I-Calcitriol

I-Calcitriol

I-Calcitriol, uhlobo olunamandla lwe i-vitamin D, isithole ukunakwa ngendima yayo ebalulekile ekumunceni i-calcium nokumetabolism kwamathambo. Lesi sakhi esibalulekile, esivame ukunikezwa njengethebhulethi ye-calcitriol, sisiza ukugcina amathambo namazinyo aqinile futhi sisekela impilo yonke.

Ithebhulethi yeCalcitriol idlulela ngale kwempilo yamathambo, iyenze ibe umuthi obalulekile ezimeni ezahlukahlukene. Lesi sihloko sizohlola ukuthi iyini i-calcitriol, indlela yokusebenzisa amaphilisi e-calcitriol kanye nemiphumela emibi engase ibe khona. Sizophinde sihlole ukuthi i-calcitriol isebenza kanjani emzimbeni, ukusebenzisana kwayo neminye imithi, kanye nolwazi olubalulekile lomthamo. 

Iyini iCalcitriol?

I-Calcitriol iwuhlobo olusebenzayo olukhiqizwayo lwevithamini D, eyaziwa nangokuthi i-1,25-dihydroxycholecalciferol noma i-1alpha,25-dihydroxyvitamin D3. Iyimetabolite enamandla kakhulu kavithamini D kubantu. Umzimba ukhiqiza i-calcitriol ngochungechunge lwezinyathelo zokuguqula, kuqala ngokuchayeka kwe-7-dehydrocholesterol ekukhanyeni kwe-UV esikhumbeni.

Ukusetshenziswa kwethebhulethi yeCalcitriol

I-Calcitriol, uhlobo olusebenzayo lwevithamini D, inokusetshenziswa okuningana okubalulekile ekwelapheni izimo ezihlukahlukene zezokwelapha. 

• Enye yezindlela eziyinhloko zokusetshenziswa kwamaphilisi e-calcitriol ukuvimbela nokwelapha ukungalingani kwe-calcium ne-phosphorus ezigulini ezinezinso ezingasebenzi kahle noma izindlala ze-parathyroid noma ezithatha isikhathi eside. ukucubungula izinso. Laba bantu bavame ukuzabalaza ukukhiqiza uvithamini D owanele osebenzayo bebodwa, okwenza i-calcitriol supplementation ibaluleke kakhulu ekugcineni amazinga e-calcium afanele.
• I-Calcitriol isiza ukulawula i-hypocalcaemia ezigulini ezine-dialysis ye-renal engapheli futhi ilawula i-hyperparathyroidism yesibili kulabo isifo sezinso. 
• I-Calcitriol isiza ukwelapha i-hypocalcaemia ezigulini ezine-hypoparathyroidism kanye ne-pseudohypoparathyroidism.
• I-Calcitriol ibhekana ngokuphumelelayo nama-rickets ezinganeni, i-osteomalacia kubantu abadala, kanye ne-hypophosphatemia yomndeni. 
• Kwesinye isikhathi odokotela basebenzisa i-calcitriol ukukhulisa amazinga e-calcium ezinganeni ezizalwa ngaphambi kwesikhathi.
• Njenge-analogue kavithamini D, i-calcitriol isiza umzimba ukuthi usebenzise i-calcium eningi evela ekudleni noma ezithasiselweni futhi ilawule ukukhiqizwa kwe-PTH. 
• Kuvame ukuhlanganiswa nezincomo ezithile zokudla futhi ngezinye izikhathi neminye imithi ukuze kuzuzwe imiphumela emihle ekulawuleni ukuphazamiseka okuhlobene ne-calcium.
• Odokotela bangase futhi banikeze i-calcitriol yokwelapha izinhlobo ezithile ze-calcium, i-phosphorus, nezinkinga ze-parathyroid ezingase zenzeke nge-dialysis yezinso yesikhathi eside. Umuthi usiza ukugcina ibhalansi ethambile yalawa amaminerali emzimbeni, okubalulekile empilweni nempilo yonke.

Ungayisebenzisa kanjani i-Calcitriol Tablet

Okulandelayo eminye imihlahlandlela ejwayelekile mayelana nokuthatha amaphilisi e-calcitriol:

• Amaphilisi e-Calcitriol ngokuvamile athathwa ngomlomo kanye ngosuku noma njalo ngolunye usuku ekuseni. 
• Iziguli zingawathatha ngokudla noma ngaphandle kokudla, njengoba ziqondiswa udokotela wazo.
• Umthamo we-calcitriol uncike esimweni sezempilo sesiguli kanye nokusabela ekwelashweni. Iziguli kufanele zibambelele ngokuqinile emiyalweni yazo kadokotela futhi zisebenzise imithi njalo ukuze zithole inzuzo enkulu.
• Ukuqinisekisa izinga eliqinile lomuthi, ukuphuza i-calcitriol ngesikhathi esifanayo usuku ngalunye kuhle. 
• Kulabo abasebenzisa uhlobo oluwuketshezi lwe-calcitriol, kubalulekile ukusebenzisa isipuni sokulinganisa esikhethekile noma inkomishi ukuze uthole umthamo ofanele. 
• Iziguli kufanele zilandele ukudla okunconywe udokotela wazo ngenkathi zithatha i-calcitriol. Lolu hlelo lokudla lubalulekile ekwandiseni izinzuzo zomuthi kanye nokuvimbela imiphumela emibi kakhulu. 

Imiphumela Emibi Yethebhulethi yeCalcitriol

Amaphilisi e-Calcitriol ngokuvamile awabangeli imiphumela emibi kubantu abaningi. Kodwa-ke, iziguli kufanele ziqaphele ukusabela okungenzeka futhi zikubike ngokushesha kudokotela wazo.
Eminye imiphumela emibi kakhulu ihlanganisa:

• Ukulahlekelwa kwesifiso
• Ubuhlungu beqolo, amathambo, amalunga, noma imisipha
• ukuqunjelwa or umlomo owomile
• Ubuhlungu beso, ububomvu, noma ukuzwela ukukhanya
• bekhanda
• Ukushaya kwenhliziyo okungavamile
• Isicanucanu, ukuhlanza, noma isifo sohudo
• Ukulala
• Isisu noma ubuhlungu besisu
• Khulisa ukoma
• Izinguquko ekuphumeni komchamo
• Ukungabi namandla
• Nakuba kungavamile, ukungezwani okukhulu kwe-calcitriol kungenzeka. Izimpawu zingabandakanya ukuqubuka, ukulunywa, ukuvuvukala (ikakhulukazi ubuso, ulimi, noma umphimbo), kubi kakhulu. isiyezi, noma ukuphefumula kanzima.

Ukuqapha

• I-Allergies: Abantu kufanele bazise udokotela wabo mayelana nanoma yikuphi ukungezwani komzimba ne-calcitriol, eminye imikhiqizo kavithamini D, noma ezinye izinto. Umuthi ungaqukatha izithako ezithile ezingasebenzi ezingabangela ukungezwani komzimba noma ezinye izinkinga. 
• Umlando Wezokwelapha: Ukuxoxa ngomlando wezokwelapha nabahlinzeki bezempilo kubalulekile, ikakhulukazi mayelana namazinga aphezulu e-calcium, Isifo senhliziyo, noma izinkinga zezinso.
• Odokotela Abazisayo: Labo abahlelelwe ukuhlinzwa noma ababhekene nezikhathi ezinde zokungakwazi ukuhamba kufanele bazise udokotela wabo kusengaphambili. 
• I-Hydration: Iziguli kufanele ziphuze uketshezi oluningi ngaphandle uma ziqondiswa udokotela wazo.
• Ukukhulelwa: abesifazane abakhulelwe kufanele isebenzise i-calcitriol kuphela uma kunesidingo esicacile. Kudingeka baxoxe ngezingozi nezinzuzo nodokotela wabo. 
• Omama Abancelisayo: Akwaziwa uma umuthi udlulela obisini lwebele, ngakho omama abancelisa ibele kufanele babonane nodokotela wabo ngaphambi kokuwusebenzisa.
• Izimo Zezinso: Iziguli kufanele zazise ithimba lazo lokunakekela ngezimo ezifana nesifo sezinso nesifo se-parathyroid noma uma zithola ukwelashwa kwe-dialysis. Kufanele futhi basho noma yikuphi ukusabela okungavamile emithini, ukudla, odayi, noma izivimbelakuvunda.
• Ukunamathela Okuqinile: Iziguli kufanele zilandele ukudla okukhethekile futhi zigweme imithi engagunyaziwe equkethe uvithamini D, i-phosphorus, i-magnesium, noma i-calcium, kuhlanganise nama-antacid, ngaphandle uma iqondiswa ithimba lazo lokunakekela. 

Isebenza kanjani ithebhulethi yeCalcitriol

I-Calcitriol ingeyesigaba sezidakamizwa ezaziwa ngokuthi ama-analogues e-vitamin D. Lo muthi onamandla usebenza ngokubophezela kuma-receptors kavithamini D ezithweni ezihlukahlukene, kuhlanganise nezinso, izindlala ze-parathyroid, amathumbu namathambo. Umsebenzi wayo oyinhloko ukukhulisa amazinga e-calcium egazini ngokusebenzisa izindlela eziningi.

