Njira ina kwa triptans, koma zotsatira zake zingakhale zochepa
Migraines akupitirizabe kukhala ndi vuto la mitsempha yothetsera ubongo-ngakhale poyambitsa ma triptans , omwe ndi mankhwala omwe amachititsa kuti awonongeke msanga.
Vuto la triptans ndikuti samangogwira ntchito nthawi zonse kwa anthu-opitirira 35 peresenti, malinga ndi deta za sayansi. Komanso, nthawi zina anthu amapewa chifukwa cha zotsatira zovuta, monga chifuwa cholimba, khosi ndi kupweteka kwa minofu, ndi kupweteka komanso kumverera.
Kotero, kodi pali njira ina yoti mutenge triptan kuti mutenge migraine? Pakhoza kukhala chimodzi pambali ndipo chimatchedwa lasmiditan. Mofanana ndi mankhwala aliwonse, komabe, amadzimadzi angakhalenso ndi zochepa zomwe zikufunikiratu kuthetsedwa ndi ochita kafukufuku.
Komabe, kuphunzira za bukuli loletsa anti-migraine mankhwala kumakhala kofunika kwambiri pamene kungakhale ngati njira yabwino kwa inu m'tsogolomu. Kuonjezerapo, ngati zogwira mtima, ziphuphu zimapereka chidziwitso chowonjezereka pa zamoyo pambuyo pa kusokonezeka kwa migraine . Ndipo, makamaka, izo zikanathandiza chiphunzitso cha neural cha migraine choyambirira kusiyana ndi chiphunzitso cha migraine chiyambi.
Kodi Lasmiditan Ali Otetezeka?
Pakalipano, pali magawo awiri a gawo lachiwiri:
Phunzirani Chimodzi
Malinga ndi kafukufuku wotsogoleredwa kawiri kawiri , omwe amachititsa kuti Lancet iphunzire , amayamba kugwira bwino ntchito yochizira matenda osokoneza bongo. Phunziroli, ophunzira adangopatsidwa mankhwala a lipiritsi kapena a piritsi yovuta kwambiri (50mg, 100mg, 200mg, ndi 400mg).
Zotsatira zimasonyeza kuti mlingo uliwonse wamtunduwu umasintha kwambiri kumutu kwa mutu (kutanthauza kuchepa kwa kupweteka kwa migraine mopweteka kapena kupweteka pang'ono) pakatha maola awiri mutatha mutu, poyerekeza ndi placebo.
Ngakhale kuti akulonjeza ngati mankhwala othandiza, vuto la mankhwalawa lingakhale zotsatira zake zokhudzana ndi ubongo, zomwe ambiri omwe adakumana nawo adakumana nazo zapamwamba kwambiri.
Zotsatirapo izi zikuphatikizapo:
Chizungulire
Kutopa
Vertigo (kumverera kwa kupota)
Chisokonezo
Phunziro 2
Phunziro lina lachiwiri la ku Cephalalgia linkayesa machitidwe oyendetsa (IV) a oyimba, omwe amatanthauza kuti anaperekedwa kudzera mu mitsempha. Ophunzirawo anali ndi mutu wopweteka kwambiri wa mutu wa migraine ndipo adalandira mlingo wachinayi wa mankhwala osokoneza bongo kapena mlingo wa placebo kuchipatala.
Zotsatira zinasonyeza kuti pa mlingo wa ma ARV 20mg, kupuma kwa mutu (kutanthauza kuchepetsedwa kwa kupweteka pang'ono kapena palibe pa maola awiri) kunali 64 peresenti ndipo malowa anali 45 peresenti.
Zowononga monga chizungulire, paresthesia, ndi kuvutika kwa thupi (kawirikawiri chiwalo) chinali chofala kwambiri mu gulu losautsa kuposa gulu la placebo (65 peresenti peresenti 43 peresenti).
Kodi Maphunziro Awiri Akutanthauza Chiyani?
Maphunziro onse awiriwa akusonyeza kuti mankhwala osokoneza bongo ndi mankhwala othandiza kuti asamalidwe bwino. Komabe, maphunzirowa amabweretsa mavuto olekerera okhudzana ndi zotsatira. Phunziro lalikulu lachigawo III likufunika kuti athetsere zotsatirazi zamagulu a zamanjenje ngati izi zikhoza kukhala zolepheretsa kugwiritsira ntchito mtsogolo.
Momwe Ntchito Zachilengedwe Zimagwirira Ntchito
Mofanana ndi mankhwala ena a migraine, ndondomeko yeniyeni yomwe ntchito zowopsya sizili bwino.
Izi zati, tikudziwa kuti zimayambitsa maselo ena a serotonin mu ubongo-komanso mu ubongo wa migraineurs, magulu a serotonin apezeka atachepetsedwa.
