Created at:1/13/2025
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I-Nalmefene yimithi evimbela imiphumela ye-opioids emzimbeni wakho, isize ukuguqula ukweqisa okuyingozi futhi isindise izimpilo. Ingowesigaba semithi ebizwa ngokuthi ama-opioid antagonists, okusho ukuthi ingaphikisana ngokushesha nemiphumela esongela impilo ye-heroin, fentanyl, izidakamizwa zokubulala izinhlungu, nezinye izidakamizwa ze-opioid.
Le mithi isebenza njengokwelashwa okuphuthumayo lapho umuntu ethatha kakhulu izidakamizwa ze-opioid. Abahlinzeki bezempilo nabaphenduli bezimo eziphuthumayo bayayisebenzisa ukusiza ukubuyisela ukuphefumula okuvamile nokuqwashisa ezimweni zokweqisa.
Umjovo we-Nalmefene usetshenziswa ikakhulukazi ukuguqula ukweqisa kwe-opioid okusongela impilo yomuntu. Lapho ama-opioid egcwalisa umzimba, anganciphisa ukuphefumula emazingeni ayingozi noma akuqede ngokuphelele, okuholela ekulimaleni kobuchopho noma ekufeni ngaphandle kokungenelela ngokushesha.
Le mithi isebenza njengokwelashwa okuphuthumayo okubalulekile ezibhedlela, kuma-ambulensi, nasezindaweni zezokwelapha eziphuthumayo. Yenzelwe ngokuqondile ukulwa nemiphumela yama-opioid emvelo afana ne-morphine kanye naleyo eyenziwe ngama-synthetic afana ne-fentanyl.
Abahlinzeki bezempilo futhi basebenzisa i-nalmefene ezindaweni zezokwelapha lapho iziguli zithola imithi ye-opioid ngemisebenzi yokuhlinzwa noma ukuphatha izinhlungu. Ukuba nayo kuqinisekisa ukuthi bangakwazi ukuguqula ngokushesha noma yimiphi imiphumela ye-opioid engalindelekile noma eyeqile uma kuvela izinkinga.
I-Nalmefene isebenza ngokuvimba ama-opioid receptors ebuchosheni bakho nasemzimbeni, empeleni ixosha ama-opioid ezindaweni lapho abangela khona imiphumela yawo. Cabanga ngakho njengokuthatha izindawo zokupaka ama-opioid ngokuvamile azithatha, ukuwavimbela ukuthi anganciphisi ukuphefumula kwakho nesilinganiso senhliziyo.
Lo muthi unamandla kakhulu futhi usebenza ngokushesha, ngokuvamile phakathi nemizuzu emi-2 kuya kwemi-5 uma unikezwa ngomjovo emthanjeni. Unesikhathi eside sokusebenza uma uqhathaniswa ne-naloxone, ngokuvamile esihlala amahora ama-4 kuya kwayi-8, okusiza ekuvikeleni ukubuyela kwezimpawu zokweqisa umthamo.
Amandla e-nalmefene awenza asebenze ngempumelelo ekulweni nama-opioid anamandla okwenziwa njenge-fentanyl. Kodwa-ke, lokhu futhi kusho ukuthi kungadala izimpawu zokuhoxiswa ezinamandla kubantu abasebenzisa ama-opioid njalo.
Umjovo we-Nalmefene unikezwa kuphela ochwepheshe bezempilo ezindaweni zezokwelapha, ngakho ngeke uthathe lo muthi wena uqobo. Unikezwa ngomjovo emthanjeni, emisipheni, noma ngaphansi kwesikhumba, kuye ngesimo esiphuthumayo nokufinyelela okutholakalayo.
Umthamo uncike ekuqineni kokweqisa umthamo kanye nohlobo lwama-opioid abambe iqhaza. Abahlinzeki bezempilo baqala ngomthamo wokuqala futhi bangase banikeze eminye imithamo uma umuntu engasabeli ngendlela efanele noma uma izimpawu zibuyela.
Njengoba lo muthi ophuthumayo, awekho imiyalelo ethile mayelana nokudla noma isiphuzo. Okubalulekile ukuthola umuthi emzimbeni womuntu ngokushesha ngangokunokwenzeka ukuze kubuyiselwe emuva imiphumela esongela impilo yokweqisa umthamo we-opioid.
I-Nalmefene isetshenziswa njengokwelashwa okukodwa okuphuthumayo kunokuba ibe umuthi oqhubekayo. Uma inikeziwe ukubuyisela emuva ukweqisa umthamo, imiphumela ngokuvamile ihlala amahora ama-4 kuya kwayi-8, okuyisikhathi eside kunezeminye imithi eminingi yokubuyisela emuva i-opioid.
Kodwa-ke, lokhu akusho ukuthi ukwelashwa kuphelile ngemva komthamo owodwa. Abahlinzeki bezempilo bazogada umuntu eduze ngoba imiphumela ye-opioid yasekuqaleni ingase idlule i-nalmefene, okungenzeka ukuthi ibangele izimpawu zokweqisa umthamo ukuthi zibuyele.
Uma umuntu ebelokhu esebenzisa ama-opioid asebenza isikhathi eside noma amanani amakhulu ama-opioid, bangase badinge imithamo eminingi ye-nalmefene noma ukugadwa kwezokwelapha okuqhubekayo amahora angama-24 noma ngaphezulu.
Imiphumela eceleni ye-nalmefene ihlobene ngokuqinile nendlela ebuyisa ngayo imiphumela ye-opioid emzimbeni. Abantu abaningi abathola lo muthi abaziqondi ngenxa yokweqisa, ngakho-ke bangase bangayiboni ngokushesha imiphumela eceleni.
Ake sibheke imiphumela eceleni ejwayelekile ongase uyithole wena noma othandiweyo wakho ngemuva kokuthola i-nalmefene:
Lezi zimpawu zivame ukwenzeka ngoba i-nalmefene ingabangela izimpawu zokuhoxiswa kubantu abasebenzisa ama-opioid njalo. Ngenkathi kungakhululeki, le miphumela ikhombisa ukuthi umuthi usebenza ukubuyisa ukweqisa.
Imiphumela eceleni engathi sína ingenzeka, yize ingavamile. Lokhu kungabandakanya izinguquko ezinzima ekucindezelweni kwegazi, izinkinga zesigqi senhliziyo, noma ukuquleka. Abahlinzeki bezempilo baqapha iziguli eduze ukuze baphathe lezi zinkinga ezingaba khona.
Abanye abantu bangase bathole okubizwa ngokuthi imiphumela ye- "rebound" njengoba i-nalmefene iphela. Lokhu kusho ukuthi izimpawu zokweqisa zingabuyela uma i-opioid yokuqala isesimeni sabo, yingakho ukuqhubeka nokuqashwa kwezokwelapha kubaluleke kangako.
I-Nalmefene ngokuvamile ithathwa njengephephile kubantu abaningi abathola ukweqisa kwe-opioid, njengoba izinzuzo zokusindisa impilo yabo zidlula izingozi eziningi. Kodwa-ke, zikhona izimo lapho kudingeka khona ukuqapha okwengeziwe.
Abantu abaziwa ukuthi banezinto ezibazwela kalula ku-nalmefene noma imithi efanayo kufanele babe nalesi simo esixhunywe kubaphenduli bezimo eziphuthumayo uma kungenzeka. Kodwa-ke, ezimweni zokweqisa ezisongela impilo, abahlinzeki bezempilo bangase basebenzise umuthi ngenkathi beqapha ukusabela okungokomzimba.
Labo abanezimo ezithile zenhliziyo bangase badinge ukuqashwa okukhethekile lapho bethola i-nalmefene. Umuthi ungabangela izinguquko ezingeni lenhliziyo nomfutho wegazi ezingase zikhathaze abantu abanezinkinga zenhliziyo ezikhona.
Abesifazane abakhulelwe bangathola i-nalmefene uma behlangabezana nokweqisa kwe-opioid, njengoba ukusindisa impilo yomama kuyinto eza kuqala. Kodwa-ke, abahlinzeki bezempilo bazobheka ngokucophelela umama nomntwana, njengoba umuthi ungase ukwazi ukuthinta ukukhulelwa.
Igama eliyinhloko lomkhiqizo we-nalmefene injection yi-Revex, nakuba lingase litholakale njengomuthi ojwayelekile. Igama lomkhiqizo lisiza abahlinzeki bezempilo kanye nabokhemisi ukuthi bakhombe ukwakheka okuthile namandla omuthi.
Ezimweni eziphuthumayo, abahlinzeki bezempilo bagxila kakhulu egameni elivamile lomuthi nemiphumela yawo kunegama lomkhiqizo elithile. Okubaluleke kakhulu ukuthola lo muthi osindisa impilo wokubuyisela i-opioid uma idingeka.
I-Naloxone iyinye indlela ejwayelekile ye-nalmefene yokubuyisela ukweqisa kwe-opioid. Isebenza ngendlela efanayo ngokuvimba ama-receptor e-opioid, kodwa inesikhathi esifushane sokusebenza, ngokuvamile esihlala imizuzu engama-30 kuya kwengama-90.
I-Naloxone itholakala ngezindlela eziningi kune-nalmefene, okuhlanganisa ama-spray emakhaleni kanye nama-auto-injectors angasetshenziswa abantu abangewona odokotela. Lokhu kwenza ukuthi itholakale kalula ekusetshenzisweni komphakathi kanye namalungu omndeni abantu abasebenzisa ama-opioid.
