
prottoon-pump inhibittar

prottoon-pump inhibittarukal (pipis) vayarile assid ulppaadanam aazhathilum deerghakaalathum kuraykkaan kaaranamakunna oru tharam marunnukalaanu. vayarile echu +/keey + atpes prottoon pump maattaanaavaathavidham thadanjaanu avar angane cheiyunnathu.
labhyamaya assid sravathinte ettavum sakthamaaya inhibittarukalaanu avaa. prottoon-pump inhibittarukal pradhaanamaayum echu2-risapttar athiraalikale, samanamaaya falangalullathum ennaal vyathyasthamaaya pravartthana reethiyullathumaaya marunnukalude oru koottam, aantaasidukale marikadannu.
lokath ettavum kooduthal vittazhikkappedunna marunnukalil onnaanu pipis. prottoon-pump inhibittar marunnukalude klaas lokaarogya samghadanayude avashya marunnukalude pattikayil ulppedunnu. omepressol aanu pattikappedutthiyirikku nirddishta udaaharanam.
medical upayogangal.
eee marunnukal pala avasthakaludeyum chikilsayil upayogikkunnu, udaaharanathina
gastroesophagial reflexes rogam deerghakaalathekku chikilsikkumbol aavasyamulla chikitsa phalam nedunnathinu ettavum kuranja phalapradamaaya ppi doses edukkanamennu speciality professional oorganaiseshanukal shupaarsha cheiyunnu. amerikkayil, prelosec odisi polulla ovar-dhii-kaundar pipis oru varshathil moonnu 14 divasathe chikitsa kozhsukalil koodaruthennu phudu aandu drugg administration (fda) upadeshichu.
avayude vipulamaaya upayogam undaayirunnittum, eee avasthakalil chilathil avayude upayogathe pinthunaykkunna thelivukalude gunanilavaaram vyathyaasappettirikkunnu. ellah kesukalilum ppsinte falaprapti theliyikkappettittilla. udaaharanathinu, baarattinte annanaalathile annanaala adenocarcinomayude sambhavam avaa kuraykkunnundengilum, avaa badhikkunna neelam mattunnilla. koodaathe, yukeyile gaveshanangal soochippikkunnathu thondayile nirantharamaaya lakshanagal chikilsikkunnathil pipis phalapradamallennaanu.
pipis nirthunnathinulla soochanakal.
pipis palappozhum aavasyathiladhikam samayamedukkum. ashupathriyil praveshippikkappedukayo primery cair klinikkil kaanappedukayo cheiyunnavaril pakuthiyolam aalukalilum avarude deerghakaala pii. pii. aii. ezz upayogathinu rekhaamoolamulla kaaranamonnumilla. deerghakaala falapraapthiyude cheria thelivukal kanakkiledukkumbol, marunninte vilayum doshasaadhyathayum ardhamaakkunnathu pala aalukalilum pipis nirthunnathu klinikkanmaar pariganikkanamennu chila gaveshakar vishwasikkunnu.
naalu aazhchakalkk sesham, rogalakshanangal pariharichenkil, nencherichil, gastroesophagial reflexes rogam, allengil annanaalathinte veekkam ennivaykku upayogikkunnavaril eee avasaanathe rund lakshanagal gurutharamallengil ppi nirtthiyekkaam. baaratts annanaalamo rakthasraavam undaakunna vayarile alsaro ullavaril nirthaan shupaarsha cheiyunnilla. aadyam edutha marunninte alavu kuraykkukayo allengil rogalakshanangal undaakumbol maathram marunnu kazhikkukayo cheythukondu nirtthal nadatthaam.
prathikoola phalangal.
pothuve, prottoon pump inhibittarukal nannayi sahikkappedunnu, hraswakaala prathikoola phalangalude sambhavangal thaarathamyena kuravaanu. omepresolil kooduthal thavana report cheyyappettittunde prathikoola phalangalude vyapthiyum sambhavavum ellah ppsukalkkum samaanamaan. ithinu kaaranam athinte deerghakaala labhyathayum athinaal klinikkal anubhavavum aakam.
thalavedana, ookkaanam, vayarilakkam, vayaruvedana, ksheenam, thalakarakkam ennivayaanu saadhaarana prathikoola phalangal. parukkan paadukal, chorichil, vaayusanjaaram, malabandham, uthkanda, vishaadam enniva apoorva prathikoola phalangalil ulppedunnu. apoorvvamaayi, ppi upayogam gurutharamaaya prathikaranamaya rabdomiolysis ulppedeyulla mayoppathi undakunnathumaayi bandhappettirikkam.
ppsinte deerghakaala upayogathinu chikilsayude gunangaludeyum apakadasaadhyathakaludeyum santhulithaavastha vilayiruthendathundu. 2017 march vareyulla kanakkukal prakaram niravadhi praadhamika reportukalil deerghakaala ppi upayogavumaayi vividha prathikoola phalangal bandhappettirikkunnu, ennaal avalokanangal eee padanangalile thelivukalude mothatthilulla gunanilavaaram "thaazhnnath" allengil "valare kuravaanu" ennu vilayiruthunnu. patana roopakalppanayum phalatthinte valuppathinte cheria esttimettukalum kaaranam ppi therapy nirddishta associationukalum thammilulla kaaryakaarana bandham sthaapikkunnathinulla aparyapthamaaya thelivukale avaa vivarikkunnu. 2017 march vareyulla kanakkukal prakaram pipis sariyaaya reethiyil upayogikkumbol aanukoolyangal apakadasaadhyathakalekkaal kooduthalaayirunnu, ennaal anuchithamayi upayogikkumbol mithamaaya apakadasadhyathakal pradhaanamaan. theliyikkapetta soochanayullavaril ettavum kuranja phalapradamaaya alavil pipis upayogikkanamennu avar shupaarsha cheiyunnu, ennaal prarambha anubhavaparamaya therapyode prathikarikkaattha aalukalil doses vardhanavum vittumaaraatha therapy niruthsaahappeduthunnu.
poshakaahaaram.
bhakshanathinte thakarchaykkum sookshuma poshakangal purathuvidunnathinum gastric assid pradhaanamaan, chila padanangal irumbu, kaalsyam, magneeshyam, vitaamin bii 12 ennivayude agiranam thadassappedaanulla saadhyathakal kaanikkunnu. irumbu, vitaamin bii 12 ennivayumaayi bandhappett, daatta durbalav aashayakkuzhappamundaakkunna niravadhi gadakangalum thiricharinjittundu.
ppi therapy edukkunnavaril magneeshyathinte alavu kuravaayirikkunnathum echu2-risapttar aantagonist marunnukalilekku maarumbol iva thirichedukkaavunnathumaa.
asthi pottalukal.
uyarnna alavo deerghakaala pii. pii. aii. ezz upayogamo asthivalarchaykkulla saadhyatha vardhippikkunnu, ithu hraswakaala, kuranja alavil upayogikkunnathil kandethiyilla; 2010 ll pii. pii. aii. marunnu labelukalil fda ithinekkurichulla oru munnariyipp ulppeduthi.
sisukkalil, aarogyamulla sisukkalil (athaayath gastroesophagial reflexes rogam illaathe) rogalakshanamulla gastroesophagial reflexes chikilsikkaan assid saprashan therapy pathivayi nirddeshikkappedunnu. 2019-ll nadatthiya oru padanatthil ppiyude upayogam mathramalla histaamain echu2-risapttar athiraalikalumaayi chernnu asthi pottal apakadasaadhyatha vardhikkunnathumaayi bandhappettirikkunnavum ithu upayogathinte divasangaliloodeyum chikilsayude munkaala thudakkathiloodeyum vardhippichuvennum kaanichu. kaaranam vyakthamalla, austiyoklaastukal moolam asthi pottunnath vardhichathaayi soochippikkappettittund.
