Ua ʻike paha ʻoe i kekahi o kou ʻohana, ʻo kou makuakāne a ʻanakala paha, e lawe ana i ka lāʻau lapaʻau no ka maʻi puʻuwai, ke koko kiʻekiʻe, a i ʻole ka erectile dysfunction. Pēlā nō, kuhikuhi nā kauka i nā lāʻau lapaʻau like ʻole no nā maʻi ʻili, nā maʻi hanu e like me ka hānō, a pēlā aku. Ua ʻike anei ʻoe aia kekahi papa lāʻau lapaʻau koʻikoʻi e hoʻohana ʻia e mālama i nā ʻano maʻi he nui? ʻO kēlā papa lāʻau lapaʻau, ʻo ia hoʻi ʻo Phosphodiesterase Inhibitors, ʻo ia ka mea a mākou e kamaʻilio ai ma kēia ʻatikala i kēia lā, me ka maʻalahi a me ke akahai.
I ka ʻōlelo maʻalahi, he aha kēia mau mea hoʻopale Phosphodiesterase?
He inoa paʻakikī paha kēia, akā he mea maʻalahi loa ia. He papa lāʻau lapaʻau kēia e kōkua ai i ka hoʻomaha a me ka hoʻonui ʻana i nā kīʻaha koko i loko o ko kākou kino, e maʻalahi ai ke kaʻapuni. Ke hoʻomaikaʻi ʻia ke kahe koko, e kāohi ʻia ke koko. ʻO ia ke kumu e hoʻohana ʻia ai kēia mau lāʻau lapaʻau e mālama i nā ʻano maʻi like ʻole, mai ka ʻili, nā hono, ka puʻuwai, a me nā pilikia o ka māmā a hiki i ka hana pono ʻole o ka moekolohe.
Pehea e hana ai kēia lāʻau lapaʻau i loko o ke kino?
Aia i loko o ko kākou kino kahi ʻano enzyme i kapa ʻia ʻo Phosphodiesterases (PDEs) . I ka ʻōlelo maʻalahi, ua like nā enzymes me nā mea kōkua liʻiliʻi e hoʻolalelale i nā kaʻina hana kemika i loko o ko kākou kino. Nui nā ʻano o kēia mau enzymes PDE. Ua helu ʻia a hoʻokaʻawale ʻia lākou. ʻO ka mea kūikawā, ʻo ia ka loaʻa ʻana o kēlā me kēia ʻano enzyme PDE ma nā wahi kikoʻī o ke kino.
| ʻAno enzyme PDE | Loaʻa pinepine a hana pono |
|---|---|
| PDE-3 | Loaʻa kēia mau mea i loko o kou puʻuwai a me ka ʻōnaehana kahe koko . Pili pū lākou i ke kāpili ʻana o ke koko. |
| PDE-4 | Loaʻa kēia mau mea i loko o nā māmā . Hoʻopaʻa lākou a ʻūmiʻi nā ʻiʻo i loko o nā ala ea. |
| PDE-5 | Loaʻa kēia mau mea i loko o nā māmā a me ka penis o nā kāne. |
Hana nā mea hoʻopaʻa phosphodiesterase (PDE Inhibitors) ma ke ālai ʻana i ka hana o nā enzyme PDE i ʻōlelo ʻia ma luna. Ua like ia me ka pani ʻana i ka puka. Hoʻolālā kekahi mau mea hoʻopaʻa phosphodiesterase i hoʻokahi ʻano enzyme (koho), aʻo nā mea ʻē aʻe e hoʻopilikia i nā enzyme PDE ma ke ʻano laulā (nonselective).
He aha nā kūlana nui i mālama ʻia me kēia lāʻau lapaʻau?
Ua ʻae ʻia kēia mau lāʻau lapaʻau e mālama i nā ʻano maʻi like ʻole he ʻumikūmālua. E nānā kākou i kekahi o nā ʻano nui.
Nā maʻi o ka puʻuwai a me ke kahe koko
- ʻO ka hāʻule ʻana o ka puʻuwai decompensated: Ke nāwaliwali ka puʻuwai a hiki ʻole ke pamu i ke koko i ke kino e like me ka mea e pono ai.
- Ke koko kiʻekiʻe o ka pulmonary: Ke koko kiʻekiʻe i loko o nā kīʻaha koko i loko o nā māmā.
- Ka emi ʻana o ke kahe koko i nā lālā (Peripheral artery disease - PAD): ʻAʻole lawa ka lako koko, ʻoi aku hoʻi i nā wāwae.
- Ke pale ʻana i nā ʻōpū koko ma hope o ke ʻoki ʻana: Hiki i nā ʻōpū koko ma hope o ke ʻoki ʻana ke alakaʻi i nā kūlana weliweli e like me ka hahau ʻana, ka hōʻeha puʻuwai, a me ka embolism pulmonary. E pale iā lākou.
- Thrombocythemia: Ka hana nui ʻana o nā platelets, e kōkua ana i ke kāpili ʻana o ke koko.
