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

I-Paricalcitol iyifomu elenziwe ngamanye le-vitamin D elinikezwa nge-IV ukusiza ukuphatha izinkinga ezivela esifweni sezinso esingamahlalakhona. Lapho izinso zakho zingasebenzi kahle, azikwazi ukucubungula kahle i-vitamin D, okuholela ezinkingeni zokulinganisela kwe-calcium ne-phosphorus emzimbeni wakho. Lo muthi ungena ukusiza ukubuyisela lokho kulinganisela futhi uvikele amathambo akho nempilo yonke.

Yini i-Paricalcitol?

I-Paricalcitol iyinguqulo eyenziwe ngabantu ye-vitamin D esebenzayo esebenza ngqo kubantu abanezinkinga zezinso. Ngokungafani nezithasiselo ze-vitamin D ezivamile ongazithatha ngomlomo, lo muthi wenzelwe ukuba mnene ohlelweni lwakho ngenkathi usahlinzeka ngezinzuzo umzimba wakho ozidingayo. Iyingxenye yeqembu lemithi ebizwa ngokuthi ama-analog we-vitamin D, okusho ukuthi alingisa lokho i-vitamin D yemvelo ekwenzayo emzimbeni wakho.

Umuthi uza njengoketshezi olucacile olunikezwa ngqo emjondolo wakho nge-IV line. Le ndlela iqinisekisa ukuthi umzimba wakho uthola inani eliqondile, ngoba abantu abanesifo sezinso bavame ukuba nenkinga yokumunca izakhamzimba ngohlelo lwabo lokugaya ukudla. Ithimba lakho lezempilo lizosingatha konke ukulungiselela nokuphatha, ngakho akudingeki ukhathazeke ngemininingwane yezobuchwepheshe.

Yini i-Paricalcitol Esetshenziselwa Yona?

I-Paricalcitol iphatha isimo esibizwa ngokuthi i-hyperparathyroidism yesibili kubantu abanesifo sezinso esingamahlalakhona. Lokhu kwenzeka lapho izinso zakho zingakwazi ukwenza i-vitamin D ngendlela efanele, okubangela ukuthi amagland parathyroid akho asebenze ngokweqile futhi akhiqize i-parathyroid hormone eningi kakhulu. Cabanga ngakho njengomphumela we-domino lapho inkinga eyodwa iholela kwenye.

Uma amagciwane akho e-parathyroid esebenza ngokweqile, akhipha i-calcium eningi emathanjeni akho, okwenza abuthake futhi abe buthuntu. Lesi simo, esibizwa nge-renal osteodystrophy, singabangela ubuhlungu emathanjeni, ukuqhekeka, nezinye izinkinga ezinzima. I-Paricalcitol isiza ukuqeda lo mjikelezo ngokunikeza i-vitamin D esebenzayo umzimba wakho oyidingayo ukuze ulawule i-calcium ne-phosphorus ngendlela efanele.

Lo muthi unqunyelwe ngokuqondile abantu abase-dialysis noma abanezifo ezinzima zezinso. Udokotela wakho ngokuvamile uzokuncoma uma ukuhlolwa kwegazi kubonisa ukuthi amazinga akho e-parathyroid hormone aphezulu kakhulu naphezu kokwelashwa okuhlukile. Kuyingxenye ebalulekile yokugcina amathambo akho enempilo nokuvimbela izinkinga njengoba isifo sakho sezinso siqhubeka.

Isebenza Kanjani I-Paricalcitol?

I-Paricalcitol isebenza ngokwenza sengathi iyindlela esebenzayo ye-vitamin D emzimbeni wakho, kodwa yakhelwe ukuthi iqondiswe kakhulu futhi ibangele imiphumela emincane. Uma unezinso ezinempilo, ziguqula i-vitamin D ejwayelekile ibe yindlela yayo esebenzayo, ekhona isiza amathumbu akho ukuba amunce i-calcium futhi igcine amagciwane akho e-parathyroid ezolile. Njengoba izinso ezilimele zingakwazi ukwenza lo msebenzi kahle, i-paricalcitol ingena ukuzovala leyo gebe.

Lo muthi ubopha kuma-receptors e-vitamin D emagciwaneni akho e-parathyroid, empeleni uwatshela ukuthi anciphise ukukhiqizwa kwawo kwe-hormone. Lokhu kusiza ukubuyisela ukulinganisela okubucayi kwe-calcium ne-phosphorus egazini lakho. Ngokungafani nokwelashwa okuthile kwe-vitamin D, i-paricalcitol ithathwa njengomuthi onamandla aphakathi nendawo ongase ungabangeli ukukhuphuka okuyingozi emazingeni e-calcium.

Okuthile okwenza i-paricalcitol ikhetheke ukuthi ikhetha kakhulu esenzweni sayo. Ngenkathi iphatha ngempumelelo amazinga akho e-parathyroid hormone, mancane amathuba okuthi ibangele ukumuncwa kwe-calcium ngokweqile emathunjini akho. Lokhu kukhetha kuyenza iphephe ukusetshenziswa isikhathi eside kubantu abanezifo zezinso abadinga ukwelashwa okuqhubekayo.

Kufanele Ngiyithathe Kanjani I-Paricalcitol?

I-Paricalcitol inikezwa njengomjovo ngokuqondile emithanjeni yakho yegazi, ngokuvamile ngendlela yokufinyelela kwakho i-dialysis noma umugqa we-IV ohlukile. Ngeke kudingeke ukuthi uthathe lo muthi ekhaya ngoba udinga ukuqashwa ngokucophelela nokuphathwa ochwepheshe. Abantu abaningi bawuthola ngesikhathi sezingxoxo zabo ezivamile ze-dialysis, okwenza kube lula futhi kuqinisekise ukuqashwa okufanele kwezokwelapha.

Isikhathi semithamo yakho sizoxhomeka esimisweni sakho sokwelashwa kanye nemiphumela yelabhorethri. Ithimba lakho lezempilo lizogada amazinga egazi lakho njalo ukuze linqume imvamisa efanele yokulinganisa kuwe. Abanye abantu bayayidinga ngeseshini ngayinye ye-dialysis, kanti abanye bangayithola kaningi kancane ngokuya ngendlela umzimba wabo osabela ngayo.

Njengoba lo muthi uthinta amazinga e-calcium, udokotela wakho angase ancome iziqondiso ezithile zokudla. Kungase kudingeke ukuthi ukhawulele ukudla okunama-calcium aphezulu noma i-phosphorus ngenkathi uthatha i-paricalcitol. Nokho, ungenzi izinguquko ezinzima ekudleni ngaphandle kokuxoxa ngazo nethimba lakho lezempilo kuqala, njengoba lizofuna ukuxhumanisa uhlelo lwakho lokudla nemithi yakho.

Akukho ukulungiselela okukhethekile okudingekayo ngakho ngaphambi kokuthola i-paricalcitol. Ungadla ngokujwayelekile ngaphambi kwesikhathi futhi akudingeki ukuthi uyithathe nobisi noma ugweme iziphuzo ezithile. Umuthi usebenza ngokuzimela kokuthile okusesiswini sakho ngoba uqondile emithanjeni yakho yegazi.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Paricalcitol?

Abantu abaningi abanezifo ezingamahlalakhona zezinso badinga i-paricalcitol isikhathi eside, ngokuvamile uma nje bephatha isimo sabo sezinso. Njengoba inkinga eyisisekelo yokucubungula i-vitamin D ingathuthuki njengoba isifo sezinso siqhubeka, umuthi unikeza ukusekelwa okuqhubekayo empilweni yakho yamathambo kanye nokulawulwa kwe-calcium.

Udktela wakho uzohlola njalo amazinga egazi lakho ukuze aqinisekise ukuthi umuthi usebenza kahle. Lokhu kuhlolwa kubheka i-parathyroid hormone yakho, i-calcium, kanye namazinga e-phosphorus ukuze kunqunywe ukuthi umthamo wakho wamanje ukulungele yini. Ngokusekelwe kulezi ziphumo, udktela wakho angase alungise umthamo noma imvamisa, kodwa akunakwenzeka ukuthi bayeke umuthi ngokuphelele uma usabhekene nesifo sezinso.

Uma unenhlanhla yokuthola ukufakelwa kwezinso, isidingo sakho se-paricalcitol cishe sizoshintsha. Izinso ezintsha ezinempilo zivame ukukwazi ukucubungula uvithamini D ngokujwayelekile futhi, ngakho udktela wakho angase akwazi ukunciphisa noma ukuyeka lo muthi ngokuhamba kwesikhathi. Kodwa-ke, lesi sinqumo sincike ekutheni izinso zakho ezintsha zisebenza kahle kangakanani kanye nesimo sakho sempilo esiphelele.

Yiziphi Imiphumela Eceleni ye-Paricalcitol?

Njenganoma yimuphi umuthi, i-paricalcitol ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma iqashwe kahle. Into ebaluleke kakhulu okufanele uyiqonde ukuthi imiphumela eminingi emibi ihlobene nezinguquko emazingeni akho e-calcium ne-phosphorus, yingakho ithimba lakho lezempilo lihlole umsebenzi wakho wegazi njalo.

Nansi imiphumela emibi evame kakhulu ongase uyithole, ukhumbula ukuthi akubona bonke abantu abazoba nalezi zinkinga:

• Isicanucanu noma isisu esincane esicasukile
• Ukucindezeleka
• Isiyezi noma ukukhathala
• Ukukhathala noma ukuzizwa ukhathele kunokujwayelekile
• Ubuthakathaka bemisipha noma izinhlungu
• Ushintsho ekunambitheni
• Umlomo owomile

Lezi zimpawu zivame ukuba mnene futhi zivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi. Uma ziqhubeka noma zikukhathaza kakhulu, yazisa ithimba lakho lezempilo ukuze likusize ukuba uzilawule.

Kukhona nemiphumela emibi ethile engathi sína edinga ukunakekelwa kwezempilo ngokushesha, nakuba ingavamile uma umuthi uqashwe kahle:

• Izimpawu zamazinga aphezulu e-calcium njengokugula okukhulu, ukuhlanza, ukudideka, noma ukushaya kwenhliziyo okungajwayelekile
• Izinhlungu zekhanda ezinzima noma izinguquko embonweni
• Ubuhlungu besifuba noma ubunzima bokuphefumula
• Ama-cramps emisipha aqinile noma ubuthakathaka
• Ushintsho olungajwayelekile ekuchameni (uma usakhiqiza umchamo)
• Ubuhlungu obukhulu emathanjeni noma emalungeni

Izindaba ezinhle ukuthi imiphumela emibi engathi sína ayivamile uma i-paricalcitol isetshenziswa ngendlela efanele ngokuqapha njalo. Ithimba lakho lokunakekelwa kwezempilo linolwazi ekubhekeni lezi zinkinga futhi lizobamba izinkinga zisasekuqaleni ngokuhlolwa kwegazi lakho okuvamile.

Abanye abantu bangase babe nokusabela komzimba, nakuba lokhu kungavamile. Izimpawu zokusabela komzimba zihlanganisa ukuqubuka, ukuluma, ukuvuvukala, isiyezi esikhulu, noma ubunzima bokuphefumula. Uma uqaphela noma yiziphi zalezi zimpawu, funa ukwelashwa ngokushesha.

Ubani Ongafanele Athathwe I-Paricalcitol?

I-Paricalcitol ayilungile kuwo wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi iphephile yini kuwe ngaphambi kokuqala ukwelashwa. Okukhathaza kakhulu abantu asebenamazinga aphezulu e-calcium egazini labo, njengoba lo muthi ungenza leyo nkinga ibe yimbi futhi ibe yingozi.

Nazi izimo eziyinhloko ezingakuvimbela ukuthi ungathathi i-paricalcitol:

• Amazinga aphezulu e-calcium egazini (i-hypercalcemia)
• Amazinga aphezulu e-phosphorus angalawulwa kahle
• Isifo sesibindi esibi kakhulu
• Izinhlobo ezithile zamatshe ezinso
• Ukungezwani okwaziwayo ne-paricalcitol noma imithi efanayo ye-vitamin D
• Izinkinga ezithile zesigqi senhliziyo

Udokotela wakho uzophinda aqaphele ngokuqoka i-paricalcitol uma uthatha imithi ethile engase ihlangane nayo, njenge-digoxin yezinkinga zenhliziyo noma ama-diuretics athile.

