Ithute hore na ke hobane'ng ha li-anti-depressing le li-anticonpants li sebelisoa ho phekola bohloko bo sa foleng
Tlhahlobo ea li-adjuvant ke meriana e sa etselitsoeng ho laola bohloko empa e ka sebelisoa ka morero ona. Mehlala e meng ea lithethefatsi tse nang le lithethefatsi ke meriana e kang ho loantšana le khatello ea kelello le li-anticonvulsants . Li ka boela tsa bitsoa coanalgesics.
U ka 'na ua laeloa hore u na le litšoantšo tse ling tse bohloko ho feta litlhare tse ling tse bohloko , kapa u le mong. Li-analgesics tse nang le li-adjuvant ha li atlehe haholo bakeng sa mahlaba a mesifa, joaloka bohloko ba 'mele kapa bohloko ba mokuli.
Leha ho le joalo, li ka sebetsa hantle bakeng sa bohloko ba meriana le mahlaba a bohloko, a kang fibromyalgia . Li boetse li phetha karolo ea ho phekola bohloko ba kankere. Ho fapana le li-analgesics tse ling tse ngata tse se nang opioid , li-analgesics tse nang le li- adjuvant ha li fumanehe ka holim'a counter.
Mefuta ea Maqheku a Maiketsetso
Ho tepella maikutlo
Le hoja hangata batho ba nang le bothata ba ho tepella maikutlo ha ba nahane hore ke meriana ea bohloko, ba khona ho sebetsana ka katleho le maemo a bohloko a sa foleng. Ho nahanoa hore batho ba nang le bothata ba ho imeloa kelellong ba laola tsela eo bohloko bo ka fumanoang ho tloha mokokotlong ho ea bokong. Ho phaella moo, ho imeloa kelellong ho ka fokotsa ho tšoenyeha le ho thusa ho laola boroko.
Leha ho le joalo, hase mefuta eohle ea li-anti-depressing e atlehang ho laola bohloko bo sa foleng . Tricyclic ho loantšana ha maikutlo (TCAs) e kang amitriptyline, serotonin reuptake inhibitors (SSRIs), joaloka duloxetine, le tse ling, tse kang nefazodone, li atisa ho sebelisoa ho phekola mahlaba a mabeli a bohloko a sa foleng le bohloko ba methapo. Monoamine oxidase inhibitors (MAOIs) ha e sebetse ho laola mafu a sa foleng.
Anticonvulsants
Anticonvulsants, e leng meriana e atisang ho sebelisoa ho laola mathata a ho tšoaroa ke lefu, e ka boela ea sebelisoa ho phekola bohloko bo sa foleng. Li-anticonvulsants li sebetsa ka ho se lumelle mefuta e itseng ea methapo ea methapo, 'me e ka fokotsa bohloko ba ho ntša maikutlo, joalo ka ba bakoang ke trigeminal neuralgia kapa lefu la ho se tšoaroe ke lefu la tsoekere.
Li-anticonvulsants tse atisang ho sebelisoa ho laola bohloko bo sa foleng li kenyeletsa gabapentin le pregabalin.
Gabapentin ke setšoantšo se hlaselang ka ho fetisisa se sebelisoang ka ho fetisisa. Bakuli ba bang ba sa arabeleng hantle ka gabapentin ba arabela ho e-na le ho pregabalin, le ka tsela e fapaneng.
Ke eng eo bohloko ba mahlaba a syndromes ba e etsang ha ba ntse ba e-na le liphutheho tse sebetsang?
Oxford Textbook ea Palliative Medicine le Buka ea Merck li thathamisa li-analgesics tse latelang tse latelang ho tšoara li-syndromes tsa bohloko:
Lisebelisoa tse sebelisetsoang mefuta e mengata ea Syndromes ea bohloko
- Corticosteroids
- Dexamethasone
- Prednisone
- Tricyclic ho loantšana ha maikutlo
- Amitriptyline: ha e khothalletsoe ho ba hōlileng kapa bakuli ba nang le lefu la pelo.
- Desipramine
- Seleotonin e khethiloeng le norepinephrine reuptake inhibitor (SNRI) e thibelang ho imeloa kelellong
- Duloxetine: Ho mamelloa hamolemo ho feta tricyclic ea ho tepella maikutlo.
- Milnacipran
- Alpha-2-adrenergic agonists
- Tizanidine
- Meriana ea lefuba: capsaicin e ka sebelisoa bakeng sa bohloko ba pelo le ramatiki.
- Likokoana-hloko tsa sebakeng seo: tse kang lidocaine patch
Lisebelisoa tse sebelisetsoang bohloko ba kelello
- Antiepileptic agents
- Gabapentin: Ena ke moriana o khethiloeng oa anticonvulsants.
- Pregabalin
- Carbamazepine: ena ke eona phekolo ea pele bakeng sa trigeminal neuralgia.
- Phenytoin: e nkoa e le lithethefatsi tsa bobeli.
- Valproic acid: e sebelisetsoa hlooho.
- Clonazepam
- Lamotrigine
- Topiramate
- Tiagabine
- Oxcarbazepine
- Lacosamide
- Bahanyetsi ba NMDA ba amohelang batho
- Mememine
- Ketamine
- Dextromethorphan: e sebelisoang ha bohloko bo na le karolo ea ho ruruha.
- Li-blockers tsa methapo ea sesebelisoa ka molomo
- Mexiletine
- Tocainide
- Baclofen: E sebelisoa ka trigeminal neuralgia.
Calcitonin
Lisebelisoa li Sebelisa Bakeng sa Maqakabetsing a Mahlaba a Mahlaba a Khethehileng
- Calcitonin
- Clonidine
- Prazosin: bohloko bo bohloko ba kankere
- Bisphosphonate ( mohlala , pamidronate)
- Calcitonin
- Radiopharmaceuticals
Lentsoe le Tsoang ho
Haeba u ipotsa hore na ke hobane'ng ha ho sebelisoa meriana e sa tšoaneng ho phekola bohloko ba hao bo sa foleng, kopa ngaka kapa setsebi sa metsoako hore se hlalose. Ts'ebetso ea lintho tse phelang e ka ba e rarahaneng, empa u ka kholiseha hore u fumana meriana e nepahetseng e tla sebetsa hammoho ho fana ka phomolo ea bohloko.
> Mehloli:
> Lussier D, Portenoy RK: Tlhōlisano ea lihlahisoa. Doyle D, Hanks G, Cherny NI, Calman K (eds): Oxford Textbook ea Palliative Medicine. Oxford: Oxford University Press, Ed ea 4, Oxford: Oxford University Press, 2011.
> Markman, J, et. al. Mahlomola a Mabeli. Merck Manual Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain.