Ukwelashwa Kwe-osteoporosis

-Delile

• I-osteoporosis
• Izimbangela nezici zobungozi
• Imithi yokwelashwa kwamathambo
• AmaBisphosphonates
• I-Antibody
• I-Denosumab
• URomosozumab
• Imithi ehlobene neHormone
• Ama-modulators we-estrogen receptor akhethiwe (ama-SERM)
• I-Calcitonin
• Ama-hormone e-Parathyroid (PTHs)
• Ukwelashwa kweHormone
• I-calcium nevithamini D
• Umsebenzi womzimba
• Umbono

Amaqiniso asheshayo

1. I-osteoporosis yisimo lapho amathambo akho ehla ngokushesha kunokuba akha kabusha.
2. Ukwelashwa kuvame ukufaka inhlanganisela yemithi nezinguquko zendlela yokuphila.
3. Indlela enobudlova yokuvimbela ukulahleka kwamathambo okungeziwe ukuthatha imithi kadokotela.

I-osteoporosis

Amathambo emzimbeni wakho yizicubu eziphilayo ezihlala ziwohloka futhi zizishintshe ngezinto ezintsha. Nge-osteoporosis, amathambo akho aphuka ngokushesha kunokuba ebuyela emuva. Lokhu kubenza ukuthi bangabi mnandi kakhulu, bavuleke kakhudlwana, futhi babe brittle.

Lokhu kwenza amathambo akho abe buthakathaka futhi kungaholela ekuqhekekeni nakumakhefu amaningi.

Alikho ikhambi le-osteoporosis, kodwa kunezindlela zokwelapha ezisiza ukuyivimbela nokwelapha uma isitholakele. Inhloso yokwelashwa ukuvikela nokuqinisa amathambo akho.

Ukwelashwa kuvame ukufaka inhlanganisela yemithi kanye nezinguquko zendlela yokuphila ukusiza ukwehlisa izinga lokonakala kwamathambo ngomzimba wakho, futhi kwezinye izimo, ukwakha kabusha ithambo.

Izimbangela nezici zobungozi

Abantu abaningi banesisindo sabo esikhulu kakhulu samathambo nokuxinana lapho beseminyakeni yabo yama-20. Njengoba ukhula, ulahlekelwa yithambo elidala ngesilinganiso esisheshayo kunokuba umzimba wakho ungangena esikhundleni salo. Ngenxa yalokhu, abantu asebekhulile basengozini enkulu yokwelashwa kwamathambo.

Abesifazane nabo basengozini enkulu yokuthola i-osteoporosis ngoba banamathambo amancane kunamadoda. I-Estrogen, i-hormone evela emazingeni aphezulu kwabesifazane kunabesilisa, isiza ukuvikela amathambo.

Abesifazane abaya esikhathini sokuya esikhathini babhekana nokwehla kwamazinga e-estrogen, okuholela ekuqhekekeni kwamathambo okusheshayo futhi kungaholela emathanjeni aqhekekile.

Ezinye izinto ezinobungozi zifaka:

• ukubhema
• imishanguzo ethile, efana ne-steroids, i-proton pump inhibitors, nemithi ethile yokubanjwa
• ukungondleki
• izifo ezithile, njenge-rheumatoid arthritis (RA) kanye ne-myeloma eminingi

Imithi yokwelashwa kwamathambo

Indlela enobudlova yokuvimbela ukulahleka kwamathambo okungeziwe ukuthatha imishanguzo kadokotela, njengemithi ebalwe ngezansi.

AmaBisphosphonates

Ama-bisphosphonates yizindlela zokwelashwa kwamathambo ezivame kakhulu. Ngokuvamile yizindlela zokwelashwa zokuqala ezinconyelwe abesifazane abane-postmenopausal.

Izibonelo zama-bisphosphonate zifaka:

• i-alendronate (Fosamax), imithi yomlomo abantu abayiphuzayo nsuku zonke noma kanye ngeviki
• ibandronate (Boniva), itholakala njengethebhulethi yomlomo nyangazonke noma njengomjovo wokujova owuthola kane ngonyaka
• i-risedronate (Actonel), etholakala nsuku zonke, ngeviki, noma ngemithamo yanyanga zonke kuthebhulethi yomlomo
• i-zoledronic acid (Reclast), itholakala njengokufakwa okufaka emthanjeni okuthola kanye njalo eminyakeni eyodwa noma emibili

I-Antibody

Kunemithi emibili elwa namagciwane emakethe.

