I-Nexium vs. Prilosec: Ukwelashwa Okubili kwe-GERD

-Delile

• Kungani ama-PPI esebenza
• Kungani zibekiwe
• Umehluko
• Ukusebenza ngempumelelo
• Intengo yokusiza
• Okuqhamuka uma udla imishanguzo
• Izexwayiso nokuxhumana
• Izici zobungozi
• Ukusebenzisana kwezidakamizwa
• Ukuthatha

Sifaka imikhiqizo esicabanga ukuthi ilusizo kubafundi bethu. Uma uthenga ngezixhumanisi ezikuleli khasi, singathola ikhomishini encane. Nansi inqubo yethu.

Ukuqonda izinketho zakho

Isilungulela sinzima ngokwanele. Ukwenza ukuqonda kokukhetha kwakho kwemithi yesifo se-reflux se-gastroesophageal (GERD) kungakwenza kube nzima kakhulu.

Okubili kwama-proton pump inhibitors (PPIs) anqunyiwe kakhulu yi-omeprazole (Prilosec) ne-esomeprazole (Nexium). Kokubili manje sekutholakala njengezidakamizwa ezingaphezu kwe-the-counter (OTC).

Bheka ngokucophelela kokubili ukuze ubone ukuthi yiziphi izinzuzo umuthi ongazinikeza ngaphezu komunye.

Kungani ama-PPI esebenza

Amaphampu e-Proton angama-enzyme atholakala kumaseli weparietal wesisu sakho. Benza i-hydrochloric acid, isithako esiyinhloko se-asidi esiswini.

Umzimba wakho udinga i-asidi esiswini ukuze ugaye. Kodwa-ke, lapho umsipha ophakathi kwesisu sakho nomphimbo ungavali kahle, le asidi ingagcina isisesigodini sakho. Lokhu kubangela umuzwa oshisayo esifubeni nasemphinjeni ohlotshaniswa ne-GERD.

Kungadala futhi:

• isifuba somoya
• ukukhwehlela
• inyumoniya

Ama-PPI anciphisa inani le-asidi elenziwa amaphampu e-proton. Zisebenza kahle kakhulu uma uzithatha ihora ukuya emizuzwini engama-30 ngaphambi kokudla. Uzodinga ukuwathatha izinsuku ezimbalwa ngaphambi kokuthi asebenze ngokugcwele.

Ama-PPI abelokhu esetshenziswa kusukela ngo-1981. Athathwa njengemithi ephumelela kunazo zonke yokwehlisa i-asidi esiswini.

Kungani zibekiwe

Ama-PPIs afana ne-Nexium ne-Prilosec asetshenziselwa ukwelapha izimo ezihlobene nesisu esiswini, kufaka phakathi:

• IGERD
• isilungulela
• i-esophagitis, okuwukuvuvukala noma ukuguguleka komphimbo
• izilonda zesisu nezesisu, ezibangelwa I-Helicobacter pylori (H. pyloriukutheleleka noma izidakamizwa ezingezona ukuvuvukala (ama-NSAID)
• I-Zollinger-Ellison syndrome, okuyisifo lapho izimila zibanga khona ukukhiqizwa kwesisu esineqile

Umehluko

I-Omeprazole (Prilosec) ne-esomeprazole (Nexium) yimithi efanayo. Kodwa-ke, kunomehluko omncane ekwakhekeni kwamakhemikhali abo.

I-Prilosec iqukethe ama-isomers amabili omuthi i-omeprazole, kanti i-Nexium iqukethe isomer eyodwa kuphela.

Isomer yigama le-molecule elibandakanya amakhemikhali afanayo, kepha lihlelwe ngendlela ehlukile. Ngakho-ke, ungasho ukuthi i-omeprazole ne-esomeprazole zakhiwe ngamabhulokhi afanayo wokwakha, kodwa zihlanganiswe ngokuhlukile.

Yize umehluko kuma-isomers kungabonakala kukuncane, kungaholela kokwehluka ekusebenzeni kwezidakamizwa.

Isibonelo, i-isomer eku-Nexium icutshungulwa kancane kune-Prilosec emzimbeni wakho. Lokhu kusho ukuthi amazinga omuthi aphezulu egazini lakho, nokuthi i-esomeprazole inganciphisa ukukhiqizwa kwe-asidi isikhathi eside.

Kungasebenza futhi ngokushesha okukhulu ukwelapha izimpawu zakho uma kuqhathaniswa ne-omeprazole. I-Esomeprazole ibuye yehliswe ngokuhlukile yisibindi sakho, ngakho-ke kungaholela ekuhlanganyeleni kwezidakamizwa okumbalwa kune-omeprazole.

Ukusebenza ngempumelelo

Olunye ucwaningo lukhombisa ukuthi umehluko phakathi kwe-omeprazole ne-esomeprazole unganikeza izinzuzo ezithile kubantu abanezimo ezithile.

Ucwaningo oludala olusuka ku-2002 luthole ukuthi i-esomeprazole inikeze ukulawula okusebenzayo kwe-GERD kune-omeprazole ngamanani afanayo.

Ngokuya kocwaningo lwakamuva ngo-2009, i-esomeprazole yanikela ngokukhululeka ngokushesha kune-omeprazole evikini lokuqala lokusetshenziswa. Ngemuva kwesonto elilodwa, ukukhululeka kwezimpawu bekufana.

Kodwa-ke, ku-athikili ka-2007 ku-American Family Physician, odokotela babuza lezi nezinye izifundo kuma-PPIs. Bacaphuna ukukhathazeka okufana nalokhu:

• umehluko enanini lezithako ezisebenzayo ezinikezwe ezifundweni
• ubukhulu bezifundo
• izindlela zokwelashwa ezisetshenziselwa ukukala ukusebenza kahle

Ababhali bahlaziye izifundo ezingama-41 ngokusebenza kwama-PPIs. Baphethe ngokuthi kunomehluko omncane ekusebenzeni kwama-PPI.

Ngakho-ke, ngenkathi kunemininingwane ethile ephakamisa ukuthi i-esomeprazole isebenza kangcono ekunciphiseni izimpawu, iningi lochwepheshe liyavuma ukuthi ama-PPI anemiphumela efanayo jikelele.

I-American College of Gastroenterology ithi akukho mehluko omkhulu ekusebenzeni kahle kwe-PPIs ekwelapheni i-GERD.

Intengo yokusiza

Umehluko omkhulu phakathi kweProlosec neNexium kwakuyintengo lapho ibuyekezwa.

Kuze kube ngoMashi 2014, i-Nexium ibitholakala kuphela ngemithi kadokotela nangentengo ephakeme kakhulu. INexium manje inikela ngomkhiqizo ongaphezu kwamanani (OTC) onentengo ngokuncintisana ne-Prilosec OTC. Kodwa-ke, i-omeprazole ejwayelekile ingabiza kakhulu kune-Prilosec OTC.

Ngokwesiko, izinkampani zomshuwalense azizange zihlanganise imikhiqizo ye-OTC. Kodwa-ke, imakethe ye-PPI iholele abaningi ekutheni babuyekeze ukumbozwa kwabo kwe-Prilosec OTC neNexium OTC. Uma umshwalense wakho ungabandakanyi ama-OTC PPIs, incwadi kadokotela ye-omeprazole ejwayelekile noma i-esomeprazole ingaba yindlela yakho engcono kakhulu.

I-Nexium kwesinye isikhathi ibizwa ngomuthi "nami futhi" ngoba ifana kakhulu ne-Prilosec, umuthi okhona. Abanye abantu bacabanga ukuthi izidakamizwa “nami” ziyindlela nje yokuthi izinkampani ezidayisa izidakamizwa zenze imali ngokukopela izidakamizwa esezikhona. Kodwa abanye baphikise ngokuthi "nami" izidakamizwa zinganciphisa izindleko zezidakamizwa, ngoba zikhuthaza ukuncintisana phakathi kwezinkampani ezidla izidakamizwa.

Sebenza nodokotela wakho noma usokhemisi ukunquma ukuthi iyiphi i-PPI ekulungele. Ngaphezu kwezindleko, cabanga ngezinto ezifana:

• okuqhamuka uma udla imishanguzo
• ezinye izimo zezokwelapha
• eminye imithi oyiphuzayo

Okuqhamuka uma udla imishanguzo

Iningi labantu alinayo imiphumela emibi evela kuma-PPIs. Imvamisa, abantu bangathola:

• isifo sohudo
• isicanucanu
• ukuhlanza
• ikhanda

Le miphumela emibi kungenzeka kakhulu nge-esomeprazole kune-omeprazole.

Kukholakala nokuthi womabili la ma-PPI anganyusa ubungozi boku:

• umgogodla kanye nokuphuka kwesandla kwabesifazane be-postmenopausal, ikakhulukazi uma imithi ithathwa unyaka noma ngaphezulu noma ngemithamo ephakeme
• ukuvuvukala kwamagciwane koloni, ikakhulukazi ngemuva kokulaliswa esibhedlela
• inyumoniya
• ukuntuleka kokudla okunempilo, kufaka phakathi i-vitamin B-12 kanye nokushoda kwe-magnesium

Isixhumanisi sengozi yokuwohloka komqondo sabikwa ngo-2016, kodwa isifundo esikhulu sokuqinisekisa ngo-2017 sanquma ukuthi abukho ubungozi obuningi bokuwohloka komqondo ekusebenziseni ama-PPIs.

