I-Insomnia Imishanguzo Inokuthi Iphuculise Ukukhubazeka Kwemvakalelo Eyingozi
I-Ambien (ithengiswa njenge-generic zolpidem) imiselwe ngokukodwa ukunyangwa kokulala, kodwa ingayinceda njani ezinye iingxaki ze-neurological ezifana ne-coma, izidlo eziqhubekayo zityalo, i-dystonia, isifo se-Parkinson, isifo, isifo sengqondo, kunye nokulimala kwengqondo? Iingxelo zenkcazo kunye nezifundo ezincinci zibonisa ukuba uncedo, kwaye ukuhlaziywa kukukhuthaza uphando oluthe gqolo kwinxaxheba yonyango kwiyeza elingenasiphelo.
I-Ambien isebenza njani kwiBongo?
I-Zolpidem (ithengiswa njenge-Ambien, i-Ambien CR, kunye ne-Intermezzo) yonyango lonyango oluvunywa yi-Food and Drug Administration ukunyanga kokulala . Kukhethiweyo kwaye kuthatha isenzo ngohlobo lwam gamma-aminobutyric acid A (GABA A) benzodiazepine receptor. Oku kunokuncedisa ukunciphisa umsebenzi weengingqi ezithile zeengqondo, ngokuzithoba ukukhuthaza ukulala nokukhusela ingqalelo. Ingakhuthaza ukwanda kwe- REM ngokugxotha umsebenzi we-dopamine, umphumo onokunyusa amanqanaba eprolactin .
I-Ambien isebenza ngokukhawuleza, ifikelela ekugxininiseni kwigazi emva kweeyure eziyi-1.6 zokusetyenziswa. Ayinayo i-metabolites esebenzayo. Ngeeyure ezingaphantsi kwe-3 (kunye namafomathi aqhelekileyo ukusuka kwi-1.5 ukuya kuma-2.4 iiyure), amanqanaba egazi ase-Ambien anciphisa isiqingatha. Ukuqulunqwa okukhululwe ngokulawulwa (okuthengiswa njenge-Ambien CR) kunesigamu sokuphila kweeyure eziyi-1.5 ukuya kwi-4.5.
I-Zolpidem idityaniswe kumchamo ngeentso.
Nangona uncedo olulele kuninzi lwazo lokulala, i-Ambien ingaba neempembelelo ezincinci kumgangatho wobuthongo. Xa kuthathwa i-10 mg, kunokunciphisa ixesha elithathayo ukulala ngo-5 ukuya kwe-12 imizuzu, ngokuqhelekileyo. Inokunciphisa ixesha eliqhelekileyo elihlala liphaphekile ebusuku ngelimizuzu engama-25.
Unokuchaphazela njani ezinye iingxaki ezichaphazela ingqondo?
Indima ye-Ambien ekuPhatheni ukuphazamiseka kweziNtsholongwane
Abaphandi abavela kwiYunivesithi yaseMichigan baye batshwankathela umzimba wezenzululwazi zincwadi ngendlela i-zolpidem inokuchaphazela ngayo ezinye iimeko ezichaphazela kakhulu ingqondo, kubandakanya i-coma, i-dystonia, i-stroke, kunye ne-dementia. Ezinye zezinto ezifunyenweyo zingabakhuthaza kwabo bahlangabezana nokulimala kalisa kunye nokulimala kwengqondo.
UMartin Bomalaski, MD kunye nabalingani bakhe bahlaziywe amanqaku angama-2314 apapashwe ngo-Matshi 20, 2015. Emva kokuphonononga iziganeko, imiqulu epheleleyo yahlaziywa ngamanqaku angama-67. Uninzi lweengxelo zibandakanya iimvavanyo ezincinci kunye neengxelo zeemeko, ezimele ubungqina obuphantsi bezoklinikhi. Enyanisweni, kuphela izifundo ezili-11 zazingabandakanyeli abathathi-10. Kukho izilingo ezi-9 ezilawulwe ngandlela-thile, ziqwalaselwa njengomgangatho wegolide wophando lweklinikhi. Oku kunokuchaphazela ukuchazwa kweziphumo kunye nokufaka izicelo kubantu abaninzi.
Kukho iintlobo ezininzi zeengxaki apho i-zolpidem ihlolwe khona:
- Iziphazamiso zentshukumo (izifundo ezingama-31) - i- dystonia ne- Parkinson isifo
- Ukuphazamiseka kwengqondo (iiphando ezingama-22) - i- coma kunye nesimo sokutya esingapheliyo
- Ezinye iingxaki zeengxaki (izifundo ezili-14) - ukuphazamiseka kwengqondo , ukulimala kwengqondo, ukukhathazeka kwengqondo kunye nokugula komzimba
Abaphandi bahlalutya amanqaku malunga neentlobo zeengxaki eziphathwe ngayo, ukulingana kwe-ajpidem ezisetyenzisiweyo, ubude be-dosing, iimpembelelo eziphawulweyo, kunye nemiphumo emibi echazwe.
Ziziphi iiphuculo eziye zaphawulwa ngonyango olukhulu?
Kwakukho iimpawu ezahlukahlukeneyo ezivandlakanyweyo, ukususela ekubunzima ukuthetha (aphasia), ukungabikho kokuphendula (ukunganakwa), kunye neengxaki zokuhamba ezinxulumene nokungabikho kokuhamba kwemoto. Iimpendulo zazingqiniswanga ngokucacileyo kunye nezikali ezahlukahlukeneyo ezibonakalisiweyo zokusebenzisa i-coma, isifo se-Parkinson, i-dystonia kunye nezinye iingxaki.
