Ukushona Kwemithi Kungase Kuphuthumise Ngokuphumelelayo Ukulimala Kwegazi Okumangalisayo
I-Ambien (ithengiswa njenge-generic zolpidem) imisiwe ngokujwayelekile yokwelashwa kokulala, kodwa ingasiza yini ezinye izinkinga zezinzwa ezifana ne-coma, izifunda ze-vegetative eziqhubekayo, i-dystonia, isifo se-Parkinson, isifo, isifo sengqondo sokulimala, nokulimala kwengqondo ebuhlungu? Imibiko yocwaningo kanye nezifundo ezincane zikhomba ukuthi kungenzeka inzuzo, futhi ukubuyekezwa kukhuthaza ukucwaninga okuqhubekayo emithini yemithi ekwelapheni okungapheli.
I-Ambien isebenza kanjani ebuchosheni?
I-Zolpidem (edayiswa njenge-Ambien, i-Ambien CR, ne-Intermezzo) imithi yokulondoloza imithi evunyelwe yi-Food and Drug Administration yokuphathwa kokulala . Kuyinto ekhethayo futhi isebenza ngohlobo I gamma-aminobutyric acid A (GABA A) benzodiazepine receptor. Lokhu kungasiza ukunciphisa umsebenzi wezindawo ezithile zobuchopho, ngokuzithoba ukukhuthaza ukulala nokucindezela ukuqonda. Kungakhuthaza ukwanda kwe-REM ngokucindezela umsebenzi we-dopamine, umphumela ongase ukwandise amazinga e- prolactin .
I-Ambien isebenza ngokushesha, ifinyelela ekugxilweni kwegazi ngemva kwamahora angu-1.6 okusetshenziswa. Ayinayo i-metabolites esebenzayo. Ngamahora angaphansi kwama-3 (ngezimiso ezijwayelekile kusukela ku-1.5 ukuya ku-2.4 amahora), amazinga egazi we-Ambien anciphisa ngesigamu. Ukubunjwa okukhulunywe ngokulawulwa (okudayiswa njenge-Ambien CR) kunomzuzu wokuphila wamahora angu-1.5 kuya ku-4.5.
I-Zolpidem idonswa emcimbini ngezinso.
Ngisho noma usizo olulele kakhulu lokulala, i-Ambien ingaba nemithelela encane kumgangatho wokulala. Lapho kuthathwa i-10 mg, kunganciphisa isikhathi esithathayo ukulala ngemizuzu emihlanu kuya kweyishumi nambili, ngokwesilinganiso. Kunganciphisa isikhathi esivamile sokuhlala siphapheme phakathi nobusuku ngamaminithi angu-25 engeziwe.
Kungathinta kanjani ezinye izifo ezithinta ubuchopho?
Umsebenzi we-Ambien ekwelapheni izinkinga ze-neurological
Abacwaningi abavela eNyuvesi yaseMichigan baye bafingqa umzimba wezincwadi zesayensi ngendlela i-zolpidem engathinta ngayo ezinye izimo ezithinta kakhulu ubuchopho, kuhlanganise i-coma, i-dystonia, isifo sohlangothi, nesifo sengqondo se-dementia. Okunye okutholakele kungase kukhuthaze labo ababhekana nokulimala okujulile nokulimaza ebuchosheni.
UMartin Bomalaski, MD, kanye nabalingani bakhe babukeze izihloko ezingu-2314 ezishicilelwe ngo-Mashi 20, 2015. Emva kokubukeza okushiwo, imibhalo egcwele yabukezwa ngezihloko ezingu-67. Eziningi zale mibiko zihlanganisa ukuhlolwa okuncane kanye nemibiko yecala, emele izinga eliphansi lobufakazi bemitholampilo. Eqinisweni, izifundo eziyishumi nanye kuphela zazingamalungu angaphezu kuka-10. Kwakukhona izilingo eziyi-9 ezilawulwa ngokungahleliwe, ezibhekwa njengezinga legolide lokucwaninga ngemitholampilo. Lokhu kungathinta ukuchazwa kwemiphumela kanye nokufaka izicelo kubantu abakhulu.
Kukhona izigaba eziningana ezinkulu zezinkinga lapho i-zolpidem ihlolwe khona:
- Izinkinga zokuhamba ngezinyawo (izifundo ezingu-31) - isifo se- dystonia nesifo sika-Parkinson
- Ukuphazamiseka kwengqondo (izifundo ezingama-22) - i- coma kanye nesimo sezitshalo eziqhubekayo
- Ezinye izinkinga ze-neurological (izifundo ezingu-14) - ukulimala , ukulimala kwengqondo ebuhlungu, ukucindezeleka nokucindezeleka komqondo
Abacwaningi bahlaziya lezi zihloko ngezinhlobo zezinkinga eziphathwayo, ukulinganisa kwe-zolpidem ezisetshenzisiwe, imvamisa yokulinda, imiphumela ehlonishweyo, nemiphumela emibi kubikwe.
Yikuphi Ukuthuthukiswa Okungaqaphelwa Ngokwelashwa Okukhulu?
Kwakukhona izimpawu ezihlukahlukene ezahlolwa, kusukela ekubuneni ukukhuluma (aphasia), ukungabi nokuphendula (ukunganakwa), nezinkinga zokunyakaza ezihambisana nokungabi khona kwemoto. Izimpendulo zazilinganiselwe ngokulinganisa ngezilinganiso ezihlukahlukene eziqinisekisiwe zokusetshenziswa kwe-coma, isifo se-Parkinson, i-dystonia, nezinye izinkinga.
