Phenytoin

Phenytoin

I-Phenytoin, isidakamizwa esisetshenziswa kakhulu, isishintshile ekwelapheni isithuthwane nezinye ukuphazamiseka kwemizwa. Lo muthi onamandla unomthelela ohlelweni lwezinzwa, usiza ukugcina ukusebenza kukagesi ebuchosheni futhi kuvimbele ukuquleka ukuthi kungenzeki.

Kulesi sihloko, sizohlola ukuthi iyini ithebhulethi ye-phenytoin, ukusetshenziswa kwayo, nokuthi ithathwa kanjani ngokuphepha. Sizofunda ngemiphumela emibi yamaphilisi e-phenytoin kanye nezinyathelo ezibalulekile okufanele sizikhumbule. 

Iyini i-Phenytoin?

I-Phenytoin iyisidakamizwa esinamandla se-anticonvulsant esisetshenziswe kabanzi iminyaka engaba ngu-80. Kungokwesigaba sokuphuma kokuphuma kwe-hydantoin futhi ngokuyinhloko isetshenziselwa ukuphatha nokwelapha izinhlobo ezihlukahlukene zokuquleka ngaphandle kokuphazamisa kakhulu ukusebenza kwezinzwa. I-FDA yagunyaza i-phenytoin ngo-1939 yokwelashwa kwesithuthwane. 

Naphezu kwenkomba yayo yokwelapha emincane (umthamo osebenzayo useduze nomthamo onobuthi), i-phenytoin isalokhu iyi-anticonvulsant enqunywe kabanzi. Lokhu kungenxa yokuphumelela kwayo ekulawuleni ukuquleka ngaphandle kokuphazamisa kakhulu ukusebenza kwezinzwa. Isebenza ezicutshini zobuchopho ukumisa ukuquleka, okuyenza ibe ithuluzi elibalulekile ukuphathwa kwesithuthwane. Zombili izinhlobo zomlomo nezijovwe ze-phenytoin ziyatholakala, kanti lena yakamuva ivame ukusetshenziswa ezimeni eziphuthumayo.

Ukusetshenziswa kwethebhulethi ye-Phenytoin

Amaphilisi e-Phenytoin anomthelela omkhulu ekulawuleni izinhlobo ezahlukene zokuquleka, okuhlanganisa:

• I-Grand mal seizures, eyaziwa nangokuthi i-generalized tonic-clonic seizures
• Ukuquleka okuyingxenye okuyinkimbinkimbi
• Isimo isithuthwane

Ngaphandle kokulawula isifo sokuwa, amaphilisi e-phenytoin anezinye izinto ezisetshenziswayo, njengalezi: 

• I-Phenytoin isiza ukuvimbela ukuquleka ngesikhathi noma ngemva kokuhlinzwa kwezinzwa, iqinisekisa ukuphepha kwesiguli phakathi nalezi zinqubo ezibucayi. 
• Abanye odokotela batusa i-phenytoin ye-trigeminal neuralgia, isimo sezinzwa esibuhlungu kanye nokuphazamiseka okuthile kokuziphatha. 
• Kwezinye izimo, kusiza ukulawula ukushaya kwenhliziyo okungajwayelekile.

Isetshenziswa kanjani iPhenytoin Tablets

• Umuntu ngamunye kufanele aphuze amaphilisi e-phenytoin kanye noma kabili ngosuku, ngokudla noma ngaphandle kokudla. Uma ukushejuli yansuku zonke kabili, beka imithamo yakho ngokulinganayo. Isibonelo, thatha eyodwa ekuseni futhi enye kusihlwa. 
• Geza amaphilisi egcwele ngamanzi, ubisi, noma ijusi futhi ungawahlafuni.
• Kubalulekile ukuthatha i-phenytoin njengoba kushiwo. Ungathathi okuningi noma ngaphansi kwalokho okuqondisiwe, futhi unamathele esimisweni esifanayo sansuku zonke. Udokotela wakho angase akuqale ngedosi ephansi futhi kancane kancane awandise, ngokuvamile ngaphansi kokukodwa njalo ezinsukwini ezingu-7 kuya kweziyi-10.

Imiphumela Emibi Yezibhebhe Ze-Phenytoin

Amaphilisi e-Phenytoin angabangela imiphumela engemihle ehlukahlukene, kusukela kokuncane kuye kokuqina. Imiphumela emibi evamile ye-phenytoin ihlanganisa: 

• Ukuphathwa yikhanda
• isiyezi
• Ukulala 
• Ukuvuvukala nokopha kwezinsini
• Ukuthuthumela noma ukuthuthumela 
• Abanye abantu babika ukuzizwa noma ukugula, ukuqunjelwa, kanye nenkinga yokulala.

Imiphumela emibi kakhulu ingase ihlanganise: 

• Ukunyakaza kwamehlo okungajwayelekile
• Ukulahlekelwa kokuxhumana
• Inkinga yokukhuluma
• Ukudideka
• Ukudikiza kwemisipha
• Izinkinga zesibindi
• Ushukela wegazi ophezulu (hyperglycemia)
• Ukungezwani komzimba okunamandla, okuhlanganisa ukuqubuka kwesikhumba, ukuvuvukala kobuso, izindebe, ulimi, noma umphimbo, nokuluma

Ukuqapha

Lapho uthatha i-phenytoin, udinga ukuqaphela izinyathelo ezimbalwa ezibalulekile, njenge: 

• Umlando Wokungezwani Nomzimba: Tshela udokotela wakho mayelana nokungezwani komzimba wakho, ikakhulukazi imikhiqizo ye-hydantoin noma eminye imithi elwa nokuthunjwa. 
• Ukukhulelwa: Uma ukhulelwe noma uhlela ukukhulelwa, xoxa ngezingozi nezinzuzo nodokotela wakho, njengoba i-phenytoin ingase ilimaze ingane engakazalwa. Kodwa-ke, ungayeki ukuyithatha ngaphandle kweseluleko sezokwelapha, njengoba ukugwinya okungalawuleki kungase kube yingozi ngesikhathi sokukhulelwa.
• Ushintsho Lokuqwashisa: Qaphela lapho ushayela noma usebenzisa imishini, njengoba i-phenytoin ingabangela ukozela futhi ithinte ukusebenzelana. 
• Utshwala: Gwema utshwala ngenkathi usebenzisa lo muthi, njengoba kungandisa imiphumela emibi. 
• Ukuqapha: Ukuhlolwa njalo kubalulekile ukuze kuqashwe ukuqhubeka kwakho futhi ulungise umthamo uma kudingeka. Ukuhlolwa kwegazi nomchamo kungase kudingeke ukuze kuhlolwe imiphumela engadingeki.
• Izimo Zesistimu: Uma unesifo sikashukela, isifo sesibindi, abanale nkinga, noma ukuphazamiseka kwegazi noma bathola ukwelashwa ngemisebe, yazisa udokotela wakho, njengoba lezi zimo zingase zibe nomthelela endleleni i-phenytoin esebenza ngayo emzimbeni wakho.

Isebenza kanjani iPhenytoin Tablet

Amaphilisi e-Phenytoin avimba amashaneli e-sodium ancike ku-voltage ebuchosheni. Lesi senzo simisa iluphu yempendulo enhle edala ukudubula okuphindaphindwayo kwemvamisa ephezulu kwama-neuron, okuyimbangela yokuquleka. Ngokwenza lokhu, i-phenytoin ivimbela ukusabalala komsebenzi wokuthumba kusukela ekuqaleni kwayo.

Njenge-voltage-gated sodium channel blocker, i-phenytoin iqinisa isimo sokungasebenzi salezi ziteshi. Lokhu kwandisa isikhathi sokuphikisa phakathi kwamandla esenzo kuma-neurons, okwenza kube nzima ukuthi ukubanjwa kuqhubeke. I-Phenytoin iqondise kakhulu ama-neurons anomsebenzi wemvamisa ephezulu, evame ukubandakanyeka ekubanjweni.

