Isilumkiso nge-Grapefruit: Inokusebenzisana namayeza aqhelekileyo

Umxholo

• Inxibelelana njani namayeza?
• 1-3: Amanye amayeza e-cholesterol
• 4-7: Amayeza athile oxinzelelo lwegazi
• 8-9: Amayeza esigqi sentliziyo ambalwa
• 10-13: Amanye amayeza alwa nosulelo
• 14-20: Amayeza aliqela eemood
• 21-24: Ezinye zegazi zincinci
• 25-27: Amayeza aliqela eentlungu
• 28-31: Ukungasebenzi kakuhle kwe-erectile kunye nonyango lweprostate
• Ngaba kufuneka uyeke iidiliya?
• Umgca wezantsi

I-Grapefruit sisiqhamo esimnandi se-citrus kunye nezibonelelo ezininzi zempilo. Nangona kunjalo, inokusebenzisana namanye amayeza aqhelekileyo, ukutshintsha iziphumo emzimbeni wakho.

Ukuba unomdla malunga nesilumkiso se-grapefruit kumayeza amaninzi, eli nqaku liza kukunceda uqonde ukuba kutheni ikhona kwaye zeziphi iindlela onokukhetha kuzo.

Nanku ukujongwa ngakumbi kwamachiza aqhelekileyo angama-31 anokuba nonxibelelwano oluyingozi kunye ne-grapefruit, kunye nezinye iindlela.

Qaphela: Eli nqaku liqulathe ulwazi ngokubanzi-hayi ingcebiso ekhethekileyo yezonyango. Thetha nogqirha wakho ngaphambi kokutshintsha ukusebenzisa naliphi na iyeza.

Inxibelelana njani namayeza?

Amayeza ayenziwa kwisibindi sakho kunye namathumbu amancinci liqela elikhethekileyo leeproteni ezibizwa ngokuba yicytochrome P450 (CYPs).

Ii-CYPs ziwaphula amayeza, zinciphisa amanqanaba egazi uninzi lwazo.

Isiqhamo samagilebhisi kunye nezihlobo ezimbalwa ezisondeleyo, ezinje ngee-orenji zaseSeville, tangelos, pomelos, kunye neMinneolas, ziqulathe udidi lweekhemikhali ezibizwa ngokuba ziifuranocoumarins.

Iifuranocoumarins ziphazamisa ukusebenza kwesiqhelo kweeCYPs. Ngapha koko, uphononongo lubonisa ukuba bayawonyusa amanqanaba egazi ngaphezulu kwamayeza angama-85 (1).

Ngokucothisa indlela apho ii-CYP zihlala zisophula amayeza emathunjini nakwisibindi sakho, iziqhamo zomdiliya zinokunyusa iziphumo zala machiza (1).

Kukho izinto ezintathu zokwazi ukuqonda ukuba kwaye ungasisebenzisa njani ngokukhuselekileyo isidiliya kunye nala mayeza.

1. Ayithathi lukhulu. I-grapefruit iphela okanye iglasi enye yejusi yeziqhamo iyanele ukutshintsha indlela ekuchaphazela ngayo la mayeza.
2. Iziphumo zalo zihlala iintsuku ezininzi. Isakhono seGrapefruit sokuchaphazela amayeza sihlala iintsuku ezi-1-3. Ukuthatha amayeza akho kwiiyure ezimbalwa ngaphandle kokuwasebenzisa akude ngokwaneleyo.
3. Ibalulekile. Inani elincinci lamachiza, iziphumo zeediliya ziyababuhlungu.

Unoko engqondweni, nantsi ingcaciso eneenkcukacha malunga namayeza aqhelekileyo angama-32 anokuthi asebenzisane nesiqhamo seediliya, ahlelwe ngokusetyenziswa.

1-3: Amanye amayeza e-cholesterol

Amanye amayeza e-cholesterol abizwa ngokuba yi-statins achaphazelekayo yi-grapefruit.

Umsebenzi weStatins ngokunciphisa umda kwimveliso yecholesterol. Oku kuphucula imeko yeepoprotein egazini kunye nokunciphisa ukusweleka kwesifo sentliziyo kwizigulana ezisemngciphekweni wazo ().

Iitatins zinokubangela i-rhabdomyolysis, okanye ukonakala kwethishu yemisipha. Oku kukhokelela ekubeni buthathaka kwezihlunu, iintlungu, kwaye ngamanye amaxesha umonakalo wezintso ().

Isiqhamo samagilebhisi sonyusa amanqanaba egazi ee-statins ezintathu eziqhelekileyo, sandise umngcipheko we-rhabdomyolysis ():

1. Atorvastatin (Lipitor)
2. ILovastatin (Mevacor)
3. ISimvastatin (iZocor)

Olunye uphononongo lubonise ukuba ukusela iglasi yesiselo se grapefruit kunye ne-simvastatin okanye i-lovastatin inyuse amanqanaba egazi ale statins ngama-260% ().

