6 Iiklasi zeMithi e-Ototoxic
I-Ototoxicity ibhekisela kumonakalo owenziwe ngamakhemikhali kwindlebe yangaphakathi. Umonakalo unokuba unomphela okanye unxeshana, obangela ukulahlekelwa kwindlebe okanye ukuphazamiseka kwemali. Nangona amayeza athatyathwa ngenxa yezinzuzo zabo eziqulunqwe, onke amayeza aneempembelelo ezichaphazelekayo omele uziqaphele phambi kokuba uthathe. Ukulahleka kokuvalelwa okuhlobene nokudla imithi ye-ototoxic esinye isizathu sokuba ugqirha wakho unokuyeka ukumthatha imithi ngokubhekiselele ekuphazamiseni indlela yokuphila.
Ukulahleka kokuva kudla ngokuqhelekileyo kudibene neendidi ezintandathu ezahlukeneyo zamachiza. Ezi zilandelayo zinokudibana nokulahlekelwa kwintlanganiso ngonaphakade:
- Aminoglycoside antibiotics
- I-chemotherapy esekelwe kwiPlatinum
Amachiza anokuthi angabangela ukulahlekelwa kwexesha elifutshane:
- Loop diuretics
- Quinine
- Salicylates
- Vinca alkaloids
Uninzi lwemithi ekhankanywe ngasentla lunokulimaza intso (nephrotoxic) kwaye idinga ugqirha wakho ukuba ahlole igazi lakho rhoqo ukuze ahlole umsebenzi wakho wezintso. Ukuba uyaphawula nayiphi na utshintsho kwintetho yakho, kufuneka uhlale ucela uncedo kwi-odokotela yakho.
Ingozi ye-Ototoxicity
Ubuninzi bokuba ne-ototoxicity ayibonakali kakuhle, nangona kunjalo umonakalo osisigxina nokusisigxina ukusuka kwi-ototoxicity kuyaziwa. Amanye amayeza aya kuba nolwazi olungaphezulu kunabanye kwaye aya kuchazwa kumacandelo awo alandelayo. Ngokufanayo akukho ukuqonda okuninzi malunga nokuthintela ukuthathwa kwe-ototoxicity.
Amanye amayeza anomngcipheko wokunyuka kwe-ototoxicity njengamanye ama-antibiotics azakufuna umsebenzi wegazi uwaziwa ngokuthi "intaba kunye nenqanawa". Ubunzima beli nqanaba leziyobisi xa kufuneka lixineke kakhulu kwigazi. Umxokelelwane lizinga leziyobisi xa kufuneka libe yinkxalabo ephantsi.
Nangona ukubeka esweni ngoku ngenyameko oku kunokunceda ukugcina umphumo wokunyanga, akuqinisekisi ukuba awuyi kuba neengxaki zokutshatyalaliswa kwe-ototoxicity.
Ezinye izinto ezinokubangela ukutshatyalaliswa kwezinto ezibandakanya ukungcola ziquka:
- umthamo, ubude bonyango kunye nemali epheleleyo efunyenwe
- ukuphelelwa kweengtso
- kuthatha ezinye iiloto zemoto ngexesha elifanayo
- i-genetic predisposition to ototoxicity
Iimpawu ezihambelana no-Ototoxicity
Iimpawu ezinxulumene ne-ototoxicity zincike kakhulu kwiyiphi inxalenye yendlebe yangaphakathi eyonakaliswe. Ukulimala kwindlebe yangaphakathi kungenzeka kwi-cochlea yakho (ebizwa ngokuba yi-cochleotoxicity) okanye ubunzima bakho be-vestibular (ebizwa ngokuba yi-vestibulotoxicity). Kuzo zombini iimeko, zonke iimpawu zihambelana neeseli zengqondo ezonakele.
Ukuba i-cochlea yakho yonakaliswe, ukuva kwakho kuya kuphazamiseka. Umgangatho wokukhubazeka uhambelana ngokuthe ngqo kumonakalo obangela ukunyamezela ukugqithisa ukulahlekelwa kwindlebe . Ukulahlekelwa kwindlebe kunokuchaphazela enye okanye zombini iindlebe.
