Ðe wòle be míanya nu tso atike siwo wua ʋusɔgbɔdɔ ŋu nyuiea?

Anɔ eme be èsena le ɖokuiwò me be yeƒe lãme gbãna eye nèɖea aɖuɖɔ ɣeaɖewoɣi, alo? Enye nusi me dziɖeleameƒo le ŋutɔŋutɔ. Eyata egbea míele nu ƒom tso atike ƒomevi aɖe si ate ŋu akpe ɖe ame ŋu wòaɖu nusiawo abe ʋuʋudedi kple ʋuʋudedi ene dzi ahatɔ te wo ŋu. Esiawoe nye atike siwo míeyɔna be atike siwo wua ʋusɔgbɔdɔ . Na míakpɔ nusiwo nye esiawo, alesi wowɔa dɔe, kple ɣeyiɣi si wozãa wo ɖa.

Nukawoe nye atike siawo siwo wua ʋusɔgbɔdɔ?

Kpuie ko la, ``Antiemetic drugs`` nye atike siwo wonana be woatsɔ axe mɔ ɖe ʋuʋudedi kple ʋuʋudedi nu, alo be woatsɔ adae ne edzɔ. ``Anti-`` gɔmee nye ``tsitretsitsi.'' Nya ``-emetic`` tso nya ``emesis`` me. Le atikewɔwɔ me la, wozãa nya ``(emesis)`` hã na ʋuʋudedi. Eyata, esiawo nye atike siwo wonana be woatsɔ axe mɔ ɖe ʋuʋudedi nu.

``Antiemetic`` atike ƒomevi geɖewo li, siwo nye ``atike ƒe hatsotso vovovowo``. Wo dometɔ aɖewo ateŋu axɔ tso atikedzraƒe atike si woŋlɔ na wò manɔmee (si woyɔna be ``Over-the-counter`` alo ``OTC`` atikewo). Gake wo dometɔ aɖewo ateŋu axɔ ne ɖɔkta ƒe atikewɔmɔnu (`` atike siwo woŋlɔ na wo`` ). Esi wònye be nu geɖe li siwo hea ʋuʋudedi kple ʋuʋudedi vɛ ta la, ``Antiemetic`` atike tɔxɛ aɖewo li siwo sɔ na nusi gbɔ wòtsona ɖesiaɖe.

Ɣekaɣie mehiã atike si tsia ʋuʋudedi nu?

Fifia ɖewohĩ èle eŋu bum be, ‘Ekema ɣekaɣie mahiã atike sia tɔgbe?’

Le nyateƒe me la, aɖuɖɔtoe nye míaƒe ŋutilã ƒe ametakpɔnu ɣeaɖewoɣi. Bu eŋu kpɔ, ne èɖua nuɖuɖu siwo gblẽ, alo ne dɔgbo le vevem (dɔgbometsi) la, anyo wu be nàɖe aɖuɖɔ eye nàɖe aɖi si le wò ŋutilã me ɖa.

Gake ne ʋuɖɔɖɔa nu sẽ alo edzɔna enuenu la, ate ŋu ahe lãmesẽkuxi sesẽwo vɛ. Le kpɔɖeŋu me:

• Ƒuwo ƒe gbagbã ate ŋu adzɔ gɔ̃ hã, vevietɔ le ame tsitsiwo gome.
• Tsikuɖiɖi nye tsi si bu le ŋutilãa me.
• Nuɖuɖutome ƒe gbagbã, si wogayɔna be Boerhaave ƒe dɔléle.
• Nuɖuɖudzroame ƒe vɔvɔ .
• Nunyiame ƒe anyimanɔmanɔ (`Nunyuimakpɔɖu`).
• Susu me tɔtrɔwo.
• Aɖu ƒe ʋuʋudedi vuvuna.
• Amekoko ƒe abiwo ateŋu agbugbɔ aʋu (`Reopening of surgical wounds`).

Le nusiwo le abe esia ene ta la, ɖɔktawo ŋlɔa ``Antiemetic`` atike sia ɣeaɖewoɣi be woatsɔ axe mɔ ɖe ʋuʋudedi nu alo be woadzudzɔ ʋuʋudedi si dze egɔme xoxo.

