Odwala matenda opatsirana pogonana, anticonvulsants, ndi mankhwala osokoneza bongo amalemba izi
Pankhani ya mankhwala opweteka osatha, pali zosankha zambirimbiri kunja uko. Kodi mumadziwa bwanji kuti mankhwala opweteka ndi abwino kwa inu? Mitundu yosiyanasiyana ya mankhwala opweteka imaperekedwa kwa mitundu yosiyanasiyana ya matenda, koma palinso zosankha zambiri zomwe zilipo. Nthawi zina, muyenera kuyesa mitundu yosiyanasiyana ya mankhwala opweteka, kapena kuphatikizapo ochepa, kuti mupeze chithandizo.
Opioids (Narcotics)
Opioids ndi mankhwala opweteka omwe amatha kupweteka kwambiri. Ngakhale kuti ntchito yawo yanthaŵi yaitali yakhala yotsutsana kwambiri, opereka chithandizo ambiri amamva pamene akuyang'anitsitsa mosamala, opioids ali ndi malo opweteka kwambiri. Opioids akhoza kukhala mankhwala ochepa kapena opweteka kwa nthawi yaitali, komabe mukumva kupweteka kosalekeza , kumapeto kwake kumagwiritsidwa ntchito kwambiri.
Mitundu yosiyanasiyana ya opioids imagwiritsidwa ntchito pa mitundu yosiyanasiyana ya ululu wosatha. Mankhwalawa amapezeka m'mapiritsi onse kapena mapiritsi. Mankhwala osokoneza bongo amapezeka, ngakhale amapezeka movutikira kwa ululu wa khansa, kapena ngati mankhwala opweteka kwambiri opatsirana pambuyo pake. Zitsanzo zina za opioid zomwe zimagwiritsidwa ntchito pochiza matenda aakulu ndi oxycodone ndi fentanyl. Opioid ingagwiritsidwe ntchito yokha, kapena ikhonza kuphatikizidwa ndi mankhwala ena opweteka monga acetaminophen.
Ngakhale ma opioid nthawi zambiri amagwira ntchito yolimbana ndi ululu wosatha, amakhala ndi mavuto.
Opioid ingayambitse kusokoneza, kugona, kudzimbidwa, kusagonana komanso kugonjetsa thupi. Ngati mutenga ma opioid nthawi zonse kuti muvutike kwambiri, dokotala wanu ayenera kukuyang'anani mosamala chifukwa cha zovuta za mankhwala opweteka.
NSAIDs ndi Acetaminophen
NSAID ndi acetaminophen ndi mankhwala osamva opioid, mankhwala opweteka omwe amagwiritsidwa ntchito panthawi yowawa kwambiri.
NSAID ndi acetaminophen zingagwiritsidwe ntchito zokha kuti azipweteka kwambiri, kapena zikhoza kuphatikizidwa ndi mankhwala ena opweteka monga opioids ndi analgesics adjuvant. Angagwiritsenso ntchito kuthetsa ululu .
Mosiyana ndi ma opioids, ma NSAID ambiri amapezeka pamsika. Acetaminophen imapezanso kugula popanda mankhwala. Komabe, matembenuzidwe amphamvu a mavitamini amapezekanso ndi mankhwala opweteka aakulu. Zitsanzo zina za NSAID zomwe zimagwiritsa ntchito kupweteka kwambiri ndi ibuprofen, naproxen, ndi meloxicam.
Ngakhale kuti NSAID ndi acetaminophen ndi mankhwala opweteka osavuta, amakhala ndi zotsatirapo. Kugwiritsa ntchito nthawi yaitali kumawonjezera mwayi wa zotsatirazi, komabe ngakhale ntchito yaifupi ingakulepheretseni. Izi zimaphatikizapo zilonda za m'mimba ndi kutuluka m'magazi komanso kuwonjezeka kwapangidwe kowononga. Mitundu ina ya NSAIDS , makamaka ya COX-2 inhibitors , ingapangitse chiopsezo cha matenda a mtima kapena kupwetekedwa. Komabe, mankhwala aliwonse ndi osiyana ndipo muyenera kulankhula ndi dokotala za kuopsa ndi phindu la aliyense.
Kudetsa nkhaŵa
Matenda opatsirana pogonana ndi ma analgesics a adjuvant . Sitipangidwe mwachindunji monga mankhwala opweteka, ngakhale kuti akhoza kuthandizira bwino mitundu ina ya ululu wosatha.
Odwala matenda opatsirana amalingalira kuti amatha kupweteka kosatha m'njira ziwiri. Choyamba, angasinthe momwe ululu umayambira kuchokera mu msana wam'mimba kupita ku ubongo. Chachiwiri, akhoza kuchepetsa nkhawa ndi kuthandiza kugona.
Si mitundu yonse ya antidepressants yothandiza ngati mankhwala opweteka aakulu. Tricyclic antidepressants (TCAs) monga amitriptyline, serotonin reuptake inhibitors (SSRIs) monga duloxetine ndi ena monga nefazodone amagwiritsidwa ntchito kwambiri pochizira matenda opweteka aakulu ndi ululu wa mitsempha . Monoamine oxidase inhibitors (MAOIs), kumbali inayo, sali othandiza pa kupweteka.
Anticonvulsants
Ngakhale zikhoza kumveka zachilendo, mankhwala osokoneza bongo, omwe amagwiritsidwa ntchito pofuna kuthana ndi matenda opatsirana, angagwiritsidwe ntchito ngati mankhwala opweteka. Anticonvulsants ndi adjus analgesics. Chifukwa chakuti amagwira ntchito poletsa mitundu ina ya mitsempha, amatha kuchepetsa kupweteka kwa m'mimba , monga chifukwa cha trigeminal neuralgia kapena matenda a shuga. Anticonvulsants omwe amagwiritsidwa ntchito monga mankhwala opweteka amachititsa gabapentin ndi pregabalin.
Zojambula Zosudzo
Mankhwala otsegula m'mimba ndi mankhwala opweteka omwe amagwiritsidwa ntchito pakhungu. Zilipo ngati zokhala, zokongoletsera kapena zokopa. Mitundu ina ya mankhwala opweteka kwambiri amatha kugula pa-counter-yeniyeni, pamene ena amafunika mankhwala a mankhwala. Ntchitoyi m'njira zosiyana, malingana ndi zomwe zimagwira ntchito. Zilonda zina zam'mimba zimakhala ndi mankhwala opweteka omwe amaperekedwa kudzera pakhungu, monga trolamine salicylate (Aspercreme). Zina zili ndi khungu lopweteka lomwe lingathetsere kupweteka, monga capsaicin.
Kuganizira za Chitetezo
Mungatenge mtundu wina wa mankhwala opweteka chifukwa cha matenda anu, kapena mungagwiritse ntchito zosiyanasiyana zomwe zalembedwa pamwambapa kuti muchepetse ululu wanu. Mulimonsemo, onetsetsani kuti mumagwiritsa ntchito mankhwala anu monga momwe mwalangizira. Mankhwala ambiri opweteka amakhala ndi machenjezo othandizana ndi mankhwala , kuphatikizapo angapo mwa omwe atchulidwa pamwambapa. Ngati mukugwiritsa ntchito mankhwala opweteka ambiri, onetsetsani kuti muwadziwitse dokotala kuti athe kukuchenjezani ku mavuto omwe angakhale nawo.
Zotsatira:
American Chronic Pain Association. Mankhwala a APCA ndi Zowawa: Supplement 2007 . http://www.theacpa.org/documents/ACPA%20Meds%202007%20Final.pdf.
Makampani Opanga Mankhwala Othandiza pa Intaneti pa Merck. Ululu: Chithandizo. https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/pain/treatment-of-pain.