Neuropathy labaad ee daroogada

Neuropathy waa dhaawac ku dhaca neerfaha durugsan. Kuwani waa neerfayaal aan ku jirin maskaxda ama laf-dhabarka. Neuropathy secondary daroogada waa luminta dareenka ama dhaqdhaqaaqa qayb ka mid ah jirka sababtoo ah dhaawaca dareemayaasha ee qaadashada daawo gaar ah ama daawooyin isku dhafan.

Dhaawaca waxaa sababa saameynta sunta ah ee daawooyinka qaarkood ku yeeshaan neerfaha durugsan. Waxaa jiri kara dhaawac soo gaara qaybta axon ee unugga neerfaha, taas oo faragalin ku yeelata calaamadaha neerfaha. Ama, dhaawaca ayaa laga yaabaa inuu ku lug yeesho guntinta myelin, taas oo dahaarta qalabka, waxayna kordhisaa xawaaraha gudbinta calaamadaha iyada oo loo marayo aaladda.

Badanaa, neerfaha badan ayaa ku lug leh (polyneuropathy). Tani waxay badanaa keentaa isbeddelo xasaasi ah oo ka bilaabma qaybaha jidhka ee dibedda (distal) oo u dhaqaajiya bartamaha jirka (proximal). Waxa kale oo jiri kara isbeddello xagga dhaqdhaqaaqa ah, sida daciifnimo. Waxaa sidoo kale jiri kara xanuun gubanaya.

Daawooyin badan iyo walxo badan ayaa laga yaabaa inay u horseedaan horumarinta neerfaha. Tusaalooyinka ayaa hoos ku taxan.

Daawooyinka wadnaha ama dhiig karka:

• Amiodarone
• Hydralazine
• Perhexiline

Daawooyinka loo isticmaalo la dagaallanka kansarka:

• Cisplatin
• Docetaxel
• Paclitaxel
• Suramin
• Vincristine

Daawooyinka loo isticmaalo la dagaallanka infekshinka:

• Chloroquine
• Dapsone
• Isoniazid (INH), ayaa loo isticmaalay cudurka qaaxada
• Metronidazole (Flagyl)
• Nitrofurantoin
• Thalidomide (waxaa loo isticmaali jiray la dagaalanka baraska)

Daawooyinka loo isticmaalo daaweynta cudurka iswada

• Etanercept (Enbrel)
• Infliximab (Remicade)
• Leflunomide (Arava)

Daawooyinka loo isticmaalo in lagu daweeyo qalalaasaha:

• Carbamazepine
• Phenytoin
• Phenobarbital

Daawooyinka ka hortagga aalkolada:

• Disulfiram

Daawooyinka lagula dagaallamo HIV / AIDS:

• Didanosine (Videx)
• Emtricitabine (Emtriva)
  
• Stavudine (Zerit)
• Tenofovir iyo emtricitabine (Truvada)

Daawooyinka kale iyo walxaha sababi kara neuropathy waxaa ka mid ah:

• Colchicine (waxaa loo daaweyn jiray turqo)
• Disulfiram (waxaa lagu daaweyn jiray isticmaalka aalkolada)
• Arsenic
• Dahab

Calaamadaha waxaa ka mid noqon kara mid ka mid ah kuwan soo socda:

• Kabuubyo, dareen lumis
• Xanuun, dareemo aan caadi ahayn
• Tabar darrida
• Xanuun gubasho

Isbedelada dareenka ayaa badanaa ka bilaabma cagaha ama gacmaha waxayna u dhaqaaqaan gudaha.

Baadhitaan maskaxda iyo habdhiska dareemayaasha ah ayaa la samayn doonaa.

Tijaabooyinka kale waxaa ka mid ah:

• Tijaabooyinka dhiigga si loo hubiyo heerarka daawada (xitaa heerarka dhiigga ee caadiga ah ee daawooyinka qaarkood waxay sun ku noqon karaan dadka waaweyn ama dadka kale qaarkood)
• EMG (electromyography) iyo baaritaanka neerfaha ee waxqabadka korantada ee neerfaha iyo muruqyada

Daaweyntu waxay ku saleysan tahay astaamaha iyo sida ay u daran yihiin. Daawada keenta neuropathy waa la joojin karaa, waa la yareyn karaa qaddarkiisa, ama waxaa loo beddeli karaa daawo kale. (Weligaa ha badalin wax daawo ah adiga oo aan marka hore lahadlin bixiyaha xanaanada caafimaadkaaga.)

Bixiyahaagu wuxuu kuu soo jeedin karaa daawooyinka soo socda si looga caawiyo xakameynta xanuunka:

• Daawooyinka xanuun joojiyaha miiska laga iibsado ayaa laga yaabaa inay waxtar u yeeshaan xanuunka fudud (neuralgia).
• Phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, ama tricyclic antidepressants sida nortriptyline ayaa yareyn kara xanuunka mindida ee dadka qaar ay la kulmaan.
• Opiate xanuun joojiyeyaasha, sida morphine ama fentanyl, ayaa loo baahan karaa si loo xakameeyo xanuunka daran.

Waqtigaan la joogo ma jiraan dawooyin rogi kara luminta dareenka. Haddii dareenku kaa lumay, waxaad u baahan kartaa inaad qaaddo tallaabooyin nabadgelyo si aad uga badbaado dhaawac.

Weydii adeeg bixiyahaaga haddii ay jiraan jimicsiyo kaa caawin kara yareynta calaamadahaaga.

Dad badan ayaa qayb ahaan ama si buuxda ugu laaban kara shaqadooda caadiga ah. Cilladaan badanaa ma keento dhibaatooyin naf-gooyada ah, laakiin waxay noqon kartaa mid raaxo leh ama naafo ah.

Dhibaatooyinka waxaa ka mid noqon kara:

• Awood u la'aanta shaqada ee guriga ama guriga sababtoo ah luminta joogtada ah ee dareenka
• Xanuun leh xoqitaan aagga dhaawaca dareemaha ah
• Dareen joogto ah (ama dhif, dhaqdhaqaaq) aag

Wac adeeg bixiyahaaga haddii aad lumiso dareemid ama dhaqdhaqaaq meel kasta oo jirka ka mid ah inta aad qaadaneysid wax daawo ah.

Bixiyahaagu wuxuu si dhow ula socon doonaa daaweyntaada daroogo kasta oo sababi kara neuropathy. Hadafku waa in la ilaaliyo heerka dhiigga ee saxda ah ee daawada loo baahan yahay si loo xakameeyo cudurka iyo astaamahiisa iyadoo laga hortagayo in daawada ay gaarto heerar sun ah.

• Nidaamka neerfaha iyo nidaamka neerfaha ee durugsan

Jones MR, Urits I, Wolf J, et al. Daawada neuropathy ee daroogada, dib u eegis sheeko. Curr Clin Pharmacol. Janaayo 2019. PMID: 30666914 www.ncbi.nlm.nih.gov/pubmed/30666914.

Katirji B. Cilladaha neerfaha durugsan. Gudaha: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology ee Tababbarka Caafimaadka. 7aad ed. Philadelphia, PA: Elsevier; 2016: cutubka 107.

O'Connor KDJ, Mastaglia FL. Ciladaha daroogada ku dhaca ee nidaamka neerfaha. Gudaha: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology iyo Daawada Guud. 5aad. Waltham, MA: Elsevier Press Academic; 2014: cutubka 32.