Pono anei mākou e ʻike pono e pili ana i nā lāʻau antiemetic?

Manaʻo paha ʻoe i ka luaʻi a me ka luaʻi i kekahi manawa, ʻeā? He mea ʻoluʻolu ʻole maoli ia. No laila i kēia lā e kamaʻilio mākou e pili ana i kahi ʻano lāʻau lapaʻau e hiki ke kōkua i ka kaohi a me ka hoʻōki ʻana i kēia mau mea e like me ka luaʻi a me ka luaʻi. ʻO kēia nā mea a mākou e kapa nei he mau lāʻau antiemetic . E nānā kākou i kēia mau mea, pehea lākou e hana ai, a i ka wā e hoʻohana ʻia ai.

He aha kēia mau lāʻau antiemetic?

I ka ʻōlelo maʻalahi, ʻo "nā lāʻau antiemetic" he mau lāʻau i hāʻawi ʻia e pale aku i ka nausea a me ka luaʻi ʻana, a i ʻole e mālama iā ia inā loaʻa. ʻO "Anti-" ke ʻano he "kūʻē." Loaʻa ka huaʻōlelo "-emetic" mai ka huaʻōlelo "emesis". I ka lāʻau lapaʻau, hoʻohana ʻia ka huaʻōlelo "(emesis)" no ka luaʻi ʻana. No laila, he mau lāʻau kēia i hāʻawi ʻia e pale aku i ka luaʻi ʻana.

Aia kekahi mau ʻano lāʻau lapaʻau "Antiemetic", ʻo ia hoʻi nā "papa lāʻau" like ʻole. Hiki iā ʻoe ke loaʻa i kekahi o lākou mai ka hale kūʻai lāʻau lapaʻau me ke kauoha ʻole (i kapa ʻia ʻo "Over-the-counter" a i ʻole "OTC" lāʻau lapaʻau). Akā hiki ke lawe ʻia kekahi o lākou me ke kauoha mai ke kauka (nā lāʻau lapaʻau " kauoha" ). No ka mea, he nui nā kumu o ka nausea a me ka luaʻi ʻana, aia nā lāʻau lapaʻau "Antiemetic" kikoʻī i kūpono no kēlā me kēia kumu.

Āhea wau e pono ai i ka lāʻau anti-vomiting?

I kēia manawa ke noʻonoʻo nei paha ʻoe, 'Ahea lā wau e pono ai i kahi lāʻau lapaʻau e like me kēia?'

ʻO ka luaʻi ʻana he hopena pale ia o ko kākou kino i kekahi manawa. E noʻonoʻo e pili ana i ia mea, inā ʻoe e ʻai i ka meaʻai palaho, a inā paha he ʻeha kou ʻōpū (maʻi ʻōpū), ʻoi aku ka maikaʻi o ka luaʻi ʻana a hoʻopau i ka mea ʻawaʻawa mai kou kino.

Eia nō naʻe, inā nui ka luaʻi ʻana a i ʻole pinepine ka luaʻi ʻana, hiki iā ia ke alakaʻi i nā pilikia olakino koʻikoʻi. Eia kekahi laʻana:

• Hiki i nā iwi haʻihaʻi ke hana, ʻoiai i ka poʻe ʻelemakule.
• ʻO ka dehydration ka nalowale o ka wai mai ke kino.
• ʻO ka haki ʻana o ka esophagus, i ʻike ʻia hoʻi ʻo ka maʻi Boerhaave.
• Ka nalowale o ka makemake .
• Nā hemahema meaʻai ('Malnutrition').
• Nā loli noʻonoʻo.
• Pau ke ʻano o ka enamel niho.
• Hiki i nā ʻeha ʻoki ke wehe hou ('Ke wehe hou ʻana i nā ʻeha ʻoki').

