Kia tūpato tātou ki te Neuroleptic Malignant Syndrome, he mate morearea e hua mai ana i ngā rongoā neuroleptic!

Tērā pea kei te tango koe, kei te tango rānei tētahi atu e mōhio ana koe i tētahi momo rongoā e kiia nei ko te neuroleptic, e whakamahia ana hei rongoā i ētahi āhuatanga hauora hinengaro. Ahakoa he tino āwhina ēnei rongoā mō te tini o te tangata, he tino onge ngā wā ka taea e ēnei rongoā te whakaputa i tētahi āhuatanga morearea, tae atu ki te mate. Koinei te mea e kiia nei e mātou ko te Neuroleptic Malignant Syndrome (NMS). He ingoa uaua, engari he mea nui kia mōhio koe ki tēnei.

He aha te Neuroleptic Malignant Syndrome (NMS)? Kia mārama tātou!

Ki te whakarapopoto, he tino onge te mate pukupuku neuroleptic (NMS) ā, he mate pea te uruparenga ki tētahi momo rongoā e kiia nei ko ngā neuroleptics (e mōhiotia ana ko ngā rongoā antipsychotic). Ka whakamahia ēnei rongoā hei whakahaere me te rongoā i ngā tohu o te maha o ngā āhuatanga hauora hinengaro.

He maha ngā tohu matua ka kitea i roto i tēnei āhuatanga `NMS`:

• Te pāngia e te kirika nui (hyperthermia).
• Ka piripono, ka mamae hoki ngā uaua o te tinana (ki te haere tonu tēnei, tera pea ka pakaru ngā uaua).
• Ngā panonitanga o te āhua hinengaro (pēnei i te pōhēhē, te ngaronga o te mahara).
• Te ngoikore o te pūnaha io motuhake , te dysautonomia rānei.

He rite tō tātou pūnaha io ā-roto ki te pūnaha aunoa i roto i tō tātou tinana. Māna e whakahaere ngā mea pēnei i te toto toto me te tere o te manawa. Ina hē te mahi, ka piki, ka heke ohorere te toto toto, ka nui te werawera (te hyperhidrosis tuarua), ā, ka nui hoki te huware.

He āhuatanga ohorere hauora e morearea ana te NMS, e hiahia ana kia tere te aro atu ki te hauora. Nō reira, ki te pāngia koe e ēnei tohu, ko te mea pai ko te haere tonu ki te hōhipera.

He aha ēnei rongoā neuroleptic?

Ka taea te wehewehe i ngā rongoā neuroleptic, ngā rongoā antipsychotic rānei, kia rua ngā wāhanga matua.

1. Ngā rongoā antipsychotic o te whakatupuranga tuatahi, ngā rongoā "noa" rānei.

2. Ngā rongoā antipsychotic o te reanga tuarua, ngā rongoā "koretake" rānei.

Ka tohua e ngā tākuta ēnei rongoā ārai hinengaro o te whakatupuranga tuatahi me te tuarua mō ngā momo mate hinengaro me ngā mate pūnaha io. Anei ētahi tauira:

• Ngā raruraru whanonga e puta ana i roto i te mate wareware.
• Mate pūrua.
• Te pouri.
• Ngā mate kai.
• Te mate manukanuka whānui.
• Te whakaohooho o te kaumātua.
• Te kore moe.
• Mate pōrearea-ātete (OCD).
• Ngā mate o te tuakiri.
• Te mate ahotea muri i te whara (PTSD).
Mate hinengaro-ā-hinengaro . Te mate hinengaro me ngā mate e pā ana.

He aha ngā rongoā ka puta ai te mate pukupuku neuroleptic malignant (NMS)?

He maha ngā momo rongoā ka puta ai te `NMS`. Me titiro tātou ki ērā.

