Dumbu rakagumbuka here? Haugone kugaya chikafu here? Ngatitaurei nezve (Prokinetic Agents)!

Dzimwe nguva unonzwa wakaguta here kana kuti haugayi chikafu zvakanaka mushure mekudya? Kana kuti une matambudziko akadai sechirungurira kana kusagadzikana kwekugaya chikafu? Dzimwe nguva matambudziko aya anogona kukonzerwa nekutadza kushanda zvakanaka kweura hwedu. Nhasi tichataura nezvemhando yemushonga unobatsira panguva dzakadaro. Izvi zvinonzi `(Prokinetic Agents)`.

Ndezvipi izvi `(Prokinetic Agents)`? Zvichitaurwa zviri nyore...

Zvichitaurwa zviri nyore, `(Prokinetic Agents)` rudzi rwemushonga unowedzera kumhanya kwechikafu chinofamba nemudumbu mako, ndiko kuti, muura. Patinomedza chikafu, tsandanyama dziri mudumbu redu dzinotanga kukotama kubva kumusoro kusvika pasi semafungu akatevedzana. Izvi zvinonzi `(Peristalsis)`. Zvakafanana nekusundira chikafu pasi. Aya ndiwo mafambiro anoita chikafu kubva pahuro, pasi pegurokuro, mudumbu, uye wobva wapinda mudumbu. Panguva iyi ndipo apo muviri wedu unotora zvinovaka muviri zvaunoda.

Zvisinei, nekuda kwezvimwe zvirwere kana zvimwe zvikonzero, maitiro aya anonzi "peristalsis" angasashanda zvakanaka. Apa ndipo panoitika zviratidzo zvakaita sekuvimbiwa, chirungurira, uye kunzwa kuguta pasina kugaya chikafu. Chikafu chinogona kugara mudumbu kwenguva yakareba, uye muviri hauzowani chikafu chinodiwa.

Ndipo panouya mishonga iyi inonzi `(Prokinetic Agents)` kuzobatsira. Iyi inowedzera kufamba kweura uye inobatsira chikafu kupfuura nemudumbu nekukurumidza. Asi chinhu chakakosha kurangarira ndechekuti pane zvimwe zvinokonzera zvinogona kuuya nemishonga iyi. Saka, vanachiremba havawanzopa mishonga iyi ipapo ipapo. Kazhinji, `(Proton Pump Inhibitors - PPIs)` kana `(H2 Blockers)` vanopihwa mimwe mishonga uye `(Prokinetic Agents)` inongotariswa chete kana isingape zororo. Zvisinei, zvichienderana nemamiriro ako ehutano, chiremba wako anogonawo kupa mushonga uyu.

Aya `(Prokinetic Agents)` anoshanda sei?

Mashandiro anoita mishonga iyi akaoma zvishoma, asi ndichaiita zviri nyore. Inosimudzira tsinga dziri mudumbu mako uye inobatsira tsandanyama kugwinha.

Izvi zvinoreva:

• Zvinowedzera marwadzo mugurokuro (chikafu chinobuda), zvichibatsira kufambisa chikafu nekukurumidza mudumbu.
• Simbisa Lower Esophageal Sphincter (LES) pasi pegurokuro rako. LES yakaita sevharuvhu. Ndiyo chikamu chegurokuro rako chinobatanidza dumbu rako negurokuro rako. Kana rikasavhara zvakanaka uye rikasununguka, acid yemudumbu inogona kudzoka mugurokuro rako nepahuro. Ndipo paunonzwa chirungurira, chirungurira, uye kurwadziwa pachipfuva. Izvi zvinonziwo Acid Reflux kana GERD.
• Inowedzera kurwadziwa kwemudumbu uye inobatsira kufambisa chikafu nekukurumidza muura hudiki.
• Zvinoderedza nguva inotorwa kuti mudumbu mubude ropa. Izvi zvinoderedza mukana wekuti zviri mudumbu zvidzokere kumusoro, sezvakaita `(Acid Reflux)`.

Fungidzira, mushonga uyu unoshanda semuchina wemotokari, uye mapurisa anouya ovhura nzira yekuti mota dzifambe nekukurumidza.

