Bisphosphonates (mankhwala): kufotokoza, malangizo, ndemanga. Bisphosphonates mankhwalawa kufooka kwa mafupa

Pamene mafupa a anthu kukhala osalimba ndi Chimaona, ndipo izo zimachitika mu matenda a fupa, mkhalidwe wa moyo kwambiri yafupika. fractures pafupipafupi, kupweteka kwa m'malo olumikizirana mafupa, msana ndi miyendo anayamba ayende munthu kulikonse, nchifukwa chake mukhoza kwathunthu kusiya kudzimvera chimwemwe cha moyo ndipo agwera mu mtima.

Koma chimwemwe chathu chiri ndi inu masiku ano mankhwala wapadera kuti angathandize kulimbitsa mafupa minofu. Ndi za iwo ndipo m'nkhani yathu. Wotchedwa mankhwala "bisphosphonates" - mankhwala ndemanga amene angapereke chiyembekezo kwa anthu ambiri wosimidwa. Ndikhulupirireni, chotero kwambiri! Ife ndikuuzani inu mbiri ya ndalama izi, zimene zili zabwino, zimene ndi maziko a ubwino umoyo wawo, kodi kusindikiza mayina a bisphosphonates ali otchuka kwambiri komanso zothandiza.

Nkhani adzakhala zothandiza aliyense. Ndipotu, ngakhale lero chirichonse mu dongosolo, ndiye, mwatsoka, sizitanthauza thanzi inu ndi okondedwa anu adzakhala muyaya. Zaka ziyenda, ndi Kuwonjezera wa matenda awo likupitirirabe kwambiri. Nanga bwanji mankhwala amakono akhale zosafunika. Koma chokwanira cha ofika! Tiyeni tisunthire kwa phunziro lalikulu kwambiri la mutu wa nkhani ino.

Bisphosphonates - mankhwala thanzi fupa

Kusankha gulu la mankhwala kupanga kuti angathe ndigwire ntchito thupi osteoclasts (maselo kuwononga fupa minofu) ndi kubwezeretsa dongosolo fupa chikudziwika ngati bisphosphonates.

Ntchito mankhwala panopa pamalo oyamba chifukwa kusamalira odwala ndi kufooka kwa mafupa ndi matenda ena amene amayambitsa mafupa Chimaona. Chuma cha mtengo wapatali kwambiri wa bisphosphonates ndi chakuti iwo akhoza kugwiritsidwa ntchito mu matenda oncological yodziwika ndi mapangidwe zotupa mu fupa. Mu milandu, mankhwala, amene amasimba nkhani yathu, musataye metastases kufalitsa ndi kuchepetsa ululu odwalawo.

Limagwirira cha zochita za bisphosphonates mankhwalawa kufooka kwa mafupa

Mu mutu wapitawo, mwaphunzira kuti bisphosphonates - mankhwala omwe amalimbikitsa mafupa athanzi. Ndi nthawi kulankhula za limagwirira cha zochita zawo. maselo thupi lathu ali ndi luso chidwi nthawi kusinthidwa ndi anakongoletsa. Bone minofu - yotero. Muzipezanso nyumba zawo akhala pa dzanja limodzi, maselo osteoblast kuti ali ndi udindo yomanga minofu latsopano, winayo - osteoclasts kuti ali ndi udindo uwonongedwe. BF ndi mphamvu kusokoneza ntchito ya osteoclasts ndipo ngakhale kuthamanga awo kuonongeka wokha limagwirira. Pa katundu ameneyu ndi zochokera bisphosphonate chithandizo cha kufooka kwa mafupa.

Ine ndiyenera kunena kuti mpaka asayansi asanamvetsetse ndi kutsekereza limagwirira cha imfa fupa ntchito bisphosphonates. Amadziwika kuti zinthu zimenezi ndi anatha kum'manga ku chigawo hydroxyapatite fupa, umene iwo angasinthe kupinda ake ndipo nthawi yomweyo kuchepetsa ndende magazi a hydroxyproline ndi phosphatases.

