Tumanye obulwadde bwa Neuroleptic Malignant Syndrome, embeera ey’akabi ereetebwa eddagala eriweweeza ku busimu!

Ggwe oba omuntu gw’omanyi oyinza okuba ng’omira ekika ky’eddagala eriyitibwa neuroleptic, erikozesebwa okujjanjaba embeera ezimu ez’obulamu bw’obwongo. Wadde ng’eddagala lino liyinza okuyamba ennyo abantu bangi, waliwo emisango emitono ennyo ng’eddagala lino liyinza okuleeta embeera ey’akabi, n’okutta obulamu. Ekyo kye tuyita obulwadde bwa Neuroleptic Malignant Syndrome (NMS). Erinnya lizibu naye kikulu okumanya ebikwata ku nsonga eno.

Obulwadde bwa Neuroleptic Malignant Syndrome (NMS) kye ki? Ka tukitegeere mu ngeri ennyangu!

Mu ngeri ennyangu, obulwadde bw’obusimu obuyitibwa neuroleptic malignant syndrome (NMS) butera nnyo era buyinza okutta obulamu bw’omuntu eri ekika ky’eddagala eriyitibwa neuroleptics (era erimanyiddwa nga eddagala eriweweeza ku bwongo). Eddagala lino likozesebwa okuddukanya n’okujjanjaba obubonero bw’embeera nnyingi ez’obulamu bw’obwongo.

Obubonero obukulu obuwerako busobola okulabibwa mu mbeera eno eya `NMS`:

• Okubeera n’omusujja ogw’amaanyi (hyperthermia).
• Ebinywa mu mubiri binywezebwa era ne biruma (kino bwe kigenda mu maaso, ebinywa biyinza n’okukutuka).
• Enkyukakyuka mu mbeera y‟obwongo (nga okutabulwa, okubulwa okujjukira).
• Obutakola bulungi mu nkola y’obusimu obuyitibwa autonomic nervous system oba dysautonomia.

Enkola yaffe ey’obusimu obuyitibwa autonomic nervous system eringa enkola ya automatic mu mubiri gwaffe. Kifuga ebintu nga puleesa n’okussa. Bw’ekola obubi, puleesa esobola okulinnya n’okukka mu bwangu, n’ereetera omuntu okutuuyana ennyo (secondary hyperhidrosis), n’okuvaamu amalusu agasukkiridde.

NMS mbeera ya bujjanjabi ey’amangu eyinza okutta omuntu, nga yeetaaga okujjanjabibwa mu bwangu. N’olwekyo, bw’ofuna obubonero buno, ekisinga obulungi kwe kugenda mu ddwaaliro mu bwangu.

Eddagala lino erikendeeza ku busimu lye liruwa?

Eddagala eriweweeza ku busimu oba eddagala eriweweeza ku bwongo, liyinza okwawulwamu ebika bibiri ebikulu.

1. Eddagala eriweweeza ku bwongo ery'omulembe ogusooka oba "ery'enjawulo".

2. Eddagala ery'omulembe ogwokubiri oba "atypical" antipsychotics.

Abasawo bawandiika eddagala lino ery’omulembe ogusooka n’ogw’okubiri eriweweeza ku mbeera z’obwongo n’obusimu ez’enjawulo. Wano waliwo ebyokulabirako ebitonotono:

• Ebizibu by’enneeyisa ebibaawo mu bulwadde bw’okusannyalala.
• Obulwadde bw’okuwuguka.
• Ennaku.
• Obuzibu mu kulya.
• Obuzibu bw‟okweraliikirira okwa bulijjo.
• Okutabulwa kw’abakadde.
• Ebbula ly'otulo.
• 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’endwadde ezikwatagana nabyo.

Eddagala ki eriyinza okuleeta obulwadde bw’obusimu obuyitibwa neuroleptic malignant syndrome (NMS)?

Waliwo ebika by'eddagala ebiwerako ebiyinza okuleeta `NMS`. Ka tulabe kiki kye bali.

Eddagala erya bulijjo eriweweeza ku busimu (antippsychotic):

• Bromperidol ekika kya Bromperidol
• Eddagala lya Chlorpromazine `(Eddagala lya Chlorpromazine)`
• Ekirungo kya Clopenthixol
• Fluphenazine `(Eddagala lya Fluphenazine)`
• Haloperidol `(Eddagala lya Haloperidol)`
• Eddagala lya Loxapine
• Eddagala lya Promazine
• Thioridazine `(Eddagala lya Thioridazine)`
• Ekirungo kya Thiothixene
• Trifluoperazine `(Eddagala lya Trifluoperazine)`

Eddagala eritali lya bulijjo eriziyiza obusimu (antippsychotic):

• Amisulpride eddagala eriyitibwa Amisulpride
• Eddagala lya Aripiprazole
• Eddagala lya Clozapine
• Eddagala lya Olanzapine
• Eddagala lya Quetiapine
• Eddagala lya Risperidone
• Eddagala lya Ziprasidone
• Eddagala lya Zotepine

Eddagala erimu eriziyiza okusannyalala:

• Eddagala lya Domperidone
• Droperidol `(Eddagala lya Droperidol)`
• Eddagala lya Metoclopramide
• Prochlorperazine `(Eddagala lya Prochlorperazine)`
• Eddagala lya Promethazine

Eddagala lya dopaminergic (Parkinson’s) (nga lino liyimiriza mu bwangu):

• Eddagala lya Amantadine
• Ebirungo ebiziyiza dopamine
• Obulwadde bwa Levodopa
• Tolcapone eddagala eriweweeza ku bulwadde

Totya olw’olukalala luno. Si buli muntu amira eddagala lino nti ajja kufuna NMS. Eno mbeera ya bbula nnyo . Naye bw’oba ​​omira eddagala lino, kikulu okukimanya ku kino.

Njawulo ki eriwo wakati wa NMS ne malignant hyperthermia?

Oyinza n’okuwulira embeera eyitibwa malignant hyperthermia. Era kibeera kizibu ekitali kya bulijjo, eky’amaanyi. Naye kiva ku ddagala eriweweeza ku bulwadde buno n’eddagala eriweweeza ku binywa .

Era kiyinza okuvaako ebinywa okukaluba, okukendeeza ku binywa (hyporeflexia), n’okukyusa olususu (okufuuka bbululu, okumyuuka). Obubonero buno buyinza okufaananako n’obw’obulwadde bwa NMS. Kyokka abasawo basobola okwawula ebibiri bino nga batunuulira ebyafaayo by’obujjanjabi bw’omulwadde. Kwe kugamba, oba baakamala okubudamya oba baamira eddagala eriweweeza ku busimu.

Njawulo ki eriwo wakati wa NMS ne Serotonin Syndrome?

Serotonin syndrome y’embeera endala etabula abantu. Kiva ku ddagala eriri mu kibinja kya serotonergic, gamba ng’eddagala erimu eriziyiza okwennyamira, amphetamines, eddagala eriweweeza ku histamine, n’ery’okutebenkeza embeera y’omuntu. Mu ngeri ennyangu, kibaawo nga waliwo eddagala erisusse mu mubiri eriyitibwa serotonin.

Obubonero bw’obulwadde bwa serotonin mulimu okukaluba kw’ebinywa, okuzimba ennyo, ekiddukano, okutuuyana, okunyiga ebinywa (myoclonus), n’okukyuka mu mbeera y’obwongo. Wabula , omusujja n’okukaluba kw’ebinywa bitera obutatera kubaawo mu bulwadde bwa serotonin okusinga mu NMS.

Omusawo ajja kwawula wakati w’embeera zino ebbiri ng’awuliriza obubonero bwo n’eddagala ly’omira.

Ani afuna obulwadde bwa neuroleptic malignant syndrome (NMS)?

NMS esobola okubaawo mu muntu yenna amira eddagala eriweweeza ku busimu (antipsychotic).

Wadde nga kirowoozebwa nti ebitundu nga bibiri ku bisatu eby’abalwadde ba `NMS` bibaawo mu wiiki esooka nga batandise eddagala eriweweeza ku busimu, kikulu okujjukira nti embeera eno esobola okubaawo ekiseera kyonna mu kiseera ky’obujjanjabi.

Embeera eno eya `NMS` ya bulijjo etya?

Mu butuufu, obulwadde bwa neuroleptic malignant syndrome (NMS) mbeera etali ya bulijjo nnyo. Kibeera mu bantu wakati wa 0.01% ne 3.2% abamira eddagala eriweweeza ku busimu.

