Tangoganizani kuti inuyo kapena munthu wina wapafupi nanu akukonzekera opaleshoni. Kapena mwina muli mu chipinda chosamalira odwala kwambiri (ICU) chifukwa cha matenda enaake. Pazochitika zotere, mwina munamvapo kuti madokotala amakulemberani mankhwala ochepetsa ululu. Atracurium ndi mankhwala apadera omwe amagwiritsidwa ntchito pazochitika zotere. Awa si mankhwala omwe mungagule ku pharmacy. Awa ndi jakisoni womwe umaperekedwa kuchipatala chokha, moyang'aniridwa ndi madokotala apadera. Chifukwa chake, tiyeni tikambirane za mankhwalawa mwatsatanetsatane, mwachidule.
Kodi Atracurium iyi ndi mankhwala amtundu wanji?
Mwachidule, Atracurium ndi mankhwala omwe amapumula kapena kufooketsa minofu ya mafupa a thupi lathu kwakanthawi. Taganizirani izi ngati kugonetsa minofu yomwe timalamulira m'maganizo mwathu kwakanthawi, monga yomwe ili m'manja, miyendo, khosi, ndi m'mimba.
Tsopano mwina mukudabwa kuti, "N'chifukwa chiyani mumamasula minofu yanu motere?" Pali zifukwa ziwiri zazikulu zomwe zimapangitsa izi:
1. Pa Opaleshoni: Pochita opaleshoni yaikulu, dokotala amafunika kugwira ntchito momasuka komanso popanda choletsa chilichonse. N'zovuta kuchita izi ngati minofu ya thupi yagwedezeka. Atracurium ikaperekedwa, minofu imamasuka kwathunthu. Komanso, panthawi yopumitsa, chubu chiyenera kuyikidwa kudzera mu trachea (intubation). Ndikofunikira kuti minofu ya pakhosi ndi pakhosi ikhale yomasuka panthawiyo.
2. Ali pa Ventilator: Nthawi zina zoopsa, wodwalayo angavutike kupuma yekha. Angaikidwe pa ventilator, makina opumira. Panthawiyi, minofu ya pachifuwa cha wodwalayo ingamangike, zomwe zingasokoneze ntchito ya makinawo. Pamene atracurium iperekedwa, minofu imeneyo imamasuka, zomwe zimathandiza kuti ventilator igwire ntchito yopumira wodwalayo.
Chofunika kwambiri ndichakuti mankhwalawa asakupangitseni kukomoka. Chifukwa chake, nthawi iliyonse mukapatsidwa Atracurium, amaperekedwa pamodzi ndi mankhwala omwe amakupangitsani kugona (kugona) kapena mankhwala oletsa ululu (anesthetic).
Zinthu zoti muuze dokotala wanu musanapereke mankhwala awa
Atracurium ndi mankhwala omwe ayenera kugwiritsidwa ntchito mosamala kwambiri. Chifukwa chake, ndikofunikira kwambiri kuti mufotokoze izi popanda kubisa chilichonse pamene dokotala wa opaleshoni akukufunsani mafunso musanachite opaleshoni.
| Nkhani yomwe muyenera kuifotokoza | Kufotokozera kosavuta |
|---|---|
| Matenda a Atracurium kapena mankhwala ena | Onetsetsani kuti mwauza dokotala wanu ngati munakhalapo ndi vuto la mankhwala awa kale, kapena ngati muli ndi vuto la mankhwala ena, chakudya, kapena utoto. |
| Myasthenia Gravis kapena matenda ena a mitsempha ndi minofu | Izi ndi matenda omwe amafooketsa minofu. Mwa odwala otere, zotsatira za Atracurium zitha kuwonjezeka kwambiri. |
| Mphumu kapena matenda ena a m'mapapo | Kusamala kwambiri kuyenera kuperekedwa popereka mankhwalawa kwa odwala omwe ali ndi vuto lopuma. |
| Matenda a Mtima | Ngati muli ndi matenda a mtima, dziwitsani dokotala wanu za matendawa. |
| Kusintha kwa kuchuluka kwa mchere m'thupi (Kusalingana kwa Electrolyte) | Mchere wochepa kapena wochuluka monga calcium, magnesium, ndi potaziyamu m'magazi ungakhudze momwe mankhwalawa amagwirira ntchito. |
| Kupsa kwambiri kapena kutaya madzi m'thupi | Momwe mankhwalawa amagwirira ntchito zingakhale zosiyana kwa anthu omwe ali ndi vuto la kutentha kwambiri kapena omwe alibe madzi okwanira m'thupi. |
| Mimba kapena kuyamwitsa | Ndikofunikira kudziwitsa dokotala wanu ngati muli ndi pakati, mukufuna kutenga pakati, kapena ngati mukuyamwitsa. |
Mankhwala ena omwe angagwirizane ndi Atracurium
Mankhwala ena omwe mukumwa kale angakhudze momwe Atracurium imagwirira ntchito. Izi zikutanthauza kuti zotsatira za Atracurium zitha kuwonjezeka kapena kuchepa kwambiri. Chifukwa chake, uzani dokotala wanu za mankhwala onse omwe mukumwa, kuphatikizapo mavitamini, mankhwala azitsamba, ndi zowonjezera .
