Chifukwa chake mankhwalawa amapereka njira zina kwa mankhwala achibadwa a ADHD
Mankhwala ambiri omwe amapezeka kuti athetse vuto la kuchepa kwa matenda (ADHD) monga Adderall kapena Ritalin ndizolimbikitsa, chifukwa chake Strattera, mankhwala osakhudzidwa ndi chikhalidwe, amaonekera.
A FDA avomereza Strattera (atomoxetine) kuti adziwe ADHD kwa akuluakulu ndi ana oposa zaka zisanu ndi chimodzi. Iyi si mankhwala oyamba osakakamiza a ADHD, komabe.
Mankhwala opatsirana pogonana, kuphatikizapo Wellbutrin (bupropion hydrochloride) ndi tricyclics, monga Desipramine ndi Imipramine, akhala akudziŵika kuti ndi mankhwala achiwiri. Nthaŵi zina amagwiritsidwa ntchito pamene zowonjezera ziwiri kapena zambiri sizigwira ntchito, zimatsutsana kapena zimachititsa zotsatira zambiri.
Nthawi zambiri anthu amadandaula kuti matendawa ndi othandiza kwambiri. Ndipo mankhwalawa si a FDA omwe amavomerezedwa kuti adziwe ADHD, kotero kuti malingaliro a Strattera akuti ndi 'mankhwala osamalidwa oyamba omwe ali ovomerezedwa ndi FDA kuti athetse ADHD' ndi oonadi.
Chifukwa Strattera Akuyenderera
Ngakhale kuti anthu ambiri amadziwika kuti ndi otetezeka komanso ogwira mtima, zowonjezera monga Adderall ndi Ritalin akhala ndi mbiri yoipa ndipo makolo ambiri amatsutsana ndi Ritalin ndipo amakayikira kuika ana awo pamtendere. Kotero ngati sizotsutsa, Strattera amagwira ntchito bwanji? Amaganiziridwa kuti ndi 'chiopsezo champhamvu cha presynaptic norepinephrine transporter,' chomwe chimayambitsa norepinephrine yowonjezereka kuti ikhale yowonjezera ndi kulamulira kusakhudzidwa ndi kukhudzidwa.
Monga zolimbikitsa, sizidziwikabe momwe Strattera amagwirira ntchito, komabe.
Kafukufuku wochuluka amasonyeza kuti Strattera ndi yotetezeka komanso yothandiza. Imodzi mwa maphunzirowa, "Atomoxetine ndi Methylphenidate Treatment kwa Ana omwe ali ndi ADHD: Prospective, Randomized, Open-Label Trial," 1 poyerekeza Strattera ndi Ritalin.
Ana awa omwe ali ndi ADHD, 228 mwa onse, analandira Strattera kapena Ritalin kwa masabata khumi, ndipo awo omwe anatenga Strattera adapezeka kuti ali ndi "kuchepa kwa zizindikiro" ndi "tolerability" zomwe zinali zofanana ndi zomwe zinachitikira ndi Ritalin.
Chenjezo la Kudzipha la Strattera
Ngakhale kuti sizinasinthe, a FDA adachenjeza za chiopsezo chowonjezereka cha kudzipha kwa ana ndi achinyamata omwe akuchitidwa ndi Strattera. Mwachindunji, mofanana ndi mankhwala ena ambiri a maganizo, a FDA akuti Strattera 'angawonjezere malingaliro odzipha kapena kudzipha ana ndi achinyamata,' ndi kuti makolo ayenera kutchula dokotala wa mwana wawo ngati mwana wawo ali:
- Maganizo atsopano kapena owonjezeka a kudzipha
- Kusintha mu maganizo kapena khalidwe, kuphatikizapo kukhala okhumudwa kapena odandaula
Chenjezo silikutanthauza kuti mwana wanu sangathe kulembedwa Strattera kapena ayenera kusiya Strattera ngati akuchita ntchito yosamalira zizindikiro zake za ADHD komanso osayambitsa mavuto. M'malo mwake, phindu logwira Strattera liyenera kuyesedwa potsata zoopsa za mankhwala. Ndipo ana omwe amatenga Strattera ayenera 'kuyang'anitsitsa mwakuya, kudzipha kapena makhalidwe osasintha, makamaka m'miyezi yowerengeka yoyamba mankhwala kapena pamene mlingo umasinthidwa.
Popeza sichikudziwika ngati chinthu cholamulidwa, Strattera idzapezeka ndi mankhwala olembedwa nthawi zonse. Izi zikutanthauza kuti madokotala akhoza kuitanira ku pharmacy ndipo akhoza kupereka refills, mosiyana ndi zokakamiza ndi zinthu zina zolamulidwa, zomwe zimafuna kalata yatsopano mwezi uliwonse. Ndipo dokotala wanu wamankhwala adzakhalanso ndi zitsanzo zoti mwana wanu ayesere.
Zofufuza za Strattera
Maphunziro oyambirira a Strattera adasonyeza chimodzi mwa zovuta kwambiri kwa mankhwalawa chifukwa mosiyana ndi zambiri za kamodzi patsiku, zolimbikitsa nthawi yaitali, Strattera wapatsidwa kawiri pa tsiku. Tsiku ndi tsiku dosing yakhala ikuphunziranso, ngakhale, ndipo inasonyeza kuti 'kamodzi tsiku ndi tsiku kachitidwe ka atomoxetine ndi mankhwala othandiza kwa ana ndi achinyamata omwe ali ndi ADHD.'
Ndipo pakalipano, palibe maphunziro omwe adawonetsa kuti Strattera amagwira ntchito bwino kapena alibe zotsatira zochepa kuposa zolimbikitsa. Monga zolimbikitsa, zotsatira za Strattera zikuphatikizapo kusowa chakudya, kunyoza, kusanza, kutopa ndi kukwiya m'mimba. Ndipo ana ambiri ataya miyezi yochepa atangoyambira Strattera. Komabe, zochepa zofufuza za nthawi yaitali, zomwe ana adatenga Strattera kwa chaka chimodzi, adasonyeza kuti ana awa analemera kwambiri ndipo kutalika kwawo kunakula. Popeza kuti kulemera kolemera nthawi zambiri kumakhala kovuta kwa ana kutenga zolimbikitsa, kupeza izi ndi nkhani zabwino ndipo Strattera ikhoza kukhala njira yabwino kwa ana awa.
Komanso, Strattera imagwiritsidwa ntchito mopyolera mu njira ya cytochrome P450 2D6 (CYP 2D6) njira ya chiwindi, choncho n'zotheka kuti pakhale mgwirizano ndi mankhwala ena monga Paxil (paroxetine), Prozac (fluoxetine) ndi quinidine. Wopanga mankhwala amalangizanso kuti azichenjeza popereka mwana onse awiri a albinol (omwe sakhala nawo kawirikawiri) ndi Strattera, kotero mankhwalawa sangakhale abwino kwa ana omwe ali ndi ADHD omwe ali ndi mphumu. Ndipo monga Strattera ikhoza kuonjezera kuthamanga kwa magazi ndi kuthamanga kwa mtima, ziyenera kugwiritsidwa ntchito mosamala kwa ana omwe ali ndi kuthamanga kwa magazi , kuthamanga mtima kwa mtima (tachycardia) kapena matenda a mtima kapena cerebrovascular disease.
Chinthu china chotere ndi chakuti Strattera imapezeka kokha ngati capsule, ndipo mosiyana ndi Adderall XR, yomwe nthawi zambiri imatsegulidwa ndi kukonzedwa pa chakudya, amalangizidwa kuti Strattera yatha.
Choncho ngakhale kukhala ndi chithandizo chatsopano kwa ana omwe ali ndi ADHD ndi uthenga wabwino komanso wokondweretsa, mpaka maphunziro ena apangidwa kuti asonyeze kuti Strattera ndi yotetezeka kapena yogwira mtima kusiyana ndi zolimbikitsa, simukuyenera kuthamangira kuchipatala chanu kuti mukasinthe mankhwala.
Komabe, Strattera ikhoza kukhala yabwino kwambiri kwa ana omwe ali ndi vuto lolemera panthawi yokhala ndi zovuta, amakhala ndi zotsatira zina, kapena ngati zizindikiro zawo za ADHD siziyendetsedwa bwino.
Zotsatira:
Atomoxetine ndi mankhwala a methylphenidate kwa ana omwe ali ndi ADHD: mayesero omwe amayembekezera, otseguka, otseguka. Kratochvil CJ - J Am Amaphunziro a Achinyamata Achinyamata Odwala Psychiatry - 01-Jul-2002; 41 (7): 776-84.
Mankhwala a atomoxetine kamodzi pa tsiku ndi tsiku kwa ana ndi achinyamata omwe amatha kusokoneza matenda osokoneza bongo. Michelson D - Am J Psychiatry - 01-Nov-2002; 159 (11): 1896-901.