Ukusetshenziswa Kwezidakamizwa Ezinganeni Nasebekhulile: Ukuhlaziywa Kokuqhathanisa
Ukusetshenziswa kwezidakamizwa, okuhlanganisa imithi kadokotela kanye nemithi ethengiswa ngaphandle kwemithi kadokotela, kuyisici esibalulekile sokunakekelwa kwempilo kwanamuhla esihlanganisa bonke ubudala. Phakathi kwamaqembu asengozini kakhulu kukhona izingane kanye nabantu asebekhulile, abanezimpawu zabo ezihlukile zomzimba, zokukhula, nezengqondo ezidinga izindlela ezilungiselelwe zokuphathwa nokuphathwa kwemithi. Ngenkathi la maqembu ehluka kakhulu ku-pharmacokinetics yawo kanye ne-pharmacodynamics, abelana ngezinselele ezifanayo kanye nezingozi ezihlobene nokusetshenziswa kwemithi. Lesi sihloko sihlola ubunzima bokusetshenziswa kwemithi ezinganeni nakubantu asebekhulile, sihlola izinzuzo, izingozi, kanye nemikhuba emihle yokwenza ngcono imiphumela yokwelapha.
Ukusetshenziswa Kwezidakamizwa Ezinganeni
Izingane, kusukela ezinsaneni kuya kwentsha, zimelela umphakathi ohlukahlukene onezidingo eziningi zezokwelapha. Imizimba yazo ibhekana nezinguquko eziqhubekayo zomzimba ezithinta ukumuncwa kwemithi, ukusatshalaliswa kwayo, ukwakheka kwayo kanye nokukhishwa kwayo. Ngenxa yalokho, i-pharmacokinetics yemithi ezinganeni ihluke kakhulu kweyabantu abadala, okudinga ukunqunywa ngokweminyaka kanye nokuqapha ngokucophelela.
1. I-Pharmacokinetics kanye ne-Pharmacodynamics ezinganeni
Ezinsaneni nasezinsaneni, ukungavuthwa kwezinhlelo zezitho zomzimba kudlala indima ebalulekile ekugayweni kwemithi. Isibindi, esinomthwalo wokugaya imithi eminingi, asikakhuli ngokugcwele, okungase kuholele ekugayweni kwemithi okuhamba kancane kanye nokusebenza isikhathi eside kwemithi. Ngokufanayo, ukusebenza kwezinso, okubalulekile ekukhishweni kwemithi, akukavuthwa ebuntwaneni, okwandisa ingozi yokuqongelela imithi kanye nobuthi.
Iziguli zezingane nazo zibonisa izimpendulo ezihlukile ze-pharmacodynamic. Isibonelo, izingane zingase zithole ukusabela okuxakile ezidakamizweni, njengokusebenza ngokweqile ngenxa yezidakamizwa zokudambisa. Ukuqonda lo mehluko kubalulekile kodokotela bezingane kanye nabahlinzeki bezempilo ukuqinisekisa ukwelashwa ngezidakamizwa okuphephile nokusebenzayo.
2. Izidakamizwa Ezisetshenziswa Kaningi Nezinkomba
Izingane zivame ukudinga imithi yezimo ezahlukahlukene, okuhlanganisa ukutheleleka, i-asthma, i-ADHD, kanye nezifo ezingamahlalakhona ezifana nesifo sikashukela kanye nesifo sokuwa. Ama-antibiotic, ama-analgesic, ama-bronchodilator, kanye nama-psychostimulants aphakathi kwemithi evame ukunqunywa. Ukugoma, okuyingxenye ebalulekile yokunakekelwa kwezingane, kuhilela nokuphathwa kwe-biologics ukuvimbela izifo ezithathelwanayo.
3. Izinselele kanye Nezingozi
Ukuqinisekisa ukusetshenziswa okuphephile kwezidakamizwa ezinganeni kuhilela izinselele eziningi. Amaphutha okulinganisa, ukusabela okubi kwezidakamizwa (ama-ADR), kanye nokusetshenziswa kwezidakamizwa okungekho ku-label kuyizinto ezibalulekile ezikhathazayo. Izinhlobo zezingane, ezihlukile kwezinhlobo zabantu abadala ngokuhlushwa kanye nezinto ezisizayo, kumele zakhiwe ngokucophelela ukuze zihlangabezane nezidingo zezingane. Ngaphezu kwalokho, ukunamathela kungaba yinkinga, ikakhulukazi uma umuthi ungenambitheki kabi noma udinga umthamo ovamile.
Abazali nabanakekeli badlala indima ebalulekile ekunikezeni izingane izidakamizwa. Ukubafundisa ngemithamo efanele, imiphumela emibi engaba khona, kanye nokubaluleka kokunamathela kubalulekile ukuze kuncishiswe izingozi futhi kuthuthukiswe imiphumela yokwelapha.
Ukusetshenziswa Kwezidakamizwa Kwabantu Asebekhulile
Abantu asebekhulile, abavame ukuchazwa njengabantu abaneminyaka engu-65 nangaphezulu, baletha enye inselele eyingqayizivele ekwelashweni ngezidakamizwa. Inqubo yokuguga iletha izinguquko eziningi zomzimba ezithinta i-pharmacokinetics yezidakamizwa kanye ne-pharmacodynamics, okwandisa ubunzima bokuphathwa kwemithi.