Ngā rongoā neuroleptic (antipsychotic) noa:

• Bromperidol
• Chlorpromazine `(Chlorpromazine)`
• Clopenthixol
• Fluphenazine `(Fluphenazine)`
• Haloperidol `(Haloperidol)`
• Loxapine
• Promazine
• Thioridazine `(Tioridazine)`
• Tiothixene
• Trifluoperazine `(Trifluoperazine)`

Ngā rongoā neuroleptic (antipsychotic) kāore i te tino noa:

• Amisulpride
• Aripiprazole
• Clozapine
• Olanzapine
• Ketiapine
• Risperidone
• Ziprasidone
• Zotepine

Ko ētahi rongoā ārai-puku:

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

Ngā rongoā dopaminergic (Parkinson) (mā te whakamutu ohorere i ēnei):

• Amantadine
• Ngā kaiwhakaoho dopamine
• Levodopa
• Tolcapone

Kaua e mataku ki tēnei rārangi. Ehara i te mea ka pāngia te hunga katoa e tango ana i ēnei rongoā e te NMS. He mate tino onge tēnei. Engari ki te mea kei te tango koe i ēnei rongoā, he mea nui kia mōhio koe ki tēnei.

He aha te rerekētanga i waenga i te NMS me te hyperthermia kino?

Kua rongo pea koe i tētahi āhuatanga e kiia nei ko te malignant hyperthermia. He tauhohenga onge, he kino hoki. Engari ka puta mai i ngā rongoā whakamoe whānui me ngā rongoā whakangāwari uaua .

Ka taea hoki e ia te whakakeke i ngā uaua, te whakaiti i ngā tauhohenga (hyporeflexia), me ngā panoni kiri (kikorangi, whero). He rite tonu ēnei tohu ki ērā o te NMS. Heoi, ka taea e ngā tākuta te wehewehe i ngā mea e rua mā te titiro ki te hītori hauora o te tūroro. Arā, ahakoa kua tata nei rātou te whiwhi i te rongoā whakamoe, kua tangohia rānei he rongoā neuroleptic.

He aha te rerekētanga i waenga i te NMS me te Serotonin Syndrome?

Ko te mate Serotonin tētahi atu mate pōhēhē. Ka puta mai i ngā rongoā nō te akomanga serotonergic, pērā i ētahi rongoā antidepressants, amphetamines, antihistamines, me ngā mea whakaū kare ā-roto. He māmā noa iho, ka puta mai ina nui rawa te matū i roto i te tinana e kiia nei ko te serotonin.

Ko ngā tohu o te mate serotonin ko te pakari o te uaua, te hyperreflexia, te korere, te werawera, te wiri o te uaua (myoclonus), me ngā huringa o te āhua hinengaro. Heoi , ko te kirika me te pakari o te uaua he iti ake te kitea i roto i te mate serotonin i tērā i roto i te NMS.

Ka wehewehe tō tākuta i waenga i ēnei āhuatanga e rua mā te whakarongo ki ō tohumate me ngā rongoā e tangohia ana e koe.

Ko wai ka pāngia e te mate pukupuku neuroleptic malignant (NMS)?

Ka puta te NMS i roto i te hunga katoa e tango ana i ngā rongoā neuroleptic (antipsychotic).

Ahakoa e whakaarohia ana e rua hautoru o ngā take o te `NMS` ka puta i roto i te wiki tuatahi o te tīmatanga o te rongoā neuroleptic, he mea nui kia mahara ka taea tēnei āhuatanga te puta i ngā wā katoa o te maimoatanga.

He pēhea te noa o tēnei āhuatanga `NMS`?

Ina hoki, he tino onge te mate neuroleptic malignant syndrome (NMS). Ka puta i waenga i te 0.01% me te 3.2% o te hunga e tango ana i ngā rongoā neuroleptic.

Heoi, ko te rongo pai, kei te heke haere te maha o ngā pūrongo mō te NMS nā te whakaurunga mai o ngā rongoā hou he iti ake te mōrearea ki te whakaputa i te NMS, me te mōhiotanga o ngā tākuta me ngā tūroro ki tēnei mate.

He aha ngā tohu o te mate pukupuku neuroleptic malignant syndrome (NMS)?

