Kuyini Ukuphefumula kwe-Levodopa: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

Ukuphefumula kwe-Levodopa kuyimithi entsha ethumela i-levodopa ngqo emaphashini akho ngedivayisi ekhethekile yokuphefumula. Lokhu kwelashwa okusha kusiza abantu abanesifo sikaParkinson ukulawula izigameko ezingazelelwe "ezingasebenzi" lapho imithi yabo yomlomo ejwayelekile inganikezi ukulawulwa okwanele kwezimpawu.

Ngokungafani namaphilisi e-levodopa endabuko okufanele adlule ohlelweni lwakho lokugaya ukudla, ifomu eliphefumulwayo limuncwa ngokushesha egazini lakho ngamaphaphu akho. Lokhu kuthunyelwa okusheshayo kungasiza ukubuyisela ukunyakaza kwakho futhi kunciphise ukuqina ngemizuzu nje kunokulinda imizuzu engama-30-60 ukuthi imithi yomlomo isebenze.

Kuyini Ukuphefumula kwe-Levodopa?

Ukuphefumula kwe-Levodopa kuyifomu le-levodopa eliyimpushana eyomile okufanele uyiphefumule usebenzisa idivayisi ekhethekile yokuphefumula ebizwa nge-Inbrija device. Yenzelwe ngqo njengomuthi wokusiza abantu abanesifo sikaParkinson abahlangabezana nezikhathi ezingalindelekile "ezingasebenzi" usuku lonke.

Umuthi uqukethe isithako esifanayo esisebenzayo njengamaphilisi omlomo e-levodopa, kodwa wenziwe njengezinhlayiyana ezincane ezingamuncwa ngesicubu sakho samaphaphu. Uma uphefumula le mpushana, ingena ngokushesha egazini lakho bese iya ebuchosheni bakho, lapho iguqulwa khona ibe yi-dopamine ukusiza ukuthuthukisa izimpawu zakho zemoto.

Le nguqulo ephefumulwayo yagunyazwa yi-FDA ngo-2018 njengokwelashwa kokuqala nokuphela kokuphefumula kwezigameko ezingasebenzi zesifo sikaParkinson. Kumele isebenze kanye nemithi yakho yomlomo ejwayelekile ye-Parkinson, hhayi ukuyishintsha ngokuphelele.

Isetshenziselwani Ukuphefumula kwe-Levodopa?

Ukuphefumula kwe-Levodopa kusetshenziselwa ngokuqondile ukwelapha izigameko "ezingasebenzi" kubantu abanesifo sikaParkinson asebevele bethatha umuthi we-carbidopa/levodopa. Izigameko ezingasebenzi yizikhathi lapho umuthi wakho ovamile uphelelwa khona futhi izimpawu zakho ze-Parkinson zibuyela noma ziba zimbi.

Ngesikhathi salezi zikhathi zokuphumula, ungase uhlangabezane nokuthuthumela okwandayo, ukuqina kwemisipha, ukunyakaza okuhamba kancane, noma ubunzima ekuhambeni. Lezi zigameko zingenzeka ngokungalindelekile usuku lonke, ngisho nalapho uthatha imithi yakho yomlomo njengoba kunqunyiwe. I-levodopa ephefumulwayo inikeza ukukhululeka okusheshayo lapho lezi zimpawu zokuphuma zenzeka.

Udokotela wakho uzomisa lo muthi kuphela uma usuvele usethwe ohlelweni oluzinzile lwe-carbidopa/levodopa yomlomo. Akuhloselwe abantu abasanda kutholakala ukuthi banesifo sikaParkinson noma labo abangazange bazame ukwelashwa nge-levodopa yomlomo kuqala.

Isebenza Kanjani I-Levodopa Inhalation?

I-Levodopa inhalation isebenza ngokuletha imithi ngqo emaphashini akho, lapho imuncwa ngokushesha egazini lakho. Lokhu kudlula uhlelo lwakho lokugaya konke, yingakho isebenza ngokushesha kunezithako zomlomo.

Uma i-levodopa isifinyelela ebuchosheni bakho, iguqulwa ibe yi-dopamine yi-enzyme ebizwa nge-aromatic L-amino acid decarboxylase. I-Dopamine iyi-neurotransmitter esiza ukulawula ukunyakaza, futhi abantu abanesifo sikaParkinson banezinga elincishisiwe lalesi sithako esibalulekile ebuchosheni babo.

