Ukusetyenziswa, Imiphumo Yecala, kunye Nezilumkiso
Kuqhelekile ukuba abantwana abaneengxaki ze-bipolar ukuba bafumane ingqalelo yokungaphumeleli kwengxaki yokuxhatshazwa kwempilo (ADHD) ngokunjalo. Abantu abadala abaneentsholongwane ze-bipolar nabo banokuthi bafumane i-ADHD. I-Vyvanse (lisdexamfetamine) yenye yeyeza enokumiselwa ukuphatha i-ADHD, kwaye ivunyiwe ukusetyenziswa kubantwana, abaselula kunye nabantu abadala.
Ukusetyenziswa
I-Vyvanse kuphela ayisebenzisileyo kunyango lwe-ADHD, ngo-2015 i-US Food and Drug Administration (i-FDA) yaseYurophu nayo iyayivumile ukuba i-disorder-eating disorder nayo.
Kutheni ukuPhatha i-ADHD ne-Bipolar Disorder ingaba nzima
Ukunyanga i-ADHD kumntu onentsholongwane ye-bipolar inokukhohlisa. Ithimba leVivanse lithi, "Iimpawu ezikhuthazayo azijolise ukuba zisetyenziswe kwizigulane ezibonisa iimpawu eziphantsi kwimiba engqongileyo kunye / okanye ezinye iingxaki zokugula ngengqondo, kuquka neengqondo ." Ugqirha ocinga ukucacisa le nkunkuma kufuneka ahlolisise kakuhle iimpawu zesigulane ngasinye. Iingxaki ezifihliweyo ze-bipolar okanye i-psychotic zibangelwa zikhuthazo, kwaye izimo ezibangelwa ngengqondo ziyazibakala, ngoko ugqirha kufuneka alandele isigulane ngokukhawuleza ukuba aguquke.
Izikhokelo zonyango
La mayeza athile kufuneka awathabatheke kusasa ukususela emva kokuwuthatha kamva emini kunokukhokelela ekusileni. Ingathathwa kunye okanye ngaphandle kokutya. I-capsule inokuvulwa kwaye i-powder ngaphakathi ichithwe kwiglasi yamanzi, kodwa ayikho nayiphi na i-liquid. Umenzi uyaxwayisa ukuba kulo mzekelo, amanzi kunye noVivvan kuwo kufuneka adakwe ngokukhawuleza.
I-dose yokuqala ephakanyisiweyo ngu-30 mg. Oku kungatshintshwa ukuya kwiqondo eliphezulu lama-70 mg ngosuku.
Kukwacetyiswa ukuba ukusetshenziswa kwexesha elide leVivvanse kuphazanyiswe ngamanye amaxesha ukuba ubone ukuba iimpawu ze-ADD zibuyela kwindawo apho unyango lwangonyango luyafuneka. Ukuphazamiseka okunjalo kunokuba yinto efanelekileyo ukuba kukho iimpawu zokukhula komntwana okanye ukukhula kwentsha.
Iimbambano ezinokuthi zenze iNgxabano kunye neMida
Esi sibisi akufanele sithathwe ngexesha elifanayo naliphi na i- monoamine oxidase inhibitors (MAOIs). Ukongeza, kufuneka ulinde iintsuku eziyi-14 phakathi kokuyeka i-MAOI kwaye uqale ukuthatha iVavse, ukuze i-MAOI iphume ngokupheleleyo kwinkqubo yakho. Ukuthabatha izibini ezimbini kwandisa ingozi yentlekele eyingozi yengozi.
