Neurontin ine simba rekushandisa rinoshandiswa zvakanyanya pane raimbofunga
Kwemakore, vanachiremba vaiona Neurontin (gapapentin) uye Lyrica (pregabalin) semishonga ine zviduku kana zvisingashandisi zvisiri izvo. Zvisinei, rimwe boka rekutsvakurudza rinotsvaga rinoratidza kuti mishonga iyi inowanzoshandiswa zvisina kunaka uye kushungurudzwa.
Mune chidzidzo cheMay 2017 chakabudiswa mu Pharmacoepidemiology uye Drug Safety , Buttram uye vanyori vanyori vanosimbisa hutsva hutsva hunoita. Pakave nekuwedzera kuNeurontin diversion, uye kuparadzanisa uku kwakabatana nehosha yeopioid iyo iri kuparadza zvikamu zvizhinji zveUnited States.
Vanhu vari kukura pakusanganiswa kweNeurontin uye mishonga inonzi opioid (semuenzaniso, hydrocodone uye oxycodone).
Vanyori vekudzidza vanocherechedza zvinotevera:
Dhigiridziro data inoratidza kuti Neurontin iri kushandiswa zvisina kushandiswa pamwe chete nemishonga inonzi opioid uye kuti Neurontin uye heroin vari kusanganiswa uye kudyiwa pamwechete. Mutemo wevatori venhau vakatora mishonga iyi yekushandisa zvinodhaka kugovera kuNeurontin diversion.
Neurontin uye Lyrica
Kana paine huwandu hwehupenyu husingaperi hwekutaura uye zviratidzo zvekusagadzikana, Neurontin neRyrica vanoshandiswa mishonga pakati pevana vekuchiremba vanachiremba. Iyi mishonga inonyanya kushanda mukurapa kurwadziwa kusingaperi kupfuura Advil kana Tylenol. Uyezve, kutarisira opioid chirwere; saka, maopioid akafanana neNorco kana Vicodin anoshandiswa kungobata kurwadziwa kwakanyanya uye kwakanyanya. Mune mamwe mazwi, Neurontin yakasimba kudarika chimwe chinhu chaunogona kuwana muchitoro chemishonga uye hachina ngozi kupfuura opioid.
(Heroin inoratidzwa opioid.)
Sei Neurontin uye Lyrica Vanoshanda?
Neurontin pakutanga yakagadzirwa muna 1977 seGABA anogue. Anenge makore gumi gare gare, Lyrica, mukoma wemakemikari weNeurontin, akaumbwa. Neurontin yakagamuchirwa neDFA muna 1993. Pakazosvika 2004, Lyrica akaita kuti ikohwe.
Neurontin neRyrica vari pamwe chete vanonzi gabapentinoids uye vanoita zviito zvakafanana.
Kunyange zvazvo zvose zviri zviviri zvakagadzirirwa kutadza kugadzirisa, madhiragi aya ave akaonekwa sehubupenzi hunokonzera neuromodulators uye anowanzogadziriswa kuti asunungure marudzi akasiyana-siyana ekurwadziwa kusingaperi uye kusagadzikana.
GABA, inopera gamma-aminobutyric acid, inonzi neurotransmitter inhibitory, iyo inopararira muhutachiona hweganda, kana humwe hutongo hwehuropi hunokonzerwa nehupamhi-huropi hunoita. GABA inobatanidzwa mumabasa akasiyana-siyana europi, kusanganisira motokari yekuona uye maonero pamwe chete nekugadzirisa kushungurudzika uye kurwadziwa.
Kunyange zvazvo pakutanga chaida kurwisana neGABA receptors muuropi, gabapentinoids haisungiri kune GABA receptors. Uyezve, havasungiri kuvannabinoid, opioid, kana benzodiazepine receptors kana. Kunyange zvazvo mishonga yemishonga iyi isati ichinyatsojekeswa, inoratidzika kuti mishonga iyi inoshandisa kudzvinyirira uye zvinorwadza-zvingabatsiri zvakanyanya. Kunyange zvakadaro, gabapentinoids inoguma ichiwedzera kuwedzera kweGABA kuwedzera uye kuderera kwekuwedzera kwehutano muuropi.
Neurontin neLyrica vanogovera maitiro ezvinyorwa zvakafanana, zvose zvakadzingwa neitsvo uye hazvibvumirane nemamwe madhiragi (kureva, kuwedzerwa kungozi kwekushandisa kwezvinodhaka-zvinodhaka). Chimwe chikamu chinozivikanwa pakati pezvinodhaka izvi ndezvokudya kwavo, kana chiyero chemishonga chinonyanya kuita kuti zvipararire.
Kunyanya, Lyrica ine yepamusoro ye bioavailabilty kupfuura yeNeurontin uye yakakurumidza kunyanya uye yakawanda. Iyi misiyano yakaita kuti dzimwe nyanzvi dzifungidzire kuti Lyrica ine simba rekushandisa zvisina kunaka, uye anecdotal accounts dzinotsigira iyi hypothesis. Kunyange zvakadaro, kana inotorwa pamatareji akakwana, zvose zvinodhaka zvinokurumidzira kuita uye kubudirira, uye vose vari kushungurudzwa uye kushandiswa zvisina kunaka.
Mishonga yekushandisa yeNeurontin uye Lyrica
Iyo gabapentinoids yakafanana kune imwe neimwe mumigumisiro yavo yezvipatara.
Mahwendefa eNeurontin, capsules, uye mhinduro zvinogamuchirwa zvinotenderwa neRDA kusvika (1) kubata kukanganisa zvishoma uye (2) kurapa mushure mutsva musikana, kana shingles.
MuEurope, Neurontin inogamuchirwa kuitira kurapa marwadzo europathic.
Lyrica inogamuchirwa neRDA kuti iite (1) post-herpetic neuralgia, (2) chirwere cheshuga chinokonzerwa neuropathy, (3) fibromyalgia, uye (4) kugumburwa. MuEurope neJapan, Lyrica inobvumirwa kugadzirisa marwadzo europathic uye chirwere chinokonzera kuzvidya mwoyo.
Neurontin haina kufungidzirwa kuti inodzorwa nehurumende yeUnited States, uye mishonga iyi yakachengeteka kupfuura mamwe anticonvulsants. Izvi zvinokonzerwa nekuchengetedzwa kwepurogiramu zvakabvisa kushandiswa kwemaira kweNeurontin pasinei nehurombo hwemakiriniki ekuedza kushandiswa kwakadaro.
Pakati pe 83 kubva muzana uye 95 kubva muzana yeNeurontin yekutengeswa kwemavara. Pano pane zvimwe zvisiri pamutemo zvinoshandiswa neNeurontin:
- Doro, benzodiazepine, mbanje, uye opioid withdrawal syndrome
- Kucherechedza dambudziko dambudziko
- Bipolar disorder
- Complex regional pain syndrome
- Diabetes neuropathy
- Hot flashes
- Migraine headaches
- Peripheral neuropathy
- Periodic limb movement disorder of sleep
- Misodzi yemakumbo asingagadziki
- Trigeminal neuralgia
Kunyange zvazvo DEA inoratidzira Lyrica sechirongwa cheHedhi V, ichiratidza kukwanisa kudarika kushandiswa kwechisimba, ichiri chinhu chinodzorwa. Izvi zvinokonzerwa nechokwadi chokuti Lyrica inodhura kupfuura Neurontin inogona kutsanangura nei nei Neurontin yakawanda zvakanyanya kunyorwa.
Pakupedzisira, vanachiremba vakawanda vachapa Neurontin panzvimbo yeLyrica nokuti Neurontin inodhura. Lyrica inorapwa zvikuru. Nokuti zvose mishonga ine mhinduro imwe chete, zvinenge zvakanyanyisa kuendesa nechisarudzo chine mari.
Kutaura Neurontin Kunotsanangurwa
Kushandisa zvisina kunaka uye kushandisa zvinodhaka zvinhu zvakasiyana, uye musiyano uri muchinangwa.
Maererano neCDA: "Kana munhu akatora mishonga yepamutemo yemishonga nokuda kwechimwe chinangwa kunze kwechikonzero chakanga charairwa, kana kana munhu iyeye akatora chirwere chisina kupiwa kwaari, ndiko kushandisa zvisina kunaka mushonga."
Kushandisa zvinodhaka chinhu chinonyanya kushandiswa zvisina kunaka. Izvi zvinoitika kana vanhu vachitora zvinodhaka kuti vawane "zvakakwirira," kana kuti vanonzwa manzwiro euphoric. Nekuremekedza Neurontin neRyrica, uku kufara kwakatsanangurwa nenzira dzakasiyana uye kunofanirwa nemigumisiro yeopioid, benzodiazepines, uye psychedelics.
Vanachiremba vakawanda vanorayira Neurontin yezvinhu zvose zvezvinhu, kusanganisira kurwadziwa, mamiriro epfungwa, uye zvinetso zvekushandisa zvinhu; vakawanda vechiremba ava vangangodaro havazivi kuti ichi chinodhaka chekushandisa kushandiswa. Nokuti yakawanda kwazvo yakaparadzirwa mune zvakawanda, uye inodhura uye iri nyore kupa kune Lyrica-iyo inodzora zvinhu-Neurontin yava mhirizhonga yakawandisa yekushandiswa zvisina kunaka nevanhu vanotsvaka kukurumidza kwayo yepamusoro-soro. Uyezve, vanhu vane dambudziko rekushandisa kushandiswa uye zvirwere zvepfungwa zvinowanzoshandisa madhiragi aya zvinodhaka. Mune mamwe mazwi, Neurontin inowanzotarisirwa kune vanhu vanoratidzira zvakanyanya kushandiswa kwechisimba.
Haasi munhu wese anoshungurudza Neurontin-uye kazhinji Lyrica-ane mitsara yemishonga iyi. Kudengenyeka ibhizimusi guru kune vatengesi vezvinodhaka, uye zvinodhaka izvi zvinongopedza nzira yavo kuenda kumigwagwa. Pakati pe40 kubva muzana uye 65 kubva muzana yevanhu vanoshandisa zvisina kunaka uye vanoshungurudza Neurontin vane mitemo yemishonga.
Mharidzo ye2012 inofungidzira kuti mishonga yeLyrica neNeurontin yakanga yawedzera ne 350 muzana uye 150 muzana, zvichienderana, pamusoro pemakore mashanu apfuura.
Nhoroondo, vamwe vanhu vanorayirwa Neurontin vanongoshandisa zvinodhaka izvozvi mukuedza kuzviitira zviratidzo. Vamwe vanhu vanoshandisa zvinodhaka izvi semishonga senzira yekuzvikuvadza. Uyezve, vanhu vanoshandisa chirwere ichi nekushandisa zvimwe zvinhu, saipioid, doro, uye benzodiazepines.
Muna 2010, tsvakurudzo yekutanga yakabuda ichiratidza dambudziko rekushandisa zvisina kunaka Lyrica. Pakupedzisira, European Union yakawedzera ichi chemishonga kune rwandu rwekuvaraidza kwezvinhu zvinoshandiswa. Pakazosvika 2010 na2016, zvidzidzo zvinenge makumi maviri zvakave zvichiongorora kushandiswa kwekushandisa kushandiswa kweNeurontin uye Lyrica.
Heano zvimwe zvimwe zvakananga zvakabatana neNeurontin uye Lyrica kushandiswa zvisina kunaka uye kusashandisa zvisina kunaka. Izvi zviwanikwa zvinobva pane zvidzidzo zvenguva pfupi.
- Chimwe chidzidzo chinoratidza kuti kuwandisa kweNeurontin uye Lyrica kushandiswa zvisina kufanira pakati pevanhu vanogara muUK vane makore gumi nematanhatu nemakore makumi mashanu nemakumi matanhatu nemakumi matanhatu nemakumi matanhatu nemakumi mashanu nemakumi matanhatu nemakumi matanhatu nemakumi mashanu nemakumi matanhatu nemakumi matatu nemashanu. Maererano nekudzidza uku, chiyero chekushungurudzwa kwechirwere chinokwana 28.1 muzana uye kushandiswa kwekodineine 8.1 muzana. Mune mamwe mazwi, kune vanhu vasingashandisi zvinoshandiswa nekushandisa zvinhu kana zvirwere zvepfungwa, mutengo we gabapentinoid kushandiswa kwakaderera kune yeimwe mishonga yemitambo.
- Pakati pevanhu vane matambudziko eOpioid, zviyero zvehurumende yeNeurontin yaiva pakati pe15 ne22 muzana. Izvo, chiyero cheRyrica chakashandisa zvisina kukodzera pakati pemapoka ehuwandu hwehuwandu huwandu hwakasiyana-siyana: pakati pe3 muzana uye 68 muzana. Pasi pose, vanhu vane zvinetso zvekushandisa zvinhu vanoita sevanoshandisa gabapentinoids pamitengo yakafanana nedzimwe mishonga yemagariro.
- Pakati peAmerica avo vakashandisa zvisina kufanira opioid, chiyero chekushandisa zvisina kunaka Neurontin chaive chechipiri chekushandisa zvisina kufanira amphetamine uye nezvekuenzana ne clonazepam (rudzi rwe benzodiazepine) zvisina kunaka.
- MuScotland, 22 muzana yevanhu vakaenda kumakiriniki e methadone vakashandisa Neurontin.
- Chidzidzo chegore ra2015 chakatora kushandiswa kwekunakidzwa kweNeurontin nokukurumidza kuwedzera. Kunyanya, pakanga paine 2950 muzana yekuwedzera kwekushungurudzwa kubva muna 2008.
- Kushandiswa kwezvinoshandiswa kwezvinoshandiswa kwehurumende munyika yose kunoratidza kuti Lyrica inorayirwa pamatare akawandisa kudarika kukurudzirwa, izvo zvinogona kutungamirira kushandiswa.
- Zvimwe zvidzidzo zvinoratidza kuti avo vanoshandisa gabapentinoids zvinoshandiswa kuva varume vechidiki (30-ish) uye vasina mari. Zvisinei, dhesi rinotaura nezvehutano nekushungurudza inopesana.
- Kubva pane imwe nyaya yenyaya ye "report" yakatorwa kubva kuongororo yechina yezvinodhaka zvinodhaka
rakapedzerwa nemuenzaniso wehurumende wekuteerera kwemitemo uye masangano ehurumende anobata mishonga yekutsvaga zvinodhaka, "Buttram uye vashandi vakawana kuti kuwedzerwa kwemitengo yakasimudzwa kubva kune zero mazamu mumakamuri maviri ekutanga a2002 kusvika kune mamiriyoni 0,027 pa100 000 vanhu mukupedzisira quarter of 2015. - Kudengenyeka kweNeurontin kunoratidzika kuva kwakawanda Mujeri reUnited States.
Migumisiro Dzechimwe Kupfuura Euphoria
Kunze kwekuwedzera, vanhu vanoshandisa gabapentinoids pa supratherapeutic, kana kupfuura kudarika mazano, vanotsanangurawo zvimwe zviitiko kusanganisira zvinotevera:
- Kugutsikana
- Relaxation
- Dissociation
- Kuvandudza hukama hwevanhu
- Kunzwira tsitsi
- Uninhibited behavior
- Muchirangaridzo uye maonero ekuona
Nenzira, izvi zvinoratidzika sezviri kusiyana zvichienderana nekushivirira uye muzinga. Uyezve, kuregererwa kwekupedzisira kwegabapentinoids kunogona kukonzera kuregera pfungwa dzekuzvidzivirira kwenyama. Uyezve, vanhu vanobva kune gabapentinoids vanogonawo kuva nepfungwa dzakawanda dzepfungwa.
Ngozi dzeGabapentinoid kudengenyeka
Apo rinoshandiswa sezvinotaurwa, Neurontin uye Lyrica zvakanaka chaizvo. Zvinosvibisa zvinowanzova zvinyoro uye zvinosanganisira kurara, somnolence, ataxia, chizuru, uye kuneta.
Kusiyana nedzimwe mishonga yekudzvinyirirwa, kunyange kana yakawandisa, gabapentinoids ichiri kungokonzera zvigaro zvishoma, zvakadai sekuperevedza kwepamusoro kweropa, kuwedzera kwemwoyo, nezvimwe zvinokanganisa zvinokonzera kune izvo zvinoonekwa pamakirwere ekurapa. Gabapentinoid kudarika zvakanyanya hazvidi kuti zvipatarise uye hapana kuurayiwa kubva kune kudarika kwakataurwa. Vanhu vanowedzera kudarika vanowanzodzoka kukutanga kwekutanga mushure maawa gumi ekudya.
Basa Rinoitwa Nechiremba
Zvingava zviri nyore kwazvo kuisa mhosva ye gabapentinoid kushandiswa zvisina kunaka, kushandiswa zvisina kunaka, uye kuvimba zvakanyanya pamapfudzi ekutsanangura vanachiremba. Zvechokwadi, mishonga iyi inongororwa-iyo chete uye inogona kuramba ichidzorerwa kumashure ivo pachavo; zvisinei, tinofanira kunzwisisa nzvimbo isingazivikanwi iyo vatsigiri varipo apo murwere anonyunyuta nezvekurwadziwa kukuru uye kusagadzikana kunofamba nekurwadziwa kusingaperi.
Semuenzaniso, zvinowanzoitirwa varwere vane neuropathic uye mamwe marudzi ehurombo husingagumi uye asinganzwisisiki kuti vanzwe kurwadziwa kunogona kushamisa munhu pasina mamiriro. Kana munhu apinda muhofisi rechiremba achinyunyuta nezvekupisa mumagumo avo, manzwiro e "kufamba pagirazi" nezvakadaro, vanachiremba vane zvishoma zvokubata zviratidzo izvi zvinotyisa, uye Neurontin kana Lyrica inowanzova nzira chete inoshandiswa.
