Zimayambitsa, Kuzindikira, ndi Chithandizo
Anthu omwe amakhala ndi ululu wosatha nthawi zina amadalira mankhwala opatsirana mankhwala. Komabe, imodzi mwa mitundu yowonjezereka ya painkillers ikhoza, poyesa ntchito yaitali, yambani kupweteka kwanu.
Izi zikachitika, zimatchedwa hyperalgesia (OIH) kapena opioid -ducedduced allodynia (OIA). Apa pali tanthauzo la mawu awa:
- Opioid, yomwe nthawi zina imatchedwa opiate kapena mankhwala osokoneza bongo, ndi mtundu wa painkiller wopangidwa kuchokera ku opium yopangidwa ndi munthu.
- Hyperalgesia imakula kupweteka; Zomwe zimayambitsa ndondomeko zamanjenje zimathandiza kuwonjezera kukula kwa ululu umene mumamva.
- Allodynia ndi ululu umene umayambitsidwa ndi chinachake chimene sichiyenera kuchititsa ululu, monga kukhudza khungu kapena nsalu zikuyenda pakhungu lanu.
Pamene ma opioid amayamba kuchititsa kapena kupweteka ululu wanu, mukufunikira kuyamwa ndi kuyang'ana njira zina zothetsera ululu wanu.
Kupweteka kwa opioid (OIP) kungakhale kovuta kuti mudziwe, makamaka kwa munthu amene ali ndi matenda omwe ali kale ndi hyperalgesia ndi / kapena allodynia.
Opioids amapezeka ndi mankhwala. Mankhwala ena ali ndi opioid basi pamene ena amagwirizanitsa opioid ndi mankhwala ena monga acetaminophen. Ma opioids amodzi ndi awa:
- Hydrocodone
- Oxycodone
- Codeine
- Morphine
- Methadone
- Fentanyl
- Meperidine
- Hydromorphone
Kodi N'chiyani Chimayambitsa Mavuto Opioid?
Asayansi sanadziwe chomwe chimayambitsa OIH. OIA inadziwika kwambiri posachedwapa ndipo tikudziwa mozama za izo kuposa momwe timachitira OIH.
Komabe, ofufuza akufufuza njira zingapo.
Malingana ndi ndemanga ya OIH yomwe inafalitsidwa mu nyuzipepala ya Pain Physician, njira zina zotheka ndizo:
- Zosaoneka bwino momwe ubongo wanu umapangidwira zosautsa
- Zovomerezeka zapadera mu ubongo wanu sizikugwira ntchito
- Kuwonjezera kwa kuchuluka kwa matenda a neurotransmitter glutamate , omwe amachititsa kuti maselo anu a ubongo, nthawi zina aziwatsitsimutsa mpaka imfa
- Ntchito yowonjezera ya mapuloteni mumtsempha wamtsempha omwe amachititsa mitsempha yapadera, yotchedwa nociceptors , m'thupi lanu lamanjenje
- Kuchepetsa kubwezeretsa kachilomboka kwa ena odwala matendawa, omwe amachititsa kuti ubongo ukhale wolimba
- Kulimbitsa mphamvu ya mitsempha ya m'mimba kwa mankhwala a neurotransmitters P (yomwe imatulutsa zizindikiro zopweteka zopweteka) ndi glutamate
Zina mwa njirazi zingagwirane ntchito kuti zipangitse ndi kusunga OIP. Ngakhale kuti kafukufuku wochuluka wayamba kugwiritsidwa ntchito pa dongosolo la mitsempha yapakatikati, dongosolo la mitsempha lozungulira limatha kugwira nawo nthawi zina.
Wopweteka Wachirombo amafotokozera umboni kuti OIP ikhoza kukhala yosiyana pazinthu zosiyanasiyana zowawa, komanso.
Ndani ali pangozi ya ululu woopsa wa opioid?
Sikuti aliyense amene amatenga opioid adzakhala ndi OIP. Kafukufuku amasonyeza kuti zamoyo zina zimathandiza. Kutenga opioid nthawi yayitali kwawonjezereka chiopsezo chanu, monga kumatenga mlingo waukulu. Kuwonjezereka mlingo wanu mofulumira kumakuchititsani inu pa ngozi yaikulu.
Chifukwa chakuti anthu ambiri amalekerera mankhwalawa, ndi zachilendo kwa kuchuluka komwe mumatenga pofuna kupweteka kochulukirapo pakapita nthawi, kutanthauza kuti mumakhala ndi OIP kwambiri.
Kuzindikira Mavuto Opioid-Induced
OIP ndi zovuta kufotokoza.
Palibe chiyeso kapena kuchiyesa, kotero dokotala wanu ayenera kulingalira za zizindikiro zanu ndi kuyang'ana zina zowonjezera zomwe zimayambitsa kuwonjezereka kapena kumva kwatsopano. Izi zimatchedwa kuti matenda osokonezeka, chifukwa akhoza kungopangidwa ngati zina mwazidutswa.
Chinthu chovuta kwambiri kuti munthu apeze matenda a OIP ndikumva kupweteka kumene kumatchedwa "kupweteka pakati" kapena " kutsegula pakati ." Izi zimaphatikizapo fibromyalgia , nyamakazi ya nyamakazi , migraine , matenda opwetekedwa mtima , matenda a ME / chronic tiredness , ndi matenda osokoneza maganizo pambuyo pake. Anthu omwe ali ndi mikhalidwe imeneyi nthawi zambiri amakhala kale ndi hyperalgesia ndi / kapena allodynia, zomwe zimakhoza kusokoneza OIP.
Mosasamala kanthu komwe zimayambitsa kupweteka kwanu, chinthu chofunikira kuyang'ana ndicho kusintha kwa chikhalidwe kapena chikhalidwe cha ululu wanu. Fufuzani mitundu iyi ya kusintha:
- Kuvutika kwakukulu kapena kufalikira kwakukulu pamene chifukwa chachikulu chikukhazikika kapena chimakhala bwino
- Kuwonjezeka kupweteka kwambiri ngakhale kuti ndi chifukwa chachikulu chokhazikika chokhazikika kapena chokhazikika
- Kuchuluka kwa ululu pambuyo pa mlingo wa opioid ukukwera mmwamba
- Kupweteka kochepa pamene mutenga mankhwala ochepa
Mukamatha kuwuza dokotala wanu za momwe ululu wanu wasinthira komanso momwe zingagwirizane ndi ntchito yanu ya opioid, zidzakhala zosavuta kuti mupeze chithunzi cha zomwe zikupweteka.
OIP vs. Kuonjezera Kupirira Mavuto a Mankhwala
Kulimbana ndi matendawa kumaphatikizapo kulekerera mankhwala. Kugwiritsira ntchito mankhwalawa kwa nthawi yaitali kumadziwika kuti kumayambitsa kulekerera, komwe kungapangitse kuwonjezeka mlingo.
Choncho, nthawi zina ululu umapweteka osati chifukwa cha opioid ikuyambitsa, koma chifukwa chakuti mwakhala mukulekerera mankhwala, zomwe zikutanthauza kuti sizingagwire ntchito monga momwe zimagwirira ntchito. Kodi mumauza bwanji kusiyana kwake?
Si zophweka. Onetsetsani kuti muyankhule ndi dokotala wanu zomwe zikuchitika komanso momwe mungadziwire zomwe zikupweteka. Kuyesera ndi mlingo nokha kungakhale koopsa kwambiri, ndipo sikungakupatseni zowathandiza.
Kuchiza Mavuto Opioid
Ngati chifukwa cha kupweteka kwakukulu kwatha, ndiye mankhwala oyenera ndi opioids. Malingana ndi mlingo ndi momwe watengedwera nthawi yayitali, izi zingafunike kusamba pang'ono pang'onopang'ono kuti muteteze zizindikiro.
Ngati, ngakhale chomwe chimayambitsa kupweteka chikupitirira, dokotala wanu angalimbikitse kutsikira mlingo kuti awone ngati icho chichotsa OIP. Mukapita ku ma opioids, ndizotheka kuti ululu wanu wa OIP ukhale woipitsitsa musanapite.
Mukhozanso kupeza mpumulo mwa kusintha mtundu wa opioid yomwe mumagwiritsa ntchito. Mwachitsanzo, hydrocodone, fentanyl, ndi tramadol zonse zimachokera ku magulu osiyanasiyana.
Nthaŵi zina, madokotala amayesa kuwonjezera mtundu wina wa painkiller-kaya COX-2 inhibitor kapena non-steroidal anti-inflammatory (NSAID) -along ndi mlingo wochepa wa opioids. Mankhwalawa angathandize kuthana ndi zochita zopanda pake za glutamate ndi mankhwala P zomwe amakhulupirira kuti zimapangitsa kuti ma OIP azipezeka.
Mankhwala ena omwe angakhale othandiza pochiza OIP ndi awa:
- Dextromethorphan
- Methadone (ngati OIP si yokhudzana ndi methadone)
- Buprenorphine
- Ketamine
- Dexmedetomidine pamodzi ndi flurbiprofen axetil
Curcumin wothandizira (mankhwala mu spice turmeric) akhoza kutsutsana ndi OIH, malinga ndi kafukufuku wa 2016 ku PLoS One .
