I-Topamax yokwehlisa isisindo: Bona imininingwane yokuphepha nokusebenza
Imininingwane YezidakamizwaI-Topamax igama lomuthi wemithi ejwayelekile ebizwa topiramate . Ngokwezobuchwepheshe ihlukaniswa njenge-anticonvulsant esetshenziselwa ukwelapha izimo ezifana nesifo sokuwa, kodwa futhi isetshenziswa ekuphatheni ezinye izimo ezifana ne-migraine ne-bipolar disorder. I-Topamax inhle ekwelapheni izimo ezinjengalezi, kepha abantu abaningi abayithathayo bazothola ukulahleka kwesisindo njengomphumela oyinhloko. Ake sibheke ngokujulile ukuthi i-Topamax iphephe futhi isebenza kanjani nokuthi ihlobene kanjani nokwehlisa isisindo.
Ukulahlekelwa kwesisindo se-Topamax
I-Topamax ivunyelwe yi-Food and Drug Administration (FDA) ukwelapha isithuthwane nokuyivimbela migraine , kepha umuthi kadokotela waziwa futhi ngokubangela ukwehla kwesisindo. Noma ukwehla kwesisindo kungaba yinzuzo enhle yokuthatha i-Topamax, i-FDA ayikugunyazanga ukwehla kwesisindo kuphela.
I-Topamax idala ukwehla kwesisindo ngoba kuthinta isifiso sokudla. Abantu abayithathayo futhi abanesifiso esincishisiwe bangazizwa belambile kaningi futhi badle kancane ngenxa yalokhu. Izifundo kukhombisile ukuthi iTopamax nayo ingasheshisa imetabolism, okusho ukuthi umzimba ushisa amakhalori ngokushesha okukhulu.
Ukuhlolwa kwemitholampilo kubonise lokho cishe 6% -17% yabantu abathatha i-Topamax bazozwa ukwehla kwesisindo, kanti ngenkathi abantu abaningi bengabona lokhu njengenzuzo eyengeziwe, ukunciphisa isisindo esiningi akuyona into enhle. Iningi labantu lizolahlekelwa isisindo esilinganiselwe kusuka ku-Topamax, kusho uKuldeep Singh, MD, udokotela ohlinzayo wokunciphisa isisindo endaweni yaseBaltimore nomqondisi weMaryland Bariatric Centre eMercy Medical Center. Ukwehlisa isisindo ngokushesha kungaba yimpilo-kungaba yisikhathi sokubona udokotela uma uthatha i-Topamax futhi lokhu kwenzeka kuwe. Ukugcina isisindo esinempilo kubalulekile, futhi indlela engcono yokuthola ukuthi yini isisindo esisetshenzisiwe okungcono kakhulu kuwe ukubuza umhlinzeki wakho wezokunakekelwa kwempilo. Ukuwela ngaphansi kwesisindo somzimba wakho ngenxa ye-Topamax kungaba esinye isibonakaliso sokuthi sekuyisikhathi sokukhuluma nomhlinzeki wakho.
Kuphephile yini ukuthatha i-Topamax yokwehlisa isisindo?
Kwesinye isikhathi i-Topamax ingabekwa ngaphandle kwelebula ukusiza umuntu anciphise isisindo. Ukuchazwa kwelebula okungekho kwelebula kwenzeka lapho udokotela ebhalela umuntu incwadi kadokotela evunywa yi-FDA ukwelapha isimo esihlukile kunaleso isiguli sabo esinaso. Lokhu kusemthethweni futhi kwenzeka njalo embonini yezokwelapha, ngokulinganiselwa 1 ku-5 imiyalo ebhaliwe ingekho kwelebula.
