Ingaba amayeza owasebenzisayo ayingozi? Masifunde ngeSerotonin Syndrome?

Namhlanje siza kuthetha ngemeko enzima kancinci, kodwa enokulawulwa lula ukuba uyazi. Usenokuba usela amayeza okudakumba okanye enye imeko. Ngamanye amaxesha la mayeza anokubangela utshintsho emizimbeni yethu aze abangele iingxaki esingenakuzicinga. Enye yezi meko yi-serotonin syndrome.

Yintoni iSerotonin Syndrome?

Ngamafutshane, iSerotonin Syndrome sisiphumo seziyobisi esinokuba yingozi ebomini ngamanye amaxesha, esenzeka xa kukho ikhemikhali eninzi ebizwa ngokuba yi-serotonin emzimbeni wakho.

Cinga ngayo, i-serotonin sisithunywa sekhemikhali esibaluleke kakhulu esiveliswa ziiseli zemithambo-luvo kwingqondo yethu nakwamanye amalungu omzimba. Ngokuchanekileyo, sisithunywa esithwala imiyalezo phakathi kweeseli zemithambo-luvo. Oku sikubiza ngokuba yi-neurotransmitter . Le serotonin ichaphazela izinto ezininzi, ezifana neemvakalelo zethu, ukulala, kunye nomdla wokutya.

Uninzi lwabantu lungathatha amayeza achaphazela i-serotonin ngokukhuselekileyo (i-serotonergic) kwiidosi ezicetyiswayo, njengoko kumiselwe ngugqirha wabo. Nangona kunjalo, i-serotonin syndrome inokwenzeka kakhulu xa uqala amayeza amatsha okanye unyusa idosi yamayeza osele uwasebenzisa, ingakumbi ukuba amayeza anyusa amanqanaba akho e-serotonin. Ukuba umzimba wakho utshintsha indlela osebenzisa ngayo i-serotonin, okanye ukuba awukwazi ukumelana namanqanaba aphezulu e-serotonin, unokuba neempawu ze-serotonin syndrome.

Le meko ingaqala kwiimpawu ezibuthathaka ezifana norhudo kunye nesicaphucaphu ukuya kwiimpawu ezinzima ezifana nomkhuhlane ophezulu kunye nokuxhuzula. Kwezinye iimeko, i-serous serotonin syndrome inokuba yingozi ebomini ukuba ayiqatshelwa kwaye inyangwe ngokukhawuleza.

Oogqirha baqala ukufumanisa i-serotonin syndrome ngeminyaka yoo-1960, emva kokuba amayeza okuqala okudakumba evunyiwe. Namhlanje, njengoko amayeza amaninzi afumaneka achaphazela i-serotonin, iimeko ze-serotonin syndrome zixelwa rhoqo.

Ngubani onokuphuhlisa oku?

Enyanisweni, nabani na angayihlakulela le nto, nokuba uneminyaka emingaphi. Ukuba usebenzisa amayeza kagqirha, amayeza athengiswa ngaphandle kwemvume kagqirha, izongezo zemifuno okanye zokutya, okanye iziyobisi ezingekho mthethweni ezichaphazela amanqanaba akho e-serotonin, usengozini yokufumana i-serotonin syndrome.

Ziziphi iimpawu eziqhelekileyo zoku?

Iimpawu kunye nobunzima be-serotonin syndrome zinokwahluka kumntu nomntu. Zinokuba buthathaka, zibe phakathi, zibe nzima, kwaye zide zibulale.

Ukuba usela amayeza achaphazela i-serotonin kwaye unezinye zezi mpawu, fowunela ugqirha wakho ngoko nangoko okanye uye kwigumbi likaxakeka.

Iimpawu ezincinci

• Ndiziva ndinexhala kancinci kwaye ndingakhululekanga.
• Ukuziva unesicaphucaphu nokuhlanza.
• Ukudumba kwesisu (urhudo).
• Iimbombo ezimnyama emehlweni ziba nkulu (iimbombo ezivulekileyo).
• Ukuziva ngathi amalungu akho ayathuthumela (Ungcangcazela).

