Dɔgbo ƒe vevesesea? Mete ŋu ɖua nuɖuɖu oa? Va, mina míaƒo nu tso (Prokinetic Agents) ŋu!

Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeɖi ƒo alo mèɖua nuɖuɖu nyuie le nuɖuɖu vɔ megbe oa? Alo ɖe kuxiwo abe dzimeve alo nuɖuɖumaɖumaɖu ene le ŋuwòa? Ɣeaɖewoɣi la, míaƒe dɔgbowo ƒe dɔmawɔmawɔ nyuie gbɔ ate ŋu ahe kuxi siawo vɛ. Egbea míele nu ƒom tso atike tɔxɛ aɖe si va kpena ɖe ame ŋu le ɣeyiɣi mawo tɔgbe me ŋu. Woyɔa esiawo be `(Prokinetic Agents)`.

Nukae nye `(Prokinetic Agents)` siawo? Kpuie ko la,...

Kpuie ko la, `(Prokinetic Agents)` nye atike ƒomevi aɖe si dzia nuɖuɖu ƒe zɔzɔ kabakaba to wò nuɖuɖumeŋusẽ me, si nye dɔgbowo me ɖe edzi. Ne míemi nuɖuɖu la, lãmeka siwo le míaƒe nuɖuɖumeŋusẽ me la tea ƒoƒo tso etame yi anyime abe ƒutsotsoe siwo kplɔ wo nɔewo ɖo ene. Woyɔa esia be `(Perstalsis)`. Ele abe nuɖuɖu tutu ɖe anyi ene. Aleae nuɖuɖu zɔna tso ŋɔti me, yia nuɖuɖutome, yia dɔgboa me, eye emegbe yia dɔgboa me. Mɔzɔzɔ sia mee míaƒe ŋutilã xɔa nunyiame siwo wòhiã.

Ke hã, le dɔléle aɖewo alo susu bubuwo ta la, ɖewohĩ ɖoɖo sia si woyɔna be ``Peristalsis'' mawɔ dɔ nyuie o. Esiae nye ɣeyiɣi si me dzesiwo abe dɔmeɖui, dzimeve, kple sese le ame ɖokui me be yeɖi ƒo evɔ nuɖuɖu meɖu o la dzena. Nuɖuɖu ate ŋu anɔ dɔgboa me ɣeyiɣi didi, eye emegbe ŋutilãa mekpɔa nunyiame si hiã o.

Ɣemaɣie atike siawo siwo woyɔna be `(Prokinetic Agents)` va xɔna. Esiawo dzia dɔgboa ƒe ʋuʋu ɖe edzi eye wokpena ɖe nuɖuɖu ŋu wòtoa nuɖuɖumeŋusẽ me kabakaba. Gake nu vevitɔ kekeake si dzi wòle be míaɖo ŋkui enye be nugbegblẽ le ame ŋu ɖedzesi aɖewo li siwo ate ŋu ado tso atike siawo me. Eyata zi geɖe la, ɖɔktawo meŋlɔa atike siawo na ame enumake o. Zi geɖe la, wonaa atike bubuwo `(Proton Pump Inhibitors - PPIs)` alo `(H2 Blockers)` eye emegbe wobua `(Prokinetic Agents)` ne womena gbɔdzɔe o ko. Gake le wò dɔléle ƒe nɔnɔme nu la, wò ɖɔkta ate ŋu aŋlɔ atike sia hã na wò.

Aleke `(Prokinetic Agents)` siawo wɔa dɔe?

Alesi atike siawo wɔa dɔe la sesẽ vie, gake mana wòanɔ bɔbɔe. Wodoa ŋusẽ lãmeka siwo le wò nuɖuɖumeŋusẽ me koŋ eye wokpena ɖe lãmekawo ŋu be woatsi.

