Kwa omwe ali ndi ululu wosatha, kudzimbidwa kungakhale vuto lalikulu
Kudzitetezedwa kwa opioid (OIC) ndi chinthu chofala chomwe chimapezeka ngati zotsatira zovulaza za kugwiritsira ntchito mankhwala opweteka (analgesics). Opioids ndi mankhwala omwe amapanga mankhwala omwe ali ofanana ndi alkaloids omwe amapezeka mu opium poppy.
Mankhwala opangira mankhwala omwe ali ndi opioids ndi methadone , percocet , vicodin , demerol , dilaudid , ndi fentanyl .
Amalamulidwa kuti amve kupweteka, kaŵirikaŵiri kuti amve ululu waukulu monga pambuyo povulazidwa kapena opaleshoni, komanso chifukwa cha ululu wautali ngati umene umayambitsa khansa. Nthaŵi zina, opioids amagwiritsidwa ntchito pochizira kutsekula m'mimba, kawirikawiri muzitsulo zochepa kuti asakhale ndi zotsatirapo.
Kafukufuku wasonyeza kuti madokotala ambiri samadziwa odwala awo akukumana nawo pamene akulandira opioids. Komabe, pafupifupi odwala onse omwe akulandira opioids amafotokoza kuti ali ndi zotsatira zoyambitsa matenda ndipo pafupifupi 40 peresenti angakhale ndi kudzimbidwa.
Kugonjera kungachepetse moyo wambiri ndipo motero, ndi bwino kulankhula ndi dokotala kuti mupeze chithandizo ndikupeza mpumulo.
OIC vs. Kugwiritsidwa Ntchito
Kutseka kumachitika pamene zivomezi zimakhala zosavuta, zovuta, ndi zovuta kudutsa. Komabe, sizomwe ndemanga yeniyeni yeniyeni chifukwa munthu amasiya komanso nthawi zambiri amadutsa.
Kawirikawiri, kukhala ndi mavitamini abwino kumatanthauza kumapita kulikonse katatu patsiku katatu pa sabata.
Komabe, kusintha kwa kayendedwe ka m'mimba kungasonyeze kudzimbidwa. Ngati mwadzidzidzi zimakhala zovuta kupita ku bafa-izi zikhoza kutanthauza kukanikira pa chimbudzi chakumbudzi kapena kusungunuka komwe kumakhala kochepa kwambiri-kudzimbidwa kungakhaleko.
Zizindikiro za kudzimbidwa zingakhalepo:
- Malo ovuta
- Kumverera ngati kayendedwe ka m'mimba sikunathe
- Kuponyera pa chimbudzi mbale
Kudzimbidwa kwa opioid ndizosiyana ndi kudzimbidwa kumene kumagwira ntchito . Kuimbidwa kugwira ntchito kungakhale kochokera ku zifukwa zosiyanasiyana zomwe zimachokera ku zakudya zosakwanira mu zakudya kuti zikhale ndi matenda kapena chikhalidwe cha m'mimba. Kutsekedwa kwa opioid, komabe, ndi chifukwa cha momwe mankhwala opioid amakhudzira utumbo wawung'ono ndi utomoni , pochepetsa kuchepetsa chimbudzi.
N'chifukwa Chiyani Opioids Akupangitsa Kudyedwa?
Opioids ali ndi zotsatira zosiyanasiyana zochepetsera chimbudzi. M'mimba, ma opioids angayambitse gastroparesis , kutanthauza kuti mimba imatenga nthawi yaitali kuti ikhale yopanda kanthu kusiyana ndi yoyenera chifukwa minofu ikugwira ntchito bwino.
Chakudya chimayenda kudzera m'matumbo aang'ono chifukwa cha kupweteka kwa mitsempha yotchedwa peristalsis . Opioid imakhudza pakatikati mwa katumbo kakang'ono (jejunum) ndi kuwonjezereka kwa mitsempha yosakanikirana, yomwe imakhala yosagwiritsanso ntchito, ndipo izi zimachepetsanso zomwe zimapangitsa kuti zakudya zizikhala pamodzi. Izi zingachititsenso kuti zikhale zovuta kwambiri, zomwe zimapangitsa kuti zikhale zovuta kudutsa.
Opioid imakhudzanso mmene anal sphincter amachitira mankhwala. Pamene chophimba chiri mu rectum pali chilakolako chachibadwa chopita ku bafa ndikuchidutsa.
Opioids amatha kuchepetsanso chisamaliro ichi kuti pamene pali chitsimikizo, munthu sazimva. Izi zingachititse kuti mukhale ndi zitsulo motalika kwambiri.
