Corticosteroid-Induced Osteoporosis ne Dukansu ƙyama da Treatable
Corticosteroids daya ne irin maganin steroid. Wani lokaci ana amfani da kalmar "steroid" tare da "corticosteroid".
A cewar ACR, fiye da mutane miliyan 30 na Amurka zasu iya shawo kan cututtukan da ake yi da su tare da corticosteroids. Magunguna irin su prednisone , ana amfani da su don maganin cututtuka masu yawa da cututtuka na autoimmune , irin su:
- fuka
- rheumatoid arthritis
- lupus
- cututtukan ƙwayar zuciya
Ana amfani da su don magance yanayin rashin lafiyar mutane. Duk da yake masu ciwon sukari suna da tasiri sosai wajen magance irin wannan cuta, su ma sune magungunan maganin osteoporosis.
Corticosteroids & Bone Remodeling
Corticosteroids shafi calcium da kashi metabolism a hanyoyi da yawa.
- Magungunan ƙwayar cuta rage yawan adadin abincin da ake ciki da hanji
- Magungunan ƙwayar cuta suna ƙara ƙin ƙwayar calcium ta hanyar kodan
Wadannan dalilai guda biyu sun haɗu don haifar da raguwa a cikin ƙaddamar da ƙuƙwalwar ƙwayoyin calcium. Wannan yana haifar da ƙwayar parathyroid don ƙara yawan kwayoyin parathyroid (PTH), yanayin da aka sani da hyperparathyroidism sakandare. Matakan da aka hawanta na PTH sun haifar da karuwar ɓangaren ƙwayar jiki, kamar yadda jiki yana ƙoƙari ya gyara matakan ƙwayoyin calcium ta hanyar yada ƙwayar daga kasusuwan cikin jini.
Corticosteroids na iya rage yawan matakan jima'i na jima'i:
- estrogen (a cikin mata)
- testosterone (cikin maza)
Sakamakon raguwa yana haɗuwa da ƙãra hasara.
Corticosteroids kuma suna haifar da rauni na tsoka, wanda zai haifar da rashin aiki da ƙarin asarar kasuwa. Wani babban tasiri na corticosteroids shine cewa zasu iya tasiri kwayar ta kai tsaye ta hanyar hana aikin kasusuwan (osteoblastic).
Misalai na Asarar Bone
Akwai nau'i biyu na nama nama: cortical da trabecular.
- Cortical kashi yayi ƙananan harsashi na kashi kuma ya ƙunshi 80% na kwarangwal
- Yankin trabecular (sauran 20%) ana samuwa a cikin kashi
Kowane kashi a cikin kwarangwal yana ƙunshe da nau'i biyu, amma nauyin su bambanta. Corticosteroids na farko yana haddasa asarar kasuwa a waɗannan yankunan kwarangwal waɗanda suke da wadata a kashin daji, irin su spine.
Dose da Duration
Rashin hasara ya auku mafi sauƙi a cikin farkon watanni 6 zuwa 12 na farkawa kuma yana dogara ga duka biyu:
- kashi
- tsawon lokaci
Wasu matsalolin haɗari ga osteoporosis na iya samun sakamako mai mahimmanci akan asarar kasuwa, kamar:
- shekaru
- jinsi
- ainihin cutar
Alal misali, tsofaffi maza a kan kwayoyin cutar sittin zasu iya shawo kan ƙananan kashi kuma haɗari ga raunuka fiye da maza. ACR ta kiyasta cewa ba tare da matakan rigakafin ba, kimanin kashi 25 cikin dari na mutanen da ke cikin corticosteroids na zamani zasu fuskanci fashe.
Kashi na corticosteroids shine mai karfi mai hangen nesa na fatara. Duk da yake ba a fili ba ko akwai ƙananan ƙofa a ƙasa wanda ba a lalacewar kasuwa, binciken da aka yi a kwanan baya sun gano magungunan steroid din sunyi rashin rinjaye a kan kashi kashi yayin da ake gudanar da su a cikin kwaskwarima kuma ba tare da kwayoyin steroid ba.
Osteoporosis Management
Magungunan steroid-induced osteoporosis duka suna iya hanawa kuma sunadawa. A cewar ACR, mutane a kan corticosteroids ya kamata a yi gwajin gwaje-gwajen kashi na kashi. Wannan gwajin zai samar da ma'aunin ma'auni daga abin da za a saka idanu a canje-canje a cikin kashi kashi. ACR kuma tana bada shawarar yin amfani da ita na yau da kullum na 1500 MG. daci da 400-800 IU na bitamin D. Calcium da kuma bitamin D zasu iya taimakawa wajen daidaita ma'auni na ma'auni da kuma matakan parathyroid hormone, kuma zai iya kiyaye magungunan kasusuwa a wasu marasa lafiya akan maganin steroid.
Osteoporosis Drugs
Osteoporosis magunguna da FDA ta amince don corticosteroid-induced osteoporosis sun hada da:
- Actonel (Risedronate) don rigakafi da magani
- Fosamax (Alendronate) don magani
A cikin masu amfani da corticosteroid, dukansu kwayoyi suna amfani da illa mai amfani a kan kashin baya da kuma ƙananan ma'adinai na kashi biyu kuma suna haɗuwa da raguwar ƙwayoyi. Hanyoyin Estrogen da Miacalcin (Calcitonin) na iya taimakawa wajen adana kashin kasusuwan a cikin mata masu matsananciyar mata a kan corticosteroids, amma kuma ba a yarda da FDA don maganin ostéoporosis na corticosteroid.
Salon Canji
- Kashe shan taba da barasa, yana da mahimmanci wajen rage haɗarin mai maganin steroid-induced osteoporosis.
- Ayyukan jiki da motsa jiki zasu iya taimakawa wajen adana ƙwayar nama da muscle, yayin da kara ƙarfin tsoka da kuma rage hadarin da dama.
- Rushewa da fadawa rigakafi na da muhimmancin gaske ga mutanen tsofaffi da wadanda suka sami rauni na tsoka.
Layin Ƙasa
Ya kamata matakan rigakafin Osteoporosis su fara da wuri, daidai lokacin da aka fara maganin corticosteroid. Masana sun bayar da shawarar yin amfani da maganin steroid mafi ƙanƙanci don lokaci mafi tsawo da lokaci, kuma lokacin da za'a iya amfani da inhaled ko coryicosteroids na saman.
Source:
Glucocorticoid-Induced Osteoporosis, NIH ORBD ~ NRC, 12/2000