Metyrapone ni iki: Ibyo ikoreshwa, urugero rwo gufata, ingaruka zabyo n'ibindi

Metyrapone ni umuti wandikirwa na muganga ubuzwa umubiri wawe gukora cortisol, umusemburo w'umunaniro ukorwa n'ingingo zawe zikora imisemburo. Muganga wawe ashobora kukwandikira uyu muti kugira ngo afashe kumenya ibibazo by'imisemburo yawe cyangwa ingingo yawe ya pituitary, cyangwa kuvura indwara aho umubiri wawe ukora cortisol nyinshi.

Uyu muti ukora nk'ipfundo rigenzurwa neza ku mikorere y'imisemburo yawe. Ikoreshwa cyane cyane nk'igikoresho cyo kumenya kugira ngo gifashe itsinda ry'ubuzima bwawe gusobanukirwa n'uko ingingo zawe zikora imisemburo zikorana neza.

Metyrapone ni iki?

Metyrapone ni umuti wihariye ubuzwa by'agateganyo enzyme yitwa 11β-hydroxylase mu ngingo zawe zikora imisemburo. Iyi enzyme niyo ishinzwe intambwe ya nyuma yo gukora cortisol, umusemburo w'umubiri wawe w'ingenzi w'umunaniro.

Iyo metyrapone ibuza iyi enzyme, urugero rwawe rwa cortisol ruragabanuka, ibyo bikerekana ingingo yawe ya pituitary gusohora ACTH (adrenocorticotropic hormone) nyinshi. Iyi ngaruka ifasha abaganga gusobanukirwa niba ingingo yawe ya pituitary ikora neza kandi ishobora gusubiza neza ku rugero rwa cortisol ruto.

Umuti uza mu buryo bwa capsule kandi ukoreshwa cyane cyane mu igeragezwa ry'igihe gito aho gukoreshwa mu kuvura igihe kirekire. Ifatwa nk'igikoresho cyo kumenya mbere na mbere, nubwo rimwe na rimwe ishobora gukoreshwa mu gucunga ibibazo bimwe na bimwe bifitanye isano n'imisemburo.

Metyrapone ikoreshwa mu iki?

Metyrapone ikoreshwa cyane cyane mu kugerageza uburyo ingingo yawe ya pituitary isubiza iyo urugero rwa cortisol ruri hasi. Iri geragezwa, ryitwa metyrapone stimulation test, rifasha abaganga kumenya indwara zitandukanye zifitanye isano n'imisemburo.

Impamvu isanzwe ushobora gufata metyrapone ni ugufasha muganga wawe kumenya niba ufite adrenal insufficiency ya kabiri. Iyi ndwara ibaho iyo ingingo yawe ya pituitary itakora ACTH ihagije kugira ngo itere ingingo zawe zikora imisemburo neza.

Rimwe na rimwe, abaganga bakoresha metyrapone kugira ngo bafashe kumenya indwara ya Cushing, indwara umubiri wawe ukora cortisol nyinshi cyane. Muri ibyo bihe, uwo muti ufasha abaganga gusobanukirwa aho umusemburo mwinshi ukomoka.

Mu buryo butavugwa cyane, metyrapone ishobora gukoreshwa nk'umuti wo kugabanya by'agateganyo urugero rwa cortisol mu bantu bafite indwara ya Cushing ikaze mu gihe bategereje ko izindi nshuti zitangira gukora.

Metyrapone ikora ite?

Metyrapone ikora ibuza enzyme runaka mu ngingo zawe za adrenal zikenewe kugira ngo zikore cortisol. Bitekereze nk'uguhagarika by'agateganyo umurongo wa nyuma wo gukora cortisol mu mubiri wawe.

Iyo urugero rwa cortisol rwawe rugabanutse, ingingo yawe ya pituitary ibona iyi mpinduka maze igasubiza itanga ACTH nyinshi. Ubu ni uburyo karemano bw'umubiri wawe bugerageza gusubiza urugero rwa cortisol rusanzwe.

Uwo muti ufatwa nk'ufite imbaraga ziringaniye mu ngaruka zawo. Urashobora kugabanya cyane gukorwa kwa cortisol mu masaha make nyuma yo kuwufata, ni yo mpamvu ukora neza mu kugerageza kumenya indwara ariko kandi ni yo mpamvu bisaba gukurikiranwa na muganga witonze.

Muganga wawe ashobora gupima urugero rwawe rwa cortisol na ACTH nyuma yo gufata metyrapone kugira ngo arebe uko sisitemu yawe y'imisemburo ivugana neza. Iyi makuru ibafasha kumenya indwara zitandukanye zifata ingingo zawe za adrenal cyangwa pituitary.

Nkwiriye gufata metyrapone nte?

Ukwiye gufata metyrapone nk'uko muganga wawe abyandika, akenshi hamwe n'ibiryo cyangwa amata kugira ngo ugabanye kuribwa mu gifu. Uwo muti akenshi ufashwa buri masaha 4 mu gihe cyo kugerageza.

Abaganga benshi basaba gufata metyrapone hamwe n'akaboga gato cyangwa ifunguro ririmo poroteyine na karubohidrate. Ibi bifasha umubiri wawe kwinjiza uwo muti neza kandi bigabanya amahirwe yo kuruka.

Ni ngombwa gufata imiti ku gihe nyacyo muganga wawe yagushijeho, kabone niyo byasaba gushyiraho alarme nijoro. Igihe ni ingenzi kugira ngo ubone ibisubizo by'ibizamini by'ukuri.

Buri gihe umira ibinini byose hamwe n'ikirahure cyuzuye cy'amazi. Ntukavunagure, utahe cyangwa ufungure ibinini, kuko ibi bishobora kugira ingaruka ku buryo umuti ukora mu mubiri wawe.

Nzagenda Mfata Metyrapone Igihe Kingana Gite?

Abantu benshi bafata metyrapone mu minsi 1-3 gusa mugihe cy'ibizamini byo kumenya indwara. Igihe nyacyo giterwa n'ubwoko bw'ikizamini muganga wawe ari gukora n'uburyo umubiri wawe witwara.

Ku kizamini gisanzwe cya metyrapone, mubisanzwe uzajya ufata umuti mu masaha 24, ufata doze buri masaha 4. Muganga wawe azahita apima urugero rw'imisemburo yawe kugira ngo arebe uko umubiri wawe witwaye.

Niba ukoresha metyrapone kugira ngo ugenzure by'agateganyo urugero rwo hejuru rwa cortisol, muganga wawe ashobora kukwandikira imiti mu minsi cyangwa mu byumweru. Ariko, ibi ntibisanzwe kandi bisaba gukurikiranwa neza.

Ntuzigere uhagarika gufata metyrapone ako kanya utabanje kuvugana na muganga wawe, cyane cyane niba umaze kuyifata iminsi irenga mike. Muganga wawe ashobora gukenera guhindura gahunda yawe yo gufata imiti cyangwa gutanga ubufasha bwiyongera mugihe urugero rw'imisemburo yawe rusubira mu buryo busanzwe.

Ni Iyihe Ngaruka Ziterwa na Metyrapone?

Ingaruka zisanzwe ziterwa na metyrapone zijyanye n'urugero rwa cortisol ruto rw'agateganyo, rushobora gutuma wumva utameze neza. Izi ngaruka mubisanzwe zoroheje kandi zigenda umaze guhagarika gufata umuti.

Ushobora kugira isesemi, kuruka, cyangwa kutumva neza mu gifu, cyane cyane niba ufata umuti mugihe udafite ikintu urya. Ibi bibazo byo mu gifu biri mu byo abantu benshi bavuga iyo bafata metyrapone.

Abantu bamwe bumva bazungera, bananiwe, cyangwa bafite intege nke mugihe bafata uyu muti. Ibi bibaho kuko cortisol ifasha kugenzura umuvuduko w'amaraso yawe n'urugero rw'imbaraga, bityo kubuza umusaruro wayo bishobora kugira ingaruka ku buryo wumva.

Ibi ni ibimenyetso bishobora kukubaho, bikurikiza uko bikunda cyane kugeza ku bitajyenda kenshi:

• Kuruka no kuribwa
• Urubu mu nda cyangwa kutumva neza
• Kuribwa umutwe cyangwa kumva urushye
• Kugira umunaniro cyangwa intege nke
• Umutwe
• Kubura ubushake bwo kurya
• Uruhu rurisha cyangwa kuribwa

Ibi bimenyetso muri rusange birashoboka kandi ntibiramba. Ariko, niba ubonye ibimenyetso bikomeye cyangwa ntibigenda neza, jya kwa muganga kugira ngo agufashe.

Ibimenyetso bidasanzwe ariko bikomeye bishobora kuba harimo igabanuka rikomeye ry'umuvuduko w'amaraso, urujijo, cyangwa ibimenyetso by'ibibazo bya adrenal nk'intege nke zikomeye, kuruka, cyangwa guta umutwe. Ibi bisaba ubufasha bwihuse bw'abaganga.

Ninde utagomba gufata Metyrapone?

