Nā lāʻau no ka osteoporosis

ʻO Osteoporosis kahi maʻi e hiki ai i nā iwi ke palapū a ʻoi aku ka haki (haki). Me ka osteoporosis, nalo ka iwi i ka nui. ʻO ka iwi iwi ka nui o nā iwi iwi i helu ʻia i loko o ko ʻoukou mau iwi.

Kau kauka paha i kau lāʻau e kōkua i ka hoʻohaʻahaʻa i kou makaʻi o nā haʻi. Hiki i kēia mau lāʻau ke hana i nā iwi i kou pūhaka, iwi kuamoʻo, a me nā wahi ʻē aʻe e haki paha.

Kau kauka paha i kau lāʻau i ka wā:

• Hōʻike kahi hoʻāʻo o ka iwi iā ʻoe i ka osteoporosis, ʻoiai inā ʻaʻole i loaʻa iā ʻoe ka haʻi ma mua, akā kiʻekiʻe ka hopena o ka haki.
• He haʻihaʻi iwi kou, a hōʻike kahi hoʻāʻo o ka iwi i kou ʻoi aku ka lahilahi ma mua o nā iwi maʻamau, akā ʻaʻole ka osteoporosis.
• Loaʻa iā ʻoe kahi haʻi iwi e kū me ka ʻole o kahi ʻeha koʻikoʻi.

ʻO nā Bisphosphonates nā lāʻau nui i hoʻohana ʻia e pale a mālama i ka nalo ʻana o ka iwi. Lawe pinepine ʻia lākou e ka waha. Hiki paha iā ʻoe ke lawe i ka pila i hoʻokahi manawa i ka pule a i hoʻokahi manawa i ka mahina. Hiki iā ʻoe ke kiʻi i nā bisphosphonates ma o kahi aa (IV). ʻO ka hapanui pinepine hana ʻia kēia i hoʻokahi a ʻelua paha manawa o ka makahiki.

ʻO nā hopena ʻaoʻao āpau me nā bisphosphonates e lawe ʻia e ka waha he ʻeha puʻuwai, nausea, a me ka ʻeha o ka ʻōpū. Ke lawe ʻoe i nā bisphosphonates:

• Lawe iā lākou ma kahi ʻōpū nele i ke kakahiaka me 6 a 8 mau auneke (ʻoz), a i ʻole 200 a i 250 mau mililiter (mL), o ka wai maʻamau (ʻaʻole ka wai kalapona a wai wai paha).
• Ma hope o ka lawe ʻana i ka pila, noho mau a kū paha ma kahi o 30 mau minuke.
• Mai ʻai a inu paha ma kahi o 30 a 60 mau minuke.

ʻO nā hopena āpau ʻole:

• Pākuʻi kalipuna koko haʻahaʻa
• Kekahi ʻano o ka haʻi-iwi (femur) haʻi
• Poino i ka iwi ā
• ʻO ka wikiwiki, ka puʻuwai puʻuwai (atrial fibrillation)

Kāohi paha kāu kauka iā ʻoe e lawe i kēia lāʻau ma hope o 5 mau makahiki. Ke hana nei i mea e hōʻemi ai i ka hopena o kekahi mau hopena ʻaoʻao. Kāhea ʻia kēia he lā hoʻomaha lāʻau.

Hoʻohana pū ʻia ʻo Raloxifene (Evista) e pale a mālama i ka osteoporosis.

• Hiki iā ia ke hoʻēmi i ka makaʻu o ka haʻi o ka iwi, akā ʻaʻole nā ​​ʻano o nā haʻi.
• ʻO ka hopena ʻaoʻao koʻikoʻi he wahi liʻiliʻi loa ia o ke kahe o ke koko i nā uaua o ka wāwae a i ʻole i nā akemāmā.
• Hiki i kēia lāʻau ke kōkua i ka hōʻemi ʻana i ka pilikia o ka maʻi puʻuwai a me ka maʻi ʻaʻai umauma.
• Hoʻohana ʻia nā modulator receptor estrogen ʻē aʻe (SERMs) e mālama i ka osteoporosis.

ʻO Denosumab (Prolia) kahi lāʻau i pale i nā iwi mai lilo i nāwaliwali. ʻO kēia lāʻau:

• Hāʻawi ʻia ma ke ʻano he injection i kēlā me kēia 6 mahina.
• Hiki ke hoʻonui i ka iwi iwi ma mua o nā bisphosphonates.
• ʻAʻole ia he lapaʻau laina mua.
• ʻAʻole paha ia he koho maikaʻi no ka poʻe loaʻa nā ʻōnaehana pale nāwaliwali a i ʻole e lawe i nā lāʻau e hoʻopili i ka ʻōnaehana pale.

