Kodi mankhwala omwe mukumwa ndi oopsa? Tiyeni tiphunzire za Serotonin Syndrome?

Lero tikambirana za vuto lomwe ndi lalikulu pang'ono, koma lingathe kuthetsedwa mosavuta ngati mukudziwa. Mungakhale mukumwa mankhwala a kuvutika maganizo kapena vuto lina. Nthawi zina mankhwala amenewa angayambitse kusintha m'thupi mwathu ndikuyambitsa mavuto omwe sitingathe kuwaganizira. Limodzi mwa matenda amenewa ndi serotonin syndrome.

Kodi Serotonin Syndrome ndi chiyani?

Mwachidule, Serotonin Syndrome ndi mankhwala omwe nthawi zina amatha kupha munthu, zomwe zimachitika pamene mankhwala otchedwa serotonin ali ambiri m'thupi lanu.

Taganizirani izi, serotonin ndi mankhwala ofunikira kwambiri omwe amapangidwa ndi maselo amitsempha muubongo wathu ndi ziwalo zina za thupi. Kunena zoona, ndi mthenga amene amanyamula mauthenga pakati pa maselo amitsempha. Timatcha izi kuti neurotransmitter . Serotonin iyi imakhudza zinthu zambiri, monga momwe timamvera, kugona, ndi chilakolako chathu.

Anthu ambiri amatha kumwa mankhwala omwe amakhudza serotonin (serotonergic) mosamala pa mlingo woyenera, monga momwe dokotala wawo wanenera. Komabe, serotonin syndrome imachitika nthawi zambiri mukayamba mankhwala atsopano kapena kuonjezera mlingo wa mankhwala omwe mukumwa kale, makamaka ngati mankhwalawo akuwonjezera kuchuluka kwa serotonin m'thupi lanu. Ngati thupi lanu lisintha momwe limagwiritsira ntchito serotonin, kapena ngati simungathe kuthana ndi kuchuluka kwa serotonin m'thupi, mutha kukhala ndi zizindikiro za serotonin syndrome.

Matendawa amatha kuyambira pa zizindikiro zochepa monga kutsegula m'mimba ndi nseru mpaka zizindikiro zoopsa monga kutentha thupi kwambiri ndi khunyu. Nthawi zina, severe serotonin syndrome ikhoza kukhala yoopsa ngati siidziwika ndikuchiritsidwa mwachangu.

Madokotala adayamba kuzindikira serotonin syndrome m'zaka za m'ma 1960, pambuyo poti mankhwala oyamba oletsa kuvutika maganizo avomerezedwa. Masiku ano, popeza mankhwala ambiri omwe amakhudza serotonin akupezeka, milandu ya serotonin syndrome ikunenedwa mobwerezabwereza.

Ndani angapange izi?

Ndipotu, aliyense akhoza kudwala matendawa, mosasamala kanthu za msinkhu wake. Ngati mugwiritsa ntchito mankhwala aliwonse olembedwa ndi dokotala, mankhwala ogulitsidwa kunja kwa sitolo, zowonjezera zitsamba kapena zakudya, kapena mankhwala osaloledwa omwe amakhudza kuchuluka kwa serotonin m'thupi lanu, muli pachiwopsezo chotenga serotonin syndrome.

Kodi zizindikiro zofala kwambiri za izi ndi ziti?

Zizindikiro ndi kuopsa kwa serotonin syndrome zimatha kusiyana malinga ndi munthu. Zitha kukhala zofatsa, zapakati, zowopsa, komanso zakupha.

Ngati mukumwa mankhwala omwe amakhudza serotonin ndipo muli ndi zizindikiro izi, imbani dokotala nthawi yomweyo kapena pitani kuchipatala chadzidzidzi.

Zizindikiro zazing'ono

• Kumva mantha pang'ono komanso kusakhazikika.
• Kumva nseru ndi kusanza.
• Kutupa m'mimba (kutsegula m'mimba).
• Maso akuda amakhala aakulu (dilated pupils).
• Kumva ngati ziwalo zanu zikugwedezeka (Kunjenjemera).

