Tiyeni tidziwe za Neuroleptic Malignant Syndrome, matenda oopsa omwe amayamba chifukwa cha mankhwala osokoneza bongo!

Inu kapena munthu amene mumamudziwa mwina mukumwa mankhwala otchedwa neuroleptic, omwe amagwiritsidwa ntchito pochiza matenda ena amisala. Ngakhale kuti mankhwala awa angathandize kwambiri anthu ambiri, pali zochitika zina zomwe mankhwalawa angayambitse matenda oopsa, ngakhale oopsa. Ndicho chimene timachitcha Neuroleptic Malignant Syndrome (NMS). Ndi dzina lovuta, koma ndikofunikira kudziwa za ilo.

Kodi matenda a neuroleptic malignant syndrome (NMS) ndi chiyani? Tiyeni timvetse mosavuta!

Mwachidule, matenda a neuroleptic malignant syndrome (NMS) ndi vuto losowa kwambiri komanso lomwe lingayambitse imfa chifukwa cha mankhwala otchedwa neuroleptics (omwe amadziwikanso kuti mankhwala oletsa matenda amisala). Mankhwalawa amagwiritsidwa ntchito pochiza ndi kuchiza zizindikiro za matenda ambiri amisala.

Zizindikiro zazikulu zingapo zitha kuwoneka mu mkhalidwe uwu wa `NMS`:

• Kukhala ndi kutentha thupi kwambiri (hyperthermia).
• Minofu m'thupi imakhala yolimba komanso yopweteka (ngati izi zipitirira, minofuyo ingaswekenso).
• Kusintha kwa mkhalidwe wamaganizo (monga kusokonezeka, kulephera kukumbukira).
• Kulephera kwa dongosolo la mitsempha ya autonomic kapena dysautonomia.

Dongosolo lathu la mitsempha lodziyimira palokha lili ngati dongosolo lodziyimira lokha m'thupi lathu. Limalamulira zinthu monga kuthamanga kwa magazi ndi kuthamanga kwa mpweya. Likalephera kugwira ntchito bwino, kuthamanga kwa magazi kumatha kukwera ndi kutsika mwadzidzidzi, kuyambitsa thukuta kwambiri (secondary hyperhidrosis), komanso kuyambitsa malovu ambiri.

NMS ndi vuto lachipatala lomwe limayambitsa imfa, lomwe limafuna chithandizo chamankhwala mwachangu. Chifukwa chake, ngati mukukumana ndi zizindikiro izi, chinthu chabwino kuchita ndikupita kuchipatala nthawi yomweyo.

Kodi mankhwala a neuroleptic awa ndi ati?

Mankhwala a neuroleptic, kapena mankhwala a antipsychotic, akhoza kugawidwa m'magulu awiri akuluakulu.

1. Mankhwala oletsa matenda amisala a m'badwo woyamba kapena "achizolowezi".

2. Mankhwala oletsa matenda amisala a m'badwo wachiwiri kapena "osazolowereka".

Madokotala amapereka mankhwala oletsa matenda amisala a m'badwo woyamba ndi wachiwiri awa pa matenda osiyanasiyana amisala ndi mitsempha. Nazi zitsanzo zingapo:

• Mavuto a khalidwe omwe amapezeka mu matenda a dementia.
• Matenda a bipolar.
• Kuvutika maganizo.
• Matenda a kudya.
• Matenda a nkhawa wamba.
• Kusakhazikika kwa okalamba.
• Kusowa tulo.
• Matenda okakamiza kuchita zinthu mopitirira muyeso (OCD).
• Matenda a umunthu.
• Matenda a post-traumatic stress (PTSD).
Matenda a Schizoaffective . Schizophrenia ndi matenda ena ofanana nawo.

Ndi mankhwala ati omwe angayambitse matenda a neuroleptic malignant syndrome (NMS)?

Pali mitundu ingapo ya mankhwala omwe angayambitse `NMS`. Tiyeni tiwone zomwe zili.