Ma muli o nā mea e like me kēia, kuhikuhi pinepine nā kauka i kēia lāʻau "Antiemetic" e pale aku i ka luaʻi ʻana a i ʻole e hoʻōki i ka luaʻi ʻana i hoʻomaka mua ʻia.

Kōkua no ka nausea mau a me ka luaʻi ʻana

Inā loaʻa iā ʻoe ka nausea a me ka luaʻi nui a lōʻihi paha, hiki i kāu kauka ke kuhikuhi i kahi lāʻau "Antiemetic". E nānā kākou i kekahi mau laʻana.

• ʻO ka nausea a me ka luaʻi i hoʻoulu ʻia e ka radiation a me ka chemotherapy (CINV): ʻO ka nausea a me/a i ʻole ka luaʻi ʻana he mau hopena ʻaoʻao maʻamau o ka chemotherapy. Hiki i ka radiation therapy i ka lolo, ka ʻōpū gastrointestinal, a i ʻole ke akepaʻa ke hana i kēia mau hopena ʻaoʻao. No kēia kumu, ʻōlelo nā kauka e lawe ʻoe i kahi antiemetic i kou wā e hana ana i ka chemotherapy a i ʻole ka radiation therapy. ʻO kēia no ka mea hiki i ka nausea a me ka luaʻi nui ke lilo i mea weliweli loa no kekahi kanaka me ka maʻi kanesa.
• ʻO ka luaʻi a me ka luaʻi ʻana i ka wā hāpai (i ʻike ʻia hoʻi ʻo 'morning sickness'): Paipai kekahi mau kauka i nā 'antiemetics' ma luna o ke kauka no kēia. Pēlā nō, no ka 'hyperemesis gravidarum', paipai nā kauka i nā 'antiemetics' ma luna o ke kauka a i ʻole ke kauka.

ʻO ka mea nui loa, ʻo ia ke kamaʻilio me kāu kauka e pili ana i ka manawa a me pehea e hoʻohana ai i kēia mau lāʻau lapaʻau '(Antiemetic)'. I kekahi manawa, ʻoi aku hoʻi i nā kūlana e like me '(CINV)', pono paha ʻoe e hoʻohana ma mua o hoʻokahi '(Antiemetic)'. Inā loaʻa iā ʻoe ka nausea a me ka luaʻi i ka wā hāpai , pono ʻoe e kamaʻilio me ke kauka ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau mai ka hale kūʻai lāʻau.

He lāʻau lapaʻau no ka nausea koke a me ka luaʻi ʻana

I kekahi manawa, i ka wā e kokoke maopopo ai ka nausea a me ka luaʻi ʻana, kuhikuhi nā kauka i kēia lāʻau "Antiemetic" e pale aku ai. E noʻonoʻo e pili ana i kēia ʻano.

Hiki i nā lāʻau lapaʻau he nui, e like me nā anesthetics (i hoʻohana ʻia i ka anesthesia) a me nā opioids , ke hoʻoulu i ka nausea a me ka luaʻi ma ke ʻano he hopena ʻaoʻao. Hoʻohana nā kauka i kēia mau lāʻau lapaʻau no nā mea e like me ke ʻoki kino. No laila, i mea e pale aku ai i ka nausea a me ka luaʻi ma hope o ke ʻoki kino (postoperative nausea and vomiting - PONV), e hāʻawi lākou iā ʻoe i kahi antiemetic.

Hiki i ka vertigo a me ka maʻi neʻe ke hoʻoulu i ka nausea a me ka luaʻi. Inā ʻoe e noho ana i kahi kūlana kahi e ʻike paha ai ʻoe i kēia mau hōʻailona (no ka laʻana, ma kahi huakaʻi lōʻihi, e like me ke kaʻa a moku paha), hiki i kāu kauka ke ʻōlelo aku iā ʻoe e lawe i kahi antiemetic.

Ma waho aʻe o kēia, aia paha kekahi mau kūlana ʻē aʻe kahi e kuhikuhi ai ke kauka iā ʻoe i kahi "Antiemetic".

