Wali owuliddeko nga tolina mirembe mu ngeri eyeewuunyisa eyakuleetera obutasobola kusigala mu kifo kimu oba mu kifo kimu wadde okumala akaseera katono? Owulira ng’oyagala okutambulatambula n’okukankanya amagulu buli kiseera ng’owulira ng’obutawummula buva munda? Kino kiyinza okuba nga kiva ku ddagala ly’omira. Leero tugenda kwogera ku mbeera eno (Akathisia). Totya, kikulu nnyo okukimanya ku kino.
Kino (Akathisia) kye ki? Ka tukitegeere mu ngeri ennyangu.
Akathisia mu butuufu kukuŋŋaanyizibwa kw’obubonero obukwatagana n’enkola y’obusimu n’ebirowoozo (`(Neuropsychiatric syndrome)`). Ate era, buzibu mu ntambula. Mu mbeera eno, kizibu nnyo okutuula oba okusigala ng’osirise olw’obutawummula obw’amaanyi obuva munda. Ekigambo "akathisia" kiva mu lulimi Oluyonaani, ekitegeeza "obutasobola kutuula". Embeera eno etera okubaawo ng’okozesa eddagala erimu naddala eddagala lya `(Antipsychotic)` oba `(Neuroleptic)` erikozesebwa ku ndwadde z’obwongo. Tekikoma awo, kino (akathisia) era kiyinza okukwatagana n’embeera z’obujjanjabi ezimu nga `(Obulwadde bwa Parkinson)`. Omuntu alina (akathisia) awulira obutawummula bungi n’obutawummula munda. Eno y’ensonga lwaki balina obwagazi bungi okutambula buli kiseera naddala okutambuza amagulu. Ebiseera ebisinga entambula zino zikolebwa mu ngeri y’emu emirundi n’emirundi (`okuddiŋŋana`). Okwegomba kuno okutafugibwa okusenguka kuyinza okukunyiiza ennyo. Abasawo embeera eno (akathisia) bagigabanyamu ebika ebiwerako, okusinziira ku ddi obubonero lwe butandika n’ebbanga lye bumala.
- Acute akathisia: Kino kitera okubaawo mu nnaku ezisooka ng’omaze okutandika eddagala naddala eriweweeza ku bulwadde bw’omutima oba nga ddoozi eyongezeddwa. Bumala emyezi egitawera mukaaga.
- Akathisia etawona: Akathisia ekika kino kibaawo ng’obubonero bumaze emyezi egisukka mu mukaaga. Kiyinza okumala emyezi oba n’emyaka.
- Tardive akathisia: Kino kibaawo oluvannyuma lw’okutandika eddagala erimu, okwongera ku ddoozi oba wadde oluvannyuma lw’emyezi esatu. Kitera okukwatagana n’obuzibu obulala obw’okutambula obuyitibwa tardive dyskinesia.
- Withdrawal akathisia: Embeera eno esobola okubaawo nga ddoozi y’eddagala erimu ekendeezeddwa oba ng’eyimiriziddwa ddala.
Akathisia kye kimu ne Anxiety?
Nedda, tobuzaabuza byombi. Akathisia n’okweraliikirira mbeera bbiri ez’enjawulo. Akathisia buzibu mu ntambula, ate okweraliikirira mbeera ya bulamu bw’obwongo. Kyokka, bayinza okuba n’engeri ezimu ezifaanagana. Ng’ekyokulabirako, obutawummulamu, n’obutasobola kufuga birowoozo bye n’enneeyisa ye. Kyokka, ekikulu ekikwata ku akathisia kwe kwagala okutambula buli kiseera okutafugibwa. Obubonero obusinziira ku kutya oba okweraliikirira tebutera kulabika. Wabula kya bulijjo abantu abalina akathisia okuwulira okweraliikirira n’okubeera ku situleesi olw’okwagala kuno okutafugibwa okusenguka.
Ebyembi, embeera (Akathisia) etera okuzuulibwa obubi ng’okweraliikirira okutambula obutasalako ne/oba okutabulwa.
Akathisia ya bulijjo etya?
Akathisia bwe buzibu bw’okutambula obusinga okukwatagana n’eddagala eriweweeza ku bwongo naddala eddagala eriweweeza ku bwongo. Kiteeberezebwa nti abantu abawera 24% abalina obulwadde
bw’okutabuka emitwe abamira eddagala ly’obuzibu buno balina akathisia. Mu kunoonyereza okumu, abantu 39% abamira eddagala lya clozapine ate 45% abaali bamira eddagala ly’omulembe ogusooka eriweweeza ku bulwadde bw’omutima (FGA) baalina akathisia.
Bubonero ki obw’obulwadde bwa (Akathisia)?
