Neuroleptic - He aha ka mea? He aha ka keʻano papa hana o ka hana o ka antipsychotic ai '?

Psychotropic lāʻau, a manao - ka iapaau ana o psychotic kāna hana, antipsychotic kapaia (like antipsychotic ole neuroleptic). He aha ka mea a pehea aole ia hana? E ka maka ia.

Neuroleptic. He aha ka mea? Mōʻaukala a me nā 'ano

Antipsychotics lapaau ikea kŘpa nei. A hiki i kā lākou loaʻa ma ka iapaau ana o ka psychosis loa pinepine i hoʻohana hoomakaukau ana o kaʻai me Kinohi (e like me henbane, belladonna, opiates), intravenous hooponopono o ke kalipuna, bromide, e like me narcotic hiamoe.

Ma ka '50s kakahiaka nui o ka 20th kenekulia no kēia mau hana i hookama antihistamines a likiuma paʻakai.

Kekahi o ka mea mua antipsychotic chlorpromazine Ua lilo (a chlorpromazine), i a laila, i noʻonoʻo i kaʻike mau antihistamines. Kaiāulu pili ia hoʻomaka me 1953,ʻano nui me he kiaha dala a neuroleptic (ma ka schizophrenia).

Ma hope neuroleptic ua ka alkaloid reserpine, akā, i koke piʻi aʻela hoʻi ka 'ē aʻe, nui ka hoʻokō ai', e like me kaʻaneʻane i kanawai.

I kakahiaka nui 1958, he'ē aʻe mua hanauna antipsychotics: trifluoperazine (triftazin), haloperidol, thioproperazine a me na mea e ae.

Kaʻia "antipsychotic" Ua manaoia i ka makahiki 1967 (ka wā āna i hana mai i ka Mea Maluna o psychotropic ai 'o ka hanauna mua), a ia ia i ka ai' ole wale, ua antipsychotic hookoia, akā, i hiki i na la neurological kāna hana (akataziyu, neuroleptic parkinsonism, na dystonic reactions, etc.). Nō kāu, i kēia mau kāna hana i 'ona e like me chlorpromazine, haloperidol a me ka triftazin. Eia hoʻi, ka mea, e kokoke mau pu ma kaʻawaʻawa loaʻaoʻao 'ole i ka iapaau ana: kaumaha, uunu nui, loa eha, mea naʻau palaka.

Mua antipsychotics hiki e kapaʻia nō hoʻi "nui tranquilizers", no laila, ua antipsychotics a me tranquilizers - i kekahi, a me ka ia. No ke aha? No ka mea, ka mea hoi i kiaha dala, hypnotic a me ka antianxiety trankviliziruyusche-waiwai, e like me ka pono i hala loa he mau 'ana o ka mokumokuahua (Ataraxia). Ano keia inoa me ka manao i neuroleptics aole i pili.

All antipsychotic ai 'hiki ke maheleia i typical a me ka atypical. Typical antipsychotics mākou i hōʻike hapa 'ia, e noonoo i ka atypical antipsychotic. He aha ka mea? Kēia pūʻulu Ua oi "pahee" ai '. Lakou hana i ka nui o ka hana ma ke kino, e like me typical. Ka mea, no ia i ka hou hanauna o antipsychotics. I ka pomaikai o ka atypical antipsychotics mea i ka mea, i emi ole ma ka dopamine receptors.

Antipsychotics: hoike

All antipsychotics loaa kekahi kumu waiwai - ka hoʻokō keiki ma luna o ka hoʻomāhuahua ai symptoms (hallucination, delusions, pseudohallucinations, illusions, hana kāna hana, delusions, aggressiveness a me ka excitation). Oae, neuroleptics (ʻano nui atypical) ke hāʻawi aku i ka hana depressive a nele symptoms (autism, mea naʻau flattening, a me ka desotsializatsii m. P.). Eia naʻe, kā lākou laulā ma ka pili ana i ka iapaau ana o symptoms o ka nele o ka nui nīnau. Mau loea, paipai i ka mea hiki ke hoʻopau wale i ka kiʻekiʻe symptoms antipsychotic ai '.

Atypical antipsychotics, aʻano papa hana o ka 'ana, ua nawaliwali ma mua o typical, ua i hoʻohana' ia e pono bipolar kāna hana.

Ka 'Amelika Psychiatric Ahahui ua papa i ka hana ana o antipsychotics e hana' ano a me ka manaʻoʻike symptoms o dementia. No hoi, ka mea e ole e ia no ka Kanikani'āʻula.

He unacceptable ia e ia me elua a oi antipsychotics i ka ia manawa. A me ka hoomanao i na neuroleptics i hoʻohana no ka iapaau ana o ka maʻi mea, wale no ka mea e ole paipai e lawe.

Main 'ole a me nā maomeka o ka hoʻokō'

Hoikehonua, antipsychotic ai 'kaʻana like i naʻano papa hana o antipsychotic hana, no ka mea, ke emi ka EYI o nā aʻalolo impulses wale i loko o ka poe lolo nenoai e hoʻouna lāʻau ikiʻai wale o ka dopamine. E ka lawe i ka pilina nana i kēia mau nenoai, a me ka hope o antipsychotic ai 'o ia.

• Mesolimbic alanui. Hoemi i ka EYI o nā aʻalolo impulses ma keia ala ia lŘlŘ ka wā o ka loaa ana i kekahi antipsychotic mai ma lalo iho ia mea i manaoia ana o hoʻomāhuahua ai symptoms (e laʻa me, hallucinations, delusions a me ka mea e like. D.)
• Mesocortical ala. Aia ka lāʻau ikiʻai hoolilo ka ho'ēmiʻana hiki aku ai i ke ano o ka symptoms o schizophrenia (io kāna hana hou e like me apathy, desocialization, ilihune o ka olelo, flattening o lakou aloha ia, anhedonia) a me ka cognitive kāna hana (hoolohe nele, hoʻopōʻino hoomanao hana, a no laila, ma luna o. D.). Ka hoʻohana a typical antipsychotics, o ka oi aku lōʻihi-kau, hiki aku ai i hoomahuahua ae la lakou io kāna hana, e like me nui aʻe 'ana o ka lolo i hana'. Hawaiian neuroleptics ma keia hihia, aole ia kōkua ole.
• Nigrostriatal alanui. Dopamine mea loaʻa blockade i loko o keia hihia ana hiki aku i ka typical antipsychoticʻaoʻao 'ole (akathisia, parkinsonism, dystonia, salivation, dyskinesia, lockjaw a me ka' ole. D.). Mauʻaoʻao 'ole i malamaia i ka 60% o ka hihia.
• Tuberoinfundibular alanui (lāʻau ikiʻai wale EYI ma waena o ka limbic'ōnaehana a me ka pituitary gland). Ka paleʻana i ka mea loaʻaʻo ia, a mahuahua nui prolactin hōmona. Ma kēia kāʻei kua hana nui helu o nāʻaoʻao 'ole e like me gynecomastia, galactorrhea, moe dysfunction, infertility a hiki pathology pituitaryʻeho.

Typical antipsychotics increasingly lakou aloha ia dopamine receptors; atypical ia lakou aloha ia ma luna o nā neurotransmitters serotonin ( 'ona i ke hoʻouna i nā aʻalolo impulses). No ka mea, o keia atypical antipsychotics i poʻeʻuʻuku hyperprolactinemia, extrapyramidal kāna hana, neuroleptic kaumaha a me ka neurocognitive deficits a me ka io symptoms.

Na hoailona o ka α ₁ -adrenoceptor blockade e hookuu iho ke koko, orthostatic hypotension, pōniuniu kūpono 'ana, ka hanana o sleepiness.

I ka blockade H ₁ histamine receptors ikeia hypotension, he lālā hua nele no carbohydrates a me ke kaupaonaʻana ka waiwai, a me ka sedation.

Inā he blockade o acetylcholine receptors, ma laila nō ke kēiaʻaoʻao ole: constipation, maloo waha, tachycardia, urinary ka mālama, a mahuahua nui intraocular puʻe a me ka noho haunaele. Ua mea no hoi e hiki i ka muli o ka noʻonoʻo a me ka huikau sleepiness.

Western noiʻi Ua hōʻike ia ma waena o antipsychotics (neuroleptics, hou a kahiko, typical a atypical - ka mea, aole ia i mea) a me ka manawa e cardiac ka make, aia no he pili.

¶ A i loko o ka iapaau ana o neuroleptic-hahau, a me ka pilikia o ka naau hoouka maoli me ka nui loa. O ke kumu ho i ka mea i psychotic ai 'aloha ia lipid pūnao. Komo neuroleptics hiki i kāhea type 2 mimikō. I ka manawa o ka noho complications nui hoomahuahua i ka hoʻohui pūʻia lapaau me ka typical a me ka atypical antipsychotics.

