Cirbadda Buprenorphine

Qanacsan

• Kahor qaadashada cirbadeynta buprenorphine,
• Cirbadeynta sii-deynta Buprenorphine waxay sababi kartaa waxyeelo. U sheeg dhakhtarkaaga haddii mid ka mid ah astaamahani ay daran yihiin ama aanad tagin:
• Dhibaatooyinka qaarkood waxay noqon karaan kuwo halis ah. Haddii aad isku aragto mid ka mid ah astaamahan isla markiiba wac dhakhtarkaaga ama aad hesho daaweyn caafimaad oo degdeg ah:
• Calaamadaha xad-dhaafka ah waxaa ka mid noqon kara kuwa soo socda:

Cirbadeynta sii-deynta Buprenorphine waxaa lagu heli karaa oo keliya iyada oo loo marayo barnaamijka qaybinta gaarka ah ee loo yaqaan 'Sublocade REMS'. Dhakhtarkaaga iyo farmasigaaga waa inay kaqeyb galaan barnaamijkan kahor intaadan helin cirbadeynta buprenorphine. Weydii dhakhtarkaaga wixii macluumaad dheeraad ah ee ku saabsan barnaamijkan iyo sida aad ku heli doonto daawadaada.

Dhammaan ballamaha la dhig dhakhtarkaaga iyo shaybaarka. Dhakhtarkaaga ayaa laga yaabaa inuu dalbado baaritaano gaar ah kahor iyo inta daaweyntaadu socoto si loo hubiyo jawaabta jirkaaga ee cirbadeynta sii-fidinta buprenorphine.

Dhakhtarkaaga ama farmashiistahaaga ayaa ku siin doona warqada macluumaadka bukaanka soo saaraha (Tilmaamaha Daawada) marka aad bilowdo daaweynta cirbadeynta sii-fidinta ee buprenorphine iyo mar kasta oo aad dib u buuxiso dawadaada. Si taxaddar leh u akhri macluumaadka oo weydii dhakhtarkaaga ama farmashiistaha haddii aad wax su'aalo ah qabtid. Waxa kale oo aad booqan kartaa bogga Maamulka Cuntada iyo Dawooyinka (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) si aad u hesho Hagaha Daawada.

Cirbadeynta sii-deynta Buprenorphine waxaa loo isticmaalaa in lagu daaweeyo ku-tiirsanaanta opioid (qabatinka daawooyinka opioid, oo ay ku jiraan heroin iyo xanuun joojiyaha) dadka helay buccal ama subupual buprenorphine ugu yaraan 7 maalmood. Cirbadeynta sii-deynta Buprenorphine waxay ku jirtaa nooc daawooyin ah oo loo yaqaan 'opiate parition agonists'. Waxay u shaqeysaa inay ka hortagto astaamaha ka-noqoshada marka qof joojiyo qaadashada daawooyinka opioid isagoo soo saaraya saameyn la mid ah daawooyinkan.

Cirbadeynta mudada dheer ee Buprenorphine (waxqabadka dheer) waxay u timaadaa xalka (dareeraha) in si subagsan (oo maqaarka hoostiisa ah) laguugu mudo iyadoo bixiyaha xanaanada caafimaadka la gelinayo aagga caloosha. Badanaa waxaa la bixiyaa hal mar bishii iyadoo ugu yaraan 26 maalmood u dhexeyso qiyaaso. Cirbadeyn kasta oo buprenorphine ah ayaa si tartiib tartiib ah daawada ugu sii deysa jirkaaga muddo bil ah.

Ka dib markaad hesho qiyaas ah duritaanka buprenorphine ee fidinta-sii-fidinta, waxaad ku arki kartaa buro goobta duritaanka dhowr toddobaad, laakiin waa inay hoos u dhacdaa cabirka waqtiga. Ha xoqin ama ha duugin meesha lagaa duray. Hubso in suunka ama suunka dhexda uusan cadaadis saarin meeshii lagu duray daawada.

Dhakhtarkaagu wuu kordhin karaa ama yareyn karaa qiyaastaada iyadoo kuxiran sida daawadu kuugu shaqeyso, iyo waxyeelo kasta oo aad la kulanto. Hubso inaad u sheegto dhakhtarkaaga sida aad dareemeyso inta lagu jiro daweyntaada cirbadeynta-dheer ee sii-deynta buprenorphine.