Ifomu eliphefumulwayo lithathwa njengomuthi onamandla aphakathi nendawo onikeza ukukhululeka kwesikhashana kunokulawulwa kwezimpawu zesikhathi eside. Ngokuvamile iqala ukusebenza ngemizuzu engu-10-15 futhi inganikeza ukuthuthuka kwezimpawu cishe amahora angu-1-2, ikunike isikhathi sokuthi umthamo wakho olandelayo ohleliwe womlomo uqale ukusebenza.

Kufanele Ngiyithathe Kanjani I-Levodopa Inhalation?

Kufanele uthathe i-levodopa inhalation ngendlela enqunywe ngayo udokotela wakho, usebenzisa kuphela idivayisi ekhethekile ye-Inbrija inhaler ehambisana nomuthi wakho. Umthamo ojwayelekile uvame ukuba yikhephuli elilodwa (84 mg) eliphefumulwayo lapho uhlangabezana nesigameko sokuphuma, ngemithamo engu-5 ngosuku.

Ngaphambi kokusebenzisa i-inhaler, qiniseka ukuthi izandla zakho zihlanzekile futhi zomile. Khipha ikhaphule elilodwa ephaketheni le-blister ngaphambi nje kokulisebenzisa, bese ulifaka ekamelweni le-inhaler. Bamba idivayisi iqonde phezulu, khipha umoya ngokuphelele, bese ubeka umlomo wakho ngasemlonyeni bese uphefumula ngokujulile nangokushesha ukuze uqinisekise ukuthi uthola umthamo ogcwele.

Ungasebenzisa lo muthi ngaphandle noma ngaphandle kokudla, futhi akudingeki uphuze amanzi ngaphambi noma ngemva kokuphefumula. Kodwa-ke, kubalulekile ukuhlanza umlomo wakho ngamanzi ngemva kokusebenzisa ngakunye ukuze ususe noma iyiphi impushana esele futhi unciphise ingozi yokucasuka komphimbo. Ungadli noma uphuze lutho okungenani imizuzu emi-5 ngemva kokuthatha umthamo wakho.

Njalo gcina i-inhaler yakho namakhaphule endaweni eyomile ekamelweni lokushisa. Ungalokothi ugeze idivayisi ye-inhaler ngamanzi, futhi uyishintshe ngokwemiyalelo kadokotela wakho, ngokuvamile njalo eminyakeni embalwa.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Levodopa Inhalation?

Kufanele uqhubeke nokuthatha i-levodopa inhalation uma nje udokotela wakho ekuncoma, okuyinto ngokuvamile uma nje uqhubeka nokuzwa iziqephu ezingekho ngesifo sakho i-Parkinson. Lo muthi wenzelwe ukusetshenziswa isikhathi eside njengokwelashwa kokuhlenga kanye nemithi yakho yomlomo ejwayelekile.

Udokotela wakho uzohlola njalo ukuthi ngabe i-levodopa ephefumulwayo isasiza yini izimpawu zakho futhi ingashintsha uhlelo lwakho lokwelashwa lwe-Parkinson ngokuhamba kwesikhathi. Abanye abantu bangase badinge ukuyisebenzisa izikhathi eziningana ngosuku, kanti abanye bangase bayidinge ngezikhathi ezithile kuphela lapho kwenzeka iziqephu ezingekho.

Ubude bokwelashwa buxhomeke ekutheni isifo sakho i-Parkinson siqhubeka kanjani nokuthi imithi yakho eminye ilawula kahle kangakanani izimpawu zakho. Ungalokothi uyeke ukusebenzisa lo muthi ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala, njengoba lokhu kungaholela ekubeni izimpawu zakho zibe zimbi kakhulu.

Yiziphi Imiphumela Eceleni Ye-Levodopa Inhalation?

Njengazo zonke izidakamizwa, ukuhogela i-levodopa kungabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle. Imiphumela emibi evame kakhulu ivamise ukuba mncane futhi ihlobene nenqubo yokuhogela uqobo.

