Binciken Mafi kyawun Opioid da Ƙananan Zaɓuɓɓuka Hoto
Magunguna jinsin magungunan da ake amfani dasu don taimakawa wajen analgesia (zafi). Suna aiki ta hanyar hana sakonni masu zafi zuwa kwakwalwa ko kuma tsangwama da fassarar ƙwararrun ƙwararrun sakonni. Ana gwada jita-jita kamar yadda ba shi da wani magungunan (non narcotic) ko magunguna na nariootic).
Non-Opioid Analgesics
Wadanda ba za su yi amfani da su ba ne a cikin kashi uku: cututtuka masu tsauraran kwayoyi , masu maganin anti-inflammatory (NSAIDs) , da masu maganin COX-2.
Duk da yake kowannensu yana da nau'i daban-daban na aiki, suna aiki ta hanyar hana wani nau'in enzyme da ake kira cyclooxygenase, ko COX. Akwai nau'o'i daban-daban na wannan enzyme, COX-1 da COX-2, dukansu suna da alhakin haifar da ƙonewa da ciwo a cikin maganin rauni.
Daga cikin nau'ikan iri uku wadanda ba su da magungunan marasa lafiya:
- Acetaminophen (wanda aka fi sani da paracetamol) yana daga cikin wadanda aka fi sani da analgesics a duniya a yau. Duk da yake mutane za su san shi da yawa ta hanyar iri iri Tylenol, wanda ke aiki a cikin daruruwan matakan sanyi, sinus, da magungunan mura. Acetaminophen yana bayar da maganin analgesic da antipyretic (zazzafar cutar) amma ba ya bi kumburi. Duk da yake aikin aikinsa bai fahimta bane, yana nufin ya hana aiki na COX cikin kwakwalwa da tsarin kulawa na tsakiya kawai. Babban sakamako na hanta shi ne haɗari mai haɗari wanda ya haifar da tawaye. Bisa ga Cibiyar Abinci da Drugurma na Amurka (FDA), yau da kullum an sami ciwon hanta a Amurka, musamman ma tsakanin masu shan giya ko mutane waɗanda suke yin amfani da kwayoyi masu amfani da kwayoyin tumo da ke dauke da acetaminophen.
- Magungunan anti-inflammatory kwayoyi (NSAIDs) sune magungunan miyagun ƙwayoyi wanda ya hada da irin waɗannan abubuwa kamar Advil (ibuprofen), Aleve (naproxen), da Bayer (aspirin). Kamar yadda acetaminophen, ana samun NSAIDs a wasu nau'o'i daban-daban ciki har da kwayoyi, syrups, da alamu. Duk da haka, ba kamar acetaminophen ba, NSAIDs suna hana COX-1 da COX-2 ba kawai a cikin tsarin kulawa na tsakiya ba amma sauran sassan jiki, kazalika. Wannan faɗakarwa aikin yana taimakawa, a sashi, zuwa kwayoyi 'analgesic, anti-mai kumburi, da kuma antipyretic effects. Duk da haka, wannan nau'in na iya rage yawan amfanin da COX yake ciki a ciki. A sakamakon haka, sakamakon illa kamar lalacewa, tashin zuciya, da ulcers ba sananne ba ne. Banda aspirin, NSAIDs na iya kara yawan haɗarin ciwon zuciya da bugun jini a cikin mutane da tarihin cututtukan zuciya.
- Masu haɓaka COX-2 sune asusun na NSAIDs wanda a yau ya haɗa da miyagun ƙwayoyi guda ɗaya na FDA, Celebrex (celecoxib) . Kamar yadda sunan, masu hana masu kwakwalwan COX-2 suna kare kawai murfin COX-2, rage ragewa da ƙumburi ba tare da haifar da sakamakon illa gastrointestinal. Duk da haka, a matsayin magungunan miyagun ƙwayoyi, an san su don ƙara yawan ciwon zuciya ta kashi 40 cikin 100. A sakamakon haka, an yi watsi da mujallar Vioxx (Rofecoxib) a shekarar 2005, bayan da aka kashe wasu masu kwantar da hankalin COX-2. A bangarenta, Celebrex ya kasance daya daga cikin magunguna mafi kyau a cikin Pfizer pharmaceutical fayil.
Opioid Analgesics
Abun magani na Opioid wani nau'i ne na maganin miyagun ƙwayoyi da ke aiki ta hanyar daura ga masu kamuwa da opioid da ke cikin tsarin juyayi da gastrointestinal tract. Wadannan masu karɓar bawai kawai sun tsara wasu ayyuka na somatic irin su ciwo ba , kuma suna da alhakin haifar da cututtukan da suka shafi psychoactive (sabuntawa) wadanda ke hade da kwayoyi masu opioid.
Ana amfani da kwayoyi na Opioid don taimakon jinya, maganin cutar, da kuma magance buri. Ba su da alaka da maye gurbin kwayoyin cutar ko haifar da wani sakamako masu illa da yawanci ya haɗa da NSAIDs.
Yayin da lafiya lokacin da aka yi amfani dasu, opioids na iya haifar da lalata, tashin zuciya, maƙarƙashiya, maye gurbin jiki (numfashi marar hauka), kuma akwai wasu.