Imiphumela yomuthi ayigcini nje ebuchosheni. Ezicubu zenhliziyo, i-phenytoin ifinyeza amandla esenzo futhi inwebe isikhathi sokuphikisa phakathi kwawo. Lesi senzo esikabili kuzicubu ze-neuronal nezenhliziyo senza i-phenytoin ibe umuthi oguquguqukayo wokulawula izinhlobo ezahlukahlukene zokuquleka kanye nezimo ezithile zenhliziyo.

Ngingakwazi Ukuthatha I-Phenytoin Ngeminye Imithi?

I-Phenytoin ingasebenzisana neminye imithi, njenge: 

• Abacavir
• Abatacept
• I-Acarbose
• I-Aceclofenac
• Nemithi Elwa Namagciwane
• Izidakamizwa ze-Antifungal
• aspirin
• I-Atorvastatin
• Imithi ye-HIV 
• antidepressant
• Igazi elincane 
• Imithi yokwelapha umfutho wegazi, Isifo senhliziyo, ukushaya kwenhliziyo okungajwayelekile
• Amahomoni abesifazane, njengamaphilisi okulawula inzalo kanye i-estrogen 
• Ama-steroid afana ne-prednisone noma i-cortisone
• I-St John's wort
• Theophylline
• I-Ticlopidine

Khumbula, i-phenytoin ingaphinde ibe nomthelela endleleni eminye imithi esebenza ngayo. Njalo hlola nodokotela wakho noma usokhemisi ngaphambi kokuqala noma yimuphi umuthi omusha ngenkathi usebenzisa i-phenytoin.

Ulwazi Lomthamo

Lapho uthatha i-phenytoin, ukulandela ngokucophelela imiyalelo kadokotela wakho kuyimpoqo. 

Kwabadala abane ukuhlukunyezwa, umthamo wokuqala ojwayelekile ngu-100 mg othathwe ngomlomo kathathu ngosuku. Udokotela wakho angase alungise lo mthamo njengoba kudingeka, kanti iningi labantu abadala ligcinwa ku-300 kuya ku-400 mg ngosuku ngemithamo ehlukanisiwe. Umthamo omkhulu uvamise ukuba ngama-milligrams angama-600 ngosuku.

Ezinganeni ezineminyaka engaphezu kweyisithupha ubudala, umthamo ojwayelekile ngu-300 mg ngosuku. Imithamo yezingane ezincane isuselwa esisindweni somzimba, iqala ku-5 mg ngekhilogremu yesisindo somuntu futhi inikezwa njengemithamo emi-2 noma emi-3 ehlukanisiwe nsuku zonke.

Isiphetho

I-Phenytoin inomthelela omkhulu ekulawuleni izinhlobo ezahlukene zokuquleka kanye nezimo ezithile zenhliziyo. Le mithi elwa nokuthunjwa isebenza ngokuzinzisa umsebenzi kagesi ebuchosheni, isiza ukuvimbela ukuquleka ngaphandle kwemiphumela emikhulu ekusebenzeni kwezinzwa. Ukuguquguquka kwayo ekwelapheni izinhlobo ezihlukene zokuquleka, kusukela ku-grand mal kuya ekuqulekeni okuyinkimbinkimbi okuyingxenye, kuyenza ibe ithuluzi elibalulekile ekulawuleni isithuthwane. Naphezu kwenkomba yayo yokwelapha emincane, i-phenytoin isalokhu inqunyelwe kabanzi ngenxa yokusebenza kwayo kahle.

Uma usebenzisa i-phenytoin, ukulandela imiyalelo kadokotela wakho ngokucophelela & nokwazi ngemiphumela engemihle nokusebenzisana kuyadingeka. Ukuhlolwa kwezempilo okuvamile, okuhlanganisa nokuhlolwa kwegazi, kungase kudingeke ukuze kuqashwe ukuqhubeka kwakho futhi kulungiswe umthamo uma kudingeka. Uma unokukhathazeka noma uhlangabezana nezimpawu ezingavamile, ungangabazi ukuxhumana nodokotela wakho ukuze uthole isiqondiso.

