I-FDA ibangela isilumkiso malunga nesiphumo esinqabileyo kodwa esibi kakhulu
I-Lamictal (i-lamotrigine) isicatshulwa se-anticonvulous esisetyenziswa ngokuqhelekileyo njengendlela yokuzinza kwemizimba kubantu abaphila ngengxaki yokuguquguquka kwe-bipolar . Isebenza ngokumodarela ukutshintsha okukhulu kwiimeko kunye nokunceda kakhulu ekuphatheni ukuxinezeleka okukhulu. Amachiza ayenandise ukusetyenziswa ngokubanzi ukususela ekuqaleni kwawo ngo-1994 yaye namhlanje phakathi kweLuhlu lweMpilo yeSizwe lweeMfuno ezibalulekileyo.
Nangona kunjalo, naphezu kweenzuzo ezibonakalisiwe, uLamictal unobunzima bayo. Kwamanye abantu, uLamictal uye waziwa ngenxa yokugqithisa okukhulu nokuvuvukala, ukufumanisa okukhokelela kwi-US Food and Drug Administration (FDA) ukukhupha isilumkiso sebhokisi emnyama ekucebiseni abathengi malunga nale nto engabonakaliyo kodwa eyingozi.
Impendulo yeLamictal kunye noHyperensitivity
Ekucebiseni kwabo, i-FDA ilumkisa malunga nenani leempendulo zokuxhomekeka ezinokuthi zenzeke kubantu abathatha uLamictal. Impendulo ye-hypersensitive yinto apho imeko okanye iziyobisi ezenza ukuba isimiso somzimba sokuzivikela siphumelele, siphumelele kwisifo esithintekayo okanye impendulo engavumelekanga.
NgeLamictal, ezi ziquka ukuphendula okubizwa ngokuba yi-Stevens-Johnson syndrome (i-SJS), inetyhefu ye-epidermal necrolysis (TEN), kunye nokusetyenziswa kwezidakamizwa nge-eosinophilia kunye neempawu zesistim (i-DRESS syndrome).
Ngayinye yeemeko ibonisa inzima (abanye bathi "ukuthukuthela") ukugqithisa okuqhubekayo emva kweentsuku ezimbini ukuya kweebhozo zokusetyenziswa kweziyobisi.
Amanani okufa aphawulekayo, ukususela kuma-5 ekhulwini ukuya kuma-30 ekhulwini.
Impendulo nganye ichazwa ngamacandelo ayo:
- I-Stevens-Johnson Syndrome (i-SJS) inokuthi ilandelwe yimpawu ezinjengomkhuhlane, njengentlungu, umkhuhlane, umqala, umkhuhlane, isifo sohudo kunye nokuhlanza. Oku kunokulandelwa yindlela yokuphendula ngayo yonke into eyenziwa ngokukhawuleza ngokukhawuleza, ukuvuvukala kobuso kunye nolwimi, kunye nokuqhaqhaqhaqha okukhulu kweempawu zomlomo, impumlo kunye namehlo. Ukukhwabanisa kwesikhumba kunokuba buhlungu kakhulu kwaye, kwezinye iimeko, kukhokelela kwintambo kunye nokuchithwa kwesikhumba.
- Inetyhefu ye-epidermal necrolysis (i-TEN) i-SJS kodwa yimbi kakhulu. I-TEN ichazwa nje ngokuba yinkampani engaphezu kwama-30 ekhulwini kwesikhumba ngokuchasene ne-SJS equka ngaphantsi kwama-10 ekhulwini. Ngaphezu koko, umngcipheko wokufa ukusuka kwi-TEN uphakathi kwamaxesha amane kunye namahlanu ngaphezu kweSJS.
- I-DRESS syndrome yindlela yokusabela kwezidakamizwa ezinokubangela ukugqithisa kunye nezinye iimpawu ezinobunzima ezibandakanya ubunzima beentlungu kunye nokuvuvukala okungenani elinye iqumrhu elikhulu (esona siqhele isibindi, izintso, imiphunga, intliziyo, imisipha, okanye i-pancreas).
Unyango lubandakanya ukuyeka ukukhawuleza kweLamictal kunye nokusetyenziswa kweendlela zokwelapha ukunyanga intlungu, ukuthintela usulelo, kwaye uqinisekise ukuba umntu uhlala efanelekileyo. Umonakalo wesikhumba uphathwe ngendlela efana nokutshiswa komzimba. I-corticosteroids isetyenziselwa ukunciphisa ukuvuvukala.
Izinto ezinxulumene noHypersensitivity
Ngokubanzi, abantu abangaphantsi kwe-17 banamathuba okuba baphendule kuLamictal kunabantu abadala. Ukongezelela, kukho iinkalo ezininzi ezinokunyusa amathuba okuphendula:
- Ukuthatha okungaphezulu kwe-dose ephakanyisiweyo xa uqala unyango
- Ukwandisa umthamo ngokukhawuleza xa uqala endaweni yokugxotha kancane
- Ukuyeka unyango nokuqalisa kwakhona kwiqondo eliqhelekileyo elipheleleyo
- Ukuthatha amayeza e-Depakene (valproic acid) okanye i-Depakote (i-valproate ye-sodium) ngokubambisana noLamictal
Kufuneka kukhonjiswe, nangona kunjalo, ukuba i-hypersensitivity inokuthi ihlawulwe ngezinye iimeko nokuba uthabatha izilwanyana njengoko kuchazwe. Nangona iimeko zofuzo zibonakala zidlala indima, izibangela ngamanye amaxesha idiopathic (kuthetha ukuba asiyazi nje isizathu).
Oko Isilumkiso seBhokisi esiMnyama sisitshela
I-FDA yakhupha isilumkiso sebhokisi emnyama ngenxa yamanani aphakamileyo ekuphenduleni ukuxilongwa komzimba xa kuthelekiswa nezinye iziyobisi ezisetyenziselwa ukuphazamiseka kwezifo zengqondo.
Ngokutsho kophando lwabo, kukho ukunyuka kwintathu emngciphekweni xa uthatha uLamictal xa uthelekiswa nezinye izimo ezizinzileyo.
Ukuba uneminyaka engaphantsi kwe-16, umngcipheko uya kuphinda uphindwe kabini. Kubalulekile ukuba uqaphele, nangona kunjalo, ukuba akuyiyo yonke impendulo yokuxhomekeka kwe-hypersensitivity iza kugqiba nge-SJS. Ukubeka yonke into ebonakalayo, kukho kuphela ikhefu lesithuba esingu-0.1 kweso siganeko esenzekayo. Ekugqibeleni, kwakunzima kwempendulo, kunye nokufumaneka kwamanye amayeza okuzinzisa izidakamizwa, ezazisa isinqumo se-FDA ngokuninzi kwingozi yobalo ngokwalo.
Umgca ongundoqo ngolu: Ukuba ufumana i-rash ngelixa uthabatha uLamictal, khangela ugqirha wakho ngokukhawuleza. Ukuba usasazeka ngokukhawuleza, biza 911 okanye uye kwigumbi elisondeleyo elisondeleyo. Kungcono kakhulu ukukhuseleka kunokuba uxolo, nangona kunjalo unobungozi obuphantsi.
> Imithombo:
> GlaxoSmithKline. " Lamictal (lamotrigine) : Amaphupha ephambili ekuchazeni ulwazi" Triangle Park, North Carolina; kuhlaziywa ngoDisemba 2016.
> Wang, X; Iv, B; Wang, H .; okqhubekayo. "I-Lamotrigine-inokubangela ukuphendula okubi kakhulu: Ukuhlaziya idatha ukususela ngo-1999-2014." Umbhalo we-Clinical Neuroscience. 2015; 22 (6): 1005-1011.