Ema fia be:

• Enaa wò nuɖuɖutome (nuɖuɖu ƒe pɔmpi) ƒe tete dzina ɖe edzi, si kpena ɖe ŋuwò be nuɖuɖu nayi dɔgboa me kabakaba.
• Do ŋusẽ Lower Esophageal Sphincter (LES) si le wò nuɖuɖutome ƒe gɔme. LES la le abe ʋuƒo ene. Enye wò nuɖuɖutome ƒe akpa si doa ka kple wò dɔgbo kple wò nuɖuɖutome. Ne metu nyuie o eye wòɖe asi le eŋu la, dɔgbo me acid ate ŋu atrɔ ava wò nuɖuɖutome kple ŋɔti me. Ɣemaɣie dzimeve, dzimeve, kple akɔtave ma. Wogayɔa esia be Acid Reflux alo GERD.
• Enaa dɔgbo ƒe tete dzina ɖe edzi eye wòkpena ɖe nuɖuɖu ŋu wòyia dɔgbo suea me kabakaba.
• Eɖea ɣeyiɣi si wòxɔna hafi dɔgboa tsi ƒuƒlu dzi kpɔtɔna. Esia ɖea mɔnukpɔkpɔ si li be dɔgboa me nuwo nagatrɔ ava dzi, abe alesi wòle le `(Acid Reflux)` gome ene.

Bu eŋu kpɔ, atike sia wɔa dɔ abe ʋutɔɖoƒe ene, eye kpovitɔwo va ʋua mɔ na ʋuawo be woazɔ kabakaba.

Nɔnɔme kawo tae wozãa `(Prokinetic Agents)` le?

Wozãa atike siawo koŋ na nɔnɔme siwo gbɔna:

• Gastroparesis (dɔgbo ƒe lãmekawo ƒe dɔmawɔmawɔ nyuie/nuɖuɖu ƒe heheɖemegbe): Le nɔnɔme sia me la, dɔgbo ƒe lãmekawo metsia nyuie o, eyata nuɖuɖu ƒe ɖuɖu tsia megbe. Prokinetic atikewo dzia dɔgboa ƒe ʋuʋu siawo ɖe edzi eye wònana dɔgboa ƒuna kabakaba. Suklidɔlélawo hã ate ŋu axɔ nɔnɔme sia si woyɔna be Diabetic Gastroparesis. Metoclopramide koe nye atike si dzi FDA da asi ɖo fifia le United States na esia. Wò ɖɔkta ate ŋu aŋlɔ esia na wò ne atikewɔmɔnu bubuwo mekpe ɖe ŋuwò o.

• GERD (Gastroesophageal Reflux Disease): Esiae nye ɣeyiɣi si me dɔgbo me acid gatrɔna yia nuɖuɖutome yia nu me. Esia dzɔna ne LES (Lessive Esophageal Suppression System) si megblɔ va yi la metu nyuie o. Prokinetic agents ɖeɖe makpe ɖe GERD ŋu o. Gake ne wò dɔgbo tsi ƒuƒlu blewu la, wò ɖɔkta ate ŋu aŋlɔ esiawo kpe ɖe atike bubuwo ŋu.

• Functional Dyspepsia: Esia nye ne dɔgbo me mekɔna o ɣesiaɣi le nuɖuɖu vɔ megbe, gake womate ŋu akpɔ nusi gbɔ wòtso si me kɔ o. Ame aɖewo ate ŋu akpɔe be atike siawo ate ŋu akpe ɖe ame ŋu be woaɖe dɔlélea ƒe dzesiwo dzi akpɔtɔ. Numekulawo gblɔ be atike siawo kpena ɖe ame ŋu to dɔgbo ƒe tete ɖe edzi kple eƒe ƒuƒlu kabakaba me.

• Aɖuɖɔtoe kple aɖuɖɔtoe: Ðɔkta ate ŋu aŋlɔ atike sia na aɖuɖɔtoe si nu sẽ alo esi nɔa anyi didi si mewɔ dɔ ɖe atike bubuwo dzi o. Wozãa wo hã ɣeaɖewoɣi hena ʋuʋudedi si atike siwo wozãna tsɔ daa kansa hena vɛ.

• Dɔgbo ƒe Aʋatso-mɔxexe Atraɖii: Esia nyea ɣeyiɣi si me dɔgboa ƒe mɔxexeɖedɔléle ƒe dzesiwo dzena togbɔ be mɔxexe ŋutɔŋutɔ aɖeke mele dɔgboa me o hã . Numekulawo gale numekuku wɔm le eŋu nenye be prokinetic agent aɖewo ate ŋu akpe ɖe ame ŋu le nɔnɔme sia me hã.

Nukae nye `(Prokinetic Agents)` ƒe ƒomevi veviwo?

Woateŋu ama atike siawo ɖe hatsotso vevi eve me: `(Agonists)` kple `(Antagonists)`.

• `(Agonists)`: Esiawo wɔa dɔ abe `(Neurotransmitters)` (atike siwo tsɔa gbedasiwo le lãmekawo dome) aɖewo ene le míaƒe lãmekawo me. Eyae nye be, `(Agonists)` siawo yia ɖa léna ɖe lãmeka aɖe ŋu, gblɔna na lãmeka ma be "wòaƒo ƒu". Abe alesi ko `(Neurotransmitters)` siwo sɔ hã wɔa nu ma ke ene.
• `(Antagonists)`: Esiawo wɔa dɔ to mɔxexe ɖe `(Neurotransmitters)` aɖewo be woagabla ɖe lãmeka aɖe ŋu o. Etɔxɛe la, ne `(Neurotransmitters)` li siwo doa kplamatse `(Peristalsis)` ƒe dɔwɔwɔ la, `(Antagonists)` siawo xea mɔ na wo be woagabla ɖe lãmekaa ŋu o.

Wogama ``Prokinetic Agents'' siawo ɖe hatsotso vovovowo me, le alesi atike ɖesiaɖe wɔa dɔe nu:

• `(Cholinergic Agonists)`:Esiawo wɔa dɔ abe ``(Neurotransmitter)`` si woyɔna be `(Acetylcholine)` ene. `(Acetylcholine)` doa ŋusẽ lãmeka siwo le dɔgboa me ƒe tete. Kpɔɖeŋuwo: `(Baclofen)`, `(Bethanechol)`, `(Neostigmine)`, `(Pyridostigmine)`.
• `(Motilin Agonists)` (Macrolide Antibiotics): Esiawo wɔa dɔ abe `(Neurotransmitter)` si woyɔna be `(Motilin) ​​ene. `(Motilin)` doa ŋusẽ ʋuʋudedi le dɔgbo suea me. Atike aɖewo le ƒuƒoƒo sia me nye `(Antibiotics)` ŋutɔŋutɔ siwo wonana tsɔ daa dɔlékuiwo ƒe dɔlélewo. Kpɔɖeŋuwo: `(Erythromycin)`, `(Azithromycin)`.
• Serotonin Agonists: Esiawo wɔa dɔ abe ahɔhɔ̃mekawo ƒe dɔwɔwɔ si nye serotonin ene. Abe serotonin ene la, wodoa dɔgbo ƒe tete eye wokpena ɖe dɔgboa ŋu wòƒua ƒu. Kpɔɖeŋuwo: Cisapride, Prucalopride, Tegaserod.
• `(Dopamine Antagonists)`: Esiawo xea mɔ na `(Neurotransmitter)` si woyɔna be `(Dopamine)` be wòagabla ɖe lãmekawo ƒe lãmenugbagbeviwo ŋu o. `(Dopamine)` ɖea dɔgbo kple dɔgbo ƒe ʋuʋu dzi kpɔtɔna, eye wòɖea dzi ɖi na `(LES)` hã. Eyata, ne `(Dopamine)` dzudzɔ kadodo la, `(Dopamine Antagonists)` siawo trɔa ŋusẽkpɔɖeamedzi ma (i.e. dzia ʋuʋu ɖe edzi). Kpɔɖeŋuwo: `(Metoclopramide)`, `(Domperidone)`.

Kpɔɖeŋu aɖewo le `(Prokinetic Agents)`

Fifia la, ``Prokinetic`` atike ƒomevi aɖewo li siwo wozãna tsɔ daa dɔe, woxe mɔ ɖe wo dometɔ aɖewo nu le dukɔwo abe United States ene me le woƒe nugbegblẽ le ame ŋu ta, eye ɖewo gakpɔtɔ le numekuku ƒe afɔɖeɖea me.

• Azithromycin (Zithromax®): Atike si tsia motilin nu. Ɣeaɖewoɣi la, ɖɔktawo ŋlɔnɛ nɛ le mɔ si womeŋlɔ ɖe edzi o nu hena dɔgbo ƒe dɔmawɔmawɔ nyuie.
• Baclofen (ED baclofen®): Atike si naa ʋumenugbagbeviɣidɔ. Wogale nu srɔ̃m tso viɖe siwo le eŋu na GERD ŋu kokoko.
• `(Bethanechol)` (Urecholine®): A `(Kholinergic Agonist) ƒe ʋuƒoƒo. Ekpena ɖe `(Gastroparesis)` kple `(GERD)` ƒe dzesiwo ŋu. Gake womezãnɛ le agbɔsɔsɔ gã me o elabena ate ŋu ahe nugbegblẽ le ame ŋu vevie abe lãmekawo ƒe ʋuʋu kple ŋku ƒe ʋuʋu ene vɛ.
• Cisapride (Propulsid®): Atike si tsia serotonin nu. Ekpena ɖe dɔgboa ŋu wòƒua ƒu kabakaba. Wozãnɛ tsã na GERD. Woɖee le United States ƒe asi me le dzidɔ ƒe nugbegblẽ le ame ŋu ta.
• `(Domperidone)` (Motilium®): A `(Dopamine ƒe Dɔlékuiwutike). Le United States la, womate ŋu akpɔe bɔbɔe ne womexɔ mɔɖeɖe tɔxɛ o. Ate ŋu ahe dzidɔ sesẽwo abe dzi ƒe tsotso si mesɔ o kple dzidɔ ene vɛ.
• Erythromycin (EES®): Motilin ƒe Dɔlékuiwutike. Ðɔkta ate ŋu aŋlɔe na wò le mɔ si womeŋlɔ ɖe edzi o nu hena dɔgbo ƒe dɔmawɔmawɔ nyuie.
• Metoclopramide (Reglan®, Maxeran®, Gimoti®): Dopamine ƒe dɔlékuiwutike. Atike ɖeka kolia si dzi FDA da asi ɖo na dɔgbo ƒe dɔmawɔmawɔ nyuie. Wozãnɛ hã tsɔ daa GERD si mewɔ dɔ ɖe atikewɔmɔnu siwo wozãna ɖaa dzi o. Gake nuxlɔ̃ame aɖe kpena ɖe eŋu be ate ŋu ahe nugbegblẽ le ame ŋu si agblẽ nu le lãmekawo ŋu.
• `(Prucalopride)` (Ame ƒe ŋusẽ®):A `(Serotonin Agonist)`. Wonae na dɔmeɖui si nɔa anyi didi. Ekpena ɖe dɔgboa hã ŋu wòƒua gbɔ kaba.
• Pyridostigmine (Mestinon®): Atike si tsia ʋumenugbagbeviɣidɔ nu. Wozãnɛ koŋ tsɔ daa Myasthenia Gravis, gake wozãnɛ hã ɣeaɖewoɣi tsɔ daa Gastroparesis.

Nukae nye `(Prokinetic Agents)` siawo zazã ƒe nugbegblẽ le ame ŋu?

Esiae nye nu vevitɔ kekeake si ŋu wòle be míaɖɔ ŋu ɖo. Prokinetic agents ate ŋu agblẽ nu le ame ŋu vevie. Esia tae zi geɖe la, ɖɔktawo medina be yewoaŋlɔ wo o. Gake ne atikewɔmɔnu siwo wozãna ɖaa abe PPI siwo wozãna na GERD ene mewɔ dɔ o la, ɖɔkta ate ŋu atso nya me be yeaŋlɔ atike si naa dɔlélea nye prokinetic agent. Alo, abe afɔɖeɖe ene la, woate ŋu aŋlɔ wo le agbɔsɔsɔ si bɔbɔ wu me alo hena ɣeyiɣi kpui aɖe.

Ne ɖɔkta aɖe ŋlɔ atike si nye prokinetic agent na wò la, kpɔ egbɔ be yebia nu tso atike ma ƒe nugbegblẽ le ame ŋu koŋ ŋu.

