I-Quinine - Ukusetshenziswa, Isilinganiso, Imiphumela Engemihle Nokunye

Isingeniso: Kuyini i-Quinine?

I-quinine iyinhlanganisela yemvelo etholakala emagxolweni esihlahla se-cinchona, etholakala emagxolweni esihlahla se-cinchona, esidabuka esifundeni sase-Andes eNingizimu Melika. Ngokomlando, ibilokhu isetshenziswa amakhulu eminyaka ukwelapha umalaleveva, isifo esibangelwa yizinambuzane ezidluliselwa ngokulunywa omiyane. I-quinine ihlukaniswa njengomuthi wokulwa nomalaleveva futhi isetshenziswe ngenxa yezakhiwo zayo zokudambisa ubuhlungu kanye nokuqeda ukuvuvukala. Ngenkathi ukusetshenziswa kwayo kwehlile ngokufika kwezindlela zokwelapha ezisebenza kahle kakhulu, i-quinine isalokhu iyindlela ebalulekile ezimweni ezithile zomalaleveva nezinye izimo.

Ukusetshenziswa kwe-Quinine

I-quinine ivunyelwe kakhulu ekwelapheni:

• Malariya: I-quinine iyasebenza ngokumelene ne-Plasmodium falciparum, igciwane eliyingozi kakhulu le-malaria. Ivame ukusetshenziswa kanye neminye imithi yokulwa ne-malaria.
• Ukuqaqamba Kwemilenze Yasebusuku: I-Quinine yayisetshenziswa ngokomlando ngaphandle kwelebula lobuhlungu bemilenze yasebusuku, kodwa ayisavunyelwe yi-FDA ngenxa yalesi sibonakaliso (isuswe ngo-2006). Iziqondiso ezinkulu, okuhlanganisa i-WHO kanye ne-Indian Council of Medical Research (ICMR), ziyakwenqabela kakhulu ukusetshenziswa kwayo ngenxa yezingozi (isb., ukwanda kwe-QT, i-thrombocytopenia) ezidlula izinzuzo ezincane.

Isebenza kanjani?

I-quinine isebenza ngokuphazamisa ukukhula nokuzalana kwezinambuzane ze-malaria egazini. Iphazamisa ikhono lazo lokugaya i-hemoglobin, iphrotheni esemangqamuzaneni abomvu egazi. Ngokwenza kanjalo, i-quinine ivimbela izinambuzane ukuthi zingaphindaphindeki, okuvumela amasosha omzimba ukuba aziqede. Kalula nje, i-quinine isiza ekuvimbeleni izinambuzane ze-malaria ukuthi zingakhuli egazini lakho.

Isilinganiso nokuphathwa

Umthamo we-quinine ungahluka ngokuya ngesimo eselashwayo:

• Ngomalaleveva: Umthamo ojwayelekile wabantu abadala uvame ukuba ngu-600 mg kathathu ngosuku (njalo emahoreni angu-8) izinsuku ezingu-3-7, ngokuvamile nge-doxycycline noma i-clindamycin ngokweziqondiso ze-WHO. Imithamo yezingane ingu-10 mg/kg/umthamo njalo emahoreni angu-8.
• Ngezinkinga Zokuqaqamba Kwemilenze Yasebusuku: Umthamo ngokuvamile uphansi, ngokuvamile cishe u-200 mg ngesikhathi sokulala, kodwa lokhu kusetshenziswa kufanele kuxoxwe ngakho nomhlinzeki wezempilo.

I-quinine inganikezwa ngezindlela ezahlukene, okuhlanganisa amaphilisi omlomo kanye nemijovo yemithambo yegazi, kuye ngokuthi isimo sibucayi kangakanani kanye nezidingo zesiguli.

