Levonorgestrel: iyini le hormone, futhi iyaphendula ngani emzimbeni?

Abantu abaningi banesithakazelo kulo mbuzo: i-levonorgestrel - yimuphi uhlobo lwe-hormone? I- progestogen eyenzelwe ukuthi iguqulwe i-endometrium, iyanciphisa i-ovulation, ivimbele ukukhulelwa kweqanda elilungiselelwe. Ukwengeza, nge-receptors usizo lwama-membrane amancane athola ukuzwela okuncishisiwe. Kulesi sihloko sizocubungula ukulungiselela okuqukethe i-hormone okuthiwa.

I-Pharmacology

Isidakamizwa esithi "Levonorgestrel" yisifo se-estrogen esivimbela ukusebenza kwe-spermatozoa ngenxa yokwanda kwezakhiwo ezibucayi ze-mucus. Isidakamizwa ngaphakathi kwesibeletho sendawo sithinta ama-tubes, ama-endometrium, ukuvumelana kwe-mucus, okwenza ukuthi i- horlicone evuselela i-follicle iyanciphisa umsebenzi wayo.

Uma uphonywe, isidakamizwa sisuke singene emgodini wokugaya, i-biopoies ifika ku-100%. Egazini, izingxenye zalo zigxila ngangokunokwenzeka nge 75 ml kanye njalo ngemizuzu 60-130. I-hormone ebuzwayo ixhumana ne-plasma futhi ibopha izingxenye ze-globulin nge-50%.

I-metabolism isekelwe esibindi, lapho kuhlanganiswa ama-metabolite e-pharmacologically. I-isoenzyme eyinhloko yale hormone yi-CYP3A4. Isiqingatha-ukuphila singapheli amahora angu-30.

Izakhiwo

Ephendula umbuzo othi "Levonorgestrel - uyini le hormone?" Kufanele iqondiswe yiziqondiso kumuthi wegama elifanayo kanye nezincomo zodokotela olaphayo. Umehluko kokubaluleka kwenani lalingu-1.0 ml / min / kg (kusuka ku-plasma). I-hormone iqedwa ngokuyinhloko nge-ureter, ingxenye encane isuswa emathole.

Ngendlela yokwelashwa, izinga lokungena esibelethweni alikho ngaphezu kuka-20 μg nsuku zonke, futhi ngemva kweminyaka emihlanu lihlahlela ku-11. Ngokwesilinganiso, izinga lokukhululwa kwe-hormone lihluka cishe ngamahora angu-14 μg / 24 ngezinyanga ezingu-50-60.

Ukwelashwa kwe-intrauterine kuvunyelwe kwabesifazane abane-hormone yokwelashwa esikhundleni sokubambisana ngokuhambisana nama-estrogens angafaki isakhi se-progestational. I-Levonorgestrel iyi-hormone engena ku-plasma amaminithi angu-60 ngemva kokungenisa. Ukugxila okuphezulu kuyo kusetshenziswe emva kwezinsuku eziyi-14 zokusetshenziswa.

Izinkomba

Ukusetshenziswa kwalesi sidakamizwa kungenzeka nge-intrauterine therapy, kanye nasemacaleni alandelayo:

• I-Menorrhagia ye-orientation ye-idiopathic.
• Ukuvikelwa kokukhulelwa isikhathi eside.
• Izinyathelo ze-prophylactic zokufaka isrogen esikhundleni.
• Ukukhulelwa kokubeletha okuphuthumayo.

I-hormone levonorgestrel, isenzo sayo sinomkhakha omkhulu, kufanele isetshenziswe kuphela emva kokunconywa kukadokotela.

Isicelo nesilinganiso

Lesi sidakamizwa senziwa ngokujola kwe-intrauterine - sijojowe emgodini wesibeletho. Isetshenziswe zingakapheli izinsuku ezingu-4 ngemuva kokuqhutshwa komqulu nge-0.75 kuya ku-1.5 mg. Ochwepheshe bezimo eziphuthumayo bayelulekwa kakhulu ukuba bangazenzi ukukhulelwa kwezimo eziphuthumayo izikhathi ezingaphezu kwezinyanga eziyisithupha.

Ukukhipha ukwephulwa komjikelezo wokuya esikhathini, kumele ulandele isilinganiso esinconywayo ngaphandle kokusebenzisa kabusha. Ungasebenzisi lesi sidakamizwa ngomlomo njengendlela yokukhulelwa njalo, njengoba lokhu kuphazamisa imiphumela emibi futhi kunciphisa ukusebenza komuthi. Endabeni yokwakheka kwegazi ngemuva kokuphulwa kokuphuthumayo okuphuthumayo, inqubo yokuhlola ye-gynecologist iyanconywa kakhulu, futhi uma ukuphuphuma kwesisu kuphazamiseka isikhathi esingaphezu kwesonto elilodwa, kuyadingeka ukulinda kuze kube yilapho sekukhulelwe.

