Uribel, Uro-MP, ne-Urogesic Blue: kungani kuyimithi eyinhlanganisela

Isiguli siqala ukuphuza ikhapsuli eliluhlaza okwesibhakabhaka ngenxa yokushisa lapho sichama nokuphuthuma ukuyochama. Umchamo uba luhlaza okwesibhakabhaka. Lapho ibhodlela lomuthi elilandelayo linegama lomkhiqizo elihlukile, isiguli sibuza umbuzo ozwakalayo: ingabe udayi oluhlaza okwesibhakabhaka yiwona obusebenza, futhi ingabe noma yimuphi umkhiqizo one-methylene blue usebenza ngendlela efanayo?

Lokho kuqonda akulungile, futhi ilebula lichaza ukuthi kungani. Umuthi i-Uribel, i-Uro-MP, ne-Urogesic Blue kuyimithi eyinhlanganisela. I-methylene blue iyisithako esisodwa phakathi kweziningana, futhi ilebula liyichaza njengesibulala-magciwane esibuthakathaka, hhayi njengokwelashwa okuphelele. Ukuze uqhathanise le mikhiqizo, funda isithako ngasinye nenhloso yaso ebhaliwe kunokugxila embala.

Yonke le mikhiqizo emithathu okukhulunywa ngayo lapha ivela ku-DailyMed njengemikhiqizo yemithi engagunyaziwe, enamalebula ahlinzekwe abakhiqizi. Leso simo sibalulekile. Sisho ukuthi amalebula achaza ukwakheka komuthi othengiswayo, kodwa imikhiqizo ayizange idlule ekubuyekezweni okufanayo kwe-FDA kokugunyazwa komuthi omusha njengoba kwenzeka emuthini ogunyaziwe otholakala ngencwadi kadokotela. Hlola ilebula lomuthi onikezwe wona, hhayi igama lomndeni wemikhiqizo, ngaphambi kokucabanga ukuthi iyalingana.

Ukuqhathaniswa kwezithako ngomkhiqizo

Ithebula lisebenzisa amalebula amanje ase-US. Amanani ezithako ngawekh aphsuli ngalinye le-Uribel ne-Uro-MP, futhi ngawethebhulethi ngalinye elimboziwe le-Urogesic Blue.

Ilebula lamanje le-Uribel libala lezi zithako ezinhlanu futhi lichaze umsebenzi ngamunye ongenhla. Ilebula lamanje le-Uro-MP lifana nele-Uribel ngesithako ngasinye namanani afanayo, kanti kuphela uhlobo lukasawoti we-phosphate oluchazwe ngokuhlukile. Ilebula lamanje le-Urogesic Blue lichaza ithebhulethi elinezithako ezine, elinamanani ahlukile e-methenamine ne-methylene blue, futhi elingenayo i-phenyl salicylate.

Kunemininingwane eyodwa yokufunda ilebula okufanele iphawulwe. Ingxenye ethi Description ku-Uribel ibhala i-methenamine engu-118 mg, kanti ithebula lezithako elihleliwe ekhasini elifanayo le-DailyMed libonisa u-120 mg. Sebenzisa inani elingu-118 mg elisengxenyeni ethi Description nasephaketheni ekuchazeni ukwakheka kwekhapsuli ngalinye, futhi ubheke lokhu kungafani njengesizathu sokuqinisekisa iphakethe elinikeziwe, hhayi njengenani elihlukile lomuthi.

Lokho ilebula elithi isithako ngasinye siyakwenza

I-methenamine yenza umsebenzi oyinhloko wokulwa namabhaktheriya ochazwe kula malebula. Emchameni one-asidi iguquka ibe yi-formaldehyde, ilebula eliyichaza njengento ebulala amabhaktheriya noma evimba ukukhula kwawo. Leyo ndlela yokusebenza ichaza ukuthi kungani isithako esandisa i-asidi sibalulekile. I-sodium phosphate monobasic isiza ukugcina umchamo une-asidi ukuze i-methenamine ihlakazeke njengoba kuhlosiwe. Ngakho-ke, imithi enyusa i-pH yomchamo, kuhlanganise eminye imithi enciphisa i-asidi esiswini, ama-thiazide, nemithi eyandisa i-alkali emchameni, inganciphisa umphumela we-methenamine ochazwe elebuleni.

