Isixwayiso nge-metronidazole ne-alcohol singokoqobo kodwa esifakazelwa kancane: ilebula ye-FDA ithi gwema i-alcohol ngesikhathi sokwelashwa kanye nezinsuku ezingu-3 ngemuva komthamo wakho wokugcina, kanti i-CDC ithi ukugwema akudingekile. Zombili lezi zitatimende ziyizona ezingamanje. Ngemithamo emifushane, ukulinda kuyisinqumo esicacile.

I-TL;DR: Okubalulekile okuzothatha

  • ilebula ye-FDA ithi akukho alcohol ngesikhathi sokwelashwa kanye nezinsuku ezingu-3 ngemuva komthamo wokugcina.
  • Iziqondiso zokwelashwa ze-CDC azibheki ukuzila njengokungadingekile futhi ukusebenzisana kungafakazelwa kancane.
  • I-Metronidazole ayikuvimbeli i-enzyme i-disulfiram eyiblokayo, ngakho-ke "njenge-disulfiram" akulona igama eliqondile.
  • Uma usuvele uphuzile, kulindele ukuthi kungabi lutho noma ukubomvu okuncane nenhlupheko ezoyeka yona.
  • Ungalokothi uyeke imithamo ye-antibiotic ngoba uphuze isiphuzo.

Gxuma isiphuzo ngenkathi usebenzisa i-metronidazole, kodwa hhayi ngoba kuyingozi

Isiqondiso esisemthethweni nge-metronidazole ne-alcohol sicace bha: i-lebula egunyazwe yi-FDA, ebukeziwe ngoFebhuwari 2022, ixwayisa ngokuthi i-metronidazole yomlomo ihambisana nokuphendula okufana ne-disulfiram ku-alcohol, okuhlanganisa izimfihlo zesisu, ukuhlanza, ukuhlanza, izinhlungu zekhanda, nokubomvu. Ikutshela ukuthi uyeke i-alcohol nemikhiqizo equkethe i-propylene glycol ngesikhathi sokwelashwa kanye nezinsuku ezingu-3 okungenani ngemuva komthamo wakho wokugcina.

I-MedlinePlus, umthombo wedatha yezidakamizwa yesiguli yeNational Library of Medicine, uphinda le miyalo efanayo yezinsuku-3 ngamagama acace bha. Konke okulesi sigaba kukhuluma ngamaphilisi namakhaseli omunye, okuyikho futhi okushiwo abantu lapho befuna i-Flagyl ne-alcohol, njengoba i-Flagyl ivele iy-metronidazole ngaphansi kwegama layo lophathelentengiso.

Kubalulekile ukwazi ngaphambi kokuba abanye bangethuke: ukuphendula lezi zibhelani ezichaza, lapho zenzeka, kuyathukuthelisa kunokuba kube yingozi empilweni. Kusihlwa esibi, hhayi uhambo oluya egumbini leziphuthumayo.

I-CDC ithi ukugwema i-alcohol nge-metronidazole akudingekile

Intsomi ye-metronidazole ne-alcohol ayilona ukuthi ukuphendula akunakwenzeka, kodwa ukuthi isixwayiso sasingakaze sakhiwe ngesisekelo esiqinile. I-STI Treatment Guidelines ye-CDC ibika ukuthi ukubukeza kuthola "akukho zifundo zangaphakathi, amamodeli ezilwane, imibiko yezikhalazo, noma izifundo zezokwelapha ezinikeza ubufakazi obuqinisekile bokusebenzisana okufana ne-disulfiram phakathi kwe-alcohol ne-metronidazole," futhi iphetha ngokuthi "ukugwema ukusetshenziswa kotshwala ngenkathi uthatha i-metronidazole (noma i-tinidazole) akudingekile."

Idatha elawulwayo ikhomba ngendlela efanayo. Ekubukezeni okwakhishwe ku-Antimicrobial Agents and Chemotherapy, uMergenhagen nabalingani bakhe bachaza isifundo esiphindwe kabili, esilawulwa yi-placebo, sababambiqhaza abayi-12 esathola umehluko ezingeni le-aldehyde dehydrogenase phakathi kwamaqembu kanye nezikhalazo ezibonakalayo zokuphendula okufana ne-disulfiram. Ukufunda kwabo ngezincwadi ezibanzi ukuthi ubufakazi bumapeketshane futhi bungqubuzana, nokuthi ukusebenzisana, lapho kubikwa, kwenzeka "ngokuphindaphinda okungaqinisekile" futhi "ubunzima obuhlukahlukene."

