Awujabuli yini? Ukhathele yikho konke? Lesi simo sibiza ngokuthi ukucindezeleka. Ngakho-ke, kunezinhlobo ezahlukene zemithi enikezwa ukwelapha lesi simo sengqondo esibizwa ngokuthi ukucindezeleka. Namuhla sizokhuluma ngeqembu lemithi emidala kancane futhi okudingeka uyiqaphele kakhulu uma usebenzisa. Le mithi ibizwa ngokuthi ama-MAOI, okusho ukuthi i-Monoamine Oxidase Inhibitors. Nakuba leli gama lingase libonakale liyinkimbinkimbi kancane, ake sixoxe ngalo kalula.
Ziyini ngempela lezi MAOI?
Kalula nje, ama-MAOI awuhlobo lwemithi esiza ukulawula izimpawu zokucindezeleka. Lawa ama-antidepressant okuqala atholakala emhlabeni . Kodwa-ke, odokotela abakuniki lo muthi kalula kulezi zinsuku. Isizathu salokhu ukuthi kufanele uqaphele kakhulu ngalokho okudlayo nokuphuzayo lapho uthatha le mithi, futhi kufanele futhi unake kakhulu imiphumela ethile emibi kanye nokuphepha.
Ngokuvamile, odokotela banikeza ama-MAOI kuphela njengendlela yokugcina lapho eminye imithi yokucindezeleka emisha (njenge-SSRIs) yehlulekile ukuthuthukisa izimpawu.
Yimiphi imithi engaphansi kwalesi sigaba?
Nazi ezinye zezinhlobo ze-MAOI ezisetshenziswa emhlabeni:
- I-Isocarboxazid (Marplan®)
- I-Phenelzine (i-Nardil®)
- I-Selegiline (Emsam®)
- I-Tranylcypromine (i-Parnate®)
La magama angase angajwayelekile kuwe, njengoba engavamile ukusetshenziswa ezweni lethu. Kodwa kuhle ukuwazi.
Yiziphi izimo eziphathwa ngama-MAOI?
Le mithi ivunyelwe izifo ezahlukahlukene.
| Uhlobo lomuthi | Izimo zezokwelapha ezisetshenziswa kakhulu |
|---|---|
| I-Isocarboxazid kanye ne-Tranylcypromine | Isifo Sokucindezeleka Esiyinhloko |
| I-Phenelzine | Ukucindezeleka okumelana nokwelashwa, ukuphazamiseka kovalo, kanye nesifo sokukhathazeka komphakathi |
| I-Selegiline | Njengokwelashwa okungeziwe kwesifo sokucindezeleka okukhulu kanye nesifo sikaParkinson. |
Kuyini ukusetshenziswa "kwe-off-label"?
Ngezinye izikhathi, odokotela basebenzisa umuthi wesimo esingavunyelwe ngokusemthethweni. Lokhu kubizwa ngokuthi ukusetshenziswa "okungekho ku-label". Kwenziwa kuphela uma ulwazi nolwazi lukadokotela lusikisela ukuthi luzozuzisa isiguli. Isibonelo, i-Selegiline ngezinye izikhathi inikezwa i-ADHD, kanti i-Tranylcypromine ngezinye izikhathi inikezwa iziguli ezikhathazekile emphakathini.
Lomuthi usebenza kanjani?
Lokhu kulula kakhulu ukukuqonda. Cabanga ukuthi kunezithunywa ezincane ngaphakathi kobuchopho bethu. Sizibiza ngokuthi ama-neurotransmitter . I-Serotonin, i-Norepinephrine, kanye ne-Dopamine yizithunywa eziyinhloko ezilawula izinto ezifana nenjabulo, ukulala, kanye nenkumbulo ezingqondweni zethu.
Manje, kukhona enye i-enzyme ebuchosheni bethu ebizwa ngokuthi i-monoamine oxidase . Umsebenzi wale enzyme “ukuhlanza” lezo zithunywa. Okusho ukuthi, ukuzihlukanisa nokunciphisa amazinga azo.
Lokho okwenziwa yi-MAOI ukuthi ivimba i-enzyme ehlanzayo (i-Monoamine Oxidase) ukuthi ingasebenzi. Kwenzekani-ke? Lezo zithunywa ezijabulayo (njenge-serotonin ne-dopamine) ziqoqana ebuchosheni esikhundleni sokudilizwa. Amazinga azo ayanda. Bese isimo sethu sengqondo siyathuthuka futhi izimpawu zokucindezeleka ziyancipha.
Okwamanje, kukhona nekhemikhali ebizwa ngokuthi i-Tyramine . Isiza ukulawula umfutho wegazi emzimbeni wethu. Imithi ye-MAOI nayo iyayekisa ukuwohloka kwale Tyramine. Lena ingozi enkulu ehambisana nale mithi . Sizoxoxa ngayo kamuva.
Yiziphi imiphumela emibi kanye nezingozi ze-MAOIs?
Kunemiphumela emibi eminingana engaba khona kanye nezingozi ezinkulu ezihlobene nokusebenzisa le mithi. Ngakho-ke, kuyingozi kakhulu ukuyisebenzisa ngaphandle kweseluleko sikadokotela .
Imiphumela emibi evamile
- Isiyezi noma ikhanda elibuthakathaka (ngenxa yomfutho wegazi ophansi)
- Umlomo owomile (xerostomia)
- Isicanucanu
- Ukuqunjelwa noma ukuqunjelwa
- Ukozela
- Ukungalali
Izingozi ezinkulu kanye nezinkinga
1. Isifo se-Serotonin
Lesi yisimo esibi kakhulu futhi esingasongela impilo. Senzeka lapho amazinga e-serotonin emzimbeni eba phezulu kakhulu. Le ngozi inkulu nakakhulu uma uthatha ama-MAOI kanye neminye imithi ekhulisa amazinga e-serotonin (isb., ama-SSRI, amanye ama-painkiller). Yingakho kubalulekile ukutshela udokotela wakho ngayo yonke imithi oyithathayo, ngisho namavithamini.
| Izimpawu ze-serotonin syndrome | |
|---|---|
| Izici ezijwayelekile | Ukungaphumuli, isicanucanu, ukuhlanza, isisu esibuhlungu, amehlo aqhaqhazela , ukujuluka , ukuthuthumela, imisipha eqhaqhazela. |
| Izimpawu ezibucayi (ezidinga ukulaliswa esibhedlela ngokushesha) | Ukudideka, i-tachycardia, umfutho wegazi ophakeme, umkhuhlane, ukuquleka, ukulahlekelwa ukwazi. |
Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezimbi, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha . Ukuhlehlisa ukwelashwa kungaba yingozi empilweni.
2. Izinkinga ngokudla (ukuxhumana kwe-Tyramine)
Lena inkinga enkulu kakhulu engokoqobo ngama-MAOI. Njengoba sishilo ngaphambili, ama-MAOI ayayeka ukuwohloka kwekhemikhali ebizwa ngokuthi i-tyramine, etholakala ngokwemvelo kokunye ukudla.
Uma udla ukudla okune-tyramine eningi ngenkathi uthatha i-MAOI, izinga le-tyramine egazini lakho lingakhuphuka kakhulu ngendlela eyingozi. Lokhu kungabangela ukwanda okungazelelwe nokukhulu komfutho wegazi . Lokhu kubizwa ngokuthi "i-Tyramine Pressor Response." Ezimweni ezingavamile, lo mfutho wegazi ophakeme ungabangela ukopha ebuchosheni (ukuvuza kwegazi ebuchosheni) ngisho nokufa.
Yikuphi ukudla okufanele ukugweme lapho uthatha ama-MAOI?
