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

I-Terlipressin iyisidakamizwa esinamandla se-synthetic hormone esinikezwa ngomugqa we-IV ezibhedlela ukwelapha izimo ezisongela impilo ezibandakanya ukwehla okukhulu kwengcindezi yegazi. Lesi sidakamizwa sisebenza ngokucinisa imithambo yegazi emzimbeni wakho wonke, sisiza ukubuyisela ukugeleza kwegazi okuvamile lapho uhlelo lwakho lwe-cardiovascular lisenkingeni.

Ngokuvamile uzohlangana ne-terlipressin eminyangweni yokunakekelwa okukhulu noma eminyangweni yezimo eziphuthumayo, lapho amaqembu ezokwelapha ewasebenzisa njengokungenelela okubalulekile. Umuthi udinga ukuqapha ngokucophelela ngenxa yemiphumela yawo enamandla ohlelweni lwakho lokujikeleza kwegazi.

Yini i-Terlipressin?

I-Terlipressin iyinguqulo ye-synthetic ye-vasopressin, i-hormone umzimba wakho oyikhiqiza ngokwemvelo ukusiza ukulawula ingcindezi yegazi nokulinganisela uketshezi. Umuthi ungowesigaba semithi ebizwa ngokuthi ama-vasopressors, okusho ukuthi inciphisa imithambo yegazi ukuze ikhulise ingcindezi yegazi.

Umzimba wakho ngokuvamile wenza i-vasopressin e-hypothalamus yakho ebuchosheni, kodwa ngesikhathi sezimo eziphuthumayo zezokwelapha, ungase udinge amanani aphezulu kakhulu kunalokho umzimba wakho ongakukhiqiza. Yilapho i-terlipressin ingena khona njengokungenelela kwezokwelapha.

Umuthi ubhekwa njenge-vasopressor eqinile, okusho ukuthi inemiphumela enamandla ohlelweni lwakho lwe-cardiovascular. Ngenxa yamandla ayo, odokotela bayisebenzisa kuphela ezindaweni zezibhedlela lapho bengakwazi ukulandela ngokucophelela impendulo yakho.

Isetshenziselwani i-Terlipressin?

I-Terlipressin iphatha izimo ezimbili eziyinhloko ezisongela impilo: i-hepatorenal syndrome kanye ne-septic shock enengcindezi yegazi ephansi kakhulu. Zombili lezi zimo zihilela ukungakwazi komzimba wakho ukugcina ingcindezi yegazi eyanele nomsebenzi wezitho.

Ku-hepatorenal syndrome, isifo sakho sesibindi siqhubeke safika lapho izinso zakho ziqala ukuhluleka ngenxa yokugeleza kwegazi okuncane. Lokhu kudala umjikelezo oyingozi lapho ubuthi buqongelela emzimbeni wakho ngenkathi izitho zakho zingatholi igazi elinothile nge-oxygen elanele.

Ngesifo sokushaqeka se-septic, i-terlipressin iyasiza lapho ukusabela komzimba wakho ekutheleleni kubangela imithambo yegazi ukuthi iphumule kakhulu kangangokuthi umfutho wegazi lakho wehla uze ufinyelele emazingeni ayingozi. Lesi simo singaholela ngokushesha ekwehleni kwamalungu omzimba uma singelashwa ngokushesha.

Ngezinye izikhathi odokotela basebenzisa i-terlipressin ngokuphuma kwegazi okukhulu e-esophagus yakho okubangelwa imithambo ekhulisiwe, isimo esibizwa ngokuthi i-esophageal varices. Umuthi usiza ukunciphisa ukugeleza kwegazi kulezi zindawo ezinzima.

Isebenza Kanjani I-Terlipressin?

I-Terlipressin isebenza ngokubopha kuma-receptors athile ezindongeni zemithambo yakho yegazi, okubangela ukuthi zinciphise futhi zinciphise. Lesi senzo sikhulisa ukumelana ohlelweni lwakho lokujikeleza kwegazi, okusiza ukuthi uphushe umfutho wegazi lakho ubuyele emazingeni aphephile.

Umuthi futhi uthinta izinso zakho ngokuthuthukisa ukugeleza kwegazi kula malungu abalulekile. Ukugeleza kwegazi okungcono ezinso kusiza umzimba wakho ukuthi uqede ubuthi ngempumelelo futhi ugcine ibhalansi efanele yamanzi.

Ngokungafani namanye ama-vasopressors, i-terlipressin inemiphumela ehlala isikhathi eside emzimbeni wakho. Lokhu kusho ukuthi odokotela abadingi ukuyinika njalo, kodwa futhi kusho ukuthi imiphumela ithatha isikhathi eside ukuthi iphele uma ukwelashwa kuyeka.

Lona umuthi onamandla othinta kakhulu uhlelo lwakho lwe-cardiovascular. Imiphumela enamandla yenza ukuthi isebenze ezimweni ezibucayi kodwa futhi idinga ukugadwa kwezokwelapha ngokucophelela.

Kufanele Ngiyithathe Kanjani I-Terlipressin?

Awukwazi ukuthatha i-terlipressin ngomlomo noma ukuyinika wena ekhaya. Lo muthi unikezwa kuphela ngomugqa we-IV ochwepheshe bezokwelapha abaqeqeshiwe endaweni yasesibhedlela.

Ithimba lakho lezokwelapha lizofaka ishubhu elincane emthanjeni wakho, ngokuvamile engalweni yakho noma esandleni sakho. Bese bazojova kancane umuthi ngokuqondile emgombeni wakho wegazi emizuzwini embalwa.

Isikhathi sokuthatha imithamo sincike esimweni sakho kanye nokuthi umzimba wakho usabela kanjani. Odokotela bakho bazohlola njalo umfutho wegazi lakho, izinga lokushaya kwenhliziyo, kanye nokusebenza kwezitho ukuze banqume isimiso esifanele sokulinganisa.

Akudingeki ukhathazeke ngokudla noma ukuphuza ngoba cishe uzobe uthola okunye ukunakekelwa okusekelayo esibhedlela. Ithimba lakho lezokwelapha lizosingatha zonke izici zokuphathwa kwemithi.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Terlipressin?

Ubude bokwelashwa nge-terlipressin buhluka kakhulu kuye ngesimo sakho esiyisisekelo nokuthi umzimba wakho usabela ngokushesha kangakanani. Abanye abantu bayayidinga izinsuku ezimbalwa nje, kanti abanye bangase badinge ukwelashwa amasonto amaningana.

Ngesifo se-hepatorenal, ukwelashwa ngokuvamile kuqhubeka kuze kube yilapho ukusebenza kwezinso zakho kuthuthuka noma kuze kube yilapho odokotela benquma ukuthi imithi ayisizi. Le nqubo ingathatha noma yikuphi kusukela ezinsukwini ezimbalwa kuya emavikini amaningana.

Ezimweni ze-septic shock, ngokuvamile uzothola i-terlipressin kuze kube yilapho umfutho wegazi lakho uzinzile futhi umzimba wakho ukwazi ukugcina ukujikeleza okwanele uwedwa. Ithimba lakho lezokwelapha lizokwehlisa kancane kancane umthamo kunokuthi limise kungazelelwe.

Odokotela bakho bazohlola njalo ukuthi imithi iyasiza yini futhi balungise uhlelo lokwelashwa ngokufanele. Bazophinda baqaphele noma yiziphi izimpawu zokuthi ungase uhlangabezane nemiphumela engemihle edlula izinzuzo.

Yiziphi Imiphumela Engemihle ye-Terlipressin?

I-Terlipressin ingabangela imiphumela eminingana engemihle ngenxa yemiphumela yayo enamandla emithanjeni yakho yegazi kanye nezitho. Ithimba lakho lezokwelapha lizokuqapha eduze ukuze lithole lezi zimo ngesikhathi sokwelashwa kwakho.

Imiphumela engemihle evame kakhulu ongase uyithole ihlanganisa izinguquko esigqi senhliziyo yakho, ukwanda komfutho wegazi, kanye nokuncipha kokugeleza kwegazi emunweni wakho nasezinzwaneni zakho. Ungase uqaphele izandla nezinyawo zakho zibanda noma zibukeka zikhanya.