Iimpawu eziphakathi

• Ndiziva ndingaphumli kwaye ndiphazamisekile.
• Ukushukuma kwemisipha, ukushwabana kwemisipha ngokungazi, ukuqaqamba kwemisipha, ukuqina kwemisipha.
• Ukubila kakhulu, ukungcangcazela ngenxa yokubanda.
• Amehlo ahamba ngendlela engaqhelekanga ukusuka kwelinye icala ukuya kwelinye.

Iimpawu eziqatha

• Ukudideka okukhulu, ngokungathi ingqondo iyaphazamiseka, umntu uyalibala ukuba ukuphi kwaye lixesha lini (Ukudideka, ukudideka, ukuphazamiseka kwengqondo).
• Isantya sentliziyo sinyuka kakhulu (isantya sentliziyo esikhawulezayo).
• Igazi elonyukayo.
• Ubushushu bomzimba obuphezulu bungaphezulu kwama-38.5 degrees Celsius (101.3 degrees Fahrenheit).
• Kuza kubakho ukuxhuzula.
• Ukubetha kwentliziyo kuba yinto engaqhelekanga.
• Ndilahlekelwa zingqondo ndize ndiwe.

Iimpawu zibonakala ngokukhawuleza kangakanani?

Ezi mpawu zihlala ziqala ukubonakala kwiiyure ezimbalwa , nokuba emva kokuqala iyeza elitsha elichaphazela amanqanaba e-serotonin okanye emva kokunyusa umthamo weyeza olisebenzisayo ngoku. Phantse wonke umntu ufumana iimpawu kwiiyure ezingama-24 emva kokuthatha iyeza okanye imveliso echaphazela i-serotonin.

Kutheni oku kusenzeka? Zithini izizathu?

Eyona nto ibangela i-serotonin syndrome kukunyuka kwamanqanaba e-serotonin emzimbeni wakho. Oku kunokwenzeka kwiimeko ezilandelayo:

• Xa usebenzisa amayeza angaphezu kwelinye , oko kuchaphazela amanqanaba e-serotonin.
• Xa uqala iyeza elitsha elinyusa i-serotonin, okanye xa unyusa umthamo weyeza olisebenzisayo ngoku.
• Ukuba usela amayeza amaninzi anxulumene ne-serotonin, mhlawumbi ngengozi okanye ngabom.
• Xa usebenzisa iziyobisi ezithile ezingekho mthethweni, iimveliso zezityalo , okanye iziyobisi ezithengiswa ngaphandle kwemvume kagqirha ezichaphazela amanqanaba e-serotonin.

Ngawaphi amayeza nezinye izinto ezichaphazela amanqanaba e-serotonin?

Ngoku makhe sibone ukuba zeziphi iintlobo zamayeza ezinokuchaphazela amanqanaba e-serotonin kwaye zibangele i-serotonin syndrome.

Amayeza okudakumba

Phakathi kwezi, amayeza okudakumba zezona zibalulekileyo. La ngamayeza achaphazela kakhulu amanqanaba e-serotonin. Le meko idla ngokuvela xa la mayeza okudakumba esetyenziswa kunye namanye amayeza achaphazela i-serotonin, njengee-triptans ze-migraines okanye ii-opioids zokunciphisa iintlungu.

Nazi ezinye iindidi zemithi yokudakumba kunye nemizekelo:

• `Ii-Selective serotonin reuptake inhibitors (SSRIs): Eli qela liquka iziyobisi ezifana ne-`fluoxetine (Prozac®), `citalopram (Celexa®), `sertraline (Zoloft®), `paroxetine (Paxil®)` kunye ne-`escitalopram (Lexapro®).` Ezi zezona zisetyenziswa kakhulu kwaye ke ngoko zezona zinxulunyaniswa kakhulu ne-serotonin syndrome.
• Ii-Serotonin-norepinephrine reuptake inhibitors (ii-SNRI): Imizekelo ibandakanya i-duloxetine (i-Cymbalta®), i-venlafaxine (i-Effexor®), i-desvenlafaxine (i-Pristiq), i-levomilnacipran (i-Fetzima), kunye ne-milnacipran (i-Savella).
• `Ii-Tricyclic antidepressants`: Eli qela liquka iziyobisi ezifana ne-`amitriptyline (Elavil®)`, `clomipramine (Anafranil®)`, kunye ne-`nortriptyline (Pamelor®).`
• `Ii-Monoamine oxidase inhibitors (ii-MAOI): Iziyobisi ezifana ne-`phenelzine (i-Nardil®)`, `selegiline (i-Emsam®)` kunye ne-`tranylcypromine (i-Parnate®)` zikule candelo.
• Iimodulators zeSerotonin: ezifana ne-nefazodone kunye ne-trazodone (Desyrel®).
• Umzekelo woku yi -`Norepinephrine reuptake inhibitor`: `bupropion (Wellbutrin®).`

