Ngaphezu kwesifo sokuphuza, i-valproate nayo isetshenziselwa ezinye izimo zezokwelapha. Kuvunyelwe ukusetshenziswa ekuvimbeleni ikhanda lokuguquka kwamakhanda, ukwelashwa kweziqephu ze-manic, nokuphathwa kwe-bipolar disorder.
Kuye kwafundwa futhi kuye kwaboniswa ukuthi kungenzuzo ekunakekeleni ukwelashwa okukhulu kwekhanda, ukucindezeleka, i-schizophrenia, nobuhlungu be-neuropathic, nakuba kungavunyelwe ukuthi kusetshenziswe.
Ake sihlole indima yayo ekuvimbeleni ukuthunjwa.
Indlela Yokusebenza
Kukholelwa ukuthi i-valproate ivimbela ukugubha ngokuvimbela umsebenzi wesibindi ngokweqile ebuchosheni. Indlela eqondile yezinto eziphilayo zokuvimbela i-seizure ekuvimbeleni ayinakuqondwa ngokuphelele noma kunjalo.
- Iziteshi ze-sodium: Enye yezindlela i-valproate engasebenza ngayo ngokuvimbela iziteshi ze-sodium. Lezi ziteshi zivame ukuvumela i-neurons ukuxhumana. Ukususwa kokungaphezu kokusebenza kungasiza ekunciphiseni umsebenzi ochotshozayo wobuchopho obangela ukuqubuka.
- I-GABA: I- Valproate ingabuye iphinde yenze umsebenzi we-GABA. I-GABA iyinhlangano ye-neurotransmitter engavimbelekile, futhi ukwandisa umsebenzi wayo kungase kusebenze ukunciphisa ezinye zezinto ezingavamile ze-neuronal ebuchosheni obangela ukugubha.
- Abamukeli be-NMDA: Umphumela we-valproate kule subtype ye-glutamate receptors ingenza ukuguqula imiphumela ye-glutamate, i-neurotransmitter ebuchosheni. Lesi senzo singadlala indima ekuvimbeleni i-seizure.
I-Valproate imithi esetshenziselwa izimo eziningana, kuhlanganise nokugubha, ukuphazamiseka kwe-bipolar, nokuvimbela ikhanda lokuhlukunyezwa kwekhanda.
Ukufometha
Kunezinhlobo eziningana zomlomo nezineV valproate ezisetshenziselwa ukulawula nokuvimbela ukuwayeka.
- I-Valproic acid: I- Depakene itholakala kufomu le-capsule noma le-liquid. I-Stavzor iyatholakala kwifomu ye-capsule.
- I-Divalproex sodium: i- Depakote itholakala kuthebhulethi noma ifomu lefafaza .
- I-sodium ye- Valproate : I- Depacon yakha ukukhiqizwa kwe-IV (ukungena ngaphakathi). Ngenxa yokuthi unikezwa i-IV, ingasetshenziswa ezimweni eziphuthumayo, ukumisa isimo se-epilepticus (ukuphindaphinda okuqhubekayo noma okuqhubekayo okungazimeli ngokwabo), noma uma umuntu onesithuthwane engakwazi ukuthatha i-liquid, iphilisi, noma afafaza amafomu ngomlomo .
Ngokujwayelekile, imishanguzo yokulwa ne-anti-seizure efana ne-valproate ithathwa izikhathi ezimbili kuya kwezine ngosuku ukugcina ukulawulwa kokubamba kahle, nakuba kunabantu abathile abakwazi ukuthola ukulawulwa kokuthungatha kanye kanye ngosuku ngosuku. Ukugcina imithi evamile yemithi yokulwa nokuthumba ngokuyithatha ngesikhathi esifanayo nsuku zonke kuyisici esibalulekile sokugcina izinga elizinzile, eliza ekufezeni ukuvimbela ukuthungatha.
Ukubunjwa okuhlukile kwe-valproate kungasetshenziswa yedwa noma kuhlanganiswe nezinye izidakamizwa zokulwa nokuthunjwa. Inhlanganisela yemithi ingase ikhethwe lapho imithi eyodwa kuphela ingakwazi ukulawula ukutholwa komthamo onokubekezela. Uma kusetshenziswe okungaphezu kweyodwa i-anticonvulsant, eminye yemiphumela emibi evamile phakathi kwama-anticonvulsants amaningi , njengokulala, ukulala nokuzizwa kungeniswa.
Izinhlobo Zokwenyuka Okusetshenziselwa
U-Valproate, ngezinhlobo zawo ezihlukene, usebenza kakhulu kunezidakamizwa eziningi zokulwa ne-anti-seizure. Ingasetshenziselwa ukuvimbela izinhlobo eziningana zokuwa, okufaka:
- Ukuqothulwa kwe-tonic-clonic okujwayelekile: Lezi zinkinga ezibandakanya ukukhubazeka kokwazi nokunyakaza okungazibandakanyi komzimba. Zivame ukubhekwa njengezinhlekelele ezinkulu .
- Ukungabikho kwemithi: Lokhu kungukuqhafaza okubhekene nokukhubazeka kokuqaphela ngaphandle kokuzamazama noma ukunyakaza okuqinile ngokomzimba, ngokuvamile okubhekwa ngokuthi yiyona encane yokugula. Ukungabikho kokugubha kuhambisane nokunyakaza okubonakalayo okucashile, njengokuthi ijwabu leso likhanya ngokushesha, noma akukho ukunyakaza okungathinteki nhlobo. Kuyathakazelisa ukuthi abantu abathola ukungabi khona kwezimpahla ngokuvamile abakwazi ukugcina izimo ezifana nokuhlala noma ukuma ngaphandle kokuwa.
Ukuqothulwa kwe-myoclonic: Lezi zinkinga zibhekene nokunyakaza okuhambayo, noma okungenakukhubazeka kokwazi. Ukuqubuzana kwe-myoclonic kungaphathwa ngemithi eminingi, kuhlanganise ne-valproate. Noma kunjalo kukhona imithi ethile engadala ukuhlukunyezwa kwe-myoclonic.
Ukungafani
U-Valproate, kanye neminye imithi yokulwa ne-anti-seizure, ingaba nokuxhumana okulimazayo uma kuhlangene nodakwa noma izidakamizwa zokuzilibazisa. Uma uthatha i-valproate, ukusebenzisa izidakamizwa noma utshwala kungabangela ukuthi imiphumela emibi ibe yinkimbinkimbi, ingabangela ubuthi ngisho nangokwezinga elijwayelekile, futhi kungase kubangele izinkinga ezinkulu, kufaka phakathi ukugubha.
Kunezimo eziningana zempilo ezihlobene nemiphumela emibi noma uketshezi uma uthatha i-valproate. Okuvamile kuhlanganisa:
- Isifo sesibindi
- Izinkinga zokuphuza / amapulethi aphansi
- Ukukhulelwa
Ezimweni ezithile, udokotela wakho angakubheka njengendlela ephephile kakhulu ukuthi uthathe i-valproate noma ngabe ukhulelwe noma uma unesinye sezinkampani eziphikisanayo ukuze uqiniseke. Uma kunjalo, uzodinga ukulandela okulandelayo ukuze uqaphele kunoma yiziphi izinkinga.
Isibonelo, abanye besifazane abakhulelwe bangase badinge ukuhlala ku-valproate ukuvimbela ukuwayeka. Ukuzizwa kungase kube yingozi kumama noma kumntwana okhulayo. Izingozi nezinzuzo zezimo zezokwelapha eziyinkimbinkimbi zibhekwa ngokucophelela ngethimba lezokunakekela ezempilo ukuze kulungiswe imiphumela.
Okuqhamuka uma udla imishanguzo
Njengayo yonke imithi, i-valproate ingaveza imiphumela emibi. Imiphumela emibi kakhulu evamile ye-valproate ifaka:
- Isizungu
- Ukulala
- Umbono kabili
- Ukulahlekelwa izinwele
- Uhudo
- Inzuzo yesisindo
- Ukugquma noma ukuphuma
I-Rash: Ukuhlaselwa kuyinto engavamile kodwa engase ibe nomthelela omkhulu. Imithi eminingi yokulwa nokuthunjwa ingabangela ukusabela okujulile okuqala ngokushona. Ngenkathi i-valproate engeyona yeyodwa imithi evame ukuhlotshaniswa nale mpendulo enzima, ibike.
Ngokuvamile, ungase ucabange ukuqhuma okuncane ukuba kube nje inkinga ephazamisayo. Kodwa ngenxa yezinkinga ezinkulu ezingase zikhule, kubalulekile kuwe ukuthi utshele udokotela wakho uma uhlakulela ukushayeka ngenkathi uthatha i-valproate.
