Okudingeka Ukwazi Ngezidakamizwa
Abantu abane- fibromyalgia (i-FMS) ne- syndrome ye-fatigue syndrome ( ME / CFS ) bangaba nezimpawu eziningi, kufaka phakathi ubuhlungu, futhi ngokuvamile kuthatha imithi eminingi yokwelapha ukuze uzizwe ungcono kakhulu. Ngenxa yokuthi imithi ngayinye ibeka ingozi yayo, futhi lezo zingozi zingakhula uma kuthathwe nezinye izidakamizwa, ikhokha ukwazi imithi yakho kahle.
Izidakamizwa zokupheka, ezibizwa nangokuthi i-opioids noma izidakamizwa, zivame ukushiwo ubuhlungu obungapheli obufana neFMS ne-ME / CFS. Zisebenza ngokulingisa ikhemikhali yokudambisa ubuhlungu, ebizwa ngokuthi i-pepide opioid, eyenziwa ngumzimba wakho ngokwemvelo. Njengabalingani bazo bemvelo, izidakamizwa zibophezela emithonjeni ethile ebuchosheni bakho nasendlini yomgogodla futhi usebenze uhlelo lwakho lokusiza ubuhlungu.
Ama-Opiates ajwayelekile
Ama-opiate amaningana abelokhu esemakethe isikhathi eside, ngokuvamile ayabizi, futhi atholakalayo ngesimo esijwayelekile. Ama-opiates ajwayelekile ahlanganisa:
- i-hydrocodone
- i-codeine
- i-oxycodone
- fentanyl
- i-oxymorphone
- i-hydromorphone
- tramadol
- i-morphine
Ukwengeza, amanye ama-opiates aqokiwe ngokuvamile ayizidakamizwa ezihlanganisiwe ezihlanganisa i-acetaminophen , eseTylenol neminye imithi eminingi engaphezulu. Zihlanganisa:
- I-Percocet (i-oxycodone / i-acetaminophen)
- I-Ultracet (tramadol / i-acetaminophen)
- I-Vicodin (i-hydrocodone / i-acetaminophen)
Uma uthatha isidakamizwa, kufanele uqiniseke ukuthi ufunda izingozi zombili zombili izingxenye.
Isebenza kanjani ama-Opiates?
Ku-FMS, inkolelo evamile emphakathini wezokwelapha ukuthi ama-opiates awaphumelelanga kakhulu ngezinhlobo zethu zobuhlungu obuhlukile. Ucwaningo ngokuvamile lusekela lokho kodwa luphikisana nobufakazi bokuqala.
Asinaso ucwaningo kuma-opiates ngobuhlungu be-ME / CFS. Noma kunjalo, izinhlobo ezimbili zobuhlungu obubonakalayo yi- hyperalgesia (ubuhlungu bokukhulisa) kanye ne- allodynia (ubuhlungu obuvame ukucindezeleka okungenabuhlungu), okubili okuyingxenye ye-FMS, futhi sinomzimba obonisa ubufakazi obukhona lapho.
Futhi ubufakazi abuhle. Ucwaningo olunyathelisiwe ku- Cochrane Database of Ukuhlolwa Okuhlelekile lwahluleka ukuthola noma yikuphi ukuhlolwa okuphezulu kwekhwalithi ye-oxycodone ye-fibromyalgia noma ubuhlungu obungezona isifo sikashukela nge-neuropathic.
I-Clinical Journal of Pain ngo-2015 eyashicilele ukutadisha ukwelashwa kwe-opioid yesikhathi eside ku-FMS ithola ukuthi abantu abasebenzisa ama-opiates babonisa ukuthuthukiswa okuncane kunezimpawu kunelabo abathatha ezinye imithi. Abacwaningi bathi akukho ukusekelwa okuncane kokusebenzisa isikhathi eside kwalesi sidakamizwa ku-FMS.
Ucwaningo lwezobuhlungu nokucwaninga luthi:
Asikho ubufakazi bokuthi [i-opioids] isimo esithuthukisiwe ngaphezu kokunakekelwa okujwayelekile futhi [bona] bangase bahlanganyele nomphumela omncane kakhulu.
Uma ucela abantu abanezimo mayelana nama-opiates, noma kunjalo, uthola indaba ehlukile. Abaningi bathi amazinga abo obuhlungu abukhulu kakhulu ukuba angasebenzi ngaphandle kwalezi zidakamizwa. Odokotela abaningi bayabanika, naphezu kobufakazi obubi. Eqinisweni, isifundo seminyaka engu-11 esiphelile ngo-2010 sibonise ukuthi isilinganiso se-opiate ku-FMS sesisuka kumaphesenti angu-40 kuya ku-46%. Ezinye izifundo ziphinde zibheke ukukhushulwa ekusetshenzisweni kwama-opiates ekwelapheni ubuhlungu besikhathi eside.