Amanye Amayeza

Ukongeza kwii-antidepressants, kukho nezinye ii-medication ezichaphazela amanqanaba e-serotonin emzimbeni. Umngcipheko uphezulu ngakumbi xa ezi medication zidityaniswe nezinye ii-medication ezichaphazela ne-serotonin. La mayeza asetyenziselwa:

• Kwiintlungu eziqatha: Iipilisi zokubulala iintlungu ezivela kudidi lwe-opioid, ezifana ne-tramadol (Ultram®), i-meperidine (Demerol®), i-tapentadol (Nucynta®), i-hydrocodone (Hysingla ER®), i-oxycodone (Oxycontin®), i-fentanyl (Actiq®), kunye ne-methadone.
• Ukukhwehlela: Amanye amayeza okukhwehlela nawomkhuhlane athengiswa ngaphandle kwemvume kagqirha (OTC), anjenge-dextromethorphan, anokuchaphazela amanqanaba e-serotonin.
• Kwintloko ebuhlungu ye-migraine: IiTriptans ziquka i-almotriptan (Axert®), i-eletriptan (Relpax®), kunye ne-sumatriptan (Imitrex®).
• Kwi-HIV/AIDS: `ritonavir (Norvir®)`.
• Ii-antibiotics: i-linezolid (iZyvox®).
• Amayeza okunyanga isicaphucaphu nokuhlanza: anjenge-`metoclopramide (Reglan®)`, `granisetron (Sustol®)`, `ondansetron (Zofran®)`.
• Isizinzisi seemvakalelo: i-lithium (iLithobid®).

Ezinye iimveliso

Ukongeza kumayeza, ezinye izityalo zesintu, izongezo zokutya, kunye neziyobisi ezingekho mthethweni nazo zinokuchaphazela amanqanaba e-serotonin kwaye zibangele le meko.

• Izongezo zezityalo: Ezi zingabandakanya izinto ezifana ne-ginseng, i-St. John's wort, i-Syrian rue, kunye ne-nutmeg.
• Iziyobisi ezingekho mthethweni: Izinto ezifana ne-ecstasy, i-LSD, i-cocaine, i-amphetamines, kunye ne-methamphetamines.
• Izongezo zokutya:I-Tryptophan.

Iingcali zonyango zisafunda lukhulu nge-serotonin syndrome. Ukuba unemibuzo malunga namayeza owasebenzisayo kunye nokuba ayayichaphazela na i-serotonin, thetha nogqirha wakho okanye nomntu okwikhemesti apho ufumana khona amayeza akho.

Oogqirha bayibona njani le nto?

Ngoku makhe sibone ukuba oogqirha bayixilonga njani le nto. Akukho vavanyo lucacileyo lokuqinisekisa i-serotonin syndrome. Ugqirha wakho uya kuyixilonga ngokukuxilonga, akubuze ngeempawu zakho, aze afunde ngamayeza owasebenzisayo achaphazela amanqanaba akho e-serotonin.

Ungamnceda ugqirha wakho ngokucacisa yonke into oyithathayo (amayeza kagqirha, amayeza athengiswa ngaphandle kwemvume kagqirha, izongezo, amayeza esintu, kwaneziyobisi ezingekho mthethweni). (Thetha inyani, ungoyiki. Ugqirha ukho ukukunceda, akakugwebi.)

