Ukurhoxa kwiiOpiates kunye neeOpioids

Umxholo

• Zithini iimpembelelo ze-opioid emzimbeni?
• Yintoni ebangela ukurhoxa kwe-opioid?
• Zithini iimpawu zokurhoxa kwe-opioid?
• Ufumanisa njani ukurhoxiswa kwe-opioid?
• Zeziphi iindlela zonyango ezikhoyo zokurhoxa kwe-opioid?
• Zeziphi iingxaki zokurhoxa kwe-opioid?
• Ndingalindela ntoni kwixesha elide?

Yintoni ukurhoxiswa kweopioid?

Iiopioids ziludidi lweziyobisi eziqhelekileyo ezimiselwe ukunyanga iintlungu. Iiopioids zibandakanya zombini ii-opiates (iziyobisi ezivela kwi-opium poppy, kubandakanya i-morphine, i-codeine, i-heroin, kunye ne-opium) kunye ne-opioids eyenziweyo efana ne-hydrocodone, i-oxycodone, kunye ne-methadone, ezineziphumo ezifanayo. Amachiza opioids abandakanya:

• I-Oxycontin (i-oxycodone)
• Vicodin (hydrocodone kunye neacetaminophen)
• I-Dilaudid (i-hydromorphone)
• Imofini

Nangona iluncedo kakhulu ukunyanga iintlungu, la machiza anokubangela ukuxhomekeka komzimba kunye neziyobisi. Ngokutsho kweZiko leLizwe lokuSetyenziswa gwenxa kweziyobisi, malunga ne-2.1 yezigidi zabantu e-United States naphakathi kwama-26.4 nama-36 ezigidi zabantu ehlabathini jikelele abaxhaphaza i-opioids.

Ezinye iziyobisi ezingekho mthethweni, ezifana ne-heroin, nazo zii-opioids. I-Methadone yi-opioid esoloko imiselwe ukunyanga iintlungu, kodwa inokusetyenziselwa ukunyanga iimpawu zokurhoxa kubantu abangamakhoboka e-opioids.

Ukuba uyayeka okanye unciphise inani leeopioid ozithathayo, unokufumana iimpawu ezibonakalayo zokurhoxa. Oku kuyinyani ngakumbi ukuba ubusebenzisa la mayeza ngeedosi eziphezulu ngaphezulu kweeveki ezimbalwa. Iinkqubo ezininzi emzimbeni wakho zitshintshiwe xa uthatha izixa ezikhulu zeeopioid ixesha elide. Iziphumo zokurhoxa zenzeka kuba kuthatha ixesha ukuba umzimba wakho uhlengahlengise ekubeni ungabinazo iiopioid kwinkqubo yakho.

Ukurhoxa kwe-Opioid kunokwahlulwahlulwa njengobumnene, ngokuphakathi, ngokuqatha ngokuqatha, nangobunzima. Umboneleli wakho wokhathalelo oluphambili unokumisela oku ngokuvavanya ukusetyenziswa kwembali ye-opioid kunye neempawu, nangokusebenzisa izixhobo zokuqonda isifo njengeClinical Opiate Withdrawal Scale.

Zithini iimpembelelo ze-opioid emzimbeni?

Iiopioid zinamathela kwii-opioid receptors kwingqondo, kumqolo womqolo, kunye nakwindlela yesisu. Nanini na xa ii-opioid zinamathela kwezi receptors, zenza iziphumo zazo. Ingqondo iyayenza i-opioids yayo, ejongene nayo yonke imiphumo, kuquka ukunciphisa intlungu, ukunciphisa izinga lokuphefumula, kunye nokunceda ukukhusela uxinzelelo kunye noxinzelelo.

Nangona kunjalo, umzimba awuzivelisi ii-opioid ngobuninzi- oko kukuthi, ngokwaneleyo ukunyanga iintlungu ezinxulumene nomlenze owaphukileyo. Kwakhona, umzimba awuzange uvelise ii-opioid ngobuninzi obaneleyo bokubangela ukugqithisa. Amachiza e-opioid kunye neziyobisi ezingekho mthethweni zilinganisa ezi opioid zendalo.

La machiza anokuchaphazela umzimba ngeendlela ezininzi:

• I-Opioids inokuchaphazela i-brainstem, elawula imisebenzi efana nokuphefumla kunye nentliziyo, ngokunciphisa ukuphefumula okanye ukunciphisa ukukhwehlela.
• Iiopioids zinokusebenza kwiindawo ezithile zobuchopho ezaziwa njenge-limbic system, elawula iimvakalelo, ukwenza iimvakalelo zokonwaba okanye ukuphumla.
• Umsebenzi we-Opioids ukunciphisa iintlungu ngokuchaphazela intambo yomqolo, othumela imiyalezo evela kwingqondo kuwo wonke umzimba, kwaye ngokuchaseneyo.

Yintoni ebangela ukurhoxa kwe-opioid?

Xa uthatha amayeza e-opioid ixesha elide, umzimba wakho uba desensitised kwiziphumo. Ixesha elingaphezulu, umzimba wakho ufuna ngakumbi nangakumbi ichiza ukufezekisa umphumo ofanayo. Oku kunokuba yingozi kwaye kwandisa umngcipheko wokudlula ngengozi.

Ukusetyenziswa ixesha elide kwezi ziyobisi kuyayitshintsha indlela ezisebenza ngayo iiseli zemithambo-luvo kwingqondo yakho, kwaye ezi zamkeli zixhomekeke kwichiza ukuze lisebenze. Ukuba uyagula ngokwasemzimbeni emva kokuba uyekile ukuthatha iyeza le-opioid, inokuba luphawu lokuba uxhomekeke emzimbeni kwinto leyo. Iimpawu zokurhoxa kukusabela komzimba komzimba kukungabikho kwesiyobisi.

Uninzi lwabantu luxhomekeke kula machiza ukunqanda iintlungu okanye iimpawu zokurhoxa. Ngamanye amaxesha, abantu abaqapheli nokuba baxhomekeke kuye. Basenokwenza impazamo yokurhoxa kwiimpawu zomkhuhlane okanye enye imeko.

Zithini iimpawu zokurhoxa kwe-opioid?

Iimpawu ohlangabezana nazo ziya kuxhomekeka kwinqanaba lokurhoxa ohlangabezana nalo. Kananjalo, izinto ezininzi zinyanzelisa ukuba umntu azokufumana nini iimpawu zokurhoxa. Ngenxa yoku, wonke umntu ufumana ukurhoxa kwe-opioid ngokwahlukileyo. Nangona kunjalo, kukho umda wexesha wokuqhubela phambili kweempawu.

Iimpawu zokuqala ziqala kwiiyure ezingama-24 zokuqala emva kokuba uyeke ukusebenzisa iyeza, kwaye zibandakanya:

• iintlungu zemisipha
• ukungazinzi
• ixhala
• ukukhutshwa (amehlo aqwengayo)
• impumlo enemifinya
• ukubila okugqithisileyo
• ukungakwazi ukulala
• ukuzamla rhoqo

Iimpawu kamva, ezinokuba namandla ngakumbi, ziqala emva kosuku lokuqala okanye njalo. Ziquka:

• urhudo
• ukuxinwa esiswini
• amaqhuqhuva esikhumbeni
• isicaphucaphu nokugabha
• abafundi abaxubileyo kunye nokubona okungacacanga
• ukubetha kwentliziyo ngokukhawuleza
• igazi elonyukayo

Nangona zingathandeki kwaye zibuhlungu, iimpawu zihlala ziqala ukuphucula ngaphakathi kweeyure ezingama-72, kwaye kwiveki kufuneka uqaphele ukwehla okukhulu kwiimpawu ezibi zokurhoxa kwe-opiate.

