ʻAʻole anei ʻoe hauʻoli? Ua luhi anei ʻoe i nā mea āpau? Kāhea mākou i kēia ʻano he kaumaha. No laila, aia nā ʻano lāʻau like ʻole i hāʻawi ʻia e mālama i kēia ʻano noʻonoʻo i kapa ʻia ʻo ke kaumaha. I kēia lā e kamaʻilio mākou e pili ana i kahi hui o nā lāʻau lapaʻau i ʻoi aku ka kahiko a pono ʻoe e makaʻala loa i ka wā e hoʻohana ai. Ua kapa ʻia kēia mau mea ʻo MAOIs, ʻo ia hoʻi ka Monoamine Oxidase Inhibitors. ʻOiai paha he mea paʻakikī iki kēia inoa, e kamaʻilio maʻalahi kākou e pili ana.
He aha maoli kēia mau MAOI?
I ka ʻōlelo maʻalahi, ʻo nā MAOI kahi ʻano lāʻau lapaʻau e kōkua i ka kaohi ʻana i nā hōʻailona o ke kaumaha. ʻO kēia nā antidepressants mua i ʻike ʻia ma ka honua . Eia naʻe, ʻaʻole kuhikuhi maʻalahi nā kauka i kēia lāʻau i kēia mau lā. ʻO ke kumu o kēia, pono ʻoe e makaʻala loa i kāu mea e ʻai ai a inu ai i ka wā e lawe ai i kēia mau lāʻau lapaʻau, a pono hoʻi ʻoe e makaʻala pono i kekahi mau hopena ʻaoʻao a me ka palekana.
ʻO ka maʻamau, kuhikuhi wale nā kauka i nā MAOI ma ke ʻano he hopena hope loa ke hiki ʻole i nā antidepressants hou (e like me SSRIs) ke hoʻomaikaʻi i nā hōʻailona.
He aha nā lāʻau lapaʻau e pili ana i kēia māhele?
Eia kekahi o nā ʻano MAOI i hoʻohana ʻia ma ka honua holoʻokoʻa:
- ʻIsocarboxazid (Marplan®)
- ʻO Phenelzine (Nardil®)
- Selegiline (Emsam®)
- Tranylcypromine (Parnate®)
ʻAʻole paha ʻoe i kamaʻāina i kēia mau inoa, no ka mea, ʻaʻole lākou i hoʻohana pinepine ʻia ma ko mākou ʻāina. Akā, he mea maikaʻi ke ʻike.
He aha nā kūlana e mālama ʻia me nā MAOI?
Ua ʻāpono ʻia kēia mau lāʻau lapaʻau no nā maʻi like ʻole.
| ʻAno lāʻau lapaʻau | Nā kūlana lapaʻau i hoʻohana nui ʻia |
|---|---|
| ʻO Isocarboxazid lāua ʻo Tranylcypromine | Ka maʻi kaumaha nui |
| ʻO Phenelzine | ʻO ke kaumaha kūʻē i ka lāʻau lapaʻau, ka maʻi panic, a me ka maʻi hopohopo pili kanaka |
| ʻO Selegiline | Ma ke ʻano he lāʻau lapaʻau kōkua no ka maʻi kaumaha nui a me ka maʻi Parkinson. |
He aha ka hoʻohana "off-label"?
I kekahi manawa, hoʻohana nā kauka i kahi lāʻau lapaʻau no kahi kūlana i ʻae ʻole ʻia ai. Ua kapa ʻia kēia he hoʻohana "off-label". Hana ʻia ia inā hōʻike ka ʻike a me ka ʻike o ke kauka e pōmaikaʻi ia i ka mea maʻi. No ka laʻana, ua kuhikuhi ʻia ʻo Selegiline no ADHD i kekahi manawa, a ua kuhikuhi ʻia ʻo Tranylcypromine no ka hopohopo pili kanaka.
Pehea e hana ai kēia lāʻau lapaʻau?
He mea maʻalahi loa kēia e hoʻomaopopo. E noʻonoʻo he mau ʻelele liʻiliʻi i loko o ko kākou lolo. Kāhea mākou iā lākou he mau neurotransmitters . ʻO Serotonin, Norepinephrine, a me Dopamine nā ʻelele nui e kaohi i nā mea e like me ka hauʻoli, ka hiamoe, a me ka hoʻomanaʻo i loko o ko kākou mau manaʻo.
I kēia manawa, aia kekahi enzyme i loko o ko kākou lolo i kapa ʻia ʻo monoamine oxidase . ʻO ka hana a kēia enzyme, ʻo ia ke "hoʻomaʻemaʻe" i kēlā mau ʻelele. ʻO ia hoʻi, e wāwahi iā lākou a hoʻemi i ko lākou pae.
ʻO ka hana a ka MAOI, ʻo ia ke kāohi i ka enzyme e hoʻomaʻemaʻe ana (Monoamine Oxidase) mai ka hana ʻana. He aha ka mea e hana ʻia? Hōʻiliʻili kēlā mau ʻelele hauʻoli (e like me ka serotonin a me ka dopamine) i loko o ka lolo ma kahi o ka wāwahi ʻia. Piʻi aʻe ko lākou pae. A laila hoʻomaikaʻi ko mākou ʻano a emi iho nā hōʻailona o ke kaumaha.
I kēia manawa, aia kekahi kemika i kapa ʻia ʻo Tyramine . Kōkua ia i ka hoʻomalu ʻana i ke koko i loko o ko mākou kino. Hoʻōki pū nā lāʻau MAOI i ka haki ʻana o kēia Tyramine. ʻO kēia ka pilikia nui loa e hele mai me kēia mau lāʻau . E kamaʻilio mākou e pili ana ma hope.
He aha nā hopena ʻaoʻao a me nā pilikia o nā MAOI?
Aia kekahi mau hopena ʻaoʻao a me nā pilikia koʻikoʻi e pili ana i ka hoʻohana ʻana i kēia mau lāʻau lapaʻau. No laila, he mea weliweli loa ka hoʻohana ʻana iā lākou me ka ʻole o ke aʻo ʻana a ke kauka .
Nā hopena ʻaoʻao maʻamau
- ʻO ka poʻo hina a i ʻole ke poʻo māmā (ma muli o ke koko haʻahaʻa)
- Waha maloʻo (xerostomia)
- Ka luaʻi
- Ka pehu ʻana a i ʻole ka paʻa ʻana
- Hiamoe
- ʻAʻole hiki ke hiamoe
Nā pilikia koʻikoʻi a me nā pilikia
1. Ka maʻi Serotonin
ʻO kēia ke kūlana koʻikoʻi loa a hiki ke hoʻoweliweli i ke ola. Hana ʻia ia ke kiʻekiʻe loa nā pae serotonin i loko o ke kino. ʻOi aku ka nui o kēia pilikia inā ʻoe e lawe i nā MAOI me nā lāʻau lapaʻau ʻē aʻe e hoʻonui ai i nā pae serotonin (e.g., SSRIs, kekahi mau lāʻau ʻeha). No laila he mea nui e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei, ʻoiai nā huaora.
| Nā hōʻailona o ka maʻi serotonin | |
|---|---|
| Nā ʻano laulā | Hoʻomaha ʻole, luli, luaʻi, ʻeha ka ʻōpū, ʻoniʻoni nā maka, hou , haʻalulu, ʻoniʻoni nā ʻiʻo. |
| Nā hōʻailona koʻikoʻi (e pono ai ke lawe koke ʻia i ka haukapila) | Huikau, tachycardia, koko kiʻekiʻe, kuni, hopu, nalowale o ka ʻike. |
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona koʻikoʻi, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa . ʻO ka hoʻopaneʻe ʻana i ka mālama ʻana hiki ke hoʻoweliweli i ke ola.
2. Nā pilikia me ka meaʻai (ka pilina Tyramine)
ʻO kēia ka pilikia maoli nui loa me nā MAOI. E like me kā mākou i ʻōlelo ai ma mua, hoʻōki nā MAOI i ka haki ʻana o kahi kemika i kapa ʻia ʻo tyramine, kahi i loaʻa maoli i kekahi mau meaʻai.
Inā ʻoe e ʻai i nā meaʻai kiʻekiʻe i ka tyramine i ka wā e lawe ana i ka MAOI, hiki i ka nui o ka tyramine i loko o kou koko ke lilo i mea kiʻekiʻe loa. Hiki i kēia ke hoʻonui koke a koʻikoʻi i ke koko . Ua kapa ʻia kēia he "Tyramine Pressor Response." I nā hihia kakaikahi, hiki i kēia koko kiʻekiʻe ke hoʻoulu i ke kahe koko i loko o ka lolo (cerebral hemorrhage) a hiki i ka make.
He aha nā meaʻai e pono ai ʻoe e pale i ka wā e lawe ai i nā MAOI?
Aia ma lalo iho kahi papa inoa o nā meaʻai e pono e hōʻalo ʻia e kekahi e lawe ana i kēia lāʻau lapaʻau, ma muli o ko lākou kiʻekiʻe o ka tyramine.
| ʻAno meaʻai | Ka wehewehe a me nā laʻana |
|---|---|
| Kīhi ʻelemakule | ʻO nā tīhi e like me Cheddar, Swiss, a me Parmesan (ʻoi aku ka liʻiliʻi o ka pilikia o nā tīhi hou e like me Cottage cheese a me Mozzarella). |
| ʻAila Soy | ʻO nā huahana a pau i hana ʻia mai ka soy. |
| ʻIʻo/iʻa i hoʻomoʻa ʻia a mālama ʻia paha | Nā sausage, salami, iʻa maloʻo, a me nā mea ʻē aʻe. |
| Ake | ʻOiai ʻaʻohe tyramine i loko o ke akepaʻa hou, hiki ke piʻi aʻe nā pae tyramine no ka mea e hōʻino koke ia. |
| Hua pala loa | I ka wā e pala pono ai nā hua e like me ka maiʻa, ka ʻāpala ʻawaʻawa, a me nā fiku. |
| Pia i hoʻoulu ʻia | ʻOiai hoʻi ka pia paipa. |
ʻO ka mea nui loa: I ka wā e ʻelemakule ai ka meaʻai, piʻi aʻe kona nui o ka tyramine. No laila, pono i ke kanaka e lawe ana i kēia lāʻau lapaʻau ke pale aku i ka ʻai ʻana i nā koena a ʻai i ka meaʻai i moʻa hou ʻia .
3. ʻO ka maʻi hoʻōki antidepressant
Hiki ke loaʻa kēia ʻano inā ʻoe e hoʻōki koke i ka lawe ʻana i kēia lāʻau lapaʻau ma hope o ka lawe ʻana iā ia no nā pule he 6 a ʻoi. Hiki ke loaʻa nā hōʻailona e like me ke kuni, ka ʻeha kino, ka ʻeha poʻo, ka poniuniu, ka hiamoe ʻole, a me ka hoʻomaha ʻole. No laila, mai hoʻōki i ka lawe ʻana i kēia lāʻau lapaʻau me ka ʻole o ke kūkākūkā ʻana me kāu kauka . Inā ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau, pono ʻoe e hana mālie i loko o kekahi mau pule a ma lalo wale nō o ka nānā ʻana a kāu kauka.
4. Nā manaʻo pepehi kanaka
Aia kahi pilikia liʻiliʻi o ka hoʻonui ʻia ʻana o nā manaʻo pepehi kanaka ke hoʻomaka mua nā ʻōpio ma lalo o 25 mau makahiki e lawe i kēia lāʻau lapaʻau. Inā loaʻa iā ʻoe a i ʻole kāu keiki kēia mau manaʻo, e kamaʻilio koke me ke kauka nāna i kuhikuhi i ka lāʻau lapaʻau.
Āhea ʻoe e ʻike ai i ke kauka?
Inā ʻoe e lawe ana i kahi MAOI, pono ʻoe e ʻike pinepine i kāu kauka e nānā inā e hana ana ka lāʻau lapaʻau a inā he mau pilikia. Eia kekahi, e kamaʻilio pū me kāu kauka e pili ana i kēia mau mea.
- Inā loaʻa iā ʻoe nā hopena ʻaoʻao ʻaʻole hiki iā ʻoe ke ʻae.
- Inā ʻaʻole hoʻomaikaʻi kāu mau hōʻailona, a inā e ʻoi aʻe ka ʻino.
- Inā manaʻo ʻoe he pono ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau.
Leka Lawe-Home
- He papa ikaika loa a weliweli hoʻi nā MAOI o nā antidepressants i hoʻohana pinepine ʻole ʻia i kēia lā.
- Inā ʻoe e lawe nei i kēia lāʻau lapaʻau, he mea koi ka kaohi ʻana i ka ʻai . Pono e pale loa ʻia nā meaʻai kiʻekiʻe i ka tyramine.
- He mea nui loa e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei, inā ʻaʻole hiki iā ʻoe ke loaʻa i ka maʻi serotonin weliweli.
- Mai hoʻomaka a hoʻōki paha i ka lawe ʻana i kēia lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a ke kauka no kekahi kumu.
- Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi o ka serotonin syndrome a i ʻole nā manaʻo pepehi kanaka, e hele koke i ka lumi pilikia o ka haukapila (ETU).
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