Sufentanil - Uses, Dosage, Side Effects and More

Isingeniso: Kuyini i-Sufentanil?

I-Sufentanil iyi-opioid analgesic enamandla yokwenziwa esetshenziswa ngokuyinhloko ekulawuleni ubuhlungu ezindaweni zezokwelapha. Inamandla kakhulu kune-morphine futhi ivame ukusetshenziswa ekuhlinzeni, ekunakekelweni okujulile, nasekulawuleni ubuhlungu obukhulu. I-Sufentanil ihlukaniswa njengesidakamizwa esilawulwa yiShejuli II ngenxa yamandla ayo aphezulu okusebenzisa kabi nokuthembela.

Ukusetshenziswa kwe-Sufentanil

I-Sufentanil ivunyelwe ukusetshenziswa kwezokwelapha okuhlukahlukene, okuhlanganisa:

• Ukubulala Izinzwa Kokuhlinzwa: Ngokuvamile isetshenziswa njengengxenye ye-anesthesia ngesikhathi sokuhlinzwa ukuze kuncishiswe ubuhlungu.
• Ukuphathwa Kwezinhlungu Zangemva Kokuhlinzwa: I-Sufentanil iyasiza ekuphatheni ubuhlungu ngemva kokuhlinzwa.
• Ukuphathwa Kobuhlungu Okungapheli: Akuvamile ukusetshenziswa ngaphandle kwelebula lobuhlungu obungapheli obungalapheki ezindaweni ezikhethekile ngaphansi kokuqashwa okuqinile.
• Umsebenzi kanye Nokulethwa: Akuvamile ukusetshenziswa epidurally ezindaweni zokubeletha ezilawulwayo zokunciphisa ubuhlungu bokubeletha.
• Ukunakekelwa kwe-Palliative: I-Sufentanil ingaba yingxenye yohlelo lokwelapha iziguli ezinezifo ezingapheli ukuze kuncishiswe ubuhlungu obukhulu.

Isebenza kanjani?

I-Sufentanil isebenza ngokubopha kuma-receptor athile ebuchosheni nasemgogodleni aziwa ngokuthi ama-opioid receptors. Uma inamathela kula ma-receptor, ivimba izimpawu zobuhlungu ukuthi zingathunyelwa ebuchosheni, okuholela ekunciphiseni ubuhlungu. Lesi senzo siphinde sikhiqize imizwa yenjabulo, engabangela ukusetshenziswa kabi kwayo.

Isilinganiso nokuphathwa

Umthamo we-sufentanil uyahlukahluka kuye ngesimo sesiguli, ubudala, kanye nempendulo yokwelashwa.

Abantu abadala:

Uma kuhlinzwa, i-sufentanil ivame ukunikezwa ngomjovo, ngemithamo esukela ku-1 kuya ku-8 micrograms ngekhilogramu IV (noma i-0.25 kuya ku-30 ​​micrograms/kg/hr infusion), efakwe i-titized ukuze isebenze.

Uma ubuhlungu bungemva kokuhlinzwa, kungasetshenziswa ukumnika okuqhubekayo, kusukela ku-0.1 kuya ku-0.5 micrograms ngekhilogramu ngehora. Yehlisa izinga lokuphendula; umkhawulo ophezulu ngu-30 mcg/ihora kuzilungiselelo ezifana ne-PCA.

Izingane:

Izilinganiso zezingane zibalwa ngokusekelwe esisindweni futhi ngokuvamile ziphansi kunezabantu abadala. Ngokuvamile, i-0.5 kuya ku-1 microgram ngekhilogremu IV yokufakwa kwe-induction, kanye nokufakwa kwe-infusion ku-0.2-1 mcg/kg/hr.

I-Sufentanil ivame ukuphathwa ochwepheshe bezempilo endaweni elawulwayo, njengesibhedlela noma isikhungo sokuhlinzwa.

