Kodi mumapeza kuti mukusuntha thupi lanu mosafuna? Tiyeni tikambirane za Tardive Dyskinesia!

Kodi nthawi zina mumamva ngati ziwalo za thupi lanu, monga mkono kapena mwendo, kapena nkhope, zimangoyenda mosalamulirika? Kapena kodi pali winawake amene mumamudziwa amene wakhala ndi zizindikiro zachilendozi atamwa mankhwala enaake? Ngati mwamvapo za chinthu chotere, ndiye kuti vuto lomwe tikambirane lero, lotchedwa Tardive Dyskinesia, lidzakhala lofunika kwa inu. Ngakhale kuti ndi mawu aatali pang'ono, tiyeni timvetse bwino lomwe.

Kodi Tardive Dyskinesia ndi chiyani?

Mwachidule, Tardive Dyskinesia (TD) ndi matenda a mitsempha, kapena kusonkhanitsa zizindikiro, momwe minofu ya thupi lanu imasuntha mosadziletsa, popanda kulamulira kwanu. Monga kugwedezeka kwa dzanja kapena nkhope kusintha mwadzidzidzi.

Chifukwa chachikulu cha vutoli ndi kugwiritsa ntchito mankhwala enaake kwa nthawi yayitali pochiza matenda amisala, makamaka mankhwala a m'badwo woyamba (neuroleptics). Komabe, mankhwala awa si okhawo omwe angayambitse izi. Mankhwala ena angayambitsenso izi.

Mawu akuti "Tardive" amatanthauza "kuchedwa" kapena "kuchedwa." "Dyskinesia" amatanthauza kusachita mwadala, ndiko kuti, kusachita mwadala kwa minofu. Chifukwa chake, mu mkhalidwe uwu, kusachita mwadala kumeneku kumawonekera mutayamba kumwa mankhwala kwa kanthawi, nthawi zina zaka. Komabe, nthawi zina vutoli limatha kuchitika ngakhale mutamwa mankhwalawo kwa kanthawi kochepa. Vutoli limapezeka makamaka mwa anthu azaka zopitilira 65, ngakhale mutagwiritsa ntchito mankhwalawa kwakanthawi kochepa.

Kodi vutoli ndi lofala bwanji?

Ofufuza akuti osachepera 20% ya anthu omwe amatenga mankhwala oletsa matenda amisala a m'badwo woyamba amakhala ndi tardive dyskinesia. Kuchuluka kwa matendawa m'mitundu ina ya mankhwala sikunaphunziridwe, kotero n'kovuta kupereka chiwerengero chenicheni.

Kodi zizindikiro za Tardive Dyskinesia ndi ziti?

Tardive dyskinesia ingayambitse mayendedwe m'malo ngati awa omwe simungathe kuwalamulira:

• Minofu pankhope panu
• Lilime
• Khosi
• Minofu ya thunthu
• Manja ndi mapazi

Kusuntha kosafunikira kwa nkhope:

• Kumenya milomo kapena kuyamwa.
• Kukwinya nkhope kapena kukwinya nkhope popanda chifukwa.
• Kutulutsa lilime kapena kukanikiza lilime m'tsaya.
• Kuyenda movutikira.
• Masaya otumphuka.
• Kuthina mwachangu kwa maso / blepharospasm. Tangoganizirani momwe zingakhalire zokhumudwitsa ngati mungopitiriza kuthina maso anu.

Mayendedwe ena osadzifunira:

• Kusuntha kwa zala mobwerezabwereza, monga kusewera piyano.
• Kukankha kapena kugwedeza chiuno chanu.
• Kuyenda moyenda ngati bakha.
• Kulephera kukhala chete, kumverera kosalekeza kwa kusakhazikika (akathisia). Izi zitha kukhala zovuta kwambiri.

Zizindikiro izi zitha kukhala zofatsa kwambiri komanso zosaoneka bwino kwa anthu ena, koma kwa ena zimatha kukhala zoopsa kwambiri moti zimatha kukhudza zochita za tsiku ndi tsiku mpaka kufika poti sizingatheke .

Madokotala angagwiritse ntchito mawu ngati awa pofotokoza zizindikiro izi:

• Dystonia: Kuchepa kwa minofu kosalamulirika.
• Myoclonus: Kugwedezeka kwa minofu mwadzidzidzi komanso kwakanthawi.
• Kusinthasintha kwa mawu m'kamwa ndi lilime: Kusuntha mobwerezabwereza komwe kumakhudza pakamwa ndi lilime.
• Matenda a minofu: Kupweteka kwa minofu komwe kumachitika nthawi zambiri, makamaka pankhope.

Kodi ndi zifukwa ziti zomwe zimayambitsa Tardive Dyskinesia?

Ofufuza sakudziwa chomwe chimayambitsa izi. Komabe, lingaliro lalikulu ndilakuti zitha kuchitika chifukwa cha kugwiritsa ntchito mankhwala otchedwa ``dopamine antagonists`` omwe amatseka ma receptors a neurotransmitter ``dopamine`` muubongo. Izi zitha kuchitika kaya mutenga mankhwalawa kwa kanthawi kochepa kapena kwa nthawi yayitali. Komabe, chiopsezo chimakhala chachikulu mukawatenga kwa nthawi yayitali. Nthawi zina, TD imatha kuchitika mutasiya kumwa mankhwalawa, kusintha mlingo, kapena ngakhale kuchepetsa.

Tangoganizirani, mukatenga mankhwala oletsa dopamine receptor kwa nthawi yayitali, ma dopamine receptors muubongo (makamaka omwe ali mu basal ganglia, gawo la ubongo lomwe limathandiza kulamulira kayendedwe) amakhala omasuka kwambiri. Akuti kuyenda kosalamulirika kumeneku kumachitika chifukwa cha dopamine yambiri kapena ma receptors kukhala omasuka kwambiri.

Kuwonjezera pa dopamine, ma neurotransmitter receptors ena, monga serotonin, acetylcholine, ndi GABA, amaganiziridwanso kuti ali nawo. Ichi mwina ndichifukwa chake TD nthawi zina imayamba chifukwa cha mankhwala ena osati antipsychotics.

Ndi mankhwala ati omwe amayambitsa Tardive Dyskinesia?

Tardive dyskinesia ikhoza kuchitika chifukwa chogwiritsa ntchito mankhwala otsatirawa:

• Mankhwala oletsa matenda amisala / ma neuroleptics: Izi ndiye chifukwa chachikulu.
• Metoclopramide kapena mankhwala ena oletsa nseru.
• Mankhwala ena oletsa kuvutika maganizo .

Kawirikawiri, mankhwalawa angayambitsenso matenda a TD:

• Lithiamu.
• Mankhwala oletsa kugunda kwa mtima.
• Mankhwala oletsa kupweteka, makamaka hydroxyzine.
• Mankhwala oletsa malungo ndi mankhwala operekedwa ku malungo.

Mankhwala a antipsychotic ndi TD

Mankhwala oletsa matenda amisala (neuroleptics) amagwiritsidwa ntchito makamaka pochiza matenda amisala monga schizophrenia. Mankhwalawa ndi omwe amayambitsa matenda a TD.

Mankhwala oletsa matenda amisala a m'badwo woyamba ("wamba") amaonedwa kuti ali ndi chiopsezo chachikulu choyambitsa matenda amisala kuposa a m'badwo wachiwiri ("atypical").

Zitsanzo zina za mankhwala oletsa matenda amisala a m'badwo woyamba:

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

Metoclopramide ndi tardive dyskinesia

Metoclopramide ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda a chronic acid reflux (GERD), mtundu woopsa wa gastritis. Amagwiritsidwanso ntchito pochiza matenda a shuga otchedwa gastroparesis.

Pali mgwirizano wamphamvu pakati pa metoclopramide ndi TD. Zinthu zomwe zimayambitsa matenda a TD chifukwa cha mankhwalawa ndi izi:

• Kukhala ndi zaka 65 kapena kuposerapo.
• Kukhala mkazi.
• Kukhala ndi matenda a shuga.
• Kumwa metoclopramide kwa milungu 12 kapena kuposerapo.

Mankhwala oletsa kuvutika maganizo ndi TD

Mankhwala oletsa kuvutika maganizo amagwiritsidwa ntchito pochiza matenda monga kuvutika maganizo, nkhawa, ndi matenda ovutika maganizo. Mankhwalawa nthawi zambiri amayambitsa matenda a TD mwa anthu azaka zopitirira 65. Izi zili choncho chifukwa ubongo umasintha ndi ukalamba. Izi nthawi zambiri sizimachitika kawirikawiri kuposa matenda a TD omwe amayamba chifukwa cha mankhwala oletsa kuvutika maganizo.

Mankhwala oletsa kuvutika maganizo otsatirawa akugwirizana ndi `(TD)`:

• Trazodone (iyi ndi serotonin modulator).
• Amitriptyline, clomipramine, ndi doxepin (izi ndi mankhwala oletsa kuvutika maganizo a tricyclic).
• Fluoxetine ndi sertraline (izi ndi SSRIs).
• Phenelzine ndi rasagiline (izi ndi MAOIs).
• Selegiline (yomwenso ndi MAOI) yagwirizanitsidwa ndi TD ikatengedwa ndi levodopa.

Lithiamu ndi TD

Lithium ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda a bipolar. Amagwirizanitsidwanso ndi TD. Komabe, ngati mutenga lithiamu pamodzi ndi mankhwala oletsa matenda amisala, chiopsezo chanu chokhala ndi TD chimakhala chachikulu kwambiri.

Mankhwala oletsa kugunda kwa mtima ndi TD

Mankhwala oletsa kugunda kwa mtima amagwiritsidwa ntchito popewa ndikuwongolera khunyu. Carbamazepine ndi lamotrigine zimagwirizana ndi TD, koma sizingayambitse TD. Phenytoin yagwirizanitsidwanso ndi TD.

Mankhwala oletsa kugwidwa ndi matenda a mtima (antihistamines) ndi TD

Mankhwala oletsa kugwidwa ndi matenda a ziwengo amathandiza ndi zizindikiro za ziwengo. Makamaka hydroxyzine, yagwirizanitsidwa ndi TD ngati igwiritsidwa ntchito kwa nthawi yayitali.

Anthu azaka zopitilira 65 omwe adagwiritsapo ntchito kale mankhwala a phenothiazine (mankhwala oletsa kusokonezeka maganizo) ali ndi mwayi waukulu wopeza matenda a TD akamamwa hydroxyzine.

Mankhwala oletsa malungo ndi TD

Mankhwala oletsa malungo monga chloroquine ndi amodiaquine amagwirizana ndi TD.

Kodi ndi zinthu ziti zomwe zimayambitsa Tardive Dyskinesia?

Zinthu zina zingakulitse chiopsezo chanu chokhala ndi tardive dyskinesia. Zina mwa izo ndi izi:

• Zaka: Anthu azaka zopitilira 40 ali ndi mwayi waukulu wodwala matenda a TD. Anthu azaka zopitilira 65 ali pachiwopsezo chachikulu chifukwa cha kusintha kwa mitsempha komwe kumachitika ndi ukalamba.
• Jenda: Azimayi ali ndi mwayi waukulu wodwala matenda a shuga. Azimayi omwe asiya kusamba omwe amamwa mankhwala oletsa matenda amisala kwa chaka chimodzi amakhala ndi chiopsezo chachikulu cha matenda a shuga ndi 30%.
• Mtundu: Kafukufuku wina wasonyeza kuti anthu akuda aku America ali ndi mwayi waukulu wopeza matenda a TD kuposa azungu. Komanso, anthu ochokera ku Philippines ndi Asia ali ndi mwayi wochepa wopeza matenda a TD kuposa a Caucasus. (Mafukufuku ena akumaloko amafunika kuti adziwe momwe izi zikugwirira ntchito ku Sri Lanka.)
• Matenda a Bipolar: Anthu omwe ali ndi matenda a bipolar angakhale okhudzidwa kwambiri ndi matenda a TD kuposa ena akamamwa mankhwala oletsa matenda amisala.

Ofufuza panopa akuphunziranso zinthu za majini zomwe zimawonjezera kapena kuchepetsa chiopsezo cha matenda a TD.

Kodi ndi mavuto ati omwe angabwere chifukwa cha Tardive Dyskinesia?