Nusiwo wògblẽna le ame ŋu zi geɖe dometɔ aɖewoe nye:

• Dɔgbo ƒe vevesese
• Aɖuɖɔtoe kple ʋuʋudedi
• Aɖuɖɔtoe (ʋuʋudedi) .
• Nukpɔkpɔ si me mekɔ o
• Taɖuame (taɖuame) .
• Ðeɖiteameŋu
• Alɔ̃dɔdɔ, ɖeɖiteameŋu akpa, alɔ̃dɔdɔ enuenu (Lethargy) .
• Teteɖeanyi
• Dzitsitsi
• Lãmetsiwo ƒe tete si dzi womeɖu o (Dystonia) .
• Mo ƒe lãmekawo ƒe ʋuʋu si dzi womeɖu o (Tardive Dyskinesia) .

Woɖe atikewo abe `(Cisapride)`, `(Domperidone)` kple `(Tegaserod)` ɖa le asi me le dzidɔ sesẽwo ƒe afɔku ta. Ema nye:

• Dzi ƒe tsotso blewu (Bradycardia) .
• Dzi ƒe tsotso si mesɔ o (Arrhythmia) .
• Dzidɔ

Numekuku siwo wowɔ fifia le prokinetic agents yeyewo ŋu ku ɖe atike siwo naa viɖe si nye be woaʋã dɔgbo ƒe ʋuʋu esime woɖea afɔku si le nugbegblẽ le ame ŋu alea dzi kpɔtɔna la toto vɛ ŋu.

Nukae nye `(Prokinetic Agents)` siwo wozãna wu?

Dɔlékuiwutike siwo woŋlɔna na ame wue nye Metoclopramide kple Domperidone. Le United States la, Metoclopramide koe nye atike si dzi FDA da asi ɖo na dɔgbo ƒe dɔmawɔmawɔ nyuie. Gake ɖɔkta ate ŋu aŋlɔ Domperidone na ame ne FDA da asi ɖe edzi.

Prokinetic agents to vovo le woƒe dɔwɔwɔ kple dedienɔnɔ me le nuɖuɖumeŋusẽ ƒe dɔlélewo dada me. Le afɔku si le eƒe nugbegblẽ le ame ŋu me ta la, ɖɔkta ate ŋu ate atike bubuwo kpɔ hafi aŋlɔ atike si nye prokinetic agent na wò. Gake ne dzesi sesẽwo dze le ŋuwò le esi wò dɔgbowo mele ƒoƒom nyuie o ta la, prokinetic agent ate ŋu ana gbɔdzɔe si nèhiã vevie. Ne èle prokinetic agent nom ŋu bum la, ele vevie be nàdzro viɖe kple afɔku siwo le eme me kple wò ɖɔkta.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Eyata, mele mɔ kpɔm be èsrɔ̃ nane tso nusiwo me míedzro tso `(Prokinetic Agents)` ŋu. Kpuie ko la:

• Prokinetic agents nye atike ƒomevi aɖe si dzia nuɖuɖumeŋusẽ ƒe ʋuʋu ɖe edzi eye wòkpena ɖe nuɖuɖumeŋusẽ ŋu.
• Wozãa esiawo na nɔnɔme aɖewo abe `(Gastroparesis)` kple `(GERD)`, kpakple na nuwo abe ʋuʋudedi kple ʋuʋudedi ene.
• Atike sia wɔa dɔ to lãmeka siwo le dɔgboa me ƒe ʋuʋu kple lãmekawo ƒe ʋuʋu me.
• Nu vevitɔ kekeakee nye be atike siawo ate ŋu agblẽ nu le ame ŋu vevie ɣeaɖewoɣi. Esia tae ɖɔkta aɖe aŋlɔ wo kple ŋuɖɔɖɔɖo gã aɖe ɖo.
• Mègazã atike sia ƒomevi gbeɖe ne mèbia ɖɔkta o. Ele be ɖɔkta natso nya me le atike si sɔ na wò kple ɣeyiɣi didi si wòle be nànoe ŋu.

Ne dɔgbo le vevem alo nuɖuɖumeŋusẽ ƒe kuxi aɖe le ŋuwò abe esia ene la, nu nyuitɔ si nàwɔe nye be nàyi ɖɔkta gbɔ aƒo nu tso eŋu. Ekema àte ŋu akpɔ atike nyuitɔ.

` prokinetic agents, dɔgbo ƒe vevesese, nuɖuɖumadzroame, dɔgbo ƒe dɔléle, GERD, dɔgbo ƒe ʋuʋu, metoclopramide