Ukuxuba ukunciphisa okubuhlungu kokubili kokubuyisa
Ngokuvamile, odokotela bazama ukunciphisa i- polypharmacy noma ukuvezwa kwakho emithini ephuthumayo noma elula . Ngakho-ke, uma uletha ngomphimbo obuhlungu odinga ama-antibiotic, uzothola imithi yelinye uhlobo lwe-antibiotic hhayi imithi yezinhlobo eziningana zama-antibiotic. Kodwa ingabe lesi siqondiso sisebenza emithini yokuhlunguphaza okungaphezu kwemithi, futhi?
Okuningi mayelana ne-Polypharmacy
Izizathu zokugwema ukuphazamiseka kwe-polypharmacy phakathi odokotela zivame kakhulu.
Okokuqala, imishanguzo oyithathayo, ingozi enkulu yemiphumela emibi noma ukusebenzisana kwezidakamizwa. Imithi ehlukene ingasebenzisana ngezindlela ezingenakubalwa eziyingozi.
Okwesibili, noma nini kungenzeka, udokotela uzama ukunquma imithi ethatha isifo futhi ifike empandeni yokugula. Ngokuvamile i-polypharmacy imelela indlela ehlakazekile yokunciphisa izimpawu zesifo esikhundleni sokubhekana nesifo ngokwayo.
Okwesibili, njengendlela yokusetshenziswa kabi kwemithi ye-antibiotics, i-polypharmacy ingafaka ingozi empilweni yomphakathi. Ngokuqondile, ukuthatha ama-antibiotic amaningi ngesikhathi esisodwa futhi ungaqedi inkambo yokwelapha kwandisa amathuba okuthi amabhaktheriya anomuthi angasakazeka phakathi kwabantu abaningi. Ama-bacteria angamelana negciwane ayizindaba ezimbi ngoba amelana nokwelashwa ngama-antibiotic avamile.
Okungafani nesiqondiso esijwayelekile sokugwema ukuphazamiseka kwe-polypharmacy ukusetshenziswa okufanayo kwemithi ethile yobuhlungu njengo-acetaminophen (i-Tylenol) ne-ibuprofen (i-Motrin).
Le mithi ayiphazamisi omunye nomunye. Ngaphezu kwalokho, ukwelashwa ubuhlungu kunzima futhi kuhlanganisa i-acetaminophen ne-ibuprofen kungasiza ekunciphiseni ubuhlungu obukhulu konke kuyilapho kugweme ukugunyazwa kwama-opioids. Ukuhlukumeza i-opioid kukhula, futhi manje sisezinhlungwini ze-opioid crisis.
Okuphawulayo, i-opioids imithi enemiphumela emibi eyingozi efaka ukucindezeleka kokuphefumula kanye nokukwazi ukuhlukunyezwa.
Ngaphezu kwalokho, izinhlobo ezithile ze-opioid efana ne-Vicodin noma i-Norco zombili izinhlanganisela ze-hydrocodone-acetaminophen, futhi, ngakho-ke, uma kuthathwe iTylenol, la ma-opioid angahlanganisa ukuvezwa kwe-acetaminophen. I-acetaminophen kakhulu ingaholela ekulimaleni kwesibindi.
I-Tylenol
I-Tylenol wuhlobo lwe-analgesic olushintsha indlela esibuzwa ngayo ubuhlungu futhi linciphisa izinga lokushisa kwemizimba yethu (ie, antipyretic). Ngokuvame ukuhlanganiswa neminye imithi yokuthuthukisa ukuhlukahluka kobuhlungu obuhlukile.
Nakuba uhlelo oluqondile lwe-Tylenol alukacaci, siyakholelwa ukuthi le mithi isebenza ngokuvimbela i-cyclo-oxygenase (ngokuyinhloko i-COX-2). Ngenxa yokuthi iTylenol isetshenzisiwe ngokuyinhloko ngesibindi, abantu abanezinkinga zesibindi kufanele bagweme lo muthi uma kungenzeka.
Motrin
I-Motrin yisidakamizwa esingafuni ukuvuvukala (i-NSAID), efana ne-Tylenol, eneziphumo zayo ku-cyclo-oxygenase kanjalo evimbela i-prostaglandin synthesis. I-Prostaglandins ixazulula ubuhlungu, ukuvuvukala, nomkhuhlane.
Ukuvinjelwa kohlelo lwe-prostaglandin nakho kuholela ekutheni i-vasoconstriction ne-renal impairment engabangela ukwehluleka kwezinso. Ngakho-ke, abantu abanenkinga yezinso kufanele bahlukane ne-Motrin.
