I-Topamax yokulahleka kwesisindo: Jonga ulwazi lokhuseleko kunye nokusebenza

Ulwazi lweziyobisi

Ngaphezulu ligama lophawu lweyeza eliqhelekileyo elibizwa ngokuba itopiramate . Ubuchwephesha buhlelwe njenge-anticonvulsant esetyenziselwa ukunyanga iimeko ezinje ngokuxhuzula, kodwa ikwasetyenziswa kulawulo lwezinye iimeko ezinje nge-migraine kunye ne-bipolar disorder. I-Topamax inkulu ekunyangeni iimeko ezinje, kodwa abantu abaninzi abayithathayo baya kuba namava okuphulukana nobunzima njengempembelelo yecala eliphambili. Makhe sijonge ngokujulile ukuba i-Topamax ikhuselekile kwaye isebenza njani kwaye idibene njani nokulahleka kwesisindo.

Ukuphulukana nobunzima beTopamax

I-Topamax yamkelwe yi-Food and Drug Administration (i-FDA) ukunyanga isifo sokuwa nokukhusela migraine , kodwa iyeza likagqirha liyaziwa ngokubangela ukunciphisa umzimba. Nangona ukulahleka kwesisindo kunokuba yinzuzo efanelekileyo yokuthatha i-Topamax, i-FDA ayizange ivume ukulahleka kwesisindo kuphela.

I-Topamax ibangela ukulahleka kwesisindo kuba ichaphazela ukutya. Abantu abayithathayo kwaye banciphe ukutya banokuziva belambile rhoqo kwaye batye kancinci ngenxa yoku. Izifundo zibonise ukuba i-Topamax nayo inokukhawulezisa imetabolism, oko kuthetha ukuba umzimba utshisa iikhalori ngokukhawuleza.

Uvavanyo lwezonyango lubonise ukuba malunga 6% -17% yabantu abathatha i-Topamax baya kufumana ukulahleka kwesisindo, kwaye ngelixa abantu abaninzi banokubona oku njengenzuzo eyongeziweyo, ukunciphisa ubunzima obuninzi akuyona into enhle. Uninzi lwabantu luya kuba namava okunciphisa umzimba ngokusuka kwi-Topamax, utshilo u-Kuldeep Singh, MD, ugqirha ophulukene nobunzima kwindawo yase-Baltimore kunye nomlawuli weziko i-Maryland Bariatric Centre e-Mercy Medical Centre. Ukunciphisa umzimba ngokukhawuleza kunokuba yimpilo-inokuba lixesha lokuba ubone ugqirha ukuba uthatha i-Topamax kwaye oku kuyenzeka kuwe. Ukugcina ubunzima obusempilweni kubalulekile, kwaye eyona ndlela yokufumana ukuba yeyiphi eyona nto ekujolise kuyo kukucela umboneleli wakho wezempilo. Ukuwa ngaphantsi kobunzima bomzimba ekujoliswe kuwo ngenxa ye-Topamax kuya kuba ngumnye umqondiso wokuba lixesha lokuthetha nomboneleli wakho.

Ngaba kukhuselekile ukuthatha i-Topamax yokunciphisa umzimba?

Ngamanye amaxesha i-Topamax inokumiselwa ngaphandle kwelebula ukunceda umntu anciphise umzimba. Ukumiselwa ngaphandle kwelebheli kuyenzeka xa ugqirha ebhalela umntu amayeza amayeza avunyiweyo yi-FDA ukunyanga imeko eyahlukileyo kuleyo isigulana sinayo. Oku kusemthethweni kwaye kwenzeka rhoqo kwishishini lezonyango, kuqikelelwa 1 kwa-5 imigqaliselo ebhaliweyo ngaphandle kwelebheli.

Ugqirha unokukhetha ukubhala umntu amayeza e-Topamax ukunceda ukunciphisa umzimba okanye ukunyanga ukuphazamiseka kokutya njengokubhaka kunye nokucoca okukhokelela ekuzuzeni ubunzima. NgokukaGqirha Singh, umntu kufuneka abe nesalathiso sobunzima bomzimba (i-BMI) engama-30 okanye ngaphezulu ukuze amiselwe naliphi na iyeza lokunciphisa umzimba, kubandakanya iTopamax.

Izifundo zibonise ukuba abantu abathatha i-Topamax yokunciphisa umzimba balahle malunga Iiponti ezili-11 xa kuthelekiswa namaqela e-placebo ukuba athabatha ichiza ubuncinci iinyanga ezine, kunye nokuba iziphumo zokulahleka kobunzima beTopamax zonyuka ngalo lonke ixesha lokunyanga kunye nedosi. Izifundo zikwabonakalisile ukuba unyango lwe-topiramate lunokunyusa amathuba okuphulukana nobunzima ngokungaphezulu kokungaphezulu izihlandlo ezintandathu .

Nangona i-Topamax inokusebenza kakuhle ekulahlekeni kwesisindo, ayikhuselekanga wonke umntu. La maqela alandelayo abantu kufuneka bathethe nogqirha ngaphambi kokuba bathathe i-Topamax kuba banokuba nomngcipheko okhulayo wokufumana iziganeko ezimbi xa beyithatha:

• Abantu abanesifo sezintso
• Abantu abanesifo semiphunga okanye iingxaki zokuphefumla
• Abantu abanesifo sesibindi
• Abantu abaneengxaki zamehlo ezifana ne-glaucoma
• Abantu abanexinzelelo
• Abantu abaneengcinga zokuzibulala okanye indlela yokuziphatha
• Abantu abane-osteoporosis
• Abantu abane-ketoacidosis ye-metabolic

Kungakhuseleka kwabasetyhini abakhulelweyo ukuba bathathe i-Topamax ukuba izibonelelo zokuthatha amayeza zingaphezulu komngcipheko wazo. Akunakwenzeka ukuba i-Topamax iya kufuneka okanye kufuneka imiselwe ekukhulelweni ngenjongo yokulahleka kwesisindo. I-Topamax inokubangela ukulimala komntwana kunye nokukhubazeka komlomo xa kuthathwa ngabafazi abakhulelweyo, yingakho imiselwe ngononophelo kwaye kuphela xa kufuneka unyango. Kukhutshiwe kubisi lomntu, kodwa akwaziwa nokuba kuya kuba nefuthe elibi kwiintsana zokuncancisa. I-Topamax ingenza iipilisi zokulawula ukuzalwa zingasebenzi kakuhle, ngoko kubalulekile ukuba uthethe nogqirha wakho malunga nokusebenzisa iindlela zolawulo lokuzalwa ezingezizo ezomzimba ukuba awufuni ukukhulelwa ngelixa uthatha i-Topamax.

Abantu abangakhulelwanga kwaye abangenayo nayiphi na imeko yezempilo ekhankanywe apha ngasentla banokuthatha ngokukhuselekileyo iTopamax, kodwa basenokuba neziphumo ebezingalindelekanga ekuthatheni. Nazi ezinye zeempembelelo eziqhelekileyo ze-Topamax ngaphandle kokulahleka kwesisindo:

• Ukuba nesiyezi
• Ukudinwa
• Ubumdaka
• Urhudo
• Ukuphelelwa ngumdla wokutya
• Ukuphulukana nolungelelwaniso
• I-Paresthesia (ukutshisa)

Nangona kunqabile, i-Topamax inokubangela iziphumo ebezingalindelekanga ezinokufuna unyango njengokudideka, iingxaki zememori, ingxaki yokugxila, kunye nengxaki yokuthetha. Abanye abantu baya kuba neziphumo ebezingalunganga ezifana nokudakumba, ukoyikeka, utshintsho lweemvakalelo, kunye neengcinga zokuzibulala okanye isimilo. Ukuba unayo nayiphi na kwezi mpawu kufuneka ufune iingcebiso kwezonyango ngokukhawuleza.

