Izimpawu kanye nokwelashwa serotonin syndrome

I ukwanda okukhulu kwezincwadi ezingeni serotonin - isimo sasisibi, okuyinto kuhambisana ukwephulwa mass emsebenzini wonke umzimba. Ngokuvamile, lezi zinguquko zibangelwa ngokuphuza imithi ethile noma ukweqisa izidakamizwa by izidakamizwa ehlukahlukene. In the engekho kwezokulapha ngesikhathi esifanele lesi simo igcwele ingozi, nemiphumela ngezinye izikhathi engelapheki. Ngakho-ke kudingekile ukuba ucabangele ulwazi mayelana yiziphi izimbangela nezimpawu serotonin syndrome. Yini zokwelapha banganikeza imithi yesimanje kanye kubabangele ngaphezulu beswele ukwelashwa?

Serotonin syndrome: kuyini?

Eqinisweni, ulwazi lokuqala ngalesi isimo uvele hhayi kudala. Ngo-1960 e-United States i-izifundo zokuqala yashicilelwa ngale ndaba. Iqiniso ukuthi izimbangela yalesi sifo, okuyilokho, eqinisweni, ephelezelwa waba ukwanda okukhulu kwezincwadi nenani ketshezi amangqamuzana ezinzwa, ngezindlela ezingafani, abahlangene antidepressant.

Kuyaziwa ukuthi serotonin ukuntula syndrome kuholela ukuthuthukiswa zokucindezeleka. Futhi ekhulwini leminyaka elidlule kuze kube yasungulwa ikhambi komgomo ezinjalo, manje eyaziwa ngokuthi "antidepressant". Le mithi basize ukwandisa ezingeni le-serotonin, eyaziwa edume ngokuthi "i-hormone injabulo". Bayamthonya, ukukhathala okungamahlalakhona nokunganaki iyanyamalala kancane kancane, futhi abantu kancane kancane ukubuyela ekuphileni okuvamile. Nokho, inqwaba kakhulu serotonin uba ubuthi, nethonya elilimazayo ezinzwa, okubangela ukuphazamiseka nesisindo umzimba. A syndrome efanayo kungenzeka ngenxa antidepressant, futhi inhlanganisela antidepressant nezinye izidakamizwa (isb, abanye ukukhwehlela kumasayiraphu nokunye. D.).

Empeleni, kuleli zwe lanamuhla, amacala serotonin syndrome elotshiwe hhayi kaningi. Kodwa, ngokusho kodokotela abacwaningi, kwenzeka kuphela ngoba lesi sifo wazifihla njengendlela mass izimpawu imperceptible, ezivame kusolwa ezinzwa uhlobo noma ukukhathala. Ngakho-ke kudingekile ukuba ukwazi ukuthi kungani le-serotonin syndrome zingase zenzeke, kuyini futhi yini izimpawu ilandelwe.

Imisebenzi esemqoka serotonin

Kuwufanele ukwazi lo mshini wezenzo ka "injabulo i-hormone", ngaphambi kokucabangela umbuzo kanjani futhi kungani uthuthukisa serotonin syndrome. Kuyini lokhu Izinto? Umsebenzi oyinhloko kuyinto ukulawulwa serotonin imisebenzi izinzwa ethile ebuchosheni. Kudlulwa emqhokrweni izinhlaka zokuxhumana zobuchopho komunye namangqamuzana ezinzwa, yalolu ketshezi ihlangana receptor specific ulwelwesi we eduze ezinzwa cell, isebenze futhi kokudubula emsipheni ungacabanganga.

Kukhona izinhlelo eziningana ukuthi ungakwazi ukulawula inani serotonin emzimbeni. Kahle kahle, lokhu reuptake, lapho i-molecule ye ibuyisela ukucubungula namangqamuzana ezinzwa lokuqala (ngenhlanhla antidepressant kakhulu kukhona inhibitors ka-serotonin reuptake) nomthethonqubo enzymatic, lapho ekhethekile asebenzayo izidakamizwa ninamathele-hormone okuthiwa i-molecule.