Zonsezi, zotsatirazi pa dongosolo la kumadya zimatanthauza kuti anthu ena amatha kudzimbidwa pogwiritsa ntchito opioids. Kwa anthu amene amafunikira kuvutika kwa nthawi yaitali ndi mankhwala awa, izi zingakhale vuto lalikulu.
Kuchiza kwa Opioid-Indeded Constipation
Chithandizo cha kudzimbidwa kwa opioid chingaphatikizepo kusintha kwa moyo ndi mankhwala. Njira yochiritsira ikhoza kudalira kwambiri momwe moyo uliri panopa komanso zinthu zina monga mankhwala.
Nthaŵi zambiri, moyo umasintha komanso pamwamba pa mankhwala osokoneza bongo sagwira mokwanira kupereka mpumulo wathunthu ndi mankhwala.
Kusintha kwa Moyo
Kusintha zina pazochitika za tsiku ndi tsiku, pamodzi ndi mankhwala ena, kungathandize ndi kuvomereza.
Zakudya ndizofunika pa kudzimbidwa chifukwa kudya zakudya zamtundu wokwanira ndi kumwa madzi okwanira kungathandize kuti matumbo asunthike ndikukhala ndi zofewa mosavuta. Mafuta osapangidwanso, omwe amapezeka mu zipatso ndi ndiwo zamasamba, amapanga zitsulo zochepetsetsa ndi mabala. Mafinyumu amasungunuka mu chinthu chomwe chili ngati gel osakaniza komanso chingathandize kuthetsa kudzimbidwa.
Fiber akhoza kuwonjezeredwa mu zakudya koma ingathenso kuthandizidwa ngati chowonjezera . Anthu ena adzafunika kuyesa zowonjezera zosiyanasiyana ndikudziwa mtundu wina wa zitsulo zomwe zingathandize kuthetsa kudzimbidwa. Munthu wodya zakudya amatha kuchepetsa zakudya zomwe zimapangitsa kuti zakudya zisinthe komanso kuwonjezera zakudya zowonjezereka, kuphatikizapo zakudya zomwe zimakhala zowonongeka (monga prunes).
Kumwa madzi okwanira ndi zakumwa zina tsiku lililonse kungathandizenso kuthana ndi kudzimbidwa. Zitsulo zimakhala zosavuta kudutsa ngati pali madzi okwanira omwe amakoka m'matumbo kuti awapangitse. Kwa iwo omwe amamwa kale mokwanira, kuwonjezera madzi ambiri kapena zakumwa zina ku zakudya sizidzakhudza kwambiri njira yogaya chakudya yomwe ikukhudzidwa ndi opioids. Komabe, kukhala hydrated bwino ndizofunika kuti mukhale ndi thanzi labwino, choncho ndi bwino kumvetsera momwe madzi akutengedwera tsiku lililonse.
Kuchita masewera olimbitsa thupi ndi chinthu china chomwe chingathandize kuthetsa kudzimbidwa. Apanso, kuthekera kochita masewero olimbitsa thupi kudzadalira thanzi lathunthu. Komabe, ngakhale kuyenda kungapangitse kusiyana pankhani yosuntha matumbo nthawi zonse. Madokotala angathandize kuthandizira machitidwe olimbitsa thupi ndipo ngati kuli kotheka, kutumiza kwa wodwala wodwalayo kungathandize kukhazikitsa ndondomeko yomwe imatenga zochitika zina zaumoyo.
Zamadzimadzi
Mankhwala osokoneza bongo omwe amatsutsa zowonongeka ka opioids angakhale osowa nthawi zambiri ndipo akhoza kuuzidwa panthawi imodzimodzimodzi ndi opioid. Kawirikawiri, mankhwala ofewa mankhwala ofewetsa ululu angakhale njira yoyamba poteteza ndi / kapena kuchiza kudzimbidwa.
Mafinya a Osmotic ndi omwe amakoka madzi ambiri m'matumbo, omwe amachititsa kupanga zofunda mochepetseka mosavuta. Mavitamini ena osmotic amapezeka pamtengowo pomwe ena ali ndi mankhwala, ndipo ena mwa mitundu yosiyanasiyana ndi miralax, lactulose, ndi mkaka wa magnesia (umene sunalamulidwe nthawi zambiri). Kaŵirikaŵiri sipangakhale zotsatira zambiri za mankhwalawa ndi mitundu yambiri yamadzimadzi-amadziwika kuti ndi otetezeka komanso othandiza, koma anthu ena amakhala ndi mimba kapena kutsekula m'mimba.
