Yini i-Difelikefalin: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Difelikefalin iyimithi kadokotela enikezwa nge-IV ukusiza abantu abenza i-dialysis abahlushwa yi-pruritus ehlobene nesifo sezinso esingamahlalakhona (i-CKD-aP). Leli igama lezokwelapha lokuluma okuqhubekayo, okuvame ukungabekezeleleki okwenzeka lapho izinso zakho zingasebenzi kahle. Ungase wazi lo muthi ngegama lawo lomkhiqizo elithi Korsuva, futhi usebenza ngendlela ehlukile kunezindlela zokwelapha ezivamile zokuluma ngokugxila kuma-receptors athile emzimbeni wakho alawula umuzwa wokuluma.

Yini i-Difelikefalin?

I-Difelikefalin iyimithi eyenziwe ngendlela yokufakelwa elingisa izinhlanganisela zemvelo ezithile emzimbeni wakho ezibizwa ngokuthi ama-peptide. Ingaphansi kwesigaba semithi eyaziwa ngokuthi ama-kappa opioid receptor agonists, okusho ukuthi yenza kusebenze ama-receptors athile ohlelweni lwakho lwezinzwa ngaphandle kokubangela imiphumela ejwayelekile ongayilindela kuma-opioids afana ne-morphine noma i-codeine.

Umuthi wenzelwe ngqo ukusiza abantu abazinso zabo ezingahlungi kahle imfucuza, okuholela ekwakhekeni kwe-toxins ezingabangela ukuluma okukhulu. Ngokungafani nama-creams aphezulu noma ama-antihistamines asebenza ebusweni besikhumba sakho, i-difelikefalin isebenza ngaphakathi ngokuqondisa izindlela zemizwa ezithumela amasignali okuluma ebuchosheni bakho.

Isetshenziselwani i-Difelikefalin?

I-Difelikefalin iphatha i-pruritus ehlobene nesifo sezinso esingamahlalakhona kubantu abadala abathola i-hemodialysis. Lesi simo sithinta abantu abaningi abanesifo sezinso futhi singathinta kakhulu izinga lempilo yakho, okwenza kube nzima ukulala, ukusebenza, noma ukujabulela imisebenzi yansuku zonke.

Ukuluma okuvela esifweni sezinso akufani nokuluma okujwayelekile ongakuthola esikhumbeni esomile noma ukulunywa umiyane. Kuvame ukuchazwa njengomuzwa ojule, ovuthayo ongavela noma yikuphi emzimbeni wakho kodwa ovame ukuthinta umhlane wakho, izingalo, nemilenze. Ukwelashwa kwendabuko okufana nama-antihistamines noma ama-creams aphezulu ngokuvamile akunikezi ukukhululeka okwanele kulolu hlobo lokuluma.

Udktora wakho angase acabange ukusebenzisa i-difelikefalin uma uzamile ezinye izindlela zokwelapha ngaphandle kwempumelelo futhi ukulunywa kwakho kuphazamisa impilo yakho yansuku zonke. Lo muthi uvunyelwe ngokuqondile kubantu asebevele bethola i-dialysis, njengoba unikezwa ngesikhathi sokuhlolwa kwakho kwe-dialysis.

Isebenza Kanjani I-Difelikefalin?

I-Difelikefalin isebenza ngokuvula ama-kappa opioid receptors ohlelweni lwakho lwezinzwa olungaphandle, okuyizinzwa ezingaphandle kobuchopho bakho nomgogodla. Uma la ma-receptors esevuliwe, asiza ukunciphisa ukudluliselwa kwezimpawu zokulunywa esikhumbeni sakho ebuchosheni bakho, okunikeza ukukhululeka emzweleni oqhubekayo wokuzikloloba.

Okuhlukile ngalo muthi ukuthi wenzelwe ukuhlala ohlelweni lwakho lwezinzwa olungaphandle kunokuthi ungene ebuchosheni bakho. Le ndlela eqondiwe isho ukuthi uthola izinzuzo zokulwa nokulunywa ngaphandle kokuzwa ukuthula, injabulo, noma amathuba okulutheka ahambisana nemithi yendabuko ye-opioid.

Lo muthi ubhekwa njengosebenza kahle ngokulinganisela kulolu hlobo oluthile lokulunywa. Ngenkathi kungenzeka ukuthi akuqedi ngokuphelele izimpawu zakho, izifundo zomtholampilo zikhombisa ukuthi kunganciphisa kakhulu ukuqina kokulunywa futhi kuthuthukise izinga lakho jikelele lempilo uma lisetshenziswa ngokuqhubekayo.

Kufanele Ngiyithathe Kanjani I-Difelikefalin?

I-Difelikefalin inikezwa njengomjovo we-intravenous ngqo emgqeni wakho we-dialysis ngesikhathi seseshini ngayinye ye-hemodialysis. Ithimba lakho lezempilo lizosebenzisa lo muthi, ngakho akudingeki ukhathazeke ngokuzinika wona noma ukukhumbula ukuwuthatha ekhaya.

Umjovo uvame ukunikezwa ekupheleni kweseshini yakho ye-dialysis, ngemuva kokuthi ukwelashwa kwe-dialysis kuqediwe kodwa ngaphambi kokuthi umugqa wakho wokufinyelela ususwe. Umuthi unikezwa kancane kancane cishe iminithi elilodwa, futhi uzohlala esikhungweni se-dialysis ukuze uqashwe ngemuva kokuwuthola.

Akudingeki ukuthi wenze izinguquko ezikhethekile ekudleni noma amalungiselelo ngaphambi kokuthola i-difelikefalin. Njengoba inikezwa ngesikhathi sokuqokwa kwakho okuvamile kwe-dialysis, iba yingxenye yomkhuba wakho okhona wokwelashwa ngaphandle kokudinga ukuvakashela okwengeziwe esikhungweni sezempilo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Difelikefalin?

Ubude bokwelashwa nge-difelikefalin buxhomeke ekuphenduleni kwakho komuntu ngamunye nokuthi uyithatha kahle kangakanani imithi. Abantu abaningi baqhubeka beyithola uma nje bethola i-dialysis futhi bezuza emithini.

Udokotela wakho uzohlola njalo ukuthi imithi ikusebenzela kahle kangakanani nokuthi ngabe unayo yini imiphumela emibi. Cishe bazoxhumana nawe mayelana namazinga akho okuluma kanye nekhwalithi yakho yempilo iyonke ukuze banqume ukuthi ukuqhubeka nokwelashwa kunengqondo yini.

Abanye abantu baqaphela ukuthuthuka ekulungeni kwabo emasontweni ambalwa okuqala okwelashwa, kanti abanye bangase badinge izinyanga eziningana ukuze bathole izinzuzo eziphelele. Kubalulekile ukuba nesineke futhi uqhubeke nokwelashwa kwakho, njengoba imiphumela yokulwa nokuluma ivame ukukhula ngokuhamba kwesikhathi.

Yini Imiphumela Emibi Ye-Difelikefalin?

Njengayo yonke imithi, i-difelikefalin ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Imiphumela emibi evame kakhulu ngokuvamile imnene futhi ilawuleka, kodwa kubalulekile ukwazi ukuthi yini okufanele uyibheke.

Imiphumela emibi ebikwa kaningi ihlanganisa isifo sohudo, isiyezi, isicanucanu, nokwehla kwegazi okwesikhashana. Lezi zimpawu zivame ukuba mnene futhi zivame ukuthuthuka njengoba umzimba wakho ujwayela imithi emasontweni ambalwa okuqala okwelashwa.

