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I-Valproate

Wake wazibuza ngomuthi ongasiza ukulawula ukuquleka nokulawula ukuphazamiseka kwemizwelo? I-Valproate umuthi onamandla futhi oguquguqukayo ophatha ngokuphumelelayo izimo ezihlukahlukene zemizwa. Lo muthi, otholakala njengamaphilisi e-valproate, usuphenduke inketho yodokotela abaningi ngenxa yokusetshenziswa kwawo okubanzi kanye nerekhodi eliqinisekisiwe.

Kulesi sihloko, sizohlola izici eziningi ze-valproate. Abafundi bazofunda ngokusetshenziswa kwayo, ukuthi ithathwa kanjani ngendlela efanele, nokuthi yimiphi imiphumela emibi okufanele uyiqaphele. Sizophinde sibheke ukuthi i-valproate isebenza kanjani emzimbeni wakho, ukusebenzisana kwayo neminye imithi, kanye nolwazi olubalulekile lwemithamo ye-valproate. 

Iyini i-Valproate?

I-Valproate umuthi oguquguqukayo oye waqashelwa ngokusebenza kwawo ekwelapheni izimo ezihlukahlukene zemizwa. Kuyi-branched-chain organic acid esetshenziselwa ukuphatha isithuthwane, ukuphazamiseka kwe-bipolar, Futhi i-migraine ikhanda. I-Valproate iza ngezinhlobo ezahlukene, okuhlanganisa i-valproic acid ne-sodium valproate.

I-Valproate ivunyelwe ukusetshenziswa kusukela ngo-1978 futhi isiphenduke inketho yodokotela ngenxa yokusetshenziswa kwayo okubanzi. I-Valproate iyatholakala njengethebhulethi, esebenza isikhathi esifushane noma esebenza isikhathi eside, futhi njengesixazululo esifakwa emthanjeni.

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Ukusetshenziswa kwethebhulethi ye-Valproate

Amaphilisi e-Valproate anezinhlobonhlobo zokusetshenziswa ekwelapheni izimo zemizwa nezengqondo, njenge:

  • Njengokwelashwa okukodwa kanye nokwelashwa okuhambisanayo ukwelapha ukuquleka okuyingxenye okuyinkimbinkimbi ezigulini ezikhulile nezezingane ezineminyaka eyishumi nangaphezulu.
  • Amaphilisi e-Valproate asiza ekwelapheni ukubanjwa kokungabi khona okulula nokuyinkimbinkimbi kanye nezinhlobo eziningi zokubanjwa.
  • I-Valproate ingaphinda yelaphe futhi ilawule ukuphazamiseka kwe-bipolar, ikakhulukazi phakathi neziqephu zokuhlanya. Kuyasiza ukuzinzisa ukuma kwenhliziyo nokulawula izimpawu zokuhlanya, njengokuhlanya noma ukuziphatha okujabulile okungajwayelekile.
  • Okunye ukusetshenziswa okubalulekile kwamaphilisi e-valproate ukuvimbela ubuhlungu bekhanda elibuhlungu. Kodwa-ke, kubalulekile ukuqaphela ukuthi i-valproate ayisetshenziselwa ukukhulula ikhanda elivele liqalile.

Kwezinye izimo, odokotela bangase banikeze i-valproate ukuze isetshenziswe ngaphandle kwelebula, njenge: 

  • Isifo sikashukela se-peripheral neuropathy
  • I-neuralgia ye-posterpetic
  • Ukwelashwa okuphuthumayo kwesimo se-epilepticus
  • Izimpawu zokuthatheka, ukuyaluza, nolaka

Ungayisebenzisa kanjani i-Valproate Tablets

Ukuze usebenzise amaphilisi e-valproate ngendlela efanele, landela imiyalelo kadokotela wakho ngokucophelela, okuhlanganisa:

  • Abantu ngabanye bangathatha i-valproate ngokudla noma ngaphandle kokudla, kodwa kungcono ukunamathela ngendlela efanayo isikhathi ngasinye. 
  • Geza amaphilisi wonke ngesiphuzo samanzi noma ijusi. Ungawahlafuni. 
  • Ngokuya ngohlobo lwethebhulethi, uzoyithatha kanye noma kabili ngosuku. Uma usebenzisa umthamo kanye ngosuku, khetha isikhathi esivumelana nawe futhi unamathele kuso. Zama ukuba nesikhawu samahora ayi-10 kuye kwayi-12 wemithamo ephindwe kabili ngosuku phakathi kwabo. 
  • Udokotela wakho cishe uzokuqala ngedosi ephansi futhi kancane kancane andise ngokuhamba kwesikhathi. Kubalulekile ukuphuza i-valproate njalo futhi ungaphuthelwa imithamo, njengoba lokhu kungase kubangele ukuquleka kubantu abanesifo sokuwa.

