Inkingi ya Methadone: Ibyo ikoreshwa, urugero rwayo, ingaruka zayo n'ibindi

Inkingi ya methadone ni umuti ukomeye wa opioid utererwa mu mikaya yawe cyangwa mu muyoboro w'amaraso n'abashinzwe ubuzima. Ubu bwoko bwa methadone busanzwe bukoreshwa mu bitaro cyangwa ahantu hihariye havurirwa iyo utabasha gufata imiti yo kunywa cyangwa ukeneye guhumurizwa vuba.

Mugihe abantu benshi bazi methadone nk'umuti wo kunywa uvura ubujura bwa opioid, urugero rwo guterwa rwo rwo rukora ibintu byihariye by'ubuvuzi. Ni ikintu kigenzurwa kigomba gukurikiranwa na muganga bitewe n'imbaraga zayo n'ingaruka zishobora guteza ibibazo bikomeye.

Inkingi ya Methadone ni iki?

Inkingi ya methadone ni umuti wa opioid wa sintetike utererwa mu mubiri wawe unyuze mu rusinga. Abaganga bakoresha ubu buryo iyo imiti yo kunywa idashoboka cyangwa idakora neza ku miterere yawe.

Urugero rwo guterwa rukora vuba kuruta ibinini kuko ruca mu nzira y'igogora ryose. Umubiri wawe urayimira ako kanya unyuze mu muyoboro w'amaraso yawe, bitanga ubufasha bwihuse iyo bibaye ngombwa. Ibi bituma bikoreshwa cyane mu bihe by'ubutabazi cyangwa iyo udashobora kumira imiti.

Bitandukanye n'ibiyobyabwenge byo ku muhanda, inkingi ya methadone ivurwa neza kandi igatangwa n'abantu babihuguriwe. Urugero n'igihe bigenzurwa neza kugirango umutekano wawe wizerwe mugihe utanga ingaruka zivura ukeneye.

Inkingi ya Methadone ikoreshwa kubera iki?

Inkingi ya methadone ikoreshwa cyane cyane mu gucunga ububabare bukomeye iyo izindi mvura zitagikora. Abaganga basanzwe bateganya uru rugero rw'ibintu byihariye by'ubuvuzi aho imiti yo kunywa itakwemerwa.

Impamvu zisanzwe ushobora guterwa inkingi ya methadone zirimo ububabare bukabije butarashoboye gukira n'indi miti, ibihe udashobora gufata imiti yo kunywa bitewe n'ibibazo byo kubagwa cyangwa indwara, no gucunga ububabare bwihutirwa mu bitaro.

Muri gahunda zimwe zihariye zo kuvura ubuzererezi, abaganga bashobora gukoresha methadone y'urushinge igihe kuyifata mu kanwa bidashoboka. Ariko, ibi ntibisanzwe cyane nko mu kuvura ubuzererezi bwa methadone yo mu kanwa. Uburyo bwo kuyitera mu rushinge busanzwe bukoreshwa igihe izindi nzira zose zashiriye.

Ku barwayi ba kanseri bahura n'ububabare bukomeye, urushinge rwa methadone rushobora gutanga ubufasha igihe imiti yo mu kanwa itinjira neza. Ibi bishobora kubaho mugihe cya chimiothérapie mugihe isesemi no kuruka bituma imiti yo mu kanwa idashobora kuguma mu mubiri.

Methadone y'urushinge ikora ite?

Urushinge rwa methadone ni umuti ukomeye wa opioide ukora muguhuza n'uturemangingo twihariye mu bwonko bwawe no mu mugongo. Utu turemangingo, twitwa opioid receptors, tugenzura uburyo umubiri wawe wumva kandi ukagaragaza ibimenyetso by'ububabare.

Iyo methadone yihuje n'utu turemangingo, ibuza ubutumwa bw'ububabare kugera mu bwonko bwawe. Ibi bituma habaho ingaruka zikomeye zo kugabanya ububabare zishobora kumara igihe kirekire kurusha imiti myinshi ya opioide. Ingaruka zikunze gutangira mumaminota 15-30 nyuma yo kuyitera.

Igituma methadone idasanzwe ni igihe kirekire ikorera. Nubwo urushinge rukora vuba, ingaruka zayo zirashobora kumara amasaha 8-12 cyangwa se ndetse n'igihe kirekire kuri bamwe. Ubu bufasha bwiyongereye busobanura ko udakeneye inshinge nyinshi umunsi wose.