Ngakho-ke yini ebangela lokhu kungavumelani? Asinaso ucwaningo olwenza ukuthi kungani, kodwa ezinye izizathu ezingenzeka ukuthi iziguli ze-FMS zicabange ukuthi lezi zidakamizwa zisebenza kangcono ukuthi yiziphi iziboniso zocwaningo ezifaka:
- Impumelelo ye-placebo: Yinto ehlelwe kahle-inkolelo yabantu yokuthi okuthile okuzosebenza kungabangela ekuthuthukiseni ukuthi izidakamizwa noma ezinye izifo azikwenzi.
- Izimo zobuhlungu ezidlulayo : I- FMS iyaziwa ukuthi iyahambisana nezinye izimo eziningi, futhi kungenzeka ukuthi abantu abathola usizo kuma-opiate babona ukunciphisa ubuhlungu kusuka kokunye, okusiza ubuhlungu be-FMS buthule.
Kungakhathaliseki ukuthi yiziphi izizathu, ukuziphatha okungahambi kahle "okungawusizo" emphakathini wezokwelapha, kanye nemigomo eqhubekayo nokwandisa ukusetshenziswa kwe-opiate, kuye kwabangela intukuthelo nokufutheka emphakathini wesiguli-ikakhulukazi kusuka labo abenqatshelwe umuthi bathi bayabasiza ukusebenza.
Izingozi zokuthutha: Ukudlula ngokweqile, ukubheja kwezidakamizwa, ukuhlukunyezwa
Ama-opiates aphethe izingozi eziningi, ezinye zezokwelapha, ezinye azikho.
Ukudlula ngokweqile kungabulala. Ngezinye izikhathi umphumela wabantu ukuthatha umthamo owengeziwe ngoba owokuqala akazange akhulise ubuhlungu bawo ngokunethezeka. Ukungasebenzi kahle kwengqondo (fibro fog) ehambisana neFMS ne-ME / CFS kungenza kube nzima kuwe ukugcina ithrekhi uma uthatha imithi futhi ikuholele ukuthatha okuningi ngokushesha.
Futhi ukufaka ingozi ekudleni ngokweqile ukubekezelela izidakamizwa. Abantu abaningi abasebenzisa ama-opiates isikhathi eside bakha ukubekezelelana, okusho ukuthi izidakamizwa aziphumelelanga njengakuqala. Kodwa-ke, ngenxa yokuthi kuthatha okungaphezulu ukuthi uzizwe umphumela akusho ukuthi umzimba wakho ungakwazi ukusingatha okuningi. Kubalulekile ukuthi uhlale uthatha ama-opiate njengoba uqondisiwe.
Izimpawu ze-opiate overdose zifaka:
- Izinga lokucindezeleka (isib. ukudideka, ukulala, i-coma)
- ukuphefumula okuphuthumayo kanye / noma okungajulile
- ukunciphisa kwenhliziyo
- ukuxuba
- ukuzondwa kanye / noma ukuphelelwa amandla
- isiyaluyalu
- ukuhlanza
- abafundi abavinjiwe
- isikhumba esibanda, isikhumba
Uma usola ukuthi wena noma omunye umuntu uye waqeda ama-opiates, kubalulekile ukuthola usizo lwezokwelapha oluphuthumayo ngokushesha.
Ukulutha umlutha kuyingozi nangama-opiates. Lokhu kuthole ukunakwa okuningi ekusebenzisweni komthetho kanye nabezindaba eminyakeni yamuva, okwenze odokotela abathile benqabe ukubeka ama-opiates futhi kwenza abanye abantu bakhathazeke ngokubamba.
Kodwa-ke, ezinye izifundo zibonisa ukuthi ubungozi bokulutha umlutha buphansi kunalokho okucatshangwa ngakho, kanti ubungozi obuningi bubonakala kubantu abanomlando wokusebenzisa kabi izidakamizwa nokulutha.
Ukulungisa ukwesaba odokotela ngokubeka izidakamizwa ezingase zibe umlutha, i-American Pain Society ngo-2009 yanyathelisa leli phepha: Isikhombandlela sokusetshenziswa kwe-Opioid Therapy Chronicle in Chronic Uncancercer Pain.
Ngokuhlukunyezwa kwe-opiate, ukudlula ngokweqile, nokufa okukhuphuka ezweni lonke, i-CDC ngo-2016 ikhishwe Imihlahlandlela Yokubhala Opioids for Pain Chronicle ukuxazulula izinkinga.
Kungenzeka futhi ukuthi, ngokuhamba kwesikhathi, ama-opiate angakhulisa ubuhlungu. Olunye ucwaningo lubonisa ukuthi imithi ye-opioid ingase ibangele ukuzwela okwenyuka kwezinhlobo ezithile zobuhlungu, okufana nendlela i-FMS eyenza ngayo izimpawu zobuhlungu. Lo mphumela ubizwa ngokuthi i-hyperalgesia eyenziwe ngama-opioid.
