Burugubuguto ivuga kuri metronidazole n'inzoga ni ukuri ariko ibimenyetso bikomeye bito: ku rubuga rwa FDA handitse kuvanga inzoga mu gihe cyo kuvura no iminsi 3 nyuma y'urukingo rwa nyuma, mu gihe CDC ivuga ko kwirinda bitari ngombwa. Impinduka zombi ni izubu. Kubigutanga mugufi, gutegereza ni guhitamo neza.

TL;DR: Ibintu by'ingenzi byo kwibuka

  • Uru rubuga rwa FDA ruvuga ko nta nzoga mu gihe cyo kuvura no mu minsi 3 nyuma y'urukingo rwa nyuma.
  • Amabwiriza yo kuvura ya CDC ubwayo avuga ko kwirinda bitari ngombwa kandi ko guhuza ntabihamya bihagije bifite.
  • Metronidazole ntibuhagarika enzyme disulfiram ihagarika, bityo "nko kuri disulfiram" ni ijambo ry'ikinyoma.
  • Niba wonyoye, ugomba kwitega ko nta kintu kibaho cyangwa ufise kwotswa n'ibise bito birangira uko bukeye.
  • Ntabwo ushobora guhagarika imiti y'abageteri kuko unyoye icyo wanyoye.

Reckera inzoga mugihe uri kuri metronidazole, ariko ntabwo kubera ko byononera

Amabwiriza ku mugaragaro kuri metronidazole n'inzoga ni isobanutse: Uru rubuga rwemejwe na FDA, rwasanwe muri Gashyantare 2022, burugubuguto ko metronidazole itera ko ihura n'inzoga ikamera nka disulfiram, harimo ibise, kubabara mu nda, kuruka, kubabara umutwe, no gutukura. Ikubaza ko uhagarika inzoga n'ibicuruzwa bifite propylene-glycol mu gihe cyo kuvura kandi byibuze iminsi 3 nyuma y'urukingo rwa nyuma.

MedlinePlus, urubuga rw'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo by'ibitabo, bisubiramo amabwiriza amwe y'iminsi 3 mu magambo yoroshye. Byose muri iyi gice bivuga ku bikoresho byo mu kanwa n'amakapu, nibyo abantu bashaka bashaka iyo bashakisha Flagyl n'inzoga, kuko Flagyl ari metronidazole gusa munsi y'izina ryayo ry'ubwishingizi.

Ni byiza kumenya mbere y'uko abantu batanga panike: guhuza ibyo ibicuruzwa bivuga, mu gihe bibaho, birababaza kuruta kwica ubuzima. Ni nimugoroba mbi, ntabwo ari urugendo rwo kwa muganga.

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Si kenshi. Iburira ryerekeye imiti inywa ryanditswe kubera ko ibinini bigera mu mubiri wose. Naho ku bijyanye n'imiti isigwa mu gitsina (gel ya metronidazole), umuti muke cyane ni wo winjira mu maraso, bityo imyitwarire y'uwo muti n'inzoga ntihura cyane. Bamwe mu bakora iyo miti bakomeza gushyira iryo burira ku bwoko bwose bw'imiti, bityo reba neza ku gapapuro k'umuti wawe kandi ubaze farumasiye niba utabashije gusobanukirwa neza.

Oya. Abashinzwe farumasi bashyiraho icyo kimenyetso kuko amategeko abibasaba, kandi iyo ni imyitwarire ikwiye y'umwuga; si ikosa ryakagombye kwirengagizwa. Niba inama zerekeye metronidazole n'inzoga zikubangamiye, babaze mwegeranye aho kubyibazaho wenyine. Bashobora kureba uko umwijima wawe umerewe, indi miti ufata, n'ubwoko bw'umuti ufite, ibintu inyandiko rusange idashobora gusuzuma.

CDC ivuga ko kwirinda inzoga kuri metronidazole bitari ngombwa

Agasuzuguro ka metronidazole n'inzoga si uko guhuza bidashoboka, ahubwo ni uko burugubuguto itigeze ishingira ku bimenyetso bikomeye. Amabwiriza yo Kuvura Indwara Ziterwa N'imibonano mpuzabitsina ya CDC raporo ko isubiramo ryasanze "nta bushakashatsi bwo muri laboratwari, imiduga y'ibinyabuzima, raporo z'ibibazo by'ubuhanga, cyangwa ubushakashatsi bw'ubuvuzi butanga ibimenyetso bihamye byo guhuza nka disulfiram hagati y'inzoga na metronidazole," kandi ikemeza ko "kwirinda inzoga mugihe ufata metronidazole (cyangwa tinidazole) bitari ngombwa."

Uru rubuga rwasembuwe n'ubushakashatsi bwasohowe muri Antimicrobial Agents and Chemotherapy, Mergenhagen na bagenzi be basobanura ubushakashatsi bwo mu rwego rwa kabiri, bugenzurwa na placebo, bw'abakoresha 12 wasanze nta tandukaniro ryariho mu rwego rwa alidoscope dehydrogenase hagati y'itsinda kandi nta bibazo by'ubwigenge byo guhuza nka disulfiram. Ibisobanuro byabo ku bumenyi bwagutse ni uko ibimenyetso ari byo bito kandi bikwirakwira, kandi ko guhuza, aho bivugwa na gato, bibaho "ku buryo butazwi" kandi "buhindagurika."

Noneho iyi ni irihe tegeko ryaturutse? CDC irabizi ko ivyari mu bushakashatsi bwa laboratwari n'amateka yabayeho aho "kwihangiza byakomotse ku nzoga gusa cyangwa ku bibazo by'ubuhanga bya metronidazole". Ubushakashatsi bwakozwe mu kinyamakuru cyitwa Emergency Medicine News bwashyize ahagaragara ibyabaye bigera kuri bitandatu, byarimo abantu umunani, hagati y'imyaka 1964 kugeza 1999. Burugubuguto z'abageteri zifata kimwe cyangwa zifata kimwe zishobora kugira akamaro, kandi niwo muvugo w'ibintu byagenze nka cephalexin n'inzoga.

Ikibazo: guhamagara "Agasuzuguro ka metronidazole n'inzoga" ni byiza, ariko ibimenyetso bito ntibyemeza ubwishingizi. Abakoresha icumi babiri ntibashobora kuvuguruza ibibazo bitari byinshi, kandi ubushakashatsi bukomeye bushobora kurangiza bwo ntibwigeze bukorwa.

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Oya. Nta gihamya yerekana ko inzoga igabanya ubushobozi bwa metronidazole mu kurwanya udukoko cyangwa imungu. Ikibazo nyacyo ni uko niba kunywa inzoga bituma uruka umuti, ukibagirwa kuwufata, cyangwa ukavangirwa mu gihe cyo kuwufata, umuti ushobora kutazakora neza nk'uko bikwiye. Gufata umuti ku gihe ni byo by'ingenzi kuruta ibyo wanyoye uyuwufata.

Mu by'ukuri, yego. Amabwiriza ari ku muti areba ibintu byose birimo inzoga cyangwa propylene glycol, atari inzoga zisindisha gusa. Mu buzima busanzwe, gukaraba mu kanwa ukacira ntiyaba ari ikibazo gikomeye, ariko imiti y'inkkorora umira inshuro nyinshi ku munsi yo yakugira ingaruka. Imiti idafite inzoga iraboneka hose niba wifuza kwirinda kwibaza kuri ibyo bintu.

"Nko kuri disulfiram" ni ijambo ry'ikinyoma: agahinda nyakuri ka disulfiram ni uruvange ubwarwo

Guhinguruka kwa disulfiram metronidazole igomba gutera bifite uburyo bwihariye, kandi metronidazole ntigaragara ko ikoresha ubwo buryo. Mu guhinguruka kwa disulfiram nyakuri, inzoga ihinduka acetaldehyde hanyuma ihagarare aho, kuko enzyme alidoscope dehydrogenase ihagaritswe. Acetaldehyde yiyongera, kandi ufata kwotswa, umutima uhinda, kubabara mu nda, no kuruka.

Ibyo si byo metronidazole ikora. CDC ivuga ko metronidazole "idahagarika alidoscope dehydrogenase, nk'uko bibera kuri disulfiram". Ibisobanuro by'abaganga bo mu rwego rwa Medscape, bifatanye n'ubumenyi busubirwamo, ahubwo bigaragarira ko ihagarika alcohol dehydrogenase, ibyo bikagabanya inzoga kuruta gutera alidoscope yiyongera. Izina ryerekana ko bifitanye isano mu bibazo, atari isano kubiri.

Icyakora, hari guhuza disulfiram ku rubuga ko byemezwa neza. Metronidazole yo mu kanwa ntikwiye gutangwa ku muntu wese wafashe disulfiram (Antabuse) mu gihe cy'ibyumweru bibiri byashize, kuko guhuza byakoreshejwe hamwe n'ubuhungiro bw'ubugizi bwa bwenge. Kunywa akanywaga gato ni akaga k'ibimenyetso bito. Antabuse hamwe na metronidazole ni ibyemezwa.

