Cov thawj coj ntawm cov tshuaj: txoj kev. Cov thawj coj ntawm cov tshuaj nyob rau hauv ntau txoj kev: zoo thiab qhov tsis zoo

Therapeutic tshuaj rau hauv lub cev tej zaum yuav poob nyob rau hauv ntau txoj kev. Txoj kev ntawm yeeb tshuaj koom haum saib xyuas tus nqi txiav txim kho nyhuv, nws heev thiab ntev. Nyob rau hauv tej rooj plaub, lub sijhawm nyob rau hauv uas cov tshuaj nkag mus rau hauv lub cev yog nyob ntawm qhov xwm ntawm nws ua, thiab yog li ntawd peb rov qab. Muaj ntau ntau yooj yim txoj kev rau qhov ncauj thawj coj ntawm cov tshuaj, thiab txhua tus ntawm lawv muaj nws cov pros thiab cons. Ua ntej koj yuav nrhiav tau tawm yog dab tsi lawv cov koom haum saib xyuas xaiv, koj yuav tsum paub raws nraim li cas daim ntawv ntawm cov tshuaj ua ib ke.

Lub ntsiab ntaub ntawv ntawm cov tshuaj

Ua ntej defining rau lawv txog thawj coj ntawm cov tshuaj rau hauv lub cev, koj yuav tsum paub dab tsi txog cov tshuaj muaj nyob, thiab lawv muaj ntau:

• Solutions - yog ib tug ua kua hauv daim ntawv ntawm cov tshuaj. Lawv sawv cev rau cov tshuaj tshuaj diluted nyob rau hauv dej, haus dej cawv, glycerine los yog lwm yam kuab. Tab sis nws yog tsim nyog nco ntsoov tias qhov tsis zoo thiab unspoiled tshuaj yuav tsum muaj tseeb, tsis muaj nkos txo los yog txawv teb chaws hais. Tej zaum lawv yuav siv ob qho tib si rau parenteral thiab enteral thawj coj.
• Decoctions thiab infusions - cov nyiaj no yog npaj los ntawm cov nroj tsuag. Tab sis nws yog ib nqi nco ntsoov hais tias lawv tsis khaws cia rau ib ntev lub sij hawm, tsis ntau tshaj li 3 hnub nyob rau hauv ib tug txias, sheltered los ntawm tshav ntuj.
• Ntsiav tshuaj - ib tug khoom daim ntawv npaj uas yuav tau ua los ntawm nias. Yeej, lawv yog npaum li cas hais lus, tab sis ua tau thiab ib tug txheej txoj kev ntawm txoj kev saib xyuas cov tshuaj yog hais tias lawv yog crushed rau hauv ib lub hmoov.

• Dragee - yog lwm ntau yam ntawm cov khoom ntaub ntawv ntawm medicinal tshuaj mas siv, lawv yog tsim los ntawm laminating ib lub hauv paus cov ntaub ntawv uas nyob rau hauv lub granule. Siv qhov ncauj thawj coj.
• Tsiav tshuaj - khoom hauv daim ntawv ntawm cov tshuaj, cov ntsiav tshuaj yog coated nrog ib tug plhaub ntawm gelatin los yog lwm yam ntaub ntawv. Nyob rau hauv feem ntau tus neeg mob, cov tshuaj uas xa tuaj nrog nyob rau hauv tsiav tshuaj nrog ib tug ntsim saj los yog cov yam ntxwv tsis hnov tsw vim plhaub heev thawm txais tos ntawm cov txhais tau tias. Nyob rau hauv tas li ntawd, nws tso cai rau koj los tiv thaiv cov ntaub ntawv los ntawm ceev ceev kev puas tsuaj nyob rau hauv lub digestive ib ntsuj av.
• Taws tswm ciab - ib tug ntau npaum daim ntawv ntawm cov tshuaj, uas nyob rau chav tsev kub yog nyob rau hauv cov khoom daim ntawv no, tab sis nws yog melted hauv tib neeg lub cev. Yog hais tias peb xav txog lub koom haum saib xyuas ntawm medicaments, txoj kev taws tswm ciab emit ob hom - ib tug qhov quav thiab paum.
• Plaster - ib lub hnab yas daim ntawv txhais tau tias nyob rau hauv tus ntawm lub cev kub yog softened thiab yooj yim adheres rau ntawm daim tawv nqaij. Haum rau lwm siv xwb.
• Tshuaj pleev - txhais tau tias ntawm khov taub hau, yog siv feem ntau rau sab nraum zoov siv. Lawv yuav tsum muaj nyob rau hauv nws muaj pes tsawg leeg txog 25% cov khib nyiab.

