Baro sababta liddi ku ah antidepressants iyo anticonvulsants loo isticmaalo daaweynta xanuunka dabaysha
Calaamadaha xanuunka keena waa daawo aan loogu talagelin in lagu xakameeyo xanuunka laakiin waxaa loo isticmaali karaa ujeedadaas. Qaar ka mid ah daawooyinka daawada loo yaqaan 'adjuvant' waa daawooyinka sida antidepressants iyo anticonvulsants . Waxaa sidoo kale laga yaabaa in lagu magacaabo coanalgesics.
Waxaa laga yaabaa in laguu qoro xanuunka loo yaqaan adjuvant adjuvant, marka lagu daro daawooyinka kale ee xanuunka , ama isaga u gaar ah. Xanuunnada xanuunka 'Adjuvant' waxay u muuqdaan kuwo aan waxtar u lahayn xanuunka muruqyada, sida xanuunka dhabarka ama xanuunada wadnaha.
Si kastaba ha ahaatee, waxay si fiican u shaqeyn karaan xanuunka neuropathic iyo cudurrada xanuunka, sida fibromyalgia . Waxay sidoo kale leeyihiin door ku saabsan daweynta xanuunka kansarka. Si ka duwan noocyada kale ee aan ahayn opioid-opioid-ka , waxaa dhici karta in qalabka wax lagu dhejiyo aan laga helin miiska.
Noocyada Qalabka Kalkaaliyaha ah ee La Xiriira
Dawooyinka lid ku ah diiqadda
In kasta oo daawooyinka liddi ku ah niyadjabka aan loo qaadan karin sida daawada xanuunka, waxay si wax ku ool ah u daaweyn karaan xaaladaha xanuunka daba dheeraada. Dawooyinka liddi ku ah antidepressants ayaa loo maleynayaa inay xakameyso sida xanuunka loo arko xadhigga laf-dhabarka ilaa maskaxda. Waxaa intaa dheer, antidepressants ayaa hoos u dhigi karta welwelka waxayna caawineysaa hurdada.
Si kastaba ha noqotee, dhammaan noocyada daawada niyadjabka ma ahan kuwo waxtar u leh maareynta xanuunka dabaysha . Tricyclic antidepressants (TCAs) sida amitriptyline, serotonin resiptake inhibitors (SSRIs), sida duloxetine, iyo kuwa kale, sida nefazodone, ayaa badanaa loo isticmaalaa in lagu daaweeyo xanuunka xanuunnada dareenka iyo dareen xanuun. Kaadi-saareyaasha (Monoine oxidase oxidase) (MAOIs) ma aha mid waxtar u leh xakamaynta xanuunka dabaysha.
Anticonvulsants
Anticonvulsants, kuwaas oo ah daawooyinka inta badan loo isticmaalo si loo xakameeyo xanuunada qalalka, ayaa sidoo kale loo isticmaali karaa si loo daaweeyo xanuunka daba dheeraada. Anticonvulsants waxay shaqeyneysaa iyada oo aan loo oggolaanin noocyada kala duwan ee dareemayaasha dareemayaasha, waxayna yareeyn karaan xanuunka neuropathic, sida kuwa ay keento neuralgia xiniinyaha ama cudurka macaanka ee sonkorowga.
Anticonvulsants ayaa badanaa loo isticmaalaa in lagu maareeyo xanuunka daba-dheeraada waxaa ka mid ah gabapentin iyo pregabalin.
Gabapentin waa calaamadaha ugu badan ee la isticmaalo. Qaar ka mid ah bukaanada aan si fiican uga jawaabin gabapentin halkii ay kaga jawaabi lahaayeen pregabalin, iyo waliba.
Waa Maxay Cudurrada Xanuunada Daaweynta Kaadi-daweynta?
The Oxford Textbook of Palliative Daawada iyo Buugga Merck waxaa ku qoran liiska daaweynta xanuunka soo socda si loo daaweeyo cudurrada xanuunka:
Adjuvants loo isticmaalo noocyada kala duwan ee xanuunka 'Pain Syndromes'
- Corticosteroids
- Dexamethasone
- Prednisone
- Tricyclic antidepressants
- Amitriptyline: laguma talin dadka waayeelka ah ama bukaanka qaba wadne xanuunka.
- Desipramine
- Serotonin xulasho iyo daawada norepinephrine reuptake inhibitor (SNRI) antidepressants
- Duloxetine: Waxaa u roon in loo eego daawooyinka antidepressants ee tricyclic.
- Milnacipran
- Alpha-2-adrenergic agonists
- Tizanidine
- Daawooyinka jirka la mariyo: capsaicin waxaa loo isticmaali karaa xanuunka neuropathic iyo arthritis.
- Suuxdinta gudaha: sida booga lidocaine ah
Adjuvants ayaa loo adeegsadey Xanuunka Neerarka
- Wakiilada ka hortaga nabarrada
- Gabapentin: Tani waa daroogada la door bido ee daawada anticonvulsants.
- Pregabalin
- Carbamazepine: kani waa daaweynta ugu horeysa ee neuralgia ee trigeminal.
- Phenytoin: waxaa loo tixgelinayaa inuu yahay daroogada labaad.
- Valproic acid: loo isticmaalo madax xanuun.
- Clonazepam
- Lamotrigine
- Topiramate
- Tiagabine
- Oxcarbazepine
- Lacosamide
- Argaggixisada Reer Galbeedka NMDA
- Memantine
- Ketamine
- Dextromethorphan: waxaa loo isticmaalaa marka xanuunka uu leeyahay qayb xanuun.
- Bloodyaha laydhka ah ee afka
- Mexicane
- Tocainide
- Baclofen: Isticmaalida neuralgia ee trigeminal.
Calcitonin
Adjuvants Isticmaal Xanuunka Xanuunada Xanuunada ee Gobolka
- Calcitonin
- Clonidine
- Prazosin: Xanuunka lafaha ee kansarka
- Bisfosphonates ( tus ., Pamidronate)
- Calcitonin
- Radiopharmaceuticals
Ereyga
Haddii aad isweydiiso sababta daawooyinka kala duwan loo isticmaalo si loo daaweeyo xanuunkaaga joogtada ah, weydii dhakhtarkaaga ama farmashiistaha inaad sharaxdo. Cudurka dhirta (biokimemia) wuxuu noqon karaa mid dhib badan, laakiin waxaa laguu xaqiijin karaa in aad qaadatid daawooyinka saxda ah ee wada shaqeyn doona si aad u bixiso xanuunka xanuunka.
> Ilo:
> Lussier D, Portenoy RK: Qalabaynta La-qabsashada. Doyle D, Hanks G, Cherny NI, Calman K (eds): Oxford Buugta Daawada Palliative. Oxford: Jaamacadda Oxford University Press, 4th Ed, Oxford: Jaamacadda Oxford University Press, 2011.
> Markman, J, et. al. Xanuunka Aaladda. Nidaamka Merck Manual Professional Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain.