Ingabe imithi oyithathayo ilimaza izindlebe zakho? Ake sixoxe ngokudakwa kwe-ototoxicity!

Wake wacabanga ukuthi eminye imithi, ikakhulukazi leyo esetshenziselwa ukwelapha izifo ezinkulu, ingalimaza izindlebe zethu, okusho ukuzwa kwethu kanye nokulinganisela? Lokhu kungenzeka ngempela. Kwezokwelapha, lesi simo sibizwa ngokuthi yi-ototoxicity. Ungakhathazeki, kubalulekile ukuqaphela lokhu. Ake sixoxe ngakho ngokuningiliziwe.

Kuyini ukusha kwe-ototoxicity?

Kalula nje, ubuthi obuvela endlebeni buwumonakalo endlebeni yethu yangaphakathi njengomphumela ongemuhle wemithi ethile. Uma sibheka incazelo yegama elithi "ototoxicity", elithi "oto" lisho "indlebe" kanye nelithi "ubuthi" lisho "ubuthi". Okusho ukuthi, isimo esifana nobuthi endlebeni. Indlebe yethu yangaphakathi inamaseli ezinzwa abucayi kakhulu. Lawa maseli asisiza ukuzwa nokugcina ibhalansi emzimbeni. Eminye imithi, isibonelo, imithi yokutheleleka okukhulu kanye nemithi yezifo ezifana nomdlavuza, ingalimaza la maseli ezinzwa. Yilapho lesi simo esibizwa ngokuthi ubuthi obuvela khona.

Ziyini izimpawu ze-ototoxicity?

Lezi zimpawu aziveli ngendlela efanayo kuwo wonke umuntu. Ngezinye izikhathi izimpawu zingavela ngokushesha ngemva kokuqala umuthi. Kwabanye, izimpawu zingase zikhule kancane kancane. Ngokumangazayo, eminye imithi ingabangela ukuthi lezi zimpawu zivele kuze kube yiminyaka emihlanu ngemva kokuqala umuthi. Ngokuvamile, uphawu lokuqala ukuzwa umsindo wokukhala endlebeni. Kungase kube njengomuntu okhuluma nomunye umuntu, noma kungaba umsindo "wokukhala" noma umsindo "wokukhala". Odokotela bakubiza lokhu ngokuthi i-tinnitus . I-tinnitus ingaba uphawu lokuqala lokulahlekelwa ukuzwa. Ezinye izimpawu zifaka:

• Ukulahlekelwa ukuzwa (endlebeni eyodwa noma zombili).
• Ukuzizwa sengathi ulahlekelwa yibhalansi yakho lapho uhamba, ikakhulukazi lapho ukhuphuka izitebhisi.
• Ubunzima bokuhamba ebusuku noma ezindaweni ezimnyama.
• Kudingeka uhambe ngezinyawo zakho zihlukene ukuze ulondoloze ibhalansi.
• I-Oscillopsia umuzwa wokuthi izinto ezingashukumi zibonakala sengathi ziyajikeleza. Lokhu kubizwa ngokuthi i-oscillopsia .
• Ukuzizwa unesizungu, sengathi ikhanda lakho liyajikeleza, sengathi izingalo zakho ziyajikeleza, noma uzizwa ukhathele.

Cabanga ukuthi bekungaba nzima kangakanani uma ungazizwa unesizungu ngokuzumayo ngenkathi wenza imisebenzi yakho yansuku zonke, noma uma uqala ukuquleka ngenkathi uhamba? Lezi yizimpawu okudingeka siziqaphele.

Lokhu kubathinta kanjani abantwana abancane?

Uma lesi simo sivela ezinganeni ezincane, ikakhulukazi lezo esezikhulile ngokwanele ukuba zifunde ukukhuluma, kungaba yisithiyo esikhulu ekufundeni nasekuxhumaneni kwazo nabanye. Njengabazali, kufanele siqaphele kakhulu lezi zimpawu:

• Ubunzima bokuhlala ugxile, kungaba sesikoleni noma lapho ufunda okunye.
• Ukukhathala ngokushesha uma kufanele ulalele isikhathi eside.
• Ubunzima bokuqonda okushiwo abanye, ukungabaza ukukhuluma, noma ukungakhulumi nhlobo. Ngezinye izikhathi lokhu kungaba yisizathu sokuba inkulumo yengane ibambezeleke.