Wabula amawulire amalungi gali nti omuwendo gw’alipoota ezikwata ku NMS gukendeera olw’okuleetebwa kw’eddagala eppya eririna akabi akatono ak’okuleeta NMS, n’okumanyisa abasawo n’abalwadde ku mbeera eno.

Bubonero ki obulaga obulwadde bwa neuroleptic malignant syndrome (NMS)?

Obubonero bwa `NMS` butera okutandika okulabika mu nnaku emu oba ssatu . Obubonero obukulu bwe buno:

• Omusujja ogw’amaanyi ennyo (diguli 102 ku 104 - diguli 38.9 ku 40).
• Obutabeera bulungi mu nnyimba z’omutima (arrhythmia).
• Okweyongera kw’okukuba kw’omutima (tachycardia).
• Okweyongera kw’omutindo gw’okussa (tachypnea).
• Okukaluba/okukaluba kw’ebinywa `(okukaluba kw’ebinywa)`.
• Enkyukakyuka mu mbeera y‟obwongo (nga okutabulwa, okutabulwa, okubulwa okutegeera).
• Puleesa oba puleesa entono.
• Okutuuyana ekisusse.

Bw’oba ​​olina obubonero buno bumu oba obusingawo naddala ng’omira eddagala eriweweeza ku busimu, kuba ku 911 oba genda mu ddwaaliro erikuli okumpi mu bwangu. Eno mbeera ya bujjanjabi ya mangu.

Eddagala eriweweeza ku busimu lireeta litya `NMS`?

Embeera ya `NMS` ereetebwa eddagala eriweweeza ku busimu (antipsychotic).Kiyinza okubaawo nga ddoozi emu, nga ddoozi eyongezeddwa, oba ng’ogenda mu maaso n’okukozesa ddoozi y’emu. Wadde nga NMS esinga kukwatagana n’eddagala ery’omulembe ogusooka eriweweeza ku bulwadde bw’omutima, era esobola okubaawo, ku kigero ekitono, n’okuggyibwawo okw’amangu eddagala ery’omulembe ogwokubiri, eddagala erimu eriziyiza okusannyalala, n’eddagala lya dopaminergic erikozesebwa ku bulwadde bwa Parkinson.

Bannasayansi bakyagezaako okuzuula ekituufu ekivaako NMS. Endowooza eriwo kati eri nti kiva ku dopamine D2 receptor antagonism . Dopamine kirungo kya busimu mu bwongo bwaffe. Kye ddagala eritambuza obubaka wakati w’obutoffaali. Eddagala eriweweeza ku busimu likola nga liziyiza omubaka ono owa dopamine okuyingira mu butoffaali nga liyita mu bikwata ebitongole.

Ebikwata dopamine mu hypothalamus yo ne/oba omugongo bwe bizibikira, okusika omuguwa kw’ebinywa kweyongera. Era, okutaataaganyizibwa kw’ebikwata dopamine mu hypothalamus kye kireeta omusujja ogw’amaanyi n’enkyukakyuka ennene mu puleesa ezirabibwa mu NMS.

Obulwadde bwa neuroleptic malignant syndrome (NMS) buzuulibwa butya?

Abasawo okusobola okuzuula obulwadde bwa NMS, olina okuba n’obubonero oba embeera zino zonna :

• Omira eddagala eriweweeza ku busimu oba olekedde awo okumira eddagala eriweweeza ku bulwadde bwa dopaminergic.
• Olina okunywezebwa/okunyiga kw’ebinywa okw’amaanyi (kino kiyinza n’okuviirako ebinywa okukutuka).
• Olina omusujja omungi.
• Waliwo enkyukakyuka mu mbeera yo ey’ebirowoozo.

Okugatta ku ekyo, waakiri engeri bbiri ku zino wammanga zirina okubaawo:

• Okutuuyana okuyitiridde oba okutali kwa bulijjo.
• Okukaluubirirwa okumira.
• Obutasobola kufuga musulo oba omusulo (obutakwata musulo).
• Okweyongera kw’okukuba kw’omutima (tachycardia).
• Amangu ago nga tasobola kwogera.
• Okwongera oba enkyukakyuka enfunda eziwera mu puleesa.
• Okweyongera kw’obutoffaali obweru mu musaayi (Leukocytosis).
• Okwongera ku miwendo gya creatine phosphokinase (CPK) olw’okumenya ebinywa.
• Okuddamu okukola empola oba okutono (hyporeflexia).