Ngenxa yokuthi abanye abantu bathatha ama-opiates ukuzijabulisa, abaphethe lezi zidakamizwa bangakwenzela wena umgomo wamasela. Lapho abantu abaningi abaqaphela ukuthi unayo le mithi, kungenzeka ukuthi usengozini yokuhlukunyezwa.
I-Opiate Side Effects & Ukusebenzisana
Ungaba nemiphumela emibi kuma-opiates (noma ezinye izidakamizwa) ngisho ngenkathi uwathatha njengoba kuqondiswe. Ezinye imiphumela emibi zifana nezimpawu zokudlula ngokweqile. Imiphumela ejwayelekile ye-opiate ifaka phakathi:
- isicanucanu kanye / noma ukuhlanza
- ukulala
- umlomo owomile
- ukuzondwa lapho umile (ngenxa yokwehla kwegazi)
- izinkinga zokugeleza
- ukuqotshwa
Imiphumela emibi ingahluka ngezidakamizwa, ngakho-ke hlola uhlu oluthile lwemithi yakho. Ngokuvamile ungathola lokhu kumawebhusayithi abakhiqizi noma ekhemisi yakho.
Ukuthatha ama-opiate ngezinhlobo ezithile zezidakamizwa kungabangela ukusebenzisana okungalungile, kufaka phakathi ukufa. Izidakamizwa ezingaba yingozi uma zihlangene nama-opiate zifaka:
- nezinye imithi yobuhlungu
- ukulala imithi
- ama-antihistamines (imishanguzo yemithi)
- imisipha yokuphumula
- imithi yokucindezeleka, ukukhathazeka noma ezinye izinkinga zempilo yengqondo
- utshwala
Futhi, lokhu kungahluka ngezidakamizwa. Kubalulekile ukuthi uzise udokotela wakho kanye nemithi mayelana nazo zonke izidakamizwa ozithathayo, kufaka phakathi ngaphezulu, ukuze bakwazi ukukusiza ukugwema ukuxhumana okuyingozi.
Ukunciphisa Ingozi Yakho
Indlela engcono kakhulu yokuthatha le mithi ngokuphepha ukulandela imiyalelo eya encwadini bese uhlola kabili ukuze uqinisekise ukuthi izinto ozihlanganisayo ziphephile ndawonye. Ungase ufune ukugcina uhlu lwemithi efonini noma esikhwameni sakho ukuze atholakale kwabasebenzi abaphuthumayo uma kwenzeka ngokweqile.
Kungasiza futhi ukuba ilungu lomndeni noma umngane uqapha imithi yakho, noma ukugcina i-log yezikhathi ozithathayo ukukusiza ukugwema ukuthatha isikhathi esiningi kakhulu.
Ingabe ama-ophiates afanele wena?
Nguwe kuphela nodokotela wakho onganquma ukuthi ngabe ama-opiates ayinhle yini kuwe, ngokusekelwe ekuhloleni kwakho, izimpawu, impilo yonke, kanye nezindlela zokuphila.
Uma ungazizwa ukuthi ama-opiates aphumelela ekunciphiseni ubuhlungu bakho, khuluma nodokotela wakho mayelana nezindlela ezingenzeka.
Uma wenza izinqumo zokwelashwa, qiniseka ukuthi ucabangela iziqondiso zomthetho ezingenza kube nzima ngawe ukugcwalisa imithi yakho yesiguli, njengokunikezela-ukuhambisa imithi kadokotela ekhemisi yakho inyanga ngayinye.
Imithombo:
Fitzcharles MA, et al. Ucwaningo lobuhlungu kanye nokwelashwa. 2013; 2013: 898493. Ukusetshenziswa kwe-opioid ku-fibromyalgia kuhlotshaniswa nezinyathelo ezihlobene nezempilo ezithinta isifundo seqembu.
Gaskell H, et al. Ukubuyekezwa kwesistimu ye-Cochrane ehlelekile. 2014 Jun 23; 6: CD010692. Oxycodone ngobuhlungu be-neuropathic kanye ne-fibromyalgia kubantu abadala.
Umdwebi JT, Crofford LJ. I-Journal ye-rheumatology yemitholampilo. 2013 Mar; 19 (2): 72-7. Ukusetshenziswa kwama-opioid okuhlala njalo ku-fibromyalgia syndrome: ukubuyekezwa komtholampilo.
I-Peng X, et al. Umagazini wezokwelapha wezinhlungu. 2015 Jan; 31 (1): 7-13. Ukuhlolwa kwesikhathi eside kwesikhumba se-opioid ku-fibromyalgia.
U-Wolfe F, et al. Umagazini weYurophu wezinhlungu. 2013, 17 (4): 581-6. Amaphethini ase-Longitudinal we-analgesic kanye ne-central central abasebenzisa izidakamizwa kanye nokusebenza okuhambisanayo ku-fibromyalgia.