Methylene blue yekatsi: nei mazano anoenderana nerudzi rwemhuka achikosha

Katsi inonwa mvura mutangi rehove richangobva kuiswa mushonga wefungus. Muridzi anoverenga paindaneti kuti methylene blue yakabatsira imbwa yaiva nechirwere cheropa, obva afunga kana izvi zvingashandawo kukatsi. Mamiriro acho ose anotaridzika akafanana kana achionekwa nekunze. Mukati mekatsi, haana kufanana.

Katsi dzinonyanya kukanganiswa neimwe mhando chaiyo yekukuvara kunokonzerwa nemethylene blue: kukuvadzwa kwemasero matsvuku eropa neoxidation. Kusimba kudiki uku kunobva pamagadzirirwo ehemoglobin yekatsi pachayo, uye ndicho chikonzero mazano ekatsi achifanira kuzvimiririra. Mazano akanyorerwa hove dzemumatangi, imbwa, kana madhayi anoshandiswa mumarabhoritari haangotorwi achishandiswa kukatsi. Chinyorwa chino chinotsanangura mashandiro emuviri, zvinonyatsotaurwa nemabhuku ekurapa mhuka, uye zvekuita kana katsi yasangana nemethylene blue.

Masero matsvuku eropa rekatsi akagadzirwa zvakasiyana

Hemoglobin inotakura oxygen, asi magadzirirwo ayo ndiwo zvakare anosarudza kuti inokurumidza sei kukuvadzwa nezvinhu zvinokonzera oxidation. Hemoglobin yekatsi ine mapoka esulfhydryl anenge masere anokurumidza kuita shanduko patetramer imwe neimwe, nhamba inenge yakapetwa kaviri pane inowanikwa muimbwa kana vanhu. Mapoka aya ndiwo anonyanya kubatwa neoxidation. Kana aita oxidation, ngetani dzeglobin dzinorasikirwa nechimiro chadzo uye dzoungana kuita zvimedu zvakasviba zvinonzi Heinz bodies, zvinoonekwa muzvidimbu zveropa zvakaparadzirwa pagirazi zvikaiswa dhayi.

Zvimwe zvinhu zviviri zvinoita kuti dambudziko iri rinyanye mukatsi. Chekutanga, masero matsvuku eropa rekatsi ane simba rakaderera kana zvichienzaniswa neremamwe rekudzivirira oxidation uye kuita reduction, saka kukuvara kunowedzera kana kwangotanga. Chechipiri, spleen yekatsi hainyatsogona kubvisa zvimedu zveHeinz mumasero matsvuku eropa ichisiya sero risina kuparadzwa, basa rekuchenesa rinoitwa zviri nani mune dzimwe mhando dzemhuka, sezvinotsanangurwa muwongororo iyi yeropa rekatsi. Naizvozvo masero akakuvadzwa anoramba achitenderera muropa pane kuti agadziriswe.

Katsi dzine utano dzinogona kuva nezvimedu zveHeinz zvishoma dzisina kurwara. Zvichienderana nebhuku rinoshandiswa uye nzira yekuisa dhayi, masero matsvuku eropa ane zvimedu zveHeinz anosvika zvikamu zvishanu kusvika gumi kubva muzana angasava chinhu chinoshamisa. Kunetseka kunotanga kana zvimedu zvacho zvakawanda kana zvakakura: rimwe bhuku remishonga yemurabhoritari rinoti anemia inogona kuitika kana zvimedu zvikuru zveHeinz zviri mumasero matsvuku eropa anopfuura zvikamu makumi matatu kubva muzana, muganhu wakapfupikiswa mutsananguro iyi yeanemia ine chokuita nezvimedu zveHeinz. Saka pose panosangana katsi nemethylene blue, mubvunzo hausi wekuti zvimedu zveHeinz zviripo here. Ndewekuti zvakawanda sei, zvakakura sei, uye kuti masero matsvuku eropa anozoparara here.

