Izindlela Ezivamile Zokwelashwa Okusindayo Kwezinkinga Zokugula
Ukwelapha ubuhlungu obungunaphakade bentwaba kungaba inselele, ngoba imbangela ayiqondi ngaso sonke isikhathi. Ama-painkillers endabuko asetshenziselwa yedwa, njenge-NSAID, ngokuvamile ayisebenzi ekuphatheni lolu hlobo lobuhlungu; Nokho, izindlela zokwelapha eziningi zingagcina izimpawu zesifo senzwa ngaphansi kokulawula okungcono. Le ndlela ifaka phakathi kokubili abadayisi bendabuko, imithi yokwelashwa yangasese, nezinye izifo ezihlobene nobuhlungu.
Ukwelashwa Kwezinhlungu Ze-Neuropathic - Ama-Adjuvant Analgesics
I-analgesics ye-adjuvant , njenge-anticonvulsants kanye ne-anti-depressants, ingavame ukulwa nokuzwa ubuhlungu be-neuropathic. Ngenxa yokuthi le mithi yenzelwe ukwelapha izimo ngaphandle kobuhlungu, ukusetshenziswa kwabo ekunakekeleni ubuhlungu be-neuropathic kubizwa ngokuthi "off-label" ukusetshenziswa. Kodwa ungavumeli lokho kukukhathaze: amaningi amaningi ahlaziye adjuvant athembise ukuphumelela ekwelapheni izimpawu zokuhlunguphazeka kwezinzwa ezingapheli kunezidakamizwa zendabuko.
Ama-anticonvulsants asetshenziselwa ukwelashwa kwesifo sezinzwa:
- I-Gabapentin (Neurontin)
- I-Pregabalin (i-Lyrica)
- I-Carbamazepine (i-Tegretol)
- I-Oxcarbazepine (i-Trileptal)
- I-Phenytoin (i-Dilantin)
- I-Valproate (i-Depacon)
- I-Lamotrigine (i-Lamictal)
Ama-antidepressants asetshenziselwa ukwelashwa kwesifo sezinzwa:
- Amitriptyline (Elavil)
- I-Nortriptyline (Aventyl)
- I-Desipramine (i-Norpramin)
- I-Citalopram (Celexa)
- I-Fluvoxamine (i-Luvox)
- I-Fluoxetine (i-Prozac)
- I-Paroxetine (i-Paxil)
- I-Duloxetine (i-Cymbalta)
- I-Venlafaxine (Effexor)
Ukwelashwa Kwezinhlungu Ze-Neuropathic - Ama-Painkillers Zendabuko
Ezimweni eziningi, abadayisi bendabuko bodwa abakwazi ukulawula izimpawu zokuhlunguphazeka kwezinzwa ezingapheli ngokuphelele.
Lokhu kungenxa yokuthi abaningi abanokwelapha bendabuko, njengama-NSAID, okuhloswe ukuvuvukala, okungahle kube yimbangela yezihlungu zesibindi. Kodwa-ke, ezinye izidakamizwa zendabuko zinendima ekwelapheni ubuhlungu obungapheli bomzimba. Zingase zisetshenziswe lapho ama- analgesics adjuvant engasebenzi, noma ehlangene nama-anticonvulsants noma ama-antidepressants.
- Ama-NSAID . Ama-NSAID kuphela angeke aphumelele ekwelapheni ubuhlungu be-neuropathic ; Kodwa-ke, kwabanye abantu, ukuvuvukala kwenza izinhlungu zezinzwa zibi nakakhulu. I-NSAID, njenge-ibuprofen (Advil) noma i- naproxen (i- Aleve ), ingahlanganiswa nezinye izinhlungu zokwelashwa futhi ingasiza ekulawuleni ubuhlungu bokuhlukumezeka.
- I-Acetaminophen . I-Acetaminophen (i-Tylenol) ingahle isetshenziswe ngokuhlanganiswa nama-analgesics adjuvant ukulawula ubuhlungu be-neuropathic, noma ingasetshenziselwa iziqephu zobuhlungu obubuhlungu . Amanye ama-opioid asetshenziselwa ukwelapha ubuhlungu be-neuropathic nawo aqukethe i-acetaminophen.
- Ama-opioids . I-opioids ingase ibekwe ukuba kube nokwelashwa okukhulu kobuhlungu be-neuropathic, noma njengendlela yokugcina yokuzivikela lapho ama-analgesics adjuvant ehluleka ukukhulula ubuhlungu. I-opioid "ebuthakathaka" evame ukushiwo ubuhlungu be-neuropathic i- tramadol (Ultram); Kodwa-ke, ama-opioid anamandla angadingeka futhi.
- Ama-Analgesics e-Topical . Nakuba kungenjalo ngaso sonke isikhathi, abanye abantu abanezinhlungu ze-neuropathic bathola impumuzo ngemithi yangaphandle yobuhlungu, kuhlanganise ne-lidocaine ne-capsaicin. I-analgesics ye-topical ingase ihlanganiswe neminye imithi.
Ukwelashwa Kwezinhlungu Ze-Neuropathic - Ezinye Izinketho
Imithi akuyona impendulo kuphela uma kuziwa ekunakekeleni ubuhlungu be-neuropathic. Ezinye izinketho ezingahle zisetshenziswe yedwa, noma ngokuhlanganiswa nabanikazi bezinhlungu, zifaka:
- Ukwelapha ngokomzimba
- Amabhuloki emigodi
- Ukuvuselela kwentambo yomgogodla
- Ukuhlinzekwa kwe-nerve decompression
Imithi ehambisanayo neyehlukile (i-CAM) ingase ibe usizo ekunakekeleni ubuhlungu be-neuropathic, kufaka phakathi ukukhwabanisa kanye nemithi yokwelapha . Yize ama-CAM amaningi engadingi imithi, kufanele ukhulume nodokotela wakho ngaphambi kokuqala noma iyiphi imithi emisha ngenxa yobuhlungu bakho bomzimba.
Imithombo:
I-National Guideline Clearinghouse. Izinkombandlela ze-EFNS ekuPhileni kweMithi Yezinhlungu Ze-Neuropathic. http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10472&nbr=5495
I-National Pain Foundation. Ubuhlungu Neuropathic: Imithi. http://www.painfoundation.org/
I-Merck Manuals Medical Library Library. Ubuhlungu be-Neuropathic. http://www.merckmanuals.com/professional/neurologic-disorders/pain/neuropathic-pain