Ezinye iindlela: I-Pravastatin (Pravachol), i-rosuvastatin (iCrestor), kunye ne-fluvastatin (i-Lescol) ayinxibelelani ne-grapefruit (1).

Isiqhamo samagilebhisi sinokunyusa iziphumo ebezingalindelekanga zamayeza e-statin cholesterol, abangele ukonakala kwemisipha.

4-7: Amayeza athile oxinzelelo lwegazi

Uninzi lweentlobo zamayeza oxinzelelo lwegazi aluchaphazelekanga ziidiliya.

Nangona kunjalo, la mayeza mane alandelayo oxinzelelo lwegazi kufuneka asetyenziswe ngononophelo:

1. Felodipine
2. INifedipine (iProcardia)
3. ILosartan (iCozaar)
4. Eplerenone (Inspra)

Amayeza amabini okuqala kolu luhlu ayaziwa njenge-calcium channel blockers. Basebenza ngokutshintsha indlela imithambo yegazi yakho esebenzisa ngayo ikhalsiyam, ukuthomalalisa imithambo, kunye nokunciphisa uxinzelelo lwegazi.

Amayeza amabini okugqibela kolu luhlu asebenza ngokunciphisa umsebenzi wehomoni ebizwa ngokuba yi-angiotensin 2, eyonyusa ngokwendalo uxinzelelo lwegazi.

Olunye uphononongo lufumanise ukuba amanqanaba egazi e-nifedipine enyuke kakhulu xa ethathwa malunga neekomityi ezi-2 (500 ml) yejusi yeziqhamo, xa kuthelekiswa nejusi. Oku kubangele ukwehla okukhawulezileyo koxinzelelo lwegazi, olunokuba yingozi xa kungagadwanga ().

ILosartan ayiqhelekanga kuba iidiliya iyazinciphisa iziphumo zayo, inokuthi inciphise amandla ayo okulawula uxinzelelo lwegazi ().

I-Eplerenone isebenza ngokufanayo ne-losartan, kodwa amanqanaba ayo ayonyuka xa ithathwa ngegrapefruit. Amanqanaba e-eplerenone agqithisileyo anokubangela i-potassium eninzi egazini, enokuphazamisa isingqi senhliziyo (1).

Ezinye iindlela: I-Spironolactone (Aldactone), ichiza elifanayo ne-losartan kunye ne-eplerenone, alisebenzisani ne-grapefruit. I-Amlodipine (iNorvasc) ibhlokhi ye-calcium blocker njenge-felodipine kunye ne-nifedipine, engadibaniyo ne-grapefruit (,).

Nangona i-grapefruit ingaphazamisi uninzi lwamayeza oxinzelelo lwegazi, inokubangela ukuba amayeza ambalwa agqithise uxinzelelo lwegazi.

8-9: Amayeza esigqi sentliziyo ambalwa

Isiqhamo samagilebhisi sichaphazela amayeza ambalwa anyanga isingqisho sentliziyo esingaqhelekanga.

Oku kunxibelelana kunokuba yingozi ngakumbi kwaye kubandakanya:

1. Amiodarone
2. I-Dronedarone (iMultaq)

Isifundo sanika amadoda ali-11 awayethatha i-amiodarone iglasi yesiselo seediliya (malunga ne-300 mL). Amanqanaba eziyobisi anyuke ukuya kuthi ga kwi-84%, xa kuthelekiswa nabo bangaseliyo incindi ().

La mayeza mabini adlala indima ebalulekileyo ekulawuleni impilo yezigulana ezinesingqisho sentliziyo. Utshintsho olunxulumene neziqhamo zeGrapefruit kumanqanaba ala machiza ngamanye amaxesha abangele utshintsho lwesingqisho sentliziyo ().

Nangona zimbalwa iintliziyo zesigqi sentliziyo ezinxibelelana negrapefruit, iziphumo ebezingalindelekanga zinokuba yingozi.

10-13: Amanye amayeza alwa nosulelo

Ngokudibeneyo kubizwa ngokuba ziiantimicrobials, la mayeza okulwa nosulelo ahluka kakhulu kwizenzo zawo nakukonakala emzimbeni.

Nangona ii-antimicrobials zezona ndidi zahlukileyo zamayeza, kukho amayeza ambalwa kuphela anentsebenzo ebalulekileyo yeediliya.

1. Erythromycin
2. I-Rilpivirine kunye neziyobisi ezinxulumene ne-HIV
3. Primaquine kunye neziyobisi ezichasene nokuchasana nemalariya
4. Albendazole

I-Erythromycin isetyenziselwa ukunyanga iintlobo ezininzi zosulelo lwebacteria. Uphononongo oluthelekisa ijusi yeediliya kunye namanzi kwizigulana ezithatha i-erythromycin lubonise ukuba incindi inyuse amanqanaba egazi leziyobisi ngama-84% ().

Amanqanaba angaphezulu kweli chiza anokuphazamisa isingqisho sentliziyo ().

Isiqhamo samagilebhisi sonyusa amanqanaba amayeza e-HIV i-rilpivirine kunye ne-maraviroc, ukongeza kumachiza anxulumene ne-primaquine. Oku kunokuchaphazela isingqi sentliziyo okanye umsebenzi (1).

Ngenxa yokuba ii-antimicrobials zihlala zithathwa okwexeshana, mhlawumbi kulula kakhulu ukunqanda iziqhamo zomdiliya ngelixa uthatha la mayeza.

Ezinye iindlela: I-Clarithromycin yinyango eklasini enye njenge-erythromycin engadibaniyo nediliya. I-Doxycycline zombini zintsholongwane kunye neziyobisi ezichasayo ezingasebenziyo nayo (1).

Amanye amayeza alwa nosulelo akufuneki asetyenziswe kunye ne-grapefruit, kuba anokukhokelela ekuphazamiseni isingqi senhliziyo okanye ukusebenza.

14-20: Amayeza aliqela eemood

Uninzi lwee-anti-depressants kunye neziyobisi ezichasayo zikhuselekile ukuba zisetyenziswe kunye ne-grapefruit.

Nangona kunjalo, amayeza eemood ahambelana nawo, kubandakanya:

1. IQuetiapine (iSeroquel)
2. ILurasidone (eLatuda)
3. I-Ziprasidone (Geodon)
4. IBuspirone (iBuspar)
5. IDiazepam (Valium)
6. Midazolam (iVenkile)
7. I-Triazolam (iHalcion)

Iziyobisi ezinje ngequetiapine kunye ne-lurasidone zisetyenziselwa ukunyanga imeko kunye nokuziphatha. Ukunyuka kwamanqanaba ala machiza kunokubangela utshintsho kwisingqi sentliziyo okanye ukulala (1).

Ngaphaya koko, i-diazepam, i-midazolam, kunye ne-triazolam zizidambiso ngamanye amaxesha ezisetyenziselwa uloyiko okanye ezinye iindlela zoxinzelelo.

Olunye uphononongo luthelekise amanye ala machiza kwizigulana ezisithoba, ezinye zazo zitya iidiliya. Kubonakalisile ukuba iidrapefruit inokuwanyusa la mayeza, ekhokelela ekozeleni okugqithileyo ().

Ukutya igrapefruit ngelixa uthatha amayeza ahambelana nemood apha ngasentla kunokubangela ukutshintsha kwesingqi sentliziyo, ukulala kakhulu, kunye nezinye iziphumo ezichaphazela iziyobisi.

21-24: Ezinye zegazi zincinci

Amacoci egazi asetyenziselwa ukunyanga okanye ukunqanda amahlwili egazi. Abanye babo bayachaphazeleka ziidiliya, kubandakanya:

1. Apixaban (uEliquis)
2. IRivaroxaban powder (iXarelto)
3. IClopidogrel (iPlavix)
4. ITicagrelor (iBrilinta)

I-Clopidogrel ixhomekeke kwii-CYPs-iiprotheyini ezinomda we-grapefruit-ukuze zisebenze. Yiyo ke loo nto ingasebenziyo xa ixutywe nediliya.

Isifundo sezigulana ezisi-7 ezithatha i-clopidogrel nge-200 mL yejusi yeziqhamo okanye amanzi ibonakalise ukusebenza okuncinci kwesiyobisi kunye nejusi. Nangona kunjalo, amandla ayo okunyanga amahlwili egazi awachaphazelekanga ().

Ngokuzenzekelayo, iziqhamo zomdiliya zonyusa amanqanaba egazi amanye amayeza kolu luhlu, anokubangela ukopha ().

Ezinye iindlela: IWarfarin (Coumadin) isetyenziselwa iinjongo ezifanayo nezo ze-apixaban kunye ne-rivaroxaban powder. Ngelixa i-warfarin inovakalelo kukutya okuqukethe ivithamin K, ukwenziwa kwayo akuchaphazeleka ziidiliya ().

Abacoci gazi abaliqela bayachaphazeleka ziidiliya. Oku kunokukhokelela ekuphumeni kwegazi okanye ekuthinteleni ukungasebenzi kakuhle kwegazi.

