I-Nexium vs. Prilosec: Unyango lwe-GERD ezimbini

Umxholo

• Kutheni ii-PPI zisebenza
• Kutheni bemiselwe
• Umahluko
• Ukusebenza ngempumelelo
• Ixabiso loncedo
• Imiphumela
• Izilumkiso kunye nonxibelelwano
• Imiba yomngcipheko
• Ukusebenzisana kweziyobisi
• Ukuthatha

Sibandakanya iimveliso esicinga ukuba ziluncedo kubafundi bethu. Ukuba uthenga amakhonkco kweli phepha, sinokufumana ikhomishini encinci. Nantsi inkqubo yethu.

Ukuqonda ukhetho lwakho

Isitshabalalo kunzima ngokwaneleyo. Ukwenza uluvo kukhetho lwakho lwamayeza kwisifo se-reflux se-gastroesophageal (GERD) sinokwenza ukuba kube nzima nangakumbi.

Ezimbini ezona zixhaphakileyo ziiproton pump inhibitors (PPIs) zii omeprazole (Prilosec) kunye ne esomeprazole (Nexium). Zombini ngoku ziyafumaneka njengeziyobisi (i-OTC).

Jonga ngokusondeleyo kubo bobabini ukuze ubone ukuba loluphi uncedo olunokubonelelwa ngamanye amayeza.

Kutheni ii-PPI zisebenza

Iimpompo zeProton zii-enzymes ezifumaneka kwiiseli zeparietal zesisu sakho. Benza ihydrochloric acid, esona sithako siphambili sesisu esiswini.

Umzimba wakho udinga isisu esiswini sokucola ukutya. Nangona kunjalo, xa umsipha ophakathi kwesisu sakho kunye nomqala ungavali kakuhle, le asidi inokuphelela kwindawo yakho. Oku kubangela ukuziva uvutha esifubeni nasemqaleni kunxulunyaniswa ne-GERD.

Inokubangela:

• umbefu
• ukukhohlela
• ukukrala kwemiphunga

Ii-PPI zinciphisa inani le-asidi elenziwe ngeempompo zeproton. Zisebenza kakuhle xa uzithatha iyure ukuya kwimizuzu engama-30 ngaphambi kokutya. Kuya kufuneka ubathathe kangangeentsuku ezininzi ngaphambi kokuba basebenze ngokupheleleyo.

Ii-PPI bezisetyenziswa ukusukela ngo-1981. Zithathwa njengeyona nyango isebenzayo ekunciphiseni isisu esiswini.

Kutheni bemiselwe

Ii-PPIs ezifana ne-Nexium kunye ne-Prilosec zisetyenziselwa ukunyanga iimeko ezinxulumene nesisu esiswini, kubandakanya:

• IGERD
• isilungulela
• i-esophagitis, kukudumba okanye ukukhukuliseka komqala
• isisu kunye nezilonda zesisu, ezibangelwa Helicobacter pylori (H. pyloriusulelo okanye ii-nonsteroidal anti-inflammatory drugs (ii-NSAID)
• I-Zollinger-Ellison syndrome, esisifo apho amathumba abangela ukuveliswa kwesisu esigqithisileyo

Umahluko

I-Omeprazole (Prilosec) kunye ne-esomeprazole (Nexium) ngamachiza afanayo. Nangona kunjalo, kukho umahluko omncinci kwindlela yokwenza imichiza.

Iprilosec iqulethe ii-isomers ezimbini zechiza i-omeprazole, ngelixa i-Nexium iqulethe isomer enye kuphela.

Isomer ligama elikwimolekyuli ebandakanya imichiza efanayo, kodwa icwangciswe ngendlela eyahlukileyo.Ke, ungatsho ukuba i-omeprazole kunye ne-esomeprazole zenziwe ngeebhloko ezifanayo zokwakha, kodwa zidityaniswe ngokwahlukileyo.

Ngelixa umahluko kwii-isomers unokubonakala umncinci, unokubangela umohluko ekusebenzeni kweziyobisi.

Umzekelo, i-isomer ekwi-Nexium iqhutywa kancinci kancinci kune-Prilosec emzimbeni wakho. Oku kuthetha ukuba amanqanaba eziyobisi aphezulu kwigazi lakho, kwaye i-esomeprazole inokunciphisa ukuveliswa kweasidi ixesha elide.

Inokusebenza ngokukhawuleza ukunyanga iimpawu zakho xa kuthelekiswa ne-omeprazole. I-Esomeprazole ikwaphulwe ngokwahlukileyo sisibindi sakho, ke oko kunokukhokelela kunxibelelwano oluncinci lweziyobisi kune-omeprazole.

Ukusebenza ngempumelelo

Olunye uphononongo lubonisa ukuba umahluko phakathi kwe-omeprazole kunye ne-esomeprazole unokunika izibonelelo ezithile kubantu abaneemeko ezithile.

