Neuroleptic yog ib yam tshuaj tshwj xeeb uas siv rau ntau yam kev puas hlwb. Raws li txoj cai, cov tshuaj no yog siv los kho cov mob neurotic syndromes, psychoses, thiab cov tshuaj kuj tseem siv tau rau kev hnov lus. Tsis tas li ntawd, cov tshuaj tiv thaiv kev puas siab puas ntsws raug muab tshuaj los tiv thaiv qhov tshwm sim tseem ceeb ntawm tus neeg mob hlwb.
Qhov tseem ceeb ntawm cov tshuaj hauv nqe lus nug
Cov teebmeem ntawm neuroleptics muaj ntau yam. Lub ntsiab pharmacological feature yog ib yam ntawm calming nyhuv, uas yog yus muaj los ntawm ib tug txo nyob rau hauv cov lus teb rau sab nraud stimuli, ib tug tsis muaj zog ntawm tensions thiab psychomotor agitation, tsub kom ntshai, thiab ib tug txo nyob rau hauv aggressiveness. Cov tshuaj tiv thaiv kev puas siab puas ntsws tuaj yeem cuam tshuam kev hnov lus, kev xav thiab lwm yam kev puas siab puas ntsws, muaj kev kho mob rau cov neeg mob uas muaj tus mob schizophrenia thiab lwm yam mob puas hlwb.
Qee yam tshuaj hauv pab pawg nomuaj antiemetic kev ua si, xws li cov nyhuv ntawm neuroleptics yog tiav vim xaiv inhibition ntawm chemoreceptor trigger (trigger) thaj chaw ntawm medulla oblongata. Qee cov neuroleptics tuaj yeem muaj sedative lossis activating (energizing) nyhuv. Ib tug xov tooj ntawm cov nyiaj no yog tus cwj pwm los ntawm cov ntsiab lus ntawm normothymic thiab tshuaj tiv thaiv kev nyuaj siab.
Pharmacological thaj chaw ntawm ntau yam tshuaj neuroleptic tau qhia rau qib sib txawv. Kev sib xyaw ua ke ntawm cov nyhuv antipsychotic tseem ceeb thiab lwm yam khoom txiav txim siab qhov profile ntawm lawv qhov kev txiav txim thiab cov lus qhia rau kev siv.
tshuaj tiv thaiv kab mob ua haujlwm li cas?
Neuroleptics yog cov tshuaj uas muaj kev nyuaj siab ntawm kev tsim cov hlwb ntawm lub hlwb. Qhov kev txiav txim ntawm cov tshuaj no kuj muaj feem xyuam nrog cov nyhuv ntawm qhov tshwm sim thiab kev ua ntawm excitation nyob rau hauv ntau qhov chaw ntawm lub hauv nruab nrab thiab peripheral paj hlwb. Niaj hnub no, qhov kev tshawb fawb tshaj plaws ntawm neuroleptics yog qhov cuam tshuam rau cov txheej txheem kho mob hauv lub hlwb. Cov kws tshawb fawb tau sau cov ntaub ntawv txaus ntawm cov teebmeem ntawm cov tshuaj no ntawm adrenergic, serotonergic, dopaminergic, cholinergic, GABAergic thiab lwm cov txheej txheem neurotransmitter, uas suav nrog cov nyhuv ntawm cov neuropeptide systems ntawm lub hlwb. Tsis ntev los no cov kev saib xyuas tshwj xeeb tau them rau cov txheej txheem ntawm kev sib cuam tshuam ntawm dopamine hlwb cov qauv thiab neuroleptics. Nrog rau inhibition ntawm tus neeg nruab nrab kev ua si ntawm dopamine, qhov tshwm sim tseem ceeb ntawm cov tshuaj no tshwm sim, lub npe hu ua neuroleptic syndrome tshwm sim, uas yog tus cwj pwm los ntawm cov kab mob extrapyramidal, piv txwv li,xws li cov leeg tsis muaj zog, akathisia (tsis muaj zog), parkinsonism (tremor, nqaij tawv), lub cev tsis muaj zog, kub taub hau. Cov nyhuv no tau ua tiav vim qhov thaiv cov nyhuv ntawm neuroleptics ntawm subcortical formations ntawm lub hlwb, qhov twg ntau tus receptors uas rhiab heev rau dopamine yog localized.
Cov kev mob tshwm sim ntawm neuroleptics uas tshwm sim yog qhov laj thawj rau kho kev kho mob thiab sau tshuaj kho tshwj xeeb (cov tshuaj "Akineton", "Cyclodol").
Pharmacodynamics
Ib tshuaj tiv thaiv kab mob yog ib yam tshuaj uas, ua rau lub hauv paus dopamine receptors, provokes qee qhov endocrine ntshawv siab, suav nrog kev txhawb nqa ntawm lactation nyob rau hauv lawv cov cawv. Thaum neuroleptics thaiv cov dopamine receptors ntawm lub caj pas pituitary, qhov tso tawm ntawm prolactin nce. Los ntawm kev ua ntawm hypothalamus, cov tshuaj no cuam tshuam nrog kev tso tawm ntawm kev loj hlob hormone thiab corticotropin.
Neuroleptics yog cov tshuaj uas muaj qhov luv luv ib nrab-lub neej hauv lub cev thiab tom qab txhaj tshuaj ib zaug lawv muaj cov nyhuv luv luv. Cov kws tshawb fawb tau tsim cov kev npaj tshwj xeeb nrog kev ua haujlwm ntev (Moditen-Depot, Geloperidol Decanoate, Piportil L4, Clopixol-Depot). Feem ntau cov tshuaj tiv thaiv kab mob sib xyaw ua ke nrog ib leeg: thawj ib nrab hnub lawv noj cov tshuaj stimulating, nyob rau hauv lub thib ob - sedative. Txhawm rau kom tsis txhob muaj kev cuam tshuam-delusional syndrome, nws raug nquahu kom noj cov tshuaj tiv thaiv kev ntxhov siab thiab tshuaj tiv thaiv kev puas siab puas ntsws ua ke.
Cov lus qhia rau kev siv
Neuroleptics yog kws tshuaj feem ntau rau kev kho mob ntawm nosogenic paranoid cov tshuaj tiv thaiv (cov tshuaj tiv thaiv rhiab heev) thiab mob somatoform mob.
Txoj cai rau sau cov tshuaj no
Kev kho mob nrog tshuaj tiv thaiv kab mob pib nrog kev teem sijhawm ntawm qhov tshuaj kho qhov nruab nrab, tom qab ntawd cov txiaj ntsig raug ntsuas thiab txiav txim siab txog qhov xav tau hloov koob tshuaj. Cov koob tshuaj ntawm cov tshuaj tiv thaiv kev puas siab puas ntsws tau nce sai sai rau qee tus nqi, uas tom qab ntawd maj mam txo los ntawm 3-5 zaug, thiab cov kev kho mob dhau los ua kev tawm tsam, txhawb nqa. Hloov tus nqi ntawm cov tshuaj nruj me ntsis raws li tus kheej. Kev saib xyuas koob tshuaj yog hloov tom qab qhov kev xav tau kho tau tiav. Nws yog qhov tsim nyog los ua kom muaj kev tiv thaiv kev rov qab los nrog cov tshuaj uas muaj kev ua haujlwm ntev. Txoj kev ntawm kev tswj hwm cov tshuaj psychotropic yog qhov tseem ceeb heev. Nyob rau theem pib ntawm kev kho mob, kev tswj hwm parenteral raug pom zoo, uas qhov kev kho mob tshwm sim sai dua (ntev dav hlau, tso dej tso rau hauv lub cev, intramuscular). Tsis tas li ntawd, nws yog qhov zoo dua los noj tshuaj tiv thaiv kab mob hauv qhov ncauj. Daim ntawv teev cov tshuaj siv tau zoo tshaj plaws yuav muab hauv qab no.