Kpe ɖe ame ŋu le ʋuʋudedi kple ʋuʋudedi si nɔa anyi ɖaa ŋu

Ne ʋuʋudedi kple ʋuʋudedi sesẽ alo ɣeyiɣi didi aɖe le ŋuwò la, wò ɖɔkta ate ŋu aŋlɔ atike si nye ``Antiemetic'' na wò. Na míalé ŋku ɖe eƒe kpɔɖeŋu aɖewo ŋu.

• Kekeli kple atikewɔmɔnu ƒe ʋuʋudedi kple ʋuʋudedi (CINV): Aɖuɖɔtoe kple/alo ʋuʋudedi nye atikewɔmɔnu ƒe nugbegblẽ le ame ŋu si bɔ. Kekeli ƒe atikewɔwɔ na ahɔhɔ̃, dɔgbo, alo aklã hã ate ŋu ahe nugbegblẽ le ame ŋu siawo vɛ. Le susu sia ta la, ɖɔktawo kafui be nàno atike si wua ʋusɔgbɔdɔ ne èle atike alo keklẽŋusẽdɔdamɔnu zãm. Esia le alea elabena ʋuʋudedi kple ʋuʋudedi si gbɔ eme ate ŋu anye afɔku gã aɖe na amesi ŋu kansa le.
• Aɖuɖɔtoe kple ʋuʋudedi le fufɔɣi (si woyɔna hã be `ŋdi dɔléle`): Ðɔkta aɖewo kafu `antiemetictics` siwo womeƒlena o na esia. Nenema ke le `hyperemesis gravidarum` gome la, ɖɔktawo kafui be woaƒle `antiemesis` atike siwo womexɔna le atikedzraƒe o alo esiwo woŋlɔ na wo.

Nu vevitɔe nye be nàƒo nu kple wò ɖɔkta tso ɣeyiɣi kple alesi nàzã `(Antiemetic)` atike siawo ŋu. Ɣeaɖewoɣi, vevietɔ le nɔnɔmewo abe `(CINV)` ene me la, ahiã be nàzã `(Antimetic)` siwo wu ɖeka. Ne lãmetutudɔ kple ʋuʋudedi le fu ɖem na wò le fufɔɣi , ele be nàƒo nu kple ɖɔkta godoo hafi ano atike ɖesiaɖe le atikedzraƒe.

Atike si wozãna na ʋuʋudedi kple ʋuʋudedi kpata

Ɣeaɖewoɣi la, ne kakaɖedzi le eŋu kloe be ʋuʋudedi kple ʋuʋudedi adzɔ la, ɖɔktawo ŋlɔa ``Antiemetic`` atike sia be woatsɔ axe mɔ ɖe enu. Bu eŋu ale.

Atike geɖe, abe atike siwo naa alɔ̃dɔdɔ (siwo wozãna le alɔ̃dɔdɔ me) kple opioid , ate ŋu ana ame natsi dzodzodzoe eye wòaɖe aɖuɖɔ abe eƒe nugbegblẽ le ame ŋu ene. Ðɔktawo zãa atike siawo na nuwo abe amekoko ene. Eyata, be woaxe mɔ ɖe ʋuʋudedi kple ʋuʋudedi nu le amekoko megbe (dɔwɔwɔ vɔ megbe ʋuʋudedi kple ʋuʋudedi - PONV), woana atike si wua ʋuʋudedi wò.

Vertigo kple ʋuʋu ƒe dɔléle hã ate ŋu ana ame natsi dzodzodzoe eye wòaɖe aɖuɖɔ. Ne èle nɔnɔme aɖe si me wòanya wɔ be dzesi siawo nadze le ŋuwò (le kpɔɖeŋu me, le mɔzɔzɔ didi aɖe me, abe le bɔs alo meli me ene) la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàno atike si wua ʋusɔgbɔdɔ.

To vovo na esia la, nɔnɔme bubuwo ateŋu anɔ anyi siwo me ɖɔkta ateŋu aŋlɔ ``Antiemetic'' na wò.

Atike kawoe li be woadzudzɔ aɖuɖɔtoe?