Nansi imiphumela engemihle evamile amaqembu ezokwelapha aqaphela yona:

• Ukushaya kwenhliziyo okungajwayelekile noma izinguquko zesigqi senhliziyo
• Umfutho wegazi ophezulu
• Ukugeleza kwegazi okuncishisiwe ezandleni nasezinyaweni
• Ubuhlungu besisu noma amajaqamba
• Isicanucanu noma ukuhlanza
• Ukucindezeleka
• Ukujuluka

Le miphumela evamile ivamise ukuthuthuka njengoba umzimba wakho ujwayela imithi noma lapho odokotela belungisa umthamo.

Abanye abantu bahlangabezana nemiphumela emibi kakhulu edinga ukunakekelwa kwezempilo ngokushesha. Lezi zimo ezingavamile kodwa ezikhathazayo zingathinta inhliziyo yakho, ukujikeleza kwegazi, noma ezinye izitho ezibalulekile.

Imiphumela emibi kakhulu edinga ukunakekelwa ngokushesha ihlanganisa:

• Ubuhlungu obukhulu besifuba noma izimpawu zokuhlaselwa yinhliziyo
• Ukucindezeleka okukhulu okungazelelwe noma izimpawu zokushaywa unhlangothi
• Izimpawu zokuncishiswa kokugeleza kwegazi ezingxenyeni zomzimba (ukudideka, ubuhlungu obukhulu besisu)
• Ukungezwani komzimba okukhulu okunezinkinga zokuphefumula noma ukuvuvukala
• Izimpawu zokufa kwezicubu emunweni noma ezinzwaneni

Ithimba lakho lezempilo liqeqeshwe ukubona lezi zimo ezinzima ngokushesha futhi lizolungisa ukwelashwa kwakho ngokushesha uma zenzeka.

Ubani Ongafanele Athole I-Terlipressin?

Abantu abathile abakwazi ukuthola i-terlipressin ngokuphepha ngenxa yengozi eyengeziwe yezinkinga ezinzima. Ithimba lakho lezempilo lizobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuqala lokhu kwelashwa.

Akufanele uthole i-terlipressin uma unesifo senhliziyo esibi, ikakhulukazi izimo ezithinta ukuhlinzekwa kwegazi kwenhliziyo yakho. Umuthi ungenza ukuthi ukuhamba kwegazi kuye emsipheni wenhliziyo yakho kunciphe, okungaba yingozi.

Abantu abanezinkinga ezithile zokujikeleza kwegazi nabo babhekana nezingozi eziphezulu. Uma unezithiyo ezinkulu emithanjeni yakho yegazi noma umlando wokuncishiswa kokugeleza kwegazi ezingxenyeni ezibalulekile zomzimba, i-terlipressin ingase ingakulungele.

Nawa amazwi avamile avimbela ukusetshenziswa kwe-terlipressin:

• Isifo esibi semithambo yenhliziyo noma ukuhlaselwa yinhliziyo kwamuva nje
• Ukuphazamiseka okukhulu kwesigqi senhliziyo
• Isifo esibi semithambo yomlenze
• Ukungezwani okwaziwayo ne-terlipressin noma imithi efanayo
• Ezinye izinhlobo zomfutho wegazi ophezulu obucayi
• Ukuhlinzwa okukhulu kwamuva nje emithanjeni yegazi

Odokotela bakho bazohlola izingozi nezinzuzo ngokucophelela, ikakhulukazi uma unezinye zalezi zimo kodwa ubhekene nesimo esiphuthumayo esisongela impilo.

Amagama Omkhiqizo we-Terlipressin

I-Terlipressin itholakala ngaphansi kwamagama amaningi omkhiqizo ngokuya ngendawo yakho kanye nokwakheka okuthile. E-United States, ungahlangana nayo njenge-Terlivaz, okuyigama lomkhiqizo elivunywe yi-FDA.

Kwamanye amazwe, i-terlipressin ihamba ngamagama omkhiqizo ahlukene afana ne-Glypressin, Haemopressin, noma i-Variquel. Umuthi osebenzayo uyafana kungakhathaliseki igama lomkhiqizo.

Ithimba lakho lezokwelapha lizosebenzisa noma yikuphi ukwakheka okutholakala esibhedlela sakho. Zonke izinhlobo ze-terlipressin ezivunyiwe zithatha izivivinyo ezifanayo eziqinile zokuphepha nokusebenza kahle.

