Ukudakumba akuyonto nje yokuziva ulusizi, yimeko yezonyango efuna unyango. Ngamanye amaxesha, nokuba sele kusetyenziswe amayeza ahlukeneyo okudakumba, ukudakumba kwabanye abantu akuphucuki. Olu hlobo lwesimo silubiza ngokuba kukudakumba okunganyangekiyo. Namhlanje, sithetha ngendlela yonyango yanamhlanje enokunceda abantu abanjalo kunye nabo banengxaki yokudakumba okukhulu abaneengcinga zokuzibulala.
Yintoni iSpravato? Isebenza njani?
I-Spravato sisitshizi sempumlo esiqulethe iyeza i- esketamine . Lunyango olwamkelwe yi-US FDA ngo-2019.
Mhlawumbi sele ulivile igama elithi ketamine ngaphambili. I-Ketamine liyeza elinikwa ngemithambo yegazi (IV) njengeyeza lokuphelisa iintlungu kunye nelokuthomalalisa iintlungu ezibhedlele. Ikwasetyenziswa nakwiikliniki zezilwanyana. Kusenokwenzeka ukuba ukhe waliva eli gama kuba abanye abantu balisebenzisa kakubi ukuze bafumane utywala obuninzi baze babe namava okubona izinto ezingekhoyo.
I-Spravato luhlobo olukhethekileyo lwe-ketamine. Ngamafutshane, eli yeza lisebenza kwii-receptors ezisebuchotsheni bethu ezibizwa ngokuba yi -N-methyl D-aspartate (NMDA) receptors . Ngale ndlela, inokunciphisa iimpawu zokudakumba ngokutshintsha iikhemikhali ezibandakanyekayo kwimo yethu.
Ufumanise njani ukuba eli yeza lisebenza kangakanani?
Kuye kwenziwa izifundo ezine zeklinikhi ukuvavanya ukhuseleko kunye nokusebenza kakuhle kweSpravato. Ezi zifundo ziquka abantu abadala abaneminyaka eli-18 ukuya kwengama-64 ubudala.
Basebenzise inkqubo ekhethekileyo yokufumana amanqaku ukulinganisa ubukhali bokudakumba kunye nokuphuculwa kweempawu. Ibizwa ngokuba yiMontgomery-Asberg Depression Rating Scale (MADRS) . Yimibuzo yemibuzo eli-10. Ibuza ngezinto ezifana neemvakalelo, iimvakalelo zokuba netyala, iindlela zokulala, kunye neengcinga zokuzibulala. Amanqaku aqala ku-0 ukuya kuma-60, kunye namanqaku aphezulu abonisa ukudakumba okukhulu . Emva konyango, okukhona amanqaku e-MADRS engalunganga, kokukhona amanqaku ehla, nto leyo ebonisa ukuphucuka okungakumbi kweempawu.
Zithini iziphumo zezi zifundo?
Kubalulekile: Ezi ziziphumo ezivela kwizifundo. Iziphumo zakho zinokwahluka. Thetha nogqirha wakho ngale nto.
| Iziphumo zoxinzelelo oluxhathisa unyango | |
|---|---|
| Udidi lonyango | Ukwehla kwamanqaku e-MADRS emva kweeveki ezi-4 |
| I-Spravato (56mg okanye 84mg) kabini ngeveki + esinye isidakamizwa sokuthomalalisa uxinezeleko | Ngamanqaku amalunga nama-20 |
| I-Placebo + esinye isifo sokudakumba | Ngamanqaku amalunga ne-16 |
Ezi ziphumo zibonisa ukuba abantu abasebenzisa iSpravato baye bancipha kakhulu kwiimpawu zokudakumba. Ezi zifundo zikwafumanise ukuba abo baqhubeka besebenzisa iSpravato baye baphinda babonakale bengenazo iimpawu.
| Iziphumo zokudakumba okukhulu kunye neengcinga zokuzibulala | |
|---|---|
| Udidi lonyango | Ukwehla kwamanqaku eMADRS emva kweeyure ezingama-24 |
| I-Spravato (56mg okanye 84mg) kabini ngeveki + esinye isidakamizwa sokuthomalalisa uxinezeleko | Ngamanqaku amalunga ne-16 |
| I-Placebo + esinye isifo sokudakumba | Malunga namanqaku ali-12 |
Okukhethekileyo ngale nto kukuba iSpravato ibonisa ukwehla okukhulu kweempawu kwisithuba nje seeyure ezingama-24 emva kokuyisebenzisa . Amayeza okudakumba aqhelekileyo athatha iiveki ezininzi ukubonisa iziphumo. Ke ngoko, oku kunokuba yinto ebalulekileyo kakhulu kwimeko kaxakeka.
