Muyenera kuti munamvapo amayi athu, abambo, agogo athu, ndi agogo athu akunena kuti, "O, thupi langa lafooka tsopano," ndi "Mafupa anga ndi ofooka." Ndipotu, pamene tikukalamba, mphamvu za thupi lathu zimachepa, ndipo mphamvu za mafupa athu zimachepa pang'onopang'ono. Nthawi zina, pamene vutoli likukula kwambiri, ngakhale kugwa pang'ono kapena kudzuka pabedi kungayambitse chiopsezo chachikulu chothyoka mkono kapena mwendo. Vutoli lomwe mafupa amafooka ndi ofooka limatchedwa osteoporosis . Chifukwa chake, lero tikambirana za mankhwala ofunikira kwambiri omwe madokotala amagwiritsa ntchito poletsa kufooka kwa mafupa kwamtunduwu.
Mwachidule, kodi ma bisphosphonates awa ndi chiyani?
Ma bisphosphonates ndi gulu la mankhwala omwe amagwiritsidwa ntchito pochiza matenda monga osteoporosis omwe amachepetsa kukhuthala kwa mafupa ndi mphamvu. Izi zikutanthauza kuti palibe mankhwala amodzi omwe ali ndi dzinali, koma kuphatikiza kwa mankhwala angapo. Kuwonjezera pa osteoporosis, madokotala amaperekanso mankhwalawa kwa anthu ena omwe ali ndi calcium yambiri m'magazi (hypercalcemia).
Tiyeni tiwone mitundu ikuluikulu ya mankhwala omwe ali mgululi. Mankhwalawa amabwera m'njira ziwiri zazikulu. Limodzi ndi lakumwa (mapiritsi otengedwa pakamwa), ndipo lina ndi la mtsempha (IV) (madzi operekedwa mumtsempha).
| Momwe mungaperekere mankhwala | Zitsanzo za mankhwala (omwe amagwiritsidwa ntchito kwambiri ku Sri Lanka) |
|---|---|
| Ma Bisphosphonates Omwa | Alendronate, Risedronate, Ibandronate |
| Madzi olowa m'mitsempha (IV Bisphosphonates) | Zoledronic acid, Pamidronate |
Kodi mankhwalawa amakhudza bwanji thupi?
Kuti timvetse izi, choyamba tiyenera kumvetsetsa pang'ono za momwe mafupa athu amagwirira ntchito. Taganizirani za mafupa athu ngati nyumba yomwe ikukonzedwa nthawi zonse. Matupi athu amasweka mwachibadwa ndikuchotsa fupa lakale, lofooka. Njira imeneyi imatchedwa kusungunula mafupa.Nthawi yomweyo, fupa latsopano komanso lolimba limapangidwa m'malo omwe linachotsedwa. Malinga ngati njira ziwirizi zili bwino, mafupa athu amakhalabe olimba.
Komabe, pamene tikukalamba, makamaka akazi akasiya kusamba, mgwirizanowu umatha. Chomwe chimachitika n'chakuti fupa lakale limasweka mofulumira kwambiri kuposa momwe fupa latsopano limapangidwira. Zotsatira zake n'zakuti mafupa pang'onopang'ono amakhala opyapyala, okhala ndi mabowo ambiri, komanso ofooka.
Choncho, zomwe ma bisphosphonates amenewa amachita ndikuwongolera kwambiri ndikuchepetsa kuchuluka kwa kusungunuka kwa mafupa. Kenako, chifukwa fupa lakale limakhala lolimba pamene fupa latsopano likupangidwa, kuchulukana ndi mphamvu ya mafupa zimawonjezeka. Mwachidule, zimaletsa kutayika kwa mafupa.
Kodi ma bisphosphonates amagwiritsidwa ntchito pa matenda otani?
Madokotala makamaka amalimbikitsa mankhwalawa pazifukwa zotsatirazi:
- Matenda a mafupa ndi matenda omwe amapezeka mwa akazi akatha kusamba.
- Matenda a mafupa mwa amuna.
- Kupewa kufalikira kwa matenda a osteoporosis.
- Matenda a mafupa omwe amayamba chifukwa chogwiritsa ntchito mankhwala monga steroids (glucocorticoids).
- Matenda a Paget a mafupa ndi matenda omwe mafupa amakula modabwitsa.
- Kuletsa mavuto omwe amabwera chifukwa cha mitundu ina ya khansa (monga Multiple Myeloma) komanso pamene maselo a khansa afalikira ku mafupa (Bone Metastasis).
- Kuwongolera kuchuluka kwa calcium m'magazi komwe kumayambitsidwa ndi khansa (kuchuluka kwa calcium m'magazi chifukwa cha khansa).
Kodi ndiyenera kugwiritsa ntchito bwanji mankhwalawa? Izi ndizofunikira kwambiri!
Ndikofunikira kutsatira malangizo awa molondola kuti mupeze phindu lonse la mankhwalawo ndikuchepetsa zotsatirapo zake.
Mankhwala Omwa
Njira yomwa mapiritsi awa ndi yeniyeni kwambiri. Muyenera kutsatira malangizo a dokotala molondola.
- Piritsili liyenera kumwedwa m'mawa, musanadye kapena kumwa chilichonse (mulibe kanthu m'mimba) .
- Piritsi liyenera kumwedwa ndi galasi lodzaza la madzi (madzi wamba) . Ndikoletsedwa kumwa mankhwalawa ndi zinthu monga tiyi, khofi, mkaka, kapena zakumwa za zipatso.