Zizindikiro zocheperako

• Ndikumva kusakhazikika komanso kusokonezeka maganizo.
• Kugwedezeka kwa minofu, kupindika kwa minofu kosafunikira, kupindika kwa minofu, kuuma kwa minofu.
• Kutuluka thukuta kwambiri, kunjenjemera chifukwa cha kuzizira.
• Maso amayenda modabwitsa kuchokera mbali imodzi kupita mbali ina.

Zizindikiro zoopsa

• Kusokonezeka kwakukulu, ngati kuti chikumbumtima chikusokonezeka, munthu amaiwala komwe ali ndi nthawi yake (Kusokonezeka, kusokonezeka, kusokonezeka maganizo).
• Kugunda kwa mtima kumawonjezeka kwambiri (kugunda kwa mtima mwachangu).
• Kuthamanga kwa magazi.
• Kutentha kwambiri kwa thupi kumapitirira madigiri 38.5 Celsius (101.3 degrees Fahrenheit).
• Kugwidwa ndi khunyu kukubwera.
• Kugunda kwa mtima kumakhala kosasinthasintha.
• Ndataya chidziwitso ndipo ndagwa.

Kodi zizindikiro zimawonekera mofulumira bwanji?

Zizindikiro zimenezi nthawi zambiri zimayamba kuonekera mkati mwa maola ochepa , kaya mutayamba mankhwala atsopano omwe amakhudza kuchuluka kwa serotonin kapena mutawonjezera mlingo wa mankhwala omwe mukumwa panopa. Pafupifupi aliyense amakumana ndi zizindikiro mkati mwa maola 24 mutamwa mankhwala kapena mankhwala omwe amakhudza serotonin.

N’chifukwa chiyani izi zimachitika? Kodi zifukwa zake ndi ziti?

Chifukwa chachikulu cha serotonin syndrome ndi kuwonjezeka kwa serotonin m'thupi lanu. Izi zitha kuchitika m'mikhalidwe ngati iyi:

• Mukagwiritsa ntchito mankhwala oposa limodzi, kuchuluka kwa serotonin m'thupi kumachepa.
• Mukayamba kumwa mankhwala atsopano owonjezera serotonin, kapena mukawonjezera mlingo wa mankhwala omwe mukumwa panopa.
• Ngati mwamwa mankhwala ochulukirapo okhudzana ndi serotonin, mwina mwangozi kapena mwadala.
• Mukamagwiritsa ntchito mankhwala ena osaloledwa, mankhwala ochokera ku zitsamba , kapena mankhwala ogulitsidwa kunja kwa sitolo omwe amakhudza kuchuluka kwa serotonin m'thupi.

Ndi mankhwala ati ndi zinthu zina zomwe zimakhudza kuchuluka kwa serotonin m'thupi?

Tsopano tiyeni tiwone mitundu ya mankhwala yomwe ingakhudze kuchuluka kwa serotonin ndikuyambitsa serotonin syndrome.

Mankhwala oletsa kuvutika maganizo

Pakati pa izi, mankhwala oletsa kuvutika maganizo ndi ofunikira kwambiri. Awa ndi mankhwala omwe amakhudza kwambiri kuchuluka kwa serotonin. Vutoli nthawi zambiri limachitika pamene mankhwala oletsa kuvutika maganizowa amagwiritsidwa ntchito limodzi ndi mankhwala ena omwe amakhudza serotonin, monga ma triptan a mutu waching'alang'ala kapena ma opioid ochepetsa ululu.

Nazi mitundu ina ya mankhwala oletsa kuvutika maganizo ndi zitsanzo zake:

• `Selective serotonin reuptake inhibitors (SSRIs): Gululi limaphatikizapo mankhwala monga `fluoxetine (Prozac®), `citalopram (Celexa®), `sertraline (Zoloft®), `paroxetine (Paxil®)` ndi `escitalopram (Lexapro®).` Awa ndi mankhwala omwe amagwiritsidwa ntchito kwambiri ndipo motero ndi omwe amagwirizana kwambiri ndi serotonin syndrome.
• Mankhwala oletsa kubwerezabwereza kwa serotonin-norepinephrine (SNRIs): Zitsanzo zake ndi monga duloxetine (Cymbalta®), venlafaxine (Effexor®), desvenlafaxine (Pristiq), levomilnacipran (Fetzima), ndi milnacipran (Savella).
• `Ma Tricyclic antidepressants`: Gulu ili limaphatikizapo mankhwala monga `amitriptyline (Elavil®)`, `clomipramine (Anafranil®)`, ndi `nortriptyline (Pamelor®).`
• Mankhwala oletsa monoamine oxidase (MAOIs): Mankhwala monga `phenelzine (Nardil®)`, `selegiline (Emsam®)` ndi `tranylcypromine (Parnate®)` ali m'gulu ili.
• Ma modulators a Serotonin: monga nefazodone ndi trazodone (Desyrel®).
• Chitsanzo cha izi ndi `Norepinephrine reuptake inhibitor`: `bupropion (Wellbutrin®).`

Mankhwala Ena

Kuwonjezera pa mankhwala ochepetsa nkhawa, palinso mankhwala ena omwe amakhudza kuchuluka kwa serotonin m'thupi. Chiwopsezo chimakhala chachikulu makamaka ngati awa aphatikizidwa ndi mankhwala ena omwe amakhudzanso serotonin. Mankhwalawa amagwiritsidwa ntchito:

• Pa ululu waukulu: Mankhwala opha ululu ochokera ku gulu la opioid, monga tramadol (Ultram®), meperidine (Demerol®), tapentadol (Nucynta®), hydrocodone (Hysingla ER®), oxycodone (Oxycontin®), fentanyl (Actiq®), ndi methadone.
• Chifuwa: Mankhwala ena a chifuwa ndi chimfine omwe amaperekedwa ndi dokotala (OTC), monga dextromethorphan, amatha kukhudza kuchuluka kwa serotonin m'thupi.
• Pa mutu wa mutu wa mutu wa migraine: Triptans zikuphatikizapo almotriptan (Axert®), eletriptan (Relpax®), ndi sumatriptan (Imitrex®).
• Kwa HIV/AIDS: `ritonavir (Norvir®)`.
• Mankhwala opha tizilombo: linezolid (Zyvox®).
• Mankhwala ochizira nseru ndi kusanza: monga `metoclopramide (Reglan®)`, `granisetron (Sustol®)`, `ondansetron (Zofran®)`.
• Chokhazikitsa maganizo: lithiamu (Lithobid®).

Zogulitsa Zina

Kuwonjezera pa mankhwala, zitsamba zina zachikhalidwe, zowonjezera zakudya, ndi mankhwala osokoneza bongo zingakhudzenso kuchuluka kwa serotonin ndikuyambitsa vutoli.

• Zowonjezera za zitsamba: Izi zitha kuphatikizapo zinthu monga ginseng, St. John's wort, Syrian rue, ndi nutmeg.
• Mankhwala osokoneza bongo: Zinthu monga ecstasy, LSD, cocaine, amphetamines, ndi methamphetamines.
• Zakudya zowonjezera:Tryptophan.

Akatswiri azachipatala akuphunzirabe zambiri zokhudza serotonin syndrome. Ngati muli ndi mafunso okhudza mankhwala omwe mumamwa komanso ngati amakhudza serotonin, lankhulani ndi dokotala wanu kapena munthu amene mumagula mankhwala anu.

Kodi madokotala amazindikira bwanji izi?

Tsopano tiyeni tiwone momwe madokotala amapezera izi. Palibe mayeso enieni otsimikizira serotonin syndrome. Dokotala wanu nthawi zambiri amakupatsirani matendawa pokufufuzani, kufunsa za zizindikiro zanu, komanso kuphunzira za mankhwala omwe mukumwa omwe amakhudza kuchuluka kwa serotonin m'thupi lanu.

Mungathandize dokotala wanu mwa kumufotokozera momveka bwino chilichonse chomwe mukumwa (mankhwala ochokera kwa dokotala, mankhwala ogulitsidwa kunja kwa chipatala, zowonjezera zakudya, mankhwala azitsamba, ngakhale mankhwala osaloledwa). (Khalani oona mtima, musachite mantha. Dokotala alipo kuti akuthandizeni, osati kukuweruzani.)

