Yini i-Dantrolene (Indlela yokujova): Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Dantrolene intravenous iyimithi esindisa impilo esetshenziselwa ikakhulukazi ukwelapha i-malignant hyperthermia, okuyindlela engavamile kodwa eyingozi yokusabela kuma-anesthetics athile ngesikhathi sokuhlinzwa. Le nto enamandla yokukhulula imisipha isebenza ngokuvimba ukukhululwa kwe-calcium emangqamuzini emisipha, okusiza ukulawula ukuncipha kwemisipha okuyingozi nokushisa ngokweqile okungenzeka ngesikhathi sokuphuthuma kwezokwelapha.

Ngenkathi kungenzeka ukuthi awukaze uzwe ngalo muthi ngaphambili, udlala indima ebalulekile emakamelweni okusebenza nasemayunithi okunakekelwa okukhulu emhlabeni wonke. Ukuqonda ukuthi isebenza kanjani nokuthi isetshenziswa nini kungakusiza ukuthi uzizwe unolwazi olwengeziwe mayelana nokwelashwa kwezokwelapha eziphuthumayo.

Yini i-Dantrolene?

I-Dantrolene iyisikhululi semisipha esiza ngesimo somlomo nesokujova, ngenguqulo ye-IV esetshenziselwa izimo eziphuthumayo zezokwelapha. Ifomu le-intravenous lenzelwe ngqo ukusebenza ngokushesha lapho iminithi ngalinye libalwa ngesikhathi senkinga.

Lo muthi ungowodwa oyingqayizivele wemithi ngoba usebenza ngqo kuma-fiber emisipha kunokuthi udlule ohlelweni lwezinzwa njengezinye izikhululi zemisipha eziningi. Cabanga ngayo njengokhiye okhethekile ofanelana namangqamuzana emisipha ukuwenza anganciphi ngokungalawuleki.

Ifomu le-IV livame ukutholakala ezibhedlela nasemitholampilo yokuhlinzwa njengengxenye yemithetho yezokwelapha eziphuthumayo. Akuyona into ongahlangana nayo ekunakekelweni kwezokwelapha okuvamile, kodwa kunalokho ukwelashwa okukhethekile kwezimo ezithile ezisongela impilo.

Isetshenziselwani i-Dantrolene?

I-Dantrolene IV isetshenziswa ikakhulukazi ukwelapha i-malignant hyperthermia, okuyindlela eyingozi yokusabela engenzeka lapho abantu abathile bevezwa kuma-anesthetics athile noma izikhululi zemisipha ngesikhathi sokuhlinzwa. Lesi simo sibangela ukuthi izinga lokushisa lomzimba likhuphuke ngokushesha ngenkathi imisipha incipha ngokungalawuleki.

Ngaphandle kwe-malignant hyperthermia, odokotela ngezinye izikhathi basebenzisa i-dantrolene IV eziphuthumeni ezinzima ezihlobene nemisipha. Lokhu kuhlanganisa i-spasticity yemisipha eqinile engaphenduli kwezinye izindlela zokwelapha, ikakhulukazi ezimweni lapho ukuqina kwemisipha kusongela impilo.

Ezimweni ezingavamile, amaqembu ezokwelapha angase asebenzise i-dantrolene ukwelapha i-neuroleptic malignant syndrome, ukusabela okukhulu emithini ethile yezifo zengqondo. Lesi simo sihlobene ne-malignant hyperthermia futhi singazuza ezintweni ezifanayo zokuphumuza imisipha.

Eminye iminyango yezimo eziphuthumayo nayo igcina i-dantrolene ukuze ilaphe amacala aqinile e-serotonin syndrome noma enye i-hyperthermia ebangwa yizidakamizwa lapho ukuqina kwemisipha kuyinkinga enkulu.

Isebenza Kanjani I-Dantrolene?