Azɔ mina míakpɔe ɖa be atike siwo wua ʋusɔgbɔdɔ ƒomevi kawo li. ``Antiemetic'' atikewo ƒe hatsotso adre koŋue li. Atike ƒomevi vovovowo le hatsotso ɖesiaɖe me.

1. Serotonin ƒe dɔlékuiwutikewo

Esiawo nye ``Antiemetic`` ƒomevi aɖe si wozãna zi geɖe ŋutɔ si wonana koŋ tsɔ daa ʋuʋudedi kple ʋuʋudedi. Esiawo ƒe kpɔɖeŋu aɖewoe nye:

• `Granisetron (Kytril®)`
• `Ondansetron (Zofran®)`
• `Palonosetron (Aloxi®)`

United States ƒe Nuɖuɖu Kple Atike Ŋuti Dɔwɔƒe ( FDA ) da asi ɖe atike sia dzi be wòaxe mɔ ɖe nusiwo gbɔna nu:

• `CINV` (kansa dada ƒe ʋuʋudedi kple ʋuʋudedi) kple ʋuʋudedi kple ʋuʋudedi si keklẽŋusẽ ƒe atikewɔwɔ hena vɛ.
• `PONV` (si fia be amekoko le dɔwɔwɔ vɔ megbe ƒe ʋuʋudedi kple ʋuʋudedi).

Gake ɣeaɖewoɣi la, ɖɔktawo ŋlɔa atike siawo na dɔléle bubuwo. Woyɔa esia be `off-label` zazã, si fia be wozãa wo na taɖodzinu bubu siwo menye esiwo dzi FDA da asi ɖo o.

2. Atike siwo wua histamine

Ðɔktawo koŋ zãa atike siwo wua histamine, vevietɔ esiwo xea mɔ na histamine 1 (H1) xɔla, tsɔ léa dzesi siwo do ƒome kple nulɔdɔwo nu. Gake esiawo dometɔ aɖewo nye esiwo dzi FDA da asi ɖo be woatsɔ axe mɔ ɖe ʋuʋudedi kple ʋuʋudedi si ʋuʋu kple ʋuʋudedi hena vɛ nu ahada wo. Ɣeaɖewoɣi la, ɖɔktawo ate ŋu aŋlɔ wo na wo le mɔ si womeŋlɔ o nu ne atike bubu siwo tsia ʋuʋudedi nu kple ʋuʋudedi le fufɔɣi mewɔ dɔ o. Atike siwo wua ʋumenugbagbeviɣidɔ ƒomevi aɖewoe nye esi:

• `Dimenhydrinate` atikekui siwo woate ŋu aɖu (`Dramamine®`) .
• Diphenhydramine ƒe atikekuiwo alo atikekuiwo (Benadryl®) .
• Vitamin B6 kple `Doxylamine succinate` – Esia nye atike gbãtɔ na ʋuʋudedi kple ʋuʋudedi le fufɔɣi.
• `Meclizine (Antivert®, Ƒumeŋuɖui®, Dramamine-N®)`
• `Promethazine (Phenergan®) ƒe atike si wotsɔna ƒoa ƒui`

Atikewo abe diphenhydramine kple dimenhydrinate ene hã ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe PONV (dɔwɔwɔ vɔ megbe ƒe ʋuʋudedi kple ʋuʋudedi) nu, gake zi geɖe la, menye woawoe nyea atike gbãtɔ siwo wozãna nɛ o.

3. Glucocorticoids ƒe atikewo

Glucocorticoids (alo corticosteroids) nye atikewo ƒe hatsotso aɖe si ɖɔktawo zãna koŋ le woƒe dɔlélenutsiŋutete kple dɔlékuiwutikewo ta. Gake glucocorticoid aɖewo hã wɔa dɔ abe atike siwo wua ʋumenugbagbeviɣidɔ ene.

Dexamethasone (Baycadron Elixer®, Decadron®, Zema-Pak®, kple atike bubuwo) ye nye glucocorticoid vevitɔ si ɖɔktawo zãna tsɔ xea mɔ na CINV (aɖuɖɔtoe si kansa dada hena vɛ) kple PONV (aɖuɖɔtoe si dona le dɔwɔwɔ vɔ megbe).

Ðɔktawo naa `(Glucocorticoid)` ɣeaɖewoɣi kpe ɖe `(Antiemetic)` ƒomevi bubuwo ŋu be woaxe mɔ ɖe ʋuʋudedi kple ʋuʋudedi nu. Gake to vovo na `(Antiemetic)` bubu aɖewo la, `(Glucocorticoids)` mate ŋu ada ʋuʋudedi kple ʋuʋudedi ne enya dze egɔme ko o. Eyae nye be, ɖeko wotsɔ wo na be woatsɔ axe mɔ ɖe enu.

4. Atike siwo tsia ʋumenugbagbeviɣidɔ nu

Anticholinergics (si woyɔna hã be antimuscarinics) nye atike ƒomevi aɖe si xea mɔ na atike aɖe si woyɔna be acetylcholine (ahɔhɔ̃mekawo ƒe dɔwɔwɔ) ƒe dɔwɔwɔ. Woate ŋu akpe ɖe ame ŋu le dɔléle vovovowo dada me (abe aɖuɖɔtoe ƒe dɔmawɔmawɔ nyuie kple COPD ene), eye woate ŋu akpe ɖe ame ŋu le ʋuʋudedi kple ʋuʋudedi hã me.

Scopolamine (Maldemar, Scopace, Transderm Scop®) ye nye atike vevitɔ si wozãna tsɔ tsia ʋumenugbagbeviɣidɔ nu. Ðɔktawo zãnɛ tsɔ:

• Xɔ mɔ na `PONV` (dɔwɔwɔ le dɔwɔwɔ vɔ megbe ƒe ʋuʋudedi).
• Be woaxe mɔ ɖe ʋuʋudedi si ``ʋuʋudedi`` (ʋuʋudedi ne wole mɔ zɔm) hena vɛ nu alo adae.

5. Neurokinin-1 ƒe dɔlélenutsiŋutete ƒe mɔxenuwo

Neurokinin-1 (NK-1) receptor antagonists wɔa dɔ to dzɔdzɔmenu aɖe si le wò ahɔhɔ̃ me si woyɔna be neurokinin si hea ʋuʋudedi kple ʋuʋudedi vɛ la xexe me. Atike siawo wɔa dɔ ŋutɔ le CINV (dɔdzẽ si tsoa kansa gbɔ) kple PONV (dɔdzẽ si dona le dɔwɔwɔ vɔ megbe) dada me. Dɔlékuiwutike siwo tsia dzimaɖitsitsi nu (anxiolytic) kple blanuilélenutsitike hã le wo si.

Atike siwo le hatsotso sia mee nye:

• `Aprepitant (Aponvie®, Emend®` kple `Cinvanti®)`
• `Fosaprepitant (Emend®` kple `Focinvez®)`
• `Netupitant` kple `palonosetron` ƒe ƒuƒoƒo (`Akynzeo®)`
• `Rolapitant (Varubi®) ƒe atike si wotsɔna ƒoa ƒui`

6. Dopamine ƒe dɔlékuiwutikewo

Dopamine ƒe mɔxenuwo nye atike ƒomevi aɖe si xea mɔ na lãmenugbagbevi ƒomevi aɖewo siwo le wò ahɔhɔ̃ me be woagawɔ tu o. Wonye atike vevitɔ na susumedɔléle kple dzesi aɖewo, vevietɔ tagbɔdɔléle kple tagbɔdɔléle . Ke hã, ƒomevi siawo dometɔ aɖewo ate ŋu akpe ɖe ame ŋu le ʋuʋudedi kple ʋuʋudedi hã me.

Dopamine ƒe mɔxenu ƒomevi vovovowo li siwo wozãna na aɖuɖɔtoe:

• `Amisulpride (Barhemsys®) ƒe atike si wotsɔna ƒoa ƒui`
• ``Klorpromazine (Thorazine®) ƒe atike si wotsɔna ƒoa ƒui''.
• `Droperidol (Inapsine®) ƒe atike si wotsɔna ƒoa ƒui`
• `Haloperidol (Haldol®) ƒe atike si wotsɔna ƒoa ƒui`
• `Metoclopramide (Reglan®, Gimoti®) ƒe atike si wotsɔna ƒoa ƒui`
• ``Olanzapine (Zyprexa®, Lybalvi®, Symbyax®) ƒe atike si wotsɔna ƒoa ƒui`
• `Prochlorperazine (Compro®) ƒe atike si wotsɔna ƒoa ƒui`

Dopamine ƒe mɔxenuwo nye mɔnu bubu si woate ŋu azã ɖe `CINV` (kansa ƒe ʋuʋudedi) teƒe ne `(Antiemetic)` atike bubuwo mewɔa dɔ o. Woateŋu akpeɖeŋu hã be woaxe mɔ ɖe `PONV` (dɔwɔwɔ vɔ megbe ƒe ʋuʋudedi nu).

7. Cannabinoids ƒe atikewo

Cannabinoids nye atike siwo le gbekui ƒe numiemie (marijuana) me ƒe hatsotso aɖe. Woblana ɖe cannabinoid xɔlawo ŋu le wò ahɔhɔ̃, dɔgbo ƒe dɔwɔwɔ, kple dɔlélenutsiŋutete ƒe lãmenugbagbeviwo me.

Cannabinoid siwo wowɔ nye molecule siwo wowɔ be woasrɔ̃ tetrahydrocannabinol (THC) ƒe ŋusẽkpɔɖeamedzi. Fifia la, cannabinoid ƒomevi eve siwo wowɔ le asi me be woazã abe atike siwo wua ʋusɔgbɔdɔ ene:

• `Dronabinol (Marinol®) ƒe lãgbalẽ`
• `Nabilone (Cesamet®) ƒe lãgbalẽ

FDA da asi ɖe esiawo dzi na CINV (kansa dada ƒe ʋuʋudedi), eye ne atike gbãtɔ siwo wua ʋumenugbagbeviɣidɔ do kpo nu ko hafi wòle be woazã wo.

Cannabinoids nye atike yeyetɔ kekeake si wua ʋumenugbagbeviɣidɔ. Numekulawo gale nu srɔ̃m hele numekuku wɔm tso alesi wowɔa dɔe ŋu.

Aleke míawɔ akpɔ atike sia? (Mɔnu siwo wozãna tsɔ naa atikeawo) .

``Antiemetic`` atike geɖewo li le ``nɔnɔme`` siwo wu ɖeka me. Woate ŋu adze ale:

• Atikekui siwo woano, si fia atikekui siwo womi alo ɖuna.
• IV (si wodona ɖe ʋuka me) ƒe tsiwo, siwo nye atike siwo nye tsi siwo wonana ɖe ʋuka me.
• Atike siwo wodona ɖe wò lãmeka me (intramuscular).
• Skin patches (transdermal) – Esia nye na Scopolamine (si nye anticholinergic) koŋ.
• Atikekui siwo wotsɔna tsia dɔgboa me (suppositories).

Ðe atike siawo ate ŋu ahe nugbegblẽ le ame ŋua?

Nusiwo ate ŋu ado tso `(Antiemetic)` ƒomevi ɖesiaɖe me la to vovo. Wò ɖɔkta agblɔ nugbegblẽ le ame ŋu siawo na wò hafi nàdze atikeawo nono gɔme. Mègavɔ̃ be yeabia nya eye yeagblɔ yeƒe susuwo o. Ne nugbegblẽ aɖewo le fu ɖem na wò le `(Antiemetic)` gɔmedzedze vɔ megbe la, ƒo nu kple wò ɖɔkta.