Udokotela angakhetha ukubhalela umuntu incwadi kadokotela ye-Topamax ukusiza ekunciphiseni isisindo sakhe noma ekwelapheni ukuphazamiseka kokudla njengokubhonga nokuhlanza okuholela ekutholeni isisindo. Ngokusho kukaDkt Singh, umuntu kufanele abe nenkomba yomzimba (BMI) engama-30 noma ngaphezulu ukuze anqunyelwe noma imuphi umuthi wokwehlisa isisindo, kufaka phakathi iTopamax.
Ucwaningo luye lwabonisa ukuthi abantu abathatha i-Topamax yokwehlisa isisindo balahlekelwa cishe Amakhilogremu ayi-11 uma kuqhathaniswa namaqembu e-placebo uma ethatha umuthi okungenani izinyanga ezine, nokuthi imiphumela yokuncipha kwesisindo se-Topamax iyakhula ngazo zombili isikhathi sokwelashwa nomthamo. Ucwaningo luye lwabonisa nokuthi ukwelashwa kwe-topiramate kungakhuphula amathuba okulahleka kwesisindo okungaphezulu kokungaphezulu kasithupha .
Noma i-Topamax ingasebenza kakhulu ekwehliseni isisindo, akuphephile kuwo wonke umuntu. Amaqembu alandelayo abantu kufanele akhulume nodokotela wabo ngaphambi kokuthatha i-Topamax ngoba angaba nengozi eyengeziwe yokuhlangabezana nezehlakalo ezimbi kakhulu uma eyithatha:
- Abantu abanesifo sezinso
- Abantu abanezifo zamaphaphu noma izinkinga zokuphefumula
- Abantu abanesifo sesibindi
- Abantu abanezinkinga zamehlo njenge-glaucoma
- Abantu abane-depression
- Abantu abanemicabango yokuzibulala noma izindlela zokuziphatha
- Abantu abane-osteoporosis
- Abantu abane-ketoacidosis ye-metabolic
Kungaphepha kwabesifazane abakhulelwe ukuthi bathathe i-Topamax uma izinzuzo zokuthatha umuthi zidlula izingozi ezingaba khona. Akunakwenzeka ukuthi i-Topamax izobekwa noma kufanele inikezwe lapho ukhulelwe ngenhloso yokwehlisa isisindo. I-Topamax ingadala ukulimala kwengane nezinkinga zokuzalwa ngomlomo uma ithathwa ngabesifazane abakhulelwe, yingakho ibekiwe ngokuqapha futhi kuphela lapho kunesidingo sezempilo. Iphinde ikhishwe obisini lomuntu, kepha akwaziwa noma izothinta kabi izingane ezincelisayo noma cha. I-Topamax ingenza amaphilisi okulawula ukubeletha angasebenzi kahle, ngakho-ke kubalulekile ukukhuluma nodokotela wakho ngokusebenzisa izindlela ezingezona ezokuvimbela ukubeletha uma ungafuni ukukhulelwa ngenkathi uthatha i-Topamax.
Abantu abangakhulelwe futhi abangenayo imibandela yezempilo eshiwo ngenhla bangayithatha ngokuphepha i-Topamax, kodwa basengaba nemiphumela emibi ngokuyithatha. Nayi eminye imiphumela emibi kakhulu ye-Topamax ngaphandle kwesisindo:
- Isiyezi
- Ukukhathala
- Ubudikadika
- Uhudo
- Ukuphelelwa isifiso sokudla
- Ukulahlekelwa kokuxhumana
- I-Paresthesia (imizwa evuthayo)
Yize kungavamile, i-Topamax ingadala imiphumela emibi kakhulu engadinga ukunakekelwa kwezokwelapha njengokudideka, izinkinga zememori, inkinga yokugxila, nokukhathazeka ukukhuluma. Abanye abantu bazobhekana nemiphumela emibi yezempilo yengqondo njengokucindezeleka, ukuhlaselwa ukwethuka, ukushintsha kwemizwelo, nemicabango yokuzibulala noma isimilo. Uma unanoma iyiphi yalezi zimpawu kufanele ufune usizo lwezokwelapha ngokushesha okukhulu.