Ukukhetha phakathi kwe-nalmefene ne-naloxone kuvame ukuncika esimweni esithile. Abahlinzeki bezempilo bangase bakhethe i-nalmefene uma belindele ukuthi ukweqisa kube kubi kakhulu noma uma bebhekene nama-opioid asebenza isikhathi eside noma anamandla kakhulu.
Kokubili i-nalmefene ne-naloxone ziyasebenza ekubuyiseleni ukweqisa kwe-opioid, kodwa zinamandla ahlukene okuzenza zifanele izimo ezahlukene. Akukho noyedwa ongcono kunomunye.
I-Nalmefene inesikhathi eside sokusebenza, okungasiza uma ubhekene nama-opioid asebenza isikhathi eside noma lapho ukuhlolwa kwezokwelapha okusheshayo kungatholakali. Lo mphumela omude usho ukuthi kuncane ingozi yokuthi izimpawu zokweqisa zibuye uma imithi isiphelile.
Kodwa-ke, i-naloxone itholakala kabanzi futhi iza ngezindlela ezingasetshenziswa ngabantu abangewona abezokwelapha. Futhi ivame ukubangela izimpawu zokuhoxiswa ezingathí sina, ezingaba lula kumuntu ozitholayo.
Ukwenza okungcono kuncike ezintweni ezifana nohlobo lwe-opioid olubandakanyekayo, ubukhulu bokweqisa, kanye nesimo sezokwelapha. Abahlinzeki bezempilo benza lesi sinqumo ngokusekelwe kulokho okutholakalayo nalokho abakholelwa ukuthi kuzosebenza kahle esimweni ngasinye esithile.
I-Nalmefene ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqapha ngokucophelela. Umuthi ungabangela izinguquko ekushayeni kwenhliziyo nengcindezi yegazi ezingase zikhathaze abantu abanezimo zenhliziyo ezikhona.
Abahlinzeki bezempilo balinganisa ingozi esongela impilo yokweqisa i-opioid ngokumelene nezingozi ezingase zihlobene nenhliziyo ze-nalmefene. Ezimweni eziningi, ingozi esheshayo yokweqisa yenza i-nalmefene ibe yindlela ephephe kakhulu, ngisho nakubantu abanezinkinga zenhliziyo.
Uma umuntu ethola i-nalmefene eningi, angase abe nezimpawu zokuhoxiswa ezingathí sina noma eminye imiphumela emibi. Lokhu ikakhulukazi kuyisithiyo kubahlinzeki bezempilo abaphatha imithi.
Ingozi enkulu ye-nalmefene eningi ukubangela izimpawu zokuhoxiswa ezingakhululeki kakhulu kunokubangela imiphumela eyingozi yokweqisa. Abahlinzeki bezempilo bangakwazi ukulawula lezi zimpawu ngokunakekela okusekelayo neminye imithi uma kudingeka.
Abahlinzeki bezempilo kuphela okufanele benze izinqumo mayelana nemithamo eyengeziwe ye-nalmefene. Uma izimpawu zokweqisa zomuntu zibuyela noma zingathuthuki ngokwanele ngemva komthamo wokuqala, ochwepheshe bezokwelapha bazohlola ukuthi ngabe omunye umthamo uyadingeka yini.
Yingakho abantu abathola i-nalmefene bedinga ukuqhubeka beqashwe ngabezokwelapha. Ithimba lezempilo liqapha ukuphefumula komuntu, isivinini senhliziyo, kanye nezinga lokuqwashisa ukuze linqume ukuthi ngabe ukwelashwa okwengeziwe kuyadingeka yini.
Isinqumo sokukhipha umuntu ekunakekelweni kwezokwelapha ngemva kokuthola i-nalmefene sincike ezintweni eziningana. Abahlinzeki bezempilo bacabangela uhlobo lwe-opioid oluhilelekile, ukuthi kungakanani okuthathiwe, nokuthi umuntu usabela kanjani ekwelashweni.
Ngokuvamile, abantu badinga ukuqashwa okungenani amahora angu-4 kuya kwangu-8 ngemva kokuthola i-nalmefene, futhi ngezinye izikhathi isikhathi eside. Lokhu kuqinisekisa ukuthi izimpawu zokweqisa azibuyi njengoba imithi iphela nokuthi noma yimaphi imiphumela emibi iphathwa kahle.
Cha, i-nalmefene yenzelwe ngqo ukuguqula ukweqisa kwe-opioid futhi ngeke isize ngobuthi botshwala noma ukweqisa kwezinye izinto. Isebenza kuphela ngokuvimba ama-opioid receptors futhi ngeke ilwe nemiphumela yotshwala, ama-benzodiazepines, noma ezinye izidakamizwa.
Uma umuntu eqise utshwala noma inhlanganisela yezinto, badinga ukwelashwa okuphuthumayo okuhlukile. Abahlinzeki bezempilo bazosebenzisa imithi efanele nokunakekelwa okusekelayo ngokusekelwe kulokho okuhilelekile ekweqiseni.