I-phenyl salicylate inomsebenzi olinganiselwe kakhulu. Ilebula lithi ikhipha i-salicylate, echazwa njengesidambisi sobuhlungu esibuthakathaka. Ikhona ku-Uribel naku-Uro-MP kodwa ayikho ku-Urogesic Blue yamanje. Isiguli esishintsha sisuke ekhapsulini elinezithako ezinhlanu siye ethebhulethini elinezithako ezine bese sibona ukuncipha kokudamba kobuhlungu sinomehluko ocacile elebuleni okufanele sixoxe ngawo nochwepheshe onikeza incwadi yomuthi, hhayi into engaqondakali.

I-methylene blue inomsebenzi wokweseka kula malebula. Amalebula afana nele-Uribel kanye nele-Urogesic Blue ayibiza ngesibulala-magciwane esibuthakathaka. Lawo magama akhethwe ngamabomu. Awayichazi i-methylene blue njengokwelashwa komgudu womchamo okuzimele, futhi akukho nelilodwa kula malebula amathathu elithi i-methylene blue iyodwa ingasetshenziswa esikhundleni senhlanganisela. Umbala oluhlaza okwesibhakabhaka ukhombisa ukuba khona kwayo. Awulinganisi umphumela wezinye izithako.

I-hyoscyamine sulfate inikeza umphumela wokudambisa ukufinyela kwemisipha. Ilebula liyichaza njengento enciphisa ukusebenza kohlelo lwezinzwa lwe-parasympathetic, enciphisa izimpawu zokufinyela kwemisipha yesinye. Le ndlela yokusebenza komuthi iphinde ichaze izexwayiso eziselebula: ukoma komlomo, ukubona okufiphele, isiyezi noma ukozela, ukushaya kwenhliziyo ngokushesha, nobunzima bokuchama obungafinyelela ekuhlulekeni okuzumayo ukukhipha umchamo. Amalebula ayalela iziguli ukuba ziyeke umuthi futhi zifune usizo lwezempilo uma kuba nokushaya kwenhliziyo ngokushesha, isiyezi, noma ukubona okufiphele, futhi aqokomisa i-glaucoma, ukuvaleka komgudu wokugaya ukudla, i-myasthenia gravis, kanye nezimo ezivimba ukugeleza komchamo njengezimo ezidinga ukuqashelwa ngokukhethekile.

Kungani i-methylene blue iyodwa ingeke ithathe indawo yenhlanganisela

Uma ususa izithako ezine emkhiqizweni onezithako ezinhlanu, udayi osele awukwazi ukugcina inhlanganisela echazwe elebuleni. I-methenamine inikeza umphumela wokulwa namabhaktheriya osebenza nge-formaldehyde. I-phosphate igcina isimo sine-asidi, okuyisimo lowo mphumela oncike kuso. I-hyoscyamine inikeza umphumela wokudambisa ukufinyela kwemisipha. Ku-Uribel naku-Uro-MP, i-phenyl salicylate inikeza isithako sokudambisa ubuhlungu esichazwe elebuleni. Isixazululo esithengiselwa abathengi esinesithako esisodwa asinayo le miphumela yezithako ezihambisana naso echazwe elebuleni ngala manani, futhi akukho lebula lenhlanganisela eligunyaza lokho kushintsha.

Ukuhlolwa kokuphepha nakho kuyashintsha lapho kubhekwa umuthi wonke. Imininingwane yokunikeza i-methylene blue efakwa emthanjeni inesexwayiso esisebhokisini mayelana ne-serotonin syndrome ebucayi futhi engabulala lapho isetshenziswa nemithi esebenza ku-serotonin kanye nama-opioid. Amalebula amathathu ale nhlanganisela yemithi yomgudu womchamo awanaso leso sexwayiso esisebhokisini, futhi izingxenye zawo ezimayelana nokusebenzelana kwemithi zigxila emiphumeleni yokuvimba ama-muscarinic receptor, emiphumeleni ku-pH yomchamo, engcupheni yokwakheka kwamakristalu emchameni lapho ama-sulfonamide ehlangana ne-formaldehyde, ekungabekezelelini i-salicylate, nakwezinye izindaba ezihlobene nalokho. Ukungabikho kwaleso sexwayiso akusho ukuthi inhlanganisela ene-methylene blue iphephile ukusetshenziswa nemithi yokucindezeleka. Njengoba ingozi ehlobene ne-serotonin ye-methylene blue engafakwa emthanjeni ngemithamo ephansi ingakachazwa ngokuphelele, noma ubani othatha i-SSRI, i-SNRI, i-MAOI, i-linezolid, i-dextromethorphan, i-bupropion, umuthi ovuselelayo, noma i-opioid kufanele acele uchwepheshe onikeza incwadi yomuthi kanye nosokhemisi ukuba baqale babuyekeze uhlu oluphelele. Umhlahlandlela wethu wokusebenzelana kwe-methylene blue neminye imithi uchaza kabanzi lokho kucabangela okuqondene nendlela umuthi ongena ngayo emzimbeni.

Ikhasi elilodwa lezinhlobo zemikhiqizo, hhayi igama elilodwa lawo wonke amabhodlela

Ukusesha imithi ejwayelekile engelona igama lomkhiqizo ethatha indawo ye-Uribel kubangela ukudideka okuningi. Umuthi ojwayelekile obala izithako ezinhlanu ezifanayo ngamanani angu-118 mg, 40.8 mg, 36 mg, 10 mg, no-0.12 mg kufanele ubekwe emgqeni ofanayo wokuqhathanisa ne-Uribel enegama lomkhiqizo. Igama lomkhiqizi nombala wekhapsuli akuchazi umuthi. Uhlu lwezithako yilona oluwuchazayo.

I-Uro-MP ibekwa emgqeni ofanayo ngesizathu esifanayo. Ilebula layo lamanje lifana nesethi yezithako ezinhlanu ze-Uribel ngamanani afanayo, ngakho ukuyigcina ekhasini elifanayo kuvimbela ukudala umehluko ongelona iqiniso phakathi kwemithi emibili ecishe ifane ngokwakheka. I-Urogesic Blue idinga ukuba sekhasini elifanayo kodwa emgqeni ohlukile, ngoba ithebhulethi lamanje liwumkhiqizo oshintshwe ukwakheka, onezithako ezine, one-methenamine engu-81.6 mg ne-methylene blue engu-10.8 mg, futhi ongenayo i-phenyl salicylate. Ukuphatha la magama amathathu njengamagama asho into efanayo kushaya indiva lowo mehluko. Ucwaningo oluhlobene nezimpawu zomgudu womchamo lugcina lokhu kuqhathanisa kugxile embuzweni wokunakekelwa kweziguli, kanti indlela yethu yokufunda amalebula ikhombisa indlela yokuhlola noma yiliphi ibhodlela lomuthi elinikeziwe ngokuliqhathanisa nethebula elingenhla.

Amabhodlela amadala engeza olunye ugibe. Ukwakheka kwemithi enala magama emikhiqizo kuye kwashintsha ngokuhamba kwesikhathi, futhi ithebhulethi langeminyaka edlule lingase lingafani nelebula lamanje. Ungasebenzisi uhlu lwezithako oludala njengokungathi lusasebenza manje. Funda ilebula lebhodlela onalo.

Lapho izimpawu zishintsha, sola isithako esifanele

Ushintsho ngemva kokuqala noma ukushintshela komunye wale mikhiqizo luyindaba yokuthola ukuthi yini elubangele. Isithako ngasinye sinezimpawu zaso ezijwayelekile, futhi ilebula lisiza ukuhlobanisa umbuzo nesithako esifanele.

Ukushisa okunciphile kodwa ukuqhubeka kokuphuthuma ukuyochama nokufinyela kwemisipha kukhomba umehluko phakathi kokudambisa ubuhlungu nokudambisa ukufinyela kwemisipha. I-phenyl salicylate ibhekana nobuhlungu obuncane, kanti i-hyoscyamine ibhekana nokufinyela kwemisipha. Uma ukushintshela ku-Urogesic Blue kususa i-phenyl salicylate, ukushisa okuqhubekayo kudinga ingxoxo eqondile ngesithako sokudambisa ubuhlungu esingasekho, kunokuthatha umthamo ophakeme wethebhulethi elisha.