`(Prokinetic Agents)` inoshandiswa mumamiriro api ezvinhu?

Mishonga iyi inonyanya kushandiswa kune zvinotevera:

• Gastroparesis (kusashanda zvakanaka kwetsandanyama dzemudumbu/kunonoka kugaya): Mumamiriro ezvinhu aya, tsandanyama dzemudumbu hadzina kusimba zvakanaka, saka kugaya chikafu kunononoka. Mishonga yeprokinetic inowedzera kusimba uku uye inoita kuti mudumbu mubude mvura nekukurumidza. Vanhu vane chirwere cheshuga vanogonawo kuva nechirwere ichi chinonzi Diabetic Gastroparesis. Metoclopramide ndiyo yega mushonga unotenderwa neFDA muUnited States pari zvino. Chiremba wako anogona kunyora izvi kana mamwe marapirwo asingabatsire.

• GERD (Gastroesophageal Reflux Disease): Apa ndipo apo acid yemudumbu inodzokera mugurokuro ichipinda mumuromo. Izvi zvinoitika kana LES (Lessive Esophageal Suppression System) yandambotaura nezvayo isingavharike zvakanaka. Mishonga yeprokinetic chete haibatsire GERD. Zvisinei, kana dumbu rako rinonoka kubuda, chiremba wako anogona kunyora izvi pamwe chete nemimwe mishonga.

• Dyspepsia Inoshanda: Apa ndipo paunogara uchinetseka mudumbu mushure mekudya, asi hapana chikonzero chakajeka chingawanikwa. Vamwe vanhu vanogona kuona kuti mishonga iyi inogona kubatsira kuderedza zviratidzo. Vaongorori vanoti mishonga iyi inobatsira nekuwedzera marwadzo emudumbu uye kukurumidzisa kubuda kwechinhu mumuviri.

• Kusvotwa nekurutsa: Chiremba anogona kunyora mushonga uyu wekurutsa kwakanyanya kana kwenguva refu kusina kupindura kune mamwe marapirwo. Dzimwe nguva unoshandiswawo pakurutsa kunokonzerwa nemishonga yechemotherapy yegomarara.

• Kuvharika kweMatumbu Kusingaperi: Apa ndipo panowanikwa zviratidzo zvekuvharika kunyangwe pasina kuvharika chaiko muura . Vaongorori vachiri kuferefeta kana zvimwe zvinhu zvinogadzira prokinetic zvichigona kubatsira nechirwere ichi.

Ndedzipi mhando huru dze `(Prokinetic Agents)`?

Mishonga iyi inogona kukamurwa kuita mapoka maviri makuru: `(Agonists)` uye `(Antagonists)`.

• `(Vagoni)`: Izvi zvinoshanda semamwe `(Vanotumira mashoko pakati petsinga)` mutsinga dzedu. Kureva kuti, aya `(Vagoni)` anoenda onamatira patsinga, achiudza tsinga iyoyo kuti "ipfave". Sezvinoitawo `(Vagoni)` vakakodzera.
• `(Vanorwisa)`: Izvi zvinoshanda nekudzivirira mamwe `(Vanoshandura masero etsinga)` kuti asasungane netsinga. Kunyanya, kana paine `(Vanoshandura masero etsinga)` anokanganisa maitiro e`(Peristalsis)`, aya `(Vanorwisa)` anovadzivirira kuti vasabatane netsinga.

Aya "Prokinetic Agents" akakamurwazve muzvikamu zvakasiyana, zvichienderana nekuti mushonga wega wega unoshanda sei:

• `(Vanorwisa Choleretic)`:Izvi zvinoshanda se "(Neurotransmitter)`` inonzi `(Acetylcholine)`. `(Acetylcholine)` inokurudzira kusimba kwetsandanyama dziri muura. Mienzaniso: `(Baclofen)`, `(Bethanechol)`, `(Neostigmine)`, `(Pyridostigmine)`.
• `(Motilin Agonists)` (Macrolide Antibiotics): Izvi zvinoshanda se`(Neurotransmitter)` inonzi `(Motilin). `(Motilin)` inokurudzira marwadzo muura hudiki. Mimwe mishonga iri muboka iri chaizvoizvo `(Antibiotics)` inopiwa kurapa hutachiona hwebhakitiriya. Mienzaniso: `(Erythromycin)`, `(Azithromycin)`.
• MaSerotonin Agonists: Ava vanoshanda se neurotransmitter serotonin. Kufanana ne serotonin, vanosimudzira marwadzo emudumbu uye vanobatsira dumbu risina chinhu. Mienzaniso: Cisapride, Prucalopride, Tegaserod.
• `(Dopamine Antagonists)`: Izvi zvinodzivirira `(Neurotransmitter)` inonzi `(Dopamine)` kuti isasungane nemasero etsinga. `(Dopamine)` inoderedza kufamba kwemudumbu nemudumbu, uye inozorodzawo `(LES)`. Saka, kana `(Dopamine)` yamira kusungana, aya `(Dopamine Antagonists)` anodzosera shure mhedzisiro iyoyo (kureva kuwedzera kufamba). Mienzaniso: `(Metoclopramide)`, `(Domperidone)`.

Mimwe mienzaniso ye `(Prokinetic Agents)`

Pari zvino kune mhando dzemishonga ye "Prokinetic" inoshandiswa pakurapa, dzimwe dzacho dzakarambidzwa munyika dzakadai seUnited States nekuda kwemigumisiro, uye dzimwe dzichiri muchikamu chekutsvagisa.

• Azithromycin (Zithromax®): Mushonga wekuti motilin agonist. Dzimwe nguva vanachiremba vanoupa mushonga uyu usingashandiswe pakurapa gastroparesis.
• Baclofen (ED baclofen®): Mushonga wecholinergic agonist. Mabhenefiti ayo kuGERD achiri kudzidzwa.
• `(Bethanechol)` (Urecholine®): A `(Cholinergic Agonist). Inobatsira nezviratidzo zve`(Gastroparesis)` uye `(GERD)`. Zvisinei, haishandiswe yakawanda nekuti inogona kukonzera migumisiro yakakomba yakadai sekugwinha kwetsandanyama uye kuona zvisizvo.
• Cisapride (Propulsid®): Mushonga we serotonin agonist. Unobatsira kuti mudumbu mubude mvura nekukurumidza. Wakamboshandiswa pakurapa GERD. Wakabviswa kumusika weUS nekuda kwemigumisiro ine chekuita nemoyo.
• `(Domperidone)` (Motilium®): A `(Dopamine Antagonist). MuUnited States, haiwanikwe nyore nyore pasina mvumo yakakosha. Inogona kukonzera matambudziko makuru emwoyo akadai sekurova kwemoyo kusina kurongeka uye kurwara kwemoyo.
• Erythromycin (EES®): Motilin Agonist. Chiremba anogona kuinyora isiri yepamutemo yekurapa gastroparesis.
• Metoclopramide (Reglan®, Maxeran®, Gimoti®): Mushonga unopesana nedopamine. Mushonga wega unotenderwa neFDA wekurapa gastroparesis. Unoshandiswawo kurapa GERD isina kupindura kumishonga yechivanhu. Zvisinei, unouya nenyevero yekuti unogona kukonzera migumisiro inokanganisa tsinga.
• `(Prucalopride)` (Motegrity®):A `(Serotonin Agonist)`. Inopihwa kune vanhu vanorwara nekuzvimba kwenguva refu. Inobatsirawo kuti mudumbu mubude mvura nekukurumidza.
• Pyridostigmine (Mestinon®): Inoshanda secholinergic agonist. Inonyanya kushandiswa kurapa Myasthenia Gravis, asi dzimwe nguva inoshandiswawo kurapa Gastroparesis.

Ndezvipi migumisiro yakaipa yekushandisa `(Prokinetic Agents)` izvi?

Ichi ndicho chinhu chakakosha kungwarira. Mishonga yeprokinetic inogona kuva nemigumisiro yakaipa. Ndosaka vanachiremba vachiwanzozeza kuinyora. Zvisinei, kana mishonga yechinyakare yakaita sePPIs yeGERD isingashande, chiremba anogona kusarudza kuinyora mushonga weprokinetic. Kana, senzira yekudzivirira, inogona kunyorwa mudosi yakaderera kana kwenguva pfupi.

Kana chiremba akakunyorera mushonga weprokinetic, iva nechokwadi chekubvunza nezvemigumisiro chaiyo yemushonga iwoyo.

Migumisiro yakajairika inosanganisira:

• Marwadzo emudumbu
• Kusvotwa nekurutsa
• Manyoka (kuzvimba)
• Kuona kusina kujeka
• Musoro (musoro)
• Kuneta
• Kurara, kuneta zvakanyanya, kurara kakawanda (Nethargy)
• Kuora mwoyo
• Kunetseka
• Kusunga tsandanyama kusingadzoreki (Dystonia)
• Kufamba-famba kwetsandanyama dzechiso kusingadzoreki (Tardive Dyskinesia)

Mishonga yakaita se `(Cisapride)`, `(Domperidone)` uye `(Tegaserod)` yakabviswa pamusika nekuda kwenjodzi yematambudziko emwoyo akakomba. Izvi zvinoreva:

• Kurova kwemoyo zvishoma nezvishoma (Bradycardia)
• Kurova kwemoyo kusina kurongeka (Arrhythmia)
• Kumira kurova kwemoyo

Ongororo yazvino pamusoro pemishonga mitsva yeprokinetic yakatarisana nekugadzira mishonga inobatsira pakukurudzira marwadzo emudumbu uku ichideredza njodzi yemigumisiro yakadaro.

Ndeapi maProkinetic Agents anonyanya kushandiswa?

Mishonga inonyanya kupihwa mishonga yeprokinetic ndeyeMetoclopramide neDomperidone. MuUnited States, Metoclopramide ndiyo yega mushonga unotenderwa neFDA wekurapa gastroparesis. Zvisinei, chiremba anogona kunyora Domperidone nemvumo yeFDA.

Mishonga yeprokinetic inosiyana pakushanda kwayo uye kuchengetedzeka kwayo pakurapa zvirwere zvekugaya. Nekuda kwengozi yekukonzera migumisiro yakaipa, chiremba anogona kuedza mimwe mishonga asati akupa mushonga weprokinetic. Zvisinei, kana uine zviratidzo zvakakomba nekuti ura hwako hausi kugadzikana zvakanaka, mushonga weprokinetic unogona kukupa zororo raunoda. Kana uri kufunga kutora mushonga weprokinetic, zvakakosha kukurukura zvakanakira nenjodzi nachiremba wako.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Saka, ndinovimba wadzidza chimwe chinhu kubva pane zvatakurukura nezve `(Prokinetic Agents)`. Muchidimbu:

• Mishonga yeProkinetic imhando yemishonga inowedzera kufamba kwenzira yekugaya chikafu uye inobatsira mukugaya chikafu.
• Izvi zvinoshandiswa kune mamwe mamiriro akaita se `(Gastroparesis)` uye `(GERD)`, pamwe nezvinhu zvakaita sekuda kurutsa nekurutsa.
• Mushonga uyu unoshanda nekumutsa tsinga dziri muura uye zvichiita kuti tsandanyama dzimire.
• Chinhu chinonyanya kukosha ndechekuti mishonga iyi dzimwe nguva inogona kuva nemigumisiro yakaipa, saka chiremba achainyora nekungwarira kukuru.
• Usamboshandisa mushonga werudzi urwu usina kubvunza chiremba. Chiremba ndiye anofanira kusarudza kuti ndeupi mushonga wakakunakira uye kuti unofanira kuutora kwenguva yakareba sei.

Kana uine dambudziko remudumbu kana rekugaya chikafu rakadai, chinhu chakanakisa chekuita ndechekuona chiremba wotaura nezvazvo. Zvadaro unogona kuwana kurapwa kwakakodzera.

mishonga yeprokinetic , kurwadziwa kwemudumbu, kusagadzikana kwekugaya chikafu, gastritis, GERD, gastroparesis, metoclopramide