Ulwazi kunye neMpembelelo yeCandelo le-MAOI
I-Monoamine oxidase inhibitors yinkalo yezidandlululo eziye zaphuhliswa ngawo-1950. Ziyimpumelelo ekuphatheni ukudakumba , ukuphazamiseka kwesifo kunye nezinye iingxaki zokuxhalabisa . Nangona ngokubanzi zisebenza ngendlela efanelekileyo njenge-serotonin reuptake inhibitors (SSRI) kunye ne- tricyclic antidepressants (TCAs), zisetyenziswe kangangoko ngenxa yokutya okufunekayo kunye neengozi zempendulo ezimbi xa zixutywe neziyobisi ezithile.
Imizekelo ye-MAOI iquka:
- IPhenelzine (nardil)
- I-Tranylcypromine (isiqhelo)
- Isocarboxazid (marplan)
- Selegiline (emsam)
I-Emsam i-podermal (isikhumba) esicatshulwa esisetyenziswayo kanye ngosuku. Le ndlela yokulawula ingaba yinto encinci yokubangela iingxaki zokutya ezinxulumene nomzila womlomo wokulawula.
I-MAOIs isebenza njani
Kukholelwa ukuba ingqondo iqulethe iindidi eziliqela ezihlukeneyo zezithunywa zamakhemikhali (i- neurotransmitters ) ezisebenza njengama- intsebenziswano oonxibelelwano phakathi kweeseli ezahlukeneyo zobuchopho . Ezi zithunywa zeekhemikhali zizinto ezinomzimba ezinokuchaphazela ukukhathazeka, ukutya, ukuxhalaba, ukulala, intliziyo yeqondo, ubushushu, ubundlobongela, ukwesaba kunye nezinye izinto ezenzeka kwingqondo nangokwenyama. I-Monoamine oxidase (i-MAO) yi-enzyme eyenza ihlaziye okanye idibanise ama-neurotransmitter amathathu anxulumene nomoya kunye noxhala:
- I-Serotonin , edlala indima ekwenzeni ukuxhalabisa, ukukhathazeka, ukulala, ukutya, kunye nesondo.
- I-Norepinephrine , echaphazela ukulala nokulumkisa, ikholelwa ukuba iyahambelana nokuphendula ngokunyanzela ukulwa nokukhupha.
- I-Dopamine , echaphazela ukunyakaza komzimba kwaye ikholelwa ukuba ibandakanyeka ekukhuthazeni, umvuzo, ukuqiniswa kunye nokuziphatha kakubi. Iingcamango ezininzi zeengqondo zibonisa ukuba i-dopamine idlala indima kwimpawu zengqondo .
Ii-MAOI zinciphisa umsebenzi we-enzyme MAO. I-MAO engaphantsi iphumela kwizigaba eziphezulu ze-norepinephrine, i-serotonin kunye ne-dopamine kwingqondo. Iintlobo zale nyuksi ziphucula umgangatho kunye nefuthe elichasayo.
Iziphumo eziqhelekileyo ze-MAOIs
- Ukulala okulala / ukulala
- I sizathu
- Uhudo
- Umlomo omile
- Uxinzelelo oluphezulu (uxinzelelo lwegazi oluphezulu)
- I-Hypotension (uxinzelelo lwegazi oluphantsi)
- Utywala
- Ukutyeba kwakho
- I-Edema (ukugcinwa kwamanzi)
- Ukungasebenzi kwezesondo
- Iimfucu zamathambo
- Ubuthathaka
- Ukudideka
Olu luhlu alukho konke okubandakanya, kwaye unokufumana ezinye iziphumo ezichazwe apha. Kufuneka uxele zonke iziphumo zecandelo lezonyango ezinxulumene neyeza.
Iingxaki zeTyramine-Ezibangelwa Ngxakini
I-Tyramine yinkomfa efumaneka kwiindawo ezininzi zokutya . Olu hlobo lunefuthe kwixinzelelo legazi kwaye lulawulwa yi-MAO enzyme. Xa i-enzyme ye-MAO inqatshelwe (oko kukuthi, xa uthatha i-MAOI), i-tyramine ingafikelela kumazinga aphezulu aphezulu, okubangelwa ukunyuka kwengcinezelo yegazi. Ngoxa uthabatha i-MAOI, kuyakufuneka ukuba ugweme ukutya kunye neziphuzo eziphezulu kwi-tyramine ukukhusela i-spikes ephezulu yegazi.
