Ngaba uzifumana ushukumisa umzimba wakho ngaphandle kokuzithandela? Masithethe ngeTardive Dyskinesia!

Ngaba ngamanye amaxesha uziva ngathi amalungu omzimba wakho, njengengalo okanye umlenze, okanye imbonakalo yobuso, ashukuma nje ngokungalawulekiyo? Okanye ngaba kukho umntu omaziyo oye waba nezi mpawu zingaqhelekanga emva kokusela amayeza athile? Ukuba ukhe weva ngento enjalo, imeko esiza kuthetha ngayo namhlanje, ebizwa ngokuba yiTardive Dyskinesia, iya kuba yinto ebalulekileyo kuwe. Nangona iligama elide, masiqonde nje ukuba yintoni.

Yintoni iTardive Dyskinesia?

Ngamafutshane, iTardive Dyskinesia (TD) sisifo semithambo-luvo, okanye ingqokelela yeempawu, apho izihlunu zomzimba wakho zihamba ngokungazikhetheliyo, ngaphandle kolawulo lwakho. Njengokushukuma kwesandla okanye imbonakalo yobuso itshintsha ngequbuliso.

Eyona nto ibangela le meko kukusetyenziswa ixesha elide kwamayeza athile okugula ngengqondo, ingakumbi amayeza esizukulwana sokuqala okulwa nesifo sengqondo (i-neuroleptics). Nangona kunjalo, la mayeza awanalo kuphela elinokubangela oku. Amanye amayeza nawo anokubangela oku.

Igama elithi "Tardive" lithetha "ukulibaziseka" okanye "ukulibaziseka." Igama elithi "Dyskinesia" lithetha ukunganyanzelekanga, oko kukuthi, iintshukumo zemisipha ezingalawulekiyo. Ngoko ke kule meko, ezi ntshukumo zinganyanzelekanga zivela emva kokuba uqale ukuthatha amayeza okwethutyana, ngamanye amaxesha iminyaka. Nangona kunjalo, ngamanye amaxesha le meko inokwenzeka nasemva kokuthabatha amayeza okwethutyana. Le meko inokwenzeka ngakumbi kubantu abangaphezu kweminyaka engama-65 ubudala, nokuba basebenzise amayeza okwethutyana.

Ixhaphake kangakanani le meko?

Abaphandi bathi ubuncinci ama-20% abantu abasebenzisa amayeza okubulala iingqondo esizukulwana sokuqala baba ne-tardive dyskinesia. Ukwanda kwesi sifo kwezinye iintlobo zamayeza akukafundwa, ngoko ke kunzima ukunika inani elichanekileyo.

Ziziphi iimpawu zeTardive Dyskinesia?

I-Tardive dyskinesia inokubangela iintshukumo kwiindawo ezinje ongenakukwazi ukuzilawula:

• Izihlunu ebusweni bakho
• Ulwimi
• Intamo
• Izihlunu zesiqu
• Izandla neenyawo

Iintshukumo zobuso ezizenzekelayo:

• Ukutshaya imilebe okanye ukumunca.
• Ukufinga okanye ukufinga ubuso ngaphandle kwesizathu.
• Ukukhupha ulwimi okanye ukucinezela ulwimi esidleleni.
• Iintshukumo zokuhlafuna.
• Izidlele ezifuthayo.
• Ukuqhwanyaza kwamehlo ngokukhawuleza / i-blepharospasm. Khawuthelekelele indlela ebekuya kuba nomsindo ngayo ukuba ubunokuqhubeka nokuqhwanyaza amehlo akho.

Ezinye iintshukumo ezingenziwanga ngabom:

• Ukushukuma kweminwe okuphindaphindwayo, njengokudlala ipiyano.
• Ukutyhala okanye ukushukumisa isinqe sakho.
• Ukuhamba ngenyawo njengedada.
• Ukungakwazi ukuhlala phantsi, ukuziva ungazinzi rhoqo (akathisia). Oku kungaba ngamava angathandekiyo.

Ezi mpawu zinokuba buthathaka kakhulu kwaye zingabonakali lula kwabanye abantu, kodwa kwabanye zinokuba qatha kangangokuba zinokuchaphazela imisebenzi yemihla ngemihla zide zingenzeki .

