Yini i-Desmopressin: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Desmopressin iyimithi ye-hormone eyenziwe ngumuntu esiza umzimba wakho ukulawula ibhalansi yamanzi nokulawula ukukhiqizwa komchamo. Cabanga ngayo njengendlela ewusizo yokufaka esikhundleni se-hormone yemvelo ebizwa nge-vasopressin (eyaziwa nangokuthi i-antidiuretic hormone noma i-ADH) okungenzeka ukuthi umzimba wakho awukwazi ukuyenza ngokwanele uqobo.

Le mithi isebenza ngokutshela izinso zakho ukuthi zibambe amanzi amaningi esikhundleni sokuwavumela ukuthi adlule njengomchamo. Ivame ukunqunywa ngezimo ezinjengesifo sikashukela insipidus, ukuchamela embhedeni ezinganeni, kanye nezinkinga ezithile zokuphuma kwegazi lapho umzimba wakho udinga usizo olwengeziwe lokuphatha uketshezi noma ukujiya kwegazi.

Yini i-Desmopressin Esetshenziselwa Yona?

I-Desmopressin iphatha izimo eziningana ezihlobene nokungalingani kwe-hormone nokulawulwa koketshezi emzimbeni wakho. Ukusetshenziswa okuvame kakhulu kungokwe-diabetes insipidus, isimo lapho umzimba wakho ungakhiqizi i-antidiuretic hormone yemvelo eyanele, okukwenza ukhiphe umchamo ngokweqile futhi uzizwe ulambele njalo.

Udokotela wakho angase futhi anqume i-desmopressin uma ubhekene nokuchamela ebusuku (nocturnal enuresis), ikakhulukazi ezinganeni ezineminyaka engaphezu kwengu-6 ubudala. Kunganciphisa kakhulu inani lobusuku obumanzi ngokusiza izinso ukuthi zigxilise umchamo ngesikhathi sokulala.

Kubantu abanezinkinga ezithile zokuphuma kwegazi njenge-hemophilia A emnene noma isifo sika-von Willebrand, i-desmopressin ingasiza ukuthuthukisa ukujiya kwegazi ngaphambi kokuhlinzwa noma izinqubo zamazinyo. Isebenza ngokwandisa okwesikhashana amazinga ezinto ezijiyisa igazi egazini lakho.

Ngokuvamile, odokotela banquma i-desmopressin yokuphatha ukuchama ebusuku ngokweqile kubantu abadala (nocturia) lapho ezinye izindlela zokwelapha zingasebenzi kahle. Lokhu kungaba usizo ikakhulukazi kubantu abalala bengaphazanyiswa njalo yizivakashi zokugezela.

Isebenza Kanjani i-Desmopressin?

I-Desmopressin isebenza ngokulingisa i-hormone yakho yemvelo ye-antidiuretic, esebenza njengomthunywa etshela izinso zakho ukuthi zenzeni ngamanzi. Uma uthatha lo muthi, ubopha kuma-receptors athile ezinso zakho futhi uzitshela ukuthi zithathe amanzi amaningi abuyele egazini lakho esikhundleni sokuwavumela ukuthi aphume njengomchamo.

Le nqubo yenza umchamo wakho ugxile kakhulu futhi inciphise inani eliphelele olikhiqizayo. Kuthathwa njengomuthi oqinile ngokulinganisela ngoba uthinta ngokuqondile izindlela ze-hormone ezilawula imisebenzi ebalulekile yomzimba njengokulinganisela uketshezi.

Lo muthi futhi usebenza emithanjeni yegazi futhi ungakhuphula okwesikhashana izinto ezithile zokujiya kwegazi lakho. Lesi senzo esiphindwe kabili senza kube usizo kuzo zombili izinkinga zokulawula amanzi kanye nezifo ezincane zokuphuma kwegazi.

Ngokungafani neminye imithi esebenza kuwo wonke umzimba wakho, i-desmopressin iqondisa ama-receptors athile, okusiza ukunciphisa imiphumela engathandeki kwezinye izinhlelo zomzimba. Imiphumela ivame ukuhlala amahora angu-8-12 kuye ngomthamo kanye nokuphendula kwakho.

Kufanele Ngiyithathe Kanjani I-Desmopressin?

Thatha i-desmopressin ngendlela eqondile udokotela wakho ayichazayo, ngokuvamile kanye noma kabili ngosuku kuye ngesimo sakho. Amathebhulethi omlomo angathathwa nokudla noma ngaphandle kokudla, kodwa ukuwathatha njalo ngesikhathi esifanayo nsuku zonke kusiza ukugcina amazinga aqinile ohlelweni lwakho.

