Neuroleptic - tias ... Action neuroleptics. daim ntawv teev cov neuroleptics

Neuroleptic yog ib hom tshuaj tshwj xeeb siv rau ntau yam mob hlwb. Raws li txoj cai, xws li cov tshuaj siv los kho neurotic syndromes, psychoses, thiab cov tshuaj kuj siv tau rau kev pom kev. Tsis tas li ntawd, cov tshuaj tiv thaiv kev puas hlwb yog cov tshuaj kom tiv thaiv tau qhov tshwm sim ntawm tus neeg mob hlwb.

Lub ntsiab ntawm cov tshuaj nyob rau hauv nqe lus nug

Cov teebmeem ntawm cov neuroleptics yog ntau hom kabmob. Lub ntsiab pharmacological feature yog ib hom kev ua kom muaj calming, uas yog qhov txo qis rau cov lus teb rau sab nraud, ib qho qaug zog ntawm kev nruj nruj thiab psychomotor ntxhov siab, kev quab yuam ntawm lub siab ntawm kev ntshai, tus thawj hauv kev sib ntaus. Cov tshuaj tiv thaiv kev quav yeeb quav tshuaj muaj peev xwm txhawb kev pom, pom thiab lwm cov kev mob tshwm sim hauv kev puas siab ntsws, muaj kev kho rau cov neeg mob nyob ntawm tus mob schizophrenia thiab lwm yam kev mob hlwb.

Qee cov tshuaj ntawm cov pab pawg no muaj kev sib txuam ua kom zoo, xws li cov nyhuv ntawm cov neuroleptics yog ua tiav vim cov kev xav hauv chiv ntawm chemoreceptor triggering (pib) cov chaw ntawm medulla oblongata. Qee cov kev puas hlwb yuav muaj qhov sedative lossis activating (energizing) effect. Ib cov xov tooj ntawm cov txhais tau tias yog cov ntsiab lus ntawm cov cai normotimic thiab antidepressant.

Pharmacological thaj chaw ntawm ntau cov tshuaj yeeb dej caw tau qhia nyob hauv ntau qib. Kev sib xyaw ua ke ntawm cov tshuaj tua kab mob tseem ceeb thiab lwm yam khoom tau pom tseeb txog qhov profile ntawm lawv cov teebmeem thiab kev siv rau kev siv.

Ua li cas neuroleptics ua hauj lwm?

Antipsychotics - tshuaj uas depressing cawv rau cov reticular tsim ntawm lub paj hlwb. Cov nyhuv ntawm cov tshuaj no tseem tuaj yeem txuam nrog cov nyhuv ntawm qhov tshwm sim thiab kev ua kom muaj kev sib tw nyob rau hauv ntau txoj kev sib txuas ntawm lub hauv paus nruab nrab thiab peripheral lub paj hlwb. Niaj hnub no, feem ntau kawm tau yog qhov tshwm sim ntawm cov paj hlwb, xws li cov txiaj ntsig ntawm tus neeg tuaj kho kom sib haum xeeb hauv lub hlwb. Cov kws tshawb fawb tau sau cov ntaub ntawv txaus txaus rau cov kev siv tshuaj rau cov kab mob hauv adrenergic, serotonergic, dopaminergic, cholinergic, GABAergic thiab lwm cov txheej txheem neurotransmitter, nrog rau cov nyhuv ntawm cov hlab hlwb hauv hlwb. Kev saib xyuas tshwj xeeb tau raug them nyuam qhuav mus rau cov txheej txheem ntawm kev sib koom tes ntawm kev siv dopamine ntawm lub hlwb thiab cov paj hlwb. Thaum tus neeg tuaj kho mob ntawm dopamine ntxig li, qhov tshuaj tseem ceeb ntawm cov tshuaj no ua rau nws tus kheej, qhov hu ua neuroleptic syndrome tshwm sim, uas yog mob los ntawm extrapyramidal ntshawv siab, xws li cov leeg tsis sib haum xeeb, akathisia, parkinsonism (tremor, mob siab tawv), kev ntxhov siab, kub cev . Cov nyhuv no yog ua tiav vim muaj kev cuam tshuam ntawm cov hlab ntsha ntawm cov leeg hlwb hauv lub hlwb, uas muaj ntau tus neeg txais kev pabcuam uas muaj kev dopamine nyob rau hauv.

