Ingxaki yentshukumo ebangelwa yimichiza ye-antipsychotic
I-Tardive dyskinesia (TD) yintlupheko yentshukumo ebangelwa yimithi. Le meko enokusisigxina yinto enokwenzeka yecala yonyango lwexesha elide kunye neyeza zokulwa ne-antipsychotic ezifana neTrazine ne-Haldol, ezisoloko zisetyenziselwa ukunyanga i-schizophrenia nezinye izifo ezingundoqo zengqondo. Iipilisi ze-Antipsychotic ziye zaguqula unyango lwezi ngxaki.
Ngaphambi kokuba i-chlorpromazine (iTrarazine) iqaliswe kuma-1950, izigulane ezine-schizophrenia zazihlala ziphathwa ngonyango lwe-electroconvulsive (ECT) kunye nezinye izifo zengqondo kunye nokuba zigcinwe kwizibhedlele zengqondo ixesha elide. Iiphenothiazines ezinjengeTrazine zathulisa amazwi abo izi gulane zazivayo kwaye zanyanise ukucinga kwabo. La mayeza ayetyenziswe njengezilwanyana ezimangalisayo nangona maxa wambi beshiya izigulana ezithatyathwe kwaye zingabonakali.
Njengoko i-phenothiazines yayimiselwe ixesha elide, inani lezigulane laqala ukubonisa izihlunu ze-muscle kunye nezinye izinto ezingaqhelekanga. Uninzi lweempawu zomzimba luya kuguqulwa kwaye lunokuphathwa ngokufaka elinye imithi yokulwa neempawu ze "pseudoparkinson". Ngakolunye uhlangothi, i-Tardive dyskinesia, yimeko engunaphakade. Kubalulekile ukuba uqaphele ukuba izigulane ezininzi zihlakulela ezinye iziphumo ezichaphazelekayo ngala mayeza.
Ngamanye amaxesha kuthiwa yi- extrapyramidal side effects , iimpawu ezinamandla ziquka:
Akathisia
Uvakalelo oluzimeleyo lokungazinzi ngokunqwenela ukunyusa imilenze okanye uhambahamba. I-Dystonias - i-slowstream, i-contraction contractions okanye i-spasms ezingabangela ukunyanzelisa ngokungabikho komzimba wonke okanye amalungu omzimba ngamnye.
I-Parkinsonism - i-muscle stiffness, i-cogwheel rigidity, i-shuitling gait, i-stoped posture, i-drooling, 'ipilisi' kunye nokubonakalisa. Ezi zimpawu ezinzima zibuyiselwa kwaye ziqheleke zonyango ngokutshintshwa amayeza okanye ngokudibanisa amayeza.
Tardive
I-dyskinesia ekuphuculeni ixesha elizayo lachazwa okokuqala ngo-1964, nangona izigulana zaziye zaphuhlisa ingxaki iminyaka emininzi. Iimpawu zifana nezo zichazwe ngasentla, kodwa ziyavela kamva kunyango kwaye zibhekwa njengento engenakuphelelwa. Iimpawu zisoloko ziquka ukuphindaphinda, ukunyakaza okuzibandakanyekayo okwenzekayo nokuba kwenzeke ukuba isiguli singasayithathi. Ukunyakaza okungaqhelekanga kufaka phakathi "ulwimi oluthakathakayo, ukubetha komlomo, ukuxosha imilomo, ukunyakaza kwe-grimacing kunye nokuhlafuna, ukugubha kwetrunk, ukunyakaza kwe-pelvic, ukujikeleza kweenyawo okanye imilenze, ukuhamba endaweni, ukuphefumula okungaqhelekiyo, kunye nezandi eziphindaphindiweyo ezifana nokugcoba okanye ukugcoba. "U (IYunivesithi yaseKansas yeZonyango, 2002)
La mayeza alandelayo aboniswe ukuba enze i-tardive dyskinesia kwezinye izigulane:
Iingxaki zengxaki zesisu:
- metoclopramide (Reglan)
- prochlorperazine (Compazine) Imithi yokukhwehlela
- promethazine (Phenergan)
Amachiza okudandatheka:
- amoxapine (Ascendin)
- perphenazine / amitriptyline (Triavil)
Antipsychotics okanye i-Neuroleptics:
- chlorpromazine (iTrazine)
- thioridazine (Mellaril)
- trifluoperazine (Stelazine)
- perphenazine (Trilafon)
- i-fluphenazine (Prolixin)
- thiothixene (Navane)
- haloperidol (Haldol)
- i-pimozide (Orap)
(IYunivesithi yaseKansas yeZonyango, 2002)
Izigulane ezindala, izigulane ezitshizayo, izigulane zezilwanyana kunye nezigulane ezineesifo sikashukela kubonakala ngathi zisengozini enkulu kule ngxaki. Imbali yentsapho nayo iboniswe ukuba yi-predictor. Ukuba ilungu lentsapho lenze le ngxaki ngexesha lenye yela mayeza, ithuba lokuba isigulane siphuhlise ingxaki.
Ukuba sele isiguli isigxina kula mayeza ayenzeka ukuba bahlakulele i-dyskinesia ye-tardive.
I-tardive dyskinesia inokuthintelwa njani? Ezinye iingcamango ezincwadini ziquka:
- Ukuthintela ukusetyenziswa kwezi zonyango ekwenzeni unyango lweengqondo kunye neengcamango ezichukumisayo kunye nokukhohlisa. Musa ukuphazamiseka kokulala okanye ukuxhalabisa nge-antipsychotics.
- Gwema ukusebenzisa la mayeza akhulileyo kwizigulane ezisebekhulile.
- Nika izigulane ezincinci i-dose eziyimfuneko kwixesha elifutshane lonyango.
- Sebenzisa i-antipsychotics entsha ye-antipychotic njengendlela yokuqala yokwelapha. Sebenzisa amanye amayeza kunye nokuvumela ukuba umthamo weyeza lokulwa ne-antipsychotic ibe kwindawo ephantsi kakhulu.
- Iimvavanyo zangexesha elide azifumanekanga zingabangela ukuba i-tardive i-dyskinesia ibe ngaphezu kweminye imishanguzo, kodwa i-dose efanelekileyo kakhulu isebenzise.
- Oogqirha kufuneka baphathe kakubi iimpawu ze-Parkinson ezifutshane zangexesha elifutshane ezinokuthi zenzeke. Amachiza ukunyanga ezi mpawu - i-anticholinergic agents - musa ukwandisa umngcipheko we-TD. "Ieholide leziyobisi" kufuneka igwenywe kuba ayinciphisi kwaye ingaba yandisa ingozi yeTD.
- Uphando luhlolisise imishanguzo yokuphatha iTD. Ezi zilandelayo zidizayamachiza azange zifunyanwe ziphumelele : I-agonists ye-Cholinergic (i-deanol, i-physostigmine, i-choline, i-lecithin), i-GABA agonists, i-agonists ye-DA emva kwe-synaptic, i-peptides, i-lithium ne-papaverine. (Alexander & Lund, 1999)