Opioids (ko opiates) sune magungunan kwayoyi da aka yi daga opopodin poppy, ko an hada su da haɗuwa don aiki kamar wadannan "halittu" opioids. Ayyukan Opioids ta hanyar daura ga masu karɓa mai gina jiki musamman a cikin kwakwalwa da kashin baya, yana da muhimmanci rage ƙananan siginar da aka aika zuwa kwakwalwa, da kuma rage ambaliyar jin zafi.
Opioids sun dade suna taka muhimmiyar rawa wajen maganin magani a matsayin hanya mai iko na sarrafawa.
Duk da haka, opioids na iya haifar da matsaloli mai tsanani. Wadannan kwayoyi suna da jaraba sosai. A hakikanin gaskiya, jaraba da maganin maganin takardar maganin kwayoyi da kuma yin amfani da wariyar launin fata (babba, heroin) ya zama babbar matsalar al'umma. Rashin jima'i na Opioid yana haifar da annoba na mutuwar haɗari. A Amurka, an kashe fiye da mutane 30,000 daga cututtuka na opioid a 2015 kawai, a cewar NIH. Bugu da kari, cinikayya a cikin opioids yana haifar da talauci, aikata laifuka, tarwatsa iyalai, da sauran rudani na al'umma.
Bugu da ƙari, opioids na iya haifar da matsalolin rikice-rikice har ma a cikin mutanen da suke daukar su a hankali a karkashin kulawar likita. Irin waɗannan matsaloli sun hada da ƙwarewar jiki, tarwatsawa, rashin aiki na iya aiki, hadari da raunin da ya faru, ciwon urinary, da matsalolin zuciya.
Matsalar zuciya da aka gani tare da opioids ba sanannun mutane ba ne, ko magungunan likitoci ne. A gaskiya ma, wasu daga cikin matsalolin zuciya da ke da alaka da opioids an gane su yanzu.
Duk da haka, ga mutanen da suka bunkasa matsalolin kwakwalwa na kwayoyin cuta, waɗannan batutuwa zasu iya samun tasiri sosai akan lafiyar jiki. Mutanen da suke amfani da opioids a lokaci-lokaci don maganin ciwo, da kuma likitocin da suka rubuta su, ya kamata su kasance da masaniya game da hadarin zuciya.
Amfani da Opioids a Magunguna
Opioids suna da amfani sosai wajen sarrafa ciwo mai tsanani da ke haifar da yanayin kiwon lafiya na lokaci, kamar raunuka karya ko jin zafi na baya bayanan, da kuma kula da cutar da ke fama da matsalolin maganin matsalolin magance matsalolin, musamman magungunan ciwon daji.
A cikin waɗannan yanayi opioids suna da tasirin gaske, kuma (saboda amfani da su a waɗannan yanayi shine iyakance lokaci) haɗarin da ake haɗuwa da yin amfani da su ƙananan.
Hakanan za su iya tasiri wajen magance matsalolin da ba su da tsanani kuma mafi yawan ciwo mai tsanani, amma yin amfani da wannan irin ciwo yana da matsala sosai . Yin amfani da kayan aiki na zamani zai iya haifar da zalunci da jaraba. Wannan yana da alaka da gaskiyar cewa opioids suna nuna yanayin da ake kira "haƙuri" - wato, bayan lokaci mutane suna buƙatar girma da ƙananan samfurori na opioids don cimma daidaito iri daya da aka fara samu tare da ƙananan dosin. Tabbatacce da kuma karɓar "adadin" adalai na tsawon lokaci, sabili da haka, shine kalubale. Masana sun bayar da shawarar cewa idan ana amfani da opioids don magance ciwon daji ba tare da haɗuwa da ciwon daji ba, likitocin da suke kwarewa a ciwon shan wahala suna kula da su.
Ana amfani da opioids da yawa a halin yanzu a magani, ciki har da buprenorphine, codeine, fentanyl, Oxycontin, methadone, morphine, Percocet da Vicodin.
Matsalolin kiwon lafiya da aka gani tare da kwayoyin halitta
Kafin ka kwatanta matsalolin zuciya wanda za a iya haifar da opioids, zai zama mafi dacewa da lissafin abubuwan da ƙananan matsalolin da waɗannan kwayoyi zasu haifar.
