Zomwe muyenera kudziwa zokhudza MAOIs (Monoamine Oxidase Inhibitors)

Kodi dokotala wanu wakupatsani mankhwala otchedwa MAOI? Kapena mwamvapo za mankhwala awa kwinakwake ndipo mukufuna kudziwa bwino lomwe kuti ndi chiyani? MAOI kwenikweni ndi mtundu wa mankhwala omwe amaperekedwa pochiza matenda amisala monga kuvutika maganizo. Komabe, madokotala samawalimbikitsa kawirikawiri masiku ano. Pali zifukwa zingapo zenizeni za izi. Tiyeni tikambirane za izi kuyambira pachiyambi, mwachidule, m'njira yomwe mungamvetse.

Kodi mankhwala a MAOI ndi amtundu wanji?

Mwachidule, MAOIs (Monoamine Oxidase Inhibitors) ndi mankhwala oyamba omwe apezeka kuti athetse kuvutika maganizo. Komabe, muyenera kusamala kwambiri ndi zomwe mumadya mukamazigwiritsa ntchito. Komanso, chifukwa cha zotsatirapo zina komanso mavuto ndi mankhwala ena, madokotala nthawi zambiri amawalimbikitsa ngati njira yomaliza, pamene mankhwala ena oletsa kuvutika maganizo sagwira ntchito.

Izi zikutanthauza kuti, ngati mwapatsidwa mankhwala atsopano monga SSRIs ndipo zizindikiro zanu sizinasinthe, dokotala wanu angaganizire za MAOI ngati gawo lotsatira.

Kodi mitundu ikuluikulu ya MAOIs yomwe imagwiritsidwa ntchito padziko lonse lapansi ndi iti?

Pali mitundu ikuluikulu ingapo ya MAOI yomwe ikugwiritsidwa ntchito pakadali pano. Kaya zonsezi zilipo m'dziko lathu zingasiyane, koma ndibwino kudziwa mayina awa.

• Isocarboxazid (Marplan®)
• Phenelzine (Nardil®)
• Selegiline (Emsam®)
• Tranylcypromine (Parnate®)

Kodi mankhwala a MAOI amaperekedwa kwa matenda otani?

Ngakhale kuti mankhwalawa amaperekedwa makamaka kwa anthu ovutika maganizo, amagwiritsidwanso ntchito pa matenda ena amisala.

Kugwiritsa ntchito kovomerezeka mwalamulo

Izi ndi zochitika zomwe akuluakulu oyenerera avomereza mwalamulo kuti mankhwalawa ndi oyenera matenda amenewa.

• Matenda Ovutika Maganizo: Onse Isocarboxazid ndi Tranylcypromine ndi ovomerezeka pa vutoli.
• Matenda osachiritsika ndi mankhwala: Phenelzine imagwiritsidwa ntchito pochiza kuvutika maganizo, matenda a mantha, ndi matenda a nkhawa omwe sagwirizana ndi mankhwala ena.
• Matenda a Parkinson: Selegiline ndi mankhwala omwe amagwiritsidwa ntchito pochiza kuvutika maganizo ndipo amagwiritsidwanso ntchito ngati chowonjezera pa mankhwala ena a matenda a Parkinson.

Kugwiritsa ntchito "Off-label"

Nthawi zina, dokotala angakupatseni mankhwala awa kutengera chidziwitso chawo cha zachipatala komanso zomwe adakumana nazo pa vuto lomwe silinavomerezedwe mwalamulo. Izi zimatchedwa kugwiritsa ntchito "kunja kwa chizindikiro". Mwachitsanzo:

• Mankhwala otchedwa tranylcypromine nthawi zina amaperekedwa kwa anthu omwe ali ndi nkhawa komanso mantha omwe sagonjetsedwa ndi mankhwala.
• Pali nthawi zina pamene mankhwala a Selegiline amaperekedwa kwa matenda a attention deficit hyperactivity disorder (ADHD).

Kodi mankhwalawa amagwira ntchito bwanji m'thupi?

Izi n'zosavuta kuzimvetsa. Tangoganizani kuti ubongo wathu uli ndi mankhwala omwe amalamulira zinthu monga momwe timamvera, chisangalalo, ndi chidwi chathu. Timatcha izi ma neurotransmitters . Awa ali ngati amithenga ang'onoang'ono omwe amanyamula mauthenga muubongo.

Tsopano, thupi lathu lili ndi enzyme yotchedwa "Monoamine Oxidase." Ntchito ya enzyme iyi ndikuphwanya ndikuchotsa ma messengers (ma neurotransmitters) akagwiritsidwa ntchito.

Munthu amene ali ndi vuto la kuvutika maganizo angakhale ndi kuchuluka kochepa kwa ma agenti amenewa muubongo mwake. Chomwe mankhwala a MAOI amachita ndikuletsa kwakanthawi (kuletsa) ntchito ya enzyme 'yoyeretsa' imeneyo. Kenako chimachitika ndi chiyani?

Ma neurotransmitter angapo ofunikira muubongo amakhalabe muubongo kwa nthawi yayitali osawonongeka, zomwe zikutanthauza kuti milingo yawo imawonjezeka.

Ma neurotransmitters akuluakulu omwe amawonjezeka ndi MAOIs ndi awa:

• Serotonin: Chofunika kwambiri pamaganizo, kugona, chilakolako, komanso khalidwe la anthu.
• Norepinephrine: Yofunika kwambiri pakukhala maso, kuganizira kwambiri, komanso kuchita zinthu mopitirira muyeso.
• Dopamine: Yogwirizana ndi chisangalalo, kukhutira, ndi chidwi.
• Tyramine: Iyi ndi mtundu wa neurotransmitter. Koma ntchito yake yayikulu ndikuthandiza kulamulira kuthamanga kwa magazi. Ichi ndi chifukwa chachikulu chomwe muyenera kusamala ndi zomwe mumadya mukamamwa MAOI. Tikambirana mwatsatanetsatane posachedwa.

Kodi kusiyana pakati pa MAOIs ndi SSRIs ndi kotani?

Mankhwala otchedwa SSRIs (Selective Serotonin Reuptake Inhibitors) ndi mtundu wina wa mankhwala omwe amagwiritsidwa ntchito pochiza kuvutika maganizo. Mwina munamvapo mayina monga Prozac ndi Sertraline. Ngakhale kuti onsewa ndi mankhwala omwe amagwiritsidwa ntchito pochiza kuvutika maganizo, amagwira ntchito mosiyana.

• SSRI: Izi zili ngati zida zodulira. Zimangoyang'ana serotonin ya neurotransmitter, ndikuwonjezera kuchuluka kwake.
• MAOIs: Izi zili ngati mfuti. Zimakhudza ma neurotransmitters angapo (serotonin, norepinephrine, dopamine) nthawi imodzi.

Popeza mankhwala a SSRI ali ndi zotsatirapo zochepa ndipo palibe malamulo apadera okhudza chakudya ndi zakumwa, madokotala nthawi zambiri amalangiza mankhwala a SSRI kaye.

Kodi zotsatira zoyipa za MAOIs ndi ziti?

Monga mankhwala ena onse, mankhwalawa akhoza kukhala ndi zotsatirapo zake. Koma si aliyense amene amalandira mankhwalawa. Anthu ena akhoza kutenga chimodzi kapena ziwiri, ndipo ena sangakumane nazo konse. Ngati muli ndi vuto lina lililonse mutayamba kumwa mankhwalawa, lankhulani ndi dokotala wanu za vutoli.

Zoopsa zazikulu zokhudzana ndi kugwiritsa ntchito MAOIs!

Muyenera kudziwa bwino gawo ili. MAOIs ndi mankhwala omwe ayenera kugwiritsidwa ntchito mosamala kwambiri.

1. Kuwonjezeka kwa malingaliro ofuna kudzipha

Kuwonjezeka kwa malingaliro kapena khalidwe lofuna kudzipha kungachitike, makamaka kwa achinyamata osakwana zaka 25, pamene mankhwalawa ayamba kugwiritsidwa ntchito kapena pamene mlingo wa mankhwalawo wasinthidwa.

2. Matenda a Serotonin

Imeneyi ndi vuto losowa, koma lomwe lingathe kupha munthu . Limachitika pamene kuchuluka kwa serotonin m'thupi kukukwera kwambiri. Chiwopsezochi chimawonjezeka ngati mutenga MAOI pamene mukumwa mankhwala ena omwe amawonjezera kuchuluka kwa serotonin (monga mankhwala ena oletsa kuvutika maganizo, mankhwala ena oletsa chifuwa, ndi opha ululu).

Choncho, musanayambe kumwa mankhwala a MAOI, muyenera kuuza dokotala wanu za mankhwala onse omwe mukumwa (kuphatikizapo mavitamini ndi mankhwala achikhalidwe).

3. Matenda Oletsa Kuvutika Maganizo

Ngati mumwa mankhwala a MAOI kwa milungu yoposa 6 kenako n’kusiya mwadzidzidzi, mutha kukumana ndi zizindikiro zosiya kumwa mankhwalawo. Izi si chizolowezi, koma njira yoti thupi liziyankha mankhwalawo likayamba kuwazolowera.

Makhalidwe:

• Kupweteka thupi, kutopa, ndi thukuta, ngati kuti muli ndi malungo
• Kusowa tulo
• Kusanza
• Chizungulire
• Kumva ngati magetsi akudutsa m'thupi lanu
• Nkhawa, kukwiya

4. Kuopsa kwa chakudya (Tyramine Reaction)

Ichi ndiye chiopsezo chachikulu komanso choopsa kwambiri ndi MAOIs.

Monga tafotokozera kale, mankhwala a MAOI amaletsa enzyme yomwe imaphwanya mankhwala otchedwa tyramine. Tyramine imapezeka kwambiri muzakudya zina zomwe timadya. Mwa munthu amene sakumwa mankhwalawo, thupi limasweka mosavuta ndikuchotsa tyramine iyi.

Koma ngati munthu akumwa MAOI adya chakudya chokhala ndi tyramine yambiri, thupi silingathe kuichepetsa. Kenako kuchuluka kwa tyramine m'magazi kumakwera moopsa, zomwe zimapangitsa kuti kuthamanga kwa magazi kukwere mwadzidzidzi (Hypertensive Crisis) . Izi ndizoopsa kwambiri. Nthawi zina, izi zingayambitse kutuluka magazi muubongo komanso imfa.

Zakudya zoyenera kupewa mukamamwa MAOIs!

Ngati mukumwa MAOI, muyenera kupewa zakudya zomwe zili pamndandanda womwe uli pansipa. Lankhulani ndi dokotala wanu za izi kuti mudziwe zambiri.

Chofunika kwambiri: Idyani chakudya chikangophikidwa. Ikani zotsala mufiriji ndipo pewani kuzitenthetsanso. Pamene chakudya chikukalamba, kuchuluka kwa tyramine kumatha kukwera.

Kodi zimatenga nthawi yayitali bwanji kuti munthu amve zotsatira za mankhwalawa?

Nthawi zambiri zimatenga milungu iwiri kapena itatu kuti zotsatira zonse za mankhwala ziwonekere. Ngati simukuwona kusintha kulikonse mu zizindikiro zanu panthawi imeneyo, lankhulani ndi dokotala wanu.

Kodi muyenera kuyimbira dokotala wanu liti?

Ngati mukumwa mankhwala a MAOI, muyenera kupita kwa dokotala nthawi zonse kuti akaone ngati mankhwalawo akugwira ntchito komanso ngati muli ndi vuto lililonse. Kuphatikiza apo, onetsetsani kuti mwalankhula ndi dokotala wanu za izi:

• Ngati zotsatira zake zikukuvutitsani.
• Ngati zizindikiro zanu sizikusintha kapena kuipiraipira.
• Ngati mukuona kuti muyenera kusiya kumwa mankhwalawo.