Peb puas yuav tsum paub meej txog cov tshuaj antiemetic?

Tej zaum koj yuav xeev siab thiab ntuav qee zaum, puas yog? Nws tsis xis nyob tiag tiag. Yog li hnub no peb yuav tham txog ib hom tshuaj uas tuaj yeem pab tswj thiab tiv thaiv cov teeb meem no xws li xeev siab thiab ntuav. Cov no yog cov tshuaj antiemetic . Cia peb saib seb cov no yog dab tsi, lawv ua haujlwm li cas, thiab thaum twg lawv siv.

Cov tshuaj antiemetic no yog dab tsi?

Hais yooj yim xwb, "Cov tshuaj tiv thaiv kev ntuav" yog cov tshuaj uas muab los tiv thaiv kev xeev siab thiab ntuav, lossis kho nws yog tias nws tshwm sim. "Anti-" txhais tau tias "tiv thaiv." Lo lus "-emetic" los ntawm lo lus "emesis". Hauv kev kho mob, lo lus "(emesis)" kuj siv rau kev ntuav. Yog li, cov no yog cov tshuaj uas muab los tiv thaiv kev ntuav.

Muaj ntau hom tshuaj "Antiemetic", uas yog cov "tshuaj sib txawv." Qee cov tshuaj no koj tuaj yeem yuav tau los ntawm lub tsev muag tshuaj yam tsis tas yuav muaj daim ntawv yuav tshuaj (hu ua "Over-the-counter" lossis "OTC". Tab sis qee cov tshuaj no tsuas yog siv tau nrog daim ntawv yuav tshuaj los ntawm kws kho mob xwb (" prescription medicines". Vim tias muaj ntau yam ua rau xeev siab thiab ntuav, muaj cov tshuaj "Antiemetic" tshwj xeeb uas haum rau txhua yam ua rau xeev siab.

Thaum twg kuv thiaj xav tau tshuaj tiv thaiv ntuav?

Tam sim no tej zaum koj yuav xav tias, 'Yog li thaum twg kuv thiaj xav tau tshuaj zoo li no?'

Qee zaum ntuav yog ib qho kev tiv thaiv ntawm peb lub cev. Xav txog nws, yog tias koj noj cov khoom noj uas lwj lawm, lossis yog tias koj mob plab (mob plab), nws zoo dua rau ntuav thiab tshem tawm cov tshuaj lom ntawm koj lub cev.

Txawm li cas los xij, yog tias ntuav hnyav heev lossis tshwm sim ntau zaus, nws tuaj yeem ua rau muaj teeb meem kev noj qab haus huv loj heev. Piv txwv li:

• Cov pob txha tawg tuaj yeem tshwm sim, tshwj xeeb tshaj yog rau cov neeg laus.
• Kev qhuav dej yog qhov poob dej ntawm lub cev.
• Kev tawg ntawm txoj hlab pas, tseem hu ua Boerhaave's syndrome.
• Tsis qab los noj mov .
• Kev tsis txaus noj haus ('Malnutrition').
• Kev hloov pauv ntawm lub hlwb.
• Cov hniav enamel lwj tag.
• Cov qhov txhab phais tuaj yeem rov qhib dua ('Reopening of surgical wounds').

Vim yog tej yam zoo li no, cov kws kho mob qee zaum yuav sau cov tshuaj "Antiemetic" no kom tiv thaiv kev ntuav lossis kom tsis txhob ntuav uas twb pib lawm.

Kev pab rau kev xeev siab thiab ntuav tas li

Yog koj xeev siab thiab ntuav hnyav lossis ntev heev, koj tus kws kho mob yuav sau ntawv kom noj tshuaj "Tshuaj Tiv Thaiv Kev Ntshai". Cia peb saib qee cov piv txwv.

