Izimpikiswano Zokuqala I-Levodopa Ngaphambi Kokuqala Emzimbeni KaPasinson
I-Dopamine yinkinga ye-neurotransmitter eyimfihlo evela e-substantia nigra, isifunda esincane ku-brainstem esesifika esesifo sikaParkinson . Njengoba amazinga e-dopamine yemvelo ebuchosheni aqala ukuwa, izimpawu zesifo sikaParkinson zivela. Uma i-dopamine ishintshiwe, izimpawu eziningi ziyathuthuka.
Omunye wayengacabanga ukuthi i-dopamine kufanele inikwe ngokushesha ngangokunokwenzeka.
Kunezinye izinketho, noma kunjalo. Ngaphandle kokunikeza i-dopamine ngokuqondile (isidakamizwa esibizwa ngokuthi i-carbidopa-levodopa), iziguli zesifo se-Parkinson zingase zizuze ekilasini lemithi ebizwa ngokuthi i-dopamine agonists. Lezi izidakamizwa ezingezona i-dopamine kodwa zinezimo ezifanayo ohlelweni lwezinzwa. Abanye odokotela baye baphikisa ukuthi i-dopamine agonists kufanele isetshenziswe ekuqaleni kwenkambo yesifo nokuthi iziguli ezikhulile kuphela ezinokukhubazeka okulinganiselwe kufanele zithole i-levodopa.
Izimpikiswano Ze-Levodopa Zasekuseni Ukusebenzisa Izifo ZasePasinson
I-Levodopa iyona imithi ephumelela kunazo zonke ukuphatha izimpawu zikaParkinson. Lokho kusho, akusikho imiphumela emibi.
Enye yezinkathazo ze-levodopa ukusetshenziswa ukuthi kungabangela ukunyakaza ngokweqile okuthiwa i- dyskinesia . Abantu abane-dyskinesia banomthelela wokunyakaza ongaphandle kokulawula kwabo. Nakuba kubonakala kungakhululekile, noma kunjalo, iningi le-dyskinesia liyithanda ukuyi-parkinsonism, futhi ucwaningo lubonisa ukuthi i-dyskinesia ekugcineni ayinalo umthelela omkhulu kumgangatho wokuphila.
Abanye abacwaningi basikisela ukuthi i-dopamine ingase isheshe iqhube inkambo yesifo ngenkathi iphoqa izimpawu. Ucwaningo olungaphezulu alusekeli lo mbono, noma kunjalo.
Izimpawu zingashintsha ngenkathi zisetshenziswa ku-dopamine, okusho ukuthi kungase kube nezikhathi zosuku lapho ukuthuthumela, ukuqina nokuhamba kancane kulawulwa kangcono kunabanye.
Ngakolunye uhlangothi, akucaci ukuthi lezo zinguquko zithinta kanjani izinga lokuphila. Ngaphezu kwalokho, abantu abanezinye izidakamizwa ezifana ne-dopamine agonists bangase futhi bagcine beshintshashintsha.
Ezinye izingxabano ekusekeleni ukusetshenziswa kokuqala kwe-levodopa zithi kuzothuthukisa izinga lokuphila ekuqaleni kwenkambo yesifo, ukubaluleka okungazange kunakekelwe ngokwanele. I-Levodopa nayo ingabizi kakhulu kune-dopamine agonists.
Izinkampani ezidakamizwa azisekho ukugqugquzela ukusetshenziswa kwe-levodopa ngoba kunamafomu amaningi kakhulu. Ngamanye amazwi, kunezikhuthazi zezezimali ezinkampanini zokwelapha ukugqugquzela ukusebenzisa ezinye izidakamizwa ezibiza kakhulu ekuqaleni kwesifo sikaParkinson, kunokuthembela ku-levodopa yakudala, evivinywa futhi yeqiniso, futhi lokhu kungathonya ukukhethwa kokumisela odokotela.
Izimpikiswano Ezibhekene Ne-Levodopa Yasekuseni Ukusetshenziswa kwezifo zikaPasinson
Bambalwa abazophikisana ngokuphumelela okukhulu kwe-levodopa, futhi zonke iziguli zikaPasinson zizogcina zidinga le mithi. Kunezizathu ezithile zokukholisa ukuqala esikhathini esizayo esikoleni sesifo, noma kunjalo.
