Ngaba kufuneka sazi kakuhle ngamayeza okulwa nokugabha?

Mhlawumbi uziva unesicaphucaphu kwaye uhlanza ngamanye amaxesha, akunjalo? Akukhululeki ngokwenene. Ngoko ke namhlanje siza kuthetha ngohlobo lonyango olunokunceda ukulawula nokuphelisa ezi zinto ezifana nesicaphucaphu nokuhlanza. Ezi zizinto esizibiza ngokuba ngamayeza okulwa nokugabha . Makhe sibone ukuba zithini ezi zinto, zisebenza njani, kwaye zisetyenziswa nini.

Zithini ezi ziyobisi zokulwa nokugabha?

Ngamafutshane, "Amayeza okulwa nokugabha" ngamayeza anikwa ukuthintela isicaphucaphu nokuhlanza, okanye ukunyanga ukuba kuyenzeka. "Anti-``` ithetha "ukuchasana." Igama elithi `-emetic`` livela kwigama elithi `emesis``. Kwizonyango, igama elithi ``(emesis)`` likwasetyenziswa ekugabheni. Ngoko ke, la ngamayeza anikwa ukuthintela ukugabha.

Kukho iintlobo ezahlukeneyo zamayeza ``Antietic``, ahlukeneyo ``iiklasi zamayeza``. Amanye awo ungawafumana kwikhemesti ngaphandle kwencwadi kagqirha (ebizwa ngokuba ``Over-the-counter`` okanye ``OTC``` amayeza). Kodwa amanye awo anokuthathwa kuphela ngencwadi kagqirha (``` incwadi kagqirha`` ). Ekubeni kukho izizathu ezininzi zokucaphuka nokuhlanza, kukho amayeza athile ``Antietic``` afanelekileyo kwisizathu ngasinye.

Ndidinga nini amayeza okulwa nokuhlanza?

Ngoku mhlawumbi ucinga ukuba, 'Ngoko ke ndingadinga nini iyeza elinje?'

Ukuhlanza ngamanye amaxesha yindlela yokuzikhusela emzimbeni wethu. Cinga ngako, ukuba utya ukutya okonakeleyo, okanye ukuba unesifo sesisu esibuhlungu (umkhuhlane wesisu), kungcono ukuhlanza uze ususe ityhefu emzimbeni wakho.

Nangona kunjalo, ukuba ukuhlanza kukhulu okanye kwenzeka rhoqo, kunokukhokelela kwiingxaki ezinkulu zempilo. Umzekelo:

• Ukuqhekeka kwamathambo kunokwenzeka, ingakumbi kubantu abadala.
• Ukuphelelwa ngamanzi emzimbeni kukulahlekelwa ngamanzi emzimbeni.
• Ukuqhekeka komlomo wesibeleko, okwaziwa ngokuba yi-Boerhaave's syndrome.
• Ukulahlekelwa yintliziyo .
• Ukunqongophala kwesondlo (`Ukungondleki`).
• Utshintsho lwengqondo.
• I-enamel yamazinyo iyaphela.
• Amanxeba otyando angavulwa kwakhona (`Ukuvulwa kwakhona kwamanxeba otyando`).

Ngenxa yezinto ezinje, oogqirha ngamanye amaxesha banika eli yeza elithi "Antietic" ukuthintela ukuhlanza okanye ukuyeka ukuhlanza okusele kuqalile.

Uncedo lwesicaphucaphu esingapheliyo kunye nokuhlanza

Ukuba unesicaphucaphu esikhulu okanye esihlala ixesha elide kwaye uhlanza, ugqirha wakho angakunika iyeza elithi "Antietic". Makhe sijonge eminye imizekelo.