Uyu muti kandi ugira ingaruka ku buryo ubwonko bwawe buhemba, niyo mpamvu ifasha mu kuvura ubuzererezi. Ifasha gukumira ibimenyetso byo gukurwaho kandi igabanya irari ryo gukoresha ibiyobyabwenge itavuyeho ibyishimo bikabije bifitanye isano na opioide zindi iyo zikoreshejwe neza.

Nkwiriye guhabwa urushinge rwa methadone gute?

Urushinge rwa methadone rutangwa buri gihe n'abakozi b'ubuzima babihuguriwe mu bigo by'ubuvuzi. Ntabwo ushobora kandi ntugomba kugerageza kwitera uyu muti iwanyu.

Umuti w'urushinge ushobora guterwa mu mutsi (intramuscular) cyangwa mu mitsi y'amaraso (intravenous), bitewe n'uburwayi bwawe. Umuganga wawe azagena uburyo bwiza bushingiye ku burwayi bwawe n'uko ukeneye gukurwaho ububabare vuba.

Mbere yo guterwa urushinge, abaganga bazasuzuma amateka yawe yose y'uburwayi n'imiti urimo gufata. Bagomba kumenya niba ufite allergie, ibibazo byo guhumeka, cyangwa izindi ndwara ufite. Ibi bifasha kumenya niba urushinge rwa methadone rugukwiriye.

Mugihe cyo guterwa urushinge, uzagenzurwa cyane kugirango barebe niba nta ngaruka mbi zigira. Abaganga bazagenzura guhumeka kwawe, umuvuduko w'umutima, n'umuvuduko w'amaraso buri gihe. Ibi bikorwa nyuma y'amasaha menshi nyuma yo guterwa urushinge kuko ingaruka za methadone zimara igihe kirekire.

Ugomba kuguma mu kigo cy'ubuvuzi kugirango ukurikiranwe nyuma yo guterwa urushinge rwa methadone. Abaganga bagomba kumenya niba urimo kwakira neza umuti kandi niba nta ngaruka mbi zigira.

Nzamara igihe kingana gute nterwa urushinge rwa Methadone?

Igihe cyo kuvurwa na methadone giterwa n'uburwayi bwawe n'uburyo umubiri wawe wakiriye umuti. Umuganga wawe azagena igihe uzamara uvurwa bitewe n'uko ubuzima bwawe bumeze.

Mugihe cyo kuvura ububabare bukaze, ushobora guterwa inshinge mu minsi mike uri mu bitaro. Niba ushobora kongera gufata imiti yo kunywa, muganga wawe ashobora kuguha imiti yo kunywa cyangwa ubundi buryo bwo kuvura ububabare.

Mu gihe cy'ububabare buhoraho bukaze, gahunda yo guterwa urushinge irashobora gukomeza, ariko abaganga bazagenzura buri gihe niba iyi ariyo nzira nziza kuri wowe. Bazatekereza ku bintu nk'ububabare ufite, ingaruka z'umuti, n'uko ubuzima bwawe muri rusange bumeze.

Umuvuzi wawe ntazigera ahagarika gutera methadone ako kanya niba warayihabwaga buri gihe. Bazakora gahunda yo kugabanya buhoro buhoro kugira ngo birinde ibimenyetso byo gukurwaho. Ubu buryo, bwitwa tapering, bufasha umubiri wawe kumenyera neza kugabanya ingano y'umuti.

Ni Ibihe Bikorwa Bigaragara Byo Guterwa Methadone?

Guterwa methadone bishobora gutera ibikorwa bigaragara kuva ku byoroheje kugeza ku bikomeye. Kumva ibi bikorwa bishobora gutuma umenya icyo witegura n'igihe cyo gushaka ubufasha bw'ubuvuzi.

Ibikorwa bigaragara cyane ushobora guhura nabyo birimo gusinzira, isesemi, kubura umwanya, no kuribwa umutwe. Ibi bikorwa mubisanzwe birashobora gucungwa kandi bishobora kuzamura uko umubiri wawe umenyera umuti.

Dore ibikorwa bigaragara kenshi abantu benshi bahura nabyo:

• Gusinzira no kunanirwa
• Isesemi no kuruka
• Kubura umwanya
• Kuribwa umutwe cyangwa kumva uruhuka
• Kuvuza ibyuya
• Umunwa wumye
• Kuribwa umutwe

Ibi bikorwa bisanzwe mubisanzwe ni iby'igihe gito kandi birashobora gucungwa n'ubufasha buva mu ikipe yawe y'ubuvuzi.

Ibikorwa bikomeye bisaba ubufasha bw'ubuvuzi bwihutirwa kandi birimo ibibazo byo guhumeka, ibikorwa bikomeye byo kwanga umuti, no guhinduka kw'umutima. Ibi ntibisanzwe ariko bishobora guteza akaga.