Serotonin ulawula izinqubo eziningi emzimbeni, kuhlanganise:

• izinkathi ubuthongo futhi sihlale siphapheme;
• esesuthi;
• ukuthuthukiswa noma ukunyamalala umuzwa isicanucanu;
• ukuziphatha okungcolile ngokobulili;
• izindlela thermoregulatory;
• bezibona ubuhlungu;
• ukwesekwa kwemisipha ithoni;
• motility ipheshana wokugaya ukudla;
• ukulawulwa ithoni semithambo;
• It wafakazela ukuthi serotonin ohilelekile izindlela migraine.

Njengoba singabona, "hormone ojabulayo 'ukunikeza umzimba womuntu awuwona ngempela kuphela umuzwa kwesasa. Ngemva kokutadisha umsebenzi yalolu ketshezi, kungenzeka ukuba ukucabanga ezinye izimpawu serotonin syndrome. By the way, esiphezulu waphawula lokuhlushwa hormone empandni ubuchopho kanye kumiswa reticular.

Serotonin syndrome: oyisazi samakhemikhali ezinto eziphilayo. Yini babekwazi kubangele ukuhlukumeza?

Njengoba sekushiwo, kuhlukumeza, ingxenye enkulu athuthukile ngesikhathi ukuthatha imithi ethile, noma inhlanganisela yakho. Ngakho lokho izidakamizwa kungabangela ukunqwabelana ukuthuthukiswa izifo eziyingozi ezifana serotonin syndrome?

• "Tsipraleks" nezinye zokwenziwa serotonin reuptake inhibitor futhi monoamine oxidase.
• ukwelashwa Ngesikhathi monoamine oxidase inhibitor futhi ama-hormone egilo, "clomipramine", "carbamazepine", "imipramine" futhi "Amitriptyline".
• Mao inhibitor futhi inhlanganisela ezinye izidakamizwa ezisetshenziselwa kwesisindo, ikakhulukazi "Dezopimona", "fepranona".
• Inhlanganisela ye-SSRI noma mao inhibitors amalungiselelo equkethe L-tryptophan, St John sika wort akhiphe nenjabulo.
• Inhlanganisela lithium nezidakamizwa antidepressant, ngokukhethekile "Kontemnola" futhi "Kviloniuma".
• reception ngesikhathi esisodwa inhibitor futhi dextromethorphan (ikhemikhali etholakala eziningi ukukhwehlela Syrups, kuhlanganise "Kaffetin Cold", "Glikodin", "Tussin Plus" kanye nabanye.
• Inhlanganisela serotonin reuptake inhibitor nezidakamizwa ezifana "dihydroergotamine", "sumatriptan" (migraine izidakamizwa), "Levodopa" (elisetshenziswa Parkinson).
• Kunobufakazi bokuthi le-serotonin syndrome zingase zenzeke nokusetshenziswa utshwala ngemuva yokwelapha antidepressant.

Ngokushesha kuba zwi kuwufanele ukuthi ukubikezela ukuthi ukuthuthukisa lesi sifo ku ngemuva yokwelapha kudokotela, cishe akunakwenzeka. Konke kuncike umthamo imithi, izici ngabanye esiguli, eminyakeni yayo yobudala nakwezinye izinto eziningi. Nokho, uma ebekiwe antidepressant, qiniseka ukuthi uyamtshela udokotela wakho mayelana zonke imithi uthatha futhi qiniseka uthintane ku ukwethulwa kohlelo olusha yokwelapha, kungaba ngisho evamile ukukhwehlela isiraphu.

I izici eyinhloko esithombeni emitholampilo

Kangakanani lesi sifo-serotonin? Izimpawu kwesigamu amacala avele ngemva kwamahora angu-2-4 ngemva ukungenisa. Kodwa izimpawu zokuqala angavela ngosuku. Mayelana nomkhosi wokuhlanganisa Imisebenzi esemqoka serotonin, nakho konke ukwephulwa kunokwenzeka zihlukaniswe ngezigaba ezintathu eziyinhloko:

• yezifo zengqondo;
• kusukela izinkinga muscle izinhlelo neuropathy kwemizwa;
• iziyaluyalu autonomic.

Zonke izimpawu kungenzeka kuchazwe lapha ngezansi, kodwa okokuqala kufanele kusho ukuthi okuphula ahlukahlukene akuzona nsuku ehlukile ekwakhiweni kokutshelwa ngokukhubazeka kwengane. Kuphela ukuxilongwa ngokuphelele ngokomzimba, izifundo laboratory, futhi babe in izimpawu ezithile futhi kungenzeka engcupheni enze kube nokwenzeka ukuba ukuxilonga serotonin ngokweqile emisipheni emsipheni.

nokugula ngengqondo ngesisekelo lesi sifo

Indlela ukuqaphela serotonin syndrome? Izimpawu ngokuvamile uqale ezinokuphazamiseka engqondweni, kuhlanganise:

• ukuqhanyelwa ngokomzwelo;
• simbe, ukwesaba causeless nokukhathazeka, ngezinye izikhathi kuze kube seqophelweni uvalo;
• Ngezinye izikhathi kukhona esinye isithombe - umuntu uzizwa yenjabulo, nentokozo enkulu, isifiso sokuthutha sakhula, khuluma ngokungaphezi futhi enze okuthile ngakho;
• kungenzeka ukungakhuli ukwazi;
• Ezimweni ezimbi kakhulu, kukhona ukubukeka okuyize, ukusangana.

Kuyaphawuleka ukuthi izimpawu kanye nezinga ngobucayi kuyinto encike ngqo kwi ngobucayi imiphumela anobuthi. Ngokwesibonelo, ngezinye izikhathi kuphela excitation okuncane siyenzeka. Kwezinye izimo kukhona eziya ziba zimbi ka izimpawu zesifo oyisisekelo (isib, ukucindezeleka), ngenxa lapho imithi baqhubeka. Emacaleni angu-olunzima, isiguli uhlushwa disorientation, udidekile emhlabeni futhi self, abaphethwe okuyize, ukusangana ezahlukene.

The main izimpawu vegetative

Zikhona nezinye izimpawu ezihambisana serotonin syndrome. Umonakalo kusuka ukwanda kokutheleleka kudlange kakhulu ezingeni yalolu ketshezi angabukeka enye indlela. Ikakhulu, i-ebuka futhi autonomic neziyaluyalu, kuhlanganise nalokhu okulandelayo:

• osuke usuvulekile abafundi, anda lacrimation;
• anda kwenhliziyo, tachycardia;
• anda Izinga lokuphefumula;
• Ngezinye izikhathi kukhona imfiva (ukushisa komzimba, kuyinto encane, kodwa waloba imfiva 42 degrees kwezinye iziguli);
• waba ukwanda okukhulu kwezincwadi umfutho wegazi kanye nezimpawu concomitant kuze nokulahlekelwa ukwazi;
• ukubukeka ukoma emlonyeni ku ezinye nolwelwesi lwamafinyila;
• kuyashesha motility emathunjini, nakho kungaholela ekuphazamisekeni kwemikhuba ezifana nohudo, ukucanuzela kwenhliziyo okukhulu nokuhlanza, ukubuyisa, ukuvuvukala futhi ubuhlungu besisu of kobukhulu obuhlukahlukene;
• ukuzizwa hlala;
• Ukuphathwa yikhanda, ngezinye izikhathi migraines.