• Ukucaphuka nokuhlanza okubangelwa yimitha kunye ne-chemotherapy: Ukucaphuka kunye/okanye ukuhlanza ziziphumo eziqhelekileyo ze-chemotherapy. Unyango lwemitha ebuchotsheni, kwindlela yokugaya ukutya, okanye kwisibindi lunokubangela ezi ziphumo. Ngenxa yesi sizathu, oogqirha bacebisa ukuba uthathe i-antiemetic ngelixa usenza i-chemotherapy okanye unyango lwemitha. Oku kungenxa yokuba ukucaphuka nokuhlanza okugqithisileyo kunokuba yingozi kakhulu kumntu onomhlaza.
• Isicaphucaphu nokuhlanza ngexesha lokukhulelwa (ekwaziwa ngokuba yi-'morning sickness'): Abanye oogqirha bacebisa i-'antiemetics' ethengiswa ngaphandle kwemvume kagqirha kule meko. Ngokufanayo, kwi-'hyperemesis gravidarum', oogqirha bacebisa nokuba ithengiswa ngaphandle kwemvume kagqirha okanye i-'antiemetics' ebhalwe ngugqirha.

Eyona nto ibalulekileyo kukuthetha nogqirha wakho malunga nokuba uza kuzisebenzisa nini kwaye njani ezi `(Antiemetic)`. Ngamanye amaxesha, ingakumbi kwiimeko ezifana ne-`(CINV)`, kunokufuneka usebenzise ngaphezulu kwe-`(Antiemetic)`. Ukuba unesicaphucaphu kwaye uhlanza ngexesha lokukhulelwa , ngokuqinisekileyo kufuneka uthethe nogqirha wakho ngaphambi kokuba uthathe naliphi na iyeza kwikhemesti.

Iyeza lokunyanga isicaphucaphu nokuhlanza ngesiquphe

Ngamanye amaxesha, xa isicaphucaphu nokuhlanza sele kukufuphi ukuba kwenzeke, oogqirha banika eli yeza "lokulwa nokugabha" ukuthintela oku. Cinga ngale ndlela.

Amayeza amaninzi, anjenge-anesthetics (esetyenziswa kwi-anesthesia) kunye ne-opioids , anokubangela isicaphucaphu kunye nokuhlanza njengemiphumo emibi. Oogqirha basebenzisa la mayeza kwizinto ezifana notyando. Ngoko ke, ukuthintela isicaphucaphu kunye nokuhlanza emva kotyando (isicaphucaphu kunye nokuhlanza emva kotyando - i-PONV), baya kukunika amayeza okuthintela ukugabha.

I-Vertigo kunye ne-motion sickness nazo zinokubangela isicaphucaphu kunye nokuhlanza. Ukuba uza kuba kwimeko apho kunokwenzeka ukuba ube nezi mpawu (umzekelo, kuhambo olude, njengakwibhasi okanye enqanaweni), ugqirha wakho unokucebisa ukuba uthathe amayeza okunciphisa ukugabha.

Ngaphandle koku, kusenokubakho ezinye iimeko apho ugqirha angakunika khona "i-Antietic".

Ngawaphi amayeza akhoyo okuthintela ukuhlanza?

Ngoku makhe sibone ukuba zeziphi iintlobo zamayeza okulwa nokugabha afumanekayo. Kukho iindidi ezisixhenxe zamayeza okulwa nokugabha. Kukho iintlobo ezahlukeneyo zamayeza kudidi ngalunye.

1. Iintsholongwane zeSerotonin

Olu luhlobo olusetyenziswa kakhulu lwe-"Antietic" olunikwa ngokukodwa ukunyanga isicaphucaphu nokuhlanza. Imizekelo yale mizekelo yile:

• `IGranisetron (Kytril®)`
• `Ondansetron (Zofran®)`
• `I-Palonosetron (i-Aloxi®)`

Eli yeza livunyiwe yi-US Food and Drug Administration ( FDA ) ukuthintela oku kulandelayo:

• `CINV` (isicaphucaphu kunye nokuhlanza okubangelwa lunyango lomhlaza) kunye nesicaphucaphu kunye nokuhlanza okubangelwa lunyango lwemitha.
• `PONV` (oko kuthetha isicaphucaphu kunye nokuhlanza emva kotyando).

Nangona kunjalo, ngamanye amaxesha oogqirha banika la mayeza kwezinye iimeko. Oku kubizwa ngokuba kukusetyenziswa `ngaphandle kweleyibhile`, oko kuthetha ukuba asetyenziselwa ezinye iinjongo ezingezizo ezo zivunyiweyo yi-FDA.

