Kei te neke haere tō tinana i te kore e taea te whakaaro? Me kōrero tātou mō te Tardive Dyskinesia!

I ētahi wā, ka rongo koe i ētahi wāhanga o tō tinana, pērā i te ringa, i te waewae rānei, i ngā āhua o te kanohi rānei, e neke haere ana, kāore e taea te whakahaere? Kua pāngia rānei tētahi e mōhio ana koe e ēnei tohu rerekē i muri i te tango i ētahi rongoā? Mēnā kua rongo koe i tētahi mea pēnei, ko te mate ka kōrerohia e tātou i tēnei rā, e kiia nei ko te Tardive Dyskinesia, he mea nui ki a koe. Ahakoa he kupu roa, me mārama noa tātou he aha te mea nei.

He aha te Tardive Dyskinesia?

Ki te whakarapopototanga, ko te Tardive Dyskinesia (TD) he mate pūnaha io, he kohinga tohu rānei, e neke haere ana ngā uaua o tō tinana me te kore e taea e koe te whakahaere. Pērā i te wiri o te ringa, i te huri ohorere rānei o te āhua o te kanohi.

Ko te tino take o tēnei āhuatanga ko te whakamahinga roa o ētahi rongoā mō te mate hinengaro, inā koa ko ngā rongoā antipsychotic o te whakatupuranga tuatahi (neuroleptics). Heoi, ehara i te mea ko ēnei anake ngā rongoā ka puta ai tēnei. Ka taea hoki e ētahi atu rongoā te puta ai tēnei.

Ko te tikanga o te kupu "Tardive" he "whakaroa" he "tōmuri" rānei. Ko te tikanga o te "Dyskinesia" he koretake, arā, he nekehanga uaua kāore e taea te whakahaere. Nō reira, i roto i tēnei āhuatanga, ka puta ēnei nekehanga koretake i muri i te tīmatanga o te tango rongoā mō tētahi wā, i ētahi wā he tau. Heoi, i ētahi wā ka puta tēnei āhuatanga ahakoa i muri i te tango i te rongoā mō te wā poto. He tino tūpono tēnei āhuatanga ki te hunga neke atu i te 65 tau te pakeke, ahakoa he poto noa te whakamahinga o te rongoā.

E hia te auau o tēnei āhuatanga?

E ai ki ngā kairangahau , neke atu i te 20% o te hunga e tango ana i ngā rongoā antipsychotic o te whakatupuranga tuatahi ka pāngia e te tardive dyskinesia. Kāore anō kia rangahaua te auau tuturu o tēnei mate me ētahi atu momo rongoā, nō reira he uaua ki te hoatu i te tatauranga tuturu.

He aha ngā tohu o te Tardive Dyskinesia?

Ka taea e te tardive dyskinesia te whakaputa nekehanga i ngā wāhi penei kāore e taea e koe te whakahaere:

• Ngā uaua o tō mata
• Arero
• kaki
• Ngā uaua o te tinana
• Ngā peka

Ngā nekehanga mata koretake:

• Ngā nekehanga pakipaki ngutu, ngā nekehanga ngote rānei.
• Te menemene, te kōkō rānei, kāore he take.
• Te kōpikopiko i te arero, te pēhi rānei i te arero ki te paparinga.
• Ngā nekehanga ngaungau.
• Ngā paparinga e pupuhi ana.
• Te tere o te kimo kanohi / te blepharospasm. Whakaarohia te hoha o te mea ka pēhia tonutia e koe te kimo kanohi.

Ētahi atu nekehanga koretake:

• Ngā nekehanga auau o ngā maihao, pērā i te tākaro piano.
• Te pana, te ru rānei i tō hope.
• Te hikoi me te hikoi rite ki te parera.
• Te kore e taea te noho marino, te āhua o te kore okiokinga tonu (akathisia). He wheako tino whakamā tēnei.

Ahakoa he ngawari noa iho ēnei tohu, kāore e kitea nuitia ana e ētahi tāngata, mō ētahi atu, ka tino kino rawa atu, ā, ka pā ki ngā mahi o ia rā, tae noa ki te kore e taea .

Ka whakamahia pea e ngā tākuta ēnei kupu hei whakaahua i ēnei tohu:

• Dystonia: Ngā whakahekenga uaua kāore e taea te whakahaere.
• Myoclonus: He oho ohorere, he poto te nekehanga o te uaua.
• Te āhua o te waha me te arero: Ngā nekehanga auau e whakamahia ana e te waha me te arero.
• Ngā Tics: Ngā uaua e ngokingoki ana i ia wā, inā koa i te mata.

He aha ngā take o te Tardive Dyskinesia?

Kāore ngā kairangahau i te tino mōhio he aha te take o tēnei. Heoi, ko te whakaaro matua , tera pea nā te whakamahinga o ngā rongoā e kiia nei ko ngā "dopamine antagonists" e aukati ana i ngā kaiwhakawhiwhi mō te neurotransmitter "dopamine" i roto i te roro. Ka taea tēnei te tupu ahakoa ka tangohia e koe ēnei rongoā mō te wā poto, mō te wā roa rānei. Heoi, ka nui ake te mōrearea ina tangohia e koe mō te wā roa. I ētahi wā, ka puta te TD i muri i te whakamutu i ēnei rongoā, te whakarerekē i te horopeta, te whakaiti rānei.

Whakaarohia, ina roa koe e tango ana i ngā rongoā aukati i te dopamine receptor, ka tino tairongo ngā receptor dopamine i roto i te roro (ina koa ko ērā i roto i te basal ganglia, he wāhanga o te roro e āwhina ana ki te whakahaere i te nekehanga). E whakaarohia ana ko tēnei nekehanga kore whakahaere i puta mai i te nui rawa o te dopamine, i te tino tairongo rānei o ngā receptor.

Haunga te dopamine, e whakaarohia ana hoki kei roto i tēnei ko ētahi atu kaiwhakawhiwhi neurotransmitter, pērā i te serotonin, te acetylcholine, me te GABA . Koinei pea te take i puta ai te TD i ētahi wā nā ngā rongoā ehara i te rongoā antipsychotics.

He aha ngā rongoā e hua ai te Tardive Dyskinesia?

Ka taea te whakaputa i te tardive dyskinesia mā te whakamahi i ngā rongoā e whai ake nei:

• Ngā rongoā ārai hinengaro/ngā rongoā neuroleptics: Koinei ngā tino take.
• Metoclopramide me ētahi atu rongoā ārai-whakapaipai.
• Ko ētahi rongoā antidepressant .

He tino onge, ka taea hoki e ēnei rongoā te whakaputa i te TD:

• Ritiuma.
• Ngā rongoā ārai-hōhā.
• Ngā antihistamine, inā koa ko te hydroxyzine.
• Ko ngā rongoā ārai-malaria he rongoā e hoatu ana mō te malaria.

Ngā rongoā ārai hinengaro me te TD

Ko ngā rongoā ārai hinengaro (neuroleptics) te nuinga o te wā e whakamahia ana hei rongoā i ngā mate hinengaro pēnei i te schizophrenia. Ko ēnei rongoā te tino take o te TD.

E whakaarohia ana he nui ake te mōrearea o ngā rongoā antipsychotic o te whakatupuranga tuatahi ("noa") ki te whakaputa i te TD i ngā rongoā antipsychotic o te whakatupuranga tuarua ("koretake").

Ko ētahi tauira o ngā rongoā antipsychotic o te whakatupuranga tuatahi:

• Chlorpromazine `(Chlorpromazine)`
• Fluphenazine `(Fluphenazine)`
• Haloperidol `(Haloperidol)`
• Perphenazine `(Perphenazine)`
• Prochlorperazine `(Prochlorperazine)`
• Thioridazine `(Tioridazine)`
• Trifluoperazine `(Trifluoperazine)`

Metoclopramide me te tardive dyskinesia

He rongoā te Metoclopramide e whakamahia ana hei rongoā i te reflux waikawa mau tonu (GERD), he momo gastritis kino. Ka whakamahia hoki hei rongoā i te gastroparesis e pā ana ki te mate huka.

He hononga kaha kei waenganui i te metoclopramide me te TD. Ko ngā āhuatanga mōrearea mō te whakawhanaketanga o te TD nā tēnei rongoā ko:

• E 65 tau te pakeke, neke atu rānei.
• Te noho hei wahine.
• He mate huka tō te tangata.
• Te tango i te metoclopramide mō ngā wiki 12, neke atu rānei.