Ezinye iyeza ezinengxaki eziqhelekileyo ezisetyenziselwa ukuphatha ingxaki ye-bipolar zingabandakanya:
- I-Tricyclic antidepressants , ngakumbi i-Norpramin (desipramine) ne-Vivactil (i-protriptyline), enokubangela ukwanda okwenene kwimali kaVivvanse emzimbeni
- I-Haldol (haloperidol), engenza iVavvanse isebenze kangangoko
- I-lithium, enokwenza iVivvanse isebenze kangako
Izilumkiso
- I-Vyvanse yinto elawulwayo yeShedyuli II, oku kuthetha ukuba inamandla okusetyenziswa kakubi kunye nokusetyenziswa komlutha, kodwa inokusetyenziswa ngokusemthethweni kweyeza. Ukusetyenziswa kakubi kungakhokelela kwiingxaki ezinzulu zenhliziyo nokufa ngokukhawuleza. I-Psychosis yinto eqhelekileyo yokuqhubeka utywala.
- Izigulane kufuneka zihlolwe izifo zentliziyo ekhoyo ngaphambi kokuqala iVivvanse. Kukho umngcipheko weengxaki zeengqondo zomzimba kunye nalo myeza. Ukubetha, ukuhlasela kwentliziyo, ukufa ngokukhawuleza, kunye nokunyuswa kwengcinezelo yegazi kuye kwabikwa.
- Kwimilinganiselo efanelekileyo kwiimvavanyo zeclini, ukuvela kwempawu zengqondo okanye imania yayingavamile, kuphela 1/10 ye-1%. Nangona kunjalo, ingozi iyanda xa iichiza lixhatshazwa.
Ngokubhekiselele kwingxaki yokuguquguquka kwe-bipolar, ilebula yonyango ithi:
"Unonophelo oluthile lufanele luthathwe ngokusebenzisa izikhuthazo zokunyanga i-ADHD kwizigulane ezineengxaki ezibangelwa yi-bipolar disorder ngenxa yokukhathazeka ngokubakho kwinqanaba elixubileyo lomntu kulezi zi gulane. Ngaphambi kokuba uqalise unyango olushukumisayo, izigulane ezineempawu ezixinzelelekileyo zimele zifanele ngokwaneleyo ihlolwe ukuba iqinisekise ukuba isengozini yokuphazamiseka kwengqondo ye-bipolar. Ukuhlola okunjalo kufuneka kufake imbali epheleleyo yengqondo, kubandakanywa nembali yentsapho yokuzibulala, ukuphazamiseka kwengqondo kunye nokudandatheka. "
Iziphumo eziPhakathi
Iziphumo eziqhelekileyo ezingaphantsi kwezona ziquka:
- Intlungu yesisu, ukuhlanza, isicupunu, isifo sohudo (ikakhulukazi kubantu abadala), umlomo owomileyo
- Ukunciphisa ukutya (okuqhelekileyo), ukulahleka kwesisindo
- Ukuqhawula (okuqhelekileyo), ukucaphuka (ikakhulu kubantwana abangaphantsi kwe-13), ukuxhalabisa (ikakhulu kubantu abadala)
Iimiphumo eziMbi kakhulu
Ezinye iziphumo ezibi kakhulu ziquka:
- Inkcaso
- Tics
- Ukuphazamiseka kokubonakalayo
- Ukuxhamla
- Ukunciphisa ixesha elide lokukhula
Vyvanse Ngethuba lokukhulelwa
I-Vyvanse ikuKwimeko yokukhulelwa kweC, oku kuthetha ukuba kufuneka isetyenziswe kuphela ngexesha lokukhulelwa xa iinzuzo ezinokuthi zingaphezu komngcipheko kumntwana. Eli nyanga lidityaniswe ubisi lwebele kwaye akufanele lithathwe ngenkathi unyango, njengoko lunokulimaza umntwana.
Imithombo:
Masi, G., et al. "Ukunyamekela-ukungabi nakubungqina bokungabikho kwempilo - ukungabikho kwengqondo kubantwana nabaselula." Iingxaki zeBipolar . 2006 Agasti; 8 (4): 373-81.
US Food and Drug Administration. "I-Label evunyelweyo yeVivanse." 31 Jan 2012.
"Lisdexamfetamine." I-MedLine Plus, iThala leNcwadi likaMatriki ka-US (2015).