Bikebere ki ebikolebwa okuzuula `NMS`?

Singa omusawo wo ateebereza nti olina NMS, ayinza okulagira okukeberebwa nga:

• Ekipande ekijjuvu ekikwata ku nkyukakyuka y’emmere.
• Okukebera omusulo.
• Okukebera omukka gw’omusaayi mu misuwa oba emisuwa.
• Okukebera omusaayi gwa Creatine phosphokinase (CPK).

Obulwadde bwa neuroleptic malignant syndrome (NMS) bujjanjabwa butya?

NMS mbeera ya bujjanjabi ey’amangu. N’olwekyo kyetaagisa okuzuula embeera eno n’otandika obujjanjabi mu bwangu. Bw’oba ​​olina NMS, kirabika ojja kwetaaga okuweebwa ekitanda mu ddwaaliro.Ojja kwetaaga okufuna obujjanjabi mu kifo awajjanjabirwa abalwadde abayi (ICU).

Mu mbeera zonna eza `NMS`, abasawo bajja kuyimiriza mangu eddagala eriweweeza ku busimu (antipsychotic) eryavaako `NMS`. Okugatta ku ekyo, bajja kujjanjaba obubonero bwa `NMS` era bakole emitendera okutangira ebizibu ebiyinza okubaawo. Obujjanjabi buno buyinza okuli:

• Okukuuma omutima n’okussa nga binywevu nga okozesa empewo ey’ebyuma, eddagala eriweweeza ku kussa, ne/oba ebyuma ebikuba omukka.
• Okukuuma bbalansi y’obusannyalazo mu mubiri nga ogaba amazzi mu misuwa (IV fluids).
• Okukkakkanya ebbugumu ly’omubiri ng’okozesa emifaliso egy’okunyogoza, amazzi ga ice, ne/oba ice packs.
• Puleesa bw’eba waggulu, gifuge n’eddagala.
• Okugaba eddagala nga heparin okuziyiza omusaayi okuzimba.
• Okugaba eddagala eriyinza okuzzaawo dopamine omutono mu mubiri.
• Okuwa eddagala eriwummuza ebinywa oba amagumba.

Biki ebiyinza okuleeta akabi mu kukola `NMS`?

Waliwo ensonga eziwerako ezongera obulabe bw’okulwala obulwadde bwa neuroleptic malignant syndrome (NMS):

• Okutandika eddagala eppya eriweweeza ku busimu (antipsychotic) oba okwongera ku ddoozi.
• Okukozesa eddagala erisukka mu limu eriziyiza obusimu oba okukozesa eddagala lya lithium.
• Okuyimiriza amangu eddagala lya dopaminergic erijjanjaba obulwadde bwa Parkinson.

Kinatwala bbanga ki okudda engulu okuva mu `NMS`? (Okuteebereza)

Singa NMS ezuulibwa nga bukyali n’ajjanjabwa mu bwangu era mu ngeri entuufu, abantu abasinga bawona mu wiiki bbiri okutuuka ku nnaku 14.

Naye singa obujjanjabi bulwawo, ebizibu eby’amaanyi biyinza okubaawo ebikosa ebinywa, ensigo, omutima, ne/oba amawuggwe.

Singa tejjanjabibwa mangu, NMS eyinza okutta omuntu. Omuwendo gw’abafa olw’obulwadde bwa NMS guva ku bitundu 5% okutuuka ku bitundu 20%. Wabula, okweyongera okumanyisa abantu ku NMS n’okukozesa eddagala eppya eriweweeza ku bulwadde bw’omutima kikendeezezza ku muwendo guno ogw’okufa mu myaka egiyise.

Abantu bangi, wansi w’obulagirizi bw’omusawo, basobola okuddamu okutandika obulungi eddagala eriweweeza ku busimu (antipsychotic).

Bizibu ki ebiva mu bulwadde bwa neuroleptic malignant syndrome (NMS)?

Ebyembi, ebizibu ebiva mu NMS bya bulijjo era bya maanyi. Ebizibu ebimu biva ku bubonero obw’enjawulo obwa NMS n’obutakola bulungi bw’obusimu obukola emirimu egy’enjawulo, ate ebirala naddala yinfekisoni bisobola okuva ku kumala ebbanga eddene mu kisenge ky’abalwadde abayi (ICU).