Maikaʻi loa antipsychotics e hoʻonāukiuki epileptic ke kāʻili 'ana i ua kuu iho kāʻili' ana i paepae.

Ka hapanui o antipsychotics (ʻano nui phenothiazine neuroleptics) i he nui hepatotoxic 'ole a me ka hiki a hiki alakai i ke kūpono' ana o cholestatic jaundice.

antipsychotic lapaʻau i ka poʻeʻelemākule kanaka e hoonui i ka pilikia o ka pneumonia ma ka 60%.

Ke cognitive 'ole o nā neuroleptics

E paʻa ana i ka hamama study hōʻike i atypical antipsychotics nō kāu iki aku kona mana i loko o ka iapaau ana o neurocognitive deficiency. Eia naʻe, paa loa hoike e pili ana ia ma ka liʻiliʻi loa kekahi kanawai ma neurocognitive kāna hana ole. Atypical neuroleptics, i keʻano papa hana o ka hana i mea iki okoa mai ka typical, hoao pinepine lawa.

I kekahi lapaʻau study hākōkō pū i ka hopena o ka 'inikua risperidone, a me ka haloperidol ma haʻahaʻa nā māhele. Ma ke ao, i loaʻa i nuiʻokoʻa nāʻikepili. Ua ua no hoi, ua hōʻike i haʻahaʻa nā māhele o ka haloperidol i loko o ka maikaʻi ia ma neurocognitive hana.

Ke'ī mai, o ka hopena o neuroleptics mua ole lua o ka hanauna ma cognition nō controversial.

Mea Maluna o antipsychotics

Mākou i mua i olelo ia i antipsychotics e māheleʻia i loko o typical a me ka atypical.

Iwaena o typical antipsychotics hiki e kilakila:

1. Kiaha dala, antipsychotics (ka hoʻolako 'wawahi iho la ia ma hope o ke noi): promazine, levomepromazine, chlorpromazine, alimemazine, chlorprothixene, a me na mea e ae periciazine.
2. Incisive antipsychotics (i ka ikaika global antipsychotic hopena): fluphenazine, trifluoperazine, thioproperazine, pipotiazine, zuclopenthixol a me ka haloperidol.
3. Dezingibiruyuschie (i ka ho'ā 'ia paha, me ka hoʻokuʻu' hana): karbidin, sulpiride a me na mea e ae.

Ma atypical antipsychotics nā 'ona e like me aripiprazole, sertindole, ziprasidone, amisulpride, quetiapine, risperidone, olanzapine a me ka clozapine.

Aia i kekahi Mea Maluna o neuroleptics, a i anao? Aou e like me:

1. Phenothiazines, tricyclic a me nā nā mea loaʻa. loaʻa nā 'ano i waena o lākou:
   
   ● neuroleptics me ka noonoo ole aliphatic hoopaa (Levomepromazine, alimemazin, promazine, chlorpromazine), ikaika inhibit acetylcholine receptors a me adrenergic receptors i ka haʻi kiaha dala ia, a hiki i extrapyramidal kāna hana;
   ● neuroleptics me ka piperidine nucleus (thioridazine, pipotiazine, periciazine) ka mehana antipsychotic ai a me ka mehana a me ka neydokrinnymi extrapyramidalʻaoʻao ole;
   ● neuroleptics me ka piperazine nucleus (fluphenazine, prochlorperazine, perphenazine, thioproperazine, frenolon, trifluoperazine), hiki o ka paleʻana dopamine receptors, a me ka nawaliwali ia ma acetylcholine a me adrenergic receptors.
   
   
2. A pau thioxanthene nā mea loaʻa (chlorprothixene, flupentixol, zuclopenthixol), kona hana mea i 'ano like me ka hana ana o phenothiazines.
3. Hookomoia benzamides (tiapride, sultopride, sulpiride, amisulpride), kona 'ana o kekahi like me phenothiazine neuroleptics.
4. All butyrophenone nā mea loaʻa (trifluperidol, droperidol, galoperiodol, Benperidol).
5. Dibenzodiazapin a me kona nā mea loaʻa (olanzapine, clozapine, quetiapine).
6. Benzisoxazole a me kona nā mea loaʻa (risperidone).
7. Benzizotiazolilpiperazin a me kona nā mea loaʻa (ziprasidone).
8. Indole a me kona nā mea loaʻa (sertindole dikarbin).
9. Piperazinilhinolinon (aripiprazole).

