Une hanya nemishonga inopiwa vakwegura here? Ngatikurukurei nezve 'Doro Rinoyera'!

Kana uine munhu mukuru mumba mako, saamai vako, baba, ambuya, kana sekuru, ungangofunga zvishoma nezvemishonga yaunovapa, handiti? Dzimwe nguva patinoenda kuna chiremba, vanonyora mishonga yakasiyana-siyana . Asi sezvatinokura, maitiro emuviri wedu anochinja kumishonga, uye mimwe mishonga ingasava yakakodzera. Pane runyorwa rwemirairo inobatsira vanachiremba kutarisira zvinhu zvakadaro. Ndizvo zvatinodaidza kuti 'Beers Criteria.' Ngatitaurei nezvazvo nhasi.

Chii chinonzi 'Beers Criteria' iyi?

Zvichitaurwa zviri nyore, iyi inyaya yemirayiridzo yakagadzirwa neAmerican Geriatrics Society , boka renyanzvi muhutano hwevakuru. Inotiudza kuti mishonga ipi ingakuvadza vanhu vane makore anopfuura 65, kana kuti mishonga ipi inogona kuva nemigumisiro yakawanda kupfuura mabhenefiti. Rondedzero iyi inozivikanwawo se'Beer's List'. Funga nezvazvo, ongororo dzakaratidza kuti vanhu vanopfuura 90% vane makore anopfuura 65 vanoshandisa mushonga mumwe chete pamwedzi, uye vanopfuura 66% vanoshandisa mishonga inopfuura mitatu. Saka panguva yakaita seiyi, runyorwa urwu ruchabatsira zvikuru vanachiremba kunyora mishonga zvakachengeteka.

Ndezvipi zvinhu zvishanu zvikuru zviri mu'Beers Criteria'?

Rondedzero iyi yakavakirwa pazvinhu zvikuru zvishanu, izvo vanachiremba vanonyanya kufunga nezvazvo pavanopa mushonga kumunhu mukuru:

• Mishonga isingafaniri kupihwa vanhu vane makore anopfuura makumi matanhatu nemashanu ekuberekwa, kunyanya avo vasingawani rubatsiro rwekupedzisira rwehutano senge hospice kana palliative care .
• Mishonga inogona kukuvadza vanhu vane mamwe matambudziko ehutano (semuenzaniso, chirwere cheitsvo, chirwere chemwoyo).
• Mishonga inokonzera matambudziko nekukonzera kusawirirana kwemishonga kana ikatorwa nemimwe mishonga.
• Mishonga inogona kukonzera kukuvara kupfuura kunaka nekuda kwemigumisiro yakaipa .
• Mishonga inokanganisa mashandiro eitsvo (kureva, iyo ine dambudziko reitsvo) inofanira kupiwa zvishoma kana kumira zvachose.

Ndeapi marudzi emishonga ari pane runyorwa rwe'Beers Criteria'?

Kune mhando dzemishonga dzinosvika zana pane iyi runyorwa. Zvakaoma kutaura nezvadzo dzese, asi kuti tikupe pfungwa, ngatitarisei mienzaniso mishoma kubva muzvikamu zvakasiyana-siyana. Panguva imwe chete, ngatitarisei zvikonzero nei mishonga iyoyo ichigona kukuvadza.