2. Amayeza okulwa ne-histamine

Ii-antihistamines, ingakumbi ezo zithintela i-histamine 1 (H1) receptor, zisetyenziswa kakhulu ngoogqirha ukulawula iimpawu ezinxulumene ne-allergies. Nangona kunjalo, ezinye zezi zivunyiwe yi-FDA ukuthintela nokunyanga isicaphucaphu nokuhlanza okubangelwa kukugula ngentshukumo kunye ne-vertigo. Ngamanye amaxesha, oogqirha banokuyalela ukuba zingafakwanga kwi-label ukuba ezinye ii-antiemetics zesicaphucaphu nokuhlanza ngexesha lokukhulelwa azisebenzanga. Nazi ezinye iintlobo zee-antihistamines zokuhlanza:

• Iipilisi ezityiwayo ze-`Dimenhydrinate` (`Dramamine®`)
• Iikhaphu okanye iipilisi zeDiphenhydramine (Benadryl®)
• IVithamin B6 ene-'Doxylamine succinate' – Olu lolona nyango luphambili lokunyanga isicaphucaphu nokuhlanza ngexesha lokukhulelwa.
• `Meclizine (Antivert®, Bonine®, Dramamine-N®)`
• `I-Promethazine (iPhenergan®)`

Amayeza anjenge-diphenhydramine kunye ne-dimenhydrinate anokunceda ekuthinteleni i-PONV (isicaphucaphu kunye nokuhlanza emva kotyando), kodwa aqhelekanga ukuba ngamayeza okuqala alo nyango.

3. Iiglucocorticoids

IiGlucocorticoids (okanye iiCorticosteroids) luludidi lwamayeza asetyenziswa ngoogqirha ikakhulu ngenxa yeempawu zawo zokulwa nokwaliwa kunye nokudumba. Nangona kunjalo, ezinye iiGlucocorticoids zikwasebenza njenge-antiemetics.

I-Dexamethasone (iBaycadron Elixer®, iDecadron®, iZema-Pak®, kunye nezinye iimpawu) yeyona glucocorticoid iphambili esetyenziswa ngoogqirha ukuthintela i-CINV (isicaphucaphu esibangelwa lunyango lomhlaza) kunye ne-PONV (isicaphucaphu esisemva kotyando).

Oogqirha ngamanye amaxesha banika i-`(Glucocorticoid)` kunye nezinye iintlobo ze-`(Antiemetic)` ukuthintela isicaphucaphu nokuhlanza. Kodwa ngokungafaniyo nezinye iintlobo ze-`(Antiemetic)`, i-`(Glucocorticoids)` ayinakunyanga isicaphucaphu nokuhlanza xa sele iqalile. Oko kukuthi, zinikwa kuphela ukuthintela.

4. I-Anticholinergics

I-Anticholinergics (ekwaziwa ngokuba yi-antimuscarinics) luhlobo lwamayeza athintela ukusebenza kwekhemikhali ebizwa ngokuba yi-acetylcholine (i-neurotransmitter). Anokunceda ekunyangeni iimeko ezahlukeneyo (ezifana nokungakwazi ukuzibamba komchamo kunye ne-COPD), kwaye anokunceda nakwisicaphucaphu nokuhlanza.

I-Scopolamine (Maldemar, Scopace, Transderm Scop®) yeyona iyeza liphambili le-anticholinergic elisetyenziselwa ukuhlanza. Oogqirha bayisebenzisela oku:

• Thintela 'i-PONV' (ukuhlanza emva kotyando).
• Ukuthintela okanye ukunyanga isicaphucaphu esibangelwa "sisigulo sokuhamba" (ukuhlanza ngexesha lohambo).

5. Ii-Neurokinin-1 receptor antagonists

Ii-Neurokinin-1 (NK-1) receptor antagonists zisebenza ngokuthintela into yendalo engqondweni yakho ebizwa ngokuba yi-neurokinin ebangela isicaphucaphu nokuhlanza. La mayeza asebenza kakhulu ekunyangeni i-CINV (isicaphucaphu esibangelwa ngumhlaza) kunye ne-PONV (isicaphucaphu esisemva kotyando). Zikwanazo neempawu zokulwa nokuxhalaba (i-anxiolytic) kunye ne-antidepressant.