I-Denosumab

I-Denosumab (Prolia) ixhumene neprotheyini emzimbeni wakho ebandakanyeka ekuwohlokeni kwamathambo. Ibambezela inqubo yokonakala kwamathambo. Kuyasiza nokugcina ukuminyana kwamathambo.

IDenosumab iza njengomjovo owuthola njalo ezinyangeni eziyisithupha.

URomosozumab

I-antibody romosozumab entsha (Ubusuku) isiza ukukhulisa ukwakheka kwamathambo. Kwavunywa yi-Food and Drug Administration (i-FDA) ngo-Ephreli ka-2019. Yenzelwe abesifazane abangemva kokuya esikhathini nabanobungozi obukhulu bokuqhekeka. Lokhu kufaka phakathi abesifazane abenza lokhu:

• banezici eziyingozi zokuphuka
• unomlando wokwephuka
• ungaphendulanga noma awukwazi ukuthatha ezinye izidakamizwa ze-osteoporosis

URomosozumab uza njengemijovo emibili. Ubathola kanye ngenyanga izinyanga ezifika kwezili-12.

I-Romosozumab iza nezixwayiso ezibhokisi, okuyizixwayiso ezibucayi kakhulu ze-FDA. Kungakhuphula ubungozi bokuhlaselwa yisifo senhliziyo, isifo sohlangothi nesifo senhliziyo. Akufanele uthathe i-romosozumab uma uke wahlaselwa yisifo senhliziyo noma isifo sohlangothi phakathi nonyaka odlule.

Imithi ehlobene neHormone

Imithi eminingana enemiphumela efana ne-hormone ingabekwa ukwelapha i-osteoporosis.

Ama-modulators we-estrogen receptor akhethiwe (ama-SERM)

Ama-modulators we-estrogen receptor modulators (ama-SERMs) enza imiphumela egcina amathambo ye-estrogen.

URaloxifene (Evista) wuhlobo olulodwa lwe-SERM. Itholakala njengethebhulethi yomlomo yansuku zonke.

I-Calcitonin

I-Calcitonin iyi-hormone eyenziwa yindlala yegilo. Kuyasiza ukulawula amazinga e-calcium emzimbeni.

Odokotela basebenzisa i-synthetic calcitonin (i-Fortical, i-Miacalcin) ukwelapha i-spinal osteoporosis kwabesifazane abathile abangakwazi ukuthatha ama-bisphosphonates.

I-off-label esetshenzisiwe, i-calcitonin nayo inganciphisa ubuhlungu kwabanye abantu abane-fractional compression fractures. ICalcitonin itholakala ngomuthi wamakhala noma ngomjovo.

Ama-hormone e-Parathyroid (PTHs)

Ama-hormone e-Parathyroid (PTHs) alawula amazinga e-calcium ne-phosphate emzimbeni wakho. Ukwelashwa nge-PTH yokwenziwa kungakhuthaza ukukhula kwamathambo okusha.

Izinketho ezimbili zifaka:

• i-teriparatide (Forteo)
• i-abaloparatide (Tymlos)

I-Teriparatide iyatholakala njengomjovo wokuzilawula wansuku zonke. Kodwa-ke, lo muthi uyabiza futhi imvamisa ubekelwe abantu abane-osteoporosis enamandla abangakubekezeleli kahle okunye ukwelashwa.

I-Abaloparatide kungenye yokwelashwa kwe-PTH okwenziwe okwavunywa ngo-2017. Njenge-teriparatide, lo muthi utholakala njengomjovo ozisebenzelayo nsuku zonke. Kodwa-ke, futhi kuyabiza futhi kuvamise ukusetshenziselwa abantu abane-osteoporosis enzima lapho ezinye izindlela zokwelapha zingenzindlela ezinhle.

Ukwelashwa kweHormone

Kwabesifazane abase ukunqamuka kokuya esikhathini, ukwelashwa kwama-hormone - okubizwa nangokuthi i-hormone replacement therapy - kuyindlela yokwelashwa. Kepha imvamisa, odokotela abayisebenzisi njengendlela yokuqala yokuvikela ngoba ingakhuphula ubungozi be:

• unhlangothi
• isifo senhliziyo
• umdlavuza webele
• amahlule egazi

Ukwelashwa kweHormone kuvunyelwe ukusetshenziswa ekuvimbeleni i-osteoporosis, kepha futhi kungasetshenziswa ngaphandle kwelebuli ekwelashweni kwayo.

Ukwelashwa kweHormone kungafaka i-estrogen yodwa, noma i-estrogen ihlanganiswe neprogesterone. Kuza njengethebhulethi yomlomo, isichibi sesikhumba, umjovo nokhilimu. Amaphilisi namachashazi asetshenziswa kakhulu.

Kuthathwa nsuku zonke, amaphilisi afaka:

• Ngaphambi
• Menest
• I-Estrace

Kusetshenziswa kanye noma kabili ngesonto, ama-patches afaka:

• Climara
• IVivelle-Dot
• UMayvelle

I-calcium nevithamini D

Noma ngabe uthatha noma imuphi umuthi obhalwe ngenhla, odokotela bancoma ukuthola inqwaba ye-calcium nevithamini D ekudleni kwakho. Lokho kungenxa yokuthi lokhu okumbiwa phansi kanye nevithamini ndawonye kungasiza ekunciphiseni ukulahleka kwethambo.

I-calcium yiminerali eyinhloko emathanjeni akho, futhi uvithamini D usiza umzimba wakho ukumunca i-calcium eyidingayo.

Ukudla okunothe nge-calcium kufaka:

• imikhiqizo yobisi
• imifino eluhlaza eluhlaza
• izinhlamvu ezicebile nezinkwa
• imikhiqizo yesoya

Ama-cereal amaningi namajusi e-orange manje ayatholakala nge-calcium eyengeziwe.

I-National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) incoma ukuthi abesifazane abaneminyaka engu-19-50 kanye nabesilisa abaneminyaka engu-19-70 kufanele bathole ama-milligram angu-1 000 (mg) we-calcium ngosuku.

Bancoma ukuthi abesifazane abaneminyaka engama-51-70 kanye nawo wonke umuntu ongaphezu kweminyaka engama-70 bathole ama-calcium angu-1,200 mg ngosuku.

Abakwa-NIAMS bancoma nokuthi abantu abadala abangaphansi kweminyaka engama-70 kufanele bathole amayunithi angama-600 (IU) angama-vitamin D ngosuku. Abantu abadala abangaphezu kweminyaka engama-70 kufanele bathole u-vitamin D ongu-800 IU ngosuku.

Uma ungatholi i-calcium eyanele noma uvithamini D ekudleni kwakho, ungathatha izithasiselo ukuqinisekisa ukuthi uthola inani elinconyiwe.

Umsebenzi womzimba

Ukuzivocavoca umzimba kusiza ekuqiniseni amathambo akho. Noma ngabe hlobo luni, ukuvivinya umzimba kusiza ukwehla kwamathambo okuhlobene nobudala futhi kungathuthukisa ukuqina kwamathambo kwezinye izimo.

Ukuzivocavoca nakho kungasiza ekuthuthukiseni ukuma kwakho nokulinganisela, ukunciphisa ingozi yokuwa. Ukuwa okumbalwa kungasho ukuphuka okumbalwa.

Ukuqeqeshwa kwamandla kuzuzisa amathambo ezingalweni zakho nasemgogodleni ongaphezulu. Lokhu kungasho izisindo zamahhala, imishini yesisindo, noma amabhendi wokumelana.

Ukuzivocavoca okunesisindo njengokuhamba noma ukugijima, kanye ne-aerobics enomthelela ophansi njengokuqeqeshwa kwe-elliptical noma ukuhamba ngebhayisikili, nakho kungasiza. Kokubili kungasiza ukuqinisa amathambo emilenzeni yakho, okhalweni, nasemgogodleni ophansi.

Umbono

I-osteoporosis ithinta abantu abaningi emhlabeni wonke, futhi yize lingekho ikhambi njengamanje, imishanguzo iyatholakala. Imithi, ukwelashwa ngama-hormone, nokuzivocavoca umzimba kungaqinisa amathambo akho futhi kwehle nokuwohloka kwamathambo.

Uma une-osteoporosis, khuluma nodokotela wakho. Xoxani ngokwelashwa ngakunye nokuguquka kwendlela yokuphila. Ngokubambisana, ninganquma ngohlelo lokwelashwa olungcono kakhulu kini.