Ni iki Phenobarbital (inzira yo mu muyoboro w'amaraso): Ibikoresho, Urutonde rw'imiti, Ingaruka ziterwa n'iyo miti n'ibindi

Phenobarbital ni umuti wo mu itsinda ry'imiti yitwa barbiturates, ifasha gutuza ubwonko n'imitsi. Iyo itanzwe binyuze mu muyoboro w'amaraso (inzira yo mu muyoboro w'amaraso), ikora vuba kugira ngo igenzure ibibazo byo gufatwa n'indwara yo mu mutwe kandi itange imiti ituza mu bitaro.

Uyu muti umaze imyaka myinshi ukoreshwa neza kandi ukomeje kuba imwe mu miti ikora neza cyane mu kuvura ubwoko bumwe na bumwe bw'ibibazo byo gufatwa n'indwara yo mu mutwe n'ibihe byihutirwa by'ubuvuzi. Kumva uko ikora n'icyo witegura bishobora kugufasha kumva witeguye kurushaho niba wowe cyangwa uwo ukunda akeneye ubu buvuzi.

Phenobarbital ni iki?

Phenobarbital ni umuti wa barbiturate ugabanya imikorere mu bwonko bwawe no mu mikorere y'imitsi. Ni umwe mu miti ya kera yo kuvura ibibazo byo gufatwa n'indwara yo mu mutwe ikoreshwa kugeza ubu, umaze imyaka irenga 100 wandikirwa neza.

Iyo itanzwe binyuze mu muyoboro w'amaraso, umuti winjira mu maraso yawe mu buryo butaziguye, ukaba ushobora gukora vuba cyane kurusha ibinini cyangwa ubundi buryo. Ibi bituma bikoreshwa cyane cyane mu bihe byihutirwa aho icyakorwa gihutirwa.

Ubwoko bwo mu muyoboro w'amaraso busanzwe bukoreshwa mu bitaro, mu byumba by'abarwayi b'igitaraganya, cyangwa mu bindi bigo by'ubuvuzi aho abaganga bafite imyitozo bashobora kugukurikiranira hafi. Ifatwa nk'ikintu kigenzurwa kubera ingaruka zayo zituma umuntu atuza, bityo iboneka gusa binyuze mu kugenzurwa na muganga.

Phenobarbital ikoreshwa mu kuvura iki?

Phenobarbital yo mu muyoboro w'amaraso ikoreshwa cyane cyane mu guhagarika ibibazo byo gufatwa n'indwara yo mu mutwe bititabira indi miti cyangwa bikomeza kugaruka. Ikoreshwa kandi mu gutanga imiti ituza mbere y'uburyo bumwe na bumwe bwo kuvura cyangwa kubaga.

Muganga wawe ashobora kugusaba Phenobarbital yo mu muyoboro w'amaraso niba urimo guhura n'ibihe byinshi by'ubuvuzi bisaba ubufasha bwihuse:

• Status epilepticus (ibitero by'indwara yo mu mutwe bikomeza kumara iminota irenga 5)
• Uduce tw'ibitero bikaze tutitabira imiti yindi
• Kugenzura ibitero by'indwara yo mu mutwe byihutirwa iyo imiti yo kunywa itagikora
• Kuruhura mbere y'inzira zimwe na zimwe zo kwa muganga cyangwa kubagwa
• Ibitero by'indwara yo mu mutwe biterwa no kuva ku nzoga mu bitaro
• Umujinya ukabije cyangwa impungenge bisaba gutuza ako kanya

Mu bindi bihe, abaganga bashobora gukoresha phenobarbital ya IV ku bana bakivuka bafite ibitero by'indwara yo mu mutwe, kuko akenshi yihanganirwa neza n'abarwayi bakiri bato cyane. Uyu muti ukora neza cyane kuko ukora ku nzira nyinshi mu bwonko kugira ngo wirinde ibikorwa by'ibitero by'indwara yo mu mutwe.

Phenobarbital ikora ite?

Phenobarbital ikora yongera ingaruka z'imiti kamere yo mu bwonko yitwa GABA (gamma-aminobutyric acid), ifasha gutuza ibikorwa byo mu bwonko. Tekereza GABA nk'"pedali y'umurego" w'ubwonko bwawe ishimangira ibintu iyo biba bikabije.

