Ingabe udokotela wakho ukunike uhlobo lomuthi olubizwa ngokuthi i-MAOI? Noma uke wezwa ngalomuthi ndawana thize futhi unesifiso sokwazi ukuthi uyini ngempela? Ama-MAOI empeleni awuhlobo lomuthi onikezwa ukwelapha izimo zempilo yengqondo njengokucindezeleka. Kodwa-ke, odokotela abawancomi kaningi kulezi zinsuku. Kunezizathu eziningana eziqondile zalokhu. Ake sixoxe ngalokhu kusukela ekuqaleni, kalula, ngendlela ongayiqonda.
Uhlobo luni lomuthi oluyi-MAOI?
Kalula nje, ama-MAOI (i-Monoamine Oxidase Inhibitors) ayisigaba sokuqala semithi etholakale yokwelapha ukucindezeleka. Kodwa-ke, udinga ukuqaphela kakhulu ngalokho okudlayo lapho usebenzisa wona. Futhi, ngenxa yemiphumela emibi kanye nezinkinga ngeminye imithi, odokotela bavame ukuwancoma njengendlela yokugcina, lapho eminye imithi yokucindezeleka ingasebenzi.
Lokho kusho ukuthi, uma unikezwe imithi emisha efana ne-SSRIs futhi izimpawu zakho zingakathuthuki, udokotela wakho angase acabangele i-MAOI njengesinyathelo esilandelayo.
Yiziphi izinhlobo eziyinhloko zama-MAOI asetshenziswa emhlabeni?
Kunezinhlobo eziningana eziyinhloko zama-MAOI asetshenziswayo njengamanje. Ukuthi zonke lezi ziyatholakala yini ezweni lethu kungahluka, kodwa kuhle ukwazi la magama.
- I-Isocarboxazid (Marplan®)
- I-Phenelzine (i-Nardil®)
- I-Selegiline (Emsam®)
- I-Tranylcypromine (i-Parnate®)
Yiziphi izimo ezinqunyelwe imithi ye-MAOI?
Nakuba lo muthi unqunyelwe kakhulu ukucindezeleka, usetshenziselwa nezinye izimo zempilo yengqondo.
Ukusetshenziswa okuvunyelwe ngokusemthethweni
Lezi yizimo lapho iziphathimandla ezifanele zivumile ngokusemthethweni lo muthi njengofanele lezi zifo.
- Isifo Sokucindezeleka Okukhulu: Kokubili i-Isocarboxazid ne-Tranylcypromine kuyavunyelwa kulesi simo.
- Izifo ezingamelani nokwelashwa: I-Phenelzine isetshenziselwa ukwelapha ukucindezeleka, ukuphazamiseka kovalo, kanye nesifo sokukhathazeka komphakathi esingaphenduli kwezinye izindlela zokwelapha.
- Isifo SikaParkinson: I-Selegiline umuthi osetshenziselwa ukwelapha ukucindezeleka futhi isetshenziswa njengesithasiselo kweminye imithi yesifo sikaParkinson.
Ukusetshenziswa "okungafakwanga ilebula"
Ngezinye izikhathi, udokotela angase anikeze lo muthi ngokusekelwe olwazini lwakhe lwezokwelapha kanye nolwazi lwakhe ngesimo esingavunyelwe ngokusemthethweni. Lokhu kubizwa ngokuthi ukusetshenziswa "okungekho ku-label". Isibonelo:
- Umuthi obizwa ngokuthi i-tranylcypromine ngezinye izikhathi unikezwa ngenxa yokukhathazeka komphakathi okumelana nokwelashwa kanye nesifo sokwesaba.
- Kunezikhathi lapho umuthi iSelegiline unikezwa khona isifo sokuntuleka kokugxila (ADHD).
Lo muthi usebenza kanjani emzimbeni?
Lokhu kulula kakhulu ukukuqonda. Cabanga ukuthi ubuchopho bethu bunamakhemikhali alawula izinto ezifana nemizwa yethu, injabulo, kanye nokunaka. Sibiza lawa ma-neurotransmitter . Lawa afana nezithunywa ezincane ezithwala imiyalezo ngaphakathi kobuchopho.
Manje, umzimba wethu une-enzyme ebizwa ngokuthi "i-Monoamine Oxidase." Umsebenzi wale enzyme ukuphula nokususa lezo zithunywa (ama-neurotransmitter) ngemva kokusetshenziswa kwazo.
Umuntu onesifo sokucindezeleka angase abe namazinga aphansi alezi zithunywa ebuchosheni bakhe. Lokho okwenziwa umuthi we-MAOI ukumisa okwesikhashana (ukuvimbela) isenzo saleyo enzyme 'yokuhlanza'. Kwenzekani-ke?
Ama-neurotransmitter amaningana abalulekile ebuchosheni ahlala ebuchosheni isikhathi eside ngaphandle kokuwohloka, okusho ukuthi amazinga awo ayanda.
Ama-neurotransmitter ayinhloko akhuliswa yi-MAOIs yile:
- I-Serotonin: Ibaluleke kakhulu esimweni sengqondo, ebuthongweni, ekudlaleni nasekuziphatheni komphakathi.
- I-Norepinephrine: Ibalulekile ekuqapheni, ekugxileni, nasemsebenzini.
- I-Dopamine: Ihlobene nenjabulo, ukwaneliseka, kanye nokunaka.
- I-Tyramine: Lokhu futhi uhlobo lwe-neurotransmitter. Kodwa umsebenzi wayo oyinhloko ukusiza ukulawula umfutho wegazi. Lesi yisona sizathu esiyinhloko okudingeka uqaphele ngalokho okudlayo lapho uthatha i-MAOI. Sizoxoxa ngakho ngokuningiliziwe kamuva.
Uyini umehluko phakathi kwama-MAOI nama-SSRI?
Ama-SSRI (Selective Serotonin Reuptake Inhibitors) angolunye uhlobo lwemithi esetshenziselwa ukwelapha ukucindezeleka. Kungenzeka ukuthi uke wezwa ngamagama afana ne-Prozac ne-Sertraline. Nakuba womabili kuyimithi esetshenziselwa ukwelapha ukucindezeleka, asebenza ngendlela ehlukile.
- I-SSRI: Lezi zifana nezibhamu ezidubulayo. Zihlasela kuphela i-neurotransmitter serotonin , zandisa amazinga ayo.
- I-MAOI: Lezi zifana nesibhamu esidubulayo. Zithinta ama-neurotransmitter amaningana (i-serotonin, i-norepinephrine, i-dopamine) ngesikhathi esisodwa.
Ngenxa yokuthi imithi ye-SSRI inemiphumela emibi embalwa futhi ayikho imithetho ekhethekile mayelana nokudla nokuphuza, odokotela bavame ukuncoma imithi ye-SSRI kuqala.
Yimiphi imiphumela emibi evamile ye-MAOIs?
Njengayo yonke imithi, lo ungaba nemiphumela emibi. Kodwa akuwona wonke umuntu oyitholayo. Abanye abantu bangase bathole eyodwa noma ezimbili, kanti abanye bangase bangabi naso nhlobo. Uma unenkinga entsha ngemva kokuqala lo muthi, khuluma nodokotela wakho ngakho.
| Imiphumela emibi evamile | Incazelo |
|---|---|
| Isiyezi noma ikhanda elibuthakathaka | Lokhu kungabangelwa umfutho wegazi ophansi. Lokhu kungalawulwa ngokuvuka kancane kusukela ekumeni noma ekuhlaleni. |
| Umlomo owomile | Ungathola impumuzo ngokuphuza amanzi amaningi nokuhlafuna itshungama engenashukela. |
| Isicanucanu | Lokhu kungancishiswa ngokuthatha umuthi kanye nokudla. |
| Ukuqunjelwa noma ukuqunjelwa | Lokhu kungahluka kuye ngokudla kwakho kanye nenani lamanzi owaphuzayo. |
| Ukozela | Udokotela angase akucebise ukuthi uthathe umuthi ebusuku. |
| Ukungalali | Esimweni esinjalo, ungase welulekwe ukuthi uthathe umuthi ekuseni. |
Izingozi ezinkulu ezihlobene nokusebenzisa ama-MAOI!
Kufanele uqaphele kakhulu le ngxenye. Ama-MAOI ayisidakamizwa okufanele sisetshenziswe ngokuqapha okukhulu.
1. Imicabango yokuzibulala eyandisiwe
Ukwanda kwemicabango noma ukuziphatha kokuzibulala kungase kwenzeke, ikakhulukazi entsheni engaphansi kweminyaka engama-25, lapho lo muthi uqala ukusetshenziswa noma lapho umthamo ushintshwa.
Uma wena noma ingane yakho niqala ukuzizwa ningenathemba ngemva kokuqala lo muthi, ningangabazi ukuxhumana nodokotela oninike umuthi ngokushesha.Ungathola futhi ukwesekwa okusheshayo ngokufonela inombolo yosizo lwezempilo yengqondo yaseSri Lanka, u-1926 .
2. Isifo se-Serotonin
Lesi yisimo esingavamile, kodwa esingasongela impilo . Senzeka lapho amazinga e-serotonin emzimbeni eba phezulu ngendlela eyingozi. Le ngozi iyanda uma uthatha i-MAOI ngenkathi uthatha eminye imithi ekhulisa amazinga e-serotonin (isib., eminye imithi yokucindezeleka, amanye ama-syrup okukhwehlela, kanye nezinhlungu zobuhlungu).
Ngakho-ke, ngaphambi kokuba uqale ukuthatha i-MAOI, kufanele utshele udokotela wakho ngayo yonke imithi oyithathayo njengamanje (kufaka phakathi amavithamini nemithi yendabuko).
| Izimpawu ze-Serotonin Syndrome | |
|---|---|
| Izimpawu ezivamile |
|
| Izimpawu ezingathi sína neziphuthumayo |
|
| Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezinkulu, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha! | |
3. Isifo Sokuyeka Ukucindezeleka
Uma uthatha i-MAOI isikhathi esingaphezu kwamasonto ayisithupha bese uyiyeka ngokuzumayo, ungase ube nezimpawu zokuhoxa. Lokhu akuyona into yokulutha, kodwa kuyindlela umzimba osabela ngayo emuthini njengoba usujwayela.
Izici:
- Ubuhlungu bomzimba, ukukhathala, nokujuluka, njengokungathi unomkhuhlane
- Ukungalali
- Isicanucanu
- Isiyezi
- Ukuzizwa sengathi ugesi udlula emzimbeni wakho
- Ukukhathazeka, ukucasuka
Ungayeki ukuthatha lo muthi ngokuzumayo nganoma yisiphi isizathu ngaphandle kokubonisana nodokotela wakho. Uma uyeka ukuthatha umuthi, yenza kanjalo kancane kancane esikhathini esingangenyanga, wehlise umthamo, futhi kuphela ngaphansi kokuqondisa kukadokotela wakho.
4. Ukusabela okuyingozi ngokudla (i-Tyramine Reaction)
Lena ingozi ebaluleke kakhulu futhi eyingozi kakhulu nge-MAOIs.
Njengoba sixoxile ngaphambili, imithi ye-MAOI ivimba i-enzyme ephula ikhemikhali ebizwa ngokuthi i-tyramine. I-Tyramine ivame ukutholakala kokunye ukudla esikudlayo. Kumuntu ongawuthathi umuthi, umzimba uyaphuka kalula futhi uqede le tyramine.
Kodwa uma umuntu othatha i-MAOI edla ukudla okune-tyramine eningi, umzimba awukwazi ukuyinciphisa. Khona-ke izinga le-tyramine egazini liyakhuphuka ngendlela eyingozi, okubangela ukwanda okungazelelwe komfutho wegazi (i-Hypertensive Crisis) . Lokhu kuyingozi kakhulu. Kwezinye izimo ezingavamile, lokhu kungaholela ekuphumeni kwegazi ebuchosheni ngisho nasekufeni.
Ukudla okufanele 'ngokuphelele' ukugweme lapho uthatha ama-MAOI!
