Bisphosphonates - kuyini? Bisphosphonates ukukhumuzeka kwamathambo

uhlelo zemisipha wenza omunye wemisebenzi eyinhloko yomzimba womuntu. Lokho kuba usekelo zonke izidumbu. Bone impilo linendima ebalulekile. Lapho kunezinkinga emalungeni, emgogodleni, waphuka njalo zenzeka, izinga lomuntu zokuphila is kakhulu ziyancipha. Omunye isifo enjalo lapho uvame ukuhambisana izimpawu ezinjalo kuba kwamathambo.

Uma ngesikhathi ukuze ubone udokotela, kungenzeka ukuba ukwenza ngcono isimo lesiguli. Okwamanje, bisphosphonates asetshenziselwa ukwelapha kwamathambo. Le mithi anganika ngethemba lokuphulukiswa. Ake sibone ukuthi yini uhlobo izidakamizwa.

Yiziphi bisphosphonates

igama layo, leli qembu izidakamizwa lithole ngenxa okuqukethwe kule nokwakheka phosphonates ezimbili. Lo mshini wezenzo kube yimphumelelo ngobe zezinto ezifana ngazo nalo omkhulu pirofosfonatami ukuthi abe nomthelela omkhulu ukulawulwa okuqukethwe calcium amathambo.

Nge isakhiwo esifanayo, bisphosphonates zivimbela enzyme ezingase indle pirofosfonaty. Babonakala ukuhlanganisa uxhumano nomsebenzisi calcium ion sibadonse emuva ithambo.

Okuhle kwe-reception le mithi ukuthi izidakamizwa eziqukethe bisphosphonates, babe kuphela umphumela abakhethayo ohlelweni lwamathambo, lapho ekuqongeleleni calcium.

Ngenxa lesi senzo ekwelapheni kwamathambo kungenzeka ukuvimbela ukulahleka-calcium ne phosphorus, okuyinto kuba nomphumela omuhle ekwelapheni.

izinhlobonhlobo bisphosphonates

Abaningi namanje angazi mayelana bisphosphonates. Kuyini lokhu? Manje athuthukile isizukulwane sesithathu leli qembu izidakamizwa. Odokotela bayaqhubeka bedla izidakamizwa, futhi owokuqala izizukulwane ezimbili. Manje imithi eminingi abazalwa aqukethe bisphosphonates, bonke ngothi lwabo zingahlukaniswa ngamaqembu amabili amakhulu:

1. Simple hhayi equkethe nitrogen.
2. Iqembu bisphosphonates, okuhlanganisa i-nitrogen - aminobisphosphonates.
   

Umehluko ophakathi kwala maqembu amabili itholakala iqiniso lokuthi babe nemiphumela ehlukene kwi osteoclasts.

bisphosphonates nitrogen-oqukethe

Kuyini lokhu? Lezi zimali ukubunjwa yayo iqukethe izithako ezilandelayo:

1. Ibandronatovaya acid fanele kuze kube sesizukulwaneni sesithathu, kwemiqondo muva isetshenzisiwe kakhulu ngempumelelo ekuvimbeleni ukukhumuzeka kwamathambo kwabesifazane, ikakhulukazi menopausal.
2. Zolendronovaya acid ngokukhetha enza nezicubu ithambo, has a emelene isimila umphumela. Ngesisekelo yalolu ketshezi ekhiqizwa izidakamizwa ezifana "Zometa", "Zolendronat".
3. Alendronate sodium correctors iphathelene umzimba non-hormone e bone izicubu, ikhuthaza kumiswa ofanele amathambo aqatha.
4. sodium Ibandronate lapho ukukhiqiza "Bonviva", "Boniva", "Bondronat" kuvimbela umsebenzi osteoclast, kodwa akuphazamisi inombolo yabo. Lezi bisphosphonates ukwelashwa kwamathambo ziphumelela, ikakhulukazi njengoba ejenti prophylactic in abesifazane menopausal.
   

