Kodi tiyenera kudziwa bwino za mankhwala oletsa kutsekula m'mimba?

Mwina nthawi zina mumamva nseru ndi kusanza, eti? Zimandivuta kwambiri. Lero tikambirana za mtundu wa mankhwala omwe angathandize kuwongolera ndikuletsa zinthu izi monga nseru ndi kusanza. Izi ndi zomwe timatcha mankhwala oletsa kutsekula m'mimba . Tiyeni tiwone zomwe izi zili, momwe zimagwirira ntchito, komanso nthawi yomwe zimagwiritsidwa ntchito.

Kodi mankhwala oletsa kutsekula m'mimba awa ndi ati?

Mwachidule, ``Mankhwala oletsa kutsekula m'mimba`` ndi mankhwala omwe amaperekedwa kuti apewe nseru ndi kusanza, kapena kuchiza ngati zitachitika. ``Anti-``` amatanthauza ``motsutsana.`` Mawu akuti ``-emetic`` amachokera ku mawu akuti ``emesis``. Mu mankhwala, mawu akuti ``(emesis)`` amagwiritsidwanso ntchito pofotokoza kusanza. Chifukwa chake, awa ndi mankhwala omwe amaperekedwa kuti apewe kusanza.

Pali mitundu ingapo ya mankhwala a "Antietic" omwe ndi "magulu a mankhwala" osiyanasiyana. Ena mwa iwo mungatenge ku pharmacy popanda mankhwala (otchedwa "Over-the-counter" kapena "OTC"). Koma ena mwa iwo angatengedwe pokhapokha ndi mankhwala ochokera kwa dokotala (mankhwala a " antietic" ). Popeza pali zifukwa zambiri zomwe zimayambitsa nseru ndi kusanza, pali mankhwala enaake a "Antietic" omwe ndi oyenera pa chifukwa chilichonse.

Kodi ndi liti pamene ndikufunika mankhwala oletsa kusanza?

Tsopano mwina mukuganiza kuti, 'Ndiye ndingafunikire liti mankhwala ngati awa?'

Kusanza nthawi zina ndi njira yotetezera thupi lathu. Taganizirani izi, ngati mudya chakudya chosauka, kapena ngati muli ndi vuto la m'mimba (chimfine cha m'mimba), ndi bwino kusanza ndikuchotsa poizoni m'thupi lanu.

Komabe, ngati kusanza kuli koopsa kapena kumachitika pafupipafupi, kungayambitse mavuto aakulu azaumoyo. Mwachitsanzo:

• Kusweka kwa mafupa kumatha kuchitika, makamaka kwa okalamba.
• Kusowa madzi m'thupi ndi kutaya madzi m'thupi.
• Kuphulika kwa m'mero, komwe kumatchedwanso Boerhaave's syndrome.
• Kusowa chilakolako cha chakudya .
• Kusowa zakudya m'thupi (`Kusadya bwino`).
• Kusintha kwa maganizo.
• Enamel ya dzino imatha.
• Mabala ochitidwa opaleshoni akhoza kutsegulidwanso (`Kutsegulanso mabala ochitidwa opaleshoni`).

Chifukwa cha zinthu ngati izi, madokotala nthawi zina amapereka mankhwala a ``Antietic``` kuti apewe kusanza kapena kuti asiye kusanza komwe kwayamba kale.

Thandizo pa nseru ndi kusanza kosalekeza

Ngati mukumva nseru ndi kusanza kwambiri kapena kwa nthawi yayitali, dokotala wanu angakulembereni mankhwala a "Antietic emetic". Tiyeni tiwone zitsanzo zina.

