Hausi kufara here? Waneta nezvose here? Isu tinodana chirwere ichi kuti kuora mwoyo. Saka, kune mhando dzakasiyana dzemishonga dzinopihwa kurapa chirwere ichi chepfungwa chinonzi kuora mwoyo. Nhasi tichataura nezveboka remishonga yekare uye yaunofanira kungwarira nayo paunenge uchishandisa. Idzi dzinonzi MAOIs, zvinoreva Monoamine Oxidase Inhibitors. Kunyangwe zita iri ringaita serakaoma zvishoma, ngatitaurei nezvazvo zviri nyore.
Chii chaizvo chinonzi MAOIs idzi?
Zvichitaurwa zviri nyore, MAOIs rudzi rwemishonga inobatsira kudzora zviratidzo zvekuora mwoyo. Aya ndiwo mishonga yekutanga yekuora mwoyo yakawanikwa pasi rose . Zvisinei, vanachiremba havasi kunyora mushonga uyu zviri nyore mazuva ano. Chikonzero cheizvi ndechekuti unofanirwa kungwarira zvakanyanya nezve zvaunodya uye zvaunonwa paunenge uchitora mishonga iyi, uye unofanirwawo kunyatsoteerera mimwe migumisiro uye kuchengetedzeka.
Kazhinji, vanachiremba vanongonyora MAOIs senzira yekupedzisira kana mimwe mishonga mitsva yekuora mwoyo (yakadai seSSRIs) yakundikana kugadzirisa zviratidzo.
Mishonga ipi iri muboka iri?
Heano mamwe emhando dzeMAOI dzinoshandiswa pasi rose:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Selegiline (Emsam®)
- Tranylcypromine (Parnate®)
Mazita aya angave asina kujairika kwauri, sezvo asingawanzo shandiswa munyika medu. Asi zvakanaka kuziva.
Ndezvipi zvirwere zvinorapwa neMAOIs?
Mishonga iyi yakatenderwa zvirwere zvakasiyana-siyana.
| Rudzi rwemushonga | Zvirwere zvinonyanya kushandiswa |
|---|---|
| Isocarboxazid uye Tranylcypromine | Dambudziko Guru reKushungurudzika |
| Phenelzine | Kuora mwoyo kunoramba kurapwa, panic disorder, uye social anxiety disorder |
| Selegiline | Semushonga wekuwedzera wechirwere chekushungurudzika kukuru uye chirwere cheParkinson. |
Chii chinonzi "off-label"?
Dzimwe nguva, vanachiremba vanoshandisa mushonga wechirwere chisina kutenderwa zviri pamutemo. Izvi zvinonzi kushandiswa kwe "off-label". Zvinongoitwa chete kana ruzivo rwachiremba neruzivo rwake zvichiratidza kuti zvichabatsira murwere. Semuenzaniso, Selegiline dzimwe nguva inonyorerwa ADHD, uye Tranylcypromine dzimwe nguva inonyorerwa kuzvidya mwoyo kwevanhu.
Mushonga uyu unoshanda sei?
Izvi zviri nyore kunzwisisa. Fungidzira kuti kune vatumwa vadiki muuropi hwedu. Tinovadaidza kuti neurotransmitters . Serotonin, Norepinephrine, uye Dopamine ndivo vatumwa vakuru vanodzora zvinhu zvakaita semufaro, kurara, uye kurangarira mupfungwa dzedu.
Zvino, kune imwe enzyme muuropi hwedu inonzi monoamine oxidase . Basa re enzyme iyi ndere "kuchenesa" nhumwa idzodzo. Kureva kuti, kudziputsa nekudzikisa huwandu hwadzo.
Zvinoitwa neMAOI ndezvokuti inomisa enzyme inochenesa (Monoamine Oxidase) kuti isashande. Chii chinoitika ipapo? Vatumwa ivavo vanofara (senge serotonin nedopamine) vanoungana muuropi pane kuputsika. Huremu hwavo hunowedzera. Ipapo mafungiro edu anovandudzika uye zviratidzo zvekuora mwoyo zvinoderera.
Panguva iyi, kunewo kemikari inonzi Tyramine . Inobatsira kudzora BP mumuviri wedu. Mishonga yeMAOI inomisawo kuparara kweTyramine iyi. Iyi ndiyo njodzi huru inouya nemishonga iyi . Tichataura nezvazvo gare gare.
Ndezvipi migumisiro nenjodzi dzeMAOIs?
Kune mimwe migumisiro yakawanda inogona kuitika uye njodzi dzakakomba dzinobatanidzwa nekushandisa mishonga iyi. Saka, zvine njodzi huru kuishandisa usina kurairwa nachiremba .