Ezinye izindlela ze-Terlipressin

Eminye imithi eminingi ingelapha izimo ezifanayo ne-terlipressin, yize odokotela bekhetha ngokuya ngesimo sakho esithile nezidingo zezokwelapha. Lezi zindlela zokwelapha zisebenza ngezindlela ezihlukene kodwa zihlose ukufeza imiphumela efanayo.

I-Norepinephrine mhlawumbe iyindlela yokwelapha evame ukusetshenziswa kakhulu ye-vasopressor ye-septic shock. Isebenza ngokushesha kune-terlipressin kodwa idinga ukufakwa okuqhubekayo, okusho ukuthi uzodinga i-IV drip eqhubekayo esikhundleni semithamo ephakathi nendawo.

Ngokuqondile nge-hepatorenal syndrome, odokotela bangasebenzisa ukufakwa kwe-albumin okuhlanganiswe neminye imithi efana ne-midodrine ne-octreotide. Le ndlela yokuhlanganisa ngezinye izikhathi ingafinyelela imiphumela efanayo ne-terlipressin.

Ezinye izindlela zokwelapha i-vasopressor zihlanganisa i-vasopressin, i-epinephrine, kanye ne-dopamine. Ngayinye inamandla ahlukene futhi ikhethwa ngokusekelwe esimweni sakho esithile nokuthi umzimba wakho usabela kanjani ekwelashweni.

Ingabe i-Terlipressin Ingcono Kune-Norepinephrine?

Ukuthi i-terlipressin ingcono kune-norepinephrine kuncike esimweni sakho esithile kanye nokusabela komuntu ngamunye ekwelashweni. Zombili lezi zithako zokwelapha ziyasebenza, kodwa zisebenza ngendlela ehlukile futhi zinezinzuzo ezihlukene.

I-Terlipressin ihlala isikhathi eside emzimbeni wakho, ngakho odokotela bangayinika kaningi kune-norepinephrine. Lokhu kungaba yinzuzo ezimweni ezithile, ikakhulukazi lapho ukugcina umfutho wegazi ozinzile kuyinselele.

I-Norepinephrine isebenza ngokushesha futhi inikeza odokotela ukulawula okunembile ngomfutho wakho wegazi. Bangakwazi ukulungisa umthamo ngomzuzu ngomzuzu, okungaba kubalulekile ngesikhathi sezimo eziphuthumayo zezokwelapha ezishintsha ngokushesha.

Ngokuqondile nge-hepatorenal syndrome, i-terlipressin ikhombise ukusebenza kahle okuthile futhi ivame ukuba yindlela ekhethwayo. Nge-septic shock, i-norepinephrine ngokuvamile iyindlela yokuqala yokwelapha, nge-terlipressin esetshenziswa lapho i-norepinephrine inganele.

Ithimba lakho lezokwelapha lizokhetha inketho engcono kakhulu ngokusekelwe esimweni sakho esithile, eminye imithi oyitholayo, nokuthi udinga ngokushesha kangakanani ukusekelwa komfutho wegazi.

Imibuzo Evame Ukubuzwa Mayelana ne-Terlipressin

Ingabe i-Terlipressin Iphephile Kubantu Abanezifo Zenhliziyo?

I-Terlipressin idinga ukuqapha okukhulu kubantu abanezifo zenhliziyo futhi kungenzeka ingaphephile kulabo abanezifo ezinzima zemithambo yenhliziyo. Umuthi unganciphisa ukugeleza kwegazi emsipheni wenhliziyo yakho, okungase kwenze izinkinga zenhliziyo zibe zimbi kakhulu.

Uma unezifo zenhliziyo eziphakathi nendawo, odokotela bakho bazohlola izingozi ezisongela impilo yesimo sakho samanje ngokumelene nezingozi ezingaba khona zenhliziyo ze-terlipressin. Bazoqapha ukusebenza kwenhliziyo yakho eduze kakhulu ngesikhathi sokwelashwa.

Abantu abanezifo zenhliziyo ezinzima, ukuhlaselwa yinhliziyo kwamuva, noma ubuhlungu besifuba obungazinzile ngokuvamile abakwazi ukuthola i-terlipressin ngokuphepha. Ithimba lakho lezokwelapha lizocabangela ezinye izindlela zokwelapha ezingabeki ingozi enkulu enhliziyweni yakho.

Kufanele ngenzeni uma ngithola i-Terlipressin eningi ngengozi?

