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

I-Remimazolam iyisidambisi esisebenza ngokushesha esisetshenziswa odokotela ngesikhathi sokuhlinzwa ukukusiza uphumule futhi uhlale uzolile. Ingaphansi kohlu lwemithi ebizwa ngokuthi ama-benzodiazepines, asebenza ngokwehlisa umsebenzi wobuchopho ukuze bakhe isimo sokuthula, sokozela.

Lo muthi unikezwa ngomugqa we-IV (intravenous) ngqo emgudwini wakho wegazi. Okwenza i-remimazolam ikhetheke ukuthi isebenza ngokushesha kangakanani nokuthi umzimba wakho uyayikhipha ngokushesha kangakanani, okwenza ilungele izinqubo ezimfushane lapho udinga ukuvuka uzizwa uqaphile.

Yini i-Remimazolam?

I-Remimazolam uhlobo olusha lwama-benzodiazepine olwenzelwe ngqo ukudambisa ezokwelapha. Ngokungafani nezidambisi ezindala ezingahlala ohlelweni lwakho amahora amaningi, lo muthi uwohloka ngokushesha emzimbeni wakho ngezindlela zemvelo.

Lo muthi usebenza ngokuthuthukisa ikhemikhali yobuchopho ebizwa ngokuthi i-GABA, esebenza njengesiginali yakho yomzimba yemvelo yokuthi “thula”. Lapho i-remimazolam ithuthukisa le siginali, idala umuzwa okhululekile, ozwela ukulala okukusiza ukuthi udlule ezinqubweni zezokwelapha ngokunethezeka.

Abahlinzeki bezempilo bakhetha i-remimazolam ngoba ibanika ukulawula okunembile ezingeni lakho lokudambisa. Bangakwazi ukulungisa umthamo kalula futhi balindele ukuthi uvuke ngokushesha ngemuva kokuphela kwenqubo.

Isetshenziselwani i-Remimazolam?

Odokotela basebenzisa i-remimazolam ikakhulukazi ekudambiseni izinqubo ngesikhathi sezinqubo zezokwelapha ezidinga ukuthi uphumule kodwa ungaqwashisi ngokuphelele. Ivame ukusetshenziselwa izinqubo zokuxilonga njengama-colonoscopies, ama-endoscopies, kanye nezinqubo ezithile zokuhlinzwa.

Lo muthi ulusizo ikakhulukazi ezinqubweni zokwelapha ezigunyazwe ngaphandle lapho udinga ukuhamba ngosuku olufanayo. Ngenxa yokuthi ikhipha ngokushesha ohlelweni lwakho, mancane amathuba okuthi uzizwe ukozela noma udidekile amahora ngemuva kwenqubo yakho.

Ezinye izibhedlela zisebenzisa i-remimazolam emagumbini okunakekela okukhulu kubantu abadinga ukuthuliswa isikhashana ngesikhathi besebenzisa imishini yokuphefumula. Isikhathi sokululama esisheshayo senza kube lula odokotela ukuhlola ukuthi iziguli zinjani.

Isebenza Kanjani I-Remimazolam?

I-Remimazolam ithathwa njenge-sedative enamandla aphakathi nendawo esebenza ngokugxila kuma-receptors athile ebuchosheni bakho. Ithuthukisa imiphumela ye-GABA, i-neurotransmitter enciphisa ngokwemvelo umsebenzi wobuchopho futhi ikhuthaze ukuphumula.

Lapho umuthi ungena egazini lakho, ufika ebuchosheni bakho ngemizuzu. Umphumela wokuthulisa ngokuvamile uqala phakathi nemizuzu engu-1-3 yokunikezwa, okwenza uzizwe ukozela futhi uphumule ngaphandle kokulahlekelwa ngokuphelele ukwazi.

Okwehlukanisa i-remimazolam ukuthi umzimba wakho uyicubungula kanjani. Ama-enzyme akhethekile aqeda umuthi ngokushesha, ngokuvamile ngemizuzu engu-30-60. Lokhu kuqhekeka okusheshayo kusho imiphumela embalwa esele uma iqhathaniswa nezinye izidakamizwa ezingakwenza uzizwe uvilapha amahora amaningi.