• Kuseweretsa nseru ndi kusanza (CINV) chifukwa cha radiation ndi chemotherapy: Kuseweretsa nseru ndi/kapena kusanza ndi zotsatira zoyipa zomwe zimachitika chifukwa cha chemotherapy. Kuseweretsa nseru ku ubongo, m'mimba, kapena chiwindi kungayambitsenso zotsatirazi. Pachifukwa ichi, madokotala amalangiza kuti mutenge mankhwala oletsa kutsekula m'mimba pamene mukulandira chithandizo cha chemotherapy kapena radiation. Izi zili choncho chifukwa nseru ndi kusanza kwambiri kungakhale koopsa kwa munthu amene ali ndi khansa.
• Kusanza ndi kusanza panthawi ya mimba (komwe kumadziwikanso kuti `morning sickness`): Madokotala ena amalimbikitsa `antiemetics` yoperekedwa ndi dokotala pa izi. Mofananamo, pa `hyperemesis gravidarum`, madokotala amalimbikitsa `antiemetics` yoperekedwa ndi dokotala pa nthawi ya mankhwala kapena yoperekedwa ndi dokotala.

Chofunika kwambiri ndikulankhula ndi dokotala wanu za nthawi ndi momwe mungagwiritsire ntchito mankhwala awa a `(Antiemetic)`. Nthawi zina, makamaka pazochitika monga `(CINV)`, mungafunike kugwiritsa ntchito `(Antiemetic)` oposa amodzi. Ngati muli ndi nseru ndi kusanza panthawi ya mimba , muyenera kulankhula ndi dokotala musanamwe mankhwala aliwonse ku pharmacy.

Mankhwala ochizira nseru ndi kusanza mwadzidzidzi

Nthawi zina, pamene nseru ndi kusanza zili pafupi kuchitika, madokotala amalemba mankhwala a "Antietic" awa kuti apewe vutoli. Taganizirani izi motere.

Mankhwala ambiri, monga mankhwala oletsa ululu (omwe amagwiritsidwa ntchito pochiza ululu) ndi ma opioid , angayambitse nseru ndi kusanza ngati zotsatirapo zake. Madokotala amagwiritsa ntchito mankhwalawa pazinthu monga opaleshoni. Chifukwa chake, kuti apewe nseru ndi kusanza mutatha opaleshoni (nseru ndi kusanza pambuyo pa opaleshoni - PONV), adzakupatsani mankhwala oletsa kutsekula m'mimba.

Chizungulire ndi kutopa ndi kuyenda zingayambitsenso nseru ndi kusanza. Ngati mudzakhala mu mkhalidwe womwe mungakumane ndi zizindikiro izi (mwachitsanzo, paulendo wautali, monga pa basi kapena sitima), dokotala wanu angakulangizeni kuti mutenge mankhwala oletsa kutsekula m'mimba.

Kupatula izi, pakhoza kukhala zochitika zina pomwe dokotala angakulembereni mankhwala oletsa kutupa.

Ndi mankhwala ati omwe alipo kuti aletse kusanza?

Tsopano tiyeni tiwone mitundu ya mankhwala oletsa kutsekula m'mimba omwe alipo. Pali mitundu isanu ndi iwiri ya mankhwala oletsa kutsekula m'mimba. Pali mitundu ingapo ya mankhwala m'gulu lililonse.

1. Otsutsana ndi Serotonin

Izi ndi mtundu wa ``Antietic`` womwe umagwiritsidwa ntchito kwambiri womwe umaperekedwa makamaka pochiza nseru ndi kusanza. Zitsanzo za izi ndi izi:

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

Mankhwalawa avomerezedwa ndi US Food and Drug Administration ( FDA ) kuti apewe zotsatirazi:

• `CINV` (kuseweretsa nseru ndi kusanza komwe kumabwera chifukwa cha chithandizo cha khansa) ndi kuseweretsa nseru ndi kusanza komwe kumachitika chifukwa cha chithandizo cha radiation.
• `PONV` (zikutanthauza nseru ndi kusanza pambuyo pa opaleshoni).