Ugqirha wakho angenza iimvavanyo ezifana nezi:

• Uvavanyo lwegazi nomchamo ukujonga amanqanaba amayeza owasebenzisayo.
• Uvavanyo ukuze kubonwe ukuba amanye amalungu akho omzimba asebenza kakuhle na.
• Uvavanyo lokujonga ukuba kukho na usulelo emzimbeni, mhlawumbi nombhobho womqolo.
• I-X-ray yesifuba okanye i-CT scan ingenziwa ukuqinisekisa ukuba akukho ezinye iimeko (ezineempawu ezifanayo) okanye ukujonga ezinye iingxaki.

Iphathwa njani le nto?

Unyango olufumanayo luya kuxhomekeka ekubeni iimpawu zakho zinzima kangakanani.

• Iimpawu ezincinci: Ukuba iimpawu azincinci, ukuyeka amayeza okanye ukutshintsha umthamo kudla ngokusombulula iimpawu kwiiyure ezingama-24 ukuya kuma-72 . Ukuba iimpawu azipheli ngokukhawuleza, amayeza okuthintela i-serotonin anjenge-cyproheptadine (Periactin®) anokunikwa.
• Iimpawu eziphakathi: Ukuba iimpawu zakho ziphakathi, uza kugcinwa esibhedlele ubuncinane iiyure ezingama-24 ukuze ubone ukuba iimpawu zakho ziyaphucuka na ngonyango.
• Iimpawu ezimandundu: Ukuba iimpawu zimandundu kakhulu, uza kungeniswa kwiYunithi yoKhathalelo oluPhezulu (ICU) apho umzimba wakho kunye nemisebenzi yamalungu omzimba wakho iya kuhlolwa ngokusondeleyo.

Ngokuxhomekeke kwiimpawu, unyango olulandelayo lunokunikwa:

• Iziyobisi ezithomalalisayo ezifana ne-benzodiazepine zinokunciphisa iimpawu ezifana nokushukuma, ukuqina kwemisipha, kunye nokuxhuzula.
• I-Saline `(IV fluids)` inikwa ukunciphisa ukugcinwa kolwelo kunye nomkhuhlane, kwaye i-oksijini inikwa nge-`(mask)` ebusweni ukuphucula amanqanaba eoksijini egazini.
• Amayeza okulawula isantya sentliziyo kunye noxinzelelo lwegazi.
• Ukunciphisa umkhuhlane ophezulu kakhulu (41.1 degrees Celsius / 106 degrees Fahrenheit), kufakwa ityhubhu yokuphefumla xa kukho ubunzima bokuphefumla, kunikwe ithomalaliso, kwaye kunikwe iziphumlisi zemisipha.
• Ukuba ezinye iindlela zonyango aziniki ncedo ngokukhawuleza, kuya kunikwa iyeza elithintela i-serotonin elibizwa ngokuba yi-cyproheptadine.

Ukuba i-serotonin syndrome yakho ibangelwe sisifo sokudakumba, kungathatha iiveki ezininzi ukuba iyeza liphume ngokupheleleyo emzimbeni wakho kwaye iimpawu zakho ziphele ngokupheleleyo.

Okubaluleke kakhulu: Musa ukuyeka ukuthatha naliphi na iyeza okanye utshintshe umthamo ngaphandle kokuthetha nogqirha wakho. Nangona kunjalo, ukuba uneempawu eziqatha okanye ukuba iimpawu zakho ziya zisiba mandundu, funa uncedo lwezonyango olungxamisekileyo ngokukhawuleza. I-Serotonin syndrome inokuba yingozi ebomini.

Zeziphi iingxaki ezinokwenzeka?

Ukuba ayinyangwa, i-serotonin syndrome inokukhokelela kwiingxaki ezifana nezi:

• Ukuxhuzula.
• Ubunzima bokuphefumla.
• Ukungasebenzi kakuhle kwezintso. Xa iimveliso zokuqhekeka kwezihlunu ziqokelelana egazini kwaye zihluzwa zizintso, kunokubangela umonakalo omkhulu kwizintso ukuba azinyangwa.
• Imeko ye-Coma.
• Nokufa kunokwenzeka.

Sisindiswa njani koku?

