Ndingamnceda Njani Umntu Endimthandayo Ukwenza Izigqibo ezinolwazi ngakumbi ngonyango lwabo lweParkinson?

Umxholo

• Amayeza eDopamine
• ICarbidopa-levodopa
• Dopamine agonists
• I-MAO B inhibitors
• I-COMT inhibitors
• Ezinye iziyobisi zikaParkinson
• I-Anticholinergics
• Amantadine
• Ukuncamathela kwishedyuli yonyango
• Kwenzeka ntoni xa amayeza kaParkinson eyeka ukusebenza
• Yise kude

Abaphandi abakafumani nonyango yesifo sika-Parkinson, kodwa unyango luye lude kakhulu kwiminyaka yamuva. Namhlanje, amayeza ahlukeneyo kunye nezinye iindlela zonyango ziyafumaneka ukulawula iimpawu ezinjengokungcangcazela nokuqina.

Kubalulekile ukuba umntu wakho amthathe amayeza ngokuchanekileyo njengoko ebekiwe ngugqirha. Unokunika inkxaso kunye nezikhumbuzo ezinobumnene.

Ukuze ube luncedo, kufuneka wazi ukuba ngawaphi amayeza anyanga isifo sikaParkinson, kwaye asebenza njani.

Amayeza eDopamine

Abantu abane-Parkinson abanayo i-dopamine, eyimichiza yobuchopho enceda ukugcina iintshukumo zigudile. Kungenxa yoko le nto abantu abanesi sifo behamba kancinci kwaye benemisipha eqinileyo. Amachiza aphambili asetyenziselwa ukunyanga umsebenzi kaParkinson ngokwandisa inani le-dopamine kwingqondo.

ICarbidopa-levodopa

Iyeza elibizwa ngokuba yi-levodopa, okanye i-L-DOPA, iyeyona nyango iphambili yesifo sika-Parkinson ukusukela emva kweminyaka yoo-1960. Iyaqhubeka nokuba sesona siyobisi sisebenzayo kuba sithatha indawo yedopamine engekho kwingqondo.

Uninzi lwabantu abanesifo sika-Parkinson baya kuthatha i-levodopa ngexesha lokunyanga kwabo. I-Levodopa iguqulwa ibe yi-dopamine kwingqondo.

Amayeza amaninzi adibanisa i-levodopa kunye ne-carbidopa. ICarbidopa ithintela i-levodopa ukuba ingaphuli emathunjini okanye kwamanye amalungu omzimba kwaye iyiguqulele kwi-dopamine ngaphambi kokuba ifike kwingqondo. Ukongeza i-carbidopa kuyanceda ekuthinteleni iziphumo ebezingalindelekanga ezifana nesicaphucaphu kunye nokugabha.

ICarbidopa-levodopa iza ngeendlela ezahlukeneyo:

• ithebhulethi (Parcopa, Sinemet)
• Ithebhulethi ekhupha kancinci ukuze iziphumo zayo zihlale ixesha elide (iRytary, iSinemet CR)
• ukumnika okufakwa emathunjini ngombhobho (iDuopa)
• ipowder (inbrija)

Iziphumo ezivela kula machiza zibandakanya:

• isicaphucaphu
• isiyezi
• utywala xa umi (i-orthostatic hypotension)
• ixhala
• iitics okanye ezinye iintshukumo ezingaqhelekanga zemisipha (idyskinesia)
• ukudideka
• ukubona okanye ukuva izinto ezingezizo (ukubona izinto ezingekhoyo)
• ukozela

Dopamine agonists

La machiza akaguquki abe yi-dopamine kwingqondo. Endaweni yoko, basebenza njenge-dopamine. Abanye abantu bathatha i-dopamine agonists kunye ne-levodopa ukukhusela iimpawu zabo ekubuyeni ngexesha lokuyeka kwe-levodopa.

Iidopamine agonists zibandakanya:

• ipramipexole (iMirapex, iMirapex ER), ithebhulethi kunye nethebhulethi yokukhupha eyandisiweyo
• I-ropinirole (i-Requip, i-Requip XL), ithebhulethi kunye nethebhulethi yokukhupha eyandisiweyo
• apomorphine (Apokyn), inaliti esebenza kancinci
• irotigotine (Neupro), isiziba

La mayeza abangela ezinye zeempembelelo ezifanayo njenge-carbidopa-levodopa, kubandakanya isicaphucaphu, isiyezi kunye nokulala. Banokubangela nokuziphatha okunyanzelekileyo, njengokungcakaza kunye nokutya kakhulu.

I-MAO B inhibitors

Eli qela leziyobisi lisebenza ngokwahlukileyo kune-levodopa yokunyusa amanqanaba e-dopamine kwingqondo. Bavimba i-enzyme eyaphula i-dopamine, eyandisa iimpembelelo zedopamine emzimbeni.

I-MAO B inhibitors zibandakanya:

• iselegiline (iZelapar)
• irasagiline (Azilect)
• i-safinamide (Xadago)

La machiza anokubangela iziphumo ebezingalindelekanga ezinje:

• ingxaki yokulala (ukulala)
• isiyezi
• isicaphucaphu
• ukuqhina
• isisu esibuhlungu
• iintshukumo ezingaqhelekanga (dyskinesia)
• nemibono
• ukudideka
• intloko ebuhlungu

I-MAO B inhibitors inokusebenzisana kunye nokuqinisekileyo:

• ukutya
• amayeza eekhawuntareni
• amayeza kagqirha
• izongezo

Qiniseka ukuba uthetha nogqirha wakho malunga nawo onke amayeza kunye nezixhasi ozithandayo.

