Imithi Yokuhlukunyezwa Kwezinkinga Zokudabuka Ngezinkinga Zokuhlukunyezwa Okungapheli
Uma unesifo esingapheli futhi uzame konke ongakwenza ukuze unciphise ubuhlungu bakho, ama-opioid (ama-narcotics) angase abe umzila oyikhethayo ukuthatha. Ngesikhathi ukusetshenziswa kwalezi zinhlungu ezinamandla (ama- analgesics ) okwelashwa kwesikhashana okubuhlungu okungapheli kuyinkinga enkulu, lezi zidakamizwa zingasebenza futhi ziphephile lapho zithathwe ngokuqondiswa kwezempilo.
Nakhu okumele ukwazi ngaphambi kokunquma ukuthi i-opioids ikufanele yini.
Yini Opioids?
Ama-opioids avela kwenye yezindawo ezintathu: Ezinye zivela ezitshalweni, ezinye zakhiwa ebhodini, kanti ezinye, njenge-endorphins, zenzeka ngokwemvelo emzimbeni. I-opioids iyasebenza kakhulu ekwelapheni ubuhlungu obukhulu. Eqinisweni, zivame ukusetshenziselwa ukuphatha ubuhlungu obukhulu, njengokuhlunguphaza kokuhlinzwa, kanye nobuhlungu obukhulu obubangelwa izifo ezifana nomdlavuza.
Izinhlobo ze-opioids
Kuye ngezidingo zakho, ungathatha enye yezinhlobo ezimbalwa zama-opioid esetshenziselwa ukuphatha ubuhlungu obungapheli . Phakathi kwesigaba semithi ebizwa ngokuthi i-opioids, kunezinhlobo eziningi.
Okokuqala, ama-opioid angenziwa njengemithi yokwenza ubuhlungu obude isikhathi eside noma esebenzayo.
I-opioids ihluke kakhulu komunye nomunye ngendlela abayinikiwe ngayo. Amanye anikezwa ngaphakathi nge-IV esandleni, ingalo, noma echwebeni noma emgqeni we-picc. Amanye anikezwa ngomlomo, amanye anganikezwa njenge-suppository yamagagasi, kanti amanye afika ngendlela ye-patch oyisebenzisayo esikhumbeni sakho.
Amanye ama-opioid anganikezwa ngezindlela ezingaphezu kweyodwa, kodwa amanye anqunyelwe indlela eyodwa yokulethwa.
Omunye umehluko obalulekile wukuthi ezinye i-opioid, njenge- oxycodone ad hydromorphone "ziyizidakamizwa eziqondile. Abanye, njenge-Tylenol # 3 no- Vicodin , bangase baxubane nabanye ababulali obuhlungu njengoTylenol (acetominophen.)
Esinye isigaba sama-opioid, esichazwa njenge-agonist / antagonist, sihlanganisa imithi yokwehlisa ubuhlungu nokunciphisa amandla okuthembela. Lezi zihlanganisa buprenorphine ne-butorphanol.
I-Opioid Side Effects nezinye Izinkinga
Abantu abaningi abanezinhlungu ezingapheliyo babekezelela umthamo ofanayo we-opioid iminyaka eminingi ngaphandle kokwakha ukubekezelelana kwezidakamizwa, noma ngaphandle kokuthuthukisa ukuthembela ngokomzimba kulo muthi. Noma kunjalo, ukuthembela nokulutha umuthi kuyinkinga efanele.
Ngeshwa, abaningi abagulayo abangapheliyo abathwala ama-opioid bangase babhalwe ngokungalungile ngokuthi "izidakamizwa," noma ngabe abahlangabezane nemigomo yangempela yokulutha. Ngesinye isikhathi kukhona inhlamba ethile ehambisana nokuthatha imithi yokuhlunguphaza i-narcotic, okungase kuphazamise umuntu ozwa ubuhlungu obungapheli.