Njengoba ubona, izimpawu zalesi sifo azicacile futhi, ngoba kungenzeka izimpawu ezifanayo ephelezelwa ezinye izifo kunabantu.

iziyaluyalu kwamanyuroni ku isizinda syndrome

Njengoba sekushiwo, serotonin ulawula ukudluliselwa nerve amaza. Yingakho ushintsho ezingeni yalolu ketshezi kuthinta umsebenzi kwamanyuroni. Nalu uhlu izifo kunokwenzeka:

• nokuqina kwalo ka umsipha ikhaliphe (ikakhulukazi liphinyiselwe aphansi esitho ikhaliphe);
• Ukuthuthukiswa kwemisipha ithoni futhi ngezinye izikhathi kuze kube rigidity kwemisipha;
• ngokushesha futhi okungalindelekile ukusikwa spasmodic imisipha ngabanye (ngezinye izikhathi ngisho amaqembu yonke imisipha);
• ukuthuthumela yezingalo nemilenze;
• ukunyakaza okungalindelekile ka yeso (ngokwale nhloso kwezokwelapha igama elithi "i-nystagmus" lisetshenziswa);
• Ngezinye izikhathi kukhona okuthiwa iso spasm, okuyinto kuhambisana ugingqe okungalindelekile we zamehlo phezulu noma phansi;
• ngezinye izikhathi eqoshiwe ukuquleka;
• Ukungabibikho kokuxhumana;
• nenkinga ngenkulumo, ke anyakaza futhi AMANGA ukuthi kwenzeka ngenxa ukusikwa okungalindelekile kwemisipha ukuhambisana kulandzelana nekuhlunga tinsita.

Kuyaqondakala ukuthi babe nazo zonke izimpawu ngaphezulu serotonin syndrome zenzeka kuyaqabukela. Ezimweni eziningi, iziguli ahlupheke kuphela kusukela ezinye ukwephula, futhi ngenxa yalokho sitholakele isifo impela inqubo nzima.

I degree of isifo kobukhulu

Ngo inqubo yokwelapha yesimanje sehlukaniswe degrees ezintathu ngobucayi syndrome, njenge:

• isifo Ezintsha kuhambisana, njengoba umthetho, ukujuluka yanda, eliqhaqhazelayo engaqinile kwezandla ngamadolo, hhayi ukwanda evelele kakhulu kwenhliziyo. Ikhaliphe futhi ube kancane ezinzima, nakuba lokushisa lomzimba aliphumi. Ngezinye izikhathi isiguli kungenzeka ubona umfundi Ukuvuleka komlomo. Kungokwemvelo ukuthi abantu nge nezimpawu ezifanayo akuvamile ukuya kudokotela, futhi uqhubeke udla izidakamizwa, ngoba izimpawu ngenhla kungaba nawukucindezeleka noma ukuzikhandla ngokweqile.
• Ngo ngokulinganisela isithombe basemtholampilo lesi sifo evelele. Iziguli baphawula ukwanda okukhulu kwezincwadi lokushisa komzimba (ngezinye izikhathi afinyelela ku-40 °), wegazi lazo wawungcono, Ukuvuleka komlomo eziphikelelayo balezi zingane, ukuncishiswa imisipha, motor futhi injabulo engqondo. Ngokuvamile, lezi zimpawu kubangele umuntu ukuba afune usizo, kodwa ngeshwa, ukubeka okuyikona akunakwenzeka njalo.
• Sinzima serotonin syndrome iyingozi kakhulu kungaholela ukuxakeka. Kuleli fomu zokugula yabukela tachycardia eqinile, kukhuphuke blood pressure, imfiva, imisipha zibe kuze ukuqina, iziyaluyalu sezinzwa, disorientation. Iziguli ngokuvamile ukuzwa ukusangana acacile kakhulu. In the ukungabikho usizo ngesikhathi esifanele kungenzeka lilimele imisipha, isibindi nezinso. Ngokuvamile, iziguli awela equlekile. Ngezikhathi ezithile athuthukile kwezitho zomzimba eziningi, ngokuvamile kuyaphela ekufeni.

