Neuroleptic - he aha te mea te reira? He aha te mea te huarahi o te mahi o taero ähotea?

tarukino Psychotropic, e whakaaro - te maimoatanga o disorders psychotic, ähotea huaina (rite ähotea neuroleptic ranei). He aha te mea me pehea e mahi i te reira? Tatou i te reira.

Neuroleptic. He aha te mea te reira? Hītori me ngā āhuatanga

puta ngā tata Antipsychotics rongoa. Tae noa ratou kitea i roto i te maimoatanga o te āhotea whakamahia tino maha taka o takenga huawhenua (pērā i henbane, Belladonna, opiates), whakahaere rō-uaua o te konupūmā, pūkeha, me te moe whakapōauau.

I roto i te 50s wawe 'o te rau tau 20 mo enei take kua whāngai antihistamines tote lithium ranei.

Ko tētahi o te chlorpromazine ähotea tuatahi kua riro (chlorpromazine ranei), i tae noa ka i whakaaro he antihistamines tikanga. Whānui te tono tīmata reira ki 1953, te nuinga rite te whakarokiroki neuroleptic (i roto i te tuakoi) ranei.

I muri neuroleptic ko te reserpine pāhare, engari i hohoro te mono i e te tahi atu, taero whai hua atu, rite tata kahore pānga.

I roto i te tīmatanga o 1958 i reira i te tahi atu antipsychotics whakatupuranga tuatahi: trifluoperazine (triftazin), haloperidol, thioproperazine me etahi atu.

Ko te wā "ähotea" whakaarohia i roto i te tau 1967 (ina hanga e ia te whakarōpū o raau taero psychotropic o te whakatupuranga tuatahi), ka tukinotia ana e ia ki te raau taero e kore anake e pānga ähotea, engari ano hoki ahei o meinga disorders neurological (akataziyu, parkinsonism neuroleptic, ngā tauhohe takawiri, me ētahi atu). Tikanga, meinga enei disorders matū pērā i chlorpromazine, haloperidol me triftazin. Ano, te maimoatanga e haere tahi tata tonu ratou i pānga kino taha: korekore, manukanuka, te mamae kino, tau'a aronganui.

kia hoki kia huaina antipsychotics mua "tranquilizers nui", kia antipsychotics me tranquilizers - e tetahi me te taua. Te aha? No te mea meinga ano ratou whakarokiroki, hypnotic me antianxiety trankviliziruyusche-pānga, me te rawa he āhua motuhake o te tau'a (Ataraxia). Na e kore e tenei taitara ki te faatura ki neuroleptics tono.

Ka taea te wehea taero ähotea katoa ki angamaheni, me te mohiotia. antipsychotics Angamaheni tatou wāhanga whakaahuatia, i teie nei whakaaro he mate ähotea mohiotia. He aha te mea te reira? Tenei rōpū Ko atu "ngohengohe" taero. e kore ratou mahi na nui mahi i runga i te tinana, kia rite ki angamaheni. no ratou ki te whakatupuranga hou o antipsychotics. Ko te painga o te antipsychotics mohiotia ko e whai ratou iti mana i runga i te mau farii ohipa dopamine.

Antipsychotics: iteraa papû

riro antipsychotics katoa kotahi taonga taketake - mana whai hua i runga i te tohu hua (moemoeā, horihori, pseudohallucinations, kākaá, whakahaere whakararuraru, horihori, fakaaoao me te excitation). Haunga, neuroleptics (te nuinga mohiotia) ka taea e tautapa ki te hamani fakalotofo'í tohu takarepa ranei (autism, flattening aronganui, me desotsializatsii m. P.). Heoi, ratou whai huatanga i roto i pā ana ki te maimoatanga o tohu o nama ko te pātai nui. Tohunga whakaaro e taero ähotea e taea ki te whakakore anake nga tohu tuarua.

antipsychotics mohiotia, i te mea ngoikore atu angamaheni tikanga o te mahi, kei te whakamahia hoki ki te hamani te whakararuraru, pourua.

opani te American Psychiatric Association te whakamahi o antipsychotics ki te hamani tohu whanonga, me te hinengaro o te tupu. Ano, e kore e kia whakamahia ratou mo te ohoroa.

Ko te tautokohia ki te kia tukinotia ki e rua, neke atu rānei antipsychotics i te wa ano. Na kia mahara e te neuroleptics whakamahia mo te maimoatanga o mate nui, noa no te mea kahore e tūtohutia ratou ki te tango.

pānga matua me ngā pūhanga o te mahi

Modern taero ähotea faaite i te tikanga noa o te mahi ähotea, no te mea e taea te whakaiti i te reira i te tuku o ponana karere anake i roto i te hunga pūnaha roro e ka tukua ngātere o dopamine. Kia tango o te titiro i enei pūnaha me te pānga o te raau taero ähotea ki runga ki a ratou.

• ara Mesolimbic. Whakaiti i te tuku o ponana karere i roto i tenei ara puta ka te fariiraa i tetahi mate ähotea mai tango raro e auraa reira o tohu hua (hei tauira, moemoea, horihori me te rite. D.)
• ara Mesocortical. He arata'i whakawhiti pini whakaiti ki te ahua o tohu o tuakoi (puta disorders tōraro pērā i tau'a, desocialization, rawakore o korero, flattening o pā, anhedonia) me disorders hinengaro (whakarongo takarepa, mahi mahara waimaero, a na i runga i. D.). Ko te whakamahi o antipsychotics angamaheni, wā-roa rawa, arata'i ki nui haere disorders kino, me te maumaui nui o nga mahi roro. Whakakore neuroleptics i roto i tenei take e kore e te āwhina.
• ara Nigrostriatal. Dopamine receptor pā i roto i tenei take te tikanga arata'i ki te angamaheni pānga taha ähotea (akathisia, parkinsonism, dystonia, salivation, dyskinesia, lockjaw me te t. D.). E kitea ana ēnei pānga taha i roto i te 60% o te wā.
• ara Tuberoinfundibular (pini tuku i waenganui i te pūnaha limbic me te repe). Ārai i te receptor arata'i ki nui haere taiki prolactin. I runga i tenei papamuri i hanga maha nui o te tahi atu pānga taha pērā i gynecomastia, galactorrhea, pōrearea fakasekisualé, pākoko, me te ara puku rapae o māuiuitanga.

antipsychotics Angamaheni piki pā receptors dopamine; mohiotia taua pā i runga i ētahi atu neurotransmitters serotonin (matū e tuku ponana io). No te mea o tenei antipsychotics mohiotia meinga iti hyperprolactinemia, whakararuraru extrapyramidal, whārua neuroleptic me ngoikoretanga, neurocognitive me tohu kino.

Kei te e tukupu ana tohu o α ₁ -adrenoceptor pā pēhanga toto, hypotension orthostatic, whanaketanga whanoke, te takanga o te sleepiness.

A, no te puta pā H ₁ histamine receptors hypotension, he hiahia tipu mō warowaihā me te taonga taimaha, me whakarokiroki.

Ki te te pā o receptors acetylcholine, i reira ko nga pānga taha e whai ake: kōroke, mangai maroke, tachycardia, te pupuri mimi, nui haere intraocular pēhanga me te noho raruraru. Ko taea ano hoki te putanga o te whakama hinengaro, me te sleepiness.

Kua whakaaturia kairangahau Western e waenganui i antipsychotics (neuroleptics, hou ranei tawhito, angamaheni ranei mohiotia - e kore e mea faufaa te reira) me te mate cardiac ohorere, i reira te mea he hononga.

i roto i te maimoatanga o neuroleptic-patunga me te mōrea o te whakaeke ngakau ano whakanuia ana tino. Ko e tika ana ki te meka e pā taero psychotic lipid pākia tenei. kia hoki tīmata neuroleptics Urunga momo 2 mate huka. Ko te tūpono o whiwhi pōauautanga nui ake i ki te maimoatanga ngā ki antipsychotics angamaheni, me te mohiotia.

antipsychotics hi'oraa maitai e whakapataritari haurangi haurangi kua tuku iho ärai paepae.

Te nuinga antipsychotics (te nuinga neuroleptics phenothiazine) i he pānga nui hepatotoxic a taea noa arahi ki te whanaketanga o te jaundice cholestatic.

maimoatanga ähotea i roto i te iwi paari kia whakapiki ake i te mōrearea o te kakā e 60%.

Ko te pānga hinengaro o neuroleptics

E pupuri ana whakakitea he ako tuwhera e antipsychotics mohiotia te nuinga paku atu whai hua i roto i te maimoatanga o te hē neurocognitive. Heoi, tuturu taunakitanga e pā ana ki a ratou i te iti rawa etahi pānga i runga i te kore disorders neurocognitive. neuroleptics mohiotia, te huarahi o te mahi ko te paku rerekē i te angamaheni, whakamātautau maha nui nei.

I roto i te kotahi ako haumanu whakataurite i te pānga o te risperidone he rata, me haloperidol i roto i pota iti. I roto i te ako, i kitea kahore rerekētanga nui i tohu. Kua whakaaturia hoki te reira i e pota iti o haloperidol i roto i te pānga pai i runga i te mahi neurocognitive.

Ko te kupu, Ko tautohetohe tonu te pānga o neuroleptics tuatahi ranei whakatupuranga tuarua i runga i te hinengaro.

whakarōpū o antipsychotics

Kua whakahuatia kua matou e kua wehea antipsychotics ki angamaheni, me te mohiotia.

Ka taea e I roto i antipsychotics angamaheni kia he nunui:

1. Sedatives, antipsychotics (whakarato pānga braked i muri i tono): promazine, levomepromazine, chlorpromazine, alimemazine, chlorprothixene, me ētahi atu periciazine.
2. antipsychotics Incisive (i te pānga ähotea ao kaha): fluphenazine, trifluoperazine, thioproperazine, pipotiazine, zuclopenthixol me haloperidol.
3. Dezingibiruyuschie (i he Whakaoho, te mahi tuku): karbidin, sulpiride me etahi atu.

Na roto i te antipsychotics mohiotia ngā matū pēnei i aripiprazole, sertindole, ziprasidone, amisulpride, quetiapine, risperidone, olanzapine me clozapine.

He ko tetahi whakarōpū o neuroleptics, e kua tohaina rite ki:

1. Phenothiazines, tricyclic me ētahi atu pärönaki. i reira he momo i roto ia ratou:
   
   ● neuroleptics ki te here tīmeka ohie (Levomepromazine, alimemazin, promazine, chlorpromazine), kaha tautāwhi i receptors acetylcholine me receptors adrenergic whai he pānga whakarokiroki korerotia a taea meinga disorders extrapyramidal;
   ● neuroleptics ki piperidine karihi (thioridazine, pipotiazine, periciazine) he pānga ähotea ngawari me te neydokrinnymi ngawari me ngā pānga taha extrapyramidal;
   ● neuroleptics ki te karihi piperazine (fluphenazine, prochlorperazine, perphenazine, thioproperazine, frenolon, trifluoperazine), e taea o ārai receptors dopamine, me te pānga ngoikore i runga i acetylcholine me receptors adrenergic.
   
   
2. thioxanthene pärönaki katoa (chlorprothixene, flupentixol, zuclopenthixol), nei mahi he rite ki te mahi o phenothiazines.
3. benzamides whakakapi (tiapride, sultopride, sulpiride, amisulpride), nei mahi ko hoki rite neuroleptics phenothiazine.
4. pärönaki butyrophenone katoa (trifluperidol, droperidol, galoperiodol, Benperidol).
5. Dibenzodiazapin me ona pärönaki (olanzapine, clozapine, quetiapine).
6. Benzisoxazole me ona pärönaki (risperidone).
7. Benzizotiazolilpiperazin me ona pärönaki (ziprasidone).
8. Indole me ona pärönaki (sertindole dikarbin).
9. Piperazinilhinolinon (aripiprazole).

