Ukusebenzisana phakathi kwezidakamizwa nokudla: ukuthi kuyini nokuthi ungakugwema kanjani

-Delile

• 1. Izidakamizwa ezinomfutho wegazi ophezulu
• 2. Izidakamizwa
• 3. Izidakamizwa ezilwa nesigqi
• 4. Ama-anticoagulants omlomo
• 5. Ama-anti-hypercholesterolemics
• 6. Ama-antidiabetics omlomo
• 7. Imithi elwa namagciwane
• 8. Izidambisamagciwane
• 9. Ama-painkillers nama-anti-inflammatories
• 10. Ama-Bronchodilators
• 11. I-Levothyroxine
• 12. Ama-Antineoplastics
• 13. AmaBisphosphonates
• I-pH yesisu iyithinta kanjani imithi
• Okufanele ukwenze ngaphambi kokuqala noma imuphi umuthi

Ukudla ukudla neziphuzo ngezinhlobo ezithile zemithi kungathinta ukuthi le mithi isebenza kanjani, ibavimbele ekutheni babe nomphumela olindelekile noma bandise amathuba okubanga imiphumela emibi.

Kodwa-ke, akukhona konke ukuxhumana okukubi, ngoba eminye imishanguzo, lapho iphuzwa nokudla, ingahle ithuthukise ukumunca kwayo, okwandisa ukusebenza kokwelashwa.

Ngakho-ke, lapho uqala ukuthatha umuthi omusha noma ukwelashwa isikhathi eside, kubaluleke kakhulu ukulandela zonke izincomo zezokwelapha ukuze uthole ukwelashwa okuphephile nokusebenzayo, kufaka phakathi amathiphu wokudla.

Ukusebenzisana phakathi kwemithi nokudla kuncike esigabeni semithi esetshenzisiwe:

1. Izidakamizwa ezinomfutho wegazi ophezulu

Izidakamizwa ezinomfutho wegazi ophezulu yizona khambi ezisetshenziswa ukulawula umfutho wegazi ngoba ziyayekisa imithambo yegazi, zenza kube lula ukujikeleza kwegazi futhi zisize inhliziyo ukuthi yenze umzamo omncane wokumpompa.

Le mithi ingahlukaniswa ngezigaba ezi-3 futhi, kuya ngesigaba, udinga ukunakekelwa okuthile kokudla:

• I-Angiotensin-converting enzyme (ACE) inhibitors, njenge-captopril, i-enalapril, i-lisinopril noma i-ramipril: ukusetshenziswa ngokweqile kokudla nge-potassium kufanele kugwenywe, ngoba le mithi idala ukwanda kwalesi simbiwa egazini, okungaholela ekubonakaleni kwemiphumela emibi njengobuthakathaka bemisipha noma ukushaya kwenhliziyo okungajwayelekile . Endabeni ye-captopril, ikakhulukazi, kubalulekile futhi ukuthatha umuthi esiswini esingenalutho, ngoba ukudla kunciphisa ukumuncwa kwawo;
• Abavimbela i-Beta njengepropranolol, i-carvedilol ne-metoprolol: izithasiselo noma ukudla okunothe nge-calcium kufanele kugwenywe, ngoba le minerali inganciphisa ukusebenza kwale mithi. Okufanelekile ukuthatha umuthi amahora ama-2 ngemuva kokudla lokhu kudla noma izengezo. Endabeni yepropranolol noma i-metoprolol, kungakuhle ukuthi uthathe ithebhulethi noma ngokushesha ngemuva kokudla ukuze uthuthukise ukumuncwa nokusebenza ngempumelelo kokwelashwa;
• Ama-block block wesiteshi seCalcium njenge-nifedipine, i-amlodipine, i-nicardipine, i-verapamil ne-diltiazem: izithako zokudla noma ukudla okunothe nge-calcium kufanele kugwenywe, ngoba lokhu okumbiwa phansi kunciphisa ukusebenza kwala ma-antihypertensives.

Ngaphezu kwalokho, ujusi wamagilebhisi, owaziwa nangokuthi i- isithelo segilebhisi, kufanele kugwenywe ngesikhathi sokwelashwa ngezidakamizwa ezinomfutho wegazi ophezulu ngoba kunciphisa ukusebenza kwe-enzyme enesibopho sokwenza lezi zidakamizwa amandla, okungadala ukwanda kwemiphumela emibi noma ukudakwa.

2. Izidakamizwa

Ama-diuretics yizidakamizwa ezivame ukusetshenziselwa ukwelapha umfutho wegazi ophezulu, ukwehluleka kwenhliziyo noma ukuqongelela uketshezi futhi zisebenza ngokwandisa ukuqedwa kwamanzi ngomchamo.

Ezinye izindlela zokuphepha ezibalulekile kulabo abasebenzisa lezi zinhlobo zamakhambi yilezi:

• Sebenzisa izengezo zamaminerali: ikakhulukazi esimweni se-diuretics futhi esusa amaminerali abalulekile njenge-potassium, i-magnesium noma i-calcium. Lolu hlobo lokunezela kufanele lubhalwe ngudokotela;
• Thatha amahora angu-1 kuya kwangu-2 ngaphambi kokudla: ezinye izinto zokuchama, njenge-bumetanide, i-furosemide ne-hydrochlorothiazide, zingakhubazeka lapho zimunca ukudla;
• Gwema ukusebenzisa izitshalo zokwelapha: ezinye izitshalo zokwelapha ezifana ne-cascara engcwele, i-foxglove, i-hawthorn emhlophe, impande ye-dandelion, i-ginseng, i-mackerel, i-licorice, i-grape ursi, i-alder ne-St. John's wort, ingakhuphula ubungozi bemiphumela emibi ye-diuretics.

Ngaphezu kwalokho, ngesikhathi sokusebenzisa isisu, umuntu kufanele agweme ukusebenzisa i-licorice ngoba lokhu kudla kunganciphisa ukusebenza kokwelashwa.

3. Izidakamizwa ezilwa nesigqi

Izidakamizwa ze-antiarrhythmic zisetshenziselwa ukwelapha isifo senhliziyo njengokuhluleka kwenhliziyo noma i-arrhythmia, njengoba zisebenza ngokwandisa amandla okuqunjelwa inhliziyo. Kulesi sigaba semithi, okusetshenziswa kakhulu yi-digoxin.

I-Digoxin ine-index encane yokwelashwa, okungukuthi, ukuhluka okuncane kumthamo kungadala imiphumela emibi kakhulu. Ngakho-ke, ukuze ukwelashwa kuphephe, kufanele kulandelwe ezinye izinyathelo zokuqapha, ezinjengalezi:

• Gwema ukudla okunefayibha ephezulu, njenge-bran bran, i-oats, ilayisi elinsundu, i-broccoli noma izaqathe, ngokwesibonelo, njengoba zinciphisa ukumuncwa kwe-digoxin, kunciphisa umphumela wayo. Okufanele ukuthatha i-digoxin ihora eli-1 ngaphambi noma amahora amabili ngemuva kokudla bese ulandela isazi sokudla okunempilo esingakhombisa indlela engcono yokwehlisa ukungena kwakho kwe-fiber ngaphandle kokulimaza impilo yakho. Bheka uhlu lokudla okunothe ku-fiber okufanele kugwenywe ngokusetshenziswa kwe-digoxin;
• Gwema izithako zokudla nokudla okunevithamini D amaningingoba le vithamini ingakhuphula inani le-calcium egazini, okuholela ekwandeni kwemiphumela engemihle ye-digoxin, engadala ukudakwa ngezimpawu zokozela, ukudikibala, ukudideka, isicanucanu, ukuhlanza, isifo sohudo, ubuhlungu besisu, ukungaboni kahle noma ukushaya kwenhliziyo ngokungajwayelekile;
• Gwema ijusi lamagilebhisi noma isithelo segilebhisi, ngoba ijusi yalesi sithelo ingakhuphula ukuhlangana kwe-digoxin egazini futhi ibangele ukudakwa noma ukweqisa ngokweqile.

Ukusetshenziswa kwe-Digoxin kufanele kuhlolwe futhi kuhlolwe njalo ngudokotela wenhliziyo ukulungisa umthamo lapho kunesidingo, ukuhlola ukusebenza kokwelashwa nokugwema ukubonakala kwemiphumela emibi.

4. Ama-anticoagulants omlomo

Ama-anticoagulants omlomo, njenge-warfarin noma i-acenocoumarol, anciphisa inqubo yokuvala igazi, eyenza igazi libe uketshezi oluningi, anciphise ubungozi bezinkinga zenhliziyo ezifana nokushaywa unhlangothi, isifo senhliziyo noma i-thrombosis.

Le mithi, ikakhulukazi i-warfarin, isebenza ngokuvimbela uvithamini K, okuyi-vithamini enkulu ebamba iqhaza kwinqubo yokuvala igazi. Ngalesi sizathu, izidlo ezinothe kule vithamini zenza i-warfarin ingasebenzi kahle, igweme ukusetshenziswa kwezithako zokudla noma ukudla okunothe ku-vitamin K njenge-broccoli, iklabishi, i-kale, isipinashi, itheniphu namahlumela ama-brussels, ngokwesibonelo. Bheka uhlu olugcwele lokudla okunothe ku-vitamin K okufanele kugwenywe.

I-Warfarin ingathathwa ngesisu esigcwele noma esingenalutho, noma kunjalo, kufanele ugweme ukuyithatha ngejusi le-blueberry, eyaziwa nangokuthi i-Cranberry, noma impuphu i-Cranberry omiswe ngamaphilisi, ujusi wepomegranate, ijusi le-blackcurrant kanye namafutha embewu ye-blackcurrant, ngoba angakhuphula umphumela we-warfarin futhi andise nengozi yokopha noma ukuphuma kwegazi.

5. Ama-anti-hypercholesterolemics

Amakhambi we-anti-hypercholesterolemic, abizwa nangokuthi ama-statins, yizidakamizwa ezisebenza ngokunciphisa i-cholesterol embi ne-triglycerides yegazi, njenge-simvastatin, i-lovastatin, i-fluvastatin, i-pravastatin, i-rosuvastatin noma i-atorvastatin.

Ezinye izindlela zokuqapha ezibalulekile uma usebenzisa lolu hlobo lomuthi yilezi:

• Thatha ebusuku, ngoba ukuhlanganiswa kwe-cholesterol ngumzimba kuyahluka emini, kufinyelela phezulu kakhulu phakathi kwamabili kuya ku-5 noma ngo-6 ekuseni;
• Gwema ukudla okunothe ku-fiber noma i-pectin, njengoba zingaphazamisa ukumuncwa kwama-statins;
• Gwema ukuphuza ujusi wamagilebhisi noma isithelo segilebhisi ikakhulukazi uma usebenzisa i-atorvastatin, i-lovastatin noma i-simvastatin, njengoba le jusi inyusa amazinga ale mithi egazini kanye nengozi yemiphumela emibi efana nobuhlungu bemisipha, ubuthakathaka obedlulele, umkhuhlane, umkhuhlane noma umchamo onombala omnyama.

Ezinye izitatimende ezifana ne-fluvastatin, i-pravastatin ne-rosuvastatin azihlangani nejusi lamagilebhisi futhi zinengozi encane yemiphumela emibi.

6. Ama-antidiabetics omlomo

Ama-antidiabetics omlomo, njenge-metformin, i-glimepiride, i-acarbose noma i-glipizide, asebenza ngokwehlisa amazinga kashukela egazini ukulawula isifo sikashukela futhi ngaleyo ndlela kuvimbele izinkinga zesifo.

I-Metformin, i-glimepiride noma i-glibenclamide, i-acarbose kufanele ithathwe ngokushesha ekuqaleni kokudla okufana nebhulakufesi noma isidlo sokuqala sosuku, isibonelo. I-glipizide ekhishwa ngokushesha, i-glimepiride, i-glibenclamide noma i-gliclazide kufanele inikezwe imizuzu engama-30 ngaphambi kokudla ukuze kutholakale ukwelashwa okungcono.

7. Imithi elwa namagciwane

Ama-antibiotic yimithi esetshenziselwa ukwelapha izifo ezibangelwa amagciwane futhi isebenza ngokuvimbela ukwanda noma ukubulala amabhaktheriya abangele lesi sifo.