Ngaphezu kokubekezelelana nokuthembela emzimbeni, ama-opioid aneminye yemiphumela emibi. Lokhu kungafaka:
- Ukulala
- Ukudideka
- I-nausea
- Ukuqokwa
- Ukugcinwa kwe-Urinary
- Ukuphefumula okunzima
- Ukukhubazeka ngokocansi
- Umfutho wegazi ophansi
- Ukuthinta ukuzwa
Ama-opioids athambekele ekuthinteni abadala kanye nezingane ngaphezu kwabantu abadala, ngakho-ke lezi zizwe kumele zihlolwe ngokucophelela. Ngokuvamile, odokotela bazoqala ama-opioid amanani aphansi kakhulu futhi banda kancane kancane kuze kube yilapho kutholakala izinga lokwelapha.
Imithi ethile ingase ihlanganyele kabi nge-opioids, ngakho-ke ukuqapha okucophelelayo kuyadingeka uma uthatha nezinye iziqondiso njalo. Qinisekisa ukwazisa udokotela wakho nganoma yiziphi ezinye imithi oyithathayo, kuhlanganise nalabo abathengwa phezu kwekhasi, ukugwema izinkinga ezingenzeka, ezifana nokudlula izidakamizwa.
Ngokuqinisekile, kunikezwe ukulala nokudideka okungahle kwenzeke njengomthelela ohlangothini wale mithi, kodwa njengoba kunenkinga yokulutha izidakamizwa, ucwaningo lwamuva luye lwathola ukuthi ukushayela ngenkathi usebenzisa i-opioids yobuhlungu obungapheli akuzange kube nzima ukusebenza.
Imihlahlandlela ye-CDC yokuchaza ama-opioids for Pain Chronicle
Njengoba kunikezwe ukwanda okukhulu kwe-overdose ehlobene nokusetshenziswa kwama-opioids ngobuhlungu obungenalo umdlavuza, amaCenter for Disease Control and Prevention (CDC) akhiphe iziqondiso zokusetshenziswa okuphephile kwama-opioid kubantu abanokuhlupheka okungapheli.
Ezinye zalezi ziphakamiso ezingu-12 zihlanganisa:
- 1. Ama-opioid akufanele asetshenziswe njengendlela yokwelashwa okungapheli. Ezinye izidakamizwa zobuhlungu obungenayo i-opioid kufanele zisetshenziswe kuqala ngaphambi kokusebenzisa ama-opioid. Uma kudingeka ama-opioid, kufanele asetshenziswe kanye nalezi ezinye izindlela zokwelashwa (ukunciphisa okwenziwe ngama-opioid ezidingekayo phakathi kwezinye izizathu. Imithi engeyona i-opioid imithi ihlanganisa izidakamizwa ezingezona isifo sokuvuvukala ezifana ne-Advil (ibuprofen), i- tricyclic antidepressants , kanye nemithi yokulwa ne- anti-seizure (anticonvulsants) njenge-Neurontin ( gabapentin .)
- 2. Izinhloso zokwelapha kumele zenziwe. Kumele kunqume ukuthi ukwengeza ukwelashwa kwe-opioid kuzothuthukisa umsebenzi noma ikhwalithi yokuphila okwanele ukuze ibhekane nemiphumela emibi engase ibe khona.
- 3. Ingxoxo yesiguli-nodokotela kumele yenzeke lapho isiguli siqonda ngokucacile izingozi nezinzuzo zokusebenzisa ama-opioid ukuphatha ubuhlungu babo.
- 4. Ngokushesha ukukhululwa ama-opioid (ngokungafani nama-opioid asebenza isikhathi eside) kufanele isetshenziswe kuqala.
- 5. Umthamo ophansi kakhulu wemithi kufanele ubekelelwe. (Kunezintafula eziqhathanisa ukulinganisa kwama-narcotics ahlukene uma uzoshintsha eminye imithi kwenye.)
- 6. Izifundo ezincane zama-narcotics kufanele zibekwe izinhlungu ezibuhlungu ezenzeka ngaphezu kobuhlungu obungapheli.
