Imithi yokuThola iMigraine kwiGumbi eliPhezulu
Ngamanye amaxesha ubuhlungu bokuhlaselwa kwe-migraine bukhulu kangangokuba kufuna unyulo lwegumbi lokuphuthuma. Okanye, kwezinye iimeko, isicupunu kunye nokuhlanza okuhambisana nomlinganiselo wokuhlaselwa kwe-migraine ngomlomo weyeza unyango. Kwiindawo zamapolisa okanye kwiziko lokunakekelwa ngokukhawulezileyo, ukuhlaselwa kwe-migraine ngokuqhelekileyo kudla ngokuphathwa ngamachiza angenayo. Kodwa ngubani owona mhle?
Uphando olunye kwi- Neurology ngezigulane ezingama-330 ezinokuhlaselwa kwamagrafu ngokukhawuleza ukufumana i-1g ye-valproate ye-sodium, i-10mg Reglan (metoclopramide), okanye i-30mg i-Toradol (ketorolac).
I-valproate ye-sodium yinkqubo yokulwa ne-anti-seizure mayeza ukuba ngezinye izikhathi ifom yomlomo isetyenziselwa ukuthintela imitha. Enyanisweni, i-American Academy ye-Neurology yagqiba ukuba iimveliso ze-valproate, i-divalproex sodium kunye ne-sodium valproate, iyasebenza (iNqanaba A iziyobisi) ekukhuseleni i-migraines. Oku kuthethwa, kubalulekile ukuqaphela ukuba i-valproate iphikisana nabafazi abakhulelweyo.
I-Reglan (i-Metoclopramide) iyeza-anti-emetic okanye i-anti-nausea. Ikhusela i-dopamine receptors kwingqondo kwaye iyanciphisa ngokuyinhloko i-gastroparesis (xa ukukhutshwa kwesiqulatho sesisu kunqabile). Ngokuqhelekileyo kusetyenziswa njenge-arhente enye yokunyanga imigraines kumagumbi angxamisekileyo. Ingabangela ukuba uzive ungenasiphelo.
I-Toradol (Ketorolac) yi-NSAID ngokuqalisa ngokukhawuleza kwezenzo. Njengo-Reglan, ngokuqhelekileyo kusetyenziswa ngamagumbi aphuthumayo ukuphatha imigraines. Khumbula, nangona kunjalo, ii-NSAID zinemiphumo emibi kwaye zimele zigwenywe ngabanye abantu, ngakumbi abo baneembali zokuphuma kwisu, isifo sesifo kunye / okanye isifo senhliziyo.
Yiyiphi i-This Migraine Study Show?
Kuhlolisiso, zonke izigulane zabika ingqungquthela yokuqala ye-migraine yamanqaku angama-7 okanye ngaphezulu kwinqanaba elingu-0 ukuya kwe-10, kwaye ininzi ayithathanga unyango lwama-migraine.
Emva kweyure enye yokufumana enye imithi emithathu ekhankanywe ngentla, abo bafumana i-valproate ye-sodium baphuculwe ngamanqaku aphakathi kwama-2.8 kanti abo bafumana i-Reglan neToradol baphuculwe ngumyinge we-4.7 ne-3.9 amanqaku, ngokulandelanayo.
Iziphumo zophando zibonise ukuba abafumene i-valproate ye-sodium bafuna imithi yokunceda imfucuza yokuphucula imitha (iipesenti ezingama-69) xa kuthelekiswa nalabo bafumana i-metoclopramide (33 ekhulwini) kunye ne-ketorolac (iipesenti ezingama-52). Uncedo lwamachiza olusisindisayo
Ekugqibeleni, inani elikhulu labamkeli beReglan likhethe ukufumana eli liyeza linye kwixesha elizayo lokutyelelwa kwamagumbi xa kuthelekiswa namanye amaqela amabini.
Oku kuthethwa konke, kwiiyure ezingama-24 emva kokulawulwa kweyeza lokuqala, ukuxilwa kwentloko kwimeko ephantsi kuyo onke amaqela amathathu: i-valproate ye-sodium (i-4%), i-Reglan (iipesenti ezili-11), kunye ne-Toradol (iipesenti ezili-16) -sininzi kakhulu kwisigqibo.
Kuthetha Kanjani Oku Konke?
- I-Reglan kunye neToradol inokukhethwa ngaphezu kwe-valproate ye-sodium njengemithi yokwelapha yokuhlaselwa kwe-migraine kwigumbi loxinzelelo.
- I-Reglan ingaba yimichiza ekhethiweyo phakathi kwezigulane eziya kwi-ER ye-migraine-nangona oku akuwona umthetho okhuni kunye wokukhawuleza.
- Ukuphazamiseka oku kuboniswe apha kukuba uninzi lwezifundo azizange zithintele iintlungu zentloko. Oku kuthetha ukuba sidinga ukwelashwa okungcono ukubonelela intlungu ye-migraineurs ngexesha lokuhlasela kakubi.
I-caveat yesifundo esimele ikhankanywe kukuba uninzi lwabathathi-nxaxheba abazange bathathe i-migraine unyango lokukhusela.
Oku kwenza kube nzima ukuvelisa iziphumo kulabo abanomdla onzima kunye / okanye ongapheliyo (mhlawumbi bathatha imithi yokukhusela).
Enye ingongoma yokukhusela kukuba le miyeza emithathu ayiyiyo yodwa esetyenziselwa ukuphathwa kakubi, ukuhlaselwa kwe-migraine ekhuselekileyo kwigumbi lokuphucula.
Enye indlela yokwenza unyango lwe-migraine kwi-ER yi-sumatriptan yangaphantsi (i- triptan enikezwe njengejoyi kwiimpawu zakho ezinamafutha). Ezinye iintlobo ze-antiemetics ezinjengeCompazine (prochlorperazine) zinokunikezwa, rhoqo kunye no-Benadryl (diphenhydramine) ukukhusela imiphumo emibi ye-antiemetics, njengokungazinzi kunye ne- dystonia .
I-Dihydroergotamine ( DHE ) inokunikwa kwakhona kwigumbi elingxamisekileyo kwaye inokulawulwa njengesipopu esiswini, nge-intravenously, okanye nge-intramuscularly. I-DHE inokubangela i-nausea, ngoko ke i-antiemetic ibonelelwe kwangaphambili ukukhusela oku.
Ekugqibeleni, oogqirha be-ER banikezela i-steroid ebizwa ngokuthi i-dexamethasone enye yezinto ezikhankanywe apha ngasentla-ingcamango eyona nto inokunceda ukunciphisa ithuba lokuba intloko yomntu ibuyele ekuqaleni. I-Hydration kunye ne-IV yetsholongwane iyindawo enkulu yokuphatha i-migraines kwigumbi elingxamisekileyo, ngakumbi ukuba umntu unesicasuliso nokuhlanza.
ILizwi
Ukuba ugqibela ukuya kwi-ER ukuhlaselwa kwamagrafta, ungayifumana imithi (okanye injection, ukuba ugqirha wakho ukunika i-sumatriptan). Ekugqibeleni, yintoni ugqirha ekunika yona isinqumo esisodwa, esekelwe kwimbali yakho yempilo.
> Imithombo:
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> Kostic MA, Gutierrez FJ, Rieg TS, Moore TS, Gendron RT. Uvavanyo olulinganiselayo lwe-prochlorperazine kunye ne-sumatriptan engaphantsi kwe-acraine yonyango echaphazelekayo. Ann Emerg Med . 2010 Julayi; 56 (1): 1-6.
> Silberstein SD et al. Uhlaziyo olusekelwe kwizikhokelo-mboniso: unyango lwe-pharmacologic ye-episodic migraine yokuthintela kubantu abadala: ingxelo yeCommittee Standards Quit of the American Academy of Neurology kunye ne-American Headache Society. Neurology 2012; 78: 1337.