Wannan shi ne ainihin gaskiya ga tsofaffi waɗanda suka fi dacewa da waɗannan sakamakon.
Bugu da ƙari, amfani da dogon lokaci yana haɗari da haɗarin ƙwayar miyagun ƙwayoyi (inda ƙwayar miyagun ƙwayoyi ke ɓacewa), dogara (jaraba), da kuma janyewa. A sakamakon haka, yawancin kwayoyi masu amfani da kwayoyi masu sarrafa kwayoyi suna sarrafawa wadanda ke buƙatar takardar likita. A cewar wani rahoto daga Cibiyoyin Kula da Cututtuka da Cututtuka, kamar yadda kimanin miliyan biyu na Amirkawa suka kamu da kwayoyi masu amfani da kwayoyi.
Akwai nau'o'i uku na ƙwayoyi masu amfani da kwayoyi masu amfani da su don magance ciwo:
- Opiate alkaloids ne irin kwayoyi da aka samo mahaukaci da aka samo a cikin opium poppy shuka Papaver somniferum . Abokan mahaɗin da aka gano a opium sun hada da morphine da codeine. Dukkanansu suna aiki ne a kan kwayar cutar ta tsakiya don rage yawan jin zafi. Rashin rashawa, haskakawa, zubar da jini, da kuma maƙarƙashiya sune tasiri. Yayin da aka sani morphine ya zama babban jaraba, codeine kuma yana da yiwuwar kawar da bayyanar cututtuka idan an yi amfani da shi. Codeine kuma ita ce kawai opioid da aka haɗa a cikin magunguna masu yawa (yawancin tari maganin syrups-tare da NSAID).
- Sannan sun hada da kwayoyin halitta kamar sunadarin Oxycontin (oxycodone) da Vicodin (hydrocodone) . Ana amfani da Oxycodone zuwa matsanancin matsananciyar zafi (ciki har da ciwon daji ko ciwo mai tsanani) kuma an dauke shi sosai. A gefensa, an gurfanar da hydrocodone fiye da kowane magani na opioid a Amurka, bisa ga rahoto na shekara ta 2014 daga Cibiyar Nazarin Harkokin Kiyaye ta Duniya. Wadannan kwayoyi masu karfi zasu iya amfani dashi don jin dadi na dan lokaci, amma, kamar yadda Jigilar II ya yi, yana buƙatar kula da lafiya na kusa.
- An yi cikakken hoton opioids a cikin lab don aiwatar da aikin haɗakar mai karɓa kamar yadda ake kira opiates na halitta. Sun haɗa da ciwon daji da kuma buprenorphine (wanda ake amfani da su don biyan maganin tarkon) da tramadol (an yi amfani dasu akai-akai don jin zafi). Duk da yake an dauke su da ƙananan ƙwayar cuta fiye da sauran kwayoyi masu amfani da kwayoyi, an san mutanen da suka bunkasa dogara idan an yi amfani da su na tsawon lokaci.
Kalma Daga
Harkokin bincike na iya zama mai tasiri sosai wajen sarrafa ciwo na arthritis kuma an yi amfani da shi lafiya in an dauka kamar yadda aka tsara. Yayinda mafi yawan likitoci zasu mayar da hankali ga magungunan marasa magani don magani, akwai lokuta masu tsanani, zafi mai tsanani zai iya buƙatar magunguna masu karfi . Wannan zai zama don sauƙi na gajeren lokaci don kauce wa kowane hadarin dogara.
Bugu da ƙari, har yanzu ba a bayyana yadda tasiri masu amfani da ƙananan kwayoyin halitta suke ba idan aka kwatanta da wasu nau'in farfadowa marasa lafiya. Saboda haka, idan kana da tsanani, rashin jin ciwon ciwon maganin arthritis, ka yi la'akari da saduwa da likita mai kula da cutar shan wahala wanda zai iya magana da kai ta hanyar jigilar hanyoyin da kake da ita, da magunguna da kuma marasa magani.
> Sources:
> Cibiyoyin Kula da Cututtuka da Cututtuka. "Muhimmiyar alamun: Bambanci Daga cikin jihohin da aka kwatanta da raunin Opioid da kuma Benzodiazepines-Amurka, 2012." MMWR . 2014; 63 (26); 563-568.
> Cicero, J. Ellis, M .; Surratt, H. et al. "Hanyoyin da ke tasiri na zaɓi na hydrocodone da oxycodone a matsayin masu amfani da magunguna a cikin masu amfani da zalunci a Amurka." PAIN. 2013; 154 (12): 2639. DOI: 10.1016 / j.pain.2013.07.025.
> Cibiyar Kasa ta Kasa ta Kasa ta Drug. "Abincin Yammacin Amurka ga Opioids: Heroin da Abuse Drug Abuse." Washington, DC; bayar da Mayu 14, 2014.
> Yoon, E; Babar, A .; Choudhary, M. et al. "Harkokin Harkokin Cutar Guda-Tsarin Halitta: Tsarin Mulki.". Journal of Clinical da translational hepatology . 2016; 4 (2): 131-42. DOI: 10.14218 / JCTH.2015.00052.