I-Dantrolene isebenza ngokuvimba ukukhululwa kwe-calcium ngaphakathi kwamaseli emisipha, okuvimbela imisipha ukuthi ingaqinani. Lapho i-calcium ingakwazi ukuhamba ngokukhululeka ngaphakathi kwemisipha, imisipha ayikwazi ukugcina ukuncipha kwayo okuqinile, okuyingozi.

Lo muthi uthathwa njengonamandla kakhulu futhi usebenza ngokushesha uma unikezwa nge-intravenously. Ngokungafani nezidambisi zemisipha eziningi ezisebenza ngobuchopho bakho noma umgogodla, i-dantrolene isebenza ngokuqondile esicutshini semisipha ngokwayo, okuyenza isebenze ngendlela eyingqayizivele ezimweni eziphuthumayo ezithile.

Lo muthi uqondise ngqo iphrotheni ebizwa nge-ryanodine receptor, elawula ukunyakaza kwe-calcium emangqamuzaneni emisipha. Ngokuvimba le receptor, i-dantrolene empeleni icisha ikhono lemisipha lokuncipha ngamandla nangokuqhubekayo.

Ngemizuzu yokuthola i-dantrolene IV, iziguli ngokuvamile ziqala ukubonisa ukuthuthuka ekuqineni kwemisipha nasezingeni lokushisa lomzimba. Lesi senzo esisheshayo senza ukuthi singabi nani ezimweni eziphuthumayo zezokwelapha lapho isikhathi sibalulekile.

Kufanele Ngiyithathe Kanjani I-Dantrolene?

I-Dantrolene IV ihlale inikezwa ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni zasemtholampilo, ngakho ngeke kudingeke ukhathazeke ngokuyithatha wena uqobo. Umuthi uza njengempushana okumele ixutshwe namanzi ahlanzekile ngaphambi kokuba ifakwe emthanjeni.

Amaqembu ezokwelapha ngokuvamile anikeza i-dantrolene ngomugqa omkhulu we-IV ngoba umuthi ungacasula imithambo emincane. Umjovo uvame ukunikezwa kancane kancane ngemizuzu embalwa ukunciphisa ingozi yemiphumela emibi.

Ngesikhathi sokwelashwa, abahlinzeki bezempilo bazobheka ngokusondele ukushaya kwenhliziyo yakho, umfutho wegazi, kanye nezinga lokushisa lomzimba. Bazobheka futhi izimpawu zokuthi umuthi uyasebenza, njengokuncipha kokuqina kwemisipha nokuthuthuka kokuphefumula.

Uma uqaphela ngesikhathi sokwelashwa, ungase uqaphele ukuthi umuthi unokunambitheka okubabayo kancane noma ubangele isicanucanu. Le miphumela ijwayelekile futhi ivame ukuba yesikhashana njengoba umzimba wakho ujwayela umuthi.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Dantrolene?

Ubude bokwelashwa nge-dantrolene IV buqondile ngokuphelele esimweni sakho esiphuthumayo sezokwelapha nokuthi usabela kahle kangakanani emuthini. Ezimweni ze-malignant hyperthermia, ukwelashwa kungase kuthathe amahora amaningana ukuqinisekisa ukuthi ubunzima buxazululwe ngokugcwele.

Iziguli eziningi zithola imithamo eminingi ngesikhathi sokwelashwa kwazo, ngamaqembu ezokwelapha ehlukanisa le mithi ngokucophelela ngokusekelwe ekuphenduleni komzimba wakho. Abanye abantu bangase badinge ukwelashwa amahora ambalwa nje, kanti abanye bangase badinge ukuqapha kanye nemithi usuku olulodwa noma ngaphezulu.

Ngemuva kokuthi ubunzima obuqondile budlule, odokotela bavame ukushintsha iziguli ziye ku-dantrolene yomlomo ukuvimbela lesi simo ukuthi singabuyi. Lokhu kushintsha ngokuvamile kwenzeka uma uzinzile futhi ungakwazi ukuthatha imithi ngomlomo ngokuphepha.

