Isexwayiso Samagilebhisi: Singaxhumana Nemithi Ejwayelekile

-Delile

• Isebenzisana kanjani nemithi?
• 1-3: Eminye imithi ye-cholesterol
• 4-7: Imithi ethile yomfutho wegazi
• 8-9: Imithi yesigqi senhliziyo embalwa
• 10-13: Eminye imithi elwa nokutheleleka
• 14-20: Imithi eminingi yemizwa
• 21–24: Abanye abaonda igazi
• 25-27: Imithi eminingi yezinhlungu
• 28-31: Ukungasebenzi kahle kwe-erectile nemithi yokwelashwa kwendlala
• Kufanele uyeke isithelo samagilebhisi?
• Okubalulekile

I-Grapefruit isithelo esiphundu samawolintshi esinezinzuzo eziningi zezempilo. Kodwa-ke, ingaxhumana neminye imithi ejwayelekile, iguqule imiphumela yayo emzimbeni wakho.

Uma ufuna ukwazi ngesexwayiso se-grapefruit emithini eminingi, le ndatshana izokusiza uqonde ukuthi kungani ikhona nokuthi yiziphi izinketho zakho.

Nakhu ukubhekisisa imishanguzo ejwayelekile engama-31 engaba nokuxhumana okuyingozi ne-grapefruit, kanye nezinye izindlela.

Qaphela: Lo mbhalo uqukethe imininingwane ejwayelekile - hhayi izeluleko ezithile zezokwelapha. Khuluma nodokotela wakho ngaphambi kokushintsha ukusebenzisa kwakho noma imuphi umuthi.

Isebenzisana kanjani nemithi?

Imithi icutshungulwa esibindini sakho nasemathunjini amancane yiqembu elikhethekile lamaprotheni abizwa nge-cytochrome P450 (CYPs).

Ama-CYP adiliza imishanguzo, anciphisa amazinga egazi amaningi awo.

I-Grapefruit kanye nezihlobo zayo ezimbalwa eziseduze, njengamawolintshi aseSeville, i-tangelos, i-pomelos neMinneolas, aqukethe isigaba samakhemikhali abizwa ngokuthi ama-furanocoumarins.

AmaFuranocoumarins aphazamisa umsebenzi ojwayelekile wama-CYP. Eqinisweni, ucwaningo lukhombisa ukuthi bakhuphula amazinga egazi emithini engaphezulu kwama-85 (1).

Ngokunciphisa indlela ama-CYPs ahlukanisa ngayo imishanguzo esiswini nasesibindi sakho, isithelo samagilebhisi singakhuphula imiphumela emibi yale mithi (1).

Kunezinto ezintathu okufanele wazi ukuqonda ukuthi ungasidla kanjani izithelo zomvini ngokuphepha ngale mithi.

1. Akuthathi okuningi. I-grapefruit eyodwa noma ingilazi eyodwa yejusi lamagilebhisi kwanele ukushintsha ukuthi le mithi ikuthinta kanjani.
2. Imiphumela yayo ihlala izinsuku ezimbalwa. Ikhono likaGrapefruit lokuthinta imithi lihlala izinsuku ezi-1-3. Ukuthatha imithi yakho amahora ambalwa ngaphandle kokuyisebenzisa akukude ngokwanele.
3. Kuyaphawuleka. Ngenani elincane lezidakamizwa, imiphumela yamagilebhisi ingaba yimbi.

Unalokho engqondweni, nansi imininingwane eningiliziwe mayelana nemithi ejwayelekile engama-32 engaxhumana ne-grapefruit, ehlukaniswe ngokusetshenziswa.

1-3: Eminye imithi ye-cholesterol

Eminye imithi ye-cholesterol ebizwa ngama-statins iyathinteka ngo-grapefruit.

Izitatimende zisebenza ngokunciphisa ukukhiqizwa kwemvelo kwe-cholesterol. Lokhu kuthuthukisa iphrofayili yama-lipoprotein egazini futhi kunciphise ukufa kwabantu ngenxa yesifo senhliziyo ezigulini ezisengozini yaso ().

Izitatimende zingadala i-rhabdomyolysis, noma ukuwohloka kwezicubu zemisipha. Lokhu kuholela ekubeni buthakathaka kwemisipha, kubuhlungu, futhi kwesinye isikhathi kulimale izinso ().

I-Grapefruit inyusa amazinga egazi ama-statins amathathu ajwayelekile kakhulu, okwandisa ubungozi be-rhabdomyolysis ():

1. I-Atorvastatin (Lipitor)
2. I-Lovastatin (Mevacor)
3. I-Simvastatin (Zocor)

Ucwaningo oluthile lukhombisile ukuthi ukuphuza ingilazi yejusi lamagilebhisi nge-simvastatin noma i-lovastatin kukhuphule amazinga egazi alezi zimiso ngama-260% ().

Ezinye izindlela: I-Pravastatin (Pravachol), i-rosuvastatin (i-Crestor), ne-fluvastatin (i-Lescol) ayihlangani ne-grapefruit (1).

I-Grapefruit ingakhuphula imiphumela emibi yemithi ethile ye-statin cholesterol, ibangele ukulimala kwemisipha.

4-7: Imithi ethile yomfutho wegazi

Izinhlobo eziningi zemithi yengcindezi yegazi ayithinteki ngozimele.

Kodwa-ke, le mithi elandelayo yengcindezi yegazi kufanele isetshenziswe ngokuqapha:

1. Felodipine
2. I-Nifedipine (Procardia)
3. I-Losartan (Cozaar)
4. I-Eplerenone (Inspra)

Imithi emibili yokuqala kulolu hlu yaziwa njenge-calcium channel blockers. Zisebenza ngokushintsha indlela imithambo yegazi yakho esebenzisa ngayo i-calcium, ithambisa imithambo, futhi yehlise umfutho wegazi.

Imithi emibili yokugcina kulolu hlu isebenza ngokunciphisa umsebenzi wehomoni ebizwa ngokuthi i-angiotensin 2, ekhulisa ngokwemvelo umfutho wegazi.

Ucwaningo oluthile lwathola ukuthi amazinga egazi e-nifedipine akhuphuke kakhulu lapho ethathwa cishe nezinkomishi ezi-2 (500 ml) yejusi lamagilebhisi, uma kuqhathaniswa nelingenayo ijusi. Lokhu kuholele ekwehleni okusheshayo kwengcindezi yegazi, okungaba yingozi uma kungagadiwe ().

ILosartan ayijwayelekile ngoba isithelo samagilebhisi sinciphisa imiphumela yaso, okunganciphisa amandla aso okulawula umfutho wegazi ().

I-Eplerenone isebenza ngokufanayo ne-losartan, kodwa amazinga ayo ayakhula lapho ithathwa ngo-grapefruit. Amazinga we-eplerenone ngokweqile angadala i-potassium eningi egazini, engaphazamisa isigqi senhliziyo (1).

Ezinye izindlela: ISpironolactone (Aldactone), umuthi ofanayo nowe-losartan ne-eplerenone, ayihlangani ne-grapefruit. I-Amlodipine (i-Norvasc) isivimbeli sesiteshi se-calcium njenge-felodipine ne-nifedipine, nayo engasebenzisani ne-grapefruit (,).

Yize i-grapefruit ingaphazamisi imithi eminingi yomfutho wegazi, ingadala ukuthi imishanguzo embalwa yeqise umfutho wegazi.

8-9: Imithi yesigqi senhliziyo embalwa

I-Grapefruit inomthelela emithini embalwa elapha isigqi senhliziyo esingajwayelekile.

Lokhu kuxhumana kungaba yingozi ikakhulukazi futhi kufaka:

1. Amiodarone
2. I-Dronedarone (Multaq)

Ucwaningo lunikeze amadoda ayi-11 abephuza i-amiodarone ingilazi yejusi lamagilebhisi (cishe ama-300 ml). Izinga lezidakamizwa lenyuke laze lafika kuma-84%, uma kuqhathaniswa nalabo abangaphuzi ijusi ().

Le mithi emibili idlala indima ebaluleke kakhulu ekuphatheni impilo yeziguli ezinenkinga yesigqi senhliziyo. Izinguquko ezihlobene nogilebhisi emazingeni ale mithi kwesinye isikhathi zidale ushintsho lwesigqi senhliziyo esiyingozi ().

Yize kunemithi embalwa yesigqi senhliziyo ehlangana ne-grapefruit, imiphumela emibi ingaba yingozi.

10-13: Eminye imithi elwa nokutheleleka

Ngokubizwa ngokuthi ama-antimicrobial, le mithi elwa nokutheleleka iyahlukahluka kakhulu ezenzweni nasekuphukeni komzimba.

Yize ama-antimicrobial engenye yezigaba ezahlukahlukene kakhulu zemithi, kunemithi embalwa kuphela enokusebenzisana okubalulekile kwamagilebhisi:

1. I-Erythromycin
2. I-Rilpivirine kanye nemithi ehlobene ne-HIV
3. Primaquine kanye nemithi ehlobene ne-malaria
4. Albendazole

I-Erythromycin isetshenziselwa ukwelapha izinhlobo eziningana zezifo ezibangelwa amagciwane. Ucwaningo oluqhathanisa ujusi wamagilebhisi namanzi ezigulini ezithatha i-erythromycin luveze ukuthi ujusi unyuse amazinga egazi lomuthi ngo-84% ().

Amazinga athe xaxa alo muthi angaphazamisa isigqi senhliziyo ().

I-Grapefruit ibuye inyuse amazinga emishanguzo ye-HIV i-rilpivirine ne-maraviroc, ngaphezu kwezidakamizwa ezihlobene ne-primaquine-anti-malaria. Lokhu kungathinta isigqi senhliziyo noma umsebenzi (1).

Ngoba ama-antimicrobials ngokuvamile athathwa isikhathi esilinganiselwe, mhlawumbe kulula kakhulu ukumane ugweme isithelo samagilebhisi ngenkathi uthatha le mithi.

Ezinye izindlela: I-Clarithromycin ngumuthi osesigabeni esifanayo ne-erythromycin engasebenzisani ne-grapefruit. IDoxycycline yomibili imishanguzo elwa namagciwane kanye ne-antimalarial nayo engasebenzisani nayo (1).

Eminye imishanguzo yokulwa nokutheleleka akufanele isetshenziswe ne-grapefruit, ngoba ingaholela ekuphazamiseni isigqi senhliziyo noma ukusebenza.

14-20: Imithi eminingi yemizwa

Iningi lama-anti-depressants nezidakamizwa ezilwa nokukhathazeka kuphephile ukusetshenziswa ne-grapefruit.

Kodwa-ke, imishanguzo eminingana yemizwa iyasebenzisana nayo, kufaka phakathi:

1. I-Quetiapine (Seroquel)
2. I-Lurasidone (Latuda)
3. I-Ziprasidone (Geodon)
4. I-Buspirone (Buspar)
5. I-Diazepam (Valium)
6. I-Midazolam (Inamavesi)
7. I-Triazolam (Halcion)

Izidakamizwa ezinjenge-quetiapine ne-lurasidone zisetshenziselwa ukwelapha ukuphazamiseka kwemizwelo nokuziphatha. Amazinga akhuphukile ale mithi angadala ushintsho lwesigqi senhliziyo noma ukulala (1).

Ngaphezu kwalokho, i-diazepam, i-midazolam, ne-triazolam yizidambisi kwesinye isikhathi ezisetshenziselwa ukuhlaselwa ukwethuka noma ezinye izinhlobo zokukhathazeka.

Ucwaningo oluthile luqhathanise eminye yale mithi ezigulini eziyisishiyagalolunye, ezinye zazo ezidle izithelo zomvini. Kukhombisile ukuthi i-grapefruit ingayandisa imiphumela yale mithi, okuholele ekozeleni ngokweqile ().

Ukudla izithelo zomvini ngenkathi uthatha imishanguzo ehlobene nemizwelo ngenhla kungaholela ekushintsheni kwesigqi senhliziyo, ukulala ngokweqile, kanye neminye imiphumela eqondene nezidakamizwa.

21–24: Abanye abaonda igazi

Ama-thinner egazi asetshenziselwa ukwelapha noma ukuvimbela amahlule egazi. Ezinye zazo zithinteka ngovundululu, kufaka phakathi:

1. I-Apixaban (Eliquis)
2. I-Rivaroxaban powder (i-Xarelto)
3. IClopidogrel (i-Plavix)
4. I-Ticagrelor (Brilinta)

I-Clopidogrel incike kuma-CYPs - amaprotheni anqunyelwe umkhawulo wamagilebhisi - ukusebenza. Ngakho-ke, ayisebenzi kangako lapho ixutshwe novuthiwe.

Ucwaningo lweziguli eziyi-7 ezithatha i-clopidogrel nge-200 mL yejusi lamagilebhisi noma amanzi kukhombise ukusebenza okuncane komuthi nejusi. Kodwa-ke, ikhono layo lokwelapha amahlule egazi alithintekanga ().

Ngokuvamile, isithelo samagilebhisi sandisa amazinga egazi eminye imithi kulolu hlu, okungaholela ekopha ().

Ezinye izindlela: I-Warfarin (i-Coumadin) isetshenziselwa izinjongo ezifanayo nalezo ze-apixaban ne-rivaroxaban powder. Ngenkathi i-warfarin izwela ekudleni okuqukethe i-vitamin K, ukwenziwa kwayo akuthintwa yi-grapefruit ().

Abaningi abanciphisa igazi bathinteka yi-grapefruit. Lokhu kungaholela ekuphumeni kwegazi noma ekuvikeleni okungasebenzi kahle kwamahlule egazi.