Cov kev mob tshwm sim ntawm cov neuroleptics yog ib qho kev zam rau kev kho ntawm txoj kev kho mob thiab kev teem caij tshwj xeeb kev kho (tshuaj "Akineton", "Cyclodol").

Pharmacodynamics

Neuroleptic yog ib hom tshuaj, uas ua rau lub hauv paus dopamine receptors, provokes qee tus mob endocrine, nrog rau kev ua kom muaj zog ntawm tus neeg mob. Thaum neuroleptic dopamine receptors blocked los ntawm pituitary caj pas, tso tawm ntawm prolactin yog nce. Ua rau cov hypothalamus, cov tshuaj no cuam tshuam nrog lub tso pa tawm ntawm somatotropic hormone thiab corticotropin.

Neuroleptics - yeeb tshuaj uas muaj ib nrab ntawm ib nrab ntawm lub cev thiab tom qab ib txoj kev tswj hwm nkaus xwb lawv muaj cov nyhuv luv luv. Zaum tau tsim cov tshuaj tshwj xeeb uas tau ua ntev (Moditen Depot, Geloperidol Decanoate, Piportil L4, Clopixol Depot). Feem ntau cov tshuaj tiv thaiv mob ua ke nrog txhua lwm yam: thaum sawv ntxov noj ib qho tshuaj stimulant, nyob rau hauv ob - ib sedative. Nrog lub hom phiaj ntawm ntes cov affective-delusional syndrome, nws raug pom zoo kom noj cov tshuaj tua kab mob (antidepressants) thiab tshuaj tiv thaiv (antipsychotics) hauv ib qho nyuaj.

Cov kev qhia rau kev siv

Cov thawj coj ntawm neuroleptics yog cov kws kho mob ua ntej, rau txhua yam, rau kev kho tus mob nosogenic paranoid haum (hnov lus teb) thiab rau qhov mob tsis tu ncua somatoform.

Cov cai rau sau cov tshuaj no

Kev kho nrog cov neuroleptics pib nrog lub sij hawm ntawm qhov nruab nrab kev kho mob, ces cov txiaj ntsig yog ntsuas thiab txiav txim siab yog tsim los ntawm qhov xav tau los hloov cov tshuaj. Kev noj tshuaj ntawm cov neuroleptics yog nce mus rau ib qho nqi, uas yog ces maj txo los ntawm 3-5 zaug, thiab cov kev kho mob tau txais ib qho kev rov tiv thaiv, txhawb tus cwj pwm. Hloov cov tshuaj ntau npaum li cov tshuaj tsis tu ncua nyob rau hauv tus neeg txiav txim. Cov txij nkawm tau hloov mus rau tom qab kho cov tshuaj siv tau zoo lawm. Tiv thaiv kev rov qab tiv thaiv kev noj qab haus huv yog cov yeeb tshuaj uas tsim nyog uas muaj cov nyhuv dhau los. Txoj kev qhia txog kev noj tshuaj psychotropic yog ib qho tseem ceeb heev. Nyob rau theem pib ntawm kev kho mob, kev tso cai ntawm parenteral yog qhov pom zoo, uas qhov kev nqus tau tshwm sim sai dua (tshuaj tua kab mob, tso kua dej, tso cai hauv lub cev). Tsis tas li ntawd, nws yog qhov zoo tshaj rau noj cov tshuaj tiv thaiv kev mob hlwb. Cov npe ntawm cov tshuaj zoo tshaj plaws yuav raug muab rau hauv qab no.

Cov tshuaj "Propazin"

Qhov cuab yeej no muaj kev sib tov, txo txoj kev xav ntawm kev ntxhov siab thiab kev tsav tsheb. Tshuaj siv nyob rau hauv borderline mob nyob rau hauv cov neeg mob uas Somatic kab mob, yog hais tias muaj yog disturbing, phobic mob, obsessive. Noj cov tshuaj hauv 2-3 zaug ib hnub twg rau 25 mg, yog tias tsim nyog - cov koob tshuaj tau nce mus rau 100-150 mg ib hnub twg. Nrog kev siv me me ntawm txoj kev loj hlob ntawm Parkinsonism, raws li txoj cai, tsis muaj cai.

Cov tshuaj yaj yeeb "Etaperazin"

Cov tshuaj muaj ib qho kev tiv thaiv kev puas hlwb thiab cuam tshuam rau cov syndromes uas tau ua los ntawm kev qaug zog, kev tiv thaiv, kev xav tsis zoo. Tsis tas li ntawd, cov tshuaj "Etaperazin" siv los kho cov dej neuroses nrog kev nruj, kev ntshai, kev txhawj xeeb. Cov koob tshuaj txhua hnub yog 20 mg.

"Triftazine"

Cov tshuaj muaj ib qho pom tau tias ua kom tsis muaj teebmeem, nws tsis ua kom muaj kev puas tsuaj. Cov tshuaj muaj ib qho kev mob nkeeg (energizing) cov nyhuv. Nws tuaj yeem siv rau kev kho mob atypical depressive xeev nrog cov phenomenon ntawm kev xav tau. Rau kev kho mob ntawm somatoform mob, cov tshuaj Triftazin yog ua ke nrog antidepressants thiab tranquilizers. Qhov muab tshuaj ntawm cov tshuaj yog 20-25 mg ib hnub twg.

Cov tshuaj "Teralen"

Cov tshuaj muaj cov tshuaj antihistamine thiab neuroleptic. Tus yeeb tshuaj "Teralin" yog ib qho kev sib sib zog nqus thiab muaj cov nyhuv zoo ntawm cov cim npe ntawm daim ciam teb, nrog rau cov kev mob hlwb uas tsim tawm tsam ntawm keeb kwm ntawm kis kab mob, somatogenic, vascular manifestations, nrog neurovegetative pathologies. Nws yog dav siv nyob rau hauv kev xyaum ua ub no thiab kev kho menyuam yaus. Pom zoo rau siv nyob rau hauv kev mob allergic thiab tawv khaus. Siv cov tshuaj rau hauv 10-40 mg ib hnub twg, cov tshuaj siv raws li 0.5% tov.

Tiridazine

Cov tshuaj muaj ib qho kev puas hlwb ua rau muaj kev nyuab siab, uas tsis ua lub siab qeeb thiab lethargy. Tsis tas li ntawd, cov tshuaj muaj ib qho kev phais timoleptic. Cov tshuaj zoo tshaj qhia tau hais tias muaj kev puas siab ntsws, uas yog cov nyom, kev ntshai, kev zoo siab. Hauv kev kho cov kab mob kev nkeeg, 40-100 mg ntawm cov tshuaj siv tauj ib hnub. Nrog xws li phenomena raws li neurasthenia, nce irritability, ntxhov siab vim, kev kho siab plab hnyuv thiab lub plawv mob plawv noj tshuaj 2-3 zaug ib hnub twg rau 5-10-25 mg. Nrog premenstrual poob siab - 1-2 zaug ib hnub rau 25 mg.

Cov tshuaj "Chlorprothixen"

Cov tshuaj muaj antipsychotic thiab sedative ntxim, ua rau cov nyhuv ntawm cov tshuaj hypnotic. Cov tshuaj noj yog siv rau cov kev mob nkeeg hauv tus cwj pwm los ntawm kev ntshai thiab kev ntxhov siab. Kev siv cov tshuaj yog qhia nyob rau hauv neuroses, nrog rau kev tiv thaiv keeb kwm ntawm ntau yam kev mob nkeeg, nrog kev mob pw tsaug zog, tawv nqaij khaus, subdepressive xeev. Cov koob tshuaj ntawm cov tshuaj yog 5-10-15 mg, noj cov tshuaj tom qab noj mov, 3-4 zaug ib hnub twg.

