Dzidza kuti nei zvinodzvinyirira uye anticonvulsants zvinoshandiswa kurapa kurwadziwa kusingaperi
An analjuvant analgesic mishonga isinganyanyi kugadzirirwa kutarisa marwadzo asi inogona kushandiswa nokuda kwechinangwa ichi. Mimwe mienzaniso yemishonga yemadjuvant inoshandiswa mishonga sevanorwisa mweya uye anticonvulsants . Vanogonawo kunzi "coanalgesics".
Iwe unogona kunge wakarongerwa an analjuvant analgesic kuwedzera kune mamwe mishonga inorwadza , kana iwe pachako. Mazwi anorasiki eAdjuvant anotadza kunge asingakwanisi kuburikidza nekurwadziwa kwemusculoskeletal, zvakadai sekurwadziwa shure kana kurwadziwa.
Zvisinei, vanogona kushanda zvakanaka nokuda kwehutano hwepfungwa uye marwadzo anonzi syndromes, akadai se fibromyalgia . Ivo vanewo basa mukurapa kurwadziwa kwekenza. Kusiyana nedzimwewo dzakawanda dzisiri maogioid analgesics , analgesics adjuvant haisipo pane iyo.
Mhando dzeAdjuvant Analgesics
Antidepressants
Kunyange zvazvo vanorwara nehutachiona vasingawanzofungwa semarwadzo anorwadza, vanogona kubata zvakasimba marwadzo asingagumi. Zvinodzvinyirira zvinofungidzirwa kuti zvinodzora nzira iyo marwadzo anowanikwa kubva mumutsipa wepelinha kusvika kuuropi. Mukuwedzera, kuora mwoyo kunogona kuderedza kufunganya uye kubatsira kuronga kurara.
Zvisinei, havasi marudzi ose evanhu vanodzvinyirira vanobudirira mukugadzirisa kurwadziwa kusingaperi . Tricyclic antidepressants (TCAs) yakadai seamitriptyline, sarotonin reuptake inhibitors (SSRIs), seloloxetine, nezvimwewo, zvakadai sedafazodone, zvinowanzoshandiswa kurapa zvose zvirwere zvisingaperi zvinosuruvarisa uye kurwadziwa kwepfungwa. Monoamine oxidase inhibitors (MAOIs) haisi yakakosha mukurwara kusingaperi.
Anticonvulsants
Anticonvulsants, iyo mishonga inowanzoshandiswa kugadzirisa zvirwere zvekugadzirisa, inogona kushandiswawo kubata chirwere chisingaperi. Anticonvulsants inoshanda nekurega kubvumira mamwe marudzi ehutachiona, uye inogona kuderedza marwadzo europathic, akadai seaya anokonzerwa ne trigeminal neuralgia kana chirwere cheshuga chirwere.
Anticonvulsants inowanzoshandiswa kugadzirisa kurwadziwa kusingaperi inosanganisira gabapentin uye pregabalin.
Gabapentin ndiyo inonyanya kushandiswa-inoshandiswa yakafanana nedhijidhi. Vamwe varwere vasina kupindura zvakanaka gabapentin vanopindura panzvimbo panzvimbo ye pregabalin, uye pamwe chete.
Ndezvipi Zvinorwadza Zvinokanganisa Kuita Mazano Okugadzirisa?
IOxford Textbook yePalliative Medicine uye Merck Manual inonyora aya anotevera anjuges analgesics kuti atore marwadzo ekurwadziwa:
Mabizi Anoshandiswa Mhando Dzakasiyana-siyana dzeSyncromes Dambudziko
- Corticosteroids
- Dexamethasone
- Prednisone
- Tricyclic vanodzvinyirira
- Amitriptyline: kwete kukurudzirwa kune vakwegura kana varwere vane chirwere chemwoyo.
- Desipramine
- Kusarura serotonin uye norepinephrine reuptake inhibitor (SNRI) anodzvinyirira
- Duloxetine: Zviri nani kubvumira kupfuura tricyclic vanodzvinyirira.
- Milnacipran
- Alpha-2-adrenergic agonists
- Tizanidine
- Mishonga yemapurisa: capsaicin inogona kushandiswa pakurwadziwa kweuropathy uye arthritis.
- Local anesthetics: akadai se lidocaine patch
Mabizi Anoshandiswa Nehupenzi Hweuropathy
- Antiepileptic agents
- Gabapentin: Uyu ndiye mishonga inosarudzwa yeanticonvulsants.
- Pregabalin
- Carbamazepine: iyi ndiyo mushonga wekutanga wokutatura neuralgia.
- Phenytoin: inofungidzirwa kuva mishonga yechipiri yemishonga.
- Valproic acid: yakashandiswa kumusoro.
- Clonazepam
- Lamotrigine
- Topiramate
- Tiagabine
- Oxcarbazepine
- Lacosamide
- Vanopikisa NMDA
- Memantine
- Ketamine
- Dextromethorphan: inoshandiswa apo marwadzo ane chikamu chinopisa.
- Oral sodium channel blockers
- Mexiletine
- Tocainide
- Baclofen: Inoshandiswa mumutatu weeuralgia.
Calcitonin
Vashandisi Vanoshandisa Kushanda Kwemahara Paunosangana Syndrome
- Calcitonin
- Clonidine
- Prazosin: kurwadziwa kwepfupa kwekenza
- Bisphosphonates (p., Pamidronate)
- Calcitonin
- Radiopharmaceuticals
Shoko Rinobva
Kana ukashamisika kuti sei mishonga yakasiyana iri kushandiswa kurapa marwadzo ako asingagumi, bvunza chiremba wako kana kuti mishonga kuti atsanangure. Inyanzvi yezvinhu zvehupenyu inobatanidza inogona kuoma, asi iwe unogona kuvimbiswa kuti uri kuwana mishonga yakarurama iyo inoshanda pamwe chete kuti ipe marwadzo erure.
> Sources:
> Lussier D, Portenoy RK: Adjuvant Analgesics. MuDoyle D, Hanks G, Cherny NI, Calman K (eds): Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press, 4th Ed, Oxford: Oxford University Press, 2011.
> Markman, J, et et. al. Utatu hweHurwa. Merck Manual Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain.