Xa kuthathwa ixabiso elaneleyo, i-acetaminophen iyingozi kakhulu
E-Chicago ekupheleni kwee-1982, iicetules ze-acetaminophen (iTylenol) zagqitywa nge-cyanide eye yabulala ngokukhawuleza kumaxhoba asixhenxe angaziwa. Kulolu suku, ukunyanzeliswa komthetho akukafaneli ukumbamba umntu okanye abantu abajongene nale mihla.
I-Chicago Tylenol Ababulali ayibanga nje kuphela ubomi babantu abasixhenxe kodwa iphantse yachitha iMecNeil Imveliso yabathengi, incedisi ye-Behemoth umenzi weziyobisi uJohnson & Johnson nomenzi weTylenol.
Kule nto isetyenziswa ngokuqhelekileyo njengengxaki yokulawulwa kwimeko yenkathazo, ekuphakameni kweTylenol yokwesaba, iMikhiqizo yabathengi be-McNeil ikhishwe izilumkiso zoluntu kwaye ikhumbula zonke iibhotile zaseTylenol ezikhoyo, ezingama-31 ezipheleleyo. Imveliso yabathengi bakwaMcNeil nayo yaqinisekisa uluntu ukuba konke ukuphazamiseka kwenzeka ngaphandle kwefektri.
Kwiiveki ezilandelayo i-Chicago Tylenol Abahlaseli, uJohnson & Johnson bahamba bevela kwi-market-anal-counter market kunye ne-35 ekhulwini leshishini kwi-market share share. Kodwa kungakapheli unyaka weengxaki, i-Tylenol yahlaselwa emva kwe-$ 100 yezigidi zokutshala imali kwixabiso lokunciphisa, ukupakishwa kwezinto ezinobungqina, kunye nokufakwa kwe-caplet ene-gelatin eyayibonakala ilula ukuyigxina kwaye iyanzima ukuphazamisa. Ngexesha leengxaki kunye neminyaka ukususela, kwiintliziyo nangengqondo yoluntu, iTylenol iye yabangela ukholo oluhlala lukhuseleko njengolukhuseleko olukhuselekileyo, olunokuhlawulekayo noluncedo.
Nangona kunjalo, ngenxa yezizathu ngaphandle kokusongela kweso sikhokelo sokulwa nobugebengu, iTylenol inokuba yingozi. Bambalwa abantu abacingi malunga nokuba kuthatyathwa njani, i-acetaminophen ingabangela ukuhluleka kwesibindi esibulalayo. Emva kwakho konke, iibhotile ze-acetaminophen zikhangeleka zingenangxaki xa zifakwe kwikhefu kwikhabhinethi yakho okanye xa zithengiswa ngokudibeneyo kwiqela lexabiso langaphakathi.
Ngethamsanqa, iziphumo ze-acetaminophen zetyhefu zinokupheliswa xa i-antidote ilawulwa kwiiyure eziyi-10 zokuqala zetyhefu.
Ukuqonda iTylenol
Emzimbeni, iTylenol ingena ngokusabalalisa ngephepha lesisu. I-Tylenol phantse i-100 yeepesenti i-bioavailable yenza ukuba iphumelele kwaye ibe yingozi. Kuthatha malunga nemizuzu engama-30 ukuze i-analgesic (i-relief relief) kunye ne-antipyretic (i-fever-breaking break) iipropati eziza kusebenza, kwaye, phantsi kweemeko eziqhelekileyo, imizimba yethu icacile malunga nesiqingatha somthamo weTylenol iiyure ezimbini emva kokungena.
Xa kuthathwa iintlungu kubantu abadala, iTylenol idityaniswe phakathi kwe-600 mg kunye no-1000 mg nganye iiyure ezine ukuya kwezi-6. Akukho mntu kufuneka athathe ngaphezu kwama-4 amagremu eTylenol ngosuku. Iiflethi zeTylenol ziqukethe i-500 mg ye-acetaminophen ngoko akufanele uthathe ii-caplets ezingaphezu kweyesibini emva kweeyure ezithandathu okanye ii-caplets ezisibhozo ngosuku . Inqaku, ukuba unemeko ebuhlungu efuna ukuba uthathe iiflethi ezisibhozo zaseTylenol ngosuku, kufuneka ufune unyango.