Haddii buprenorphine-sii-daayo-dheer la joojiyo, dhakhtarkaaga ayaa laga yaabaa inuu si tartiib tartiib ah u yareeyo qiyaastaada. Waxaad la kulmi kartaa astaamaha ka-noqoshada oo ay ka mid yihiin degganaansho la'aan, indho ilmo, dhidid, qarqaryo, ballaarinta ardayda (wareegyada madow ee indhaha dhexdooda), xanaaq, walaac, dhabar xanuun, daciifnimo, calool xanuun, dhibaato hurdo la'aan ama hurdo la'aan, lallabbo, cunto xumo, matag, shuban, neefsasho degdeg ah, ama garaaca wadnaha oo degdeg ah. Astaamahan ka-noqoshada waxaa laga yaabaa inay dhacaan 1 bil ama ka badan ka dib markii ugu dambeysay ee lagaa siiyo mudista buprenorphine.

Daawadan waxaa loo qori karaa adeegsiyo kale; Weydii dhakhtarkaaga ama farmashiistaha wixii macluumaad dheeraad ah.

Kahor qaadashada cirbadeynta buprenorphine,

• u sheeg dhakhtarkaaga iyo farmashiistaha haddii aad xasaasiyad ku leedahay buprenorphine, dawooyin kale, ama wax kasta oo ka mid ah waxyaabaha ku jira mudista buprenorphine. Weydii farmashiistahaaga ama ka hubi Hagaha Daawada liiska waxyaabaha ay ka kooban yihiin.
• u sheeg dhakhtarkaaga iyo farmashiistaha waxa kale ee dhakhtar qoro iyo kuwa aan dhakhtar qorin, fiitamiinnada, nafaqada nafaqada, iyo alaabta dhirta ah ee aad qaadanayso ama aad qorsheyneyso inaad qaadato. Hubso inaad sheegto mid ka mid ah kuwan soo socda: antihistamines; benzodiazepines sida sida alprazolam (Xanax), chlordiazepoxide (Librium, in Librax), clonazepam (Klonopin), diazepam (Valium), estazolam, flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril) (triorlam); carbamazepine (Carbatrol, Tegretol, Teril, kuwa kale); durayaasha ('kaniiniyada biyaha'); erythromycin (E.E.S., Eryc, PCE, kuwa kale); Daawooyinka HIV sida atazanavir (Reyataz, in Evotaz), delavirdine (Rescriptor), efavirenz (Sustiva, in Atripla), etravirine (Intelence), indinavir (Crixivan), nevirapine (Viramune), ritonavir (Savina, Saletina) (Invirase); daawooyinka qaarkood ee garaaca wadnaha aan caadiga ahayn oo ay ka mid yihiin amiodarone (Nexterone, Pacerone), disspyramide (Norpace), dofetilide (Tikosyn), procainamide (Procanbid), quinidine (in Nuedexta), iyo sotalol (Betapace, Betapace AF, Sorine); daawooyinka glaucoma, cudurada maskaxda, dhaqdhaqaaqa dhaqdhaqaaqa, cudurka Parkinson, boogaha, ama dhibaatooyinka kaadi mareenka; ketoconazole, daawooyinka kale ee xanuunka; dawooyinka madax xanuunka dhanjafka sida almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), iyo zolmitriptan (Zomig); nasashada murqaha; phenobarbital; phenytoin (Dilantin, Phenytek); rifampin (Rifadin, Rimactane); dajiya; kaniiniyada hurdada; 5HT3 serotonin blockers sida alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), ama palonosetron (Aloxi); xakameeyayaasha serotonin-reuptake inhibitors sida citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), iyo sertraline (Zoloft); serotonin iyo norepinephrine reuptake inhibitors sida duloxetine (Cymbalta), desvenlafaxine (Khedezla, Pristiq), milnacipran (Savella), iyo venlafaxine (Effexor); tramadol; dejiyeyaasha; trazodone; ama tricyclic antidepressants ('mood elevators') sida amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), iyo trimipramine. Sidoo kale u sheeg dhakhtarkaaga ama farmashiistaha haddii aad qaadanaysid ama aad qaadanaysid daawadayaasha monoamine oxidase (MAO) ama haddii aad joojisay qaadashadooda labadii toddobaad ee la soo dhaafay: isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil) , selegiline (Eldepryl, Emsam, Zelapar), ama tranylcypromine (Parnate). Dhakhtarkaaga ayaa laga yaabaa inuu u baahdo inuu beddelo qiyaasta daawooyinkaaga ama uu si taxaddar leh kuugu ilaaliyo dhibaatooyinka soo raaca. Daawooyin kale oo badan ayaa sidoo kale la macaamili kara buprenorphine, markaa hubi inaad u sheegto dhakhtarkaaga dhammaan daawooyinka aad qaadanaysid, xitaa kuwa aan ka muuqan liiskan.