Iyo ibitero by'indwara yo mu mutwe bibaye, ibikorwa by'amashanyarazi mu bwonko bwawe bihinduka imvururu kandi bitagengwa. Phenobarbital ikomeza ubushobozi bw'ubwonko bwawe bwo kugenzura ibi bikorwa binyuze mu gukora ibimenyetso bituza bikomeye kandi birambye.

Uyu muti ufatwa nk'umuti ukomeye kandi wizewe wo kuvura ibitero by'indwara yo mu mutwe. Ukora neza cyane kuko ukora ku bwoko bwinshi bw'ibice by'ubwonko, bituma ugira ingaruka zose zo kurwanya ibitero by'indwara yo mu mutwe. Uburyo bwa IV akenshi butangira gukora mu minota 15-30 nyuma yo gutangwa.

Nkwiriye gufata phenobarbital nte?

Phenobarbital ya IV ihabwa buri gihe n'abakozi b'ubuzima bafite imyitozo mu rwego rw'ubuvuzi. Ntabwo bizakugora gufata uyu muti wenyine, kuko bisaba gukurikiranwa neza n'ibikoresho bya IV bikwiye.

Itsinda ryawe ry'ubuzima rizagushyiriraho agati gato kitwa IV catheter mu urutsi, akenshi mu kuboko kwawe cyangwa ukuboko. Uyu muti uza hanyuma uterwa buhoro buhoro binyuze muri iyi tube mu maraso yawe.

Mugihe cyo kuyobora, itsinda ryawe ry'abaganga rizakurikirana umwuka wawe, umuvuduko w'umutima, n'umuvuduko w'amaraso. Bashobora gutanga umuti buhoro buhoro mu minota myinshi kugirango bagabanye ibyago byo kugira ingaruka mbi kandi barebe ko umubiri wawe uwihanganira neza.

Ntabwo ukeneye kurya cyangwa kunywa ikintu icyo aricyo cyose mbere yo guhabwa IV phenobarbital. Mubyukuri, niba ufite ibibazo byo gufatwa, itsinda ryawe ry'abaganga rishobora gukunda ko utariye vuba kugirango ugabanye ibyago byo kugira ibibazo.

Nzamara Igihe Kingana Iki Ndafashe Phenobarbital?

Igihe cyo kuvura IV phenobarbital giterwa rwose n'uburwayi bwawe bwihariye n'uburyo witwara neza ku muti. Mu bihe byihutirwa, ushobora kuwuhabwa rimwe gusa cyangwa amasaha make.

Kubijyanye na status epilepticus cyangwa ibibazo bikomeye byo gufatwa, kuvura mubisanzwe bikomeza kugeza igihe gufatwa kwawe kugenzurwa kandi ubuzima bwawe bugahagarara. Ibi bishobora kuba amasaha make cyangwa iminsi myinshi, bitewe n'uburyo wihariye witwara.

Niba IV phenobarbital igenzura neza gufatwa kwawe, muganga wawe ashobora kuguha imiti yo gufatwa yo kunywa kugirango icungwe igihe kirekire. Iyi mpinduka mubisanzwe ibaho buhoro kugirango habeho kugenzura gufatwa buri gihe.

Itsinda ryawe ry'abaganga rizafata ibyemezo byose bijyanye n'igihe bitewe n'ibikorwa byawe byo gufatwa, ubuzima bwawe muri rusange, n'uburyo witwara neza ku kuvurwa. Bazakomeza gusuzuma niba ugikeneye umuti cyangwa niba byemewe kuwugabanya cyangwa kuwuhagarika.

Ni Iyihe Ngaruka Ziterwa na Phenobarbital?

IV phenobarbital irashobora gutera ingaruka, nubwo abantu benshi bayihanganira neza iyo itangwa mu maso y'abaganga. Ingaruka zisanzwe zifitanye isano n'imiti ituma umuntu asinzira.

Dore ingaruka ushobora guhura nazo, wibuke ko itsinda ryawe ry'abaganga rizakurikirana hafi:

• Gusinzira cyane cyangwa guhumeka gahoro (ibisanzwe kandi byitezwe)
• Kuribwa umutwe cyangwa kumva utameze neza
• Urujijo cyangwa kumva "umwotsi"
• Guhumeka gahoro (bikurikiranwa neza n'ikipe yawe y'ubuvuzi)
• Umubyimba muke w'amaraso
• Urugimbu cyangwa kuribwa mu nda
• Umutwe
• Kugira umujinya cyangwa guhinduka kw'imitekerereze

Ibi bimenyetso bisanzwe mubisanzwe biragenda bikemuka igihe umuti uva mu mubiri wawe. Ikipe yawe y'ubuvuzi yiteze ibi bimenyetso kandi ifite uburyo bwo kubicunga neza.

Nubwo bitabaho kenshi, hariho ingaruka zikomeye ziterwa n'uyu muti zisaba ubufasha bwihuse bw'abaganga, nubwo wibuke ko uzaba uri mu kigo cy'ubuvuzi:

• Guhumeka gahoro cyane cyangwa kugorana
• Igabanuka rikomeye ry'umubyimba w'amaraso
• Urugero rukomeye rwo kwibasirwa n'umubiri (ibibara, kubyimba, kugorana guhumeka)
• Impinduka zidasanzwe mu mutima
• Urujijo rukomeye cyangwa kutagira ubwenge birenze uko byari byitezwe

Ikipe yawe y'ubuvuzi ikomeza gukurikirana ibi bimenyetso bikomeye kandi yiteguye guhita igira icyo ikora nibiramuka bibaye. Uburyo bwo kuvura bugenzurwa bugabanya cyane ibyago bifitanye isano n'ibi bibazo bishobora kuvuka.

Ninde utagomba gufata Phenobarbital?

Abantu bamwe ntibagomba guhabwa IV phenobarbital, cyangwa bashobora gukenera ingamba zidasanzwe nibabihabwa. Ikipe yawe y'ubuvuzi izasuzuma neza amateka yawe y'ubuzima mbere yo gutanga uyu muti.

Muganga wawe azitonda cyane mugihe aguha phenobarbital niba ufite kimwe muri ibi bibazo:

• Ibibazo bikomeye byo guhumeka cyangwa guhagarara guhumeka
• Allergie izwi kuri phenobarbital cyangwa izindi barbiturates
• Indwara ikomeye y'umwijima cyangwa kunanirwa kw'umwijima
• Porphyria idahagarara (indwara idasanzwe yo mu bwoko)
• Indwara ikomeye y'impyiko
• Ibibazo bikomeye by'umutima cyangwa umubyimba muke cyane w'amaraso
• Amateka yo gukoresha ibiyobyabwenge cyangwa inzoga (nubwo ibi bituma bitabaho buri gihe)

Niba utwite cyangwa wonka, muganga wawe azagereranya inyungu n'ibishobora guteza akaga. Mu gihe cyo gufatwa n'indwara ifata ubuzima, inyungu akenshi ziruta ibyago, ariko iki cyemezo gisaba ubuganga bwitondewe.

Abantu bakuze bashobora kwitwara nabi ku ngaruka za phenobarbital kandi bashobora gukenera imiti mike cyangwa gukurikiranwa cyane. Itsinda ryawe ry'ubuvuzi rizahindura uburyo bakoresha hashingiwe ku myaka yawe n'ubuzima bwawe muri rusange.

Amazina ya Phenobarbital

Phenobarbital iboneka mu mazina menshi y'ubwoko, nubwo ubwoko bwa rusange bukoreshwa cyane mu bitaro. Umuti ubwawo ukora kimwe na kimwe hatitawe ku izina ry'ubwoko.

Andi mazina y'ubwoko ushobora guhura nayo harimo Luminal, nubwo ibitaro byinshi bikoresha ubwoko bwa rusange bwitwa gusa "phenobarbital." Itsinda ryawe ry'ubuvuzi rizakubwira neza ubwoko urimo guhabwa, nubwo ingaruka n'ibisabwa byo gukurikiranwa bikomeza kimwe.

Mu bihe by'ubutabazi, ubwoko bwihariye ntibugira akamaro kanini ugereranije no kugera ku kugenzura neza vuba. Abaganga bawe bazakoresha ubwoko ubwo aribwo bwose buboneka kandi bukwiye kubera uko ubuzima bwawe bumeze.

