Ingabe ubufakazi bamanje busekela ukusetshenziswa kwawo?
Kungenzeka yini ukuthi izidakamizwa ezisetshenziselwa ukuphatha umlutha we-opioid nokuphuza utshwala zingathuthukisa izimpilo kanye nombono wabantu abaphila ne- multiple sclerosis (MS) ?
Olunye ucwaningo lubonisa ukuthi lungenzeka. Ngenkathi kungavunyelwe ukusetshenziswa okunjalo, i-dose encane naltrexone (i-LDN) isanda kunqunyulwa-ilebuli ukuphatha ukukhathala okuhlobene ne-MS , uphawu oluvame futhi oluvame ukulimaza lesi sifo.
Ukusetshenziswa Okuvunyelwe kwe-Naltrexone
I-Naltrexone yamukelwa yi-US Food and Drug Administration ngo-1984 yokwelashwa kwezidakamizwa ze-opioid futhi ngo-1994 ukuphatha ukwelashwa kokusetshenziswa kotshwala (AUD). Ngomthamo owenziwe ngokugcwele (i-50 kuya ku-100 milligram ngosuku), i-naltrexone ivimbela umphumela we-opioid futhi inciphisa isifiso somuntu sokuphuza.
Kuzo zombili amandla, i-naltrexone iye yaboniswa ukuthi inikeze ngokuthobeka kumiphumela embi ekuphulukeleni ukungezelela kepha ingasiza uma isetshenziswe njengengxenye yendlela yokwelashwa ehleliwe, ehlonzwe ngokuqondile.
I-Off-Label Ukusetshenziswa kwe-Naltrexone
Ngaleso sikhathi i-naltrexone yaqala ukuthuthukiswa, abacwaningi be-Penn State College of Medicine baqala ukutadisha ukusetshenziswa kwayo ekuphatheni izifo ezizimele (lapho amasosha omzimba ahlaselela khona amangqamuzana omzimba) ngephutha.
I-Multiple sclerosis ikholelwa ukuthi abaningi bayabangelwa impendulo yokuzimela futhi babephakathi kwabokuqala bokuphenya. Lokho abacwaningi abathola ukuthi ukulinganisa okuncane kakhulu kwezidakamizwa kwaqinisa ukukhiqizwa kwe-hormone endorphin, okubangelwa ukwanda kwamazinga omandla kanye nempendulo enamandla yokulwa nokuvuvukala.
Kufana nalokho okwenzeka ngesikhathi sokukhulelwa lapho ukukhiqizwa kwe-endorphin okwandisiwe kuhlotshaniswa nezinkathi ezandisiwe ze-MS ukukhululwa.
Ngenkathi kungakaze kube khona ubufakazi obunzima bokusekela emqondweni, abanye abacwaningi bakholelwa ukuthi i-LDN ingakwazi ukunciphisa izimpawu ze-MS ezinzima nokuvama njengokukhathala, ubuhlungu, ukusabalalisa , ukungasebenzi kahle nokucindezeleka .
Izincomo Zezokwelapha
Uma kunqunywe amanani amancane kangaka (ngaphansi kwamaphesenti angama-10 alowo asetshenziselwa ukwelapha izidakamizwa), i-LDN ibhekwa njengephephile futhi ibekezelelwe kahle.
Imilinganiselo evame ukushiwo kubantu abane-MS kusuka ku-1.5 milligram kuya kuma-milligram angu-4.5 ngosuku. Kunconywa ukuthi abantu abanoma yiluphi uhlobo lwe-spasticity bangathathi ama-milligram nsuku zonke ngoba kungabangela ukuqina kobunzima.
I-LDN ingathathwa noma ngaphandle kokudla kodwa kufanele ithathwe phakathi kuka-9: 00 ntambama naphakathi kwamabili ukuze ihambisane nomsebenzi wokukhululeka komzimba we-endorphin.
Umphumela ovame kakhulu ohlangothini lwe-LDD yiziphupho ezicacile ezivame ukwehlisa ngemuva kwesonto lokuqala noma ezimbili. Ngokuvamile, ukucasula kuye kwaziwa nokuthi kwenzeke.
Ukucatshangelwa nokuphambana
Enye yezingxabano ezinkulu ekusebenziseni i-LDN ukusebenzisana kwayo nezidakamizwa eziningi eziguqula isifo esetshenziswa ukuphatha i-MS. Ngokusekelwe kwesenzo se-pharmacokinetic yezidakamizwa, i-LDN akufanele isetshenziswe nge- Avonex , Rebif , noma i- Betaseron . Ngokuphambene, kubonakala kungekho izingxabano neCopaxone .
Ngenxa yokuthi ikhishwe emzimbeni ngesibindi, i-LDN ayinconywa kubantu abane-hepatitis, isifo sesibindi, noma i-cirrhosis.
I-LDN akufanele ihlanganiswe nanoma yiziphi izidakamizwa ezisekelwe opiate ezifaka i-Oxycontin (oxycodone), i-Vicodin (i-hydrocodone) .noma i-codeine-based based syrup.
Ukubuyekeza Ubufakazi Banje
Nakuba ukuvumelanisa okudumile kungase kusiphakamise ukuthi i-LDN igalela ekuthuthukiseni impilo nenhlalakahle yabantu abane-MS, ubufakazi obunjalo buye buxutshwe. Phakathi kwazo:
- Ucwaningo olwenziwa eYunivesithi yaseCalifornia eSan Francisco lwahlanganisa nabantu abangu-80 abane-MS abaphathwa nge-LDN ngaphezu kwamasonto ayisishiyagalombili. Ngenkathi i-LDN ingashintshi umsebenzi womzimba noma umthamo wabahlanganyeli, yanikeza ukuthuthukiswa okuphawulekayo emkhakheni wabo wokuphila (kubandakanya ukunciphisa ubuhlungu nokucindezeleka kanye nokunyuka komsebenzi wokucabangela).
- Isivivinyo sesigaba sesibili esenziwa e-Italy ngonyaka ka-2008 sabheka abantu abangu-40 abane-MS okuqhubekayo ngokunyanga kwe-LDN izinyanga eziyisithupha. Ekugcineni, kwakukhona ukuthuthukiswa kwezibalo ku-spasticity (amaphesenti angama-47 athuthukisiwe, amaphesenti angu-11 aphuthumayo) kodwa akukho ukuthuthukiswa kokucindezeleka (amaphesenti angu-56 athuthukisiwe, amaphesenti angu-33 aphuthumayo) noma ukukhathala (amaphesenti angu-33 athuthukisiwe, amaphesenti angu-41 aphuthumayo). Ngokuphambene nalokho, i-LDN yayihlotshaniswa nokuhlukunyezwa kwezibalo (amaphesenti angu-28 athuthukisiwe, amaphesenti angu-56 ashuba kakhulu).
- Ucwaningo lwamaviki angu-17 oluhleliwe, olulawulwa ngo-2010 alutholanga umehluko wezibalo phakathi kwabantu abathatha i-LDN noma i-placebo noma yikuphi ukuthuthukiswa kwekhwalithi yokuhlukahluka kwempilo, kuhlanganise nobuhlungu, amandla, umsebenzi wokuqonda nokuphila kahle ngokomzwelo.
> Imithombo
> I-Cree, B .; I-Kornyeyeva, E .; noGoodin, D. "Isivivinyo sezindiza esincane se-naltrexone nekhwalithi yokuphila ku-multiple sclerosis." U-Annals Neurol . 2010; 68 (2): 145-150.
> Gironi, M .; Martinelli-Boneschi, F .; Sacerdote, P. et al. "Isivivinyo somshayeli we-low-dose naltrexone e-primary progressive multiple sclerosis." I-Mult Scler . 2008; 14 (8): 1076-83.
> Sharaaddinzadeh, N .; Moghtederi, A .; Kashipazha, D. et al. "Umphumela we-dose low-naltrexone ngekhwalithi yokuphila kweziguli ezine-multiple sclerosis: isilingo esilawulwa ngokungahleliwe kwe-placebo." I-Mult Scler. 2010; 16 (8): 964-9.