Neuroleptic - abin da yake da shi? Mene ne ginshikai na mataki na antipsychotic kwayoyi?

Psychotropic miyagun ƙwayoyi, wanda manufarsa - da magani daga psychotic cuta, antipsychotic kira (as antipsychotic ko neuroleptic). Mene ne shi da kuma yadda yake aiki? Bari mu fuskanci shi.

Neuroleptic. Mene ne wannan? Tarihi da kuma halaye

Antipsychotics magani bayyana gwada da kwanan nan. Har su samu a lura da psychosis mafi sau da yawa amfani shirye-shirye na kayan lambu asalin (kamar henbane, belladonna, opiates), igiyar jini gwamnati na alli, bromide, kazalika da narcotic barci.

A farkon '50s na karni na 20th ga wadannan dalilai sun soma antihistamines ko lithium gishiri.

Daya daga cikin na farko antipsychotic chlorpromazine ya zama (ko chlorpromazine), wanda har sai da aka dauke a al'ada antihistamines. Yadu yi amfani da shi ya fara da 1953, yafi a matsayin wani magani mai kantad da hankali ko neuroleptic (a schizophrenia).

Wadannan neuroleptic shi ne alkaloid reserpine, amma aka zarar share ta sauran, mafi inganci da kwayoyi, kamar yadda kusan babu sakamako.

A farkon shekarar 1958 akwai sauran farko tsara antipsychotics: trifluoperazine (triftazin), haloperidol, thioproperazine da sauransu.

Kalmar "antipsychotic" da aka samarwa a 1967 (a lokacin da ya halitta rarrabuwa na psychotropic kwayoyi na ƙarni na farko), da bi da shi zuwa kwayoyi ba kawai yana da antipsychotic sakamako, amma kuma iya haddasa neurological cuta (akataziyu, neuroleptic parkinsonism, daban-daban dystonic halayen, da dai sauransu). Yawanci, wadannan cuta sa abubuwa irin chlorpromazine, haloperidol da triftazin. Bugu da ƙari, da magani suna kusan ko da yaushe tare da m gefen effects: ciki, da damuwa, ciwo mai tsanani, wani tunanin rashin tunani.

Tun da farko antipsychotics ƙila za a kira "manyan tranquilizers", don haka da cewa antipsychotics da tranquilizers - ne daya da kuma guda. Me ya sa? Saboda su ma sa magani mai kantad da hankali, hypnotic da antianxiety trankviliziruyusche-effects, kazalika da quite wani takamaiman Jihar rashin tunani (Ataraxia). Yanzu wannan lakabi game da neuroleptics ba tambaya.

All antipsychotic kwayoyi za a iya raba hankula da kuma atypical. Hankula antipsychotics mu partially bayyana, yanzu la'akari da wani atypical antipsychotic. Mene ne wannan? Wannan kungiya ne mafi "m" kwayoyi. Sun yi ba sosai yi a cikin jiki, kamar hankula. Sun kasance a wani sabon ƙarni na antipsychotics. A amfani da atypical antipsychotics ne cewa suna da kasa da tasiri a dopamine rabe.

Antipsychotics: shaidar

All antipsychotics mallaka daya na asali dukiya - tasiri tasiri a kan m bayyanar cututtuka (mafarki, da masifa, ainihin pseudohallucinations, komai bane illa kawayeniya, hali cuta, da masifa, ainihin mutunci kuma zumudi). Bayan haka, neuroleptics (yafi atypical) iya sanya mu bi depressive ko kasawa cututtuka (Autism, wani tunanin flattening, kuma desotsializatsii m. P.). Duk da haka, su tasiri a dangane da magani daga cututtuka da kasawa ne a babban tambaya. Masana sun bayar da shawarar cewa antipsychotic kwayoyi ne iya kawar kawai sakandare bayyanar cututtuka.

Atypical antipsychotics, wanda inji na mataki ne weaker fiye da hankula, kuma an amfani da su bi bipolar cuta.

