Ngaba usela i-lithium? Ngoko ke lumka ngale ngozi! (Ubuthi beLithium)

Ngaba wena okanye umntu omaziyo usebenzisa i-lithium, iyeza elichazwe ngoogqirha kwiimeko ezithile zempilo yengqondo, ingakumbi i-bipolar disorder? Nangona eli yeza linokuba luncedo kakhulu xa lisetyenziswa ngokufanelekileyo, ukulisela kakhulu kunokukhokelela kwimeko eyingozi ebizwa ngokuba yi-lithium toxicity. Makhe sithethe ngale nto namhlanje. Ngamafutshane, i-lithium toxicity iyenzeka xa umzimba wakho une-lithium eninzi kakhulu. Oku kunokubangela ukuphazamiseka kwesisu (njengokuhlanza, urhudo) kunye neempawu zenkqubo yemithambo-luvo (ezifana nokudideka, ukungcangcazela). Ukuba ayinyangwa ngokufanelekileyo, oku kunokuba yingozi ebomini. I-lithium yityuwa yendalo. Iyanciphisa i-mania. Yiyo loo nto oogqirha behlala benika eli yeza kwi-bipolar disorder. Nangona kunjalo, umda phakathi kwedosi ekhuselekileyo neyingozi yale yeza mncinane kakhulu. Oku kuthetha ukuba nokuba ininzi kakhulu ayinakunyamezeleka emzimbeni.

Inokwenzeka njani ityhefu ye-lithium?

Kukho iindlela ezahlukeneyo ezinokwenzeka ngazo oku. Masibone ukuba zithini.

Ubuthi obubukhali

Oku kwenzeka ukuba ngequbuliso uthatha iipilisi ezininzi ze-lithium, okanye ukuba umzimba wakho uphelelwa ngamanzi emzimbeni ngequbuliso. Cinga ngako, ngamanye amaxesha wenza iimpazamo xa uthatha amayeza akho. Oko kunokwenzeka.

Ukuthatha okungaphezulu kokufunekayo imihla ngemihla (Ubuthi obungapheliyo)

Oku kunokwenzeka ukuba udla ngokuthatha i-lithium yonke imihla, kodwa ngenye imini uthatha idosi eyongezelelweyo, okanye ukuba umzimba wakho uphelelwa ngamanzi emzimbeni ngenye imini. Umzekelo, ukuba awuseli manzi aneleyo kangangeentsuku ezimbini okanye ezintathu, okanye ukuba uhlanza kakhulu kwaye ulahlekelwa ngamanzi emzimbeni wakho.

Ubuthi obungapheliyo

Oku kwenzeka kuba xa usela i-lithium yonke imihla, ubungakanani be-lithium emzimbeni wakho buyanda kancinci kancinci kwaye buyanda ngokuhamba kwexesha. Oku kunokwenzeka ngokulula. Izinto ezininzi, ezinje ngokuphelelwa ngamanzi emzimbeni, impilo yezintso, kunye namanye amayeza owasebenzisayo, zinokuchaphazela indlela umzimba wakho ophatha ngayo i-lithium.

Zithini iinqanaba zetyhefu ye-lithium?

Oogqirha bajonga amanqanaba akho e-lithium ngovavanyo lwegazi. Ugqirha wakho uya kugqiba ukuba leliphi inqanaba elifanelekileyo kuwe. Ngokubanzi, amanqanaba obuthi be-lithium ahlulwe ngolu hlobo lulandelayo:

• Ubuthi obuncinci: 1.5 ukuya kwi-2.5 mmol/L.
• Ubuthi obuphakathi: 2.5 ukuya kwi-3.5 mmol/L.
• Ubuthi obugqithisileyo: Ngaphezulu kwe-3.5 mmol/L.

Akufuneki ucinge kakhulu ngale yunithi ibizwa ngokuba yi-millimoles (`mmol/L`), yinto ebalulekileyo koogqirha. Okubalulekileyo kuwe kukwazi iimpawu.

Zithini iimpawu zetyhefu ye-lithium?

Ezi mpawu zinokwahluka ngokuxhomekeke kuhlobo lwetyhefu kunye nokuba iyingozi kangakanani.

Iimpawu zetyhefu ebukhali nengapheliyo

Ngamaxesha anje, into yokuqala efika engqondweni ziingxaki zesisu (Iingxaki zesisu - GI). Oko kuthetha:

• Isicaphucaphu nokuhlanza .
• Urhudo (ukuhlanza).
• Isisu esibuhlungu .
• Ukuziva ngathi isisu sakho sigcwele.

Ezi mpawu zihlala ziqala ukubonakala kwiyure emva kokusela i-lithium eninzi.

Kubalulekile: Ukuba ufumana ezi mpawu, kubaluleke kakhulu ukufuna iingcebiso zonyango ngokukhawuleza.

Ukuba ityhefu iphakathi ukuya kweyona inzima, iimpawu ezinxulumene nenkqubo yemithambo-luvo zinokulandela ukudumba kwesisu. Ezi ziquka:

• Utshintsho kwimeko yengqondo: Lunokusuka ekudidekeni okuncinci ukuya ekuphazamisekeni okukhulu kwengqondo.
• Ukungcangcazela okungalawulekiyo (iiNgcangcazela).
• Ukulahlekelwa yibhalansi kunye nokulungelelana komzimba xa uhamba okanye umi (`Ataxia`).
• Ukushukuma kwemisipha (`Myoclonus`).
• Ukungathethi kakuhle (`Dysarthria`).
• I-Hyperreflexia (ukusabela ngokugqithisileyo).
• Ukunyakaza kwamehlo okungalawulekiyo (i-Nystagmus).
• Kwiimeko ezinzima, umkhuhlane uyanda (iHyperthermia).
• Kwiimeko ezinzima, ukuxhuzula .
• Kwiimeko ezinzima, ukulahlekelwa yingqondo (`Coma`).

Ukuba uthatha i-lithium kwaye ufumana naziphi na ezi mpawu, kufuneka ubone ugqirha ngokukhawuleza.

Iimpawu ze-Chronic Lithium Toxicity

Xa i-lithium ityiwa ixesha elide, idla ngokonakalisa izintso. Oku kunokukhokelela kwiintlobo ngeentlobo zezifo zezintso, ngasinye sineempawu zaso. Nazi ezinye zeemeko ezinokwenzeka:

Isifo seswekile i-Insipidus ye-Nephrogenic Diabetes

Kulapho izintso zakho zingakwaziyo ukulinganisela ulwelo emzimbeni wakho ngokufanelekileyo. Azikwazi ukuphendula ngokufanelekileyo kwi-antidiuretic hormone (ADH). Iimpawu ziquka:

• Ukuphelelwa ngamanzi emzimbeni: Umlomo owomileyo, ukudinwa, kunye nesiyezi.
• Ukuziva unxaniwe kakhulu (` Polydipsia` ).
• Ukuchama kakhulu (`i-Polyuria`).

I-Nephritis elahlekelwa yiSodium

Kule meko, ukonakala kwezintso kubangela ukungalingani kwe-electrolyte emzimbeni. Iimpawu ziquka:

• Inyama iyaguquka kwaye iba buthathaka.
• Utshintsho kwimeko yengqondo.
• Ndidiniwe.
• Ukoma kakhulu.
• Ukuchama kakhulu (`iPolyuria`).

Isifo seNephrotic

Kule meko, izintso zakho zikhupha iiproteni ezininzi kakhulu kumchamo wakho (`iProteinuria`). Iimpawu:

• Ukwanda kwe-cholesterol (i-Hyperlipidemia).
• Ukudumba kwemilenze namaqatha (`Edema`).
• Ukutya akunancasa.
• Isisu esibuhlungu.
• Umchamo uyaphuma ugwebu.

