Chirwere chekufambisa chinokonzerwa nemishonga yakwegura yekurapa
Tardive dyskinesia (TD) chirwere chekufamba chinokonzerwa nemishonga. Izvi zvinogona kugara zvakagadzikana ndezvimwe zvinogona kuitika-kushanda kwenguva refu kwenguva refu nemishonga antipsychotic yakadai seTrarazine neHaldol, iyo inowanzoshandiswa kurapa schizophrenia nezvimwe zvirwere zvikuru zvepfungwa. Antipsychotic mishonga yakashandura kurapwa kwematambudziko aya.
Pamberi peklorpromazine (Thorazine) yakatangwa muma1950, varwere vane schizophrenia vaiwanzobatwa ne electroconvulsive therapy (ECT) uye mamwe maitiro ekurapa uye anogona kuchengetwa muzvipatara zvepfungwa kwenguva refu. Phenothiazines akadai saTrarazine akanyaradza manzwiro avo varwere ava kazhinji vakanzwa uye vakanyaradza mafungiro avo ekunyengera. Iyi mishonga yakarumbidzwa semishonga inoshamisa kunyange dzimwe nguva yakasiya varwere vakakundwa uye vasingadi.
Sezvo phenothiazines dzakanyorerwa kwenguva yakareba, varwere vanoverengeka vakatanga kuratidza maitiro emasumbu uye mamwe maitiro asina kujairika. Zviratidzo zvakawanda zvemuviri zvinodzokororwa uye zvinogona kurapwa nekuwedzera imwe mishonga inopikisa zviratidzo zve "pseudoparkinson". Tardive dyskinesia, kune rumwe rutivi, inogara yakasimba. Zvakakosha kucherechedza kuti vamwe vakawanda varwere vanoita mamwe madhara nemishonga iyi.
Dzimwe nguva inonzi extrapyramidal madhara , zviratidzo zvinotyisa zvinosanganisira:
Akathisia
Kuzviisa pasi kwekusagadzikana nechishuvo chakamanikidzwa chekutamisa makumbo kana kufamba-famba. Dystonias - inononoka, yakasimudzika maitiro emusana kana kupisa kunogona kukonzera musangano usingabatsiri wemuviri wose kana zvikamu zvemuviri.
Parkinsonism - kuoma kwemisungo, kugadzikana kwekodwheel, kushamwaridzana, kukonzera kumira, kudonha, kudengenyeka kwepirin 'uye kutaura kwakashata. Zviratidzo izvi zvinotyisa zvinodzokorora uye zvinowanzobatwa nekushandura mishonga kana kuwedzera mamwe mishonga.
Tardive
Kubvira shure-kukura dyskinesia kwakatanga kurondedzerwa muna 1964, kunyange zvazvo varwere vakanga vachiri kuwedzera chirwere chemakore akawanda. Zviratidzo zvakafanana kune zvinorondedzerwa pamusoro apa, asi zvinowanzoonekwa munguva yekurapa uye zvinowanzoonekwa sezvisingagoneki. Zviratidzo zvinowanzova nekudzokororazve, rhythmic kushamwaridzana kunoitika kana zvichiitika kana murwere achiri kutora mishonga. Maitiro akadai asingabatsiri anosanganisira "rurimi runokurudzira, miromo inoputika, miromo inosungirirwa, kugadzirisa uye kutsvaira, kufamba-famba kweguru, kusvetuka kwepachivi, kutenderera kwezvikwama kana makumbo, kufamba-famba panzvimbo, kusuruvara kusina kukwana, uye kuchema zvakare sezvinongoita kunyorera kana kugunun'una. " (University of Kansas Medical Centre, 2002)
Mishonga inotevera inoratidzwa kuti inokonzera tardive dyskinesia kune vamwe varwere:
Mishonga yematambudziko emimba:
- metoclopramide (Reglan)
- prochlorperazine (Compazine) Mishonga yekukanganiswa
- promethazine (Phenergan)
Mishonga yekuora mwoyo:
- amoxapine (Ascendin)
- perphenazine / amitriptyline (Triavil)
Antipsychotics kana Neuroleptics:
- chlorpromazine (thorazine)
- thioridazine (Mellaril)
- trifluoperazine (Stelazine)
- perphenazine (Trilafon)
- fluphenazine (Prolixin)
- thiothixene (navane)
- haloperidol (Haldol)
- pimozide (Orap)
(University of Kansas Medical Centre, 2002)
Varwere vakwegura, varwere vanoputa, varwere vechikadzi, uye varwere vane chirwere cheshuga vanoita sevanonyanya kutyisirwa nehutachiona ichi. Nhoroondo yemhuri yakaratidzawo kuti inofanirwa. Kana imwe nhengo yemhuri yakagadzirisa chirwere ichi apo pane imwe yemishonga iyi, mukana wokuti murwere achaita kuti chirwere chacho chiwedzere.
Iyo yakareba murwere ari pamishonga iyi inowanzova iyo yekudzidzira tardive dyskinesia.
Ko tardive dyskinesia inogona kudzivirirwa sei? Mamwe mazano mumabhuku anosanganisira:
- Dzorera kushandiswa kwemishonga iyi pakurapwa kwema psychosis yakaoma uye kushingaira kwekunyengedza nekunyengedza. Usabata zvinetso zvehope kana kuzvidya mwoyo ne antipsychotics.
- Dzivisa kushandisa mishonga iyi yakwegura kune vakwegura vakwegura vane dhementi.
- Ipa varwere vashoma mazamu anodikamwa kuitira nguva pfupi yekurapa.
- Shandisa mutsva "atypical" antipsychotics sokurapa kwekutanga. Shandisa mamwe mishonga pamwe chete kubvumira muroti wemishonga inorwisa antiyystysi kuti ive iri pasi.
- Mishonga yakareba kwenguva refu haichazogadzirisa tardive dyskinesia kupfuura mamwe mishonga, asi chirwere chakanyanya kuderera chinofanira kushandiswa.
- Vanachiremba vanofanira kurwisa zvakasimba zviratidzo zvenguva pfupi zvePacinson-sezvingaitawo. Mishonga yekurapa zviratidzo izvi - anticholinergic agents - musawedzera dambudziko reTD. "Mazororo emishonga" anofanira kudziviswa sezvo asingaderedzi uye angatowedzera ngozi yeTD.
- Kutsvakurudza kwakaongorora mishonga yekurapa TD. Zvidzidzo zvinotevera zvemishonga hazviwanikwi kuti zvinobudirira : Cholinergic agonists (deanol, physostigmine, choline, lecithin), GABA agonists, post-synaptic agonist DA, peptides, lithium, uye papaverine. (Alexander & Lund, 1999)