Amayeza akweli candelo ngala:

• `I-Aprepitant (Aponvie®, Emend®` kunye ne `Cinvanti®)`
• `Fosaprepitant (Emend®` kunye ne `Focinvez®)`
• Indibaniselwano ye-`Netupitant` kunye ne-`palonosetron` (`Akynzeo®)`
• `I-Rolapitant (iVarubi®)`

6. Abachasi beDopamine

Ii-Dopamine antagonists luhlobo lwamayeza athintela iintlobo ezithile zeeseli engqondweni yakho ukuba zingaqhubi. Ziyindlela ephambili yonyango lwezinye izifo zengqondo kunye neempawu, ingakumbi i-psychosis kunye ne -schizophrenia . Nangona kunjalo, ezinye zezi ntlobo zinokunceda nakwisicaphucaphu kunye nokuhlanza.

Kukho iintlobo ezahlukeneyo ze-dopamine antagonists ezisetyenziselwa ukuhlanza:

• `I-Amisulpride (iBarhemsys®)`
• ``I-Chlorpromazine (Thorazine®)''
• `I-Droperidol (Inapsine®)`
• `Haloperidol (Haldol®)`
• `Metoclopramide (Reglan®, Gimoti®)`
• ``I-Olanzapine (iZyprexa®, iLybalvi®, iSymbyax®)``
• `I-Prochlorperazine (Compro®)`

Ii-dopamine antagonists ziyindlela eyahlukileyo ye-'CINV' (ukuhlanza okubangelwa ngumhlaza) xa amanye amayeza '(Antietic)' engasebenzi. Anokunceda ukuthintela i-'PONV' (ukuhlanza emva kotyando).

7. IiCannabinoids

IiCannabinoids luhlobo lweekhompawundi ezifumaneka kwisityalo secannabis (intsangu). Zibopha kwii-receptors ze-cannabinoid engqondweni yakho, kwinkqubo yesisu, nakwiiseli zomzimba.

Iicannabinoids ezenziweyo ziimolekyuli ezenzelwe ukulinganisa imiphumo ye-tetrahydrocannabinol (THC). Okwangoku kukho iintlobo ezimbini zeecannabinoids zokwenziwa ezithengiswayo ukuze zisetyenziswe njenge-antiemetics:

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

Ezi zivunyiwe yi-FDA kwi-CINV (unyango lomhlaza olubangelwa kukuhlanza), kwaye kufuneka zisetyenziswe kuphela ukuba amayeza okulwa nokugabha odidi lokuqala aye aphumelelanga.

IiCannabinoids lolona hlobo lutsha lwe-antiemetic. Abaphandi basafunda kwaye baphanda indlela ezisebenza ngayo.

Silifumana njani eli yeza? (Iindlela zokusetyenziswa)

Amayeza amaninzi ``Antietic`` afumaneka ngeendlela ezingaphezu kwesinye. Angabonakala ngolu hlobo:

• Iipilisi zomlomo, oko kukuthi iipilisi eziginywayo okanye ezihlafunwayo.
• Izisombululo ze-IV (ezifakwa emithanjeni), ezingamayeza olwelo afakwa emthanjeni.
• Ukujova kwisihlunu sakho (ngaphakathi kwezihlunu).
• Iziqwenga zesikhumba (i-transdermal) – Oku ikakhulu kwenzelwa iScopolamine (i-anticholinergic).
• Iipilisi ze-rectal (ii-suppositories).

Ngaba la mayeza angabangela iziphumo ebezingalindelekanga?

Iziphumo ebezingalindelekanga ezinokwenzeka kuhlobo ngalunye lwe-`(Antiemetic)` ziyahluka. Ugqirha wakho uza kukuxelela ngezi ziphumo bezingalindelekanga ngaphambi kokuba uqale ukuthatha iyeza. Musa ukoyika ukubuza imibuzo nokwabelana ngeengcinga zakho. Ukuba uneziphumo ebezingalindelekanga ezikhathazayo emva kokuqala i-`(Antiemetic)`, thetha nogqirha wakho.

