Mukuwedzera pakufa, valproate zvakare yakashandiswa kune zvimwe zvirwere. Inogamuchirwa kuti ishandiswe mumigraine kudzivirira musoro, pakurapa manic episodes, uye kutarisira bipolar disorder.
Iyo yakave ichidzidzwa uye yakaratidzwa kuva yezvinobvira inobatsira mukurapa kwakakomba migraine misoro, kuora mwoyo, schizophrenia, uye marwadzo europathic, kunyange zvazvo isina kubvumirwa nekuda kwekushandiswa uku.
Ngationgororei basa rayo mukudzivirira kudzivirira.
Mechanism of Action
Zvinotendwa kuti valproate inodzivisa kukanganisa kuburikidza nekudzivisa kukanganisa kwakanyanya kuita muuropi. Iyo chaiyo inyanzvi yehupenyu hwekudzivirira hutachiona haina kunyatsonzwisiswa kunyange zvakadaro.
- Sodium channels: Imwe nzira iyo valproate inogona kushanda nayo nekudzivirira nzira dze sodium. Aya maitiro anowanzobvumira neuroni kutaura. Kuregererwa kwekusagadzikana kunogona kubatsira kuderedza basa rinokanganisa hweuropi rinoita kuti kugumburwe.
- GABA: Valproate inogonawo kusimbisa basa reGABA. GABA inoratidzira neurotransmitter, uye kuwedzera basa rayo inogona kushanda kuderedza zvimwe zvezvinhu zvisingaoneki neuronal muuropi izvo zvinokonzera kugunun'una.
- NMDA receptors: Mhedzisiro yev valproate pane iyi subtype ye glutamate receptors inogona kugadzirisa migumisiro ye glutamate, neurotransmitter muuropi. Izvi zvinogona kuita basa mukudzivirira kudzivirira.
Valproate imishonga inoshandiswa kwehuwandu hwemamiriro ezvinhu, kusanganisira kukanganisa, bipolar disorder, uye migraine kudzivirira musoro.
Formulations
Kune mimwe miviri yemuromo uye IV inonzi valproate formulations iyo inoshandiswa kudzora nekudzivirira kugumburwa.
- Valproic acid: Depakene inowanika mune capsule kana kuti mafomu. Stavzor inowanika mune capsule form.
- Divalproex sodium: Depakote inowanikwa muhwendefati kana kupisa fomu.
- Valproate sodium: Depacon inonzi IV (intravenous). Nemhaka yokuti inopiwa IV, inogona kushandiswa mumamiriro ezvinhu ekukurumidzira, kumira maitiro epilepticus (zvinowanzoitika kana kuti zvinopfuurira zvinogumburwa izvo zvisingaregi pachavo pachavo), kana kana munhu ane chirwere chepfupa asingakwanisi kutora mvura, mapiritsi, kana kusasa mafomu nemuromo .
Kazhinji, mishonga inorwisa-seizure yakadai sev valproate inotorwa maviri kana mana pazuva kuburikidza nekuchengetedza zvakakwana kugadzirisa kudzora, kunyange kune vamwe vanhu vanogona kuwana kudzora kugadzirisa kamwechete pazuva pazuva dosing. Kuchengetedza chirongwa chemazuva ose chekurwisa-kugadzirisa mishonga nekuitora panguva imwechete zuva rimwe nerimwe chinhu chinonyanya kukosha kuchengetedza chimiro chakasimba, chinobatsira kukwanisa kudzivirira kudzivirira.
Mhando dzakasiyana dzev valproate dzinogona kushandiswa dzoga kana kusanganiswa nemamwe mishonga yekurwisa mutsotsi. Kusanganiswa kwemishonga kunogona kusarudzwa apo imwe mishonga chete inogona kutadza kugadziriswa pamwero unoregererwa. Apo zvinopfuura rimwechete anticonvulsant rinoshandiswa, mamwe emigumisiro inowanzoonekwa pakati peanticonvulsants , yakadai sekubatwa, kurara, uye gungwa zvinogona kuwedzerwa.
Mhando dzekutengesa zvakashandiswa
Valproate, mumitemo yakasiyana-siyana, inonyanya kushandiswa kupfuura mishonga yakawanda yekurapa. Iyo inogona kushandiswa pakudzivirira kwemhando dzakawanda dzekugumburwa, kusanganisira:
- Zvose zvinokonzera tonic-clonic kugumburwa: Izvi ndizvo zvinokonzera kukanganiswa kwekuziva uye kufamba kusingabatsiri kwomuviri. Vanowanzotumidzwa sehukuru hunotambura .
- Kusagadzikana kwezvirwere: Izvi zvinokonzera kuora mwoyo kwekuziva pasina kunyunyutika kana kufamba kwakasimba kwemuviri, kunowanzotumidzwa sekuti petit mal inogumburwa. Kusagadzikana kunokonzerwa nemafambiro akajeka, zvakadai sokukanganisika kwemaosidhi, kana kuti kushamwaridzana kusingabatsiri zvachose. Zvinofadza kuti vanhu vanoona kusagadzikana kunowanzogadzirisa kuchengetedza zvakadai sekugara kana kumire pasina kuwira.
Myoclonic seizures: Izvi zvinogumburwa zvinoratidzirwa nekufamba-famba, kana kusina kuora mwoyo kwekuziva. Myoclonic seizures inogona kurapwa nemishonga inoverengeka, kusanganisira valproate. Asi pane mishonga inogona kukuvadza myoclonic kugumburwa.
Contraindications
Valproate, pamwe chete nemimwe mishonga inorwisa-seizure, inogona kuva nekubatana kunokuvadza kana ichibatanidzwa nedoro kana zvinodhaka zvinodhaka. Paunotora valproate, kushandisa zvinodhaka kana doro kunogona kukonzera kuti migumisiro yechirwere iwedzere, inogona kukonzera utsvina kunyange pamatare ezvakanaka, uye inogona kukonzera zvinetso zvakakomba, kusanganisira kugunun'una.
Kune hutano hwakawanda huri hunoenderana nehuwandu hwemigumisiro kana kuti chepfu paunotora valproate. Zvose zvinosanganisira:
- Chiropa chechiropa
- Matambudziko ekubvisira / pasi pasi
- Kuberekwa
Mune mamwe mamiriro ezvinhu, chiremba wako angafunga kuti yakachengetedzeka kuti iwe utore valproate kunyange iwe uri nepamuviri kana iwe une chimwe chezvimwe zvinopesana kuti upinde. Kana zvakadaro, iwe unoda kuswedera pedyo kutevera kuti uongorore chero matambudziko.
Somuenzaniso, vamwe vakadzi vane pamuviri vangave vachida kuramba vari muvharoti kuti vadzivirire. Kushungurudzwa kunogona kunge kunogona kukuvadza amai kana mwana ari kusimukira. Njodzi uye zvibatsiro zvezviitiko zvakakomba zvezvehutano zvinongororwa zvakanyatsotarirwa neboka rehutano kuitira kuti kugadzirisa migumisiro.
Migumisiro Yechiri
Sezvo nemishonga yose, valproate inogona kubudisa migumisiro yechirwere. Zviyo zvakanyanya zvinowanzoitika zve valproate zvinosanganisira:
- Chizutu
- Kukurova
- Chiono chechipiri
- Kuora bvudzi
- Diarrhea
- Kuwedzera kwehuwandu
- Kuchema kana kubuda ropa
Rash: Kurwisana kunowanzoshamisa asi kunogona kunge kwakakomba. Mishonga yakasiyana-siyana inopesana nekugunun'una inogona kukonzera kukanganisa kwakakura kunotanga nekukurumidza. Kunyange zvazvo valproate isiri imwe yemishonga inowanzobatanidzwa nechishuvo ichi chakaipa, yakataurwa.
Kazhinji, iwe unogona kufunga kukurumidza kuratidza kuva dambudziko rinoshungurudza. Asi nekuda kwezvinetso zvakakomba zvinogona kukura, zvakakosha kuti iwe uudze chiremba wako kana iwe uchikurumidza kuputika paunotora valproate.
