Chinokonzera Narcotic Pain Medication for Chronic Pain
Kana uri kutambura nekurwadziwa kusingaperi uye wakamboedza zvose zvaunogona kuti udzivise marwadzo ako, opioid (narcotics) inogona kunge iri nzira yaunosarudza kutora. Kunyange zvazvo kushandiswa kweizvi simba remapinja ( analgesics ) yenguva refu yekurapa kwekusagadzikana kusingaperi kunopesana, mishonga iyi inogona kuva yakagadzikana uye yakachengeteka kana inotorwa pasi pekutarisirwa kwehutano hwepedyo.
Hezvino izvo zvaunofanira kuziva asati usarudza kana maopioid akakodzera iwe.
Chii Chinonzi Opioids?
Opioids inobva kune imwe yenzvimbo zvitatu: Zvimwe zvinobva kunezvirimwa, zvimwe zvinoumbwa mubazi, uye zvimwe, zvakadai seendorphins, zvinowanzoitika mumuviri. Opioids inoshanda zvikuru mukurapa kurwadziwa kwakanyanya. Ichokwadi, iyo inowanzoshandiswa kurapa kurwadziwa kwakanyanya, kwakadai sekurwadziwa kwepashure-kupora, pamwe nekurwadziwa kwakanyanya kunokonzerwa nezvirwere zvakadai sekenza.
Mhando dzeOpioids
Zvichienderana nezvido zvako, unogona kutora imwe yemhando shomanana yeopioid inoshandiswa kurapa kurwadziwa kusingaperi . Pakati pekirasi yemishonga inonzi maopioids, kune misiyano yakawanda.
Kutanga, maopioid anogona kuumbwa sekuita kwenguva refu-kushanda kana kuti kwenguva pfupi inorapa mishonga.
Opioids yakasiyanawo kubva kune mumwe nemumwe munzira yavanopiwa. Zvimwe zvinopiwa mukati-kati ne-IV iri muruoko, ruoko, kana muchiteshi kana kuti picc line. Zvimwe zvinopiwa nemuromo, zvimwe zvinogona kupiwa se rectal suppository, uye zvimwe zvinouya muhutu hwechiganda chaunoshandisa paganda rako.
Dzimwe maopioid inogona kupiwa nenzira dzinopfuura imwe chete, asi imwe yacho inongogumira kune imwe nzira yekugovera.
Chimwe chikamu chakakosha ndechokuti mamwe opioid, akadai se oxycodone ad hydromorphone "yakananga narcotics." Vamwe, zvakadai saTylenol # 3 naVicodin , vangave vakavhengana nevamwe vanouraya zvakadai saTylenol (acetominophen.)
Chimwe chikwata cheopioid, chinotsanangurwa segonist / mutsigiri, inosanganisira mishonga yekuderedza marwadzo uye kuderedza zvingaita zvekuvimba. Izvi zvinosanganisira buprenorphine uye butorphanol.
Opioid Side Effects uye Dzimwe Matambudziko
Vanhu vazhinji vane marwadzo asingagumi vanotsungirira imwechete yeopioid yemakore kwemakore vasina kuvaka kuvhiringidzwa kwezvinodhaka, kana kusina kuwedzera kuzvidzora kwemuviri pamushonga. Zvisinei, kuvimba uye kukanganisa zvinokonzerwa nepamutemo.
Zvinosuruvarisa, vazhinji vanorwara vanorwara vanotora maopioid vanogona kunge vasina kukodzera kunyoreswa se "kuvhiringidza," kunyange kana vasingakwanisi kugadzirisa zviyero zvekudhakwa. Pane dzimwe nguva imwe tsvina inobatanidzwa nokutora mishonga inorwadza nenyota, iyo inogona kuodza mwoyo kune munhu ane kurwadziwa kwakanyanya kusingaperi.
Mukuwedzera pakuregerera uye kuvimba kwepanyama, opioid ine zvimwe zvimwe zvinogona kuva nemigumisiro. Izvi zvinogona kusanganisira:
- Kukurova
- Kusanganiswa
- Nausea
- Constipation
- Urinary retention
- Kuoma kufema kufema
- Kuita zvepabonde kusagadzikana
- Low blood pressure
- Itching sensations
Opioids inowanzokonzera vakwegura nevana kupfuura vanhu vakuru, naizvozvo vanhu ava vanofanira kuongororwa kunyanya kunyatsorongeka. Kakawanda, vanachiremba vanotanga maopioid doses zvakaderera zvikuru uye vachiwedzera zvishoma nezvishoma kusvikira chirwere chekurapa chiri kusvika.
Mamwe mishonga inogona kuwirirana zvisina kunaka neopioid, saka kuchenjerera kunotarisirwa kana iwe uchizotorawo mamwe mitsara nguva dzose. Iva nechokwadi chekuudza chiremba wako nezveimwe mimwe mishonga yaunotora, kusanganisira iyo inotengwa pamusoro pekambani, kuti urege kudzivisa zvinetso, zvakadai sekuderedza zvinodhaka.
Zvechokwadi, kupa kwakarara uye kuvhiringidzika kunogona kuitika semigumisiro yemigumisiro yemishonga iyi, asi sekune zvinodhaka zvinodhaka, kuongororwa kwechangobva kuwanikwa kwakaona kuti kutyaira paunenge uchishandisa maopioid yekutambudzika kusingaperi hakuna kuwedzera kushanda.
CDC Zvinyorwa zvekutsanangura maOpioid for Chronic Pain
Zvichipa kuwedzera kukuru kwehuwandu hwehutano hwakabatana nekushandiswa kweapioid kune marwadzo asina kukonzerwa nekenza, Centers for Disease Control uye Kudzivirira (CDC) yakabudisa mirayiridzo yekushandiswa kwakachengeteka kweapioid kune vanhu vane kurwadziwa kusingaperi.