Mai a pau o ka luna, e hiki līkaia no ka loaʻa antipsychotics - ai 'ole kuhikuhi kuai lilo aku la i loko o keʻena kūʻai lāʻau lapaʻau, a me ka pae o antipsychotics, a i kūʻai pololei ma ka Kauka mau kauoha.

antipsychotic lāʻau hana kūleʻa

Like kekahi'ē aʻe laau lapaau, laekahi antipsychotics pāʻani aku me nā lapaʻauʻia, ina ia i ka mea ia manawa. Kekahi hana kūleʻa i loa pilikia no ke kanaka kino, no laila ia mea nui ia i mea e lawe antipsychotic ai 'Ua pilikia loa. E hoomanao i neuroleptics kaʻapu kōheoheo pinepine ia lŘlŘ no o ko lākou mau hana kūleʻa me nā ai '.

AaOIeIOUIeXAOAaIN me antidepressants hiki aku ai, e hoomahuahua ae la lakou hana me neuroleptics a me antidepressants lākou iā lākou iho. Ko lakou hui pu ke alakai i ka constipation, lolo ileus, hypertension.

Mai Mai lawe a:

• Ke me ka hui pu ana o antipsychotics a me benzodiazepines hiki aku ai i ka ÷ naehana hanu kaumaha, sedationʻaoʻao 'ole.
• I ka concomitantly me ka likiuma Inc e ulu hyperglycemia, nānā aku o ka haunaele, drowsiness. Ko lakou hui pu hiki ke tolerated, akā, ma lalo o 'inikua hooponopono wale.
• Noi me ka agonists (ephedrine, metazonom, noradrenaline, adrenaline) ho'ēmi i kā ka hopena o nā ai '.
• Antihistamines i coadministration me neuroleptics ka hōʻoi 'kā lākou inhibitory ia ma luna o ka Central ko mākou hopohopo nenoaiu.
• Ka mea ia ia e lawe pu me antipsychotic ka waiʻona, 'o ia hoʻi no ka anesthesia, hypnotics paha anticonvulsants.
• Komo antipsychotics me analgesics a me anesthetics hiki aku ai i ka hoomahuahua i loko o ko lākou hopena. Keia hui malu pu ana o kekahi e kaumaha ana ia ma luna o ka CNS.
• Antipsychotics ia me ka insulina a me ka antidiabetic ai 'hiki aku ai i ka emi i loko o kā lākou laulā.
• I ka loaa ana antipsychotics me tetracyclines maoli i ka pilikia o ke akepaʻa toxins.

Contraindications

A me ka atypical a me typical antipsychotic ai 'i he nōhie papa inoa o nā contraindications:

• idiosyncrasy hoomakaukau;
• i ke alo o ka paʻa-huina glaucoma, prostatic adenoma, porphyria, Parkinson ka maʻi, pheochromocytoma;
• allergic reactions i neuroleptics i loko o kanaka mōʻaukala;
• kāna hana o ke ake, a puʻupaʻa;
• hāpai keiki, a lactation;
• maʻi o ka mea'ōnaehana mānowai koko oihana;
• huʻi febrile maʻi;
• coma.

ʻaoʻao 'ole o nā neuroleptics

Ka wā lōʻihi-makahiki Inc,ʻo ka maikaʻi hōʻike nō ia o neurolepticʻaoʻao ole.

All antipsychotic ai 'ke hoʻonui i ka pilikia o ka hypersensitivity dopamine, i ka huli hele aku ai i symptoms o psychosis a me tardive dyskinesia.

Loa pinepine, i kēia mau symptoms i hoʻomaka ai ka wā e ana i ka neuroleptic (keia ua kapaia "withdrawal maʻi pale"). withdrawal maʻi pale loaʻa paha kekahi mauʻano likeʻole: tardive psychosis, dyskinesia unmasked (ole recoil dyskinesia), o cholinergic maʻi pale "recoil" listen'ōlelo.

oe Pono e hoʻopau i nā e pale aku i kēia maʻi pale, neuroleptic lapaʻau, ke kiʻekiʻe o hoemi i ka mahele lāʻau.

kiʻekiʻe nā māhele o nā neuroleptics ka wā i loaʻa ai kaulanaʻaoʻao hookoia e like me neuroleptic-ʻonou nele maʻi pale. E like me ke unofficial ikepili, ua hookoia ia lŘlŘ i loko o 80% o nā mea maʻi e lawe typical antipsychotics.

Mall loli ma ka lolo no ka hooloihi ae i hana

Placebo-kekahi lāʻau 'haʻawina o rhesus ikepili, a no nā makahiki i haawiia mai haloperidol a olanzapine ma maʻamau laʻau heluna, ka leo a me ke kaumaha o ka lolo, mai ka loaa ana neuroleptics hoemi ma ka awelika e 11,8%. O ke kumu ho i ka emi i loko o ka buke o ke keʻokeʻo, a poohina mea. Hou mai neuroleptics ole i ke Akua.

Ma hope iho o ka puke o ka hopena o ka noiʻi ia i ke kanawai o neuroleptics i ole, ua hoao ia ma na holoholona ma mua pai ana ma luna o ka mea lāʻau lapaʻau market, a me ia mea, ho oweliweli he pilikia i kānaka.

Kekahi o ka noiʻi, Nancy Andreasen, o ka paulele aku i ka ka ho'ēmiʻana i loko o oho mea buke, a ua loaa ia antipsychotics i loko o kekahi mau mea o ka hopena maikaʻi 'ole ma o ka kanaka kino, a hiki aku i ka atrophy o ka prefrontal cortex. Ma ka kekahi lima, ka mea i kaulana i ka antipsychotics i nui ka lapaau i hiki ke hoola i na maʻi puʻuwai, akā, pono ka mea, e e lawe wale i ka mea uuku loa mea.

I ka makahiki 2010, noiʻi. Leo a me ka. Moncrieff John John paʻi i ka loiloi 'ia o ka noiʻi ma luna o ka muli oʻume mākenēki resonance kiʻi o ka lolo. Ke kuka nei lakou i lawe mai, e hoohalike i ka lolo o nā mea maʻi loli lawe neuroleptics, a me nā mea maʻi i i ole lawe ia.

I ka 14 o ka 26 hihia (hoʻomanawanui iki mai ia ia me neuroleptics) i ke komoʻana i ka emi ma ka lolo buke, ka buke o ke poʻo, a keʻokeʻo mea.

O ka 21 hihia (e hoomanawanui i ka poe i ole lawe antipsychotics, aʻae, akā, ma ka liʻiliʻi nā māhele) i loko o kekahiʻaʻohe loli i loaʻa.

I ka 2011, a pau i ka hookahi kanaka noiʻi Nancy Andreasen i paʻiʻia hopena o ke ao a i loaʻa loli ma ka lolo buke i 211 hoʻomanawanui iki mai ia me ka antipsychotic ai 'no ka lōʻihi manawa (ma 7 makahiki). Ka oi aku o ka lāʻau mahele lāʻau ua, i ka mea i oi aku ka nui o ka ua hoʻemi lolo.

Ka hooulu ana o ka hou ai '

Ma keia manawa mākou e ulu hou antipsychotics i i ole ia ma luna o nā receptors. Kekahi pūʻulu o ka noiʻi mai la oia i ka antipsychotic ia mea cannabidiol cannabis eiiiiiaiou. Pela ka mea, ua hiki ia mākou e kokeʻike i kēia mea ma luna o nā shelves o keʻena kūʻai lāʻau lapaʻau.

ka hopena

Hopefully, i kekahi koe i ka nīnau, e like me ka mea i ka antipsychotic. He aha ka mea, i ka mea a kona mau hana, a me ka hopena o? Eaiaʻano papa hana mākou hookolokolo aku la ia ma luna. It wale koe, e hoʻouka hou aku au i na mea a pau i ka nui o ke lapaau i loko o ka o kēia au nei, kekahi o ka waiwai hiki ole ke aʻo a hiki i ka hopena. A me ka liana a oe e manaʻo mai i kekahi mea, no ka emi ana ma luna o ka luna 'huahana like antipsychotics.

Ma nā makahiki, na hihia o antipsychotic kanaka o ke kaumaha. Mai o ka naaupo o na pilikia o keia k, kanaka ia lakou iho e hana ino. Antipsychotics ma kekahi hihia hiki ole ke hoʻohana 'ia no kekahi hana' ē aʻe ma mua o kona Manao iho la ia mea. A e pili ana i ka hopena o kēia mau ai 'ana ma o ka lolo produces, ua hiki mai o ka ninau.

I mea no ke aha la antipsychotics - ai 'ole kuhikuhi loaʻa no ka kuai ana, e ke hoʻohana me ka mālama nui (a wale ina oe e ia oe pono ia 100%ʻoiaʻiʻo), a me ka hiki maikai ole ia e ia me ke kauka o ka kuhikuhi.