Nthawi zina kukonzekera BF akhoza kutumikiridwa mu mankhwala ngakhale matenda monga herniation kapena protrusion wa zimbale intervertebral, oimira analgesic. Ndi mfundo pang'ono: bisphosphonates chifukwa kufooka kwa mafupa akhala akugwiritsidwa ntchito kwa nthawi yaitali, koma khansa, akhala posachedwapa. Mwa maphunziro chinapezeka kolowa thupi, kumene yogwira likupezeka mu ndondomeko neoplastic, bisphosphonates musataye chotupa maselo coalesce ndi masanjidwewo fupa ndipo potero ziletsa mapangidwe metastases. Zambiri za izi ayankhidwa mu chaputala osiyana.

A mbiri pang'ono

Iwo likukhalira kuti bisphosphonates ankagwidwa asayansi kwa nthawi yaitali, ngakhale m'zaka za m'ma XIX. Kwa nthawi yoyamba kaphatikizidwe wa BF woyamba anachitika ku Germany. Ndi zosadabwitsa kuti zinthu zimenezi poyamba ntchito kokha kumabungwe osiyanasiyana mafakitale (kwa kupanga feteleza, kupanga nsalu, kuyenga mafuta ndi zina zotero. D.) Ndipo zifukwa mankhwala analibe.

Mankhwala zolinga - zochizira fupa - bisphosphonates anayamba kugwiritsidwa ntchito cha m'ma-makumi awiri, atazindikira katundu wawo chodabwitsa kusonkhezera njira monga calcification ndi decalcification. Bisphosphonates chifukwa kufooka kwa mafupa ntchito kuyambira padziko lonse mwakhama kwambiri.

gulu la bisphosphonates

Lero, mankhwala anayamba mbadwo wachitatu biosfosfonatov. Koma zimenezi sizikutanthauza kuti madokotala akhala kwathunthu anasiya kugwiritsa ntchito mankhwala a m'badwo woyamba ndi wachiwiri, amene anali anatulukira kale kwambiri. Ayi! Today pali mankhwala ambiri zochokera bisphosphonates. zosiyanasiyana Zonsezi ndi mankhwala omwe m'magulu awiri: bezazotovye mankhwala ndi asafe. mmene pa maselo osteoclast ali ndi njira zosiyana. Pansipa tiona magulu onse mwatsatanetsatane.

Asafe munali bisphosphonates

Gulu la mankhwala ndi bisphosphonates, munali zotsatirazi yogwira zosakaniza:

• Ibandronatovaya acid. E thunthu anali apanga posachedwapa, kotero ndi mankhwala a mbadwo wachitatu. Izo ntchito kwambiri bwinobwino mankhwala ndi kupewa kufooka kwa mafupa mu akazi amene unalowa m'nyengo zovuta kusintha. Amuna kutenga mankhwala ali osavomerezeka. asidi Ibandronatovuyu amagwiritsidwanso ntchito pathological kuwonjezeka mu kashiamu magazi (hypercalcemia).
• Zolendronovaya acid. Komanso ukukamba mbadwo wachitatu bisphosphonate. Akhoza kuchita kusankha pa minofu fupa. Zimenezo bwino ntchito zochizira kufooka kwa mafupa. The kusankha zochita zolendronovoy asidi pa dongosolo fupa zachokera kuyandikana ake okwezeka latisi osseous amene amapereka chopinga kwambiri a osteoclasts. katundu ina yofunika ya mankhwala - ndi kutchulidwa odana ndi chotupa tingati. Pamaziko a zilipo asidi zolendronovoy bisphosphonates otchuka "Zometa", "Zolendronat".
• Alendronate ndi sodium - wachiwiri m'badwo njira bisphosphonates. Ndi sanali m'thupi yeniyeni yoona kagayidwe kachakudya fupa minofu kupanga dongosolo olondola a fupa. Chimaonekera ntchito kufooka kwa mafupa akazi ndi amuna onse.
• Ibandronate ndi sodium ( "Bonviva" "Bondronat" "Boniva" - bisphosphonates kukonzekera pa maziko ake) - m'badwo mankhwala lachitatu. Kumabwezera mmbuyo ntchito osteoclast popanda okhudza chiwerengero cha iwo. Zilibe m'mavuto mapangidwe maselo fupa, motero bwino kuchepetsa kuonongeka kwawo. Good thandizo akazi postmenopausal ngati wothandizira njira ya fractures fupa.