Mankhwala odziwika bwino a neuroleptic (antipsychotic):

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

Mankhwala oletsa matenda amisala (antipsychotic):

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

Mankhwala ena oletsa kutsekula m'mimba:

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

Mankhwala a Dopaminergic (Parkinson's) (mwa kusiya mwadzidzidzi):

• Amantadine
• Mankhwala a dopamine agonists
• Levodopa
• Tolcapone

Musachite mantha ndi mndandanda uwu. Si aliyense amene amamwa mankhwalawa amene adzadwala matenda a NMS. Vutoli ndi losowa kwambiri . Koma ngati mukumwa mankhwala awa, ndikofunikira kudziwa izi.

Kodi kusiyana pakati pa NMS ndi malignant hyperthermia ndi kotani?

Mwina munamvapo za matenda otchedwa malignant hyperthermia. Ndi vuto losowa komanso loopsa. Koma limayamba chifukwa cha mankhwala oletsa ululu komanso mankhwala ochepetsa ululu .

Zingayambitsenso kuuma kwa minofu, kuchepa kwa reflexes (hyporeflexia), ndi kusintha kwa khungu (buluu, kufiira). Zizindikiro izi zitha kukhala zofanana ndi za NMS. Komabe, madokotala amatha kusiyanitsa ziwirizi poyang'ana mbiri ya matenda a wodwalayo. Izi zikutanthauza kuti, kaya adapatsidwa mankhwala oletsa ululu kapena akumwa mankhwala a neuroleptic posachedwapa.

Kodi kusiyana pakati pa NMS ndi Serotonin Syndrome ndi kotani?

Matenda a Serotonin ndi vuto lina losokoneza. Amayambitsidwa ndi mankhwala omwe ali m'gulu la serotonergic, monga mankhwala ena oletsa kuvutika maganizo, amphetamines, antihistamines, ndi oletsa kukhumudwa. Mwachidule, zimachitika pamene thupi lili ndi mankhwala ambiri otchedwa serotonin.

Zizindikiro za serotonin syndrome ndi monga kulimba kwa minofu, hyperreflexia, kutsegula m'mimba, thukuta, kugwedezeka kwa minofu (myoclonus), ndi kusintha kwa maganizo. Komabe , malungo ndi kulimba kwa minofu nthawi zambiri sizimapezeka kawirikawiri mu serotonin syndrome poyerekeza ndi mu NMS.

Dokotala wanu adzasiyanitsa pakati pa matenda awiriwa pomvetsera zizindikiro zanu ndi mankhwala omwe mukumwa.

Ndani amadwala matenda a neuroleptic malignant syndrome (NMS)?

NMS ikhoza kuchitika kwa aliyense amene akumwa mankhwala a neuroleptic (antipsychotic).

Ngakhale kuti akuganiza kuti pafupifupi magawo awiri mwa atatu a milandu ya NMS imachitika mkati mwa sabata yoyamba kuyambira pamene anayamba kugwiritsa ntchito mankhwala a neuroleptic, ndikofunikira kukumbukira kuti vutoli likhoza kuchitika nthawi iliyonse panthawi ya chithandizo.

Kodi vuto la `NMS` limeneli ndi lofala bwanji?

Ndipotu, matenda a neuroleptic malignant syndrome (NMS) ndi vuto losowa kwambiri. Limapezeka pakati pa 0.01% ndi 3.2% ya anthu omwe amamwa mankhwala a neuroleptic.

Komabe, nkhani yabwino ndi yakuti chiwerengero cha malipoti a NMS chikuchepa chifukwa cha kuyambitsidwa kwa mankhwala atsopano omwe ali ndi chiopsezo chochepa choyambitsa NMS, komanso kudziwa bwino kwa madokotala ndi odwala za vutoli.

Kodi zizindikiro za matenda a neuroleptic malignant syndrome (NMS) ndi ziti?