Ibikorwa bikomeye bisaba ubufasha bwihutirwa birimo:

• Guhumeka gahoro cyangwa bigoye
• Kuribwa umutwe cyane cyangwa guta ubwenge
• Umutima utagenda neza
• Ibikorwa bikomeye byo kwanga umuti (uruhu rurashya, kubyimba, kugorana guhumeka)
• Kuvurungana cyangwa imyitwarire idasanzwe
• Gufatwa n'ibihungabanyo

Niba uhuye n'ikimenyetso icyo aricyo cyose muri ibi bikomeye, ikipe yawe y'ubuvuzi izafata ingamba ako kanya kugira ngo yemeze umutekano wawe.

Hari ibibazo bike ariko bikomeye bishobora kuvuka iyo umuntu aterwa methadone, cyane cyane iyo imaze igihe kinini ikoreshwa. Ibyo birimo guhumeka bigenda gake (guhumeka gake cyane), indwara z'umutima (umutima utera nabi), n'ibimenyetso bikomeye byo kuva mu biyobyabwenge iyo umuti uhagaritswe ako kanya.

Guhumeka bigenda gake ni kimwe mu bibazo bikomeye bishobora kuvuka, cyane cyane ku bantu bafite ibibazo byo guhumeka. Itsinda ry'abaganga bakurikirana ibi byegereye, cyane cyane mu masaha make ya mbere nyuma yo guterwa urushinge.

Ninde utagomba guterwa urushinge rwa methadone?

Abantu bamwe ntibagomba guterwa urushinge rwa methadone kubera ibyago byiyongereye byo guhura n'ibibazo bikomeye. Muganga wawe azasuzuma neza amateka yawe y'ubuzima mbere yo gutekereza kuri ubu buvuzi.

Ntugomba guterwa urushinge rwa methadone niba ufite ibibazo bikomeye byo guhumeka, indwara zimwe na zimwe z'umutima, cyangwa allergie zizwi kuri methadone. Abantu bafite indwara zikomeye z'umwijima cyangwa ibibazo by'impyiko nabo bashobora gukenera ubuvuzi bundi.

Ibyo bikorwa byihariye bisanzwe bibuza gukoresha urushinge rwa methadone birimo:

• Asima ikomeye cyangwa indwara y'ubuhumekero idakira (COPD)
• Uburwayi bukomeye bw'umutima
• Allergie izwi kuri methadone cyangwa imiti isa nayo
• Kunanirwa gukora kw'umwijima
• Paralytic ileus (inzira y'igifu yazibye)
• Urukomere rukomeye rwo mu mutwe hamwe no kwiyongera k'umuvuduko mu bwonko

Ibi bibazo byongera cyane ibyago byo guhura n'ibibazo biteye ubuzima bwawe inkeke biturutse ku guterwa urushinge rwa methadone.

Abagore batwite bakeneye kwitabwaho by'umwihariko mbere yo guterwa urushinge rwa methadone. N'ubwo methadone ishobora gukoreshwa mu gihe cyo gutwita mu kuvura ubujura bw'ibiyobyabwenge, urushinge rukenera isuzuma ryitondewe ry'inyungu n'ibibazo. Itsinda ry'abaganga bazatekereza ku buzima bwawe n'ubuzima bw'umwana wawe.

Abantu bageze mu zabukuru n'abafite indwara nyinshi bagomba kwitonda cyane bakoresha urushinge rwa methadone. Bashobora kuryumva cyane kandi bagasaba doze ntoya cyangwa gukurikiranwa kenshi.

Amazina y'ubwoko bw'urushinge rwa Methadone

Methadone y'urushinge iboneka mu mazina menshi y'ubwoko, nubwo kandi isanzwe iboneka nk'umuti rusange. Izina ry'ubwoko rizwi cyane ni Dolophine, iza mu ishusho y'urushinge rukoreshwa mu buvuzi.

Andi mazina y'ubwoko bwa methadone y'urushinge arimo Methadose n'uburyo butandukanye rusange. Umuganga wawe azahitamo ubwoko bwihariye cyangwa verisiyo rusange hashingiwe ku kuboneka n'ibyo ukeneye mu buvuzi.

Ibicuruzwa byose byemewe na FDA bya methadone y'urushinge bikubiyemo ikintu kimwe gikora kandi bikora kimwe. Guhitamo hagati y'izina ry'ubwoko na verisiyo rusange mubisanzwe biterwa n'ibyo ikigo cyawe cy'ubuvuzi gishaka n'ibitekerezo by'ikiguzi.

