Ese umuti urimo gufata ni ikibazo gikomeye? Reka twige ku ndwara ya Serotonin Syndrome?

Uyu munsi tugiye kuvuga ku ndwara ikomeye gato, ariko ishobora kugenzurwa byoroshye niba uyimenye. Ushobora kuba ufata imiti yo kwiheba cyangwa indi ndwara. Hari igihe iyi miti ishobora guteza impinduka mu mibiri yacu no guteza ibibazo tutashoboraga kwiyumvisha. Imwe muri izo ndwara ni serotonin syndrome.

Indwara ya Serotonin ni iki?

Muri make, Serotonin Syndrome ni ingaruka z'ibiyobyabwenge rimwe na rimwe zishobora gushyira ubuzima mu kaga, zibaho iyo hari chemical yitwa serotonin nyinshi mu mubiri wawe.

Tekereza kuri ibi, serotonin ni ubutumwa bw'ingenzi cyane bukorwa n'uturemangingo tw'imitsi mu bwonko bwacu no mu bindi bice by'umubiri. Mu by'ukuri, ni ubutumwa bujyana ubutumwa hagati y'uturemangingo tw'imitsi. Tubyita neurotransmitter . Iyi serotonin igira ingaruka ku bintu byinshi, nko mu byiyumvo byacu, ibitotsi byacu, no kurya.

Abantu benshi bashobora gufata imiti igira ingaruka kuri serotonin (serotoninergic) mu mutekano ku rugero rwagenwe, nk'uko muganga wabo yabitegetse. Ariko, serotonin syndrome ikunze kubaho iyo utangiye umuti mushya cyangwa wongereye urugero rw'umuti usanzwe ufata, cyane cyane iyo umuti wongereye urugero rwa serotonin. Iyo umubiri wawe uhinduye uburyo ukoresha serotonin, cyangwa niba udashobora kwihanganira kwiyongera kwa serotonin, ushobora kugira ibimenyetso bya serotonin syndrome.

Iyi ndwara ishobora kuva ku bimenyetso byoroheje nko gucibwamo no kugira isesemi kugeza ku bimenyetso bikomeye nk'umuriro mwinshi n'igicuri. Hari ubwo serotonin syndrome ikomeye ishobora gushyira ubuzima mu kaga iyo itamenyekanye kandi igavurwa vuba.

Abaganga bamenye indwara ya serotonin mu myaka ya za 1960, nyuma y’uko imiti ya mbere yo kurwanya indwara zo mu mutwe yemejwe. Muri iki gihe, uko imiti myinshi iboneka igira ingaruka kuri serotonin, abarwayi ba serotonin syndrome barimo kugaragara kenshi.

Ni nde ushobora guteza imbere ibi?

Mu by’ukuri, umuntu wese ashobora kubyibasira, uko imyaka yaba iri kose. Iyo ukoresheje imiti yanditswe na muganga, imiti igurishwa mu maguriro, inyunganiramirire cyangwa imiti ikomoka ku bimera, cyangwa imiti itemewe n’amategeko igira ingaruka ku rugero rwa serotonin yawe, uba uri mu kaga ko kurwara serotonin syndrome.

Ni ibihe bimenyetso bikunze kugaragara kuri ibi?

Ibimenyetso n'ubukana bwa serotonin syndrome bishobora gutandukana bitewe n'umuntu ku giti cye. Bishobora kuba byoroshye, biri hagati, bikomeye, ndetse bikaba byanahitana umuntu.

Niba ufata umuti ugira ingaruka kuri serotonin kandi ukaba ufite kimwe muri ibi bimenyetso, hamagara muganga wawe ako kanya cyangwa ujye mu cyumba cy’ubutabazi bw’ibanze.

Ibimenyetso bito

• Numva mfite ubwoba kandi nta mahoro mfite.
• Kumva ufite isesemi no kuruka.
• Kubyimba inda (impiswi).
• Imboni z'umukara mu maso ziba nini (imboni zagutse).
• Kumva nk'aho ingingo zawe zitigita (Guhinda umushyitsi).