Triptans , mankhwala achizoloŵezi ochizira migraines ochepa, amamanganso serotonin receptors. Kotero, kodi lasmiditan ikusiyana bwanji ndi triptans? Akatswiri amanena kuti mchitidwe wonyansa umasankha kwambiri kuposa triptans-sichimamatira ku serotonin receptors kuti, atatsegulidwa, amachititsa kuti magazi asokonezeke (zomwe triptans zimachita).
Ndipotu, zotsatirazi zoipa (zotchedwa vasoconstriction) ndizovuta kwambiri kwa triptans ndipo chifukwa chake zimatsutsana ndi anthu omwe ali ndi mbiri ya:
- Matenda a mtima
- Sitiroko
- Matenda a mitsempha
- Kuthamanga kwa magazi komwe sikumayendetsedwa ndi mankhwala
- Mitundu ina ya migraines (mwachitsanzo, hemiplegic migraine ndi basilar migraine)
Komanso, mu maphunziro a zinyama, amitundu anapezeka kuti atseke zizindikiro zomwe zimagwirizanitsidwa ndi magetsi a trigeminal ganglion. Izi zikugwirizana ndi zatsopano zokhudzana ndi "chifukwa" chakumutu kwa mutu wa migraine, chomwe chimapweteka sizomwe zimayambitsa mitsempha yamagazi yozungulira ubongo, koma m'malo mwake amachititsa kuti mitsempha yambiri ikhale yovuta.
Choncho, chilakolako chimayambitsa vuto la mitsempha yambiri ya kupweteka kwa migraine mosiyana ndi mitsempha ya magazi. Izi zikhoza kufotokoza chifukwa chake triptans sizigwira ntchito kwa ena ogwira ntchito.
Zochiritsira Zina Zolimbikitsa
Kuyambira kale kwambiri kuti tidziwe momwe zidzakhalira, koma zosankha zilipo posachedwa, ndipo akusintha njira yomwe timamvetsetsera mmene migraine imakhalira. Mwachitsanzo, pokhapokha pulogalamu ya trigeminal imayambitsidwa pa migraine, zinthu monga peptide zokhudzana ndi majini a calcitonin (CGRP) zimamasulidwa. Izi zimathandizanso kuti mitsempha yambiri iwonjezere ubongo. Mankhwala omwe amaletsa mapuloteni CGRP mwina mwakumangiriza kwachindunji kapena kumangika kumalo ake akukambidwa, ndipo maphunziro oyambirira akulonjeza.
Kuonjezerapo, komanso zosangalatsa kwambiri ndi zipangizo (osati mankhwala) omwe amachititsa mitsempha inayake, monga mitsempha ya vagus kapena mitsempha ya supraorbital. Izi zikhoza kukhala zosankha zabwino kwa anthu omwe sangathe kutenga kapena kulekerera mankhwala omwe akugwiritsidwa ntchito pakamwa. Komabe, akhoza kukhala okwera mtengo komanso inshuwalansi kungakhale vuto.
Mawu Ochokera
Zowonjezereka, chithunzi chachikulu apa n'chakuti chilakolako chowoneka ngati chowopsa chimawoneka bwino mu maphunziro awiri a Gawo II pofuna kuchepetsa ululu wopuma. Koma, ndikofunika kukumbukira kuti maphunziro akuluakulu amafunika ( maphunziro a gawo lachitatu ) kuti athetse zotsatira za mitsempha monga izi zikhoza kukhala zolepheretsa anthu ena. Nkhani yabwino ndi yakuti pali kulembetsa kapena maphunziro opitiliza gawo lachitatu pa nthawi ino.
> Zotsatira:
> Aggarwal M, Puri V, Puri S. Serotonin ndi CGRP ku Migraine. Ann Neurosci . 2012 Apr; 19 (2): 88-94.
> Capi M et al. Lasmiditan pofuna kuchiza migraine. Ofufuza Opin Ofufuza Mankhwala Osokoneza Bongo . 2017 Feb; 26 (2): 227-34.
> Farkkila M et al. Kuchita bwino ndi kulekerera kwa chilakolako chogonana, chamlomo chodziwika bwino cha 5-HT (1F) receptor agonist, chifukwa cha mankhwala ovuta a migraine: gawo lachiwiri lopangidwa ndi malo, lofanana, gulu lophunzirira. Lancet Neurol. 2012 May; 11 (5): 405-13.
> Ferrari MD et al. Kuchepetsa mankhwala a migraine pogwiritsa ntchito 5-HT1F receptor agonist lasmiditan - ndondomeko yowonongeka yowonongeka. Cephalalgia . 2010 Oct; 30 (10): 1170-8.
> Peer C Tfelt-Hansen, Olesen J. Wachiwiri wa 5-HT1F receptor agonist lasmiditan monga njira yothandizira kugwidwa kwa migraine: kubwereza kawiri kawiri kawiri kawiri kawiri. J Mutu wa Mutu . 2012 Jun; 13 (4): 271-75.