• Kev siv tshuaj tua kab mob thiab tshuaj kho mob qog noj ntshav ua rau xeev siab thiab ntuav (CINV): Xeev siab thiab/lossis ntuav yog cov kev mob tshwm sim ntau ntawm kev siv tshuaj tua kab mob qog noj ntshav. Kev siv tshuaj tua kab mob qog noj ntshav rau lub hlwb, txoj hnyuv, lossis lub siab kuj tuaj yeem ua rau muaj cov kev mob tshwm sim no. Vim li no, cov kws kho mob pom zoo kom koj noj tshuaj tiv thaiv kev ntuav thaum koj tab tom siv tshuaj tua kab mob qog noj ntshav lossis tshuaj kho mob qog noj ntshav. Qhov no yog vim tias xeev siab thiab ntuav ntau dhau tuaj yeem ua rau muaj kev phom sij heev rau ib tus neeg uas muaj mob qog noj ntshav.
• Xeev siab thiab ntuav thaum cev xeeb tub (tseem hu ua 'mob plab sawv ntxov'): Qee tus kws kho mob pom zoo kom noj cov tshuaj 'antiences' uas yuav tsis tas yuav muaj daim ntawv yuav tshuaj. Ib yam li ntawd, rau 'hyperemesis gravidarum', cov kws kho mob pom zoo kom noj cov tshuaj 'antiences' uas yuav tsis tas yuav muaj daim ntawv yuav tshuaj lossis cov tshuaj uas yuav tsum tau muaj daim ntawv yuav tshuaj.

Qhov tseem ceeb tshaj plaws yog nrog koj tus kws kho mob tham txog thaum twg thiab yuav siv cov tshuaj '(Antiemetic)' no li cas. Qee zaum, tshwj xeeb tshaj yog nyob rau hauv cov xwm txheej zoo li '(CINV)', koj yuav tsum siv ntau dua ib qho '(Antiemetic)'. Yog tias koj xeev siab thiab ntuav thaum cev xeeb tub , koj yuav tsum nrog kws kho mob tham ua ntej noj tshuaj los ntawm lub tsev muag tshuaj.

Ib qho tshuaj kho rau kev xeev siab thiab ntuav tam sim ntawd

Qee zaum, thaum yuav luag muaj xeev siab thiab ntuav, cov kws kho mob yuav sau tshuaj "Tshuaj Tiv Thaiv Kev Ntshai" no los tiv thaiv. Xav txog nws li no.

Muaj ntau yam tshuaj, xws li tshuaj loog (siv rau hauv kev siv tshuaj loog) thiab cov tshuaj opioid , tuaj yeem ua rau xeev siab thiab ntuav ua ib qho kev phiv. Cov kws kho mob siv cov tshuaj no rau tej yam xws li kev phais. Yog li, txhawm rau tiv thaiv kev xeev siab thiab ntuav tom qab phais (postoperative xeev siab thiab ntuav - PONV), lawv yuav muab tshuaj antiemetic rau koj.

Kab mob kiv taub hau thiab kev mob taub hau kuj tuaj yeem ua rau xeev siab thiab ntuav. Yog tias koj yuav nyob rau hauv qhov xwm txheej uas koj yuav muaj cov tsos mob no (piv txwv li, thaum mus ncig deb, xws li caij tsheb npav lossis nkoj), koj tus kws kho mob yuav pom zoo kom koj noj tshuaj tiv thaiv kev ntuav.

Tsis tas li ntawd xwb, tej zaum yuav muaj lwm yam xwm txheej uas tus kws kho mob yuav sau ntawv rau koj noj tshuaj "Antiemetic".

Muaj tshuaj dab tsi los pab kom tsis txhob ntuav?

Tam sim no cia peb saib seb muaj hom tshuaj tiv thaiv kev ntuav dab tsi. Muaj xya pawg tshuaj "Tshuaj Tiv Thaiv Kev Ntshai". Muaj ntau hom tshuaj hauv txhua pawg.

1. Cov tshuaj serotonin antagonists

Cov no yog cov tshuaj "Antiemetic" uas feem ntau siv los kho qhov xeev siab thiab ntuav. Piv txwv li:

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

Cov tshuaj no tau txais kev pom zoo los ntawm US Food and Drug Administration ( FDA ) los tiv thaiv cov hauv qab no:

• 'CINV' (kev xeev siab thiab ntuav los ntawm kev kho mob qog noj ntshav) thiab xeev siab thiab ntuav los ntawm kev kho mob hluav taws xob.
• 'PONV' (uas txhais tau tias xeev siab thiab ntuav tom qab phais mob).

Txawm li cas los xij, qee zaum cov kws kho mob tau sau cov tshuaj no rau lwm yam mob. Qhov no hu ua kev siv 'tsis suav nrog daim ntawv lo', txhais tau tias lawv siv rau lwm lub hom phiaj dua li cov uas FDA tau pom zoo.

