Ukuxhatshazwa kweengxaki zoNyango lwezoNyango zoNyango oluPhezulu
Ukuba unobandezeleka obungapheliyo kwaye uzame konke onokukwazi ukukhupha intlungu yakho, i-opioids (i-narcotics) ingaba yindlela okhetha ukuyithatha. Nangona ukusetyenziswa kwezi zintlungu ezinamandla (i- analgesics ) kwixesha elide lokunyangwa kwengxaki engapheliyo kuyinto engavisisaniyo, leziyobisi zingasebenza kwaye zikhuselekileyo xa zithathwa phantsi kolawulo lwezempilo olufutshane.
Nakhu okumele uwazi ngaphambi kokugqiba ukuba i-opioids ilungile kuwe.
Ziziphi ii-opioids?
I-opioids ivela kwenye yeendawo ezintathu: Ezinye zivela kwizityalo, ezinye zenziwa kwibhabhi, kwaye ezinye, njenge-endorphins, zivela ngokwemvelo emzimbeni. I-opioids iyasebenza kakhulu kunyango lweentlungu. Enyanisweni, bahlala besetyenziselwa ukunyanga iintlungu ezinjenge-post-injection, kunye neentlungu ezibangelwa zizifo ezifana nomhlaza.
Iintlobo zeepioids
Ngokuxhomekeka kwiimfuno zakho, unokuthatha enye yeentlobo ezimbalwa zeepioids ezisetyenziselwa ukuphatha intlungu engapheliyo . Phakathi kweklasi yamayeza eyaziwa ngokuba yi-opioids, kukho ukuhlukana okukhulu.
Okokuqala, i-opioids inokuqulunqwa njengamayeza atywala ixesha elide okanye elifutshane.
I-opioids ihluke kunye nomnye ngendlela ewanikwa ngayo. Ezinye zinikezwa nge-IV ngaphakathi kwesandla, ingalo, okanye kwi-port okanye umgca we-picc. Ezinye zinikezwa ngomlomo, ezinye ziyakunikwa njenge-rectal suppository, kwaye ezinye ziza kwifom ye-patch oyisebenzisayo kwesikhumba sakho.
Ezinye i-opioids zinokunikezwa ngendlela engaphezu kweyodwa, kodwa ezinye zilinganiselwe kwindlela enye yokuhambisa.
Olunye umehluko obalulekileyo kukuba ezinye i-opioids, ezifana ne- oxycodone ad hydromorphone "ziyi-narcotics ngqo." Abanye, njengeTylenol # 3 no- Vicodin , banokuxutyaniswa nezinye iintlungu ezibulala abafana neTylenol (acetominophen.)
Enye iklasi ye-opioids, echazwa njenge-agonist / antagonist, idibanisa amachiza ukunciphisa intlungu kunye nokunciphisa amandla okuxhomekeka. Ezi ziquka i-buprenorphine kunye ne-butorphanol.
Iimpembelelo zeeOpioid Side and Other Complications
Abantu abaninzi abaneentlungu ezingapheliyo banokunyamezela isilinganiselo se-opioid efanayo iminyaka ngaphandle kokwakha ukunyamezela kweziyobisi, okanye ngaphandle kokuxhomekeka kwimeko yeziyobisi. Nangona kunjalo, ukuxhomekeka kunye nokuxhatshazwa kukukhathazeka ngokusemthethweni.
Ngelishwa, abaninzi abanezifo ezingapheliyo abazithatha i-opioids bangadla ngokugqithiseleyo "njengezilonda," nangona bengayifumani imigaqo yokubakho umlutha. Ngamanye amaxesha uhlazo oluthile lunxulumene nokuthatha imithi yeentlungu ze-narcotic, ezinokukhungathekisa umntu onentlungu engapheliyo.