YPropazine
Cov tshuaj no muaj cov nyhuv sedative, txo kev ntxhov siab thiab kev ua haujlwm ntawm lub cev muaj zog. Cov tshuaj yog siv rau ciam teb tsis sib haum nyob rau hauv cov neeg mob nrog somatic pathology, yog hais tias muaj kev ntxhov siab vim, phobic ntshawv siab, obsession. Noj cov tshuaj hauv 2-3 zaug hauv ib hnub, 25 mg, yog tias tsim nyog -Cov koob tshuaj tuaj yeem nce mus rau 100-150 mg ib hnub. Thaum siv tshuaj me me, kev loj hlob ntawm kev tshwm sim ntawm Parkinsonism, raws li txoj cai, tsis tau pom.
Etaperazine npaj
Cov tshuaj muaj cov nyhuv antipsychotic activating thiab cuam tshuam cov tsos mob uas muaj xws li lethargy, lethargy, apathy. Tsis tas li ntawd, cov tshuaj "Etaperazine" yog siv los kho neurosis, nrog rau kev ntxhov siab, ntshai, ntxhov siab vim. Qhov koob tshuaj txhua hnub ntawm cov tshuaj yog 20 mg.
Means "Triftazin"
Cov tshuaj muaj cov txiaj ntsig zoo los tiv thaiv kev xav, nres kev puas hlwb. Cov tshuaj muaj ib tug nruab nrab stimulating (energizing) nyhuv. Nws tuaj yeem siv rau hauv kev kho mob ntawm atypical kev nyuaj siab xeev nrog qhov tshwm sim ntawm kev xav. Rau kev kho mob ntawm somatoform mob, cov tshuaj "Triftazin" yog ua ke nrog antidepressants thiab tranquilizers. Qhov koob tshuaj ntawm cov tshuaj yog 20-25 mg ib hnub twg.
Teralen
Cov tshuaj muaj tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kev puas siab puas ntsws. Cov tshuaj "Teralen" yog ib tug me me sedative thiab muaj ib tug zoo tshwm sim ntawm synestopathic-hypochondriac cov cim ntawm ciam teb chaws sau npe, nrog psychosomatic cov tsos mob uas tshwm sim tawm tsam keeb kwm ntawm kis kab mob, somatogenic, vascular manifestations, nrog neurovegetative pathologies. Nws yog dav siv nyob rau hauv gerontological xyaum thiab pediatrics. Pom zoo siv rau cov kab mob ua xua thiab khaus tawv nqaij. Noj cov tshuaj ntawm qhov ncauj ntawm 10-40 mg ib hnub,intramuscularly siv nyob rau hauv daim ntawv ntawm 0.5% tov.
Means "Tiridazine"
Cov tshuaj muaj cov nyhuv antipsychotic nrog cov nyhuv calming, tsis ua rau lethargy thiab lethargy. Tsis tas li ntawd, cov tshuaj muaj cov nyhuv thymoleptic nruab nrab. Cov tshuaj qhia tau hais tias muaj txiaj ntsig zoo tshaj plaws hauv kev xav tsis zoo, uas yog tus cwj pwm los ntawm kev nruj, kev ntshai, kev zoo siab. Hauv kev kho cov kab mob ciam teb, 40-100 mg ntawm cov tshuaj siv ib hnub. Nrog xws li tshwm sim xws li neurasthenia, nce irritability, ntxhov siab vim, neurogenic functional gastrointestinal thiab mob plawv, noj cov tshuaj 2-3 zaug ib hnub twg, 5-10-25 mg. Nrog premenstrual nervous disorder - 25 mg 1-2 zaug ib hnub twg.
Tshuaj "Chlorprothixen"
Cov tshuaj muaj cov tshuaj tiv thaiv kev puas siab puas ntsws thiab sedative, txhim kho cov nyhuv ntawm cov tshuaj tsaug zog. Cov tshuaj yog siv rau cov mob psychoneurotic yam ntxwv los ntawm kev ntshai, kev ntxhov siab. Kev siv cov tshuaj yog qhia rau neurosis, nrog rau kev tawm tsam keeb kwm yav dhau los ntawm ntau yam kev mob somatic, thaum pw tsaug zog, khaus khaus, xeev siab. Cov koob tshuaj yog 5-10-15 mg, noj tshuaj tom qab noj mov, 3-4 zaug ib hnub.