Imiphumela emibi yethebhulethi ye-valproate

Amaphilisi e-Valproate angabangela imiphumela engemihle ehlukahlukene, kusukela kokumnene kuye kokuqina. Imiphumela emibi evamile ihlanganisa: 

Imiphumela emibi kakhulu, nakuba ingavamile, ingenzeka, kuhlanganise: 

  • Imicabango yokuzilimaza
  • Ukucindezeleka
  • Izinkinga zesibindi ezibangela ukuba phuzi kwesikhumba noma amehlo, ubuhlungu obukhulu besisu, kanye nemihuzuko engavamile
  • Ukungezwani nomzimba okungathi sína, njengokuvuvukala okungazelelwe kwezindebe, umlomo, noma umphimbo, ukuphefumula kanzima, noma ukushintsha kwesikhumba

Ezimweni ezingavamile kakhulu, i-valproate ingabangela ukuphazamiseka kwengqondo okubulalayo (i-encephalopathy), ikakhulukazi ezigulini ezinokuphazamiseka okuthile kwe-metabolic (i-urea cycle disorders). Izimpawu zingase zihlanganise ukuhlanza okukhulu, ubuthakathaka obungachazeki, noshintsho olusheshayo lwengqondo/yemizwa.

Ukuqapha

Lapho uthatha i-valproate, udinga ukuqaphela izinyathelo ezimbalwa ezibalulekile, njenge: 

  • Ukungezwani komzimba: Ngaphambi kokuthatha i-valproate, yazisa udokotela wakho uma uguliswa yiyo noma eminye imithi. Kufanele futhi utshele udokotela wakho ngayo yonke imithi yakho eqhubekayo, amavithamini/amaminerali, nezithako zemithi.
  • Izifo Zesibindi: Kuyadingeka ukwazisa udokotela wakho nganoma yiziphi izinkinga zesibindi, njengoba i-valproate ingabangela ukwehluleka kwesibindi, ikakhulukazi ezinganeni ezingaphansi kweminyaka emibili kanye nalabo abanezinkinga ezithile zofuzo. Akufanele usebenzise i-valproate uma unesifo sesibindi, ukuphazamiseka komjikelezo we-urea, noma izimo ezithile zofuzo ezifana nesifo sika-Alpers.
  • Ukukhulelwa: ukukhulelwa Ukukhathazeka okukhulu ngokusetshenziswa kwe-valproate. Kungaba nomthelela kumntwana ongakazalwa futhi kungabangela ukukhubazeka kokuzalwa, ikakhulukazi phakathi nezinyanga ezintathu zokuqala zokukhulelwa. Xoxa ngalokhu nodokotela wakho uma ukhulelwe noma uhlela ukukhulelwa. Bangase bakunikeze eminye imithi noma balungise uhlelo lwakho lokwelapha.
  • Ukuqapha: Ukuhlolwa njalo kanye nophenyo lwegazi kubalulekile ukuze kuqashwe noma yimiphi imiphumela engadingeki. Qaphela izimpawu zesibindi noma izinkinga zamanyikwe (ukuphelelwa ukudla, ubuhlungu besisu, isicanucanu, umchamo omnyama, noma ukuphuzi kwesikhumba noma amehlo). Uma uhlangabezana nalezi zimpawu, zama ukuxhumana nodokotela wakho ngokushesha.

Isebenza kanjani ithebhulethi yeValproate

Amaphilisi e-Valproate asebenza ngezindlela eziningi zokulawula ukuquleka nokulawula ukuphazamiseka kwemizwelo. Zikhulisa amazinga e-gamma-aminobutyric acid (GABA) ebuchosheni, zinikeze umphumela wokupholisa futhi zisize ukunciphisa ukusebenza kukagesi ngokweqile. Lokhu kwanda kwe-GABA nakho kunomthelela ekusebenzeni kahle kwe-valproate ekwelapheni i-bipolar disorder. 

