I-Valproate, eyaziwa nangokuthi i-valproic acid, umuthi osetshenziswa kabanzi ekwelapheni ukuphazamiseka kwemizwa njengesithuthwane, i-bipolar disorder, kanye nemigraines. Isebenza njenge-mood stabilizer kanye ne-anticonvulsant, isiza ukulawula umsebenzi kagesi ongajwayelekile ebuchosheni. Kodwa-ke, i-valproate ingabangela imiphumela emibi efana nokuzuza isisindo, ukozela, ukuthuthumela, nokucanuzela kwenhliziyo, phakathi kwabanye. Kubalulekile ukuthi isiguli sibe ngaphansi kokuqondisa kodokotela ngenkathi sisebenzisa lo muthi ukuqapha ukusabela okungekuhle okungenzeka futhi silungise umthamo njengoba kudingeka.
Izinkomba ze-valproic acid: uyini lo muthi?
I-Valproic acid, eyaziwa nangokuthi i-valproate, umuthi osetshenziselwa ukwelapha izifo ezahlukahlukene zezinzwa nezengqondo. Phakathi kwezinkomba eziyinhloko ze-valproic acid ukwelashwa kwesifo sokuwa, isifo se-bipolar, kanye ne-migraine.
Endabeni yesifo sokuwa, i-valproic acid isetshenziselwa ukulawula ukuquleka nokuvimbela ukuphindeka kwakho. Ku-bipolar disorder, umuthi usiza ukuzinzisa isimo sengqondo futhi unciphise iziqephu ze-mania nokucindezeleka. Kuma-migraines, i-valproic acid ingasetshenziswa ukuvimbela ukuquleka nokunciphisa ukushuba kwekhanda elibuhlungu.
Ngaphezu kwalokho, i-valproic acid inganikezwa nezinye izimo, njengokwelashwa kwezinkinga zokuziphatha, ulaka, kanye nokungathandi izinto ezithile ezinganeni nasebancane.
Kubalulekile ukugcizelela ukuthi i-valproic acid kufanele isetshenziswe kuphela ngaphansi komyalelo wezokwelapha kanye nokuqapha okufanele, njengoba ukusetshenziswa kwayo kabi kungadala imiphumela emibi kakhulu. Eminye yemiphumela emibi engaba khona ye-valproic acid ihlanganisa ukozela, isiyezi, ukukhuluphala, ukuthuthumela, kanye nokuphazamiseka kwesisu.
Ngakho-ke, ngaphambi kokuqala ukwelashwa nge-valproic acid, kubalulekile ukubonana nodokotela futhi ulandele imiyalelo yabo ukuze uqinisekise ukuphepha nokusebenza komuthi ekwelapheni isimo esithile.
Imiphumela ye-valproate emzimbeni: thola ukuthi le nto isebenza kanjani emzimbeni.
I-Valproate, eyaziwa nangokuthi i-valproic acid, umuthi osetshenziselwa ukwelapha izimo ezihlukahlukene zemizwa, njengesithuthwane, ukuphazamiseka kwengqondo, kanye nemigraines. Isenzo saso emzimbeni senzeka ngokuyinhloko ngokulawula amazinga ama-neurotransmitters, afana ne-GABA, abambe iqhaza ekulawuleni injabulo ye-neuronal.
Ngaphezu kwalokho, i-valproate iphinde isebenze njenge-mood stabilizer, esiza ukunciphisa izimpawu ze-bipolar disorder, futhi njenge-vasodilator, enomthelela ekuthuthukisweni kwezimpawu ze-migraine. Kodwa-ke, njenganoma yimuphi umuthi, i-valproate ingabangela imiphumela emibi, njengokulala, ukuzuza isisindo, nokuthuthumela.
