Odokotela bamemezele ukuthi abantu kufanele bazame ukugwema ukuphuza i-acetaminophen esebenzayo encibilika kusawoti, nemiphumela yocwaningo ihlobanisa nengozi eyanda kakhulu yokuhlaselwa yinhliziyo, unhlangothi, ukumelwa yinhliziyo nokufa.
Ucwaningo lweziguli ezingaba ngu-300.000 ezibhaliswe nodokotela base-UK bokunakekelwa okuyisisekelo lushicilelwe ku-European Heart Journal.
I-sodium, enye yezingxenye eziyinhloko zikasawoti, isetshenziselwa ukusiza izidakamizwa ezifana ne-acetaminophen zincibilike futhi ziphule emanzini.
Kodwa-ke, ukwakheka okunamandla nokuncibilika kwamaphilisi e-paracetamol angu-0,5 g kungase kube no-0,44 no-0,39 g we-sodium, ngokulandelana. Uma umuntu enomthamo omkhulu ongu-0,5 g womthamo ocindezelwe njalo emahoreni ayisithupha, edla u-3,5 no-3,1 g wesodium ngokulandelanayo, umthamo ongaphezu kwesamba somthamo wansuku zonke womthamo ongu-2 g otuswe yi-World Health Organization. Kukhona okunye ukwakheka okuqukethe inani elincane kakhulu le-sodium noma engekho nhlobo.
Usawoti wokudla oweqile waziwa njengenkinga enkulu yezempilo yomphakathi futhi uhlotshaniswa nengozi eyengeziwe yokuvalwa kwenhliziyo kanye nokufa phakathi kweziguli ezinomfutho wegazi ophakeme. Kodwa-ke, kunobufakazi obungaguquki bengozi efanayo kubantu abanomfutho wegazi ovamile futhi kungaba okungenangqondo ukuzama ukulawula okungahleliwe ukuhlola lokhu.
Abacwaningi, abaholwa uSolwazi Chao Zeng waseSibhedlela i-Xiangya, e-Central South University e-Changsha, e-China, bahlaziye idatha evela ku-UK Health Network, okuyisizindalwazi sezokwelashwa esisebenza ngogesi esinamarekhodi ezokwelapha acishe abe yizigidi ezingu-17.
Iziguli ze-4.532 ezine-arterial hypertension ezithola i-paracetamol equkethe i-sodium zahlolwa futhi ziqhathaniswa neziguli ze-146.866 ezine-arterial hypertension ezithola i-paracetamol ngaphandle kwe-sodium.
Iphinde yaqhathanisa iziguli ezingu-5.351 ezingenawo umfutho wegazi ophakeme lapho zithola i-paracetamol equkethe i-sodium neziguli ezingu-141.948 ezingenawo umfutho wegazi ophakeme lapho zithola i-paracetamol ngaphandle kwe-sodium. Iziguli bezineminyaka ephakathi kuka-60 no-90, abacwaningi bezilandela unyaka wonke.
Abacwaningi bathola ukuthi ingozi yonyaka owodwa yokuhlaselwa yinhliziyo, isifo sohlangothi, noma ukuhluleka kwenhliziyo ezigulini ezinomfutho wegazi ophezulu ezithatha amaconsi e-acetaminophen ane-sodium yayiyi-5,6% (amacala angu-122 CVD), kuyilapho i-4,6% (amacala angu-3051 CVD) phakathi labo abathatha i-paracetamol engenayo i-sodium. Ingozi yokufa nayo yayiphezulu; ubungozi onyakeni owodwa bekungama-7,6% (abashonile abangama-404) kanye nama-6,1% (abashonile abangu-5.510), ngokulandelana.
Kube khona ingozi efanayo eyandayo phakathi kweziguli ezingenawo umfutho wegazi ophakeme. Phakathi kwalabo abathatha i-paracetamol ene-sodium, ingozi ye-CVD ngonyaka yayingu-4,4% (amacala angu-105 e-CVD) kanye no-3,7% (amacala e-CVD ka-2079) phakathi kwalabo abathatha i-paracetamol engenayo i-sodium. Ingozi yokufa yayingama-7,3% (ukufa okungu-517) kanye no-5,9% (ukufa okungu-5.190), ngokulandelana.
