Txhawj xeeb txog cov tshuaj uas muab rau cov neeg laus? Cia peb tham txog 'Cov Qauv Haus Dej Cawv'!

Yog tias koj muaj ib tug neeg laus hauv koj lub tsev, xws li koj niam, txiv, pog, lossis yawg, tej zaum koj yuav xav me ntsis txog cov tshuaj uas koj muab rau lawv, puas yog? Qee zaum thaum peb mus ntsib kws kho mob, lawv sau ntau yam tshuaj . Tab sis thaum peb laus zuj zus, txoj kev uas peb lub cev teb rau cov tshuaj hloov pauv, thiab qee cov tshuaj yuav tsis haum rau lawv. Muaj ib daim ntawv teev cov lus qhia uas pab cov kws kho mob saib xyuas cov khoom zoo li no. Ntawd yog qhov peb hu ua 'Cov Qauv Npias.' Cia peb tham txog qhov no yooj yim hnub no.

Cov 'Criteria Beers' no yog dab tsi?

Hais yooj yim xwb, qhov no yog daim ntawv teev cov lus qhia uas tau tsim los ntawm American Geriatrics Society , ib pawg kws tshaj lij hauv kev noj qab haus huv ntawm cov neeg laus. Nws qhia peb tias cov tshuaj twg yuav ua rau cov neeg hnub nyoog tshaj 65 xyoo muaj kev phom sij , lossis cov tshuaj twg yuav muaj ntau yam kev phiv ntau dua li cov txiaj ntsig. Daim ntawv teev npe no kuj hu ua 'Daim Ntawv Teev Npe Haus Cawv'. Xav txog nws, cov kev tshawb fawb tau qhia tias ntau dua 90% ntawm cov neeg hnub nyoog tshaj 65 xyoo siv tsawg kawg ib yam tshuaj hauv ib hlis, thiab ntau dua 66% siv ntau dua peb yam tshuaj. Yog li thaum lub sijhawm zoo li no, daim ntawv teev npe no yuav pab tau zoo rau cov kws kho mob kom sau tshuaj kom muaj kev nyab xeeb.

Tsib lub ntsiab lus tseem ceeb hauv 'Beers Criteria' yog dab tsi?

Daim ntawv teev npe no yog raws li tsib yam tseem ceeb, uas cov kws kho mob tshwj xeeb xav txog thaum sau tshuaj rau tus neeg laus:

• Cov tshuaj uas yuav tsum tsis txhob muab rau cov neeg hnub nyoog tshaj 65 xyoos, tshwj xeeb tshaj yog cov neeg uas tsis tau txais kev saib xyuas thaum kawg ntawm lub neej xws li kev saib xyuas hospice lossis kev saib xyuas palliative .
• Cov tshuaj uas yuav ua rau cov neeg uas muaj tej yam mob nkeeg puas tsuaj (piv txwv li, kab mob raum, kab mob plawv).
• Cov tshuaj uas ua rau muaj teeb meem los ntawm kev ua rau muaj kev sib cuam tshuam ntawm cov tshuaj thaum noj nrog lwm cov tshuaj.
• Cov tshuaj uas ua rau muaj kev phom sij ntau dua li qhov zoo vim muaj cov kev mob tshwm sim .
• Cov tshuaj uas cuam tshuam rau kev ua haujlwm ntawm lub raum (piv txwv li, cov neeg uas muaj teeb meem raum) yuav tsum tau muab tsawg tsawg xwb los yog tsum tsis txhob noj kiag li.

Cov tshuaj twg nyob rau hauv daim ntawv teev npe 'Beers Criteria'?

Muaj ze li ntawm 100 hom tshuaj nyob rau hauv daim ntawv teev npe no. Nws nyuaj rau tham txog lawv txhua tus, tab sis kom muab lub tswv yim rau koj, cia peb saib ob peb qho piv txwv los ntawm ntau pawg. Tib lub sijhawm, cia peb saib cov laj thawj vim li cas cov tshuaj ntawd tuaj yeem ua rau muaj kev phom sij.