Uburyo bwo gusimbuza Phenobarbital

Imiti myinshi ishobora gukoreshwa mu mwanya wa cyangwa hamwe na IV phenobarbital kugirango igenzure gufatwa n'indwara. Muganga wawe ahitamo uburyo bwiza bushingiye ku bwoko bwihariye bwo gufatwa n'indwara yawe n'ubuzima bwawe.

Uburyo busanzwe bwo kugenzura gufatwa n'indwara byihutirwa harimo lorazepam (Ativan), diazepam (Valium), cyangwa levetiracetam (Keppra). Buri kimwe gifite inyungu zitandukanye kandi gishobora gukora neza kubwoko bumwe bwo gufatwa n'indwara cyangwa uko abarwayi bameze.

Kubijyanye no gucunga gufatwa n'indwara igihe kirekire, imiti yo kunywa nk'amazi ya lamotrigine, carbamazepine, cyangwa valproic acid bishobora kuba uburyo bwiza. Ibi ntibisaba gukoresha IV kandi birashobora gufatwa murugo mugihe ubuzima bwawe bukomeye bumaze gukemurwa.

Itsinda ryawe ry’abaganga rizagushyikiriza gahunda nziza yo kuvura igihe kirekire nyuma y’uko ibibazo byawe byihutirwa byo gufatwa byagenzurwa. Intego ni ukubona umuti ukora neza ufite ingaruka nke kuri wowe.

Ese Phenobarbital iruta Lorazepam?

Bombi phenobarbital na lorazepam ni imiti ikora neza yo gufata, ariko bakora mu buryo butandukanye kandi bafite inyungu zitandukanye. Guhitamo “neza” biterwa n’uburwayi bwawe bwihariye n’ubwoko bwo gufatwa urimo guhura nabyo.

Lorazepam akenshi ikora vuba (mu minota 2-5) ariko ntirambana mu mubiri wawe. Akenshi ikoreshwa nk'umuti wa mbere wo guhagarika gufatwa kwihutirwa kubera ko ikora vuba.

Phenobarbital itinda gukora (iminota 15-30) ariko itanga uburyo bwo kugenzura gufatwa burambye. Akenshi ikoreshwa iyo lorazepam itakoze cyangwa iyo hakenewe kugenzura gufatwa igihe kirekire.

Abaganga benshi bakoresha iyi miti bahujwe, batangira na lorazepam kugirango bagenzure gufatwa vuba hanyuma bakongeraho phenobarbital kugirango bagenzure igihe kirekire. Itsinda ryawe ry’abaganga rizagena uburyo bushobora gukora neza kuri wowe.

Ibikunze Kubazwa Kuri Phenobarbital

Ese Phenobarbital irakwiriye indwara z'umutima?

Phenobarbital irashobora gukoreshwa ku bantu barwaye indwara z'umutima, ariko bisaba kwitonda cyane no gukurikiranwa. Uyu muti ushobora kugabanya umuvuduko w'amaraso no gutuma umutima utera gahoro, ibyo bishobora kugira ingaruka ku bantu bafite indwara z'umutima zimwe na zimwe.

Itsinda ryawe ry’abaganga rizagenzura neza ubuzima bw’umutima wawe mbere yo gutanga phenobarbital. Bazakurikirana umuvuduko w'amaraso yawe n'imiterere y'umutima wawe mu gihe cyo kuvurwa kugirango barebe neza ko umutima wawe wakira neza uyu muti.

Niba ufite umutima udakora neza cyangwa umuvuduko w'amaraso uri hasi cyane, muganga wawe ashobora guhitamo undi muti cyangwa agakoresha urugero ruto rwa phenobarbital. Icyemezo giterwa no kuringaniza ibikenewe byo kugenzura gufatwa n'umutima ufite umutekano.

Ninkora iki niba mbonye Phenobarbital nyinshi mu buryo butunguranye?

Kubera ko Phenobarbital ya IV itangwa gusa n'abantu b'inzobere mu by'ubuvuzi ahantu hakorerwa ibikorwa by'ubuvuzi, kwirengagiza umuti mu buryo butunguranye ni gake cyane. Itsinda ryawe ry'abaganga ribara neza urugero rwawe kandi rigukurikiranira hafi mugihe cyo kuvurwa.

Niba hatanzwe Phenobarbital nyinshi, impungenge nyamukuru ni ukuryama cyane no guhumeka gahoro. Itsinda ryawe ry'abaganga ryatojwe kumenya ibimenyetso ako kanya kandi rifite imiti ihari yo guhangana n'ingaruka.

Ubuvuzi bwo kwirengagiza Phenobarbital bushobora gukubiyemo ubufasha nk'ubufasha bwo guhumeka, amazi ya IV kugirango akomeze umuvuduko w'amaraso, na charbon activé mubihe bimwe na bimwe. Itsinda ryawe ry'abaganga rizahita rifata icyemezo niba bakeka ikosa iryo ariryo ryose ryo gutanga imiti.

Ninkora iki niba nciwe urugero rwa Phenobarbital?

Iki kibazo ntigikora kuri Phenobarbital ya IV kuko itangwa gusa n'inzobere mu by'ubuvuzi ahantu hakorerwa ibikorwa by'ubuvuzi. Ntabwo uzaba ufite inshingano zo gutegura cyangwa gutanga imiti wenyine.

Niba amaherezo wahinduriwe Phenobarbital yo kunywa kugirango ugenzure ibibazo byawe by'igihe kirekire, muganga wawe azaguha amabwiriza yihariye yerekeye urugero rwatanzwe. Muri rusange, wafata urugero rwatanzwe ako kanya wibuka, keretse niba rwegereye urugero rwawe ruteganyijwe.

Kuri Phenobarbital yo kunywa, ntukigereho urugero rwakubye kabiri kugirango usubizeho izatanzwe, kuko ibi bishobora guteza akaga. Buri gihe vugana n'umuganga wawe niba utazi icyo wakora n'urugero rwatanzwe rwa imiti iyo ariyo yose yo guhagarika ibibazo.

Nshobora guhagarika ryari gufata Phenobarbital?

Icyemezo cyo guhagarika Phenobarbital ya IV giterwa n'uburyo ibibazo byawe bigenzurwa n'ubuzima bwawe muri rusange. Itsinda ryawe ry'abaganga rizafata iki cyemezo hashingiwe ku bintu byinshi harimo n'uburyo ibibazo byawe bigenzurwa neza n'uburyo witwara mugihe uvurwa.

Abantu benshi bahabwa phenobarbital ya IV by'agateganyo gusa mu gihe cy'uburwayi bukomeye. Iyo ibibazo byawe by'ubwonko bigabanutse kandi ubuzima bwawe bugahagarara, muganga wawe ashobora kuguha imiti yo kunywa cyangwa akagabanya urugero rwa phenobarbital buhoro buhoro.

Ntuzigere uhagarika phenobarbital ako kanya, kuko ibyo bishobora gutera ibibazo by'ubwonko byongera. Itsinda ryawe ry'abaganga rizagena gahunda yo kugabanya imiti iteje umutekano niba ukeneye guhagarika imiti, rikabanza kureba ko ibibazo by'ubwonko bitazongera mu gihe cyose cyo guhagarika imiti.

Nshobora gutwara imodoka nyuma yo guhabwa phenobarbital ya IV?

Ntabwo ukwiriye gutwara imodoka byibuze mu masaha 24-48 nyuma yo guhabwa phenobarbital ya IV, ndetse bishobora no gutinda bitewe n'uko umubiri wawe wakiriye imiti. Ingaruka zo gutuma usinzira zirashobora gukomeza nubwo wumva umeze neza, bigatuma igihe cyo gusubiza vuba kigabanuka ndetse n'ubushishozi bugahungabana.

Muganga wawe azaguha ubuyobozi bwihariye ku gihe cyo kongera gutwara imodoka bitewe n'uko ubuzima bwawe bumeze. Iyi myanzuro ishingiye ku bintu nk'urugero rwa imiti wahawe, uburyo umubiri wawe wihutisha imiti, n'ubuzima bwawe muri rusange.

Niba utangiye gufata imiti y'igihe kirekire yo kuvura ibibazo by'ubwonko, muganga wawe azanaganira nawe ku bijyanye n'inzitizi zo gutwara imodoka zijyanye n'uburwayi bwawe bw'ubwonko. Intara nyinshi zifite amategeko yihariye yerekeye gutwara imodoka nyuma yo kugira ibibazo by'ubwonko, hatitawe ku mikoreshereze y'imiti.