Oogqirha banokusebenzisa amagama anjengala ukuchaza ezi mpawu:

• I-Dystonia: Ukuxinana kwemisipha okungalawulekiyo.
• I-Myoclonus: Ukuxhuzula kwemisipha ngequbuliso nangokufutshane.
• I-Buccolingual stereotypy: Iintshukumo eziphindaphindayo ezibandakanya umlomo nolwimi.
• IiTics: Ukuxinana kwemisipha okuqhelekileyo, ingakumbi ebusweni.

Ziziphi izizathu zeTardive Dyskinesia?

Abaphandi abazi ukuba yintoni kanye kanye ebangela oku. Nangona kunjalo, ingcamango ephambili kukuba kusenokubangelwa kukusetyenziswa kweziyobisi ezibizwa ngokuba yi-"dopamine antagonists" ezithintela ii-receptors ze-neurotransmitter "dopamine" engqondweni. Oku kunokwenzeka nokuba uthatha la mayeza ixesha elifutshane okanye ixesha elide. Nangona kunjalo, umngcipheko uphezulu xa uwathatha ixesha elide. Ngamanye amaxesha, i-TD inokwenzeka emva kokuyeka la mayeza, ukutshintsha idosi, okanye nokunciphisa.

Khawucinge nje, xa usela iziyobisi zokuthintela i-dopamine receptor ixesha elide, ii-dopamine receptors ezisebuchotsheni (ingakumbi ezo zikwi-basal ganglia, inxalenye yengqondo enceda ukulawula intshukumo) ziba novakalelo olugqithisileyo. Kucingelwa ukuba olu hambo lungalawulekiyo lubangelwa yi-dopamine eninzi okanye ii-receptors ziba novakalelo olugqithisileyo.

Ukongeza kwi-dopamine, ezinye ii-neurotransmitter receptors, ezifana ne -serotonin, i-acetylcholine, kunye ne-GABA, nazo kucingelwa ukuba ziyabandakanyeka. Oku kusenokuba yimbangela yokuba i-TD ngamanye amaxesha ibangelwa ngamayeza angengawo awe-antipsychotics.

Ngawaphi amayeza abangela iTardive Dyskinesia?

I-Tardive dyskinesia inokubangelwa kukusetyenziswa kwamayeza alandelayo:

• Amayeza okulwa nesifo sengqondo / ii-neuroleptics: Ezi zezona zinto zibangela ingxaki.
• I-Metoclopramide okanye amanye amayeza okulwa nesicaphucaphu.
• Ezinye izinto ezibangela uxinezeleko .

Amaxesha amaninzi, la mayeza anokubangela i-TD:

• I-Lithium.
• Amayeza okuthintela ukuxhuzula.
• Ii-antihistamines, ingakumbi i-hydroxyzine.
• Amayeza okulwa nemalariya anikwa amayeza okunyanga imalariya.

Amayeza e-antipsychotic kunye ne-TD

Amayeza okulwa nesifo sengqondo (i-neuroleptics) asetyenziswa kakhulu ukunyanga izifo zengqondo ezifana ne-schizophrenia. La mayeza ngawona abangela isifo sentliziyo.

Kucingelwa ukuba amayeza okulwa neengqondo esizukulwana sokuqala ("aqhelekileyo") anomngcipheko ophezulu wokubangela i-TD kunee-antipsychotics zesizukulwana sesibini ("angaqhelekanga").

Eminye imizekelo ye-antipsychotics yesizukulwana sokuqala:

• I-Chlorpromazine `(Chlorpromazine)`
• I-Fluphenazine `(Fluphenazine)`
• IHaloperidol `(Haloperidol)`
• I-Perphenazine `(Perphenazine)`
• I-Prochlorperazine `(Prochlorperazine)`
• I-Thioridazine `(Thioridazine)`
• I-Trifluoperazine `(Trifluoperazine)`

I-Metoclopramide kunye ne-tardive dyskinesia

I-Metoclopramide liyeza elisetyenziselwa ukunyanga i-chronic acid reflux (GERD), uhlobo olubi lwe-gastritis. Ikwasetyenziselwa ukunyanga i-gastroparesis enxulumene nesifo seswekile.

