Izidakamizwa Nezidakamizwa Zengqondo Ezibhedlela
Izidakamizwa ezidakayo kanye nezidakamizwa ezithinta ingqondo ziyiqembu elibalulekile lezidakamizwa ekunakekelweni kwezempilo kwanamuhla, ikakhulukazi ezibhedlela. Zombili zinikeza izinzuzo ezibalulekile zezokwelapha, okuhlanganisa ukwelapha ubuhlungu obukhulu, ukuquleka, izinkinga zokukhathazeka okukhulu, ngisho nokunikeza isidambisi-zinhlungu ngesikhathi sokuhlinzwa. Kodwa-ke, ngenxa yokuthi zingaba khona ngenxa yokuncika, ukusetshenziswa kabi, kanye nemiphumela emibi kakhulu, ukusetshenziswa kwazo, ukugcinwa kwazo, kanye nokuqoshwa kwazo ezibhedlela kumele kugadwe ngokuqinile futhi kuhambisane nemithethonqubo esebenzayo.
Ukuqonda okuvamile kanye nomehluko
Ngokuvamile, izidakamizwa ziyizidakamizwa ezisebenza kakhulu ohlelweni lwezinzwa oluphakathi, okubangela ukwehla kokuqwasha, ukuqeda ubuhlungu, kanye nethuba lokuncika. Esibhedlela, izidakamizwa zivame ukusetshenziswa njengemithi yokunciphisa ubuhlungu enamandla noma njengengxenye ye-anesthesia. Okwamanje, izidakamizwa ze-psychotropic ziyizidakamizwa ezithinta nohlelo lwezinzwa oluphakathi, kodwa zihlotshaniswa kakhulu nezinguquko emsebenzini wengqondo kanye nokuziphatha, njengemiphumela yokudambisa, yokulwa nokukhathazeka, yokulwa nengqondo, noma yokuvuselela. Izidakamizwa ze-Psychotropic nazo zinengozi yokusebenzisa kabi futhi zingaholela ekuncikeni, yize imiphumela yazo ihlukile kweyezidakamizwa.
Umehluko omkhulu phakathi kwalokhu okubili ungabonakala ezinkomba zazo ezivelele zezokwelapha: izidakamizwa zivame ukusetshenziselwa ubuhlungu, kuyilapho izidakamizwa zengqondo zivame ukusetshenziselwa izifo zengqondo, izinkinga zokulala, ukudambisa ubuhlungu, noma izimo ezithile zezinzwa. Kodwa-ke, ezibhedlela, la maqembu amabili ezidakamizwa avame ukufana ngomongo we-anesthesia, ukunakekelwa okujulile, kanye nokuphathwa kwezimo ezibucayi.
Izindima zemitholampilo ezibhedlela
Ezingeni lesibhedlela, izidakamizwa ezidakisayo kanye nezidakamizwa ezidakisayo zidlala indima ebanzi. Isibonelo, ezigulini ezilandela ukuhlinzwa, ubuhlungu obuphakathi kuya kobunzima buvame ukudinga izidakamizwa ezidakisayo ukuze zibasize baphefumule kangcono, bahambe ngokushesha, futhi banciphise ukucindezeleka ngokomzimba. Ezigulini ezihlukumezekile, ubuhlungu obukhulu obuvela ekulimaleni bungalimaza ukuzinza kwe-hemodynamic, okwenza ukuphathwa kwemithi okuphumelelayo kube yingxenye ebalulekile yokuphathwa okusindisa impilo.
Ekubulaleni izinzwa, kokubili izidakamizwa kanye nezidakamizwa ze-psychotropic zivame ukusetshenziswa njengengxenye yezinqubo zokubulala izinzwa, ukudambisa inqubo, noma ukudambisa iziguli ezidinga ukuphefumula ngomshini egunjini lokunakekelwa okujulile (i-ICU). Ngaphezu kwalokho, emnyangweni wezimo eziphuthumayo, imithi ethile isetshenziselwa ukwelapha ukucasuka okukhulu, ukuphazamiseka kwengqondo, noma ukuhlaselwa uvalo okusongela ukuphepha kweziguli nabasebenzi.
Kodwa-ke, lezi zinzuzo ezibalulekile kumele zihlolwe ngokucophelela ngaso sonke isikhathi. Isilinganiso, indlela yokusetshenziswa, isikhathi sokwelashwa, ngisho nezinkinga ezihambisana nesiguli (isib., izinkinga zokuphefumula, izinkinga zesibindi, noma umlando wokusebenzisa kabi izidakamizwa) ziyizici ezibalulekile ekwenzeni izinqumo zomtholampilo.
