He maʻi weliweli anei ka lāʻau lapaʻau āu e lawe nei? E aʻo kākou e pili ana i ka Serotonin Syndrome?

I kēia lā, e kamaʻilio mākou e pili ana i kahi maʻi koʻikoʻi iki, akā hiki ke hoʻomalu maʻalahi ʻia inā ʻike ʻoe. Ke lawe nei paha ʻoe i ka lāʻau lapaʻau no ke kaumaha a i ʻole kekahi maʻi ʻē aʻe. I kekahi manawa hiki i kēia mau lāʻau lapaʻau ke hoʻololi i ko mākou kino a hoʻoulu i nā pilikia i hiki ʻole iā mākou ke noʻonoʻo. ʻO kekahi o ia ʻano maʻi ʻo ia ka serotonin syndrome.

He aha ka maʻi Serotonin?

I ka ʻōlelo maʻalahi, ʻo ka Serotonin Syndrome kahi hopena lāʻau i hiki ke hoʻoweliweli i ke ola, e hana ʻia ana ke nui loa ka kemika i kapa ʻia ʻo serotonin i loko o kou kino.

E noʻonoʻo e pili ana i ia mea, he ʻelele kemika koʻikoʻi ka serotonin i hana ʻia e nā hunaola nerve i loko o ko kākou lolo a me nā ʻāpana ʻē aʻe o ke kino. I ka pololei, he ʻelele ia e lawe ana i nā leka ma waena o nā hunaola nerve. Kāhea mākou i kēia he neurotransmitter . Hoʻopilikia kēia serotonin i nā mea he nui, e like me ko kākou ʻano, ka hiamoe, a me ka makemake.

Hiki i ka hapa nui o ka poʻe ke lawe palekana i nā lāʻau lapaʻau e hoʻopilikia ana i ka serotonin (serotonergic) ma nā dosis i ʻōlelo ʻia, e like me ke kauoha a kā lākou kauka. Eia nō naʻe, ʻoi aku ka nui o ka hiki ʻana mai o ka maʻi serotonin ke hoʻomaka ʻoe i kahi lāʻau lapaʻau hou a hoʻonui paha i ka nui o kahi lāʻau lapaʻau āu e lawe nei, ʻoiai inā hoʻonui ka lāʻau i kāu mau pae serotonin. Inā hoʻololi kou kino i ke ʻano o ka hoʻohana ʻana i ka serotonin, a inā ʻaʻole hiki iā ʻoe ke lawelawe i nā pae serotonin i hoʻonui ʻia, hiki iā ʻoe ke hoʻomohala i nā hōʻailona o ka maʻi serotonin.

Hiki i kēia ʻano ke ʻano mai nā hōʻailona ʻoluʻolu e like me ka maʻi pākī a me ka nausea a hiki i nā hōʻailona koʻikoʻi e like me ke kuni nui a me nā hopu ʻana. I kekahi mau hihia, hiki i ka maʻi serotonin koʻikoʻi ke hoʻoweliweli i ke ola inā ʻaʻole ʻike ʻia a mālama koke ʻia.

Ua ʻike mua nā kauka i ka maʻi serotonin i nā makahiki 1960, ma hope o ka ʻāpono ʻia ʻana o nā antidepressants mua. I kēia lā, ʻoiai ka nui o nā lāʻau lapaʻau e loaʻa ana e hoʻopilikia i ka serotonin, ke hōʻike pinepine ʻia nei nā hihia o ka maʻi serotonin.

ʻO wai ka mea hiki ke hoʻomohala i kēia?

ʻOiaʻiʻo, hiki i kekahi ke loaʻa i kēia, me ka nānā ʻole i ka makahiki. Inā ʻoe e hoʻohana i nā lāʻau lapaʻau i kuhikuhi ʻia, nā lāʻau lapaʻau ma luna o ke kūʻai aku, nā mea hoʻohui lāʻau a meaʻai paha, a i ʻole nā ​​​​lāʻau lapaʻau kū ʻole i ke kānāwai e hoʻopilikia i kāu mau pae serotonin, aia ʻoe i ka pilikia no ka loaʻa ʻana o ka serotonin syndrome.

He aha nā hōʻailona maʻamau o kēia?

Hiki ke ʻokoʻa nā hōʻailona a me ke koʻikoʻi o ka serotonin syndrome mai kēlā kanaka a kēia kanaka. Hiki iā lākou ke akahai, kaulike, koʻikoʻi, a hiki i ka make.

Inā ʻoe e lawe ana i kahi lāʻau lapaʻau e hoʻopilikia ana i ka serotonin a loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​e kāhea koke i kāu kauka a i ʻole e hele i kahi lumi pilikia.

Nā hōʻailona liʻiliʻi

• Ke hopohopo iki nei a me ka hopohopo ʻole.
• Manaʻo luaʻi a me ka luaʻi.
• ʻŌpū pehu (diarrhea).
• Lilo nā haumāna ʻeleʻele i mea nui aʻe (dilated pupils).
• Manaʻo e haʻalulu ana kou mau lālā (Tremor).

Nā hōʻailona maʻamau

• Ua hopohopo loa wau a me ka hoʻonāukiuki.
• ʻŌniʻoniʻo ʻiʻo, ʻūmiʻi ʻana o nā ʻiʻo me ka makemake ʻole, ʻūmiʻi ʻana o nā ʻiʻo, paʻakikī o nā ʻiʻo.
• E hou nui ana, e haʻalulu ana i ke anu.
• Neʻe nā maka i ke ʻano ʻē mai kēlā ʻaoʻao a i kēia ʻaoʻao.

Nā hōʻailona koʻikoʻi

• He nui ka huikau, me he mea lā e hoʻopilikia ʻia ana ka ʻike, poina iā ia kahi a me ka manawa hea (Confusion, disorientation, delirium).
• Piʻi nui ka helu o ka puʻuwai (wikiwiki ka helu o ka puʻuwai).
• Ke koko kiʻekiʻe.
• ʻOi aku ka mahana o ke kino ma mua o 38.5 degere Celsius (101.3 degere Fahrenheit).
• Ke hiki mai nei nā ʻōhū.
• Lilo ka puʻuwai i mea ʻē.
• Ua nalowale koʻu ʻike a hāʻule au.

Pehea ka wikiwiki o ka ʻike ʻia ʻana o nā hōʻailona?

Hoʻomaka pinepine kēia mau hōʻailona e ʻike ʻia i loko o kekahi mau hola , ma hope o ka hoʻomaka ʻana i kahi lāʻau lapaʻau hou e hoʻopilikia ai i nā pae serotonin a i ʻole ma hope o ka hoʻonui ʻana i ka nui o ka lāʻau lapaʻau āu e lawe nei. Loaʻa i ka aneane nā kānaka a pau nā hōʻailona i loko o 24 mau hola o ka lawe ʻana i kahi lāʻau lapaʻau a huahana paha e hoʻopilikia ai i ka serotonin.

No ke aha e hana ʻia ai kēia? He aha nā kumu?

ʻO ke kumu nui o ka maʻi serotonin ka piʻi ʻana o nā pae serotonin i loko o kou kino. Hiki ke hana ʻia kēia i nā kūlana e like me kēia:

• Ke hoʻohana ʻana i nā lāʻau lapaʻau he nui e hoʻopilikia ai i nā pae serotonin.
• I ka wā e hoʻomaka ai i kahi lāʻau hoʻonui serotonin hou, a i ʻole i ka wā e hoʻonui ai i ka nui o ka lāʻau āu e lawe nei.
• Inā lawe nui ʻoe i ka lāʻau lapaʻau e pili ana i ka serotonin, malia paha he mea ulia pōpilikia a manaʻo ʻia paha.
• Ke hoʻohana nei i kekahi mau lāʻau lapaʻau kū ʻole i ke kānāwai, nā huahana lāʻau lapaʻau , a i ʻole nā ​​​​lāʻau lapaʻau ma luna o ke kauka e hoʻopilikia ana i nā pae serotonin.

He aha nā lāʻau lapaʻau a me nā mea ʻē aʻe e hoʻopilikia ai i nā pae serotonin?

I kēia manawa e nānā kākou i nā ʻano lāʻau lapaʻau e hiki ke hoʻopilikia i nā pae serotonin a hoʻoulu i ka maʻi serotonin.

Nā lāʻau hoʻēmi kaumaha

Ma waena o kēia mau mea, ʻo nā antidepressants ka mea nui loa. ʻO kēia nā lāʻau lapaʻau e hoʻopilikia nui i nā pae serotonin. Hoʻomaka pinepine kēia ʻano ke hoʻohana pū ʻia kēia mau antidepressants me nā lāʻau lapaʻau ʻē aʻe e hoʻopilikia ana i ka serotonin, e like me nā triptans no nā migraines a i ʻole nā ​​opioids no ka hoʻomaha ʻeha.

Eia kekahi mau ʻano o nā antidepressants a me nā hiʻohiʻona:

• ʻO nā mea pale i ka hoʻihoʻi hou ʻana o ka serotonin koho (SSRIs): Loaʻa i kēia hui nā lāʻau lapaʻau e like me fluoxetine (Prozac®), citalopram (Celexa®), sertraline (Zoloft®), paroxetine (Paxil®) a me escitalopram (Lexapro®). ʻO kēia nā mea i hoʻohana nui ʻia a no laila ʻo ia nā mea e pili nui ana me ka maʻi serotonin.
• Nā mea hoʻopaʻa i ka serotonin-norepinephrine reuptake (SNRIs): ʻO nā hiʻohiʻona o kēia mau mea ʻo duloxetine (Cymbalta®), venlafaxine (Effexor®), desvenlafaxine (Pristiq), levomilnacipran (Fetzima) a me milnacipran (Savella).
• ʻO nā lāʻau lapaʻau e like me ka ʻamitriptyline (Elavil®)`, ʻo ka clomipramine (Anafranil®)`, a me ka nortriptyline (Pamelor®)`:
• ʻO nā mea hoʻopaʻa monoamine oxidase (MAOIs): Aia nā lāʻau lapaʻau e like me phenelzine (Nardil®)`, `selegiline (Emsam®)` a me `tranylcypromine (Parnate®)` i loko o kēia māhele.
• Nā mea hoʻololi Serotonin: e like me nefazodone a me trazodone (Desyrel®).
• ʻO kahi laʻana o kēia ʻo `Norepinephrine reuptake inhibitor`: `bupropion (Wellbutrin®).`

Nā Lāʻau Lapaʻau ʻē aʻe

Ma waho aʻe o nā lāʻau antidepressants, aia kekahi mau lāʻau lapaʻau ʻē aʻe e hoʻopilikia i nā pae serotonin i loko o ke kino. Kiʻekiʻe loa ka pilikia ke hui pū ʻia kēia mau mea me nā lāʻau lapaʻau ʻē aʻe e hoʻopilikia pū ana i ka serotonin. Hoʻohana ʻia kēia mau lāʻau lapaʻau i:

• No ka ʻeha nui: Nā lāʻau hoʻopau ʻeha mai ka papa opioid, e like me tramadol (Ultram®), meperidine (Demerol®), tapentadol (Nucynta®), hydrocodone (Hysingla ER®), oxycodone (Oxycontin®), fentanyl (Actiq®), a me methadone.
• ʻŪlū: ʻO kekahi mau lāʻau lapaʻau ʻūlū ma luna o ka counter (OTC) a me nā lāʻau anu, e like me dextromethorphan, hiki ke hoʻopilikia i nā pae serotonin.
• No nā ʻeha poʻo migraine: ʻO nā Triptans e komo pū me almotriptan (Axert®), eletriptan (Relpax®), a me sumatriptan (Imitrex®).
• No ka maʻi HIV/AIDS: `ritonavir (Norvir®)`.
• Nā lāʻau lapaʻau: linezolid (Zyvox®).
• Nā lāʻau lapaʻau no ka nausea a me ka luaʻi: ​​e like me `metoclopramide (Reglan®)`, `granisetron (Sustol®)`, `ondansetron (Zofran®)`.
• Hoʻopaʻa manaʻo: lithium (Lithobid®).

Nā Huahana ʻē aʻe

Ma waho aʻe o nā lāʻau lapaʻau, hiki i kekahi mau mea kanu kuʻuna, nā mea hoʻohui meaʻai, a me nā lāʻau lapaʻau ʻole ke hoʻopilikia i nā pae serotonin a hoʻoulu i kēia ʻano.

• Nā mea hoʻohui lāʻau lapaʻau: Hiki i kēia ke komo pū me nā mea e like me ka ginseng, ka wort St. John, ka rue Syrian, a me ka nutmeg.
• Nā lāʻau lapaʻau kū ʻole i ke kānāwai: Nā mea e like me ka ecstasy, LSD, cocaine, amphetamines, a me methamphetamines.
• Nā mea hoʻohui meaʻai:ʻO ka triptofan.

Ke aʻo nui nei nā loea lapaʻau e pili ana i ka serotonin syndrome. Inā he mau nīnau kāu e pili ana i nā lāʻau lapaʻau āu e lawe ai a inā paha e pili ana lākou i ka serotonin, e kamaʻilio me kāu kauka a i ʻole ke kanaka ma ka hale kūʻai lāʻau kahi āu e loaʻa ai kāu lāʻau lapaʻau.

Pehea e ʻike ai nā kauka i kēia?

I kēia manawa, e nānā kākou pehea e ʻike ai nā kauka i kēia. ʻAʻohe hoʻāʻo kikoʻī e hōʻoia i ka maʻi serotonin. ʻO ka maʻamau, e ʻike kāu kauka iā ia ma ka nānā ʻana iā ʻoe, e nīnau e pili ana i kāu mau hōʻailona, ​​a me ke aʻo ʻana e pili ana i nā lāʻau lapaʻau āu e lawe nei e hoʻopilikia i kāu pae serotonin.

Hiki iā ʻoe ke kōkua i kāu kauka ma ka maopopo ʻana i nā mea āpau āu e lawe nei (nā lāʻau lapaʻau i kuhikuhi ʻia, nā lāʻau lapaʻau i kūʻai ʻole ʻia, nā mea hoʻohui, nā lāʻau lapaʻau lāʻau, a me nā lāʻau lapaʻau kū ʻole i ke kānāwai). (E ʻoiaʻiʻo, mai makaʻu. Aia ke kauka ma laila e kōkua iā ʻoe, ʻaʻole e hoʻohewa iā ʻoe.)

Hiki i kāu kauka ke hana i nā hoʻokolohua e like me kēia:

• Nā hoʻāʻo koko a me ka mimi e nānā i nā pae o nā lāʻau lapaʻau āu e lawe nei.
• Nā hoʻāʻo e ʻike ai inā e hana pono ana kāu mau ʻāpana ʻē aʻe.
• Nā hoʻāʻo e ʻike ai inā he maʻi i loko o ke kino, malia paha he kī ʻana i ka iwi kuamoʻo.
• Hiki ke hana ʻia kahi X-ray umauma a i ʻole CT scan e hōʻoia ʻaʻohe mau kūlana ʻē aʻe (i loaʻa nā hōʻailona like) a i ʻole e nānā i nā pilikia ʻē aʻe.

Pehea e mālama ʻia ai kēia?

ʻO nā lāʻau lapaʻau āu e loaʻa ai e pili ana i ke koʻikoʻi o kāu mau hōʻailona.

• Nā hōʻailona liʻiliʻi: Inā liʻiliʻi nā hōʻailona, ​​​​ʻo ka hoʻōki ʻana i ka lāʻau lapaʻau a i ʻole ka hoʻololi ʻana i ka nui o ka lāʻau e hoʻopau pinepine i nā hōʻailona i loko o 24 a 72 mau hola . Inā ʻaʻole e hoʻopau koke nā hōʻailona, ​​​​hiki ke kuhikuhi ʻia kahi lāʻau pale serotonin e like me cyproheptadine (Periactin®).
• Nā hōʻailona kaulike: Inā kaulike kāu mau hōʻailona, ​​e mālama ʻia ʻoe i ka haukapila no 24 mau hola ma ka liʻiliʻi e ʻike inā hoʻomaikaʻi kāu mau hōʻailona me ka mālama ʻana.
• Nā hōʻailona koʻikoʻi: Inā koʻikoʻi loa nā hōʻailona, ​​e hoʻokomo ʻia ʻoe i ka Intensive Care Unit (ICU) kahi e nānā pono ʻia ai kou kino a me nā hana o kou ʻōkana.

Ma muli o nā hōʻailona, ​​​​hiki ke hāʻawi ʻia nā lāʻau lapaʻau penei:

• Hiki i kahi mea hoʻomaha e like me ka benzodiazepine ke hōʻemi i nā hōʻailona e like me ka hoʻonāukiuki, ka ʻoʻoleʻa o nā ʻiʻo, a me nā hopu ʻana.
• Hāʻawi ʻia ka saline `(IV fluids)` e hōʻemi i ka paʻa ʻana o ka wai a me ke kuni, a hāʻawi ʻia ka oxygen ma o kahi `(mask)` i ka maka e hoʻomaikaʻi i ka pae oxygen i loko o ke koko.
• Lāʻau lapaʻau e kaohi ai i ka helu o ka puʻuwai a me ke koko.
• No ka hoʻēmi ʻana i ke kuni kiʻekiʻe loa (41.1 degere Celsius / 106 degere Fahrenheit), hoʻokomo ʻia kahi ʻōmole hanu no nā pilikia hanu, hāʻawi ʻia ka lāʻau hoʻomālielie, a hāʻawi ʻia nā lāʻau hoʻomaha ʻiʻo.
• Inā ʻaʻole hāʻawi koke nā lāʻau ʻē aʻe i ka hōʻoluʻolu, ua kuhikuhi ʻia kahi lāʻau pale serotonin i kapa ʻia ʻo cyproheptadine.

Inā ua hoʻokumu ʻia kāu maʻi serotonin e kahi antidepressant, hiki ke hala i kekahi mau pule no ka lāʻau e haʻalele loa i kou kino a no ka nalo loa ʻana o kāu mau hōʻailona.

ʻO ka mea nui loa: Mai ho'ōki i ka lawe ʻana i kekahi lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke kamaʻilio ʻana me kāu kauka. Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi a inā e ʻoi aʻe kou ʻano, e ʻimi koke i ke kōkua lapaʻau. Hiki i ka maʻi Serotonin ke hoʻoweliweli i ke ola.

He aha nā pilikia e hiki ke hana?

Inā ʻaʻole mālama ʻia, hiki i ka serotonin syndrome ke alakaʻi i nā pilikia e like me:

• Nā ʻōʻili.
• Paʻakikī ka hanu ʻana.
• Ka hāʻule ʻana o nā puʻupaʻa. Ke hōʻiliʻili ʻia nā huahana haki ʻiʻo i loko o ke koko a kānana ʻia e nā puʻupaʻa, hiki iā ia ke hōʻeha nui i nā puʻupaʻa inā ʻaʻole mālama ʻia.
• Mokuʻāina koma.
• Hiki ke make.

Pehea lā kākou e ola nei i kēia?

• He mea nui loa ia e makaʻala pono i nā lāʻau lapaʻau āu e lawe ai. E heluhelu i nā ʻōlelo aʻo a pau ma ka pūʻolo lāʻau a i ʻole ka pepa ʻike e hele pū mai me ia. E haʻi aku ia iā ʻoe inā he pilikia o ka serotonin syndrome.
• Mai ho'ōki i kekahi lāʻau lapaʻau me ka ʻole o ke kamaʻilio ʻana me kāu kauka.
• E hoʻomaopopo i nā kauka a pau e mālama iā ʻoe e pili ana i nā lāʻau lapaʻau a pau āu e lawe nei (nā lāʻau lapaʻau i kauoha ʻia, nā lāʻau lapaʻau ma luna o ke kūʻai aku, nā mea kanu kuʻuna, nā mea hoʻohui, a me nā lāʻau lapaʻau kū ʻole i ke kānāwai).
• Inā ʻoe e lawe ana i ka triptan no ka migraines me nā antidepressants (ʻoi aku hoʻi nā SSRI a i ʻole SNRI), pono kāu kauka e nānā pono iā ʻoe. Manaʻo ʻia he liʻiliʻi loa ka pilikia, ʻaʻole paha. Akā e hoʻomanaʻo, he kuleana kou: Inā ʻike ʻoe i kekahi o nā hōʻailona i ʻōlelo ʻia ma kēia ʻatikala, e kāhea koke i kāu kauka .
• ʻO ka hahai ʻana i kēia mau hana palekana e kōkua iā ʻoe a me kāu kauka e ʻike i nā hōʻailona o ka serotonin syndrome i ka wā mua. Hiki i ka ʻike mua ʻana ke kōkua i ka pale ʻana i nā hōʻailona koʻikoʻi.