I-Polycystic i- ovary syndrome (i-PCOS): Ukuhlangana phakathi kokusetshenziswa kwe-valproate ne-PCOS kuye kwaqanjwa iminyaka, ikakhulukazi kwabesifazane abanesithuthwane abathwala i-valproate. Kodwa isixhumanisi esicacile asisungulwe. Uma ungowesifazane ethatha i-valproate, ngokuvamile kunconywa ukuthi uhlale ulandela ukulandelana nomzimba wezifo zomzimba, okufanele ukwaziswa ukuthi uthatha noma uthathe i-valproate.
Ubuthi
Utshwala ohlobene nemithi kuhluke nemiphumela emibi yemithi. Ubuthi obuyingozi uma kwenzeka umthamo wemithi noma ukuhlushwa emzimbeni kuphakeme kunokunconywa. Imiphumela emibi yimiphumela emibi eyenzeka kumthamo ophakanyisiwe ovamile.
Izimbangela ezivame kakhulu zokwehla kwesifo se-valproate zibandakanya ukulinganisa okungekho emthethweni, ukweqisa ngokweqile, noma ukudlula ngokweqile. Inkinga yangokomzimba nge-metabolism ingabangela nokudakwa kwe-valproate.
I-Valproate isxicity ingabangela:
- Isizungu
- Ukudideka
- Ukulahlekelwa ibhalansi
- I-Hypothermia (izinga lokushisa lomzimba eliphansi)
- I-Hyperthermia (izinga lokushisa lomzimba ophezulu)
- Ukulahlekelwa kokwazi
- Ukushaya kwenhliziyo okusheshayo
- Ukungahambi kahle
- Ukufa
Isidakamizwa se-Valproate yisimo esiphuthumayo sezokwelapha futhi, uma sitholakale ngokuhamba kwesikhathi, singaphathwa ukuze sinciphise imiphumela yesikhathi eside.
Ukuhlolwa kwegazi
Izinga legazi le-valproate lingalinganiswa ukuze linqume ukuthi unayo yini imfucuza elinezinhlanzi zokwelapha. Nakuba izinga lakho legazi elihle lingase lingalingani nanjengomunye umuntu, izintambo eziphakanyisiwe ziwusizo ekunqumeni ukuthi ngabe izinga lakho liguqukile, uma uthola izinga elanele legazi, futhi nokuxwayisa ekungcoleni ubuthi.
Ukuyeka
Njengawo wonke ama-anti-seizure imithi, ukumisa ngokungazelelwe kungabangela ukuthunjwa noma ezinye izinkinga. Uma uzoyeka ukuthatha i-valproate, qiniseka ukuthi uxoxisane ne-dokotela kuqala nge-plan, ngubani ongayithatha enye imithi yokulwa nokuthunjwa noma akululekele ngesimiso sokunciphisa kancane kancane umthamo wakho.
Izwi elivela
Uma unikezwe i-prescription ye-valproate, kungenzeka ukuthi iyasiza ekulawuleni isimo sakho sezokwelapha. I-Valproate imithi esetshenziselwe iminyaka, ikakhulukazi ukugubha. Imiphumela yayo, imiphumela emibi, kanye nobuthi buqondakala kahle.
Ngokuvamile, kudinga amasonto amaningana ukuthi imishanguzo yokulwa nokuthunjwa ifinyelele ekugxileni okuzinzile. Ngaleso sikhathi, wena kanye neqembu lakho lezokwelapha lingakwazi ukwahlulela ukuthi noma liphumelela yini ekunciphiseni ukuhlukunyezwa kwakho.
Unganquma ukuthi uyakwazi yini ukubekezelela imiphumela emibi ye-valproate esikhathini esifushane ngemuva kokuqala imithi. Kuzuzisa ukuba uzijwayele ngemiphumela emibi yemithi yakho ukuze ukwazi ukuwabona ngokushesha.
Qinisekisa ukuthi uhlala uxhumane neqembu lakho lezokwelapha mayelana nanoma yikuphi ukulimala noma ukulimala kwemithi. Ngale ndlela uzokwazi ukuthola ukunakekelwa okwanele okuphuthumayo uma kudingeka futhi udokotela wakho angenza izinguquko ezidingekayo emithini yakho yokwelapha.
> Imithombo:
> Bilo L, i-Meo R. Polycystic i-ovary syndrome kubesifazane abasebenzisa i-valproate: ukubuyekezwa. I-Gynecol Endocrinol. 2008; 24 (10): 562-70. i-doi: 10.1080 / 09513590802288259.
> Ukuphathwa Kwezokudla Nezidakamizwa zase-US. Ulwazi lwe-Valproate.