Izibonelo zokusetshenziswa kanye nezinkomba
Ezinye izidakamizwa ezivame ukusetshenziswa ezibhedlela (kuye ngokuthi ziyini izinqubomgomo zemithi kanye nemithetho yendawo) zifaka phakathi i-morphine, i-fentanyl, i-pethidine, kanye ne-oxycodone. Izimpawu zazo eziyinhloko ubuhlungu obukhulu, ubuhlungu bomdlavuza, ubuhlungu bangemva kokuhlinzwa, kanye ne-anesthetic adjuvant.
Okwamanje, izidakamizwa ze-psychotropic ezivame ukutholakala ezibhedlela zifaka phakathi i-benzodiazepines (isb., i-diazepam noma i-midazolam) ngezinjongo zokudambisa ukucindezeleka, ukulwa nokukhathazeka, kanye nezinhloso zokulwa nokuquleka; kanye neminye imithi engasetshenziswa ezinkingeni zengqondo, ukucasuka, noma izimo ezithile njengoba kudingeka emtholampilo. Ezigulini ezine-seizure ende, isibonelo, i-benzodiazepines ingaba ukwelashwa kokuqala okubalulekile.
Kuzo zonke lezi zindlela zokusebenzisa, izimiso eziyisisekelo ziyinkomba efanele, isiguli esifanele, umuthi ofanele, umthamo ofanele, kanye nokuqapha okufanele. Amaphutha kunoma yiziphi zalezi zindawo angabangela ukucindezeleka kokuphefumula, ukwehla kokuqwashisa, izinkinga zenhliziyo, ngisho nokufa—ikakhulukazi uma umuthi unikezwa ngaphandle kokuqapha okwanele.
Izingozi nemiphumela emibi okufanele uyilindele
Izidakamizwa zingadala imiphumela emibi efana nokucanuzela kwenhliziyo, ukuqunjelwa, ukulunywa, ukugcinwa komchamo, kanye, okubi kakhulu, ukucindezeleka kokuphefumula. Ingozi iyanda ezigulini esezikhulile, lezo ezinesifo samaphaphu esingamahlalakhona, izinkinga zokulala ezifana ne-sleep apnea, noma lapho izidakamizwa zihlanganiswa nezinye izidakamizwa zokudambisa ukucindezeleka.
Imithi ye-psychotropic, ikakhulukazi imithi yokudambisa ukucindezeleka, ingabangela ukozela ngokweqile, ukuncipha kokuxhumana, ukuphazamiseka kwengqondo (ikakhulukazi kwasebekhulile), ukuthembela ekwelashweni, kanye nengozi yokuwa. Ukusetshenziswa kweziguli ezinesifo sesibindi noma sezinso esingasebenzi kahle kudinga ukuqaphela okukhethekile njengoba kungandisa imiphumela yalo muthi.
Ngaphandle kwemiphumela emibi yezokwelapha, enye ingozi ebaluleke ngokulinganayo ukuphambukisa imithi (ukuphambukisa imithi ukuze isetshenziswe kabi), okungase kwenzeke ezikhungweni zezempilo lapho izinhlelo zokuphepha zibuthakathaka khona. Ngakho-ke, izibhedlela ngokuvamile zisebenzisa izinqubo eziqinile zale mithi.
Ukuphathwa kokufakwa kwekhemisi ezibhedlela
Ukuphathwa kwezidakamizwa nezidakamizwa ezibhedlela ngokuvamile kungumthwalo wemfanelo we-Hospital Pharmacy Unit (IFRS), ngokubambisana namayunithi ezinsizakalo (i-ER, iwadi, iyunithi yokunakekelwa okujulile, iwadi, njll.). Ukuphathwa kuhlanganisa ukuhlela izidingo, ukuthenga, ukwamukela, ukugcina, ukusatshalaliswa, ukusetshenziswa, kanye nokubhujiswa kwemithi ephelelwe yisikhathi noma eyonakele.
1. Ukuhlela nokuthenga
Izibhedlela zihlela izidingo ngokusekelwe kumaphethini esifo, izinombolo zeziguli, izitayela zokusetshenziswa, kanye nokutholakala kwezinye izindlela zokwelapha. Ukuthengwa kwenziwa ngemigudu esemthethweni ukuqinisekisa ikhwalithi kanye nokuba semthethweni.
2. Isitoreji
Izidakamizwa kanye nezinto ezibangela ingqondo kumele zigcinwe ezindaweni ezikhiyiwe ezinokufinyelela okulinganiselwe, ngokuvamile kusetshenziswa amakhabethe akhethekile noma amakamelo okugcina izinto anezilawuli ezikhiyiwe kabili. Kwezinye izibhedlela, amayunithi athile asebenzisa “amakhabethe ezidakamizwa alawulwayo” noma izinhlelo zokuphepha ezengeziwe.
3. Ukusatshalaliswa
Ukukhipha izimpahla ekhemisi kuya egunjini lokunakekelwa kwenziwa ngokwezinqubo ezibhaliwe, ngokuvamile kuhambisana nedokhumenti yesicelo kanye nobufakazi bokulethwa. Lokhu kuqinisekisa ukuthi inani elikhishwe liyaqoshwa futhi liyalandelelwa.