Kufanele Ngiyithathe Kanjani I-Remimazolam?

Ngeke uzithathele wena i-remimazolam - ngaso sonke isikhathi inikezwa ochwepheshe bezempilo abaqeqeshiwe endaweni yezokwelapha. Umuthi uza njengoketshezi olucacile oluxutshwe ne-saline futhi lunikezwa ngomugqa we-IV engalweni yakho.

Ngaphambi kwenqubo yakho, ithimba lakho lezokwelapha lizofaka ipayipi elincane lepulastiki (i-IV catheter) emthanjeni engalweni yakho noma esandleni sakho. Bese bazojova kancane i-remimazolam ngalo mugqa ngenkathi beqapha ukuphefumula kwakho, izinga lokushaya kwenhliziyo, nomfutho wegazi.

Udokotela wakho uzolungisa umthamo ngokuya ngeminyaka yakho, isisindo, umlando wezokwelapha, nokuthi usabela kanjani emuthini. Abantu abaningi badinga amanani amancane kakhulu - ngokuvamile amamiligremu ambalwa nje - ukuze bathole izinga elifanele lokuthuliswa.

Kuzodingeka ukuthi ugweme ukudla noma ukuphuza amahora ambalwa ngaphambi kwenqubo yakho, njengoba kuqondiswe ithimba lakho lezokwelapha. Lesi sikhathi sokuzila ukudla sisiza ukuvimbela izinkinga futhi siqinisekisa ukuthi umuthi usebenza ngempumelelo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Remimazolam?

I-Remimazolam isetshenziswa kuphela isikhathi esifushane ngesikhathi sezinqubo zezokwelapha, ngokuvamile ithatha noma yikuphi kusuka kumaminithi ayi-15 kuya emahoreni ambalwa. Ubude besikhathi buxhomeke ngokuphelele ekutheni inqubo yakho ethile ithatha isikhathi esingakanani ukuqeda.

Umhlinzeki wakho wezempilo uzoqhubeka ekunika imithamo emincane kuyo yonke inqubo njengoba kudingeka ukuze ugcine izinga lakho lokunethezeka. Bazoyeka umuthi uma inqubo isiqediwe, futhi uzoqala ukuvuka ngemizuzu.

Ngokungafani nemithi oyithatha ekhaya, i-remimazolam ayenzelwe ukusetshenziswa okuqhubekayo. Njalo uma udinga ukuthuliswa ngenqubo, ithimba lakho lezokwelapha lizoyiphatha njengokuqala okusha, lilungise umthamo ngokusekelwe esimweni sakho samanje sempilo.

Yiziphi Imiphumela Eceleni Ye-Remimazolam?

Njengayo yonke imithi, i-remimazolam ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma inikezwa abahlinzeki bezempilo abanolwazi. Imiphumela evame kakhulu empeleni iyingxenye yokuthi umuthi usebenza kanjani - ukozela kanye nezikhala zesikhashana zememori ngesikhathi senqubo.

Nansi imiphumela ejwayelekile ongase uyithole:

• Ukozela okungahlala amahora angu-1-2 ngemva kwenqubo
• Ukulahlekelwa yimemori okwesikhashana ngesikhathi senqubo
• Isiyezi esincane noma ukuzizwa ungaqinile
• Isicanucanu noma isisu esibuhlungu
• Ikhanda
• Ukuzizwa udidekile noma ungahambisani uma uvuka kuqala

Le miphumela ngokuvamile imnene futhi iyazixazulula yona ngokwayo njengoba umuthi usuka emzimbeni wakho. Ukuba nomuntu okushayela ekhaya futhi ahlale nawe amahora ambalwa kusiza ukuqinisekisa ukuphepha kwakho ngesikhathi sokululama.

