Tinofanira kuziva chaizvo nezvemishonga yekurwisa kukosora here?

Pamwe unonzwa kuda kurutsa uye kurutsa dzimwe nguva, handiti? Hazvina kunaka zvechokwadi. Saka nhasi tichataura nezvemhando yemushonga unogona kubatsira kudzora nekumisa zvinhu izvi zvakaita sekuda kurutsa nekurutsa. Iyi ndiyo yatinodaidza kuti mishonga yekudzivirira kusagaya . Ngationei kuti iyi chii, inoshanda sei, uye kuti inoshandiswa riini.

Ndeipi mishonga iyi yekudzivirira kugwinha?

Zvichitaurwa zviri nyore, "Mishonga yekudzivirira kusvotwa" mishonga inopihwa kudzivirira kuda kurutsa kana kurutsa, kana kurapa kana zvikaitika. "Anti-`` zvinoreva "kurwisa." Izwi rekuti "-emetic" rinobva pashoko rekuti "emesis". Mukurapa, izwi rekuti "(emesis)`` rinoshandiswawo pakurapa kurutsa. Saka, iyi mishonga inopihwa kudzivirira kurutsa.

Kune mhando dzakasiyana dzemishonga ye "Antiemetic", iyo iri "makirasi emishonga" akasiyana. Mimwe yacho unogona kuiwana ku pharmacy usina kunyorerwa mushonga (inonzi "Over-the-counter" kana "OTC"). Asi mimwe yacho inogona kungotorwa chete netsamba yachiremba (mishonga ye " prescription" ). Sezvo paine zvikonzero zvakawanda zvekusvotwa nekurutsa, kune mishonga chaiyo ye "Antiemetic" yakakodzera chimwe nechimwe chikonzero.

Ndirini pandinofanira kushandisa mushonga wekudzivirira kurutsa?

Zvino pamwe uri kufunga kuti, 'Saka ndichada mushonga wakadai riini?'

Kurutsa dzimwe nguva inzira yekudzivirira miviri yedu. Funga nezvazvo, kana ukadya chikafu chakaora, kana kuti uine dumbu rinorwadza (furuu yemudumbu), zviri nani kurutsa wobvisa chepfu mumuviri wako.

Zvisinei, kana kurutsa kwakanyanya kana kuti kuchiitika kakawanda, zvinogona kukonzera matambudziko makuru ehutano. Semuenzaniso:

• Kutyoka kwemapfupa kunogona kutoitika, kunyanya kune vakwegura.
• Kushaya mvura mumuviri ndiko kurasikirwa nemvura mumuviri.
• Kuputika kwegurokuro, kunozivikanwawo seBoerhaave's syndrome.
• Kushaya chido chekudya .
• Kusakwana kwezvekudya zvinovaka muviri ('Kusadya Zvakakwana').
• Kuchinja kwepfungwa.
• Enamel yemazino inopera.
• Maronda ekuvhiyiwa anogona kuvhurwazve (`Kuvhurwazve kwemaronda ekuvhiyiwa`).

Nekuda kwezvinhu zvakaita seizvi, vanachiremba dzimwe nguva vanopa mushonga uyu we "Antiemetic" kudzivirira kurutsa kana kumisa kurutsa kwatotanga.

Rubatsiro rwekusvotwa nguva dzose uye kurutsa

Kana muine kuda kurutsa kwakanyanya kana kwenguva refu, chiremba wenyu anogona kukupai mushonga we "Antiemetic". Ngatitarisei mimwe mienzaniso.

• Kusvotwa nekurutsa kunokonzerwa nemwaranzi uye chemotherapy (CINV): Kusvotwa nekurutsa uye/kana kurutsa ndizvo zvinowanzokonzera chemotherapy. Kurapa nemwaranzi kuuropi, mudumbu, kana muchiropa kunogonawo kukonzera migumisiro iyi. Nechikonzero ichi, vanachiremba vanokurudzira kuti utore mushonga wekudzivirira emetic paunenge uchirapwa nechemotherapy kana nemwaranzi. Izvi zvinodaro nekuti kusvotwa nekurutsa zvakanyanya kunogona kuva nengozi kune munhu ane kenza.
• Kusvotwa uye kurutsa panguva yekuzvitakura (kunozivikanwawo sekuti `kurwara kwemangwanani`): Vamwe vanachiremba vanokurudzira `kudzivisa kugaya` pasina kunyorerwa mushonga wekurapa. Saizvozvowo, kune `hyperemesis gravidarum`, vanachiremba vanokurudzira `kugaya` pasina kunyorerwa mushonga wekurapa kana kuti `kudzivisa kugaya mushonga wekurapa.

Chinhu chinonyanya kukosha ndechekutaura nachiremba wako nezvekuti ungashandisa riini uye sei mishonga iyi ye `(Antiemetic)`. Dzimwe nguva, kunyanya mumamiriro ezvinhu akadai se `(CINV)`, ungangoda kushandisa anopfuura `(Antiemetic)`. Kana uine kuda kurutsa uye kurutsa panguva yekuzvitakura , unofanira kutaura nachiremba usati watora chero mushonga kubva kupharmacy.

Mushonga wekukurumidza kuda kurutsa nekurutsa

Dzimwe nguva, kana kuda kurutsa nekurutsa kwava pedyo nekuitika, vanachiremba vanopa mushonga uyu we "Antiemetic" kuti udzivise dambudziko iri. Funga nezvazvo nenzira iyi.

Mishonga yakawanda, yakaita seanesthetics (inoshandiswa muanesthesia) uye opioids , inogona kukonzera kuda kurutsa nekurutsa semhedzisiro. Vanachiremba vanoshandisa mishonga iyi pazvinhu zvakaita sekuvhiyiwa. Saka, kudzivirira kuda kurutsa nekurutsa mushure mekuvhiyiwa (kuda kurutsa nekurutsa mushure mekuvhiyiwa - PONV), vachakupa mushonga wekudzivirira kuchema.

Chiremara uye kutadza kufamba zvinogona kukonzera kuda kurutsa nekurutsa. Kana uchizosangana nezviratidzo izvi (semuenzaniso, parwendo rurefu, senge mubhazi kana ngarava), chiremba wako anogona kukukurudzira kuti utore mushonga wekudzivirira kuta kurutsa.

Kunze kweizvi, panogona kunge paine dzimwe nguva apo chiremba anogona kukupa mushonga we "Antiemetic".

Mishonga ipi iripo yekumisa kurutsa?

Iye zvino ngationei kuti ndeapi marudzi emishonga yekudzivirira kugaya anowanikwa. Kune mhando nomwe dzemishonga ye "Antiemetic". Kune mhando dzakasiyana dzemishonga muchikamu chimwe nechimwe.

1. Zvinopikisa serotonin

Iyi imhando ye "Antietic" inoshandiswa zvakanyanya iyo inopihwa kurapa kuda kurutsa nekurutsa. Mienzaniso yeiyi ndeiyi:

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

Mushonga uyu unotenderwa neUS Food and Drug Administration ( FDA ) kudzivirira zvinotevera:

• `CINV` (kusvotwa nekukurutsa kunokonzerwa nekurapwa negomarara) uye kuda kurutsa nekukurutsa kunokonzerwa nemwaranzi.
• `PONV` (zvinoreva kuda kurutsa mushure mekuvhiyiwa).

Zvisinei, dzimwe nguva vanachiremba vanonyora mishonga iyi kune zvimwe zvirwere. Izvi zvinonzi kushandiswa kwe 'off-label', zvichireva kuti inoshandiswa kune zvimwe zvinangwa zvisiri izvo zvakatenderwa neFDA.

2. Mishonga inorwisa histamine

Mishonga inorwisa histamine, kunyanya iyo inovhara histamine 1 (H1) receptor, inonyanya kushandiswa navanachiremba kudzora zviratidzo zvine chekuita neallergies. Zvisinei, mimwe yacho yakatenderwa neFDA kudzivirira nekurapa kuda kurutsa nekurutsa kunokonzerwa nekufamba uye vertigo. Dzimwe nguva, vanachiremba vanogona kuanyora zvisiri pamutemo kana mimwe mishonga inorwisa kuda kurutsa nekurutsa panguva yekuzvitakura isina kushanda. Heano mamwe marudzi emishonga inorwisa kurutsa:

• Mapiritsi anotsenga e`Dimenhydrinate` (`Dramamine®`)
• Makapisi kana mapiritsi eDiphenhydramine (Benadryl®)
• Vhitamini B6 ine `Doxylamine succinate` – Iyi ndiyo nzira yekutanga yekurapa kuda kurutsa nekurutsa panguva yekuzvitakura.
• `Meclizine (Antivert®, Bonine®, Dramamine-N®)`
• `Promethazine (Phenergan®)`

Mishonga yakaita sediphenhydramine nedimenhydrinate inogonawo kubatsira kudzivirira PONV (kusvotwa mushure mekuvhiyiwa uye kurutsa), asi kazhinji haisi mishonga yekutanga yekurapa chirwere ichi.