Ebimu ku bizibu ebiva mu NMS bye bino:

• Rhabdomyolysis (okumenya obutoffaali bw’ebinywa - kino kye kizibu ekisinga okutawaanya).
• Okubulwa amazzi mu mubiri.
• Okulemererwa kw’ekibumba okw’amaanyi.
• Okulemererwa kw’okussa okw’amaanyi.
• Embeera z’okusannyalala/ okukonziba .
• Obulwadde bw’okuzimba emisuwa gy’omutima.
• Okuzimba omusaayi mu mubiri gwonna (Disseminated intravascular coagulation).
• Okulemererwa kw’ekibumba okw’amaanyi.
• Obulwadde bw’ekifuba.
• Sepsis (obuwuka obuyingira mu musaayi).
• Obulwadde bw’omusulo (UTI).
• Obulwadde bw’okuzimba amawuggwe.

Olw’okuba ebizibu bino biba bya maanyi nnyo era nga bitiisa obulamu, kikulu nnyo okukuba ku ssimu 911 mu bwangu n’ogenda mu ddwaaliro erikuli okumpi okufuna obujjanjabi bw’oba ​​olina obubonero bwa NMS. Nate, NMS mbeera ya mangu eriko obulamu era eyinza okwetaaga okujjanjabibwa mu Intensive Care Unit (ICU).

Ddi lwe nnina okulaba omusawo wange?

Bw’oba ​​omira eddagala limu oba okusingawo eriweweeza ku busimu (antippsychotics), eriweweeza ku kuzimba, ne/oba dopaminergic (Parkinson’s), kikulu okulaba omusawo wo buli kiseera okukakasa nti likukolera bulungi. Ekirala, buuza omusawo wo ebizibu ebiva mu ddagala ly’omira n’obubonero bw’osaanidde okwegendereza.

Ngende mu kitongole ky'abalwadde ab'amangu (ETU) singa mba n'obubonero bwa `NMS`?

Bw’oba ​​olina obubonero bw’obulwadde bwa neuroleptic malignant syndrome (NMS), gamba ng’omusujja omungi ennyo n’okukaluba kw’ebinywa, kikulu okukuba ku ssimu 911 oba okugenda mu ddwaaliro erikuli okumpi amangu ddala. NMS yeetaaga okujjanjabibwa mu bwangu. Singa tebujjanjabwa mangu era mu ngeri entuufu, kiyinza n’okuviirako okufa.

Obulwadde bwa Neuroleptic malignant syndrome (NMS) mbeera ya maanyi era eyinza okutta omuntu. Kale bw’oba ​​olina obubonero, kikulu nnyo okugenda ew’omusawo amangu ddala nga bwe kisoboka. NMS nnyangu nnyo okujjanjaba singa ekwatibwa nga bukyali. Wadde nga NMS tetera kubaawo, bw’oba ​​omira eddagala eriweweeza ku busimu (antippsychotic), yogerako n’omusawo wo oba omukugu mu by’eddagala ku bizibu ebiyinza okuvaamu n’obubonero bw’olina okwegendereza. Baliwo okukuyamba.

Ebintu ebikulu bye twayiga mu kitundu kino (Take-Home Message)

Okay, kale ka tukujjukize ebimu ku bintu ebikulu by'olina okukuuma mu birowoozo okuva ku bye twogeddeko mu `NMS` eno:

• NMS mbeera etali ya bulijjo, naye eyinza okuteeka obulamu mu matigga ereetebwa eddagala eriweweeza ku busimu.
• Omusujja omungi, okulumwa ebinywa, n’okutabulwa mu birowoozo bye bisinga okulaga obulwadde buno.
• Bw’olaba obubonero buno bwonna, genda mangu omusawo amagezi. Tolwawo.
• Bw’oba ​​omira eddagala eriweweeza ku busimu, yogerako n’omusawo wo ku ddagala lino n’ebizibu ebivaamu. Totya kubuuza bibuuzo.
• NMS esobola okuwona ddala singa ezuulibwa n’ejjanjabibwa nga bukyali.

Tusuubira nti otegeezeddwa amawulire gano. Sigala nga oli mulamu bulungi!

` Neuroleptic Malignant Syndrome, NMS, eddagala ly’eby’omutwe, ebizibu ebivaamu, omusujja omungi, okukaluba kw’ebinywa