Ib qho kev tsis sib haum xeeb tshwm sim los ntawm cov tshuaj tiv thaiv kev puas hlwb loj
Tardive dyskinesia (TD) yog ib qho mob tsis zoo los ntawm cov tshuaj. Qhov mob uas nyob ruaj khov yog ib qho mob tau ntev ntawm kev kho mob nrog cov tshuaj tiv thaiv kev mob hlwb xws li Thorazine thiab Haldol, uas feem ntau siv los kho tus mob schizophrenia thiab lwm yam kev puas hlwb loj. Cov tshuaj tiv thaiv kev noj qab haus huv tau hloov kho cov kev mob no.
Ua ntej chlorpromazine (Thorazine) tau pib rau xyoo 1950, cov neeg mob schizophrenia tau raug kho nrog electroconvulsive therapy (ECT) thiab lwm yam kev kho mob thiab tau txais lub xeev cov tsev kho mob ntev ntev. Phenothiazines xws li Thorazine ntsiag to cov suab lus uas cov neeg mob tau hnov thiab tso lawv cov kev xav tsis zoo. Cov tshuaj no tau hailed li txuj ci yeeb tshuaj txawm tias lawv tau tso cov neeg mob txo qis thiab tsis khov kho.
Raws li cov phenothiazines tau sau tseg ntev dua, ntau tus neeg mob tau pib muaj cov leeg tw tw thiab lwm yam txawv txav. Ntau cov leeg mob yog rov qab thiab kho tau los ntawm kev ntxiv lwm cov tshuaj los tiv thaiv cov kab mob "pseudoparkinson". Tardive dyskinesia, ntawm qhov tod tes, yog ib tus mob mus tas li. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ntau tus neeg mob tau tsim muaj qee qhov mob rau cov tshuaj no.
Qee lub sij hawm hu ua extrapyramidal phiv , cov tsos mob me ntsis yog:
Akathisia
Lub tswv yim zoo ntawm kev nyob tsis tswm nrog lub siab xav ua kom tsiv mus taw lossis taug kev ncig. Dystonias - qeeb, mob qog nqaij hlav qis los sis muaj roj ntsha uas ua rau lub cev tsis muaj zog ntawm tag nrho lub cev lossis tus neeg ntawm lub cev.
Parkinsonism - mob nqaij tawv, cog pob rigidity, shuffling kev voog, stooped posture, drooling, 'ntsiav tshuaj dauv' thiab lub ntsej muag masked. Cov tsos mob ntawm cov tsos mob yuav rov qab kho dua thiab feem ntau yuav raug kho los ntawm kev hloov cov tshuaj los yog ntxiv cov tshuaj ntxiv.
Tardive
Lub caij pib txhim kho dyskinesia thawj zaug tau piav nyob rau hauv 1964, tab sis cov neeg mob tau tsim muaj qhov teeb meem no tau ntau xyoo. Cov tsos mob zoo li cov neeg tau piav saum toj no, tab sis lawv tshwm sim tom qab hauv kev kho mob thiab feem ntau pom tias yuav ua tsis tau rov qab. Cov tsos mob feem ntau muaj xws li rov qab ua tsis taus, tsis muaj zog, uas ua rau tus neeg mob tseem noj tshuaj. Cov kev tsis sib haum xeeb xws li "nplaig ntsaum, di ncauj smacking, di ncauj caum, grimacing thiab zom mov, pob ntseg ntawm pob tw, pob txha, pauv txoj hlab lossis ceg, khiav tawm hauv qhov chaw, tsis muaj pa, thiab suab nrov dua xws li kab npau yaig los yog grunting. " (University of Kansas Qhov Chaw Kho Mob, 2002)
Cov tshuaj nram qab no tau pom tias ua rau tardive dyskinesia hauv qee tus neeg mob:
Cov tshuaj rau cov teeb meem hauv plab:
- metoclopramide (Reglan)
- prochlorperazine (Compazine) Cov tshuaj rau hnoos
- promethazine (Phenergan)
Cov tshuaj rau kev nyuaj siab:
- amoxapine (Ascendin)
- perphenazine / amitriptyline (Triavil)
Tshuaj Tua Kab Mob Ntshav los sis Neuroleptics:
- chlorpromazine (Thorazine)
- thioridazine (Mellaril)
- trifluoperazine (Stelazine)
- perphenazine (Trilafon)
- fluphenazine (Prolixin)
- thiothixene (Navane)
- haloperidol (Haldol)
- pimozide (Orap)
(University of Kansas Qhov Chaw Kho Mob, 2002)
Cov neeg mob laus, cov neeg mob uas haus luam yeeb, cov poj niam cov neeg mob, thiab cov neeg mob ntshav qab zib zoo li feem ntau yuav kis tau tus kab mob no. Tsev neeg keeb kwm kuj tau pom tias nws yog ib qho twv ua ntej. Yog tias tus neeg hauv tsev neeg tau tsim qhov teeb meem no thaum nyob rau ntawm ib qho ntawm cov tshuaj no, lub sijhawm uas tus neeg mob yuav ua rau tus kabmob no siab dua.
Ntev ntev ntev rau tus neeg mob yog cov tshuaj no ntau dua lawv yuav tsim muaj tus kab mob tardive dyskinesia.
Yuav ua li cas tiv thaiv tau tus kab mob tardive dyskinesia? Qee cov tswv yim hauv cov ntawv nyeem muaj xws li:
- Txwv tsis pub siv cov tshuaj no rau cov kev kho mob nyuaj siab mob hlwb thiab kev pom kev nrhau thiab kev tsis txaus siab. Tsis txhob kho cov kab mob pw tsaug zog lossis kev ntxhov siab nrog kev puas siab ntsws.
- Txhob siv cov tshuaj loj no rau cov neeg laus cov neeg laus uas muaj ntshav siab.
- Muab cov neeg mob tsawg tshaj plaws txhaj rau lub sij hawm luv tshaj plaws.
- Siv cov tshuaj tshiab "atypical" antipsychotics ua ntej kho kab mob. Siv lwm cov tshuaj kom zoo thiab cia cov tshuaj ntawm cov tshuaj tiv thaiv kev puas siab puas ntsws nyob rau theem qis tshaj plaws.
- Cov tshuaj tivthaiv ntev mus ntev yuav tsis ua rau tardive dyskinesia dua lwm yam tshuaj, tabsis qhov siv tau qis dua yuav tsum tau siv.
- Cov kws kho mob yuav tsum siv cov tsos mob xws li Parkinson uas zoo xws li cov tsos mob uas yuav tshwm sim tau. Cov tshuaj siv los kho cov tsos mob no - anticholinergic cov neeg ua hauj lawm - tsis txhob muaj kev pheej hmoo ntawm TD. "Cov hnub so yeebtshuaj" yuav tsum raug zam rau vim tias lawv tsis txo thiab tseem yuav ua rau kom muaj kev pheej hmoo ntawm TD.
- Kev tshawb nrhiav tau tshawb nrhiav cov tshuaj kho tus mob TD. Cov tshuaj hauv qab no tsis tau pom tias zoo : Cholinergic agonists (deanol, physostigmine, choline, lecithin), GABA agonists, post-synaptic DA agonists, peptides, lithium, thiab papaverine. (Alexander & Lund, 1999)