Cov tshuaj "Fluanxol"

Cov tshuaj no muaj antidepressant, activating, cuam tshuam tsis zoo. Thaum kho cov kev nyuaj siab, tsis zoo, noj cov tshuaj 0.5-3 mg ntawm ib hnub. Rau cov kev kho mob ntawm kev mob hlwb nrog cov tshuaj mob subdepression, asthenia, hypochondriacal tshwm sim, cov tshuaj txhua hnub yog 3 mg. Cov tshuaj yeeb "Fluanxol" tsis ua rau muaj kev tsis zoo siab thaum nruab hnub thiab tsis ua kom muaj mob.

Txhais tau tias "Eglonil"

Cov tshuaj tswj xyuas lub hauv paus paj hlwb, muaj ib qho kev ua si neuroleptic nquag, uas yog tag nrho nrog qee yam kev mob nkeeg thiab antidepressant. Nws yog siv rau cov kev mob rau kev nkeeg, kev tiv thaiv, kev quav ntawm tus cwj pwm. Siv rau cov neeg mob nrog somatoform, somatized ntshawv siab nyob rau tom qab ntawm subdepressive mus ob peb vas thiab nrog rau ntawm daim tawv nqaij ailments nrog los ntawm khaus. Cov tshuaj no yog tshwj xeeb tshaj qhia rau kev siv rau cov neeg mob uas muaj kev nyuaj siab mob ntsws, cov kab mob hauv siab yogethostatic. Nws kuj pom zoo rau kev siv ntawm cov tshuaj "Eglonil" muaj kev nyuaj siab nrog pronounced cephalgic syndrome, lub xub ntiag ntawm xws ncus li kiv tauv hau thiab migraine. Tus neeg sawv cev kuj muaj cov cytoprotective nyhuv ntawm lub plab hnyuv, vim li no nws yog siv los kho cov mob xws li gastritis, duodenal ulcer thiab plab ulcer, chim siab plob tsis so tswj syndrome, Crohn tus kab mob. Qhov kev pom zoo ntawm koob tshuaj yog 50-100 mg ib hnub twg, txhua hnub, yog tias tsim nyog, tuaj yeem nce mus txog 150-200 mg. Cov tshuaj siv tau nrog rau cov tshuaj antidepressants.

Lwm cov kev mob ntawm cov tshuaj tua kab mob

Zoo ib yam li lwm yam tshuaj, cov tog neeg tsis zoo muaj cov neuroleptics, lub tswv yim ntawm cov neeg uas siv cov tshuaj yeeb tshuaj, qhia txog kev loj hlob ntawm cov teeb meem tsis txaus siab. Ntev mus ntev los yog tsis siv cov tshuaj no tuaj yeem ua raws li cov hauv qab no:

• Tag nrho cov taw yog ceev, tus neeg tsis tsim nyog yog txav hauv cov lus qhia ntau, feem ntau ntawm kev kub ceev. Tau tshem ntawm obsessive xav, calm down, nrhiav ib tug xis txoj hauj lwm, koj ua tau tsuas yog tom qab lub txais tos ntawm psychotropic tshuaj.

• Muaj qhov dav ntawm qhov muag, lub ntsej muag ntawm lub ntsej muag thiab ntau qhov chaw hauv lub cev, grimacing.

• Vim hais tias ntawm lub yeej ntawm cov leeg ntawm lub ntsej muag, nws cov nta hloov. Lub ntsej muag "skewed" tsis tuaj yeem rov qab mus rau qub, nyob nrog ib tus neeg kom txog rau thaum kawg ntawm lub neej.

• Vim yog siv cov kev kho mob kho siab neuroleptics thiab txoj kev nyuab siab ntawm txoj kev xav ntawm lub paj hlwb, kev nyuab siab loj heev, uas cuam tshuam qhov txiaj ntsig ntawm txoj kev kho mob.

• Neuroleptic yog ib hom tshuaj uas muaj cov nyhuv rau ntawm txoj hnyuv, yog li thaum kho cov tshuaj no, tej zaum koj yuav tsis xis nyob hauv plab, qhov ncauj qhuav.

• Tej yam tshuaj no, uas yog ib feem ntawm cov neuroleptics, zoo li thioxanthene thiab phenothiazine, muaj qhov tsis zoo rau tib neeg lub zeem muag.