Ukuba ukutshatyalaliswa komzimba kuthintela ubunzima be-vestibular, ibhalansi yakho iya kuthinteka. Njengomonakalo kwi-cochlea yakho, umonakalo unokuchaphazela indlebe enye okanye zombini iindlebe. Ukuba umonakalo kuphela ochaphazela enye indlebe ngokukhawuleza, awuyi kuba neyiphi na impawu. Nangona kunjalo ukuba umonakalo uvela ngokukhawuleza kwenye indlebe, uya kwenzeka:
- vertigo
- ukuhlanza
- ukunyuka kwamehlo okungalawulwayo (nystagmus)
Iimpawu ezenzeka ngokukhawuleza zinokubangela ukuba uhlale ulala kuze kube yilapho iimpawu zigqiba ngokuthe ngcembe. Ukuba umonakalo uvela kumacala omabini endlebe yakho, unokufumana:
- intloko
- ukuzalisa indlebe
- ukungalingani okuchaphazela ukuhamba
- Umbono ongenangqondo obonakala i-jerky (oscillopsia)
- ukunganyamezeli kwentloko
- ukuhamba ngokubanzi
- kunzima ukuhamba ebumnyameni
- ukungaqiniseki
- u bunzima
- ukukhathala
Ukuba umonakalo kwinkxalabo yakho ye-vestibular isisulu, i-oscillopsia kunye nobunzima bokuhamba ebusuku kuya kuphucula. Ezinye iimpawu ziya kuphucula ixesha elide. Ngomonakalo omkhulu, unako ukubuyela kwiinkalo ezininzi ezinxulumene nokulinganisela ngenxa yokuba amandla akho omzimba azivumelanise.
Aminoglycoside Antibiotics
Aminoglycoside antibiotics yiqela elibalulekileyo lonyango lwe-bloodstream and urinary tract infections kunye nesifo sofuba esifanelekileyo. Amayeza afaka:
- gentamicin
- tobramycin
- streptomycin
Aminoglycoside antibiotics inomngcipheko wama-20 ekhulwini ekuphuhliseni iingxaki zeengxoxo kunye neengozi ezimalunga ne-15 yokujongana neengxaki zokulinganisela. Umngcipheko wokuphuhlisa iingxaki ezinxulumene ne-ototoxicity ukwanda xa uthatha i-dioptic loop (njengeLasix) okanye i-vancomycin (i-antibiotic) ngexesha elifanayo.
Loop Diuretics
I-Loop diuretics ibangele ukwanda kwendlela yokuvelisa umchamo. Oku kunceda ekuphelelweni kwentliziyo, ukunyamezela kwegazi, kunye nokungaphumeleli kwezintso. Amachiza aqhelekileyo afaka:
- Lasix (furosemide)
- Bumex (i-bumetanide)
I-Loop diuretics inomngcipheko ophantsi wokutywala i-ototoxicity kodwa inokuthi ibe yintandathu kuba bantu abayi-100 basebenzisa iyeza. Ngokuqhelekileyo kucingelwa ukuba kwenzeke kumayeza aphezulu aphethwe kwiinkcaso zegazi ezingama-50 milligram (mg) nganye ngeyure.
I-Platinum-Based Based Chemotherapy
I-Cisplatin kunye neCarboplatin zimbini zezilwanyana eziphambili ze-chemotherapy (anti-neoplastics) ezi-ototoxic. Ziqhelekileyo zisetyenziselwa unyango lwee-khansa ezahlukeneyo kubandakanya:
- umhlaza wesibeleko kunye nomhlaza
- nomhlaza wesisu
- umhlaza wemiphunga
- intloko kunye nentamo yomhlaza
Quinine
I-Quinine isetyenziselwa ukunyanga i-malaria kunye neentambo zomlenze. Ukunyanga kwexesha elide kunye ne-quinine kuthwala ingozi engama-20 ekhokelela ekubeni kukho ukulahlekelwa kwindlebe ephakamileyo, edlalwa ukuba isisigxina ukuba ukulahlekelwa kwintetho yengxoxo evamile. I-Quinine nayo ibangela ukuba ilahleko yokuva idibene ne-syndrome ebizwa ngokuthi i- cinchonism :
- u sithulu
- vertigo
- ukukhala ezindlebeni zakho
- intloko
- ukulahleka kombono
- isicaphulelo
Salicylates
I-Salicylates efana ne-aspirin inomngcipheko we-ototoxicity kumazinga aphezulu kwaye ingabangela ukulahlekelwa kweendlebe ze-decibel ezingama-30, ezilinganayo nokuhlekisana. Nangona kunjalo, umonakalo ungabalwa ngokuphantsi nje kwe-tinnitus ezincinci kwiqondo eliphantsi le-aspirin. Amadoda abancinci ngokukhethekileyo abonakala esemngciphekweni wokulahlekelwa kwindlebe ehlobene nokusetyenziswa kwe-aspirin. Umngcipheko unako ukusuka kuma-12 ukuya kuma-33 ekhulwini ngokusekelwe kwimiba yokusetyenziswa.
Vinca Alkaloids
I-Vincristine yinyango ekwenzeni unyango lwe-lymphocytic leyemia (ALL), i-Hodgkin lymphoma kunye nezinye i-cancer. Eli galelo lijongene kakhulu nomngcipheko omkhulu wokubangela ukulahlekelwa kwindlebe xa isetyenziselwa ukudibanisa ne-anti-antibiotics yama-aminoglycoside.
Ukuchonga ukuvalelwa kokulahleka okuhlobene no-Ototoxicity
Ngaphambi kokunyanga unyango kunye neyeza elijongene nobungozi bokuthi u-ototoxicity, kufuneka ubone i-audiologist ye-audiogram yesiseko. Ugqirha wakho uya kuthi ke ukuba ngaba i-audiogram ehleliweyo ehleliweyo iya kufuneka iqhutywe okanye i-self-assessment of hearing yakho. Ngoxa le nto ayiyi kuthintela ukulahlekelwa kwindlebe ehambelana nokutshatyalaliswa kwamanzi, kuya kukunceda uqonde iingxaki ekuqaleni.
Ukunyangwa kwe-Ototoxicity evelele Ukulahlekelwa
Akukho okwangoku naluphi na unyango olufumanekayo ukubuyisela umonakalo osisigxina kwiindlebe zangaphakathi. Ukuba unesifo sokulahlekelwa kwindlebe, ukuxhamla kwindlebe kukuxhaswa ngokuqhelekileyo. Ukuba unokulahlekelwa kwindlebe ngonaphakade kwiindlebe zombini, ugqirha wakho unokuncoma iimplantshi ze-cochlear . Ukulungiswa ngokuqhelekileyo kuqhelekileyo unyango olukhethiweyo ukuba unobungozi benkxalabo yexeshana okanye isigxina.
> Imithombo:
> I-American Speech-Language-Hearing Association. (2017). Imithi yama-Ototoxic (Imiphumo yeMithi). http://www.asha.org/public/hearing/Ototoxic-Medications/
> Boldenberg, D, Goldstein, BJ. (2011). I-Handbook ye-Otolaryngology Inhloko kunye nokuPhepha kweNeck. Thieme Abapapashi Bonyango. ENew York, NY.
> I-Merck Manual. (2017). I-Ototoxicity eyenziwa yiziyobisi. http://www.merckmanuals.com/professional/ear--nose--and-throat-disorders/inner-ear-disorders/drug-induced-ototoxicity
> Rybak, LP & Brenner, MJ. (2015). I-Otolaryngology yeCumming: i-Vestibular ne-Auditory Ototoxicity. http://www.clinicalkey.com (Ubhaliso olufunekayo)
> I-Vestibular Disorders Association. (2017). Ototoxicity. http://vestibular.org/ototoxicity