Abantu abaningi bathola ukukhiqizwa kwe-asidi ngokweqile lapho beyeka ukusebenzisa ama-PPIs. Kodwa-ke, kungani lokhu kwenzeka akuqondakali ngokuphelele.

Ezindabeni eziningi ze-asidi esiswini, kunconywa ukuthi uthathe ama-PPIs isikhathi esingaphezu kwamasonto amane kuya kwayisishiyagalombili ngaphandle kokuthi udokotela wakho anqume ukuthi isikhathi eside sokwelapha siyadingeka.

Ekupheleni kwesikhathi sokwelapha okunconyiwe, kufanele ususe kancane kancane emithini. Sebenza nodokotela wakho ukwenza kanjalo.

Izexwayiso nokuxhumana

Ngaphambi kokuthatha noma imuphi umuthi, khuluma nodokotela wakho ukuze ufunde ngezinto ezinobungozi nokuhlangana kwezidakamizwa okuhambisana nakho.

Izici zobungozi

• bangabokudabuka e-Asia, njengoba umzimba wakho ungathatha isikhathi eside ukucubungula ama-PPIs futhi ungadinga umthamo ohlukile
• unesifo sesibindi
• babe namazinga aphansi we-magnesium
• ukhulelwe noma uhlela ukukhulelwa
• ziyancelisa

Ukusebenzisana kwezidakamizwa

Njalo utshele udokotela wakho ngazo zonke izidakamizwa, amakhambi, namavithamini owaphuzayo. I-Prilosec ne-Nexium ingaxhumana neminye imithi okungenzeka uyayiphuza.

I-U.S. Food and Drug Administration (FDA) ikhiphe isexwayiso sokuthi umuthi osePrilosec wehlisa ukusebenza kwegazi elincanyana le-clopidogrel (Plavix).

Akufanele uthathe le mithi emibili ndawonye. Amanye ama-PPI awafakiwe esixwayisweni ngoba awakahlolwa lesi senzo.

Le mithi akufanele ithathwe nge-Nexium noma i-Prilosec:

• clopidogrel
• dokuzi
• umagazine
• phumlani
• umabhebhana
• isihle
• Isibungu iSt

Eminye imishanguzo ingaxhumana ne-Nexium noma i-Prilosec, kepha isengathathwa noma yimuphi umuthi. Tshela udokotela wakho uma uthatha noma iyiphi yalezi zidakamizwa ukuze bakwazi ukuhlola ubungozi bakho:

• amphetamine
• umabhebhana
• atazanavir
• ama-bisphosphonates
• busentan
• isithombe
• I-cilostazol
• ubathe
• i-clozapine
• cyclosporine
• dextroamphetamine
• esitalopramu
• imishanguzo yokulwa nobungozi
• fosphenytoin
• insimbi
• i-hydrocodone
• mesalamine
• imethotrexate
• imethylphenidate
• mthombeni
• busisiwe
• sphiwe
• tacrolimus
• warfarin noma abanye abaphikisana novithamini K
• voriconazole

Ukuthatha

Ngokuvamile, ungakhetha i-PPI etholakala kalula futhi ibiza kancane. Kepha khumbula ukuthi ama-PPI alapha kuphela izimpawu ze-GERD nezinye izifo. Abayiphathi imbangela futhi baboniswa kuphela ukusetshenziswa kwesikhashana ngaphandle kokuthi udokotela wakho anqume ngenye indlela.

Izinguquko zendlela yokuphila kufanele zibe yizinyathelo zakho zokuqala ekulawuleni i-GERD nesilungulela. Ungahle uthande ukuzama:

• ukuphathwa kwesisindo
• ukugwema ukudla okukhulu ngaphambi kokulala
• ukuyeka noma ukuyeka ukusebenzisa ugwayi, uma uyisebenzisa

Ngokuhamba kwesikhathi, i-GERD yesikhathi eside ingaholela kumdlavuza we-esophageal. Yize bambalwa abantu abane-GERD abathola umdlavuza wokuqopha, kubalulekile ukuthi wazi ingozi.

Ama-PPI aqala ukusebenza kancane, ngakho-ke kungenzeka angabi yimpendulo yesilungulela noma i-reflux ngezikhathi ezithile.

Ezinye izindlela zinganikeza ukukhululeka kokusetshenziswa kwesinye isikhathi, okufana:

• amaphilisi e-calcium carbonate angahlafunwayo
• iziphuzo ezifana ne-aluminium hydroxide ne-magnesium hydroxide (Maalox) noma i-aluminium / i-magnesium / i-simethicone (i-Mylanta)
• izidakamizwa zokunciphisa i-asidi njenge-famotidine (Pepcid) noma i-cimetidine (Tagamet)

Konke lokhu kuyatholakala njengezidakamizwa ze-OTC.