Ungawuthatha umuthi ngamanzi, futhi asikho isidingo sokugwema ubisi noma ezinye iziphuzo ngaphandle kwalapho udokotela wakho ekweluleka ngokuqondile ngenye indlela. Kodwa-ke, kubalulekile ukulandela imiyalelo kadokotela wakho mayelana nokuthatha uketshezi, njengoba ukuphuza amanzi amaningi ngenkathi uthatha i-desmopressin kungaholela ekugcinweni kwamanzi.

Ukuze kulashwe ukuchama embhedeni, odokotela bavame ukuncoma ukuthatha umthamo cishe ihora elingu-1 ngaphambi kokulala esiswini esingenalutho. Lesi sikhathi sisiza umuthi ukuthi usebenze ngempumelelo kakhulu ngamahora okulala lapho udinga ukugxila komchamo okuphezulu.

Uma uthatha i-desmopressin ye-diabetes insipidus, ungase udinge ukuyithatha izikhathi eziningi ngosuku ukuze ugcine ukulinganisela kwamanzi okuqhubekayo. Udokotela wakho cishe uzoqala ngomthamo ophansi futhi awulungise ngokusekelwe ekutheni usabela kahle kangakanani kanye nanoma yimaphi imiphumela emibi oyitholayo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Desmopressin?

Ubude bokwelashwa nge-desmopressin buhlukahluka kakhulu kuye ngesimo sakho esithile nokusabela komuntu ngamunye. Nge-diabetes insipidus, ungase udinge ukwelashwa kwesikhathi eside njengoba lesi simo ngokuvamile sidinga ukufakwa kwamahomoni okuqhubekayo ukuze kugcinwe ukulinganisela okufanele kwamanzi.

Uma usebenzisa i-desmopressin yokuchamela embhedeni, ukwelashwa kuvame ukuhlala izinyanga ezi-3-6 ekuqaleni, ngamagebe avamile ukuze kubonakale ukuthi inkinga iyazixazulula ngokwemvelo. Izingane eziningi zingagcina ziyeka umuthi njengoba zikhula futhi zithuthukisa ukulawula okungcono kwesinye ngesikhathi sasebusuku.

Ngezifo zokuphuma igazi, ungase udinge i-desmopressin okwesikhashana ngaphambi kwenqubo yokuhlinzwa noma umsebenzi wamazinyo. Kulezi zimo, ukwelashwa kungase kuhlale izinsuku ezimbalwa ngesikhathi senqubo yakho.

Udokotela wakho uzoqapha njalo ukusabela kwakho futhi angase ancome amagebe ngezikhathi ezithile emuthini ukuze ahlulele ukuthi usawudinga yini. Ungayeki ukuthatha i-desmopressin ngokuzumayo ngaphandle kwesiqondiso sezokwelapha, ikakhulukazi uma une-diabetes insipidus, njengoba lokhu kungaholela ekuphelelwe amanzi emzimbeni okuyingozi.

Yiziphi Imiphumela Emibi ye-Desmopressin?

Njengayo yonke imithi, i-desmopressin ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma ithathwa njengoba kunqunyiwe. Umphumela omubi kakhulu ukugcinwa kwamanzi, okungaholela emazingeni aphansi e-sodium egazini lakho (i-hyponatremia) uma uphuza uketshezi oluningi ngenkathi uthatha umuthi.

Imiphumela emibi evamile ongase uyithole ihlanganisa ikhanda, isicanucanu, ukuqina kwesisu, kanye nesiyezi esincane. Lezi zimpawu zivame ukuthuthuka njengoba umzimba wakho uzivumela emuthini, ngokuvamile phakathi namasonto ambalwa okuqala okwelashwa.

Nawa amanye amaphutha avamile okufanele uwazi ngawo:

• Ikhanda elibuhlungu nesiyezi esincane
• Isicanucanu noma isisu esibuhlungu
• Ukuvaleka kwamakhala noma amakhala agobhozayo
• Ukubomvu noma umuzwa ofudumele ebusweni bakho
• Ukukhathala okuncane noma ubuthakathaka

Le miphumela ejwayelekile ngokuvamile ayidingi ukuyeka imithi ngaphandle uma iba yinkinga noma iphazamisa imisebenzi yakho yansuku zonke.

