Chiremba wako akakunyorerera mushonga unonzi MAOI here? Kana kuti wakambonzwa nezvemushonga uyu pane imwe nzvimbo uye uchida kuziva kuti chii chaizvo? MAOIs chaizvoizvo rudzi rwemushonga unopiwa kurapa zvirwere zvepfungwa zvakaita sekuora mwoyo. Zvisinei, vanachiremba havawanzokurudzira mazuva ano. Pane zvikonzero zvakawanda zveizvi. Ngatitaurei nezvazvo kubva pakutanga, zviri nyore, nenzira yaunogona kunzwisisa.
Mhando ipi yemushonga inonzi MAOI?
Zvichitaurwa zviri nyore, MAOIs (Monoamine Oxidase Inhibitors) ndiwo mushonga wekutanga wakawanikwa uchirapa kushungurudzika. Zvisinei, unofanira kungwarira zvakanyanya zvaunodya paunenge uchiashandisa. Zvakare, nekuda kwezvimwe migumisiro uye matambudziko nemimwe mishonga, vanachiremba vanowanzokurudzira kuti ushandise senzira yekupedzisira, kana mimwe mishonga yekuora mwoyo isingashande.
Izvi zvinoreva kuti, kana wakapihwa mishonga mitsva senge SSRIs uye zviratidzo zvako zvisati zvachinja, chiremba wako anogona kufunga nezveMAOI sedanho rinotevera.
Ndedzipi mhando huru dzeMAOI dzinoshandiswa pasi rose?
Kune mhando dzakawanda dzeMAOI dziri kushandiswa pari zvino. Kana dzese idzi dziripo munyika medu dzinogona kusiyana, asi zvakanaka kuziva mazita aya.
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Selegiline (Emsam®)
- Tranylcypromine (Parnate®)
Mishonga yeMAOI inonyorerwa zvirwere zvipi?
Kunyangwe mushonga uyu uchinyanya kunyorerwa vanhu vane dambudziko rekuora mwoyo, unoshandiswawo kune mamwe matambudziko epfungwa.
Mashandisirwo akatenderwa zviri pamutemo
Izvi zviitiko apo vane masimba vakabvumidza zviri pamutemo mushonga uyu kuti wakakodzera zvirwere izvi.
- Dambudziko Guru reKushungurudzika: Isocarboxazid neTranylcypromine zvose zvinotenderwa pachirwere ichi.
- Matambudziko asingarapike: Phenelzine inoshandiswa kurapa kuora mwoyo, panic disorder, uye social anxiety disorder isingarapike kune mamwe marapirwo.
- Chirwere cheParkinson: Selegiline mushonga unoshandiswa kurapa kushungurudzika uye unoshandiswawo semushonga wekuwedzera pamwe chete nemimwe mishonga yechirwere cheParkinson.
Mashandisirwo e "Off-label"
Dzimwe nguva, chiremba anogona kunyora mushonga uyu zvichibva paruzivo rwavo rwezvekurapa uye ruzivo rwavo pachirwere chisina kutenderwa zviri pamutemo. Izvi zvinonzi kushandiswa kwe "off-label". Semuenzaniso:
- Mushonga unonzi tranylcypromine dzimwe nguva unonyorerwa vanhu vane kuzvidya mwoyo kwevanhu uye vane panic disorder vasingarapike.
- Pane dzimwe nguva apo mushonga weSelegiline unonyorerwa chirwere cheADHD (attention deficit hyperactivity disorder).
Mushonga uyu unoshanda sei mumuviri?
Izvi zviri nyore kunzwisisa. Fungidzira kuti pfungwa dzedu dzine makemikari anodzora zvinhu zvakaita semanzwiro edu, mufaro, uye kutarisisa. Tinodaidza kuti ma neurotransmitters . Aya akafanana nevatumwa vadiki vanotakura mashoko muuropi.
Zvino, muviri wedu une enzyme inonzi "Monoamine Oxidase." Basa re enzyme iyi nderekuputsa nekubvisa ma messengers (neurotransmitters) mushure mekunge ashandiswa.
Munhu ane kuora mwoyo anogona kunge aine huwandu hushoma hwezvinhu izvi muuropi hwake. Zvinoitwa nemushonga weMAOI kumisa kwenguva pfupi (kudzivisa) kushanda kweenzyme iyoyo 'yekuchenesa'. Chii chinoitika ipapo?
Ma neurotransmitter akawanda akakosha muuropi anoramba ari muuropi kwenguva yakareba asingakanganiswi, zvinoreva kuti huwandu hwawo hunowedzera.
Ma neurotransmitters makuru anowedzera neMAOIs ndeaya:
- Serotonin: Inonyanya kukosha pamanzwiro, kurara, kuda kudya, uye maitiro evanhu.
- Norepinephrine: Zvakakosha pakungwarira, kutarisisa, uye kuita basa.
- Dopamine: Yakabatana nemufaro, kugutsikana, uye kutarisirwa.
- Tyramine: Iyi imhando ye neurotransmitter. Asi basa rayo guru nderekubatsira kudzora BP. Ichi ndicho chikonzero chikuru chaunofanira kungwarira nezvekudya kwako paunenge uchitora MAOI. Tichataura nezvazvo zvakadzama munguva pfupi iri kutevera.
Chii chiri musiyano uripo pakati peMAOIs neSSRIs?
SSRIs (Selective Serotonin Reuptake Inhibitors) imwe mhando yemishonga inoshandiswa kurapa kuora mwoyo. Ungave wakambonzwa nezvemazita akadai seProzac naSertraline. Kunyangwe ese ari maviri ari mishonga inoshandiswa kurapa kuora mwoyo, anoshanda zvakasiyana.
- SSRI: Izvi zvakafanana nezvombo zvinopfura nepfuti. Zvinongonanga serotonin ye neurotransmitter, zvichiwedzera huwandu hwayo.
- MAOIs: Izvi zvakafanana nepfuti. Zvinokanganisa ma neurotransmitters akawanda (serotonin, norepinephrine, dopamine) panguva imwe chete.
Nekuti mishonga yeSSRI haina migumisiro yakawanda uye hapana mitemo yakakosha maererano nechikafu nechinwiwa, vanachiremba vanowanzo kurudzira mishonga yeSSRI kutanga.
Ndezvipi migumisiro inowanzo konzerwa neMAOIs?
Kufanana nemishonga yese, uyu unogona kuva nemigumisiro yakaipa. Asi havasi vese vanouwana. Vamwe vanhu vanogona kuwana mumwe kana miviri, uye vamwe vangasawana zvachose. Kana uine kusagadzikana kutsva mushure mekutanga mushonga uyu, taura nachiremba wako nezvazvo.
| Migumisiro yakajairika | Tsananguro |
|---|---|
| Dzungu kana kuti musoro wakapfava | Izvi zvinogona kukonzerwa neBP yakaderera. Izvi zvinogona kudzorwa nekusimuka zvishoma nezvishoma kubva pakamira kana kugara. |
| Muromo wakaoma | Unogona kuwana zororo nekunwa mvura yakawanda uye kutsenga chingamu isina shuga. |
| Kusvotwa | Izvi zvinogona kuderedzwa nekutora mushonga pamwe chete nechikafu. |
| Kuzvimba kana kuvimbiwa | Izvi zvinogona kusiyana zvichienderana nekudya kwako uye huwandu hwemvura yaunonwa. |
| Kurara | Chiremba anogona kukukurudzira kuti utore mushonga uyu husiku. |
| Kushaya hope | Muchiitiko chakadaro, unogona kukurudzirwa kutora mushonga uyu mangwanani. |
Njodzi dzakakomba dzine chekuita nekushandisa MAOIs!
Unofanira kungwarira zvikuru chikamu ichi. MAOIs mushonga unofanirwa kushandiswa nekungwarira kukuru.
1. Kuwedzera kwepfungwa dzekuzviuraya
Kuwedzera kwepfungwa dzekuda kuzviuraya kana maitiro ekuzviuraya kunogona kuitika, kunyanya kune vechidiki vari pasi pemakore makumi maviri nemashanu, kana mushonga uyu watanga kushandiswa kana kuti kana mushonga wacho wachinja.
Kana iwe kana mwana wako mukatanga kunzwa kushaya tariro mushure mekutanga mushonga uyu, musazeza kutaura nachiremba akakunyorerai mushonga nekukasika.Unogona zvakare kuwana rubatsiro nekukasika nekufonera nhamba yerubatsiro rwehutano hwepfungwa yeSri Lanka, 1926 .
2. Chirwere cheSerotonin
Ichi chirwere chisingawanzoitiki, asi chinogona kuisa hupenyu panjodzi . Chinoitika kana huwandu hweserotonin mumuviri hwakwira zvine njodzi. Njodzi iyi inowedzera kana ukatora MAOI uchitora mimwe mishonga inowedzera huwandu hweserotonin (semuenzaniso, mimwe mishonga inorwisa kushushikana kwepfungwa, mimwe mishonga yekukosora, uye mishonga inoderedza marwadzo).
Saka, usati watanga kutora MAOI, unofanira kuudza chiremba wako nezvemishonga yese yauri kutora (kusanganisira mavhitamini nemishonga yechivanhu).
| Zviratidzo zveSerotonin Syndrome | |
|---|---|
| Zviratidzo zvakajairika |
|
| Zviratidzo zvakakomba uye zvekukurumidzira |
|
| Kana ukaona chimwe chezviratidzo izvi zvakakomba, enda kuchipatara chiri pedyo neEmergency Department (ETU) nekukasika! | |
3. Chirwere cheKurega Kushushikana Mupfungwa
Kana ukatora MAOI kweanopfuura mavhiki matanhatu wozoirega kamwe kamwe, unogona kuona zviratidzo zvekurega. Izvi hazvisi zvekupindwa muropa, asi inzira yekuti muviri upindure mushonga wacho paunotanga kuujaira.
Hunhu:
- Kurwadziwa kwemuviri, kuneta, uye kudikitira, sekunge une fivha
- Kushaya hope
- Kusvotwa
- Dzungu
- Kunzwa sekuti magetsi ari kufamba mumuviri wako
- Kunetseka, kugumbuka
Usarega kutora mushonga uyu kamwe kamwe pasina chikonzero chipi zvacho usina kubvunza chiremba wako. Kana ukarega kutora mushonga, zviite zvishoma nezvishoma kwemwedzi mumwe chete, uchideredza mushonga wacho, uye uchitarisirwa nachiremba wako chete.
4. Kusangana nenjodzi nechikafu (Tyramine Reaction)
Iyi ndiyo njodzi inonyanya kukosha uye ine njodzi ine MAOIs.
Sezvatakambokurukura, mishonga yeMAOI inovhara enzyme inopwanya kemikari inonzi tyramine. Tyramine inowanzo kuwanikwa mune zvimwe zvekudya zvatinodya. Mumunhu asiri kutora mushonga uyu, muviri unopwanya nyore nyore wobvisa tyramine iyi.
Asi kana munhu achitora MAOI akadya chikafu chine tyramine yakawanda, muviri haugone kuibvisa. Ipapo huwandu hwetyramine muropa hunokwira zvine njodzi, zvichikonzera kuwedzera kweBP kamwe kamwe (Hypertensive Crisis) . Izvi zvine njodzi zvikuru. Mune dzimwe nguva zvisingawanzoitiki, izvi zvinogona kukonzera kubuda ropa muuropi uye kunyange kufa.
Zvekudya zvekusafanira 'kurega' kana uchitora MAOIs!
Kana uri kutora MAOI, unofanira kurega zvachose kudya zviri pazasi. Taura nachiremba wako nezveizvi kuti uwane rumwe ruzivo.
| Rudzi rwechikafu | Zvinhu zvekudzivisa uye chikonzero |
|---|---|
| Chizi | Dzivisai zvachose chizi dzakasakara . Semuenzaniso: Cheddar, Blue cheese, Parmesan. (Huwandu hweTyramine hunowedzera nekufamba kwenguva). Chizi itsva dzakadai seCottage cheese, Mozzarella dzakanaka. |
| Nyama nehove zvakagadziriswa | Masoseji, salami, nyama dzakaomeswa, nyama dzakakangwa, uye nyama dzakasvuta/hove. |
| Masosi | Soy sauce nemamwe masosi akaviriswa. |
| Michero nemiriwo zvakaviriswa | Mabhanana akaibva zvakanyanya , maavocado, maonde. Fava beans (rudzi rwembeu). |
| Doro | Doro reTap (doro redhiraini) nedoro rakaviriswa. Mamwe waini anewo tyramine yakawanda. |
| Zvimwe | Chingwa chesourdough, chiropa, nezvimwewo (tyramine inowedzera nekukurumidza kana isiri itsva). |
Chinonyanya kukosha: Idya chikafu chichangobva kubikwa. Isa zvasara mufiriji uye usazvidziyise zvakare. Sezvo chikafu chichikura, huwandu hwetyramine hunogona kuwedzera.
Zvinotora nguva yakareba sei kuti munhu anzwe kushanda kwemushonga uyu?
Zvinotora mavhiki maviri kusvika matatu kuti mhedzisiro yemushonga ionekwe. Kana usingaoni kuvandudzika kwezviratidzo zvako panguva iyoyo, taura nachiremba wako.
Unofanira kufonera chiremba wako rini?
Kana uri kutora MAOI, unofanira kuona chiremba wako nguva nenguva kuti uone kana mushonga wacho uchishanda uye kana uine matambudziko. Pamusoro pezvo, iva nechokwadi chekutaura nachiremba wako nezvezvinhu izvi:
- Kana migumisiro yacho ichikunetsa.
- Kana zviratidzo zvako zvikasavandudzika kana kuti zvikasawedzera kuipa.
- Kana uchinzwa sekuti unofanira kurega kutora mushonga.
Chekupedzisira, semunhu ari kutora MAOI, zvakakosha kuudza chero chiremba waunoona (kunyangwe chiremba wemazino) kuti uri kutora mushonga uyu, sezvo mimwe mishonga inonyaradza marwadzo nemimwe mishonga inogona kukonzera matambudziko neMAOIs.
Mharidzo Yekuenda Nayo Kumba
- MAOIs imhando yemushonga wekuderedza kushungurudzika usingachashandiswi zvakanyanya, asi unoshanda zvikuru mune dzimwe nguva.
- Zvikafu zvine Tyramine (zvakaita sechizi chakachekwa, nyama dzakagadzirwa, soy sauce) zvinofanira kudziviswa zvachose paunenge uchitora mushonga uyu. Izvi zvinogona kuisa hupenyu panjodzi.
- Zvakakosha kuzivisa chiremba wako nezve mimwe mishonga yauri kutora.
- Usamborega kutora mishonga kamwe kamwe usina kubvunza chiremba wako.
- Kana ukava nezviratidzo zvakakomba zve serotonin syndrome (kuvhiringidzika, fivha yakanyanya, pfari) kana kufunga kuzviuraya, enda kuchipatara che emergency (ETU) nekukasika.
- Udza nyanzvi yehutano yese yaunorapa kuti uri kutora MAOI.
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