Atypical kev puas siab ntsws

Xws li cov tshuaj ua rau lub serotonin receptors ntau dua dopamine receptors. Yog li ntawd, qhov kev ntxhov siab thiab ntxhov siab yog qhov qhia tau ntau dua rau lawv tshaj li qhov kev puas hlwb. Tsis zoo li cov neuroleptics, lawv tsis tshua muaj kev cuam tshuam los ntawm lub hlwb kev ua haujlwm.

Xav txog lub ntsiab atypical antipsychotics.

Kev Tshuaj Noj "Sulpirid"

Cov tshuaj no yog siv los kho cov mob xws li mob ntsws mob hlwb, hypochondriacal, senestopatic syndromes. Cov tshuaj muaj activating nyhuv ntawm qhov kev txiav txim.

Qhov kev npaj "Solian"

Qhov kev txiav txim ntawm cov tshuaj no yog zoo li cov tshuaj yav dhau los. Thov nws nyob rau hauv tej yam kev mob nrog hypobulosis, apathic manifestations, nrog ib tug saib kom siv ceev xwmphem tus cwj pwm-delusional mob.

"Klozapin" tshuaj

Cov tshuaj muaj ib cov nyhuv qhia yooj yim, tab sis tsis ua kev nyuaj siab. Siv cov tshuaj hauv kev kho cov kab mob catatonic thiab hallucinatory-delusional syndromes.

Txhais tau tias "Olanzaline"

Cov tshuaj siv rau cov kev puas siab puas ntsws thiab cov kab mob catatonic syndrome. Nrog kev siv cov tshuaj no ntev heev, kev rog tsim muaj.

Cov tshuaj "Risperidone"

Tus neeg saib xyuas hauv atypical no siv ntau tshaj plaws. Cov tshuaj muaj qhov txuam yuaj tshwj xeeb rau kev sib raug zoo ntawm cov tsos mob tshwm sim, cov tsos mob ntawm cov kab mob, cov tsos mob ntawm obsessive.

"Rispolept-konsta" kev kho mob

Nws yog ib lub tshuaj noj ntev heev uas ua rau muaj kev ruaj ntseg ntawm cov neeg mob lub cev. Tsis tas li ntawd nws txhais tau hais qhia tau hais tias siab miv nyuas siv zug tiv thaiv mob hallucinatory-paranoid syndromes endrogennogo genesis.

Tshuaj Quetiapine

Cov tshuaj no, zoo li lwm yam atypical mob hlwb, cuam tshuam ob qho tib si dopamine thiab serotonin receptors. Nws yog siv rau kab mob paranoid, tus kab mob hauv kev zes, kev ntxhov siab heev. Cov tshuaj muaj cov tshuaj tua kabmob antidepressant thiab mob tshwjxeeb.

Cov tshuaj Ziprasidone

Tus neeg sawv cev no muaj kev cuam tshuam rau dopamine D-2 receptors, 5-HT-2 receptors, thiab tseem tuaj yeem ua rau tus neeg tsis tuaj yeem los ntawm norepinephrine thiab serotonin. Qhov no txiav txim siab nws cov hauj lwm zoo ntawm txoj kev kho mob ntawm txoj kev mob nyaum heev, thiab kev ua rau muaj kev puas siab ntsws. Kev siv ntawm cov tshuaj yog nyob rau hauv arrhythmias thiab muaj cov pathologies ntawm cov hlab plawv system.

Txhais tau ntawm "aripiprazole"

Cov tshuaj siv rau txhua hom kev puas siab puas ntsws. Cov tshuaj siv rau kev rov qab los ntawm kev paub txog kev kho tus mob schizophrenia.

Txhais tau tias ntawm Sertindol

Cov tshuaj noj siv tshuaj tua kab mob rau lub xeev, cov tshuaj pab txoj kev paub txog kev txawj ntse, muaj kev ua noj tshuaj antidepressant. Nrog ceev faj siv cov tshuaj "Sertindol" hauv plawv kab mob plawv - tuaj yeem ua rau muaj kev ntxhov siab.

