Ua kuhikuhi anei kāu kauka iā ʻoe i kahi ʻano lāʻau i kapa ʻia he MAOI? A i ʻole ua lohe paha ʻoe e pili ana i kēia lāʻau lapaʻau ma kekahi wahi a makemake ʻoe e ʻike pono i ke ʻano o ia mea? ʻO nā MAOI he ʻano lāʻau lapaʻau maoli nō ia i hāʻawi ʻia e mālama i nā kūlana olakino noʻonoʻo e like me ke kaumaha. Eia naʻe, ʻaʻole paipai pinepine nā kauka iā lākou i kēia mau lā. Aia kekahi mau kumu kikoʻī no kēia. E kamaʻilio kākou e pili ana i kēia mai ka hoʻomaka ʻana, ma ke ʻano maʻalahi loa, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
He aha ke ʻano lāʻau lapaʻau he MAOI?
I ka ʻōlelo maʻalahi, ʻo MAOIs (Monoamine Oxidase Inhibitors) ka papa mua o nā lāʻau i ʻike ʻia e mālama i ke kaumaha. Eia nō naʻe, pono ʻoe e makaʻala loa i kāu mea e ʻai ai i ka wā e hoʻohana ai iā lākou. Eia kekahi, ma muli o kekahi mau hopena ʻaoʻao a me nā pilikia me nā lāʻau lapaʻau ʻē aʻe, ʻōlelo pinepine nā kauka iā lākou ma ke ʻano he koho hope loa, ke hana ʻole nā ʻano antidepressants ʻē aʻe.
ʻO ia hoʻi, inā ua hāʻawi ʻia ʻoe i nā lāʻau hou e like me SSRIs a ʻaʻole i hoʻomaikaʻi ʻia kāu mau hōʻailona, e noʻonoʻo paha kāu kauka i kahi MAOI ma ke ʻano he hana aʻe.
He aha nā ʻano MAOI nui i hoʻohana ʻia ma ka honua holoʻokoʻa?
Aia kekahi mau ʻano nui o nā MAOI e hoʻohana ʻia nei i kēia manawa. Inā loaʻa kēia mau mea a pau ma ko mākou ʻāina, ʻokoʻa paha, akā he mea maikaʻi ke ʻike i kēia mau inoa.
- ʻIsocarboxazid (Marplan®)
- ʻO Phenelzine (Nardil®)
- Selegiline (Emsam®)
- Tranylcypromine (Parnate®)
He aha nā kūlana i kauoha ʻia ai nā lāʻau MAOI?
ʻOiai ua kuhikuhi nui ʻia kēia lāʻau lapaʻau no ke kaumaha, hoʻohana ʻia nō hoʻi no nā kūlana olakino noʻonoʻo ʻē aʻe.
Nā hoʻohana i ʻae ʻia e ke aupuni
ʻO kēia nā hihia kahi i ʻāpono kūhelu ai nā luna pili i kēia lāʻau lapaʻau he kūpono no kēia mau maʻi.
- Maʻi Kaumaha Nui: Ua ʻāpono ʻia ʻo Isocarboxazid lāua ʻo Tranylcypromine no kēia kūlana.
- Nā maʻi pale i ka lāʻau lapaʻau: Hoʻohana ʻia ʻo Phenelzine e mālama i ke kaumaha, ka maʻi panic, a me ka maʻi hopohopo pili kanaka i pane ʻole i nā lāʻau lapaʻau ʻē aʻe.
- ʻO ka maʻi o Parkinson: ʻO Selegiline kahi lāʻau lapaʻau i hoʻohana ʻia e mālama i ke kaumaha a hoʻohana ʻia hoʻi ma ke ʻano he mea hoʻohui i nā lāʻau lapaʻau ʻē aʻe no ka maʻi o Parkinson.
Nā hoʻohana "Ma waho o ka lepili"
I kekahi manawa, hiki i ke kauka ke kuhikuhi i kēia lāʻau lapaʻau ma muli o ko lākou ʻike lapaʻau a me ka ʻike no kahi kūlana i ʻae ʻole ʻia. Ua kapa ʻia kēia he "off-label" use. Eia kekahi laʻana:
- ʻO kekahi manawa i kau ʻia kahi lāʻau lapaʻau i kapa ʻia ʻo tranylcypromine no ka hopohopo pili kanaka a me ka maʻi panic kūʻē i ka lāʻau lapaʻau.
- Aia kekahi mau manawa i kuhikuhi ʻia ai ka lāʻau lapaʻau ʻo Selegiline no ka maʻi hyperactivity deficit attention (ADHD).
Pehea e hana ai kēia lāʻau lapaʻau i loko o ke kino?
He mea maʻalahi loa kēia e hoʻomaopopo. E noʻonoʻo he mau kemika ko ko kākou lolo e kaohi ana i nā mea e like me ko kākou ʻano, ka hauʻoli, a me ka nānā ʻana. Kāhea mākou i kēia mau neurotransmitters . Ua like kēia me nā ʻelele liʻiliʻi e lawe ana i nā leka i loko o ka lolo.
I kēia manawa, loaʻa i ko mākou kino kahi enzyme i kapa ʻia ʻo "Monoamine Oxidase." ʻO ka hana a kēia enzyme ka wāwahi a wehe i kēlā mau ʻelele (neurotransmitters) ma hope o ka hoʻohana ʻia ʻana.
Hiki i ke kanaka me ke kaumaha ke loaʻa nā pae haʻahaʻa o kēia mau ʻelele i loko o ko lākou lolo. ʻO ka hana a ka lāʻau MAOI, ʻo ia ke hoʻōki (kāohi) i ka hana o kēlā enzyme 'hoʻomaʻemaʻe' no kekahi manawa. He aha ka mea e hana ʻia?
Noho kekahi mau neurotransmitters koʻikoʻi i loko o ka lolo no ka lōʻihi me ka ʻole e wāwahi ʻia, ʻo ia hoʻi ke piʻi nei ko lākou pae.
ʻO nā neurotransmitters nui i hoʻonui ʻia e nā MAOI:
- Serotonin: He mea nui loa ia no ke ʻano, ka hiamoe, ka makemake, a me ke ʻano pilikanaka.
- Norepinephrine: He mea nui no ka makaʻala, ka noʻonoʻo, a me ka hana.
- Dopamine: Pili i ka leʻaleʻa, ka ʻoluʻolu, a me ka nānā ʻana.
- Tyramine: He ʻano neurotransmitter nō hoʻi kēia. Akā ʻo kāna hana nui ke kōkua i ka kaohi ʻana i ke koko. ʻO kēia ke kumu nui e pono ai ʻoe e makaʻala i kāu mea e ʻai ai i ka wā e lawe ana i kahi MAOI. E kamaʻilio mākou e pili ana i ia mea me nā kikoʻī hou aku ma hope iki.
He aha ka ʻokoʻa ma waena o nā MAOI a me nā SSRI?
ʻO SSRIs (Selective Serotonin Reuptake Inhibitors) kekahi ʻano lāʻau lapaʻau i hoʻohana ʻia e mālama i ke kaumaha. Ua lohe paha ʻoe i nā inoa e like me Prozac lāua ʻo Sertraline. ʻOiai he mau lāʻau lapaʻau ʻelua i hoʻohana ʻia e mālama i ke kaumaha, ʻokoʻa kā lāua hana.
- SSRI: Ua like kēia me nā snipers. Hoʻopaʻa wale lākou i ka neurotransmitter serotonin . Hoʻonui wale lākou i kona mau pae.
- MAOIs: Ua like kēia me ka pū panapana. Hoʻopilikia lākou i kekahi mau neurotransmitters (serotonin, norepinephrine, dopamine) i ka manawa hoʻokahi.