Kukho unxibelelwano oluqinileyo phakathi kwe-metoclopramide kunye ne-TD. Izinto ezibangela umngcipheko wokuphuhlisa i-TD ngenxa yale mayeza ziquka:

• Ukuba neminyaka engama-65 okanye ngaphezulu.
• Ukuba ngumfazi.
• Ukuba nesifo seswekile.
• Ukuthatha i-metoclopramide kangangeeveki ezili-12 nangaphezulu.

Ii-Antidepressants kunye ne-TD

Amayeza okudakumba asetyenziselwa ukunyanga iimeko ezinje ngokudakumba, ixhala, kunye nesifo sokungakhathali. La mayeza anokubangela i-TD kubantu abaneminyaka engaphezu kwama-65 ubudala. Oku kungenxa yokuba ingqondo iyatshintsha ngokuhamba kweminyaka. Oku kudla ngokuba kuncinci kakhulu kune-TD ebangelwa ngamayeza okulwa nesifo sengqondo.

Ezi ziyobisi zilandelayo zokudakumba zinxulumene ne-`(TD)`:

• I-Trazodone (le yi-modulator ye-serotonin).
• I-Amitriptyline, i-clomipramine, kunye ne-doxepin (ezi zii-tricyclic antidepressants).
• I-Fluoxetine kunye ne-sertraline (ezi zii-SSRI).
• I-Phenelzine kunye ne-rasagiline (ezi zii-MAOIs).
• I-Selegiline (ekwayi-MAOI) inxulunyaniswe ne-TD xa ithathwa ne-levodopa.

I-Lithium kunye ne-TD

I-Lithium liyeza elisetyenziselwa ukunyanga isifo se-bipolar. Ikwanxulunyaniswa ne-TD. Nangona kunjalo, ukuba uthatha i-lithium kunye namayeza okulwa nesifo sengqondo, umngcipheko wakho wokuba ne-TD uphezulu kakhulu.

Amayeza okuthintela ukuxhuzula kunye ne-TD

Amayeza okulwa nokuxhuzula asetyenziselwa ukuthintela nokulawula ukuxhuzula. I-Carbamazepine kunye ne-lamotrigine zinxulunyaniswa ne-TD, kodwa azinakwenzeka ukuba zibangele i-TD. I-Phenytoin ikwanxulunyaniswa ne-TD.

Ii-Antihistamines kunye ne-TD

Ii-antihistamines zinceda kwiimpawu zokunganyamezelani. I-Hydroxyzine, ngakumbi, inxulunyaniswe ne-TD ukuba isetyenziswa ixesha elide.

Abantu abangaphezu kweminyaka engama-65 ubudala abakhe basebenzisa ii-phenothiazines (ii-antipsychotics eziqhelekileyo) banamathuba amaninzi okufumana i-TD xa bethatha i-hydroxyzine.

I-Antimalarials kunye ne-TD

Izinto zokulwa nemalariya ezifana ne-chloroquine kunye ne-amodiaquine zinxulumene ne-TD.

Ziziphi izinto ezibangela umngcipheko weTardive Dyskinesia?

Ezinye izinto zinokunyusa umngcipheko wakho wokuba ne-tardive dyskinesia. Ezinye zazo ziquka:

• Ubudala: Abantu abangaphezu kweminyaka engama-40 banamathuba amaninzi okufumana isifo sentliziyo (TD). Abantu abangaphezu kweminyaka engama-65 basengozini enkulu ngenxa yotshintsho oluqhubekayo kwinkqubo yemithambo-luvo.
• Isini: Abafazi banamathuba amaninzi okufumana isifo sentliziyo. Abafazi abasele beyekile ukuya exesheni abasebenzisa amayeza okulwa nesifo sengqondo malunga nonyaka basengozini ephezulu ngama-30% yokufumana isifo sentliziyo.
• Uhlanga: Ezinye izifundo zibonise ukuba abantu abamnyama baseMelika banamathuba amaninzi okufumana isifo sentliziyo kunabamhlophe. Kwakhona, abantu basePhilippines naseAsia abanamathuba amaninzi okufumana isifo sentliziyo kunabo baseCaucasus. (Kufuneka ezinye izifundo zasekuhlaleni ukuze kuchongwe indlela oku kusebenza ngayo eSri Lanka.)
• Isifo se-Bipolar: Abantu abanesifo se-bipolar banokuba novelwano ngakumbi kwi-TD kunabanye xa besebenzisa amayeza okulwa nesifo sengqondo.

