Ungave wakambonzwa nezvemishonga inonyaradza marwadzo yakasimba yakaita seTramadol neMorphine. Vanachiremba vanoshandisa mishonga iyi mushure mekuvhiyiwa kwakati kana kana paine marwadzo akanyanya akadai sekenza. Asi kana ikashandiswa zvisirizvo, kureva kuti, kana ukaishandisa zvakanyanya, inogona kukuvadza zvikuru uye kutouraya. Mumamiriro ezvinhu ane njodzi akadaro, kune mhando yemushonga inogona kumisa kushanda kwemishonga iyi nekukasika uye kuponesa hupenyu. Ndiyo yatinodaidza kuti 'Opioid Antagonist'.
Kutanga, ngationei kuti iyi 'opioid' chii?
Zvichitaurwa zviri nyore, maopioid iboka remakemikari anoshanda nemasero edu etsinga kuderedza marwadzo. Mamwe anoitika ega, nepo mamwe achigadzirwa mumarabhoritari. Vanachiremba vanowanzoashandisa kurapa marwadzo ari pakati nepakati kusvika akanyanya. Zvisinei, kunewo mishonga isingabvumirwe seheroin iri muboka iri.
Vanhu vanowanzopindwa muropa nemishonga iyi yeopioid. Chikonzero ndechekuti haingorerutsi marwadzo chete, asiwo inounza mufaro unoshamisa, kunzwa kwekuyangarara (euphoria). Nekufamba kwenguva, mushonga unotorwa usati wawana mufaro iwoyo hauna kukwana. Tinoti izvi 'kushivirira'. Wobva wanzwa kuda kuwedzera mushonga. Pakupedzisira, izvi zvinogona kukura kuva chirwere chekushandisa opioid.
Saka uyu muvengi weopioid anoshanda sei?
Kuti tinzwisise izvi, ngatitorei muenzaniso mudiki. Fungidzira kuti muviri wedu, kunyanya muuropi nemumusana (central nervous system), une 'receptors' dzakakosha dzinopindura maopioid. Sema keyholes. Aya anonzi mu, kappa, uye delta receptors. Chinhu chikuru chinoshanda ndeche ma mu receptors aya.
- Maopioid (mishonga inouraya marwadzo) akafanana ne'kiyi yekurudyi' inopinda muburi iri rekiyi. Paunoisa kiyi iyoyo woitenderedza, kureva kuti, paunotora opioid, mareceptor iwayo anotanga kushanda uye kurwadziwa kunopera, kufema kunononoka, uye mufaro wandambotaura nezvawo unouya.
- Mishonga inorwisa maopioid yakafanana ne'kiyi yenhema' inopinda muburi rekiyi, asi haigone kudzoserwa. Kana mushonga uyu ukapinda mumuviri, unokurumidza kuenda kumareceptor iwayo, maburi ekiyi. Asi haubatidze receptor. Pane kudaro, unovhara buri rekiyi.
Zvino mava kunzwisisa here? Nekuti kiyi yenhema yakabatirira muburi rekiyi, hapana nzira yekuti 'kiyi chaiyo', iyo opioid, iuye yobatana. Saka mhedzisiro yeopioid inomira zvachose. Kana mumwe munhu anwa opioid zvakanyanya uye zvichiita sekunge amira kufema, ndizvo zvinoitika kana ukamupa iyi antagonist. Inobva yapinda nekukasika yomisa kushanda kweopioid, uye inomubvumira kufema zvakanaka zvakare.
Ndeapi marudzi makuru evanorwisa opioid?
Kune mhando dzakasiyana dzemishonga iyi. Imwe neimwe inoshandiswa pazvinangwa zvakasiyana. Ngatinyatsoongorora tafura iyi.