Ma muli o ka liʻiliʻi o nā hopena ʻaoʻao o nā lāʻau SSRI a ʻaʻohe lula kūikawā e pili ana i ka meaʻai a me ka mea inu, ʻōlelo mua nā kauka i nā lāʻau SSRI.
He aha nā hopena ʻaoʻao maʻamau o nā MAOI?
E like me nā lāʻau lapaʻau āpau, hiki i kēia ke loaʻa nā hopena ʻaoʻao. Akā, ʻaʻole loaʻa i nā kānaka a pau. Loaʻa paha i kekahi poʻe hoʻokahi a ʻelua paha, a ʻaʻole paha e ʻike kekahi i kekahi. Inā loaʻa iā ʻoe kekahi ʻeha hou ma hope o ka hoʻomaka ʻana i kēia lāʻau lapaʻau, e kamaʻilio me kāu kauka e pili ana i ia mea.
| Nā hopena ʻaoʻao maʻamau | Wehewehena |
|---|---|
| Pōʻino a poʻo hina paha | Hiki ke hana ʻia kēia e ke koko haʻahaʻa. Hiki ke kāohi ʻia kēia ma ke ala mālie ʻana mai ke kū ʻana a i ʻole ka noho ʻana. |
| Waha maloʻo | Hiki iā ʻoe ke hoʻomaha ma ka inu ʻana i ka wai hou aku a me ka nau ʻana i ka gum kō ʻole. |
| Ka luaʻi | Hiki ke hoʻēmi ʻia kēia ma ka lawe ʻana i ka lāʻau lapaʻau me ka meaʻai. |
| ʻO ka paʻa ʻana o ka ʻōpū a i ʻole ka paʻa ʻana o ka ʻōpū | Hiki ke loli kēia ma muli o kāu ʻai a me ka nui o ka wai āu e inu ai. |
| Hiamoe | Hiki i ke kauka ke aʻo iā ʻoe e lawe i ka lāʻau lapaʻau i ka pō. |
| ʻAʻole hiki ke hiamoe | I kēlā hihia, e aʻo ʻia paha ʻoe e lawe i ka lāʻau lapaʻau i ke kakahiaka. |
Nā pilikia koʻikoʻi e pili ana i ka hoʻohana ʻana i nā MAOI!
Pono ʻoe e makaʻala nui i kēia ʻāpana. He lāʻau lapaʻau nā MAOI e hoʻohana ʻia me ke akahele nui.
1. Hoʻonui ʻia nā manaʻo pepehi kanaka
Hiki ke piʻi aʻe nā manaʻo a i ʻole ke ʻano pepehi kanaka, ʻoiai hoʻi i nā poʻe ʻōpio ma lalo o 25 mau makahiki, i ka wā e hoʻomaka mua ʻia ai kēia lāʻau lapaʻau a i ʻole ke hoʻololi ʻia ka dosage.
Inā hoʻomaka ʻoe a i ʻole kāu keiki e manaʻo i ka manaʻolana ʻole ma hope o ka hoʻomaka ʻana i kēia lāʻau lapaʻau, mai kānalua e hoʻokaʻaʻike koke aku i ke kauka nāna i kuhikuhi i ka lāʻau lapaʻau.Hiki iā ʻoe ke loaʻa koke ke kākoʻo ma ke kelepona ʻana i ka helu kōkua olakino noʻonoʻo aupuni o Sri Lanka, 1926 .
2. Ka maʻi Serotonin
He kūlana kakaikahi kēia, akā he mea hoʻoweliweli paha i ke ola . Hana ʻia ia i ka wā e piʻi nui ai ka nui o ka serotonin i loko o ke kino. Hoʻonui ʻia kēia pilikia inā ʻoe e lawe i kahi MAOI i ka wā e lawe ana i nā lāʻau lapaʻau ʻē aʻe e hoʻonui ai i nā pae serotonin (e.g., nā antidepressants ʻē aʻe, kekahi mau syrup cough, a me nā painkiller).