Uma ingane inesithakazelo esikhulu sokufunda okuthile, kodwa ngokuzumayo ilahlekelwa yisithakazelo kukho, noma uma ihlala ithi ikhathele, kufanele ucabange ngalokhu okungaphezu nje kokucabanga ukuthi kuyihlazo.

Kungani lokhu kwenzeka ngenxa ye-ototoxicity?

Ngokusho kodokotela, kunezinhlobo ezingaphezu kuka-200 zemithi engalimaza indlebe yethu yangaphakathi (imithi enobuthi). Eminye yale mithi idinga ukunikezwa udokotela kadokotela. Kodwa eminye, isibonelo, eminye imithi yokubulala izinhlungu, ingathengwa ekhemisi ngaphandle kokuthola udokotela kadokotela.

Into ebalulekile ukuthi imithi eminingi okuthiwa iyingozi endlebeni empeleni iyimithi ebalulekile esindisa impilo. Isibonelo, imithi yomdlavuza, noma imithi yokutheleleka okukhulu kwamagciwane. Ezimweni ezinjalo, inzuzo yokusebenzisa umuthi, okuwukusindisa impilo , idlula kakhulu umonakalo omncane ongase wenziwe endlebeni.

Futhi, eminye imithi `(eyingozi)` ibangela umonakalo kuphela uma ithathwa ngemithamo ephezulu kakhulu. Ngokuvamile asiyithathi imithamo ephezulu kangaka. Kunezinhlobo eziningana zemithi eziyinhloko ezingalimaza indlebe:

Ama-antibiotic e-Aminoglycoside

Lezi uhlobo lwe-antibiotic olunikezwa ukwelapha izifo ezibangelwa amagciwane. Kanye nemithi yokulwa nomdlavuza, lolu hlobo lwemithi (aminoglycosides) lubhekwa njengembangela eyinhloko ye-ototoxicity. Nazi ezinye izibonelo:

• `(Amikacin)`
• `(I-Gentamicin)`
• `(I-Kanamycin)`
• `( Neomycin )`
• `(I-Netilmicin)`
• `(I-Streptomycin)`
• `(I-Tobramycin)`
• `(Vancomycin)` (Lokhu futhi ngezinye izikhathi kufakiwe kulesi sigaba)

Imithi yokwelapha ngamakhemikhali

Imithi esetshenziswa ukwelapha izinhlobo ezahlukene zomdlavuza. Eminye yale mithi ingaba yingozi ezindlebeni:

• `(I-Carboplatin)`
• `( Cisplatin )`

Ama-diuretics e-Loop - "amaphilisi amanzi"

Lena imithi esiza izinso ukukhipha usawoti namanzi amaningi emzimbeni ngomchamo. Abanye abantu bayibiza nangokuthi “amaphilisi amanzi.” Eminye yale mithi ihlanganisa:

• `(I-Bumetanide)`
• `(I-asidi ye-ethacrynic)`
• `( I-Furosemide )` (Lona umuthi abantu abaningi abawaziyo)
• `(I-Torsemide)`

Eminye imithi namakhemikhali

Nakuba kungavamile, i-ototoxicity ingabangelwa nalokhu:

• I-Quinine:Imithi enikezwa ukwelapha umalaleveva.
• Ama-salicylates : Lawa aqeda ubuhlungu ngaphandle kwemithi kadokotela. I-aspirin, esiyaziyo sonke, iwuhlobo lwe-salicylate. Kodwa-ke, uma ithathwa ngemithamo ephezulu futhi isikhathi eside lapho izinkinga zingavela khona.
• Amakhemikhali endaweni ezungezile: Ngezinye izikhathi lesi simo singabangelwa izinto ezifana ne -mercury , i-tin, i-lead, kanye ne-carbon monoxide endaweni ezungezile.

Yiziphi izinto ezibangela ingozi?

