Awuvuyi? Ngaba udiniwe yinto yonke? Le meko siyibiza ngokuba yi-depression. Ngoko ke, kukho iintlobo ezahlukeneyo zamayeza anikwayo ukunyanga le meko yengqondo ebizwa ngokuba yi-depression. Namhlanje siza kuthetha ngeqela lamayeza amadala kancinci kwaye ekufuneka ulumke kakhulu xa uwasebenzisa. La abizwa ngokuba yi-MAOIs, emele i-Monoamine Oxidase Inhibitors. Nangona eli gama lisenokubonakala liyinkimbinkimbi kancinci, masithethe ngalo ngokulula.
Zithini kanye kanye ezi MAOI?
Ngamafutshane, ii-MAOI luhlobo lwamayeza anceda ukulawula iimpawu zokudakumba. La ngamayeza okuqala okudakumba afunyenweyo ehlabathini . Nangona kunjalo, oogqirha abaniki eli yeza lula kule mihla. Isizathu soku kukuba kufuneka uqaphele kakhulu malunga nokutya nokuselayo xa usela la mayeza, kwaye kufuneka uqaphele kakhulu iziphumo ezithile kunye nokhuseleko.
Ngokwesiqhelo, oogqirha banika ii-MAOIs kuphela njengesisombululo sokugqibela xa ezinye ii-antidepressants ezintsha (ezifana ne-SSRIs) zingaphumelelanga ukuphucula iimpawu.
Ngawaphi amayeza akweli candelo?
Nazi ezinye zeentlobo ze-MAOIs ezisetyenziswa ehlabathini:
- I-Isocarboxazid (Marplan®)
- IPhenelzine (iNardil®)
- I-Selegiline (Emsam®)
- I-Tranylcypromine (iParnate®)
La magama asenokuba awaqhelekanga kuwe, njengoko engasetyenziswa rhoqo kwilizwe lethu. Kodwa kulungile ukwazi.
Zeziphi iimeko ezinyangwa nge-MAOIs?
La mayeza avunyiwe kwizifo ezahlukeneyo.
| Uhlobo lweyeza | Iimeko zonyango ezisetyenziswa kakhulu |
|---|---|
| I-Isocarboxazid kunye neTranylcypromine | Ingxaki Enkulu Yokudakumba |
| I-Phenelzine | Uxinzelelo olunganyangekiyo kunyango, ukuphazamiseka kovalo, kunye nesifo sokuxhalaba kwezentlalo |
| ISelegiline | Njengonyango oluncedisayo kwisifo sokudakumba okukhulu kunye nesifo sikaParkinson. |
Yintoni ukusetyenziswa "kwe-off-label"?
Ngamanye amaxesha, oogqirha basebenzisa iyeza kwimeko engavunywanga ngokusemthethweni. Oku kubizwa ngokuba kukusetyenziswa "ngaphandle kweleyibhile". Kwenziwa kuphela xa amava nolwazi lukagqirha lubonisa ukuba kuya kunceda isigulana. Umzekelo, iSelegiline ngamanye amaxesha inikwa i-ADHD, kwaye iTranylcypromine ngamanye amaxesha inikwa ixhala loluntu.
Lisebenza njani eli yeza?
Kulula kakhulu ukuyiqonda le nto. Khawucinge ukuba kukho abathunywa abancinci ngaphakathi kwengqondo yethu. Sibabiza ngokuba zii-neurotransmitters . I-Serotonin, i-Norepinephrine, kunye ne-Dopamine zezona zithunywa ziphambili ezilawula izinto ezinje ngolonwabo, ubuthongo, kunye nenkumbulo ezingqondweni zethu.
Ngoku, kukho enye i-enzyme engqondweni yethu ebizwa ngokuba yi-monoamine oxidase . Umsebenzi wale enzyme kukucoca ezo zithunywa. Oko kukuthi, ukuziqhekeza nokunciphisa amanqanaba azo.
Oko kwenziwa yi-MAOI kukuba iyayimisa i-enzyme ecocayo (i-Monoamine Oxidase) ukuba ingasebenzi. Kwenzeka ntoni ke ngoko? Ezo zithunywa zivuyayo (ezifana ne-serotonin kunye ne-dopamine) ziqokelelana engqondweni endaweni yokuba ziqhekeke. Amanqanaba azo ayanda. Emva koko isimo sethu sengqondo siyaphucuka kwaye iimpawu zokudakumba ziyancipha.
Okwangoku, kukwakho nekhemikhali ebizwa ngokuba yiTyramine . Inceda ekulawuleni uxinzelelo lwegazi emzimbeni wethu. Amayeza e-MAOI akwathintela ukuqhekeka kwale Tyramine. Le yeyona mngcipheko mkhulu oza nala mayeza . Siza kuthetha ngayo kamva.
Zithini iziphumo ebezingalindelekanga kunye neengozi ze-MAOIs?
Kukho iziphumo ebezingalindelekanga ezininzi kunye neengozi ezinkulu ezinxulumene nokusebenzisa la mayeza. Ngoko ke, kuyingozi kakhulu ukuwasebenzisa ngaphandle kwengcebiso kagqirha .
Iziphumo ebezingalindelekanga eziqhelekileyo
- Ukudinwa okanye ukuba nentloko ebuhlungu (ngenxa yoxinzelelo lwegazi oluphantsi)
- Umlomo owomileyo (xerostomia)
- Isicaphucaphu
- Ukudumba okanye ukuqhina
- Ukozela
- Ukungalali
Iingozi ezinkulu kunye neengxaki
1. Isifo seSerotonin
Le yeyona meko imbi kakhulu nenokuba yingozi ebomini. Yenzeka xa amanqanaba e-serotonin emzimbeni ephakama kakhulu. Lo mngcipheko uba mkhulu ngakumbi ukuba uthatha ii-MAOIs kunye namanye amayeza anyusa amanqanaba e-serotonin (umz., ii-SSRIs, ezinye izithomalalisi zentlungu). Yiyo loo nto kubalulekile ukuxelela ugqirha wakho ngawo onke amayeza owasebenzisayo, kuquka neevithamini.
| Iimpawu ze-serotonin syndrome | |
|---|---|
| Iimpawu ngokubanzi | Ukungazoli, isicaphucaphu, ukuhlanza, isisu esibuhlungu, amehlo aqhaqhazelisayo , ukubila , ukungcangcazela, ukuxhuzula kwemisipha. |
| Iimpawu eziqatha (ezifuna ukulaliswa esibhedlele ngokukhawuleza) | Ukudideka, i-tachycardia, uxinzelelo lwegazi oluphezulu, umkhuhlane, ukuxhuzula, ukulahlekelwa zingqondo. |
Ukuba ufumana naziphi na kwezi mpawu zinzima, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko . Ukulibazisa unyango kunokuba yingozi ebomini.
2. Iingxaki ngokutya (ukudibana kweTyramine)
Le yeyona ngxaki inkulu esebenzayo ngee-MAOI. Njengoko besitshilo ngaphambili, ii-MAOI ziyayithintela i-chemical ebizwa ngokuba yi-tyramine, efumaneka ngokwemvelo kwezinye izidlo.
Ukuba utya ukutya okune-tyramine eninzi ngelixa uthatha i-MAOI, inqanaba le-tyramine egazini lakho linokuba phezulu kakhulu. Oku kunokubangela ukunyuka okukhawulezileyo nokuqatha koxinzelelo lwegazi . Oku kubizwa ngokuba yi-"Tyramine Pressor Response." Kwiimeko ezingaqhelekanga, olu xinzelelo lwegazi luphezulu lunokubangela ukopha ebuchotsheni (ukubola kwegazi ebuchosheni) kwanokufa.
Zeziphi ukutya ekufuneka uziphephe xa usebenzisa ii-MAOIs?