Ngaba iSpravato ingadibana namanye amayeza?
Ewe, kufuneka ulumke ngamanye amayeza xa usebenzisa iSpravato.
- Amayeza oxinzelelo lwegazi: I-Spravato inokunyusa uxinzelelo lwegazi okwethutyana. Le ngozi iyanda ukuba uthatha olunye uhlobo lwe-antidepressant, njenge -monoamine oxidase inhibitor (MAOI) , okanye izinto ezikhuthaza iingxaki zokunika ingqalelo. Ke ngoko, ukuba uthatha la mayeza, kufuneka uhlolwe uxinzelelo lwegazi rhoqo.
- Amayeza abangela ukozela kunye nesiyezi: I-Spravato inokubangela ukozela kunye nesiyezi. Ezi ziphumo bezingalindelekanga zingenziwa zibe zimbi ngakumbi ukuba usebenzisa amayeza acinezela inkqubo yemithambo-luvo ephakathi, njenge- benzodiazepines (umz., i-alprazolam, i-clonazepam), ii-opioids (iipilisi zokunciphisa iintlungu), kunye notywala .
Ukuba awuqinisekanga ukuba ufanele uwasebenzise la mayeza, ungakhathazeki. Xelela ugqirha wakho ngawo onke amayeza owasebenzisayo . Nguye oza kugqiba ukuba iSpravato ikulungele na. Soloko unxibelelana nogqirha wakho ngaphambi kokuba uqalise naliphi na iyeza elitsha okanye ivithamini.
Ndingalufumana njani unyango lweSpravato?
Eli asiloyeza onokulithenga kwikhemesti uze ulithathe uye nalo ekhaya ukuze ulisebenzise.
Ngenxa yeziphumo ebezingalindelekanga kunye nomngcipheko wokusetyenziswa gwenxa kweSpravato, olu nyango lunokunikwa kuphela kumaziko onyango aqinisekisiweyo . La maziko kufuneka abhaliswe phantsi kwenkqubo ekhethekileyo ebizwa ngokuba yiSpravato REMS (Risk Evaluation and Mitigation Strategy).
1. Thetha nogqirha wakho: Ukuba unomdla kolu nyango, thetha nogqirha wosapho lwakho okanye ingcali yezifo zengqondo.
2. Ukudluliselwa: Ukuba ugqirha wakho ucinga ukuba iSpravato ikulungele, uza kukuthumela kwiziko lonyango eliqinisekisiweyo.
3. Ukubonisana: Emva koko uza kunikwa ingcebiso kwiziko lonyango. Apho, oogqirha baza kuhlola imeko yakho baze bagqibe kwelokuba ingaba oku kulungile na kuwe.
4. Ukuqala unyango: Ukuba yonke into ilungile, unyango lungaqala kutyelelo lwakho lwesibini.
Uyisebenzisa njani iSpravato?
Oku kuthathwa kanye okanye kabini ngeveki, kwiziko eliqinisekisiweyo, phantsi kweliso labasebenzi bezonyango .
- Idosi kunye nokusetyenziswa kwayo: Ugqirha wakho uza kugqiba idosi oyifunayo. Baza kukufundisa nendlela yokusebenzisa i-nasal spray.
- Ukutya namanzi: Ekubeni amayeza enokubangela isicaphucaphu nokuhlanza, kuyacetyiswa ukuba ungatyi iiyure ezi-2 ngaphambi konyango kwaye usele amanzi imizuzu engama-30 ngaphambi kokuba utye .
- Ixesha lokujonga:Emva kokuthatha iSpravato, ugqirha wakho uza kukujonga ubuncinane iiyure ezi-2 ukujonga utshintsho kuxinzelelo lwakho lwegazi kunye nezinye iziphumo ebezingalindelekanga.