I-COMT inhibitors

Amachiza entacopine (Comtan) kunye ne-tolcapone (Tasmar) ikwathintela i-enzyme eyaphula i-dopamine kwingqondo. I-Stalevo sisiyobisi esidibeneyo esibandakanya zombini i-carbidopa-levodopa kunye ne-COMT inhibitor.

Ii-COMT inhibitors zibangela iziphumo ebezingalindelekanga ezifanayo njenge-carbidopa-levodopa. Banokonakalisa isibindi.

Ezinye iziyobisi zikaParkinson

Nangona iziyobisi ezonyusa amanqanaba e-dopamine zizinto eziphambili kunyango lukaParkinson, amanye amayeza ambalwa anceda ukulawula iimpawu.

I-Anticholinergics

I-Trihexyphenidyl (Artane) kunye ne-benztropine (Cogentin) inciphisa ukuthuthumela kwisifo sika-Parkinson. Iziphumo zazo zibandakanya:

• amehlo owomileyo nomlomo
• ukuqhina
• ingxaki yokukhupha umchamo
• iingxaki zememori
• ukudakumba
• nemibono

Amantadine

Eli chiza linokunceda abantu abanesifo sokuqala seParkinson abaneempawu ezinqabileyo kuphela. Inokudibaniswa nonyango lwe-carbidopa-levodopa kumanqanaba okugqibela esi sifo.

Iziphumo ziquka:

• ukudumba komlenze
• isiyezi
• amabala eluswini
• ukudideka
• amehlo owomileyo nomlomo
• ukuqhina
• ukozela

Ukuncamathela kwishedyuli yonyango

Unyango lwakwangoko lwesifo sikaParkinson lulandela inkqubo elula kakhulu. Umntu wakho omthandayo uya kuthatha i-carbidopa- levodopa amaxesha ambalwa ngemini kwishedyuli ebekiweyo.

Emva kweminyaka embalwa kunyango, iiseli zobuchopho ziphulukana namandla abo okugcina i-dopamine kwaye babe novakalelo ngakumbi kwichiza. Oku kunokubangela ukuba idosi yokuqala yamayeza iyeke ukusebenza ngaphambi kokuba kufike ixesha ledosi elandelayo, ebizwa ngokuba "kukunxiba."

Xa oku kusenzeka, ugqirha wakho omthandayo uya kusebenza nabo ukulungisa idosi yonyango okanye ukongeza elinye iyeza ukunqanda amaxesha "okuphuma". Kungathatha ixesha kunye nomonde ukufumana uhlobo lweziyobisi kunye nedosi ngokuchanekileyo.

Abantu abanesifo sikaParkinson abathathe i-levodopa iminyaka eliqela banokuphuhlisa i-dyskinesia, ebangela iintshukumo ezingazibandakanyiyo. Oogqirha banokuhlengahlengisa amayeza ukunciphisa idyskinesia.

Ixesha libaluleke kakhulu xa kufikwa ekuthatheni amayeza kaParkinson. Ukulawula iimpawu, umntu wakho omthandayo kufuneka athathe amayeza abo kwidosi elungileyo kwaye ngexesha elifanelekileyo suku ngalunye. Unokukunceda ngexesha lotshintsho lwamayeza ngokubakhumbuza ukuba bathathe iipilisi zabo kwishedyuli entsha, okanye ngokubathenga isixhobo sokuhambisa ipilisi esizenzekelayo ukwenza ukuba kube lula ukuba nomthamo.

Kwenzeka ntoni xa amayeza kaParkinson eyeka ukusebenza

Namhlanje, oogqirha banamayeza amaninzi ahlukeneyo okulawula iimpawu zikaParkinson. Kusenokwenzeka ukuba umntu omthandayo uya kufumana ichiza elinye- okanye indibaniselwano yeziyobisi- esebenza.

Ezinye iintlobo zonyango ziyafumaneka, kubandakanya ukukhuthaza ubuchopho obunzulu (DBS). Kolu nyango, ucingo olubizwa ngokuba lukhokelo lubekwa kwindawo ethile yengqondo elawula intshukumo. Olu cingo luqhotyoshelwe kwisixhobo esifana nesomatshini esibizwa ngokuba sisixhobo esiphembelela ukufakwa phantsi kwekhola. Esi sixhobo sithumela iimpompo zombane ukukhuthaza ingqondo nokuyeka iimpembelelo zobuchopho ezingaqhelekanga ezibangela iimpawu zikaParkinson.

Yise kude

Unyango lukaParkinson luhle kakhulu ekulawuleni iimpawu. Iindidi zamachiza kunye namayeza owathandayo anokufuna ukuhlengahlengiswa kwiminyaka edlulileyo. Unokukunceda kule nkqubo ngokufunda ngamayeza akhoyo, nangokunika inkxaso ukunceda umntu omthandayo anamathele kunyango lwakhe.