Nazi zina mwa zinthu zazikulu zomwe zingakhudzidwe:
- Maantibayotiki ena (monga amikacin, gentamicin)
- Mankhwala ena oletsa ululu (monga isoflurane, halothane)
- Lithiamu
- Magnesium
- Mankhwala a matenda a mtima monga Quinidine ndi Procainamide
- Mankhwala ena omwe amagwiritsidwa ntchito kupumula minofu panthawi ya opaleshoni
Mankhwala ndi Kuchuluka kwa Mankhwala Opitirira Muyeso
Mankhwalawa amaperekedwa ngati jakisoni mumtsempha kapena kudzera mu saline infusion. Izi zimachitika kuchipatala, moyang'aniridwa ndi gulu lachipatala. Chifukwa chake simuyenera kuda nkhawa kuti mwaphonya mlingo kapena kumwa mopitirira muyeso. Chilichonse chimachitika molamulidwa kwambiri. Ngati pali kukayika kulikonse kwa kumwa mopitirira muyeso, gulu lachipatala limatenga njira zofunikira. Ngati pakufunika chidziwitso chokhudza vuto la poizoni wotere, National Poisons Information Centre ku Colombo National Hospital ndiye malo oyenera kupitako. Pakagwa mwadzidzidzi, wodwala amatumizidwa ku Emergency Treatment Unit (ETU) .
Kodi zotsatirapo zake zingakhale zotani?
Monga mankhwala ena aliwonse, Atracurium ingayambitse zotsatirapo zina. Koma kumbukirani, mukapatsidwa mankhwala awa, mumakhala ndi madokotala ndi anamwino ozungulira. Choncho ngati pabuka vuto lililonse, adzalithetsa nthawi yomweyo.
| Zotsatira zoyipa za Atracurium | |
|---|---|
| Zotsatirapo zoyipa zomwe ziyenera kufotokozedwa kwa gulu lachipatala nthawi yomweyo | |
| Matenda a ziwengo | Kutupa pakhungu, kuyabwa kwambiri, kutupa kwa nkhope, milomo kapena lilime. |
| Mavuto Opuma | Kupuma movutikira, kusintha kosazolowereka kwa kapumidwe ka mpweya. |
| Zizindikiro za Kutsika kwa Magazi | Chizungulire chachikulu, kumva mutu wopepuka, ndi maso abuluu. |
| Zizindikiro za Kuvulala kwa Minofu | Mkodzo wakuda (wokhala ngati wa cola), kupweteka kwambiri kwa minofu, kuvutika kukodza. |
| Zina | Kufiira kwa nkhope, kuyabwa kapena maso omwe ali ndi vuto la ziwengo, khunyu. |
| Zinthu zomwe nthawi zambiri sizili zazikulu, koma ziyenera kunenedwa ngati zikupitirira | |
| Kupweteka kwa minofu/kufooka | Kumva kupweteka kapena kufooka kwa minofu ngakhale pambuyo poti mankhwala atha. |
| Ululu pamalo obayira jakisoni | Kufiira, kupweteka, kapena kutupa pamalo omwe jakisoni amaperekedwa. |
Uthenga Wopita Nawo Kunyumba
- Atracurium ndi mankhwala apadera omwe amagwiritsidwa ntchito kupumula minofu kwakanthawi panthawi ya opaleshoni komanso chithandizo chamankhwala ofunikira.
- Izi zimaperekedwa kuchipatala chokha, motsogozedwa ndi madokotala apadera. Simukuyenera kuzigwiritsa ntchito kunyumba.
- Ndikofunikira kuuza dokotala wanu za matenda anu onse (makamaka ziwengo, mphumu, matenda a mtima, Myasthenia Gravis) ndi mankhwala ena onse omwe mukumwa.
- Palibe chifukwa choopa chifukwa gulu lachipatala lidzakuyang'anirani nthawi zonse mukapatsidwa mankhwala awa.
- Ngati pali zizindikiro kapena zotsatirapo zina zachilendo, gulu lachipatala lichitapo kanthu nthawi yomweyo. Lankhulani momasuka ndi dokotala wanu za izi.
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