No laila, ma mua o kou hoʻomaka ʻana e lawe i kahi MAOI, pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (me nā huaora a me nā lāʻau lapaʻau kuʻuna).
| Nā Hōʻailona o ka Serotonin Syndrome | |
|---|---|
| Nā hōʻailona maʻamau |
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| Nā hōʻailona koʻikoʻi a wikiwiki hoʻi |
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| Inā ʻike ʻoe i kekahi o kēia mau hōʻailona koʻikoʻi, e hele koke i ka haukapila Emergency Department (ETU) kokoke loa! | |
3. ʻO ka maʻi hoʻōki antidepressant
Inā ʻoe e lawe i kahi MAOI no nā pule he 6 a ʻoi aʻe a laila e hoʻōki koke iā ia, hiki iā ʻoe ke ʻike i nā hōʻailona haʻalele. ʻAʻole kēia he mea hoʻomaʻamaʻa, akā he ala no ke kino e pane ai i ka lāʻau lapaʻau i ka wā e maʻa ai iā ia.
Nā ʻano:
- ʻEha kino, luhi, a me ka hou ʻana, me he mea lā he kuni kou
- ʻAʻole hiki ke hiamoe
- Ka luaʻi
- Pōʻino
- Manaʻo e like me ke uila e hele ana i loko o kou kino
- Hopohopo, huhū
Mai ho'ōki koke i ka lawe ʻana i kēia lāʻau lapaʻau no kekahi kumu me ka ʻole o ke kūkākūkā ʻana me kāu kauka. Inā hoʻōki ʻoe i ka lawe ʻana i ka lāʻau lapaʻau, e hana mālie i loko o kahi manawa o hoʻokahi mahina, e hoʻēmi ana i ka nui, a ma lalo wale nō o ka nānā ʻana a kāu kauka.
4. Ka hopena weliweli me ka meaʻai (Tyramine Reaction)
ʻO kēia ka pilikia nui a weliweli loa me nā MAOI.
E like me kā mākou i kūkākūkā ai ma mua, pale nā lāʻau MAOI i ka enzyme e wāwahi i kahi kemika i kapa ʻia ʻo tyramine. Loaʻa pinepine ʻia ka Tyramine i kekahi mau meaʻai a mākou e ʻai ai. I loko o ke kanaka e lawe ʻole ana i ka lāʻau lapaʻau, wāwahi maʻalahi ke kino a hoʻopau i kēia tyramine.
Akā inā ʻai kekahi e lawe ana i ka MAOI i kahi meaʻai kiʻekiʻe i ka tyramine, ʻaʻole hiki i ke kino ke wāwahi iā ia. A laila piʻi nui ka nui o ka tyramine i loko o ke koko, e hoʻonui koke i ke koko (Hypertensive Crisis) . He mea weliweli loa kēia. I kekahi mau hihia kakaikahi, hiki i kēia ke alakaʻi i ke kahe koko o ka lolo a me ka make.
Nā meaʻai e 'hōʻalo loa' ai i ka wā e lawe ana i nā MAOI!
Inā ʻoe e lawe ana i kahi MAOI, pono ʻoe e pale loa i nā meaʻai ma ka papa inoa ma lalo nei. E kamaʻilio me kāu kauka e pili ana i kēia no ka ʻike hou aku.