He aha nā lāʻau lapaʻau e hoʻōki ai i ka luaʻi ʻana?

I kēia manawa, e nānā kākou i nā ʻano lāʻau antiemetic i loaʻa. ʻEhiku mau māhele nui o nā lāʻau "Antiemetic". Aia kekahi mau ʻano lāʻau lapaʻau i kēlā me kēia māhele.

1. Nā mea kū'ē i ka serotonin

He ʻano "Antiemetic" kēia i hoʻohana nui ʻia no ka mālama ʻana i ka nausea a me ka luaʻi ʻana. Eia nā hiʻohiʻona o kēia mau mea:

• ʻO Granisetron (Kytril®)
• ʻO ka ʻOndansetron (Zofran®)
• ʻO Palonosetron (Aloxi®)

Ua ʻāpono ʻia kēia lāʻau lapaʻau e ka US Food and Drug Administration ( FDA ) e pale aku i kēia mau mea:

• ʻO `CINV` (ka nausea a me ka luaʻi i hoʻokumu ʻia e ka lāʻau lapaʻau maʻi kanesa) a me ka nausea a me ka luaʻi i hoʻokumu ʻia e ka radiation therapy.
• ʻO `PONV` (ʻo ia hoʻi ka nausea a me ka luaʻi ma hope o ke ʻoki ʻana).

Eia nō naʻe, i kekahi manawa, kuhikuhi nā kauka i kēia mau lāʻau lapaʻau no nā kūlana ʻē aʻe. Ua kapa ʻia kēia he hoʻohana 'off-label', ʻo ia hoʻi, hoʻohana ʻia lākou no nā kumu ʻē aʻe ma mua o nā mea i ʻāpono ʻia e ka FDA.

2. Nā lāʻau antihistamine

ʻO nā antihistamines, ʻoiai nā mea e ālai ana i ka histamine 1 (H1) receptor, hoʻohana nui ʻia e nā kauka e kāohi i nā hōʻailona e pili ana i nā maʻi allergies. Eia nō naʻe, ua ʻae ʻia kekahi o kēia mau mea e ka FDA e pale a mālama i ka nausea a me ka luaʻi i hoʻokumu ʻia e ka maʻi neʻe a me ka vertigo. I kekahi manawa, hiki i nā kauka ke kuhikuhi iā lākou ma waho o ka lepili inā ʻaʻole i holo pono nā antiemetics ʻē aʻe no ka nausea a me ka luaʻi i ka wā hāpai. Eia kekahi mau ʻano antihistamines no ka luaʻi:

• Nā papa nau ʻia ʻo `Dimenhydrinate` (`Dramamine®`)
• Nā kāpule a i ʻole nā ​​papa Diphenhydramine (Benadryl®)
• ʻO ka Wikamina B6 me ka 'Doxylamine succinate' - ʻO kēia ka lāʻau lapaʻau mua no ka nausea a me ka luaʻi ʻana i ka wā hāpai.
• ʻO Meclizine (Antivert®, Bonine®, Dramamine-N®)
• ʻO ka Promethazine (Phenergan®)

Hiki i nā lāʻau lapaʻau e like me diphenhydramine a me dimenhydrinate ke kōkua i ka pale ʻana i ka PONV (nausea a me ka luaʻi ma hope o ke ʻoki ʻana), akā ʻaʻole lākou nā lāʻau lapaʻau mua no ia.

3. Nā Glucocorticoids

ʻO nā Glucocorticoids (a i ʻole corticosteroids) kahi papa o nā lāʻau lapaʻau a nā kauka e hoʻohana nui ai no ko lākou mau waiwai anti-allergic a me anti-inflammatory. Eia nō naʻe, hana pū kekahi mau glucocorticoids ma ke ʻano he antiemetics.

ʻO Dexamethasone (Baycadron Elixer®, Decadron®, Zema-Pak®, a me nā lama ʻē aʻe) ka glucocorticoid nui i hoʻohana ʻia e nā kauka e pale aku i ka CINV (nausea i hoʻoulu ʻia e ka lāʻau lapaʻau) a me ka PONV (nausea ma hope o ke ʻoki ʻana).

I kekahi manawa hāʻawi nā kauka i kahi `(Glucocorticoid)` me nā ʻano `(Antiemetic)` ʻē aʻe e pale aku i ka nausea a me ka luaʻi. Akā, ʻaʻole e like me kekahi mau `(Antiemetic)` ʻē aʻe, ʻaʻole hiki i nā `(Glucocorticoids)` ke ho'ōla i ka nausea a me ka luaʻi ke hoʻomaka. ʻO ia hoʻi, hāʻawi wale ʻia lākou e pale aku.

4. Nā lāʻau anticholinergic

ʻO nā Anticholinergics (i ʻike ʻia hoʻi he antimuscarinics) he ʻano lāʻau lapaʻau e ālai ana i ka hana o kahi kemika i kapa ʻia ʻo acetylcholine (he neurotransmitter). Hiki iā lākou ke kōkua i ka mālama ʻana i nā ʻano maʻi like ʻole (e like me ka incontinence urinary a me COPD), a hiki nō hoʻi ke kōkua me ka nausea a me ka luaʻi.

ʻO Scopolamine (Maldemar, Scopace, Transderm Scop®) ka lāʻau anticholinergic nui i hoʻohana ʻia no ka luaʻi ʻana. Hoʻohana nā kauka iā ia no:

• E pale i ka `PONV` (ka luaʻi ʻana ma hope o ke ʻoki ʻana).
• No ka pale ʻana a i ʻole ka mālama ʻana i ka nausea i hoʻokumu ʻia e ka "maʻi neʻe" (ka luaʻi ʻana i ka wā e hele ana).

5. Nā mea kū'ē i ka mea loaʻa Neurokinin-1

Hana nā mea hoʻokūkū receptor Neurokinin-1 (NK-1) ma ke ālai ʻana i kahi mea kūlohelohe i loko o kou lolo i kapa ʻia ʻo neurokinin e hoʻoulu ai i ka nausea a me ka luaʻi. He kūpono loa kēia mau lāʻau lapaʻau i ka mālama ʻana i ka CINV (nausea i hoʻoulu ʻia e ke kanesa) a me ka PONV (nausea ma hope o ke ʻoki ʻana). Loaʻa iā lākou nā waiwai anti-anxiety (anxiolytic) a me antidepressant.

ʻO nā lāʻau lapaʻau ma kēia māhele:

• 'Aprepitant (Aponvie®, Emend®` a me 'Cinvanti®)`
• 'Fosaprepitant (Emend®' a me 'Focinvez®)`
• ʻO ka hui pū ʻana o `Netupitant` a me `palonosetron` (`Akynzeo®)`
• ʻO ka `Rolapitant (Varubi®)`

6. Nā mea kū'ē i ka Dopamine

ʻO nā mea hoʻouka kaua Dopamine kahi ʻano lāʻau lapaʻau e kāohi ana i kekahi mau ʻano o nā cell i loko o kou lolo mai ke ahi ʻana. He kumu nui lākou no ka mālama ʻana i kekahi mau kūlana olakino noʻonoʻo a me nā hōʻailona, ​​​​ʻoi aku ka psychosis a me ka schizophrenia . Eia nō naʻe, hiki i kekahi o kēia mau ʻano ke kōkua i ka nausea a me ka luaʻi.

Aia kekahi mau ʻano antagonists dopamine i hoʻohana ʻia no ka luaʻi ʻana:

• ʻAmisulpride (Barhemsys®)
• ʻO Chlorpromazine (Thorazine®)
• ʻO Droperidol (Inapsine®)
• ʻO Haloperidol (Haldol®)
• 'Metoclopramide (Reglan®, Gimoti®)`
• ʻOlanzapine (Zyprexa®, Lybalvi®, Symbyax®)
• ʻO Prochlorperazine (Compro®)

ʻO nā mea hoʻouka kaua Dopamine kahi koho ʻē aʻe no ka `CINV` (luaʻi i hoʻoulu ʻia e ke kanesa) ke ʻole ka hopena o nā lāʻau lapaʻau `(Antiemetic)` ʻē aʻe. Hiki iā lākou ke kōkua i ka pale ʻana i ka `PONV` (luaʻi ma hope o ke ʻoki ʻana).

7. Nā Cannabinoids

He papa hui nā Cannabinoids i loaʻa i loko o ka mea kanu cannabis (marijuana). Hoʻopaʻa lākou i nā mea loaʻa cannabinoid i loko o kou lolo, ka ʻōnaehana gastrointestinal, a me nā pūnaewele pale.

ʻO nā cannabinoids i hana ʻia he mau molekala i hoʻolālā ʻia e hoʻohālike i nā hopena o ka tetrahydrocannabinol (THC). Aia i kēia manawa ʻelua ʻano o nā cannabinoids synthetic ma ka mākeke no ka hoʻohana ʻana ma ke ʻano he antiemetics:

• ʻO Dronabinol (Marinol®)
• ʻO Nabilone (Cesamet®)

Ua ʻāpono ʻia kēia e ka FDA no ka CINV (ka luaʻi ʻana i hoʻoulu ʻia e ka lāʻau lapaʻau), a pono e hoʻohana wale ʻia inā ʻaʻole i holomua nā antiemetics laina mua.

ʻO nā Cannabinoids ke ʻano hou loa o ka antiemetic. Ke aʻo nei nā kānaka noiʻi a me ka noiʻi ʻana pehea lākou e hana ai.

Pehea mākou e loaʻa ai kēia lāʻau lapaʻau? (Nā ʻano lawelawe)

Loaʻa nā lāʻau lapaʻau "Antiemetic" he nui ma mua o hoʻokahi "ʻano". Penei paha ko lākou ʻano:

• ʻO nā pila waha, ʻo ia hoʻi nā pila i moni ʻia a nau ʻia paha.
• ʻO nā hopena IV (intravenous), he mau lāʻau lapaʻau wai ia i hāʻawi ʻia i loko o kahi aʻa.
• Nā inikini i loko o kou ʻiʻo (intramuscular).
• Nā ʻāpana ʻili (transdermal) - ʻO kēia no Scopolamine (kahi anticholinergic).
• Nā pila rectal (nā suppositories).

Hiki i kēia mau lāʻau lapaʻau ke hana i nā hopena ʻaoʻao?

ʻOkoʻa nā hopena ʻaoʻao e hiki ke loaʻa me kēlā me kēia ʻano `(Antiemetic)`. E haʻi aku kāu kauka iā ʻoe e pili ana i kēia mau hopena ʻaoʻao ma mua o kou hoʻomaka ʻana e lawe i ka lāʻau. Mai makaʻu e nīnau a kaʻana like i kou mau manaʻo. Inā loaʻa iā ʻoe kekahi mau hopena ʻaoʻao hoʻopilikia ma hope o ka hoʻomaka ʻana i kahi `(Antiemetic)`, e kamaʻilio me kāu kauka.

