Dokotala Wathu Wovomerezeka wa FDA Wachiwiri
Cymbalta (duloxetine) ndi FDA-yovomerezeka ku fibromyalgia , kuvutika maganizo, matenda a shuga, ndi kumva ululu wamisala.
Chivomerezo chake cha 2008 chinayambitsa mankhwala ovomerezeka ochizira fibromyalgia. Fomu yachibadwa imapezeka ku US
Cymbalta ndi mankhwala ena ovomerezeka, Lyrica (pregabalin) ndi Savella (milnacipran) , amaonedwa kuti ndi mankhwala oyamba a fibromyalgia.
Izi zikutanthauza kuti akulimbikitsidwa pamaso pa mankhwala ena onse. Amagwira ntchito bwino kwa ena koma osati kwa aliyense. Kwa anthu ena, amachititsa zotsatira zoyipa zomwe ziri zoopsa kapena zosasangalatsa kuti anthu apite. Kwa ena, sizingagwire ntchito bwino kwambiri.
(Izi sizodziwika ndi Cymbalta. Palibe mankhwala omwe amathandiza tonsefe ndi matendawa.)
Kodi Cymbalta Imachita Chiyani?
Cymbalta imadziwika ngati SNRI kapena serotonin norepinephrine reuptake inhibitor. Zimatanthauza chiyani?
Serotonin ndi norepinephrine ndi opaleshoni ya ubongo (mankhwala amtundu wanu mu ubongo.) Serotonin akukhudzidwa ndi kugona ndi kupweteka. Norepinephrine imakuthandizani kuti mukhale omasuka komanso okondweretsedwa komanso kuti muzichita nawo chidwi pamtima.
Ambiri amakhulupirira kuti matendawa amatha kuwonongedwa mu fibromyalgia, kutanthauza kuti tilibe zokwanira kapena zomwe tili nazo sizigwiritsidwa ntchito bwino ndi ubongo wathu. Njira iliyonse, tingagwiritse ntchito zambiri.
Cymbalta ndi SNRI zina siziwonjezera serotonin ndi norepinephrine ku ubongo wathu, koma zimapangitsa kuti zikhalepo kwa nthawi yaitali, zomwe zimakhala ndi zotsatira zofanana ndi kuwonjezerapo. Kuti achite zimenezo, amachepetsanso njira yotchedwa reuptake yomwe maselo apadera a ubongo wanu amachotsa ntchito serotonin ndi norepinephrine atagwiritsidwa ntchito kutumiza mauthenga kuchokera ku neuron kupita ku wina.
(Ziri ngati neurotransmitter ndi envelopu yomwe yatsala itagona pozungulira mutatsegula makalata anu.) Kusunga khungu lanu nthawi yaitali kumapangitsa ubongo wanu kugwiritsira ntchito bwino.
Chithunzithunzi cha Fibromyalgia
Mayesero ambiri am'chipatala amasonyeza kuti Cymbalta ikhoza kuchepetsa kupweteka kwa fibromyalgia, zonse ndi popanda kupweteka kwa comorbid. Kafukufuku akuwonetsanso kuti mankhwalawa akupitirizabe kugwira ntchito kwa chaka chimodzi.
Ochita kafukufuku samvetsetsa momwe mankhwalawa amagwirira ntchito. Komabe, phunziro la 2015 (Wang) limasonyeza kuti kumachepetsanso zizindikiro zopweteka zomwe zimabwera chifukwa cha mitsempha ya mitsempha (ubongo wa m'mimba). Chiphunzitso chimodzi cha ululu wa fibromyalgia ndi chakuti umakhala ndi matenda a ubongo m'mitsempha yaing'ono pafupi ndi khungu lanu. Ngati ndi zoona, zikhoza kukhala chifukwa chake Cymbalta nthawi zambiri imakhala yovuta polimbana ndi ululu wathu.
Mu phunziroli, Cymbalta inawoneka kuti athetse mitundu iwiri ya ululu yomwe imakhala ya fibromyalgia: hyperalgesia ndi allodynia. Hyperalgesia ndi chimene "chimatembenuza voliyumu" ya ululu wathu, pamene kuvuta kwapweteka kwa zinthu zomwe sizimabweretsa ululu, monga kupweteka kwapang'onopang'ono.