Imibuzo Evame Ukubuzwa

1. Isidakamizwa se-phenytoin sisetshenziselwa ini?

I-Phenytoin isetshenziswa ngokuyinhloko ukulawula izinhlobo ezithile zokuquleka esithuthwaneni. Isebenza ngempumelelo ekulawuleni ukuquleka okukhulu, ukuquleka okuyingxenye okuyinkimbinkimbi, kanye ne-status epilepticus. Odokotela baphinde banikeze i-phenytoin ukuvimbela ukuquleka ngesikhathi noma ngemva kokuhlinzwa kobuchopho. Kwezinye izimo, odokotela bangase bayisebenzise ukwelapha i- trigeminal neuralgia, uhlobo lobuhlungu bezinzwa ebusweni, nokulawula ukushaya kwenhliziyo okungajwayelekile.

2. Ingabe i-phenytoin iyisidakamizwa sezinhlungu?

Nakuba i-phenytoin ingeyona i-painkiller ngokuyinhloko, ingasiza ukukhulula izinhlobo ezithile zobuhlungu bezinzwa. Ngezinye izikhathi isetshenziselwa ukwelapha i- trigeminal neuralgia ngokunciphisa ijubane likagesi emithanjeni, okunciphisa amandla abo okudlulisa izimpawu zobuhlungu. Kodwa-ke, ukusetshenziswa kwayo okuyinhloko kunjenge-anticonvulsant yokulawula ukubanjwa.

3. Uyithatha nini i-phenytoin?

Ngokuvamile uzothatha i-phenytoin kanye noma kabili ngosuku, njengoba udokotela wakho ekubeka. Abantu bangayithatha ngokudla noma ngaphandle kwayo, kodwa kubalulekile ukungaguquguquki endleleni okuthatha ngayo. Uma ukushejuli yansuku zonke kabili, zama ukubeka imithamo yakho ngokulinganayo, isibonelo, ekuseni nakusihlwa. Kubalulekile ukulandela imiyalelo kadokotela wakho ngokucophelela.

4. Kungani i-phenytoin inikezwa ebusuku?

I-Phenytoin ivame ukunikezwa ebusuku ukuze kuqinisekiswe ukugcwala okwanele kwezidakamizwa egazini nasezicutshini ekuseni. Kuyasiza ukunciphisa ingozi yokuquleka kwasekuseni. Ukuyiphuza ebusuku kungasiza nasekulawuleni imiphumela engemihle efana nokozela noma isiyezi abanye abantu ababa naso lapho beqala umuthi.

5. Yini okufanele ngiyigweme nge-phenytoin?

Imithi eminingana ingasebenzisana ne-phenytoin. Gwema ukuyiphuza nama-antifungal athile, ama-antibiotics, nemithi ye-HIV. Amanye ama-antidepressants nama-blood thiners nawo angabangela izinkinga. Imikhiqizo ye-herbal efana ne-St. John's wort inganciphisa ukusebenza kwe-phenytoin. Ngaso sonke isikhathi wazisa udokotela wakho ngayo yonke imithi yakho kanye nezithako zokuvikela ukuze ugweme ukusebenzisana okungaba khona.

6. Yikuphi ukudla okufanele kugwenywe nge-phenytoin?

Nakuba kungekho ukudla okuqondile okufanele ukugweme, kubalulekile ukuhambisana nokudla kwakho lapho uthatha i-phenytoin. Imikhiqizo yokudla kwangaphakathi ingathinta ukumuncwa kwe-phenytoin, ngakho-ke kungcono ukuyihlukanisa okungenani ihora ngaphambi nangemva komthamo wakho. Abantu kufanele bagweme utshwala njengoba bungathinta amazinga e-phenytoin egazini lakho. Hlala uthintana nodokotela wakho mayelana nanoma yikuphi ukukhathazeka ngokudla.

7. Kwenzekani uma ngiphuthelwa umthamo?

Uma uphuthelwa umthamo we-phenytoin, yithathe ngokushesha nje lapho ukhumbula. Kodwa-ke, uma kuseduze nomthamo wakho olandelayo ohleliwe, yeqa ogejiwe futhi uqhubeke nomkhuba wakho ojwayelekile womthamo. Ungalokothi uthathe umthamo ophindwe kabili ukuze wenze lowo okhohliwe. Uma ungaqiniseki, thintana nodokotela wakho ukuze uthole isiqondiso.