Usenokuba ukhe weva ngeepilisi zokunciphisa iintlungu ezinamandla ezifana neTramadol kunye neMorphine. Oogqirha basebenzisa la mayeza emva kotyando oluthile okanye kwiimeko zentlungu enzima njengomhlaza. Kodwa ukuba la mayeza asetyenziswa gwenxa, oko kukuthi, ukuba ugqithisile, anokuba yingozi kakhulu kwaye ade asongele ubomi. Kwimeko eyingozi kangaka, kukho uhlobo oluthile lweyeza olunokuthi lumise ngoko nangoko ukusebenza kwala mayeza kwaye lusindise ubomi. Yiloo nto siyibiza ngokuba yi-'Opioid Antagonist'.
Okokuqala, masibone ukuba yintoni le 'opioid'?
Ngamafutshane, ii-opioids liqela leekhemikhali ezisebenza neeseli zethu zemithambo-luvo ukunciphisa iintlungu. Ezinye zenzeka ngokwendalo, ngelixa ezinye zenziwe kwiilebhu. Oogqirha badla ngokuzisebenzisa ukunyanga iintlungu eziphakathi ukuya kwezinzima. Nangona kunjalo, kukwakho neziyobisi ezingekho mthethweni ezifana ne-heroin ezikweli qela linye.
Abantu banamathuba amaninzi okuba ngamakhoboka ezi opioid. Isizathu kukuba azipheleli nje ekunciphiseni iintlungu, kodwa zizisa novuyo olungaqhelekanga, uvakalelo lokudada (uvuyo). Ekuhambeni kwexesha, idosi ethathwayo ngaphambi kokufumana olo lonwabo ayanelanga. Oku sikubiza ngokuba 'kukunyamezelana'. Emva koko uyalingeka ukuba unyuse idosi. Ekugqibeleni, oku kunokukhokelela ekubeni yingxaki yokusebenzisa i-opioid.
Ngoko ke lo mchasi we-opioid usebenza njani?
Ukuze siqonde oku, masithathe umzekelo omncinci. Khawucinge ukuba umzimba wethu, ingakumbi engqondweni nakwi-spinal cord (inkqubo ye-nervous central), une-'receptors' ezikhethekileyo eziphendula kwi-opioids. Njengee-keyholes. Ezi zibizwa ngokuba yi-mu, kappa, kunye ne-delta receptors. Eyona nto iphambili isebenza ngezi receptors ze-mu .
- Ii-opioid (izibulali-ntlungu) zifana 'nesitshixo esifanelekileyo' esingena kule ngxunya yesitshixo. Xa ufaka eso sitshixo uze usijike, oko kukuthi, xa uthatha i-opioid, ezo receptors ziyasebenza kwaye intlungu iyaphela, ukuphefumla kuyacotha, kwaye loo mvakalelo yolonwabo endikhankanyileyo ngaphambili iyafika.
- Ii-opioid antagonists zifana 'nesitshixo sobuxoki' esingena kuloo mngxuma wesitshixo, kodwa asinakujikwa. Xa esi siyobisi singena emzimbeni, siya ngokukhawuleza kwezo receptors, ii-keyholes. Kodwa asiyisebenzisi i-receptor. Endaweni yoko, siyayivala isitshixo.
Ngoku uyaqonda? Ngenxa yokuba isitshixo sobuxoki sinamathele kumngxuma wesitshixo, akukho ndlela yokuba 'isitshixo esifanelekileyo', i-opioid, sifike size sidibane. Ngoko ke isiphumo se-opioids siyeke ngokupheleleyo. Xa umntu esebenzise kakhulu i-opioids aze abonakale ngathi uyeke ukuphefumla, yiloo nto eyenzekayo xa umnika esi sithinteli. Singena ngoko nangoko size siyeke ukusebenza kwe-opioids, size simvumele ukuba aphefumle ngokuqhelekileyo kwakhona.
Ziziphi iintlobo eziphambili ze-opioid antagonists?
Kukho iintlobo ezahlukeneyo zala mayeza. Ngalinye lisetyenziselwa iinjongo ezahlukeneyo. Masijonge ngakumbi le theyibhile.