Ngakho-ke livelaphi leli mithetho? I-CDC iyilandela ezivivinyweni zaseleborethri nemibiko yamacala lapho ukuphendula kwakuyoba "kulinganayo ukuthi kungabangelwa i-alcohol eyedwa noma izikhalazo ze-metronidazole." Ukubuyekezwa kwamacala kuyi-journal yase-Emergency Medicine News kubala amacala ayisithupha kuphela abikwayo, abandakanya iziguli ezishayile, kusukela ngo-1964 kuya ku-1999. Izixwayiso ezibanzi ze-antibiotic ziyathambekela ukuqina ngale ndlela, okuyindaba efanayo ngemuva kwe-i-cephalexin ne-alcohol.

Inkinga: ukuyibiza ngentsomi ye-metronidazole ne-alcohol kuyisifinyezo esihle, kodwa ubufakazi obubandayo akubufakazi bokuphepha. Abazithandayo abayi-12 abakwazi ukuqeda ukuphendula okungavamile, futhi isifundo esikhulu esiyokwenza kube sobala asikaze senziwa.

"Okufana ne-disulfiram" akulona igama eliqondile: ingozi yangempela ye-disulfiram yiyona imidala uqobo

Ukuphendula okufana ne-disulfiram okuthiwa yi-metronidazole ibangela kunezinhlobonhlobo eziqondile, futhi i-metronidazole ayibonakali iyisebenzisa. Ekuphenduleni okuyikho kwe-disulfiram, i-alcohol iguquka ibe yi-acetaldehyde bese iyama lapho, ngoba i-enzyme i-aldehyde dehydrogenase iyablocheka. I-acetaldehyde iyanqwabelana, futhi uthola ukubomvu, ukushaya okunamandla kwenhliziyo, ukuhlanza, nokuhlanza.

Akulona lokho okwenza i-metronidazole. I-CDC itshela bha ukuthi i-metronidazole "ayiblokisi i-acetaldehyde dehydrogenase, njengokwenzeka nge-disulfiram." Ukuphawula okubonakala kudokotela kuMedscape, okuhambisana nezincwadi ezibuyekeziwe, kubonisa ukuthi iblokisa i-alcohol dehydrogenase, okuyandisa kancane ukungasebenzi kotshwala kunokubangela ukukhuphuka kwe-acetaldehyde. Leli gama lichaza ukufana ezikhalazweni, hhayi indlela efanayo yobulili.

Ngaleso sikhathi, kunezinguquko ze-disulfiram esikhwameni ezisemthethweni ezifakazelwa kahle ngempela. I-metronidazole yomlomo akufanele inikezwe noma ubani owathatha i-disulfiram (Antabuse) ngaphakathi emavikini amabili adlule, ngoba inhlanganisela ibihambisana nokuphendula okuyimfihlo. Isiphuzo esivamile yingozi enobufakazi obubandayo. I-Antabuse ne-metronidazole kuyinto eqoshiwe.

Izinsuku ezintathu ngemuva komthamo wakho wokugcina yinombolo okumele ithenjwe

Uma ubuzisa ukuthi kungashiya isikhathi esingakanani ngemuva kwe-metronidazole ungaphuza, impendulo ezenzakalelayo yizinsuku ezingu-3, noma amahora angu-72, ngemuva komthamo wakho wokugcina, okuyikho okuchazwa yilebula ye-FDA ne-MedlinePlus.

Funa ukuthi kungashiya isikhathi esingakanani ngemuva kwe-metronidazole ungaphuza bese uthola amahora angu-24, 48, no-72 acashunywe imithombo ehlukahlukene. Isibalo samahora angu-24 sivela ku-pharmacokinetics: i-metronidazole inohlangothi olufushane lwamahora ayisishiyagalolunye futhi ikhishwe kakhulu ngaphakathi cishe ezinsukwini ezimbili. Ezinye iziqondiso zesizwe zisebenzisa amahora angu-48. Izinsuku ezingu-3 zalelebula ziyisikhwama esihle kunokuba kube yingozi, futhi akukho lutho olushintshayo ngokuphathelene nokubaluleka kwezinto ngaphakathi kwesikhathi esingama-72.

