Ingxaki eqhelekileyo kwisifo sikaParkinson idinga indlela yokucinga
I-Levodopa yiyona "imilinganiselo yegolide" yegciwane le-Parkinson, oko kuthetha ukuba yinto efanelekileyo kuncedo kunye neyintloko. Isebenza ngokuguqulwa ibe yi-dopamine, encedisa umntu ukuba ahambe aze alawulwe izihlunu zawo.
Ngelishwa, nangona kunjalo, ngokubaluleka kwabantu, njengoko i-Parkinson iyaqhubeka, i- levodopa ayisebenzi kakuhle ekupheliseni okanye ukulawula iimpawu zomntu.
Oku kungenxa yokuba, ngokuhamba kwexesha, i-levodopa iqalisa ukugqithisa ngokukhawuleza ngokukhawuleza, kubangela ukuba imithi "i-off-off phenomenon."
Ngokufanelekileyo, xa uthatha amayeza amachiza afana ne-levodopa kwishedyuli esiqhelekileyo, akufanele uqaphele umlinganiselo omkhulu kwimpawu zakho phakathi kwamanani. Ngamanye amazwi, iimpawu zakho kufuneka zihlale zihlala zihlala zihamba rhoqo, kungakhathaliseki ukuba uthe wagcina uthatha unyango lwakho.
Nangona kunjalo, xa i-off-off phenomenon iqala kwisifo sika-Parkinson, uya kuziva ungcono ("kwi") njengokuba umthamo omtsha weyeza zakho ziqala ukusebenza, kwaye zibi kakhulu ("ukucima") ngaphambi kokuba ufumane enye idosi . Ekugqibeleni, ubude be-"on" buba bufutshane kwaye ugqoke "ukucima" kwenzeka ngokukhawuleza (ngokukhawuleza kwenye enye i-levodopa).
Indlela amaPhenomenon e-Off-Off Phenomenon ngayo
Ezinye iingcali zichaze "kwixesha" ngokufana nokutshintsha ukukhanya, kunye nexesha "elikude" njengoko izibane zihamba.
Kwimeko "kwi", umntu onesifo sikaParkinson unokuziva enamandla kwaye akwazi ukuhamba ngokulula. Nangona kunjalo, kwiimeko "ezikude", loo mntu unokuba nzima, ophuzayo, kwaye angenakho ukuhamba yonke imizuzu embalwa. Umntu unokufumana ubunzima bokuthetha, kwaye unokumqaphela ukuba asebenzise amagama abo.
Njengoko unokucinga, i-"off" state ingaba nzima.
UkuLawula iPhenomenon yokuNqanyulwa kwi-Parkinson
Kwabanye abantu abanesifo sikaPasinson, i-"on-off" ukuguqulwa kwezinto ziqikeleleke. Bayazi ukuba iziphumo ze-levodopa ziya kuguguka emva kweeyure ezintathu, ngoko banokucwangcisa ngokufanelekileyo.
Kwabanye abantu, ngelishwa, ukuguqulwa kwe-"off-off" akunakulinganiswa, kwaye oku, okwenene, yimeko eyingozi. Akukho mntu uyazi ukuba kutheni ukuguqulwa kukungaqiniseki kwezinye iimeko.
Oko kwathiwa, kukho iindlela ezimbalwa ezifumanekayo xa wena okanye wakho umthandayo uqala ukufumana isenzo esiphezulu.
Kwabanye abantu, ukuguqulwa kweemoto kubonakala kuphendulela kwiifom zokukhutshwa ezilawulwayo ze-levodopa (ebizwa ngokuthi iSinemet CR). Nangona kunjalo, i-levodopa elawulwe ngokulawulwayo ayisebenzi kakuhle kuwo wonke umntu kwaye ngelanga, kunokubangela ukuba ezinye iimpawu zibe zibi nakakhulu.
Endaweni yokutshintshela uhlobo oluthile lwe-levodopa, ugqirha wakho unokunciphisa ixesha eliphakathi kwamayeza e-levodopa malunga nemizuzu engama-30 ukuya kwangama-60 (ingakumbi kwi-Parkinson ephambili).
Ngaphandle koko, ugqirha wakho unokuncoma ukongeza iyeza. I-Dopamine agonists, xa ifakwe kwi-levodopa, inokunciphisa ubude bexesha ochithayo "ngaphandle," kodwa bafumana umngcipheko wemiphumo emibi efana nemiboniso ebonakalayo kunye nokuziphatha okunyanzelisayo.
I-COMT inhibitors njengo-Comtan (entacapone) inokuyandisa kwaye ikhulise umphumo we-levodopa kodwa inokunyusa imiphumo yecala kuyo.
Ekugqibeleni, xa kufakwa kwi-levodopa, ii-inhibitors ze-MAO-B zinganceda (kunye neempembelelo). Ii-inhibitors ze-MAO-B zisebenza ngokuthintela i-enzyme evimbela i-dopamine kwingqondo.
Ngenxa yesifo esiphezulu se-Parkinson, ukunyuka kwe-gel yamathumbu emathunjini angasiluncedo, kwaye kwiimeko ezinzima zezi zigqoke, isicirisi esinjengenwayiyo esibizwa ngokuba yiApokyn (apomorphine hydrochloride injection) sinokunceda.
ILizwi
I-phenomenon ye-off-off yinkathazo enyango ekhatyweni kwesifo se-Parkinson, kwaye ngelixa abanye abantu bengaqaphela okokuqala ekuqalekeni kwe-levodopa, baninzi bayayibona kwiminyaka emithathu ukuya kwemihlanu.
Nangona kukho iindlela ezahlukahlukeneyo zokulwa nale nto, ukubheja kwakho kukugqwesa ukuxoxa ngazo zonke iinketho zakho kunye nogqirha wakho. Izidingo zakho ngabanye zifaneleke ngokufanelekileyo kwisicwangciso esinye okanye amayeza ngokumelene nomnye-oko kusebenza ngokusemandleni akho ukuba kungabi ngcono kumnye umntu.
> Imithombo:
> Fasano A et al. I-Intrajejunal levodopa i-infusion kwisifo sePacinson esiphezulu: iziphumo ezide kwiimoto kunye neempawu ezingekho imoto kunye neempembelelo kumgangatho wobomi nomnakekeli wobomi. Ukuhlaziywa kweYurophu ngezoNyango kunye neFajemi yeSayensi. 2012 uJan; 16 (1): 79-89.
> Martinez-Martin P et al. I-EuroInf: isifundo esicatshungulwa ngokubanzi ngokumalunga ne-apomorphine kunye ne-levodopa ukunyanyiswa kwesifo se-Parkinson. Iingxaki zokuhamba. 2015 Ngo-Apr; 30 (4): 510-6.
> Pahwa R, uLyons KE. Ingubo e-Levodopa egqoke kwisifo sikaParkinson: ukuchonga nokuphathwa. Curr Med Res Opin . 2009 Ngo-Apr; 25 (4): 841-9.
> Stocchi F, Jenner P, Obeso JA. Xa i-levodopa ihamba ngokuhamba kweemoto okokuqala ibonakala njani kwisifo sikaPasinson? Eur Neurol . 2010; 63 (5): 257-66.
> UTarsy D. (2017). Ukutshintsha kweemoto kunye ne-dyskinesia kwisifo sikaParkinson. Ukulimaza HI, ed. Isemgangathweno. Waltham, MA: UpToDate Inc.