3. Glucocorticoids

Glucocorticoids (kana kuti Corticosteroids) imhando yemishonga inoshandiswa navanachiremba kunyanya nekuda kwesimba rayo rekurwisa allergy uye rekudzivirira kuzvimba. Zvisinei, mamwe maGlucocorticoids anoshandawo semishonga inorwisa emergency.

Dexamethasone (Baycadron Elixer®, Decadron®, Zema-Pak®, nedzimwe mhando) ndiyo glucocorticoid huru inoshandiswa navanachiremba kudzivirira CINV (kusvotwa kunokonzerwa nekurapwa kwekenza) uye PONV (kusvotwa mushure mekuvhiyiwa).

Vanachiremba dzimwe nguva vanopa mushonga we `(Glucocorticoid)` pamwe chete nedzimwe mhando dze `(Antiemetic)` kudzivirira kuda kurutsa nekurutsa. Asi kusiyana nedzimwe mhando dze `(Antiemetic)`, `(Glucocorticoids)` hadzigone kurapa kuda kurutsa nekurutsa kana zvatanga. Kureva kuti, dzinongopihwa kudzivirira kuda kurutsa.

4. Mishonga yekuderedza kushushikana kweropa

Mishonga yeAnticholinergics (inozivikanwawo seantimuscarinics) imhando yemishonga inodzivisa kushanda kwekemikari inonzi acetylcholine (neurotransmitter). Inogona kubatsira kurapa zvirwere zvakasiyana-siyana (sekusagona kudzora weti uye COPD), uye inogonawo kubatsira nekurutsa nekurutsa.

Scopolamine (Maldemar, Scopace, Transderm Scop®) ndiyo mushonga mukuru unoshandiswa pakurapa kurutsa. Vanachiremba vanoushandisa ku:

• Dzivirira kurutsa mushure mekuvhiyiwa.
• Kudzivirira kana kurapa kuda kurutsa kunokonzerwa ne "kufamba kwemuviri" (kurutsa uri parwendo).

5. Vadzivisi veNeurokinin-1 receptor

Mishonga inorwisa manyuko eNeurokinin-1 (NK-1) inoshanda nekuvhara chinhu chechisikigo muuropi hwako chinonzi neurokinin chinokonzera kuda kurutsa nekurutsa. Mishonga iyi inoshanda zvikuru mukurapa CINV (cancer-induced nausea) uye PONV (post-operative nausea). Inewo simba rekudzivirira kuzvidya mwoyo (anxiolytic) uye antidepressant.

Mishonga iri muchikamu ichi ndeiyi:

• `Aprepitant (Aponvie®, Emend®' uye `Cinvanti®)`
• `Fosaprepitant (Emend®` uye `Focinvez®)`
• Musanganiswa we `Netupitant` uye `palonosetron` (`Akynzeo®)`
• `Rolapitant (Varubi®)`

6. Vadzivisi veDopamine

Mishonga inorwisa dopamine imhando yemishonga inomisa mamwe marudzi emasero muuropi hwako kuti asashande. Inonyanya kushandiswa pakurapa mamwe matambudziko epfungwa nezviratidzo, kunyanya psychosis ne schizophrenia . Zvisinei, mamwe emhando idzi anogonawo kubatsira pakusvotwa nekurutsa.

Kune mhando dzakasiyana dze dopamine antagonists dzinoshandiswa pakurutsa:

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

Mishonga inodzivirira dopamine inogona kushandiswa panzvimbo pe'CINV' (kurutsa kunokonzerwa nekenza) kana mimwe mishonga '(Antiemetic)' isingashande. Inogonawo kubatsira kudzivirira 'PONV' (kurutsa mushure mekuvhiyiwa).

7. MaCannabinoids

MaCannabinoids imhando yemakomichi anowanikwa mumuti wembanje (mbanje). Anosunga kumareceptor ecannabinoid muuropi hwako, mudumbu, uye mumasero ekudzivirira muviri.

Macannabinoids anogadzirwa mamorekuru akagadzirwa kutevedzera mhedzisiro ye tetrahydrocannabinol (THC). Parizvino kune mhando mbiri dzemacannabinoids ekugadzira ari pamusika ekushandiswa semishonga yekudzivirira emergency:

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

Izvi zvakatenderwa neFDA kuti zvishandiswe pakurapa kenza (CINV) uye zvinofanirwa kushandiswa chete kana mishonga yekutanga yekurwisa kusvipa yakundikana.

Cannabinoids ndiyo mhando itsva yemishonga yekurwisa kusagaya chikafu. Vaongorori vachiri kudzidza nekutsvaga mashandiro ayo.