Abaphandi okwangoku bafunda ngezinto zemfuza ezonyusa okanye ezinciphisa umngcipheko wokufumana i-TD.

Ziziphi iingxaki ezinokubakho zeTardive Dyskinesia?

Iintshukumo ezingalawulekiyo ezibangelwa yi-tardive dyskinesia zinokuba zimbi kakhulu. Zinokuchaphazela impilo-ntle yakho yentlalo neyeemvakalelo. Oku kunokuba nefuthe elikhulu kwimpilo yakho yengqondo. Kunokwenza kube nzima nokwenza imisebenzi yemihla ngemihla.

I-TD ayisoloko iyingozi. Nangona kunjalo,Amaxesha amaninzi, ukuba i-TD iba yingozi ize ichaphazele i-larynx (apho kukho khona iintambo zelizwi - i-laryngospasm) kunye ne-diaphragm (imisipha ekuncedayo ukuphefumla), inokubangela ubunzima bokuphefumla kwaye ibe yingozi ebomini.

Ifunyanwa njani iTardive Dyskinesia?

Ugqirha wakho uza kukubuza ngeempawu zakho, imbali yakho yezonyango, kunye nokusetyenziswa kwamayeza. Ugqirha wakho unokurhanela ukuba i-tardive dyskinesia (TD) ibangela i-tardive dyskinesia. Baza kwenza uvavanyo lomzimba kunye novavanyo lwe-neurological. Ungathunyelwa kwingcali, efana ne-neurologist, ingcali ye-movement disorder, okanye i-psychiatrist.

Oogqirha basebenzisa i-Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ukufumanisa i-tardive dyskinesia. Ngokutsho kwe-DSM-5 , ukuze kufunyaniswe ukuba une-tardive dyskinesia, iimpawu kufuneka zihlale ubuncinane inyanga enye emva kokuyeka amayeza. Ukuba uneminyaka engama-40 okanye ngaphantsi, kufuneka ukuba ubusebenzisa amayeza ubuncinane iinyanga ezintathu, okanye ukuba ungaphezulu kweminyaka engama-40, kufuneka ukuba ubusebenzisa amayeza inyanga enye.

Ugqirha wakho unokuyalela ezinye iimvavanyo ukuqinisekisa i-TD okanye ukuthintela ezinye iimeko ezineempawu ezifanayo, ezifana nesifo sikaHuntington. Ezi zinokubandakanya iimvavanyo zelebhu kunye novavanyo lomfanekiso, olufana ne-CT scan okanye i-MRI yobuchopho. Nangona kunjalo, i-TD idla ngokuba luxilongo lweklinikhi. Oku kuthetha ukuba oogqirha benza uxilongo ngokusekelwe kwimbali yezonyango enzulu kunye novavanyo lomzimba olupheleleyo, ngaphandle kovavanyo olongezelelweyo.

Ziziphi iindlela zonyango lweTardive Dyskinesia?

Izifundo malunga nolawulo lwe-tardive dyskinesia zibonise iziphumo ezahlukeneyo. Ezinye izifundo zibonisa ukuba iimpawu ziyaphucuka xa umthamo wamayeza okulwa nesifo sengqondo uncitshiswa okanye uyekwa. Ezinye zibonisa ukuba akukho mahluko.

Ugqirha wakho unokucebisa ukuba uyeke amayeza abangela isifo sakho sentliziyo, ukuba kunokwenzeka. Ngelishwa, oku akunakwenzeka rhoqo. Oku kungenxa yokuba ukuyeka amayeza kunokwenza imeko engaphantsi kolawulo lwamayeza ibe mandundu.

Ukuba ufumana i-TD ngelixa uthatha i-antipsychotic yesizukulwana sokuqala, ugqirha wakho unokukutshintshela kwi-antipsychotic yesizukulwana sesibini.

Ngaphandle kokuyeka okanye ukutshintsha amayeza okunyanga ingqondo, ubungqina obunamandla bonyango lwe-TD bufumaneka okwangoku kudidi lwamayeza abizwa ngokuba yi-VMAT inhibitors. I-Deutetrabenazine kunye ne-valbenazine ngoku zibonakalisiwe zikhuselekile kwaye zisebenza kakuhle. Ukuba une-TD ephakathi ukuya kweqatha echaphazela umgangatho wobomi bakho, ugqirha wakho unokucebisa la mayeza.

