Ua kuhikuhi anei kāu kauka iā ʻoe i kahi lāʻau lapaʻau no ke koko kiʻekiʻe a i ʻole, inā he kāne ʻoe, no ka hoʻonui ʻana i ka prostate? Inā pēlā, he mea hiki paha i ka lāʻau lapaʻau ke alpha-blocker. ʻOiai ke kani iki nei ka inoa i kahi paʻakikī, he ʻano lāʻau lapaʻau kēia i hoʻohana nui ʻia e kōkua i ka kaohi ʻana i kekahi mau kūlana i loko o ko mākou kino. No laila i kēia lā, e kamaʻilio kākou e pili ana i kēia mau alpha-blockers ma ke ʻano maʻalahi hiki iā ʻoe ke hoʻomaopopo.
Pehea ka hana a kēia mau alpha-blockers?
I mea e hoʻomaopopo ai i kēia, e noʻonoʻo kākou i ka ʻōnaehana kamaʻilio o ko kākou kino. Ua like ko kākou ʻōnaehana nerve me kahi lawelawe leka. Hoʻouna ia i nā leka kemika (a mākou e kapa nei he "Neurotransmitters") i nā ʻāpana like ʻole o ko kākou kino. No ka loaʻa ʻana o kēia mau leka, loaʻa i ko kākou mau cell nā "mea loaʻa" kūikawā. Ua like ia me ke kī a me ka laka. Aia wale nō ke hiki mai ka leka kemika (ke kī) a kūpono i loko o ka mea loaʻa kūpono (ka laka) e hoʻāla ʻia ai kēlā cell.
ʻO nā mea hoʻokipa Alpha kahi ʻano mea hoʻokipa i loko o ko mākou kino. Loaʻa nui lākou i loko o ko mākou mau kīʻaha koko a ma nā wahi e like me ke kelepa prostate. Ke loaʻa i kēia mau mea hoʻokipa alpha kahi leka, hoʻomaka kēlā mau cell e ʻūmiʻi. No ka laʻana, ke hoʻāla ʻia nā mea hoʻokipa alpha i loko o nā kīʻaha koko, ʻūmiʻi nā kīʻaha koko a piʻi ke koko.
No laila, ʻo ka hana a ka alpha-blocker , ua like ia me ke kau ʻana i ke kī hewa i loko o kahi honu a ke ālai nei iā ia. Hele kēia lāʻau lapaʻau a hoʻopili i kēlā mau alpha-receptors a pale iā lākou mai ka loaʻa ʻana o ka leka kūpono. ʻO ia hoʻi, 'ālai' ia i kēlā mau receptors. A laila ʻaʻole e ʻaelike kēlā mau cell, hoʻomaha lākou. Ke hoʻomaha nā cell i loko o nā kīʻaha koko, ākea nā kīʻaha koko, a iho ke koko. Ke hoʻomaha nā ʻiʻo i loko o ka prostate, e maʻalahi ka mimi. ʻO ia wale nō ka mea e hana ʻia.
Nā ʻano o nā alpha-receptors a me kā lākou hana
ʻElua ʻano nui o nā mea loaʻa alpha: alpha-1 (A1) a me alpha-2 (A2). He ʻokoʻa iki nā hana a lāua ʻelua.
| ʻAno Mea Hoʻokipa | Kahi a me nā hana nui |
|---|---|
| Mea hoʻokipa Alpha-1 (A1) |
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| Mea hoʻokipa Alpha-2 (A2) |
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He aha nā kūlana e hoʻohana ʻia ai nā alpha-blockers?
Hoʻohana nui ʻia kēia ʻano lāʻau lapaʻau e mālama i kekahi mau ʻano maʻi.
1. Ke koko kiʻekiʻe (Hypertension)
ʻO kēia ka hoʻohana nui. E like me kā mākou i kūkākūkā ai ma mua, hoʻomaha nā alpha-blockers i nā kīʻaha koko a hoʻohaʻahaʻa i ke koko. Hoʻohana pinepine ʻia nā lāʻau lapaʻau e like me Doxazosin, Prazosin, a me Terazosin no kēia kumu.
2. ʻO ka Benign Prostatic Hyperplasia (BPH)
He ʻano maʻamau ka BPH i nā kāne i ko lākou wā ʻelemakule. I kēia ʻano, hoʻonui ka ʻōpū prostate a kaomi i ka urethra, e hana ana i nā pilikia e like me ka paʻakikī o ka mimi ʻana a me ka paʻa ʻana o ka mimi. Hoʻomaha nā Alpha-blockers e like me Tamsulosin, Alfuzosin, a me Silodosin i nā ʻiʻo o ka prostate a me ka ʻāʻī o ka ʻōpū mimi, e maʻalahi ai ke kahe ʻana o ka mimi.
3. Nā hoʻohana ʻē aʻe (Nā hoʻohana ma waho o ka lepili)
I kekahi manawa, kuhikuhi nā kauka i kahi lāʻau no nā kūlana ʻē aʻe ma mua o ka mea i ʻae ʻia. Ua kapa ʻia kēia he hoʻohana 'off-label'.
- Nā Pōhaku Puʻupaʻa: Hāʻawi ʻia nā lāʻau lapaʻau e like me Tamsulosin e kōkua i nā pōhaku liʻiliʻi i paʻa i loko o ke ala mimi e hele maʻalahi.
- ʻO ka maʻi kaumaha ma hope o ka trauma (nā moeʻuhane e pili ana i ka PTSD): Hoʻohana ʻia ka lāʻau lapaʻau ʻo Prazosin i kekahi manawa e mālama ai i kēia kūlana.