Uma uthatha i-MAOI, kufanele ugweme ngokuphelele ukudla okusohlwini olungezansi. Khuluma nodokotela wakho ngalokhu ukuze uthole ulwazi olwengeziwe.
| Uhlobo lokudla | Izinto okufanele uzigweme nokuthi kungani |
|---|---|
| Ushizi | Gwema ushizi osekhulile ngokuphelele. Isibonelo: I-Cheddar, ushizi oluhlaza okwesibhakabhaka, i-Parmesan. (Amazinga e-Tyramine ayanda ngokuhamba kwesikhathi). Ushizi omusha njengoshizi we-Cottage, i-Mozzarella ulungile. |
| Inyama nenhlanzi ecutshunguliwe | Amasoseji, i-salami, inyama eyomisiwe, inyama eyomisiwe, kanye nenyama/inhlanzi ebhemayo. |
| Amasosi | Isosi yesoya kanye nezinye izisosi ezibilisiwe. |
| Izithelo nemifino ebilisiwe | Ubhanana ovuthiwe kakhulu , u-avokhado, amakhiwane. Ubhontshisi be-Fava (uhlobo lwe-legume). |
| Utshwala | Ubhiya we-tap (ubhiya obuqanjiwe) kanye nobhiya obubilisiwe. Amanye amawayini nawo ane-tyramine eningi. |
| Okunye | Isinkwa se-sourdough, isibindi, njll. (i-tyramine iyanda ngokushesha uma ingekho entsha). |
Okubaluleke kakhulu: Yidla ukudla ngokushesha nje lapho sekuphekiwe. Faka okusele esiqandisini futhi ugweme ukufudumeza kabusha. Njengoba ukudla kuguga, amazinga e-tyramine anganda.
Kuthatha isikhathi esingakanani ukuzwa imiphumela yomuthi?
Ngokuvamile kuthatha amasonto amabili kuya kwamathathu ukuthi kuzwakale imiphumela ephelele yomuthi. Uma ungaboni ukuthuthuka ezimpawini zakho phakathi naleso sikhathi, khuluma nodokotela wakho.
Kufanele ushayele nini udokotela wakho ucingo?
Uma uthatha i-MAOI, kufanele ubonane nodokotela wakho njalo ukuze ubone ukuthi umuthi uyasebenza yini nokuthi unezinkinga yini. Ngaphezu kwalokho, qiniseka ukuthi ukhuluma nodokotela wakho ngalezi zinto:
- Uma imiphumela emibi ikukhathaza.
- Uma izimpawu zakho zingathuthuki noma zingabi zimbi kakhulu.
- Uma uzizwa sengathi udinga ukuyeka ukuthatha umuthi.
Okokugcina, njengomuntu othatha i-MAOI, kubalulekile ukutshela noma yimuphi udokotela ombonayo (ngisho nodokotela wamazinyo) ukuthi uthatha lo muthi, njengoba eminye imithi yokubulala izinzwa neminye imithi ingabangela ukusabela okuyingozi nge-MAOI.
Umlayezo Wokuya Nawe Ekhaya
- Ama-MAOI uhlobo lomuthi wokucindezeleka ongasasetshenziswa kabanzi, kodwa osebenza kahle kakhulu kwezinye izimo.
- Ukudla okuqukethe i-tyramine (njengoshizi osukhulile, inyama ecutshunguliwe, isosi yesoya) kufanele kugwenywe ngokuphelele ngenkathi kuthathwa lo muthi. Lokhu kungaba yingozi empilweni.
- Kubalulekile ukwazisa udokotela wakho nganoma yimiphi eminye imithi oyithathayo.
- Ungalokothi uyeke ukuthatha imithi ngokuzumayo ngaphandle kokubonisana nodokotela wakho.
- Uma uba nezimpawu ezinkulu ze-serotonin syndrome (ukudideka, umkhuhlane ophakeme, ukuxhuzula) noma imicabango yokuzibulala, iya ekamelweni eliphuthumayo (ETU) ngokushesha.
- Tshela wonke uchwepheshe wezempilo omelaphayo ukuthi uthatha i-MAOI.
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