Imiphumela emibi kakhulu ayivamile kodwa idinga ukunakekelwa kwezempilo ngokushesha. Ubuthi bamanzi bungenzeka uma uphuza amanzi amaningi ngenkathi uthatha i-desmopressin, okuholela ezimpawini ezinjengekhanda elibuhlungu kakhulu, ukudideka, ukuquleka, noma ubunzima bokuphefumula.

Qaphela lezi zimpawu zokuxwayisa ezidinga ukunakekelwa kwezempilo ngokushesha:

• Ikhanda elibuhlungu kakhulu elinokudideka noma ukulahlekelwa yizinto
• Ukuminyana kwemisipha noma ubuthakathaka
• Ukuquleka noma ukuhlaselwa
• Ubunzima bokuphefumula noma ubuhlungu besifuba
• Isicanucanu esikhulu nokuhlanza
• Ukukhuluphala ngokushesha noma ukuvuvukala

Uma uhlangabezana nanoma yiziphi lezi zimpawu ezinzima, xhumana nomhlinzeki wakho wezempilo ngokushesha noma funa ukunakekelwa kwezimo eziphuthumayo.

Abanye abantu bangase babe nokusabela komzimba ku-desmopressin, nakuba lokhu kungavamile. Izimpawu zihlanganisa ukuqubuka kwesikhumba, ukuluma, ukuvuvukala kobuso noma umphimbo, noma ubunzima bokuphefumula. Noma yikuphi ukusabela komzimba kudinga ukunakekelwa kwezempilo ngokushesha.

Obani okungafanele bathathe i-Desmopressin?

Abantu abathile kufanele bagweme i-desmopressin ngenxa yengozi eyengeziwe yezinkinga ezinzima. Akufanele uthathe lo muthi uma unomlando wamazinga aphansi e-sodium egazini lakho (hyponatremia) noma uma unesifo sezinso esithinta ikhono lakho lokucubungula amanzi kahle.

Abantu abanenhliziyo ehlulekayo noma ezinye izimo ezibangela ukugcinwa kwamanzi ngokuvamile kufanele bagweme i-desmopressin, njengoba ingenza ukuvuvukala kube kubi kakhulu futhi ibangele ukucindezeleka enhliziyweni. Udokotela wakho uzohlola ngokucophelela impilo yenhliziyo yakho ngaphambi kokukuyalela lo muthi.

Uma unomfutho wegazi ophezulu ongagadiwe, udokotela wakho angase angakuncomi ukuthi usebenzise i-desmopressin ngoba ingathinta ukusebenza kwemithambo yegazi. Ngokufanayo, abantu abanezinhlobo ezithile zokuphazamiseka kokujiya kwegazi noma labo abathatha izinciphisi zegazi badinga ukucatshangelwa okukhethekile.

Abantu abadala badinga ukuqapha okwengeziwe lapho bethatha i-desmopressin ngoba basengozini enkulu yokuthuthukisa amazinga aphansi e-sodium nokugcinwa kwamanzi. Udokotela wakho angase aqale ngemithamo ephansi futhi akuqaphe eduze uma uneminyaka engaphezu kwengama-65.

Abesifazane abakhulelwe nabancelisayo kufanele baxoxe ngezingozi nezinzuzo nomhlinzeki wabo wezempilo, njengoba umuthi ungangena ngaphakathi kwe-placenta futhi udlulele obisini. Ngenkathi ngezinye izikhathi isetshenziswa ngesikhathi sokukhulelwa, ukuqapha ngokucophelela kubalulekile.

Amagama Omkhiqizo we-Desmopressin

I-Desmopressin itholakala ngaphansi kwamagama amaningi omkhiqizo, i-DDAVP iyona eyaziwa kakhulu. Leli gama lomkhiqizo lisetshenziselwa kokubili amaphilisi omlomo kanye namafomu e-spray yamakhala omuthi.

Amanye amagama omkhiqizo afaka i-Minirin, etholakala kwamanye amazwe, kanye ne-Nocdurna, eyenzelwe ngqo ukwelapha ukuchama ebusuku kubantu abadala. Ikhemisi lakho lingase libe nezinhlobo ezivamile ze-desmopressin, eziqulathe isithako esifanayo esisebenzayo kodwa zibiza ngaphansi kwezinhlobo zamagama omkhiqizo.

Uhlobo oluthile lomkhiqizo noma oluvamile olutholayo lungahluka ngokuya ngomshwalense wakho nezintandokazi zekhemisi. Zonke izinhlobo ze-desmopressin ezivunyelwe zisebenza ngendlela efanayo, kodwa izithako ezingasebenzi zingahluka kancane phakathi kwabakhiqizi.

Ezinye Izindlela ze-Desmopressin

Ezinye izindlela eziningi zikhona ze-desmopressin ngokuya ngesimo sakho esithile kanye nemigomo yokwelashwa. Nge-diabetes insipidus, ezinye izinketho zokwelapha zifaka ama-diuretics e-thiazide, asebenza ngendlela ehlukile ngokwenza izinso zakho zizwele kakhulu kunoma iyiphi i-hormone yemvelo osayivelayo.

Ukuze kulashwe ukuchama embhedeni ezinganeni, izindlela zokuziphatha ezifana nokuqeqeshwa kwesitho somchamo, ama-alamu omswakama, nokuphumula okuqondisiwe endlini yokugezela kungaba ezinye izindlela eziphumelelayo. Abanye odokotela batusa ukuzama lezi zindlela ngaphambi noma kanye nemithi.

Uma ubhekene nokuchama ebusuku, izinguquko zendlela yokuphila njengokukhawulela ukuthatha uketshezi ngaphambi kokulala, ukugwema i-caffeine notshwala, nokwelapha izifo zokulala ezingaphansi kungasiza ukunciphisa izimpawu.

Ukuze kulashwe izifo zokuphuma igazi, ezinye izindlela zihlanganisa ezinye izinto ezihlanganisa ukugcotshwa noma imithi efana ne-tranexamic acid, esiza ukuvimbela ukuthi amahlule egazi angabhidliki. Udokotela wakho we-hematologist angaxoxa ngokuthi iyiphi inketho esebenza kahle kakhulu ngohlobo lwakho oluthile lwesifo sokuphuma igazi.

Ingabe i-Desmopressin ingcono kune-Vasopressin?

I-Desmopressin inikeza izinzuzo eziningi ngaphezu kwe-vasopressin yemvelo ekusetshenzisweni okuningi kwezokwelapha. Ihlala isikhathi eside ohlelweni lwakho (amahora angu-8-12 uma kuqhathaniswa nemizuzu engu-10-20 ye-vasopressin), okusho ukuthi udinga imithamo embalwa usuku lonke.

Ngokungafani ne-vasopressin, i-desmopressin inemiphumela emincane ekucindezelweni kwegazi nesilinganiso senhliziyo, okuyenza iphephe kubantu abanezimo zenhliziyo nemithambo yegazi. Lesi senzo esikhethiwe sisho ukuthi uthola izinzuzo zokuthuthukiswa kokugcinwa kwamanzi ngaphandle kwemiphumela engathandeki yemithambo yegazi.

I-Desmopressin nayo iza ngendlela yethebhulethi yomlomo elula, kuyilapho i-vasopressin ngokuvamile idinga ukujovwa. Lokhu kwenza i-desmopressin ibe lula kakhulu ukuyisebenzisa ekwelashweni kwesikhathi eside, ikakhulukazi ezimweni ezinjenge-diabetes insipidus noma ukuchama embhedeni.

Nokho, i-vasopressin ingase ithandwe ezimweni eziphuthumayo lapho ukuqala okusheshayo kubalulekile, njengezinhlobo ezithile zokushaqeka noma ukuphuma igazi okukhulu. Udokotela wakho uzokhetha umuthi ofanele kakhulu ngokusekelwe ezidingweni zakho zezokwelapha kanye nezimo.

Imibuzo Evame Ukubuzwa Mayelana ne-Desmopressin

Ingabe i-Desmopressin iphephile ku-Diabetes?

Yebo, i-desmopressin ngokuvamile iphephile kubantu abanesifo sikashukela (i-diabetes mellitus), njengoba ingawathinti amazinga kashukela egazini. Kodwa-ke, kubalulekile ukuhlukanisa phakathi kwe-diabetes mellitus ne-diabetes insipidus, njengoba lezi zimo zihluke ngokuphelele ngaphandle kokuba namagama afanayo.

Uma unesifo sikashukela futhi udinga i-desmopressin ye-diabetes insipidus noma esinye isimo, udokotela wakho uzokuqapha ngokucophelela. Imiphumela yokugcinwa kwamanzi ye-desmopressin ayiphazamisi imithi yesifo sikashukela efana ne-insulin noma i-metformin.