Obubonero bwa Akathisia butera okulabika ng’omaze okutandika okumira eddagala eriweweeza ku bwongo, oba ng’omusawo amaze okwongera ku ddoozi. Akabonero akakulu kwe
kuwulira ng’omuntu tateredde oba okuwuubaala . Abantu abalina akathisia bawulira okwagala okusukkiridde okukankanya omubiri naddala amagulu okuva mu bisambi okutuuka ku bisambi. Bw’oba olina akathisia, osobola okukola ebintu bino:
- Bulijjo nsala amagulu gange olwo ne nddamu okugagolola.
- Amagulu gange gasigala gatambula nga ntudde.
- Bw’oba oyimiridde, okyusa obuzito okuva ku kigere ekimu okudda ku kirala.
- Nnyiganyiga nga ntudde.
- Bulijjo batambula nga badda n’okudda, oba nga bayimiridde mu kifo kimu ne beefuula abatambula.
Eri omuntu omulala, obubonero buno n’entambula zino biyinza okulabika ng’omuntu atambulatambula buli kiseera era nga tasobola kutuula.
Bw’oba olina obubonero buno, kikulu okwogera n’omusawo mu bwangu. Kiwulira kitya okubeera ne (Akathisia)?
Abantu abalina Akathisia batera okunnyonnyola okuwulira nga tebalina mirembe gya maanyi munda n’okwagala okutambula okutafugibwa. Batera okunnyonnyola okuwulira nga tateredde era nga tasobola kuwummulamu. Era bayinza okuwulira nga basika omuguwa nga beetaaga okusigala nga basirise, gamba nga bali mu nnyiriri. Obutawummula buno obw’omunda butera okuleetera abantu abalina Akathisia okufuna okweraliikirira n’okwennyamira. Akathisia okumala ebbanga eddene egamba, .
Kibadde kikwatagana n’obulabe obw’okwongera okwetuusaako obulabe oba okwetta. Bw’oba olina ebirowoozo by’okwetta oba ng’owulira ng’oyagala okwetuusaako obulabe, kyetaagisa nnyo okugenda mu basawo obuyambi mu bwangu.
Biki ebivaako Akathisia?
Bannasayansi n’okutuusa kati tebamanyi kituufu kivaako akathisia. Naye balowooza nti kiva ku ddagala erimu liziyiza obutoffaali obukwata eddagala mu bwongo obufuna eddagala eriyitibwa dopamine. Dopamine ddagala eriyamba mu mirimu mingi egy’omubiri, omuli n’entambula yaffe. Okuzibikira kuno kuleeta entambula ezitafugibwa. Waliwo eddagala eriwerako erikwatagana n’obulwadde bwa akathisia: Akathisia era ekwatagana n’embeera z’obulamu ezimu:- Obulwadde bwa Parkinson .
- Obulwadde bw’obwongo/ okuzimba (`Encephalitis`).
- Obuvune ku mutwe (Obuvune ku bwongo obuva ku buvune - TBI).
Eddagala eriweweeza ku bwongo erikwatagana n’obulwadde bwa Akathisia
Akathisia bwe buzibu obusinga okutawaanya entambula obukwatagana n’eddagala eriweweeza ku bwongo. Abasawo oluusi bakiyita akathisia ekiva ku ddagala eriweweeza ku bwongo. Eddagala eriweweeza ku bwongo oba eriweweeza ku busimu, ligwa mu biti bibiri ebikulu:- Omulembe ogusooka oba "typical" antipsychotics (FGA).
- Omulembe ogwokubiri oba "ogw'enjawulo" `(Antipsychotics - SGA)`.
Akathisia esinga kukwatagana n’eddagala eriri mu kibinja kya `(FGA)` naddala eryo ery’amaanyi ennyo era nga likozesebwa mu dose ennene. Obulabe buba wansi katono ku ddagala lya `(SGA)`. Abasawo bawandiika eddagala lino erya `(FGA)` ne `(SGA)` ku mbeera ez'enjawulo ez'obusimu bw'omutwe. Okugeza nga:- Okutaataaganyizibwa mu nneeyisa mu bulwadde bw’okusannyalala.
- Obulwadde bw’okuwuguka.
- Ennaku.
- Obuzibu mu kulya.
- Obuzibu bw ‟okweraliikirira okwa bulijjo.
- Ebbula ly'otulo .
- Obuzibu bw‟okulowooza ennyo (`Obuzibu bw‟okulowooza ennyo -OCD `).
- Obuzibu mu buntu.
- Obuzibu bw‟okunyigirizibwa oluvannyuma lw‟okukosebwa (PTSD).
Obuzibu bw’okutabuka emitwe (Schizoaffective disorder). Obulwadde bw’okutabuka emitwe n’obuzibu obukwatagana nabyo.
Eby’okulabirako by’eddagala erimu erya FGA (eririna amannya g’ebika) eriyinza okuba nga likwatagana ne Akathisia:- ``Eddagala lya Chlorpromazine (Thorazine®)''.
- `Eddagala lya Fluphenazine (Prolixin®)`
- `Eddagala lya Haloperidol (Haldol®)`
- `Eddagala lya Loxapine (Loxitane®)`
- ``Eddagala lya Prochlorperazine (Compro®, Compazine®)''.
Ezimu ku ddagala lya SGA erisinga okubeera mu bulabe bw’okulwala Akathisia mulimu:- `Eddagala lya Paliperidoni (Invega®)`
- `Eddagala lya ziprasidoni (Geodon®)`
Eddagala eriweweeza ku kweraliikirira erikwatagana n’obulwadde bwa Akathisia
Wadde nga si kya bulijjo ng’eddagala eriweweeza ku bwongo, eddagala erimu eriweweeza ku kweraliikirira nalyo libadde likwatagana n’obulwadde bwa akathisia. Mu bino mulimu:- Selective serotonin reuptake inhibitors (SSRIs): Zino ze ddagala erisinga okulagirwa eriweweeza ku kweraliikirira. Eby’okulabirako: ekirungo kya fluoxetine (Prozac®), ekirungo kya paroxetine (Paxil®).
- Monoamine oxidase inhibitors (MAOIs): Zino ze zaasooka okukolebwa eddagala eriweweeza ku kweraliikirira. Wadde nga zaali zikola bulungi, kati eddagala eppya eritali lya bulabe eririna ebizibu ebitono litera okukozesebwa.
- Eddagala eriweweeza ku kweraliikirira erya Tricyclic (TCA): Abasawo bawandiika bino ng’eddagala eddala eriweweeza ku kweraliikirira terikola. Eby’okulabirako: eddagala eriyitibwa clomipramine (Anafranil®), amitriptyline (Elavil®).
Abasawo bawandiika eddagala eriweweeza ku kweraliikirira ku mbeera nga:- Ennaku.
- Obulwadde bw’okuwuguka.
- Obuzibu bw‟okweraliikirira.
- Obulumi obutawona.
- Obuzibu bw‟okulowooza ennyo (OCD).
- Obulwadde bw’okutya.
- Obuzibu bw‟okunyigirizibwa oluvannyuma lw‟okukosebwa (PTSD).
Kiteeberezebwa nti wakati wa 10% ne 18% ku bantu abalina obuzibu bw’okuwuguka I abamira eddagala eriweweeza ku kweraliikirira bafuna akathisia. Eddagala eddala erikwatagana n’obulwadde bwa Akathisia
Eddagala eddala eriyinza okuba nga likwatagana ne Akathisia:- Eddagala eriweweeza ku kuziyira oba okusiiyibwa (antiemetics), e.g. eddagala lya metoclopramide.
- Eddagala eriwonya puleesa, e.g. `reserpine`, `ekirungo kya methyldopa`.
- Ebiziyiza emikutu gya kalisiyamu, e.g. cinnarizine, eddagala eriyitibwa diltiazem.
- Eddagala eriweweeza ku bulwadde.
- Eddagala eriweweeza ku kuziyira.
- `Azithromycin` (eddagala eritta obuwuka erikozesebwa ennyo).
- `Buspirone` (eddagala eriweweeza ku kweraliikirira).
Akathisia era asobola okuva ku biragalalagala ebimenya amateeka nga amphetamine, methamphetamine, ne cocaine. Otegeera otya (Akathisia)?
Abasawo batera okuzuula Akathisia nga beetegereza enneeyisa y’omulwadde n’obubonero bwe (`clinical observation`). Kino tekyetaagisa kukeberebwa musaayi oba kukebera bifaananyi. Enkola esinga okukozesebwa okwekenneenya omutindo gwa Akathisia ye ``Barnes Akathisia-Rating Scale (BARS)``. Bw’oba olowooza nti olina Akathisia, omusawo ajja kukubuuza ebibuuzo ebikwata ku bubonero bwo, ebyafaayo by’obujjanjabi n’eddagala ly’okozesa mu kiseera kino. Era bajja kwetegereza enneeyisa yo n’entambula zo. Ebyembi, Akathisia etera okuba enzibu okuzuula. Kubanga obubonero bwayo bufaananako n’embeera endala ez’obulamu bw’obwongo, okugeza:- Obulwadde bw’okutabuka emitwe.
- Mania (Mania) nga.
- Obuzibu bw‟okussaayo omwoyo/okukola ennyo (ADHD).
- Okwennyamira okutabuse.
Akathisia ajjanjabwa atya?