Emathunjini, i-calcitriol ithuthukisa ukumuncwa kwe-calcium ne-phosphate yokudla. Isebenza njenge-transcription factor, efaka ikhodi yephrotheni ebopha i-calcium ehambisa i-calcium ne-phosphate ions kuwo wonke amaseli e-epithelial amathumbu. Le nqubo iqinisekisa ukuthi umzimba ubamba kahle la maminerali abalulekile ekudleni.

I-Calcitriol iphinde ikhuthaze ukumuncwa kabusha kwe-calcium e-renal tubular ezinso. Lokhu kusho ukuthi kusiza umzimba ukuthi ugcine i-calcium eningi ebingalahleka ngomchamo. Ukwengeza, ikhuthaza ukukhululwa kwezitolo ze-calcium ohlelweni lwamathambo lapho kudingeka.

Ukusebenza ngekhonsathi ne-hormone ye-parathyroid (PTH), i-calcitriol yenza kusebenze ama-osteoclasts, amaseli anomthwalo wemfanelo wokubuyisela amathambo. Le nqubo ikhulula i-calcium emathanjeni iye egazini, igcine izinga eliphezulu le-calcium. I-Calcitriol isiza futhi ukulawula ukukhiqizwa kwe-PTH, idale uhlelo olulinganiselayo lokulawulwa kwe-calcium.

Ngaphandle kwendima yayo ku-calcium metabolism, i-calcitriol ineminye imisebenzi ebalulekile. Inezici zokulwa ne-osteoporotic, isiza ukugcina amathambo aqinile. Umuthi ubuye ube nemiphumela ye-immunomodulatory, ethonya umsebenzi wamangqamuzana athile omzimba omzimba. Ngaphezu kwalokho, i-calcitriol ibonise imisebenzi engaba khona ye-anticarcinogenic, antipsoriatic, kanye nemodulatory, nakuba lezi kuyizindawo zocwaningo oluqhubekayo.

Ngingakwazi Ukuthatha I-Calcitriol Ngeminye Imithi?

I-Calcitriol ingasebenzisana nemithi ehlukahlukene, ngakho-ke iziguli kudingeka ziqaphe lapho ziyithatha kanye nezinye izidakamizwa. Odokotela kufanele baqaphele yonke imithi, amakhambi, nezithako ezisetshenziswa isiguli ukuze kuvinjelwe ukusebenzisana okungenzeka.

• Ama-antacid
• I-Burosumab nezinye izithako ze-vitamin D 
• Calcium supplements
• I-Cholestyramine
• Corticosteroids
• Digoxin
• I-Ketoconazole
• Izithako zeMagnesium
• Phenobarbital
• Phenytoin
• Ama-agent abopha i-phosphate
• Thiazide diuretics

Ulwazi Lomthamo

Odokotela banikeza izinhlobo ezahlukene kanye nemithamo ye-calcitriol ngokusekelwe esimweni sesiguli kanye neminyaka yobudala. Umuthi utholakala ngamaphilisi (0.25mcg kanye no-0.5mcg), isixazululo somlomo (1mcg/mL), nesisombululo esijovayo (1mcg/mL).

• Kubantu Abadala abane-Hypocalcemia ngenxa ye-Chronic Renal Dialysis: 
  • Umthamo wokuqala womlomo - i-0.25 mcg nsuku zonke noma zonke izinsuku, ikhuphuke ngo-0.5-1 mcg njalo emavikini angama-4-8. 
  • Umthamo wokuqala we-intravenous (IV)- 1-2 mcg (0.02 mcg/kg) kathathu ngesonto, ulungiswa njalo emavikini angu-2-4. 
  • Isondlo IV- 0.5-4 mcg kathathu ngesonto.
• Abantu abadala abane-Hypoparathyroidism noma i-Pseudohypoparathyroidism:
  • Umthamo wokuqala womlomo ngu-0.25 mcg ngomlomo nsuku zonke, ukhuphuka ngo-0.25 mcg njalo emavikini angu-2-4. 
  • Umthamo wesondlo ngu-0.5-2 mcg nsuku zonke.
• Umthamo Wezingane: 
• Nge-Hypocalcemia: 
  • Izingane ngokuvamile ziqala ngo-0.25 mcg ngomlomo nsuku zonke, ngemithamo yesondlo engu-0.5-1 mcg nsuku zonke. Umthamo we-IV wezingane ufana nowabantu abadala.
  • Odokotela bahlose ukugcina amazinga e-serum calcium phakathi kuka-9-10 mg/dL. Baqapha amazinga e-calcium eduze ngesikhathi sokwelashwa futhi balungise imithamo yabo ukuze bavimbele i-hypercalcaemia noma i-hypocalcaemia.

Isiphetho

Amaphilisi e-Calcitriol asiza ukuphatha amazinga e-calcium nempilo yamathambo ezimeni ezihlukahlukene zezokwelapha. Lolu hlobo olunamandla lwevithamini D luthonya ukumuncwa kwe-calcium, ukusebenza kwezinso, nokulawulwa kwehomoni ye-parathyroid. Ukusetshenziswa kwayo kusuka ekwelapheni i-hypocalcaemia ezigulini ze-dialysis kuya ekulawuleni i-hypoparathyroidism nezinye izifo ezihlobene ne-calcium. 

Ukuqonda ukuthi isetshenziswa kanjani i-calcitriol ngendlela efanele, okuhlanganisa umthamo wayo, ukusebenzisana okungaba khona, kanye nezinyathelo zokuphepha, kubalulekile ekwelapheni okuphephile nokuphumelelayo. Njenganoma yimuphi umuthi, ukuxoxa ngazo zonke izici zokusetshenziswa kwe-calcitriol nomhlinzeki wezokunakekelwa kwempilo kubalulekile ukuze kuqinisekiswe imiphumela engcono kakhulu yempilo yamathambo kanye nempilo yonke.

FAQ sika

1. Singayithatha yini i-calcitriol nsuku zonke?

Odokotela bavame ukunikeza i-calcitriol okufanele iphuzwe nsuku zonke. Umthamo ojwayelekile uba kanye ngosuku noma zonke izinsuku, ngokuvamile ekuseni. Kodwa-ke, umthamo oqondile uncike esimweni sezempilo sesiguli kanye nokusabela ekwelashweni. 

2. Isetshenziselwa ini i-calcitriol?

I-Calcitriol, uhlobo olusebenzayo lwevithamini D olwenziwe umuntu, lunokusetshenziswa okuningana okubalulekile:

• Ukwelapha amazinga e-calcium aphansi kanye nezifo zamathambo ezigulini ezinezinkinga zezinso noma ze-parathyroid gland
• Ukuphatha i-hypocalcemia ezigulini eziku-dialysis okungapheli kwezinso
• Ukuvimbela nokwelapha i-hyperparathyroidism yesibili kubantu abanesifo sezinso esingamahlalakhona
• Ukubhekana nokungalingani kwe-calcium ne-phosphorus okuhlobene ne-dialysis yezinso zesikhathi eside
• Ukwelapha izinhlobo ezithile zama-rickets, i-osteomalacia, ne-hypophosphatemia yomndeni
• Ukwandisa amazinga e-calcium ezinganeni ezizalwa ngaphambi kwesikhathi

3. Isebenza ngokushesha kangakanani i-calcitriol?

I-Calcitriol ngokuvamile iqala ukusebenza phakathi nosuku noma ezimbili iqale ukwelashwa. Nokho, imiphumela ebonakalayo ingase ithathe amasonto ambalwa ukuze ivele. Umzimba ungamunca kalula i-calcitriol njengoba iwuhlobo olucushiwe lwevithamini D. 

4. Ubani okungafanele aphuze i-calcitriol?

Abantu abathile kufanele bakugweme ukuthatha i-calcitriol noma bayisebenzise ngokuqapha:

• Abantu abangezwani ne-calcitriol noma eminye imikhiqizo kavithamini D
• abesifazane abakhulelwe
• Omama abancelisa ibele, ngaphandle kokubonisana nodokotela kuqala
• Iziguli ezinamaleveli aphezulu e-calcium noma izimo ezithile zenhliziyo
• Labo abahlelelwe ukuhlinzwa noma ababhekene nezikhathi ezinwetshiwe zokungakwazi ukuhamba

5. Yimuphi umphumela oseceleni obalulekile we-calcitriol?

Umphumela ovame kakhulu nobalulekile we-calcitriol yi-hypercalcaemia, ethinta okungenani ingxenye eyodwa kwezintathu yeziguli ezithatha i-systemic calcitriol. Izimpawu zokuqala ze-hypercalcemia zihlanganisa:

• Ukukhathala nokubuthakathaka
• I-nausea nokuhlanza
• Ubuhlungu besisu nokuqunjelwa
• I-Vertigo ne-tinnitus
• Ukuthukuthela

6. Ngingakwazi yini ukuphuza i-calcitriol ebusuku?

Ngenkathi i-calcitriol ivame ukuthathwa ekuseni, ezinye iziguli zingayithatha ebusuku uma udokotela wazo eziyala. Lokhu kungase kudingeke lapho kuhlukaniswa i-calcitriol kweminye imithi engaphazamisa ukumuncwa kwayo, njengama-sequestrants e-bile acid noma uwoyela wamaminerali. Njalo landela imiyalelo kadokotela wakho mayelana nesikhathi somthamo wakho.

7. Kwenzekani uma ngiyeka ukuthatha i-calcitriol?

Ukumisa i-calcitriol kungazelelwe ngaphandle kweseluleko sezokwelapha kungaholela ekwehleni ngokushesha kwamazinga e-calcium, okungase kubangele izinkinga ezinkulu zempilo.