Kuongorora Maitiro Opioid Akanakisa uye Asina Opioid Drug Options
Analgesics ikirasi yemishonga inoshandiswa kugadzirisa analgesia (marwadzo). Dzinoshanda nekudzivirira zvirwere zvinorwadza kuuropi kana kupindira nekududzirwa kweropi kwezviratidzo izvozvo. Analgesics zvakarongeka sekuti haisi opioid (kwete narcotic) kana opioid (narcotic) kurwadziwa kunorwadza.
Kwete-Opioid Analgesics
Maitiro anorapioid opioid aputsika muzvikamu zvitatu: acetaminophen , nonsteroidal anti-inflammatory drugs (NSAIDs) , uye COX-2 inhibitors.
Kunyange zvazvo imwe neimwe ine nzira yakasiyana-siyana yekuita, inoshanda nekuvhara rudzi rwe enzyme inozivikanwa se cyclooxygenase, kana COX. Ikoko maitiro maviri akasiyana e enzyme iyi, COX-1 ne COX-2, zvose zviri zviviri zvinokonzera kukonzera kutuka uye kurwadziwa mukupindura kukuvara.
Pakati pemhando nhatu dzisina maopioid marwadzo ekudzosa:
- Acetaminophen (inozivikanwawo separacetamol) ndiyo inonyanya kutaurwa pamusoro pe-analgesics munyika nhasi. Nepo vanhu vachawanzozviziva nemazita mazita eTylenol, iyo inoshandiswa inoshandiswa inowanikwa mumakumi ezviuru kune-the-cold-cold, sinus, uye remirwere remakemikari. Acetaminophen inopa zvose analgesic uye antipyretic (fever relieving) nemigumisiro asi haibati kupisa. Kunyange zvazvo kushandiswa kwechiito chacho kusinganzwisisiki, zvinoratidzika sechisingaiti kubvisa chiitiko che COX muuropi uye pakati pehutachiona hwehurumende chete. Chikamu chayo chikuru chinokonzerwa nechiropa chinokonzerwa neropa chinokonzerwa kunyanya nekushandisa. Maererano neU.S. Food and Drug Administration (FDA), acetaminophen nhasi ndiyo inokonzera kukanganisika kwechiropa muU.S., kunyanya pakati pevanhu vane doro vasingaperi kana vanhu vanovaraidza vanoshandisa mishonga yeopioid ine acetaminophen.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) ikirasi yemishonga inosanganisira mabhii akadai se Advil (ibuprofen), Aleve (naproxen), uye Bayer (aspirin). Sezvo neAcetaminophen, NSAIDs inowanika mumhando dzakawanda dzakasiyana-siyana kusanganisira mapiritsi, syrups, uye mapepa. Zvisinei, kusiyana neAcetaminophen, NSAIDs inosarudza kuvhara COX-1 ne COX-2 kwete mumutambo wepakati mukati asiwo dzimwe nhengo dzomuviri, zvakare. Ichi chakawedzera chiito chinopa, muchikamu, kumishonga 'analgesic, anti-inflammatory, uye antipyretic madhara. Zvisinei, izvi zvakafanana zvinogona kuderedza zvidziviriro zvinobatsira iyo COX iri pamakumbo emudumbu. Somugumisiro, migumisiro yakaita sa indigestion, keusea, uye zvionda zvinowanzojairika. Kunze kweAspirin, NSAIDs inogonawo kuwedzera zvakanyanya dambudziko rekurwadziwa kwepfungwa uye kurwisa kune vanhu vane nhoroondo yezvirwere zvepfungwa.
- COX-2 inhibitors ichinyorwa cheNSAIDs icho nhasi chinosanganisira chete FDA-inogamuchirwa mishonga, Celebrex (celecoxib) . Sezvakanyorwa nezita racho, COX-2 inhibitors inodzvinyirira chete COX-2 enzyme, kuderedza marwadzo nekuputika pasina kukonzera kumagumisiro emigumisiro. Zvisinei, sekirasi yemishonga, vanozivikanwa kuti vawedzere ngozi yekurwadziwa kwemoyo ne40 muzana. Somugumisiro, iyo yaimbove yakakurumbira Vioxx (rofecoxib) yakazvipira kubva pamusika weUnited States muna 2005, yakatevera mushure mekuurayiwa kwevamwe COX-2 inhibitors. Nekudaro, Celebrex inoramba iri yemishonga inotengesa zvakanyanya muPfizer pharmaceutical portfolio.
Opioid Analgesics
Opioid analgesics rudzi rwechirwere chinoshanda nekusunga maopioid receptors ari mukati mehutachiona hwehutachiona uye mapuropa emimba. Izvi zvinogamuchirwa kwete kungogadzirisa zvimwe zvinhu zvakadai semarwadzo , zvinokonzerawo kukonzera kushushikana kwepfungwa (pfungwa-kuchinja) vanhu vanoshamwaridzana nemashizha epipiid.
Opioid mishonga inoshandiswa pakurapa kwekurwadziwa, anesthesia, nekurapa opiate muropa. Hazvibatanidzi nehutano hwechirwere kana kuti zvinokonzera chero mimwe migumisiro inowanzobatanidzwa neNSAIDs.
Kunyange zvazvo yakachengeteka kana inoshandiswa sezvinorondedzerwa, maopioid inogona kukonzera kugona, kuora mwoyo, kuvimbiswa, hypoventilation (kufema zvisina kufema kufema), uye kufara mune dzimwe.