Nā maʻi mumū o ka ʻili a me nā hono
- ʻEczema (Atopic dermatitis): Ka mumū, ka ʻulaʻula ʻāʻī o ka ʻili.
- Psoriasis: He maʻi mumū o ka ʻili i hoʻokumu ʻia e kahi ʻōnaehana pale kino overactive.
- ʻO ka ʻāʻī psoriatic: ʻO ka mumū o nā hono e kū mai ana me ka psoriasis.
Nā maʻi e pili ana i ka ʻōnaehana hānau kāne
- ʻO ka hyperplasia prostatic benign: Ka pehu ʻana o ka ʻōpū prostate ma muli o nā kumu ʻaʻole he maʻi kanesa.
- Ka hana ʻino ʻana o ke kūkulu ʻana: Paʻakikī i ka loaʻa ʻana o kahi kūkulu.
Nā maʻi o ka ʻōnaehana hanu
- ʻO ka maʻi pulmonary obstructive mau loa (COPD): He hui o nā maʻi e pilikia ai ka hanu ʻana.
- Apnea neonatal: Nā pilikia hanu e kū mai ana i nā pēpē hānau mua , ʻoiai nā mea i hānau ʻia ma mua o 7 pule.
He aha nā pono o kēia lāʻau lapaʻau?
Nui nā pono o ka hoʻohana ʻana i kēia mau lāʻau lapaʻau.
- Nā ʻano kūpono: Loaʻa kēia ma ke ʻano o nā pila waha, nā kirīmi topical, a me nā inikini IV. Pono e lawe ʻia kekahi mau lāʻau lapaʻau i kēlā me kēia lā, aʻo nā mea ʻē aʻe e hiki ke lawe ʻia i ka wā e pono ai.
- Hoʻōla i kuhikuhi ʻia:E like me kā mākou i kūkākūkā ai ma mua, ʻoiai hiki ke kuhikuhi ʻia ka lāʻau lapaʻau i kahi ʻano kikoʻī o ka enzyme PDE, hiki ke hoʻemi nui ʻia nā hopena ʻaoʻao i makemake ʻole ʻia.
- ʻElua mau pono o hoʻokahi lāʻau lapaʻau: I kekahi manawa hiki ke mālama ʻia nā maʻi ʻelua e kū pū ana me hoʻokahi lāʻau lapaʻau. No ka laʻana, hiki ke hāʻawi ʻia i kahi kanaka me ka prostate i hoʻonui ʻia a me ka erectile dysfunction ka PDE-5 inhibitor tadalafil . Pēlā nō, hoʻohana ʻia ʻo Apremilast e mālama i ka psoriasis a me ka psoriatic arthritis.
E makaʻala hoʻi kākou i nā hopena ʻaoʻao a me nā pilikia.
E like me nā lāʻau lapaʻau āpau, hiki i kēia ke hana i nā hopena ʻaoʻao. Pili nui kēia mau hopena ʻaoʻao i ke ʻano o ka mea hoʻopaʻa PDE āu e lawe nei.
He mea nui loa: Inā ʻoe e lawe i kahi mea hoʻopaʻa PDE-5 (e.g. Sildenafil, Tadalafil) a loaʻa ka ʻeha o ka umauma i loko o 24 mau hola, a lawe i kahi papa nitroglycerin sublingual, e hele koke i ka lumi pilikia o ka haukapila (ETU). ʻO ka hui pū ʻana o kēia mau lāʻau lapaʻau ʻelua hiki ke hoʻoulu i ke koko haʻahaʻa weliweli.
Aia ma lalo iho kekahi mau hopena ʻaoʻao e pili ana i nā ʻano nui o nā lāʻau lapaʻau.
| Māhele lāʻau lapaʻau | Nā hopena ʻaoʻao liʻiliʻi a me ke kaulike | Nā hopena ʻaoʻao koʻikoʻi/pōʻino |
|---|---|---|
| Nā mea pale PDE-3 (Hāʻawi ʻia i ka puʻuwai) | ʻEha ke poʻo, nāwaliwali, pehu, ʻeha ka ʻōpū (nausea, luaʻi), kahe koko. | Nā ʻano hewa o ka puʻuwai (arrhythmia), ʻeha umauma, kahe koko kūpono ʻole, nā platelets koko haʻahaʻa. |
| Nā mea pale PDE-4 (Hāʻawi ʻia no nā maʻi hanu/ʻili) | ʻO ka pohō kaumaha, ka nausea, ka maʻi pākī, ka ʻeha poʻo, ka hiamoe ʻole, ka mumū ma kahi i hoʻopili ʻia ai ka kirīmi. | Hoʻonui ʻia ke kaumaha, nā manaʻo pepehi kanaka, nā hopena hypersensitivity (ʻili nui, pehu). |
| Nā mea pale PDE-5 (Hāʻawi ʻia no ka nāwaliwali o ka moekolohe) | ʻEha poʻo, ʻulaʻula, ʻeha o ka ʻōpū, ihu paʻa, ʻeha ʻiʻo, poniuniu. | Priapism: He kūkulu ʻeha e mau ana ma mua o 4 mau hola me ka ʻole o ka hoʻoulu ʻana i ka moekolohe. E hele koke i ka ETU. Nā loli i ka ʻike, ka emi ʻana o ka lohe a nalowale paha. |
| Nā mea pale PDE koho ʻole (e.g. Caffeine, Theophylline) | Hoʻomaha ʻole, hiamoe ʻole, haʻalulu, ʻeha ʻōpū, ʻeha poʻo. | Puʻuwai wikiwiki, puʻuwai kūpono ʻole, nā ʻūlū. |
I ka manawa hea ʻoe e pono ʻole ai e lawe i kēia lāʻau lapaʻau?
