Matenda a Serotonin

Matenda a Serotonin (SS) ndi mankhwala omwe amatha kuwopsa. Zimapangitsa kuti thupi likhale ndi serotonin yochuluka kwambiri, mankhwala omwe amapangidwa ndi maselo amitsempha.

SS nthawi zambiri imachitika pamene mankhwala awiri omwe amakhudza kuchuluka kwa thupi la serotonin amatengeredwa nthawi imodzi. Mankhwalawa amachititsa kuti serotonin yochuluka kwambiri imasulidwe kapena kuti ikhale m'dera laubongo.

Mwachitsanzo, mutha kukhala ndi vutoli ngati mutamwa mankhwala a migraine otchedwa triptans pamodzi ndi antidepressants omwe amatchedwa serotonin reuptake inhibitors (SSRIs), komanso serotonin / norepinephrine reuptake inhibitors (SSNRIs).

Ma SSRI wamba amaphatikizapo citalopram (Celexa), sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), ndi escitalopram (Lexapro). SSNRIs imaphatikizapo duloxetine (Cymbalta), venlafaxine (Effexor), Desvenlafaxine (Pristiq), Milnacipran (Savella), ndi Levomilnacipran (Fetzima). Ma triptan wamba amaphatikizapo sumatriptan (Imitrex), zolmitriptan (Zomig), frovatriptan (Frova), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), ndi eletriptan (Relpax).

Ngati mutenga mankhwalawa, onetsetsani kuti mwawerenga chenjezo lomwe lili paphukusi. Ikukufotokozerani za chiopsezo cha matenda a serotonin. Komabe, osasiya kumwa mankhwala anu. Lankhulani ndi dokotala wanu za nkhawa zanu poyamba.

SS imatha kuchitika poyambitsa kapena kuwonjezera mankhwala.

Mankhwala okalamba omwe amatchedwa monoamine oxidase inhibitors (MAOIs) amathanso kuyambitsa SS ndi mankhwala omwe afotokozedwa pamwambapa, komanso meperidine (Demerol, painkiller) kapena dextromethorphan (mankhwala a chifuwa).

Mankhwala osokoneza bongo, monga chisangalalo, LSD, cocaine, ndi amphetamines adalumikizidwanso ndi SS.

Zizindikiro zimachitika pakangopita mphindi mpaka maola, ndipo mwina ndi izi:

• Kusakhazikika kapena kusakhazikika
• Kusuntha kwamaso kosazolowereka
• Kutsekula m'mimba
• Kuthamanga kwa mtima komanso kuthamanga kwa magazi
• Ziwerengero
• Kuchuluka kwa kutentha kwa thupi
• Kutaya kwa mgwirizano
• Nseru ndi kusanza
• Kuganiza mopitilira muyeso
• Kusintha mwachangu kuthamanga kwa magazi

Matendawa amapangidwa ndikufunsa munthuyo mafunso okhudza zamankhwala, kuphatikiza mitundu ya mankhwala.

Kuti apezeke ndi SS, munthuyo ayenera kuti anali kumwa mankhwala omwe amasintha thupi la serotonin (serotonergic drug) ndikukhala ndi zizindikilo zitatu zotsatirazi:

• Kusokonezeka
• Kusuntha kwamaso kosazolowereka (clonus wamafuta, chinthu chofunikira kwambiri pakukhazikitsa matenda a SS)
  
• Kutsekula m'mimba
• Thukuta lolemera osati chifukwa cha zochitika
• Malungo
• Kusintha kwa malingaliro, monga chisokonezo kapena hypomania
• Matenda a minofu (myoclonus)
• Zosokoneza bongo (hyperreflexia)
• Ndikunjenjemera
• Kugwedezeka
• Kusuntha kosagwirizana (ataxia)

SS sichipezeka mpaka zonse zomwe zingayambitse zichotsedwa. Izi zingaphatikizepo matenda, kuledzera, mavuto amadzimadzi ndi mahomoni, komanso kusiya kugwiritsa ntchito mankhwala osokoneza bongo kapena mowa. Zizindikiro zina za SS zimatha kutengera zomwe zimachitika chifukwa cha cocaine, lithiamu, kapena MAOI.

Ngati munthu angoyamba kumene kumwa kapena kuwonjezera kuchuluka kwa mankhwala osokoneza bongo (neuroleptic drug), mavuto ena monga neuroleptic malignant syndrome (NMS) adzaganiziridwa.

Mayeso atha kuphatikiza:

• Zikhalidwe zamagazi (kuti muwone ngati alibe matenda)
• Kuwerengera kwathunthu kwa magazi (CBC)
• Kujambula kwa CT kwa ubongo
• Mankhwala osokoneza bongo (toxicology) ndi mawonekedwe a mowa
• Magulu a Electrolyte
• Electrocardiogram (ECG)
• Ntchito ya impso ndi chiwindi
• Mayeso a chithokomiro

Anthu omwe ali ndi SS atha kukhala mchipatala kwa maola 24 kuti awone bwino.

Chithandizo chingaphatikizepo:

• Mankhwala a Benzodiazepine, monga diazepam (Valium) kapena lorazepam (Ativan) kuti achepetse kusakhazikika, mayendedwe okomoka, komanso kuuma kwa minofu
• Cyproheptadine (Periactin), mankhwala omwe amalepheretsa kupanga serotonin
• Mitsempha yolumikiza (kudzera mumitsempha)
• Kuleka kwa mankhwala omwe adayambitsa matendawa

Pazochitika zoika moyo pangozi, mankhwala omwe amasunga minofu (kuumitsa), ndi chubu chakanthawi chopumira komanso makina opumira adzafunika popewa kuwonongeka kwa minofu.

Anthu amatha kuyamba kuchepa pang'onopang'ono ndipo amatha kudwala kwambiri ngati sathandizidwa mwachangu. SS yosachiritsidwa, SS imatha kupha. Ndi chithandizo, zizindikilo zimatha nthawi yochepera maola 24. Kuwonongeka kwanthawi yayitali kumatha kuchitika, ngakhale atalandira chithandizo.

Kupindika kosalamulirika kwa minyewa kumatha kuyambitsa kuwonongeka kwa minofu. Zinthu zomwe zimapangidwa minofu ikamatuluka zimatulutsidwa m'magazi ndipo pamapeto pake zimadutsa mu impso. Izi zitha kupangitsa kuwonongeka kwa impso ngati SS sidziwika ndikuchiritsidwa moyenera.

Itanani nthawi yomweyo ngati mukufuna kukhala ndi matenda a serotonin.

Nthawi zonse uzani omwe akukupatsani mankhwala omwe mumamwa. Anthu omwe amatenga ma triptan omwe ali ndi SSRIs kapena SSNRIs ayenera kutsatiridwa bwino, makamaka atangoyamba kumene mankhwala kapena kuwonjezera kuchuluka kwake.

Hypererotonemia; Matenda a Serotonergic; Serotonin kawopsedwe; Matenda a SSRI - serotonin; Matenda a MAO - serotonin

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Levine MD, Ruha AM. Mankhwala opatsirana. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 146.

Meehan TJ. Yandikirani kwa wodwala yemwe ali ndi poyizoni. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 139.