{"id":199,"date":"2015-03-25T10:17:59","date_gmt":"2015-03-25T09:17:59","guid":{"rendered":"https:\/\/spravodajstvo24.sk\/?p=199"},"modified":"2015-03-30T10:34:57","modified_gmt":"2015-03-30T09:34:57","slug":"dermatolog-liecba-kortikoidmi-moze-odstartovat-cukrovku-obezitu-ci-vysoky-tlak-je-vsak-nenahraditelna","status":"publish","type":"post","link":"https:\/\/spravodajstvo24.sk\/?p=199","title":{"rendered":"Dermatol\u00f3g: Lie\u010dba kortikoidmi m\u00f4\u017ee od\u0161tartova\u0165 cukrovku, obezitu \u010di vysok\u00fd tlak, je v\u0161ak nenahradite\u013en\u00e1"},"content":{"rendered":"

Kortikoidy. Pri z\u00e1paloch, mokvan\u00ed, opuchoch \u010di svrben\u00ed s\u00fa pod\u013ea lek\u00e1rov \u010dasto nenahradite\u013en\u00e9. Pri dlh\u0161om \u010di celkovom u\u017e\u00edvan\u00ed v\u0161ak m\u00f4\u017eu oslabova\u0165 imunitu a\u00a0prispieva\u0165 k\u00a0rozvoju cukrovky, vredov alebo napr\u00edklad psychick\u00fdch probl\u00e9mov. Ak\u00e9 s\u00fa hlavn\u00e9 pozit\u00edva a\u00a0z\u00e1rove\u0148 rizik\u00e1 u\u017e\u00edvania kortikoidov, ak\u00e9 m\u00f4\u017eu ma\u0165 \u013eudia n\u00e1sledky a\u00a0\u010d\u00edm sa daj\u00fa tieto l\u00e1tky nahradi\u0165, o\u00a0tom v\u0161etkom hovor\u00ed vo svojom koment\u00e1ri dermatol\u00f3g MUDr. Tom\u00e1\u0161 Kampe. <\/strong><\/p>\n

\u00c9ra pred a po objaven\u00ed kortizolu<\/strong><\/p>\n

Term\u00ednom kortikoidy \u010di kortikosteroidy sa v\u00a0u\u017e\u0161om slova zmysle ozna\u010duj\u00fa chemick\u00e9 l\u00e1tky s\u00a0prstencovou \u0161trukt\u00farou. Kortikoidy pou\u017e\u00edvan\u00e9 v\u00a0medic\u00edne s\u00fa syntetick\u00e9 molekuly, ktor\u00e9 maj\u00fa siln\u00fd protiz\u00e1palov\u00fd \u00fa\u010dinok. Ich jedine\u010dnos\u0165 dokazuje aj fakt, \u017ee z\u00a0historick\u00e9ho h\u013eadiska v\u00a0medic\u00edne hovor\u00edme o\u00a0\u00e9re pred objaven\u00edm kortikoidov, pri\u010dom kortizol bol objaven\u00fd v\u00a0roku 1948, a\u00a0\u00e9re po ich objaven\u00ed. Tento objav u\u010dinil v\u00a0roku 1950 z\u00a0troch vedcov Tadeusa Reichsteina, Philipa Henche a Edwarda Kendalla dokonca laure\u00e1tov Nobelovej ceny. Do lie\u010dby ko\u017en\u00fdch ochoren\u00ed boli kortikoidy vo forme kr\u00e9mov, mast\u00ed a\u00a0roztokov zaraden\u00e9 v\u00a0roku 1952. Dnes sa s\u00a0lie\u010dbou kortikosteroidmi stret\u00e1vame v\u00a0reumatol\u00f3gii, dermatol\u00f3gii, gastroenterol\u00f3gii a\u00a0v\u00a0p\u013e\u00facnom lek\u00e1rstve.<\/p>\n