ʻO Teriparatide (Forteo) kahi ʻano bio-engineered o ka parathyroid hormone. ʻO kēia lāʻau:

• Hiki ke hoʻonui i ka iwi iwi a hoʻoliʻiliʻi i ka makaʻi no nā haki.
• Hāʻawi ʻia ma ke ʻano he injection i lalo o ka ʻili ma ka home, pinepine i kēlā me kēia lā.
• ʻAʻole paha e like me ka hopena o ka hopena lōʻihi lōʻihi, akā hiki ke kumu i ka nausea, dizziness, a i ʻole nā ​​wāwae wāwae.

ʻO Estrogen, a i ʻole ka hoʻowalewale hōmona (HRT). ʻO kēia lāʻau:

• He maikaʻi loa i ka pale ʻana a me ka mālama ʻana i ka osteoporosis.
• ʻO ia ka lāʻau osteoporosis i hoʻohana pinepine ʻia no nā makahiki he nui. Ua hoʻēmi kona hoʻohana ʻana no ka hopohopo no kēia maʻi i hōʻeha i ka maʻi puʻuwai, ka maʻi ʻaʻai o ka umauma, a me nā huʻa koko.
• He koho maikaʻi nō ia no nā wahine ʻōpio he nui (50 a 60 mau makahiki). Inā lawe ka wahine i ka estrogen, pono ʻo ia a me kāna kauka e kūkākūkā i nā pilikia a me nā pōmaikaʻi o ka hana ʻana pēlā.

Hoʻokumu ʻo Romosuzomab (Evenity) i kahi ala hormonone i ka iwi i kapa ʻia ʻo sclerostin. ʻO kēia lāʻau:

• Hāʻawi ʻia i kēlā me kēia mahina ma ke ʻano he injection i lalo o ka ʻili no hoʻokahi makahiki.
• Maikaʻi i ka hoʻonui ʻana i ka nui o ka iwi.
• Hiki ke hoʻohaʻahaʻa i nā pae o ka calcium.
• Hiki paha ke hoʻonui i ka makaʻu o ka puʻuwai puʻuwai a me ka hahau.

Hīmona parathyroid

• Hāʻawi ʻia kēia lāʻau i kēlā me kēia lā nā pana ma lalo o ka ʻili. E aʻo aku kāu kauka a kahu hānai paha iā ʻoe pehea e hāʻawi ai iā ʻoe iho i kēia mau kī ʻana ma ka home.
• Hana ʻoi aku ka maikaʻi o ka hormone Parathyroid inā ʻaʻole ʻoe i lawe i nā bisphosphonates.

ʻO Calcitonin kahi lāʻau e hoʻolohi i ka helu o ka nalo ʻana o ka iwi. ʻO kēia lāʻau:

• Hoʻohana ʻia i kekahi manawa ma hope o ka haki o ka iwi no ka mea e hōʻemi ia i ka ʻeha o ka iwi.
• ʻOi aku ka maikaʻi ma mua o nā bisphosphonates.
• Hele mai me he ehu ihu a i ʻole he injection.

Kāhea i kāu kauka no kēia mau ʻōuli a i ʻole nā ​​hopena ʻaoʻao:

• ʻEha o ka umauma, ʻehaʻeha naʻau, a i ʻole nā ​​pilikia e ale ana
• ʻO Nusea a me ka luaʻi
• ʻO ke koko i loko o kāu pahu
• ʻO ka pupuhi, ʻeha, ʻulaʻula i hoʻokahi o kou mau wāwae
• Kuʻi ka puʻuwai wikiwiki
• ʻ Skinhū ʻili
• E ʻeha i kou ʻūhā a i kou ʻūhā
• ʻEha ma kou iwi ā

Alendronate (Fosamax); Ibandronate (Boniva); Risedronate (Actonel); Zoledronic acid (Hoʻomaha hou); Raloxifene (Evista); Teriparatide (Forteo); Denosumab (Prolia); Romosozumab (ahiahi); Ka momona o ka iwi haʻahaʻa - nā lāʻau; Osteoporosis - nā lāʻau

• Osteoporosis

De Paula FJA, DM ʻEleʻele, Rosen CJ. Osteoporosis: nā kumu a me nā ʻano lapaʻau. I: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 30.

Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. ʻO ka mālama ʻana i ka osteoporosis ma nā wahine postmenopausal: kahi Endocrine Society * Papa Kuhikuhi Hoʻolālā Clinical. ʻO J Clin Endocrinol Metab. 2019; 104 (5): 1595-1622. PMID: 30907953 pubmed.ncbi.nlm.nih.gov/30907953/.

• Osteoporosis