He aha kā mākou e manaʻo ai ma kēia kūlana?

Inā ʻike koke ʻia a mālama ʻia, e hoʻopau loa ʻia nā hōʻailona o ka hapa nui o ka poʻe i loko o 24 a 72 mau hola.

Ma hope o ka ho'ōla ʻana, hiki i kāu kauka ke:

• E hōʻemi i ka nui o ka lāʻau lapaʻau i hoʻoulu ai i kēia kūlana i ka nui haʻahaʻa loa.
• E ho'ōki i ka hāʻawi ʻana i ʻelua mau lāʻau lapaʻau kiʻekiʻe e hoʻopili pū ana i ka serotonin.
• E hoʻololi i kahi lāʻau lapaʻau ʻē aʻe i hoʻopilikia ʻole i ka serotonin.

Āhea wau e kāhea aku ai i kaʻu kauka ?

• Inā loaʻa iā ʻoe nā hōʻailona o ka serotonin syndrome (a i ʻole ka hoʻonui ʻia ʻana o nā hōʻailona), e kāhea koke i kāu kauka a i ʻole e hele i ka lumi pilikia. E makaʻala loa inā ua hoʻomaka ʻoe i kahi lāʻau lapaʻau hou, hoʻonui i ka nui o ka lāʻau lapaʻau o kēia manawa, a i ʻole e lawe ana i nā lāʻau lapaʻau āu i ʻike ai e pili ana i nā pae serotonin.
• Mai ho'ōki i ka lawe ʻana i ka lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke kamaʻilio ʻana me kāu kauka.
• E hōʻoia i ka ʻike o kāu mau kauka a pau i nā lāʻau lapaʻau a pau āu e lawe ai.
• E heluhelu pono i nā ʻōlelo aʻo a me nā pepa ʻike e hele mai me kāu lāʻau lapaʻau.
• E aʻo e pili ana i nā hōʻailona o ka serotonin syndrome. E makaʻala pono i kēia mau hōʻailona inā ʻoe e lawe ana i nā antidepressants.
• Inā he mau nīnau kāu e pili ana i kāu lāʻau lapaʻau a i ʻole nā ​​hōʻailona, ​​e nīnau i kāu kauka a mea kūʻai lāʻau paha.
• Inā ʻike ʻoe i nā hōʻailona, ​​a inā e ʻoi aʻe ka ʻino o kāu mau hōʻailona, ​​mai poina e kāhea koke aku i kāu kauka a i ʻole e hele i kahi lumi pilikia.

He aha ka leka a mākou e makemake ai e lawe i ka home mai kēia moʻolelo?

• He kūlana koʻikoʻi ka Serotonin Syndrome, akā hiki ke ho'ōla ʻia inā mālama pono ʻia.
• E kamaʻilio ākea me kāu kauka e pili ana i kekahi lāʻau lapaʻau āu e lawe ai, ʻoiai inā ʻoe e hoʻomaka ana i kahi mea hou a hoʻololi paha i ka dosage.
• E makaʻala i nā hōʻailona. Inā he kānalua kou , e ʻimi i ke aʻo lapaʻau me ka hoʻonele ʻole i ka manawa.
• E hoʻomanaʻo, ʻo ʻoe ka mea ʻoi loa ka ʻike i kou olakino, no laila he mea nui e makaʻala i nā loli.

ʻO ka maʻi Serotonin, serotonin, nā antidepressants, nā hopena ʻaoʻao lāʻau, nā kemika lolo, nā neurotransmitters, nā hopena lāʻau