2. Cov tshuaj Antihistamines

Cov tshuaj Antihistamines, tshwj xeeb tshaj yog cov uas thaiv cov histamine 1 (H1) receptor, feem ntau yog siv los ntawm cov kws kho mob los tswj cov tsos mob ntsig txog kev ua xua. Txawm li cas los xij, qee cov no tau txais kev pom zoo los ntawm FDA los tiv thaiv thiab kho qhov xeev siab thiab ntuav uas tshwm sim los ntawm kev mob taub hau thiab kiv taub hau. Qee zaum, cov kws kho mob yuav sau ntawv rau lawv yog tias lwm cov tshuaj antiemetics rau xeev siab thiab ntuav thaum cev xeeb tub tsis ua haujlwm. Nov yog qee hom tshuaj antihistamines rau ntuav:

• Cov ntsiav tshuaj Dimenhydrinate uas zom tau (Dramamine®)
• Cov tshuaj ntsiav Diphenhydramine los yog cov ntsiav tshuaj (Benadryl®)
• Vitamin B6 nrog 'Doxylamine succinate' - Qhov no yog thawj kab kev kho mob rau xeev siab thiab ntuav thaum cev xeeb tub.
• Meclizine (Antivert®, Bonine®, Dramamine-N®)
• `Promethazine (Phenergan®)`

Cov tshuaj xws li diphenhydramine thiab dimenhydrinate kuj tseem tuaj yeem pab tiv thaiv PONV (xeev siab thiab ntuav tom qab phais), tab sis feem ntau lawv tsis yog cov tshuaj thawj kab rau nws.

3. Cov tshuaj Glucocorticoids

Cov tshuaj Glucocorticoids (lossis corticosteroids) yog ib hom tshuaj uas cov kws kho mob siv vim lawv cov yam ntxwv tiv thaiv kev ua xua thiab tiv thaiv kev o. Txawm li cas los xij, qee cov tshuaj glucocorticoids kuj ua haujlwm ua cov tshuaj tiv thaiv kev ntuav.

Dexamethasone (Baycadron Elixer®, Decadron®, Zema-Pak®, thiab lwm hom) yog cov glucocorticoid tseem ceeb uas cov kws kho mob siv los tiv thaiv CINV (kev xeev siab vim kev kho mob qog noj ntshav) thiab PONV (kev xeev siab tom qab phais).

Cov kws kho mob qee zaum muab tshuaj '(Glucocorticoid)' ua ke nrog lwm yam '(Antiemetic)' kom tiv thaiv kev xeev siab thiab ntuav. Tab sis tsis zoo li lwm yam '(Antiemetic)', '(Glucocorticoids)' tsis tuaj yeem kho kev xeev siab thiab ntuav thaum nws pib lawm. Yog li ntawd, lawv tsuas yog muab los tiv thaiv nws xwb.

4. Cov tshuaj Anticholinergics

Cov tshuaj Anticholinergics (tseem hu ua antimuscarinics) yog ib hom tshuaj uas thaiv kev ua haujlwm ntawm cov tshuaj hu ua acetylcholine (ib qho neurotransmitter). Lawv tuaj yeem pab kho ntau yam mob (xws li kev tso zis tsis tu ncua thiab COPD), thiab tseem tuaj yeem pab txo qhov xeev siab thiab ntuav.

Scopolamine (Maldemar, Scopace, Transderm Scop®) yog cov tshuaj anticholinergic tseem ceeb uas siv rau kev ntuav. Cov kws kho mob siv nws los:

• Tiv thaiv 'PONV' (ntuav tom qab phais).
• Txhawm rau tiv thaiv lossis kho qhov xeev siab uas tshwm sim los ntawm "mob taub hau" (ntuav thaum mus ncig).

5. Cov tshuaj tiv thaiv Neurokinin-1 receptor

Cov tshuaj Neurokinin-1 (NK-1) receptor antagonists ua haujlwm los ntawm kev thaiv ib yam khoom ntuj tsim hauv koj lub hlwb hu ua neurokinin uas ua rau xeev siab thiab ntuav. Cov tshuaj no zoo heev rau kev kho CINV (xeev siab vim mob qog noj ntshav) thiab PONV (xeev siab tom qab phais). Lawv kuj muaj cov yam ntxwv tiv thaiv kev ntxhov siab (anxiolytic) thiab antidepressant.

