Kutheni le mayeza enika ezinye izidakamizwa ze-ADHD zemveli
Uninzi lweziyobisi ezikhoyo ukunyamekela ingxaki yokungathandabuzeki kwengxaki (ADDD) njenge- Adderall okanye i-Ritalin ivuselela, yingakho iStrattera, isilwanyana esingenakuvuselela imeko, siphumelele.
I-FDA ivume iStrattera (i-atomoxetine) ukuphatha i-ADHD kubantu abadala kunye nabantwana abangaphezu kweminyaka emithandathu. Oku akusiyo imveliso yokuqala ye-ADHD, kodwa.
I-Anti-depressants, kuquka i-Wellbutrin (bupropion hydrochloride) kunye ne-tricyclics, njenge-Desipramine kunye ne-Imipramine, sele ithathwa njengamayeza emibini. Ngamanye amaxesha asetyenziswa xa iziphumo ezimbini okanye ngaphezulu zingasebenzi, zichasene okanye zibangele imiphumo emibi kakhulu.
Iingxaki zokuxhatshazwayo aziqhelekanga njengento ebonakalayo njengezikhuthazayo, nangona kunjalo. Kwaye la mayeza awayivunyelwe i-FDA ukuphatha i-ADHD, ngoko ukuba isimangalo sikaStrattera sokuba 'imithi yokuqala engalawulwa yi-FDA-avunyelwe ukuphatha i-ADHD' iyinyaniso yezobuchwepheshe.
Kutheni iStrattera ibeka ngaphandle
Nangona eyaziwa ngokubanzi ukuba ikhuselekile kwaye isebenzayo, izikhuthazo ezinjengo-Adderall kunye noRitalin zide zinegama elibi kwaye abazali abaninzi banxamnye no-Ritalin kwaye banqikazi ukubeka abantwana babo kwi-stimulant. Ngoko ukuba akusivuseleli, uStrattera usebenza njani? Kucingelwa ukuba 'inhibitor enamandla ye-presynaptic norepinephrine transporter,' ebangela ukuba i-norepinephrin ibe ngakumbi ukuze ikhulise ingqalelo kwaye ilawulwe ukungaxhamli nokungafuneki.
Njengazo zivuselela, ayikaziwa ngokucacileyo indlela iStrattera isebenza ngayo, nangona kunjalo.
Ucwaningo oluninzi lubonisa ukuba iStrattera ikhuselekile kwaye isebenza kakuhle. Esinye sezifundo, "i-Atomoxetine kunye ne-Methylphenidate Treatment kwi-Children ene-ADHD: i-Outlook, i-Randomized, i-Label-Open-Trial Trial," 1 efanisa uStrattera noRitalin.
Aba bantwana abane-ADHD, i-228 kubo bonke, bafumana iStrattera okanye iRitalin iiveki ezili-10, kwaye abo bathatha iStrattera bafunyaniswa ukuba 'banciphisa impawu' kunye 'nokunyamezela' okungafaniswa nento ebonwa kunye noRitalin.
IStrattera yokuzibulala
Nangona kunjalo, u-FDA uye walumkisa malunga neengozi yokuzibulala kubafundi kunye nabantwana abaselula abaphathwa ngeStrattera. Ngokukodwa, njengamanye amaninzi eengqondo, i-FDA ithi iStattera 'inokwandisa iingcinga zokuzibulala okanye ukuzama ukuzibulala kubantwana kunye nentsha,' kwaye ukuba abazali mababizele ugqirha wengane ukuba umntwana wabo unalo:
- Ukutsha okanye ukunyuka kwengcinga yokuzibulala
- Utshintsho kwimvakalelo okanye ekuziphatheni, kuquka ukucaphukisa okanye ukuxhalabisa
Esi silumkiso asithethi ukuba umntwana wakho akanako ukumisela iStrattera okanye ukuba kufuneka ayeke ukuthatha i-Strattera ukuba wenza umsebenzi omhle olawula iimpawu zakhe ze-ADHD kwaye angabangeli imiphumo emibi. Kunoko, inzuzo yokuthatha i-Strattera kufuneka ilinganiswe nemingcipheko enokwenzeka yeziyobisi. Kwaye abantwana abathatha i-Strattera kufuneka 'baqwalaselwe ngokugqithiseleyo ukunyuka kweekliniki, ukucinga okuzibulala okanye ukuziphatha okanye ukuguqulwa okungavamile kokuziphatha,' ingakumbi kwiinyanga ezimbalwa zokuqala zonyango okanye xa i-dosage ishintshiwe.