Kubalulekile ukugcizelela ukuthi i-valproate kufanele isetshenziswe ngaphansi kokuqondisa kwezokwelapha, njengoba umthamo kanye nobude besikhathi sokwelashwa kungase kuhluke kuye ngokuthi isimo siphathwa kanjani kanye nezici zomuntu ngamunye zesiguli ngasinye. Ngakho-ke, hlala uthintana nochwepheshe bezempilo ngaphambi kokuqala noma yiluphi uhlobo lokwelashwa kwe-valproate.
Izinzuzo ze-valproate: thola izinzuzo zalo muthi ekwelapheni izifo ezahlukahlukene.
I-Valproate, eyaziwa nangokuthi i-valproic acid, umuthi osetshenziswa kabanzi ekwelapheni izimo ezihlukahlukene zemizwa, njengesithuthwane, ukuphazamiseka kwengqondo okuguquguqukayo, kanye nemigraines. Izinzuzo zayo ziningi futhi zihlanganisa ukunciphisa imvamisa nokuqina kokuquleka kwesithuthwane, ukuzinza kwemizwelo ezigulini ezine-bipolar disorder, nokuvimbela ubuhlungu bekhanda obukhulu kuma-migraines.
Ngaphezu kwalokho, i-valproate iphinde yasetshenziswa ngempumelelo ekwelapheni ukuphazamiseka kokuziphatha nokukhathazeka, ifakazela ukuthi isebenza ngempumelelo ekwehliseni izimpawu nasekuthuthukiseni izinga lempilo yeziguli. Isenzo saso ohlelweni lwezinzwa olumaphakathi sisiza ukulawula umsebenzi we-neuronal kanye ne-neurotransmission, okufaka isandla ekulawulweni kwezimpawu ezihlobene nalezi zimo.
Naphezu kwezinzuzo ze-valproate, kubalulekile ukuqaphela ukuthi ukusetshenziswa kwayo kungahlotshaniswa neminye imiphumela emibi, njengokulala, ukukhuluphala, nokuthuthumela. Ezimweni ezingavamile, ukusabela okubi kakhulu, njengezinkinga zesibindi kanye ne-pancreatitis, kungenzeka. Ngakho-ke, kubalulekile ukuthi umuthi usetshenziswe ngaphansi kwencwadi kadokotela kanye nokuqapha njalo.
Kodwa-ke, kubalulekile ukuthi ukusetshenziswa kwayo kube ngobuhlakani futhi kuqashelwe, ukuze kuncishiswe ubungozi bemiphumela engemihle futhi kuqinisekiswe ukusebenza ngempumelelo kokwelashwa.
Imiphumela emibi ye-Depakene: yini ongayilindela lapho uthatha lo muthi?
I-Valproate, eyaziwa nangokuthi i-valproic acid, umuthi osetshenziswa kabanzi ekwelapheni ukuphazamiseka kwemizwa njengesithuthwane, i-migraines, ne-bipolar disorder. Kodwa-ke, njenganoma yimuphi omunye umuthi, i-valproate ingabangela imiphumela emibi kwabanye abantu.
Phakathi kwemiphumela emibi evame kakhulu ye-Valproate kukhona isicanucanu , ukuhlanza , ukozela , kanye nesiyezi . Lezi zimpawu ngokuvamile zincane futhi zivame ukuncipha ngokuhamba kwesikhathi njengoba umzimba ujwayela umuthi.
Ngaphezu kwalokho, i-valproate ingabangela ukukhuluphala , izinguquko zombono , kanye nokukhathala . Kubalulekile ukuqaphela noma yiziphi izinguquko emzimbeni wakho nokwazisa udokotela wakho uma ubona noma yiziphi zalezi zimpawu.
Ezimweni ezingavamile, i-valproate ingabangela imiphumela emibi kakhulu njenge- pancreatitis , i-hepatitis , kanye ne -thrombocytopenia . Uma uhlangabezana nezimpawu ezifana nobuhlungu obukhulu besisu, i-jaundice, noma ukuphuma kwegazi okungavamile, kufanele ufune usizo lwezokwelapha ngokushesha.
Kubalulekile ukuqaphela ukuthi akuwona wonke umuntu othatha i-valproate ozothola le miphumela emibi. Umzimba womuntu ngamunye usabela ngendlela ehlukile emuthini, ngakho-ke kubalulekile ukulandela imiyalelo kadokotela wakho futhi ubike noma yiziphi izimpawu ezingajwayelekile phakathi nokwelashwa.
I-Valproate (i-Valproic Acid): Ukusetshenziswa kanye Nemiphumela Emibi Yalo Muthi
Kusukela ezikhathini zasendulo, kuye kwaba namakhulu ezinkinga noshintsho oluye lwathinta impilo yomuntu. Kodwa phakathi kwazo zonke lezi zifo, kukhona okuhlotshaniswa ne-hyperexcitability yamaqembu e-neuronal asendulo futhi anonya kangangokuthi kuye kwabhekwa "isifo esingcwele."
Kuyisifo sokuwa , isimo esasingaqondakali kahle kwaze kwaba muva nje futhi esiba nemiphumela emibi kakhulu kulabo abahlushwa yiso uma bengalutholi ukwelashwa.
Ngenhlanhla, intuthuko yesayensi ivumele ukuthuthukiswa kwezinhlobo ezahlukene zokwelapha, phakathi kwazo esingathola ukusetshenziswa kwemithi. Ngale ndlela, omunye wemithi evame ukusetshenziswa ekwelapheni lesi simo yi -valproate noma i-valproic acid , esizoxoxa ngayo kulo lonke lesi sihloko.
Valproic acid noma valproate: kuyini?
I-Valproic acid umuthi oqeda ukuxhuzula engqondweni , uhlobo lomuthi oluwusizo ekulweni nasekuvimbeleni ukuxhuzula kanye nokuxhuzula ngokujwayelekile. Ungomunye wemithi eyaziwa kakhulu futhi esetshenziswa kakhulu ekwelapheni isithuthwane, ngokuvamile uhlanganiswa ne-carbamazepine kanye ne-topiramate.
Naphezu kokuba i-anticonvulsant, ukwakheka kwayo kwamakhemikhali kuyahluka kwabanye abameleli eqenjini layo.
I-Valproate umuthi osebenza kahle kakhulu futhi onamandla (utholakala kuphela ngomuthi kadokotela) onemiphumela yokuzinzisa imizwa futhi ubhekwa njengomuthi obanzi. Ingatholakala ngamagama ahlukahlukene, njenge-valproate, i-manganese valproate, noma i-sodium valproate, kanti amanye amagama emikhiqizo aziwa kakhulu yi-Depakote noma i-Depakine.
I-Valproic acid inganikezwa ngezindlela ezimbili eziyinhloko: ngomlomo kanye nangemithambo yegazi . Eyokuqala itholakala kakhulu kwezentengiselwano, ngesimo samaphilisi noma amaphilisi, futhi ivame ukusetshenziswa ekwelashweni kwangaphandle. Uhlobo lwe-intravenous lutholakala emabhodleleni anokuqukethwe okujovwe futhi ngokuvamile lugcinelwe izimo zesibhedlela noma izimo eziphuthumayo.
Indlela yokwenza
I-Valproic acid inemiphumela yayo emzimbeni ngendlela yokusebenza esekelwe ku-agonism ye-gamma-aminobutyric acid noma i-GABA , okungukuthi, ukukhuthaza ukukhiqizwa nokusebenza kwale neurotransmitter emzimbeni. Ngaphezu kwalokho, iphinde yehlise amazinga e-glutamate futhi ishintshe ukuziphatha kwama-receptor e-sodium, potassium, kanye ne-calcium kuma-neurons ethu (kunciphisa ukuhanjiswa kwawo).
