Ukhathazekile ngemithi enikezwa asebekhulile? Ake sixoxe 'ngezindlela zokuphuza utshwala'!

Uma unomuntu osekhulile ekhaya lakho, njengonyoko, ubaba, ugogo, noma umkhulu wakho, cishe ucabanga kancane ngemithi obanika yona, akunjalo? Ngezinye izikhathi lapho siya kudokotela, banikeza imithi eyahlukahlukene . Kodwa njengoba sikhula, indlela imizimba yethu esabela ngayo emithini iyashintsha, futhi eminye imithi ingase ingafaneleki kubo. Kukhona uhlu lweziqondiso ezisiza odokotela ukunakekela izinto ezinjalo. Yilokho esikubiza ngokuthi 'Imigomo Yobhiya.' Ake sixoxe ngalokhu namuhla.

Iyini le 'Migomo Yobhiya'?

Kalula nje, lolu uhlu lweziqondiso ezithuthukiswe yi -American Geriatrics Society , iqembu lochwepheshe empilweni yabantu abadala. Lisitshela ukuthi yimiphi imithi engaba yingozi kubantu abaneminyaka engaphezu kwengu-65, noma ukuthi yimiphi imithi engaba nemiphumela emibi eminingi kunezinzuzo. Lolu hlu lwaziwa nangokuthi 'Uhlu Lukabhiya'. Cabanga ngakho, ucwaningo lukhombisile ukuthi abantu abangaphezu kuka-90% abaneminyaka engaphezu kwengu-65 basebenzisa okungenani umuthi owodwa ngenyanga, kanti abangaphezu kuka-66% basebenzisa imithi engaphezu kwemithathu. Ngakho-ke ngesikhathi esinjengalesi, lolu hlu luzoba usizo kakhulu kodokotela ukukunikeza imithi ngokuphephile.

Yiziphi izinto ezinhlanu eziyinhloko 'ku-Beers Criteria'?

Lolu hlu lusekelwe ezintweni ezinhlanu eziyinhloko, odokotela abazicabangela kakhulu lapho benikeza umuntu omdala umuthi:

• Imithi okungafanele inikezwe abantu abaneminyaka engaphezu kwengu-65, ikakhulukazi labo abangakutholi ukunakekelwa kokuphela kwempilo njenge- hospice noma ukunakekelwa kokunciphisa ubuhlungu .
• Imithi engaba yingozi kubantu abanezimo ezithile zezokwelapha (isibonelo, isifo sezinso, isifo senhliziyo).
• Imithi ebangela izinkinga ngokubangela ukusebenzisana kwemithi uma ithathwa neminye imithi.
• Imithi engabangela umonakalo omkhulu kunokuhle ngenxa yemiphumela emibi .
• Imithi ethinta ukusebenza kwezinso (okungukuthi, labo abanenkinga yezinso) kufanele inikezwe ngemithamo elinganiselwe noma imiswe ngokuphelele.

Hlobo luni lwezidakamizwa olusohlwini lwe-'Beers Criteria'?

Kunezinhlobo zemithi ezingaba yi-100 kulolu hlu. Kunzima ukukhuluma ngazo zonke, kodwa ukuze sikunike umbono, ake sibheke izibonelo ezimbalwa ezivela ezigabeni eziningana. Ngesikhathi esifanayo, ake sibheke izizathu ezenza leyo mithi ibe yingozi.