Komabe, nthawi zina madokotala amapereka mankhwala awa pa matenda ena. Izi zimatchedwa kugwiritsa ntchito `off-label`, kutanthauza kuti amagwiritsidwa ntchito pazinthu zina osati zomwe zavomerezedwa ndi FDA.

2. Mankhwala oletsa kugwidwa ndi histamine

Mankhwala oletsa histamine, makamaka omwe amaletsa histamine 1 (H1) receptor, amagwiritsidwa ntchito makamaka ndi madokotala kuwongolera zizindikiro zokhudzana ndi ziwengo. Komabe, ena mwa awa ndi ovomerezeka ndi FDA kuti apewe ndikuchiza nseru ndi kusanza komwe kumachitika chifukwa cha chizungulire komanso vertigo. Nthawi zina, madokotala amatha kuwalembera mankhwala osayenera ngati mankhwala ena oletsa kutsekula m'mimba chifukwa cha nseru ndi kusanza panthawi ya mimba sanagwire ntchito. Nazi mitundu ina ya mankhwala oletsa kutsekula m'mimba:

• Mapiritsi otafuna a `Dimenhydrinate` (`Dramamine®`)
• Makapisozi kapena mapiritsi a Diphenhydramine (Benadryl®)
• Vitamini B6 yokhala ndi `Doxylamine succinate` – Iyi ndi njira yoyamba yothandizira nseru ndi kusanza panthawi ya mimba.
• `Meclizine (Antivert®, Bonine®, Dramamine-N®)`
• `Promethazine (Phenergan®)`

Mankhwala monga diphenhydramine ndi dimenhydrinate angathandizenso kupewa PONV (nseru ndi kusanza pambuyo pa opaleshoni), koma nthawi zambiri si mankhwala oyamba a izi.

3. Glucocorticoids

Glucocorticoids (kapena Corticosteroids) ndi gulu la mankhwala omwe madokotala amagwiritsa ntchito makamaka chifukwa cha mphamvu zawo zoletsa ziwengo komanso kutupa. Komabe, Glucocorticoids ena amagwiranso ntchito ngati mankhwala oletsa emergency.

Dexamethasone (Baycadron Elixer®, Decadron®, Zema-Pak®, ndi mitundu ina) ndi glucocorticoid yayikulu yomwe madokotala amagwiritsa ntchito popewa CINV (nseru yoyambitsidwa ndi chithandizo cha khansa) ndi PONV (nseru yochokera pambuyo pa opaleshoni).

Madokotala nthawi zina amapereka mankhwala a `(Glucocorticoid)` pamodzi ndi mankhwala ena a `(Antiemetic)` kuti apewe nseru ndi kusanza. Koma mosiyana ndi mankhwala ena a `(Antiemetic)`, `(Glucocorticoids)` sangachiritse nseru ndi kusanza akangoyamba. Izi zikutanthauza kuti amangoperekedwa kuti apewe.

4. Mankhwala oletsa kutsekula m'mimba

Mankhwala oletsa cholinergic (omwe amadziwikanso kuti antimuscarinics) ndi mtundu wa mankhwala omwe amaletsa ntchito ya mankhwala otchedwa acetylcholine (neurotransmitter). Angathandize kuchiza matenda osiyanasiyana (monga kusadziletsa kwa mkodzo ndi COPD), komanso angathandize ndi nseru ndi kusanza.

Scopolamine (Maldemar, Scopace, Transderm Scop®) ndiye mankhwala akuluakulu oletsa cholinergic omwe amagwiritsidwa ntchito pochiza kusanza. Madokotala amagwiritsa ntchito izi:

• Pewani kusanza pambuyo pa opaleshoni (PONV).
• Kupewa kapena kuchiza nseru yomwe imayamba chifukwa cha "kudwala kuyenda" (kusanza paulendo).