He mea weliweli paha kēia lāʻau lapaʻau no kekahi poʻe. Inā loaʻa iā ʻoe kekahi o kēia mau maʻi, pono ʻoe e kamaʻilio me kāu kauka ma mua o ka lawe ʻana i kēia lāʻau lapaʻau.
- No kekahi mea hoʻopaʻa PDE: Inā ua loaʻa mua iā ʻoe kahi hopena alerika koʻikoʻi (hypersensitivity) i kekahi lāʻau lapaʻau a mea paha.
- Cilostazol (PDE-3): ʻAʻole kēia e ʻōlelo ʻia inā loaʻa iā ʻoe kekahi ʻano o ka hāʻule ʻana o ka puʻuwai.
- Nā mea pale PDE-5: Pono ʻoe e pale i ka lawe ʻana i kēia mau mea inā loaʻa iā ʻoe ka maʻi puʻuwai koʻikoʻi, ua loaʻa koke iā ʻoe ka hōʻeha puʻuwai a i ʻole ka hahau ʻana, a i ʻole he angina paʻa ʻole.
- Inā ʻoe e lawe ana i nā nitrates , hiki i ka lawe ʻana i nā mea hoʻopaʻa PDE-5 ke hoʻohaʻahaʻa loa i kou koko.
- ʻAʻole kūpono kekahi mau mea hoʻopaʻa PDE (e like me Cilostazol) inā he maʻi kahe koko kou.
E hoʻohana i ka wā hāpai
Inā hāpai ʻoe a i ʻole e hoʻolālā ana e hāpai, he mea naʻauao paha ke pale aku i ka lawe ʻana i kekahi mau ʻano mea hoʻopaʻa PDE. E kūkākūkā me kāu kauka e pili ana i kēia.
Āhea ʻoe e ʻike koke ai i ke kauka?
He mea maikaʻi ke haʻi aku i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē i ka wā e hoʻohana ana i kēia lāʻau lapaʻau. Eia nō naʻe, inā loaʻa kekahi o kēia mau mea, e hele koke i ka ʻOihana Hoʻopilikia (ETU) o ka haukapila.
- Nā hōʻailona o ka hōʻeha puʻuwai:Nā mea e like me ka ʻeha o ka umauma, ka ʻūmiʻi, ka paʻakikī o ka hanu ʻana, ka hou ʻana, ka poniuniu, ka luaʻi.
- Priapism: He kūkulu ʻeha e mau ana no nā hola he 4 me ka ʻole o ka hoʻoulu ʻana i ka moekolohe. He kūlana kēia e pono ai ka mālama koke ʻia.
- Ka nalowale/emi koke ʻana o ka ʻike a i ʻole ka lohe: Pono e mālama ʻia kēia mau mea ma mua o ka hiki ʻana mai o ka hōʻino mau loa.
He mea nui loa kēia mau lāʻau lapaʻau, ʻo ia hoʻi ka hoʻōla ola a me ka hoʻomaikaʻi ʻana i ke ʻano o ke ola. Akā, pono e lawe ʻia ma ke ʻōlelo aʻoaʻo a ke kauka a ma ka nui i kuhikuhi ʻia.
Leka Lawe-Home
- He papa lāʻau ikaika nā mea hoʻopaʻa phosphodiesterase e mālama ai i nā ʻano maʻi like ʻole, me ka maʻi puʻuwai, ka hana moekolohe, nā maʻi ʻili, a me nā maʻi hanu.
- E lawe mau i kēia mau lāʻau lapaʻau ma ke ʻōlelo aʻoaʻo a ke kauka . E pale i ke noi ʻana i nā hoaaloha a i ʻole ke noi ʻana i kahi hale kūʻai lāʻau lapaʻau no lākou a hoʻohana iā lākou ma kāu iho.
- E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei a me nā maʻi ʻē aʻe āu e loaʻa nei.
- Inā loaʻa iā ʻoe nā hopena ʻino e like me ka ʻeha o ka umauma, ka priapism e mau ana ma mua o 4 mau hola, a i ʻole ka nalowale koke o ka ʻike a i ʻole ka lohe, e hele koke i ka Emergency Department (ETU) o ka haukapila.
- Mai kaʻana like i kāu lāʻau lapaʻau me kekahi. ʻO kahi lāʻau lapaʻau kūpono no kekahi kanaka he mea weliweli loa ia no kekahi.
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