Nawa imiphumela emibi evamile ongase uyithole:

• Ukuqunjelwa, okungase kwenzeke kungakapheli amahora ngemuva kokuthola umjovo
• Isiyezi noma ukuzwa sengathi uyakhathala, ikakhulukazi uma usukuma
• Ukucasuka kwesisu noma isicanucanu esincane
• Ukuphalaza, nakuba lokhu kuvamile kancane kunesicanucanu
• Ukwehla kwengcindezi yegazi okwesikhashana
• Ukukhathala noma ukuzizwa ukhathele kunokujwayelekile

Iningi lalezi zinkinga ezincane zisesikhashana futhi zivame ukuncipha njengoba umzimba wakho ujwayela umuthi. Ithimba lakho le-dialysis lizokuqapha ngokucophelela, ikakhulukazi ngesikhathi sokwelashwa kwakho kokuqala.

Nakuba kungavamile, abanye abantu bangase babe nemiphumela emibi kakhulu edinga ukunakekelwa kwezempilo ngokushesha. Lokhu kuhlanganisa ukusabela okukhulu komzimba, izinguquko ezinkulu zengcindezi yegazi, noma ukuphalaza okuqhubekayo okukuvimbela ukuthi ungagcini uketshezi.

Ukusabela komzimba ku-difelikefalin akuvamile kodwa kungahlanganisa izimpawu ezinjengobunzima bokuphefumula, ukuvuvukala kobuso bakho noma umphimbo, noma ukuqubuka okubanzi. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, ithimba lakho lezokwelapha lizoyeka umuthi ngokushesha futhi linikeze ukwelashwa okufanele.

Ubani Ongafanele Athole I-Difelikefalin?

I-Difelikefalin ayifanele wonke umuntu, futhi udokotela wakho uzobukeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyibhala. Umuthi uvunyelwe ngokuqondile kuphela kubantu abadala abathola i-hemodialysis, ngakho-ke awusetshenziswa kubantu abanomsebenzi wezinso ojwayelekile noma labo abasezinjeni ze-dialysis.

Akufanele uthole i-difelikefalin uma wazi ukuthi unokungezwani komzimba nomuthi noma yiziphi izingxenye zawo. Udokotela wakho uzosebenzisa ukuqapha uma unezimo ezithile zenhliziyo, isifo sesibindi esibi, noma umlando wezinkinga ezinkulu zengcindezi yegazi.

Nazi izimo lapho i-difelikefalin ingase ingafaneleki khona:

• Ukuhluleka kwenhliziyo okukhulu noma ukushaya kwenhliziyo okungazinzile
• Isifo sesibindi esikhulu esithinta indlela umzimba wakho oqhubula ngayo imithi
• Umlando wokungezwani komzimba okukhulu emithini efanayo
• Ukukhulelwa noma ukuncelisa, njengoba ukuphepha kungakahlolwa
• Ukungazinzi okukhulu komfutho wegazi
• Ukusetshenziswa kabi kwezinto eziluthayo ezibandakanya ama-opioids

Udokotela wakho uzoqaphela izinzuzo ezingaba khona uma ziqhathaniswa nezingozi ngokusekelwe esimweni sakho sempilo. Bazophinda bacabange ukuthi eminye imithi oyithathayo ingase isebenzisane kanjani ne-difelikefalin.

Igama Lomkhiqizo le-Difelikefalin

I-Difelikefalin ithengiswa ngaphansi kwegama lomkhiqizo elithi Korsuva yi-Cara Therapeutics. Leli njengamanje yilona kuphela igama lomkhiqizo elitholakalayo lalo muthi, njengoba kuyindlela yokwelapha entsha eqashelwe yi-FDA ngonyaka ka-2021.

Uma ukhuluma nethimba lakho lezempilo noma inkampani yomshuwalense, bangase babhekisele emuthini nganoma yiliphi igama. Kokubili i-Korsuva ne-difelikefalin zibhekisela emuthini ofanayo, ngakho-ke ungadideki uma uzwa womabili la magama esetshenziswa ngokushintshana.

Ezinye izindlela zokwelapha i-Difelikefalin

Uma i-difelikefalin ingasebenzi kahle kuwe noma idala imiphumela engathandeki, kunezindlela eziningi zokwelapha ezingenye zokulunywa okuhlobene nesifo sezinso. Udokotela wakho angakusiza ukuthi uhlole lezi zinketho ngokusekelwe esimweni sakho esithile kanye nomlando wezokwelapha.