Uma usebenzisa i-antibiotic, kubalulekile ukuthi uhlale uyiphuza ngengilazi yamanzi, ngoba imikhiqizo yobisi efana nobisi nemikhiqizo yobisi iqukethe amaminerali, njenge-calcium ne-magnesium, evimbela ukumuncwa kwayo, inqume umphumela wayo. Ngaphezu kwalokho, izithasiselo eziqukethe amaminerali akufanele zithathwe ngasikhathi sinye nokuphuza ama-antibiotic, okungenani amahora amabili phakathi kwe-antibiotic kanye ne-supplement.

Ezinye izindlela zokuphepha ezinama-antibiotic athile zifaka:

• I-Ciprofloxacino: gwema ukuwuthatha ngejusi yezithelo, ngoba kunciphisa ukumuncwa kwaleli antibiotic, futhi kufanele ulinde amahora ama-2 phakathi kokufaka umuthi nokudla uhlobo oluthile lwejusi yezithelo;
• I-Azithromycin: kufanele ithathwe esiswini esingenalutho, njengoba ukudla kunciphisa ukumuncwa kwayo. Okufanelekile ukuthatha lo muthi ihora eli-1 ngaphambi noma amahora amabili ngemuva kokudla;
• I-Tetracycline, i-doxycycline noma i-minocycline: kumele zithathwe ngesisu esingenalutho ukwenza ngcono ukumuncwa kwazo, ngakho-ke, kufanele kudlule okungenani amahora ama-2 phakathi kokudla kanye nomthamo we-antibiotic;
• Ama-penicillin, afana ne-amoxicillin noma i-ampicillin: kufanele ithathwe ekuqaleni kwesidlo esilula ukunciphisa ukucasuka kwesisu. Kodwa-ke, gwema ukudla ukudla okunjengobisi nemikhiqizo yobisi kanye nalawa ma-antibiotic;
• I-Erythromycin: kufanele idliwe esiswini esingenalutho njengoba ukudla kunciphisa ukumuncwa kwaleli antibiotic. Okufanelekile, thatha lo muthi imizuzu engama-30 ngaphambi noma amahora amabili ngemuva kokudla.

Kubalulekile futhi ukugwema ukuphuza iziphuzo ezidakayo ngesikhathi sokwelashwa nganoma yiluphi uhlobo lwama-antibiotic, ngoba utshwala bungalimaza isibindi futhi buphazamise imetabolism yama-antibiotic, okudala ukwehla komphumela, ukudakwa noma ukwanda kwemiphumela emibi.

8. Izidambisamagciwane

Ama-anti-depressants yizidakamizwa ezisetshenziselwa ukwelapha ukudangala, ukukhathazeka, i-schizophrenia, ukungasebenzi kahle noma ukuphazamiseka kokulala, ngokwesibonelo.

Kunezinhlobo eziningi ze-anti-depressants, kepha phakathi kwazo, kunesigaba esidinga ukunakekelwa okuqondile kokudla. Lesi sigaba sibizwa ngokuthi yi-monoaminoxidase inhibitors futhi sifaka phakathi i-amitriptyline, clomipramine, imipramine, phenelzine, tranylcypromine, isocarboxazide noma selegiline. Le mithi ingasebenzisana nokudla okuqukethe i-tyramine futhi ibangele inkinga yomfutho wegazi ophakeme onezimpawu zokuba nesiyezi, ukukhiqizwa kwezithukuthuku okwandisiwe, ukukhathala ngokweqile, ukungaboni kahle, ukwethuka, ukukhathazeka, ikhanda elibuhlungu nobuhlungu entanyeni.

I-Tyramine ingatholakala ikakhulukazi ekudleni okuvutshiwe noma ekudleni okudala okufana noshizi ophulukisiwe, ubhekeni, amasoseji, i-salami, i-ham, isipinashi, iklabishi, i-soy sauce, ubhiya newayini, isibonelo. Lokhu kudla kufanele kugwenywe ngesikhathi sokwelashwa nge-monoamine oxidase inhibitors.

9. Ama-painkillers nama-anti-inflammatories

Ama-painkillers nemithi elwa nokuvuvukala isetshenziselwa ukwelapha ubuhlungu obumaphakathi kuya kokulingene nomkhuhlane futhi ingaxhumana nokudla okuthile:

• I-Paracetamol: kufanele idliwe esiswini esingenalutho ngoba ukudla, ikakhulukazi lokho okuqukethe i-pectin, kunganciphisa ukumuncwa kwayo, kunciphise ukusebenza kwayo. Ngaphezu kwalokho, umuntu kufanele agweme ukuphuza iziphuzo ezidakayo ngoba zingadala ubuthi besibindi futhi zenze ukubonakala kwesifo sokuqina kwesibindi noma isifo sokusha kwesibindi. Bheka uhlu lokudla okunothe nge-pectin okufanele kugwenywe.
• I-Acetylsalicylic acid, ibuprofen, naproxen ne-ketoprofen: kufanele ithathwe ngokudla ukugwema ukucasuka kwesisu.

Ngaphezu kwalokho, ezinye izitshalo zokwelapha ezifana ne-St. John's wort noma i-ginkgo biloba kufanele zigwenywe lapho kusetshenziswa ama-anti-inflammatories, ngoba angandisa ubungozi bokucasuka noma ukuphuma kwegazi esiswini.

10. Ama-Bronchodilators

Ama-bronchodilators yimithi esetshenziselwa ukwelapha nokuvimbela ukuhlaselwa kubantu abanezinkinga zokuphefumula ezifana nesifuba somoya, i-bronchitis engamahlalakhona, i-emphysema noma isifo esingapheliyo sokuphefumula.

Ezinye izindlela zokuqapha ezibalulekile ngokudla, ikakhulukazi uma usebenzisa ama-bronchodilators isikhathi eside, yilezi:

• Gwema ngesitshalo somuthi se-foxglove ngoba ingakhuphula imiphumela emibi ye-bronchodilators noma ibangele ukudakwa;
• Gwema ukusetshenziswa kokudla neziphuzo eziqukethe i-caffeine, njengekhofi, itiye eliluhlaza, itiye elimnyama, ushokoledi, iziphuzo ezibandayo noma iziphuzo ezinamandla, ngoba zingakhuphula ubungozi bemiphumela emibi, njengokuxokozela, ukwethuka noma ukushaya kwenhliziyo okusheshayo;
• Gwema ukuphuza utshwala, ikakhulu ekusetshenzisweni kwe-theophylline ngoba utshwala bungakhuphula ubungozi bemiphumela engemihle, njengokucanuzela kwenhliziyo, ukugabha, ikhanda elibuhlungu noma ukucasuka.

Amanye ama-bronchodilators, ikakhulukazi i-salbutamol ne-theophylline, uma esetshenziselwa isikhathi eside, angadala ukulahleka okwengeziwe kwamaminerali afana ne-calcium, i-magnesium ne-potassium ngakho-ke, ukusetshenziswa kwezithasiselo ezikhonjiswe ngudokotela kungadingeka.

11. I-Levothyroxine

I-Levothyroxine iyi-hormone yokwenziwa yegilo esetshenziselwa ukwelapha i-hypothyroidism noma lapho kunokushoda kwaleli hormone egazini.

Lo muthi kufanele uphuzwe esiswini esingenalutho, njengoba ukudla kunciphisa ukumuncwa kwawo, kunciphisa ukusebenza kwawo kahle. Ngakho-ke, kunconywa ukuthatha i-levothyroxine ekuseni esiswini esingenalutho, okungenani imizuzu engama-30 kuya kwengu-60 ngaphambi kokudla kwasekuseni.

12. Ama-Antineoplastics

Ama-antineoplastic agents yizidakamizwa ezisetshenziswa ekwelapheni umdlavuza futhi amandla abo angancishiswa uma ethathwa nokunye ukudla. Ezinye izibonelo yilezi:

• Tamoxifen: umuntu kufanele agweme ukudla ukudla nemikhiqizo nge-soy njengoba kunciphisa isenzo se-tamoxifen, kunciphisa ukusebenza kwayo ekwelapheni umdlavuza webele;
• I-Mercaptopurine: kufanele iphuzwe esiswini esingenalutho futhi ihlale inengilazi yamanzi, ingalokothi ibe nobisi. Ukudla kunciphisa ukumuncwa kwayo, kunciphisa ukusebenza kahle kokwelashwa kwe-leukemia. Okufanelekile ukuthatha lo muthi ihora eli-1 ngaphambi noma amahora amabili ngemuva kokudla;
• I-Capecitabine: kufanele ithathwe kungakapheli imizuzu engama-30 ngemuva kokudla, njengoba ukudla kuthuthukisa ukumuncwa kwayo, okwandisa ukusebenza kahle kokwelashwa komdlavuza webele, wamathumbu noma wesisu.

Lapho uqala ukwelashwa komdlavuza, i-oncologist noma i-oncology pharmacist kufanele yeluleke ngokusebenzisana kwama-antineoplastic agents ngokudla ngakunye, ngokusho komuthi nohlobo lokwelashwa.

13. AmaBisphosphonates

Ama-bisphosphonates yizidakamizwa ezisetshenziselwa ukuvimbela nokwelashwa kwezifo ezahlukahlukene zamathambo, njenge-osteoporosis, umdlavuza onethambo le-metastasis, ukwanda kwe-calcium egazini noma i-myeloma eminingi.

Le mithi kufanele iphuzwe esiswini esingenalutho, okungenani imizuzu engama-30 ngaphambi kokudla, njengoba ukutholakala kokudla emgodini wamathumbu kunciphisa ukumuncwa futhi kunciphise ukusebenza kahle kokwelashwa.

I-pH yesisu iyithinta kanjani imithi

Eminye imishanguzo incike ku-pH yesisu ukuze isebenze kahle, njenge-omeprazole noma i-esomeprazole, ngokwesibonelo, edinga i-acid esiswini ukuthi isebenze futhi isebenze, futhi kufanele iphuzwe esiswini esingenalutho.

Esinye isibonelo esihle ngama-antifungal, njenge-ketoconazole, esebenza kahle kakhulu uma kune-pH ene-asidi esiswini. Kulokhu, kunganconywa ukuthi ukhethe ukuthatha umuthi ngemuva kokudla ngokudla okune-asidi, njengeqanda, ushizi noma inhlanzi. Ngaphezu kwalokho, kunconywa ukuthi ugweme ukusebenzisa amakhambi we-antacid, ngokwesibonelo.

Ngokunjalo, ama-probiotic nawo asebenza kahle kakhulu lapho kunendawo ene-asidi ethe xaxa esiswini. Ngakho-ke, icebo elihle ukuthatha i-probiotic ngemuva kokudla okuncane, okufana nesiphuzo sasekuseni, okungcono okuqukethe ukudla okhuthaza i-acidity elinganiselwe, njengobisi noma iyogathi. Bona uhlu oluphelele lokudla okuyinhloko okune-acid.

Ezimweni lapho umuthi unganciphisa isenzo sawo nge-asidi yesisu noma okungadala ukucasuka esiswini, ithebhulethi noma i-capsule ingaba nokumboza, okubizwa ngokuthi i-enteric coating, ukuze umuthi ungene ngqo emathunjini, uvikele ukusebenza okunciphise nohlangothi imiphumela efana nesilungulela, umuzwa ovuthayo noma ubuhlungu besisu, isibonelo.

Okufanele ukwenze ngaphambi kokuqala noma imuphi umuthi

Ezinye izincomo ezibalulekile lapho uqala ukusebenzisa imithi zifaka:

• Njalo thatha imithi ngengilazi yamanzi, ugweme amajusi noma ubisi;
• Buza udokotela noma usokhemisi mayelana nokudla okungadliwa noma okungadliwa ngesikhathi sokwelashwa;
• Ngaso sonke isikhathi landela imihlahlandlela yezokwelapha maqondana namashejuli emithi nokuthi imithi kufanele iphuzwe esiswini esigcwele noma esingenalutho;
• Tshela udokotela wakho ngokushesha uma uba nemiphumela engemihle.

Ngaphezu kwalokho, kubalulekile ukwazisa udokotela ngayo yonke imithi, izitshalo zokwelapha noma izithako zokudla ezisetshenziselwa ukugwema ukukhulisa noma ukunciphisa ukusebenza komuthi.