Ngokuvamile, i-zolpidem inikeze ukusizwa okwesikhashana: ukuthuthukiswa okuningi, uma kukhonjisiwe, kwaphela amahora amabili kuphela. Lezi zithuthukisiwe zaphinda ziphindaphindwa, zidinga ukulandwa njalo ngenxa yesikhashana sempilo yomuthi. Ukuthuthukiswa kubonwe ngamakhono, amakhono, nokubhala. Ezinye iziguli ezinama-comate noma zemifino zithuthukiswa ukuze zizwe kancane, ezinye zazama ngisho nokuzama ukukhuluma.
Kwakukhona futhi izifundo ezabonisa ukuthuthukiswa ekusebenzeni kwe-neuroimaging esebenzayo, okuphakamisa ushintsho olucacile emkhakheni wezobuchopho nokuxhumana. Imiphumela engavamile ingase ibe khona kuziguli ezitholakala ezikhungweni ze-basal gang, okuyingxenye yobuchopho esisiza ukucubungula ulwazi ukuxhumanisa ukuhamba okufisayo noma impendulo yezimoto.
Imiphumela emibi yayingase ilindeleke: i-zolpidem ihlezi. Lokhu kungabangela ukulala futhi kwabikwa kwabangu-13 kweziguli ezingu-551 abazivivinya. Njengoba izimpawu zenzelwe ukuthuthukiswa ngesikhathi sokuvuka, lokhu kungaba umkhawulo omkhulu wokusebenzisa imithi. Njengoba kuhlanganisa futhi kuthinta ukubunjwa kwememori, kungase kucatshangwe ukuthi kungaba nemithelela kwimemori yesikhathi esifushane . Njengoba abantu abasebenzisa le mithi kungenzeka ukuthi behluleke kakhulu ngesikhathi esisezingeni eliyisisekelo, ukwaziswa okugcwele kwemiphumela emibi kungahle kukhishwe.
Ngeshwa, i-zolpidem ayisebenzi kuwo wonke umuntu. Empeleni, kuphela iziguli eziyisihlanu kuya kwezingu-7 kuphela ezinezifo eziphazamisa ukuqonda eziphendule izidakamizwa. Lokhu kusho ukuthi amaphesenti angaba ngu-95 wabantu abasebenzisa wona awazange abe nokuthuthuka okuhle emazweni abo okuqaphela. Phakathi kwalezi zihloko ezinenkinga yokunyakaza, amazinga okuphendula aphezulu, afinyelela amaphesenti angu-24.
Abaningi abazange baphendule kulo muthi, kodwa ngezinketho ezimbalwa zokwelapha, i-zolpidem ingahle ibe yindlela ekhangayo emindenini elithemba noma yimuphi amathuba ekuthuthukiseni.
Izwi elivela
Nakuba lezi zibika zezindaba kanye nokuhlolwa okuncane komtholampilo kungase kubonakale kukhuthazayo, kungcono imindeni nabangane balabo abanokulimala okuphawulekayo kwe-neurolo ukuhumusha le miphumela ngesilinganiso esiphezulu se-pragmatism. Kungenzeka ukuthi i-zolpidem ngeke isisize iningi leziguli ezibhekene nalezi zifo ezikhubaza ngokujulile. Noma kunjalo, kungaba khona isizathu sethemba: ucwaningo olwengeziwe lufanelekile.
Akuqondi kahle ukuthi i-zolpidem ingayithuthukisa kanjani le mibandela ehlukahlukene. Kungenzeka ukuthi kuthinte ukulingana kwama-neurotransmitters kanye nokuxhumana phakathi kwezindawo ezihlukahlukene zobuchopho. Ngomfanekiso, uma ubuchopho bunamathele esimweni sokungasebenzi kahle ngenxa yokungalingani kwamandla aphikisayo, kungasiza ukuphothula umzabalazo ngendlela ehle. Lezi zinqubo kudingeka zicaciswe. Ukuhlolwa kocwaningo olusenyakatho olukhulu kungasisiza ukuba siqonde ukuthi ngubani okhubazekile kakhulu wezinzwa zezinzwa uyozuza ekusetshenzisweni kwe-zolpidem-futhi kungani.
> Imithombo:
> IBomalaski, MN et al . "I-Zolpidem ye-Treatment of Neurologic Disorders: Ukubuyekezwa Okuhlelekile." UJAMA Neurol . Ishicilelwe ku-intanethi ngoJuni 26, 2017. kufanele: 10.1001 / jamaneurol.2017.1133.
> Kilduff, TS kanye noMendelson, WB. "Imithi yokwenza ama-Hypnotic: Izindlela Zokusebenza kanye Nemiphumela Yase-Pharmacologic," ezimisweni kanye nezenzo zokulala . Ihlelwe ngu-Kryger MH, i-Roth T, iDement WC. USt. Louis, eMissouri, u-Elsevier Saunders, ngo-2017, k. 429.
> Miyazaki, Y et al. "Ukusebenza kwe-ajpidem ye-dystonia: isifundo phakathi kwe-subtypes ehlukene." Ngaphambili kwe-Neurol . 2012 Apr 17; 3: 58.
> Sateia, MJ et al . " Umhlahlandlela Wokusebenza Ngokwemitholampilo we-Pharmacologic Treatment of Chronic Insomnia in Adult: I-American Academy of Sleep Medicine Guideline Practice Guideline ." I- Journal of Clinical Sleep Medicine . 2017; 13 (2) 307-349.
> Sutton, JA noClauss, RP. "Ukubuyekezwa kobufakazi bokusebenza kahle kwe-zolpidem ekukhubazekeni kwengqondo ngemuva kokulimala komqondo ngenxa yokushaywa yisifo, ukuhlukumezeka kanye ne-hypoxia: Ukulungiswa kokuhlolwa okuqhubekayo kwemitholampilo." Ubuchopho Inj . 2017; 31 (8): 1019-1027.