Muaj ntau ntau kev ntawm cov thawj coj ntawm cov tshuaj, ib tug los ze zog saib lawv txhua txhua tus.

Hom enteral

Enteral lawv ntawm cov thawj coj ntawm cov tshuaj yog suav tias yog ib qho ntawm feem yooj yim thiab muaj kev nyab xeeb. Muaj ntau ntau subspecies ntawm txoj kev: qhov ncauj, sublingual, lub qhov quav.

1. Qhov Ncauj thawj coj ntawm cov tshuaj, nyob rau hauv lwm yam lus, haus - qhov no yog ib tug ntawm cov nyuaj txoj kev, uas yog vim li cas nws yog feem ntau cov tshuaj los ntawm ntau cov kws kho mob. Haum ntawm cov tshuaj, tau txais txoj kev no, yog tsuas yog los ntawm diffusion nyob rau hauv cov hnyuv, nyob rau hauv uas tsis tshua muaj mob - nyob rau hauv lub plab. Daim ntawv thov nyhuv yog hnov tom qab 30-40 feeb. Qhov no yog vim li cas rau ib tug thaum muaj xwm ceev xws txoj kev yog tsis haum. Cov kev ceev thiab tiav ntawm haum nyob ntawm seb cov mov noj, nws muaj pes tsawg leeg thiab kom muaj nuj nqis. Yog li, yog tias ib tug tshuaj haus dej haus nyob rau hauv ib qho kev npliag plab, lub haum yog zoo tsis muaj zog hauv paus, raws li acidity nyob rau hauv lub plab yog tsawg tsawg, tab sis cov acid yog zoo dua absorbed tom qab haus. Tab sis muaj ib co tshuaj, xws li "Calcium chloride" uas nkag mus rau hauv lub cev tom qab haus, tej zaum yuav tsim insoluble calcium ntsev, uas txwv tau lawv haum mus rau hauv cov ntshav.

2. Lwm yooj yim thiab siv tau txoj kev ntawm enteral thawj coj ntawm cov tshuaj - sublingual. Cov tshuaj yog muab tso rau hauv tus nplaig, ua tsaug rau ib tug loj network ntawm cov hlab ntsha nyob rau hauv lub mucosa, nws yog nqis heev sai sai. Cov nyhuv no tshwm sim nyob rau hauv ib ob peb feeb. Qhov no txoj kev ntawm koom haum saib xyuas yog feem ntau siv rau kev thov "nitroglycerin" angina "clonidine" thiab "Nifedipine" rau xa hypertensive ntsoog.

3. Lub qhov quav lawv tsis siv ntau heev. Yeej nws yog siv yog hais tias tus neeg mob muaj hnyuv kab mob, los yog yog hais tias nws tsis nco qab lawm.

Enteral thawj coj: zoo thiab qhov tsis zoo

Tag nrho txoj kev thiab txhais tau tias ntawm yeeb tshuaj cov thawj coj, muaj lawv zoo, lawv kuj muaj enteral muaj:

• Simplicity thiab yooj yim ntawm kev siv.
• Txwm hais lus.
• Tus txheeb ze muaj kev ruaj ntseg rau tus neeg mob.
• Nws yuav tsum tau tsis muaj sterility xyuas los ntawm kev kho mob cov neeg ua.
• Cov tau ntev-lub sij hawm kev kho mob.
• Kev nplij siab rau tus neeg mob.

Tab sis tseem muaj disadvantages ntawm enteral lawv ntawm cov thawj coj ntawm cov tshuaj:

• Cov nyhuv yog qeeb.
• Tsis tshua muaj bioavailability.
• Txawv ceev thiab tiav ntawm haum.
• Nyhuv ntawm noj mov thiab lwm yam rau lub suction txheej txheem.
• Tsis muaj peev xwm siv los ntawm cov neeg mob nyob rau hauv ib lub xeev ntawm hnovqab.
• Nws yog undesirable siv cov neeg mob uas muaj cov kab mob ntawm lub plab thiab cov hnyuv.

Cov ntaub ntawv ntawm parenteral thawj coj ntawm cov tshuaj

Lub parenteral lawv ntawm cov thawj coj ntawm cov tshuaj yuav koom haum saib xyuas ntawm cov tshuaj tsis muaj uas tus txheej txheem ntawm lub digestive system. Nws yuav tsum tau muab faib mus rau hauv ob peb hom.

Cov ntaub:

• Intradermally - Qhov no yog feem ntau yog siv rau diagnostic hom phiaj, rau piv txwv rau kev tsis haum tshuaj xeem Burne los yog rau hauv zos tshuaj loog.
• Sc - siv tau thaum koj xav tau lub siab tshaj plaws cov nyhuv ntawm cov tshuaj. Qhov no yog tiav vim hais tias cov subcutaneous roj txheej yog muab nrog ib tug zoo cov hlab ntsha, thiab nws txhawb nqa sai haum.
• Intramuscularly - yog siv thaum subcutaneous txhaj ua voos los yog mob, raws li tau zoo raws li cov tshuaj rau nws tus kheej yog maj mam absorbed.

• Intraosseous - qhov no txoj kev yog siv ncaw, mas nrog nws kim heev kev kub nyhiab thiab povtseg deformation thaum lwm cov kev xaiv yuav tsis tau mus thov.

Yog hais tias koj muaj yeeb cov thawj coj, txoj kev los ntawm cov hlab ntsha yog raws li nram no:

• IV - Qhov no yog siv los kom paub ib tug loj tus naj npawb ntawm cov tshuaj thiab ib co tshuaj uas muaj xws li ib tug yuav tsum tau rau kev siv.

• Intraarterially - thov tau davhlau ya nyob twg mob, uas yog tshwm sim los ntawm ib tug poob siab, poob loj ntawm cov ntshav, asphyxia, electrocution poob plig, qaug cawv thiab kab mob.
• Lub lymphatic hlab ntsha - qhov no txoj kev yog siv los ua tshuaj tsis poob mus rau hauv lub siab thiab ob lub raum, los muab ib tug ntau tseeb hits mus rau lub site ntawm tus kab mob mas.

Nws tsis yog ib txwm yooj yim rau intravascular thawj coj ntawm cov tshuaj, yuav ua rau txoj kev thiab los ntawm cov kab noj hniav:

• Pleural.
• Plab.
• Lub plawv.
• Articular.

Parenteral thawj coj: pros thiab cons

Parenteral thawj coj muaj ob peb qhov tsav:

• Qhov no txoj kev yuav ua rau nws tau los ua kom paub cov tshuaj mus rau bypass lub digestive ib ntsuj av tau, uas yog tseem ceeb heev rau cov neeg mob uas loj pathologies ntawm lub plab.
• Ceev ntawm kev txiav txim uas yuav tsum tau nyob rau hauv ib qho xwm ceev.
• Qhov siab tshaj plaws dosing raug.
• Tau txais daim ntawv ntawm cov tshuaj mus rau hauv cov hlab ntsha nyob rau hauv unchanged daim ntawv.

Lub parenteral lawv ntawm koom haum saib xyuas ntawm medicaments muaj ob peb tsis zoo:

• Yuav Tsum tshuaj yuav tsum tau muab los ntawm kev kawm kho mob.
• Yuav tsum tau ua raws li cov aseptic thiab antiseptic.
• Nyuaj thiab muab tshuaj txawm tsis yooj yim sua nrog los ntshav, txhab ntawm daim tawv nqaij ntawm lub qhov koob.

nqus tau pa

Nqus tau cov pa txoj kev ntawm cov thawj coj ntawm cov tshuaj yuav tsum tau siv nyob rau hauv cov kev kho mob ntawm aerosols, gases (volatile antiseptics) thiab cov hmoov (sodium cromoglycate). Nrog no txoj kev ntawm cov thawj coj ntawm cov tshuaj yuav tau hauv sai sai thiab pheev lawv kho los. Nyob rau hauv tas li ntawd, nws yooj yim yog cov kev tswj neeg sawv cev concentration hauv cov ntshav - lub cessation ntawm nqus tau pa ua rau qhov kev ncua ntawm cov tshuaj. Nrog nqus tau pa aerosol concentration txhais tau tias nyob rau hauv lub bronchi heev muaj tsawg heev mauj cov nyhuv.

Tiam sis peb yuav tsum tsis txhob hnov qab hais tias tsis muaj teeb meem li cas rau hauv lub nqus tau pa yuav zoo, nws tsis pub ua ntaub ntawv thov irritants. Nws yuav tsum raug borne nyob rau hauv lub siab hais tias tus nqus tau cov pa tshuaj muaj feem xyuam rau lwm leej lwm tus (xws li, tshuaj loog).

Pros thiab cons ntawm nqus tau pa

Peb yog ntxiv rau kev xav txog txoj kev ntawm yeeb tshuaj koom haum saib xyuas. Zoo thiab tsis zoo ntawm cov txoj kev thiab nqus tau pa. nqus tau pa pluses:

• Nws ua hauj lwm ncaj qha nyob rau hauv lub site pathology.
• Cov tshuaj yuav tau yooj yim mus rau qhov chaw ntawm o, lub siab kis unaltered uas ua rau nws ntau dua concentration hauv cov ntshav.

nqus tau pa Cons:

• Yog hais tias mob loj bronchial patency, cov tshuaj penetrates tsis zoo mus rau hauv tus kab mob rau ntawm qhov chaw.
• Lub formulations yuav chim siab qhov ntswg, qhov ncauj thiab lub caj pas.

Lub ntsiab txoj kev ntawm cov thawj coj ntawm cov tshuaj xam tau tias yog, tab sis muaj lwm tus neeg uas yog tseem nyob rau hauv tej rooj plaub muaj peev xwm ua indispensable.

Ntsuas ntawm, paum thiab urethral kev ntawm koom haum saib xyuas

Yog hais tias peb los sib piv cov qhov quav lawv cov koom haum saib xyuas ntawm cov tshuaj los qhov ncauj cov thawj coj, nws yog tau hais raws nraim li cas cov nyhuv uas cov thawj txoj kev tshwm sim sai npaum li cas. Lub tshuaj no yog sai absorbed rau hauv cov hlab ntsha tsis tau rhuav pov tseg thaum tib lub sij hawm nyob rau hauv qhov kev txiav txim ntawm cov enzymes ntawm cov hnyuv thiab daim siab.

Ntsuas ntawm lub suppositories muab mus rau hauv lub cev, tshuaj pleev, thiab lwm yam ntaub ntawv ntawm cov kev npaj, yav tas los pulverized thiab diluted, lub sij hawm no nrog enemas. Tab sis nws yog ib nqi nco ntsoov hais tias kev daws nkag rectally, yuav effect sai npaum li cas tshaj ib tug tswm ciab. Xaav enemas rau cov neeg laus yog 50 mus rau 100 ml, thiab rau cov me nyuam - los ntawm 10 mus rau 30 ml. Tab sis qhov no txoj kev tshuaj kev tswj hwm tseem muaj disadvantages:

• Phim daim ntawv thov.
• Tshwj xeeb nqi hloov mus hloov los thiab ua kom tiav daim duab ntawm suction.

Uas yog vim li cas lub qhov quav lawv cov thawj coj los yog pom zoo xwb nyob rau hauv tus neeg mob qhov twg qhov ncauj thawj coj yog nyuab thaum koj yuav tau ntaus cov tshuaj sai sai mus rau hauv cov hlab ntsha thiab ua tshuaj yog contraindicated rau cov ib co yog vim li cas los yog lwm.

