Akatengedwa mokwanira, acetaminophen ndi owopsa kwambiri
Ku Chicago kumapeto kwa 1982, makapulisi a acetaminophen (Tylenol) anali atakulungidwa ndi cyanide yomwe inapha anthu asanu ndi awiri osadziwika. Mpaka lero, lamulo la malamulo siliyenera kugwira munthu kapena anthu omwe ali ndi udindo wotsutsa.
The Chicago Tylenol Kupha sikuti anangotchula miyoyo ya anthu asanu ndi awiri koma adawononganso McNeil Consumer Products, wothandizira kupanga mankhwala osokoneza bongo Johnson & Johnson ndi wopanga tylenol.
Mu zomwe zikugwiritsidwa ntchito nthawi zonse monga phunziro la kasamalidwe ka mavuto, pakufika kwa Tylenol mantha, McNeil Consumer Products anatulutsa machenjezo a anthu ambiri ndipo amakumbukira mabotolo onse a Tylenol omwe alipo, okwana 31 miliyoni. McNeil Consumer Products anatsimikiziranso anthu kuti zonse zowonongeka zimachitika kunja kwa fakitale.
Mu masabata otsatira a Chicago Tylenol ophedwa, Johnson & Johnson adachoka kulamulira msika wamakono wolemera kwambiri ndi 35 peresenti ya msika ku gawo limodzi la magawo 8 pa msika. Koma pasanathe chaka chimodzi, Tylenol inabwerera pambuyo pa ndalama zokwana madola 100 miliyoni pothandizira mitengo, kutsekemera kwapadera, komanso kutsekedwa kwa gelatin-yokutidwa ndi kapuloti kamene kanali kosavuta kuyanika ndi kovuta kusokoneza. Panthawi yavutoli komanso zaka zambiri, m'mitima ndi m'maganizo a anthu, Tylenol yathandiza kuti anthu akhale ndi chikhulupiriro cholimba monga otetezeka, ogula komanso opweteka kwambiri.
Komabe, chifukwa cha zifukwa zomwe zimakhala zoopsa kwambiri tsopano, Tylenol ingakhale yoopsa. Ndi anthu ochepa chabe omwe saganizira za momwe angapititsire mopitirira muyezo, acetaminophen amatha kupha chiwindi. Pambuyo pake, mabotolo a acetaminophen amawoneka osasamala pamene akupezeka pa shelefu mu mankhwala a kabati kapena pamene amagulitsidwa osakaniza ku kampani yogula mitengo.
Mwamwayi, zotsatira za acetaminophen poizoni zingathe kusinthidwa ngati mankhwala atha kuperekedwa mkati mwa maola 10 oyambirira poizoni.
Kumvetsetsa Tylenol
Mu thupi, Tylenol imayamba kufalikira kudzera m'matumbo a m'mimba. Tylenol pafupifupi 100 peresenti sizinapangidwe kuti izi zitheke komanso zingakhale zoopsa. Zimatengera pafupifupi 30 mphindi kuti analgesic (pain relieving) ndi antipyretic (kutentha thupi) zikhale zogwiritsidwa ntchito, ndipo, mwachibadwa, matupi athu amadziwika pafupifupi theka la dola ya Tylenol maola 2.5 mutatha kudya.
Akatengedwa kuti amve kupweteka kwa akuluakulu, Tylenol imamangidwa pakati pa 600 mg ndi 1000 mg maola 4 mpaka 6. Palibe amene ayenera kutenga magalamu 4 a Tylenol patsiku. Zikhomo za Tylenol zili ndi 500 mg ya acetaminophen kotero kuti musamangotenga makapu oposa awiri pa maola asanu ndi limodzi kapena asanu ndi atatu pa tsiku . Zindikirani, ngati muli ndi vuto lofuna kuti mutenge malo asanu ndi atatu a Tylenol patsiku, muyeneradi kuchipatala.