Ukoma komlomo okusha, ukubona izinto eziseduze ngokufiphele, ukuqunjelwa, ukushaya kwenhliziyo ngokushesha, noma ubunzima bokuqala ukuchama kukhomba i-hyoscyamine. Lena yimiphumela yokuvimba ama-muscarinic receptor ebhalwe elebuleni, futhi ukungakwazi ukukhipha umchamo kungadinga usizo oluphuthumayo. Ungazami ukuyinqanda ngomunye umuthi oxegisa imisipha yesinye ngaphandle kweseluleko sochwepheshe onikeza incwadi yomuthi, ngoba eminye imithi evimba ama-muscarinic receptor ingawandisa umphumela.

Ukuqubuka kwesikhumba, ukukhala ezindlebeni, noma ukungabekezeleli umuthi kumuntu ozwela ku-aspirin kukhomba isithako se-salicylate ku-Uribel naku-Uro-MP. Amalebula asho ukuthi iziguli ezingawabekezeleli ama-salicylate zingase nazo zingayibekezeleli le mithi. Ukukhetha umuthi ongenayo i-salicylate kuyisinqumo sochwepheshe onikeza incwadi yomuthi, hhayi ukushintsha okuzenzela wena, ngoba umuthi ozothatha indawo yawo usene-methenamine, i-methylene blue, ne-hyoscyamine, nazo ezinemikhawulo yazo.

Imibuzo mayelana nokwakheka kwamakhemikhali emchameni oguqubele ihlobene ne-methenamine ne-phosphate ezisebenza ndawonye. Umchamo one-alkali uphazamisa indlela yokusebenza kwe-methenamine echazwe elebuleni, futhi amalebula axwayisa ukuthi imithi ye-sulfonamide ingakha izinsalela eziqinile lapho ihlangana ne-formaldehyde emchameni, yandise ingozi yokwakheka kwamakristalu emchameni. Leso sexwayiso sichaza ukusebenzelana nomunye umuthi we-sulfonamide. Asisho ukuthi le mikhiqizo yomgudu womchamo ine-antibiotic ye-sulfa. Letha uhlu oluphelele lwemithi, kuhlanganise imithi enciphisa i-asidi esiswini nama-thiazide, lapho kubuyekezwa imithi yakho. Imibuzo mayelana nokuqhubeka kokutheleleka nesikhathi sokuphinda ukwelashwa ihlobene nendlela yethu yokunakekela ukutheleleka komgudu womchamo.

Ungacabangi ukuthi umkhiqizo wakwelinye izwe onegama elifanayo uyafana

Izinhlanganisela zemithi yokubulala amagciwane neyokudambisa ubuhlungu emgudwini womchamo ziyahlukahluka ngokwamazwe. Umkhiqizo othengiswa phesheya ngaphansi kwegama elifanayo elihlobene nombala oluhlaza okwesibhakabhaka noma elisekelwe ku-methenamine ungaba nezithako ezihlukile, izinhlobo zikasawoti ezihlukile, noma amanani ezithako ahlukile kulawo aselebula ase-US aqhathaniswe lapha. Okuwukuphela kokuqhathanisa okuthembekile kusebenzisa ipheshana elingaphakathi kwephakethe eliqondene nalelo zwe noma isifinyezo sezici zomkhiqizo zephakethe elinikezwe isiguli. Qhathanisa zonke izindawo ezinhlanu ethebuleni: i-methenamine, uhlobo lwe-phosphate, ukuba khona noma ukungabikho kwe-phenyl salicylate, inani le-methylene blue, kanye nenani le-hyoscyamine. Okungaphansi kwalokho kuwukufana kwesigaba somkhiqizo, hhayi ukufana kwezithako. Izindlela zokuqanjwa kwamagama emikhiqizo emazweni ahlukene zichazwe ekuqhathaniseni kwethu imikhiqizo yomgudu womchamo yamazwe ngamazwe.

Letha izinto ezintathu ekhawuntani yasekhemisi: ibhodlela lomuthi onikezwe wona, uhlu oluphelele lwemithi nezithasiselo kuhlanganise izinto ezisebenza ku-serotonin nemithi enciphisa i-asidi esiswini, kanye nesimpawu esishintshile. Lezo zinto ezintathu zivumela usokhemisi ukuba ahlobanise inkinga nesithako esiyibangelayo kunokuphinde aphikisane ngegama lomkhiqizo.