Funda ukuba kutheni i-anti-depressants kunye ne-anticonstsants isetyenziselwa ukunyanga intlungu
I-analgesic adjuvant yileyeza ayilungiselelwe ukulawula intlungu kodwa ingasetyenziselwa le njongo. Eminye imizekelo yeziyobisi ezigulisayo ziyimithi ezinjenge- antidepressants kunye ne- anticonvulsants . Zingabizwa ngokuba yi-coanalgesics.
Unokumiselwa i-analgesic adjuvant ngaphezu kweminye imilenze , okanye yedwa. Iimpawu ze-adjuvant ze-adjuvant zihlala zingasebenzi kakuhle kwiintlungu zomzimba, ezifana nentlungu emva okanye intlungu.
Nangona kunjalo, banokusebenza kakuhle ngenxa yeentlungu zentlungu kunye neentlungu zesifo , ezifana ne- fibromyalgia . Kananjalo banendima ekwenzeni unyango lomhlaza. Ngokungafani namanye amanqaku angama-opioid, ama-analgesics adjuvant ayitholakali kwi-counter.
Iintlobo zeeAjjali zeAjju
Ukuxhatshazwa
Nangona i-anti-depressants idla ingacingi nje ngokuba yimithi yeentlungu, iyakwazi ukunyanga ngokufanelekileyo imeko ezibuhlungu. Abaxinzelelo beengcinezelo bacingelwa ukulawula indlela intlungu ebonakala ngayo ukusuka kumgca wesipelini ukuya kwengqondo. Ukongezelela, i-antidepressants inokunciphisa uxhalaba kwaye inokunceda ukulawula ubuthongo.
Nangona kunjalo, akuzona zonke iintlobo zokuxhatshazwa kweengcinezelo ezisebenzayo ekulawuleni ubuhlungu obungapheliyo . I-Tricyclic antidepressants (TCAs) ezifana ne-amitriptyline, i-serotonin reuptake inhibitors (i-SSRIs) ekhethiweyo, njenge-duloxetine kunye nezinye, njenge-nefazodone, zisetyenziselwa ukuphatha iintlungu zombilini ezingapheliyo kunye neentlungu zentlungu. I-Monoamine oxidase inhibitors (i-MAOIs) ayisebenzisi kakuhle ekulawuleni ubuhlungu obungapheliyo.
Anticonvulsants
I-Anticonvulsants, eziyimichiza esetyenziswa kakhulu ekulawuleni iziphazamiso zokungena, zingasetyenziselwa ukuphatha intlungu engapheliyo. I-Anticonvulsants isebenza ngokungavumeli iintlobo ezithile zeentsholongwane zegazi, kwaye zinokunciphisa intlungu e-neuropathic, njengaleyo ebangelwa yi -neuralgia ye-trigeminal okanye i-neuropathy ye-diabetes.
I-Anticonvulsants ezisetyenziswa ngokubanzi ukulawula intlungu engapheli ziquka i-gabapentin kunye ne-pregabalin.
I-Gabapentin yiyona ndlela isetyenziswa ngayo kakhulu. Ezinye izigulane ezingaphenduli kakuhle kwi-gabapentin zithatha indawo endaweni ye-pregabalin, kwaye ngokufanayo.
Ziziphi ii-Syndromes zobuhlungu Ngaba uhlalutyo lwe-adjuvant Treatment?
I-Oxford Textbook ye-Mediclium Palliative kunye ne-Merck Manual dwelisa ezi zilandelayo zi-analgesics ezihlaziyiweyo ukuphatha unyango lweentlungu:
Iimvumi ezisetyenziselwa iintlobo ezininzi ze-Syndromes zobuhlungu
- Corticosteroids
- Dexamethasone
- Prednisone
- I-Tricyclic antidepressants
- I-Amitriptyline: ayinyanzeliswa kwabalupheleyo okanye izigulane ezineengxaki zentliziyo.
- Desipramine
- I-serotonin ekhethiweyo kunye ne-norepinephrine reuptake inhibitor (SNRI)
- I-Duloxetine: Kungcono ukunyamezela ngaphezu kwe-tricyclic antidepressants.
- EMilnacipran
- I-Alpha-2-adrenergic agonists
- Tizanidine
- Iingongoma zengqondo: i-capsaicin ingasetyenziselwa ubuhlungu be-neuropathic kunye ne-arthritis.
- I-anesthetics yendawo: njenge-lidocaine patch
Izilwanyana ezisetyenziselwa ubuhlungu be-neuropathic
- Antiepileptic agents
- I-Gabapentin: Le yiyilisi ekhethiweyo ye-anticonvulsants.
- Pregabalin
- I-Carbamazepine: le yonyango lokuqala lokuqala lwe-neuralgia yama-trigeminal.
- I-Phenytoin: ithathwa njengesicatshulwa sesibini.
- I-Valproic acid: isetyenziselwa intloko.
- Clonazepam
- Lamotrigine
- Topiramate
- Tiagabine
- Oxcarbazepine
- Lacosamide
- Abaphikisi be-NMDA
- IMemantine
- Ketamine
- I-Dextromethorphan: isetyenziswe xa intlungu inomlinganiselo ovuzayo.
- Iimpawu zecaladi zesineli zomlomo
- Mexiletine
- Tocainide
- I-Baclofen: Isetyenziselwa kwi-neuralgia yama-trigeminal.
Calcitonin
Iimvumi ezisebenzisayo Ukusetyenziswa kwiComplex Pain Syndrome
- Calcitonin
- Clonidine
- Prazosin: Intlungu yesifo somhlaza
- I-bisphosphonates ( umzekelo , i-pamidronate)
- Calcitonin
- Radiopharmaceuticals
ILizwi
Ukuba uyazibuza ukuba kutheni amayeza ahlukeneyo asetyenziselwa ukunyanga ubuhlungu bakho obungapheliyo, cela udokotela wakho okanye ukhemistri ukuba achaze. I-biochemistry echaphazelekayo ingaba nzima, kodwa unokuqinisekiswa ukuba uyamkela imishanguzo echanekileyo eya kusebenza kunye ukubonelela ukuxhamla intlungu.
> Imithombo:
> Lussier D, Portenoy RK: Ii-Analgesics ze-Adjuvant. KuDoyle D, uHanks G, uCherny NI, uCalman K (eds): I-Oxford Textbook ye-Mediclial Palliative. I-Oxford: I-Oxford University Press, 4 Ed, iOxford: i-Oxford University Press, ngo-2011.
> Markman, J, et. al. Inqatyana Yobunzima. I-Merck Manual Professional Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/pain/threatment-of-pain.