Nusiwo bɔ wu (gake menye wo katã o) siwo ateŋu adzɔ le ``Antiemetic'' ƒomevi ɖesiaɖe ŋu la dometɔ aɖewoe nye esi:

• Serotonin ƒe mɔxenuwo: Taɖuame, taɖuame, kple dɔmeɖui.
• Antihistamines: Alɔ̃dɔdɔ.
• Glucocorticoids: Alɔ̃madɔmadɔ, dzidzɔkpɔkpɔ, kple seselelãme ƒe tɔtrɔ.
• Anticholinergics: Nu ƒe ƒuƒu, nukpɔkpɔ ƒe tɔtrɔ, kple alɔ̃dɔdɔ.
• NK-1 receptor antagonists: Ate ŋu ana ta naɖu ame, taɖuame, eye le ame aɖewo gome la, nulɔdɔ sesẽwo (anaphylaxis).
• Dopamine ƒe mɔxenuwo: taɖuame, taɖuame, kple ʋuʋu ƒe kuxiwo, abe dystonia (lãmekawo ƒe ʋuʋu le wo ɖokui si) kple tardive dyskinesia (ŋutilã ƒe ʋuʋu le lɔlɔ̃nu faa me, vevietɔ mo kple nu ƒe ʋuʋu le lɔlɔ̃nu faa me).
• Cannabinoids ƒe atikewo:Vertigo, ʋusɔgbɔdɔ, kple dysphoria (seselelãme si nye be yemevo le ye ɖokui me o alo yeƒe dzi medzɔ o).

Ðe wònyo be mano atike sia ne mefɔ fua?

Ne ʋuʋudedi kple ʋuʋudedi le fu ɖem na wò le fufɔɣi la, ele be nàƒo nu kple wò vidzidziŋutinunyala-nyɔnuwo ƒe dɔléleŋutinunyala (Ob/Gyn) alo ɖɔkta bubu. Woaɖo aɖaŋu zi geɖe be nàwɔ tɔtrɔ le nuɖuɖu siwo nèɖuna alo ɣeyiɣi siwo nèɖua wo ŋu. Ne ema mekpe ɖe ŋuwò o la, woate ŋu aŋlɔ atike na wò.

Numekuku geɖe ɖee fia be zi geɖe la, atike aɖewo siwo tsia ʋumenugbagbeviɣidɔ nu zazã le fufɔɣi le dedie. Gake dedienɔnɔ ŋuti nyatakaka siwo le ame bubuwo si la tsi tre ɖe wo nɔewo ŋu alo seɖoƒe li na wo. Mia kple wò ɖɔkta miatso nya me ɖekae le nusi nyo na wò ŋu.

Ne ènya nya be yefɔ fu ko la, yi ɖɔkta gbɔ be nàdzro atike siwo zãm nèle la me. Azɔ hã, ele be nàƒo nu kple ɖɔkta godoo hafi adze atike yeye ɖesiaɖe zazã gɔme le fufɔɣi.

Nukae nèwɔna ne atike ƒe agbɔsɔsɔme aɖe to ŋuwò?

Ne ``Antiemetic'' atike ƒe agbɔsɔsɔme aɖe to ŋuwò, vevietɔ ne enye atike si xea mɔ na ʋuʋudedi kple ʋuʋudedi si ate ŋu anɔ anyi, abe ``CINV,'' ene la, ƒo nu kple wò ɖɔkta. Aɖo aɖaŋu na wò le nu si nàwɔ ŋu.

Gbedasi kae míedi be míatsɔ ayi aƒemee tso nyati sia me?

Ame aɖeke melɔ̃a ʋuʋudedi kple ʋuʋudedi o. Ɣeaɖewoɣi la, nuteƒekpɔkpɔ siawo siwo meɖea dzi ɖi o la hiãna na míaƒe ŋutilã. Gake ɣebubuɣiwo la, woate ŋu agblẽ nu le ame ŋu vevie. Dzɔgbenyuietɔe la, atike siwo wua ʋumenugbagbeviɣidɔ ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe ʋuʋudedi kple ʋuʋudedi nu eye/alo woadae, eɖanye kaba alo esi yia edzi o. Tiatia vovovowo li nàte ŋu atia tso wo dome. Mia kple wò ɖɔkta miawɔ ɖeka atso nya me le nusi anyo na wò ŋu. Eyata, ne kuxi sia le fu ɖem na wò la, mègavɔ̃ be yeaƒo nu kple ɖɔkta o, enyoa?

`Atike siwo tsia ʋuʋudedi nu, ʋuʋudedi, ʋuʋudedi, atike siwo tsia ʋuʋudedi nu, eƒe nugbegblẽ le ame ŋu, fufɔfɔ, kansa dada