Vanachiremba vanofanira kunge vari kutarisa zviratidzo izvo murwere ari kushandisa zvisina kunaka kana kushandisa zvinodhaka izvi kana kuronga kuita zvinhu zvakasiyana-siyana kusanganisira zvinotevera:
- Varwere vane zvirwere zvepfungwa kana zvekushandisa zvinoshandiswa kunofanira kunyatsoongororwa kuti vashandise kana kushandiswa.
- Zviratidzo zvekushungurudza zvinosanganisira murwere achikumbira Neurontin kana Lyrica zvakananga, nokuda kwepamusoro doses kupfuura yakatemwa, kana kuti mitemo yakawanda munguva pfupi.
- Vanachiremba vanofanira kuve nechokwadi chokuti varwere havasi "chiremba zvekutengesa" kana kugamuchira mitemo yakawanda kubva kune vakawanda vanopa. Chikonzero chinowanzoitirwa maitiro akadaro ndechokuti mishonga "yakarasika" kana "yakabiwa."
- Chiremba anofanira kufungidzira kuita chirwere chemuorivhi chirwere (UDS) kune varwere vanofungidzirwa kuti vanofuratira. Kana varwere ava vari kugamuchira mitsara ye gabapentinoids asi madhiragi aya haawanikwi mumuguta, zvino mishonga iyi inogona kuendeswa kumigwagwa.
Shoko Rinobva
Kunyange zvazvo zvichikwira, kushandiswa kweNeurontin neRyrica kuchiri kukanganisa vashomanana vevarwere, uye kunyanya avo vanofanirwa kushungurudzwa, sevanhu vane hutano hweopioid. Uyezve, kunyange mumamiriro ezvinhu ekudarika, migumisiro yemishonga iyi inowanzoita zvishoma uye inononoka-kurema zvikuru kubva pamigumisiro yeipioid, doro, uye benzodiazepine kuvimba (mamiriro ayo madhiragi anoshandiswa kurapa).
Kana iwe kana munhu waunoda achitora mishonga iyi kuti uwane marwadzo asingagumi kana kusagadzikana, uye izvi zvinodhaka zvinopa zororo, zvino mishonga iyi iri kushandiswa sezvinodiwa. Zvisinei, kuderedza dambudziko rako rekushungurudzwa, zvakakosha kuti iwe unonyatsoongororwa nachiremba wako uye utore mishonga iyi chete pamatare anofungidzirwa. Kunzwisisa maitiro avanoita kunogona kubatsira. Uyewo, usatora mishonga iyi kuti uite "yakakwirira," usasanganise zvinodhaka izvi newaini, benzodiazepines, opioid, kana zvimwe zvinodhaka zvekushungurudzwa, uye usapa kana kutengesa mishonga iyi kune vamwe.
Kana imi mose mune mibvunzo pamusoro pemishonga yemishonga yamunotora-kunyanya mishonga nekugona kushandiswa-tapota bvunza chiremba wako. Chiremba wako anogona kutora nguva yekukurukurirana nezvengozi uye kubatsirwa kwemishonga ipi yaunenge watarirwa. Mukuwedzera, unogonawo kubvunza chiremba wemishonga yako nezvemishonga inorayirwa. Somurwere, ndiyo kodzero yako yekuudzwa nezvemishonga yauri kutora.
> Sources:
> Kurwisana zvisina kunaka uye kushatiswa kwemishonga yemishonga: Q & A naMichael Klein, Ph.D. July 28, 2010. www.fda.gov.
> Evoy KE, Morrison MD uye Saklad SR. "Kushatiswa uye kusashandiswa zvisina kunaka kwePregabalin neGabapentin." Zvinodhaka . 2016.
> Mack A. Kuongororwa kweUchapupu hweKuchenesa-Kushandisa Kushandiswa kweGabapentin. Zvinyorwa zveKushandiswa Kuchengetedza Pharmacy . 2003; 9: 559-568.
> Smith RV, Havens JR, naWalsh SL. "Gabapentin kusashandisa zvisina kunaka, kushungurudza uye kuparadzanisa: kurongeka kwakagadziriswa." Kudhakwa . 2016; 111: 1160-1174.
> Tcheremissine, OV, uye Bestha DP. Kushandisa Gabapentin Mukushivirira Nehupenyu Hwakashata uye Zvimwe Zvishandiso Zvokushandisa. Innovations in Clinical Neuroscience . 2016; 13: 13-14.