Ukwalungisa kabili kubalulekile. Abantu abanezigulo zesibindi basusa i-metronidazole kancane kancane futhi kufanele bacela umdokotela ngokudlula isikhathi eside. Futhi i-tinidazole iphethe imiyalelo efanayo yezinsuku-3. Uma ucabanga ukuthi i-CDC ibheka ukusebenzisana okuyisisekelo njengokungafakazelwa kahle, inombolo eqondile ayibaluleki kakhulu kunendlela ilebula ebonakala ngayo.

Usukhona uphuzile? Izikhalazo ezimnene cishe zihlale zodwa

Uma ngengozi uphuze i-alcohol ngenkathi uthatha i-metronidazole, umphumela owenzeka kakhulu ukuthi akubange khona lutho. Uma kukhona, kulindele ukubomvu, ukuhlanza, inhlungu yekhanda, nezimfihlo zesisu, ngokuvamile kuqala ngaphakathi kwehora noma ezimbili bese kuncipha ngaphandle kokwelashwa.

Yeka ukuphuza okunye ngesikhathi sokwelashwa, phuza amanzi, udle okuthile, futhi umelane nesifiso sokuyihlobanisa nesiphuzo sesibili ukuze ubone ukuthi okokuqala kwakuyiphupho yini. Abantu abaningi abaphumelele ukuphuza i-alcohol ngenkathi bethatha i-metronidazole bazizwa bejwayelekile ngovivi.

Into ongayenzi ukuthi uyeke i-antibiotic. Isifo esingelashwanga, kungaba i-bacterial vaginosis, i-trichomoniasis, noma isifo se-anaerobic, siyinkinga enkulu kunokuba kusihlwa okubomvu. Shayela udokotela wakho ngaphambi kokweqa noma imiphi imithamo. Uma izikhalazo zingaphakathi kwesithombe esingenhla, hlola uhlu olubomvu olungezansi.

Usazizwa ugula futhi ungazi ukuthi ubhekana nani? I-u-$39 online urgent care visit ka-August ikuxhumanisa nodokotela ogunyazwe yi-US ongahlola izikhalazo zakho futhi anikeze imithi lapho kufaneleka; udokotela wenza leso sicelo, hhayi ukubhuka. Ividiyo yombono ayikwazi ukuhlola ubuhlungu besifuba, ukuqhafuneka, noma ubunzima bokuphefumula, okudinga ukunakekelwa kweziphuthumayo emtholampilo.

Nini ukuthola usizo lwezokwelapha, futhi nini i-drug, hhayi isiphuzo, okuyinkinga

Shayela u-911 noma uye egumbini leziphuthumayo manje uma:

  • Ukuquma kwezibhakabhaka, izindebe, ulimi, noma umphimbo, ama-hives abanzi, noma ubunzima bokuphefumula
  • Ubuhlungu besifuba, ukushaya okusheshayo noma okungajwayelekile kwenhliziyo, noma ukuqhafuneka ngemuva kokuphuza
  • Izivunguvungu
  • Ukuhlanza okunzima noma okuqhubekayo ngezimpawu zokuphela kwamandla

Bhukha umbono ngaphakathi kweviki elilandelayo uma:

  • Ukuhlikihla okusha, ukuluma, noma ubuthakathaka ezandleni noma ezinyaweni
  • Ukuzizwa kakhulu noma okuqhubekayo
  • Noma yikuphi ukuphendula okuhlala isikhathi esidlula usuku

Lezi zibonakaliso ezihambisana nezinzwa yizikhalazo ze-metronidazole, hhayi ukusebenzisana kotshwala.

Khuluma nodokotela ngaphambi kokuthi uqale uma:

  • Uthathile i-disulfiram (Antabuse) emavikini amabili adlule
  • Uneziguli zesibindi ezaziwayo
  • Uphuza kakhulu nsuku zonke, lapho ukuyeka ngokuphazima kuhambisana nengozi yakho yokubuyela emuva

Okubalulekile nge-metronidazole ne-alcohol

ilebula ye-FDA isasho ukuthi akukho alcohol ngesikhathi sokwelashwa kanye nezinsuku ezintathu ngemuva; iziqondiso zokwelashwa ze-CDC zithi ukuzila akudingekile. Zombili ziyizona, futhi akumele ube umhlaziyi wazo. Kwenye imithamo yamasonto ayisikhombisa noma eyishumi, ukulinda kuyinto engabizi futhi kuqeda umbuzo ngokuphelele. Ingozi okufanele iphathelane nayo ngempela yileyo yokuthatha i-disulfiram emavikini amabili ngaphambi kwe-metronidazole, hhayi ingilazi eyodwa yewayini. Futhi noma ngabe uphuzile, qeda i-antibiotic.