Imiphumela emibi engathi sína ayivamile kodwa ingabandakanya izinkinga zokuphefumula, izinguquko zomfutho wegazi, noma ukusabela komzimba ngaphandle. Ithimba lakho lezokwelapha likuqapha eduze ngesikhathi nangemva kwenqubo ukuze libheke noma yiziphi izimpawu ezikhathazayo.

Ezimweni ezingavamile kakhulu, abanye abantu bangase bahlangabezane nokusabela okungaqondakali lapho beba nexhala noma bekhathazekile esikhundleni sokuzola. Uma lokhu kwenzeka, umhlinzeki wakho wezempilo angakwazi ukuguqula ngokushesha imiphumela ngomunye umuthi.

Ubani Ongafanele Athathe I-Remimazolam?

I-Remimazolam ayifanele wonke umuntu, futhi ithimba lakho lezokwelapha lizobuyekeza ngokucophelela umlando wakho wezempilo ngaphambi kokusebenzisa lo muthi. Abantu abanezinkinga ezinkulu zokuphefumula, izimo ezithile zenhliziyo, noma ukungezwani okwaziwayo nama-benzodiazepines ngokuvamile badinga ezinye izindlela zokuthulisa.

Udokotela wakho uzoba nokuqapha okukhethekile uma unesinye salezi zimo:

• Isifo esibi samaphaphu noma izinkinga zokuphefumula
• I-Sleep apnea engalawulwa kahle
• Isifo esibi sesibindi noma sezinso
• Umlando wokulutheka kwezidakamizwa noma utshwala
• I-Myasthenia gravis (ukuphazamiseka kobuthakathaka bemisipha)
• Izinkinga ezinkulu zenhliziyo
• Ukungezwani okwaziwayo kuma-benzodiazepines

Abesifazane abakhulelwe kanye nomama abancelisayo badinga ukucatshangelwa okukhethekile, njengoba umuthi ungangena esithweni somzimba futhi ubonakale obisini lwebele. Umhlinzeki wakho wezempilo uzohlola izinzuzo ngokumelene nezingozi ezingaba khona kulezi zimo.

Abantu abadala bangase babe nobucayi obengeziwe emiphumeleni ye-remimazolam futhi ngokuvamile bathola imithamo ephansi. Umuthi ungenza futhi ukuthi uhlangane neminye imithi, ngakho qiniseka ukuthi utshela ithimba lakho lezokwelapha ngayo yonke imithi, izithasiselo, kanye nemithi yezitshalo oyithathayo.

Amagama Omkhiqizo we-Remimazolam

I-Remimazolam itholakala ngaphansi kwegama lomkhiqizo elithi Byfavo e-United States nakwamanye amazwe amaningi. Leli njengamanje igama eliyinhloko lomkhiqizo ozohlangana nalo ezindaweni eziningi zezokwelapha.

Kwezinye izifunda, ungase ukubone kuthengiswa ngaphansi kwamanye amagama, kodwa isithako esisebenzayo sihlala singashintshi. Umhlinzeki wakho wezempilo uzokwazi umuthi ngegama lawo elivamile (remimazolam) kungakhathaliseki igama lomkhiqizo elisetshenziswa endaweni yabo.

Njengoba le yimithi entsha, evunywe yi-FDA ngonyaka ka-2020, azikho izinhlobo ezivamile ezitholakalayo okwamanje. Wonke ama-remimazolam okwamanje avela kumkhiqizi wokuqala.

Ezinye Izindlela Zokwelapha Nge-Remimazolam

Uma i-remimazolam ingakulungele, ezinye izinketho zokuthulisa zitholakala ngokuya ngezidingo zakho ezithile nomlando wakho wezokwelapha. Umhlinzeki wakho wezempilo angakhetha ezinkethweni ezihlukahlukene ezisebenza ngendlela ehlukile kodwa zifeza imiphumela efanayo.