1. I-Pharmacokinetics kanye ne-Pharmacodynamics Kwabadala
Ukuguga kuthinta zonke izigaba zokucubungula izidakamizwa. Ukwehla kwe-asidi esiswini kanye nokuncipha kokuphuma kwesisu kungashintsha ukumuncwa kwezidakamizwa. Ukwehla kwemisipha kanye nokwanda kwamafutha emzimbeni kuthinta ukusatshalaliswa kwezidakamizwa, kuyilapho ukwehla kokusebenza kwesibindi kanye nezinso kungaphazamisa ukugaywa kwemithi kanye nokukhishwa kwayo. Lezi zinguquko zivame ukudinga ukulungiswa komthamo kanye nokuqapha ngokucophelela ukuze kugwenywe imiphumela emibi futhi kuqinisekiswe ukusebenza kahle kokwelapha.
Ushintsho lwe-pharmacodynamic kubantu asebekhulile luhlanganisa ukuzwela okukhulu emithini ethile, njengemithi yokudambisa kanye nemithi yokunciphisa ukugabha kwegazi, kanye nokuncipha kokusabela kweminye, njenge-beta-blockers. I-Polypharmacy, noma ukusetshenziswa kwemithi eminingi, kuvamile ezigulini esezikhulile futhi kunegalelo engcupheni ephezulu yokusebenzisana kwemithi kanye ne-ADR.
2. Izidakamizwa Ezisetshenziswa Kaningi Nezinkomba
Iziguli esezikhulile zivame ukubhekana nezimo eziningi ezingamahlalakhona, okuhlanganisa umfutho wegazi ophakeme, isifo sikashukela, isifo samathambo, izifo zenhliziyo kanye nesifo sengqondo. Ngenxa yalokho, zinikezwa imithi eminingi, njengemithi yokwehlisa umfutho wegazi, imithi yokunciphisa ushukela, imithi yokunciphisa ubuhlungu, imithi yokunciphisa igazi, kanye nemithi yokucindezeleka.
Ukunamathela ezindleleni zemithi kubantu asebekhulile kungaba yinselele ngenxa yezici ezifana nokukhubazeka kwengqondo, ukulinganiselwa ngokomzimba, amashejuli omthamo ayinkimbinkimbi, kanye nemiphumela emibi. Ukwenza lula izindlela zemithi, ukuhilela abanakekeli, kanye nokusebenzisa izinsiza zokunamathela kungasiza ekubhekaneni nalezi zinselele.
3. Izinselele kanye Nezingozi
Ukusabalala kwe-polypharmacy ezigulini esezikhulile kwandisa kakhulu ingozi yokusebenzisana kwezidakamizwa kanye ne-ADR. I-Beers Criteria, uhlu lwemithi engaba engafanele kubantu abadala, isebenza njengethuluzi elibalulekile kubahlinzeki bezempilo ukunciphisa lezi zingozi. Ukubuyekezwa kwemithi njalo kanye nokunikezwa imithi, uma kufaneleka, kunganciphisa kakhulu umthwalo we-polypharmacy.
Abantu asebekhulile basengozini enkulu yokuwa, ukuphuka kwamathambo, kanye nokunye ukulimala ngenxa yemiphumela emibi yemithi ethile, njengemithi yokudambisa ukucindezeleka kanye nemithi yokwehlisa umfutho wegazi. Ukusebenzisa amasu okuvimbela ukuwa kanye nokuhlola njalo isilinganiso sengozi nezinzuzo zemithi kuyizinyathelo ezibalulekile ekunciphiseni lezi zingozi.
Ukuhlaziywa Kokuqhathanisa kanye Nemikhuba Emihle Kakhulu
Naphezu komehluko ohlukile ekusetshenzisweni kwezidakamizwa phakathi kwezingane nabantu asebekhulile, kunezimiso ezibalulekile ezisebenza kuwo womabili amaqembu eminyaka. Imithi eyenzelwe wena, ebheka izici zomzimba nezemithi zomuntu ngamunye, iyisisekelo sokwenza ngcono ukwelashwa kwezidakamizwa. Ukuqapha njalo, imfundo yesiguli kanye nomnakekeli, kanye nokuxhumana phakathi kwabahlinzeki bezempilo kuyizinto ezibalulekile zokusetshenziswa kwezidakamizwa okuphephile nokuphumelelayo.
Ezinganeni, ukuqinisekisa ukuthi umthamo kanye nokunamathela kunembile, kanye nokuthuthukiswa kwemithi efanele iminyaka, kungathuthukisa kakhulu imiphumela yokwelapha. Ukubandakanya abazali nabanakekeli enkambisweni yokwenza izinqumo nokunikeza imiyalelo ecacile kuyizinyathelo ezibalulekile ekufezeni lo mgomo.
Kwasebekhulile, ukunciphisa i-polypharmacy, ukubuyekeza njalo imithi, kanye nokufaka izindlela ezingezona ezemithi lapho kungenzeka kunganciphisa ingozi ye-ADR kanye nokusebenzisana. Ukusebenzisana nosokhemisi, ukwenza ukuhlolwa okuphelele kwabantu abadala, kanye nokusebenzisa amathuluzi afana ne-Beers Criteria kungathuthukisa kakhulu ukuphepha kwemithi.
Isiphetho
Ukusetshenziswa kwezidakamizwa ezinganeni nakubantu asebekhulile kudinga indlela ehlelekile echaza izici ezihlukile zomzimba, zentuthuko, nezengqondo zalaba bantu. Nakuba izinselele nezingozi kuyizinto ezingokwemvelo, ukunamathela emikhubeni emihle kanye nokuzibophezela emithini eyenzelwe wena kungenza ngcono imiphumela yokwelapha futhi kuthuthukise ikhwalithi yokuphila kwala maqembu asengozini. Ngokuqonda ubunzima bokusetshenziswa kwezidakamizwa ezinganeni nakubantu asebekhulile, abahlinzeki bezempilo bangadlula kangcono esimweni esiyinkimbinkimbi sokuphathwa kwemithi futhi baqinisekise ukwelashwa okuphephile nokusebenzayo kwabo bonke ubudala.