dahananaalangal.
chila padanangal ppsinteyum clostridioids deficile anubaadhayudeyum upayogam thammilulla parasparabandham kaanichittundu. daatta parasparavirudhavum vivaadaparavumaanenkilum, ppi marunnukalude labelil eee prathikoola falathekkurichu oru munnariyipp ulppeduthaan efdaic mathiyaya aashankayundaayirunnu. pipis edukkunna praayamaayavarilum pipis edukkunna irritable bowell syndrome ullavarilum swamedhayaa bacteria perittonitis (ezz. bii. pii) undakunnathinekkurichum aashanka uyarnnittund; adisthaana avasthakal kaaranam eee janasamkhyayil rund tharatthilulla anubaadhakalum undaakunnu, ithu ppsinte klaas efakttaano ennu vyakthamalla. pipis oru vyakthiye cherukudal bacteriayude amithavalarchayo fungus valarchayo vikasippikkaan prerippichekkaam.
syrotic rogikalil, valia alavil asaittukalum veraisukal vazhi kuracha annanaala chalanaseshiyum jerdine prakopippikkum. acidity prakopippikkal, pakaramaayi, verisukalude villalin kaaranamaayekkam. athinaal, syrotic rogikalkku jerd chikilsikkunnathinum verisiyal rakthasraavathe thadayunnathinum pipis palappozhum pathivayi nirddeshikkappedunnu. ennirunnaalum, sirosis rogikalil ppsinte deerghakaala upayogam ezz. bii. pii. yude apakadasaadhyatha vardhippikkunnuvennum deerghakaala fooloo-appinide klinikkal decompensation, karalumaayi bandhapetta maranam ennivayude vikaasavumaayi bandhappettirikkunnavum aduthide theliyikkappettittund.
kudalil vasikkunna bakteeriyakalude koottamaaya kudal microbiota ghadanaye ppi upayogam maattunnuvennathin thelivukalundu. pipis eee maattangalkk kaaranamakunna samvidaanangal ithuvare nirnnayikkappettillettim, ppi upayogathiloode bacteria anubaadhaykkulla saadhyatha vardhippikkunnathil avaykku oru pankundaakaam. eee anubaadhakalil "helicobacter pailori" ulppedaam, kaaranam eee inam oru assid paristhithiye anukoolikkunnilla, ithu janithakamaayi saadhyathayulla rogikalil alsarinum gastric cancerinum saadhyatha vardhippikkunnu.
echu" enna sramam labhicha aalukalil ppi upayogam. pailori nirmmarjanam gastric kaansarinulla saadhyatha vardhippikkunnathumaayi bandhappettirikkam. kaaryakaaranatthinte abhaavathodoppam eee kandethalinte saadhuthayum karuthum eee bandhathe chodyam cheyyaan kaaranamaayi. vyakthiyude risk-benifit profile pariganicha sesham, prathyekichu "echu" charithramullavarkkidayil deerghakaala pipis vivekathode upayogikkanamennu shupaarsha cheiyunnu. pailori anubadhayum kooduthal, nannayi roopakalppana cheytha, bhaavi padanangalum aavasyamaanu.
ppsinte deerghakaala upayogam funtic grandhikalil ninnulla (ithu funtic grandhi polyposisil ninnu vyathyasthamaan) haanikaramallaatha poolipukalude vikaasavumaayi bandhappettirikkunnu; eee poolipukal cancerinu kaaranamakunnilla, pipis nirthalaakkumbol pariharikkukayum cheiyunnu. pipis upayogikkunnathu gastric cancerukaleyo mattu gurutharamaaya gastric prashnangaleyo maraykkumenna aashankayundu.
ppi upayogam microscopic vankudalinte vikaasavumaayi bandhappettirikkunnu.
hridayasambandhamaaya.
