Matenda a Arthritis ndi Fibromyalgia Angapangidwe Omwe Amakhala Opatsirana Maganizo
Mwina mungadabwe ngati dokotala wanu akuthandizani kuti munthu azivutika maganizo chifukwa cha ululu wosatha. Kodi izi ndi chifukwa amakhulupirira kuti ndinu ovutika maganizo? Kapena kodi kuthetsa vutoli kumathandiza kupweteka ngakhale kwa anthu omwe alibe zizindikiro za kuvutika maganizo? Tiyeni tiwone zomwe kafukufukuyu akutiuza za udindo wa magulu osiyana siyana a antidepressant pakuchulukitsidwa kwa ululu wosatha.
Kugwirizana Pakati pa Kuvutika Maganizo ndi Kuvutika Kwambiri
Si zachilendo kwa anthu omwe ali ndi matenda aakulu komanso zowawa, monga matenda a nyamakazi , lupus , fibromyalgia , ndi ululu wa m'mimba kuti akhudzidwe. Anthu omwe ali ndi matenda osatha amakhala ndi nthawi yochuluka ya moyo wachisokonezo chachikulu. Mwa kuyankhula kwina, kupweteka ndi kupsinjika maganizo nthawi zambiri zimakhala zovuta (zimayendera limodzi). Ku mbali inayo ya equation, chiwerengero chachikulu cha anthu omwe amapezeka kuti ali ndi vutoli amakhalanso ndi ululu wosatha. Kugwirizana pakati pa kuvutika maganizo ndi ululu wopweteka kumagwira ntchito zonse ziwiri.
Izi zimati, si zachilendo kwa anthu omwe ali ndi ululu wosatha kupatsidwa mankhwala opatsirana pogonana ngakhale alibe zizindikiro za kupsinjika maganizo.
Kulimbana ndi Matenda Ovutika Kwambiri Popanda Kuvutika Maganizo
Ngakhale kuti matenda opatsirana maganizo amatchulidwa kuti apititse patsogolo maganizo a odwala matenda ovutika maganizo pokhudza odwala matenda a ubongo mu ubongo, kupatsirana maganizo kungathenso kuuzidwa ngati chithandizo choyamba cha ululu wosatha, matenda ovutika maganizo, kapena matenda ogona.
Akagwiritsidwa ntchito pofuna kupweteka kosatha cholinga chawo kawirikawiri ndi " zizindikiro za adjuvant ." Izi zikutanthauza kuti iwo amaperekedwa limodzi ndi mankhwala ena opweteka m'malo mogwiritsira ntchito okha ngati mankhwala opweteka. (Phunzirani zambiri za mankhwala asanu apamwamba othetsera ululu wosatha .)
Njira yeniyeni imene anti-depressing imawathandiza kuchepetsa ululu makamaka sadziwa, ngakhale zikuwoneka kuti njira yomwe amathandizira kupweteka kosatha kungakhale yosagwirizana ndi njira zomwe zimachepetsa kuvutika maganizo.
Kawirikawiri amaganiza kuti odwala matendawa amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda komanso norepinephrine . Mankhwala opatsirana pogonana angagwiritsenso ntchito histamine receptors kapena ma sodium.
Maphunziro a Antidepressants
Pali magulu osiyanasiyana a antidepressants omwe adayesedwa kwa anthu omwe ali ndi ululu wosatha komanso njira yomwe ntchito yothetsera vutoli imakhala yosiyana ndi ina. Mankhwala omwe adaphunziridwa ndi awa:
- Tricyclic zowonongeka
- Kusankha serotonin reuptake inhibitors (SSRIs)
- Serotonin ndi norepinephrine reuptake inhibitors (SNRIs)
- Norepinephrine ndi dopamine reuptake inhibitors (NDRIs)
- Kuphatikizapo reuptake inhibitors ndi receptor blockers
- Monoamine oxidase inhibitors (MAO inhibitors)
Tiyeni tione mbali iliyonse ya makalasiwa padera.
Tricyclic Oponderezedwa
Mankhwala opatsirana pogwiritsa ntchito Tricyclic ankaonedwa ngati njira yabwino yothandizira kuvutika maganizo pamaso pa SSRIs. Ngakhale kuti mankhwalawa sagwiritsidwa ntchito mobwerezabwereza chifukwa cha kupsinjika maganizo, ndiwo mtundu wambiri wodzitetezera womwe umagwiritsidwa ntchito pa ululu wosatha. Zikuwoneka kuti zimagwira bwino ntchito yoyendetsa ululu wam'mimba koma zimagwiritsidwa ntchito pa ululu uliwonse.