• Ama-analgesics: Isibonelo, imithi efana ne-`(meperidine)`. Lokhu kungaba yingozi ohlelweni lwezinzwa (`(Ubuthi be-neurotoxic ()) kanye ne -delirium (`(delirium)`) nakho kungase kwenzeke.
• Ama-antibiotic: Amanye ama-antibiotic, isibonelo i-ciprofloxacin, angandisa ingozi yokopha uma ethathwa ne-warfarin (into enciphisa igazi).
• Imithi yokuvimbela ukuqunjelwa: Imithi efana ne-carbamazepine ingabangela isimo esibizwa ngokuthi i-SIADH - Isifo sokukhishwa kwama-hormone okulwa nokuqunjelwa okungafanele, okuphazamisa ibhalansi yamanzi nosawoti emzimbeni.
• Ama-antihistamine (izinhlobo ezindala): Imithi efana ne-brompheniramine ingabangela ukudideka, ukuphazamiseka kwengqondo , kanye nokuphambana kwengqondo .
• Eminye imithi yokwelapha umfutho wegazi ophakeme (Ama-Antihypertensive): Eminye imithi, njenge-`(alpha-blockers),` ingabangela ukwehla okungazelelwe komfutho wegazi (`(Hypotension)`) .
• Ama-antiplatelet noma ama-anticoagulant: Imithi efana ne-edoxaban ngezinye izikhathi ingathinta izinso (ukukhubazeka kwezinso) .
• Ama-antipsychotics: Noma yimuphi umuthi okulesi sigaba ungandisa ingozi yokushaywa yisifo sohlangothi, ukwehla komqondo , kanye nokuphambana kwengqondo uma unikezwa abantu abadala.
• Imithi yokukhathazeka: Imithi eqenjini le-benzodiazepines (isib. i-diazepam) inganciphisa ukuwohloka komzimba komuthi, ibangele ukwehla kokuqwashisa, futhi ibangele ukuthuthumela lapho uhamba .
• Eminye imithi yenhliziyo: Imithi efana ne-disopyramide ingenza ukwehluleka kwenhliziyo kube kubi kakhulu.
• Izinto ezibangela uhlelo lwezinzwa oluphakathi: I-Dimenhydrinate (etholakala kwezinye izidakamizwa zokulwa nokugabha) ingabangela ukudideka, ukuncipha kokuqwasha, kanye nokuphambana kwengqondo .
• Eminye imithi yesifo sikashukela: Imithi emidala efana ne-chlorpropamide ingabangela amazinga kashukela egazini aphansi ngendlela eyingozi (hypoglycemia) .
• Imithi yesisu: Eminye imithi esekilasini elithi ``H2-blocker'' ingenza ukuphambana kube kubi kakhulu, ikakhulukazi uma umuntu esenayo kakade .
• Ama-hormone: Uma i-estrogen inikezwa ngaphandle, abanye besifazane bangase babe sengozini enkulu yokuba nomdlavuza webele kanye nomdlavuza wesibeletho .
• Amanye amaphilisi okulala (hypnotics): Kukhona ingozi yokuba umlutha wezidakamizwa ezifana nama-barbiturates futhi ukudlula ngokweqile kungaholela ezimweni eziyingozi .
• Izinto ezisiza ekuphumzeni imisipha: Lokhu kungabangela izinto ezifana nokudideka, umlomo owomile, kanye nokuqunjelwa .
• Imithi elwa nokuvuvukala engeyona eye-steroidal (ama-NSAID): Imithi efana ne-aspirin (engaphezu kwama-milligram angu-325 ngosuku) ingabangela izimo ezibucayi njengezilonda zesisu, ukopha, noma ukubhoboka .
• Eminye imithi yokuphefumula: Imithi efana ne-atropine ingabangela ukudideka, ukwehla kokuqwasha, kanye nokuphambana kwengqondo .
• Eminye imithi yomchamo: ``(desmopressin)`` ingabangela amazinga aphansi e-sodium egazini (``(hyponatremia)``) , okuyinto eyingozi futhi.
• Eminye imithi evula imithambo yegazi (ama-vasodilator): Imithi efana ne-`(ergoloid mesylates)` ingase ingavezi imiphumela elindelekile .

Okubalulekile: Lezi yizibonelo ezimbalwa nje. Udokotela wakho uzonquma ukuthi yimuphi umuthi okulungele wena. Ngisho noma unikezwe umuthi kulolu hlu, kungase kube nesizathu salokho. Ngakho ungesabi, khuluma nodokotela wakho njalo.

Lolu hlu 'lwezindlela zobhiya' luzobuyekezwa kangaki? Kwenziwa kanjani?

Lolu akulona uhlu oluqalwa kanye kuphela olubekwe eceleni. I-American Geriatrics Society ibuyekeza futhi ibuyekeze lolu hlu cishe njalo eminyakeni emithathu.

Kwenziwa kanjani? Lokhu kwenziwa kusetshenziswa ulwazi lwakamuva oluvela ocwaningweni olusha lwezokwelapha kanye nezivivinyo zemitholampilo. Ithimba lochwepheshe bezokwelapha liyahlangana, libukeze uhlu oludala, futhi lingasusa eminye imithi, lengeze emisha, noma lishintshe izincomo ezikhona ngokusekelwe ebufakazini obusha.

Odokotela basebenzisa nini 'i-Beers Criteria'?