Mavitamini otsitsimutsa amapezekanso pamtengowo ndipo amagwiritsa ntchito bisacodyl, bicarbonate ya sodium ndi bitartrate ya potaziyamu, senna, ndi mafuta odzola. Mtundu woterewu umapangitsa kuti thupi liziyenda bwino (peristalsis). Sitikulimbikitsidwa kuti azigwiritsa ntchito nthawi yaitali chifukwa cha zotsatira zake, ndipo kulekerera kungasinthe (zomwe zikutanthauza kuti zingaleke kugwira ntchito patapita kanthawi).
Zochita Zachidule
Nthaŵi zina, kuchotsa choponderezedwa kungakhale kofunikira. Izi zikhoza kuchitidwa ndi ulimi wothirira madzi (colonic enema kapena colonic) (madzi kapena madzi ena omwe amaphatikizidwa kudzera mu anus ndi mu rectum), suppositories, kapena kuchoka mwatsatanetsatane .
Glycerin suppositories angakhale sitepe yoyamba yosunthira chofufumitsa, motsogoleredwa ndi enema, ulimi wothirira, kapena kuchoka pamanja (kuika chidutswa chokongoletsera kuti chichotse chophimbacho ndi kuchichotsa).
Mankhwala Olemba
Pali mankhwala omwe amapezeka kuti athe kuchipatala. Relistor ndi Movantik ndi mankhwala awiriwa. Mankhwalawa amagwira ntchito poletsa zotsatira zomwe opioids zimachepetsa kuchepetsa matumbo.
Mankhwalawa angakuthandizeni kubweretsa pang'onopang'ono mutatenga kapena kulandira. Zina mwa zotsatira zoyipa za mankhwalawa zingakhale kuphweteka, kutsegula m'mimba, kupweteka m'mimba, ndi mpweya.
Mawu Ochokera
Kudzola kwa opioid ndi vuto lalikulu kwa anthu omwe akulandira opioids pofuna kuchiza kupweteka, makamaka, kupweteka kosatha. Ndi vuto lomwe lingakhale lochititsa manyazi kuti anthu ambiri akambirane, koma kudziletsa kumachepetsa kwambiri khalidwe la moyo, motero ndibwino kuti tizilumikize ndi dokotala.
Komanso, pali mankhwala omwe ali otetezeka komanso ogwira mtima ndipo amatha kuchepetsa zizindikiro za kudzimbidwa ndipo potero amapewa mavuto. Pamene kudzimbidwa ndi nkhani yovuta kulera paulendo wa dokotala, ndi chimodzi chomwe sichiyembekezeka pamene mukulimbana ndi ululu wosatha.
> Zotsatira:
> Akbarali HI, Inkisar A, Dewey WL. "Malo ndi njira ya kulekerera kwa morphine m'matumbo a m'mimba." Neurogastroenterol Motil. 2014; 26: 1361-1367: doi: 10.1111 / nmo.12443
> Galligan JJ, Sternini C. "Malingaliro oyenerera udindo wa Opioid Receptors mu GI Tsamba: Umboni ndi Zomwe Akuchiritsidwa." Mankhwala Opatsa Pharmacol. 2017; 239: 363-378. lembani: 10.1007 / 164_2016_116
> Gupta S, Patel H, Scopel J, Mody RR. "Mmene zimakhudzidwira kuti anthu azitha kugwiritsa ntchito opioid chithandizo cha opioid pakati pa opioid ogwiritsa ntchito nthawi yaitali, pogwiritsa ntchito kafukufuku wodwala." J Opioid Manag. 2015 Jul-Aug; 11: 325-38. Do: 10.5055 / jom.2015.0282
> LoCasale RJ, Datto C, Margolis MK, Coyne KS. "Kukhutira ndi Thandizo Pakati pa Odwala Amene Ali ndi Matenda Osakanikirana Osavuta ndi Opioid-Induced Constipation." J Manag Care Spec Pharm 2016; 22: 246-253. Do: 10.18553 / jmcp.2016.22.3.246
> LoCasale RJ, Datto C, Wilson H, Yeomans K, Coyne KS. "Kulemberana kwa Opioid-Kuchokera Kwambiri: Kulimbana pakati pa Odwala ndi Odwala Thandizo Labwino." J Manag Care Spec Pharm 2016; 22: 236-45. Do: 10.18553 / jmcp.2016.22.3.236