Xa kuthatyathwa ngokwexabiso lezonyango, ininzi iTylenol iphulwe ngokusesikweni ngesibindi ngokusebenzisa iinkqubo ze-sulfation kunye ne-glucuronidation. Ukongezelela, inani elincinci leTylenol (elingaphantsi kweesentimitha ezintlanu) lichithwe ngqo ngeentso.
Ekugqibeleni, ngeentlobo zonyango, ipesenti encinci kakhulu ixiliswe yi-cytochrome P-450 inkqubo yokusebenza i-metabolite N-acetyl- p -benzoquinoneimine (NAPQI); I-NAPQ1 ixutywa ngokukhawuleza nge-glutathione ye-hepatic kwi-acetaminophen-mercapturate compound ephinda ikhutshwe yizintso.
Kwiimeko zeTylenol zetyhefu, i-enzyme yesibindi i-cytochrome P-450 ixakeka ngokukhawuleza kwaye izitolo ze glutathione ziphela. Ngenxa yoko, i-metabolite esebenzayo, i-NAPQ1, inobungozi kwaye ibulala iiseli zesibindi, leyo ibangela ukuhluleka kwesibindi.
Ngomnyaka we-2008, i-American Association of Controls Centres yabika ama-71,328 ukutshatyalaliswa kweTylenol kunye kunye nama-80,845 avela eTylenol yedwa.
Abantu abangamashumi amahlanu anesithathu babulawa nguTylenol ubuthi obuncinci ukuya kumalungiselelo ahlangeneyo, kwaye abantu abangama-69 bafa ngenxa yeTylenol yedwa. Ezi zibalo zibonisa inyaniso ebalulekileyo yekliniki malunga neTylenol yetyhefu: Abanye abantu bagqiba ukugqithisa kwi-acetaminophen kuba kubonakala ngathi "banesibindi," kodwa inani elilingana labantu liphela ngokuzenzekelayo letyhefu ngokwabo ngenxa yokuba behluleka ukuqonda ukuba iTylenol yayisemilonyeni ba thabatha.
Wena kunye nabathandekayo bakho kufuneka niqonde ukuba yiyiphi i-formulations-analgesics, amayeza okulala kunye nokubandayo kunye nokunyanga kwamayeza) -nceda i-acetaminophen:
- Lorcet
- ENorco
- NyQuil
- Percocet
- Vicodin
- Darvocet
- Excedrin ES
- I-Unisom I-Formula yesiXhosa yoNcedo
- Lorcet
- Tylox
- NyQuil
- I-Vicks Formula 44-D
- PM Tylenol
- Sominex 2
Ukwenza izinto zibe zibi nakakhulu, iziphumo ezintle zala mayeza ahlanganiswe kunye ne-acetaminophen zingabonakalisa okokuqala iimpawu zeTylenol. Ukuxubusha kungakhokelela ekubambezelweni kokusongela ubomi kwonyango.
I-Tylenol yetyhefu ingabonwa njengezigaba ezine.
- Isigaba 1. Ngeeyure ezingama-24 zokuqala, iimpawu azixhomekekanga kwaye zibandakanya i-malaise, i-anorexia, i-nausea, kunye nokuhlanza. Ngenxa yezizathu ezingaziwa, umntu onobuthi unokuhlakulela i-hypokalemia okanye amanqanaba aphantsi e-potassium egazini.
- Isigaba 2. Ngomhla emibini okanye emithathu, iimpawu zokuqala eziye zadlula, iimpawu kunye nempawu zengozi yesibindi okanye zingasetyenziselwa kubandakanywa ubuhlungu besibindi kunye nesantya kunye neenzymes eziphakamileyo zesibindi (i-serum transaminases). Ngaphandle kwonyango, abaninzi abantu abanetyhefu yesibindi (kuya kuthi, i-hepatoxicity) bafumane ngaphandle kwe-sequelae kwaye bangangeni kwiSigaba 3.
- Isigaba 3. Ngomhla ka-3 okanye wesi-4, ukungaphumeleli kwe-hepatic eqhubela phambili kwenzeka: i-acidosis ye-metabolic, ukungaphumeleli kwintliziyo, ukuxhamla, ukuxhamla kunye neengxaki zesisu esisisigxina.