Dokotala wanu angachitenso mayeso monga awa:

• Kuyezetsa magazi ndi mkodzo kuti muwone kuchuluka kwa mankhwala omwe mukumwa.
• Kuyesa kuti muwone ngati ziwalo zina za thupi lanu zikugwira ntchito bwino.
• Kuyesa kuona ngati pali matenda aliwonse m'thupi, mwina ngakhale kupopera kwa msana.
• Kujambula pachifuwa pa X-ray kapena CT scan kungachitike kuti zitsimikizire kuti palibe matenda ena (omwe ali ndi zizindikiro zofanana) kapena kuti aone ngati pali mavuto ena.

Kodi izi zimachiritsidwa bwanji?

Mankhwala omwe mumalandira adzadalira momwe zizindikiro zanu zilili zovuta.

• Zizindikiro zazing'ono: Ngati zizindikiro zili zochepa, kusiya kumwa mankhwala kapena kusintha mlingo nthawi zambiri kumathetsa zizindikiro mkati mwa maola 24 mpaka 72. Ngati zizindikiro sizitha msanga, mankhwala oletsa serotonin monga cyproheptadine (Periactin®) angakupatseni.
• Zizindikiro zocheperako: Ngati zizindikiro zanu zili zochepa, mudzasungidwa m'chipatala kwa maola osachepera 24 kuti muwone ngati zizindikiro zanu zikuyenda bwino mukalandira chithandizo.
• Zizindikiro zoopsa: Ngati zizindikirozo ndi zazikulu kwambiri, mudzaloledwa ku Intensive Care Unit (ICU) komwe ntchito za thupi lanu ndi ziwalo zanu zidzayang'aniridwa mosamala.

Kutengera ndi zizindikiro, mankhwala otsatirawa angaperekedwe:

• Mankhwala ochepetsa ululu monga benzodiazepine angathandize kuchepetsa zizindikiro monga kukwiya, kuuma kwa minofu, ndi khunyu.
• Mankhwala a Saline `(IV fluids)` amaperekedwa kuti achepetse kusunga madzi ndi kutentha thupi, ndipo mpweya umaperekedwa kudzera mu `(mask)` kumaso kuti mpweya ukhale wabwino m'magazi.
• Mankhwala oletsa kugunda kwa mtima ndi kuthamanga kwa magazi.
• Kuti muchepetse kutentha kwambiri (madigiri Celsius 41.1 / madigiri Fahrenheit 106), chubu chopumira chimayikidwa chifukwa cha vuto la kupuma, mankhwala oletsa kupuma amaperekedwa, ndipo minofu imaperekedwa mankhwala opumulira.
• Ngati mankhwala ena sapereka mpumulo mwachangu, mankhwala oletsa serotonin otchedwa cyproheptadine amaperekedwa.

Ngati matenda anu a serotonin adayambitsidwa ndi mankhwala oletsa kuvutika maganizo, zingatenge milungu ingapo kuti mankhwalawo achoke kwathunthu m'thupi lanu komanso kuti zizindikiro zanu zithe kwathunthu.

Chofunika kwambiri: Musasiye kumwa mankhwala aliwonse kapena kusintha mlingo popanda kulankhula ndi dokotala wanu. Komabe, ngati muli ndi zizindikiro zoopsa kapena ngati zizindikiro zanu zikuipiraipira, pitani kuchipatala mwamsanga. Matenda a Serotonin akhoza kukhala oopsa.

Kodi ndi mavuto otani omwe angachitike?

Ngati sichikuchiritsidwa, serotonin syndrome ingayambitse mavuto monga:

• Kugwidwa ndi khunyu.
• Kuvuta kupuma.
• Kulephera kwa impso. Zinthu zosweka minofu zikasonkhana m'magazi ndipo zimasefedwa ndi impso, zimatha kuwononga impso kwambiri ngati sizikuthandizidwa.
• Chikhalidwe cha kukomoka.
• Ngakhale imfa ingachitike.

Kodi timapulumutsidwa bwanji ku izi?