Ake sibheke imiphumela emibi ongase uyithole, siqale ngaleyo evame kakhulu ethinta uhlelo lwakho lokuphefumula:

• Ukhwehlela (kuthinta cishe u-15% wabantu)
• Ukutheleleka kwepheshana eliphezulu lokuphefumula
• Ukuqubuka komphimbo noma ukungakhululeki
• Ukushintsha kombala we-sputum (amafinyila akho angase abonakale emnyama)
• Ukuminyana noma izinguquko zezwi

Le miphumela yokuphefumula ivamise ukwenzeka ngoba impushana ingathukuthelisa imigudu yakho yomoya, kodwa ngokuvamile imnene futhi yesikhashana. Ukugeza umlomo wakho ngemva kokusebenzisa ngakunye kungasiza ukunciphisa ukucasuka komphimbo.

Ngaphandle kwemiphumela yokuphefumula, ungase futhi uthole imiphumela emibi efana naleyo evela emithini ye-levodopa yomlomo:

• Isicanucanu noma isisu esibuhlungu
• Isiyezi noma ukukhathala
• I-Dyskinesia (ukuhamba okungazelelwe)
• Ukucabanga noma ukudideka
• Ushintsho emfuthe yegazi

Le miphumela yenzeka ngoba i-levodopa ithinta wonke umzimba wakho uma ingena egazini lakho, hhayi nje ubuchopho bakho.

Eminye imiphumela emibi engavamile kodwa ebucayi idinga ukunakekelwa kwezokwelapha ngokushesha. Lokhu kuhlanganisa ubunzima obukhulu bokuphefumula, ubuhlungu besifuba, izinguquko ezinkulu esigqi senhliziyo, noma ukuqala okungazelelwe kokulala ngokweqile. Uma uthola noma yiziphi zalezi zimpawu, xhumana nodokotela wakho ngokushesha noma funa ukunakekelwa kwezimo eziphuthumayo.

Ubani Ongafanele Athathwe Ukuhogela i-Levodopa?

Amaqembu amaningana abantu akufanele asebenzise ukuhogela i-levodopa ngenxa yokukhathazeka ngokuphepha. Udokotela wakho uzohlola ngokucophelela ukuthi lo muthi ulungele yini isimo sakho esithile.

Abantu abanezimo ezithile zamaphaphu kufanele bagweme lo muthi ngoba ukuhogela impushana kungase kwenze izinkinga zabo zokuphefumula zibe zimbi:

• Isifuba somoya esisebenzayo noma umlando wokuhlaselwa yisifuba somoya
• Isifo esingamahlalakhona sokuvinjelwa kwamaphaphu (COPD)
• Ezinye izifo zamaphaphu ezingamahlalakhona ezithinta ukuphefumula
• Ukutheleleka kwakamuva ngamaphaphu noma umshiso wamaphaphu

Izinhlayiya zempushana zingabangela ubunzima bokuphefumula noma zikwandise ukuvuvukala kwamaphaphu okukhona kulezi zimo.

Ngaphezu kwalokho, izimo ezithile zezokwelapha nokusebenzisana kwemithi kwenza ukuhogela i-levodopa kungaphephile:

• Abantu abathatha ama-monoamine oxidase inhibitors (MAOIs) phakathi nezinsuku eziyi-14 ezedlule
• Labo abane-narrow-angle glaucoma
• Abantu abanezilonda zesikhumba ezingabazisayo noma umlando we-melanoma
• Abantu abanesifo senhliziyo esibi noma ukuhlaselwa yinhliziyo kwakamuva
• Abantu abanesifo sezinso noma sesibindi (bangase badinge ukulungiswa komthamo)

Udokotela wakho uzobuye acabangele iminyaka yakho, eminye imithi, kanye nesimo sempilo yakho esiphelele ngaphambi kokunquma lo muthi.

Igama Lomkhiqizo Lokuhogela i-Levodopa

Igama lomkhiqizo lokuhogela i-levodopa yi-Inbrija, ekhiqizwa yi-Acorda Therapeutics. Lolu okwamanje yilona kuphela uhlobo lwe-levodopa oluhogelwayo olugunyazwe yi-FDA olutholakala e-United States.