Encwadini ehlobene, kwezinye izinto, i-Motrin ingabangela futhi izilonda zesisu nokuphuma kwegazi.
Ukuhlanganisa ababili
Ngokuthakazelisayo, nakuba kungumkhuba ovamile, kwenziwa ucwaningo oluncane lokuhlola ukusebenzisana kweTylenol noMotrin.
Olunye ucwaningo lokuqala ekuqaleni kwesihloko lwenziwe ezinganeni. Kodwa-ke, kunzima ukudweba ama-correlates aqondile phakathi kobuhlungu nokukhululeka komkhuhlane kubantwana uma kuqhathaniswa neyabantu abadala. Ngokuqondile, izingane ezinqunyelwe kokubili iTylenol noMotrin ngezinhlungu nangemfiva ngokuvamile zithola le mithi njengezinye izindlela.
Imiphumela evela ocwaningweni oluthile olwanyatheliswa kuyi- British Journal of Anesthesia lisikisela ukuthi uma iTylenol noMotrin bebanjwe ndawonye (ngendlela yokuxuba okubizwa ngokuthi i-Maxigesic) ngeziguli ezanda kuhlinzwa ngomlomo, le nhlanganisela ibangela ukukhululeka okukhulu kobuhlungu.
Ngokufanayo, imiphumela yokubuyekezwa okuhlelekile ehlola ukuhlolwa okulawulwe ngokungahleliwe futhi eyanyatheliswa ngoMuthi Wezobuhlungu ibonisa ukuthi "ukuhlanganiswa kweparacetamol [acetaminophen] ne-NSAID kwakuphumelela kakhulu kune-paracetamol noma iNSAID kuphela ngo-85% no-64% wezifundo ezifanele, ngokulandelana."
Ngaphansi
Ngakho kubonakala sengathi-ngokungafani nenhlanganisela ye- aspirin ne-Motrin , okubili kokubili i-NSAID-ethatha i-acetaminophen ne-ibuprofen ndawonye iphephile futhi isebenza kahle.
Kodwa ngaphambi kokuba usebenzise izidingo zokuphumula ezibuhlungu, ngizofanelekela le mpendulo ngamagceke amathathu.
Okokuqala, uma unenkinga yesibindi noma izinso, akufanele uthathe i-acetaminophen noma i-Motrin (okungukuthi, i-NSAID), ngokulandelana.
Okwesibili, ama-analgesics angaphezu kwe-counter afana ne-Tylenol noma i-Motrin ahloselwe ukusetshenziselwa isikhathi esifushane kuphela. Sicela ukhumbule ukuthi ubuhlungu abukona nje uphawu kodwa futhi luphawu lokulimala noma isifo. Uma ubuhlungu bakho buqhubeka, udinga ukubona udokotela.
Okwesithathu, ungakwazi ukudlula ngaphezulu kokubili iTylenol noMotrin ukwenza umqondo omuhle owengeziwe ukuthi ube nemithi efana nale yale mithi ehlolwe udokotela.
> Imithombo:
I-Borazan NH, i-Furst DE. Izidakamizwa ezingavumelani nokuvuvukala, izifo-Ukuguqula izidakamizwa ze-Antirheumatic, i-Nonopioid Analgesics, nezidakamizwa ezisetshenziswa ku-Gout. Ku: Katzung BG, Trevor AJ. ama-eds. I-Basic & Clinical Pharmacology, 13e . ENew York, NY: McGraw-Hill; 2015. Kufinyelelwe ngo-Okthoba 11, 2015.
Cliff KS et al. Ukuhlanganisa i-Paracetamol (i-Acetaminophen) ne-Nonsteroidal Anti-inflammatory Drugs: Ukubuyekezwa okuhlelekile kohlelo lwe-Analgesic Efficiency for Acute Postoperative Pain. Imithi Yezinhlungu . 2010. > https://doi.org/10.1213/ANE.0b013e3181cf9281
I-Merry AF et al. Ukuhlanganiswa kwe-Acetaminophen no-Ibuprofen ngokuthola usizo lwezinhlungu Emva kokuhlinzwa okusemthethweni kubantu abadala: Isivivinyo Esilawulwe Ngokungahleliwe. I-British Journal ye-Anesthesia . 2010. https://doi.org/ > 10.1093 / bja / aep338
Olson KR. Isahluko 4. I-Acetaminophen. Ku: Olson KR. ama-eds. Ukushisa nokudlulela kwezidakamizwa, 6e . ENew York, NY: McGraw-Hill; 2012.