Zvinotaurwa nemabhuku ekurapa mhuka

Chinyorwa chekare chePlumb's Veterinary Drug Handbook chinoti vanachiremba vemhuka vakawanda vanoona methylene blue semushonga usingafaniri kushandiswa kukatsi, nokuti katsi dzinogona kuita anemia ine zvimedu zveHeinz uye methemoglobinemia. Matambudziko anonyorwa imomo anosanganisira kuchinja kwechimiro chemasero matsvuku eropa, methemoglobinemia inoitika zvinopesana nechinotarisirwa, uye kupfupika kwenguva inorarama masero matsvuku eropa. Zvisinei, tsananguro imwe cheteyo yemushonga inopa mwero wekushandisa kukatsi pakukurumidzira kwe methemoglobinemia, kazhinji 1 kusvika 1.5 mg pa kg ichiiswa mutsinga kamwe chete. Kubatanidzwa kwezvinhu izvi ndiko kunoburitsa nyaya chaiyo: pano, kusafanira kushandiswa kunoreva kuudzivisa kunze kwemamiriro mashoma chaiwo anotarisirwa nachiremba, kwete kuti haumbopihwi zvachose. Mashoko anowanikwa echinyorwa chekare chemushonga ari mukopi iyi yereferensi yaPlumb, nepo chinyorwa chegumi chazvino chine tsananguro yemushonga papeji 859.

Merck Veterinary Manual ine maonero akafanana mumazano ayo ekurapa muchetura unobva kumishonga yekunyaradza marwadzo, ichinyora methylene blue pa1 kusvika 1.5 mg pa kg yemvura ine mushonga wechikamu chimwe kubva muzana, ichiiswa mutsinga senzira inogona kushandiswa kuderedza methemoglobin, kuchiongororwa methemoglobinemia, anemia ine zvimedu zveHeinz, uye kuparara kwemasero matsvuku eropa. Merck inotaurawo mutsananguro yayo yeanemia mumhuka kuti katsi dzinokurumidza kugadzira zvimedu zveHeinz kupfuura dzimwe mhando dzemhuka.

Mashoko akasimba zvikuru ari mumitemo ane chokuita nezvigadzirwa zvinopihwa nemuromo. Mutemo wehurumende yeUnited States 21 CFR chikamu 500.27 unonyora kuti zvigadzirwa zviviri zvekuuraya utachiona mumugwagwa weti zvinopihwa nemuromo, zvine methylene blue, zvakakonzera anemia yekuparara kwemasero matsvuku eropa ane zvimedu zveHeinz mukatsi pazvaishandiswa maererano nemirayiridzo yepachiratidzo, dzimwe nguva zvichikonzera kufa, uye methylene blue yakaonekwa sechikonzero. Mutemo uyu unogumisa kuti mishonga yemhuka yemethylene blue yerudzi irworwo inopihwa nemuromo yakanga isina kuchengeteka uye yaisazivikanwa seinoshanda pasina chikumbiro chakabvumidzwa. Imbwa dzakaitawo kukuvara kwerudzi rumwe chete mukuyedzwa, saka mushonga uyu hauzi usingakuvadzi imbwa. Asi njodzi yemwero wakanyorwa pachiratidzo yakatanga kuratidzwa mukatsi.

Migumisiro isingadiwi yakashumwa mukatsi inonyanya kuva muropa: kuumbwa kwezvimedu zveHeinz, anemia inobva pakuparara kwemasero matsvuku eropa, uye methemoglobinemia inoitika zvinopesana nechinotarisirwa kana huwandu hwasvika mumuviri hwakakura kana huchidzokororwa. Mabhuku anotaura nezvemishonga zvakazara anonyorawo kusvotwa uye kurutsa, asi humbowo hwakanangana nekatsi hune chokuita neropa, uye ndimo munofanira kunyanya kuongororwa.

Chinhu chinopesana: kurapa nemuchetura mumorekuru rimwe chete

Mukati mesero dzvuku reropa, methylene blue inogona kuita reduction ichiva leucomethylene blue, iyo inopa maerekitironi kuiron yehaem inenge yaita oxidation uye yodzorera hemoglobin inokwanisa kushanda. Ndiyo shanduko yekurapa iri shure kwekushandiswa kwayo pamethemoglobinemia, uye inotsanangurwa zvakadzama muchinyorwa chinotsanangura methemoglobinemia. Asi methylene blue pachayo inokonzera oxidation. Kana huwandu hwasvika mumuviri hukawedzera kana masisitimu esero anoita reduction akurirwa, morekuru rimwe chete iroro rinowedzera methemoglobin uye kukuvara kweglobin pane kuzvigadzirisa. Naizvozvo methemoglobinemia zvose mamiriro anogona kuita kuti mushonga uyu ushandiswe uye mugumisiro usingadiwi waunogona kukonzera. Musiyano uri pakati pezviviri izvi mudiki, uye mudiki zvikuru mukatsi.

Muenzaniso wakajeka zvikuru mukatsi unobva muongororo yakadzorwa ya1992 yekatsi dzakura makumi mana. Mwero mumwe chete we1.5 mg pa kg wakaiswa mutsinga wakakurumidza kudzorera methemoglobinemia yakakonzerwa nenitrite pasina kuwedzera masero ane zvimedu zveHeinz aitenderera muropa. Mimwe mwero miviri yakadaro yakapihwa pakapatsanurwa nemaawa mana yakawedzera zvakanyanya kuwanda kwezvimedu zveHeinz, kunyanya mushure mekusangana nenitrite, kunyange zvazvo anemia iri pachena inobva pakuparara kwemasero matsvuku eropa isina kuitika panguva yeongororo (Rumbeiha naOehme, 1992). Mwero mumwe wakabatsira. Kudzokorora mwero mukati memaawa mashoma kwakachinja mamiriro acho kuchiwedzera mukana wekukuvara.

Mishumo yekurapa inoratidzawo izvozvo. Wongororo ya2019 muJournal of Veterinary Internal Medicine inotsanangura methylene blue inoiswa mutsinga semushonga unotanga kushandiswa pamethemoglobinemia yakangoerekana yatanga ine zviratidzo, inotaura kushandiswa kwayo kukatsi pa1 mg pa kg ichiiswa mutsinga, uye inoyambira kuti katsi yatova nemethemoglobinemia kana anemia ine zvimedu zveHeinz inogona kuwedzerwa kukuvara neoxidation, ichikurudzira kuongororwa kwehematocrit kwemazuva akati wandei mushure mezvo (DOI 10.1111/jvim.15637). Nyaya yakabudiswa yekatsi diki yaifungidzirwa kuva nemethemoglobinemia ine chokuita nemvura yekunwa yakaratidza kupindura mukati memaminitsi mushure mekupihwa 1 mg pa kg yemvura ine mushonga wechikamu chimwe kubva muzana ichiiswa mutsinga, ichiongororwa kakawanda neco-oximetry payaive muchipatara (mushumo wenyaya yacho). Nyaya yekukurumidzira ya2023 yeRagdoll yaiva nemwedzi mitanhatu ine methemoglobinemia yakaipisisa yaidzokorora yakatanga kurapwa nemushonga waiswa mutsinga, ichizoteverwa nemushonga wakapihwa nemuromo nokungwarira, ikapora uye isina migumisiro mikuru isingadiwi ine chokuita nekurapwa (DOI 10.1111/vec.13298). Kubudirira kwega kwega kwaiva kushandiswa mumamiriro akasiyana aitungamirirwa nachiremba uye achiongororwa, kwete muenzaniso wekushandisa mushonga kumba.

