Amakilasi angu-6 weMithi e-Ototoxic
I-Ototoxicity ibhekisela ekulimaleni okwenziwe ngamakhemikhali endlebeni yangaphakathi. Umonakalo ungaba unomphela noma wesikhashana, okwenza ukulahlekelwa kokuzwa noma ukuhluleka kokulinganisela. Ngenkathi imithi ithathwa ngezinzuzo zabo ezisungulwe, yonke imithi ibe nemiphumela emibi okufanele uyiqaphele ngaphambi kokuthatha. Ukuzwa ukulahlekelwa okuhlobene nokudla imithi e-ototoxic kungesinye isizathu sokuthi udokotela wakho angakuyeka ukuphuza imithi ngokuphathelene nokuphazamiseka kokuphila.
Ukuzwa ukulahlekelwa kuvame ukuhambisana nezigaba eziyisithupha zemithi. Lokhu okulandelayo kungase kuhlotshaniswe nokulahlekelwa kokulalela okuphakade:
- Ama-antibiotic e-Aminoglycoside
- I-Platinum-based chemotherapy
Imithi engase idale ukulahlekelwa kwezwi okwesikhashana:
- I-Loop diuretics
- Quinine
- Ama-salicylates
- Vinca alkaloids
Imithi eminingi engenhla ingaphazamisa izinso (nephrotoxic) futhi idinga udokotela wakho ukuba ahlole igazi lakho njalo ukuze ahlole umsebenzi wakho wezinso. Uma ubona noma yikuphi ushintsho ekulaleleni kwakho, kufanele ufune usizo njalo kudokotela wakho odokotela.
Ingozi ye-Ototoxicity
Ukusabalala kokuthola i-ototoxicity akubhalwanga kahle, kodwa kokubili ukulimala okwesikhashana nokuhlala unomphela kusuka ekutheni kube yi-ototoxicity. Imithi ethile izoba nolwazi oluningi kunabanye futhi izochazwa ezigabeni zabo ezalandela. Ngokufanayo akukho ukuqonda okuningi mayelana nokuvimbela i-ototoxicity ukuthi ingenzeki.
Eminye imishanguzo enengozi eyengeziwe yokwelapha njenge-antibiotics izodinga umsebenzi wegazi ngokuthi "ukuphakama nokugubha" okuzokwenziwa. Ukuphakama yizinga lezidakamizwa uma kufanele kube ukuhlushwa okuphezulu kakhulu egazini. Ummbila yizinga lezidakamizwa uma kufanele kube ngaphansi kokuhlushwa okuphansi kakhulu.
Ngenkathi ukuqapha ngokucophelela lokhu kungasiza ukugcina umphumela wokwelashwa, akuqinisekisi ukuthi ngeke ube ne-otoxicity.
Ezinye izici ezingase zibe nomthelela ekwenzeni i-ototoxicity zihlanganisa:
- umthamo, ubude bokwelashwa, kanye nenani eliphelele elitholiwe
- ukuhluleka kwezinso
- ukuthatha imithi ye-ototoxic ngesikhathi esifanayo
- ukuguquka kwezakhi zofuzo kuya kwe-ototoxicity
Izimpawu ezihlobene no-Ototoxicity
Izimpawu ezihlobene nokwehliswa kwe-ototoxicity kuncike kakhulu kulokho okuyingxenye yendlebe yangaphakathi ewonakele. Ukulimala kwendlebe yangaphakathi kungenzeka ku-cochlea yakho (okubizwa ngokuthi i-cochleotoxicity) noma isakhiwo sakho se-vestibular (okubhekwa njenge-vestibulotoxicity). Kuzo zombili izimo, izimpawu zonke zihlobene namangqamuzana anomonakalo.
Uma i-cochlea yakho ibonakalisiwe, ukuzwa kwakho kuzophelelwa amandla. Izinga lokukhubazeka liqondana ngokuqondile nomonakalo obangelwa amaminithi amancane ukuqedela ukulahlekelwa kokuzwa . Ukulahlekelwa kwezindlebe kungathinta eyodwa noma zombili izindlebe.