Iqembu lakho lezokwelapha lizokwenza zonke izinqumo mayelana nokuthi kufanele liqhubeke isikhathi esingakanani ukwelashwa ngokusekelwe ezimpawini zakho ezibalulekile, imiphumela yelabhorethri, kanye nokuthuthuka okujwayelekile komtholampilo. Ngeke bayeke umuthi kuze kube yilapho beqiniseka ukuthi isimo esiphuthumayo sesidlulile.

Ziyini Imiphumela Eceleni ye-Dantrolene?

Ngenkathi i-dantrolene IV isindisa impilo, ingabangela imiphumela eminingi eceleni ezolandelelwa ngokusondela ithimba lakho lezokwelapha. Imiphumela evame kakhulu ihlanganisa isicanucanu, ukuhlanza, nobuthakathaka obujwayelekile njengoba imisipha yakho iphumula.

Nansi imiphumela eceleni ongase uyithole ngesikhathi sokwelashwa:

• Isicanucanu nokuhlanza
• Ubuthakathaka bemisipha emzimbeni wakho wonke
• Ukozela noma ukudideka
• Ukuphefumula kanzima (ngenxa yobuthakathaka bemisipha yokuphefumula)
• Umfutho wegazi ophansi
• Ukushaya kwenhliziyo okungajwayelekile
• Ubuhlungu noma ukucasuka endaweni yokujova

Le miphumela ngokuvamile iyalawuleka endaweni yasesibhedlela lapho uqashwe ngokusondela. Imiphumela eminingi eceleni iyathuthuka njengoba umuthi uphela futhi umzimba wakho ululama esimweni esiphuthumayo.

Imiphumela emibi kodwa engavamile ingahlanganisa ubunzima obukhulu bokuphefumula obudinga ukungenelela ngemishini, ukwehla okukhulu komfutho wegazi, noma izinkinga zesigqi senhliziyo. Ithimba lakho lezokwelapha liqeqeshwe ukubhekana nalezi zinkinga uma zenzeka.

Abanye abantu bathola ubuthakathaka bemisipha obuqhubekayo izinsuku eziningana ngemuva kokwelashwa, yingakho odokotela bevame ukuncoma ukuphumula nokubuyela kancane kancane emisebenzini ejwayelekile. Lobu buthakathaka ngokuvamile buyanyamalala ngokuphelele njengoba umuthi usuka emzimbeni wakho.

Ubani Ongafanele Athole I-Dantrolene?

Kunezizathu ezimbalwa eziqondile zokugwema i-dantrolene IV ngesikhathi esiphuthumayo esisongela impilo, ngoba izinzuzo ngokuvamile zidlula izingozi. Kodwa-ke, ithimba lakho lezokwelapha lizocabangela izici ezithile ngaphambi kokunikeza lo muthi.

Abantu abanezifo zesibindi ezinzima bangase badinge ukuqashwa okukhethekile ngesikhathi sokwelashwa, njengoba i-dantrolene ingathinta ukusebenza kwesibindi. Odokotela bakho bazohlola ingozi esheshayo yesimo sakho ngokumelene nezingozi ezingaba khona zesibindi.

Uma unomlando wesifo esibi samaphaphu noma izinkinga zokuphefumula, ithimba lakho lezokwelapha lizoba nokuqapha okwengeziwe mayelana nokuqapha ukuphefumula ngesikhathi sokwelashwa. Umuthi unganciphisa imisipha yokuphefumula, okungase kube ngukukhathazeka kubantu abanezinkinga zamaphaphu ezikhona.

Abesifazane abakhulelwe bangathola i-dantrolene uma kudingeka esimweni esiphuthumayo esisongela impilo, kodwa odokotela bazocabangela ngokucophelela izingozi kumama nomntwana. Umuthi ungangena esithweni somzimba, kodwa ukusinda komama kuyinto eza kuqala.

Abantu abanokungezwani okwaziwayo ne-dantrolene kufanele bakugweme uma kungenzeka, nakuba ezinye izindlela zokwelapha i-malignant hyperthermia zilinganiselwe. Ithimba lakho lezokwelapha lingase lidingeke ukulisebenzisa ngisho noma unokungezwani okwaziwayo uma impilo yakho isengozini.

Amagama Omkhiqizo we-Dantrolene

I-Dantrolene IV ivame ukutholakala ngaphansi kwegama lomkhiqizo elithi Dantrium, okuyilona hlobo olwaziwa kakhulu ezibhedlela nasemitholampilo yokuhlinzwa. Lolu hlobo selusetshenziswe ngokuphepha amashumi eminyaka ezimweni eziphuthumayo zezokwelapha.

Elinye igama lomkhiqizo ongase uhlangane nalo yi-Revonto, okuyindlela entsha eyenzelwe ukuncibilika ngokushesha uma ixutshwe namanzi. Lokhu kungasiza ngesikhathi esiphuthumayo lapho wonke umzuzwana ubalulekile.

Ezinye izibhedlela zingase zibhekisele kuyo ngokuthi

Ngezinhlobo ezahlukene ze-muscle spasticity noma rigidity, odokotela bangasebenzisa imithi efana ne-baclofen, diazepam, noma ezinye izinto eziphumuzisa imisipha. Kodwa-ke, lezi zisebenza ngezindlela ezihlukene futhi azisebenzi ku-malignant hyperthermia.

Kwezinye izimo ze-drug-induced hyperthermia, ukunakekelwa okusekelayo ngamabhilidi okupholisa, uketshezi lwe-IV, neminye imithi kungase kusize kanye ne-dantrolene. Kodwa lezi yizindlela zokwelapha ezingeziwe, hhayi izindlela zokushintsha.

Yingakho izibhedlela ezenza ukuhlinzwa kudingeka zibe ne-dantrolene etholakalayo kalula. Ukuba nale mithi ethile esandleni kungasho umehluko phakathi kokuphila nokufa ezigulini ezithintekayo.

Ingabe i-Dantrolene Ingcono Kunezinye Izinto Eziphumuzisa Imisipha?

I-Dantrolene akudingeki ukuthi

I-Dantrolene inganikezwa kubantu abanezifo zenhliziyo uma idingeka esimweni esiphuthumayo esisongela impilo njenge-malignant hyperthermia. Nokho, ithimba lakho lezokwelapha lizobheka ukushaya kwenhliziyo yakho nomfutho wegazi ngokuqinile ngesikhathi sokwelashwa.

Umuthi ngezinye izikhathi ungabangela ukushaya kwenhliziyo okungajwayelekile noma umfutho wegazi ophansi, okungase kube ngukukhathazeka kubantu abanezinkinga zenhliziyo ezikhona. Odokotela bakho bazoba nemithi nemishini elungele ukuphatha le miphumela uma kwenzeka.

Ezimweni eziphuthumayo, ingozi esheshayo evela ku-malignant hyperthermia ngokuvamile idlula izingozi zenhliziyo ezivela ku-dantrolene. Ithimba lakho lezokwelapha lizokwenza lesi sinqumo ngokusekelwe esimweni sakho esithile kanye nesimo sempilo yakho esiphelele.

Kufanele Ngenzeni Uma Ngithola I-Dantrolene Eningi Ngengozi?

Akudingeki ukhathazeke ngokuthola i-dantrolene eningi ngengozi, njengoba inikezwa kuphela ochwepheshe bezokwelapha abaqeqeshiwe ababala ngokucophelela umthamo ofanele ngokusekelwe esisindweni sakho kanye nesimo sakho. Izimiso zesibhedlela zihlanganisa ukuhlolwa kokuphepha okuningi ukuvimbela amaphutha okulinganisa.

Uma ukweqisa kwenzeka, ithimba lakho lezokwelapha lingaqala ngokushesha ukunakekelwa okusekelayo okuhlanganisa usizo lokuphefumula uma kudingeka, ukusekela umfutho wegazi, kanye nokubheka eduze zonke izimpawu ezibalulekile. Akukho umuthi oqondile we-dantrolene, ngakho ukwelashwa kugxila ekuphatheni izimpawu.