Mai i te katoa i runga, ka taea e koe tohatoha i te antipsychotics e wātea ana - taero kahore prescriptions hokona i roto i pharmacies, me te rōpū o antipsychotics, e kua hokona tino i runga i whakahau a tākuta.

taunekeneke tarukino ähotea

Ka rite ki tetahi atu rongoa, taunekeneke antipsychotics hou ki ētahi atu rongoā, ki te tangohia i te wa ano. He tino kino mo te tinana tangata ētahi taunekeneke, na ko te mea nui ki te mohio te mea ki te tango taero ähotea he mōrearea. Kia mahara e maha puta neuroleptics poisoning no o ratou taunekeneke ki ētahi atu taero.

Ngā pāhekoheko ki pōuritanga arata'i ki nui haere ngā mahi rite neuroleptics me pōuritanga ratou. Ka taea e ratou huinga arahi ki kōroke, ileus pararutiki, takawhita.

Kaua e tangohia e haere:

• Ko te huinga o antipsychotics me benzodiazepines arata'i ki te korekore romahā, pānga taha whakarokiroki.
• A, no te concomitantly ki konukōhatu therapy whakawhanake ai Hyperglycemia, ahua o whakama, te momoe. Ka taea te nohotahi ratou huinga, engari anake i raro i te tirotiro hauora.
• Taupānga ki agonists (ephedrine, metazonom, noradrenaline, Adrenaline) whakaiti te pānga o raau taero e rua.
• Antihistamines i roto i coadministration ki neuroleptics whakarei ratou pānga inhibitory i runga i te pūnaha io pokapū.
• Kua tangohia tahi te taua pānga ki te waipiro ähotea, te tikanga mo te rehunga, hypnotics anticonvulsants ranei.
• antipsychotics Urunga ki Pë me anesthetics arata'i ki te hua i roto i to ratou pānga. Tenei huinga Ko te pānga depressing i runga i te CNS.
• Antipsychotics tangohia ki taiāki me taero antidiabetic arata'i ki te hekenga i roto i to ratou whai huatanga.
• A, no te fariiraa i antipsychotics ki tetracyclines faarahi te mōrea o tāoke ate.

contraindications

Na i nga taero ähotea mohiotia, me te angamaheni he rārangi kano o contraindications:

• taka idiosyncrasy;
• te aroaro o kati-koki papahewa, adenoma prostatic, porphyria, mate a Parkinson, pheochromocytoma;
• tauhohe mate pāwera ki neuroleptics i hītori tangata;
• disorders o te ate, me nga whatukuhu;
• hapū me te hohipera;
• mate o te pūnaha Cardiovascular;
• mate febrile whakapeka;
• pōroa.

pānga te taha o neuroleptics

A, no te therapy wā roa-, ara te faaiteiteraa pai pānga taha neuroleptic.

Ka taea e taero ähotea katoa ake i te mōrea o te hypersensitivity dopamine, i roto i te tahuri arata'i ki ngā tohu o te āhotea me dyskinesia tardive.

Nuinga o ngā wā, enei tohu puta ina whakakore koe he neuroleptic (i huaina tenei ko te "syndrome withdrawal"). He maha ngā momo withdrawal syndrome: āhotea tardive, dyskinesia e itehia (ranei e utu dyskinesia), o te syndrome cholinergic "utu te" et al.

Me koe ki te whakaoti āta ki te ārai i tenei syndrome, maimoatanga neuroleptic, āta whakaiti i te horopeta.

