Ikindi ku bijyanye no guterwa urushinge rwa Midazolam: Ibyo rukoreshwa, urugero rwo kurufata, ingaruka mbi n'ibindi

Urushinge rwa Midazolam ni umuti ukomeye utuma umuntu aruhuka wo mu cyiciro cy'imiti yitwa benzodiazepines. Muganga wawe akoresha uyu muti kugira ngo agufashe kuruhuka no kumva unaniwe mbere yo gukorerwa ibizamini by'ubuvuzi, kubagwa, cyangwa igihe ukeneye kuvurwa bikomeye. Utekereze nk'igikoresho cy'ubuvuzi gituma sisitemu yawe y'imitsi yorohera iyo ukeneye cyane mu bihe by'ubuvuzi biruhije.

Urushinge rwa Midazolam ni iki?

Urushinge rwa Midazolam ni umuti utuma umuntu aruhuka ukora vuba ukoreshwa unyuze mu maraso yawe. Ni wo mu muryango umwe w'imiti nka Valium cyangwa Xanax, ariko rwihariwe mu rwego rw'ubuvuzi aho hakenewe kuruhuka kwihuse kandi kugenzurwa. Abaganga barutera banyuze mu muyoboro wa IV, urushinge mu mikaya, cyangwa rimwe na rimwe banyuze mu mazuru mu bihe by'ubutabazi.

Uyu muti ufata nk'ukomeye cyane ugereranije n'imiti yo mu kanwa igabanya umunabi. Mu gihe ibinini ushobora gufata mu rugo bikora buhoro buhoro mu minota 30-60, urushinge rwa midazolam akenshi rutangira gukora mu minota 1-3 iyo rutewe mu maraso. Iki gikorwa cyihuse gituma gifite agaciro gakomeye mu bikorwa by'ubuvuzi aho igihe kigira uruhare.

Urushinge rwa Midazolam rukoreshwa mu iki?

Abaganga bakoresha urushinge rwa midazolam cyane cyane kugira ngo bagufashe kumva utuje kandi unaniwe mbere yo gukorerwa ibizamini by'ubuvuzi. Akenshi rukoreshwa mu gukora colonoscopies, endoscopies, kubagwa amenyo, n'ibikorwa bito byo kubaga aho ukeneye kuruhuka ariko utari mu gihe cyo kutagira ubwenge. Ushobora kandi kuruhabwa mu byumba by'ubutabazi kugira ngo bifashe kugenzura ibibazo byo gufatwa n'indwara cyangwa ibihe bikomeye by'umunabi.

Mu byumba by'ubuvuzi bwihariye, midazolam ifasha gufasha abarwayi kumva bameze neza iyo bari ku byuma bifasha mu guhumeka cyangwa bakira indwara zikomeye. Ikoreshwa kandi nk'igice cy'amabwiriza yo gutera imiti yo gutera mu gihe cyo kubagwa gukomeye, ikorana n'indi miti kugira ngo yemeze ko umeze neza neza mu gihe cyose cy'igikorwa.

Usibye ibyo bikoreshwa bisanzwe, hariho n'ibindi bihe byihariye aho midazolam iba ingenzi cyane. Itsinda ry'abaganga b'ubutabazi rirayikoresha mu gufasha abantu bahura n'uburwayi bukomeye, ibitero by'ubwoba, cyangwa ibimenyetso byo kuva ku nzoga. Mu bana, bifasha abana kuguma bishimye mu gihe cy'ibikorwa by'ubuvuzi biteye ubwoba, bigatuma ibyo bibaho bitabangamira umwana n'umuryango wabo.

Midazolam Injection ikora ite?

Midazolam ikora yongera ingaruka z'imiti isanzwe mu bwonko bwawe yitwa GABA. GABA ni nk'ibinyabutabazi bisanzwe by'ubwonko bwawe, bifasha kugabanya imikorere y'imitsi no guteza umutuzo no kuruhuka. Iyo midazolam yongereye ingaruka za GABA, iteza umutuzo, igatuma umuntu asinzira, bigatuma ibikorwa by'ubuvuzi biba byiza cyane kuri wowe.

Uyu muti ufashwe nk'ukomeye cyane mu isi y'ibitotsa. Nubwo bitazagutera kutamenya ibikubaho nk'uko biba muri anesthesia rusange, iteza icyo abaganga bita

Ubusanzwe kwitegura bitangira mu ijoro ryo mbere y'igikorwa. Muganga wawe ashobora kugusaba kwirinda kurya cyangwa kunywa ikintu icyo aricyo cyose mu masaha 8-12 mbere yo kujya mu gihe cyagenwe. Iki gihe cyo kwiyiriza ni ingenzi kuko midazolam ishobora kugira ingaruka ku myitwarire y'umubiri wawe, kandi kugira ibiryo mu gifu cyawe bishobora gutera ibibazo uramutse uruka urimo guhabwa imiti.

Ku munsi wo gukora igikorwa, wambare imyenda yoroshye kandi yagutse kandi ukureho imitako iyo ariyo yose, amaso y'ubwenge, cyangwa amenyo ya gihanga nk'uko byategetswe. Menya neza ko ufite umuntu mukuru ushobora kukugira mu rugo nyuma, kuko ingaruka za midazolam zishobora kumara amasaha menshi nubwo wumva umeze neza.

Menyesha ikipe yawe y'ubuvuzi ku bijyanye n'imiti yose urimo gufata, harimo imiti itangwa itagomba kwandikwa na muganga n'ibyongerera imbaraga. Imwe mu miti ishobora gukorana na midazolam, kandi muganga wawe ashobora gukenera guhindura urugero cyangwa igihe cyo gufata indi miti yawe.

Nzamara Igihe Kingana Gite Ntera Midazolam?

Midazolam iterwa akenshi rimwe gusa, itangwa by'umwihariko ku gikorwa cyawe cyangwa ikibazo cyawe cy'ubuvuzi. Bitandukanye n'imiti ya buri munsi ushobora gufata mu rugo, ibi si ikintu uzakoresha kenshi cyangwa mu gihe kirekire. Urugero rwa buri dose rubarwa neza hashingiwe ku byo ukeneye, uburemere, imyaka, n'ubwoko bw'igikorwa urimo gukora.

Ingaruka zikunze gutangira mu minota 1-3 niba itewe mu maraso, cyangwa mu minota 5-15 niba itewe mu misitsi. Ingaruka zikomeye zibaho hafi y'iminota 15-30 nyuma yo kuyitera, kandi ingaruka zo gutuza zikunze kumara amasaha 2-6, bitewe n'urugero n'uburyo umubiri wawe ubyakira.

Mu bigo byita ku barwayi barembye, abarwayi bashobora guhabwa midazolam bakoresheje urushinge rwa IV iminsi cyangwa se ibyumweru barimo gukira indwara zikomeye. Ariko, abaganga babikurikirana neza kandi bagabanya buhoro buhoro urugero uko abarwayi barushaho gukira, bahora bakora kugira ngo bahagarike imiti vuba na bwangu uko bishoboka.

Ni Ibihe Bikorwa Bigaragara Nyuma yo Kwinjiza Midazolam?

Abantu benshi boroherwa no kwinjiza midazolam, ariko nk'imiti yose, ishobora gutera ibikorwa bigaragara. Ibikunze kugaragara ni ukongera ibyo umuti ugamije gukora - gutuma wumva unaniwe kandi utuje.

Dore ibikorwa bigaragara ushobora guhura nabyo cyane, wibuke ko akenshi biba byoroheje kandi by'igihe gito:

• Kunanirwa bishobora kumara amasaha menshi nyuma y'igikorwa cyawe
• Umutwe w'igihe gito cyangwa kumva "umutwe" mugihe umuti ugenda ushiramo imbaraga
• Urugimbu ruto cyangwa guhinda umushyitsi mugihe cyangwa nyuma y'igikorwa
• Ubwibushye bw'igihe gito ku gihe cy'igikorwa cyawe
• Umutwe woroshye mugihe ingaruka zigenda zishira
• Kumva utagendera neza ku birenge byawe mu masaha make

Ibi bikorwa bisanzwe muri rusange ntibiteje akaga kandi bizagenda bishira uko umubiri wawe ukoresha umuti. Iyi niyo mpamvu gufashwa n'umuntu kukujyana mu rugo no kugumana nawe mu masaha make ari ngombwa cyane.

Hariho ibikorwa bigaragara bitari ibisanzwe ariko bikomeye cyane abaganga bawe bakurikirana neza. Ibi birimo ibibazo byo guhumeka, cyane cyane niba ufite ikibazo cyo guhumeka mu ijoro cyangwa ibibazo by'umwijima, kugabanuka gukomeye kw'umuvuduko w'amaraso, cyangwa ibikorwa bidasanzwe nk'uburakari aho gutuza. Abaganga bawe bahawe imyitozo yo kumenya no gukemura ibi bibazo ako kanya.

Gahoro cyane, abantu bamwe bahura n'icyitwa "igikorwa gitunguranye," aho aho gutuza, bahinduka abarakari cyangwa bahangayitse. Ibi bikunda kugaragara cyane ku barwayi bakuze cyangwa abafite ibibazo bimwe na bimwe byo mumutwe. Ibi nibiba, abaganga bawe bashobora guhindura vuba ingaruka bakoresheje undi muti.

Ninde Utagomba Gufata Midazolam?

Umuti wa midazolam ntukwiriye buri wese, kandi muganga wawe azasuzuma neza amateka yawe y'ubuzima mbere yo gufata icyemezo niba ukwiriye. Ikintu cy'ingenzi cyane cyo kutagikoresha ni uko ufite ibibazo bikomeye byo guhumeka cyangwa apnea yo gusinzira, kuko midazolam ishobora gutuma guhumeka kwawe kugenda gahoro.

Ntabwo ukwiriye guhabwa midazolam niba ufite allergie kuri benzodiazepines cyangwa ibice byose by'urushinge. Abantu bafite indwara ikomeye y'umwijima bakeneye kwitabwaho by'umwihariko kuko imibiri yabo itunganya umuti gahoro cyane, bishobora gutuma ingaruka zikomeza mu buryo buteye akaga.

Dore izindi mimerere aho midazolam itakwiriye kuri wowe:

• Glaucoma ifunganye (ubwoko bwihariye bw'indwara y'amaso)
• Kugabanuka gukomeye k'ubuhumekero cyangwa ingorane zo guhumeka
• Gusama, cyane cyane mu gihembwe cya mbere
• Konsa (umuti ushobora kujya mu mata y'ibere)
• Myasthenia gravis (indwara yo kunanuka kw'imitsi)
• Ibibazo bikomeye by'umutima cyangwa umuvuduko w'amaraso uri hasi cyane

Imyaka nayo ni ikintu cy'ingenzi. Abarwayi bageze mu zabukuru n'abana bato cyane bakeneye kwitabwaho mu buryo bwihariye kuko bafite ubushobozi bwo kwakira ingaruka z'umuti. Muganga wawe azahindura urugero rwawo neza bitewe n'imyaka yawe, uburemere bwawe, n'ubuzima bwawe muri rusange.

Niba ufite amateka yo gukoresha ibiyobyabwenge, cyane cyane inzoga cyangwa benzodiazepines, menyesha muganga wawe ibi. Nubwo bitagutera guhita utabona midazolam, bisaba gukurikiranwa by'umwihariko ndetse n'uburyo butandukanye bwo gutanga imiti.

Amazina y'ubwoko bwa Midazolam

Umuti wa midazolam uboneka mu mazina menshi y'ubwoko, nubwo ibitaro byinshi na za clinique bikoresha verisiyo rusange. Izina risanzwe ry'ubwoko muri Leta Zunze Ubumwe z'Amerika ni Versed, ushobora kubona ku nyandiko zawe z'ubuvuzi cyangwa ukumva ikipe yawe y'ubuzima ibivuga.

Izindi nyito z'ubucuruzi zirimo Dormicum (ikoreshwa ku isoko mpuzamahanga) n'uburyo butandukanye bwa rusange buzwi nka "midazolam injection." Umuti ubwawo ni umwe uko byagenda kose ku izina ry'ubucuruzi - icy'ingenzi ni urugero n'umubare wa muganga wawe ahitamo kubera imiterere yawe yihariye.

Ikigo cyawe cy'ubuzima mubisanzwe kizabika urwo ruzabaye rworoshye kandi rworoshye. Ingero zose zigomba guhura n'amabwiriza akomeye ya FDA yerekeye umutekano n'ubushobozi, bityo urashobora kumva ufite icyizere uko byagenda kose ku izina ry'ubucuruzi wakiriye.

Izindi nzira z'inyongera za Midazolam Injection

Mugihe midazolam ari umwe mu miti ikunzwe cyane yo gukoreshwa mu buvuzi, hariho izindi nzira nyinshi muganga wawe ashobora gutekereza ashingiye ku byo ukeneye byihariye n'amateka yawe y'ubuvuzi. Buri nzira ifite inyungu zayo zihariye n'ibitekerezo.

Propofol ahari ni yo nzira isanzwe, cyane cyane kubikorwa bisaba gukomera. Ikora vuba kuruta midazolam kandi irashira vuba, bituma iba nziza kubikorwa byo hanze aho ukeneye gukira vuba. Ariko, bisaba gukurikiranwa cyane kandi mubisanzwe bikoreshwa na anesthesiologists.

Kugirango ugabanye, muganga wawe ashobora guhitamo lorazepam (Ativan) cyangwa diazepam (Valium). Iyi miti ikora kimwe na midazolam ariko ifite ingaruka zirambye. Akenshi zikoreshwa iyo gukomera birambye bikenewe cyangwa kubarwayi bashobora kungukirwa no guhumurizwa kwirambye.

Ketamine ni indi nzira irimo gukundwa kubikorwa bimwe na bimwe. Bitandukanye na midazolam, ketamine itanga gukomera no kuruhuka, bituma bikoreshwa kubikorwa bibabaza. Ariko, birashobora gutera ingaruka zitandukanye, harimo inzozi zidasanzwe cyangwa urujijo rw'agateganyo.

Ku barwayi b'abana, abaganga rimwe na rimwe bakoresha izindi nzira nka chloral hydrate ku bana bato cyane, cyangwa nitrous oxide (gaze isekera) ku mirimo yo mu menyo. Izi nzira zirashobora kuba zoroshye ku bana bashobora gutinya inshinge.

Ese Midazolam Injection iruta Lorazepam?

Gusanisha midazolam injection na lorazepam (Ativan) ntibireba ko imwe iruta indi muri rusange - bireba umuti ukwiriye kurusha undi ku miterere yawe. Byombi ni benzodiazepines zikora kimwe, ariko zifite ibihe bitandukanye n'igihe zikoreramo bituma buri imwe iba nziza ku bintu bitandukanye.

Inyungu ikomeye ya Midazolam ni umuvuduko wayo n'uburyo bwizewe. Itangira gukora mu minota mike kandi ifite igihe gito cyo gukora, akenshi amasaha 2-6. Ibi bituma iba nziza ku mirimo yo hanze aho ukeneye gukira vuba ukagenda mu rugo uwo munsi. Gutangira kwayo vuba bituma abaganga bagira ubugenzuzi bwuzuye ku gihe cyo gutuza.

Ku rundi ruhande, lorazepam ifite igihe kirekire cyo gukora, kimara amasaha 6-12 cyangwa arenga. Ibi bituma iba nziza mu bihe aho gutuza cyangwa gufasha umuntu kugabanya impungenge bikenerwa, nko mu gihe cyo kurara mu bitaro igihe kirekire cyangwa ku barwayi bafite indwara zikomeye zo guhangayika. Iraboneka kandi mu buryo bwo guterwa inshinge no kunywa, bituma abaganga bagira ubwigenge bwinshi.

Ku mirimo yo kwa muganga, midazolam ikunze gukoreshwa cyane kubera gutangira kwayo vuba n'igihe gito cyo gukora. Ku micungire ikomeje y'impungenge cyangwa ibihe bisaba gutuza igihe kirekire, lorazepam ishobora kuba ariyo nziza. Muganga wawe azatekereza ibintu nk'uburebure bw'umurimo wawe, amateka yawe y'ubuvuzi, n'uburyo ukeneye gukira vuba mu gihe afata iki cyemezo.

Ibibazo Bikunze Kubazwa Kuri Midazolam Injection

Q1. Ese Midazolam Injection irakwiriye ku barwayi b'umutima?

Umuti wa midazolam uterwa mu mushonga urashobora kuba mwiza ku barwayi b'umutima, ariko bisaba kwitonderwa byihariye no gukurikiranwa. Uyu muti ushobora gutuma igihe gito amaraso amanuka ndetse n'umuvuduko w'umutima ukagabanuka, ibyo bishobora guhangayikisha abantu bafite indwara zimwe na zimwe z'umutima. Muganga wawe w'umutima n'ikipe y'abaganga bakora icyo gikorwa bazakorana kugira ngo bamenye niba midazolam ikwiriye kuri wowe.

Niba ufite indwara y'umutima idahinduka, midazolam akenshi iracyakoreshwa neza hamwe no gukurikiranwa neza. Ariko, niba ufite urugero rwo hejuru rwo kunanirwa k'umutima, amaraso make cyane, cyangwa utuntu tw'umutima twabaye vuba aha, muganga wawe ashobora guhitamo uburyo bwo gutuza butandukanye cyangwa agahindura urugero rwawo cyane. Ikintu cy'ingenzi ni ukugirana ibiganiro by'ukuri ku bijyanye n'indwara yawe y'umutima n'imiti ukoresha ubu.

