Luu y khi dung thuoc kiem soat lo au

Thứ hai, 19 Tháng chín 2011, 14:06 GMT+7

Roi loan lo au toan the (RLLATT) la mot benh ly rat thuong gap. Bai viet sau day nham muc dich gioi thieu den ban doc nhung net chinh cua can benh thoi dai nay, nguyen nhan, bieu hien lam sang, cac tieu chi de chan doan va mot so khai niem ve dieu tri bang thuoc men va tam ly lieu phap.

Dau hieu nhan biet

Trieu chung va dau hieu cua RLLATT bieu hien o nhieu muc do khac nhau bao gom: dung ngoi khong yen, cam giac kich dong cang thang, cam giac co cuc, hon vuong o co; kho tap trung, met moi, de kich thich, mat kien nhan; hay dang tri, cang co; roi loan giac ngu, (kho ngu va giac ngu chap chon); do mo hoi nhieu, cam giac ngop tho; dau vung da day, tieu chay, nhuc dau. Khi bi RLLATT, co nhung luc ban cam thay bi bao vay boi su bon chon, lo lang, lo au cang thang ve moi khia canh cua cuoc song. Vi du, cam thay lo au cang thang ve su an toan cua minh va nhung nguoi than yeu, cam giac rang mot dieu gi te hai sap xay ra, ke ca khi khong co nguy hiem thuc su.

Nguyen nhan gay benh

Tuong tu cac roi loan tam than khac, nguyen nhan cua RLLATT chua duoc biet ro. Cac nha nghien cuu cho rang co the lien quan den cac chat hoa hoc trong nao thuong goi la cac chat dan truyen than kinh nhu serotonin, GABA va norepinephrine. Tuy nhien, nguyen nhan co the la mot su phoi hop cua nhung qua trinh sinh hoc trong co the, cac yeu to di truyen, moi truong xung quanh va nhung tinh huong trong cuoc song.

Mot so yeu to tang nguy co hinh thanh RLLATT la: tuoi tho bat hanh; mac benh tram trong; stress; nhan cach (mot so dang nhan cach nao do de sinh roi loan lo au. Nhung nguoi khong dat duoc nhu cau ve tam ly, nhu truong hop khong co nhung lien he gan gui duoc dap ung day du, co the cam thay kem an toan va co nguy co cao RLLATT. Ngoai ra, mot so roi loan nhan cach nhu roi loan nhan cach giap ranh, cung di kem RLLATT) va di truyen.


Luu y khi dung thuoc kiem soat lo au

Lam sao de kiem soat duoc su lo au?

RLLATT gay nhung hau qua nang ne hon, no co the lam nguoi benh bi tram cam; lam dung chat gay nghien; mat ngu; nhung van de ve da day ruot; nhuc dau; nghien rang. Do do can duoc phat hien som va dieu tri kip thoi. Dieu tri RLLATT bao gom dung thuoc don doc hoac ket hop voi tam ly lieu phap. Can phai dieu tri thu bang nhieu loai thuoc truoc khi tim duoc loai phu hop nhat cho ban.

Dung thuoc

- Cac thuoc chong lo au: Benzodiazepines la nhung thuoc an than co uu diem lam giam bot lo au trong vong 30 den 90 phut. Nhuoc diem cua chung la gay le thuoc thuoc neu dung qua vai tuan. Do do, bac si chi dung thuoc nay trong thoi gian ngan de giup ban vuot qua giai doan dac biet cang thang. Nhung thuoc nay co the gay lao dao, choang vang va mat phoi hop van dong. Dung lieu cao va trong thoi gian dai co the gay roi loan tri nho. Khong duoc lai xe va van hanh may moc khi dang uong thuoc.

Buspirone (buSpar) la mot loai thuoc khac thuong dung de dieu tri RLLATT. Thuoc nay phai mat vai tuan moi cai thien duoc cac trieu chung, tuy nhien uu diem cua no la khong gay le thuoc thuoc. Tac dung phu thuong gap cua buspirone la cam giac lang lang trong mot thoi gian ngan xay ra sau khi dung thuoc. Nhung tac dung phu it gap hon la nhuc dau, buon non, cam giac bon chon va mat ngu.

- Thuoc chong tram cam: Cac thuoc nay anh huong den hoat dong cua mot so chat dan truyen than kinh duoc xem la co vai tro trong hinh thanh roi loan lo au. Cac thuoc chong tram cam thuong dung dieu tri RLLATT gom: fluoxetine (prozac), paroxetine (paxil), imipramine (tofranil), venlafaxine (effexor), escitalopram (lexapro) va duloxetine (cymbalta).

Du dung thuoc chong lo au, thuoc chong tram cam hoac ca hai, bac si can dieu tri thu vai thu thuoc truoc khi chon duoc mot loai thich hop va it tac dung phu nhat cho ban. Ban khong duoc tu y mua va su dung thuoc khi khong co chi dinh cua bac si.

Tam ly lieu phap

Con goi la dieu tri qua doi thoai va tu van. Tam ly lieu phap can duoc su giup do cua bac si chuyen khoa tam than qua su lang nghe va trao doi.

Co bang chung cho thay viec dieu tri bang phuong phap nhan thuc ung xu (cognitive behavior therapy) co the cai thien cac trieu chung cua RLLATT. Dieu tri bang nhan thuc ung xu giup ban phan biet giua nhung niem tin va cung cach ung xu khong lanh manh, tieu cuc voi nhung niem tin dung dan va cung cach ung xu tich cuc. No dua tren co so la nhung y nghi cua ban - chu khong phai la nguoi khac va nhung tinh huong se xac dinh cach ban se ung xu ra sao. Ngay ca khi mot tinh huong ban khong mong muon van cu ton tai, ban van co the thay doi suy nghi cua minh va ung xu sao cho tich cuc. Phuong phap dieu tri nhan thuc ung xu thuong duoc dung trong mot dot ngan han, no nhan manh den viec hoc hoi de hinh thanh va phat trien kha nang lam chu tu duy va cam xuc cua ban.

Viec dieu tri RLLATT hoac bat ky benh ly tam than nao khac can phai thich ung voi tung truong hop. Khong co mot che do dieu tri kieu mau nao co the ap dung cho toan bo benh nhan. Chu yeu la dieu tri ngoai tru, nhung co mot so truong hop nang can phai nhap vien.

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