Tsarin zinariya na maganin cutar Parkinson (PD) shine maganin magani . Kusan dukkanin magungunan da ake amfani da ita sunyi aiki don ƙara yawan dopamin cikin kwakwalwa. Hanyar da aka ba da maganin da aka ba da wannan alamar yana da tasirin da ya dace tare da tasiri da tasiri mai tasiri.
Levodopa a maganin motocin cututtuka
Levodopa ita ce maganin farko na kwayoyin PD-kwakwalwa ta amfani da levodopa a matsayin ginin gini don samar da karin dopamine.
Levodopa yana aiki ne ta hanyar cigaba da tabbatar da alamar motsa jiki, yana sa ka ji karami, mafi sauki, kuma mafi sauki. Abin baƙin ciki shine, ba ya warkar da PD kuma ba zai iya dakatar da tsarin cutar da kanta ba.
Levodopa ma yana da tasiri. Wadannan sakamako masu illa, duk da haka, ana iya kawar da su ta hanyar hada levodopa da wasu magunguna. Alal misali, wani babban sakamako mai karfi na levodopa lokacin da ake amfani da shi shi ne tashin hankali-sakamakon sakamako mai yawa na dopamin da ke rarraba a jikin jini maimakon a cikin kwakwalwa. Don hana yin aiki da kuma inganta yawan levodopa kai kwakwalwa, ana ba da levodopa tare da wani magungunan miyagun ƙwayoyi da ake kira dopa decarboxylase inhibitor (DDI). DDI ta buƙatar fasalin levodopa don dopamine a cikin jini ta jiki don haka ya ba da ƙarin levodopa zuwa kwakwalwa da kuma hana tashin hankali.
Mafi yawan nau'ikan DDI da ake amfani dashi a mafi yawan ƙasashe shi ne carbidopa. Haɗuwa da levodopa da carbidopa da sunan Sinemet suna saninsa.
A yawancin ƙasashe ana daukar ƙananan ƙwayoyin motsa jiki / levodopa a matsayin ɓangare-ƙididdiga (lambar farko) shine adadin carbidopa a kowace kwamfutar hannu, da kuma lambar ƙididdiga (lambar ƙasa) adadin levodopa. Alal misali, haɗin 25/100 ya ƙunshi nau'in mita 25 na carbidopa da 100 milligrams na levodopa.
Carbidopa / levodopa yana samuwa a cikin tsarin sarrafawa da aka sani da Sinemet CR. Tsarin tsaftacewa na Sinemet yana ba da izini don saurin saki na levodopa cikin jini, wanda zai taimaka wajen sassaukar ƙaddamarwa da tsoma baki, tare da damuwa da barcin dare.
Sauran Drugs
Kodayake levodopa yana magance cututtukan cututtuka na kwayar cutar Parkinson , amma duk da haka har yanzu ci gaba yana ci gaba kuma ya kara muni. Cututtukan Parkinson ya lalata kwayoyin kwakwalwa da suke yin dopamine ko kuma maida levodopa zuwa dopamine. Yayin da cutar ta ci gaba, yana ƙara tsanantawa wajen tayar da kwakwalwar kwayar cutar dopamine . Sabili da haka, muna buƙatar hanyoyin madaidaiciya don kiyaye kwakwalwar ƙwayoyin cuta na dopamine matuka don tallafawa aiki mai kyau.
Tunda kwayoyin halittar dopamine sun lalace ta hanyar cutar dole ne mu ci gaba da wasu kwayoyin halitta waɗanda bazai haifar da dopamine amma aiki don amfani da kwayar da ake ciki a yanzu ba. Magunguna biyu na iya yin wannan:
- magunguna da ke motsawa kwayoyin halitta da suke amfani da dopamine-da "kwayoyin halitta"
- magunguna da ke hana rushewar dopamine cikin jiki kuma ta haka ne kara yawan matakan da ake samu zuwa kwakwalwa - "masu kwanto COMT da MAO"
Magunguna a cikin kwayar cuta ta Parkinson
Akwai 'yan damun kwayoyi kamar haka:
- (Mirapex) Pramipexole
- (Sake) Ropinirole
- (Neupro) Rotigotine
Duk wadannan magungunan sunyi amfani da kwayoyin dopamine a masu karɓa na dopamine, wadanda su ne kwayoyin da ke bunkasa sakamakon dopamine a kwakwalwa.