Q2. Nkwiriye gukora iki niba nanyweje midazolam nyinshi ku buryo butunguranye?

Ntabwo uzifata umuti wa midazolam wenyine - buri gihe utangwa n'abantu b'inzobere mu by'ubuzima batojwe neza babara kandi bagakurikirana urugero rwawo. Ariko, niba wigeze ukeka ko wakiriye nyinshi cyangwa urimo guhura n'ingaruka zikomeye, ibi ni ibihe by'ubuvuzi byihutirwa bisaba ubufasha bwihuse.

Ibimenyetso byo kurenza urugero rwa midazolam birimo gusinzira cyane aho udashobora kubyuka, kugorwa no guhumeka, iminwa cyangwa inzara z'ubururu, cyangwa umuvuduko w'umutima utinda cyane. Abaganga bafite umuti witwa flumazenil ushobora guhindura vuba ingaruka za midazolam niba bibaye ngombwa. Iyi ni yo mpamvu ibikorwa by'ubuvuzi bikoresha midazolam bihora bibera ahantu hari ibikoresho by'ubutabazi n'abakozi batojwe.

Q3. Nkwiriye gukora iki niba nanyimye urugero rwa midazolam?

Iki kibazo ntigisobanura ku muti wa midazolam uterwa mu mushonga kuko si umuti ufata ku gihe giteganijwe. Urugero rwawo rutangwa by'umwihariko ku gikorwa cy'ubuvuzi cyangwa ikibazo gikomeye. Niba uteganyirijwe gukora igikorwa gisaba midazolam kandi ukeneye kongera guteganya, ohereza ubutumwa ku muganga wawe kugira ngo utegure gahunda nshya.

Niba uri mu bitaro byita ku barwayi barembye bakoresha imiti ya midazolam ikoreshwa buri gihe, itsinda ry'abaganga bakurikirana imiti yose. Bakurikirana buri gihe uko ubuzima bwawe buhagaze kandi bagahindura imiti uko bikwiye - nta "dosi yawe yabuze" ugomba guhangayikishwa.

Q4. Ni ryari nshobora kureka gufata inshinge za Midazolam?

Inshinge za Midazolam zisanzwe zihagarara zonyine igihe umubiri wawe umaze gukoresha umuti nyuma yo kubagwa. Mu gihe cyo kubagwa nk'ibikorwa byo hanze y'ibitaro, umuti usanzwe uvamo nyuma y'amasaha 2-6 nta kindi ugomba gukora. Akazi kawe ni ukuruhuka gusa ukareka umubiri wawe ukongera imbaraga.

Mu bitaro byita ku barwayi barembye aho abarwayi bakoresha imiti ya midazolam buri gihe, abaganga bagabanya buhoro buhoro urugero rw'umuti uko abarwayi barushaho kumererwa neza. Ubu buryo, bwitwa gukura umuti, birinda ibimenyetso byo gukurwaho umuti kandi bituma abarwayi baguma bameze neza uko bakira. Itsinda ry'abaganga rifata ibyemezo byose ku gihe n'uburyo bwo guhagarika umuti hashingiwe ku iterambere ryawe n'ubuzima bwawe.

Q5. Nshobora gutwara imodoka nyuma yo guhabwa inshinge za Midazolam?

Oya, ntushobora na rimwe gutwara imodoka nyuma yo guhabwa inshinge za midazolam. Iri ni rimwe mu mategeko y'ingenzi y'umutekano ajyana n'uyu muti. N'iyo wumva umeze neza kandi ukibwira ko wakize, umuti uracyashobora kugira ingaruka ku buryo witwara, imitekerereze yawe, n'uburyo ukora ibintu mu buryo bukurikiranwa mu masaha 24 nyuma yo kubagwa.

Ugomba gutegura umuntu mukuru ufite inshingano zo kukugeza mu rugo kandi akagumana nawe amasaha menshi nyuma yo kubagwa. Ibi si ugusaba gusa - ni ibisabwa by'umutekano ibitaro byose bigomba gukurikiza. Tegura mbere usaba umuntu wo mu muryango wawe cyangwa inshuti kugufasha, cyangwa ushobora gukoresha serivisi yo gutwara niba ufite umuntu uguherekeza kandi akagufasha kugera mu rugo amahoro.