Ngati mankhwalawa atengedwa, tylenol yambiri imathyoledwa ndi chiwindi kudzera mu njira zamagetsi zowonongeka ndi glucuronidation. Kuwonjezera pamenepo, Tylenol ing'onoing'ono (osakwana asanu peresenti) imachotsedwa mwachindunji kudzera impso.
Potsirizira pake, ndi mankhwala ochizira, peresenti yaing'ono imapangidwira ndi cytochrome P-450 dongosolo lothandizira metabolite N-acetyl- p -benzoquinoneimine (NAPQI); NAPQ1 imathamangitsidwa mwamsanga ndi diso lopweteka kwambiri kumalo osakanizidwa a acetaminophen-mercapturate omwe amachotsedwanso ndi impso.
Panthawi ya poizoni wa Tylenol, chiberekero cha chiwindi cha cytochrome P-450 chimangowonongeka ndipo malo ogulatione amatha. Chifukwa chake, metabolite yowonongeka, NAPQ1, imawononga ndi kupha maselo a chiwindi motero imatsogolera ku chiwindi kulephera.
Mu 2008, bungwe la American Association of Poison Control Centers linalongosola kuti anthu 71,328 akuwonetsa Tylenol kuphatikizapo 80,845 ku Tylenol yekha.
Anthu makumi asanu ndi atatu mphambu zitatu anafa ndi poizoni wa Tylenol pamtundu umodzi wokonzedweratu, ndipo anthu 69 anamwalira chifukwa cha Tylenol yekha. Ziwerengero izi zimatsindika mfundo zofunika kwambiri zachipatala zokhudzana ndi poizoni wa Tylenol: Anthu ena amatha kutaya mavitamini pa acetaminophen chifukwa amawoneka kuti ndi "amanyazi," koma nambala yofanana ya anthu imathera poizoni okha chifukwa amalephera kuzindikira kuti Tylenol anali ngakhale mankhwala omwe anali kutenga.
Inu ndi okondedwa anu muyenera kumvetsetsa zomwe zimapanga-analgesics, kugona mankhwala ndi kuzizira ndi mankhwala a chimfine) -thetseni acetaminophen:
- Lorcet
- Norco
- NyQuil
- Percocet
- Vicodin
- Darvocet
- Excedrin ES
- Maulendo Othandizira Amodzi a United States
- Lorcet
- Tylox
- NyQuil
- Vicks Mpangidwe 44-D
- Tylenol PM
- Sominex 2
Zowonjezera, zotsatira za mankhwala ambiri omwe akuphatikizidwa ndi acetaminophen angayambe kusokoneza zizindikiro za tylenol poizoni yokha. Kugwedeza uku kungachititse kuchedwa koopsa kwa chithandizo.
Poizoni wa Tylenol akhoza kuyamikiridwa ngati magawo anayi.
- Gawo 1. Pakati pa maola 24 oyambirira, zizindikiro ndizosafunika kwenikweni ndipo zimakhala ndi malaise, anorexia, nausea, ndi kusanza. Pazifukwa zosadziwika, munthu woizoni akhoza kuyamba hypokalemia kapena potassium m'munsi mwazi.
- Gawo lachiwiri 2. Patsiku awiri kapena atatu, zizindikiro zoyamba zowonongeka, zizindikiro ndi zizindikiro za chiwindi kapena zimatha kukhala ndi ululu ndi chifuwa cha chiwindi komanso ma serzy transaminases. Ngakhale popanda chithandizo, anthu ambiri omwe ali ndi poizoni wa chiwindi pang'ono (mpaka, hepatoxicity) amachira popanda sequelae ndipo samalowa mu Gawo lachitatu.
- Gawo 3. Patsiku lachitatu kapena lachinayi, kulephereka kwapadera kumayambira: kuchepa kwa magazi, kuperewera kwa thupi, kupweteka kwa thupi, kugonana komanso kugwirizanitsa m'mimba.
- Gawo 4. Kwa omwe apulumuka Gawo lachitatu, kuchira kumayamba pafupifupi masabata awiri ndikubwezeretsa chiwindi ntchito miyezi iwiri.