YDrug "Fluanxol"
Cov tshuaj no muaj cov tshuaj tiv thaiv kev nyuaj siab, ua kom muaj zog, muaj kev ntxhov siab. Hauv kev kho mob ntawm kev nyuaj siab, apathetic mob noj 0.5-3 mg ntawm cov tshuaj ib hnub twg. Rau kev kho mob ntawm kev puas siab puas ntsws nrog kev nyuaj siab, asthenia, hypochondriacal tshwm simkoob tshuaj txhua hnub yog 3 mg. Fluanxol tsis ua rau tsaug zog thaum nruab hnub thiab tsis cuam tshuam rau kev mloog.
Means "Eglonil"
Cov tshuaj muaj kev tswj hwm ntawm lub hauv nruab nrab lub paj hlwb, muaj cov tshuaj tiv thaiv kev puas siab puas ntsws, uas yog ua ke nrog qee qhov kev txhawb nqa thiab tshuaj tiv thaiv kev ntxhov siab. Nws yog siv nyob rau hauv tej yam kev mob uas yog yus muaj los ntawm lethargy, lethargy, anergy. Nws yog siv nyob rau hauv cov neeg mob nrog somatoform, somatized mob nyob rau hauv lub keeb kwm yav dhau ntawm subdepressive mus ob peb vas thiab nyob rau hauv daim tawv nqaij ailments nrog khaus. Cov tshuaj no tshwj xeeb tshaj yog qhia rau kev siv rau cov neeg mob uas muaj ib daim ntawv latent ntawm kev nyuaj siab, senestopathic mob. Nws kuj tseem pom zoo kom siv cov tshuaj "Eglonil" rau kev nyuaj siab nrog cov tsos mob ntawm cephalgic, thaum muaj kev xav xws li kiv taub hau thiab migraines. Cov cuab yeej tseem muaj cov nyhuv cytoprotective ntawm lub plab mucosa, yog li nws yog siv los kho cov mob xws li gastritis, duodenal ulcer thiab gastric ulcer, chim siab plob tsis so tswj syndrome, Crohn tus kab mob. Cov koob tshuaj pom zoo ntawm cov tshuaj yog 50-100 mg ib hnub, koob tshuaj txhua hnub, yog tias tsim nyog, tuaj yeem nce mus rau 150-200 mg. Cov tshuaj tuaj yeem noj ua ke nrog sedative antidepressants.
Cov teebmeem ntawm cov tshuaj tiv thaiv kab mob
Zoo li lwm yam tshuaj, cov tshuaj tiv thaiv kev puas siab puas ntsws kuj muaj qhov tsis zoo, kev tshuaj xyuas ntawm cov neeg siv cov tshuaj no qhia txog kev txhim kho ntawm qhov tsis zoo. Kev siv cov tshuaj no mus ntev lossis tsis raugprovoke qhov tshwm sim hauv qab no:
- Txhua qhov kev txav nrawm nrawm, ib tus neeg txav tsis muaj laj thawj nyob rau hauv cov lus qhia sib txawv, feem ntau ntawm kev kub ceev. Koj tuaj yeem tshem tawm cov kev xav xav, ua siab ntev, nrhiav txoj haujlwm yooj yim tsuas yog tom qab noj tshuaj psychotropic.
- Muaj qhov txav mus tas li ntawm lub qhov muag, cov leeg ntawm lub ntsej muag thiab ntau qhov chaw ntawm lub cev, grimacing.
- Vim kev puas tsuaj rau cov leeg ntawm lub ntsej muag, nws cov yam ntxwv hloov pauv. Lub ntsej muag "skewed" yuav tsis rov qab los li qub, nyob nrog ib tug neeg mus txog thaum kawg ntawm lub neej.
- Raws li kev kho mob hnyav nrog tshuaj tiv thaiv kev puas siab puas ntsws thiab kev nyuaj siab ntawm lub paj hlwb, kev nyuaj siab loj zuj zus, uas cuam tshuam rau kev kho mob zoo.
- Ib tshuaj tiv thaiv kab mob yog ib yam tshuaj uas muaj kev cuam tshuam ncaj qha rau hauv plab hnyuv, yog li thaum kho nrog cov tshuaj no, tsis xis nyob hauv plab, qhov ncauj qhuav yuav hnov.