Qaphela ukuthi kufanele akazibekanga medicate, imithi kumele udokotela.

bisphosphonates elula

Hhayi equkethe nitrogen bisphosphonate izidakamizwa ukukhumuzeka kwamathambo nazo ngenkuthalo esetshenziswa. Lezi zihlanganisa:

1. "Etidronate" ngesimo amaphilisi kanye imijovo. it is evame ukunikezwa kwamathambo hhayi kuphela, kodwa futhi ngoba isifo Paget sika, hypercalcemia, okuyinto eyenzeka ngo-ngemuva umdlavuza.
2. "Clodronate" ikhishwe ngendlela amaphilisi, amaphilisi kanye nezixazululo. kwamathambo ukusebenza futhi osteolysis.
3. "Tiludronate" ngokuvamile kunqunyiwe abadala abaphethwe isifo Paget sika. Izingane, it is contraindicated.
   

Kukholakala ukuthi la maqembu amabili izidakamizwa nemiphumela ehlukene kwi besilisa umzimba female, ngakho izintokazi zinhle nemithi kangcono nitrogen-oqukethe. Kunoma ikuphi, ukukhetha ukwenza udokotela wakho kuphela.

Kusebenta yezifo ezihlukahlukene

Kukhona lonke uhlu izifo okuyiwona yokwelapha bisphosphonate kungaba nethonya elihle.

1. Lokhu kwakubangelwa ukukhumuzeka kwamathambo.
2. Myeloma.
3. Deforming osteodystrophy.
4. hyperparathyroidism Primary.
5. Ukwephula inqubo ithambo kumiswa.
6. Lapho amathambo metastases.

Ngayinye yalezi izimo kuphela udokotela ekunika umuthi, umthamo yayo kanye nesikhathi ukusetshenziswa. Ukwenza self-ukwelashwa, kungamane nje kusilimaze emzimbeni.

mshini wezenzo

Njengoba bisphosphonates ukukhumuzeka kwamathambo mithi esetshenziswa kakhulu, kubalulekile ukuba ngayo lo mshini wezenzo zabo.

Zonke amaseli asemzimbeni yethu olusha njalo, okufanayo kungathiwani ithambo. It alondolozwa ukulingana osteoblasts, okuyinto banesibopho synthesis yakhe izicubu ezintsha, futhi osteoclasts banesibopho ukubhujiswa kwalo. Ngakho, BF ngandlela-thile kuthiye ngokuyisimangaliso umsebenzi osteoclasts, futhi kwezinye izimo ngisho kuvuse indlela self-ukubhujiswa.

Kuthiwa ngesikhathi samanje, ososayensi baye bahluleka ngokuphelele ukuthola indlela yokuphatha bisphosphonates block ithambo ekubhujisweni. It is kuphela eyaziwa ukuthi kungenzeka le mithi kuhambisana hydroxyapatite ku izingxenye ithambo, kanjalo ekushintsheni ithambo eguqa.

Ungase futhi uqaphele ukuthi uma esetshenziswa isikhathi eside, ukuthi umdlavuza yokwelapha esekelwe lezi bisphosphonates samuva nje asetshenziselwa ukwelapha kwamathambo.

Bisphosphonates metastases

Nge ukuthuthukiswa yomdlavuza kufika esigabeni lapho amangqamuzana omdlavuza agqashule ekusebenzelaneni isimila eyinhloko nokubhebhetheka kwazo wonke umzimba. Endaweni entsha basuke enamathiselwe bese eqala ukukhula, ukwakha metastases.

Nezicubu ithambo othuthukiswa njalo, ngakho-ke kwandisa amathuba okutheleleka nge hematogenous. Lapho amangqamuzana omdlavuza singene umnkantsha, bona ukuphazamisa interplay evamile phakathi osteoclasts futhi osteoblasts, okuholela ukuthuthukiswa okungavamile ithambo izicubu.

Njengoba ukucacisa khona Ukudlulela kunzima, ngoba okwakuhlalwa kuzo lapho kusaqalwa, le nqubo kwenzeka cishe ngaphandle izimpawu, nomdlavuza ngizodabula ukuxilongwa okujuli- ukuhlonza foci yesibili.

Phakathi kwabo bonke labo ukwelashwa metastases Bisphosphonates kabanzi. Le mithi kuthiwa ngempela kalula ikubekezelele iziguli, akuvamile neminye imiphumela emibi.