Uma i-ototoxicity ithinta i-complex vestibular, ibhalansi yakho izothinteka. Njengomonakalo ku-cochlea yakho, umonakalo ungathinta indlebe eyodwa noma zombili izindlebe. Uma umonakalo wathinta kuphela indlebe eyodwa kancane, cishe ngeke ubone noma yiziphi izimpawu. Kodwa uma ukulimala kwenzeka ngokushesha kakhulu endlebeni eyodwa, cishe uzothola:
- i-vertigo
- ukuhlanza
- ukunyakaza kwamehlo okungalawuleki (nystagmus)
Izimpawu ezenzeka ngokushesha zingabangela ukuba ulale ubhekwe kuze kube yilapho izimpawu zixazulula kancane kancane. Uma umonakalo kwenzeka emaceleni omabili endlebeni yakho, ungase uhlangabezane nalokhu:
- ikhanda
- ukugcwalisa indlebe
- ukungalingani okuthinta ikhono lokuhamba
- umbono obonakalayo obonakala i-jerky (oscillopsia)
- ukungahambisani nokunyakaza kwentloko
- ukuhamba ngesimo esikhulu
- kunzima ukuhamba ebumnyameni
- ukungaqiniseki
- ikhanda elikhanyayo
- ukukhathala
Uma ukulimala kwinkimbinkimbi yakho yokugqoka kuyingozi, i-oscillopsia nobunzima ukuhamba ebusuku ngeke kuthuthuke. Ezinye izimpawu zingase zithuthuke ngokuhamba kwesikhathi. Ngokulimala kanzima, ungaphinde utholakale emanzini amaningi ahlobene nokulinganisela ngenxa yokuthi amandla omzimba wakho azivumelanisa.
Aminoglycoside Antibiotics
Ama-antibiotic e-Aminoglycoside yiqembu elibalulekile lemithi ye-bloodstream kanye ne-urinary tract infections kanye nesifo sofuba esifanele. Imithi ihlanganisa:
- i-gentamicin
- tobramycin
- streptomycin
I-Aminoglycoside antibiotics inengozi yezingu-20 amaphesenti ekuthuthukiseni izinkinga zokuzwa kanye nengozi engamaphesenti angu-15 okubhekana nezinkinga zokulinganisela. Ingozi yokuthuthukisa izinkinga ezihlobene nokwenyuka kwe-ototoxicity yanda uma uthatha i-loop diuretic (njengoLasix) noma i-vancomycin (i-antibiotic) ngesikhathi esifanayo.
Loop Diuretics
I-Loop diuretics yenza ukwanda komthamo wokukhiqiza umchamo. Lokhu kuyasiza ekuhlulekeni kwenhliziyo, ukucindezela kwegazi, nokuhluleka kwezinso. Imithi ejwayelekile ihlanganisa:
- I-Lasix (i-furosemide)
- I-Bumex (i-bumetanide)
I-Loop diuretics inengozi ejwayelekile yokudoba umzimba kodwa kungenzeka ukuthi iningi labantu abayisithupha kwabangu-100 basebenzisa le mithi. Ngokuvamile kucatshangwa ukuba kwenzeke kumazinga aphezulu aholela ekuhlungeni kwegazi okungaba ngu-50 milligram (mg) ngelitha ngalinye.
