazole (Prilosec) ndi esomeprazole (Nexium). Zonsezi tsopano zikupezeka ngati mankhwala owonjezera pa-kauntala (OTC).

Yang'anirani zonse ziwiri kuti muwone zabwino zomwe mankhwala ena angapereke kuposa ena.

Chifukwa chiyani ma PPI amagwira ntchito

Mapampu a Proton ndi michere yomwe imapezeka m'maselo am'mimba mwanu. Amapanga asidi wa hydrochloric, chinthu chachikulu cha asidi m'mimba.

Thupi lanu limafunikira asidi m'mimba kuti chimbidwe. Komabe, pamene mnofu wapakati pamimba ndi kholingo sukutseka bwino, asidi uyu amatha kumapeto kwanu. Izi zimayambitsa kutentha pamtima panu ndi pakhosi pokhudzana ndi GERD.

Ikhozanso kuyambitsa:

• mphumu
• kukhosomola
• chibayo

Ma PPI amachepetsa kuchuluka kwa asidi omwe amapangidwa ndi mapampu a proton. Amagwira ntchito bwino mukamawatengera ola limodzi mpaka mphindi 30 musanadye. Muyenera kuwatenga kwa masiku angapo asanagwire bwino ntchito.

Ma PPI akhala akugwiritsidwa ntchito kuyambira 1981. Amawoneka ngati mankhwala othandiza kwambiri ochepetsa asidi m'mimba.

Chifukwa chake amapatsidwa

Ma PPI monga Nexium ndi Prilosec amagwiritsidwa ntchito pochiza matenda okhudzana ndi asidi, kuphatikizapo:

• GERD kutanthauza dzina
• kutentha pa chifuwa
• esophagitis, komwe ndikutupa kapena kukokoloka kwa kholingo
• Zilonda zam'mimba ndi mmatumbo, zomwe zimayambitsidwa ndi Helicobacter pylori (H. pylori) matenda opatsirana pogonana kapena ma nonsteroidal anti-inflammatory (NSAIDs)
• Matenda a Zollinger-Ellison, omwe ndi matenda omwe zotupa zimayambitsa asidi am'mimba kwambiri

Kusiyana

Omeprazole (Prilosec) ndi esomeprazole (Nexium) ndi mankhwala ofanana. Komabe, pali kusiyana kochepa pakapangidwe kawo ka mankhwala.

Prilosec ili ndi isomers awiri a mankhwala omeprazole, pomwe Nexium imangokhala ndi isomer imodzi.

Isomer ndi mawu oti mamolekyulu omwe amaphatikizapo mankhwala omwewo, koma amakonzedwa mwanjira ina.Chifukwa chake, mutha kunena kuti omeprazole ndi esomeprazole zimapangidwa ndi zomangira zomwezo, koma zimayikidwa mosiyana.

Ngakhale kusiyanasiyana kwa ma isom kumawoneka ngati zazing'ono, kumatha kubweretsa kusiyana kwamomwe mankhwala amagwirira ntchito.

Mwachitsanzo, isomer yomwe ili ku Nexium imakonzedwa pang'onopang'ono kuposa Prilosec mthupi lanu. Izi zikutanthauza kuti kuchuluka kwa mankhwalawa ndikokwera kwambiri m'magazi anu, ndipo esomeprazole imatha kuchepetsa kupangika kwa asidi kwakanthawi.

Itha kugwiranso ntchito mwachangu pang'ono kuchiza matenda anu poyerekeza ndi omeprazole. Esomeprazole imaphwanyidwanso mosiyana ndi chiwindi, chifukwa chake zimatha kuyambitsa kuchepa kwa mankhwala kuposa omeprazole.

Kuchita bwino

Kafukufuku wina akuwonetsa kuti kusiyana pakati pa omeprazole ndi esomeprazole kumatha kupindulitsa anthu omwe ali ndi zina.

Kafukufuku wakale wochokera ku 2002 adapeza kuti esomeprazole imathandizira kuyang'anira GERD kuposa omeprazole pamlingo womwewo.

Malinga ndi kafukufuku wina wamu 2009, esomeprazole idapereka mpumulo mwachangu kuposa omeprazole sabata yoyamba yogwiritsira ntchito. Pambuyo pa sabata limodzi, kupumula kwa zizindikiro kunali kofanana.