Ukwelashwa kwendabuko kufaka phakathi ama-antihistamines afana ne-hydroxyzine noma i-cetirizine, nakuba lokhu kuvame ukungasebenzi kahle ekulunyeni okuhlobene nezinso. Ukwelashwa okusebenzayo njengama-creams asekelwe ku-menthol noma i-calamine lotion kungahlinzeka ngosizo oluthile, ikakhulukazi uma lusetshenziswa kanye nezinye izindlela zokwelapha.

Ezinye izindlela zokwelapha ezinqunywe ngudokotela zifaka i-gabapentin, ethinta amasignali ezinzwa ngendlela ehlukile kune-difelikefalin, noma i-pregabalin, omunye umuthi ongase usize ngezimpawu ezihlobene nezinzwa. Abanye abantu bathola usizo ngemithi yokukhanya kwe-ultraviolet, nakuba lokhu kudinga imishini ekhethekile nokuqapha.

Kwezinye izimo, ukuthuthukisa ukwelashwa kwakho kwe-dialysis ngokwako kungasiza ekunciphiseni ukulunywa. Lokhu kungabandakanya ukulungisa isimiso sakho se-dialysis, ukushintsha uhlobo lwe-dialyzer olusetshenziswayo, noma ukuguqula amazinga akho okususwa kwamanzi.

Ingabe i-Difelikefalin Ingcono Kunezinye Imithi?

I-Difelikefalin inikeza ezinye izinzuzo eziyingqayizivele ngaphezu kokwelashwa kwendabuko kokulunywa okuhlobene nesifo sezinso, kodwa ukuthi 'ingcono' ngokuya ngempendulo yakho kanye nezimo zakho. Ngokungafani nama-antihistamines, avame ukungasebenzi kahle ekulunyweni okuhlobene nezinso, i-difelikefalin iqondisa ngqo izindlela zemizwa ezihilelekile kulolu hlobo lokulunywa.

Uma kuqhathaniswa nemithi efana ne-gabapentin, i-difelikefalin inikezwa ngesikhathi se-dialysis kunokuthi idinge amaphilisi ansuku zonke ekhaya. Lokhu kungaba lula futhi kuqinisekisa ukuthi awuphuthelwa imithamo, kodwa futhi kusho ukuthi ungalithola kuphela uma uthola i-hemodialysis ejwayelekile.

Umuthi uvame ukubangela imiphumela emincane yohlelo lwezinzwa oluphakathi nendawo kunezinye izindlela ngoba awungeni ebuchosheni bakho. Lokhu kusho ukulala kancane noma imiphumela yokuqonda uma kuqhathaniswa nemithi efana nama-antihistamines noma imithi ethile elwa nokuthuthumela esetshenziselwa ukulunywa.

Nokho, i-difelikefalin ingase ibangele imiphumela eminingi ye-gastrointestinal efana nohudo uma iqhathaniswa nokwelashwa kwendawo. Udokotela wakho uzokusiza ukuthi ulinganise lezi zinto lapho unquma ngendlela engcono kakhulu yokwelapha isimo sakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Difelikefalin

Ingabe i-Difelikefalin Iphephile Kubantu Abanesifo Senhliziyo?

I-Difelikefalin ingasetshenziswa kubantu abanesifo senhliziyo, kodwa idinga ukuqapha ngokucophelela kanye nokucatshangelwa kwesimo sakho senhliziyo esithile. Umuthi ungabangela ukwehla kwengcindezi yegazi okwesikhashana, okungase kukhathaze uma unezinhlobo ezithile zezinkinga zenhliziyo.

