Kana inotorwa zvakakwana, acetaminophen ine ngozi zvikuru
MuChicago mukunaya kwa1982, acetaminophen (Tylenol) capsules yakanga yakazara ne cyanide iyo yakakurumidza kuuraya mune vanomwe vasingazivikanwi vakaurayiwa. Kusvikira nhasi, kushanda kwemitemo kusati kwasvika kumunhu kana kuti vanhu vane mhosva yezviito izvi zvinotyisa.
Iyo Chicago Tylenol Inouraya kwete kungoti upenyu hwevanhu vanomwe asi zvakare yakaparadza McNeil Consumer Products, rutivi rwemhando yebazi rebenhemouth Johnson & Johnson uye muiti weTylenol.
Mune izvo zvino zvinowanzoshandiswa sekunetseka kwekutonga nyaya nyaya, pakukwirira kweTylenol kutya, McNeil Consumer Products yakabudisa kunyevera kwevanhu vakawanda uye yakarangarira mabhodhoro ose eTylenol aripo, mamiriyoni 31 muhuwandu. McNeil Consumer Products akavimbisawo vanhu kuti zvose zvinokanganisa zvakaitika kunze kwefekitari.
Mumasvondo anotevera Chicago Tylenol Murders, Johnson & Johnson vakabva kutonga pamusana we-analgesic market ne 35% yemugove wemari kune imwe chete yezana yezana yemusika. Asi mukati megore rematambudziko, Tylenol yakawedzera mushure me $ 100 mamiriyoni ekutsvaga kwekutengesa, kutengesa-kupupurirwa kwepurasitiki, uye kuiswa kwegelatin-yakavharwa caplet iyo yakanga iri nyore nyore kumedza uye yakaoma kupindira nayo. Munguva yematambudziko uye makore kubva ipapo, mumoyo nepfungwa dzevanhu vose, Tylenol yakagadzirisa kutsungirira kutenda kwakanaka sekuchengeteka, kukwanisika, uye kunetseka kunorwadza.
Zvisinei, nokuda kwezvikonzero kunze kweiyo ikozvino yakangoerekana yakanganisa kuparwa kwemhosva, Tylenol inogona kuva nengozi. Vanhu vashomanana havafungi nezvekuti kana kutorwa zvakanyanya sei, acetaminophen inogona kukonzera kufa kwechiropa kusakundikana. Mushure mezvose, mabhodhoro eAcetaminophen anotarisa asina mhosva paanenge ari pane imwe shefu murapa rako cabinet kana kana uchitengeswa pamwe chete mumutambo wemutengo wemunharaunda yako.
Nenzira yakanaka, zvinokonzerwa neAcetaminophen poisoning zvinogona kudziviswa kana chirwere chinoshandiswa mukati memaawa gumi ekutanga chepfu.
Kunzwisisa Tylenol
Mumumuviri, Tylenol inopinda nekupararira kuburikidza nehutachiona. Tylenol inenge 100 muzana yehupenyu husina kuwanikwa inoita kuti iyo yose ishande uye inogona kunge ine ngozi. Zvinotora anenge maminitsi makumi matatu ekurwara (pain relieving) uye antipyretic (fever-breaking) yemishonga iyi yemishonga inoshanda, uye, pasi pemamiriro ezvinhu akajairika, miviri yedu yakajeka nehafu yengero yeTylenol 2.5 maawa mushure mekudya.
Kana kutorwa kunorwadza kune vanhu vakuru, Tylenol yakaiswa pakati pe 600 mg uye 1000 mg maawa mana kusvika maawa matanhatu. Hapana munhu anofanira kutora magiramu mana eTylenol pazuva. Tylenol caplets ine 500 mg yeAcetaminophen saka iwe haufaniri kutora mamwe maviri maketani maawa matanhatu kana masere makumi matanhatu pazuva . Nyaya, kana iwe uine chirwere chinorwadza chinoda kuti iwe uende kune imwe nzvimbo pedyo nemaketani masere eTylenol pazuva, unofanira kunyatsotsvaka kurapwa.
Kana inotorwa mukurapa, vazhinji veTylenol vanoputsika zvakanaka nechiropa kuburikidza nekugadzirisa zvirongwa zve sulfation uye glucuronidation. Uyezve, zvishoma zvinyorwa zveTylenol (zvisingasviki ne5 kubva muzana) zvakanyatsobudiswa kuburikidza netsvo.
Pakupedzisira, nemaitiro ekurapa, peresenti yakawanda zvikuru inoshandiswa ne cytochrome P-450 system reactive metabolite N-acetyl- p -benzoquinoneimine (NAPQI); NAPQ1 inokurumidza kusimbiswa nehepatic glutathione kune rimwe risina tsvina acetaminophen-mercapturate ekamu iyo inobviswawo neitsvo.
Mune zviitiko zveTylenol chepfu, chiropa chechiropa chinonzi cytochrome P-450 chinokurumidza kupera uye mabhuku e glutathione anobuda. Nokudaro, iyo inoshandisa metabolite, NAPQ1, inokuvadza uye inouraya masero eropa, izvo zvinoita kuti chiropa chisakundikana.
Muna 2008, American Association of Poison Control Centers yakashambadza zviratidzo 71,328 zveTylenol pamwe chete uye kuonekwa 80,845 kwaTylenol chete.
Makumi makumi mashanu nematatu akaurawa neTylenol chepfu yepiri kune yekubatanidzwa pamwe chete, uye vanhu 69 vakafa nekuda kweTylenol chete. Iyi nhamba inotsanangurira chokwadi chinokosha chekliniki pamusoro peTylenol chepfuu: Vamwe vanhu vanopedzisira vachingonyanya kuderedza acetaminophen nokuti inoratidzika se "vanyengeri," asi nhamba dzinenge dzakaenzana dzevanhu dzinoguma dzichikanganisa nokuzvidzivirira pachavo nokuti dzinokundikana kuziva kuti Tylenol yaive iri mumishonga yavanenge vakanga vachitora.
Iwe nevadiwa vako munofanira kunzwisisa maitiro-analgesics, kurara kwemishonga uye kutonhora uye kurwara kwemishonga) -nowedzera acetaminophen:
- Lorcet
- Norco
- NyQuil
- Percocet
- Vicodin
- Darvocet
- Excedrin ES
- Unisom Dual Relief Formula
- Lorcet
- Tylox
- NyQuil
- Vicks Fomu 44-D
- Tylenol PM
- Sominex 2
Kuita kuti zvinhu zviwedzere kuipa, migumisiro yakaipa yezhinji yemishonga iyi inosanganiswa neacetaminophen inogona kutanga kuvhara zviratidzo zveTylenol chepfuyo pachayo. Izvi zvinogona kutungamirira kunonoka kuisa upenyu mukurapa.
Tylenol chepfu inogona kuongororwa sezvikamu zvina.
- Nhanho 1. Mumaawa 24 ekutanga, zviratidzo hazvibvumirwi uye zvinosanganisira malaise, anorexia, nausea, uye kurutsa. Nokuda kwezvikonzero zvisingazivikanwi, munhu ane chepfu anogona kukura hypokalemia kana kuti pasi mashoma e potassium muropa.
- Nhanho 2. Masikati maviri kana matatu, kamwechete zviratidzo zvekutanga zviderera, zviratidzo uye zviratidzo zvekuropa kwechiropa kana kuti zvinogona kuiswa mukati kusanganisira kurwadziwa kweropa uye unyoro uye mapurovheni emuropa anokwidziridzwa (serum transaminases). Kunyangwe pasina kurapwa, vanhu vazhinji vane unyoro kusvika kuenzanisi chechipfu chepfu (kureva, hepatoxicity) vanodzoka pasina sequelae uye musapinda Chikamu 3.
- Nhanho 3. Pamasikati 3 kana 4, kukundikana kunokonzerwa nehupenzi kunoitika: metabolic acidosis, kusagadzikana kwechirwere, kupererwa kwemazino, kubata uye kugadzikana kwezvirwere zvemimba.
