{"id":3570,"count":7,"description":"Chronick\u00e1 z\u00e1cpa postihuje p\u0159ibli\u017en\u011b 16 % dosp\u011bl\u00fdch a 33 % osob nad 60 let, co\u017e v\u00fdznamn\u011b ovliv\u0148uje kvalitu \u017eivota. Modern\u00ed doporu\u010den\u00ed navrhuj\u00ed postupnou l\u00e9\u010dbu za\u010d\u00ednaj\u00edc\u00ed zm\u011bnami \u017eivotn\u00edho stylu a stravov\u00e1n\u00ed (tekutiny, vl\u00e1knina, pohyb), pot\u00e9 objemov\u00fdmi laxativy, n\u00e1sledn\u011b osmotick\u00fdmi a stimula\u010dn\u00edmi laxativy, s nov\u011bj\u0161\u00edmi sekretagogy pro refraktern\u00ed p\u0159\u00edpady. Katalog l\u00e9k\u016f na z\u00e1cpu MedsBase nab\u00edz\u00ed kompletn\u00ed farmakologick\u00fd sortiment, dod\u00e1van\u00fd spole\u010dnostmi <strong>WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong>.\n\n<strong>Osmotick\u00e1 laxativa \u2014 farmakoterapie prvn\u00ed volby.<\/strong> Laktul\u00f3za (nevst\u0159ebateln\u00fd disacharid, kter\u00fd vtahuje vodu do tlust\u00e9ho st\u0159eva a je metabolizov\u00e1n bakteriemi za vzniku osmoticky aktivn\u00edch mastn\u00fdch kyselin s kr\u00e1tk\u00fdm \u0159et\u011bzcem \u2014 rovn\u011b\u017e sni\u017euje hladinu amoniaku p\u0159i jatern\u00ed encefalopatii) je skladem jako <a href=\"https:\/\/medsbase.com\/cs\/duphalac-syrup\/\">Duphalac Syrup<\/a>. N\u00e1stup \u00fa\u010dinku za 24\u201348 hodin; titrujte d\u00e1vku (za\u010dn\u011bte 15 ml denn\u011b, zvy\u0161te na 15 ml dvakr\u00e1t denn\u011b) dle mno\u017estv\u00ed stolice. Makrogol \/ polyethylenglykol (PEG) 3350 \u2014 l\u00e9pe sn\u00e1\u0161en ne\u017e laktul\u00f3za, m\u00e9n\u011b nad\u00fdm\u00e1n\u00ed \u2014 je dostupn\u00fd ve form\u011b Movicol Sachets. Sm\u00edchejte jeden s\u00e1\u010dek ve vod\u011b, lze u\u017e\u00edvat 1\u20133 s\u00e1\u010dky denn\u011b.\n\n<strong>Stimula\u010dn\u00ed laxativa \u2014 ke kr\u00e1tkodob\u00e9mu u\u017eit\u00ed nebo jako dopln\u011bk.<\/strong> Bisacodyl 5 mg (p\u0159\u00edmo stimuluje st\u0159evn\u00ed peristaltiku) je skladem jako <a href=\"https:\/\/medsbase.com\/cs\/dulcoflex\/\">Dulcoflex<\/a>. U\u017e\u00edvejte ve\u010der pro rann\u00ed vypr\u00e1zdn\u011bn\u00ed (n\u00e1stup \u00fa\u010dinku za 6\u201312 hodin). Vhodn\u00fd pro p\u0159\u00edpravu st\u0159eva p\u0159ed v\u00fdkony, poopera\u010dn\u00ed z\u00e1cpu a z\u00e1cpu vyvolanou opioidy. Cremalax (kombinovan\u00fd bylinn\u00fd laxativ) jako <a href=\"https:\/\/medsbase.com\/cs\/cremalax\/\">Cremalax<\/a>. Dlouhodob\u00e9 denn\u00ed u\u017e\u00edv\u00e1n\u00ed stimula\u010dn\u00edch proj\u00edmadel (m\u011bs\u00edce\/roky) bylo kdysi pova\u017eov\u00e1no za p\u0159\u00ed\u010dinu \"l\u00edn\u00e9ho st\u0159eva\" \u2014 modern\u00ed d\u016fkazy to nepotvrzuj\u00ed, ale objemov\u00e1 a osmotick\u00e1 proj\u00edmadla z\u016fst\u00e1vaj\u00ed preferov\u00e1na pro chronick\u00e9 u\u017e\u00edv\u00e1n\u00ed.\n\n<strong>Lubiproston \u2013 pro refraktern\u00ed IBS-C a chronickou idiopatickou z\u00e1cpu.<\/strong> Lubiproston (aktiv\u00e1tor chloridov\u00e9ho kan\u00e1lu-2, kter\u00fd stimuluje sekreci st\u0159evn\u00ed tekutiny) je schv\u00e1len FDA pro chronickou idiopatickou z\u00e1cpu, IBS-C (u \u017een) a z\u00e1cpu vyvolanou opioidy. U\u017e\u00edvejte 24 mcg dvakr\u00e1t denn\u011b s j\u00eddlem (ni\u017e\u0161\u00ed d\u00e1vka 8 mcg pro IBS-C u \u017een). Skladem jako <a href=\"https:\/\/medsbase.com\/cs\/lubowel-24\/\">Lubowel 24<\/a>. Vedlej\u0161\u00ed \u00fa\u010dinek: nevolnost (zm\u00edrn\u011bno u\u017eit\u00edm s j\u00eddlem).\n\n<strong>Prukaloprid \u2013 selektivn\u00ed agonista 5-HT4 pro chronickou z\u00e1cpu.