Ibimenyetso biringaniye

• Numva ntaruhutse kandi mfite ubwoba.
• Kunyeganyega kw'imitsi, kubyimba kw'imitsi ku bushake, kubabara kw'imitsi, no gukomera kw'imitsi.
• Kubira ibyuya byinshi, guhinda umushyitsi kubera ubukonje.
• Amaso agenda mu buryo budasanzwe kuva ku ruhande rumwe kugera ku rundi.

Ibimenyetso bikomeye

• Urujijo rwinshi, nk'aho ubwenge burimo guhungabana, umuntu yibagirwa aho ari n'igihe ari cyo (Urujijo, kubura icyerekezo, guta umutwe).
• Umuvuduko w'umutima wiyongera cyane (umuvuduko w'umutima wihuta).
• Umuvuduko w'amaraso ukabije.
• Ubushyuhe bwinshi bw'umubiri burenze dogere selisiyusi 38.5 (dogere selisiyusi 101.3).
• Indwara zigiye kuza.
• Umutima utera uhinduka utari usanzwe.
• Ndatakaza ubwenge ndagwa.

Ibimenyetso bigaragara vuba gute?

Ibi bimenyetso bikunze kugaragara mu masaha make , haba nyuma yo gutangira umuti mushya ugira ingaruka ku rugero rwa serotonin cyangwa nyuma yo kongera urugero rw'umuti urimo gufata. Hafi ya buri wese agira ibimenyetso mu masaha 24 nyuma yo gufata umuti cyangwa ikintu kigira ingaruka kuri serotonin.

Kuki ibi bibaho? Impamvu ni izihe?

Impamvu nyamukuru itera serotonin syndrome ni ukwiyongera kwa serotonin mu mubiri wawe. Ibi bishobora kubaho mu bihe bikurikira:

• Iyo ukoresheje imiti irenze imwe bigira ingaruka ku rugero rwa serotonin.
• Mu gihe utangiye umuti mushya wongera serotonin, cyangwa mu gihe wongera ingano y'umuti urimo gufata ubu.
• Niba ufashe imiti myinshi ijyanye na serotonin, wenda ku buryo butunguranye cyangwa nkana.
• Iyo ukoresheje imiti imwe n'imwe itemewe n'amategeko, ibikomoka ku bimera , cyangwa imiti igurishwa mu kigo ikagira ingaruka ku rugero rwa serotonin.

Ni iyihe miti n'ibindi bintu bigira ingaruka ku rugero rwa serotonin?

Noneho reka turebe ubwoko bw'imiti ishobora kugira ingaruka ku rugero rwa serotonin ndetse igatera indwara ya serotonin.

Imiti igabanya kwiheba

Muri ibyo, imiti igabanya ububabare ni yo y'ingenzi cyane. Iyi ni yo miti igira ingaruka ku rugero rwa serotonin cyane. Iyi ndwara ikunze kubaho iyo iyi miti igabanya ububabare ikoreshejwe hamwe n'indi miti igira ingaruka kuri serotonin, nka triptans zo kuvura migraine cyangwa opioids zo kugabanya ububabare.

Dore ibyiciro bimwe na bimwe by'imiti igabanya ubukana bw'indwara zo mu mutwe n'ingero:

• `Selective serotonin reuptake inhibitors (SSRIs): Iri tsinda rigizwe n'imiti nka `fluoxetine (Prozac®), `citalopram (Celexa®), `sertraline (Zoloft®), `paroxetine (Paxil®)` na `escitalopram (Lexapro®).` Iyi ni yo ikoreshwa cyane, bityo ikaba ari yo ifitanye isano cyane n'indwara ya serotonin.
• Ibyuma bigabanya ubukana bwa serotonin-norepinephrine (SNRIs): Ingero zabyo ni duloxetine (Cymbalta®), venlafaxine (Effexor®), desvenlafaxine (Pristiq), levomilnacipran (Fetzima) na milnacipran (Savella).
• `Imiti igabanya ubukana bwa Tricyclic`: Iri tsinda rigizwe n'imiti nka `amitriptyline (Elavil®)`, `clomipramine (Anafranil®)`, na `nortriptyline (Pamelor®)`.
• `Indabyo zigabanya ubukana bwa monoamine oxidase (MAOIs): Imiti nka `phenelzine (Nardil®)`, `selegiline (Emsam®)` na `tranylcypromine (Parnate®)` iri muri iki cyiciro.
• Ibikoresho byo guhindura serotonin: nka nefazodone na trazodone (Desyrel®).
• Urugero rw'ibi ni `Norepinephrine reuptake inhibitor`: `bupropion (Wellbutrin®).`