Isifundo esidala esivela kwi-2002 safumanisa ukuba i-esomeprazole ibonelela ngolawulo olusebenzayo lwe-GERD kune-omeprazole kwiidosi ezifanayo.

Ngokwophononongo lwamva ngo-2009, i-esomeprazole yanikezela ngesiqabu esikhawulezileyo kune-omeprazole kwiveki yokuqala yokusetyenziswa. Emva kweveki enye, ukukhululeka kweempawu kwakufana.

Nangona kunjalo, kwinqaku le-2007 kwi-American Family Physician, oogqirha babuza ezi kunye nezinye izifundo kwi-PPIs. Bacaphule iinkxalabo ezinje:

• Umahluko kwinani lezinto ezisebenzayo ezinikwe kwizifundo
• ubungakanani bezifundo
• iindlela zeklinikhi ezisetyenziselwa ukulinganisa ukusebenza

Ababhali bahlalutye izifundo ezingama-41 ngokusebenza kwee-PPIs. Baye bagqiba kwelokuba kukho umahluko omncinci ekusebenzeni kwee-PPIs.

Ke, ngelixa kukho idatha ethile yokucebisa ukuba i-esomeprazole isebenza ngakumbi ekunciphiseni iimpawu, uninzi lweengcali ziyavuma ukuba ii-PPIs zinempembelelo efanayo ngokubanzi.

I-American College ye-Gastroenterology ithi akukho mahluko ubalulekileyo kwindlela esebenza ngayo i-PPI ukunyanga i-GERD.

Ixabiso loncedo

Umahluko omkhulu phakathi kweProseosec neNexium ngamaxabiso xa kuvavanywa.

Kude kube ngoMatshi 2014, i-Nexium ibifumaneka kuphela ngommiselo kwaye ngexabiso eliphezulu kakhulu. INexium ngoku ibonelela ngemveliso engaphaya kwekhawuntare (OTC) enexabiso elinokhuphiswano kunye neProseosec OTC. Nangona kunjalo, i-omeprazole yohlobo oluqhelekileyo ingabiza ngaphantsi kune-Prilosec OTC.

Ngokwesiko, iinkampani zeinshurensi azikhange zigubungele iimveliso ze-OTC. Nangona kunjalo, imakethi ye-PPI ikhokelele uninzi ukuba luhlaziye ukugubungela i-Prilosec OTC kunye ne-Nexium OTC. Ukuba i-inshurensi yakho ayiyigubungeli i-OTC PPIs, amayeza e-generic omeprazole okanye i-esomeprazole isenokuba lolona khetho lwakho.

I-Nexium ngamanye amaxesha ibizwa ngokuba sisiyobisi "nam" kuba ifana kakhulu ne-Prilosec, iyeza esele likho. Abanye abantu bacinga ukuba "nam" iziyobisi ziyindlela yeenkampani zamachiza ezenza imali ngokukopa iziyobisi esele zikhona. Kodwa abanye baye bathi "nam" iziyobisi zinokunciphisa iindleko zamachiza, kuba zikhuthaza ukhuphiswano phakathi kweenkampani zamachiza.

Sebenza nogqirha wakho okanye usokhemesti ukuthatha isigqibo sokuba yeyiphi i-PPI ekulungeleyo. Ukongeza kwiindleko, jonga izinto ezinje:

• imiphumela
• ezinye iimeko zonyango
• amanye amayeza owasebenzisayo

Imiphumela

Uninzi lwabantu alunazo iziphumo ebezingalindelekanga ezivela kwii-PPI. Rhoqo, abantu banokufumana:

• urhudo
• isicaphucaphu
• ukugabha
• intloko ebuhlungu

Iziphumo ebezingalindelekanga zinokubakho ngakumbi nge-esomeprazole kune-omeprazole.

Kukholelwa ukuba zombini ezi PPI zinokunyusa umngcipheko woku:

• umqolo kunye nokuqhekeka kwesandla kwabasetyhini abasemva kwemini, ingakumbi ukuba amayeza athatyathwa unyaka okanye nangaphezulu okanye ngeedosi eziphezulu
• ukudumba kwebacteria kwikholoni, ngakumbi emva kokulaliswa esibhedlele
• ukukrala kwemiphunga
• ukuswela ukutya, kubandakanya ivithamini B-12 kunye nokusilela kwe-magnesium

Unxibelelwano olunokuba semngciphekweni wesifo sengqondo esixhalabisayo lwachazwa ngo-2016, kodwa isifundo esikhulu sokuqinisekisa ngo-2017 safumanisa ukuba akukho mngcipheko ukwanda kwengqondo ngenxa yokusebenzisa ii-PPIs.

Abantu abaninzi bafumana ukuveliswa kweasidi engaphezulu xa beyeka ukusebenzisa ii-PPIs. Nangona kunjalo, kutheni oku kusenzeka akuqondwa ngokupheleleyo.

Kwimicimbi emininzi yesisu esiswini, kuyacetyiswa ukuba uthathe ii-PPIs ngaphezulu kweeveki ezine ukuya kwezisibhozo ngaphandle kokuba ugqirha wakho umisela ukuba ixesha elide lonyango luyafuneka.

Ekupheleni kwexesha lokunyanga elicetyiswayo, kuya kufuneka unciphise amayeza ngokuthe ngcembe. Sebenza nogqirha wakho ukwenza njalo.

Izilumkiso kunye nonxibelelwano

Ngaphambi kokuba uthathe amayeza, thetha nogqirha wakho malunga nezinto ezinobungozi kunye nokunxibelelana kweziyobisi okunxulumene nazo.

Imiba yomngcipheko

• zinemvelaphi yaseAsia, njengoko umzimba wakho ungathatha ixesha elide ukwenza ii-PPIs kwaye unokufuna idosi eyahlukileyo
• unesifo sesibindi
• babe namanqanaba asezantsi e-magnesium
• ukhulelwe okanye ucwangcise ukukhulelwa
• bayancancisa

Ukusebenzisana kweziyobisi

Soloko uxelela ugqirha wakho malunga nawo onke amayeza, amayeza kunye neevithamini ozithathayo. I-Prilosec kunye ne-Nexium banokusebenzisana namanye amayeza onokuthi uwathathe.

Ukutya neDrug Administration (i-FDA) yase-US ikhuphe isilumkiso sokuba ichiza lase-Prilosec linciphisa ukusebenza kwegazi le-clopidogrel (Plavix).

Akufanele uthathe la machiza mabini kunye. Ezinye ii-PPI azibandakanywanga kwisilumkiso kuba khange kuvavanywe eli nyathelo.

La machiza akufuneki athathwe kunye ne-Nexium okanye Prilosec:

• clopidogrel
• dlavini
• mzwqdb
• rifampin
• wboydine
• ziba
• Wort yaseSt

Amanye amachiza anokunxibelelana ne-Nexium okanye i-Prilosec, kodwa isenokuthathwa kunye neziyobisi. Xelela ugqirha wakho ukuba uthatha naliphi na kula machiza ukuze ahlole umngcipheko wakho:

• amphetamine
• sifisozi
• mzing
• bisphosphonates
• bosentan
• umfanekiso oqingqiweyo
• qulosazol
• yeyokine
• clozapine
• cyclosporine
• dextroamphetamine
• ifumanayipram
• iziyobisi ezichasayo
• fosphenytoin
• intsimbi
• hydrocodone
• imesalamine
• imethotrexate
• imethylphenidate
• Yenyani
• yingqine
• iqequa
• itrolrolimus
• warfarin okanye ezinye izichasi ze-vitamin K
• voriconazole

Ukuthatha

Ngokubanzi, unokukhetha i-PPI efumaneka ngokulula kunye neendleko ezingaphantsi. Kodwa gcinani engqondweni ukuba ii-PPI ziphatha kuphela iimpawu ze-GERD kunye nezinye iingxaki. Abayiphathi eyonobangela kwaye baboniswa kuphela ukusetyenziswa kwexesha elifutshane ngaphandle kokuba ugqirha wakho umisele ngenye indlela.

Utshintsho kwindlela yokuphila kufuneka ibe ngamanyathelo akho okuqala ekulawuleni i-GERD kunye nesitshisa. Unokufuna ukuzama:

• ulawulo lobunzima
• ukunqanda ukutya okukhulu ngaphambi kokuba ulale
• ukuyeka okanye ukuyeka ukusebenzisa icuba, ukuba uyakusebenzisa

Ngokuhamba kwexesha, i-GERD yexesha elide inokukhokelela kumhlaza wesifo sokudumba. Nangona bambalwa abantu abane-GERD abafumana umhlaza wokuqina, kubalulekile ukuba wazi umngcipheko.

Ii-PPI zisebenza ngokuthe ngcembe, ngenxa yoko zisenokungabi yimpendulo yokubetha kwentliziyo okanye ukubuyisa.

Ezinye iindlela zinokubonelela ngoncedo ekusetyenzisweni ngamanye amaxesha, ezinje:

• Amacwecwe e-calcium carbonate ahlafunwayo
• ulwelo olunje ngealuminium hayidroksayidi kunye nemagniziyam hayidroksayidi (Maalox) okanye ialuminiyam / nemagniziyam / simethicone (Mylanta)
• iziyobisi ezinciphisa i-asidi njenge-famotidine (Pepcid) okanye i-cimetidine (Tagamet)

Zonke ezi zinto ziyafumaneka njengeziyobisi ze-OTC.