Imiphumela Engemihle ye-Sufentanil

Imiphumela emibi evamile ye-sufentanil ihlanganisa:

• Ukulala
• I-nausea nokuhlanza
• ukuqunjelwa
• isiyezi
• Ukudideka

Imiphumela emibi kakhulu ingase ihlanganise:

• Ukucindezeleka kokuphefumula okusongela impilo (kuncike kumthamo, ingozi ephezulu kakhulu ezigulini ezingenayo i-opioid) (ukuphefumula okuhamba kancane noma okunzima)
• Ukusabela okukhulu kwe-allergic (ukuqubuka, ukulunywa, ukuvuvukala)
• Umfutho wegazi ophansi
• Izimpawu zokuthembela kanye nokuhoxa
• I-Hypotension
• I-Bradycardia
• Ileus
• Ukugcinwa kwe-Urinary
• Ukubekezelelana

Ukusebenzisana kwezidakamizwa

I-Sufentanil ingasebenzisana nemithi eminingana kanye nezinto, okuhlanganisa:

• Amanye ama-opioid: ingozi eyengeziwe yokucindezeleka kokuphefumula
• Ama-Benzodiazepine: ukudambisa ubuhlungu okwandayo
• Iziphumuli zemisipha: ukuphumula kwemisipha okuthuthukisiwe
• Utshwala: ingozi eyengeziwe yokudambisa ukucindezeleka kokuphefumula
• Ama-inhibitor e-CYP3A4 (isb., i-ketoconazole, i-ritonavir): Amazinga e-sufentanil akhuphukile
• Ama-inducer e-CYP3A4 (isb., i-rifampin): Ukwehla kokusebenza kahle

Njalo yazisa umhlinzeki wakho wezempilo ngayo yonke imithi kanye nezithasiselo ozithathayo ukuze ugweme ukusebenzisana okungenzeka.

Izinzuzo ze-Sufentanil

Izinzuzo zezokwelapha zokusebenzisa i-sufentanil zifaka:

• Potency: I-Sufentanil inamandla kakhulu kune-morphine, okuvumela ukuqeda ubuhlungu ngempumelelo ngemithamo emincane.
• Ukuqala Okusheshayo: Isebenza ngokushesha, okwenza kube kuhle kakhulu ekuphatheni ubuhlungu obukhulu.
• Isikhathi Esifushane: Imiphumela yayo ihlala isikhathi esifushane, okungaba wusizo ezindaweni zokuhlinzwa lapho kudingeka khona ukululama okusheshayo.
• Ukuhlukahluka: I-Sufentanil ingasetshenziswa ezimweni ezahlukene zezokwelapha, kusukela ekuhlinzweni kuya ekuphathweni kobuhlungu obungapheli.

Ukuphikisana kwe-Sufentanil

Abantu abathile kufanele bagweme ukusebenzisa i-sufentanil, okuhlanganisa:

• Labo abanokungezwani komzimba okwaziwayo ne-sufentanil noma eminye imithi yama-opioid.
• Iziguli ezinezinkinga zokuphefumula ezinzima, i-asthma enzima, noma i-COPD exacerbations.
• Abantu abanomlando wokusebenzisa kabi izidakamizwa noma umlutha wazo.
• Abesifazane abakhulelwe noma abancelisayo, ngaphandle uma belulekwe ngokuqondile ngumhlinzeki wezempilo.
• Iziguli ezine-ileus ekhubazekile.
• Iziguli ezithintekile ekhanda zine-ICP ekhuphukile.

