Mankhwala a Ana ndi Mavuto Ake
Mankhwala a ana ndi nthambi ya sayansi ya mankhwala ndi machitidwe omwe amayang'ana kwambiri kugwiritsa ntchito mankhwala mwa makanda, ana, ndi achinyamata. Gulu la zaka izi silingaganizidwe ngati "akuluakulu ang'onoang'ono" chifukwa ali ndi makhalidwe osiyana a thupi, maganizo, ndi chikhalidwe. Kusiyana kumeneku kumakhudza momwe mankhwala amayamwidwira, kugawidwa, kusinthidwa, ndi kutulutsidwa ndi thupi. Kusankha mankhwala molondola, kuwerengera mlingo, mtundu wa mlingo, ndi njira yoperekera mankhwala ndikofunikira kwambiri. Kuphatikiza apo, zovuta mu mankhwala a ana zimakhala zovuta kwambiri chifukwa cha zosowa zosiyanasiyana zamankhwala, zochepa za mayeso azachipatala mwa ana, komanso zofunikira kwambiri pachitetezo.
Kupadera kwa odwala a ana pa chithandizo cha mankhwala
Kukula ndi kukula kwa ana kumapita patsogolo mofulumira. M'kanthawi kochepa, kusintha kwakukulu kumachitika pa kulemera kwa thupi, kapangidwe ka madzi m'thupi, magwiridwe antchito a ziwalo, komanso mphamvu ya machitidwe a ma enzyme a chiwindi ndi impso. Kusintha kumeneku kumakhudza mwachindunji pharmacokinetics (zomwe thupi limayankhira ku mankhwala) ndi pharmacodynamics (zomwe mankhwala amachita ku thupi).
Mwachitsanzo, makanda obadwa kumene amakhala ndi madzi ambiri m'thupi kuposa akuluakulu, kotero mankhwala osungunuka m'madzi nthawi zambiri amakhala ofala kwambiri. Pakadali pano, ntchito ya chiwindi ndi impso siikula, kotero mankhwala ena amatha kukhalabe m'thupi kwa nthawi yayitali, zomwe zimawonjezera chiopsezo cha poizoni. Mwa ana okalamba, kagayidwe kachakudya kamakhala kofulumira kuposa kwa akuluakulu pa mankhwala ena, zomwe zimapangitsa kuti pakhale kusintha kwa mlingo kapena kuchuluka kwa nthawi yoperekera. Kusintha kumeneku kumapangitsa kuti chithandizo cha odwala ana chifunike kuyang'aniridwa bwino komanso kumvetsetsa bwino zachipatala.
Vuto lalikulu: kudziwa mlingo molondola
Chimodzi mwa zovuta zazikulu mu pharmacy ya ana ndi mlingo. Mlingo wa ana nthawi zambiri umawerengedwa kutengera kulemera kwa thupi (mg/kg) kapena malo a thupi (mg/m²). Kuwerengera kumeneku kumawoneka kosavuta, koma nthawi zambiri kumakhala kolakwika, makamaka m'malo otanganidwa azachipatala kapena pamene deta ya kulemera si yolondola kapena yakale. Cholakwika chaching'ono pakuwerengera mlingo wa munthu wamkulu sichingakhale chachikulu, koma mwa makanda kapena ana aang'ono, kusiyana pang'ono kungatanthauze kumwa mopitirira muyeso kapena kuchepetsa mlingo.
Vuto lina ndi kukhalapo kwa malire apamwamba a mlingo. M'machitidwe, mlingo wowerengedwa kutengera kulemera kwa thupi uyenera kuyerekezeredwa ndi mlingo wapamwamba kwambiri wa munthu wamkulu kuti apewe kumwa mopitirira muyeso. Akatswiri a zamankhwala amachita gawo lofunika kwambiri ngati odziyimira pawokha, kuonetsetsa kuti mlingo woyenera, kuganizira momwe ziwalo zimagwirira ntchito, komanso kuwunika momwe mankhwala angagwirizanitsire ntchito.
Kupezeka kochepa kwa mankhwala abwino kwa ana
Mankhwala ambiri omwe alipo pamsika amapangidwa kwa akuluakulu, potengera mphamvu ya mlingo ndi mtundu wa mlingo. Ana nthawi zambiri amafunika milingo yochepa komanso yosavuta kumeza. Komabe, si mankhwala onse omwe amapezeka mu madzi, madontho, kapena mapiritsi omwazika. Chifukwa chake, akatswiri azaumoyo nthawi zina amafunika kusintha: kugawa mapiritsi, kuphwanya ndi kusakaniza ndi chakudya, kapena kukonzekera zokonzekera zamadzimadzi mosaganizira.
Apa ndi pomwe mavuto achitetezo amabuka. Kugawa mapiritsi sikutanthauza kuti nthawi zonse pamakhala mlingo woyenera, makamaka ngati piritsilo lilibe mzere wogawanika kapena kuchuluka kwa mankhwalawo sikugawidwa mofanana. Mapiritsi ophwanyika amathanso kusintha momwe mankhwala amatulutsidwira, makamaka m'njira zotulutsira mankhwala zomwe zimatulutsidwa nthawi zonse kapena zomwe zimakhala ndi utoto wa enteric, zomwe zimayambitsa zotsatirapo zoyipa kapena kuchepetsa mphamvu. Kupanga mankhwala ophatikizana amadzimadzi kumafunanso miyezo yokhwima: kusankha zosungunulira, kukhazikika, kufanana, ndi kusungidwa bwino. Popanda njira zomveka bwino, chiopsezo cha kusintha kwa mlingo ndi kuipitsidwa kumawonjezeka.
Mavuto okhudzana ndi kukoma bwino komanso kutsatira malamulo a mankhwala
Kukoma kwa mankhwala ndi chinthu chofunikira kwambiri kwa ana. Mankhwala ambiri amakhala ndi kukoma kowawa kapena fungo losasangalatsa, zomwe zingapangitse ana kukana kumwa mankhwala awo. Izi sizimangokhudza kuphweka kwa mankhwalawo komanso zimakhudza kupambana kwa chithandizo. Mwachitsanzo, kusamwa maantibayotiki pa nthawi yake kungapangitse kuti chithandizocho chilephereke komanso kuti mankhwalawo asagwire bwino ntchito.
Akatswiri a zamankhwala angathandize popereka maphunziro okhudza njira zoyenera zoperekera mankhwala, kupereka malingaliro a njira zochepetsera kukoma kosasangalatsa popanda kusokoneza kuyamwa kwa mankhwala, kapena kupereka malingaliro a mitundu yovomerezeka ya mlingo. Komabe, njira zothetsera mavuto sizipezeka nthawi zonse, makamaka pa mankhwala ofunikira omwe ndi ovuta kuwasintha.
Kusowa kwa deta yoyesera zachipatala mwa ana
M'mbuyomu, mankhwala ambiri omwe amagwiritsidwa ntchito mwa ana anali ozikidwa pa deta ya akuluakulu yomwe "inamasuliridwa" ku ana. Izi zili choncho chifukwa mayesero azachipatala mwa ana amakumana ndi zovuta zamakhalidwe abwino, zoyendera, komanso zotsika mtengo. Komabe, ana amayankha mosiyana ndi mankhwala, kotero kutengera kwa akuluakulu sikoyenera nthawi zonse. Zotsatira zake, machitidwe osagwiritsidwa ntchito (kugwiritsa ntchito mankhwala kunja kwa chizindikiro chovomerezeka, mlingo, kapena msinkhu) ndi ofala kwambiri mwa ana.
Ngakhale kuti kugwiritsa ntchito mankhwala osakhala ndi chizindikiro nthawi zina n’kofunika kuti pakhale chithandizo chabwino kwambiri, izi zimafuna kuyang’aniridwa bwino, zikalata zomveka bwino, komanso kulankhulana momveka bwino ndi makolo. Akatswiri azamankhwala a zachipatala amachita nawo mbali poyesa umboni waposachedwa, kuyeza ubwino ndi zoopsa, komanso kuthandiza gulu lachipatala posankha chithandizo chotetezeka komanso chogwira mtima kwambiri.
Chiwopsezo chachikulu cha zolakwika za mankhwala
Dongosolo la mankhwala a ana lili ndi mfundo zambiri zosatetezeka: kuwerengera mlingo, kuchepetsa, kugwiritsa ntchito zida zoyezera zosakhazikika, komanso kupereka ndi makolo kunyumba. Zolakwika zimatha kuchitika chifukwa cha mayunitsi osiyanasiyana (mg vs. mL), kugwiritsa ntchito supuni ngati zida zoyezera, kapena chisokonezo chokhudza nthawi ya mankhwala. M'zipatala, zolakwika zimatha kuchitika pokonzekera ma infusions, makamaka mankhwala omwe ali ndi index yocheperako yochiritsira monga aminoglycosides kapena mankhwala a chemotherapy.
Kupewa kumafuna njira yogwirira ntchito: kugwiritsa ntchito e-prescribing ndi chida chowerengera mlingo wa ana, kulemba zilembo momveka bwino, jakisoni wambiri, ndi maphunziro kwa ogwira ntchito zachipatala. Kwa odwala osapita kuchipatala, maphunziro okhudza kugwiritsa ntchito zipangizo zoyezera (ma syringe omwa), zitsanzo za kupereka mankhwala, ndi zolemba zosavuta kumva ndizothandiza.
Mavuto m'mikhalidwe yapadera: makanda ndi matenda osatha
Makanda (obadwa kumene) ndi omwe ali pachiwopsezo chachikulu. Kugwira ntchito kwawo kosakhwima kwa ziwalo kumavuta kusankha mankhwala ndi mlingo wake. Kuphatikiza apo, makanda nthawi zambiri amachiritsidwa ku NICU ndi mankhwala ovuta, kuphatikizapo zakudya zopatsa thanzi komanso kulowetsedwa m'mitsempha yambiri. Kulephera kupeza bwino kwa mitsempha kumapangitsa kuti kugwirizanitsa mankhwala ndi kuyang'anira mzere wa IV kukhale kovuta kwambiri.