- Nhanho 4. Kune avo vanopona Nhanho yechitatu, kupora kunotanga pavanenge mavhiki maviri nekudzorerwa kwechiropa basa mumwedzi miviri.
Nhoroondo, vanhu vanovimba newaini kana avo vasina kudzivirirwa (semuenzaniso, AIDS) vane nzvimbo dzakasara dzekutengesa glutathione uye vanonyanya kunetseka neAcetaminophen poisoning uye kusagadzikana kunokonzerwa nehepatic. Uyezve, vanhu vari kutora chirwere chekufa kwepachifu kana chirwere chepachifuva vanewo mungozi mukuru nokuti mishonga iyi inobatsira cytochrome P-450 inzymatic activity.
Kurapa kweTylenol kudarika
Vanachiremba vanobata chirwere cheTylenol zvichienderana nemitemo iyo yakave nokubudirira kukuru munguva yakapfuura kusanganisira yakawanda yakashandiswa rimwe chete acetaminophen kudarika overodose nomogram, rudzi rwakasiyana rwemufananidzo.
Izvozvo zvinopesana neTylenol kudarika zvinodhaka zvinonzi N-acetylcysteine (NAC). Kubudirira kweNAC kwakanyanya kunobva panguva yekurapa, uye inonyanya kushanda kana inotarisirwa mukati ma8 kusvika ku10 maawa asingabviri kuisa kudarika. Paawa 12 kusvika ku16, unotanga kuona kuora kwechirwere chezvirwere; zvisinei, kurapa kunogona kutanga mukati maawa makumi maviri nemaviri.
Nekusawirirana kwakaoma, NAC inogona kutarisirwa mumayero gumi nemana makumi manomwe nemaviri panguva yeawa 72. Inogonawo kugadziriswa mukati-kati mumashoma maawa makumi maviri. Chiropa function test (enzyme levels) inotevera kuteverwa. Muawa imwe kusvika maawa maviri ekudarika, mashizha anoburitswa anogonawo kugadziriswa kubatsira kubatsira mamwe eTylenol. Muchiitiko chinosuruvarisa icho acetaminophen chakatotadza kubvisa chiropa, uye kukundikana kwemafupa akazara mukati maro, kuiswa kwechiropa kunogona kudiwa.
Shoko Rinobva
Kana iwe kana mumwe munhu waunoda wanyora pamusoro peTylenol kana kuti chigadzirwa chine Tylenol, shanyira 911 kana mazano ekukurumidzira pakarepo. Tylenol toxicity mamiriro ezvinhu akaoma uye nguva yakakosha-f iwe wakamirira kwenguva yakareba kurasikirwa kweNAC hakushande. Nokuti zviratidzo zveAcetaminophen toxicity zvakazara, zvakakosha kuti iwe ugovaudza vose vanopa utano vehutano iwe zvichida wakatora zvikuru Tylenol. (Emergency room physicians inowanzoona urineni yeTylenol asi hazvibvi pane izvi.)
Mamwe mazwi akawanda pamusoro peTylenol: Kunyange zvazvo Tylenol neTylenol ine zvigadzirwa zvinenge zvisingakuvadzi, hazvisi izvo. Zvechokwadi funga nezvekuti nei uri kutora Tylenol kana zvimwe zvekare-the-counter-analgesics uye remarwadzo ekurwadza. Mishonga yakadaro inofanirwa kurwirwa kwenguva pfupi. Kana marwadzo ako achiwedzera kwenguva yakati, unofanira kutsvaga kurapwa. Ndapota ramba uchifunga kuti Tylenol haigoni kuporesa mamiriro ezvinhu asingagumi semigraines kana kukuvara kwekudzokera kumashure.
> Sources:
> Hung OL, Nelson LS. Chitsauko 184. Acetaminophen. Muna: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e . New York, NY: McGraw-Hill; 2011.
> Olson KR. Chitsauko 4. Acetaminophen. Mu: Olson KR. eds. Kutyisa uye Kuwedzerwa Kwemishonga, 6e . New York, NY: McGraw-Hill; 2012.