Ukuqapha Nezexwayiso

Ngaphambi kokusebenzisa i-sufentanil, iziguli kufanele zihlolwe ngokucophelela. Izinyathelo ezibalulekile zokuphepha zifaka:

• Umlando Wezokwelapha: Yazisa udokotela wakho nganoma yimuphi umlando wezinkinga zokuphefumula, isifo sesibindi noma sezinso, noma izinkinga zempilo yengqondo.
• Ukuhlolwa Kwelebhu: Kungadingeka ukuqapha njalo ukuze kuhlolwe ukusebenza kwesibindi nezinso.
• Ingozi Yokuncika: Ngenxa yokuthi ingase ibe umlutha, i-sufentanil kufanele isetshenziswe ngokuqapha futhi kuphela njengoba kuyalelwe.
• Ukusetshenziswa Kwabantu Asebekhulile: Gwema kubantu asebekhulile (qala ngo-50-75% wesilinganiso esiphansi); qaphela ukwelulwa kwe-QT ngesilinganiso esiphezulu.

Imibuzo Evame Ukubuzwa

• Isetshenziselwani i-sufentanil? I-Sufentanil isetshenziselwa ukulawula ubuhlungu ngesikhathi sokuhlinzwa kanye nokunakekelwa ngemva kokuhlinzwa.
• Isetshenziswa kanjani i-sufentanil? Ngokuvamile inikezwa ngomjovo esibhedlela, ngokuvamile ngesikhathi sokuhlinzwa noma ukuqeda ubuhlungu obukhulu.
• Yimiphi imiphumela emibi evamile? Imiphumela emibi evamile ihlanganisa ukozela, isicanucanu, ukuqunjelwa, kanye nesiyezi.
• Ingabe i-sufentanil ingabangela umlutha? Yebo, i-sufentanil inamandla amakhulu okulutha futhi kufanele isetshenziswe kuphela njengoba kuyalelwe.
• Ingabe i-sufentanil iphephile ezinganeni? I-Sufentanil ingasetshenziswa ezinganeni kuphela ngochwepheshe abasezindaweni eziqashwe ngokucophelela, kodwa izilinganiso kumele zibalwe ngokusekelwe esisindweni.
• Yini okufanele ngiyenze uma ngiphuthelwa umthamo? Uma uphuthelwa umthamo, xhumana nomhlinzeki wakho wezempilo ukuze uthole isiqondiso. Ungaphindi kabili umthamo.
• Ngingaphuza utshwala ngenkathi ngithatha i-sufentanil? Cha, utshwala bungandisa ingozi yemiphumela emibi kakhulu, okuhlanganisa nokucindezeleka kokuphefumula.
• I-sufentanil ihlala isikhathi esingakanani? I-V bolus: imizuzu emi-5-10; imiphumela yokumnika iyaphela ngemva kwemizuzu engama-30-60 ngemva kokuyekiswa.
• Yini okufanele ngiyenze uma ngiba nemiphumela emibi kakhulu? Funa usizo lwezokwelapha ngokushesha uma ubhekene nobunzima bokuphefumula, ukusabela okukhulu kokungezwani komzimba, noma ukozela okukhulu.
• Ngingayisebenzisa yini eminye imithi nge-sufentanil? Njalo thintana nomhlinzeki wakho wezempilo ngaphambi kokuthatha noma yimiphi eminye imithi ukuze ugweme ukusebenzisana okungenzeka.

Amagama Omkhiqizo

I-Sufentanil itholakala ngaphansi kwamagama emikhiqizo eminingana, okuhlanganisa:

• I-Sublimaze
• I-Dsuvia (indlela yokwelapha engaphansi kolimi; yavunywa ngo-2018 yokwelapha ubuhlungu obukhulu ezindaweni eziqinisekisiwe kuphela)

Isiphetho

I-Sufentanil iyi-opioid analgesic enamandla edlala indima ebalulekile ekuphathweni kobuhlungu, ikakhulukazi ezindaweni zokuhlinzwa nezokunakekelwa okubucayi. Nakuba inikeza izinzuzo ezibalulekile maqondana namandla kanye nesenzo esisheshayo, futhi inezingozi, okuhlanganisa umlutha ongaba khona kanye nemiphumela emibi emibi kakhulu. Iziguli kufanele zihlale zixhumana nabahlinzeki bazo bezempilo ukuze zithole iseluleko esiqondene nomuntu siqu kanye nezinhlelo zokwelapha.