Damdawi Nghawng Ṭha Lo (Adverse Drug Reactions)

Damdawi reng reng hi hman a nih ṭhinna chhan chu mihring/damlo taksaah eng nge nghawng danglam a neih theih vang a ni a, chu a nghawng, taksa a danglamna a thlen theih avang chuan a ṭha zawnga thawkin damlo natna chhawktu, damlohna thlentu natna hrik thahna atante, natna lo awmchhan zirchianna atante, nakna laka invenna atan leh damlo natna zual zel tur venna atante hman a ni ṭhin a ni.

Hetianga mihring taksa a danglamna thlena nghawng a neih theih avang hian damdawi reng reng hian a hmangtute tum reng vang ni lovin nghawng ṭha lo dang hi a nei ṭhin a, chumi chungchang chu tawi te, hriatthiam awl thei ang berin kan tarlang dawn a ni. Damdawi reng reng chu damlo hnena chawhtuin damlo hman tura a duan reng reng hian damlo dinhmun leh a damdawi azirin damlo tana ṭha tur leh a nghawng ṭha lo awm thei a bûk a, damlo tana ṭha thei ang ber turin damlo enkawlna atan a hmang ṭhin a, damlo natna dinhmun azirin damdawi hman hunchhung turte, damdawi hman hun turte, damdawi hman zat turte chu damloah nghawng ṭha lo awm palh thei veng chungin a ruahman ṭhin a ni. Damlovin damdawi thar a hman dawn reng rengin damlovah eng ang takin nge damdawiin a ṭha lam leh ṭha lo lamah hna a thawh dawn tih hi zaa zain hriat lawk theih a ni ṭhin lo a, damlo dinhmun leh damdawiin nghawng a neih theihte chu zirna leh tawnhriat aṭangin eng emaw chen hriat theih bawk mah se fimkhur a ṭul hle a ni.

Tunlai science thiamna hmanga (modern system of medicine/allopathy) siamchhuah damdawi reng reng hi damlovin a hman theih tura chhawpchhuah a nih hma hian nasa taka zirchian a ni ṭhin a, mipuiin an hman hnuah pawh hian nasa takin zirchianna kalpui reng a ni a, damdawi nghawng ṭha lo leh beisei loh deuh lam damdawiin nghawng dang a nei em tihte, damdawi kha a him tawk em tihte, damdawi nghawng ṭha lo laka damlo ven a nih theihna turin mithiamte chuan hna an thawk chhunzawm reng a, chu chu sap ṭawngin Pharmacovigillance an ti a, damdawiin leh zirna in lian leh ṭhaah chuan mipui mimirin kan hriat loh hian mithiamten an zirchiang reng a, damdawi hman nasat leh lar tak takte pawh a nghawng ṭha lo nasat lutuk avanga hman khap tak emaw, a hmanna ber thlak tak daih te, fimkhur lehzuala damdawi hman a nih theihna tura khuahkhirhna khauh zawk kenkawh takte a awm leh nawk ṭhin a, hei hian damdawiin nghawng chi hrang hrang a neih theihzia a tilang chiang viau awm e.

Damdawi nghawng ṭha lo (Adverse Drug Reaction) kan tih hi chhan hrang hrang avangin a awm thei a, chi hrang hranga thliar hran a ni bawk. Taksa damna a thlen theih ruala a nghawng ṭha lo awm thei hriat lawk theihte, rin lawk leh hriat lawk miah loha damdawi leh a hmangtu mihring azira nghawng ṭha lo hlauhawm tak a thlen theih, thihna hial thlen thei te, damdawi hman rei ngai avanga nghang ṭha lo thlen theite, nghawng ṭha lo lang nghal mai lo, a hnu fea langchhuak chauhte, (kum 1960 chho fel khan rai laia luakchhuak luhai leh awm nuam lo atana hman ṭhin damdawi ṭha tak mai anga ngaih Thalidomide damdawi ei fate sing chuang teh meuh chu kutke kim lo, phocomelia piangsuala piang an awm avangin he damdawi hi hman phal tawh loh a ni.) damdawi hmanlai chawlh thut avanga nghawng ṭha lo awmte leh damdawi dang nena ei pawlh avang emaw, damdawiin a hna thawh tur ang a thawh loh avanga nghawng ṭha lo a awm thei bawk.

World health Organisation chuan kan thupui, damdawi nghawng ṭha lo chu damdawi reng reng mihringah, natna awm tur venna atan emaw, natna hmuhchhuahna atan leh natna enkawlna atana a nihna ang taka hman a nih laia tum reng vang ni lo leh, beisei leh hriat lawk miah loha nghawng duhawm lo a thlen hi a ni tiin a hrilhfiah a. Adverse drug reactions (ADRs), damdawi nghawng ṭha lo kan tih mai hi chi hrang hrangin a ṭhen theih.