Lolu hlu luyithuluzi elivamile elisetshenziswa odokotela lapho benikeza imithi kubantu abaneminyaka engaphezu kwengu-65. Kodwa akuyona into oyibheka nje bese uthatha izinqumo ngayo. Udokotela wakho uzocabangela umlando wakho ophelele wezokwelapha, impilo yakho yamanje, kanye nanoma yimiphi eminye imithi, amavithamini, kanye nezithasiselo ozithathayo . Bazobe sebenquma ukuthi umuthi omusha noma umthamo womuthi wamanje uphephile yini kuwe. Kungase kudingeke futhi bashintshe umuthi, umthamo, noma imvamisa yokusetshenziswa ngokusekelwe kulolu hlu.

Yiziphi izinto okufanele uzicabangele uma usebenzisa 'Imigomo Yobhiya'?

Lona umbuzo obaluleke kakhulu. Iyini 'Imigomo Yobhiya'?Yenzelwe abantu abaningi. Ngakho-ke, ayibhekiseli "kumuntu ngamunye" . Okusho ukuthi, lolu hlu alubheki impilo yomuntu jikelele, noma yiziphi ezinye izifo angase abe nazo, noma izici ezithile eziholele udokotela ekukhetheni umuthi othile.

Ngakho-ke, leli ithuluzi elihle nje lodokotela. Alikwenzi izinqumo kudokotela onekhono nonolwazi.

Isibonelo, uma udokotela efuna ukukunika umuthi kulolu hlu obhekwa njengoyingozi, uzocabangela izici eziningi, okuhlanganisa isimo sakho sempilo kanye nendawo olashwa kuyo. Kulapho-ke kuphela lapho ezokwenza khona isinqumo sokugcina sokuthi umuthi uphephile yini kuwe. Ezimweni eziningi, odokotela bangakhetha omunye umuthi esikhundleni somuthi kulolu hlu. Kodwa-ke, uma umuthi kulolu hlu unikezwe udokotela, udokotela uzokuqapha eduze ukuze abone ukuthi kukhona yini imiphumela emibi.

Kungani indlela imithi ethinta ngayo imizimba yethu ishintsha njengoba sikhula?

Leli iphuzu elibaluleke kakhulu. Njengoba sikhula, imizimba yethu ibhekana nezinguquko eziningi. Lezi zinguquko zingathinta indlela imithi emuncwa ngayo kanye nendlela esebenza ngayo emizimbeni yethu. Nazi ezinye izibonelo:

• Kuthatha isikhathi eside ukuthi umzimba uqhekeke (ugaye) futhi ususe umuthi. Lokhu kusho ukuthi umuthi ungase uhlale emzimbeni wakho isikhathi eside. Yingakho odokotela ngezinye izikhathi benikeza abantu abadala imithi ephansi.
• Umuthi wesifo esisodwa ungathinta esinye. Ngenxa yokuthi eminye imithi ishintsha indlela imizimba yethu esabela ngayo, ingathinta nendlela eminye imithi yokwelapha esebenza kahle ngayo.
• Izinguquko zendlela yokuphila. Izinto ezifana nezinga lomsebenzi wakho kanye nokudla okudlayo kungathinta indlela eminye imithi esebenza kahle ngayo. Ngakho-ke uma ubona udokotela, kubalulekile ukukhuluma ngenqubo yakho yansuku zonke, lokho okudlayo, nokuthi uyawuvocavoca yini umzimba. Ngaleyo ndlela, angakhetha ukwelashwa okukulungele kangcono.

Odokotela bayayazi kahle imizimba yethu nokuthi ishintsha kanjani ngokuguga. Uma bekubhalela umuthi, bazoqapha indlela umzimba wakho osabela ngayo kuwo ukuqinisekisa ukuthi uphephile.

Ngakho-ke, yiziphi izinto okufanele sizikhumbule kule ndaba?

Kulungile, manje cishe usuyaqonda ukuthi 'Imigomo Yobhiya' esikhulume ngayo iwuhlu lweziqondiso ezibalulekile ezisiza odokotela lapho benikeza imithi kubantu abaneminyaka engaphezu kwengu-65.

Lokhu kusiza odokotela ukuthi bagxile emithini engaba yingozi kumuntu omdala futhi bakhethe ezinye izindlela eziphephile.

Khumbula, leli ithuluzi lodokotela, hhayi into okufanele uyisebenzisele ukuyeka noma ukuqala imithi wena.Uma unemibuzo noma ukukhathazeka mayelana nomuthi owusebenzisayo, sicela ukhulume nodokotela wakho. Ungumuntu ongcono kakhulu ukukunikeza iseluleko esinembile. Ukulalela imizwa yakho kuyindlela engcono kakhulu yokuhlala uphilile.

Imigomo Yobhiya , Impilo Yabantu Abadala, Imithi, Imiphumela Engemihle, Imithi Ephephile, Ukuguga