Malangizo ochokera kwa AHS / AAN
Kusunga mutu wa mutu ndi chinthu chomwe ambiri mwa ife timachita kuti tigwiritse ntchito migraine yoyambitsa. Pofufuza mosamala ndi kupeŵa zovuta zathu, tikuyembekeza kuteteza kusokonezeka kwa migraine. Komabe, tiyeni tiyesetse kunena momveka bwino, ngakhale kuti tipewe kupeweratu, ambiri ogwiritsira ntchito migraineurs akufunikiranso mankhwala tsiku ndi tsiku kuti ateteze kupweteka kwa mutu.
Kodi Migraine Preventive Medication ndi Chiyani?
Mankhwala othandiza amatengedwa tsiku ndi tsiku kuti athe kuchepetsa chiwerengero, kuuma, komanso kutha kwa migraine, komanso kuchepetsa kufooka kumene kumabwera chifukwa cha mutu. Amagwiritsidwa ntchito mobwerezabwereza kwa anthu omwe ali ndi matenda achilendo , koma amatha kugwiritsidwanso ntchito kwa odwala matenda osokoneza bongo .
Zitsanzo za zizindikiro zomwe zingakhalepo (kupatulapo migraine yosachiritsika) zothandizira mankhwalawa ndizo: kusagwirizana ndi mankhwala ochotsa mimba ndi / kapena khalidwe lopanda moyo kapena kugwira ntchito tsiku ndi tsiku. Mitundu yambiri ya migraine monga hemiplegic migraine kapena basilar migraine ingakhalenso chizindikiro cha mankhwala othandiza.
Bungwe la American Headache Society (AHS) ndi American Academy of Neurology (AAN) linakhazikitsa malangizo pa mankhwala omwe amalimbikitsa kuti athe kupewa matenda a episodic migraine omwe samapezekapo masiku 15 pa mwezi. Komabe, mankhwala ambiri omwewa amagwiritsidwa ntchito pofuna kupewa anthu omwe ali ndi matenda osapatsirana.
Njira zochiritsira zothandizira migraine.
- Antihypertensives (kuthamanga kwa magazi)
- Kudetsa nkhaŵa
- Anticonvulsants
- Petasites (Butterbur)
Kupanikizika kwa Magazi Mankhwala Ochepetsa Kupewera Migraines
Mitundu ingapo ya mankhwala imagwiritsidwa ntchito popewera migraine. Omwe amatsitsa magazi , makamaka beta-blockers, amagwiritsidwa ntchito kwambiri.
AHS / AAN yatsimikiza kuti metoprolol, propranolol, ndi timolol ndizitsulo A mankhwala. Izi zikutanthauza kuti iwo amawoneka kuti ndi othandiza kuti asagwiritsidwe ntchito ndi migraine, pomwe atenolol ndi mankhwala a Nambala B kapena "mwinamwake ogwira ntchito."
Beta-blockers ayenera kugwiritsidwa ntchito mosamala kwa iwo omwe ali ndi chifuwa cha shuga ndi shuga ndipo amatsutsana kwambiri ndi iwo omwe ali ndi chidziwitso cha mtima (kutsika kwa mtima). Zotsatira zina za beta blockers zimaphatikizapo kutaya mtima, kutopa, ndi kuwonongeka kwa erectile.
Mankhwala ena a magazi omwe amapezeka ngati timeneti, timene timagwiritsira ntchito calcium , nthawi zina amagwiritsidwa ntchito popewera migraines, ngakhale umboni wa sayansi suli wamphamvu ngati wa beta-blockers. Malamulo a AHS / AAN 2012 adatanthauzira verapamil ngati mankhwala "U", kutanthauza kuti "deta yosakwanira yosamalira kapena kukana kugwiritsa ntchito migraine prophylaxis." Mankhwala ophera antihypertensives lisinopril ndi candesartan (omwe amadziwika kuti ACE inhibitors) adagawidwa monga mankhwala a C level C AHS / AAN, zomwe zikutanthauza kuti "ndizotheka" pogwiritsa ntchito phunziro limodzi.
Kudetsa nkhaŵa Kumateteza Migraines Amasowa
Mankhwala opatsirana pogonana, makamaka amitriptyline ndi venlafaxine, amaonedwa kuti ndi Mzere B mankhwala ("mwina ogwira mtima") kuti asatengeke. Venlafaxine (Effexor) ndi serotonin-norepinephrine yobwezeretsa kachilombo koyambitsa.
Amitriptyline (Elavil) ndi wodwala kwambiri wotchedwa tricyclic wodetsa nkhaŵa womwe umagwira ntchito poletsa kubwezeretsa kwa odwala awiri a ubongo mu ubongo, serotonin ndi norepinephrine. Ndi mankhwala ozunguza bedi ndipo nthawi zambiri amatengedwa pakagona.
Amitriptyline imatetezeranso acetylcholine receptors ndi histamine receptors mu ubongo, zomwe zimayambitsa zotsatira zoyipa za anticholinergic ngati mkamwa wouma, kudzimbidwa, ndi kusungidwa kwa mkodzo. Ikhozanso kuyambitsa kulemera ndi kusokonezeka. Pomaliza, amitriptyline akhoza kukhala ndi zotsatira zoyipa monga kuperewera kwa mtima, choncho tiyenera kupewa anthu omwe ali ndi matenda a mtima.
Anticonvulsants Kuteteza Migraines Azimaso
Ponena za anticonvulsants , American Academy of Neurology inanena kuti mankhwala a valproate, divalproex sodium, ndi sodium valproate, komanso topiramate (topamax) ndi othandiza (Mzere A mankhwala) poletsa migraines. Zotsatira za topiramate zikuphatikizapo
- kulemera
- kutopa
- chizungulire
- paresthesias
- kusokonezeka maganizo
- kusintha kwa kulawa.
Zotsatirapo za mankhwala a valproate ndi monga: kulemera kwapweteka, kunyowa, kunjenjemera, ndi kutayika tsitsi.
Butterbur ndi Mankhwala Ena Kuti Apewe Migraine Yoposera
Petasites (butterbur) ndi mlingo wina wa mankhwala wogwira ntchito popewera migraine. Awa ndi mankhwala omwe amamwa mankhwala kapena mankhwala omwe amachotsedwa kawiri tsiku ndi tsiku. Mbali yaikulu ya zotsatira ndi yofatsa GI kukwiya, makamaka burping.
Mankhwala ena a B-level kapena mankhwala omwe ndi "ogwira ntchito" pofuna kuchepetsa migraine, monga momwe amanenera ndi American Headache Society ndi American Academy of Neurology zikuphatikizapo:
- Njira Zochiritsira Zosiyanasiyana : feverfew, magnesium, ndi riboflavin
- NSAID zina (ibuprofen, naproxen)
- Zina za triptans (naratriptan, zolmitriptan): Chonde onani , izi zikusonyezedwa chifukwa cha kusamba kwa migraines .
Mfundo Yofunika Kwambiri
Nthawi zina mankhwala amathandiza kuchepetsa chiwerengero, kuuma, kutalika, ndi kulemala komwe kumagwirizana ndi migraines. Malinga ndi akatswiri, akatswiri otchedwa beta-blockers (metoprolol, timolol, propanolol), anticonvulsants (valproate products, topiramate), komanso mankhwala a zitsamba zotchedwa butterbur adakhazikitsidwa monga Mzere A kapena "ogwira ntchito" ngati mankhwala othandiza kuti asamamve mankhwalawa.
Ngati muwona kuti migraine yanu ikukhudzidwa kwambiri ndi ntchito yanu ya tsiku ndi tsiku kapena khalidwe lanu labwino, kambiranani ndi dokotala zokhudzana ndi zomwe mungachite komanso kuopsa koyambitsa mankhwala othandizira a migraine - zikhoza kukhala zomwe mumasowa kanthawi mpaka mutha kudziwa kuti migraine yayamba kapena Pezani njira ina yothetsera.
Zotsatira:
Bajwa Z, Sabahat A. Kuteteza matenda a migraine kwa akuluakulu. Mu: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites hybridus mizu (butterbur) ndi mankhwala othandiza kuthandizira migraine. Neurology . 2004 Dec 28; 63 (12): 2240-4.
Loder E, Burch R, Rizzoli P. Zotsatira za 2012 AHS / AAN zothandizira kupewa matenda a episodic migraine: mwachidule ndi kufanana ndi njira zina zamakono zothandiza kuchipatala. Mutu . 2012; 52: 930-45 .
Podrid P. Zotsatira zoyipa za beta blockers.In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Silberstein SD, Holland S, Freitag F, et al. Zolemba zowonjezera zowonjezera: mankhwala osokoneza bongo omwe amachititsa kuti anthu achikulire azipewa matendawa: lipoti la Quality Standards Subcommittee ya American Academy of Neurology ndi American Society Headache. Neurology 2012; 78: 1337.
KUDZIZIRANI: Zomwe zili pa tsamba ili ndi zolinga za maphunziro okha. Sitiyenera kugwiritsidwa ntchito ngati choloweza m'malo mwa chisamaliro cha munthu wodwala wovomerezeka. Chonde funsani dokotala wanu kuti apeze matenda ndi chithandizo cha chilichonse chokhudza zizindikiro kapena matenda .