Mankhwala osokoneza bongo omwe amadziwika kuti tricyclic anti-depressants ndi awa:
- Elavil (amitriptyline)
- Ascendin (amoxapine)
- Anafranil (clomipramine)
- Pamelor (nortriptyline)
- Norpramin (desipramine)
- Tofranil (imipramine)
- Vivactil (protriptyline)
- Surmontil (trimipramine)
- Sinequan (doxepin)
Pamene tricyclic anti-depressants (makamaka amitriptyline) imagwiritsidwa ntchito pozunzika kwanthawi yaitali, kaŵirikaŵiri amaperekedwa mochepetsa kwambiri kuposa omwe amagwiritsidwa ntchito kuvutika maganizo, motero amakhala ndi zotsatira zochepa. Zotsatira zoyipa zimaphatikizapo kuwona masomphenya, kulemera, ndi kugona.
Serveonin Reuptake Inhibitors (SSRIs)
Kusankha serotonin reuptake inhibitors (SSRIs) ndi ena mwa omwe amadzitetezera kwambiri chifukwa chovutika maganizo ndi nkhawa.
Mankhwalawa m'gulu ili ndi awa:
- Prozac (fluoxetine)
- Lexapro (escitalopram)
- Luvox (fluvoxamine)
- Celexa (citalopram)
- Zoloft (sertraline)
- Paxil (paroxetine)
Monga momwe dzina limatanthawuzira, SSRIs imayang'ana khungu la brain (serphenic) serotonin ndipo cholinga chake ndi kuwonjezera ma serotonin mu ubongo. SSRIs ndi mankhwala othandiza kwa odwala ambiri komanso zotsatira zake zimakhala zochepa komanso zolekerera kuposa zomwe zimagwirizanitsidwa ndi tricyclic anti-depressants.
Kafukufuku akuyang'ana kugwiritsa ntchito SSRIs kupweteka kosalekeza popanda kupanikizika amapeza kuti mankhwalawa amakhala ndi zotsatira zowawa zambiri, koma kufufuza kwina kumafunikira.
Serotonin ndi Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin ndi norepinephrine reuptake inhibitors (SNRIs) amagwiritsa ntchito serotonin ndi neorepinephrine komanso zimagwiridwa kuti ndi ziwalo ziwiri.
Ma SSRIs ndi SNRI amathandiza kuchepetsa kupweteka ndi kutopa komwe kumayenderana ndi matenda aakulu kapena fibromyalgia, koma SNRIs ikhoza kukhala yochuluka kuposa SSRIs mwa kupumula kwa ululu.
Mankhwalawa m'gulu ili ndi awa:
- Cymbalta (duloxetine)
- Effexor (venlafaxine)
- Pristiq (desvenlafaxine)
- Savella (milnacipran)
Cymbalta inavomerezedwa ndi a FDA kuti azitsatira matenda a fibromyalgia mu 2008 ndi mankhwala opweteka a minofu mu 2010.
Zotsatira zofanana zomwe zimagwirizanitsidwa ndi SNRI zimaphatikizapo kunyoza, kusowa kwa njala, nkhawa, mutu, kusowa tulo, ndi kutopa.
Norepinephrine ndi Dopamine Reuptake Inhibitors (NDRIs)
NDR ndi mtundu wina wodzitetezera, wokhala ndi bupropion (Wellbutrin kapena Zyban) mankhwala aakulu mu kalasi iyi.
Zotsatira zoyipa zimaphatikizapo kukhumudwa, kupwetekedwa mtima, kupweteka mutu, kusowa kwa njala, kusowa tulo, ndi kuwonjezeka kwa magazi.
Kuphatikizapo Reuptake Inhibitors ndi Receptor Blockers
Kuphatikizidwa ndi reuptake Inhibitors ndi receptor blockers angagwiritsidwe ntchito kuvutika maganizo, kugona, kapena kupweteka kosalekeza kolembapo ndikuphatikizapo:
- Desyrel ( trazodone )
- Remeron (mirtazapine)
- Serzone (nefazodone)
Zotsatira zofanana zimaphatikizapo kugona, kuuma mkamwa, kunyowa, ndi chizungulire, ndipo mankhwalawa sayenera kugwiritsidwa ntchito ndi anthu omwe ali ndi mbiri ya mavuto a chiwindi.
Monoamine Oxidase Inhibitors (MAO Inhibitors)
MAO Inhibitors ndi achikulire omwe amatetezedwa kwambiri omwe sagwiritsidwe ntchito kwambiri kuti athetse kuvutika maganizo kapena zochitika zina chifukwa cha mbiri yotsatira.