Eia kekahi o nā hopena ʻaoʻao maʻamau (akā ʻaʻole nā ​​​​mea āpau) e hiki ke hana me kēlā me kēia ʻano "Antiemetic":

• Nā antagonists Serotonin: ʻEha poʻo, dizziness, a me ka constipation.
• Nā lāʻau antihistamine: Hiamoe.
• ʻO Glucocorticoids: Ka hiamoe ʻole, ka hoʻonāukiuki, a me nā loli o ke ʻano.
• Anticholinergics: Waha maloʻo, loli o ka ʻike, a me ka hiamoe.
• Nā mea kū'ē i ka mea loaʻa NK-1: Hiki ke hoʻoulu i ka ʻeha poʻo, ka poniuniu, a i kekahi poʻe, nā hopena aleri koʻikoʻi (anaphylaxis).
• Nā mea kū'ē i ka Dopamine: ka dizziness, ka ʻeha poʻo, a me nā pilikia neʻe, e like me ka dystonia (nā ʻokiʻoki ʻana o nā ʻiʻo me ka makemake ʻole) a me ka tardive dyskinesia (nā neʻe kino me ka makemake ʻole, ʻoiai o ka maka a me ka waha).
• Nā Cannabinoid:ʻO ka vertigo, ke koko haʻahaʻa, a me ka dysphoria (kahi manaʻo o ka ʻoluʻolu ʻole a i ʻole ka ʻoluʻolu ʻole).

Ua maikaʻi anei ke lawe ʻana i kēia lāʻau lapaʻau inā hāpai au?

Inā ʻoe e ʻeha ana i ka nausea a me ka luaʻi ʻana i ka wā hāpai, pono ʻoe e kamaʻilio me kāu kauka hānau keiki (Ob/Gyn) a i ʻole kekahi kauka ʻē aʻe. E paipai pinepine lākou e hoʻololi i nā meaʻai āu e ʻai ai a i ʻole nā ​​manawa āu e ʻai ai iā lākou. Inā ʻaʻole kōkua kēlā, hiki iā lākou ke kuhikuhi i ka lāʻau lapaʻau.

Ua hōʻike ʻia e nā haʻawina he nui he palekana kekahi mau lāʻau antiemetic e hoʻohana i ka wā hāpai. Eia nō naʻe, kūʻē a palena paha ka ʻike palekana no nā poʻe ʻē aʻe. E hoʻoholo pū ʻoe a me kāu kauka i ka mea maikaʻi loa iā ʻoe.

I ka manawa koke e ʻike ai ʻoe ua hāpai ʻoe, e ʻike i ke kauka e kūkākūkā i nā lāʻau lapaʻau āu e lawe nei. Eia kekahi, pono ʻoe e kamaʻilio me ke kauka ma mua o ka hoʻomaka ʻana i kekahi lāʻau lapaʻau hou i ka wā hāpai.

He aha kāu e hana ai inā e hala ʻoe i kahi mahele o ka lāʻau lapaʻau?

Inā ʻoe e hala i kahi mahele o ka lāʻau "Antiemetic", ʻoiai inā he lāʻau ia e pale ai i ka nausea a me ka luaʻi e hiki ke hoʻomau, e like me "CINV," e kamaʻilio me kāu kauka. E aʻo aku ʻo ia iā ʻoe i ka mea e hana ai.

He aha ka leka a mākou e makemake ai e lawe i ka home mai kēia ʻatikala?

ʻAʻohe mea makemake e ʻike i ka nausea a me ka luaʻi. I kekahi manawa, pono kēia mau ʻike ʻoluʻolu ʻole no ko mākou kino. Akā i nā manawa ʻē aʻe, hiki iā lākou ke hōʻino nui. ʻO ka mea pōmaikaʻi, hiki i nā lāʻau antiemetic ke kōkua i ka pale ʻana a/a i ʻole ka mālama ʻana i ka nausea a me ka luaʻi, inā paha he kakahiaka a i ʻole e hoʻomau nei. Nui nā koho e koho ai. E hui pū ʻoe a me kāu kauka e hoʻoholo i ka mea maikaʻi loa iā ʻoe. No laila, inā loaʻa iā ʻoe kēia pilikia, mai makaʻu e kamaʻilio me ke kauka, ʻae?

`Nā lāʻau antiemetic, nausea, luaʻi, nā lāʻau antiemetic, nā hopena ʻaoʻao, hāpai keiki, lāʻau lapaʻau no ka maʻi kanesa