Kamar yadda muka gani, yadda aikin opioids ke aiki ne ta hanyar daukan magungunan marasa lafiya na tsakiya a cikin tsakiya da na jiki, kuma ta yin hakan sun rage fahimtar jin zafi. Duk da haka, idan ana amfani da allurai masu amfani da opioids, aikin su a kan tsarin mai juyayi zai iya haifar da wasu cututtuka, ciki har da: sedation, euphoria, numfashi, rikici, rikicewa, vomiting, almajirai, da damuwa.
Mutuwa daga lalacewa da yawa a lokuta da yawa yana faruwa ne a lokacin tsigburar da aka samu, wanda motsa jiki na motsa jiki ya ɓace ƙwarai da gaske cewa numfashi yana tsayawa kawai.
Kwayar Cardiac tare da Opioids
Idan aka ba da wadannan cututtukan da ba na zuciya ba ne na opioids, bazai yi mamakin cewa yawancin matsalolin zuciya na wannan cuta sun samo asali ba.
Duk da haka, ana amfani da opioids tare da nau'o'in matsalolin zuciya, wasu kuma suna iya zama barazanar rai.
Matsanancin matsalolin da ke hade da opioids sun hada da:
Ƙunƙasar aiki na zuciya tsoka. Yayinda yake yin amfani da ƙwayar zuciya don yin aiki da karfi (wato, a kan ƙwaƙwalwa na zuciya), kwangila zai iya zamawa a yayin da aka haɗu da opioids tare da benzodiazepines (kwayoyi kamar Valium). Wannan haɗuwa ba abu ne mai ban sha'awa a cikin mutane da ke dauke da opioids ba. A cikin mutanen da ke da matsalar zuciya da ke haifar da wani rauni a cikin aikin zuciya, kamar su cardiomyopathy , haɗuwa da opioid da benzodiazepine na iya haifar da ƙetare zuciya .
Bradycardia. Bradycardia, ko jinkirtaccen zuciya, yana ganin yawanci a cikin mutane masu daukar nauyin ado. Yawancin wannan wannan jaridar ta hanyar jinkirin ɓacin cutar sinus, kamar yadda aka gani a ciwo mai rashin lafiya . Abokin daji na Opioid baya haifar da bayyanar cututtuka a hutawa, amma zai iya haifar da rashin haƙuri na motsa jiki, tun da yake zuciyar zuciya ba zata iya karuwa ba tare da motsa jiki.
Vasodilation. Rashin gyaran jini, ko gubar da jini, zai iya haifar da amfani da opioid. Wannan zubar da jini zai iya haifar da hypotension (ƙananan jini). Domin opioids ma zai iya samar da bradycardia tare da vasodilation, lokacin da mutum a kan opioids tashi tsaye da sauri za su iya samun kwatsam saukewa a cikin jini-wani yanayin da ake kira orthostatic hypotension . Tsarin tsauraran ƙwaƙwalwa na ainihi zai iya haifar da hasken wuta mai haske yayin da yake tsaye, ko ma a daidaita .
Tachycardia na Ventricular. Biyu na opioids musamman (methadone da buprenorphine) na iya haifar da wani abu a kan electrocardiogram (ECG) da ake kira QT tsawo . A wasu mutane, haɗin QT zai iya haifar da mummunar hanyar tachycardia na ventricular da ake kira torsades de pointes. Wannan nau'i na arrhythmia na zuciya yana haifar da samfurori na tsabtace haske, syncope, ko ma mutuwa ta kwatsam.
Atrial fibrillation. Jirgin kararrawa mai saurin kararrawa , mai juyayi, wanda ba shi da alakantattun zuciya wanda ya haifar da siginar wutar lantarki a cikin zuciya (atisoshin zuciya na zuciya ), an nuna ya zama mafi yawanci a cikin mutanen da suke amfani da opioids. Mutanen da ke da alamar dabarar da ke tattare da kwayar cutar suna da mummunar tasiri na ciwon bugun jini , kuma yiwuwar haɗarin zuciya .
M endocarditis. Rashin endocarditis mai cututtuka shine kamuwa da rayukan zuciya na kwakwalwar zuciya, ko sauran sifofin zuciya. Wannan matsala ne wanda ba a sani ba, wadda, yawanci, tana nunawa a cikin tsofaffi da ƙwayar cuta mai kwakwalwa . A cikin 'yan shekarun nan, duk da haka, an gano cutar cututtuka na ƙwayar cuta a cikin yawancin matasa fiye da kowane lokaci-musamman ma matasa, mata masu farin. Lambar mabiya tsakanin wadannan matasa tare da endocarditis shine sunyi amfani da opioids mai tsanani, musamman heroin. Cutar cutocarditis mai cututtuka yana da mummunan ƙimar mutuwa, kuma yawancin wadanda suka tsira suna da yawancin ciwon zuciya na zuciya.