Uma ukhulelwe noma uncelisa, udokotela wakho uzodinga ukulinganisela ngokucophelela izinzuzo nezingozi. Ngenkathi i-paricalcitol ingaba yinto ebalulekile empilweni yakho, akucaci ukuthi ingamthinta kanjani umntwana osakhula. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukuthola indlela ephephe kakhulu kuwe nakumntwana wakho.

Ubudala ngokwabo ngokuvamile abuyona into evimbela ukuthatha i-paricalcitol. Abantu abadala kanye nabantu abancane bangasebenzisa le mithi ngokuphepha lapho iqashwe kahle. Nokho, abantu abadala bangase badinge ukuqashwa kaningi ngoba bangase bazwele kakhulu ezingeni le-calcium.

Amagama Omkhiqizo we-Paricalcitol

I-Paricalcitol itholakala ngaphansi kwegama lomkhiqizo elithi Zemplar e-United States. Leli igama elaziwa kakhulu le mithi, futhi yilokho ongase ukubone emarekhodini akho ezokwelapha kanye nemibhalo yomshuwalense. Umuthi uza ngamandla ahlukene, futhi udokotela wakho uzokhetha elungile ngokusekelwe ezidingweni zakho ezithile.

Ezinye izikhungo zokunakekelwa kwezempilo zingase zibhekisele kuyo ngegama layo elivamile, i-paricalcitol, ikakhulukazi ezindaweni zezibhedlela noma kumalebula kadokotela. Womabili la magama abhekisela emuthini ofanayo, ngakho-ke ungakhathazeki uma ubona amagama ahlukene esetshenziswa ngamalungu ahlukene eqembu lakho lokunakekelwa kwezempilo.

Uma uhamba noma uthola ukunakekelwa ezikhungweni ezihlukene, kuyasiza ukwazi kokubili igama lomkhiqizo negama elivamile. Lokhu kuqinisekisa ukuxhumana okucacile ngemithi yakho futhi kusiza ekuvikeleni noma yikuphi ukudideka ngalokho okuthathayo.

Ezinye Izindlela ze-Paricalcitol

Uma i-paricalcitol ingeyona inketho efanele kuwe, kukhona eminye imithi engasiza ekuphatheni i-hyperparathyroidism yesibili. Udokotela wakho angase acabange lezi ezinye izindlela ngokusekelwe esimweni sakho esithile, imiphumela emibi, noma ukuthi usabela kahle kangakanani ekwelashweni.

Ezinye izinto ezifanayo ze-vitamin D zihlanganisa i-calcitriol ne-doxercalciferol, ezisebenza ngendlela efana ne-paricalcitol kodwa zinomthelela ohlukile emzimbeni wakho. I-Calcitriol inamandla kakhulu futhi isebenza ngokushesha, kuyilapho i-doxercalciferol idinga ukucutshungulwa yisibindi sakho ngaphambi kokuthi isebenze. Udokotela wakho uzokhetha ngokusekelwe ezidingweni zakho zomuntu ngamunye kanye nesimo sempilo.

Kukhona nemithi emisha ebizwa ngokuthi i-calcimimetics, efana ne-cinacalcet, esebenza ngendlela ehlukile ngokwenza amaglandla akho e-parathyroid azwela kakhulu ku-calcium. Lezi azinikezi i-vitamin D kodwa zingasiza ukulawula amazinga e-parathyroid hormone ngendlela ehlukile.

Abanye abantu bangazuza endleleni yokuhlanganisa, besebenzisa kokubili i-vitamin D analog kanye ne-calcimimetic ndawonye. Lokhu kungahlinzeka ngokuqapha okungcono ngemiphumela emincane engemihle kunokusebenzisa imithamo ephezulu yomuthi owodwa kuphela.

Ukukhethwa kokwelashwa kuncike ezintweni eziningi ezihlanganisa amanani akho elebhu, eminye imithi oyithathayo, nokuthi usabela kanjani ekwelashweni okuhlukene. Udokotela wakho uzosebenza nawe ukuthola inketho esebenzayo kakhulu futhi ebekezelelekayo esimweni sakho esithile.

Ingabe i-Paricalcitol Ingcono Kune-Calcitriol?

Kokubili i-paricalcitol ne-calcitriol kuyizindlela zokwelapha ezisebenzayo ze-hyperparathyroidism yesibili, kodwa zinamandla ahlukene nezici. I-Paricalcitol ivame ukukhethwa ngoba ivame ukubangela izigameko ezimbalwa zamazinga aphezulu e-calcium uma iqhathaniswa ne-calcitriol, okuyenza iphephe kakhulu ekusetshenzisweni kwesikhathi eside kubantu abaningi.

I-Calcitriol iyona nto enamandla kakhulu ye-vitamin D futhi isebenza ngokushesha okukhulu, okungaba nenzuzo kwezinye izimo. Kodwa-ke, lawa mandla asho nokuthi maningi amathuba okuthi abangele amazinga e-calcium ukuthi anyuke kakhulu, okudinga ukuqapha okucophelelayo nokulungiswa kwemithamo njalo. Kubantu abadinga ukwelashwa okuzinzile, kwesikhathi eside, lokhu kungaba yinselelo.

I-Paricalcitol inikeza indlela elinganiselwe. Isebenza ngempumelelo ekunciphiseni amazinga e-parathyroid hormone ngenkathi ingase ibangele ukwanda okuyinkinga ekumunceni kwe-calcium emathunjini akho. Lokhu kukhetha kwenza kube lula ukuphatha futhi kuvame ukuvumela ukulinganisa okungaguquki ngokuhamba kwesikhathi.

Ucwaningo lubonise ukuthi i-paricalcitol ingase futhi ibe nezinzuzo ezengeziwe zempilo yenhliziyo, yize kudingeka izifundo ezengeziwe ukuqonda ngokugcwele le miphumela. Abanye abantu futhi babika imiphumela emincane engemihle efana nesicanucanu nokukhathala nge-paricalcitol uma kuqhathaniswa ne-calcitriol.

Ukukhetha okungcono kakhulu kuwe kuncike esimweni sakho ngasinye, okuhlanganisa amanani akho elabhorethri amanje, ezinye izimo zempilo, nokuthi usabele kanjani ekwelashweni esikhathini esidlule. Udokotela wakho uzocabangela zonke lezi zinto lapho encoma umuthi ofanele kakhulu izidingo zakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Paricalcitol

Ingabe i-Paricalcitol iphephile kubantu abanezifo zenhliziyo?

I-Paricalcitol ngokuvamile ingasetshenziswa ngokuphepha kubantu abanezifo zenhliziyo, kodwa idinga ukuqapha ngokucophelela. Njengoba umuthi uthinta amazinga e-calcium, futhi i-calcium idlala indima ebalulekile ekusebenzeni kwenhliziyo, udokotela wakho uzofuna ukubheka ukushaya kwenhliziyo yakho namazinga e-calcium ngokucophelela. Abantu abaningi abanezifo zezinso nezinkinga zenhliziyo bathatha i-paricalcitol ngempumelelo.

Udokotela wakho wenhliziyo nodokotela wezinso bazosebenzisana ukuqinisekisa ukuthi ukwelashwa kwakho kuhlelelwe. Bazobheka ngokukhethekile noma yimiphi imithi yenhliziyo oyithathayo, ikakhulukazi i-digoxin, engase ihlangane nezinguquko emazingeni e-calcium. Ukuhlolwa kwegazi okuvamile nokuqapha kwenhliziyo kusiza ekuqinisekiseni ukuthi ukwelashwa kwakho kuhlala kuphephile futhi kusebenza kahle.

Ngingenzani uma ngithola i-Paricalcitol eningi ngengozi?

