6 Makirasi eOototoxic Mishonga
Ototoxicity inoreva kukemikari-induced damage in the ear ear. Kukanganisa kunogona kuva kwekusingaperi kana kwechinguva, zvichikonzera kurasikirwa kwekunzwa kana kushaya matambudziko. Kunyange zvazvo mishonga inotorwa nokuda kwezvakabatsirika, mishonga yose ine migumisiro yechirwere yaunofanira kunge uchiziva asati yatora. Kunzwa kurasikirwa kwakabatana nokudya mishonga inotapisa ndeimwe chikonzero icho chiremba wako angakuita kuti urege kutora mishonga maererano nehupenyu hwekuvhiringidza.
Kunzwa kurasikirwa kunowanzobatanidzwa nematanhatu matanhatu emishonga. Izvo zvinotevera zvinogona kusanganiswa nekurasikirwa kwekunzwa kwekusingaperi:
- Aminoglycoside antibiotics
- Platinum-based chemotherapy
Mishonga inonyanya kukonzera kurasikirwa kwemashoko kwenguva pfupi:
- Loop diuretics
- Quinine
- Salicylates
- Vinca alkaloids
Mishonga yemishonga inotaurwa pamusoro ino inogona kukuvadzai itsvo (nephrotoxic) uye inoda chiremba wako kuti aongorore ropa rako nguva dzose kuti uongorore mafungiro ako. Kana ukacherechedza chero kuchinja munzeve yako, iwe unofanira kugara uchitsvaga rubatsiro kubva kune chiremba wako.
Ngozi ye Ototoxicity
Kuwanda kwekutora ototoxicity hakuna kunyatsoratidzwa, zvisinei zvose zvinokanganisa kwenguva pfupi uye zvisingaperi kubva ku ototoxicity inozivikanwa. Mamwe mishonga ichave nezvimwe ruzivo kupfuura vamwe uye icharondedzerwa muzvikamu zvavo zvinotevera. Saizvozvowo hakuna kunzwisisa kukuru kwekudzivirira ototoxicity kubva pakuitika.
Mamwe mishonga ine ngozi yakawanda yekutotoxicity yakafanana nemishonga inorwisa mabhakitiriya inoda kuti ropa rekuzivikanwa se "chikwata nehombodo" inotorwa. Iyo nhamba yepamusoro yehuwandu hwechirwere kana iyo inofanirwa kuva pane yakanyanya kukwirira muropa. Chibage chiyero chechirwere kana chichifanira kunge chichiri pasi.
Nepo kunyatsotarisa izvi zvinogona kubatsira kuchengetedza maitiro ekurapa, hazvirevi kuti hauzove nehutano ne ototoxicity.
Zvimwe zvinhu zvinogona kuita kuti ototoxicity iite:
- chiremba, urefu hwekurapa, uye zviyero zvakakwana zvakagamuchirwa
- kidyo kutadza
- kutora mimwe mishonga inodhakwa panguva imwe chete
- genetic predisposition to ototoxicity
Zviratidzo zvine chokuita neOototoxicity
Zviratidzo zvine chokuita neodotoxicity zvakanyanya kunobva pane chikamu chenzeve yomukati chave chaparadzwa. Kukuvadza kunzeve yomukati kunogona kuitika kune yako cochlea (inonzi cochleotoxicity) kana chipfeko chako chemavara (chinonzi vestibulotoxicity). Muzviitiko zvose izvi, zviratidzo zvose zvinoratidzika kune zvakakanganisika masero.
Kana chechlea yako yakakuvara, kunzwa kwako kuchave kusina kunaka. Iko kukanganisika kunobatanidza zvakananga kumwero wekukuvadza kunokonzerwa netinitus yekunaka kupedza kurasikirwa kwekunzwa . Kurasikirwa kwekunzwa kunogona kuchinja imwe kana nzeve mbiri.
Kana hutotoxicity inobata chidimbu chekudzivirira, chiyero chako chichagadziriswa. Kufanana nekukuvadza kwekikilea yako, kukuvara kunogona kuchinja nzeve imwe kana nzeve mbiri. Kana kukanganisa kunokanganisa imwe nzeve zvishoma nezvishoma, iwe pachako haungatongoratidzi zviratidzo. Zvisinei kana kukanganisa kuchiitika nokukurumidza kune imwe nzeve, iwe unogona kunge uine:
- vertigo
- kurutsa
- uncontrolled eye movement (nystagmus)
Zviratidzo zvinowedzera nokukurumidza zvinogona kuita kuti iwe urove-wakasungwa kusvikira zviratidzo zvigadzire zvishoma nezvishoma. Kana kukanganisa kunowanikwa kumativi ose omunzeve yako, unogona kuwana:
- headache
- nzeve izere
- kusagadzikana kunobatsira kukwanisa kufamba
- chiratidzo chakajeka chinowanikwa jerky (oscillopsia)
- kusagutsikana kumusoro kusununguka
- achifamba nepfungwa yakajeka
- kuoma kunofamba murima
- unsteadiness
- kuchena kwemusoro
- kuneta
Kana kukanganisa kwechigadziro chako chekufuka chiri chakanyanya, oscillopsia uye kuoma kufamba usiku hazvizovandudzi. Zvimwe zviratidzo zvingangodaro zviri nani nekufamba kwenguva. Nekukuvadza kwakanyanya, unogona kudzoka kubva kuhuwandu hwezviratidzo zvine chokuita nekuenzanisa nekuda kwemuviri wako kukwanisa kugadzirisa.