Zvinyorwa zvekare zvemuchetura zvinoratidza rimwe divi. Mumishumo ya1973, katsi nhanhatu dzakaita anemia yekuparara kwemasero matsvuku eropa ane zvimedu zveHeinz mushure mekupihwa nemuromo mishonga yemugwagwa weti yaiva nemethylene blue, uye dzimwe katsi mbiri dzakapihwa huwandu hwakaenzana mukuyedzwa dzakaita kuparara kwakanyanya kwemasero matsvuku eropa mukati memazuva mashoma uye dzakada kuwedzerwa ropa (Schechter nevamwe, 1973). Nyaya ya2016 yakaguma nekufa kwekatsi diki yerudzi rwakasanganiswa neAngora, yakanga yarapwa chirwere chemugwagwa weti, yakaratidza kuchinja kukuru kuita ruvara rwebhuruu kwenzvimbo dzemukati dzine hunyoro uye nyama dzemuviri, pamwe nekukuvara kwechiropa neitsvo; yakaonekwa semuchetura wemethylene blue zvichibva munhoroondo yayo nekuongororwa kwekukuvara kwemuviri (mushumo wenyaya yacho). Hapana muganhu wemwero unovimbika unokonzera muchetura unogona kutorwa mumishumo iyi uchishandiswa zvakafanana pakupihwa nemuromo, mutsinga, paganda, uye pakusangana nemvura yemutangi rehove ine mushonga wakanyungudutswa zvakanyanya, uye chinyorwa chino hachipi muganhu wakadaro.

Imwe fananidzo inoda kugadziriswa. Acetaminophen inozivikanwa kuva nenjodzi kukatsi nokuti hadzina mamwe maenzayimu akakosha e glucuronidation, uye vamwe vanyori vanoshandisa tsananguro iyoyo pamethylene blue. Kuishandisa saizvozvo hakuna humbowo. Kushomeka kwe glucuronidation inzira yakatosimbiswa ine chokuita neacetaminophen, yakawongororwa muchinyorwa ichi chekugadziriswa kwemishonga nemuviri wekatsi. Pamethylene blue, zvinyorwa zvekurapa mhuka zvinosimbisa mashandiro ayo eredox pamwe nekukurumidza kukuvadzwa kwemasero matsvuku eropa rekatsi, uye FDA inoti nzira chaiyo inoitika nayo kukuvara kwezvimedu zveHeinz haisati yanyatsosimbiswa. Nyaya yeacetaminophen chiyeuchidzo chinobatsira chekuti miviri yekatsi inogadzirisa mishonga zvakasiyana. Haisi tsananguro yemushonga uyu.

Kana katsi yasangana nayo: mibvunzo inowanzo bvunzwa

Katsi yangu yanwa mvura yemutangi rehove yakaiswa methylene blue. Iwoyo muchetura here?

Hazvirevi izvozvo nguva dzose, uye hapana chinyorwa chingapindura mubvunzo uyu pasina kuziva huwandu hwacho. Kunwa mvura shoma yemutangi ine mushonga wakatonyungudutswa hakuna kufanana nekumedza mushonga wakakora usati wanyungudutswa, uye hapana muganhu wekatsi wemvura yemutangi ine mushonga wakanyungudutswa zvakanyanya wakasimbiswa neongororo yakaongororwa nedzimwe nyanzvi. Usaverenga mwero wekurapa uchishandisa mirayiridzo yetangi rehove kana hurukuro dzemwero wemishonga yembwa. Bata chiremba wekatsi, kiriniki yekukurumidzira, kana sangano rinopa rubatsiro pamusoro pemuchetura wemhuka, uine mashoko echigadzirwa chacho.

Ndinofanira kuuya neruzivo rwupi?

Chiratidzo chechigadzirwa kana mufananidzo wacho, chinhu chinoshanda chiri mumushonga uye kusimba kwacho, huwandu hwemushonga wakakora wakaiswa muhuwandu hupi hwemvura kana zvichibatsira, huwandu hunofungidzirwa kuti katsi yanwa, uremu hwekatsi, nguva yayakasangana nayo, uye chero mushonga wairi kutora kana chirwere chainacho. Mazano ezvemuchetura anobva kuASPCA anokumbira varidzi kuti vachengete mudziyo wechigadzirwa uye vafonere rubatsiro pane kumirira zviratidzo. Izvozvo zvinoshandawo pano.

