Abadala abadala, i-Dementia ne-Mood Stabilizers
Ukuzinza kweempawu zonyango ezenzelwe ukukhupha iimvakalelo eziguquke kakhulu. Ngokomzekelo, umntu ophezulu ophezulu (mania) kunye ne-lows (ukudakumba) unokufumanisa ukuba une-bipolar disorder kwaye umiselwe ukuba ahlaziye amayeza azinzileyo ukuze azame ukuhlaziya ukuguquguquka kwemizwa kunye neemvakalelo zabo. Ezi zi yobisi ziye zisiwe ngamanye amaxesha ukuphatha iimpawu zokuziphatha kunye nengqondo yengqondo (BPSD) .
Ezi zihlandlo ngamanye amaxesha zibizwa ngokuba " ziphatha imingeni " kwisifo sengqondo somqondo.
Ngaba zizinzi zokuzimelela ngokuphumelelayo kwi-Dementia?
Amachiza amaninzi ahlukeneyo-amaninzi awo anticonvulsants (iziyobisi zokunciphisa ukuxhatshazwa) -wachazwa njengento yokuzinza. Ngokubanzi, uphando aluzange luxhase ukusetyenziswa kweemeko ezizinzileyo ekudemeni kweengqondo , nangona kukho ezinye izinto ogqirha ugqirha ngayo xa eyala la mayeza. Ngexesha elide, uphando olongezelelweyo lunokuthi lucacise ngakumbi ukusetyenziswa kwala mayeza kubantu abaphila ngengqondo yokugula.
Nazi ezinye zezinto eziqhelekileyo ezizinzileyo, ezibandakanya ubukhulu bokusebenza kwazo ekuphatheni ukukhathazeka kunye nobudlova ekudemeni kwengqondo, ngokutsho kweengxelo zophando.
I-lithium (i-Eskalith, iLithobid):
I-lithium imiselwe ukuba ilawule ingxaki ye-bipolar. Izifundo ngokuqhelekileyo azifumananga ukuba ziphumelele ekuphatheni iimpawu ezicelomngeni kwiqondo lomqondo.
Valproate (Depakote):
Leli qela le-anticonbulsant drug, elibandakanya i-divalproex sodium (Depakote), i-valproate sodium (Depacon) kunye ne-valproic acid (i-Depakene, iStvzor), isetyenziswe ngamagqirha athile ukunyanzelisa ingqondo kwi-dementia kodwa ngokubanzi, ukusetyenziswa kwayo akuxhaswa ngophando . Olunye uphando luye lwabonisa ukulahleka okwandisiweyo komthamo wengqondo kunye nokusetyenziswa kwe-divalproex sodium ekudemeni kwengqondo.
Carbamazepine (Tegretol):
Le ngonyango i-anticonbulsant edlalwa ukuba ixhaphake kubantu abanesithuthwane. Olunye uphando lufumene ukuba eli liyeza lisebenza ngendlela efanelekileyo ekwenzeni unyango kwi-dementia. Nangona kunjalo, ayisoloko isetyenziselwa kuba ingaba nemiphumo emibi emibi, njengentsebenziswano namanye amayeza, ukuphuhliswa kwe-sodium ephantsi kunye nokunciphisa amanani e-white cell counts.
I-Oxcarbazepine (Trileptal):
Uphando lubonisile ukuba le mithi ye-anticonbulsant iye yinto engasebenziyo ekunciphiseni iimpawu ezinzima ezinxulumene nengqondo.
Lamotrigine (Lamictal):
I-Lamotrigene yinye isicatshulwa esivunyelwe ukuba siphumelele ekuthinjeni. Kukho uphando oluthile oluye lwabonisa ukuphucuka kwintlupheko yengqondo kunye nokusetyenziswa kwayo, kwaye uphando oluthile lufumanise ukuba ukulawula kunye neyeza zokulwa ne-antipsychotic kunceda ukunqanda ukwandisa izidakamizwa zokulwa ne-antipsychotic. I-US Food and Drug Administration ibhala ukuba i-lamotrigene inomngcipheko omncinci wokusongela ubomi onokuphuhliswa njengempembelelo.
Imithi yokulwa ne-antipsychotic, edlalwa ngamanye amaxesha njengemigudu yokuzinza, iyakuthi imiselwe ukukunceda ukunciphisa ukuziphatha okunzima kunye neemvakalelo eziphazamisayo.