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Birashoboka. Kubera ko inzoga ishobora kuguma mu mubiri igihe kirekire kuruta uko ubyiteze, ikirahure kimwe gishobora kugusindisha cyangwa kikagira ingaruka ndende kuruta uko watekerezaga. Icyo ugomba kwitondera kiroroshye: ntugakeke ko wihanganira inzoga nk'uko bisanzwe, cyane cyane niba ugiye gutwara imodoka cyangwa gukora ikindi kintu cyose gisaba kuba utasinze. Icyitonderwa: Iyi nyandiko ni iy'amakuru gusa kandi si inama z'ubuvuzi. Buri gihe jya ugisha inama umuganga wabigize umwuga kugira ngo aguhe ibisubizo n'imiti ikwiye. Niba ufite ikibazo cy'ubuzima gihutirwa, hamagara 911 cyangwa ujye ku bitaro bya hafi ako kanya.

Iminsi itatu nyuma y'urukingo rwa nyuma ni umubare wo kwizerwa

Niba uri kubaza igihe nyuma ya metronidazole ushobora kunywa, igisubizo cyihisemo ni iminsi 3, cyangwa amasaha 72, nyuma y'urukingo rwa nyuma, niko ibi byanditswe ku rubuga rwa FDA na MedlinePlus byerekana.

Shakisha igihe nyuma ya metronidazole ushobora kunywa maze uzasanga amasaha 24, 48, n'amasaha 72 yavuzwe n'ibindi bitabo. Igice cya amasaha 24 kiva mu mikorere ngenderwaho: metronidazole ifite igihe gito cy'amasaha agera kuri umunani kandi isukuye mu bihe bigera ku minsi ibiri. Amabwiriza akomeye ya leta akoresha amasaha 48. Iminsi 3 y'urubuga ni ikintu gikomeye cyane kuruta kwirinda, kandi nta kintu gihinduka mu buryo bw'imibiri ku masaha 72.

Impinduka ebyiri zirakenewe. Abantu bafite ikibazo cy'umwijima basohora metronidazole gahoro kandi bagomba gusaba umuganga kubyerekeye igihe cy'igihe kinini. Na tinidazole-for-bv-when-it-is-used-instead-of-metronidazole" target="_blank" rel="noopener noreferrer">tinidazole ifite amabwiriza amwe y'iminsi 3. Urebye ko CDC isanga guhuza gutari bifitanye isano, umubare nyawo ntukagire agaciro kurenza uko urubuga rw'imbere rubitekereza.

Wamaze kunywa? Ibibazo bito bikunda kwishira ubwabyo

Niba wanyoye inzoga utabizi mugihe ufata metronidazole, ibisubizo byiza ni uko nta kintu kibaho na gato. Niba hari ikintu kibaye, ugomba kwitega kwotswa, kubabara mu nda, kubabara umutwe, n'ibise, bisanzwe bibaho mu isaha cyangwa ebyiri kandi bikagenda nta mvura.

Hagarika kunywa inzoga mu gihe cyo kuvura, kunywa amazi, kurya ikintu, kandi wihanganire kwishuka cyo kwishuka kubindi kunywa kugirango urebe niba icya mbere cyari amahirwe. Abantu benshi banyoye inzoga batabizi mugihe bafata metronidazole barumva bari mu mwanya mwiza mu gitondo.

Icyo udakwiye gukora ni guhagarika imiti y'abageteri. Indwara itavuwe, yaba bacteria vaginosis, trichomoniasis, cyangwa indwara ya anaerobic, ni ikibazo kinini kuruta nimugoroba wotswe. Hamagara umuganga wawe mbere yo gusiba imwe mu minsi.

Kugeza ubu ufite ikibazo kandi ntuzi icyo uhanganye nacyo? Uru rubuga rwa August rwa $39 rw'ibitaro byihutirwa kuri online rkukubaza uwuganga wemewe muri Amerika bushobora kwemeza ibimenyetso byawe kandi ukagenera imiti mugihe bikwiye; uwuganga ni we ukora icyemezo, atari uw'agashyimbo. Urubuga rwa video ntishobora kwemeza ibibazo by'umutima, kubiniga, cyangwa ingorane zo guhumeka, ibyo bikaba bikenera ubuvuzi bwihutirwa.

Igihe ugomba kuganga ubuvuzi, n'igihe uruvange, atari inzoga, ari ikibazo

Hamagara 911 cyangwa ugende mu bitaro byihutirwa ubu:

  • Guhungabana mu maso, iminwa, ururimi, cyangwa ijosi, kwishushanya cyane, cyangwa ingorane zo guhumeka
  • Ibibazo by'umutima, umutima uhinda cyane cyangwa utameze neza, cyangwa kubiniga nyuma yo kunywa
  • Kwihangamura
  • Kuruka bikomeye cyangwa bikomeza kubaho hamwe n'ibimenyetso byo kwahuka

Shyiramo urugendo mu cyumweru gitaha niba:

  • Kubura bushya, gusongera, cyangwa intege nke mu ntoki cyangwa ibirenge
  • Kwicisha ubwenge bikomeye cyangwa bikomeza kubaho
  • Ibibazo byose byo guhuza bikomeza kuruta umunsi

Ibyo bibazo byo mu bwenge ni ibibazo by'ubuhanga bya metronidazole, atari ibibazo by'inzoga.

Vugana n'uwaguhaye urukingo mbere yuko utangira niba:

  • Wafashe disulfiram (Antabuse) mu minsi ibiri ishize
  • Ufite indwara y'umwijima
  • Unywa inzoga cyane buri munsi, aho guhagarika gutera igitera n'ibindi bibazo bibaho

Ibisubizo bya nyuma kuri metronidazole n'inzoga

Uru rubuga rwa FDA ruracyavuga ko nta inzoga mu gihe cyo kuvura no mu minsi 3; amabwiriza yo kuvura ya CDC avuga ko kwirinda bitari ngombwa. Bombi ni izubu, kandi ntugomba kwemeza impaka zabo. Ku rugendo rw'iminsi irindwi cyangwa icumi, gutegereza ni byiza kandi birakuraho ikibazo burundu. Ikibazo cy'agahinda nyakuri ni disulfiram yafashwe mu gihe cy'ibyumweru bibiri bya metronidazole, atari ikirahure kimwe cy'imbuto. Kandi uko wanyoye kose, tangira imiti y'abageteri.

Ikibazo gisanzwe cyabajijijwe

Noneho burugubuguto y'inzoga ireba metronidazole gel cyangwa ibikoresho byo mu gifu?

Ntabwo bikunze kubaho. Burugubuguto yo mu kanwa irahari kuko ibinyobwa byo mu kanwa bituma uruvange rugera mu mubiri wose, mu gihe metronidazole gel yo mu gifu n'inzoga bidahuriraho cyane, kuko imikoranire y'uburyo bwinshi mu gifu ni bito. Bimwe mu bikoresho by'abakora by'ibitabo bikomeza gusubiramo burugubuguto yose, bityo reba igikoresho cyihariye cyahawe kandi usabe umuganga wawe niba bitari byiza.

Noneho nsigaye kwirengagiza "hitondere inzoga" y'umuganga w'ibinyobwa kuko CDC ivuga ko kwirinda bitari ngombwa?

Oya. Abaganga b'ibinyobwa bashyira agashyimbo kuko urubuga rw'ibyemezwa rubisaba, kandi ni iby'ubwishingizi, ntabwo ari ikosa ryo guhindura. Niba amabwiriza kuri metronidazole n'inzoga akugira akamaro, babaze ubasabe kuruta kwemeza utavugishije. Bashobora kugira ingaruka ku bwoko bwawe bw'umwijima, imiti yawe ikindi, n'igikoresho cyihariye, kandi ikiganiro rusange nticyabikora.

Noneho kunywa inzoga bigabanya metronidazole gukora mu kuvura indwara?

Oya. Ntabwo hari ibimenyetso byerekana ko inzoga igabanya imikorere ya metronidazole ku bageteri cyangwa parasite. Akaga gakomeye ni katalisiti: niba kunywa inzoga bitera kuruka igice, gusinzira, cyangwa kwibagirwa gahunda, urugendo rugira akamaro. Kwirinda gahunda bikomeye kuruta uko wabikora.

Noneho umunyu wo mu kanwa, imiti y'inshuti, n'ibindi bisubizo by'inzoga byihishe birakoreshwa?

Mu buryo bwemewe, yego. Amabwiriza y'urubuga aribwirizwa ku bikoresho bifite inzoga cyangwa propylene glycol, atari inzoga gusa. Mu buryo bwo kwirinda, umunyu wo mu kanwa usukura kandi ukinyagiza ni ubwenge bwinshi, mu gihe imiti y'inshuti ufata inshuro nyinshi ku munsi ni ikintu gikomeye. Versiyoni zidasanzwe za bombi zirahari niba waba utashaka gutekereza kuri icyo.

Noneho metronidazole ishobora kugira akamaro mu gutera inzoga imwe kuruta bisanzwe?

Birashoboka. Kubera ko inzoga ishobora gutinda kuruta uko wari wabiteze, inzoga imwe ishobora kwumva irushijeho cyangwa ikamara igihe kuruta uko wari wabiteze. Ikibazo gikomeye ni ikihirika: ntukatekere ko ibyo wanyoye bisanzwe bibaho, cyane cyane mu gihe utwaye cyangwa ikindi kintu aho guhinduka gato kuruta uko wari wabiteze bifite agaciro.

Inyandiko: Iki kiganiro ni kubw'amakuru gusa kandi ntabwo ari ubuvuzi. Hamagara umuganga ufite ubushobozi kugirango uhitemo ubuvuzi n'imiti. Niba ufite impuzankano y'ubuvuzi, hamagara 911 cyangwa ugende mu bitaro byihutirwa ubu ngubu.