Izimpawu ze-dantrolene eningi zihlanganisa ubuthakathaka obukhulu bemisipha, ubunzima bokuphefumula, umfutho wegazi ophansi kakhulu, kanye nokulala ngokweqile. Ithimba lakho lezokwelapha liqeqeshwe ukubona nokwelapha lezi zimpawu ngokushesha nangempumelelo.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Dantrolene?

Njengoba i-dantrolene IV inikezwa kuphela ezindaweni zesibhedlela ngesikhathi sezimo eziphuthumayo zezokwelapha, ngeke kudingeke ukhathazeke ngokulahlekelwa imithamo. Ithimba lakho lezokwelapha lizoqinisekisa ukuthi uthola umuthi ngqo uma futhi kaningi ngendlela owudinga ngayo.

Uma kamuva unikezwa i-dantrolene yomlomo ukuze uqhubeke nokwelashwa ekhaya, udokotela wakho uzokunikeza imiyalelo ethile mayelana nokuthi wenzeni uma uphuthelwa umthamo. Ngokuvamile, kufanele uthathe umthamo owuphuthelwe ngokushesha lapho ukhumbula, ngaphandle uma sekuseduze isikhathi somthamo wakho olandelayo.

Ungalokothi uphindaphinde imithamo ye-dantrolene ngaphandle kokukhuluma nodokotela wakho kuqala, ngoba lokhu kungandisa ingozi yakho yemiphumela emibi efana nobuthakathaka bemisipha obukhulu noma izinkinga zokuphefumula.

Ngingayeka nini Ukuthatha i-Dantrolene?

Nge-dantrolene ye-IV enikezwa ngesikhathi sezimo eziphuthumayo, ithimba lakho lezokwelapha lizinqumela ukuthi lingayeka nini umuthi ngokusekelwe ekululameni kwakho nasezimpawini ezibalulekile. Ngeke kudingeke ukuthi uzenzele lesi sinqumo, njengoba kudinga ubuchwepheshe bezokwelapha ukunquma ukuthi kuphephile nini ukuyeka.

Uma unikezwe i-dantrolene yomlomo ukuze uqhubeke ekhaya, ungalokothi uyeke ukuyithatha kungazelelwe ngaphandle kokukhuluma nodokotela wakho kuqala. Ukuyeka ngokushesha kungavumela ukuthi imisipha eyingozi ibuye.

Udokotela wakho ngokuvamile uzokwehlisa umthamo wakho kancane kancane ngokuhamba kwesikhathi kunokuyeka kungazelelwe. Lokhu kusiza ekuvikeleni noma yiziphi izinkinga zemisipha eziphindayo futhi kuqinisekisa ukuthi umzimba wakho uzivumela ngokuphepha ukuba ngaphandle komuthi.

Ngingashayela Ngemva Kokuthola i-Dantrolene?

Akufanele ushayele noma usebenzise imishini okungenani amahora angu-24-48 ngemva kokuthola i-dantrolene IV, njengoba umuthi ungabangela ukozela, ubuthakathaka bemisipha, kanye nokusabela okuhamba kancane okungenza ukushayela kube yingozi.

Noma ngemva kokuzizwa ungcono, umuthi usengase ube nomthelela ekuxhumaniseni kwakho nasezikhathini zokuphendula. Udokotela wakho uzokweluleka ukuthi kuphephile nini ukuqala kabusha imisebenzi ejwayelekile efana nokushayela ngokusekelwe ekululameni kwakho.

Uma uthatha i-dantrolene yomlomo ekhaya, khuluma nodokotela wakho mayelana nemikhawulo yokushayela. Abanye abantu bangashayela ngenkathi bethatha imithamo ephansi, kanti abanye badinga ukugwema ukushayela ngokuphelele baze baqede ukwelashwa.