Esinye isiphumo esinqabileyo se-Topamax iingxaki zamehlo ezingakhokelela ekutshintsheni kombono kunye nokungaboni, yingakho kubaluleke kakhulu ukubiza ugqirha wakho ukuba umbono wakho uqala ukutshintsha. Olu luhlu lweziphumo ebezingalindelekanga alubanzi; ukuba ungathanda uluhlu olupheleleyo lweziphumo ebezingalindelekanga ze-Topamax buza ugqirha wakho okanye usokhemesti ngesikhokelo sonyango.

Ukuba i-Topamax ibangela iziphumo ebezingalindelekanga ezininzi, yazi ukuba unolunye ukhetho. Isithako esisebenzayo kwi-Topamax, i-topiramate, sesona sithako siphambili kwichiza lokulahleka kobunzima Qsymia , Yindibaniselwano equlathe phentermine. NgokukaGqirha Singh, iQsymia lelinye lawona chiza asebenzise ixesha elide ngokudibeneyo nokutya kunye neenguqulelo kwindlela yokuphila yokunciphisa umzimba, ngakumbi kwizigulana ezityebe kakhulu ezineklasi yoku-1 okanye iklasi yokukhuluphala. Ke ukuba awukwazi ukuthatha i-Topamax ngenxa yengxaki esempilweni okanye ngenxa yokuba uneziphumo ezibi ezininzi, unokuzama ukubuza ingcali kwezonyango malunga neQsymia okanye ezinye iindlela zokunciphisa umzimba.

Ungayithatha njani iTopamax ukunciphisa umzimba

I-Topamax ingathathwa ukukhuthaza ukunciphisa umzimba kunye nokunceda ukulawula ukubheja nokucoca, kodwa kubalulekile ukuba ukhumbule ukuba akuyiyo indawo yokuya kugqirha kunye nokwenza isicwangciso sokulahleka kwesisindo esifanelekileyo. Ukuba unomdla wokuthatha i-Topamax kungcono ukucwangcisa i-aphoyintimenti kunye nogqirha wakho ukuze ubone ukuba kulungile yini kuwe. Ugqirha wakho uya kwenza uvavanyo olupheleleyo lomzimba kwaye abuze malunga nembali yakho yonyango. Ukuba wena nogqirha wakho uthatha isigqibo sokuba i-Topamax inokukunceda ukhululeke emzimbeni, unokufumana iyeza layo.

Ukuba ufumana umyalelo kumgqirha wakho, kubalulekile ukwazi ukuba ungayithatha njani i-Topamax ukuze ufumane iziphumo ezilungileyo. Idosi yokuqala yeTopamax yokunciphisa umzimba yidosi esezantsi 25 mg ngemini, kodwa la mandla omthamo anokunyuswa kwimeko-nge-imeko esekwe kwimbali yezonyango yomntu ngamnye kunye nokuba kufuneka baphulukane nobunzima obungakanani.

Kwisifundo esenziwe yi Ijenali yoNyango lwezeMpilo , i-bipolar kunye ne-schizophrenic yezigulana ezinikwe umyinge ophakathi we-195 mg ye-topiramate ngemini ilahlekile malunga neepawundi ezingama-22 ngokuhamba kwexesha. Oku kubonisa ukuba uluhlu lwee-Topamax dosages luyahluka ukusuka kumzantsi ukuya phezulu, kwaye oogqirha banokunyusa okanye banciphise inani le-Topamax umntu athatha ngokusekelwe kwiziphumo zabo ngokuhamba kwexesha.

