Amiodarone shine mafi magungunan ƙwayar ƙwayar ƙwayar cuta wanda ya taɓa inganta. Abin takaici, shi ma ya fi mai guba.
Daga cikin matsaloli masu yawa da aka gani tare da behadarone, matsalolin karoid sune wasu na mafi yawan. Amiodarone-induced thyroid cuta na iya zama quite consequential kuma zai iya zama da wuya a gane. Bugu da ƙari, halayen thyroid-induced thyroid ne sau da yawa mafi wuya a bi da sauran nau'o'in thyroid cuta.
Ta yaya Amiodarone ke haifar da ciwon karoid
Amiodarone yana haifar da matsalolin karoid a hanyoyi biyu. Na farko, amiodarone yana da babban abun ciki na iodine, kuma idan wasu mutane suna amfani da yawaninininin su za su iya ci gaba da cutar thyroid. Abu na biyu, behadarone na iya haifar da mummunan sakamako a kan glandon kanta (samar da irin thyroiditis), kuma miyagun ƙwayoyi na iya rage aikin aikin hormonal thyroid (musamman, zai iya rage tuban T4 zuwa T3, kuma zai iya rage da daurin-sabili da haka tasirin-na T3).
Matsaloli na Thyroid
Amiodarone na iya haifar da ko dai hypothyroidism (ciwon da ke ciwo) ko hyperthyroidism (maganin thyroid). Bayanai daban-daban sun ba da kimanin mahimmanci na matsalolin maganin thyroid tare da behadarone, amma yana nuna cewa har zuwa 30% na marasa lafiya da aka bi da behadarone na iya bunkasa hypothyroidism, kuma har zuwa 10% na iya bunkasa hyperthyroidism.
Saboda haladarone ya kasance cikin jiki har tsawon watanni (ko ma shekaru) bayan an dakatar da miyagun ƙwayoyi, matsalolin karoid zai iya ci gaba ko da bayan da aka dakatar da ladabi da kuma likitoci su kasance masu lura da wannan yiwuwar.
Hypothyroidism
Hanyoyin cututtuka na hypothyroidism da lalacewa ta hanyar behadarone sun kasance kama da wadanda aka gani tare da wasu nau'o'in hypothyroidism, kuma sun hada da gajiya, wadataccen abu, tunani mai ban tsoro, kumburi, maƙarƙashiya, da damuwa.
Binciken hypothyroidism a cikin marasa lafiya shan behaviordarone na iya zama dabara. Amiodarone yana haifar da tayi a cikin matakan TSH a kusan dukkanin mutane har zuwa watanni 6, don haka masana sun bada shawara kada su gano asalin yanayin hypothyroidism na haladarone har sai an nuna cewa matakan TSH da aka haɓaka suna ci gaba, ko kuma matakan T4 ba su da ƙasa. Duk da haka, idan hypothyroidism yana samuwa (koda yake yana da hypothyroidism ), yana da mahimmanci don tabbatar da ganewar asali musamman ga mutanen dake fama da cututtukan zuciya.
Yin maganin hypothyroidism da aka haifar da sindarone yana da mahimmanci kamar zalunta da kowane irin hypothyroidism (wato, tare da maganin hormone mai maganin maganin karoid), amma, kuma, zai iya zama mai sauƙi saboda amiodarone na iya canja tasiri na hormonal thyroid. A yawancin lokuta, yawancin maganin maganin maganin maganin thyroid yana bukatar mu bi da marasa lafiya hypothyroid. Saboda wannan dalili, da yawa daga cikin wadannan marasa lafiya za a yi amfani da su sosai don ganin likitancin likita don taimakawa wajen magance su.
Hyperthyroidism
Akwai hanyoyi daban-daban guda biyu wanda amiodarone ke haifar da hyperthyroidism. A cikin wasu marasa lafiya (wadanda ke da magunguna , ko kuma tare da cututtuka na Graves ), duk wani karuwa a cikin abun ciki na iodine zai iya haifar da thyroid don fara haifar da kima mai yawa na hormone thyroid.
Kuma shan behadarone ya gabatar da thyroid tare da gaske mai yawa iodine load.
Na biyu, a wasu mutane mutumdarone zai iya zama mai guba ga nauyin maganin thyroid kanta, samar da lalata thyroiditis . A cikin wannan yanayin, halakar thyroid nama ya bar mai yawa hormone thyroid cikin jini. Wannan thyroiditis ƙarshe "kone kansa kanta fita" lokacin da babu sauran ciwon thyroid nama da za a hallaka. A haƙuri sa'an nan kuma ya zama hypothyroid. Amma a halin yanzu-lokaci mai tsawo da zai iya wucewa don wata ko wata-hyperthyroidism shine matsala.