UProfesa Zeng uthe "kuphinde kwatholakala ukuthi ingozi yesifo senhliziyo nokufa kwanda njengoba isikhathi sokuthatha i-acetaminophen ene-sodium sanda. Ingozi yesifo senhliziyo nemithambo yegazi yanda ngengxenye eyodwa ezigulini ezinomfutho wegazi ophakeme ezazinencwadi eyodwa kadokotela ye-acetaminophen ene-sodium, kanye nengxenye yeziguli ezazinemiyalelo emihlanu noma ngaphezulu ye-acetaminophen ene-sodium. Sibone ukwanda okufanayo kwabantu abangenawo umfutho wegazi ophakeme. Ingozi yokufa iphinde yengezwe nge-acetaminophen ene-sodium ene-sodium ephezulu ezigulini ezinomfutho wegazi ophakeme."
Ingozi yokufa iyanda futhi ngethamo eliphezulu le-paracetamol enesodium ezigulini ezinomfutho wegazi ophakeme.
I-sodium ivame ukusetshenziswa emalungiselelweni emboni ukuze kuthuthukiswe ukuncibilika nokuhlakazeka. Ngo-2018, abantu abayi-170 kubantu abayi-10.000 e-UK basebenzisa izidakamizwa ezine-sodium, nenani eliphakeme kwabesifazane.
Ohlelweni lokuhlela oluhambisana nalesi sihloko, u-Alta Schutte, weNyuvesi yaseNew South Wales kanye neGeorge Institute for Global Health, eSydney, e-Australia, noBruce Neal, base-Imperial College London, e-UK, babhala ukuthi e-UK kuphela ethole izigidi ezingama-2014. Imithi equkethe i-paracetamol ngo-42, namanye amaphakethe ayizigidi ezingama-200 athengiswe ngaphandle kwerisidi.
E-Spain, ngo-2015 kwathengiswa amaphakheji e-pacetamol ayizigidi ezingu-32 (emele u-3,8% wesamba).
Icubungula Ingobo yomlando yesifinyezo
“Lokhu kulingana namathani angu-6.300 e-paracetamol athengiswa minyaka yonke e-UK, kanti isibalo sisondela kumathani angu-10.000 eFrance. Ngenhlanhla, ingxenye encane kuphela yokwakheka kwe-acetaminophen equkethe i-sodium kodwa, ngenxa yokwanda kokuthandwa kwezidakamizwa 'ezisebenza ngokushesha' kanye 'nezidakamizwa ezisebenzayo', imiphumela emibi ehlobene nezidakamizwa yokusetshenziswa kwe-sodium ibonakala incipha endaweni”, babhala.
U-Zeng uthi odokotela neziguli kufanele baqaphele izingozi ezihlobene ne-acetaminophen ene-sodium futhi bagweme ukusetshenziswa ngokungadingekile, ikakhulukazi uma umuthi uthathwa isikhathi eside.
“Odokotela kufanele banikeze iziguli zabo i-acetaminophen engenasosodium ukuze banciphise ingozi yesifo senhliziyo nokufa. Abantu akumele banake kuphela usawoti odlayo ekudleni kwabo, kodwa futhi bangakushayi indiva usawoti ocashile otholakala ekhabetheni labo lemithi,” usho kanje.
Ucingo lukaSolwazi Schutte kanye noNeal lunesenzo sokuhlela esiphuthumayo. "Isisindo sobufakazi senza ukuntuleka okuqhubekayo kwesenzo emithini equkethe i-sodium kungavumelekile," bayabhala. “Ukwanda kokusetshenziswa kwezidakamizwa ezingasasebenzi emphakathini kanye nemithamo emikhulu yeziphuzo ezingaphuzwa zingaphuzwanga ngoba abathengi abangaqaphile badinga izinyathelo eziphuthumayo. Okukhathaza kakhulu ukubonwa kwezinye izinhlolovo ukuthi kufikela ku-94% wabasebenzisi bemithi yegesi baziphilisa nge-OTC elungisiwe. Kunesidingo esisheshayo sokuvikelwa kwabathengi kulezi zingozi.
Cishe isu elingase libe khona nelisebenza ngempumelelo ukulebula okuyimpoqo kuyo yonke imithi equkethe amanani abalulekile e-sodium enelebula eliyisixwayiso elingaphambili kwephakheji. Izinhlelo zolwazi eziphakamisa ukuqwashisa umphakathi nochwepheshe mayelana ne-sodium efihliwe emithini yemithi, kanye nemfundo ngesidingo sokugwema imithi ephumelelayo nencibilikayo kuzo zonke izimo kodwa ezibalulekile, kufanele kucatshangelwe. "