Kungathatha ixesha ukubona iziphumo zokulahleka kobunzima ekuthatheni i-Topamax. Abanye abantu abanakuwubona umohluko de babe bathathe ichiza ubuncinci iinyanga ezine , Ngelixa abanye abantu bangaqala ukunciphisa umzimba kwinyanga yokuqala yokuthatha. Iziphumo zokunciphisa umzimba kwi-topiramate kuqinisekisiwe ukwanda ngokuhamba kwexesha.

I-Topamax ingathathwa kunye okanye ngaphandle kokutya kwaye ngokuqhelekileyo ithathwa ngexesha elifanayo ngosuku ngalunye. Akufanele ithathwe ngaxeshanye namanye amayeza ngenxa yokubanakho ukuhlangana kweziyobisi. Nalu uluhlu lwamayeza iTopamax akufuneki ukuba ithathwe kunye:

• Iziyobisi antiepileptic
• Iicarbonic anhydrase inhibitors
• Uxinzelelo lwe-CNS
• Izinto zokucwangcisa ngomlomo
• IHydrochlorothiazide (HCTZ)
• IPioglitazone
• ILithium
• Amitriptyline

Ukongeza kula mayeza, i-Topamax akufuneki ithathwe ngotywala kuba oku kunokubangela ukulala, kwandise umngcipheko wokufumana amatye ezintso, kwaye kubangele metabolic acidosis . I-Metabolic acidosis yimeko apho i-asidi eninzi yakha kakhulu kulwelo lomzimba, kwaye inokubusongela ubomi ukuba ayinyangwa. Ukuba uqala ukuphefumla ngokukhawuleza, ukudideka, ukukhathala kakhulu, kunye nokunyuka kwenhliziyo ngelixa uthatha i-Topamax, kuya kufuneka ufune unyango ngokukhawuleza kuba le yimiqondiso yokuba unokuba ne-metabolic acidosis.

Ukutyeba emva kweTopamax

Xa umntu eyeka ukuthatha i-Topamax, kunokwenzeka ukuba banokufumana ubunzima ngexesha, ngakumbi ukuba khange badibanise iTopamax kunye notshintsho kwindlela yokuphila esempilweni. Kuphononongo lokujonga olwenziwe yi ILayibrari yeSizwe yoNyango Ukuyekiswa kweTopamax ubuncinci iinyanga ezintandathu kubonise imeko yokubuyela kubunzima besiseko. Ke abantu banokubakho ukubuyela kwinto abayilinganisileyo ngaphambi kokuba baqale ukuthatha iTopamax, kodwa oku kungathatha ixesha.

Oku kubuyela kubunzima besiseko kunokwenzeka ngenxa yokuba umzimba awusafumani kutya kuncitshisiweyo kunye nokukhawuleza kwemetabolism. Indlela efanelekileyo yokuqinisekisa ukuba unako ukugcina ubunzima emva kokumisa i-Topamax kukufumana utshintsho kwimpilo yokuphila eya kukuxhasa kuhambo lwakho lokunciphisa umzimba.

Iindlela ezi-5 ezikhuselekileyo zokunciphisa umzimba

I-Topamax inokuba luncedo kuhambo lwakho lokwehla kobunzima ukuba ugqirha wakho uyayamkela, kodwa ayisiyiyo kuphela indlela yokunciphisa umzimba. Utshintsho kwindlela yokuphila lunokukunceda ukuba unciphise umzimba kwaye ugcine kude ukuze ukwazi ukonwabela izibonelelo zokulahleka kwesisindo ngaphandle kokuthatha i-Topamax, ngelixa uyithatha, okanye emva kokuyithatha. Nazi ezinye zeendlela ezikhuselekileyo zokunciphisa umzimba.

1. Phucula indlela otya ngayo

Ukutya okunempilo yenye yeendlela ezikhuselekileyo nezona zilungileyo zokunciphisa umzimba. Ukukhumbula ukuba yintoni kunye nokuba utya kangakanani kunokukunceda ukuba unciphise umzimba ukuba wenza kakuhle. Ukufumana iingcebiso ezilungileyo malunga nokuba ungatya ntoni ukunciphisa umzimba kufuneka uthethe nogqirha wakho, kodwa ukwenza utshintsho oluncinci njengokutya iziqhamo kunye nemifuno kunokuba yindlela elungileyo yokuqala.