Omunye umphumela wecala ongavamile we-Topamax yizinkinga zamehlo ezingaholela ekushintsheni kombono nokungaboni, yingakho kubaluleke kakhulu ukubiza udokotela wakho uma umbono wakho uqala ukushintsha. Lolu hlu lwemiphumela engemihle alunabele ngokuphelele; uma ungathanda uhlu oluphelele lwemiphumela emibi ye-Topamax cela udokotela noma usokhemisi wakho umhlahlandlela wemithi.
Uma i-Topamax ibangela imiphumela emibi kakhulu, yazi ukuthi unezinye izinketho. Isithako esisebenzayo ku-Topamax, i-topiramate, naso siyisithako esiyinhloko somuthi wokunciphisa isisindo Qsymia , okuyinto inhlanganisela equkethe phentermine. Ngokusho kukaDkt Singh, iQsymia ngomunye wemithi engcono kakhulu ongayisebenzisa isikhathi eside ngokuhambisana nokudla kanye nokushintsha indlela ophila ngayo ukuze wehlise isisindo, ikakhulukazi kwiziguli ezikhuluphele ezinesigaba 1 noma isigaba 2 sokukhuluphala. Ngakho-ke uma ungakwazi ukuthatha i-Topamax ngenxa yenkinga yezempilo eyisisekelo noma ngoba uhlangabezana nemiphumela emibi kakhulu, ungazama ukubuza uchwepheshe wakho wezokunakekelwa kwempilo mayelana ne-Qsymia noma ezinye izindlela zokwehlisa isisindo.
Ungayithatha kanjani i-Topamax ukuze wehlise isisindo
I-Topamax ingathathwa ukukhuthaza ukwehlisa isisindo futhi isize ukulawula ukubheja nokuhlanza, kepha kubalulekile ukukhumbula ukuthi akuyona indawo yokuya kudokotela nokwenza uhlelo lokunciphisa isisindo oluhle kahle. Uma unesifiso sokuthatha i-Topamax kungcono ukuhlela i-aphoyintimenti nodokotela wakho ukuze ubone ukuthi kulungile yini kuwe. Udokotela wakho uzokwenza ukuhlolwa okuphelele komzimba bese ebuza ngomlando wakho wezokwelapha. Uma wena nodokotela wakho ninquma ukuthi i-Topamax ingakusiza ngokuphepha ukunciphisa isisindo, khona-ke ungathola incwadi kadokotela yayo.
Uma uthola incwadi kadokotela, kubalulekile ukwazi ukuthi ungayithatha kanjani i-Topamax ukuthola imiphumela emihle. Umthamo wokuqala we-Topamax wokwehlisa isisindo umthamo ophansi we 25 mg ngosuku, kodwa la mandla esikali angakhuphuka ngokuya ngamacala ngokuya ngomlando wezokwelapha womuntu ngamunye nokuthi kufanele alahlekelwe isisindo esingakanani.
Ocwaningweni olwenziwe yi Ijenali ye-Clinical Psychiatry , iziguli ze-bipolar kanye ne-schizophrenic ezinikezwe isilinganiso esilinganiselwe se-195 mg ye-topiramate ngosuku zilahlekelwe cishe ngamakhilogremu angama-22 ngokuhamba kwesikhathi. Lokhu kukhombisa ukuthi ububanzi bemithamo ye-Topamax bungahluka kusukela kokuphansi kuye phezulu, nokuthi odokotela bangakhuphula noma banciphise inani le-Topamax umuntu alithathayo ngokuya ngemiphumela yakhe ngokuhamba kwesikhathi.
Kungathatha isikhathi ukubona imiphumela yokulahlekelwa isisindo ngokuthatha i-Topamax. Abanye abantu kungenzeka bangawuboni umehluko kuze kube yilapho sebethathe umuthi okungenani izinyanga ezine , kanti abanye abantu bangaqala ukunciphisa isisindo ngenyanga yabo yokuqala yokuthatha. Imiphumela yokwehla kwesisindo kusuka ku-topiramate yi kufakazelwe ukwanda ngokuhamba kwesikhathi.