• Kubaluleke kakhulu ukuqaphela naliphi na iyeza olithathayo. Funda zonke izilumkiso ezikwiphakheji yamayeza okanye kwincwadana yolwazi eza nawo. Iya kukuxelela ukuba kukho umngcipheko we-serotonin syndrome.
• Musa ukuyeka amayeza ngaphandle kokuthetha nogqirha wakho.
• Gcina ugqirha ngamnye okunyangayo enolwazi malunga nawo onke amayeza owasebenzisayo (amayeza kagqirha, amayeza athengiswa ngaphandle kwemvume kagqirha, amachiza esintu, izongezo, kwaneziyobisi ezingekho mthethweni).
• Ukuba uthatha i-triptan xa uphathwa yi-migraines kunye ne-antidepressants (ingakumbi ii-SSRI okanye ii-SNRI), ugqirha wakho kufuneka akujonge ngokusondeleyo. Umngcipheko ucingelwa ukuba mncinane kakhulu, mhlawumbi awukho. Kodwa khumbula, unoxanduva: Ukuba ufumana naziphi na iimpawu ezikhankanyiweyo kweli nqaku, tsalela umnxeba ugqirha wakho ngoko nangoko.
• Ukulandela la manyathelo okhuseleko kuya kukunceda wena nogqirha wakho niqaphele iimpawu ze-serotonin syndrome kwangethuba. Ukufunyanwa kwangoko kunokunceda ukuthintela iimpawu eziqatha.

Yintoni esifanele siyilindele kule meko?

Ukuba ziqatshelwe kwaye zinyangwa ngokukhawuleza, iimpawu zabantu abaninzi ziya kuphela ngokupheleleyo kwiiyure ezingama-24 ukuya kuma-72.

Emva kokuchacha, ugqirha wakho unokuthi:

• Nciphisa idosi yamayeza abangele le meko ibe yeyona dosi iphantsi kakhulu nesebenzayo.
• Yeka ukunika amayeza amabini anedosi ephezulu achaphazela i-serotonin kunye.
• Tshintshela kwenye iyeza elingachaphazeli i-serotonin.

Ndifanele ndibize ugqirha wam nini?

• Ukuba uneempawu ze-serotonin syndrome (okanye iimpawu eziya ziba mandundu), tsalela umnxeba ugqirha wakho ngoko nangoko okanye uye kwigumbi likaxakeka. Lumka ngakumbi ukuba uqalise amayeza amatsha, wonyuse idosi yeyeza elikhoyo, okanye uthatha amayeza owaziyo ukuba achaphazela amanqanaba e-serotonin.
• Musa ukuyeka ukuthatha amayeza okanye ukutshintsha umthamo ngaphandle kokuthetha nogqirha wakho.
• Qiniseka ukuba bonke oogqirha bakho bayazi malunga nawo onke amayeza owasebenzisayo.
• Funda izilumkiso kunye neencwadana zolwazi eziza namayeza akho ngononophelo.
• Funda ngeempawu ze-serotonin syndrome. Qaphela ezi mpawu ukuba usela amayeza okudakumba.
• Ukuba unemibuzo malunga namayeza okanye iimpawu zakho, buza ugqirha wakho okanye ikhemisti.
• Ukuba ubona iimpawu, okanye ukuba iimpawu zakho ziya zisiba mandundu, ungalibali ukufowunela ugqirha wakho ngoko nangoko okanye uye kwigumbi likaxakeka.

Sithini isigidimi esifuna ukusithatha sibuyele ekhaya kweli bali?

• I-Serotonin Syndrome yimeko enokuba yingozi, kodwa inokunyangeka ukuba ilawulwa ngokufanelekileyo.
• Thetha ngokukhululekileyo nogqirha wakho malunga namayeza owasebenzisayo, ingakumbi ukuba uqala elinye okanye utshintsha idosi.
• Qaphela iimpawu. Ukuba unamathandabuzo , funa ingcebiso kagqirha ngaphandle kokuchitha ixesha.
• Khumbula, uyazi kakuhle impilo yakho, ngoko ke kubalulekile ukuba uqaphele naluphi na utshintsho.

Isifo seSerotonin , i-serotonin, amayeza okunciphisa uxinzelelo, iziphumo ebezingalindelekanga zamayeza, iikhemikhali zobuchopho, ii-neurotransmitters, iimpendulo zamayeza