Izvi zvinonyanya kukosha kune vakwegura vakwegura vanonyanya kutarisana nemigumisiro iyi.
Uyezve, kushandiswa kwenguva yakareba kunobatanidzwa nehutano hwekuregererwa kwezvinodhaka (apo mushonga wacho unopera zvishoma nezvishoma), kuvimba (kushaya zvinodhaka), uye kubvisa. Somugumisiro, mishonga yakawanda yeopioid inodzorwa zvinhu zvinoda chiremba chiremba. Maererano nemushumo unobva kuCenters for Disease Control nekudzivirira, vazhinji vanoita mamiriyoni maviri eAmerica vanopindwa muropa nemishonga yeopioid.
Kune zvikamu zvitatu zvakapetwa zveipioid zvinoshandiswa kurapa marwadzo:
- Opiate alkaloids iyo yakagadzirwa nemishonga yakagadzirwa nemakemikari anowanzowanikwa muopium poppy plant Papaver somniferum . Zvinokonzerwa nemapfungwa zvinowanika mu opium zvinosanganisira morphine uye codeine. Zvose izvi zvinoshanda zvakananga pamusoro penheyo yenheyo yekuderedza kunzwa kwekutambudzika. Kutsiva, kuchena, kusvetuka, uye kubvongodzwa ndezvakaipa zvinowanzovhiringidza. Kunyange zvazvo morphine ichizivikanwa kuti inodhakwa, codeine inokwanisawo kubvisa zviratidzo kana ichishandiswa zvakanyanya. Codeine ndeyewo opioid chete inowanikwa mune dzakawanda kupfuura-the-counter remedies (zvinowanzokanganiswa nehosi yakagadzirwa neNSAID).
- Semi-synthetic opioid ndiyo iyo yakagadziridzwa kubva kune opioid chaiyo uye inosanganisira mishonga yakadaro seOxycontin (oxycodone) uye Vicodin (hydrocodone) . Oxycodone inoshandiswa kuratidza kurwadziwa kunononoka (kusanganisira kenza kana kurwadziwa kweperi-chirwere) uye inonzi inodhaka zvikuru. Nokuda kwayo, hydrocodone inoshungurudzwa kupfuura chero ipi zvayo chero mishonga yeopioid muU.S., maererano nemushumo wegore ra2014 kubva kuNational Institute of Drug Abuse. Iyi mishonga ine simba inogona kushandiswa nekuchengetedzeka kwekusunungurwa kwenguva shoma kwenguva refu asi, seParamende II madhiragi, inoda kutarisirwa kwepamusoro kweutano.
- Zvose zvakagadzirwa nemaopioid zvinoshandiswa zvachose mubasa kuti dziite chimwe chinhu chinogamuchirwa-chengetedza sechimiro chechiedza. Zvinosanganisira methadone uye buprenorphine (inowanzoshandiswa kurapa opiate zvinodhaka) uye tramadol (inowanzoshandiswa pakurwadziwa kwemashure). Kunyange zvazvo vachionekwa sevashoma kuderedza kune mamwe maopioid, vanhu vanozivikanwa kukudziridza kuvimba kana vakashandiswa kwenguva yakareba.
Shoko Rinobva
Analgesics inogona kuva yakakosha mukugadzirisa marwadzo eArthritis uye yakashandiswa zvakachengeteka kana yakatorwa sezvinorayirwa. Kunyange zvazvo vanachiremba vakawanda vachinyanya kufunga nezvemisiyo isina opioid mishonga yekurapwa, pane mamiriro ezvinhu apo kurwadziwa kwakakomba kunogona kudiwa mishonga yakasimba yeopioid . Izvi zvingangova zvekusunungurwa kwenguva pfupi kuti tidzivise ngozi ipi neipi yekuzvidzivirira.
Panguva imwecheteyo, hazvisati zvanyatsojekesa kuti maharai opioid anoshanda zvakadini kana achienzaniswa nemamwe maitiro asina opioid emishonga. Sezvo zvakadaro, kana uine chirwere chakasimba, chisingaregi che arthritis, funga musangano nemumwe muchengeti wehutano wehutano uyo anogona kukutaurira kuburikidza nehuwandu hwehutano hwehutano hwako, zvose zvinodhaka uye kwete-mishonga.
> Sources:
> Centres for Disease Control and Prevention. "Zviratidzo Zvinokosha: Kusiyana Pakati Pematunhu Mukunyorwa kweApioid Pain Relievers neBenzodiazepines-United States, 2012." MMWR . 2014; 63 (26); 563-568.
> Cicero, J .; Ellis, M .; Surratt, H. et al. "Zviitiko zvinokonzera kusarudzwa kwehydrocodone uye oxycodone sezvakakosha opioid muvanodhaka vanoshandisa kurapa muUnited States." PAIN. 2013; 154 (12): 2639. DOI: 10.1016 / j.pain.2013.07.025.
> National Institute on Drug Abuse. "America's Addiction to Opioids: Heroin uye Prescription Drug Abuse." Washington, DC; yakabudiswa musi waMay 14, 2014.
> Yoon, E .; Babar, A .; Choudhary, M. et al. "Acetaminophen-Induced Hepatotoxicity: A Comprehensive Update.". Nyaya yemakiriniki nekushandura hepatology . 2016; 4 (2): 131-42. DOI: 10.14218 / JCTH.2015.00052.