Imibuzo evame ukubuzwa

Ingabe isixwayiso kotshwala siyasebenza kwi-metronidazole gel noma imijovo yomlomo?

Hhayi ngokuvamile. Isixwayiso somlomo sikhona ngoba amaphilisi aletha umuthi emzimbeni wakho wonke, ngenkathi i-metronidazole gel yomlomo newayini kunciphisa ukusebenzisana kancane, njengoba ukumunca komzimba kusuka ku-gel kungaphansi kakhulu. Amanye ama-leaflet omkhiqizi asaqhubeka nokuphinda isexwayiso somlomo kuwo wonke amafomethi, ngakho-ke hlola umkhiqizo onikezwe wena bese ubuza umchwepheshe wakho wezidakamizwa uma kungacaci.

Ngiyakuyishiya isitika somchwepheshe wezidakamizwa esithi "gwema i-alcohol" manje njengoba i-CDC ithi ukuzila akudingekile?

Cha. Ochwepheshe bezidakamizwa banamathisela isitika ngoba ilebula eligunyazwe liyidinga, futhi lokho kuyizindlela ezifanele zochwepheshe, hhayi iphutha okumele ligadulwe. Uma isiqondiso nge-metronidazole ne-alcohol sibalulekile kuwe, babuze ngqo kunokuba unqume ngasese. Bangakwazi ukubheka impilo yesibindi sakho, neminye imithi yakho, kanye nomkhiqizo onayo, okungakwenzi umbhalo ovamile.

Ingabe ukuphuza i-alcohol kwenza i-metronidazole ingasebenzi ekususeni isifo?

Cha. Akukho bufakazi bokuthi i-alcohol inciphisa ukusebenza kwe-metronidazole kumagciwane noma amaparasiti. Ingozi yokuphila yingeqiniso: uma ukuphuza kukuhlanza imithamo, kukwenza ulalele ubuthongo, noma ukudlula ishejuli, imithamo iyayihlehlisa. Ukubeka imithamo ngokungaguquguquki kubaluleke kakhulu emiphumeleni kunokuthi uphuze okwenzeka ngakho.

Ingabe i-mouthwash, i-syrup yomkhuhlane, neminye imithombo yotshwala eyifihliwe ibalwa?

Ngokobuchwepheshe, yebo. Imithamo yalelebula ihlanganisa imikhiqizo equkethe i-alcohol noma i-propylene glycol, hhayi iziphuzo kuphela. Ngokweqiniso, i-mouthwash oyigcoba bese uyayikhwehlela iyinto encane kakhulu, ngenkathi i-syrup yomkhuhlane oyigwinyayo izikhathi eziningi ngosuku iyinto ebaluleke kakhulu. Izinhlobo ezingenayo i-alcohol zazo zombili zitholakala kabanzi uma ungathanda ukuzicabangela.

Ingabe i-metronidazole ingenza isiphuzo esisodwa sibe namandla kunokujwayelekile?

Mhlawumbe. Ngoba i-alcohol ingase kudingeke isikhathi eside kunezinye izikhathi, isiphuzo esisodwa singazizwa sikhulu noma sihlale isikhathi eside kunokulindelekile. Umphumela ongokoqobo ulula: ungacabangi ukuthi amandla akho ajwayelekile ayasebenza, ikakhulukazi uma usezingeni lokushayela noma okunye lapho ukuba ubuthakathaka kancane kunokulindelekile kubalulekile.

Isitatimende: Le mbhalo ingeyezinjongo zolwazi kuphela futhi ayisho izeluleko zezokwelapha. Hlale uxhumana nomhlinzeki wokunakekelwa kwezempilo ofanelekile ukuze uthole ukuxilongwa nezinqumo zokwelashwa. Uma ubhekene nesimo esiphuthumayo sezokwelapha, shayela u-911 noma uye egumbini leziphuthumayo eliseduze ngokushesha.