<\/strong> Prukaloprid 2 mg denn\u011b je selektivn\u00ed agonista receptoru 5-HT4, kter\u00fd stimuluje st\u0159evn\u00ed motilitu \u2013 vhodn\u00fd pro chronickou z\u00e1cpu refraktern\u00ed na laxativa. Skladem jako <a href=\"https:\/\/medsbase.com\/cs\/pruvict\/\">Pruvict<\/a>. Lep\u0161\u00ed bezpe\u010dnostn\u00ed profil pro srdce ne\u017e star\u0161\u00ed agonisty 5-HT4 (cisaprid, tegaserod). Zvl\u00e1\u0161t\u011b u\u017eite\u010dn\u00fd u z\u00e1cpy vyvolan\u00e9 opioidy a u star\u0161\u00edch pacient\u016f.\n\n<strong>Bylinn\u00e9 dopl\u0148ky.<\/strong> Formulace Himalaya Herbolax (obsahuj\u00edc\u00ed trivanga bhasma, kasani, sat isabgol \u2013 ekvivalent psyllia a dal\u0161\u00ed bylinn\u00e9 slo\u017eky) poskytuje objemov\u00fd + m\u00edrn\u00fd stimula\u010dn\u00ed \u00fa\u010dinek. Skladem jako <a href=\"https:\/\/medsbase.com\/cs\/herbolax\/\">Herbolax<\/a>.\n\n<strong>Jak vybrat.<\/strong> M\u00edrn\u00e1 z\u00e1cpa, \u017e\u00e1dn\u00e9 rizikov\u00e9 faktory \u2192 nejprve zm\u011bna \u017eivotn\u00edho stylu (vl\u00e1knina 25\u201330 g\/den, tekutiny 1,5\u20132 l\/den, pravideln\u00e1 aktivita), pot\u00e9 objemov\u00e9 laxativum (psyllium \/ methylcelul\u00f3za). Nedostate\u010dn\u00e1 odpov\u011b\u010f \u2192 osmotick\u00e9 laxativum (laktul\u00f3za nebo PEG\/makrogol). P\u0159\u00eddavek pro pr\u016flomov\u00fd \u00fa\u010dinek \u2192 stimula\u010dn\u00ed laxativum (bisakodyl). Chronick\u00e1 refraktern\u00ed \u2192 lubiproston nebo prukaloprid. Z\u00e1cpa vyvolan\u00e1 opioidy \u2192 nejprve osmotick\u00e9 + stimula\u010dn\u00ed laxativum; specifick\u00e9 opioidn\u00ed antagonist\u00e9 (naloxegol, methylnaltrexon), pokud jsou k dispozici. Star\u0161\u00ed pacienti s v\u00edce l\u00e9ky \u2192 p\u0159ehled polyfarmakoterapie (anticholinergika, opioidy, blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f, \u017eelezo) pro faktory p\u0159isp\u00edvaj\u00edc\u00ed k z\u00e1cp\u011b.\n\n<strong>D\u016fle\u017eit\u00e9.<\/strong> Nov\u011b vznikl\u00e1 z\u00e1cpa u dosp\u011bl\u00fdch nad 50 let (zejm\u00e9na s \u00fabytkem hmotnosti, rekt\u00e1ln\u00edm krv\u00e1cen\u00edm, rodinnou anamn\u00e9zou rakoviny st\u0159ev nebo st\u0159\u00eddav\u00fdm vyprazd\u0148ov\u00e1n\u00edm) vy\u017eaduje vy\u0161et\u0159en\u00ed na kolorekt\u00e1ln\u00ed karcinom sp\u00ed\u0161e ne\u017e empirick\u00e9 u\u017e\u00edv\u00e1n\u00ed proj\u00edmadel \u2014 nav\u0161tivte sv\u00e9ho praktick\u00e9ho l\u00e9ka\u0159e pro FIT test nebo doporu\u010den\u00ed na kolonoskopii. Siln\u00e1 bolest b\u0159icha, zvracen\u00ed nebo absolutn\u00ed z\u00e1cpa (\u017e\u00e1dn\u00e9 v\u011btry ani stolice) nazna\u010duje st\u0159evn\u00ed obstrukci a je to nouzov\u00fd stav. T\u011bhotenstv\u00ed: objemov\u00e1 proj\u00edmadla, laktul\u00f3za a makrogol jsou prvn\u00ed volbou; stimulancia jsou ur\u010dena pro kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed. D\u011bti: PEG s elektrolyty (PEG 4000 \/ Makrogol s elektrolyty) je modern\u00ed l\u00e9\u010dbou prvn\u00ed volby.\n\nV\u0161echny produkty MedsBase Constipation Medicine jsou expedov\u00e1ny z <strong>WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong> s diskr\u00e9tn\u00edm balen\u00edm a jsou kryty na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>.","link":"https:\/\/medsbase.com\/cs\/constipation-medicine\/","name":"L\u00e9ky na z\u00e1cpu","slug":"constipation-medicine","taxonomy":"product_cat","parent":3342,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3570","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3342"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3570"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}