Ekubeni kungabonwa njengento elawulwayo, iStrattera iya kufumaneka kunye nemithi eqhelekileyo. Oku kuya kuthetha ukuba oogqirha banokuyibita kwikhemistri kwaye banakho ukunika ii-refills, ngokungafani nezikhuthazo kunye nezinye izinto ezilawulwayo, ezifuna umyalelo omtsha nyanga nganye. Kwaye isifo sakho sezilwanyana siya kuba neesampuli ezikhoyo ukuba umntwana wakho azame.
Izifundo zeStrattera
Izifundo zokuqala zeStrattera zibonise enye yeepsides kule myeza ukususela ngokungafani neyodwa ngosuku, i-Strattera inikwe kabini ngosuku. Kanye kanye ngosuku ngosuku ifunyenwe kwakhona, nangona kunjalo, kwaye yabonisa ukuba 'ukulawulwa kwe-atomoxetine yosuku olulodwa yinkqubo efanelekileyo yabantwana kunye nabaselula kunye ne-ADHD.'
Kwaye kwangoku, akukho zifundo zibonisa ukuba iStrattera isebenza bhetele okanye ineziphumo ezincinci kunezikhuthazo. Njengemishukumisayo, iziphumo ezingamanzi zakwaStrattera zazibandakanya ukutya, isisu, ukuhlanza, ukhathala nokugulisa isisu. Kwaye abaninzi abantwana banciphisa ubunzima kwiinyanga ezimbalwa zokuqala emva kokuqala iStrattera. Nangona kunjalo, izifundo ezimbalwa zangexesha elide, apho abantwana bathatha iStrattera ngaphezu konyaka, babonise ukuba aba bantwana bafumana ubunzima kwaye ukuphakama kwabo kwanda. Ekubeni ukufumana ubunzima obuthathaka ngokuqhelekileyo kuyinkathazo kubantwana abathatha izikhuthazo, oku kufumana iindaba ezilungileyo kunye ne-Strattera ingaba yinto efanelekileyo kubantwana.
Kwakhona iStrattera isetyenziswe nge-cytochrome P450 2D6 (CYP 2D6) endleleni yesibindi, kwaye kuya kwenzeka ukuba kukho ukusebenzisana namanye amayeza, njengePaxil (paroxetine), i-Prozac (i-fluoxetine) kunye ne-quinidine. Umenzi uphinda ucebise xa enika umntwana kunye ne-IV albuterol (okungafanekiyo yenziwe) kunye ne-Strattera, ngoko le nyilisi ayikwazi ukukhetha ngokufanelekileyo kubantwana abane-ADHD abane-asthma. Kwaye njengokuba iStrattera inokunyusa ingcinezelo yengcinezelo yegazi kunye nentliziyo, kufuneka isetyenziswe ngabantwana abanomfutho wegazi ophezulu , isantya senhliziyo esheshayo (i-tachycardia) okanye i-cardiovascular or cerebrovascular disease.
Omnye umgca wukuthi iStrattera ifunyanwa kuphela njenge-capsule, kwaye ngokungafani ne-Adderall XR, leyo ingaqhelekanga ivule kwaye ifefe ekudleni, kucetyiswa ukuba iStrattera ithathwe ngokupheleleyo.
Ngoko ngelixa unyango olutsha kubantwana abane-ADHD yindaba evulekileyo neyolisayo, kude kubekho uphando olongezelelweyo olwenziwe ukubonisa ukuba iStrattera ikhuselekile okanye iphumelele ngakumbi kunokukhuthaza, akufanele ukuba ukhawuleze kuMphathi wakho wezilwanyana ukuba utshintshe unyango.
Nangona kunjalo, i-Strattera ingaba yinto enhle kakhulu kubantwana abanenkinga yokunyuka xa besetyenzisayo, banezinye iziphumo, okanye ukuba iimpawu zabo ze-ADHD zilawulwa kakuhle.
Imithombo:
I-Atomoxetine kunye ne-methylphenidate unyango kubantwana abane-ADHD: uvavanyo olulindelekileyo, olukhethiweyo, oluvulekileyo lwe-ilebula. I-Kratochvil CJ-J I-Academy Adolesc I-Psychiatry - 01-Jul-2002; 41 (7): 776-84.
Inkqubo yonyango lwe-atomoxetine yosuku olulodwa kubantwana nakwishumi elivisayo kunye neengxaki zokungabikho kwezifo ezibangelwa yintlupheko: i-random, i-placebo elawulwa ngokufunda. UMichelson D - Am J Psychiatry - 01-Novemba-2002; 159 (11): 1896-901.