I-Drug yethu yesibili ye-FDA-Approved drug
I-Cymbalta (duloxetine) i-FDA-evunyelwe i- fibromyalgia , ukuxinezeleka, ukugula kwe- diabetes, kunye neentlungu ezingapheliyo zesifo se-musculoskeletal.
Ukuvunywa kwayo ngo-2008 kwenzeni nje isicatshulwa sesibini esivunyelwe ukunyanga i-fibromyalgia. Ifomu yokuvelisa ifumaneka e-US
I-Cymbalta kunye nezinye izidakamizwa ezivunyiweyo, uLyrica (pregabalin) kunye no- Savella (milnacipran) , zithathwa njengonyango lokuqala lwe-fibromyalgia.
Oko kuthetha ukuba bacetyiswa ngaphambi kweyiphi na imithi. Basebenza kakuhle kwabanye kodwa kungekhona kuwo wonke umntu. Kwabanye abantu, bangela iziphumo ezingasemngciphekweni ezinobungozi okanye ezingathandekiyo ukwenzela ukuba abantu bahambe kuzo. Kwabanye, asebenzi kakuhle.
(Oku akukodwa kwiCymbalta. Akukho unyango olulodwa lusinceda sonke ngesifo.)
Yiyiphi iCymbalta
I-Cymbalta ibalwa njengeSNRI okanye i-serotonin norepinephrine reuptake inhibitor. Ithetha ntoni le nto?
I-Serotonin kunye ne- norepinephrin yi-neurotransmitters (izithunywa zeekhemikhali kwingqondo yakho.) I-Serotonin ibandakanyeka ekuhambeni kwexesha lokulala kunye nentlungu. I-Norepinephrine ikunceda uzive uqaphele kwaye unomdla kunye nokudlala indima kwimemori.
Bobabini ba baxhamli be-neurotransmitter bakholelwa ukuba bahlanjululwe kwi-fibromyalgia, oku kuthetha ukuba asinakho okwaneleyo okanye into esinayo ayisebenzisi kakuhle ngokubaluleka kwethu. Ngayiphi indlela, sinokusebenzisa ezininzi.
I-Cymbalta kunye nezinye i-SNRIs azifaki i-serotonin kunye ne-norepinephrin kwiibongo zethu, kodwa zenza ukuba zifumaneke ixesha elide, eliyisisiphumo esifanayo kunye nokongeza ngaphezulu. Ukwenza oko, bancipha inkqubo ebizwa ngokuba yi-reuptake apho iiseli ezikhethekileyo kwingqondo yakho zicima i-serotonin esebenzayo kunye ne-norepinephrine emva kokuba isetyenziselwe ukuthumela imiyalezo esuka kwi-neuron enye ukuya kwenye.
(Kufana ne-neurotransmitter imvulophu ekhohlo ehleli ejikelezileyo emva kokuba uvule i-imeyile yakho.) Ukugcina i-neurotransmitter malunga nexesha elide kukuvumela ukuba ubuchopho bakho buyisebenzise ngokufanelekileyo.
I-Cymbalta yeFibromyalgia
Izilingo ezininzi zeekliniki zibonisa ukuba iCymbalta inokunciphisa intlungu ye-fibromyalgia, kokubili kunye nangaphandle kokudandatheka kwe-comorbid. Uphando lubonisa ukuba le nkunkuma iyaqhubeka isebenza ngempumelelo ubuncinane ngonyaka.
Abaphandi abaqondi kakuhle ukuba le mveliso isebenza njani. Nangona kunjalo, isifundo se-2015 (Wang) sichaza ukuba ukutyhafa kweempawu zentlungu ezithandanayo ezibangelwa ngumonakalo weentlanzi (i-neuropathy.) Intetho enye yeentlungu ze-fibromyalgia kukuba kubandakanya ukuphelelwa yintsholongwane emantanjeni amancinci eduze kwesikhumba sakho. Ukuba oko kuyinyaniso, yintoni eyenza iCymbalta isebenza ngokubhekiselele kwiintlungu zethu.
Kulo cwaningo, iCymbalta yabonakala ekunciphiseni iintlobo ezimbini zentlungu efana ne-fibromyalgia: hyperalgesia kunye ne-allodynia. I-Hyperalgesia yinto "ijika umthamo" weentlungu zethu, ngelixa i-allodynia ibuhlungu ezintweni eziqhelekanga ezingabangeli intlungu, njengengcinezelo yokukhanya.
