Ua haʻi aku anei kāu kauka iā ʻoe ua nāwaliwali iki kou mau iwi, ʻo ia hoʻi, he osteoporosis kou, kahi maʻi lahilahi o ka iwi? Ua haʻi aku paha ʻo ia iā ʻoe e hoʻomaka e lawe i kahi lāʻau i kapa ʻia he bisphosphonate. Ke lohe ʻoe i kēia inoa, makaʻu iki paha ʻoe, me ka noʻonoʻo ʻana, "He aha kēia lāʻau? He aha kāna hana?" Mai makaʻu. I kēia lā, e kamaʻilio mākou e pili ana i kēia ʻano lāʻau e hiki ke kōkua i ka hoʻoikaika ʻana i kou mau iwi ma ke ʻano maʻalahi loa , ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha kēia mau bisphosphonates?
ʻO nā Bisphosphonates kahi papa nui o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i ka osteoporosis. E noʻonoʻo e nāwaliwali mālie kou mau iwi i ka hala ʻana o ka manawa, e like me kahi ʻāpana lāʻau i ʻai ʻia e nā pepeke. A laila, ʻoiai he hāʻule liʻiliʻi e hoʻonui i ka pilikia o ka haki ʻana o kou mau iwi. ʻO ka Osteoporosis kēlā ʻano. No laila, hoʻōki nā bisphosphonates i kou mau iwi mai ka nāwaliwali hou ʻana, e hoʻoikaika ai iā lākou, a e hōʻemi ana i ka pilikia o ka haki ʻana.
Ua kuhikuhi nā kauka i kēia lāʻau lapaʻau ʻaʻole wale no ka osteoporosis, akā no kekahi mau maʻi ʻē aʻe e hoʻopilikia ai i ka nui o ka iwi, a i kekahi mau hihia o nā pae calcium koko kiʻekiʻe loa (hypercalcemia).
Loaʻa anei kēia mau lāʻau lapaʻau? E nānā kākou.
ʻAe, ʻelua mau ʻano nui o nā bisphosphonates.
1. Nā bisphosphonates waha
2. Nā inikini i loko o kahi aa (IV bisphosphonates)
E nānā ke kauka i kou kūlana a hoʻoholo i ke ʻano kūpono loa iā ʻoe.
| ʻAno lāʻau lapaʻau | Nā lāʻau lapaʻau i hoʻohana pinepine ʻia (me nā inoa lama) |
|---|---|
| Nā papa waha |
|
| Nā inikini intravenous (IV) |
|
He aha nā kūlana e hoʻohana ʻia ai nā bisphosphonates?
Ua ʻae nui ʻia kēia lāʻau lapaʻau e mālama i nā kūlana i lalo:
- ʻO ka osteoporosis i nā wahine postmenopausal.
- ʻO ka osteoporosis i nā kāne.
- I mea e pale ai i ka lahilahi o ka iwi.
- ʻO ka osteoporosis i hoʻokumu ʻia e Glucocorticoid ke kumu o ka hoʻohana lōʻihi ʻana i kekahi mau lāʻau steroid.
- Hoʻonui kekahi mau maʻi kanesa i nā pae calcium i loko o ke koko (hypercalcemia pili i ka maʻi kanesa).
- ʻO ka maʻi o Paget o ka iwi kahi maʻi e hoʻopilikia ai i nā iwi.
- ʻO kahi maʻi kanesa i kapa ʻia ʻo multiple myeloma.
- No nā hihia kahi i laha ai ke kanesa i hoʻomaka ma kahi ʻē (metastasized) i nā iwi.
I kekahi manawa, hoʻohana nā kauka i kēia lāʻau lapaʻau no nā kūlana ʻē aʻe ma mua o nā mea i ʻae ʻia. No ka laʻana, hāʻawi ʻia i kekahi manawa i nā keiki a me nā pākeke me kahi kūlana genetic i kapa ʻia ʻo osteogenesis imperfecta .
Pehea e hana ai kēia lāʻau lapaʻau i loko o ke kino?
I mea e hoʻomaopopo ai i kēia, pono mua kākou e ʻike iki e pili ana i ko kākou mau iwi. ʻAʻole noho wale ko kākou mau iwi ma kahi hoʻokahi. Ke hoʻololi mau ʻia nei lākou. E like me ka pā kahi e wehe ʻia ai nā piliki kahiko a kūkulu ʻia ai nā mea hou. Hoʻopau maoli ke kino a wehe i ka iwi kahiko. Kāhea mākou i kēia he resorption iwi. A laila hoʻokumu ʻia ka iwi hou ma ia mau wahi.
I ko kākou ʻelemakule ʻana, ʻoiai hoʻi i nā wāhine ma hope o ka menopause, lilo kēia kaʻina hana i mea kaulike ʻole. ʻO ia hoʻi, hoʻomaka ka iwi kahiko e haki a wehe ʻia i ka wikiwiki ma mua o ka hoʻokumu ʻia ʻana o ka iwi hou. ʻO ia ka manawa e nāwaliwali mālie ai nā iwi a emi ka mānoanoa, e alakaʻi ana i ka osteoporosis.
Hana nā Bisphosphonates ma ka hoʻolohi ʻana i ka wikiwiki o ka wāwahi ʻia a me ka wehe ʻia ʻana o ka iwi kahiko. I nā huaʻōlelo ʻē aʻe, "wehe lākou i nā piliki kahiko." Hāʻawi kēia i ka manawa hou aʻe no ka hoʻokumu ʻia ʻana o ka iwi hou, kahi e hoʻonui ai i ka nui o nā iwi a hoʻoikaika iā lākou.
Pehea e hoʻohana ai i kēia lāʻau lapaʻau? He mea nui loa kēia!
ʻOkoʻa ke ʻano o ka hoʻohana ʻana ma muli o ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai.
Inā lawe ʻia nā pila ma ka waha ...
ʻO kēia ka ʻāpana e pono ai ʻoe e makaʻala loa . E haʻi aku ke kauka iā ʻoe e lawe i kēia mau pila i hoʻokahi manawa i ka lā, hoʻokahi manawa i ka pule, a i ʻole hoʻokahi manawa i ka mahina. Eia nō naʻe, pono ʻoe e lawe i kēia mau pila.Aia kekahi ʻano hana kūikawā .
- Pono ʻoe e lawe i kēia pila i kou ala ʻana i ke kakahiaka, ma mua o ka ʻai ʻana a inu ʻana paha i kekahi mea ʻē aʻe .
- Pono e lawe wale ʻia ka pila me ke aniani piha o ka wai maʻemaʻe . Kapu loa ka lawe ʻana i kēia pila me ke kī, ke kofe, ka waiū, a i ʻole nā mea inu hua.
- Ma hope o ka lawe ʻana i ka pila, ʻaʻole pono ʻoe e moe i lalo a moe paha no 30 mau minuke (hiki i 60 mau minuke). Pono ʻoe e noho a kū pololei paha.
- Eia kekahi, ʻaʻole hiki iā ʻoe ke lawe i kekahi meaʻai, mea inu, a lāʻau lapaʻau ʻē aʻe i loko o kēia manawa 30-60 mau minuke.
He mea nui e hahai pono i kēia mau lula. A i ʻole, ʻaʻole paha e komo pono ka lāʻau lapaʻau e ke kino a hiki ke hoʻoulu i nā maʻi ʻaleka ma ka puʻu a me ka ʻōpū. E wehewehe pono kāu kauka i kēia iā ʻoe.
Inā he injection intravenous ia...
Hāʻawi pinepine ʻia kēia iā ʻoe ma kahi haukapila a i ʻole ke keʻena lapaʻau. ʻO ka hapa nui, hāʻawi ʻia kēia lāʻau pale i hoʻokahi manawa i ka makahiki . Eia nō naʻe, ma muli o ke kūlana, hiki ke hāʻawi pinepine ʻia.
Makemake ʻoe e hana i nā mea ʻē aʻe me ka lāʻau lapaʻau?
ʻAe. ʻOiai e lawe ana i kēia lāʻau lapaʻau, e ʻōlelo pinepine kāu kauka i kēia mau mea:
- E ʻai i nā meaʻai waiwai i ka calcium (e.g. waiū, yogurt, tīhi, iʻa liʻiliʻi, nā mea kanu ʻōmaʻomaʻo)
- Inā nele ʻoe i ka wikamina D, e lawe i kahi mea hoʻopihapiha wikamina D.
- Inā ʻaʻole lawa ka calcium mai ka meaʻai, e lawe i nā pila calcium .
Pehea ka lōʻihi e pono ai iaʻu ke lawe i kēia lāʻau lapaʻau?
Aia kēia i kou kūlana a me ke ʻano o ka pane ʻana o kou kino i ka lāʻau lapaʻau. ʻO ka maʻamau, kaupalena nā kauka i ka lōʻihi o nā papa waha i kahi o 5 mau makahiki a ʻo ka inikini zoledronic acid intravenous i kahi o 3 mau makahiki . ʻO kēia ke pale aku iā ʻoe mai nā hopena ʻaoʻao kakaikahi loa e hiki ke loaʻa me ka hoʻohana lōʻihi ʻana o kēia mau lāʻau lapaʻau. Eia nō naʻe, pono paha kekahi poʻe e mālama ʻia no ka manawa lōʻihi. ʻO kāu kauka ke kanaka maikaʻi loa e hoʻoholo.
E aʻo pū kākou e pili ana i nā hopena ʻaoʻao.
E like me nā lāʻau lapaʻau āpau, hiki i nā bisphosphonates ke hana i nā hopena ʻaoʻao, akā ʻaʻole i loaʻa i nā mea āpau.
| ʻAno lāʻau lapaʻau | Nā hopena ʻaoʻao maʻamau e hiki ke loaʻa |
|---|---|
| Nā papa waha | Nā pilikia o ka ʻōnaehana hoʻoheheʻe. Eia kekahi laʻana: GERD, nā ʻeha ma ka puʻu a me ka ʻōpū, gastritis. (ʻO ia ke kumu e ʻōlelo ʻia ai e kū pololei ma hope o ka lawe ʻana i ka pila!) |
| Nā inikini intravenous | ʻO nā hōʻailona o ke anu a i ʻole ka maʻi palū, e like me ke kuni, nā ʻeha kino, a me ka ʻeha o ka iwi a me nā ʻiʻo, hiki ke ʻike ʻia i loko o 1-3 mau lā ma hope o ka lāʻau pale. ʻO ka maʻamau, hiki ke hoʻomalu ʻia kēia mau mea me kahi lāʻau lapaʻau e like me ka paracetamol. |
| Nā hopena ʻaoʻao kakaikahi loa akā hiki ke koʻikoʻi (no ka waha a me ka IV) | |
| |
Mai hopohopo i kēia mau hopena ʻaoʻao kakaikahi. ʻOi aku ka maikaʻi o nā pono o ka lawe ʻana i kēia lāʻau lapaʻau ma mua o ka pilikia o ka haki ʻana o kahi iwi nui e like me ka ʻūhā ma muli o ka osteoporosis.
He pono maoli anei kēia lāʻau lapaʻau?
ʻAe, ʻoiaʻiʻo nō. Ua hōʻike ʻia nā noiʻi e hoʻonui kēia mau lāʻau lapaʻau i ka nui o ka iwi a hōʻemi nui i ka pilikia o nā haki.
- Alendronate: Hoʻemi i nā haki o ke kuamoʻo ma kahi o 50% a me nā haki ʻūhā a me nā ʻūhā ʻē aʻe ma kahi o 30%.
- Risedronate: Hoʻemi i nā haki iwi kuamoʻo a me nā haki ʻē aʻe ma kahi o 40%.
- ʻO ka waikawa Zoledronic: Hoʻemi i nā haki o ke kuamoʻo ma kahi o 70% a me nā haki ʻūhā a me nā haki ʻē aʻe ma kahi o 35%.
Āhea wau e ʻike ai i ke kauka?
Inā ʻoe e lawe i kēia lāʻau lapaʻau, e hana e like me ka ʻōlelo a ke kauka.He mea nui loa ka hele ʻana i nā keʻena lapaʻau i ka manawa kūpono. E kōkua kēia iā mākou e ʻike inā e hana ana ka lāʻau lapaʻau a inā he mau hopena ʻaoʻao. Hiki i kāu kauka ke ʻōlelo aku i kahi scan DXA, kahi e ana ai i kou nui o ka iwi.
E hoʻomanaʻo pono:
Inā ʻoe e lawe ana i nā bisphosphonates no nā makahiki ʻekolu a ʻoi a loaʻa iā ʻoe ka ʻeha hou ma kou ʻūhā a i ʻole ka ʻūhā , mai hoʻowahāwahā iā ia. E haʻi koke aku i kāu kauka.
He lāʻau lapaʻau koʻikoʻi loa kēia e hiki ke hoʻomaikaʻi i kou ola maikaʻi a pale iā ʻoe mai nā pilikia koʻikoʻi e hiki mai ana mai ka iwi haʻihaʻi. Inā he mau nīnau a hopohopo paha kāu e pili ana i kēia, e kamaʻilio ākea me kāu kauka.
Leka Lawe-Home
- ʻO nā Bisphosphonates kahi hui o nā lāʻau lapaʻau e pale ai i ka osteoporosis a hoʻoikaika i nā iwi.
- Inā ʻoe e lawe ana i nā lāʻau waha, e hahai pono i nā ʻōlelo a ke kauka (ma ka ʻōpū ʻole i ke kakahiaka, me ka wai wale nō, a e noho pololei i luna ma hope o ka lawe ʻana iā lākou).
- He mea nui e loaʻa ka lawa ʻana o ka calcium a me ka wikamina D i ka wā e lawe ana i kēia lāʻau.
- ʻOiai hiki ke loaʻa nā hopena ʻaoʻao, ʻaʻole ʻike ka hapa nui o ka poʻe iā lākou. ʻOi aku ka maikaʻi o nā pono o ka lawe ʻana i kēia lāʻau lapaʻau ma mua o nā pilikia o ka haki ʻana o ka iwi.
- Inā he mau hopohopo a hopohopo paha kāu e pili ana i ka lāʻau lapaʻau, mai kānalua e kūkākūkā me kāu kauka.
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