I-Inbrija iza njengesistimu ephelele ehlanganisa womabili amaphilisi empushana eyomile kanye nedivayisi ekhethekile yokuhogela. Awukwazi ukusebenzisa amaphilisi nganoma yiluphi olunye uhlobo lwe-inhaler, futhi awukwazi ukusebenzisa eminye imithi nedivayisi ye-Inbrija inhaler.

Umuthi utholakala ngemiyalelo kuphela futhi ngokuvamile uhlanganiswa yizinhlelo eziningi zomshuwalense kubantu abanesifo sikaParkinson abahlangabezana nemibandela ethile yokusetshenziswa kwayo.

Ezinye Izindlela Zokuhogela i-Levodopa

Uma ukuhogela i-levodopa kungakulungele, ziningi ezinye izinketho ezikhona zokuphatha iziqephu zesifo sikaParkinson. Udokotela wakho angakusiza ukuthi uhlole lezi zindlela ezinye ngokusekelwe ezidingweni zakho ezithile kanye nomlando wezokwelapha.

Eminye imithi esheshayo yezigaba zokuvala zihlanganisa:

• Imijovo ye-Apomorphine (Apokyn) - isebenza ngaphakathi kwemizuzu engu-10-20
• Imichilo ye-apomorphine engaphansi kolimi (Kynmobi) - iyancibilika ngaphansi kolimi lwakho
• I-levodopa/carbidopa yomlomo ekhishwa ngokushesha - nakuba ihamba kancane kunezinhlobo eziphefumulwayo
• Ukulungisa isikhathi noma umthamo wemithi yakho yomlomo ejwayelekile

Lezi ezinye izindlela zisebenza ngezindlela ezihlukene zokulethwa kodwa zihlose ukufeza umgomo ofanayo wokubuyisela ngokushesha amazinga e-dopamine ebuchosheni bakho.

Kwabanye abantu, ukuthuthukisa ukwelashwa kwabo okuvamile komlomo kungase kwanele ukunciphisa iziqephu zokuvala. Lokhu kungabandakanya ukushintshela ekulungiselelweni okukhishwe isikhathi eside, ukwengeza eminye imithi ye-Parkinson efana nama-dopamine agonists, noma ukulungisa isikhathi sokudla ukuze kuthuthukiswe ukumuncwa kwemithi.

Ingabe Ukuphefumula i-Levodopa Kungcono Kune-Levodopa Yomlomo?

Ukuphefumula i-Levodopa akudingeki ukuthi kungcono kune-levodopa yomlomo, kodwa kusebenzela injongo ehlukile ohlelweni lwakho lokwelashwa olujwayelekile. Ifomu eliphefumulwayo lenzelwe ukugcwalisa imithi yakho yomlomo ejwayelekile, hhayi ukuyithatha yonke.

Inzuzo enkulu ye-levodopa ephefumulwayo isivinini. Ngenkathi i-levodopa yomlomo ngokuvamile ithatha imizuzu engama-30-60 ukusebenza, ifomu eliphefumulwayo livame ukuqala ukusebenza ngaphakathi kwemizuzu engu-10-15. Lokhu kwenza kube yigugu ikakhulukazi ekuphatheni iziqephu zokuvala ezingalindelekile lapho udinga usizo olusheshayo.

Nokho, i-levodopa yomlomo ihlala iyisisekelo sezinhlelo eziningi zokwelashwa kwe-Parkinson ngoba inikeza ukulawulwa kwezimpawu isikhathi eside usuku lonke. Ifomu eliphefumulwayo lisebenza kuphela cishe amahora angu-1-2, okwenza lingafaneleki njengomuthi wakho oyinhloko.

Udokotela wakho uzokusiza ukuthi unqume ukuhlanganiswa okungcono kakhulu kwemithi ngokusekelwe kumaphethini akho ezimpawu, indlela yokuphila, nokuthi uzithola kanjani kahle izindlela zokwelapha ezihlukene. Abantu abaningi bathola ukuthi ukusebenzisa zombili izinhlobo ndawonye kunikeza ukuphathwa kwezimpawu okuphelele kakhulu.

Imibuzo Evame Ukubuzwa Mayelana Nokuphefumula i-Levodopa

Ingabe Ukuphefumula i-Levodopa Kuphephile Kubantu Abanezifo Zenhliziyo?