Ntugomba gufata metyrapone niba ufite indwara zimwe na zimwe cyangwa ufata imiti imwe na rimwe ishobora kugirana imikoranire nabi nayo. Muganga wawe azasuzuma neza amateka yawe mbere yo kugusaba uyu muti.

Abantu bafite indwara zikomeye z'impyiko cyangwa ibibazo by'umwijima bagomba kwirinda metyrapone, kuko izi ngingo zifasha gutunganya umuti. Niba impyiko zawe cyangwa umwijima wawe bidakora neza, umuti ushobora kwiyongera mu mubiri wawe ukagera ku rwego ruteje akaga.

Niba ufite amateka y'uburwayi bwa adrenal cyangwa umaze gufata imiti ya steroid, metyrapone ntishobora kuba ifite umutekano kuri wowe. Uyu muti ushobora gutuma urwego rwa cortisol rugabanuka kandi rugatera ibibazo bikomeye.

Abagore batwite muri rusange bagomba kwirinda metyrapone keretse inyungu zigaragara neza kurusha ibyago. Uyu muti ushobora kwambuka placenta kandi ugashobora kugira ingaruka ku mikorere y'imisemburo y'umwana ukura.

Ugomba kandi kwirinda metyrapone niba ufata imiti imwe na rimwe igabanya umuvuduko w'amaraso, cyane cyane ACE inhibitors, kuko iyi mvange ishobora gutuma umuvuduko w'amaraso yawe ugabanuka cyane.

Amazina y'ubwoko bwa Metyrapone

Metyrapone iboneka munsi y'izina ry'ubwoko bwa Metopirone muri Leta Zunze Ubumwe z'Amerika. Iyi ni yo miti isabwa cyane.

Mu bihugu bimwe na bimwe, ushobora gusanga metyrapone yitwa amazina atandukanye y'ubucuruzi, ariko ikintu gikora kiguma kimwe. Buri gihe jya ubaza umufarimasi w'umuganga wawe kugira ngo wemeze ko urimo guhabwa umuti ukwiye.

Ubwoko bwa metyrapone busanzwe bushobora kuboneka mu turere tumwe na tumwe, ariko ntibusanzwe kurusha ubwoko bw'izina ry'ubucuruzi. Muganga wawe cyangwa umufarimasi barashobora kugufasha kumenya uburyo bukwiye bw'ikibazo cyawe.

Uburyo bwo gusimbuza metyrapone

Imiti myinshi itandukanye irashobora gukoreshwa mu ntego zo gupima zisa cyangwa kugenzura urwego rwo hejuru rwa cortisol. Guhitamo biterwa n'uburwayi bwawe bwihariye n'icyo muganga wawe agerageza kumenya cyangwa kuvura.

Mu bipimo byo gupima, muganga wawe ashobora gukoresha ibizamini byo guhagarika dexamethasone aho gukoresha metyrapone. Ibi bizamini bikora mu buryo butandukanye ariko birashobora gutanga amakuru asa n'ayo yerekeye sisitemu yawe y'imisemburo.

Niba ukeneye kuvurwa urwego rwo hejuru rwa cortisol, ibindi bisimbura birimo ketoconazole, mifepristone, cyangwa cabergoline. Buri muti muri iyi miti ukora ukoresheje uburyo butandukanye kandi birashobora gukwira bitewe n'uburwayi bwawe bwihariye.

Mu bihe bimwe na bimwe, muganga wawe ashobora gushimira ikizamini cya CRH cyangwa ikizamini cyo kwihanganira insuline nk'ibindi bisimbura ibizamini bya metyrapone. Ibi bizamini birashobora gutanga amakuru asa n'ayo yo gupima ariko birashobora gukwira kurushaho abarwayi bamwe na bamwe.

Ese Metyrapone iruta Ketoconazole?

Metyrapone na ketoconazole byombi bigabanya urwego rwa cortisol, ariko bikora mu buryo butandukanye kandi bikoreshwa mu bihe bitandukanye. Nta na kimwe muri byo kiruta ikindi.

Metyrapone ikoreshwa cyane mu bipimo byo gupima kuko ikora vuba kandi byizerwa. Ni nziza cyane mu kizamini cya metyrapone stimulation ariko ntisanzwe ikoreshwa mu kuvura igihe kirekire.

Ku rundi ruhande, ketoconazole ikoreshwa cyane mu kuvura urwego rwo hejuru rwa cortisol mu gihe kirekire. Irashobora gufatwa buri munsi mu byumweru cyangwa amezi, mugihe metyrapone isanzwe ikoreshwa mu minsi mike gusa.

