Kungenzeka ukuthi uke wezwa ngemithi yokubulala izinhlungu enamandla njengeTramadol neMorphine. Odokotela basebenzisa le mithi ngemva kokuhlinzwa okuthile noma ezimweni zobuhlungu obukhulu njengomdlavuza. Kodwa uma isetshenziswa ngendlela engafanele, okungukuthi, uma uphuza ngokweqile, ingaba yingozi kakhulu futhi isongela nokuphila. Esimweni esiyingozi kangaka, kukhona uhlobo olukhethekile lomuthi olungamisa ngokushesha ukusebenza kwale mithi futhi lusindise izimpilo. Yilokho esikubiza ngokuthi 'Umphikisi We-Opioid'.
Okokuqala, ake sibone ukuthi iyini le 'opioid'?
Kalula nje, ama-opioid ayiqembu lamakhemikhali asebenza namaseli ethu ezinzwa ukunciphisa ubuhlungu. Amanye ayenzeka ngokwemvelo, kanti amanye enziwa emalabhorethri. Odokotela bavame ukuwasebenzisa ukwelapha ubuhlungu obuphakathi kuya kobunzima. Kodwa-ke, kukhona nezidakamizwa ezingekho emthethweni njenge-heroin ezikuleli qembu elifanayo.
Abantu banamathuba amaningi okuba umlutha wale mithi ye-opioid. Isizathu ukuthi ayigcini nje ngokuqeda ubuhlungu, kodwa futhi iletha umuzwa ongavamile wenjabulo, umuzwa wokuntanta (injabulo). Ngokuhamba kwesikhathi, umthamo othathwa ngaphambi kokuthola leyo njabulo awanele. Lokhu sikubiza ngokuthi 'ukubekezelelana'. Bese ulingeka ukuba wandise umthamo. Ekugcineni, lokhu kungaphenduka inkinga yokusebenzisa i-opioid.
Ngakho-ke lo mphikisi we-opioid usebenza kanjani?
Ukuze siqonde lokhu, ake sithathe isibonelo esincane. Cabanga ukuthi umzimba wethu, ikakhulukazi ebuchosheni nasemgogodleni (isimiso sezinzwa esiphakathi), unama-'receptor' akhethekile asabela kuma-opioid. Njengezimbobo zokhiye. Lawa abizwa ngokuthi ama-mu, ama-kappa, nama-delta receptors. Into eyinhloko esebenza ngala ma-mu receptors .
- Ama-opioid (ama-painkiller) afana 'nesihluthulelo esifanele' esingena kule mbobo yesihluthulelo. Uma ufaka leso sihluthulelo bese usiphendula, okungukuthi, uma uthatha i-opioid, lawo ma-receptor ayavuselelwa futhi ubuhlungu buyanyamalala, ukuphefumula kuyehla, bese kufika lowo muzwa wenjabulo engikhulume ngawo ekuqaleni.
- Abaphikisi be-opioid bafana 'nesihluthulelo mbumbulu' esingena kulowo mgodi wokhiye, kodwa esingenakuphendulwa. Uma lo muthi ungena emzimbeni, uya ngokushesha kulawo ma-receptor, ama-keyholes. Kodwa awusebenzi i-receptor. Kunalokho, uvimba imbobo yokhiye.
Manje uyaqonda? Ngenxa yokuthi ukhiye mbumbulu ubhajwe emgodini wokhiye, ayikho indlela yokuthi 'ukhiye ofanele', i-opioid, ufike uxhumeke. Ngakho-ke umphumela wama-opioid uyaphela ngokuphelele. Uma umuntu esebenzise ama-opioid ngokweqile futhi kubonakala sengathi uyeke ukuphefumula, yilokho okwenzekayo uma umnikeza lo mphikisi. Ungena ngokushesha futhi uyeke ukusebenza kwama-opioid, futhi umvumele ukuthi aphefumule ngendlela evamile futhi.
Yiziphi izinhlobo eziyinhloko zabaphikisi be-opioid?
Kunezinhlobo eziningana zale mithi. Ngayinye isetshenziselwa izinjongo ezahlukene. Ake sibheke leli thebula ngokuningiliziwe.
