Okwenza Odokotela Baqhubeke Bethembele ku-Levodopa e-Treatinson kaParkinson
I-Levodopa ibhekwa njengezinga legolide le-dopamine yokwelashwa kabusha esikhundleni sesifo sikaParkinson. Umuthi wakhiwa eminyakeni yama-1960 eminyakeni eminingi emva kukaJacob Parkinson ngo-1817 wabhala ngesimpawu sezimpawu namuhla esizazi njengesifo sikaParkinson. Emashumini eminyaka kamuva, i-levodopa isalokhu isetshenziselwa kakhulu lesi sifo esingapheli.
Uma kuthathwa umlomo, i-levodopa igxila egazini kusukela emathunjini amancane.
Lokho kuguqulwa libe yi-dopamine ngama-enzyme ebuchosheni, okusiza ukushintsha indawo ye-neurotransmitter elahlekile njengoba i-neuron eveza ubuchopho i-dopamine ifa.
Indlela i-Levodopa isebenza ngayo
I-Levodopa ihlale ihlanganiswa ne- carbidopa yezidakamizwa (njengegama le-brand name yeSinemet), elisiza ukwandisa ukusebenza kwe-levodopa futhi kuvimbela imithi ukuba iphule egazini ngaphambi kokuba ifinyelele ebuchosheni. Esikhundleni sokudinga okuphezulu okudingekayo kuqala, ukufakwa kwe-carbidopa kuvumela i-levodopa ukuba inikezwe ngamanani amancane. Lokhu kunciphisa ukucabangela nokuhlanza, okuvame ukulimaza imiphumela emibi. EYurophu, i-levodopa ihlangene nenhlanganisela ehlukene ebizwa ngokuthi i-benserazide ene-effect efanayo nomuthi wegama lomkhiqizo iMadopar.
Ukwelashwa kwe-Dopamine esikhundleni sokusebenza esikhundleni kusebenza kahle ngokulawula izimpawu zezimoto futhi kusiza ukuthuthukisa ukusebenza kwansuku zonke kwalabo abathintekayo nguParkinson.
Kodwa-ke, kungabangela nemiphumela emibi kakhulu efana ne- dyskinesias (ukunyakaza okungazibandakanyi kahle), okunganciphisa inani lemithi engasetshenziswa. Lokhu kubangela ukuthi iningi labantu lihlehliswe kuze kube yilapho inani le-dopamine lingashintshwa khona. Ngezinye izikhathi, imiphumela emibi ibi kakhulu kunezimpawu zokuqala eziphathwayo.
Ukwengeza, ayihambisani nezimpawu ze-nonmotor ze -Parkinson, eziyaziwa ukuthi zibangela iningi lokukhubazeka kuziguli.
I-Levodopa Imiphumela Yomsindo
Imiphumela emibi ye-dopamine yokwelashwa esikhundleni sokufaka imithi ihlanganisa, kepha ayikhawulelwe, isicanucanu, ukuhlanza, ukucindezela kwegazi ephansi , ikhanda eliphansi , nomlomo omile. Kwamanye abantu kungabangela ukudideka nokuhlelwa. Esikhathini eside, ukusebenzisa i-dopamine esikhundleni kungase kuholele kuma-dyskinesias nokuhamba kwezimoto (okungukuthi, izinkathi eziningi "ezikude" lapho imithi ingasebenzi kahle).
Izinhlobo ze-Dopamine Replacement Therapies
I-Dopamine yokwelashwa esikhundleni sithathela ngezindlela ezihlukahlukene kanye nezinhlanganisela. Amalungiselelo avamile kakhulu kanje:
I-Levodopa / I-Carbidopa: Le nhlanganisela ifika efomini elincane (Sinemet) kanye nesikhathi eside (Sinemet CR) esidinga kuphela ukuphindwa kabili-kwansuku zonke. I-Levodopa / i-carbidopa nayo ifika kuthebhulethi yomlomo ehlukanisa ngomlomo (i-Parcopa) engadingi amanzi ukuthatha futhi iyasiza kulabo abanenkinga yokugwinya.
I-Levodopa / i-Carbidopa / i-Entacapone: I- Stalevo ingenye igama lomkhiqizo elilungiselelwe isikhathi eside sokulungiswa kwe-dopamine ukuthi ngaphezu kwe-levodopa ne-carbidopa ine-addacacone yemithi eyengeziwe, okuqhubeka yandisa ukusebenza kwalesi sakhiwo okuvumela isikhathi eside.
Njengamanje itholakale kuphela eCanada naseYurophu, i-levodopa / carbidopa gel (i-Duodopa) ifomu lokuguqula i-dopamine elinikezwa ngqo emathunjini amancane nge-tube ehlinzekwe ngokuhlinzwa. Kungcono kakhulu ukusetshenziselwa labo abanezifo ezithuthukisiwe abangakwazi ukulawula phezu kwempawu zabo zokukhubaza izimpawu ngeminye imithi etholakalayo. Ngokusebenzisa uhlelo lwepompo olufana ne-insulin pump elesifo sikashukela, i-Duodopa iyakwazi ukuletha imithi ngokuqhubekayo kulo lonke usuku.
Izwi elidumile elithi "endala igolide" ngokuqinisekile lifakazela iqiniso uma kuziwa nge-levodopa. Naphezu kwentuthuko emkhakheni wokucwaninga kwesifo sikaParkinson, akukho esinye isidakamizwa esisha esiye sabonisa ukuthi siyasebenza njenge-levodopa ngokukhulula izimpawu zalesi sifo.
Kodwa-ke, imiphumela emibi, ikakhulukazi yesikhathi eside eside ehilela ukushintsha kwezimoto kanye nama-dyskinesias, ukunciphisa ukusebenza kwayo kweqiniso njengokwelashwa okuhle.
Imithombo:
I-Parkinson's Clinic and Clinical Research Centre. Imithi ye-Parkinson's Medicine . UCSF, 2014.
"Imishanguzo yezinhlamvu." - I-Parkinson's Disease Foundation (PDF) . I-Parkinson's Disease Foundation, n