Ukuphefumula kwe-Levodopa kudinga ukucatshangelwa ngokucophelela uma unesifo senhliziyo. Umuthi ungase uthinte izinga lokushaya kwenhliziyo yakho nomfutho wegazi, okungenzeka kubangele izinkinga kubantu abanezimo zenhliziyo ezikhona.

Udokotela wakho uzodinga ukuhlola isimo sakho senhliziyo esithile kanye nemithi yakho yamanje ngaphambi kokubhala i-levodopa ephefumulwayo. Bangase batusa ukuqapha okwengeziwe kwenhliziyo noma balungise imithi yakho yenhliziyo ukuze baqinisekise ukusetshenziswa okuphephile. Kwezinye izimo, abantu abanesifo senhliziyo esibi kakhulu bangase badinge ukugwema lo muthi ngokuphelele.

Kufanele ngenzeni uma ngingahlosile ukusebenzisa i-Levodopa inhalation eningi kakhulu?

Uma ngengozi uphefumula ngaphezu komthamo wakho obekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ukuthatha i-levodopa eningi kakhulu kungabangela imiphumela emibi engathi sína ehlanganisa isicanucanu esibi, ukuhlanza, ukushaya kwenhliziyo okungajwayelekile, ukucabanga okungamanga, noma ukozela okukhulu.

Ungazami ukuzenza uhlanze, ngoba lokhu ngeke kusize ukususa umuthi oseluvele wamuncwa ngamaphaphu akho. Ziqaphele ngokucophelela nganoma yiziphi izimpawu ezingavamile futhi funa ukunakekelwa kwezempilo okuphuthumayo uma uzwa ubuhlungu besifuba, ubunzima bokuphefumula, noma ukulahlekelwa ukwazi.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Levodopa inhalation?

Uma uphuthelwa umthamo ngesikhathi sesigameko esingekho, ungasithatha ngokushesha lapho ukhumbula, inqobo nje uma ungeqi imithamo engu-5 ngosuku olulodwa. Ngokungafani nemithi ehleliwe, i-levodopa inhalation isetshenziswa njengoba kudingeka ngezimpawu zokuphuma.

Ungathathi imithamo eyengeziwe ukuze ulungise lezo eziphuthelwe, futhi ngaso sonke isikhathi hlukanisa imithamo yakho okungenani ngamahora angu-2. Uma uneziqephu ezivame ukungabi khona lapho uphuthelwa amathuba okuphatha, xoxa ngalokhu nodokotela wakho njengoba ungase udinge ukulungiswa emithini yakho yomlomo ejwayelekile.

Ngingayeka nini ukuthatha i-Levodopa inhalation?

Ungayeka ukuthatha i-levodopa inhalation uma wena nodokotela wakho ninquma ukuthi awusadingi ukuyilawula izigameko ezingaphandle. Lokhu kungenzeka uma imithi yakho yomlomo ejwayelekile ilungiswa futhi inikeze ukulawulwa okungcono kwezimpawu, noma uma izigameko zakho ezingaphandle ziba ngavamile noma zibe zimbi.

Njalo xoxa ngokuyeka lo muthi nodokotela wakho kuqala, kunokuthi uwuyeke ngokwakho. Bangakusiza ukuthi uhlole ukuthi ngabe umuthi usasebenza yini futhi bakuqondise kunoma yiziphi izinguquko ezidingekayo ohlelweni lwakho lokwelashwa.

Ngingahamba ne-Levodopa Inhalation?

Yebo, ungahamba nge-levodopa inhalation, kodwa uzodinga ukuthatha izinyathelo ezithile ezengeziwe. Njalo thwala imithi yakho emaphaketheni ayo okuqala enelebula likadokotela, futhi ulethe incwadi evela kudokotela wakho echaza isidingo sakho sezokwelapha sedivayisi ye-inhaler.

Uma undiza, gcina imithi yakho esikhwameni sakho esithwalwayo kunokuba imithwalo ethunyelwe ukuze ugweme amazinga okushisa aphezulu nokulahleka okungenzeka. I-TSA ivumela ama-inhaler ezokwelapha ukuthi adlule ezokuphepha, kodwa ukuba nemibhalo kungasiza ukusheshisa inqubo yokuhlola. Cabanga ngokuletha amaphilisi engeziwe uma kwenzeka ukubambezeleka kohambo.