Njengoba i-paricalcitol inikezwa ochwepheshe bezempilo ezindaweni ezilawulwayo, ukweqisa ngengozi akuvamile. Kodwa-ke, uma usola ukuthi uthole okuningi kakhulu, noma uma uhlangabezana nezimpawu ezinjengokucasuka okukhulu, ukudideka, ukushaya kwenhliziyo okungajwayelekile, noma ukukhathala okukhulu ngemuva komthamo wakho, xhumana nethimba lakho lezempilo ngokushesha.

Izimpawu ze-paricalcitol eningi ngokuvamile zihlobene namazinga aphezulu e-calcium futhi zingabandakanya ikhanda elibuhlungu elibuhlungu, ubuthakathaka bemisipha, ukoma ngokweqile, noma izinguquko ekucaceni kwengqondo. Ithimba lakho lezokwelapha lingahlola ngokushesha amazinga egazi lakho futhi linikeze ukwelashwa okufanele uma kudingeka. Ungalindi ukubona ukuthi izimpawu ziyathuthuka yini zodwa.

Ngingenzani Uma Ngiphuthelwa Umthamo We-Paricalcitol?

Uma uphuthelwa umthamo ohleliwe we-paricalcitol, xhumana nethimba lakho lezempilo ukuze nixoxe ngendlela engcono kakhulu. Njengoba lo muthi unikezwa ezindaweni zezokwelapha, ukuphuthelwa umthamo ngokuvamile kusho ukuphuthelwa iseshini ye-dialysis noma ukuqokwa kwezokwelapha. Udokotela wakho uzokusiza ukuthi unqume ukuthi uzohlela nini kabusha nokuthi ngabe kukhona yini ukulungiswa okudingekayo.

Ungazami ukwenza umthamo ophuthelwe ngokuthatha okwengeziwe ekuqokweni kwakho okulandelayo. Uhlelo lwakho lokulinganisa luhlelwe ngokucophelela ngokuya ngemiphumela yakho yelabhorethri nezidingo zokwelashwa. Ithimba lakho lezempilo lizokuqondisa ngendlela ephephe kakhulu yokubuyela emgqeni ngohlelo lwakho lokwelashwa.

Ngingayeka Nini Ukuthatha I-Paricalcitol?

Isinqumo sokuyeka i-paricalcitol kufanele senziwe ngaso sonke isikhathi ngesiqondiso sikadokotela wakho. Abantu abaningi abanezifo ezingamahlala-khona zezinso badinga lo muthi uma nje belawula isimo sabo sezinso. Ukuyeka kungazelelwe kungabangela amazinga akho e-parathyroid hormone ukuthi anyuke futhi, okungenzeka kuholele ezinkingeni zamathambo nezinye izinkinga.

Udktela wakho angase acabange ukunciphisa noma ukuyeka i-paricalcitol uma ukusebenza kwezinso zakho kuthuthuka kakhulu, uma wamukela ukufakelwa kwezinso, noma uma amanani akho elebhu ekhombisa ukuthi awusadingi ukwengezwa kwe-vitamin D. Kodwa-ke, lezi zinqumo zidinga ukuqapha ngokucophelela kanye nezinguquko ezinensayo kunokuyeka kungazelelwe.

Ngingakwazi yini ukuthatha izithasiselo ze-calcium ngenkathi ngise-Paricalcitol?

Noma ngabe ungakwazi yini ukuthatha izithasiselo ze-calcium ngenkathi use-paricalcitol kuncike emazingeni akho egazi ngamanye kanye nezincomo zikadokotela wakho. Abanye abantu badinga i-calcium eyengeziwe, kanti abanye badinga ukuyikhawulela ukuvimbela amazinga ukuthi angabi phezulu kakhulu. Ithimba lakho lokunakekelwa kwezempilo lizokwengamela amazinga akho e-calcium njalo futhi likucebise ngendlela efanele.

Uma udokotela wakho encoma izithasiselo ze-calcium, bazochaza uhlobo nenani eliphephile kuwe. Bazophinda bahlele isikhathi ngemithamo yakho ye-paricalcitol neminye imithi ukuqinisekisa ukuthi konke kusebenza ndawonye ngokuphepha. Ungalokothi uqale noma uyeke izithasiselo ze-calcium ngokwakho ngenkathi uthatha i-paricalcitol.