Yingakho noma kunjalo kufanele ungazinaki izimpawu ngoba kungaba azenza njengendlela evamile serotonin syndrome ngenxa yokusebenza ngokweqile. Indlela ukuphuma kulesi simo, futhi kungakhathaliseki ukuthi kukhona ukwelashwa okuphumelelayo?

Usizo lokuqala kulesi sifundazwe

Kuthiwani uma umuntu esolwa serotonin syndrome? ukunakekelwa eziphuthumayo ngokuvamile kuyinto ukumisa ngokushesha zomuthi, eyavusa lesi simo. Ngokwemvelo, kufanele nakanjani thatha isiguli esibhedlela.

It lavage esiswini sokuqala, senza akwazi ukubonisa ukuba ahlanze umzimba umuthi uye okwamanje kwadingeka isikhathi ugxile. Ngenhloso efanayo, iziguli ebekiwe ukuyeka izidakamizwa nezinye sorbents deducing ubuthi emzimbeni. Ezimweni omnene kwemicimbi efana kwanele ukwenza abantu bazizwe kangcono. Izimpawu ziyefana phansi ngemva kwamahora angu-6-12.

Kushiwo ngamuphi umqondo ukuthi ukwelapha lesi sifo?

Ngeshwa, izidakamizwa ukuhoxiswa futhi ihlanze umzimba kusuka doti akuyona njalo ngokwanele. Ngakho lokho yokwelapha kudinga serotonin syndrome? Ukwelashwa Yiqiniso, kuncike esigabeni futhi zaba namandla kakhulu. Ngokuvamile, isiguli esimisiwe serotonin yokwamukela abantu abamelene nani, kuhlanganise "methysergide" futhi "Cyproheptadine". Ngaphezu kwalokho, njengoba ukwelashwa lingaze, okuyinto kuncike khona izifo ezithile.

• Ngokwesibonelo, e zesifo sokuwa futhi imisipha rigidity linqume benzodiazepines, kuhlanganise "lorazepam" futhi "Sibazon".
• Ephambi kwezinduna imfiva abazenzi rubdown abandayo namanye nezinqubo. Iqiniso ukuthi ukunyuka kwezinga lokushisa lapho serotonin syndrome ongakaphathelani nokuvuvukala, futhi lenyuka imisipha contractility, futhi ngenxa yokuthi imithi ezivamile antipyretic futhi nonsteroidal eqeda ukuvuvukala azinamphumela. Okuwukuphela paracetamol, nakuba kufanele siyisebenzise ngokucophelela.
• Lapho izinga lokushisa likhuphuka ukuba 40 nokuningi imisipha relaxants iphathwa esigulini. Le mithi ukusiza ukukhulula imisipha, ukuqeda imfiva, ukuvimbela ukuthuthukiswa kwempilo, kuhlanganise nezinkinga nge igazi ekunqandeni.
• Futhi ukumnika emthanjeni waqhuba ukujuluka ngokweqile, uhudo, imisipha ukungezwani futhi kuholele amanzi emzimbeni.
• Ngaphezu kwalokho, kubalulekile ukuqapha umfutho wegazi nokushaya kwenhliziyo esiguli, uma kunesidingo normaliziruya lezi zibalo ngosizo izidakamizwa.

Ezimweni eziningi, ukwelashwa uphenyo olwenziwe kahle kungaba ngokushesha ngcono ngezimo zesiguli futhi ukuba sigweme imiphumela. Ngeshwa, ezimweni ezingajwayelekile, ikakhulu uma isiguli engakaze enikeziwe ukunakekelwa ngezokwelashwa ngesikhathi esifanele, serotonin syndrome zingase ziholele nokwahlukana imisipha izicubu, isibindi nokulimala kwezinso, kwalapho, futhi ekugcineni ekufeni. Yingakho noma kunjalo akufanele kalula antidepressant nezinye izidakamizwa.