Udktora wakho uzohlola impilo yenhliziyo yakho ngaphambi kokuqala i-difelikefalin futhi angase afune ukuqapha umfutho wegazi lakho kanye nesigqi senhliziyo ngesikhathi sokwelashwa. Uma unenhliziyo ehluleka kakhulu noma izigqi zenhliziyo ezingazinzile, udktora wakho angase ancome ezinye izindlela zokwelapha noma izinyathelo zokuphepha ezengeziwe.

Kufanele Ngenzeni Uma Ngithola Ngengozi I-Difelikefalin Eningi Kakhulu?

Njengoba i-difelikefalin inikezwa ochwepheshe bezempilo ngesikhathi se-dialysis, ukweqisa ngengozi akuvamile kakhulu. Umuthi ulinganiswa ngokucophelela futhi unikezwe abasebenzi abaqeqeshiwe abalandela imithetho ethile ukuze baqinisekise ukuthi uthola umthamo olungile.

Uma usola ukuthi uthole umuthi omningi kakhulu noma uhlangabezana nemiphumela emibi efana nobunzima bokuphefumula, isiyezi esikhulu, noma ukulahlekelwa ukwazi, yazisa ithimba lakho le-dialysis ngokushesha. Baqeqeshwe ukubona nokwelapha izinkinga ezihlobene nemithi futhi bazothatha isinyathelo esifanele ukuqinisekisa ukuphepha kwakho.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Difelikefalin?

Uma uphuthelwa iseshini ye-dialysis futhi ngenxa yalokho uphuthelwa umthamo wakho we-difelikefalin, vele uqale kabusha isimiso sakho sokwelashwa esivamile ngokuqokwa kwakho okulandelayo kwe-dialysis. Ungazami ukwenza umthamo ophuthelwe ngokuthatha umuthi owengeziwe noma ukushintsha isimiso sakho sokwelashwa.

Ukuphuthelwa imithamo ngezikhathi ezithile ngeke kubangele ingozi enkulu, kodwa zama ukugcina isimiso sakho se-dialysis esivamile ngangokunokwenzeka ukuze uthole imiphumela engcono kakhulu. Uma uvame ukuphuthelwa ama-aphoyintimenti, khuluma nethimba lakho lezempilo mayelana namasu okukusiza ukuthi uhlale uvumelana nokwelashwa kwakho.

Ngingayeka Nini Ukuthatha I-Difelikefalin?

Ungayeka ukuthatha i-difelikefalin nganoma yisiphi isikhathi ngokubonisana nodktora wakho. Akudingeki ukuthi unciphise umthamo kancane kancane, njengoba umuthi ungabangeli ukuncika ngokomzimba noma izimpawu zokuhoxiswa uma uyekwa kungazelelwe.

Udktela wakho angase ancome ukuyeka umuthi uma uba nemiphumela emibi kakhulu, uma ukulunywa kwakho kululama ngokwanele kangangokuthi ukwelashwa akusadingeki, noma uma ungasatholi i-hemodialysis. Isinqumo sokuqhubeka noma sokuyeka kufanele senziwe ngaso sonke isikhathi kanye nethimba lakho lezempilo ngokusekelwe esimweni sakho.

Ngingawathatha Eminye Imithi Ngesikhathi Ngisebenzisa I-Difelikefalin?

Imithi eminingi ingathathwa ngokuphephile kanye ne-difelikefalin, kodwa kubalulekile ukutshela udktela wakho ngayo yonke imithi kadokotela, imithi etholakala ngaphandle kwemvume kadokotela, kanye nezithasiselo ozisebenzisayo. Eminye imithi ingase isebenzisane ne-difelikefalin noma yandise ingozi yakho yemiphumela emibi.

Qaphela ngokukhethekile imithi enganciphisa umfutho wegazi noma ebangela ukozela, njengoba le miphumela ingase ithuthukiswe uma ihlanganiswe ne-difelikefalin. Udktela wakho kanye nethimba le-dialysis bazobuyekeza uhlu lwakho oluphelele lwemithi ukuze bathole noma yikuphi ukusebenzisana okungase kube khona futhi benze izinguquko ezifanele uma kudingeka.