Gu hitamo imiti yombi biterwa niba ukeneye ibizamini byo kumenya indwara cyangwa kuvurwa buri gihe. Muganga wawe azareba uko ubuzima bwawe buhagaze, imiti urimo gufata, n'ubuzima bwawe muri rusange mbere yo gufata icyemezo.

Ibikunze Kubazwa Kuri Metyrapone

Ese Metyrapone irakwiriye abantu barwaye diyabete?

Metyrapone ishobora kugira ingaruka ku isukari mu maraso, bityo abantu barwaye diyabete bagomba gukurikiranwa cyane igihe bafata uyu muti. Uyu muti ushobora gutuma isukari mu maraso yiyongera kubera ko ituma cortisol itagira akamaro, kandi cortisol ifasha kugenzura isukari.

Muganga wawe ashobora gushaka gupima isukari yawe kenshi niba urwaye diyabete kandi ukeneye gufata metyrapone. Ashobora kandi guhindura imiti yawe ya diyabete by'agateganyo mugihe cyo gupima.

Abantu benshi barwaye diyabete igenda neza bashobora gufata metyrapone mu gihe gito cyo gupima. Ariko, itsinda ry'abaganga bazagukurikiranira hafi kugirango barebe ko isukari yawe iguma mu rugero rwiza.

Nigira iki niba mfata metyrapone nyinshi bitunguranye?

Niba ufata metyrapone nyinshi kuruta uko byategetswe, vugana na muganga wawe cyangwa ikigo gishinzwe ubumara ako kanya. Guhafa nyinshi bishobora gutera cortisol kuba nkeya cyane kandi bikagira ingaruka zikomeye.

Ibimenyetso byo kurenza urugero rwa metyrapone birimo isesemi ikabije, kuruka, intege nke zikabije, urujijo, cyangwa guta umutwe. Ibi bimenyetso bisaba ubufasha bwihuse bw'abaganga.

Ntugerageze kwivura wenyine ukoresheje imiti ya steroid cyangwa indi miti. Abaganga bakeneye gusuzuma urugero rw'imisemburo yawe kandi bagatanga ubuvuzi bukwiye bushingiye ku buzima bwawe.

Nigira iki niba nirengagije gufata urugero rwa metyrapone?

Niba wibagiwe gufata urugero rwa metyrapone mugihe cyo gupima, vugana na muganga wawe ako kanya. Kwibagirwa gufata imiti bishobora kugira ingaruka ku byavuye mu bizamini kandi bishobora gusaba ko wongera gutangira ibizamini.

Ntugasubiremo imiti cyangwa ngo ugerageze kwihutisha ufata imiti yiyongereye. Ibi bishobora guteza akaga kandi bishobora gutuma urwego rwa cortisol yawe rugabanuka cyane.

Muganga wawe azakugira inama niba ugomba gukomeza ikizamini cyangwa ukagisubika. Icyemezo giterwa n'igihe gishize n'ubwoko bw'ikizamini uri gukora.

Nshobora Kureka Gufata Metyrapone Ryari?

Ushobora kureka gufata metyrapone mugihe muganga wawe akubwiye ko ikizamini kirangiye, akenshi nyuma y'iminsi 1-3. Ibyegeranyo byinshi by'ubuvuzi bifite iherezo ryihariye itsinda ry'ubuzima rirakurikirana.

Niba ufata metyrapone kugirango uvurwe aho gukora ibizamini, ntuzigere uhagarara ako kanya utabifashijwemo na muganga. Muganga wawe ashobora gukenera kugabanya buhoro buhoro urugero rwawe cyangwa gutanga ubufasha bwa steroid.

Nyuma yo guhagarika metyrapone, urwego rwawe rwa cortisol ruzasubira mu buryo busanzwe muminsi mike. Muganga wawe azasanzwe ategura gahunda yo gusuzuma ibisubizo byawe by'ikizamini n'intambwe zikurikira.

Nshobora Gutwara Imodoka Ngihe Ndafata Metyrapone?

Ugomba kwirinda gutwara cyangwa gukoresha imashini mugihe ufata metyrapone, kuko umuti ushobora gutera isereri, intege nke, cyangwa urujijo. Ibi bishobora kubangamira ubushobozi bwawe bwo gutwara neza.

Umuti ugira ingaruka ku rwego rwawe rwa cortisol, rushobora kugira ingaruka ku gitutu cy'amaraso yawe n'imbaraga. Ibi bishobora gutuma wumva udashikamye cyangwa utari maso kurusha uko bisanzwe.

Teganya ko undi muntu azakujyana mu nama z'ubuvuzi mugihe ufata metyrapone. Abantu benshi bashobora gusubira mu bikorwa bisanzwe, harimo gutwara, muminsi mike nyuma yo guhagarika umuti.