Ingozi yokuthola lesi simo sobuthi obuvela emathanjeni ayifani kuwo wonke umuntu. Kuye ngemithi oyithathayo, udokotela wakho uzokuchazela lezi zici eziyingozi. Ezinye izici ezivamile zifaka:

• Uhlobo lwemithi oyiphuzayo: Eminye imithi inengozi enkulu yalokhu kuneminye.
• Isilinganiso somuthi: Inani okufanele ulithathe.
• Isikhathi esingakanani okufanele usithathe umuthi.
• Ukuthi kufanele yini uphuze imithi eminingana engaba yingozi ezindlebeni kanyekanye. Uma kunjalo, ingozi inganda kakhulu.

Ngaphezu kwalokho, ososayensi bathole ukuthi izakhi zofuzo zabanye abantu (i-DNA) nazo zingaba nomthelela . Ikakhulukazi, ukwakheka kwezakhi zofuzo zabanye abantu (noma isakhiwo) kungandisa ingozi yokuba yingozi lapho kuthathwa ama-antibiotic athile e-aminoglycoside.

Izinkinga ezibangelwa yi-ototoxicity

Umonakalo endlebeni yangaphakathi obangelwa yile mithi "eyingozi" uvame ukuba "owungeke uguqulwe" . Lokho kusho ukuthi izinkinga zesikhathi eside zokuzwa nokulinganisela zingaba khona. Ikakhulukazi ezinganeni ezincane, lezi zinkinga zokuzwa zingaphazamisa ikhono lazo lokukhuluma, ukufunda ulimi, ngisho nokuthuthukisa amakhono eziwadingayo ukuze zikhulumisane nabanye. Cabanga nje, uma ingane ingakwazi ukuzwa amagama kahle, izofunda kanjani ukuwasebenzisa lawo magama ukukhuluma? Kodwa-ke, noma umonakalo ungenakulungiseka, odokotela bangaqapha isimo sakho, baphathe izimpawu uma zivela, futhi banikeze ukwesekwa okudingekayo.

Ungasibona kanjani lesi simo?

Uma unalezi zimpawu, kungadingeka ukuthi ubonane nochwepheshe wezindlebe, impumulo, nomphimbo (otolaryngologist noma uchwepheshe we-ENT) noma udokotela wezindlebe. Bazokwenza izivivinyo ezahlukene ukuhlola indlebe yakho yangaphakathi, kuye ngezimpawu zakho. Into ebaluleke kakhulu ukuthi udokotela wakho angahlola ukuzwa kwakho kanye nokulinganisela ngaphambi kokukunikeza umuthi okusolwa ukuthi uyingozi endlebeni.Futhi, ungenza lezi zivivinyo ngezikhathi ezithile ngenkathi uthatha umuthi. Ngaleyo ndlela, uma kukhona ushintsho njengomphumela omubi womuthi, ungalubona ngokushesha.

Yiziphi izivivinyo ezenziwayo?

Ukuze abone ukuthi indlebe yakho yangaphakathi isebenza kanjani, udokotela wakho angenza izivivinyo ezinjengalezi:

• I-Audiogram: Lokhu kuhlola ukuthi uzwa kahle kangakanani imisindo ehlukene, okungukuthi imisindo ethambile, imisindo ephezulu, imisindo ephezulu nephansi (iphimbo), kanye nokuthi uqonda kahle kangakanani amagama.
• Ukuhlolwa kwe-Auditory Brainstem Response (ABR): Lokhu kuhlola indlela i-auditory nerve yakho esabela ngayo emisindweni nokuthi leyo mpendulo iya kanjani ebuchosheni.
• Ukuhlolwa Kokukhishwa Kwe-Otoacoustic (OAEs): Izakhiwo ezincane kakhulu ezifana nezinwele endlebeni yangaphakathi (amangqamuzana ezinwele ku-cochlea) zikhipha ukudlidliza okuhamba kancane (ukudlidliza komsindo) ngenxa yomsindo. Lokhu kuhlolwa kulinganisa lokhu kudlidliza ukuze kubonwe ukuthi amangqamuzana asebenza kahle kangakanani.
• Ibhethri lokuhlola i-Vestibular: Lokhu akulona ukuhlolwa okukodwa, kodwa uchungechunge lwezivivinyo zokuhlola izinkinga zokulinganisela. Isibonelo, lokhu kungafaka phakathi izivivinyo ezifana ne-`(Videonystagmography - VNG)` (ukubuka ukunyakaza kwamehlo), `(Vestibular Evoked Myogenic Potentials - VEMPs)` (ukubuka izimpendulo zemizwa ehilelekile ekulinganiseni), `(Rotary chair test)` (ukuhlola ngenkathi uhleli esihlalweni esijikelezayo), kanye ne-`(video Head Impulse Testing - vHIT)`.

Iphathwa kanjani i-ototoxicity?

Ngeshwa, ukuyeka umuthi obulala amagciwane akuwushintshi umonakalo osuvele wenzeke. Kodwa-ke, ukuyeka umuthi noma ukunciphisa umthamo (uma kungenzeka) kungasiza ekuvimbeleni umonakalo owengeziwe. Kodwa-ke, njengoba sesishilo kakade, le mithi ebulala amagciwane ivame ukusindisa impilo. Ngakho-ke, ukuyiyeka noma ukwenza izinguquko ezinkulu ohlelweni lwakho lokwelashwa akwenzeki njalo. Ezimweni ezinjalo, udokotela wakho uzoqapha impendulo yakho emithini futhi akusize ulawule izimpawu zakho.

Amathuluzi nezindlela zokusiza ukuphatha izimpawu

Nakuba umonakalo ungenakuguqulwa, kunezindlela zokukusiza uphile nezimpawu:

• Izinsiza-kuzwa: Lawa madivayisi asiza abantu abanenkinga yokuzwa, ikakhulukazi labo abanenkinga yokuzwa, ukuzwa izinto kangcono nokwenza ukuxhumana kube lula.
• Izimila ze-Cochlear: Lezi yizinto zikagesi ezifakwa ngokuhlinzwa ngaphakathi kwendlebe. Zivame ukusetshenziswa kubantu abanenkinga yokuzwa kakhulu abangasabeli kahle ezinsizeni zokuzwa ezivamile.
• Ukuvuselelwa kwe-Vestibular:Lolu uqeqesho olukhethekile. Uzosebenzisana nodokotela we-vestibular noma uchwepheshe wezokwelapha ngokomzimba ukuze ufunde izivivinyo namasu azosiza umzimba wakho ukuthi uvumelane futhi ubhekane nezinkinga zokulinganisela ezibangelwa izinkinga zendlebe yangaphakathi. Lokhu kungasiza ekunciphiseni izimpawu ezifana nokuzungeza kanye nobunzima bokuhamba.

Ingabe ubuthi obungasuswa emzimbeni bungavinjelwa?

Lesi simo asivimbeki ngokuphelele ngaso sonke isikhathi. Ngezinye izikhathi, kuyadingeka ukunikeza umuthi obulala amagciwane ukuze usindise impilo yakho. Kodwa-ke, uma ubona izimpawu kusenesikhathi, udokotela wakho angakusiza ngokushesha futhi mhlawumbe athathe izinyathelo zokunciphisa umonakalo owengeziwe. Uma uthatha umuthi ongase ulimaze izindlebe zakho, udokotela wakho uzokuqapha njalo. Uzokutshela nokuthi yiziphi izimpawu okufanele uziqaphele nokuthi yiziphi izimpawu okufanele uzibone kudokotela uma uzibona.

Lesi simo sizohlala isikhathi esingakanani?

Ukulimala kwendlebe yangaphakathi okubangelwa ubuthi obuvela endlebeni akunakulungiseka . Lokhu kusho ukuthi umonakalo uhlala unomphela. Kodwa-ke, kuye ngesimo sakho, udokotela wakho angase akwazi ukushintsha uhlelo lwakho lokwelashwa (uma kungenzeka) ukuze ayeke umonakalo owengeziwe kanye nezimpawu zingabi zimbi kakhulu. Kodwa-ke, ngenxa yokuthi ngokuvamile akunakwenzeka ukuyeka ukuthatha umuthi, udokotela wakho uzokwakha uhlelo lokwelashwa lwesikhathi eside ukuze akusize ulawule izimpawu zakho. Kuye ngokuthi uxilongwe kanjani kanye nomuthi owunikiwe, udokotela wakho uzokhuluma nawe ngezingozi zokuthatha umuthi obangelwa ubuthi obuvela endlebeni.