Aminoglycoside Antibiotics
Aminoglycoside mishonga inorwisa mabhakitiriya inhengo inokosha yemishonga ine ropastream uye urinary tract infections pamwe nekurwisana nechirwere chetachiona. Mishonga inosanganisira:
- gentamicin
- tobramycin
- streptomycin
Aminoglycoside antibiotics ine ngozi yekusvika 20 muzana yekutambisa zvinetso zvekunzwa uye inenge 15 muzana yekutengesa matambudziko ekugadzirisa. Ngozi yekugadzirisa zvinetso zvine chokuita neototoxicity inowedzera kana uri kutora loop diuretic (saLasix) kana vancomycin (antibiotic) panguva imwe chete.
Loop Diuretics
Loop diuretics inokonzera kuwedzera kwehuwandu hwekugadzira urinhi. Izvi zvinobatsira mu congestive mwoyo kusakundikana, kuwedzera kwehutano weropa, nekushaya kwepvo. Mishonga yakajairika inosanganisira:
- Lasix (furosemide)
- Bumex (bumetanide)
Loop diuretics vane njodzi yakawanda yakanyanya yeodotoxicity asi inogona kuitika kune vakawanda kana vatanhatu pavanhu vatatu vanoshandisa mushonga. Inowanzofungidzirwa kuti inowanikwa pamatokisi akareba anokonzera kuwedzerwa kweropa kwemamirigiramu anenge 50 (mg) neregi.
Platinum-Based Chemotherapy
Cisplatin uye Carboplatin ndiwo maviri emakemikari makuru emishonga (anti-neoplastics) ayo anonzi ototoxic. Iyo inowanzoshandiswa mukurapa kwekenza dzakasiyana siyana kusanganisira:
- ovarian & testicular kansa
- kenza yemukaka
- kenza yemapapu
- musoro nomutsipa kanzura
Quinine
Quinine inoshandiswa kurapa marariya uye makumbo makumbo. Kurapa kwenguva refu ne quinine kunotakura chikamu che20 muzana chekuita kuti kuve nekubatanidzwa kwepamusoro-kutadza kunzwa kunzwa, izvo zvinowanzotaridzirwa kusingaperi kana kunzwa kurasikirwa kwekukurukurirana kwechiitiko kune ruzivo. Quinine inowanzokonzera kunzwa kurasikirwa kunobatanidza ne syndrome inonzi cinchonism :
- matsi
- vertigo
- kuridza munzeve dzako
- headache
- kurasikirwa kwechiono
- nausea
Salicylates
Saricylates yakadai se aspirin ine njodzi ye ototoxicity pamadhora makuru uye inogona kukonzera kurasikirwa kwekunzwa kwe 30 decibels, iyo inofananidzwa nekunyunyuta. Zvisinei, kukanganisa kunogona kuenzanisa zvakaderera sezvinonzi tinnitus zvishoma pamasero maduku e aspirin. Vakomana vaduku kunyanya vanoita kunge vari pangozi yekunzwa kurasikirwa kwakabatana nekushandiswa kwe aspirin. Dambudziko racho rinogona kubva kubva pa12 kusvika ku33 muzana zvichienderana nehuwandu hwekushandiswa.
Vinca Alkaloids
Vincristine imishonga yekurapa acute lymphocytic leukemia (ALL), Hodgkin lymphoma, nedzimwe kenza. Iyi mishonga inonyanyobatanidzwa nehutano hwakanyanya hwekukonzera kurasikirwa kwekunzwa apo inoshandiswa kuwirirana neaminoglycoside antibiotics.
Kuongorora Kunzwa Kurasikirwa Kunobatanidza Ototoxicity
Usati waita kurapwa nemishonga pangozi ye ototoxicity, iwe unofanira kuona mutori wenhau yepamusoro wezwi rekutanga remitambo. Chiremba wako achazoona kana sarogram yakagara yakarongeka ichadikanwa kuitiswa kana kuti kuzviongorora kwakajeka kwekunzwa kwako. Kunyange zvazvo izvi zvisingagoni kudzivirira kunzwa kurasikirwa kwakabatana ne ototoxicity, ichakubatsira kuona zvinetso kare.
Kurapa Ototoxicity Related Hearing Loss
Iko hakusi ikozvino mishonga inowanika kuchinja kusagadzikana kusingaperi kune nzeve yomukati. Kana iwe uchitambura nekunze kwekunzwa kurasikirwa, rubatsiro rwekunzwa ruzhinji runokurudzirwa. Kana uine kurasikirwa kwekunzwa kwekunze kune dzose nzeve, ipapo chiremba wako anogona kukurudzira cochlear implants . Kuvandudza kunowanzoitwa kurapwa kwesarudzo kana iwe uri kutarisana nezvinetso zvenguva pfupi kana zvekusingaperi.
> Sources:
> American Speech-Mutauro-Kunzwa Sangano. (2017). Mishonga yeAototoxic (Mishonga yeMishonga). http://www.asha.org/public/hearing/Ototoxic-Medications/
> Boldenberg, D, Goldstein, BJ. (2011). Handbook of Otolaryngology Head uye Neck Surgery. Thieme Medical Publishers. New York, NY.
> Merck Manual. (2017). Mishonga-Inobatsira Ototoxicity. http://www.merckmanuals.com/professional/ear--nose,-and-throat-disorders/inner-ear-disorders/drug-induced-ototoxicity
> Rybak, LP & Brenner, MJ. (2015). Cumming's Otolaryngology: Vestibular uye Auditory Ototoxicity. http://www.clinicalkey.com (Kubhadharwa Kunodikanwa)
> Vestibular Disorders Association. (2017). Ototoxicity. http://vestibular.org/ototoxicity