Imithi idinga ukufakwa kulo lonke ukuqhubeka kwesifo. Ngamanye amazwi, umuntu ophethe isifo esibucayi se-Parkinson oqaliswe ku-levodopa uzodinga ukuthi imithi ikhule kancane njengoba isifo sabo siqhubeka.
Ngokuvamile, amandla e-dopamine azoguga emva kweminyaka emithathu. Uma ukulinganisa okuphezulu kwe-levodopa kungasakwazi ukulawula izimpawu, yini enye ekhona yokuvula? Ngaphandle kwezinketho zokwelashwa ezinamandla, ukuhlinzwa kungase kube yindlela kuphela yokuthola. Akusihle yini ukusindisa "isibhamu esikhulu" kamuva, lapho izimpawu zikhuni kakhulu?
Ngaphandle kwemiphumela emibi ye-levodopa ekhulunywe kakade, kunezinkinga ezengeziwe ezingase zenzeke, okufaka phakathi ukubhebhethekisa ukusebenza kwengqondo, ukucindezeleka kwengqondo nokunciphisa ukulawula umfutho. Kodwa kuyiqiniso ukuthi ezinye izidakamizwa ezifana ne-dopamine agonists nazo zinemiphumela emibi, njengokuvuvukala, ukungahlali kahle kanye nemiphumela emibi yengqondo, njengokulutha ukugembula.
Ngamafuphi, kungani ungasebenzisa "isibhamu sakho" ekuqaleni, ikakhulukazi uma abacwaningi abadlulile (ngisho noma bebephikisana nabo) baye basikisela ukuthi kungenza lesi sifo sibi nakakhulu? Ikakhulukazi uma ungasebenzisa imishanguzo enamandla engase inganciphise inqubo yesifo, ngaphezu kokusiza ngezimpawu?
Ingabe kukhona ezinye izinketho zokwelapha ngezifo zikaParkinson?
Enye indlela kungaba ukuqala imithi efana ne-monoamine oxidase inhibitor. Isibonelo i-rasagiline, ebonakala ibasiza kakhulu lapho iqala ekuseni. Ezinye izifundo ziye zaphakamisa nokuthi i-rasagiline inganciphisa ukuwohloka kwegazi ngokwemvelo ngaphezu kwezimpawu zokulawula, lezo zifundo ziphikisana kakhulu. Lokhu kuqhathaniswa ne-dopamine, lapho izifundo ezithile zakuqala ziphakamisa ukuthi isifo sibhekene nesidakamizwa.
Ukuxazulula impikiswano:
Lezi zimbono ezimbili zingahlanganiswa kanjani? Ekugcineni, ayikho imithi yemithi ehambisana nayo yonke umuntu. Abantu bahlukile futhi badinga imithi ngayinye ehlotshaniswa. Enye indlela ongase ibe nayo kungase kube ukuqala ngemithi efana ne-rasagiline, elandelwa umthamo we-levodopa ophansi. Njengoba lesi sifo sithuthuka, i-dopamine agonist ingezwa, ilandelwe umthamo omkhulu we-levodopa. Kodwa ekugcineni, indlela enhle kakhulu izohlukahluka kokubili ngokusekelwe kwezidingo eziyingqayizivele zesiguli kanye nokuthanda kukadokotela mayelana nemithi ehlukene.
Imithombo:
Marras C, Lang A, Krahn M, Tomlinson G, Naglie G; I-Parkinson Study Group. Ikhwalithi yokuphila ekuqaleni kwesifo sikaParkinson: umthelela we-dyskinesias nokuhamba kwezimoto. I-Disv Disord. 2004 Jan; 19 (1): 22-8.
UParkkinen L, O'Sullivan SS, Kuoppamäki M, Collins C, Kallis C, Holton JL, Williams DR, Revesz T, Lees AJ. Ingabe i-levodopa iqhubekisela phambili inqubo ye-pathologic ebuchosheni be-Parkinson? I-Neurology. 2011 Okthoba 11; 77 (15): 1420-6.
I-Vlaar A, i-Hovestadt A, i-Van Laar T, i-Bloem BR. Ukwelashwa kwesifo sokuqala sika-Parkinson: i-levodopa ivuselelwe. Pract Neurol. 2011 Jun; 11 (3): 145-52.