Tun kar ni 17-23 hi National Pharmacovigilance Week, damdawi hnathawh dan enchianna hapta atan India ram chhunga damdawi lam enkawlna lama thuneitu sang Pharmacy Council of India chuan a puang a, a thupuiah pawh “Encouraging Reporting of ADRs by Pathients” tih hman a ni a, chumi awmzia chu damdawi nghawng ṭha lo emaw beisei loh deuha taksaa hnathawh awm theite thuneitute hnena thlen vat tura mi nawlpui zirtir tihna a ni mai awm e. Hemi pual hi ni 22, Ningani khan H& FW Dept hnuaiah Food and Drugs Administration hmalaknain hun hman a ni nghe nghe a ni. Damdawi chungchang reporting centre hi Zoram Medical College ah ṭha tak a awm a, mipui tam zawk leh abikin hriselna lama thawktu zawng zawngten ngaihvenzual ila a duhawm ngawt mai. Tun hnai maiah pawh damdawi nghawng ṭha lo avangin thihna hial Mizoram ngeiah a thleng a, kan hriat chian lem loh hian mi tam tak hian damdawi nghawng ṭha lo avangin natna zual zawk leh thihna hial tawk an awm nualin a rin theih. Hetiang thleng tur veng tur hian mi zawng zawng mawhphurhna a ni a, damdawi hi pawngtawng ngam lo ila, fimkhur leh dik takin damdawi hi hmang tlat zel ang u. Natna avanga thihna hi chu khuarel ve reng a ni, mahse damdawi hman dik tawk loh emaw, a nghawng ṭha lo leh hmansual avanga thihna thleng hi chu a pumpelh theih a. Mi tinin theihtawp chhuah zel ang u.

Kan tarlan tak adverse drug reactions mihring/damlovah a thlen theihna chhan tawi te i han tarlang leh ila :

■ Polypharmacy: Miin damdawi pakhat aia tam a hman hian damdawi nghawng ṭha lo thlen theihna, damdawi pakhat chauh hmang aiin a tam a, damdawi leh damdawi inhal emaw a damdawi hnathawh intichak tawn avangin a ni tlangpui, hemi chungchang (drug interaction) hi lehkhabu bung dangah chiang zawka tarlan a ni. Damdawi hman a tam poh leh a nghawng ṭha lo thlen theihna a sang zel a ni.

■ A chunga kan tarlan nena inzul deuh, mihringin a taksaah natna benvawn leh damlohna pakhat aia tam a neihin damdawi nghawng ṭha lo a awm duh bik a, thin ṭha lo leh kal ṭha lo nei kawp ang chiahte, lung lama harsatna neite, thisen sang leh zunthlum nei kawp damlovate damdawi nghawng ṭha lo hi a thleng hma bik ṭhin a, entirna atan kal ṭha lo nei damlovah chuan a damdawi a zirin damlo pangngaiin an hman ang kha hman ve mai a rem lo a, a kal hnathawh dan milin damdawi dose kha uluk taka thlang danglam a nih loh chuan damdawi nghawng ṭha lovin damloah harsatna nasa zawk a thlen hlauh ṭhin a ni.

■ Kum upa leh naupang/nausenah damdawi nghawng ṭha lote hi a thlen hma theih bik avangin damdawi dose thlak danglam a ngai ṭhin, hei hi a chhan chu mihring taksain damdawi a lo sawngbawl dan leh damdawi hnathawh lanchhuah dan hi nausea/naupang leh kum upa lamah hian puitling pangngai nen a inan loh theih vang a ni. Hemi chungchang pawh hi bung dangah chiang zawkin tarlan a ni.

■ Zirchiannain a tarlan dan chuan mipa aiin hmeichhiaah damdawi nghawng ṭha lo hi a thleng hma bik tih a ni a, hei hi a chhan chu taksa pianphunga hmeichhia an danglam zawk vangte, damdawi taksain a dawnsawn dan leh damdawi hnathawh lanchhuah danah an danglam avang leh taksa tana pawimawh tak hormone hnathawhte mipa leh hmeichhiaah a danglam vangte a ni a. Chloramphenicol damdawi avanga thisen tlakchhamna aplastic anaemia hi mipa aiin hmeichhiaah a let hnihin a thleng hma zawk a, phenylbutazone damdawi avanga thisen var tlakchhamna agranuloytosis pawh mipa aiin a let thum zetin hmeichhiaah a thleng hma zawk bawk.

■ Mihringte hi inthlahchhung zel, kan thlahtute chi kal chhawm zel kan ni a, mihring chi leh hnam azir hian damdawi ṭhenkhat nghawng ṭha lo taksaa a lanchhuah dan hi a danglam ṭhin. Kan taksa chhunga damdawi nihna inthlak danglam dan azir hian damdawi hnathawh hi a lanchuah dan a danglam thei ṭhin a, abik takin kan thin (liver) a damdawi nihna thlak danglamtu angsar ber cytochrome P 450 (CYP 450) hnathawh hi a pawimawh hle a. CYP 450 hi chi hrang tam tak a awm a, hnathawh pawimawh tak tak an nei theuh a ni, entirna atan CYP 450 zinga mi CYP2C9 hnathawh dan inan loh avangin sap kan tih mai, mingo hovah hian mihang (black)-te aiin warfarin damdawi nghawng ṭha lo a thleng nasa bik ṭhin a ni. Hetiang chi bakah hian mi ṭhenkhat chuan an taksaah damdawi sawngbawltu pakhat glucose-6-phosphate dehydrogenase (G6PD) an tlakchham avangin malaria damdawi primaquine, antibiotics sulphonamides leh nitrofurantoin damdawite nghawng ṭha lo thlen theih thisen tlakchhamna (haemolytic anaemia) an nei hma bik a ni.

■ Damdawi ṭhenkhat chu an hnathawh ṭha viau mah se, nghawng ṭha lo nei tam sa hrim hrim hi an awm ve bawk a, cancer damdawi hman avanga luakchhuak leh luhai awm ṭhinte hi entirna a ni a, tin, damdawi ṭhenkhat chu a dose fimkhur ngai zual tak, thisena a nih dan tur aia sang hreta a awma nghawng ṭha lo nei awl bik a awm ve bawk a, lung damdawi digoxin leh antibiotic gentamycin te hi entirna ṭhenkhat a ni.

Engtin Nge Damdawi Nghawng ṭha lo Lak Aṭangin I Him Theih ang?

DAMDAWI EI HMA IN

1) Doctor emaw pharmacist (OTC drugs bikah) chawh ni lovin damdawi ei mai mai suh.

2) Midang nen in natna thlentu kha a inang lo thei, miin an damdawi ngeih kha I ngeih ve kher lo thei, mi damdawi ei ang ei ve ngawt loh a him ber.

3) Pharmacist emaw doctor hnenah I damdawi chungchang chiang takin zawt ṭhin ang che.

4) Damdawi ei tur doctor-in a chawh che zingah tun hmaa I lo ei/hman ṭhin a awm hrim hrimin hriattir ṭhin la, abikin kha damdawi a huat (allergy/hypersensitivity) emaw I neih phei chuan hrilh ngei ngei ang che.

DAMDAWI EI LAIIN

1) Doctor emaw pharmacist (OTC drugs bikah) chawh che damdawi reng reng ei dan tur an hrilh che angin ei ṭhin ang che.

2) Zu emaw Grape wine/juice nen damdawi ei/in pawlh ngai suh ang che, abikin paracetamol, diazepam, alprazolam, escitalopram, ibuprofen, etc. Zu in mi tan damdawi ei lai chuan zu in loh a him ber, doctor emaw pharmacist hnenah zawt chiang ṭhin rawh.

3) Doctor emaw pharmacist-in ti tura a hrilh che a nih loh chuan tui lum, thingpui nen emaw I damdawi kha ei pawlh ngaih suh.

4) Damdawi I ei dawn reng rengin ei dan tur inziak chhiar ṭhin ang che, chutiang a awm lo a nih chuan I doctor emaw pharmacist rawn ṭhin rawh.

5) I damdawi ei/in reng reng kha hunbi vawng thlapin ni tin a hun ngaiah ei/in ṭhin ang che. Nikhatah darkar 12 a awm a, vawi hnih ei a nih chuan darkar 12 danah, vawi thum ei chu darkar 8 danah, chutiangin vawi li chu darkar 6 danah.

DAMDAWI EI ZAWHAH

1) Thawklehkhatah I damdawi ei lai kha chawlhsan ngawt zel suh ang che. (I doctor-in ti tura a ti che a nih loh chuan)

2) I damdawi ei zawh hnuah thawhah, lungphu rang ut ut emaw hmui, lei leh hmai velah vung neih phaha I inhriat chuan a rang thei ang berin hospital/healthcare centre pan la, doctor hrilh vat ṭhin ang che.

Damdawi hi a nihna ang tura hman a nih chuan mihring nunna chhantu leh hrisel lohna laka damna min thlentu pawimawh tak a nih rualin, damdawi hman sual emaw a nih lohna tur leh hman dan tur anga kan hman loh chuan ṭul loa kan taksa tana chhiatna thlentu, ṭul loa sum leh pai sen thlawnna leh nunna hial chan theihna a ni. Fimkhur takin I damdawi hmang ṭhin ang che. Damdawi chungchanga harsatna leh hriat duh I neih reng rengin doctor emaw pharmacist rawn vat ṭhin ang che.

*OTC drugs tih hi doctor prescribe (chawh) ngai loa damdawi dawr (pharmacy)-a lei mai theih damdawi tihna a ni.

- Dr.C. Zothanmawia, Dept. of Pharmacy, RIPANS