Cov tshuaj hauv pawg no yog:

• 'Aprepitant (Aponvie®, Emend®' thiab 'Cinvanti®)'
• Fosaprepitant (Emend® thiab 'Focinvez®)'
• Kev sib xyaw ua ke ntawm `Netupitant` thiab `palonosetron` (`Akynzeo®)`
• `Rolapitant (Varubi®)`

6. Cov tshuaj tiv thaiv dopamine

Cov tshuaj dopamine antagonists yog ib hom tshuaj uas tiv thaiv qee hom hlwb hauv koj lub hlwb kom tsis txhob ua haujlwm. Lawv yog cov tshuaj kho mob tseem ceeb rau qee yam mob hlwb thiab cov tsos mob, tshwj xeeb tshaj yog kev puas siab puas ntsws thiab schizophrenia . Txawm li cas los xij, qee hom tshuaj no kuj tseem tuaj yeem pab txo qhov xeev siab thiab ntuav.

Muaj ntau hom dopamine antagonists uas siv rau ntuav:

• `Amisulpride (Barhemsys®)`
• Chlorpromazine (Thorazine®)
• `Droperidol (Inapsine®)`
• Haloperidol (Haldol®)
• Metoclopramide (Reglan®, Gimoti®).
• Olanzapine (Zyprexa®, Lybalvi®, Symbyax®)
• `Prochlorperazine (Compro®)`

Cov tshuaj dopamine antagonists yog lwm txoj hauv kev los hloov 'CINV' (kev ntuav uas ua rau mob qog noj ntshav) thaum lwm cov tshuaj '(Antiemetic)' tsis ua haujlwm. Lawv kuj tseem tuaj yeem pab tiv thaiv 'PONV' (kev ntuav tom qab phais).

7. Cov tshuaj cannabinoids

Cov cannabinoids yog ib pawg ntawm cov tshuaj uas pom muaj nyob rau hauv cov nroj tsuag cannabis (marijuana). Lawv khi rau cov cannabinoid receptors hauv koj lub hlwb, lub plab zom mov, thiab cov hlwb tiv thaiv kab mob.

Cov cannabinoids uas tsim tawm yog cov molecules uas tau tsim los ua kom zoo li cov teebmeem ntawm tetrahydrocannabinol (THC). Tam sim no muaj ob hom cannabinoids tsim tawm hauv khw rau kev siv ua tshuaj tiv thaiv kev ntuav:

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

Cov no tau txais kev pom zoo los ntawm FDA rau CINV (kev ntuav los ntawm kev kho mob qog noj ntshav), thiab tsuas yog siv yog tias cov tshuaj tiv thaiv kev ntuav thawj zaug tsis ua haujlwm.

Cov tshuaj cannabinoids yog hom tshuaj tiv thaiv kev ntuav tshiab tshaj plaws. Cov kws tshawb fawb tseem tab tom kawm thiab tshawb nrhiav seb lawv ua haujlwm li cas.

Peb yuav tau cov tshuaj no li cas? (Txoj kev siv tshuaj)

Muaj ntau yam tshuaj "Antiemetic" muaj ntau hom. Tej zaum lawv yuav zoo li no:

• Cov tshuaj noj, txhais tau tias cov tshuaj uas nqos los yog zom.
• Cov tshuaj IV (intravenous), uas yog cov tshuaj ua kua uas muab rau hauv cov leeg ntshav.
• Cov tshuaj txhaj rau hauv koj cov leeg (intramuscular).
• Cov ntaub nplaum rau ntawm daim tawv nqaij (transdermal) - Qhov no feem ntau yog rau Scopolamine (ib qho anticholinergic).
• Cov tshuaj ntsiav qhov quav (suppositories).

Cov tshuaj no puas ua rau muaj kev phiv?

Cov kev mob tshwm sim uas tuaj yeem tshwm sim nrog txhua hom '(Antiemetic)' sib txawv. Koj tus kws kho mob yuav qhia koj txog cov kev mob tshwm sim no ua ntej koj pib noj tshuaj. Tsis txhob ntshai nug cov lus nug thiab qhia koj cov kev xav. Yog tias koj muaj cov kev mob tshwm sim tsis zoo tom qab pib noj '(Antiemetic)', tham nrog koj tus kws kho mob.