Wadannan magunguna na iya haifar da sakamako mai lalacewa irin su rashin tsoro, ƙananan jini, da damuwa da hankali don haka dole ne a fara su kamar ƙananan sashi, kuma hankali ya karu a ƙarƙashin jagorancin neurologist mutum.
Mai shigarwa COMT da MAO Masu hana
Masu haɗin COMT (catechol-O-methyltransferase) da kuma MAO-B (ma'anar monoamine oxidase type B) sunyi aiki don katse fashewa da rashin aiki na dopamine cikin jiki da kwakwalwa.
Idan an katange ko an haramta COMT, alal misali, ƙarin levodopa iya isa tsarin tsarin motar kwakwalwa. Mafi yawan masu hanawa COMT sune (Tasmar) tolcapone da (Comtan) entacapone. Masu haɓaka COMT sun taimaka sosai ga mutanen da ke hawan motsi.
Amma kamar mafi yawan magungunan, magunguna COMT da MAOI suna da tasiri. Alal misali, kashi biyar zuwa goma bisa dari na marasa lafiya dauke da mai hana COMT ya haifar da zawo. Wannan yana nufin cewa dole ne a dakatar da miyagun ƙwayoyi. Kashi biyu zuwa kashi uku na mutanen da ke shan maganin ciwon haɓaka suna haifar da matsalolin hanta mai tsanani da ke kula da aikin hanta a lokacin da ake amfani da miyagun ƙwayoyi ko kuma katse amfani da miyagun ƙwayoyi. Ba'a iya samun wadannan matsalolin hanta na hanta.
Masu hana MAO-B, irin su (Eldepryl) selegiline da (Azilect) rasagiline, sun hana MAO-B enzyme daga watse dopamine a kwakwalwa kanta.
Ana amfani da Selegiline da farko don hana ko sassaukar da haɓaka motsi. Sakamakonta suna da m. An yi la'akari da Selegiline a matsayin kwayar cutar neuroprotective wadda ta hana ƙarin lalacewa da kwayoyin dopamine a kwakwalwa. Ya nuna cewa wannan aikin neuroprotective na selegiline karami ne ko babu.
Rasagiline, a gefe guda, ya dubi ya zama mai karbar albashi game da tasirin da yake da nasaba da koda yake shaidun suna ci gaba da yin tasirin wannan magani. Rasagiline mafi yawancin amfani da shi a farkon da kuma rashin lafiyar Parkinson na rage yawan hawan motsa jiki. Ana bukatar karin bayani game da inganci da aminci da rashin lafiyar rasagiline.
Layin Ƙasa
Duk da yake levodopa shine magani mafi kyau don magance matsalolin motar cutar ta Parkinson, wani lokacin magungunan kamar kwayoyin dopamine agonists ko MAO masu hanawa za a iya farawa farko, musamman idan bayyanar mutum ta kasance mai sauƙi. Wadannan magunguna kuma za a iya ƙara su zuwa levodopa farra don gudanar da hawan motsi.
Bishara ita ce, yayin da cutar ta Parkinson ba ta da lafiya, akwai hanyoyin da za a magance cutar da inganta rayuwarka ko ƙaunarka ta yau da kullum da kuma rayuwarka.
Sources:
Kamfanin Pharmacists na Amirka, Levodopa da Carbidopa
Connolly, BS, Lang, AE (2014). Nazarin Pharmacological na cutar Parkinson: wani bita. JAMA , Apr 23-30; 311 (16): 1670-83.
R. Pahwa da KE Lyons (Masu gyara), Handbook of Parkinson's Disease ; 4th Edition, New York, Informa Healthcare Publishers, 2007.