Iyo yegoridhe-kurapa kwakakwana kwePalinson's Disease (PD) inorapwa mishonga . Zvinenge mishonga yose inowanikwa inoita kuti kuwedzere huwandu hweDopamine muuropi. Nzira iyo mishonga inopiwa inoita izvi ine zvakawanda zvine chokuita nekubudirira kwayo uye zvingave nemigumisiro.
Levodopa Mukurapa Zviratidzo
Levodopa ndiwo mushonga wekutanga wep-brain masero anoshandisa levodopa sechivakwa chekuvaka kuti agadzire zvimwe dopamine.
Levodopa inoshanda nekuita zvinogadzirisa zviratidzo zvemagetsi, zvichiita kuti uchinzwe usingaomeswi, unowedzera kushambadzira, uye unogadziriswa. Zvinosuruvarisa, hazvina kuporesa PD uye hazvigoni kumira chirwere chepachirwere chaicho.
Levodopa anewo migumisiro. Izvi zvingava nemigumisiro, zvisinei, zvingawanzobviswa nekubatanidza levodopa nedzimwe mishonga. Semuenzaniso, chimwe chinhu chikuru chinokonzerwa nevivodopa pachinoshandiswa chiri choga chiyeuchidzo-chigumisiro chekuita dopamine yakawandisa mumhepo yeropa panzvimbo yemuropi. Kuchengetedza kushungurudza uye kuwedzera huwandu hwevavodopa hunoenda kuuropi, levodopa inowanzopiwa neimwe mishonga yemishonga inonzi dopa decarboxylase inhibitor (DDI). DDI inodzivisa kutendeuka kwevavodopa kuti dopamine muropa remutumbi kuitira kuti mamwe mavodopa asvike pakuropi uye kudzivirira kuora mwoyo.
Nzira yakakurumbira yeDDI inoshandiswa munyika dzakawanda carbidopa. Kubatanidzwa kweLevodopa uye carbidopa inozivikanwa nezita rekutengeserana Sinemet.
Munyika dzakawanda carbidopa / levodopa madheji emuviri anosarudzwa sechikamu chiduku-nhamba (nhamba yepamusoro) ndiyo yakawanda ye carbidopa mubhesi rimwe nerimwe, uye denominator (pasi nhamba) muyero wevodopa. Somuenzaniso, kusanganiswa kwe 25/100 kunoumbwa 25 milligrams ye carbidopa uye 100 milligrams yevodopa.
Carbidopa / levodopa inowanikwawo mumutauro unochengetwa-kusunungurwa unonzi Sinemet CR. I-controlled-release formulations yeSinemet inobvumira nguva yekudzikinura yakaderera yevodopa muropa, iyo inobatsira kubvisa kuguma-kwe-chiremba kupfeka kuchinja, pamwe nekuvhiringidzika kwekurara usiku.
Zvimwe Dopamine Zvinodhaka
Kunyange zvazvo levodopa inonyatsobata zviratidzo zvePalinson's disease , chirwere ichi zvisati chichiri kuwedzera uye chinowedzera kupfuura nguva. Chirwere chePacinsinson chinokuvadza masero europi anoita dopamine kana kuti anoshandura levodopa kuti dopamine. Sezvo chirwere chacho chiri kufambira mberi, chinowedzera kuoma kukurudzira uropi hugadzirwa dopamine . Isu, saka, tinoda dzimwe nzira dzokuchengetedza uropi dopamine mazinga akakwirira zvakakwana kuti atsigire motokari inoshanda.
Sezvo dopamine mashizha ekugadzirwa akaparara nechirwere chatinofanira kutarisa mamwe masero asingagoni kubudisa dopamine asi aita kushandisa dopamine iripo zvinobudirira. Makirasi maviri emishonga anogona kuita izvi:
- mishonga inonyatsosimudzira masero anoshandisa dopamine-"dopamine agonists"
- mishonga inobvisa kuputsika kwe dopamine mumuviri uye nokudaro kuwedzera maitiro anowanikwa kuuropi-"COMT uye MAO inhibitors"
Dopamine Agonist muChipinsin's Disease
Iko kune vashomanana dopamine agonist vakaita se:
- (Mirapex) Chimiro
- (Requip) Ropinirole
- (Neupro) Rotigotine
Zvose izvi mishonga inofanana nemigumisiro ye dopamine pane yakasarudzwa dopamine receptors, iyo masero anowedzera zvinokonzera dopamine muuropi.
Iyi mishonga inogona kubudisa migumisiro yakadai sechezzinesi, kuderedza ropa, uye kushungurudzika kwepfungwa kuitira kuti ivo vatange kutangiswa semutengo wakadzika kwazvo, uye zvishoma nezvishoma vakawedzera pasi pekutungamirirwa kweukama hwevanhu.
COMT Inhibitors uye MAO Inhibitors
Iyo COMT (catechol-O-methyltransferase) inhibitors uye MAO-B (monoamine oxidase rudzi B) inhibitors inoshanda kudzivirira kuparara uye kusagadzikana kwedopamine mumuviri uye muuropi.
Kana COMT ichidzivirirwa kana ichidzivirirwa, somuenzaniso, mamwe mavodopa anogona kusvika kuuropi motokari yekudzivirira. Inonyanya kuzivikanwa COMT inhibitors ndeye (Tasmar) tolcapone uye (Comtan) entacapone. COMT inhibitors inonyanya kubatsira vanhu vane mafambiro ekuchinja.
Asi kufanana nemishonga yakawanda, COMT uye MAOI inhibitor vane madhara. Somuenzaniso, zvishanu kusvika gumi kubva muzana zvevarwere vanotora COMT inhibitor vanoita mararamiro. Izvi zvinowanzoreva kuti mishonga inofanira kumira. Vaviri kusvika ku3 kubva muzana yevanhu vanotora tolcapone vanoita zvirwere zvakakomba zvechiropa zvinoda kuswedera pedyo nekucherechedza kwechiropa chinoshanda kana paine mishonga kana kupedza kushandiswa kwemishonga zvachose. Entacapone haina matambudziko ehupukisi hwechiropa.
Iyo MAO-B inhibitors, yakadai se (Eldepryl) selegiline uye (Azilect) rasagiline, inodzivirira ma enzyme MAO-B kuti irege kuputsa dopamine muuropi pachake.
Selegiline inoshandiswa kunyanya kudzivirira kana kubvisa kunze kwekupedzisira-kwema-dose motodhi kuchinja. Migumisiro yaro ine unyoro kwazvo. Selegiline akambotenda kuti akaita seuroproproductive drug inodzivisa kukanganisa kune dopamine neurons muuropi. Icho chinotarisa kuti iyi yeuroprotective effect ye selegiline yakawanda kana isipo.
Rasagiline, kune rumwe rutivi, anotarisa kuti ave akavimbisa kune kuremekedza kukwanisa kwaro kusagadzikana kwehutachiona asi juri rinenge riri kunze kwechiitiko chinokosha chechirwere. Rasagiline inowanzoshandiswa muPasinson yekutanga uye yakaenzana yekuderedza kuchinja kwemotokari. Uhu humwe humwe huripo hwehushandi hwe rasagiline nekuchengeteka kunodiwa.
Pasi Pasi
Kunyange zvazvo levodopa ndiyo mishonga yakanakisisa yekurapa zvinetso zvemotokari zvechirwere chePasinson, dzimwe nguva mamwe mishonga seDopamine agonist kana MAO inhibitor inogona kutanga kutanga, kunyanya kana zviratidzo zvemunhu zvinyoro. Iyi mishonga inogonawo kuwedzerwa kune levodopa therapy kuti ishandise kutengesa motokari.
Mashoko akanaka ndeokuti kunyange zvazvo chirwere chePasinson chisingareswi, kune nzira dzokurarama nayo chirwere ichi uye kuvandudza iwe kana wehudiwa wako zuva nezuva nekushanda kwehupenyu hwehupenyu.
Sources:
American Society of Health-System Vanachipatara, Levodopa naCarbidopa
Connolly, BS, Lang, AE (2014). Kurapa kwepachipatara kwePalinson chirwere: kuongorora. JAMA , Kubva 23-30; 311 (16): 1670-83.
R. Pahwa uye KE Lyons (Vatungamiri), Handbook yeMagetsi ePasinson ; 4th Edition, New York, Informa Healthcare Publishers, 2007.