Njira Zochiritsira Zochiza Matenda Akumphawi Kwambiri
Kuchepetsa ululu wosatha wamtundu kungakhale kovuta, chifukwa chifukwa chake sichimamvetsedwa nthawi zonse. Mankhwala omwe amapangidwa okha, monga NSAIDs, nthawi zambiri sagwira ntchito pakuchulukira kupweteka kotere; Komabe, njira yothandizira ma multimodal ingathandize kuti mitsempha isamve kupweteka kwambiri. Njira imeneyi ikuphatikizapo mankhwala opweteka, amamva kupweteka kwambiri, komanso mankhwala ena opweteka.
Kuchiza Kwakumva Kwaukali - Adjuvant Analgesics
Mankhwala otchedwa Adjuvant analgesics , monga anticonvulsants ndi antidepressants, nthawi zambiri amatha kulimbana ndi ululu wa m'mimba. Chifukwa mankhwalawa adapangidwa kuti athetse mavuto ena osati kupweteka, ntchito yawo mu mankhwala opweteka a mtima amatchedwa "off-label" ntchito. Koma musalole kuti izi zikudetseni: ma analgesics ambiri a adjuvant agwira ntchito bwino pochiza zizindikiro zakumva kupweteka kwapadera kusiyana ndi zizindikiro zowononga.
Anticonvulsants amagwiritsa ntchito mankhwala opweteka m'mitsempha:
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
- Carbamazepine (Tegretol)
- Oxcarbazepine (Trileptal)
- Phenytoin (Dilantin)
- Valproate (Depacon)
- Lamotrigine (Lamictal)
Mankhwala opatsirana pogwiritsa ntchito mankhwala opweteka m'mitsempha:
- Amitriptyline (Elavil)
- Nortriptyline (Aventyl)
- Desipramine (Norpramin)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
Kuchiza Kwakumva Kwaukali - Zojambula Zachikhalidwe
Kawirikawiri, anthu ochizira okhawo sangathe kuchepetsa zizindikiro za ululu wa matenda .
Ichi ndi chifukwa chakuti ambiri amapanga mankhwala, monga NSAIDs, kutukusira, zomwe zingayambitse kapena zimakhala zovuta chifukwa cha ululu wa mitsempha. Komabe, ena odwala painkillers amathandizira kuchiza matenda aakulu. Zikhoza kugwiritsidwa ntchito ngati analgesics ya adjuvant siyenela , kapena ikuphatikiza ndi antiticulants kapena anti-depressants.
- NSAIDs . NSAIDs zokha sizingakhale zothandiza pakuchiritsa ululu wa ubongo ; Komabe, kwa anthu ena, kutupa kumapangitsa kupweteka kwa mitsempha kumakhala koopsa kwambiri. NSAIDs, monga ibuprofen (Advil) kapena naproxen ( Aleve ), ikhoza kuphatikizidwa ndi mankhwala ena opweteka ndipo ingathandize kuchepetsa kupweteka.
- Acetaminophen . Acetaminophen (Tylenol) ingagwiritsidwe ntchito kuphatikiza ndi analgesics ya adjuvant pofuna kuchepetsa ululu wamagazi, kapena ingagwiritsidwe ntchito pa nthawi zowawa zopweteka . Ma opioid ena omwe amagwiritsidwa ntchito pochizira matenda a ubongo amakhalanso ndi acetaminophen.
- Opioids . Opioids angapangidwe kuti azitha kupweteka kwambiri pamtima, kapena ngati chotsiriza cha chitetezo pamene adjuvant analgesics alephera kuthetsa ululu. Opioid "yofooka" yomwe nthawi zambiri imatchulidwa kuti ululu wa m'mimba ndi tramadol (Ultram); Komabe, ma opioid amphamvu angakhale oyeneranso.
- Zojambula Zosudzo . Ngakhale kuti nthawi zonse sizothandiza, anthu ena omwe amamva kupweteka kwa mtima amapeza mpumulo ndi mankhwala opweteka kunja, kuphatikizapo lidocaine ndi capsaicin. Mankhwala otsekemera amatha kukhala pamodzi ndi mankhwala ena.
Kuchiza Kwachisoni Chakumva - Zina Zosankha
Mankhwala siwo okhawo amene angayankhe pankhani ya chithandizo cha ululu wa m'mimba. Zosankha zina zomwe zingagwiritsidwe ntchito payekha, kapena kuphatikizapo painkillers, zikuphatikizapo:
- Kuchiza thupi
- Mitsempha ya mitsempha
- Mimba ya msana
- Kuchita opaleshoni yachinyengo
Mankhwala othandizira komanso othandizira (CAM) angathandizenso kupweteka kwa m'mimba, kuphatikizapo mankhwala opatsirana ndi mankhwala . Ngakhale kuti CAMs ambiri safuna mankhwala, muyenera kumalankhula ndi dokotala musanayambe mankhwala atsopano chifukwa cha ululu wanu wa mitsempha.
Zotsatira:
National Guideline Clearinghouse. Malangizo a EFNS pa Chithandizo cha Pharmacological of Pauropathic Pain. http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10472&nbr=5495
National Pain Foundation. Kupweteka kwa Neuropathic: Mankhwala. http://www.painfoundation.org/
Makampani Opanga Mankhwala Othandiza pa Intaneti pa Merck. Zowawa za Neuropathic. http://www.merckmanuals.com/professional/neurologic-disorders/pain/neuropathic-pain