I-Valproate iphinde ithinte iziteshi ze-sodium, inciphise ukudubula kwe-high-frequency yama-neurons. Lesi senzo sisiza ukuvimbela ukuquleka futhi sizinzise isimo sengqondo. Ukwengeza, i-valproate ithinta i-fatty acid metabolism, engashintsha uketshezi lwe-membrane futhi ikhulise umkhawulo wamandla esenzo.

Indlela ye-Valproate yokuvimbela i-migraine ayikaqondwa ngokugcwele. Nokho, kucatshangwa ukuthi inciphisa indlela izinzwa ezidlulisela ngayo izimpawu zobuhlungu ebuchosheni. I-Valproate nayo inemiphumela ye-neuroprotective, ivimbela ukulimala kwe-neural kanye nokuwohloka kwezimo ezihlukahlukene.

Ngingakwazi Ukuthatha I-Valproate Ngeminye Imithi?

Eminye yemithi engase ihlanganyele ne-valproate ihlanganisa: 

  • Utshwala
  • Ama-antidepressants afana ne-phenelzine
  • Izidakamizwa ze-Antiepileptic njenge-lamotrigine ne-phenobarbital
  • Ama-antibiotic afana ne-imipenem
  • Ama-Antihistamine afanayo cetirizine, i-diphenhydramine
  • Imithi ye-antiseizure, njenge-amitriptyline, i-carbamazepine, ne-lamotrigine 
  • Izidakamizwa ezivimbela ama-enzyme e-UGT, njenge-aspirin nezinye izidakamizwa ezingezona ukuvuvukala (ama-NSAID)
  • I-Mefloquine
  • Ukudambisa izinhlungu ze-opioid, njenge-codeine, i-hydrocodone
  • I-Orlistat
  • Rifampin
  • Ama-salicylates
  • AmaSulfonamides
  • Warfarin 
  • i-zidovudine 

Hlala uthintana nodokotela wakho noma udokotela ochwepheshe ngaphambi kokuqala, ukuyeka, noma ukushintsha noma yimiphi imithi ngenkathi usebenzisa i-valproate.

Ulwazi Lomthamo

Umthamo we-Valproate udinga ukulungiswa ngokucophelela okusekelwe kumazinga egazi ukuze kuqinisekiswe ukugxila okuzinzile phakathi kwebanga lokwelapha. 

Umthamo wokuqala wokuquleka okuyinkimbinkimbi kwengxenye yi-10 kuye ku-15 mg/kg/ngosuku ngomlomo, imithamo engaphezu kuka-250 mg/ngosuku inikezwa ngemithamo ehlukanisiwe. 

Ukungabikho okulula nokuyinkimbinkimbi ukuhlukunyezwa, umthamo wokuqala uvame ukuba ngu-15 mg/kg/usuku ngomlomo. Imithamo inyuswa kancane kancane, ngokuvamile ngo-5 kuya ku-10 mg/kg masonto onke, kuze kube yilapho ukuquleka kulawulwa noma imiphumela engemihle ivimbela ukwanda okwengeziwe.

Ukuvimbela i-migraine, umthamo ojwayelekile ngu-250 mg kabili ngosuku, ungadluli ku-1000 mg / ngosuku. 

Ku-bipolar mania, ukwelashwa kuvame ukuqala ku-750 mg/ngosuku ngemithamo ehlukanisiwe, kulungiswa njengoba kudingeka kuze kufike ku-60 mg/kg/ngosuku.

Ibanga lokwelapha lesithuthwane lingama-50-100 mcg/mL, kanti kwe-mania lingu-50-125 mcg/mL.

Kubalulekile ukuqapha ukuhlolwa kokusebenza kwesibindi kanye namazinga e-valproate njalo. 