Mu kiseera kino tewali bujjanjabi butongole eri Akathisia. Singa Akathisia yo eva ku ddagala, omusawo wo ajja kugezaako okukukyusa n’afuna eddagala eddala oba okukendeeza ku ddoozi y’eddagala ly’omira mu kiseera kino (bwe kiba kisoboka). Okunoonyereza okumu kulaga nti eddagala lino wammanga liyinza okuyamba ku Akathisia:- Ebirungo ebiziyiza beta okugeza propranolol.
- Benzodiazepines (ekika ky’eddagala erikozesebwa okujjanjaba embeera ng’okweraliikirira, obuteebaka, n’okukonziba).
- Eddagala lya mirtazapine erya ddoozi entono (eddagala eriweweeza ku kweraliikirira).
- Anticholinergics (ekika ky’eddagala erikozesebwa okujjanjaba embeera nga asima).
- Vitamiini B6.
Akathisia asobola okuziyizibwa?
Bannasayansi bakyagezaako okutegeera mu bujjuvu Akathisia, ebibuleeta n’obujjanjabi. Naye bakimanyi nti Akathisia atera okukula mu mbeera zino wammanga:- Bw’oba omira eddagala ly’omulembe ogusooka eriweweeza ku bulwadde bw’omutima.
- Bw’omira eddagala erisusse.
- Singa omusawo wo ayongera mu bwangu ku ddoozi y’eddagala lyo, oba nnyo.
- Bw’oba wa myaka gya wakati oba omukadde.
Okusinziira ku nsonga zino, engeri esinga okuziyiza Akathisia kwe kuba nti abasawo batandike eddagala lino ku ddoozi esinga obutono ne bongera mpolampola ddoozi bwe kiba kyetaagisa. Nga tonnatandika ddagala lyonna, kikulu okwogera n’omusawo wo ku kabi, emigaso, n’ebizibu ebiyinza okuvaamu. Enteekateeka y’okuteebereza (Akathisia) eri etya?
Singa Akathisia amanyibwa nga bukyali era eddagala eribuleeta ne liyimirizibwa (bwe kiba kisoboka), embeera etera okutereera. Wabula singa Akathisia erekebwa nga tajjanjabiddwa, eyinza okumunafuya ennyo. Abantu bangi abalina Akathisia bafuna okweraliikirira okw’amaanyi n’okwennyamira (`dysphoria`). Bayinza n’okuba n’ebirowoozo eby’okwetta. Bw’oba olina ebirowoozo by’okwetta, kyetaagisa okunoonya obuyambi bw’abasawo mu bwangu.
Ddi lw’osaanidde okulaba omusawo ku (Akathisia)?
Bw’oba olina obubonero bw’obulwadde bwa Akathisia, kikulu okwogera n’omusawo wo. Gy’okoma okuzuula amangu ekivaako, gye bakoma okukyusa amangu eddagala lyo ne bafugira embeera. Akathisia kizibu ekinyiiza ennyo ekiyinza okuva ku ddagala erimu. Bw’oba weeraliikirira nti oyinza okukwatibwa Akathisia oluvannyuma lw’okutandika okumira eddagala eriwonya obulwadde bw’obwongo oba obuzibu bw’obusimu, totya kubuuza musawo wo ku nsonga eno. Bw’oba olina obubonero bw’obulwadde bwa Akathisia, tegeeza omusawo wo amangu ddala nga bwe kisoboka. Ebintu ebikulu by'olina okujjukira (Take-Home Message)
- Akathisia mbeera ng’obutawummula munda buleeta obutasobola kusigala mu kifo kimu n’okwagala okutambula buli kiseera.
- Kino kiyinza okuva ku ddagala erimu eriweweeza ku bwongo. Era kiyinza okuva ku ddagala eriweweeza ku kweraliikirira n’eddagala eddala.
- Obubonero buno mulimu okukankana amagulu, okutambula n’obutasobola kusigala mu kifo kimu.
- Kino si kweraliikirira, naye kiyinza okuleeta okweraliikirira.
- Bw’oba olina obubonero buno, kakasa nti otegeeza omusawo wo. Embeera eno eyinza okuddukanyizibwa ng’okyusa mu ddoozi y’eddagala lyo oba okukyusa n’odda ku ddagala eddala.
- Tolekera awo kumira ddagala lyo oba okukyusa eddagala nga tolina magezi ga musawo.
- Akathisia asobola okukyusibwa singa azuulibwa n’ajjanjabibwa nga bukyali.
Bw’oba olina ekibuuzo ekirala kyonna ku nsonga eno, tolwawo kwogera na musawo wo. Sigala nga oli mulamu bulungi!
💬 Comments (0)
Tewali bigambo biwandiikiddwa n'okutuusa kati. Yongera wano comment yo omulundi ogusoose.
Yongera ku comment yo