Apha ngezantsi kukho uluhlu lokutya ekufuneka kuphetshwe ngumntu othatha eli yeza, ngenxa yamanqanaba aphezulu e-tyramine.
| Uhlobo lokutya | Inkcazo kunye nemizekelo |
|---|---|
| Itshizi ekhulileyo | Iitshizi ezifana neCheddar, iSwiss, kunye neParmesan (iitshizi ezintsha ezifana neCottage cheese kunye neMozzarella azinabungozi kangako). |
| Isosi yesoyi | Zonke iimveliso ezenziwe ngesoya. |
| Inyama/intlanzi ebilisiwe okanye egciniweyo | Iisoseji, isalami, intlanzi eyomisiweyo, nezinye izinto. |
| Isibindi | Nangona isibindi esitsha singenayo i-tyramine, amanqanaba e-tyramine anokunyuka kuba siwohloka ngokukhawuleza. |
| Isiqhamo esivuthiweyo kakhulu | Xa iziqhamo ezifana neebhanana, iiavokhado, kunye namakhiwane zivuthiwe ngokupheleleyo. |
| Ibhiya ebilisiweyo | Ingakumbi ibhiya yetap. |
Eyona nto ibalulekileyo: Njengoko ukutya kuguga, amanqanaba e-tyramine ayanda. Ngoko ke, umntu othatha eli yeza kufuneka aphephe ukutya okuseleyo aze atye ukutya okusandul’ ukuphekwa .
3. Isifo Sokuyeka Ukuxinezeleka
Le meko inokwenzeka ukuba uyeka ukuthatha eli yeza ngequbuliso emva kokulithatha kangangeeveki ezingaphezu kwezi-6. Iimpawu ezinje ngomkhuhlane, iintlungu zomzimba, intloko ebuhlungu, isiyezi, ukungalali, kunye nokungazinzi zinokubakho. Ngoko ke, ungaze uyeke ukulithatha eli yeza ngaphandle kokubonisana nogqirha wakho . Ukuba uyeka ukulithatha, kufuneka ukwenze oko kancinci kancinci kangangeeveki ezininzi kwaye kuphela phantsi kweliso likagqirha wakho.
4. Iingcinga zokuzibulala
Kukho umngcipheko omncinci wokwanda kweengcinga zokuzibulala xa abantu abaselula abangaphantsi kweminyaka engama-25 ubudala beqala ukuthatha eli yeza. Ukuba wena okanye umntwana wakho ninezi ngcinga, thetha nogqirha oninike iyeza ngoko nangoko.
Ufanele uye nini kugqirha?
Ukuba usebenzisa i-MAOI, kufuneka ubonane nogqirha wakho rhoqo ukuze ajonge ukuba amayeza ayasebenza na kwaye ukuba kukho naziphi na iingxaki. Ukongeza, thetha nogqirha wakho ngezi zinto.
- Ukuba ufumana iziphumo ebezingalindelekanga ongenakukwazi ukuzinyamezela.
- Ukuba iimpawu zakho aziphucuki, okanye ukuba ziya zisiba mandundu.
- Ukuba uziva ngathi kufuneka uyeke ukusebenzisa iyeza.
Umyalezo Wokuya Ekhaya
- Ii-MAOI ziluhlobo oludala olunamandla kakhulu noluyingozi lwemithi yokudakumba engasetyenziswa rhoqo namhlanje.
- Ukuba usela eli yeza, ulawulo lokutya luyimfuneko . Ukutya okune-tyramine eninzi kufuneka kuphetshwe ngokupheleleyo.
- Kubaluleke kakhulu ukwazisa ugqirha wakho malunga neminye imithi oyithathayo, kungenjalo unokufumana isifo se-serotonin esiyingozi.
- Musa ukuqala okanye ukuyeka ukusebenzisa la mayeza ngaphandle kwengcebiso kagqirha nangasiphi na isizathu.
- Ukuba ubonakalisa iimpawu ezinzulu ze-serotonin syndrome okanye iingcinga zokuzibulala, yiya kwigumbi longxamiseko esibhedlele (ETU) ngokukhawuleza.
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