Yini i-Colesevelam: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Colesevelam iyimithi kadokotela esiza ukwehlisa amazinga e-cholesterol egazini lakho. Lolu uhlobo lwe-bile acid sequestrant olusebenza ngokubopha kuma-bile acids emathunjini akho, okuphoqa umzimba wakho ukuthi usebenzise i-cholesterol ukwenza ama-bile acids engeziwe, ekugcineni kunciphisa i-cholesterol ejikeleza egazini lakho.

Le mithi ivame ukunqunywa lapho ukudla nokuzivivinya kunganele ukulawula amazinga aphezulu e-cholesterol. Udokotela wakho angase ancome i-colesevelam njengengxenye yendlela ebanzi yokuvikela impilo yenhliziyo yakho nokunciphisa ingozi yakho yesifo senhliziyo nemithambo yegazi.

Yini i-Colesevelam?

I-Colesevelam ingeyeqembu lemithi ebizwa ngokuthi ama-bile acid sequestrants. Cabanga ngayo njengesiponji esikhethekile esisebenza ngaphakathi kohlelo lwakho lokugaya ukudla ukusiza ukulawula amazinga e-cholesterol ngokwemvelo.

Ngokungafani neminye imithi ye-cholesterol esebenza esibindini sakho, i-colesevelam isebenza ngokuphelele emathunjini akho. Ayikaze ingene egazini lakho, okwenza kube yindlela enobungane kubantu abaningi. Umuthi uza ngesimo samaphilisi futhi uthathwa ngomlomo, ngokuvamile ngokudla.

Le ndlela yokuphatha i-cholesterol isetshenziswe ngokuphepha iminyaka eminingi. I-Colesevelam imele isizukulwane esisha sama-bile acid sequestrants athambekele ekubekezeleleni kangcono kunemithi endala kulolu hlobo.

Isetshenziselwani i-Colesevelam?

I-Colesevelam isetshenziswa ikakhulukazi ukwehlisa i-LDL cholesterol, evame ukubizwa ngokuthi i-cholesterol "embi". Udokotela wakho angase ayinikeze lapho amazinga akho e-cholesterol esahlala ephezulu naphezu kokulandela ukudla okunempilo yenhliziyo kanye nomkhuba wokuzivivinya.

Umuthi ulusizo ikakhulukazi kubantu abadinga ukwesekwa okwengeziwe kokwehlisa i-cholesterol ngaphandle kwezinguquko zokuphila. Ivame ukusetshenziswa kanye neminye imithi ye-cholesterol efana nama-statins ukuhlinzeka ngokuphathwa kwe-cholesterol okubanzi.

Kwezinye izimo, i-colesevelam ingase futhi inikezwe ukusiza ukuphatha amazinga kashukela egazi kubantu abanesifo sikashukela sohlobo 2. Le nzuzo ephindwe kabili yenza ibaluleke kakhulu kubantu abanayo kokubili i-cholesterol ephezulu nesifo sikashukela.

Isebenza Kanjani I-Colesevelam?

I-Colesevelam isebenza ngokuphazamisa inqubo yomzimba yakho yokusebenzisa kabusha i-cholesterol. Uma udla, isibindi sakho sikhiqiza ama-bile acids ukusiza ukugaya amafutha, futhi la ma-bile acids ngokuvamile aphinde afakwe futhi asetshenziswe kabusha.

Lo muthi ubopha kuma-bile acids emathunjini akho, uwavimbela ukuthi angaphinde afakwe. Umzimba wakho-ke udinga ukwenza ama-bile acids amasha usebenzisa i-cholesterol evela egazini lakho. Le nqubo inciphisa kancane kancane inani le-cholesterol elijikelezayo egazini lakho.

I-Colesevelam ithathwa njengomuthi we-cholesterol onamandla aphakathi nendawo. Ngokuvamile yehlisa i-LDL cholesterol ngamaphesenti angaba ngu-15-20%, okuyinto enengqondo kodwa ingashayi ngendlela emangalisayo njengeminye imithi ye-cholesterol. Indlela enobumnene, eqhubekayo ivame ukuyenza ilungele ukusetshenziswa isikhathi eside.

Kufanele Ngiyithathe Kanjani I-Colesevelam?

Thatha i-colesevelam ngendlela eqondile udokotela wakho ayalela ngayo, ngokuvamile ngesikhathi sokudla namanzi amaningi. Umthamo ovamile wokuqala ngamaphilisi amathathu kabili ngosuku ngesikhathi sokudla, nakuba udokotela wakho ezoqoka inani elifanele lesimo sakho esithile.

Ukuthatha umuthi nokudla kuyawusiza ukuthi usebenze ngempumelelo futhi kunciphisa ithuba lokuthi isisu singakhathazeki. Qiniseka ukuthi uphuza okungenani ama-ounces angu-8 amanzi ngomthamo ngamunye ukusiza umuthi ukuthi udlule ohlelweni lwakho lokugaya ukudla kahle.

Uma uthatha eminye imithi, uzodinga ukuyihlukanisa ne-colesevelam. Thatha eminye imithi okungenani ihora elingu-1 ngaphambi noma amahora angu-4 ngemva kokuthatha i-colesevelam, njengoba ingaphazamisa ukumuncwa kweminye imithi.

Zama ukuthatha i-colesevelam ngezikhathi ezifanayo nsuku zonke ukusiza ukusungula umkhuba. Lokhu kuvumelana kusiza ukuqinisekisa ukuthi uthola inzuzo ephelele yomuthi futhi kwenza kungenzeki ukuthi ukhohlwe umthamo.

Kufanele Ngiyithathe Isikhathi Eside Kangakanani I-Colesevelam?

I-Colesevelam ngokuvamile iyimithi yesikhathi eside ozoyithatha izinyanga noma iminyaka. I-cholesterol ephezulu ngokuvamile iyisimo esingamahlala-khona esidinga ukuphathwa okuqhubekayo kunokulungiswa kwesikhashana.

Kungenzeka uqaphele ukuthuthuka emazingeni akho e-cholesterol phakathi kwamasonto angu-2-4 ngemuva kokuqala ukwelashwa. Kodwa-ke, kungathatha amasonto angu-4-6 ukubona imiphumela ephelele yokwehlisa i-cholesterol yomuthi.

Udokotela wakho uzoqapha amazinga akho e-cholesterol njalo ngemihlolokhono yegazi ukuze abone ukuthi umuthi usebenza kahle kangakanani. Ngokuya ngemiphumela, bangase balungise umthamo wakho noma batusa ukwelashwa okwengeziwe ukukusiza ukuthi ufinyelele imigomo yakho ye-cholesterol.

Ungayeki ukuthatha i-colesevelam ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Amazinga akho e-cholesterol cishe azobuyela emazingeni awo angaphambilini uma uyeka umuthi ngaphandle kokuwufaka enye indlela yokwelapha.

Yiziphi Imiphumela Eceleni Ye-Colesevelam?

Abantu abaningi bayayibekezelela i-colesevelam kahle, kodwa njengayo yonke imithi, ingabangela imiphumela emibi. Izindaba ezinhle ukuthi imiphumela emibi engathi sína ayivamile ngoba umuthi awungeni egazini lakho.

Imiphumela emibi evame kakhulu ihilela uhlelo lwakho lokugaya ukudla, ngoba yilapho umuthi usebenza khona. Le miphumela ivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi emasontweni ambalwa okuqala kokwelashwa.

Imiphumela emibi ejwayelekile ongase uyithole ihlanganisa:

• Ukuqunjelwa (umphumela ovame kakhulu)
• Ukuphazamiseka kwesisu noma isicanucanu
• Igesi noma ukuqunjelwa
• Ukusha kwenhliziyo noma i-acid reflux
• Ikhanda
• Ukulimala kwemisipha

Lezi zimpawu zivame ukuba mnene futhi zilawuleka. Ukuphuza amanzi amaningi, ukudla ukudla okunothile nge-fiber, nokuhlala usebenza ngokomzimba kungasiza ekunciphiseni imiphumela emibi yokugaya ukudla.

Imiphumela emibi engavamile kodwa engathi sína ingahlanganisa:

• Ukuqunjelwa okukhulu okungathuthuki
• Ubuhlungu obukhulu besisu noma ukuqaqamba
• Ubunzima bokugwinya
• Ukuphuma kwegazi okungavamile noma ukulimala
• Izimpawu zokuvaleka kwamathumbu (ubuhlungu obukhulu besisu, ukuhlanza, ukungakwazi ukukhipha umoya)

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu ezingathi sína. Nakuba kungavamile, ukuvaleka kwamathumbu kuyisimo esingase sibe sibi esidinga ukunakekelwa kwezempilo ngokushesha.

Ubani Ongafanele Athatha I-Colesevelam?

I-Colesevelam ayilungile kuwo wonke umuntu, futhi udokotela wakho uzocabangela impilo yakho yonke ngaphambi kokuyinika. Abantu abanezimo ezithile zokugaya ukudla bangase badinge ukugwema lo muthi noma bawusebenzise ngokuqapha okwengeziwe.

Akufanele uthathe i-colesevelam uma unomlando wokuvaleka kwamathumbu noma uma unamazinga aphezulu kakhulu e-triglyceride (ngaphezu kuka-500 mg/dL). Umuthi ungase uqhubekisele phambili lezi zimo.

Udokotela wakho uzophinda aqaphele ngokunika i-colesevelam uma une:

• Ukuqunjelwa okungapheli noma izifo zokugaya ukudla
• Ubunzima bokugwinya
• Umlando wokuhlinzwa kwesisu noma kwamathumbu
• Ukugaya ukudla okuhamba kancane kakhulu (gastroparesis)
• Ukuntula kwamavithamini, ikakhulukazi amavithamini ancibilika emafutheni

Abantu abanesifo sikashukela kufanele baqashwe ngokucophelela, njengoba i-colesevelam ingathinta amazinga kashukela egazini. Nakuba lokhu kungaba usizo kwabanye abantu abanesifo sikashukela, kudinga ukuqashwa ngokucophelela nokulungiswa okungenzeka kwemithi yesifo sikashukela.

Uma ukhulelwe noma uncelisa, xoxa ngezingozi nezinzuzo nodokotela wakho. Nakuba i-colesevelam ingangeni egazini, kubalulekile ukulinganisa izinzuzo ezingaba khona nezingozi ezingase zibe khona ngesikhathi sokukhulelwa.

Amagama Omkhiqizo we-Colesevelam

I-Colesevelam itholakala ngaphansi kwegama lomkhiqizo elithi Welchol e-United States. Lolu wuhlobo oluvame kakhulu olunikezwayo lomuthi futhi lukhiqizwa yi-Daiichi Sankyo.

Njengamanje, izinhlobo ezivamile ze-colesevelam ziyatholakala, ezingasiza ukunciphisa izindleko zokwelashwa. Lezi zinhlobo ezivamile ziqukethe isithako esifanayo esisebenzayo futhi zisebenza ngempumelelo njengohlobo lwegama lomkhiqizo.

Ikhemisi lakho lingase lithathele indawo ngohlobo olujwayelekile ngaphandle uma udokotela wakho efuna ngokuqondile igama lomkhiqizo. Zombili izinhlobo zisebenza ngendlela efanayo, ngakho ukukhetha kuvame ukwehla ezindlekweni kanye nomshwalense.

Ezinye izindlela ze-Colesevelam

Uma i-colesevelam ingasebenzi kahle kuwe noma ibangela imiphumela engathandeki, imithi eminingi ehlukile ingasiza ekuphatheni amazinga e-cholesterol. Udokotela wakho angakusiza ukuthi uthole inketho engcono kakhulu yesimo sakho esithile.

Ezinye izinto ezithatha i-bile acid zihlanganisa i-cholestyramine (Questran) kanye nomanduleli we-colesevelam, i-colestipol (Colestid). Lezi zisebenza ngendlela efanayo ne-colesevelam kodwa zingase zibe nemiphumela ehlukile noma izidingo zokulinganisa.

Ama-Statins avame ukuba ukwelashwa kokuqala kwe-cholesterol ephezulu futhi afaka imithi efana ne-atorvastatin (Lipitor), simvastatin (Zocor), kanye ne-rosuvastatin (Crestor). Lezi zisebenza ngendlela ehlukile kune-colesevelam ngokuvimba ukukhiqizwa kwe-cholesterol esibindini.

Ezinye izindlela zihlanganisa:

• Ezetimibe (Zetia) - ivimba ukumuncwa kwe-cholesterol emathunjini
• Ama-PCSK9 inhibitors afana ne-evolocumab (Repatha) - imithi entsha ejovwayo
• Ama-Fibrates - asiza ukwehlisa ama-triglycerides futhi angase athuthukise i-cholesterol ngokulinganisela
• I-Niacin (i-nicotinic acid) - ingathuthukisa iphrofayela ye-cholesterol kodwa inemiphumela emibi kakhulu

Udokotela wakho angase futhi ancome imithi ehlanganisiwe ehlanganisa i-colesevelam neminye imithi yokwehlisa i-cholesterol. Ukukhetha okungcono kuncike emazingeni akho e-cholesterol, ezinye izimo zempilo, nokuthi uyayibekezelela kangakanani imithi ehlukene.

Ingabe i-Colesevelam ingcono kune-Cholestyramine?

I-Colesevelam inikeza izinzuzo eziningi ngaphezu kwe-cholestyramine, i-bile acid sequestrant endala. Zombili lezi zithako zisebenza ngendlela efanayo, kodwa i-colesevelam ivame ukubekezelelwa kangcono ngabantu abaningi.

Inzuzo enkulu ye-colesevelam ukuthi ibangela imiphumela emibi emincane yokugaya ukudla. Ngenkathi zombili izithako zingabangela ukuqunjelwa nokuphazamiseka kwesisu, i-colesevelam ngokuvamile ikhiqiza izimpawu ezithambile okulula ukuzilawula.

I-Colesevelam nayo iza ngesimo samaphilisi alula, kuyilapho i-cholestyramine itholakala njengempushana okumele ixutshwe noketshezi. Abantu abaningi bathola ukuthi amaphilisi kulula kakhulu ukuwathatha njalo, okuthuthukisa ukunamathela ekwelashweni.

Ngokombono wokusebenza kahle, zombili izithako zinikeza izinzuzo ezifanayo zokwehlisa i-cholesterol. Ukukhetha phakathi kwazo kuvame ukwehla ekubekezeleleni, ukulula, kanye nokucatshangelwa kwezindleko.

Nokho, i-cholestyramine isitholakale isikhathi eside futhi ingase ibize kancane, ikakhulukazi ngesimo esivamile. Udokotela wakho angakusiza ukuthi ulinganise izinzuzo nobubi ngokusekelwe ezidingweni zakho ezithile nezintandokazi zakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Colesevelam

Q1. Ingabe i-Colesevelam iphephile kubantu abanesifo sikashukela?

Yebo, i-colesevelam ngokuvamile iphephile kubantu abanesifo sikashukela futhi ingase isize ngisho nokuthuthukisa ukulawulwa kukashukela egazini. Eqinisweni, ivunywe ngokuqondile yi-FDA ukusiza ukulawula amazinga kashukela egazini kubantu abanesifo sikashukela sohlobo 2.

Umuthi ungasiza ukwehlisa kokubili i-cholesterol kanye namazinga kashukela egazini, okuzuzisa ikakhulukazi ngoba abantu abanesifo sikashukela banengozi enkulu yesifo senhliziyo. Nokho, uzodinga ukuqapha eduze amazinga akho kashukela egazini lapho uqala i-colesevelam.

Udokotela wakho angase adinge ukulungisa imithi yakho yesifo sikashukela lapho uqala i-colesevelam, ngoba ukulawulwa okuthuthukisiwe kukashukela egazini kungasho ukuthi udinga okuncane kwemithi yakho yesifo sikashukela yamanje. Ungalokothi ulungise imithi yakho yesifo sikashukela ngokwakho.

Q2. Kufanele ngenzeni uma ngithatha i-Colesevelam eningi ngengozi?

Uma ngabe uthathe i-colesevelam eningi kunaleyo oyinikiwe, ungesabi. Njengoba umuthi ungangeni emsingeni wakho wegazi, ukweqisa okuncane akunakwenzeka ukuthi kubangele umonakalo omkhulu.

Ungase uhlangabezane nemiphumela emibi yokugaya ukudla eyengeziwe efana nokuqina kwesisu, ukuphazamiseka kwesisu, noma ukuqunjelwa. Phuza amanzi amaningi futhi udle ukudla okunothile nge-fiber ukusiza ukuhambisa umuthi ngohlelo lwakho.

Uma ngabe uthathe inani elikhulu noma uhlangabezana nezimpawu ezinzima, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi. Bangakunikeza isiqondiso esiqondile esisekelwe enanini olithathile kanye nezimpawu zakho zamanje.