Iingxaki zenkqubo ye-endocrine nazo zinokwenzeka ngenxa yetyhefu ye-lithium ixesha elide. Imizekelo:

• Ukungasebenzi kakuhle kwe-thyroid (`Hypothyroidism`).
• Ukwanda komsebenzi we-thyroid gland (`Hyperthyroidism`).
• Ukwanda komsebenzi weendlala ze-parathyroid (`Hyperparathyroidism`).

Ukuba ufumana naziphi na ezi mpawu ngelixa uthatha i-lithium, thetha nogqirha ngokukhawuleza.

Ulwalamano phakathi kwe-lithium kunye ne-serotonin syndrome

I-Lithium inokubangela imeko ebizwa ngokuba yi-serotonin syndrome. Lo mngcipheko uphezulu ngakumbi ukuba usebenzisa amanye amayeza achaphazela amanqanaba e-serotonin. Oku kunokuba yingozi ebomini. Iimpawu ze-serotonin syndrome (ukusuka kwencinci ukuya kweyona inzima):

• Ukungazoli.
• Isicaphucaphu nokuhlanza.
• Urhudo.
• Iimbombo zamehlo ziba nkulu.
• Ungcangcazelo.
• Ixhala, ukungazinzi.
• Ukusila nokucinezela iibhola zenyama.
• Ukubila nokungcangcazela.
• Ukudideka, ukulahlekelwa zingqondo (Delirium).
• Ukubetha kwentliziyo.
• Igazi elonyukayo.

Ukuba unale mpawu, funa ingcebiso kagqirha ngokukhawuleza!

Zithini izizathu zetyhefu ye-lithium?

Kukho izizathu ezintathu eziphambili zoku:

• Ukusela kakhulu i-lithium: Ukusela iipilisi ezininzi ze-lithium, nokuba ngabom okanye ngengozi, kunokubangela ubuthi obuqatha okanye obungapheliyo. Oku kunokwenzeka nokuba ugqirha unyusa idosi yakho kakhulu, kodwa oku kunqabile kakhulu.
• Ukuphelelwa ngamanzi emzimbeni okanye utshintsho lolwelo: Le yeyona nto ixhaphakileyo. Xa umzimba ulahlekelwa yi-sodium (ityuwa) namanzi, izintso ziphinda zifunxe i-lithium. Oku kwandisa uxinano lwe-lithium egazini. Izizathu ezinokubakho ziquka:
• Xa uhlanza.
• Xa kuvela urhudo.
• Xa ufumana umkhuhlane.
• Ukungasebenzi kakuhle kwezintso.
• Xa usebenzisa amayeza abangela ukuchama, anjenge-diuretics.
• Xa usenza umthambo ngokugqithisileyo.
• Ukubila okugqithisileyo (i-Hyperhidrosis).
• Njengaxa ungaseli manzi.
• Xa usitya ukutya okungenatyuwa ingako.
• Iimeko zentliziyo (`Ukusilela kwentliziyo okubangelwa kukunganyamezelani`).
• Ngexesha lokukhulelwa okanye ukuzala.
• Utshintsho kwi-thyroid gland (`i-Hyperthyroidism`).
• Iingxaki zokukhupha i-lithium: Ngamanye amaxesha umzimba awukwazi ukuyikhupha ngokufanelekileyo i-lithium. Oku kusenokubangelwa zizizathu ezichazwe apha ngasentla.

Ngubani osengozini enkulu yokuba netyhefu ye-lithium?

Abantu abalandelayo basengozini enkulu yokuba netyhefu ye-lithium engapheliyo:

• Abantu abangaphezu kweminyaka engama-50 ubudala.
• Abantu abanesifo se-thyroid.
• Abantu abangasebenzi kakuhle kwezintso.
• Abantu abanesifo seswekile insipidus.

Nokuba usebenzisa i-lithium ixesha elide, usemngciphekweni omkhulu wokuba ne-nephrogenic diabetes insipidus, ebangelwa yi-lithium. Oku kunokukhokelela kwityhefu ye-lithium. Ukuba ufumana nayiphi na kwezi meko ngelixa usela i-lithium, thetha nogqirha wakho.

Oogqirha bayixilonga njani ityhefu ye-lithium?