Tutitaye ku izina ry'ubwoko, inshinge zose za methadone zigomba kubikwa no gutangwa hakurikijwe amabwiriza akomeye y'ubuvuzi. Ibi bituma wakira doze nziza kandi ikora neza buri gihe.

Uburyo bwo gusimbuza urushinge rwa Methadone

Hariho uburyo bwinshi bwo gusimbuza urushinge rwa methadone mu gucunga ububabare no kuvura ubujura. Umuganga wawe azatekereza izi nzira hashingiwe ku byo ukeneye mu buvuzi n'imimerere yawe.

Mu gucunga ububabare, uburyo bwo gusimbuza burimo ibindi byinshi by'urushinge nka morphine, fentanyl, cyangwa hydromorphone. Iyi miti ikora kimwe ariko ifite igihe kirekire cyo gukora n'ingaruka zitandukanye.

Uburyo bwo gusimbuza butari bwa opioid bwo gucunga ububabare burimo:

• Imiti irwanya umubiri y'urushinge
• Guhagarika imitsi hamwe n'imiti y'agace
• Kwinjiza Ketamine kubera ububabare bukomeye
• Pompe za analgesia zigenzurwa n'umurwayi (PCA)
• Uburyo bwo gucunga ububabare bwa epidural cyangwa spinal

Izi nzira zishobora kuba zikwiriye cyane bitewe n'ubwoko bw'ububabare ufite n'amateka yawe y'ubuvuzi.

Mu kuvura ubujura, methadone yo kunywa mu kanwa iracyariyo nzira ya mbere igihe bishoboka. Izindi nzira zo kuvura zifashisha imiti zirimo buprenorphine (Suboxone) na naltrexone (Vivitrol). Iyi miti ikora mu buryo butandukanye ariko ishobora kugira akamaro mu kuvura ubujura bwa opiyoide.

Itsinda ryawe ry'ubuvuzi rizagufasha gusobanukirwa inzira zishobora gukora neza kurusha izindi mu bihe byawe. Bazatekereza ibintu nk'amateka yawe y'ubuvuzi, imiti urimo gufata ubu, n'intego zo kuvurwa mu gihe bagena ibyo bagusaba.

Ese methadone y'urushinge iruta methadone yo kunywa mu kanwa?

Niba methadone y'urushinge iruta methadone yo kunywa mu kanwa biterwa rwose n'ibihe byawe by'ubuvuzi. Buri buryo bufite inyungu zihariye kandi bukoreshwa mu bihe bitandukanye.

Methadone y'urushinge ikora vuba kurusha imiti yo kunywa mu kanwa kuko yirengagiza sisitemu yawe yo mu gifu. Ibi bituma igira agaciro mu bihe by'ubutabazi cyangwa iyo udashobora gufata imiti yo kunywa mu kanwa bitewe n'isuka, kuruka, cyangwa kugorana kumeza.

Ariko, methadone yo kunywa mu kanwa akenshi ikundwa mu kuvurwa igihe kirekire kuko itekanye kandi yoroshye. Ushobora gufata imiti yo kunywa mu kanwa uri mu rugo ufashijwe n'abaganga, mu gihe inshinge zisaba ibigo by'ubuvuzi n'abantu babihuguriwe.

Uburyo bw'urushinge akenshi bubikirwa ibihe by'ubuvuzi byihariye aho kuyikoresha mu kanwa bidashoboka cyangwa bidatanga umusaruro. Ibi birimo indwara zikomeye, gukira nyuma yo kubagwa, cyangwa iyo sisitemu yawe yo mu gifu idakora neza.

Mu kuvura ubujura, methadone yo kunywa mu kanwa hafi ya hose irakundwa kuko ituma habaho imicungire ihamye, y'igihe kirekire. Uburyo bw'urushinge bukoreshwa gake mu kuvura ubujura usibye mu bihe byihariye cyane.

Ibikunze Kubazwa ku bijyanye na Methadone y'urushinge

Ese methadone y'urushinge iratekanye ku bantu barwaye indwara z'umutima?

Umuti wa methadone uterwa mu urushinge bisaba kwitonda cyane ku bantu barwaye indwara z'umutima kuko bishobora kugira ingaruka ku mutima. Muganga wawe azasuzuma neza uko umutima wawe umeze mbere yo gutekereza kuri ubu buvuzi.

Niba urwaye indwara y'umutima, itsinda ry'abaganga bazakurikiranira hafi uko umutima wawe utera igihe cyose uri guhabwa methadone mu urushinge. Bashobora gukoresha ibikoresho bya electrocardiogram (EKG) kugirango barebe impinduka zose ziteje akaga mu mikorere y'amashanyarazi y'umutima wawe.

Abantu bafite uburwayi bw'umutima runaka, cyane cyane indwara ya long QT syndrome, ntibashobora kuba bakwemererwa guhabwa methadone mu urushinge. Muganga wawe azasuzuma amateka yose y'uburwayi bw'umutima wawe n'imiti urimo gufata ubu kugirango amenye niba ari byiza kuri wowe.

Nkwiriye gukora iki niba ngize ingaruka zikomeye ziterwa na methadone mu urushinge?

Niba ugize ingaruka zikomeye ziterwa na methadone mu urushinge, menyesha itsinda ry'abaganga bahita. Kubera ko uzaba uri mu kigo cy'ubuvuzi igihe uri guhabwa urushinge, ubufasha buzaba buri hafi.

Ingaruka zikomeye nk'uguhumeka nabi, kuribwa mu gituza, cyangwa isereri rikomeye bisaba ubufasha bwihuse bw'abaganga. Itsinda ry'abaganga bawe ryatojwe kumenya no kuvura ibi bibazo vuba.

Itsinda ry'abaganga bawe rizaba rifite imiti n'ibikoresho byiteguye guhindura ingaruka ziteje akaga niba bibaye ngombwa. Bashobora gukoresha naloxone (Narcan) kugirango barwanye guhagarara gukabije kw'ubuhumekero cyangwa izindi mvura zihutirwa nkuko bikwiriye.

Nkwiriye kwitega iki mu gihe cyo gukira nyuma yo guhabwa methadone mu urushinge?

Gukira nyuma yo guhabwa methadone mu urushinge bikubiyemo amasaha menshi yo gukurikiranwa n'abaganga kugirango barebe ko urimo gusubiza neza ku muti. Uzaguma mu kigo cy'ubuvuzi kugeza igihe itsinda ry'abaganga bawe rizemeza ko byemewe ko usohoka.

Mugihe cyo gukira, ushobora kumva uruhuka, uribwa umutwe, cyangwa ugahura n'izindi ngaruka zoroheje. Ibi ni ibisanzwe, kandi itsinda ry'abaganga bawe rizakurikirana hafi. Bazagenzura ibimenyetso byawe by'ingenzi buri gihe kandi barebe ibimenyetso byose biteye impungenge.

Ntabwo ugomba gutwara imodoka cyangwa gukoresha imashini byibuze amasaha 24 umaze guterwa urushinge rwa methadone. Uyu muti ushobora kugutera kutagira ubushishozi no gutekereza neza kabone niyo imbaraga zo kugabanya ububabare zatangiye gushira.

Ni ryari nshobora kureka guterwa urushinge rwa Methadone?

Ushobora kureka guterwa urushinge rwa methadone igihe muganga wawe abona ko bikwiye mu rwego rwa muganga kandi bitekanye. Iyi myanzuro ishingiye ku buzima bwawe, urugero rw'ububabare ufite, n'ubushobozi bwo kwimukira ku zindi nshuti.

Niba umaze guterwa inshinge za methadone buri gihe, muganga wawe azagutegurira gahunda yo kugabanya buhoro buhoro aho guhagarara ako kanya. Ibi birinda ibimenyetso byo kuva mu muti kandi bigatuma ukomeza kumva umeze neza kandi ufite umutekano.

Igihe cyo guhagarara gitandukanye cyane bitewe n'uko umuntu ameze. Abantu bamwe bahagarara nyuma y'iminsi mike, mu gihe abandi bashobora gukenera gahunda ndende yo kugabanya.

Ese urushinge rwa methadone rushobora guhura n'indi miti nshobora gufata?

Yego, urushinge rwa methadone rushobora guhura n'indi miti myinshi, niyo mpamvu ikipe yawe y'abaganga isuzuma urutonde rw'imiti ufata mbere yo kuvurwa. Izi ngaruka zirashobora guteza akaga kandi bishobora gusaba guhindura imiti ufata.

Ingaruka ziteje akaga cyane zibaho iyo zihujwe n'indi miti igabanya imikorere y'imitsi nk'imiti ya benzodiazepines, inzoga, cyangwa izindi opioids. Izi mpuzankano zirashobora gutera guhumeka nabi cyane n'izindi ngaruka ziteje ubuzima akaga.

Umuvuzi wawe azasuzuma kandi niba hari ingaruka zihari n'imiti y'umutima, imiti igabanya ubwoba, n'indi miti igira ingaruka ku mutima wawe. Bashobora gukenera guhindura urugero rwa dose cyangwa gukoresha ubundi buryo bwo kuvura kugirango umutekano wawe wizerwe.