Ɛtɔ mmere bi a, yɛdidi wie a, yɛn yafunu yɛ ma na yɛn yafunu mu ayɛ ma, ɛnte saa? Ɛte sɛ nea aduan no nkɔ yɛn yafunu mu. Anaasɛ yenya ɔhaw te sɛ bere nyinaa a yɛtow yɛn ho, komayare, ne ɔfe. Ade biako nti a saa nneɛma yi ba ne sɛ wo aduan mu nneɛma, kyerɛ sɛ, wo dwensɔtwaa, yɛ brɛoo kakra. Ɛnnɛ, yɛreka nnuru soronko bi a ɛboa wɔ mmere a ɛtete saa mu ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne saa Prokinetic Agents yi?
Prokinetic agents yɛ aduru bi a ɛkanyan ntini a ɛwɔ wo yafunu mu no ma ɛtwetwe, anaasɛ "ɛpia," na ɛboa ma aduan kɔ ntɛmntɛm.
Fa no sɛ, sɛ yɛmene aduan a, ntini a efi yɛn yafunu mu kɔ yɛn yafunu ne yɛn dwensɔtwaa mu no twetwe kɛkɛ na ɛhome te sɛ asorɔkye, na ɛpia aduan no kɔ yɛn anim. Yɛfrɛ saa adeyɛ a ɛba ara kwa yi peristalsis . Ɛte sɛ nea worepiapia na woapiapia biribi wɔ tube mu na wode akɔ w’anim. Esiane sɛ saa adeyɛ yi kɔ so yiye nti, yɛn nipadua no tumi twetwe aduannuru a ehia fi aduan mu.
Nanso, sɛ biribi nti saa adeyɛ a ɛma obi tumi keka ne ho yi brɛ ase a, aduan betumi atra yafunu no mu akyɛ. Eyi betumi ama obi ho ayɛ no yaw te sɛ ne ho ayɛ no yaw, akisikuru, ne komayare. Ɛno ne bere a nnuru a wɔfrɛ no Prokinetic Agents boa ma yɛn dwensɔtwaa "push" kakra na ɛsan de saa adeyɛ no ba.
Ɔkwan bɛn so na saa aduru yi yɛ adwuma wɔ nipadua no mu?
Prokinetic agents yɛ adwuma denam ntini a ɛwɔ yɛn dwensɔtwaa mu a ɛkanyan no so, na ɛma ntini ahorow no twetwe. Eyi yɛ nneɛma atitiriw kakraa bi:
- Ɛma aduan a ɛtwetwe no yɛ kɛse: Eyi ma aduan kɔ yafunu no mu ntɛmntɛm.
- Hyɛ Lower Esophageal Sphincter (LES) Den: Eyi ne "ɔpon" a ɛda yɛn esophagus ne yafunu ntam. Sɛ ɛyɛ mmerɛw a, yafunu mu acid betumi asan akɔ soro akɔhyɛ aduan no mu. Eyi ne nea yɛfrɛ no komayare, anaa GERD . Nnuru a ɛma nipadua no tumi yɛ adwuma no ma ɔpon yi mu yɛ den na esiw acid no kwan sɛ ɛnsan nkɔ soro.
- Ɛma yafunu mu twetwe yɛ kɛse: Eyi ma aduan a ɛwɔ yafunu no mu tumi kɔ dwensɔtwaa ketewa no mu ntɛmntɛm. Sɛ yafunu no mu da mpan ntɛmntɛm a, hokwan a ɛwɔ hɔ sɛ ɛbɛsan aba soro no sua.
- Ɛtew bere a egye ansa na yafunu no da mpan so: Eyi nso boa kɛse wɔ tebea horow te sɛ GERD a yɛaka ho asɛm wɔ atifi hɔ no ano aduru mu.
Tebea bɛn na wɔde prokinetic agents di dwuma ma?