• Cov Tshuaj Tua Kab Mob: Piv txwv li, cov tshuaj zoo li '(meperidine)'. Cov no tuaj yeem ua rau lub paj hlwb lom ('(Kev ua xua rau lub paj hlwb ()) thiab kev chim siab (`(delirium)`) kuj tseem yuav tshwm sim.
• Tshuaj tua kab mob: Qee cov tshuaj tua kab mob, piv txwv li ciprofloxacin, yuav ua rau muaj kev pheej hmoo ntawm kev los ntshav thaum noj nrog warfarin (tshuaj ua kom ntshav nyias).
• Cov tshuaj tiv thaiv qaug dab peg: Cov tshuaj xws li carbamazepine tuaj yeem ua rau muaj mob hu ua SIADH - Syndrome of inappropriate antidiuretic hormone secretion, uas cuam tshuam lub cev cov dej thiab ntsev sib npaug.
• Cov Tshuaj Antihistamines (hom qub): Cov tshuaj xws li brompheniramine tuaj yeem ua rau tsis meej pem, tsis nco qab , thiab chim siab .
• Qee cov tshuaj kho mob ntshav siab (Antihypertensives): Qee cov tshuaj, xws li '(alpha-blockers),' tuaj yeem ua rau ntshav siab poob qis sai sai ('(Hypotension)') .
• Cov tshuaj Antiplatelets lossis anticoagulants: Cov tshuaj xws li edoxaban qee zaum tuaj yeem cuam tshuam rau lub raum (kev puas tsuaj rau lub raum) .
• Cov Tshuaj Tiv Thaiv Kev Puas Siab Puas Ntsws: Txhua yam tshuaj hauv pawg no tuaj yeem ua rau muaj kev pheej hmoo ntawm kev mob stroke, kev poob qis ntawm kev xav , thiab kev chim siab thaum muab rau cov neeg laus.
• Cov tshuaj kho kev ntxhov siab: Cov tshuaj hauv pawg benzodiazepines (piv txwv li diazepam) tuaj yeem ua rau lub cev zom cov tshuaj qeeb qeeb, ua rau tsis nco qab zoo, thiab ua rau tshee hnyo thaum taug kev .
• Qee cov tshuaj kho mob plawv: Cov tshuaj xws li disopyramide tuaj yeem ua rau lub plawv tsis ua haujlwm hnyav dua.
• Cov tshuaj tua kab mob hauv lub paj hlwb: Dimenhydrinate (pom muaj nyob rau hauv qee cov tshuaj tua kab mob) tuaj yeem ua rau tsis meej pem, tsis nco qab, thiab chim siab .
• Qee cov tshuaj kho mob ntshav qab zib: Cov tshuaj qub xws li chlorpropamide tuaj yeem ua rau cov ntshav qab zib qis heev (hypoglycemia) .
• Cov tshuaj kho mob plab hnyuv: Qee cov tshuaj hauv pawg "H2-blocker" tuaj yeem ua rau kev chim siab zuj zus, tshwj xeeb yog tias ib tus neeg twb muaj nws lawm .
• Cov Tshuaj Hormones: Thaum cov tshuaj estrogen raug muab rau sab nraud, qee tus poj niam yuav muaj feem yuav mob qog noj ntshav hauv lub mis thiab mob qog noj ntshav hauv tsev menyuam ntau dua.
• Qee cov tshuaj pw tsaug zog (hypnotics): Muaj kev pheej hmoo ntawm kev quav yeeb quav tshuaj xws li barbiturates thiab kev siv tshuaj ntau dhau tuaj yeem ua rau muaj mob txaus ntshai .
• Cov tshuaj kho mob pob txha thiab cov leeg nqaij (cov tshuaj ua kom cov leeg so): Cov no tuaj yeem ua rau muaj tej yam xws li tsis meej pem, qhov ncauj qhuav, thiab cem quav .
• Cov tshuaj tsis yog steroidal anti-inflammatory drugs (NSAIDs): Cov tshuaj xws li aspirin (ntau tshaj 325 milligrams ib hnub) tuaj yeem ua rau muaj mob hnyav xws li mob plab, los ntshav, lossis mob plab .
• Qee cov tshuaj kho mob ua pa: Cov tshuaj xws li atropine tuaj yeem ua rau tsis meej pem, tsis nco qab, thiab chim siab .
• Qee cov tshuaj kho mob tso zis: "(desmopressin)" tuaj yeem ua rau cov ntshav sodium qis ("hyponatremia") , uas kuj yog qhov txaus ntshai.
• Qee cov tshuaj uas ua rau cov hlab ntsha nthuav dav (vasodilators): Cov tshuaj xws li '(ergoloid mesylates)' tej zaum yuav tsis ua rau muaj txiaj ntsig zoo li xav tau .

Tseem Ceeb: Cov no tsuas yog ob peb yam piv txwv xwb. Koj tus kws kho mob yuav txiav txim siab seb hom tshuaj twg zoo tshaj plaws rau koj. Txawm tias koj tau txais tshuaj hauv daim ntawv teev npe no los xij, tej zaum yuav muaj ib qho laj thawj rau nws. Yog li ntawd, tsis txhob ntshai, ib txwm tham nrog koj tus kws kho mob.

Daim ntawv teev cov 'Beers Criteria' no yuav raug hloov kho ntau zaus npaum li cas? Yuav ua li cas?

Daim ntawv teev npe no tsis yog ib daim ntawv teev npe uas tsuas yog muab tso tseg xwb. Lub Koom Haum American Geriatrics Society tshuaj xyuas thiab hloov kho daim ntawv teev npe no txhua peb xyoos ib zaug.

Ua li cas? Qhov no ua tiav los ntawm kev siv cov ntaub ntawv tshiab los ntawm kev tshawb fawb kho mob tshiab thiab kev sim tshuaj. Ib pab kws kho mob tuaj sib sau ua ke, tshuaj xyuas cov npe qub, thiab tej zaum yuav tshem tawm qee cov tshuaj, ntxiv cov tshuaj tshiab, lossis hloov cov lus pom zoo uas twb muaj lawm raws li cov pov thawj tshiab.

Cov kws kho mob siv cov 'Beers Criteria' thaum twg?

Daim ntawv teev npe no yog ib qho cuab yeej uas cov kws kho mob siv thaum sau tshuaj rau cov neeg hnub nyoog tshaj 65 xyoos. Tab sis nws tsis yog ib yam dab tsi uas koj tsuas yog saib thiab txiav txim siab txog. Koj tus kws kho mob yuav xav txog koj keeb kwm kev kho mob tag nrho, koj txoj kev noj qab haus huv tam sim no, thiab lwm yam tshuaj, cov vitamins, thiab cov tshuaj ntxiv uas koj noj . Tom qab ntawd lawv yuav txiav txim siab seb cov tshuaj tshiab lossis qhov ntau npaum li cas ntawm cov tshuaj tam sim no puas muaj kev nyab xeeb rau koj. Lawv kuj tseem yuav tsum hloov cov tshuaj, qhov ntau npaum li cas, lossis zaus ntawm kev siv raws li daim ntawv teev npe no.

Thaum siv cov 'Beers Criteria', yuav tsum xav txog dab tsi?

Qhov no yog ib lo lus nug tseem ceeb heev. Cov 'Category Beers' yog dab tsi?Nws yog tsim los rau cov pej xeem coob. Yog li ntawd, nws tsis yog "tshwj xeeb rau tus neeg" . Ntawd yog, daim ntawv teev npe no tsis hais txog tus neeg txoj kev noj qab haus huv dav dav, lwm yam kab mob uas lawv muaj, lossis cov yam ntxwv tshwj xeeb uas ua rau tus kws kho mob xaiv ib yam tshuaj tshwj xeeb.

Yog li ntawd, qhov no tsuas yog ib qho cuab yeej zoo rau cov kws kho mob siv. Nws tsis txiav txim siab rau tus kws kho mob uas muaj kev txawj ntse thiab muaj kev paub dhau los.

