Ka Hoʻokaʻawale ʻana i nā Lāʻau Antipsychotic: He Alakaʻi Piha
ʻO nā antipsychotics kahi papa o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā hōʻailona o nā maʻi psychotic, me ka schizophrenia, ka maʻi schizoaffective, a, i kekahi mau hihia, ka maʻi bipolar. Hoʻi kā lākou hoʻohana ʻana i ka waena o ke kenekulia 20, a ua loaʻa iā lākou nā hoʻomohala koʻikoʻi i ka pono a me ka hōʻemi ʻana i nā hopena ʻaoʻao. Manaʻo kēia ʻatikala e hāʻawi i kahi alakaʻi piha i ka hoʻokaʻawale ʻana o nā lāʻau antipsychotic, e kālele ana i ko lākou mōʻaukala, nā ʻano, nā ʻano hana, a me nā hopena.
Ka Moolelo o ka Hoʻohana ʻana i ka Antipsychotic
Ua hoʻomaka ka mōʻaukala o nā antipsychotics i nā makahiki 1950 me ka ʻike ʻia ʻana o ka chlorpromazine, i manaʻo ʻia he antipsychotic hanauna mua (antipsychotic maʻamau). Ua hoʻomākaukau kēia ʻike i ke ala no ka hoʻomohala ʻana i nā lāʻau lapaʻau e hiki ke hōʻoluʻolu i nā hōʻailona o ka psychosis ma ka hōʻemi ʻana i nā delusions, hallucinations, a me ka maʻi noʻonoʻo. ʻOiai he pono, ua pili pinepine nā antipsychotics hanauna mua me nā hopena ʻaoʻao koʻikoʻi, me nā hōʻailona extrapyramidal e like me ka haʻalulu, ka paʻakikī, a me ka tardive dyskinesia.
Ka Hoʻokaʻawale ʻana o nā Antipsychotics
Hiki ke hoʻokaʻawale ʻia nā antipsychotics ma muli o kekahi mau ʻano hana like ʻole, ʻo ka mea maʻamau ma muli o ko lākou hanauna a me ke ʻano hana.
1. Nā Antipsychotics o ka hanauna mua (Maʻamau)
Kaha
ʻO nā antipsychotics hanauna mua, i ʻike ʻia hoʻi he antipsychotics maʻamau, hoʻohana nui ʻia e mālama i nā hōʻailona maikaʻi o ka schizophrenia, e like me nā hallucinations a me nā delusions. Hana lākou ma ke ālai ʻana i nā mea loaʻa dopamine D2 i loko o ka lolo, kahi i manaʻo ʻia he pili i ka ulu ʻana o nā hōʻailona psychotic.
Nā Laʻana Lāʻau Lapaʻau
ʻO Chlorpromazine: ʻO ka lāʻau antipsychotic mua i ʻike ʻia.
ʻO Haloperidol: ʻO kekahi o nā antipsychotics maʻamau i hoʻohana pinepine ʻia.
– Fluphenazine: Hoʻohana pinepine ʻia no ka schizophrenia mau loa.
Nā hopena ʻaoʻao
He nui nā hopena ʻaoʻao o nā antipsychotics maʻamau, e pili nui ana i ka ʻōnaehana extrapyramidal:
– Nā hopena extrapyramidal: Me ka haʻalulu, ka paʻakikī o nā ʻiʻo, a me ka ʻoni ʻana o nā ʻiʻo i ka hiki ʻole ke hoʻomalu ʻia.
– Tardive Dyskinesia: Nā neʻe ʻana me ka makemake ʻole e ulu mālie me ka hoʻohana lōʻihi.
– Sedation a me Orthostatic Hypotension: Nā hopena ʻē aʻe i ʻike pinepine ʻia.
2. Nā Antipsychotics o ka hanauna ʻelua (Atypical)
Kaha
Ua hoʻolauna ʻia nā antipsychotics hanauna ʻelua, a i ʻole nā antipsychotics atypical, i nā makahiki 1990 a ua manaʻo ʻia he holomua koʻikoʻi i ka lāʻau antipsychotic. Ma waho aʻe o ka pale ʻana i nā mea loaʻa dopamine, kuhikuhi pū nā antipsychotics atypical i nā mea loaʻa serotonin (5-HT2A), e hāʻawi ana i nā pono hou aʻe i ka hoʻoponopono ʻana i nā hōʻailona maikaʻi ʻole a me ka noʻonoʻo o ka schizophrenia.
Nā Laʻana Lāʻau Lapaʻau
– Clozapine: ʻO ka antipsychotic atypical mua loa a manaʻo pinepine ʻia ʻo ia ka mea kūpono loa, ʻoiai no nā hihia o ke kūʻē.
– Risperidone: Hoʻohana pinepine ʻia no ka schizophrenia a me ka maʻi bipolar.
ʻO Olanzapine: Loaʻa iā ia kahi hopena maikaʻi a me nā hopena ʻaoʻao.
– Quetiapine: He hana ia i ka mālama ʻana i ka maʻi bipolar a ma ke ʻano he antidepressant adjuvant.
Nā hopena ʻaoʻao
ʻOi aku ka makemake ʻia o nā antipsychotics atypical no ka mea he haʻahaʻa ko lākou pilikia o nā hopena ʻaoʻao extrapyramidal, akā ʻaʻole lākou i kaʻawale mai nā hopena ʻaoʻao:
– Ka Piʻi ʻana o ke Kaumaha: He hopena ʻaoʻao maʻamau a koʻikoʻi kēia, e pili ana i ka pilikia o ka metabolic syndrome.
– Diabetes Mellitus: Hiki i kekahi mau antipsychotics atypical ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka maʻi diabetes type 2.
– Nā hopena ʻaoʻao Metabolic: Me ka hoʻonui ʻia o ka cholesterol a me nā triglycerides.
ʻAno Hana
Hana nā Antipsychotics ma o nā ʻano hana like ʻole e hoʻopilikia ai i nā neurotransmitters i loko o ka lolo:
– Dopamine: Hana ka hapa nui o nā antipsychotics ma ke ālai ʻana i nā mea loaʻa dopamine, ʻoiai ke ʻano D2. Kōkua kēia ālai ʻana i ka kaohi ʻana i nā hōʻailona maikaʻi o ka psychosis.
– Serotonin: Hoʻopili nā antipsychotics atypical i nā mea loaʻa serotonin (ʻo 5-HT2A paha), e kōkua ana i ka hōʻemi ʻana i nā hōʻailona maikaʻi ʻole o ka schizophrenia a me nā hopena ʻaoʻao extrapyramidal.
– Glutamate: Aia kekahi kuhiakau e pili ana i ka hana ʻole o ka ʻōnaehana glutamate i ka schizophrenia, a ke hana ʻia nei kekahi noiʻi e hoʻomohala i nā lāʻau lapaʻau e pili ana i kēia ʻōnaehana.
Hoʻohana Lapaʻau
Pono ka nānā pono ʻana i ka hoʻohana ʻana i nā antipsychotics i ka hana lapaʻau. Hoʻokumu ʻia ke koho ʻana o ka antipsychotic ma ke ʻano o ka mea maʻi, ka mōʻaukala olakino, ka pane ʻana i ka lāʻau lapaʻau ma mua, a me ka hiki ke hoʻomanawanui i nā hopena ʻaoʻao.
1. ʻO ka maʻi ʻo Schizophrenia:
– Nā Hōʻailona Koʻikoʻi: Hoʻomaka pinepine me nā antipsychotics i hiki ke hāʻawi waha ʻia a i ʻole ma ka inikini.
Mālama: Nā pahuhopu lōʻihi e pale aku i ka hoʻi hou ʻana a hoʻomaikaʻi i ke ʻano o ke ola.
2. Maʻi Bipolar:
– Mania ʻĀkiu: Hoʻohana pinepine ʻia nā antipsychotics e like me olanzapine a me risperidone.
– Mālama ʻana i ke ʻano: Hoʻohana ʻia kekahi mau antipsychotics atypical e like me nā mea hoʻopaʻa ʻano.
3. Ka maʻi Schizoaffective:
– I ka hoʻohui ʻana i nā hōʻailona o ka naʻau a me ka schizophrenic, makemake pinepine ʻia ka hoʻohana ʻana i nā antipsychotics atypical.
Nā Pilikia a me ka Wā E Hiki Mai Ana
ʻOiai ua lawe mai nā antipsychotics i nā holomua koʻikoʻi i ka mālama ʻana i ka psychosis, ke mau nei nā pilikia. Hoʻemi pinepine ʻia ke ʻano o ke ola o nā mea maʻi ma muli o nā hopena kino a me ka metabolic. Ke hoʻomau nei ka noiʻi ʻana i nā mea hana me nā ʻaoʻao hopena ʻaoʻao i hoʻomaikaʻi ʻia.
ʻO kekahi mau wā e hiki mai ana i ka ... hoʻomohala ʻana i ka antipsychotic e pili ana i ke aʻo ʻana o:
– Lapaʻau Transcranial: Ka hoʻohana ʻana i ka ʻenehana neuromodulation non-invasive e hoʻololi i ka hana o ka lolo.
– Gene Therapy: Noiʻi ma nā pae genetic a me epigenetic e hoʻomaopopo i ke kumu olaola o ka maʻi noʻonoʻo a me nā lāʻau lapaʻau e hiki ke kuhikuhi pololei i kēia mau hana.
Ka hopena
He mea koʻikoʻi nā antipsychotics i ka mālama ʻana i nā maʻi psychotic. ʻOiai ua holomua nui lākou i ka mālama ʻana i nā maʻi me ka schizophrenia a me nā maʻi pili, pono e mālama pono ʻia kā lākou koho a me ka hoʻohana ʻana e nā loea lapaʻau e hoʻonui i nā pono a hoʻemi i nā hopena ʻaoʻao. He nui ka manaʻolana o ka wā e hiki mai ana, me ka noiʻi e hoʻomau nei e hoʻomaikaʻi i ke ʻano o ke ola no nā maʻi me nā maʻi noʻonoʻo.
