Ukuhoxa kuma-Opiates nama-Opioids

-Delile

• Athinta kanjani ama-opioid emzimbeni?
• Yini ebangela ukuhoxa kwe-opioid?
• Ziyini izimpawu zokuhoxa kwe-opioid?
• Kutholakala kanjani ukuhoxiswa kwe-opioid?
• Yiziphi izindlela zokwelapha ezikhona zokuhoxiswa kwe-opioid?
• Yiziphi izinkinga zokuhoxa kwe-opioid?
• Yini engingayilindela esikhathini eside?

Kuyini ukuhoxa kwe-opioid?

Ama-opioid isigaba semithi ejwayele ukubekwa ukwelapha ubuhlungu. Ama-opioid afaka phakathi ama-opiates womabili (izidakamizwa ezitholakala ku-opium poppy, kufaka phakathi i-morphine, i-codeine, i-heroin, ne-opium) nama-opioid enziwe afana ne-hydrocodone, i-oxycodone, ne-methadone, enemiphumela efanayo. Ama-opioid kadokotela afaka:

• I-Oxycontin (oxycodone)
• I-Vicodin (i-hydrocodone ne-acetaminophen)
• I-Dilaudid (i-hydromorphone)
• morphine

Yize ilusizo kakhulu ekwelapheni ubuhlungu, le mithi ingadala ukuncika komzimba nokulutha. Ngokusho kweNational Institute on Drug Abuse, cishe abantu abayizigidi eziyi-2.1 e-United States kanye nabantu abaphakathi kwezigidi ezingama-26.4 kanye no-36 emhlabeni jikelele abahlukumeza ama-opioid.

Izidakamizwa ezithile ezingekho emthethweni, njenge-heroin, nazo zingama-opioid. I-Methadone iyi-opioid evame ukunikezwa ukwelapha ubuhlungu, kepha futhi ingasetshenziselwa ukwelapha izimpawu zokuhoxa kubantu asebephatheke kabi ngama-opioid.

Uma umisa noma wehlisa inani lama-opioid owathathayo, ungahlangabezana nezimpawu zomzimba zokuhoxa. Lokhu kuyiqiniso ikakhulukazi uma ngabe usebenzise le mithi ngemithamo ephezulu isikhathi esingaphezu kwamasonto ambalwa. Izinhlelo eziningi emzimbeni wakho ziyashintshwa lapho uthatha inani elikhulu lama-opioid isikhathi eside. Imiphumela yokuhoxa yenzeka ngoba kuthatha isikhathi ukuthi umzimba wakho uzivumelanise nokungasenawo ama-opioid kusistimu yakho.

Ukuhoxa kwe-opioid kungahlukaniswa njengokuncane, okulingene, okunzima ngokwedlulele, futhi okunzima. Umhlinzeki wakho wokunakekelwa okuyinhloko anganquma lokhu ngokuhlola umlando nezimpawu zakho zokusebenzisa i-opioid, nangokusebenzisa amathuluzi okuxilonga afana ne-Clinical Opiate Withdrawal Scale.

Athinta kanjani ama-opioid emzimbeni?

Ama-opioid azinamathela kuma-opioid receptors ebuchosheni, emgogodleni, nasemgodini wamathumbu. Noma nini lapho ama-opioid enamathela kulawa ma-receptors, enza imiphumela yawo. Ubuchopho empeleni bukhiqiza ama-opioid ayo, anesibopho semiphumela eminingi, kufaka phakathi ukuncipha kobuhlungu, ukwehlisa izinga lokuphefumula, nokusiza ukuvimbela ukudangala nokukhathazeka.

Kodwa-ke, umzimba awukhiqizi ama-opioid ngamanani amakhulu - okungukuthi, anele ukwelapha ubuhlungu obuhambisana nomlenze ophukile. Futhi, umzimba awukaze ukhiqize ama-opioid ngobuningi obukhulu ngokwanele ukudala ukudlula ngokweqile. Imithi ye-opioid nezidakamizwa ezingekho emthethweni zilingisa la ma-opioid avela ngokwemvelo.