Ngā rongoā ārai pouri me te TD

Ka whakamahia ngā rongoā ārai pouri hei rongoā i ngā āhuatanga pēnei i te pouri, te manukanuka, me te mate pōrearea. Ko ēnei rongoā te mea pea ka puta te TD i roto i te hunga neke atu i te 65 tau te pakeke. Nā te mea ka huri te roro i te pakeketanga. He iti ake te kitea o tēnei i te TD i puta mai i ngā rongoā ārai pouri.

Ko ngā rongoā ārai pouri e whai ake nei e pā ana ki te `(TD)`:

• Trazodone (he rongoā whakarerekētanga serotonin tēnei).
• Amitriptyline, clomipramine, me te doxepin (he rongoā ārai pouri tricyclic ēnei).
• Ko te Fluoxetine me te sertraline (he SSRI ēnei).
• Ko te Phenelzine me te rasagiline (he MAOI ēnei).
• Kua honoa te Selegiline (he MAOI anō hoki) ki te TD ina tangohia me te levodopa.

Ritiumu me te TD

He rongoā te lithium e whakamahia ana hei rongoā i te mate hinengaro rua. E hono ana hoki ki te TD. Heoi, ki te tangohia e koe te lithium me te rongoā antipsychotic, ka nui ake tō tūponotanga ki te whakawhanake i te TD.

Ngā rongoā ārai-hopu me te TD

Ka whakamahia ngā rongoā ārai-hōhā hei ārai me te whakahaere i ngā hōhā. E pā ana te carbamazepine me te lamotrigine ki te TD, engari he iti ake te tūponotanga ka puta te TD i a rāua. Kua honoa hoki te phenytoin ki te TD.

Ngā Antihistamine me te TD

Ka āwhina ngā rongoā ārai mate pāwera ki ngā tohumate mate pāwera. Ko te Hydroxyzine, inā koa, kua honoa ki te TD mēnā ka whakamahia mō te wā roa.

Ko te hunga neke atu i te 65 tau te pakeke kua whakamahi i ngā phenothiazines (ngā rongoā antipsychotics noa) ka nui ake te tūponotanga ka pāngia rātou e te TD ina tango ana i te hydroxyzine.

Ngā rongoā ārai mate pāwera me te TD

He hononga tō ngā rongoā ārai mate pāwera pērā i te chloroquine me te amodiaquine ki te TD.

He aha ngā āhuatanga mōrearea mō te Tardive Dyskinesia?

Tērā pea ētahi āhuatanga ka whakanui ake i tō tupono ki te whakawhanake i te tardive dyskinesia. Ko ētahi o ēnei ko:

• Tau: Ko te hunga neke atu i te 40 tau te pakeke ka nui ake te tūponotanga ki te pāngia e te TD. Ko te hunga neke atu i te 65 tau te pakeke ka tino mōrearea nā ngā huringa o te pūnaha io e puta ana i te kaumātuatanga.
• Ira Tangata: He nui ake te tūponotanga o ngā wāhine ki te pāngia e te TD. Ko ngā wāhine kua pāngia e te menopause e tango ana i ngā rongoā antipsychotic mō te tau kotahi, he 30% te nui ake o te tūponotanga ki te pāngia e te TD.
• Iwi: Kua whakaatuhia e ētahi rangahau he nui ake te tūponotanga o te hunga mangu o Amerika ki te pāngia e te mate TD i ngā tāngata mā. Waihoki, he iti ake te tūponotanga o te hunga nō ngā uri Filipino me Āhia ki te pāngia e te mate TD i ngā tāngata nō ngā uri Pākehā. (Me whai atu anō ngā rangahau ā-rohe hei whakatau me pēhea te pānga o tēnei ki Sri Lanka.)
• Mate pūrua: Ko te hunga whai mate pūrua ka nui ake te aro ki te TD i ētahi atu ina tango ana i ngā rongoā antipsychotic.

Kei te rangahauhia hoki e ngā kairangahau ngā āhuatanga ira e whakanui ana, e whakaiti rānei i te mōrearea o te whakawhanake i te TD.

He aha ngā raruraru pea ka pā mai i te Tardive Dyskinesia?

Ka tino whakararuraru ngā nekehanga kore whakahaere e puta mai ana i te tardive dyskinesia. Ka pā hoki ki tō oranga pāpori me tō oranga kare ā-roto. Ka pā nui tēnei ki tō hauora hinengaro. Ka uaua hoki te mahi i ngā mahi o ia rā.

Ehara te TD i te mate whakamate i te nuinga o te wā. Heoi anō,He tino onge, ki te kaha rawa te TD ka pā ki te larynx (te wāhi kei reira ngā taura reo - te laryngospasm) me te diaphragm (te uaua e āwhina ana i a koe ki te manawa), ka uaua pea te manawa, ā, ka mōrearea hoki te ora.

Me pēhea te tautuhi i te Tardive Dyskinesia?

Ka pātai tō tākuta mō ō tohu, tō hītori hauora, me te whakamahinga rongoā. Tērā pea ka whakapae tō tākuta he tardive dyskinesia (TD) koe mēnā kei te tango koe i tētahi rongoā e mōhiotia ana ka puta te tardive dyskinesia. Ka whakahaerehia e rātou he whakamātautau tinana me te whakamātautau io. Tērā pea ka tukuna koe ki tētahi tohunga, pērā i te tohunga roro, te tohunga mate nekehanga, te tohunga hinengaro rānei.

Ka whakamahia e ngā tākuta te Diagnostic and Statistical Manual of Mental Disorders (DSM-5) hei tātaritanga i te tardive dyskinesia. E ai ki te DSM-5 , kia tātaritangahia ai koe he tardive dyskinesia, me mau tonu ngā tohu mō te iti rawa kotahi marama i muri i te whakamutu i te rongoā. Mena he 40 tau te pakeke, he iti iho rānei, me toru marama te iti rawa e kai ana koe i te rongoā, ki te neke atu rānei i te 40 tau te pakeke, me kotahi marama te roa e kai ana koe i te rongoā.

Tērā pea ka tonoa e tō tākuta ētahi atu whakamātautau hei whakaū i te TD, hei whakakore rānei i ētahi atu āhuatanga he rite ngā tohu, pērā i te mate a Huntington. Kei roto pea i ēnei ko ngā whakamātautau taiwhanga me ngā whakamātautau whakaahua, pērā i te matawai CT, te MRI rānei o te roro. Heoi, ko te TD he tātaritanga haumanu i te nuinga o te wā. Ko te tikanga o tēnei ka whakatauhia e ngā tākuta te mate i runga i te hītori hauora whānui me te whakamātautau tinana whānui, me te kore he whakamātautau tāpiri.

He aha ngā maimoatanga mō te Tardive Dyskinesia?

He rerekē ngā hua o ngā rangahau mō te whakahaere i te tardive dyskinesia. E whakaatu ana ētahi rangahau ka pai ake ngā tohu ina whakaitihia, ina mutu rānei te horopeta o te rongoā antipsychotic. E whakaatu ana ētahi kāore he rerekētanga.

Mena ka taea, ka tūtohu pea tō tākuta kia mutu te rongoā e puta ai tō TD. Engari, kāore e taea i ngā wā katoa. Nā te mea ka kino ake te āhua o te mate i whakahaerea e te rongoā mā te whakamutu i te rongoā.

Mena ka pāngia koe e te TD i a koe e tango ana i te rongoā antipsychotic o te whakatupuranga tuatahi, ka taea e tō tākuta te whakawhiti i a koe ki te rongoā antipsychotic o te whakatupuranga tuarua.

Haunga te whakamutu, te whakawhiti rānei i ngā rongoā ārai mate hinengaro, ko te taunakitanga kaha rawa atu mō te maimoatanga o te TD kei te wātea i tēnei wā mō tētahi momo rongoā e kiia nei ko ngā aukati VMAT. Kua whakaatuhia inaianei he haumaru, he whai hua hoki a Deutetrabenazine me valbenazine. Mena he TD ngawari ki te kino tōu e pā ana ki tō kounga o te oranga, ka tūtohu pea tō tākuta i ēnei rongoā.

Ka taea te whakaora i te Tardive Dyskinesia? (Ka taea te whakakore?)

Engari, ko te nuinga o ngā mate o te tardive dyskinesia he mau tonu, arā, he roa te wā e mau ana. Ahakoa ka taea e ngā rongoā te āwhina i te whakahaere i ngā tohu, kāore e taea te whakaora katoa, te whakakore rānei i te āhua.

He aha ngā mea ka tumanakohia e au mēnā kei a au te Tardive Dyskinesia?

Kāore te Tardive dyskinesia e pā ki te katoa i te huarahi kotahi. Ka rerekē ngā tohu mai i te ngawari ki te kino. Ahakoa he āwhina te maimoatanga i ētahi tāngata ki te whakahaere i ō rātou tohu, kāore pea mō ētahi atu. Ka mahi tahi tō tākuta me koe ki te kimi i te mahere maimoatanga pai rawa atu. Ka taea e rātou te hoatu he whakaaro pai ki a koe mō ngā mea hei tumanako atu.

Ka taea te ārai i te Tardive Dyskinesia?

He uaua te matapae i te mate Tardive dyskinesia. Ehara i te mea ka pāngia te hunga katoa e tango ana i ētahi rongoā.

Mena kei a koe ngā āhuatanga mōrearea e nui ake ai te tūponotanga kia pāngia koe e tēnei mate, kōrero ki tō tākuta. Tērā pea ka taea e koe te ārai i te tardive dyskinesia mā te whakamahi i tētahi atu rongoā. Hei whakaiti i tō tūponotanga ki te pāngia e te TD, ka tohua e tō tākuta te horopeta iti rawa o te rongoā antipsychotic mō te wā poto rawa.

Mena kei te tango koe i tētahi rongoā e mōhiotia ana ka puta ai te TD, kōrero ki tō tākuta mō te tirotiro auau mō ngā mate nekehanga. Mā te kitenga wawe i ngā tohu o te TD ka āwhina i te whakaiti i tōna kaha. He pai ake te whakahaere i ēnei tirotiro i roto i ngā marama e toru ki te ono i muri i te tīmatanga o tētahi rongoā ka puta ai te TD.

Me pēhea taku tiaki i ahau anō mēnā kei a au te Tardive Dyskinesia?

Ka mahi tahi tō tākuta me koe ki te whakarite i tō mahere maimoatanga ina hiahiatia. Anei ētahi atu mahi ka taea e koe te mahi hei whakahaere i te TD:

• Me arotakehia ngā tohumate e tō tākuta i ia toru ki te ono marama.
• Puritia he tuhinga mō ō tohumate. Mēnā ka puta he tohumate hou, me whakamōhio atu ki tō tākuta.
• Me tiaki i a koe anō, tae atu ki te whakakorikori tinana. Ka taea e te whakakorikori tinana te whakaora i ētahi tohu nekehanga.
• Kōrero ki tō tākuta mō ō mahi o ia rā me te kounga o te oranga.
• Mena kei te pāngia tō hauora hinengaro me tō hauora pāpori e te TD, rapua he āwhina mai i tētahi kaitohutohu hauora hinengaro .

Āhea ahau me haere ki te rūma whawhati tata?

Mena kei te uaua koe ki te manawa nā te tardive dyskinesia, waea atu ki te 911 (1990 i Sri Lanka) tonu atu, haere rānei ki te rūma whawhati tata.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He rerekē te pānga o te Tardive dyskinesia (TD) ki te tangata. Mō ētahi, ka pā nui ki te kounga o ō rātou oranga. Engari kia maumahara, ka mahi tahi tō tākuta me koe ki te aroturuki me te whakahaere i tō TD. Ka taea e rātou te tūtohu me te whakarerekē i tētahi mahere maimoatanga kia rite ki ō hiahia, me te whakaaro i ngā rautaki tiaki whaiaro hei āwhina. Kaua rawa e mutu te tango i tō rongoā, kaua hoki e whakarerekē i te horopeta me te kore he tohutohu a tō tākuta. Kōrero ki tō tākuta mō ngā pātai, ngā āwangawanga rānei kei a koe.

` Tardive dyskinesia, ngā nekehanga koretake, ngā pānga taha rongoā, ngā rongoā antipsychotics, ngā neuropathies, te dopamine, ngā aukati VMAT