ppi upayogathinteyum hridayasambandhamaaya sambhavangaludeyum bandhangalum vyaapakamaayi padikkappettittundile eee aapekshika apakadasadhyathakal mattu gadakangalaal aashayakkuzhappathilaaknaalppathinu vyakthamaaya nigamanagalil athiyittilla. aspirin athinte antipletlett pravarthanangalkkaayi nalkumbol hridayasambandhamaaya rogangalullavaril gastric samrakshanathinaayi pipis saadhaaranayaayi upayogikkunnu. pps platelet inhibittar clopidogralinte metabolisavum thammilulla oru prathipravartthanam ariyappedunnu, eee marunnu palappozhum hrudrogamulla aalukalilum upayogikkunnu.<ref namam = "doyi/10.1136 bmj.ell1580 "> strock varaanulla saadhyatha vardhikkunna bandhangalund, ennaal ithinakam uyarnna apakadasaadyathayulla aalukalil ithu sambhavikkaan kooduthal saadhyathayund.
asymmetric dimethylarginine (adma) tharamthaazhthunna ensaimaaya dimethylargininesine pipis bandhippikkukayum thadayukayum cheiyunnu, ithu uyarnna adma alavil kalashikkukayum bioavable naitrik ooksaid kurayukayum cheiyunnu ennathaanu hridayasambandhamaaya falangalkkulla oru nirddeshitha samvidaanam.
kyaansar.
2022leeii nireekshana padanangalude samagra avalokanavum mettaa vishakalanavum kaanikkunnath prottoon-pump inhibittar naalu arbudangalude saadhyatha ganyamaayi vardhippikkunnu ennaanu.
matoraal.
ppi upayogavum pneumoniayude vardhicha apakadasaadhyathayum thammilulla bandhangal kaanichittundu, prathyekichu therapy aarambhich 30 divasathinullil, community upayogathil ithu 50 sathamaanam kooduthalaanennu kandethi. vittumaaraatha vrukkarogam, demensia, echu. sii. sii thudangiya ppi upayogathinte mattu durbalamaaya associationukal kandethiyittundu. 
2016 leeii kanakkanusarichu, nireekshana padanangalil ninnu phalangal uruthirinjathinaal atharam associationukal kaaryakaarana bandhangalaano ennu anishchithathvathilaayirunnu.
pravartthana samvidaanam.
prottoon pump inhibittarukal gastric paariyettal koshangalude hydrajan/pottasyam adenosine triphosphates ensime systethe (echu +/keey + atpes, allengil, kooduthal saadhaaranayaayi, gastric prottoon pump) maattaanaavaathavidham thadayunnathiloodeyaanu pravartthikkunnathu. prottoon pump gastric assid sravathile avasana gattamaanu, ithu gastric lumenilekk echu + ionukal sravikkunnathin nerittu utharavaadiyaanu, ithu assid sravathe thadayunnathinulla anuyojyamaaya lakshyamaakkunnu. echu, keey-atpes assid sravathinte avasana ghattamayathinaal, eee ensaiminte oru inhibittar gastric assid sravathe adichamarthunnathil risapttar athiraalikalekkaal falapradamaanu. eee marunnukalellaam dahananaalathile echu, keey-atpesine kovalant binding vazhi thadayunnu, athinaal avayude phalatthinte dairkhyam rakthathile avayude alavil ninnu pratheekshichathilum kooduthalaanu.
assid ulppaadanathile avasana ghattavum athupole thanne inhibishante maattaanaavaatha swabhaavavum lakshyamidunnathu echu 2 athiraalikalekkaal ganyamaayi kooduthal phalapradamaayathum gastric assid sravam 99 sathamaanam vare kuraykkunnathumaaya oru tharam marunnukalkk kaaranamaakunnu.