Ko ngā tohu o te `NMS` ka tīmata te puta i roto i te kotahi ki te toru rā . Ko ngā tohu matua ko:

• He kirika tino teitei (102 ki te 104 nekehanga Fahrenheit - 38.9 ki te 40 nekehanga Celsius).
• Ngā koretake o te manawa o te ngakau (arrhythmia).
• Te pikinga o te tere o te ngakau (tachycardia).
• Te pikinga ake o te tere manawa (tachypnea).
• Te pakari/te pakari o te uaua `(te pakari o te uaua)`.
• Ngā panonitanga o te āhua hinengaro (pēnei i te pōhēhē, te ohorere, te ngaro o te māramatanga).
• Te toto toto tiketike, te toto toto iti rānei.
• Te werawera nui.

Mena kei a koe tētahi, ētahi rānei o ēnei tohu, inā koa kei te tango koe i tētahi rongoā neuroleptic, waea atu ki te 911, haere rānei ki te hōhipera tata tonu. He āhuatanga ohorere hauora tēnei.

He aha te take o te `NMS` e te rongoā neuroleptic?

Ko te mate `NMS` ka puta mai i te rongoā neuroleptic (antipsychotic).Ka puta pea tēnei mā te horopeta kotahi, me te whakanui ake i te horopeta, me te whakamahi tonu rānei i taua horopeta. Ahakoa e hono ana te NMS ki ngā rongoā antipsychotic o te whakatupuranga tuatahi, ka puta anō hoki, ki tētahi taumata iti iho, me te whakamutu ohorere o ngā rongoā antipsychotic o te whakatupuranga tuarua, ētahi rongoā antiemetic, me ngā rongoā dopaminergic e whakamahia ana mō te mate a Parkinson.

Kei te ngana tonu ngā kaipūtaiao ki te rapu i te pūtake o te NMS. Ko te ariā o nāianei ko te take o tēnei ko te whakaekenga o te dopamine D2 receptor . Ko te Dopamine he neurotransmitter i roto i tō tātou roro. He matū e kawe ana i ngā karere i waenga i ngā pūtau. Ko te mahi a ngā rongoā neuroleptic mā te aukati i tēnei karere dopamine kia kaua e uru ki roto i ngā pūtau mā roto i ngā kaiwhakawhiwhi motuhake.

Ina aukatia ngā kaiwhakawhiwhi dopamine i roto i tō hypothalamus me/ranei i tō taurakira, ka piki ake te taumahatanga o ngā uaua. Waihoki, ko te whakararuraru i ngā kaiwhakawhiwhi dopamine i roto i te hypothalamus te take o te kirika nui me ngā piki me ngā heke nui o te toto toto e kitea ana i roto i te NMS.

Me pēhea te tautuhi i te mate pukupuku neuroleptic (NMS)?

Kia taea ai e ngā tākuta te tautuhi i te NMS, me whai koe i ēnei tohumate, i ēnei āhuatanga rānei :

• Kei te tango koe i tētahi rongoā neuroleptic, kua mutu whakarere rānei tō tango i tētahi rongoā dopaminergic.
• He tino kikī/pōturi tō uaua (ka taea hoki e tēnei te pakaru o te uaua).
• He nui tō kirika.
• He panoni kei roto i tō āhua hinengaro.

Hei tāpiritanga, me rua pea o ngā āhuatanga e whai ake nei :

• Te werawera nui rawa, te werawera rerekē rānei.
• Te uaua ki te horomi.
• Te kore e taea te whakahaere i te mimi, i te tūtae rānei (te kore e taea te pupuri i te mimi).
• Te pikinga o te tere o te ngakau (tachycardia).
• Kāore i taea te kōrero.
• Te pikinga ake, te maha rānei o ngā huringa o te toto toto.
• Te pikinga o te maha o ngā toto toto ma (Leukocytosis).
• Ka piki ake ngā taumata o te creatine phosphokinase (CPK) nā te pakaru o te uaua.
• He puhoi, he iti rānei ngā urupare ā-tinana (hyporeflexia).

He aha ngā whakamātautau e mahia ana hei tautuhi i te `NMS`?

Mena kei te whakapae tō tākuta kei a koe te NMS, ka tono pea rātou i ngā whakamātautau pēnei i:

• He papatohu pākia whānui.
• Te tātaritanga mimi.
• Whakamātautau hau toto uaua, uaua rānei.
• He whakamātautau toto mō te creatine phosphokinase (CPK).

Me pēhea te rongoā i te mate pukupuku neuroleptic (NMS)?

He āhuatanga ohorere hauora te NMS. Nō reira, he mea nui kia tātaritatia te mate, kia tīmata wawe ai te maimoatanga. Mena kei a koe te NMS, me kawe pea koe ki te hōhipera.Me whiwhi koe i te maimoatanga i roto i te wāhanga tiaki nui (ICU).

Mō ngā āhuatanga katoa o te `NMS`, ka mutu tonu te whakamahi a ngā tākuta i te rongoā neuroleptic (antipsychotic) i puta ai te `NMS`. Hei tāpiri, ka rongoāhia e rātou ngā tohu o te `NMS`, ā, ka mahi i ngā mahi hei ārai i ngā raruraru pea. Kei roto pea i ēnei maimoatanga:

• Te pupuri i te pumau o te ngākau me te manawa mā te whakamahi i te manawa mīhini, ngā rongoā ārai arrhythmia, me/ngā taputapu whakatere rānei.
• Te pupuri i te taurite o ngā electrolytes i roto i te tinana mā te tuku wai ki roto i te uaua (ngā wai IV).
• Te whakaheke i te pāmahana o te tinana mā te whakamahi i ngā paraikete whakamatao, te wai hukapapa, me/ngā kete hukapapa rānei.
• Mena he tiketike te toto toto, whakahaerea mā te rongoā.
• Te hoatu rongoā pēnei i te heparin hei aukati i te toto totoka.
• Te hoatu rongoā hei whakaora i ngā taumata dopamine iti o te tinana.
• Te hoatu i ngā rongoā whakangāwari uaua, angaanga rānei.

He aha ngā āhuatanga mōrearea e pā ana ki te whakawhanaketanga o te `NMS`?

He maha ngā āhuatanga e whakanui ake ai i te mōrearea o te whakawhanake i te mate pukupuku neuroleptic malignant syndrome (NMS):

• Te tīmatanga o tētahi rongoā neuroleptic (antipsychotic) hou, te whakanui rānei i te horopeta.
• Te whakamahi i te neke atu i te kotahi ngā rongoā neuroleptic , te whakamahi rānei i te rongoā lithium.
• Te whakamutu ohorere o te rongoā dopaminergic mō te mate a Parkinson.

Kia pēhea te roa ka ora ake i te `NMS`? (Matapae)

Mena ka kitea wawetia te NMS, ā, ka rongoatia wawetia, ka ora te nuinga o te tangata i roto i ngā wiki e rua ki te 14 rā.

Heoi, ki te whakaroa te maimoatanga, ka puta pea ngā raruraru kino ka pā ki ngā uaua, ngā whatukuhu, te ngākau, me/ranei ngā pukahukahu.

Ki te kore e rongoatia wawetia, ka mate pea te NMS. Ko te reiti mate mō te NMS kei waenga i te 5% ki te 20%. Heoi, nā te pikinga ake o te mōhiotanga ki te NMS me te whakamahinga o ngā rongoā antipsychotic hou kua whakaiti i tēnei reiti mate i ngā tekau tau kua pahure ake nei.

He tokomaha te hunga ka taea te tīmata anō i te rongoā neuroleptic (antipsychotic) i raro i te arataki a te tākuta.

He aha ngā raruraru o te mate pukupuku neuroleptic malignant syndrome (NMS)?

Engari, he mea noa, he kino hoki ngā raruraru o te NMS. Ko ētahi raruraru ka puta mai i ngā tohu motuhake o te NMS me te ngoikore o te pūnaha io ā-roto, ko ētahi atu, inā koa ko ngā mate pukupuku, ka puta mai i te noho roa ki te wāhanga tiaki nui (ICU).

Ko ētahi o ngā raruraru o te NMS ko:

• Rhabdomyolysis (te pakaru o ngā pūtau uaua - koinei te raruraru tino noa).
• Te maroketanga.
• Te ngoikore o te whatukuhu.
• Te ngoikore o te manawa.
• Ngā mate haurangi/ ngā hopuhopu .
• Te mate pāwera o te ngākau.
• Te toto totoka puta noa i te tinana (Te totoka totoka i roto i ngā oko toto kua horapa).
• Te ngoikore o te ate.
• Pūngāwerewere.
• Sepsis (ngā huakita e uru ana ki te toto).
• Mate pāwera o te ara mimi (UTI).
• Te embolism pūkahukahu.

Nā te mea he tino kino, he mōrearea hoki ēnei raruraru, he mea tino nui kia waea atu ki te 911 tonu, kia haere ki te hōhipera tata rawa atu mō te maimoatanga hauora mēnā kei a koe ngā tohu o te NMS. Anō, he āhuatanga ohorere te NMS, ā, me rongoa pea ki te Wāhanga Tiaki Kaha (ICU).

Āhea ahau me toro atu ki taku tākuta?

Mena kei te tango koe i tētahi, i ētahi atu rānei rongoā neuroleptics (antipsychotics), antiemetics, me/ranei dopaminergic (Parkinson's), he mea nui kia toro atu koe ki tō tākuta i ia wā, kia mōhio ai koe kei te pai te mahi a ēnei rongoā māu. Pātai atu hoki ki tō tākuta mō ngā pānga taha o ngā rongoā e tangohia ana e koe, me ngā tohumate me mōhio koe.

Me haere ahau ki te Tari Whawhati Tata (ETU) mēnā kei te pā mai ngā tohumate o te `NMS`?

Mena kei a koe ngā tohu o te mate pukupuku neuroleptic malignant syndrome (NMS), pērā i te kirika nui me te uaua pakari, he mea nui kia waea atu ki te 911, kia haere rānei ki te hōhipera tata tonu. Me tere tonu te aro hauora ki te NMS. Ki te kore e tere te rongoā me te tika, ka mate pea.

He mate kino, he mate morearea te mate pukupuku roro (NMS). Nō reira, ki te pāngia koe e ngā tohu, he mea nui kia rapu awhina hauora i te wā e taea ai. He māmā ake te rongoā i te NMS mēnā ka kitea wawe. Ahakoa he onge te NMS, ki te mea kei te tango koe i te rongoā neuroleptic (antipsychotic), kōrero ki tō tākuta, ki tō kaiwhakahaere rongoā rānei mō ngā pānga taha me ngā tohu hei tūpato. Kei reira rātou hei āwhina i a koe.

Ngā mea tino nui i akohia e mātou i tēnei tuhinga (Karere hei tango i te kāinga)

Āe, me whakamahara atu mātou ki a koutou ētahi o ngā mea tino nui hei maumahara māu i roto i ngā kōrero kua kōrerohia e tātou i roto i tēnei `NMS`:

• He mate onge te NMS, engari he mate morearea pea te ora, e hua mai ana i ngā rongoā neuroleptic.
• Ko te kirika nui, te mamae o ngā uaua, me te pōhēhē hinengaro ngā tohu matua.
• Ki te kite koe i tētahi o ēnei tohu, rapua tonutia he tohutohu hauora. Kaua e whakaroa.
• Mena kei te tango koe i te rongoā neuroleptic, kōrero ki tō tākuta mō te rongoā me ōna pānga taha. Kaua e wehi ki te pātai.
• Ka taea te whakaora rawa i te NMS mēnā ka kitea me te rongoā wawe.

Ko te tumanako kua whakamōhiotia koe e ēnei kōrero. Kia ora tonu!

` Te Mate Pūngāwerewere Mate Pūngāwerewere, NMS, ngā rongoā hinengaro, ngā pānga taha, te kirika nui, te pakari o te uaua