- Ukuqhuba: Eli yeza linokukuchaphazela ukugxininisa kwakho kunye nokukwazi kwakho ukwenza izigqibo ngosuku lonyango. Ngoko ke, kufuneka ulungiselele ukuba umntu akuqhubele ekhaya esuka kwiziko lonyango . Kungcono ukuqhuba okanye ukwenza eminye imisebenzi efuna ukugxininisa ngosuku olulandelayo emva kokuba ulele kamnandi ebusuku.
Zithini iziphumo ebezingalindelekanga kwaye zingaphetshwa njani?
I-Spravato inokuba nemiphumo emibi kakhulu, yiyo loo nto inikwa kuphela phantsi kweliso likagqirha.
- Ukozela nokudideka: Ukozela kakhulu, isiyezi, ukuquleka, kunye nokuqhekeka kungenzeka.
- Ubunzima bokuphefumla: Ukuphefumla kusenokucotha okanye kube nzulu. Oku kuyinyani ngakumbi ukuba unezinye iingxaki zokuphefumla okanye uthatha amanye amayeza acothisa ukuphefumla kwakho.
- Uxinzelelo lwegazi olunyukileyo: Uxinzelelo lwegazi lunokunyuka okwethutyana malunga neeyure ezi-4 emva kokusela iyeza. Ukuba ufumana iintlungu esifubeni, ubunzima bokuphefumla, intloko ebuhlungu kakhulu, utshintsho lombono, okanye ukuxhuzula , xelela ugqirha wakho ngoko nangoko .
- Ukwanda kweengcinga zokuzibulala: Njengakwezinye iziyobisi zokudakumba, kukho umngcipheko omncinci wokuba abanye abantu banokuba neengcinga okanye izenzo zokuzibulala ezandileyo ngexesha lokuqala lokuthatha iSpravato. Xelela ugqirha wakho ngoko nangoko ukuba kukho naluphi na utshintsho olutsha okanye olunzima kwindlela oziphatha ngayo okanye kwiingcinga zakho.
- Umngcipheko wokulutha: Kukho umngcipheko wokulutha kweli yeza. Ke ngoko, kubalulekile ukulisebenzisa kuphela phantsi kwengcebiso kagqirha kunye nomlinganiselo omiselweyo. Ukuba ukhe waluthanda utywala, iziyobisi, okanye amanye amayeza ngaphambili, xelela ugqirha wakho ngalo mbandela.
- Iingxaki zenkqubo yomchamo: Abanye abantu baye baxela utshintsho okanye ubunzima bokuchama. Ukuba oku kuyenzeka, yazisa ugqirha wakho.
- Oomama abakhulelweyo nabancancisayo: I-Spravato ayikhuthazwa ukuba isetyenziswe ngexesha lokukhulelwa okanye lokuncancisa, kuba inokuchaphazela umntwana.
- I-Spravato (esketamine) lunyango oluthile kubantu abanengxaki yokudakumba okukhulu kunye neengcinga zokuzibulala abangakhange baphendule kwiindlela eziqhelekileyo zokudakumba.
- Eli asiloyeza elinokuthengwa kwikhemesti lize lisetyenziswe ekhaya. Linikwa kuphela kumaziko onyango aqinisekisiweyo, phantsi kweliso lezonyango.
- Ufanele ukuphephe ukuqhuba okanye ukwenza nantoni na efuna ingqalelo ngomhla wonyango. Usenokufuna omnye umntu ukuba akuncede ufike ekhaya.
- Iziphumo ebezingalindelekanga ezinzulu ezifana noxinzelelo lwegazi oluphezulu, ukozela kakhulu, kunye nokudideka zinokwenzeka. Xela ugqirha wakho naziphi na iimpawu ezingaqhelekanga ngoko nangoko.
- Xelela ugqirha wakho ngazo zonke iziyobisi ozisebenzisayo, ingakumbi amayeza ezinye izifo zengqondo kunye neepilisi zokuthomalalisa iintlungu.
- Nguwe nogqirha wakho kuphela enifanele nigqibe ukuba olu nyango lukulungele na.
Kwimeko kaxakeka, fowunela iSuwa Saria Ambulance Service ngo-1990 , okanye ufowunele i-hotline yezempilo yengqondo ngo-1926. Okanye uye kwisibhedlele esikufutshane neYunithi yoNyango oluNgxamisekileyo (ETU) .
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