Ngaba i-Tardive Dyskinesia inokunyangeka? (Ngaba inokuguqulwa?)

Ngelishwa, uninzi lweemeko ze-tardive dyskinesia azihlali ixesha elide, oko kuthetha ukuba zihlala ixesha elide. Nangona amayeza enokunceda ukulawula iimpawu, awanakunyanga okanye aguqule imeko ngokupheleleyo.

Yintoni endimele ndiyilindele ukuba ndineTardive Dyskinesia?

I-Tardive dyskinesia ayibachaphazeli bonke abantu ngendlela efanayo. Iimpawu zinokuqala kwezincinci ukuya kwezinzima. Kwakhona, nangona unyango lunceda abanye abantu ukuba balawule iimpawu zabo, lusenokungabancedi abanye. Ugqirha wakho uza kusebenza nawe ukufumana isicwangciso sonyango esifanelekileyo. Banokukunika umbono olungileyo wento omawuyilindele.

Ngaba i-Tardive Dyskinesia inokuthintelwa?

I-Tardive dyskinesia yimeko enzima ukuyiqikelela. Ayinguye wonke umntu othatha amayeza athile oza kuba nayo.

Ukuba unezinto ezinokubangela ukuba ube sengozini enkulu yokuba nale meko, thetha nogqirha wakho. Usenokukwazi ukuthintela i-tardive dyskinesia ngokusebenzisa amayeza ahlukileyo. Ukunciphisa umngcipheko wakho wokuba ne-TD, ugqirha wakho uza kukunika idosi ephantsi kakhulu yeyeza le-antipsychotic ngexesha elifutshane kangangoko.

Ukuba usela amayeza aziwayo ukuba abangela i-TD, thetha nogqirha wakho malunga nokufumana uvavanyo oluqhelekileyo lweengxaki zokunyakaza. Ukufunyanwa kwangoko kweempawu ze-TD kunokunceda ukunciphisa ubukhali bazo. Kungcono ukuba nolu vavanyo kwiinyanga ezintathu ukuya kwezintandathu emva kokuqala amayeza anokubangela i-TD.

Ndingazinyamekela njani ukuba ndineTardive Dyskinesia?

Ugqirha wakho uza kusebenzisana nawe ukulungisa isicwangciso sakho sonyango njengoko kufuneka. Nazi ezinye iindlela onokuzithatha ukulawula i-TD:

• Yiba novavanyo lweempawu rhoqo nogqirha wakho rhoqo kwiinyanga ezintathu ukuya kwezintandathu.
• Gcina ingxelo yeempawu zakho. Ukuba ubonakalisa iimpawu ezintsha, yazisa ugqirha wakho.
• Ziqhelise ukuzinyamekela, kuquka nokwenza umthambo. Ukuzilolonga kunokunceda ekunciphiseni ezinye iimpawu zokushukuma.
• Thetha nogqirha wakho malunga nemisebenzi yakho yemihla ngemihla kunye nomgangatho wobomi bakho.
• Ukuba impilo yakho yengqondo neyentlalo iyachaphazeleka yi-TD, funa uncedo kumcebisi wezempilo yengqondo .

Ndingaya nini kwigumbi likaxakeka?

Ukuba unengxaki yokuphefumla ngenxa ye-tardive dyskinesia, fowunela u-911 (1990 eSri Lanka) ngoko nangoko okanye uye kwigumbi likaxakeka elikufutshane.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Tardive dyskinesia (TD) ichaphazela abantu ngeendlela ezahlukeneyo. Kwabanye, inokuba nefuthe elikhulu kumgangatho wobomi babo. Kodwa khumbula, ugqirha wakho uza kusebenza nawe ukujonga nokulawula i-TD yakho. Banokucebisa kwaye batshintshe isicwangciso sonyango ukuze sihambelane neemfuno zakho, kwaye bacebise amaqhinga okuzinyamekela anokunceda. Ungaze uyeke ukuthatha amayeza akho okanye utshintshe umthamo ngaphandle kwengcebiso kagqirha wakho. Thetha nogqirha wakho malunga nayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo.

I- Tardive dyskinesia, iintshukumo ezizenzekelayo, iziphumo ebezingalindelekanga zamayeza, ii-antipsychotics, ii-neuropathies, i-dopamine, ii-VMAT inhibitors