Bisphosphonates (zvinodhaka): tsananguro, mirayiridzo, wongororo. Bisphosphonates pakurapa osteoporosis

Kana mapfupa evanhu kuva kusimba uye pfava, uye zvinoitika mune zvimwe zvirwere pfupa, kunaka upenyu yekudyidzana ipfupi. Kakawanda mitswe, marwadzo majoini, musana uye maoko nemakumbo dzinotanga kuperekedza murume kwese, ndokusaka unogona kumisa zvachose kunzwa mufaro muupenyu uye vanoshamba mwoyo.

Asi mufaro wedu nemi munyika yanhasi ndivo zvinodhaka chaiyo kuti zvinobudirira kunogona kusimbisa mapfupa tishu. Zviri pamusoro pavo uye ichakurukurwa munyaya yedu. Akadana mishonga izvi "bisphosphonates" - mishonga akaongororazve chinogona kupa tariro mushonga vazhinji kwazvo vanhu. nditende, zvizhinji zvakadaro! Tichatevera kukuudza nezvenhoroondo mari idzi, pamusoro zvavari zvakanaka, chii chinoita zvavo zveutano, achaita kubudisa mazita bisphosphonates ndiyo inonyanya dzakakurumbira uye inobudirira.

Nyaya achava runobatsira wose. Pashure pezvose, kunyange kana nhasi zvose zviri muhurongwa, ipapo, zvinosuwisa, hazvirevi utano iwe nevadiwa vako, richagara nokusingaperi. Makore zvaanopfuura, pamwe kuwedzera chirwere dzavo kungoramba. Saka chii pamusoro mishonga yemazuva ano haangavi okushamisira. Asi zvakakwana vanosvika! Ngatitaurei anozodzidza kudzidza dingindira nyaya ino zvikuru.

Bisphosphonates - zvinodhaka kuti mapfupa utano

Kusarudza boka zvinodhaka chakaita zvokugadzirwa kuti anokwanisa kuvhara basa muviri wacho osteoclasts (masero kuti kuparadza pfupa rinenge) uye kudzorera pfupa mamiriro rinozivikanwa bisphosphonates.

Aishandisa zvinodhaka ava Parizvino panzvimbo rokuchengeta varwere osteoporosis nezvimwe zvirwere kuti anokonzera mapfupa pfava rokutanga. The chinokosha pfuma bisphosphonates ndiko chokwadi kuti aitwe oncological zvirwere dzinoratidzwa paumbwe anomera munzvimbo pfupa. Muzviitiko izvi, mushonga, iro rinotiudza nyaya yedu, regai kupa metastases kupararira uye kuderedza marwadzo pavarwere izvi.

The mashandiro chiito kuti bisphosphonates pakurapa osteoporosis

Muzvirevo chitsauko, wakadzidza kuti bisphosphonates - zvinodhaka kuti vasimudzire mapfupa hutano. Zviri nguva yokutaura zvakawanda pamusoro mashandiro avo chiito. masero omuviri wedu vane kunoshamisa anokwanisa kubva nguva yoku- ndokugadziridzwa. Bone rinenge - hapana anosara. Zviyero Zvivako avo vakaramba, kune rumwe rutivi, ari osteoblast masero kuti vane basa pakuvaka zvinyama itsva, vamwe - osteoclasts kuti vane basa kuparadzwa kwayo. BF vane simba kunetesa basa osteoclasts uye kumhanya kunyange vaizvitora destruct mashandiro. At ichi pfuma kunoshamisa uye anotsanangura bisphosphonate Mabatirwo osteoporosis.

Ndinofanira kutaura kuti masayendisiti saka kure havana kunzwisisa zvakakwana ichivharira mashandiro repfupa kurasikirwa kushandisa bisphosphonates. Zvinozivikanwa kuti izvi zvinhu anogona kusunga kune hydroxyapatite pfupa zvikamu, kwavakazvidza vanogona kushandura vachikotama kwayo uye panguva imwecheteyo kuderedza ropa wevasungwa kuti hydroxyproline uye phosphatases.

Dzimwe nguva BF gadziriro anogona kupiwa ari kurapwa kunyange zvirwere zvakadai herniation kana protrusion kuti intervertebral discs, sezvo unonyaradza marwadzo nevamiririri. Uye zvishoma mashoko: bisphosphonates nokuti osteoporosis dzave kushandiswa kwenguva refu, asi nokuti kenza, ivo zvave ichangopfuura. Kuburikidza zvidzidzo izvozvo Vakawana kuti kupinda muviri, umo basa zvinowanikwa muna neoplastic muitiro, bisphosphonates musapa bundu masero coalesce pamwe pfupa chizvaro uye pakudaro tunodzivisa inotungamirwa metastases. More mashoko pamusoro ichi ichakurukurwa ari oga chitsauko.

A Nhoroondo shoma

Zvakaratidza kuti bisphosphonates dzakafukurwa nemasayendisiti kwenguva refu, kunyange XIX remakore. Nokuti kokutanga kwetunhu wokutanga BF akanga muGermany. Zvinoshamisa kuti izvi zvinhu pakutanga kushandiswa chete siyana maindasitiri sectors (nokuti Kugadzirwa fetiraiza, kugadzirwa kwezvinhu akamendwa peturu achinatsa uye zvakafanana. D.) Uye chokuita mushonga akanga asina.

Kwezvokurapa zvinangwa - nokuti mishonga repfupa - bisphosphonates akatanga kushandiswa chete pakati pezana-ramakumi remakore, pakwakanga yakawanikwa zvavo zvinoshamisa pfuma kuchinja pezvakaitwa zvakadai calcification uye decalcification. Bisphosphonates nokuti osteoporosis kushandiswa kubva munyika kwazvo kushingaira.

kupatsanura pakati bisphosphonates

Nhasi, pharmacology yakatanga wechitatu chizvarwa biosfosfonatov. Asi izvi hazvirevi kuti vanachiremba vakasiya zvachose kushandisa zvinodhaka pane kwekutanga nekwechipiri chizvarwa, rakanga yakagadzirwa ipapa. Ngazvisadaro! Nhasi kune zvinodhaka zvakawanda kuti anotorerwa bisphosphonates. All siyana iri mishonga rakakamurwa mapoka maviri: bezazotovye mishonga uye senitrogen. Chaizvoizvo avo osteoclast masero ane zvakasiyana mashandiro. Below tichakurukura mapoka maviri zvizere.

Nitrogen tubhokisi bisphosphonates

Ichi boka zvinodhaka ndivo bisphosphonates, rine zvinotevera unorapa:

• Ibandronatovaya acid. E nefuma akanga synthesized ichangodarika, saka ndiyo chinodhaka vorudzi rwechitatu. Rinoshandiswa zvikuru zvinobudirira mukurapa uye kudzivirira osteoporosis vakadzi vapinda chakaoma munguva kubereka. Men kutora mushonga uyu haisi inokurudzirwa. Ibandronatovuyu asidhi rinoshandiswawo pathological yakawedzera karusiyamu ropa (hypercalcemia).
• Zolendronovaya acid. Uyewo chokuita yechitatu chizvarwa bisphosphonate. Kukwanisa kuita zvokusarudza pamusoro pfupa tishu. With izvi zvinobudirira kushandiswa nokurapa osteoporosis. The vanosarudza kuita zolendronovoy asidhi pamusoro pfupa mamiriro hunobva ayo kumusoro sungano kune osseous yekamuri kuti anopa kwazvo chinovhiringidza pamusoro osteoclasts. Chimwe pfuma inokosha zvinodhaka - a raidudzwa Anti-bundu maturo. Pahwaro iripo asidhi zolendronovoy dzakakurumbira bisphosphonates "Zometa", "Zolendronat".
• Alendronate yavaibvisa - wechipiri chizvarwa pachishandiswa bisphosphonates. Zviri asiri hormone dzakananga muverengi metabolic mapfupa rinenge achiumba yakarurama nemamiriro mafupa. Zvinonzi kuratidzwa kushandiswa mune osteoporosis vose vakadzi nevarume.
• Ibandronate yavaibvisa ( "Bonviva" "Bondronat" "Boniva" - bisphosphonates gadziriro iri kwayo hwaro) - chechitatu nechizvarwa zvinodhaka. Kuchititadzisa osteoclast basa pasina kukanganisa kuwanda kwavo. Hazvina kukanganisa paumbwe pfupa masero, saka zvinobudirira achidzikisa kuparadzwa kwavo. rubatsiro zvakanaka vakadzi postmenopausal kuzvidzivirira nomumiririri pfupa mitswe.