- Cov khoom uas yog ib feem ntawm cov neuroleptics, xws li thioxanthene thiab phenothiazine, cuam tshuam rau tib neeg lub zeem muag.
Atypical Antipsychotics
Cov tshuaj no ua ntau dua ntawm serotonin receptors dua li dopamine receptors. Yog li ntawd, lawv cov tshuaj tiv thaiv kev ntxhov siab thiab kev ntxhov siab yog ntau tshaj li cov tshuaj tiv thaiv kab mob. Tsis zoo li cov tshuaj tiv thaiv kab mob, lawv cuam tshuam rau lub hlwb kom tsawg dua.
Cia peb saib lub ntsiab atypical antipsychotics.
Tshuaj "Sulpiride"
Cov tshuaj no yog siv los kho cov mob xws liKev puas siab puas ntsws somatized, hypochondriacal, senestopathic syndromes. Cov tshuaj muaj cov nyhuv activating.
Drug "Solian"
Qhov kev txiav txim ntawm cov tshuaj no zoo ib yam li cov tshuaj yav dhau los. Nws yog siv nyob rau hauv tej yam kev mob nrog hypobulia, apathetic manifestations, nyob rau hauv thiaj li yuav tsum tsis txhob hallucinatory-delusional ntshawv siab.
Clozapine
Cov tshuaj muaj cov nyhuv sedative, tab sis tsis ua rau kev nyuaj siab. Cov tshuaj yog siv nyob rau hauv kev kho mob ntawm catatonic thiab hallucinatory-delusional syndromes.
Means "Olanzalin"
Cov tshuaj no yog siv rau kev puas siab puas ntsws thiab catatonic syndrome. Kev siv cov tshuaj no mus ntev yuav ua rau rog rog.
Risperidone
Cov tshuaj atypical no yog siv dav tshaj plaws. Cov tshuaj muaj cov txiaj ntsig zoo hauv kev cuam tshuam rau cov tsos mob ntawm kev hnov mob-delusional, cov tsos mob catatonic, obsessive-compulsive xeev.
Means "Rispolept-consta"
Nov yog ib yam tshuaj uas ua rau cov neeg mob muaj kev noj qab nyob zoo. Tsis tas li ntawd, cov cuab yeej qhia tau hais tias muaj txiaj ntsig zoo nyob rau hauv kev sib raug zoo rau mob hallucinatory-paranoid syndromes ntawm endogenous genesis.
Tshuaj "Quetiapine"
Cov tshuaj no, zoo li lwm yam tshuaj tiv thaiv kab mob atypical, ua rau ob qho tib si dopamine thiab serotonin receptors. Nws yog siv rau paranoid, hallucinatory syndromes, manic excitement. Cov tshuaj muaj antidepressant thiab nruab nrabpronounced stimulating nyhuv.
Ziprasidone
Cov tshuaj cuam tshuam rau dopamine D-2 receptors, 5-HT-2 receptors, thiab tseem thaiv cov reuptake ntawm norepinephrine thiab serotonin. Qhov no txiav txim siab nws cov txiaj ntsig hauv kev kho mob ntawm tus mob hallucinatory-delusional, nrog rau cov kev mob tshwm sim. Kev siv cov tshuaj yog contraindicated nyob rau hauv arrhythmia thiab lub xub ntiag ntawm pathologies ntawm lub plawv system.
Means "Aripiprazole"
Cov tshuaj yog siv rau txhua yam kev puas siab puas ntsws. Cov tshuaj pab txhawb kev paub txog kev ua haujlwm hauv kev kho tus mob schizophrenia.
Means "Sertindole"
Cov tshuaj siv rau cov mob sluggish-apathetic, cov tshuaj txhim kho kev txawj ntse, muaj cov tshuaj tiv thaiv kev nyuaj siab. Sertindole yog siv nrog ceev faj nyob rau hauv cov hlab plawv pathologies - nws yuav provoke arrhythmia.
Invega tshuaj
Cov tshuaj tiv thaiv exacerbation ntawm catatonic, hallucinatory-delusional, psychotic tsos mob rau cov neeg mob schizophrenia.
Cov teebmeem ntawm atypical antipsychotics
Kev ua ntawm cov tshuaj xws li Clozapine, Olanzapine, Risperidone, Ariprazol yog nrog los ntawm qhov tshwm sim ntawm neurolepsy thiab kev hloov pauv tseem ceeb hauv cov kab mob endocrine, uas tuaj yeem ua rau hnyav nce, kev loj hlob ntawm bulimia, thiab nce qib. ntawm qee cov tshuaj hormones (prolactin). Thaum kho nrog Clozapine, qaug dab peg thiab agranulocytosis yuav tshwm sim. Kev noj Quetiapine feem ntau yogua rau qaug zog, mob taub hau, siab siab transaminases, hnyav nce.
Nws tsim nyog sau cia tias niaj hnub no cov kws tshawb fawb tau sau cov pov thawj txaus tias qhov zoo tshaj ntawm cov tshuaj tiv thaiv kab mob atypical dua li cov neeg tsis tseem ceeb. Thiab lawv qhov kev txais tos tau raug sau tseg thaum, nrog kev siv cov tshuaj tiv thaiv kev puas siab puas ntsws, kev txhim kho tseem ceeb hauv tus neeg mob tus mob tsis pom.
Neuroleptic rho tawm syndrome
Zoo li lwm yam tshuaj uas muaj kev puas siab puas ntsws, cov tshuaj tiv thaiv kev puas siab puas ntsws ua rau muaj kev puas siab puas ntsws thiab lub cev muaj zog. Kev tshem tawm sai sai ntawm cov tshuaj tuaj yeem ua rau muaj kev cuam tshuam loj heev, kev nyuaj siab. Tus neeg ua siab ntev heev, whiny. Tej zaum kuj yuav muaj cov tsos mob ntawm tus kab mob uas siv tshuaj tiv thaiv kab mob.
Los ntawm qhov kev xav ntawm lub cev, qhov tshwm sim ntawm kev tshem tawm cov tshuaj tiv thaiv kab mob zoo ib yam li cov tsos mob ntawm kev tshem tawm cov tshuaj: tus neeg raug tsim txom los ntawm qhov mob hauv pob txha, nws raug mob taub hau, insomnia. Kev xeev siab, raws plab thiab lwm yam kab mob hauv plab tuaj yeem tshwm sim.
Txoj kev quav yeeb quav tshuaj tsis tso cai rau tus neeg tsis kam siv cov tshuaj no, vim nws raug kev tsim txom los ntawm kev ntshai rov qab los rau lub neej tsaus ntuj, kev nyuaj siab.
Yuav ua li cas kom tsis txhob noj tshuaj tiv thaiv kab mob tsis cuam tshuam koj lub xeev kev noj qab haus huv? Ua ntej ntawm tag nrho cov, koj yuav tsum paub hais tias nws yog contraindicated siv antipsychotics tsis muaj ib tug kws kho mob cov tshuaj. Tsuas yog ib tus kws paub txog kev paub dhau los tuaj yeem ntsuas txaustus neeg mob tus mob thiab sau cov kev kho mob uas tsim nyog. Tsis tas li ntawd, tus kws kho mob yuav muab cov lus pom zoo txog kev txo cov tshuaj noj. Qhov ntau npaum ntawm cov tshuaj yuav tsum tau txo qis, tsis txhob ua rau muaj kev xav tsis xis nyob. Tsis tas li ntawd, tus kws kho mob tshwj xeeb tshaj tawm cov tshuaj tiv thaiv kev nyuaj siab uas yuav pab txhawb tus neeg mob lub siab lub ntsws thiab yuav tiv thaiv kev txhim kho kev nyuaj siab.
Ib qho tshuaj tiv thaiv kab mob yog ib yam tshuaj uas tso cai rau koj ua kom tib neeg lub siab lub ntsws zoo. Txawm li cas los xij, txhawm rau zam kev txhim kho cov kev mob tshwm sim, nco ntsoov ua raws li tus kws kho mob cov lus pom zoo thiab tsis txhob noj tshuaj rau tus kheej. Noj qab nyob zoo!