Komabe, mu nkhani ya 2007 mu American Family Physician, madokotala adakayikira izi ndi maphunziro ena a PPIs. Adatchula zovuta monga:

• kusiyanasiyana kwa kuchuluka kwa zinthu zomwe zimaphunzitsidwa m'maphunziro
• kukula kwa maphunziro
• njira zamankhwala zomwe zimagwiritsidwa ntchito poyesa kuchita bwino

Olemba adasanthula maphunziro a 41 pakuthandizira ma PPIs. Iwo adatsimikiza kuti pali kusiyana kochepa pakuthandizira ma PPI.

Chifukwa chake, ngakhale pali zina zomwe zikusonyeza kuti esomeprazole ndiyothandiza kuthana ndi zizindikilo, akatswiri ambiri amavomereza kuti ma PPI ali ndi zovuta zofananira kwathunthu.

American College of Gastroenterology imanena kuti palibe kusiyana kwakukulu pamomwe ma PPI osiyanasiyana amagwirira ntchito pochiza GERD.

Mtengo wa mpumulo

Kusiyana kwakukulu pakati pa Prilosec ndi Nexium kunali mtengo ukaunikiridwa.

Mpaka Marichi 2014, Nexium imangopezeka mwa mankhwala okhaokha komanso pamtengo wokwera kwambiri. Nexium tsopano ikupereka mankhwala owonjezera pamsika (OTC) omwe amtengo wotsutsana ndi Prilosec OTC. Komabe, generic omeprazole ikhoza kukhala yotsika mtengo kuposa Prilosec OTC.

Pachikhalidwe, makampani a inshuwaransi sanaphimbe zinthu za OTC. Komabe, msika wa PPI watsogolera anthu ambiri kuti awunikenso za Prilosec OTC ndi Nexium OTC. Ngati inshuwaransi yanu sikuphatikizira OTC PPIs, mankhwala a omeprazole kapena esomeprazole akhoza kukhala njira yabwino kwambiri.

Nexium nthawi zina amatchedwa mankhwala "inenso" chifukwa ndi ofanana kwambiri ndi Prilosec, mankhwala omwe alipo kale. Anthu ena amaganiza kuti "inenso" mankhwala osokoneza bongo ndi njira yoti makampani azamalonda azipanga ndalama potengera mankhwala omwe alipo kale. Koma ena anena kuti "inenso" mankhwala osokoneza bongo atha kuchepetsa mtengo wa mankhwala, chifukwa amalimbikitsa mpikisano pakati pa makampani ogulitsa mankhwala.

Gwiritsani ntchito dokotala kapena wamankhwala kuti mupeze PPI yomwe ingakuthandizeni. Kuphatikiza pa mtengo, lingalirani zinthu monga:

• zotsatira zoyipa
• matenda ena
• mankhwala ena omwe mukumwa

Zotsatira zoyipa

Anthu ambiri alibe zovuta kuchokera ku PPIs. Nthawi zambiri, anthu amatha kuwona:

• kutsegula m'mimba
• nseru
• kusanza
• mutu

Zotsatirazi zitha kukhala zowopsa ndi esomeprazole kuposa omeprazole.

Amakhulupiliranso kuti ma PPI onsewa atha kukulitsa chiopsezo cha:

• msana ndi fractures yamanja mwa amayi omwe atha msinkhu, makamaka ngati mankhwalawa atengedwa kwa chaka chimodzi kapena kuposerapo kapena pamlingo waukulu
• kutupa kwa bakiteriya m'matumbo, makamaka atagonekedwa mchipatala
• chibayo
• kuperewera kwa zakudya, kuphatikizapo mavitamini B-12 ndi kuchepa kwa magnesium

Chiyanjano cha chiwopsezo cha matenda a dementia chidanenedwa mu 2016, koma kafukufuku wamkulu wotsimikizira mu 2017 adatsimikiza kuti palibe chiwopsezo chowonjezeka cha matenda amisala pakugwiritsa ntchito ma PPIs.

Anthu ambiri amakumana ndi asidi wambiri akasiya kugwiritsa ntchito ma PPI. Komabe, chifukwa chake izi zimachitika sizimamveka bwino.