Kukonzekera kuti mulibe asafe

Ndipo tsopano tiona zomwe ndi asafe-free bisphosphonates. Mankhwala, amene maina mukuwerenga tsopano, mu m'badwo woyamba wa bisphosphonates:

• "Clodronate." Iwo chindiletsa onse osteolysis ndi hypercalcemia chitukuko. Ndipamene kugwirizana zovuta ndi hydroxyapatite fupa chimasintha latisi galasi ndi mwachangu anatchula kulekana kwa kashiamu ndi mankwala mamolekyulu. Metastases mu mafupa kumalepheretsa chitukuko ndi midadada chilengedwe mabungwe atsopano.
• "Sodium Etidronate". Kumathandiza kubwezeretsa imfa fupa akazi ndi matenda a "kufooka kwa mafupa". Angagwiritsidwenso ntchito matenda Paget a, hypercalcemia ndi zina zotero. D.
• "Sodium tiludronate". Mineralizes ndiponso kulimbikitsa fupa minofu, wambirimbiri m'menemo maselo pawiri ndi calcium mankwala, kumabwezera mmbuyo kuwonongedwa kwa fupa. Kwalamulidwa kwa odwala diagnoses a "deforming osteodystrophy" kapena "matenda Paget a" Akhozanso kusankha zina m'malo mahomoni.

Bisphosphonates - mankhwala, mndandanda zimene ife lofalitsidwa - anagulitsa yekha mankhwala, ndiko kukhala amphamvu zinthu ... Gwiritsani ntchito pa nzeru zawo zikhoza kukhala zoopsa thanzi lanu! Kumbukirani kuti BF - si vuto lililonse mavitamini kapena zowonjezera ndi calcium. Mankhwalawa ndi kuthandizapo mwachangu njira kunachitika thupi, ngati yosayenera ntchito kungathandize m'malo zoipa.

malamulo chikuonetseratu

mankhwala bisphosphonates ndithu kwambiri chosakanikirana ndi kapepala kakuti m'mimba, mayamwidwe yovuta. Choncho, mwamphamvu malangizo n'kukulemberani kumwa mankhwala amenewa pa chopanda kanthu m'mimba, mphindi 30. pamaso chakudya - kumakonda amathandiza mayamwidwe zinthu mankhwala yogwira. Odwala ayenera kudziwa kuti gulu la mankhwala angathe kuchititsa kutupa ndi kukokoloka m'madera osiyanasiyana pa mundawo m'mimba. Kupewa mavuto amenewa, atalandira mapiritsi zofunika kuyesa patsikulo osati kupita ndi kukakhala mu malo woongoka. mlingo amasankhidwa ndi dokotala nawo.

Childs, poika bisphosphonates dokotala n'kukulemberani wodwala akadali ndi ingestion wa Mlingo waukulu wa calcium. Choncho, munthawi yomweyo phwando onse akuwasala. Kukonzekera munali calcium, akhoza kumwedwa atakhala bisphosphonate pokhapokha maola awiri, osati kale. kuimilidwa ina yofunika: CF kumwa palibe tiyi, mkaka, madzi kapena khofi, ndi madzi opanda (zambiri).

Ntchito bisphosphonates matenda neoplastic

nkhani zambiri za bisphosphonate zochizira matenda yokhudza kukula kwa zotupa za chikhalidwe chosiyana. Nthawi ya metastasis mu minofu fupa limodzi mogwirizana ndi reciprocal pakati pa maselo chotupa ndi ntchito kagayidwe kachakudya minofu fupa. Nawonso chitukuko wochitachita wa metastases limodzi ndi guluu wolimba maselo chotupa ku nyumba fupa, komanso kuwukira, kuchuluka ndi neoangiogenesis. Ambiri maphunziro preclinical asiya asayansi kuti maganizo oti BF ziletsa aliyense wa magawo awa a pathogenesis.