Ezinye izindlela ezivamile zihlanganisa:

• Midazolam - enye i-benzodiazepine esetshenziswe amashumi eminyaka
• Propofol - olunye uhlobo lwemithi yokuthulisa olusebenza ngokushesha okukhulu
• Dexmedetomidine - umuthi ohlinzeka ngokuthulisa ngaphandle kokuthinta ukuphefumula kakhulu
• Ketamine - ngezinye izikhathi esetshenziselwa izinqubo ezidinga ukuthulisa okujulile
• I-Nitrous oxide - "igesi yokuhleka" yezidingo zokuthulisa ezilula

Ngayinye enye indlela inezinzuzo zayo kanye nokucatshangelwa kwayo. Udokotela wakho we-anesthesiologist noma iqembu lezinqubo lizokhetha inketho engcono kakhulu ngokusekelwe emlandweni wakho wezokwelapha, uhlobo lwenqubo, nokuthi kulindeleke ukuthi kuthatha isikhathi esingakanani.

Ukwenza isinqumo kuvame ukuncika ezintweni ezinjengobudala bakho, eminye imithi oyithathayo, nokuthi ngabe unazo yini izimo zezempilo ezingaphansi ezenza enye inketho iphephe kunabanye.

Ingabe i-Remimazolam Ingcono Kune-Midazolam?

I-Remimazolam ne-midazolam zombili ziyi-benzodiazepines ezisetshenziselwa ukuthulisa, kodwa zinezinto ezibalulekile ezihlukile ezenza ngamunye afaneleke kangcono ezimweni ezihlukene. Akukho noyedwa "ongcono" ngokujwayelekile - kuncike ezidingweni zakho ezithile kanye nezimo.

Inzuzo enkulu ye-Remimazolam yisikhathi sayo sokululama esilindelekile, esisheshayo. Ngenxa yokuthi umzimba wakho uyayihlukanisa ngokushesha ngezinqubo zemvelo ze-enzyme, cishe uzozizwa uqaphile ngokushesha ngemva kwenqubo yakho uma uqhathaniswa ne-midazolam.

I-Midazolam isetshenziswe ngokuphepha amashumi eminyaka futhi ivame ukungabizi. Kodwa-ke, ingaqongelela ohlelweni lwakho, ikakhulukazi uma usumdala noma unezinkinga zesibindi, okungenzeka kuholele ezikhathini ezinde zokululama kanye nobuthongo obude.

Ngezindlela zokwelapha ezingaphandle lapho udinga ukuhamba ngosuku olufanayo, ukusheshisa kuka-remimazolam kungaba yinzuzo enkulu. Ngezindlela ezinde noma uma izindleko ziyisici esikhulu, i-midazolam ingaba yindlela engcono.

Imibuzo Evame Ukubuzwa Mayelana ne-Remimazolam

Ingabe i-Remimazolam iphephile kubantu abanezifo zenhliziyo?

I-Remimazolam ingasetshenziswa ngokuphepha kubantu abaningi abanezifo zenhliziyo, kodwa udokotela wakho wenhliziyo kanye nethimba le-anesthesia kuzodingeka basebenze ndawonye ukuqinisekisa ukuthi yindlela efanele kuwe. Umuthi ngokuvamile ubangela izinguquko ezingaphansi kakhulu ekucindezelweni kwegazi nesilinganiso senhliziyo uma kuqhathaniswa neminye imithi yokuthulisa ubuhlungu.

Ithimba lakho lezokwelapha lizogada isigqi senhliziyo yakho nokucindezelwa kwegazi ngokuqhubekayo ngesikhathi senqubo. Bazobuye babuyekeze isimo sakho senhliziyo esithile, imithi yamanje, nesimo sempilo esiphelele ngaphambi kokunquma ukuthi i-remimazolam ifanele yini.

Abantu abanenhliziyo ehlulekayo noma izigqi zenhliziyo ezingazinzile kakhulu bangase badinge ezinye izindlela zokuthulisa ubuhlungu. Abahlinzeki bakho bezempilo bazohlala bekhetha inketho ephephe kakhulu esimweni sakho somuntu ngamunye.

Ngingenzani uma ngithola i-Remimazolam eningi ngengozi?