Kortikoidy s\u00fa nenahradite\u013en\u00e9, m\u00f4\u017eu ale zapr\u00ed\u010dini\u0165 napr\u00edklad cukrovku<\/strong><\/p>\n

Pozit\u00edvne p\u00f4sobenie kortikoidov vych\u00e1dza z\u00a0ich \u00fa\u010dinkov \u2013 dok\u00e1\u017eu ve\u013emi dobre tlmi\u0165 z\u00e1pal, maj\u00fa antialergick\u00fd \u00fa\u010dinok a potl\u00e1\u010daj\u00fa reakciu imunity. Vzh\u013eadom k\u00a0ich farmakologick\u00e9mu \u00fa\u010dinku, r\u00fdchlosti a\u00a0razantnosti n\u00e1stupu \u00fa\u010dinku nie s\u00fa kortikosteroidy \u00faplne nahradite\u013en\u00e9. Ve\u013emi dobre pom\u00e1haj\u00fa napr\u00edklad v\u00a0boji proti atopick\u00e9mu ekz\u00e9mu, lupienke a\u00a0aj mnoh\u00fdm alergi\u00e1m a\u00a0roztr\u00fasenej skler\u00f3ze. Prospievaj\u00fa \u013eu\u010fom s\u00a0autoimunitn\u00fdmi ochoreniami, kam zara\u010fujeme napr\u00edklad Crohnovu chorobu alebo z\u00e1palov\u00e9 ochorenie \u010driev, a\u00a0mnoh\u00fdmi \u010fal\u0161\u00edmi zdravotn\u00fdmi \u0165a\u017ekos\u0165ami. Aj tak je ale nutn\u00e9 proces lie\u010dby dobre str\u00e1\u017ei\u0165 a\u00a0dodr\u017eiava\u0165 pokyny, preto\u017ee dlhodobej\u0161ia lie\u010dba kortikoidmi je v\u00a0istom oh\u013eade rizikov\u00e1.<\/p>\n

Samozrejme v\u017edy z\u00e1le\u017e\u00ed na type u\u017e\u00edvan\u00e9ho lieku, jeho d\u00e1vkovan\u00ed, d\u013a\u017eke lie\u010dby \u010di sp\u00f4sobu. Av\u0161ak k\u00a0negat\u00edvnym \u00fa\u010dinkom u\u017e\u00edvania kortikosteroidov sa vo v\u0161eobecnosti zara\u010fuje porucha l\u00e1tkovej v\u00fdmeny cukrov, \u010do m\u00f4\u017ee vies\u0165 a\u017e k\u00a0cukrovke, \u00fatlmu \u010dinnosti nad\u013eadviniek, \u017eal\u00fado\u010dn\u00fdm vredom, neuropsychiatrick\u00fdm komplik\u00e1ci\u00e1m alebo napr\u00edklad k\u00a0rastu krvn\u00e9ho tlaku.<\/p>\n

\u010co sa t\u00fdka u\u017e\u00edvania v\u00a0tehotenstve, tak hoci syst\u00e9mov\u00e9 kortikoidy nesp\u00f4sobuj\u00fa v\u00fdvojov\u00e9 poruchy plodu, ak by sa u\u017e\u00edvali vo ve\u013ek\u00fdch d\u00e1vkach, m\u00f4\u017eu spomali\u0165 jeho rast. In\u00e9 typy kortikoidov nie s\u00fa v\u00a0tehotenstve odpor\u00fa\u010dan\u00e9 v\u00f4bec. U\u00a0detsk\u00fdch pacientov je d\u00f4le\u017eit\u00e9 vo\u013ebu kortikoidov tie\u017e zv\u00e1\u017ei\u0165, pr\u00edpadne sa vyhn\u00fa\u0165 aplik\u00e1cii najsilnej\u0161\u00edch horm\u00f3nov na cel\u00fd ko\u017en\u00fd povrch. Lok\u00e1lne aplikovan\u00e9 lie\u010div\u00e1 m\u00f4\u017eu pri dlhodobom u\u017e\u00edvan\u00ed sp\u00f4sobova\u0165 atrofiu, teda sten\u010denie poko\u017eky. V\u00a0prv\u00fdch t\u00fd\u017ed\u0148och lie\u010dby sa daj\u00fa \u0165a\u017ekosti e\u0161te zvr\u00e1ti\u0165, nesk\u00f4r u\u017e to nejde. Stanovi\u0165 \u010dasov\u00fa hranicu, kedy sa zmeny na poko\u017eke st\u00e1vaj\u00fa trval\u00fdmi ale mo\u017en\u00e9 nie je.<\/p>\n

