Ukudakwa kwe-opioid

Izidakamizwa ezisuselwa ku-opioid zifaka i-morphine, i-oxycodone, ne-synthetic (eyenziwe ngabantu) i-opioid narcotic, efana ne-fentanyl. Banikezwe ukwelapha ubuhlungu ngemuva kokuhlinzwa noma inqubo yamazinyo. Kwesinye isikhathi, zisetshenziselwa ukwelapha ukukhwehlela okunzima noma isifo sohudo. Iheroin yezidakamizwa engekho emthethweni nayo iyi-opioid. Lapho ihlukunyezwa, ama-opioid abangela ukuthi umuntu azizwe ekhululekile futhi ejabule kakhulu (euphoria). Ngamafuphi, izidakamizwa zisetshenziselwa ukukhuphuka.

Ukudakwa yi-opioid yisimo lapho ungagcini nje ngokusetshenziswa kwesidakamizwa, kodwa futhi unezimpawu zomzimba wonke ezingakugulisa futhi ukhubaze.

Ukudakwa kwe-opioid kungenzeka lapho umhlinzeki wezokunakekelwa kwezempilo ebeka i-opioid, kepha:

• Umhlinzeki akazi ukuthi umuntu usevele uthatha enye i-opioid ekhaya.
• Umuntu unenkinga yezempilo, enjengesibindi noma inkinga yezinso, engahle iholele ekudakweni.
• Umhlinzeki ubeka umuthi wokulala (ukuthambisa) ngaphezu kwe-opioid.
• Umhlinzeki akazi ukuthi omunye umhlinzeki usevele unikeze i-opioid.

Kubantu abasebenzisa ama-opioid ukukhuphuka, ukudakwa kungabangelwa:

• Usebenzisa kakhulu izidakamizwa
• Sebenzisa i-opioid nezinye izidakamizwa, njengemithi yokulala noma utshwala
• Ukuthatha i-opioid ngezindlela ezingasetshenziswanga ngokujwayelekile, njengokubhema noma ukuhogela ngekhala (kufuthwa)

Izimpawu zincike ekutheni ungakanani umuthi othathwe.

Izimpawu zokudakwa kwe-opioid zingafaka:

• Isimo sengqondo esishintshile, esifana nokudideka, i-delirium, noma ukuncipha kokuqwashisa noma ukuphendula
• Izinkinga zokuphefumula (ukuphefumula kungancipha futhi ekugcineni kuyeke)
• Ukulala ngokweqile noma ukulahlekelwa ukuqapha
• Isicanucanu nokuhlanza
• Abafundi abancane

Ukuhlolwa oku-odwe kuncike ekukhathazekeni komhlinzeki ngezinkinga ezengeziwe zezokwelapha. Ukuhlolwa kungafaka:

• Ukuhlolwa kwegazi
• Ukuskena kwe-CT kobuchopho, uma umuntu ehlaselwa noma kungenzeka alimale ekhanda
• ECG (electrocardiogram) ukukala umsebenzi kagesi enhliziyweni
• I-x-ray yesifuba ukuhlola i-pneumonia
• Ukuhlolwa kwe-Toxicology (poison)

Umhlinzeki uzolinganisa futhi aqaphe izimpawu ezibalulekile zomuntu, kufaka phakathi izinga lokushisa, ukushaya kwenhliziyo, izinga lokuphefumula, nomfutho wegazi. Izimpawu zizophathwa ngendlela efanele. Umuntu angathola:

• Ukwesekwa kokuphefumula, kufaka phakathi i-oxygen, noma ishubhu elingena ngomlomo liye emaphashini nokunamathiselwa kumshini wokuphefumula
• Uketshezi lwe-IV
• Imithi ebizwa nge-naloxone (i-Evzio, i-Narcan) ukuvimba umphumela we-opioid ohlelweni oluphakathi lwezinzwa
• Eminye imithi njengoba kudingeka

Njengoba umphumela we-naloxone uvame ukuba mfushane, iqembu lokunakekelwa kwezempilo lizobheka isiguli amahora ama-4 kuye kwayi-6 emnyangweni ophuthumayo. Abantu abanokudakwa okulingene kuya kokulingene cishe bazongeniswa esibhedlela amahora angama-24 kuye kwangama-48.

Ukuhlolwa kwezempilo yengqondo kuyadingeka uma umuntu ezibulala.

Izici eziningi zinquma umphumela wesikhashana nesikhathi eside ngemuva kokudakwa kwe-opioid. Ezinye zazo yilezi:

• Izinga lobuthi, isibonelo, uma umuntu eyeka ukuphefumula, nokuthi isikhathi esingakanani
• Izidakamizwa zisetshenziswa kangaki
• Umphumela wokungcola okuxubene nezinto ezingekho emthethweni
• Ukulimala okwenzeka ngenxa yokusetshenziswa kwezidakamizwa
• Izimo zezokwelapha ezingaphansi

Izinkinga zempilo ezingenzeka zibandakanya noma yikuphi okulandelayo:

• Ukulimala okungapheli kwamaphaphu
• Ukudlikizela, ukuthuthumela
• Ukwehlisa ikhono lokucabanga kahle
• Ukungazinzi nobunzima bokuhamba
• Ukutheleleka noma ukulimala unomphela kwezitho ngenxa yokusebenzisa umjovo womuthi

Ukudakwa - ama-opioid; Ukuhlukunyezwa kwe-opioid - ukudakwa; Ukusetshenziswa kwe-opioid - ukudakwa

U-Aronson JK. Ama-agonists we-opioid receptor. Ku: Aronson JK, ed. Imiphumela emibi kaMeyler yezidakamizwa. Umhla ka-16. I-Waltham, MA: Elsevier; 2016: 348-380.

I-National Institute on Drug Abuse iwebhusayithi. Ama-opioid. www.drugabuse.gov/drugs-abuse/opioids. Kufinyelelwe ngo-Ephreli 29, 2019.

I-National Institute on Drug Abuse iwebhusayithi. Ziyini izinkinga zezokwelapha zokusetshenziswa kwe-heroin engapheli? www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use. Kubuyekezwe uJuni 2018. Kufinyelelwe ngo-Ephreli 29, 2019.

UNikolaides JK, uThompson TM. Ama-opioid. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 156.