Polycystic ovary syndrome (PCOS): Sangano pakati pekushandisa valproate neCPOS rave richizivikanwa kwemakore, zvikurukuru pakati pevakadzi vane chifuyo vanobata valproate. Asi hukama hwakananga harina kugadziriswa. Kana iwe uri mukadzi achitora valproate, zvinowanzokurudzirwa kuti uchengetedze tsika yekutevera neye gynecologist, uyo anofanira kuudzwa kuti uri kutora kana kutora valproate.
Toxicity
Utachiona hunokonzerwa nemishonga hwakasiyana nemishonga yemigumisiro. Dhiyabhorosi inowanikwa apo mishonga yemishonga kana kuiswa mumutumbi yakakwirira pane yakakurudzirwa. Migumisiro yechirwere ndeyekukanganisa kwakaipa kunowanikwa pamusana wekurudzirwa.
Zvinonyanya kukonzerwa newaini inonzi valproate inosanganisira maitiro asingatauriki, kunyanya kudengenyeka, kana kudarika zvakadzama. Dambudziko remuviri ne metabolism rinogonawo kuunza valproate toxicity.
Valproate toxicity inogona kukonzera:
- Chizutu
- Kusanganiswa
- Kurasikirwa kweyero
- Hypothermia (kutsetseka kwemuviri)
- Hyperthermia (kutsetseka kwemuviri mukuru)
- Kurasikirwa kwekuziva
- Rapid heartbeat
- Kunopisa zvisiri izvo
- Rufu
Valproate toxicity ndeyekukurumidzira mune zvehutano uye, kana ichinge yaongororwa munguva, inokwanisa kutarisirwa kuderedza migumisiro yenguva refu.
Ropa Kuedzwa
Ropa revhapate rinogona kuyerwa kuti rione kana iwe une mazamu ari munharaunda yekurapa. Kunyange zvazvo hutano hwako hwakanaka hungave hwakaenzana nehumwe humwe humwe, mazamu akakurudzirwa anobatsira pakusarudza kana nhamba yako yakashanduka, kana wakagadzikana nehuwandu hweropa, uyewo kuti uone kuti zvinogona kutyisa.
Discontinuation
Sezvo nemishonga yose yekurwisa-gadzirisa, kungomira zvishoma kunogona kukonzera kukanganisa kana zvimwe zvinetso. Kana iwe uchizorega kutora valproate, iva nechokwadi chekukurukura chirongwa nachiremba wako wekutanga, ndiani angatsiva iyo nemamwe mishonga yekurwisa kana kukurudzira iwe purogiramu yokuderedza zvishoma nezvishoma chiremba chako.
Shoko Rinobva
Kana iwe wakapiwa chiremba chevharoti, inogona kunge yakakosha pakugadzirisa chirwere chako. Valproate imishonga yakashandiswa kwemakore, kunyanya kukanganisa. Migumisiro yaro, migumisiro, uye chepfu inonyatsonzwisiswa.
Kazhinji, zvinotora mavhiki mashomanana kuti mishonga inorwisa kugunun'una isvike pakugadzikana kwakasimba. Panguva iyoyo, iwe neboka rako rezvechirwere rinogona kutonga kana kana risina kubudirira mukuderedza kupera kwako.
Iwe unogona kuona kana iwe uchikwanisa kubvumira mitezo yemagumisiro evharoti munguva shomanana mushure mokutanga mishonga. Zvakakunakira iwe kuti uzvizive nemagumisiro akafanana emishonga yako kuitira kuti iwe ukwanise kuvaziva nokukurumidza.
Iva nechokwadi chekuramba uchitaurirana neboka rako rezvehutano pamusoro pekupi kwekugumburwa kana kukanganiswa kwemishonga. Nzira iyi iwe uchakwanisa kuwana rubatsiro rwakakwana rwekukurumidzira kana zvichidiwa uye chiremba wako anogona kuita chero kuchinja kwakakodzera kumishonga yako yemishonga.
> Sources:
> Bilo L, Meo R. Polycystic ovary syndrome kuvakadzi vanoshandisa valproate: kuongorora. Gynecol Endocrinol. 2008; 24 (10): 562-70. doi: 10.1080 / 09513590802288259.
> US Food and Drug Administration. Valproate Information.