Funda ukuthi kungani izidakamizwa zokulwa nezidakamizwa kanye nama-anticonvulsants zisetshenziselwa ukuphatha ubuhlungu obungapheli
I-analgesic ye-adjuvant imithi engeyona eyakhelwe ngokuyinhloko ukulawula ubuhlungu kodwa ingasetshenziswa ngale njongo. Ezinye izibonelo zemithi adjuvant yimithi efana ne- antidepressants kanye nama- anticonvulsants . Kungase futhi kuthiwa yi-coanalgesics.
Ungase ubekwe i-adjuvant analgesic ngaphezu kweminye imithi yobuhlungu , noma yedwa. I-analgesics ye-Adjuvant ayifuni kangcono kakhulu ubuhlungu besisu, njengokubuhlungu emuva noma ubuhlungu obuhlangene.
Noma kunjalo, zingasebenza kahle ngobuhlungu be-neuropathic kanye nobuhlungu be-syndromes, njenge- fibromyalgia . Futhi banendima ekwelapheni ubuhlungu bomdlavuza. Ngokungafani namanye ama-analgesics angekho opioid , ama-analgesics adjuvant awatholakali ngaphezu kwekhawunt.
Izinhlobo ze-Adjuvant Analgesics
Ama-antidepressants
Nakuba izidakamizwa ezidinga ukucindezeleka zivame ukubhekwa njengemithi ebuhlungu, zingakwazi ukuphatha kahle izimo ezibuhlungu ezingapheli. Kucatshangwa ukuthi izifo zokucindezeleka zilawula indlela ubuhlungu obonakala ngayo kusukela emthonjeni womgogodla kuya ebuchosheni. Ngaphezu kwalokho, izidakamizwa zokunciphisa umzimba zinganciphisa ukukhathazeka nokusiza ukulawula ukulala.
Kodwa-ke, akuzona zonke izinhlobo zezidakamizwa zokucindezeleka eziphumelelayo ekulawuleni ubuhlungu obungapheli . I-Tricyclic antidepressants (TCAs) njenge-amitriptyline, i-serotonin reuptake inhibitors (SSRIs) ekhethiwe, njenge-duloxetine, nezinye, njenge-nefazodone, ngokuvamile isetshenziselwa ukuphatha kokubili ubuhlungu obungapheli obuhlungu nobuhlungu benzwa. I-Monoamine oxidase inhibitors (MAOIs) ayiphumeli ekulawuleni ubuhlungu obungapheli.
Anticonvulsants
Ama-anticonvulsants, okuyimithi evame ukusetshenziselwa ukulawula ukuphazamiseka kwengcindezi, ingasetshenziswa futhi ukuphatha ubuhlungu obungapheli. Ama-anticonvulsants asebenza ngokungavumeli izinhlobo ezithile zokudluliselwa kwamagciwane, futhi anganciphisa ubuhlungu obungokwemvelo, njengalabo abangelwa i-neuralgia ye-trigeminal noma i-neuropathy ye-diabetes.
Ama-anticonvulsants asetshenziselwa ukuphatha ubuhlungu obungapheli ahlanganisa i-gabapentin ne-pregabalin.
I-Gabapentin yi-analgesic esetshenziswa kakhulu kunazo zonke. Ezinye iziguli ezingaphenduli kahle i-gabapentin zingaphendula esikhundleni se-pregabalin, futhi ngokufanayo.
Yimaphi Ama-Syndromes Ebuhlungu Owenza Ama-Adjvant Analgesics Ukuphatha?
I-Oxford Textbook ye-Palliative Medicine kanye noMqulu We-Merck uhlunga ama-analgesics adjuvant alandelayo ukuze aphathe ubuhlungu be-syndromes:
Ama-Adjuvants asetshenziselwa izinhlobo eziningi zobuhlungu bezinhlungu
- Corticosteroids
- Dexamethasone
- I-Prednisone
- I-Tricyclic antidepressants
- I-Amitriptyline: ayinconywa kubantu asebekhulile noma iziguli ezinezinkinga zenhliziyo.
- Desipramine
- I-serotonin ekhethiwe kanye ne-norepinephrine reuptake inhibitor (SNRI) yokucindezeleka
- I-Duloxetine: Kungcono ukubekezelela kune-tricyclic antidepressants.
- I-Milnacipran
- I-Alpha-2-adrenergic agonists
- Tizanidine
- Imithi yokwelashwa: i-capsaicin ingasetshenziselwa ubuhlungu be-neuropathic ne-arthritis.
- Izinzwa zokubulala izinzwa zasendaweni: njenge-lidocaine patch
Amakhemikhali asetshenziselwa ubuhlungu be-neuropathy
- Ama-Antiepileptic agents
- I-Gabapentin: Lesi yisidakamizwa esikhethwe ama-anticonvulsants.
- I-Pregabalin
- I-Carbamazepine: lena yindlela yokwelapha yokuqala ye-neuralgia ye-trigeminal.
- I-Phenytoin: ibhekwa njengesidakamizwa sesibili.
- I-Valproic acid: isetshenziselwa ikhanda.
- I-Clonazepam
- I-Lamotrigine
- I-Topiramate
- I-Tiagabine
- Oxcarbazepine
- I-Lacosamide
- Abaphikisi be-NMDA
- I-Memantine
- I-Ketamine
- I-Dextromethorphan: isetshenziswe lapho ubuhlungu bunenxenye yokuvuvukala.
- Izivimbela zesiteshi se-sodium yomlomo
- Mexiletine
- I-Tocainide
- Baclofen: Isetshenziswa nge-neuralgia yezintathu.
I-Calcitonin
I-Adjuvants Sebenzisa I-Complex Regional Pain Syndrome
- I-Calcitonin
- I-Clonidine
- I-Prazosin: Ubuhlungu besifo somdlavuza
- Ama-bisphosphonates ( isb. , I-pamidronate)
- I-Calcitonin
- Radiopharmaceuticals
Izwi elivela
Uma uzibuza ukuthi kungani imishanguzo ehlukene isetshenziselwa ukuphatha ubuhlungu bakho obungapheli, cela udokotela wakho noma ummithi ukuthi achaze. I-biochemistry ehilelekile ingaba nzima, kepha ungaqinisekiswa ukuthi uthola imithi efanelekile ezosebenza ndawonye ukuhlinzeka ukukhululeka kobuhlungu.
> Imithombo:
> Lussier D, Portenoy RK: Ama-Adjuvant Analgesics. Ku-Doyle D, uHanks G, uCherny NI, uCalman K (eds): Oxford Textbook of Medicine Palliative. I-Oxford: I-Oxford University Press, i-Edine yesi-4, i-Oxford: i-Oxford University Press, ngo-2011.
> Markman, J, et. al. I-Tratment of Pain. I-Merck Manual Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain.