Kuchokera ku Opiates ndi Opioids

Zamkati

• Kodi ma opioid amakhudza bwanji thupi?
• Nchiyani chimayambitsa kuchotsedwa kwa opioid?
• Kodi zizindikiro zakutha kwa opioid ndi ziti?
• Kodi kuchotsedwa kwa opioid kumapezeka bwanji?
• Ndi mankhwala ati omwe amapezeka kuti achotse opioid?
• Kodi zovuta zakutha kwa opioid ndi ziti?
• Kodi ndingayembekezere chiyani pakapita nthawi?

Kodi kuchotsedwa kwa opioid ndi chiyani?

Opioids ndi gulu la mankhwala omwe amalembedwa kuti athetse ululu. Opioids amaphatikiza ma opiate onse (mankhwala omwe amachokera ku opium poppy, kuphatikiza morphine, codeine, heroin, ndi opium) ndi ma opioid opanga monga hydrocodone, oxycodone, ndi methadone, omwe ali ndi zovuta zofananira. Mankhwala opioid ndi awa:

• Mpweya (oxycodone)
• Vicodin (hydrocodone ndi acetaminophen)
• Dilaudid (hydromorphone)
• morphine

Ngakhale ndizothandiza kuthana ndi ululu, mankhwalawa amatha kuyambitsa kudalira thupi komanso kusuta. Malinga ndi National Institute on Drug Abuse, pafupifupi anthu 2.1 miliyoni ku United States komanso pakati pa 26.4 ndi 36 miliyoni padziko lonse lapansi amamwa ma opioid.

Mankhwala ena oletsedwa, monga heroin, nawonso ndi ma opioid. Methadone ndi opioid yomwe nthawi zambiri imaperekedwa kuti ithetse ululu, koma itha kugwiritsidwanso ntchito kuthana ndi zizindikiritso za anthu omwe asiya kugwiritsa ntchito ma opioid.

Mukayimitsa kapena kuchepetsa kuchuluka kwa ma opioid omwe mukumwa, mutha kukhala ndi zizindikilo zakuthupi zakusiya. Izi ndizowona makamaka ngati mwakhala mukugwiritsa ntchito mankhwalawa pamlingo waukulu kwa milungu yoposa ingapo. Machitidwe ambiri m'thupi lanu amasinthidwa mukatenga ma opioid ambiri kwakanthawi. Zotsatira zakubwezeretsa zimachitika chifukwa zimatenga nthawi kuti thupi lanu lizolowere kusakhalanso ndi ma opioid m'dongosolo lanu.

Kuchotsa kwa opioid kumatha kugawidwa m'magulu ochepetsa, ochepa, owopsa, komanso ovuta. Wothandizira wanu wamkulu angazindikire izi pofufuza momwe mumagwiritsira ntchito opioid mbiri ndi zizindikilo zanu, ndikugwiritsa ntchito zida zodziwira ngati Clinical Opiate Withdrawal Scale.

Kodi ma opioid amakhudza bwanji thupi?

Opioids amadziphatika ku opioid receptors muubongo, msana, komanso m'mimba. Nthawi zonse ma opioid akamagwirizana ndi ma receptors awa, amakhala ndi zotsatira zake. Ubongo umapanga ma opioid ake omwe, omwe amachititsa mavuto ambiri, kuphatikiza kuchepa kwa kupweteka, kutsitsa kupuma, komanso kuthandizira kupewa kukhumudwa ndi nkhawa.

Komabe, thupi silimapanga ma opioid ochulukirapo - ndiye kuti, okwanira kuthana ndi ululu wophatikizidwa ndi mwendo wosweka. Komanso, thupi silimatulutsa ma opioid ochulukirapo okwanira kuti apange bongo. Mankhwala opioid ndi mankhwala osokoneza bongo amatsanzira ma opioid achibadwawa.

Mankhwalawa amatha kukhudza thupi m'njira zingapo:

• Opioids imatha kukhudza ubongo, womwe umawongolera ntchito monga kupuma ndi kugunda kwa mtima, pochepetsa kupuma kapena kuchepetsa kutsokomola.
• Opioids amatha kugwira ntchito m'malo ena am'magazi omwe amadziwika kuti limbic system, omwe amawongolera momwe akumvera, kuti apange chisangalalo kapena kupumula.
• Opioids amagwira ntchito kuti achepetse ululu pokhudzana ndi msana, womwe umatumiza mauthenga kuchokera kuubongo kupita ku thupi lonse, komanso mosemphanitsa.

Nchiyani chimayambitsa kuchotsedwa kwa opioid?

Mukamamwa mankhwala a opioid kwa nthawi yayitali, thupi lanu limakhala losavomerezeka pazotsatira zake. Popita nthawi, thupi lanu limafunikira mankhwala ochulukirapo kuti akwaniritse zomwezo. Izi zitha kukhala zowopsa ndikuwonjezera chiopsezo chanu chodzetsa bongo mwangozi.

Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kumasintha momwe mapulogalamu amitsempha amagwirira ntchito muubongo wanu, ndipo olandilawa amadalira mankhwalawa kuti agwire ntchito. Mukadwala mutasiya kumwa mankhwala opioid, mwina ndi chisonyezo choti mumadalira mankhwalawo. Zizindikiro zobwerera ndikuthupi kwakomwe thupi limachita pakalibe mankhwala.

Anthu ambiri amadalira mankhwalawa kuti apewe zowawa kapena kusiya. Nthawi zina, anthu samazindikira ngakhale kuti akhala odalira. Amatha kulakwitsa kuchoka pazizindikiro za chimfine kapena vuto lina.

Kodi zizindikiro zakutha kwa opioid ndi ziti?

Zizindikiro zomwe mumakumana nazo zimatengera kuchuluka kwa momwe mukumvera posachedwa. Komanso, zinthu zingapo zimalamulira kuti munthu azikhala ndi nthawi yayitali bwanji atasiya. Chifukwa cha ichi, aliyense amakumana ndi kuchotsedwa kwa opioid mosiyana. Komabe, nthawi zambiri pamakhala nthawi yofananira kwakukula kwa zizindikilo.

Zizindikiro zoyambirira zimayamba m'maola 24 oyamba mutasiya kugwiritsa ntchito mankhwalawa, ndipo zimaphatikizapo:

• kupweteka kwa minofu
• kusakhazikika
• nkhawa
• kuphulika (maso akung'ambika)
• mphuno
• thukuta kwambiri
• kulephera kugona
• kuyasamula pafupipafupi

Zizindikiro zamtsogolo, zomwe zimatha kukhala zazikulu kwambiri, zimayamba pambuyo pa tsiku loyamba kapena apo. Zikuphatikizapo:

• kutsegula m'mimba
• kuphwanya m'mimba
• tsekwe ziphuphu pakhungu
• nseru ndi kusanza
• kuchepa kwa ana komanso mwina kuwona masomphenya
• kugunda kwamtima mwachangu
• kuthamanga kwa magazi

Ngakhale ndizosasangalatsa komanso zopweteka, zizindikilo zimayamba kuwonjezeka mkati mwa maola 72, ndipo mkati mwa sabata muyenera kuzindikira kuchepa kwakukulu kwa zizindikilo zoopsa za kusiya opiate.

Ana obadwa kwa amayi omwe amamwa kapena omwe adagwiritsa ntchito ma opioid ali ndi pakati nthawi zambiri amakhala ndi zizindikiritso za kusiya. Izi zingaphatikizepo:

• zovuta zam'mimba
• kusadya bwino
• kusowa kwa madzi m'thupi
• kusanza
• kugwidwa

Ndikofunika kukumbukira kuti mankhwala osiyanasiyana amakhalabe m'dongosolo lanu nthawi yayitali ndipo izi zimatha kukhudza kuyambiranso. Nthawi yomwe zizindikiro zanu zimatha zimadalira kugwiritsidwa ntchito pafupipafupi komanso kuopsa kwake, komanso zinthu zina monga thanzi lanu lonse.

Mwachitsanzo, heroin imachotsedwa mwachangu m'dongosolo lanu, ndipo zizindikilo zimayamba pakadutsa maola 12 mutagwiritsa ntchito. Ngati mwakhalapo pa methadone, zingatenge tsiku ndi theka kuti zizindikilo ziyambe.

Akatswiri ena amati kuchira kumafuna nthawi yochepera miyezi isanu ndi umodzi yakulera, pomwe munthuyo amatha kukhala ndi zizindikilo zakuti wasiya. Nthawi zina amatchedwa "kudziletsa kwakanthawi." Ndikofunika kuti mukambirane za zomwe zikuchitika nthawi zonse ndi omwe amakuthandizani.

Kodi kuchotsedwa kwa opioid kumapezeka bwanji?

Kuti mupeze kuchotsedwa kwa opioid, woyang'anira wanu wamkulu amayesa ndikufunsani mafunso pazokhudzana ndi zomwe mukudwala. Angathenso kuyitanitsa kuyesa kwamkodzo ndi magazi kuti muwone ngati kuli ma opioid m'dongosolo lanu.

Mutha kufunsidwa mafunso okhudza kugwiritsa ntchito mankhwala osokoneza bongo m'mbuyomu komanso mbiri yanu yazachipatala. Yankhani poyera komanso moona mtima kuti mulandire chithandizo ndi chithandizo chabwino kwambiri.

Ndi mankhwala ati omwe amapezeka kuti achotse opioid?

Kuchotsa ma opioid kumatha kukhala kosasangalatsa, ndipo anthu ambiri amapitiliza kumwa mankhwalawa kuti apewe zizindikilo zosasangalatsa, kapena amayesetsa kuthana ndi izi pazokha. Komabe, chithandizo chamankhwala m'malo olamulidwa chingakupangitseni kukhala omasuka ndikubweretsa mwayi wabwino wopambana.

Kuchotsa pang'ono kumatha kuchiritsidwa ndi acetaminophen (Tylenol), aspirin, kapena mankhwala osagwiritsa ntchito anti-inflammatory (NSAIDs) monga ibuprofen. Madzi ambiri ndi kupumula ndizofunikira. Mankhwala monga loperamide (Imodium) amatha kuthandiza kutsekula m'mimba ndi hydroxyzine (Vistaril, Atarax) kumachepetsa nseru.

Zizindikiro zowononga kwambiri zimatha kufunikira kuchipatala ndi mankhwala ena. Mankhwala amodzi omwe amagwiritsidwa ntchito makamaka m'malo ogona ndi clonidine. Clonidine amatha kuthandiza kuchepetsa kukula kwa zizindikiritso zakudzipatula ndi 50 mpaka 75%. Clonidine ndiwothandiza kwambiri pakuchepetsa:

• nkhawa
• kuphwanya
• kupweteka kwa minofu
• kusakhazikika
• thukuta
• misozi
• mphuno

Suboxone ndiphatikizira opioid yolimba (buprenorphine) ndi opioid blocker (naloxone) yomwe siyimatulutsa zovuta zambiri zama opioid ena. Opioid blocker imagwira ntchito makamaka m'mimba kupewa kudzimbidwa. Ngati jekeseni imayambitsa kuchotsedwa msanga, motero kuphatikiza sikungazunzidwe kuposa mitundu ina. Mukamwa pakamwa, kuphatikiza uku kungagwiritsidwe ntchito kuthana ndi zizindikiritso zakutha ndipo kumatha kufupikitsa mphamvu ndi kutalika kwa detoxification kuchokera kumaopioid ena owopsa, owopsa.

Methadone itha kugwiritsidwa ntchito pochiza kwanthawi yayitali. Adakali opioid yamphamvu, koma imatha kuchepetsedwa mwanjira yolamuliridwa yomwe imatha kutulutsa zizindikilo zazikulu zakutha.

Kuchotsa msanga msanga sikuchitika kawirikawiri. Zimachitika pansi pa dzanzi ndi mankhwala oletsa opioid, monga naloxone kapena naltrexone. Pali umboni wina wosonyeza kuti njirayi imachepetsa zizindikiro, koma sizimakhudza kuchuluka kwa nthawi yomwe mumathera mukuchoka. Kuphatikiza apo, kusanza nthawi zambiri kumachitika pakutha, ndipo kuthekera kwa kusanza komwe kumachitika chifukwa cha mankhwala ochititsa dzanzi kumawonjezera ngozi zakufa. Chifukwa cha izi, madokotala ambiri amazengereza kugwiritsa ntchito njirayi, chifukwa zoopsa zake zimaposa phindu lomwe lingachitike.

Kodi zovuta zakutha kwa opioid ndi ziti?

Nsautso ndi kusanza zitha kukhala zizindikilo zazikulu pakutha. Kupuma mosazindikira kwa zinthu zosanza m'mapapu (zotchedwa aspiration) kumatha kukhala vuto lalikulu lomwe limakhudzana ndikusiya, chifukwa kumatha kubweretsa chibayo (aspiration pneumonia).

Kutsekula m'mimba ndichizindikiro china chosasangalatsa komanso chowopsa chosiya. Kutaya madzi ndi ma electrolyte ochokera m'mimba kumatha kupangitsa mtima kugunda modzidzimutsa, zomwe zimatha kubweretsa zovuta m'mitsempha komanso ngakhale matenda amtima. Ndikofunika m'malo mwa madzi omwe ataya kusanza ndi kutsegula m'mimba kuti mupewe zovuta izi.

Ngakhale simukusanza, kunyansidwa kungakhale kosavomerezeka. Zilonda zam'mimba ndi zowawa pamalumikizidwe zitha kukhalaponso panthawi yochotsa opioid. Nkhani yabwino ndiyakuti wothandizira wanu wamkulu amatha kugwira nanu ntchito popereka mankhwala omwe angakuthandizeni kuthana ndi zovuta za kusiya.

Ndikofunikanso kudziwa kuti anthu ena atha kukhala ndi zina zomwe achita sizikupezeka apa. Ichi ndichifukwa chake ndikofunikira kuti mugwire ntchito limodzi ndi omwe amakupatsani chisamaliro choyambirira munthawi yosiya.

Kodi ndingayembekezere chiyani pakapita nthawi?

Ngati mwasiya kumwa mankhwala a opioid ndipo mukukumana ndi zizindikiritso zakutha, pitani kuchipatala posachedwa. Dokotala wanu amatha kuthandizira kuthana ndi zizolowezi ndikusintha mtundu wamankhwala anu. Simuyenera kusiya kumwa mankhwala opioid popanda kufunsa dokotala.

Kufunafuna chithandizo cha chizolowezi cha opioid kumakulitsa thanzi lanu lonse ndikuchepetsa chiopsezo chanu chobwereranso, kumwa mopitirira muyeso, komanso zovuta zokhudzana ndi chizolowezi cha opioid. Lankhulani ndi dokotala wanu kapena wothandizira zaumoyo za mapulogalamu kapena magulu othandizira m'dera lanu. Kukula kwathunthu kwakuthupi ndi kwamaganizidwe oyenera ndikumapweteka komanso kusapeza bwino pakutha.