Le mithi ingathinta umzimba ngezindlela eziningana:

• Ama-opioid angathinta i-brainstem, elawula imisebenzi efana nokuphefumula nokushaya kwenhliziyo, ngokwehlisa ukuphefumula noma ukunciphisa ukukhwehlela.
• Ama-opioid angahle asebenze ezindaweni ezithile zobuchopho ezaziwa ngokuthi i-limbic system, elawula imizwa, ukudala imizwa yenjabulo noma yokuphumula.
• Ama-opioid asebenza ukunciphisa izinhlungu ngokuthinta umgogodla, othumela imiyalezo evela ebuchosheni kuya kuwo wonke umzimba, futhi okuphambene nalokho.

Yini ebangela ukuhoxa kwe-opioid?

Uma uthatha imishanguzo ye-opioid isikhathi eside, umzimba wakho uyahlulwa yimiphumela. Ngokuhamba kwesikhathi, umzimba wakho udinga umuthi owengeziwe nokuningi ukuthola umphumela ofanayo. Lokhu kungaba yingozi kakhulu futhi kwandisa ingozi yokudlula ngokweqile ngengozi.

Ukusetshenziswa isikhathi eside kwale mithi kuguqula indlela ama-nerve receptors asebenza ngayo ebuchosheni bakho, futhi lawa ma-receptors ancike emuthini ukuze usebenze. Uma ugula emzimbeni ngemuva kokuyeka ukuthatha umuthi we-opioid, kungaba yinkomba yokuthi uncike emzimbeni kulokho. Izimpawu zokuhoxa yimpendulo yomzimba emzimbeni ukungabikho komuthi.

Abantu abaningi bathembela kule mithi ukuze bagweme izinhlungu noma izimpawu zokuhoxa. Kwezinye izimo, abantu abaqapheli nokuthi sebethembele kuye. Bangase benze iphutha lokuhoxa ngezimpawu zomkhuhlane noma esinye isimo.

Ziyini izimpawu zokuhoxa kwe-opioid?

Izimpawu ohlangabezana nazo zizoncika ezingeni lokuhoxa obhekene nalo. Futhi, izinto eziningi zilawula ukuthi umuntu uzozibonela isikhathi esingakanani izimpawu zokuhoxa. Ngenxa yalokhu, wonke umuntu uhlangabezana nokuhoxa kwe-opioid ngokuhlukile. Kodwa-ke, ngokuvamile kunomugqa wesikhathi wokuqhubeka kwezimpawu.

Izimpawu zokuqala zivame ukuqala emahoreni angama-24 okuqala ngemuva kokuyeka ukusebenzisa umuthi, futhi zifaka:

• ubuhlungu bemisipha
• ukungahlaliseki
• ukukhathazeka
• ukukhishwa (amehlo adwengula)
• ikhala eligijimayo
• ukujuluka okweqile
• ukungakwazi ukulala
• ukuzamula kaningi

Izimpawu zakamuva, ezingaba namandla kakhulu, ziqala ngemuva kosuku lokuqala noma njalo. Kubandakanya:

• isifo sohudo
• ukuqunjelwa esiswini
• uhlevane amaqhuqhuva esikhunjeni
• isicanucanu nokuhlanza
• abafundi abahlanjululwe futhi mhlawumbe ukufiphala kwamehlo
• ukushaya kwenhliziyo okusheshayo
• umfutho wegazi ophakeme

Yize kungathandeki futhi kubuhlungu, izimpawu zivame ukuqala ukuthuthuka kungakapheli amahora angama-72, futhi kungakapheli isonto kufanele uqaphele ukwehla okukhulu kwezimpawu ezinzima zokuhoxa kwe-opiate.

Izingane ezizalwa omama abayimilutha noma abake basebenzisa ama-opioid ngenkathi abakhulelwe bevame ukuba nezimpawu zokuhoxa. Lokhu kungafaka:

• izingqinamba zokugaya ukudla
• ukungondli kahle
• ukoma komzimba
• ukuhlanza
• isithuthwane

Kubalulekile ukukhumbula ukuthi izidakamizwa ezahlukahlukene zihlala ohlelweni lwakho ngobude obuhlukile besikhathi futhi lokhu kungathinta ukuqala kokuhoxa. Isikhathi sokuthi izimpawu zakho zihlale isikhathi eside sincike ebangeni lokusetshenziswa nobukhali bomlutha, kanye nezici ezithile ezifana nempilo yakho yonke.

Isibonelo, i-heroin ivame ukukhishwa ngokushesha kusistimu yakho, futhi izimpawu zizoqala kungakapheli amahora ayi-12 zisetshenzisiwe okokugcina. Uma ngabe ubukade ukwimethadone, kungathatha usuku nohhafu ukuthi izimpawu ziqale.

Abanye ochwepheshe baveza ukuthi ukululama kudinga isikhathi okungenani sezinyanga eziyisithupha zokuyeka ngokuphelele, lapho umuntu esengaba nezimpawu zokuhoxa. Lokhu kwesinye isikhathi kubizwa ngokuthi “ukungadli isikhathi eside.” Kubalulekile ukuxoxa ngezimpawu eziqhubekayo nomhlinzeki wakho wezokunakekelwa kwempilo.

Kutholakala kanjani ukuhoxiswa kwe-opioid?

Ukuhlonza ukuhoxiswa kwe-opioid, umhlinzeki wakho wokunakekela oyinhloko uzokwenza ukuhlolwa komzimba abuze imibuzo mayelana nezimpawu zakho. Bangabuye bahlele ukuhlolwa komchamo nokuhlolwa kwegazi ukubheka ubukhona bama-opioid ohlelweni lwakho.

Ungabuzwa imibuzo mayelana nokusetshenziswa kwezidakamizwa ezedlule nomlando wakho wezokwelapha. Phendula ngokusobala nangokwethembeka ukuze uthole ukwelashwa nokusekelwa okungcono kakhulu.

Yiziphi izindlela zokwelapha ezikhona zokuhoxiswa kwe-opioid?

Ukuhoxa kwe-opioid kungakhathazi kakhulu, futhi abantu abaningi bayaqhubeka nokuphuza le mithi ukugwema izimpawu ezingathandeki, noma bazama ukuphatha lezi zimpawu bebodwa. Kodwa-ke, ukwelashwa endaweni elawulwayo kungakwenza ukhululeke kakhudlwana futhi kuholele ethubeni elikhulu lokuphumelela.

Ukuhoxa okuncane kungalashwa nge-acetaminophen (Tylenol), i-aspirin, noma izidakamizwa ezingezona ukuvuvukala (ama-NSAID) njenge-ibuprofen. Iziphuzo eziningi nokuphumula kubalulekile. Imithi efana ne-loperamide (Imodium) ingasiza kuhudo ne-hydroxyzine (Vistaril, Atarax) inganciphisa isicanucanu.

Izimpawu ezinqala zokuhoxa zingadinga ukulaliswa esibhedlela neminye imithi. Imithi eyodwa esetshenziswa ikakhulu kusimo seziguli i-clonidine. I-Clonidine ingasiza ekunciphiseni ubukhulu bezimpawu zokuhoxa ngamaphesenti angama-50 kuye kwangama-75. I-Clonidine isebenza ngokukhethekile ekunciphiseni:

• ukukhathazeka
• ukunyanyiswa
• ubuhlungu bemisipha
• ukungahlaliseki
• ukujuluka
• izinyembezi
• ikhala eligijimayo

I-Suboxone iyinhlanganisela ye-opioid enamandla (buprenorphine) kanye ne-opioid blocker (naloxone) engakhiqizi imiphumela eminingi yokulutha yamanye ama-opioid. I-opioid blocker isebenza kakhulu esiswini ukuvimbela ukuqunjelwa. Uma ijojowe izodala ukuhoxa ngokushesha, ngakho-ke inhlanganisela mancane amathuba okuthi ihlukunyezwe kunezinye izindlela. Uma ithathwa ngomlomo, le nhlanganisela ingasetshenziselwa ukwelapha izimpawu zokuhoxa futhi inganciphisa ukuqina nobude bokukhishwa kobuthi emzimbeni kusuka kwamanye, ama-opioid ayingozi kakhulu.

I-Methadone ingasetshenziselwa ukwelashwa kwesikhathi eside. Kusengama-opioid anamandla, kepha ingancishiswa ngendlela elawulwayo engeke ibe nethuba lokukhiqiza izimpawu ezinqala zokuhoxa.

Ukukhipha ubuthi ngokushesha akuvamile ukwenziwa. Kwenziwa ngaphansi kwe-anesthesia ngezidakamizwa ezivimbela i-opioid, njenge-naloxone noma i-naltrexone. Kunobunye ubufakazi bokuthi le ndlela inciphisa izimpawu, kodwa ayithinti isikhathi esichithwa ekuhoxisweni. Ngokwengeziwe, ukuhlanza kuvame ukwenzeka ngesikhathi sokuhoxa, futhi amandla okuhlanza ngaphansi kwe-anesthesia andisa kakhulu ingozi yokufa. Ngenxa yalokhu, odokotela abaningi bayanqikaza ukusebenzisa le ndlela, njengoba izingozi zidlula izinzuzo ezingaba khona.

Yiziphi izinkinga zokuhoxa kwe-opioid?

I-nausea nokuhlanza kungaba yizimpawu ezinkulu ngesikhathi senqubo yokuhoxa. Ukuphefumula ungahlosile kwento ehlanziwe emaphashini (eyaziwa ngokuthi i-aspiration) kungaba yinkinga enkulu ehambisana nokuhoxa, ngoba kungaholela ekwakhiweni kwe-pneumonia (aspiration pneumonia).

Uhudo kungenye yezimpawu zokuqaleka ezingakhululekile futhi ezingaba yingozi. Ukulahleka koketshezi nama-electrolyte avela kuhudo kungadala ukuthi inhliziyo ishaye ngendlela engajwayelekile, okungaholela ezinkingeni zokujikeleza kwegazi nokuhlaselwa yisifo senhliziyo. Kubalulekile ukufaka okunye uketshezi olulahlekelwe ukuhlanza kanye nohudo ukuvikela lezi zinkinga.

Noma ungakutholi ukuhlanza, isicanucanu singahle singakhululeki neze. Amajaqamba wemisipha nobuhlungu obuhlangene nakho kungaba khona ngesikhathi sokuhoxa kwe-opioid. Izindaba ezinhle ukuthi umhlinzeki wakho wokunakekela oyinhloko angasebenza nawe ngokunikeza imithi ekhethiwe engasiza ngalezi zimpawu zokuhoxa ezingathandeki.

Kubalulekile futhi ukuqaphela ukuthi abanye abantu bangathola ezinye izimpawu zokuhoxa ezingabhalisiwe lapha. Yingakho kubalulekile ukusebenza nomhlinzeki wakho wokunakekela oyinhloko ngesikhathi sokuhoxiswa.

Yini engingayilindela esikhathini eside?

Uma uyekile ukuthatha imishanguzo ye-opioid futhi uhlangabezana nezimpawu zokuhoxa, bheka udokotela wakho ngokushesha okukhulu. Udokotela wakho angakusiza ukuphatha izimpawu futhi alungise uhlobo lwemithi yakho. Akufanele uyeke ukuthatha imishanguzo enikezwe i-opioid ngaphandle kokubonisana nodokotela wakho.

Ukufuna usizo ngomlutha we-opioid kuzothuthukisa impilo yakho yonke futhi kunciphise ubungozi bokuphinda ubuye, ukweqisa izidakamizwa ngengozi, kanye nezinkinga ezihlobene nokulutha kwe-opioid. Khuluma nodokotela wakho noma umhlinzeki wezokunakekelwa kwezempilo mayelana nezinhlelo zokwelashwa noma amaqembu okusekela endaweni yangakini. Ukuthuthuka okuphelele empilweni yomzimba nangokwengqondo kufanele izinhlungu nokungakhululeki kokuhoxa.