Uma ubheka ukuthi i-glutamate ingenye yama-neurotransmitter ashukumisayo ebuchosheni futhi i-GABA iyisithibi esikhulu sama-neurotransmitter ohlelweni lwezinzwa, imiphumela yalezi zinguquko emazingeni azo zombili idala ukwehla komsebenzi wezinzwa, into ebalulekile ekwelapheni isifo sokuwa (lapho kukhona ukusebenza ngokweqile kwamaqembu ama-neuron azwela kakhulu, ukuze ukukhuthazwa okuncane kungabangela impendulo enamandla) kanye nakwezinye izifo lapho kukhona umsebenzi owengeziwe wezinzwa.
- Ungase ube nentshisekelo kulokhu: ” Isifo sokuwa: incazelo, izimbangela, ukuxilongwa kanye nokwelashwa “
Izinkomba eziyinhloko zalo muthi
Njengesidakamizwa sokulwa nesifo sokuwa noma sokudlikiza, i-valproic acid isetshenziswa kakhulu kulabo abanesifo sokuwa noma sokuwa , kokubili labo abahlanganisa ukudlikiza kanye nalabo abaziwa ngokuthi "ukudlikiza kokungadlikiza." Lo muthi unikezwa kokubili abantu abadala kanye nezingane ezihlushwa yilesi simo, yize kufanele kuthathwe izinyathelo zokuphepha ngemithamo kanye nemiphumela emibi engaba khona.
Ngaphezu kwalokho, i-valproate iyona kuphela i-anticonvulsant eboniswe ngokusemthethweni nge-bipolar disorder, nakuba eminye imithi eqenjini elifanayo ingase ibe nenzuzo. Lokhu kungenxa yomphumela oshiwo ngenhla we-euthymizing noma wokuzinzisa kwemizwa.
Ayiphakamisi noma yehlise isimo sengqondo ngokwayo, kodwa kunalokho iyigcina ingaphakathi kwebanga elithile. Ngale ndlela, iyasebenza ekwelapheni nasekuvimbeleni iziqephu zokudabuka , kungakhathaliseki ukuthi isetshenziswa kanye nosawoti we-lithium noma inikezwa njenge-monotherapy.
Lezi akuzona zodwa izinkomba ze-valproic acid. Ngaphezu kwalokhu okungenhla, iboniswa futhi ekwelapheni i-migraines kubantu abadala, futhi ukusebenza kwayo okungenzeka kuyahlolwa ezinkingeni ezifana ne-HIV-related dementia noma i-muscle atrophy ngenxa yomonakalo womgogodla.
Imiphumela emibi kanye nezingozi
I-Valproic acid iwumuthi obalulekile ongasiza ekwelapheni izimo ezihlukahlukene, kodwa ukusetshenziswa kwayo ngezinye izikhathi kungaholela emiphumeleni engathandeki eyingozi futhi eyingozi.
Eminye yemiphumela emibi evame kakhulu ihlanganisa ukuthuthumela, isicanucanu, noma ukuhlanza.
Eminye imiphumela engemihle ingase ihlanganise izinguquko ze-extrapyramidal (motor), ukozela, ukunyakaza kwamehlo ngokuzenzakalelayo, ukudideka, ukungakwazi ukuzibamba, izinkinga zokuzwa, ukuqothuka kwezinwele zesikhashana, i-gingival hypertrophy, ukuvuvukala komlomo, ubuhlungu besisu, isifo sohudo, ukukhuluphala, noma izinkinga zenkumbulo, ukunaka, nokufunda, ukucasuka, nokuba nolaka.
I-Parkinsonism (eguqukayo), ukuntuleka kokuxhumana noma i-paresthesia, i-dysmenorrhea kanye nobuhlungu ngesikhathi sokuya esikhathini, ukungazali (kwabesilisa), kanye nokubona izinto ezingekho.