Imiphumela Engemihle ye-Quinine

Imiphumela emibi evamile ye-quinine ingafaka:

• I-nausea nokuhlanza
• Uhudo
• isiyezi
• I-tinnitus (ukukhala ezindlebeni)
• bekhanda

Imiphumela emibi kakhulu ingabandakanya:

• I-Cinchonism (i-quinine toxicity syndrome ene-tinnitus enzima, i-vertigo, ukulahlekelwa ukuzwa, kanye nokuphazamiseka kokubona)
• Ukungezwani komzimba (ukuqubuka, ukulunywa, ukuvuvukala)
• I-hypoglycemia enkulu (ushukela wegazi ophansi)
• Ukwanda kwe-QT kanye nokuphazamiseka kwenhliziyo (ukushaya kwenhliziyo okungajwayelekile)
• I-Hemolytic anemia (ukubhujiswa kwamaseli abomvu egazi)

Iziguli kufanele zifune usizo lwezokwelapha ngokushesha uma zithola imiphumela emibi kakhulu.

Ukusebenzisana kwezidakamizwa

I-Quinine ingasebenzisana nemithi eminingana, okuhlanganisa:

• Ama-anticoagulants: I-quinine ingathuthukisa imiphumela yemithi yokunciphisa igazi njenge-warfarin, okwandisa ingozi yokopha.
• Ama-Antidepressants: Ama-SSRI/SNRI (isib. i-fluoxetine) kanye nama-TCA andisa ukwanda kwe-QT kanye nezingozi zemiphumela emibi.
• Ama-Antimalarials: Ukuhlanganiswa nezinye izidakamizwa zokulwa nomalaleveva kudinga ukuqapha ukuze kugwenywe ubuthi.
• Ama-inhibitor e-CYP3A4: Imithi efana ne-ketoconazole inyusa amazinga e-quinine, okwandisa ingozi yobuthi.

Njalo yazisa umhlinzeki wakho wezempilo ngayo yonke imithi oyiphuzayo ukuze ugweme ukuhlangana okungenzeka.

Izinzuzo ze-Quinine

I-Quinine inezinzuzo eziningana zezokwelapha:

• Ukusebenza Kahle Kokulwa Nomalaleveva: Isebenza kahle kakhulu ekwelapheni izimo ezimbi kakhulu zomalaleveva, ikakhulukazi uma ezinye izindlela zokwelapha zingaphumeleli.
• Isenzo esisheshayo: I-quinine inganciphisa ngokushesha umkhuhlane futhi inciphise izimpawu ezihambisana nomalaleveva.
• Ukubaluleka Komlando: I-quinine inomlando omude wokusetshenziswa, inikeza inketho ethembekile yokwelapha umalaleveva ezindaweni lapho ukumelana neminye imithi kuvame khona.

Ukuphikisana kwe-Quinine

Abantu abathile kufanele bagweme i-quinine, okuhlanganisa:

• Abesifazane Abakhulelwe: Gwema ekukhulelweni (Isigaba C/D; esihlotshaniswa nokukhubazeka kwengane esanda kuzalwa njenge-cinchonism kanye nokungezwa, ngokwe-WHO).
• Abantu Abanesifo Sesibindi: I-quinine iyagaywa esibindini, futhi labo abanenkinga yesibindi bangase babe nemiphumela emibi eyengeziwe.
• I-Alergic: Noma ubani owaziwayo ngokungezwani komzimba ne-quinine noma izithako ezihlobene nayo akufanele athathe lo muthi.
• I-Myasthenia Gravis, i-Optic Neuritis, ukuntuleka kwe-G6PD: Ingozi yokubhebhetheka noma i-hemolysis.