Mlingo
Mlingo wa Cymbalta womwe umalimbikitsidwa ndi 60 mg, watengedwa kamodzi pa tsiku. Nthawi zambiri amayamba 30 mg pa tsiku ndikuwonjezeka kufika 60 mg patatha pafupifupi sabata.
Mankhwala apamwamba kwambiri kuposa awa sakhulupirira kuti ndi othandiza kwambiri ku fibromyalgia, ndipo amakhala ogwirizana kwambiri.
Anthu amene akufuna kusiya kumwa mankhwalawa ayenera kuyankhula ndi dokotala wawo za njira yoyenera kuchotsera pang'onopang'ono; kusiya mwadzidzidzi n'koopsa. Dokotala wanu akhoza kukuthandizani kuchepetsa zizindikiro za kuchotsedwa.
Zotsatira Zotsatira
Cymbalta imagwirizanitsidwa ndi zotsatira zambiri zovuta. Zomwe muyenera kulengeza kwa dokotala nthawi yomweyo ndizo:
- Zomwe zimayambitsa matenda (kuthamanga, kuyabwa kapena ming'oma, kutupa kwa nkhope, milomo kapena lirime),
- Kuponderezedwa kwa magazi kumasintha,
- Kusokonezeka,
- Chizungu ndi / kapena kutayika,
- Kulankhula mofulumira, kukhudzidwa mtima, kapena zochita zodziletsa,
- Kufulumira, kuphwanya mtima kwapadera,
- Fever,
- Zilumikizidwe kapena kutaya kukhudzana ndi zenizeni,
- Kugonjetsa,
- Kutsekula m'mimba, kusanza,
- Maganizo odzipha kapena maganizo ena amasintha,
- Mtsinje wakuda,
- Kutuluka mwachilendo kapena kuvulaza.
Zotsatira za Cymbalta zomwe sizikusowa chithandizo chamankhwala ndi izi:
- Masomphenya obisika,
- Zosintha kusintha,
- Kusintha kwa kugonana kapena kugwira ntchito,
- Mutu,
- Kuwonjezeka thukuta,
- Nausea.
Kodi Cymbalta Ndi Yofunika Kwambiri?
Ngati mukufuna kuyesa Cymbalta, lankhulani ndi dokotala wanu. Onetsetsani kuti mumayang'anitsitsa zowonjezera ndi zovuta ndikuyang'aniranso zomwe zingakhale zovuta kuti muthane ndi mankhwala ena omwe mumakhala nawo.
Ndilo lingaliro labwino, ndi mankhwala aliwonse, kuti mukhale ndi mndandanda wa zotsatira zotheka zowonjezeka. Mutha kuwalola anthu kuti adziŵe za zotsatira zoyipa, monga kukhumudwa, kutaya kukhudzana ndi zenizeni, kapena malingaliro odzipha, kuti adziwe zomwe zikuchitika, mwinamwake.
Zotsatira:
Arnold LM, ndi al The Clinic journal of pain. 2009 Jul-Aug; 25 (6): 461-8. Kuyerekeza kwa mphamvu ndi chitetezo cha duloxetine pofuna kuchiza fibromyalgia kwa odwala omwe amatsutsana popanda vuto lalikulu lachisokonezo.
Choy EH, ndi al Clinical rheumatology. 2009 Sep; 28 (9): 1035-44. Doloxetine ndi zotetezeka komanso zolekerera pochiza odwala omwe ali ndi fibromyalgia: kufotokozera deta kuchokera ku mayesero asanu.
Hauser W, et al. Kufufuza kwa nyamakazi ndi mankhwala. 2014 Jan 17; 16 (1): 201. Kupenda kwa mankhwala opatsirana mankhwala m'thupi la fibromyalgia.
NIH Publications NO. 04-5326
Uceyler N, et al. Ubongo. 2013 Jun; 136 (Pt 6): 1857-67. Matenda aang'ono omwe ali ndi matenda a fibromyalgia.
Wang CF, ndi al. Anesthesia ndi analgesia. 2015 Aug; 121 (2): 532-44. Zochitika za m'deralo ndi zowonongeka za duloxetine mu chipatala ndi hyperalgesia pogwiritsa ntchito khungu lopweteka khungu la khungu.