| Igama lesiyobisi | Ukusetyenziswa okuphambili | Amanqaku abalulekileyo |
|---|---|---|
| I-Naloxone | Amayeza okusindisa ubomi ngenxa yokugqithisa i-opioid. | Inikwa njengenaliti okanye njenge-spray yempumlo. Ukuba umntu uyekile ukuphefumla ngenxa yokugqithisa i-opioid, inokubuyisela ukuphefumla kwimizuzu emi-2-5. Kwilizwe lethu, isetyenziswa kakhulu kwiiyunithi zonyango olungxamisekileyo (ii-ETU) zezibhedlele. |
| I-Naltrexone | Njengonyango lokugcinwa ixesha elide lokuxhomekeka kwi-opioid kunye notywala. | Oku kunceda ukoyisa umlutha. Kuthintela uvuyo oluza nokusela ii-opioids. Kodwa akulawuli iimpawu zokurhoxa okanye iminqweno. Kuza ngeepilisi okanye ngeenaliti. |
| I-Methylnaltrexone | Ukuqhinwa okubangelwa ziipilisi zentlungu ezinamandla ze-opioid. | Oku kwahlukile kancinci. Akuyi engqondweni. Endaweni yoko, kuthintela kuphela ii-opioid receptors emathunjini. Ngoko ke ayiphazamisi ukusebenza kwamayeza eentlungu, inciphisa nje ukuqhina. Imiselwe abantu abanyangwa iintlungu ezingapheliyo. |
| INalmefene | Ukuba uthatha i-opioid ngokugqithisileyo. | Oku kufana ne-naloxone, kodwa ihlala isebenza emzimbeni ixesha elide. Nangona kunjalo, ayisetyenziswa kakhulu njenge-naloxone. |
Zithini iziphumo ebezingalindelekanga zala mayeza?
Isiphumo esiphambili nesikhawulezileyo samachiza afana neNaloxone kunye neNaltrexone kukuvela 'kweempawu zokurhoxa kwi-opioid' . Khawucinge nje, umzimba womntu sele uqhelene ne-opioids ixesha elide. Le yindlela umzimba osabela ngayo xa umntu ochasene naye ngequbuliso enikwa kwaye isenzo sakhe siyeka.
Zithini ezi mpawu zokurhoxa?
- Impumlo enemifinya
- Ukukrazula okugqithisileyo emehlweni
- Ukukhafula rhoqo
- Ukwanda kwesantya sokuphefumla (iHyperventilation)
- I-Hyperthermia
- Ukwanda kwesantya sentliziyo (iTachycardia)
- Intlungu yemisipha
- Isicaphucaphu nokuhlanza
- Urhudo
- Ixhala
Ubunzima bezi mpawu buyahluka kumntu nomntu. Kuxhomekeke ekubeni kusetyenziswe ixesha elingakanani kwaye luhlobo luni lwe-opioid. Esibhedlele, oogqirha baphatha le meko kakuhle. Banika i-saline (IV fluids) kunye namanye amayeza.
Iziphumo ebezingalindelekanga zeMethylnaltrexone, esetyenziselwa ukuqhina kwesisu, zahlukile. Nazi:
- Intlungu yesisu
- Ukuzalisa isisu
- Isicaphucaphu okanye ukuhlanza
- Intloko ebuhlungu
- Ukuqengqeleka kwezihlunu
- Isiyezi
Zithini iingenelo zala mayeza?
Nangona kukho iziphumo ebezingalindelekanga, iingenelo zala mayeza zingaphezulu kakhulu kunezo.
I-Naloxone liyeza elisindisa ubomi . Lingathintela ukufa ngenxa yokugqithisa i-opioid. Leyo yeyona nto ibalulekileyo.
I-NaltrexoneYinxalenye ebaluleke kakhulu yokunyanga iimeko ezinzima ezifana nokuluthwa yi-opioid okanye utywala. Kodwa akwanelanga ngokwako. Ukuluthwa ziziyobisi sisifo esinzima kakhulu. Sifuna unyango oluvela kwiinkalo ezahlukeneyo, njengonyango lwengqondo kunye nokuvuselelwa. I-Naltrexone liyeza elinika amandla amakhulu kolo hambo.
Ukuba wena okanye umntu omaziyo unale ngxaki, nceda uthethe nogqirha wakho ngayo. Kukho oogqirha abaninzi kunye neendlela ezinokunceda kwezi meko.
Umyalezo Wokuya Ekhaya
- I-opioid antagonist luhlobo lwamayeza athintela ukusebenza kwee-opioid (i-painkiller enamandla kunye neziyobisi ezifana ne-heroin) emzimbeni.
- I-Naloxone liyeza elibaluleke kakhulu nelisebenza ngokukhawuleza elinokunikwa ukusindisa ubomi bomntu osele esebenzise ii-opioid ngokugqithisileyo.
- La mayeza, ingakumbi xa enikwa umntu oqhelene nomzimba wakhe ukusebenzisa ii-opioid, anokubangela iimpawu ezinzima zokurhoxa. Ke ngoko, kufuneka asetyenziswe phantsi kweliso likagqirha.
- Ukuxhomekeka kwiziyobisi akubobuthathaka, sisifo esinokunyangeka. Ukuba wena okanye umntu omaziyo ufuna uncedo, musa ukuba neentloni uze uthethe nogqirha ngalo mba.
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