• u sheeg dhakhtarkaaga haddii adiga ama xubin qoyskaaga ka mid ahi aad cabtaan ama aad weligiin cabtaan khamri aad u tiro badan ama aad weligiinba qabateen QT Syndrome (xaalad kordhinaysa halista ah inuu ku dhaco wadno garaac aan caadi ahayn oo sababi kara miyir beelid ama dhimasho lama filaan ah). Sidoo kale, u sheeg dhakhtarkaaga haddii aad leedahay ama aad waligaa dhiiggaagu ku yar yahay maadada potassium ama magnesium; wadnaha oo istaaga; garaaca wadnaha oo gaabis ah ama aan caadi ahayn; Cudurka sambabaha ee joogtada ah (COPD, koox cuduro ah oo saameeya sambabada iyo hawo mareenka); cudurada kale ee sanbabada; dhaawac madaxa ah; buro maskaxda ah; xaalad kasta oo kordhinaysa xaddiga cadaadiska maskaxdaada; dhibaatooyinka adrenal sida cudurka Addison (xaalad qanjirka adrenal soo saaro hormoon ka yar kan caadiga ah); qanjirka 'prostatic hypertrophy' (BPH, ballaarinta qanjirka 'prostate'); dhibaatada kaadida; dhalanteed (aragtida wax ama maqalka codad aan jirin); qallooca lafdhabarta oo adkeeya neefsashada; ama tayroodh, xameetida, ama cudurka beerka.
• u sheeg dhakhtarkaaga haddii aad uur leedahay ama aad qorsheyneyso inaad uur yeelato. Haddii aad si joogto ah u hesho buprenorphine cirbad-sii-fidis joogto ah inta aad uurka leedahay, ilmahaagu wuxuu la kulmi karaa astaamaha ka-noqoshada nolosha ee halista ku ah dhalashada ka dib. Isla markiiba u sheeg dhakhtarka ilmahaaga haddii ilmahaagu la kulmo astaamaha soo socda midkood: xanaaq, kacsanaan, hurdo aan caadi ahayn, oohin qaylo-dhaan ah, gariir aan la xakamayn karin oo ka mid ah jirka, matag, shuban, ama miisaanka oo kordha.
• u sheeg dhakhtarkaaga haddii aad naas nuujinayso. U sheeg dhakhtarka ilmahaaga isla markiiba haddii ilmahaagu ka seexdo sidii caadiga ahayd ama ay dhibaato ka haysato neefsashada inta aad qaadanayso dawadan.
• waa inaad ogaataa in daawadani ay yareyn karto bacriminta ragga iyo dumarka. Kala hadal dhakhtarkaaga khataraha ku jira isticmaalka cirbadeynta sii-daynta ee buprenorphine.
• haddii aad qalliin ku jirto, oo ay ku jiraan qalliinka ilkaha, u sheeg dhakhtarka ama dhakhtarka ilkaha in aad qaadanayso cirbadeyn dheeri ah oo lagu sii daayo buprenorphine.
• waa inaad ogaataa in duritaanka buprenorphine ee muddada dheer lagu sii daayo ay kaa dhigi karto mid hurdo badan. Gaari ha wadin ama ha ku shaqeynin mishiin ilaa aad ka ogaato sida daawadani kuu saameyneyso.
• waa inaadan cabin aalkolo ama aad isticmaasho daroogada dariiqa inta lagu jiro daweyntaada. Cabitaanka khamriga, qaadashada daawada dhakhtar qoro ama daawooyinka aan dhakhtar qorin ee ay ku jiraan aalkolada, ama isticmaalka daroogada dariiqa inta lagu guda jiro daaweyntaada cirbadeynta buprenorphine waxay kordhisaa halista inaad la kulmi doonto dhibaatooyin neefsasho oo halis ah
• waa inaad ogaataa in buprenorphine ay sababi karto dawakhaad, madax-wareer, iyo miyir beelid markaad si dhakhso leh uga kacdo booska jiifka. Si looga hortago dhibaatadan, si tartiib ah uga kac sariirta, adoo cagahaaga ku dhigaya dhulka daqiiqado ka hor intaadan istaagin.
• waa inaad ogaataa in buprenorphine ay sababi karto calool fadhiga. Kala hadal dhakhtarkaaga wixii ku saabsan beddelaadda cuntadaada ama isticmaalka daawooyin kale si looga hortago ama loo daaweeyo calool istaagga intaad isticmaaleyso mudista buprenorphine.

Ilaa dhakhtarkaagu kuu sheego mooyee, sii wad cuntadaada caadiga ah.