Awukwazi ukuthola i-terlipressin eningi ngengozi ngoba ochwepheshe bezokwelapha abaqeqeshiwe balawula yonke imithamo esibhedlela. Kodwa-ke, uma uhlangabezana nezimpawu zomuthi omningi kakhulu, ithimba lakho lezokwelapha lizophendula ngokushesha.

Izimpawu ze-terlipressin eningi zihlanganisa umfutho wegazi ophezulu kakhulu, ubuhlungu besifuba, ikhanda elibuhlungu kakhulu, noma izimpawu zokuncipha kokugeleza kwegazi ezingxenyeni zomzimba wakho. Ithimba lakho lezokwelapha liqapha lezi zimpawu ngokuqhubekayo.

Uma kwenzeka ukweqisa umthamo, odokotela bazoyeka umuthi ngokushesha futhi banikeze ukunakekelwa okusekelayo. Bangase bakunikeze imithi yokulwa nemiphumela noma ukusiza ukuphatha noma yiziphi izinkinga ezingavela.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Terlipressin?

Akudingeki ukhathazeke ngokulahlekelwa imithamo ngoba ithimba lakho lezokwelapha liphatha konke ukunikezwa kwe-terlipressin. Balandela isimiso esithile esisekelwe esimweni sakho kanye nokuphendula kwakho ekwelashweni.

Uma ithimba lakho lezokwelapha libambezela umthamo nganoma yisiphi isizathu, lizolungisa uhlelo lwakho lokwelashwa ngokufanele. Bangase banikeze umthamo ophuthelwe uma kuphephile ukwenza kanjalo, noma bangase balungise isikhathi semithamo yesikhathi esizayo.

Odokotela bakho baqapha ngokuqhubekayo isimo sakho futhi bazoqinisekisa ukuthi uthola umuthi ofanele ngesikhathi esifanele. Bazokwenza noma yiziphi izilungiso ezidingekayo ukuze bakugcine uphephile futhi bathuthukise ukwelashwa kwakho.

Ngingayeka nini ukuthatha i-Terlipressin?

Ithimba lakho lezokwelapha lizinquma ukuthi lingayeka nini i-terlipressin ngokusekelwe ekuphenduleni kwakho ekwelashweni kanye nokuthuthuka esimweni sakho esiyisisekelo. Lesi sinqumo sidinga ukwahlulela okucophelelayo kwezokwelapha futhi asikwazi ukwenziwa iziguli noma amalungu omndeni.

Ngokuvamile, odokotela bayeka i-terlipressin lapho umfutho wegazi lakho uzinzile, ukusebenza kwezinso zakho kuthuthuka, noma lapho imithi ingasawusizi umzimba wakho. Bazokwehlisa kancane kancane umthamo kunokuthi bayeke kungazelelwe.

Inqubo yokuyeka iyahluka kumuntu nomuntu. Abanye abantu bangayeka i-terlipressin ezinsukwini ezimbalwa, kanti abanye badinga ukwehliswa kancane kancane emasontweni amaningi. Ithimba lakho lezokwelapha lizokuqapha eduze ngalesi sikhathi sokuguquka.

Ingabe i-Terlipressin ingabangela imiphumela emibi yesikhathi eside?

Imiphumela eminingi emibi ye-terlipressin iyanyamalala uma ukwelashwa kuyekwa, kodwa abanye abantu bangase babe nemiphumela ehlala isikhathi eside kuye ngempilo yabo yonke nobude bokwelashwa. Ithimba lakho lezokwelapha lizokuqapha nganoma yiziphi izinkinga eziqhubekayo.

Umphumela omubi kakhulu ongaba khona wesikhathi eside ukuncipha kokugeleza kwegazi emunweni noma ezinzwaneni, okungase, ezimweni ezingavamile, kuholele ekulimaleni kwezicubu. Ithimba lakho lezokwelapha liqapha ngokucophelela izimpawu zakuqala zezinkinga zokujikeleza kwegazi.

Abantu abaningi balulama ngokugcwele ekwelashweni kwe-terlipressin ngaphandle kwemiphumela ehlala njalo. Nokho, odokotela bakho bazoqhubeka nokuhlola inhliziyo yakho, izinso, kanye nokusebenza kokujikeleza kwegazi ngisho nangemva kokuphela kokwelashwa ukuze kuqinisekiswe ukululama okuphelele.