Kuphela emva kokuthatha isinqumo sokuthintana nokwaziswa kwesigqila sezinzwa emasosheni angavamile kungenzeka ukuthi usebenzise lesi sidakamizwa sokukhulelwa kwabesifazane uma kwenzeka kuphuthumayo.

I-hormone ye-levonorgestrel isetshenziswa kanjani?

Ukusetshenziswa kwe-hormone echazwe kanjani kuthinta umzimba, futhi yini okufanele uyenze ukuze ugweme imiphumela emibi? Abantu abaningi babuza lo mbuzo. Ukunamathela ngokuqinile ezinconyweni zomchwepheshe, ukuhambisana nomthamo nokulandela imiyalelo - lokhu kuqinisekisa ukusetshenziswa okuphephile kwesidakamizwa.

Ngaphambi kokusebenzisa i-IUD kuyadingeka ukuba uhlolwe umjozi wezifo zogciwane, kuhlanganise nokuhlola izigulane ezincelisayo, izitho zangasese, nokwenza isisu somlomo wesibeletho.

Ukuhlolwa kabusha kwenziwa emva kwezinsuku ezingu-30-40 emva kokufakwa kwe-spiral, njalo ngonyaka, futhi uma kwenzeka kube khona izinto ezidingekayo - ngokuphindaphindiwe. Le ngculaza ye-intrauterine isebenza iminyaka engu-4 kuya kwengu-5. Ukufakwa kwalo kufanele kuthathwe kuphela udokotela onguchwepheshe kule nsimu noma abanolwazi ngokuhlunga izidakamizwa ezibuzwayo.

Izingozi

Kulaba besifazane abasebenzisa izidakamizwa nge-gestagen, kungase kube nokwanda kwe-thrombosis emangalisa ngesikhathi esibucayi. Ngezimpawu ezinjalo, izinyathelo eziphuthumayo zokuxilongwa nokuphathwa kufanele zithathwe ngokushesha.

Ngemuva kokuqothulwa kwe-IUD, ukubeletha kuvuselelwa phakathi nengxenye yonyaka phakathi kwengxenye yabesifazane abaguqulwe, emva kwezinyanga ezingu-12 - ezingaphezu kwamaphesenti angu-96. Ukuqondisa kokubeletha akuphumelelanga kangako iziguli ezikhulu kakhulu.

Ukungafani

Ubuzwa umbuzo othi "Levonorgestrel - uhlobo luni lwehomoni?" Zonke ukuphikisana kufanele kufundwe. Phakathi kwabo:

• Ukuzwela okukhulu (hyper), ukuphathwa kwe-thrombophlebitis.
• I-Thromboembolism, ukuguqulwa kwamathambo.
• Izifo zesimo se-cerebrovascular , ukukhulelwa.
• Mayelana nokusetshenziswa kwangaphakathi: i-jaundice (kufaka phakathi ku-anamnesis), izinkinga zempilo yokuxoshwa kwe-bile noma isibindi, isikhathi se-lactation.
• Ukuvuthwa ngokocansi.
• Ngaphezu kwalokho, ngenxa ye-IUS - ukutheleleka kwe-node urogenital, ubuyela noma ukuvuvukala okusebenzayo ku-pelvis encane, ukugqithisa kwe-endpartum endometritis, isifo sobindi esibi.
• Ukungenelela kwe-Septic yokukhipha isisu ku-trimester yokugcina, inguqu ye-dysplastic ye-neck uterine, i-pathology enegazi elifanayo lemvelaphi engaziwa, amafomu amabi.
• Ukuhlukumeza okuzayo noma kokuzalwa, ukubola kwe-fibroids.
• I-progestogenesis (i-tumor, kuhlanganise nezilonda zomdlavuza zesifuba).

Izithibelo

Isici esinqunyelwe ngaso sonke isikhathi sihambisana nokungenelela kokwelashwa ngaphakathi kwesibeletho uma lezi zimpawu ezilandelayo noma izifo ezingapheli zenzeka:

• Izinsizwa ezinzima, i-migraine evamile neyendawo yendawo yokukhubazeka okubukwayo, nezinye izifo zesifo, ezihloswe ukuthi kungenzeka isifo se-ischemic;
• Ukucindezeleka okuvelele kokuqondisa komzimba, i-jaundice, izinqubo eziyinkimbinkimbi ezonakalisayo ohlelweni lokujikeleza, kuhlanganise nokuhlaselwa kwenhliziyo nokushaya;
• Ishukela sikashukela.

Kubalulekile ukuthi uxoxe ngokushesha mayelana nokukhishwa kwe-IUD ekubunjweni noma ukutholakala kwanoma yimiphi yalezi zimo.