Haddii aad seegto qiyaasta mudista ah ee sii-ballaadhinta buprenorphine, waa inaad u wacdaa dhakhtarkaaga si aad u hesho qiyaasta sida ugu dhakhsaha badan ee suurtogalka ah. Qiyaastaada xigta waa in la siiyaa ugu yaraan 26 maalmood ka dib.

Cirbadeynta sii-deynta Buprenorphine waxay sababi kartaa waxyeelo. U sheeg dhakhtarkaaga haddii mid ka mid ah astaamahani ay daran yihiin ama aanad tagin:

• lallabbo
• matagid
• madax xanuun
• daal
• xanuun, cuncun, barar, raaxo la'aan, guduudasho, nabarro, ama kuuskuus ah meeshii laga muday

Dhibaatooyinka qaarkood waxay noqon karaan kuwo halis ah. Haddii aad isku aragto mid ka mid ah astaamahan isla markiiba wac dhakhtarkaaga ama aad hesho daaweyn caafimaad oo degdeg ah:

• neefsashada oo adkaata
• kacsan, dhalanteed (aragtida wax ama maqalka codad aan jirin), qandho, dhidid, jahwareer, garaaca wadnaha oo dhaqso ah, gariirid, hadal xarago leh, murqaha oo adkaada ama qallooca, lumitaanka isku xirnaanta, lallabbo, matag, ama shuban
• lallabbo, matag, rabitaan la'aanta cuntada, daciifnimo, ama wareer
• awood u lahayn inuu kaco ama kacsanaado
• caadada oo aan caadi ahayn
• rabitaanka galmada oo yaraaday
• finan
• finan
• cuncun
• hadal xanaf leh
• aragga oo xumaada
• isbedelada garaaca wadnaha
• xanuun qeybta kore ee midig ee caloosha
• hurdi maqaarka ama indhaha
• kaadi midab madow
• saxaro midab khafiif ah leh

Cirbadeynta sii-daynta Buprenorphine waxay sababi kartaa waxyeelo kale. Wac dhakhtarkaaga haddii aad qabtid dhibaatooyin aan caadi ahayn inta aad qaadanaysid dawadan.

Haddii aad isku aragto waxyeellooyin daran, adiga ama dhakhtarkaaga ayaa warbixin u diri kara Barnaamijka Ka Warbixinta Dhacdooyinka Xun ee Maamulka Cuntada iyo Dawooyinka (FDA) (http://www.fda.gov/Safety/MedWatch) ama taleefan ( 1-800-332-1088).

Ka wac khadka caawinta sunta 1-800-222-1222. Macluumaadka sidoo kale waxaa laga heli karaa internetka https://www.poisonhelp.org/help. Haddii dhibbanuhu burburay, suuxdin qabtay, neefsashadu dhib ku tahay, ama aan la kici karin, isla markiiba wac adeegyada gurmadka ee 911.

Calaamadaha xad-dhaafka ah waxaa ka mid noqon kara kuwa soo socda:

• yaraynta ama ballaarinta ardayda (wareegyada madow ee isha bartamaha)
• gaabis ah ama neefsashada oo ku adkaata
• hurdo saaid ah ama lulmo
• miyir beelid (miyir beelid muddo ah)
• garaaca wadnaha oo gaabis ah

Kahor baaritaanka shaybaarka (gaar ahaan kuwa ku lugta leh methylene blue), u sheeg dhakhtarkaaga iyo shaqaalaha sheybaarka inaad isticmaaleyso cirbadeynta buprenorphine.

Xaaladda degdegga ah, xubin qoyska ka mid ah ama daryeel bixiye waa inuu u sheegaa shaqaalaha caafimaadka ee deg-degga ah inaad jir ahaan ku tiirsan tahay opioid isla markaana aad ka helayso daaweynta cirbadeynta sii-fidinta ee buprenorphine.

Buprenorphine cirbadeynta sii-deynta-dheer waa walax la kontoroolo. Hubso inaad ballan la sameysatid dhakhtarkaaga si joogto ah si aad u hesho cirbadahaaga. Weydii farmasiilahaaga haddii aad wax su'aalo ah qabtid.

Waxaa muhiim kuu ah inaad haysato liis qoran oo ku saabsan dhammaan daawooyinka laguu qoro iyo kuwa aan dhakhtar qorin (warqad dhakhtar la aan ah) ee aad qaadanaysid, iyo sidoo kale wax soo saar kasta sida fiitamiinnada, macdanta, ama nafaqooyinka kale ee nafaqada leh. Waa inaad soo qaadataa liiskan markasta oo aad booqato dhakhtar ama haddii isbitaal la dhigo. Sidoo kale waa macluumaad muhiim ah inaad lasocoto haddii ay jiraan xaalado deg deg ah.

• Sublocade^®