Nov yog qee qhov kev mob tshwm sim feem ntau (tab sis tsis yog txhua yam) uas tuaj yeem tshwm sim nrog txhua hom "Antiemetic":

• Cov tshuaj serotonin antagonists: Mob taub hau, kiv taub hau, thiab cem quav.
• Cov tshuaj Antihistamines: ua rau tsaug zog.
• Glucocorticoids: Kev pw tsaug zog tsis taus, kev zoo siab, thiab kev hloov pauv ntawm lub siab.
• Cov tshuaj Anticholinergics: Qhov ncauj qhuav, kev pom kev hloov pauv, thiab qaug zog.
• Cov tshuaj NK-1 receptor antagonists: Tej zaum yuav ua rau mob taub hau, kiv taub hau, thiab rau qee tus neeg, ua xua hnyav heev (anaphylaxis).
• Cov tshuaj dopamine antagonists: kiv taub hau, mob taub hau, thiab teeb meem txav mus los, xws li dystonia (cov leeg nqaij tsis kam txav) thiab tardive dyskinesia (kev txav mus los ntawm lub cev tsis kam txav, tshwj xeeb tshaj yog ntawm lub ntsej muag thiab qhov ncauj).
• Cov tshuaj cannabinoids:Vertigo, ntshav siab qis, thiab dysphoria (kev xav tsis xis nyob lossis tsis txaus siab heev).

Puas zoo rau kuv noj cov tshuaj no yog tias kuv cev xeeb tub?

Yog tias koj xeev siab thiab ntuav thaum cev xeeb tub, koj yuav tsum nrog koj tus kws kho mob poj niam (Ob/Gyn) lossis lwm tus kws kho mob tham. Lawv feem ntau yuav pom zoo kom hloov cov khoom noj uas koj noj lossis lub sijhawm koj noj. Yog tias qhov ntawd tsis pab, lawv yuav sau tshuaj rau koj.

Muaj ntau txoj kev tshawb fawb tau qhia tias qee cov tshuaj tiv thaiv kev ntuav feem ntau muaj kev nyab xeeb siv thaum cev xeeb tub. Txawm li cas los xij, cov ntaub ntawv kev nyab xeeb rau lwm tus tsis sib haum xeeb lossis tsawg. Koj thiab koj tus kws kho mob yuav txiav txim siab ua ke seb qhov twg zoo tshaj plaws rau koj.

Thaum koj paub tias koj cev xeeb tub, mus ntsib kws kho mob kom tham txog cov tshuaj uas koj noj. Tsis tas li ntawd, koj yuav tsum nrog kws kho mob tham ua ntej pib noj tshuaj tshiab thaum cev xeeb tub.

Yog koj tsis nco qab noj tshuaj, koj yuav ua li cas?

Yog koj tsis nco qab noj tshuaj "Antiemetic", tshwj xeeb yog tias nws yog tshuaj uas tiv thaiv kev xeev siab thiab ntuav uas tuaj yeem kav ntev, xws li "CINV," nrog koj tus kws kho mob tham. Nws yuav qhia koj txog yam koj yuav tsum ua.

Cov lus uas peb xav coj los ntawm tsab xov xwm no yog dab tsi?

Tsis muaj leej twg nyiam xeev siab thiab ntuav. Qee zaum, cov kev tsis xis nyob no yog qhov tsim nyog rau peb lub cev. Tab sis lwm lub sijhawm, lawv tuaj yeem ua rau muaj kev phom sij heev. Zoo hmoo, cov tshuaj antiemetic tuaj yeem pab tiv thaiv thiab / lossis kho xeev siab thiab ntuav, txawm tias nws yog thaum ntxov lossis txuas ntxiv mus. Muaj ntau txoj kev xaiv los xaiv. Ua ke, koj thiab koj tus kws kho mob yuav txiav txim siab qhov twg zoo tshaj plaws rau koj. Yog li, yog tias koj muaj qhov teeb meem no, tsis txhob ntshai tham nrog kws kho mob, puas yog?

`Tshuaj tiv thaiv kev ntuav, xeev siab, ntuav, tshuaj tiv thaiv kev ntuav, cov kev mob tshwm sim, cev xeeb tub, kev kho mob qog noj ntshav