Abantu abanesifo sikashukela abathatha i-desmopressin kufanele bagcine isimiso sabo esijwayelekile sokuqapha ushukela wegazi futhi babike noma yiziphi izimpawu ezingavamile kumhlinzeki wabo wezempilo ngokushesha.

Kufanele Ngenzeni Uma Ngisebenzisa Ngengozi I-Desmopressin Eningi Kakhulu?

Uma ngengozi uthatha i-desmopressin eningi kakhulu kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ukuthatha okuningi kakhulu kungaholela ekugcinweni kwamanzi okuyingozi kanye namazinga e-sodium aphansi kakhulu egazini lakho.

Ungaphuzi amanzi amaningi noma ezinye iziphuzo uma uthathe i-overdose, ngoba lokhu kungase kubhebhethekise inkinga. Kunalokho, nciphisa ukuthatha kwakho uketshezi futhi ufune ukwelashwa ngokushesha.

Izimpawu ze-overdose zihlanganisa ikhanda elibuhlungu elibuhlungu, ukudideka, isicanucanu, ukuhlanza, nobuthakathaka bemisipha. Uma uhlangabezana nokuhlaselwa, ubunzima bokuphefumula, noma ukulahlekelwa ukwazi, shayela izinsiza eziphuthumayo ngokushesha.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Desmopressin?

Uma uphuthelwa umthamo we-desmopressin, yithathe ngokushesha lapho ukhumbula, ngaphandle uma sekuyisikhathi somthamo wakho olandelayo ohleliwe. Kulokho, weqa umthamo ophuthelwe futhi uqhubeke neshejuli yakho ejwayelekile yokulinganisa.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe, ngoba lokhu kungandisa ingozi yakho yemiphumela emibi. Uma uvame ukukhohlwa imithamo, cabanga ukusetha izikhumbuzi zocingo noma usebenzise umhleli wamaphilisi ukukusiza ukuthi uhlale emkhondweni.

Ukuze kulashwe ukuchama embhedeni, uma uphuthelwa umthamo wakusihlwa, ungawuthatha ngaphambi kokulala uma nje kungakadluli isikhathi. Nokho, ungawuthathi uma usuvele ulele, ngoba lokhu kungase kuphazamise isimiso sakho sokulala.

Ngingayeka nini ukuthatha i-Desmopressin?

Isinqumo sokuyeka i-desmopressin sincike esimweni sakho esiyisisekelo futhi kufanele senziwe ngaso sonke isikhathi ngesiqondiso sikadokotela wakho. Nge-diabetes insipidus, ungase udinge ukwelashwa impilo yakho yonke, kuyilapho ukuchama embhedeni kuvame ukuxazululeka ngokwemvelo njengoba izingane zikhula.

Udkt wakho cishe uzofuna ukwenza izivivinyo ngezikhathi ezithile ngaphandle komuthi ukuze abone ukuthi isimo sakho sithuthukile noma sixazululiwe yini. Lokhu okuthiwa “amaholide emithi” kusiza ukunquma ukuthi usadinga yini ukwelashwa.

Ungayeki ukuthatha i-desmopressin ngokuzumayo ngaphandle kokuqondiswa kwezokwelapha, ikakhulukazi uma une-diabetes insipidus, ngoba lokhu kungaholela ekuphelelwe amanzi emzimbeni ngokushesha kanye nokungalingani okuyingozi kwama-electrolyte.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Desmopressin?

Kufanele ukhawulele ukusetshenziswa kotshwala ngenkathi uthatha i-desmopressin, njengoba utshwala bungaphazamisa ukusebenza komuthi futhi kwandise ingozi yakho yemiphumela emibi. Utshwala buthinta ukulinganisela kwama-hormone emzimbeni wakho futhi kungenza kube nzima ukuthi i-desmopressin isebenze kahle.

Ukuphuza utshwala kungakhuphula nengozi yakho yokuphelelwa amanzi emzimbeni noma, ngokuphambene nalokho, kukwenze ukuthi uthambekele ekuphuzeni uketshezi oluningi, kokubili okungaba yinkinga lapho uthatha i-desmopressin.

Uma ukhetha ukuphuza utshwala ngezikhathi ezithile, kwenze ngokulinganisela futhi uqaphele ngokwengeziwe ukuqapha ukuthatha kwakho uketshezi. Xoxa ngokusebenzisa kwakho utshwala nodokotela wakho ukuze uqinisekise ukuthi ngeke kuphazamise imigomo yakho yokwelashwa.