Ukuze wazi kakuhle ukuba oku kuyingozi kangakanani, olu lwazi lubaluleke kakhulu koogqirha:

• Uthathe i-lithium engakanani?
• Uyithathe nini ixesha?
• Kodwa ngaba ukhe wasebenzisa amanye amayeza okanye ezinye izinto ngaxeshanye?
• Ingaba oku bekungabom okanye yimpazamo?

Ukuqinisekisa ubuthi be-lithium, oogqirha benza uvavanyo oluninzi. Ezinye zazo ziquka:

• Uvavanyo lwegazi ukujonga inqanaba le-lithium egazini lakho.
• Uvavanyo lwegazi olujonga amanqanaba ee-electrolytes (ezifana ne-sodium kunye ne-calcium) egazini lakho.
• Uvavanyo lwegazi olujonga amanqanaba e-thyroid-stimulating hormone (TSH).
• Uhlalutyo lomchamo.
• Uvavanyo lokusebenza kwezintso (ezifana namanqanaba e-urea kunye ne-creatinine egazini).
• Uvavanyo lwemifanekiso yobuchopho (oku kwenziwa rhoqo).

Oogqirha baya kujonga impilo yakho kwizinto ezifana nezi:

• Intliziyo yakho ine-'EKG' (i-electrocardiogram).
• Ungakanani umchamo wakho (ukuphuma komchamo).
• Inqanaba lakho le-oksijini - lihlala lilinganiswa nge-'pulse oximeter' ('pulse ox').

Iphathwa njani ityhefu ye-lithium?

Unyango lwe-lithium poison ebukhali nengapheliyo luyahluka ngokuxhomekeke ekubeni imbi kangakanani kwaye ufika ngokukhawuleza kangakanani kwigumbi longxamiseko. Iinjongo eziphambili kukususa i-lithium emzimbeni wakho nokulawula iimpawu zakho. Unyango lungabandakanya:

• Ukuhlamba isisu.
• Ukunkcenkceshela amathumbu apheleleyo: Oku kuquka ukunika ulwelo olukhethekileyo ngomlomo okanye ngetyhubhu efakwe ngempumlo esiswini. Oku kususa yonke i-lithium kwindlela yokugaya ukutya.
• I-activated charcoal: Oku kunikwa ukuba ukhe wathatha amanye amayeza okanye izinto ezithile.
• I-Hemodialysis: Le yindlela ephambili yokususa i-lithium kwizintso.
• Ukunika i-saline (`i-IV fluids`).
• Amayeza ahlukeneyo anyanga iimpawu.

Ixesha elininzi, uza kunyangwa kwigumbi likaxakeka. Ukuba ityhefu inzima, kunokufuneka unyangwe kwigumbi labagula kakhulu (ICU).

Unyango lwe-Chronic Lithium Toxicity

Ukutyhefa i-lithium ixesha elide kudla ngokubangela umonakalo kwizintso. Unyango luxhomekeke kuhlobo lwengxaki yezintso. I-Hemodialysis inokuba yimfuneko.

Zithini amathuba okuphila kule meko? (Ingqikelelo)

Ukuchacha emva kokuba unesifo se-lithium kuxhomekeke kuhlobo lwetyhefu, ukuba inzima kangakanani, kunye nokuba ufuna unyango ngokukhawuleza kangakanani. Abantu abangafumani zimpawu ze-neurological ngenxa yokuba unesifo se-lithium esibukhali badla ngokuba neengxaki ezihlala ixesha elide. Nangona kunjalo, ukuba unesifo se-neurological, zinokuba sisigxina. Yiyo loo nto unyango olukhawulezileyo lubaluleke kakhulu. Kwiimeko ezinzima, isifo se-lithium sinokukhokelela kwi-coma, umonakalo wobuchopho, okanye nokufa. I-lithium toxicity engapheliyo inokuba nzima ukuyibona kuba iimpawu zinokuvela ngokuhamba kwexesha. Oku kulibaziseka kunokukhokelela kwiingxaki zezintso kunye nenkqubo yemithambo-luvo ixesha elide.

Ungayithintela njani ityhefu ye-lithium?

Ukulandela la manyathelo kunokunceda ukuthintela ubuthi be-lithium ebukhali:

• Sela amayeza akho njengoko kumiselwe: Sela kuphela ubungakanani be-lithium (kunye namanye amayeza) achazwe ngugqirha wakho. Gcina ilebheli kwiibhotile zakho zamayeza, okanye ubhale phantsi amaxesha owasela ngawo. Oku kunokukunceda uphephe ukuthatha idosi ephindwe kabini ngengozi.
• Gcina amayeza akho e-lithium ekhuselekile: Gcina kude nabantwana nabanye abantu.
• Hlala unamanzi emzimbeni:Sela amanzi amaninzi. Ukuphelelwa ngamanzi emzimbeni kunokubangela ubuthi be-lithium. Xelela ugqirha wakho ukuba ufumana ukuhlanza, urhudo, okanye umkhuhlane.
• Soloko uxelela ugqirha wakho uluhlu lwamayeza owasebenzisayo: Ngaphambi kokuba uqale amayeza amatsha, xelela ugqirha wakho ukuba usebenzisa i-lithium (kunye nawo nawaphi na amanye amayeza). Amanye amayeza anokuchaphazela indlela umzimba wakho ophatha ngayo i-lithium.
• Xelela ugqirha wakho ukuba kukho naluphi na utshintsho olutsha okanye olukhawulezileyo kwimpilo yakho: umzekelo, ukukhulelwa kunye notshintsho lwe-hormone (endocrine).

Ukuba ucinga ngokuzibulala, okanye ukuba ucinga ngokuthatha i-lithium eninzi ngabom, nceda uye kwisebe likaxakeka lesibhedlele elikufutshane, okanye uthethe nomntu omthembayo. ESri Lanka, ungafumana uncedo kwimibutho efana neSumithrayo (inombolo yefowuni 0112692909 okanye 0112682535).

Ukuba uthatha i-lithium ixesha elide, ugqirha wakho uya kucebisa uvavanyo lwegazi nomchamo rhoqo ukuze kujongwe impilo yakho. Olu vavanyo lunokunceda ekufumaneni ubuthi be-lithium obungapheliyo kwangethuba. Ezi zivavanyo kunye nezikhokelo:

• Amanqanaba e-lithium egazini ajongwa kwiintsuku ezintathu ukuya kwezintlanu emva kokuqala i-lithium okanye ukutshintsha idosi.
• Abo bathatha amayeza ixesha elide , amanqanaba e-lithium egazini ajongwa rhoqo kwiinyanga ezintathu ukuya kwezintandathu.
• Amanqanaba e-electrolyte, urea, kunye ne-creatinine ajongwa rhoqo kwiinyanga ezintathu ukuya kwezintandathu.
• Amanqanaba e-calcium kunye ne-thyroid stimulating hormone (TSH) ajongwa rhoqo kwiinyanga ezintandathu ukuya kwezilishumi elinesibini.

Okokugqibela, izinto ekufuneka uzikhumbule

I-Lithium liyeza elinamandla kakhulu nelisebenzayo, kodwa lifuna unonophelo olongezelelekileyo xa ulisebenzisa. Ubuthi be-Lithium yingxaki enokuba yingozi ebomini enokubangelwa kukuthatha amayeza amaninzi okanye ukulahlekelwa ngamanzi amaninzi ngelixa ulisebenzisa. Thetha nogqirha wakho malunga neendlela zokuthintela ubuthi be-lithium kunye neempawu ekufuneka uziqaphele. Oogqirha bakhona ukukunceda nokukugcina usempilweni. Ngoko ke, ungoyiki ukubuza ukuba unemibuzo okanye iinkxalabo. Khumbula, eyona nto ibalulekileyo kukuthatha amayeza akho kanye njengoko ugqirha wakho ekuyalele, ngamaxesha afanelekileyo. Kwakhona, ungalibali ukusela ulwelo oluninzi.