Mpɛn pii no, nnuruyɛfo kamfo nnuru a ɛte sɛɛ kyerɛ wɔ nsɛm a ayaresa afoforo nnyaa ahotɔ biara mu, efisɛ eyinom betumi de ɔhaw ahorow bi aba.
| Aduruyɛ mu tebea | Sɛ yɛbɛka no tiawa a... | Ɔkwan bɛn so na saa aduru yi boa? |
|---|---|---|
| Yafunu mu yare a ɛma obi ho kyere no | Nnuan a wɔyam no kyɛ efisɛ yafunu mu ntini no ntumi nyɛ adwuma yiye. Saa tebea yi abu so wɔ nnipa a wɔwɔ asikreyare mu. | Ɛma yafunu mu twetwe yɛ kɛse, na ɛboa ma ɛda mpan ntɛmntɛm. Metoclopramide yɛ aduru titiriw a wɔapene so sɛ wɔmfa nyɛ eyi. |
| GERD (komayare/koko mu yaw) . | Tebea a ɛtra hɔ kyɛ a yafunu mu acid a ɛsen kɔ aduan mu bere nyinaa na ɛde ba. | Saa nnuru yi nyɛ GERD aduru wɔ n’ankasa so. Nanso, sɛ yafunu mu a ɛkyɛ nso na ɛde GERD ba a, ebia wo duruyɛfo bɛkyerɛw ama wo aka nnuru afoforo ho. |
| Dwumadi mu Dyspepsia | Nsɛnkyerɛnne a ɛkɔ so daa a ɛkyerɛ sɛ aduan a ɛnyɛ dɛ bere a wɔadi akyi, nanso wontumi nhu nea ɛde ba pefee. | Ɛboa ma yare no ho sɛnkyerɛnne so tew denam yafunu a ɛtwetwe kɔ soro no so, na ɛma emu da hɔ ntɛmntɛm. |
| Akisikuru ne ɔfe | Ɔfe ne akisikuru a ɛkɔ so tra hɔ a ɛyɛ den sɛ wɔde ayaresa afoforo bedi so. Wɔde sa ɔfe a nnuru a wɔde sa wɔn a wɔwɔ kokoram nso de sa. | Wɔnam mmeae a ɔfe wɔ amemene no mu a ɛka na ɛma yafunu no mu da hɔ ntɛmntɛm no so di saa sɛnkyerɛnne ahorow yi so. |
Dɛn ne nneɛma atitiriw a ɛma obi nya prokinetic?
Wobetumi akyekyɛ nnuru yi mu akuw atitiriw abien a egyina sɛnea ɛyɛ adwuma so: Agonists ne Antagonists .
- Agonists: Eyinom yɛ adwuma te sɛ neurotransmitters wɔ yɛn nipadua mu na wɔyɛ ade koro no ara a wɔyɛ. Ɛne sɛ, wɔde nkrasɛm no kɔma ntini a ɛwɔ dwensɔtwaa no mu no ma ɛtwetwe.
- Nneɛma a ɛko tia: Eyinom yɛ adwuma denam nnuru bi a ɛde ntini mu nkrasɛm a ɛma dwensɔtwaa no dwumadi brɛ ase na entumi nkɔ ntini bi mu no a wogyae so. Ɛne sɛ, wosiw nkrasɛm a ɛma dwensɔtwaa no "brɛ ase" no ano.
Nnuru ahorow pii wɔ eyi ase:
- Nnuru a ɛko tia dopamine: Dopamine, nnuru bi a ɛwɔ amemene ne dwensɔtwaa mu no brɛ dwensɔtwaa no dwumadi ase. Saa nnuru yi yɛ adwuma denam dopamine dwumadi a esiw ano no so. Nhwɛso ahorow: Metoclopramide, Domperidone .
- Serotonin agonists: Wɔyɛ adwuma te sɛ nnuru bi a wɔfrɛ no serotonin na ɛkanyan dwensɔtwaa no ma ɛtwetwe. Nhwɛso ahorow: Prucalopride .
- Motilin agonists: Motilin yɛ nnuru a ɛhwɛ yɛn dwensɔtwaa ketewa no mu. Eyi ne sɛnea nnuru yi yɛ adwuma. Nea ɛyɛ nwonwa no, nnuru a ekum ɔyare mmoawa te sɛ Erythromycin ka kuw yi ho.