| ʻAno meaʻai | Nā mea e pale aku ai a me ke kumu |
|---|---|
| Kīhi | E pale loa i nā tīhi kahiko . Eia kekahi laʻana: Cheddar, Blue cheese, Parmesan. (Piʻi ka nui o ka Tyramine i ka hala ʻana o ka manawa). Maikaʻi nā tīhi hou e like me ka Cottage cheese, Mozzarella. |
| ʻIʻo a me ka iʻa i hana ʻia | Nā sausage, salami, ʻiʻo maloʻo, ʻiʻo i hoʻōla ʻia, a me nā ʻiʻo/iʻa i puhi ʻia. |
| Nā mea ʻono | ʻO ka mea ʻono soy a me nā mea ʻono ʻē aʻe i hoʻomoʻa ʻia. |
| Nā huaʻai a me nā mea kanu i hoʻomoʻa ʻia | Nā maiʻa pala loa , nā ʻāpala ʻawaʻawa, nā fiku. Nā pī fava (he ʻano legume). |
| ʻAila | ʻO ka pia tap (pia draft) a me nā pia fermented. Loaʻa i kekahi mau waina ka tyramine kiʻekiʻe. |
| ʻĒ aʻe | Berena sourdough, akepaʻa, a pēlā aku (piʻi koke ka tyramine inā ʻaʻole hou). |
ʻO ka mea nui loa: E ʻai i ka meaʻai i ka wā e moʻa ai. E hoʻokomo i nā koena i loko o ka pahu hau a pale i ka hoʻomehana hou ʻana. I ka wā e ʻelemakule ai ka meaʻai, hiki ke piʻi aʻe nā pae tyramine.
ʻEhia ka lōʻihi e ʻike ai i nā hopena o ka lāʻau lapaʻau?
ʻO ka maʻamau , ʻelua a ʻekolu pule ka lōʻihi e ʻike ʻia ai nā hopena piha o ka lāʻau lapaʻau. Inā ʻaʻole ʻoe e ʻike i kekahi hoʻomaikaʻi ʻana i kāu mau hōʻailona i loko o ia manawa, e kamaʻilio me kāu kauka.
Āhea ʻoe e kāhea aku ai i kāu kauka?
Inā ʻoe e lawe ana i kahi MAOI, pono ʻoe e ʻike pinepine i kāu kauka e ʻike inā e hana ana ka lāʻau lapaʻau a inā he mau pilikia kāu. Eia kekahi, e kamaʻilio me kāu kauka e pili ana i kēia mau mea:
- Inā hoʻopilikia nā hopena ʻaoʻao iā ʻoe.
- Inā ʻaʻole hoʻomaikaʻi a ʻoi aku paha ka ʻino o kāu mau hōʻailona.
- Inā manaʻo ʻoe he pono ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau.
ʻO ka mea hope loa, ma ke ʻano he kanaka e lawe ana i ka MAOI, he mea nui e haʻi i kekahi kauka āu e ʻike ai (ʻoiai he kauka niho) e lawe ana ʻoe i kēia lāʻau lapaʻau, no ka mea, hiki i kekahi mau anesthetics a me nā lāʻau lapaʻau ʻē aʻe ke hana i nā hopena weliweli me nā MAOI.
Leka Lawe-Home
- ʻO nā MAOI kahi ʻano lāʻau lapaʻau no ke kaumaha i hoʻohana nui ʻole ʻia i kēia manawa, akā he hopena maikaʻi loa ia i kekahi mau hihia.
- Pono e hōʻalo loa ʻia nā meaʻai i loaʻa ka tyramine (e like me ka tīhi kahiko, nā ʻiʻo i hana ʻia, ka mea ʻono soy) i ka wā e lawe ana i kēia lāʻau. Hiki i kēia ke hoʻoweliweli i ke ola.
- He mea nui e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei.
- Mai ho'ōki koke i ka lawe ʻana i ka lāʻau lapaʻau me ka ʻole o ke kūkākūkā ʻana me kāu kauka.
- Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi o ka serotonin syndrome (ka huikau, ke kuni nui, nā hopu ʻana) a i ʻole nā manaʻo pepehi kanaka, e hele koke i kahi lumi pilikia (ETU) .
- E haʻi aku i kēlā me kēia kauka lapaʻau āu e mālama ai e lawe ana ʻoe i kahi MAOI.
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