Isiphetho

Amaphilisi e-Valproate afakazele ukuthi ayimithi eguquguqukayo futhi ephumelelayo yokulawula izimo ezihlukahlukene zemizwa. Kusukela ekulawuleni ukuquleka kuya ekuzinziseni isimo sengqondo nokuvimbela imigraines, lesi sidakamizwa sinomthelela omkhulu ekuthuthukiseni izinga lempilo yeziguli eziningi. Kubalulekile ukukhumbula ukuthi nakuba i-valproate ingaba yinzuzo enkulu, futhi iza nemiphumela engemihle engaba khona kanye nezinyathelo zokuphepha ezidingekayo ezidinga ukucatshangelwa ngokucophelela. Ukuhlolwa njalo nokuhlolwa kwegazi kuqinisekisa ukuthi umuthi usebenza ngempumelelo nangokuphepha. I-Valproate isalokhu iyithuluzi elibalulekile emkhakheni wezokwelapha, enikeza ithemba nempumuzo kulabo abahlushwa isithuthwane, ukuphazamiseka kwengqondo okuguquguqukayo, kanye nemigraines engapheli.

Imibuzo Evame Ukubuzwa

1. Isetshenziselwa ini i-valproate yomuthi?

I-Valproate imithi ehlukahlukene esetshenziselwa ukwelapha izimo ezihlukahlukene zemizwa. Inqunyelwe ngokuyinhloko isithuthwane ukulawula izinhlobo ezahlukene zokuquleka. I-Valproate isetshenziselwa ukuphatha i-bipolar disorder, ikakhulukazi phakathi neziqephu ze-manic. Ukwengeza, iyasebenza ekuvimbeleni ikhanda elibuhlungu, nakuba lingawaqedi amakhanda aseqalile kakade.

2. Ubani okungafanele athathe i-valproate?

I-Valproate ayifanele wonke umuntu. Abantu abanesifo sesibindi, ukuphazamiseka komjikelezo we-urea, noma izimo ezithile zofuzo ezifana nesifo sika-Alpers kufanele bakugweme. Akunconyelwe futhi kwabesifazane abakhulelwe noma labo abafisa okufanayo, njengoba kungabangela ukukhubazeka okukhulu kokuzalwa. Uma unomlando wezinkinga zesibindi noma izinkinga ze-pancreatic, kufanele uxoxe ngalokhu nodokotela wakho ngaphambi kokuthatha i-valproate.

3. Ingabe i-valproate ikwenza ulale?

I-Valproate ingabangela ukozela kwabanye abantu. Lo mphumela uvame ukubonakala kakhulu lapho uqala umuthi noma lapho umthamo unyuswa. Uma ubhekana nokulala ngokweqile, ukukhuluma nodokotela wakho kubalulekile. Khumbula ukuthi ungashayeli noma usebenzise imishini uze wazi ukuthi i-valproate ikuthinta kanjani.

4. Ingabe i-valproate idala ukulimala kwezinso?

Ngenkathi i-valproate ingahlotshaniswa nayo ukulimala kwezinso, ezinye izifundo ziye zaphakamisa ukuthi kungase kubangele ukulimala kwezinso ze-paucisymptomatic kwezinye izimo. Lokhu kungenzeka kakhulu ngemva kokusetshenziswa isikhathi eside komuthi, ngokuvamile izinyanga eziyisikhombisa noma ngaphezulu. Uma uthatha i-valproate, udokotela wakho angase aqaphe ukusebenza kwezinso zakho ngesikhathi sokuhlolwa okuvamile.

5. Ngingakwazi ukuyeka ukuthatha i-valproate?

Ungalokothi uyeke ukuthatha i-valproate kungazelelwe ngaphandle kokubonisana nodokotela wakho. Ukuyeka imithi kungazelelwe kungase kubangele ukuquleka okukhulu, okuhlala isikhathi eside, nokusongela ukuphila. Uma ufuna ukuyeka ukuthatha i-valproate, udokotela wakho uzodala uhlelo lokunciphisa kancane kancane umthamo wakho ngokuhamba kwesikhathi. Le nqubo, eyaziwa ngokuthi i-tapering, isiza ukunciphisa izimpawu zokuhoxa futhi inciphise ingozi yokuquleka.

6. Ingabe i-valproate iyanciphisa ukukhathazeka?

Nakuba odokotela ngokuyinhloko musa ukunikeza valproate for ukukhathazeka, ezinye izifundo ziphakamisa ukuthi ingaba nezimpawu ze-anxiolytic (ezokwehlisa ukukhathazeka). Uma ubhekene nokukhathazeka, kungcono ukuxoxa ngezinketho ezithile zokwelapha nodokotela wakho.