Ukuqapha Nezexwayiso

Ngaphambi kokusebenzisa i-quinine, iziguli kufanele zicabangele okulandelayo:

• Umlando Wezokwelapha: Yazisa udokotela wakho nganoma yimuphi umlando wezinkinga zenhliziyo, isifo sesibindi, noma izinkinga zegazi.
• Ukuqapha Okuvamile: Iziguli ezisebenzisa i-quinine zingadinga ukuhlolwa kwegazi njalo ukuze kuqashwe imiphumela emibi, ikakhulukazi uma isetshenziswa isikhathi eside.
• Gwema Utshwala: Utshwala lungabhebhethekisa imiphumela emibi futhi kufanele lugwenywe ngesikhathi sokwelashwa.
• Izinyathelo Zokuqapha Zesikhawu Se-QT: Gwema ezigulini ezinesikhathi eside se-QT noma ezisebenzisa imithi yokwandisa i-QT; Kunconywa ukuqapha i-ECG.
• Ukuqapha Okuqondile Kwase-India: Hlola umkhuhlane we-blackwater ezimweni ze-malaria ye-falciparum.

Imibuzo Evame Ukubuzwa

• Isetshenziselwani i-quinine? I-quinine isetshenziswa kakhulu ekwelapheni umalaleveva, futhi kwezinye izimo, ukuqaqamba kwemilenze ebusuku.
• Ithathwa kanjani i-quinine? I-quinine ingathathwa ngomlomo ngesimo sethebhulethi noma inikezwe ngomjovo, kuye ngesimo.
• Iyini imiphumela emibi ye-quinine? Imiphumela emibi evamile ihlanganisa isicanucanu, isiyezi, kanye ne-tinnitus. Imiphumela emibi emibi ingafaka phakathi ukusabela kokungezwani komzimba kanye nokushaya kwenhliziyo okungajwayelekile.
• Ngingayisebenzisa yini i-quinine uma ngikhulelwe? Cha, i-quinine ayivunyelwe ukuthathwa ngesikhathi sokukhulelwa ngenxa yezingozi zokusha kwengane kanye nokukhubazeka kwayo (iziqondiso ze-WHO).
• Isebenza kanjani i-quinine? I-quinine iphazamisa ukukhula kwezinambuzane ze-malaria egazini, izivimbe ukuthi zingaphindaphindi.
• Ingabe kukhona ukuhlangana kwezidakamizwa ne-quinine? Yebo, i-quinine ingasebenzisana nemithi yokunciphisa igazi kanye neminye imithi yokucindezeleka, okwandisa ingozi yemiphumela emibi.
• Yini okufanele ngiyenze uma ngiphuthelwa umthamo we-quinine? Thatha umthamo ophuthelwe ngokushesha nje lapho ukhumbula kodwa weqe uma sekuyisikhathi somthamo wakho olandelayo. Ungawuphindi kabili. Xhumana nomhlinzeki wezokwelapha umalaleveva, njengoba ukuphuthelwa umthamo kuyingozi yokumelana nawo.
• Ingabe i-quinine iphephile ezinganeni? I-quinine ingasetshenziswa ezinganeni, kodwa izilinganiso kumele zibalwe ngokusekelwe esisindweni.
• Ngingaphuza utshwala ngenkathi ngithatha i-quinine? Kunconywa ukugwema utshwala, njengoba bungandisa ingozi yemiphumela emibi.
• Kuthatha isikhathi esingakanani ukuthi i-quinine isebenze? Ukuncipha komkhuhlane kwenzeka emahoreni angu-24-48; ukusulwa kwezinambuzane kungathatha izinsuku ezingu-3-7.

Amagama Omkhiqizo

I-Quinine itholakala ngaphansi kwamagama emikhiqizo eminingana, okuhlanganisa:

• I-Qualaquin
• I-Quinine Sulfate
• I-Quinamm

Isiphetho

I-quinine isalokhu iwumuthi obalulekile ekulweni nomalaleveva futhi inikeza izinzuzo kwezinye izimo ezithile. Nakuba inomlando omude wokusetshenziswa, kubalulekile ukuqaphela imiphumela yayo emibi engaba khona, ukusebenzisana kwemithi, kanye ne-contraindications. Njalo xhumana nomhlinzeki wezempilo ngaphambi kokuqala noma yimuphi umuthi omusha ukuqinisekisa ukuthi uyafaneleka ezidingweni zakho ezithile zezempilo.