Zizindikiro za `NMS` nthawi zambiri zimayamba kuonekera mkati mwa tsiku limodzi kapena atatu . Zizindikiro zazikulu ndi izi:

• Malungo amphamvu kwambiri (102 mpaka 104 madigiri Fahrenheit - 38.9 mpaka 40 madigiri Celsius).
• Kusakhazikika kwa kayendedwe ka mtima (arrhythmia).
• Kuwonjezeka kwa kugunda kwa mtima (tachycardia).
• Kuwonjezeka kwa kupuma (tachypnea).
• Kuuma/kuuma kwa minofu `(kulimba kwa minofu)`.
• Kusintha kwa maganizo (monga chisokonezo, kusokonezeka maganizo, kutaya chidziwitso).
• Kuthamanga kwa magazi kwambiri kapena kuthamanga kwa magazi kochepa.
• Kutuluka thukuta kwambiri.

Ngati muli ndi chimodzi mwa zizindikirozi, makamaka ngati mukumwa mankhwala a neuroleptic, chonde imbani 911 kapena pitani kuchipatala chapafupi nthawi yomweyo. Izi ndi zadzidzidzi zachipatala.

Kodi mankhwala a neuroleptic amayambitsa bwanji `NMS`?

Matenda a `NMS` amayamba chifukwa cha mankhwala a neuroleptic (antipsychotic).Zitha kuchitika ndi mlingo umodzi, ndi kuwonjezeka kwa mlingo, kapena ndi kupitiriza kugwiritsa ntchito mlingo womwewo. Ngakhale kuti NMS imagwirizana kwambiri ndi mankhwala oletsa matenda amisala a m'badwo woyamba, imathanso kuchitika, pang'ono, ndi kusiya mwadzidzidzi mankhwala oletsa matenda amisala a m'badwo wachiwiri, mankhwala ena oletsa kutsekeka m'mimba, ndi mankhwala a dopaminergic omwe amagwiritsidwa ntchito pa matenda a Parkinson.

Asayansi akuyesetsabe kupeza chomwe chimayambitsa NMS. Chiphunzitso chamakono ndi chakuti imayambitsidwa ndi dopamine D2 receptor antagonism . Dopamine ndi neurotransmitter muubongo mwathu. Ndi mankhwala omwe amanyamula mauthenga pakati pa maselo. Mankhwala a neuroleptic amagwira ntchito poletsa dopamine messenger iyi kuti isalowe m'maselo kudzera m'ma receptors enaake.

Pamene ma dopamine receptors mu hypothalamus yanu ndi/kapena msana wanu atsekedwa, kupsinjika kwa minofu kumawonjezeka. Komanso, kusokonezeka kwa ma dopamine receptors mu hypothalamus ndi komwe kumayambitsa kutentha thupi kwambiri komanso kusinthasintha kwakukulu kwa kuthamanga kwa magazi komwe kumachitika mu NMS.

Kodi matenda a neuroleptic malignant syndrome (NMS) amawapeza bwanji?

Kuti madokotala adziwe matenda a NMS, muyenera kukhala ndi zizindikiro kapena mikhalidwe yonse iyi :

• Mukumwa mankhwala a neuroleptic kapena mwasiya mwadzidzidzi kumwa mankhwala a dopaminergic.
• Muli ndi minofu yolimba/yolimba kwambiri (izi zingayambitsenso kuphulika kwa minofu).
• Muli ndi malungo amphamvu.
• Pali kusintha kwa maganizo anu.

Kuphatikiza apo, ziyenera kukhala ndi makhalidwe awiri mwa awa :

• Kutuluka thukuta kwambiri kapena kwachilendo.
• Kuvuta kumeza.
• Kulephera kulamulira mkodzo kapena ndowe (kusadziletsa).
• Kuwonjezeka kwa kugunda kwa mtima (tachycardia).
• Mwadzidzidzi sankatha kulankhula.
• Kuwonjezeka kapena kusintha kwa kuthamanga kwa magazi pafupipafupi.
• Kuchuluka kwa maselo oyera m'magazi (Leukocytosis).
• Kuchuluka kwa creatine phosphokinase (CPK) chifukwa cha kusweka kwa minofu.
• Kusinthasintha pang'onopang'ono kapena kochepa (hyporeflexia).

Ndi mayeso ati omwe amachitidwa kuti adziwe `NMS`?