Esikhathini esizayo, cabanga ukusebenzisa umhleli wamaphilisi noma ukusetha izikhumbuzi zocingo ukusiza ukuvimbela ukuthatha kabili ngengozi. Ukuthatha imithi ngesikhathi esifanayo nsuku zonke nakho kuyasiza ukusungula umkhuba onciphisa amaphutha.

Q3. Kufanele Ngenzeni Uma Ngedlula Umthamo We-Colesevelam?

Uma udlula umthamo we-colesevelam, yithathe ngokushesha lapho ukhumbula, inqobo nje uma ukudla. Njengoba umuthi usebenza kahle uma uthathwa nokudla, ungathathi umthamo owudlulile esiswini esingenalutho.

Uma sekuseduze isikhathi somthamo wakho olandelayo ohleliwe, weqa umthamo owudlulile bese uqhubeka neshejuli yakho ejwayelekile. Ungathathi imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo owudlulile, njengoba lokhu kungakhuphula ingozi yakho yemiphumela emibi.

Ukudlula umthamo ngezikhathi ezithile ngeke kukulimaze, kodwa zama ukuthatha i-colesevelam ngokuqhubekayo ukuze uthole imiphumela engcono yokwehlisa i-cholesterol. Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho ngamasu okuthuthukisa ukunamathela emithini.

Cabanga ukusetha izikhumbuzi zansuku zonke ocingweni lwakho noma usebenzise umhleli wamaphilisi wamasonto onke ukukusiza ukuthi ukhumbule imithi yakho. Ukuthatha i-colesevelam ngesikhathi esifanayo nokudla kwakho nakho kungasiza ukusungula umkhuba.

Q4. Ngingayeka Nini Ukuthatha I-Colesevelam?

Kufanele uyeke kuphela ukuthatha i-colesevelam ngaphansi kokuqondisa kukadokotela wakho. I-cholesterol ephezulu ngokuvamile iyisimo esingamahlala-khona esidinga ukuphathwa okuqhubekayo, ngakho ukuyeka ukwelashwa ngokuvamile akukhuthazwa ngaphandle uma kunesizathu esithile sezokwelapha.

Udokotela wakho angase acabange ukuyeka i-colesevelam uma ufinyelele ukulawulwa okuhle kakhulu kwe-cholesterol ngokushintsha okukhulu kwendlela yokuphila, uma uhlangabezana nemiphumela engemihle engabekezeleleki, noma uma udinga ukushintshela emuthini ohlukile.

Uma udinga ukuyeka ukuthatha i-colesevelam, udokotela wakho uzoqapha amazinga akho e-cholesterol ngokucophelela futhi angase ancome ezinye izindlela zokwelapha. Amazinga akho e-cholesterol cishe azobuyela emazingeni awo angaphambilini kungakapheli amasonto ambalwa ngemva kokuyeka umuthi.

Ungalokothi uyeke ukuthatha i-colesevelam ngokuzumayo ngoba uzizwa ungcono noma ngoba amazinga akho e-cholesterol athuthukile. Lokhu kuthuthuka kungenzeka ngenxa yokuthi umuthi usebenza ngempumelelo, hhayi ngoba awusadingi ukwelashwa.

Q5. Ngingayithatha i-Colesevelam neminye imithi?

I-Colesevelam ingasebenzisana neminye imithi eminingi ngokuthinta ukuthi imuncwa kahle kangakanani emathunjini akho. Yingakho isikhathi sibalulekile uma uthatha i-colesevelam neminye imithi.

Thatha eminye imithi okungenani ihora elingu-1 ngaphambi noma amahora angu-4 ngemva kokuthatha i-colesevelam. Lesi sikhathi sisiza ukuqinisekisa ukuthi eminye imithi yakho imuncwa kahle ngaphambi kokuba i-colesevelam ingaphazamisa inqubo.

Eminye imithi ethinteka ikakhulukazi ihlanganisa ama-blood thinners, imithi yegilo, imithi yesifo sikashukela, kanye nama-antibiotics athile. Hlala utshela udokotela wakho nomuthi ngayo yonke imithi oyithathayo, okuhlanganisa nemithi etholakala ngaphandle kwe-oda kanye nezithasiselo.

Udokotela wakho kungase kudingeke ukuthi alungise isikhathi noma umthamo weminye imithi yakho uma uqala i-colesevelam. Ungashintshi isikhathi semithi yakho ngaphandle kokubonisana nomhlinzeki wakho wezempilo kuqala.