5. Otsutsana ndi Neurokinin-1 receptor

Mankhwala oletsa kutupa otchedwa Neurokinin-1 (NK-1) receptor antagonists amagwira ntchito potseka chinthu chachilengedwe muubongo wanu chotchedwa neurokinin chomwe chimayambitsa nseru ndi kusanza. Mankhwalawa ndi othandiza kwambiri pochiza CINV (nseru yoyambitsidwa ndi khansa) ndi PONV (nseru yochitidwa pambuyo pa opaleshoni). Amakhalanso ndi mphamvu zotsutsana ndi nkhawa (anxiolytic) komanso zoletsa kupsinjika maganizo.

Mankhwala omwe ali mgululi ndi awa:

• `Aprepitant (Aponvie®, Emend®` ndi `Cinvanti®)`
• `Fosaprepitant (Emend®` ndi `Focinvez®)`
• Kuphatikiza kwa `Netupitant` ndi `palonosetron` (`Akynzeo®)`
• `Rolapitant (Varubi®)`

6. Otsutsa a Dopamine

Mankhwala oletsa dopamine ndi mtundu wa mankhwala omwe amaletsa mitundu ina ya maselo muubongo wanu kugwira ntchito. Ndi mankhwala ofunikira kwambiri pa matenda ena amisala, makamaka matenda amisala ndi schizophrenia . Komabe, ena mwa mitundu iyi angathandizenso ndi nseru ndi kusanza.

Pali mitundu ingapo ya mankhwala oletsa dopamine omwe amagwiritsidwa ntchito pochiza kusanza:

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

Mankhwala oletsa kutupa otchedwa dopamine antagonists ndi njira ina ya `CINV` (kusanza koyambitsidwa ndi khansa) pamene mankhwala ena a `(Antietic emetic)` sagwira ntchito. Angathandizenso kupewa `PONV` (kusanza pambuyo pa opaleshoni).

7. Mankhwala a cannabis

Mankhwala a cannabinoid ndi gulu la mankhwala omwe amapezeka mu chomera cha chamba (chamba). Amalumikizana ndi ma cannabinoid receptors mu ubongo wanu, m'mimba, komanso m'maselo a chitetezo chamthupi.

Ma cannabinoid opangidwa ndi mamolekyu omwe amapangidwira kutsanzira zotsatira za tetrahydrocannabinol (THC). Pakadali pano pali mitundu iwiri ya ma cannabinoid opangidwa pamsika omwe amagwiritsidwa ntchito ngati mankhwala oletsa kutsekula m'mimba:

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

Izi zavomerezedwa ndi FDA kuti zigwiritsidwe ntchito pa CINV (kusanza komwe kumayambitsa khansa), ndipo ziyenera kugwiritsidwa ntchito pokhapokha ngati mankhwala oyamba oletsa kutsekula m'mimba alephera.

Mankhwala a cannabinoid ndi mtundu watsopano wa mankhwala oletsa kutsekula m'mimba. Ofufuza akuphunzirabe ndi kufufuza momwe amagwirira ntchito.

Kodi timapeza bwanji mankhwala awa? (Njira zoperekera mankhwala)

Mankhwala ambiri a ``Antietic`` amapezeka m'njira zosiyanasiyana. Angawoneke motere:

• Mapiritsi omwa, kutanthauza mapiritsi omwe amamezedwa kapena kutafunidwa.
• Mayankho a IV (omwe amaperekedwa kudzera m'mitsempha), omwe ndi mankhwala amadzimadzi omwe amaperekedwa mumtsempha.
• Jakisoni m'minofu yanu (m'mimba).
• Mabala a pakhungu (transdermal) - Izi makamaka ndi za Scopolamine (mankhwala oletsa cholinergic).
• Mapiritsi a rectal (suppositories).

Kodi mankhwala awa angayambitse zotsatirapo zoyipa?

Zotsatira zoyipa zomwe zingachitike ndi mtundu uliwonse wa `(Antiemetic)` zimasiyana. Dokotala wanu adzakuuzani za zotsatira zoyipazi musanayambe kumwa mankhwala. Musaope kufunsa mafunso ndikugawana malingaliro anu. Ngati muli ndi zotsatira zoyipa zilizonse mutayamba kumwa `(Antiemetic)`, lankhulani ndi dokotala wanu.

Nazi zina mwa zotsatirapo zoyipa kwambiri (koma osati zonse) zomwe zingachitike ndi mtundu uliwonse wa ``Antietic'':

• Otsutsana ndi Serotonin: Mutu, chizungulire, ndi kudzimbidwa.
• Mankhwala oletsa kugona: Kugona.
• Glucocorticoids: Kusowa tulo, kukwiya, ndi kusintha kwa malingaliro.
• Mankhwala oletsa kupweteka kwa m'mimba: Pakamwa pouma, kusintha kwa masomphenya, ndi kugona.
• Mankhwala oletsa kutupa otchedwa NK-1 receptor antagonists: Angayambitse mutu, chizungulire, ndipo mwa anthu ena, angayambitse ziwengo (anaphylaxis).
• Mankhwala oletsa dopamine: chizungulire, mutu, ndi mavuto oyenda, monga dystonia (kuchepa kwa minofu kosafuna) ndi tardive dyskinesia (kuyenda kosafuna thupi, makamaka nkhope ndi pakamwa).
• Mankhwala a cannabinoid:Chizungulire, kuthamanga kwa magazi pang'ono, ndi dysphoria (kumva kusasangalala kwambiri kapena kusakhutira).

Kodi ndi bwino kumwa mankhwalawa ngati ndili ndi pakati?

Ngati mukuvutika ndi nseru ndi kusanza panthawi ya mimba, muyenera kulankhula ndi dokotala wa ana oyembekezera (Ob/Gyn) kapena dokotala wina. Nthawi zambiri amalangiza kuti musinthe zakudya zomwe mumadya kapena nthawi zomwe mumadya. Ngati zimenezo sizikuthandizani, angakupatseni mankhwala.

Kafukufuku wambiri wasonyeza kuti mankhwala ena oletsa kutsekula m'mimba nthawi zambiri amakhala otetezeka kugwiritsa ntchito panthawi ya mimba. Komabe, mfundo zachitetezo kwa ena ndizosemphana kapena zochepa. Inu ndi dokotala wanu mudzasankha pamodzi zomwe zili zabwino kwa inu.

Mukangodziwa kuti muli ndi pakati, pitani kwa dokotala kuti akuuzeni za mankhwala omwe mukumwa. Komanso, muyenera kulankhula ndi dokotala musanayambe kumwa mankhwala atsopano panthawi ya mimba.

Kodi mumatani ngati mwaphonya mlingo wa mankhwala?

Ngati mwaphonya mlingo wa mankhwala a "Antietic", makamaka ngati ndi mankhwala omwe amaletsa nseru ndi kusanza zomwe zingapitirire, monga "CINV," lankhulani ndi dokotala wanu. Iye adzakulangizani zomwe mungachite.

Kodi uthenga umene tikufuna kutenga kuchokera m'nkhaniyi ndi wotani?

Palibe amene amakonda kumva nseru ndi kusanza. Nthawi zina, zinthu zosasangalatsazi ndizofunikira m'thupi lathu. Koma nthawi zina, zimatha kukhala zovulaza kwambiri. Mwamwayi, mankhwala oletsa kutsekula m'mimba angathandize kupewa ndi/kapena kuchiza nseru ndi kusanza, kaya ndi msanga kapena kupitirira. Pali njira zingapo zomwe mungasankhe. Pamodzi, inu ndi dokotala wanu mudzasankha zomwe zili zabwino kwa inu. Chifukwa chake, ngati muli ndi vutoli, musaope kulankhula ndi dokotala, chabwino?

'Mankhwala oletsa kutsekula m'mimba, nseru, kusanza, mankhwala oletsa kutsekula m'mimba, zotsatirapo zake, mimba, chithandizo cha khansa