U\u017e\u00edvajte kortikoidy len v\u00a0ak\u00fatnych pr\u00edpadoch<\/strong><\/p>\n

\u013dudsk\u00e9 telo je ve\u013emi individu\u00e1lne \u2013 \u010do m\u00f4\u017ee pom\u00f4c\u0165 jedn\u00e9mu, m\u00f4\u017ee druh\u00e9mu, naopak, u\u0161kodi\u0165 a\u00a0nie je mo\u017en\u00e9 ni\u010d zaru\u010di\u0165 stopercentne. Napriek tomu by som \u013eu\u010fom s\u00a0ko\u017en\u00fdmi probl\u00e9mami s\u00a0oh\u013eadom na ne\u017eiaduce \u00fa\u010dinky kortikoidov odporu\u010dil u\u017e\u00edva\u0165 \u010do najmen\u0161iu mo\u017en\u00fa d\u00e1vku, ktor\u00e1 je v\u0161ak efekt\u00edvna a\u00a0potrebn\u00e1 k\u00a0zlep\u0161eniu zdravotn\u00e9ho stavu, teda v\u00a0najak\u00fatnej\u0161om \u0161t\u00e1diu ko\u017en\u00fdch ochoren\u00ed. Po odstr\u00e1nen\u00ed ak\u00fatnych probl\u00e9mov je vhodn\u00e9 farmakologick\u00fa lie\u010dbu postupne vynech\u00e1va\u0165 a\u00a0pomaly prech\u00e1dza\u0165 na udr\u017eiavaciu lie\u010dbu, napr\u00edklad smerom k\u00a0produktom s\u00a0obsahom Aloe vera g\u00e9lu. V\u00a0pr\u00edpadoch chronick\u00fdch nez\u00e1va\u017en\u00fdch ochoren\u00ed je, naopak, vhodn\u00e9 t\u00fdmito produktmi za\u010da\u0165 a\u00a0farmakologick\u00fa lie\u010dbu kortikoidmi aplikova\u0165 a\u017e v\u00a0pr\u00edpade ich zlyhania.<\/p>\n

Autor koment\u00e1ra: <\/strong>MUDr. Tom\u00e1\u0161 Kampe, dermatol\u00f3g a konzultant spolo\u010dnosti\u00a0LR Health & Beauty.<\/p>\n","protected":false},"excerpt":{"rendered":"

Kortikoidy. Pri z\u00e1paloch, mokvan\u00ed, opuchoch \u010di svrben\u00ed s\u00fa pod\u013ea lek\u00e1rov \u010dasto nenahradite\u013en\u00e9. Pri dlh\u0161om \u010di celkovom u\u017e\u00edvan\u00ed v\u0161ak m\u00f4\u017eu oslabova\u0165 imunitu a\u00a0prispieva\u0165 k\u00a0rozvoju cukrovky, vredov alebo napr\u00edklad psychick\u00fdch probl\u00e9mov. Ak\u00e9 s\u00fa hlavn\u00e9 pozit\u00edva a\u00a0z\u00e1rove\u0148 rizik\u00e1 u\u017e\u00edvania kortikoidov, ak\u00e9 m\u00f4\u017eu ma\u0165…<\/p>\n

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