Iintsana ezizalwe ngoomama abangamakhoboka okanye abasebenzisa i-opioids ngelixa ukhulelweyo bahlala befumana iimpawu zokurhoxa. Oku kunokubandakanya:

• Imicimbi yokwetyisa
• ukondla okungondlekanga
• ukuphelelwa ngamanzi emzimbeni
• ukugabha
• ukuxhuzula

Kubalulekile ukuba ukhumbule ukuba amachiza ahlukeneyo ahlala kwinkqubo yakho ngobude bexesha kwaye oku kunokuchaphazela ukuqala kokurhoxa. Ubungakanani bexesha lokugqibela kweempawu zakho kuxhomekeke kubuninzi bokusetyenziswa kunye nobukrakra bokuba likhoboka, kunye nezinto ezinje ngempilo yakho iyonke.

Umzekelo, i-heroin isuswa kwinkqubo yakho ngokukhawuleza, kwaye iimpawu ziya kuqala kwiiyure ezili-12 zokugqibela kokusebenzisa. Ukuba ubukwi methadone, kungathatha usuku olunesiqingatha ukuqala kweempawu.

Ezinye iingcali zibonisa ukuba ukubuyela kwimeko yesiqhelo kufuna ixesha elingangeenyanga ezintandathu zokuyeka, ngexesha apho umntu esenokuba neempawu zokurhoxa. Maxa wambi oku kubizwa ngokuba “kukuzila ixesha elide.” Kubalulekile ukuxoxa ngeempawu eziqhubekayo nomboneleli wakho wezempilo.

Ufumanisa njani ukurhoxiswa kwe-opioid?

Ukufumanisa ukurhoxiswa kwe-opioid, umboneleli wakho oyintloko uya kwenza uvavanyo lomzimba kwaye abuze imibuzo malunga neempawu zakho. Banokuyalela umchamo kunye novavanyo lwegazi ukujonga ubukho be-opioids kwinkqubo yakho.

Unokubuzwa imibuzo malunga nokusetyenziswa kweziyobisi kwangaphambili kunye nembali yakho yezonyango. Phendula ngokuphandle nangokunyanisekileyo ukuze ufumane olona nyango nenkxaso.

Zeziphi iindlela zonyango ezikhoyo zokurhoxa kwe-opioid?

Ukurhoxa kwe-Opioid kungangonwabisi, kwaye abantu abaninzi bayaqhubeka nokuthatha la machiza ukunqanda iimpawu ezingathandekiyo, okanye bazama ukulawula ezi mpawu bebodwa. Nangona kunjalo, unyango kunyango olulawulwayo lunokukwenza ukhululeke ngakumbi kwaye lukhokelele kwithuba elikhulu lokuphumelela.

Ukurhoxa kancinane kunokunyangwa nge-acetaminophen (iTylenol), i-aspirin, okanye iziyobisi ezingezizo ezokulwa nokudumba (i-NSAIDs) ezinje nge-ibuprofen. Amanzi amaninzi kunye nokuphumla kubalulekile. Amayeza afana ne-loperamide (Imodium) anokunceda kurhudo kunye nehydroxyzine (Vistaril, Atarax) inokunciphisa isicaphucaphu.

Iimpawu zokurhoxa kakhulu zinokufuna ukulaliswa esibhedlele kunye namanye amayeza. Elinye iyeza elisetyenziswa ikakhulu kwisigulana esinganyangekiyo yi-clonidine. I-Clonidine inokunceda ukunciphisa ubunzima beempawu zokurhoxa ngama-50 ukuya kuma-75 eepesenti. I-Clonidine isebenza ngokukodwa ekunciphiseni:

• ixhala
• ukuxinana
• iintlungu zemisipha
• ukungazinzi
• ukubila
• iinyembezi
• impumlo enemifinya

I-Suboxone yindibaniselwano ye-opioid enamandla (buprenorphine) kunye ne-opioid blocker (naloxone) engazivelisiyo ezinye zeziphumo zezinye iiopioid. I-opioid blocker isebenza ikakhulu esiswini ukuthintela ukuqhina. Ukuba itofwe iya kubangela ukurhoxa kwangoko, ke indibaniselwano ayinakufane iphathwe gadalala kunezinye iifom. Xa uthathwe ngomlomo, olu dibaniso lungasetyenziselwa ukunyanga iimpawu zokurhoxa kwaye lunokunciphisa ubungakanani kunye nobude bokuchithwa kwezinye izinto, eziyingozi ngakumbi, iiopioids.

I-Methadone inokusetyenziselwa unyango lwexesha elide. Isengamandla opioid, kodwa inokuncitshiswa ngendlela elawulwayo ekungenakwenzeka ukuba ivelise iimpawu zokurhoxa kakhulu.

Ukukhupha i-detoxification ngokukhawuleza kunqabile ukuba kwenziwe. Kwenziwa phantsi kwe-anesthesia ngamachiza okuthintela i-opioid, anje nge-naloxone okanye i-naltrexone. Kukho ubungqina bokuba le ndlela iyanciphisa iimpawu, kodwa ayichaphazeli ixesha elichithwe ekurhoxiseni. Ukongeza, ukugabha kuhlala kwenzeka ngexesha lokurhoxa, kwaye amandla okugabha phantsi kwe-anesthesia anyusa kakhulu umngcipheko wokufa. Ngenxa yoku, uninzi loogqirha aluthandabuzi ukusebenzisa le ndlela, njengoko umngcipheko ungaphezulu kwezibonelelo ezinokubakho.

Zeziphi iingxaki zokurhoxa kwe-opioid?

Isicaphucaphu kunye nokugabha kunokuba ziimpawu ezibonakalayo ngexesha lokurhoxa. Ukuphefumla okungaziwayo kwezinto ezigabileyo emiphungeni (eyaziwa ngokuba yi-aspiration) kunokuba yingxaki enkulu enxulunyaniswa nokurhoxa, njengoko oko kungakhokelela kuphuhliso lwenyumoniya (aspiration pneumonia).

Urhudo lolunye uphawu olungathandekiyo nolunokuba yingozi. Ukuphulukana nolwelo kunye nee-electrolyte ezivela kurhudo kunokubangela ukuba intliziyo ibethe ngendlela engaqhelekanga, enokubangela iingxaki zokujikeleza kwegazi kunye nokuhlaselwa sisifo sentliziyo. Kubalulekile ukubuyisela ulwelo olulahlekileyo ukugabha kunye norhudo ukuthintela ezi ngxaki.

Nokuba awufumani kugabha, isicaphucaphu sinokungonwabi. Iikhram zesisu kunye neentlungu ezidibeneyo zinokubakho ngexesha lokurhoxa kwe-opioid. Iindaba ezimnandi zezokuba umboneleli wakho wokhathalelo ophambili unokusebenza nawe ngokubonelela ngamayeza akhethiweyo anokunceda kwezi mpawu zingahambi kakuhle.

Kubalulekile ukuba uqaphele ukuba abanye abantu banokufumana ezinye iimpawu zokurhoxa ezingadweliswanga apha. Kungenxa yoko le nto kubalulekile ukuba usebenze nomboneleli wakho wokuqala ngexesha lokurhoxa.

Ndingalindela ntoni kwixesha elide?

Ukuba uyekile ukuthatha amayeza e-opioid kwaye ufumana iimpawu zokurhoxa, jonga ugqirha wakho ngokukhawuleza. Ugqirha wakho unokunceda ukulawula iimpawu kunye nokuhlengahlengisa amayeza akho amayeza. Akufanele uyeke ukuthatha amayeza e-opioid ngaphandle kokubonisana nogqirha wakho.

Ukufuna uncedo kumlutha we-opioid kuya kuyiphucula impilo yakho iyonke kwaye kunciphise umngcipheko wokuphinda ubuye, ukudlula ngengozi, kunye neengxaki ezinxulumene nokulutha kwe-opioid. Thetha nogqirha wakho okanye umboneleli wezempilo malunga neenkqubo zonyango okanye amaqela enkxaso kwindawo yakho. Ukuphuculwa ngokubanzi kwempilo yomzimba neyengqondo kufanelekile ukuba kubekho iintlungu kunye nokungathandeki kokurhoxa.