Mu kafukufuku wa 2016 wofalitsidwa mu Scientific Reports , ofufuza anafotokoza kuti kupunduka kwa mtundu wina wa stem cell unasintha OIH komanso kulekerera kwa morphine.
Kuteteza Mavuto Opioid
Inde, ndibwino ngati mutha kuteteza OIP poyamba. Phunziro la 2017 lofalitsidwa mu Opaleshoni Ino mu Anaesthesiology limalimbikitsa kuyendayenda kudzera m'kalasi ya opioids, kukhala pa mlingo wotsika kwambiri, ndi kuphatikiza ma opioids ndi ophera opioid. Kutumiza kwa mlingo wapamwamba pang'onopang'ono kungapangitse OIP kuti asapange.
Mungafunenso kufufuza mankhwala osaphatikizapo kupweteka kwanu kuti muteteze ntchito yanu ya opioid pomwe simukutsutsa khalidwe labwino.
Mankhwala Osamva Mankhwala Opweteka
Mankhwala osayenera kwa inu amadalira chifukwa cha ululu wanu ndipo ndi chinthu chomwe muyenera kukambirana ndi dokotala wanu. Njira zopweteka zambiri zimaphatikizapo:
- Kupangidwanso
- Kuchiza mankhwala
- Kuchiza thupi
- Chiropractic
- Biofeedback
- Njira yothetsera chidziwitso
- Zakudya
Anthu ena omwe amamva kupweteka kosalekeza amapewa mpumulo ku zozoloŵera zabwino monga:
Mawu Ochokera
Mukawona kuwonjezeka kwa ululu kapena kusintha kwa mtundu wa ululu wanu, kambiranani ndi dokotala wanu ngati zingakhale chifukwa cha opioid yanu. Kupweteka kopweteka kumatenga nthawi yokwanira pa moyo wanu monga momwe simukusowa mankhwala anu kukupweteketsani kwambiri!
Ngati inu ndi dokotala wanu mukuganiza kuti muleke kuchitenga, onetsetsani kuti mukuphunzira kuyamwa bwino ndikutsatira malangizo.
Ndi mankhwalawa, kuledzera ndi kotheka. Palibe manyazi mwa izo-ndi zotsatira zachirengedwe za mankhwala. Komabe, kungatanthauze kuti mukufuna thandizo lina. Icho ndichinthu chinanso chomwe mungakambirane ndi dokotala wanu.
Zingakhale zowopsya kusiya kusiya mankhwala omwe mwadalira kuti agwire. Yesetsani kulingalira momwe zingachepetsere ululu wanu ndi kusintha moyo wanu, ndipo kumbukirani kuti muli ndi njira zina zothandizira kuti mufufuze.
> Zotsatira:
> Lee M, Silverman SM, Hanse H, Patel VB, Manchikanti L. Kukambirana kwakukulu kwa opioid-stimulated hyperalgesia. Dokotala wowawa. 2011 Mar-Apr; 14 (2): 145-61.
> Li SQ, Xing YL, Chen WN, et al. Kugwira ntchito kwa NMDA receptor kumagwirizanitsidwa ndi kukweza kwa kayendedwe ka COX-2 m'mphepete mwa nyongolotsi ya msana pamphuno. Neurochem Res . 2009; 34: 1451-1463.
> Ramasubbu C, Gupta A. Mankhwala opatsirana pogwiritsa ntchito opioid-stimulated hyperalgesia: kubwereza umboni. Journal za ululu & chisamaliro chosamalidwa pharmacotherapy. 2011; 25 (3): 219-30. do: 10.3109 / 15360288.2011.589490.
> Silverman S. Opioid amachititsa kuti munthu azidwala matenda oopsa: zotsatira zachipatala zomwe zimapangitsa munthu wopwetekedwa mtima. Pain Physician . 2009; 12: 679-684.
> Wasserman RA, Brummett CM, Goesling J, Tsodikov A, Hassett AL. Zizindikiro za opweteka kwambiri odwala omwe amatenga opioids ndikupitiriza kunena za ululu waukulu. Mankhwala a antiesthesia ndi mankhwala opweteka. 2014 Jan-Feb; 39 (1): 13-7. lembani: 10.1097 / AAP.0000000000000024.
> Yu Z, Wu W, Wu X, et al. Zotetezera za dexmedetomidine pamodzi ndi flurbiprofen axetil on remifentanil-induced hyperalgesia: kuyesedwa kosasinthika. Mankhwala othandiza ndi ochiritsira. 2016 Oct; 12 (4): 2622-2628.