Lapho kuthathwa ngokulingana, i-acetaminophen iyingozi kakhulu
EChicago ekuwa kuka-1982, amakhemikhali ase-acetaminophen (iTylenol) ayegqoke nge-cyanide eyabonakala ishonela ngokushesha kubantu abayisikhombisa abangenayo. Kuze kube yilolu suku, ukuphoqelelwa komthetho okwamanje akufanele kubambe umuntu noma abantu abaphethe lezi zenzo ezimbi.
I-Chicago Tylenol Ababulali hhayi nje kuphela yabulala abantu abayisikhombisa kodwa futhi baqeda ukubhubhisa imikhiqizo ye-McNeil Consumer, eyisibonelelo somkhiqizi wezidakamizwa uJohnson & Johnson nomenzi weTylenol.
Kulokhu okusetshenziselwa njalo njengenkinga yokulawulwa kwezinhlekelele, ekuphakameni kweTylenol ukwesaba, imikhiqizo yabathengi kaMcNeil ikhishwe izixwayiso zomphakathi futhi ikhumbula zonke izikhumba zeTylenol ezikhona, izigidi ezingu-31 zizonke. Imikhiqizo yabakwaMcNeil yabathengi nayo yaqinisekisa umphakathi ukuthi konke ukudubula kwenzeka ngaphandle kwefektri.
Emasontweni alandela iChicago iTylenol Ababulali, uJohnson & Johnson bahamba ngokulawula imakethe ye-analgesic engama-35% wamasheya emakethe engxenyeni engamaphesenti angu-8 kuphela. Kodwa kungakapheli unyaka wenkinga, iTylenol yavuselela ngemuva kokutshalwa kwemali eyizigidi eziyizigidi eziyizigidi eziyizinkulungwane ezingu-R6 ($ 100 million) ekunciphisanisweni kwamanani, ukupakishwa kwempahla emangcwabeni, nokufakwa kwephetheni eline-gelatin eyayikulula ukugwinya futhi kube nzima ukuyiphazamisa. Phakathi nenkinga futhi iminyaka kusukela, ezinhliziyweni nasezingqondweni zomphakathi, iTylenol iye yaholela ekukhuthazeni ukholo oluhle njengendlela yokuphepha ebuhlungu, engabizi futhi ephumelelayo.
Kodwa-ke, ngenxa yezizathu ngaphandle kokusongela kwamanje ukuhlukumeza ubugebengu, iTylenol kungaba yingozi. Bambalwa abantu abangacabangi ukuthi uma kuthathwa kanjani ngokweqile, i-acetaminophen ingabangela ukwehluleka kwesibindi esibulalayo. Phela, amabhodlela ase-acetaminophen abukeka engenangqondo uma ekhonjiswe eshalofini emkhakheni wakho wezokwelapha noma uma uthengiswa ngenhlanganisela eklabhu yakho yamanani wendawo.
Ngenhlanhla, izimpikiswano ze-acetaminophen poisoning zingasuswa uma i-antidote ilawulwa ngaphakathi kwamahora ayishumi okuqala we-poisoning.
Ukuqonda iTylenol
Emzimbeni, i-Tylenol ingena ngokusabalalisa ngegciwane lesisu. I-Tylenol cishe ingamaphesenti angu-100 ayitholakali okwenza kube kokubili okuphumelelayo futhi okungaba yingozi. Kuthatha cishe imizuzu engama-30 ukuthi i-analgesic (ukuphulukisa ubuhlungu) kanye ne-antipyretic (imfiva-breaking properties) yale mithi ezosebenza, futhi, ngaphansi kwezimo ezivamile, imizimba yethu icacile cishe ingxenye yesilinganiso seTylenol 2.5 amahora ngemuva kokungenisa.
Lapho kuthathwa ubuhlungu kubantu abadala, iTylenol idonswa phakathi kuka-600 mg no-1000 mg njalo amahora amane kuya ku-6. Akekho okufanele athathe okungaphezu kwama-4 amagremu eTylenol ngosuku. Ama-caplen a-Tylenol aqukethe ama-500 mg we-acetaminophen ngakho akufanele nanini uthathe ama-caplets angaphezu kwamabili njalo ngamahora ayisithupha noma ama-caplets ayisishiyagalombili ngosuku . Inothi, uma unesimo esibuhlungu esidinga ukuthi uthathe noma yikuphi lapho kukhona khona ama-caplets ayisishiyagalombili eTylenol ngosuku, kufanele nakanjani ufune usizo lwezokwelapha.
Lapho kuthathwa ngemali yokwelashwa, iningi le-Tylenol liphulwa ngokuphephile ngesibindi ngokusebenzisa izinqubo zokuqubuzana zesulfure kanye ne-glucuronidation. Ngaphezu kwalokho, inani eliyingcosana leTylenol eliphuzwayo (elingaphansi kwamaphesenti amahlanu) lihanjiswa ngokuqondile ngezinso.
Okokugcina, ngezinyathelo zokwelapha, iphesenti elincani kakhulu lixhunywe yi-cytochrome P-450 isimiso se-metabolite esisebenzayo se-N-acetyl- p -benzoquinoneimine (NAPQI); I-NAPQ1 ixoshwa ngokushesha yi-glutathione ye-hepatic ibe yinkimbinkimbi engeyona i-acetaminophen-mercapturate ebuye isuswe izinso.
Ezimweni zobuthi beTylenol, i-cytochrome P-450 ye-enzyme yesibindi isheshe igcwale futhi izitolo ze-glutathione ziphela. Ngenxa yalokho, i-metabolite esebenzayo, i-NAPQ1, ilimaza futhi ibulala amaseli wesibindi kanjalo eholela ekuhlulekeni kwesibindi.
Ngonyaka ka-2008, i-American Association of Poison Control Centers ibike ukuchayeka kuka-71 328 eTylenol ngokuhlanganiswa kanye nokuvezwa kuka-80 845 iTylenol yedwa.
Abantu abangamashumi ayisishiyagalolunye nantathu babulawa yiTylenol enobuthi emzimbeni, kanti abantu abangu-69 bafa ngenxa yeTylenol yedwa. Lezi zibalo zibeka iqiniso elibalulekile mayelana nomtholampilo weTylenol: Abanye abantu baqeda ukudlula i-acetaminophen ngoba kubonakala sengathi "banesibindi," kodwa izinombolo ezilinganayo zabantu ziphelela ngengozi ngokwabo ngoba zihluleka ukubona ukuthi iTylenol nayo imithi babethatha.
Wena nabathandekayo bakho kufanele niqonde ukuthi yimaphi ama-analgesics, imithi yokulala kanye nemithi ebandayo kanye neyomkhuhlane) -ngenisa i-acetaminophen:
- I-Lorcet
- Norco
- NyQuil
- I-Percocet
- Vicodin
- Darvocet
- Excedrin ES
- I-Unisom Dual Relief Formula
- I-Lorcet
- I-Tylox
- NyQuil
- I-Vicks Formula 44-D
- I-Tylenol PM
- Sominex 2
Ukwenza izinto zibe zimbi nakakhulu, imiphumela emibi kakhulu yale mithi eminingi ehlanganiswe ne-acetaminophen ingase ifihle ekuqaleni izimpawu ze-Tylenol poisoning ngokwayo. Lokhu ukugijima kungaholela ekubambezelekeni kokusongela impilo yokwelapha.
Uketshezi lwe-Tylenol kungakwaziswa njengezigaba ezine.
- Isigaba 1. Phakathi namahora angu-24 okuqala, izimpawu azifani futhi zihlanganisa i-malaise, i-anorexia, isicashu, nokuhlanza. Ngenxa yezizathu ezingaziwa, umuntu onobuthi angase athuthukise hypokalemia noma amazinga aphansi e-potassium egazini.
- Isigaba 2. Emini emithathu noma emithathu, lapho izimpawu zokuqala seziyeke, izibonakaliso nezibonakaliso zokulimala kwesibindi noma zingabekwa ngaphakathi kubandakanya ubuhlungu besibindi kanye nobubele kanye ne-enzymes ye-foam ephakeme (amaseva e-serum transaminases). Ngisho nangaphandle kokwelashwa, iningi labantu abane-poisoning yesibindi emnene kuya ekulinganiseni (okungukuthi, i-hepatoxicity) ilulame ngaphandle kwe-sequelae futhi ungangeni eSiteji sesi-3.
- Isiteji 3. Ngosuku lwesithathu noma 4, ukwehluleka kwe-hepatic okuqhubekayo kwenzeka: i-acidosis ye-metabolic, ukwehluleka kwezintuthwane, ukuphazamiseka kwengqondo, ukuhlukumezeka nezinkinga eziphindaphindiwe zomzimba.
- Isigaba 4. Kwalabo abasinda esigabeni sesi-3, ukuvuselela kuqala cishe amasonto amabili ngokubuyiselwa kwesibindi ukusebenza ezinyangeni ezimbili.
Okuphawulayo, abantu abaxhomeke kotshwala noma labo abangazivikeli kahle (isib., I-AIDS) banezitolo zokugcina ze-glutathione futhi ikakhulukazi bangenwa yi-acetaminophen yobuthi nokuhluleka kwe-hepatic ephelele. Ngaphezu kwalokho, abantu abathwala imithi yesifo sofuba noma isifo sofuba basengozini enkulu ngoba le mithi ibangela umsebenzi we-cytochrome P-450.
Ukwelashwa kwe-Tylenol Overdose
Odokotela baphatha umthamo we-Tylenol ngokusekelwe emiphakathini ephumelele kakhulu esikhathini esidlule kufaka phakathi i-nomogram elilodwa eliyinkimbinkimbi eline-acetaminophen elidumile kakhulu, uhlobo olukhethekile lomdwebo.
I-antidote ye-Tylenol ngokweqile kuyisidakamizwa esibizwa nge-N-acetylcysteine (NAC). Ukusebenza kwe-NAC kakhulu kuxhomeke esikhathini sokuphathwa, futhi kuphumelela kakhulu uma kulawulwa amahora angama-8 kuya kwangu-10 wokudlula kokungavamile kokungenisa. Ngamahora angu-12 kuya kwangu-16, uqala ukubona umphumela wokunciphisa we-antidote; Noma kunjalo, ukwelashwa kungaqala phakathi namahora angu-24.
Ngokudlula ngokweqile, i-NAC ingenziwa ngezikhathi ezingu-17 ngesikhathi samahora angu-72. Kungasetshenziswa futhi nge-intravenously ngamahora ambalwa amahora angu-20. Ukuhlolwa kokusebenza kwesibindi (amazinga e-enzyme) kulandelwa ukuthuthukisa. Kungakapheli amahora amabili okudlula ngaphezulu, amalahle acushiwe angaphathwa futhi ukuze asize ekutholeni ezinye zeTylenol. Esimweni esibuhlungu ukuthi i-acetaminophen isivele ibonakalisile isibindi, futhi ukwehluleka kwe-hepatic ephelele kuye kwafakwa, ukufakelwa kwesibindi kungadingeka.
Izwi elivela
Uma wena noma omunye umuntu omthandayo usule ngokweqile iTylenol noma umkhiqizo oqukethe iTylenol, shayela u-911 noma izinsizakalo eziphuthumayo ngokushesha. Isifo sofuba se-Tylenol yisimo esiphuthumayo futhi isikhathi sibalulekile-f ulinde isikhathi eside isikhathi sokuvimbela i-NAC ngeke isebenze. Ngenxa yokuthi izibonakaliso ze-acetaminophen toxicity zenziwe jikelele, kubalulekile ukuthi ukwazise bonke abahlinzeki bakho bokunakekelwa kwezempilo okungenzeka ukuthi uthathe iTylenol kakhulu. (Igumbi eliphuthumayo odokotela ngokuvamile bahlola umchamo kumazinga we-Tylenol kodwa azixhomeki kulokhu.)
Inothi elijwayelekile ngokuphathelene neTylenol: Ngisho noma iTylenol nemikhiqizo equkethe iTylenol ibonakala ingalutho, ayikho. Cabanga ngempela ukuthi kungani uthatha iTylenol noma amanye ama-analgesics angaphezu kwe-counter and counter and remedies. Izinyathelo ezinjalo zenzelwe ukukhululeka okwesikhashana. Uma ubuhlungu bakho buqhubeka isikhathi eside, udinga ukuthola usizo lwezokwelapha. Sicela ugcine engqondweni ukuthi iTylenol ngeke ikwazi ukuphulukisa izimo ezingapheli njenge-migraines noma ukulimala okuphansi emuva.
> Imithombo:
> Hung OL, uNelson LS. Isahluko 184. I-Acetaminophen. Ku: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Umuthi Ophuthumayo We-Tintinalli: Umhlahlandlela Wokufunda Ophelele, 7e . ENew York, NY: McGraw-Hill; 2011.
> Olson KR. Isahluko 4. I-Acetaminophen. Ku: Olson KR. ama-eds. Ukushisa nokudlulela kwezidakamizwa, 6e . ENew York, NY: McGraw-Hill; 2012.