Ukuqonda iimpawu ze-Extrapyramidal kunye noNyango oluZibangelayo

Umxholo

• Zithini iimpawu ze-extrapyramidal?
• Akathisia
• Idystonia efanelekileyo
• Iparkinsonism
• Isifo se-Neuroleptic malignant syndrome (NMS)
• I-Tardive dyskinesia
• Iintlobo ezincinci zedyskinesia
• Yintoni ebangela iimpawu ze-extrapyramidal?
• Zichongwa njani iimpawu ze-extrapyramidal?
• Zinyangwa njani iimpawu ze-extrapyramidal?
• Umgca wezantsi

Iimpawu ze-Extrapyramidal, ezibizwa ngokuba kukuphazamiseka kwentshukumo yeziyobisi, zichaza iziphumo ebezingalindelekanga ezibangelwa zii-antipsychotic kunye nezinye iziyobisi. Ezi ziphumo zibandakanya:

• iintshukumo ezingalawulekiyo okanye ezingalawulekiyo
• ukungcangcazela
• izihlunu zezihlunu

Iimpawu zinokuba nzima ngokwaneleyo ukuba zichaphazele ubomi bemihla ngemihla ngokwenza kube nzima ukuhamba, ukunxibelelana nabanye, okanye ukukhathalela imisebenzi yakho yesiqhelo emsebenzini, esikolweni, okanye ekhaya.

Unyango luhlala lunceda, kodwa ezinye iimpawu zinokuhlala zihleli. Ngokubanzi, ngokukhawuleza ufumana unyango, ngcono.

Funda ukuze ufunde ngakumbi malunga neempawu ze-extrapyramidal, kubandakanya amayeza anokubangela ukuba bafumane kwaye baphathwe njani.

Zithini iimpawu ze-extrapyramidal?

Iimpawu zinokwenzeka kubantu abadala nakubantwana kwaye kunokuba nzima.

Iimpawu zokuqala zingaqala kungekudala emva kokuba uqale iyeza. Bahlala bebonisa iiyure ezimbalwa emva kwethamo lakho lokuqala kodwa banokubonisa nangaliphi na ixesha kwiiveki zokuqala.

Ixesha linokuxhomekeka kwisiphumo secala esithile. Iimpawu ezilibazisekayo zinokwenzeka emva kokuba uthathe ichiza ixesha elithile.

Akathisia

Nge-akathisia, unokuziva ungonwabanga okanye uxakekile kwaye unomnqweno wokuhamba. Kubantwana, oku kunokubonakalisa ukungonwabi emzimbeni, ukuphazamiseka, uxinzelelo, okanye ukucaphuka ngokubanzi. Unokufumanisa ukuba ukuhamba, ukushukumisa imilenze yakho, ukugungqa iinyawo zakho, okanye ukuphulula ubuso bakho kunceda ukunciphisa ukungazinzi.

Uphando lubonisa umngcipheko wokunyuka kwe-akathisia ngamayeza aphezulu. Iimpawu ze-Akathisia ziye zadityaniswa nomngcipheko ophezulu wenye imeko ebizwa ngokuba yi-tardive dyskinesia.

Naphi na ukusuka kubantu abathatha i-antipsychotic banokuphuhlisa i-akathisia.

Amanye amayeza, kubandakanya i-beta-blockers, anokunceda ekunciphiseni iimpawu. Ukunciphisa idosi yeyeza antipsychotic nako kunokukhokelela kuphuculo.

Idystonia efanelekileyo

Ukuphendula kweDystonic kukungafani ngokungafaniyo nezihlunu. Ezi ntshukumo zihlala ziphindaphindeka kwaye zinokubandakanya ukungqubana kwamehlo okanye ukuqhwanyaza, intloko ejijekileyo, ulwimi olukhulayo, kunye nentamo eyandisiweyo, phakathi kwabanye.

Iintshukumo zinokuba mfutshane kakhulu, kodwa zinokuchaphazela ukuma kwakho okanye ziqinise izihlunu zakho kangangexesha elithile. Zihlala zichaphazela intloko nentamo yakho, nangona zinokwenzeka kwamanye amalungu omzimba wakho.

I-Dystonia inokubangela ukuqina kwemisipha ebuhlungu kunye nokunye ukungahambi kakuhle. Unokukrwitshwa okanye unengxaki yokuphefumla ukuba impendulo ichaphazela izihlunu emqaleni wakho.

Izibalo zibonisa ukuba naphi na phakathi kwabantu abathatha i-antipsychotic experience ye-acute dystonia, nangona ixhaphake kakhulu kubantwana nakubantu abadala abancinci.

Ihlala iqala kwiiyure ezingama-48 emva kokuba uqale ukuthatha i-antipsychotic kodwa ihlala iphucula ngonyango. Ukunciphisa idosi yeyeza antipsychotic kunokunceda. Iziphumo zeDystonic zinokunyangwa nge-antihistamines kunye neziyobisi ezinyanga iimpawu zesifo sika-Parkinson.

Iparkinsonism

I-Parkinsonism ichaza iimpawu ezifana nezo zesifo sika-Parkinson. Olona phawu luxhaphakileyo yimisipha engqongqo kwimilenze yakho. Unokuba nokungcangcazela, ukunyuka kwe-salivation, ukunyakaza okucothayo, okanye utshintsho kwimo yakho okanye ukuhamba.

Phakathi kwabantu abathatha i-antipsychotic bakhulisa iimpawu zeParkinsonia. Bahlala beqala kancinci kancinci, rhoqo kwiintsuku ezimbalwa emva kokuba uqale ukuthatha i-antipsychotic. Idosi yakho inokuchaphazela ukuba ngaba eli cala liyakhula.

Iimpawu ziyahluka ngobunzima, kodwa zinokuchaphazela intshukumo kunye nokusebenza. Banokuphela bazihambele ngokwabo ngexesha, kodwa banokuphathwa.

Unyango ngokubanzi kubandakanya ukwehlisa idosi okanye ukuzama i-antipsychotic eyahlukileyo. Iziyobisi ezisetyenziselwa ukunyanga iimpawu zesifo sika-Parkinson zinokusetyenziselwa ngokukodwa ukunyanga iimpawu.

Isifo se-Neuroleptic malignant syndrome (NMS)

Oku kusabela kunqabile, kodwa kubi kakhulu.

Ngokubanzi, iimpawu zokuqala zezihlunu eziqinileyo kunye nomkhuhlane, emva koko ukozela okanye ukudideka. Unokufumana ukuxhuzula, kwaye ukusebenza kwenkqubo yakho yemithambo kunokuchaphazeleka. Iimpawu zihlala zibonakala kwangoko, rhoqo kwiiyure ezimbalwa emva kokuba uqale ukuthatha i-antipsychotic.

Uphando alucebisi ukuba ngaphezulu kwabantu baya kuphuhlisa i-NMS. Le meko inokukhokelela kwi-coma, ukusilela kwezintso kunye nokufa. Ihlala inxulunyaniswa nokuqala i-antipsychotic, kodwa ikwanxulunyaniswa nokuyeka ngesiquphe okanye ukutshintsha amayeza.

Unyango lubandakanya ukumisa kwangoko i-antipsychotic kunye nokubonelela ngenkxaso yezonyango. Ngokukhathalelwa ngonyango olukhawulezileyo, ukubuyela kwimeko yesiqhelo kuhlala kunokwenzeka, nangona kunokuthatha iiveki ezimbini okanye ngaphezulu.

I-Tardive dyskinesia

I-Tardive dyskinesia luphawu lokufika emva kwexesha lwe-extrapyramidal. Kubandakanya ukuphindaphinda, ukushukuma kobuso ngokungazenzisiyo, njengokujija ulwimi, intshukumo yokuhlafuna kunye nokubamba imilebe, ukukhukhumala kwesidlele, kunye nokuqaqamba. Unokufumana utshintsho kwi-gait, ukushukuma kwamalungu, okanye ukunyusa amagxa.