• Mishonga inonyaradza marwadzo: Semuenzaniso, mishonga yakaita se `(meperidine)`. Iyi inogona kuva chepfu kuhurongwa hwetsinga (`(Kukuvadzwa nepfungwa ()) uye kuvhiringidzika kwepfungwa (`(delirium)`) zvinogonawo kuitika.
• Mishonga inorwisa mabhakitiriya: Mimwe mishonga inorwisa mabhakitiriya, semuenzaniso ciprofloxacin, inogona kuwedzera njodzi yekubuda ropa kana ikatorwa newarfarin (mushonga unobvisa ropa rakawanda).
• Mishonga yekudzivirira pfari: Mishonga yakaita secarbamazepine inogona kukonzera chirwere chinonzi SIADH - Syndrome yekuburitswa kwemahormone ekurwisa diuretic zvisina kunaka, izvo zvinokanganisa kuenzana kwemvura nemunyu mumuviri.
• Mishonga yeAntihistamine (yekare): Mishonga yakaita sebrompheniramine inogona kukonzera kuvhiringidzika, kutadza kuziva , uye kupenga .
• Mimwe mishonga yeBP yakakwira (Mishonga yeBP): Mimwe mishonga, yakaita se `(alpha-blockers),` inogona kukonzera kudzikira kweBP kamwe kamwe (`(Hypotension)`) .
• Mishonga inorwisa maplatelet kana mishonga inorwisa ropa: Mishonga yakaita seedoxaban dzimwe nguva inogona kukanganisa itsvo (kukanganisika kweitsvo) .
• Mishonga yekurwisa pfungwa: Chero mushonga uri mukirasi iyi unogona kuwedzera njodzi yekurohwa nehana, kudzikira kwepfungwa , uye kupenga kana ukapihwa vakuru.
• Mishonga yeAnxiolytics: Mishonga iri muboka rebenzodiazepines (semuenzaniso diazepam) inogona kunonoka kuputsika kwemushonga mumuviri, kukonzera kusangwarira, uye kukonzera kudedera pakufamba .
• Mimwe mishonga yemwoyo: Mishonga yakaita sedisopyramide inogona kuwedzera kutadza kushanda kwemoyo .
• Mishonga yetsinga dzepakati: Dimenhydrinate (inowanikwa mune mamwe mishonga inorwisa kugaya) inogona kukonzera kuvhiringidzika, kusaziva zvakanaka, uye kuvhiringidzika mupfungwa .
• Mimwe mishonga yechirwere cheshuga: Mishonga yekare yakaita sechlorpropamide inogona kukonzera kuderera kweshuga muropa (hypoglycemia) .
• Mishonga yemudumbu: Mimwe mishonga iri mukirasi ye "H2-blocker" inogona kukonzera kuvhiringidzika kwepfungwa, kunyanya kana mumwe munhu achitova nayo .
• Mahormone: Kana estrogen ikatorwa kubva kunze, vamwe vakadzi vanogona kunge vari panjodzi yakakura yekubatwa nekenza yemazamu nekenza yechibereko .
• Mamwe mapiritsi ekurara (hypnotics): Pane njodzi yekupindwa muropa nemishonga yakaita sebarbiturates uye kunyanya kushandisa zvinodhaka kunogona kukonzera zvirwere zvine njodzi .
• Zvinonyaradza tsandanyama: Izvi zvinogona kukonzera zvinhu zvakaita sekuvhiringidzika, kuoma muromo, uye kuvimbiwa .
• Mishonga isingashandisi steroidal inorwisa kuzvimba (NSAIDs): Mishonga yakaita seaspirin (inopfuura 325 milligrams pazuva) inogona kukonzera zvirwere zvakakomba zvakaita semaronda emudumbu, kubuda ropa, kana kubooka .
• Mimwe mishonga yekufema: Mishonga yakaita seatropine inogona kukonzera kuvhiringidzika, kusaziva zvakanaka, uye kuvhiringidzika mupfungwa .
• Mimwe mishonga yeweti: ``(desmopressin)`` inogona kukonzera kudzikira kwehuwandu hwe sodium muropa (``(hyponatremia)``) , izvo zvine njodzi zvakare.
• Mimwe mishonga inotambanudza mitsipa yeropa (vasodilators): Mishonga yakaita se `(ergoloid mesylates)` inogona kusaburitsa mhedzisiro inotarisirwa .

Zvakakosha: Iyi inongova mienzaniso mishomanana. Chiremba wako ndiye achasarudza kuti ndeipi mishonga yakakunakira. Kunyangwe wakanyorerwa mushonga pane iyi rondedzero, panogona kunge paine chikonzero chacho. Saka usavhunduke, gara uchitaura nachiremba wako.

Runyorwa urwu rwe'Beers Criteria' ruchagadziriswa kangani? Zvinoitwa sei?

Iyi haisi rondedzero inongoitwa kamwe chete inongosiyiwa parutivi. Sangano reAmerican Geriatrics Society rinoongorora uye rinogadzirisa rondedzero iyi anenge makore matatu ega ega.

Zvinoitwa sei? Izvi zvinoitwa uchishandisa ruzivo rutsva kubva mukutsvagurudza kutsva kwezvekurapa uye miedzo yekiriniki. Chikwata chenyanzvi dzezvekurapa chinoungana, choongorora runyorwa rwekare, uye chinogona kubvisa mimwe mishonga, kuwedzera mitsva, kana kuchinja mazano aripo zvichibva pauchapupu hutsva.

Vanachiremba vanoshandisa riini 'Beers Criteria'?

Rondedzero iyi chishandiso chinowanzo shandiswa navanachiremba pavanopa mishonga kuvanhu vane makore anopfuura 65. Asi hachisi chinhu chaunongotarisa wosarudza nezvacho. Chiremba wako achafunga nezvenhoroondo yako yese yehutano, hutano hwako hwazvino, uye chero mimwe mishonga, mavhitamini, nezvimwe zvinowedzera zvauri kutora . Ivo vachazosarudza kana mushonga mutsva kana chiyero chemushonga wazvino chakachengeteka kwauri. Vangangodawo kuchinja mushonga, chiyero, kana kuti kakawanda kacho kanoshandiswa zvichienderana nerunyorwa urwu.

Ndezvipi zvinhu zvekufunga nezvazvo pakushandisa 'Beers Criteria'?

Uyu mubvunzo unokosha zvikuru. Chii chinonzi 'Doro Criteria'?Yakagadzirirwa vanhu vakawanda. Saka, haisi "yemunhu oga" . Kureva kuti, runyorwa urwu haruna chekuita nehutano hwemunhu, chero humwe hurwere hwaangave nahwo, kana zvinhu chaizvo zvakaita kuti chiremba asarudze mushonga chaiwo.

Saka, ichi chishandiso chakanaka chekuti vanachiremba vashandise. Hachiiti sarudzo dzechiremba ane hunyanzvi uye ane ruzivo.

Semuenzaniso, kana chiremba achida kukupa mushonga uri pane urongwa urwu unoonekwa seune njodzi, achafunga nezvezvinhu zvakawanda, zvinosanganisira hutano hwako nenzvimbo yauri kurapwa. Ndipo chete paachasarudza kana mushonga wacho wakachengeteka kwauri. Kazhinji, vanachiremba vanogona kusarudza imwe nzira yekurapa pane urongwa urwu. Zvisinei, kana mushonga uri pane urongwa urwu ukapihwa chiremba, chiremba achakutarisa zvakanyanya kuti aone kana paine mimwe migumisiro yakaipa.

Sei nzira iyo mishonga inokanganisa miviri yedu ichichinja sezvatinokura?

Iyi inyaya inokosha zvikuru. Sezvatinokura, miviri yedu inosangana nekuchinja kwakawanda. Kuchinja uku kunogona kukanganisa mashandisirwo emishonga uye mashandiro ayo mumiviri yedu. Heano mimwe mienzaniso:

• Zvinotora nguva yakareba kuti muviri uparare (metabolism) uye ubvise mushonga uyu. Izvi zvinoreva kuti mushonga uyu unogona kugara mumuviri wako kwenguva yakareba. Ndosaka vanachiremba dzimwe nguva vachipa vanhu vakuru mishonga yakaderera.
• Mushonga wechimwe chirwere unogona kukanganisa chimwe. Nekuti mimwe mishonga inochinja maitiro emuviri wedu, inogonawo kukanganisa mashandiro anoita mimwe mishonga.
• Kuchinja kwemararamiro. Zvinhu zvakaita sedanho rekuita kwako uye kudya kwaunodya zvinogona kukanganisa mashandiro anoita mimwe mishonga. Saka paunoona chiremba, zvakakosha kutaura nezvemaitiro ako ezuva nezuva, zvaunodya, uye kana uchirovedza muviri. Nenzira iyi, anogona kusarudza kurapwa kwakakunakira.

Vanachiremba vanoziva miviri yedu zvakanaka uye kuti inochinja sei nekukura. Kana vakakupa mushonga, vanozotarisa kuti muviri wako unopindura sei pauri kuti uve nechokwadi chekuti hauna njodzi.

Saka, ndezvipi zvinhu zvatinofanira kurangarira kubva munyaya iyi?

Zvakanaka, saka ikozvino ungangove wanzwisisa kuti 'Beers Criteria' yatataura nezvayo runyorwa rwemitemo yakakosha inobatsira vanachiremba pavanopa mishonga kuvanhu vane makore anopfuura makumi matanhatu nemashanu.

Izvi zvinobatsira vanachiremba kuti vatarise pamishonga inogona kukuvadza munhu mukuru uye kusarudza dzimwe nzira dzakachengeteka.

Rangarirai, ichi chishandiso chevanachiremba, kwete chimwe chinhu chamunofanira kushandisa kumisa kana kutanga mishonga mega.Kana muine mibvunzo kana zvinokunetsai nezvemushonga wamuri kunwa, ndapota taurai nachiremba wenyu. Iye ndiye munhu akakodzera kukupai mazano akarurama. Kuteerera manzwiro enyu ndiyo nzira yakanakisisa yekuchengetedza hutano.

Zvinodiwa paDoro, Hutano hweVakuru, Mishonga, Migumisiro Yakashata, Mishonga Yakachengeteka, Kukwegura