Vuto lomwe anthu ambiri amagwiritsa ntchito mu matenda a Parkinson limafuna kuganiza mozama
Levodopa ndi mankhwala "a golide" a matenda a Parkinson, omwe amatanthauza kuti ndi mankhwala opindulitsa kwambiri. Zimagwira ntchito potembenuzidwa kukhala dopamine, zomwe zimathandiza munthu kusunthira ndi kuyendetsa minofu yawo.
Koma mwatsoka, chifukwa cha kuchuluka kwa anthu, monga Parkinson ikupita, levodopa sichigwira ntchito komanso kuthetsa zizindikiro za munthu.
Izi ndi chifukwa, patapita nthawi, levodopa imayamba kuvutukuka mofulumira, kuyambitsa mankhwala "zowonongeka."
Ndibwino kuti, mutatenga mankhwala ngati levodopa nthawi zonse, musamazindikire kusiyana kwakukulu pakati pa zizindikiro zanu pakati pa mlingo. M'mawu ena, zizindikiro zanu ziyenera kukhalabe nthawi zonse, mosasamala kanthu kuti mudatenga mankhwala anu nthawi yanji.
Komabe, pamene choyamba chikuyamba mu matenda a Parkinson, mumamva bwino ("pa") monga mankhwala atsopano a mankhwala anu ayamba kugwira ntchito, ndipo poipa ("kusiya") musanayambe kumwa mankhwala ena . Potsirizira pake, nthawi ya "on" imakhala yochepa ndipo kuvala "kuchoka" kumachitika posachedwa (posachedwa kwa mlingo wina wa levodopa).
Momwe Maonekedwe a Pentiomenon a Parkinson Alili
Akatswiri ena adanena za "pa" nthawi kuti ayambe kuunika, ndipo nthawi "yotsala" pamene magetsi akuchoka.
Mu "pa" boma, munthu yemwe ali ndi matenda a Parkinson akhoza kumva kuti ali ndi mphamvu komanso amatha kuyenda mosavuta. Komabe, mu "chikhalidwe", munthuyo akhoza kukhala wolimba kwambiri, wochedwa, ndipo mwina sangathe kusuntha konse kwa mphindi zingapo. Mwinanso munthu akhoza kuvutika kulankhula, ndipo mukhoza kumuwona akukweza mawu awo.
Monga momwe mungaganizire, chikhalidwe cha "off" chikhoza kukhala chosasangalatsa.
Kusamalira Phenomenon Yotsitsimula ku Parkinson
Kwa anthu ena omwe ali ndi matenda a Parkinson, kusintha kwakukulu kwa "kuchoka" kumakhala kosayembekezereka. Amadziwa kuti zotsatira za levodopa zidzatha patapita maola atatu, kotero iwo akhoza kukonzekera molingana.
Kwa anthu ena, mwatsoka, kusintha kwa "kuchoka" sikungatheke, ndipo izi, ndithudi, ndizoopsa kwambiri. Palibe amene amadziwa chifukwa chake kusinthasintha sikungakwaniritsidwe nthawi zina.
Izi zati, pali zinthu zingapo zomwe mungachite mukakhala mukuyambe kukumana ndi zochitikazo.
Kwa anthu ena, kusinthasintha kwa magalimoto kumawoneka kuti akuyankhidwa ndi mitundu yowonongeka ya levodopa (yotchedwa Sinemet CR). Komabe, levodopa yoyenera kutulutsidwa sikugwira ntchito kwa aliyense ndipo mwatsoka, zingayambitse zizindikiro zina.
Mmalo mosintha mtundu wina wa levodopa, dokotala wanu akhoza kuchepetsa nthawi pakati pa mankhwala a levodopa pafupi mphindi 30 mpaka 60 (makamaka Parkinson yapamwamba).
Mwinanso, dokotala angakulimbikitseni kuwonjezera mankhwala. Dopamine agonists, akawonjezeredwa ku levodopa, akhoza kuchepetsa nthawi yomwe mumagwiritsa ntchito "kusiya," koma amakhala ndi chiopsezo cha zotsatira zoyipa monga kuwonetsa maonekedwe ndi makhalidwe okhwima.
COMT inhibitors ngati Comtan (entacapone) ikhoza kupitirira ndi kupititsa patsogolo zotsatira za levodopa koma zikhoza kuonjezera zotsatira zake.
Potsirizira pake, powonjezedwa ku levodopa, MAO-B inhibitors angathandize (ngakhale ndi zotsatira). Ma-B-inhibitors amagwira ntchito poletsa ma enzyme omwe amachititsa kuti dopamine mu ubongo.
Pa matenda a Parkinson, ubongo wamatumbo wa levodopa ukhoza kukhala wowothandiza, ndipo muzigawo zoopsa za mankhwalawa, mankhwala osokoneza bongo otchedwa apokyn (apomorphine hydrochloride) angakhale othandiza.
Mawu Ochokera
Chochitika chotsutsana ndi vuto lalikulu pochiza matenda a Parkinson, ndipo pamene anthu ena angazindikire molawirira kumayambiriro kwa levodopa, amadziwa zambiri mkati mwa zaka zitatu kapena zisanu.
Ngakhale pali njira zosiyanasiyana zolimbana ndi zovutazi, phindu lanu ndi kukambirana zomwe mungachite ndi dokotala wanu. Zosowa zanu payekha zingakhale zogwirizana ndi njira imodzi kapena mankhwala motsutsana ndi wina-zomwe zimapindulitsa kuti musakhale wabwino kwa wina.
> Zotsatira:
> Fasano A et al. Intrajejunal levodopa kulowetsedwa m'matenda apamwamba a Parkinson: zotsatira za nthawi yayitali pamagalimoto komanso osakhala ndi magalimoto ndipo zimakhudza moyo wa wodwala ndi wosamalira. European Review for Scientific and Medical Sciences. 2012 Jan; 16 (1): 79-89.
> Martinez-Martin P et al. EuroInf: zowerengera zambiri zowerengera za apomorphine ndi levodopa kulowetsedwa mu matenda a Parkinson. Kusokonezeka kwa Movement. 2015 Apr; 30 (4): 510-6.
> Pahwa R, Lyons KE. Kuvala kwa Levodopa mu matenda a Parkinson: kudziwika ndi kusamalira. Sakanizani Op Op . 2009 Apr; 25 (4): 841-9.
> Stocchi F, Jenner P, Oso JA. Kodi levodopa zimasintha liti ku matenda a Parkinson? Eur Neurol . 2010; 63 (5): 257-66.
> Tarsy D. (2017). Kuyenda kwa magalimoto ndi dyskinesia mu matenda a Parkinson. Kukhumudwitsa HI, ed. Zaposachedwa. Waltham, MA: UpToDate Inc.