4. Ukurekhoda nokubika
Esinye sezimpawu zalolu hlelo lokuphathwa kwemithi yimfuneko yokugcina amarekhodi ngokuqinile: inani lemithi etholakele neyakhishwa, isitokwe sokugcina, ubunikazi besiguli, udokotela onikeza imithi, kanye nabasebenzi abakhipha futhi bathole imithi. Ukuhlolwa kwangaphakathi kwenziwa njalo ukuze kutholakale ukungafani kwesitokwe.
5. Ukubhujiswa
Imithi eyonakele noma ephelelwe yisikhathi ayinakulahlwa ngokunganaki. Inqubo yokubhubhisa imvamisa idinga umbiko, ofakazi, kanye nokuhambisana nemithethonqubo esemthethweni.
Imikhuba yokunikeza imithi nokukhipha imithi ngokuphephile
Ukuqinisekisa ukuphepha, ukunikeza imithi yezidakamizwa kanye nemithi ye-psychotropic ezibhedlela kufanele kulandelwe kahle iziqondiso zokwelapha kanye nezindinganiso zokunakekelwa. Odokotela babhala imithi ngokusekelwe ezinkombeni, bacabangele ukungavumelani, ukusebenzisana kwemithi, futhi bamise imigomo yokwelapha (isb., isikali sobuhlungu obuqondiwe). Osokhemisi babuyekeza imithi ukuze baqinisekise umthamo ofanele, ifomu lomthamo, indlela yokuphatha, kanye nokusebenzisana okungenzeka.
Abahlengikazi, njengabaphathi bokunikezwa kwemithi, badlala indima ebalulekile ekuqinisekiseni "isiguli esifanele, umuthi ofanele, umthamo ofanele, isikhathi esifanele, umzila ofanele, kanye nemibhalo efanele." Ukuqapha isiguli ngemva kokunikezwa kubalulekile, ikakhulukazi ezigulini ezifakwe ngemithambo yegazi noma ezisengozini enkulu. Uma kuvela imiphumela emibi emibi njengokwehla kwesilinganiso sokuphefumula noma ukwehla kokuqwasha, isinyathelo esisheshayo kanye nohlelo lokudlulisela lwangaphakathi olusebenzayo kubalulekile.
Isiko lokuvimbela ukuhlukunyezwa kanye nokuphepha
Ukuvimbela ukusetshenziswa kabi akugcini nje ngokukhiya ikhabhinethi, kodwa futhi kumayelana nesiko lokuphepha kweziguli kanye nobuqotho bohlelo. Izibhedlela zidinga ukusebenzisa ukuqeqeshwa okuvamile kwabasebenzi bezempilo, ukuhlolwa kwempahla kanye nokusetshenziswa, isiko lokubika izehlakalo ngaphandle kokusola, kanye nezinhlelo ezinciphisa amathuba okuphathwa kwedatha. Ukusebenzisa amarekhodi ezokwelapha kagesi kanye nezinhlelo zekhemisi ezihlanganisiwe nakho kusiza ukulandelela ngokunembile ukusetshenziswa kwemithi.
Ngasohlangothini lwesiguli, imfundo nayo ibalulekile. Iziguli nemindeni yazo kudingeka ziqonde ukuthi lo muthi usetshenziselwa izinjongo zezokwelapha ngaphansi kwemithetho eqinile, akufanele wabelane ngawo, futhi kufanele zazise ochwepheshe bezempilo nganoma yikuphi ukungezwani komzimba, izinkinga zokuphefumula, noma ukusetshenziswa kweminye imithi engase ihlanganyele.
I-Penutup
Imithi yokwelapha i-narcotic kanye ne-psychotropic iyizingxenye ezibalulekile zokunakekelwa esibhedlela—ukusiza iziguli ukuphatha ubuhlungu obukhulu, ukuxhuzula, kanye nokukhathazeka okukhulu, kanye nokusekela i-anesthesia kanye nokunakekelwa okujulile. Naphezu kwezinzuzo zayo, kunezingozi ezinkulu zemiphumela emibi kakhulu kanye nokungahle kube nokusetshenziswa kabi, ngakho-ke ukuphathwa kwayo kumele kulandele izimiso zokuqapha, imithethonqubo, kanye nezindinganiso zesevisi eziqinile. Ngokuhlela okufanele, ukugcinwa okuphephile, ukugcinwa kwamarekhodi okunembile, kanye nokubambisana phakathi kodokotela, osokhemisi, nabahlengikazi, izibhedlela zingaqinisekisa ukusetshenziswa okufanele, okuphephile, nokunomthwalo wemfanelo kwale mithi ukuze kuphephe iziguli kanye nomphakathi.