Harkokin asibiti na hyperthyroidism da ke haifar da sindarone zai iya bambanta da hyperthyroidism ba a lalacewa ta wannan magani.
Saboda sindarone yana da tasiri na beta , kuma saboda ƙwayar miyagun ƙwayoyi na iya rage aikin gwargwadon maganin thyroid, yawancin alamun bayyanar cututtuka na hyperthyroidism (irin su jitteriness, juyayi, damuwa, jin dadi, ko sukar kisa), ana masked. Don haka likita bazaiyi tunani akan ganewar asali ba.
Magunguna da halayyar hyperthyroidism da ke haifar da cututtuka sunyi kuskure su fuskanci cututtuka na bayyanar cututtukan zuciya. (Mutane da yawa marasa lafiya suna shan wannan magani ne saboda sakamakon cututtukan zuciya). Saboda haka sukan saba wa arrhythmias (sau da yawa, ƙaddamar da yanayin da aka tsara a cikin sindarone), damuwa da rashin tausayi na zuciyar zuciya , yana kara tsananta cututtuka na cututtukan cututtuka , ƙananan zazzabi, ko asarar nauyi don babu dalilin dalili. Ma'aikatan da ba su jijjiga bazai iya tunanin matsalolin maganin karoid lokacin da irin waɗannan cututtuka suka ci gaba.
Yin maganin cututtukan hyperroid zai haifar da kalubale. Kwayoyin maganin Thionamide da ke hana yin amfani da hormone thyroid (irin su propylthiouracil-PTU), ana amfani da su. Perchlorate, wanda ya rage maƙaryacin aidin ta glandon thyroid, zai iya zama taimako. Duk da haka, maganin wadannan magungunan da ake bukata don rage yawan kayan hawan kawan da ke jikinka suna karuwa sosai, kuma yana iya zama kalubalanci don amfani da wadannan kwayoyi yadda ya kamata. Mafi mahimmanci, idan hyperthyroidism ya haifar da sinadarone-induced thyroiditis, kwayoyi da nufin rage cinikin horromon thyroid yawanci ba aiki ko kaɗan, kuma thyroidectomy (m thyroid-cire) ne kawai tunani.
Ablation ta thyroid tare da iodine na rediyo-hanyar da ba ta da ɗabi'ar da ke aiki sosai a hankulan jini-ba kullum ba ne wani zaɓi a cikin mai haƙuri shan behadarone. Wannan shi ne saboda glandar thyroid a cikin wadannan marasa lafiya an riga an yi amfani da shi tare da iodine cewa maganin thyroid na maida rediyocin ya rage ƙwarai.
Idan hyperthyroidism yana haifar da rashin zuciya, angina marar ƙarfi , ko damuwa mai rai, zai iya zama gaggawa don cimma magani mai kyau kamar yadda ya kamata-wanda aka sanya shi mafi wuya ta hanyar rage yawan zafin jiki. A kowane hali, yin maganin hyperthyroidism wanda ya haifar da lalacewar jiki yana da matukar damuwa da cewa gwani na ilimin endocrinology ya kamata ya kasance a kowane lokaci.
Layin Ƙasa
Rashin lafiyar kawanci ne na kowa a cikin marasa lafiya. Wadannan cututtuka na iya zama da wuya a gane, da wuya a bi da su, kuma zai iya zama barazanar rai. Yana da muhimmanci a kula da yiwuwar matsalolin thyroid a duk wanda ke shan behadarone.
Rashin yiwuwar sakamako na maganin thyroid shine kawai dalili daya da ya sa likitoci ya kamata su kasance da wuya su rubuta dabi'a. Idan sun ga ya kamata su yi haka, to suna jin wajibi ne su bi wadannan marasa lafiya a hankali, don shekaru idan ya cancanta, don saka idanu don sakamako na maganin karoid, da sauran abubuwan da ke faruwa da wannan magani.
Sources:
Basaria S, Cooper DS. Amiodarone da thyroid. Am J Med 2005; 118: 706.
Bogazzi F, Bartalena L, Martino E. Zama ga mai haƙuri da sindarone-induced thyrotoxicosis. J Clin Endocrinol Metab 2010; 95: 2529.