Akudingeki ukhathazeke ngokuthola i-remimazolam eningi ngengozi ngoba ochwepheshe bezempilo abaqeqeshiwe balawula yonke into yokuphathwa kwemithi yakho. Baqapha impendulo yakho ngokuqhubekayo futhi balungise umthamo njengoba kudingeka kuyo yonke inqubo yakho.

Uma uthole okuningi kunokuhlosiwe, ithimba lakho lezokwelapha linezindlela eziningi zokukusiza ukuthi ululame ngokuphepha. Bangakunika umuthi obizwa ngokuthi i-flumazenil esheshisa imiphumela ye-remimazolam, ikusize ukuthi uvuke ngokushesha.

Abahlinzeki bakho bezempilo baqeqeshwe ukubona izimpawu zokulaliswa ngokweqile futhi basabele ngokushesha. Bazosekela ukuphefumula kwakho uma kudingeka futhi baqaphe izimpawu zakho ezibalulekile ngokucophelela kuze kube yilapho uqaphele ngokugcwele futhi uzinzile.

Kufanele Ngenzeni Uma Ngedlula Umthamo We-Remimazolam?

Lo mbuzo awusebenzi ku-remimazolam ngoba akuyona imithi oyithatha ekhaya ngohlelo. Ochwepheshe bezempilo banikeza i-remimazolam kuphela ngesikhathi sezinqubo zezokwelapha ezindaweni zezokwelapha ezilawulwayo.

Uma unenhlelo oluhleliwe oludinga ukulaliswa futhi uphuthelwa ukuqokwa kwakho, kuzodingeka ukuthi uhlele kabusha nodokotela wakho. Bazokunikeza imithi entsha ngesikhathi senqubo yakho ehlelelwe kabusha.

Njalo uma udinga ukulaliswa, ithimba lakho lezokwelapha liliphatha njengesimo esisha, lihlole ngokucophelela isimo sakho sempilo samanje futhi lilungise imithi ngokufanele.

Ngingayeka Nini Ukuthatha I-Remimazolam?

Akudingeki ukuthi wenze noma yiziphi izinqumo mayelana nokuyeka i-remimazolam ngoba ithimba lakho lezempilo lilawula ukuthi liqala nini futhi liyeke nini imithi ngesikhathi senqubo yakho. Bazoyeka ukuyinikeza uma inqubo yakho isiqediwe.

Imithi izosuka ngokwemvelo ohlelweni lwakho kungakapheli imizuzu engama-30-60 ngemuva kokuthi umhlinzeki wakho wezempilo eyeke ukukunikeza yona. Uzokwazi kancane kancane njengoba umuthi usuka emzimbeni wakho.

Inqubo yakho yokululama iqondiswa ithimba lakho lezokwelapha, elizokuqapha kuze kube yilapho uqaphele ngokwanele ukuthi ungahamba ekhaya ngokuphepha. Bazokwazisa uma usulungele ukuhamba nokuthi yini ongayilindela ngesikhathi sokululama kwakho okuqhubekayo ekhaya.

Ngingashayela Ngemuva Kokuthola I-Remimazolam?

Akufanele ushayele noma usebenzise imishini okungenani amahora angama-24 ngemuva kokuthola i-remimazolam, yize ungase uzizwe uqaphile ngokushesha. Imithi ingathinta isikhathi sakho sokusabela nokwahlulela ngezindlela ezicashile ongase ungaziqapheli.

Hlela ukuthi othile akuqhubele ekhaya ngemva kwenqubo yakho futhi ahlale nawe amahora amaningana. Lokhu akuyona nje isinyathelo sokuzivikela - kuyimfuneko yokuphepha ezikhungweni eziningi zezokwelapha eziyogcizelela ngaphambi kokukuvumela ukuthi uhambe.

Noma ngabe uzizwa ujwayelekile ngokuphelele, ubuchopho bakho busaqhuba imiphumela yemithi. Imisebenzi edinga ukusabela okusheshayo noma ukwenza izinqumo ezibalulekile kufanele ilinde kuze kube ngosuku olulandelayo lapho usubuyele ngokugcwele ekuqaleni.