| Zita remushonga uyu | Kushandiswa kukuru | Pfungwa dzakakosha |
|---|---|---|
| Naloxone | Mushonga unoponesa hupenyu hwemunhu anonyanya kushandisa opioid. | Inopihwa sejekiseni kana sepfapfaidzo yemhino. Kana munhu akamira kufema nekuda kwekunwa opioid zvakanyanya, inogona kudzorera kufema mukati memaminitsi maviri kusvika mashanu. Munyika medu, inonyanya kushandiswa mumakamuri ekurapa emergency (ETUs) muzvipatara. |
| Naltrexone | Semushonga wekuchengetedza kwenguva refu wekurapa kupindwa muropa neopioid nedoro. | Izvi zvinobatsira kukunda kupindwa muropa. Zvinodzivirira kufara kunouya nekutora maopioid. Asi hazvidzore zviratidzo zvekurega kana kuda zvinodhaka. Zvinouya mumapiritsi kana majekiseni. |
| Methylnaltrexone | Kuzvimba kunokonzerwa nemishonga inorwisa marwadzo yeopioid. | Izvi zvakasiyana zvishoma. Hazviendi kuuropi. Pane kudaro, zvinongovhara ma opioid receptors muura. Saka hazvikanganisi kushanda kwemishonga inoderedza marwadzo, zvinongoderedza kuvimbiwa. Zvinonyorerwa vanhu vari kurapwa marwadzo asingaperi. |
| Nalmefene | Kune vanhu vanonwa opioid zvakanyanya. | Izvi zvakafanana ne naloxone, asi zvinogara zvichishanda mumuviri kwenguva yakareba. Zvisinei, hazvishandiswi zvakanyanya se naloxone. |
Migumisiro yemishonga iyi ndeipi?
Mhedzisiro huru uye inonyanya kukosha yemishonga yakaita seNaloxone neNaltrexone ndeyekuonekwa kwe'zviratidzo zvekurega kushandisa opioid' . Fungidzira, muviri wemunhu wagara uchijaira maopioid kwenguva yakareba. Iyi ndiyo mhinduro yemuviri kana munhu anopikisa angoerekana apiwa uye basa racho rikamiswa.
Ndezvipi zviratidzo zvekurega kushandisa zvinodhaka?
- Mhino inoyerera
- Kubvaruka zvakanyanya kubva mumaziso
- Kushama kakawanda
- Kuwedzera kwekufema (Hyperventilation)
- Kupisa kwakanyanya kwemuviri
- Kuwedzera kwekurova kwemoyo (Tachycardia)
- Kurwadziwa kwetsandanyama
- Kusvotwa nekurutsa
- Manyoka
- Kunetseka
Kuoma kwezviratidzo izvi kunosiyana kubva pamunhu nemunhu. Zvinoenderana nekuti yakashandiswa kwenguva yakareba sei uye rudzii rweopioid. Muchipatara, vanachiremba vanobata chirwere ichi zvakanaka. Vanopa mishonga yemunyu (IV fluids) nemimwe mishonga.
Migumisiro yeMethylnaltrexone, iyo inoshandiswa pakurapa kuvimbiwa, yakasiyana. Idzi ndeidzi:
- Kurwadziwa kwedumbu
- Kuzadza dumbu
- Kusvotwa kana kurutsa
- Musoro
- Kutenderedza tsandanyama
- Dzungu
Ndezvipi zvakanakira mishonga iyi?
Pasinei nemigumisiro yacho, mabhenefiti emishonga iyi anodarika ayo zvachose.
Naloxone mushonga unoponesa hupenyu . Unogona kudzivirira rufu nekuda kwekunwa opioid zvakanyanya. Ndicho chinhu chakakosha.
NaltrexoneChinhu chakakosha pakurapa zvirwere zvakaoma zvakaita sekupindwa muropa neopioid kana doro. Asi hazvina kukwana zvega. Kupindwa muropa nezvinodhaka chirwere chakaoma zvikuru. Chinoda kurapwa kubva muzvinhu zvakasiyana-siyana, zvakaita sekurapa kwepfungwa uye kurapwa. Naltrexone mushonga unopa simba guru parwendo irworwo.
Kana iwe kana mumwe munhu waunoziva ari kusangana nedambudziko iri, ndapota taura nachiremba wako nezvazvo. Kune vanachiremba vakawanda uye nzira dzinogona kubatsira nematambudziko aya.
Mharidzo Yekuenda Nayo Kumba
- Mushonga weopioid antagonist rudzi rwemushonga unodzivisa kushanda kweopioid (mishonga inonyaradza marwadzo yakasimba uye mishonga yakaita seheroin) mumuviri.
- Naloxone mushonga unokosha zvikuru, unoshanda nekukurumidza unogona kupihwa kuponesa hupenyu hwemunhu akanwa maopioid akawandisa.
- Mishonga iyi, kunyanya kana ikapihwa munhu ane muviri wakajaira mishonga yeopioid, inogona kukonzera zviratidzo zvakakomba zvekurega kushandisa. Saka, inofanira kushandiswa nguva dzose pasi pekutarisirwa nachiremba.
- Kupindwa muropa nezvinodhaka hakusi kushaya simba, chirwere chinorapika. Kana iwe kana mumwe munhu waunoziva achida rubatsiro, usanyara kutaura nachiremba nezvazvo.
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