Ngokubanzi, i-zolpidem yanikezela uncedo olusisithuba esiphezulu: ukuphuculwa kweninzi, ukuba kuyabonwa, kwaphela kuphela kwiiyure ezine. Ezi mphuculo zaziphinda ziphinda, zifuna i-dosing rhoqo ngenxa yecandelo elincinci lobomi bechiza. Ukuphuculwa kubonwe kwiimoto, ukuphicotha, kunye nezakhono. Amanye ama-comatose okanye izigulane zityalo ziphuculwe kwiimeko ezincinci, abambalwa baze bazama ukuthetha.
Kwakukho nezifundo ezibonise ukuphuculwa kwindlela yokusebenza kwe-neuroimaging, ebonisa ukuba utshintsho olucacileyo kwi-chemistry yengqondo kunye nokudibanisa. Imiphumo ekhethekileyo ingaba khona kwizigulane ezenzakaliswe yi-gangal basil, inxalenye yengqondo eyinceda ukucwangcisa ulwazi ukudibanisa intshukumo efunwayo okanye impendulo yemoto.
Iimiphumo zecala zinokulindeleke: i-zolpidem iya kuhlala. Oku kungabangela ubuthongo kwaye kwaxelwa kwi-13 yezigulane ezingama-551 ezizama. Ekubeni iimpawu zenzelwe ukuphuculwa ngexesha lokuvuka, oku kungaba ngumqobo omkhulu wokusebenzisa imithi. Njengoko ukongezelela kwimpembelelo yokwakhiwa kwememori, kusenokucingwa ukuba kukho iimpembelelo kwimemori yesikhashana . Njengoko abantu abasebenzisa le mayeza banokuba banokungaphumeleli kakhulu kwisiseko, ukuxabiswa ngokupheleleyo kweziphumo ezichaphazelekayo kungahle kuthinteke.
Ngelishwa, i-zolpidem ayisebenzi kuwo wonke umntu. Enyanisweni, kuphela iipesenti ezi-5 ukuya kwezingama-7 zezigulane ezineengxaki ezichaphazela ukuqonda ziphendulwe kwilisi. Oku kuthetha ukuba kuma-95 ekhulwini abantu abasebenzisayo abazange baphuculwe kakuhle kwiindawo zabo zokuqonda. Phakathi kwezi zifundo ngeentshukumo zokunyakaza, amazinga okuphendula aphezulu, afikelela kuma-24 ekhulwini.
Abaninzi abazange baphendule kwilisiza, kodwa ngeendlela ezimbalwa zokwenza unyango, i-zolpidem isenokuba yinto ekhangayo kwiintsapho ezixhomekeke kunoma yintoni ithuba lokuphucula.
ILizwi
Nangona ezi ngxelo kunye nezilingo ezincinci zonyango zingabonakala zikhuthazayo, kukulungele ukuba iintsapho kunye nabahlobo babo banemiphumo ebalulekileyo yokuphelelwa yintsholongwane ngenxa yokuzichazela ezi ziphumo kunye neqondo elimangalisayo lokubonga. Kungenzeka ukuba i-zolpidem ayinakunceda uninzi lwezigulane ezithwaxwa yizi ngxaki ezikhubaza kakhulu. Nangona kunjalo, kunokukho isizathu sokuba nethemba: uphando olongezelelweyo lufanelekile.
Ayiqondi kakuhle ukuba i-ajpidem ingayiphucula njani le miqathango eyahlukeneyo. Kusenokwenzeka ukuba ithintele ukulinganisela kwama-neurotransmitters kunye nokudibanisa phakathi kweendawo ezahlukeneyo zobuchopho. Ngomfanekiso, ukuba ingqondo ibambelele kwisimo sokungasebenzi ngenxa yokungalingani kwemibutho echasene nayo, kunokukunceda ukuphosa umzabalazo ngendlela efanelekileyo. Ezi ndlela kufuneka zicaciswe. Izilingo zophando ezinkulu zonyango zingasinceda ukuba siqonde ukuba ngubani onokukhubazeka kwemvakalelo enomdla uya kuzuza ngokusetyenziswa kwe-ajpidem-kwaye kutheni.
> Imithombo:
> IBomalaski, MN et al . "I-Zolpidem yonyango lweengxaki ze-Neurologic: Uhlolo lokuHlola." UJAMA Neurol . Ishicilelwe kwi-intanethi ngoJuni 26, 2017. yenze: 10.1001 / jamaneurol.2017.1133.
> Kilduff, TS kunye neMendelson, WB. Iimpawu zoMzimba: iiNkqubo zokuSebenza kunye neMiphumo ye-Pharmacologic Impact " kwiMigaqo neMigangatho yoLwazi lweMpilo . Ehlelwe ngu-Kryger MH, uRoth T, iDement WC. St. Louis, eMissouri, uElsevier Saunders, 2017, iphe. 429.
> Miyazaki, Y et al. "Ukusebenza kwe-ajpidem ye-dystonia: isifundo phakathi kwamacandelo ahlukeneyo." I- Front Neurol . Ngo-2012 uMvulo 17; 3: 58.
> Sateia, MJ et al . " Isikhokelo seKliniki yoLwazi lwe-Pharmacologic Treatment of Insolnia engapheliyo kubantu abadala: i-American Academy yoLondolozo lwezeNtsholongwane ." I- Journal of Clinical Sleep Medicine . 2017; 13 (2) 307-349.
> Sutton, JA noClauss, RP. "Ukuhlaziywa kobungqina bentsholongwane ye-ajpidem emva kokukhubazeka kwengqondo emva kokulimala kwengqondo ngenxa yokuphazamiseka, ukuxhwaleka kunye ne-hypoxia: Ukulungiswa kwezilingo eziqhubekayo zekliniki . 2017; 31 (8): 1019-1027.