Ukongeza kwenyamezelo kunye nokuxhomekeka kwenyama, i-opioids ineminye yemiphumo emibi. Ezi ziquka:
- Ukulala
- Ukudideka
- I sizathu
- Ukutyunjwa
- Ukugcinwa kweedolophu
- Ukuphefumula okunzima
- Ukungasebenzi kwezesondo
- Uxinzelelo lwegazi oluphantsi
- Ukutsalwa kwemizwa
I-opioids inokuchaphazela abantu abadala kunye nabantwana abangaphezu kwabantu abadala, ngoko ke la maqela kufuneka ahlolwe ngenyameko. Ngamaxesha amaninzi, oogqirha baya kuqala amayeza e-opioid kakhulu kwaye bawandise ngokukhawuleza ukuya kwinqanaba leyeza.
Amanye amachiza angasebenzisana kakubi nama-opioids, ngoko kuhlolwa ngokunyamekileyo kuyadingeka ukuba uthathe nezinye iimiselo rhoqo. Qinisekisa ukuxelela ugqirha wakho nayiphi na enye imichiza oyithathayo, kuquka abo bathengiweyo kwi-counter, ukuphepha iingxaki ezinokubakho, ezifana nokugqithiswa kweziyobisi.
Ngokuqinisekileyo, kunikwe ubuthongo nokudideka okunokuthi kwenzeke njengempembelelo yecala lala mayeza, kodwa njengolu hlobo lwezoxilongo, uphando olutshanje lufumene ukuba ukuqhuba ngexesha lokusebenzisa i-opioids ngenxa yobuhlungu obungapheliyo akuzange kube nzima ngakumbi ukusebenza.
Izikhokelo ze-CDC zokuLawulwa kwama-Opioids for Pain Chronic
Ngenxa yokunyuka okukhulu kwee-overdoses ezinxulumene nokusetyenziswa kwama-opioids ngenxa yeentlungu ezingekho komhlaza, amaZiko okuLawulwa kweNtsholongwane kunye nokuVikela (i-CDC) akhuphe izikhokelo zokusetyenziswa okukhuselekileyo kweepioids kubantu abaneentlungu ezingapheliyo.
Ezinye zezi ngcebiso ziquka:
- 1. I-opioids ayifanele isetyenziswe njengolu hlobo "lokuqala" lonyango olunezinhlungu ezingapheliyo. Ezinye iziyeza zentlungu kufuneka zingasetyenziswanga kuqala ngaphambi kokusebenzisa i-opioids. Xa i-opioids iyadingeka, kufuneka isetyenziswe kunye nezinye iindlela zokwelapha (ukunciphisa okwenziwe ngama-opioids ezifunekayo kwezinye izizathu.) Iimvumi ezingekho nge-opioid zibandakanya izidakamizwa ezingekho-steroidal ezichasayo ezifana ne-Advil (ibuprofen), i- tricyclic antidepressants , kunye namayeza anxamnye ne-anti-seizure (anticonvulsants) njenge-Neurontin ( gabapentin .)
- 2. Iinjongo zonyango kufuneka zenziwe. Kumele kugqitywe ukuba ukongeza kwonyango lwe-opioid kuya kuphucula umgangatho okanye umgangatho wobomi obaneleyo ukuba ubhekane neemeko ezifanelekileyo ezifanelekileyo.
- Ingxoxo yomgulane isigulane kufuneka ivele apho isigulane siyiqonda ngokucacileyo ingozi kunye neenzuzo zokusebenzisa i-opioids ukuphatha intlungu.
- 4. Ukukhutshwa ngokukhawuleza i-opioid (ngokungafani ne-opioid ende ende) kufuneka isetyenziswe kuqala.
- 5. Inani eliphantsi kakhulu leyeza kufuneka libekwe. (Kukho amacwecwe adibanisa amanani wee-narcotics ezahlukeneyo ukuba uya kutshintshwa kwimiyeza enye kwenye.)
- 6. Iifutshane ezimfutshane zeengxaki zonyango kufuneka zichazwe ukuba zenzeke iintlungu ezibangelwa ngentlungu engapheliyo.
- 7. Vala ukulandelelana kuyadingeka. Ekuqaleni kunyango, ukuhanjelwa kweklinikhi kufuneka kwenzeke kanye ngeveki okanye ubuncinane amaxesha amaninzi ngenyanga. Xa la mayeza asetyenziswa ixesha elide, ukusebenzisa kwabo kufuneka kuhlolwe ubuncinane kwiinyanga ezintathu kwaye ukuba intlungu ayiphuculanga kwiyeza kufuneka imiswe.
- 8. Oogqirha kufuneka basebenzise iindlela zokunciphisa kakubi imichiza. Oku kungabandakanya ukusebenzisa intsebenziswano ye-agonist / umchasene ukuba kunokusetyenziswa kakubi.
- 9. Oogqirha kufuneka basebenzise iinkcukacha ze-POMP ukuqinisekisa ukuba omnye ugqirha akayi kugunyazisa i-opioids ukwenzela ukunciphisa umngcipheko wokugqithisa.
- Ukuhlolwa kweziyobisi ze-urine kufuneka kusetyenziswe ukuqinisekisa ukuba umntu usebenzisa zombini amayeza akhekileyo kwaye akasebenzisi iziyobisi ezingaphazamisa unyango.
- 11. Ukuba kunokwenzeka, i-opioids ayifanele ihlanganiswe ne-benzodiazepines.
- 12. Ukuba ukuxhomekeka kwi-opioid kwenzeka, oogqirha kufuneka ukuba balungele ukunikezela unyango lobisi.
Kutheni Usebenzisa ii-opioids kuzo zonke?
Ngenxa yokuphikisana okuninzi malunga nokusetyenziswa kwabo kwiimeko ezibuhlungu ezingapheliyo, unokuzibuza ukuba kutheni oogqirha beka opioids nonke. Ukubeka nje, i-opioids iyasebenza kakhulu ekunciphiseni ubuhlungu obukhulu, kwaye abaninzi abantu abangazange bafumane imiphumo evela kwezinye izibonelelo bafumane ukukhulula kuphela ngokusebenzisa i-opioid. Kuba bantu, iinzuzo ze-opioids zigqithise kakhulu ingozi. Imiphumo emibi nefuthe yokuxhomekeka ayenzeki nakwiimeko zonke. Kubantu abaninzi abaneentlungu ezingapheliyo, i-opioids inokubanceda ukubuyisela umgangatho wobomi.
Ngaphambi kokuba uqale kwi-opioids, ugqirha wakho kufuneka enze uvavanyo olupheleleyo kunye nokucwangcisa ukubonisana rhoqo ukujonga imeko yakho. Abanye oogqirha banokuqala ngetyala le-opioid, ngokunyuka kwandisa umthamo wakho ngelixa ukhangelelwa iingxaki ezinokubakho.
Imithombo:
I-Campos-Outcalt, D. I-Opioids ye-Pain Pain: Iingcebiso ze-CDC ze-12. Umbhalo Wezenzo Zentsapho . 2016. 65 (12): 906-909.
Amacandelo okuLawula nokuKhuselwa kwezifo. Ukuxhatshazwa kunye nokufa kweeVeki ngeveki (MMWR). I-CDC Isikhokelo sokuBhala iiOpioids for Pain Pain - United States, 2016. Ukuhlaziywa 03/18/16. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
Chou, R., Devo, R., noJ. Fryly. I-Pharmacologic Treatment System yoBugcino obuPhezulu obungapheliyo: Ukuphononongwa ngokuSisiseko kwi-College of Physicians. Amanqaku angamayeza angaphakathi . 2017 Feb 14. (Epub ngaphambi kokuprinta).
Schumacher, M., Jongen, S., Knoche, A. et al. Impembelelo Yonyango lwe-Opioid kwiNgqinisiso yokuSebenza ngokuPhezulu kwiiNgxaki ezingenayo iCancer Pain Patients. Psychopharmacology . 2017 Feb 12. (Epub ngaphambi kokuprinta).