• Ndikofunikira kwambiri kusamala kwambiri ndi mankhwala aliwonse omwe mumamwa. Werengani machenjezo onse omwe ali pa phukusi la mankhwala kapena kabuku ka chidziwitso komwe kamabwera nawo. Idzakuuzani ngati pali chiopsezo cha serotonin syndrome.
• Musasiye kumwa mankhwala aliwonse popanda kulankhula ndi dokotala wanu.
• Mudziwitse dokotala aliyense amene akukuthandizani za mankhwala onse omwe mukumwa (mankhwala ochokera kwa dokotala, mankhwala ogulitsidwa kunja kwa chipatala, zitsamba zachikhalidwe, zowonjezera zakudya, ngakhale mankhwala osaloledwa).
• Ngati mukumwa triptan ya mutu waching'alang'ala pamodzi ndi mankhwala ochepetsa nkhawa (makamaka SSRIs kapena SNRIs), dokotala wanu ayenera kukuyang'anirani mosamala. Chiwopsezo chake ndi chochepa kwambiri, mwina sichikupezeka. Koma kumbukirani, muli ndi udindo: Ngati mukukumana ndi zizindikiro zilizonse zomwe zatchulidwa m'nkhaniyi, imbani dokotala wanu nthawi yomweyo.
• Kutsatira malangizo awa kudzakuthandizani inu ndi dokotala wanu kuzindikira zizindikiro za serotonin syndrome msanga. Kuzindikira msanga kungathandize kupewa zizindikiro zoopsa.

Kodi tiyenera kuyembekezera chiyani pankhaniyi?

Ngati zizindikiro za anthu ambiri zitazindikirika ndi kuchiritsidwa mwachangu, zimatha kwathunthu mkati mwa maola 24 mpaka 72.

Pambuyo pochira, dokotala wanu akhoza:

• Chepetsani mlingo wa mankhwala omwe ayambitsa vutoli kufika pa mlingo wotsika kwambiri.
• Siyani kupereka mankhwala awiri amphamvu omwe amakhudza serotonin pamodzi.
• Sinthani kugwiritsa ntchito mankhwala ena omwe sakhudza serotonin.

Kodi ndiyenera kuyimbira dokotala wanga liti?

• Ngati muli ndi zizindikiro za serotonin syndrome (kapena zizindikiro zikuipiraipira), imbani dokotala nthawi yomweyo kapena pitani kuchipatala chadzidzidzi. Samalani kwambiri ngati mwayamba mankhwala atsopano, mwawonjezera mlingo wa mankhwala omwe mukugwiritsa ntchito panopa, kapena mukumwa mankhwala omwe mukudziwa kuti amakhudza kuchuluka kwa serotonin m'thupi.
• Musasiye kumwa mankhwala kapena kusintha mlingo popanda kulankhula ndi dokotala wanu.
• Onetsetsani kuti madokotala anu onse akudziwa za mankhwala onse omwe mumamwa.
• Werengani machenjezo ndi timapepala todziwitsa zomwe zimabwera ndi mankhwala anu mosamala.
• Dziwani zizindikiro za serotonin syndrome. Dziwani bwino zizindikiro izi ngati mukumwa mankhwala ochepetsa nkhawa.
• Ngati muli ndi mafunso okhudza mankhwala kapena zizindikiro zanu, funsani dokotala wanu kapena wamankhwala.
• Ngati muwona zizindikiro, kapena ngati zizindikiro zanu zikuipiraipira, musaiwale kuyimbira dokotala nthawi yomweyo kapena kupita kuchipatala chadzidzidzi.

Kodi uthenga umene tikufuna kutenga kuchokera mu nkhaniyi ndi wotani?

• Matenda a Serotonin ndi matenda omwe angakhale aakulu, koma amatha kuchiritsidwa ngati atathandizidwa bwino.
• Kambiranani momasuka ndi dokotala wanu za mankhwala aliwonse omwe mumamwa, makamaka ngati mukuyamba mankhwala atsopano kapena kusintha mlingo.
• Dziwani zizindikiro zake. Ngati muli ndi kukayikira kulikonse , funsani upangiri wa dokotala popanda kuwononga nthawi.
• Kumbukirani, mumadziwa bwino thanzi lanu, choncho ndikofunikira kudziwa kusintha kulikonse.

Matenda a Serotonin, serotonin, mankhwala oletsa kuvutika maganizo, zotsatira zoyipa za mankhwala, mankhwala a muubongo, ma neurotransmitters, ndi zotsatira za mankhwala