Kugadzirira dzinenge dzisina senitrogen

Zvino tichakurukura chii muri senitrogen isina bisphosphonates. Zvinodhaka, iyo mazita zvaunoverenga ikozvino, ndezvaJehovha chizvarwa rokutanga bisphosphonates:

• "Clodronate." Rinovatadzisa zvose osteolysis uye hypercalcemia kukura. Anoumba kunzwisisa nezvichaitika hydroxyapatite pfupa anochinja sekristaro yekamuri uye kushingaira anofumura kuparadzana calcium phosphate mamorekuru. Metastases mu mapfupa kunokutadzisa kukura kwavo namatombo pakusika chitsva masangano.
• "Sodium Etidronate". Anotsigira kudzorerwa mapfupa kurasikirwa vakadzi vane chirwere che "osteoporosis". It rinogona kushandiswa chirwere Paget vake, hypercalcemia uye zvakafanana. D.
• "Sodium tiludronate". Mineralizes uye kunosimbisa mapfupa rinenge kuunganidza imomo samolecular remubatanidzwa uye calcium yakawanda phosphate, kuchititadzisa kuparadzwa pfupa. Ushandiswe varwere vane diagnoses kuti "deforming osteodystrophy" kana "chirwere Paget kuti" anogona vanogadzwa pachinzvimbo mahormone.

Bisphosphonates - zvinodhaka, ndandanda yatiri zvakabudisa - vakatengesa chete mushonga, ndiko kuva simba zvinhu ... Shandisa navo nokungwara dzavo kunogona kuva nengozi nokuti utano hwako! Rangarirai kuti BF - haasi chisingakuvadzi mavhitaminzi kana zvokuwedzera pamwe karusiyamu. zvinodhaka izvi vari kushingaira kupindira kwemasayendisiti kuitika mumuviri, uye kana isina kukodzera vakashandisa anogona kubatsira pane zvakaipa.

rubvumo mitemo

bisphosphonates mishonga zvikuru zvikuru yokuita zvinoitwa nemudumbu, Absorção de Água yavo zvakaoma. Saka, zviri zvakasimba kurairirwa prescribes kunwa zvinodhaka izvi chete usina chawadya, anenge 30 maminitsi pamberi kudya - zvinowanzoda anobatsira Absorção de Água kuti basa zvinodhaka zvinhu. Varwere vanofanira kuziva kuti boka iri mishonga inokwanisa kukonzera kuzvimba uye kupera mune dzakasiyana-siyana nemudumbu. Kudzivisa matambudziko akadaro, pashure kugamuchira mahwendefa zvakafanira kuedza panguva mumaawa kuenda, uye kuramba akarurama chinzvimbo. The chipimo chemushonga anosarudzwa kupinda chiremba.

Kazhinji, kugadzwa bisphosphonates chiremba prescribes murwere achiri uye ingestion makuru mishonga calcium. Saka, mawa negashiro vaviri kunze. Kugadzirira ine calcium, anogona kutorwa pashure pokutora bisphosphonate chete pashure pemaawa maviri, uye kwete pamberi. Chimwe chinokosha rutsigiro: CF vanofanira kunwa tii, mukaka, muto kana kofi, uye bani mvura (yakawanda).

Kushandiswa bisphosphonates mu neoplastic zvirwere

More hurukuro pamusoro bisphosphonate kurapwa kwezvirwere hunobatanidza kukura anomera dzakasiyana hunhu. The panowanikwa metastasis mune mapfupa rinenge riri parutivi rwechipo itirana kusakarongeka pakati bundu masero uye metabolic basa mapfupa tishu. Uyewo, kukumikidza kukura metastases iri pamwe adhesion kuti bundu masero kuti pfupa zvivako, uyewo Kurwisa, kuwanda uye neoangiogenesis. Vakawanda preclinical ongororo vakabvumira masayendisiti kuti kubvuma kuti BF tunodzivisa nomumwe mumatanho idzi pathogenesis.

Nokufamba anoverengeka tsvakurudzo zvirongwa isu dzinoongororwa nezvaizoitwa bisphosphonate "Clodronate" pamusoro pokumuka metastases mune mapfupa vakadzi kenza yemazamu. nemigumisiro yakanaka avapo: kugadzirira wakabatsira kuderedza kuitika metastases uye kukura itsva mapfupa rinenge pavarwere. Pari, kutsvakurudza mirayiridzo iyi kuramba vachishingaira. Bisphosphonates kana pfupa metastases zvechokwadi anokwanisa kubatsira.

Nyanyisa mapundu kazhinji pamwe hypercalcemia (karusiyamu kusunungurwa kubva pfupa). Kana metastatic lesion repfupa karusiyamu nokukurumidza kurasikirwa kunoitika nokuda kuparadzwa yaro osteoclasts. Mukuwedzera, hypercalcemia mu kenza inokwanisa kuitika nokuda kuona bundu peptide. Uyezve, pane activation pamusoro osteoclasts, zvichitungamirira hypercalcemia. Izvi ndizvo kwakatooma uye nokukurumidza Akaroromesawo renal basa.

azvaiitwa kuti nokuitika malignancies akadai squamous muchitokisi carcinoma, vakawanda myeloma, kenza yemazamu, renal kenza sero uye zvimwe lymphomas. Hypercalcemia, kushatiriswa kenza, zvinodhaka inonyatsobudirira ndivo bisphosphonates kuti intravenous aizomupa. Well yakatangwa muzviitiko izvi, mishonga yakadaro, bisphosphonates, se "Zolendronovaya asidhi" uye "Pamidronate".

Zvingaonekwa dzinoratidza kuti mazuva kare mashomanana pashure kudzidziswa chourongwa varwere nomutsinga umboo zvinodhaka muropa karusiyamu wevasungwa riri normalized nokuitika kunotora refu zvikuru nguva (kubvira imwe vhiki mbiri).

The pamazita zvirwere umo bisphosphonates dzinoshandiswa zvinobudirira

• Osteoporosis.
• Myeloma.
• Kutyorwa pfupa inotungamirwa.
• Paget nehosha (osteodystrophy deforming).
• Primary hyperparathyroidism.
• Namamota uye metastases vari pfupa, kunyanya pamwe hypercalcemia.

nemishonga

Zvinosuruvarisa zvinoshingaira bisphosphonate kunokwanisa kuva Hakuna Basa. Kunyanya kana toreva intravenous kwokubatsira zvinodhaka izvi. Vanogona kukonzera zvinotevera kunaka nemishonga:

• Kana achiita nomutsinga, - hypocalcemia.
• Zvinogona kukanganisa itsvo, kudhaka.
• Dzimwe nguva kugamuchirwa amine biosfosfonatov chinokurwadzai kukura osteonecrosis pakati shaya.
• Batsirawo Kuti kukura nemaronda mu yegurokuro uye mudumbu.
• Anogona kukonzera kupatirwa kana manyoka, mu zvisingawanzoitiki zviitiko - kuome kumedza.
• General zvakawanda zvive, utera, kuda kurutsa.
• Tsandanyama marwadzo.
• Vision matambudziko.
• Rashes pamusoro muviri.

Hongu, vose mumatambudziko izvi zvinogona kukonzera bisphosphonates. Zvinodhaka, mazita iyo wasangana munyaya ino, imi hamugoni gadzai pachangu pasina kuti kwete nokusaziva kuti muviri irreparable kukuvadza. We nemaune kudzokorora kakawanda mundima! Kutonga nezvinooneka wongororo, iyo inogona kuverenga forum siyana, vanhu vari kushingaira kuudzawo mashoko pamusoro pezvinhu zvakasiyana-siyana BF uye nyore kutokurudzira vamwe. Izvi zvishoma unethical. Zvinodhaka izvi simba zvinokosha chete pamusoro dzinoenda ari kupinda chiremba uye nguva dzose pasi pokudzora ake.