Cov tshuaj "Invega"

Cov tshuaj no ua rau cov kev mob plawv dhia ntawm cov kab mob ntawm cov kab mob schizophrenia, cov kabmob zais plab, cov neeg mob hlwb.

Lwm cov kev mob ntawm cov tshuaj atypical

Qhov kev txiav txim ntawm cov tshuaj xws li Clozapine, Olanzapine, Risperidone, Ariprazole yog nrog qhov tshwm sim ntawm kev kho paj hlwb thiab cov kev hloov loj hauv cov kev tswj qhov ntswg, uas tuaj yeem ua rau lub cev muaj zog, kev loj hlob, thiab nce qib ntawm qee cov tshuaj hormones (prolactin). Nyob rau hauv cov kev kho mob ntawm cov tshuaj "Clozapine" tej zaum yuav muaj kev qaug dabpeg thiab agranulocytosis. Kev txais tos ntawm cov tshuaj "Quetiapine" feem ntau ua rau nkees nkees, mob taub hau, nce qib ntawm hepatic transaminase, hnyav nce.

Nws yuav tsum raug sau tseg hais tias niaj hnub no cov kws tshawb fawb tau sau txaus pov thawj tias qhov zoo tshaj plaws ntawm atypical antipsychotics tshaj li qhov tsis tseem ceeb. Thiab lawv cov kev txais tos yog raug taw thaum, thaum siv cov neuroleptics, tsis muaj kev txhim kho tseem ceeb hauv tus neeg mob tus mob.

Syndrome ntawm kev tshem tawm ntawm kev puas siab ntsws

Zoo li lwm yam kev tshuaj, muaj psychoactive zog, antipsychotic tshuaj ua mob loj heev puas siab puas ntsws thiab lub cev nyob tos. Ceev tshem ntawm cov tshuaj yuav ua rau txoj kev loj hlob muaj zog aggression, kev nyuaj siab. Tus txiv neej yuav dhau siab luv, whining. Tsis tas li ntawd tej zaum yuav tshwm sim tej yam tshwm sim ntawm tus kab mob, cov kev kho mob yog thov antipsychotics.

Los ntawm ib tug muaj sia taw tes ntawm view ces tus neeg mob uas zoo sib xws rau cov tsos mob neuroleptic tshuaj thaum lub sij hawm lub abolition: ib tug txiv neej plagued los ntawm kev mob nyob rau hauv cov pob txha, nws suffers los ntawm mob taub hau, insomnia. Tej zaum tsim xeev siab, raws plab thiab lwm yam plab hnyuv mob.

Puas siab puas ntsws dependence tsis pub ib tug neeg muab mus siv ntawm cov nyiaj no, vim hais tias nws mob ntshai rov qab mus rau tu siab heev, depressing lub neej.

Yuav ua li cas yuav tsum tsis noj neuroleptics, tsis muaj puas tabkaum qub xeev kev kho mob? Ua ntej ntawm tag nrho cov, koj yuav tsum paub tias siv antipsychotic tshuaj tsis muaj ib tug kws kho mob tshuaj yog txhob. Tsuas yog ib txog tej tus kws khomob tshwjxeeb yog tau txaus ntsuam xyuas qhov mob ntawm tus neeg mob thiab tus uas tsim nyog kho mob. Tsis tas li ntawd, tus kws kho mob yuav muab tswv yim rau kom txhob muaj cov tshuaj ntawm tshuaj noj. Ntau npaum yuav tsum raug txo maj, tsis tas yuav ua mob loj heev tsis xis nyob. Ntxiv cov kws prescribes antidepressants, uas yuav pab txhawb rau tus neeg mob lub siab ntsws lub xeev thiab tiv thaiv kom txhob txoj kev loj hlob ntawm kev nyuaj siab.

Neuroleptic - ib tug kho mob lub cuab tam uas tso cai rau koj mus normalize lub hlwb lub xeev ntawm ib tug neeg. Txawm li cas los, yuav tsum tsis txhob loj hlob ntawm sab los, nco ntsoov ua raws li cov tswv yim pom zoo ntawm tus kws kho mob thiab tsis self-medicate. Nyob twj ywm noj qab nyob zoo!