- 7. Vala ukulandelela kuyadingeka. Ekuqaleni kokwelashwa, ukuvakashelwa kwemitholampilo kufanele kwenzeke kanye ngesonto noma okungenani izikhathi eziningana ngenyanga. Uma le mithi isetshenziswa isikhathi eside, ukusetshenziswa kwayo kufanele kuhlolwe okungenani njalo ngemva kwezinyanga ezintathu kanti uma ubuhlungu bungaphuthuki emithini yemithi kufanele kumiswe.
- 8. Odokotela kumele basebenzise amasu okunciphisa ukusetshenziswa kabi kwemithi. Lokhu kungabandakanya ukusebenzisa inhlanganisela ye-agonist / umphikisi uma kungenzeka ukuthi kukhona ukuxhashazwa.
- 9. Odokotela kufanele basebenzise idatha ye-POMP ukuqinisekisa ukuthi omunye udokotela akaqedi ama-opioid ukuze anciphise ingozi yokudlula ngaphezulu.
- Ukuhlolwa kwezidakamizwa ze-Urine kufanele kusetshenziselwe ukuqinisekisa ukuthi umuntu kokubili usebenzisa imithi yakhe enqunyiwe futhi akasebenzisi izidakamizwa ezingaphazamisa ukwelashwa.
- 11. Uma kungenzeka, i-opioid akufanele ihlanganiswe ne-benzodiazepines.
- 12. Uma ukuxhomeka kuma-opioid kwenzeka, odokotela kumele balungele ukunikeza ukwelapha izidakamizwa.
Kungani Kufanele Usebenzise Ama-opioids Kuzozonke?
Njengoba kunengxabano enkulu ehambisana nokusetshenziswa kwabo ezimweni ezibuhlungu ezingapheli, ungase uzibuze ukuthi kungani odokotela beka opioids nhlobo. Ngokulula nje, i-opioids iphumelela kakhulu ekunciphiseni ubuhlungu obunzima, futhi abantu abaningi abangazange bathole usizo kwezinye izifo bathola usizo ngokusebenzisa i-opioid. Kulaba bantu, izinzuzo ze-opioids zidlula izingozi. Imiphumela emibi engalungile kanye nokukwazi ukuthembela kungenzeki ngaso sonke isikhathi. Kubantu abaningi abanezinhlungu ezingapheliyo, ama-opioids angasiza ekubuyiseleni izinga labo lokuphila.
Ngaphambi kokuba uqale kuma-opioids, udokotela wakho kufanele enze ukuhlolwa okugcwele futhi uhlele ukubonisana okuvamile ukuqapha isimo sakho. Abanye odokotela bangase baqale ngesilingo se-opioid, kancane kancane kwandisa umthamo wakho ngenkathi ubhekene nezinkinga ezingase zibe khona.
Imithombo:
Campos-Outcalt, D. Opioids for Pain Chronic: Izincomo ze-CDC 12. I-Journal of Practice Family . 2016. 65 (12): 906-909.
Amasevisi Okulawula Nokuvimbela Izifo. Ukulimala nokufa Kwembiko Yamaviki onke (MMWR). Umhlahlandlela we-CDC Wokubhala Opioids for Pain Chronic - U-United States, ngo-2016. Kubuyekezwe 03/18/16. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
UChou, R., uDevo, R., noJ. Friedly. I-Symbol Pharmacologic Treatment for Chronic Back Back Pain: Ukubuyekeza Okuhlelekile Kwe-American College of Physicians. Ama-Annal of Medicine yangaphakathi . 2017 Feb 14. (Epub ngaphambi kokuphrinta).
Schumacher, M., Jongen, S., Knoche, A. et al. Umphumela weTherapy Opioid on Performance Real Ukushayela in Non-Cancer Pain Patients. I-Psychopharmacology . 2017 Feb 12. (Epub ngaphambi kokuphrinta).