Ngezansi uhlu lokudla okufanele kugwenywe ngumuntu othatha lo muthi, ngenxa yamazinga aphezulu e-tyramine.
| Uhlobo lokudla | Incazelo nezibonelo |
|---|---|
| Ushizi Omdala | Ushizi olufana neCheddar, iSwiss, neParmesan (ushizi omusha njengoshizi weCottage neMozzarella awunangozi kangako). |
| I-soy sauce | Yonke imikhiqizo eyenziwe ngesoya. |
| Inyama/inhlanzi ebilisiwe noma egciniwe | Amasoseji, i-salami, inhlanzi eyomisiwe, nezinye izinto. |
| Isibindi | Nakuba isibindi esisha singenayo i-tyramine, amazinga e-tyramine anganda ngoba ancipha ngokushesha. |
| Isithelo esivuthiwe kakhulu | Uma izithelo ezifana nobhanana, u-avokhado, namakhiwane sezivuthiwe ngokuphelele. |
| Ubhiya obubilisiwe | Ikakhulukazi ubhiya we-tap. |
Into ebaluleke kakhulu: Njengoba ukudla kuguga, amazinga ako e-tyramine ayanda. Ngakho-ke, umuntu othatha lo muthi kufanele agweme ukudla okusele futhi adle ukudla okusanda kuphekwa .
3. Isifo Sokuyeka Ukucindezeleka
Lesi simo singavela uma uyeka ukuthatha lo muthi ngokuzumayo ngemva kokuwuthatha isikhathi esingaphezu kwamasonto ayisithupha. Izimpawu ezifana nomkhuhlane, izinhlungu zomzimba, ikhanda elibuhlungu, isiyezi, ukuqwasha, kanye nokungahlaliseki zingase zivele. Ngakho-ke, ungalokothi uyeke ukuthatha lo muthi ngaphandle kokubonisana nodokotela wakho . Uma uyeka ukuthatha umuthi, kufanele ukwenze kancane kancane esikhathini esingamasonto amaningana futhi kuphela ngaphansi kokuqondisa kukadokotela wakho.
4. Imicabango yokuzibulala
Kukhona ingozi encane yokwanda kwemicabango yokuzibulala lapho abantu abasha abangaphansi kweminyaka engama-25 beqala ukuthatha lo muthi. Uma wena noma ingane yakho ninemicabango enjalo, khuluma nodokotela oninike umuthi ngokushesha.
Kufanele ubonane nini nodokotela?
Uma uthatha i-MAOI, kufanele ubonane nodokotela wakho njalo ukuze ahlole ukuthi umuthi uyasebenza yini nokuthi kukhona yini izinkinga. Ngaphezu kwalokho, khuluma nodokotela wakho ngalezi zinto futhi.
- Uma uhlangabezana nemiphumela emibi ongeke uyibekezelele.
- Uma izimpawu zakho zingathuthuki, noma uma ziba zimbi kakhulu.
- Uma uzizwa sengathi udinga ukuyeka ukuthatha umuthi.
Umlayezo Wokuya Nawe Ekhaya
- Ama-MAOI ayiqembu elidala elinamandla kakhulu neliyingozi lemithi yokucindezeleka engasetshenziswa kakhulu namuhla.
- Uma uthatha lo muthi, ukulawula ukudla kubalulekile . Ukudla okune-tyramine eningi kufanele kugwenywe ngokuphelele.
- Kubaluleke kakhulu ukwazisa udokotela wakho nganoma yimiphi eminye imithi oyithathayo, ngaphandle kwalokho ungase ube nesifo se-serotonin esiyingozi.
- Ungaqali noma uyeke ukuthatha lo muthi ngaphandle kweseluleko sikadokotela nganoma yisiphi isizathu.
- Uma uba nezimpawu ezinzima ze-serotonin syndrome noma imicabango yokuzibulala, iya ekamelweni lezimo eziphuthumayo esibhedlela (ETU) ngokushesha.
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