Zindikirani, anthu omwe amadalira mowa kapena omwe sagonjetsedwa (mwachitsanzo, Edzi) ali ndi malo ogulitsika a glutathione ndipo amakhala otengeka kwambiri ndi poizoni ya acetaminophen ndi kulephera kwamphamvu. Komanso, anthu amene akudwala mankhwala a khunyu kapena chifuwa chachikulu amakhalanso ndi chiopsezo chachikulu chifukwa mankhwalawa amachititsa kuti ntchito ya cytochrome P-450 ikhale yovuta.
Kuchiza kwa Kuchuluka kwa Tylenol
Madokotala amachiza mlingo wa Tylenol pogwiritsa ntchito mapulogalamu omwe apambana bwino m'zaka zapitazo kuphatikizapo kugwiritsa ntchito kwambiri acetaminophen overdose overogose nomogram, mtundu wapadera wa chithunzi.
Mankhwala oletsa kutsekemera kwa Tylenol ndi mankhwala otchedwa N-acetylcysteine (NAC). Mphamvu ya NAC imadalira nthawi ya chithandizo, ndipo imakhala yothandiza kwambiri ngati ikuperekedwa mkati mwa maola 8 mpaka 10 osakwanira. Pa maola 12 mpaka 16, mumayamba kuona zotsatira zochepa za mankhwalawa; Komabe, chithandizo chingayambe mkati mwa maola 24.
Pogwiritsa ntchito mankhwala osokoneza bongo, NAC ikhoza kuperekedwa mu mazira 17 pa nthawi ya maola 72. Ikhoza kuperekedwanso intravenously mu ochepa ngati maola 20. Matenda a mphamvu ya chiwindi (mazira a enzyme) amatsatiridwa kuti awoneke. Pakangotha maola awiri kapena awiri owonjezera, mazira amatha kuperekedwa kuti athandize zina zotchedwa Tylenol. Muzosautsa kuti acetaminophen yayamba kale kuononga chiwindi, ndipo kuperewera kwapachiyambi kosalekeza kwatha, kuika chiwindi kungafunike.
Mawu Ochokera
Ngati inu kapena munthu wina amene mumamukonda atha kale pa Tylenol kapena mankhwala omwe ali ndi Tylenol, pitani 911 kapena ntchito zam'tsogolo mwamsanga. Kuchuluka kwa mankhwala a Tylenol ndi nthawi yachangu ndipo nthawi ndi yofunika-mukudikirira nthawi yaitali kuti mankhwala a NAC asagwire ntchito. Chifukwa chakuti zizindikiro za acetaminophen toxicity ndizofala, ndizofunikira kuti muwadziwitse onse omwe akupereka chithandizo chamankhwala omwe mwinamwake mudatenga Tylenol kwambiri. (Chipatala chodzidzimutsa kawirikawiri amawonetsa mkodzo kwa ma tylenol koma sichidalira pa izi.)
Zambiri zokhudza Tylenol: Ngakhale kuti mankhwala a Tylenol ndi Tylenol alibe vuto, iwo sali. Ganizirani zenizeni chifukwa chake mukugwiritsira ntchito Tylenol kapena mankhwala ena oyambitsana ndi mankhwala opweteka. Njira zoterezi zimapangidwira mpumulo wachangu. Ngati ululu wanu umatenga nthawi, muyenera kupita kuchipatala. Chonde kumbukirani kuti Tylenol sichidzachiritsa matenda aakulu monga migraines kapena kuvulala kumbuyo.
> Zotsatira:
> Hung OL, Nelson LS. Mutu 184. Acetaminophen. Mu: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Mankhwala Odzidzimutsa a Tintinalli: Buku Lophunzira Loyamba, 7e . New York, NY: Hill ya McGraw; 2011.
> Olson KR. Mutu 4. Acetaminophen. Mu: Olson KR. eds. Kuchepetsa & Kudyetsa Mankhwala Osokoneza Bongo, 6e . New York, NY: Hill ya McGraw; 2012.