| Igama lomuthi | Ukusetshenziswa okuyinhloko | Amaphuzu abalulekile |
|---|---|---|
| I-Naloxone | Umuthi osindisa impilo wokudlula ngokweqile i-opioid. | Inikezwa njengomjovo noma njengesifutho samakhala. Uma umuntu eyekile ukuphefumula ngenxa yokudlula ngokweqile kwe-opioid, ingabuyisa ukuphefumula kungakapheli imizuzu emi-2-5. Ezweni lakithi, isetshenziswa kakhulu emayunithi okwelashwa okuphuthumayo (ama-ETU) ezibhedlela. |
| I-Naltrexone | Njengokwelashwa kwesikhathi eside kokulutheka kwe-opioid notshwala. | Lokhu kusiza ukunqoba umlutha. Kuvimbela injabulo ehambisana nokuthatha ama-opioid. Kodwa akulawuli izimpawu zokuhoxa noma izifiso. Kufika ngamaphilisi noma imijovo. |
| I-Methylnaltrexone | Ngokuqunjelwa okubangelwa amaphilisi okudambisa ubuhlungu anamandla e-opioid. | Lokhu kuhlukile kancane. Akuyi ebuchosheni. Kunalokho, kuvimbela ama-receptor e-opioid emathunjini kuphela. Ngakho-ke akuphazamisi ukusebenza kwemithi yobuhlungu, kunciphisa ukuqunjelwa. Kunikezwa abantu abalashwa ubuhlungu obukhulu obungapheli. |
| I-Nalmefene | Ngokudlula ngokweqile kwe-opioid. | Lokhu kufana ne-naloxone, kodwa kuhlala kusebenza emzimbeni isikhathi eside. Kodwa-ke, akusetshenziswa kabanzi njenge-naloxone. |
Iyini imiphumela emibi yale mithi?
Umphumela oyinhloko nosheshayo wemithi efana neNaloxone neNaltrexone ukuvela 'kwezimpawu zokuhoxa kwe-opioid' . Cabanga nje, umzimba womuntu usujwayele ama-opioid isikhathi eside. Lena impendulo yomzimba lapho umphikisi enikezwa ngokuzumayo futhi isenzo sakhe simiswa.
Ziyini lezi zimpawu zokuhoxa?
- Impumulo egobhozayo
- Ukudabuka okukhulu emehlweni
- Ukukhamuluka njalo
- Ukwanda kwesilinganiso sokuphefumula (i-Hyperventilation)
- I-Hyperthermia
- Ukwanda kwesilinganiso senhliziyo (i-Tachycardia)
- Ubuhlungu bemisipha
- Isicanucanu nokuhlanza
- Uhudo
- Ukukhathazeka
Ubukhulu balezi zimpawu buyahlukahluka kuye ngomuntu nomuntu. Kuya ngokuthi kusetshenziswe isikhathi esingakanani nokuthi hlobo luni lwe-opioid. Esibhedlela, odokotela baphatha lesi simo kahle. Banikeza usawoti (i-IV fluids) kanye neminye imithi.
Imiphumela emibi ye-Methylnaltrexone, esetshenziselwa ukuqunjelwa, ihlukile. Yile:
- Ubuhlungu besisu
- Ukugcwalisa isisu
- Isicanucanu noma ukuhlanza
- Ikhanda elibuhlungu
- Ukugingqa imisipha
- Isiyezi
Ziyini izinzuzo zale mithi?
Naphezu kwemiphumela emibi, izinzuzo zale mithi zidlula kakhulu lezo.
I-Naloxone iyisidakamizwa esisindisa impilo . Ingavimbela ukufa ngenxa yokudlula ngokweqile kwe-opioid. Yilokho okubaluleke kakhulu.
I-NaltrexoneKuyingxenye ebaluleke kakhulu yokwelapha izimo eziyinkimbinkimbi njengokulutha kwe-opioid noma utshwala. Kodwa akwanele ngokwakho. Ukulutha izidakamizwa kuyisifo esiyinkimbinkimbi kakhulu. Kudinga ukwelashwa ngezici ezahlukene, njengokwelashwa kwengqondo kanye nokuvuselelwa. I-Naltrexone umuthi onikeza amandla amakhulu kulolo hambo.
Uma wena noma othile omaziyo enale nkinga, sicela ukhulume nodokotela wakho ngayo. Kunezindlela eziningi zodokotela nezindlela ezingasiza ngalezi zimo.
Umlayezo Wokuya Nawe Ekhaya
- I-opioid antagonist uhlobo lomuthi oluvimba ukusebenza kwama-opioid (ama-painkiller anamandla kanye nezidakamizwa ezifana ne-heroin) emzimbeni.
- I-Naloxone iwumuthi obaluleke kakhulu, osebenza ngokushesha onganikezwa ukusindisa impilo yomuntu osebenzise ama-opioid ngokweqile.
- Le mithi, ikakhulukazi uma inikezwa umuntu umzimba wakhe ojwayele ama-opioid, ingabangela izimpawu ezinkulu zokuhoxa. Ngakho-ke, kufanele isetshenziswe njalo ngaphansi kokuqondisa kukadokotela.
- Ukuluthwa yizidakamizwa akusona ubuthakathaka, kuyisimo esingelapheka. Uma wena noma othile omaziyo edinga usizo, ungabi namahloni futhi ukhulume nodokotela ngakho.
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