Indi miti

Uretse imiti igabanya ubukana bw'indwara zo mu mutwe, hari indi miti igira ingaruka ku rugero rwa serotonin mu mubiri. Ingaruka ziba nyinshi cyane iyo iyi miti ihujwe n'indi miti inagira ingaruka kuri serotonin. Iyi miti ikoreshwa muri ibi bikurikira:

• Ku bubabare bukabije: Imiti igabanya ububabare yo mu bwoko bwa opioid, nka tramadol (Ultram®), meperidine (Demerol®), tapentadol (Nucynta®), hydrocodone (Hysingla ER®), oxycodone (Oxycontin®), fentanyl (Actiq®), na methadone.
• Inkorora: Imiti imwe n'imwe ivura inkorora n'ibicurane itangwa na muganga (OTC), nka dextromethorphan, ishobora kugira ingaruka ku rugero rwa serotonin.
• Ku ndwara y'umutwe uterwa n ...
• Ku bijyanye n'ubwandu bwa virusi itera SIDA: `ritonavir (Norvir®)`.
• Antibiyotike: linezolid (Zyvox®).
• Imiti ivura isesemi no kuruka: nka `metoclopramide (Reglan®)`, `granisetron (Sustol®)`, `ondansetron (Zofran®)`.
• Ituma umuntu ahora amerewe neza: lithiyumu (Lithobid®).

Ibindi Bicuruzwa

Uretse imiti, bimwe mu bimera gakondo, inyongeramusaruro, n'ibiyobyabwenge bitemewe nabyo bishobora kugira ingaruka ku rugero rwa serotonin bigatera iyi ndwara.

• Inyongeramusaruro z'ibimera: Ibi bishobora kuba birimo ibintu nka ginseng, wort ya Mutagatifu Yohani, rue ya Syrian, na nutmeg.
• Ibiyobyabwenge bitemewe n'amategeko: Ibintu nka ecstasy, LSD, kokayine, amfetamine, na methamphetamine.
• Inyongeramusaruro ku mirire:Tryptophan.

Impuguke mu by'ubuvuzi ziracyarimo kwiga byinshi ku bijyanye na serotonin syndrome. Niba ufite ikibazo ku miti ufata n'uko igira ingaruka kuri serotonin, vugana na muganga wawe cyangwa umuntu wo muri farumasi aho ufata imiti yawe.

Abaganga babimenya bate?

Noneho reka turebe uko abaganga basuzuma ibi. Mu by'ukuri nta kizamini cyihariye gitangwa cyo kwemeza indwara ya serotonin. Muganga wawe asanzwe ayisuzuma agusuzuma, akubaza ibimenyetso byawe, kandi akamenya imiti ufata igira ingaruka ku rugero rwa serotonin yawe.

Ushobora gufasha muganga wawe umubwira neza ibyo ufata byose (imiti yanditswe na muganga, imiti igurishwa mu kigo, inyongeramusaruro, imiti ikomoka ku bimera, ndetse n'imiti itemewe). (Vuga ukuri, ntutinye. Muganga ariho kugira ngo agufashe, ntabwo ari ukugucira urubanza.)

Muganga wawe ashobora kandi gukora ibizamini nk'ibi:

• Gupima amaraso n'inkari kugira ngo harebwe urwego rw'imiti ufata.
• Ibizamini kugira ngo harebwe niba izindi ngingo zawe zikora neza.
• Ibizamini kugira ngo harebwe niba hari ubwandu mu mubiri, wenda ndetse no mu mugongo.
• Gupima X-ray cyangwa CT scan mu gituza bishobora gukorwa kugira ngo harebwe neza ko nta zindi ndwara (zifite ibimenyetso bisa) cyangwa ngo harebwe izindi ngorane.

Ibi bivurwa bite?

Uburyo bwo kuvura buzaterwa n'uburemere bw'ibimenyetso byawe.

• Ibimenyetso bito: Iyo ibimenyetso ari bito, guhagarika imiti cyangwa guhindura ingano akenshi bikemura ibimenyetso mu masaha 24 kugeza kuri 72. Iyo ibimenyetso bidakemutse vuba, ushobora guhabwa umuti ubuza serotonin nka cyproheptadine (Periactin®).
• Ibimenyetso biri hagati: Niba ibimenyetso byawe biri hagati, uzaguma mu bitaro nibura amasaha 24 kugira ngo urebe niba ibimenyetso byawe bizagenda neza nyuma yo kuvurwa.
• Ibimenyetso bikomeye: Iyo ibimenyetso bikomeye cyane, uzajya mu cyumba cy’ubuvuzi bw’inyongera (ICU) aho imikorere y’umubiri wawe n’ingingo zawe bizakurikiranirwa hafi.

Bitewe n'ibimenyetso, imiti ikurikira ishobora gutangwa:

• Umuti utuma umuntu aruhuka nka benzodiazepine ushobora kugabanya ibimenyetso nko gushyuha, imitsi ikagira ingaruka mbi, ndetse no gucika intege.
• Umunyu `(ibitonyanga bya IV)` bitangwa kugira ngo bigabanye kubika amazi n'umuriro, naho umwuka wa ogisijeni ugatangwa binyuze kuri `(mask)` mu maso kugira ngo wongere urugero rwa ogisijeni mu maraso.
• Umuti wo kugenzura umuvuduko w'umutima n'umuvuduko w'amaraso.
• Kugira ngo ugabanye umuriro mwinshi cyane (dogere selisiyusi 41.1 / dogere selisiyusi 106), hashyirwaho umuyoboro wo guhumeka ku bibazo byo guhumeka, hagatangwa umuti utuma imitsi iruhuka, hanyuma hagatangwa imiti igabanya ubushyuhe.
• Iyo ubundi buryo bwo kuvura budatanga ubutabazi bwihuse, hatangwa umuti ubuza serotonin witwa cyproheptadine.

Niba serotonin syndrome yawe yatewe n'umuti ugabanya ubukana bw'indwara zo kwiheba, bishobora gufata ibyumweru byinshi kugira ngo umuti uve mu mubiri wawe burundu kandi ibimenyetso byawe bishire burundu.

Icy'ingenzi kurushaho: Ntugahagarike gufata imiti iyo ari yo yose cyangwa ngo uhindure urugero rw'imiti utabanje kuvugana na muganga. Ariko, niba ufite ibimenyetso bikomeye cyangwa ibimenyetso byawe bikarushaho kwiyongera, shaka ubufasha bwihutirwa bwa muganga vuba. Serotonin syndrome ishobora gushyira ubuzima mu kaga.

Ni izihe ngorane zishobora kubaho?

Iyo itavuwe, serotonin syndrome ishobora gutera ingorane nka:

• Indwara zo mu mutwe.
• Kugorwa no guhumeka.
• Kunanirwa kw'impyiko. Iyo ibintu byo kwangirika kw'imitsi byirundanyije mu maraso bikayungururwa n'impyiko, bishobora kwangiza impyiko cyane iyo bitavuwe.
• Leta ya koma.
• Ndetse n'urupfu rurashobora kubaho.

Twakizwa dute ibi?

• Ni ngombwa cyane kwitondera cyane imiti iyo ari yo yose ufata. Soma imiburo yose iri ku gapaki k'imiti cyangwa agapapuro k'amakuru kayijyana. Bizakubwira niba hari ibyago byo kurwara serotonin syndrome.
• Ntugahagarike imiti iyo ari yo yose utabanje kuvugana na muganga wawe.
• Menya neza imiti yose ufata (imiti yanditswe na muganga, imiti igurishwa mu kigo, ibyatsi gakondo, inyongeramusaruro, ndetse n'imiti itemewe).
• Niba ufata triptan yo kuvura migraine hamwe n'imiti igabanya ubukana bw'indwara zo mu mutwe (cyane cyane SSRIs cyangwa SNRIs), muganga wawe agomba kugukurikiranira hafi. Ingaruka zishobora kuba nke cyane, wenda ndetse nta n'izihari. Ariko ibuka ko ufite inshingano: Niba ubonye kimwe mu bimenyetso bivugwa muri iyi nkuru, hamagara muganga wawe ako kanya.
• Gukurikiza izi ngamba bizagufasha wowe na muganga wawe kumenya ibimenyetso bya serotonin syndrome hakiri kare. Kuyimenya hakiri kare bishobora gufasha gukumira ibimenyetso bikomeye.

Ni iki twagombye kwitega muri iki gihe?

Iyo ibimenyetso by’indwara bigaragaye kandi bigavurwa vuba, ibimenyetso by’indwara abantu benshi bizashira burundu mu masaha 24 kugeza kuri 72.

Nyuma yo gukira, muganga wawe ashobora:

• Gabanya urugero rw'umuti wateye iyi ndwara kugeza ku rugero rwo hasi cyane.
• Reka gutanga imiti ibiri ifite urugero runini igira ingaruka kuri serotonin hamwe.
• Hindura ukoreshe undi muti utagira ingaruka kuri serotonin.

Ni ryari ngomba guhamagara muganga wanjye?

• Niba ufite ibimenyetso bya serotonin syndrome (cyangwa ibimenyetso birushaho kwiyongera), hamagara muganga wawe ako kanya cyangwa ujye mu cyumba cy’ubutabazi bw’ibanze. Witondere cyane cyane niba watangiye umuti mushya, wongereye urugero rw’umuti usanzwe ufata, cyangwa ufata imiti uzi ko igira ingaruka ku rugero rwa serotonin.
• Ntureke gufata imiti cyangwa ngo uhindure igipimo utabanje kuvugana na muganga wawe.
• Menya neza ko abaganga bawe bose bazi imiti yose ufata.
• Soma witonze amabwiriza n'udutabo tw'amakuru bizana n'imiti yawe.
• Menya ibimenyetso bya serotonin syndrome. Menya neza cyane ibi bimenyetso niba ufata imiti igabanya ubukana bw'indwara zo kwiheba.
• Niba ufite ikibazo icyo ari cyo cyose ku bijyanye n'imiti yawe cyangwa ibimenyetso byayo, baza muganga wawe cyangwa umufarumasiye wawe.
• Niba ubonye ibimenyetso, cyangwa niba ibimenyetso byawe birushijeho kwiyongera, ntukibagirwe guhamagara muganga wawe ako kanya cyangwa kujya mu cyumba cy’ubutabazi bw’ibanze.

Ni ubuhe butumwa twifuza kujyana muri iyi nkuru?

• Indwara ya Serotonin ni indwara ishobora kuba ikomeye, ariko ishobora gukira iyo yivuwe neza.
• Vugana na muganga wawe nta guhishanya ku bijyanye n'imiti iyo ari yo yose ufata, cyane cyane niba utangiye indi mishya cyangwa uhindura ingano yayo.
• Menya ibimenyetso. Niba ufite gushidikanya , shaka inama kwa muganga udapfushije igihe.
• Wibuke ko uzi ubuzima bwawe neza, bityo rero ni ngombwa kumenya impinduka iyo ari zo zose.

Indwara ya Serotonin, serotonin, imiti igabanya ubudahangarwa bw'imiti, ingaruka mbi ku biyobyabwenge, imiti ikoreshwa mu bwonko, imiti igabanya ubukana bw'imiti, ingaruka ku biyobyabwenge