A, no te fariiraa i pota tiketike o neuroleptics tuhia pānga taha pērā i takarepa syndrome neuroleptic-piri. E ai ki te raraunga unofficial, puta tenei pānga i roto i te 80% o tūroro tango antipsychotics angamaheni.

huringa hanganga i roto i te roro mō te whakamahi roa

rangahau placebo-te mana o te raraunga Rhesus, e hoki e rua nga tau i hoatu haloperidol olanzapine ranei i noa inenga, rōrahi me te taimaha o te roro i te fariiraa i neuroleptics iti i runga i toharite e 11.8%. Ko te tika ki te hekenga i roto i te rōrahi o te mea ma, me te hina tenei. Ora i neuroleptics taea.

I muri i te whakaputanga o nga hua o nga kairangahau whakatupato e kore kua whakamatauria te pānga o neuroleptics i runga i te kararehe i mua i tā i runga i te mākete ho'oraa, a e tū ratou he ati ki te tangata.

Ko tētahi o nga kairangahau, Nancy Andreasen, he māia e te whakaiti i roto i te rōrahi mea hina, a ka riro antipsychotics i roto i te whānui he pānga tōraro i runga i te tinana tangata, me te arata'i ki atrophy o te uho prefrontal. I te tahi atu te ringa, te reira tuhia ano e te antipsychotics he he rongoā nui e taea te whakaora e rave rahi e ua, engari e hiahia ana ratou ki te kia mau anake i roto i ngā rahinga iti rawa.

I roto i te 2010, kairangahau Hoani. Leo ko Hoani. Moncrieff whakaputaina he arotake o te rangahau i runga i te pūtake o whakapakoko hāngai autō o te roro. kawea te ako i roto i ki te whakarite i te roro o te tūroro huringa tango neuroleptics, me tūroro kahore e manako nei ratou.

I te 14 o 26 take (tūroro peratia ki neuroleptics) i ite i te hekenga i roto i te rōrahi roro, te rōrahi o te mea hina, me te ma.

O te wā 21 (tūroro nei kihai i tango antipsychotics, ranei manako, engari i roto i ngā pota iti) i roto i rānei kahore huringa i kitea.

I roto i te 2011, kua whakaputaina nga taua kairangahau katoa Nancy Andreasen hua o te ako i kitea nei huringa i roto i te rōrahi roro i roto i 211 tūroro peratia ki taero ähotea mo te wa roa (i runga i te 7 tau). Ko te nui, ko te horopeta tarukino, te nui te nui o roro heke.

Ko te whanaketanga o te raau taero hou

I tenei momeniti e whakawhanake tatou antipsychotics hou e whai kahore pānga i runga i te mau farii ohipa. ka mea tetahi rōpū o kairangahau e te pānga ähotea he wae tarukino cannabidiol. Na ko reira taea e hohoro tatou e kite i tenei mea i runga i nga whata o pharmacies.

mutunga

Te tūmanako, kahore tetahi e noho te pātai e rite ana ki te mea ko te mate ähotea. He aha te mea te reira, te mea ana mahi, me te mau hopearaa o te fariiraa tikanga te uiui i runga matou. Reira anake tonu ki te tāpiri i taua mea katoa e te taumata o te rongoā i roto i te ao hou, e kore e taea te ako tetahi o te taonga noa te mutunga. Na te whakapati e titau koutou i tetahi mea, nui iti i runga i taua hua matatini rite antipsychotics.

I roto i nga tau tata nei, take o te maimoatanga ähotea o te korekore. I roto o te kuware o te mau fifi o tenei tarukino, iwi e mahi ratou kino. e kore e taea te whakamahi Antipsychotics i roto i tetahi take mo tetahi whakaaro atu atu i tona whakaaro e tūmanakohia ana. A e pā ana ki te pānga o ēnei raau taero i runga i te roro hua, kua ara i roto o te pātai.

Ko te aha antipsychotics - taero kahore prescriptions e wātea ana mō te hoko, kia whakamahia ki te tūpato (a anake, ki te e 100% tino e hiahia ana koe i te reira koutou), me pai noa e kore ki te kia whakamahia, kahore whakahaunga o te tākuta.