Isistim
Umlinganiselo weCymbalta umcebisi u-60 mg, uthathwa kanye ngosuku. Ngokuqhelekileyo iqalwe kwi-30 mg ngosuku kwaye yanda ukuya kuma-60 mg emva kweveki.
Amanqanaba aphezulu ngaphezu koku akukholelwa ukuba ayasebenza ngakumbi kwi-fibromyalgia, kwaye idibene nomngcipheko ophezulu wemiphumo emibi.
Abantu abafuna ukuyeka ukuthatha le nkunkuma kufuneka bathethe nodokotela wabo ngendlela efanelekileyo yokucima kancane kancane; ukuyeka ngokukhawuleza kuyingozi. Ugqirha wakho unokukwazi ukunceda unciphise iimpawu zokuyeka.
Imiphumela
I-Cymbalta idibene neempembelelo ezininzi ezinokwenzeka. Ezi zinto kufuneka uxelele ugqirha wakho ngokukhawuleza ziquka:
- Ukuphendula okuvakalayo (ukukhawuleza, ukucheka okanye ukuvutha, ukuvuvukala ubuso, imilomo okanye ulwimi),
- Uxinzelelo lwegazi,
- Ukudideka,
- Utywala kunye / okanye ukulahleka kwe-balance,
- Ukuthetha ngokukhawuleza, iimvakalelo ezivuyayo, okanye izenzo ezingekho phantsi kokulawula,
- Ngokukhawuleza, intliziyo engavumelekanga,
- Fever,
- I-hallucinations okanye ukulahlekelwa koqhagamshelwano kunye nenyaniso,
- Ukuxhamla,
- Uhudo, ukuhlanza,
- Iingcamango zokuzibulala okanye ezinye iinguqu zengqondo,
- Umchamo omnyama,
- Ukuphaphaza ngokwemvelo okanye ukutyumla.
Imiphumo emibi yeCymbalta engadingi ukufuna unyango iquka:
- Umbono o
- Ukutshintsha ukutya,
- Utshintsho kwi-sex drive okanye ukusebenza,
- Intloko,
- Ukwandisa ukujuluka,
- I sizathu.
Ngaba iCymbalta Ilungelo Lakho?
Ukuba unomdla wokuzama iCymbalta, xela ugqirha wakho. Qinisekisa ukuba uqikelele ngokucophelela ubuqili kunye nokuqhawula kwaye ubhekisele kuyo nayiphi na intsebenziswano engalunganga kunye nezinye iziyobisi ozithathayo.
Ingcinga efanelekileyo, kunye nawaphi na amachiza, ukuba uluhlu lweemiphumo ezichaphazelekayo ezifanelekileyo. Unokufuna ukuvumela abantu abasondeleyo kuwe ukuba bazi malunga nemiphumo emibi, njengokwenyuka, ukulahleka koqhagamshelwano kunye nenyaniso, okanye iingcinga zokuzibulala, ukuze bazi ukuba kwenzekani, mhlawumbi xa kwenzeka.
Imithombo:
Arnold LM, et al Incwadi yekliniki yentlungu. 2009 Julayi-Aug; 25 (6): 461-8. Ukuthelekiswa kokusebenza kunye nokukhuselwa kwe-duloxetine ukwenzela unyango lwe-fibromyalgia kwizigulana ezinxamnye nokungaxakeki okukhulu kwengxaki.
I-Choy EH, kunye ne-Clinic rheumatology. 2009 Sep; 28 (9): 1035-44. Ukhuseleko kunye nokunyamezela kwe-duloxetine kwonyango lwezigulane nge-fibromyalgia: uhlalutyo oluqokelelweyo lweenkcukacha ezivela kwizilingo ezinhlanu zonyango.
Hauser W, et al. Uphando lwe-arthritis kunye neyeza. 2014 Jan 17; 16 (1): 201. Ukuphononongwa kwezilwanyana zonyango kwi-fibromyalgia syndrome.
NIH Publications NO. 04-5326
Uceyler N, et al. Ubunjani. 2013 Juni; 136 (Pt 6): 1857-67. Iifayibrari ezincinci kwizifo kwizigulane ze-fibromyalgia syndrome.
Wang CF, et al. Anesthesia kunye ne-analgesia. Agasti ka-2015; 121 (2): 532-44. Izenzo zendawo kunye neenkqubo ze-duloxetine kwi-allodynia kunye ne-hyperalgesia esebenzisa imodeli yentlungu ye-intensive pain incision model.