So aduru a wonom no betumi de wo nkwa ato asiane mu? Momma yɛnka Serotonin Syndrome ho asɛm

So woyɛ obi a ɔnom nnuru a wɔde sa adwenemhaw, atiridiinini, anaa ɛyaw a emu yɛ den? Anaasɛ wonom nnuru fi nnuruyɛfo pii hɔ ma yare koro no ara? Afei saa asɛm yi bɛyɛ nea ɛho hia wo paa. Ɛnnɛ yɛreka tebea bi a ebetumi aba yɛn nipadua mu esiane nnuru ahorow bi nti, a sɛ wɔante ase yiye a ebetumi de nkwa ato asiane mu ho asɛm. Yɛfrɛ eyi ‘Serotonin Syndrome’ . Mma ɛnhaw wo, sɛ yenim eyi ho asɛm yiye a, yebetumi akwati asiane kɛse bi.

Sɛ yɛbɛka no tiawa a, dɛn ne Serotonin Syndrome?

Sɛ yɛbɛte eyi ase a, ɛsɛ sɛ yedi kan hu nea ‘Serotonin’ yɛ. Fa no sɛ ɔbɔfo ketewaa bi a ɔde nkrasɛm kɔ yɛn amemene ne yɛn nipadua a aka no ntam. Wɔ aduruyɛ mu no, yɛfrɛ saa nnuru abɔfo yi ‘neurotransmitters’. Serotonin nso yɛ neurotransmitter a ɛho hia yiye ma yɛn nipadua, na ɛhwɛ nneɛma pii te sɛ yɛn adwene, nna, ne aduan ho akɔnnɔ so.

Mpɛn pii no, sɛ wonom aduru a oduruyɛfo akyerɛw wo a, serotonin dodow a ɛwɔ nipadua no mu no kari pɛ. Nanso, sɛ biribi nti saa nnuru a wɔfrɛ no serotonin yi kɔ soro dodo wɔ yɛn nipadua mu , kyerɛ sɛ, sɛ ɛboaboa ano dodow a nipadua no ntumi nni ho dwuma a, wɔfrɛ sɛnea yɛn nipadua no yɛ n’ade wɔ ho no ‘serotonin syndrome’. Eyi betumi ayɛ adeyɛ a asiane wom a aduru bi (nnuru a wɔde yɛ adwuma) de ba.

Hena na ɛda adi sɛ obenya saa tebea yi?

Nokwarem no, obiara a wadi mfe biara a ɔde nnuru, nnuru a wɔde ka aduan ho, anaa nnuru a mmara mma ho kwan a ɛka serotonin dodow di dwuma no wɔ asiane mu. Wɔtaa hu saa tebea yi wɔ tebea horow te sɛ eyinom mu:

• Bere a worefi aduru foforo ase: Sɛ wufi ase de aduru foforo a ɛma serotonin dodow kɔ soro ara pɛ.
• Bere a worema aduru bi dodow akɔ soro: Sɛ wo duruyɛfo ma aduru bi a worenom dedaw no dodow kɔ soro a.
• Sɛ wɔde nnuru pii bom di dwuma a: Eyi ne ade a asiane wom sen biara na ɛtaa de ba. Fa no sɛ, wo nkwaa ayɛ wo yaw. Wofa aduru a wɔde kum ɛyaw fi oduruyɛfo biako hɔ ma no. Saa bere yi de, esiane sɛ wohaw wo ho kakra nti, wokɔ oduruyɛfo foforo nkyɛn na wonom nnuru ma ɛno nso. Nanso wonka aduru a ɛto so abien no ho asɛm nkyerɛ oduruyɛfo a odi kan no, na saa ara nso na wonka aduru a edi kan no ho asɛm nkyerɛ oduruyɛfo a ɔto so abien no. Eyi ne bere a hokwan kɛse wɔ hɔ sɛ wɔde nnuru abien a ɛma serotonin yɛ kɛse bedi dwuma a wonnim na wɔde tebea yi aba no.
• Sɛ wonom nnuru pii a: Sɛ wofa nnuru pii sen dodow a wɔakyerɛw ama wo no a, wohyɛ da anaasɛ wɔ akwanhyia mu.