I-Platinum-Based Based Chemotherapy
I-Cisplatin neCarboplatin yizibili zemithi emikhulu ye-chemotherapy (anti-neoplastics) e-ototoxic. Zivame ukusetshenziselwa ukwelashwa kwamanqamu ahlukahlukene ahlanganisa:
- umdlavuza we-ovarian & testicular
- umdlavuza wesisu
- umdlavuza wamaphaphu
- ikhanda kanye nentamo kanomdlavuza
Quinine
I-Quinine isetshenziselwa ukwelapha i-malaria kanye nama-leg cramps. Ukwelapha isikhathi eside nge quinine kuthwala ingozi engamaphesenti angama-20 okuholela ekulahlekelweni kokuzwa kwe-high-frequency hearing, okuvame ukubhekwa njengomphela uma ukuzwa ukulahlekelwa kwengxoxo evamile kuhlangene. I-Quinine ivame ukudala ukulahlekelwa ukuzwa okuhambisana nesifo esibizwa nge- cinchonism :
- isithulu
- i-vertigo
- ukukhala ezindlebeni zakho
- ikhanda
- ukulahlekelwa umbono
- isiyaluyalu
Ama-salicylates
I-salicylates efana ne-aspirin inengozi yokudoba ngokwezinga eliphezulu futhi ingaholela ekulahlekelweni kokuzwa kwama-decibel angu-30, okulingana nokuhlekisana. Kodwa-ke, umonakalo ungaba ophansi njengama-tinnitus amancane ngamazinga aphansi e-aspirin. Abesilisa abasebasha ikakhulukazi babonakala bengengozini yokulahlekelwa ukuzwa okuhlobene nokusetshenziswa kwe-aspirin. Ingozi ingaba ngamaphesenti angu-12 kuya ku-33 ngokususelwa kumvuthwandaba wokusetshenziswa.
Vinca Alkaloids
I-Vincristine imithi yokwelapha i-acute lymphocytic leukemia (KONKE), i-Hodgkin lymphoma, nezinye izifo zomdlavuza. Le mithi ibhekiswe ikakhulukazi engozini enkulu yokubangela ukulahleka kokuzwa uma isetshenziselwa ukuxilonga nge-aminoglycoside antibiotics.
Ukubona ukulahlekelwa kokuzwa okuhlobene no-Ototoxicity
Ngaphambi kokuthola ukwelapha ngemithi engozini yokwehliswa kwe-ototoxicity, kufanele ubone i-audiologist ye-audiogram eyisisekelo. Udokotela wakho uzobe esecabanga ukuthi ngabe i-audiogram ehleliwe ehleliwe izokwenziwa kanjani noma ukuhlolwa okulula kokuzwa kwakho. Nakuba lokhu kungavimbele ukulahlekelwa kokuzwa okuhlobene nokuthungathwa kwe-ototoxicity, kuzokusiza ukuthi ubone izinkinga ekuqaleni.
Ukwelapha Ukulahlekelwa Okulalelwayo Okuphathelene Ne-Ototoxicity
Akukho okwamanje okwelapha okutholakala ukuguqula umonakalo unomphela ezindlebeni zangaphakathi. Uma uzwa ukulahlekelwa ukuzwa okuphakathi komuntu, ngokuvamile kunconywa usizo lokuzwa. Uma unokulahleka kokuzwa okungahleliwe kuzo zombili izindlebe, udokotela wakho angase atusa izimpande ze-cochlear . Ukuvuselelwa ngokuvamile kuvame ukwelashwa kokuzikhethela uma unenkinga yokungabi nabhaliswa okwesikhashana noma okuhlala njalo.
> Imithombo:
> I-American Talk-Language-Hearing Association. (2017). Imithi ye-Ototoxic (Imithi Yomuthi). http://www.asha.org/public/hearing/Otootoxic-Medications/
> Boldenberg, D, Goldstein, BJ. (2011). I-Handbook ye-Otolaryngology Head and Neck Surgery. Thieme Medical Publishers. ENew York, NY.
> I-Merck Manual. (2017). I-ototoxicity ebizwa ngezidakamizwa. http://www.merckmanuals.com/professional/ear--nose,-and-throat-disorders/inner-ear-disorders/drug-induced-ototoxicity
> Rybak, LP & Brenner, MJ. (2015). I-Otolaryngology ye-Cumming: i-Vestibular kanye ne-Auditory Ototoxicity. http://www.clinicalkey.com (Okubhaliselwe Kudingeka)
> I-Vestibular Disorders Association. (2017). Ototoxicity. http://vestibular.org/ototoxicity