Zvimwe zvemashoko gumi nemaviri aya zvinosanganisira:
- 1. Opioids haafaniri kushandiswa se "rokutanga" kurapwa kwekusingaperi. Mimwe mishonga isingaiti maopioid inofanira kushandiswa kutanga isati yashandisa opioid. Kana maopioid achidikanwa, anofanira kushandiswa pamwe chete nemamwe maitiro ekurapa (kuti kuderedza maitiro eopioid anodiwa mune zvimwe zvikonzero.) Mishonga isingaiti maopioid inosanganisira steroidal anti-inflammatory drugs like Advil (ibuprofen), tricyclic antidepressants , uye mishonga inorwisa-seizure (anticonvulsants) yakadai saNeurontin ( gabapentin .)
- 2. Zvinangwa zverapi zvinofanira kusimbiswa. Inofanira kuve yakatsunga kuti kuwedzera muropiyiti inopihwa kuchavandudza basa kana hutano hwehupenyu hunokwana kuti utarisana nemigumisiro inogona kuitika.
- 3. Kukurukurirana kwechiremba-chiremba kunofanira kuitika umo murwere anonzwisisa zvakajeka njodzi uye kubatsira kwekushandisa maopioid kuti vararame marwadzo avo.
- 4. Kusunungurwa kwemaopioid (nguva yakasiyana nemaawa opioids) inofanira kushandiswa kutanga.
- 5. Mushonga wakadzika kwazvo wemishonga inofanira kuiswa. (Pane matafura anoenzanisa doses re narcotics dzakasiyana kana iwe uchishandura kubva kune imwe mishonga kune imwe.)
- 6. Nhepfenyuro shoma dze narcotics inofanira kurongerwa kunorwadza kwakanyanya kunoitika pamusoro pemarwadzo asingagumi.
- 7. Kuratidzira kutevera kunoda. Pakutanga mukurapwa, kliniki inoshanyira inofanira kuitika kamwechete pavhiki kana zvingani kazhinji pamwedzi. Apo mishonga iyi iri kushandiswa kwenguva yakareba, kushandiswa kwavo kunofanira kuongororwa mushure mega mwedzi mitatu uye kana kurwadziwa kusingavandudzi pamishonga inofanira kumira.
- 8. Vanachiremba vanofanira kushandisa mazano ekuderedza kusashandiswa kwemishonga zvisina kunaka. Izvi zvingasanganisira kushandiswa kusanganiswa kwegonist / mutsigiri kana kukwanisa kushandiswa kushandiswa.
- 9. Vanachiremba vanofanira kushandisa pOMP data kuti vaone kuti imwe chiremba haisi kuronga maopioid kuitira kuti vaderedze ngozi yekuwedzerwa.
- 10. Kuongorora mishonga yemishonga kunofanira kushandiswa kuve nechokwadi chokuti munhu wese ari kushandisa mishonga yakarongeka uye haashandisi zvinodhaka zvinogona kukanganisa kurapwa.
- 11. Kana zvichibvira, maopioid haafaniri kusanganiswa ne benzodiazepines.
- 12. Kana kuvimba neopioid kuchiitika, vanachiremba vanofanira kunge vakagadzirira kupa mishonga yekushandisa zvinodhaka.
Sei Uchishandisa Opioids Pose?
Nekukakavadzana kwakawanda kwakapoteredza kushandiswa kwavo muhupenyu husingaperi, unganetseka kuti nei vanachiremba vanopa opioid zvachose. Zvinyorwa zvese, maopioid anobudirira zvikuru mukuderedza kurwadziwa kwakanyanya, uye vanhu vazhinji vasina kuwana zororo kubva kune dzimwe mishonga vanowana zororo kunze kwekushandiswa kweopioid. Kune vanhu ava, zvikomborero zveipioid zvinopfuura zvikwereti. Nzira dzisina kunaka uye zvigaro zvekuvimba hazviitike pane zvose. Kune vanhu vazhinji vane marwadzo asingagumi, maopioid anogona kubatsira kuvadzosa zvakare mararamiro avo ehupenyu.
Usati watanga iwe paopioid, chiremba wako anofanira kuita chizere chakazara pamwe nekugadzirisa nguva dzose mazano kuti uone mamiriro ako. Vamwe vanachiremba vanogona kutanga neutori hweipioid, zvishoma nezvishoma kuwedzera chiremba chako apo iwe unotaridzirwa kuti zvingave zvinetso.
Sources:
Campos-Outcalt, D. Opioids for Chronic Pain: ICCC's 12 Recommendations. Zvinyorwa zveMhuri Practice . 2016. 65 (12): 906-909.
Nzvimbo dzeDaase Control uye Kudzivirira. Kuipa uye Kufa Kwemavhiki Gwaro (MMWR). CDC Guideline yekutsanangura maOpioids for Chronic Pain - United States, 2016. Updated 03/18/16. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
Chou, R., Devo, R., uye J. Friedly. Systemic Pharmacologic Mishonga ye Chronic Chronic Back Pain: Ongororo Yakarongeka yeAmerican College of Physicians. Anals of Internal Medicine . 2017 Feb 14. (Epub mberi kwekudhinda).
Schumacher, M., Jongen, S., Knoche, A. uye al. Migumisiro yeApioid Therapy pane Zvechokwadi Kufambisa Kuronga muHasina Kanzerwa Varwere. Psychopharmacology . 2017 Feb 12. (Epub mberi kwekudhinda).