- Pheochromocytoma: He ʻano puʻupuʻu kēia e ulu ana i loko o nā kelepa adrenal a hana i nā nui o nā hormones. Hāʻawi ʻia nā Alpha-blockers e kāohi i ke koko kiʻekiʻe i hoʻokumu ʻia e kēia mau puʻupuʻu.
He aha nā hopena ʻaoʻao a me nā pilikia o nā alpha-blockers?
E like me nā lāʻau lapaʻau āpau, hiki i nā alpha-blockers ke loaʻa nā hopena ʻaoʻao. ʻO ia ke kumu e akahele loa ai nā kauka i ke kuhikuhi ʻana i kēia mau lāʻau lapaʻau. Hiki ke ʻokoʻa nā hopena ʻaoʻao āu e ʻike ai ma muli o ke ʻano o ka lāʻau lapaʻau āu e lawe ai.
ʻO kahi mea nui loa ka "hopena mua." Ke lawe ʻoe i ka pila mua o kahi alpha-blocker, hiki i kou koko ke hāʻule koke i lalo. Hiki i kēia ke hana i ka poniuniu , ka ʻike pohihihi, a me ka manaʻo o ka hāʻule ʻana ke kū ʻoe (orthostatic hypotension) . No ka hōʻemi ʻana i kēia pilikia, e haʻi pinepine kāu kauka iā ʻoe e lawe i ka lāʻau lapaʻau i ka wā hiamoe a hoʻomaka me kahi mahele haʻahaʻa.
Eia kekahi mau hopena ʻaoʻao maʻamau:
- ʻO ka poniuniu a i ʻole ka ʻike maka pohihihi (ʻoi aku hoʻi i ke kū ʻana)
- ʻEha poʻo
- Manaʻo luhi
- Paʻa ihu
- Ka wikiwiki o ka puʻuwai (tachycardia)
- Nā hopena i ka hana moekolohe: Hiki i kekahi mau kāne ke loaʻa i kahi kūlana i kapa ʻia ʻo anejaculation. He mea kākaʻikahi loa, hiki ke loaʻa kahi kūkulu ʻeha e mau ana ma mua o 4 mau hola (priapism). He kūlana kēia e pono ai ke kōkua lapaʻau koke.
Nā mea e hoʻomanaʻo ai i ka wā e lawe ai i kēia lāʻau lapaʻau
- Nā pilina me nā lāʻau lapaʻau ʻē aʻe: Hiki i nā Alpha-blockers ke launa pū me nā lāʻau lapaʻau koko ʻē aʻe, kekahi mau lāʻau lapaʻau erectile dysfunction, a me nā lāʻau lapaʻau ʻē aʻe. No laila, he mea nui e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
- Ka inu ʻona: Hiki i ka inu ʻana i ka waiʻona ke hoʻonui i nā hopena ʻaoʻao e like me ka poniuniu .
- ʻO ke ʻoki cataract: Inā ʻoe e hoʻolālā nei e hana i ke ʻoki cataract, pono ʻoe e hoʻomaopopo i kāu kauka maka e lawe ana ʻoe i nā alpha-blockers, no ka mea hiki i kēia mau lāʻau lapaʻau ke hoʻopilikia i ka wā o ke ʻoki.
- Ke hoʻōki ʻana i ka lāʻau lapaʻau: Mai hoʻōki koke i ka lawe ʻana i kēia lāʻau lapaʻau me ka ʻole o ke kūkākūkā ʻana me kāu kauka. ʻO ka hana ʻana pēlā e hiki ai ke hana i nā hopena ʻaoʻao koʻikoʻi, e like me ke koko kiʻekiʻe. Inā pono ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau, e hana pēlā ma ke ʻano palekana a e like me nā kuhikuhi a kāu kauka.
Āhea ʻoe e ʻimi ai i ke aʻo lapaʻau?
Inā he mau nīnau kāu e pili ana i ka lāʻau lapaʻau, a inā paha he paʻakikī nā hopena ʻaoʻao e hana i nā hana o kēlā me kēia lā, e kamaʻilio me kāu kauka.
Eia nō naʻe, inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e hele koke i ka Emergency Department (ETU) o ka haukapila:
- Ka nalowale o ka ʻike a i ʻole ka nawaliwali
- ʻEha umauma (`(Angina)`)
- Paʻakikī ka hanu ʻana
- Puʻuwai wikiwiki a ʻano ʻole paha (palpitations)
- ʻO ke kūkulu ʻeha ʻana e mau ana ma mua o 4 mau hola (`(Priapism)`)
- Nā hōʻailona o kahi hopena maʻi koʻikoʻi (e.g., ka ʻulaʻula, ka maneʻo, ka pehu ʻana o ka maka/ʻāʻī, ka paʻakikī i ka moni ʻana)
Leka Lawe-Home
- He papa koʻikoʻi nā lāʻau lapaʻau Alpha-blockers e mālama ai i nā kūlana e like me ke koko kiʻekiʻe a me ka benign prostatic hyperplasia (BPH).
- Hana kēia mau hana ma ka hoʻomaha ʻana i nā kīʻaha koko a me nā ʻiʻo o ka prostate gland.
- I ka hoʻomaka ʻana o ka lāʻau lapaʻau, ʻoiai ma hope o ka mahele mua ʻana, hiki ke ʻike ʻia ka dizziness , no laila e lawe i ka pō, e like me ke kuhikuhi a kāu kauka.
- E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei.
- Mai ho'ōki koke i ka lawe ʻana i kēia mau lāʻau me ka ʻole o ke aʻo ʻana a kāu kauka.
- Inā loaʻa iā ʻoe kekahi mau hopena ʻaoʻao koʻikoʻi, e ʻimi koke i ke kōkua lapaʻau.
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