Ukutya okucutshungulwayo, ii-carbohydrate ezihlaziyiweyo, iswekile kunye notywala yiyo yonke imizekelo yokutya okunokubangela ukutyeba. Iziqhamo, imifuno, kunye neeproteni ezikumgangatho ophezulu ezifana nesalmon, iimbotyi kunye namaqanda ziyimizekelo emihle yokutya okunokwenziwa ngumzimba ngokulula kunye nokufumana izakhamzimba ezibalulekileyo.

2. Zilolonge rhoqo

Ngokutsho kwamaZiko oLawulo lweNtsholongwane kunye noThintelo ( i-CDC ), umthambo awuncedisi kuphela ukulawula ubunzima, kodwa unciphisa uxinzelelo lwegazi oluphezulu, unciphisa umngcipheko wohlobo lweswekile yesi-2, kwaye unokunciphisa iimpawu zoxinzelelo kunye noxinzelelo. Abantu bayohluka kubungakanani bomthambo ekufuneka bawenze ukuze banciphise ubunzima, kungumbono olungileyo ukuthetha nogqirha wakho malunga nokuba kufuneka usebenzise umthambo kangaphi. Olunye uqeqesho olukhulu lokunciphisa umzimba lubandakanya ukuhamba, ukuhamba ngeebhayisikile, ukuqubha, kunye noqeqesho lobunzima.

3. Nciphisa uxinzelelo

Uxinzelelo lunxulunyaniswa neengxaki ezininzi zempilo ezinje ngoxinzelelo kunye noxinzelelo. Ukuziva uxinezelekile kunokukhokelela ekutyeni ngokweemvakalelo, oko kunokukhokelela ekuzuzeni ubunzima ekuhambeni kwexesha. Ukufumana iindlela zokunciphisa uxinzelelo kunokukunceda ukunciphisa umzimba. Unokuzama ukucamngca, iyoga, ukuhamba, okanye ukubiza umhlobo okanye ilungu losapho. Unokucela ugqirha wakho okanye umcebisi ngeendlela eziqinisekisiweyo zokunciphisa uxinzelelo oluya kulunga kwindlela ophila ngayo.

4. Lala ngokwaneleyo

Ngokwe- Isiseko sokulala , Ukungabikho kokulala kunokunyusa ukutya kwaye kukhokelele kwiingxaki ze-metabolic. Ukulala ngokwaneleyo kunokunceda umzimba wakho usebenze kakuhle kwaye kukunike amandla okwenza izinto ezinjengokuzilolonga, okuya kukunceda ukunciphisa umzimba. Ukulala ngokwaneleyo kunokunciphisa uxinzelelo lwakho, oluya kukunceda ulawule nayiphi na iminqweno onokuthi utye kakhulu kuyo.

5. Ukuzama iipilisi zokutya kunye nezongezelelo

Kukho iipilisi zokutya ezingenakubalwa kunye nezongezo kwintengiso ezibanga ukuba zibangele ukwehla kobunzima, njengeHydroxycut kunye neglucomannan, kodwa akufuneki bakhonze njengendawo yokutshintsha indlela yokuphila esempilweni. Xa abantu beye kusela amayeza okunciphisa umzimba, uninzi lwabo luyenza kuba kulula ukuyenza, utshilo uGqirha Singh. Ukuba umntu utshintshe kakhulu indlela yakhe yokuphila kunye nokutya kuqala, baya kubona ukuphuculwa okuqinileyo kunye ne-Topamax okanye amanye amayeza okunciphisa umzimba. Ingqondo yeyona nto ibalulekileyo. Amayeza awasebenzi endaweni yokutya ngendlela efanelekileyo kunye nokuzilolonga.