Opioid janyewa. Rigawar Opioid zai iya shafar tsarin kwakwalwa, amma wadanda basu da kyakwalwa na zuciya sun kasance mafi shahararren (musamman rashin tausin zuciya, ƙwaƙwalwar ƙyama da hanci mai haɗari, ƙuƙwalwa mai raɗaɗi da haɗin gwiwa, tashin zuciya, vomiting da zawo). Zuciyar sauri da hawan jini yana shafe tare da cirewar cirewa, amma waɗannan alamun basu da mahimmanci yayin da suke tare da maye gurbin shan barasa. Duk da haka, zubar da cututtuka da cututtukan da ake haifarwa ta hanyar cirewa na opioid zai iya haifar da jin dadi, ƙananan jini, da hasken wuta ko syncope. Bugu da ƙari kuma, idan an cire ragowar opioid mai sauri ta hanyar ba da magani na magungunan opioid irin su naloxone (Narcan) (wanda shine hanyar ceton rayayye idan an samarda overdose), tashin hankali a cikin adrenaline na iya haifar da rashin lafiyar zuciya.
Kashi na jini na zuciya. Wani binciken da aka buga a Journal of the American Medical Association a 2016 ya yi mamaki da damuwa da al'umma ta hanyar bayar da rahoton cewa, daga cikin wadanda ke samun maganin maganin likita don ciwo marasa ciwon daji, an sami karuwa sosai a cikin mutuwar jijiyoyin jini, da mahimmancin karuwa a cikin mace-mace ba tare da haɓaka ba. Dalilin wannan ƙwayar cuta a cikin cututtuka na zuciya da jijiyoyin jini tare da maganin likitanci na opioid na yaudara ne a wannan lokaci. Ɗaya daga cikin ka'idar shine cewa yin amfani da opioid kullum na iya haifar da numfashi na rashin barci , yanayin da ke haɗuwa da arrhythmias na cardiac, ciwon zuciya, da kuma mutuwar kwatsam. Duk da haka, ana buƙatar ƙarin nazarin don tabbatar da binciken wannan binciken, da kuma yin watsi da yiwuwar haddasawa.
Takaitaccen
Kamar abubuwa masu mahimmanci, masu tsauraran kwayoyi-waɗanda sun sanya mummunar zafi mai wuya ga miliyoyin mutane - sun kasance albarka mai yawa. Bugu da ƙari, da yawa matsaloli da aka sani da amfani da opioid shine ƙananan sanannun gaskiyar cewa zasu iya samar da nau'o'in nau'in zuciya. Rashin yiwuwar matsalolin kwakwalwa shine wata dalili da cewa likitoci da marasa lafiya ya kamata su yi watsi da yin amfani da wadannan magungunan don kulawa da ciwo na kullum.
> Sources:
> Opioids: Drug & Heroin Overdose Epidemic. Ma'aikatar Lafiya da Ayyukan Dan Adam. https://www.hhs.gov/opioids/.
> Ray WA. Cjung CP, Murray KT, et al. Rubutattun Harkokin Tsarin Gudanar da Ayyuka da Mutuwa A Yanayin Marasa lafiya Ba tare da Kisa ba. JAMA. 2016; 315 (22): 2415-2423. Doi: 10.1001 / jama.2016.7789.
> {Ungiyar Harkokin Wajen {asar Amirka, tare da Harkokin Kasuwancin Amirka. Sharuɗɗa don Amfani da Tarihin Opioid na Farko a Bikin Bacin Abinci: Bincike Shaida. http://americanpainsociety.org/uploads/education/guidelines/chronic-opioid-therapy-cncp.pdf.
> Wurcel AG, Anderson JE, Chul KH, et al. Ƙara Ƙararrun Ƙungiyar Cutocarditis Ta Ciki Daga Ƙararrun Mutane da Suka Yi Magunguna. Ƙungiyar Wuraren Buɗaɗɗiyar Buga (2016) 3 (3): ofw157. DOI: https://doi.org/10.1093/ofid/ofw157