Kusuntha kosalamulirika komwe kumachitika chifukwa cha tardive dyskinesia kungakhale kovuta kwambiri. Kungakhudzenso thanzi lanu la anthu komanso la maganizo. Izi zingakhudze kwambiri thanzi lanu la maganizo. Zingapangitsenso kuti zikhale zovuta kuchita ntchito za tsiku ndi tsiku.

Matenda a TD nthawi zambiri si matenda oopsa. Komabe,Kawirikawiri, ngati TD ikukula kwambiri ndikukhudza kholingo (komwe kuli zingwe zolumikizira mawu - laryngospasm) ndi diaphragm (minofu yomwe imakuthandizani kupuma), ingayambitse mavuto opuma komanso kupha anthu.

Kodi Tardive Dyskinesia imafalitsidwa bwanji?

Dokotala wanu adzakufunsani za zizindikiro zanu, mbiri yanu yachipatala, komanso momwe mumagwiritsira ntchito mankhwala. Dokotala wanu angaganize kuti tardive dyskinesia (TD) ndi mankhwala omwe amadziwika kuti amayambitsa tardive dyskinesia. Adzakuyezani thupi lanu ndi kuyeza mitsempha. Muthanso kutumizidwa kwa katswiri, monga katswiri wa mitsempha, katswiri wa matenda oyenda, kapena wamisala.

Madokotala amagwiritsa ntchito Buku Lodziwitsa Matenda a Mitsempha (DSM-5) kuti adziwe matenda a tardive dyskinesia. Malinga ndi DSM-5 , kuti munthu apezeke ndi tardive dyskinesia, zizindikiro ziyenera kukhala zitapitirira kwa mwezi umodzi mutasiya kumwa mankhwala. Ngati muli ndi zaka 40 kapena kuchepera, muyenera kuti mwakhala mukumwa mankhwala kwa miyezi itatu, kapena ngati muli ndi zaka zoposa 40, muyenera kuti mwakhala mukumwa mankhwala kwa mwezi umodzi.

Dokotala wanu angafune mayeso ena kuti atsimikizire TD kapena kuti athetse matenda ena omwe ali ndi zizindikiro zofanana, monga matenda a Huntington. Izi zitha kuphatikizapo mayeso a labotale ndi mayeso ojambulira zithunzi, monga CT scan kapena MRI ya ubongo. Komabe, TD nthawi zambiri ndi matenda achipatala. Izi zikutanthauza kuti madokotala amapanga matendawa kutengera mbiri yakale yachipatala komanso kuyezetsa thupi mokwanira, popanda mayeso ena.

Kodi ndi mankhwala otani a Tardive Dyskinesia?

Kafukufuku wokhudza kasamalidwe ka tardive dyskinesia wasonyeza zotsatira zosiyana. Kafukufuku wina akusonyeza kuti zizindikiro zimachepa pamene mlingo wa mankhwala oletsa matenda amisala wachepetsedwa kapena kuyimitsidwa. Ena akusonyeza kuti palibe kusiyana kulikonse.

Dokotala wanu angakulangizeni kuti musiye mankhwala omwe amayambitsa matenda anu a TD, ngati n'kotheka. Tsoka ilo, izi sizichitika nthawi zonse. Izi zili choncho chifukwa kusiya mankhwalawo kungawonjezere vuto lomwe mankhwalawo anali kulamulira.

Ngati mukupeza matenda amisala pamene mukumwa mankhwala amisala a m'badwo woyamba, dokotala wanu angakusintheni ku mankhwala amisala a m'badwo wachiwiri.

Kupatula kusiya kapena kusintha mankhwala oletsa matenda amisala, umboni wamphamvu kwambiri wochiritsira matenda a TD ulipo pakali pano pa gulu la mankhwala otchedwa VMAT inhibitors. Deutetrabenazine ndi valbenazine tsopano zawonetsedwa kuti ndi zotetezeka komanso zothandiza. Ngati muli ndi matenda a TD ochepa kapena amphamvu omwe akukhudza moyo wanu, dokotala wanu angakulangizeni mankhwala awa.

Kodi Tardive Dyskinesia ingachiritsidwe? (Kodi ikhoza kusinthidwa?)

Mwatsoka, matenda ambiri a tardive dyskinesia ndi osatha, zomwe zikutanthauza kuti amatenga nthawi yayitali. Ngakhale kuti mankhwala angathandize kuchepetsa zizindikiro, sangachiritse kapena kusintha vutoli kwathunthu.

Kodi ndiyenera kuyembekezera chiyani ngati ndili ndi Tardive Dyskinesia?

Tardive dyskinesia sikhudza aliyense mofanana. Zizindikiro zimatha kuyambira zofatsa mpaka zowopsa. Komanso, ngakhale chithandizo chimathandiza anthu ena kuthana ndi zizindikiro zawo, ena sangatero. Dokotala wanu adzagwira nanu ntchito kuti apeze njira yabwino kwambiri yothandizira. Angakupatseni lingaliro labwino la zomwe mungayembekezere.

Kodi Tardive Dyskinesia ikhoza kupewedwa?

Tardive dyskinesia ndi vuto lovuta kuneneratu. Si aliyense amene amamwa mankhwala enaake amene angadwale vutoli.

Ngati muli ndi zinthu zomwe zingakupangitseni kukhala ndi vutoli, lankhulani ndi dokotala wanu. Mutha kupewa tardive dyskinesia pogwiritsa ntchito mankhwala ena. Kuti muchepetse chiopsezo chanu chokhala ndi matenda amisala, dokotala wanu adzakupatsani mankhwala ochepetsa mphamvu ya ubongo omwe ndi otsika kwambiri kwa nthawi yochepa kwambiri.

Ngati mukumwa mankhwala omwe amadziwika kuti amayambitsa matenda a TD, lankhulani ndi dokotala wanu za kuyesedwa nthawi zonse kuti muwone ngati pali vuto la kuyenda. Kuzindikira msanga zizindikiro za TD kungathandize kuchepetsa kuopsa kwake. Ndi bwino kuyezetsa izi mkati mwa miyezi itatu kapena isanu ndi umodzi mutayamba kumwa mankhwala omwe angayambitse matenda a TD.

Kodi ndingadzisamalire bwanji ngati ndili ndi Tardive Dyskinesia?

Dokotala wanu adzagwira nanu ntchito kuti akonze dongosolo lanu la chithandizo ngati pakufunika kutero. Nazi njira zina zomwe mungachite kuti muchepetse matenda a TD:

• Yesani kuwunika zizindikiro zanu nthawi zonse ndi dokotala wanu miyezi itatu kapena isanu ndi umodzi iliyonse.
• Lembani zizindikiro zanu. Ngati mwayamba zizindikiro zatsopano, dziwitsani dokotala wanu.
• Yesetsani kudzisamalira nokha, kuphatikizapo kuchita masewera olimbitsa thupi. Kuchita masewera olimbitsa thupi kungathandize kuchepetsa zizindikiro zina zoyenda.
• Lankhulani ndi dokotala wanu za zochita zanu za tsiku ndi tsiku komanso moyo wanu wabwino.
• Ngati thanzi lanu la maganizo ndi chikhalidwe chanu likukhudzidwa ndi matenda a TD, funani thandizo kwa mlangizi wa zaumoyo wamaganizo .

Kodi ndiyenera kupita ku chipinda chadzidzidzi liti?

Ngati mukuvutika kupuma chifukwa cha tardive dyskinesia, imbani 911 (1990 ku Sri Lanka) nthawi yomweyo kapena pitani ku chipinda chapafupi chadzidzidzi.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Tardive dyskinesia (TD) imakhudza anthu mosiyana. Kwa ena, imatha kukhala ndi zotsatirapo zazikulu pa moyo wawo. Koma kumbukirani, dokotala wanu adzagwira nanu ntchito kuti ayang'anire ndikusamalira TD yanu. Akhoza kulangiza ndikusintha dongosolo la chithandizo kuti ligwirizane ndi zosowa zanu, ndikukupatsani njira zodzisamalira zomwe zingakuthandizeni. Musasiye kumwa mankhwala anu kapena kusintha mlingo popanda upangiri wa dokotala wanu. Lankhulani ndi dokotala wanu za mafunso kapena nkhawa zilizonse zomwe mungakhale nazo.

Kusokonezeka kwa Tardive , kuyenda kosafunikira, zotsatira zoyipa za mankhwala, mankhwala oletsa matenda amisala, matenda a neuropathies, dopamine, zoletsa za VMAT