A Amirka, tabin hankali Association haramta yin amfani da antipsychotics mu bi da halayya da m bayyanar cututtuka na gigin-tsufa. Har ila yau, ya kamata su ba za a yi amfani da ga rashin barci.

Yana da unacceptable da za a bi da tare da biyu ko fiye antipsychotics a lokaci guda. Kuma ku tuna cewa neuroleptics amfani domin lura da tsanani cututtuka, saboda kawai ba a ba da shawarar a yi.

Main effects da sunadaran da mataki

Modern antipsychotic kwayoyi raba na kowa inji na antipsychotic mataki, domin zai iya rage yaduwar jijiyar kawai a cikin wadanda kwakwalwa tsarin cewa aika hatsaisai na dopamine. Bari mu dauki wani kusa look at wadannan tsarin da sakamako na antipsychotic kwayoyi a kan su.

• Mesolimbic hanya. Rage yaduwar jijiyar a cikin wannan hanya na faruwa a lokacin da karbar duk wani antipsychotic tun daga ƙarƙashinsa, yana da ake nufi kau na m bayyanar cututtuka (msl, hallucinations, r ?? i kuma kamar. D.)
• Mesocortical hanya. Akwai bugun jini canja wurin rage take kaiwa zuwa bayyanar cututtuka na schizophrenia (korau cuta bayyana kamar apathy, desocialization, talauci na magana, flattening na shafi, anhedonia) da kuma fahimi cuta (hankali gaira, illa ƙwaƙwalwar aiki, da sauransu. D.). A amfani da hankula antipsychotics, musamman dogon lokaci, take kaiwa zuwa ƙãra korau cuta, kazalika da tsanani take hakki na kwakwalwa ayyuka. Soke neuroleptics a cikin wannan hali ba ya taimaka.
• Nigrostriatal hanya. Dopamine tsoka mai amsa sigina kawancen a cikin wannan harka kullum take kaiwa zuwa wani hali antipsychotic illa (akathisia, parkinsonism, dystonia, salivation, dyskinesia, lockjaw da t. D.). Wadannan illa an lura a 60% na lokuta.
• Tuberoinfundibular hanya (bugun jini watsa tsakanin limbic tsarin da pituitary gland shine yake). Tarewa da tsoka mai amsa sigina take kaiwa zuwa ƙãra prolactin hormone. A wannan bango kafa babbar dama sauran illa kamar gynecomastia, galactorrhea, jima'i tabarbarewa, rashin haihuwa da kuma ko da Pathology pituitary ƙari.

Hankula antipsychotics ƙara shafi dopamine rabe. atypical wannan shafi a kan sauran neurotransmitters serotonin (abubuwa da aika da jijiyar). Saboda wannan atypical antipsychotics sa m hyperprolactinemia, extrapyramidal cuta, neuroleptic ciki da kuma neurocognitive deficits da kuma mummunan cututtuka.

Ãyõyin α ₁ -adrenoceptor kawancen an rage hawan jini, orthostatic hypotension, dizziness ci gaba, abin da ya faru na sleepiness.

Lokacin da kawancen H ₁ histamine rabe bayyana hypotension, wani girma bukatar carbohydrates da kuma nauyi riba, kuma kwantad da hankali.

Idan wani kawancen na acetylcholine rabe, akwai da wadannan illa: maƙarƙashiya, bushe baki, tachycardia, urinary riƙewa, ya karu intraocular matsa lamba da kuma masauki disturbances. Shi ne kuma zai yiwu fitowan da shafi tunanin mutum da rikice da sleepiness.

Yammacin masu bincike sun nuna cewa tsakanin antipsychotics (neuroleptics, sabon ko tsufa, ko hankula atypical - ba kome) kuma kwatsam cardiac mutuwa, akwai wani connection.

Har ila yau, a lura da neuroleptic-bugun jini da kuma hadarin ciwon zuciya qara muhimmanci. Wannan shi ne saboda gaskiyar cewa psychotic kwayoyi shafi sia metabolism. Kudin shiga neuroleptics iya fararwa da irin 2 ciwon sukari. A chances na samun tsanani da rikitarwa kara da hada magani tare da hankula da kuma atypical antipsychotics.

Exemplary antipsychotics iya tsokana farfadiya seizures an saukar da kãmun bakin kofa.

Mai antipsychotics (yafi phenothiazine neuroleptics) da babban hepatotoxic illa da kuma iya ko da kai ga ci gaban cholestatic jaundice.

antipsychotic magani a tsofaffi mutane na iya kara hadarin ciwon huhu da 60%.

A fahimi effects na neuroleptics

Rike da wani bude binciken ya nuna cewa atypical antipsychotics yawanci dan kadan ya fi tasiri a lura da neurocognitive rashi. Duk da haka, na ƙarshe shaida game da su a kalla wasu sakamako a kan neurocognitive cuta ba. Atypical neuroleptics, ginshikai na mataki wanda shi ne dan kadan daban-daban daga hankula, gwajin sau da yawa isa.

A daya na asibiti binciken gwada sakamakon likita risperidone, kuma haloperidol a low allurai. A cikin binciken, babu wani gagarumin bambance-bambance da aka samu alamomi. An kuma an nuna cewa low allurai haloperidol a wani tabbatacce sakamako a kan neurocognitive yi.

Saboda haka, da tasiri na neuroleptics farko ko na biyu ƙarni a kan cognition ne har yanzu rigima.

rarrabuwa na antipsychotics

Mun riga mun ambata cewa antipsychotics kasu kashi hankula da kuma atypical.

Daga cikin hankula antipsychotics za a iya bambanta:

1. Sedatives, antipsychotics (bayar da braked sakamako bayan aikace-aikace): promazine, levomepromazine, chlorpromazine, alimemazine, chlorprothixene, da sauransu periciazine.
2. Incisive antipsychotics (da wani iko da duniya antipsychotic sakamako): fluphenazine, trifluoperazine, thioproperazine, pipotiazine, zuclopenthixol da haloperidol.
3. Dezingibiruyuschie (da wani Kunna, da sakewa mataki): karbidin, sulpiride da sauransu.

By atypical antipsychotics hada da abubuwa kamar aripiprazole, sertindole, ziprasidone, amisulpride, quetiapine, risperidone, olanzapine da clozapine.

Akwai wani rarrabuwa na neuroleptics, wanda ake kasaftawa a cewar:

1. Phenothiazines, tricyclic da sauran Kalam. akwai iri, daga gare su:
   
   ● neuroleptics tare da wani sauki aliphatic bond (Levomepromazine, alimemazin, promazine, chlorpromazine), karfi da hana acetylcholine rabe da adrenergic rabe da pronounced magani mai kantad da hankali sakamako da kuma zai iya sa extrapyramidal cuta.
   ● neuroleptics da piperidine tsakiya (thioridazine, pipotiazine, periciazine) da ciwon m antipsychotic sakamako da kuma m neydokrinnymi da extrapyramidal illa.
   ● neuroleptics da piperazine tsakiya (fluphenazine, prochlorperazine, perphenazine, thioproperazine, frenolon, trifluoperazine), iya tarewa dopamine rabe, da kuma wani rauni sakamako a kan acetylcholine da adrenergic rabe.
   
   
2. All thioxanthene Kalam (chlorprothixene, flupentixol, zuclopenthixol), wanda mataki ne kama da mataki na phenothiazines.
3. Sauya benzamides (tiapride, sultopride, sulpiride, amisulpride), wanda mataki ne ma kamar wancan phenothiazine neuroleptics.
4. All butyrophenone Kalam (trifluperidol, droperidol, galoperiodol, Benperidol).
5. Dibenzodiazapin Irinta (olanzapine, clozapine, quetiapine).
6. Benzisoxazole Irinta (risperidone).
7. Benzizotiazolilpiperazin Irinta (ziprasidone).
8. Indole Irinta (sertindole dikarbin).
9. Piperazinilhinolinon (aripiprazole).

Daga duk na sama, za ka iya ware da samuwa antipsychotics - kwayoyi ba tare da prescriptions sayar a Pharmacy, da kuma kungiyar na antipsychotics, wanda aka sayar tsananin a kan likita ya umarta.

antipsychotic miyagun ƙwayoyi interactions

Kamar kowane sauran magunguna, ta zamani, antipsychotics hulɗa tare da wasu magunguna, idan dauka a lokaci guda. Wasu interactions ne sosai a kawo hadari ga jikin mutum, don haka yana da muhimmanci a san abin da ya dauki antipsychotic kwayoyi ne m. Ka tuna cewa neuroleptics guba sau da yawa yakan faru saboda su interactions da sauran kwayoyi.

Hulda da antidepressants take kaiwa zuwa ƙãra ayyuka kamar yadda neuroleptics da antidepressants kansu. Su hade iya kai wa ga maƙarƙashiya, shanyayyen ileus, hauhawar jini.

Kada ku riƙi tare:

• A hade da antipsychotics da benzodiazepines take kaiwa zuwa numfashi ciki, kwantad da hankali illa.
• Lokacin da concomitantly da lithium far iya ci gaba hyperglycemia, bayyanar rikice, drowsiness. Su hade za a iya jure, amma kawai a karkashin likita dubawa.
• Aikace-aikace tare da agonists (ephedrine, metazonom, noradrenaline, adrenaline) rage sakamako na biyu kwayoyi.
• Antihistamines a lokacin coadministration da neuroleptics bunkasa su hana ruwa guda sakamako a kan ta tsakiya m tsarin.
• Wannan sakamako da ake dauka tare da antipsychotic barasa, yana nufin don maganin sa barci, hypnotics ko anticonvulsants.
• Kudin shiga antipsychotics da analgesics da anesthetics take kaiwa zuwa wani karuwa a cikin sakamako. Wannan hade ne da wani depressing sakamako a kan CNS.
• Antipsychotics dauka tare da insulin da antidiabetic kwayoyi take kaiwa zuwa wani karu a cikin tasiri.
• Lokacin da samun antipsychotics da tetracyclines kara hadarin hanta da gubobi.

contraindications

Kuma da atypical da hankula antipsychotic kwayoyi da Generic jerin contraindications:

• idiosyncrasy shirye-shirye;
• gaban rufaffiyar-kwana glaucoma, prostatic adenoma, porphyria, Parkinson ta cuta, pheochromocytoma.
• rashin lafiyan halayen ga neuroleptics a tarihin dan Adam.
• cuta na hanta da kuma kodan.
• ciki da kuma lactation.
• cututtuka na zuciya da jijiyoyin jini tsarin.
• m febrile rashin lafiya.
• coma.

Side effects na neuroleptics

Lokacin da dadewa far, ko mafi kyau nuna neuroleptic illa.

All antipsychotic kwayoyi na iya kara hadarin hypersensitivity dopamine, wanda a bi take kaiwa zuwa bayyanar cututtuka na psychosis da tardive dyskinesia.

Mafi sau da yawa, wadannan cututtuka faruwa lokacin da ka soke wata neuroleptic (wannan ne ake kira "karbo ciwo"). karbo ciwo yana da dama iri: tardive psychosis, dyskinesia unmasked (ko recoil dyskinesia), na cholinergic ciwo "recoil" et al.

kana bukatar ka gama hankali don a hana wannan ciwo, neuroleptic magani, sannu-sannu rage kashi.

Lokacin da samun high allurai neuroleptics lura gefen sakamako kamar neuroleptic-jawo gaira ciwo. A cewar unofficial data, wannan tasirin ne ke faruwa a 80% da marasa lafiya shan hankula antipsychotics.

Tsarin canje-canje a cikin kwakwalwa don shafe tsawon amfani

Placebo-sarrafawa karatu na rhesus data, wanda har shekara biyu aka bai wa haloperidol ko olanzapine a al'ada sashi, juz'i na da nauyin kwakwalwa daga samun neuroleptics rage a kan talakawan da 11.8%. Wannan shi ne saboda wani karu a cikin juz'i na fari da launin toka al'amarin. Murmurewa daga neuroleptics ba zai yiwu ba.

Bayan da littafin da sakamakon da masu bincike ya yi zargin cewa sakamakon neuroleptics ba a gwada a kan dabbobi kafin buga a kan pharmaceutical kasuwar, da kuma cewa su gabatar da wani hadari ga mutane.

Daya daga cikin masu bincike, Nancy Andreasen, shi ne m cewa raguwa a launin toka al'amari girma, da kuma samun antipsychotics a general yana da mummunan tasiri a kan jikin mutum da take kaiwa zuwa atrophy na prefrontal bawo. A daya hannun, shi ma ya lura da cewa antipsychotics ne wani muhimmin magani da za a iya warkar da yawa ailments, amma suna bukatar da za a dauka kawai a sosai kananan yawa.

A 2010, masu bincike Yahaya. Leo da Yahaya. Moncrieff wallafa wani nazari da bincike a kan tushen da Magnetic rawa images of kwakwalwa. A binciken da aka za'ayi kwatanta kwakwalwa na marasa lafiya canje-canje shan neuroleptics, da kuma marasa lafiya da suke da aka ba da shan su.

A 14 na 26 lokuta (marasa lafiya bi da tare da neuroleptics) aka lura da wani karu a kwakwalwa girma, da girma da launin toka da fari al'amarin.

Na 21 lokuta (marasa lafiya da suke da aka ba shan antipsychotics, ko yarda, amma a kananan allurai) a cikin ko dai wani canji da aka samu.

A shekarar 2011, duk da wannan bincike Nancy Andreasen ta wallafa sakamakon wani binciken wanda ya samu canje-canje a cikin kwakwalwa girma a 211 marasa lafiya bi da tare da antipsychotic kwayoyi na dogon lokaci (a kan shekaru 7). A mafi girma da miyagun ƙwayoyi kashi ya, da girma da adadin rage kwakwalwa.

A ci gaba da sabon kwayoyi

A wannan lokacin da muke tasowa sabon antipsychotics cewa da wani sakamako a kan rabe. Wata kungiya daga cikin masu bincike ya bayyana cewa, antipsychotic sakamako ne cannabidiol cannabis aka gyara. Saboda haka yana yiwuwa cewa za mu nan da sannu ganin wannan kaya a kan shelves na Pharmacy.

ƙarshe

Da fatan, babu daya da ya rage da tambaya ga abin da yake an antipsychotic. Mene ne shi, abin da ayyukansa da kuma sakamakon da liyafar inji mun yi nazari a sama. Yana kawai ya rage don ƙara da cewa duk abin da matakin na magani a cikin zamani, babu wani daga cikin abu ba za a iya karatu har zuwa karshen. Kuma abin zamba ka yi tsammanin daga wani abu, da yawa kasa a kan wannan hadaddun kayayyakin kamar yadda antipsychotics.

A cikin 'yan shekaru, lokuta da antipsychotic magani daga ciki. Da jãhilci daga hatsarori da wannan magani, mutane da kansu suke yin muni. Antipsychotics a wani hali ba za a iya amfani da duk wata manufa da wasu fiye da manufar da aka nufa. Kuma game da tasiri na wadannan kwayoyi a kan kwakwalwa tsirarwa, riga ko da daga cikin tambaya.

Wannan shi ne dalilin da ya sa antipsychotics - kwayoyi ba tare da prescriptions don sayan, ya kamata a yi amfani da tare da taka tsantsan (da kawai idan kana 100% tabbata cewa kana bukatar shi), kuma ko da mafi alhẽri ba a yi amfani ba tare da wani likita ta sayen magani.