Bisphosphonates - wongororo vanachiremba uye varwere

Maiziva here kuti nerimwe gore, musi October 20, munyika dzese World Day of pakurwisa osteoporosis? chirwere ichi mumakore achangopfuura, tive zvechokwadi dambudziko zvikuru. Kunyange zvazvo dzimwe nyanzvi dzinodavira kuti kukurumidzira dambudziko osteoporosis iri zvishoma akawedzeredzwa, nekuti hosha hachisi pachayo zvinouraya. Zvisinei, vanhu vakawanda vakwegura vanofa pashure hudyu nokutyora, izvo zvinowanzoitika kana nokukurumidza mapfupa kurasikirwa guru chaizvo. Naizvozvo, vazhinji vanhu ane chaiyo tariro pamusoro bisphosphonates. Reviews wevarwere vakagamuchira zvinodhaka izvi nekuda kwetariro kupora, zvakazadza nokuonga vanachiremba uye pharmacology ano, iro akakwanisa dzinovapa kundibatsira.

Dr. with. , Purofesa musoro Scientific-Clinical Muzinda osteoporosis Svetlana Rodionova anotenda kuti zvinhu pamwe osteoporosis kwazvo zvakakwana muRussia. Chiremba inozivikanwa anoti pamazuva edu, kana simba vakawanda vanhu chakaremara (kushaiwa calcium), wana vakawanda kuparadzirwa vakadaro tsika dzakaipa dzakadai sokusvuta, kushandisa zvinodhaka uye doro, uye kurovedza muviri yava kusvika zero, vechiduku vakawanda, kunyanya vakadzi vakatondeswa akura makore osteoporosis. Saka kudiwa zvinodhaka zvakanaka inobudirira kubatsira kurapa chirwere ichi chaizvo.

Sezvo kakawanda chiremba agadzwa bisphosphonates, purofesa pfungwa kuti hazvina nguva dzose dzinoruramiswa. Bisphosphonates - waivako vakunde zvinodhaka, asi murwere vasati varwere imwe mushonga, chiremba anofanira kuva nechokwadi kuti kufunga kwakadaro zvinhu sezvo muviri remafupa uye calcium yakawanda homeostasis. Apo kutyaira uye kusingadzoreki bisphosphonate kurapa kungaita zvakakomba yematambudziko: atrial fibrillation, osteonecrosis pakati shaya, subtrochanteric mitswe ari femur.

Zvichienderana maonero chiremba airemekedzwa, bisphosphonates havasi zvakasikwa mushonga, avo kushandiswa anofanira akaswedera nokungwarira. Zvichakadai, chirongwa "Health" iri kutepfenyurwa paterevhizheni, apo Elena Malysheva pamwe chinonhuhwira kunyemwerera vanyatsobvuma vateereri kuti hapana nyore pane kubatwa kuti osteoporosis, chechitatu chizvarwa bisphosphonate. Usava zvakare kuvimba infomercial. Vamwe vanhu kugamuchira BF iri zvachose contraindicated. Somuenzaniso, varwere zvikuru renal zvirwere.

Zvino kudzokorora sei ishande bisphosphonates kana pfupa metastases. Medical pfungwa zvakajeka: zvinodhaka ava kunyatsokwanisa kumisa zviri pfupa kukura masero nyanyisa, izvo, chokwadi, kunobatsira varwere kukurira chimwe chezvinhu zvikuru zvirwere, rinongowanika riri munyika.

mhedziso

Zvino munoziva kuti chii - bisphosphonates. Mirayiridzo kwavo kushandisa pakusimuka pano, uyewo mazita zvinodhaka dzakapiwa kwatiri kwete kurumbidzwaka uku uye vari kutungamirirwa chete - ndapota kubhadhara yako chaiyo nzeve ichi! Kana zvinetso zvakakomba havafaniri pakuzvinyengera medicate pamwe utano, zvakanakisisa - nekukurumidza kuona chiremba, saka akatora kuti gadziriro dzokurapa. Tinokuropafadzai zvose nesimba utano uye mufaro!