Abakwazi kuhlangene ngemisebe nangamakhemikhali. Uma usebenzisa izidakamizwa ezifana zihlonzwe ukunciphisa kwezehlakalo ithambo Ukudlulela komdlavuza webele, futhi myeloma amaningi.

Lapho eba hypercalcemia okuyinto cishe esivamile lapho izifo oncological, izidakamizwa nomphumela enkulu ngesimo imijovo infusions. Imiphumela Excellent baye babonisa izindlela ezifana "Zolendronovaya acid", "Pamidronate". Kakade ezimbalwa izinsuku emva Ukusungula ukuhlolwa nokwelashwa ukukhombisa normalizing igazi calcium, futhi umphumela ungaba qhubeka izinsuku ezimbalwa.

izincomo Specific ukuthola bisphosphonates

Uma awuzwanga mayelana bisphosphonates, ukuthi kuyini, utshele udokotela wakho. Ukwemukelwa mithi kufanele kwenziwe ngokuvumelana nezimiso ezithile:

• Kumele uthathe imithi ngemva Awakening, okungenani ibe ihora elilodwa ngaphambi kokudla.
• Geza phansi ngokuba namanzi amaningi kufanele kube.
• Ungayisebenzisi zapivaniya olunye uketshezi, ezifana juice, itiye, ikhofi. Bona ukuvimbela ukumuncwa bisphosphonates.
• Ngemva ukusetshenziswa amaphilisi akanakuwaqamba amanga phansi, kuthatha cishe isigamu sehora sesimweni uqotho ukwenza emphinjeni kwaba omncane.
• It is hhayi Kunconywa ukuhlanganisa BF reception calcium zinsiza, magnesium, insimbi kanye ne-aluminium.

Uma ulandela zonke lezi izincomo, le bisphosphonate ngeke nilingenise engadingeki side effects.

Bisphosphonates ukukhumuzeka kwamathambo: ngobuhle nangobubi bawo

Ekwelapheni bisphosphonates ebisetshenziswa kwamathambo. Izidakamizwa asetshenziswa kahle ngokufanayo kokubili amadoda nabesifazane. Izinzuzo main le mithi kungabandakanya:

• It ayiqukethe hormone.
• Musa iqhaza entuthukweni izifo zenhliziyo nemithambo yegazi.
• izimila ebulalayo usebenzisa BF hhayi intuthuko.

Kodwa nganoma iyiphi wamafutha uhlale kungenzeka ukuthola impukane e lamafutha. Bisphosphonates, naphezu ukusebenza kwazo ngempumelelo ekwelapheni kwamathambo, namanje sikude kakhulu nokuphelela. Entrainment ngokweqile reception zinganikeza imiphumela elandelayo uhlangothi:

• Zibulale isibindi kanye nezinso.
• Uma iqondiswa ngemithambo yegazi, kungenzeka ukuthuthukisa hypocalcaemia.
• Kungenzeka emphinjeni noma esiswini.
• Kukhona ukuqubuka emzimbeni.
• Kwezinye kukhona jikelele ubuthakathaka, ukucobeka nesicanucanu.
• Ubuhlungu bemisipha.
• izinkinga Vision.
• Isifo sohudo noma isifo sohudo.
  

Asinakusho ukuthi zonke lezi imiphumela engathandeki kumelwe ukuzibonakalisa kuzo zonke nesineke, kodwa odinga ukukwazi mayelana nabo. Uma bisphosphonates enqunyiwe, ukuthi kuyini, ukuchazela udokotela, ayoyikhetha okufanayo izidakamizwa umthamo kanye isikhathi sokwelashwa.

izidakamizwa ezinjalo ekwelapheni kwamathambo kanye nezinye izifo. Ngaphambi kokunika imithi, udokotela liyadingeka ukuze afeze ucwaningo ukuthola isimo umzimba bone ne-calcium homeostasis, ngakho musa uzibone ukuba linqume izidakamizwa kuleli qembu.

, Udinga ahole indlela yokuphila enempilo, landela zonke izincomo odokotela, ukudla ngendlela efanele ukuze sigweme ukuba iphendukele imithi. Kuphela kuleli cala, yakho nohlaka lwamathambo kuzolunga.