Nazi ezinye zezona ziphumo zixhaphakileyo (kodwa kungekhona zonke) ezinokwenzeka kuhlobo ngalunye lwe-"Antietic":

• Izinto ezichasene neSerotonin: Intloko ebuhlungu, isiyezi, kunye nokuqhina.
• Ii-Antihistamines: Ukulala.
• IiGlucocorticoids: Ukungalali, ukuvuseleleka, kunye notshintsho kwimo yeemvakalelo.
• I-Anticholinergics: Umlomo owomileyo, utshintsho ekuboneni, kunye nokozela.
• Ii-NK-1 receptor antagonists: Zinokubangela iintloko ezibuhlungu, isiyezi, kwaye kwabanye abantu, iziphumo ezibi kakhulu ze-allergy (i-anaphylaxis).
• Izinto ezichasene ne-dopamine: isiyezi, intloko ebuhlungu, kunye neengxaki zokunyakaza, ezifana ne-dystonia (ukuqhawuka kwemisipha ngokunganyanzelekanga) kunye ne-tardive dyskinesia (iintshukumo zomzimba ezinganyanzelekanga, ingakumbi ubuso nomlomo).
• IiCannabinoids:I-Vertigo, uxinzelelo lwegazi oluphantsi, kunye ne-dysphoria (ukuziva ungakhululekanga okanye unganeliseki).

Ingaba kulungile na ukusela eli yeza ukuba ndikhulelwe?

Ukuba unesicaphucaphu nokuhlanza ngexesha lokukhulelwa, kufuneka uthethe nogqirha wakho wezifo zabesifazane (Ob/Gyn) okanye omnye ugqirha. Bahlala becebisa ukuba wenze utshintsho ekutyeni okutyayo okanye amaxesha okutya. Ukuba oko akuncedi, banokukunika amayeza.

Izifundo ezininzi zibonise ukuba amanye amayeza okulwa nokugabha akhuselekile ukusetyenziswa ngexesha lokukhulelwa. Nangona kunjalo, ulwazi lokhuseleko kwabanye luyangqubana okanye lulinganiselwe. Wena nogqirha wakho niya kugqiba kunye ukuba yintoni ekulungeleyo.

Wakuba nje ufumanise ukuba ukhulelwe, bonana nogqirha ukuze akuxelele ngamayeza owasebenzisayo. Kwakhona, ngokuqinisekileyo kufuneka uthethe nogqirha ngaphambi kokuba uqalise naliphi na iyeza elitsha ngexesha lokukhulelwa.

Wenza ntoni ukuba uphoswe yidosi yeyeza?

Ukuba uphoswe yidosi yeyeza elithi "Antietic", ingakumbi ukuba liyeza elithintela isicaphucaphu nokuhlanza elinokuhlala ixesha elide, njenge-"CINV," thetha nogqirha wakho. Uza kukucebisa ngento omawuyenze.

Sithini isigidimi esifuna ukusithatha kweli nqaku?

Akukho mntu uthanda ukuba nesicaphucaphu nokuhlanza. Ngamanye amaxesha, la mava angathandekiyo ayimfuneko emizimbeni yethu. Kodwa ngamanye amaxesha, anokuba yingozi kakhulu. Ngethamsanqa, amayeza okulwa nokugabha anokunceda ukuthintela kunye/okanye ukunyanga isicaphucaphu nokuhlanza, nokuba kusekutsha okanye kuyaqhubeka. Kukho iindlela ezininzi onokukhetha kuzo. Kunye, wena nogqirha wakho niya kugqiba ukuba yeyiphi ekulungeleyo. Ngoko ke, ukuba unale ngxaki, ungoyiki ukuthetha nogqirha, kulungile?

"Imithi yokulwa nokugabha, isicaphucaphu, ukuhlanza, imithi yokulwa nokugabha, iziphumo ebezingalindelekanga, ukukhulelwa, unyango lomhlaza