- Nardil (phenelzine)
- Parnate (tranylcypromine)
- Marplan (isocarboxazid)
- Emsam (selegilint)
Pali zakudya zambiri zomwe anthu amadya mankhwalawa komanso zotsatira zake zimakhala zofala.
Kafukufuku Wogwiritsira Ntchito Matenda Opatsirana Opatsirana
Kafufuzidwe kafukufuku wapindula ndi kugwiritsa ntchito mankhwala opatsirana pogonana poyang'anira ululu wopitirira kwa akuluakulu, makamaka amitriptyline. Mwamwayi, pali zambiri zochepa zomwe zimagwiritsidwa ntchito pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito ululu wosakhudzana ndi khansa kwa ana kapena achinyamata.
Mankhwala Ovomerezedwa kwa Mavuto Osautsa Ndi Ogwiritsa Ntchito
Poyankhula za kugwiritsira ntchito mankhwala opatsirana pogwiritsa ntchito ululu wopweteka, ndikofunika kusiyanitsa mankhwala omwe amavomerezedwa kuti agwiritsidwe ntchito pamagwiritsidwe ntchito omwe akugwiritsidwa ntchito. Pamene mankhwala ali ndi FDA ovomerezedwa kuti agwiritse ntchito makamaka amatanthauza kuti FDA yasanthula maphunzirowo ndipo yapeza kuti mankhwalawa akhoza kukhala othandiza komanso otetezeka. Kugwiritsira ntchito mankhwala , komabe, amatanthauza mankhwala omwe FDA amavomereza kuti akhale ndi vuto limodzi (mwachitsanzo apa, kupanikizika) koma angagwiritsidwe ntchito pazifukwa zina (mwachitsanzo, kupweteka kosatha.)
Machenjezo okhudza kugwiritsa ntchito antidepressants
Kugwiritsira ntchito mankhwala opatsirana pogonana kulibe machenjezo. The FDA imanena kuti akuluakulu makamaka ana ayenera kuonedwa kuwonjezeka maganizo kapena kudzipha kapena kudzipha m'miyezi ingapo yoyamba mankhwala kapena kusintha kusintha mankhwala. Anthu ayenera kukaonana ndi dokotala nthawi yomweyo ngati kuvutika maganizo kumawonjezereka kapena ngati kuwonjezereka maganizo kapena khalidwe likuwonjezeka. Ndikofunikanso kwa iwo omwe amadwala matendawa kuti adziŵe zifukwa zoopsya ndi zizindikiro za kudzipha.
Mfundo Yofunika Kugwiritsa Ntchito Antidepressants for Chronic Pain
Kudetsa nkhaŵa kungathandize anthu kuthana ndi ululu wosatha mwa njira zambiri. Anthu ambiri okhala ndi fibromyalgia kapena matenda ena aakulu amadwala matenda ovutika maganizo. Komabe matenda ena opatsirana pogonana angathandize munthu kupweteka kosatha mwa njira zosiyanasiyana. M'magulu osiyanasiyana a antidepressants, tricyclic anti-depressants, makamaka amitriptyline, adayesedwa bwino kwambiri, makamaka pofuna kuchiza ululu wa m'mimba.
Kulimbana ndi ululu wosatha ndi kovuta, ndipo kumakhudza mbali iliyonse ya moyo wanu. Kusakaniza mankhwala osiyanasiyana (monga kuwonjezerapo mankhwala olepheretsa) kungakhale kopindulitsa kwambiri, koma mankhwala osagwiritsidwa ntchito ndi mankhwala ndizofunikira kwambiri.
> Zotsatira:
> Chou, R., Devo, R., Friedly, J. et al. Mankhwala Opatsirana Othandizira Odwala Pafupipafupi Pafupipafupi: Kusanthula Kwambiri kwa American College of Physicians Guide Clinic Practice Guideline. Annals of Internal Medicine . 2017. 166 (7): 480-492.
> Cooper, T., Heathcote, L., Clinch, J. et al. Matenda olepheretsa matenda osaphatikizapo khansa kwa ana ndi achinyamata. Dongosolo la Cochrane la Zosintha Zogwirizana . 2017. 8: CD012535.
> Dosenovic, S., Jelicic Kadic, A., Miljanovic, M. et al. Zomwe Mungachite Kuti Mukhale ndi Mtima Wokhudzana ndi Matenda Okhudza Mtima Anesthesia ndi Analgesia . 2017. 125 (2): 643-652.
> Patetsos, E., ndi E. Horjales-Araujo. Kuchiza Mavuto Osautsa ndi SSRIs: Kodi Timadziwa Chiyani? . Ululu Wofufuza ndi Utsogoleri . 2016. 2016: 2020915.