I-Topamax ingathathwa nokudla noma ngaphandle kokudla futhi ngokuvamile ithathwa ngasikhathi sinye usuku ngalunye. Akufanele iphuzwe ngesikhathi esifanayo neminye imithi ethile ngenxa yamandla okuhlangana kwezidakamizwa. Nalu uhlu lwemithi iTopamax okungafanele ithathwe ngayo:
- Izidakamizwa ze-antiepileptic
- I-Carbonic anhydrase inhibitors
- Ukudangala kwe-CNS
- Izindlela zokuvimbela inzalo ngomlomo
- IHydrochlorothiazide (HCTZ)
- UPioglitazone
- ILithium
- Amitriptyline
Ngaphezu kwale mithi, iTopamax akufanele ithathwe ngotshwala ngoba lokhu kungadala ukulala, kwandise ubungozi bokuthola amatshe ezinso, futhi kubangele i-metabolic acidosis . I-Metabolic acidosis yisimo lapho i-asidi eningi yakha khona oketshezini lomzimba, futhi ingaba yingozi empilweni uma ingalashwa. Uma uqala ukuthola ukuphefumula okusheshayo, ukudideka, ukukhathala ngokweqile, nokushaya kwenhliziyo ngenkathi uthatha i-Topamax, kufanele ufune usizo lwezokwelapha ngokushesha okukhulu ngoba lokhu kuyizimpawu zokuthi ungaba ne-metabolic acidosis.
Ukuzuza kwesisindo ngemuva kwe-Topamax
Lapho umuntu eyeka ukuthatha i-Topamax, kungenzeka ukuthi angathola ukuzuza kwesisindo ngokuhamba kwesikhathi, ikakhulukazi uma engazange ahlanganise i-Topamax nezinguquko zokuphila ezinempilo. Esifundweni sokubuka esenziwe yi Umtapo Wezincwadi Kazwelonke Wezokwelapha , ukuyekiswa kweTopamax okungenani izinyanga eziyisithupha kukhombise ukuthambekela kokubuyela esisindweni sokuqala. Ngakho-ke abantu bangase babe namathuba amaningi okubuyela kulokho abakukalile ngaphambi kokuba baqale ukuthatha i-Topamax, kepha lokhu kungathatha isikhathi.
Lokhu kubuyela esisindweni sokuqala kuyenzeka ngoba umzimba awusatholi ukudla okuncishisiwe kanye nokushesha komzimba. Indlela enhle yokuqinisekisa ukuthi uyakwazi ukugcina isisindo ngemuva kokumisa i-Topamax ukuthola izinguquko zokuphila ngendlela ezokusiza ohambweni lwakho lokwehlisa isisindo.
Izindlela ezi-5 eziphephile zokwehlisa isisindo
I-Topamax ingaba wusizo ohambweni lwakho lokwehlisa isisindo uma udokotela wakho ekuvumela, kodwa akuyona ukuphela kwendlela yokwehlisa isisindo. Izinguquko zokuphila zingakusiza ukuthi wehlise isisindo futhi usigcine kude ukuze ukwazi ukujabulela izinzuzo zokwehlisa isisindo ngaphandle kokuthatha i-Topamax, ngenkathi uyithatha, noma ngemuva kokuyithatha. Nazi ezinye zezindlela eziphephe kakhulu zokwehlisa isisindo.