Dɛn ne sɛnkyerɛnne ahorow no? Yɛyɛ dɛn hu eyi?

Serotonin yare no ho sɛnkyerɛnne betumi ayɛ soronko wɔ onipa biara ho. Ebia nnipa binom benya yare no ho sɛnkyerɛnne a emu nyɛ den koraa, bere a afoforo nso betumi anya yare no ho sɛnkyerɛnne a emu yɛ den a ɛde wɔn nkwa to asiane mu. Mpɛn pii no, saa sɛnkyerɛnne ahorow yi fi ase wɔ nnɔnhwerew kakraa bi akyi bere a wɔanom aduru foforo anaasɛ wɔasesa dodow a wɔde ma no.

Sɛnea ɛbɛyɛ a ɛbɛyɛ mmerɛw sɛ yɛbɛte ase no, momma yɛnkyekyɛ saa sɛnkyerɛnne ahorow yi mu abiɛsa.

Dɛn ne nnuru yi a ɛma serotonin dodow kɔ soro?

Saa list yi ware kakra, nanso ɛho hia paa ma w’ahobammɔ sɛ wobɛhu eyi.

Nnuru a wɔde kum adwenemhaw

Eyinom ne nnuru a wɔtaa de bata serotonin yare no ho. Asiane no yɛ kɛse titiriw bere a wɔde eyinom ka nnuru afoforo (e.g., nnuru a wɔde sa atiridiinini) ho no.

• SSRIs (Nnuru a wɔpaw a esiw serotonin a ɛsan gye ano): Nnuru te sɛ Fluoxetine, Sertraline, Citalopram, Escitalopram, Paroxetine.
• SNRIs (Serotonin-norepinephrine a ɛmma obi ntumi nnye bio): Nnuru te sɛ Venlafaxine, Duloxetine, Desvenlafaxine.
• Nnuru a wɔde kum adwenemhaw a wɔde di dwuma abiɛsa: Nnuru te sɛ Amitriptyline, Nortriptyline, Imipramine.
• MAOIs (Monoamine oxidase inhibitors): Ɛwom sɛ wɔntaa mfa eyinom nni dwuma bio de, nanso wɔde ma wɔ tebea horow bi mu.

Nnuru afoforo

• Nnuru a wɔde sa ɛyaw a emu yɛ den: Nnuru a wɔde kum ɛyaw te sɛ Tramadol, Pethidine (Meperidine), Fentanyl, ne Methadone.
• Aduru a wɔde sa ɔfe: Ade bi a wɔfrɛ no Dextromethorphan wɔ ɔfe aduru bi a wonya fi nnurutɔnbea ahorow mu. Eyi nso betumi aka serotonin dodow.
• Nnuru a wɔde sa atiridiinini: Triptan nnuru te sɛ Sumatriptan ne Rizatriptan.
• Nnuru a wɔde sa ɔfe: Nnuru te sɛ Metoclopramide ne Ondansetron.
• Nnuru bi a ekum ɔyare mmoawa: Nnuru a ekum ɔyare mmoawa a wɔfrɛ no linezolid.
• Nnuru a wɔde siw adwene so: Lithium.

Nneɛma afoforo

• Nnuru a wɔde ma: Nneɛma te sɛ St. John’s wort ne Ginseng.
• Nnubɔne a mmara mma ho kwan: Nneɛma te sɛ Ecstasy (MDMA), LSD, Cocaine, Amphetamines.

Mma saa nsɛm a wɔahyehyɛ yi nnyɛ wo hu. Ɛnyɛ obiara na obenya saa tebea yi bere a wanom nnuru yi biako akyi. Asiane no sɔre bere a wode eyinom pii bom di dwuma, ma dodow no kɔ soro, anaasɛ wo nipadua no te nka wɔ ho nkutoo.

Ɔkwan bɛn so na oduruyɛfo hu eyi?

Mogya mu nhwehwɛmu anaa scan pɔtee biara nni hɔ a wɔde besi serotonin yare no so dua. Oduruyɛfo begyina nneɛma pii so ahu tebea no:

1. Wo yare no ho sɛnkyerɛnne: Tie nea wote nka no yiye.

2. Nipadua mu nhwehwɛmu: Wɔbɛhwɛ sɛnea wo koma bɔ, wo mogya mmoroso, wo nipadua mu hyew, ne wo ntini tebea.

3. Nnuru a worenom no din: Eyi ne ade a ɛho hia sen biara.

Bio nso, wobɛtumi nso ayɛ wo mogya ne wo nsuo mu nhwehwɛmu, wo koko X-ray, anaa CT scan de ahwɛ sɛ wo nni tebea foforɔ (e.g., ɔyareɛ) a ɛde sɛnkyerɛnne a ɛte saa ara reba.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Ayaresa no gyina sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den so.

• Sɛ wowɔ sɛnkyerɛnne a emu nyɛ den a: Ayaresa a wɔtaa yɛ ne sɛ wubegyae nnuru a ɛde sɛnkyerɛnne no bae no nom. Mpɛn pii no, eyi besiesie sɛnkyerɛnne ahorow no koraa wɔ nnɔnhwerew 24-72 mu.
• Sɛ wowɔ sɛnkyerɛnne ahorow a ɛkɔ fam a: Wɔde wo bɛto ayaresabea na anyɛ yiye koraa no wɔahwɛ wo nnɔnhwerew 24. Saa bere yi mu no, wɔbɛma wo saline (IV nsu) ne nnuru te sɛ benzodiazepines a wɔde sa dadwen.
• Sɛ wowɔ sɛnkyerɛnne ahorow a emu yɛ den a: Eyi yɛ aduruyɛ mu asɛm a egye ntɛmpɛ. Wɔbɛgye wo akɔ ayaresabea a wɔhwɛ wɔn a wɔyare denneennen (ICU) na wɔama wo ayaresa te sɛ mmoa a wɔde ma wɔ ɔhome a ɛyɛ den ho, atiridiinini a ano yɛ den a wɔde siw ano, ne nnuru a wɔde hwɛ koma a ɛbɔ ne mogya mmoroso so. Ɛtɔ da bi a, wobetumi de aduru bi a wɔfrɛ no Cyproheptadine a esiw serotonin dwumadi kwan nso ama.

Yɛbɛyɛ dɛn atumi abɔ yɛn ho ban afi tebea yi ho?

Nneɛma kakraa bi wɔ hɔ a ɛnyɛ den, nanso ɛho hia yiye a yebetumi ayɛ na yɛakɔ so anya ahobammɔ afi tebea a asiane wom yi mu.

1. Kyerɛkyerɛ wo ho wɔ wo nnuru ho: Yɛ nnuru biara a wobɛnom no din, dodow, ne atirimpɔw ho kyerɛwtohɔ.

2. Ka nsɛm no nyinaa kyerɛ oduruyɛfo biara: Sɛ nnuruyɛfo pii resa wo yare a, hwɛ hu sɛ wobɛka nnuru a afoforo no akyerɛw ama wo no ho asɛm akyerɛ oduruyɛfo biako.

3. Nnyae nnuru nom a wommisa wo duruyɛfo: Sɛ mpo wote nka sɛ wo ho nyɛ wo dɛ a, nnyae nnuru nom anaasɛ nnsesa dodow a wo ne oduruyɛfo nkasa.

4. Hwɛ yiye bere a woretɔ nnuru afi nnurutɔnbea: Sɛ woretɔ nnuru a wode bɛyɛ nneɛma te sɛ ɔfe ne atiridiinini a, bisa aduru a ɛne aduru a worenom dedaw no hyia.

5. Hwɛ yiye wɔ sɛnkyerɛnne ahorow ho: Hwɛ nsakrae biara a ɛbɛba wo nipadua mu yiye, titiriw bere a worefi ase anom aduru foforo anaasɛ worema dodow no akɔ soro no.