M'kupita kwa mapulogalamu angapo kafukufuku ife ayesedwa zotsatira za bisphosphonate "Clodronate" pa zomwe metastases mu fupa akazi ndi khansa ya m'mawere. zotsatira zabwino zimapezeka: yokonza vutoli ndi zochitika za metastases ndi kukula kwa latsopano minofu fupa odwala. Panopa, kafukufuku umenewu ndi kupitiriza mwachangu. Bisphosphonates pamene fupa metastases alidi angathe kuthandiza.

zotupa zilonda nthawi zambiri limodzi ndi hypercalcemia (kashiamu kumasulidwa ku fupa). Pamene metastatic chotupa fupa kashiamu imfa mofulumira kumachitika chifukwa kuti uwonongedwe ndi osteoclasts. Komanso, hypercalcemia khansa angathe zimachitika chifukwa kukhudzana ndi chotupa peputayidi. Komanso, pali kutsegula kwa osteoclasts, zikubweretsa hypercalcemia. Zimenezi ndi zovuta komanso inapita patsogolo ndi kuchepetsa ntchito aimpso.

njira izi zimachitika ndi malignancies monga carcinoma squamous selo, myeloma angapo, khansa, selo aimpso ndi ena lymphomas. Hypercalcemia, chikwiyire ndi khansara, mankhwala yabwino kwambiri ndi bisphosphonates kwa kulowetsedwa mtsempha. Kukhazikika bwino mu milandu, mankhwala, bisphosphonates, monga "Zolendronovaya asidi" ndi "Pamidronate".

Kuzipenya zikusonyeza kuti masiku kale ochepa ukatha mwambo wa utsogoleli odwala kudzera m'mitsempha mankhwala deta mu ndende magazi kashiamu ndi dekhetsa, ndi mmene kumatenga nthawi yaitali ndithu nthawi (milungu limodzi kapena awiri).

Mndandanda wa matenda amene bisphosphonates ntchito bwinobwino

• Kufooka kwa mafupa.
• Myeloma.
• Kupondelezedwa kwa mapangidwe fupa.
• Paget ndi matenda (osteodystrophy deforming).
• Pulayimale hyperparathyroidism.
• Zotupa ndi metastases mu fupa, makamaka pamodzi hypercalcemia.

zotsatira zoyipazi

Mwatsoka, yogwira bisphosphonate chithandizo sangakhale palibe vuto lililonse. Makamaka pankhani makonzedwe mtsempha wa mankhwala. Angathe kuyambitsa zotsatira mavuto mbali:

• Pamene kutumikiridwa m'nsinga, - hypocalcemia.
• Kungam'lepheretse impso, chifukwa kuledzera.
• Nthawi zina phwando amine biosfosfonatov amakwiya chitukuko cha osteonecrosis cha pachibwano.
• Zimathandiza kuti chitukuko cha zilonda mu mmero ndi mmimba.
• Zingachititse kudzimbidwa kapena m'mimba mwa nthawi zina - vuto kumeza.
• General malaise, kufooka, nseru.
• Minofu ululu.
• mavuto masomphenya.
• Totupa pa thupi.

Inde, onse mavuto izi zingathe kudzetsa bisphosphonates. Mankhwala, mayina a amene mwakumana m'nkhani ino, simungathe anaika ndekha paokha kuti mosadziwa chifukwa thupi mpaka kalekale zoipa. Ife mwadala kubwereza kambirimbiri m'lembali! Tikayang'ana ndemanga, amene angathe kuwerenga mu maonekedwe osiyana, anthu zikukangalika kufotokoza ndi mzake za BF zosiyanasiyana komanso zosavuta amalangiza iwo kwa ena. Izi ndi kuba. Tengani mankhwala amphamvu Ndikofunikira Kuchokela pamawu a dokotala kupezeka ndi nthawi kuiyang'anira.

