E-Spain, iArhente yaseSpain yamaYeza kunye neeMveliso zeMpilo (AEMPS), exhomekeke kwi-Ofisi yoMphathiswa Wezempilo, ithathe isigqibo thintela ukusetyenziswa kwe-codeine yokukhwehlela ngaphakathi ongaphantsi kweminyaka eli-12 ubudala kunye nangexesha ukuncelisa okoko iingozi zempilo ziye zafunyanwa kwizigulana ezithile kwaye, ukongeza, abukho ubungqina benzululwazi bokuba i-codeine iyasebenza ngokwenene kwiinkqubo ze-catarrhal. Kukwacebise ukuba abo bangaphantsi kweminyaka eli-18 ubudala bakuphephe ukuthatha la mayeza ukuba baneengxaki zokuphefumla.
Kodwa yintoni ngoku ngoku? Ndiza kukuxelela yonke into engezantsi.
La ikhowudi Yiyo ivela kwi-opium. Le opioid igunyaziselwe unyango lweempawu zokuqaqamba kwentlungu kunye nokukhohlela okungavelisi, kwaye ikwasetyenziselwa ukunyanga ukukhohlela okunxulunyaniswa neenkqubo ze-catarrhal ebantwaneni.
Uphando
Ngo-2013, i IKomiti yoVavanyo loMngcipheko we-Pharmacovigilance Risk (PRAC) wenze uphononongo malunga Umyinge womngcipheko kumngcipheko wamayeza ekhodine isetyenziselwe ukunyanga iintlungu kubantwana, emva kokuba zazi iimeko ezinzima, ezinye zazo zibulalayo, zabantwana abaye banxila kwi-morphine emva kokufumana i-codeine njenge-analgesic. Ezi meko zenzekile kuba Isiphumo se-pharmacological se-codeine Kungenxa yotshintsho lwayo lube yi-morphine yi-cytochrome P2 enzyme CYP6D450, kwaye abanye abantu banemetabolis ekhawulezayo yemfuza kwaye ke ngoko baguqula ikhowudiine ibe yi-morphine ngokukhawuleza okukhulu. Ipesenti yezigulana ezichaphazeleke yile metabolism ikhawulezayo iyahluka kwaye ixhomekeke kwimvelaphi yobuhlanga, kodwa yenza ukuba ezi zigulana zibekho amathuba okuba zinxilise i-morphine.
Ngenxa yolu phando, kwaqaliswa olunye uvavanyo lomngcipheko ofunyenweyo onokuthi wongezwe ekusebenziseni ikhowudi xa kunyangwa ukukhohlela okunxulunyaniswa neenkqubo ze-catarrhal kubantwana. Yiyo le indlela ubungqina obuncinci bobunzululwazi obufunyenwe ngayo ukuxhasa ukusetyenziswa kwe-codeine kunyango lokukhohlela olunxulunyaniswa neenkqubo ze-catarrhal ebantwaneni.
Ikhowudi yokuvalwa
Nangona Ityhefu ye-morphine zinokwenzeka nakweyiphi na iminyaka, abantwana abangaphantsi kweminyaka eli-12 ubudala basemngciphekweni owandayo wokuphendula gwenxa emva kolawulo lwecodeine. Ezi mpendulo zinokuba nzulu ngakumbi kwimeko yee-metabolism ezikhawulezayo. Lo mngcipheko ukwasebenza nakwizigulana, nokuba zingakanani ubudala, zinengxaki yokuphefumla ngenxa yezinye izifo.
Inyani yile yokuba impilo ithathe isigqibo sokuba unyango kunyango lwesikhohlela esinganyangekiyo ebantwaneni kufanele ukuba lube yi-etiological, kwaye ukusetyenziswa kweziyobisi ezine-codeine kufuneka kuthintelwe kubantwana abangaphantsi kweminyaka eyi-12 ubudala nakwizigulana ezisebenzisa ngokukhawuleza umzimba. Ukongeza, abasetyhini bayathintelwa ngexesha lokuncancisa ngenxa yomngcipheko wokuba umntwana angafumana iimpendulo ezibi xa umama esenza ngokukhawuleza.
Ukongeza, iMpilo icebisa malunga nokusetyenziswa kwe-codeine kwizigulana ezineminyaka eli-12 ukuya kweli-18 ubudala ezineengxaki zokuphefumla ezinje ngezo zinengxaki ye-neuromuscular, isifo sokuphefumla okanye isifo sentliziyo, usulelo lwemiphunga, umothuko omninzi okanye izigulana ezenze iinkqubo zoqhaqho.
Okwangoku ulwazi oluvela kwindawo yogcino-zincwadi i-AEMPS Pharmacoepidemiological Research Database (BIFAP) ye-AEMPS ibonisa ukuba ukusetyenziswa kwe-codeine ebantwaneni abaphakathi kweminyaka emi-2 ukuya kweli-11 ubudala ikakhulu kukuchasana, kuba yinto engekhoyo kubantwana abangaphantsi kweminyaka emi-2 ubudala.
Amayeza ane codeine
Owona mayeza uqhelekileyo athengiswa eSpain ngala alandelayo:
Ikhowudi
- I-Codeine isiraphu ithoba okanye isuse iintlungu eziphakathi (isiphumo se-analgesic) kunye nokunciphisa ukukhwehlela (i-antitussive).
- Eli yeza lisetyenziswa kunyango lwexeshana elifutshane leentlungu ezilinganiselweyo kwizigulana ezingaphezulu kweminyaka eli-12 ubudala kunye nezinye izinto zokuthomalalisa iintlungu, ezinje ngeparacetamol kunye ne-ibuprofen, azithathwa njengefanelekileyo.
- Isetyenziselwa unyango lweempawu zokukhohlela ngaphandle kwemfihlo.
Tosein
- It is a arhente antitussive, zombini iimeko ezingapheliyo kunye ezingapheliyo zokuphefumla, nto leyo eyenza kube lula ukucinezela ukuthintela okhohlela gqolo, ezifana izifo ezithile kwinkqubo yokuphefumla.
- Kwakhona ine-analgesic kunye ne-sedative effect.
Imbali
- Iyeza elikhohlela elingenamveliso, ukukhohlela okomileyo kunye nokukhohlela ebusuku.
- Ngenxa yokwakheka kwayo, kufuneka ilawulwe ngononophelo kubantu abadala nakwizigulana ezibuthathaka ezinesibindi, imisebenzi yentliziyo okanye yezintso, kunye nakwiimeko zehypothyroidism, i-prostatic hypertrophy, isifo sezilonda esinganyangekiyo kunye nezifo ezibonisa ukunciphisa amandla okuphefumla.