25-27: Amayeza aliqela eentlungu

Amayeza amaninzi entlungu achaphazeleka ziidiliya:

1. Fentanyl
2. Oxycodone
3. Colchicine

I-Fentanyl kunye ne-oxycodone ziiphelisa iintlungu. Nangona amanqanaba egazi lawo echaphazeleka kancinci sisixa esincinci segrapefruit, inokutshintsha ubude bexesha abahlala ngalo emzimbeni (,).

Colchicine liyeza elidala elisetyenziselwa ukunyanga igawuthi. Iqhubekeka zii-CYPs kwaye inokunxibelelana ne-grapefruit. Nangona kunjalo, uphononongo luka-2012 lubonise ukuba ukusela i-240 mL yejusi yeziqhamo zeediliya kwaba nefuthe elincinci kumanqanaba ayo ().

Ezinye iindlela: I-Morphine kunye ne-Dilaudid ziintlungu zokuthomalalisa iintlungu ezingachaphazeleki ziidiliya (1).

Ezinye iintlungu ze-narcotic ziyancipha ziqhubeka ixesha elide egazini xa zithathwa nge-grapefruit.

28-31: Ukungasebenzi kakuhle kwe-erectile kunye nonyango lweprostate

Ukungasebenzi kakuhle kwe-erectile kunye nonyango lweprostate lufanelwe ukuqwalaselwa ngokubhekisele kunxibelelwano lwediliya

1. ISildenafil (Viagra)
2. ITadalafil (iCialis)
3. ITamsulosin (Flomax)
4. Isilodosin (iRapaflo)

Amayeza e-erectile ukungasebenzi njenge-sildenafil kunye ne-tadalafil isebenza ngokuphumla kwimithambo yegazi, eyonyusa ukuhamba kwegazi kulwakhiwo.

Kungenxa yokuba eminye imithambo yegazi iyaphumla nala mayeza ngokunjalo, ukonyuka kwamanqanaba egazi kula machiza abangelwa sisiqhamo somdiliya kunokunciphisa uxinzelelo lwegazi ().

Ngaphaya koko, amayeza okwandisa i-Prostate anje nge-tamsulosin anokubangela ukwanda kwesiyezi kunye noxinzelelo lwegazi xa usiwe kwigrapefruit ().

Ezinye iindlela: Olunye udidi lwamayeza okwandisa i-Prostate, olubandakanya i-finasteride kunye ne-dutasteride, aluchaphazeleki kakhulu ziidiliya ().

Isiqhamo samagilebhisi akufuneki sigqitywe ngamayeza e-erectile dysfunction okanye amayeza athile okwandisa iprotate.

Ngaba kufuneka uyeke iidiliya?

Ngelixa eli nqaku lidwelisa amayeza aqhelekileyo angama-31 asebenzisana nesiqhamo somdiliya, ayilulo uluhlu olupheleleyo.

IDrugs.com ibonelela ngokujonga iziyobisi onokuzisebenzisa ukujonga amayeza akho ekusebenzisaneni.

Ukongeza, iRxlist.com idwelisa amayeza athile aqhelekileyo asebenzisanayo nesiqhamo somdiliya.

Kubalulekile ukuba ukhumbule ukuba i-grapefruit enye iphela okanye malunga neglasi enye enkulu yejusi yanele ukutshintsha amanqanaba egazi amachiza amaninzi. Kwaye amanye ala mayeza anokuba neziphumo ebezingalindelekanga ezibi xa enxibelelana ne-grapefruit.

Ukuba ngoku uthatha amayeza ngokudibana kweediliya, tshintshela kwelinye iyeza okanye uyeke ukutya iidiliya.

Ukuba uyathandabuza, fikelela kugqirha wakho okanye kwikhemesti ukuze ufumane iingcebiso ezizezakho.

Nokuba isixa esincinci seediliya sinokusebenzisana namanye amayeza kwaye sibangele iziphumo ebezingalindelekanga ezibi.

Umgca wezantsi

Isiqhamo samagilebhisi siphazamisa iiproteni kumathumbu amancinci nakwisibindi esihlala sidiliza amayeza amaninzi.

Ukutya i-grapefruit okanye ukusela i-grapefruit juice ngelixa uthatha la mayeza kunokukhokelela kumanqanaba aphezulu egazini lakho-kunye nezinye iziphumo ebezingalindelekanga.

Ngezinye iziyobisi, nokuba zincinci izixa zeediliya zinokubangela iziphumo ebezingalindelekanga ezibi. Ke, indibaniselwano kufuneka ithintelwe.

Ikhemesti yakho inokumakisha la mayeza ngesilumkiso sokusebenzisana kweediliya.

Qinisekisa ukuba ugqirha wakho kunye nosokhemesti bayazi ukuba uhlala usitya iidiliya. Banokukunceda uthathe isigqibo sokuba ngaba kukhuselekile ukuyisebenzisa ngelixa usemayeza athile.