Dhayi yasvika pamvere. Ndoita sei zvino?

Dzivisa katsi kuti isananzve dhayi ichizvichenesa, nokuti kusvibiswa kwemvere kunozoita kuti chinhu chacho chipinde nemuromo painozvinanzva. Mazano eASPCA ekubvisa zvinhu zvinosvibisa muviri anokurudzira kushandisa magirovhosi, sipo yemvura yakapfava yekugezesa ndiro nemvura inodziya pazvisaririra zvakawanda, kunyatsosukurudza, kudzivisa kuti chigadzirwa chisvike mumaziso nemunzeve, uye kutsvaga mazano achiremba wemhuka enzira yakakodzera chinhu chacho. Bvunza kiriniki usati wagezesa katsi yakashushikana kana ine zviratidzo.

Ndinofanira kuita kuti irutse here?

Kwete, kunze kwekunge chiremba wemhuka kana nyanzvi yemuchetura anyatsokurayira kudaro. Nzira dzepamba dzekuitisa imbwa kurutsa, kunyanya hydrogen peroxide, hadzina kukodzera katsi.

Ndezvipi zviratidzo zvinoda kuongororwa nekukurumidza?

Kushaya simba kana kusava nesimba kwakanyanya, kufema nekukurumidza kana nekunetseka, matadza akacheneruka kana ane ruvara rweyero, ropa kana nzvimbo dzemukati dzine hunyoro dzine ruvara rwakasviba kana rwebhurawuni, kudonha nekushaya simba, kana weti yakasviba. Cherechedza kuti kukuvara kweropa kunogona kunonoka kuoneka: zvinyorwa zvekare zvezvigadzirwa zvemugwagwa weti zvinotsanangura anemia ichikura kwemazuva akati wandei, saka katsi inoratidzika zvakanaka manheru ezuva rayakasangana nemushonga ichiri kuda kuongororwa nachiremba wemhuka kuti aone kukurumidza nerudzi rwerubatsiro rwainoda uye, kana chiremba azvikurudzira, kuongororwa kweropa kunotevera kunosanganisira hematocrit uye kuongorora ropa rakaparadzirwa pagirazi kutsvaga zvimedu zveHeinz.

Nei mazano embwa achifanira kuramba akaparadzana

Imbwa dzinogonawo kuita anemia ine zvimedu zveHeinz inokonzerwa nemethylene blue, saka hapana chiri pano chinoreva kuti mushonga uyu haukuvadzi imbwa. Asi katsi dzine hemoglobin inokurumidza kukuvadzwa neoxidation pamwe nekudzivirirwa kwakaderera kwemasero matsvuku eropa uye kucheneswa kushoma nespleen, izvo zvinoita kuti musiyano uri pakati pemwero unobatsira neunokuvadza uve mudiki. Mabhuku ekurapa anoratidza izvozvo: mamwe marongero ekare ekurapa imbwa anosvika pa4 mg pa kg ichiiswa mutsinga mune mamwe mamiriro, nepo mabhuku ekatsi achinyanya kutaura 1 kusvika 1.5 mg pa kg kamwe chete pamethemoglobinemia uye achinyatsoyambira nezvekudzokorora mwero. Kungoderedza chirongwa chekurapa imbwa zvichienderana neuremu hwemuviri hakubati nyaya yacho chaiyo. Musiyano wemwero wakachengeteka neunokuvadza, mapinduriro eropa, uye chirongwa chekuongorora zvakasiyana, ndicho chikonzero sarudzo dzekurapa katsi dzichifanira kuitwa nachiremba wemhuka anogona kuenzanisa chikonzero chekushandisa mushonga nenjodzi yeoxidation uye kuyera mugumisiro. Kubvisa mvura yakaiswa mushonga mutangi mushure mekushandisa, kunotsanangurwa mugwaro rekuchenesa tangi rehove, ibasa renguva dzose rekuchengetedza mhuka. Kurapa katsi hakusi kudaro.