- Isigaba 4. Kwalabo abasinda kwiNqanaba lesi-3, uhlaziyo luqala malunga neeveki ezimbini ngokubuyiselwa komsebenzi wesibindi kwiinyanga ezimbini.
Ingqalelo, abantu abaxhomekeke kotywala okanye abo abangaxilwanga (umz., I-AIDS) baye bahlala begciniwe kunye ne-acutaminophen kunye nokuhluleka kwe-hepatic. Ukongezelela, abantu ababethabathe isifo sokuhluthwa okanye isifo sofuba basengozini enkulu kuba la mayeza aqhuba umsebenzi we-cytochrome P-450.
Unyango lweTylenol Overdose
Oogqirha baphatha i-Tylenol dose ngokusekelwe kwiiprotoksi eziye zaba nempumelelo ephakamileyo kwixesha elidlulileyo kuquka i-nomogram ekhethiweyo esetyenziswa ngokubanzi esisodwa esisetyenziswayo, uhlobo oluthile lomzobo.
I-antidote yeTylenol ukugqithisa isisifo esibizwa ngokuba ngu-N-acetylcysteine (NAC). Ukusebenza kwe-NAC kuncike kakhulu kwixesha lonyango, kwaye lisebenza kakuhle xa lisebenza kwiiyure eziyi-8 ukuya kwi-10 zokungena komzimba ngokukodwa. Iiyure eziyi-12 ukuya kwi-16, uqala ukubona umphumo wokunciphisa i-antidote; nangona kunjalo, unyango lunokuqaliswa kwiiyure ezingama-24.
Ngaphandle kokugqithisa okunzima, i-NAC inokulawulwa ngamaxabiso angama-17 ngexesha leeyure ezingama-72. Inokuphinda ilawulwe nge-intravenously kwimizuzu engama-20. Izilingo zomsebenzi wesibindi (amazinga enzyme) zilandelwa ukuphucula. Ngeyure enye ukuya kwiiyure ezimbini zokudlula, i-charcoal isebenze inokuphinda ilandelwe ukufumana ezinye zeTylenol. Kwiimeko ezibuhlungu ukuba i-acetaminophen sele ibonakalise intsholongwane, kwaye ukungaphumeleli kwe-hepatic kufikeleleke kuyo, ukutshintshwa kwesibindi kunokufuneka.
ILizwi
Ukuba wena okanye umntu omthandayo uphelile kwiTylenol okanye umkhiqizo oqulethwe yiTylenol, fowuni ye-911 okanye iinkonzo zxamisekileyo ngokukhawuleza. I-Tylenol inetyhefu yimeko yexakeka kwaye ixesha libaluleke-ukulinda ixesha elide ixesha lokulwa ne-NAC liza kusebenza. Ngenxa yokuba izibonakaliso ze-acetaminophen zonyango zizaliswe ngokubanzi, kubalulekile ukuba uxelele bonke ababonelela ngempilo yakho ukuba mhlawumbi uthatha iTylenol kakhulu. (Igumbi eliphuthumayo amagqirha ngokuqhelekileyo ukucima umchamo kumazinga aseTylenol kodwa akuxhomekeke kule nyaniso.)
Inqaku eliqhelekileyo malunga neTylenol: Nangona iTylenol neTylenol ziqulethe izinto zingabonakali, azikho. Ngokwenene ucinge ngesizathu sokuba uthatha iTylenol okanye amanye ama-analgesics angaphezu kwe-counter and counter-remedies. Ezi zonyango zenzelwe ukukhululwa okwethutyana. Ukuba intlungu yakho iqhubeka ixesha elide, kufuneka ufune unyango. Nceda ugcine ukhumbule ukuba iTylenol ayiyi kuphulukana nemiqathango engapheliyo njengemigraines okanye ukulimala kokubuyela emuva.
> Imithombo:
> Hung OL, uNelson LS. Isahluko 184. I-Acetaminophen. Ku: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. I-Tintinalli Yonyango Elijongene Nezimo Eziphuthumayo: Isikhokelo Sokufunda Esipheleleyo, 7e . New York, NY: McGraw-Hill; 2011.
> Olson KR. Isahluko 4. I-Acetaminophen. Ku: Olson KR. eds. Ukutyhefuza nokugqithiswa kweDrug, 6e . New York, NY: McGraw-Hill; 2012.