Piv txwv li, yog tias tus kws kho mob xav muab tshuaj rau koj hauv daim ntawv teev npe no uas suav tias muaj peev xwm ua rau muaj kev phom sij, nws yuav xav txog ntau yam, suav nrog koj txoj kev noj qab haus huv thiab ib puag ncig uas koj raug kho. Tsuas yog tom qab ntawd nws thiaj li txiav txim siab zaum kawg seb cov tshuaj puas muaj kev nyab xeeb rau koj. Feem ntau, cov kws kho mob tuaj yeem xaiv lwm txoj hauv kev rau cov tshuaj hauv daim ntawv teev npe no. Txawm li cas los xij, yog tias cov tshuaj hauv daim ntawv teev npe no tau sau tseg, tus kws kho mob yuav saib xyuas koj kom ze kom pom tias puas muaj kev phiv.

Vim li cas txoj kev uas cov tshuaj cuam tshuam rau peb lub cev thiaj hloov pauv thaum peb laus zuj zus?

Qhov no yog ib qho tseem ceeb heev. Thaum peb laus zuj zus, peb lub cev yuav muaj ntau yam kev hloov pauv. Cov kev hloov pauv no tuaj yeem cuam tshuam rau txoj kev uas cov tshuaj raug nqus thiab lawv ua haujlwm li cas hauv peb lub cev. Nov yog qee qhov piv txwv:

• Nws siv sijhawm ntev dua rau lub cev kom zom (ua kom cov tshuaj yaj) thiab tshem tawm cov tshuaj. Qhov no txhais tau tias cov tshuaj yuav nyob hauv koj lub cev ntev dua. Qhov no yog vim li cas cov kws kho mob qee zaum muab cov tshuaj tsawg dua rau cov neeg laus.
• Cov tshuaj rau ib yam mob tuaj yeem cuam tshuam rau lwm yam mob. Vim tias qee cov tshuaj hloov txoj kev uas peb lub cev teb, lawv kuj tuaj yeem cuam tshuam rau seb lwm yam kev kho mob ua haujlwm zoo li cas.
• Kev hloov pauv hauv lub neej. Tej yam xws li koj qib kev ua ub ua no thiab kev noj zaub mov uas koj noj tuaj yeem cuam tshuam rau qee cov tshuaj ua haujlwm zoo li cas. Yog li thaum koj mus ntsib kws kho mob, nws yog ib qho tseem ceeb uas yuav tsum tham txog koj txoj kev ua neej txhua hnub, koj noj dab tsi, thiab seb koj puas tawm dag zog. Ua li ntawd, nws tuaj yeem xaiv txoj kev kho mob uas zoo tshaj plaws rau koj.

Cov kws kho mob paub peb lub cev zoo heev thiab lawv hloov pauv li cas raws li hnub nyoog. Yog tias lawv sau ntawv rau koj noj tshuaj, lawv yuav saib xyuas seb koj lub cev teb li cas rau nws kom paub tseeb tias nws muaj kev nyab xeeb.

Yog li ntawd, peb yuav tsum nco ntsoov dab tsi ntawm zaj dab neeg no?

Zoo, yog li tam sim no koj yuav nkag siab tias 'Beers Criteria' uas peb tau tham txog yog cov npe ntawm cov lus qhia tseem ceeb uas pab cov kws kho mob thaum sau tshuaj rau cov neeg hnub nyoog tshaj 65 xyoo.

Qhov no pab cov kws kho mob tsom mus rau cov tshuaj uas yuav ua rau tus neeg laus raug mob thiab xaiv lwm yam tshuaj uas muaj kev nyab xeeb dua.

Nco ntsoov, qhov no yog ib qho cuab yeej rau cov kws kho mob, tsis yog ib yam dab tsi uas koj yuav tsum siv los nres lossis pib noj tshuaj ntawm koj tus kheej.Yog koj muaj lus nug lossis kev txhawj xeeb txog cov tshuaj uas koj noj, thov nrog koj tus kws kho mob tham. Nws yog tus neeg zoo tshaj plaws los muab cov lus qhia tseeb rau koj. Kev mloog koj tus kheej txoj kev xav yog txoj hauv kev zoo tshaj plaws los noj qab nyob zoo.

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