- Chofunika kwambiri: Mukatha kumwa mankhwalawo, muyenera kukhala pansi kapena kuyimirira kwa mphindi zosachepera 30 mpaka 60. Musawerama, kugona pansi, kapena kugona pazifukwa zilizonse.
- Chifukwa cha izi ndi chakuti mankhwalawa amatha kuwononga mmero. Chiwopsezo chimenecho chimatha mukayimirira chifukwa mankhwalawa amalowa m'mimba mwachangu.
- Si bwino kudya kapena kumwa china chilichonse panthawiyi ya mphindi 30-60. Nthawi ikatha, mutha kudya chakudya cham'mawa monga mwachizolowezi.
Mankhwala a IV
Simungathe kuchita izi kunyumba. Chithandizochi chimaperekedwa kuchipatala kapena ku chipatala. Kutengera ndi momwe mulili, jakisoni (infusion) iyi nthawi zambiri imaperekedwa kamodzi pachaka kapena miyezi ingapo iliyonse.
Mukumwa mankhwalawa, dokotala wanu nthawi zambiri amalangiza kuti mudye zakudya zokhala ndi calcium yambiri (mkaka, yogati, tchizi, nsomba zazing'ono) ndikudya vitamini D yowonjezera , chifukwa zonsezi ndizofunikira kuti mafupa akhale olimba.
Kodi zotsatirapo zoyipa za bisphosphonates ndi ziti?
Monga mankhwala ena aliwonse, pakhoza kukhala zotsatirapo zina. Koma musadandaule, zambiri mwa izo ndi zazing'ono.
| Mtundu wa mankhwala | Zotsatirapo zomwe zingatheke |
|---|---|
| Mankhwala omwa | Mavuto a m'mimba monga kutentha pamtima, GERD, esophagitis, kupweteka m'mimba, ndi zilonda zam'mimba. (Izi zitha kupewedwa kwambiri potsatira njira yoyenera yogwiritsira ntchito mankhwala anu.) |
| Mankhwala operekedwa m'mitsempha (IV) | Zizindikiro zofanana ndi za chimfine kapena chimfine, monga kutentha thupi, kupweteka kwa thupi, mutu, ndi kupweteka kwa mafupa ndi minofu, zimatha kuchitika kwa tsiku limodzi kapena awiri mutamwa mankhwalawo. Izi nthawi zambiri zimatha pakatha masiku ochepa. |
Zotsatirapo zomwe sizipezeka kawirikawiri koma zoyenera kuzidziwa
Ngakhale izi sizichitika kawirikawiri , ndikofunikira kuzidziwa.
- Osteonecrosis ya nsagwada: Chiwopsezochi n'chochepa kwambiri, makamaka mukachita opaleshoni monga kuchotsa dzino. Choncho ngati mukumwa mankhwala awa, uzani dokotala wanu nthawi iliyonse mukapita kukaonana naye.
- Kusweka kwa femur kosazolowereka: Izi sizichitika kawirikawiri pakati pa anthu omwe akumwa mankhwalawa kwa nthawi yayitali (zaka zoposa 3-5).
- Mavuto a maso: Kutupa (uveitis, scleritis) m'mbali zosiyanasiyana za diso kungachitike.
Chofunika kwambiri ndichakuti chiopsezo chothyoka fupa chifukwa cha matenda a osteoporosis ngati simutenga mankhwalawa ndi chachikulu kuwirikiza ka 1,000 kuposa chiopsezo chochepa cha zotsatirapozi. Chifukwa chake, ndikofunikira kwambiri kutsatira malangizo a dokotala wanu.
Kodi mukufuna kukaonananso ndi dokotala liti?
Ngati mukumwa mankhwalawa, ndikofunikira kuonana ndi dokotala nthawi ndi nthawi kuti muwone ngati mankhwalawa akugwira ntchito komanso ngati pali zotsatirapo zina. Muthanso kutumizidwa kwa katswiri wa mafupa (Endocrinologist kapena Rheumatologist).
Dokotala wanu angakulangizeninso kuti mupange DXA scan kuti muwone ngati mafupa anu ndi olimba.
Chidziwitso Chapadera: Ngati mwakhala mukugwiritsa ntchito mankhwalawa kwa zaka zoposa zitatu ndipo mukumva kupweteka kwatsopano mu ntchafu kapena m'mimba mwanu, musanyalanyaze ndipo dziwitsani dokotala wanu nthawi yomweyo.
Uthenga Wopita Nawo Kunyumba
- Ma bisphosphonates ndi mankhwala othandiza kwambiri omwe amathandiza kulimbitsa mafupa ofooka chifukwa cha osteoporosis.
- Mankhwalawa amagwira ntchito pochepetsa kuchuluka kwa mafupa omwe amataya mafupa.
- Mukamamwa mankhwala omwa, ndikofunikira kumwa pamimba yopanda kanthu, ndi madzi okha, ndikukhalabe chilili kapena kukhala pansi kwa mphindi 30-60 mutamwa mankhwalawo.
- Ngakhale kuti zotsatirapo zazing'ono zingachitike, zotsatirapo zoyipa kwambiri sizimachitika kawirikawiri. Ubwino wa mankhwalawa umaposa zoopsa zake.
- Ngati muli ndi mafunso, nkhawa, kapena kukayikira za mankhwalawa, lankhulani ndi dokotala wanu za izi momasuka. Musasiye kumwa mankhwala anu popanda upangiri wa dokotala.
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