1. Thuthukisa indlela odla ngayo
Ukudla ukudla okunempilo kungenye yezindlela eziphephe futhi ezingcono kakhulu zokwehlisa isisindo. Ukuqaphela ukuthi udlani nokuthi ungakanani kungakusiza wehlise isisindo uma ukwenza kahle. Ukuze uthole iseluleko esihle kakhulu sokuthi yini ongayidla ukuze unciphise umzimba kufanele ukhulume nodokotela wakho, kepha ukwenza ushintsho oluncane njengokudla izithelo nemifino ethe xaxa kungaba yindlela enhle yokuqala.
Ukudla okusetshenzisiwe, ama-carbohydrate acwengekile, ushukela, notshwala konke kuyizibonelo zokudla okungadala ukuzuza kwesisindo. Izithelo ezintsha, imifino, namaprotheni asezingeni eliphakeme njenge-salmon, ubhontshisi, namaqanda konke kuyizibonelo ezinhle zokudla umzimba ongakucubungula kalula futhi uthole izakhamzimba ezibalulekile kuwo.
2. Vocavoca umzimba njalo
Ngokusho kweCenters for Disease Control and Prevention ( i-CDC ), ukuzivocavoca akusizi kuphela ukulawula isisindo, kepha kunciphisa umfutho wegazi ophakeme, kunciphisa ubungozi bohlobo lwesifo sikashukela sohlobo lwe-2, futhi kunganciphisa nezimpawu zokudangala nokukhathazeka. Abantu bayahlukahluka ekutheni badinga kangakanani ukuvivinya umzimba ukuze banciphise isisindo, ngakho-ke kuwumqondo omuhle ukukhuluma nodokotela wakho mayelana nokuthi kufanele uvivinye kangaki. Ukuzivocavoca okuhle kokunciphisa umzimba kufaka phakathi ukuhamba, ukuhamba ngebhayisikili, ukubhukuda, nokuqeqeshwa kwesisindo.
3. Nciphisa ukucindezeleka
Ingcindezi ixhunyaniswa nezinkinga eziningi zempilo njengokukhathazeka nokudangala. Ukuzizwa ucindezelekile kungaholela ekudleni okungokomzwelo, okungaholela ekutholeni isisindo ngokuhamba kwesikhathi. Ukuthola izindlela zokunciphisa ukucindezeleka kungakusiza ulahlekelwe isisindo. Ungazama ukuzindla, i-yoga, ukuhambahamba, noma ukubiza umngani noma ilungu lomndeni. Ungacela futhi udokotela wakho noma umeluleki ngezindlela ezifakazelwe zokunciphisa ukucindezeleka okuzongena empilweni yakho.
4. Lala ngokwanele
Ngokusho kwe- Isisekelo Sokulala , ukuntuleka kokulala kungakhuphula isifiso sokudla futhi kuholele ezinkingeni zemetabolism. Ukulala ngokwanele kungasiza umzimba wakho ukuthi usebenze kahle futhi kukunikeze amandla amaningi okwenza izinto ezifana nokuzivocavoca umzimba, okuzokusiza wehlise isisindo. Ukulala ngokwanele nakho kunganciphisa amazinga akho okucindezeleka, okuzokusiza ulawule noma yiziphi izifiso ongazithola ekudleni ngokweqile.
5. Ukuzama amaphilisi okudla okuphephile nezithasiselo
Kunamaphilisi nezithako zokudla ezingenakubalwa emakethe ezithi zidala ukwehla kwesisindo, njenge-Hydroxycut kanye ne-glucomannan, kepha akufanele zisebenze njengezindawo zokushintsha indlela yokuphila enempilo. Lapho abantu beyofuna imishanguzo yokwehlisa isisindo, iningi labo liyenza ngoba kulula ukuyenza, kusho uDkt Singh. Uma umuntu eshintsha ngokungathí sina indlela yakhe yokuphila nemikhuba yokudla kuqala, bazobona ukuthuthuka okuqinile ngeTopamax noma eminye imithi yokwehlisa isisindo. I-mindset yinto ebaluleke kakhulu. Imithi ayikwazi ukuthatha indawo yokudla okufanele nokujwayeza imikhuba.