Ngati dokotala wanu akukayikira kuti muli ndi NMS, akhoza kuyitanitsa mayeso monga:

• Gulu lonse la kagayidwe kachakudya.
• Kusanthula mkodzo.
• Kuyesa mpweya wa m'magazi a mitsempha kapena a m'mitsempha.
• Kuyezetsa magazi kwa creatine phosphokinase (CPK).

Kodi matenda a neuroleptic malignant syndrome (NMS) amachiritsidwa bwanji?

NMS ndi vuto lachipatala. Chifukwa chake ndikofunikira kuzindikira vutoli ndikuyamba kulandira chithandizo mwachangu. Ngati muli ndi NMS, mwina mungafunike kupita kuchipatala.Mudzafunika kulandira chithandizo mu chipinda chosamalira odwala kwambiri (ICU).

Pazochitika zonse za `NMS`, madokotala nthawi yomweyo amasiya mankhwala a neuroleptic (antipsychotic) omwe adayambitsa `NMS`. Kuphatikiza apo, adzachiza zizindikiro za `NMS` ndikuchitapo kanthu kuti apewe mavuto omwe angakhalepo. Mankhwalawa angaphatikizepo:

• Kusunga mtima ndi kupuma bwino pogwiritsa ntchito makina opumira mpweya, mankhwala oletsa kupweteka kwa mtima, ndi/kapena makina oletsa kupweteka kwa mtima.
• Kusunga bwino ma electrolyte m'thupi mwa kupereka madzi m'mitsempha (madzi a m'mitsempha).
• Kuchepetsa kutentha kwa thupi pogwiritsa ntchito mabulangeti ozizira, madzi oundana, ndi/kapena mapaketi a ayezi.
• Ngati kuthamanga kwa magazi kuli kokwera, chepetsani vutoli ndi mankhwala.
• Kupereka mankhwala monga heparin kuti magazi asatseke.
• Kupereka mankhwala omwe angabwezeretse kuchuluka kwa dopamine m'thupi.
• Kupatsa minofu kapena mafupa mankhwala opumulira.

Kodi ndi zinthu ziti zomwe zimayambitsa `NMS`?

Pali zinthu zingapo zomwe zimawonjezera chiopsezo chotenga matenda a neuroleptic malignant syndrome (NMS):

• Kuyambitsa mankhwala atsopano a neuroleptic (antipsychotic) kapena kuonjezera mlingo.
• Kugwiritsa ntchito mankhwala oposa limodzi a neuroleptic kapena kugwiritsa ntchito mankhwala a lithiamu.
• Kusiya mwadzidzidzi kumwa mankhwala a dopaminergic a matenda a Parkinson.

Kodi zitenga nthawi yayitali bwanji kuti munthu achire ku `NMS`? (Zomwe zimachitika)

Ngati NMS yapezeka msanga ndikuchiritsidwa mwachangu komanso moyenera, anthu ambiri amachira mkati mwa milungu iwiri mpaka masiku 14.

Komabe, ngati chithandizo chachedwa, mavuto aakulu angachitike omwe angakhudze minofu, impso, mtima, ndi/kapena mapapo.

Ngati sichilandira chithandizo mwachangu, NMS ikhoza kupha. Chiwerengero cha imfa cha NMS chili pakati pa 5% ndi 20%. Komabe, kudziwa zambiri za NMS ndi kugwiritsa ntchito mankhwala atsopano oletsa matenda amisala kwachepetsa chiwerengero cha imfa m'zaka makumi angapo zapitazi.

Anthu ambiri, motsogozedwa ndi dokotala, amatha kuyambitsanso bwino mankhwala a neuroleptic (antipsychotic).

Kodi mavuto a neuroleptic malignant syndrome (NMS) ndi otani?

Mwatsoka, mavuto a NMS ndi ofala komanso oopsa. Mavuto ena amayamba chifukwa cha zizindikiro za NMS komanso kusagwira bwino ntchito kwa dongosolo la mitsempha lodziyimira palokha, pomwe ena, makamaka matenda, amatha kuchitika chifukwa chokhala nthawi yayitali mu chipinda chosamalira odwala kwambiri (ICU).

Zina mwa zovuta za NMS ndi izi:

• Rhabdomyolysis (kusweka kwa maselo a minofu - iyi ndiye vuto lofala kwambiri).
• Kusowa madzi m'thupi.
• Kulephera kwa impso mwachangu.
• Kulephera kupuma mokwanira.
• Matenda a khunyu/ khunyu .
• Kutsekeka kwa mtima.
• Kugayika kwa magazi m'thupi lonse (kufalikira kwa magazi m'mitsempha).
• Kulephera kwa chiwindi mwachangu.
• Chibayo.
• Sepsis (majeremusi omwe amalowa m'magazi).
• Matenda a mkodzo (UTI).
• Kutuluka kwa mpweya m'mapapo.

Popeza mavutowa ndi aakulu kwambiri komanso oopsa, ndikofunikira kwambiri kuyimbira 911 nthawi yomweyo ndikupita kuchipatala chapafupi kuti mukalandire chithandizo ngati muli ndi zizindikiro za NMS. Apanso, NMS ndi vuto lalikulu lomwe lingayambitse imfa ndipo lingafunike chithandizo mu Intensive Care Unit (ICU).

Ndiyenera kupita liti kwa dokotala wanga?

Ngati mukumwa mankhwala amodzi kapena angapo a neuroleptics (antipsychotics), antiemetics, ndi/kapena dopaminergic (Parkinson's), ndikofunikira kukaonana ndi dokotala nthawi zonse kuti muwonetsetse kuti akukugwirani ntchito bwino. Komanso, funsani dokotala wanu za zotsatirapo zoyipa za mankhwala omwe mukumwa komanso zizindikiro zomwe muyenera kudziwa.

Kodi ndiyenera kupita ku Dipatimenti Yothandiza Anthu Odwala Pangozi (ETU) ngati ndili ndi zizindikiro za `NMS`?

Ngati muli ndi zizindikiro za matenda a neuroleptic malignant syndrome (NMS), monga kutentha thupi kwambiri komanso kuuma kwa minofu, ndikofunikira kuyimba 911 kapena kupita kuchipatala chapafupi nthawi yomweyo. NMS imafuna chithandizo chamankhwala mwachangu. Ngati sichichiritsidwa mwachangu komanso moyenera, ingayambitse imfa.

Matenda a neuroleptic malignant syndrome (NMS) ndi matenda oopsa komanso oopsa kwambiri. Chifukwa chake ngati muli ndi zizindikiro, ndikofunikira kupita kuchipatala mwachangu momwe mungathere. NMS ndi yosavuta kuchiza ngati yapezeka msanga. Ngakhale kuti NMS ndi yosowa, ngati mukumwa mankhwala a neuroleptic (antipsychotic), lankhulani ndi dokotala wanu kapena wamankhwala za zotsatirapo zake ndi zizindikiro zomwe muyenera kuzisamala nazo. Alipo kuti akuthandizeni.

Zinthu zofunika kwambiri zomwe taphunzira kuchokera m'nkhaniyi (Uthenga Wopita Nawo Kunyumba)

Chabwino, tiyeni tikukumbutseni zina mwa zinthu zofunika kwambiri zomwe muyenera kukumbukira kuchokera pa zomwe takambirana mu 'NMS' iyi:

• NMS ndi vuto losowa, koma lomwe lingathe kupha munthu chifukwa cha mankhwala a neuroleptic.
• Malungo aakulu, kupweteka kwa minofu, ndi kusokonezeka maganizo ndi zizindikiro zazikulu.
• Ngati muwona chimodzi mwa zizindikiro izi, funsani upangiri wa dokotala nthawi yomweyo. Musazengereze.
• Ngati mukumwa mankhwala a neuroleptic, lankhulani ndi dokotala wanu za mankhwalawo ndi zotsatira zake. Musaope kufunsa mafunso.
• NMS imatha kuchiritsidwa kwathunthu ngati yapezeka ndi kuchiritsidwa msanga.

Tikukhulupirira kuti mwadziwitsidwa ndi izi. Khalani ndi thanzi labwino!

` Neuroleptic Malignant Syndrome, NMS, mankhwala amisala, zotsatirapo zake, kutentha thupi kwambiri, kuuma kwa minofu