Ihlala ingakhuli de ube uthathe iyeza iinyanga ezintandathu okanye nangaphezulu. Iimpawu zingaqhubeka nangona unyango. Abasetyhini kunokwenzeka ukuba babe nale mpembelelo yecala. Ubudala kunye neswekile zinokunyusa umngcipheko, njengoko kunokubakho kwiimpawu zeschizophrenia okanye iimpawu ezichaphazela ukusebenza okuqhelekileyo.

Phakathi kwabantu abathatha i-antipsychotic yesizukulwane sokuqala, ukuya kuthi ga malunga nokufumana le mpembelelo yecala.

Unyango lubandakanya ukuyeka ichiza, ukunciphisa idosi, okanye ukutshintshela kwelinye ichiza. IClozapine, umzekelo, inokunceda ekunciphiseni iimpawu ze-tardive dyskinesia. Ukuvuselelwa kwengqondo okunzulu kukwabonakalise isithembiso njengonyango.

Iintlobo ezincinci zedyskinesia

• Idystonia ebambekayo. Le subtype inzima ngakumbi kune-dystonia ebukhali kwaye ihlala ibandakanya ukujikeleza okucothayo emzimbeni wonke, njengokwandiswa kwentamo okanye ityhuna.
• I-akathisia eqhubekayo okanye engapheliyo. Oku kubhekisa kwiimpawu ze-akathisia, ezinje ngokuhamba kwemilenze, ukuhamba ngengalo, okanye ukunyikimisa, okuhlala inyanga enye okanye ngaphezulu ngelixa uthatha idosi efanayo yamayeza.

Zombini ezi zinto zinokuqala kwaye zinokuqhubeka nangona unyango, kodwa iintlobo zentshukumo ezinxulumene nezi mpawu ziyahluka.

Abantwana abayeka ukuthatha amayeza ngequbuliso banokurhoxa kwiidyskinesias. Oku kushukuma okuphindaphindayo kubonakala kumzimba, entanyeni nasemilenzeni.Bahlala bemka bodwa kwiiveki ezimbalwa, kodwa ukuqala ichiza kwakhona kwaye ngokuthe ngcembe ukunciphisa idosi kunokunciphisa iimpawu.

Yintoni ebangela iimpawu ze-extrapyramidal?

Inkqubo yakho ye-extrapyramidal yinethiwekhi ye-neural kwingqondo yakho enceda ukulawula ulawulo lweemoto kunye nokulungelelanisa. Ibandakanya i-basal ganglia, iseti yezakhiwo ezibalulekileyo ekusebenzeni kweemoto. I-basal ganglia ifuna i-dopamine ukuze isebenze ngokufanelekileyo.

I-Antipsychotic inceda ekuphuculeni iimpawu ngokuzibophelela kwii-dopamine receptors kwinkqubo yakho ye-nervous system kunye nokuvimba i-dopamine. Oku kunokuthintela i-basal ganglia ekufumaneni i-dopamine eyaneleyo. Iimpawu ze-Extrapyramidal zinokuphuma njengesiphumo.

I-antipsychotic yesizukulwane sokuqala ihlala ibangela iimpawu ze-extrapyramidal. Nge-antipsychotic yesizukulwane sesibini, iziphumo ebezingalindelekanga zihlala zenzeka kumanqanaba asezantsi. La machiza anobudlelwane obuncinci be-dopamine receptors kwaye abopha ngokukhululekileyo kwaye abhloke ezinye ze-serotonin receptors.

I-antipsychotic yesizukulwana sokuqala ibandakanya:

• chlorpromazine
• haloperidol
• ilevomeprini
• thioridazine
• trifluoperazine
• perphenazine
• flupentixol
• fluphenazine

I-antipsychotic yesizukulwana sesibini ibandakanya:

• clozapine
• iqeqeshwe
• olanzapine
• quetiapine
• ipaliperidone
• sifisozi
• izipro

Zichongwa njani iimpawu ze-extrapyramidal?

Kubalulekile ukuba uqaphele ezi mpawu ukuba wena okanye umntu omthandayo uthatha i-antipsychotic. Iziphumo ebezingalindelekanga ngamanye amaxesha ziye zifane neempawu zesimo esisetyenziselwa ukunyanga ichiza, kodwa ugqirha unokunceda ukufumanisa iimpawu.

Ugqirha wakho unokukubuza okanye ilungu losapho malunga neempawu zakho. Basenokukwazi ukubona ubunzima onabo ngokuhamba okanye ukulungelelanisa ngexesha lotyelelo lweofisi.

Banokusebenzisa inqanaba lokuvavanya, elinje ngeSikali seDraphramramidal Symptoms Scale (i-DIEPSS) okanye i-Extrapyramidal Symptoms Rating Scale (ESRS). Ezi zikali zinokunika ulwazi oluthe kratya malunga neempawu zakho kunye nobukhali bazo.

Zinyangwa njani iimpawu ze-extrapyramidal?

Unyango lweempawu ze-extrapyramidal kunokuba nzima. Iziyobisi zinokuba neziphumo ebezingalindelekanga ezahlukeneyo, kwaye zichaphazela abantu ngokwahlukileyo. Akukho ndlela yokuqikelela impendulo onokuba unayo.

Rhoqo, ekuphela kwendlela yonyango kukuzama amayeza ahlukeneyo okanye iidosi ezisezantsi ukuze ubone ukuba zeziphi ezona zincedisa kwezona ziphumo bezingalindelekanga zimbalwa. Ngokuxhomekeka kwiimpawu zakho, unokumiselwa olunye uhlobo lweziyobisi kunye ne-antipsychotic yakho ukunceda ukubaphatha.

Akufanele uhlengahlengise okanye utshintshe idosi yamayeza akho ngaphandle kwesikhokelo somboneleli wakho wezempilo.

Ukutshintsha idosi okanye amayeza akho kunokukhokelela kwezinye iimpawu. Qaphela kwaye ukhankanye naziphi na iziphumo ezingafunekiyo okanye ezingathandekiyo kugqirha wakho.

Ukuba umiselwe idosi esezantsi ye-antipsychotic, xelela ugqirha okanye ugqirha ukuba uqala ukuba neempawu zengqondo okanye ezinye iimpawu amayeza akho enzelwe ukunyanga.

Ukuba uqala ukufumana ubuqili, ukukhohlisa, okanye ezinye iimpawu ezixhalabisayo, fumana uncedo ngokukhawuleza. Ezi mpawu zinokwandisa umngcipheko wokuzenzakalisa wena okanye omnye umntu, ke ugqirha wakho unokufuna ukuzama indlela eyahlukileyo yonyango.

Inokukunceda ukuthetha nonyango lwakho ukuba ufumana uxinzelelo ngenxa yeempawu ze-extrapyramidal. Unyango alunakho ukujongana neziphumo ebezingalunganga ngokuthe ngqo, kodwa ugqirha wakho unokunika inkxaso kunye neendlela zokumelana nazo xa iimpawu zichaphazela ubomi bakho bemihla ngemihla okanye zikhokelela kuxinzelelo.

Umgca wezantsi

Ngamanye amaxesha, iimpawu ze-extrapyramidal zisenokungakuchaphazeli kakhulu. Ngamanye amaxesha, banokuba buhlungu okanye bangonwabi. Banokuchaphazela kakubi umgangatho wobomi kwaye banegalelo kuxinzelelo kunye noxinzelelo.

Ukuba uneziphumo ebezingalindelekanga, ungagqiba ekubeni uyeke ukuthatha amayeza akho ukubenza bahambe, kodwa oku kunokuba yingozi. Ukuba uyeka ukuthatha amayeza akho, unokufumana iimpawu ezibi kakhulu. Kubalulekile ukuqhubeka uthatha amayeza akho njengoko umiselweyo de uthethe nogqirha wakho.

Ukuba uqala ukufumana naziphi na iziphumo ebezingalindelekanga ngelixa uthatha i-antipsychotic, thetha nogqirha wakho ngokukhawuleza. Ngamanye amaxesha, banokuhlala ngokusisigxina, kodwa unyango lukhokelela kuphuculo.