Pazovuta zambiri zam'mimba zam'mimba, ndikulimbikitsidwa kuti mutenge ma PPI osapitilira milungu inayi kapena isanu ndi itatu pokhapokha dokotala atazindikira kuti mankhwalawa atenga nthawi yayitali.

Pamapeto pa chithandizo chamankhwala chomwe mukufuna, muyenera kusiya kumwa mankhwalawo pang'onopang'ono. Gwiritsani ntchito ndi dokotala kuti muchite izi.

Machenjezo ndi kuyanjana

Musanamwe mankhwala aliwonse, lankhulani ndi dokotala wanu kuti mudziwe zomwe zingayambitse ngozi zomwe zimayambitsa matendawa.

Zowopsa

• ndi ochokera ku Asia, popeza thupi lanu limatha kutenga nthawi yayitali kuti likonze ma PPIs ndipo mungafunike mulingo wina
• ali ndi matenda a chiwindi
• anali ndi milingo yotsika ya magnesium
• ali ndi pakati kapena akukonzekera kutenga pakati
• akuyamwitsa

Kuyanjana kwa mankhwala

Nthawi zonse uzani dokotala wanu za mankhwala, zitsamba, ndi mavitamini omwe mumamwa. Prilosec ndi Nexium amatha kulumikizana ndi mankhwala ena omwe mwina mukumwa.

US Food and Drug Administration (FDA) yatulutsa chenjezo loti mankhwalawa ku Prilosec amachepetsa mphamvu ya magazi ochepa kwambiri a clopidogrel (Plavix).

Simuyenera kumwa mankhwala awiriwa limodzi. Ma PPI ena sanaphatikizidwe mu chenjezo chifukwa sanayesedwe kuti achitepo kanthu.

Mankhwalawa sayenera kumwedwa ndi Nexium kapena Prilosec:

• clopogwire
• adiza
• alireza
• rifampin
• alireza
• risedronate
• Wort wa St.

Mankhwala ena amatha kulumikizana ndi Nexium kapena Prilosec, komabe atha kumwa mankhwala aliwonse. Uzani dokotala wanu ngati mumamwa mankhwala aliwonse kuti athe kuwona kuwopsa kwanu:

• amphetamine
• alireza
• atazanavir
• ziphuphu
• chithu
• chosema
• chililaz
• citalopram
• clozapine
• cyclosporine
• dextroamphetamine
• kutuloji
• mankhwala antifungal
• fosphenytoin
• chitsulo
• hydrocodone
• mesalamine
• methotrexate
• methylphenidate
• muthoni
• alireza
• alireza
• tacrolimus
• warfarin kapena mavitamini ena a vitamini K
• alireza

Kutenga

Nthawi zambiri, mutha kusankha PPI yomwe imapezeka mosavuta ndipo imawononga ndalama zochepa. Koma kumbukirani kuti ma PPI amangotenga zizindikiro za GERD ndi zovuta zina. Samachotsa vutoli ndipo amangowonetsedwa kuti azigwiritsidwa ntchito kwakanthawi pokhapokha dokotala atazindikira mwina.

Kusintha kwa moyo wanu kuyenera kukhala njira zanu zoyambirira kuwongolera GERD ndi kutentha pa chifuwa. Mungafune kuyesa:

• kasamalidwe kulemera
• kupewa chakudya chachikulu musanagone
• kusiya kapena kusuta fodya, ngati mukugwiritsa ntchito

Popita nthawi, GERD yayitali imatha kubweretsa khansa ya m'mimba. Ngakhale anthu ochepa omwe ali ndi GERD amatenga khansa ya m'mimba, ndikofunikira kudziwa zoopsa.

Ma PPI amayamba kugwira ntchito pang'onopang'ono, chifukwa chake sangakhale yankho lakumva kutentha kwanthawi kapena Reflux.

Njira zina zitha kupereka mpumulo pakugwiritsa ntchito nthawi zina, monga:

• mapiritsi otchedwa calcium carbonate
• zamadzimadzi monga aluminium hydroxide ndi magnesium hydroxide (Maalox) kapena aluminium / magnesium / simethicone (Mylanta)
• mankhwala ochepetsa acid monga famotidine (Pepcid) kapena cimetidine (Tagamet)

Zonsezi zimapezeka ngati mankhwala a OTC.