25-27: Imithi eminingi yezinhlungu

Imithi eminingi yezinhlungu iyathinteka ngozimele:

1. Fentanyl
2. I-Oxycodone
3. I-Colchicine

I-Fentanyl ne-oxycodone kuyadambisa izinhlungu. Yize amazinga abo egazi ethinteka kancane ngamanani amancane we-grapefruit, kungashintsha ubude besikhathi abasele emzimbeni (,).

IColchicine ngumuthi omdala osetshenziselwa ukwelapha i-gout. Icutshungulwa ama-CYP futhi ingaxhumana ne-grapefruit. Yize kunjalo, isifundo sango-2012 sikhombise ukuthi ukuphuza ama-mililitha angama-240 wejusi lamagilebhisi kube nomthelela omncane emazingeni ayo ().

Ezinye izindlela: I-Morphine ne-Dilaudid yizidambisa izinhlungu ze-narcotic ezingathintwa yi-grapefruit (1).

Abanye ubuhlungu be-narcotic buqeda isikhathi eside egazini lapho buthathwe ne-grapefruit.

28-31: Ukungasebenzi kahle kwe-erectile nemithi yokwelashwa kwendlala

Imithi embalwa yokungasebenzi kahle kwe-erectile nemithi ye-prostate ifanele ukunakwa maqondana nokusebenzisana kwamagilebhisi:

1. I-Sildenafil (Viagra)
2. I-Tadalafil (Cialis)
3. I-Tamsulosin (Flomax)
4. I-Silodosin (Rapaflo)

Imithi yokungasebenzi kwe-Erectile efana ne-sildenafil ne-tadalafil isebenza ngokuphumuza imithambo yegazi, ekhulisa ukugeleza kwegazi kuye ekwakhiweni.

Ngoba eminye imithambo yegazi iyakhululeka nayo le mithi, amazinga egazi akhuphukile alezi zidakamizwa abangelwa i-grapefruit anganciphisa umfutho wegazi ().

Ngaphezu kwalokho, imishanguzo yokwandisa i-prostate efana ne-tamsulosin nayo ingadala isiyezi nokukhuphuka kwengcindezi yegazi lapho ithathwa nge-grapefruit ().

Ezinye izindlela: Esinye isigaba semithi yokwandisa i-prostate, efaka i-finasteride ne-dutasteride, ayithinteki kakhulu nge-grapefruit ().

I-Grapefruit akufanele idliwe ngemithi yokungasebenzi kahle kwe-erectile noma imishanguzo ethile yokwandisa i-prostate.

Kufanele uyeke isithelo samagilebhisi?

Ngenkathi lo mbhalo ubala imishanguzo ejwayelekile engama-31 esebenzisana ne-grapefruit, akulona uhlu oluphelele.

I-Drugs.com inikeza isihloli sokusebenzisana kwezidakamizwa ongasisebenzisa ukuhlola imithi yakho ngokusebenzisana.

Ngokwengeziwe, iRxlist.com ibala eminye imishanguzo engajwayelekile esebenzisana ne-grapefruit.

Kubalulekile ukukhumbula ukuthi isithelo samagilebhisi esisodwa esisodwa noma cishe ingilazi eyodwa enkulu yejusi kwanele ukushintsha amazinga egazi emithi eminingi. Futhi eminye yale mithi ingaba nemiphumela emibi kakhulu lapho ihlangana ne-grapefruit.

Uma njengamanje uthatha imishanguzo ngokusebenzisana kwamagilebhisi, shintshela kwesinye isidakamizwa noma uyeke ukudla ubhamubhamu.

Uma ungabaza, thintana nodokotela wakho noma usokhemisi ukuthola izeluleko ezenziwe zaba ngezakho.

Ngisho inani elincane lamagilebhisi lingasebenzisana neminye imithi futhi lidale imiphumela emibi kakhulu.

Okubalulekile

I-Grapefruit iphazamisa amaprotheni emathunjini amancane nasesibindi esivame ukwehlisa imithi eminingi.

Ukudla isithelo samagilebhisi noma ukuphuza ijusi lamagilebhisi ngenkathi uthatha le mithi kungaholela emazingeni aphezulu ayo egazini lakho - kanye neminye imiphumela emibi.

Ngezinye izidakamizwa, noma ngabe inani elincane lamagilebhisi lingadala imiphumela emibi kakhulu. Ngakho-ke, inhlanganisela kufanele igwenywe.

Ikhemisi lakho lingamaka le mithi ngesexwayiso sokusebenzisana kwamagilebhisi.

Qiniseka ukuthi udokotela kanye nosokhemisi bayazi ukuthi uhlala udla izithelo zomvini. Bangakusiza unqume ukuthi kuphephile yini ukukudla ngenkathi usebenzisa imithi ethile.