Okubaluleke kakhulu futhi okuyingozi kakhulu (okungase kube yingozi ngempela, yingakho imithamo nokuphathwa kwalo muthi kudingeka kubhekwe ngokucophelela), nakuba kungavamile, izinkinga ezifana ne-anemia, i-hypothyroidism, i-thrombocytopenia engaba khona noma ukwehla kwenani leplatelet, ukwehla kwe-sodium yegazi, ukopha nesibindi, i-pancytopenia noma ukwehla kwezingxenye ezinkulu zegazi, i-leukopenia, izinkinga ze-antidiuretic, i-encephalitis eyancipha, i-pancreatitis, i-encephalopathy yesifo sofuba. kanye nokuncipha kwama-electrolyte, i-hyperandrogenism, ukwehluleka kwezinso, i-vasculitis, ukwehluleka komnkantsha wamathambo, ingozi eyengeziwe ye-myelodysplastic syndrome, ukungazali, i-rhabdomyolysis, i-nephritis, noma izinkinga zokuvala.
Contraindications
Naphezu kokuba usizo olukhulu ekwelapheni izimo ezishiwo ngenhla, i-valproic acid iyisidakamizwa esinamandla kakhulu, njengoba sesibonile, esingaba nemiphumela emibi eyingozi kakhulu . Ngale ndlela, kunezinhlobo zabantu kanye nemikhakha lapho ukusetshenziswa kwe-valproate kuvinjelwe kakhulu khona.
Ukusetshenziswa kwe-valproate akuvunyelwe kubantu abananoma yiluphi uhlobo lwesibindi, i-pancreas, noma isifo sezinso , ikakhulukazi ezimweni zokwehluleka kwezinso noma kwesibindi. Kubalulekile futhi ukuthi abantu abananoma yiluphi uhlobo lwesifo segazi bangayithathi.
Futhi kuyaphikiswa futhi akukhuthazwa kwabesifazane abakhulelwe , njengoba kuye kwabonakala kwandisa ingozi yokukhubazeka komntwana kanye noshintsho olufana ne-spina bifida, kanye nokuba khona kwe-fetal valproate syndrome. Ngale ndlela, kufanele kuqashelwe hhayi kuphela kwabesifazane abakhulelwe kanye nezinsana, kodwa nakwabesifazane abazibheka njengomama maduze (kuzodingeka ukuhlela i-aphoyintimenti nodokotela ukuze kuhlolwe ezinye izindlela zokwelapha esikhundleni se-valproate).
Abantu abangaguliswa yi-valproate nanoma yiziphi izithasiselo zayo akufanele futhi bayithathe ihlanganiswe ne-topiramate noma i-MAOIs (njengoba ukusebenzisana kwabo kungaba yingozi). Akufanele zithathwe ngotshwala, futhi ukuqapha kufanele kusetshenziswe uma usebenzisa izivimbela-nzalo ze-hormonal (njengoba zingabangela ukusebenzisana). Uma kuthathwa eminye imithi, kufanele kukhulunywe nodokotela mayelana nokufaneleka kokwelashwa nge-valproic acid.
Izinkomba ze-Bibliographic:
- I-Spanish Agency for Medicines and Healthcare Products (2018). Ipheshana lephakheji: Ulwazi lomsebenzisi. Depakine 200 mg/ml isisombululo somlomo. UMnyango Wezempilo. I-Spain [Ku-inthanethi] Itholakala ku-: https://cima.aemps.es/cima/dochtml/p/48828/P_48828.html.
- Macritchie, K. noGeddes, J.R., Scott, J., Haslam, D., De Lima, M., Goodwin, G. (2008). I-Valproate ye-acute mood episodes ye-bipolar disorder. I-Cochrane Library [Ku-inthanethi] Itholakala ku-: https://www.cochrane.org/es/CD004052/valproato-para-los-episodios-agudos-del-estado-de-animo-del-trastorno-bipolar.
- I-US National Library of Medicine (2017). I-Valproic acid MedlinePlus [Ku-inthanethi]. Itholakala ku: https://medlineplus.gov/spanish/druginfo/meds/a682412-en.html.