- Cholinergic agonists: Ɛyɛ adwuma te sɛ neurotransmitter acetylcholine na ɛma ntini a ɛwɔ dwensɔtwaa no mu no twetwe. Nhwɛso ahorow: Bethanechol, Neostigmine .
Nea ɛho hia yiye: Nsunsuanso bɔne a efi aduru yi mu ba
Eyi ne asɛm yi fã a ɛho hia sen biara. Prokinetic Agents nyɛ aduru te sɛ Panadol a wɔde sa tiyɛ a ɛtaa ba. Ebetumi anya nsunsuanso bɔne a emu yɛ den na ɛnsɛ sɛ wɔnom esiane biribiara nti a oduruyɛfo afotu nka ho.
Nnuruyɛfo kyerɛw nnuru yi bere a ayaresa afoforo adi nkogu nkutoo, na wɔtaa de ma wɔ dodow a ɛba fam ne bere tiaa bi mu.
Nneɛma bɔne a wɔtaa hu:
- Yafunu mu yaw
- Akisikuru ne ɔfe
- Ayamtuo
- Anisoadehu a ɛyɛ kusuu
- Tipaeɛ
- Ɔbrɛ a ɛtra so, nna a ɛma obi da
- Adwenemhaw ne Dadwen
Nneɛma bɔne a anibere wom a ɛsɛ sɛ yɛhwɛ yiye wɔ ho:
Saa sɛnkyerɛnne ahorow yi ho hia yiye. Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi bere a worenom aduru a ɛma obi nya prokinetic a, ɛsɛ sɛ wobɔ wo duruyɛfo amanneɛ ntɛm ara.
- Dystonia: Eyi yɛ tebea a ɛma nipadua no mu ntini twetwe wɔ ɔkwan a wontumi nni so, te sɛ kɔn a wɔtwe kɔ ɔfã biako, aniwa a ɛbobɔw, anaa tɛkrɛma a ɛpuepue.
- Anim akwaa a ɔmpɛ (Tardive Dyskinesia): Eyi yɛ tebea a ebetumi aba bere a wanom nnuru bere tenten akyi. Anim no afã horow te sɛ ano, tɛkrɛma, ne hwene, tu a ɔmpɛ. Ɛtɔ mmere bi a, saa tebea yi ntu mpɔn bere a wɔagyae aduru no mpo akyi.
- Koma mu haw: Nnuru bi, titiriw Domperidone , betumi ama koma abɔ a ɛnteɛ (arrhythmias) ne komayare. Eyi nti, wɔabara nnuru yi a wɔde di dwuma wɔ aman bi mu.
Esiane asiane ahorow yi nti, sɛ wo duruyɛfo kyerɛw saa aduru yi a, wo ne no nkasa yiye wɔ mfaso ne ɔhaw ahorow a ɛwom no ho. Hwɛ hu sɛ wobɛka aduruyɛ mu tebea foforo biara a wowɔ ne nnuru foforo biara a wonom ho asɛm akyerɛ wo duruyɛfo.
Nkrasɛm a Wɔde Kɔ Fie
- Prokinetic agents yɛ aduru bi a ɛma "push" kɔ aduan mu nhyehyɛe a "ɛyɛ brɛoo" so, na ɛma aduan tu ntɛmntɛm.
- Wɔde eyinom sa tebea horow te sɛ gastroparesis (yafunu a ɛnyɛ adwuma yiye) ne GERD a emu yɛ den.
- Wɔntaa mfa eyinom nni dwuma sɛ ayaresa a edi kan esiane asiane a ɛwɔ hɔ sɛ ebefi mu aba a emu yɛ den nti.
- Mfa nnuru yi nni dwuma da a wunni aduruyɛ mu afotu.
- Sɛ wuhu sɛnkyerɛnne biara a ɛyɛ soronko bere a worenom aduru yi, titiriw ntini a ɛwosow w’anim anaa nipadua mu a wontumi nni so a, ka kyerɛ wo duruyɛfo ntɛm ara.
- Sɛ wo duruyɛfo akyerɛw saa aduru yi ama wo a, ɛyɛ nea wabu atɛn sɛ mfaso a ɛwɔ so no sõ sen asiane a ebetumi aba no nti. Enti, di wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ.
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