vayattile assid kuraykkunnathu duvodenal alsar bhedamaakkaanum dahanakked, nencherichil ennivayil ninnulla vedana kuraykkaanum sahayikkum. ennirunnaalum, proteinukal, vitaamin bii 12, kaalsyam, mattu poshakangal enniva dahippikkaan aamashaya aasidukal aavasyamaanu, koodaathe valare kurachu aamashaya assid hypochlorhydria enna avasthaykku kaaranamaakunnu.
neutrally charjju (lipophilic) ulla nishkriyamaaya roopathilaanu pipis nalkunnathu, koodaathe acidic parithasthithikalode kosha stharangale intra sellular compartmentukalaayi (paariyettal sell canaliculus pole) eluppathil kadakkunnu. oru assid parithasthithiyil, nishkriyamaaya marunnu protonated cheyyukayum athinte sajeeva roopathilekku punakrameekarikkukayum cheiyunnu. mukalil vivarichathupole, sajeevamaaya roopam gastric prottoon pambumaayi sahavarthithvathodeyum maattaanaavaatha vidhathilum bandhippikkukayum athu nirjjeevamaakkukayum cheyyum.
echu. pailori nirmmarjanam, vayarile piechu vardhippikkunnathiloode pipis sahayikkunnu, ithu bacteria aasidukalkkum antibioticukalkkum prathirodhasheshiyulla cocoid roopathil ninnu maattunnu. nirmmaarjjanathil chila durbalamaaya adhika phalangalum pipis kaanikkunnu.
pharmacokinetics.
omepressol agiranam cheiyunnathinte nirakk oresamayam kazhikkunna bhakshanathiloode kuraykkunnu. koodaathe, lansopresolinteyum esomepresolinteyum agiranam bhakshanam moolam kurayukayum vaikukayum cheiyunnu. ennirunnaalum, eee pharmacokinetic efakttukal falapraapthiyil kaaryamaaya swaadheenam cheluthunnillennu report cheyyappettittund.
aarogyamulla manushyaril, ppsinte ardhaayuss ekadesham 1 manikkooraan (tenatopresolinu 9 manikkoor), ennaal echu, keey-atpesumaayi maattaanaavaatha bandhanam kaaranam assid inhibishante dairkhyam 48 manikkooraan. tenatopresol ozhikeyulla ellah pipisukalum saip ensimeukal (kooduthalum saip 2 sii 19,3eiii 4 enniva vazhi) karalil athivegam metabolise cheyyappedunnu. omepressol sulfide purathuvidunnathilekkum ensime veendum sajeevamaakunnathilekkum nayikkunna endogenous aantiooksidant glutathayoninte falamaayirikkaam inhibittari complexinte vighadanam.
udaaharanagal.
vaidyashaasthraparamaayi upayogikkunna prottoon pump inhibittarukal
oru prottoon pump inhibittar mattonninekkaal nannayi pravarthikkunnuvennath vyakthamaaya thelivukalonnumilla.
charithram.
1980kalil omepressol purathirakkiyathode pipis vikasippicheduthu. eee marunnukalil bhooribhaagavum omepresolumaayi bandhapetta benzemidasol derivateevaanu, ennaal tenatopresol polulla imidasopyridine derivative vikasippichittund. rivaprasan polulla pottasyam-malsara inhibittarukal prottoon pambinte pottasyam-binding saittine vipareethamaayi thadayunnu, ithu kooduthal vegathil pravartthikkunnu, pakshe mikka raajyangalilum labhyamalla.
samoohavum samskaaravum.
chelavu.
britiish kolambiyayil, kaanadayil ppsinte vila oro dosinum ganyamaayi vyathyaasappedunnu, athesamayam classile ellah ejantumaarum erekkure thulyamaayi phalapradamaanennu thonnunnu.
niyanthranaparamaaya amgeekaaram.
ppsinte fda-amgeekritha soochanakalude oru thaarathamya pattika chuvade kaanichirikkunnu.
gaveshanam.
covid-19.
oru padanamanusarichu prottoon-pump inhibittarukal covid-19nte lakshanangalude theevratha vardhippikkum.