Bisphosphonates - ndemanga madokotala ndi odwala

Kodi mukudziwa kuti chaka chilichonse, pa October 20, m'mayiko onse a tsiku lokumbukira polimbana kufooka kwa mafupa? matenda zaposachedwapa, ndapeza mliri kufanana. Ngakhale akatswiri ena amakhulupirira kuti kufunika vuto la kufooka kwa mafupa ndi penapake akukokomeza, chifukwa matenda ndi pakokha amapha. Komabe, kuchuluka kwa anthu okalamba amene amafa pambuyo ntchafu wovulala, nthawi zambiri zimachitika pamene inapita imfa fupa ndi lalikulu kwambiri. Choncho, chiwerengero chachikulu cha anthu ali ziyembekezo makamaka pa bisphosphonates. Reviews a odwala amene mankhwala chifukwa cha chiyembekezo cha kuchira, zinapatsira moyamikira madotolo ndi mankhwala amakono, amene anatha kupereka iwo ndi thandizo yake.

Dr. Med. Pulofesa ndi mutu wa Center Scientific-chipatala cha kufooka kwa mafupa Svetlana Rodionova amakhulupirira kuti vuto kufooka kwa mafupa aakulu okwanira mu Russia. A dokotala odziwika limanena kuti m'masiku athu, pamene mphamvu ya anthu ambiri zolakwika (kupanda kashiamu), kutenga kupezeka kwa makhalidwe oipa oterowo monga kusuta fodya, kugwiritsa ntchito mankhwala osokoneza bongo ndi mowa, ndipo zolimbitsa thupi ikuyandikira ziro, achinyamata ambiri, makamaka akazi likupita zaka okhwima kwambiri kufooka kwa mafupa. Kotero kufunika mankhwala zabwino zothandiza kuthandiza kuchiza matenda ndi mkulu.

Monga kusankhidwa bisphosphonates pafupipafupi dokotala, ndi pulofesa wa maganizo kuti si nthawi zonse wolungama. Bisphosphonates - oletsedwa mankhwala, koma wodwala pamaso kupereka mankhwala makamaka, dokotala ayenera kuonetsetsa kuganizira zinthu monga kagayidwe mafupa ndi calcium homeostasis. Pamene wakulungama ndi kusalankhula bisphosphonate mankhwala angayambitse mavuto aakulu: matenda fibrillation, osteonecrosis cha pachibwano, fractures subtrochanteric wa femur lapansi.

Potengera maganizo a dokotala wolemekezeka bisphosphonates si limathetseratu vuto lina lililonse chilengedwe, ntchito zawo ayenera kulankhula mosamala. Pakali pano, dongosolo "Health" ukufalitsidwa pa TV, kumene Elena Malysheva ndi kumwetulira wokoma anditsutsa omvera kuti palibe mosavuta kuposa mankhwala kwa kufooka kwa mafupa, ndi wachitatu m'badwo bisphosphonate. Musati kwambiri kudalira infomercial. Ena anthu akulandira BF mwamtheradi contraindicated. Mwachitsanzo, odwala matenda aakulu aimpso.

Tsopano ndemanga pa momwe ntchito bisphosphonates pamene fupa metastases. Medical maganizo momveka bwino: mankhwala awa ali kwenikweni kuwaletsa mu kukula fupa la maselo zilonda, amene, ndithudi, kumathandiza odwala kugonjetsa imodzi mwa matenda aakulu, omwe alipo okha mu dziko.

Pomaliza

Tsopano inu mukudziwa chomwe izo ziri - bisphosphonates. Malangizo awo ntchito pano, komanso mndandanda wa mankhwala tinapatsidwa osati monga kuimilidwa ndi ziti malangizo chabe - choonde mvetselani chanu chapadera ichi! Ngati mavuto aakulu safuna kudzimvera medicate ndi thanzi, yabwino - mwamsanga dokotala, chotero iye anatenga inu kwa kukonzekera mankhwala. Tikufuna inu nonse thanzi wangwiro ndi chimwemwe!