Ukukhulelwa kanye nenkathi yokulahlwa

Naphezu kokuthi i-levonorgestrel iyi-hormone yesifazane, ukusetshenziswa kwayo akuvumelekile ekukhulelwe. Uma kwenzeka, ukuqedwa kwesistimu kunconywa ngoba noma yikuphi ukwelashwa kwe-intrauterine kwandisa ingozi yokuzalwa ngaphambi kokuzalwa nokukhubazeka. Ukukhishwa kwe-uterine ukuzwakala noma ukuqedwa kwesistimu ngezinye izikhathi kuholela ekukhulelweni kokukhipha isisu okwenzeka ngokungazelelwe. Kuzodingeka ukuthi uthintane nochwepheshe mayelana nokuhleleka kokuqedwa kokufakelwa kokukhulelwa lapho kungenakwenzeka ukukhipha imithi ngendlela efanele.

Uma kungenakwenzeka ukususa uhlelo lwe-intrauterine kanye nesifiso sokuphikelela ukuqhubeka nokukhulelwa, isiguli kufanele siqaphele imiphumela engenzeka kanye nengozi yengane ngenxa yokulethwa kokuqala. Ezimweni ezinjalo, kubalulekile ukuqapha ngokucophelela inkambo yokukhulelwa. Ngaphambi kokuba isiguli kufanele saziswe ukuthi kufanele ngokushesha sikhombise zonke izimpawu ezingase ziphakanyise ukuphikisana kwenqubo.

Ukubamba iqhaza

Uma ukondla nokusebenzisa i- "Levonorgestrel" mayelana nengxenye eyodwa yeshumi yomuthi ungena emzimbeni womntwana. Ukubeletha ngaphakathi ngaphakathi ngenxa yokukhulelwa kwezimo eziphuthumayo kufanele kukhishwe izinsuku ezingu-1.5.

Ukuze uthole uhlelo lwezokwelapha, i-intrauterine efakwe, kanye nanoma yimuphi indlela yokwelapha ngokweqile ye-gestagenetic, kuyisici sokuthi uhlelo lokusebenza emva kwezinyanga eziyisithupha emva kokuzalwa alinayo umphumela omubi ekuthuthukiseni nasekukhuleni kwengane, ngakho-ke, lesi sidakamizwa cishe asibeka engozini emntwaneni wezinyosi ezinconywayo .

Izimpawu ezimbi

Futhi ubuyela embuzweni othi "Levonorgestrel" - kuyini na? ", Ake sicabangele imiphumela emibi kanye nemibono yokuphikisana kwezidakamizwa, okungahle kwenzeke ezinhlotsheni ezahlukene zomzimba futhi ubonise izimpawu ezilandelayo:

1. Kusukela ohlelweni lwezinzwa: ukukhathala, isimo sokucindezeleka, ukuphathwa ikhanda, ukushintsha kwemizwelo.
2. I-GIT. Ukunciphisa, ukuthukuthelisa, ukuphahlazeka, ukubhuqa.
3. Izitho ze-Genitourinary. Ukukhipha igazi, ukuphuma, ubuhlungu, i-candidiasis, amathuba okuba nezicubu ezimbi futhi ezinobuthi.
4. Ukuqhaqhaza isikhumba, ukubonakaliswa kwe-eczema, ukuchithwa, ukuvuthwa, izigqoko.
5. Okunye: ukuvuvukala, ubuhlungu obuhlanganyelwe, ukunyuka kwengcindezi, isisu.

Ezimweni ezingavamile, ukuhlukunyezwa kwesibindi, ukuphazamiseka nokuphelelwa amandla kungenzeka.

Ukuhlanganiswa nezinye izidakamizwa

Ukufunda "i-Levonorgestrel" (yiliphi i-hormone), kuyadingeka ukuthi sikhulume ukuthi kungenzeka ukuhlanganiswa kwayo namanye amalungiselelo okwelapha. Endabeni yokusebenzisa into ekhonjiwe nge-inductors yama-iso-proythi ye-cytochrome P450, ukwehla kokusebenza kahle kunokwenzeka ngenxa yokwanda kwezinqubo zayo zemethamo.

Imithi elandelayo inganciphisa umphumela we "Levonorgestrel":

• Iqembu lama-barbiturates, "i-Tretinoin", "i-Carbamazepine", izingoma ze-St John's wort futhi equkethe ukwakheka kwayo.
• Ukusebenza kwama-anticoagulants, i-hypoglycemic, izidakamizwa ze-anticonvulsant ziyancipha.
• "I-Levonorgestrel" yandisa ikhono le-glucocorticosteroids egazini, futhi liyakwazi nokuhlehlisa umzimba.
• Ngenxa yokuvimbela ukuphindaphinda kwe-sex steroids, okubangelwa ukuhlelwa kabusha kwemifino yamathumbu, ukuphuma kwendoda kungakhula ngokusetshenziswa kwezidakamizwa ezithile.

Ngeke ukwazi ukungeza, ukukhuluma ngendlela uLevonorgestrel esetshenziswa ngayo, ukuthi le mithi ibangela ukwanda kwemiphumela emibi yeminye imithi, ayikho i-antidote kuyo. Uma kwenzeka ukudlula ngokweqile, ukwelashwa kwesifo kuyadingeka .