Migumisiro yakajairika
- Dzungu kana kusuruvara (nekuda kweBP yakaderera)
- Muromo wakaoma (xerostomia)
- Kusvotwa
- Kuzvimba kana kuvimbiwa
- Kurara
- Kushaya hope
Njodzi dzakakomba nematambudziko
1. Serotonin Syndrome
Ichi ndicho chirwere chakakomba uye chinogona kuisa hupenyu panjodzi. Chinoitika kana huwandu hweserotonin mumuviri hwakwira zvakanyanya. Njodzi iyi inotowedzera kana ukatora MAOIs pamwe chete nemimwe mishonga inowedzera huwandu hweserotonin (semuenzaniso, SSRIs, mimwe mishonga inoderedza marwadzo). Ndosaka zvichikosha kuudza chiremba wako nezvemishonga yese yauri kutora, kunyangwe mavhitamini.
| Zviratidzo zve serotonin syndrome | |
|---|---|
| Hunhu hwakawanda | Kusagadzikana, kuda kurutsa, kurutsa, dumbu rinorwadza, maziso anodzungunyika , kudikitira , kudedera, tsandanyama dzinodzungunyika. |
| Zviratidzo zvakakomba (zvinoda kuti munhu apinde muchipatara nekukasika) | Kuvhiringidzika, tachycardia, BP yakakwira, fivha, pfari, kurasikirwa nepfungwa. |
Kana ukaona chimwe chezviratidzo izvi zvakakomba, enda kuchipatara chiri pedyo neEmergency Department (ETU) nekukasika . Kunonoka kurapwa kunogona kuisa hupenyu panjodzi.
2. Matambudziko nechikafu (Tyramine inosangana)
Iri ndiro dambudziko guru rinoshanda nemaMAOI. Sezvatakambotaura, MAOIs inomisa kuputsika kwekemikari inonzi tyramine, iyo inowanikwa mune zvimwe zvekudya.
Kana ukadya chikafu chine tyramine yakawanda paunenge uchitora MAOI, huwandu hwetyramine muropa rako hunogona kukwira zvine njodzi. Izvi zvinogona kukonzera kuwedzera kweBP kamwe kamwe uye kwakanyanya . Izvi zvinonzi "Tyramine Pressor Response." Muzviitiko zvisingawanzoitiki, BP iyi inogona kukonzera kubuda ropa muuropi (cerebral hemorrhage) uye kunyange kufa.
Ndezvipi zvekudya zvaunofanira kudzivisa paunenge uchitora MAOIs?
Pazasi pane runyorwa rwezvikafu zvinofanirwa kudziviswa nemunhu anotora mushonga uyu, nekuda kwehuwandu hwakawanda hwetyramine.
| Rudzi rwechikafu | Tsananguro nemienzaniso |
|---|---|
| Cheese Yakwegura | Chizi dzakadai seCheddar, Swiss, neParmesan (chizi chitsva senge Cottage cheese neMozzarella hadzina njodzi yakawanda). |
| Soy Soo | Zvese zvakagadzirwa kubva ku soy. |
| Nyama/hove dzakaviriswa kana kuti dzakachengetwa | Masoseji, salami, hove dzakaomeswa, nezvimwe zvinhu. |
| Chiropa | Kunyange hazvo chiropa chitsva chisina tyramine, huwandu hwetyramine hunogona kuwedzera nekuti hunoderera nekukurumidza. |
| Muchero wakaibva zvakanyanya | Kana michero yakaita semabhanana, maavocado, nemaonde yaibva zvakwana. |
| Doro rakaviriswa | Kunyanya doro remuto. |
Chinhu chinonyanya kukosha: Sezvo chikafu chichikura, huwandu hwacho hwetyramine hunowedzera. Saka, munhu anotora mushonga uyu anofanira kugara achidzivisa kudya zvasara uye kudya chikafu chichangobva kubikwa .
3. Chirwere cheKurega Kushushikana Mupfungwa
Dambudziko iri rinogona kuitika kana ukarega kutora mushonga uyu kamwe kamwe mushure mekuutora kwemavhiki anopfuura matanhatu. Zviratidzo zvakaita sefivha, kurwadziwa kwemuviri, musoro, dzungu, kushaya hope, uye kusagadzikana zvinogona kuitika. Saka, usamborega kutora mushonga uyu usina kubvunza chiremba wako . Kana ukarega kutora mushonga, unofanira kuzviita zvishoma nezvishoma kwemavhiki akati wandei uye uchitarisirwa nachiremba wako chete.
4. Pfungwa dzekuzviuraya
Pane mukana mudiki wekufunga zvekuzviuraya kana vechidiki vari pasi pemakore makumi maviri nemashanu vatanga kutora mushonga uyu. Kana iwe kana mwana wako muine pfungwa idzi, taurai nachiremba akakunyorerai mushonga nekukasika.
Unofanira kuona chiremba rini?
Kana uri kutora MAOI, unofanira kuona chiremba wako nguva nenguva kuti uone kana mushonga wacho uchishanda uye kana paine matambudziko. Pamusoro pezvo, taura nachiremba wako nezvezvinhu izvi zvakare.
- Kana ukasangana nemigumisiro yausingakwanise kutsungirira.
- Kana zviratidzo zvako zvikasavandudzika, kana zvikawedzera kuipa.
- Kana uchinzwa sekuti unofanira kurega kutora mushonga.
Mharidzo Yekuenda Nayo Kumba
- MAOIs iboka rekare rine simba uye rine njodzi remishonga yekudzora kushungurudzika isingawanzo shandiswa mazuva ano.
- Kana uri kutora mushonga uyu, kudzora kudya kwako kunofanira kuitwa . Zvikafu zvine tyramine yakawanda zvinofanira kudziviswa zvachose.
- Zvakakosha kuzivisa chiremba wako nezvemimwe mishonga yauri kutora, zvikasadaro unogona kutanga chirwere che serotonin chine njodzi.
- Usatange kana kurega kutora mushonga uyu usina kupiwa mazano nachiremba chero chikonzero chipi zvacho.
- Kana ukava nezviratidzo zvakakomba zve serotonin syndrome kana kuti pfungwa dzekuzviuraya, enda kuchipatara nekukurumidza.
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