Ngingazinakekela kanjani mina kanye nengane yami?

• Khuluma nodokotela wakho ngezingozi nemiphumela emibi yanoma yimuphi umuthi owunikezwayo. Ungesabi ukubuza imibuzo.
• Uma ubona noma yiziphi izinguquko ezintsha ekuzweni kwakho, ekulinganiseni, noma kwezinye izimpawu ngemuva kokuqala umuthi osola ukuthi unobuthi, noma ngabe uncane, bheka udokotela wakho ngokushesha.
• Uma ungumzali noma umnakekeli onikeza ingane encane lo muthi, qaphela kakhulu noma yiziphi izinguquko enganeni yakho. Kungaba nzima ukubona izimpawu ezinganeni ezincane. Ngaphezu kokufuna izimpawu zezinkinga zokuzwa noma zokulinganisela, qaphela noma yiziphi izimpawu zokuthi ingane yakho inenkinga yokugxilisa ingqondo noma ihlala ikhathele. Kungenzeka ukuthi ukukhungatheka ingane yakho ebhekene nakho kungaba ngenxa yenkinga yokuzwa. Uma unenkinga, bheka udokotela wakho ukuze uthole iseluleko.

I-ototoxicity iqala ngokushesha kangakanani?

Kuyahlukahluka kuye ngomuntu nomuntu. Abanye abantu bangase babe nemiphumela emibi ngokushesha lapho beqala ukuthatha imithi. Kwabanye, lezi zimpawu zingase zingabonakali kuze kube yiminyaka emihlanu ngemva kokuqala ukwelashwa. Ezinye izindlela zokwelapha kanye nemithi zinemiphumela ebambezelekile. Yingakho kubalulekile ukuba nokuhlolwa kokuzwa njalo okunconywa udokotela wakho ukuze aqaphe ukuzwa kwakho.

Khumbula, imithi eminingi ehlobene nokusha kwe-ototoxicity, njengemithi elwa namagciwane kanye nemithi yokwelapha ngamakhemikhali, ibalulekile empilweni. Nakuba ingabangela umonakalo endlebeni yangaphakathi, izinzuzo zokuyithatha, kungakhathaliseki ukuthi ukwelapha lesi sifo noma ukusindisa impilo, zidlula kakhulu izingozi.

Uma uphuza umuthi owaziwa ukuthi uyingozi ezindlebeni zakho, khuluma nodokotela wakho nganoma yiziphi izimpawu zokuxwayisa ezingase zivele endlebeni yakho yangaphakathi. Uma usheshe uqaphele izinguquko, udokotela wakho angakusiza ngokushesha futhi akunike uhlelo lokunakekelwa olufanele.

Into ebaluleke kakhulu okudingeka siyikhumbule! (Umyalezo Wokuya Ekhaya)

Kulungile, ake sibheke isifinyezo salokho esikhulume ngakho ukuze sikusize ukhumbule amanye amaphuzu abaluleke kakhulu:

• Ubuthi be-Ototoxicity buwumonakalo endlebeni yangaphakathi obangelwa imithi ethile. Lokhu kungathinta ukuzwa kanye nokulinganisela.
• Qaphela izimpawu ezifana ne-tinnitus (ukukhala ezindlebeni), ukulahlekelwa ukuzwa, kanye nesiyezi.
• Ngisho noma kunezingozi lapho uthatha imithi esindisa impilo, izinzuzo zomuthi zivame ukwedlula izingozi. Kodwa-ke, kubalulekile ukuqaphela izingozi.
• Uma unikezwe umuthi oyingozi, khuluma nodokotela wakho ngawo bese uya ezivivinyweni ezihleliwe.
• Uma ubona noma yiziphi izimpawu ezintsha, noma ngabe zincane, tshela udokotela wakho ngokushesha. Ukwelashwa okusheshayo kungasiza ekuvimbeleni isimo ukuba singabi sibi kakhulu.

Kungumthwalo wakho ukunakekela impilo yakho. Sithemba ukuthi lolu lwazi luzokusiza ukuthi wenze kanjalo!