Imithi ye-Antipsychotic iquka i-Abilify (i-aripiprazole), i-Clozaril (clozapine), i-Haldol (i-haloperidol), i-Risperdol (risperidone), iSeroquel (quetiapine), ne-Zyprexa (i-olanzapine).
Izifundo eziliqela ziye zaqhutyelwa kwizidakamizwa ze-antipsychotic kunye nokusetyenziswa kwazo kwi-BPSD. La mayeza anokufumana inkxaso engakumbi ekuphandeni ukubonisa ukuba banokunceda ngokuziphatha okucelomngeni kumqondo weengqondo, kodwa banokubeka ingozi enkulu yokuxakeka, kunye nokufa, ngokusetyenziswa kwabo. Ngenxa yo mngcipheko, kukho ikholi yelizwe lonke evela kwiziko leMedare neMedicaid ukunciphisa ukusetyenziswa kwezidakamizwa zokulwa ne-antipsychotic kubantu abaneengqondo.
Iipilisi ze-antipsychotic zifanelekile xa umntu onesifo sengqondo somzimba ejongene ne- paranoia , ukukhohliswa okanye iingcamango ezibangela ukuba zicinezeleke. I-Antipsychotics ayifanele isetyenziswe nje ngokuba umntu akaphumli, uxhalabile, ujikeleze , okanye angalali kakuhle ebusuku.
ILizwi
Okubaluleke kakhulu, ukungenelela kweziyobisi ezingenayo iziyobisi ekujongeni nokuziphatha komngcipheko kufuneka kuhlolwe phambi kokuba imichiza isetyenziswe. Nangona kungekho sisisombululo esisebenza ngaso sonke isikhathi, iindlela ezingekho kweziyobisi ziye zabonisa ukuphumelela ekunciphiseni nasekuphenduleni, i-BPSD.
Ukuzikhusela
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Imithombo:
Iziyobisi kunye nokuguga. 2012 uAgasti 1; 29 (8): 627-37. I-Efficacy noKhuselo lwe-Anticonvulsants Entsha kwiziguli ezine-Dementia. http://www.ncbi.nlm.nih.gov/pubmed/22734626
Ukuphononongwa koMhloli weeurotherapeutics. 2012 Feb; 12 (2): 155-8. Umbutho we-Chronic Divalproex Usetyenziso lweSodium kunye ne-Brain Atrophy kwisifo se-Alzheimer's. http://www.ncbi.nlm.nih.gov/pubmed/22288670
Umbhalo we-Huazhong Yunivesithi yeSayensi kunye neThekhnoloji [iSayensi yezoLwazi]. Oktobha 2010, uMqulu 30, Issue 5, iphe 652-658. I-Meta-Analysis ye-Mood Stabilizers yeSifo se-Alzheimer's. http://link.springer.com/article/10.1007%2Fs11596-010-0559-5
I-Kaohsiung Journal of Sciences yezoNyango. 2012 kuMeyi; 28 (4): 185-93. Iimpawu zokuQinisekisa kweMimoya kwiNyango yeZenzo zokuziphatha kunye neengqondo zengqondo ye-Dementia: Isibuyekezo sokuhlaziywa. http://www.ncbi.nlm.nih.gov/pubmed/22453066
Psychogeriatrics. Ngo-2015 uMar; 15 (1): 32-7. Ulwaphulo-mthetho lwe-Amotrigine kunye noTshintsho kwiiNkalo zoMxhatshazo ezisetyenziselwa izidakamizwa ze-Psychotropic kwi-Alzheimer's's Disease ngeendlela zokuziphatha kunye neengqondo zengqondo ye-Dementia: I-Trial's Pre-Mineral Label-Trial. http://www.ncbi.nlm.nih.gov/pubmed/25516380
Isebe lezeMpilo yengqondo yaseSanta Clara. Izikhokelo zoLwazi lweMithi. Iimpawu zokuzinza. Juni 2014. https://www.sccgov.org/sites/mhd/Providers/PharmacyInformation/MHDGuidelines/Mood%20Stablizers%20Complete%206-2014.pdf
I-United States iThala leNzululwazi yeMithi. Iirekhodi zeMithi. ICarbamazepine. NgoSeptemba 30, 2015. http://livertox.nih.gov/Carbamazepine.htm
I-United States iThala leNzululwazi yeMithi. Lamotrigine. NgoJanuwari 13, 2016. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a695007.html