Kwa ana omwe ali ndi matenda osatha—monga khunyu, mphumu, matenda a shuga, matenda a mtima obadwa nawo, kapena khansa—chithandizo cha nthawi yayitali chimafuna kutsatira kwambiri ndikuyang'anira zotsatirapo zake. Kukula kwa mwana kumafunanso kusintha mlingo nthawi zonse. Akatswiri a zamankhwala angathandize popereka ndemanga za mankhwala nthawi zonse, kuyang'anira mankhwala ochiritsira, komanso upangiri wa mabanja pa momwe angagwiritsire ntchito mankhwala kunyumba.
Udindo wa akatswiri a zamankhwala mu gulu la chisamaliro cha ana
Pakati pa mavuto amenewa, akatswiri a zamankhwala amachita gawo lofunika kwambiri. Akatswiri a zamankhwala samangokonza mankhwala okha, komanso amaonetsetsa kuti chithandizo cha mankhwala ndi chotetezeka, chogwira ntchito, komanso chogwirizana ndi zosowa za mwana. Ntchito zawo zofunika kwambiri ndi izi:
1. Kutsimikizira mankhwala ndi kusintha kwa mlingo kutengera kulemera kwa thupi, zaka, momwe impso/chiwindi chimagwirira ntchito, komanso momwe matenda alili.
2. Kuyang'anira momwe mankhwala amagwirizanirana ndi mankhwala ena komanso zotsatira zake zoyipa, kuphatikizapo ziwengo ndi poizoni.
3. Kukonza bwino komanso kokhazikika kwa ana, limodzi ndi njira zodziwika bwino.
4. Maphunziro kwa makolo ndi odwala, kuphatikizapo momwe angagwiritsire ntchito zida zoyezera, nthawi ya mankhwala, ndi zizindikiro zoopsa.
5. Kugwirizana kwa akatswiri ndi madokotala ndi anamwino kuti apange njira zochiritsira komanso miyezo yokhudza kuchuluka kwa mankhwala.
Malangizo amtsogolo: luso latsopano ndi kulimbitsa machitidwe
Tsogolo la mankhwala a ana likusonyeza kuti padzakhala njira zabwino zogwiritsira ntchito mankhwala ophera ana, kafukufuku wowonjezereka wa zachipatala za ana, komanso kugwiritsa ntchito ukadaulo woletsa zolakwika pakupereka mankhwala. Mankhwala monga mapiritsi ang'onoang'ono, mafilimu osungunuka, kapena zophikira zokometsera zakudya ndi njira zabwino zowonjezerera kutsatira malamulo. Kumbali ya machitidwe, kuphatikiza zolemba zachipatala zamagetsi, kupereka mankhwala a barcode, ndi malangizo ogwiritsira ntchito mankhwala ozikidwa pa umboni kungachepetse kuchuluka kwa zolakwika.
Kuphatikiza apo, maphunziro a anthu onse ndi ofunikiranso. Makolo ayenera kumvetsetsa kuti "kuchepetsa mlingo wa mankhwala a akuluakulu" sikotetezeka nthawi zonse, ndipo kugwiritsa ntchito mankhwala popanda kufunsa mwana kungakhale kovulaza. Kulimbitsa malamulo, kuonetsetsa kuti mankhwala ofunikira a ana akupezeka, komanso kupereka mwayi kwa akatswiri azamankhwala azachipatala m'malo azaumoyo kudzakulitsa ubwino wa chisamaliro.
Mapeto
Mankhwala a ana ndi gawo lomwe limafuna kulondola kwambiri chifukwa ana ali ndi mawonekedwe osiyanasiyana a thupi ndipo amayankha mankhwala mosiyana ndi akuluakulu. Mavuto akuluakulu ndi monga kudziwa mlingo woyenera, mankhwala ochepa omwe amaperekedwa kwa ana, mavuto okhudzana ndi kukoma ndi kutsatira malamulo, kusowa kwa deta yoyesera zachipatala, komanso chiopsezo chachikulu cha zolakwika za mankhwala. Ngakhale kuti izi ndi zovuta, akatswiri a zamankhwala amachita gawo lofunika kwambiri monga oteteza chitetezo cha mankhwala, othandizana nawo pa maphunziro a mabanja, komanso mamembala a gulu la akatswiri osiyanasiyana. Ndi njira zatsopano zopangira mankhwala, kulimbitsa machitidwe ogwirira ntchito, komanso kuwonjezeka kwa kafukufuku wa ana, chithandizo cha mankhwala mwa ana chingakhale chotetezeka, chogwira ntchito, komanso choganizira odwala.
