Momwe Mungadziwire ndi Kuchiza Mankhwala Osokoneza bongo

Zamkati

• Kodi kuthamanga kwa mankhwala ndi chiyani?
• Kodi zotupa za mankhwala zimawoneka bwanji?
• Zotupa zambiri
• Ziphuphu zam'mimba
• Zochita za photosensitivity
• Chithokomiro
• Matenda a Stevens-Johnson (SJS) ndi poizoni epidermal necrolysis (TEN)
• Khungu lopangidwa ndi anticoagulant necrosis
• Kugwiritsa ntchito mankhwala osokoneza bongo ndi eosinophilia ndi systemic zviratidzo (DRESS)
• Chifukwa chiyani ziphuphu zimachitika?
• Kodi zotupa za mankhwala zimathandizidwa bwanji?
• Maganizo ake ndi otani?

Kodi kuthamanga kwa mankhwala ndi chiyani?

Ziphuphu, zomwe nthawi zina zimatchedwa kuphulika kwa mankhwala, ndizomwe khungu lanu limatha kuchita ndi mankhwala ena.

Pafupifupi mankhwala aliwonse angayambitse totupa. Koma maantibayotiki (makamaka ma penicillin ndi mankhwala a sulfa), ma NSAID, ndi mankhwala oletsa kulanda ndiwo mankhwala omwe amapezeka kwambiri omwe amachititsa kuti ziphuphu zitheke.

Pemphani kuti mudziwe zambiri zamitundu yosiyanasiyana ya totupa mankhwala ndi momwe mungawongolere.

Kodi zotupa za mankhwala zimawoneka bwanji?

Ziphuphu zambiri zamankhwala ndizofanana. Izi zikutanthauza kuti zimawoneka chimodzimodzi mbali zonse ziwiri za thupi lanu.

Ziphuphu zamankhwala osokoneza bongo sizimayambitsanso zizindikiro zina kupatula mawonekedwe awo, ngakhale zina zimatsagana ndi kuyabwa kapena kukoma mtima.

Nthawi zambiri mumatha kusiyanitsa zotupa zamankhwala ena chifukwa cha ziphuphu zina chifukwa zimagwirizana ndikupanga mankhwala atsopano. Koma nthawi zina, zimatha kumwa mankhwala mpaka milungu iwiri kuti ziyambitse.

Ziphuphu nthawi zambiri zimasowa mukasiya kumwa mankhwalawo.

Nazi zina mwa zotupa zofala kwambiri zamankhwala osokoneza bongo.

Zotupa zambiri

Uwu ndiye mtundu wofala kwambiri wamankhwala osokoneza bongo, womwe umapanga pafupifupi 90% ya milandu. Amadziwika ndi zotupa zazing'ono pakhungu lofiira. Zilondazi zimatha kukwezedwa kapena kukhala mosalala. Nthawi zina, mutha kuwonanso zotupa ndi zilonda zodzaza mafinya.

Zomwe zimayambitsa kuphulika kwamankhwala osokoneza bongo ndi monga:

• penicillin
• mankhwala a sulfa
• cephalosporins
• mankhwala oletsa kulanda
• alirakhalid

Ziphuphu zam'mimba

Urticaria ndi liwu lina lotanthauza ming'oma. Ming'oma ndi mtundu wachiwiri wofulumira kwambiri wa mankhwala osokoneza bongo. Ndi mabampu ang'onoang'ono ofiira ofiira omwe amatha kupanga zigamba zazikulu. Ming'oma nthawi zambiri imakhalanso yoyipa.

Zomwe zimayambitsa kuphulika kwa mankhwala osokoneza bongo zimaphatikizapo:

• mankhwala osagwiritsa ntchito zotupa (NSAIDs)
• Zoletsa za ACE
• maantibayotiki, makamaka penicillin
• mankhwala oletsa ululu

Zochita za photosensitivity

Mankhwala ena amatha kupangitsa khungu lanu kukhala lowala ndi kuwala kwa ultraviolet. Izi zitha kubweretsa kutentha kwa dzuwa ngati mutatuluka panja popanda chitetezo choyenera.

Mankhwala omwe amakonda photosensitivity ndi awa:

• maantibayotiki ena, kuphatikizapo tetracycline
• mankhwala a sulfa
• antifungals
• mankhwala oletsa
• retinoids, monga isotretinoin
• zikondwerero
• okodzetsa
• ma NSAID ena

Chithokomiro

Mtundu uwu umapangitsa pafupifupi khungu lonse kukhala lonyansa komanso lofiira. Khungu limathanso kukulira mamba ndikumamva kutentha. Malungo amathanso kuchitika.

Mankhwala ambiri amatha kuyambitsa erythroderma, kuphatikiza:

• mankhwala a sulfa
• penicillin
• mankhwala oletsa kulanda
• chloroquine
• alirakhalid
• isoniazid

Matenda oyambanso amathanso kuyambitsa erythroderma.

Erythroderma imatha kukhala yayikulu ndikuwopseza moyo. Funsani kuchipatala mwachangu ngati mukuganiza kuti uwu ndi mtundu waziphuphu zomwe muli nazo.

Matenda a Stevens-Johnson (SJS) ndi poizoni epidermal necrolysis (TEN)

SJS ndi TEN zimawerengedwa kuti ndizofanana, koma pali kusiyana pang'ono pakati pa ziwirizi:

• SJS imakhudza zosakwana 10 peresenti ya thupi.
• TEN imakhudza zoposa 30 peresenti ya thupi.

SJS ndi TEN amadziwika ndi matuza akulu, opweteka. Zitha kupanganso madera akuluakulu akhungu lanu kutuluka, kusiya zilonda zosaphika, zotseguka.

Zomwe zimayambitsa matendawa ndi monga:

• mankhwala a sulfa
• mankhwala oletsa kulanda
• ma NSAID ena
• alirakhalid
• nevirapine

SJS ndi TEN ndizochita zazikulu zomwe zingawononge moyo. Onsewa amafunikira chithandizo chamankhwala mwachangu.

Khungu lopangidwa ndi anticoagulant necrosis

Ochepetsa magazi ena, monga warfarin, amatha kuyambitsa khungu la khungu la necrosis. Izi zimapangitsa khungu kukhala lofiira komanso lopweteka.

Pamapeto pake, ziwalo zamkati mwa khungu zimafa. Nthawi zambiri zimangochitika kumayambiriro kwa kumwa magazi ochepa kwambiri.

Khungu la necrosis lomwe limayambitsa matenda a Anticoagulant ndi vuto lalikulu lomwe limafunikira kuchipatala mwachangu.

Kugwiritsa ntchito mankhwala osokoneza bongo ndi eosinophilia ndi systemic zviratidzo (DRESS)

KUVALA ndi mtundu wosowa wa mankhwala osokoneza bongo omwe angawononge moyo. Zitha kutenga milungu iwiri kapena isanu kuti zizindikiritso ziwonekere mutayamba mankhwala atsopano.

MPHAMVU yovala imawoneka yofiira ndipo imayamba kumaso ndi kumtunda. Zizindikiro zogwirizana nazo ndizolimba ndipo zimatha kuphatikizira ziwalo zamkati. Zikuphatikizapo:

• malungo
• zotupa zam'mimba zotupa
• kutupa nkhope
• ululu woyaka ndi khungu loyabwa
• zizindikiro ngati chimfine
• kuwonongeka kwa ziwalo

Mankhwala omwe angayambitse DRESS ndi awa:

• anticonvulsants
• alirakhalid
• @alirezatalischioriginal
• minocycline
• sulfasalazine
• proton pump pump inhibitors

KUVALA ndi vuto lalikulu lomwe limafunikira kuchipatala mwachangu.

Chifukwa chiyani ziphuphu zimachitika?

Ziphuphu zamankhwala osokoneza bongo zimachitika pazifukwa zingapo, kuphatikizapo:

• zosavomerezeka
• mankhwala omwe amayambitsa poizoni pakhungu
• mankhwala amachititsa khungu kumvetsetsa kuwala kwa dzuwa
• mogwirizana awiri kapena kuposa mankhwala

Nthawi zina ziphuphu zimatha kuchitika zokha ndikukula popanda chifukwa.

Zinthu zina zingakulitsenso chiopsezo chanu chokhala ndi vuto la mankhwala osokoneza bongo, monga kukhala wamkulu komanso wamkazi.

Zina mwaziwopsezo zimaphatikizapo kukhala ndi:

• kachilombo ka HIV ndikumwa maantibayotiki
• chitetezo chofooka chamthupi chifukwa cha vuto linalake kapena mankhwala ena
• khansa

Kodi zotupa za mankhwala zimathandizidwa bwanji?

Nthaŵi zambiri, mankhwala osokoneza bongo amatha okha mutasiya kumwa mankhwala omwe anakupangitsani.

Ngati kuthamanga kuli kovuta kwambiri, antihistamine kapena oral steroid ingathandize kuthana ndi kuyabwa mpaka kuphulika kutatha.

Nthawi zonse lankhulani ndi dokotala musanasiye mankhwala. Izi ndizofunikira kwambiri kuti mutenge mankhwala angapo. Poterepa, adotolo azikutsatirani dongosolo lakuletsa mankhwala aliwonse mpaka mutazindikira chomwe chikuyambitsa.

Ngati muli ndi urticaria yovuta, erythroderma, SJS / TEN, anticoagulant-induced skin necrosis, kapena DRESS, mufunika chithandizo chokwanira. Izi zitha kuphatikizira ma intravenous steroids ndi hydration.

Maganizo ake ndi otani?

Nthawi zambiri, kuthamanga kwa mankhwala osokoneza bongo sikudandaula chilichonse. Nthawi zambiri amatsuka mukasiya kumwa mankhwalawo. Onetsetsani kuti mwalankhula ndi dokotala musanasiye mankhwala aliwonse omwe akupatsani.

Pazizindikiro zakuchulukira kwamankhwala osokoneza bongo, pitani kuchipatala mwachangu kuti mupewe zovuta.