Ezinye iinkqubo zokuqapha kunye nokuchasene
Ngaphambi kokuqala unyango lwe-MAOI, xela ugqirha wakho ukuba unayo na le miqathango ilandelayo:
- Isifo se-renal (isifo sesifo)
- Ingxaki yokugula
- Izifo zenhliziyo (oko kukuthi, ukuhlasela kwentliziyo kwangaphambili, isifo senhliziyo)
- Hyperthyroidism
- Uxinzelelo oluphezulu (uxinzelelo lwegazi oluphezulu)
- Sikashukela
Xelela bonke ababoneleli bakho bokuphatha ukuba uthatha i-MAOI. Oku kubandakanya oogqirha, abancedisi boogqirha, amazinyo, kunye nabanye ababoneleli ngezempilo.
Musa ukuthatha nayiphi na imithi ngaphandle kokuba ugqirha lwakho luvunywe.
Serotonin Syndrome
Amanqanaba aphezulu kakhulu e-serotonin engqondweni angabangela imeko ebangela ukuba ubomi bungozi bubizwa ngokuba yi- serotonin syndrome . Lo mqathango onqabileyo uyisiphumo sokubambisana kwezilwanyana ezimbini okanye ngaphezulu ezichaphazela amaqondo enqanaba le-serotonin.
Nangona ezinye izongezelelo ezingaphezulu kwee-counter, ezifana neSt. John's Wort, zingakhokelela kwisifo se-serotonin xa ixutywe nama-MAOI. Ukunciphisa umngcipheko we-serotonin syndrome, ii-MAOIs akufanele zithathwe ngama-SSRI okanye ii-TCA. Kunconywa ukuba olunye unyango oluxhatshazwayo aluqalanga de ukuya kwiintsuku ezili-10 ukuya kwezi-14 emva kokucinywa kwe-MAOI.
MAOIs kunye nokukhulelwa
Uphando malunga nokukhulelwa kunye ne-MAOI unyango lukhawulelwe. Kucetyiswa ukuba unyango lwe-MAOI luphephe ngexesha lokukhulelwa. Ukuba unonyame okanye ukhulelwe, kukulungele ukuxoxa ngengozi kunye neenzuzo zonyango lwe-MAOI kunye nogqirha wakho.
I-MAOI yokuCima i-Syndrome
Abanye abantu baye babika izimpawu zokurhoxisa xa behla okanye beka ii-MAOI unyango. Kukholelwa ukuba ezi zimpawu zibangelwa yingqondo ezama ukuzinzisa i-serotonin kunye namazinga e-norepinephrin emva kokutshintsha ngokukhawuleza.
Iimpawu ezinokuthi zenzeke ngexesha lokucinywa kwe-MAOI unyango ziquka:
- I sizathu
- Intloko
- Iintsimbi zomzimba
- Utywala
- Ukutshukunyiswa kwamandla njengomsi entanyeni nentloko
Ngoxa zonke ezi zimpawu zingakholelwa ukuba ziyingozi, zinokudideka. Musa ukunciphisa okanye ukuyeka unyango lwe-MAOI ngaphandle kokubonisana nodokotela wakho.
MAOIs kunye nokuzibulala
Ubambiswano lweengcamango zokuzibulala , ngakumbi phakathi kwabaselula, kunye nokunyanga okuxinzelelekileyo, luye lwaba liziko lokuqwalasela kunye nokuphikisana kwiminyaka yamuva. Ukuphendula kwiingxaki ezicetyiswayo kwizifundo kunye nenye uphando, i- US Food and Drug Administration (i-FDA) ikhuphe isitatimenti ngo-2007. I-FDA icetywe ukuba abenzi bazo zonke iimishanguzo ezichasayo zibonisa isilumkiso kwimveliso yabo malunga nokuba yengozi yokuzibulala ukucinga kunye nokuziphatha kwabaselula, abaneminyaka eyi-18 ukuya ku-24, ngexesha lokuqala unyango.
Kuze kube ngoku, abaphandi abafumananga impendulo ecacileyo malunga nokuxhatshazwa kokuzibulala. Ngenxa yobuninzi babantu, i-anti-depressants iyanciphisa ukuxinezeleka nokunciphisa ukungenakunceda nokungaphumeleli okudla ubomi babo bemihla ngemihla. Kodwa, ngenxa yepesenti encinci yabantu abathatha i-antidepressants, oku akunjalo. Ukuba unenkxalabo malunga nale ngxaki, vula kunye nodokotela wakho kwaye ungesabi ukubuza imibuzo.
Imithombo:
> Ukusetyenziswa kwe-Antidepressant kuBantwana, i-Adolescents kunye nabantu abadala. Iingxelo zoLungiso lweMveliso. US Food and Drug Administration. Meyi 2, 2007.
> Kaplan MD, uHarold I. kunye noSadock MD, uBenjamin J. Isiqendu se-Psychiatry, i-Eighth Edition 1998 Baltimore: Williams & Wilkins.