Paum thiab urethral txoj kev tso cai rau yuav ua kom paub ib daim ntawv npaj. Txawm li cas los, ob leeg txoj kev muab qhov zoo tshaj plaws kev tshwm sim thaum ua ntawv thov rau cov kev kho mob ntawm tus kab mob nyob rau hauv cov kabmob los yog rau mob, rau Piv txwv li rau lub koom haum saib xyuas ntawm contrast agents, xws li "yodamid" "Triombrast" thiab lwm tus neeg.

Txha caj thiab intracranial lawv ntawm koom haum saib xyuas

Nyob rau hauv tsis tshua muaj heev neeg mob siv intracranial thiab tus txha caj (suboccipital, subarachnoid, subdural, etc.) txhaj tshuaj. Qhov no yog vim kev lom zem ntau mus rau lub fact tias xws li txoj kev ua kom paub cov tshuaj yuav tsum tsuas tsim nyog. Tej kev yuav tsum tau siv xwb menyuam tsis taus, kiag li pob tshab tseeb aqueous dlaws nrog ib tug nruab nrab ras txog. Qhov kev txiav txim los ceev ceev.

Transdermal kho tshuab

Nyob rau hauv tsis ntev los no lub sij hawm muaj tshuaj nyob rau hauv ib daim ntawv tshiab. Transdermal kho tshuab (TTS) - ib tug ntawm lawv. Lawv yog cov mos mos, ntau npaum daim ntawv siv tau rau sab nraud daim ntawv thov mus rau lub qeeb tso tawm ntawm cov tshuaj substance. Niaj hnub nimno TTC - qhov no zaj duab xis, thiab thaj ua rau thaj uas tau ua siv art technology thiab heev yooj yim mus use: lub thaj adhered rau ntawm daim tawv nqaij thiab cov zaj duab xis nteg sab plhu. Wherein qhov yooj yim yam khoom uas yog absorbed rau hauv cov hlab ntsha ntawm daim tawv nqaij los yog mucosa.

Muaj ntau cov kws kho mob ib ncig ntawm lub ntiaj teb no nyob rau hauv xyoo tsis ntev los ntau thiab ntau them nyiaj saib xyuas mus rau qhov tseeb txoj kev ntawm cov thawj coj ntawm cov tshuaj. Zoo thiab tsis zoo muaj txhua leej txhua tus, xws li thiab TTC. Xav txog cov pluses:

• Tshuaj ua hauj lwm nyob rau ntawm ib ceev pace.
• Cov tshuaj nkag mus rau hauv cov ntshav maj mam tsis muaj ib tug so, uas tso cai rau rau ib tug ruaj khov theem ntawm lub hauv paus khoom.
• Tsis kaj siab ncus yog kiag li cais, qhov no kuj siv rau retching, thiab cov mob los ntawm cov tshuaj.
• Lub tiav tsis tuaj kawm ntawv ntawm phiv los nyob rau ib feem ntawm lub digestive ib ntsuj av.
• Txo lub zaus ntawm kev tsis haum tshuaj.
• Cov tau sai tshem ntawm cov tshuaj, thaum mam li nco dheev muaj ib tug contraindication.
• Lub caij nyoog npaum li cas.
• Opportunity rau taw tes tus me nyuam cov tshuaj rau lub Desired ib feem ntawm lub cev.

Txhua yam ntawm tus piav tseem khiav ntawm koom haum saib xyuas ntawm cov tshuaj nws muaj nws tus kheej pros thiab cons. Tab sis tsis muaj teeb meem yuav ua li cas zoo yog txoj kev, qhov tseem ceeb tshaj plaws uas nws yuav tsum tau xaiv ib tug kws kho mob, thiab nws yog ntshaw tias cov feem ntau complex thiab tsis tshua muaj hom ntawv nqa tawm los ntawm qhia tshwj xeeb uas kawm neeg nyob rau hauv ib tug tsev kho mob. Saib xyuas ntawm koj tus kheej, yuav tsis muaj xav hais tias, yog dab tsi txoj kev uas yuav xa cov tshuaj rau hauv lub cev.