Tinotora sei mushonga uyu? (Nzira dzekuushandisa)

Mishonga yakawanda ye "Antiemetic" inowanikwa mu "mhando" dzinopfuura imwe chete. Inogona kutaridzika seizvi:

• Mapiritsi anonwiwa, zvichireva mapiritsi anomedzwa kana kutsengwa.
• Mishonga yemutsinga (intravenous solutions), inova mishonga yemvura inopinzwa mutsinga.
• Majekiseni mutsandanyama yako (mutsinga).
• Zvigamba zveganda (transdermal) - Izvi zvinonyanya kushandiswa neScopolamine (mushonga unoderedza cholinergic).
• Mapiritsi emudumbu (suppositories).

Mishonga iyi inogona kukonzera migumisiro yakaipa here?

Migumisiro inogona kuitika pamhando yega yega ye `(Antiemetic)` inosiyana. Chiremba wako achakuudza nezvemigumisiro iyi usati watanga kutora mushonga. Usatya kubvunza mibvunzo uye kugovana zvaunofunga. Kana uine mimwe migumisiro inonetsa mushure mekutanga `(Antiemetic)`, taura nachiremba wako.

Heano mamwe emigumisiro yakajairika (asi kwete yese) inogona kuitika nerudzi rumwe nerumwe rwe "Antiemetic":

• Zvinopikisa serotonin: Musoro, dzungu, uye kuvimbiwa.
• Mishonga inorwisa hope: Kurara.
• Glucocorticoids: Kushaya hope, kushamisika, uye kuchinja kwemafungiro.
• Mishonga yeAnticholinergics: Muromo wakaoma, kuchinja kwekuona, uye hope.
• Zvinorwisa NK-1 receptor: Zvinogona kukonzera musoro, dzungu, uye mune vamwe vanhu, allergy yakanyanya (anaphylaxis).
• Zvinokonzera dopamine: dzungu, musoro, uye matambudziko ekufamba-famba, zvakaita sedystonia (kudzikira kwemhasuru dzisingadiwi) uye tardive dyskinesia (kufamba-famba kwemuviri kusingadiwi, kunyanya kwechiso nemuromo).
• MaCannabinoids:Chiso chakakombama, BP yakaderera, uye dysphoria (kunzwa kusagadzikana kukuru kana kusagutsikana).

Zvakanaka here kutora mushonga uyu kana ndine pamuviri?

Kana uchirwara nerutsa uye uchirutsa panguva yekuzvitakura, unofanira kutaura nachiremba wezvemadzimai kana mumwe chiremba. Vanowanzo kurudzira kuti uchinje chikafu chaunodya kana nguva dzaunodya. Kana izvozvo zvikasabatsira, vanogona kukupa mishonga.

Ongororo dzakawanda dzakaratidza kuti mimwe mishonga yekudzivirira kusvotwa inowanzo shandiswa panguva yekuzvitakura. Zvisinei, ruzivo rwekuchengetedza kune mimwe runopesana kana kuti rushoma. Iwe nachiremba wako muchasarudza pamwe chete kuti chii chakakunakirai.

Kana wangoziva kuti une pamuviri, enda kuna chiremba kuti akuudze nezvemishonga yauri kutora. Zvakare, unofanira kutaura nachiremba usati watanga chero mishonga mitsva panguva yekuzvitakura.

Unoita sei kana ukarasikirwa nemushonga?

Kana ukarasikirwa nemushonga we "Antietic", kunyanya kana uri mushonga unodzivirira kuda kurutsa uye kurutsa unogona kuramba uripo, senge "CINV," taura nachiremba wako. Iye achakupa mazano ezvekuita.

Ndeipi meseji yatinoda kuunza kubva munyaya ino?

Hapana anoda kunzwa kuda kurutsa nekurutsa. Dzimwe nguva, izvi zvinhu zvisingafadzi zvinodiwa nemiviri yedu. Asi dzimwe nguva, zvinogona kukuvadza zvakanyanya. Nerombo rakanaka, mishonga yekudzivirira kusvotwa inogona kubatsira kudzivirira uye/kana kurapa kuda kurutsa nekurutsa, kungave kuri kutanga kana kuenderera mberi. Pane sarudzo dzinoverengeka dzekusarudza kubva. Pamwe chete, iwe nachiremba wako muchasarudza zvakakunakirai. Saka, kana muri kusangana nedambudziko iri, musatya kutaura nachiremba, zvakanaka here?

'Mishonga inorwisa kusvotwa, kuda kurutsa, kurutsa, mishonga inorwisa kusvotwa, migumisiro yakaipa, pamuviri, kurapwa kwegomarara